Because of the way the human brain is designed, it feeds resources to the most basic functions first. This is for survival, so our autonomic functions (breathing, heartbeat) are first. Emotions and survival instincts are second. Finally, last is our cortex and rational thinking.

 

It is often very difficult to say goodbye. Whether the result of life passing, ending a relationship, or, moving far away, there is a period of our lives that are ending. On the other hand, there is a new period of life that is beginning. As for my friend, Brett Newcomb, I will forever be grateful for the contributions he made to the show and for being my friend!

 https://www.apa.org/pubs/highlights/spotlight/issue-135 

You make the decision to go to therapy. Good on you! Now make sure you are ready to make it a useful and rewarding experience!

https://psychcentral.com/lib/therapists-spill-tips-for-making-the-most-of-therapy

 

https://www.healthline.com/health/what-to-talk-about-in-therapy

 

The Surgeon General of the US recently released a report on loneliness. In it, the physiological effects of loneliness were found to be equivalent to smoking 15 cigarettes a day. These kinds of physiological findings just affirm what all of us already know, loneliness hurts! It hurts us both psychologically and physically.

 Surgeon General's Report

 https://www.hhs.gov/about/news/2023/05/03/new-surgeon-general-advisory-raises-alarm-about-devastating-impact-epidemic-loneliness-isolation-united-states.html#:~:text=Disconnection%20fundamentally%20affects%20our%20mental,levels%20comparable%20to%20smoking%20daily.

Articles of Loneliness

 https://www.psychologytoday.com/us/blog/how-be-yourself/202001/7-ways-feel-less-lonely-and-more-connected

https://ggia.berkeley.edu/practice/feeling_connected

 Link to Epidemic of Loneliness from Psych with Mike

https://psychwithmike.com/the-epidemic-of-loneliness

 

Many people find it harder to forgive themselves than they do to forgive others. We may feel like we do not deserve forgiveness or that if we forgive ourselves then we were never truly sorry for the behavior. Whatever the reason, when we do not forgive ourselves we remain in perpetual psychological bondage. 

 

https://psyche.co/guides/how-to-forgive-yourself-and-move-past-a-hurtful-mistake?utm_source=Aeon+Newsletter&utm_campaign=f4ecbb6ed5-EMAIL_CAMPAIGN_2023_03_29&utm_medium=email&utm_term=0_-66d1b44a50-%5BLIST_EMAIL_ID%5D

 

What is nihilism and what does it have to do with psychology? Most of us have heard of the philosopher Friedrich Nietzsche and some know that he is credited with promoting the ideas of nihilism. But how many actually know what nihilism is and how it plays a role in psychology?

https://psyche.co/ideas/for-nietzsche-nihilism-goes-deeper-than-life-is-pointless?utm_source=Aeon+Newsletter&utm_campaign=639b69be36-EMAIL_CAMPAIGN_2023_04_06&utm_medium=email&utm_term=0_-0a72083c10-%5BLIST_EMAIL_ID%5D

Does our personality change and evolve over the lifespan? Or does personality remain consistent and static from adolescence?

 

https://psyche.co/ideas/theres-a-reason-some-of-us-find-it-easier-to-change-than-others?utm_source=Aeon+Newsletter&utm_campaign=8e4e0f2ec4-EMAIL_CAMPAIGN_2023_03_10&utm_medium=email&utm_term=0_-b1f49aa884-%5BLIST_EMAIL_ID%5D

 

The term "Brain Fog" has been around for a long time but has gained increased significance during the pandemic. What IS brain fog and can we do anything about it? 

 

https://www.cnbc.com/2023/01/31/neuroscientist-how-to-avoid-brain-fog.html

 

Communication is the most basic way that humans connect. Good knowledgeable skills are the foundation of good interactions!

https://www.inc.com/minda-zetlin/3-things-people-who-are-good-at-conversation-dont-do-according-to-a-research-psychologist.html

 

Research is building an indisputable record of evidence supporting the belief that the experience of trauma changes the way the brain is wired. Trauma that is low-level over a long period of time (chronic) can be just as transformative as trauma that is intense and sudden (acute)

https://www.sciencenews.org/article/trauma-distorts-time-self-new-therapy

 

The introduction of concepts like "mindfulness" and "positive psychology" is only helpful if they can be defined. In science, this is called operational definition. Is Positive Psychology an actual theoretical orientation or just a new-wave fad? 

https://www.verywellmind.com/what-is-positive-psychology-2794902

 

As long-time educators, Brett and I have always accepted the concept that different people learn in different ways. A recent article in Aeon magazine challenges this long-held belief. 

 

https://aeon.co/essays/the-evidence-is-clear-learning-styles-theory-doesnt-work?utm_source=Aeon+Newsletter&utm_campaign=83087b53bc-EMAIL_CAMPAIGN_2023_01_24_05_07&utm_medium=email&utm_term=0_-83087b53bc-%5BLIST_EMAIL_ID%5D 

Heinz Kohut and Self Psychology establish the foundational understanding of the development of emotional regulation. But perhaps his most impressive contribution to the field was his introduction of empathy into the therapy relationship.  

 

https://www.selfpsychologypsychoanalysis.org/about.html 

Clients are often very curious about the private lives of their therapists. But therapists are educated to present themselves as a blank slate. The amount of self-disclosure that a therapist engages in therefore is a balance between what is most therapeutic for the client and the therapist's presentation as genuine and sincere. 

 

https://aeon.co/videos/pondering-the-peculiar-one-sided-intimacy-of-the-client-therapist-relationship?utm_source=Aeon+Newsletter&utm_campaign=974bf7efe0-EMAIL_CAMPAIGN_2023_01_16_06_08&utm_medium=email&utm_term=0_-974bf7efe0-%5BLIST_EMAIL_ID%5D

 

 

Breathwork is a core technique in counseling and psychotherapy. It has also been a central tenet of practices as old as Zen meditation. But what are the therapeutic and/or health benefits of breathwork? 

https://www.inc.com/jeff-haden/science-says-use-relaxing-breath-method-to-fall-asleep-faster-starting-tonight.html

 

Otto Kernberg is one of the most influential theorists responsible for our understanding of Borderline Personality Disorder (BPD)!  

https://www.verywellmind.com/borderline-personality-disorder-meaning-425191

 

There is a whole vocabulary associated with recovery from alcohol and drugs. For those who are not in the program or do not work professionally with those in recovery, this can be very confusing. Brett recently was talking to a friend about what it means to be a dry drunk and found that even he had many questions. 

https://www.webmd.com/mental-health/addiction/what-to-know-dry-drunk-syndrome

 

Ketamine is the only psychedelic substance that has been approved by the FDA for the treatment of depression, so far. How does this drug help depression and will other psychedelics get approval in the future? 

https://www.washingtonpost.com/wellness/2022/09/12/ketamine-therapy-explained/

 

In early 2023, Brett and I discuss 10 lessons from 2022.

https://www.wellandgood.com/best-advice-from-therapists/

 

Attachment styles play a huge part in successful and enjoyable relationships. But most of us do not even know what our attachment style is. 

 

https://www.verywellhealth.com/insecure-attachment-5220170

A current buzzword in psychology and also society at large is, entitled child. But before that psychology had a word for those who saw themselves as wonderful and that was narcissism. Are these separate concepts or just opposite sides of the same coin? 

 

https://awarenessact.com/narcissistic-children-are-raised-by-parents-who-do-these-8-things/?fbclid=IwAR1wcd8eu0xHxiY3nW24f3mZ9Dr7zxmg2jo9jwcULvBPhqIt1lcKoDXwJts

 

It's been a long two years. Over this holiday season, many of us may be re-evaluating our behavior in the hopes of making better choices and improving our physical and mental health in the new year. But to do this effectively we need to know what behaviors we may have fallen into that are not the healthiest for us. 

https://www.forbes.com/sites/travisbradberry/2016/07/26/10-troubling-habits-of-chronically-unhappy-people/?sh=33018b6b70f3

All of us have past trauma that affects us in the present. It is cliche to hear someone say "you have to let it go". But how do you do this?

 

https://www.berkeleywellbeing.com/letting-go.html

 

https://unfoldingtheuniversewithin.com/the-art-of-letting-go-of-the-past/

 

Relationships are at the core of being a healthy human being.  We develop attachment styles as a result of our experiences early in our lives. One of these attachment styles is avoidant attachment. Today we discuss the characteristics of this attachment style and how it impacts our relationships. 

 

https://www.psychologytoday.com/us/blog/the-clarity/202206/what-is-avoidant-self-attachment

 

As better ways of exploring the way our brains are connected become available, we are mapping these connections with greater precision. Does a better, more comprehensive map of the way areas of the brain operate make psychology more of a "hard" science? 

 

https://neurosciencenews.com/amygdala-emotion-20969/

 

We all have heard someone accuse someone of being passive-aggressive. But how many of us really know what that means or how to identify the behavior? 

 

https://www.cnbc.com/2022/09/25/the-3-biggest-signs-of-passive-aggressive-and-childish-behavior-harvard-body-language-expert.html

 

 

Therapy and mental health are recognized as being in epidemic-like short supply. With the pandemic and political division, people are finding their mental health has taken a big hit over the last couple of years. And yet there is growing dissatisfaction among therapy devotees and unequal availability of therapy services across socioeconomic domains. 

https://www.wired.com/story/therapy-broken-mental-health-challenges/

As we move beyond the pandemic we are seeing a significant increase in the number of persons who express that they are feeling lonely. What are the factors that are contributing to this besides the isolation of the pandemic? 

https://www.psychologytoday.com/us/blog/understanding-ptsd/202207/how-childhood-trauma-can-lead-adult-loneliness

We could all use a little boost to our self-esteem. You're welcome!

https://www.cnbc.com/2022/09/18/want-to-sound-and-feel-more-confident-ditch-these-11-phrases-from-your-vocabulary-say-psychologists.html 

Studies indicate that the human attention span has significantly shortened since the rise of social media. Why is it getting so hard for us to focus our attention? 

 

https://www.ranieriandco.com/post/changing-attention-span-and-what-it-means-for-content-in-2021

 

https://www.theguardian.com/society/2019/apr/16/got-a-minute-global-attention-span-is-narrowing-study-reveals

 

Enlightenment, self-actualization, and, mindfulness are ideal states of being that we are all striving for. But what is the neuroscience that supports the idea that enlightenment is a real phenomenon that has beneficial effects? 

 

https://bigthink.com/the-well/neuroscience-of-enlightenment/

 

Should you go or not go to Thanksgiving? Are you the one tearing the family apart when you identify familial dysfunction? Good questions.

https://www.psychologytoday.com/us/blog/brothers-sisters-strangers/202206/how-family-estrangement-echoes-across-generations

 

Sure your therapist has framed pieces of paper on the wall, but how do you truly know if your therapist is any good? 

https://www.psychologytoday.com/us/blog/get-out-your-mind/202209/how-tell-you-have-good-therapist

 

 

Sometimes a child's parent goes beyond the stereotypical defaming of the other parent. When this happens we have to think of this process as similar to the type of programming associated with a cult. 

 

https://www.familylawpleasanton.com/blog/2020/10/the-8-symptoms-of-parental-alienation/

 

Have you ever wondered what is the most important question in psychotherapy? No spoilers here just check out the conversation!

 

https://www.psychologytoday.com/us/blog/insight-therapy/202209/the-most-important-question-in-therapy

 

Transcript:

you're listening to psych with Mike for more episodes or to connect with the show with comments ideas or to be a 0:07 guest go to www.psychwithmike.com follow the show on 0:12 Twitter at psych with Mike or like the Facebook page at psych with Mike now 0:18 here's psych with Mike welcome into the site with Mike Library this is Dr Michael Mahon and I am here with Mr Brett Newcombe hello the uh psych with 0:26 Mike Library window is open that's a new way to start yeah I mean I 0:32 guess people could walk by and ask for ice cream but you can either look in the window or jump out yeah whichever you 0:37 want whichever you feel is how do you feel about that I I feel really good about it I'm the point is that it's it's 0:45 very nice outside and after the summer that we've had in St Louis I am really 0:53 glad that the weather is milder it's been a beautiful week yeah so uh we 1:01 don't even need to get into global warming because that's because that's a crazy kind of divisive 1:07 topic but uh it was really hot this summer yeah and it's hard still hot in 1:14 major sections of the country and the world yeah it and and when you look at what's been going on in India uh in a 1:21 third of the country underwater that's I can't even conceive of what that would 1:27 be like yeah so anyway so I'm glad that we're going to get some milder temperatures I am uh a feared that the 1:37 Farmer's Almanac is predicting a tremendous amount of snow in the St 1:44 Louis area for this winter so we'll see how how that works out yeah 1:50 so how are you today I'm doing well you don't want to talk about anything we were talking about before the before we 1:56 started this do you no okay because there's been lots of stuff going 2:03 on there is always always interesting in doing therapy people come in and it's 2:08 like there's always going on lots of stuff going on yeah so 2:14 um when you were doing therapy I think that 2:19 uh probably each individual person doing 2:26 therapy has their own style obviously yes yeah 2:34 and probably most people would have a different answer to this question but 2:39 what was your favorite or most important question in therapy 2:52 how are you this week and what would you like to talk about so what's hot what's Burning uh in your 3:00 mind your Mentor slash hero um 3:05 blanking on his name yellow yeah Irving yallum uh uh his intro question was what 3:14 hails so in all of his books that's how he would start out all of his therapy 3:20 sessions what what else what else yeah um which I always found pedantic and 3:28 beatnik like yeah but uh but yeah I mean he always wore the black turtleneck and 3:34 I don't know that he wore what is the the cap that the French wear you know we all have our affectations in 3:42 our presentation exactly I used to tell people would call and say yeah I'm thinking about coming to you I've been referred to you uh 3:49 How will I know and I would say you know it is incredibly important that there is 3:55 a sense of safety and connectivity for this to work so come see me come see me 4:00 once or twice and don't pay me but if you come back the third time pay me for 4:06 three sessions and every session after that but I really feel like if you spend some time with me you'll get a sense of 4:13 whether I'm going to be a fit for you whether I'm going to be able to hear you and what you need to talk about right uh 4:21 well you're Jumping the Shark because we we definitely want to talk about what is a good therapist yeah but so when we're 4:29 talking specifically about the questions do you believe 4:34 that the therapists questions 4:41 are important for directing the course of therapy or do you believe that the 4:46 therapist is more of a passenger a passive so I taught in a counseling 4:52 program for 35 years and I would constantly say to my students who wanted 4:58 to become therapists and in addition to having my private practice for all those years but I would say to my students you 5:05 cannot do formula therapy you can't have a formula that you follow for every client that comes in whether that's a 5:13 label that you apply to yourself I'm a cognitive behavioral therapist or I'm a union therapist or whatever 5:21 uh because people don't know that and don't understand that they don't know what it represents what it means what 5:28 you need to say is I am invested in paying attention to you and 5:35 hearing what it is that you need to have heard and then proving to you that I've heard you 5:41 accurately and correctly both both in terms of what you say and in terms of what you're feeling when you say it so 5:47 we will explore that reality for you and if that's a fit then be spending time here will help you 5:54 make progress with whatever concerns that you have I think you'll get better but if if I'm not the fit then go 6:01 somewhere else don't say well therapy doesn't work I went to this guy he was a bozo there are bozos out there but if 6:07 you feel comfortable with me and we can spend time together I believe that we 6:14 can make progress in terms of what hurts you or what you need to address in your life to make your life better but just 6:22 as far as the the who's driving the train yeah do you 6:27 believe that the therapist no drives a trainer do you believe the client right yeah yeah and I'm not bringing it to the 6:35 table you are my job is to ask you what are you bringing to the table right what what's going on and then do reflective 6:41 uh listening to say well this week you said you were bringing to the table an 6:47 argument that you had with your boss but we spent 45 minutes here talking about other things and I'm wondering how to 6:53 understand that if that's what was hot for you when you got here we haven't even approached it and we've nibbled at 6:59 a time or two but we keep going down these other paths about this or that or the other so I'm wondering how to 7:05 understand it I'm wondering how you understand that so the most important question is the question that helps to 7:12 direct the client towards themselves better self-awareness right and they'll 7:19 come out in and they'll throw out red herrings so that they feel like we spent a 7:25 productive hour and you feel like we spend a productive hour because we try to solve this puzzle it's a very seductive thing they'll ask for advice 7:32 what do you think in your experience how does this work uh why and they always 7:37 want to talk about somebody else why is my mother doing this why is my mother this way and the 7:44 to my thinking the point of being there isn't to figure out why your mothers are your boss or your next door right why 7:50 you are enduring this or tolerating this or making these choices 7:56 and we talk about emotional economics you know you're frustrated you're upset you're angry you're hurt you're sad 8:01 whatever how's that costing you what's that costing you in terms of physiological 8:08 issues are you having chest pains or you're having anxiety attacks do you have headaches you're having trouble sleeping you've got TMJ problems what's 8:16 going on with the way that you handle this issue and then in terms of your emotional 8:22 status are you grouchy are you angry are you sad are you numb uh are you 8:28 frustrated I so many times having conversation with parents and they would come in and talk about 8:34 and I said to my child how many times do I have to tell you and I'd start laughing at them and I'd say you know if 8:40 you've heard yourself say that more than twice you've said it too many times yeah so let's let's talk about Plan B if just 8:48 telling them you need to do your homework and they're not or you need to wash the dishes clear the table whatever 8:54 it is you've asked them to do and they haven't done it what's next so I think that 9:01 many therapists we've both been involved in programs teaching in programs that 9:07 educate the next generation of therapists and 9:12 from the therapist that I know and the students that I've taught 9:18 it feels like to me and I could be wrong so I'll ask you what your reflection on 9:23 this is that a lot of their a lot of people who are going to school to be therapists want the formula they want 9:31 some kind of reassurance that you you give me the formula the questions to ask 9:37 I'll ask the questions and then I've discharged my duty that'll make me feel like that I'm doing what is right and 9:45 you know the insurance companies uh support that thought absolutely because they want to pay certain amounts for 9:51 certain things and they claim that the data collection that they have justifies the approval or the expense or the money 9:57 investment at a time uh but I I keep coming back to you know formula therapy 10:02 and agenda therapy I think both are not therapy and I also would say 35 years of 10:11 teaching and counseling program at two different universities um a lot of people who come to try to 10:18 become therapists are so seriously wounded that they're going to hamstring 10:24 themselves right by their issues right uh and their agendas you know you can't be 10:31 proselytizing for your agenda uh whatever it may be 10:36 whatever you're really promoting is the right answer that's not doing therapy yeah and when we were in grad school and 10:44 and you did Role Play Everybody did role play we hate role play okay but but everybody does it and and I did it 10:51 poorly well but we did I mean we had actual groups in in your group therapy 10:57 class we did and but I said we're not role playing what what whether you call that role playing or not but but you 11:05 know I used to say all the time the next time that somebody says to me the reason I got into this because everybody asks 11:11 oh why'd you get into this program you know that's the first that's the Icebreaker for every class that you go to so the next time somebody says oh you 11:18 know I have a dysfunctional family I wanted to understand it but I'm gonna punch him in the throat okay you know no which is a very clinical reaction well 11:25 you're in a Therapy Program well I was in there yeah it wasn't like I was doing therapy uh and and no doctor said oh I 11:32 went to medical school because I knew my appendix was going to go bad at some point and I wanted to be able to take it out I know how to deal with it yeah so 11:39 you know that's a bad bad reason to go I went to to school to be a therapist 11:44 because I couldn't pass calculus is what they're saying it's the answer that they 11:49 give but they're not deep enough there's something under that for what drives you I want to help people I'm on a mission 11:55 from God I believe in doing good in the world whatever it might be or I think uh 12:00 I know I was abused as a child and I know how damaging abuse is and so I want 12:06 to protect all children from being abused but that's a reason to be in therapy not a reason to do therapy 12:12 exactly yeah yeah I agree with that 100 yeah and and so you know that doesn't 12:18 mean that you shouldn't be doing therapy but you shouldn't be if you're using your own dysfunctional past as the 12:25 motivation for why you're doing therapy I think you're going to get caught up in that agenda profile 12:32 well that is uh one of the reasons why for a number of years I refuse to see 12:38 active acting out alcoholics because I came from a violent alcoholic family and 12:44 I had so many of my own personal and that's called counter okay don't feed me lines like 12:50 that you want to say it say it that's called counter transfer yes I know okay uh so you try not to do that you don't 12:58 want to do that as a therapist yeah it disrupts the connection the dynamic the 13:05 orientation of the session they're paying you to listen to you and that's 13:11 not what you're supposed to be doing right and I didn't work with and still don't if I can help it work with sexual 13:18 abusers and people say oh well you should you know work with everybody or what you know I didn't feel like I don't 13:26 work with borderlines I don't feel like that that is my clinical expertise yeah I don't have the expertise or you say 13:32 those those issues are too close to me I can't I can't see clearly I can't hear but it is the therapist's responsibility 13:40 to know what you know the Old Dirty Harry line a man's got to know his limitations yeah you got to know what 13:45 your limitations are and you have to practice within those limitations I don't I don't not see borderlines 13:53 because I don't think I'm clinically able I don't see borderlines because I find that push your buttons yeah I get 13:59 seduced by the borderline presentation seduce or distracted 14:04 yeah because they'll say here chase this rabbit or here chase this rabbit and every once in a while you're so focused 14:11 on a particular kind of rabbit that you're like oh I'm after that and then again they're steering the 14:17 direction of the conversation to reinforce their own circumstances 14:23 right and justify them but it isn't to me it isn't a weakness 14:28 for a therapist to say this isn't my area of special I agree it's a string I 14:34 would agree with that yeah now that at the same time I also don't think that 14:39 new therapists should say I'm exclusively an alcohol substance abuse 14:46 counselor no because I think that makes them feel safe because they are trained or they know the right answer they know 14:53 the theories that they're taught in school or that they've been taught in school slash AAA uh and so they notice 15:00 that you know one day at a time uh let go and let God and never say those 15:05 things automatically in conversations uh they can laugh about things like 13 15:12 stepping uh on a 12-step program the hell does that mean what's going on there uh so they know the inside Works 15:19 they feel safer but individuals are never limited to 15:25 whatever the presenting pathology is and so if you say oh I can only work with 15:31 substance abuse individuals then but but those people have other issues this 15:36 diamond only has one facet right yeah right so I'm my you know 15:42 encouragement my advice to people who are doing therapy or newly thinking about going into therapy is you got to 15:49 find that balance don't try and practice outside your expertise but also don't limit yourself to one specific pathology 15:58 so then that brings me to therapists need to either uh okay hold 16:05 on to that question and or that thought and we'll pick that up after our break I might forget 16:12 hey Brett if you were going to tell somebody to check out something on the 16:19 Internet to help them with their mental health what would you tell them I tell them to listen to sex with Mike why 16:25 would you tell him that because it's probably one of the most easily listenable experiences you can have that 16:32 would give you information that's useful for a whole spectrum of concerns that 16:38 people have I agree and I have actually been told that by at least a dozen 16:44 people several of whom were not married to me and some of them didn't even know 16:50 me that's amazing that is amazing it's when when we get that kind of feedback 16:56 from people it is so incredibly humbling and overwhelming for me it is for both 17:03 of us so we really appreciate it and as always if it's Friday it's Mike 17:09 [Music] all right we're back did you forget I 17:15 don't know like it just comes and goes so quickly now what I was going to say is and again the thing that I used to 17:21 say to people all the time never practice alone if you practice alone it's too easy to get distorted and 17:29 caught up in rhythms that uh if you had supervision or and even collegial not 17:36 hierarchical supervisor yeah working for a boss who can tell you yes or no but uh 17:42 collegial supervision and most therapists I know do have those kind of groups that they meet with and they talk 17:47 to and you say I have this client that's really pushing all my buttons all right this client that's presenting this this 17:53 singing and it makes me so sad or I'm so concerned about them that I am losing my objectivity uh or I have issues with 18:02 keeping boundaries for this particular kind of experience and other therapists 18:08 and clinicians can say well I have that so you're not crazy you're not not rare and this is a way that I work with it 18:15 how do you work with it and we can have those conversations to help keep you professional and focused keep both you 18:22 and your clients safe from contamination and it's really an important issue so do 18:27 you think that therapy so if I'm doing therapy and I'm in therapy does that 18:33 serve that was the same question that we had for 35 years yeah does every therapist need to be in therapy and I 18:40 would not make that as a legalistic qualifier I would say it's probably a good idea but I would say you need to 18:47 have collegial or hierarchical supervision over your cases so okay so 18:53 uh I want to I want to drill down on that a little bit because you know I think that you should be in therapy if 18:59 you're doing therapy because I think it keeps clean the transference counter transference projective identification 19:05 but I'm not sure that it serves the same function as collegial supervision 19:12 I'm not sure anymore okay so if I'm going to therapy and I'm talking about my counter transference that may help me 19:20 be cleaner in being able to identify and deal with the counter transference but 19:25 may not necessarily help me in the area of boundaries so I I went to therapy and 19:34 one of the challenges that I understood going in that I discussed with my 19:39 therapist going in is having done therapy as a provider for 35 19:45 years I feel like I'm at risk to play therapy games and 19:51 head games if you helped me find a live nerve that might 19:56 be painful or frightening for me instead of going with that and 20:02 experiencing whatever that is I'm capable of distracting you with something else 20:07 and I don't want to do that so we both need to help watch me and so that I can 20:15 avoid that because as any other human being when I 20:20 get to the most raw places inside me that I'm trying to get out and put on 20:25 display for the therapist to say how do you understand this uh what does 20:31 that make you think about me am I accurately pulling it out of me or am I 20:38 still guarding it and guiding it and lying about it uh it's a scary proposition so I will avoid 20:44 it and people do that in therapy all the time that's why the presenting problem that they first come to you with is almost never the real issue in their 20:51 lives it is an issue it's a real issue but it's never the issue 20:57 so you have to spend enough time making them safe solving problems not solving 21:02 for them but with them so they can build the trust in the process and in you and 21:10 in themselves to be able to look deeper yeah so do you agree though that therapy 21:16 is not the same as collegial supervision yes I do and and so if you're going to have 21:21 one you should definitely have collegial supervision you can certainly have both 21:27 yeah absolutely okay so that's what we're saying to people is that you got to at 21:32 least have the collegial supervision yeah and and it doesn't have to be formalized like you and I have had a 21:38 relationship since before I was ever a therapist so for as long as I've been a 21:44 a practicing therapist you and I have had that relationship 21:51 okay not not that I'm aware of okay uh but I mean you you have to you're trying 21:57 to blame all that on me I know where this is you have to take that responsibility for yourself but uh so 22:02 sometimes that was more formalized when we were in a group practice together and sometimes it's been less formalized I 22:07 don't think that it needs to be formal I think that you have to oh you're gonna do it over coffee you just need to get 22:14 it on a regular basis right and and all of the knowledgeable or trained or licensed participants need to bring 22:21 something to the table mm-hmm well what have you been seeing because another thing that happens is really that's such 22:27 a great point though is themes or threads go through a community and it's 22:32 like wildfire contagion so you get a half a dozen new clients and they're all 22:39 dealing with depression and you go to collegial therapy and everybody else is saying my god I've had so many people 22:44 coming in with depression in the last couple weeks which it's in the water uh just to by way of an example and it's 22:51 helpful to get that feedback and it's helpful to get everybody else's perspective on how are you dealing with 22:58 that how are you approaching that I remember having a meeting I don't know if you'll remember this but when we were 23:03 in a group practice right and the gal who was the director actually took you 23:09 and I into a room because she wanted to have these Grand uh clinical meetings 23:16 yeah and so we would have these meetings and say okay somebody needs to present a 23:21 case and crickets crickets crickets and she took you and I into a room and said you guys are the seniors here everybody 23:29 looks up to you and you guys need to present because that'll make everybody 23:34 else feel safe and and I don't know that either one of us well 23:39 I wasn't opposed to the presenting I was opposed to the way it was presented to 23:45 me yeah because I quasi staged yeah well I mean it was like you you like we were 23:51 getting dressed down because nobody else would participate but I will say that we started doing those things regularly and 23:58 other people did start to open up and some of those meetings were really 24:04 really good and beneficial I think not just for the individual who was presenting the information but for 24:10 everybody the community that was in that room yeah exactly yeah I mean that can be so powerful absolutely and 24:17 encouraging you know you get reinforced that you're not saying it wrong you're not seeing it 24:22 incorrectly you're handling it well according to the committee opinion and 24:28 that's positive affirmation and we all appreciate positive affirmation so let's Circle back to what the original topic 24:34 was which was the most important question in therapy and this idea of the 24:41 difference between an open-ended and a closed-ended question what's the difference between so a couple things 24:46 occurred to me one is when clients becoming new clients would come in sometime in the first session or two one 24:53 of the questions that I would ask is if our work together is productive and 25:01 positive and on target how will your life be different if what we do together is beneficial for you 25:08 what will be different what are you looking for do you know do you think do you feel 25:15 your relationship your mother be improved your relationship with your mother will be severed you'll get out of 25:20 bankruptcy who knows what it's going to be but you have a concept of that so 25:27 then they start talking and what that does is sets for the 25:33 therapist if not the client what the goals of therapy are so a lot of times people talk about oh you had to have 25:39 goals and you got around but it doesn't have to be that formalized that question right there helps me as the therapist 25:45 understand that may be you know what the client says in in response to that 25:51 question might be what they're looking for but it might not I mean it might just be what they're talking about 25:57 because they haven't they don't feel safe enough to really peel back the layers of the onion yeah yeah right 26:03 right but but those are ways of establishing goals in therapy so if you're a new therapist and you're asking 26:10 that question what you're getting the information you're getting back helps you to understand where the client might 26:17 want to go in the therapy session and so as you listen to a client 26:25 one I mean there are different labels and skill techniques that this discusses 26:31 but you you listen to the phraseology and the verbalisms that they use 26:39 and that helps you learn how they think and how they experience 26:45 neuro-linguistic programming is a term and you listen to what they say and you 26:51 you listen between the lines you hear more and you're watching on verbals and you learn when to say wait a minute I'm 26:59 I'm picking something up here it's not in focus it could be me that's out of focus but 27:06 it could be you and so give me some feedback you're not getting this 27:11 accurately are you struggling with this did you just twitch did you just have a flash of a distraction or a thought and 27:17 you that's called uh I think it was a call it just went blank 27:24 uh silent uh okay uh I'm I lost it okay well but so a 27:34 closed-ending question is in question that can be answered with a single word so if I say did you go to the store 27:40 yesterday yes sir you can say yes or no yeah on which store right but an open-ended question it requires more of 27:48 an elucidation so if I say to you you know what it was your fun this childhood 27:54 memory and you say Saturday well obviously it requires more input than 27:59 that so in therapy we're trying to ask open-ended questions because the answer 28:08 that is provided by the client could give us additional information that's 28:14 more than Justice it gives you a directional approach but but there is one open-ended question that you never 28:20 ever ever ever ever ask you like me everybody always does no why oh yeah 28:26 yeah yeah I lost my temper and punched my questioning us why would you do that 28:31 why do you lose your temper I don't know how they're going to answer that yeah so 28:36 you don't say why so you don't ask open-ended questions that put the client 28:43 in a down position no you don't do that 28:49 you ask them exploratory questions yeah how do you understand that how did you 28:54 experience what did it feel like yeah uh well and then so now you're going back because I asked you originally what was 29:01 your most important question in therapy but I never answered that for me it is 29:06 how do you feel about that because emotional regulation is so much a central part of how I see human 29:15 pathology that that for me is the most important question how do you feel about that I think most people answer that 29:20 with how they think about that and and I point that out yeah because you got to get to the field right and so one of the 29:28 first things that I do is to train clients that if I say how do you feel 29:34 about that you have to answer glad mad sad or scared you can't because if you 29:39 don't use an affective AFF ECT affective word which is the psychological word for 29:47 emotion then you're telling me how you think so if I ask you how do you feel about that and you say I felt 29:54 disrespected well you can't feel disrespected that's not a Feeling you can think that you were disrespected and 30:00 let's assume for the sake of argument that you did think that you were disrespected how do you feel about that 30:05 well I felt angry okay now we're talking about affect and so I train people to 30:11 use that affective language so that and as they start to go through therapy they 30:18 get reinforced with that hopefully they'll take that outside of therapy so when they start talking to other people in their lives they'll actually start 30:25 having those affective conversations rather than just talking about how they think because you're absolutely right 99 30:32 of us 99 of the time when we are asked how we feel we tell people what we think 30:38 well and classically Men answer I don't know yeah how do you feel about that I don't know yeah I I and I'll end with 30:45 this little anecdote but uh when I was working at the hospital there was another guy that worked there and 30:52 I'm not going to say his name but to be honest with you I don't remember what his name was this was a long long time ago uh and he would do groups and his 31:02 response to everything that anybody said in group was anger about that anger 31:09 about that yeah anger about that and I said to him one day you know there are more emotions than 31:17 just anger I I you know I how how much it would have just been so easy to say oh so how did you feel about that how 31:23 did that make you feel but he would just always say anger about that and yes maybe the person was angry but maybe 31:31 they were hurt and they were using anger as a cover-up and that's one of the things and that's what I want to end on 31:37 is that most people in our society at least and I think in the 31:43 world in general use anger as a way to cover up hurt and a part of therapy is 31:50 to go deep enough to help people recognize the way that they might be 31:55 covering their emotions with other emotions camouflage yeah yeah accurate 32:00 reflective listening yes what I couldn't remember so important yeah essential the 32:06 music that appears inside with Mike is written and performed by Mr Benjamin declue what we would love is if you are 32:13 a regular listener to the show or even if you're not even if you this is the first time you've ever heard the show if you're irregular yeah go to Apple 32:20 podcasts and find psych with Mike and rate US and leave a review that is super super beneficial we would really really 32:27 like it if you would go on to the YouTube spine psych with Mike and subscribe to the show there that is very 32:34 very helpful and as always if it's Friday it's psych with me foreign 32:41 [Music]

 

Sometimes it is important to try and re-focus our perspective. A great deal of anxiety is about the privilege we enjoy because of the place we live. Trying to understand that concept can help us consider how the perspective of the world at large. Refocusing is an essential tool for reducing anxiety. 

 

https://forge.medium.com/panic-is-a-luxury-c4330107b80a

 

Transcript:

you're listening to psych with Mike for more episodes or to connect with the show with comments ideas or to be a 0:07 guest go to www.sitewithmike.com follow the show on 0:12 Twitter at psych with Mike or like the Facebook page at psych with Mike now 0:18 here's psychic welcome in Insight with Mike Library this is Dr Michael Mahon and I'm here 0:24 with my good friend and colleague Mr Brett Newcombe I love it when you say that which part good friend or colleague 0:30 both because it gives me some identity yeah well I I am very aware 0:38 um that there was a period of time where I was an experiment for you 0:44 Oh I thought I kept that better hidden oh no you used to tell me that all the time I don't know how how you thought it 0:51 was hidden when you used to say that you used to say like those words to me well you're just really an experiment well I 0:57 mean if if you were feeling anxiety about that it's exactly what I wanted you to feel because anxiety can be a 1:03 motivator yeah and I was trying to motivate you well I was if you don't turn your sound machine you're going to 1:08 fail I was initially reluctant to believe that you would care enough about 1:14 me to want to be my friend well and I understood that and you said well there were reasons why but I'm in a period of 1:20 my life where I'm trying to be a better person and I'm using that I can bring 1:25 along as an opportunity to try and yeah I promise a turd yeah yeah and I was 1:31 like oh no thanks that's wonderful okay now you're making me anxious yeah so so 1:38 uh do you get anxious a must it's part of the human condition 1:43 yeah but I don't know that anxiety is a part of the human condition and this is why I say that because 1:50 where even if there are other uh psychological conditions that may be 1:58 actually linked to some kind of chemical imbalance or some neural processing I 2:04 don't think things I I've always believed anxiety is a thought disorder and so if you can correct the thought 2:13 disorder then you don't have anxiety so what I mean by that is that anxiety generalized anxiety other than the 2:19 fear-based anxieties I believe we should make a distinction between fear-based non-fear-based anxieties okay say more 2:26 so fear-based anxieties which are like post-traumatic stress disorder things like that those actually are ways in 2:33 which the brain processes information incorrectly so instead of the cortex 2:39 which is the area of your brain where rational thought lives processing information first and then giving 2:45 information to the limbic system which is your emotional Center and then that triggering the 2:52 fight-or-flight response when you have post-traumatic stress disorder that's turned upside down you just immediately 2:57 get into fight or flight and you don't ever process the information but generalized anxieties which are 3:03 situationally based you always process the information first and those are the result of cognitive dissonance so the 3:10 inability for the human mind to hold two conflicting thoughts comfortably so I 3:16 want to ask a girl out but I'm afraid of rejection right that's that's a that's a 3:21 a a a a conflict and the friction of those two ideas rubbing together in our 3:28 brains causes what we consider to be anxiety so if you don't have any cognitive dissonance if you don't live 3:34 with that and you don't fuel that on a regular basis then you could live fairly 3:40 anxiety free my question would be it is The Human Condition such that a person can do that 3:48 um I don't think so yeah because I think things happen I mean uh I recently had I was reflecting on your question about 3:55 anxiety uh I don't think I'm very situationally anxious uh 4:03 I mean it does happen but it's really rare uh if I'm in a dangerous environment and 4:10 I see I'm Jesse Jackson talking about walking down the streets of Chicago being followed by a group of young black 4:16 males I said made him anxious just because they were there because the reputation of the area and the community 4:21 and so on I've had that experience I remember hitchhiking through Hartford 4:27 Connecticut in the Spanish section being followed by a bunch of teenagers because 4:32 I was obviously an outsider didn't belong in that neighborhood and they wondered who I was and what I was doing there I felt some anxiety while they 4:39 followed me to the edge of the boundary and then they went away they didn't do anything they were just there but I felt 4:45 anxiety and and was asking myself questions like how'd you get here stupid well it's not where you should be get 4:51 out of here uh I had a I had a cancer scare earlier this year 4:58 and I had a lot of anxiety about well if I have cancer I'm going to die and do I have cancer am I going to die is it now 5:04 time to make my peace with that and figure out you know how to get from here to there to 5:11 an acceptable death right uh assuming I have anything to do with that at all or do I and so there's a lot of existential 5:18 anxiety uh so I think that may be the two types of 5:24 anxiety that you're talking about one one is a situational existential anxiety a baseline level of anxiety one's one is 5:30 an immediate reaction to a set of circumstances it could be scary causing you to have a reaction so I 5:37 don't think I'm very prone to one but I think I'm prone to both so I don't know 5:44 how to answer your question well I originally answered the question because of all of the people that I know 5:50 you demonstrate what I would consider observable anxiety 5:56 the least good yeah good and and I've always and I've always thought that now I've I've been in situations and I've 6:05 seen times where I have where I know that you were anxious but that's pretty 6:12 rare and so what I wonder is because anxiety is just so ubiquitous now in 6:20 society it's actually overtaken depression as the number one diagnosis 6:26 diagnosed psychological disorder in the United States and so is that a real 6:32 thing has anxiety overtaken it do we see it more and so when we're treating it 6:39 are we treating it in a way that is effective and beneficial 6:47 thank you I don't know yeah and I I don't know the 6:52 answer to the question because I don't have a global map for 6:58 society I try to see clients as individuals when somebody comes in and they're struggling 7:05 to digest something they want to figure out what that is and and try to find a way to help with that problem 7:12 uh now what I'm aware of doing counseling is that we may make progress 7:17 on this problem and when we take it off the table another underlying problem or 7:22 what we call comorbid problem will surface because it's like cards in a 7:28 deck and you play some down but there's still some there and I think life is a statement that there are problems 7:35 and you're going to experience having to encounter them and having to manage them 7:40 and resolve them to the best of your ability all of your life if you're alive there's going to be something out there 7:46 yeah that you need to be dealing with right and 7:51 I'm so so being anxious about it just saying oh my God I'm anxious I'm Frozen with 7:57 anxiety yeah isn't helpful to me no so so then my question becomes well what 8:03 are the things that we can do about the anxiety when I reframe the way you expand define it experience while I was 8:10 listening to you talk what I was thinking about was at what point did 8:17 things like psychological disorders start to become an actual thing like 8:22 when we were hunter-gatherers did we have the ability to experience 8:28 depression anxiety bipolar disorder and my guess would be long enough yeah even 8:34 if we did it didn't matter because environmental factors were such you had to have the survival skills right right 8:40 if they were survival skill enhancing yeah we had them yeah if they weren't no 8:45 and and so for me a lot of what we consider 8:50 mental disorders are really the luxury of our Advanced Society well I agree 8:56 actually okay you do agree with that I do and I also think that a lot of them are artificially created yeah uh by 9:02 advertising you know you watch Saturday morning television Sunday morning television every ad is a medical ad yeah 9:09 and they don't tell you what the product is for they they show glorious happy uh 9:16 sunshiny smiling people because they take this drug and then they and at the 9:21 end of the commercial they give don't take this drug if it can cause bleeding it cause heart attacks it can kill you you can't take it with other drugs be 9:27 sure to talk to your doctor about it oh and by the way if you have trouble forwarding it we can get it to you too yeah uh and then and then so then I sit 9:35 around like do I have that yeah is that do I have that so I don't know just call your doctor and tell them you want the 9:40 medicine ah yeah just in case yeah exactly right well you know that's magical thinking 9:46 everybody's medicine cabinet is full of drugs they didn't take a full dosage yes especially uh I I remember 9:52 20 30 years ago doctors were regularly talking about we don't want to give people penicillin because they're going 9:58 to be superbugs that come along that don't respond to those things and uh sure enough there were then there are 10:05 and so now they've uh I was in hospital one time because I got bitten by a spider a black widow spider yeah I 10:10 remember and I had uh my I think it was a brown recluse yes yes she was I said Black Widow yeah 10:18 yeah that was a different issue uh but we're not going to talk about that the doctor told me you're in the hospital 10:24 and I was there for a week yeah because we have to put you on this drip antibiotic because we can't give you anything strong enough that isn't coming 10:30 through an IV feed in your arm yeah uh to kill this bacteria because it 10:35 it'll kill you yeah so I lead in the hospital for a week waiting on the fight to be resolved while I read books no I 10:43 remember that and that was terrifying ah so if if 10:49 the if a lot of psychological disorders are the result of the luxury we have by 10:58 living in such an advanced Society does that matter in the context of doing 11:03 Psychotherapy can you say to a client you know a lot of what we suffer from is 11:10 the result of how good we have it is that a message that matters doesn't make them feeling better yeah I mean so what 11:17 the point is I have it now I'm worried about it I'm upset about it uh I'm in 11:24 the hospital with something that's probably going to kill me unless this drug works right so what can I do but 11:30 that's now that's an extreme case I mean but I mean that's where you get to well but I mean most of the time we see people in therapy they're not there 11:37 because they got bit by a spider and almost died they're there because you know their teenager is back talking them 11:45 and they don't have the intestinal fortitude to enforce consequences to make stop 11:51 or the societal support system you know I'm a five foot two 35 year old woman 11:58 with no husband and a job uh trying to manage a 13 year old who's starting to 12:04 feel his oats and get in my face and tell me you can't tell me what to do he's bigger than I am and I'm worried 12:10 about okay yeah that that is that is an um yeah that is a situation we I didn't 12:16 see a lot of people in that situation because we live in a fairly affluent part of St Louis I had a number of 12:22 clients that were dealing with that yeah and and that certainly is much more 12:27 problematic than the guy who is just so distracted by work that he's not really 12:32 active in the daily discipline of the children the mom is just furious because 12:38 the dad is checked out I mean that's mostly what I saw in therapy and and uh 12:44 to me those situations are the result of 12:50 I mean too much affluence I mean you're we're lucky that we have the uh the 12:59 luxury of having psychological disorders you whip out a chart of Maslow's 13:04 hierarchy I don't explain to them you have meals I mean this is yeah this is more of an uh a kind of a 13:12 intellectual argument between you and I as as people who did therapy for a long 13:17 time but the goal is to discuss with 13:22 clients what their situation is from their perspective in their reality and 13:29 I'm aware of that and I try and do that but for myself I see a lot of 13:35 psychological disorders as a luxury that we have because of the society that we 13:43 live in and that doesn't make them less real to the person I understand that but 13:48 I do think that if a individual can put that in context it could make it easier 13:55 for them so couple thoughts 14:03 when you address let's identify this let's look at other options 14:09 other considerations one of the things that 14:15 people are regularly told is you uh you can't think your way out of this 14:21 it's not an intellectual problem to solve it's not a data-based resolution you know the old Ben Franklin uh 14:29 conflict resolution thing pros and cons make a list divided up and weigh them 14:35 out I remember when I had a job in sales I used to teach us what they call the Ben Franklin close if you had a client 14:41 Mr Prospect who's considering uh because you've been so forceful your product 14:47 purchasing your product they're thinking yeah and you say well you know Ben Franklin had a solution for that to take 14:53 out a piece of paper and draw a line down the middle of it you say yes and no you see make up all the reasons for why 15:00 this is a good decision and then you help them with that he said well look it's cheaper it's affordable and you get 15:06 monthly payments it's guaranteed for five years it comes in multiple colors and whatever and then over on the other 15:12 side Ben Franklin put all the reasons for not buying it and then you don't say 15:17 a damn thing you make them come up with it and so if you're a trained professional you've given them 20 things 15:23 for doing it you give them nothing for not doing it they'll come up with two or three but then you're looking at the 15:30 balance it's like oh my God that's an obvious decision and that closes the sale right okay let's run to our break 15:36 and when we come back we'll pick this up hey everybody Dr Michael Mahon here from 15:41 Psych with Mike and I couldn't be more excited to talk to you about athletic greens which is a new sponsor we have 15:48 here on the show I started taking athletic greens watching some YouTube 15:53 videos and doing my own research I wanted to add something to my daily workout program to give me some energy 16:00 and to support gut health and that was the one thing that kept coming up again 16:05 and again with athletic greens is the guy who started the company did a bunch of research because he was having some 16:11 gut health issues that he couldn't get any resolution for he developed athletic 16:17 greens and it's just exploded from there so it's 75 superfoods vitamins minerals 16:23 probiotics Whole Foods sources that's all in one daily scoop you put it in 8 16:30 or 12 ounces of water you shake it up and you drink it The Taste is very very 16:35 drinkable I actually enjoy it and I have been using and my energy levels have 16:41 just been through the roof I really like athletic greens because of some of the sustainability things that they do so 16:48 they buy carbon credits and you know to help protect the rain forest which is 16:54 something that I really like but if you order athletic Greens in your 16:59 subscription you're going to also get a year's supply of their vitamin D 17:05 supplementation and five free travel packs and that vitamin D is so important 17:11 during those winter months when we're not getting enough sunlight we've talked about how that decreases your mood and 17:18 increases depression and that can be a real deal changer so you go to 17:24 athleticgreens.com emerging that's athletic greens.com 17:32 emerging that's the psych with Mike promo and you're going to get that additional vitamin D support for a year 17:40 and five free travel packs so take control of your own health today and as 17:46 always if it's Friday it's psych with Mike okay so before the break you had 17:53 adroitly refocused us and and on to what we wanted to talk about which was 17:58 anxiety and some of the ways in which people ineffectively try and deal with 18:03 it and so you're talking about this idea that I can think my way out of something which is the message that we get from 18:11 our Protestant upbringing which is hey you know you should be able to think 18:16 your way out of this situation and you had given an example of a way that you did that in business so are you saying 18:24 that that works in therapy or doesn't uh it does not yeah because it's not you're 18:30 dealing with a an affective State not an intellectual problem so it's not a 18:35 weights and measures kind of uh problem can we weigh this amount of anxiety and 18:41 say well I've got two pounds of anxiety today but tomorrow I'll have one pound yeah yeah 18:48 and so but but we are uh conditioned to say we should be able to problem solve 18:55 by thinking our way through it well if I just focus on One credit card payment 19:00 leave the others alone maximize my payment on the one until I get it paid off then I can roll over what I'm paying 19:06 on it into the next one and focus on them one at a time and solve the problem so and then I'll solve all my financial 19:12 anxieties over time typically doesn't work that way because other things intervene right uh most 19:19 people are not able to do that not able to do that for a long enough time that they have success so somebody comes 19:27 along gives them another credit card says I can help you out here there's 500 that you can charge and so they charge 19:32 up to the max they have 12 credit cards they're all charged to the max they're making minimum payments and they're 19:38 screwed so you got to figure how can I resolve this but it's not as much a 19:45 dollars and cents solution as it is an effective solution why do you keep buying stuff you can't afford right 19:51 what's the hunger driving the need to possess right you know what are the feelings involved 19:57 can we identify them and address the feelings that drive you as opposed to 20:03 focusing on the mechanics of operation that are the expression or the outcome 20:10 of being driven by those feelings right you know I need to keep up with the Joneses all my neighbors have a newer 20:15 car we haven't bought a new car my kids need to go to college and everybody in town is going to this college I got to 20:20 at least be able to you know so people get trapped in those binds that 20:25 generate anxiety and in fact affective discomfort right but they can't think 20:31 their way through it but problem solving we oftentimes talk about emotional economics and so I think what we're 20:39 saying is you may not be able to think your way intellectually out of a problem 20:44 but you can consider what is the cost liability 20:49 or the the liability benefits of my emotions of my ethics so when you have 20:56 to feel the feelings first okay you have to feel you have to label you have to externalize them then you can process 21:02 them if you just stay in your head and don't feel any of that stuff you'll come up with logical Solutions right that 21:08 don't solve anything yeah because you aren't dealing with the affect right which is the argument that's made in the 21:14 article that you have listed about thinking your way through anxiety the other thing that people get bound up in 21:21 with regard to anxiety is thinking that they have to find a perfect solution camp and that's Sometimes the best 21:28 solution is to throw a whole bunch of crap on the wall see what sticks and then among the things that stick which one is a more attractive piece and can 21:36 you get there but if you're invested in thinking there is a perfect 21:42 solution I'm going to not take a vacation until I get all my 21:48 bills paid off right I can go and pay cash for my vacation you may work your entire working life and never take a 21:54 vacation so then you say well the alternative is I can go on vacation but then I'll just 22:00 go deeper in debt right well but you know I think that the the 22:06 intellectual exercise oh yeah butt thing is a way of 22:12 restricting yourself to an action yes or from an action because you think oh I'm 22:18 investing all of this energy in trying to think about this problem so I'm doing something when in reality you're not 22:26 doing anything because all you're doing is sitting there thinking about the problem and sometimes all you just have to take in action even if it isn't 22:33 beneficial just to get mobile my father used to say on a regular basis to me son 22:39 you have to do what the fighter pilot does yeah uh that's what I don't know what that means because I'm not a fighter pilot and neither you did uh but 22:46 it would be lead follower get out of the way do something he could have been a fire pilot 22:51 no uh yeah because they say when the plane's 22:57 gonna crash yeah you got to do something even if it's wrong it doesn't at that point it doesn't matter what he was 23:03 riding on the plane right you're gonna die anyway yeah so you might as well do something even if you don't think it's 23:10 gonna help do something don't just sit there immobile so I was raised in an era 23:16 uh where the lesson that I learned is whenever you get in financial trouble 23:22 go get another job yeah get an additional job work a second job work a third job bring in more income 23:29 pay these so that you don't negatively impact your standard living so I became 23:34 a workaholic and I spent most of my adult life being a workaholic working two and three jobs working 70 80 hours a 23:41 week making good money but for much of my life didn't manage my 23:47 money just no matter how much I made it all went out the other end and it wasn't even better 23:53 so that was a real mental adjustment to 23:58 recognize that solution wasn't a solution and that other things had to be 24:04 dealt with that I won't deal with they hurt and going to work didn't hurt right and 24:11 so do you is that an example of trying to think your way out of a problem yeah 24:17 yeah I'll just go get another job yeah absolutely yeah which then actually kind 24:23 of I'll see five more clients this week right that brings in money it kind of feels like that's a solution because 24:29 you're doing something but then it really isn't solving the problem you're 24:34 not changing anything right right and then you kind of touched on the third one which is to think that you have to 24:40 pause everything to and tell you in 2010 right yeah and you were talking about 24:45 not taking a vacation and you know a lot of times that feels like good 24:53 advice stop doing everything else and just focus on this problem right and that I even argue that might be good 25:01 advice if you were actually going to do something about the problem but if you're gonna pause everything else and 25:08 just sit and focus on the problem and not do anything then that's not really helpful so as a 25:13 therapist when you look at suggesting behavioral interventions behavioral changes 25:19 one of the things that you can suggest that your client initially will think you're really stupid I'm paying you 25:25 money for this and you're saying this to me you have to challenge habituated automation 25:32 so an example that I would give to people most of you get up in the morning 25:38 and get dressed in the exact same way right every day if you put your pants on first you put your left leg in first 25:45 then your right leg then you pass your pants then you put your t-shirt on then you put your shirt on you put your socks 25:50 on what order do you do that well I don't know well think about it pay attention just watch yourself because 25:55 you'll do it and you'll do it the same way every day so do it differently what do you mean I said well for instance lay 26:03 your clothes out tonight that you're going to wear tomorrow and when you wake up in the morning go take a shower brush your teeth do whatever you need to do 26:09 without opening your eyes come back in and get dressed without opening your eyes 26:15 you always put your wallet in your left Hip Pocket put your right hip pocket do something different and be aware that 26:23 you're doing something different notice the difference and how uncomfortable it makes you how comforting it is to have 26:30 an automated ritual because we have to break the rhythm of the automated ritual 26:35 and so even stupid little things like put your wallet in a different pocket give you an opportunity to say well I'm 26:42 going to do that differently uh so you challenge them to do little things that are under their control you 26:49 can decide this morning not to have four cups of coffee you can decide to have three glasses of water 26:55 oh that's stupid well no it's really not if you make it as a proactive choice 27:00 and then we can decide and it's really an exercise in being able to get out of 27:07 the comfort zone yes people don't recognize automated if it's anxiety yes 27:13 that's your comfort zone people say well I'm I'm uncomfortable with my anxiety no 27:18 you're not yeah because if you were uncomfortable with an old friend right 27:23 you would not live in the anxiety and so that's something that I think people get 27:28 stuck with is that they assume that because they say to themselves I feel 27:35 uncomfortable with my anxiety that that means that they're out of their comfort zone no that's what you know well and so 27:43 then there are classic defenses resistance as we call them against 27:48 challenging the anxiety provoking situation yeah one is well wait a minute that's not logical I have to think my 27:54 way through it one is I have to find the perfect solution because let lesson that 28:00 will solve the problem so it's got to be perfect and the third one is I can't do anything else until I find this right 28:06 solution right so those mental traps are defenses that preserve the anxiety right 28:14 exactly yeah they stop you from being able to work your way through the 28:19 anxiety to an actual resolution yeah and 28:24 you know that touches on this fifth one which is people believe that if they didn't have 28:33 anxiety their lives would be better and that's just not true because as you 28:38 and I started this discussion just have different anxiety exactly you're going to having having anxiety is an artifact 28:44 of the society that we live in and now if you know the world Goes to Hell and we have a nuclear Holocaust and 28:51 everybody's living in survival mode people are going to have less anxiety that's why millions are going to be 28:56 living in survival would that be better no that wouldn't be better millionaires can never have enough money 29:01 right they have to have a billion and billionaires can never have to have money they have to have more because you've always got to have more because 29:07 enough is Never Enough right even if you have more money than Jesus 29:14 you still have to have more because well if somebody took some away from you right well if somebody used uh control 29:19 of the state to limit what you could do with your money you know like the Jerry Reed song you know uh 29:26 it's a song You country singer I had a song about playing dice in the alley and 29:32 they're going to put him in jail and he said who's going to collect my welfare check who's going to pay for my Cadillac 29:38 if I'm in jail I can't do those things rich people have the same issues you 29:43 know it's not so much I got to pay rent it's like I got to pay fifty thousand dollars in Property 29:50 Maintenance right for all my houses right you know and so I have to make more money 29:55 and that's the Trap of anxiety that those individuals live with right and so the 30:02 question is if you gave all that up yeah and said okay I'm just gonna live on the 30:08 beach and you know not worry about making money well you we did a podcast a 30:15 few weeks back and you spent a considerable amount of time talking about messages from the Buddha about not 30:21 being invested in things owning things having things doing 30:27 things but just being uh as a goal for life 30:34 in which you didn't experience anxiety and so I am not 30:40 capable of citing the references that you decided but you were making the point that your understanding of the 30:46 message of the Buddha was the less invested we are in things attachments 30:52 relationships the less anxiety we will experience the less suffering we will experience the 30:58 more at one with the universe will become and that that was a goal of life 31:04 so so do you agree with that do you think that's no I'm not smart enough to know I 31:11 just we were talking about someone who's negatively and adversely impacted by anxieties to the point that they're 31:17 crippling how do they deal with them one of the ways if you could get the perfect 31:23 Buddhist solution you wouldn't feel them because you wouldn't have right investment in those things those agendas 31:29 those needs those goals those desires but being a normal person 31:34 which is a given uh I got them you got them everybody I know has them how much do they interfere how 31:41 much of a problem are they that's what brings some people to therapy so and 31:46 we'll go out on this question but uh if we're 31:53 correct and what we're saying that anxiety is a part of the human existence there's no 32:01 way to separate that out then control the volume yeah physical can can a can 32:07 an individual monitor their own anxiety or do you think that it is 32:15 necessary for someone to get some outside perspective 32:21 I don't think there's a I don't have a single answer that to me it depends on how much distress are you in do you have 32:28 the resources to moderate it yourself or do you need help yeah yeah it's my old 32:34 adage about no one goes to therapy because they have a problem they go to therapy because a problem they have 32:39 causes them emotional dysregulation right yeah 32:46 so the message is be less anxious 32:51 yeah as as Nancy Reagan used to say just say no just say no just say no but don't 32:57 just say no to contacting us if you have a question or reaction to today's podcast and would like to be involved in 33:05 topics for the future that's so beautiful I'm a professional the music that appears inside with Mike is written 33:11 and performed by Mr Benjamin declue and the thing that we always would appreciate is if you listen to the show 33:18 and you want to do us a solid find us on the YouTubes And subscribe to us there find us on Apple podcasts and leave us a 33:26 review and a comment that is super super helpful and as always if it's Friday get 33:31 psych with Mike [Music]

 

For most, the goal of therapy is to increase your self-understanding. The only way to truly do this is through honest self-reflection. 

 

https://medium.com/perennial/the-discipline-of-clarity-according-to-jung-630e8434252f

 

Transcript:

you're listening to psych with mike for more episodes or to connect with the show with comments ideas or to be a 0:06 guest go to www.cyclicmike.com follow the show on twitter at psych with 0:13 mike or like the facebook page at psych with mike now here's psycho welcome into the psych 0:19 with mike library this is dr michael mahana i'm here with mr brett newcomb and intern michael 0:25 hello again good morning how are you guys doing great you guys are i guess i guess i should say consummate 0:32 professionals yes i think you could basically say that you can say i've always said the 0:37 shenanigans that were going on before we turned the mics on were 0:43 raucous and and then the mic goes on and you guys are like i'm much more well behaved when the 0:49 camera is on it's the sunday paper rule never put it in writing unless you want it to end up 0:54 in the sunday paper exactly true don't say anything that you don't want somebody to shout with a megaphone 1:01 in the local mall yes dear yeah although now malls are 1:07 empty yeah going out of business it's amazing so how can the economy 1:13 be running so hot and yet have just facilities that sell 1:20 stuff going out of business left and right there's this really cool new invention uh came out in the 90s or 1:25 something called the internet and uh people what's this internets that you speak of well everybody has a box in 1:32 their house and when they get sad or lonely they get on the box for several hours and advertisers show them pictures 1:39 and then they buy things for dopamine hits this is it's it's great it's going to be the next big thing i think al gore 1:45 had something to do with that did he invent it actually all right i think amazon has had a lot 1:51 more to do with al gore mm-hmm with the changes that you're talking about yeah so happy i could support jeff 1:58 bezos riding into space he's flying that phallic symbol all the way to the moon 2:04 oh jealous we're along for the i am jealous because i want to go to space but i'll never have that kind of money 2:11 so i'll miss it by just a couple of of years probably like like 2:18 three years after i die space travel will be affordable that i could have done it but i'll be dead well 2:24 now you've spoken it and manifested that into the world so that's your own fault so yeah i got 2:30 nobody to blame but me so i wish i could be more clear 2:37 i do too but i struggle with that you've been telling this 2:42 story all day well this 2:48 use your words yeah uh uh you've been talking about this phenomenon all day where i will start multiple sentences 2:56 and build this large narrative rather than just answer a simple question 3:02 and i feel like that uh this subject is very apropos for that 3:10 it's a reflection of reality now yeah so i have for the last year 3:16 been really really into reading jung so reading original young 3:22 like not reading things but one of the things that i was kind of like reading the bible yeah you actually read the 3:28 bible or just read stuff people say is in the book exactly yeah right because 3:35 i feel like there's a lot of literature out there in psychology which there obviously is 3:41 but what happens if you go back and you read the original stuff that the original 3:48 person like if i decided that i wanted to be a jungian therapist call myself a union 3:54 therapist then the psychoanalytic community here in st louis would say well you can't be a jungian therapist 3:59 because you haven't gone through our classes and been officially sanctioned 4:04 by us but the truth is how many of them have read jung 4:09 jung's original work probably not very many of them they've read a lot of stuff that people have said about jung just 4:14 like i feel about heinz kohut a lot of people have read a lot of stuff that peop that that people have said about 4:20 heinz kohut but how many people have gone back and actually read heinz kohut's original work so i've really 4:26 been trying to pay a lot of attention to jung's original works 4:31 and one of the things that that i am very aware of is that a lot of the 4:39 a lot of what i think people think they know about jung is not accurate 4:46 say more okay so uh young so the the the types that jung 4:55 came out with and and that now are manifested in the myers-briggs or are 5:01 you know explored through the myers-briggs there's very little of what jung 5:08 originally wrote that actually supports that 5:15 so that doesn't mean that what the myers-briggs tests is necessarily 5:21 wrong but i don't know that jung would have 5:26 necessarily supported the myers-briggs in its current 5:31 iteration i don't know maybe he would have but it didn't exist when he was 5:37 alive and so we don't know what he thinks about it but a lot of people would tell you that 5:43 the myers-briggs represents essentially the principles of jung's type typology and 5:52 maybe it does i don't know i don't know what young would think about that but i do know that he was very specific about what he 5:59 what you're talking about the distinction between the manifestation of his theory yeah 6:05 and the origination of his theory and your argument is if you go back and read what he originally wrote 6:11 then you have a clearer understanding of his thoughts exactly but as i understand it when 6:16 when he wrote this stuff it was coming out of his intellect not scientific experimentation 6:24 um brilliant man conceptualized these things wrote them 6:30 down the myers-briggs is someone else taking that and trying to interpret it or 6:36 develop a mechanism that would evoke it when clients take a test right 6:43 so they're not the same thing but they may be different facets of the same diamond 6:50 yeah that's a political scientist and you hear it's that we're saying that law is the manifestation of philosophy 6:57 but the philosophy is not born to the end of law most of the time yes 7:03 got that so one of the things that jung wrote about 7:09 that i would like to explore is this concept 7:14 of clarity so i sent you guys an article about uh jung's thoughts on clarity and so i 7:21 would just ask you what was your guys's thoughts or reflections about that 7:29 michael you wanna sure um i have always looked at young's clarity 7:36 going back to stoicism right marcus aurelius know thyself um and i think 7:42 there is a lot of wisdom in this and how we interpret this and how we can use 7:47 this uh to better our lives or to to connect with people around us 7:52 um i in my everyday job right as an engineer 7:58 i will get into uh not tiffs but uh confrontations with a teammate of mine 8:05 because he's very wordy right and the more words he uses the less i understand about what he's actually saying 8:13 and i think young's argument here is if you don't know yourself how can 8:18 anybody else know you and to get to the point where you can other people can know you or you can 8:25 enact that get really deep with yourself and understand what your you are what 8:30 your convictions are and what you want them to be um i think there's wisdom in that i also 8:36 think there's always some understanding that you even like knowing them knowing them is different than 8:42 choosing them and you can do both you can do both 8:47 so what would what would you say is the difference between the knowing and the choosing i would say that knowing a 8:54 conviction that you currently hold for for example my father is relatively 8:59 religious yes he knows that conviction of himself but it wasn't until much 9:04 later in his life that he really wrestled with his own faith um that did he choose that 9:11 conviction oh i got you himself so you could be brought up in a family where a conviction were indoctrinated into you 9:17 and it could be something like racism you could have been indoctrinated into a racist 9:22 family and you could have that as a part of you but you hadn't ch chosen it and 9:29 then if you actually look back and and at yourself critically and say is this an aspect of my personality that i want 9:36 to embrace you could choose not to you could choose to change yes i think young falls in that camp as well not only can 9:43 you choose to change but you have a responsibility to make the choice it falls back in that 9:49 stoicism or even back to the aristocracy of i have the responsibility of knowing 9:54 myself of understanding this philosophy in myself because eventually as a human being or a 10:00 member of society i should i need to make the choice 10:06 okay i thought you had something but uh so for me this is 10:11 from the psychodynamic perspective the real distinction between what they call 10:17 catharsis and cathexis so catharsis is the evocation of a strong emotional reaction 10:23 cathexis is like an epiphany understanding into the true nature of a thing and 10:29 i have always believed that cathexis is the goal of therapy at least for me 10:36 if i'm going to go to therapy cathexis is my goal and i try and create cathexis 10:42 for my clients but i've had a lot of people tell me that capexis is could be 10:48 could be a goal but is not a necessary goal of therapy so do you guys think 10:53 that better personal understanding is a required goal of therapy or should 11:01 be an expectation of therapy or do you think that just alleviation of symptomology 11:07 is the goal or the point of therapy 11:16 so i think that depends on if we're talking about therapies and intellectual exercise in this field of study 11:21 or if we're talking about what the client coming to see you is hoping to achieve 11:26 because they're the ones that get to decide so it's really in service to what the client's 11:32 goals are it should be but then there's also a pure intellectual 11:38 description that you can buy into as a therapist but i don't think you can impose it on 11:44 the client i had i had dinner this week with an uh old friend of mine 11:52 who is struggling with some things in her life right now and she was saying i was raised lutheran 11:57 i feel these shoulds about how i should be certain ways 12:04 and i'm discovering at this point in my life i don't want to be that way and so i'm feeling guilt about it she said talk 12:09 to me about guilt and i said my personal belief because i'm not doing 12:15 therapy with her so i'll talk more about what i believe with her 12:22 is that guilt the feeling of guilt is an imposed script 12:27 that was internalized inside you in your early childhood messages that you were given to try to 12:33 control your behaviors your options and your thoughts remorse is something totally different remorse 12:40 is something comes out of my own personal sense of integrity to be the person i 12:46 want to be as i understand it requires me to behave this way think this way feel this way 12:54 so if i'm not behaving in a way if i idealize myself for instance this is a good christian 12:59 how do i understand the message about christianity in christ i said well you should behave this way 13:04 okay so i want to behave this way but then i'm walking through the mall and i see somebody that i immediately just 13:10 want to go slap i have a visceral sense of antagonism to this person i don't 13:16 know where it came from i just feel it that primitive part of me wants to go punch me in the nose when i recognize that the christian part 13:23 of me or the the integrity part of me is saying wait a minute a good christian 13:28 wouldn't have those feelings you wouldn't respond to those people what the hell is wrong with you you're a sick person so then i'm in conflict 13:36 internally between the person i'm now seeing myself to be and the idealized person that i would wish to be 13:43 so what i try to explain to my friend is i make a distinction between feeling remorse if i did or didn't do something 13:50 i drive down the highway and these people are standing on the side of the road with homeless signs and little children a woman a man and a couple 13:57 little children and i think i can't believe that the city hasn't run 14:02 them off they're interrupting traffic it's dangerous they shouldn't be there then i drive half a mile on i think what 14:07 if they're really homeless well if those little kids are hungry you got some money you could have given them what's wrong with you you're not a 14:13 good person so i get caught up in those conflicts so then i ask myself who do you choose to 14:19 be do you choose to be a person who tries to help the downtrodden if so 14:25 how do you do that do you support a food pantry do you 14:31 support a homeless shelter do you physically go down and cook meal i mean what do you do to say well i'm helping 14:38 and then can you discriminate between that and passing somebody on the highway with a 14:44 homeless son as as a matter of personal choice so we get into the shoots and what i told 14:50 my friend is the way i try to distinguish this with clients who are suffering from this 14:55 is can you make a distinction between the have two shoulds and the chooser shoots the behavior may be the same the 15:01 visible behavior i'm going to put twenty dollars in a pot somewhere the have to should 15:07 if i listen to that and i do it i'm go the way the way i'll know i'm going to 15:12 feel resentful and angry the choose to should i'm going to feel good about it because my superhero will 15:18 come in and give me an atta boy oh you did the right thing you did what we wanted to do so i try to make the distinction between 15:24 the have two shoulds and the choose to show but so then the only way that you can know the difference between the have two shoulds and the choose two shoulds 15:31 is to find this clear clarity absolutely which brings us back full circle so i 15:36 want to go back though and ask you a question about why i was listening to this well actually let's go to our break and 15:42 then we'll come back and i'm going to ask you a question hey brett if you were going to 15:48 tell somebody to check out something on the internet to 15:53 help them with their mental health what would you tell them i tell them listen to psych with mike why would you tell 15:58 them that because it's probably one of the most easily listenable experiences you can have that 16:05 will give you information that's useful for a whole spectrum of concerns that 16:10 people have i agree and i have actually been told that 16:16 by at least a dozen people several of whom were not married to me and some of 16:22 them didn't even know me that's amazing that is amazing it's when when we get 16:27 that kind of feedback from people it is so incredibly 16:32 humbling and overwhelming for me it is for both of us yeah so we really 16:38 appreciate it and as always if it's friday it's side with mike [Music] 16:44 okay we're back and and so the question that i wanted to ask you is so do you conceptualize guilt as an 16:53 external message and remorse as an internal message no uh i conceptualize guilt as an 17:00 indoctrinated message okay so but that's what i mean the the the the it's coming from outside the message is coming from 17:06 outside originally yeah but i've internalized sure sure yeah yeah okay yeah but but remorse has to 17:12 come from inside right for my own developed sense of integrity the person that to be the husband that i want to be 17:19 requires me to behave this way and not behave that way so even though 17:25 the primitive me may want to behave that way right the chosen me 17:30 shouldn't it's a should is it a have to should is it coming from my religious training as a child or is 17:37 it a choose to should come into my sense of grown-up integrity i walk this path because i choose to walk this path it 17:43 makes me feel better about me so would you would you say that remorse yes is more a function of clarity yes 17:51 yes okay because i think that's really helpful when thinking about you know 17:56 we've all treated individuals who are sexual abuse surprisers right and we've 18:02 always had and we've had we've talked about this multiple times you come to thanksgiving i got to go to belong to 18:08 you belongs to the perpetrator and but i think that that's a great way to be able to present that to the 18:15 client to say you feel guilty but do you feel remorse so that's what you have to do you have to break up the script that 18:21 they've internalized and offer them the option to write a new one right because if you feel guilty 18:28 then that's pressure that's coming from you from outside from other members well the rest of the family still wants to 18:34 keep the imagery in place and so they're going to be really devastated if you out uncle joe at thanksgiving dinner you 18:41 ruined our thanksgiving right and so if i say to the client let's not focus on your guilt let's 18:48 focus on your remorse where's your remorse comfort my remorse comes from that i couldn't protect that little girl 18:54 my remorse comes from that my other people in my family didn't protect that little girl and so that wouldn't be 19:00 remorse that would be anger oh well i mean it could be yeah i mean if if johnny didn't protect 19:07 susie i don't own any of that it's regret okay it's really rewarding okay okay yeah yeah yeah yeah yeah yeah i 19:13 think is that they're both rooted they both gain power through shame yes both guilt and remorse and 19:20 even regret all three gain their power through an unspoken shame yeah but who's right but where's the shame 19:26 coming from is it coming from an external message or is it coming from an internal message a whole personal integrity so that's the conversation i 19:32 want to have with the client what is your sense of integrity not my 19:38 judgment not my external observation saying good girl bad girl but what do you see when you look in the mirror what 19:43 do you hear in your head and i think that's what jung was suggesting in the 19:48 article about clarity of self-awareness self-perception uh 19:54 self-examination michael you were gonna say something no okay so so uh uh 20:04 have you ever used that terminology though in therapy i would like for you to have more clarity 20:11 no yeah i haven't either no um have you ever conceptualized it that way in a way 20:17 that you were aware of i don't know okay because i think i do 20:24 that i think i do and i don't know that i ever used the word clarity but it is 20:31 i tend to be fairly socratic and you know there's a whole 20:38 controversy in psych how should you be so should you teach in therapy or should you let the 20:44 client come to their own conclusions and i tend to be more socratic and that's 20:50 just how i am and so i know that about myself but i want people to genuinely come to an 20:58 understanding of themselves not one that i've 21:03 given them or projected on to them but one that they internally believe is true because i don't think you can make 21:10 accurate choices about your behavior and how you want to be if you don't understand that so what 21:16 i try to talk about a teaching moment what i try to do is teach a client that 21:21 words matter and that it's really important if we can get to the manifestation of the script that 21:26 they hear in their head what are the words that you hear with my friend what she was saying is i hear should 21:34 and so i said could you work on changing every time you hear [ __ ] in your head 21:39 stop and say will or won't i should take my friend to dinner 21:45 stop and say i will take my friend to dinner this week or i won't take my friend to dinner this week and let that 21:51 go and re-script the words you hear in your head because i believe if the script is 21:58 rewritten the message changes we find that there's a powerful effect 22:03 um this reminds me a lot of uh danny kahneman again right uh danny kahneman and amos tversky have this whole idea of 22:10 framing as a language frame yes right and they would say people are much more effective at quitting smoking if they 22:16 say oh i'm not a person who smokes right right or i'm not smoking today right yeah you 22:23 say you if you pull that into your identity as a person uh it was much more powerful 22:31 so if you okay so then that's a choose to sure so so we're focusing on this idea 22:40 of clarity when we're we're connecting it to those choose to shoulds 22:46 well the clarity comes as young says the clarity comes from self-examination and self-reflection 22:51 so when you can examine this the language of the script 22:57 then you can edit it to your liking right okay so now 23:03 this is kind of blowing my mind but okay so uh one of the things that that we 23:10 struggle with in therapy all the time is the client who is struggling to be able 23:17 to conceptualize themselves as a good person or a bad person so 23:22 using what we're talking about here how how do we apply that to help the 23:29 client with that kind of struggle 23:36 do you understand what i'm saying i think so i think my approach to that would just simply be to ask them for more clarity 23:44 definition of how they experienced them as bad how they experienced themselves as being 23:50 bad and unworthy and so what they will tell you is they've had this behavior that behavior or they'll tell you that 23:57 their church says they should do this that the shoulds from other message points and then you start to take those one at 24:03 a time just examine them where does it come from is that yours do you own that or somebody hand you that well i think 24:09 that coming from you know the the old albert ellis kind of rational emotive therapy 24:14 you know messaging unconscious self-talk uh that a lot of what i see 24:22 as the affliction of our society in in western culture is 24:29 unworthiness unlovableness that people are carrying from those pre-verbal years 24:36 and that we go go back to we were talking in a previous episode about the 24:42 unthought known that we've learned from michael garanzini and that that is one of those 24:48 really profound deeply rooted unthought knowns i am unlovable and that you know 24:57 looking at this idea of clarity what i would say to that client is what makes you 25:03 unlovable is this a message that you've internalized from your environment 25:10 if you really believe that about you what is it about you that you think 25:16 so the way i understand guaranteeing you used that in connection with something called attachment theory 25:24 your ability to have attachments to make relationships to be connected um 25:30 a lot of the pain that people experience and the dysfunction that they experience comes from their feeling of 25:36 not being securely attached not being safely attached 25:43 and so you have to spend enough time to get to that messaging 25:49 what did you hear and learn about your worthiness to be 25:54 attached about your expectation that you will be abandoned right uh cast out 25:59 because you're unacceptable and that didn't come into your head the incident that you 26:05 were born right as a tabula raza blank tablet that was written by someone on the wall 26:12 you know like the biblical message about the finger of god writing a message on the wall somebody wrote that on your wall can we 26:19 examine it can we possibly edit it and if we can 26:24 what does that suggest to you right about relationships about self-acceptance about self-worth 26:31 because if you got a message from your family of origin from your primary so i 26:37 think this is what i believe is that you are born into a family that this family 26:42 demonstrates appropriate emotional regulation to you you internalize that 26:48 if that message of a regulation but the the the effectiveness of that 26:53 internalized process is really based on the extent to which you feel secure and attached and so when you don't have good 27:01 secure attachment in those early years it's going to be really really difficult to develop effective emotional 27:07 regulation later in life and so then now you're an adult coming to my office 27:12 telling me that you don't feel loved and what i'm wanting to say to that person 27:18 is where is that coming from if we look at if we go through a process of 27:24 delineation to try and figure out clearly where that message comes from from 27:30 inside you where do you see yourself being unlovable and and you know clients will 27:36 always have examples well you know this person says the messages they were yeah they're exactly 27:42 i was just going to say i saw this movie once yeah yeah they're they're but they're all messages it's not an actual 27:49 real intrinsically felt kind of thing and so then when we get to the heart of that and and we we 27:56 say okay this sense of unlovableness isn't coming intrinsically from you 28:04 then i think that it comes back to what michael's talking about with this identity internalization if that's not really 28:10 your identity are you willing to now challenge that and reject this idea of 28:16 unlovableness in favor of some identity structure that's more congruent with 28:22 what you truly see about yourself i think for me that is that is the the 28:28 core of this idea of clarity it's the theory is that clarity is the 28:34 groundwork earlier you mentioned is should the goal of should one of the goals of therapy 28:40 be getting a client to know themselves and we said ultimately it depends on what what are 28:46 the goals of this particular client but that has to leave me wondering can you do 28:53 work with a client without that level of clarity i think you do have to reach a certain point of clarity with a client 28:59 either understanding the messages that they're receiving understanding um the dialogue within themselves 29:05 understanding the propensities within themselves um and then additionally finally their convictions right so 29:11 that's a great question michael my experience the presenting problem that brings 29:16 somebody to therapy is almost never the underlying problem that's causing real difficulty in their life 29:22 but if you don't appear to address the presenting problem and make progress with the presenting problem you'll never 29:28 get the opportunity to go beneath that so it is a dance that again the therapist is challenged 29:35 to track at a existential level and at a superficial 29:41 level to keep the client secure 29:46 and uh wanting to come back feel good about 29:51 what they're getting out of coming to therapy and it's a real challenge sometimes and 29:57 you know the the idea of clarity is a spectrum right and so if you're doing 30:02 cognitive behavior therapy somebody comes in and says i'm always late to work so we're going to do cognitive behavior therapy to identify why it is 30:10 that you're always late to work and you know we identify all of these unconscious self-talk messages you know 30:18 like oh i have more time or i you know i i need to eat a good breakfast all these things and then we we you know modify 30:26 those so that you're more on time that really isn't getting to oh i was 30:33 unloved as a child but it is getting to a level of clarity that is dealing with 30:39 that very specific symptomology presentation so yes we always are going 30:44 to be working on clarity because there's just no other way to be able to do therapy you can't 30:51 get change if you don't work on that process of clarity but my question is 30:58 you know are we and i don't want to say disservice because it always does always have to be 31:03 with the client but for me psychotherapy is good really really foundational 31:09 psychotherapy is a deeper process that does get to that point of cathexis at 31:15 least for me that's at least a part of my goal now i'm not going to force that on a client that doesn't want to go 31:21 there but i am always looking for the avenues for 31:27 what helps me to clinically understand that 31:32 individuals process that that that process of catheters more what are you laughing 31:38 about i'm sorry i when you said i'm not going to force that on the client i flashed i remember 31:43 one time working with a family the mother had lost her cool because she had gotten up 31:49 at four o'clock in the morning taking these three kids to six flags and she wanted to ride a particular ride 31:55 that they didn't want to ride and she lost it and went in this whole diatribe about i got up at four o'clock in the 32:02 morning i drove several hours to get here you're going to write every right out here and you're goddamn going to have fun 32:09 so that's where i flashed when he said i'm not going to push that on my client here's your interpretation of reality that i insist you had what you wanted 32:15 was the recognition you wanted yes you did that's awesome yeah did i get that did they ride the ride 32:22 yes and they cried the whole time nobody had fun 32:27 all right that sounds like a good place to uh leave it for today we would really love it if you would go 32:34 to the youtubes and find psych with mike and subscribe to the show there you can also go on to the 32:41 apple podcast site and find psych with mike and leave us a comment and a rating that always helps people find the show 32:47 and we really appreciate that as always the music that appears inside with mike is written and performed by mr benjamin 32:53 the clue and if it's friday it's cycling

 

How our bodies experience and process stress and anxiety are important considerations when examining situations like police shootings. It is also important for therapists to understand when working with clients who have experienced trauma. 

 

https://www.verywellmind.com/general-adaptation-syndrome-gad-definition-signs-causes-management-5213817

 

Transcript:

you're listening to psych with mike for more episodes or to connect with the show with comments ideas or to be a 0:06 guest go to www.cyclicmike.com follow the show on twitter at psych with 0:13 mike or like the facebook page at psych with mike now here's psych with mike 0:20 welcome into the psych with mike library this is dr michael mahon and i am here with intern michael and mr brett newcomb 0:27 what's this how you doing everybody i i you know we i did this again i did it 0:32 again i'm so used to there only being two people in the studio that when we have more i don't know what to say so 0:41 i apologize how are you gentlemen doing good somebody has to be in charge yeah as 0:47 well be one of us might as well yeah yeah so who's got gas 0:53 um i don't know i can't go [Laughter] 1:00 yeah so uh i wanted to talk about something i don't 1:06 know um how familiar that the two of you were with the 1:12 general adaptive syndrome before i sent the article did were you 1:17 guys you know to me again and especially after having read the article which i thought was fine 1:23 it's just a rehash and restatement of old thoughts under a new name 1:28 well i mean sally who who started this work i mean this was back in the 1940s so so i mean this was 1:37 a work that i don't that i think gets less 1:42 talked about and you're right people repackage it but the reason 1:48 why i wanted to talk about this today is actually twofold number one is that the 1:54 general adaptive syndrome is a very good biological explanation of how we 2:00 experience stress and or anxiety certain types of that but number two is 2:06 that we've seen so many examples of police shootings and 2:12 all of these things that are going on and one of the things that i don't hear being talked about and i want to say up 2:18 front that i am not condoning shooting an unarmed man i'm not condoning police 2:24 brutality none of these things are right and appropriate they should be investigated they should be stopped 2:31 but what i am saying is that if we look at the general adaptive syndrome there are 2:37 things biologically that are going on in the body of a human being that we can't expect to be turned off 2:44 just because something changes in three seconds and so that needs to be a 2:52 part of what we look at we need to look at the biology of the human being and 2:57 talk about how do we incorporate that into the training that we are giving 3:04 these individuals and so then the second part of it for me is 3:09 because when i worked at the eap we had the st louis police department 3:16 contract and so whenever there was a police shooting we would have to 3:22 do therapy with these gentlemen to get them back on to their job and for 3:29 therapists who are working with individuals in whatever capacity whether they're first 3:35 responders they're they're riding the ambulance whether they're going on to the you know responding to fires or 3:42 responding in police matters this is something that therapists need 3:48 to be aware of this is the biological process that's happening in the human 3:53 person and so then when you are debriefing them that needs to be something that you are cognizant of 4:02 i think there are two parts to this right one one is that in in situations 4:07 of shooting people can go through all five stages of general adaptive syndrome right you're allowed 4:14 to get to the exhaustive syndrome um where i see a lot of popularity in 4:20 culture and in academia right now is work by robert zapolsky where he's talking about human beings 4:28 not being allowed to get into that exhaustion syndrome so they do further damage to their bodies he calls it 4:34 speciocentric or speciesocentric uh stressors and this idea that only 4:40 human beings can can cognitively place themselves under such stress that it it 4:46 uh has a negative cortical response oh i think that's 4:51 interesting to consider you're absolutely right when it comes to law enforcement officers as well um that 4:58 there are uh different psychologies and different biological underlyings for those psychologies uh in high stress 5:05 situations um one idea that comes to mind just the contagious shooter syndrome 5:12 um the fact that other officers are much more likely to shoot if they're in one shot by an officer 5:17 so how do we how do we make people aware of that bias training with with law enforcement and 5:23 the criminal justice system and progress forward i think we should go with the barney fife 5:29 solution you only get one bullet 5:34 no i'm just joking so what's going on brad what are you what i'm just thinking about the things you're saying and 5:41 i have incredible sympathy for a police officer in a high-risk situation like a 5:48 high-speed chase in traffic where gunshots are fired somewhere by somebody 5:54 and you ultimately go through whatever you have to go through to get the car stopped and 6:01 the guy gets out of the car and he runs away and you're adrenalized to the max 6:06 because you've been driving high speed through traffic with potential gunshots worry about somebody that you care about 6:13 or know getting harmed or shot or killed or what have you and worry about yourself am i going home today you know 6:19 i got to do this job am i going home today and then you get somebody who is 6:25 running away or you get somebody that's giving you lip or attitude when you stop them and all of your 6:31 human impulses try to break through whatever training you've had and then i'm concerned about 6:38 small town cops in america who don't get good training or don't get any training they get a gun and a badge and they're 6:45 told okay go get them and they have whatever biases and prejudices and 6:51 ignorance they bring to the job in addition to a sense of responsibility and a need for courage it's an 6:56 impossible situation right so in some respects it sounds like us just talking into the wind about ethereal 7:03 intellectual concepts it's a real world crisis that we need to have 7:10 a way to explain so that police officers can embrace the concept 7:15 right that there's something worth obtaining right uh like debriefing therapy talking people 7:22 that that aren't on the job but expecting that those people can 7:28 understand you and respect you and might be able to help you right then the flip side of that is the guy 7:35 who's in the car running away you know what what are his uh adrenal responses what's he going 7:41 through if i'm a black man and i'm being chased by a policeman i'm thinking there's a 70 chance i'm not going to 7:47 survive right so what does that do to my body my attitude that's my response so it's a it's a really complex and you've 7:54 hit on exactly the point that i wanted to make with this whole topic and that 8:00 is that both individuals are experiencing exactly this kind of physiological 8:07 response and you know i want to say up front i believe in systemic racism i'm 8:13 not trying to say that there aren't biases on both sides of this equation what i'm trying to say 8:20 is instead of talking about oh people are bad and trying to keep other people 8:25 down let's talk about what is the biology of what's going on here how do we use that to inform us to be able to 8:33 do things differently inform us but not limit us yeah i mean like the young man that was killed last week 8:40 did all the stupid things that he could possibly do to ensure his death i mean he put on a ski mask as he broke from a 8:47 car and ran away from police and contagion effect he was shot 60 8:54 times offering no threat no immediate in the moment threat to the officers he may 8:59 have offered threat in terms of driving recklessly trying to escape driving dangerously what have you 9:05 adrenalizing them in their response how much of their response is power syndrome 9:10 yeah i'm a white man with a gun i'm in charge how dare you uh challenge that authority and the 9:16 psychology from the victim side i mean i understand that he's running from the cups because he knows he's got a 70 9:23 chance of not going home tonight yeah he probably put on the ski mask not you know because he's now trying to be a 9:28 criminal we don't know but he just got stupid whatever well because if he he's probably thinking okay i gotta you know 9:35 protect my identity from the cctv and all these cameras right and so if i so then this is a stolen car 9:42 i don't know and then they found a gun in it was it a spare drop gun or was it the gun that supposedly was fired from 9:47 the car or was there even shots fired from the car we don't know right supposedly this is so 9:52 and this is the that's exactly the point that got me thinking about this is 9:58 you know whether there were shots fired from the car or not what i believe is that the policemen 10:05 that state that they saw shots fired from the car believe that statement and 10:11 they will pass lie detector tests in their perception of reality they believed that that happened and that 10:17 contributed to their actions but i also think as a more fundamental concern 10:24 men and i don't know about women men who are drawn to 10:30 police officer work especially in the south especially in 10:36 rural communities tend to be more macho dominant and if you challenge 10:41 their machismo they want to physically beat you into submission they want to 10:46 take you and make you surrender and break you if they can my father was one 10:52 of those he was a cop after world war ii he was a very violent man at home and away from home and whenever 10:59 somebody challenged him he wanted to break them down and beat him and or shoot him or whatever 11:04 uh and i know that he i don't know but i wonder was he representative of a 11:11 group and can we do something about our selection process that hires these individuals and and go ahead you guys 11:19 i think you're there's an exhibition of a a response 11:25 mode here right you're saying that these individuals are experiencing a low feeling of control and a low feeling of 11:32 predictability so that really puts them in high stress panic absolutely so how can we 11:37 as as therapists or as psychologists as clinicians train 11:43 police officers that one right their primary job is crisis response and then 11:49 the first three steps of that of crisis response are response to itself so getting more information containment of 11:56 the situation and de-escalation of the situation so they have to be trained to de-escalate the situation they may also 12:02 have to be trained to de-escalate themselves right and yes and that's the part the the self-soothing and the kind 12:10 of every cop anywhere knows that the single most dangerous call is a domestic call 12:15 right so how do we move them we can't really change the predictability of the situation any of these situations are 12:21 going to be low predictability but maybe we can change the level of control uh 12:26 law enforcement feels over their situation so we move them out of panic and into defense mode 12:32 well another good example last week's fourth of july parade when the cops caught that guy they 12:38 asked him to please kneel on the ground and he did now he wasn't physically resisting at that point 12:44 but those guys were trained differently than what i've seen before they just blow him away then jump on top of him and punch 12:51 him and tase him and and beat him uh they didn't kneel on his neck but was that really because he was a white 12:57 girl i mean we don't know that sick uh and was it because he adopted a 13:03 submissive attitude right from the minute they stopped it yeah yeah so you know but when we talk about the idea 13:10 of solutions to me there are two uh real qualities to that that i'm not 13:16 sure we have any control over the first one is that we have to start to think in 13:22 our society about what are the things that we believe are truly important 13:28 right should you be making billions of dollars literally billions of dollars a year as a hedge fund manager when a 13:34 policeman is making thirty two thousand dollars a year and if we increase the 13:40 amount of money that we invest in those social goods do we then draw from a 13:46 larger pool of qualified individuals so in the last 15 years the federal 13:51 government as well i don't know i correlate to time frames 13:56 but one of the things that they have done is arm local police departments with military caliber weapons 14:04 tanks anti-personnel machines uh riot control machines 14:11 and you know there's the law of the hammer and you you know the law of the hammer if you give a three-year-old a hammer 14:16 everything is a nail right and so they have this equipment they want to use it and they want to they want to have a 14:22 swat team you've aldi had a swat team swat team doing respond right well 14:29 didn't show up the guy that was there only part-time that that was there and had the bead on the perpetrator was 14:36 waiting for right approval that he never got yeah and so then missed the shot right uh so you're now you're hitting on 14:42 my second point which is we have to have some kind of 14:48 realistic conversation about the proliferation 14:53 well so let me come back and finish my thought well because you know about funding yeah uh 14:59 funding individuals so paying them more money paying individuals more money yes not giving departments more money to 15:04 spend on fun toys and gadgets uh the ability to track your cell phone the ability to break the encryption all of 15:10 those kind of things cost money as well and that's where the money that we give police departments tends to be going 15:16 and to administrative level responses but in the city of st louis nine-minute 15:22 wait for an emergency call to be answered by the police department they have two separate systems one for police one for 15:28 fire which makes no sense at all so you got to call the right people and then you have to wait because they don't pay 15:34 the people answering the phone they haven't upgraded the computers they don't know what to to how to prioritize 15:41 and respond to the calls and so people are dying because they can't get an answer from a 9-1-1 call 15:48 so if you're talking about investing money or time i pay i mean what's the best use of the money pay those people 15:53 more salary more for training more for equipment it's that's what i'm saying we have to 16:00 have that conversation so your leadership is another question here why absolutely going to 16:06 they these toys are fun right these are fun toys encryption breaking tanks these 16:11 aren't toys um the very real toys with very real consequences um 16:18 what if we ran police departments like we run tech corporations where when we have an influx of money we 16:25 prioritize things that will garner responses so hang on let's let's take our break 16:31 and let's come back and pick that point up and then we'll garner a response right what helps 16:37 hey everybody dr michael mahon here from psych with mike and i couldn't be more excited to talk to you about athletic 16:43 greens which is a new sponsor we have here on the show i started taking athletic greens watching 16:50 some youtube videos and doing my own research i wanted to add something to my daily workout program to give me some 16:57 energy and to support gut health and that was the one thing that kept coming 17:02 up again and again with athletic greens is the guy who started the company did a bunch of research because he was 17:08 having some gut health issues that he couldn't get any resolution for he developed athletic greens and it's just 17:16 exploded from there so it's 75 superfoods vitamins minerals probiotics 17:22 whole foods sources that's all in one daily scoop you put it in eight or 12 17:28 ounces of water you shake it up and you drink it the taste is very very 17:33 drinkable i actually enjoy it and i have been using it and my energy 17:38 levels have just been through the roof i really like athletic greens because of 17:43 some of the sustainability things that they do so they buy carbon credits and 17:49 you know to help protect the rain forest which is something that i really like but if you order athletic greens in your 17:57 subscription you're gonna also get a year's supply of their vitamin d 18:02 supplementation and five free travel packs and that vitamin d is so important 18:09 during those winter months when we're not getting enough sunlight we've talked about how that decreases your mood and 18:16 increases depression and that can be a real deal changer so you go to 18:21 athleticgreens.com emerging that's athleticgreens.com 18:28 e-m-e-r-g-i-n-g that's the psych with mike promo and 18:33 you're going to get that additional vitamin d support for a year and five 18:38 free travel packs so take control of your own health today and as always if 18:44 it's friday it's psych with mike okay we're back so you were talking 18:50 about if we somehow created and whether it was an algorithm or not 18:57 but but some kind of checklist that graded the way in which the police were 19:03 delivering their their their services and we did that more like it was a privatized 19:09 institution would that create a different outcome well we do have a checklist of 19:16 a theoretical societal checklist requirements that we have for police officers and we and we are for police 19:23 departments and we enact that through through democratic voting vote for those people to put them into those positions 19:30 based off of a feeling of how good or bad they are performing 19:35 so i question whether or not that's an effective 19:41 method sometimes um is there a better way to do that can we 19:46 as a society hire better leaders and pay them more well how can we hire the ceo of a 19:52 criminal justice department yeah i mean larger cities do do that yeah for instance the chicago police department 19:57 does this um where they do bring in consultants from business and from industrial and organizational psychology 20:03 uh backgrounds to take a look at their police department and find where are my holes where can i 20:09 be using my funding so i i appreciate your thinking i don't know 20:14 that i agree with it and the comparative basis that i have for saying that is as a school teacher 20:20 every year my school district would hire expensive outside consultants to come in 20:26 and have faculty meetings for the district teachers all together and those 20:31 people tell us how to be better teachers how to better manage our classroom and i'm sitting out in the crowd and all the 20:37 people i'm sitting here are scoffing under their breath saying this is a complete waste of time i need to be in my room getting my bulletin boards ready 20:43 i need to be going over my student lists i need to be making lesson plans why am i listening to this bozo he's not in a 20:49 classroom in this district he doesn't know what i deal with and i think that police officers would 20:54 be similar you have been under fire you haven't been under fire my city right i don't know and then you have 21:01 within the context of the police officers in st louis you have the black police officers union the white police officers union the general police 21:08 officers union and then you have the administrative system 21:13 so and so my first point is if we had a different financial structure and we 21:21 actually invested in the things that we believed as a society were important i i'm a big advocate of that i know that 21:28 that's big that that's a heavy lift my second point is that if the police 21:33 had some way of being able to know if i see a gun that's a bad guy right 21:39 now you don't know that because the proliferation of guns is so ubiquitous 21:44 everybody gets to have a gun everybody gets to carry a gun openly and so now whenever the police show up they always 21:51 have to assume that there's a gun they always have to assume that that could be potentially used against them if we had 21:57 fewer guns if we had a real conversation about how we want guns to be seen or 22:04 used in our society we don't have a conversation the only conversation we have is you have a second amendment 22:09 right to have a gun and so we have no restrictions on it the only thing they say they say two things thoughts and prayers second amendment 22:16 um but there are some new things being done even in the st louis area 22:23 which involves sending trained mental health professionals mental 22:29 health professionals thank you on calls that 22:34 are potentially violent and having those people supported by an armed police officer but 22:40 not have an armed cop have to be the enemy to absolutely so you don't have the law of the hammer in operation as uh 22:47 efficiently uh as you historically have had yeah the other thing i love about this this new 22:53 initiative that st louis is really taking forward is the idea of involving community leaders in these calls as well 23:00 we're not only trying to send the right professional to the right call but we're also looking at church leaders or 23:07 neighborhood watch leaders or people who are in their community who know their people and who can effectively say yes 23:14 that person's a danger to themselves and others right now this is what they need they do need it they do need armed 23:20 police response or know that person is uh unhoused and mentally unwell they are 23:26 being a disturbance but they're not violent and maybe they just need a visit from a social worker absolutely and and 23:33 the police know now they're able to know where the concentration of danger is where the 23:39 concentration of gunfire shots and killings are in the community and so they know some 23:44 neighborhoods it's extremely rare and highly unlikely that that's what we're facing in other neighborhoods that's 23:50 almost exactly what we're going to be facing so if you get the right combination of public servants 23:55 who can do their jobs you have a better opportunity 24:01 but you still don't have you and i don't know that there is a universal answer but we take one step at a time and try 24:07 to so let's bring this for the time we got remaining let's let's bring this back to a 24:12 clinical discussion so when we have this particular police officer who is 24:18 involved in a shooting and he's got to be debriefed before he can be cleared to go back into service 24:25 what should the therapist be doing to address that man in that room or that 24:31 person i should say in that room first you have to evaluate the mental 24:36 state of the individual are they consenting to feedback at this point right are they okay well and that's 24:43 issues so that's a good point so if a person is in a position to not hear what 24:49 you're saying it doesn't matter what you say right well and as a clinician one of the things that you have heard 24:56 from clients is have you been through my experience were you sexually abused were you abused at all were you an alcoholic 25:03 uh have you ever been in prison then how can you advise me if you haven't had that experience you can't advise me 25:10 cops are gonna have the same reaction oh yeah oh i know because i've done it but uh uh uh you know and then people say 25:15 that all the time about substance abuse well if you've never abused a drug you haven't been raped yeah you can't you don't know and and what i say to people 25:23 is this you're correct i've never experienced what you experienced but what i know is 25:29 there are four primary human emotions that every human being has and i have those emotions i know how those emotions 25:36 get triggered i know what it feels like to be scary i hear that as an argument and i quit listening i don't want to 25:42 hear it okay i would want you to 25:48 defuse my hostility and if you rebut me that isn't defusing 25:54 me okay so how do you show empathy through that how do you how do you forward your empathy so that that 26:01 diffusion and that understanding can take place i think you use reflective listening i hear what you're saying you 26:07 think i don't know enough to be able to be helpful to you can you tell me more what would be helpful to you 26:14 if i did know enough what could i say i'm not challenging you i'm not 26:20 disagreeing with you i certainly confess that i've not been in that situation or walked in your shoes 26:26 but i want to know can you talk to me and you just get them to talk and as they do that windows open that's what 26:34 therapy is about that's how it works as those windows open i think those are your opportunities for training 26:39 absolutely we talk about um in crisis intervention and crisis response we talk about using 26:45 transactional analysis to look at different situations and and respond in different ways right can we 26:52 do open-ended questions can we um can we do minimal encouragements and 26:57 paraphrasing right absolutely all those things help and so much of it in a crisis especially is uh like blah blah 27:04 ginger it's just background noise conversation while you wait for a window to open and then when the window opens 27:10 you seize that moment for connection for tension reduction um and the 27:17 key term that i use is reflective listening if you feel like i hear you 27:24 and understand you you calm down and imagine if we 27:30 required police officers well what if we paid them more in two who required a four-year degree and part of that 27:35 four-year degree was was counseling or therapy i mean i think that that's 27:42 that's a of way to think about it but i'm not sure that i want my law 27:48 enforcement officers to be therapists i don't know that i mean because those are 27:53 two different specialties and i think there is a place for law enforcement and i think there is a place for therapy 28:00 that's why i like the idea of therapists working in conjunction with the police department because i 28:07 think those are two different things like i wouldn't want a therapist to get training as a police officer i don't 28:14 necessarily 28:20 i want there to be fewer guns not more guns but uh you know that that puts me in a 28:25 certain segment of the population i even saw that a republican politician in texas the other day was suggesting we 28:30 should arm students yeah well that's a good idea how young 28:36 i quit listening if they get their heritage card i was doing some confirmation bias research and i changed 28:41 channels yeah that's uh that seems like a recipe for disaster 28:47 but you know i need to be able to hear that person's point of view and 28:53 say i respectfully disagree and here's why one hopes yeah 28:58 so uh going back to this idea of the policemen in the room 29:05 my concern always was when i was working with law enforcement is that they are 29:13 very very resistant to the idea of self-care that they hear that as 29:21 a weakness as a personal failure they should be able to pull themselves up by their own bootstraps they should be able 29:27 to be stopped but you also don't acknowledge that police spend their days dealing 29:34 with the dregs of humanity the human condition is the most negative form 29:39 and that's poisonous and so over time not just in the moment of a crisis somebody 29:46 goes into a building where the shot's been fired and bodies laying on the ground but just 29:52 ordinary everyday moments you deal with corruption you deal with hostility you 29:57 deal with viciousness victimization wounded people of all kinds of wounds 30:03 and it poisons you if you don't have a way to get rid of that or reframe that 30:09 every day that you go to work so i think when we talk about counseling for police officers uh or 30:17 training i think part of the conceptualization of a training module involves 30:24 how do we prevent them from getting poisoned by 30:30 the negativity of humanity that they experience every day and they do that through self-care 30:35 that's the only way that you can do it you have to do something else to number 30:41 one detoxify yourself but number two then replace that with positive energy 30:47 that makes you feel recharged and rejuvenated and and i just i i'm in my 30:53 own personal experience that's that's a hard sell yeah yeah and and so you know 30:59 and and i want to say up front i have no idea what police officers go through on a daily basis i've never been a police 31:06 officer and so i don't have that experience but what i would be 31:11 interested in is if there are police officers who are listening to this is 31:16 for them to inform us what would they find beneficial to hear 31:22 from someone when they are in those debrief sessions or even if they just sought therapy on their own which is 31:28 rare but could happen what do what would what would be beneficial for them to hear 31:35 in that area of self-care what's what's language that would be less 31:42 cause them to put up then less likely to cause them to put up a wall more likely to be impactful and and and language 31:50 that they could hear in that realm of self-care because i don't know what it is because 31:55 i don't know what their life is like so i do what i what i normally do and i 32:00 don't know if that's effective great question so hopefully those musings were 32:07 beneficial for somebody out there um i thought we got a little bit passionate and fired up about it so i think we had 32:13 a good time but the music that appears in psych with mike is written and performed by mr benjamin the clue as 32:20 always we would love it if you would go to apple podcasts find psych with mike 32:26 and leave us a comment and a rating but mostly what we really like is for people 32:31 to go to the youtubes and subscribe to the channel there that's really really helpful so that's like with mike on 32:37 youtube and as always if it's friday it's psych with mike [Music]

 

Post Traumatic Stress Disorder (PTSD) is recognized as a significant issue that can affect people in everyday life. The sum total of small traumas can have the same biological effect as those experienced in combat. It is important for therapists and clients to understand the biology of this process to best help those dealing with this potentially debilitating issue. 

 

https://www.ptsduk.org/what-is-ptsd/the-science-and-biology-of-ptsd/

https://www.psychologytoday.com/us/blog/understanding-ptsd/202206/the-common-effects-complex-relational-trauma 

 

Transcript:

you're listening to psych with mike for more episodes or to connect with the show with comments ideas or to be a 0:06 guest go to www.cyclicmike.com follow the show on twitter at psych with 0:13 mike or like the facebook page at psych with mike now here's psych with mike 0:21 welcome into the site with mike library this is dr michael mahon and i am here again with intern michael and brett 0:26 newcomb once more dear friends into the fray that's what i i'm leaving into the breach into the breach yeah yeah 0:33 i hadn't started the quotation yet you you say that every time i never mind say that once 0:40 okay and then i say oh yeah you're a shakespeare guy and then you say no i'm not i'm not like oh yeah you always 0:46 quote shakespeare i'm a liar okay 0:54 all right so how's everybody doing today doing well um you 1:01 said some incredibly nice things about intern michael before 1:07 the mics were hot and you don't say those things to me and i'm jealous isn't that interesting isn't 1:13 that interesting i wonder why you're going to have so are you begging what do you want i think nicest not no 1:19 yes you are so 1:25 yeah i secure need those that's what it is i don't know i feel like i got a little post traumatic your wife has asked me to stop blowing smoke in your 1:31 direction you inhale too much of it your shirt looks nice today michael thank you 1:37 thank you i appreciate that so uh so speaking of ptsd speaking of 1:42 yeah um this is not your forte right 1:48 it's not a biology not this aspect right yeah um so you're gonna try and hang with it and see i'm waiting for clear 1:55 elucidation from michael yeah because i know all you'll do is build a clock well the reason why for me 2:03 the biology is important is because understanding the biology helps me to 2:10 understand the concept and i understand i get that that isn't everybody's cup of tea but i've had 2:17 clients who have said the reason that i come to you is because you understand the biology 2:23 really well and you are able to explain that and that's really meaningful and that's why uh i have always said you know there's 2:30 different therapists for different people not all therapists are going to be for everybody but 2:36 a person shouldn't assume that just because they go to one therapist and that wasn't for them that that means 2:43 that therapy doesn't work no i and i and i can conceptualize being able to get some 2:50 comfort from saying i'm really sorry about the way that i behaved when i lost my temper and 2:55 slapped you but it wasn't really me it was my amygdala i'm sure that will help her 3:01 that's not exactly what the article talks about oh it is exactly what the article talks 3:08 about it doesn't say that you say i'm sorry that i said no it doesn't say that it says you need to understand that your 3:14 amygdala is out of balance and that's why you have these reactions when your stress triggers are pulled well so 3:21 the idea here that i think is so important 3:27 for both clients but also for therapists to understand is that 3:33 instead of thinking about anxiety as a 3:39 thing what we really need to start doing as a i think as a community of helping 3:46 professionals is to start thinking about the difference between anxieties and 3:51 fear-based anxieties because the way in which those things operate in the brain 3:58 are vastly different okay 4:03 so i if i can paraphrase just a little bit yeah understanding of the biology can help 4:11 drive the therapeutic approach because fundamentally there are 4:17 different mechanics underlying what may appear to be the same consequence but isn't 4:23 necessarily the same concept exactly and and i don't hear this being talked about 4:28 a tremendous amount this is what i did my dissertation on and i don't hear this being talked about a tremendous amount 4:34 in psychology but i do believe that in the future we are going to see exactly 4:40 that distinction instead of talking about depression and anxiety as two 4:45 sides of the same coin i think we have to think about depression as a separate 4:50 entity anxiety as a separate entity but within anxiety the generalized anxiety 4:57 disorders and the fear-based anxiety disorders 5:02 okay okay so in a regular anxiety disorder so just the 5:08 kind of run-of-the-mill generalized anxiety disorder what i say is that those things operate on the concept of 5:16 cognitive dissonance so you have two conflicting thoughts that causes distress in the human brain trying to 5:23 resolve that is what creates the energy for anxiety that 5:28 most people feel so i want to go to the grocery store but i have agoraphobia 5:34 and i don't want to go to the grocery store so that conflicting thought is going to cause me a lot of anxiety 5:43 even easier for i worked with a lot of adolescent males that's typically what i 5:48 do and when an adolescent male comes in and says hey i want to ask this girl out but 5:55 he treats it as if it's a schrodinger experiment where he wants to ask her out but he's afraid of creating 6:02 the answer so he lives in this perpetual world of i could ask her out but i could 6:09 also you know then be uh what do you call it rejected and then 6:15 then you know that's scary so i don't ask her out now i'm living with both of those things potentially available to me 6:23 i could ask her out and or i could not ask her out and and that's what i think is generalized 6:28 anxiety so that operates on the same kind of top-down brain function where your the 6:36 the cortex of your brain operates on the information and then informs your limbic system whether or not there's a reason 6:41 to become excited and then if there is a reason to become excited then your adrenal gland tells or or your pituitary 6:49 gland tells what gland to distribute the hormones to start an emotional reaction 6:55 that's slow responsible yeah yes exactly so that's typically the way the brain works is top down in ptsd or in 7:02 fear-based anxieties that gets flipped on its head so that the immediate activation 7:09 of the brain are the fear-based response areas like the cerebellum like the 7:17 medulla oblongata and then that causes a fight-or-flight response to be initiated 7:24 over which the person has no rational control so an individual who's been in 7:31 combat and has seen horrible horrible things and then gets triggered by a car 7:37 back firing the response that gets activated in that person is not a 7:43 top-down response it's a bottom-up response and so in those fear-based anxieties the 7:50 way in which the individual is triggered is radically different and if you don't 7:56 appreciate that in therapy then you could be treating that 8:02 inaccurately and appropriately or ineffectively so that's my my 8:07 conceptualization in a nutshell so you're following me so far i think so okay do you agree with that 8:13 or yeah absolutely okay i don't have any trouble understanding the concept i have trouble understanding how to 8:18 apply it um in counseling clients which is my 8:23 primary frame of reference i also have 8:28 some issues and been able to sort out anxiety from depression because they're often 8:34 comorbid and if you in my experience if you deal with one of them if you can alleviate a level of 8:40 intensity for anxiety the depression explodes then you have to do that and you need to 8:46 tell the client this is likely to happen and when it does it doesn't mean what we're doing is not 8:52 working it doesn't mean that you're unable to change it means that's part of what's stuffed down inside you and we're 8:58 going to have to come to grips with yeah then you have taught me a lot 9:05 over the years about the biology of depression and the issues there 9:11 in terms of chemical responses and so on it's just really um 9:19 an incredibly complicated challenge to then say however much of that i understand 9:25 how do i apply what i understand to hearing the client accurately and being helpful to them and that's where i get 9:31 lost in this conversation so for me and and what i would say is 9:37 the extent to which an individual therapist understands or wants to understand 9:43 better the biology of these different disorders is whatever it is and and i'm not saying 9:50 that everybody has to be a neurobiologist but what i am saying is that specifically 9:55 in the venue of anxiety it is very very important to identify 10:01 whether you think the anxiety is just a generalized anxiety disorder or it's fear i see that 10:07 uh and i see the value of the merit and saying okay this is a 10:13 reflex driven fear anxiety that you'll see triggered in this way when a car back fires or when a door 10:19 slams a loud noise goes off so 10:25 if we know that you're susceptible to that can we take that piece out and work on it loud noises anticipating it 10:33 responding to it differently because you're conditioned by the trauma experience to have this response 10:39 immediately overwhelmingly then the generalized anxiety is is a different issue 10:45 that we want to approach differently is am i understanding what you're saying absolutely and and so then when we think about 10:52 individuals who have experienced childhood traumas right so for a person 10:58 who has been abused by a family member sometimes it's hearing the creaking of 11:04 the floorboards yeah there's some research that shows that that's imprinted on these children if it happens in an early enough age 11:10 and so their response to that almost as hardwired in your brain yeah but it is hardwired when i i think 11:17 you're asking the question how do i use this to guide my practice yeah uh and maybe one way that i'm seeing 11:24 uh as an opportunity here is to think of the brain as taking the path of least resistance with different experiences 11:32 so in the instance of ptsd right we're saying that we no longer have to involve 11:37 the the prefrontal medial cortex right we no longer have to involve this expensive 11:42 part of the brain to deal with the same reaction as a brain 11:48 that we would around certain events so car backfiring is gunshot 11:54 floor creaking is fear in a child right um for whatever abusive reason 12:01 maybe as a clinician understanding that that is the current path of least 12:06 resistance says exactly what you're saying already we need to take that out look at that as a part and find other 12:13 paths that work better because that's no longer serving okay right no longer 12:20 this is actually more resistant and i think that that really fits in very well with your idea of emotional 12:28 economics so is this old behavior too expensive yeah yeah 12:33 yeah and and would you like to try and investigate other avenues that helps i 12:39 mean i have to have a way to frame it i have to have a way to hear it and when i read these articles 12:44 that in what happens to me so i need a better 12:52 modulator no not not analogy so much as uh i need a better understanding of how 12:59 this is applicable as you were suggesting i think one of the places that uh i i am by no means an expert 13:06 right but one of the things that i see keep popping up um is bessel vander kulk's work 13:12 the body keeps the score um he's a medical doctor that's gone into this foray of of um 13:18 psychology really one of the trauma i mean trauma informed therapy is his whole deal exactly one of the foundational uh creators and 13:25 understanders of ptsd as a as a condition um and i really did like that book i think 13:32 that book does help frame an idea of why is some of the biology important or like 13:38 how can it drive my practice so i have met and talked with and read a 13:44 book by dr mark gordon who's a neurophysiologist and he does a lot of work on traumatic 13:51 brain injury for the military and much of that work is focused on what's his name 13:57 mark gordon and much of his work is focused on 14:03 the biochemical aspects of the brain and where the brain injury occurs and how 14:09 the system adapts and responds and what needs to be rebalanced 14:14 biochemically so that you can then do other things it's a it's a whole area that i don't know 14:21 enough about to talk about or do work with but i think it's in line with what we're discussing i think it 14:28 comes back to some of the philosophies that i have around psychiatry right psychiatry is 14:34 a medically assisted therapy overall right it's drug assisted therapy but 14:39 overall the point is still the therapy right i would hope 14:44 we know that a lot of the time uh antidepressants or anti-anxiety or even 14:50 things like antipsychotics aren't as effective as they could be they they're they have 14:56 a five percent difference in the overall efficacy without therapy included 15:03 so i look at understanding the biology as just another tool to help assist this idea of getting 15:09 somebody back to a place of security and getting somebody back to a place of um being in control of what they want 15:16 exactly okay so let's take our break and when we come back i'm going to ask you a question brett all right 15:23 well one of the reasons that i want to participate in this show is because it gives me an opportunity 15:29 to clinically review my understanding of what therapy is and 15:34 how it works especially for the consumer so my hope is that we will find 15:41 conversations that broaden my understanding of that and my hope is that we do that in a way 15:49 that is useful but also entertaining for people so that they want to listen 15:56 not only because they're getting good psychology information but because they 16:01 just enjoy the show easy listening with an informational twist 16:06 that's a new tagline they're not sitting there going huh easy listening with an informational twist i'm really good at 16:12 this i'm a professional you're a professional if it's friday it's psycho 16:18 okay we're back and so uh does the idea or the the language of the 16:24 emotional economics does that make that the the what what yeah that all makes 16:29 more sense to me that's the language i can hear yeah i get bogged down in the analysis of the prefrontal cortex and 16:36 the amygdala and all that that to me is not a language i'm comfortable 16:41 and you make a great point though that that therapists who are doing therapy to the extent that they're not comfortable 16:47 with that then they're not going to hear that message all i'm talking about is the first thing you got to do when 16:53 you're dealing with an anxiety is to identify whether or not it's generalized anxiety or fear-based anxiety and then 16:59 and the most obvious way for you to know that is what well for me what i would say is 17:05 whether or not you think that the anxiety is based on cognitive dissonance 17:11 so is it is it what i'm hearing is if it's a global reflexive response boom 17:17 yes then that's on the floor ptsd yeah yeah uh yeah and so when i'm talking about kind of 17:23 distance you know do you see the anxiety as based on two conflicting thoughts 17:28 that the individual is trying to harbor give me an example 17:34 so uh uh i want to ask a girl out but i'm afraid to ask her out okay so that's not you know that's not 17:40 interesting anxiety okay yeah that's generalized anxiety and then you know i'm i hear the floor creek and i'm 17:48 terrible that's like albert ellis with rational emotive therapy uh the experiment that he offered you 17:54 know a guy that claimed i could never have sex with him and he said i want you to stand on the street and ask the first 100 women that 18:00 walk by if you can you have sex with me and you'll get slapped you'll get rejected 18:06 the police may be called but you know four out of 100 they'll say sure let's go and you're not going to know whether 18:12 it's real or not unless you do it mm-hmm so he would give people assignments like that 18:18 which you couldn't do today but well you can't really well yeah yeah 18:23 you have to deal with the clarification anticipatory set right right so uh 18:29 in my view then if you are if you've identified that you are dealing 18:36 primarily with a post-traumatic stress disorder then the first thing that you 18:41 have to do is to try and find some way into that because 18:48 what you have to recognize is that a lot of the techniques that we use in therapy 18:54 are directed at talking to the person's cortex you got to have rational thought 19:00 so cbt is an approach that's often recommended for post-traumatic stress yeah may not 19:06 be as effective because that's not really the right part of the brain yeah you're not talking about exactly exactly 19:12 so then we get things like emdr emdr here's where we start to move into let's get out of the head and start 19:19 feeling the feelings we we're having a good conversation about this earlier yeah well and feel those feelings 19:26 and you don't understand those feelings and find a way to redirect that energy 19:34 but i also think that that brett's idea of emotional economics when he talks 19:39 about that what i hear and i don't know if this is what you intend but 19:45 what i hear is that that's affective aff ect emotion-based therapy that's not 19:52 cognitive behavioral therapy when you're talking about emotional economics that is the way to approach the 19:59 post-traumatic stress disorder when we're talking about it's an activation of those baser areas of the brain you're 20:06 not going to approach that by talking to somebody's cortex you're going to approach that by talking to their limbic 20:12 system to their emotions so we're back to what does the therapist need to know in 20:17 order to do what they're doing and how much of that is even relevant for the client to know so if i'm talking to you about emotional 20:24 economics i'm not going to have this more extended exactly you don't have to now yeah i would i know you know but for 20:31 me that's a waste of time i know okay and well i think part of that conversation is valuable right in in 20:37 behavioral economics and emotional economics we talk about the idea that people have biases and those biases 20:42 aren't necessarily rational right and maybe we stare away from the word rational it's also a 20:48 message of power there's an empowerment if i say to you okay you could choose to behave differently 20:54 if you wanted to and if you could afford it you know i could choose to drive a corvette 21:00 but do i want to can i afford it uh what would i do i want you to fight can i afford it yeah what am i willing 21:06 to give to have one so that allows you a weigh-in 21:11 that isn't a direct challenge that they can rebut or refuse to hear 21:17 because you come up with an example or they come up with an example of some behavioral choice driven by cost 21:27 and you know so for me i don't really it doesn't bother me whether the therapist 21:33 talks about the biology or talks about emotional economics as long as they understand that when i am looking at 21:40 this presentation trying to do regular cbt is probably not 21:46 going to be as effective because that's not the area of the brain that this person is operating out of and i think 21:52 that the ubiquity of cbt and now we're talking more and more about trauma and i 21:58 think that there's going to be less effectiveness of that 22:04 of those treatment outcomes because that's not the area of the brain that that person's operating in yeah that 22:10 makes sense ultimately the goal is to move someone from that external locus of control to 22:15 that internal locus of control yeah with cbt emotional economics they're all saying the same thing right of 22:22 i'm putting the power back in your hands to make a choice of this thing which is one of the goals we have when we talk 22:28 about increasing your level of your sense of security if you have the power and the autonomy to make the choices if 22:34 you're free to choose you can freely choose to behave differently and i think that that's the goal so the internal 22:41 locus of control as opposed to the external locus of control is the goal but that's a rational concept so 22:49 initially that person may not be thinking in that area of the brain and 22:54 so you you that may be the goal for the therapist right but that isn't the way you go in to the therapy so the way you 23:02 go into the therapy is through that affective aff ect the the emotional 23:08 economic way however that makes sense to you as a therapist but you have to apply 23:13 some kind of effective therapy so not ptsd per se 23:20 but i had an adolescent male client that was on the autism spectrum and he was really in trouble a lot 23:26 because he would decompensate and act out because kids bullied him and picked on and what have you 23:32 uh and i had to work with the school the teacher the family and the student to 23:38 say is there a way we can get a handle on this and achieve different outcomes 23:44 and it wasn't useful at all to understand or explain where why how is he autistic 23:53 what makes that happen it was more useful we found that to say 23:58 can we find a way to characterize this for him where he can 24:04 feel a sense of power and where he can choose from that power to make different 24:10 choices and so i was able to ask him i said do you want to be popular do you want to be 24:16 liked and he was like yeah i said you have any idea why people don't like you no 24:22 i said well you're a snot sucker you make these horrible noises all the time and people react negatively to it 24:29 and you don't even see it you don't even notice it you just do what you do and i had to work with the teacher on 24:35 like a red card or a yellow card whenever he would suck snot and she could hold it up and he would 24:42 consciously learn to recognize after the fact oh i did that 24:47 and then we worked on could you do something instead like burn your nose is this just a reflexive habituated 24:54 behavior or is there some do you know we need to go to an ent and find something to deal with this which isn't going to 25:01 change the autism spectrum but it can change your acceptability level right and your 25:07 intensity level to maybe a better place sure and and what i would say is that that is an 25:13 example of behavior modification right which is a different 25:19 kind of therapy that we haven't talked about but but at least in this show 25:24 but the initial way you went in was through emotional economics yeah so you 25:31 didn't you didn't start with the behavior modification you started with the presentation of the emotion 25:37 life sucks and you're screwed right you know it it helps to say we can do something with this if you'll work with 25:43 me and if your system will tolerate it yeah and and it goes back to the what michael was talking about when you were 25:50 moving him from an external locus of control to an internal locus of control and all of those things are i mean those 25:57 are the goals of therapy but if you are talking to a part of the brain that 26:03 isn't being triggered it's going to be less effective i'm not saying that no one ever got help through cognitive 26:10 before post-traumatic stress through cognitive behavior therapy but i'm saying that if you think about what the 26:16 biology is my sense my my understanding of human 26:22 pathology tells me to be informed by what i think is the biology and then use 26:30 that to help me to devise a treatment plan that i think is going to be most effective efficient effective economical 26:38 sure yeah then i think further about um other types of therapy modality uh like 26:43 drug assisted therapy so if we look at things like psilocybin assisted therapy or ketamine assisted therapy these are 26:49 really getting a lot of attention right now in the ptsd community and understanding that 26:55 neurobiology and the neurobiological effects of the different drugs what are those pharmacodynamics of those 27:02 different drugs um we can build are you better tool kit are you asking or is that rhetorical it's 27:08 rhetorical okay because you go into 30 minutes 27:13 no i took your addiction and treatment yeah yes and and you know and and i'm not saying that that isn't 27:21 going to be a breakthrough i think that especially for me you know when you're talking about the 27:27 medically assisted treatments for anxiety or for post-traumatic stress 27:32 i think psilocybin is a is a is a more effective molecule than the ketamine i 27:37 agree but uh but there are real reasons why that happens and they're based in 27:44 biology i mean the way in which that the psilocybin molecule opens up the 27:50 connectedness of the brain can allow you to have a conversation with that person 27:57 in a different way that isn't necessarily triggering for them and they can get realizations out 28:04 of that experience that they might not get any other way and and so i think that can be very 28:09 effective is the reverse true for depression with ketamine being the predominant or ketamine is the preferred 28:15 for depression yes and and um i don't know i i don't know my my sense is that the 28:24 reason that ketamine was the initial breakthrough drug was because it was the 28:29 one that they were able to aerosolize and be able to deliver in the context of 28:35 the doctor's visit and the ketamine is a 15-minute reaction 28:41 rather than a six-hour reaction so i mean if you're going to do drug the these these 28:47 psychedelic drug-assisted molecule therapies you're talking that's an all day just 28:52 stay there for 90 minutes afterwards so don't you for the ketamine yeah yeah it's yeah just to make sure that there are no 28:58 adverse reactions but you don't have to stay there for six hours yeah if you took silicibe and you'd be there for all 29:03 day all day oh and just uh just to reiterate that this is another tool in the toolbox right i see a lot of 29:10 instagram ads or snapchat ads for this idea of ketamine assisted therapy 29:16 on people saying oh i feel so much better i feel so much better and there's a real danger in that 29:21 advertisement i think it's important to understand that this is another tool 29:27 in a large toolbox um and isn't the only thing to reach for and might be 29:33 one of the last things you start to reach for other work has to occur first that's right i see the same conflation 29:40 with emdr right people look at the exercise of tapping and they look at different um the light bar exercises and 29:47 that is just so far down the line in emdr and so far removed from the actual 29:53 work that's taking place the emotional lifting that's taking place and especially with what you're saying 29:59 with the the you know the ads but to me that's just like any pharmaceutical agent it's not the 30:07 patient's job to decide what medication is best for them yes and it really burns 30:13 my behind that you have ads on television for any pharmaceutical talk to any physician in america they say the 30:20 same thing about any drug that somebody comes in because they've watched all these ads on tv oh i want this truck and 30:26 that is exclusive to the united states yes um other countries don't not allowed to do it well because it doesn't make 30:32 any logical sense no it's economic yeah i mean a controlled market even if you 30:37 are a doctor you're not supposed to devise your own treatment plan and if you're not a doctor you don't really 30:44 have the informed ability to decide that this medication is a right fit for you 30:49 so yeah i but that point is well taken just because you 30:55 even if you anecdotically know somebody who had psilocybin treatment and that 31:01 person said oh it was great for me it may have been great for them that doesn't mean it's a great choice for you 31:07 but if it is something that you are interested in it is a growing network what happens all the time 31:13 think back about your years of doing therapy with adolescents on adhd medicines right and their family members 31:19 would say oh joey takes this bill why don't you give it to bobby it'll make him better yeah and not involve any kind 31:25 of professional medical or psychological in that loop 31:31 yeah well and this is apropos of nothing but what really burned my behind is that 31:37 i always wanted to know this would always happen or most commonly would happen 31:43 at the end of high school when the person was getting ready to take the act or the sat yeah and then they'd say oh 31:48 well this medication take it on wait a minute no if you're just going to use this as a performance enhancing drug that's not 31:56 the point of the medication yeah but a lot of people used it for that 32:02 tisk disk disk so how how did this strike you 32:08 was the conversation okay uh yeah because we got away from and 32:13 intense analysis of the chemicals in the amygdala and we talked about how that knowledge is useful to a therapist and 32:21 to a person in therapy good good so hopefully good article right we've 32:26 taken something from it to us exactly that's always a good thing 32:33 so hopefully that was helpful for other people in the audience as always if you have any questions or comments you can get us at psychwithmike.com we would 32:40 love it if you would go to apple podcasts and find psych with mike and leave us a comment and a review but most 32:46 importantly the thing that is most helpful for us is for you to go to the internet and find us on the youtubes 32:53 site with mike there and subscribe to the show that really helps other people to be able to find the show and as 32:59 always oh the music that is inside with mike is written and performed by mr benjamin the clue and as always if it's 33:05 like with mike

Adolescence is a time of distance from the family of origin and identification with a peer group. So what are the perils and benefits of attachment during this developmental period?

https://www.newportacademy.com/resources/mental-health/teen-attachment-disorder/

 

Transcript

you're listening to psych with mike for more episodes or to connect with the show with comments ideas or to be a 0:06 guest go to www.cyclicmike.com follow the show on twitter at psych with 0:13 mike or like the facebook page with mike now here's psych with mike 0:19 [Music] welcome into the psych with mike library this is dr michael mahon i am here with 0:24 mr brett newcomb hello i have too many pens well you know freud has an explanation 0:29 for that sometimes a cigar is just a cigar that's what they say but sometimes not huh 0:36 how are you today i'm good so anything uh new and exciting going on in your life 0:41 not a thing yeah life is just bland is that well bland or just 0:48 stable good yeah yeah yeah so not blank life is good yeah life is good and you're wearing a pink shirt today for 0:54 anybody who is watching you on the youtubes i've always liked the color pink do you yeah 0:59 you don't feel uh conscientious in a pink shirt 1:05 no yeah well i always feel conscientious uh conspicuous is it oh well well can't 1:11 you i mean yeah conspicuous yes or or uh 1:17 uh what would what would you call it if you were were worried about what other people thought not conscientious 1:22 well yeah okay anyway it doesn't matter all right so uh good segue though 1:29 yes because we we're going to talk about um 1:34 attachment i would say that's because i'm a professional exactly uh you know 1:41 that the foundation of what i believe in 1:46 psychotherapy is emotional regulation i believe that that emotional regulation 1:52 is the result of how you are how you internalize the external objects 1:58 so you're the quality of the relationship with the primary caregiver when the child is young 2:05 and we talk a lot about how childhood trauma and this emotional regulation 2:12 developmental process can cause issues when the child is developing one 2:19 of the things that we've never talked about and i found an article about it and then i thought oh yeah we definitely should talk about this 2:25 is how does this affect the developmental process during adolescence 2:30 and i know that you were talking about this morning that 2:36 when you were young you felt like that 2:42 the movers and shakers of the peer group that 2:48 you were associated with didn't really give you a lot of positive 2:53 feedback no uh if that's what you heard i didn't say it clearly okay 2:59 i grew up in a large suburban high school yeah when i got to high school and adolescence 3:06 that was very cast organized i grew up in a southern town where 3:12 your social standing could be measured by how far away from the railroad tracks you lived the closer that you lived to 3:19 the railroad tracks the poorer and less socially acceptable your family was 3:24 but when they put us in high school they lumped us all together so people had to have identifiers we had groups that we 3:30 belong to we had letterman jackets for band and for athletics and debate team 3:36 and and what have you to find little sub categories and clicks and so on 3:42 i was acutely aware of how all that played out when i was in high school because i read all the time 3:48 and i had a curiosity about how does this work and what i was telling you is that by 3:55 definition i was relegated to the lower socioeconomic 4:00 community because of where i lived what my father did for a living how much money we had those kind of things 4:07 but intellectually i was put in accelerated classes so i was mixed in with 4:13 kids from the upper social spectrum who who tended to get put in those accelerated classes 4:21 and i was commenting that it used to frustrate the heck out of me because sometimes i would tell a joke 4:27 that i thought was funny and they would all sneer about how low class i was and 4:32 how horrible it was that i told that joke and it wasn't couth and you know nobody would laugh and 4:37 everybody act like they smelled something bad and then later over the course of the next day or two i would hear various 4:44 ones of those individuals tell that joke and have it laughed at as if it was 4:49 hysterical because they were telling it within their own social subgroup 4:55 so there was no cross-boundary there that had to be acknowledged but you 5:01 have said many times that you didn't feel as though the quality of the emotional 5:07 relationship that you had with your primary caregivers growing up was positive 5:12 yeah and did you feel as though that impacted you 5:17 during adolescence when you were in junior high school or high school i don't know that i thought about 5:25 it that until years later uh when i was in junior high in high school 5:31 what i and that's probably fair i don't know that anybody does that that anybody i 5:36 mean i don't i was obviously not consciously aware of the quality of the 5:41 relationship that i had with my primary caregivers and the effect that that had in high school i know that during high 5:48 school i felt profoundly like 5:54 the things that i knew from my family of origin didn't make any sense 6:00 in the context of things that i was learning in high school so i grew up 6:06 in a violent alcoholic family one of the rules of the alcoholic family is you never talk 6:12 outside of home about home you don't talk about what happened at home last 6:18 night you don't talk about the way your father behaves or your mother behaves or any of that stuff you just don't say anything about it 6:25 so because i read all the time i learned i remember vividly in the third grade 6:33 that you could read and go away somewhere and so i could read a story 6:40 about something in ancient history or something in another country and transport myself to that place and 6:47 be caught up in that book and not be in the environment that i was in so i read 6:53 voraciously most nights i read a book in overnight just read all night 6:59 a lot of nights and uh would try to incorporate within my personality 7:05 presentation traits uh that i read in the books that the hero had 7:12 uh dialect dialogue information whatever 7:17 so i consciously created an identity a public persona for 7:25 being at school that was different from the person that i was at home 7:30 so do you do you know 7:35 did you know then have you thought about it in retrospect and do 7:41 you know now how you were able to come to that that realization for yourself where you 7:47 actually would read the books and then select specific personality traits 7:54 i think that's pretty unusual i don't know i only have my own experience right well 8:00 what i know is there was a a boy that went to it's almost like you re-parented yourself by reading the 8:06 books yeah yeah yeah yeah i think that's pretty unique i learned it from somebody else 8:13 there was a boy in the third grade that was bullied by everybody including myself 8:20 trying to fit in trying to socialize with that group of aggressive nine-year-old boys 8:27 and i noticed this kid would go out at recess and climb to the top of the jungle gym we had an old-fashioned 8:32 jungle gym in the playground and sit up there at recess and read a book and he would be out of reach of 8:38 everybody most of the boys would go off and play ball or tag or what have you and the girls would go off in little 8:44 groups and do whatever they did i kept watching him and so one day i asked him i said what are you doing and 8:49 he said i'm reading and i said why and he said because i'm not here 8:55 so i thought oh that's interesting and so then i got a couple books and read them and 9:00 started to realize i didn't have to be there either i could do it at home i mean my father could be in a drunken rage and breaking furniture and knocking 9:07 people around i could sit in my bedroom and read a book and not be afraid so so the article that i sent 9:16 is actually a science-based article and it talks about the attachment with the primary caregiver 9:24 the quality of that attachment and that's you know all goes into john bolby and mary ainsworth's 9:30 attachment theory so you have secure you have the ambivalent and then the resistant attachments and then the 9:37 disorganized we don't really look at disorganized much because that's pretty pathologic so the insecure attachments 9:44 are the ambivalent and then the resistant and then how that plays out during 9:50 adolescence but we know now that these attachments and specifically trauma 9:58 has a real biological impact on the development 10:04 of the brain physiological development and yet i think you and i both would say 10:11 that our histories with our families of origin were difficult traumatic 10:17 and yet i think we turned out pretty good so 10:22 clearly there are ways that you can compensate for that but then there are 10:28 some people who really struggle with that and then they get to adolescence and i just i i just weep 10:36 for the individuals that were like you and me that didn't find 10:43 some way of being able to transcend that so my father was married to 10:49 married five different times and in the course of my early childhood 10:56 regularly i mean when i was nine years old i came home and they'd all moved away yeah i mean the house was empty i 11:01 mean you tell that story and and and i know you to be a person who doesn't 11:07 tend towards a hyperbole no that's an absolute literal story i know and and and i just think of a nine-year-old 11:14 coming home from school and the house being empty and not knowing where in the world everybody went yeah i 11:21 thought we've been robbed it's just that's that's i i don't even know how to wrap my head around that well so but 11:26 that wasn't the point of i don't know what to say um 11:32 i want to say that i don't know who can't identify especially in infancy 11:38 who was the object in object relations theory 11:44 who provided the consistent nurturing presence in my life what i do know is that as i grew up 11:52 there were teachers and scout masters and coaches who 11:59 played significant periods of support 12:04 that gave me positive reinforcement and a sense of security about capacity yeah 12:10 about intelligence about performance about courage whatever and the books that i read 12:18 gave me an understanding for how to manipulate the environment at 12:24 home and differently manipulate the environment in school so that i felt more safe 12:32 and more capable of moving through 12:38 the social hierarchy one of my absolute expectations in high school because of 12:46 where i lived and the circumstances of small southern town was that i would get a college education 12:52 to be able to get a job that would pay me enough money to live in a different social custom level 12:59 uh so that's what i did i mean i knew i had to otherwise my my destiny uh was the 13:05 script that was written for me by generations of my family none of whom had ever gone to school right and and no one in my family ever 13:12 went to school and i and and i hear very profoundly what you're saying about there were teachers there were coaches 13:19 there were other persons adult persons in the environment that provided you with an example that 13:26 you could use in place of that external object you know i i 13:31 really felt like i was was bumbling through you know grade school and junior high 13:38 school and then uh you know went to high school and started playing football mostly because 13:45 i was trying to get my dad's attention yeah but every year that i played and i 13:50 tell people all the time the only thing that stopped me from being able to 13:55 play professional football is a general basic lack of coordination 14:01 i was i am not what you would consider an athlete but i 14:07 played every year and i worked hard and every year that i played football at the 14:12 end of the year i got the most improved player award which is what you give to 14:18 the guy right who who is not going to get it but and i was willing to do anything that a 14:24 coach asked me and and they and i won these awards and i really genuinely 14:31 attribute that to profoundly changing my conceptualization 14:37 of myself because i wasn't getting that anywhere else and i don't know what would have 14:43 happened to me if i hadn't done that so i i'm thinking in particular and it's just it's a good 14:50 time to have this conversation because a lot of conversations out right now about teachers yeah and the role that teachers 14:55 play in society i had several teachers in high school in particular 15:02 that reached out to me and said you have these abilities you have to learn how to 15:07 navigate it so that you can get something out of it one of whom was the school librarian 15:14 and i became a volunteer library assistant and became the president of the arkansas junior librarians 15:21 association through her support and auspices which means nothing 15:26 to anybody now but it meant a lot to me then mm-hmm uh 50 years after i graduated my high 15:32 school i went to a high school reunion first time i'd gone back 50 years later so i'm having dinner with 15:37 some friends and we were talking about school and i said well mrs carpenter elaine carpenter mrs carpenter was such 15:43 a significant person in my life i wish i had been able to tell her that and somebody said well you still can't i 15:49 said what do you mean i thought she was dead no she's not dead so i called her mm-hmm and i said i want 15:55 to tell you you steered my life into the survival lane 16:01 and you helped me become a teacher and you have helped me reach other kids and 16:06 i want you to know that 50 years after you worked with me your lessons are still echoing into generations of kids 16:13 you've never met five years later i heard from one of her 16:18 sons she had died and he said i just want to let you know my mother 16:23 uh became senile to the end of her life toward the end of her life there were very few memories that she could hold 16:30 and she held the memory of your phone call wow and it she repeated it to me every day 16:36 the last few weeks of her life about how important that phone call was and what it meant to her 16:42 that you had called her and you told her she was that seminal in your life yeah 16:47 and that's what i want to say is if you have a teacher who has touched 16:53 your life who has reached you at whatever level of education let them know 16:58 tell them because they do an incredible service to all of us and 17:04 they need more respect so let's take our break and when we come back i'm going to tell you my story all right 17:10 oh because i was your teacher yes [Laughter] hey everybody dr michael mahon here from 17:16 site with mike and i couldn't be more excited to talk to you about athletic greens which is a new sponsor we have 17:22 here on the show i started taking athletic greens watching some youtube videos and doing my own 17:29 research i wanted to add something to my daily workout program to give me some energy and to support gut health and 17:37 that was the one thing that kept coming up again and again with athletic greens is the guy who started the company 17:43 did a bunch of research because he was having some gut health issues that he couldn't get any resolution for he 17:50 developed athletic greens and it's just exploded from there so it's 75 17:56 superfoods vitamins minerals probiotics whole food sources that's all in one 18:02 daily scoop you put it in eight or twelve ounces of water you shake it up and you drink it the taste is very very 18:09 drinkable i actually enjoy it and i have been using it and my energy 18:15 levels have just been through the roof i really like athletic greens because of 18:20 some of the sustainability things that they do so they buy carbon credits and 18:26 you know to help protect the rain forest which is something that i really like but if you order athletic greens in your 18:34 subscription you're going to also get a year's supply of their vitamin d 18:39 supplementation and five free travel packs and that vitamin d is so important 18:45 during those winter months when we're not getting enough sunlight we've talked about how that decreases your mood and 18:53 increases depression and that can be a real deal changer so you go to 18:58 athleticgreens.com emerging that's athleticgreens.com 19:04 e-m-e-r-g-i-n-g that's the psych with mic promo and 19:10 you're going to get that additional vitamin d support for a year and five 19:15 free travel packs so take control of your own health today and as always if 19:21 it's friday it's psych with mike okay we're back so you know 19:27 uh i hadn't originally thought about this in the context of the current 19:34 societal uh zeitgeist but you're you're absolutely right this is a great time to 19:40 and this wasn't why i had originally thought about this topic but you but this is a great great segue or great 19:47 avenue to go down you know my son is a teacher my son is a teacher in the 19:53 school that you started your teaching career yeah which is amazing to me 19:58 but uh so i i have a great and respect for teachers and i i don't know why 20:05 while you were telling this story this came to me i do not remember i remember the name of 20:12 the all the names of every football coach i ever had i do not remember the name of a single teacher save two 20:20 when i was living in granite city illinois going to washington elementary school 20:25 which doesn't exist anymore there were two teachers there that i actually remember mr dixon and mr 20:32 swabota i know these are real people because downstairs in my workshop i actually 20:40 have a ruler that has swaboda written on the back of 20:46 it that was a ruler that he gave me when i was in fourth or fifth grade and 20:52 the reason why these names stay with me is because we were having a 20:59 discussion in a class about 21:04 origins and mr dixon had who taught social studies was talking 21:11 about you know origins and he was asking kids in the class 21:16 what is your family origin and he got to me and i 21:22 said i've known jim beam i said you know i don't think i have an origin and he said 21:29 your last name is mahan and i said yeah he said that's irish and that was the first 21:35 time that anybody had ever given me any kind of a compass 21:40 to be able to think about in terms of who i was 21:47 and and and that changed my foundational perception of 21:52 myself finally i could say oh my family comes from ireland i'd never known that no one in my family ever 21:59 talked about such things yeah so then mr swabota taught math 22:05 but i would go to summer school every year not because i had to i made great grades 22:11 but because i didn't have anything else to do so back if i walked to school every day 22:17 which is what we did back then they would let me go to school and so over the summer i would just walk 22:24 to school because i didn't have anything else to do and i would hang out there and in mr swabo's class we didn't have 22:30 air conditioning and so we would open all of the windows and turn on these gigantic fans and sit on 22:39 the floor and turn out all of the lights and during summer school mr swabota 22:45 would read to us the hardy boys and nancy drew mysteries 22:51 and i would go every day just to be able to go 22:56 and sit on the floor and have him read to us that's one of the more important things that parents can do yeah 23:03 and and my kids will tell you to this day that there was not a single day that 23:10 went by in either one of their lives that they can remember from the time that they were born until they started 23:16 school when i did not read to them that's really important and i was i i 23:24 these memories that that that i i hadn't thought about these things until you were telling me this and you're 23:30 absolutely right those were seminal things that's the impact of teachers and 23:35 so whatever people think about teachers right now in our society and i can't even imagine a more difficult time to be 23:42 a teacher and i think about this with my son every day i mean if if somebody walked into a school that my 23:49 son were teaching at with a gun i i don't know what i would do well it's not that's not the only issue 23:56 you also have the issues about he's a social science teacher does he use critical race theory uh what does he 24:01 teach about the transgendered and other sexual orientations or realities what does he 24:07 teach about what's going on in our society because there's rage in the community about how what 24:13 should be taught and how it should be taught and how pathetic teachers are and how they're all on some kind of liberal 24:19 agenda and change the world and destroy christianity and so on i i think it's a 24:25 horrible time to be a teacher but i would also say thank god for the teachers absolutely 24:31 who were seminal in my life i mean yeah i i don't even know 24:37 and thank god for the opportunity to tell elaine carpenter what yeah it meant to me well i was just thinking you know i 24:42 i don't think i could find these gentlemen i i may try and and see if i can 24:48 can can discover uh uh but you know just the the fact that this is 24:55 all coming back to me is making me recognize that you are absolutely right 25:02 in those fam when those family of origins are not good where are you getting somewhere to go 25:08 yeah and and thank god that you and i had teachers in 25:14 our lives let's also make the point coaches our teachers yeah and if you had coaches who encouraged you and got more 25:21 out of you than you would normally give that needs to be acknowledged and validated yeah yeah yeah yeah mr 25:27 jennings and mr robbie do that my coaches were debate coaches yes i know because you're so much more intellectual 25:33 than i am uh more verbally verbally astute i think yeah yeah and you know what but 25:40 i mean we're obviously i'm making light of that and i shouldn't because there's no question that choir debate 25:49 those kinds of pursuits are just as legitimate as playing football 25:56 or soccer or baseball amen yeah but uh 26:02 okay so i i teach college i 26:08 i call myself a professor well the college calls me a professor um i don't think of myself as a teacher i 26:15 don't feel did you feel like that teaching college was the same as teaching high school 26:24 teaching is teaching the content 26:29 is what you present but what you do is make connections with your students 26:35 and open windows for them maybe i feel like it's different because i feel like by 26:41 the time they get to me in college most of that 26:47 formulative development has already taken place i don't feel like i'm probably making the 26:53 same kind of impact because 26:59 if you're the second third or fourth grade you have a very limited range of access 27:05 to world experiences the older you get if you're in the 10th 11th and 12th grade and that's same 27:10 thing with doing counseling with adolescents they can find other 27:16 reference points to pay attention to and other things to invest themselves in than you and your opinion of them and by 27:23 the time they're in graduate school that's even a broader challenge yeah so 27:29 you have the opportunity you present your material you're committed to knowing what you know and you're offering that to the people 27:35 that say i want to know what you know but it's still the dance of relationship 27:40 and the effort to open windows in their mind 27:45 but i think that both of us then are saying that 27:52 these individuals who are spending time with our children 27:58 in these classrooms from first grade until high school 28:04 are the people who have the ability to potentially correct 28:10 damage that may be being done to those individuals in their families of origin yes yeah absolutely and that any teacher 28:18 who might be hearing this and and hopefully this will be disseminated broadly and other and lots of teachers 28:24 will hear it any teacher that's hearing this do not take that for granted don't 28:30 undersell the potential impact of that because you have two people who had horrible family 28:36 of origin stories who are sitting here saying that we attribute our ability to 28:43 have transcended that to the teachers that we knew in our lives yeah 28:49 and and that's i i just can't imagine something that is more profound than 28:55 that i wish more people saw it that way so 29:02 do you think that that's what caused you to want to be a teacher absolutely oh okay 29:09 i don't think i ever knew that yeah and not that one no no yeah yeah yeah two or three other 29:15 teachers did the debate coach but i'm saying teacher you had a much more 29:22 profound understanding that these teachers had given you something that you didn't get 29:28 from your family of origin then i did until i was much older 29:34 i'll have to accept your analysis there well but i'm saying because it drove you to want to be a teacher absolutely yeah 29:40 and and i'll tell you i love teaching high school as much the day i quit teaching high school 20 29:46 years down the road as i did the day i started yeah but i don't think i would teach high school today yeah 29:52 yeah it's changed too much it's changed too much and and uh it's just amazing to me 29:58 there's too many agendas too many uh righteously indignant people and people 30:05 managing headphones hedge funds are just making out like 30:10 robber barons and we can't pay teachers a living wage that's unbelievable it's you know we we 30:17 our culture doesn't value it no we've we need to have a come to jesus meeting 30:22 about what we think the priorities are in life but that's not 30:27 a topic for this show for today all right hopefully uh people enjoyed that and if you are a teacher and you 30:36 have a perspective that you would like to share with us we would certainly be open to that you can get us 30:42 psych with mike.com as always the music that appears in psych with mike is written and performed by mr benjamin the 30:49 clue we would love it if you would go on to the apple podcast find psych with 30:54 mike and rate us leave a review but most importantly please go to the youtubes if 30:59 you haven't already done so and subscribe to the show that is super super beneficial for us and as always if 31:07 it's friday it's psych with mike

The news seems to get crazier and people are getting more polarized. How is a person supposed to find solace and meaning in life? Perhaps the best way is to learn to appreciate the small things. 

https://neurosciencenews.com/meaning-life-small-things-21063/

 

Transcript:

you're listening to psych with mike for more episodes or to connect with the show with comments ideas or to be a 0:06 guest go to www.cyclicmike.com follow the show on twitter at psych with 0:13 mike or like the facebook page at psych with mike now here's psych with mike 0:19 [Music] welcome into the psych with mike library this is dr michael mahon and i'm here 0:25 with mr brett newcomb hello it's really hot and it's well there are 0:31 issues of concern around something called climate change and drought climate change is a pigment of your 0:37 imagination that's what some people say with sweat rolling down their face yeah 0:44 yeah and no water in the pipe yeah and i guess uh uh we should clarify or or at least set 0:50 the the the frame of reference it's the end of july 0:55 in st louis missouri and it is it's just oppressively oppressively hot i heard 1:02 you supposed to get to 104 today 104 today i that i heard on the radio this 1:08 morning that there was a uh 1:13 that the the the mercury reached 115 in oklahoma yesterday wow 1:19 yeah so my sound quality just changed did you turn something down i i manipulated 1:25 something because it was really loud in my in my it's just only mattering if you can be heard 1:31 we'll see everybody can be heard one one hopes you know uh i think that 1:37 um you would live longer if you could reduce your 1:43 level of anxiety and one way to do that would be to learn how to appreciate small things like oh well i'm not this 1:50 is amazing i'm not anxious i'm perfectionistic 1:56 is there a difference i'm not sure they are yeah yeah so i i sent you this article on uh 2:03 from neuroscience news yes not psychology today or bride magazine 2:09 well you're reaching more a field for your your intellectual acumen we've had 2:15 articles from neuroscience before i know but i just was recognizing today that you but 2:21 my reluctance to do that is because then you say oh she's got all these 2:26 words and things in it that you can't win yeah yeah that's true i should just change the rules for the conversation i 2:32 should just learn to appreciate that yeah as long as you're not anxious about it yeah yeah you appreciate the small things that 2:39 uh enjoy the moment set in the moment meditate and you but 2:45 the reason that i wanted to uh so this is an article about enjoying 2:50 the moment what's it what's the title of the article searching for meaning try appreciating the small things right 2:57 yeah and my philosophy is that there are no new 3:02 things that everything's a rebranding of something that somebody did before i 3:08 mean obviously maybe if you discuss that's actually been said before yeah nothing new under the sun exactly i read 3:14 that years ago and you talk about this all the time that that people come up with new theories or come up with words 3:20 they just rebrand old theories yeah and put them back in the mixer come out with something else i remember when 3:29 back in 2008 2009 2010 when we were still at webster and 3:36 the concept of mindfulness was huge in the zeitgeist of the psychological 3:43 community and all of our students would come in and talk about oh i'm going to be a mindfulness counselor 3:49 that's what i'm and and i would say what do you use the word zeitgeist yeah when i was young it was uh the term was 3:56 velchong world view mm-hmm yeah 4:01 same stuff yeah same point so they're going to be mindful counselors and you said what are you going to be mindful ah 4:07 yeah and i would say what does that mean and it was 4:12 if you ask 10 different people what it means to be mindful you're going to get 10 different answers we will all emote 4:17 and obfuscate because there really isn't a definition of that i mean we all think 4:24 we know what that means but there's not an official psychological definition 4:29 well and even if there were people wouldn't adhere to it rigorously right 4:35 yeah it's because it's all smoking mirrors well i don't know about that 4:41 actually yes you you you have said that for so okay so explain what you mean by that 4:47 um it's not a hard science it's not replicable you can't do an experiment 4:53 with measurable ingredients and then have someone on the other side of the world with similar training and equipment replicate the experiment get 5:00 same results so it's a fluid medium it's a dance of relationship and understanding of 5:05 connectivity where people who are struggling in their lives with with 5:12 pain or distress of one kind or another frequently referred to you by someone else like the 5:18 wife says if you don't go to counseling we're going to get a divorce or the judge says if you don't go to counseling 5:24 you're going to have a longer prison sentence or the employer says if you don't go to counseling you're not going 5:29 to have a job be employed so you get people to come in and say my life is really 5:35 i'm unhappy and i'm angry if they'll say that they'll frequently make a joke if 5:41 they're men and say i don't know why i'm here but my boss or wife told me i need to be here i don't really agree 5:47 and then you start trying to have conversations with them and you have to do all the posturing of who's in charge 5:54 whose is the biggest who has the most authoritative interpretation of reality uh and who's 6:00 going to win the competition so my original question was i'm sorry 6:06 did i lose the thread how is well no you you created a tapestry ah there we go uh 6:12 my original question was how is this what we're talking about learning to appreciate the small stuff 6:17 different from mindfulness but now i'm interested in exploring this idea of 6:26 then what really is therapy so you're saying that that it's smoking mirrors in that it's 6:33 about the quality of the relationship so does that mean that you don't think that 6:40 it really matters what the therapist says well i think it matters exponentially i 6:45 i just don't think that i have a defined answer it's not like you bring it to me and say how much does this cost and i 6:51 say oh it's 32 dollars and 12 cents or how much does this weigh and i sell it 18 ounces 6:57 it's not it doesn't work that way it is an interactive experiential medium 7:04 where we spend time together and i try to facilitate a conversation 7:10 that you have with yourself with me being a reflector and a repository so i listen to what you say 7:17 and i reflect it back to you and if i do that accurately it's like holding a mirror up and what i try to 7:24 surround the mirror with is a zone of safety so that you're not feeling attacked or 7:30 criticized or threatened by what you see in the mirror you're able to express it 7:35 reflect on it reflect back on it and then we can discuss if you wanted to 7:41 see a different vision what would that look like and how could you implement it 7:47 and if you do that then you can make different choices in your life that hopefully will alleviate 7:54 or remediate the pain that's existing so when i would talk to students they would 8:00 say oh i'm going to be a mindfulness counselor i'd say what does that mean and they would oftentimes 8:06 say to me things that are in this article i'm going to ask people to you know slow down to deep breathe maybe 8:13 meditate pay attention to the trees listen to the birds and that may actually be 8:19 good advice but if you are delivering that advice to a really anxious person 8:26 who doesn't see the ability to slow down and look at the trees and listen to the 8:32 birds that messages is is useless isn't it yeah it is it 8:38 reminds me of the opening song of the music band where all the traveling salesmen on the train are 8:45 confed fabulating about professor harold hill being so successful selling boys bands 8:51 around the midwest and especially in iowa and their constant reiteration or complaint 8:58 is he doesn't know the territory meaning he doesn't follow the rules he doesn't do it the way he's supposed to he doesn't do it the way we do it 9:05 he manages though to make an incredible living and impact and influence lives 9:10 doing what he does he just doesn't do what they do what they want him to do and the outlier then is always 9:17 criticized by the mainstream because he's not walking in the middle of the road that they want him to walk 9:23 in and that they are convinced is the right road so they society puts pressure on you to 9:29 stay in the middle of the road and so then you inculcate that pressure 9:35 with an impact on your self-image your sense of 9:40 what do i need to accomplish what's a positive win for me how can i avoid losing 9:47 how will i know when i've what what how will i know when i'm satisfied happy are you happy 9:54 i don't know i don't have this or that or the other and so this approach the 10:00 neurology news approach article is saying that there is value 10:06 and potentially progress in learning to slow down the mental script that's echoing in your head 10:13 that's been imposed on you by your culture your family your religion 10:18 your boss your corporate messaging 10:23 and just experience something so you just hit on a on a point that i 10:28 think is salient but is really the heart of the issue which is 10:33 you know to slow down the mental processing 10:39 to me that's more what mindfulness to the extent that meditation is an 10:46 allegory for mindfulness that's really what is the the the 10:51 therapeutically effective part i think so uh but it's like my wife and i were 10:58 commenting the other day in conversation we're both retired and people will ask us well what do you 11:03 do now that you're retired and i give some smart ass comment i'll say like i don't do i be 11:11 and they don't understand what that means and so they they think i'm being a smart aleck which of course i am 11:18 but what we are astonished by my wife and i 11:23 is we pretty much do whatever we want to do although she will put me in the trick 11:28 box on a regular basis because she'll turn up me and say what do you want to do today and i don't have a road map for today 11:35 sometimes i do oh i want to go to the botanical gardens or i want to go to the art museum or i'm going to go to the movie or what have you but oftentimes i 11:42 don't i don't have a map for today i just want to be here and do whatever comes to mind so then what is your 11:48 response i don't have a map for today i just want to be here and do whatever comes to mind do you have something you want to do 11:53 i'll consider that and sometimes she does because sometimes it's a lead-in like when where do you want to go for dinner any kind of question uh but 12:00 sometimes no neither of us have anything to do we'll just sit here and stare at him so then if if 12:06 are you okay with your wife's name yeah absolutely i love her no no but i mean if i say that yeah so if if you and 12:13 phyllis are having a conversation and she says what do you want to do today and you say i don't have a road map and 12:20 did you have something and she says no is she okay with that answer or does that answer 12:26 make either her or you feel like oh now i'm anxious now i need to find because i 12:31 think that that's a lot of times what we we go out and we try and find things to do because we think we're supposed to be 12:36 doing something yeah well she's more that way than i am she she still hears voices in her head about you need to be 12:43 doing something yeah at the end of the day she'll think back and say did i do anything today and or did i was i just a slug 12:51 and she gets herself worked up about that much more than i do i don't i'm not that 12:57 self-aware or self-reflective that at the end of the day i add all the pluses and minuses to give it a point value i 13:04 think the old white protestant message is 13:09 you must be productive you must be doing something yes that is the message and it's a cultural imperative it was for 13:15 men of our generation but what i've found is now that i'm off the treadmill now that i'm not uh a wage slave or 13:23 don't work for someone or for something i don't have the same yardstick to 13:29 measure progress so this article is suggesting that there is 13:35 benefit to just being but being aware that you are being but that's the the 13:41 we've done shows on the difference between doing and being right and we both agree that 13:48 being is superior a way of if you can it's hard that's a challenge i think 13:55 that the that you know white anglo-saxon protestant messaging is what gets in the 14:00 way of that because people have that is you your word inculcated into them 14:05 and and how do you stop hearing that message so that you can 14:11 just sit and be um for me 14:17 it's a i think it's a reflection of my stubbornness and my oppositionality i have always been oppositional i don't 14:24 like authority i don't like rules that limit or constrain me 14:30 in in service of someone else's agenda 14:37 i'm willing to be self-disciplined if i set an agenda for myself i will limit or constrain myself to try to reach that 14:43 goal but if someone imposes one on me you've got to increase your sales output 14:48 by 32 this month it will fire you i don't like i don't respond well to that 14:53 okay let's run to our break and when we come back we'll pick this up all right 14:59 hey guys dr michael mahan here from cyclic mike and do you think that you 15:05 have a story to tell i know that when we started cyclic mic 15:11 the things that we really wanted in a podcast hosting 15:16 company was that they knew what they were doing and libsyn has been around since the 15:22 very beginning they're the oldest running consecutive still existing podcast hosting company in the entire 15:29 world i think but certainly in the united states so they've been around since people started uploading things to 15:37 the internet and so they have a lot of experience but we also needed a service 15:43 that was easy to use and libsyn is just so intuitive and even 15:49 though they've got all of this experience they just keep on upgrading so they just recently went through a 15:56 major renovation a major upgrade to libsyn5 and made the service even more 16:02 intuitive and user friendly than it was before and it was so user-friendly before that i was able to figure it out 16:10 and get site with mike up on the surface so we've been using uh libsyn since the very beginning of 16:16 psych with mike for over two years now we love them and as a friend of the show 16:23 if you go to libsyn and start a podcast right now you get your first month free 16:29 so you go to libsyn.com and use the code 16:34 n f-r-i-e-n-d so friend of the show friend that's l i b 16:40 s y n dot com and use the code f r i e n 16:46 d and you get your first month free and as always if it's friday it's cycling 16:52 okay we're back and so all right so i hear you saying that that you can be oppositional and so someone says this is 16:59 the message or this is the expectation you will try and bristle against that so does that 17:04 well i will try to find a way to do it but differently from how you told me to okay just to prove to you that i was 17:10 smarter than you were and i could but then how do you at the end when you get to retirement how do you 17:17 exist mental adjustment it's a significant one yeah and it doesn't happen overnight and 17:23 as a counselor i worked with a lot of men who reached retirement age or families where the men reached retirement age and men would retire and 17:30 they would say well i sold my company or i've taken my buy out and now i'm gonna play golf every day 17:36 and so they play golf every day for six months and then they come in saying i'm going crazy right uh 17:42 i need to find something to do i need to to measure myself against another hill to climb i remember one man telling 17:49 me i need the force of a wind to lean against something that will push me 17:56 so i can overcome so it it's still part of his internalized script that he needs to be a go-getter 18:02 and conquering mountains right uh and so we had conversations but what if 18:07 you you don't find that what if there's not something to lean against and he's a 18:12 pretty smart guy and his response was his life will give you one mm-hmm you know his wife got sick or you'll create 18:19 one same difference yeah um but he had to find it wasn't what he expected to find 18:25 to lean against but he had to find a way to survive that particular set of obstacles 18:30 so when i hear all of that yeah that you're talking about and and 18:36 you know when i've done therapy and come up against this where people are struggling to hear that message you 18:42 know appreciate the small things see the trees hear the birds to me especially when you're talking 18:49 about retirement what that comes down to is a 18:54 lack of identity so the the protestant message says you'll be a good person 19:02 you'll have an identity if you are working towards these productive goals 19:07 when you're talking about mindfulness and appreciating the small things and slowing that 19:13 mental kind of of rush of thought down 19:18 what i see is that people then are forced to 19:25 be more aware maybe not even consciously but intuitively of this 19:30 question of identity and they don't have an answer for that and that's what they struggle against and so for me i want to 19:38 try and help people to establish an answer to those existential questions 19:44 i think that that has to be a part of learning how to slow down 19:49 i think there's significant value in having the conversations but i think you have to frame it in your own mind not 19:55 necessarily in the client's mind in terms of trying to identify the 20:00 cultural messaging that creates the world view of your client whether it's a religious one you know i 20:08 think a cotton mather a famous puritan preacher in the 1700s 1600s 20:14 gave a speech called sinners in the hands of a sermon centers in the hands of an angry god 20:21 the theory was that it wasn't a matter of grace if you got 20:26 to heaven it was a matter of earning brownie points with god so if you behaved 20:32 in a set of strictures uh that were defined by what would get you to heaven 20:38 meaning not sin and these ways this is one this is one that's one those are three 20:44 don't do those then you can go to heaven when you die and the whole philosophy of life was that this life was to be one of 20:52 uh woe and conflict through which you navigated to get to a place where you could get off and be in 20:58 a joyful state for eternity um so if that's the messaging that you 21:04 received from childhood and from the surrounding culture it's going to be internalized in your 21:09 head and if it's not working for you as a message you find out that you're inherently 21:15 sinful and they say oh that's satan talking to you you know be alarmed alarm 21:20 what if little pleasures are not sinful what if little pleasures are okay what if 21:26 sitting on the mountaintop watching the birds fly beneath you and seeing the valley out in front of you 21:31 is a pleasurable thing for you but you're not 21:36 productively digging in the coal mine so as a therapist 21:43 my job is to say well what if right and so then okay so i'm going to be the client yeah and you just said to me what 21:50 if what is sitting on the mountain top watching the birds below you and the the clouds and all 21:56 is pleasurable and then i say well then my family won't eat because i'm not working in the coal mine 22:02 possibly but what if your family then had to get their own food 22:07 could they have you raised have you raised your children to be able to support themselves right 22:12 and so when do you let go of that right i think the not in this lifetime right yeah i think 22:18 that's the the expectation of most people and certainly the majority of 22:23 males so what happens then when you become physically disabled and you're not physically able to go to work and 22:28 bring home the bacon right you had better take out disability insurance to make sure that you can cover your wages 22:35 for the rest of your life i mean that's what that's what the protestant message why not just go rob a bank 22:42 because that would have a lot of other consequences associated with it that you might not 22:48 want to negative consequences negative costs for the choice behavior right if the choice behavior you have is i'm 22:54 going to sell drugs on the side right or i'm going to rob a bank you might make good money 23:00 but if you do there are going to be consequences that society will impose right are you willing to accept those 23:06 well no i don't want that to happen to me well then you need to consider are there other alternatives for what to do 23:14 i don't like my job i don't like doing physical labor i don't want to be a physical laborer all my life i don't want to wear a shirt that says dave on 23:21 it and work for minimum wage well 23:27 what other choices could you make right to impact that outcome right but 23:32 you know i think that when we're talking to people about this idea of slow down 23:37 you know you don't have to be so driven then i think that what for a lot of 23:42 people where the uphill swim is or the the upstream swim is 23:50 that okay even if i choose this for me yeah then what about my wife what about my 23:56 kids what if they what if i can't make as much money and now we can't go on as many vacations right so uh 24:06 i am 75 years old i grew up and was functionally productive in an era where 24:11 there was a world view about making a commitment to a job showing up for work every day my 24:19 some of my clients came from similar backgrounds and i remember having a number of 24:24 conversations of frustration about the younger group today 24:30 aren't driven by the same messaging and so they're willing to take a job on the assembly line at 24:36 chrysler but they'll call in two days a week and say they're going fishing because they want to go fishing more 24:41 than they want to come to work but i worked that job and i worked overtime 24:47 in double time and saturday time to make money to get to a significant place of financial stability 24:54 and i was very successful i managed to do that but these kids are not doing that and yet they want the new pickup 25:00 truck and they want the big house and they want it all right now well how are they going to get it all 25:05 right now well some of it is going to come from me you know i don't have to pay for my kids truck well 25:11 i remember one of the most devastating life lessons is that i learned early i 25:16 learned sitting next to a friend who experienced it i was able to observationally encounter it and he had 25:23 bought a college mate of mine we were working together in the student center and he 25:28 had bought a brand new mustang convertible and his father told him don't buy that 25:33 you can't afford it you have these other things that you have to pay for like college 25:39 and he said i can do it i can do it right now i've got this job i can make this money summer summer off 25:45 so he came summer ended he lost his job and then now we're working at the student center for three bucks an hour 25:51 right and he can't make his payments so he goes to his dad and says can you pick up the payments on my car instead 25:56 said no he said but but then they'll repossess my card which i told you that's the cost of the choice you made 26:02 so he lost his down payment he lost his licensure fee lost his insurance fee he lost his car 26:08 and still had to pay off the note yeah so he didn't have a car and he still owed the bill right so he was devastated yeah it was it was his dad's fault right 26:15 my dad's a cheap sob he wouldn't pay for the garden he could afford to sure so he wants me to suffer 26:22 but i know that guy now 50 years later and he still has that car i mean bought 26:28 years later he bought that car back but he still has it and he drives a 15 year old car as his everyday car he 26:35 doesn't go spend money willy-nilly he doesn't buy things that he can't pay cash for he learned a lesson in college that hurt 26:42 significantly yeah but it changed his world and and this is obviously going down a different tangent thing yeah 26:48 sorry sweating the small stuff no no but but you make such a great point that's such a hard 26:55 thing to do in therapy is to talk to parents about setting boundaries for 27:00 their adolescent children and then consistently enforcing them i think that that's a lost art i don't think that 27:06 people do that very much anymore how many conversations do we have with parents that came in because they had adolescent 27:12 boys were acting out and they couldn't find any way to have consequences that worked right i'm 27:18 telling me he has to stay home he doesn't stay home he sneaks out and then what and he steals my car uh he goes out 27:24 with his buddies well you have to you have to find what does he value well he values soccer 27:30 well don't let him play soccer oh no the team counts on that yeah he's the best player on the team 27:36 and the coach and the team will be upset we can't take that away right you know right so your suggestion is 27:42 well let the team put pressure on him to behave my you know my remembrance of the early days in the 27:50 group practice was that cell phones were just starting to think yeah and i 27:56 remember that in the early days of our the group practice one of the things 28:02 that we struggled with was as a group coming up with a philosophy for what we 28:07 were going to say to parents about what was the age to give your child a cell phone and then 28:13 once they started to become more and more ubiquitous i would have conversations with parents all the time 28:19 and and one of the things that i would say is you know you can take away that cell phone and be like well no we can't 28:25 because then we won't be able to get a hold of him and i'd say to the parent how often does he answer the phone when 28:31 you call him they're like well never i'm like well then you can't get a hold of him now but they still 28:37 couldn't pull the trigger on taking the phone away and i can't take the car away from my kid as a consequence of bad 28:43 behavior because i need him to drive his sister's right well what if you had a rule that he 28:49 couldn't drive it for his own personal reasons he could only drive it for the reasons that you wanted right oh we can't do that right well why can't you 28:55 do that well because it won't work so as long as they put themselves in that box of i can't do that i can't do 29:00 this i can't do that nothing changes exactly and so then what are you so then you say 29:06 well learn to appreciate the small things yeah you know your garage is empty right now you could 29:11 clean it up or you just sit in it and say wow it's a nice garage you could do that you could do that yeah 29:18 yeah and then they left and you said that's really stupid and he said well you're the one that's tied to not right 29:23 can you untie it exactly yeah and so and then what am i paying you for well i 29:29 don't know i don't know what are you paying me for exactly uh so what 29:34 i've learned from this conversation is that what it all comes down to 29:41 is every human being is involved in a series of 29:47 psychological gymnastics that they are conducting within their own mind 29:53 and what we're trying to do is to help them learn some new moves you got to 29:58 walk that lonesome valley yeah you got to walk it by yourself nobody else can walk it for you and anybody who can't 30:06 take away their child's cell phone is going to have the same problem when we talk about learn to slow down and see 30:14 the trees and hear the birds until the individual is ready to hear that 30:20 message and which will happen when they can't hear any other message yeah as 30:26 long as they can still hear the siren call they're going to try to respond it that's their preference right and i've 30:32 said that forever about people who abuse substances that a person's going to abuse substances until the consequences 30:40 for doing that is no longer acceptable to them not to the boss not to the wife not to 30:46 the police officer and that's really the the secret of psychotherapy 30:52 it's all about trying except there's a there's no corollary that i agree with you but the coral area is that they have 30:58 to have a glimpse of an alternative way forward no that's what i was going to say and that's what psychotherapy is is 31:05 trying to give them an opportunity to see a different candle 31:10 in the darkness and can you choose to walk towards this candle rather than 31:16 staying in within the the boundaries of the light that the candle you're with is casting and for a lot of people that's 31:24 scary because there's a period of time where you're walking in darkness between the two 31:30 glows of light and i think that's hard for people but to me that's what psychotherapy is is holding that 31:36 person's hand while they're walking through that darkness and hopefully they can find that other 31:42 candle sometimes people don't yes but because you also creature 31:48 your acculturation you have to be leery of not taking on responsibility for the 31:54 outcome if you're the therapist you have to provide the options you have to provide the safe holding environment 31:59 you have to provide the reflective listening but you can't provide the solution right and it's so damn tempting 32:05 to do and what you can't do quit your job stop drinking get a divorce kick your kid out 32:13 those are not answers that you can provide that solve a problem 32:18 and you can't take responsibility for the client not being able to take positive action in their lives that's 32:25 not the therapist's responsibility i mean can you imagine how narcissistic that 32:30 you have to be to be able to think oh but i should be able to change this 32:36 person's behavior well i just had to think of some of the bosses i had yeah yeah 32:42 is that a shot i mean not at me well you're never my boss no yeah no okay i 32:48 think it's time to close this all right hopefully that was beneficial for people as always if you would like to get a 32:54 hold of us at psych with mike you can get us through psych with mike.com the music that appears in psych with mike is 32:59 written and performed by mr benjamin the clue and we always love it if you want to do us a solid go on the youtubes and 33:07 find psych with mike and subscribe to the show there and as always if it's friday it's cycling 33:20 [Music] 33:37 you AllRecently uploadedWatched

Emotional regulation is a necessary skill for secure attachment. In other words, people who are a "hot mess" have difficulty feeling secure about themselves or having good relationships with others. 

https://www.psychologytoday.com/intl/blog/head-games/202206/how-become-more-secure-person 

 

Transcript:

you're listening to psych with mike for more episodes or to connect with the show with comments ideas or to be a 0:06 guest go to www.cyclicmike.com follow the show on twitter at psych with 0:13 mike or like the facebook page at psych with mike now here's psych with mike 0:20 welcome to the site with mike library this is dr michael mohan i'm here with mr brett newcomb and intern michael 0:25 hello hello how are you gentlemen doing doing well i i asked if we were ready and the response i got did not seem 0:32 overly enthusiastic ho-hum is a response it is a response sometimes no news is good news uh that's 0:40 yeah that's what they say no news is good news so uh 0:46 this is uh a subject that i find compelling i'm not sure the rest of the room finds 0:53 it compelling is that fair to say interesting uh i i don't know how compelling it 0:58 needs to be to to talk about it uh what what are you talking about 1:04 what are we talking about uh my i told you this morning when you got 1:10 here that i did something that i never do which is i actually listened to an 1:15 episode of psych with mike and i listened to the episode that i 1:20 posted today which is friday the 8th of july for anybody keeping track at home 1:29 and in that show we had michelle stieg here who you had brought 1:37 with you a couple of weeks ago and uh we were talking about theoretical orientation and i was saying that you 1:45 know my theoretical orientation comes from the psychodynamic perspective and 1:50 heinz kohut and the development of 1:55 parenting models which leads to attachment and i have talked about piaget's original stage of 2:03 development which is trust versus mistrust and it's just so 2:08 uh that is so much the foundation of how i understand human psychology that when i 2:16 think about doing therapy and i think about people who have had challenges in their sense 2:23 of security and in their attachment styles the question becomes as an adult 2:30 what can you do about that let's assume that this underlying 2:36 theory of psychology that i subscribe to is cogent that it makes sense that it's 2:42 accurate and you have struggles with those early 2:47 years in those early relationships as a lot of us have brett you and i know that we talk about that all the time we don't 2:53 know as much about michael's relationship with his primary caregivers as an infant but we know that you and i 3:00 really struggled with that and so as adults we've had to learn compensatory 3:05 behaviors or whatever compensatory abilities to be able to be 3:13 in attached relationships and to feel more secure and so how do you give that 3:18 to somebody in therapy that's that's really kind of my my focus 3:26 so you are questioning whether or not 3:31 atypical if there is such a thing client coming in for the first time that you don't know 3:37 whatever their presenting uh issue or reason for being there is is in all likelihood suffering from some 3:45 kind of attachment disorder suffered from childhood 3:50 distress or trauma is that is that what your postulate 3:59 i think i would agree with that that that that's an accurate 4:05 encapsulation yeah and capitulization of what's going on in therapy yeah and i 4:10 think a lot of therapy if it's successful involves re-parenting 4:15 that wounded inner child whether that's the individual learns how to reparent 4:21 themselves or whether you model and demonstrate for them how to re-parent themselves i think if the 4:28 therapy is beneficial and successful it will involve re-parenting some of 4:33 those scripts that are wounded in broken scripts that we carry around inside ourselves yeah i remember when i was in 4:40 graduate school i don't know if you knew this at the time but 4:46 uh people talk about inner child and and back in the uh in the mid 90s when i was 4:51 actually in grad school uh it was a buzz it was like absolutely and i used to say all the time the only 4:58 thing that i want from my inner child is his skittles and then i'm going to kick his ass 5:04 you know and because i didn't want to hear that kind of language it felt 5:12 i mean i it felt offensive to me and what i realized later was not because that's not true 5:20 or accurate but because i wasn't ready you were too resisting yeah yeah i 5:25 was resisting it big time um and so i think that that that that we 5:30 look at things like internal family systems right where when we ignore or suppress those inner children or 5:37 whatever parts of us that they are they really show up in other places in our life yeah and in ways that we didn't 5:44 necessarily absolutely yeah absolutely i think that's the central premise of ifs yeah yeah 5:50 and listen to your parts and be aware of their existence and i don't know if you've seen the episodes that we've done 5:56 with michelle but she is an ifs therapist and so that was exactly the 6:02 conversation that we were having and you know brett and i have always been i think brett's more open to it now i'm 6:09 still less open to it the idea of ifs which i don't for me it's a it's a 6:15 descriptor you have to find a language that you and your client can share yeah so one of the challenges of being a 6:21 therapist is to listen to the language that the client uses so that you can 6:27 do appropriate feedback and and reflective listening in a way that demonstrates that you hear 6:34 them accurately uh so if i have a client who's a truck driver 6:39 and i can do it appropriately i try to use driving analogies as often as i can because it's like what you experience if 6:46 i have a client's computer programmer i'll use computer examples whatever i can do if i can do it if i 6:53 can't do it then i say you have to educate me i don't know teach me your language but i listen and 6:58 some of it is neuro-linguistic programming you hear the things they say 7:04 and you can determine the way they experience the world if they do it visually if they do it orally if they do 7:09 it tactically and that helps you then speak in the rhythm that they can hear so i think 7:15 that's a critical component i think ifs also offers that language too because children talk about 7:22 this idea that oh there's a part of me that got angry and so it's really easy to latch on to that apart oh let's talk 7:29 about this part and not take ownership of the whole thing that was just a part a minute and it reminds me of um uh you 7:35 talk about it's just another frame or another language or another structure on top of some very good very old ideas it 7:42 reminds me of you know gestalt's uh empty chair technique where we 7:48 set somebody down and we say what would you say to yourself but now instead of talking to your whole self maybe you're just talking to one part of yourself 7:54 absolutely and if you've ever had an opportunity to experience that literally making them move from one 8:01 chair to the other yeah is an essential component of that technique they they sit in one chair and 8:08 they say what their mother said then they sit in their chair and say what they would say right if their mother 8:14 could hear them if you're if you're saying you want to your mother even if she's dead 8:19 and she could hear you and understand you what would you say give yourself permission say it out loud then get back 8:25 in the chair and so the you facilitate that conversation but they do all the work yeah they have all the conversation 8:31 they generate all the concepts but let's not gloss over the technique it's super 8:37 super important that they change chairs oh absolutely because psychologically they change they shift the viewpoint and 8:44 and you don't have to understand why that happens as a therapist but you got to understand to try and ask them to 8:51 remain in the same chair and have that dualistic kind of 8:57 message going on in their brain is extremely difficult which one you can't do therapy with yourself you need another what what you hate 9:04 you can't do therapy with yourself and therein lies the rub [Laughter] 9:11 well even the article talks about this idea of when you're making interpersonal changes making peace with the past 9:18 they quote one participant is saying that she was able to observe 9:24 something that happened in her past and become aware of it so we're talking about how do we inch towards security 9:31 and how do we how do we progress towards that idea of the secure attachments and awareness i think is what we're 9:37 really touching on being critically aware of all of these things that got you to the place that you are 9:43 and then being able to critically ask yourself what do i like what don't i like what do i just have to live with 9:51 and because they said it doesn't make it so correct uh i was told you're too 9:56 stupid to go to college 10:02 so okay also the article the article talks about in the process of doing that this individual was able 10:08 to reframe her understanding and compassion for her mother who had 10:13 been pretty traumatizing for reasons that she now had a better uh grasp on 10:20 which helped her reframe the dance between she and her mother 10:26 and you know that i'm like in a real young phase right now i'm reading all of 10:32 young stuff and everything and so that's kind of my where my focus is and one of the things 10:38 that i am really starting to realize 10:44 and i'm going to go off track here because i'm building a clock uh you know you talk about all the time 10:49 um whose perspective is it that you can't uh uh 10:55 kernberg's idea that you can't really address your 11:00 whatever they are bipolar or narcissistic or whatever personality issues until in your 50s or later late 11:07 40s early 50s and i am so in that vein right now because i've been doing all of 11:12 this study with jung and one of the things that i'm recognizing is this idea 11:18 of trying to embrace the shadow and so you know this and michael you probably may or may not know this but i'm blind 11:24 in my left eye and it doesn't always track with my right eye when i tell 11:29 people this the first time most people say oh i never knew that i never and and it's amazing to me how little other 11:37 people but people don't really pay attention to their environment and and so it's amazing to me how much people will say 11:44 oh i never knew that because it's been such a my retina detached when i was in high 11:50 school playing football it was the end of my football career and if i tell people this it makes me 11:57 seem very sympathetic to most people right to me it's something that is 12:03 embarrassing and shameful and i've always tried to hide it so it's been a part of my shadow and so i've really 12:09 been trying to work on embracing that but that to me that's what young's 12:17 so what jung talks about in the shadow and the persona and the self is really 12:23 an aspect of ifs sure yeah and and i know i only just now 12:30 made that comparison because we've been talking to michelle and there's nothing new under this 12:36 there's nothing new under the sun yeah it's amazing but so when we're talking about the inner 12:41 child what seems to me to be the clinical 12:47 focus would be how do i help you brett or you michael 12:53 identify what are those pieces of your wounded 12:58 child that you live with or try and hide and how can i help you to embrace that 13:06 not so that you can resolve the trauma but so that you can live with it without 13:13 fear insecurity or shame so i think one of the ways that a therapist does that is to begin with 13:22 what carl rogers called unconditional positive regard i 13:27 want to say to you that i hear what you are saying and i 13:33 honor you for surviving whatever your experience was nothing shameful or 13:38 disgusting or horrible or evil or wicked in what you did to survive 13:43 however you managed it you got here how you got here today is 13:49 not on you that's on others and the adults in your life in particular how you leave here is on you and what i can 13:57 offer you is the the promise that if we do this work properly you will leave here 14:05 with more power and more control than you've ever had yeah at 14:10 hearing the voice from among those voices inside you that you want to hear that you need to hear 14:17 so if you will talk to me and you will trust the process what you'll see is that i absolutely 14:24 accept and honor who you are and how you got here especially those that have had 14:31 severe and chronic abuse experiences in right life who were shamed 14:36 and threatened and punished because of that to say to them you don't have to be in 14:42 touch with that part of that any longer than you want to you don't need it anymore to survive you survived to this 14:48 point let's talk about what you need to go out of here and be able not necessarily to get rid of that but to 14:54 put it back in the bag and keep it so that you can take it out if you want to so let's go to our break and then when 14:59 we come back i really like the language that you're using here and so i want to ask you a question about that but let's 15:04 go to our break and i'll do that on the other side all right hey everybody dr michael mahon here from site with mike and i couldn't be more 15:12 excited to talk to you about athletic greens which is a new sponsor we have here on the show 15:17 i started taking athletic greens watching some youtube videos and doing my own 15:22 research i wanted to add something to my daily workout program to give me some energy and to support gut health and 15:30 that was the one thing that kept coming up again and again with athletic greens is the guy who started the company 15:36 did a bunch of research because he was having some gut health issues that he couldn't get any resolution for he 15:43 developed athletic greens and it's just exploded from there so it's 75 15:49 superfoods vitamins minerals probiotics whole foods sources that's all in one 15:56 daily scoop you put it in 8 or 12 ounces of water you shake it up and you drink it the taste is very very drinkable i 16:04 actually enjoy it and i have been using it and my energy levels have just been through the roof i 16:11 really like athletic greens because of some of the sustainability things that they do so they buy carbon 16:18 credits and you know to help protect the rain forest which is something that i really like 16:24 but if you order athletic greens in your subscription you're going to also get a 16:30 year's supply of their vitamin d supplementation and five free travel 16:35 packs and that vitamin d is so important during those winter months when we're 16:41 not getting enough sunlight we've talked about how that decreases your mood and 16:46 increases depression and that can be a real deal changer so you go to 16:51 athleticgreens.com emerging that's athleticgreens.com 16:58 e-m-e-r-g-i-n-g that's the psych with mike promo and 17:03 you're going to get that additional vitamin d support for a year and five 17:08 free travel packs so take control of your own health today and as always if 17:14 it's friday it's psych with mike okay we're back and so i really like 17:21 that language that you're using and what i'm wanting to to know the the 17:28 to try and crystallize this for me is how do you initially 17:35 approach that shame that the client 17:40 feels how do you do that in a way that doesn't get them to turtle up and 17:45 and want to defend themselves so one of the things that 17:50 occurs and do you understand what i'm saying yeah okay i think yeah one thing that 17:56 occurs is i get angry that some adult has abused a child i am angry 18:02 a child that survived that kind of abuse is hypersensitive to my anger 18:08 so i want to identify it and say i am angry but i'm not angry with you i'm not 18:13 angry at whatever you had to do to survive i have no antagonism towards that at all wow okay okay this is what 18:20 this is exactly where i wanted to go yeah yeah because i and i didn't know that it was but yeah this is exactly right so you're counter transference 18:28 is to be angry shutting off their their radar though but their transference then 18:34 is to experience that anger as similar to similarly traumatizing 18:40 to their original experience it interferes with the connection yeah and the and the uh 18:47 strengthening of that individual mm-hmm so what they have to experience from me and i don't know if you pay close enough 18:54 attention but my when when i drop into therapy mode that way my voice changes my delivery changes it's more soothing 19:01 yeah i've never noticed that uh then when i'm just casually in conversation uh that's because you've never been in 19:06 therapy with me yes i've noticed that a million different i could i could identify a million different times when 19:12 i knew brett just dropped into the he's doing it oh he's doing it yeah and i'm sure if i called your wife she would be 19:17 able to correct it robin williams and matt damon spent an entire movie getting to this point that 19:24 we're getting to here where it's not your fault it's a very powerful message 19:29 absolutely it's it's an incredibly powerful message and necessary but okay so so let me let me go back to this and 19:35 so so the the the counter transference is you would be angry and just counter 19:40 transference is the therapist projected onto you and then the the transference is the client's experience of the 19:46 therapist and therapy and and so uh well the client is constantly going to try to 19:51 manipulate me into the traditional response that they have received yeah which is you have to 19:57 they're going to say today they say are you going to give me homework i said well do you need 20:02 homework do you want homework yeah i think so well all right here's some homework the next week thinking oh 20:07 you're going to be really mad yeah i didn't do my homework well why am i going to measure i didn't do my homework okay so what 20:13 no i didn't want i wasn't going to give you homework to begin with yeah what grade yeah exactly but but i really want to go back failure you loser so so the 20:21 transference is the counter transference is that you get angry because the child's been abused the transference is 20:26 this is re-traumatizing the same way so you're saying okay so i say to them 20:32 uh i'm not angry at you i'm angry that the situation occurred 20:38 do you ever try and not be angry i don't try to not be angry if i'm angry 20:45 i'm angry what i try to do is is clarified right you are picking up accurately what you're getting 20:52 but let me clarify it's not you that i'm angry with but this is the point that i think is so 20:58 important for therapists generally and for new therapists the goal isn't for you to not have 21:04 emotions right you're not the blank mirror that beginners are told they need to be 21:10 exactly uh you are a real person with real feelings and the client picks up on all that so you have to be able to say 21:16 i'm sad and cry when you hear something sad or laugh when something's funny to you 21:21 and then say i didn't mean to offend you it just struck me as funny uh 21:26 how do we work past right but you have to be aware enough of your own internal processes i had a couple come see me one 21:33 time a black man a white woman came from marital counseling first session i'm talking to him about coming for marriage 21:39 counseling and i said i really was that clarence thomas 21:44 want to communicate to you that i think i can hear you and i want 21:50 to hear if you have any concerns about my ability to hear you and the 21:56 black man looked at his wife they looked at me and he said one of the troubles that we are having 22:02 has to do with sex and i fantasize all the time about having sex with white women 22:10 are you too white to hear that which i thought was a brilliant question 22:17 and one he needed to have answered if i was going to be able to help him if i was going to be able to sit in a room with him if i'm sitting there judging 22:22 him and and condemning him for his fantasies right i can't help him right 22:28 and i know that and he knows that so he was able to ask can you listen but i think here and and i'm glad that that 22:34 the client was able to do that but i think the point that you made about therapists in in their training are 22:42 conditioned to believe they're supposed to be blank slate which is that is an 22:47 unachievable goal it's impossible you have to be a human person in humane but 22:52 you have to be a human person capable of monitoring their own processes well enough to know when it's not your i'm 22:59 sitting here i'm angry because you're telling me this story of abuse but i'm not angry at you 23:06 because this happened to a child so that's the point of the conversation about modeling 23:12 and re-parenting because they experience in their most vulnerable and anxious moments 23:19 modeling of appropriate responsiveness not what they experienced in their childhood yeah and so then you can 23:25 process that and discuss what did that feel like what just happened do you are you aware of that can we can do what are 23:31 your reactions to it what's your level of awareness to it because in doing that we're 23:38 re-parenting their script and one of the things that i will point 23:44 out now because this is sailing or coming into my consciousness is i have had many clients 23:52 especially when i was younger because now i'm pretty old but when i was younger i had many clients who were much 23:58 older than me that were able to experiencing experience me 24:04 as a caring nurturing parent so you don't have to necessarily think oh 24:11 i'm 32 how am i going to do this for a 50 year old man you can do it because 24:16 it's not yours to do it's the client's experience that matters and the client 24:23 can have that experience i don't know if i fully agree with that you don't i i think i do but i'm mindful of the fact 24:29 that for years what i would tell my students in counseling program younger students especially is i don't care what 24:35 skills you learn you need some aging because if i walk into your office with 24:41 marital issues and i look at you and you're 27 and i'm 70. 24:46 i'm not going to talk to you i'm not going to take that risk because i can't imagine that you can understand my 24:51 circumstances so i don't know how that changes but there's a there is a presentation that they have 24:58 to learn how to make yeah that says to me okay there's something here that maybe i can take this risk right there's 25:04 something here that maybe i'm willing to float this out here right but initially my impressions 25:10 are you're too young to know what you're talking about have you ever had any children and been a parent 25:15 and i think that this goes back to the idea of there are different therapists for different people absolutely and so 25:22 if the 70 year old man comes in and can't put themselves in that position then that's not a good therapy experience for 25:28 them and they should find somebody else but what i have experienced is that you 25:34 can present yourself as timeless once you learn how to do if you get the 25:39 opportunity yeah yeah but but the client has to buy into it right and if the client doesn't then no then it's not 25:45 going to work but i have had men who were twice my age yeah who i know experienced me as a nurturing 25:53 parent and so that can happen as long as the therapist is good at their job and 25:59 doing things right and the client is able to open themselves up to it i think another part of your point there is also 26:06 you were speaking about getting angry with the not angry at the client i'm 26:12 angry with the client for the client or the client that's the language that i think i want 26:17 to pick on maybe a little bit because your job as a as a therapist is not to 26:23 feel the emotion for the client oh absolutely i have to take clearly say this is mine it's coming out of me and 26:30 my friend at the whole counter transfer message but it's not at you 26:36 it's at however you were wounded and the fact that any child is wounded that way 26:41 and that comes from me i take ownership of it and you don't need to feel it and 26:47 we need to have this is not one-time trial learning we will repeat this conversation a number of times before 26:52 you can internalize it and and the clarification the clarification though that i would make is that 26:59 we are not so counter transference i guess if technically if it's counter transparency could be the therapist's 27:05 own stuff but when you're doing therapy you are going to experience emotions as 27:12 a therapist that are being projected by the client so you're not feeling it 27:17 for them you're feeling it with them and they may not have the language to be 27:23 able to identify like the client may be experiencing shame over that trauma 27:29 event and you may be experiencing anger and so it's important for the therapist to help them be able to identify that 27:36 language and then once you do that then the client says you know what i i'm pretty angry about that yeah and i 27:42 didn't know that and so it's important for the therapist to be able to help the client develop 27:48 language around their own emotional regulation michael's right you have to make the distinction yeah 27:54 these are not your feelings or my reflection of your feelings these are mine and they're not really about you at all 28:01 they're about the circumstances you're describing and that's a it's hard and i think there's a consent 28:07 there too but your client has to be willing to feel that with you and maybe they don't feel that at all 28:14 nudge it repeatedly right if they keep coming back right right right they will and that's the other piece that shocks 28:21 me about what doesn't necessarily shock me about security but that i find interesting about becoming more secure 28:28 somebody very close to me is going through a therapy process right now and they have had an [ __ ] an abusive 28:35 an emotionally abusive mother for almost all of their lives um then they're also gay and they came out with this 28:43 they came back to me one day and said i said well how did therapy go and they said i didn't realize that not 28:49 everybody's parents called them a [ __ ] and i said that's correct 28:54 that is an emotionally abusive situation and that hurts um 29:00 and he said i got a lot out of this therapy session because suddenly i realized that that wasn't 29:07 normal and that i didn't like that i said okay very good right and so that 29:12 i i really felt that there's a marked difference in this person and how they see themselves and 29:19 how they accept themselves and their sexual identity after that conversation 29:25 right good and and and so wow you know i think that that when it works it's beautiful 29:31 it's powerful you can see it yeah you know we started this out talking about the idea of the inner child and the 29:37 relationship of that to jung's theory of the the shadow and you know 29:43 so i think that there is a part of therapy that is directed 29:50 towards helping people embrace the shadow i think that's how you truly are able to establish security as an 29:57 adult is to be able to embrace those parts of yourself that you have felt either shame or 30:03 you know tried to hide i think that that is the healthy way to be able to do that but you know when you're talking about 30:10 this is he going to embrace the idea that his 30:15 mother called him a [ __ ] for all of his life maybe not and so he it it's about acceptance i got to find a way to 30:23 accept that so do you think that he found that or is he still looking for 30:29 that i think he has accepted that that is his reality yeah and that that was and 30:36 that's very liberating and i think he always accepted that that was what happened right he didn't deny that as as 30:43 a reality it was more the understanding that that wasn't the norm yeah that that when that 30:50 happens to other people they also get angry and it is okay to feel that anger right he is 30:56 justified in that anger and it doesn't mean so maybe that's what he's working to accept is the anger that he yeah 31:03 because he was always in denial about that yes yeah well he wouldn't he wasn't allowed to feel that feeling because on 31:09 top of on top of the hate that he gets from the idea of the sexual identity there are 31:16 other ideas of masculinity underneath that and a less than man who 31:23 is gay right if i show emotion if i express this idea well that makes me 31:29 more feminine and that leans into this idea of being this thing that my parents 31:34 dislikes or my parents is picking on so many so many shame-based messages yes 31:39 it's a shame yeah so i think that's a good point to jump 31:44 off the train um hopefully this was beneficial for people as always if you have any questions or 31:50 comments about things that we're talking about please reach out to us at psychwithmike.com we would love it if 31:55 you would go to apple podcast find psych with mike and leave us a comment and a rating but most importantly we really 32:02 really really really really love it when people go to the internet and find us on 32:08 youtube psych with mike and subscribe to the show that's super super beneficial helps people find the show as always the 32:15 music that appears in cyclic mic is written and performed by mr benjamin de clue and if it's friday it's psyched