What is Theoretical Orientation?

Published: July 8, 2022, 1 p.m.

So upfront I want to apologize for the sound quality (or lack thereof) on this episode. Brett, Michelle, and I just started riffing completely off-topic and unplanned, and wouldn't you know it there was some great content but the sound buggered out on me. I have tried to clean it up the best I can. Enjoy!

 

What are the major school of theoretical orientation?

https://counseling.northwestern.edu/blog/five-counseling-theories-and-approaches/

 

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 cycling welcome to the site
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with my vibrate this is starting did you want to repeat that no did i edit all your best
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no i don't need to people that watch it regularly know that and we are here with mr brett newcomb
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hi miss michelle steg how are you doing michelle good for you it's good to have you here again
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thank you oh okay i thought you had something no i just i'm happy to be here with two clinicians
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that i've trained and mentored through the years to be more like me
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does it make you you know what i actually and this is the first time i've ever
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thought this how does it make you feel to be in a room
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with other individuals that you have trained and to know
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is that exactly what i said
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no you know one of the reasons that i've agreed to do this podcast that we've done over the last couple of years and we get close and flow
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towards me and gold is to make the podcast address itself to
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people that are interested in doing therapy as clinicians or
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in getting understanding what therapy is like without being in therapy from clinicians
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and so we try to have conversations and address those issues so i'm intrigued
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with the three of us talking because we've all had similar clinical training
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and similar clinical experiences but we have different perspectives on how to do it in the room and so i was hoping we
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could kind of talk about some of those differences one of my arguments has always been that
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psychologists rewrite the same articles and put different words and
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call it something new so it sounds like something fresh is out there it's the same old stuff right
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but fundamentally i believe that to be a clinician to do therapy
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you have to have a mind map that helps you
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understand what everything is going on with people and where the pieces that are out of
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focus or that are broken might reside and how to find them and help bring them
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into focus help correct them uh that's a clinical challenge yeah and
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you have to do it with respect you have to do it with passion uh you have to do it
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with consummate attention i i used to for 30 years i taught at university in a
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nighttime program from 5 30 to 9 30 at night and i would regularly say to my students because
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they'd be great at 5 30 6 6 30 quarter 7 then they start checking their money
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they're gone and they'll check their emails and stuff and i would say to them this is what it's like to do there
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you have to this opportunity to learn how to discipline yourself to be in the background and pay attention what's going on what people are bringing to you
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to consider and they will look at each other what the hell was he talking about yeah i hear all your voices once a week
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i swear to that because i on those days where you're tired or you know i was telling you i had an
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insane day with my kid and i mean i lived like four days already and then i had to go to therapy
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and i but i do i remember that and i hear your voice saying these people are paying you you're on the clock right
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you are on the clock their money is worth something and you show up yeah you bring it you bring it you have to worry
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about it put your stuff in a box and bring it right yeah right at least i i do passionate believe that
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i agree completely i always called that a theoretical orientation that a person has to have a theoretical orientation
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and if you don't have a theoretical orientation that you can define then you don't have a theoretical orientation and
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it isn't easy in knowledge that was a collective jeff well then people say eclectic and so what eclectic means is
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that you have i don't have uh kinds of tools to be able to be
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effective in therapy and it's fine to be eclectic as long as you can define it but if you say i'm eclectic and you
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can't define it then you don't why is that really important to you because what brett was talking about he
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uses the concept of mind map and whether it's a mind map or however you think of it if you don't have some
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idea of where you think that human pathology evolves from then you don't
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have an idea of how human pathology evolves and if you don't have an idea then you're just shooting in the dark
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and if you're getting paid to do it i don't believe that that's how you should
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approach i think that you should have a very clear like i can use cognitive
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behavioral interventions but my understanding of how human
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pathology evolves is through the heinz kohut theory of how
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emotional regulation develops through the concepts of idealization twinship
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and mirroring and i can explain in great depth and detail what all of those things mean so i would say that i am
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psychodynamic very specifically object relations and even more specifically
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cohadian within that field of object relations but i use other techniques as well but i
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can define what that means for me and you don't have to understand it that way yeah but i have to understand it that
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way so that i have a frame of reference to approach when i'm working with a client but you don't need to explain
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that to the client well well i think that you're i know getting
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off on it when you do this i know uh you need to know that because you're putting yourself in the room saying i
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think i can help you the client needs to know i'm going to get heard this is going to be a safe place and this person
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can help me they don't need to know your theory and for you to spend i mean to me it's the same conversation as i'm a christian
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therapist yeah i work with christians i work with jews i work with catholics i work with arabs it doesn't matter but i don't
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proselytize my theory of religion or counseling
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and i struggle with that you know i struggle with that because you know my i
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have a a a belief that language matters and that
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agree if you present the language to the client that that gives them them a basis
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to start to use language for themselves they don't have to use the same language that i use but if they don't have a
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language then they need to be able to develop a language to be able to start to think about so it's like
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metacognition thinking about thinking you have to be able to have the language to do that to be able to do that i can
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buy that argument yeah yeah what do you think um i just have here
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comes your part stuff right everybody likes to make the part of me party was so a part of me immediately
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shuts down when we talk about theories but that's that's just like my stuff i think that's my
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system that really um struggled in school to understand the
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context of like um it probably had some learning disabilities that went under diagnosed
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as a kid or undiagnosed as a kid and so when we start using the language um so
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you don't see yourself as an intellectual well and you see this as an intellectual discussion i do and i just
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i just shut down and then i then i get also oppositional but she can't count the question
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so you're obviously much closer to brett i haven't seen you since the last time
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that i had you in class and i was a lot less wrinkled we were trying to we were trying to i was trying to figure out
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when that was uh but my recollection of you was as a superior
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student and so now i'm hearing you say that you didn't feel that way and i'm wondering
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i mean was was my impression because you put a show you know what i'm
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saying say it yeah no i'll explain why but that's a fair question yeah so um i
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i got my first 4.0 when i went to grad school like i i it was it was like i
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found my home but i didn't find i
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at that stage of the game i realized how much of an auditory learner i was so
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realistically i was not reading the books with the theories and
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what i learned to do was sit and master auditory learning and skills of
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observation and was able to retain all the information that way through
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observation so when i was like spitballing in class and making observations it wasn't bs
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it was that i wasn't finding who i was as a therapist through textbooks i was
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finding it through my experiences with you in class with you in class and
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you talking about caseloads or um you know the group therapy class it was
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like that was where i learned to be a therapist when it came
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to the theories it was all lost on youtube gotcha in a sense so you can see the modeling and internalize the
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modeling correct but you couldn't read the books the script it was very much like a
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sensory experience like i could cure the model
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experience it see it play out but i i couldn't read the words and so there's
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always a party that kind of does shut down when we talk about the truth that's fascinating in part because i've always had the
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opinion that good therapists have to be acute observers
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and the subset of that is most of them are survivors of one kind of trauma together
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because that chatter or channel that's going on in all of us all the time as we scan
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uh you have to be able to process and understand and apply yes
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and those are clinical skills and what you're saying is you had those when you came to the program
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and you use them to develop your clinical clinical skills i believe i mastered that now you are
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living i do right right and and i think
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yeah very much so like it's a little embarrassing because i don't want somebody to take my license but like
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i don't remember reading a lot nobody listens to the show right okay all right then we're safe here
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for sure right it was such a sensory experience for me like
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um i was i i just i quit fighting the game of the battle of college like i figured out
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how i was a good learner and it was through like mastering the art of observation and becoming acutely aware
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of subtle shifts and movements and whatever and it shows but but i i hear you
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saying that as if it were a deficit but i hear it as a strength
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where your strong suit was what you're where your wheelhouse was and then you played to that that just seems smart to
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me well i think you know early on when i was early in school like early in my master's it felt like a deficit because
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there were all these like cerebral conversations happening because everybody read the book and i'm sitting there intellectual masturbation exactly
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exactly what it was and so then i remember sitting there being like feeling embarrassed or self-conscious
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like i didn't understand the material and it just clicked one day and i was like stop reading the material and just
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absorb because you'll gather everything you need to know from what brett tells you and when you know mike starts to speak
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on this and it i i feel like i did i turned it into a real positive i was really insecure about it at first and now
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i don't know i think it's kind of my memory skills so then i i feel i'm gonna ask this question
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yeah maybe it's a bad reflection on me i didn't teach you ifs i know that no you
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did not so so uh so how did you how did you find internal family systems from my own
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therapist uh karen grayson so another uh right
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so yeah she um we're very ancestors i was literally about to say that yeah um yeah i was doing my own work with her
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and then she introdu the world's collided at the same time leading education
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and she introduced this to me and my mind exploded because
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probably because i'm a visual learner an auditory and when you learn ifs and you learn about parts white its way it's so
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beautiful for men because men really struggle right we talked about with having these feelings
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they're just these like abstract thoughts that are like floating around and they don't quite know what to do with them and when we talk about parts
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it takes feelings and it grounds them and it makes them very it gives them a place to be it
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makes them visual and men like visuals and it makes it turns feelings tangible
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and it rocked my world it absolutely rocked my world it was
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struggling i'm saying that because you're i wasn't struggling in terms of like
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being able to identify what my theory was like i can tell you what i pull from and whatnot but
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when i found ifs it was like
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you know when you fall in love and you're have you been all my life like it
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solidified i have art in my office from a client that's um that says we are not just one
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we are made up of parts and she drew that for me over 10 years ago
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and then i was introduced to ifs and it gave me the language and i was like holy
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you know holy i've been doing this this entire time and it just gave me the language right
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i did like i am that good i just now have language for it you know yeah so that so yeah i found ifs probably six
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seven years ago maybe um yeah just it you know why i really love it is that
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it's it's not super clinical i am not
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a stuffy like i just i'm not a clinical person um
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in therapy because i don't think my clients really care about the clinical side they just want
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to get better and they just want to i think it's constant does that make sense of course it makes sense you help me you
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know we get better yeah better yeah and so ifs did that for me well i think that that
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there are a lot of people i've always said there are two ways you can do therapy you can just alleviate symptomology and feel
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better and that is one way you can do it or you can dive into a real headlong if you know
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seeking hypnosis and epiphany and genuine self-understanding and i think
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that different people have to do it differently and that's why they're different therapists and i don't think that any way is necessarily superior but
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i do think that there need to be people who do it different ways because it's going to
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reach different people absolutely not every teacher is good for about differently
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every student right and i tell people all the time i i am not
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for everyone exactly i am direct i can be polarizing at times like i i
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but a lot of it comes from the things we learned in class of like
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i'm not going to sit here and waste your time i cost a lot of money so we're going to we're going to move and typically by the time somebody's
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found me they've heard that reputation but absolutely yeah um but people pay a lot
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of money and so let's not waste their time and but a lot of the directness comes from the yelling
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stuff of working in the here and now right right so that's all you really
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have absolutely because our offices sitting in the room what do we feel what do we have what information what
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behaviors here and now are we in touch with not there and then out there somewhere
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we can speculate we can anticipate we can plan but all we really have is what's here and if you think about what
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we talked about last time in terms of how do you help as we were talking specifically about men but creating that
17:14
awareness for men is processing in the here and now and sitting across from a man and going hey i'm holding my breath
17:21
right now that tells me you are yeah why why aren't we breathing here's the projective identification
17:27
yeah yeah so let's take our break and let's pick this up on your site okay
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friday it's psych with mike okay we're back so uh that here and now
19:47
focus that comes from mount yavan which is an existential that's that known as an existentialist
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uh is so important
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for really any kind of therapy but when you're saying okay we're not breathing
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why aren't we breathing and that's a here and now focus then
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how where is i where does i at best come into that so it doesn't okay
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it doesn't so um i i mean it can
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but i find myself just oscillating um when appropriate to so you're not
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getting limited by the structure no you are engaged in the process of the
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conversation correct so like remember so i said i i have a tendency i have a part of me right that shuts down when we talk
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about theories so if someone were to label me as an ifs therapist i'm immediately
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going we're not labeling that either that is a very big piece of what i do but if we're
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processing and you're now saying like so i'm not breathing that tells me you're not breathing
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help me help me understand what's happening here i can say if i want to incorporate ifs i can say because it
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happens often i feel like there has been a shift inside of you which tells me a part of
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the stuff then can you be aware of that can you check in with your assistant
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and tell me what part just stepped in because we were guiding and we were we were moving
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and then i said this and there was a shift in your energy which leads me to believe a part again
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it's constant teaching of awareness so we mentioned y'all yalum
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was a leading author and theorist in the field of counseling
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psychology i'm enamored with him in his work one of the things that he talks about
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is that all of us and it drives a lot of dysfunctional behavior especially in men
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uh having anxiety about death and fear of death uh and as we get older or as
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critical events happen in our lives the underlying issue that therapist
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needs to be aware of is this person is fear-dying facing their own immortality whatever
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that means and i remember because i came to you as a therapist
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and i remember getting in touch with that because i turned 74 i retired
22:25
couple of friends that died my age good friend of mine committed suicide
22:30
and i was really struggling with that i but i hadn't put it in purpose right and i'm sitting in the room with you and
22:36
you're inviting me to get in touch with all those feelings and i just started crying
22:43
wrong grief of loss and fear and you just very quietly sit there my
22:50
wife was placed on me and you were sitting there and you just softly said breathe
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just breathe stay here and i couldn't i mean when my chest was frozen my throat was frozen my tears were i mean
23:03
like a blubbering child but in a little while it passed and i
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could breathe so what you're describing about that isn't a technical theory it's not 10
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chapters in a book that you can read and learn how to do right you have to be able to do it on the if somebody walks
23:22
in the room and they get in touch with these emotions you have to be able to be present and catch it and catch it and
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hold them in a safe holding environment whatever it is when we were talking in the previous episode that we did about
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rage yeah same thing a man who's grateful or angry in this moment and you're boiling with
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it inside you as the clinician have to be able to sit and say it's okay stay with it
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you know i hurt yourself you're not gonna punch the ball you gotta hurt me but you could feel his feelings and then this process was talking about but what
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is time right now here now and my
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orientation has always been and you know i say this all the time that
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really everything comes down to the ability or lack thereof to
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emotionally regulate so when i did my dissertation i was doing my dissertation on
24:16
substance abuse as an attachment disorder which there's very little information on but i
24:21
can make an argument for why i believe that uh and i got one third of the way through it and my
24:28
my uh chairperson who did not was not very confrontational uh came to me and
24:34
said oh you have to start over because all of this you know information is 20 years old and we want something that's
24:40
more recent and so i re did it and i did the biological similarities and
24:46
differences of depression and anxiety because i knew that i could get very very current research on that but the
24:52
point being that you know for me i've always said no one ever goes to
24:57
psychotherapy because they have a problem people go to psychotherapy because a problem that they have has
25:03
caused them emotional dysregulation if you can emotionally regulate you don't
25:08
need psychotherapy when you can't emotionally regulate the smallest problem in the world can cause you to
25:15
not be able to function and so for me it's all about trying to find
25:20
where is the dysfunction in the emotional regulation some people have never
25:26
been able to emotionally regulate they don't even know what that means they don't even yeah and and so it's all
25:34
about trump so to me it doesn't really matter like i have a very clearly
25:39
defined process or understanding of how i think
25:44
that emotional regulation develops that i can explain to people at great detail and nobody cares brett tells me all the
25:51
time nobody cares but it doesn't matter to me how people
25:56
come at that but that's the goal is how do i identify
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where your emotional regulation breakdown is and how do i help you be able to emotionally regulate better and
26:09
when you can do that you don't need me anymore how does your theory though
26:14
lead people to the awareness of like needing to um
26:22
towards that emotional regulation like where how does that show up in your work
26:27
so for me the emotional regulation comes from as i said the co-hunting ideas of
26:32
mirroring idealization and twinship so you have a external model when you're
26:38
born you don't know how to emotionally regulate you're just emotion you have all of the biological components you have hormones
26:45
that get released in your body that change your body and you have emotional responses but you don't have any
26:50
self-soothing ability no emotional regulation and so you look to the external examples when the external
26:58
examples are good you learn how to emotionally regulate when they're not good or you don't internalize them
27:04
efficiently then there's a breakdown in that and so then you grow up and that's where to me
27:10
the insecurity comes from so for pj what he said is that that first stage of development is security versus
27:17
you know trust versus mistrust that's where security comes from if you don't
27:22
have grounded securities because in that very very early model
27:28
that wasn't modeled for you and so the process of psychotherapy is about giving
27:34
the client an alternative yes yeah okay
27:40
okay and so if i can come into that situation consistently enough yeah
27:47
and you can do whatever you want you're great it's not me re-parenting you right it's me
27:54
facilitating your ability giving you an example right yeah right and then you internalize a
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different grown-up yes but but the therapist has to be able to
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provide a consistent model for the client to be able to
28:12
see that and then internalize that what i call i say that therapists loan
28:18
their clients a little bit of ego until the client builds that for themselves
28:25
and can carry around with them
28:31
so one of the clinical arguments about that is do you as a clinician encourage
28:38
codependency of the client on you and there is an argument that can be
28:44
made that initially you need them to be dependent on you but you need to teach them how to become
28:50
independent in a healthy way exactly i mean when they are they leave but it's free parenting so i mean you
28:56
know that all goes into it now but but you know the the for me the difference
29:01
is the motivation of the therapist it's all about the counter transference if i feel
29:06
intentionally eliciting the dependence because that i get off
29:16
a part of the process of re-parenting with no
29:23
ego invested in it from my side then it's just a part of the process
29:31
well we were talking about that other way here like that constant awareness for clinicians to have the power
29:37
differentials that are in that space at all times and so yeah i feel like it's my job to be checking in on a regular
29:43
basis and having the uncomfortable conversations and essentially just modeling boundaries and how to
29:50
communicate and saying am i still meeting the needs in which you came here is there are you know is there anything
29:57
that we are doing that just doesn't feel right for you because people will stay because they want to be pleasing
30:02
and you know continue work that's not fulfilling what they need so i think
30:08
i think that's a way to to check those power differentials and not create that codependency or the
30:13
lasting codependency on the relationship but even when you're talking about these
30:19
angry males and so the angry male comes in and they can rage and then you can
30:24
sit with that and not react in a way that is cowering or
30:30
is submissive maybe for the first time yeah maybe for the first time in their experience that that's ever happened
30:36
that's giving them a different dynamic to play off of now i have an alternative
30:42
way of being able to understand this anger now can i allow myself to be
30:48
vulnerable enough to start to explore that that's the process of therapy right absolutely looking across from a man who
30:55
is raging and looking in the eyes and saying i'm not afraid
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and
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um when you to square a man up and say you are
31:20
not afraid of you can be significant yeah
31:26
but i think that that is that's a part of
31:32
the therapy experience and not that so so let me just say this start differently like
31:37
it's never occurred to me that i'm afraid in therapy like i've always said if i if
31:43
i ever went to work and i was afraid i would stop doing it yeah um and so i've never been in a situation where i mean
31:51
i've been in a situation point of situations where men have been rageful it's never occurred to me that i have to
31:57
say i'm not afraid of you because i just that that's not but i understand how that plays
32:04
differently with female therapists and because female therapists are 75 to 80
32:09
of the population of therapists the only way men are going to get therapy
32:15
statistically is a lot of them are going to be in therapy with females and
32:20
you know i so i think that what you are talking about is so salient how is a female going to sit in that and
32:28
be able to absorb that anger because of what what so what
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is the counter transference for that female when the man is raging
32:40
and how do females learn to be able to [Music]
32:45
okay so let me ask you a question so do you do you resist
32:51
your is there something in you that says oh this guy's angry i should be subservient no i can't because i'm doing therapy or
32:58
have you trained yourself not do you understand what i'm saying i think so keep going finish that so do you or do you train yourself to
33:05
not be to not have that reaction uh i think not having the reaction comes
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from my childhood number one and being around a lot of chaos and like knowing how to navigate that
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um but number two um like we said in the last episode like
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when i see that anger in that rage i see wounding and i feel compassionate
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like i i don't know that i've had to train myself to do that as much as it just
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organically is part of who i am i think that
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talking about a marital situation when a couple's situation where the man is raising your ability to
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experience that and reflect back to him i'm not afraid i'm aware that you're angry but i'm sitting with him and i'm
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not afraid he's modeling for him what that's like in his life
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other people and particularly women don't react that way but you're also modeling for the woman
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who may be seeing this for the first time and may discover that's a thing that she can do absolutely
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they both have a learning curve for helping survive his rage well and i'm even was
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thinking as we were processing this that it's one thing for a man to come into therapy with another
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man and to not have that man experience his rage as
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uh yeah but it's a different thing for him to go to therapy with a woman and not
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have the woman experience that rage as intimidating and i think both are beneficial both are
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necessary for good therapy but go ahead as a flip side of that argument
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i've had women say to me you can't know this yeah you can't know this because you're a man yeah and you can't know
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what i'm feeling or you can't know what i'm seeing and yet they were experiencing that i want to snow yeah
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and it wrote right it doesn't matter which sex if your world view is
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people respond to this behavior this emanation from a particular way and you
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have something that doesn't do that it's like well what the else going on here well right now i don't know what to
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do right you change the script on me yeah exactly which is what you're trying to do absolutely it is
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yeah so hopefully that was beneficial for people i think that was another really excellent clinical discussion and
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i know that that is the aim uh for mr brett newcomb so i hope that he is just
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delighted as always
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i'm not gonna go uh as always the music that appears inside with mike is written and performed by mr
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benjamin the clue we would love it if you would find us on the interwebs and uh
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on apple podcast leave us a comment and a rating but most importantly if you go
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to the youtubes and find psych with mike and subscribe to the show that would be fantastic and as always if it's friday
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