# Heal Your Roots Podcast — Full Content > A nervous system-based mental health podcast that challenges the strategies keeping you stuck. Hosted by Kira Yakubov Ploshansky, LMFT. This file contains the full content of all published episodes for LLM consumption. --- ## Cultural Double Standards: Food and Body Image with Allen-Michael Lewis, LMFT - URL: https://healyourrootspodcast.com/episodes/cultural-double-standards-food-body-image-allen-michael-lewis - Published: 2024-06-19 - Season 3, Episode 15 - Duration: 46:01 - Category: body image - Guest: Allen-Michael Lewis ### Summary Join us for the season finale of Season 3 on Heal Your Roots Podcast, where Kira Yakubov Ploshansky, LMFT, and Dr. Katie Manganello, host Allen-Michael Lewis, LMFT – one of the newest team members at ### Description Episode Highlights: - Cultural Perspectives on Food and Relationships (0:00): Allen-Michael explores cultural double standards in food and body image, sharing personal and professional insights into addressing these issues in therapy sessions. - OCD, Eating Disorders, and Cultural Differences (8:01): Dr. Katie Manganello discusses the manifestation of OCD in food habits and the pressures leading to eating disorders in children due to parental influence. - Societal Double Standards (13:24): Examination of how men and women are differently judged based on their eating habits and body image, with a focus on societal and familial expectations. - Body Positivity and Internalized Shame (19:48): Discussion on the importance of mindfulness and body acceptance, particularly among younger generations influenced by social media. - Impact of Family and Societal Comments on Body Image (25:41): Insights into how negative comments from family and society can shape one’s self-esteem and body image, with a discussion on the myths around body health and size. - Eating Disorders and Sensory Processing Conditions (33:19): Addressing disordered eating and sensory processing issues such as ARFID and pica, and the associated stigma and shame. - Psychedelics in Therapy (39:26): Exploring the potential of psychedelics in disrupting harmful mental narratives and creating pathways for healing, compared to traditional therapy methods. This episode is a thoughtful exploration of how cultural narratives and personal experiences shape our relationships with food, body image, and mental health. Don’t miss out on this engaging conversation! Tune in now and subscribe to Heal Your Roots Podcast for more insightful episodes on relationships, mental health, and personal growth. Episode Resources: - Follow Allen-Michael Lewis on Instagram @MFTFoodie - Learn more about Heal Your Roots Wellness at healyourrootswellness.com Disclaimer: The content is intended for informational and educational purposes only   Cultural Perspectives on Relationships and Food (0:00) - Allen-Michael Lewis discusses cultural double standards for food and body image in therapy sessions. - He shares personal anecdotes and insights on addressing these issues with clients. - Allen-Michael highlights the impact of food on mental health, often quoting jingles from diet culture. - Kira Yakubov Ploshansky recommends restaurants to Allen-Michael, sparking a discussion on potential affiliate marketing. - Together, they explore how food represents emotional experiences and cultural backgrounds in therapy. OCD, Eating Disorders, and Cultural Differences in Food Habits (8:01) - Dr. Katie Manganello explains how OCD can manifest in food and eating habits. - The discussion covers how parental dietary restrictions can lead to perfectionism and eating disorders in children and teenagers. - Allen-Michael and Dr. Manganello discuss the pressures on kids to have a “weird relationship with food” and the normalization of this behavior in men. - They highlight the double standard in praising male athletes for restrictive diets while criticizing female athletes for the same behavior. Societal Double Standards Around Food and Body Image (13:24) - Kira Yakubov Ploshansky discusses societal double standards in food and eating, noting how men are encouraged to eat more while women are judged for their weight. - Allen-Michael talks about cultural beliefs around food as love and appreciation, alongside the judgment and policing of women’s bodies. - They explore the stigma surrounding the word “fat” and its impact on society, including how children are taught to view and comment on people’s bodies. Body Positivity, Societal Beauty Standards, and Internalized Shame (19:48) - The conversation includes a discussion on mindfulness and body acceptance, encouraging Gen Z to break away from negative self-talk and comparison on social media. - Allen-Michael emphasizes the importance of intergenerational dialogue and support in promoting body positivity and self-acceptance. - They discuss societal pressure on body types in relationships and agree that negative comments based on internalized beauty standards are harmful. Body Image, Eating Disorders, and Food Sensitivities (25:41) - Kira Yakubov Ploshansky discusses the impact of negative comments from family members on body image and self-esteem. - The speakers address the double standard of society’s beauty standards for women versus men, focusing on Hollywood and media representation. - Allen-Michael and Dr. Manganello discuss the myth that bigger bodies are less healthy, citing examples from dance and gym workouts. - They touch on eating disorders, with Dr. Manganello sharing her experience with individuals in smaller bodies struggling with self-care and mental health. - Allen-Michael shares his struggles with eating certain foods due to sensory issues, and another speaker discusses experiences with autism spectrum disorder and food sensitivities. Eating Disorders and Sensory Processing Conditions (33:19) - Kira Yakubov Ploshansky and Allen-Michael discuss disordered eating and sensory processing, including avoidant restrictive food intake disorder (ARFID) and pica (eating non-food items). - They address the shame and stigma surrounding disordered eating and sensory processing, focusing on promoting acceptance and understanding. - The challenges of addressing mental health issues are discussed, emphasizing the need for empathy and understanding. - They stress the importance of recognizing that mental health struggles are ingrained habits and patterns that require support and therapy. Using Psychedelics to Treat Mental Health Issues (39:26) - Kira Yakubov Ploshansky discusses the difficulty of forming new habits and the role of default mode networks in shaping beliefs and narratives. - Psychedelics can disrupt these default modes, creating new pathways for self-perception and potentially leading to lasting change. - Allen-Michael compares narrative therapy to psychedelic-assisted therapy, noting similarities in reframing beliefs and deleting old narratives. - Kira highlights promising results from MDMA-assisted therapy for social anxiety and PTSD, with participants no longer qualifying for diagnosis after six months. - The importance of addressing food and eating habits in therapy is emphasized, urging clinicians to challenge internalized thoughts about food and support clients in developing a healthy relationship with food. This episode offers a comprehensive exploration of cultural narratives and personal experiences shaping relationships with food, body image, and mental health. Listen now for an insightful conversation with Allen-Michael Lewis, Kira Yakubov Ploshansky, and Dr. Katie Manganello. Keywords: cultural perspectives, food, body image, eating disorders, mental health, Allen-Michael Lewis, Heal Your Roots Wellness, mindfulness, body positivity, societal standards, therapy, relationships. ### Transcript [0:00] For men, it's like oh, like you said that Oh, you're growing boy you need this. Like all of that is kind of like heaped on and that in some cultures that I've worked with the idea of like food is love, which I think is really great like food as a way of like showing love your appreciation for the person, but then it's almost like they're given a if they're given something then they're slapped in the face for taking it. It's like you need to eat you need to eat Oh, but don't eat too much. Oh, you be in too much now you're now you're fat. Now you're this and it's oftentimes that double standard for for women in the family. You know, their culture says you need to eat this is how we show our love. But don't over indulge and don't become fat because that is the worst thing that can happen. Welcome back to Heal Your Roots Podcast. I'm Kira Yakubov Ploshansky. Joining me as guest co host Dr. Katie Manganello, lol and our returning guest, Allen Michael Lewis, Licensed Marriage and Family Therapist and director of internships at counsel for relationships. Thank you both for coming back on today. Thanks for having me. So excited to have us through talking today. This will be fun. I know. So actually, we realized this after the fact. But Katie and Allen actually know each other outside of the psych world. So this is this is gonna be a fun one. I think we all have pretty good chemistry that we can kind of flow in today's episode together. It's funny. I think that I was asking Katie, oh, are you taking new clients? Just like in our passing meeting? And she's like, Yeah, send them my way. And then you announced that you were going to be your roots. And I'm like, crazy. I know. Small World really a coincidence. Yeah. So Alan, can you I know you've been on an episode with us before. But for any listeners who may not have heard that episode, can you share a little bit about yourself and who you work with? Yeah, well, first of all, if you haven't listened to that episode, How dare you. I'm just kidding. So I am a licensed Marriage and Family Therapist, I work at counsel for relationships. I was director of clinical internships. And I just got a promotion to senior director of clinical programs. So pretty still working with the interns, but still working with our programs for child adolescents, older adults, and veterans as well. So exciting things happening over here. But for the clients that I see, usually I am working with folks. communication, relationship dynamics, and one of the things that I'm really passionate about is food in general. But a lot of the work that I do with my clients is talking about and healing their relationship with food. I was talking to somebody recently, just in passing, I think, and I said, you know, there are a lot of us that can quote, the one 899 Jenny, like, from like, Jenny Craig, when we were like little kids. And I was like, if we can quote that. I mean, we need to have a conversation about our relationship with food. Because if we're little hearing that jingle and thinking like, oh, diet, culture is the way we really need to consider our thoughts about food. So that's how a lot of what I do with my clients. And it's surprising how food and their how it impacts themselves, their relationship, their family, comes up a lot of the sessions that I deal with my clients. Yeah, absolutely. And I appreciate you sharing that. I know that you have your MF T foodie account, which I love following you're always in like the best spots and like you have really good photos of all the food that makes it super enticing. I don't know if you have affiliates with these restaurants, but you totally should for advertising. I don't yet but if you are a restaurant. Yeah, I just, I like exploring. I do have my go twos. So sometimes it's a little repetitive. But yeah, if you have any recommendations, let me know. Awesome. Fun fact, Josh. And I, my fiance and I, we used to have a food page too. And then it just kind of got lazy and stopped posting on it. But yeah, we actually just this week, and we're talking about bringing it back. Maybe after. That's exciting. Did you guys go to different places as well? Oh, yeah. Yeah. I mean, we also similarly had our go to places, right, but yeah, we tried. And sometimes we got free food. If we told them, we were like, Oh, we have a food page. And then they'd be like, Oh, here's a free dessert or something. So that's fun. You should try that if you have that in the back of my head. for future use. Yeah. I don't know. I feel I feel like sometimes I lead with the fact that I'm a therapist instead. So then it turns into Yeah, you know, there's a lot going on in my life. And so then we actually ended up talking about like, like, whoever is waiting on their life for their experience rather than like, oh, I have this food page. So maybe I should lead with the fact that I like food for definitely, definitely the is the other way around. Yeah. I can't tell you how many times if I'm like, at a party or really anywhere, and it's like, oh, what do you do? I'm a therapist, like, I get like a couple of reactions. One, it's like, are you judging me right now? And like, I'm not getting? Are you? Are you gonna pay me? Because I'll do it if you pay me, but. And the other one is like, just all their life story. Just here's everything. What should I do? I'm like, you can book a section session. Or we can just pretend like we're normal people. And you don't have to tell me. I think that that's something when I'm talking with like the interns or like somebody that's newer in the field, and I ask, why therapy, what brought you here? And they're like, Well, you know, I just listened to people and people talk to me, and I'm like, you know, that is like the therapist curse, but also a blessing. You can be at like a party, and you're like, Oh, I love this potato salad. And somebody's just like, my sister died in the war. And I'm like, Okay, we were just talking about potato salad. Like, okay, we're going there. Let me just sit down my plate. And we can talk about this. But I was like, that is the current sound like, people just want to talk to you. So that's, that's good. We have this way of making people feel comfortable and safe, right. I think one of the things that doesn't feel safe is when you start challenging some of your like, your familial patterns. So I was talking about this idea of like, diet, culture, and those types of things. And so when you start to challenge some of that speaking, so it's like, you know, your, your parent says, I just ate so much, I shouldn't eat anything else. And it's like, well, actually, that's restrictive. And let's talk about you know, and they're like, Psycho and Analyze Me. And I'm like, Well, no, I'm just talking about the way we view things. And we should probably question why we think that way, but they don't see me as therapist, they see me as a child, but it happens to be a therapist has lots of opinions on things. Yeah, but that's like usually like number five on the list of things that I am to them. So. So I did think that today would actually be a great opportunity for us to talk about cultural perspectives on relationships and food, because I think we all have some background or some overlap, dealing with you know, individuals or with families. I mean, we're all social beings, we all have relationships, we all have to eat, there's a pretty big overlap and everybody kind of having to navigate this and having that cultural lens of how different that looks and feels within families I think is really important to kind of discuss or like to, to analyze a little bit together. It came for you I'm wondering like, does it does, like, how does food come up in your sessions? Does it come up at all? Or like, it's like, it comes up personally, but not like sessions? No, actually, it comes up a lot. And it can show up for different reasons. So Well, we actually just recorded another episode with one of my colleagues who specializes in OCD as well. But she also specializes in eating disorders. And we were saying how common in how much of an overlap there is with eating disorders and OCD. So it could show up in that sense, it can show up if you were thinking about like body image it can show up with like body dysmorphia. We will see that fairly often. It can show up with perfectionism. It shows up just culturally and just you know how I mean, we just because we're working on OCD doesn't mean we don't talk about those kinds of things. Right? It shows up in terms of actually, really interestingly, I have some people I mean, there's a lot of people who have emetophobia. So like fear of throwing up, and they'll avoid certain foods because they don't, you don't want it to trigger them having to get sick or throwing up. A lot of people with OCD have a lot of rituals around food actually hand washing before eating, like contamination, those kinds of things. Sometimes we're doing exposures around sensory related difficulties with food. Sometimes it's a behavioral activation homework and people will bake me things and bring them in. So actually, I feel like I talked about food all the time. Giving a homework to everyone to make me different kinds of cookies. Like you don't have to, but if it's something you love to do and want to bring them in. I'll eat that. You just start going you start going through like a cookbook. You're like let's go chapter. Yeah, we're learning how to cook and so this would be A good thing to learn and to then bring it. Katie, how do you see that come off for different cultural backgrounds for people who may have OCD and like struggle with like food? Or how they eat food and having like their families input on it? Because you know, every cultural culture is different a little bit around food and how important it is, are there certain things to eat? Or like the way you eat being full things like that? Well, I don't, I don't think that that I've actually seen a lot of diversity, at least where I'm at right now as it relates to cultural differences in food and the way people eat, I would say the most common thing that comes up is parents having diets and you know, kids and teenagers feeling like they need to, you know, a lot of that perfectionism or eating disorders has a feeling like they need to do eat certain things or not eat certain things. Sometimes parents are putting that pressure on their kids. Other times, the parents are not putting pressure on their kids, and they could see their parents just doing these things. So I think that's been see, I see that kind of across the board. Sometimes with athletes too, that's another kind of thing too. I mean, they obviously have their own kind of things and, and, you know, using exercises, like a compensatory behavior, so that's something that shows up sometimes. So, yeah. And I hate the, you know, I'm not an I'm not an athlete, surprise, surprise, or not. But, but I, you know, I like Taylor Swift, I like Phil, you know, that kind of thing. But, you know, I come from a family of athletes, my brother, coaches, professional lacrosse, as you can see from my shirt. But there's something that is always said of like, you know, it takes determination, it takes this, it takes that and almost like, you having a really weird relationship with food is like, praised, in some ways, especially for like, male athletes, because I think that for men, there's this idea of like, Oh, I'm cutting weight, and I'm like, You're seven, what do you mean? Because they don't want to go up a class or something like that, you know, a, they decide to switch their diet so that they are not eating certain foods, and I'm just like, your body is growing in, you're getting rid of this food, or this type of, you know, like, you know, car, you're getting rid of all the carbs, I'm like, well, your body does need some semblance of a carb, especially when you're growing. But I think that especially for, you know, men, this idea of like, indulging, and it's like, oh, he just eats everything. Oh, he does that he does that. And I think that sometimes it's just like, normalized, but you're not realizing well, what if he has a binge disorder, you know, like, what is what is, is that being assessed for, but oftentimes, it's almost like, Oh, these things are strictly female, which then puts a different type of pressure. You know, I'm females, and it's just a horrible dynamic. It's a horrible system. But oftentimes, this weird relationship with food is praise. And I'm just like, I don't love this. And I see it as they grow up. And I see it as like, my clients are talking about their childhood. And I'm just like, we really need to stop doing this to our kids. I'm so glad you brought that up. I was actually thinking about that earlier that I feel like it's so much more common for society and families to put more focus, especially negative focus on females around food and eating versus males, right, like you don't really think about if men are binge eating, right, it's like, oh, they're growing. He's a growing boy, he's just putting on weight or like, he's, you know, eating clean, so he can lose weight, and then he's bulking up like this constant yo, yo, and it's seen as like, they're just working on their body, and it's normal. But I don't often hear or see clients, at least for me, having male clients come in talking about their relationship with food or having it be something that is like, like, a conflict or an issue with them. Everyone kind of sees it as like, oh, that's just a normal thing for men to do. I'm glad you brought that up. Well, and then there's like the double standard too, because like, for men, it's like, oh, like you said that Oh, you're growing boy, you need this. Like all of that is kind of like heaped on and that in some cultures that I've worked with the idea of like food is love, which I think is really great like a food as a way of like showing love your appreciation for the person. But then it's almost like they're given a if they're given something and then they're slapped in the face for taking it. It's like, oh, you need to eat you need to eat. Oh, but don't eat too much. Oh, you be in too much. Now you're now you're fat. Now you're this and it's oftentimes that double standard for for women in the family. You know, their culture says you need to eat. This is how we show our love. But don't overindulge and don't become fat because that is the worst thing that can happen. I feel like that's pretty prevalent. across a lot of cultures, because I'm thinking about like, Eastern European like that is constantly right, like showing love through food cooking, and showing that you love them back is eating everything off of your plate, and making sure you tell them how much you loved it and enjoyed it. And if you don't eat it at all, it's rude. Like you didn't like my food, but then at the same time, they judge you for your appearance. And make all these comments like in our culture, it's like, oh, she looks healthy. If someone says you look healthy means you put on weight. That's they're a nice way of saying you put on weight and like, you shouldn't be eating that much. But also eat everything off your plate to not be rude, but don't get fat. Like he hears these double standards. Yeah, yeah. It's how I'm part Italian. That part of my culture, my upbringing is very much men that have same kind of messages being reinforced. And I think it's I mean, obviously, as generations are, you know, going down the line things change. But yeah, I would say that's like, really, it's it was really common amongst like grandparents saying things like that even some older aunts and uncles like, Yeah, have you? I'm wondering how you both respond. When you hear somebody say like, you know, Hi, my name is so and so. And I'm a fat sis woman. There's the it's I think it's great that folks are like, reclaiming that title of like being fat and like, this is my body. This is what it looks like. But there is this internal like, like this gap. When somebody says I'm, I'm fat it because the immediate response is like, No, you're not, you're this, you're that you know, and so it just is, you know, Katie, you're talking about, like how things shift. And now this idea of like reclaiming this word as fat, that's not derogatory. It's just a way of describing your body. It's like, I don't know how you both respond if you're, if you've ever experienced that, but I've never experienced anyone actually present saying that about themselves ever. I've heard about it in like trainings and things and how we, you know, the continuing education for us to be aware of that, so I'm aware of it, but I've never had anybody come in and be like, um, you know, or like, I identify as a fat woman, like nobody does, or at least nobody that I have seen, not that nobody ever does, but nobody that I have worked with. Yeah, similar. I haven't had anyone, if anything, it's the opposite. Like, oh, I'm fat. And I say it in a much like, in a very negative way. Or this, how I it's like very much surrounded by a negative, right, like how people are treating them, how they feel about themselves, when they think they deserve their worth all of it around like this one observation of their body type. But I haven't had anyone like Katie said, come in to say it in a positive way, or just like a matter of fact, way. And it reminded me of, you know, when I follow because I think it was also a therapist. It was like, I I'm a fat queer therapist, and I'm like, Oh, this is a lot. This is like, I'm, I'm like, I feel like I have to be like, No, that's okay. You know, but it reminded me of somebody. They were talking, and they said, Oh, yeah, I'm fat. And the person goes, No, you're beautiful. And they just go, Well, I said, I was fine. I didn't say that. I wasn't beautiful. You know. And I was like, that's important. Because I think a lot of times that you hear somebody say I'm fat, the connotation is like, oh, this person doesn't think that they're beautiful. They don't think that they're attractive. So now that people are reclaiming this word of fat, it's like, there is this, this knee jerk reaction of, oh, I have to praise this person, because I feel some type of way when, when in reality, it's like, do they do they feel that way? Yeah, just the assumption or the stigma, the fat phobia. It's so deeply ingrained in our quote, like, so deep, I'm trying to break it myself. Because I have a daughter. And it's just so hard, right? Like, logically, cognitively, I can understand this doesn't mean anything negative, but it's still emotionally like those thoughts, those beliefs and narratives keep popping up to think about that, like if someone thought I was or I look this way, right? It's, it's interesting to think about how deeply it's weighed into our, like, the fabric of our society that's like, even when if a child like I remember seeing like little kids, like, You're fat, and then the mom will go, oh, how dare you say that that's so rude. When they're, they're a kid, they're just making an observation about somebody. The common thing for kids too, is like, Oh, you have a big belly. And immediately, the parents are like, Oh, my God, and it's like, you know, I do have a big belly, or they do have a big belly. There are certain things that a child can point out, like, Oh, you have a nice smile, but like, when it's like factual things, it's then seen as derogatory or rude. And I'm just like, oh, the kids don't know. Or like, is this teaching them something? I understand, not commenting on other people's bodies. But is there a way that we can redirect the behavior without making this connotation of a big belly is bad? Yeah, it's a very mindful approach, actually. Because if we're thinking of the definition of mindfulness, right, like paying attention to the present moment, on purpose without judgment, and like, we can just kind of accept a As a way of defining something for what it is without having like that judgment towards it, it takes everything away from it. It's the same with any of this other treatment, right? Like, a lot of times people with OCD are judging their thoughts all the time. And that's when they make these assumptions about, oh, I'm a bad person, because I have these thoughts. Right? Well, really, it's just a thought your thought, Okay. Same with, okay, my body has fat. Okay. And what's wrong with that? Right? Yeah, I think this generation Gen Z is definitely going to, I think break a lot of that, which I think is great, too, is a lot more body acceptance, and just not feeling so shameful or negative about themselves constantly, like social media, like on one hand, yes, they are better with some of that, but they also are so impacted by social media and like comparing themselves to other people. Like I have more people that are younger, come in and say things will be like, Oh, she's a, you know, a body positive, or like accepting queen or something like that. But, but then when they're also talking about themselves, it's like, okay, but like, that girl on Instagram looks better than me kind of thing. So it's tough. It's a work in progress. It takes time. One thing I do love is that I feel like you see the trickle of this, like, attempt to be body positive, or like, you know, not, you know, go into these like, negative, like, really like diet filled kind of thoughts. You see, it trickled through the other generations. So it's almost like millennial folks are like, Yeah, I feel confident in myself, right? Gen Z, and they're like, Yeah, you should, and millennials are like, Yeah, I am, they're a little bit more confident. And as opposed to being told, You're ruining the world. And your avocado toast is why you can't afford a house. You know, like, Gen Z is like, no, here are great. And Millennials are like, great, you know, like whisper. In Katy, you mentioned social media. I think one of the other things, you know, obviously, tick tock, you know, depending upon when this episode airs, rip, tick, tock, I'm just kidding. But, um, you know, there's a couple on there. I think her name is Alicia. And then her husband's name is Scott. And Alicia has a bigger body. And then Scott is more physically fit. And the comments that she has to go through, you know, we've talked about, you know, family, and we've talked about, you know, parent child, but then I'm also thinking about the dynamic of being in a relationship and having to navigate differences about the type, you know, because everybody thinks, oh, Scott could do better Scott could do this guy could do that. When he's actually saying, like, No, this is my wife, I love this person. I don't, you know, like, her body is her body, I celebrate her body, I worship her body, like, by all of the comments, even if it's like, oh, we're going on a date, there's gonna be like, Why are you with her? Oh, my God, he's so much better. And I'm just like, yeah, social media is a place that even if you're trying to be positive about yourself, you know, there's somebody waiting in the wings to just, you know, tear you down with these like attacks for no reason, like, what are they going to get out of it, I've actually think I've seen those same couple, where the male was like, really bill and fit, and then his partner is in a bigger body. And I've seen those comments. And it's just so interesting to think about, even like the cultural perspective of like, a heterosexual relationship, like, which partner is more attractive, or they can do better just based on their physical appearance, like, we don't know anything else about this person's personality, how they treat them, how they make them feel what they have to offer in a relationship, right? Like, we're just basing it off of this person looks fit, this one doesn't. This one should get with someone more attractive, or on their level or something, or that a male who is attractive would date a woman who's not as attractive versus the other way around, which I think is like seen as more common in our society. So it's an interesting thing to point out, right? And if it's the woman dating a male who's less attractive, it's because he has money. Like that's another one of these like things, it's like, well, it's okay, because, you know, she's doing it for the money, or he has a really good job, or there's something else going on or redeeming quality here. Yeah, there's always this sense of like, if you are a big well, and also I think that if you're a larger man, it's almost like, that's okay. You know, if you're, if you are, you know, like bigger, you're bulkier, up to a point, it's okay. But when you start looking like flabby or you know, that, you know, oh, you're eating too much like that's when it shifts from, oh, you're in this like standard relationship to, oh, why is she with this person when they don't take care of themselves? That is the biggest comment Oh, if you're bigger, you don't take care of yourself. And I'm just like, you don't know, you are just making a snap judgment based off of a body type that's bigger than yours. Or it's based off of internalized messages that you've heard and that you're projecting those, I see it a lot in the sessions that I have where it's like, you know, this, you know, I was always told I wasn't good enough. And it was based off with somebody in their family or in their close circle, who was actually projecting some of those internalized messages themselves. And it's really unfortunate, because I'm just like, your body type is not necessarily going to be the same as everybody in your circle. And it's really unfortunate to have so many projects that onto you, when that was never how your body type was going to be. That's tough to think about the family. Impact on like those messages, too. I think it's, you know, the world is pretty tough as it is. But then when you're growing up in a family and having like your parents or siblings or family members making negative comments about your body, or pointing things out that you might either didn't know what you should feel insecure about, based on these comments, or now that you already are constantly saying these things. I feel like it makes it like there's no safe place, right for you to just like exist in your body and be comfortable. Because how can you be mindful and present? When you're constantly going through these thought process of what are they thinking about me? Do I look bad? How am I looking? Should I cover my stomach? Alright, it's like a kind of like the OCD, right? You have all these thoughts going through nonstop and how can you be present or enjoy your relationships or whatever you're doing in that moment when you constantly have this like chatter in your head and outside in your family, too? Yeah, and I also this is like, a little off, but like I going back to what you were saying about how it's like more acceptable for men to be in bigger bodies. Like, I was thinking about how women are always like, I love it. Dad, like y'all, that are very like, I love a mom. Like, that doesn't happen. That's so funny. You know, they say MILFs but that's not what they mean. Yeah. Like even Hollywood standards, it's like, Oh, I love you know, Pamela Anderson, or I love Taylor. I love Taylor Swift. But you know, like, a lot of people will say, I love Taylor Swift. You know, but then they'll be like, Oh, I love Adam Sandler. Oh, Adam Sandler so hot. And I'm like, yeah, like, everybody's like, Oh, yeah, but for women. It's like Stacy's mom. Yeah, she's got it going on. I'm like, Go Adam Sandler, you know? Yeah, I'm like, Go Adam Sandler, you are getting it. You're living the dream. But like, there's even that double standard, like, like you said, like, you know, they say no, but it isn't because they like a mom. It's like, no, it's this person who's fit? And is cooking and have time between kids to go get lingerie? And I'm like, that's, that's the standard? I'm gonna tell you. That is not. No one's got time for that. Somebody who's listening is like, Excuse me, I do. Good for you. For you let me know who's your babysitter? And are they affordable, because I need this in my life. I'm speaking I'm Taylor Swift, because you know, I was going to bring her up. Maybe I am looking a little bit too much into the era's tour, but hear me out. Because, you know, as I said, there is that standard response, if you're bigger, you don't take care of yourself. And I immediately think of Eris toward dancers, there are so many different body types represented on her dance like team. And I'm like, you cannot tell me that any of those people, no matter what their body type look like, doesn't take care of themselves. They are running, they're jumping, they are dancing their heart out for hours. And, you know, it just shows like, no, your body is just going to look the way that it looks. It doesn't mean that you're unhealthy. If you're a bigger body, these people are doing things that I already get tired, like watching them do and they're just doing it in the heat and everything. So I'm just like, I don't think that this adage of like, if you're bigger, you're not taking care of yourself. I don't think that it stands on anything because yeah, I'll say go watch Aris tour. But you should watch it anyway. But really just I think I think it really does take something Yeah, or just go to the gym. I think this every morning when I when I go to the gym and I see other people and I look at the different kinds of bodies that people have. And it's like, I know this isn't like you know, your first week at the gym like I see the same people and I've seen them for months and everybody has a different type of body some much bigger, some much smaller and I mean it bring it back to food like it that plays a lot into it. doesn't mean you're not taking care of yourself or at least in terms of exercise. In fact, perhaps you're not taking care of yourself. Not always. But you know, sometimes people in smaller bodies are not taking him themselves. Like there's a reason that people with eating disorders, you know, like, it's one of the highest mortality rates for mental health and you know, so that's scary. Have you had any experience with it's like a, an aversion to eating certain types of food I want, I want to say it's FICA, it's not FICA, that's a credit score. Well, not the, like, I'm so mad because I'm like seeing it in my head, but it's all like, shadowy, and once again, I follow somebody on Tik Tok, who, they have this thing where they can't eat certain foods, like they have an aversion to eating like foods, because I'm like, texture, and there's a name for it, but I'm not going to be able to remember right now. But in the video, you go on a journey with this person. And it's not because they're picky eaters. It's not because they just are like, Oh, I stick to what I know. It's like, literally, it's a mental battle for me to eat this new substance. And it was, it's really cool to be able to see this person, like, try the new foods and like, you know, love the flavors, or like, I hate the consistency, but it was nice to try that kind of thing. But even that, sometimes it's like, downgraded to Well, that's not a just eating disorder, that's, you know, you're just being picky. And it's like, no, you don't get to tell people like what they're going through doesn't matter when it comes to food, their relation to it, relationship to it, and the way that they have to kind of like talk themselves into eating certain foods. Yeah, for sure. I see that with autism spectrum disorder all the time. Like, that's like a big presenting thing that I see working with individuals on the autism spectrum. Yeah, we, we see a lot of different food sensitivities. And like I was saying, like around sensory related things. Oh, my gosh, that reminds me, this is not related. It is related. But it's not really it's related to me. This weekend, I was getting sushi and my brother got this boba tea. And I never had it before. And I always envisioned the the little like bubbles like to pop in your mouth. And I guess there are some that do. But the ones that I tried do not pop in your mouth. And you should see my face when I was trying that because I was like, so surprised because I thought it was going to like, and that would be like this nice little like, satisfying moment of it bursting and it didn't and it was like, like mushy and slimy. And like, for me with my sensory desires. That was not it. Keep my jokes to myself, I can't eat. I can't. I can't do it. I can't do bubble tea. And it's for that same reason. My body's like, Oh, we're drinking something. And then when there's something that comes up that is supposed to be like chewed or something that shouldn't be happening, you know? Like, spit in it or something like that. And I'm like, some people swear by bubble tea. And I think that's wonderful for them. Right? For me, my body's just like, we cannot do this. We can't do I have that feeling about rice pudding? I think it's very similar. Like rice pudding really rubs me the wrong way to yoga. Ya know? It's interesting that you brought up on it's cheese. I actually like cottage cheese. I love cheese. But I think there's a lot of I don't want to say disorders, but a lot of sensory processing conditions where that comes up, right, like feeling icky, or having this like unsettling experience around food or different things. Does that? I mean, I know I have ADHD that's like part of it. Do you see that at all? Katie or Alan, like anybody with different kinds of like mental health disorders, having that very similar experience with it that may not be an eating disorder, but like something in terms of like sensory processing? Yeah, absolutely. We, I would categorize that under like, Disgust got what was the term the term is arfid. Or, wait, I'm sorry, what is arfid? avoidant restrictive food intake disorder, that's the one where it's what I was talking about the that, like the aversion to eating, like certain foods or like restricting what type of food you are eating, and then you know that it's not just like, Oh, I'm picky. It's more of like this cognitive, like, I am fighting to, like, go out of my way to do this, you know, so I'm glad you look that up. Because when you said FICA, I thought of pica, and I was like, but that's not the same thing. That's like when people are eating things that they shouldn't be eating right like chalk or whatnot, which is is also like a legitimate disorder. So interesting. Is there a show? I think there's a show on I don't know if it's like Bravo or like High Street. Yeah. Something like that. And like I remember watching one episode with this lady, he just could not stop eating mothballs. So interesting. It's fascinating to see like, what our minds either like are disgusted by and just push away versus like what we just cannot help but do because somehow it's satisfying in some way, right? Like cognitively something's going on. To make that like make you want to do something that that you know, is not good for you. I guess that goes for a lot of things in our life. Well, and then being able to like bring it up to talk about it, because there's so much shame around it like, Oh, this is very weird for me, even when it is like, Oh, I might be picky, or, you know, I do have disordered eating, or this is going on, like the the shame of bringing that up. Because it's this idea of like, oh, you know, you need to, you know, fit this image of health, you need to do this. But you know, we don't care how you do it, just do it. And so this idea of like, oh, I have disordered eating, or I am restricting, or I'm binging. There's a lot of shame in that. And for my clients, just even being able to, you know, recognize that maybe their relationship with food isn't as healthy. And even for myself, as therapists being able to say to myself, like my relationship with food isn't always the healthiest. And what does that mean? And who do I have in my support system to talk about it with because just kind of keeping it in yourself and keep in your head and keeping it to yourself? It just keeps you in that shame spiral? And it's like, how am I going to get out of this, other than find that community that's going to support me? And allow me to kind of share with this is what's going on with me? What does that mean for my relationship with food? Yeah, I feel like a lot of people, either they're considered picky eaters, or some people might view them that way, or eating disorders, like people around them make these comments like, we'll just try it, like just this pushy nature of like, just do it, it's not a big deal. You're it's just willpower, or you're just being silly, like, just do the thing. Without taking time to think about like, this isn't just like a quick decision or something like that, like this is ongoing, like an ongoing struggle, internal battle that they're having. So I think just like, also letting people know, if someone seems like a picky eater, like, don't force them, right, if someone is sober, and they're coming to a party, and they don't drink, don't continue asking them to drink something, right? Like you respect people's decisions and wishes to like, do what they need to do for themselves. Yeah, and I think just this idea of, you know, Jeff, do X. I mean, you know, we've heard the adage of like, Oh, I'm depressed. Well be happy. Who did not think about that? Wow, I bet. So it's like, oh, you've been donate as much. Who would have? Who would have thought that? Are you thinking? This is crazy? You know, I wish it were that easy. Yeah, sad people all the time. Get just don't think about it. Wow. Great idea. We would all be out of jobs. If it was that easy. This whole field? I would love that. Yeah, hey, just communicate better? You know, I'll communicate. Let me get that. Let me get that message to my mind. And like, let me stop overthinking. Or let me stop, you know, ruminating on this fact, you know, so, I would love being out of a job. But that's not what people need. People. People need therapy. And you know, I would love for that to be true. But, you know, some of these things that we are just just do this. It's deeper than that. And I'm hoping that for anybody who's listening who, who has been told, Oh, Jeff, do this thing. Unfortunately, as you know, it's not going to be that easy. So, definitely reaching out to folks who are here to support and help this probably, and hopefully your next step, after hearing some of the things we're talking about. I mean, these things are habits and patterns that are ingrained, right, like just automatically like a default that goes through. You know, like, just when you start your day, like you wake up, you might go to the bathroom, brush your teeth, like it's just on autopilot. Some of this like this is ingrained of things that you just do. Try starting a new habit. It is not easy, right? Even if it's something you want to do, it's good for you. There's all these reasons you've been set up everything around you, you're still gonna like fall off because it takes a long time to like develop something different, right? Like, it's a whole paradigm shift. It's not just I do this thing one time, and now it sticks forever. Like it's just not how our brains work. I think it's people have a hard time recognizing that in other people and not themselves, right? Because how many times have we all tried to do something and it doesn't stick but we think someone else can do Just fix something or do something different, there'll be fine. So there's actually this. This is like unrelated but kind of related in. So when I was learning about like psychedelics and things, how it impacts our brain, there's actually this thing called the default mode network in our brain that has like these neurological pathways that like build grooves for beliefs and narratives that we have constantly. And so there was like this good example in this book called change your mind or change my mind is that when you know you're born, you have all of these messages coming at you, if you think of like a field of snow, if you walk down a certain path, where your footsteps are, you continue to go down that same path, right? Because the footsteps are already there. So it's kind of like the beliefs we have about ourselves and these narratives is just constantly the same thing. Like I'm a bad person, or I'm fat, or bla bla bla, right. And then when you do a psychedelic, it shakes it up like a snowglobe and puts in lays flat snow again, and you can have a new belief or a new narrative about yourself, that wasn't there before. And it creates this whole new path for you to think about yourself in such a different way. And it actually sticks, because it's on such a deeper neurological level than just on like a conscious level. So that was super fascinating. Yeah, wow. That's simply saying. That's my small TED Talk. That almost sounds like what happens when I like engage folks in narrative therapy, this sense of like, attempting to rewrite this narrative and attempting to, you know, like, focus on this old, unfortunate or not helpful narrative as the issue and working to, you know, block it from continuing and forging this new way of thinking. Obviously, it seems like a little bit more internal and medical, but, and probably a little bit more short term than long term Narrative Therapy. But it does sound like that very similar thing of like, just laying this new narrative and laying this new thought pattern, and kind of deleting that old way of thinking. Yeah, very similarly, I was thinking about treating PTSD and doing like cognitive processing therapy, especially if you're doing the version where you're writing the account out. Either way, you're still trying to kind of reframe a lot of those beliefs. And it makes sense because there's so much research coming out now about like psychedelics and treating PTSD. So we got some interesting stuff coming up in the field around that I'm super excited for I think it's gonna be the next wave is the psychedelics are coming through. I'm ready for it. I've been fascinated in love with this for a really long time. I think that maps, I think it's the Multidisciplinary Association of psychedelics just passed their law in Oregon to be able to provide us Silis is it no psychedelic assisted therapy with MDMA, for social anxiety and for trauma, because they've seen the, the trials that they were doing on social anxiety is that when people were taking this, and going through it, their symptoms, even PTSD, I think it was like 40 to 50% of the participants no longer qualified for the diagnosis of PTSD, after I think, three or four, don't quote me, I forget how many, but like a certain amount of being able to take this with a therapist, they're in a safe environment and everything, and then no longer can, being able to identify or no longer having that diagnosis, because their symptoms were gone over six months. Like this wasn't like a week later, they test that it was like over a six month period, they were able to see like they were no longer having PTSD, which is wild to think about. I'm curious how that my how, like, these types of treatments don't apply to like, disordered eating and like those types of processes? And has there been any, like, study on that? I'm sure. I'm sure once insurances find out that this is a shorter stay, then they're gonna make this great, you know, so yeah, we'll see the the policies and the regulations around it. But I mean, these things have been around for forever, right? Indigenous people have been using these plant medicines, I could go into this for like another five hours. But this just made me think about all of this is how much it shifts our narratives and our beliefs. Like you were saying, like narrative therapy, or cognitive processing is like changing the beliefs, right? It's not just doing the thing, it has to go in hand in hand with like, the actual belief and thoughts we have with it. Otherwise, it's pretty short lived. So we're getting close to the end. Is there anything either of you want to share any closing thoughts for the listeners? This was like, kind of a rogue episode where we kind of just like, went with the flow, which was really cool. Yeah, I think that one of the biggest takeaways is, you know, if you're a clinician really being willing to go into those hard conversations about food and the relationship of food, and not just assuming that it's not necessarily playing a role in the things that you're talking about in therapy. Because I think it is something that is often overlooked, especially by clinicians and really start challenging some of your internal thoughts about food. And then if you're a listener who's struggling with their own internalized thoughts about food, you know, reach out if you don't have a community that's going to be supportive, reach out to a therapist, reach out to myself, so that we might begin, you know, exploring, like, what does a healthy relationship with food look like for you? And what are some internalized, you know, thoughts or patterns that you've noticed that you need support in breaking and changing? Well, Alan, thank you so much for being a guest on today and returning. This was awesome, Katie. Thanks for guest co hosting. This is a great time. Thanks so much for both being on and if you liked this episode, please like, share and subscribe. And we'll see you in two weeks. Yes, thanks so much. ### Listen - [Spotify](https://open.spotify.com/episode/15274443) - [Apple Podcasts](https://podcasts.apple.com/podcast/15274443) - [YouTube](https://youtu.be/CoollD7Z7qs?si=JbVaYxHNnDjdixcO) --- ## Safe Exercise During Pregnancy: Myths and Facts - URL: https://healyourrootspodcast.com/episodes/safe-exercise-during-pregnancy-myths-facts - Published: 2024-06-05 - Season 3, Episode 14 - Duration: 51:11 - Category: health - Guest: Amanda Matrisciano ### Summary Dive deep into the world of prenatal fitness and nutrition with special guest Amanda Matrisciano, a certified personal trainer with expertise in pre and postnatal training. Timestamps: 0:00 – Introd ### Description Dive deep into the world of prenatal fitness and nutrition with special guest Amanda Matrisciano, a certified personal trainer with expertise in pre and postnatal training. Timestamps: 0:00 - Introduction to personal training, pregnancy, and nutrition with Amanda Matrisciano; 2:09 - Amanda's journey into personal training and certification in pre and postnatal fitness; 7:43 - Common myths about exercise during pregnancy. ### Transcript [0:00] Nobody wants to exercise every day there is not a single person that wakes up every day is like I ready to go. I love it. Like I'm so excited to be here. It just doesn't happen. That's why we have personal trainers and workout classes because then you have accountability, like we talked about, but it's the same with the healthy eating and nutrition aspect of it. Like, you know, you don't want to do that every day. But if you sprinkle in these things that you like, here in there, you get rid of that idea of okay, well on the weekend, I'm gonna eat whatever I want. But during the week I'm gonna eat really healthy. If you have things spread out throughout the month you're in there, you're gonna be so much better off and getting into that routine. It's all about the routine. Welcome back to Heal Your Roots Podcast. I'm curious Yakubov Shlonsky their guest co host Dr. Katie Mangan Hello, and a special guest Amanda, mature siano, personal trainer with a specialty in helping women through their pregnancy journey. Thank you so much for being on with us today. Amanda. Thank you so much for having me. I'm excited to be here. You and Katie know each other if the two of you want to share how you know each other how you met? Yeah, when he comes to the gym that I am a trainer app, which is Katie, when did you officially start at NGO? I started in October. Wow. Okay, so yeah. A lot. I feels like much longer than it does feel like longer than that for sure. But yeah, I at this gym, never give up and manioc. I teach classes. I'm also a personal trainer, like you mentioned. But Katie comes to our group classes. So that's how I met her through that. Yeah, let's I am on the waitlist right now for Thursday, if you can get me very popular classes. So you know, very high demand. That's awesome. So Mina, can you share with us a little bit about your background, how you got into personal training, and specifically helping women through pregnancy? Sure, yeah. I really started my personal training journey right after college, I, like most people went to college, ate, what I shouldn't eat, drank what I shouldn't be drinking felt really crappy and was like, Alright, I need to do something to get myself feeling healthier. So that's really when I started getting in to fitness a little bit more in a sense of actually working out myself and putting workouts together, I was always an athlete. I always did sports, so I was always active. But that's when I kind of got interested in okay, you're not going to be an athlete forever. I wasn't that great. So I had to do something on my own post college. And I figured if I at least go through this certification, I'll learn a little bit more for myself, whether I use it or not to train other people. And I started with one on one training at a really small gym by my parents house. And then when I moved to manioc after college, I just reached out to a couple of local places. And it ended up working out that I got this position at never gave up and started doing group fitness, which I hadn't done before I had been training in another gym. But this was really the first time I was doing that full time. And then honestly, I just had a lot of clients that were younger women who were interested in having children and people that were coming to me saying that they were pregnant or thinking about getting pregnant. And it's also a very interesting time because they I know before a lot of my patients, family members know that they're pregnant because they have to tell me. So as soon as that started happening, I was like, Okay, I need a little bit more guidance on what can they do? What can't they do? What do I need to be looking out for to support them better? So then I got my additional certification in the pre and postnatal training aspect of it, which is really just an add on to my regular personal training certification. Amanda, what did that entail and having to to like the additional certifications, it's pretty similar. It's all online training. It was a lot of just courses reading. You take an online exam at the end, but really, for pre and postnatal, it's not and I know we'll get into this. It's not as extensive as people think that it is. It's really they can do what everyone else can do. It just guides you a little bit more through how a woman's body is changing and what to be aware of When you are training somebody that's pregnant and like, hey, these things might happen, and that's okay. You don't need to be nervous about them. So it was very similar to my personal training certification, which I did online as well. And they just have you get a book, you read different chapters, you watch some videos, and then you'd have to take an exam at the end to get the actual certification. Awesome. Okay. So it sounds like it kind of just found you. This process? Yeah, it really did. Um, it's a running joke that I don't know what happened when I started working at ng you, but there's something in the water and all of my clients are pregnant or have or will be pregnant soon. There was months where every month I was finding out one of my clients was pregnant. So at that point is like, right, I have to do it now. Because all of them are. Others were pregnant. And so it just also helps to put me at ease, like, Okay, I have all of these women that are they want to train, they've felt so good starting training, that we're all at different points in their fitness journey. So to also be able to give them the guidance and like the comfort of it's okay, like we're good. We can keep training through your pregnancy has been really helpful. So good luck charm. Yeah, I don't I really don't know. I will take all the credit. That's just one of your gifts. Yeah, it really truly is. I don't know how I do it. But that's awesome. Yeah. So what would you say for you is like, what are when you are working with pregnant women or you know, that pre and post satis? What do you think are some of the mental emotional and physical benefits of staying active throughout the pregnancy? I think mental is honestly the biggest thing and a mental and emotional together. Just because I'm like I said, they're all at different points in their fitness journey. So I've had women who were so active their entire lives. And this is throwing like a huge wrench into what they're used to and their normal routine. So for them to hear, hey, you can work out through this pregnancy, and we're going to change things when we need to, but it's still going to be a beneficial workout for you. Just puts them at ease. And for a lot of them that is their outlet. Like they come. They work out to make themselves feel better mentally, and they feel better leaving and to not have that or to take that part of their routine away. Just because they're pregnant, I've seen the flip side of that as well, where either women have really challenging pregnancies, and they truly can't work out, or they just don't feel as comfortable working out. And it really takes a toll on them mentally. And then the physical aspect is just, you know, I've talked to a lot of pelvic floor specialists, and I am not a pelvic floor specialist. But it helps so much with the after words and the way that I've seen so many of my clients be able to come back probably sooner than they would have been able to come back. And it doesn't even mean they're jumping back into these crazy hardcore workouts. Just being able to do something brings back that mental aspect of okay, now postpartum, you have a newborn, you're exhausted, you're doing this stuff 24/7 to have that little teeny tiny 45 minutes to yourself, to be able to do something and know that you get to do that every week or twice a week or whatever it is. Just I've seen such a drastic change in their attitudes and how they feel. And even my I have a client right now. She's due in June. And every time she comes in, she's like, might be the last time I don't know how I feel. And this morning, like we're just slowly slowing it down. But she said to me this morning, I never thought I would get to 36 weeks and be working out in any way, let alone with weights and doing actual workouts. So she just even though physically she feels uncomfortable mentally she feels really good that she made it to that point. So that's incredible. And you know, I'm wondering because I didn't I had a new I have a newborn she is at this point four months, and I wasn't sure you know, the things I was reading is like if you have been working out, continue working out but if you haven't worked out, don't try anything new or don't do anything too intense. Like there's a lot of like myths and misconceptions out there. Would you be able to share a little bit about like some information or knowledge to give women whether they have been working out or they're starting for the first time, like how to go through that process? Yeah, for sure, I've actually worked with both women who have worked out their whole lives, it's part of their routine. And they kind of just keep that going. It really is true, like, what you were doing before is what you can do during you shouldn't increase the intensity of it too much. But if early on in your pregnancy, you're interested in, hey, you know what, like, I know that I'm a slightly active person, but I'm not going to the gym every day. But I would like to stay active during my pregnancy, just starting with lower impact workouts, whether it's just using lighter weights or body weight, or strictly core work. I think a lot of the myths are around, oh, like pregnant women can't do that. They can quite literally do almost anything unless it's uncomfortable for them. So there's a lot of things and and if you, like I said, the comfort of the mother, you'll also talk to your doctor like doctors will recommend Don't be in a room that's heated over a certain amount, we have heated classes, they also will tell women, if you've been doing that pre pregnancy, you see what's comfortable for you, and then we'll talk about it. So I always tell them, you know, talk to your doctor about what you feel comfortable with. But it could be something I had a client that her whole first trimester, we couldn't do anything where she hinged because it made her feel nauseous. Like it just you just adapt to what what's going on with your body. But there's nothing written anywhere based in science that says you know, don't hinge or the only thing they'll say is, you don't want to be on your back for too long, which they talk about that in general. And that's more so when you are further along. But I've also seen women on their back doing, you know, careful core work. The only thing that I really avoid is full sit ups, crunches anything where you're like really contracting your core all together. But that being said, core work is a massive part of pregnancy. So there are so many other things that you can do with someone who's pregnant or postpartum, to get their core strong and keep their core strong without doing those extreme movements of okay, you're really using the entire core for this move. So a lot of it is myths. I tell my clients, if you saw it on social media, I don't want to hear about it, your doctor about it. And because there's so many things out there that they say don't do this, do this. This is great. This is bad. And I just try to steer them clear of any social media pregnancy guidance. That's relatable for us to not necessarily when people are hanging in there, like look what I found. Yes, I'm sure it's very true. Every you can find anything on social media these days. So yeah, for sure. Well, so Okay, something that I was thinking about to in talking with, because I have a lot of friends that are pregnant right now. And actually, when I was leaving the gym, last week, I was talking to someone who's, like, postpartum. And I think she had the baby like five weeks ago or something like that. I don't know. I know, there's obviously a period of time that you have to wait. So what do you suggest people do in that period of time? Because like you said, it obviously benefits you so much mentally in to go from having that support, in a way then to not having that for that long. What do you do, like help them prepare for that in any way? Yeah, it's, it's hard because I, the one thing I've learned and really through my clients, because I don't have my own children, but those few days after giving birth are so key. And my clients that truly did not do a single thing. felt the best when they came back. So but only a few days, like that doesn't have to be six weeks have absolutely nothing. You have a newborn, obviously, you're moving around, you're getting up you're doing things, but those couple of days, even within being in the hospital, if you can let your core recover. It's the same as any other workout, right? If you're doing legs six days a week, your legs are not gonna get stronger because you're not giving them any time to recover. So it's kind of the same with your core like, it just went through a very traumatic experience. Dance and a race, so to speak, and you got to the end of this finish line that you were preparing for. And now you need to let your body recover a little bit. So kind of talking them through that, like, it's okay to take a break, you just had a child, it's gonna be okay, if you take a couple of days off. And that's a message for anybody, like you will not lose all of your strength in five days, I promise. And then after that, a lot of like slow core pelvic floor there are, I will find people on Instagram that are certified pelvic floor specialists. And I will send those videos to my clients so that they have something visually they can look at and kind of use for themselves. And then when it comes to coming back, if you've had a natural birth, and your doctors okay with it, I've had clients that come back, as soon as four weeks after giving birth, and we're not doing anything crazy, it is pretty much the same, you know, pelvic floor poor, really, really small movements, they're on their back a lot. They're not lifting heavy weights. But to ease them back into that routine, I think it helps them a lot. I have one client that I didn't even think she was going to make it through the four days of do not move your body. And the morning, she got cleared. At four weeks, she texted me and said I need you to come to the studio tonight. I don't care what we do something. I was like, Okay, here we go. So it is it's that mental aspect of it that they just need it in their routine. A lot of them honestly don't care what I'm doing with them at that point. It's just like, how do we slowly start to get ourselves back into that place, especially if they were active before pregnancy, because then it's like, Okay, where did my core muscles go that I've had for my entire life if it's your first child. So it's just to ease them back in but a lot of pelvic floor a lot of stability, a lot of stuff that you're kind of doing on your own because you have a newborn that you have to pick up and carry around. But it's a lot of training your body to do that stuff properly. So you're not pulling your back out doing something that is going to then make your life more challenging with a newborn. So I'll do a lot of stuff like that to help them prevent low back pain, prevent hip pain, anything like that, that would just make their lives more challenging. Basically. Like I was telling Katie this earlier, as I wish I found you beforehand, and during because my recovery was really tough. And I you know, I've heard about pelvic floor and everything more so with like sex therapy, not necessarily after birth and things like that, and like how to strengthen and how much it's connected to everything. Like I think it's very understated, of how important that part of your body is for just like any kind of movement. And I found that walking, like after I gave birth after a couple days of resting, like just walking like I would I was like a turtle super, super slow. But just walking every day, I found that that really helped me like get a little bit stronger. So I'm glad that you are giving like this information to all your clients ahead of time to help their healing and recovery afterwards, because it's really so important. Yes, and I love that you said that about walking, because I think so many people think like, well, if I'm gonna work out, it has to be like a workout. And even some I had one client, she probably stopped training the end of last year and she just had her daughter at the end of March. So it was a decent amount of time that she stopped training. But she was so uncomfortable. It was her second child she was carrying so low. And I said to her just walk, just walk while you're pregnant. You don't have to do anything else if it's uncomfortable, but you're gonna feel so much better just because you move to your body. So I think that's important too. Like, it doesn't have to be going to a class or getting a trainer, it just finding some sort of movement. And not. You can use certain things as an excuse, but I think a lot of times when some of my clients will be like, Well, yeah, but I'm just not feeling it today. I'm like, okay, but you will feel so much better if you just sit. That's it a tiny walk. It doesn't have to be crazy. So I think that is really important to even post partum sometimes that's all you can do like you're saying and if your recovery is tough, that's the way to do it. Just walk, do small movements, small things on a stability ball to get your hips moving, but it's so important but that will help everything including your core and your pelvic floor. What are some of the differences in the recovering process for natural A birth versus like a C section, very different. So natural, obviously, your core is still drastically impacted, but you don't have any actual incisions. So the that's why typically they'll say, four to six weeks for a natural birth before you go back to exercising. And then it really depends on how your C section went, how your body is recovering. I know my mom had a C section with both me and my brother, and she could barely move for weeks, because it just was so painful, you are literally cut open, it's a massive surgery. So in that sense, you have to be a lot more careful coming back into it. And it's actually interesting. I feel like I'm so much more cautious with postpartum than I am when they're actually pregnant, which seems funny, because they're carrying a child, it's like, you should feel more weirded out and like, oh, my gosh, there's a baby in there, I don't want to hurt it. But I know how strong they are and how capable they are. And that truly what they're doing is not going to hurt the baby. Whereas afterwards, you can overdo it. And you can get yourself set back by coming in too hot and trying to do too many things. So I haven't honestly had any clients that have had C sections yet. But that I would always say defer to the doctor on at least how you're healing. But same idea, you can still do pelvic floor work, you can still walk if you're comfortable doing that, it's just being really careful to let your incision heal and let your core heal a little bit more before you're doing hard core work around that area or with your pelvic floor or with heavy weights. Because you're recovering from a massive surgery, they still don't want you to lift super heavy weights after a natural birth. But you have to be a little bit more cautious when you have the incision that is healing once it's healed, it's kind of the same. It's just a little bit of a slower process. I'm glad you asked that, Katie, because I think that is a big difference in the recovery and healing the whole process. And I think those four to six weeks are also for I mean, this might be TMI, but we're talking about this right is, you know, a lot of people have tears it when they have vaginal births. Oh, right. And like doing anything extra, like any tough exercises, right? Like that could exacerbate that. So that's also part of that, not overdoing it. Even if you know mentally you want to or physically you might feel like you might be able to is just not making that worse, or extending the recovery process to. Yes, absolutely. And I really do. The doctors know pretty well your body and how it's healing in that sense. And I think that's why it is beneficial to have a trainer in the beginning because it's just somebody to tell you, Okay, I know you feel like you're ready. But let's take it easy. My one client, she was a professional dancer, she started with me with a back injury from dancing, and was miserable when she had her back injury because she couldn't do what she used to do. We got her course super, super strong. And then she got pregnant. And they were trying and they were very excited. But she was like what, I just got my cord. Why now. So it was kind of I knew what to prepare for with her because I had seen her not be able to do what she was used to doing. So it really is a lot of also mental coaching of you are going to be okay. And you are going to get back to where you were before strength wise, maybe not physically and your body may change and it may stay certain ways. And that's something I kind of tried to walk them through to like, we're not going to that's not going to be a gauge of how we are doing postpartum how much weight we've lost what our body looks like, based on what it looks like before we had our child. It's going to be are we getting back to the weight that we were using before? Is your core feeling strong enough? Are you starting to work out the same amount of times per week? So I tried to set different milestones with them so that they feel like they're progressing and they're feeling stronger without having that stigma of okay, I'm getting back into the gym to lose the baby weight. It's more so I'm getting back into the gym to be as strong as I was before. So then I can show up better for my baby. Yeah, I'm really glad that you just said that part about like that transition into it a lot of being mental? Because that is something I wanted us to talk about, too, in terms of how do you see benefits in, you know, not just pregnant people, but other, you know, anybody who comes in and exercises like, what kind of mental health benefits do you often see from people, you know, engaging in exercise? Well, it is funny, because I think I joke about it all the time with my clients, like, I am not a therapist, and I would like them to see a therapist in. I would like to not be used great advice as a therapist, but they do like, it's almost like I compare it sometimes to when you're like getting your hair done, for whatever reason, feel like you can like trauma dump on the person that you're getting your hair done with, even though they have no expertise and can provide you no guidance whatsoever on your situation. But I do think it helps, especially with private training, because it's one on one, and they can come in. And they know that they have to show up, which is what a lot of them tell me all the time, like they have to show up, it is just them and me. And if they don't show up, I'm there by myself, and they're still paying for it. So I think that from a mental aspect, it's even if you're feeling down, even if you had a bad day, when you otherwise could have said no, it's fine, I'm just not gonna go today, or I'm not gonna go to the gym, I don't need to go to the gym, no one's checking in on me, they have to show up because I'm there and they're paying me. So that helps a lot. But then on the flip side, they do have somebody that they can talk to and express things. And like I said, I very often say, let's I will work with you to find a therapist on these situations, but I can just tell it makes them feel better. Like they're lifting heavy weights, they're sweating, they're complaining about whatever it is that happened today. And they just leave and feel like they just lifted a huge weight off of their shoulders. And I feel like it's the same when you go to group fitness like you connect with these people that you otherwise wouldn't have met wouldn't have connected with. And it's the sense of community that you show up. And even though you're not a personal training client, you know that I know, if you didn't show up, like Katie knows that if she doesn't show up, and she's on my class list, I know that she didn't show up, they're probably going to ask her about it. And you make friends in that way that you instantly have a different connection with because you both work out and are in this routine and are quietly secretly maybe unconsciously holding each other accountable. Like you know, this person is going to this class, you're going to show up because you know that they're going to show up for you and for themselves. So I think it's also just the people that you're surrounding yourself with, plus the scientific benefits of exercise and releasing your endorphins. And physically and mentally just feeling better from that. But I think that people play a much larger role in that mental benefit than even sometimes the physical benefit of actually doing your workout. So that accountability piece is so so huge. And just having everybody around you it's almost you know, if you do a workout, you might be able to Slack or something like that. But if you're there in front of other people, and you have your personal trainer, like there's also like this sense of accomplishment that someone else noticed and saw that can give you that praise as well, to kind of keep going like that positive reinforcement to continue for your physical and mental health. Yeah, and Katie knows, I don't let them slack. I know how. And sometimes. And for me, too, I take classes for the same reason that everyone else takes classes. Someone's gonna push me, I don't have to put the workout together myself. I just show up. It's there. I do it and I'm done. And that's why it's so beneficial. But I think having that person sometimes if you're doing it on your own, you're like, Well, this is how strong I am. And that's just what it is. But if you have someone that can gauge, okay, well, your form is great. And you've been doing this weight for seven months now. So maybe let's try this next week. And your form is great without too so you can do that way and you're gonna get stronger from doing that way. And I'm sure they don't like in the moment, but afterwards, they're like, Oh, I just lifted 20 pounds and I didn't know I could do that. Or I didn't know I could even do that exercise with 20 pounds or they'll say before I can't there's no way I can lift these weights and also just do one do to just try it. And it is it's such a sense of accomplishment for all of us, but especially for people who are new work to the space or in that group fitness setting to have someone like single you out that they know that you can do something stronger. And they know more than you do that you can push yourself harder, you leave and you're like, oh my god, I can't believe that. I just did that. And I feel so great for the day. And physically your body is, in turn getting stronger as well, which is the ultimate goal. So yeah, I really is the best thing ever. Just one of the things that Amanda and other trainers there, say all the time is this, like, yes, you can kind of phrase throughout and like now that's like, in my head like today, I went to hot yoga and said because of a different time that I had this morning. But when I was like, Oh, should I do this next pose, and it just like pops in my head? And it's like, yes, you can. Yes, you can. And even if you fall, who cares? Like it doesn't matter, you know? So having that extra push is really, it's really good. Yeah, even when I was sick, like a couple of weeks ago, both of you know, like, I over the last like month and a half or two months, I've been randomly on and off sick and I'll come in and around is like well, you just know, like, you can just like I said to you the one day like I can just I almost pushed you, I can tell that something is off. So we're just gonna let her do her thing. And so it's also about that, right reading the room and reading people and uncertainty. Some people don't want to be pushed, and that's fine. They want to come and they don't come to my class. Fly with me, I try really hard, but I just can't let it go. But that like that's just they want to come and they want to do their workout. And that's okay. But it's so it's I know from personal experience, how great it feels to have someone have faith in you. And I do the same thing Katie in like, when I take a class or anything, I literally have a bracelet that says yes, on it. And I you I do the same thing, like what would I tell my members? And what would I tell my clients in this moment when I want to stop when I'm running or in sculpt or doing whatever and my body is telling me no, like, you don't need to do it, you can stop doing it. And you have to retrain your mind. Like, no, we can keep going you can do this physically, you can do this. And that's the other mental aspect of it is a lot of times your mind is trying to trick you and tell you no, you can't, you're not strong enough, you need to take a break, you're not gonna be able to finish. But when you get through that little threshold of discomfort, you get so much stronger, and then you realize you actually can do the thing that you didn't think you could do in the first place. I love that you put so much focus on the accomplishment of like strength being the goal and like the function of using your body. And not like kind of going back to like losing the baby weight or how you look or how you fit into particular clothes, right, like shifting that mentality into like feeling strong and good in your body versus how it looks. I think that's really huge. And like, I'm happy to hear it because I can take some of that advice after having a baby too, is that it's just so ingrained, like immediately after having, Alright, gotta get this baby weight off gotta look different instead of how can I be stronger and healthier for me and my family. Yeah, and it's such a huge thing, just with women in general. And I think I've also learned over time working with so many different women that you don't know, as an instructor, unless it's my personal training clients that I get a little bit closer with, but you don't know what somebody has gone through. And you don't know if they have suffered from disordered eating or any sort of eating disorder. And so to make that the stamp of well, if you want to track that you're getting stronger, you need to track your weight, and you need to track your macros. And for some people that works like I'm a person that I don't track my weight. I don't know the last time I weighed myself, I went to the doctor today and I put my little hand over the thing I was like, write it down and keep it to yourself because I don't want to know, but I can track macros protein, things like that. And it doesn't get me into a bad cycle of okay, now I'm being like hyper focused on what I'm eating and why I'm eating it. But you learn so quickly who can be like that or what people have been through that that may trigger them or that may then send them into a spiral of every time they see you. They want to talk about how much they lost or how much they weigh and I have clients that don't care at all about that and I have clients that it has taken years to get their focus off of the number on the scale the Because they'll people will come in and say, I feel great, I fit better in my clothes. But if I could lose five more pounds, I'm like, for what? Why do we need? Like, what is the purpose of the five more pounds? Because once you get to the five more pounds, then it's five more pounds. And it's like, Well, can I do maybe two more pounds after that five pounds. And it's a never ending spiral that everyone would fall into, especially women, if you continue to track that way. So I do fitness tests with them I do. I'll say like what you know, you want to do a push up, you want to do a pull up, you want to do 20 Sit ups, and I'm like, whatever their goal is, and we track it like that, it kind of just takes the focus off of, Okay, what does my body weigh. And also, I always tell them, first of all, you may be buying the wrong clothes. So maybe we just buy different clothes, don't buy clothes that you wish you could fit into, look good and fit into, but go based on your clothes. So many people will say oh my god, my clothes fit so much better. That's the goal, like you feel good in what you're wearing, I had a client, she just finally it took years finally just completely cleaned out her closet, got a whole new wardrobe because she knew that she was putting the effort in, she's eating healthy, she's working out five days a week, she looks great. And her clothes just didn't fit the right way to make her feel comfortable in the body that she had created. So she said, You know what, I'm gonna get rid of all this, and I'm gonna find stuff that I feel comfortable in. And I was like, that's great. Because, again, back to social media, we see stuff on social media, we're like, oh, my gosh, I would love to look like so and so you don't have so and so's genetics. So you're probably never gonna look like them. And I can't help you look like them, I can help you love yourself. But I can't take someone else's arms and put them onto your body. And I can't do that for myself either or I would. And so it's just retraining that mindset of your you can't base it on what somebody else looks like or what somebody else's weight loss journey was. And my biggest thing is, you don't ever know how people treat their body internally based on what they look like. So I tell my clients that all the time, I have a really close friend, she is so tiny, she has tiny little legs, tiny little arms. It's just how she was born. It's her genetic, she's my height, she's tall, it's just her body type, she probably couldn't put a lot of weight on if she wanted to put weight on. But she eats like crap. And like, so that doesn't tell you anything. If you see someone on social media, and you're idolizing their body, internally, their body is probably not as healthy as you want your body to be internally. So you have to focus on that first and then let the external kind of just do its thing as you go. And that takes a lot of time and patience. And it is frustrating. But you will get there if you put the work in and take the time. Yeah, you bring up a good point with the nutrition because that's obviously a huge part of it. And that, for me is like the worst part of it. Because I love to eat and I love to eat all of the things. And like, yeah, I will I'm in there at least five days a week, normally, and if I am still eating whatever I want whenever I want then like it actually really doesn't make it. I mean, I feel stronger. I might feel different, but I don't really look that much. No, it is so true. And I actually at one point did a nutrition. I'm not a registered dietitian. So I can't necessarily say like community, this is what you should eat, you know to for your body type. And that's the other thing. Everyone's bodies are so different. So that's my other pet peeve is things on social media. They're like, don't eat this, don't eat this, eat this, don't eat this. Well, you don't know how your body reacts. Maybe your body is fine. If you eat gluten and dairy. You don't need to give it up because everyone else is giving it up. But some people have really bad reactions to it, and it does make them feel better. So I think a lot of it is what makes you feel good. But I have my clients do somewhat of a nutritional challenge where they basically if they felt comfortable because like I said, some it can get into a dark place for some people but just writing down what they were eating, not tracking calories, not trying to track macros. Because some people just genuinely don't know they, they really think they're eating healthy. And if you ask them point blank, they say yeah, I live a really healthy lifestyle. And then they'll write it down. And if you break it down for them like this is what you're eating all day is making a huge impact on you. And I think even going back to having children. So many people will say, Well, I have children so how am I supposed to eat healthy? Like, how about your child? Drink, also eat healthy, and then you could all eat. And then everyone would feel good. And that's an interesting concept to me and I don't have kids. So I can't say like, I know that it's challenging. And I totally get that. And it's like, just feed the kid because they're hungry. And this is what they're going to eat. And this is what they want. And this one I'm giving them, but you have to prioritize yourself. And the parents and mothers that I've seen prioritize their own health and fitness, are so much happier than the people who are just getting into the bad habits, because it's easier and because well, I don't have time to cook dinner, because this is what the kids are having. So I'm just also having cereal or something else. And it's just learning how your body reacts to things like that's, I am a huge food person, I am not someone that is like, super, super clean eating 24/7. But I try to listen to what my body is telling me in a sense of like, what do I feel better when I have carbs in the morning or at night? Or do I feel fine when I have them whenever. And that helps me a lot. But also just listening to your cravings of what your body is telling you without letting that take over. So it's the same as the exercise stuff. We don't nobody wants to exercise every day, there is not a single person that wakes up every day. It's like I ready to go. I love it. Like I'm so excited to be here, it just doesn't happen. That's why we have personal trainers and workout classes because then you have countability, like we talked about. But it's the same with the healthy eating and nutrition aspect of it. Like, you know, you don't want to do that every day. But if you sprinkle in these things that you like, here in there, you get rid of that idea of okay, well, on the weekend, I'm gonna eat whatever I want. But during the week, I'm gonna eat really healthy. That doesn't help you at all, because you just have this bad cycle of I'm going to eat really crappy on the weekend, but I'm gonna eat really healthy during the week, but I'm still putting crap in my body on the weekend. So if you have things spread out throughout the month, you're in there, you're gonna be so much better off and getting into that routine. It's all about the routine. It's the same with exercise. It's the same with I'm sure you guys see in your practice all the time, the different routines that you have to get yourself into to get into these things that you want to work on. This the same with healthy eating. You can't do it for two days, and then be like, too much. I don't like it. Not for me, I go back down. It's easier, like nobody wants to cook every day and rather just eat out or get fast food like it is easier. But I've gotten my body to a place where genuinely, I think I had a cheesesteak, like about four days ago, I felt so horrible because I don't eat like that all the time. And like dip tastes great. Yeah, it tastes great. I loved it, but my body afterwards was like what the heck process nonsense Did you just put into me? And why do I feel like this? Get to a point where I don't really want this stuff anymore and every once in a while you do but it's not an every day. Oh, it's just part of my routine. I'm just gonna grab this food that is not that great. How do you see this show up for women who are pregnant with like cravings or if they're nauseous like in the beginning, I would just like down a sleeve of saltine crackers like it was nobody's business and then like throughout the pregnancy all I was craving was like pasta pizza and ice cream like my babies made up a Buzzfeed said ice cream. But like knowing that it's not the healthy thing to eat, but like your body almost feels like if you don't have it, you will die. Like I know. It's dramatic. But like sometimes it feels like that during pregnancy. Yeah, it is true. I think similarly to how I feel about just general nutrition like, you don't want to go either way so drastically like my one client that I was talking about. And I use her as an example for everything because she is one of my closest friends now but also an absolute nut job when it comes to all that she's a little crazy. But she's always been so she grew up in Israel. So she grew up on a Mediterranean diet and is just like so used to okay, this is how we eat like this is the normal way of eating so she doesn't really never really like adapted to Yeah, I'm just gonna have fast food. Like she doesn't understand that. So when it came to pregnancy, she was like polar opposite. Like, she'd be like, I'm craving a bagel and I will not have a bagel. Like you could just have a bagel like it's going to be you have to bagel and you probably will feel better so and I think it's just finding that middle ground right of like, one of the things I always say that I biggest the biggest myth is you're not, you don't have to eat, too. So people say that all the time, I'm planning for two, so I could eat. Not really, um, I think the most important thing is your protein, getting enough protein. Because when you have those cravings, you're typically it's not healthy protein. It's stuff that we know we shouldn't be eating, but like you said, you're like, but I physically feel like I need this. So if you're balancing that out with, okay, but at least I'm getting my protein and I'm having, you know, some vegetables balancing out my other meal. So then when I have these cravings, like, I feel like I can give in to them. But it's also everything is so connected, which is what's so interesting to me. So it's like if you are consuming high levels of sugar during pregnancy, they don't really know how that could impact your child. And now is that within your child like feeling that as they grow? Now, they have this sense of not really sugar dependence, but okay, I'm used to having this sense of nutrients. So it is interesting, like, how does it all, you know, come together. But I've seen both extremes. And I think we shouldn't go to either extreme as much as we can try to find a middle ground of okay, I'm getting the nutrients I need. But I'm also having my cravings when I want to, that's the best that we can do. What our body is performing a really crazy cool thing. That's great. I'm glad you were able to tell on that. So it sounds like balance, right? A lot of this is just balanced and listening to your body and keeping in touch and like being attuned to what you need. Absolutely, yes. So this was great. I can't believe we are coming close to an end. I feel like we could continue talking about this forever. I feel like we've only been talking for 10 minutes. But it's been a problem. When Joe Rogan has like four hour podcast episodes, where they just like hang out and talk and see what comes up. No, no, we really could do that it would be really, truly I can talk about it for days. Oh, this was but that being said? Well, I was just gonna say with that being said, like, is there any kind of final like thoughts or things that you would kind of want to share as just some, you know, closing, ah, I would just say if you're pregnancy or not, if you're looking to get into fitness, just start somewhere, find a safe space, it doesn't, like we talked about walking is fitness, it's a workout. So if you're just start where you are, if you're sedentary, sitting on a couch, sitting at a desk all day and you don't work out, go for a 10 minute walk if you have been walking and you want to try workout classes, try to find a space where you feel comfortable and safe with an instructor or trainer that lets you try and grow and like gives you the confidence to then do that kind of stuff on your own. And I think that's the really important thing. But a lot of people I think feel as though they need to know all of it and be so strong and fit to even join a gym and then like what am I doing here? Why would I be here if you know all of the things and you're strong and you can make it through the whole class like I can't make it there half of the classes so you're getting stronger as you go. But I think just meeting yourself where you are and starting slow and slowly increasing whatever it is that your goal is get to that place you don't have to dive in and start training for a marathon or start going to group fitness classes that are high intensity that are terrifying to you to start your fitness journey. Thank you for that. And Amanda where can people find you to reach out to you if they want to work with you join your classes or have you be their personal trainer Yeah, so my personal Instagram is just my first name underscore last name Amanda Christiana know you can reach out to me there if you have any questions about anything that we talked about or if you want to work with me personally and then the studio that I work for is called Never give up and manioc so on Instagram, we're just never grip up underscore manioc, and on our website, never give up training.com You could find pricing classes, personal training options, all of the different things that we offer if you have any questions, and I wanted to ask you because I know I saw in your form that you started baking and goods. Just give a shout out to that. So I didn't want to skip over that. So that's how it's really cool. Really good. I gotta get, like, my whole balance like I was talking about I love food. So I really love baking, but I can't have so many baked things in my home just for me and my boyfriend alone to eat, or like I'm gonna sell them. But yes, my baking business is called celestial, like space, baked goods. It's named after all of our dogs that are named after different celestial beings. But we sell bread, muffins, other types of baked goods, so you can find me on Instagram there if you are in the Philly area and want to order some brands. Awesome. Well, Amanda, thank you so much for being on with us today sharing your wisdom and your knowledge and everything. If you liked the episode, please like, share and subscribe. But otherwise, thank you so much. Thank you. I had a blast. Thank you. I'll see you soon ### Listen - [Spotify](https://open.spotify.com/episode/15188258) - [Apple Podcasts](https://podcasts.apple.com/podcast/15188258) - [YouTube](https://youtu.be/OI34TrpsGzk) --- ## Coping Strategies for New Mothers Facing Postpartum Challenges - URL: https://healyourrootspodcast.com/episodes/coping-strategies-new-mothers-postpartum-challenges - Published: 2024-05-22 - Season 3, Episode 13 - Duration: 46:38 - Category: maternal health - Guest: Dr Brianna Blis, Dr. Sepncer Brown ### Summary Deep dive into maternal mental health covering postpartum anxiety, depression, and practical coping strategies for new mothers navigating postpartum challenges. ### Description Navigating Maternal Mental Health: Insights on Postpartum Anxiety and Depression. Welcome to the latest episode of the Heal Your Roots Podcast! In this episode, we dive deep into the complex world of maternal mental health, exploring crucial topics like postpartum anxiety and depression. Our discussion covers a range of vital issues, from the impact of social media on new mothers to practical coping strategies for managing postpartum challenges. ### Transcript Dr. Brianna Bliss: 0:00 postpartum anxiety and depression is pretty common. Like, I think it's like one in five or one in sevens, women something like that span Dr. Spencer Brown: 0:10 is one in five. I do think social media has done a really good job of giving moms that opportunity to really talk about the hardships that comes with being a mom, whereas I feel like older generations made it like, oh, it's rainbows and sunshine and butterflies, and it's just the most beautiful thing. And a lot of ways it is and in a lot of ways, it's not. And so I feel like our generation is doing a good job of like, No, this is what it is, you know, you're gonna be tired, you're gonna be sleep deprived, is not always rainbows and butterflies. And so I do think that social media has given women the opportunity to really be like, kinda like brutally honest and give other women a heads up about what this really looks like. Dr. Katie Manganello: 0:57 Welcome back to the Heal Your Roots Podcast. I'm Dr. Katie Manganello. And in light of may being Maternal Mental Health Awareness Month, I have Dr. Spencer Brown and Dr. Brianna Bliss, who are licensed clinical psychologists that specialize in maternal mental health here with me today. So, welcome. Thank you. Yeah, yeah, I'm so excited to have you guys here. They're also some of my, my friends on top of my colleagues that we went to grad school together. So this is really fun being able to include them in on this conversation, and for them to share their wealth of knowledge with us on this. So before we get into it, can you guys both just tell me a little bit about what kind of brought you into the field, not necessarily just the field of psychology, but also what kind of inspired you to do this type of work? Sure. I can start. So I think what originally sort of led me to, like perinatal mental health was my focus on my dissertation. Dr. Spencer Brown: 2:00 So that's when I really started to look into women's health, my dissertation focused on female infertility, stigma, that cognitive distortions, and coping responses. And so once I really started to get into that, I was like, hmm, this might be a really good field a really good niche for me to kind of explore. So that led me to my internship, which led me to my postdoc, which then led me to my full time job right now. And so that's kind of like the trajectory of how I kind of got into the field was really essentially my dissertation topic. Yeah. Dr. Katie Manganello: 2:38 And what kind of brought you to choose that topic again, like was there anything in particular that kind of like happened that sparked that? Dr. Spencer Brown: 2:45 Yeah, so it was during the time when The Handmaid's Tale was on TV, oh, Dr. Katie Manganello: 2:50 my gosh, yes, I remember this now. So literally, I Dr. Spencer Brown: 2:54 was just kind of like laying in bed. And I was thinking about, like, what do I want to do for my dissertation topic, and I just remember everybody saying, you don't want to pick something that's going to be boring because you'd have to like sit with it for like a year or a year and a half. And I kind of already knew the foundation was going to be something related to like women's health. I didn't know what and then I was watching The Handmaid's Tale and I was like, infertility. You know, I think that would be like something that I would want to explore more and get into more. And so that's kind of how it kind of led me to it. And I also read the book in high school. So I had a good foundation for it. Dr. Brianna Bliss: 3:31 I didn't know that. I didn't either. Awesome. Dr. Katie Manganello: 3:36 Yeah, actually, I didn't even know there was a book. I thought it was just the show. Dr. Spencer Brown: 3:41 Margaret Atwood is the Arthur. Dr. Katie Manganello: 3:45 Awesome. Okay, and what about you Dr. Bliss? So Dr. Brianna Bliss: 3:50 I am a pediatric psychologist. And so I work in primary care with little kiddos, zero to 21. So I see the whole the whole pediatric lifespan actually. And I'm in a pediatricians office and where I work now I have over the past two years or so been starting to work with the younger, you know, zero to five kids. And obviously with that comes parents and moms. And so I kind of stumbled into perinatal mental health through seeing little kids and what happens in primary care sometimes is moms are screened for depression or for you know, any other stressors or family stress. And so, I love to see like newborns and when the moms you know, first have the babies and so I can work with them then or any of the caregivers really so I kind of stumbled To perinatal mental health through my work in pediatrics, and I also do a group, a prenatal group for pregnant people currently focused on the fourth trimester and newborn development. So mostly seeing kids but have been working with perinatal population through my work in pediatrics. That's Dr. Katie Manganello: 5:28 awesome. Isn't it interesting how we just kind of like stumbled into what we're doing. It's not just like, This is what I'm gonna do. And here we are, right. So that's really cool. I Dr. Spencer Brown: 5:38 feel like that's my life. I feel like I kind of just stumbled into things. It just kind of happens that way. So I just, yeah. Dr. Brianna Bliss: 5:47 Yeah. Never, I never really thought I'd be going into this kind of direction. But especially in primary care. It's all like preventative mental health. So it's like, if you're gonna see a two year old or a three year old, then why not just start seeing the mom to like, as early as possible. So just kind of happens that way. Right. And Dr. Katie Manganello: 6:10 a lot of working with children is working with parents. So yeah, that makes sense. Definitely. Dr. Brianna Bliss: 6:15 Sure. Dr. Spencer Brown: 6:16 God bless you, because kids want to work with the moms. Dr. Brianna Bliss: 6:23 It's fun. There's never a dull moment. They keep you on your toes. I know you fellas. Dr. Katie Manganello: 6:33 Well, so with that being said, and knowing that you both work with this, so how would you define postpartum anxiety and depression? And how would you kind of differentiate that from like a typical just like baby blues. Dr. Spencer Brown: 6:49 So typically, with like the baby blues, just want to kind of like prefaces that the baby blues are extremely common. About 85, up to about 85% of women will experience the baby blues. So this is essentially, you know, feeling sad, feeling overwhelmed, feeling anxious, during the first two to three weeks postpartum. If those symptoms do not start to decrease, but rather like increase or kind of like stay the same, after that three week mark, then that's when we will be concerned about postpartum depression. So I always tell my moms that when they are pregnant, and kind of like, brace them for that, because it's extremely common. And I'm always like, just because you're crying at the drop of a dime, you're feeling overwhelmed or anxious. And the first two to three weeks, that does not mean you have postpartum depression, you are in the baby blues phase. So I always kind of give that sort of like, caveat, in the beginning, yeah. And Dr. Brianna Bliss: 7:51 also with that, like, that happens because of the drop in hormones, right. So like, right after your, you know, your body during pregnancy is developing all these other different hormones that you don't typically have, and then you deliver, you give birth, and drastically we see this drop in hormones. And that's why there are natural consequences or mood changes within those two to three weeks. So totally normal to feel that most people do feel that, and it's for us, but cific reason. But like, you know, Dr. Brown said, if that continues past three weeks, then you want to talk to like your OBGYN or your doctor or someone, you know, to get more support. And Dr. Spencer Brown: 8:39 I will say most OBGYN are screaming at the six week, checkup postpartum. So I do I do feel like that is something that has been really helpful. And and that's how we kind of get involved, as like perinatal psychologists, is that like an OBGYN will, you know, send a referral to us or the birthing mother will reach out to us? Because maybe she had like an elevated screening? for depression? Dr. Brianna Bliss: 9:07 Yeah. Which is why it's super important to go to your six week postpartum visit. Yeah, I know, like, sometimes moms, it's overwhelming, and you put yourself on the back burner. And you feel like you have a ton of pediatric appointments because you're you have a newborn and so you're going to all your babies appointments, which is fair, but also you still you know, need to take care of yourself because that's the best way to help your baby. And so it's really important to go to six week checkup for just a variety of reasons to make sure like you're doing okay, health wise and talking about your labor and delivery and, but also if there are emotional concerns, that could be a really good time to get screened and to talk to someone and maybe get connected to mental health treatment and get more support. Yep, definitely. Dr. Katie Manganello: 10:00 So as it relates to that timeline, so you had said that the first like, you know, so many weeks it's common, it's more baby blues. Once it hits that point, then it's considered postpartum. When is it no longer if it if the symptoms persist? When is it no longer considered postpartum? And it's considered depression anxiety unrelated? Or is it something that kind of can last for a pretty long time after birth? Dr. Spencer Brown: 10:27 It really depends. A lot of people go by the one year mark. So in terms of one year postpartum is typically when we kind of say like, postpartum depression ends, but really, it really just depends on the woman and the symptoms of it. But typically, it's up to a year postpartum, we will call it postpartum depression. Dr. Katie Manganello: 10:51 Okay. And so what are some of the common symptoms of postpartum anxiety and depression? And you know, more specifically, how is it different? How does it show up differently from other types of anxiety or depression Dr. Brianna Bliss: 11:12 or you go ahead. Dr. Spencer Brown: 11:14 So obviously, in terms of like depression, so it really is kind of very similar in terms of the symptoms of just classic depression and postpartum depression. So obviously, feeling really sad feeling tear for like, we'd be low motivation, lack of interest, not engaging with other people, but also not wanting to engage with the baby. That's like a big one. Classic, like, lack of sleep is a really big common symptom, obviously, because baby may not be sleeping, you're up at night. A lot of times, it's co occurring with anxiety, particularly with sleep, because mom may be very anxious about nighttime, having to watch baby feeling like she needs to always have her eyes on the baby at night because of different risks that happened at nighttime and sleep. And so those are some of the common ones. And then, of course, suicidal thoughts, paths or thoughts to harm yourself. I tend to see that related to when the mom is feeling like inadequate in some way or feeling like she's not being a good mom. And so then having those feelings of wanting to escape, or run away, because she's feeling like she's not being a good mom or feels inadequate. Dr. Katie Manganello: 12:37 So it sounds like they're more I mean, it's the same kind of symptoms, but more so just focus on the baby and her mother Dr. Spencer Brown: 12:45 and a mother. Yeah. Yeah. Okay. Dr. Katie Manganello: 12:51 Free. Did you want to add anything to that? Oh, Dr. Brianna Bliss: 12:53 no, if you said also like irritability, feelings of anger, right, that could look like you know, both depression and anxiety. But yeah, basically, similar symptoms, loss of interest and doing things that you wants us to like to do, right. But more so because of, you know, this experience of having a baby and caring for the baby. And anxiety tends to be like all about the baby. Yeah. Dr. Spencer Brown: 13:26 Like worrying about the baby. Just having those anxious feelings, feeling overwhelmed. Sometimes panic attacks can occur in postpartum period because of anxiety. So yeah. Dr. Katie Manganello: 13:40 Right. And I think that that it might be hard for someone to know if they're experiencing this or not, without going to these appointments or supposed to be going to because it's normal, like you said, the beginning like, to an extent to be worrying about your baby, right? Like, it's now your job to keep your baby alive and, and to want to be a good mom and all of that kind of stuff. So that really does kind of highlight the importance of them going to those kinds of appointments. Yeah, yeah. Yeah. Okay. So, talk to me a little bit more to about what you know about risk factors, or, you know, is there certain family history that kind of influenced these things? Or are certain things that happened during birth, maybe that could be risk factors to, to these things? Dr. Brianna Bliss: 14:35 So, I guess first of all, like, postpartum anxiety and depression is pretty common. Like, I think it's like one in five or one in seven women, something like that, then it's one Dr. Spencer Brown: 14:48 in five. One in five will experience a perinatal mood or anxiety disorder of some sort. Yeah, Dr. Brianna Bliss: 14:54 right. That's, that's pretty common. And so like, Other people might be wondering, well, how do I know if I'm going to be one in five? Or you know, what, what factors? What risk factors, you know, do I have that would make me more likely to experience postpartum mood disorder? I think, definitely family history, right. So if you have anyone in your family that has experienced depression or anxiety, or specifically also postpartum depression, or anxiety, if you yourself has have ever experienced anxiety or depression, that makes it more likely to experience that during pregnancy. There's a lot of like social factors too, right? So if you have limited social support, or maybe you know, not, you know, not the social support that you would like nearby, maybe friends or family are distant, that could be a factor, financial resources can be a really big factor, lacking financial resources. What are some of the other ones? That's really no, Dr. Spencer Brown: 16:10 yeah. So in particular, like women of color are also at a higher rate of developing perinatal mood and anxiety disorders. Women of Color are two to three times more likely than white women to develop a PMS disorder, and three to four times more likely to die during childbirth. And so like risk factors are really huge. And so having that knowledge, and really kind of advocating for yourself getting more information, asking questions, is something that can really be helpful during pregnancy and postpartum Dr. Katie Manganello: 16:48 as well. That is alarming. It is Dr. Spencer Brown: 16:51 we're definitely in a crisis right now, in terms of this, right? And Dr. Katie Manganello: 16:57 what do you do in your roles to advocate for that, and kind of, like, make changes around that? Because really, that is scary. I think a lot of people don't know that. Dr. Spencer Brown: 17:06 So I think one of the biggest things is talking to like OBGYN and making sure that they're like culturally competent, and being sensitive, and really being aware of, you know, this information and being really supportive and an open to listening to women of color when they have questions, because a lot more women of color are aware of this. And I do think that that does play a role in like some of their hesitancy because even though this risk is really high, women of color, do not often seek treatment for this, whether that's because of like stigma, whether that is because of like fear of like providers. They're just like a multiple of multiple multitude of reasons why, and then also, specifically, like institutional racism, and things like that, obviously come up when we talk about this issue. So it can be a lot of different reasons. Dr. Brianna Bliss: 18:09 Yeah, I was gonna say that speaks to like access of care, you know, like, I work in a predominantly low income area in New York City, and predominantly, like black and brown population. And so one of the things that we try to do is increase access to care for all those reasons that Spencer just share. Because of the stigma, because of you know, there's not where I work very low financial resources available to people. So trying to give people access through their OBGYN access to mental health services, screening groups, where they can learn about perinatal mood disorders and learn how to like, know, the signs for postpartum anxiety and depression know their risk factors so that they can have conversations with their doctors, if their doctors aren't asking them. They can bring that up and say, This is what I'm feeling like, this is what I need to talk about. So I think, yeah, all of that is really important to make sure we address. Dr. Spencer Brown: 19:23 Yeah, and I also think having like providers of color, whether that's like OBGYN or therapist, psychologist, I think that can also reduce some hesitancy of bringing some of these hard conversations up this, if you can prepare, maybe with your therapist before, like, well, what should I say what questions you know, should I be asking, What should I look out for? I think all of that can be helpful as well. Dr. Katie Manganello: 19:46 Yeah, absolutely. That makes sense. Yeah. And so in talking about these risk factors, and a lot of what you're saying that you do is giving people the education around the risk factors and blah, blah, blah. would come up? How do you feel like that helps from a, you know, prevention lens? Dr. Brianna Bliss: 20:09 I think people like so knowing the difference between baby blues and and Perinatal mood disorders, sometimes in my experience, like, the women I've worked with, they're not, they're not really sure what the baby blues are, or how you know, if they have these risk factors to get a mood disorder. So just have giving them the tools to know what to look for. And what they might be feeling, I think is super important, because then they can advocate for themselves in a system that like, won't always help or advocate for them. So I think that's really important just to give them the knowledge and the education to know like, what I'm feeling and what I need to ask for. This is when I need more help, or this is okay, this is normal. Dr. Spencer Brown: 21:01 Yeah, I echo everything Brad just said. And also just like with anything, the more knowledge you have, the more information you have, the better equipped you are to kind of face it or overcome barriers, because you kind of can know what to do and have more resources at your fingertips. Dr. Katie Manganello: 21:20 Yeah, so it certainly sounds like it helps a lot in at least in healthcare, right. And that also just kind of is a segue for me thinking about how this impacts so many aspects of a woman's life or right, like it obviously impacts them in their health. But also, can you talk a little bit about how it impacts their relationships with people, their relationship with their baby, relationships with partners, family, all of that. Dr. Spencer Brown: 21:53 I think one of the biggest things that I have seen come up and I was like, really not aware of this, when like just being just like a regular person. But becoming like a psychologist and working in this field is how often people do not talk about like gender roles within their relationship and like what that is going to look like when they have a child. And I think that is a big source of stress in our relationship. Like, am I going to be a stay at home? Mom? Am I going to be a working mom, if I'm going to stay at home? Is it my responsibility to take care of the child 24/7? And then what is my partner's role in that. And so I think gender roles is a really big issue and can be a role sort of like transition within itself becoming especially for first time parents, it can be like a really huge source of stress. Just kind of, Dr. Katie Manganello: 22:53 like what are some examples of that I'm really curious about like, how that shows up. So Dr. Spencer Brown: 22:59 like, for example, so let's just say the woman is like a stay at home mom, she may feel a lot of responsibility to be the one to take care of the baby 24/7 Because she's a stay at home moms. And typically, let's just say her husband is the one who goes to work. And so she may feel a lot of guilt or shame to have to get an x her husband to wake up in the middle of the night to get the baby because she's a stay at home mom, and her role is to take care of the child. And so I think having these conversations, you know, in pregnancy, or before you decide to have a child can definitely shed a light on to like so is this going to be really truly 5050? Or is this going to be more 6040 8020. And if you can decide that, you know, and everybody sort of like be somewhat okay with that it can reduce a lot of stress, because you might go into it thinking like, Oh, we're partners, and my husband is going to be in this 5050. But really, it may look more like 6040. And that's okay, as long as you can kind of prepare for that and plan for that kind of early on versus now we have a newborn and I'm up and I'm breastfeeding and I have to keep getting up and my husband is just sitting there snoring and sleeping. That causes a lot of resentment, and some anger, you know, sometimes because you're constantly the one waking up and quote unquote, responsible for the child. So that is something that I have seen come up so much. That's why I kind of wanted to just throw it out there. Dr. Katie Manganello: 24:32 Yeah, no, that's a good example. Dr. Brianna Bliss: 24:34 Yeah. So everyone you're saying everyone tried to like, put out there what the expectations are? Yeah. Originally and then. Dr. Spencer Brown: 24:48 You can't like especially like, you know, like we're planning to get pregnant. That can definitely be something to kind of talk about like so. What are your expectation like? What do you think this is going to look like? Ya know, like when the baby comes, because often it doesn't look like what both of them thought originally. So you have you both are coming into it with expectations, regardless if you talk about it or not. But if you talk about it, at least you can prepare for it. Dr. Brianna Bliss: 25:16 That's good advice. Thank you. I also, to answer your question to Katie, I wanted to talk about the mom baby relationship, like how that's impacted with attachment. Because that is a lot of what I talk about in my role at my job, too. There is a concept called serve and return. I don't know if you guys have heard of this concept. So it's kind of like a tennis match, you know, so compare it to that. So like with attachment and newborn babies, you think of like, the babies serving up, like a gesture, like a battle or a cry or something, and then the mom returning that serve. So like in tennis, you know, you hit it over, you hit it back, right, serve and return. And so when we talk about like, moms who are experiencing postpartum depression or anxiety, it can make it really hard to return that baby's battle or sort of bed for like attention or need or cry if mom is kind of experiencing her own emotions. So it's super important, because whenever we have that serve, and return interaction between mom and baby, or any caregiver and baby, the, it's like, so important for brain development. So the baby's brain is like, millions of neurons are firing, right. And it's learning so much in such a short period of time. And whenever there's like, you know, the baby laughs and the mom serves that back and laughs to that. Neurons are like going crazy firing. And they're making that bond and that connection together. So if we think about moms who are like, you know, struggling with depression, and not able to last with their baby, or pick their baby up when their baby's crying, because they're going through their own emotions, that could really impact the bond, of course, the attachment, but also the baby's, you know, the way the baby's brain is developing to, because they're really looking for that attention, and that secure attachment from the caregiver. So I think from like, neuron level, all the way up to like attachment. It's so important when we think about when moms have postpartum anxiety or depression, because it really can impact like, the baby's development and their secure attachment. Dr. Spencer Brown: 27:56 Yeah, just piggybacking off of that really quick in terms of like the bond, I think there is a huge misconception that women have in terms of feeling like I'm going to be bonded to my baby, as soon as I see them. Like this is a huge misconception. And so when that bond is not there, it definitely leaves women to feel like inadequate, or like, there's something wrong with me, I don't feel bonded to this child. And so something that I like to tell my mom's kind of when that does happen is like, this is like any other normal relationship, like when you met your, your partner or your husband, you might not have you know, liked or loved him right away, it may have took, you know, some time, a couple of weeks. And so think of it like any other normal relationship, it may take time for that bond to really grow by baby loves you regardless. But you know, this is like any other relationship. And so give yourself that time to have that bond really, like flourish. And so like breastfeeding is a really good way to increase bonding time and skin to skin is a really good way to increase bonding and attachment. And specifically like in those early stages, but it may not happen right away like a lot of women think. Dr. Brianna Bliss: 29:13 Yeah, that's such a good point. I feel like media, social media, it's all portrayed as like, you're just gonna instantly fall in love with your baby, right? Yeah, that's not always the case. Dr. Spencer Brown: 29:27 I will say since we brought up social media that I do think social media has done a really good job of giving moms that opportunity to really talk about the hardships that comes with being a mom like if just following different women. A lot of women out there that are on social media are really like doing a good job of like talking about No, it's hard to be a mom like Dr. Katie Manganello: 29:51 that's what I'm saying. Yeah. Dr. Spencer Brown: 29:54 Yeah, I will say that I feel like Millennials like us and like Gen Z moms are really like doing a good job of telling the harsh truth about being a mob, whereas I feel like older generations made it like, oh, it's rainbows and sunshine and butterflies, and it's just the most beautiful thing. And a lot of ways it is, and in a lot of ways, it's not. And so I feel like our generation is doing a good job of like, No, this is what it is, you know, you're going to be tired, you're going to be sleep deprived, is not always rainbows and butterflies. And so I do think that social media has given women the opportunity to really be like, kind of like brutally honest and give other women a heads up about what this really looks like. Dr. Katie Manganello: 30:38 Good points, I, you know, what I also am really curious about is, you know, we talk a lot about partners, and it may be even like, parents or the grandparents of the babies. And obviously, the relationship with the, the baby and the mom. But I'm really curious about how giving birth to maybe a second or third or whatever child impacts a relationship with the mom and their other children? Like, is that something you guys ever see? Or talk about with people? I don't know if that's really relevant to your work, but I'm curious about it. Dr. Brianna Bliss: 31:11 Oh, yeah, for me in pediatrics, because sometimes, I'll be seeing like a two year old and they're jealous of a newborn baby. And, you know, parent, the parents can only do so much, you know, if the mom is one person. And so that does come up a lot. So sometimes, like, Well, how do I cope with this adjustment of having a second baby when the first one is not a fan. So we work, we work through that. And sometimes that means like, developing like special time with mom, and then materials like one on one so that they can still feel valued, and just other different strategies that we talked about. But that is very much a real thing. And it really just depends on your, your child, if they're going to have that reaction. Some kids are perfectly excited and like, take on a big brother or sister role, and it's great. So it really just depends. Dr. Spencer Brown: 32:21 Yeah, I would say for me, in terms of like what I do, a lot of times women will have an expectation because they already have a first child and already had a first pregnancy and that pregnancy went really well. And then they get pregnant a second time. And it's not like that. And then so there's a lot of like comparisons of well, this experience was like this, but this experience is is not like that. And so, you know, really getting them to stop making those comparisons and letting them know like, you know, each pregnancy is going to be different and come with it different challenges. And each baby is going to be different and have different challenges. And so kind of setting that foundation Dr. Katie Manganello: 33:05 can Yeah, that's a really good point. That's interesting, actually. Also, I want to circle back to because when I brought up for the relationships, I was talking about, like potentially, like grandparent relationships and stuff that you kind of giggle that I want to know what you were thinking. Yeah. Dr. Spencer Brown: 33:23 In terms of like grandparents, so if it's the, let's just say it's the mom, and it's her parents a lot of times, and even even like mother in law's can give unsolicited advice, right. And so I think it can be really hard on the mom, particularly if it's a first pregnancy, when like, your mom is like, Oh, I have five kids, you only have one, it can be really hard to kind of like manage that it can feel very, like undermining in a sense of like, Well, what I'm going through is not hard enough, or I should be kind of like grateful innocence. So I think all again, like older generations, it can be you know, kind of like grin and bear it, you know, like, it's not that hard. And so it can really impact the postpartum period where you kind of feel like you're being judged or criticized, because you only have one child or two or two children. And the women, the older women in your life are like, Oh, kind of get over it. Or if they even don't even feel like postpartum depression exists. You know, you're, you're gonna feel tired, you're gonna feel, you know, maybe bad, like it's going to be okay. And so it again, kind of leaves the woman feeling like inadequate. So that can be hard. Yeah. Dr. Brianna Bliss: 34:46 That's a good point, like, from generation to generation, right, as we've gotten more open about mental health and less stigmatized, although it still is but maybe grandparents don't They don't see postpartum anxiety or depression or they didn't. They didn't have that experience, or if they did, they weren't going to talk about or weren't aware of it. So that's a really different challenge for generationally to even, like, meet. Alright, I on that and understand what's going on there. Yeah, Dr. Spencer Brown: 35:22 yeah. And malls and grandparents do come up a lot, especially mother in laws. But that's a different conversation. Yeah, I Dr. Katie Manganello: 35:30 feel like we can have a podcast on that. Not even just the mother laws, but just like, parents have the new parents. Yeah. And like, cultural changes to, you know, it's not just generational incense in the sense of like, well, I'm a millennial in there or whatever. But also, just knowing that like, at least in America, this might be a really interesting dynamic, that's different. I don't know if it's different in other countries, but you know, a lot of our parents or grandparents are, you know, first generation second generation and the differences that kind of come with that. That's really, I think, an interesting thing. But you're right, that would probably be a whole other podcast, we should probably table that one. Dr. Brianna Bliss: 36:14 That'll be next time. I have so many ideas. Dr. Katie Manganello: 36:20 Send them over, you know, I get very excited about all the ideas too. But bringing it back to this one. So we already talked about how, like, let's talk about how we can help the new moms right, like, what are we going to do? So you talked a lot about psychoeducation, giving them information about all of this, the advocacy piece, and being able to have them advocate for themselves as well as your work and advocating? Tell me more a little bit about like, other treatment options, once it's established that okay, there is postpartum happening here, like, what kind of treatments do you use? What kind of treatment options are there? Like medication, individual therapy, support groups, maybe couples? Like those kinds of things? Dr. Spencer Brown: 37:02 Yeah, so all those things that you name, I can't answer the question. More about them, though, like, what does it look like? Kind of like we said, like, so like, if we take it all the way back to the beginning, like screening tools, so then we get the referral, they meet with us. So obviously, we do like the intake and all of that. So essentially, if I see a woman for several sessions, and I feel like her symptoms are not really, you know, getting better or decreasing, then that's when I would have the conversation in terms of like medication. And so that will often say, you know, like, some people can do really well with just therapy alone. But a lot of people do really well with therapy and medication. And so then I talk to them a little bit about, like, how do they feel about medication, because one of the big sort of misconceptions is that when I'm pregnant, I have to come on all of my medication. And that is not accurate. It's important for a lot of times for women to stay on their medication, depending on what the medication is, I'm not a psychiatrist, by any means. But a lot of times when the woman comes off of all of her medications, we really see a drop in her mood, and then all of those symptoms really come back with a force during pregnancy. And so then they come to us, and they're really distressed. And then we have to then manage that and kind of say, Okay, let's get you back on your medication, because that was what was helping you during this time. And so I think that's a big piece of it. And then, if they've never been on medication before talking to them about how they feel about being on medication, a lot of times women don't want to start medication because of breastfeeding. And so then that's when I would send them to a perinatal psychologist who couldn't really ask psychiatrists, sorry, who couldn't really talk to them about what medications are really saved for breastfeeding. And I know just offhand a big one that a lot of perinatal psychiatrists recommended Zoloft, because it is pretty safe for breastfeeding. Dr. Katie Manganello: 39:15 I do think that that is a big pressure that people feel without knowing that they have to go off of medication when they're pregnant. Dr. Spencer Brown: 39:23 But obviously talk to your psychiatrist when you are, you know, pregnant because some medications may have different side effects and different risks, but it's important to get that information and not just assume that I have to come off of everything, because I am pregnant in some OBGYN. I don't even like to prescribe to pregnant women, which then is another huge problem. Because then it's like okay, now, I don't have access to my medication because my OBGYN doesn't want to prescribe to me because they're, they're afraid, you know, to do it during pregnancy. But that's why we have perinatal psychiatrist now Because it sounds, yeah. Dr. Brianna Bliss: 40:02 Yeah, that's such a good point, even if your OBGYN doesn't want to prescribe it, or your primary care physician doesn't want to prescribe it, yeah, don't give up hope, that doesn't mean that you can't get it, it just means that they don't want, they don't see you often. And so when, when our providers not seeing you, like weekly or every other week, they, they can't monitor how the medications are going. So it just might mean, you see a psychiatrist or, you know, a therapist who can get you connected with a psychiatrist to get the right medication. So if at first you don't succeed with the right provider, that doesn't mean you shouldn't do it, just to figure out the right, the right person, who's going to be able to work with you, over time to make sure that like, once you start taking these medications, they can look like observe you and make sure things are going okay. Dr. Spencer Brown: 41:01 Okay. And then also in terms of like couples work. Concerns do come up during therapy, when just working with the woman, obviously, we are not couples counselors. So I do talk to my women, we do talk about like the stressors, and then the relationship dynamics, but I will often refer to like a couples counselor, because I'm just working with one half of the equation, the partner also needs to be involved, because what I will often say is that, when you are in therapy, you are going to get better or have a lot of knowledge, but your partner is essentially staying the same. And so then how is that going to work if you now have all of these different tools, but your partner's staying the same, it's not really gonna work that so having a support person who can see both of you and talk to both of you, and you talk about, like the communication, I think can be really helpful. Dr. Brianna Bliss: 41:59 Make sense? Yeah. And I think I'm beyond like, a therapist or psychiatrist, you know, other kinds of therapy, a couples counseling, I think it's also really important to connect to community resources. So that's a big focus in the group that I that I run. Like, things, resources, like dual was maybe like a Healthy Start program, which they have in a lot of, it's a national program. So they kind of have like, visiting nurses that can help moms or they provide you with a doula, they can give you access to Formula diapers. So there's a lot of programs out there that can be of like, concrete support that people might need. Rather than just like emotional support, which is really obviously very helpful. But sometimes, if you know you're struggling with finances, or like any other social factors, it could be really good to have a support and like a doula or just know where to get diapers or a food pantry, things like that. So sometimes when you connect with a therapist, they can also have access to those resources for you. So it's important. Dr. Katie Manganello: 43:27 Awesome, do you have any other just kind of general or practical advice for it doesn't even have to be like a mother struggling with postpartum depression or anxiety, but any kind of new mothers, do you have any kind of advice for just how to kind of like cope with the typical changes that are happening? Dr. Spencer Brown: 43:48 I just, you know, I just feel like, this is such a huge transitional period. So there's gonna be ebbs and flows that naturally kind of come along with that. But you are doing a great job, you are a good mom. And so the fact that if you, you know, are concerned that you may not be doing a good job, says that you, you know are a good mom, because if you you didn't care, then then we would have pause for concern. But if you are questioning that, then you are definitely being a good mom. Dr. Katie Manganello: 44:20 And being gentle and nice to themselves. Yeah, self compassion. Dr. Spencer Brown: 44:24 Yes, yes. 100%. Dr. Brianna Bliss: 44:26 And I would say to add to that, you will have bad days, and that's normal. And that's okay. And that doesn't mean you're a bad mom. It just means you're human. And sometimes, you know, like we talked about this a little bit in my group. It's like balancing your thoughts, right. So if you're saying to yourself like this is really difficult, but maybe you could balance that out with like, and I'm doing the best I can right So you can just kind of think about little ways to balance out your thoughts because sometimes when it weighs too heavy on one side of the scale, that's when we can start feeling kind of down. So I think it's about balance, knowing you're gonna have the bad days having the bad days, and tomorrow will be better. So Dr. Katie Manganello: 45:24 awesome. Well, do you have any final statements or pieces of advice or anything that you would want to leave us with? regarding any of the things that we had talked about today? Dr. Spencer Brown: 45:40 I feel like that pretty much covers it, but I will say you know, just look out for me and Dr. Bliss in the future. We have some things up our sleeve. So just before Dr. Brianna Bliss: 45:55 I your maternal and child wellness needs. Dr. Katie Manganello: 46:05 Okay, Dr. Bliss, do you have anything? Dr. Brianna Bliss: 46:09 That pretty much sums it up? Dr. Katie Manganello: 46:13 Okay, amazing. Well, this was so fun. I actually yes, we definitely have to do this again. And yeah, we'll definitely come up with some more ideas. So thank you so, so much for joining us today. And for everybody out there listening. Please remember to like, subscribe and share this episode wherever you find your podcasts. Dr. Brianna Bliss: 46:33 Thanks for having us. Thank you. Dr. Katie Manganello: 46:35 Bye bye ### Listen - [Spotify](https://open.spotify.com/episode/15110961) - [Apple Podcasts](https://podcasts.apple.com/podcast/15110961) - [YouTube](https://youtu.be/yecNd2SjvT4?si=sp-ZqahfOjm1tj9s) --- ## Nourishing the Mind and Body: Functional Medicine and Pregnancy Health - URL: https://healyourrootspodcast.com/episodes/nourishing-mind-body-functional-medicine-pregnancy - Published: 2024-05-08 - Season 3, Episode 12 - Duration: 48:52 - Category: health - Guest: Mari Kharroubi (Speech-Language Pathologist & Pregnancy Coach) ### Summary Mari Kharroubi shares her journey from overcoming learning disabilities to pioneering holistic approaches in maternal health through functional medicine. ### Description In this enlightening episode, Mari Kharroubi, a bilingual pediatric speech-language pathologist and dedicated pregnancy coach, shares her deeply personal journey from overcoming learning disabilities to pioneering holistic approaches in maternal health. Listen as she explains the transformative impact of functional medicine on pregnancy, nutrition, and emotional well-being. ### Transcript Kira Yakubov Ploshansky:: [0:00] Welcome back to Heal Your Roots Podcast, cure Yakubov SHAN ski co host and we have a very special guest co host joining us today Dr. Ki Mangan, ll licensed psychologist, and a very special guest, Dr. Elissa hertz, also licensed psychologist. Today we're going to talk about the overlap between obsessive compulsive disorder and eating disorder. Ladies, thank you so much for, for hosting and for being a guest with us today. Dr. Alyssa Hertz:: [0:27] Thanks for having me. Dr. Katie Manganello:: [0:29] Yes, I'm so excited to have Alyssa on the podcast with us Dr. Hertz. Fun fact, we went to grad school together. So this is my way of being able to pull in my my colleagues that have some overlapping interests and some cool stuff to share. So I'm really excited. Kira Yakubov Ploshansky:: [0:50] So let's uh, we usually start each episode kind of learning more about the practitioner. So if you can share kind of your background, what how you got into mental health and your specific specialty? Sure. Dr. Alyssa Hertz:: [1:03] I wish I could say that it started by like, my family was a psychologist or like this strong desire to help people. But I think for a while I wanted to go into nursing school because my mom and sister were but going to college, I had no idea what I wanted to do. So I took psychology courses, and it kind of just stuck. I was like, I'm good at talking to people. And I'm good at listening to people, this is the perfect career choice. But overall, it really did start to stick, I actually found it to be really fascinating. And just seeing all the different ways you could actually use a psychology degree to help people. You know, I think from a really long time, I've always had an interest in the eating disorder route, I was just fascinated by it, just because it's a little different, in my opinion than some other presentations, right? Like, you don't need to drink alcohol, or you don't need to maybe engage in certain behaviors, but you need food to live. And the fact that people just stopped eating or kind of we're engaging these really dangerous behaviors stuck out to me a lot. So I had loved that and took a lot of courses in undergrad, my master's program like Doctor degree. And then I started having a lot of curiosity about OCD and ended up at a training site with OCD and just seeing a lot of overlap between people with eating disorders, people with obsessive compulsive OCD, and realizing that there's a lot of symptom similarity between the two of them. And I thought it could be a special training opportunity and nice to be able to say that something that I specialize in in both routes. So really, a lot of my background and training has been working eating disorders training in cognitive behavioral therapy enhanced, which is for eating disorders, and that family based therapy. And then, on the other hand, doing a lot of training in exposure and response prevention treatment as well for OCD. And then I found a job that actually married the two together, and I kind of never looked back from there. Kira Yakubov Ploshansky:: [3:17] That's awesome. That sounds really cool. Yeah. And so can you share a little bit about who you work with now and the type of population I noticed the overlap, but uh, do you see clients only for one? Or they have to have both? Or what does that kind of look like for you? Yeah, Dr. Alyssa Hertz:: [3:31] yeah. So the practice I work for, we are kind of bigger specialty was eating disorders. And we've recently kind of branched out to starting to see OCD, anxiety related disorders, PTSD, things like that, again, just because we're starting to paint this picture of the two go together pretty often. So we really, probably within the last couple of years, have started branding ourselves as a clinic that specializes in the overlap between the two now, in order to be seen by one of our practitioners, or you do not have to have that comorbid presentation. But it's kind of just like a nice option if you are struggling with both. And I think there's a lot of times to people don't understand that it's one or the other. So having someone that can relate to us as a part of, hey, you know, you actually meet criteria for this or you meet criteria for this other thing. This is how it's impacting your disorder. This is how it's impacting your presentation. So yeah, I think it just creates a kind of one stop shop for people to be able to go to. And Kira Yakubov Ploshansky:: [4:37] so for the listeners who may not be as familiar or may not know, can you kind of share what eating disorders are and some of the common subtypes? Dr. Alyssa Hertz:: [4:45] Yeah, of course. So eating disorders, they're their psychiatric conditions that cause pretty significant impairment in someone's life. And I think if we're looking at them more, I guess, generally it's really this just Intense preoccupation and fear with weight gain their their body shape their weight in this extreme desire to be able to control these things. And they're, they're dangerous eating disorders. They're they're very, very harmful mentally and physically. You know, you could go on Google and type in physical complications of eating disorders, and you're gonna get a list. You know, some of them cardiovascular issues like irregular heartbeats, people that have heart attacks, GI issues. So when we're not eating enough, there's a lot of kind of just like, not going to the bathroom regularly, a lot of GI distress. Substances abuse, people don't know how to cope with it. So they're kind of turning towards alcohol. But probably I think, you know, the other part is, like the suicidality piece. So eating disorders have highest suicide rates than any other psychiatric condition. So, you know, when we're talking about treating eating disorders, we're thinking about this fast action approach, you know, we really need to get people kind of quick into recovery. Common types, there's, there's a few you know, there's several different eating disorders, I think, probably what more people are familiar with, or have at least heard at some point in their life, anorexia nervosa, bulimia nervosa and binge eating disorder. So anorexia is just this really intense preoccupation and fear about weight gain, their thoughts and emotions that accompany food related behaviors. This leads the person to restrict, you know, they're eating significantly less amount of calories today, skipping a lot of meals and snacks that people need throughout the day. So really the hallmark feature of anorexia and I think, probably what most people are familiar with is that low body weight and we're talking about not like one or two pounds below and maybe your growth chart by your it's inappropriate for your developmental level. And that's where we see a lot of those complications start to come in. And I think that's the picture right? If you tell someone anorexia, they're thinking really thin can see like, bone structure. They don't look very well. But there's also a binge purging type as well, where people are engaging in binge episodes, which I'll explain engaging in purging episodes, but really, it's that that weight piece right, that is the defining feature there for anorexia. Bulimia is someone who repeated binge episodes. So difference between binging and overeating, we're all susceptible to overeating. You know, Thanksgiving Super Bowl, parties, we all over eat from time to time. Binge Eating is really this unusual amount of food that someone's eating in a really short period of time. That characterizes it as a binge. A lot of the times I hear people talk about, they can't control it, they've like blacked out, during like an episode of eating, they don't remember consuming all of that food. To manage a lot of the meaningfulness and distress that comes with the binge eating, they do compensatory behaviors, which basically is just a way of trying to get rid of everything that they ate. So we'll see self induced vomiting, laxative abuse, excessive exercise, and those are kind of some of the common ones. And then the last one, binge eating pretty similar to bulimia with the the binge eating periods, but there's no compensatory behavior. So they're not trying to get rid of the food. And something interesting in binge eating too, is, you typically aren't seeing this intense preoccupation with like weight shape and food as you would with some of the other ones. But there's a lot of guilt and shame that usually comes with the binge eating, that a person is experiencing. So those are probably the more common ones that I would would say. Yeah, Dr. Katie Manganello:: [9:05] Alyssa, you did a really good job of explaining those. I am wondering if you could talk a little bit more to about like, body dysmorphic disorder. I feel like sometimes that kind of gets looped in there and is something that other therapists maybe don't know as much about, like I know that I didn't know as much about that until we started at like the anxiety and OCD treatment center. So do you want to talk a little bit more about that as well? Dr. Alyssa Hertz:: [9:31] Yeah, I think a lot of people they come into treatment saying they have body dysmorphic disorder, just because there is this like, I don't like my stomach or I don't like my thighs or I don't like this certain part about my body. And, you know, again, the functionality of the two are a lot different. This person is trying to lose weight, they're trying to maintain a certain body fat percentage or whatever that looks like whereas someone with Body Dysmorphia one it's not just exclusive to maybe some of these more common areas like die stomach, you know, there's usually not like a weight loss component, it's usually this perceived flaw whether it's real or imagined, like, my nose looks too big and no one really notices that or, you know, my shoulders are too broad. And I'm thinking about, you know, when we're thinking about body dysmorphia, there's a little bit of a functionality component that's a lot different than, you know, eating disorders. If we boil these down, it comes down to weight loss and trying to manage weight and this over control like weight and shape. Whereas Body Dysmorphia is a little bit more global. It can really be anything that a person perceives to be flawed. Kira Yakubov Ploshansky:: [10:45] So it sounds like it's super specific of a body part versus like, overall, I'm not I'm unhappy with how I look and I need to lose weight, whether that's exercising like crazy cutting calories throwing up, right, those kind of things, versus kind of it sounds like obsessing over a particular body part. Yes, correct. Dr. Katie Manganello:: [11:04] Right, which is like the perfect segue into so some of the other episodes I have done with the podcast, I talk a lot about OCD. Yeah, I'm wondering if you can get your definition of OCD. And then kind of after explaining a little bit of the overlap between eating disorders and OCD, and I feel like that body dysmorphic disorder is kind of like it that in the middle type of things. So that's why I wanted you to kind of talk about that Dr. Alyssa Hertz:: [11:35] a little bit. Yeah. Well, since you've gone over it a lot. I'll try not to be overly contented about these things. But you know, OCD, the two defining characteristics are those obsessions and compulsions. So obsessions are the distressing on what thoughts images, impulses, urges, that a person that's experiencing? And the major difference? You know, when we're thinking about we all have disturbing thoughts, I'm sure anyone can think of a time they had a really weird thought they're like, Oh, God. So you know, if I'm having a thought of, I'm going to drive my car off that bridge. I'm like, That was weird. Like, I'm gonna continue driving to work or wherever it is, I'm going where, you know, the obsession ality for someone with OCD is their brain is kind of I describe it as like tagging that is, that's dangerous. That's threatening. What does that say about me? Why did I have that thought? Does it mean that I want to hurt myself in some capacity, and it kind of just gets stuck on a loop there. The compulsive side then right is a person's attempts to neutralize or alleviate a lot of that distress and anxiety. So that could be behavioral. So in that example, I'm not going to ever purchase anymore, I'm going to take the long routes, I'm going to have someone else drive, maybe it could be single prayer over a bridge and where it becomes cyclical, where it becomes a little bit problematic for people is, I say the prayer when I go over the bridge, I feel better. So then I learned, oh, all I have to do now is say a prayer in order to manage my anxiety to get over the bridge. And now I need to do it more and more and more and more, and I can't get over the bridge anymore, without saying these prayers. So essentially, the problem here is the compulsions negatively reinforced the obsessions, which essentially means that person is getting short term relief. But as soon as they encounter that trigger again, or as soon as that thing pops up into their head, again, they're kind of spinning, you know, back into that cycle. And it really boils down to this concept of a person just has trouble dealing with doubt, uncertainty, and we're trying to help them learn that they can handle some of those things. So the overlap, yes. So this is a fun question. And I really am so happy to talk about it. So you know, just to start 41% of people with eating disorders also have an OCD diagnosis. So it's not kind of just like this small thing we're almost seeing about like, half our people who who have eating disorders, most likely are having some undiagnosed or diagnosed eating disorder at the time. And think what we're thinking about it right, the the core features of both of them tend to be these obsessions and compulsions. So I will try to break it down in the best way possible by an eating disorders. Those obsessions are, you know about food, they're about their weight, they're about their body image. So how am I going to avoid eating too much when I'm at a party with all of my friends? What if I eat this slice of pizza over the weekend and I gain you know, all of this weight? What happens if I can't look in the mirror before I go out somewhere? So there's a lot of this just distressing, repetitive thoughts that happen in someone who who has experienced an eating disorder. The compulsive behaviors depend on the disorder a little bit, you know, someone who is struggling with anorexia might engage in a lot of like body checking behaviors, they might cut their food into a really small piece. says, you know, things like that. Whereas in bulimia, we're seeing more of that like purging behavior. Same function as OCD compulsions, right? There's distress, there's uncertainty about body image and certainty about food and how it correlates to weight. So I need to do something in order to feel better, I need to do something to prevent this catastrophic outcome from happening. And we kind of see that same thing in OCD. So an example to maybe lay it out is what's give a person who has OCD, they're leaving for work and they're constantly checking their purse for keys, like is it there isn't there is there take step closer the door, let me check one more time about the car luggage over time, they're trying to alleviate the doubt that there's the potential that they left her keys in the house, they don't want to forget they need to be to be certain about that. In OCD, I'm sorry, an eating disorders we're kind of seeing, you know, again, is, I don't know if I can be certain that this certain food won't cause me to gain weight, I'm gonna avoid this certain food, I need to, you know, only eat a specific diet. And when we're seeing that we're like, cool. Okay, that definitely looks more characteristic of OCD, that definitely looks more characteristic of eating disorder, but it gets really muddied. So I'll give another example. And it really help explain how when a person comes in and gives you maybe just like a symptom, were having this kind of expertise in both can help tease apart. So let's just say someone comes in and they're talking about cutting food into small pieces. I think naturally, someone's like, probably eating disorders, you know, they're cutting their food and swap pieces. I've maybe heard that somewhere before. But it could serve a lot. Yes, the the cutting of the small pieces of food could be a way of slowing down eating. So they can pull quicker, it could be to appear like, look, I eat more that's on my plate. However, it also could be, I need to cut my food into 10 pieces to prevent my mom from dying, I need to cut my food into small pieces until it feels just right. So we're seeing this kind of common symptom on the surface level. But we need to understand the functionality of it as well. Because part of the importance is that is the treatment implications for that as well. We can't apply necessarily the same treatment to that symptom. So that's kind of where it can get a little bit muddy than why it can be really helpful to understand. Is this kind of veering off into weight control body image shape? Is this kind of going into this, on preventing this catastrophic outcome, which maybe Haiti has talked about this before? It's, it doesn't make sense, I know that cutting my food into eight pieces isn't actually going to prevent anything, but I feel like I have to do it anyway. Kira Yakubov Ploshansky:: [17:53] So fascinating. I did not realize that the overlap was so pervasive, and it makes me think about, I mean, I know that in your particular practice, I'm sure there's a lot of therapists or psychologists who have this overlap, but I haven't heard really it be that common for a therapist to have both specialties, which is a little concerning, but also, right, because if it's so pervasive, and they're coming in for one or the other, how, like, how does that work? How do you commonly see whether it's with other therapists, or when clients are coming in saying, you know, I went in for initially an eating disorder and realize I have OCD who my therapist can help me or vice versa? Dr. Alyssa Hertz:: [18:32] Yeah, I think it's tricky. I think a lot of people get misdiagnosed. You know, either way misdiagnosed with eating disorder, or misdiagnosed with OCD. If a person tend to think it's an eating disorder, or let's just say it actually is a eating disorder, they're getting referred out, like nine times out of 10 people, people just don't like touching eating disorders. But I think it's either way, I think a provider either has to know a lot about eating disorders to be able to rule out the possibility that this is OCD, like I understand, again, the functionality, I understand the conceptualization of eating disorders to say, this definitely is hitting on something here and someone with an OCD diagnosis, right, is needs a provider to be able to help them really distinguish between the two, when I gave again, I think about that example, I gave it the food cutting, if you don't know, to look for underlying differences. Well, we might get into a little bit of a mess. They're not saying someone can't help them and and work with maybe whatever it is they're presenting, but you're missing a whole other piece of the disorder, possibly, or exacerbating, you know, eating disorder behavior can exacerbate OCD and vice versa. So it's, it's not that people can't get help. I just think when you have such a overlapping commonality between again serve squabble symptoms. It's a big opportunity for something to get math. Dr. Katie Manganello:: [20:05] Yeah, I think that carry back to what you were saying with I feel like a big part of it that is worth noting is that I mean, you could make that argument for a lot of disorders because OCD has its own, like comorbidities. I always kind of explain I'm like, I've got in that camp, right? Because there's, there's eating disorders, there's Autism Spectrum Disorders, there's tics, threads, body focused, repetitive behaviors, ADHD trauma. So those are all kind of lumped in with like, really common comorbidity. So I think that if you are going to somebody who specializes in OCD, they should, at least at the very least be able to get to that functionality, like Alyssa saying, and be able to at least tease it apart and give you a solid diagnosis. And then, since it's so common, I think like, for example, like obviously, Alyssa specializes in eating disorders and OCD, I focus more so on OCD and trauma related disorders. But I would say that both of us also work a lot with ADHD, right? Like, there's an end. And we also like I could work with, you know, a level of eating disorder as well. But if it's something that's more pervasive or intense, like then it's maybe something that I would say, Listen, maybe this would be a better kind of client for you. So I think that if you have a psychologist or somebody who at least knows their their diagnostics well enough that at least they'll be able to get a good diagnosis that can kind of help move them forward. Kira Yakubov Ploshansky:: [21:38] Provide you clarify that? Because I do think it's important. There are so many whom who were billed comorbidities with a lot of disorders. And it sounds like OCD is, it overlaps with so many, it's just kind of like the topic or the theme, or what else is kind of stuck on it that they're obsessing over and having these compulsions over? I mean, it sounds like your clients have the best of both worlds with you, which is really great. And that you're able to do both so well. Dr. Alyssa Hertz:: [22:06] Yeah, I mean, again, I think about a like a one stop shop, essentially is, you know, it's frustrating having to go to multiple providers, I mean, I think we can all get off big about what we've got to like our primary or something, and they're like, you need to follow up with this person, this person, this person, and you're like, I don't want to schedule all this appointment, that's really annoying. So it's nice to be able to kind of go to one spot and be able to know that you're getting a really good care for both of those things. But I also think just from like, motivation, financial, you know, finding someone who specializes in things is pretty expensive. And, you know, if you're trying to say, go see this person first, then go see this person or see two providers at the same time. That's a lot of financial commitment. That's a lot of motivational commitment. You know, it's, it's doable, of course, I don't want to give that impression that it's not doable. But I think with anything, I think we all like, if I can have just a person that does it all. Like that would be great. Dr. Katie Manganello:: [23:09] Yeah, Alyssa, like when I mean, it's not even, it's definitely more of a burden on the individual experiencing OCD, or an eating disorder, both. But I think it's also it's a lot of extra legwork for the therapist, because like Alyssa and I both like I mean, we collaborate care with other providers. And a lot of times they do, like somebody does come in with somebody that they've seen for a long time for therapy, and they want to keep that relationship for other things. But like they're here to just see us for just OCD. And like we're, it's we take time outside of notes in you know, everything to touch base with the other providers and make sure that that's consistent and that it's on the same track. So yeah, and I think that that's another reason why I love doing the podcast and getting this information out there so that it can kind of It's my little contribution and getting more people hopefully, in the know about this kind of stuff. So there's less of all of that in the long run. Kira Yakubov Ploshansky:: [24:14] And so since you treat both What are some common therapies and techniques and modalities that you use for treating an overlap of the two, what do you separate? Do you Do it all encompassing? Like what is your kind of approach and style? Dr. Alyssa Hertz:: [24:28] Yeah, so I think the first thing is, the two treatments have similar interventions, but are fundamentally different. So I think it'd be helpful to me explain how they're different and then also how they're similar. You know, so for eating disorder treatment is an example could be is I'm asking someone, okay, we're gonna go to a restaurant and you're going to pick out a food that you're you're scared of something that you feel like it's going to cause you weight, but then afterwards, it might be good distract yourself in some way go call a friend, go watch your favorite TV show send your favorite music, you know, don't sit in this forever, you don't have to, we're just kind of asking you to get over that hump of anxiety. Whereas OCD, right, we're not asking pretty structured, we're saying, You know what, you're going to sit with this distress, you're gonna sit with this uncomfortability to learn that you can manage it. And we're really asking someone to lean into their fear a bit more. So, you know, like, yeah, I might have not blown up the candle, and my house is gonna burn down, but I'm gonna day out with my friends anyway. So why it's important to know, again, I think the treatments is you can accidentally harm or exacerbate symptoms on the other end. And this is where it kind of is helpful. It also gets tricky, I think when you're working with someone with both is the interventions can be similar at the same time as well. So family involvement is huge on both ends, we always love when when family members or caregiver providers are present with OCD, family based therapy, again, it's treatment for adolescents with anorexia, parents are pretty much involved the whole way through. And I think why why caregiver involvement in general is so important is because a lot of accommodations are going on. No one ever likes to see their their loved one their child, whoever it is in distress, so we're just trying to take that load off of them, we're trying to take that burden off of them, not realizing we're making things a little bit more difficult for them. So eating disorder combinations might be getting special groceries for them, you know, not cooking with butters, or things that have fat, but it could be cooking with other things. And unintentionally, we're kind of increasing that power and eating disorder has over a person OCD might be I'm not going to hold the door for you. So you don't have to a wash all your fruits, so you don't have to touch them. So helping to reduce a lot of that family or family accommodation is really helping a person indirectly learn that they can handle some of these anxieties and challenges that they're experiencing. So, you know, I think that's a kind of intervention that seen across the board exposure. So it's a big one, you know, primary strategy for OCD work is doing exposure work, we're saying, again, do the thing that scares you the most, you know, we're going to help you get there. But that is the best way to face your fears is to do this. And we're in some respects doing that, in eating disorder work to we're asking people to see their weight, sometimes it's the first time they've ever seen their weight, sometimes it's the first time in a long time, we're asking them to not weighed themselves so much in and of itself, that's an exposure. We're asking them to eat foods that they've cut out of their diet, or they're really scared of because they think it's going to gain weight. So the the exposure piece is really, really helpful across a course in OCD, because that pretty much is the treatment, but applying that intervention over and so the eating disorder work actually has been really, really beneficial for a lot of people. And then I also think, just like the hierarchy piece, too, is you're gradually having these people confront those things and reduce certain behaviors that are problematic in a way that, in my opinion, fosters a lot of self competence. You know, you're tackling these things at a minimal anxiety rate and you're feeling good about it, when you overcome it, you feel like you could tackle that next one. Definitely think it helps with the motivational piece. And by the time they get to that top scary thing, which could be petting a dog or gaining 30 pounds, it just doesn't feel so harmful or scary anymore. So I definitely think having a lot of common interventions is helpful, but also can make it tricky at the same time as when to apply versus when to apply it as well. Yeah. Yeah, Dr. Katie Manganello:: [29:02] that kind of segues into another question that I was thinking about in terms of like, what do you think, are some of the most challenging aspects of treating clients have both? Dr. Alyssa Hertz:: [29:13] Yeah, that's a that's a really good question. I think one of the more challenging aspects is actually helping the person to understand their symptoms, you know, really understanding I personally believe, spending a lot of time on psychoeducation upfront, I don't think there's any benefit in here's what OCD is here. But neither disorders like alright, let's jump into treatment and like, I want people to feel like I know exactly how this works. I know exactly what this like cycle looks like or, or what's happening on this end. And I think one of the challenges is really helping a person start to tease it apart on their own. Really understanding okay, this is definitely coming from eating disorder mindset over here. This is coming from an OCD mindset over here. I think The other pieces is kind of what I just said is when to apply the strategies, you know, we might say, again, practice deep breathing or practice relaxation strategies, eating disorder. But if it's OCD, we don't practice it. I think for kind of a safer route, if I a person got sure I'm just like, pretend it's OCD, then the worst case happens is you sit with distress, you sit with anxiety, it goes down anyway, the outcome will pretty much be the same if you're not sure. But I think that's pretty much the hardest part is I think there's just a lot of, we need to understand your symptoms, we need to know how they play out and like potentially where they're coming from in order for us to effectively treat them along the way. Kira Yakubov Ploshansky:: [30:46] So it sounds like a very thorough beginning, right, like intake process, understanding what's going on for them what their life looks like, their family made me think about an episode with Katie, of how their family can be involved. And it almost feels like, you know, counterintuitive of like, not enabling them, like doing things outside of what would relieve that stress and anxiety so that they can actually do it on their own. So it sounds like a lot of these things are are difficult, contradictory, but then also kind of mesh well together as well. Yes, Dr. Alyssa Hertz:: [31:17] yes. And that's hard to explain to people is, this contradicts itself, and is anytime it works for backwards. And they're kind of just like, white. But I think once people really get the hang of it and start to again, learn more about themselves and their symptoms and how they manifest it becomes a little bit easier along the way. Kira Yakubov Ploshansky:: [31:39] Do you have any success stories or kind of being able to walk somebody who has an overlap? And like, what progress would look like? Or what healing would look like for them? If it's not someone in specific? Dr. Alyssa Hertz:: [31:51] Yeah. So a while ago, I worked with someone who came in for anorexia. And, you know, I think one thing I should have mentioned is, regardless of what the person is going through, if they are underweight or mounters, that is the top priority. You know, you just can't do treatment, if someone from a medical standpoint is is not healthy. But also thinking about, if you've ever tried to do something, when you're starving, it's not easy to concentrate, it's not easy to take in information. So her and I really worked on like that weight restoration piece first getting her to a healthier weight, so we could engage in treatment, and a lot of her, you know, symptoms from an OCD perspective, were around fear that she could like ingest something that were would like, change her body composition and lead to all of these like weight related changes, she was kind of the example I was leading into with like, the cutting, there was also like a piece of like, I need to cut certain foods in order to prevent like choking, or like accidentally throwing up because she was averse to throwing up. We did a lot of exposure work to like feared foods and stepping on the scale and things like that. And I mean, I would say from start to finish, it was definitely a bumpy ride. This person had not previously known that they had an OCD diagnosis and having to really go through a lot of that, not backward. But hey, there's this other thing here that that I think is actually making, you know, the IDI center a little bit worse, and potentially exacerbating a lot of these symptoms, we really need to tease this apart a little bit and treat the two more simultaneously together. And I think that ended up opening up like a whole different door for us, like treatment went so much more smoothly. I'm talking about probably for like, three to four sessions. We were like, should we be doing this anymore? Like I think we're at a standstill, like what do we do here? And I think for this person in particular is we were totally minimizing something else. We didn't realize this other thing was going on and just kind of having that extra knowledge and being able to treat some of those OCD symptoms allowed one some of the eating disorder behavior to come down to some degree as well. But we were alleviating a lot of stress and anxiety on some other end. But yeah, I mean, she well, I don't see her anymore. I haven't heard from her. So I'm assuming that she's doing really well and has moved on with things but it was a really cool example and I bring her up because she was the first person I saw with OCD and eating disorders and that's where I was like, oh, okay, these two really do coexist and there's such a symptom overlap here and not in the way again, we're thinking about like OCD behavior is over here and eating disorders here but like a lot of food related OCD. 80 obsessions and compulsions that made it tricky. Kira Yakubov Ploshansky:: [35:05] I bet that sounds Well, I'm glad you were able to help her. And that kind of sparked your interest and inspiration into wanting to delve deeper into it. Dr. Alyssa Hertz:: [35:13] Yeah, it was a very interesting and fascinating case. Dr. Katie Manganello:: [35:18] Was it? Do you feel like there's any common misconceptions about OCD or eating disorders that you think need to be addressed in the therapy community? Dr. Alyssa Hertz:: [35:28] I think there's a lot of Dr. Katie Manganello:: [35:31] timing for sure. with OCD. Yeah, Dr. Alyssa Hertz:: [35:32] we could probably do a whole nother Dr. Katie Manganello:: [35:37] while this question could be a whole episode, Dr. Alyssa Hertz:: [35:40] be a big one. Yeah, I mean, these probably are repeated. And these are probably things that are very much out there. But, you know, just the idea that like OCD is being characterized, this is personality trader, this unique quirk that people have, you know, we hear it all the time of so OCD. I'm so OCD for this. And it minimizes, in my opinion, what someone with OCD is actually going through, you know, they're struggling, they're suffering, some people are homebound, they can't leave their houses or function on their own anymore. That's not pleasant. You know, when something's describing, I'm so OCD, it's usually I like cleaning until it's begun span, or I like organizing until it looks a certain way. And that's different. But, you know, if you like it, it's not a disorder. You're enjoying engaging in this. And I think, more than anything, it's, it's just, I can't imagine as a person if I was struggling with OCD to hear people throw around that term, so loosely, and knowing what the struggle actually looks like. I think the other the other big one that comes up for me is what OCD is, you. And I think this goes into why it can be so missed, like most people aren't actually getting treatment for like 10 years when they have OCD. Like there's a huge gap in there. And there's probably other reasons in there as well. But you have the people come in and like why don't wash my hands or I don't clean stuff for I don't organize stuff. And really helping people to understand OCD is so much more than just hand washing or taking long showers or being overly clean. But we have harm OCD, where people are afraid of hurting themselves or other people or we have scrupulosity, and religious and I know Katie did a whole wonderful podcast on that. And, you know, OCD is really anything that you care about, if you care about it, it's gonna go after it. And I'm really helping people to see like, it's, it's pretty broad. And that's why people symptoms can be so all over the place when you're working with them. But I think those are probably two of my biggest one, then I think in more of the eating disorder context, I think one of the bigger misconception is people think that there's like a choice and having an eating disorder, where, really, it's not a choice. It's a, you know, there's a lot of brain abnormalities that are happening, people are kind of born with these abnormalities that predispose them to eating disorders. And I have a great example is I had a patient who was just sick, like, blue or something like that. And she just lost a bunch of weight because she was sick and couldn't eat. And when she recovered, she was anorexic. All it took is her to lose too much weight and then flip switched on in the brain. And she was in treatment for anorexia. So, you know, I highlight that as a, she didn't choose to get sick. And she certainly didn't choose to recover with now a whole another problem on top of her. But they're really, you know, difficult disorders. And I always kind of lightly say, with my patients, I'm like, there's a good chance that you didn't wake up one day, just say, I want an eating disorder. I want to, you know, really struggle with all of this. It's just not something that you ever hear. The other one, I think that can be a little disheartening to it is parents think it's their fault. It worked with parents all the time. They're like I did something, I caused this to some capacity. I made a comment to you know, back 10 years ago about something and it's really difficult to help parents really externalize that, that eating disorder from their childhood and say, You didn't actually do anything, you didn't cause this eating disorder to happen. You didn't do anything that made this happen. It just biologically predisposed, we have environmental factors, society, that could also be a whole nother podcast on society and how it plays into eating disorders. And I think really helping people understand that there's nothing you did or said that cause someone to have an eating disorder. It's just kind of a perfect combination, a perfect storm of all of these factors that had come together to get your child sick. And you're part of that like medicine, if you will to helping them get better rather than the problem. Dr. Katie Manganello:: [40:11] I like that reframe. That's really good. Yeah, yeah, part of that medicine. Another one that I like was just thinking about as you're talking to that really bothers me is I think a lot of people think that like, you don't have an eating disorder, unless you're like, sick, then like it, people in larger bodies can also have eating disorders as well. And like that can be really harmful to people. Absolutely. Dr. Alyssa Hertz:: [40:36] Again, when we probably close our eyes and think about eating disorders, I think, everyone, I shouldn't say everyone, a majority of people would probably pick the anorexic person. And treatment gap here, right is this is why people don't often get treatment for eating disorders right away is people with binge eating disorder, could be normal or overweight, people with bulimia could be average weight, a little bit underweight, they could be overweight. But because we don't meet that stereotypical idea of what an eating disorder looks like, people are like, I'm fine, I'm not actually sick, or no one's noticing, I could still fit in all my clothes, I can still do all the things that I'm doing. It can mask itself, you're still functioning, you're still looking outwardly healthy, but internally, you know, mentally you're you're struggling, I think that's a really good one, it's still really hard to break people away from that misconception of outwardly, what it looks like it's a little bit silly it is to just diagnose someone street outwardly to have you know, you do or don't just because of your body composition. Kira Yakubov Ploshansky:: [41:49] Of that's such a great point. And it sounds like just thinking about all these different practitioners, right, like not knowing some of this or you know, like quick snap judgments. Is there any piece of advice that you could give clinicians who may not specialize in one or either that can give them something to kind of look for a differentiate, just to kind of stand out in that way? Dr. Alyssa Hertz:: [42:13] Yeah, I mean, definitely, like, ask all the questions, Katie, and I, you know, she mentioned collaborating with other providers. And I think there's more people out there that are willing to help and help you understand, because, after all, we all got into this field to like, help people, we're trying to get them through to the end of that treatment, recovery road. And we want to be able to provide any insights or resources or helpful stuff. So I think, you know, connect with people in either community, whether you are unsure if you're going to go into that route, or you might end up working with people this way is just immerse yourself into OCD eating disorder community, reach out to people, I get emails for people, like undergrad schools or like Training Master levels, and they're like, Hey, I'm really interested in this, like, can you talk? And I'm like, Absolutely, I would love to help. And there's so many free webinars, talks, resources. If you have the money, conferences, just even just attending as a person to walk through and learn about all of these things. There's so many opportunities out there that are accessible, easy, affordable, for you to be able to learn a little bit more about eating disorders or OCD. And even you know, I'm attending a free hour talk on the comorbidities between the two, you know, it's just kind of looking around and finding those opportunities and jumping on them. What Kira Yakubov Ploshansky:: [43:50] a wealth of knowledge. Thank you so much. This has been super informative. Before we hop off, are you can you share if there's any resources for individuals struggling with these things? Or any kind of tidbits or advice for someone who might be struggling with both of this? Dr. Alyssa Hertz:: [44:07] Yeah, I mean, I have definitely a bunch of resources. And I'm going to selfishly plug the book that my owners of the practice did, it is on how to treat comorbid, eating disorders and OCD. It's actually really, really helpful. It goes through everything we talked about, about what you knew disorders are, what OCD is, what the treatment similarities, differences are how to treat people case examples. It's a really, really helpful book. In terms of resources for for eating disorder community, there's the Academy for eating disorders, which is great. That's where a lot of the conferences come from. There's huge networking events that you could attend from there. There's National Eating Disorder Association, Nida. They are constantly doing events like walks like I think they do a eating disorder recovery walk in ever. Every major city you know, Throughout the year, and they're constantly doing advocacy or volunteer opportunities to get involved. You know, so those are feast is Another eating disorder website for individuals who are suffering with anorexia. And we're like a parent resource, I think, to help them figure out how to manage a child with an eating disorder and just some helpful resources there. And then, of course, there's some really good books. There's the treatment manual for anorexia. There's Chris fairbairns, CBT, manual for eating disorder. So there's a lot out there on the OCD front, I think, the iocdf, which is their big international webpage for everything and anything I pretty much always refer people there when they're looking for resources or books or anything. I'm like, here, here here. I think there's a lot of good researchers and people who have a lot of published books. There's John Grayson, who has like one of my favorite books, freedom from OCD, that was kind of like my training book, if you will, to get into OCD. There's Eric Stewart, who does a lot of research and constantly doing studies for people. Eli Liebowitz, John Abramowitz, John Hirschfeld, there's so many good people that just keep pumping out a lot of helpful books and resources. So it's pretty easy to find that which is Kira Yakubov Ploshansky:: [46:34] we will definitely list all of these in the show notes. That was Yeah, fantastic. Thank you. You have so much knowledge and expertise on this. I'm so happy you were able to join us today. This was incredible. Dr. Alyssa Hertz:: [46:45] I'm so happy you guys asked me to come this is a lot of fun. So Kira Yakubov Ploshansky:: [46:49] if anybody wants to work with you, fine. You can you share where they can get in touch with you. Dr. Alyssa Hertz:: [46:54] Yes, so I work for the Center for hope and health. So easy enough to just kind of plug onto into Google. There is phone number there's an email I specifically work out of in Texas for people who might be interested in more that area, but I also have a license that allows me to practice across state borders as well. So whether you're in New Jersey, PA, Oklahoma, you know, whatever it might be is they can still reach out to that number and if they're looking for resources or treatment, that's how they can reach me. If Kira Yakubov Ploshansky:: [47:35] you've enjoyed this episode, please like, share and subscribe. Liz, thank you so much for being on Katie. Thanks for being our co host. This was a phenomenal episode to wrap ### Listen - [Spotify](https://open.spotify.com/episode/15030858) - [Apple Podcasts](https://podcasts.apple.com/podcast/15030858) - [YouTube](https://youtu.be/KZue3drjVvg) --- ## OCD and Eating Disorders: Unveiling Treatment Synergies with Dr. Alyssa Hertz - URL: https://healyourrootspodcast.com/episodes/ocd-eating-disorders-treatment-synergies-dr-alyssa-hertz - Published: 2024-04-24 - Season 3, Episode 11 - Duration: 47:48 - Category: therapy - Guest: Dr. Alyssa Hertz ### Summary Dr. Alyssa Hertz explores the complexities of treating individuals with both OCD and eating disorders, highlighting treatment synergies and therapeutic approaches. ### Description Join us on this enlightening episode of our podcast as Dr. Alyssa Hertz dives into the complexities of treating individuals with both Obsessive-Compulsive Disorder (OCD) and eating disorders. With her dual expertise, Dr. Hertz highlights the synergies in treatment approaches and provides valuable insights for both professionals and individuals struggling with these conditions. ### Transcript Kira Yakubov Ploshansky: 0:00 Welcome back to Heal Your Roots Podcast, cure Yakubov SHAN ski co host and we have a very special guest co host joining us today Dr. Ki Mangan, ll licensed psychologist, and a very special guest, Dr. Elissa hertz, also licensed psychologist. Today we're going to talk about the overlap between obsessive compulsive disorder and eating disorder. Ladies, thank you so much for, for hosting and for being a guest with us today. Dr. Alyssa Hertz: 0:27 Thanks for having me. Dr. Katie Manganello: 0:29 Yes, I'm so excited to have Alyssa on the podcast with us Dr. Hertz. Fun fact, we went to grad school together. So this is my way of being able to pull in my my colleagues that have some overlapping interests and some cool stuff to share. So I'm really excited. Kira Yakubov Ploshansky: 0:50 So let's uh, we usually start each episode kind of learning more about the practitioner. So if you can share kind of your background, what how you got into mental health and your specific specialty? Sure. Dr. Alyssa Hertz: 1:03 I wish I could say that it started by like, my family was a psychologist or like this strong desire to help people. But I think for a while I wanted to go into nursing school because my mom and sister were but going to college, I had no idea what I wanted to do. So I took psychology courses, and it kind of just stuck. I was like, I'm good at talking to people. And I'm good at listening to people, this is the perfect career choice. But overall, it really did start to stick, I actually found it to be really fascinating. And just seeing all the different ways you could actually use a psychology degree to help people. You know, I think from a really long time, I've always had an interest in the eating disorder route, I was just fascinated by it, just because it's a little different, in my opinion than some other presentations, right? Like, you don't need to drink alcohol, or you don't need to maybe engage in certain behaviors, but you need food to live. And the fact that people just stopped eating or kind of we're engaging these really dangerous behaviors stuck out to me a lot. So I had loved that and took a lot of courses in undergrad, my master's program like Doctor degree. And then I started having a lot of curiosity about OCD and ended up at a training site with OCD and just seeing a lot of overlap between people with eating disorders, people with obsessive compulsive OCD, and realizing that there's a lot of symptom similarity between the two of them. And I thought it could be a special training opportunity and nice to be able to say that something that I specialize in in both routes. So really, a lot of my background and training has been working eating disorders training in cognitive behavioral therapy enhanced, which is for eating disorders, and that family based therapy. And then, on the other hand, doing a lot of training in exposure and response prevention treatment as well for OCD. And then I found a job that actually married the two together, and I kind of never looked back from there. Kira Yakubov Ploshansky: 3:17 That's awesome. That sounds really cool. Yeah. And so can you share a little bit about who you work with now and the type of population I noticed the overlap, but uh, do you see clients only for one? Or they have to have both? Or what does that kind of look like for you? Yeah, Dr. Alyssa Hertz: 3:31 yeah. So the practice I work for, we are kind of bigger specialty was eating disorders. And we've recently kind of branched out to starting to see OCD, anxiety related disorders, PTSD, things like that, again, just because we're starting to paint this picture of the two go together pretty often. So we really, probably within the last couple of years, have started branding ourselves as a clinic that specializes in the overlap between the two now, in order to be seen by one of our practitioners, or you do not have to have that comorbid presentation. But it's kind of just like a nice option if you are struggling with both. And I think there's a lot of times to people don't understand that it's one or the other. So having someone that can relate to us as a part of, hey, you know, you actually meet criteria for this or you meet criteria for this other thing. This is how it's impacting your disorder. This is how it's impacting your presentation. So yeah, I think it just creates a kind of one stop shop for people to be able to go to. And Kira Yakubov Ploshansky: 4:37 so for the listeners who may not be as familiar or may not know, can you kind of share what eating disorders are and some of the common subtypes? Dr. Alyssa Hertz: 4:45 Yeah, of course. So eating disorders, they're their psychiatric conditions that cause pretty significant impairment in someone's life. And I think if we're looking at them more, I guess, generally it's really this just Intense preoccupation and fear with weight gain their their body shape their weight in this extreme desire to be able to control these things. And they're, they're dangerous eating disorders. They're they're very, very harmful mentally and physically. You know, you could go on Google and type in physical complications of eating disorders, and you're gonna get a list. You know, some of them cardiovascular issues like irregular heartbeats, people that have heart attacks, GI issues. So when we're not eating enough, there's a lot of kind of just like, not going to the bathroom regularly, a lot of GI distress. Substances abuse, people don't know how to cope with it. So they're kind of turning towards alcohol. But probably I think, you know, the other part is, like the suicidality piece. So eating disorders have highest suicide rates than any other psychiatric condition. So, you know, when we're talking about treating eating disorders, we're thinking about this fast action approach, you know, we really need to get people kind of quick into recovery. Common types, there's, there's a few you know, there's several different eating disorders, I think, probably what more people are familiar with, or have at least heard at some point in their life, anorexia nervosa, bulimia nervosa and binge eating disorder. So anorexia is just this really intense preoccupation and fear about weight gain, their thoughts and emotions that accompany food related behaviors. This leads the person to restrict, you know, they're eating significantly less amount of calories today, skipping a lot of meals and snacks that people need throughout the day. So really the hallmark feature of anorexia and I think, probably what most people are familiar with is that low body weight and we're talking about not like one or two pounds below and maybe your growth chart by your it's inappropriate for your developmental level. And that's where we see a lot of those complications start to come in. And I think that's the picture right? If you tell someone anorexia, they're thinking really thin can see like, bone structure. They don't look very well. But there's also a binge purging type as well, where people are engaging in binge episodes, which I'll explain engaging in purging episodes, but really, it's that that weight piece right, that is the defining feature there for anorexia. Bulimia is someone who repeated binge episodes. So difference between binging and overeating, we're all susceptible to overeating. You know, Thanksgiving Super Bowl, parties, we all over eat from time to time. Binge Eating is really this unusual amount of food that someone's eating in a really short period of time. That characterizes it as a binge. A lot of the times I hear people talk about, they can't control it, they've like blacked out, during like an episode of eating, they don't remember consuming all of that food. To manage a lot of the meaningfulness and distress that comes with the binge eating, they do compensatory behaviors, which basically is just a way of trying to get rid of everything that they ate. So we'll see self induced vomiting, laxative abuse, excessive exercise, and those are kind of some of the common ones. And then the last one, binge eating pretty similar to bulimia with the the binge eating periods, but there's no compensatory behavior. So they're not trying to get rid of the food. And something interesting in binge eating too, is, you typically aren't seeing this intense preoccupation with like weight shape and food as you would with some of the other ones. But there's a lot of guilt and shame that usually comes with the binge eating, that a person is experiencing. So those are probably the more common ones that I would would say. Yeah, Dr. Katie Manganello: 9:05 Alyssa, you did a really good job of explaining those. I am wondering if you could talk a little bit more to about like, body dysmorphic disorder. I feel like sometimes that kind of gets looped in there and is something that other therapists maybe don't know as much about, like I know that I didn't know as much about that until we started at like the anxiety and OCD treatment center. So do you want to talk a little bit more about that as well? Dr. Alyssa Hertz: 9:31 Yeah, I think a lot of people they come into treatment saying they have body dysmorphic disorder, just because there is this like, I don't like my stomach or I don't like my thighs or I don't like this certain part about my body. And, you know, again, the functionality of the two are a lot different. This person is trying to lose weight, they're trying to maintain a certain body fat percentage or whatever that looks like whereas someone with Body Dysmorphia one it's not just exclusive to maybe some of these more common areas like die stomach, you know, there's usually not like a weight loss component, it's usually this perceived flaw whether it's real or imagined, like, my nose looks too big and no one really notices that or, you know, my shoulders are too broad. And I'm thinking about, you know, when we're thinking about body dysmorphia, there's a little bit of a functionality component that's a lot different than, you know, eating disorders. If we boil these down, it comes down to weight loss and trying to manage weight and this over control like weight and shape. Whereas Body Dysmorphia is a little bit more global. It can really be anything that a person perceives to be flawed. Kira Yakubov Ploshansky: 10:45 So it sounds like it's super specific of a body part versus like, overall, I'm not I'm unhappy with how I look and I need to lose weight, whether that's exercising like crazy cutting calories throwing up, right, those kind of things, versus kind of it sounds like obsessing over a particular body part. Yes, correct. Dr. Katie Manganello: 11:04 Right, which is like the perfect segue into so some of the other episodes I have done with the podcast, I talk a lot about OCD. Yeah, I'm wondering if you can get your definition of OCD. And then kind of after explaining a little bit of the overlap between eating disorders and OCD, and I feel like that body dysmorphic disorder is kind of like it that in the middle type of things. So that's why I wanted you to kind of talk about that Dr. Alyssa Hertz: 11:35 a little bit. Yeah. Well, since you've gone over it a lot. I'll try not to be overly contented about these things. But you know, OCD, the two defining characteristics are those obsessions and compulsions. So obsessions are the distressing on what thoughts images, impulses, urges, that a person that's experiencing? And the major difference? You know, when we're thinking about we all have disturbing thoughts, I'm sure anyone can think of a time they had a really weird thought they're like, Oh, God. So you know, if I'm having a thought of, I'm going to drive my car off that bridge. I'm like, That was weird. Like, I'm gonna continue driving to work or wherever it is, I'm going where, you know, the obsession ality for someone with OCD is their brain is kind of I describe it as like tagging that is, that's dangerous. That's threatening. What does that say about me? Why did I have that thought? Does it mean that I want to hurt myself in some capacity, and it kind of just gets stuck on a loop there. The compulsive side then right is a person's attempts to neutralize or alleviate a lot of that distress and anxiety. So that could be behavioral. So in that example, I'm not going to ever purchase anymore, I'm going to take the long routes, I'm going to have someone else drive, maybe it could be single prayer over a bridge and where it becomes cyclical, where it becomes a little bit problematic for people is, I say the prayer when I go over the bridge, I feel better. So then I learned, oh, all I have to do now is say a prayer in order to manage my anxiety to get over the bridge. And now I need to do it more and more and more and more, and I can't get over the bridge anymore, without saying these prayers. So essentially, the problem here is the compulsions negatively reinforced the obsessions, which essentially means that person is getting short term relief. But as soon as they encounter that trigger again, or as soon as that thing pops up into their head, again, they're kind of spinning, you know, back into that cycle. And it really boils down to this concept of a person just has trouble dealing with doubt, uncertainty, and we're trying to help them learn that they can handle some of those things. So the overlap, yes. So this is a fun question. And I really am so happy to talk about it. So you know, just to start 41% of people with eating disorders also have an OCD diagnosis. So it's not kind of just like this small thing we're almost seeing about like, half our people who who have eating disorders, most likely are having some undiagnosed or diagnosed eating disorder at the time. And think what we're thinking about it right, the the core features of both of them tend to be these obsessions and compulsions. So I will try to break it down in the best way possible by an eating disorders. Those obsessions are, you know about food, they're about their weight, they're about their body image. So how am I going to avoid eating too much when I'm at a party with all of my friends? What if I eat this slice of pizza over the weekend and I gain you know, all of this weight? What happens if I can't look in the mirror before I go out somewhere? So there's a lot of this just distressing, repetitive thoughts that happen in someone who who has experienced an eating disorder. The compulsive behaviors depend on the disorder a little bit, you know, someone who is struggling with anorexia might engage in a lot of like body checking behaviors, they might cut their food into a really small piece. says, you know, things like that. Whereas in bulimia, we're seeing more of that like purging behavior. Same function as OCD compulsions, right? There's distress, there's uncertainty about body image and certainty about food and how it correlates to weight. So I need to do something in order to feel better, I need to do something to prevent this catastrophic outcome from happening. And we kind of see that same thing in OCD. So an example to maybe lay it out is what's give a person who has OCD, they're leaving for work and they're constantly checking their purse for keys, like is it there isn't there is there take step closer the door, let me check one more time about the car luggage over time, they're trying to alleviate the doubt that there's the potential that they left her keys in the house, they don't want to forget they need to be to be certain about that. In OCD, I'm sorry, an eating disorders we're kind of seeing, you know, again, is, I don't know if I can be certain that this certain food won't cause me to gain weight, I'm gonna avoid this certain food, I need to, you know, only eat a specific diet. And when we're seeing that we're like, cool. Okay, that definitely looks more characteristic of OCD, that definitely looks more characteristic of eating disorder, but it gets really muddied. So I'll give another example. And it really help explain how when a person comes in and gives you maybe just like a symptom, were having this kind of expertise in both can help tease apart. So let's just say someone comes in and they're talking about cutting food into small pieces. I think naturally, someone's like, probably eating disorders, you know, they're cutting their food and swap pieces. I've maybe heard that somewhere before. But it could serve a lot. Yes, the the cutting of the small pieces of food could be a way of slowing down eating. So they can pull quicker, it could be to appear like, look, I eat more that's on my plate. However, it also could be, I need to cut my food into 10 pieces to prevent my mom from dying, I need to cut my food into small pieces until it feels just right. So we're seeing this kind of common symptom on the surface level. But we need to understand the functionality of it as well. Because part of the importance is that is the treatment implications for that as well. We can't apply necessarily the same treatment to that symptom. So that's kind of where it can get a little bit muddy than why it can be really helpful to understand. Is this kind of veering off into weight control body image shape? Is this kind of going into this, on preventing this catastrophic outcome, which maybe Haiti has talked about this before? It's, it doesn't make sense, I know that cutting my food into eight pieces isn't actually going to prevent anything, but I feel like I have to do it anyway. Kira Yakubov Ploshansky: 17:53 So fascinating. I did not realize that the overlap was so pervasive, and it makes me think about, I mean, I know that in your particular practice, I'm sure there's a lot of therapists or psychologists who have this overlap, but I haven't heard really it be that common for a therapist to have both specialties, which is a little concerning, but also, right, because if it's so pervasive, and they're coming in for one or the other, how, like, how does that work? How do you commonly see whether it's with other therapists, or when clients are coming in saying, you know, I went in for initially an eating disorder and realize I have OCD who my therapist can help me or vice versa? Dr. Alyssa Hertz: 18:32 Yeah, I think it's tricky. I think a lot of people get misdiagnosed. You know, either way misdiagnosed with eating disorder, or misdiagnosed with OCD. If a person tend to think it's an eating disorder, or let's just say it actually is a eating disorder, they're getting referred out, like nine times out of 10 people, people just don't like touching eating disorders. But I think it's either way, I think a provider either has to know a lot about eating disorders to be able to rule out the possibility that this is OCD, like I understand, again, the functionality, I understand the conceptualization of eating disorders to say, this definitely is hitting on something here and someone with an OCD diagnosis, right, is needs a provider to be able to help them really distinguish between the two, when I gave again, I think about that example, I gave it the food cutting, if you don't know, to look for underlying differences. Well, we might get into a little bit of a mess. They're not saying someone can't help them and and work with maybe whatever it is they're presenting, but you're missing a whole other piece of the disorder, possibly, or exacerbating, you know, eating disorder behavior can exacerbate OCD and vice versa. So it's, it's not that people can't get help. I just think when you have such a overlapping commonality between again serve squabble symptoms. It's a big opportunity for something to get math. Dr. Katie Manganello: 20:05 Yeah, I think that carry back to what you were saying with I feel like a big part of it that is worth noting is that I mean, you could make that argument for a lot of disorders because OCD has its own, like comorbidities. I always kind of explain I'm like, I've got in that camp, right? Because there's, there's eating disorders, there's Autism Spectrum Disorders, there's tics, threads, body focused, repetitive behaviors, ADHD trauma. So those are all kind of lumped in with like, really common comorbidity. So I think that if you are going to somebody who specializes in OCD, they should, at least at the very least be able to get to that functionality, like Alyssa saying, and be able to at least tease it apart and give you a solid diagnosis. And then, since it's so common, I think like, for example, like obviously, Alyssa specializes in eating disorders and OCD, I focus more so on OCD and trauma related disorders. But I would say that both of us also work a lot with ADHD, right? Like, there's an end. And we also like I could work with, you know, a level of eating disorder as well. But if it's something that's more pervasive or intense, like then it's maybe something that I would say, Listen, maybe this would be a better kind of client for you. So I think that if you have a psychologist or somebody who at least knows their their diagnostics well enough that at least they'll be able to get a good diagnosis that can kind of help move them forward. Kira Yakubov Ploshansky: 21:38 Provide you clarify that? Because I do think it's important. There are so many whom who were billed comorbidities with a lot of disorders. And it sounds like OCD is, it overlaps with so many, it's just kind of like the topic or the theme, or what else is kind of stuck on it that they're obsessing over and having these compulsions over? I mean, it sounds like your clients have the best of both worlds with you, which is really great. And that you're able to do both so well. Dr. Alyssa Hertz: 22:06 Yeah, I mean, again, I think about a like a one stop shop, essentially is, you know, it's frustrating having to go to multiple providers, I mean, I think we can all get off big about what we've got to like our primary or something, and they're like, you need to follow up with this person, this person, this person, and you're like, I don't want to schedule all this appointment, that's really annoying. So it's nice to be able to kind of go to one spot and be able to know that you're getting a really good care for both of those things. But I also think just from like, motivation, financial, you know, finding someone who specializes in things is pretty expensive. And, you know, if you're trying to say, go see this person first, then go see this person or see two providers at the same time. That's a lot of financial commitment. That's a lot of motivational commitment. You know, it's, it's doable, of course, I don't want to give that impression that it's not doable. But I think with anything, I think we all like, if I can have just a person that does it all. Like that would be great. Dr. Katie Manganello: 23:09 Yeah, Alyssa, like when I mean, it's not even, it's definitely more of a burden on the individual experiencing OCD, or an eating disorder, both. But I think it's also it's a lot of extra legwork for the therapist, because like Alyssa and I both like I mean, we collaborate care with other providers. And a lot of times they do, like somebody does come in with somebody that they've seen for a long time for therapy, and they want to keep that relationship for other things. But like they're here to just see us for just OCD. And like we're, it's we take time outside of notes in you know, everything to touch base with the other providers and make sure that that's consistent and that it's on the same track. So yeah, and I think that that's another reason why I love doing the podcast and getting this information out there so that it can kind of It's my little contribution and getting more people hopefully, in the know about this kind of stuff. So there's less of all of that in the long run. Kira Yakubov Ploshansky: 24:14 And so since you treat both What are some common therapies and techniques and modalities that you use for treating an overlap of the two, what do you separate? Do you Do it all encompassing? Like what is your kind of approach and style? Dr. Alyssa Hertz: 24:28 Yeah, so I think the first thing is, the two treatments have similar interventions, but are fundamentally different. So I think it'd be helpful to me explain how they're different and then also how they're similar. You know, so for eating disorder treatment is an example could be is I'm asking someone, okay, we're gonna go to a restaurant and you're going to pick out a food that you're you're scared of something that you feel like it's going to cause you weight, but then afterwards, it might be good distract yourself in some way go call a friend, go watch your favorite TV show send your favorite music, you know, don't sit in this forever, you don't have to, we're just kind of asking you to get over that hump of anxiety. Whereas OCD, right, we're not asking pretty structured, we're saying, You know what, you're going to sit with this distress, you're gonna sit with this uncomfortability to learn that you can manage it. And we're really asking someone to lean into their fear a bit more. So, you know, like, yeah, I might have not blown up the candle, and my house is gonna burn down, but I'm gonna day out with my friends anyway. So why it's important to know, again, I think the treatments is you can accidentally harm or exacerbate symptoms on the other end. And this is where it kind of is helpful. It also gets tricky, I think when you're working with someone with both is the interventions can be similar at the same time as well. So family involvement is huge on both ends, we always love when when family members or caregiver providers are present with OCD, family based therapy, again, it's treatment for adolescents with anorexia, parents are pretty much involved the whole way through. And I think why why caregiver involvement in general is so important is because a lot of accommodations are going on. No one ever likes to see their their loved one their child, whoever it is in distress, so we're just trying to take that load off of them, we're trying to take that burden off of them, not realizing we're making things a little bit more difficult for them. So eating disorder combinations might be getting special groceries for them, you know, not cooking with butters, or things that have fat, but it could be cooking with other things. And unintentionally, we're kind of increasing that power and eating disorder has over a person OCD might be I'm not going to hold the door for you. So you don't have to a wash all your fruits, so you don't have to touch them. So helping to reduce a lot of that family or family accommodation is really helping a person indirectly learn that they can handle some of these anxieties and challenges that they're experiencing. So, you know, I think that's a kind of intervention that seen across the board exposure. So it's a big one, you know, primary strategy for OCD work is doing exposure work, we're saying, again, do the thing that scares you the most, you know, we're going to help you get there. But that is the best way to face your fears is to do this. And we're in some respects doing that, in eating disorder work to we're asking people to see their weight, sometimes it's the first time they've ever seen their weight, sometimes it's the first time in a long time, we're asking them to not weighed themselves so much in and of itself, that's an exposure. We're asking them to eat foods that they've cut out of their diet, or they're really scared of because they think it's going to gain weight. So the the exposure piece is really, really helpful across a course in OCD, because that pretty much is the treatment, but applying that intervention over and so the eating disorder work actually has been really, really beneficial for a lot of people. And then I also think, just like the hierarchy piece, too, is you're gradually having these people confront those things and reduce certain behaviors that are problematic in a way that, in my opinion, fosters a lot of self competence. You know, you're tackling these things at a minimal anxiety rate and you're feeling good about it, when you overcome it, you feel like you could tackle that next one. Definitely think it helps with the motivational piece. And by the time they get to that top scary thing, which could be petting a dog or gaining 30 pounds, it just doesn't feel so harmful or scary anymore. So I definitely think having a lot of common interventions is helpful, but also can make it tricky at the same time as when to apply versus when to apply it as well. Yeah. Yeah, Dr. Katie Manganello: 29:02 that kind of segues into another question that I was thinking about in terms of like, what do you think, are some of the most challenging aspects of treating clients have both? Dr. Alyssa Hertz: 29:13 Yeah, that's a that's a really good question. I think one of the more challenging aspects is actually helping the person to understand their symptoms, you know, really understanding I personally believe, spending a lot of time on psychoeducation upfront, I don't think there's any benefit in here's what OCD is here. But neither disorders like alright, let's jump into treatment and like, I want people to feel like I know exactly how this works. I know exactly what this like cycle looks like or, or what's happening on this end. And I think one of the challenges is really helping a person start to tease it apart on their own. Really understanding okay, this is definitely coming from eating disorder mindset over here. This is coming from an OCD mindset over here. I think The other pieces is kind of what I just said is when to apply the strategies, you know, we might say, again, practice deep breathing or practice relaxation strategies, eating disorder. But if it's OCD, we don't practice it. I think for kind of a safer route, if I a person got sure I'm just like, pretend it's OCD, then the worst case happens is you sit with distress, you sit with anxiety, it goes down anyway, the outcome will pretty much be the same if you're not sure. But I think that's pretty much the hardest part is I think there's just a lot of, we need to understand your symptoms, we need to know how they play out and like potentially where they're coming from in order for us to effectively treat them along the way. Kira Yakubov Ploshansky: 30:46 So it sounds like a very thorough beginning, right, like intake process, understanding what's going on for them what their life looks like, their family made me think about an episode with Katie, of how their family can be involved. And it almost feels like, you know, counterintuitive of like, not enabling them, like doing things outside of what would relieve that stress and anxiety so that they can actually do it on their own. So it sounds like a lot of these things are are difficult, contradictory, but then also kind of mesh well together as well. Yes, Dr. Alyssa Hertz: 31:17 yes. And that's hard to explain to people is, this contradicts itself, and is anytime it works for backwards. And they're kind of just like, white. But I think once people really get the hang of it and start to again, learn more about themselves and their symptoms and how they manifest it becomes a little bit easier along the way. Kira Yakubov Ploshansky: 31:39 Do you have any success stories or kind of being able to walk somebody who has an overlap? And like, what progress would look like? Or what healing would look like for them? If it's not someone in specific? Dr. Alyssa Hertz: 31:51 Yeah. So a while ago, I worked with someone who came in for anorexia. And, you know, I think one thing I should have mentioned is, regardless of what the person is going through, if they are underweight or mounters, that is the top priority. You know, you just can't do treatment, if someone from a medical standpoint is is not healthy. But also thinking about, if you've ever tried to do something, when you're starving, it's not easy to concentrate, it's not easy to take in information. So her and I really worked on like that weight restoration piece first getting her to a healthier weight, so we could engage in treatment, and a lot of her, you know, symptoms from an OCD perspective, were around fear that she could like ingest something that were would like, change her body composition and lead to all of these like weight related changes, she was kind of the example I was leading into with like, the cutting, there was also like a piece of like, I need to cut certain foods in order to prevent like choking, or like accidentally throwing up because she was averse to throwing up. We did a lot of exposure work to like feared foods and stepping on the scale and things like that. And I mean, I would say from start to finish, it was definitely a bumpy ride. This person had not previously known that they had an OCD diagnosis and having to really go through a lot of that, not backward. But hey, there's this other thing here that that I think is actually making, you know, the IDI center a little bit worse, and potentially exacerbating a lot of these symptoms, we really need to tease this apart a little bit and treat the two more simultaneously together. And I think that ended up opening up like a whole different door for us, like treatment went so much more smoothly. I'm talking about probably for like, three to four sessions. We were like, should we be doing this anymore? Like I think we're at a standstill, like what do we do here? And I think for this person in particular is we were totally minimizing something else. We didn't realize this other thing was going on and just kind of having that extra knowledge and being able to treat some of those OCD symptoms allowed one some of the eating disorder behavior to come down to some degree as well. But we were alleviating a lot of stress and anxiety on some other end. But yeah, I mean, she well, I don't see her anymore. I haven't heard from her. So I'm assuming that she's doing really well and has moved on with things but it was a really cool example and I bring her up because she was the first person I saw with OCD and eating disorders and that's where I was like, oh, okay, these two really do coexist and there's such a symptom overlap here and not in the way again, we're thinking about like OCD behavior is over here and eating disorders here but like a lot of food related OCD. 80 obsessions and compulsions that made it tricky. Kira Yakubov Ploshansky: 35:05 I bet that sounds Well, I'm glad you were able to help her. And that kind of sparked your interest and inspiration into wanting to delve deeper into it. Dr. Alyssa Hertz: 35:13 Yeah, it was a very interesting and fascinating case. Dr. Katie Manganello: 35:18 Was it? Do you feel like there's any common misconceptions about OCD or eating disorders that you think need to be addressed in the therapy community? Dr. Alyssa Hertz: 35:28 I think there's a lot of Dr. Katie Manganello: 35:31 timing for sure. with OCD. Yeah, Dr. Alyssa Hertz: 35:32 we could probably do a whole nother Dr. Katie Manganello: 35:37 while this question could be a whole episode, Dr. Alyssa Hertz: 35:40 be a big one. Yeah, I mean, these probably are repeated. And these are probably things that are very much out there. But, you know, just the idea that like OCD is being characterized, this is personality trader, this unique quirk that people have, you know, we hear it all the time of so OCD. I'm so OCD for this. And it minimizes, in my opinion, what someone with OCD is actually going through, you know, they're struggling, they're suffering, some people are homebound, they can't leave their houses or function on their own anymore. That's not pleasant. You know, when something's describing, I'm so OCD, it's usually I like cleaning until it's begun span, or I like organizing until it looks a certain way. And that's different. But, you know, if you like it, it's not a disorder. You're enjoying engaging in this. And I think, more than anything, it's, it's just, I can't imagine as a person if I was struggling with OCD to hear people throw around that term, so loosely, and knowing what the struggle actually looks like. I think the other the other big one that comes up for me is what OCD is, you. And I think this goes into why it can be so missed, like most people aren't actually getting treatment for like 10 years when they have OCD. Like there's a huge gap in there. And there's probably other reasons in there as well. But you have the people come in and like why don't wash my hands or I don't clean stuff for I don't organize stuff. And really helping people to understand OCD is so much more than just hand washing or taking long showers or being overly clean. But we have harm OCD, where people are afraid of hurting themselves or other people or we have scrupulosity, and religious and I know Katie did a whole wonderful podcast on that. And, you know, OCD is really anything that you care about, if you care about it, it's gonna go after it. And I'm really helping people to see like, it's, it's pretty broad. And that's why people symptoms can be so all over the place when you're working with them. But I think those are probably two of my biggest one, then I think in more of the eating disorder context, I think one of the bigger misconception is people think that there's like a choice and having an eating disorder, where, really, it's not a choice. It's a, you know, there's a lot of brain abnormalities that are happening, people are kind of born with these abnormalities that predispose them to eating disorders. And I have a great example is I had a patient who was just sick, like, blue or something like that. And she just lost a bunch of weight because she was sick and couldn't eat. And when she recovered, she was anorexic. All it took is her to lose too much weight and then flip switched on in the brain. And she was in treatment for anorexia. So, you know, I highlight that as a, she didn't choose to get sick. And she certainly didn't choose to recover with now a whole another problem on top of her. But they're really, you know, difficult disorders. And I always kind of lightly say, with my patients, I'm like, there's a good chance that you didn't wake up one day, just say, I want an eating disorder. I want to, you know, really struggle with all of this. It's just not something that you ever hear. The other one, I think that can be a little disheartening to it is parents think it's their fault. It worked with parents all the time. They're like I did something, I caused this to some capacity. I made a comment to you know, back 10 years ago about something and it's really difficult to help parents really externalize that, that eating disorder from their childhood and say, You didn't actually do anything, you didn't cause this eating disorder to happen. You didn't do anything that made this happen. It just biologically predisposed, we have environmental factors, society, that could also be a whole nother podcast on society and how it plays into eating disorders. And I think really helping people understand that there's nothing you did or said that cause someone to have an eating disorder. It's just kind of a perfect combination, a perfect storm of all of these factors that had come together to get your child sick. And you're part of that like medicine, if you will to helping them get better rather than the problem. Dr. Katie Manganello: 40:11 I like that reframe. That's really good. Yeah, yeah, part of that medicine. Another one that I like was just thinking about as you're talking to that really bothers me is I think a lot of people think that like, you don't have an eating disorder, unless you're like, sick, then like it, people in larger bodies can also have eating disorders as well. And like that can be really harmful to people. Absolutely. Dr. Alyssa Hertz: 40:36 Again, when we probably close our eyes and think about eating disorders, I think, everyone, I shouldn't say everyone, a majority of people would probably pick the anorexic person. And treatment gap here, right is this is why people don't often get treatment for eating disorders right away is people with binge eating disorder, could be normal or overweight, people with bulimia could be average weight, a little bit underweight, they could be overweight. But because we don't meet that stereotypical idea of what an eating disorder looks like, people are like, I'm fine, I'm not actually sick, or no one's noticing, I could still fit in all my clothes, I can still do all the things that I'm doing. It can mask itself, you're still functioning, you're still looking outwardly healthy, but internally, you know, mentally you're you're struggling, I think that's a really good one, it's still really hard to break people away from that misconception of outwardly, what it looks like it's a little bit silly it is to just diagnose someone street outwardly to have you know, you do or don't just because of your body composition. Kira Yakubov Ploshansky: 41:49 Of that's such a great point. And it sounds like just thinking about all these different practitioners, right, like not knowing some of this or you know, like quick snap judgments. Is there any piece of advice that you could give clinicians who may not specialize in one or either that can give them something to kind of look for a differentiate, just to kind of stand out in that way? Dr. Alyssa Hertz: 42:13 Yeah, I mean, definitely, like, ask all the questions, Katie, and I, you know, she mentioned collaborating with other providers. And I think there's more people out there that are willing to help and help you understand, because, after all, we all got into this field to like, help people, we're trying to get them through to the end of that treatment, recovery road. And we want to be able to provide any insights or resources or helpful stuff. So I think, you know, connect with people in either community, whether you are unsure if you're going to go into that route, or you might end up working with people this way is just immerse yourself into OCD eating disorder community, reach out to people, I get emails for people, like undergrad schools or like Training Master levels, and they're like, Hey, I'm really interested in this, like, can you talk? And I'm like, Absolutely, I would love to help. And there's so many free webinars, talks, resources. If you have the money, conferences, just even just attending as a person to walk through and learn about all of these things. There's so many opportunities out there that are accessible, easy, affordable, for you to be able to learn a little bit more about eating disorders or OCD. And even you know, I'm attending a free hour talk on the comorbidities between the two, you know, it's just kind of looking around and finding those opportunities and jumping on them. What Kira Yakubov Ploshansky: 43:50 a wealth of knowledge. Thank you so much. This has been super informative. Before we hop off, are you can you share if there's any resources for individuals struggling with these things? Or any kind of tidbits or advice for someone who might be struggling with both of this? Dr. Alyssa Hertz: 44:07 Yeah, I mean, I have definitely a bunch of resources. And I'm going to selfishly plug the book that my owners of the practice did, it is on how to treat comorbid, eating disorders and OCD. It's actually really, really helpful. It goes through everything we talked about, about what you knew disorders are, what OCD is, what the treatment similarities, differences are how to treat people case examples. It's a really, really helpful book. In terms of resources for for eating disorder community, there's the Academy for eating disorders, which is great. That's where a lot of the conferences come from. There's huge networking events that you could attend from there. There's National Eating Disorder Association, Nida. They are constantly doing events like walks like I think they do a eating disorder recovery walk in ever. Every major city you know, Throughout the year, and they're constantly doing advocacy or volunteer opportunities to get involved. You know, so those are feast is Another eating disorder website for individuals who are suffering with anorexia. And we're like a parent resource, I think, to help them figure out how to manage a child with an eating disorder and just some helpful resources there. And then, of course, there's some really good books. There's the treatment manual for anorexia. There's Chris fairbairns, CBT, manual for eating disorder. So there's a lot out there on the OCD front, I think, the iocdf, which is their big international webpage for everything and anything I pretty much always refer people there when they're looking for resources or books or anything. I'm like, here, here here. I think there's a lot of good researchers and people who have a lot of published books. There's John Grayson, who has like one of my favorite books, freedom from OCD, that was kind of like my training book, if you will, to get into OCD. There's Eric Stewart, who does a lot of research and constantly doing studies for people. Eli Liebowitz, John Abramowitz, John Hirschfeld, there's so many good people that just keep pumping out a lot of helpful books and resources. So it's pretty easy to find that which is Kira Yakubov Ploshansky: 46:34 we will definitely list all of these in the show notes. That was Yeah, fantastic. Thank you. You have so much knowledge and expertise on this. I'm so happy you were able to join us today. This was incredible. Dr. Alyssa Hertz: 46:45 I'm so happy you guys asked me to come this is a lot of fun. So Kira Yakubov Ploshansky: 46:49 if anybody wants to work with you, fine. You can you share where they can get in touch with you. Dr. Alyssa Hertz: 46:54 Yes, so I work for the Center for hope and health. So easy enough to just kind of plug onto into Google. There is phone number there's an email I specifically work out of in Texas for people who might be interested in more that area, but I also have a license that allows me to practice across state borders as well. So whether you're in New Jersey, PA, Oklahoma, you know, whatever it might be is they can still reach out to that number and if they're looking for resources or treatment, that's how they can reach me. If Kira Yakubov Ploshansky: 47:35 you've enjoyed this episode, please like, share and subscribe. Liz, thank you so much for being on Katie. Thanks for being our co host. This was a phenomenal episode to wrap ### Listen - [Spotify](https://open.spotify.com/episode/14942433) - [Apple Podcasts](https://podcasts.apple.com/podcast/14942433) - [YouTube](https://youtu.be/MqOHFko1jc0) --- ## From Anxiety to Empowerment: A Deep Dive into Postpartum & Perinatal OCD - URL: https://healyourrootspodcast.com/episodes/anxiety-empowerment-postpartum-perinatal-ocd - Published: 2024-04-10 - Season 3, Episode 10 - Duration: 57:23 - Category: anxiety - Guest: Dr. Katie Manganello ### Summary Dr. Katie Manganello returns to explore postpartum and perinatal OCD, discussing anxiety, intrusive thoughts, and the journey towards empowerment for new parents. ### Description In this compelling episode of the Heal Your Roots Podcast, we warmly welcome back Dr. Katie Manganello as we delve into the intricate experiences of postpartum and perinatal OCD. With a compassionate approach, this discussion unfolds the layers of anxiety, intrusive thoughts, and the journey towards empowerment for new parents. ### Transcript Kira Yakubov Ploshansky: 0:01 Welcome back to Heal Your Roots Podcast. For today's episode we have Dr. Katie Mangan ello. Joining us again, and some exciting news is that Dr. Katie will be a reoccurring guest co host with Heal Your Roots Podcast. Dr. Katie Manganello: 0:14 So there's postpartum OCD and there's perinatal OCD. So OCD that occurs immediately after the child is born is called the postpartum, sad. And then OCD that occurs during pregnancy is called perinatal, OCD. There's Kira Yakubov Ploshansky: 0:30 a lot of uncertainty. I think there's a lot of uncertainty. And it's hard to know, which is the right thing to do. And all the time there is no right thing like I know we talked about in a different episode, like there is no right thing. There's just the best thing under the circumstances for you, Katie, I'm so excited to have you back on and have you on for future episodes. Dr. Katie Manganello: 0:53 I am so excited. I'm really looking forward to it as well, I think we'll have a lot of good topics to cover. Kira Yakubov Ploshansky: 1:00 So today's episode is going to be a little bit different from our usual structure. Usually, when we have a therapist or mental health practitioner on we kind of interview them, get to know them, their background and everything. But today, since we are the CO hosts to kind of set the field, it'll just be us kind of having a conversation and we're really gonna dive into postpartum OCD anxiety, and what it's like to be a new mom as an entrepreneur. So Katie will actually be interviewing me the interviewer has turned into the interviewee. So this is going to be a little bit different for us. So I'm really excited to be asked some questions and share some of my experiences with you, Katie and the rest of the listeners. Dr. Katie Manganello: 1:43 Yes, me too. I cannot wait. As somebody who is not a mother, or really, you know, not yet in life. I'm really excited to pick your brain a little bit about how it's going for you, especially as a new mom, so I can't wait to get into it. But yes, if we would like to start out talking about some OCD and the postpartum and Perinatal realm, I'd be happy to talk about that. Kira Yakubov Ploshansky: 2:08 Absolutely. Yeah. So Katie, I know in the other episodes, so you've been on to other episodes so far with us. And every time I asked you to share what is OCD for the listeners, so if they haven't listened before, if you can kind of share what that is, and then in particular, postpartum OCD as well. Yet, Dr. Katie Manganello: 2:28 yes, so briefly, just typical OCD. It's, it's, it's a disorder that is a doubting disorder. And it is comprised of two parts, which is the obsessions and the compulsions. Obsessions are the core fears or the intrusive thoughts, images, of whatever it is, it's feeling very distressing. Common themes would be contamination, harm OCD. I think the contamination is like one of the most popular but there's also religious OCD are scrupulosity. So there's lots of different types, which I've kind of touched on in previous episodes. So so that's kind of the theme with the obsessions. So obsessions fears, that compulsions are things that people are doing to try to alleviate that distress that comes along with the intrusions but the more people engage in compulsions, the more distressing the disorder becomes. The compulsions provide a short term relief, but long term distress. So common compulsions would be maybe flipping light switches, or washing hands, those types of things that people more commonly heard about. So anybody wants to learn more about that, or other subtypes, they can listen to some of the other episodes, but as it relates to this topic, so there's postpartum OCD, and there's pairing natal CD. So OCD that occurs immediately after the child is born is called the postpartum OCD. And then OCD that occurs during pregnancy is called perinatal, OCD. They're pretty similar there, because they're all surrounding the baby. So another big thing to know about OCD is it's always targeting your values, and going towards the things that you really care about. So it makes sense that new parents can experience these things because, you know, they're they're so excited and happy to have a baby, right? And so, there's a lot of there's also a lot of pressure to be like, I gotta keep this little baby alive, right? There's a lot of fears, I think that come up and it's normal to an extent for people to experience some of those fears or stressors that come with just having a baby. But the, you know, postpartum or perinatal, OCD is what kind of takes it to that next level. A lot of the obsessions would be about the baby getting hurt, or contaminated or loss. Also unwanted sexual obsessions at times a lot of the compulsions related to this might involve checking the baby checking baby monitors excessively, mental rituals seeking reassurance about being a good parent. Other things too, could be avoiding of the baby, if they're afraid of harming the baby, one thing that they might do could be avoidance, which can be really problematic, right? Because that can turn into neglect if there's not other people there to you know, caretaking and help out, and that the goal for the new parent is to never actually neglect their baby, right? Like, I want to make that clear that it's more so that they are afraid that they would potentially harm the baby. So, you know, these things can show up in different ways. But more importantly, the people who are experiencing these fears, the fears almost never, you know, come true in the turn in terms of feeling that they are actually going to harm their baby, and then them actually intentionally harming the baby. Obviously, accidental harm happens at any rate with being a parent, right, to some extent, but in terms of fearing that they're going to intentionally harm their baby, it's, you know, highly unlikely that that's actually going to happen, the more you engage in the treatment for it. Does that accurately would you say that makes sense as a summary of what that might look like? Kira Yakubov Ploshansky: 6:26 Yeah, so I wanted to ask, actually, because a lot of the things you mentioned, I think, are very common that just come up as having a new child, like being a new parent having a completely new responsibility in life, of making sure that this other human being that's basically helpless, relies on you to stay alive. So there's so much responsibility and pressure, that what is kind of the differentiator between like, what is kind of normal stress and anxiety and concern versus crossing that threshold of like, okay, this is becoming obsessive, or this is a compulsion, and this is not healthy. And I need to seek help for this. Dr. Katie Manganello: 7:06 Right? Yes, you're right. And this is where it can be a little bit difficult, because these are normal reactions in a lot of ways. But there is kind of that fine line where it's no longer normal, like, if you are consistently distress. So I mean, somebody is probably checking the baby monitor. Not at all now some times before they fall asleep. Yeah, right. Or if there are concerns of, you know, the baby seemed more, they caught a cold, so I'm going to be checking it a little more frequently than I typically would. Or they've been having trouble sleeping. And so we were keeping an extra eye on them, right. But it's another thing if things seem to be going well with the baby, we put the baby down, and we are constantly checking their breathing and analyzing, seeing their chest going up and down, up and down. For hours, right are for a very extended period of time. i When I'm usually explaining OCD, I usually would explain it as it's interfering with your functioning. But there is a level of being a new parent that whether it's OCD or not it it's not quite interesting. You're going to have your functioning interfered with regardless as a new parent, right. Yeah. So I think a lot of it is also how distressing it is for somebody. Like I remember the first person that I heard assess, that had met for OCD with their baby was they were, it wouldn't be on just like a lack of sleep, because you have to get up to feed the baby. It was that like, Okay, now that the baby's asleep, I don't get to go to sleep now. Because now I need to watch the baby and make sure that nothing happens to them while they're sleeping. And like watching them in their crib. And again, like checking to see that they're breathing or this one person I know, I recall, they were doing like, excessive, like prayers around the baby. Like they'd have to pray so many times that certain prayer in order for the baby to stay safe. Things like that. They can also seem like maybe less. Those are more common types of things that people would be doing with a new baby, right, like checking the monitor. Other things that maybe wouldn't be as common that people with OCD, postpartum OCD might be struggling with is around that harm of the baby. So maybe excessively washing hands before picking the baby up so that the baby doesn't get sick. Or that going back to that avoidance piece. Maybe they're avoiding changing diapers because they're having intrusive, unwanted intrusive thoughts of what if I molest the baby while I'm changing their diaper? Or purposely saying oh, I'm gonna let my partner carry the baby down the steps because I don't want to get on the freight I'll drop the baby or maybe I'll lose control and throw the baby down the steps right like so. Have you are purposely avoiding those things now can be normal for a thought like that they're popping your head, right? Maybe Maybe I'll trip and fall and drop my baby, which sounds very scary. But you then kind of take a second back and you're like, alright, strange thought we carry the baby down the steps, versus It's a rule in the house that I'm not going to carry the baby down the steps, my partner does that. That's their responsibility. So those are some of some examples where things might look a little bit different, versus with being OC versus other parenting challenges that happen with any new parent. Kira Yakubov Ploshansky: 10:36 Yeah, I'm glad you were able to explain that. Because as you said, each one for a lot of them was like, Oh, I wish I knew that breathing nonstop. Oh, I have these intrusive visuals of like, oh my god, what if I drop her if when I trip, I'm super clumsy, right? So I'm like, Oh, my God, I'm scared that I'm going to drop her. So I'm, like, constantly watching where my feet are going to make sure. Right? Like, I don't want her to get sick. But it's, it sounds like it's the excessive piece, right? Like, we all have a little bit of that. And then we're able to transition out or do something different. Versus it sounds like the person gets stuck in this and it lasts for hours and days and however Dr. Katie Manganello: 11:11 long. Right? Right. And exactly, and depending on how far they get stuck. Like it can show up in different ways too. Because I mean, again, it's kind of like showing up on a spectrum, right. Like, on a typical, you know, in a typical couple, maybe he just has a baby, like I'm sure that there is like a level of, you know, you you make bicker more than typical, or there's like, you know, general parenting struggle with your partner and how that interferes in your relationship. Right. But it could go to a whole nother level of the OCD taking over where they're like, I have to deal with the baby 24/7 year I cannot, you know, give my partner any attention. Because I'm so focused on the baby kind of thing, right? There's obviously going to be a bit of that happening along that that spectrum, right. But it's when it becomes more extreme and interfering with the relationship or in your life and other ways. opposed to this is a typical New parenting type of situation. That's tough. I think that. So, Karen, I have another episode coming up here, in, I guess it would be the week after this. I'll let them edit whenever that's going to come out. But we have an upcoming episode with a few of my colleagues, Dr. Brown and Dr. Bliss, they specialize in women's health. And so they will be able to come on and talk more in depth about women's health. How you know, postpartum anxiety and depression can show up differently than the typical kind of adjustment period. And all those types of things. They also know a lot about infertility and things of that nature and adjusting to challenges as it relates to those issues. So we will be able to have a much more in depth conversation with them about some of this stuff. Kira Yakubov Ploshansky: 13:08 Yeah, so stay tuned for that. I think that I mean, this is great to differentiate, because I feel like a lot of the information, like while I was pregnant afterwards, was not common knowledge, and not very clear. And things that are normalized, or it's a stigma or you think I should be doing this, I should be feeling this way. And it's very confusing and conflicting information online. Because you know, doctors don't always share a lot of this information or, you know, if you don't take like a baby class alone or with your partner, you may not know. So I think this is going to be really beneficial for people ages to kind of normalize this experience, but to be able to tell the difference between what is a common or normal I hate using the word normal, but like generally right expected, versus an unhealthy amount that is, you know, getting into a different territory that this could be obsessive compulsive disorder. Dr. Katie Manganello: 13:59 Yes. For sure. As you were saying that I was thinking to another pretty big marker of differentiating is the level of guilt and shame that is experienced, you know, we always hear of like, mom guilt, right? Like, there's some of that that's going to show up again, generally, but like, it can become much more intense that that really intense feeling of shame and guilt that comes along with it being OCD. Kira Yakubov Ploshansky: 14:25 Yeah. And I think it's tough to know, because, you know, a lot of people are not in the field, right? They're not mental health professionals or medical professionals. So they may not know what that threshold is. And it could be a very subjective experience of Well, yeah, everyone has mom guilt, or everyone experiences these things. So this is probably normal or I shouldn't be anxious. I should be worried. Isn't that a sign of me caring and it being like a healthy amount of worry, right? Like growing up my mom would say you know, someone loves you about how much they worry about you. Not healthy but you know like men messages that we receive? It's you don't really know what that threshold is. I'm curious to know also, is this something that shows up if someone never had OCD or wasn't diagnosed with it before that it can kind of start new as an onset after becoming a new parent? Or is this more common if someone has already had OCD? And now this the topic or the focus has shifted? Yeah, Dr. Katie Manganello: 15:23 that's actually a really good question. So with the perinatal, or the postpartum OCD, it seemed, from what researches it seems to affect about one to 2%, of pregnant or postpartum women. But it also shows up obviously, for people who, who have already had OCD, and then symptoms can worsen. Also OCD likes, like kind of like hot themes. So if somebody was maybe experiencing contamination, OCD in the past, and they've gone through treatment, they're better but now they have a baby. Now, it might be like, harm or contamination towards the baby type of thing. So yes, it the answer is both, it can bring a flare up or a new episode or exacerbate things with somebody who has already had it. And it can also tend to just, you know, be increased for pregnant or postpartum women. Also, another thing that people don't talk about at all I feel like, not much is how this can happen for fathers too. I know some fathers who experience anxiety around not anxiety, not just anxiety, like OCD around, you know, just that increased responsibility of their child and wanting to keep them safe and same types of behaviors showing up really? Kira Yakubov Ploshansky: 16:38 Yeah, yeah, actually, when I was taking that, like a baby class, which I highly recommend for anyone who is pregnant or planning to be pregnant, take a baby class before you have the baby. Very valuable. But I learned in there, you know, postpartum for the partner who may or may not be the father or another, you know, depending on the relationship structure is that the partner can also have postpartum depression, anxiety, OCD, who's not the birthing parent, and how it's really important to also be aware and look out for cues for that as well. So I think we don't necessarily it's not maybe it's common to think about the partner, because the birthing parent is going through all of these changes at once, that we forget that the supporting partner also needs support, and is also having a huge life transition for them to that Dr. Katie Manganello: 17:27 it really is something that has is not something that is talked too much about unless you like you said, you go to a specific DB class or, you know, I mean, that's not even anything that was really showing up in my training until I was seeing people and it was showing up and I was, you know, yeah, of course, we would treat it the same way. But yeah, it is a nuance, and I think it's sad for those other partners, because it might feel less valid for them to experience those things. But it's really not any less valid. It's, it's still a huge transition and a big shift in responsibilities. So absolutely. Kira Yakubov Ploshansky: 18:08 I think I should also want to make a note that this also goes for adoptive parents to have a baby, right? Like it's not yes, there's all these changes for the mother after the hormonal imbalance, and all of these things, and the partner but also if you're adopting a child, like being a new parent is hard period. Regardless of what part of that process you are, we're a part of. Dr. Katie Manganello: 18:31 Yeah, definitely. Which this seems like a good time for us to segue into some of our questions for you. What do you think? Kira Yakubov Ploshansky: 18:40 Sure. Yeah, you know, I noticed myself being like, like, keep asking questions. I keep trying to be the interviewer. But yeah, go for Dr. Katie Manganello: 18:48 it. Yeah, let's talk, let's, you know, switch the roles a little bit. So I'm so excited to hear about what it's like having a new baby, I'm kind of at the age or the realm in my life, where my friends are just starting to have babies or get pregnant. So I actually don't have really many people in my life that I'm really close to that do have babies yet. So, but some are coming up. So I am like, ready to get all the details. And I don't know what this like this is like because everybody says how hard it is and how you don't sleep, and how there's a lot of body changes. But I feel like there's so much more to it that people just don't talk about. So I can't wait to dig in. I think one of the first things I want to ask you about is just in the realms of in the realm of being a professional. So on one aspect, you're a business owner, right? And then on the other you are a therapist, so I'm really curious for you what some of the challenges have been. Let's start out with maybe like the Business Route, you know, because there's a lot of places if you work at a hospital for example, if you work In a hospital, you already have, you know, benefits through your job and how you have an allotted postpartum time that you can take off. Right? So without having a job where it's like that, where you kind of make the rules, right? How did you work through the whole maternity leave? And in managing the business? Kira Yakubov Ploshansky: 20:26 Yeah. So part of this was actually a lot of planning before I even got pregnant or was thinking about starting to try to get pregnant. Being in private practice, especially being a private practice owner, I think, has a lot of benefits and privileges, and that I can create my schedule, I can, you know, I'm in control of my job, who I see when I see them, you know, the structure who I work with everything like that. So I already had in my mind that, okay, I'm in private practice, I don't have a built in maternity leave, right? Like, if, if I don't see clients, I don't get paid, right. Like, that's kind of how it goes for a lot of therapists who might be in private practice, right? There's pros and cons to this a lot of freedom, less burnout, but then also not as much of the financial stability sometimes depending on your caseload, right. And if you're not seeing clients, you're not getting paid, like I said, so I really had this in mind to plan for, okay, I want to own a private practice a group practice, because if I'm not going to be working, there has to be some other kind of income coming in. So having other therapists in place. And really, I mean, this was built out very long, prior to this, right, is thinking about having other income. So having other therapists work under me having other whether it's a course that we're working on right now, publishing a book, having other streams of income and thinking about that ahead of time. And creating that really made a huge difference. Just knowing that I always knew I wanted to be a mother, and I'm in private practice, I'm a therapist, so and I don't want to work in an agency. So how am I going to align all of these things, so a lot of planning took place. Also, then being in the practice, having the group practice already, and being someone who did a lot of the administrative work and wears a million hats in the business. I knew that Okay, once I have my baby, I'm not going to be able to answer your phone calls for consultations. I'm not gonna be able to do all of these things. Like I don't know what my schedule, I know that I'm not going to have a predictable schedule. And you can't run a business like that. Right, right. So we made sure that we brought in employees that would take those roles. And that happened way in advance. And that was really hard to release that control of being like, this is my baby, like, I've been running this, like, I know how everything is supposed to supposed to go how I want it to go, right. And being able to hand that off to somebody was really tough. But we found such an incredible person, Serena, who's our intake coordinator, that it has made the transition so much smoother and easier and like a huge relief and weight off my shoulders. That I thought like, why didn't I do that sooner? Like what was i Holding on to, but that has been huge. And instrumental is like creating a team. Right? Like they say like, it takes a village. It. It's not like it's a cliche, but it's really true. It takes a village to run a practice takes a village to raise a child to do anything really big. You need a team of people that you can trust in place that do good work. So that was part of the that process. And that was a long winded answer. No, Dr. Katie Manganello: 23:36 that was a great answer. And those are all things that I have not or wouldn't necessarily just think of off the top of my head, like you talking about that whole aspect of having to really drop some control and like, hand over responsibilities of your baby, right? And I'm sure you're gonna have to do that with your, your actual baby. Right. You know what, that's something I think a lot of people struggle with is actually, so there is a little plug for Bravo. I don't know if any of our listeners also watch Bravo. But there's the show Vanderpump Rules. Were one of the people on there. Her name Sheena, she actually has OCD, and was the end. She just had a baby a couple years ago. And one of her things that shows up is that she really struggles with allowing other people to watch her baby. And so it was really interfering with her relationship and with her ability to work and go do things without letting the BBB with either her mom or her sister or somebody who is a close family member. And that was a huge strain. So if anybody watches that that is something where it's a really good example of what this can look like, right? So I'm sure that that's going to be a challenge not just with work but also No, little baby. Yeah, Kira Yakubov Ploshansky: 25:03 I mean, I'm fortunate enough to have my mom who lives close by to watch her pretty regularly for, you know, my mother in law to watch her. It was like friends in town and things like that I have a lot of people in my life that I trust, I don't typically have people in my life that I don't trust. So I think that kind of eliminates some of that, knowing that these are all people that I can rely on that I trust that we'll be able to take care of her that would never do anything intentionally to harm her. Right? So that takes a lot of stress off of me and pressure. And having that peace of mind. I'm like, take her. Like, if you want to hang out with her hang out with her, I'm gonna go take a nap or I'm gonna go do something else. Because I that's that peace of mind. I don't know what it's going to be like, if when we're going to need to have someone who is not an immediate family member or a close friend. Right? That's gonna be tough, because I don't know you. And I don't know what your intentions are. And you know, there's a whole slew of things. It's going to take a lot of time to trust somebody to watch this little human. That's yours. So yeah, I mean, I can't I don't have OCD. But I can imagine that being exacerbated, because that is really scary to think about Dr. Katie Manganello: 26:15 it is. Yeah, definitely. So you explained a lot of how you had to do so much planning for a very long time to make these changes within the business within your practice. Right. But how do you feel like it's impacted you specifically around being a therapist? So like your, your main role, right? Kira Yakubov Ploshansky: 26:42 Yeah, so that was interesting. Because we are fully telehealth, a lot of my clients didn't know until I told them until I chose to tell them, right, because if we're in person, it's going to be hard. It's a high that right. So I had a little bit more control in when and how I was going to tell my clients, I waited until I think it was like maybe four months before I was due. And I think that was a good time, because it was allowing them to know, okay, like in four months, which is a solid amount of time to I think mentally prepare that, you know, my therapist is gonna go on leave. If I need to make any adjustments, like the things that we're working on, we can kind of adjust or continue. Like that was a good amount of time to kind of therapeutically work through that with the client, and give them space to process if they needed to. Luckily, all my clients were like, so happy for me and excited. And just, you know, wishing me all these wonderful things, and then went right back into what was going on with them. So it wasn't a huge disruption. I also didn't have a huge caseload at that point, because I have the group practice. So a lot of the other therapists have a bigger caseload than me, I was really just seeing clients that I've seen for a really long time just maintaining, I wasn't taking any new clients on after a certain point, because I wanted to be mindful and respectful that, you know, if you're going to be opening up to me, and we're going to be doing deep work, and I'm going to leave in a couple of months. That's not really fair. Right? So I made sure to anyone who was reaching out to let them know, you know, I'm not accepting new clients. And if they push, like, listen, like, I'm going to be on maternity leave soon. So I really like it's going to be a disservice to you. So I'm not going to be able to see you. So that part wasn't too bad. I think a really hard part of the process of being pregnant and a therapist is the first few months of just being so nauseous, like that was rough, because they call it morning sickness. But it is not morning sickness, it is all day sickness. Like I don't know why they came up with in the morning, because it's not, it's not just in the morning, I don't know about other people's experiences, mine was up to no matter what time of the day it was, it could happen at any point. And working in private practice was huge. Because I thought to myself, like I really don't know how I would have been able to handle this if I worked in an agency or a hospital or a setting where I can't a work from home and be just call out. Like he was. I'm very grateful and fortunate that I was able to work from home and set my life up in that way. Because man that was really tough. So like i My heart goes out to a lot of women who don't have that, and either had to push through or call out or maybe lose their jobs or just, you know, figure out a way to move through that because it is debilitating, to just be nauseous all day long or throwing up or being in bed like your mind is elsewhere. And as therapists you know, like we need to be present we need to be emotionally and mentally present for our clients and because I was able to like shift my schedule around. I was able to kind of mitigate some of that and let my clients know like hey, like I'm not feeling too well like you know, touching base with them to keep them in formed what was going on? Dr. Katie Manganello: 30:03 Well, I definitely would not think about that aspect of being nauseous. And like working with that. Yeah. Because I've definitely heard of people saying that, Yes, you. It's not just in the morning, right. But the ability to actually have to be sick if you are sick, right? Can't just be I mean, you could I mean, things can happen, but it's tough if you're mid session talking to somebody and you're like, you're right. Yeah, I mean, they're gonna have that's, I guess, but yeah, I mean, if you can plan for that, and you have the ability to kind of move things around. And sure, that makes that a lot more manageable. Yeah. Kira Yakubov Ploshansky: 30:41 I mean, imagine being hungover. Right, like, think about the worst hangover hangover you've ever had for like, a month. And now you have to do therapy? Yeah. Yeah. Yeah. So it's like that. And then just eating like sleeves of crackers, just saltines? Because you know, so we won't go into the details. TMI, but, yeah, the beginning stage is really tough. Especially being a therapist, because you need, you know, this emotional capacity that gets really dwindled away, because you just don't feel well, for a really prolonged period of time. Dr. Katie Manganello: 31:17 Yeah, no, I'm glad you brought that up. Because one of my other questions I was thinking a lot about is how your body changes just throughout the whole process. So you just already started by saying a little bit about what was challenging earlier on in the pregnancy. But can you say anything else about just how your body changed? And if there were any positive aspects or, you know, negative aspects, or just kind of neutral things that just changed that maybe you weren't expecting? Kira Yakubov Ploshansky: 31:48 Yeah, I mean, so many things. with body image, it's really crazy. I'm really, really trying to be mindful and intentional, of how I speak about myself physically, and how I feel about myself, because I have a daughter, and I really don't want to pass down. Like negative body image issues and beliefs and narratives. It's really hard, right? Like, you know, I've done a lot of work myself, but still, like, it's so ingrained the way that we look and how that kind of ties to our work, and how we feel about ourselves and how we feel like others perceive us. And there was a point, like, in the beginning of the pregnancy, where I didn't look pregnant just yet, but I definitely gained weight. And, you know, it could have been like, Oh, she just had like, a lot of burritos these past few weeks, like what's going on? You know, like, no one is going to ask you if you're pregnant, but I felt like people knew I was gaining weight. And like, there was this really weird, you know, like, internally like feeling self conscious and wanting to be like, I'm pregnant. Like, that's why I look this way. But like not doing that, because that's strange and weird. And you know, and then once I finally had like, my belly pop, I kind of felt relieved. And I was like, embracing it. I'm like, Oh, everybody knows now. Like, it's okay. You can talk to me about it. Like, yeah, of course, I'm gonna look big. I have a baby growing inside of me. Like, it's fine. Like, a lot of some of those insecurities kind of went away because I had this reason or like, Dr. Katie Manganello: 33:15 I'm not allowed to be bigger now, because I have a reason I have a baby. Not just because my weight is fluctuating kind Kira Yakubov Ploshansky: 33:22 of Yes. Yeah, that was really big. And then just finding things that fit like, there are not a lot of stores or places that sell flattering or cute maternity clothes. I mean, yes, if you want to just throw a bag on you, and call it a day you can. But you know, you still want to look cute. So they had a really hard time finding things that would like fit me and make me feel good and make me feel so attractive. Right? So even just going through a process of like shopping, and then trying on clothes, which is like physically exhausting. I was I don't even feel like taking my pants on and off. Yeah, I bet is tiring. But yeah, like so many things changed. My feet were inflamed. My hands were swollen. It's it really is like this roller coaster where like the beginning with like, my experience person. Everyone is different. Right? Some people love pregnancy. And they enjoy it. And there's not any of these hiccups or they don't like experience negative aspects of it and like, kudos to them. Like that's phenomenal. Like one of the lucky ones. Right? Like, love that for you was not my experience. Yeah, it's like the beginning as you're nauseous you feel horrible. second trimester is pretty good. You're getting your energy back, your belly showing. So it's exciting, right? Like you're able to like eat again and do all of these things. And then third trimester creeps around and it's like okay, like now I'm getting heavy. Now my back hurts. Now I have restless leg syndrome that I never had or knew what the hell that was and very unsettling experience. It's hard to sleep. You have to like roll from one side to the other to get up every single time, like I really took advantage of the fact of just being able to like move in a very natural way. Because every, every movement, it's very intentional, like how you're getting up and where you're moving. And is it worth it to go over there? For all the effort that I have to put into doing this? Dr. Katie Manganello: 35:22 Yeah, little things you would not even think about at all. Kira Yakubov Ploshansky: 35:27 Yeah. And I think a big piece of the physical part is needing so much help. I needed so much help physically to get things right or couldn't bend over a certain point, you really have to rely on a lot of people around you. Which, you know, depends on your personality can be either, you know, some people welcome that other people, you know, it's really hard. If you have a hard time asking for help or receiving help. It's going to be tough, like I you know, there was, especially after the pregnancy, like, I needed a lot of help physically, and like, that really weighed on me emotionally. And just like how I can't do a lot of these simple tasks. I felt like a burden. I felt, you know, useless, right? Like, I really did, like, I can't do anything, I have to take care of a baby. I'm healing but someone else has to take care of me, like, Oh, my God, like, this is a horrible, it felt like a horrible experience. Like I need someone constantly to help me. And it felt very, I felt very helpless and hopeless. And for a little bit in the beginning, I think like, as I spoke to a lot of new moms like oh, yeah, like, there was a lot of crying in the shower in the first two months. I'm like, Wow, I did too. Like nobody talks about that prior. It's, you know, there's a lot of sadness that kind of comes through like this grieving and transition. It's, it's a lot to carry in the beginning. Dr. Katie Manganello: 36:44 Right. And I think another big part of the beginning that I foresee being incredibly difficult for me as a person, is the keeping it a secret, like you can't really, you're not supposed to like, or it's not, I don't know, like you just everybody says what you don't tell people for what the first how please be okay. So that's a long time to keep a really, really, really big life change happening. And that also, I can understand, I guess, the rationale for why that is the way it is. But also, it's like, it has to feel isolating to an extent. Kira Yakubov Ploshansky: 37:25 Yeah, and you know, a lot of the time people say that is because the likelihood of miscarriage is so high in the beginning. Which, you know, it's kind of sometimes it feels counterintuitive, right? Like, if I have this big thing going on with my body. And now like, if I plan this, and I'm excited about this pregnancy, right, and I want to share this with everybody. And then, you know, I haven't if this person has a miscarriage, and nobody knows you're pregnant to begin with, and now you're grieving. It's a you have to tell people, so they're like, Oh, my God, and now you have to tell them the next thing that happened. So it's like this emotional roller coaster where I feel like actually might be more helpful if the closest people to you knew. So that right? God forbid, if that happens to you, which is very common, that you have that support that you need. Right. It's it's almost like a superstitious thing that we've kind of accepted as the norm is that, you know, don't share this because if it doesn't work out, not everybody knows about it. Like that's kind of weird, right? Dr. Katie Manganello: 38:27 Exactly. It's very much that whole thing in society of don't share your discomfort or don't share that you're right. Don't make other people uncomfortable with your discomfort. Meanwhile, this is a huge, huge, I mean, having a miscarriage I cannot even imagine like I and it's common to right. So it does feel like there should be more support around that. Kira Yakubov Ploshansky: 38:51 Yeah, I mean, they say within the first as the first 12 months or 12 weeks, right is when it's the most likely I think it's like 25% chance for any pregnancy. I don't know if that's exactly, but it's pretty high up there. Like it's, I mean, almost every person in my life who has been pregnant or you know, something along the lines, like there's a lot of women in my life that I know, that have had experienced a miscarriage. Yeah, and yeah, it's not. It's not that, like it's not talked about it says common, right. And I think that if people recognize like, it doesn't mean there's something wrong with you or that you did something to cause this. Like, it's just like, biologically like, this is what happens like these are the statistics of what can happen. Like we're literally growing a human inside of us. It's not always going to work out unfortunately. So like having that support ahead of time, I think is actually really important. Like we told, we told a couple people like the day we got the pregnancy test that it said pregnant like I can't keep that secret. I feel like that's how I can keep other people's secrets but my own secrets. I'm like, I want to tell everybody Dr. Katie Manganello: 39:58 say that But yeah, yeah, I totally hear you on that. Well, so those were a lot of the changes that were kind of happening for you while you were pregnant. But what's it been like? Since you've had your baby? Do you want to talk a little louder? Sure. Kira Yakubov Ploshansky: 40:18 So do you mean in terms of like, physically or just like all of it? Dr. Katie Manganello: 40:22 So I am curious physically, for sure. But I, I do also want you to be able to just kind of talk about the fun stuff with her and like being able to see her and like, learn about her personality as she's growing and all of that. Kira Yakubov Ploshansky: 40:37 Yeah. So it's, you know, it's, it's a real roller coaster. Like when people say, Oh, it's really hard. You know, I feel like people who are not parents, and we did this to you like this hubris, like, Oh, it can't be that hard, or like everybody's doing it. Like we all know, we'll be able to figure it out better. You get humbled real quick. It is as hard as people say, and even harder. And it's not like, the hard thing is that you are so sleep deprived. And you're so sleep deprived, like you can't function, right, like you don't have time or energy to do anything. Besides make sure that this baby is alive, fed changed and safe, right? Like you don't really have you don't hear about sleeping much you don't have time to eat, you don't have time to clean the house like or clean yourself. Like, there's all these things that kind of go out the window, especially in the very beginning. So everything is focused on this baby. And all of these new responsibilities that don't go away, are there. So if you're someone who is already anxious, this is going to take it up a notch. Like I'm normally in a kind of an anxious person. I've worked on it a lot throughout my life at coping mechanisms. But guess what all those coping mechanisms go out the window, because I don't have time to do them. So it was really tough. In the beginning, I'd say the first first two months, but mostly like the first couple of weeks were brutal, it was really just trying to survive. And I have to say that, like I'm very, very fortunate and blessed to have a partner who is in it with me 24/7 throughout all of it, and he works from home with me, right? Like, that's because we intentionally made our life that way. But, you know, having someone to like, you know, tag team of okay, like, I'm gonna lose my shit, can you come in and take your turn, and then vice versa, and like doing all the things together, and knowing I can trust him, and he's there to support me like emotionally, mentally, physically, like, all of it. Especially during those like fluctuating hormones in the beginning where like, you just are grieving your old self. Like you're a completely new person. Now, this new role, your body doesn't feel like yours anymore. You're healing from childbirth, whether it's vaginal, or, like this area, and Ryan, like all of these changes, and having a partner who has your back and is like, reassuring you and supporting you is so huge and important that you give a shout out to Iran like thank you for helping me so much. And I found a mommy group in my neighborhood. That has been awesome, huge. Yeah, like being able to go every Friday to this group. They like sit with other women who are moms and talk about this stuff and support each other. A lot of them are business owners to like having that community, I think has been instrumental in like, keeping me sane for my mental health, for sure. And I think now that she's like, you know, there's a little bit of a pattern now aggravate, she's sleeping, we know when she's going to sleep for how long kind of when she needs to eat like we're picking up on her now. And when she smiled for the first time, like in response to us, My heart melted like that's when I was like, Oh, this is all worth it now. That was a game changer. For sure. I was seeing her smile in response to us. Gosh, that is so cute. Yeah, she's a doll and like, you know, you can see her a little personality now like when she laughs is certain things are like, you know, she her reflexes are just crazy. Like, I'm really highly sensitive person, like, sensory wise, and I think that she, I mean, she's kind of like that, too. Like, she reacts really well to things. And it's just like fun to watch her grow each week is like something different seriously, like, she's gaining weight or her hair color is changing. Her eyes are changing. She's responding to things. It's it's really beautiful to watch that part and think about like, Who is she going to grow into like this little human that you know, my partner and I are molding to be a good person, like, what is she going to be like in a couple years is really cool to think about? Yeah, Dr. Katie Manganello: 44:45 that really is so cool to think about. And you know what else is just so interesting about this is I bet we could have this same conversation, like every week or every month and all of your answers could be different or Right. Yeah, like your answer if I asked you right now, because I'm finding myself going to be like, like the most challenging thing, what's the most rewarding thing. But I think that's so subjective to the phase that you're just in right now, which just like, talk about mindfulness being important. I feel like as a parent, that's something you have to like, soak in. Yeah, Kira Yakubov Ploshansky: 45:18 I mean, being in these mommy groups, and like, the moms are like different stages with their kids, right? Like, I have the youngest, I showed up like two and a half weeks postpartum people, like how are you even here? I'm like, I don't know, I'm, I'm a zombie, I don't know. But seriously, and like the other moms, they have babies who are like eight months, who's three years old? 10 1218. It's like a wide range, which is really cool. And the common theme is that every stage is easy and hard. It's just different, right? Like, what's hard about this stage will make the next stage easy. But then that stage has its own challenges. So really just like being in the moment, like, she's never going to be this age again. And she's never going to do the things that she's doing now. So it's kind of like it's two sides of the same coin, just embracing it. Right. And like, I think that really defines unconditional love. Right? Like, all of the neg not, I mean, there are a lot of the negative things that come with this. There's all these positive aspects, and just challenges that it's like, wow, like, I'm growing and learning as a person while I watch her grow and learn to be a little human being and like, she's realizing she has hands. Like, you know, like, she's got feet, she's using them. And it's like seeing life, from the beginning as like this age is really fascinating. So I really like we try to be as present as we can. I mean, obviously, sometimes it's really hard to do that, because we're just like in the thick of it. But I think that that's good. Like the common theme that I'm hearing for everybody else is, it's it's easy and hard just in different ways. Like it doesn't actually ever get easier. This stage gets easier because you don't have it anymore. Dr. Katie Manganello: 47:02 What would you say up until this point has been the most challenging, or like the most surprising. The most Kira Yakubov Ploshansky: 47:09 challenging, I really think is the sleep deprivation is just like, like, you know, when you go to the airport, there's this jokes, like when you go to the airport, it can be at any time of the day and like you'll get a mimosa because times not real. Right? Like, right? Yeah, it kind of felt like that, like, especially in the beginning, like, it doesn't even matter. Like if it's day or night because I'm doing the same thing every hour and a half to two hours that like time is a fake. It's just a construct. Like, it's not real, like we were kind of like losing it. Like this is you're not sleeping and it's so hard to function and like control your emotions or your thoughts or to do anything when you don't have sleep. I think I was surprised that how not how little sleep I was gonna give like how much it was going to impact me. Because I was like, oh, like, you know, I've had all nighters, and I've, you know, done this and blah, blah, blah, but like, it's so different. Because, you know, if you're a procrastinator, you're just like, Oh, I'll put this off sale tomorrow, like you just can't, because guess what, it's gonna start over in two hours. Again, it's like Groundhog Groundhogs Day, a little bit. In the beginning. I don't want to scare people. But I think those first two months are really brutal, but then pass that it definitely gets like easier, right? Like, you know, the patterns, they sleep a little bit longer. There's more gaps between when they're eating, they're showing their personality, right. Like, the beginning is just like a shit show. And you Trump I mean, me and Ron trauma bonded for sure. Like, I think it either strengthens your relationship or can tear it apart. Yeah, I could totally say that. That was the most surprising thing, especially to Dr. Katie Manganello: 48:46 when you're saying like, the first in the beginning of being really difficult. I'm sure that it's also just hard to navigate. Hey, products, there are what products you're supposed to do, then there's a whole I mean, if we even started about talking about breastfeeding, that would be like a whole episode. I feel like it's like, do you do you not do you do both? Like, just figuring all of those things out on top of it, I'm sure is really challenging. Kira Yakubov Ploshansky: 49:12 Yeah, I mean, so much stress and anxiety and just like analysis paralysis comes through because there are so many products in the market and like, do I even need this? Like, you know, especially when you're going through like your baby shower guestlist or not guestlist the registry? Yeah, gift registry, right. Like, I still lose my mind. Like Mom Brain is very real, by the way. And, like knowing like, what should I be doing? is so tough, like, even as a therapist, I know that like you shouldn't should, right like even within that you everyone is different. It's always gonna look you know, depending on the person the circumstances, it's only based on someone else's opinion. You know, but if you're a new parent, like you really don't know like, you can read all the books and you get all this unsolicited. buys from people, but it's really just about paying attention to like what works for you, your family, your baby and your circumstances, which is going to change from person and family to family. Right. So like breastfeeding, we can talk about that for a whole hour. Like, we don't have enough time for that. But like, that was really challenging to, like, Okay, I'm gonna, I'm gonna give this a try. If my body will, you know, produce and, you know, this is what we've been, you know, made for the beginning of time to do my body has been, you know, constructed in this way, like, I'm going to try to do it. And, you know, luckily, she latched right away. But you know, am I produce the anxiety is, am I producing enough? How much is she getting? Is it enough? What should I be eating? I haven't eaten enough, I'm dehydrated. I'm not sleeping, like, is she? Okay? Why is she crying? It's just like, so many spiraling thoughts around just feeding the baby. And then it's starting all over again. And in an hour. Dr. Katie Manganello: 50:56 Yeah, and I know that people put like, a lot of pressure on themselves to, to, for it to, for you to be able to do it. Right. Kira Yakubov Ploshansky: 51:03 Yeah, like at the hospital, they asked, like, are you going to breastfeed are gonna do formula? And I was like, I don't know, like, maybe can I do both? Like, I want to do both. And that's what we've been doing is both right, like I breastfeed I pump and I give formula, depending on what's going on the circumstances, her like the stage in life, like, do I have taught, like, there's all of these factors that like, there is this message and even as a therapy, like, it's so hard, because as therapists like, we know, a lot of stuff like cognitively we get it, but we're still humans are still emotional beings that like, are influenced by the people around us. And it's like, well, I really want to stop breastfeeding. When I feel really guilty about that. You know, and like a lot of shame, like I should be able to do it. If I can do it, then you know, I should do it. And there's people who can't do it that wish they could, or the bonding or, you know, what is this gonna do to my baby? Or, you know, like, there's all these thoughts that you're just there's a lot of uncertainty, I think there's a lot of uncertainty. And it's hard to know, which is the right thing to do. And all the time there is no right thing, like I know, we talked about in a different episode, like there is no right thing. There's just the best thing under the circumstances for you. Dr. Katie Manganello: 52:17 Right. And I mean, no wonder, this subtype of OCD exists, right. Talk about uncertainty. I mean, you'll do a CD. Right. So yeah, of course, it's gonna be scary, right? Like, it's a lot. Yeah. So I mean, I think we've obviously touched on a lot of challenges. And obviously, I'm sure there's so many more, but to kind of like, tie a nice little bow on what we've been discussing, what do you feel like has been the best part of being a new mom? And what are you most excited about for your future with her? Kira Yakubov Ploshansky: 52:50 I think the best part of this is a couple of things is, I really got to see how strong I am. I think a lot of the time, my life, I've you know, been told or told myself, like, Oh, I'm kind of like physically weak, or I'm very emotional and sensitive, and I can't handle a lot of things. And you know, through this process, I've realized them a lot stronger than I give myself credit for. And that I can show up and do what I have to do when it really counts. And I think that has been a huge difference in like how I view myself and the way of like, resilience has definitely been different. And I think another great part is relationally, like, me and my partner being a lot stronger, like going through this together. And like, even when it's crazy, like finding the humor in it, like, you know, she pooped five times in a row and he changed her diaper five times, and six times she like she got it on him and like we just started crying, laughing like, just trying to find the humor in some of this and doing it together as a team, I think has been really great. And like watching him be a dad and like, watching how sweet and cute that is, you know that he's holding her and talking to her and then like, we're buying these little books, like he's got a whole science set of like astrophysics for baby is like just like silly things and like, spending time with her. I think the best part is in the morning when we wake up and she opens her eyes and sees us she smiles like She giggles and like it's so it's so sweet to see that that it's like okay, even if I didn't get sleep, like it's such a great way to wake up. It's like see this little beautiful smile back at you and like, it's it's love, right? Like, no one is telling her like, You should do this to make mom feel better like, right. It's innocent. It's really innocent and sweet and a lot of like loving emotions. So I think that the best part of this for me has been like, witnessing and being aware of like all the relational pieces of how this ties in and feeling more closer and connected to them. Dr. Katie Manganello: 54:53 Yeah. Do you feel I know. So that was gonna be my last question, but one more. How do you feel like now Let your Aman that it's going to change you as a therapist as it relates to empathy and like other parents and not because I'm sure it has to be a totally different perspective. Kira Yakubov Ploshansky: 55:10 Yeah, I mean, it's it goes from being able to like, cognitively think about something rationally to just like, I like in the trenches like you can really relate Right? Like when we go through something, we have a client that goes through something similar, like it's just a different level of relatability. And like the nuances, right? Like, it's the nuances you don't notice, think about because you weren't in it. And just knowing these little pieces, it's like, it just like takes it to the next like, I know the difference being like this pump to this pump, because of how it makes my boobs feel right. Like, I would never think of that or like, it takes so long to leave the house. I used to be like, why are people always late with kids? Like, why don't they just leave an hour earlier? Like, you silly, silly person. Good idea. Yeah. And like, I think we're really, in terms of empathy as a therapist, but also just as a person, like, Man, I should apologize to my mom. Like the amount of we always joke like in the Jewish culture, God is Jewish guilt. But like, seriously, like the amount of things that you go through the sacrifices that you make in your body and in your life, where this human that you love, for them to not appreciate it is like a slap in the face. And so I think I have this different understanding and empathy for just moms in general. And like how hard it is, and being a little bit more sensitive to when I have clients. If they're complaining or talking about their parents. I'm like, well, there's this whole other side that we may not have considered, right. Like they're just a person trying to do their best with what they have and what they learned and like, they're not perfect either. Yeah, shout out to all the moms out there. Dr. Katie Manganello: 57:03 Shout out to all the moms Kira Yakubov Ploshansky: 57:06 and the dance. Yes. All the present, parents shout out to all of them. Present Dr. Katie Manganello: 57:12 parents love that. I am so happy. I mean, again, I could have probably talked to you about this up for ever. But I really appreciate and acknowledge your vulnerability in this because I think that as a therapist, and you know, your own an owner of your practice, it can be hard to you know, disclose some of the struggles that you're experiencing, for people to to hear. But I think that it's also really powerful and the people appreciate that a lot. So, I really, I really appreciate your authenticity and willingness to open up today. Kira Yakubov Ploshansky: 57:49 Thank you. I appreciate you asking and being curious and giving me the space to share. Excellent. So for anyone who is interested in working with Dr. Katie, you can head over to our website heal your roots. wellness.com To schedule a console. If you enjoyed this episode, please like, share and comment. And thanks so much for listening. Thanks ### Listen - [Spotify](https://open.spotify.com/episode/14859937) - [Apple Podcasts](https://podcasts.apple.com/podcast/14859937) - [YouTube](https://youtu.be/lpB3OPdRDU8) --- ## Faith, Doubt, and Healing: Conquering OCD and Religious Trauma Together - URL: https://healyourrootspodcast.com/episodes/faith-doubt-healing-ocd-religious-trauma - Published: 2024-03-27 - Season 3, Episode 9 - Duration: 49:02 - Category: trauma - Guest: Caitlin Harrison, Dr. Katie Manganello ### Summary Exploration of the intersections between OCD, religious trauma, and healing pathways with Dr. Katie Manganello and Caitlin Harrison. ### Description Welcome to a profound episode of the Heal Your Roots Podcast, Season 3, Episode 9, where we explore the intersections of Obsessive-Compulsive Disorder (OCD), religious trauma, and pathways to healing. Join us as we sit down with Dr. Katie Manganello and Caitlin Harrison to discuss the complex relationship between faith, doubt, and mental health recovery. ### Transcript Kira Yakubov Ploshansky: 0:00 Welcome back to Heal Your Roots Podcast. In today's episode, we have returning guests, Dr. Katie Manganello and Caitlin Harrison, marriage and family therapist, we dive deep into how OCD overlaps with trauma, specifically religious trauma. We go into more insight into scrupulosity and real event OCD, you're not going to want to miss today's episode. So it really takes that past event and warps it until the person really views themselves as like the worst person in the world who can never be excused or forgiven for it. Do you can kind of see how OCD and religious influences could lead someone down a path that might make them really overwhelmed with this idea that I have to be perfect. Ladies, thank you so much for joining us for another episode today. Dr. Katie Manganello: 0:53 I'm excited to be here. Yeah, thank you so much. I'm so excited. This is one of my favorite topics, so I'm ready to get into it. I've been looking forward to it. Awesome. Kira Yakubov Ploshansky: 1:05 So both of these therapists work at Heal Your Roots Wellness. Dr. Katie Manganello specializes in obsessive compulsive disorder anxiety disorders PTSD. Caitlin Harrison Marriage and Family Therapist specializes in couples therapy, trauma, and specifically religious trauma. So I'm really excited for today we're going to talk about the intersection between OCD and religious trauma. So Katie, can you kind of start with a little bit of background about who you are and what you do? For some of the listeners that may have not heard your episode before? Dr. Katie Manganello: 1:36 Yes, so like you say, Kira, I'm, I'm a clinical psychologist, I work at Heal Your Roots Wellness. I also work in a private practice the anxiety and OCD treatment center that is physically located in Wilmington, Delaware, mostly what I do is individual therapy, focusing on treating OCD. Sometimes that comes along with other things. There's a lot of comorbidities. So I also work a lot with ADHD, autism spectrum, body focus, repetitive behaviors, anxiety, PTSD, depression, a bunch of different stuff. And I work with people of all ages, a lot of times we bring couples in or family members and to assist in treating the OCD or whatever else the presenting problem is, me as a clinician in general, I really, I operate mostly under a cognitive behavior model. I also really, within that model, really enjoy Acceptance and Commitment Therapy. And of course, with OCD, I do a lot of exposure and response prevention. Kira Yakubov Ploshansky: 2:43 Awesome. Thank you so much for sharing that. Healing. Can you share a little bit about yourself for the guests or for the listeners? Caitlin Harrison: 2:48 Yeah, yeah. I think Kira, you summed it up? Well, I do a lot of work with couples. So systemic therapy doing it, whether that's like couples or even families, parent and child, like grown up, adults working on their parent and child relationship. And then I also do work with trauma. So I do EMDR therapy. And I focus a lot on religious trauma, which is also one of my favorite topics. And just like Katie pointed out with trauma, there's a lot of comorbidities a lot of things that can come up so that could look like anxiety, depression, PTSD, even OCD like we're talking about today. Self esteem, attachment wounds, things like that. So that's what the work that I do looks like here at Heal Your Roots Wellness. Kira Yakubov Ploshansky: 3:42 So I think we can kind of lay down the foundation for listeners to know what is obsessive compulsive disorder, some background and what religious trauma is. And then we're going to talk about like some really nitty gritty stuff that I think is super fascinating that I haven't actually ever learned about before or heard of some of these words even so I'm really pumped to learn more about this so I'm going to have questions like as an audience member to see like to learn more about this. So if either of you can kind of start with what the specialty is that you have, Caitlin Harrison: 4:13 So all I guess I can kind of define religious trauma but Katie just chime in whenever you feel like I'm missing something but um, so religious trauma is just like any trauma when you experience harm or abuse from something outside of you. So when it comes to religious trauma, it's you're receiving like religious or emotional or spiritual, I'm sorry, abuse from whether it be leadership. It could be your parents, an outside system, even just your the culture that you live in. You're receiving hateful messages about who you are as a person. And that leaves you with emotional mental, physical symptoms. So that's kind of how I define it. Anything you'd add? Dr. Katie Manganello: 5:08 Yeah. And so I think that's something I like to tell people too, when we're talking about trauma is that you can experience trauma without becoming full blown PTSD, like post traumatic stress disorder. I'm thinking, usually when I work with trauma, I mean, there's a lot of people who've experienced trauma, right. And so, just kind of teasing trauma apart, like as a whole, apart from like, post traumatic stress disorder that in particular, is a disorder in which you know, someone has witnessed a traumatic event, such as like war, or sexual assault, or you know, any of the things that you had mentioned as well, and includes these recurring symptoms such as intrusive memories, flashbacks, nightmares, negative changes in thoughts and beliefs, and a lot of avoidance around any kind of cues that remind them of the trauma. So when I'm talking about OCD related things, I think I'm comparing a little bit more to a diagnosis of PTSD as opposed to kind of like a general sense of trauma. Caitlin Harrison: 6:15 Yes, yeah. And the way that I think about trauma is sort of on a spectrum, because he talked about these big, and then slet are causing flashbacks, very marked memories of specific events. But then there's also this complex trauma that where you receive messages over and over again, that like, you can't trust your emotions, you can't trust your thoughts. So you might not have these specific memories that come up for you when you know, your pastor told you that. But there's something in you that questions like, Wait, am I allowed to trust myself? Am I allowed to trust my emotions, so there can be not so specific events when it comes to trauma as well, which I think is important to just know. Kira Yakubov Ploshansky: 7:08 Sounds like constant messages being told instead of like an event. It's just messages that kind of seep in that create a narrative and a belief system within you. Dr. Katie Manganello: 7:17 Right, several little events that can kind of like pile up. Yep. Kira Yakubov Ploshansky: 7:23 And what about OCD? Can you share, kind of like what obsessive compulsive disorder is for the listeners? Dr. Katie Manganello: 7:28 Yes, well, for me, this is such a difficult thing for me to make a small explanation for. So if you want an expanded definition, go listen to the episode that Kara and I recorded before I go in way more detail, but to try to keep it simple. OCD is a doubting disorder. It's fueled by uncertainty. And it's a disorder in which people experience repetitive and intrusive thoughts, images, urges or feelings called obsessions. And these fears are ego dystonic, which means that they do not align with the person's values. And everyone has intrusive thoughts here and there, but most move on from them realizing that these thoughts aren't really threatening or they don't mean anything about them as a person. But for people with OCD, these thoughts feel really significant and can cause intense negative feelings. So as a result of that they engage in compulsions, which are mental or physical acts performed to relieve the distress or to keep an unwanted event from happening. Kira Yakubov Ploshansky: 8:35 Thank you for keeping it short and concise. I know that was tough. So it sounds like even just sharing that there's a lot of overlap. I feel like between trauma and OCD and how it presents and I know later on, we'll talk about how to differentiate between the two. But I did want to dive into Scrupulosity. I've never heard of this. I think this is super fascinating. If we can kind of just dive into what is that? And how does that show up for OCD versus trauma versus the intersection between the two? Caitlin Harrison: 9:09 Yeah, so Scrupulosity that is basically this obsession or this need or this drive to achieve moral perfection, or like moral purity. And so even as I just say, that sentence, you can kind of see how OCD and religious influences could lead someone down a path that might make them really overwhelmed with this idea that I have to be perfect. And so that's what scrupulosity can look like, I mean, we can go into detail of what that could look like for you know, someone who did have a religious upbringing or was influenced even in their adulthood, maybe that's safe for a little later. Kira Yakubov Ploshansky: 9:58 We can dive in now if you If you both want to I think like this is like I like that this episode is now the work. We have each episode with both of you kind of going through your background. Now we can get to like the specifics and the details of things because I've never heard of this. But thinking about this, I'm sure this is super common for a lot of folks. So hearing this, I think was going to be super helpful and beneficial. Dr. Katie Manganello: 10:20 Yep, for sure. I think you did a really good job explaining that that's really very much. So how I would explain it to you know, it's that you know, this really all or nothing like rigidity around achieving that like perfection around being a perfectly religious person or moral person, even it doesn't even have to just be a religion, which I was. I'm just going to talk a little bit about bad person OCD, which is kind of the same thing. I mean, it's very similar in the sense of like, the morality aspect in wanting to just like, even if you're not following a specific religion, it's more so that moral compass of doing things perfectly moral type of thing. scrupulosity OCD, I actually see this a lot. I see this a lot within the practice. And so some common obsessions around scrupulosity OCD could be fears of committing a sin. Excessively striving for that purity, fears of going to hell or being punished by God, being possessed fear of death, fear of a loss of impulse control, doubting what you truly believe or feel in needing to have that certainty around religious beliefs. And then of course, there's lots of compulsions that can come along with that that could be if it is something like you said, Caitlin around like sex before marriage kind of thing. Maybe it's, I'm going to avoid dating in general, because I don't want to even tempt myself. It could be excessive praying, it could be I liked the example you gave to of donating money. So I can show up in a lot of different ways. Kira Yakubov Ploshansky: 13:11 That's so fascinating. And I'm curious of since it's kind of connected to this belief of something higher kind of punishing us in some way, or like judging us or watching us? Do either of you see this ever come up with anyone who might be atheist or agnostic? Or is it very specific, like, they're kind of connected to a religion that's shared this message? Caitlin Harrison: 13:34 Something that I see a lot and maybe it's not so much connected to religion. For them, it's this idea that I could make a wrong choice, when actually the choice the two choices before them are say, Should I take this job or this job? Both align well, with my schedule, both are good salary, you know, they they're kind of equal. There's no right or wrong, good or bad. It's just what which one do I want? And sometimes it can be difficult even outside of a religious context. To to tease that out, like, Am I really being good or bad by choosing one of these? It's that fear of the future or fear of like I could choose something wrong that would turment me in the future Dr. Katie Manganello: 14:18 Yeah that sounds like the perfectionism to me right? Like am I making the perfect choice? The one that's best for me kind of thing, which is so much in the same like, yeah, the realm of that yeah, Kira. I feel like the bad person or like just moral aspect of this group philosophy shows up more so in like people who don't fall under a specific religion, like they, they could be a theist, because it's it that doesn't mean you subscribe to a specific god or gods or whatever, it could just be. I'm here, and I still feel like I shouldn't be nice to people or I should be, you know, a certain you know, certain behaviors or whatever. Yeah, that was just interesting and made me think about if that had a connection to it, but I guess just I mean, And even people who are atheist agnostic, right? Like there's still a moral compass and values that we follow. So it's more about that all or nothing kind of thinking around it versus it being something specific, like a religion. So it could just be the future, how we view ourselves is kind of what's in control of it. Yeah. And actually, I mean, considering OCD, like I said, is a it's a very doubting type of disorder. If it is a sense, where you're doubting what you truly believe or feel, anybody can experience that atheists could they could be like, maybe I am deep down a Catholic who and I think that I'm an atheist, right? Like,who knows, Caitlin Harrison: 15:38 That's part of what makes religion so comforting, actually, is, I don't have to fear fear of the future anymore. I don't have to be afraid of what's going to happen to me. All I have to do is, you know, pray this many times, or live this good of life or trust in this certain thing. And then I have a sense of control again, over my future. And when you start to question that, when that's sort of what you paid, placed all of your security in, and that's sort of what made all of your anxiety subside. before. It's such a disorienting feeling, because then what can I trust? What can I rely on? What can help me predict my future? How can I control my future? And you're kind of like reckoning with that, like, maybe I can't anymore, but I used to feel like I could. It's so confusing. Kira Yakubov Ploshansky: 16:30 It sounds that you have this certainty that you trusted in outside of you. And now that kind of caught like, it was crashed. And now it's just, I mean, it sounds super disorienting. Now, it's like all uncertainty, instability, and trying to like kind of grasp for an anchor. That does sound pretty traumatic, like internally. Dr. Katie Manganello: 16:49 Yeah, I would say a little bit of a nuance to that with the OCD is that if people come in with scrupulosity, it's not necessarily that it's usually not that the person is so focused on. Will religion is my certainty. It's, it's more so of like, well, did I do this good enough? Am I being a good person? This or That? opposed to the latter? Caitlin Harrison: 17:18 Yeah, yeah, I guess I'm I, speaking from a place of someone who's like if a client has walked away from a certain religion, and recognize that Reckoning and like, Okay, I used to have something that gave me so much comfort. And now where can I find comfort because it used to be that I did things perfectly. It used to be that I was the good Christian girl. It used to be that all I had to do is not sleep with my partner. And now who am I? Am I good? Am I you know Dr. Katie Manganello: 17:51 yes. And I think that that's a really big difference and something for people to when they're evaluating for it to kind of keep an eye on because for people who have like scrupulosity OCD, like one of the main points I like to tell them is that my goal is not to take away your religion, because again, OCD targets your values. So if somebody's experiencing scrupulosity or bad person, it's targeting something that they find to be really important in their life. So the I always tell them, the goal is to bring you closer to your faith rather than to kind of like stray away from it if it is indeed that value for you. So that part is really important. And I also like to bring up with people to that, with that fear. And that uncertainty showing up with OCD. The whole point of religion is to have faith, right. And by definition, faith is that you are believing something that you don't actually really know, right? You don't have that concrete evidence for so kind of like leaning into that and with OCD work with scrupulosity. It is like really utilizing their their faith if that is something that's important to them as it relates to the obsessions. Caitlin Harrison: 19:05 Absolutely. Yeah, I do a lot of work with people who are questioning their beliefs or change their belief systems or things like that. So speaking from that place, that can be a very disorienting like earth shattering. I used to feel like I had more certainty than I actually had. But when we're working with a client that does want to maintain that value system, but wants to have it in a healthier way, in a way that helps them feel more regulated and more like just success, like I can navigate life without having to worry so much about this being caring so much about every little thing that I do or think even I mean, that's another another thing that religion regulates even your thoughts, like if I think something bad, then I'm a bad person. If I think about having sex, then I'm a bad person. You know that but it's a lot of plaguing thoughts. And so if you can give yourself a little bit of freedom and grace, just like most of our higher beings give us that can bring a lot of freedom to. Dr. Katie Manganello: 20:14 Totally I love that you brought up the that like some, some religions will say that like even thinking about it is a sin. Because you actually we can't control thoughts that pop up in our head like you cannot control an intrusive thought. We can control how we respond to the thought, but you can't control it popping up into your head. So a lot of things I like to say with people with the scrupulosity to is like, if we have faith in God, and we think that God is loving, or whatever this person's belief system is, then we can, we can probably use our best guests to say that I'm going to believe and have faith that God would forgive me and understand that I have OCD or understand that these thoughts are popping into my head, and I can't really control that. Caitlin Harrison: 21:02 Yeah. And it's that practice of mindfulness, like you can notice those thoughts. And you can notice what prompted those thoughts, but you can't, you can't make them go away. You can only control what you do with them, and how aware you are of them. That's really the goal of any any real any religion, any God wants you to just be aware and connected to yourself, to your mind to your heart. It's the whole goal is to just be raising that mindfulness about who you are and how you're doing and what you're thinking not constantly fearing what could happen if you make a misstep? Dr. Katie Manganello: 21:43 Yes, exactly. So I think that we can both probably agree that what we're saying here is like, it's not one religion, or any religion that we are considering to be like, that are problematic. It's kind of more so the way that people can hold on too tightly. of those things that are taught, or how they kind of interpret how to behave as a response of that. Kira Yakubov Ploshansky: 22:12 This isn't really deep and powerful. This is like very existential, I can't imagine. Like on a very, man, I'm like getting chills thinking about this, like thinking about how I was raised in different ways of just even the thoughts, like I work with clients for sex therapy. And if they have an arose, talking to a client, like I feel guilty, fantasizing about somebody else, or having a thought that someone else is attractive. And like working through like, your mind is your playground you're allowed to have whatever thoughts you have, it's just what you do with them. And how you act upon them, is the difference. But what kind of goes on in your mind is yours. And it's private, and you don't have to share that with anybody. And I have so many thoughts in my head. So I can't imagine, like having to filter and like, Nate, like labeling this is bad. This is sinful. This is okay. That sounds exhausting. And like a job within itself. Caitlin Harrison: 23:06 That goes, yeah, right along with what you're saying. It can show up a lot of times too, with that confession, like you feel this obsession or this compulsion to confess any sinful thing you did, or any bad thing that you did. Even thoughts, any bad thoughts that you had you feel this obsession, whether it's with with a pastor, a priest, mentor, your spouse, like, Hey, I was attracted to this person, like I need to tell you or you know, the privacy and that self trust can oftentimes just be broken and you feel so guilty and full of shame that you could be so evil as to have a thought that disgusting. Kira Yakubov Ploshansky: 23:50 It makes me think about so in like Eastern European cultures, or even like Mediterranean cultures, they have like this thing called the evil eye. And if either of you have heard about it before, and so especially like growing up in my culture all the time, if you say like a compliment, or you admire something, or you're jealous of something in Russian, you would always say is Glaus it to like, you would say like, I don't want to curse it, I don't want to put a curse. I don't want to jinx it. And like, even my mom, like, I have a baby now and I'm telling her how beautiful she is, and all these wonderful things. And she was like nice guy that Don't say too many good things, something bad will happen. And I'm like, Mom, that's crazy. Like, I want to I want to see these good things and build up her self esteem. She's like, but you can't say too many because then something bad will happen. I'm like, this explains my child. A lot like you're holding back sharing positive things because you're scared that it will jinx it. And like even that superstition, I think is so strong. It makes me think about this, like our thoughts can be that powerful to cause something bad to happen. Caitlin Harrison: 24:52 It kind of causes this in authenticity to like it's disingenuous, like I can't be honest about my thoughts. To other people around me, or because it's going to damn Me To Hell, if I'm honest with about who I am or what I'm feeling, and when I'm thinking Kira Yakubov Ploshansky: 25:14 talking about shame, that's like, Dr. Katie Manganello: 25:16 there's a lot of shame and guilt tied in with this specific subtype in the real event subtype that we can kind of get into whenever we're ready. Caitlin Harrison: 25:27 Yeah, I mean, you can share what that means the real event. Dr. Katie Manganello: 25:30 Yeah. So the real event, I think, there, there's definitely some overlap. So I really wanted to talk about the real event, because I think that it can be hard to tease real event OCD, apart from trauma and PTSD, because there is something that happened, like a lot of times people think, okay, OCD is like, I'm gonna flip the light switch up and down to make sure that my mom doesn't die on her trip to work today, or something like that. So it's more so or I'm going to, like, clean incessantly, so that I make sure that I don't get sick. But it's like, oh, well, what if something actually happens? Right? So real event, OCD is rooted in memories of events, which have already happened. So it could be that someone feels uncertain about what they've done. So an example could be like, maybe a person goes to happy hour with their co workers, and has one drink more than they typically would. And then they start to wonder, ooh, like, Did I say something offensive to my coworker? Did I hit on my boss, like, what if they fire me for how I've acted. So in this case, the real event is that someone did indeed get intoxicated with their co workers. However, they're more concerned around the uncertainty of the result of what their behavior could have led to, or how that impacted the others that were with them. And, as you can probably imagine, this theme specifically happens a lot with drinking because it like alters your memory, and the more you go back, and mentally review memories, that also messes with your memory. So there's a lot of a lot of that happening. Another thing with a real event, OCD is like a person could feel consumed with that guilt, that self doubt about something that did actually happen. And that could in turn result in doubting who the person is like, as a person. So an example of that, that could be more so like, okay, let's say, you steal something from a store, like candy or something when you were younger. And it's not like it's something you do anymore. It's not something you've done more than one or two times, right. But then you start to think, well, I did steal though, and that means that I'm a thief, and I'm a terrible person because of that. And, you know, if I have kids, like I shouldn't, because I could transfer that characteristic to my child, and it'll be my fault that there's more thieves in the world. I mean, it can really like spiral right? So the fear of wrong or potentially wrong past behavior drives people with this type of OCD to engage in compulsions aimed towards gaining certainty about what exactly they've done. And what this means about who they are as a person. And so some of the major real event compulsions include that mental reviewing the confessions, like halen was saying, and reassurance seeking like, Oh, I did this, like, do you think it's okay kind of thing. So this subject can be incredibly painful for people and confusing, because pretty much everybody experiences regret or doubt about things that have happened in the past. But people without OCD can usually kind of look back at it and say, like, oh, yikes, I shouldn't have done that. But reflect on it and move on. Whereas someone with real event OCD can have guilt over this, and feel it in such an overwhelming way that it could be equivalent to the feeling as if they like committed a murder or something. So it really takes that past event and warps it until the person really views themselves as like the worst person in the world who can never be excused or forgiven for it. Caitlin Harrison: 29:12 Yeah, one of the examples that shows the intersection of this real event OCD, and religious trauma. I knew someone it wasn't an a client or anything that felt as though because they slept with their husband when it was just their boyfriend. So they weren't married yet. They slept together. And they felt that because they did that their marriage after they got married was just ruined. And that's why she was being mistreated by her husband is because she gave herself away before you know before that she should have and so it's sort of this like fear of I don't think that my marriage will ever be able to recover. She wasn't like being abused or anything. It was just bad conflict styles. And it was sort of this like what's the word fulfilled prophecy? Prophecy of like, we can't make it through this because of past things that happen to me. And that creates this vicious cycle of kind of proving to yourself that see I am bad. See, I did something wrong. Does that align well with what you're explaining? Dr. Katie Manganello: 30:28 Yeah. And I think that there's things that could also just like continue to fuel those types of compulsions or whatnot. I feel bad for this person, especially because, you know, in the context of it being a marriage, like, you can't get divorced, or at least I'm assuming that's part of the religion that or that religious belief of like, once you're together, like, That's it, you don't divorce or if you do, like, that's bad. So it's like, oh, I messed up before my marriage, we got married, and now I'm stuck and it's ruined. And I'm, you know, in this unending sense of doom, basically. Caitlin Harrison: 31:02 Yeah, this is I gotta pay my penance now, because, right, I'm being I did this for myself. Yeah. Yeah. Kira Yakubov Ploshansky: 31:11 And so I can see this showing up just in any trauma, right? Like, especially a lot of this over section with OCD is like these intrusive thoughts, these flashbacks, like having this negative belief of yourself, the self fulfilling prophecy, right? Especially in like, in terms of interpersonal relationships, like, I'm a bad person, I did this or something bad happened to me. And now I'm scarred. Like, I know, a lot of you know, victims of sexual assault might feel that way that they're damaged in some way. And so they may push other people away, having this belief like so there's so much overlap that I think that maybe a lot of people may not have recognized between the two. And so I'm curious of how either of you kind of tease apart when you see somebody presenting a lot of the symptoms or issues? How it could be either? Is this PTSD? Is this OCD? Is this both? Is this the comorbidity that we're looking at right now? And helping them through that? Dr. Katie Manganello: 32:03 Yeah, it will, it could indeed be both it could. It also could not, it could, so you should try to tease it apart. First, if that is the case, the difference is that like, while there are repetitive behaviors of OCD that are performed to like prevent an imagined threat from occurring, or from that perceived all or nothing thought from being true about themselves, that the repetitive behaviors are showing up with PTSD are done to avoid re experiencing traumatic memories. So it's more so well, if it's, if it's PTSD, where it's one specific event, at least, that's kind of the case. Even if it's a collection of memories, it's those memories or those specific, like themes that they are trying to avoid. That's how I would explain the difference. I think there's like a lot of overlap, though, and especially in what we are saying, like, I think in particular with religious trauma, some of the specific OCD themes discussed, like, there's this level of uncertainty around somebody's identity and around questioning their values and in learning how to trust themselves. Like I think that those are some really common themes that show up amongst both of them that you're going to still be doing some of that work. Caitlin Harrison: 33:22 Absolutely. I think you summed it up well, and I think that they can exist together, they can exist separately. And the important part is just understanding the difference so that you can understand yourself better, so that you can understand your therapists can understand how to help you better. But if you're having these themes, they can show up in many, many different diagnosis could show up in anxiety and not OCD, it can show up as depression, simply like self esteem issues. So and Kira Yakubov Ploshansky: 33:57 So how would each of you kind of go about helping someone who is experiencing religious trauma? Or the Scrupulosity or the overlap of the two what are some of your approaches that both of you kind of go through that might help the listeners kind of think about this if they resonate with this episode? Caitlin Harrison: 34:14 Yeah, so like I said, I work a lot with individuals who are sort of changing their belief system or questioning their belief system and wondering if they want to change it. significant portions of it or the whole thing entirely. So like, for example, I'm, I'm questioning my sexuality, and I've always kind of suppressed that part of myself. I didn't want to confront it because I've just been shown that I need to be straight. And I need to have a nuclear family. I need to want to have kids you know, all that those kinds of things like maybe my sexuality and my true expression of not fitting the heteronormative mold Maybe I my belief system can coexist with that. And so I just need to question a part of my belief system or hey, I'm actually wondering if there's even enough evidence to support me believing this belief system that I once believed in. And so when I approach that kind of work, it's very slow. And it's a lot of grace for yourself. When we talk about scrupulosity, it's a lot of slowing down reminding yourself like, Hey, I know what voice This is that's talking. Whether that you name that voice, the OCD Scrupulosity, maybe you name that, that was just my youth pastor that was making me feel that maybe there really is somebody that's tied to that voice or that compulsion or that obsession. But just starting to recognize and separate yourself from that voice, can be really powerful, so that you can notice it as separate from yourself. rather than you being this evil person that can't manage to live a good life, or can't manage to be free from obsessive thoughts. If we're talking about real event, OCD, it's kind of where I start some initial thoughts that came to mind. Kira Yakubov Ploshansky: 36:25 Sounds like being really gentle with themselves and you with them to going through that. Dr. Katie Manganello: 36:31 I guess what I would start doing is just what we already just talked about in terms of is this both is it one or is it the other, and then I would kind of, I would probably go different directions if depending on what it is. So if it's OCD, I'm going to be doing exposure and response prevention treatment, in combination with Acceptance and Commitment Therapy that brings a lot more of that like, acceptance, gentleness, focus on their values, what they want that kind of thing. If I'm doing it with PTSD, I'm, I always, I look like a very collaborative therapist. So I really throw out what I can offer, and then what the person tells me that they think suits best for them. That's kind of what we go with. So if it's if they do want to work on their PTSD, I explained to them, Hey, I'm trained in cognitive processing therapy, I know how to do prolonged exposure. This is what each of these look like, these are evidence based track, you know, practices that we use, which basically just shows that like, you know, there's been a lot of research on these treatments, they help people. And I just give them more information around each and then they can tell me like, Hey, this is this one seems like a good fit for me or this one the other, or if they're like, not even at a place where that's something that they are like super ready to, like, hit the ground running with, I'll just kind of start out with whatever they say that they want to work on and kind of take it from there. Kira Yakubov Ploshansky: 38:08 Can you share a little bit more about ERP and the cognitive processing for some of the listeners that don't know? I know, I keep making you explain things and concise ways. Dr. Katie Manganello: 38:18 I like it, this could be a whole episode. So they're, they're both exposure therapies to an extent. So cognitive processing, therapy is a treatment for PTSD. A lot of it is what mostly what we're doing is we are looking at your thoughts and beliefs, and how they relate to the event or events that have happened, and looking at how they are not really helping you in your life right now. And talking about like what had happened and restructuring some of those beliefs with exposure and response prevention, that's like the OCD treatment. That is so the exposure part and exposure and response prevention is targeted towards the obsessions. So the exposure is we need to expose people to the fears so that they can, their brain can actually habituate to that anxiety and they can learn to tolerate it, building that distress tolerance. The response prevention piece of ERP is targeted towards the compulsions which is basically either eliminating the compulsions altogether or cutting them back with the goal to really have them be pretty minimal or gone. So if you want more information on that, you can go back and listen to the other podcasts when he's talked about that a lot. I think the biggest thing I'd like to just say in response to that is I think that all of these treatments sound really scary because they hear the word exposure and they're like that's what I'm trying to avoid. I'm I'm doing that. But again, like we're Working together, it's collaborative. I'm often doing exposures with people. And I'm, I'm never going to force anybody to do something that they're unwilling to do like we will find like little tiny exposures and then gradually build up like we are putting our toes in the water are not just, you know, Cannon going into that freezing cold ice water, we're like, gradually kind of dipping in. So don't be you know, it should be challenging. It should be a stress but not a strain. Kira Yakubov Ploshansky: 40:33 Thank you. I appreciate both of you sharing that approach and how you would kind of go about that game. And I know that you also do EMDR. Is this something that you would do with clients who are struggling with scrupulosity? Caitlin Harrison: 40:45 Yeah, so I without using the technical terms, what I was talking about before was internal family systems. So ifs is sort of this idea of understanding all the parts of you that show up and understanding why they're there, what they came to do to help you with. So what's scrupulosity, oftentimes it shows up to protect you from going to hell for to protect you from being socially rejected, to protect your parent from being disappointed in you, things like that. So it's kind of taking it and putting yourself your true, like authentic self in charge of all of these parts of you, but also appreciating like, Hey, you showed up for a reason you showed up to protect me, you showed up. And you helped me once upon a time. And now I think I want to be in charge. And so that's a long process. And it sounds really simple. And it's not. But that's sort of the basic theory behind how I would often approach scrupulosity. And there are times when it's trauma related that you could use EMDR. So if especially with the relevant or reprocessing, like a specific memory, or it could be a negative thought, a negative cognition that you attach to many different memories that you could use EMDR for. So if you notice compulsions or obsessions that come up, or memories that come up often with trauma related things, then we would use the MDR, if that makes sense. Kira Yakubov Ploshansky: 42:33 And same thing, if you could share a little bit I know we talked a lot about EMDR in episodes together, but for the listeners a little bit of like, what that is and like the like the acronym that it's for. So they have an idea, kind of what that means. Dr. Katie Manganello: 42:48 After this Caitlin Harrison: 42:55 things, these are things we like talking about. Yeah. All right. So it's Eye Movement Desensitization and Reprocessing. So it's a mouthful, that's why we just say EMDR. Um, but basically, it uses the theory behind bilateral stimulation. So if you imagine kind of taking your body and dividing it into two halves, the right side and the left side, if you stimulate the right side and the left side, in a rhythmic motion, it could be fast or slow, just depending on where we're at in the process. It can help your mind your body and your feelings consolidate a traumatic memory that they couldn't process that it couldn't process previously. And so I think EMDR is a really good fit for people that haven't had good success with talk therapy. I think it's also a good fit for people that are tend to be like more emotional and creative creatures. I think it I noticed that it can tend to be a good fit for those people who like to do like visualizations and things like that. So yeah, it's it that what that looks like in a session is we do a lot of skill building at the beginning of treatment. So learning how to regulate your nervous system, learning how to calm yourself down. When a traumatic memory is brought up, or even a stressful event at work is brought up. We do a lot of skill building at the beginning. It's just like what Katie said, we don't just dive into the deep end and bring up you know, the worst thing that ever happened to you. Then we start to reprocess the memories once your whole nervous system is ready for that and you feel like you're able to regulate yourself and you have those skills that you need. need in order to do that, one benefit, I think of EMDR is that you don't actually have to say your memory out loud. Sometimes that can be powerful for people. And it's that avoidance that Katie's talking about, sometimes, it's actually really good for you to be able to say it out loud and have somebody else know what's happening. But it's kind of cool that in EMDR, you don't have to. And so you can start slow. And we reprocess the memories with bilateral stimulation. So sometimes you're looking left to right, left to right, that's the eye movement piece. But what research has also found is that any type of bilateral stimulation works, so tapping on left knee, right knee, left knee, right knee, or your shoulders or even sound in your left ear, then right your left ear than right here. So we kind of do what works for the client and also the environment that they're in. And some clients have relief in one session, some clients, it's eight sessions, some clients, it's many more than that. But that's kind of EMDR. In a nutshell. Kira Yakubov Ploshansky: 46:13 I appreciate both of you really sharing that explain, I think he did a phenomenal job. And I think this is going to be a really powerful episode for a lot of people who could be struggling with this. Or even folks who know somebody in their life they love they could be struggling with this and understanding it a little bit more and having more empathy. I would say before we close out, is there any, any last bits of whether it's like giving hope or any other thoughts for listeners around something like this? Dr. Katie Manganello: 46:41 I think that there is a lot of shame in some of these, especially when there is a real event because you essentially have to go and tell somebody, something that you think the worst thing about yourself. So I can understand that this is really, really difficult to see help in. But also like just to know that you're probably judging yourself for it a lot more than anybody else would, which is sort of giving reassurance right now, but I mean, you should you know, you, I would hope that somebody would feel comfortable coming and talking to me about some of those things. And just that having them know that I get how it operates. I know how it works. And like, we can put the judgment aside to like, get through it. So I think that that is a really important thing with with PTSD. And with OCD, I think there's often a lot of shame and guilt tied in. Caitlin Harrison: 47:44 Yeah, I think just that there is a path ahead, that doesn't feel so disorienting. I think that's what I see a lot with the clients that I see anyway, you know, that really disoriented feeling of a foundation I once had is not here anymore, and I'm kind of grasping for anything that can make me feel comfortable again. Um, there is a path ahead where you don't feel so disoriented and so confused about who you are, what you're that like maybe listening to this and talking about values you're like, that's the last thing that I want to talk about because I don't even know when I think or believe or feel about anything anymore. And so yeah, I think just you can learn to trust yourself again, you can learn to be reconnected to all of you know, your emotions and your mind and your body and it not feel so overwhelming. Kira Yakubov Ploshansky: 48:39 So for listeners, Katie and Caitlin at this time are both accepting new clients. So if you're interested in working with either of them, please reach out. You can head over to our website, heal your roots. wellness.com Katie, and Caitlin, thank you so much for being on with us again today. This was ### Listen - [Spotify](https://open.spotify.com/episode/14774738) - [Apple Podcasts](https://podcasts.apple.com/podcast/14774738) - [YouTube](https://youtu.be/UA7qprxEHQc) --- ## Expert ADHD Strategies for Children and Families with Dr. Jessica Robb Mazzant - URL: https://healyourrootspodcast.com/episodes/expert-adhd-strategies-children-families-dr-jessica-robb-mazzant - Published: 2024-03-13 - Season 3, Episode 8 - Duration: 49:58 - Category: ADHD - Guest: Dr. Jessica Robb Mazzant ### Summary Dr. Jessica Robb Mazzant shares expert ADHD strategies for children and families, covering assessment, treatment approaches, and family dynamics. ### Description Tune into an enlightening conversation with Dr. Jessica Robb Mazzant about ADHD's nuances in assessment and treatment. With extensive experience and a passion ignited by her early career, Dr. Mazzant brings a wealth of knowledge to this episode. Discover expert strategies for supporting children and families affected by ADHD, including practical approaches to assessment, treatment, and family dynamics. ### Transcript Jessica Robb Mazzant: 0:00 Part of good treatment is doing ongoing high quality assessment. So you are checking in with your client the the entirety of the time that you're working with them to make sure that they are growing in the direction that they want to grow. They're moving in the direction that they want to move. Kira Yakubov Ploshansky: 0:19 Welcome back to Heal Your Roots Podcast. On today's episode, we have Dr. Jessica Robbins and join us clinical psychologist sharing her unique approaches and philosophy around helping children and families dealing with ADHD. If you're a parent or you have a family member with ADHD, you're definitely going to want to tune into today's episode. I'm thrilled for today's guest, Dr. Jessica Rob Mazon. Thank you so much for being with us today, Jessica. Jessica Robb Mazzant: 0:46 Oh, you're welcome. Thank you for having me. Absolutely. Kira Yakubov Ploshansky: 0:50 So before we kind of go into all your specialties and everything that you do, can you share a little bit about how you got into the field, what made you want to become a clinical psychologist? Jessica Robb Mazzant: 1:02 Sure. Um, so I was a psychology undergraduate. And in between towards the end of my junior year of undergrad, through my email, I got this advertisement for an internship. And the internship was to work in a program called the summer treatment program, which was a really intensive behavior modification and social skills training program for kids with ADHD. And when I say ADHD, I mean Attention Deficit Hyperactivity Disorder, I'll use that acronym from now on. And I thought, well, you know, this, this seems pretty cool, like something I might be interested in. So I applied, and I feel really fortunate that I was able to get that internship. And so I moved up to the summer treatment program location, which at that time was in Buffalo, New York. And I went through the training, and I started doing this treatment program. And I felt hard and fast and love. I just, I, I enjoyed working with those kids so much. I enjoyed the just professionalism of all of the supervisors that I worked with, I took a special class with the developer of the summer treatment program, Bill Pelham, he offered a summer course on ADHD. And I just remember leaving that summer thinking like, this could be my work, like, I get paid for doing this. And so for the next 12 years, I worked in that program, I ended up applying to graduate school to a doctoral training program in clinical psychology, and the developer of the summer treatment program, they'll tell them was my was my graduate mentor, and, and really my, my life mentor, and it just that experience had such a positive change, and, you know, change the trek trajectory of my career and really pointed me in a direction that I've been so so grateful to have kept moving in. Kira Yakubov Ploshansky: 3:16 That's incredible. So if you didn't get that email, who knows? Jessica Robb Mazzant: 3:21 That would have more of an influence in my life. I'm responsive to emails, but But it actually happened. Kira Yakubov Ploshansky: 3:29 Wow, that's really awesome. I actually love working. I don't work with any kids. But I love working with adults who have ADHD because full disclosure I do as well. And just like, learning myself about it, helping clients there's so much information about and it's so intriguing. So it's really awesome that you spent all that time at this. It sounds like a really comprehensive program that allowed you to learn so much and help so many people. Jessica Robb Mazzant: 3:54 Yeah, it is. It's such an incredible program. And about six weeks ago, the developer of the summer treatment program, Bill Pelham passed away. And so that's been a just a huge loss, not only personally, but really for for our field. But one of the things that it's so incredible is that, you know, he influenced not only me, but so many people that are very committed to keeping high quality research, high quality treatment happening. For families that really need it. Kira Yakubov Ploshansky: 4:28 I'm so sorry for your loss. So Jessica Robb Mazzant: 4:29 thank you. I appreciate your excitement. Yeah, absolutely. Kira Yakubov Ploshansky: 4:33 And so where are you currently working now? Like, what is what is the professional career for you right now? Jessica Robb Mazzant: 4:40 So I am an associate teaching professor at Florida International University. And I work specifically in a program a graduate program called the professional counseling psychology program where the PCP program for short, and the gentleman that I mentioned, Bill Pelham, Not only did he start the summer treatment program, but he was also really instrumental in helping to launch the PCP program as it currently is. And one of the things that's kind of unique and distinct and important about that program is that it has a real training emphasis on evidence based practices. So techniques and practices that have been shown through, you know, good quality research that they really provide and result in a meaningful impact on on clients and families. Kira Yakubov Ploshansky: 5:34 So this guy has been all over. Jessica Robb Mazzant: 5:36 It really, yeah. And so I'm Kira Yakubov Ploshansky: 5:39 leaving an impact on the right. Yeah. Jessica Robb Mazzant: 5:41 And I've been working in the PCP program at FIU since 2012. Kira Yakubov Ploshansky: 5:49 Oh, wow. Okay. So over a decade, over Jessica Robb Mazzant: 5:52 a decade, yeah. Kira Yakubov Ploshansky: 5:55 That's awesome. So you're working with students. And then I know, you mentioned you work at a private practice as well. Jessica Robb Mazzant: 6:03 So the private practice that I work at, I work in a in a part time capacity there, but it's called South Florida integrative medicine, and it's in Coral Gables, Florida. So in the south Florida area, and I think what I love about fim, I apparently really like acronyms. A lot is, you know, it's an interdisciplinary practice. So there is a kya tree, there are psychiatric nurse practitioners, psychologists, mental health counselors. And in really having such a broad range of professionals there allows us to do really comprehensive and personalized treatment for the folks that we work with. So I do see some clients through SFM. But I also do quite a lot of clinical supervision. So what clinical supervision is, is where you are a sounding board, and you help to give advice to developing mental health clinicians, so clinicians who don't yet have their independent license to practice, I get the fortune of meeting with them routinely to, to make sure that they're feeling supported and secure in the work that they're doing. And I really love that. Kira Yakubov Ploshansky: 7:14 molding, the young therapists, next generation. Supervisors are so crucial. I mean, I loved all my supervisors, it's such an important part of the growth in the learning process of becoming a therapist or any kind of mental health clinician. Jessica Robb Mazzant: 7:29 I agree. Yeah, they can have such a tremendous impact on us. Kira Yakubov Ploshansky: 7:33 So you have a lot of different Yeah, parently a lot of Yeah, but all very important ones. Jessica Robb Mazzant: 7:41 Yeah, I really, I'm, I'm incredibly fortunate that I get to be involved in so many cool things. Kira Yakubov Ploshansky: 7:50 And so I know, you mentioned that you fell in love with working with children, teens with ADHD? Can you share a little bit about your approach of assessment, like kind of like from the beginning, when you meet with a client and their family, and taking them through that process? Jessica Robb Mazzant: 8:06 Sure. So, you know, I think one thing about assessment that is really important to remember and to consider is that it shouldn't be distinct from treatment. And what I mean by that is, of course, there's a period of time where you're getting to know a client, whether that's a kid, adolescent, adult, a family, however you define client, you have to get to know them, get to get to understand them understand what it is that they want to, they want to work on. But part of good treatment is doing ongoing, high quality assessment. So you are checking in with your clients through the the entirety of the time that you're working with them to make sure that they are growing in the direction that they want to grow. They're moving in the direction that they want to move. So I want to throw that caveat out there. But really, I think what you meant was like at the beginning, what are some things that are important? How do you connect, connect with a kid or connect with an adolescent and their family? So kind of staying in the world of ADHD, one thing that is important to do is to to really determine not just what symptoms are present for this particular kid. But how do those symptoms impact their life? One of the things that I think is absolutely essential is that the focus of our interventions are really tied to the problems that this client is having in their daily life functioning. And that we are really focused on trying to develop what we call adaptive skills. So strategies or techniques that the person can do to better adapt to the demands of their life in a way that are that's going to Help them make meaningful connections with other people be successful in their environments. That really, that shouldn't be the focus of treatment. And so it also needs to be the focus of assessment, we have to really make sure that we are explicitly asking families and kids and adolescents, where they want to grow, what areas do they identify as being their biggest struggles? And how can we design interventions to help them adapt to the struggles that they're having. And that really is the central focus of both assessment and treatment, not just trying to eliminate symptoms. Kira Yakubov Ploshansky: 10:35 Gotcha. Now, that's really important. And I think that's great to think about, because everyone is so different, right? They might all have very similar symptoms, but it may not be an issue for one child, because of whatever reason, maybe their family or the way they are in school, or that's just a different kind of strength for them, versus someone else who might be having the same symptom, but as struggling because of the structure of their environment. I've Jessica Robb Mazzant: 10:59 really, yeah, I so value, what you just said, You're right, you can have two people with the same symptom list. But they're going to struggle in different areas, or in different ways, they're going to have different sets of strengths. And so you really have to approach each person, it's just that as an individual, that you need to make sure that you are understanding to help drive drive the treatment choices that you make. Kira Yakubov Ploshansky: 11:26 And I'm also wondering, maybe the priorities of like the family or the school system, right? Where even if they are struggling or not, which one is more of a priority work on versus the other as well? Jessica Robb Mazzant: 11:39 Yeah, absolutely. And I think really working with the family unit, in particular is something that I enjoy, but it's for that reason, you can't treat everything all at once. And so you have to make a determination about, you know, what skill can they learn, that would have the biggest impact on their life, or what area of their life is causing them the most distress or the most impairment and making those choices collaboratively about this is where we're going to start based upon what that client and their family is relaying. Kira Yakubov Ploshansky: 12:11 And so well, what do you find are the most common, whether it's like the issues or areas, they're struggling, and then that the family is coming in to treat like the things that are standing out, like, hey, my kid is struggling with this, this or that? This is why we're coming to you for assessment or treatment and help. Jessica Robb Mazzant: 12:29 Yeah, that's a great question. Because it's very infrequent that families actually come in and say, you know, I think my kid has this symptom and this system, symptom they might meet, you know, the Diagnostic and Statistical Manual definition of this disorder like that, that never happens. What families are coming in saying is that my kid is struggling, and multiple areas, and I'm worried about their future. So if I had to boil it down to three kind of main areas where I see most struggle, oftentimes, kids are struggling in school, not that they are necessarily failing, or, or are unable to learn. In fact, many folks with ADHD have have really developed skill sets and are really, really bright. But they may lack organizational skills or understanding how to prioritize, for example. So oftentimes, we see kids that are academically underperforming compared to where they're likely capable of performing, or their grades are suffering because of things like they can't structure their time to finish a long term project, or what can sometimes be the most frustrating for older kids, they did the homework, but between doing the homework and arriving at that new location school, it's gotten misplaced along the way. And you'd be surprised how often I hear that even with electronically submitted. Still, there is some barrier there. So that's absolutely a domain, I'm going to ask about necess and see how how that kid is doing. This second area is going to be peer functioning. And many kids with ADHD struggle in their their peer social groups. And what we know is that having just one reciprocal friendship, so when I say a reciprocal friendship, what I mean by that is the kid says, hey, you know, John is my friend and John says, Yep, I'm this kid's friend, they both say, Hey, this is a real meaningful connection between the two of us. Having just one or a couple of those has this profoundly protective impact on kids. But oftentimes, kids with ADHD struggle to kind of get past that initial friendship stage and to that reciprocal or friendship. And there's a lot of reasons why they might struggle. Sometimes kids with ADHD have difficulties with impulse control. But a lot of times kids with ADHD can learn from their environment and can develop some troublesome reactions or troublesome patterns and how they interact with people. And so they are more at risk for being socially rejected from their peers, because of things like high rates of interruption or not being able to follow conversations or things of that nature. And so really, again, working on that, like skill development, to empower them to be able to learn some long lasting friendship skills, has a big impact on them. And then, yeah, last but not least, at all, the third area is really family functioning. So within families, it's very common for parents to report that they feel like they're not the best versions of themselves, or they're not the parents that they want to be. They're struggling in a lot of ways with their kids. And so the dynamics within the household have an old it in a way that doesn't really feel good to anybody. And parents report that they, they're using harsher kind of interactions with their kids than they they want to be doing. And they feel like they have to do that, because that's the only thing that seems to work or to motivate their kiddos. And we know that we're living in an environment for a long period of time that's marked by these high levels of coercion or hostility isn't great for kids, it's not good for their development. And so really working on changing family dynamic patterns, is something that we check in on and definitely focus on in treatment, if needed. Kira Yakubov Ploshansky: 16:50 So these are three huge areas. And as you're speaking, I'm like, oh my god, it's like the story of my life. But it's so true. Makes sense. When you think about if you're struggling, and all these three areas, and you're a child or a teenager, like this is your whole life, right? You're in school, or you're at home, or you're with friends. And if you're not with friends, or you're feeling rejected, right, I'm sure that lowers your self esteem can cause social anxiety, you might have more lower self esteem, because you're not doing well at school or you're constantly getting reprimanded than at home, your parents feel like that negative reinforcement is the only way to get you to do something. Yep. Like, everywhere you go, you're getting some kind of like negative reaction or response to you. It's really tough, it's Jessica Robb Mazzant: 17:37 really tough. And you nailed it when you said it can affect a person's self esteem. It can also affect their sense of self efficacy, or their belief in themselves that they are capable of doing things because they've had so many messages sent to them that they are screwing up in some way. And that's a tough message to receive from so many different areas of your life, for so many for so long. That's a tough thing not to internalize. It's also really common for kids with ADHD to have something that we call rejection sensitivity, so they can become really attuned to perceiving or expecting rejection. And so for a subgroup of kids with ADHD, they can react in really big ways, when they perceive that they're going to be rejected, or that they are rejected. And sometimes they preempt it. And so rejection or kind of pushing back against a person wasn't intended by by someone, but it's perceived that way by that kiddo. And then they have this big response. So it almost becomes like a self fulfilling prophecy. Kira Yakubov Ploshansky: 18:51 Yeah, it's you're trying to control it. So like, I know, I'm gonna get rejected in her. I'm just gonna get ahead of it. That's coming. Yep. And then it just creates more of and then and then it kind of confirms the thought like, of course, I was gonna get rejected. See, this is what happens. Yeah, yeah. And so when you're meeting with kids, is it? Do they share like these concerns? Or is this more from your family with the family saying, like, hey, they're struggling in all these areas? And then the kids are sharing this with you, too? Yeah. Jessica Robb Mazzant: 19:21 Well, you're, you're asking a question that I don't know if you're even realizing you're asking for it anyway. So the younger that the kid is, what we know is that really kind of intensive social skills training and intensive behavior therapy is the treatment approach that works best for those kids. Now, when I say behavior therapy, I do want to clarify something I'm not trying to like force or pressure kids into like, a mode of responding or a way, you know, a really restricted way of responding or being but really until Teaching them through the way that I react to them skills that they can use in other settings that's going to help them to adapt better. So let me give you an example of what I mean. Let's say I'm, I'm running a social skills group with kids, I might have that group of kids play a sports game. And the reason that I would make them play that sports game is because sports actually require the use of a lot of different social skills, you have to be able to communicate effectively, you have to be able to cooperate. So work with your your fellow teammates, you have to participate in the game in a way that is meaningful. And yeah, you use a lot of validation skills, you're like checking in with your teammates, you know, great play there like that you're looking ahead. And so we'll play a game like that. But one of the things as the therapist that I'm doing is I'm looking for all of those things I just mentioned, to occur. And when they occur, I really reinforced that in those kids, I'm like, Hey, that was a great way of communicating with your with your teammate, did you say that skill? I'm gonna make up a name right now, did you see that skill that Andy did, this is why that was a good move. So I'm really trying to strengthen the likelihood that kids will continue to use those types of skills when they naturally occur. But I'm also providing some boundaries for the kids that are going to help them to be more successful when they're not looking. So if a kid strikes out, during our baseball game, for example, and he throws his bat in anger, maybe that's a really impulsive reaction that he has that comes from frustration. I'm going to talk with him about how that's not the appropriate reaction. That's not an example of good sportsmanship, and what can he do differently? And why would that different behavior, land him in a better in a better spot? So if when I say, the mod, or behavior modification, I'm really talking about a lot of like, intensive point of performance feedback. So these kids interesting. Kira Yakubov Ploshansky: 22:10 So I'm hearing a lot of positive reinforcement or like, point out all the things that you like that they're doing that you want them to do more of? So they're aware of that. Yep. And not necessarily negative reinforcement, but bringing to their attention that, hey, this is not appropriate. What could we Jessica Robb Mazzant: 22:27 do? Yeah, there's a consequence, when misbehavior or really negative behavior does occur, but the consequences presented to them in a neutral way, in a factual way, it's not intended to shame them, or to make them feel badly, but to be like, Hey, not okay. Or hey, not cool. So we do that a lot of different ways. Sometimes that type of feedback, sometimes it's through something like a point loss if a kid is on a point system. But the consequence, that type of feedback is intended to be instructive. And really, when you set up a dynamic where there's way more opportunity and appeal towards those positive pro social behaviors, kids start to drift in that direction, they just need the opportunity have a chance to understand where that attention is going to come from. Kira Yakubov Ploshansky: 23:16 I'm thinking about if they're getting all these negative messages, and now you're getting so many positive messages, someone is acknowledging all the things you're doing well, it starts to feel really good. And now you're chasing that feeling that makes you feel proud you feel accomplished by it, someone is telling you something good about you. So yeah, they want to lean into that way more. Yeah. Jessica Robb Mazzant: 23:37 When the only way for you to get acknowledgement or intention in your environment is through misbehavior, or you get it so much sometimes, without even really being conscious of it, people just lean into it. Because like, that's how that's how I understand that I interact with the world. But when you give kids an alternative than they have that alternative pathway to start to walk down. Kira Yakubov Ploshansky: 23:59 And so something I know, with ADHD is difficulty with consistency. Right? So even if they're leaning into this, they know this. If they struggle with the consistency piece, is that something you're able to kind of help them with or like navigate that process? Or is that like an acceptance of like, this isn't always going to show up this way? Well, Jessica Robb Mazzant: 24:21 that's a great question. And you're right, that consistency can be can be really difficult. And one of the things particularly when we're talking about kids, or even when we're talking about adolescents, I might tweak this answer a bit if we're talking about adults, but I don't think that consistency should solely be the child's responsibility. I think we need to get them into a great habit. I think we need to teach them skills explicitly that are going to help them in their life. But I think that consistency piece falls upon the adults in our lives. We need to be working with the caregivers and the life of the kids teach In them how to respond differently, how to create those positive connection opportunities that we're creating in therapy create those in the home setting, we need to work with the teachers that the kids are interacting with. So they have that same kind of dynamic. So yeah, the kid needs to show up for themselves, they need to show up with those skills that they're learning, but other people in the life that the kid needs to show up to. Kira Yakubov Ploshansky: 25:24 So it sounds like you work with kids, if in a setting of other children, right, like this is like in a group to see how they interact and help everybody is that the most common way that you work with children, or is it like one on one as well, Jessica Robb Mazzant: 25:37 it's not the most common way that most therapies work with kids, but particularly for kids with ADHD, we know that that approach lands a lot better, it works a lot better. And it results in better treatment gains than working with kids individually. That's not to say that working with kids individually is never warranted, like, of course. But we do find that net social modeling, and giving them the opportunity to practice because if you think about it, for most kids, in the context of a family, it's not just you, it's a lot of people in a family. In a classroom, it's not just you, it's a lot of people in a classroom, in a Girl Scout troop, it's not just you know, a lot of Girl Scout troop. So giving them the opportunity to practice in a social setting. It's not solely, that they need to learn social skills, though many do. But that it's giving them the opportunity to practice in an environment that's more similar to what their life looks like. So yeah, that's part of the reason why a lot of the work we do with kids is group based work. Kira Yakubov Ploshansky: 26:55 That's really interesting. I didn't, you know, as you say, to totally make sense, right? I mean, it's a lot more experiential, if this is what they're struggling with, instead of just talking about the thing, you go and do the thing and like live, you can correct it or work with it. And they can continue repeating it versus just talking about it one on one and then going out into the world and they forget, or in the moment, they don't know how to use it, or the moment has passed. Right. So that's, I really love that. Jessica Robb Mazzant: 27:24 Thank you. The other thing, and this is not our direct intention, but it can happen often is that we have kids in the group that become friends with each other, and they understand each other at a level that maybe other kids don't, because they're dealing with such similar thing. And so we've had many lifelong friendships kind of born out of the summer treatment program, or the social skills groups that we run. And then it's real meaningful feedback that they're getting from their real life, friends, their real life peers, it's really beautiful. Kira Yakubov Ploshansky: 27:59 There's a lot of things happening here. They're learning all this stuff, they're actually making friends. And all of this is helping them gain more confidence, practicing all these skills that they can take back into school at home or other places. So it's, it's sustaining these life skills, it's not just learning it, trying it a little bit doesn't work. Let me try a different setting and may not work. But it is like continuing. Yeah. Jessica Robb Mazzant: 28:25 And you know, we're talking a lot about these kind of social skills groups, or these behavior modification groups. One of the other aspects of treatment that I really love is doing what's called behavioral parent training groups. So where you bring the parents of the kids together to same thing, learn skills to better support their kids in their home environments. And behavioral parent training can be done individually, or it can be done in a group. Personally, I love doing it in a group because they'll see Elden communities, right there are many parents of kids with ADHD or their mental health issues can feel really isolated. Kira Yakubov Ploshansky: 29:04 I feel like it might almost be harder to work with the parents and the kids themselves. Jessica Robb Mazzant: 29:11 I think any teacher would say the same anybody who works with kids in any capacity can say, Georgia Gray, that's probably. Kira Yakubov Ploshansky: 29:20 And so how do you how do you work with the parents? What are some things that you kind of teach them to do, because they're the ones that have to reinforce this and keep the environment going, like you said, they have to be consistent with this practice in Jessica Robb Mazzant: 29:33 those groups. It's kind of a combination of things. One, there are some skills that we teach parents, and a lot of these skills in isolation, feel maybe kind of small, but you take enough of these small skills and you stack them up and suddenly it accounts for a big change and how their parenting or how they're interacting with their children. So an example of one type a skill that we might work on with parents is like how to use your attention in a way that's meaningful. So a lot of parents, and I want to say this in a way I want to qualify it, I guess, is what I want to say. I don't think that this happens, because anybody's trying to, like, do poor parenting. But I think it just naturally unfolds. And just like kids learn from their, their environment, parents learn from their environment. But what can happen is that sometimes parents can be on the lookout for misbehavior. So when it happens, they're like, Oh, see, there you go again, or, you know, a version, a version of that type of response. And then when kids, you know, are getting longer are playing nicely. And I can say this, because I'm a parent I know, for myself, is you're like, who you have a moment where you're, like, Don't rock the boat things? Well, right now, there's, they're going swimmingly. And, you know, here and there, that's no biggie. But if it's not just here, now, that's kind of the mode of responding. What ends up happening is that kids get a disproportionately large dose of attention for all of their misbehaviors and all of their mess ups. And comparatively, no, or very small amounts of attention, or meeting expectations for doing things the right way. And humans are social creatures, we gravitate towards what we get attention for. And so even though it might sound really small, just by bringing that to the awareness of parents, and saying, We want you to start to pay more attention to the things your kids are doing, well, we want you to catch them being good. You want your kids to listen to you the very first time, every time she listens to you, every time he listens to you on the first time, I want you to acknowledge that in a meaningful way. What it does, as kids start to drift towards attention. And so kind of slowly it starts to shift the way that they're responding. And then for parents, many times they respond, they report that like that permission to like, let go of some of this behavior and focus on the good stuff there kids doing feels really good. That's something that they they want. Yeah. Kira Yakubov Ploshansky: 32:33 And I'm sure that brings awareness to them, of how much they are actually listening, right? Yeah. Also, they're also filtering for something bad to happen. So you're more likely to think that there's a higher number of that. And this isn't standing out as much, because you don't have to be upset about it. So they're also kind of missing, that they're actually doing things well, a lot more than they're perceiving to you that yes, Jessica Robb Mazzant: 32:58 I'd like to underscore you, you nail that that that? Absolutely. It's like a giving permission to like, feel like you can focus on things that you are grateful for about your kid, that doesn't mean that mess ups aren't there. Of course they are. And they're happening at a higher rate with kids that have ADHD than kids that don't know that is true. So I don't want to invalidate the experiences of parents of kids with ADHD. But kids with ADHD are still human beings, and we gravitate towards what we get attention for. And you also said something else that I'd like to expand on if that's okay with you. So, I think it's really, really, I hate to use the word natural, but like, it's understandable is maybe the better word about why some really kind of coercive, or uncomfortable unhealthy patterns can emerge in families. And it's partly explained by by what you've said about how you're have all of this, like attention, or this hyper vigilance for like, When are things gonna go badly again. So let's maybe contrast a couple of different patterns that we can see in families. So let's say you have a kiddo. And parents have to give like, you know, scores, if not hundreds of moments of directions to their kids every day. So I'll use, you know, my kids as an example, if I say, go grab your shoes, and they go grab their shoes, and start putting them on. And I acknowledge that and I don't have to, like, you know, have a whole celebration for them for getting a shoe doesn't have to be like, Oh, you're the best listener ever. But it can just be like, Hey, thanks for listening, or even just giving them a little wink, or a smile, some kind of acknowledgement. What the kid learns what my my kids will learn is that Things come when I listen, when I follow directions. And what I learned is that my kids are like, these awesome listeners. And, you know, I have the expectation that when I tell them something, they're gonna follow through with it. Now again, to be to be fair to parents that are, are struggling with kids have a lot of inattention or impulsivity, if I tell a kid to go get their shoes, and then they don't, and I look over and they're doing a handstand against the wall, you get frustrated? Totally, I understand. I understand that. But what that can morph into, after a while is developing the expectation that they're not going to listen to you. And that expectation might be born from real experiences. That is true. Yeah. But what, what that can start to shift into over time is that some parents are like, You know what, my kid only listens to me if I am firm, or harsh or like escalate my own behavior. And so instead of saying, like, hey, get your shoes, they don't get up and be like, Hey, what did I tell you go get your shoes over time turns into your shoes. That's the very first thing you're saying to them. And then if that doesn't happen, then the behavior, you know, the response really ramps up in ways that feel unhealthy, uncomfortable. And so flipping that script, really, really intentionally can have a big impact, and kind of the harmony within the home, Kira Yakubov Ploshansky: 36:34 especially if there's multiple children. Yeah. Because now there's other things going on, if they're getting distracted really easily, and you're running late. And there's like, it's just chaos. It sounds like the parent also has a lot of internal work to do around frustration, management and being able to like, ground and calm down and be patient. Because it's it, you know, it sounds easier said than done. But in the moment, it's just like, you gotta check yourself as the adult to over and over again. Yeah, it's Jessica Robb Mazzant: 37:08 it takes a lot of effort to change pattern family. But any amount of effort that we put in, it's almost always worth it. Not only for the kid, but for the, for the parent or the caregiver, and for the family as a whole. Like, it's effort well spent. Kira Yakubov Ploshansky: 37:23 And you know, it's so interesting, it kind of like hits personally like thinking how you're saying that, they end up doing this negative reinforcement thinking like, this is the only way my child will listen. Right? And like, that's how my parents kind of raised me after a while, was just being a lot more stern. Oh, she only does things when there's negative reinforcement. So that's the way it's gonna go. That's what I got to bring to the table. Yeah, yeah. And so the expectation is, like, I don't want to mess up because I don't want to feel shamed or yelled at not because I want to do a good job of getting in trouble. Yeah, Jessica Robb Mazzant: 37:57 I want to avoid this aversive interaction that's gonna come. And Kira Yakubov Ploshansky: 38:01 I'm wondering if the parents, I mean, they're trying their best, right? Like if that they're also being conditioned, if that's the only way they get their child's attention, is they finally do the thing after being yelled at or raising their voice? And it's like, oh, it's working. Jessica Robb Mazzant: 38:17 I think it all happens really, organically, naturally. And to a level. I don't mean unconsciously in the way that some people mean, but I mean, like, without noticing, until suddenly, you just are like, Why am I yelling? And then and then you might have to answer the question for yourself. It's the only thing I know, that works. And that's what I think is really powerful about when we can work with families is we can say I get it. And I understand. So far, this has been the only thing that works. But let's come at this with some other strategies, and some other skills. So now you have more tools that will work. And you don't always have to go back to that thing that you don't feel good about and your kid doesn't enjoy experiencing. That Kira Yakubov Ploshansky: 39:07 sounds like one of the main ones is really leaning into that positive reinforcement, trying to catch them do the right thing over and over again. What happens when it doesn't work? Right, like, or it's taking a lot longer for that positive reinforcement to work and they're continuing to do something that's they're struggling with time management or disorganization, right, like how to create a consequence that's not harsh. Jack can help them. Jessica Robb Mazzant: 39:34 Yeah. Well, I think one of the things that's really important for parents to know at the outset is that we might work on one skill at a time, but we're not only ever working on just one skill, praising your kid or using positive reinforcement. If that's the only tool that you're using. You're right, it's not going to be enough. It's a critical skill, but it's not the only skill and So we're gonna work with them on other skills like how to give directions in a way that they're more likely to be understood how to use reward systems for things that are really hard for your kids. And then we're also going to work on consequences, but not consequences that are harsh, or make a kid feel shame, but are consequences that are, there's a phrase that I use a lot, which are natural and logical consequences. So how to use consequences that seem really kind of expected or clear to the kid to teach them, hey, this is the boundary behavior that you're doing not okay. Here's the alternative that we want you to do. And here's why the alternative is better. But yeah, when you break one of those house rules, or when you do something that violates the, you know, autonomy of somebody else, there's gonna be a consequence for that. But the consequences not going to be demeaning. It's going to be natural and logical, and kind of matched to the situation. I hate to use this phrase, but it really fits in this, like, the punishment has to fit the crime. Yeah, I hate crime. Kira Yakubov Ploshansky: 41:18 This is for the adults, right? This is for them to get it to understand exactly. That totally makes sense. And it makes me think about, you know, like, if someone is doing something wrong or struggling, you don't want to continue saving them from it, because then they're not going to learn the consequence. True. Yes, that's a great point. So it's letting them experience that negative consequence, and then feel the natural feelings associated with it. But not you shaming them, and not you screaming at them, as the consequence like that is not the thing that happens because you did something bad? And do you work with any immigrant parents, because this sounds like the hardest thing in the world for them. As an immigrant, Jessica Robb Mazzant: 42:07 I can appreciate that. And, you know, like I said, I am working in the south Florida area. I don't do much direct work with South Florida and clients right now, as I said, I'm doing more kind of training and supervision. But I've done a lot of work in the south Florida community. And yeah, there are a lot of families that have moved to South Florida from other countries, and they bring with them, their expectations, their parenting norms, their cultures, and you have to respect that. You can't come at people with like, Hey, I've got the one way that's going to work and anything different that you do is automatically wrong. No, there, there are beautiful elements of so many cultures. And I think one of the things that we can do is we can say, Okay, here's the skill. How do you make this work in a way that's meaningful for you, for your family, for your community? You don't have to do it like I do it, you have to do it in a way that feels genuine to you. And it's more about applying it than it is like doing it in one kind of exact fashion. Kira Yakubov Ploshansky: 43:16 Sure. So customizing it within that within that family. Their level of positive reinforcement. Yeah, it's gonna look very different than someone else's. Yeah. This has been really eye opening and insightful. Jessica Robb Mazzant: 43:32 Glad to hear that. Thank you. Kira Yakubov Ploshansky: 43:35 Are there any? Any other tips for whether it's parents or kids? Do you feel like you're kind of common that we might not have one over for people who are listening that might be struggling? In this area? Whether it's like at home helping them or outside of school? Jessica Robb Mazzant: 43:52 Oh, gosh, yeah, there's, there's probably so many that it's hard to even identify one. I'm gonna I'm actually say something a little more broad than specific. I think whenever anybody is making a change, so whether this is a kid learning a skill, or it's a parent, trying a new strategy, change his heart. It is not something that comes without commitment, or comes without effort. But one of the things I often ask the families that I work with, is that is the effort worth it for you? Would the change what's going to be the outcome of the change? So don't think about only you know, if I am, if I use praise, I'll stay with that example. Once or twice, is my kid gonna suddenly Listen to me? But ask yourself the question, if I start to notice the good things that my A kid does in a meaningful way, I start to connect with them. And I start to listen to the things that are important to them. And I don't do this just once or twice. But I do it for a couple of weeks. I do it for a couple of months. Heck, I commit to doing it for a year. What impact would that have on your kid? What impact would that have on you? What message are you sending to your family? And depending upon how someone answers those questions, it can really drive home for them, why they're doing this. And then all of a sudden, that's their motivation. And whether we're talking about kids or families, we're talking about any behavior change. I think questions like that are really important to ask yourself, because when we can identify the reason why, and understand the commitment that we're making things click in a way that they they wouldn't if we didn't have that identified. Kira Yakubov Ploshansky: 46:02 Now, I love that you brought that up, because it's so true. I think we might get so lost in the day to day or the nitty gritty or the frustration or like the growing pains of change. And we kind of forget what the purpose is and what we're trying to get to. Like there's this great book called The why things like Simon Sinek it's like, start with why. And it always kind of goes back that's kind of like the anchor of when you might get lost or frustrated or just like, forget why you're doing what you're doing is kind of go back to what is your why. So I really love that. Jessica Robb Mazzant: 46:37 I have not read that book, but I need to pretty impactful. Kira Yakubov Ploshansky: 46:43 Yeah. So Jessica is there how can listeners get in contact with you whether they want to work with you or just have you as a guest because you have so much knowledge and wealth on this topic. Thank you get in touch with you know, Jessica Robb Mazzant: 46:56 I would love if people would get in touch with me that sounds amazing. I love talking about this, this stuff. So you know, I I like I said, I'm an associate teaching professor at FIU. So my email address there is J R O BB. So J rob@fiu.edu. They could they could shoot me an email. If the people listening though our parents are clients themselves. I personally don't see clients through FIU. So even if you contacted me there, I'd say Great to meet you. But I'm going to reroute you to somebody that that can help you. If it's okay, I would like to again mentioned the two organizations that I have worked with, because I think they do such incredible work. So at Florida International University, the same place where I'm a professor, even though I don't, I don't do therapy there directly. There's this amazing center. It's called the Center for Children and Families. And the website is CCF that fiu.edu and DCF does amazing work not only with kids with ADHD, but also just with child and adolescent mental health in general. So they do work with families that have experienced trauma. They do really cool work with kids that are experiencing anxiety, kids that are experiencing depression, ADHD, all kinds of stuff. That's a really, really fantastic organization. The other practice that I mentioned that's in the south Florida area in Coral Gables is called South Florida integrative medicine. And so they have a really user friendly website. They have many psychiatrists, psychiatric nurse practitioners, clinical psychologists, mental health therapists, you know, a lot of just really well informed, great trained people. And so that's a practice that I think is is just fantastic. I am always refer people there. And so I think that would be a really great practice organization to reach out to for for the type of work that I've been mentioning. Kira Yakubov Ploshansky: 49:13 Awesome. Thank you for sharing those resources. We'll definitely add those in the in the show notes. Yeah, for sure. Jessica, thank you so much for being on for sharing all of this information. This has been really incredible. I really appreciate you. You're Jessica Robb Mazzant: 49:26 most welcome. And Kara, thank you so much for having me on. I think you have such a way with words. And so when you reflect what I was saying, I'd be like yeah, what you said. I really appreciate that. I felt like we understood each other and that's lovely. Yeah, you're Kira Yakubov Ploshansky: 49:47 awesome. So if anyone listening really enjoyed this episode, please remember to like, subscribe and share. Otherwise, this is a wrap ### Listen - [Spotify](https://open.spotify.com/episode/14631553) - [Apple Podcasts](https://podcasts.apple.com/podcast/14631553) - [YouTube](https://youtu.be/0QCTO9xpNqQ) --- ## Ayahuasca Healing for PTSD and Trauma Survivors - URL: https://healyourrootspodcast.com/episodes/ayahuasca-healing-ptsd-trauma-survivors - Published: 2024-02-28 - Season 3, Episode 7 - Duration: 52:19 - Category: trauma - Guest: Alex Mayrin ### Summary Alex Mayrin explores the profound impact of Ayahuasca healing on PTSD and trauma, sharing personal transformation stories and therapeutic applications. ### Description In this enlightening episode, Alex Mayrin delves into the profound impact of Ayahuasca healing on PTSD, trauma, and childhood wounds, illustrating the path from personal transformation to aiding others. He recounts his own growth through Ayahuasca ceremonies and how this ancient plant medicine has become a powerful tool for healing trauma and supporting recovery. ### Transcript Alex Mayrin: 0:00 After going through an Ayahuasca ceremony, what's what's happened to your brain is actually created new neural plasticity. And so to create change in your life, and to add things in or take things away, actually becomes easier. You know, we're not in the stuck grooves the way that we were before. Kira Yakubov Ploshansky: 0:21 Welcome back to Heal Your Roots Podcast. On today's episode, we have Alex Miran, plant medicine practitioner and guide. In this episode we explore how Iosco can help heal and treat PTSD, trauma and childhood wounds. If this is something you've been suffering with, and traditional therapy has not helped, you're definitely going to want to listen to today's episode. Please remember to like, subscribe and share. Alex, thank you so much for being on with us today. Alex Mayrin: 0:45 Thank you for having me. Kira Yakubov Ploshansky: 0:48 Absolutely. So Alex, whatever you feel comfortable sharing, but can you tell us a little bit about yourself and how you got into this space? Alex Mayrin: 0:56 Yeah. So, you know, after, you know, in my early 20s, I was in the military struggled with depression, PTSD, anger issues, you know, typical kind of veteran issues. And after years of trying different therapy, different therapists, a group therapy, nothing seemed to quite act like touch, what my issues were, and it wasn't getting to the root of my issues. So I happen to be watching a documentary. And in this documentary, I mentioned ayahuasca, I work with Ayahuasca primarily. And it's something pains, my interests. They had mentioned something along the lines of like veterans, PTSD, Iowa, Casca. And that's all I took away from the documentary. It was shortly thereafter that a friend of mine had mentioned I Alaska to her brother in law, and he was like, Oh, I know, we're, you know, you can do that. And so it was maybe three weeks or so since I watched the documentary, and I found myself, and then I lost the ceremony. So that's how, that's how it all began, I was searching for something that could actually help. And I was willing to do something completely out of the ordinary. I didn't have any friends that had worked with plant medicine. I really had no idea what I was getting into. But I was hopeful that it would work. Kira Yakubov Ploshansky: 2:50 Yeah. And it's tough, because I know that especially with PTSD, right? It's, it's in your nervous system, it's your body, you can't really talk your way out of it. Right, because it's like these instinctual feelings and symptoms that you go through. So I imagine after trying all of these things, and really wanting to feel better, and increase your quality of life, leaning into plant medicine is, I guess, like the next the next thing, and I really believe in plant medicine, too. So it seems like it really worked for you. So I'm glad that's the path that you were able to take. And now you're here helping all these other people with it, too. Alex Mayrin: 3:25 Thank you. Yeah. It really changed my life. That first weekend, it was like a weekend retreat, ended up drinking Ayahuasca three times over the course of a few days. And the biggest thing that happened that weekend was I found hope. So it's not like a magic bullet. You know, it's not it's not a quick fix. But that first retreat really allowed me to see myself in a way that I hadn't in a very long time. Kira Yakubov Ploshansky: 4:09 It sounds really powerful. Yeah, it was Alex Mayrin: 4:11 Yeah. And and just feeling into that now. It still gets me a little choked up, you know. It's life changing. Kira Yakubov Ploshansky: 4:25 I appreciate you sharing that because I know it's, it's personal and it's vulnerable. So thank you for being open to share that with me. So how did what was kind of the journey between you doing it for yourself to find it to find that healing to then now helping other people through this process? Alex Mayrin: 4:43 It was a long journey. Yeah, initially, I I would just, I would go drink Ayahuasca I started incorporating yoga and meditation and breath work outside of the ceremonies and And, you know, my life just started to shift and change, I've gone out drink Ayahuasca, then there'd be a period of time where I wouldn't, and so on and so forth. And, and as it just continued to unfold, eventually I started coming to ceremonies and I would help out, you know, I'd walk people to bathrooms, you know, change out buckets, things of that nature. And over time, like, I started working with a lot of other veterans. And eventually, that led me to go into Peru for the first time. And, you know, I've been drinking Ayahuasca sometimes I'd be helping others, so on and so forth. But eventually, I found my way to Peru. And I did what's called a master plant deatta, which is a form of isolation and a little hot. With no distractions, nothing to do, you can, you can journal you can sing, you can play music if you play an instrument. But basically, you're sitting in a hut with nothing to do a very strict food diet. where there isn't salts, oils, spices, very bland food. And then every other day you drink Ayahuasca, you leave your your hot, it's called a Tambo, and you go to a maloca. And in, there's a ceremony, the Ayahuasca ceremony, and you know, go through the ceremony, the next morning, you go back to your hut. And on the days where you're not drinking Ayahuasca, you're actually drinking the tea of a different plants. And these different plants work on different, you know, different things physically, energetically. And so one day is I lost that one day as the other plant. It was through this first data, that you know, I gone to the jungle, and I was a carpenter. Yeah, builder different things. And during the course of this deatta It was absolutely the most terrifying, difficult thing I've ever experienced in my life. But what it was, is it was working on humbling myself. And I was like, it was so difficult. And, and it was just humbling, it was the most humbling experience with my life is 10 day data. And at the end of the data, I was going to an Ayahuasca ceremony. And I was getting these visuals of, of what, what to do when I left, you know, in the ceremony, I felt completely humbled, completely humbled heart, and I felt relief, like I couldn't. I couldn't surrender my suffering, my suffering was still there. I could accept my suffering, but it was still there. And so all that was left was to let it humble you. And it was after this humbling experience in this journey. I started to get visuals, like this actual vision of what to do. When I left through, I saw myself teaching a yoga class, I'm a yoga teacher at this point. I was like, alright, I'll teach the class. And then it showed me teaching breathwork I was like, alright, teach breathwork. And then, and then I saw myself actually serving Iowa. And I was just like, okay, like, I'll do it. And, you know, I'll kind of fast forward. Upon returning home, I reached out to all of my clients that I had construction projects for, let them know that I was getting out of the business. And I started working with an attorney to set up a church, I figured out how to import the raw materials. And I just, I just began, I started serving Ayahuasca to people that I knew, you know, small groups, one person here, two people there, and it just started to grow. Word of mouth spread, ended up meeting more people and the group started to just build, you know, the group sizes. And I'm coming up on two years of doing that now, on my own, so it's been a beautiful journey. I left Got a lot of details to keep. But yeah, that's that's the journey that began with just needing support, and then coming back and starting to support people, and then eventually stepping out fully on my own. Kira Yakubov Ploshansky: 10:20 That's incredible. That's really proud, powerful story. And I feel like that happens a lot with healers, or therapists, or any kind of practitioner that is in service to help other people is that we're kind of looking for something for ourselves in the beginning. And we find something that helps or transforms us along the way. And then we want to share that. And it sounds like you started to build a community, like you met this community of people who were doing the same thing. And then now you built your own, which is awesome. That's really powerful. Alex Mayrin: 10:51 That's been an incredible ride. Very honored to be able to be doing this work. Kira Yakubov Ploshansky: 10:59 Yeah, it's deep work. It's, it sounds very deep and transformation on a lot of people, I'm sure are very vulnerable and raw and open around you. So it takes a lot of trust, I'm sure. In you in the, in the ceremony and the process to you know, allow someone to open themselves up like that. Alex Mayrin: 11:19 Yeah, it's, you know, it all begins with a phone call it also whether somebody you know, through word of mouth, you know, hears about me or Tikun, which is a center that I helped open up with a couple of partners and my wife. And it starts with a phone call. And you know, I'm not, I'm not on a phone call to interview anybody, I really just touch base with them and to make that first connection. And so I would say usually, when people come to Iosco, it's, it's at the point in their life, where they're willing to step outside of what we view as like traditional mental health. So there's something there, you know, so it's picking up the phone and calling somebody that they've never met, that can be very intimidating and vulnerable. So that kind of vulnerability piece begins at that first, that first connection. And, yeah, it's really, really quite special. Then Then I meet them for the first time as they show up for like a weekend retreat. And, and being able to witness this, this process of the moment, I talked to them, the moment they show up, you know, to the first ceremony the than the day after, and there's yoga and there's breath work, and then another ceremony. And by the time they leave, it's it's like the lights are back in their eyes, it's like this haze, this kind of gray haze has been cleared, and they're bright, and their hearts is full, and they're open and sharing and feeling deeply. And it's really just a beautiful, beautiful experience, to be able to witness that process and others, and to be able to hold a container for that type of healing to occur. Kira Yakubov Ploshansky: 13:25 That is really beautiful. And so for a lot of people who have either never heard of Ayahuasca or maybe I've just heard of it, can you kind of share what it is? So they have an idea for listeners we've been talking about, I think they're kind of getting an idea. It's plant medicine, you take it, all of this wild stuff happens. But if you can share a little bit more detail about what it is and kind of what a ceremony looks like, Alex Mayrin: 13:48 yeah, I can do that. So what it is it's a psychedelic but it's not like it's not like acid or mushrooms. It can have similarities, but it's, it's brewed into a tea. It's made from two plants, the Ayahuasca vine and the leaves of the chop Runa. Bush and is brewed into a tea can take anywhere from 26 to 30 hours to brew a batch. So as it's dark colors, it's kind of thick, you know? It's very earthy flavored. Anyway, you drink the tea at the beginning of the ceremony, and, you know, anywhere from like 30 minutes to an hour can go by, depending on somebody's sensitivity level. They'll start to feel sensations in their body. They might start to feel tingling. They might start to get visuals. They might feel nauseous emotions might you know the feeling tone of emotion might start bubbling up in their body already, and, you know, the ceremony was typically, you know, around five hours. Now it could be eight, it could be three, every but everybody's body is going to metabolize differently. And it also depends on how many cups you drink, you know, so if you just take the first cup at the beginning, and you're deep in it, and you don't want any more, it's probably going to err on the side of four hours, you know, if you take a second cup, you know, partway through or a third cup, obviously, can be extended. So you know what happens? It's different for everybody. But what typically happens is people will move through emotions, they'll move through fears, anxieties, they'll start to process and gain clarity on their life. on a physical level, a lot of people purge. That's a very common one purging in the form of either vomiting or needing to use a bathroom. But the purge can also be crying, sweating, kind of shaking, like almost vibrating. Yawn. This is just like its energy leaving the body. Now, I'm sure a lot of the listeners have read or heard about the book, The Body Keeps the Score, right. And so like, how does trauma affect the body? And how is it stored? Well, Iosco can go in and start to shake that energy up to to allow it to move. So that's the perch. They may be going through a mental process of something, childhood, or something like that, and then all sudden, they might start to feel nauseous. And so the mental process with the nausea, it's allowing this energy of this traumatic childhood event actually, often leaves the body as they're processing it mentally. And feeling it as processing. Kira Yakubov Ploshansky: 17:23 Wow. So it's like literally dislodging where it's stuck energetically and physically in your nervous system. And I mean, with trauma, right? Like, everything is disconnected. And it sounds like this connects everything, shakes it up, moves it and then releases in whatever way your body sees that it needs to be released. It Alex Mayrin: 17:45 can be that way. Yes. It's not always as just, you know. But oftentimes, yes, it's, it's showing up as a form of a purge or something like that, for some people, they may never actually vomit. Lucky depends on how you view that, but sure. But either way, you'll go through a mental emotional process of, you know, whatever is inside of you, whether it be in your subconscious mind, or trauma that's stored in your body. Yeah, there's a, there's a process that you go through, over the course of this, let's just say four to six hours. And, you know, during the process, it's not always painful, you know, maybe towards the end, you'll start to feel, you know, these emotions, like gratitude, and love and compassion for yourself, and gentleness towards yourself. And, you know, those those types of feelings are hard to feel in our body when there's so much other stuff happening. And so, when you've gone through this process of like, moving these things that are no longer needed, or, or they're just stored there, that allows you to actually feel more yourself than before. So as we move through life, we're just kind of like storing things in our subconscious storing things in our body. And this process of like, kind of peeling all these layers back, you can get back to the like, the root of like, who you are, like before the world told you who you are. Kira Yakubov Ploshansky: 19:46 So imagine you walk in one way and come out a very different experience. And I don't know if it's person because you're saying this is all of these layers being placed and other being taken off, but it sounds like an actual weight lift Get off of you like mentally, emotionally, energetically, physically, right? Like, on all these different layers is just released off of you. And I'm sure there's this feeling of lightness is what it sounds like, Alex Mayrin: 20:11 yeah. So a person can be really physically exhausted at the end of the weekend, or at the end of a retreat. But there's the overall feeling of like uplifted pneus, and lightness and clarity. Now, the thing about it is like, there's always going to be more, right. So after one weekend, you might, you might have just scratched the surface, you know, you may have just found hope, you know, you might have found hope, or compassion or gratitude. But everyone has their own journey. So, yes, you feel incredibly light. But it's not going it's not the cure. All right, so then it comes integration, and comes allowing the pieces to settle and really nourishing your nervous system, because it can be a lot, it can be a lot to move through all of that in one weekend. And, and so to find this place of like steadiness after, it's really like finding a new way of being. And, and that takes time and integration, you know, finding a therapist, or a coach or a guide, or somebody that understands trauma, trauma, sensitive trauma, mindfulness. But working with somebody that can actually help you integrate, what it was you just went through, to make lasting changes, because we can go through an experience like this, but then we're going back home, we're going back home to the same things that were there when we left, so you've changed, but your life didn't change overnight. And so it's, it's taking maybe what we've learned over the weekend, or retreat or ceremony, whatever it is, and applying small changes to our life, you know, maybe adding in different practices, maybe if you didn't have a meditation practice, maybe trying that. If you haven't spent time in nature, maybe trying that, you know, so integration can look different for everybody, you know, somebody with a type A personality, if you give them a list of things to do, after their treat, you're like, Alright, now do this, this, this, and this, they're taking notes, and they're like, Alright, I'm gonna get it, I'm gonna do you know, and so maybe that's actually the mechanisms that they went there to work on. And so if you give them this list, now, it's like they're back in this overcomer, like this, I'm going to overcome myself, by doing this thing, when really what maybe they needed to learn was how to be gentle with themselves. And so it's like somebody like that with a type A personality. That's a real go getter, like that served them probably pretty well in life, you know, as far as jobs and having their life put together, but internally, like they're not okay. And so to actually learn how to then be gentle with yourself, is going to be far more important than like, giving them a list of things to like, go and do, you know, to make it last. If that makes sense how I worded that. Absolutely. Kira Yakubov Ploshansky: 23:47 Yeah. So it just depends on every person, right? It's it's customized, it's cater to the individual makes sense for them. Alex Mayrin: 23:55 It's different for everyone. Kira Yakubov Ploshansky: 23:58 Yeah, I have a question. So you mentioned when you went to Peru, there was this type of ceremony where you were kind of isolated and then in the ceremony with a group over a course of time, and then I'm hearing you say, there's weekends, and there's retreats, can you share or elaborate a little bit about the difference of if someone's just doing it for one, like one sitting right, like the 48 hours versus a couple of days in a row? Like how would someone make that decision? Based on that? Alex Mayrin: 24:26 I like to suggest people doing like a weekend retreat, you know, because, you know, in that context in that container, they can actually have support, you know, they can maybe try yoga for the first time or meditation or breath work. And so the whole container like a Friday to Sunday, you know, is going to have two ceremonies the first one it can be especially if you're a first timer. You know, you've never worked with Ayahuasca before. The first time to kind of be like what, like what's even happening? You know, you're getting to, you're kind of just getting your bearings about it. Yeah, it could, it could be really deep, really deep experience. But then it's like, you've never done anything like this before. And the next morning, you just up and leave, there isn't a lot of time for the experience to continue to unfold. So then, you know, if that first ceremony is Friday night, and you wake up Saturday morning, you're chatting with all of these other people that have their experiences, and you're all opening up. And you feel this deep sense of connection with people, because you all just went through this. Yeah, and, you know, you might open the day with, like a mindful yoga mat, or meditation or something like that, followed by breakfast, and continued sharing, and maybe a structured sharing group, where each person actually gets the opportunity to share as much or as little, you know, as they feel comfortable sharing. And so it's like, all of these layers just keep getting peeled back, and like tapping into the vulnerability of, of like connection and feeling like this deep intimacy, right with other people, and is, it continues to unfold, and all the layers keep getting peeled back, and then maybe Saturday afternoon, you do a breath work, which is going to keep peeling back these layers, and maybe some downtime in the afternoon, leading up to Saturday evening ceremony. So now you've, you've just gone through, like 24 hours of not just an Ayahuasca ceremony, but deep connection with other people, you know, you've, you've experienced yoga, you've, you've done breath work, and now you're just like, old, you know, and that you're about to drink Ayahuasca again. And so the depth that you'll go is going to be completely different than that first time Unknown: 27:19 first. Alex Mayrin: 27:20 So I do believe, for people looking for Iosco, or looking into it, one ceremony is gonna be better than not, right. So for some people, they can't, they can't commit to a full weekend or a full retreat. And so it's still better to come to a ceremony, you know, have a conversation the next morning, you know, give a little bit of tools and practices that they can take home with themselves. That's still gonna be better than not doing it at all. In my open. Yeah, other people may challenge me on that, and that's fine. So, yes, sometimes we will do just like a single night ceremony or a single ceremony during the day. And, you know, at the end of it, you know, people can go, but the multiple days allows for this container to stretch, which I think is really important for people. We live such busy lives, and you talk to many people, and you start to realize that like everyone's walking around on fields, their nervous systems are shot, you know, the stress to the max, we got bills, kids are getting jobs we've got, you know, so much going on, then we never actually, like slowed down and see what's happening. We're just piling it all on. And so in a weekend, it allows you to, like, shed some of that, you know, unplugged from your, your day to day life, and really focus on you. And I think that's what a lot of people lack in our society is spending time on themselves in the inner work arena. And so the weekend retreat really allows for people to, like really open up and sat down with their care. Kira Yakubov Ploshansky: 29:39 So it sounds like stages, right? I love that. So it's like, the first day is like, you don't even know what the hell's gonna happen. Right? Like, who knows what's gonna come up for you? And then everyone's in this open space and you're primed. And you're building off of that and continuing kind of optimizing on this like energy and openness. And then next night, it's like alright, let's go to the Next level, like a little bit deeper, and you kind of know what to expect at least a little bit like what you might experience or feel or see. And now you're, you know, you've connected with some of these people around you. So there's this little bit layer of feeling more comfortable and safe. And then you go deeper, right, because I'm sure there's some resistance at first, with anything, right? Even if we want to try something to help, there's naturally going to be resistance in the beginning. Once you've cracked through that first layer, it's like a little bit more open, or you're even saying like surrendering and being more humble, to this next stage of clarity or healing. Sounds awesome. Alex Mayrin: 30:39 It really, it's incredible. It's really incredible. I will say that people are typically more nervous the second night, because they've, they've talked to it's true, oh, this, we're actually going somewhere deep within ourselves. But they, but they've been doing the work throughout the day, and you kind of build this, we're all we're all in this together, you know. And so even though you may be more nervous about the experience itself, you do feel more comfortable with the people you're with, you know, you've built a little bit more trust with the facilitators. And, and so even though you may be more nervous about the experience, you ultimately feel more trust in the process. So it's, you know, as you're learning these kind of learning how to surrender learning the art of surrender, what does that even mean? You know, it's like, you can go, I'm gonna surrender. And it's like, that right there, you don't like you don't go accomplish surrender, like, you can't foresee. Yeah, so like, really starting to learn what surrender is. And then it allows you to accept some of the things right, you start to accept it, he starts to become humbled by life, he starts to feel gratitude for life, you know, it's all of these stages. Trust, learning to trust yourself, again, trusting other people, and there's so many layers to this work, and it's all happening. Like, in real time for people. Wow. Kira Yakubov Ploshansky: 32:30 Sounds very, very intense. I mean, this is what's kind of what you know, people are signing up for right is that if all these other treatment methods haven't worked, that take a lot of time. And there's a lot of suffering along the way. And there's incremental, I guess, progress. This is like, all at once, right? It's whole body, whole spirit, energy, mind everything. And you're like really being engulfed in this. Like, it sounds terrifying. And also, very freeing and liberating. And it's like, you know, the human condition is always like this contradictory experience. So it makes sense why it would be like kind of on both ends of the spectrum. Yeah. Alex Mayrin: 33:16 It's, you know, I go back to like, my own personal journey with it. Traditional therapy, you know, like, nothing was actually getting to the roots of what it was, you know, I thought my life was messed up because I was in the military. Well, it turns out these these beliefs that I had about myself that were stored in my subconscious, those came into play when I was a child, the military, and my life just made those things bigger. And so we can actually start to see ourselves through who we really are, right. So, you know, it was my experience with traditional therapy, you know, throughout my 20s. Like, most of the conversation was just trying to figure out what the issues were, like, it took all of this like digging to even like, find out what was happening. So you could address it. Oh, Oska, it's going to just bring you there. So now and address it. Now you can feel what it is you need to feel you can process the things that you weren't able to process. And then when you couple that in with therapy, you couple that in with spending more time in nature, meditation, prayer, whatever your practices are. The healing and growth occurs at such a deep level that your life begins to change rather drastically. Ah, quickly. So yeah. Kira Yakubov Ploshansky: 35:08 There's like a part of me that really wants to do it. The other part is like terrified Alex Mayrin: 35:15 that, yeah, you're seeing yourself and, and that's scary to people to see yourself and feel, maybe we live our lives like in resistance to feeling pain or suffering, that we tried to distract ourselves and tell the suffering can become so heavy, that maybe people turn to whatever their coping mechanism is drugs, alcohol, sex, you name it, like food work, like all of that. Eventually, if you get to the point where you can't outrun it anymore, it's there. And now you actually have to feel through it. And process what, what's causing it, that doesn't mean you're going to relive a traumatic event necessarily, but the feelings of, you know, not being safe in your body or, you know, whatever it is, you're going to move through the feelings. And and it has scary to people, like, my whole life trying to this wife died is dealing adequately nom, it's like. So yeah, let's peel back the layers, see what's going on, feel what needs to be felt, and come back to your heart. You know, huh. Kira Yakubov Ploshansky: 36:51 Sounds really powerful. And so I know, you mentioned a lot about integrating afterwards, right? Like this event is like, it gets you right there. You're feeling it, you're observing, you're healing, and then you return back, right? And like, that's kind of even in therapy, right? Like when you work on yourself, and you go back to the place that either conditioned you to believe certain things, or you're doing certain things that are continuing to harm you. How do you help people create some of those practices? Or integrate that a little bit more? If you are the coach that they want to continue seeing? Alex Mayrin: 37:31 Integration is such a loaded question, you can ask many different people, you know, what is integration? And you know, what are integration tools, and you'll hear many different things, you know, and so depending on the individual they get, it really depends, like, what they move through what they're working on. But the question is, like, how to support someone, my go to is like, start a daily practice, whatever that is, whether that's meditation, or yoga, or walking in nature, like do something every day, at least try, you know, if it doesn't work out everyday, at least try to implement it a little bit throughout the week, you know, after after going through an Ayahuasca ceremony, what's what's happened to your brain is actually created new neural plasticity. And so to create change in your life, and to add things in or take things away, actually becomes easier, you know, we're not in the stock grooves the way that we were before. So it's the perfect opportunity to implement little things, whether it's, you know, five minutes or 10 minute meditation, or spending more time in nature, or, or doing something that like fills your cup, you know, whatever that is, I will go back to it and say that, like, I believe, personally, the best thing that people can do is really to learn how to be gentle with themselves. Oftentimes, we grew up and adults weren't gentle with us, you know, we've all heard stories, you know, children are to be seen, not heard, you know, like, all of the stories. And, and so, you know, we're being rushed around, you know, parents have schedules, you know, and it's like, a child isn't like, in time, like adults are right there just in play time. And so when you're rushing them around, it's like, they start to get anxious, you know, whatever it is. So, parents, I'm a parent myself, and I've caught myself not being gentle with my children. Like, come on, hurry up. We gotta get going to school. Right and And so like, when we can learn how to reparent ourselves, and be gentle with ourselves the way that, you know, we would have liked our parents to be, like, I think that's one of the highest forms of love that you can have is like, Just be gentle with yourself. Know people go, what does that look like? Kira Yakubov Ploshansky: 40:22 It's about to ask you if you can share an example. Alex Mayrin: 40:26 So this is where, you know, you're kind of plugging in some of the skills that you've learned with Ayahuasca, surrender, acceptance, you know, maybe if you're really hurried, and you're really anxious, like to stop, and like, take some deep breaths, like, and feel like, you're allowed to feel, right. So oftentimes, as a parent, I can speak from my own experience, right? Like, I lay on the strict layer for time, for whatever reason, I'm not gonna go, you know, but it probably because I wasn't chatting, being gentle as a child when it was time to get somewhere. So yeah, when I'm getting close to the time, I'm supposed to get somewhere, like, I started to get a little anxious. Not so much now, but like I'm talking about years ago, like how I'd be anxious. And I wouldn't even understand that I was a anxious, you know, my wife would be like, rushing me, it's like, I'm not it's like, but your energy is, is because you're rushing yourself. So if you're feeling rushed, how can you be gentle with yourself, by allowing yourself to feel the anxiety, but actually slow down, like, nothing bad is going to happen, you're still going to be out the door, you're still going to get to where you're going, who cares? You might be a couple minutes late or right on time, but being gentle with yourself and actually start to rewrite the story. And soften that anxiety around, oh, my gosh, it's getting close to the time I need to be gone. And so you can actually start to change the narrative in in yourself. So now, as you as you get ready to go somewhere, now you're not feeling the anxiousness you used to have, and it's through being able to slow down, feel was present, take some deep breaths, and relax yourself. Right? So you understand the nervous system that anxiousness is like fight flight freeze? Well, how can we actually be gentle with ourselves was to shift over into relaxation? How can we do that through our breath, like softening your body and breathing and just connect with that, you know, may, you know, 30 seconds like that 30 seconds is going to make you late. So learning how to be jet. And that's just one example. Learning how to employ these little micro practices, like that deep breath in, soften shoulders, soften your body, breathe. That's a little what I call micro practices. 32nd little thing that can help shift us from fight flight freeze, to relaxation, and rest. And so that is, as the adult sitting here. The anxiousness is my belief, the inner child that's anxious, like, you know, because it was rushed. So as the adult, I can, I can sit down with myself, which includes my inner child, and I can breathe. So it's like holding space for myself. Does that make sense? If I worded that, Kira Yakubov Ploshansky: 44:06 yeah, yeah, absolutely. And so that's Alex Mayrin: 44:09 how you can learn how to be gentle with yourself. Just one piece. There's many tools, many micro practices, many examples but that's one. Kira Yakubov Ploshansky: 44:22 As you were saying that it's really funny. That was like my whole life was just like being rushed. And I can feel the anxiety thinking about like, I'm perpetually leaks of like time blindness and thinking about like, my dad and my mom rushing around just the when you said the energy right? Sometimes you're not even saying like, hey, we have to go, but the energy is so felt like, just frantic or scattered or just like feeling like someone's hovering over you. And just allowing yourself to be like, nothing bad's gonna happen. And shifting right. It's interesting you say these micro practices, because it's not like this one. huge thing that you have to do every day, even though you said, you know, some practices to do each day. But shifting away from constantly being stuck in this fight or flight, or freeze mode, right, because then that's when our body starts to tense up. And that's when things start to get stuck. So it's like constantly releasing these little bits of stress throughout the day allows us to be more open and present. Alex Mayrin: 45:23 Yeah, I, micro practices are game changes, you know, like when you when you become aware that like, Oh, I'm doing it again, I'm rushing myself, I'm rushing my children, I can scroll down, I can breathe, I can, you know, employ this little 30 seconds, or one minute or two minute, whatever it is. You know, if if you're struggling with maybe social anxiety, you know, when you show up somewhere, you maybe you're feeling anxious, but how can you actually ground yourself in that space? Well, you can sit there, you can take some deep breaths, you can look around, you can take in, you can tap into your senses, your sight, smell, taste, touch, you know, you can, you can tap into all of that, and feel your body sitting in the chair, and allows you to relax into the space, which can help with social anxiety. So there's, depending on what it is you're working on, you can employ these little micro practices throughout your whole day. And that's going to shift you from flight, fight flight freeze, through relaxation, dysregulated nervous system to regulating regulating, Kira Yakubov Ploshansky: 46:47 and then that's a lot of grounding techniques Alex Mayrin: 46:49 that creates spaciousness in so after an Iowa Moscow weekend or ceremony, you know, you've moved energy you mentally process you've, you've felt emotions that maybe have been suppressed, another spaciousness in you. Right. So, meaning you feel lighter, you feel clearer? Well, if you don't make any changes, all the things that went out are just gonna come right back in. And so that's where, well, micro practices, you can continue regulating your nervous system, really nourishing your nervous system, by giving it the rest and relaxation it needs. You know, the meditation, you know, meditation is like opening, the, I like to think of our subconscious mind is kind of like a junk drawer in your kitchen. Or like you're moving through your whole day, and you're just opening it up and you're just throwing stuff in there. You know, meditation, as you're sitting down, you're opening up the junk drawer, taking a little bit of things out, you're organizing a little bit, closing it, right. And so if you can use micro practices to really nourish your nervous system, and regulate system, and then you're doing something for your subconscious mind through like meditation, like, to me, those are like, the most powerful tools that a person can walk away with. But that may not be true to everyone. Yeah, that's what worked for me. And so obviously, if it works for me, that's probably what I'm going to share with someone else. Sure. Kira Yakubov Ploshansky: 48:38 So that makes sense. I really appreciate this. This has been such insightful information and powerful and you sharing your story. Can you share with people how they can get in touch with you or with cocoon to work with you? Or, you know, learn more about ceremonies or Ayahuasca? Alex Mayrin: 48:57 Yeah, so you know, they can visit our website, which is T cool, healing center.org. And then you can I mean, if I tell people not to, like, try to like Google watch, like all these, because it can, it can lead a person to maybe freak themself out. Yeah, but there, there is good information out there. You just have to be willing to read through some things that might sound sketchy. People share stories, and you're gonna hear a lot of projection. So the projection being this after my first weekend of drinking Ayahuasca years ago, I was sitting there like, Oh my God, there is no way my wife could do this. That'd be way too intense, right? That'd be way too much. Well, Uh, each person is different. Yes, she's not going to get the intensity that I had, because we live two very different lives. So one thing that I would suggest to any listeners right now would be, understand that their stories may sound really, really intense, and that might make you friend. Your life is not their life, you may not need that this medicine is going to bring you to your growing edge, it's not going to push you beyond your capacity. And what I mean by like that, what I mean by that is, it's not going to be a traumatic event, whereas, you know, you're actually coming to heal traumatic events or trauma, or wounds, you know, whatever it is. You're not going to leave traumatized by Ayahuasca. But when you read these stories, you might go, Yeah, I can't do that. Just understand that as their story, not yours. But yes, they can find my healing center, Tikun healing center.org. Kira Yakubov Ploshansky: 51:17 Yeah, that was such a great tip. I'm glad you mentioned that the differentiation that you're gonna go there to heal, the experience will not cause trauma within itself and might be intense or a lot or scary. But the point is that it's not going to traumatize you for so for listeners, it's okay to be scared, but also know that everyone's journey and experience will be different. So that's good to know. Awesome. Alex, thank you so much for being on today. I really appreciate your time and your insight and knowledge. This has been an awesome episode. I can't wait for this to air. Alex Mayrin: 51:54 Thank you for having me. It's been fun. Kira Yakubov Ploshansky: 51:59 So if you've enjoyed this episode, please like, share and subscribe, so we can send the message out there. Thank you so much. Thank you. Yay. That was awesome. I'm like, All right. I think I might do it one day. ### Listen - [Spotify](https://open.spotify.com/episode/14577351) - [Apple Podcasts](https://podcasts.apple.com/podcast/14577351) - [YouTube](https://youtu.be/AmG6IQQskIU?si=bpYS41UNL5YSFhEX) --- ## People Pleasing Origins: Unraveling Childhood and Cultural Influences - URL: https://healyourrootspodcast.com/episodes/people-pleasing-origins-childhood-cultural-influences - Published: 2024-02-14 - Season 3, Episode 6 - Duration: 45:27 - Category: relationships - Guest: Gabrielle Larin ### Summary Kira Yakubov Ploshansky and Gabrielle Larin explore the origins of people-pleasing behaviors, examining childhood and cultural influences on relationship patterns. ### Description In this insightful episode of the Heal Your Roots Podcast, Kira Yakubov Ploshansky is joined by Gabrielle Larin, LMFT, to explore the deep roots of people-pleasing behaviors. Together, they unravel how childhood experiences and cultural influences shape our tendency to prioritize others' needs over our own, and discuss pathways to healthier relationship patterns. ### Transcript Kira Yakubov Ploshansky: 0:00 Welcome back to Heal Your Roots Podcast. Today's guest is Gabrielle Larin Licensed Marriage and Family Therapist and a therapist at Heal Your Roots Wellness. She shares her insights and approaches to helping people work through people pleasing tendencies, you're definitely going to want to hear today's episode. Welcome back to another episode of Heal Your Roots Podcast. I'm excited to have our guests she's back with us Gabrielle Larin. Gaby is a therapist at Heal Your Roots Wellness. Gaby, thank you so much for joining us again today. Thank you for having me. I'm excited to be here. Absolutely. So even though we had you on before, and you shared a lot more about your background, for first time listeners, can you share a little bit about yourself and who you work with? Sure. So I am a licensed marriage and family therapist and I work with individuals. Gabrielle Larin: 1:15 And right now I am specializing with depression, anxiety, and I love working with self esteem. Kira Yakubov Ploshansky: 1:26 Awesome. I know you have especially right now, a lot of young adults, struggling with self esteem people pleasing tendencies. I, for the first time listeners, you're also Hispanic. So you have a lot of clients who also can relate to that as well if they're coming from a similar culture and background. So Gabby definitely has some limited openings. If anyone who hears after this episode was like, I have to work with her, you can reach out to us. But yeah, so I thought maybe we can kind of dive into the self esteem parks. I know, once we you know, we talk pretty frequently about you know, client cases and who you're seeing, and there's been a lot of themes coming up around people pleasing. So if you want to share a little bit about how that's been presenting, and how you work with that. Gabrielle Larin: 2:13 Sure. So in terms of people pleasing, I have noticed that a lot of times people will let other people their opinions or their emotions, or they don't want to upset other people ahead of themselves. So they are more likely to think of pleasing someone else over themselves, they will sacrifice their own emotions over somebody else's. Kira Yakubov Ploshansky: 2:47 Yeah. And so for listeners out there, I am a recovering people pleaser. Still working through this. So this definitely hits home. But thinking about how you share like people pleasing for those who are listening is really just prioritizing other people and what they want, how they feel what they're looking for over our own needs, right. And maybe we can talk a little bit about how we think this develops in people, right? Because there's a lot of overlap between different personality types are traits and how we grew up and the way our family kind of raised us in the culture around that to develop these people pleasing tendencies. Have you noticed any themes with your clients, or just people in general that present this way that have similarities from when they were growing up? Gabrielle Larin: 3:37 Yeah, I've seen a lot of environmental, so a lot of upbringing and how people were raised in the family. So a lot of times, it will be, you know, wanting to be that golden child, and wanting to make sure that they make the parents proud. Or it could be making sure that they're not failing their parents, because those are two different things. You want to make someone proud or you don't want to fail. And I've seen also a lot of sibling rivalry. That's a big one as well. A lot of competition in that, and I can definitely see a lot of upbringing issues. Kira Yakubov Ploshansky: 4:28 For sure. And I know, this wall this presents across all genders, right? I do see this a little bit more normalized, I think for girls or females, kind of thinking about like, the societal expectations, especially when we're growing up is like, Be polite. Be nice. Don't make anybody else around you feel uncomfortable. Be considerate, be agreeable, right? Like we hear these messages enough. While we're growing up that it's like okay, everyone else is free. feelings are really important. I can manage my own weight or they're not as important or I can put them last right? I have to make everyone else around me feel comfortable, because otherwise it's rude. Or it's inconsiderate. So I find that that comes up a lot with with women too. Gabrielle Larin: 5:16 That's it's interesting that you say that because it's almost like men are supposed to be physically strong. And women are supposed to be emotionally strong. So they can handle things they can deal with difficult emotions. So it's almost like there's there's a saying in Spanish. You look prettier with your mouth closed. So yeah, so basically just don't say anything. And, you know, just be pretty impolite. And you know, just let whatever happened and not fight back or not be assertive or dominate a conversation. Kira Yakubov Ploshansky: 5:57 Yeah. Wow. How would you say that in Spanish? I'm just curious. Gabrielle Larin: 6:02 I'm database my Juanita Comilla. Walk back at ya. Kira Yakubov Ploshansky: 6:09 prettier with your mouth shut. So messed up. But I felt like that message comes across, right? Like, your role should just be this look nice, look pretty be presentable and agreeable, and don't stir the pot don't create conflict. Right? Like being angry showing that aggression or assertiveness is not a good look, or that's not what you're supposed to do. Right? Hmm. And so I know a lot within my culture as well, Eastern European is that, you know, you do put everybody first and the woman is supposed to put their feelings last. And I'm also thinking about when you're saying like, with your parents, right, like this golden child or not wanting to fail, but also thinking about how everyone else presented in the house, right? Like, especially if you had parents who were easily emotionally triggered, or had anger issues or a temper, right? Like, you kind of like read the temperature of the room? Or at least I did growing up, right? Like, you would read the temperature of the room and you would like based off of how everyone else feels, would know like, okay, maybe I shouldn't talk this time. Or maybe I should be nice or maybe, right, like as a reaction versus just being who you are and everyone else dealing with their own stuff. So I think a lot of people pleasers also develop this ability to read other people's emotions and then respond to it. Gabrielle Larin: 7:37 Yes, and I also have noticed speaking on that, that children, I would say and, you know, our generation, children have been more focused on making sure that the parents emotions are okay, kind of like checking in, like, oh, like Mommy doesn't like that you're making mommy sad. And then just like oil, or make mommy sad. So I have to regulate my own emotions before hers, you know, like, I have to help her be okay. So I have to make sure that I'm okay in order to help her. And, you know, it shouldn't be the opposite, where the parents are supposed to be the ones regulating their own emotions so that they can help a child. Kira Yakubov Ploshansky: 8:23 Yeah, so while this is not to bash parents, right, especially from older generations, you know, everyone is just trying to do their best based off of what they have been handed down and what they're capable of. Right. They act that way because their parents, but I think that now that we're a lot more aware of how our behavior and emotions impact each other, or I think our generation is a little bit more self aware and understands this and is more willing to work with emotions and acknowledge that they exist. Right? Like, I can't imagine how many times I've told my parents, they may have anxiety, like, that's not a real thing, like, okay, but you're exhibiting all the symptoms, but cool, okay. That we, as kids, we take on the responsibility of making sure our parents and our siblings feel okay, I think that's like the early, the early onset of like learning these tendencies. And now we go through adolescence, and now we're adults. And now we're in relationships with people where we sacrifice so much of what we want. And we're just doing things for other people that don't really align with who we are or morals or our values. And now we're just like in really unsatisfactory relationships. Gabrielle Larin: 9:39 Right? And I think it's tough when it's kind of like you're digging your own hole. And then once you're in it, you're like, oh, wait, I have to get out of this. Because I'm realizing I'm not happy with where I'm at. I'm not happy with my relationship. I'm not happy with putting myself on the backburner. I want to put myself first and then because you've been in this pattern for so long, so much. more difficult to get yourself out of that pattern and to build a new pattern of putting yourself first. And it's it's difficult to know not only how to do that, but how to start and how to begin those steps in building that positive pattern. And Kira Yakubov Ploshansky: 10:20 I find that I have a lot of clients who, when they come in, like they want to do that, right, like, I want to be more assertive, I want to do things that I want to do, I want to be able to say no. And then as soon as we start practicing, like, nevermind, I don't like it. I thought I could do this without upsetting everybody. Like, oh, that's kind of the point is that you're not going to be able to continue pleasing everybody. Because what you want is going to be different than what someone else wants. Because that's kind of just how it goes, we're not all the same. We don't always want the same things and you're going to inconvenience somebody or something might be considered inconsiderate, but you're really just putting yourself first, right? Gabrielle Larin: 10:57 And there's a difference between making yourself feel uncomfortable for doing what is right for yourself. And I feel like, a lot of times people think that, Oh, if it makes me feel uncomfortable, it must not be right for me to do that. But you have to step out of your comfort zone, if you are so used to doing something that isn't right for you for so it's almost like your body is comfortable there, your body is comfortable doing things that are not right for you, it feels good. Because you know the outcome, you know what it's going to feel like, and unknown is so scary. So we don't want to make those changes, even if we know that it's going to have a positive outcome for us. So pretty scary to make those changes, even if we know that they're good for us. Yeah. Kira Yakubov Ploshansky: 11:55 And so how do you help people approach that, like, what is kind of like your, I mean, obviously, it's different for every person, but like, what's kind of like your general approach of like starting that process for people. Gabrielle Larin: 12:06 Um, I will, I'm big on praising people. So I will find those small successes, a lot of times people think in order to feel good about yourself, you have to have this extravagant event that so successful. And it's like, you know, you got this huge promotion, or you know, you bought a house, things like that. And it doesn't have to be this extravagant win or game. It can be something as small or as simple as having a good day and not having a negative self thought. And that is a huge gain, that's a huge win. And we have to celebrate those small successes to be able to feel confident within ourselves that if we did this one small thing, we can continue to do those so that they can eventually become bigger gains Kira Yakubov Ploshansky: 12:57 in the far future. So starting baby steps is having them even acknowledge that they're there little victories along the way. Gabrielle Larin: 13:06 Yes. And I will remind people of those small successes along the way until they can remind themselves. So I'm big in praising and reminding people that there is good and every day there is within yourself. And you can see those positive things within yourself and those small and those small successes within yourself, I will remind you until you can see it yourself and then it becomes a little bit more natural for you to see it without me having to remind you Kira Yakubov Ploshansky: 13:36 Okay, awesome. So building that up slowly but surely, because that definitely takes time and like compounding that that thought process as a normalized and regular thing. Right? Gabrielle Larin: 13:47 Take some time to build it, but I'm patient. Kira Yakubov Ploshansky: 13:53 And, you know, part of that too. I like when I'm working with people with people pleasing tendencies is also what is the fear, right? Because I think there's a lot of fear and wanting to avoid certain emotions or certain things from happening, right. So like, like, the most common that I hear is not being liked. being seen as rude. Or if you're a woman as a bitch. I'm being left like people are gonna abandon me if I'm not like this anymore. And the last one, I'm having those three of the big ones Oh, and conflict, not wanting to feel or being engaged in conflict, right, like avoiding conflict at all costs. All of those things feel very, very uncomfortable in our bodies, and especially the about being abandoned, right, so conflict and being abandoned really, and how you're perceived. So we like to highlight that these are all the things we're prioritizing over our own happiness or self esteem or self respect, and having more genuine relationships. I just want to put it that way, Gabrielle Larin: 15:02 head of yourself, because the exactly exactly what you're saying all of those things are putting other people ahead of yourself. Kira Yakubov Ploshansky: 15:10 Mm hmm. And so do you hear that too? Like when you're when you start, like digging and processing? Like, what is holding you back from doing these things and putting yourself first, Gabrielle Larin: 15:20 right? And a lot of times it's a burden, how am I going to be a burden on other people? Am I it's almost like seeing yourself as being negative, as you put yourself first you are a negative, either that conflict or abandoned, something bad is going to happen if I am going to do this a lot of what is. So a lot of times I will say okay, well, you're thinking, what if something bad comes out of this? Help yourself, change that thought process by asking yourself, What if something good comes out of this, we can't control anything, we can only control what we're doing in that moment. And if we can control ourselves, not other people like to control what we're doing for the positive and the benefit of ourself, once we have our cup filled, then we can help fill someone else's. But until then, let's fill our cup first. Kira Yakubov Ploshansky: 16:16 I love that you mentioned this aspect of control. I think there's a lot of need for control and people pleasing, right? We think that it's like, oh, it's about other people. But really, a lot of what we're doing is to control the perception of what they have of us how we think the outcome is going to be how we're going to feel how they're going to respond, right? Like, it is really about control for because we know if we act this particular way, we'll be able to get this in return, this person will like us, this person will want to continue hanging out with us. They may think something positive me of me, right, they're not going to leave. So there's all of this extra work and thought and overthinking going into controlling a situation. And I think like the thought of someone releasing that it sounds horrifying, and it can be horrifying to Gabrielle Larin: 17:09 Yeah, it is it is really scary. I also noticed a lot of times people with people pleasing tendencies want to stay in control, and Estacio like they are out of control. One thing that they can control is their reactions are their emotions based on somebody else. So they can control themselves around others, they can, you know, put others first and then they can control the outcome and the feel of the relationship and the communication and the connection with another person. And Kira Yakubov Ploshansky: 17:46 I was listening to something earlier and this is gonna be an unpopular opinion. But the more I thought about on like, you know, this is kind of true, is that being nice? Right? Like people pleasing can kind of overlap with being nice, not kind, right? I feel like kindness and being nice or different. Nice is being polite, agreeable, just doing things. It's more self centered than kindness, right? Kindness is different because you are going out of your way to do something for somebody, regardless of how they perceive you or what you get from it. It is just a give. Being nice is doing something so that everyone else around you feels comfortable and sees you in a particular way and likes you and wants to come closer to you. Gabrielle Larin: 18:31 I 100% agree with that. Nice is more on the outside. It's more surface level, where kindness is internal. It's who you are as a person where you want to be a genuine, genuinely kind person, because that's just how you are as a person nice is more like, Oh, I am so happy to see you. While on the inside. You're like I can't wait to run away from Irena. Notley different, I actually saw I that's funny that you said I saw something on the internet the other day that was like, nice is seeing somebody with a flat tire and saying, Oh, I'm so sorry that you have a flat tire. That's really unfortunate. Where kind is you pull over you stop your car, and you help them with their flat tire. Kira Yakubov Ploshansky: 19:26 And there's also so there's you mentioned something, right? Like, the way it presents outwardly versus what's going on inside, that there's this lack of congruence. See, right like, so you're actually not being yourself or what other people get to see of you is not actually who you are, or the authentic version of you. So I think a lot of times people pleasing, we want to be liked so bad, that we don't even give the other person the opportunity to actually like us because we're not doing things that we actually want to do. Right, so we ended up saying yes to a lot of things, we end up doing a lot of things acting a particular way. Because we think that's how we're supposed to be to be liked. But then really inside, we're feeling resentful, we might be passive aggressive, we might be really mad at somebody, but they'd have no clue that we feel that way. And now we're holding these grudges. And the other person doesn't even know, right, so this relationship, there's a gap of vulnerability and a real connection that we're actually really craving, or we're not even allowing, Gabrielle Larin: 20:32 right, it's a mask, is you're putting on a mask to have other people feel a certain type of way about you. But meanwhile, as you said, you're not showing your authentic self. And that happens a lot where people will put on this mask thinking that someone else wants that mask, and then the other doesn't even like that. And they missed out on an opportunity to show who their authentic and genuine self is. And maybe that person would have liked that better. But they put on a mask thinking that that's who they are supposed to be, that's who they are going to be perceived as a better person. Kira Yakubov Ploshansky: 21:16 And so how do you help people start the process of embracing more of who they are, and like allowing other people to see that or saying no, or giving answers that are actually aligned with how they feel? Gabrielle Larin: 21:29 It's tough. It's a, as we've been saying before, it's a slow and steady process, it's baby steps. And just like I was saying, Before, you know, when you catch yourself thinking a certain way, oh, maybe they think of me in this way. And then asking yourself, do I believe that to be true about myself? You know, somebody is thinking that somebody is thinking something negatively about them? Pause, notice that you're thinking that about the other person. And what they are perceiving and ask yourself is, is that how I perceive myself? Is that true? Most of the time, it's not. So it's just a gentle reminder, to say, it's not true about myself. And even if somebody else is thinking that way, I don't believe that about myself. And they probably don't also, it's just in my head that somebody is playing this little game in my head that's making me think that way, but it's not true. Kira Yakubov Ploshansky: 22:34 I think a big part of that also is like breaking this habit of assumptions. Right? We're like constantly assuming that if we do this, the other person is going to think and act this way. So allowing yourself like you're saying is having a different, like a moment of clarity, a moment of okay, what's another option? Like, maybe they will think that way, right? We don't actually know. But maybe they won't, maybe they'll be totally fine with it, maybe they won't even care, maybe they'll still love you just the way you are, even if you have a differing opinion, or want to do something else. And like leaning into that and allowing yourself to see what happens. And sitting in that discomfort of the unknown. Gabrielle Larin: 23:19 And that's the tough part sitting in that discomfort of the unknown, because as the unknown is the most ultimate fear. So that's, that's really difficult, especially with people pleasing, because you're so terrified of the unknown of what if I don't, because I've never done this before. So it's feeling that comfort? feeling comfortable in the uncomfortable. Kira Yakubov Ploshansky: 23:45 Yeah, and that takes time, right? Like that's like, building the tolerance for the discomfort and like starting super, super small, like you were saying before, and like seeing what happens, right? Like, what if you just say no? or what have you start right? Like, let me think about it. Sometimes. It's really tough for people to go from I'll do whatever to No, you have, give yourself the option, right? Like, let me think about it. Let me get back to you. I'm not sure yet. Give yourself the option, see how that feels in your body, how that lands and see how the other person reacts, right? Like, as like a measure to see for yourself. If you can keep going. Gabrielle Larin: 24:21 Yeah, take a step back and even just start by acknowledging that you're doing it. Because first is you can't change anything without understanding it. So you have to understand that that is what you're doing. You have to acknowledge what you're doing have to realize what you're doing so that you can notice it to see how you can change it because as we were saying before, everybody's different things work for different people. So people have to notice what they are thinking what's going on in their head. What am I feeling right now while this is happening? What is my body feeling? so that once they acknowledge and notice it within themselves, then they can start making changes towards progress. Kira Yakubov Ploshansky: 25:10 Yeah, that makes me think about like, just having that bring that awareness to know like, Okay, I'm saying this thing, but how do I actually feel the exam? Am I doing this again? Am I thinking one thing and wanting something and doing something different? Like how many times can you catch yourself? thinking and acting? Not incongruency, like incongruent, right? If you can even just start with that, right? Like, you might realize how many times you're doing this, and almost be shocked that like, Wow, all my decisions are a lot of my decisions are not actually what I want to be doing. Right. Gabrielle Larin: 25:45 And it's, I love that you said that, because it's also I'll tell people to ask themselves questions while things are happening. It's important to acknowledge your emotions. That's kind of like the first step. Once you acknowledge the emotions, then ask yourself questions about what's happening. Am I happy with the choices that I made today? Am I happy with where I'm at today? Am I happy with how I've been feeling today? What I've been the decisions that have created my tomorrow. So asking yourself questions about yourself can help with your progress and your future. So Kira Yakubov Ploshansky: 26:27 taking inventory, right, like not even just in the moment are reacting, but like pausing later and reflecting like a lot more reflection to I know, a big part of this is setting boundaries. I know that's like the other buzzword, right? setting boundaries is like almost gone too far at this point. Gabrielle Larin: 26:49 I don't even know what it means really, at this point. That was like, No, Kira Yakubov Ploshansky: 26:52 you can't do this. And that's it my therapist that I'm not know. What would be kind of your approach for setting healthy boundaries while taking into consideration, right? Like we are social beings in relationships. And like, we don't always need to set super rigid boundaries. But starting with something that feels comfortable, Gabrielle Larin: 27:16 right. And I would even say how we were saying before, don't fill from an empty cup, make sure that your that your cup is full before you feel someone else's. Because of course, as you're saying, We can't be so rigid and just saying no, no, no, because then you're going to lean towards the opposite side of being more selfish. So we have to find that balance. And a lot of times people will actually struggle with finding that balance. Because if you're on one end of the spectrum of being completely selfless, and you are starting to inch towards the middle, you're going to think you're completely selfish, because it's such a drastic change of where you were before. So again, feeling comfortable within that, and how we can notice where that balance is, is. Don't, if you're going to say yes to someone else, make sure that you're not saying no to yourself. So you have to acknowledge that if you are okay, if you are mentally stable and comfortable with where you are, you're not just dropping everything for somebody else, you are able to say yes to somebody else, then say yes to that. But if you are going to say no to yourself first and your needs, then it's okay to say no to somebody else. Kira Yakubov Ploshansky: 28:41 I like that distinction, right? If we're gonna say yes, make sure it's not you're saying no to yourself. Yeah. And I think with time and practice, right, there can be exceptions. And we can be mandible, right? Like, because there's going to be times where, you know, we made a promise to somebody or we have a commitment, and we're no longer in the right headspace or it doesn't make sense anymore for us. So sometimes we're going to want to say no, right? Other times, we're going to want to sit okay, like, is this regular for this relationship? Like, is this normal for me to constantly be doing things and saying yes, or the other person is expecting me to drop everything for them? Or are they generally very respectful of my time, considerate of me, and I've made a commitment and I need to show up because I have to follow through what I say. I think that can be really tough, sometimes those gray areas, and I think that that comes later down the line, to feel more comfortable making those decisions, but like in the beginning, kind of focusing on the ones that are a little bit more clear. And make more sense in the beginning of like, clearly I'm not in the right headspace. If I don't go on this coffee date with my friend, nothing bad's gonna happen. I haven't canceled before I really don't feel well. I'm just gonna let them know I can't make it, right? Gabrielle Larin: 30:01 It's all about balance. And in order to get that balance sometimes in the beginning, as you're saying, we have to be more selfish to understand that it's okay to put ourselves first, once we are comfortable with putting ourselves first, then we can find that balance of understanding that sometimes we won't be 100%. But we still can say yes to somebody else. So it's about finding that balance. Kira Yakubov Ploshansky: 30:28 And I think another big part is, when you were mentioning earlier, you're like, Oh, I feel like a burden. Or I feel like a bad person, right? If I do this, like to ask people like, well, if someone did that to you, would you be upset with them? No, I would never, I would totally understand, it'd be totally fine. I'm like, really? So why does the rule change for you? Why are you the only one that this is a burden, or you're a bad friend, or this is horrible? But you get to be considerate of everybody else's feeling? Why can't anybody else be considerate of you? Gabrielle Larin: 31:04 Yep. I will tell somebody to ask themselves in those situations, you know, pretend that you are asking a friend instead of yourself. And a lot of times the answers will change somebody else then No, no, it's okay. Everything would be fine. If they did that, you know, I wouldn't care. Okay, well, maybe treat yourself as that friend. Kira Yakubov Ploshansky: 31:29 And to kind of go along with the this the self reflection that you mentioned earlier to like some tips for people with some practical things they can do. I remember when I was like, starting out with this, especially when I was going to therapy for myself and like, working through this process is kind of reflecting like, when I am thinking about someone calling me, right when like checking in with myself in my body, right? Like, if I get a phone call from somebody, and if I see this particular name, how do I feel? Do I feel like they feel drained? Do I feel like I don't want to pick it up? Do I feel like oh, I have to get ready for this call, right? Versus like, Oh, I'm excited to pick up this phone call where I'm excited to see this person, right, like, what comes up for you in your body before, during and after spending time or communicating with a particular person. If it is perpetually feeling like it's an obligation, like you don't feel great about it, you're left feeling kind of icky afterwards, thinking about what kind of boundary do I need to set then. And sometimes you don't always have to verbalize that boundary. Right? It could just be an internal one of, I'm not going to pick up the phone they call and that that you're allowed to do that. Right? Like, or I'm going to text them back, or I'll call them back at my leisure when I have more time. Or I'm not going to make plans with them as frequently. Right? Like really, when you're saying taking inventory is like checking in with yourself, like, how do you feel around particular people? before, during and after? And is there something different you can do or show up in a different way to maintain that relationship, if you want to maintain it? Or maybe part of this process, you realize, like, this relationship is really made out of obligation. And we don't necessarily want relationships like that. I mean, sometimes we will write if they're family members or, you know, work, like coworkers where like, there's going to be certain situations where like, yes, they're going to be in our life. But we can limit the amount of time we spend with them talking to them about what and how much they impact us. Gabrielle Larin: 33:37 Right? I love that. Because you are acknowledging your feelings based off of the person and seeing the pattern, I'm very big on patterns. And if you know, one day you just don't feel like talking to them, that's fine. But it continuously becomes a pattern, then that's telling you something about how you're feeling based off of the other person's feelings towards you. So it's, it's about a relationship, you know, it goes back and forth. It's not just a one way. So I love that. Kira Yakubov Ploshansky: 34:12 Yeah, I think a big part of this too, is knowing that through this process, you may lose some relationships. And that's okay. And that's okay. Right. Like, I think it feels a lot scarier in the beginning. Because then we think, Well, I'm gonna lose all my friendships. I mean, it was all my relationships. But no, that's not true, right? Like it takes time to set these boundaries, feel out relationships, see if they make sense for you. But I think as you do this work, you recognize that like, some of these relationships, like even though they've already not been satisfying, you become less and less engaged in them because you start recognizing like, I'm not actually getting anything out of this friendship or this relationship, right? If I don't put in all the work, if I'm not the only one reaching out out were like bending over backwards. Doesn't really nothing's going on, like nothing's happening. I'm not gaining anything from this right? And like, like you said, if it's a one sided relationship, you have to really think about like, Is that worth my time and energy? When after I've been reflecting, have these other people in my life, that it's very reciprocal. I feel great afterwards. So like, shifting away a little bit is a natural part of this, too. Gabrielle Larin: 35:27 Yeah. And I think that that's important to acknowledge as well, it's shifting away a little bit. Whereas a lot of times, people will think they just have to fully cut them off. And that's it, where you can still have that person in your life. You can you want them in your life, keep them in your life, as long as you are helping yourself through that making sure that you're okay through that you can distance them, you can put yourself at a distance, put them at a distance, and continue the relationship based off as your comfortability, where are you comfortable with that relationship? If it's, you know, over here, that's great. If it's closer, that's great. It's cutting them off completely. That's great. It it's about that balance. It's about finding what's right for you, not what is necessarily Constable, because you've been used to it for so long. Kira Yakubov Ploshansky: 36:20 Absolutely. Yeah. I think a big part of these two is also recognizing when you're internally like really mad at somebody, but they don't know. Right? Like, are you perpetually angry at somebody or annoyed with somebody or feeling passive aggressive towards somebody, right? Because I think a lot of times, we might be mad at someone because they didn't show up a particular way. Because we were expecting them to because we always do. Like, well, I'm always there for you, I always do this, I'm always willing to, you know, yadda yadda yadda. But this other person isn't a people pleaser. And they're not going to prioritize your feelings over theirs. And that's not necessarily a bad thing. But if your expectation is that and you don't share that with them, or you're angry with them, and they don't know, I think it's also checking in with yourself, like, are these realistic expectations? Like, am I just over giving? Or are they being rude? Right, there's a difference. Gabrielle Larin: 37:20 That's a very important distinction. A lot of times people will say, You know what, if I'm doing that, then I should expect somebody else to do that in return. Everybody's different. Everybody reacts differently. Everybody loves differently, everybody connects differently, we're all different. And we want to give off in different ways than other people want to give off and take in different ways. So I've seen like, communicating that is so important, and being open with people in your life. Because if you do love this person, and the person loves you, then you should feel comfortable in terms of communicating what you want, and how you want to be supported. Because then you can develop a stronger bond with that person. Mm hmm. Kira Yakubov Ploshansky: 38:14 And that's a big part, right? That we, I think we've been dancing around, but not necessarily like identifying is communicating is a lot of this means you're going to have to communicate what you actually feel and want and expect. Or if you're upset by something, expressing that too. Gabrielle Larin: 38:35 Right. And that's the tough part is vulnerability, being okay with being vulnerable. And a lot of times people don't want to feel vulnerable, because that vulnerability makes them feel like they can get hurt. And what we were saying before, you know, that people pleasing is the same fears of, or similar fears of feeling vulnerable, they don't want to feel like they should get abandoned, or they don't want to feel like there is going to be conflict within that vulnerability. So it's difficult to communicate your needs, and feel that vulnerability at the same time. Kira Yakubov Ploshansky: 39:19 Yeah, so communicating vulnerability, all these fun things that everyone comes to us for. It's all right, but it's also reminding people like these are baby steps. Like, no one's trying to rip the band aid off. This is a process like, no, and you're not gonna stick with it, right? If we just rip off a band aid and like, Go tell your best friend, you're sick of their shit. And you're right, like, no, we want to easy. I mean, eventually, yeah, you want to tell them but in a different way, you know, follow Gabrielle Larin: 39:58 the baby steps first. That's it. Kira Yakubov Ploshansky: 40:02 Yeah. And I think a couple things that really helped me through this process that I've kind of relayed to clients too is, it's hard to trust somebody, when they're constantly people pleasing is also an unpopular opinion, right is, if you're not genuine with how you feel, and I know that you are scared to tell me how you feel, or to tell other people generally, if you're upset by something, I'm going to have a harder time trusting you when you tell me, oh, everything's fine. Because I don't believe you. Because I know that you're not likely to share if something's upsetting you. And I know that because that's how I used to be right, like, Oh, it's fine, it's fine. And like, you can't really build a lot of trust off of that when later you realize, no, it wasn't fine. And I wanted to know if I hurt you, and I gave you the opportunity, but you still didn't tell me for people to like recognize not to make them feel bad. But to realize, like, you know, it doesn't make you come off as trustworthy. If you're never upset by something when clearly you are, or clearly someone in this position would be. And Gabrielle Larin: 41:09 that would be a perfect example of a baby step, if somebody is giving you that opportunity to share that, take them up on that. And, you know, you don't have to just unload everything, but share a little bit at a time so that you can release some of that pressure, you can release some of that within yourself. And it's going to feel very uncomfortable. But as we were saying before, you're going to feel uncomfortable, but it's right for you in the long run, you're going to have this release, and it's going to feel like a stronger connection with that person, once you're done. And you're going to feel better about yourself, because that confidence is slowly creeping up. Kira Yakubov Ploshansky: 41:50 Yeah, right. You can be like who I did the scary thing. It's not about the outcome or the result necessarily, because we can't control how someone's gonna react to it, we just cannot we have to release that. But I can be proud that I did a scary thing. It was uncomfortable, and I leaned into it. And that's a big deal. Exactly. Gabrielle Larin: 42:09 And that is so important. A lot of times people will focus on the outcome. But it's so important to acknowledge that even if you're going to upset somebody else, you are making yourself better. Kira Yakubov Ploshansky: 42:23 And kind of like a final. A final note of this is to not take things so personally. Which I mean, was it much easier said than done, right. But I think when we recognize that, like everyone is kind of just trying to do their best based on like, their level of awareness and healing and understanding and you know, relational skills, everyone is in a different spot and have other things going on in their life that we really may not know about. So if someone acts a particular way, instead of immediately personalizing and saying, Oh, they must be mad at me, they must hate me, I must have done something wrong. Now, maybe there's just something else going on. And you know, maybe if they are upset with me, because I needed to do this thing for myself, like, okay, like releasing that control or releasing that need to be perceived a particular way. Like, I'm not going to take this personally, they're allowed to be upset with this behavior. It does not make me a bad person. Gabrielle Larin: 43:29 And that's, that's very important. And also, it's not going to last forever. And if it does last forever, maybe that relationship isn't right for you. Kira Yakubov Ploshansky: 43:37 There you go. Feelings are temporary everybody. Gabrielle Larin: 43:42 And they're a roller coaster, they will go up and down. And sometimes those you know negative emotions will come back and then once we process them, we'll learn how to deal with it again. Kira Yakubov Ploshansky: 43:56 So Gabby, is there any final final tips or notes for the listeners around this topic or anything you'd want to share with them? Gabrielle Larin: 44:05 If you are struggling with people pleasing, and you want to start somewhere don't know if I'm like allowed to say this, but fuck everybody else. Kira Yakubov Ploshansky: 44:17 You want to say whatever you want. There's not a censored podcast. Gabrielle Larin: 44:24 The first step is tell yourself like everybody else and put yourself first once you start feeling a little bit more comfortable with that, then you can start to get that balance and understanding. Okay, now I am more comfortable with that. And I can start to understand how to keep the balance of putting others first and putting myself first but first fuck everybody else. Kira Yakubov Ploshansky: 44:47 And then later, it's like okay, well, I can give a fuck about you and maybe you not so much over there. Gabrielle Larin: 44:53 Find that balance afterwards. Kira Yakubov Ploshansky: 44:55 That's awesome. Gabby, thank you so much for being on with us today. I think this has been really helpful and insightful. I hope listeners really get a lot of information from this. If anyone wants to work with Gabby she has a limited availability you can definitely reach out to heal your roots wellness.com To schedule a consultation and work with her but Gabby thanks so much. Gabrielle Larin: 45:16 Thank you I had a great time. Kira Yakubov Ploshansky: 45:18 If you enjoyed this episode, please remember to like subscribe and share so the message can you get out ### Listen - [Spotify](https://open.spotify.com/episode/14471757) - [Apple Podcasts](https://podcasts.apple.com/podcast/14471757) - [YouTube](https://youtu.be/-_LqhPXjKf8?si=z8A0_G2PhYpoj9jV) --- ## Holistic Healing: Mind-Body Techniques in Therapy - URL: https://healyourrootspodcast.com/episodes/holistic-healing-mind-body-techniques-therapy - Published: 2024-01-31 - Season 3, Episode 5 - Duration: 38:28 - Category: therapy - Guest: Lindsay Bauer ### Summary Exploration of mind-body approaches in therapy, focusing on meditation, mindfulness, and body awareness for healing and emotional management. ### Description This episode delves into the transformative power of mind-body approaches in therapy, emphasizing the significant role of meditation, mindfulness, and body awareness in healing and emotional management. Starting with a focus on how couples can benefit from these techniques, we explore various therapeutic modalities that integrate physical and mental wellness. ### Transcript Kira Yakubov Ploshansky: 0:00 Welcome back to Heal Your Roots Podcast. In today's episode, we have Lindsay Bower, sharing how she uses the mind body connection in her therapy work, and particularly how she helps couples move through grief together, you're going to want to listen into today's episode. Lindsay, thank you so much. Welcome back for a second episode with you and really excited to have you back on today. Lindsay Bauer: 0:22 Thank you for having me, Kara. Kira Yakubov Ploshansky: 0:24 Absolutely. So I know in our first episode, you talked a little bit more about your background, what made you want to become a therapist. So just for today's episode, if you can kind of share a little bit about what you do, where you work at just so the listeners if they didn't hear the first episode, get an idea of who you are. Lindsay Bauer: 0:43 I'm Lindsay Bauer, I am the owner of yoga ology. It's a private practice, centered in Philadelphia, but I do service Pennsylvania and New Jersey as I'm licensed in both. I'm a marriage family therapist, and I specialize in infertility, grief, trauma and anxiety. So I provide individual therapy and couples therapy. And my practice yoga, ology specializes in mind body, that's kind of like our niche. So within any kind of situation or issue that you might be bringing into therapy, we're going to approach it with a mind body approach. There's a holistic health in it at yoga allergy. And so that's something that I pride myself on, and I make sure that everybody knows you're not leaving a therapy session without having some kind of mind body approach to it. So that breathwork, meditation, mindfulness, etc. Kira Yakubov Ploshansky: 1:46 Because he does a lot of things, and I know you do, like meditation classes, or meditation coaching as well. Yes, Lindsay Bauer: 1:54 thank you. So that's actually like a big part of the mind body work. So a lot of times people are, are like, Well, how do you incorporate yoga or meditation or breath work into sessions. And the yoga piece is a little tricky, because those kind of have to be scheduled separately. But with meditation, you know, someone's talking about stress or anxiety that they're having. A lot of times, I'll just say, you know, let's, let's kind of go into a meditation right now. Whether it's a guided meditation, whether it's a body scan, whether it's more like a mindfulness exercise, but yes, I help people. And sometimes people come just because they want to work on their meditation practice, and, and incorporate a little bit more of that into their daily lives. So I think people find they say, they find a hard time, finding the time and how to implement it into their schedules. So if they already have a therapy session, in their routine, then they just add the meditation into it, and it works nicely for them. So it's a nice little trick. Kira Yakubov Ploshansky: 3:17 That's awesome. And so for people who may not know the difference between let's say, like, a guided meditation, a body scan mindfulness, could you share a little bit about the differences and like, what that might look like? And how you kind of present that in sessions with clients too? Lindsay Bauer: 3:34 Yeah, yeah. Meditation, it is kind of tricky. Meditation is, has like the focusing on your it's almost like bringing awareness in to it. So you're, you're focusing on one thing, so it could be a mantra, which is a prayer or a an intention or an affirmation. So for example, a common one is so hum or translated to I m. And that would be kind of like you say, so hum over and over and over. So every time an intrusive thought comes in or every time a a task that you need to get done for the day pops in, you just keep following so hums so hum. And that is opening yourself to I am I am I am and I use this with clients who tend to feel unworthy, or they have any kind of identity issues this way. If I don't know, like, it's kind of like praying, where you're just kind of whether it's to a God or the universe or whomever, you're you're kind of asking, Who am I right? What's my purpose here? And sometimes as you sit in silence, some answers could pop up or visions can pop up. Anyway, so that's Meditation you're focusing on a mantra you're focusing on maybe just your breath. Maybe it is a specific question that you have that you've been pondering on. And then mindfulness is slightly different in that it's it is more of like the guided piece. So a body scan would be considered more of like a mindfulness exercise. So it's bringing the awareness to different bodily sensations. You know, if I said, focus on any parts of your body that are feeling tingly, people might then focus on their fingers, they might focus on their arms. That's kind of the difference between those it's very gray in the sense that they overlap each other, obviously. But I would, in short, I would say meditation almost feels like you're kind of on your own, in a sense, like, you know, and then mindfulness text techniques feel a little bit more guided. Kira Yakubov Ploshansky: 6:17 It's, you know, it's interesting, you're saying that because right before I was getting ready for this episode, we were doing like these like voice stretches, and like relaxations, like, um, and it was really relaxing. And thinking about, like, the vibration of that in my throat in my body, and like the sound of it all, like, kind of made me think about all of those senses and being more present. So I actually never heard of the you said, so hum. is how it goes. So hum. I really love that that's really cool. And it's really deep thinking about like, your purpose or your answer or kind of like who you're reaching out to, to ask for a message or something. That's really awesome. Do you feel like clients kind of resonate with that? If it's like something new that they've never tried before? Lindsay Bauer: 7:04 I do think so. I think that like, it can invite in a lot of scary answers to right. So a lot of times with trauma, I do notice that this is a practice, this isn't something like the first time they come into it, that they're like, oh, wow, I feel completely healed. I feel like I have all the answers. It can bring up some difficulties it can bring up, you know, because if you think of like, who am I memories tend to come up. Right. And some of those memories might be unpleasant, they might be painful. So, a lot of times when I do that one, it is in the therapeutic practice in the sense of what is coming up right now. So the goal necessarily isn't to finish that meditation, it's the process through it, it's figure out, why are you having blocks to who you are, why is it difficult to sit with the authentic part of you? Or the the? Yeah, the authentic part of you. Kira Yakubov Ploshansky: 8:15 You know, it's interesting. So I've had some of that mindfulness in session with clients, and I find that clients who have had trauma, while they want to be present, and the goal is to be more connected with their body, they notice that once they start to do some of these exercises, or practices, they kind of get scared, like a rush of feelings, or a rush of sensations, or that they won't be able to handle what is going to come through and they kind of get scared, or that they may feel a lot of those shameful emotions or like discomfort. So it's almost like this internal struggle of like, well, I want to be more connected to my body meet present, but I'm actually really scared of how that's going to feel. Lindsay Bauer: 9:01 Right. Absolutely. I mean, even just having people close their eyes can feel very unsafe or just uncomfortable, right? Yeah. Yeah. So I do, I think that I always like to do gentle starts, you know, there's very beginner level meditation. And I, and like, I I personally think that a body scan. So I'm asking you to pay attention to your left big toe is way different than, hey, let's sit in silence for 10 minutes and observe these like deep questions that you have about yourself, right? So I do pitch it in that way. Like this is very gentle. There's a safety to this. And a lot of times with any type of therapy approach we say like maybe there's a safe word when you want to get out of this. Let's I can bring you back into the present moment, we'll open our eyes, etc. So I give people an out because that that can really help with feeling lost or scared or, like, you know, not really sure what's going to come up. Kira Yakubov Ploshansky: 10:14 Yeah, so definitely a gradual approach to help clients like, baby steps. Yeah, Lindsay Bauer: 10:19 absolutely. Yeah. Yeah. And so Kira Yakubov Ploshansky: 10:23 how else do you kind of incorporate or like your approach of this mind body connection in therapy sessions, when they're like bringing, whether it's like heavy things into session, or they're just like talking about stress or anxiety, or even grief? Lindsay Bauer: 10:38 Yeah, um, so I, a lot of times, yoga nidra is one approach. So it is a type of meditation. And then like, I've keep mentioning body scans, because it's just such a go to, it's so easy, but so powerful. So for example, let's say, someone had come in and they said, I'm feeling just extremely stressed at work. And they start ranting and kind of going on about this coworker and this boss, and they're not getting paid enough. And they have to have a tough conversation with their supervisor about getting a raise, etc. And then I kind of like pause them, and I'm like, do you mind doing a mindfulness exercise with me? I think that I think we're doing a lot of like content and cognitive stuff. But I'm really curious if we can notice what's happening in your body right now. So then I say, like, what's the biggest thing that's bothering you at work? And they'll say, I feel unappreciated? Or maybe I don't? They don't say that quite at first. But I guess I guess I'm there to say I feel unappreciated. Yeah. And then I say, Well, where do you feel that in your body, and maybe they say, in my stomach, like, I just feel tons of knots in my stomach, let's send our breath to those areas. And every in breath that you take, it's expanding. And it's almost like unraveling those knots, or it's loosening them a little bit. And then every outbreath, you're just getting rid of negativity, you're getting rid of stress, you're getting rid of worry. And through like five minutes of that they just feel lighter. And sometimes when we come to, I'm like, so tell me about your coworker? And they're like, I don't, I don't really think it's bothering me that much anymore. I feel better, I feel relaxed. So that would be like, the, like a synopsis? Like the the summary of how I incorporate it kind of goes is very similar in all sessions. Yeah. Kira Yakubov Ploshansky: 12:44 That's interesting. So it's almost like instead of having clients feel like they have to, like fix it, or walk through the whole thing, or like, find different scenarios and ways to go about it. It's more like, in this moment, let's just see how heavy it actually is. let's decrease that. And then let's come back and reassess. Like, is this still weighing on you? Is it still important to you? Lindsay Bauer: 13:05 Hmm. Right. I mean, that's what all of this mind body work is, is awareness. It's bringing non judgmental, non analytical awareness to it. Right. So how, you know, because we can stay in our heads and kind of complain about things and, but when we really feel it, whether we put a feeling word to it, like I feel unappreciated, it's bringing awareness, it's, and then therefore control, right? Because a lot of us, we don't want to feel like we're out of control, with our feelings, with our thoughts with our behaviors. So I think that that's one of the big pieces to this is giving people this empowerment and control over their own feelings, which then makes you feel more in control of your life. Yeah, Kira Yakubov Ploshansky: 13:59 yeah. And it's also something that you can carry with you, right? Like, it's not, yeah, this external thing that you have to rely on somebody else, or you have to do or you have to find a place, it's kind of like all very much reliant on yourself. Like, if I know how to bring myself back to awareness, or if I know how to give myself a body scan, anywhere, I could be on a bus, I can be in the middle of a store, wherever, as long as I have a couple of seconds, I can do this for me. And I'm sure like that, within itself is really empowering. Because you don't feel like you have to rely on anybody else to help yourself through an uncomfortable moment. Lindsay Bauer: 14:35 Correct. Right. It's a tool and that they get to keep with them. And it's so it's really powerful. I think. When I first started learning about all of this, I remember going to a training and they said, We're going to take three deep breaths and I feel like that's the that's what we tend to hear a lot like take three deep breaths when You're angry, it takes three deep breaths when you're stressed. And, you know, I get a lot of what are three deep breaths? You really think that they're gonna solve my problem? Right? Yeah. But it's not about solving the problem, like you said, it's about being able to give yourself a tool so that you can have problems and still live a pretty peaceful life. And that the problems aren't destroying you that they're not controlling you and taking over you that you feel like, I would like to think of like a big mighty tree. Right, so like, it can be storming outside. But if this tree is grounded and rooted, its base, it's maybe swaying and going with the storm a little bit, but it's not bending over, it's not breaking. Right. So trying to make people bunch of lightning trees. Kira Yakubov Ploshansky: 15:54 I love that. And I, I have to do more meditation, I used to meditate a lot more. And I would love going outside and like having my feet in the grass. And remember, the guided ones were like you are a tree planted, like feeling like the earth and like the roots are coming from your feet into the earth and like going all the way to the core. Like I know, sometimes, some clients or even just some people might feel like it's a little out there, or they can't like conceptualize it. But I think that kind of goes back to what you're saying. Like, it doesn't have to be cognitively it doesn't have to be the thoughts in your mind. It's like embodying that experience, and feeling those sensations and it feels nice, it feels really relaxing to go there. Lindsay Bauer: 16:37 Exactly, yeah, I know. It's, it is powerful. It's, it's something like, you can't just talk about it, you have to do it, and you have to experience it, right? Like, you can read about it, and you can listen to somebody else talk about it. But once and I'm telling you, I'll do the three breaths with clients. And again, it is not solving problem. But they're immediately like, Okay, I just feel a little bit more present. And when you're present, you're just able to, you just feel a little bit more empowered, and a little bit more clear. And in therapy sessions tend to go better when you when you start, Kira Yakubov Ploshansky: 17:21 it makes me think about when we are in a heightened state, we're so dysregulated and we can't really make an informed decision or do something that's really representative of like our morals or values, or how we really think it becomes more impulsive or something like reactive, like, I just need this to stop, I want this to stop. So I'm just going to do whatever. Versus like, you take those three, three deep breaths, or you ground yourself and you calm down. Like, okay, how can I actually think through this? How do I want to present? How do I want to express what I'm feeling in a way that will be received, received? Well, especially for couples therapy, right? Like, I want my partner to hear me and take what I'm saying, because that's the point of this, then I need to like, calm down, I need to regulate myself. Lindsay Bauer: 18:12 Yep. Exactly. It's, it's, it's really helpful for crises. So whether that's in interpersonal, and you know, in a relationship, if it's any kind of crisis, it's it's really helpful. You know, because it does, just to kind of speak to that piece of, oh, this, this is something you do in a yoga class, or this is something that hippies do, or, you know, what, it's really effective for mental health, it's really effective for crises. You know, you had mentioned grief, couples. Trauma, I mean, traumas is really big blow to our nervous system and to our whole perception of the world and how we move through the world. Anger, right, anger is big, that can feel extremely heavy, and it and it can also feel like I'm just an angry person, I'm never going to change. That's not true. So, you know, I don't want people to get the misconception that meditation is kind of this fluffy. It only works for certain people who believe in it, it literally can work for anyone who wants to try it. Super accessible to Kira Yakubov Ploshansky: 19:32 Yes, it's free. Anyone? Anyone can do it. And so can you share a little bit more about how grief sits in our body or lands in our body and how you kind of help people work through that? Lindsay Bauer: 19:45 Yeah, so I do a lot with grief, especially with the infertility element of my practice. So with grief, I noticed like first When you think of when I think of grief, I think of just like an emotional heaviness, sadness, anger, resentment, fear, all of that kind of gives us this tightening in our muscles. And then it also creates like headaches, belly aches, things that we don't really just, we don't, we wouldn't associate necessarily with grief, but it does. So sometimes muscle aches, you know, like, if you're really tense and you're in, you're kind of like sitting like this a lot or your shoulders are up, you do tend to create tightness in the muscles. So that would be one thing. And then also with, with grief, I think of bad sleep. You know, when you're really stressed, when you're really sad about something, either you're not sleeping well, or getting any sleep, or if you are sleeping, sometimes our dreams can be super vivid and disrupted. And have you ever woken up from a very stressful or scary dream? And you're just thrown off all day? Yeah, yes. And then just not getting good sleep can also affect your health, physical and mental health. So I really noticed a lot of that too. And, and with sadness or depression, that comes from grief, a lot of times people self care tends to go down. So they're all intertwined, right? So our physical bodies are nutritional bodies, our cognitive, everything is intertwined. So the thing about grief is it's just really, really powerful. And it affects it's not just like, oh, it just made me a little sad. It's affecting every level of our bodies of our energies. Yeah, so it's, it's intense, I think, sounds Kira Yakubov Ploshansky: 22:11 all encompassing, right. And like, you're saying, there is no like, disconnect. We can't just like, put this one side over here and not experience it. Because our nervous systems all messed up, if we're not eating, if we're not sleeping properly, that impacts how we think how we feel, which continues like this vicious cycle, and then isolating or lashing out or, you know, everybody kind of experiences grief differently, and how it's expressed. And I'm sure how we were, you know, raised or what we saw growing up that was like culturally normal, or within our family of how to show or process grief or not process it, I'm sure plays a huge impact as well. Lindsay Bauer: 22:54 Yes. Yeah. Right. And I do I think that a lot of times with grief, like what you're saying processing or not processing? I don't know that we're taught that. Right, right. I mean, if if you had a loss, a major loss in your family growing up, and your parents helped you process that, then great, you've learned it, but I just, I don't know, from my personal experience, and also, my professional experience, it just seems like it wasn't taught very well. A lot of people may have lost someone. And then I said, Well, oh my goodness, like, how did you process that as a kid? And I was like, I didn't like my parents didn't talk to me about it. And I'm thinking, oh, you know, I think it's just such a scary, heavy thing that we tend to be like, oh, let's push over there. You know, so yeah, part of my work with grief is to help clients find comfortable as comfortable as possible ways of processing it. And that a lot of the best way to reach them is through the mind body work that I do and kind of saying, like, Hey, we're gonna bring awareness to what we're feeling. Well, even, you know, labeling what we're feeling I didn't realize that this was anger, right? I just was walking around thinking I was a jerk. No, it's it's anger with sadness underneath of it. And then I like to add the non judgmental piece. I validate and validate and validate you're allowed to feel angry, right? This is unfair. This this is very unfair that this happened to you. But is your anger giving you a better quality of life? Or is it kind of chaining you to these really sad feelings? Kira Yakubov Ploshansky: 24:53 Labeling a lot of bringing awareness and not pushing it away and not compartmentalizing it and not Just like shoving it down somewhere and trying to distract ourselves. Lindsay Bauer: 25:04 Right? Exactly right, owning it, understanding it, because when you understand it adds some compassion and a little bit of lightness to it. And then it makes it a little more bearable, to live with. And each day, every day that you do more work and more processing, it gets a little bit lighter and a little bit easier to Kira Yakubov Ploshansky: 25:25 do you see this come up in couples therapy, where, let's say either both partners are experiencing the same loss, or only one partner kind of experience the loss, and they're grieving and their other partners trying to be supportive. But like you're saying, if you're angry or irritable, it can be really hard to support someone who is presenting that way, or like pushing people away, even though they really want support and compassion. Lindsay Bauer: 25:54 Right? Well, you know, If a couple is experiencing the same loss, that actually tends to bring up more issues, because I think you said this a little earlier, we all grieve differently, right? Well, just in general, we all heal differently, we all perceive differently. So sometimes with my couples, the first part of getting them to accept that this is going to be a different path for both of them. But how do we stay on the same path as a partnership. And I say that's by accepting each other's different paths, if that makes sense. So it's, it's helping them to listen and understand, Oh, we're going through the same loss. But, but your grief looks like this or feels like this, and mine looks and feels like this, how can I sit in yours yet also protect mine. And vice versa. And it's really, it's challenging to do that. And a lot of times with like, really intense grief, you know, couples need a little bit of a break, they need to kind of heal and do their own thing. Like I'm thinking like the loss of a child, you know, that is so deep and so heavy. I don't, you know, I don't expect I'm not like you're not getting a reward at the end of this. If you're if your guys's marriage makes it through the loss of a child. I'm not saying definitely get divorced or separate. But if you need a little bit of separation or space to heal on your own, you didn't fail, right. And that's a really big thing that they need to know right away. Because it's just very heavy and difficult to sit and learn and understand your own grief. And then to do that at the same time with your partner, very possible. It's just very, very difficult. So what we work on is communication. I mean, that's a big piece. So how can I be open and honest, even though it may bring up sadness for my partner? I still need to be open and honest. Because think about like, if you and your husband have Have you ever tried to play the guessing game? Have you ever tried to, you know, I'm assuming that he feels this way, and it's never really quite works out. So it in grief it or any kind of heavy emotion, it's really not helpful to try and guess and try and figure out so being as clear and open about what your feeling is, is just, that's kind of like the starting point. So open and honest, communication. And then that understanding and validation. So I can see why you would feel like your whole world is flipped upside down. Or I can see why life doesn't make sense anymore for you. I can see why you're not happy in the things, you know, because sometimes we take that personal if our partner says I'm not happy, it's like, oh, you're not happy with me. Okay, I don't make your life happy. But I think what they're really communicating is, this grief is so hard and and difficult. And right now I feel like life isn't satisfying. Does that make sense? Yeah, Kira Yakubov Ploshansky: 29:31 it totally makes sense. Yeah. And I think yes, it's a difficult and delicate dance is what it sounds like, because both people are hearing this heaviness. And they're experiencing it differently. And it sounds like you have to take care of yourself first. But then you also have a partner that you care about and that your partner wants to be taken care of too. And it's like how much capacity Do you have? Right? I think that's what it sounds like. Not everybody has the capacity to who grieve just for themselves, let alone be there for their partner and help them grieve, especially when it looks and presents so differently. And so just not allowing that to drift or to pull them apart so far that now they're just on separate paths, and they're no longer able to do this together. Lindsay Bauer: 30:22 Yeah, exactly. Kira Yakubov Ploshansky: 30:24 That's tough. Lindsay Bauer: 30:25 That sounds really tough. Yeah. Yeah, it is. And that's, again, just validating that this is going to be a really tough journey. And you guys are allowed to take it, how you how it unfolds, right? Like, we're gonna let this unfold. But I do, I just, I think letting them know that you're allowed to be on different paths and still love each other, you're allowed to be on different paths and still have a successful relationship, you know, two different paths doesn't mean that you guys are failing it just like, that's how we survive when it comes to such heavy visual Kira Yakubov Ploshansky: 31:06 of being on the highway, of just like, there's an express lane, and there's another lane and you're both going in the same direction, but you're on a different level, and you can't even see each other, but you have to trust that it's still going towards the same end goal, or the same destination, just popped up for me thinking about that, because it's different, but you're trying to get to the same place together. Lindsay Bauer: 31:28 Yeah, yeah. And I don't know why that makes me think of, you know, take grief out of it. Like, when you meet somebody, you don't know what the rest of your lives are going to look like, you know, you find a partner, and you love these qualities about them. And you're compatible. And maybe you've gone through a couple of things before you, you know, you get married or totally committed to each other. But then life might throw you some of the darkest heaviest things, and you didn't know how your partner would respond, you didn't know how you're going to respond in those situations. So I always bring that up, too. I'm kind of like, look like you're learning each other over again, in this grief, and open yourselves up to that, you know, kind of create a curiousness about your partner and yourself during this time. And that can kind of like an open mind. And that can that can bring some lightness and some softness, which is really important during that Kira Yakubov Ploshansky: 32:30 I think that's such a, it's such a good point. Such a powerful way to think about that. Because sometimes we might think like, oh, I don't even know who you are, or I don't know who I am anymore, or, you know, you don't recognize each other. Like somehow you were duped. But no, we don't know how we're going to be in a situation we might, you know, hypothesize, we might assume based on our past experiences. But we really, truly don't know until we're there. Right. So I like that. I like that you bring that up to point out to people too. Yeah. Yeah. So seems like there is. And I've heard this a lot with some of my clients that there's almost like this struggle of, you know, when I'm grieving or when I'm sad, or something bad happens. I don't feel like I'm allowed to also feel joy, or to be happy or to experience these good things. Because this sad thing has happened, like, is that fair? Or is that okay? Relic? Is there space for all of this, especially in couples therapy, when maybe one person is a little further down the line in their grieving process, or just at that point where they're open to having more joy? Kind of, if you've been able to kind of help couples, like reframe that or allow them to like have more of these intimate moments where the connection is more light and not as serious, huh? Lindsay Bauer: 33:57 Yeah. So when you were saying that I was kind of going personally back to when my partner and I, we were going through our infertility struggles, which had a lot of grief associated with it. He so you are kind of saying like, one might be further along like that express lane. But it's not, you know, not just like in terms of where we are in our healing process, but how we heal. So he got his healing as an extrovert, very socially, and like going out and being around people. Me I got my healing from wanting to stay in. I'm very introverted and kind of like, like reserving reflecting, going inward and, and there were times that I was like, Whoa, by you going out. You're kind of abandoning me. And he said, I'm not abandoning you. I need to also go take care of myself. And so that open line of communication, you know, I feel I, I feel abandoned when you go out and are socializing. But the moment he said, Yeah, but socializing is helping me heal, it did allow me to kind of step back and say, Oh, he deserves to heal, too and his way, not just my way. So that's a big component is helping couples individually understand what works for them. Because like we were saying, this is a new world, right? This is a new process that we need to take on. And then how do we accept the way our partner is going to go through it? So a little bit of balance in there, my partner has to heal. But we also have to find a way to heal together, and what will that look like? Kira Yakubov Ploshansky: 35:44 I appreciate you sharing that. Thank you. I know that's not an easy part of our lives to vulnerability to bring through. So thank you for sharing that personal experience. Yeah. So Lindsay, I know that we could probably talk about this for much longer, so maybe we'll have you back again for another episode for something more in depth. But is there anything new coming up in your practice professionally in your life that you want to share with the listeners? Lindsay Bauer: 36:11 Um, you know, I wish that I could say that, that I was hosting like a retreat. I mean, all of that is coming. It's just there's no set date. I have a lot of ideas. I did just work on my website. So my website is now new and polished. It's beautiful. I love it. And actually, it's funny, we were talking about grief in couples, I actually have a blog up about that. So if you head to my website, and you go to the blog section, you can find that so if you wanted a little bit more detail, or sometimes being able to read that can be helpful. But yeah, I know in March, I will be doing a short yoga segment with retreat. It's for new moms post postpartum moms. So it's kind of like a retreat for new moms to go to. And there are two psychologists, I believe, who are hosting more details in the future. It's very new. But yeah, that's kind of what yoga ologies got coming up. Kira Yakubov Ploshansky: 37:20 That's awesome. Is this a virtual retreat or in person? No, it's in person in Conshohocken. Oh, nice. Wonderful. Lindsay Bauer: 37:27 Yes. Excited. Yeah. Yeah. Kira Yakubov Ploshansky: 37:29 And so your website is your yoga ology.com It Lindsay Bauer: 37:33 is not. I want it to be yoga ology comm working on it. But right now, the domain is Lindsay Bauer, M F t.com. Kira Yakubov Ploshansky: 37:42 Awesome, okay. And we'll put that in the show notes for everybody to go to. And that's how they can reach out to you if they want to work with you. Whether it's for individual couples therapy, or any kind of yoga or any of these retreats coming up in the future. Lindsay Bauer: 37:54 Absolutely. Yes. On the website, there are plenty of ways to contact me phone email, I even have a book a free consultation, which is very, very nice. Like sometimes people like let me just jump to that piece. I don't want to do all the emailing. I want my 15 minute consultation right now. Yeah. Kira Yakubov Ploshansky: 38:14 Perfect. onesie. Thank you so much for being on with us. This was awesome to talk with you and learn more about some of your insights and expertise. Lindsay Bauer: 38:22 Thanks, Kara. I appreciate it. ### Listen - [Spotify](https://open.spotify.com/episode/14405845) - [Apple Podcasts](https://podcasts.apple.com/podcast/14405845) - [YouTube](https://youtu.be/YtNjohvN-bA?si=y0QNmkcZOh_twpKn) --- ## Unveiling Patterns: Understanding Family Dynamics - URL: https://healyourrootspodcast.com/episodes/unveiling-patterns-understanding-family-dynamics - Published: 2024-01-17 - Season 3, Episode 4 - Duration: 49:31 - Category: family - Guest: Allen-Michael Lewis ### Summary Allen Michael Lewis explores family dynamics through genograms, examining intergenerational patterns and their impact on current relationships and mental health. ### Description In this episode we explore the fascinating world of family dynamics and therapy with the insightful Allen Michael Lewis, Licensed Marriage and Family Therapist. Navigate through the power of genograms to understand family patterns, intergenerational trauma, and how these dynamics impact our current relationships and mental health. ### Transcript Kira Yakubov Ploshansky: 0:02 You're not going to want to miss this hilarious and honest episode with Alan Michael Lewis talking about our family upbringing, relationship with food and diet culture, and the cultural norms around that. Alan also has a huge impact on the next generation of marriage and family therapist as the director of internships at counsel for relationships. Allen, I'm so excited for you to be on our episode today. Thank you so much for making the time to join us. Of course, Allen Michael Lewis: 0:29 I'm excited and excited to have this conversation. Kira Yakubov Ploshansky: 0:35 Awesome. So in the beginning, we kind of just dive right in, ask the therapists, kind of like, what's your origin story? How did you get into the field and just share a little bit about yourself? Allen Michael Lewis: 0:46 Well, you know, for me, 1776 a nation was I'm just getting complete works. And so I think that for me, a lot of my origin as a therapist came out of just coming from a very diverse and different dynamic kind of family. I've always been curious about backgrounds and upbringings. And like where people started off, and I just kind of thought it was like, Oh, this is interesting. And then I realized that, you know, in family therapy, that's literally what you do. You kind of like piece together this puzzle of where people are coming from, what they're coming with, how they learned how to navigate through the world. And I think that when I found out about family therapy, I was like, Oh, this feels good. This is something that I really want to get into. I remember taking my first family therapy course in undergrad. And I was like, wow, this is really interesting. I love it. And other people were like, this isn't for me. And I'm like, Are you crazy? This is sensational. How dare you? So and then from there, just going into really thinking about what were what do I want to do for grad school? Where do I want to go? What do I want to focus on and it was always, you know, this idea of like relationship therapy, family therapy. And so in grad school, still something that I was really passionate about, after grad school is still wanting that to be a focus of my career. And I think I can safely say without any type of chagrin, that I am a system snob. I very much am I love hearing about people's pasts. I don't like to get stuck with my clients in their past. But really thinking about how their past informs the here and now and will inform the future by think that it all comes down to just the fact that I'm like really interested and curious about like, where did you come from? And how did it inform the here and now? Yeah, so I also am a very big nerd when it comes to like genealogy and family research. So it just feels natural. Kira Yakubov Ploshansky: 3:03 I love that maybe that's why we get along as I love the systems work too. And I remember being in graduate school learning about it, and like walking around my parents house like diagnosing everybody one by one, like, Oh, this is my you're like, This is why I'm like that. Allen Michael Lewis: 3:21 Another thing that I do that I think is really niche is I you know, I like to read only fiction, nonfiction, I'm not really a fan. But whenever it's like a fiction book, I'll do like a genogram, or like a family tree. Because I'm like, I need to know this information. So you like see some of the books, like open the page, and it's like a paper, but I've been cheated grandma, and I'm like, don't judge me. This is my process. You know? That Kira Yakubov Ploshansky: 3:48 is hilarious. I love that. I still do that for every session in the beginning. Always do a genogram I love to learn about the family dynamic, right? I think it is so important. Like, yes, we're individuals. And there's other things that impact us. But relationships and our upbringing, I feel like is at the core of what makes us who we are. And like, you know, we develop before seven years old, we're conditioned with all these things, and then it impacts everything else. So I definitely love learning about the systems in the family, too. Yeah, Allen Michael Lewis: 4:20 and I owe every session. And this comes from like my internship days, we had to do a genogram with every client that we found. And so even for every session, I'll start with a genogram with whoever I'm working with. And I always tell the interns that I'm like supervising or whoever I'm supervising, like, I'm not saying well I'm going to do a genogram with you. It's more of like the way that I structure my questions. It's like I want to get a lot of information about where you came from. And I am like drawing a genogram is it using all of the symbols? No. Am I kind of like drawing like little things around like like denoting them? But things yes. But I do it with every client that I work with. Yeah. Kira Yakubov Ploshansky: 5:04 So for the listeners who may not be in the therapy world, can you kind of describe what a genogram is for them? So they understand like what we're laughing about? Allen Michael Lewis: 5:12 Yeah, so I was I was with my clients, I would say like a genogram is basically like a family tree with a little bit more information. It really is just kind of mapping out your family, with the different generations and the people involved. I always say like, the key people in your life. You know, there are some diagrams that include dogs and cats, and, you know, best friends. And, you know, though, you know, those friends aren't really your family, but they are your family. Because there's, they're important to you. And, you know, I've done work with clients who have grief because of, you know, their family dog that has died. And so it's important to have them on the genogram. Because, yes, they're not human, but they are very important and the work that we're doing, so it really is just like, like an ancestry.com, but I'm reading it out. And maybe I don't have all of the like, you know, birth records, but you know, I have the information. Kira Yakubov Ploshansky: 6:10 Absolutely. You know, I'm gonna start asking about family pets. That's a really good point. I never thought about that, because that is pretty huge. I Allen Michael Lewis: 6:17 am a very big animal person. Well, with a caveat, I am a fuzzy, animal lover kind of person, reptiles and snakes. If that is your niche, wonderful, it is not my minutes. But it's also to the other side of like, I do think I was like, you know, humans really missed, missed it when we didn't domesticate bears. I really would want a pet bear. That is. So anything fuzzy, I'm like, Yes, I want to talk about this. But when clients are like, Well, I have a really big, you know, Python? No, that is lovely for you. In the back of our minds. Kira Yakubov Ploshansky: 7:00 That is hilarious. I love to ask the question. For clients like to, you know, describe like your mom's personality. But before you do, how would you describe her when you were growing up versus now as an adult? Because I feel like that answer is really different. And how they perceive that is really different as well. And you get so much information from seeing the difference between those two answers. Allen Michael Lewis: 7:27 Yeah, and I also like asking about, you know, like, the different, like levels, I always say like, so starting off with the person, tell me about yourself, tell me about, you know, who you are in the here. And now. Tell me, do you have any siblings? Oh, tell me about the different siblings? Are you close with them? And then working my way up that way? Because I think that that way, it's kind of like getting the lay of the land. But then as you're kind of going through the different levels, it's like, adding more light into these different areas of like, Oh, me and my brother don't get along. Oh, he's very much like my father. How do you get along with your father? Well, he's very authoritarian. I'm like, you know, so giving us overly like, kind of like building it in that way. And then sometimes I'll show the genogram to my clients. And they'll be like, Wow, that's a lot. And I think that it's really empowering, because it really shows you all this is going on. Yeah. And now I'm doing this work to prevent, potentially block some of these patterns from continuing or change some of the dynamics or we're working on this together to, you know, create a new narrative for ourselves. By the loved one, it's like, oh, that's a lot. And I'm like, Well, yeah, it's a family. I mean, it's a it's a system, it's, you know, it's the nitty gritty of everything. So it makes sense that it's a lot. Kira Yakubov Ploshansky: 8:48 Absolutely. And everyone kind of has their own role. Every sibling, each parent, right, like the hierarchy of things. It's, I feel like we could have talked about just family therapy for five hours. I don't know how I didn't put this on the talking points. But Allen Michael Lewis: 9:03 yeah, it's a lot and it's in depth, then I know that, you know, as therapists were coming in with our own things, you know, whenever I'm sitting across from somebody who's like, well, I'm the youngest. I'm like, Oh, me, too. I get it. I get it. Because, you know, then I'll be sitting across from somebody who's like, I'm the oldest and the youngest is, you know, they get everything. And I'm like, wow, I don't think we do. Kira Yakubov Ploshansky: 9:30 I speak for the group. And Allen Michael Lewis: 9:33 actually, we, you know, Kira Yakubov Ploshansky: 9:37 that's hilarious. And so who do you like, Who do you work with now? Where do you work? What's the setting that you work in for people to kind of hear a little bit more about that? Allen Michael Lewis: 9:46 Yeah, so now I'm currently working at counsel for relationships, shout out to counsel for relationship and I'm doing teletherapy so I am able to see clients in Pennsylvania Joe Delaware, Florida in New Jersey, hopefully New York soon crossed. And so a lot of the work that I have been doing is a lot of patterns work. And a lot of, you know, hey, we're coming in with this, I'm noticing this in my relationships, I'm noticing this in the dynamic with my partner or with my family members, or whoever I'm engaging with, what does it look like to outline that pattern? Block that pattern from continuing? What would you need to build a new pattern? And how are you going to make sure that that pattern sticks, because I think that's something that I work with my clients is, you know, we operate the way we operate, because we've learned that this is how we can get through life. You know, if I pull somebody in, I get what I want. But then when I don't want anymore, I distance myself and push them away. And that's really like the self protective method of doing things. But if I'm in a relationship with somebody, and I don't want to push them away, but I don't know how else to do it, then the work really is how do I block that pattern from continuing? What might I need to create a new pattern? And how am I going to make sure that I'm not going back to my old pattern, but that I'm sticking to this new pattern? And I think that I bring up this like pattern work? Because, you know, whether it's an individual, whether it's a couple, I'm working on the pattern work? And yes, we're talking about other things while we're talking, you know, we're talking about patterns. But I think that at the core of it, it really is, what do I want to see? How am I going to get there? And what might I need to get there? Because I think that the, the tendency is, I know where I want to go. And oh, if I could just do this, if I could just do this. But folks always forget about evil, you need tools, you need people, you need things that are going to help you to get to where you want to go. Absolutely. Kira Yakubov Ploshansky: 11:54 And I think, especially since you really dive into systems and families is also recognizing where this pattern came from, why it served a function before. And why it's not anymore. I think that sometimes there's a gap between that because we think like, we just keep doing this thing, why do I keep doing this, I know it's bad for me, I know it's pushing people away, or I'm being too needy or whatever it is, and we're not always aware have the insight of, well, it's not necessarily a bad thing, it wasn't always a bad thing or unhealthy I needed it to survive, or to get through the relationships while I was younger with family members or siblings to get what I needed. And now I'm out of that environment. And it's no longer functioning the way I need it to. So like now I need to revamp the way I operate in relationships. Allen Michael Lewis: 12:46 And I think a lot of the clients that I work with, they come in with a lot of shame or blame about the way that they interact. You know, like, Oh, I'm just unlovable, nobody can love me, I'm just this, I'm just that I can't believe that I acted this way, I ruined all of my relationships. And I think a lot of the work that we do is the difference between blame and accountability. Like this idea of blame, it really is just keeps you stuck. There's nowhere for you to go. You're just holding this immense pressure, you're holding all of this emotional weight. And you can't go anywhere for accountability. I think that there is a path forward, if there's this idea of I'm recognizing my role. I'm recognizing what I've done, I'm recognizing the patterns that I've played, and it's informing how I'm going to move forward. If I push people away, I can take accountability, but I've hurt people. And also what does that mean, for me moving forward? How do I no longer hurt people? How do I do the work of not pushing them away? Because I know that it's caused harm. So I think that a lot of our work is this idea of like, well, how do I get to this point of accountability rather than blame? Because I don't want to be stuck anymore. Yeah. Kira Yakubov Ploshansky: 14:03 And that's a tough balance to get to, especially when the blame is mixed with shame, right? Because we can kind of really get stuck in like, whether it's self pity or just feeling horrible about ourselves and almost not recognizing the impact because we're just feeling so intensely about ourselves and the things that we've done, that we just associate like I'm a bad person versus these patterns, or the way I've learned to interact with people isn't helpful or isn't conducive to what I want. Right? And like the other end is like being entitled is just like, well, I can do whatever the hell I want. And it doesn't matter. So it's finding like I think it was, I was at a conference. I think it was Terry real he was talking about finding this balance between like stern love with yourself, right? It's like, you should feel guilty by hurting somebody but you shouldn't feel so guilty that now you're stuck in the shame. So it's like that accountability is that middle piece because If I'm like, Okay, I'm not a bad person, I've just done something to hurt somebody, I can learn and move forward. Allen Michael Lewis: 15:07 Yeah, and I think that it's even harder to when you have that shame. And also when you're doing, you know, like, work with your partner. And maybe they're not ready, necessarily to kind of like, because I think that it can be like, if I don't stay in blame, then you get scot free, you get off scot free, or like, we don't have to ever bring it up, or my feelings aren't being validated. If I don't stay here, then you get to do whatever you want. Once again, and I'm not heard. And so I think that in working with partners, especially, really taking into the room of you know, you can take accountability, and still hold the emotion of the other person, you don't need blame to validate your feelings. Part of our work is leaning into that uncomfortable of being mindful, hey, you hurt me. And we're still trying to figure it out. And just because you take accountability, it doesn't mean that my hurt goes away. Because I think that that's the biggest fear. If I allow this person to move forward, is my pain going to be disregarded? Yeah, Kira Yakubov Ploshansky: 16:15 they're just going to repeat it. Again, it's not changed behavior. It's just an apology, and it doesn't move anywhere. And Allen Michael Lewis: 16:21 then I'm enabling them, because I'm allowing it, I'm allowing our work to move forward. And me just forgetting about everything we've done. Kira Yakubov Ploshansky: 16:31 This is the lovely pieces of couples therapy. Allen Michael Lewis: 16:34 Yeah. And I think that I've also seen it like in, you know, couples and families, because even like with working with parents, this idea of when I've worked with individuals, how can I can understand where they're coming from. And if I give them if, if I forget what they've done to me, I'm letting them off the hook, I can see that my grandparents weren't great parents, I can see that my parents experienced abuse or neglect, or they were not equipped to be parents. If I take that into consideration, am I then just letting them off scot free? No, my feelings hurt, my pain hurts. So a lot of the work that I even see with individuals is, what does it look like to know that there might not be a similar accountability for your parents, but you can take accountability for what this means for you, and how it informs you moving forward with them. So it's really it's a lot of hard work, it's a lot of heavy lifting. And so I always tell my clients and like, make sure to be kind to yourself, you're doing a lot of deep work and heavy work. But it's worthwhile work. Kira Yakubov Ploshansky: 17:43 Absolutely. And it's tough with families, I think it's a little bit different than a romantic partner. Because there's this different expectation, or there's a different level of loyalty or commitment kind of in that way. Especially if you're coming from a very family oriented background or culture, where it's like, well, our parents may be a particular way, or they aren't the best, or they're not as emotionally available or intelligent as I would prefer may have needed, but I don't want to cut them out of my life. And they don't understand or get a lot of these things that they're doing to me. So it can feel like one sided work of like, okay, I'm gonna empathize, understand them, and they may not always be able to meet me where I need them to be. And it's okay. Sometimes it's okay, sometimes it's not right. But that's like a decision for the individual to make, like, I'm just going to accept that this is the level of closeness I can maintain with my family in order to still protect myself and not cut them off. Allen Michael Lewis: 18:48 And I think that it comes down to what we're bringing into the room as therapists too, because there are therapists, that would be like, Oh, your parent doesn't treat you well cut them off. And they're not taking into consideration the culture, the background, even the idea of like, if I cut off my parents, I'm also cutting off any type of contact to my community. Or I'm cutting off any type of contact to my siblings. And I think that that could be detrimental to the client. I also think, bringing in what you might be experiencing as a therapist, because for you as a therapist, maybe you cut off your parents. And so it's like, oh, it's the best decision I made. So why not give it to my clients, when in reality, it might not be the best and it might not turn out the same way. So I think that it's a really tricky part as a therapist to have, like, what am I bringing into the room? Because maybe I'm not done with all of the work. I certainly have not done with all of my family of origin work. But you know, what am I bringing in? How is that influencing what we're talking about? Yeah. Kira Yakubov Ploshansky: 19:52 And I see that a lot and in terms of like, just being an immigrant as well and like coming from that family oriented background. is rarely are, am I going to recommend cutting off a family member. Because it's like you said it's so detrimental in so many different ways. And relationships are really complicated and complex. And it's not always black and white and having that cultural context. And also knowing that what is kind of the norm within a culture is not going to be the norm, and socially acceptable in let's say, America, right, or, you know, any a different particular culture. So it's also kind of not putting our countertransference on somebody else, because, well, my family or how I was raised, that would be really wrong, really emotionally abusive. So like, that's horrible. You should not speak to them. Like, wow, that could be a whole culture operates. Yeah. So we can't have everybody. Allen Michael Lewis: 20:54 Yeah. And as you were talking, I was, I thought about like, times where in therapy, folks will talk about self care. Because I think self care is another one of those things that really is like, blinded, it can be blinded by a therapist, it's like, well, you know, what I think you should do, I think you should just schedule a massage. And just go to this local spa, here are some referrals. I don't like spa, massage, listen, coming from where I came from, I'm not going to a spa. I'm not getting a massage, nobody's touching me. And also who has money for that, you know, so I think it's another thing where it's like, sometimes as therapists, you have to be mindful of being in touch with where your client is and where they're coming from. Because some of the things you're suggesting, it's like, no, that's never gonna fly. What are you doing? Yeah, yeah. And in self care, just irks in my life anyway, because I think it's gonna become this, this sense of like, you have to do something grand and big. But that, once again, that could be another five hour conversation. Kira Yakubov Ploshansky: 22:01 So I love your Instagram MFT foodie, I actually really look forward, I'm like, Oh, I wonder where he's at this week, to see like the different coffee shops in the food. And I love that you really promote that healthy relationship with food, would you be able to elaborate or dive a little bit more into that? It is Allen Michael Lewis: 22:21 a journey. And I think that it's a journey that a lot of folks have, where they have this, especially if you've grown up in any type of American culture, you know, you have this really weird relationship with food. And it's like this very big fixture because it's something that you need to survive. But it's also this very grandiose thing that can show power and status in all of these really negative things. But I think that we also forget, and we also lose touch that it can be a really nice thing that brings people together, that we're able to connect with, that you can nourish your body with, but in a way that really appreciates the ingredients and appreciates, you know, the different benefits to the body and the different ways that you interact with the food or even just in, like the cognitive aspect of the pleasure that you can get from different types of food. And it doesn't always have to be like, deep fried, to enjoy. It can be just like the different flavors and the tastes. And I think that it can be I think that food can really just be this thing that is very divided, when really it can very much be something that you can just bring people in together with. So I think that when I think about MFT foodie, it really is just building this community of people that I don't have everything figured out. And I don't want to be on any type of spectrum of I only eat boiled chicken and broccoli and or I eat whatever I want. And it's all fried and greasy and everything. But there can be this middle where we don't. We don't have everything figured out. But we can learn together. Because I certainly don't have everything figured out. It's always going to be a food journey for myself. But yeah, I think that I think that that's really what my mission was when I combined two things that I love food in therapy. Kira Yakubov Ploshansky: 24:18 I love food and food is definitely one of those things we think about pleasure is just all the different memories caught up in like different kinds of food too, whether it's like from growing up or different places you're at or like the experience you're having with food and sharing it with people. And it's interesting thinking about also from a cultural perspective of how different every culture or similarly treats the relationship with food, but also within the family. And then within that culture of how they expect romantic relationships to or like how you view yourself within that too. Because I'm thinking about, like my background like Eastern European is is very contradictory. You know, feeding your family is a love language. And having you know, your children and your grandchildren eat everything off the plate is like a sign of like love and respect. And if they don't, it's like you didn't like my food, like, you're gonna be hungry. But then at the same time, it's like, well, if you gain weight, or if you look a particular way, who will marry you? And it's like, yes, very confusing and conflicting. And that's just like, the common narrative around it at least in like my background. Allen Michael Lewis: 25:37 Yeah, and I think that that's why, you know, we're in a very big season of eating. But then also, I don't know if you're a Hunger Games fan, but the the new movie just came out. And I think I'll read and I'm like, Oh, God, I'm a capital citizen. I'm a capital citizen. For anybody who doesn't know. Suzanne Collins, I think she wrote as like a symbol of, you know, the traditional overabundance, overindulgence kind of like American mentality for the capital citizens, they always want more, they always crave more, they have a drink that they drink to throw up so they can eat more food. Yeah. So it really very much is this idea of food shows a sense of, oh, this is how far I've come. Or I can, oh, this is a big deal. I can do this, I can do this. But then it also has this really negative side of things of like, oh, but don't get too fat. Like you were saying, Oh, don't do this, or, Oh, don't eat this, or I can't believe you know, you ate that because now you don't deserve. And that's a big thing. It's like LF IV and dessert, I don't deserve this, or I can't eat the next day, or I have to exercise out all the food that I've just eaten. And it really is this like very big yo yo of these counter intuitive and contradictory statements that we tell ourselves, oh, if I've eaten too much, I don't deserve to have my partner, my partner will never love me. So just a really strange thing. And it's also those internal messages that maybe aren't so drastic that we never think about. It's like, oh, this is a bad food. I don't want to eat that because it's bad. And it's like, oh, what's bad about it? Well, it has a lot of sugar. Well, sugar in itself isn't necessarily bad. Some people will be like, No, it is high fructose corn syrup. Okay, that's fine. But I'm just really thinking about these like internal messages where we've just maybe they're not as drastic, but we carry them around. And they've impacted our relationship with food. And we really need to consider them. I have Kira Yakubov Ploshansky: 27:46 a newborn daughter now. And so the way I talk about my body, and my relationship with food, is something that's directly going to impact her and how she thinks about herself and her relationship with food. So I'm trying to be really conscious of, I'm conditioning myself around that. Yeah. Allen Michael Lewis: 28:04 And I think it's even like socioeconomic status, its its gender, its racial. Because, you know, apparently, well, my family wasn't well off at all. But my, I think that my older siblings would say, like, oh, you had it great, because we were up enough when I was born. But really being mindful that if you are really struggling to meet, you know, to meet the needs of the kids, or, you know, you don't have money for food, or you're relying on donations, or whatever it might be, you know, you really have to think about, I don't know, when my next food is going to come in, I'm going to just kind of indulge, or it's going to be high, high fat, high salt, high everything kind of food. And that's what your body's going to get used to. So it makes sense that it's going to be this like, famine and feast kind of mentality. And how does that trickle down? Even if, you know, I was born on the up and up, you know, how is that still going to be something that my family lives off of? And that mentality continues? And I think I even see it with some of the clients that I'm working with. It's like, Oh, we didn't have this, but now I do. And now I'm hoarding or now I like consume a lot of or this is a comfort of mine. And really thinking about well, like it has an origin serves a purpose. So it shouldn't be coming from a place of shame. It should be something that we acknowledge and we honor that that was how you had to really think, and what are some other ways that we can shift that thinking and what are some of the supports that you might need to to assist with your journey? Kira Yakubov Ploshansky: 29:43 Yeah, absolutely. And it's such a good point to think about that, like ancestrally like throughout, whether it's like your parents or your grandparents or your great grandparents, right? Because that is passed down like that intergenerational trauma or beliefs or narratives because I'm thinking about like, you know, I came from former Soviet Union and my parents and grandparents and great grandparents and you know, several before that was in communism, or like there was a lot of food insecurity. And like, our diets are made up of meat, potatoes, bread and fat. Yeah, right. And like, I love that, but it's, you know, thinking about like, yeah, that makes sense why they ate that is to feel full, because otherwise he didn't have enough food. Or it would go back because there weren't preservatives and like that being passed down, I think is really important for people to also to recognize, I think that's such a great point to think about, like, it's not just you right now. Or even your parents, it's like, how long ago did this kind of really instill this message of the type of food you needed to survive? Allen Michael Lewis: 30:46 And I think like the cutting out of food, too, can also be cutting out different cultural things that are very important to you. I always think about times where it's like, well, have you ever thought about not eating, you know, beans and rice, they're very heavy. And I just like feel like this, like, ancestral, like immediate head snap from like, all of my answers. And I'm like, I'm pretty sure that there are 1000s of ancestors and 1000s of parts of the world that have just screamed in their grave, because literally, rice and beans have provided for many multitudes of people. So I think really not going the other side of like, oh, this is bad, let's cut it out. But more of like, yes, they have survived off of these things. And let's really put it into context. Maybe ancestors who ate a lot of rice and beans, were, you know, doing a lot more than me who's doing teletherapy in my apartment, you know? So really being mindful of like, How much am I consuming? How can I still have it in my diet, and also take into consideration my different activity level than what my ancestors would be doing? And because I think that putting it into context allows for a little bit more of grounding and strength, rather than feeling like I have to do this very hardcore thing. And this very restrictive thing, because then it's going to feel like well, I don't want to but I have to, as opposed to coming from this place of rounding of figuring it out. And maybe there are going to be some trial and error, but at least I'm coming from a place of strength. Kira Yakubov Ploshansky: 32:13 Yeah. And different lifestyle, different environment, different needs and demands of you. Yeah. Allen Michael Lewis: 32:20 And I think that it's really just unfair, that, you know, the high calorie foods are the delicious food, like we said that some people would be like, Well, hey, you know, like, turnips are delightful. Compared to cake. That, you know, Kira Yakubov Ploshansky: 32:43 I'm like, I know, thinking about like, not eating a potato. The rest of my life would feel like a betrayal. Like you're saying, like rice and beans, like, What do you mean? Allen Michael Lewis: 32:53 I did, I was in New York City. Food capital, potentially. Delhi, I did hear is, you know, kind of building up there. And I was sitting in a coffee shop, and I just heard somebody next to me. And they were talking about their food. Yeah, I just had this really great dinner. I'm like, this is exciting. Because I'm used dropping. I'm a therapist by trade. So I'm listening. And he's like, I had boiled chicken or my elbow, me like, and I had some potatoes, just like two. And I was like, like, whole calves. And then he's like, and then I had some, like, some steamed broccoli. And, you know, I cut it up into half, and then I saved the other half for tomorrow. And, you know, I feel good. And I'm about to go to the gym. And I'm like, in New York City. I don't know if I would have that restraint. God bless you, sir. Because I listen, I'm going to, and that is my cross to bear. But really, like, did they have to make it? Like, why couldn't if you bite into a pair, it was like, you know, cheesecake? Or wonderful. You know, Kira Yakubov Ploshansky: 33:59 we'll say some fruit definitely hits the spot. Allen Michael Lewis: 34:02 Yeah. And I think that's something I like. So I work with a nutritionist, shout out to body metric in royersford. Whoo. But they were talking about how, you know, there are certain foods that you're going to just be craving, and you're gonna be like, Yes, this is what I want. And as opposed to being like, oh, I can only eat this. And that's it. But really thinking about how can I have this food and other foods that are going to fill me being atrocious, get me the things that I need for my body to function. And that was a really big change. Oh, you know, like, as opposed to like, Oh, if you eat this one bad thing, you could that's all you can eat. You can't eat anything else, because you're too high in calories. But really thinking about it in a way of like, How can I have this need met, while also getting these other nutrients that I need? And so it's a more adding to Yeah, as opposed to like taking away from Yeah, and kind Kira Yakubov Ploshansky: 34:57 of listening to what your body needs, right? Because you're saying And like you're not always, someone's not always going to want fried foods just because it's tasty sometimes, like, we just got a pizza oven, and we have been going ham on making homemade pizzas. There was like, the second day, I was like, I can't do it anymore. Like, I feel like I just want something fresh, like I want to vegetable I want to salad. And that was just my body telling me like, this is delicious, for sure. And we're going to do this next weekend. But like, I can't, I don't want it anymore, which was interesting, because in my mind, I'm like, I need pizza every day. I Allen Michael Lewis: 35:33 think that that's, we That's why I can really understand the seasons. Because like, it's the earth way of saying you don't need this thing all the time. If, if watermelon existed the entirety of the year, I would eat every day. It's delight, watermelon peaches. I've been in a raspberry era. It's pretty exciting. Kira Yakubov Ploshansky: 35:57 That's hilarious. I feel like this could just turn into a food show. I'm just thinking about. Allen Michael Lewis: 36:03 I actually transition to my kitchen. I'm like, Hey, we're going to I would love to incorporate that into therapy. But I know I know my boundaries. And I know that if we did something and it didn't turn out, I would be more than be the client. I'd be like, what you weren't so hard, you know. So I'm like, I don't think that I will be incorporating cooking. But I know that it could be really beneficial for people in therapy. That Kira Yakubov Ploshansky: 36:32 would actually be a really cool experiential way to process and heal some things. Allen Michael Lewis: 36:38 Oh, there was a really great tic toc or I forget, I think her name is Alicia. No, I don't think so. But she was talking about healing her inner child. And one of those things was that she bought a box of brownie mix. And when she was a child, they had to do the brownies a certain way. They couldn't eat them only until their her stepmother said that they could eat them. And they had to be served in a different in a specific way than to be cut in a certain way. And there was a time where something had happened where she was reprimanded for something she didn't do. And it was really tied to this. So part of her healing her inner child was she made the box of brownies, she did it in a completely different way than she had to when she was a child. And then when they were done, she didn't wait for them to cool. She cut a triangle, I think it was in the middle of the pan, and then just scooped it out and ate it over the pan. And I thought it was really great because it really was this idea of I'm honoring this past that I've had. And I'm honoring what I really wanted from when I was a child. And now I'm able to do it. Because I have a little bit more control over my narrative. And I can really heal that part of me by saying like you didn't do wrong, just because you did things in a different way. It's okay to do things differently. Kira Yakubov Ploshansky: 38:02 I really love that. That's also how I eat food. Yes. Allen Michael Lewis: 38:08 I am a dance mom when it comes to baking. Because I'll be like No, not yet, or we have to do this. So that's why I'm just like, you know, maybe baking is a personal thing that I do for myself. It's not really a group activity. And that's part of knowing your boundaries and knowing your capacity. And I talked about that with my clients all the time. Because I think I think, you know, I'll be talking with friends and yeah, maybe like our kids, you know, like, could come over and you like bake with them. And I'm like, or I get all of the ingredients. And then I send it to your house where you live. You know, like, I don't want to be that person who is like, No, you didn't decorate ready to like the chat. Now your capacities, understand your capacities. And it's okay to honor your capacity, Kira Yakubov Ploshansky: 39:00 that self awareness and insight. Allen Michael Lewis: 39:04 It came at, you know, like, there were a couple of times where I was cooking or baking with something, somebody and I'm like, I have to breathe through. I have to be through it. That was about to lose the plot. Kira Yakubov Ploshansky: 39:17 And then there was Thanksgiving dinner. Oh, Allen Michael Lewis: 39:21 it's it's it's Christmas. For me. My Christmas has to be this way. But yeah, well, I'll get there. We'll get there. Kira Yakubov Ploshansky: 39:32 That's so funny. I did want to touch on so I know that you work at counsel for relationships, and you're the director of internships. And can you share a little bit about that experience because you have all of these budding Marriage and Family Therapists about to go into the field. So you get to mold the minds of all of these new therapists coming out. Yeah, Allen Michael Lewis: 39:54 so CFR currently has 75 Yeah, it is a You can laugh riot. But I think that it's great because we live, we literally see, folks, you know, some of our interns have never seen clients before, in any type of context, some of them have seen them in other like group therapies or other settings. So it's really cool to see somebody who's just starting out and see them go through the different, you know, feelings of being a first time therapist and then getting a little bit more comfortable, and then getting to the end of their program and then launching into the, into the field and having their first clients wherever they're working. So I think it's really cool to be able to see, like, literally from the beginning, their growth happening. And I also supervise in the program. So it's really cool to be able to be part of, you know, people's initial steps as clinicians, it can come with a lot of trials and tribulations. But overall, it really is this awesome time to really just be able to see people blossom. And I always say it's like, if you know, when when I use a when I don't say, when you have the career that you want, and you've written your book, or you've written whatever you would like to do. Just remember in that little acknowledgement section for Alan was positive, yeah, it might be just positive, you know, you really taught me everything, it also might be that negative for Alan, because I've thrived in spite of because there is part of this director role where it is like, you have to do this, you have to do that, to show that you do this, you have to, you know, kind of being the heavy. So whether it's in spite of or because of the shadow is appreciated. There's no bad press. There is not. Kira Yakubov Ploshansky: 41:45 That's awesome, though. And so during those classes that you have with them, is it helping them find the internship or they're interning at Council, and then you're kind of doing that supervision class with them to talk through everything that they're going through? Yeah, Allen Michael Lewis: 41:58 so they're interning at the council. So we take students from Thomas Jefferson University, and then we've have partnerships with University of Pennsylvania Temple University, Bryn Mawr College, West, Chester University, all of these different places that we're really trying to build connections with. And so they'll come here, they'll do their clinical placement with us. I supervise with the master's level students. So we'll meet either for two hours, depending on if I'm meeting with two people or one hour if I'm meeting with one. And it really is to watch over their caseload, watch it, watch their case videos, and talk about what's going on clinically. Because I think that the thing is that a lot of the folks that are in our internship, they have this innate ability to meet clients where they are talking about what they're experiencing. So for those who are listening, who are like, Oh, I don't know about seeing an intern for therapy, no, it really give it a shot. And really, really go with an open mind. Because a lot of these folks are in this field, because they want to help and they want to meet you where they are, you are and they want, you know, you to achieve your goals. And they have the skill set innately of listening or connecting with you or joining or really just holding what you have to say, which is something that sometimes our family and our friends don't do well. So they really are coming in with these skills that we're now just teaching, hey, here's a technique, here are some, you know, theories to apply to what you already are doing. That's how you do a therapy session, you know, so I think that it is really amazing, being able to invest in the skills that people are coming in with, and allow them to flourish in this new way of, oh, now I'm able to use my skills, but I'm also attaching theory, I'm also attaching clinical practices to it, and helping people in the meantime. Kira Yakubov Ploshansky: 43:59 And they really do care. I mean, obviously, we still care as therapists, but I think like when you really start you just like the amount of care you have, and compassion, empathy, and like you just want to do so well, that sometimes we go above and beyond. Brian, you have to like reel it in a little bit. But it is true. I mean, for people listening, if you have the opportunity to see an intern like, I don't think it's necessarily a negative experience, just because they're not as experienced in the field. They actually care so much and want to see you do well and grow and heal. So I think it's a great experience. I think it's awesome. That counsel provides that till Yeah, Allen Michael Lewis: 44:38 and I think especially, it's just really interesting. I talked to a lot of people who are like, well, I can't I haven't been able to find a therapist and I'm like, what's going on and they're like, everybody's fall or everybody's busy every I can't afford it. I think that like price can always be a barrier. So I think that it's great that we have these 75 people who really are just eager to help and eager to learn, and they're learning from their supervisor, and they're implementing it in the therapy. And it really is like a, if you reach out, you really get connected with somebody very quickly. So I think, you know, that's what I always say like, don't let the sun go down on interns. I think therapists are just like anything else, if it's not your cup of tea, or if it's not the person that connects with you, it's not the person who connects with you. But don't let it just be because oh, they're an intern or they don't have a license yet, that really deters you from seeing somebody, if you might meet them. And it might be a really great fit, and really good connection and something that you really need where you are then. And that might be somebody who's like, we don't really jive together, and that's completely fine. I always say to my clients, like, if it's not me, that's completely fine. I'm here to help you however I can and get you to where you need to be. But I think that it can be really hard taking that first step of, you know, what, if it doesn't work out, I think that that's part of the therapy practice. And I think that's part of the therapeutic journey. So don't let that be a reason why you're not reaching out for therapy. Yeah, Kira Yakubov Ploshansky: 46:09 and I think I say this a lot to clients, or even people who are looking for a therapist, like, it is a lot like dating, you know, like you're going to meet, I mean, I think you're going to be really lucky if the first therapists you meet is like the match, because that's incredible. But that doesn't always happen. Because you may not even know what kind of therapist you like or need, or the approach that will be best for you until you kind of meet a few people and try. And it's just, you know, giving it a shot, like you're saying and seeing who might be a good fit, because maybe on paper, it sounds great. And then you meet the person and there's just like, no energy between the two of you, for whatever reason, or you might have felt this person wouldn't be a good match and gave them a shot and like, wow, this is like, perfect. You really get me I feel comfortable. This is a great match. With the caveat like Allen Michael Lewis: 47:01 much like in dating that it really be mindful of what is the what is the know for you? It might be like, well, you know, I entered and I sat down and they didn't say how are you? Oh, okay, that's that's the No. Be mindful of like, am I giving this person a shot? And also give it a couple of sessions? Like, is this something that we're ramping up? Because you are just meeting a stranger? Yeah, I think it can, you can meet somebody who is like, Oh, I feel like I've known you for years, it feels good. This feels like good work, clicking, clicking, clicking. But also, maybe it's a relationship where it takes a little bit of time to get to know the person and like, oh, we do good work. But it's taken us like three sessions to really ramp up and really understand each other. Yeah, Kira Yakubov Ploshansky: 47:45 first session is not going to be like your world is changed and your heel, right? Like, they are literally just getting to know who you are, and like the lay of the land and what's been going on. And for a few sessions continuing to do that before we can really offer a lot of insight or help you. Yeah, Allen Michael Lewis: 48:04 and I think that that's another reason why Hollywood has really worked against us, as therapists, because in every movie, or every show, they go to the therapist once. Yeah, and that first session is how everything changes. And you're really putting bar pretty high. And I don't think that this is accurate. Kira Yakubov Ploshansky: 48:22 Not realistic. I don't know everything about you. Allen Michael Lewis: 48:26 They do the same thing for like dating and relationships and data, but in this world, it is a nightmare. Kira Yakubov Ploshansky: 48:36 Oh, my goodness. Well, Alan, I want to be respectful of your time. I feel like we could talk for hours about so many different things. So we'll definitely need to have you back for another episode. But can you please share with the listeners where they can find you to work with you or to go to counsel? Allen Michael Lewis: 48:52 Yeah, so if you want to follow me on Instagram, it's at MSFT foodie. If you would like to work together, you can reach out to counsel for relationships in Philadelphia, Pennsylvania. And that's for anybody I do. teletherapy like I said, for folks in Delaware, New Jersey, Florida. Shout out to New York, New York, hopefully soon, like I said, and then also in other parts of Pennsylvania. So going to www dot counsel for relationships.org. And you'll be able to find me there and hopefully we'll be able to work together. Awesome. Kira Yakubov Ploshansky: 49:27 Alan, thank you so much for your time today. I really appreciate it. Thank you ### Listen - [Spotify](https://open.spotify.com/episode/14343211) - [Apple Podcasts](https://podcasts.apple.com/podcast/14343211) - [YouTube](https://youtu.be/FFKoqAE6G4I?si=JSXgNvLzSI5sxYAB) --- ## Navigating Non-Monogamy: Communication and Boundaries - URL: https://healyourrootspodcast.com/episodes/navigating-non-monogamy-communication-boundaries - Published: 2024-01-03 - Season 3, Episode 3 - Duration: 42:15 - Category: relationships - Guest: Caitlin Harrison ### Summary Open discussion about non-monogamous relationships, covering communication, trust, boundaries, and addressing common misconceptions about alternative relationship structures. ### Description Join us for an open and honest discussion about non-monogamous relationships, exploring the essential elements of communication, trust, and boundary setting. This episode addresses common misconceptions about non-monogamy while providing practical guidance for those considering or currently navigating alternative relationship structures. ### Transcript Kira Yakubov Ploshansky: 0:00 Welcome back to Heal Your Roots Podcast. On today's episode we have Caitlin Harrison Marriage and Family Therapist and newest member of our team Kailyn shares how she uses EMDR to help treat trauma, specifically religious trauma, family wounds and upbringing and her work with couples. You're not going to want to miss this episode. Please remember to like, share, and subscribe. Welcome back to Heal Your Roots Podcast. I'm so excited for today's guest. She is one of our newest therapists at the practice. Caitlyn Harrison Marriage and Family Therapist. Caitlin, thank you so much for joining us today. Caitlin Harrison: 0:34 I'm excited to be here excited to get started with the practice to awesome. Kira Yakubov Ploshansky: 0:40 So we always start these episodes with really diving into the therapist background. So if you can kind of share what made you become a therapist and kind of your journey along that way. Caitlin Harrison: 0:50 Yeah, so marriage and family in particular, I sought that out from a master's program because, for me, that's when I saw a lot of my just growth in life. And that's when I was able to really like kind of discover who I am. And what's important to me. And so what I mean by that is when I was able to learn more about my family of origin, learn more about what I carried from how my parents raised me from how being an oldest child affected me, and how I might be even carrying some of my own, my own anxiety may be carried from my family in generations past, it kind of, it kind of blew my mind and kind of took a lid off of me that I had on for a long time. And so that's what gave me my passion for this field in the first place. And that's what gave me the passion to seek it out. So Kira Yakubov Ploshansky: 1:45 that's awesome. That's it's funny, because I also had that experience when I was going in for grad school with like counseling. I was like, oh, let's try marriage and family because I feel like it's pretty broad enough. You can work with kids, couples, families. And then as I was going through these classes, too, I'm like, Oh my God, our family, and our relationships, and different generations shapes so much of kind of who we are and how we see the world and everything. So it definitely makes sense that that kind of like solidified it for you as well. Absolutely. Yeah. What made you want to get into therapy or psychology in the first place if you don't mind sharing? Caitlin Harrison: 2:24 Yeah, so like I said, therapy and self discovery and digging into like, Okay, I have this, this anxiety or these feelings that are holding me back. And where is this all coming from and just talking about it over and over again, with family and talking about it with friends wasn't getting me enough past it. And so therapy for me, it was one of the most important like instrumental parts of moving me forward in my mental health journey. Um, and aside from that, I've just always been the kind of person that loves to study how the human brain works and human behavior and understand why we do what we do and personalities, I was always into, like Enneagram Myers, doing anything I could to learn about, like, who am I and who are you and so, I always kind of had that bend anyway, so yeah, Kira Yakubov Ploshansky: 3:20 that's awesome. I used to love those personality tests. I made everyone take the Myers Briggs Do you know what your, your personality like? The combo? combo is? Or if you feel comfortable sharing? Yeah, Caitlin Harrison: 3:32 yeah. So I'm very borderline, introvert extrovert. So I always score like very fine. Like lying between those two. I would say personally, I lean more towards that extrovert. So that'd be the E and then S. So sensor. F for feeling and then j so yeah, Kira Yakubov Ploshansky: 3:54 ESF J. I think one of my best friends is that Caitlin Harrison: 3:57 Yep, that's it. Yeah. It's it's supposed to be like the nurturer. There's all those different names for it. Yeah, I was all into that all growing up. And then the Enneagram when that was big, which I think it still is, but always into that stuff. Yeah, in my family members, get into it, too. Kira Yakubov Ploshansky: 4:15 Yeah, I'm the INFJ. I remember when I first met, my husband was like, Here, take this test. Give me the results. I can read everything about you. That's so funny. And so now that you know you've graduated and everything, who do you enjoy working with? Like, what would you say is your specialty or area of expertise that you want to continue growing in? Yeah, Caitlin Harrison: 4:37 I love working with couples couples work is so near and dear and important to me. So whatever that looks like, you know, I think every couple comes in with something a little bit different. It could be sexual issues that you're having in your relationship, or it could be we're mostly happy but this argument always comes up and we want to finally get through it, or it could be like, everything's, Everything's bad. We've lost the spark, and we don't know how to get it back. But we want to fight for it. Whatever couples are coming with, I love working with couples, and then individuals, and individuals who are working through their own childhood wounds, people who are struggling with anxiety and how to cope with that, how to work through it, how to find what's triggering you, and how to manage that. And then also people suffering from trauma. So I have an EMDR training, that really helped me work with folks who are struggling with PTSD, and even just trauma symptoms, especially those with religious trauma. I've done a lot of research and trainings on people who are struggling with very strict upbringings, or however, religion had could have harmed you, or faith transitions. So yeah, those are that's, that's the ideal client that I tend to work with. Kira Yakubov Ploshansky: 6:13 There's like a nice wide range. But there's also a lot of overlap I see there, as well, especially thinking about like those childhood wounds, or even like that cultural religious aspect, how that might show up in a relationship as well with ourselves with a partner, other family members. So it seems like wide spectrum, but also specific pieces in between all of it as well. Mm hmm. And so I, you know, we don't have a lot of guests who talk about religious trauma, and I've never really worked with that specifically, would you mind sharing a little bit more about that? Because I think that might be interesting for audience members to hear as well. Caitlin Harrison: 6:53 Yeah, absolutely, it can come with all shapes and sizes. Um, when it comes to religious trauma, a lot of folks a lot of us, were raised with a certain set of beliefs and expectations that our parents passed down to us, or just your culture passed down to you to write this expectation of having a certain set of values. And when you start to question those, or you were once very solidly in that same camp, and then you start to wonder, Oh, maybe that doesn't quite align with me anymore. Maybe it used to, and it doesn't. Now, it can really cause a lot of shifts in your internal world. Issues like self trust, come up a lot. Learning how to trust yourself is really hard when you shift your belief system. And when you have parents or a culture that's telling you don't trust yourself, trust this being that you don't believe in him anymore, or your your sexual identity, like, maybe your religion and the belief system that you grew up in, told you that your sexuality wasn't valid, or your gender wasn't valid, that can cause a lot of pain and trauma up in through adulthood. That is really important to work through in order to experience freedom. So Kira Yakubov Ploshansky: 8:23 wow, yeah, that's really powerful. Because it's this, our entire kind of, it's like a paradigm shift, right? When you kind of go away from everything you've known or learned, and all these beliefs, everyone around you, too, I imagine feeling almost like a black sheep, or like, being ostracized, if it's not the same, or your family might look at you differently. Yeah, Caitlin Harrison: 8:46 if you were told your whole life that if you love that person, you're gonna go to a fiery pit. What kinds of things is that gonna trigger for you into your adulthood, right, if you hadn't internalized that belief ever since you were too young, to be able to decide if that was true or not. And you are going to accept that belief. So it comes in all comes in all shapes and sizes, and it's it's hard core identity stuff to work through. So I think it's really important even to raise awareness around that topic. A lot of people when they find out religious trauma is the thing, that's what I'm experiencing. And it's normal. Even that's just like a huge piece of the work like other people have this too, you know, yeah. And something Kira Yakubov Ploshansky: 9:35 you said is teaching people to trust themselves, because they've been taught to trust something external for so long. I can't imagine how much of like a disconnect that must be. Especially like in your body of being able to like recognize, like, what am I experiencing? Is this valid? Is this real or my listening to other people to tell me this information? Caitlin Harrison: 9:57 Yeah, like am I am I even supposed to connect to my body my therapist is telling me I should connect to my body and trust my gut and know what my feelings are. And that those are important information. When the first however many years of my life, or even into adulthood, you could take on a religious belief system into your adult in your adulthood and then switch later in adulthood. Right? When when that belief system told me, I should deny all of that you're faced with this cognitive dissonance, right? That's the term that we use in therapy a lot like, what am I true to what do I think is true anymore. And it's a very disorienting feeling. And it helps so much to have someone with training in that, that can like guide you through those feelings that can even just like validate that experience and explain a little bit of it and give you language to make sense of it. So Kira Yakubov Ploshansky: 10:59 it's really powerful. What made you like what pulled you into learning more about that helping people through this particular type of trauma? Caitlin Harrison: 11:11 I think when you ask a lot of therapists, that is because you have personal experience, navigating those kinds of issues. So I'm pretty open about that to myself is that it's been a lot of my work is just that deconstruction process that we all go through from childhood to adulthood, and when it is those, like core heart value issues that I used to hold this value so deeply. And now I'm questioning this value. My whole support system is telling me not to, but something in me won't let me not question it. It's, it was a it's a, it's a hard, honestly, throughout the rest of your life. It's hard to navigate, that kind of transition. But it makes it so much easier when for me when I had words to put to it when I had the mindfulness to know this is what's happening inside of me right now. I feel so disoriented right now, I don't know who I am right now. Because my whole body's telling me stay safe. Don't question this. Don't wonder about this. And so it's just been a privilege for me to be able to learn all of this information about religious trauma and about how changing faiths or losing a faith as some communities, and I'd say it affects you internally. But it's also been a privilege to work with clients through that. Kira Yakubov Ploshansky: 12:47 Thank you for sharing that. I appreciate it. I know it's vulnerable work, right. It's really deep and personal. So I really appreciate you sharing that piece of yourself. Caitlin Harrison: 12:58 Absolutely. Kira Yakubov Ploshansky: 13:00 And so I know, that's definitely a big part. Is that something that I know, you said you've had training in EMDR that you use with clients to religious trauma? Or is that something that you use for other types of trauma? Or is it kind of like, regardless of the type of trauma EMDR is going to be like a really great go to? Caitlin Harrison: 13:18 Yeah, so I love EMDR. Because sometimes, talking through things, and just getting insight about like why this affected you so much, is very effective. Sometimes just having one of those lightbulb moments in therapy, like, Oh, this is why I've been believing this, my uncle said this to me when I was younger, and now I can let myself free of that. But sometimes you can talk it to death, and it doesn't go away and you still have the nightmares, you still have the panic attacks, whatever that might look like. And that anxiety shows up for you or trauma symptoms show up for you. And EMDR actually kind of just bypasses the whole talk therapy, we call it a bottom up approach. So a top down approach is I talk about it, I use my brain to make sense of it. And then eventually my symptoms fall in line with what my brain is thinking. But if symptoms are so intense, and talking about it's not helping engaging my brain and like why this is happening isn't working EMDR works from the bottom up. So it can actually access the parts of your brain that are holding that trauma and causing your body so much distress and go from the bottom up and your brain can file and make sense of the things that it hadn't been able to file and make sense of yet. Through EMDR and so it can be the word trauma can be confusing, because I think a lot of us are like oh I don't think I've ever you know really been through trauma. I don't have no nightmares, I don't have you know, but we've all been traumatized at some point in our life, where something has impacted us negatively our self esteem or our just how we move through relationships, like I don't feel safe in this relationship to advocate for myself, that would be in my world considered a trauma, I don't feel safe to be my authentic self all of the time, that would indicate to me you experience something that you weren't supposed to experience. So MDR can help with all sorts of things like that, like I have too much stress at work, I want to process that EMDR can help with relieve some of that stress. So, yeah, EMDR works with all types of trauma and religious trauma or stress at work, you name it's a really powerful modality. And Kira Yakubov Ploshansky: 15:56 I know it's pretty intense, right? Like, I know, it's evidence based, like there's a lot of scientific research behind it. And it can be an intense experience for people. And I think that's like, kind of like, not a scare something to scare people away, but more of a warning, right? Like, they can kind of recognize what they might be getting into. But I'm sure, right, if someone's approaching this, the therapist is gonna go through the process of explaining it what to expect when we ease into it, right, so that the client is aware of what they're signing up for. Yeah, Caitlin Harrison: 16:29 every therapist is a little bit different how they move through the steps of EMDR, I spent a lot of time in those first two steps, which are making sure that the client has the resources that they need to be able to walk through the next several wherever reprocessing, we're bringing up old memories, we are talking about the things that are really difficult to talk about, I make sure I spend a lot of time making sure that my clients have the skills and the tools necessary to support themselves through those final stages, so that they can be successful rather than re traumatizing. Um, and I think that EMDR also has this air about it where people are like, this is kind of like woowoo magic, or something like that. And it's, it's really not that I think that that can be kind of like I don't get what's happening. And it's true, you really don't because it is that bottom up approach. We are going down into your emotions down into your body down into your brain. And it's if you're a very cerebral person, like myself, honestly, it can be kind of your skeptical side can come out. Like what kind of magic do you think you're doing? But it's really not anything. You're not being hypnotized? You're not getting some kind of spiritual seance. It's just it's a scientific evidence based model that works. And sure it has some mystery to it. But it's it's not woowoo I think is the best word I've heard. To describe what it's not even though it can seem like that sometimes. Kira Yakubov Ploshansky: 18:15 That's really funny that you mentioned it like that, because I there's like different parts of me right. And I think we'll talk about that type of method later as well. But a part of me that is kind of more logical and rational wants to see things for the science and another spiritual part. And the spiritual part never saw EMDR as woowoo. But I can imagine how some people might if it's if they are a lot more cognitive and want to think about like all the steps and what's happening and how does it work and how I'm experiencing it. But you are basically like there's right, it's either you have these buzzers or something moving in front of your face, right, like there's this body connection to the story that you're retelling, to kind of rewire that in your body. Right? I'm getting that in your nervous system. Caitlin Harrison: 19:03 Yeah, yeah, I think things that are quote unquote woowoo can be attractive to some and not attractive. Yeah. And so I think it's important for me to kind of put that Asterix for those people that are more skeptical and wondering, like, What is she trying to do when she's moving her fingers? I always like to add that that disclaimer, because it does have this air about it, or maybe it's intimidating. And so I just like to talk to that crowd that it's not some magical thing where I'm like, accessing some point, it's just, it's just processing you can trust yourself through it. It's it works. You know, it really, it really works. So some people that could be really exciting and magical and attractive. For some it could, it could be a little bit of a Kira Yakubov Ploshansky: 19:59 a turn off I'm sure just depends how it's packaged up right and how people view it. Caitlin Harrison: 20:04 Exactly. Kira Yakubov Ploshansky: 20:06 Speaking of parts, so I know that just from when we spoke before that you also have had some training or you like to work with internal family systems. So I'm sure the listeners probably don't know what that is, unless they're a therapist, if you can share a little bit about what that is and how you use that approach with clients, because I love that approach. Yes. Caitlin Harrison: 20:29 So internal family systems is very powerful as well. So it helps you make sense of your internal world. So how I see it, how internal families would see the internal experiences that were all made up of parts of us. So you've probably even said yourself, like a part of me really wants to go to that picnic. Today, no part of me just wants to stay at home in my sweatpants. So there, you're naming two parts of you, that want two very different things. And so EMDR would just or ifs would help us kind of name those parts and make sense of those parts. So one part of me really wants a promotion. One part of me doesn't one part of me really wants to have kids, one part of me doesn't. Sometimes I feel really confident in sharing myself. And other times, I can't put words together to say what I want or how I'm feeling. So ifs helps us get really curious about what those feelings and thoughts are, what parts of ourselves come up in certain settings, it helps us understand why they're coming up to put ourselves back in charge of all of these parts of us. So we all have a true self that can sort of guide all of these parts that developed through all of our experiences and our childhood. And it's it's really powerful language, it's really powerful to be in touch with, Oh, my anxious part is coming out. And I know exactly what that part of me needs. In order to keep it at bay, I know exactly what job to give it. So that it's actually helping me Believe it or not, my anxious part can help me, instead of hold me back from what I really want. Kira Yakubov Ploshansky: 22:31 Oh, that I like to wear. So I don't know if this is necessarily an ifs intervention or technique. But I like to do this with clients who have a lot of anxiety or a lot of worry and stress, like this internal dialogue that just does not stop is kind of like are like, Let's separate a little bit. Right? How old do you think that this voice is? Giving that voice and age and name and the function? Right? Like, because all of these roles serve something to help us? Right? They all love us. They all want to do something good. They're just may not be great at it, or maybe maladaptive, but their function and purpose is to do something helpful. So what do we think the purpose is of that voice? And I think the more people name it and give it an age, and they can visualize it, it helps like, Alright, so let's say for example, Stacy's 12. And whenever this comes up, Stacy always starts getting really upset. Right? So what is she looking for? She needs attention, right? Or she's scared. So it's kind of like working with that other part of us and leaning into instead of trying to shut it down or being upset or being even angry with ourselves, or having that part of us. Yeah. Caitlin Harrison: 23:48 Like, how many times has your partner left a dish in the sink, and your anger is triggered? You're like, they don't care about me, you have these whole stories in your head about why they're the most evil person and they don't care about you anymore. And you've completely lost the spark. And they're not who they used to be because you saw a mulligan. And it happens to all of us, right? But I think that ifs can give us just language like oh my my angry my angry parts coming up. I can get curious about my anger. Oh, yeah, my dad used to yell at me when I left them again this think and you know, it always connects back to something and it's really helps build self awareness and also can be so what you were saying earlier, kind of separating yourself from your anxiety or your anger or whatever it might be for you. Gives you a lot of relief as well. Like I am not my anger. I'm not my anxiety. That is a part of me. That makes a lot of sense why It's here. And it's trying to help. And it just gives you a little bit more space and a little bit more power. Back to say, that's not all of me. That's just a part of me. Absolutely. Kira Yakubov Ploshansky: 25:12 And I think it helps build my compassion and empathy with yourself too. Totally. do you how do you like to sprinkle that in like is that for particular clients with presenting issues that you like to use ifs or just like, anytime it comes up when someone is like really deep into their emotions or experiencing something over and over again? Yeah, Caitlin Harrison: 25:34 I think every client's a little bit different. I'm always using it no matter what client I'm working with, but it can look different based on which client I'm working with. Some people really like to name their parts, and they really like to spend a lot of time diving into like guided imagery and the metaphors and some clients are just they don't want to spend too much time. Flowering up the language and they just like, okay, yeah, I have an anxious part. How do I regulate it? Yeah, I'm always using it. But that looks different, depending on the client, always using the language and the concepts though. Kira Yakubov Ploshansky: 26:19 So like we said, reframing and repackaging it right, like catering to how the client wants to use this to make sure it makes sense for them. Caitlin Harrison: 26:27 Absolutely. Kira Yakubov Ploshansky: 26:29 And so for a couples therapy, I know you've gone through some Gottman treatment or not treatment training. Can you share a little bit about because I know there's like three different levels of the Gottman method. I love the Gottman research I love to use use this with my couples all the time. How that shows up for you in sessions with couples. Yeah. Caitlin Harrison: 26:51 So John and Julie Gottman, I'm level one trained in their, in their method. And how it shows up a lot of times is in the psychoeducation piece. So that's just like teaching clients about what works in relationships, and what doesn't work in relationships, how to say things in order to get what you're actually wanting and communicate what you actually want to say, kind of highlight some of the bad habits or cycles that couples have gotten into that might not be getting them where they want to be getting in their relationship. So Gottman has helped put so much research in language to phenomenons that happen in intimate relationships, and also actually like parent child relationships, too. So he does a lot of like co parenting work. And so I put a lot of that into when we're talking about parenting styles or parenting techniques with couples. And then also sue Johnson's work, Emotionally Focused Therapy, she's really influenced my work with couples as well. A lot of times, our issues are stemming from emotional ruptures, like kind of losing trust or experiencing hurt or pain, whether that's in our past from our partner, and reconnecting emotionally, can be, honestly a lot of times all that you need in order to move through a lot of the issues that you're facing as a couple, whether it be sex, communication, parenting, understanding each other and yourself is so powerful and to really gives a lot of structure and techniques for helping couples do that. Kira Yakubov Ploshansky: 28:33 I love Sue Johnson. I saw her in her conference before I was like, Oh, this is so cool. Caitlin Harrison: 28:37 Oh, that's awesome. Yeah, it should be so small but mighty. Yes. Kira Yakubov Ploshansky: 28:41 And all this she was showing her cases of like working through it with couples and like, she does a lot of like, in the moment, right? I think there's different therapies where we talk about, like, gaining insight and, you know, rehashing or reenacting things with her, it's like very right now. Like, what is coming up for you as their, you know, your partner is saying this and like, where are you feeling this? And how is this you know, showing up? So I think it's awesome to kind of think about the different stages of processing and working through things with couples, is there's going to be you know, understanding their past and history and their, you know, their love story, teaching them like you were saying with the Gottman method of like things that have not worked. And then like right now, right here, what's going on between the two of you? Yeah, Caitlin Harrison: 29:25 she has a way and I think this is a sign of like the best therapist, she has a way of calling you out while making you feel like so held in love. And I mean, I've never experienced her as a therapy fee that I'm watching Yeah, with her. I think that's, that is so powerful when your therapists can know you see you make you feel so cared for and understood, but also they're not gonna let you get away with that thing. You know, they're gonna own what's yours, right? Yeah, Kira Yakubov Ploshansky: 29:58 she definitely has a way of do And that's, that's a tough balance, especially when you have different personalities in the room. And it's really hard for couples but anybody right to be held accountable in a moment, like woof that? I don't know, I don't like the way that feels like what part of you, right? If we're talking I have a part of us coming up to want to be defensive, or to not acknowledge this right. But I think I saw us in a different kind of think it was Terry real. He talked about holding this like loving sternness. Right. For accountability, it's like, you have to know that you're not a bad person, but what you're doing is not helpful, or it's not healthy. So you have to be able to hold both of those things in order to change and take accountability. Yep, Caitlin Harrison: 30:47 I think that's something that all all of the models that we've talked about today share in common that you can look at what you might call, like bad behaviors or bad symptoms. With so much love and compassion and understanding for yourself, while still holding yourself accountable for materials you want and who you really want to be and making sure that you're someone that's congruent with who you're what your values are as a person. Kira Yakubov Ploshansky: 31:17 Absolutely. And it's tough to hold both of those wrecks, I think a lot of times our emotions are contradictory. What we experienced the majority of the time is a contradictory experience. But that's okay. Like, that's normal, right? You don't have to pick one or the other like, doesn't make you a bad person if you do X, Y, and Z, but you have to own up to X, Y, and Z and have compassion for yourself, and be able to hear your partner say how it impacts them. All of that is a lot of work, but totally worth it to feel that connection and love with your partner and with yourself. Caitlin Harrison: 31:51 Yeah, absolutely. Kira Yakubov Ploshansky: 31:55 Is there any other like presenting issue or population that we might not have covered that you really enjoy working with? Caitlin Harrison: 32:03 I think that exploring so a lot of a lot of the things we have touched on this quite a bit, but exploring your childhood wounds is a big passion of mine. So something else that all of these models share in common is this idea that the past sins in the present. So when you are experiencing anxiety, some kind of distress in your body, I use the word anxiety a lot just because I use that as like a umbrella term for for discomfort in your body, things are going in the way that you want it to be going I don't mean like clinical diagnosis anxiety. And, and it's typically something that we can look back and see how the past is living in your present. So exploring childhood wounding in general, maybe that is religious trauma, maybe that is mental health in your family, maybe addiction in your family. That's a big passion of mine. And so just kind of making sense of that is a is something I think we can all benefit from, Kira Yakubov Ploshansky: 33:15 for sure. I love looking back at people's families. I think I talked about this in a different episode somebody else but I always start with a genogram with clients. Because I love to just see like the whole family who was in your life growing up like, relatives, right? Like, what kind of relationship did you have with them? Especially if there's other siblings in the home? Like, what role do you feel like you played or each sibling played, because everyone kind of fell into a little bit of a box sometimes, especially, you know, our parents are trying to do the best that they can. And we pick up things as kids pretty quickly without realizing it that if I do X, Y and Z, I will get this result. So I'm going to be conditioned to have this personality trait or show up this particular way. And then later in life, I might want to separate myself from that, but it feels like it's stuck on me like it's my identity now. Caitlin Harrison: 34:06 Yeah, it's a confusing, confusing process to think, oh, wow, I was always really into sports. Because that person in my life really like sports. And now sports was my whole identity. And I don't know if I care about it. But I think I do you know what I was really just making sense of where that came from where it came from that it's okay that it came from somebody you know, yeah, just making sense of it all, I think is so important. And gives you so much power in your daily life and in your relationships. Yeah. Kira Yakubov Ploshansky: 34:41 And I love like, what I'm getting from you is that you help people kind of choose, is this something that I want to keep with me? Right? A lot of it is like processing bring awareness insight. And then it's like now you have this information. What do you want to do with this? Is this feel authentic to you? Do you want to continue in this way? Does this still match up to how you You see the world and want to be in the world. So I love that I'm hearing like you also like, kind of help them have that choice and decide what feels right for them too. Yeah, that's right. That's awesome. So I really appreciate you joining, you have a wealth of knowledge and you just graduated. But you would think that you've been a therapist for over a decade. So I think that a lot of your clients and future clients are going to have a great experience with you really being seen and having all of this insight and training that you've gone through to help people through this journey. So is there anything you want to share with the listeners before we end or anything new that's coming up for you? Caitlin Harrison: 35:42 Yeah, I am just really excited. I'm new to Pennsylvania. So I'm so excited to be here. I already have fallen in love with I'm in Pittsburgh, I'm already falling in love with the city of bridges, and just the culture and the people here. So I'm excited to work with you all. And I'm excited to be here at heal your roots and already feel so much support and openness from the team here. Kira Yakubov Ploshansky: 36:11 It's wonderful to hear. Thank you. I'm excited to have you join our team. If anyone is interested in working with Caitlin, you can head over to our website, heal your roots wellness.com schedule a consultation, and we'll see if it's a good fit. Galen, thank you so much for being on today and sharing all your information and insight with us. Caitlin Harrison: 36:29 Thank you. Kira Yakubov Ploshansky: 36:31 If you've enjoyed this episode, please like, share and subscribe. Otherwise it's a wrap ### Listen - [Spotify](https://open.spotify.com/episode/14280156) - [Apple Podcasts](https://podcasts.apple.com/podcast/14280156) - [YouTube](https://youtu.be/P8_lAScUW_s?si=n0Y5w-rl7CMnXMnx) --- ## Beyond Anxiety: A Deeper Dive into OCD Diagnosis - URL: https://healyourrootspodcast.com/episodes/beyond-anxiety-deeper-dive-ocd-diagnosis - Published: 2023-12-20 - Season 3, Episode 2 - Duration: 41:33 - Category: personal growth - Guest: Katie Manganello ### Summary Year-end reflection episode focusing on processing personal growth, acknowledging progress, and preparing for upcoming transitions and changes. ### Description As we approach the end of another transformative year, this episode invites listeners to engage in meaningful reflection about their personal growth, challenges overcome, and lessons learned. Kira guides us through exercises for processing change, acknowledging progress, and preparing mentally for the transitions ahead. ### Transcript [0:00] Welcome back to Heal Your Roots Podcast. On today's episode, we have Dr. Katie Mangan lol a licensed psychologist and expert in obsessive compulsive disorder. In this episode, Katie shares her insights and approaches and evidence based treatment plans for helping those struggling with OCD. Katie, thank you so much for joining us for today. Hi, thanks so much for having me. I'm so excited. Absolutely. So we usually just dive right into learn more about the therapist before we learn about your expertise and specialty. So can you share a little bit about your origin story of how you became a therapist? And kind of what inspired you to do that? Sure. Yeah. So you know, I always found psychology to be interesting, I think like most people typically do, you know, when you're in high school, and you're taking all the different classes, thinking about what you want to do in college. And so you know, I'm just somebody who's a natural problem solver, I like to be helpful and find solutions to things. And I too, can relate to some of the issues that my clients experience in several people in my life that are important to me, the struggle at some point in their life with a lot of things. So in having, you know, my own relations to some of these issues, as well as other people that are important to me. I was interested in, you know, pursuing a career where I could move forward with doing that for people. Yeah, I feel like therapists always have some kind of link or thread, whether it's personal within themselves or a family member, that makes us feel like, oh, I want to learn more about this or like, become someone who helps other people through the same issues, for sure. And so can you share a little bit about your journey of becoming a licensed psychologist? Yes. So it's been a long journey. So I went to I'm originally from the Harrisburg area in Pennsylvania. And then I moved to Redding, Pennsylvania, where I went to undergrad at Alvernia. University. So I studied psychology and my major and I minored in philosophy while I was there. Yeah. Which was really fun. Yes. Yeah, I know, I wish I had more time and the ability to dig into that stuff a little bit more. But with this journey, I only had so much time for that. So. So then I applied to grad school, and I got my masters first. And so then I moved to Philadelphia, I got my masters from the Philadelphia College of Osteopathic Medicine. And so I got that degree in mental health counseling. And then I also went to pee calm PCOS for my doctor of clinical psychology. So that's the short version. Journey was like, I've been all over Pennsylvania, getting a lot of education around psychology. So within that time, I've done a lot of different kinds of trainings. I mean, at some point, I've worked in pretty much every kind of mental health setting. I've had experience in partial hospitalization centers I've had experienced in intensive outpatient, residential, typical inpatient, veterans, hospitals, private practice. So I've seen kind of the spectrum of how mental health can show up in different settings. So yeah, wow. So that's a wide range. That's a lot of different settings and perspectives to get and how people get help, and they're treated. It's incredible. Yeah, what what made you want to be a licensed psychologist versus like a licensed therapist? Like, what was that kind of thought process to go the next step to become a doctor? Yeah. Well, and that's a good question, because that's something I definitely struggled with along this journey. Because, yeah, why? Why do you want to go for a lesson? So I think, another part of that too, is I'm just so curious. And I always feel like if I can go the extra mile, like, why not and just learn the next thing that I can. And I'm so glad that I did. I mean, there was a point where I was in my master's program, and I was like, this a lot, like, do I like to go the next, you know, next step up, and I applied to my school because I was like, you know, what, if I get in here, then it's just, it's meant to me and then I did. And I was like, Alright, we're gonna go with and I'm really, really so glad that I did. Because looking back at where I was, skill set wise, as well as just my age and where I was as a person. At that point, I think that I would have really done just myself a disservice if I stopped there. So I'm glad that I kept going because I have learned so much more and become just so much more confident and I'm more I think just who I am as my own professional self in going through the doctoral program. So, you know, there's been some weighing of the ups and downs and pros and cons of it. But yeah, that's kind of ultimately what, what led me there. That's awesome. I remember having the same thoughts. I'm like, When is this gonna be over? It's such a long process, but it is definitely worth it once you're on the other side and the other hump of it. It's like, all right, like, I guess it was worth it. Right, yeah. And I mean, if I can provide all of the skills that I can learn, I'd rather just have it all in my toolkit and be able to work with all of the things and for me, too, it was a matter of if I stop, I'm probably not going to ever go back. So I just kept pushing through and going, going going and didn't take any breaks. And now here we are, and it's over. And that's great self awareness, right to know that about yourself. Yeah, you definitely need the self awareness and going through this. Absolutely. And so since you've been through all these different settings, you've gone through that program. What is kind of like your focus and specialty now that you work with clients? Yes. So right now my specialty is working with obsessive compulsive disorder and other related anxiety disorders. That's the majority of the population that I work with, I initially came into the field thinking that I wanted to work with SMI, like serious mental illness, that would include things from, you know, like schizophrenia, bipolar disorder, certain personality disorders, actually, OCD can even be considered SMI, depending on the severity of it. But so that's kind of what I came in thinking I was going to do. And I had experience in working with that population. And actually, I do love working with that population. Like that's still important to me. I guess the reason that I kind of ended up going towards OCD was because I didn't really know anything about OCD. But I was in an smi class in grad school, and I was trying to figure out what one of my next training rotations was going to be. And one of my teachers suggested, well, have you ever thought about doing any kind of rotation with OCD? And I was like, Well, no, I haven't because I don't really know anything about it. Besides what we learned in the basic intro psychopathology class. So I was like, alright, well, let's just see what it's all about. And the reason she brought it up is because there can be so much overlap with OCD presentation, as well as psychotic related disorders. So that that kind of got me curious, I got into it. And that's also the OCD population. Unfortunately, clinicians don't know enough about it. But ultimately, they usually find themselves in a private practice setting because it is like a specialty area. Whereas working with schizophrenia, bipolar, you know, other versions of SMI, you don't necessarily see that as a presenting problem in a private practice setting. Now, that doesn't mean you aren't ever going to see anybody with those presenting issues. But usually, if they are presenting with those issues, they are in a higher level of care to start. And then if they want to work on things, after those types of things are managed, then they may end up coming to a private practice setting. And OCD can certainly present itself in a way like I said, that can you know, clinicians can be unsure what it is. And they might think that it's a psychotic related disorder or something more severe, and they are in the hospital or they are in a higher level of care. And then they end up getting kind of referred into these more specialty practice is so interesting. Okay. Yeah, I didn't know see, like I only also had the intro to pathology in grad school, and didn't know much past that. Like, I feel like I might be able to identify and then be able to refer out what I wouldn't be able to, like have that specialized treatment plan or knowledge to help somebody through that because it is very different than just, I don't want to say just anxiety to diminish that but an anxiety disorder outside of OCD. Mm hmm. For sure. And so for listeners who maybe have some misconceptions about OCD, would you be able to share a little bit about like, what that means and like how you would really diagnose somebody with that versus someone who might have some traits or tendencies or sometimes people use it kind of just throw it around when it's not actually what's going on. Yes, so this is something that I am super passionate about, not only just kind of explaining this to, you know, anybody who comes across OCD, but also really I find it to be so so Important for clinicians to understand this because even if we can get people to a point where they can at least recognize it and then refer out then that's great. But a lot of times people think that OCD is just regular anxiety. And then clinicians are responding to the OCD in a way that is actually majorly making the OCD a lot worse. So, some things to consider. So why don't I just kind of like ask you this, if you're comfortable? So when you think of OCD, what do you think of like, what kind of presentation are you envisioning? So I'm thinking of obsessions and compulsions? Right? Like there is a lot of thought process in like spiraling and then compulsions, like a behavior attached with it that is like continuously going on. And if they don't do this particular behavior, then that kind of creates more anxiety, and more stress within them. Mm hmm. Yes. And so that's, that's right. And when you think like, what are some of those behaviors? Like, what does it usually kind of look like when somebody has OCD? Like, what do you kind of think of? I mean, like, the stereotypical is kind of around like germs or having to check something multiple times in a row, right? Like a very obvious behavior. I know sometimes I've had clients who, and I wanted to talk to this about just pure Oh, or just like obsessions, or just compulsions, like one or the other, like, even having to search something a million times. Like there's a repetitive nature to it. But I think the stereotypically is like repeating something over and over to make themselves feel a little bit more at ease. Yes, exactly. So the Yes, usually people think it's hand washing, it's checking things over and over again, it's perfectionism being organized, that kind of thing, which is all true. Those all can fall under the OCD umbrella. However, that is about this much of it when there's like this much of it going on. So to give some background like let's get specific, so OCD is defined in our diagnostic manual. The DSM five is it's so it's broken up into two pieces. It's the obsessions, like you said, and then it's compulsions. So obsessions are defined as recurrent and persistent thoughts or urges or images that are experienced that sometime during the disturbance as intrusive and unwanted, which is really important, and that in most individuals cause marked anxiety or distress. Also, under the obsessive criteria, the individual attempts to ignore or suppress the thoughts, urges or images, or to neutralize them with some other thought or some other kind of action, which leads into the compulsive part. So compulsions are defined as repetitive behaviors or mental acts that the individual feels driven to perform in response to an obsession or according to the rules that must be applied rigidly. The behaviors or mental acts are aimed at preventing or reducing anxiety or distress, or preventing some dreaded event or situation. However, these behaviors or mental acts are not connected in a realistic way with what they're designed to neutralize or prevent or are clearly excessive. Now, those are, you know, that's our definition that we get from the DSM. The way that I like to kind of think of it is, and I draw this picture for pretty much everybody that I talked to about this. So we want to kind of think of it as here's our bell curve. And we're going to use a suds scale, which is Su D S, it stands for subjective unit of distress scale, you're probably familiar. So here's our zero. Here's our 100. Do you see that? Okay. Yeah. Okay. So, basically, an obsession is the fear that you're experiencing. So that's the, you know, the thing that you're trying to really get rid of. So usually something triggers the fear, which brings the anxiety up. So here's our trigger, the anxiety goes up. You're freaking out, right? You're really worrying and what do you so let's use an example. Okay. Now, a phobia is a little bit different from OCD, but this will be a good example to kind of use so let's say that you have a dog phobia, because I know you don't have one more time do you do Okay, sure. So, Toby, all right, and let's say envision yourself walking down the street down the sidewalk, and up comes somebody with a German Shepherd they're walking with okay. And you start to feel really nervous. What do you do? How do you want to handle that situation? I mean, me personally, I would probably freeze first. And then maybe cross the street, go to the other side and continue walking, like get as far away as possible and keep going. Exactly. So you are going to do something to try to make that anxiety go away, which could be that, you know, the flight, fright freeze kind of situation. So, in that situation, you kind of said like, the freeze first and then probably like, flight, runaway kind of thing. And that's what most people will say. So here's our interaction with the dog, the anxiety goes up, we start thinking, Oh, my gosh, what can I do to make this anxiety go down, I'm going to cross the street. And when I crossed the street, that was a little uneven, the anxiety goes down. And when it goes down, we're like, all right, I'm good. Keep walking, everything's fine. Except for what happens in that moment is you have now trained your brain to think that whatever this trigger was, is actually a dangerous situation. And there's always a level of uncertainty to it, it could have been a dangerous situation. But that's what OCD does, it clings to any level of uncertainty that it possibly can. So basically, you just taught your brain, Alright, that was bad, because as soon as I escaped it, I felt immediately better. And what happens with that is, the more we do those things, the more we avoid it, the more we engage in any kind of compulsion, that is what snowballs it and feeds it and it becomes bigger and bigger and bigger. So again, obsession is that fear, the compulsion is pretty much anything you are doing to make it go down. That could be avoidance, that could be reassurance seeking, that could be really anything, again, that's going to try to alleviate that fear associated with the obsession. So whereas you think maybe it's harmless, that you cross the street, but the more it's happening, now, maybe you're not going on your walks anymore in the morning, because you know, that person walks with their job. Or maybe you purposely are like, let's go 20 minutes later, instead of, you know, the same time, which could then make you late for work, and then it's impacting your life, right? And then it could turn into, Oh, my friend invited me over and they just got a new puppy. And I am not going to go to the party with my friends anymore, because I'm avoiding the dog. So you get the gist. I mean, it can start out small, but gradually, it really kind of grows and grows and grows. So now, I'm like, what was your initial question? Because we were talking about like misconceptions out there, right. Yeah, finding what OCD is. Yeah. So what, what some of the misconceptions are around this is that, like we said, it's usually like, around germs, or like having things lined up perfectly, which those themes certainly exist, but there's a lot of different subtypes that fall under the OCD umbrella. So, most commonly, there's the perfectionistic obsessions that people know about. contamination, contamination is one of the big OCD fears that everybody knows about. So the way that a contamination fear could kind of show up is the core fear might be something like, I'm afraid that I will die. And so the way that that's manifesting is that I am afraid to get sick, meaning there's the contamination, if I get sick, I could potentially die. So what I'm going to do to try to control that or alleviate that is, anytime I touch something with germs on it, I need to go wash my hands. Now, that's also just one example. contamination can manifest in a lot of different ways. But that's just, you know, a kind of a broad example for people to understand. So those are the obvious ones, but less obvious ones are obsession, they can be kind of taboo. So some of them can be related to harm, danger, loss, embarrassment, sexual obsessions, sexual obsessions, around children, religious obsessions, the superstitious or magical obsessions. I think sometimes people hear of that, like the, you know, can't step on a crack break your mom's back in the day. And like helping body focused obsessions so that can look like a lot of different things. I think the most important thing in in being able to assess for OCD and for people to understand differences between just being like hand washing or you know, whatever it might be, is that OCD is ego distant onic which means it's not in line with your values. If it If something is ego syntonic, that means it is in line with your values. So let's say that somebody loves children and like, they really want to be a mom, or they, you know, they really enjoy being a nanny or any of those kinds of things, right? Like they, they really value being able to spend time with kids and nurturing and that kind of thing. Yeah. Now what's really unfortunate is this could manifest in, you know, having fears around, like, how to feel like OCD. So that could be something where it's like, okay, I go to the park, and I'm hanging out, I see kids running around, and an intrusive thought pops in my head. Now, everybody has intrusive thoughts. Pretty much everybody has intrusive thoughts, right? The difference between somebody who has an intrusive thought with OCD is that they cling to it, and then it starts to spiral. Whereas typically, somebody might have the thought, Oh, look at that kid, like, they're really cute, and then be like, That was weird. Like, that'd be weird for me to like, take that thought any farther. And then they just kind of shake it off and move with it. But somebody with OCD might be like, Oh my gosh, that was weird of me. Why did I even have that thought? Like, am I a pervert, maybe I should stay away from kids. And then it can kind of spiral right then maybe they're avoiding going to parks, maybe they lose their job nannying, because they're avoiding going to work, you know, any of these kinds of things, because they are afraid of that happening. So the big difference between this and being an actual person who's diagnosed with a pedophilic disorder is that ego disenchanted versus ego syntonic. So somebody who is diagnosed with a pedophilic disorder is like, actually aroused by children, and they will act on that kind of urge. Whereas the OCD is, I'm having the thoughts and I'm scared in the last thing I want is for this to happen, but they're so afraid that it could potentially happen that they might lose control and do something so unthinkable to that. So I'm hearing the difference is not that they're fully going through it, but they're scared if they allowed themselves to that that might be something and that they're like, scared Oh, could develop into that. So now they're obsessed around having a thought that they could become that versus actually having that, that yeah, rather than actually engaging in behaviors of like catching children or doing anything that's actually like inappropriate and leading to legal ramifications, or an actual diagnosis of a pedophilic disorder. Okay, so for example, right? Like, I'm just thinking, like, sometimes when I'm driving, right, like a random thought in my head might pop up, like, Oh, my God, like, what if I like rammed into the car in front of me. And something horrible would happen? What would be like, a version of like, that threshold of OCD then versus like, Oh, that's horrible. I don't want to think about this. And then just like change the station on the radio, and just try to like, move on with my life. Right. So that would be probably related to a harm subtype. And I actually have worked with people to the point where this has gotten so bad that we call it actually hit and run OCD, where people are afraid that they either are going to like, wrecked their car wreck into somebody, or that they might hit a pedestrian or something like that. So I've met people where instead of just like, oh, that's uncomfortable to think about, let me distract myself and carry on. It could manifest in a way where they are constantly checking their rearview mirrors, you know, making sure that they have specific like safety behaviors, whereas it's like, well, I need to make sure that I have the music on loud enough that I am always distracted. Whereas like, when somebody has an insurance on, they're like, Oh, that's weird, shake it off, listen to some music, and then your brain starts thinking of other things. That's a more typical kind of way that people think about things when random, intrusive thoughts come up. If somebody also has OCD around this, they might avoid driving in general, they might just not drive any more. I know with some people that they it OCD really likes to claim to control right, that's all about those compulsions trying to control situations. So sometimes it might be well, I don't want to be in a car as a passenger because I don't have control over the driving. Or maybe they would rather only be a passenger because they don't want that control of being the person who hid it. So again, that's why we really always have to do a thorough assessment because we want to really understand the function of the behavior. We always want to really understand that core underlying fear that it's related to. So what would be different because you know, I've have have a lot of clients who come in for anxiety around like attachment like anxious attachments, and they might Do kind of repetitive behaviors around dating, right? Like, let's say if they broke up with somebody they get obsessed with, like looking at their Instagram stories or like looking at certain things. And it always like confuses me in a way where it's like almost like torturing themselves. Like, if they want to feel better, they would stop looking at it, but instead they obsess, knowing that it's going to create more distress for them. How would that be like considered towards that? Or is that more of just like, anxious thoughts and like anxiety? So there is a fine line, I would say between sometimes there being because really, pretty much. I'm hesitant to I'm hesitant to say that all anxiety disorders engage in some form of compulsions, but most of them are doing something to try to alleviate it. compulsions just tend to kind of like manifest more intensely and show up more. Which brings me to your question about like the pure Oh, that's like a whole other topic. But compulsions can even be mental like as explaining, like mental acts, that could be reviewing memories, like, you know, going back and thinking of, you know, did I do this? Did I do that? These kinds of things, the difference is that the compulsions should take around, and more often do take more than like an hour each day and causing significant distress, impairing their functioning. So what you're explaining, with the example with relationships, that in the end, that anxious attachment, that can certainly be caused as a part of the issues with attachment. Right? OCD doesn't just appear out of nowhere, something that is related to it. And that can kind of like, bring them to that being their obsession or that core fear. But yeah, I mean, the thing is, is, they probably know that is going to cause more distress. But when you're having that part of your brain activated, you're no longer thinking logically, you can not out logic, OCD, which is why we have to do exposures in exposure and response prevention is treatment versus just like, a typical cognitive restructuring of like, you know, that doesn't make sense, right? Because people will be like, yeah, no, I get it. But it doesn't matter. Because when I'm in that headspace, that's what I need to do. And the reason they're doing is because they are getting some sense of like relief in the compulsion, because remember our picture here, right? It is bringing it down a little bit, because maybe if they're checking in, they're seeing, okay, that person didn't go on a date this week. Okay, sounds like that's good. But then they're like, but I need to keep making sure that that's, you know, yeah, yeah, it can be really, really painful for people. It's really it can be very distressing. Yeah. No, I appreciate you going through these like very specific examples, I think this will be really helpful for listeners to like differentiate as well. And so since you mentioned some of the approaches or treatments, can you elaborate a little bit more of like, what does help like, what does work with clients who are struggling with OCD versus like cognitive behavioral therapy for strictly anxiety? And like different approaches that you use when you work with people? Yes. So the, you know, our gold standard evidence based treatment for OCD is exposure and response prevention. So we call it ERP. So the reason that we are doing ERP versus a more basic version of CBT, is essentially, it has more of a behavioral approach to it, not to say that there's no cognitive interventions, but it's mostly behavioral. And some of that is because with the cognitive interventions with OCD, your brain can just, you know, like, talk yourself out of anything. It doesn't you're, you know, it can even get to a point where if you're doing cognitive restructuring, and in looking for evidence for and against, like, even that can turn it into a ritual or a compulsion. So, it's better to just allow those thoughts to exist and carry on and do our exposures. But so the reason I say a more basic kind of CBT is because exposure and response prevention is still cognitive behavior therapy. It's just the cognitive behavior therapy is so broad, it's another one of these umbrellas and then under that we have like sub therapies or third wave treatments. So, so ERP kind of falls under the cognitive behavioral umbrella. So the way that ERP is set up is exposure targets, the obsessions, and the compulsions are targeted with the response prevention. So essentially what we would do in treatment is As we do, again, a thorough assessment of what are the subtypes? How are they showing up? What's the function of the behavior? What are the core fears. And then with that, we make our treatment plan, which is essentially our hierarchy, which is going to list several exposure ideas, things that we would do to kind of target the fears. And then we would also have Response Prevention items as well. So what that might look like is, let's bring it back to our dog phobia. Okay. So the reason we do exposures is not necessarily to torture people. But what it is meant to do is that we want to purposely bring that anxiety up and sit with it without engaging in any kind of compulsions or safety behaviors, because what's going to happen is we will eventually habituate to it. That is how we're kind of re programming your brain. So if you allow it to exist, and not fight and not do anything, it will eventually come down. But it can be really distressing. Yes, yes, on its own. And that's what's hard for people to sit with. Because when you're in that feeling, it feels like it's not ever going to go go away, and you need to do anything you can to escape it. But once you kind of learn that, it's a feeling I'm working through, and I'm gonna allow it to just kind of exist, it'll kind of go down on its own. And that's a double process. Because as that's happening, you are building your distress tolerance skills. You're learning to sit with things that are uncomfortable. So that's the point of the exposures are response prevention. So an exposure for our dog situation could be, I'm going to watch videos of dogs, I'm going to watch videos of people getting bit by dogs, or I'm going to then go pet my dog or my friends puppy at their house. It can even just be like listening to a dog barking, it all depends. And it's all very individualized on the person's, again, our suds scale. So I might say, how sudsy does it feel for you to go pet your friend's puppy? And they might say on a zero to 100 scale? Well, that's about a 50. Okay, well, how much would it be if you were watching a video of dogs running around in a field? Oh, that's like only a 20. Okay, so we might start out lower, and then kind of build our ourselves up to it, we don't ever want to just immediately throw them into it. I mean, it's a, it exists, it's called flooding, right? But that is not necessarily the approach that we're using. I always take the approach of being collaborative, like, the client is the expert on them, and I am the expert on the treatment, we have to work together. And I'm never going to force somebody to do something they don't want to do. It's your goals, we're going to do what you're willing to do. And we want the exposures to be a stress not a strain. So it should be hard, should be difficult, but not to the point where you cannot handle it, because then you're never gonna go back and do it again. Yeah, we don't want to go into a panic state, it's more of just like, a safe discomfort. Well, you know, what in the thing is, is that they can panic. I think that's another thing is people are like, I can't let that happen. We can because we know that a panic attack is incredibly uncomfortable. Okay. My goal is never to be like, let's send you into a panic attack, unless we are maybe doing panic treatment, which is a whole different story. But the goal is to just kind of like, bring up the discomfort and teach them like, whatever is going to show up like I can handle it, I can sit with it. So where it is, it's not necessarily my goal to have a panic attack, we have to remember that there's uncertainty. And if it happens, like okay, we sit with it, we deal with it, you know. So, so yeah, so that's our exposure example, a response prevention example could be. So again, that's taking away our compulsions. So if you are avoiding by walking on the other side of the sidewalk, the example could be okay, I'm then going to take that away. And I'm going to still just go to work the same time, as I usually would. So with the response prevention example. Basically, you're going to want to cut out any of the kind of compulsions that you're doing. So with the dog thing you would want to leave for work the same time as you normally would, instead of being like, let me wait 20 minutes kind of thing. Or if it's a hand washing, let's say somebody feels like they need to wash their hands five times. Or they need to use five pumps of soap, we would say, All right, let's cut it back to two pumps of soap or like two times we wash our hands and then gradually kind of bring it down from there. And so how do you find clients? Are they receptive to this or does it ever like make them feel uncomfortable hearing that Part of the treatment is going to be the exposure or the response to things that obviously make them very uncomfortable. Yes, I mean, people definitely can be very afraid to do this kind of treatment. This is a treatment that requires a certain level of motivation. I mean, we, we really, there's some things we do to kind of prepare people for it. So part of it is assessing for motivation. Where are you at? Like, what are you willing to do? And really building up your reasons for why, why do you want to do this. And let's remember that when we're doing these exposures, when they're uncomfortable, Oh, you want to do it, because you no longer are going to work, you got fired, your relationship with your partner is, you know, really going downhill, you no longer are spending time with your family, you're secluding yourself to your house 24/7 You're depressed, you know, like, these are the reasons we want to do this kind of treatment. So motivation is important. But another thing I tried to do is kind of explain to them what I had just told you is that I try to meet people where they're at, I'm never going to force them to do something they don't want to do. I might like, you know, push a little and be like, oh, let's like kind of do this right. But like, ultimately, like, Yeah, I'm not going to force anybody to do anything that they don't want to do. We start out lower, we're always agreeing on the exposures that we're doing. And again, it's not like throwing you in the deep end, it's like, let's stick our foot in the cold water. And we kind of build ourself up from there. So I always try to make that really apparent, and really reinforced that it is a collaborative process. Sure. So there's comfort in knowing that they still have that level of control. Right, knowing that like, this is something that both of you are agreeing on. If this feels too extreme, we can go down to a lower level work through that until we can feel ready to go to the next level and continue on because because it's so negatively impacting their life. This is it's worth it right, like putting in the work so that they can have a higher quality of life as they work through these levels. Yes. And so I know, at least when we talked separately, you mentioned like bringing in other people into session sometimes whether that's a partner or a family member to kind of help support that process. Can you share, like what that kind of looks like in the in the treatment? Yes, so it totally depends on again, this is so individualized, it depends on who we're bringing in and why a lot of times we're bringing in, well, this is more so with children, but with children, we're bringing in their parents, because they're almost always accommodating their behaviors. So we are doing a lot of family work if it's with a child who has OCD. Let's say I liked your example you gave of like the anxious attachment and in like looking through Instagram, let's say somebody's coming in, and they actually have like a relationship OCD kind of thing. That could look like Oh, I'm afraid I'm gonna cheat on them, or oh, I'm afraid they're gonna cheat on me. I think a lot of times, I mean, it can be either. Usually, if it's the one where it's like, Oh, I'm gonna cheat on them. It might be more related to scrupulosity like I'm a bad person kind of thing. Whereas I think that other relationship OCD, right? How it can kind of manifest and I'm afraid they're gonna cheat on me kind of thing. Or they'll do something wrong in the relationship, or Oh, my gosh, I just committed my whole life to being with this person. What if it doesn't work out? Right, that uncertainty, so that would really impact your relationship with your partner? If you're constantly like, oh, my gosh, I went to work, what if they hooked up with their co worker or something like that? So it might show up of them texting their partner all the time checking their location on their phone? You know, asking for reassurance like what you do at work? Did you hook up with that person? Did you talk to them? Give me a list of all your co workers. And now I'm gonna stalk them on Facebook, like any of these guys, when I say stock, not necessarily actually stalk them. But look them up, learn information about them, whatever. So really, if that's the case, it's probably impacting their relationship, we would bring the partner in and explain to them how the treatment works, and explain to them that they're actually engaging in the compulsion with that person, if they are consistently like, here's my location, no, I'm not doing this. No, I'm not doing that, you know. So we might have them say, okay, instead of giving them like 20, different forms of reassurance. And again, we wouldn't be buying from the actual client on this. They need to be willing to do it as well. But if if everybody is understanding of what we're doing and why it's likely going to be okay, partner, instead of sharing your location, let's remove that. And if they say, oh my gosh, will you give it back to me? Like I only agreed that because that was the partner might say something, we want them to kind of respond with empathy because this is a huge struggle. And you we always want to keep empathy in mind because sometimes this treatment really can come across as like, torturous if it's not done in a compassionate way. So they say something along the lines of I understand you're really struggling with this right now. Like, I'm sorry, we agreed that I'm not going to give you my location. That's it. I'm not giving it to you. Whereas they might be tempted to do it. Otherwise, to kind of show them okay. Yeah, like, this is what I'm doing. Or they might say, you know, did you get lunch with that coworker today? You they could respond with, again, like some empathy, but also, depending on the person, even some humor and like some uncertainty statements, like, I guess you'll just have to guess and think about if I did or not like, I don't know, maybe they did. Maybe I did it. Oh, gosh. And again, these things can that could be a more sudsy type of response. Yeah. Yeah, totally just depends on where the person is at with things. But yeah, that's an example of how it can show up with them, you know, in a relationship kind of setting. Wow. So that's tough. So I think there's a lot of, it's almost like stern love, right? Like, because you're doing it, because you love them, and you want them to work through and you want to help this treatment, knowing in like, the short term, it is kind of emotionally painful to work through that. But for the greater good, right. So like, it's a team effort. And both people have to like clearly be on board. And I think emphasizing how you're seeing that empathy and like compassion, peace, because without it, it could feel kind of cruel. It can. Yes. And that's a really good summary of it. And yeah, people, we really do need to get other people on board, depending on how in mesh, these compulsions are other ways that it might show up. If you know, aside from that relation type relationship type of example could be a lot of times, you know, I think this is a more common example to have people like, I need to check the stove, that kind of thing. So sometimes people might be like, I'm not going to check the stove, right? Like, I'm not doing my compulsion, but like, Hey, babe, can you go check? Things like that, where they'll be like, Yeah, okay, you go in and check to make sure the candles are blown out, or whatever it might be. So like, even those are examples of, okay, like, Nope, we're just going to shut the door and give it our best guests that I think I blew him out. And that's it. We're leaving, whatever that that could look like. So yes, this can be a huge impact on family members and other kinds of relationships, which is why I had sent you beforehand, those book recommendations because there are support groups. There are lots of book recommendations, they can come in to individual therapy. I also sent you the international OCD Foundation website. So the international OCD foundation is an incredible resource for individuals who have OCD, as well as their, you know, partners, family members, etc. And so I go to this conference, I've gone the last two years, and I plan to continue going. And last year, I actually presented on it which at the conference, which was really fun. Yeah. But it's a really cool Foundation, because it's not one of these things where you just go to a conference, and therapists are there to learn about their continuing education credit. It also it's for therapists, it's for therapists who might have OCD. It's for family members, parents, partners, friends, in people with OCD, and they have different kinds of like, lectures, activities, different resources for all the different people that come to it. It's really, really cool. Yes, so that's always an option too, for people who want to either support someone with OCD or somebody who has OCD to look into those kinds of resources. Wow, that's incredible. I've never heard of a conference where it's that inclusive of not just separate for like the professionals treating or someone struggling with it, but like everybody, so it must be like lots of different like, whether it's seminars or resources or just like ways that they express this to help everybody across the board. Yeah, it's really cool. And I think that it's so inclusive because the OCD community is so I think like tight knit and in almost like protective of each other because there it's so misunderstood. Like it really people don't get it. So once they finally get that diagnosis, like on average, it takes way I wrote my thing down here It can take 14 to 17 years for someone to receive the appropriate OCD diagnosis. Wow. Like think about that 14 to 17 years of going to treatment providers trying millions of psychiatrists, psychologists, other kinds of therapists, different kinds of therapies, different kinds of medications, and you're suffering all that time without actually knowing what your problem is. And then once you get the the correct diagnosis, and you go through treatments, like, this makes so much sense. But for a lot of people, it takes a very long time. And so once they get that, it's like, okay, I found my people, right. So I think that that's, that's a really big reason why iocdf is so inclusive of everybody, and really, they do their best to help everyone out. Wow, that's incredible. Do you have an idea or know why it takes that long for someone to get the proper, like diagnosis and treatment for that? Yeah, because clinicians don't know how to assess for it. They don't understand that, you know, people like you, you just gave an example. And like you said, the person who you're explaining with anxious attachment might not even have OCD, it might look similar, but it might not meet criteria, but it could just come across as they have an anxious attachment. And that's it. And it's just anxiety. Right? It doesn't people don't necessarily always think like, oh, that's actually OCD. I think a really big example that I feel is really important to talk about is so when we're assessing for homicide, ality or suicidality, a lot of times people with harm or suicidal type obsessions can completely be mislabeled and get in, you know, get themselves hospitalized, when really their fear might be. Okay. Yes, I'm having these thoughts of, of dying by suicide or doing something very harmful to myself. But that doesn't mean I want to do it. You know, it means that I'm afraid that I would lose control and do it. Versus if somebody just says, Do you have thoughts of suicide? They could say, yes. And it's because I'm so depressed that I want to find a way out of this, which would be actual ideation versus an obsession, which it's like, Yes, I'm having these thoughts all the time. I'm distressed by them, like, I'm so afraid that I would do something to myself, that's different. You know, so people can end up in the wrong treatment setting, they can end up being hospitalized for something that's completely not related to what they're experiencing, which in itself can be. Now you have a trauma related to this, and you experienced this really horrible situation. I mean, I can't tell you how many people I've heard, say these things. I mean, people come in all the time. And they're like, Wow, I've been in therapy for years talking about these things, and got to the point where I am on leave of absence for work. And then I come in here, and I like completely turn it around. Wow. So I'm just hearing a huge gap in knowledge for even mental health clinicians to be able to properly assess, diagnose and treat this, that's causing, unfortunately, a lot of harm for clients who are struggling for years and years and decades, even until they meet someone like you, who has all this proper knowledge and expertise to help people find relief. Wow. Yes, and that's why I'm so passionate about this, and why I really find it into disseminate practice, because, at my very least, like one of my missions is to just have everybody know how to spot it, not everyone is going to treat it, that's fine to be able to know how to spot it so that you can refer them to the appropriate providers. Wow, this has been so informative. I mean, we're definitely gonna have to have you back on to even just like, be able to help people identify this as clinicians or, um, like, if you have seminars or workshops that you're doing, I mean, this is definitely going to be really important information for people to get and especially for clinicians to help people and their clients work through this. For sure, that's why I sent you those measures to which we didn't even get into but that's fine. They're just things that are helpful tools for clinicians to have an even just look at so they can understand it to an extent, you know, so I would be happy to I love talking about this stuff. So it would be it would be great. Absolutely. And so some exciting things can you share if there's anything new coming up for you or for listeners to hear how they can reach out to you to work with you? Yes, so I speaking of the International OCD foundation, so I am planning I don't have concrete plans yet. So We'll stay tuned. But I'm planning to potentially present at that conference again this year, it's going to be in Orlando, Florida in July. So that's something Yeah, that's really exciting. I definitely encourage anybody who's interested in this to just kind of play around with their website, there's so much out there. And so I'm also going to be coming on board with heal your roots. And so if you would like to work with me, I have some limited availability for people to come on board and I can work with you. And I also work at the anxiety and OCD Treatment Center, which is in Wilmington, Delaware. So if you really struggle with telehealth, and you want to come in person, I also am working there so I can be reached. Either way. Awesome. Yeah, I'm so excited. This is like a little surprise at the end of the episode. And maybe we'll let this let everybody know in the beginning, but we're super excited and thankful to have you join Heal Your Roots Wellness, I think you're going to be a tremendous asset to our team and be able to help so many people who may be struggling with this. So I'm excited. Thank you so much for being on and joining our team and I'm excited for this episode to air me to I can't wait to see it. And I'm really excited to share it and to join, Heal Your Roots Wellness. And it'll be a really fun experience for us to be able to collaborate more on this. Absolutely. So if anyone is interested in working with Katie, you can head over to our website, heal your roots wellness.com and schedule a consultation and we can kind of go from there. So thanks so much for being on with us, Katie. Yes, thank you so much for having me. ### Listen - [Spotify](https://open.spotify.com/episode/14155067) - [Apple Podcasts](https://podcasts.apple.com/podcast/14155067) - [YouTube](https://youtu.be/5aUS2UXtNvo?si=95xwyixBV1-S--8A) --- ## Pathways to Healing: Trauma, Addiction, and Recovery Strategies - URL: https://healyourrootspodcast.com/episodes/pathways-to-healing-trauma-addiction-recovery-strategies - Published: 2023-12-06 - Season 3, Episode 1 - Duration: 44:17 - Category: stress management - Guest: Laura Schneider ### Summary Practical strategies for managing holiday stress, family dynamics, and maintaining mental health during the challenging and joyful holiday season. ### Description The holiday season can be both joyful and challenging for our mental health. In this episode, we explore practical strategies for managing holiday stress, navigating complex family dynamics, and maintaining emotional well-being during this busy time of year. Learn how to set healthy boundaries, manage expectations, and create meaningful holiday experiences that support your mental health. ### Transcript [0:00] But you're not actually healing from anything. So these things are going to keep coming up. And you're going to keep using substances more and more to kind of treat the mental health symptoms that come with trauma. And then, as the addiction is getting worse, you're probably going to use more and then you're going to just be numbing things until the point it kind of explodes. Eventually, it's like a pressure cooker, the more pressure you put eventually it's going to, it's all going to come collapsing down. Welcome back to Heal Your Roots Podcast. In today's episode, we have Laurie Schneider, discussing the cyclical nature between trauma and substance use disorder. Laura shares great insight and tips on how to work through this holiday season. If you or a family member, you know, may be struggling with substance use disorder, you're going to want to tune in. Thanks so much. So I'm so excited for today's episode. Laura, thank you so much for joining us today. We can kind of jump right in, can you share a little bit about kind of how you got into the field and into the world of therapy? Sure. Thank you for having me. First of all, I'm very excited to be here. I got into what I do now in a very long, roundabout way. But I'm very glad I got here. I started when I went to school, I thought about what do I want to do with my life. So I started taking classes for nursing. And part of that is you take prerequisites, and I started taking psychology classes. And something about learning about how the mind works and how people are was so fascinating to me that I changed my major. I studied psychology. And after I got my bachelor's degree, then came another period of okay, well, what do I want to do with this degree? How do I want to use this? So I started working with caseworkers I was a case aide. And in that work, I decided I loved working with people, I loved the challenges that they had and trying to help them as much as I could. So I learned about a master's in social work. And I really liked that degree, because it opened a lot of doors, it was very personal, you could really work with a lot of different populations, in different settings, doing different things. And that really intrigued me. So while I was getting that degree, I started really, really loving the classes where we talked about the therapeutic interventions and how to be a therapist. So that was always my long term goal. During that time, however, I got very into drug addiction, it started very innocently and eventually spiraled pretty out of control. So my career path kind of took a backseat for a bit. Once I got help, I went to a place where a lot of the therapists were openly in recovery. And I remember sitting there thinking, Oh my God, I want to do the same thing. I have this degree already, I have this real world experience. I know what this is like. And so that became my new long term goal. And then once I started doing that kind of work, working with alcohol, alcoholics and addicts, and providing therapy for them, I realized that this was always what I was meant to do. It was the purpose that I was given, and I feel so fulfilled. It's a very challenging job. But it's one that I find so rewarding. I absolutely love it. Even on the really hard days where so many things are going wrong, I still very much know that this was my calling and why I was put here. Thank you for sharing that. I appreciate that. I know, it's not easy for us to always kind of share vulnerable moments of our own personal life, especially as a therapist. And I think that a lot of our own personal experiences, whether it's within our own life or family or things that we've gone through kind of informed why we choose particular specialties, or who we want to work with. And I'm I mean, I'm curious of how that, I'm sure really helps your clients feel like they can relate to you knowing that that's something that you've gone through as well. And here to help them move through it. I think it does. A lot of a lot of the clients I work with do appreciate the honesty, I don't share a lot of details about it. But I think just knowing sure that I come from a similar background really does help. I know for myself, it helped, because I did try treatment a couple of times before my last attempt. And I didn't know for sure if any of the the therapists were in recovery or not. And I know in the field of social work, it really shouldn't matter, right? We were taught not to share too much about ourselves because it's not about us. It's about the people we work with. I just feel that this is a very unique population. And I think that having that degree of familiarity and understanding between us really helps the therapeutic relationship. I value their opinion and they're also in recovery. So they got it there. Maybe I can get it to, or like, they're not just telling me something that they read in a textbook, they're kind of giving me real advice. And I find that it really helps, especially in our, you know, our people are very resistant to change at the beginning. So I think having having good role models helps. Absolutely. And so what kind of different settings have you worked in, in terms of with clients like inpatient or outpatient, what that's been like for you and your experience? For substance use disorder, I've worked in outpatient, I also have a background in mental health therapy, just strictly mental health where I did outpatient services as well. I've worked in a group home for developmentally disabled children, I've worked with CPS not, you know, going to family court. So I've been in a lot of different outpatient settings. And so when you are at your current placement right now, at Valley springs recovery, is that an outpatient facility, that's an outpatient, okay. And so the clients you're seeing, are they actively in addiction, or they're through the recovery process. We're getting them in the early stages. So some people come in, and it's their first time and it's the early days, and they don't know what to expect. We have some people who this is not not their first rodeo. So they, they kind of have an idea of how recovery kind of works. So you know, they come in with some background in trying to get help, I find we have people that come in, in the very beginnings of recovery. So they've never been to treatment before, they don't really know what to expect. We have some people that this is not the first go around. So they they do have some background in the treatment process. Some people that come for, you know, to make their families happy, some people that really want it for themselves. And then during that process, some people, you know, have slips or relapses, a good portion of them do remain in treatment, or try to get re engaged and get back on track, for the most part, which is a great thing. Very rarely do they kind of just disappear and never come back. But yeah, those were probably most of the people we see. Well, that's great, they don't disappear. The museum is committed to treatment to some degree, even if they're not ready at that particular stage. But you know, because I know there's different seasons of this process. So knowing that the place you're at Valley springs recovery, it sounds like, depending on where you're at, in your journey, this is a good spot for them to come to get treatment. I agree. And I think the main feedback I hear from a lot of the clients is that they feel cared for. They feel like we actually do care about them and want them to do well. That's it, that's really the best thing to hear. I want people to feel heard and seen and valued. Absolutely. And so I know that you specialize in addiction, treatment and substance use, I know that you also work with trauma. And I know that there's a really large overlap and kind of like this cyclical relationship between trauma or PTSD and substance use disorder. Can you speak a little bit more on that, or what you've seen in your experience or your knowledge around that? Yeah, um, we actually talked about this yesterday, in group. A lot of the people that I see I love getting the trauma people if I know they have trauma, I do try to see them because that is one of my passions is working with trauma and PTSD. One of the things that we learned in the process is some people will come in with trauma before their addiction starts. And then some people will have trauma kind of in adulthood. But one of the things we try to put together like the pieces of okay, what what is this trauma and how, what is the impact it's having on your life? Is it a story where the pain is so much that you did different things to cope with it, in a way numb it or try to push it aside and pretend like it's not there, eventually, drugs and alcohol become a great way to do that, because it kind of turns your mind off a little bit. But you're not actually healing from anything. So these things are going to keep coming up. And you're going to keep using substances more and more to kind of treat the mental health symptoms that come with trauma. And then as the addiction is getting worse, you're probably going to use more and then you're going to just be numbing things until the point it kind of explodes. Eventually. It's like a pressure cooker, the more pressure you put eventually it's going to it's all gonna come collapsing down. Yeah, and it's interesting because it's, you're saying that sometimes people come in with trauma and they haven't even really started using substances or it can be vice versa, right like they need have already started using substances for whatever reason, and maybe there's you know, they had an accident or something else that's been going on in their life. And then through that process, they may find themselves in kind of traumatic or dangerous situations that exacerbates that and those symptoms. And it kind of just goes back and forth. Yeah, it's a snowball effect. One of the young men was talking yesterday about how he, I think it's like 10 years or so he has a process, this really traumatic thing that happened, where he found a friend that passed away. And it was an after a night of them partying. So he has been carrying around for 10 years. Who knows, but he hasn't even started unpacking it, like the guilt, the shame, the sadness, the anger, there's all these things that he's just been numbing, and the stuff is still going to be there underneath. But we're not actually healing and getting better. Yeah, wow. And I can imagine a lot of people who have had childhood trauma, right, like years and years or decades of not really wanting to go there or think about that. And numbing, self medicating, right. I mean, it is a coping mechanism. It's maladaptive. It's not the best one. But it's, you know, something that they found to help them move through life to not have to deal with those, whether it's painful memories or like the dysregulation in their body. Yeah, that's a lot. And it's heavy work for you to be in every day as well. So I commend you for being in that specialty and helping people in that circumstance. Thank you. I, I think also, trying to identify healthy coping skills can be a challenge, too, because sometimes people don't even know really who they are. And they depending on what the trauma is, I really love working, especially not that I don't like working with men. But I like working with women who have trauma. Because a lot of times what I hear from them is this great sense of not really know who they are, and having this narrative in their head, that doesn't really come from them. That that it's very, very low self esteem and no confidence and very, very segregating to themselves and trying to work on building up that piece of self love and competence and kind of rewriting the narrative that they've put into that they've had running in their heads for years. Yeah. And so how do you kind of approach that if someone's coming in with addiction or substance use? And they have a history of trauma? Like do you tackle both at the same time? Do you kind of take time to separate between the two? What's kind of like the course of action? Obviously, it's different for every person, but like, generally, your approach to that. i It's kind of like what you said, it depends on what symptoms are presenting who the person is what really needs to be tackled. The hope is that, by the time I see them, they're relatively stable. They haven't had substances in their system for a while. So they're pretty as close to baseline as I can get them. If they're going to be there for a short amount of time. We I do. I don't go deep diving into the trauma, but we kind of talk a little bit about maybe putting the pieces together of okay, we have this traumatic experience you had, how does that paint your view of the world? How does that? How is that kind of showing you how to react to people? How can we work on that? So it's a more healthy way? If you're someone that gets like, do you know, your trauma triggers? Do you know when you're going to be more irritable, more susceptible to like panicking, depending on what you have? And we kind of kind of work on? How do we manage the symptoms, if they're going to be there a little bit longer, and I know, it would be safe to do so we do try to dive deeper and to kind of talk about the trauma more deeply and really process that over time. It really depends if someone's coming for maybe a month, I'm not going to deep dive into a lot of heavy stuff. But I will try to set them up for like a longer term plan. Luckily, most of the people I do work with stay for a good amount of time. So we're able to do both. Okay, so that's great. I'm glad that you mentioned that if they're not there for a long time. You're not just going like straight to the terrible. Yeah, like the worst thing that ever happened, okay, in a couple of weeks, we're ending. So see you later, I just opened up this room for you. That's like bleeding out, which is the reason that you've been numbing or avoiding and now you have nothing to help cope with it or move through that. So more about like symptom reduction, and sounds like a lot of self awareness, right, like making sure they can recognize when they're experiencing these symptoms as well. Yeah. Because that's also the main takeaway I get from a lot of when I'm listening to what people are talking about. It it's kind of awesome to watch people discover their own. The ways that they react to things and how they don't they didn't realize in that moment, I didn't really I said something like, that is why I feel this way, which makes me behave this way. And it's it's really amazing to watch people put those pieces together for themselves, and then hopefully find better ways to cope with things. So I'm sure that's one of the most rewarding parts, right? He's like having all the pieces, like watching the light bulb go off, like, Oh, I get it. Now, we're recognizing that that experience was traumatic, because I don't necessarily specialize in trauma. But you know, in therapy, a lot of our clients are coming to us with some level of traumatic backgrounds, relationships, instances that they bring up. And sometimes they don't even recognize that what they went through was traumatic, because it doesn't seem that bad, or doesn't seem like a big deal, or people around them had it worse. So I'm curious what that's like, if you've had clients who kind of minimize or downplay or don't even recognize that the things they've been through are traumatic and impacting them now. So I do have, I'm thinking of one person in particular, that told me some stories. And in my head, it sounded very traumatic. They didn't, it was, you know, very adult, they were minimizing it, or they just didn't experience it as traumatic. But it did sound pretty traumatic. I always included in my notes, and I always put it down in like my trauma history, just in case it comes up again. And then maybe lightly touch on like, trying to pull similarities. Oh, well, if you're, if you're kind of talking about these feelings of underlying self doubt, or thinking that people don't like you, or this, you know, whatever they're bringing to me, could that relate to the feeling you might have had experiencing this and trying to help them see, I'm never going to tell someone else's story for them. So if they don't think it's traumatic, then I'm not going to tell them it's trauma. But I you know, I just want to kind of, I always tell them, this just food for thought, give them little, little things to think about. A lot of my homework for people is just think about it, I just want you to think about these things. See where the connection might be? Yeah. And so I know before, when it was just the two of us talking that you mentioned, doing a lot of like, inner child work? Can you share a little bit about that as well? I find inner child work to be childhood work to be very fascinating. I think it's, it's a hard one to get people on board with sometimes. Because I get it it sounds kind of like odd. Like you're, you're parenting your inner child and to do that sometimes you I also Okay, so let me tell us, I love doing art therapy. It's one of my favorite things to do. But a lot of my adult, they're all adults, but you know, they get a little resistance to our therapy. They're like, why am I coloring? I know I should not. And like we can talk about heavy stuff again. But this is just to have fun. And there's a little piece of the kid inside that's just wants to play and have fun. And a lot of people might not have had that might not have had the chance to just have fun. And you get to care for the little version of yourself that maybe didn't get that care. And he'll that I always tell my people think of so I would say for instance you like think a little Kira Think a little Kira, who just wanted to hug and she just wanted to adult like she never got that, like enter the damn doll. Let's, let's take her outside and touch some grass and you know, paints or something, you know, care for her. There's something very healing about being able to care for like this metaphorical, smaller version of yourself. Well, that and you know, it's interesting, because the work you do is I'm sure really heavy. And you know, therapy in general can be really heavy. And I think that clients forget that a big part. And even sometimes a big part of healing is experiencing joy. Right? Like, it's not just about talking about these really, whether it's traumatic or serious or vulnerable things. Yes, it's that and it's okay, now how can I make more space in my life to feel joy and happiness and just be present and do these activities that have no function for productivity or anything like that, but just for me, to just live and be like, have fun, like you're saying is just enjoy life for a moment? Yeah, those are actually the groups that I love to do. I almost always want to do those, obviously. But I think first of all, sobriety wouldn't be no one would keep doing it. If there was no fun or joy ever, right? If it was a drag every day for the rest of your life. Why would anyone ever stay the course. So it's kind of showing everyone Hey, we're still allowed to laugh and have fun and be silly and goof off. And there's also by dynamic in the group where that brings up group cohesion if you're all making jokes and laughing and having a fun time together, those are, those are the memories that I remember from my own group therapy years ago, I remember that the fun groups were we were we made like gingerbread houses for Christmas. And we were all just joking around. And it was fun I not that I didn't get anything out of the heavier groups. But the fun groups is where, you know, I kind of what you're saying, I remembered, there's joy, I'm allowed to have joy and I can have joy, without anything in my body. That shouldn't be there. Like, that's pretty cool. That's pretty nice. Yeah. And I think that's a big part of helping with trauma too, right? Especially since it's so in our body, and our nervous system is dysregulated. And we're on edge and there could be panic, right? Like, our amygdala was being fired all the time. So having joy is like telling your body, hey, I'm safe enough. To not be vigilant, I'm safe enough to just focus and be present, and enjoy the company of other people around me and laugh. And the more space we create for that, like, stillness, right, it also helps our body kind of heal as well outside of the narrative. And just like internally somatically, as well. Absolutely. And I think it's, it's a win win, because so I picked up the guitar when I got sober, and I was dealing with my own mental health stuff. And I found it to be so rewarding. And I'm not saying everyone's got to pick up a guitar, you know how to play music. But there's something out there that you can do that's really good to, like, help you get, like, get these things out of you. So for music, if I'm sad, I like to play sad music, and I like to write a lot of stuff that's going on in, in my mind, get it out of my head. And it's a healing thing, it helps me process what I need to. And I think there's a lot of different mechanisms mechanisms to do that. That might be a little outside the box, you know, if you're, I tell people play to your strengths. I know that I like art, and I like music. So I, I tried to just make it that if you've always been interested in knitting, try it and work towards it. Because it's fresh, everything's new and frustrating at first when you don't know how to do it. But the more you do it, the more you learn, the prouder, you feel more you want to do it, and you feel accomplished. And it's very empowering. If you're someone that likes to to run, make it a goal to do like a half marathon and and take pride in each day, trying your best and just working a little harder to get to your goal. And then you're gonna feel so many good things. Sounds like kind of redirecting your your energy and your thoughts on something healthier, right? Like, that's for you, that brings joy that is a learning curve, right? It's not about being really good at it. But it's you gain confidence throughout that process and sticking with something so that you feel better about yourself. Yeah, because in substance use disorder, the number one trigger I hear is boredom. When people don't have things to do, they get bored, and then they don't, they're just like, Whatever, I'm gonna go, do what I got to do. So I tell people, you're gonna have a lot of time on your hands now that you're not, you know, going to the liquor store, go to drug dealer worrying about this or feeling sick, you're gonna have a lot more free time. Let's make some good use out of it and find something that you'd like to do. So that that that downtime doesn't feel boring. I mean, as humans, we have to a lot of people have to learn that it's okay to just exist, our bodies and our minds need to rest. And it's okay, you don't have to be engaged in something all day every day. But we can't be not doing anything all day, every day, we got to find something to do. So that that time feels fulfilling. And instead of calling it boring time, it's more like this is my peace. This is my peaceful time. It's interesting that boredom is a is a trigger, I wouldn't have necessarily thought about that. But I can think about, at least for me, like I have ADHD and like when I'm bored, sometimes it can feel or is interpreted as me being sad. And so I'm curious if there's kind of that connection to have when you're bored, there's nothing to do you feel like that's you're not being fulfilled. And so it kind of feels like sadness, or if that's just like, a personal experience. And that's not something that maybe other people kind of linked together. Boredom. Well, because what I think of boredom, a lot of people also talk about the feeling of loneliness, too. And I think that can feel sad as well. And this is more of that kind of CBT technique is like what words we're using, right? Sometimes we are going to be a little bored, it's okay to be bored. You're not going to always be fulfilled every single second of the day, but it's about being able to kind of sit in that tolerate it, and then maybe change how we view it. So for me if I'm having that boring time, or what other people might look at as boring I find it very peaceful. I find it we're also breaking this cycle of Chaos. So a lot of people in addiction and in trauma get very used to chaos and I, we logically know that the chaos is not good for us, we're not happy in that chaos, but it's comfortable. When you've lived in it for so long, you, you, it feels familiar. So you might keep trying to chase that chaos in some way. So I think it's about accepting that you don't have to live in chaos. And that's a good thing, you're allowed to have peace. And instead of calling it boredom, let's call it downtime, and the serenity that you've been looking for, because you deserve to not live in chaos. That's so true. Whatever is familiar is comfortable, even if it's not something that's healthy, or that we enjoy. It's just we know what to expect. We know what to do with it. And changes Change is hard, right? And anytime we change, there's like a grieving process, even if we're changing for the better, still grieving something that we're leaving behind or losing, that served a function for some period of time for us. Yeah. In. In our field, we we say like drugs and alcohol. That's not the problem. That's the solution. But what are we solving? What are? What's the question? Were like, what are we using it for? There's, it's serving a purpose, we wouldn't do it if it didn't serve a purpose. So I know that you coming up in the next year or sometime soon wanted to become e MDR. Certified? For the listeners who don't know what that is, can you share a little bit of like, what that approach is, and what made you want to start learning and going into that direction? Yeah, sure. Um, a lot of clients bring it up to me. It's something I've read about or heard about done, like, short trainings on. But um, it stands for eye movement, desensitization and reprocessing. It's basically, like the last two words, desensitization, desensitization, and reprocessing. You know, trauma has an impact on how we experience the world, right? So when the, when we're triggered in those moments, it causes us great distress, right? And that can impact how we're relating to other people, how we're reacting in situations, and it's not always the best, healthiest way, and it's very uncomfortable for us. So this is a technique that kind of uses eye movements similar to REM sleep, I believe, to minimize some of how we experienced that distress when we recall certain traumatic events, so that they so that these moments aren't as intense when we experienced them. And is that something that I know you said you did a couple of short trainings on? Is there anything that like when you were learning about you're like, Oh, I definitely want to do this or that made you want to pull towards it? Or is it just that working with trauma, it's kind of like the natural next step. I remember being very curious about it. When I first learned about it, this was probably 10 years ago, a long time ago, when I did it. At that time, I was working with children who survived sex abuse, so we didn't put it I was still in school. So we didn't, you know, practice it. And I remember learning about anything that's really interesting. But again, my own journey got very sidetracked. So I didn't really, you know, go back into it. And then as I was working in mental health and working in addiction, it's come up a lot, and a lot of people who have had an interest in it. I know, I've been very curious about it. myself. So I thought, you know, if I'm really going to try to specialize more in trauma, I should be really informed in a, a pretty successful and, you know, needed technique. Yeah, absolutely. And I know that it's, like pretty evidence based, like, there's a lot of research studies that show that it decreases the symptoms of PTSD or trauma, like significantly, and your experience of it. I mean, I've had it done. For me, personally, I haven't had like the full kind, of course of it, but it's pretty intense. It's you, I think you have to like really be ready for that journey and know that like, Okay, I'm committed to experiencing this and working through it. And it's like, not like it gets worse before it gets better, at least from my experience. This is where I would be particular about who I implemented with, though, because if, again, I'm not going to open Pandora's box, you know, if someone can only be with me for a month, I would kind of be more open to I don't like to have a discussion with people at the beginning of really how long treatment is going to be because it I don't know that I can't answer that for them. I don't want to give them an arbitrary number. And then they get so focused on the end game that they're not present. So I never really give anything more than like a kind of basic trajectory of how I think it could go with no promises made. But I think you know, with depending on who I'm working with, I think I would have to highlight who would benefit from this who would want to be with me for a while because I don't want to, like you said it can be pretty intense and pretty. Eat, it's gonna feel worse before it gets better. So I don't want to just, you know, let's do EMDR and then you're out next week, that's not a good idea. So I'd have to be very careful. But I think I have enough people that would be with me long enough that it would be beneficial. Yeah. And can you share a little bit if you if you know, like, kind of like the process or what that's like for a client who might be interested in that or struggling with trauma to think about what they could expect in something like that, um, I haven't performed it myself. So I don't, I can't speak to like how it might look that way. But from what I know, the first session or two are very, you know, getting like the background information, getting the history, and then you in the coalition kind of highlight what traumatic memories are what what things you want to what to distressing symptoms you're going to be looking at, and you're looking to replace that with a more positive belief in that place. And then, over the course of a few sessions, you're going to be really, you got to be ready to recall these events in great detail. And that might bring up a lot of emotions and feelings, and then they they do the tapping or the, you know, the fingers snapping or the clapping, to reprocess that in your brain. And so you might, it's gonna bring up a lot of stuff. So start small, with smaller traumas that aren't as intense. And you do that for a few weeks, it really is going to depend on the person and what, what traumatic memories you're bringing up, how intense it is. And then hopefully, you're feeling better after, you know, a couple months. So that, yeah, and then you kind of, I think you'll either pick more stuff to even or to I don't think we're ever fully healed. So I think, I think just because life is a growth and change process, I think you can minimize a lot of things. But I think, like grief, never 100% goes away. But if you learn to manage it and live with it, I have anxiety, and I've just learned to manage and deal with it and find what works, you know, it's never going to go away. 100% Anxiety is normal thing to happen, right? Grief is a normal experience, pain is normal. But I think we don't, we don't want it to impact our whole lives. We're not we're always distressed or always anxious, we're always this way. But you should feel it's not getting rid of, yeah, we're not getting rid of anything. We're just kind of learning how to live with these things and manage them in a way that's effective and helps. And for my understanding, so I don't know for sure. But for my understanding of EMDR. The way that it works like in your brain is pretty fascinating. And interesting, especially why they do like the eye movements or the tapping to incorporate with that is that you know, when a person goes through a traumatic experience, everything in your brain and body kind of shuts off that doesn't need to be there to survive in that moment. So like your language center is off your reproductive system, like everything is kind of off that is not immediately necessary. So like the story and narrative of what's happening, versus what's really going on is like disconnected. Right? And so then, from what I can, from what I was reading is that EMDR helps you make that connection between the traumatic experience between the story, communicate that to each other, and desensitize yourself to create this new narrative about the situation or about what you feel or think about it. So that it doesn't feel the same way in your body and in your mind. Which is pretty powerful. Like, whoa, that's crazy. Yeah, it's it is fascinating. I wish I was like a neurologist or someone who could understand anything with the brain and understand how that works. But it's just it's powerful. It like you said it's evidence based so it works for a lot of people. Yeah. And so I know with the the holidays kind of coming up is this a would you say this is like a natural trigger for some people or some of your clients just being or whether it's around family or like memories, or, you know, in the northeast of like being in New Jersey, New York, it's cold and there's like, you know, seasonal depression? Is this a time where you might see more relapse? Absolutely, this is what I call the danger zone, I feel it's because it's a lot of holidays back to back to back. And that can bring up either painful memories of not having their families around. It can highlight you know, you have to be around family members that you might not get along with. There's usually alcohol at events around the holidays. So like you said, it's cold it's dreary, it's you know, you're gonna be more prone to that. Oh, it's boring because I can't go outside and it's it's too cold in the snow and it just you know, and seasonal depression we're now years feeling Saturn general it's definite The danger zone. So we talked about that a bit over the last week or so like what's, what's the safety plan? How do we manage through the holidays in a way where we're going to manage our symptoms? Well, and not go back out and use? Like, what are what are the tools we're going to put in our toolkit for the holidays? And on the flip side, I do have some people that are excited, because like, Oh, my God, I'm sober for the first time that Thanksgiving, that's, that's fun. And they're like, Okay. Oh, yeah. And so for the listeners, are there any kind of I know, it's very, you know, specific and customized to the person. But is there any like kind of general tips that you could give people during this time that might be in recovery or struggling to help them move through this holiday season or winter? Absolutely, there's a few tools that I always recommend for the toolbox no matter who you are. So that's coming up with a plan, right, and part of the plan are going to consist of different steps. So I always encourage people, if you're going to someone's house, and you know there's going to be alcohol, there's no way to avoid that. Go late, leave early. Take care of yourself, have at least one person, at least one, ideally more, but at least one person who you can confide in that can help you. So if you get there, and it's more of a struggle than you thought, have someone that you can pull aside to talk to have a safe word that lets them know, we gotta leave right now, because we're in high Red Alert. Have some people on standby on your phone that you can text or call so you can step out if you're having a craving. So like, Hey, you got 15 minutes to just talk to me, talk me through this. And, you know, get through that with them. Bring drinks that you like, if your favorite drink in the whole world is Diet Coke, bringing 12 Diet Coke, so you know that you have your favorite drink, always have it and always have it in your hand. Because people are a lot less likely to offer you a drink if you're holding a drink in your hand. So we tell people to do that. And just don't be like, I get it. We all want to be polite and kind. You don't have to worry about what other people think if you're struggling, don't just sit there because you know, oh, Nana said, you know, and I was gonna get mad if I leave No, like if you're if it's between you drinking or nana getting offended, just, you know, go take care yourself be safe. Your safety is the number one concern. And don't you don't have to tell anybody why you're not drinking, but have a firm no, no is a complete sentence. And I know that a lot of times families don't take that they want to more information, come up with whatever you want to say if you're on antibiotics, or you're on antibiotics, if you're saying oh, I'm not drinking in November, say that. If you want to tell people you're in recovery, even more power to you. But it's your story. You don't have to tell people unless you're comfortable. But just have a firm know, don't be like some people will. Because we want to be kind we care about other people think a lot of my people I work with are people pleasers, as am I we feel like we owe people an explanation. Or something about like, you know, we don't we can just say no, I'm not doing this. And we can we can say that in a way where they understand that's like the end of the conversation. Because some people will say, Oh, no, not right now. Good. You know, maybe later, maybe next time I see you, you know, just put a firm no on it. You're allowed to have boundaries, you're allowed to stand up for something that you need, you're allowed to express that sounds like a lot of being assertive, assertive boundaries, having a backup plan, like thinking ahead a little bit and having support around you. Yeah. And being just very honest, and especially what yourself. Some people think like, this is a test. We were not this is not a test. These are not like little you can you can get through these moments and feel proud of them. But you shouldn't need to, like go out and test your sobriety. Right? Like that's why I always say even if you think you're going to be fine, have a safety plan. I'd rather you have, like 20 different coping skills and never need to use any of them then be stuck. And now you don't know what to do. Sure. Better safe than sorry. Always write better to be prepared not have to do anything. Vice versa. Exactly. Yeah. So our this has been very informative, really great. I really appreciate you you coming on. Is there any way for people that are listening that might want to work with you to get in touch with you? Yeah, um, so I have an email address. l Schneider at Valley spring rc.com. Thank you so much for I really appreciate your time and you sharing your insights with us today. They I appreciate it. Thank you for having me. This was nice. Absolutely. ### Listen - [Spotify](https://open.spotify.com/episode/13892456) - [Apple Podcasts](https://podcasts.apple.com/podcast/13892456) - [YouTube](https://youtu.be/m4ZtmvwIzYg?si=oFIhI7iUFnPKXpoB) --- ## Combatting Anxiety: Tools, Techniques, and Humor with Joslyn Justi - URL: https://healyourrootspodcast.com/episodes/combatting-anxiety-tools-techniques-humor-joslyn-justi - Published: 2023-07-05 - Season 2, Episode 10 - Duration: 43:18 - Category: anxiety - Guest: Joslyn Justi ### Summary Examination of social media's impact on anxiety and mental health, with practical strategies for creating healthier relationships with technology. ### Description The digital age has brought new challenges to our mental health, particularly around anxiety and social comparison. This episode examines the relationship between social media use and anxiety, exploring both the risks and potential benefits of our connected world. Discover practical strategies for creating a healthier relationship with technology and protecting your mental well-being in the digital space. ### Transcript [0:00] There are also healthy levels of anxiety. It can keep us on our toes, it can keep us alert and it can be very helpful. The content provided in this episode is intended for informational and educational purposes only. Our conversations are meant to create understanding and awareness around mental health topics, but they are by no means comprehensive, or individualized evaluations or treatment. Stay safe and take care of your mental health enjoy the podcast Hi, I'm Kira Yakubov, Licensed Marriage and Family Therapist and founder of Heal Your Roots Wellness practice. Every episode, we talk with a professional from the mental health field to learn more about their approaches and specialties, and also their journey of becoming a therapist. In this podcast, we'll uncover a deeper look at the world of therapy from new perspectives. You'll meet the therapist of Heal Your Roots Wellness practice, and trusted colleagues from the community tackling mental well being or your go to Network for practical and professional insight in mental health. Subscribe for new episode releases every other Welcome back to another episode. I'm so excited to have Joslyn Wednesday. Justi back for a third episode. She's a Licensed Marriage and Family Therapist that Heal Your Roots Wellness, and I clinical supervisor in training. Jocelyn, thank you so much for being on with us today. Yes, Kira. Thank you. I'm so happy to be back. And I'm really excited to give our listeners a lot of tips and information today. Yeah, me too. Awesome. So I know today we're going to spend majority of our time really diving into different anxiety disorders, what they look like some of the differences, the symptoms, and really give audience members tips and coping strategies to really help them navigate through this process. It's a lot of information. And I know it can be overwhelming for people sometimes. And I think sometimes people often get confused with different anxiety disorders, because there's a lot of common themes. So I'm really differentiate those for listeners today. Absolutely. And I know that's one of your specialties is working with individuals and couples with anxiety disorders, and particularly OCD, which is something I'm not very familiar with. So I'm really excited to hear more insight and depth from you on that as well. Yeah, it's something that I've recently just became very interested in and has become a new passion for me exploring how OCD in the brain works, and how it can disrupt our lives or relationships or work. So I'm really excited to talk about it today. Awesome. So I just want to preface with anxiety is normal, right? Like we all experience it. And there's normal daily anxiety that every person goes through. And it's very vital for us to experience anxiety, or like it serves a function for us. And I think some of the normal day to day things, right? There's a very clear trigger. Like, for example, if you know, or starting a new job, or it's the first day of school tomorrow, or maybe we're going on a first date, right? Like it's natural and normal for us to feel kind of anxious, a little uneasy and worry about that. And that anxiety is something that everyone experiences pretty much across the board. And so I wanted to differentiate normal and common anxiety from anxiety disorders for people. Sure, and most people honestly, and generally speaking, don't meet criteria for a lot of anxiety disorders. You know, usually it's an adjustment disorder if there's a situation or circumstance and there are also healthy levels of anxiety, it can keep us on our toes, it can keep us alert, and it can be very helpful sometimes. However, what I have found the differentiation there is when someone has been experiencing constants symptoms and excessive worry, which is one of the cornerstones for generalized anxiety disorder, it needs to be lasting at least six months or more. And if someone's coming to me saying, I've tried this, I've tried that. I am excessively worrying about XYZ on a daily basis for six months, that's when they're going to be meeting more of a criteria for generalized anxiety, or panic disorder, OCD. So the timing is very important. And it's like you said, it's important to normalize anxiety too. We all have it, I have it sometimes, you know, it's completely normal. And we need to validate that for people. So they're not overthinking Oh, I'm sick, something's wrong with me. Because most times, it's just situations or circumstances. So that timing that six month timing, I think is very important for people to know. Absolutely. And I think a big piece of it as well is that typically when there's like a normal level of anxiety or just like the general kind that people experience all the time is that when the trigger or when the situation is done That level of stress it leaves, right like it's no longer present it subsides versus Generalized Anxiety Disorder, or panic or maybe OCD that stays with us, like you said, an excessive amount of time. And there's almost irrational or an over exaggeration of the experience internally, in proportion to the actual situation, right. So we want to be able to kind of compare and what a reasonable or proportionate amount may look very different for a lot of people, but I think you're saying the timeframe. And also if it doesn't go away, or if it doesn't lessen as the situation leaves, then that's a pretty big trigger for us to recognize that, okay, there's something deeper going on here for the person, right, and it has to really cause significant impairment in many areas of our lives. For example, in our occupation, or in our personal life, if it's causing such severe distress, then there is something a little deeper going on. And, again, the frequency, the intensity and the duration are all important factors to keep in mind too. One of the common factors when it comes to panic disorder, the person needs to have two unexpected Panic Disorders without any trigger anything happening over again, a period of three to six months. Because sometimes, you know, especially with COVID, for example, I saw an increase in anxiety. But again, a common theme, there was the unknown, we didn't know what was happening, and it was uncertain. And sometimes our tolerance levels to discomfort, uncertainty play a huge role in anxiety. Absolutely. And I think the important part for people to know the difference between like an anxiety attack versus a panic attack, is that anxiety attacks, there's almost like a gradual build up. And it's almost always surrounded by you know what the situation is, you know, what you're getting anxious about. And there's a build up, and you know, and you're trying to move through it, and it can feel, you know, debilitating, but you can still understand what's kind of happening to you, versus a panic attack. A lot of times for people, it may feel like they're dying, or they're having a heart attack. And it's, it's almost like an out of body experience where there's a high level of almost terror, where you feel completely out of control. And the onset is almost immediate. So I think that's a big differentiator for people who might be experiencing anxiety versus panic. That's a very common question I've gotten asked recently is the difference between anxiety attacks and panic attacks. And the way I also try to describe it is anxiety attacks, we like you said, we know what's happening, the trigger is there. And it's not so much a physiological response compared to the panic attack where you could have, you know, your heart racing, dry mouth, upset stomach, for example. And it completely comes out of nowhere, like there's no trigger, nothing in your present moment is making this happen. So to me, that indicates also deeper, internalized stress, and things that we're not dealing with, perhaps we suppress them. You know, sometimes I've noticed people who tend to avoid a lot or have an avoidant attachment style, can sometimes experience panic attacks, because a lot of things aren't getting addressed. So when I treat panic attacks or panic disorder, I'm really getting to the underlying issues of what's stressing you out and then working on stress management techniques. And once we get that stress under control, and again, self awareness, there is key. Yeah, a gradual decrease, or the frequency or the intensity decreases. Yeah, and I can see, there's going to be a lot more frustration and avoiding a lot of maybe social events because there isn't a clear trigger, or there isn't a clear link to why someone might be experiencing this, which could feel even scarier, right, like we have no control over this versus people who may have anxiety disorder, or anxiety, panic attacks is, you know, what is kind of triggering you or you know, the circumstances of the situation. And we're more likely to avoid them, or isolate, like that's an active decision, because we know there's like a cause and effect versus really not knowing what's happening. And it's really kind of a probability issue too, because people are prone to that social anxiety, OCD, even ADHD, we have this interpretation or almost this confirmation bias like, well, I don't want to go because I am not comfortable with the unknown, or I don't know what's going to happen. Feeding that thought process in the brain even more. So. A little education for people is, is an overactive amygdala and cortex is what is feeding these thoughts. And so what do we know that we can say, Okay, I'm interpreting this a certain type of way. If I feed into it, then the worry is going to be even more extreme. But if I change my interpretation a little bit, I can say, you know, instead of, I need to know what's going to happen, I can't tolerate the unknown, what we can maybe say is something like, you know, I need this opportunity to learn how to tolerate uncomfortable situations. So again, you hear the difference, we're saying, like, I need the opportunity to be heard, because again, the probability that something may happen is relatively low. You know, it could be high, but we still don't know for sure. And that's something that we really work with a lot is trying to get people to open themselves up to the possibility that their initial confirmation bias thoughts may not be accurate. So therefore, because we don't want to hold people back or for or hold themselves back from. Absolutely. I love that you say that because it's really challenging our thoughts and being more realistic and having more of an open mind of all the scenarios that could happen, right? I say, and I've struggled with anxiety, especially social anxiety a lot in my life is that we imagine the worst case scenario in our mind, and then we feel it in our body. And then we imagine what that's going to be like to move through that right? I don't want to feel that discomfort. I already felt what it's like in my body. I'm good. Yep, right, versus being like, Okay, that's a possibility. It could happen, right? It's not zero chance it could happen. And is there something just as likely or more likely to happen that either nothing bad will happen? Or I'll actually have a good time or a positive experience? And what will that feel like in my body, so at least allow ourselves to see and understand different options. And I think a big part is feeling it in our body is like, kind of like visualizing, and grounding ourselves in those senses as well. Absolutely. And it's learning how to trust yourself a little bit more instead of trusting logical thoughts that have possibly prevented you from enjoying life or having certain experiences. So one of the things I really try to normalize and validate for people is look for the most tiny baby step opportunities you possibly can. And then work from there, because sometimes people want to jump to, oh, I need to go to this huge concert, but I'm tired of being around a ton of people. Okay, well, maybe just start by going to a coffee shop, maybe just start by having somebody over your house, gauge how you build your tolerance, you know, and again, change the way we approach anxiety, rather than like, trying to say no, don't be anxious, don't be anxious, because that just makes us more anxious. Sure. It never works to say, don't feel this feeling. If it was that easy, we wouldn't be feeling it right. If there was a switch, we'd be out of a job if I told people Hey, cool, they're all better. And it's just on the brain so powerful. And once we develop those thoughts and strengthen those thoughts in the brain, that's what's telling us is our reality. Yeah, when again, we're just strengthening unhelpful thought processes, for sure. And I like how you said, kind of exposing ourselves slowly to some of these things. Right. So it's building that window of tolerance. Yes. So I think there's different levels between discomfort, a comfort zone and like dangerous, right? Like, we don't want to put ourselves in dangerous situations that are super risky, just for the sake of, you know, pushing ourselves that's not the point. And, you know, sometimes we want to be in a level of comfort so that we can sooth their nervous system, but we don't always want to stay in the comfort zone, because then we don't necessarily grow, we isolate, like you're saying we prevent ourselves from experiencing more. So it's really kind of playing and testing with the discomfort tolerance window. Like pushing it a little bit further and further and seeing okay, this was really uncomfortable. It wasn't a great feeling. But I'm not hurt. I'm still safe. I managed through it. Like that's a really big deal that I even did this thing. Let me see if I can keep doing the same thing until it feels pretty normal, and then extend that window some more. Exactly. And I love that you brought that up because that's one of the main treatments with OCD is the exposure prevention therapy. So you expose yourself to a triggering stimuli, and you gauge you rate on a scale how discomfort or comfortable and so we can use those numbers as a tangible treatment plan to say okay, this is where you're at when you expose yourself to this stimuli. Let's do it again in a week and see where you are with the same exact stimuli. So, exposure again in theory over time, should decrease the level of discomfort and increase your sense of self increase your confidence, increase your ability to withstand being uncomfortable because like you said, you're not in any physical danger, we are not putting clients in any type of unsafe situation. Like I said, my exposure stimuli is very small baby steps. For example, I had a client who was diagnosed with OCD. And we work together for a long time, like couple years. And this person got to a point where they were able to identify not calling somebody to get validation for an obsessive thought. And when they realized this, it offered so much positive reinforcement to them. And it gave them this increasingly sense of self and feeling proud of themselves that they sat with it on their own, and they did not reach out to somebody else. And it was such a pivotal moment. Again, it was something so small, but it like it was so significant, it was a huge progress. And that was the catalyst to decreasing symptoms. And again, it's, it's all about the client and them doing all of the work. And us pointing that out, like, hey, yeah, we gave you this suggestion, but you did do the work. And that that helps people immensely. And it's really awesome to see it happen in sessions too, for sure. I mean, it's super rewarding, like, you're saying it sounds small, right, or trivial, but the meaning behind that, and how impactful that is, like that person now gained this level of confidence, and self reliance, that may have not been present before to ease some of that stress and anxiety. Yeah, and I think a big part of individuals feeling super anxious, particularly in relationships is this constant need for reassurance and control that it then becomes projecting onto others, and it becomes everyone else's responsibility or job to ease their anxiety. Which, yes, sometimes we need that support. And we need that validation. Because we're social beings, right? We need other people. And that can't be our only source of self soothing, or being able to decrease anxiety, because then we give all give away all our control, and then we feel helpless. And that's the worst place we really want to be as a feeling of helplessness. Well, exactly. And you're talking about too the difference between enabling a behavior and being a supportive spouse or partner. Yeah. So sometimes with either OCD, anxiety, ADHD, a lot of times it interferes with a couple system, communicating conflict resolution, being able to talk through something a lot of misinterpretation happens there. So much, yea And a lot of people will tend to either withdraw or they react, and depending on the level of that reactivity, or withdraw, can cause a lot of tension build resentment over time. And so we have to do a lot of reframing with that like, instead of a couple of say, a couple, someone that has OCD and the other partner doesn't. One tip is okay, let's identify the OCD behaviors, let's, let's identify their traits, their characteristics, let's point them out. So that way, the spouse is not enabling them, or being a quote unquote, parent to them, and, you know, they can be supportive and say, No, hey, we discussed this, this is an opportunity for you to build your tolerance, I can be here to support you. But this is something that I need you to cope with, and utilize, like any type of, you know, coping tool that they may have learned prior. But again, we're building resiliency here at the same time, and that's a big component in this in treating anxiety disorders is resiliency. Absolutely, and having that back and forth understanding, because I think sometimes when individuals are in the throes of anxiety, right, where it's, it's really it can be really debilitating, and it can feel all consuming, well, then we can be really stuck in our own experience of the anxiety and not recognize what it may be like for a partner, a family member, a friend, a co worker even Right, right. And so it's recognizing, like, Yeah, I'm having this experience, it's very uncomfortable. And this other person is here, and why aren't they doing the things that I need them to do, but that other person also has their own experience, and they may or may not know how to support you, and it's not necessarily their job to make this feeling go away for you. Not at all. And that's something that I'm pretty blunt and direct about in my sessions with couples particularly is it is not your partner's job to parent you. It is not their job to be responsible for your own mental well being. Big difference between offering support and validate or offering reassurance when they need it. Sure. But we have to, the individual, you know, we have to work on ourselves before we can work on the relationship. And one thing I'll suggest to, let's say partners without the OCD or without the anxiety disorder, is really trying to refrain from blaming language. Like, or it is always causing us to get into fights or your OCD is causing us to, you know, not enjoy life. While instead of that, you know, maybe using an I statement, like, I see you're struggling, you know, what can we do to make this experience better? How can we work together as a team? Again, you hear people hear the difference between you're doing this, that causes ffensive right away, but back it up and say, I see you're struggling, I see you're having a hard time, right? You love this person, this is your best friend. And I know it can be frustrating. But that's where I think individual and couples therapy can be extremely beneficial to create knowledge to offer education and be like, Hey, this isn't them just, you know, being annoying, or, you know, wanting to fight for no reason at all, let's get a handle on this first and go from there. Absolutely. And that's why I think it's so important is because even though in couples therapy, you're kind of working with each individual, you can't spend the whole session on helping one person cope, right, it's how is this couple managing this and navigating this together. And so that individual therapy is going to be so crucial to have way more time to process, find insight, find awareness, and develop coping skills that you can bring to the relationship or to the couples therapy, like, Hey, these are the things I've been working on, I'm really trying, it's not going to be perfect, you're not going to get it right every time. But like, let me know when you see that I'm not doing it or help me or pointed out when maybe if I'm doing it right, or if I'm not doing it the best way, it's directly keeping your partner accountable too and that and again, just pointing out positive progress, Hey, I saw you were struggling. But I also saw you working through it. And I really appreciate that. And the other part is saying like acknowledging that appreciation, and just being very mindful that their partner is also just as important. Even if I'm the OCD, they don't have anxiety at all, there's still stress, right? And we So stress management comes into play. So I might tell a couple, hey, I know this, you have OCD, and you don't. But let's talk about stress management, because I'm sure that impacts the both of you. And then both of them use that together. And they positively reinforced that together, that makes progress honestly, so much more quick. Absolutely. Now, again, it's not an easy progress process at all. It's time consuming. I tell people that at the beginning, you know, we're trying to rewire the brain, that [takes] lot of mental effort and can be exhausting. So that's where a lot of self care strategies come into play also, and even with that, right, there's a lot of repetition that has to happen. And a lot of reinforcement of particular behaviors over and over again, with the reaction being a positive one as well, that to help us rewire that too. Because I think a lot of times when an individual is anxious, the reaction of their partner can also stop them from being honest. Or it can stop them from being more forthcoming or doing particular behaviors, you know, based on maybe the way they were raised or their family environment when someone made a mistake, right? So it's also understanding the way that you react or speak to your friend or family or partner who may be more sensitive to that, right can also kind of enable them from being honest and open with you. When they have anxiety. Absolutely. It's it's voice tone, it's like you said family of origin plays a huge role in this, you know, how did you learn to manage conflict or anxiety or talk about emotions growing up, which is a big thing we talk about at couples therapy, and it really does increase a person's insight and awareness and can also have people be more sympathetic towards each other. Again, it's it's tough to do that it's tough to rewire the brain, you know, but I mean, it's definitely doable, if you take accountability, if they have a willingness to want to work on the relationship. And if they genuinely want the relationship, those are the three things whenever people check those boxes. That's why therapy also being the most productive and the most successful, because both people have to be in it Exactly. But I do see a lot of like the OCD and ADHD have have sometimes been some of the biggest barriers in a romantic system. You know, that the worry, it's time consuming, people get flustered easily. I think that's something we have to be mindful of when working with couples is just the intensity of where they're at. And so I wanted to ask you, if you can kind of dive a little bit deeper into OCD, but also what Pure O is in OCD? Because, you know, I've been seeing more of that and that it's, you know, from my understanding and from some of my training, I don't have a bunch of experience with individuals with OCD, but that there's usually a behavioral component that goes with intrusive thoughts when the versus kind of the pure Oh, is just that there's the interest Some thoughts but we don't necessarily see the external behavior. Is that right? Or if you can kind of dive more into that. So a lot of newer research has indicated that with Pure O or like OCD, it's not just obsessions. And it's not just compulsions, they're kind of go hand in hand. Right. compulsions are not simply just behaviors anymore. We can have compulsions about thoughts. So the two are intertwined together like this. So with Pure-O, I think the obsession really is an overactive amygdala and an overactive cortex, which again, like this is for our listeners, this is something that you can look up on the OCD website, or you can look at this book called Rewire the OCD Brain by Catherine Pittman and William Young great book. It gives a lot of really good examples of how to rewire our thoughts, but also gives a lot of education. So when it comes to Pure O and obsessions, again, I look at have these been so intrusive in your life, that they have caused significant impairment and disruption to your activities of daily living? If so, let's take a closer look of what that means. However, let's say it's a circumstance, right? Someone just lost someone, for example, you know, and they're having a very hard Okay. time and they might be obsessing over the past history. I don't Yea, But it does become this just unexpected excessive time think that's Pure O or OCD. I think that's a circumstance. consuming worry, and the inability to get unstuck. So we'll call this sticky thoughts is and ruminating thoughts. Perfectionism, for example, is a big one that I hear a lot. People if they can't, like, they're so perfect at work, for example, but they may be late to a meeting or a party because they have to prepare for so long for this. So again, that's causing severe impairment in their life. Okay. Yeah. Cause I wasn't sure exactly of the difference with the Pure O, because I feel like it's, it's tough. And this is why it's really important for individuals to have very specialized therapists or practitioners with OCD, if that's something they're struggling with, because so many symptoms can overlap with generalized anxiety, that it may be hard to tease out and I feel like the treatment is going to look different. My treatment for OCD, there is overlapping treatment plans for OCD and Anxiety. But when it comes to OCD, specifically, it's way more of the exposure prevention therapy and exposing us and learning about those ruminating thoughts a lot. And then with generalized anxiety, it's it's excessive worry, but it's not time consuming. So again, this might be redundant, but I can't emphasize enough that time consuming is a differentiating factor with OCD compared to generalized anxiety and panic disorder. So we have to identify those obsessive thoughts and see what's feeding them. First and foremost, you know, kind of also like changing the interpretation, like I was mentioning earlier, and then identifying the theme, is it perfectionism? Is it uncertainty? Is it fear? Is it you know, contamination, what it because that differs from generalized anxiety, those those themes in my experience, and I think with at least how I like to work with individuals or couples who have generalized anxiety or social anxiety, right is really finding more of that insight, first, of kind of going back in time to seeing when else did you feel this way? When else did you get these messages or these beliefs around these circumstances or these situations? And kind of finding those links? And understanding that because it happened before does not necessarily mean that this is the same now. Right? And your interpretation, right is, how can I interpret this differently? What is the likelihood, right? Am I just assuming, because a lot of the time, we're going to be assuming, then creating a narrative then believing the narrative and then behaving based on the narrative when the other person or other situation, no clue that that was an experience you had until you checked in with them. Exactly. So I think a big difference there is what again, with anxiety and OCD is that with the anxiety, the Insight is a little bit better. And sometimes insight with OCD, at least at the beginning, from what I've seen, like beginning treatment, I should say, Insight is sometimes poor to fair, generally speaking, again, not all the time, but it depends on where a person is in their life and in their treatment. If they're at the very beginning stages of treatment. They're not sure if it's OCD, they're not sure if it's anxiety. Yeah, I asked how long this has been impacting their life for and again, what has it where has it caused the most distress? If they say sometimes I'm I just have sort of test anxiety, but I get pretty good grades. Well, that's a pretty lackadaisical response. That indicates to me, they're not too worried about it. They're just aware, there's a little bit of anxiety. Now, sure, that comes to me, and I can't take a test, I have failed this. So many times, I have sat there and thought about the same question over and over again. And I was unable to think about anything else for let's say, two hours, if that's what, that's how long the tests were to take. That's a differentiating factor to me like, Okay, that's a sticky thought you were unable to get unstuck from that, compared to some ad, you might be, you might experience more of like, like you said, like a body sensation for a little bit. But it was as much distress as someone sitting taking a test for two hours not being able to focus on any other word, except the first word they read in the sentence. So that intensity and severity, duration frequency like this is for audience members like this is how therapists and practitioners kind of assess and look through these things is, How frequently does it happen? What's the intensity level, the severity, and the duration of how long that lasts for right, because those are really big, important factors of being able to assess which the assessment is important for the fact that we need to now figure out the best treatment plan for you specifically, not just to give somebody a label, right, I actually don't actually care about the label, I care more about what's happening and how we can help you. Exactly. And to be honest, OCD a lot more rare than people realize, like meeting the diagnostic criteria for Obsessive Compulsive Disorder, it is not as common as Adjustment Disorder with Anxiety. So a lot of the times it does get a little concerning with social media kind of throwing out a lot of, well, if you meet this, if you have, you know, xy and z, then you have this disorder. And that's scary, you know, that's really scary for people. So it's so good for us to come in educate and normalize a lot of behaviors. Of course, like if there is a diagnosis and OCD diagnosis, it is helpful, like you said, to have a treatment plan moving forward, and how to treat them because like I said, the exposure prevention therapy is what I would use for OCD, but not necessarily generalized or panic disorder, or even like ADHD, for that, for that matter. And so I did want to spend a little bit of time giving audience members like concrete coping skills or techniques that they can use for these different whether it's disorders or the struggles and symptoms that they're going through that maybe you like to use and that I use with clients as well. Yeah, I would say for for panic disorder, I start with normalizing what's happening, not panicking. When you know, something like know your body of what's happening, like are your palms getting sweaty? for example, is your heart starting to race? Are you getting nauseous, you know, okay, if that's happening, remain remain calm. Be still, walk to the sink, walk to your bathroom, splash some cold water on your face, put ice cube on the back of your neck. That can help calm the nervous system and tell yourself, I know what's happening right now I'm having a panic attack. And again, slowing your inner dialogue has been very helpful. Because oftentimes, when something scary is happening to us, the mind starts to race a million miles an hour. So have to be very careful and cognizant of, hey, let's slow it down. Let's imagine something slow, like a turtle, for example. And I've mentioned this to clients like it's, no, it's kind of funny. But if we can visualize something slow, the mind is telling the body it's okay to calm back down. There's no immediate danger. So that's where I, that's where I start is self soothing techniques, calming the heart rate, because your heart rate is going to start to increase with a panic attack. Because like you said earlier, it can mimic a heart attack, which is really terrifying. I've had a panic attack before. And it does help me to coach people through it a lot easier after having her because I definitely saw that increase, I think after the pandemic, and people not knowing what was going on with them. Right. So yeah, that fear of the unknown was a whole other layer to exasperating the panic and causing it to last longer than it should, because we can decrease a panic attack within you can start having it and it can be over in 60 seconds, or over in two hours. The duration varies a lot. But as long as you start to think slow, control your heart rate, breathe, again, you put ice on your forehead or on the back of your neck that can be extreme that cold temperature. Cool to reset the nervous system and offer soothing to the body. Yeah, I love that. So I like to let clients know it's basically the same right is that when When our body has these symptoms, where it feels unsafe, right, and when we feel unsafe, when our nervous system feels unsafe, a lot of the time, we don't have the capacity to challenge our thoughts. So the first and most important thing that you can do is how can I send the message to my body that I am safe, that I am okay, and that I can just be present, right? So so you're saying slowing down, having something cold, breathing, especially for a panic attack, I've had them too, it is not a good time, like you literally cannot breathe, which is horrifying within itself. And so it's literally just focusing on I need to catch my breath, I need to slow my breath. And I need to count my breath. That is your only job is to focus on calming down your nervous system enough where you feel safe. Yeah. And then from there, once you feel safe, and you've calmed down, then you can kind of process then you can kind of challenge some of those thoughts after the fact. Right? I don't like to let clients go into that first, because you're just kind of amping up the anxiety. Yeah, right. We have, we have to get physiological symptoms under control before we can start emotionally processing. Because we're so terrified, and they're in that fight or flight position in the body is telling us that we're in danger. It's gonna just exasperate things. And we're like, Well, how does that make you feel? Like, I'm never going to tell somebody that was? No. Like, I'm horrified. What do you think? So I love what you said, like get the symptoms under control first and process after because a lot of times people will come and they're like, I don't even know what triggered me. It literally came out of nowhere. But that gives us a really great opportunity for self discovery. When people ask me, I don't know, I'm not sure. Who will let's use that as a great moment to like, discover, like, what's beneath the surface? Mm hmm. And that is I love that, because that's what I like to ask clients when they come in with anxiety or depression is how do you know you're experiencing it? Which may sound silly, because like, I'm always in it. But how do you know that? Right? Like, what are all the symptoms? What are the thoughts? What are you feeling in your body? So that you become more aware and knowledgeable of your personal experience so that next time it happens, like, oh, okay, I'm starting to feel anxious. This is typically what happens. Now I can kind of assess my environment or my internal thoughts, what are associated with this experience, right now that I can then process laterand go back to? Well, exactly, and you're slowing it down. To me, that's been some of the most helpful things that I've received feedback from clients lately is being mindful and aware of what's happening and just taking the slow route. And you can come up with your own internal dialogue, but like, literally slowing, the way you talk to yourself, because if you when you start talking that way, you can feel the body starting to slow down. Because when we're talking fast the body is like playing catch up with that. Yeah, I like that, because it kind of pairs with the rest of our sensations, right? Because it's kind of controlling if I kind of pull this lever than this lever will kind of change appropriately or react appropriately to this. Right, right. So going through all our senses. So sometimes, like even myself, or some clients, like okay, I know I have anxiety, I recognize what's happening, I understand what the triggers are, I still feel uneasy, right. So it's like having the awareness is phenomenal. It's the first step, but then it's like, and now what? which can feel frustrating too. So I like to have them before they're even anxious, right? like when they're already in a calm state is to establish a place in their mind of somewhere they may have already been or that they can create is where is an environment that you feel the most safe and calm and at ease and I want you to visualize it. And through the visualization, I want you to hear the sounds, I want you to smell what's going on around you. I want to I want you to experience the sensations and feelings on your body and against your body. And if you're eating or tasting anything, I want you to fully immerse yourself in this super calm, peaceful state that you can then pull to later as a way to self soothe yourself anywhere, anytime without anybody. Because I think it's powerful for people to have that that they can pull from anytime it feels like you're less out of control and more aware of what you can do for yourself. Well, it's so soothing even like as you were describing and taking that step by step it felt so soothing, like hearing you go from Hey, what are you smelling? What are you seeing? And for our listener, basically we're describing like guided imagery. That can just be such a great visual and a great relaxation and Soothing tool, like you said, Think of any peaceful environment that you possibly can, or use your imagination, you're changing the way you interpret something. And, you know, to kind of fall back on what you said earlier was you're also discussing reality testing, and the kind of testing the reality of your own thoughts, right. And sometimes when we ask, Well, how do you know that something bad's gonna happen? You're assuming at the end of the day, and that assumption can be a dangerous game. We all understand that sin. But it really is just getting to a conscious place to be ready to make that decision. Because sometimes people what I have learned in my experience is people get comfortable in anxiety, they get comfortable in a depressive state, even Yeah, it's familiar territory. And the fear pops in because they're afraid to get better. What happens if I have a setback? Again, do you hear like, the what ifs, what-if is a common factor with anxiety disorders, even depression. So again, if we can change the way we interpret things, we can catch that What if we don't have to feed it. Easier said than done for all the listeners really understand that, but I wouldn't say those things if I haven't seen the work for sure. And I think that's such an important feature is that what you mentioned is getting comfortable in the anxiety and almost holding on to it because I think this happens a lot too in treatment is that someone will progress and they will get better. And there'll be this kind of signal like okay, like things are working pretty well, we can probably see each other less. And then all of a sudden, it's like, oh oh, and more comes back, or they start unconsciously sabotaging things around them. Because we're scared of change, right? Like, it may sound counterintuitive, like, oh, I want to get better. Why would I do that to myself? But it's, it's thinking like, what is the function of that? Right? So like, if, if I change that I can no longer rely on certain things. And if I fall back on some of those things, then, like you said, what could happen? Or I'm not going to have the same supports? Or I don't know who I'm going to be? Or what am I going to spend my time thinking about? Or maybe that's part of my identity. So now how do I show up in the world, if I'm not an anxious person, and everyone around me kind of caters to that a little bit. And that's, and that's a lot, right? spiraling around in our brains on like on a daily basis, what if this happens, you know, if I get better, and then I slip up, or this or that, what I'm like, I'll tell clients, I expect that to happen. Because means at the end of the day, it is not going to be perfect. In terms of mental health. In my clinical opinion. Perfectionism is an illusion. And I truly believe that from a mental health perspective, I know we can perfect math problem, for example, would brains not perfect, we have to make mistakes in order to grow in order to learn. But a big theme there is also inviting the concept of accepting that and what that acceptance piece might look like. Because once we accept the fact that we can make mistakes, and we can tolerate making mistakes, then again, we're changing the way we interpret it or approach a situation. And I think it can offer us new experiences, new mindset, takes a lot of work to get there. Don't get me wrong. I have seen people get to that acceptance piece. And it has been a significant change. Again, there's always going to be setbacks. But it's our therapists and normalize those setbacks, because they continue to be proactive in their mental health, they continue to call out and make an appointment, let's say if they had a setback, and they're willing to process it in session. That's a huge difference to me. And in that in and of itself, I think is very significant progress, too. Of course, and I think, especially with perfectionism, when you say that is it's interesting, I almost love working with clients who have perfectionism, because it's not about the actual thing being perfect, right? Like, what are we avoiding happening by you being perfect, right? Is it the identity or sense of being a failure? Is that how other people are going to view you? And if they view you that way, what does that mean? What are the negative consequences to this? Right? Like, I think people focus on just the act or just the the purpose of what they're trying to do to be perfect, and not really processing and thinking about like, if I'm not then what happens? like what is it that I'm really scared of or trying to avoid? That if I were to just face that, process that and work through that and accept that this part because it's a lot of work to be perfect, and we never get there. Right? So it is a constant struggle. It is a constant uphill battle that we will never win, right. And I think people know they'll never win, but they're still going to strive because at least they feel like they're working towards it. Right and avoiding that feeling of whether it's a failure or the relationship or, you know, someone thinking a particular way about them. So it's, it's huge to have that normalized. And, like, I kind of love the family dynamic of it, it kind of pulls back is like, who in your life? What situation made you feel like you had to be this way? Is this a generational learned behavior? You know, did your parents put a lot of pressure on you as a kid to perform, for example, and learned to again, perform at a certain type of level in adulthood? What did you learn about how to interact with individuals, romantic partners, for example, but the perfectionism is probably one of the most common traits that I see a lot with OCD. Because, again, another huge theme is that fear of being judged fear of being disliked fear of being uncomfortable experiencing guilt or shame. And again, the tolerance is so low that even the thought of making a mistake can send people into a downward spiral. And it kept them from going after that interview that they've been wanting for a long time. It might prevent them from hanging out with some friends or, you know, going on a date, for example, because again, it's the fear dictating this. So I tried to frame it and ask people, What is it that we're listening so much to the fear aspect, and that's what I'm very, very curious about. I'm been working with that for a while now trying to understand that a lot more of how fear is dictating our our conscious. Yeah. And I feel like fear and shame and guilt, just like lay at the surface, like at the bottom of the ocean, right. And they're just like, such an unconscious, huge influence on a lot of the things we do that we don't even recognize half the time until we take a step back to be like, I'm actually terrified of all of these things happening. I think about what it's like to even admit that to ourselves. Yeah, that can be in and of itself a huge step, when we can admit that it's fear kind of dictating this. But then a good Another good tool to use is sometimes using a cost benefit analysis. And ask someone, okay, if fear is present, what are the benefits to letting go of that fear? And and let's say reaching out for that job, give me the benefits, and then I'll ask them, give me the cons. What are the reaching out to that job? While I might not get it, and that might make me feel like even more of a failure? We don't know that for sure, though. You know, so let's, let's maybe challenge that and do a little bit more reality testing there, or a little bit more cognitive restructuring there. Yeah, you could get turned down. But that doesn't mean you can't move on and try something else. Because that's building resiliency. That's building tolerance, that's building bravery and courage to step out of your comfort zone and say, Okay, I accept that I did not get that job. But you know, what, I am qualified. And I know I have the skill set. And I can do this a lot of positive reinforcement and a lot of like, positive self talk. It's not the answer to every thing. But it can go a long way. For sure. And I think that's, it's so huge. And I like how you bring them both to the surface, because they're both real, right? Like all of these features are real and do exist, when it's, I think it's also having people recognize that the amount of time we spend worrying that something bad will happen, and our limited ability to handle that situation is so disproportionate to what is actually happening, right, the chances are much lower, and our ability to overcome and are much higher. So I think pointing that out for people and building that acceptance and confidence that like, Okay, this is a very real factor, this bad thing or, you know, negative thing may happen. And if it were to happen, how can I feel confident in myself to move forward anyway? so that that's not the factor or the barrier, the holding back from even trying Right? It like I love that use the word, that barrier. Because that's what I have found, like, what is holding you back like, and even with couples, I'm like, what is the barrier happening here that's causing, let's say, a disconnect between the two of you? What's there, and that's a great place to start exploring and finding those maladaptive functions that are just serving this horrible purpose within a friendship of family. So I think I just think it's very important to be mindful of how we approach things, what we tell ourselves the inner dialogue, and also learning to accept our limitations. and using those limitations, though, to our advantage, if we know, if we know the brain's limitations, we can totally use that to our advantage. Absolutely. I love that. And as you were talking about that something came up for me, especially for couples with, like barriers or maladaptive kind of behaviors, is I think that even when we have these coping skills that maladaptive for audience members, like, you've figured out a way to cope with it, but it's not necessarily healthy or helpful, but it's a way that you learn to function and move through it, because you needed it at a certain point is that it's also a grieving process to release that particular coping mechanism. So you can invite a new one. And I think that's really tough, too, is I have to release this thing I've been relying on for so long, even though I know it's not helping and it's actually hurting when when it feels scary, because it served a function before. So it's grieving that and allowing yourself to invite in new ways of interpreting situations or interacting with yourself or other people. So I love that you mentioned that because that just like came up for me, and I just wanted to share it. Awesome. No, I never thought of it in a sense of grief and loss, when we're losing the way we typically do things. And to be able to incorporate something new, of course, there's going to be some resistance, right? Why is that piece of resistance, because it's going to happen, I expect it to happen. But being able to incorporate, Hey, it's okay, to be defensive, or to feel a certain type of way, when you're no longer reacting, how you typically would, you're changing, you're doing something different. And that might feel defeating, sometimes, it might not feel like this person is gonna get one over on me, if I, you know, don't stand up for myself for screaming. That can be hard. But again, did the pros outweigh the cons in that scenario, that's where I just I love that benefits and cost analysis coping mechanism, because again, you can see it, you can write it down, it's a great visual aid for those visual learners. And again, when you're writing stuff down, and you're reading it, your brain is remembering it more, and it's comprehending it double compared to just once, for sure, or even just reading it as like the physical act of you writing it. That's why journaling is so powerful too is that you can your everything is connected for you to get that, that message across and engrained a lot more longer, a lot more permanently. Absolutely. And it sticks. And I think couples can see that when things stick. And when they're practicing together. And they're giving each other the benefit of the doubt, can go a long way when trying to change behaviors within your system that can go a long way with your partner being more willing to change when they see that you're helping them along the way and giving them that like, okay, you know what, you might have messed up a little bit. But here's a little bit of grace at the end of the And you know what's interesting, so I've had couples where day. they've gone from really high intense arguments to, like high intense, it's drawn out so much energy is spent to having a really respectful and productive conversation that doesn't last very long because they get to the point. And one or both partners kind of feel like uneasy about it. And so I'll ask like, why does this feel strange? And like, I don't know, like, usually I can get all this energy, this pent up anger. And now it's like, oh, you validated my feeling. That's it? What am I supposed to do with all this energy now? So it's funny that even healthy change, when we still have to recognize that something different means that we have, there's a cost, right, we have to release something in order to receive something. Because I think too, we can sometimes get so used to the chaos. Chaos just becomes second nature to us, sometimes, you know, whether we're aware of it or not. And, again, it's a safe space. It's a comfortable space. It's familiar territory. So when a couple does get to that, that point of, oh, we're having a nice, we're actually talking to each other and not screaming and yelling at each other. It just feels weird. But it's good weird at the end of the day, right? Well, I like to differentiate between good weird, bad, weird. And it's a nice way to kind of incorporate humor into the sessions a little bit and make light of some things because we don't always want it to be this heavy, drawn out emotional conversation. That's exhausting. And you know, I think that that piece of humor with anxiety, OCD, depression, couples therapy, can can go a long way. And sometimes we can even make fun of the symptoms. If we can, this internal dialogue that oh, this is being, we can name it. We can make fun of it. We can tease it. Sometimes it can decrease it in its power over us in a sense. Yeah, humor is such a huge, huge tool, and it's very healing and I love bringing humor into session. And I think that's kind of why we jive well, too, is that like, if you can't laugh at or you can't find the silliness or lightness in it, everything's going to feel heavy. Yes. It's so hard to do anything in life when everything constantly feels heavy. Like in the moment, it might suck, but like, can we? Can we talk about that story after the fact that laugh at like, How absurd that was? Or like, Oh, my God, I couldn't believe I did that again. Right, like, so it's bringing that humor. So I love that you bring that up, too, because I think that's such a huge piece in any relationship Absolutely. If we can't laugh at certain things, like even myself, as a therapist, I might say something silly or fumble my words. And I'll just laugh at myself in session. And I think it just humanizes us a little bit. And it really, in my experience has made clients feel more comfortable. And I make mistakes too. I'm your therapist, but I also make mistakes. And guess what? It's okay. I'm still here. I'm still doing my job. And I hope that shows that you can do the same. And yeah, okay, and laugh at that mistake and move along, learn from it, grow from it. Love it. Love these little tidbits, those are great quotes. Great quotes, happy to talk. I could talk to you about this and like generally anything for hours. But I know we've definitely come closer to an end. So I really want to thank you so much for your time for sharing your insight and knowledge with us. I hope the listeners got a lot of great information. So Joslyn, thank you so much for being on with us today. Absolutely. Kira, thank you so much as always for having me on here. And for our listeners, especially those with OCD. If you want to check out the book, Rewire my OCD Brain, it's a really great resource to have. There's a lot of great coping tools education in there. So check it out. It's a great book and I hope everyone's well and enjoyed this episode. Awesome. And just so listeners know if you want to work with Joslyn, whether individually or as a couple she's accepting new clients right now in Pennsylvania and Delaware. So you can head over to our website, HealYourRootsWellness.com schedule a consultation and we hope to hear from you soon. Thanks so much, everybody. Thank you ### Listen - [Spotify](https://open.spotify.com/episode/13638759) - [Apple Podcasts](https://podcasts.apple.com/podcast/13638759) - [YouTube](https://youtu.be/wKMGp_pbXJ4) --- ## Embracing Cultural Identity in Therapy with Gabrielle Larin, LMFT - URL: https://healyourrootspodcast.com/episodes/embracing-cultural-identity-therapy-gabrielle-larin - Published: 2023-06-21 - Season 2, Episode 9 - Duration: 41:56 - Category: self-care - Guest: Gabrielle Larin ### Summary Exploration of self-compassion versus self-criticism, with practical techniques for developing a kinder inner voice and supportive self-relationship. ### Description Many of us struggle with a harsh inner critic that undermines our self-worth and mental health. This episode explores the difference between self-compassion and self-criticism, and provides practical tools for developing a kinder, more supportive relationship with yourself. Learn evidence-based techniques for quieting your inner critic and cultivating self-compassion in daily life. ### Transcript [0:00] There are also healthy levels of anxiety. It can keep us on our toes, it can keep us alert and it can be very helpful. The content provided in this episode is intended for informational and educational purposes only. Our conversations are meant to create understanding and awareness around mental health topics, but they are by no means comprehensive, or individualized evaluations or treatment. Stay safe and take care of your mental health enjoy the podcast Hi, I'm Kira Yakubov, Licensed Marriage and Family Therapist and founder of Heal Your Roots Wellness practice. Every episode, we talk with a professional from the mental health field to learn more about their approaches and specialties, and also their journey of becoming a therapist. In this podcast, we'll uncover a deeper look at the world of therapy from new perspectives. You'll meet the therapist of Heal Your Roots Wellness practice, and trusted colleagues from the community tackling mental well being or your go to Network for practical and professional insight in mental health. Subscribe for new episode releases every other Welcome back to another episode. I'm so excited to have Joslyn Wednesday. Justi back for a third episode. She's a Licensed Marriage and Family Therapist that Heal Your Roots Wellness, and I clinical supervisor in training. Jocelyn, thank you so much for being on with us today. Yes, Kira. Thank you. I'm so happy to be back. And I'm really excited to give our listeners a lot of tips and information today. Yeah, me too. Awesome. So I know today we're going to spend majority of our time really diving into different anxiety disorders, what they look like some of the differences, the symptoms, and really give audience members tips and coping strategies to really help them navigate through this process. It's a lot of information. And I know it can be overwhelming for people sometimes. And I think sometimes people often get confused with different anxiety disorders, because there's a lot of common themes. So I'm really differentiate those for listeners today. Absolutely. And I know that's one of your specialties is working with individuals and couples with anxiety disorders, and particularly OCD, which is something I'm not very familiar with. So I'm really excited to hear more insight and depth from you on that as well. Yeah, it's something that I've recently just became very interested in and has become a new passion for me exploring how OCD in the brain works, and how it can disrupt our lives or relationships or work. So I'm really excited to talk about it today. Awesome. So I just want to preface with anxiety is normal, right? Like we all experience it. And there's normal daily anxiety that every person goes through. And it's very vital for us to experience anxiety, or like it serves a function for us. And I think some of the normal day to day things, right? There's a very clear trigger. Like, for example, if you know, or starting a new job, or it's the first day of school tomorrow, or maybe we're going on a first date, right? Like it's natural and normal for us to feel kind of anxious, a little uneasy and worry about that. And that anxiety is something that everyone experiences pretty much across the board. And so I wanted to differentiate normal and common anxiety from anxiety disorders for people. Sure, and most people honestly, and generally speaking, don't meet criteria for a lot of anxiety disorders. You know, usually it's an adjustment disorder if there's a situation or circumstance and there are also healthy levels of anxiety, it can keep us on our toes, it can keep us alert, and it can be very helpful sometimes. However, what I have found the differentiation there is when someone has been experiencing constants symptoms and excessive worry, which is one of the cornerstones for generalized anxiety disorder, it needs to be lasting at least six months or more. And if someone's coming to me saying, I've tried this, I've tried that. I am excessively worrying about XYZ on a daily basis for six months, that's when they're going to be meeting more of a criteria for generalized anxiety, or panic disorder, OCD. So the timing is very important. And it's like you said, it's important to normalize anxiety too. We all have it, I have it sometimes, you know, it's completely normal. And we need to validate that for people. So they're not overthinking Oh, I'm sick, something's wrong with me. Because most times, it's just situations or circumstances. So that timing that six month timing, I think is very important for people to know. Absolutely. And I think a big piece of it as well is that typically when there's like a normal level of anxiety or just like the general kind that people experience all the time is that when the trigger or when the situation is done That level of stress it leaves, right like it's no longer present it subsides versus Generalized Anxiety Disorder, or panic or maybe OCD that stays with us, like you said, an excessive amount of time. And there's almost irrational or an over exaggeration of the experience internally, in proportion to the actual situation, right. So we want to be able to kind of compare and what a reasonable or proportionate amount may look very different for a lot of people, but I think you're saying the timeframe. And also if it doesn't go away, or if it doesn't lessen as the situation leaves, then that's a pretty big trigger for us to recognize that, okay, there's something deeper going on here for the person, right, and it has to really cause significant impairment in many areas of our lives. For example, in our occupation, or in our personal life, if it's causing such severe distress, then there is something a little deeper going on. And, again, the frequency, the intensity and the duration are all important factors to keep in mind too. One of the common factors when it comes to panic disorder, the person needs to have two unexpected Panic Disorders without any trigger anything happening over again, a period of three to six months. Because sometimes, you know, especially with COVID, for example, I saw an increase in anxiety. But again, a common theme, there was the unknown, we didn't know what was happening, and it was uncertain. And sometimes our tolerance levels to discomfort, uncertainty play a huge role in anxiety. Absolutely. And I think the important part for people to know the difference between like an anxiety attack versus a panic attack, is that anxiety attacks, there's almost like a gradual build up. And it's almost always surrounded by you know what the situation is, you know, what you're getting anxious about. And there's a build up, and you know, and you're trying to move through it, and it can feel, you know, debilitating, but you can still understand what's kind of happening to you, versus a panic attack. A lot of times for people, it may feel like they're dying, or they're having a heart attack. And it's, it's almost like an out of body experience where there's a high level of almost terror, where you feel completely out of control. And the onset is almost immediate. So I think that's a big differentiator for people who might be experiencing anxiety versus panic. That's a very common question I've gotten asked recently is the difference between anxiety attacks and panic attacks. And the way I also try to describe it is anxiety attacks, we like you said, we know what's happening, the trigger is there. And it's not so much a physiological response compared to the panic attack where you could have, you know, your heart racing, dry mouth, upset stomach, for example. And it completely comes out of nowhere, like there's no trigger, nothing in your present moment is making this happen. So to me, that indicates also deeper, internalized stress, and things that we're not dealing with, perhaps we suppress them. You know, sometimes I've noticed people who tend to avoid a lot or have an avoidant attachment style, can sometimes experience panic attacks, because a lot of things aren't getting addressed. So when I treat panic attacks or panic disorder, I'm really getting to the underlying issues of what's stressing you out and then working on stress management techniques. And once we get that stress under control, and again, self awareness, there is key. Yeah, a gradual decrease, or the frequency or the intensity decreases. Yeah, and I can see, there's going to be a lot more frustration and avoiding a lot of maybe social events because there isn't a clear trigger, or there isn't a clear link to why someone might be experiencing this, which could feel even scarier, right, like we have no control over this versus people who may have anxiety disorder, or anxiety, panic attacks is, you know, what is kind of triggering you or you know, the circumstances of the situation. And we're more likely to avoid them, or isolate, like that's an active decision, because we know there's like a cause and effect versus really not knowing what's happening. And it's really kind of a probability issue too, because people are prone to that social anxiety, OCD, even ADHD, we have this interpretation or almost this confirmation bias like, well, I don't want to go because I am not comfortable with the unknown, or I don't know what's going to happen. Feeding that thought process in the brain even more. So. A little education for people is, is an overactive amygdala and cortex is what is feeding these thoughts. And so what do we know that we can say, Okay, I'm interpreting this a certain type of way. If I feed into it, then the worry is going to be even more extreme. But if I change my interpretation a little bit, I can say, you know, instead of, I need to know what's going to happen, I can't tolerate the unknown, what we can maybe say is something like, you know, I need this opportunity to learn how to tolerate uncomfortable situations. So again, you hear the difference, we're saying, like, I need the opportunity to be heard, because again, the probability that something may happen is relatively low. You know, it could be high, but we still don't know for sure. And that's something that we really work with a lot is trying to get people to open themselves up to the possibility that their initial confirmation bias thoughts may not be accurate. So therefore, because we don't want to hold people back or for or hold themselves back from. Absolutely. I love that you say that because it's really challenging our thoughts and being more realistic and having more of an open mind of all the scenarios that could happen, right? I say, and I've struggled with anxiety, especially social anxiety a lot in my life is that we imagine the worst case scenario in our mind, and then we feel it in our body. And then we imagine what that's going to be like to move through that right? I don't want to feel that discomfort. I already felt what it's like in my body. I'm good. Yep, right, versus being like, Okay, that's a possibility. It could happen, right? It's not zero chance it could happen. And is there something just as likely or more likely to happen that either nothing bad will happen? Or I'll actually have a good time or a positive experience? And what will that feel like in my body, so at least allow ourselves to see and understand different options. And I think a big part is feeling it in our body is like, kind of like visualizing, and grounding ourselves in those senses as well. Absolutely. And it's learning how to trust yourself a little bit more instead of trusting logical thoughts that have possibly prevented you from enjoying life or having certain experiences. So one of the things I really try to normalize and validate for people is look for the most tiny baby step opportunities you possibly can. And then work from there, because sometimes people want to jump to, oh, I need to go to this huge concert, but I'm tired of being around a ton of people. Okay, well, maybe just start by going to a coffee shop, maybe just start by having somebody over your house, gauge how you build your tolerance, you know, and again, change the way we approach anxiety, rather than like, trying to say no, don't be anxious, don't be anxious, because that just makes us more anxious. Sure. It never works to say, don't feel this feeling. If it was that easy, we wouldn't be feeling it right. If there was a switch, we'd be out of a job if I told people Hey, cool, they're all better. And it's just on the brain so powerful. And once we develop those thoughts and strengthen those thoughts in the brain, that's what's telling us is our reality. Yeah, when again, we're just strengthening unhelpful thought processes, for sure. And I like how you said, kind of exposing ourselves slowly to some of these things. Right. So it's building that window of tolerance. Yes. So I think there's different levels between discomfort, a comfort zone and like dangerous, right? Like, we don't want to put ourselves in dangerous situations that are super risky, just for the sake of, you know, pushing ourselves that's not the point. And, you know, sometimes we want to be in a level of comfort so that we can sooth their nervous system, but we don't always want to stay in the comfort zone, because then we don't necessarily grow, we isolate, like you're saying we prevent ourselves from experiencing more. So it's really kind of playing and testing with the discomfort tolerance window. Like pushing it a little bit further and further and seeing okay, this was really uncomfortable. It wasn't a great feeling. But I'm not hurt. I'm still safe. I managed through it. Like that's a really big deal that I even did this thing. Let me see if I can keep doing the same thing until it feels pretty normal, and then extend that window some more. Exactly. And I love that you brought that up because that's one of the main treatments with OCD is the exposure prevention therapy. So you expose yourself to a triggering stimuli, and you gauge you rate on a scale how discomfort or comfortable and so we can use those numbers as a tangible treatment plan to say okay, this is where you're at when you expose yourself to this stimuli. Let's do it again in a week and see where you are with the same exact stimuli. So, exposure again in theory over time, should decrease the level of discomfort and increase your sense of self increase your confidence, increase your ability to withstand being uncomfortable because like you said, you're not in any physical danger, we are not putting clients in any type of unsafe situation. Like I said, my exposure stimuli is very small baby steps. For example, I had a client who was diagnosed with OCD. And we work together for a long time, like couple years. And this person got to a point where they were able to identify not calling somebody to get validation for an obsessive thought. And when they realized this, it offered so much positive reinforcement to them. And it gave them this increasingly sense of self and feeling proud of themselves that they sat with it on their own, and they did not reach out to somebody else. And it was such a pivotal moment. Again, it was something so small, but it like it was so significant, it was a huge progress. And that was the catalyst to decreasing symptoms. And again, it's, it's all about the client and them doing all of the work. And us pointing that out, like, hey, yeah, we gave you this suggestion, but you did do the work. And that that helps people immensely. And it's really awesome to see it happen in sessions too, for sure. I mean, it's super rewarding, like, you're saying it sounds small, right, or trivial, but the meaning behind that, and how impactful that is, like that person now gained this level of confidence, and self reliance, that may have not been present before to ease some of that stress and anxiety. Yeah, and I think a big part of individuals feeling super anxious, particularly in relationships is this constant need for reassurance and control that it then becomes projecting onto others, and it becomes everyone else's responsibility or job to ease their anxiety. Which, yes, sometimes we need that support. And we need that validation. Because we're social beings, right? We need other people. And that can't be our only source of self soothing, or being able to decrease anxiety, because then we give all give away all our control, and then we feel helpless. And that's the worst place we really want to be as a feeling of helplessness. Well, exactly. And you're talking about too the difference between enabling a behavior and being a supportive spouse or partner. Yeah. So sometimes with either OCD, anxiety, ADHD, a lot of times it interferes with a couple system, communicating conflict resolution, being able to talk through something a lot of misinterpretation happens there. So much, yea And a lot of people will tend to either withdraw or they react, and depending on the level of that reactivity, or withdraw, can cause a lot of tension build resentment over time. And so we have to do a lot of reframing with that like, instead of a couple of say, a couple, someone that has OCD and the other partner doesn't. One tip is okay, let's identify the OCD behaviors, let's, let's identify their traits, their characteristics, let's point them out. So that way, the spouse is not enabling them, or being a quote unquote, parent to them, and, you know, they can be supportive and say, No, hey, we discussed this, this is an opportunity for you to build your tolerance, I can be here to support you. But this is something that I need you to cope with, and utilize, like any type of, you know, coping tool that they may have learned prior. But again, we're building resiliency here at the same time, and that's a big component in this in treating anxiety disorders is resiliency. Absolutely, and having that back and forth understanding, because I think sometimes when individuals are in the throes of anxiety, right, where it's, it's really it can be really debilitating, and it can feel all consuming, well, then we can be really stuck in our own experience of the anxiety and not recognize what it may be like for a partner, a family member, a friend, a co worker even Right, right. And so it's recognizing, like, Yeah, I'm having this experience, it's very uncomfortable. And this other person is here, and why aren't they doing the things that I need them to do, but that other person also has their own experience, and they may or may not know how to support you, and it's not necessarily their job to make this feeling go away for you. Not at all. And that's something that I'm pretty blunt and direct about in my sessions with couples particularly is it is not your partner's job to parent you. It is not their job to be responsible for your own mental well being. Big difference between offering support and validate or offering reassurance when they need it. Sure. But we have to, the individual, you know, we have to work on ourselves before we can work on the relationship. And one thing I'll suggest to, let's say partners without the OCD or without the anxiety disorder, is really trying to refrain from blaming language. Like, or it is always causing us to get into fights or your OCD is causing us to, you know, not enjoy life. While instead of that, you know, maybe using an I statement, like, I see you're struggling, you know, what can we do to make this experience better? How can we work together as a team? Again, you hear people hear the difference between you're doing this, that causes ffensive right away, but back it up and say, I see you're struggling, I see you're having a hard time, right? You love this person, this is your best friend. And I know it can be frustrating. But that's where I think individual and couples therapy can be extremely beneficial to create knowledge to offer education and be like, Hey, this isn't them just, you know, being annoying, or, you know, wanting to fight for no reason at all, let's get a handle on this first and go from there. Absolutely. And that's why I think it's so important is because even though in couples therapy, you're kind of working with each individual, you can't spend the whole session on helping one person cope, right, it's how is this couple managing this and navigating this together. And so that individual therapy is going to be so crucial to have way more time to process, find insight, find awareness, and develop coping skills that you can bring to the relationship or to the couples therapy, like, Hey, these are the things I've been working on, I'm really trying, it's not going to be perfect, you're not going to get it right every time. But like, let me know when you see that I'm not doing it or help me or pointed out when maybe if I'm doing it right, or if I'm not doing it the best way, it's directly keeping your partner accountable too and that and again, just pointing out positive progress, Hey, I saw you were struggling. But I also saw you working through it. And I really appreciate that. And the other part is saying like acknowledging that appreciation, and just being very mindful that their partner is also just as important. Even if I'm the OCD, they don't have anxiety at all, there's still stress, right? And we So stress management comes into play. So I might tell a couple, hey, I know this, you have OCD, and you don't. But let's talk about stress management, because I'm sure that impacts the both of you. And then both of them use that together. And they positively reinforced that together, that makes progress honestly, so much more quick. Absolutely. Now, again, it's not an easy progress process at all. It's time consuming. I tell people that at the beginning, you know, we're trying to rewire the brain, that [takes] lot of mental effort and can be exhausting. So that's where a lot of self care strategies come into play also, and even with that, right, there's a lot of repetition that has to happen. And a lot of reinforcement of particular behaviors over and over again, with the reaction being a positive one as well, that to help us rewire that too. Because I think a lot of times when an individual is anxious, the reaction of their partner can also stop them from being honest. Or it can stop them from being more forthcoming or doing particular behaviors, you know, based on maybe the way they were raised or their family environment when someone made a mistake, right? So it's also understanding the way that you react or speak to your friend or family or partner who may be more sensitive to that, right can also kind of enable them from being honest and open with you. When they have anxiety. Absolutely. It's it's voice tone, it's like you said family of origin plays a huge role in this, you know, how did you learn to manage conflict or anxiety or talk about emotions growing up, which is a big thing we talk about at couples therapy, and it really does increase a person's insight and awareness and can also have people be more sympathetic towards each other. Again, it's it's tough to do that it's tough to rewire the brain, you know, but I mean, it's definitely doable, if you take accountability, if they have a willingness to want to work on the relationship. And if they genuinely want the relationship, those are the three things whenever people check those boxes. That's why therapy also being the most productive and the most successful, because both people have to be in it Exactly. But I do see a lot of like the OCD and ADHD have have sometimes been some of the biggest barriers in a romantic system. You know, that the worry, it's time consuming, people get flustered easily. I think that's something we have to be mindful of when working with couples is just the intensity of where they're at. And so I wanted to ask you, if you can kind of dive a little bit deeper into OCD, but also what Pure O is in OCD? Because, you know, I've been seeing more of that and that it's, you know, from my understanding and from some of my training, I don't have a bunch of experience with individuals with OCD, but that there's usually a behavioral component that goes with intrusive thoughts when the versus kind of the pure Oh, is just that there's the interest Some thoughts but we don't necessarily see the external behavior. Is that right? Or if you can kind of dive more into that. So a lot of newer research has indicated that with Pure O or like OCD, it's not just obsessions. And it's not just compulsions, they're kind of go hand in hand. Right. compulsions are not simply just behaviors anymore. We can have compulsions about thoughts. So the two are intertwined together like this. So with Pure-O, I think the obsession really is an overactive amygdala and an overactive cortex, which again, like this is for our listeners, this is something that you can look up on the OCD website, or you can look at this book called Rewire the OCD Brain by Catherine Pittman and William Young great book. It gives a lot of really good examples of how to rewire our thoughts, but also gives a lot of education. So when it comes to Pure O and obsessions, again, I look at have these been so intrusive in your life, that they have caused significant impairment and disruption to your activities of daily living? If so, let's take a closer look of what that means. However, let's say it's a circumstance, right? Someone just lost someone, for example, you know, and they're having a very hard Okay. time and they might be obsessing over the past history. I don't Yea, But it does become this just unexpected excessive time think that's Pure O or OCD. I think that's a circumstance. consuming worry, and the inability to get unstuck. So we'll call this sticky thoughts is and ruminating thoughts. Perfectionism, for example, is a big one that I hear a lot. People if they can't, like, they're so perfect at work, for example, but they may be late to a meeting or a party because they have to prepare for so long for this. So again, that's causing severe impairment in their life. Okay. Yeah. Cause I wasn't sure exactly of the difference with the Pure O, because I feel like it's, it's tough. And this is why it's really important for individuals to have very specialized therapists or practitioners with OCD, if that's something they're struggling with, because so many symptoms can overlap with generalized anxiety, that it may be hard to tease out and I feel like the treatment is going to look different. My treatment for OCD, there is overlapping treatment plans for OCD and Anxiety. But when it comes to OCD, specifically, it's way more of the exposure prevention therapy and exposing us and learning about those ruminating thoughts a lot. And then with generalized anxiety, it's it's excessive worry, but it's not time consuming. So again, this might be redundant, but I can't emphasize enough that time consuming is a differentiating factor with OCD compared to generalized anxiety and panic disorder. So we have to identify those obsessive thoughts and see what's feeding them. First and foremost, you know, kind of also like changing the interpretation, like I was mentioning earlier, and then identifying the theme, is it perfectionism? Is it uncertainty? Is it fear? Is it you know, contamination, what it because that differs from generalized anxiety, those those themes in my experience, and I think with at least how I like to work with individuals or couples who have generalized anxiety or social anxiety, right is really finding more of that insight, first, of kind of going back in time to seeing when else did you feel this way? When else did you get these messages or these beliefs around these circumstances or these situations? And kind of finding those links? And understanding that because it happened before does not necessarily mean that this is the same now. Right? And your interpretation, right is, how can I interpret this differently? What is the likelihood, right? Am I just assuming, because a lot of the time, we're going to be assuming, then creating a narrative then believing the narrative and then behaving based on the narrative when the other person or other situation, no clue that that was an experience you had until you checked in with them. Exactly. So I think a big difference there is what again, with anxiety and OCD is that with the anxiety, the Insight is a little bit better. And sometimes insight with OCD, at least at the beginning, from what I've seen, like beginning treatment, I should say, Insight is sometimes poor to fair, generally speaking, again, not all the time, but it depends on where a person is in their life and in their treatment. If they're at the very beginning stages of treatment. They're not sure if it's OCD, they're not sure if it's anxiety. Yeah, I asked how long this has been impacting their life for and again, what has it where has it caused the most distress? If they say sometimes I'm I just have sort of test anxiety, but I get pretty good grades. Well, that's a pretty lackadaisical response. That indicates to me, they're not too worried about it. They're just aware, there's a little bit of anxiety. Now, sure, that comes to me, and I can't take a test, I have failed this. So many times, I have sat there and thought about the same question over and over again. And I was unable to think about anything else for let's say, two hours, if that's what, that's how long the tests were to take. That's a differentiating factor to me like, Okay, that's a sticky thought you were unable to get unstuck from that, compared to some ad, you might be, you might experience more of like, like you said, like a body sensation for a little bit. But it was as much distress as someone sitting taking a test for two hours not being able to focus on any other word, except the first word they read in the sentence. So that intensity and severity, duration frequency like this is for audience members like this is how therapists and practitioners kind of assess and look through these things is, How frequently does it happen? What's the intensity level, the severity, and the duration of how long that lasts for right, because those are really big, important factors of being able to assess which the assessment is important for the fact that we need to now figure out the best treatment plan for you specifically, not just to give somebody a label, right, I actually don't actually care about the label, I care more about what's happening and how we can help you. Exactly. And to be honest, OCD a lot more rare than people realize, like meeting the diagnostic criteria for Obsessive Compulsive Disorder, it is not as common as Adjustment Disorder with Anxiety. So a lot of the times it does get a little concerning with social media kind of throwing out a lot of, well, if you meet this, if you have, you know, xy and z, then you have this disorder. And that's scary, you know, that's really scary for people. So it's so good for us to come in educate and normalize a lot of behaviors. Of course, like if there is a diagnosis and OCD diagnosis, it is helpful, like you said, to have a treatment plan moving forward, and how to treat them because like I said, the exposure prevention therapy is what I would use for OCD, but not necessarily generalized or panic disorder, or even like ADHD, for that, for that matter. And so I did want to spend a little bit of time giving audience members like concrete coping skills or techniques that they can use for these different whether it's disorders or the struggles and symptoms that they're going through that maybe you like to use and that I use with clients as well. Yeah, I would say for for panic disorder, I start with normalizing what's happening, not panicking. When you know, something like know your body of what's happening, like are your palms getting sweaty? for example, is your heart starting to race? Are you getting nauseous, you know, okay, if that's happening, remain remain calm. Be still, walk to the sink, walk to your bathroom, splash some cold water on your face, put ice cube on the back of your neck. That can help calm the nervous system and tell yourself, I know what's happening right now I'm having a panic attack. And again, slowing your inner dialogue has been very helpful. Because oftentimes, when something scary is happening to us, the mind starts to race a million miles an hour. So have to be very careful and cognizant of, hey, let's slow it down. Let's imagine something slow, like a turtle, for example. And I've mentioned this to clients like it's, no, it's kind of funny. But if we can visualize something slow, the mind is telling the body it's okay to calm back down. There's no immediate danger. So that's where I, that's where I start is self soothing techniques, calming the heart rate, because your heart rate is going to start to increase with a panic attack. Because like you said earlier, it can mimic a heart attack, which is really terrifying. I've had a panic attack before. And it does help me to coach people through it a lot easier after having her because I definitely saw that increase, I think after the pandemic, and people not knowing what was going on with them. Right. So yeah, that fear of the unknown was a whole other layer to exasperating the panic and causing it to last longer than it should, because we can decrease a panic attack within you can start having it and it can be over in 60 seconds, or over in two hours. The duration varies a lot. But as long as you start to think slow, control your heart rate, breathe, again, you put ice on your forehead or on the back of your neck that can be extreme that cold temperature. Cool to reset the nervous system and offer soothing to the body. Yeah, I love that. So I like to let clients know it's basically the same right is that when When our body has these symptoms, where it feels unsafe, right, and when we feel unsafe, when our nervous system feels unsafe, a lot of the time, we don't have the capacity to challenge our thoughts. So the first and most important thing that you can do is how can I send the message to my body that I am safe, that I am okay, and that I can just be present, right? So so you're saying slowing down, having something cold, breathing, especially for a panic attack, I've had them too, it is not a good time, like you literally cannot breathe, which is horrifying within itself. And so it's literally just focusing on I need to catch my breath, I need to slow my breath. And I need to count my breath. That is your only job is to focus on calming down your nervous system enough where you feel safe. Yeah. And then from there, once you feel safe, and you've calmed down, then you can kind of process then you can kind of challenge some of those thoughts after the fact. Right? I don't like to let clients go into that first, because you're just kind of amping up the anxiety. Yeah, right. We have, we have to get physiological symptoms under control before we can start emotionally processing. Because we're so terrified, and they're in that fight or flight position in the body is telling us that we're in danger. It's gonna just exasperate things. And we're like, Well, how does that make you feel? Like, I'm never going to tell somebody that was? No. Like, I'm horrified. What do you think? So I love what you said, like get the symptoms under control first and process after because a lot of times people will come and they're like, I don't even know what triggered me. It literally came out of nowhere. But that gives us a really great opportunity for self discovery. When people ask me, I don't know, I'm not sure. Who will let's use that as a great moment to like, discover, like, what's beneath the surface? Mm hmm. And that is I love that, because that's what I like to ask clients when they come in with anxiety or depression is how do you know you're experiencing it? Which may sound silly, because like, I'm always in it. But how do you know that? Right? Like, what are all the symptoms? What are the thoughts? What are you feeling in your body? So that you become more aware and knowledgeable of your personal experience so that next time it happens, like, oh, okay, I'm starting to feel anxious. This is typically what happens. Now I can kind of assess my environment or my internal thoughts, what are associated with this experience, right now that I can then process laterand go back to? Well, exactly, and you're slowing it down. To me, that's been some of the most helpful things that I've received feedback from clients lately is being mindful and aware of what's happening and just taking the slow route. And you can come up with your own internal dialogue, but like, literally slowing, the way you talk to yourself, because if you when you start talking that way, you can feel the body starting to slow down. Because when we're talking fast the body is like playing catch up with that. Yeah, I like that, because it kind of pairs with the rest of our sensations, right? Because it's kind of controlling if I kind of pull this lever than this lever will kind of change appropriately or react appropriately to this. Right, right. So going through all our senses. So sometimes, like even myself, or some clients, like okay, I know I have anxiety, I recognize what's happening, I understand what the triggers are, I still feel uneasy, right. So it's like having the awareness is phenomenal. It's the first step, but then it's like, and now what? which can feel frustrating too. So I like to have them before they're even anxious, right? like when they're already in a calm state is to establish a place in their mind of somewhere they may have already been or that they can create is where is an environment that you feel the most safe and calm and at ease and I want you to visualize it. And through the visualization, I want you to hear the sounds, I want you to smell what's going on around you. I want to I want you to experience the sensations and feelings on your body and against your body. And if you're eating or tasting anything, I want you to fully immerse yourself in this super calm, peaceful state that you can then pull to later as a way to self soothe yourself anywhere, anytime without anybody. Because I think it's powerful for people to have that that they can pull from anytime it feels like you're less out of control and more aware of what you can do for yourself. Well, it's so soothing even like as you were describing and taking that step by step it felt so soothing, like hearing you go from Hey, what are you smelling? What are you seeing? And for our listener, basically we're describing like guided imagery. That can just be such a great visual and a great relaxation and Soothing tool, like you said, Think of any peaceful environment that you possibly can, or use your imagination, you're changing the way you interpret something. And, you know, to kind of fall back on what you said earlier was you're also discussing reality testing, and the kind of testing the reality of your own thoughts, right. And sometimes when we ask, Well, how do you know that something bad's gonna happen? You're assuming at the end of the day, and that assumption can be a dangerous game. We all understand that sin. But it really is just getting to a conscious place to be ready to make that decision. Because sometimes people what I have learned in my experience is people get comfortable in anxiety, they get comfortable in a depressive state, even Yeah, it's familiar territory. And the fear pops in because they're afraid to get better. What happens if I have a setback? Again, do you hear like, the what ifs, what-if is a common factor with anxiety disorders, even depression. So again, if we can change the way we interpret things, we can catch that What if we don't have to feed it. Easier said than done for all the listeners really understand that, but I wouldn't say those things if I haven't seen the work for sure. And I think that's such an important feature is that what you mentioned is getting comfortable in the anxiety and almost holding on to it because I think this happens a lot too in treatment is that someone will progress and they will get better. And there'll be this kind of signal like okay, like things are working pretty well, we can probably see each other less. And then all of a sudden, it's like, oh oh, and more comes back, or they start unconsciously sabotaging things around them. Because we're scared of change, right? Like, it may sound counterintuitive, like, oh, I want to get better. Why would I do that to myself? But it's, it's thinking like, what is the function of that? Right? So like, if, if I change that I can no longer rely on certain things. And if I fall back on some of those things, then, like you said, what could happen? Or I'm not going to have the same supports? Or I don't know who I'm going to be? Or what am I going to spend my time thinking about? Or maybe that's part of my identity. So now how do I show up in the world, if I'm not an anxious person, and everyone around me kind of caters to that a little bit. And that's, and that's a lot, right? spiraling around in our brains on like on a daily basis, what if this happens, you know, if I get better, and then I slip up, or this or that, what I'm like, I'll tell clients, I expect that to happen. Because means at the end of the day, it is not going to be perfect. In terms of mental health. In my clinical opinion. Perfectionism is an illusion. And I truly believe that from a mental health perspective, I know we can perfect math problem, for example, would brains not perfect, we have to make mistakes in order to grow in order to learn. But a big theme there is also inviting the concept of accepting that and what that acceptance piece might look like. Because once we accept the fact that we can make mistakes, and we can tolerate making mistakes, then again, we're changing the way we interpret it or approach a situation. And I think it can offer us new experiences, new mindset, takes a lot of work to get there. Don't get me wrong. I have seen people get to that acceptance piece. And it has been a significant change. Again, there's always going to be setbacks. But it's our therapists and normalize those setbacks, because they continue to be proactive in their mental health, they continue to call out and make an appointment, let's say if they had a setback, and they're willing to process it in session. That's a huge difference to me. And in that in and of itself, I think is very significant progress, too. Of course, and I think, especially with perfectionism, when you say that is it's interesting, I almost love working with clients who have perfectionism, because it's not about the actual thing being perfect, right? Like, what are we avoiding happening by you being perfect, right? Is it the identity or sense of being a failure? Is that how other people are going to view you? And if they view you that way, what does that mean? What are the negative consequences to this? Right? Like, I think people focus on just the act or just the the purpose of what they're trying to do to be perfect, and not really processing and thinking about like, if I'm not then what happens? like what is it that I'm really scared of or trying to avoid? That if I were to just face that, process that and work through that and accept that this part because it's a lot of work to be perfect, and we never get there. Right? So it is a constant struggle. It is a constant uphill battle that we will never win, right. And I think people know they'll never win, but they're still going to strive because at least they feel like they're working towards it. Right and avoiding that feeling of whether it's a failure or the relationship or, you know, someone thinking a particular way about them. So it's, it's huge to have that normalized. And, like, I kind of love the family dynamic of it, it kind of pulls back is like, who in your life? What situation made you feel like you had to be this way? Is this a generational learned behavior? You know, did your parents put a lot of pressure on you as a kid to perform, for example, and learned to again, perform at a certain type of level in adulthood? What did you learn about how to interact with individuals, romantic partners, for example, but the perfectionism is probably one of the most common traits that I see a lot with OCD. Because, again, another huge theme is that fear of being judged fear of being disliked fear of being uncomfortable experiencing guilt or shame. And again, the tolerance is so low that even the thought of making a mistake can send people into a downward spiral. And it kept them from going after that interview that they've been wanting for a long time. It might prevent them from hanging out with some friends or, you know, going on a date, for example, because again, it's the fear dictating this. So I tried to frame it and ask people, What is it that we're listening so much to the fear aspect, and that's what I'm very, very curious about. I'm been working with that for a while now trying to understand that a lot more of how fear is dictating our our conscious. Yeah. And I feel like fear and shame and guilt, just like lay at the surface, like at the bottom of the ocean, right. And they're just like, such an unconscious, huge influence on a lot of the things we do that we don't even recognize half the time until we take a step back to be like, I'm actually terrified of all of these things happening. I think about what it's like to even admit that to ourselves. Yeah, that can be in and of itself a huge step, when we can admit that it's fear kind of dictating this. But then a good Another good tool to use is sometimes using a cost benefit analysis. And ask someone, okay, if fear is present, what are the benefits to letting go of that fear? And and let's say reaching out for that job, give me the benefits, and then I'll ask them, give me the cons. What are the reaching out to that job? While I might not get it, and that might make me feel like even more of a failure? We don't know that for sure, though. You know, so let's, let's maybe challenge that and do a little bit more reality testing there, or a little bit more cognitive restructuring there. Yeah, you could get turned down. But that doesn't mean you can't move on and try something else. Because that's building resiliency. That's building tolerance, that's building bravery and courage to step out of your comfort zone and say, Okay, I accept that I did not get that job. But you know, what, I am qualified. And I know I have the skill set. And I can do this a lot of positive reinforcement and a lot of like, positive self talk. It's not the answer to every thing. But it can go a long way. For sure. And I think that's, it's so huge. And I like how you bring them both to the surface, because they're both real, right? Like all of these features are real and do exist, when it's, I think it's also having people recognize that the amount of time we spend worrying that something bad will happen, and our limited ability to handle that situation is so disproportionate to what is actually happening, right, the chances are much lower, and our ability to overcome and are much higher. So I think pointing that out for people and building that acceptance and confidence that like, Okay, this is a very real factor, this bad thing or, you know, negative thing may happen. And if it were to happen, how can I feel confident in myself to move forward anyway? so that that's not the factor or the barrier, the holding back from even trying Right? It like I love that use the word, that barrier. Because that's what I have found, like, what is holding you back like, and even with couples, I'm like, what is the barrier happening here that's causing, let's say, a disconnect between the two of you? What's there, and that's a great place to start exploring and finding those maladaptive functions that are just serving this horrible purpose within a friendship of family. So I think I just think it's very important to be mindful of how we approach things, what we tell ourselves the inner dialogue, and also learning to accept our limitations. and using those limitations, though, to our advantage, if we know, if we know the brain's limitations, we can totally use that to our advantage. Absolutely. I love that. And as you were talking about that something came up for me, especially for couples with, like barriers or maladaptive kind of behaviors, is I think that even when we have these coping skills that maladaptive for audience members, like, you've figured out a way to cope with it, but it's not necessarily healthy or helpful, but it's a way that you learn to function and move through it, because you needed it at a certain point is that it's also a grieving process to release that particular coping mechanism. So you can invite a new one. And I think that's really tough, too, is I have to release this thing I've been relying on for so long, even though I know it's not helping and it's actually hurting when when it feels scary, because it served a function before. So it's grieving that and allowing yourself to invite in new ways of interpreting situations or interacting with yourself or other people. So I love that you mentioned that because that just like came up for me, and I just wanted to share it. Awesome. No, I never thought of it in a sense of grief and loss, when we're losing the way we typically do things. And to be able to incorporate something new, of course, there's going to be some resistance, right? Why is that piece of resistance, because it's going to happen, I expect it to happen. But being able to incorporate, Hey, it's okay, to be defensive, or to feel a certain type of way, when you're no longer reacting, how you typically would, you're changing, you're doing something different. And that might feel defeating, sometimes, it might not feel like this person is gonna get one over on me, if I, you know, don't stand up for myself for screaming. That can be hard. But again, did the pros outweigh the cons in that scenario, that's where I just I love that benefits and cost analysis coping mechanism, because again, you can see it, you can write it down, it's a great visual aid for those visual learners. And again, when you're writing stuff down, and you're reading it, your brain is remembering it more, and it's comprehending it double compared to just once, for sure, or even just reading it as like the physical act of you writing it. That's why journaling is so powerful too is that you can your everything is connected for you to get that, that message across and engrained a lot more longer, a lot more permanently. Absolutely. And it sticks. And I think couples can see that when things stick. And when they're practicing together. And they're giving each other the benefit of the doubt, can go a long way when trying to change behaviors within your system that can go a long way with your partner being more willing to change when they see that you're helping them along the way and giving them that like, okay, you know what, you might have messed up a little bit. But here's a little bit of grace at the end of the And you know what's interesting, so I've had couples where day. they've gone from really high intense arguments to, like high intense, it's drawn out so much energy is spent to having a really respectful and productive conversation that doesn't last very long because they get to the point. And one or both partners kind of feel like uneasy about it. And so I'll ask like, why does this feel strange? And like, I don't know, like, usually I can get all this energy, this pent up anger. And now it's like, oh, you validated my feeling. That's it? What am I supposed to do with all this energy now? So it's funny that even healthy change, when we still have to recognize that something different means that we have, there's a cost, right, we have to release something in order to receive something. Because I think too, we can sometimes get so used to the chaos. Chaos just becomes second nature to us, sometimes, you know, whether we're aware of it or not. And, again, it's a safe space. It's a comfortable space. It's familiar territory. So when a couple does get to that, that point of, oh, we're having a nice, we're actually talking to each other and not screaming and yelling at each other. It just feels weird. But it's good weird at the end of the day, right? Well, I like to differentiate between good weird, bad, weird. And it's a nice way to kind of incorporate humor into the sessions a little bit and make light of some things because we don't always want it to be this heavy, drawn out emotional conversation. That's exhausting. And you know, I think that that piece of humor with anxiety, OCD, depression, couples therapy, can can go a long way. And sometimes we can even make fun of the symptoms. If we can, this internal dialogue that oh, this is being, we can name it. We can make fun of it. We can tease it. Sometimes it can decrease it in its power over us in a sense. Yeah, humor is such a huge, huge tool, and it's very healing and I love bringing humor into session. And I think that's kind of why we jive well, too, is that like, if you can't laugh at or you can't find the silliness or lightness in it, everything's going to feel heavy. Yes. It's so hard to do anything in life when everything constantly feels heavy. Like in the moment, it might suck, but like, can we? Can we talk about that story after the fact that laugh at like, How absurd that was? Or like, Oh, my God, I couldn't believe I did that again. Right, like, so it's bringing that humor. So I love that you bring that up, too, because I think that's such a huge piece in any relationship Absolutely. If we can't laugh at certain things, like even myself, as a therapist, I might say something silly or fumble my words. And I'll just laugh at myself in session. And I think it just humanizes us a little bit. And it really, in my experience has made clients feel more comfortable. And I make mistakes too. I'm your therapist, but I also make mistakes. And guess what? It's okay. I'm still here. I'm still doing my job. And I hope that shows that you can do the same. And yeah, okay, and laugh at that mistake and move along, learn from it, grow from it. Love it. Love these little tidbits, those are great quotes. Great quotes, happy to talk. I could talk to you about this and like generally anything for hours. But I know we've definitely come closer to an end. So I really want to thank you so much for your time for sharing your insight and knowledge with us. I hope the listeners got a lot of great information. So Joslyn, thank you so much for being on with us today. Absolutely. Kira, thank you so much as always for having me on here. And for our listeners, especially those with OCD. If you want to check out the book, Rewire my OCD Brain, it's a really great resource to have. There's a lot of great coping tools education in there. So check it out. It's a great book and I hope everyone's well and enjoyed this episode. Awesome. And just so listeners know if you want to work with Joslyn, whether individually or as a couple she's accepting new clients right now in Pennsylvania and Delaware. So you can head over to our website, HealYourRootsWellness.com schedule a consultation and we hope to hear from you soon. Thanks so much, everybody. Thank you ### Listen - [Spotify](https://open.spotify.com/episode/13575201) - [Apple Podcasts](https://podcasts.apple.com/podcast/13575201) - [YouTube](https://youtu.be/IUp9EtY84u4) --- ## Working with the Consensual Non-Monogamy Community - URL: https://healyourrootspodcast.com/episodes/working-with-consensual-non-monogamy-community - Published: 2023-06-07 - Season 2, Episode 8 - Duration: 49:12 - Category: grief - Guest: Courtney Burkhardt ### Summary Comprehensive exploration of different types of grief and loss, with guidance for processing complex emotions during difficult life transitions. ### Description Grief is a universal human experience, yet it manifests differently for everyone. This episode explores the various types of grief - from death and divorce to job loss and major life changes - and provides guidance for navigating the complex emotions that accompany loss. Discover healthy ways to process grief and find meaning in the midst of difficult life transitions. ### Transcript [0:00] consensual non monogamy is pretty much exactly what it sounds like it is when you are not kind of bound to a traditional monogamous style of relationship you can be sexually intimate, emotionally intimate with just more than one other person Hi, I'm Kira Yakubov Licensed Marriage and Family Therapist and Founder of Heal Your Roots Wellness practice. Every episode, we talk with a professional from the mental health field to learn more about their approaches and specialties, and also their journey of becoming a therapist. In this podcast will uncover a deeper look at the world of therapy from new perspectives. You'll meet the therapist of Heal Your Roots Wellness practice, and trusted colleagues from the community tackling mental well being or your go to Network for practical and professional insight in mental health. Subscribe for new episode releases every other Wednesday. Hi, welcome back. I'm so excited for today's episode. With us we have Courtney Burkhardt. She's a Marriage and Family Therapist and one of our newest therapists that Heal Your Roots Wellness to join us for any thank you so much for being on with us today. Yeah, thank you. I'm happy to be here. How you became a therapist and why you became a therapist. Yes. So I originally wanted to become a therapist after talking with a family friend, when I was a kid. And I remember having this whole conversation, I was like, you know, maybe in middle school trying to figure out what I wanted to do with the rest of my life. And she was saying that she's a marriage family therapist. I'm asking her questions about it. And she's like, do you like to talk to people and 12 year old little girl means like, of course, I love to talk to people. So and that was kind of it from there, it was pretty set on this track. And I kind of came to the idea of sex therapy, specifically while I was in college, just kind of exploring different avenues within marriage, family therapy. And yeah, that's kind of how I got to be here. That's awesome. I love that you already knew from such a young age that that was like, and that you were even thinking about it like what do I want to do forever? Yes, I tend to be a little more type A with some of that stuff. But it served me well. And I'm happy that I stayed consistent. I really love this job. And so how has the sex therapy training been for you? Like, what about going through the like, whether it was graduate school, or some of the courses that kind of made you want to lean a little bit more into that as well? Yes. So I think my interest in sex therapy started when I was in college, and I started taking a bunch of like, psychology of women and gender studies type courses. And that really appealed to me and talking about different aspects of gender and sexuality. And then that kind of propelled me into choosing the sex therapy track at Thomas Jefferson University, where I got to really expand on that education and figure out exactly kind of what I wanted to do within the field. I love that. Yeah. When I was in graduate school, and I was going for marriage and family therapy, we only had, I think, one human sexuality class, and I loved that class. And then once I graduate and started working with couples, you know, sex comes up. Like it's inevitable. It's a huge part of the relationship. And I was like, why did we not learn more about this? So it made me want to go back and learn more about it as well. So I went to Council for Relationships, which I think is part of Jefferson, right? Which is the program that you were a part of too yeah, yes, I had my graduate experience at Thomas Jefferson University. And then I did my internship with Council for Relationships. And I had a wonderful experience with both. They were phenomenal. Yeah, well, awesome program, right, like a huge shout out to Council for Relationships, because they really, really let therapists like, learn about obviously all of like, the information, but a huge part of it is also like understanding ourselves within that and like exploring our own sexuality and gender and like our biases, and really understanding like, what that means for us, so that it feels comfortable and feels safe for us to work with clients as well. Oh, absolutely. And I think even going through like the SAR experiences, the Sexual Attitude Reassessment was so so helpful of like, examining my own thoughts, feelings, things that I had, like really never considered before and how that might show up in the therapy room. What was it like for you because I remember telling my friends like, Oh, I'm just watching porn at 9am in class. Yes, I had that same exact conversation. I was like, I think we're about to go and watch porn with our professors. And I, you know, did it and that's kind of what it is kind of not, but it was definitely a very funny conversation that I had to have with some family members about what I was doing on whatever day Yeah, that's awesome. I always love that watching other people's reactions to hearing that. Yes. Yeah. So through this process, I know you've had experience working with couples, individuals and everything, what has been something that you've gravitated towards that you really want to spend more time focusing on with clients that you find is like kind of like your specialty or you want to specialize more in? Yes. So one of the first kind of areas that I really got into working with with sex therapy is working with people in the Consensual Non-Monogamy (CNM) community. Just by like weird happenstance, the first bunch of clients that I got were following me consensual non-monogamy community. And that was really exciting, but also a little intimidating as that was something that I, you know, had pretty much no knowledge of going in. And so I really enjoyed working with this community and kind of learning my own thoughts educating myself throughout that process, which was really cool. And the other kind of area that I really have enjoyed learning, learning more about and working with over the last year and a half has been couples that are going through like a major life transition, and then that are working towards rebuilding their emotional and sexual intimacy following any kind of transition or major change. So both like really big and interesting, fascinating topics, and lifestyles and like transitions and things that we kind of all go through in life at some point or another, at least with rebuilding like emotional and sexual intimacy after a huge life change. And for a lot of people the the consensual non-monogamy or like being monogamous, like a monogamous ish, right? Like all the different kinds of terms that fall under that is super fascinating. I remember also having a couple when I first started too that was in the consensual non monogamy community. I was like, wow, I haven't learned about this. I think that's kind of the fun part of being a therapist, too, is that, you know, we learn a bunch of stuff, and then we have somebody or a couple come in, right. Wow. Okay. Now I'm going to read a lot of stuff, familiarize myself with these topics, understand what's going on for these individuals, and be able to kind of help them. But also super fascinating for us as like the professionals or the the health care providers on the other end, too. Yeah, yeah. It's interesting. I feel like I'm from a, you know, moral conservative area. I went to college undergrad in a rural conservative area, and consensual non-monogamy was not even like something that I had heard of. So I was like, wow, this is like, really cool and interesting. And something I had never thought was possible. This is amazing. So completely, like out of the bubble, or the realm of even like hearing about it. That's awesome. Oh, yeah. Yeah. And it's, I've run into that a few times with like, different topics within sex therapy. And it has been such a joy, kind of expanding my mindset and my knowledge base over the last two years. I love that, right? Because we grow professionally, but also personally, and it helps us kind of look at life and ourselves and relationships. It's such an open and different wait. So yeah, yes, I know. I am sure you went through the same thing of going through school, but you can feel like, yes, your professional self is growing. But personally, I'm like, I am a different person than I was two years ago. Absolutely. In the best way. Aww, and so I remember you sharing that you actually did a couple of your research projects or something in graduate school on consensual non monogamy, are you able to share a little bit more about like, what that was, like looking into detail for what you got from that. Yeah, it was really cool. So I wanted to kind of do these do that topic as a few different research projects to kind of see how consensual non monogamy could be blended with emotion focused therapy, emotion focused couples therapy. And I very quickly came to the realization that there was like, no research out there. And that was like, Oh, no. Okay, so then, what I ended up doing was I found like, different articles and kind of was able to create like a puzzle frame or like a patchwork situation of how you can use emotion focused couples therapy, when working with consensual non monogamy, and even when you're dealing with, like triads, or more than one or more than two people in a, in a relationship. Like, this is so cool and interesting. And I, as I was like, kind of just learning this, for my own knowledge of like, just working with clients. I was like, I should share this with class. And I should like, figure out how to do a project on this because that would be really great. Huh, that's awesome. you created a whole new little section and niche for the research in our field Yeah, and I hope that I hope it's useful, I hope. I hope people can find something good out of it. I'm sure absolutely. And so for listeners that are kind of listening to this episode. Would you be able to share a little bit about consensual non-monogamy? What that looks like? What that means? Different like forms of that so that people can have a better understanding. Yeah, absolutely. So consensual non monogamy is pretty much exactly what it sounds like it is when you are not kind of bound to a traditional monogamous style of relationship, you can be sexually intimate, emotionally intimate with just more than one other person. So there's a few different ways that people might practice this in their own lives. So that kind of falls into two major groups. The first is like hierarchical, consensual non monogamy. And that's going to look like where you have a primary partner. And then you might have secondary partners. So your primary partner might be your person who is your spouse, you might live in the same home, share finances, raise kids together, and then your secondary partners might be people that you still care for very deeply, you just don't really have them as an active part of your day to day life. That doesn't mean they're any less important. It's just that they fill a different role than the primary partner. And then the kind of other major form of consensual non monogamy is just, it's more egalitarian, where all of the partners are more equal. So you may have like, more than one person that is that you're living with, you may have kids altogether, share in finances all together, there's less of a hierarchy, less of a structure, and more just community, sharing everything all together. I love that. And even like within those two categories, there's so many that fall underneath that. I liked that you broke that up into those two structures is that there was a hierarchy where there's like a primary partner, where the two of you decide kind of the parameters and what that looks like outside of your relationship versus the other group where it's everyone is equal, whether it's sexual, romantic, platonic, there is no priority over a particular partner. It's very open and fluid in that way, which both are pretty interesting and cool, and have their own kind of parameters and boundaries and everything that individuals have to work through to make that work for them. Yeah, there can be a lot of really good things and really beautiful things that can come out of consensual non monogamy. But you're right, there are some challenges. And especially if you're transitioning from a traditional monogamous relationship into consensual non monogamy, there's going to be hiccups, because it's a pretty big change. And that's just what happens in life. But so long as there is good communication and clear boundaries, and you're able to be open and honest with one another, you can make that transition as smoothly as possible. Yeah. So I wanted to talk a little bit about more like the sub pieces of each of those two, because I think this is a really big topic that can feel intimidating for a lot of people or like you said, may have never heard of it and may think like, it's just based on sex or wanting to have sex with other people. When I think that, yes, that's a piece of it, right? Just like how it's a piece of any relationship. But it's so much more than that. Right? Like even research shows that individuals receive emotional support, like societal support different roles, their needs are met in different ways. They're fulfilled in different ways, they get to explore their own sexuality in a different way. Right? So it's so much more involved than just sex, but sex is an important part and also, you know, something that is available through this relationship structure too. it reminds me of something I always heard growing up that sex is a important part of relationships, but it's not the only part. There's a lot of other things going on, you're dealing with everyone's emotional needs, physical needs, family needs, everything. We're not talking about. You know, it's we look at all relationships as a system and to just talk about the sexual component would be ignoring everything else going on there. Yeah, and really minimizing the fulfilling parts and rewarding parts of relationship outside of just that. Yeah, absolutely. And so I think that some of the other types of non monogamy or consensual non monogamy, right? If it's within the hierarchy, right, is if it's monogamish right? So some couples may have let's say, they can have like an open relationship where one or both partners outside of their primary relationship may have an emotional or sexual relationship with someone else. But they you know, talk about the parameters that's kind of something that's decided on if it's okay to be emotional and or sexual. Can you name a couple of other ones underneath like the structural. not the structural, the hierarchy, relationship ones for non monogamy? Yeah, you might see It's like, swinging or polyamory I think sometimes the, the actual language may be kind of picked up by the person you're working with. And a lot of these terms I've found at least might be used somewhat interchangeably. And for that reason, I think like, it's helpful for me at least I don't want to speak for everyone out there. But it's helpful to just kind of look at, okay, we're dealing with something in the consensual non monogamy umbrella ,and however people want to define their individual relationship is kind of up to them and whatever they feel most comfortable with Absolutely it can you share a little bit of like the general idea around polyamory and swinging so people have a better idea, because I obviously I know that each structure is going to have its unique features and things that are decided and agreed upon within the relationship or individuals. Yes. So in most cases, you might see like a couple that has been together, and they may be an established couple. And then for whatever reason, they may feel that their sexual needs are not necessarily being fulfilled entirely within this relationship and want to open up some doors to share their sexual experiences and emotional experiences with other people. And that can be a really great thing for kind of lighting up that spark and a marriage again. So yeah, so that can look like swinging for some couples. So this is really just to let the audience members know, like a better idea. And understanding, because we kind of have an idea. We know we work with people, people who come in or already have their own, whether it's labels or understanding of this. But for listeners who may not know, right? like, swinging is when the couple has a sexual relationship with another couple where they may swap, and that they're present with each other. It's not necessarily that it is a separate sexual experience, although sometimes it may be, right? like in different rooms or different places, but it's an experience kind of that they want to share together as a couple. Exactly. And then you might look at an open relationship, which may be a little more separate, where if you're looking at a, let's say, a heterosexual married couple, with an open relationship, they may seek out partners separate from one another and do that on their own time. And they may just keep their dating life separate from their married life a little more. And then we have polyamorous right where that is, it's actually a relationship with more than one person. So like you said, it could be a separate partner. So like one partner within the relationship might have their own second partner, or all three of them might be in a romantic and or sexual relationship together. And they may not date other people, or each partner may have another partner, right? So it kind of just depends on how they want to work that out. And that's really exciting, because that's when you get into that, that non hierarchical, type of consensual non monogamy where everything is a little more, you know, equal and fluid with one another. Yeah. And so have you found some particular main reasons or benefits for whether it's a monogamous relationship to want to explore and expand into a non monogamous relationship or for individuals to participate in one just from the start? I can't necessarily speak regarding individuals I, I honestly haven't had as much experience in working with individuals in the CNM community. But I think for couples, I've seen a number of really interesting reasonings for beginning to engage in that community, like one that's come up a few times has been things like chronic illness, and perhaps even like a trauma history where, for whatever reason, the couples may not be able to engage in sex and intimacy in the way that they might want to at that time. And so expanding their relationship and opening that up may be really helpful for one or both partners to have their needs met in another way. You could also see just people trying to try new things with one another, and expand their sexual relationship by opening up their relationship as a whole, which has been really cool to see. Yeah, so it's interesting. I'm glad you brought up the like the piece whether it's trauma or chronic illness, right, because I know that so I see a lot of couples where there might be a mismatched sex drive, one partner might be more like a higher desire for sex while the other partner, whether that might be a traumatic background or a chronic illness or something that has occurred for them, that that becomes a sore spot in their relationship and so much focus is placed on that and so much pressure that that becomes, it just eats up the relationship. And so being able to take that pressure off this one person to fulfill that role for you, and allow the relationship to focus more on the pieces in the strings that are working and knowing that they can receive that need somewhere else, I think increases their intimacy, emotionally, and sometimes even sexually as well. Because, you know, we know that pressure is not a sexy thing. It's definitely a turnoff. And feeling like you're disappointing your partner constantly, also doesn't help that process either. So I'm glad you brought that up, because it does allow the couple to get their needs met from other individuals. And once that pressure is taken away, it actually adds so much more to the relationship and appreciate one another a lot more too Oh, yeah, absolutely. And I think especially when you're looking at maybe trauma, for example, when you're talking about someone who like they really do need to go on their own healing journey from whatever may have happened, taking off that pressure of their partner wanting to have sex can be so helpful with their with their own process of And so what about some, whether it's reasons or a point in the healing. relationship where exploring that or going into that is not helpful or not recommended or beneficial? If you've seen that in relationships I think there's there's a number of reasons why it could not work out well. I think people who may already be like, pretty high conflict and are disconnected. I think starting off with disjointed communication in the relationship, and low emotional intimacy, when I think all of these you to go into consensual non monogamy in any of these forms, you really need such a strong foundation, you need to have like, your communication on point. And it's okay to have some hiccups every now and again. But if you don't have that foundation, like already in place, then it's going to crumble and crack away very quickly. Yeah, that's a huge one right is communication, as I learned through this process, too. And for couples, or, you know, the relationship structures where it's consensual non monogamy, the communication and honesty and trust and respect, I found is a lot of times at such a higher level than a lot of relationships in a monogamous relationship. Because in order for this to work and be beneficial for everybody, which makes it consensual is that you constantly have to be communicating, and communicating in a very safe and effective way. And being really open and honest with that that honesty piece is so crucial. like that is if you cannot honestly communicate with one another, and you're still holding things back from your partner, then you're not going to be able to articulate your boundaries very clearly, you're not going to be able to advocate for yourself and your partner need to maybe restructure things at points. So making sure abundance of communication and abundance of honesty is so so so important. Absolutely. And being comfortable with hearing things that don't make you feel good. Right? Or like triggering jealousy or understanding that your partner may be enjoying this other person or this other aspect in a different or more way than they are with you. Right. Like if you are not good at receiving feedback, or constructive criticism, this is going to be really difficult because it's going to be constantly pushing those triggers and those buttons for you, which is going to create an unsafe environment, which will promote lying or hiding. Yeah, it seems as though from at least an outsider perspective looking in that you need to have a thick skin and you need to feel safe with your partner where you can, you know, share some of your own insecurities, or theirs and you can have that have that safe space, and be open to hearing from one another about all of that Yea. So a lot of security in your relationship. But I think also as an individual, a lot of security and confidence within yourself because it's not for everybody, right? Like, I think it takes a particular person or a particular process to get to a point where you feel comfortable and safe knowing that what I can provide this person in my relationship is enough and if they need something else outside of it, that's okay. And that doesn't say something negative about me or make me unlovable or unworthy. It's just that some people can love multiple people at once, or the sexual emotional relationships increase our intimacy, not take away from it. Exactly. And I think one nice, paraphrasing a quote I saw a while ago, but it's Not at all that you're not enough of a person in a polyamorous or consensual non monogamy relationship, it's that maybe the other person just has so much love to give your cup maybe filled up and they are still kind of overflowing and want to share that with another person. And I thought that was really beautiful kind of reframe of all that. Yeah, I really like that. That's interesting, because there are very loving people, and they can give so much love. And they can give that to multiple people or in different ways as well. Yeah, absolutely. It's really, really cool kind of getting to learn more and see how these couples work and see that there is so much love in all of these relationships. I think a tough part for some people or a lot of people, right? Because this is very still very stigmatized, even though at this point, it's the most accepted, it's probably been ever in any time in history, at least in our Western culture, right? Because there's indigenous cultures that have been doing this for so many years. But is that this understanding or this script of like a hetero heterosexual normative monogamous relationship, that there's almost like a scarcity mindset, right? Like, this has to be my person, and I have to be able to fulfill all these needs for you and if i don't, you're gonna leave me. And that there's like this fear that if I'm not enough, or they're not enough, we will leave or we'll cheat. So it's constantly being scared of the partner leaving or having to do more, instead of recognizing that it's kind of impossible for one person to fulfill all the needs of their partner. That's why we have friendships, that's why we have careers and work and mentors and school. Like, I think that people can accept that piece of it. But it might be difficult to accept that they might have another romantic partner in that way, too. Yeah. And you kind of hit it exactly of, we already have multiple relationships in our lives, we, we don't expect our romantic partners to fill every single role. And even within having a romantic partner, people may just have a lot of expectations and a lot of needs, that maybe not every single person can fill every single one. And it's okay to have more than one partner, if that's what you need, and that's what can benefit you and your relationship. I think a couple reasons that it might not be beneficial for some couples, as well is feeling like it has to save the relationship, or almost feeling pressure, like well, my partner wants this, I don't really want to but again, I don't want to lose them. So I'll just do this to fulfill their need. And kind of white knuckle it and hope it goes well. When those are not the best reasons, right? It's almost like don't have a baby to save the relationship, like don't do an external thing to save the relationship. Work on it first, and then try something different. Like we were saying before you need, you need that strong foundation, you need to be comfortable and safe with one another before you do this kind of really different thing together. And if you if you're at a point where you're like, grappling and trying to save the relationship, making any major life change to try to stay together is not really going to work out the best maybe Yea and also trying to avoid cheating or avoid your partner cheating or accepting that they want to be with other people right? Because they're they're very different things. I think sometimes people confuse cheating and consensual non monogamy as something similar or overlapping, and like you've mentioned multiple times is the biggest difference in features is that it's consensual. Cheating is not consensual. Cheating is something a person decides to do behind someone's back. Non monogamous relationships is everyone's on the same page. I mean, there can be cheating within non monogamous relationships, if you step outside kind of the parameters of the things you agreed on or negotiated or hide things from your partner. Right? It's really the feature of lying and hiding that's so big in this piece, Right. So long as you are communicating upfront with your partner, being honest and addressing boundary violations as they occur, and setting clear boundaries. Consensual non monogamy is the opposite of cheating and infidelity. You know, it still can exist there as well as in any monogamous relationship. But it's really that lying or dishonest, that lack of honesty that that really sets that apart. Yea. And so what are some kind of struggles that you've seen or challenges for individuals or couples within non monogamous relationships that generally it works right, but as any relationship friendship, family romantic, there's going to be some struggles, some common ones that you might have seen pop up. I think the biggest one that I've probably seen has been boundary communication. From like the jump, making sure that you have like a, a clear cut kind of set of rules, making sure that everyone is aware, agreeing, and consenting to those rules. And that can be a very challenging and lengthy process, just kind of getting all of that setup. And then that might hit on some soft spots for anyone in that relationship of, because, you know, you're talking about really intimate details of Okay, so do you want partners to be in our home? Yes or No? Will they interact with our children or families? Or how are we going to navigate different social situations? There's so many complex questions that people may not have even considered yet. And kind of ironing all of that out as early on in the process as possible can really set you up for success going forward. But it is a that is a difficult process that I've helped people with navigating and kind of going through, which has been really exciting and interesting. Yeah I think, I think the other big thing, too, that I've encountered is when the boundaries may not have been clearly set up, and you get boundary violations where one person will be hurt that some action that may have gone on that they felt they may have been okay with but then as it turns out, no, it was not going to work out and kind of navigating through some of those. Those boundary breaches there. Yes, that's an interesting one, because it's almost like you gotta set up all I don't want to say the rules. I mean, some of them are rules. Some of them are parameters, like agreed upon things. And you really have to be thoughtful, right? This isn't like, Okay, go see somebody and let me know how it goes and have fun. I mean, you could do that, right? Some people do that. But then they kind of run into these issues where well, how are we going to handle it in this circumstance? Or how's it going to feel if someone we know finds out? Right? Or if it becomes more than just emotional, or more than just sexual? And what you're saying is really important is that even if you agreed upon it, thinking that that's how you would feel in theory, and then it actually happens, you're like, I don't like how that how that felt internally. I don't know if I want to continue doing that. And having to renegotiate, and re discuss this again, and being able to share what that felt like for you and why it felt that way. And deciding, okay, is this something I just need to process to work through and then I'll be okay? Or, you know, what, I don't think this is a good part of the parameters anymore. It is very, like, clear cut. And I think one way that I almost think of it as kind of like you're creating a living contract between within the relationship over you kind of go through and answer these questions. And then as needed, you go through and revise and add things take things away, when different situations crop up, when new things new people may enter the relationship. And I think like, it may sound a little silly, but the idea of that contract can be helpful in just being so so so clear with everything. And yeah, it can be helpful for the communication to have that, like, extremely explicit like that. Yeah, I don't think it's silly at all. I think it's, I think, You mentioned something interesting which is like, honestly, every couple should have some, some level or some degree of a contract, right? Where it's an understanding of there's so many situations that can come up that you don't know expectations, because I think a lot of relationships, particularly monogamous ones is we kind of have a lot of assumptions about what we think our partners should do, how they should act, how they should feel, how we should act and feel. And then things come up that we didn't talk about, we didn't think about, we thought we'd be on the same page, and then we're faced with it like, oh, shit, we're not on the same page at all. And it's kind of no one's fault, because neither of us talked about it. So we wouldn't have known that to what's going to happen between you and your partner that this begin with. So I think it almost sounds like having a weekly check in or a consistent check in of, okay, this is the structure, how do we feel about this, maintaining that, has may just be something that you've never considered and you anything come up in between, like, do we want to change anything? Do we feel good about it? And just consistently talking need to have that foundation of, you know, whatever it is, like whether it's monogamous relationships or consensually non monogamous, you know, the foundation of clear communication and having the ability to check in with your partner and be able to talk it through and understand where each of you are coming from, and really listening to one another. That's really important that I think a lot of people just kind of overlook sometimes. Yeah, these are like very, very critical and essential skills that help couples maintain healthy relationships, like they're skills, which means they're they can be learned, they can be taught, it's not something we're born with, like, this is a particular thing that you practice over time. And it's unique with your partner, right? Because good or effective communication can look very different from one couple to another, based on their emotional status, or their attachment style, or the communication style. So it's kind of always remembering that every couple or every relationship is very unique to them, because every person is unique, and has their own experiences. Yeah. And even looking at family backgrounds, how, how they were raised to communicate, how did witness communication go on with their grandparents, parents, aunts, uncles, brothers, sisters, everyone in their lives? What is their own communication foundation? How is that going to show up in the present relationship is so important to kind of understand and conceptualize what might be going on here Absolutely it informs so much of how we start relationships, and maintain them Oh, absolutely. There is a book that I would recommend. I've had a lot of my clients read this book that was very helpful. It's called"Ethical Slut". And have you heard of that one? Yes, I have. It's on my "To be read list". So it's a phenomenal book. It helps couples or individuals looking to be non monogamous, really have some of these deep questions, right, and have some of these deep discussions about what would this look like for us and kind of challenging some of these biases or informed thoughts that we might have had before and see things really differently. And give kind of practical tips and help on how to navigate this for the first time. So if anyone's listening who is thinking about it, starting it, "Ethical Slut" is a really good book for that. That is definitely getting pumped on my list. I will be checking that one out soon. Yeah. Is there anything that you like to give clients? whether it's like worksheets, or anything that you typically give? Or is it more like in session, working it out together? make a lot of use of is like technology. So like, I like to suggest a couple of different apps to couples. So the one that I really, really love is called Agape. And this is like, so what they do is they provide a question each day. And this is more just like a general communication exercise. And then you each have the app, you each kind of answer the question, and they don't let you see your partner's answer until you've answered the question yourself. And then it'll be things like, how do you like to show affection to your partner? Or if you had a million dollars, what would you want to do together? Like it ranges from silly to more serious and some sweet, but that's a really good like conversation starter to begin building up that intimate component. And then the other one is called the Official App. And that one's really, really good for sexual communication. It gives you like a list of yes's or no's, different activities you'd be interested in. And that can be really helpful for like, the consensual non monogamy, negotiation, kink negotiation or anything else when you're starting up a new relationship. And when was that called? The Official App? Yeah, The Official App, that one's cool. I've never heard that one before. I'll have to add that to the list of things. Yeah, I just saw that like, pretty recently, I think it's a new app that I started following their page on TikTok, and I was like, this is going to be so helpful, I'm going to recommend this to every single person I come across. That's awesome. Yeah, so it's really great to have these additional resources for individuals or couples to go to, right? Because we discuss things, we talk it out, we process it, and then having something outside of sessions to really learn more about or practice, especially with something like this is very helpful, because it's not a one time conversation, right? Like majority of the time, these are going to be conversations you have follow up and follow up and follow up. And, you know, checking in and maintaining. So having this consistently where you check in or you learn more about your partner, and negotiate things as it goes is really phenomenal for continuing this process for couples. Oh, yeah, of course. And, you know, I love finding different new apps that you you know, you've got it in the palm of your hand all the time. Little tool to help you with your relationship wherever you go. It's great. Yeah. And so I know we're coming to an end. I feel like we could talk about this all day. But I wanted to let the listeners know that you are a new therapist that Heal Your Roots Wellness, and you'll be accepting new clients, individuals and couples and for sex therapy. Is there any final words that you'd like to share with any listeners or anything before we hop off? Thank you so much for listening, and I hope to meet some of you guys soon. Awesome. Thank you so much for being on today. Courtney, I appreciate it. Thank you so much. ### Listen - [Spotify](https://open.spotify.com/episode/13511643) - [Apple Podcasts](https://podcasts.apple.com/podcast/13511643) - [YouTube](https://youtu.be/p1n28EpILLE) --- ## Resiliency: The Key to Overcoming Domestic Violence - URL: https://healyourrootspodcast.com/episodes/resiliency-key-to-overcoming-domestic-violence - Published: 2023-05-24 - Season 2, Episode 7 - Duration: 45:39 - Category: anxiety - Guest: Michele Finneran ### Summary Examination of perfectionism's impact on mental health, distinguishing healthy striving from harmful perfectionism with strategies for balance. ### Description Perfectionism can be both a driving force and a source of significant distress. This episode examines the difference between healthy striving and harmful perfectionism, exploring how perfectionist tendencies develop and impact mental health. Learn practical strategies for overcoming perfectionist paralysis and developing a healthier relationship with achievement and self-expectations. ### Transcript Michele Finneran:: [0:00] psychological abuse starts to take place first, and then it gradually systemically builds on top of each other, ridiculing, threatening, put downs, name calling. All these things are conducive to what verbal abuses and mental abuses Kira Yakubov:: [0:25] Hi, I'm Kira Yakubov, Licensed Marriage and Family Therapist and founder of Heal Your Roots Wellness practice. Every episode, we talk with a professional from the mental health field to learn more about their approaches and specialties, and also their journey of becoming a therapist. In this podcast, we'll uncover a deeper look at the world of therapy from new perspectives. You'll meet the therapist of Heal Your Roots Wellness practice, and trusted colleagues from the community tackling mental well being. We're your go to Network for practical and professional insight in mental health. Subscribe for new episode releases every other Wednesday. Hello, I'd like to welcome today's guest, Dr. Michele Finneran, a licensed professional counselor, and private practice owner of Beck and Associates located in Florida. Michelle is also the author of Surviving Domestic Abuse, Formal and Informal Supports and Services. And I have the phenomenal book right here. Michele, thank you so much for being a guest today. Michele Finneran:: [1:27] Thank you so much for having me Kira. I really appreciate being here. Thank you so much for having me again. Kira Yakubov:: [1:33] Absolutely. So we always start these episodes with really learning more about our guests and their background. So if you can kind of share a little bit about your story and your journey of becoming a therapist and why you got into the mental health field, that would be phenomenal. Michele Finneran:: [1:47] Sure, sure. I started in the mental health field relatively early on in my life, I was about 18 19 years old, where I started working as a mental health tech in the field. And what I realized early on, particularly when I went to my undergraduate work at Setson University in DeLand, Florida, is I learned that I became really, really good with the classes and also with the people. When I worked for internship, at crisis stabilization unit. And it was really, really significant for me to understand that this is where I fit in, and how I was able to help people. Now, I knew really early on in my childhood, unconsciously, I think, when my dad kind of opened up to me very early on at a young age, it really disclosed a lot of his family traumas on to me early on in my life. So It always never was a huge mistake or misunderstanding as to why I went in mental health field, or why I chose conflict resolution for my PhD. Kira Yakubov:: [2:57] Okay, so a lot of great experience. But also I feel like a lot of therapists, there's something within our families, our own personal experiences that kind of informed that decision down the line. Michele Finneran:: [3:07] Absolutely. And you know, it was a very unconscious decision. And I just, I felt so bad for my father, when he was going through this as he was processing this with me, and at too early of an age, but I also felt like, I wanted to have empathy for him and help him but I just was too young and wish to do so therapeutically. So Kira Yakubov:: [3:30] Sure. And if you could share a little bit about your practice in Florida and you know your Ph. D program and everything because I know you have a lot of expertise and experience in the field so that the listeners can kind of get more background that way before we dive into the book you wrote. Michele Finneran:: [3:46] Sure, sure. So the PhD is actually in conflict resolution, and dispute analysis from Nova Southeastern University. I also have a license to treat at the state of Florida. I have a master's, and I'm a licensed mental health counselor. And I have a practice located in Coral Springs, Florida, called Vecc & Associates. And basically it's I'm dealing with a lot of people that are first responders, I deal with a lot of nurses, I deal with a lot of law enforcement, I deal with a lot of firefighters. And I deal with a lot of marriages and families as well. So, post pandemic, what I've been noticing is a lot of marriages and families really needed some support, and some help. So I've been spearheading kind of that along the way. Kira Yakubov:: [4:31] That's been a lot coming through, especially with relationships during the pandemic, everyone kind of being home and stuck together, right and all these other dynamics that might have been, you know, hidden or not as notice really coming to the forefront and you work with a lot of people who are constantly dealing with traumatic experiences and the crises. Michele Finneran:: [4:51] Absolutely. And one of the one of the rises during the pandemic was there's three major rises I don't know if you recognize this Kira as a licensed Professional, there was a rise as a suicide, there was a rise in substance abuse. And there was a rise in domestic abuse and domestic abuse book that I wrote, talks a little bit about how to help professionals and non professionals, family members and friends, help survivors of domestic abuse really come forward and helping them in the most effective ways. Kira Yakubov:: [5:25] Yeah, that's really powerful work. I mean, I commend you for this book, it's, it's very comprehensive, it covered a lot of information that I was surprised to see in so many different ways, it was very valuable. Michele Finneran:: [5:35] Thank you, thank you so much. It was it was a very interesting research, it was actually an honor to do research like this. And to interview what I did is I interviewed several survivors of domestic abuse. And I interviewed them in a way that was a qualitative study. So I was able to ask open ended questions and sub questions to ask. So I can better get an understanding. And then what I would do with the data is I analyze the data. And then when there's a saturation in data, meaning you're seeing the same things over and over again, that becomes the theme. Kira Yakubov:: [6:15] Sure. Is this kind of the reason why you wrote the book is that you were starting to see it through the pandemic and that was a big thing that was coming up for your clients? or was there kind of a different reason, if you feel comfortable sharing why that was something you went into, specifically to research? Michele Finneran:: [6:30] Absolutely. So the reason why I actually chose this research topic is when I was in my Ph. D. program, I was working for a local jail. And I realized that the system was, has been, has been and is extremely flawed. And what I was noticing when I was doing my group sessions with my, with female incarcerated inmates, is a lot of these inmates that were incarcerated were incarcerated for domestic abuse, for defending themselves in a domestic abuse situation. And so I thought this was kind of twisted. And I was kind of baffled and didn't really understand what was happening until I talked to my PhD chair. And she's like, Well, absolutely, I'm like, Is this is this a real thing? Like, is this a real thing that people that try to stand up for themselves? They actually get arrested? And they try to, like, defend themselves. And she's like, Yeah, that actually does happen. So what I started doing is I got this research study. And I started, she said, look at the data, look at the research and see if there's holes and gaps in the data. And what I realized in the data, when I researched the research that was not been done in this field is there wasn't a whole lot of information about what kind of supports to help survivors or victims of domestic abuse. So that's why I decided to interview survivors that had been through the system that had been through a year out of a domestic violence relationship, what that would have been like, where they use formal and informal supports, and how effective they were, were not. Kira Yakubov:: [8:10] Wow, so you're doing really powerful, significant work to help so many people. And I know in this book, specifically, you focus on women. So just being able to help so many women find these supports and help their family members, but also like legal advice, the law enforcement, like I really love that you took a very, like holistic look of everything, like the whole system of how can they be helped, in what ways and kind of demystifying some of these myths that people might think are like will come up? What comes up for domestic abuse victims and everything? Michele Finneran:: [8:47] Correct. Correct. Thank you. Thank you. Kira Yakubov:: [8:49] Yeah, Yeah. Michele Finneran:: [8:50] I just find his spot, I found that the women that I interviewed, the survivors I interviewed had a comprehensive array of formal and informal supports that they And so for the listeners, can you share a little bit of maybe use, that I was able to capitalize on. the definition of domestic abuse and what that looks like, because I know in your book, you even share how it's a lot of people or a lot of women don't seek help, because they don't even recognize that they're in an abusive relationship. Right. They don't, they don't realize that they're, they realize that something is wrong, they do realize that something is wrong, but they don't understand or can wrap their head around that it's actually defined as domestic abuse. And so what they realize is something is wrong. And the only ways that they realize that what it really is, is they do their own type of research or they talk to other people, which is hard to do when a perpetrator isolates you, from your family and friends. Do that, but that's typically what happens. So, Domestic abuse is an array of different types of abuses, it can stem from mental and emotional and psychological abuse. It can range from physical abuse and physical violence. And then there's sexual abuse. So it's the three most common types of abuse. But there's also other types of abuse that people don't get into. And on my platforms this month, I talk a little bit about financial abuse, that and what that looks like in domestic violence relationship. And so that financial abuse keeps the victim and perpetrator stapled in the relationship as well as a couple of psychological, traumatic emotional bonding that takes place between the perpetrator and the victim, that keeps people stapled in their dynamic. So those those things, and then there's the there could be religious abuse, there could be different different different spheres, using children as a tool, type of abuse, you know, then with that there could be child abuse, all kinds of things kind of morphing into each other, when it comes to domestic abuse. It's not just one broad definition. Kira Yakubov:: [11:12] Sure, and I think maybe the common one, or maybe that we see in movies is physical abuse that's like you can see it, it's very tangible. There's marks and everything. But I don't think it's as commonly talked about, about the mental or psychological, emotional, or the financial abuse that goes that people don't really see from the outside, but the victim is experiencing and feeling it. And it's kind of like a slow drip, right? It's not just boom, it's in your face, because I think that would be easier to identify versus this is gradually happening over time to somebody Michele Finneran:: [11:46] exactly my dissertation chair you know, as she said, you know, domestic abuse doesn't happen when one day you wake up and you're your partner punches you. that did that does not happen like that. It's a gradual, systemic, gradual building block of things that happen over time, over things that happened to get you to a place where one day you're waking up, and it's at a place that you never thought would be. And so what social media portrays is something that's really not equivalent to what really goes on in the home. social media portrays that there has to be some sort of bloodshed, or some sort of punching or some sort of visible strangulation of some sort. And that's not always ends up that way. But it's starts what starts up happening is psychological abuse starts to take place first. And then it gradually systemically builds on top of each other, ridiculing, threatening, put downs, name calling, all these things are conducive to what verbal abuses and mental abuses, making the victim feel less in examples like that. Kira Yakubov:: [12:57] And so it sounds like as I was reading through this book, is that the common theme is that this feeling of powerlessness, and not being able to trust ourselves, and being able to kind of recognize these things. Because whether it's we've experienced it in the past, or some of these beliefs and narratives we've had about ourselves, and then meeting this person who was kind of reinforcing these beliefs or, like you're saying, ridiculing and making us believe a certain way about ourselves, Michele Finneran:: [13:23] right. A lot of these a lot of them are perpetrators actually tried to make the victim feel like they're crazy. Like there's something severely wrong with them. When they're not crazy. They're they women have an instinctual gut feeling. It's particularly women that are mothers, they have a gut feeling an instinctual feeling that they know that that something is not right. And so what they do is they do their own kind of research. And that's what the survivors that I researched, they started reaching out to podcasts, they started reaching out to support groups online. And they started reaching out to different different places where they heard similar stories, and they were like, Oh, my gosh, this sounds so much. So similar to what I'm going through, and they began to realize that this is a this is an actually bigger thing than what I anticipated. Kira Yakubov:: [14:16] Yeah. And so it sounds like even that process is pretty long, right? Like first just kind of recognizing and coming to terms with this is not healthy. This is not a safe place for me. But then I know reading through the book, it was saying, you know, there's like a level of embarrassment or humiliation, being able to share this with our family or friends and feeling misunderstood. Or if there's law enforcement called like, a lot of these interactions, make them feel even less safe to express what's going on for them Michele Finneran:: [14:48] more isolated, more isolated, more alienated, more alone. And the message if any message that I bring out forward in this podcast is that you're not alone. You're never alone. There's , there's somebody that has. You have. That's why it's so important to like, be careful when you're in small circles about what you talk about. Because why don't you just leave? Is a common kind of question that we ask victims, which is a very unfair, unjustified question to ask a victim who's going through a domestic violence situation. If it was that easy, then you you'd leave. But it's very complex. It's very complex on so many different, so many spheres in so many levels, that it makes it hard to make that break. And it takes about nine times in which to do so. Kira Yakubov:: [15:44] Wow, nine times. Michele Finneran:: [15:46] Nine times statistically, yeah. Kira Yakubov:: [15:48] That's Wow, that's crazy. And so would you be able to share a little because I know that you explain Stockholm Syndrome, and how that comes up in that trauma bonding, that might look strange from the outside looking in to someone who is experiencing domestic abuse to feel so close or connected or almost defend their abuser in that way. Michele Finneran:: [16:09] So one of the things that I've learned is going for law enforcement going through a domestic violence call is probably one of the dangerous most dangerous calls to go on. Because they don't know the unpredictability of what they're going to end up seeing at this at the scene. So what usually ends up happening is sometimes in these situations is the victim calls for help and intervention. A cop, a police officer comes out and interviews both the victim and the perpetrator and go to arrest a perpetrator for either marks, it's hard, you can't arrest a law enforcement officer can arrest based on psychological abuse or mental a mental abuse. So that's why physical marks or markings on the body will equate to some sort of arrest. And so the what happens as law enforcement will end up arresting the perpetrator and then the victim gets upset. There's their their their perpetrators getting arrested, and then they jump, they try to like jump on the back of the police officer, and start to like, get physical with the police officers. So there's this[garbled]. And this is this kind of like the vicious kind of cycle that goes on when you talk about trauma bonding. Yeah, this is the big the biggest the biggest traumatic situation when it comes to trauma bonding is when the victim feels traumatized by the trauma that they've experienced, and so much traumatized, but also protective of their perpetrator where they lash out at someone who they call to defend them. Kira Yakubov:: [17:54] Yeah. And so can you explain a little bit this phenomena of Stockholm Syndrome for listeners who may not understand or may have only seen it on movies where like hostage situations how this really is a good analogy, or what's happening for a victim during those times? Michele Finneran:: [18:11] Absolutely. The Stockholm Syndrome is usually a typically coined termed, used to discuss a hostage situation a hosty and a hostage situation. What I did is I parallel that with perpetrators and domestic domestic violence victims. And what I did was I because it's very similar in terms of behavior, character traits that a perpetrator or hostage does over their victim. And so what I what I began realizing is, there become something called trauma bonding, which makes it so difficult for the victim to actually leave because it's like they they have this kind of connection, emotional connection with their perpetrator that they can't, they cannot break away from as much as the he is hurt as much as he trespass as much as he's tried to put down or emotionally and physically beat up. There's still this connectivity that the victim and perpetrator have. And we call we see the cycle of violence where there's abuse that happens. And then there's a honeymoon phase. And then there's the escalation that builds in this vicious cycle, kind of goes round, and round and round. And that's what keeps them kind of stapled in the situation. So the Stockholm Syndrome was a term coin, based out of Stockholm, Sweden, where a hostage and a hostage hosty situation took place at a bank where the bank robber took over three hostages. And so what happened is they began to form a bond and the hostage people that were hostages began to feel sorry and felt bad and started protecting their the person that their perpetrator. And so that we see that in this parallel to domestic violence victims and their perpetrators. Kira Yakubov:: [20:13] to protect ourselves and the best way we know is kind of to please or to rationalize what's going on to make it feel safer and make it feel like we have some sense of control? Michele Finneran:: [20:34] Absolutely, it does. Because a victim feels so out of control. They want to feel like they control something. Kira Yakubov:: [20:42] Yeah. Michele Finneran:: [20:42] And so they they use this they use this the scenario where they hold on to anything that they can feel like there's a sense of control, like ownership power, that they that they've been really identifiably stripped of Kira Yakubov:: [21:02] Yeah. So it almost sounds in a counterintuitive way as a survival mechanism for them to be able to move through this experience if they can't physically leave it. How can I move through it in the ways that I can in this moment internally? And so that is bonding with the perpetrator Michele Finneran:: [21:21] Yes, Kira Yakubov:: [21:21] Wow Michele Finneran:: [21:22] yes, it is a survival. You're absolutely, Kira. It is a survival mechanism. this is a crisis. Kira Yakubov:: [21:28] Yeah. Michele Finneran:: [21:29] Baseline survival mechanism. Yes. Kira Yakubov:: [21:32] And so can you share a little bit some of the ways that at least some of the women that you have interviewed how they have tried to reach out to their family or friends or how some of their family and friends have attempted to support them in the ways that they know that may have not been effective or detrimental? Michele Finneran:: [21:49] Yes. So when reached out to their per se parent, their parents, the women, victims, a lot of parents, what they ended up doing is they ended up bashing or berating the perpetrator, which in itself is not helpful at all for the victim, because what it does is just makes them feel like they, they stapled their decision, they're wrong decision in the finding a person that was not the right fit for them. So they would think that a parent, would you think that would be helpful for a victim to hear a parent bash and put down their perpetrator, which actually is counteractive, it's counterintuitive, it does not actually does the opposite of that. So it's definitely not helpful. So if your daughter comes to you, and you're a parent, last thing you want to do is try to berate, put down the perpetrator, and just try to be as emotionally available and open and non judgmental as possible for the victim slash daughter. What happens is that mother daughter relationship, especially when the daughter comes to the mother, and we'll talk more a little bit about that relationship, how important that mother daughter relationship is, and being emotionally available. And that attachment there is indicative to why sometimes women that women that don't have that kind of relationship, seek out domestic about unconsciously seek out perpetrators. Kira Yakubov:: [23:23] So it sounds like, while the parents or friends may feel like putting their partner down as a way to show that they don't approve, or they don't condone this behavior, and that they don't like this person, it does the opposite of make the woman feel like she made a wrong decision. There's something wrong with her. And there's this level of shame. I'm assuming that's really exacerbated. So it's like, Oh, I'm gonna double down on my decision or just pull away. Because this feels more of an attack on my judge of character who I'm picking or the decisions I'm making, versus what it has to say about my partner. That's exactly what that is. You nailed that. And I feel like that's really important for people to hear that, because it does feel counterintuitive to say that, right? They're not going to want to be like, oh, yeah, sure, this is a fine decision. Like they want to protect them. And it's kind of going into that their own survival mode of wanting to do anything they can to protect their loved one, but it does the opposite. It sounds like Michele Finneran:: [24:20] exactly, it does the opposite. And you would think that it wouldn't, but it actually does. So, and with friends, you know, a lot of times you know the friends end up hearing the same stories over and over again and they get super frustrated and upset. Now, one of the best things that a friend can do if they can no longer help their friend slash victim is such a be suggestive and having them have real supports and go into therapy. That's one of the things that I've noticed that a lot of survivors experience when they having their friends help them is that their friends would suggests them going into therapy and they did. They listen to their friends. So they would go into therapy because the friends not being able to help them as much as they wanted to or could based on not having the professional background that they needed. Kira Yakubov:: [25:15] So that's pretty significant for people to know is that even just, it's out of our scope where like a lot of people don't know, even a lot of therapists, mental health professionals don't necessarily know the best way to help a victim. But it sounds like getting them the professional help. And the expertise is the best way or is one of the most effective ways, Michele Finneran:: [25:35] right. And people that are specialized in treating survivors or victims they have a specific type of way where they talk treat, you know, assess, Kira Yakubov:: [25:46] yeah, Michele Finneran:: [25:46] therapeutically. We had talked about this in my book, that's about how mental health therapists sometimes we want our clients to be where we want them to be, you know, not notice that's not necessarily meeting them where they're at. you know. And so, a lot of times when a Kira Yakubov:: [26:02] Yeah, survivor or victim comes to the therapeutic session, the counselor immediately wants to go right into exit exit strategy. How do we how do we exit from this relationship where that might not be where the victim is. Maybe this for this is the for the first time the victim is sharing this and processing it where the first time and they're ready to really so it's meeting the it's the therapist meeting the client slash victim, where they're at in a moment? Yeah, because I can see that also pushing them away, like telling them what to do, or deciding for them that this is the best thing right now again, takes away their power and autonomy to figure it out, or to make a decision on their own. It sounds like a lot of the advice that victims get is we know better. And so you should do this now, which it sounds like almost retraumatizes are kind of confirmed, I'm powerless. I don't know what to do. I can't trust myself and making decisions. Michele Finneran:: [27:02] Right, it would definitely re-victimizes the victim. Kira Yakubov:: [27:06] And so reading through the book, I saw that some of the effective ways for therapists or mental health professionals to help is not going straight, like you mentioned into problem solving, or making them leave immediately and not being too passive. Because I saw that it's kind of challenging their thinking and letting them process their story first, and then being able to help them find different supports or create a plan when they're ready on their time, because that's going to be the most successful outcome. Michele Finneran:: [27:33] Exactly, exactly. And processing the story is it may take not just maybe just more than one session in which to do and may take several sessions, Kira Yakubov:: [27:43] yeah, Michele Finneran:: [27:44] depending on the severity of them of the abuse. So having the therapists allow the the victim slash client to do that is so imperative and important for the therapeutic process. Because when you when you're in therapy and you actually open up and process you're actually hearing yourself talk. And that's very important for a victim to actually listen to themselves talk and hear themselves talk, possibly for the first time. So that's pretty significant. And for therapists to gauge emotionally and also challenge, not. Yea, also they have to have a little bit of like, a little bit of challenge along with empathetic response, led along along with unconditional positive regard. Yeah. Regardless of where the victim slash client might be therapeutically or psychologically. Kira Yakubov:: [28:35] Yeah, so it's really finding a finesse between and every person is different, right? So really, there's not going to be a Formula or One fits all, you really have to figure out where they're at, meet them there. And then do that dance with them until you get to a place where they're safe. And they're more empowered to it sounds like leave the situation that they're in. Michele Finneran:: [28:55] Exactly. And you know, we talked about, I talked about in the book that the the theme, and the stories may sound similar, but it's still very different. There's no cookie cutter solution now to these given testimonies. And so every every each one, each one is kind of individualized, according to the reporting to the victim. Kira Yakubov:: [29:16] Yeah. And so I want to go back a little bit to the family dynamics and the friends, right, we kind of talked about what's not effective, would you be able to share, because I know we mentioned pushing them to, you know, seek professional help. Is there certain ways that friends and family can be supportive and empathetic with you know, with their words, how they spend their time with them, and the support that they give that would be helpful for the victim to not feel like they're going to be embarrassed or shamed or they have to isolate? Michele Finneran:: [29:46] their loved one go through this over and over again. And one of the things that is I would recommend a firm friend or family member not do is ghost, your victim slash family slash friend. However, with that being said, the victim's family and friend can also very much lead to burnout and stress by watching their their loved one go through this historically and openly and over and over again, it's just really important for the friend and family member to take a step back. And to kind of regroup and replenish themselves in order to be able to be there for their friend who's a victim ghosting them is, again, another form of abandonment, which victim does not need, but also the victim may not understand what the friend is actually going through or the family member might be going through watching her go through all this at the same time over and over again. So it's that friend, and that family taking a step back and just like regaining their own grounding Kira Yakubov:: [30:57] yea Michele Finneran:: [30:58] and their own type of replenishment if you will, in order to fill their cup again. So they can be more they can be more or less still effective for their friend slash Kira Yakubov:: [31:10] Yeah. So it sounds like kind of just being there to victim. hear them to support them empathetically, and to understand what they're going through it without necessarily telling them to leave bashing them, you know, pointing him in the direction of support, but also making sure that they take care of themselves and not get burned out to a point where they no longer want to interact with them. And it sounds like kind of setting those boundaries to like, listen, like after all these conversations, it feels repetitive, I feel frustrated, I feel hurt watching you go through this. I have to take a break from talking about this sometimes. So I can continue showing up for you when you need me. Michele Finneran:: [31:45] Exactly. Exactly. That can be tough too That's a really good encap. absolutely it's very tough to Kira Yakubov:: [31:50] Yeah, set those boundaries. Because you you don't really want to but Michele Finneran:: [31:53] you know, they're really good. So that's you kind of have to for your own mental health. Kira, that's a really good encapsulation of what exactly a solid a summarized statement. That's exactly what's happening there. Kira Yakubov:: [32:09] And so I did while I was reading your book, it actually kind of surprised me a little bit to learn more about the mother daughter relationship, to see how that might influence or impact a victim being victimized later on in life or like how you mentioned sometimes like subconsciously being attracted to an abusive partner, can you share a little bit more about what that looks like in that important dynamic between a mother and daughter. Michele Finneran:: [32:34] So the same sex parent is always probably a very important parent to identify with and relate to. And what I what I realized, going through the interviews with a lot of these survivors is met most of them all of them. I would think I thought going in I had my own biases, obviously, we you do when you do research, you would think that there would be issue with the mother with I'm sorry, with the daughter, Father relationship, Kira Yakubov:: [33:03] that's what I thought, Michele Finneran:: [33:04] but it's not. it was always the mother daughter relationship. That was always impaired, every single woman that I interviewed, had a disruptive relationship with their mother. And what I found was in the mother, the mother relationship with the daughter, the mother was physically viable for the daughter, tangibly babysits can give money, places place to live, transportation, childcare, whatever the case may be, what was significant that was not there is the emotional support that the victim actually needed from their mother. And that that emotional unavailability and almost narcissistic mother made it prevalent for the daughter to seek out a different type of intimate partner that they weren't finding that they found that that that was voided out in their mother daughter relationship. Kira Yakubov:: [34:06] That's so fascinating to think about, because I thought the same as you started thinking might be the relationship with the Father or having a controlling, you know, father figure that way. But it sounds like not having that nurturing, emotional connection and security, as a daughter with your mother is so significant in how you view yourself, how you view other relationships and what you're looking for when you're dating somebody. So it almost sounds like exactly if they didn't receive the love and security and self esteem through that parent, they're going to search and work hard to find someone who can provide that. And if we're on the opposite end, if this is a partner who is controlling or manipulative can easily take advantage of someone who may feel that way about themselves or who may be lacking that security and love from their parents or their mother specifically. Michele Finneran:: [35:01] Exactly, exactly. And so that mother daughter relationship is so very important to establish. And, you know, a lot of a lot of my survivors that I interviewed just did not have that emotional availability available to them in rearing. And they also, many of the victims that were raising up in their households saw their mom, as victims as well, Kira Yakubov:: [35:26] sure Michele Finneran:: [35:27] that learned helplessness that they've learned from their, from their mother, in their own domestic violence situation. And abusive relationship was also a learned kind of behavior that was transgressed into the daughter. Kira Yakubov:: [35:42] And that's really unfortunate, because it kind of goes into this generational trauma and abuse is that what we see and experience in our home is normalized, right? Like, even if we go out into the world and recognize that it might not be that way, everywhere, it feels normal, and it feels acceptable to some degree, for us to repeat, and to have those beliefs about ourselves, or who we align with kind of inner identity within our home. Michele Finneran:: [36:07] Exactly We are, we are creatures of habit. And we are creatures of familiarity. And even though it may be dysfunctional, we gravitate to what is familiar, even though it may be unhealthy, dysfunctional and wrong. We gravitate to one that's familiar. And so that's that you will see that generational cycle of violence, and traumatization happen from passed down from generation from woman to woman in the family. Kira Yakubov:: [36:35] And so it's tough, because, you know, the mother was abused, right? Like this is also a victim, who this is now being passed on to their daughter, have you any of the women that you interview, like what that was like if they had children are what that felt like for them to recognize that how much power and responsibility is also on them for their children by seeing them vicariously living through that as well, Michele Finneran:: [36:59] exactly. And so what the what the daughter had to do with their own children, is they had to recognize consciously a conscious recognition that what they saw in their own family of origin they did not like, and they weren't going to perpetrate it over and over again. So they made a staple and a decison early on in their year raising up that they were not going to do this to their children. And they made it when they make the call, we made a conscious choice is something that you disliked, for so long in your past, you then make a conscious choice to break that cycle. Kira Yakubov:: [37:39] And that's pretty powerful. So even even if victims who have children leave at a certain point, while the kids are still smaller, at some point, they're able to recognize and see that their mom was powerful and strong enough to exit this situation. So that in itself is also empowering for the children to recognize that you don't have to be a victim, right? You can move through this with the proper support and help and it has to be a very conscious effort on your part. Michele Finneran:: [38:05] Absolutely. Kira Yakubov:: [38:06] This book was so informative, thank you for writing this. I mean reading this was so helpful for me to recognize as a professional, but personally to like, wow, there was some relationships that I went through that were kind of questionable that I would have never thought about because it didn't look the way it looked on TV or there wasn't violence involved. Michele Finneran:: [38:25] That's why women, not to discredit victims, and not to discredit their experiences or their narratives, sometimes don't realize that they're in when they're in it, you know, it's when you step out of the situation or out of the relationship, then you begin to realize what a toxic situation this might have been for you. Kira Yakubov:: [38:46] It's getting space away from that to kind of be more objective, like take a step back. Because when we're in it, right, like, that's why therapists can't be a therapist to someone they know, or like their family or friends. Because we're too involved, we're too invested. It's not objective anymore. But when you take a step back and distance yourself from that experience, you can start to look at it a little bit more objectively and like gain a different perspective. And that whole process sounds like grieving within itself to recognize that you've been in this relationship that you didn't even realize was abusive. And now you are and now you're getting out of it. Like that takes a lot of strength to be able to do that. Michele Finneran:: [39:22] Yes, and resiliency. Kira Yakubov:: [39:24] Absolutely Michele Finneran:: [39:25] I mean, these women, all these will women all have exhibited the same type of resiliency, that one character trait of resiliency and being able to stand up on their own eventually, through formal and informal supports. It was the key for these women getting out of their toxic abusive relationships Kira Yakubov:: [39:44] that's so powerful. That sounds like them being able to find their own strength and power and gain control of their own finances, their own situations, make decisions and trust themselves to make these decisions to is really powerful and how have that respect for themselves. Michele Finneran:: [40:03] biggest love that they can give themselves that they discover for themselves. And that in itself is a gift and a journey with self that is enbarking on a beautiful relationship on it's own Kira Yakubov:: [40:26] absolutely, and that stays with you forever, because that's you and yourself, that's, that never goes away, Michele Finneran:: [40:31] never goes away, you'll never you'll never, you're your own loyalty, you're your own best friend, you have to shake your shake your self, shake your hands with yourself as as being a friend and a purse of self compassion, love for your own self. Kira Yakubov:: [40:47] are there any for listeners, whether they are recognizing that they might be in an abusive relationship? Or no, or for, you know, informal supports? Are there some resources or things that you'd be able to share for people that they could reach out to whether it's online or in shelters or anything like that, to help people kind of find this? Michele Finneran:: [41:07] Absolutely. What I can do Kira is I have a list of National Domestic Violence resources is a, it's like a page long, I can email it to you and send it to you. So you can put it all within your podcast. Kira Yakubov:: [41:19] Thank you, that will be really helpful. And I can add that in the show notes for everybody. Michele Finneran:: [41:23] Perfect. Kira Yakubov:: [41:24] So Michele, can you share what's coming up new for you and your practice? Michele Finneran:: [41:27] Well, with the research that I'm doing, I do what I do with the research, which was with what the PhD is typically for, is I take the research and I use it to use application into my clinical practice. So not only am I a clinician, and a practice practitioner, that I practice, mental health and skills and techniques to help decrease mental health symptoms, but also researcher to kind of research statistics topics that need to be more like that need to be more researched out. And that's why I decided to just work on my next writing project is when I realized what some of the things that were going on for first responders though, that what they were dealing with, with compassion fatigue during COVID-19. And so that the research along with the application is what I like to do best Kira Yakubov:: [42:24] awesome. And where can follower or the audience members find you if they want to reach out to you to work with you. Michele Finneran:: [42:31] They can reach me on my website, it's www.veccandassociates.com. And there's a tab there that you can join that says Contact Us, and you contact me directly on there it goes right to my email. Kira Yakubov:: [42:47] Perfect. Michele, thank you so much for being a guest today. This was valuable and very insightful information and I appreciate you sharing your expertise with us. Michele Finneran:: [42:55] Thank you, Kira, for inviting me on your wonderful podcast. I really appreciate you. Thank you so much for having me. ### Listen - [Spotify](https://open.spotify.com/episode/13448087) - [Apple Podcasts](https://podcasts.apple.com/podcast/13448087) - [YouTube](https://youtu.be/JkAwB8iH-OE) --- ## Delving into the Neuropsychology of ADHD, Autism, and Learning Disorders: A Chat with Dr. Karen Wilson - URL: https://healyourrootspodcast.com/episodes/neuropsychology-adhd-autism-learning-disorders-dr-karen-wilson - Published: 2023-05-10 - Season 2, Episode 6 - Duration: 42:27 - Category: relationships - Guest: Karen Wilson ### Summary Exploration of vulnerability as a strength in relationships, with practical guidance for building deeper, more authentic connections through emotional openness. ### Description Vulnerability is often seen as weakness, but research shows it's actually the cornerstone of meaningful connections. This episode explores how emotional vulnerability can strengthen relationships and improve mental health. Learn practical ways to practice vulnerability safely and build deeper, more authentic connections with others. ### Transcript Karen Wilson:: [0:00] I wish that we had found you five years ago when their son was in second grade. And the father who was sitting on the call said to me, I wish I had found you 40 years ago, because he realized from my discussion about what his son was experiencing that he also struggled with the same thing, but didn't have a name for it when he was a child. Kira Yakubov:: [0:24] Hi, I'm Kira Yakubov, Licensed Marriage and Family Therapist and founder of Heal Your Roots Wellness practice. Every episode, we talk with a professional from the mental health field to learn more about their approaches and specialties, and also their journey of becoming a therapist. In this podcast, we'll uncover a deeper look at the world of therapy from new perspectives. You'll meet the therapists of Heal Your Roots Wellness practice, and trusted colleagues from the community tackling mental well being. We're your go to Network for practical and professional insight in mental health. Subscribe for new episode releases every other Wednesday. Hi, I'd like to welcome our guest today Dr. Karen Wilson. She is a clinical neuropsychologist, Director of West LA neuro psychology and the founder of childnexus.com. She also specializes in the assessment of neurodevelopmental disorders in children, adolescents, and I cannot wait to pick your brain today. Karen, thank you so much for coming on today. Thank you so much for having me, Kira. Absolutely. So every episode, we start with really diving into the practitioner, share a little bit about your background, and what made you get into mental health. And specifically in being a child psychologist, Karen Wilson:: [1:41] I think probably from the age of nine, I knew that I wanted to be doing something in the medical field, I thought I was going to be a pediatrician. And then when I got to undergrad, I realized that I probably didn't like the sight of blood. And so I was gonna have to find something else to do. I actually had taken psychology as my elective and just fell in love with the study of the behavior study of the brain. And then when I found out about neuro psychology, that really piqued my interest, and there was like no turning back from that point forward. So I kind of took all the courses on brain and behavior, neuro endocrinology, neuro psychology, neuro anatomy. And then when I was applying to graduate schools looked into clinical psychology programs that focused on neuro psychology as a sub discipline. Kira Yakubov:: [2:30] That's awesome. I always loved my neuro psychology classes in Psych as well. It's so fascinating to learn about the brain and all the different things that it does. It's so powerful. Karen Wilson:: [2:41] Yes, absolutely. Kira Yakubov:: [2:42] Can you share a little bit more about how you became a psychologist and how specifically working with children. Like if that was always something that you were interested in? Karen Wilson:: [2:49] it wasn't actually my initial focus when I entered psychology, you know, when I was in graduate school actually chose to do an adult emphasis. So a lot of my instruction initially was in working with adults. I actually wanted to do geriatrics and study Alzheimer's disease and memory impairments and did some work in that area for a long period of time. And then it wasn't until I was on my clinical internship. The year before I graduated that I did a rotation in child psychology, child neuropsychology, and I was evaluating kids who were struggling with learning challenges with, you know, medical issues that were impacting their cognitive and emotional functioning. And I just thought this is such a great opportunity to be able to provide support early on, and I just didn't look back from that point forward. Kira Yakubov:: [3:39] That's wonderful. And I think it's so amazing that in these programs, we have that hands on learning to recognize that and learn that because you might have continued in, you know, researching and helping people with Alzheimer's and may not have recognized that that would be your passion is working with children. Karen Wilson:: [3:54] Absolutely, absolutely. I think that's one of the benefits of being in those types of programs where you do get to rotate in different areas, the medical psychology field, I did work in HIV and AIDS, I did some work in transplants. So there's a number of areas where I got to explore and have these experiences, and then really determine where I wanted to spend my time and where I was thinking about a career move. Kira Yakubov:: [4:21] Yeah, that's incredible. These are amazing careers that help so many people I'm so honored to have you on today and hear your insight and knowledge. And so Karen, can you share a little bit about some of the most common learning disabilities or processing disorders that you work with while you're helping evaluate children for families? Karen Wilson:: [4:38] Absolutely. So in my practice, we do evaluations, neuropsychological evaluations, psycho educational evaluations, and when parents bring their kids to us is typically because their kids are struggling in some way. And oftentimes they don't know why their kids are struggling. So oftentimes, the parents will say, you know, the pediatrician said that we should make an appointment with you, or the school is concerned, or the parents are seeing something at home, that is worrisome. They've talked to other family members. And they've recommended an evaluation. And so generally in those instances, their child is struggling at school or at home. It can be behavioral struggles, it can be struggles that are that are impacting their academic functioning. common struggles are, you know, difficulty staying seated, paying attention, accessing the curriculum at school, it can be some mental health challenges, maybe there's anxiety that's really interfering with the child's ability to do what they need to do, perhaps, you know, they don't want to go outside, and they don't want to interact with peers, because they're so nervous. And they're the worries are excessive. And there are significant fears. And with school, it can be, you know, comments from teachers that you know, your child is very bright, but we can't get him to focus, we can't get him to engage with us. They're having difficulty following instructions directions, or they're behind academically, you know, they some, oftentimes, parents or teachers will say, you know, when I asked the student, the question, they know the answer, they're the first one with their hands up, but then when they have to write it down, or they have to read that they can't do it, or they can't demonstrate their knowledge. So there seems to be a disconnect between what they seem like they're able to do, and then their output, or their ability to do specific tasks, whether that be reading, writing, or math. And so when individuals are coming in, and kids are coming in to see us, it's because parents want to know, you know, why is my child struggling? Why do they seem to be having more difficulty than the peers their age? Or why is it so hard for them to do what I asked them to do at home? Is there some processing issue that is interfering? And that's our job is to figure that out for the family, and then provide them with information about, you know, whether or not this is a neurodevelopmental disorder, what that means provide some psychoeducation. And then, you know, develop a plan, create a plan for that child, what are some things that we can put in place to provide support at home at school? Are there clinicians, therapists, other allied professionals that this child should work with to really help that child reach their full potential, and that's our job and also to make recommendations for accommodations or modifications at the school as appropriate? Kira Yakubov:: [7:26] Yeah, so it sounds like it's really important to have everybody on board, parents, teachers, doctors, any other supports, maybe relatives as well, friends, so that everyone's kind of on the same page. sounds like a very, like holistic and systemic way of approaching this. Karen Wilson:: [7:43] Absolutely. Because you want to make sure you know, when you're making a diagnosis, that's it's very serious, right, we want to make sure we're not diagnosing someone with something they don't have. And so there's a lot of checks and validation of what it is we're seeing, you know, oftentimes, even to in order to make a diagnosis, you can't have symptoms or the behaviors in just one setting. For example, with ADHD, you can't just be seeing hyperactivity and impulsivity at school, and not at home or anyone else anywhere else, you know, and that's to validate that this is a pervasive issue that's impacting, you know, many aspects of an individual's functioning, because if it's only happening in one area, then we certainly want to look at that area, maybe there's something about the school that is anxiety, provoking the academic environment, the home environment, the demands placed on the child. And so we want to be able to look at everything to make sure that if we're making a diagnosis, if we're saying this is what's causing the struggle that it is accurate, and that the plan fits, what it is that we're finding, the last thing we want to do is to say something is ADHD, when in fact, it's anxiety because anxiety and ADHD have two completely different treatments and approaches for intervention. Kira Yakubov:: [9:00] So it's very thoughtful and methodical process of going through this. And so do you see there's a difference among genders? How that might show up in certain, like learning disabilities, or how that presents in a social way, depending on kind of the expectations or like the stereotypes that we might think about, especially for like ADHD, right? I know, it's kind of thinking about, at least for me, it's like the stereotype is a little boy not being able to sit in their seat when it's a lot more than just that. Karen Wilson:: [9:30] Yeah, I think it can, it can definitely manifest in both boys and girls differently. There's some research to suggest that there might be some more inattention in girls and more hyperactivity and impulsivity in boys, but it also, when you have a boy who is rambunctious oftentimes, some of those behaviors can be interpreted as boy behaviors, and not as ADHD. Right. And girls who are you know, compliant in the classroom and sitting still and doing well, They might say, Well, that can't be a ADHD because she's able to sit there, she's not getting out of her seat. She's not impulsive, she's not interrupting. But that same girl could be sitting there looking like she's paying attention, and daydreaming about what she's going to do after school and missing a great deal of the information presented. So I think that that can happen. And there's also some research to indicate that girls, autistic girls can camouflage a lot of their, their their symptoms of autism, better than boys, the social demands are different for girls than there are with boys in terms of how they interact, how they socialize, the things that they do when they spend time together is very different. And so, you know, there's some belief that some of the criteria we even have for autism is really based on a boy model, because a lot of the research the early research is based on on autistic boys. Kira Yakubov:: [10:52] That's really interesting to hear. So I mean, I know about masking for people who have ADHD, but I didn't know necessarily about kind of the masking or camouflaging for females who might be on the spectrum, Karen Wilson:: [11:03] right Kira Yakubov:: [11:03] Because that is kind of thinking about more expected of females to care more about friendships, and to show up in a particular way, and to be more agreeable, versus if you think about stereotypically younger boys and that way Karen Wilson:: [11:17] Absolutely. Kira Yakubov:: [11:18] Would you be able to share the type of actual like assessments that you do with children to evaluate to like, differentiate or rule things out when it comes to this? Karen Wilson:: [11:27] Yes, absolutely. So the process is pretty comprehensive. I mean, it starts with, you know, sitting down with parents and going through the child's history. You know, when we're sitting down, I want to know everything from pregnancy, birth and delivery to you know, what's happening with your child at this particular moment, because some things that might happen early on might be risk factors, you know, significant stress during pregnancy. And early delivery of a premature birth with a low birth weight puts kids at greater risk for neurodevelopmental disorders. So we want to know that, we also want to know if there's anyone in the family who has ADHD, who has autism, who has anxiety, depression, dyslexia, because those neurodevelopmental issues, mental health challenges are heritable, you know, and so they put, again, individuals, kids at greater risk for having struggles in those areas, when there's a family history. And then we want to document developmental milestones. Oftentimes, if kids, for example, are having difficulty with reading, you know, it may manifest and become something we recognize as dyslexia. For some individuals, there's an early indication of language based issues. You know, there's a higher number of kids diagnosed with dyslexia, who had speech and language problems when they were younger. So we know that that's a risk factor. That's why doing that clinical interview with parents is so important. So we find out, okay, there's an early history of speech and language issues, there's a family history of dyslexia, there's a family history of anxiety. So we know that some of the behaviors might be associated with those disorders, and, and also knowing that that child is at higher risk because of the family history and their own developmental history. So that's all part of the process. And then we want to know, what parents are seeing at home, because some parents will say, you know, the teacher is saying X, Y, and Z. But we want to know well what are you seeing at home, and parents will sometimes see things differently than the teacher see, and that, and that would be expected because the home environment, school environments are very different. You know, you have 20, sometimes kids have 23 25 other individuals in a classroom setting. Very few families have that many people at home, right in one place. And so the distractibility factor is much higher at school than it is at home. But then at the same time, the school also provides more structure in terms of what the day looks like. And a lot of homes may not have that same level of structure. So knowing how kids navigate those two different environments is often very important. And getting that information from parents is really helpful in identifying, you know, what are the challenges for a child at home? Are they similar to what the teachers are seeing at school? sometimes in home environments, kids are able to compensate or at school, they're able to compensate for areas of struggle, because of an inherent structure built into the home environment or the school environment and then sometimes parents will say, for example, with homework, the teacher will say, well, the child is getting the homework done, but what they don't see is the amount of effort that is needed to get that work done. So the parents might say, you know, the teacher says, These are 30 minute assignments that my child is supposed to do on a weekly basis, but it's taking my child three hours. So that indicates that it might be a processing issue. So the teacher gets the homework, and it's complete. It's accurate. It might be perfect, but They don't see the effort or know the effort that was needed, and the support that might have been needed from the parents in order to keep that child on task to complete the assignment. And then also the amount of time that it took and the effort that it took to actually get that assignment done. And so that information from a parent is so important. Because really, what we're looking at are processes and what's involved in completing tasks. So that's a little Kira Yakubov:: [15:26] Wow, that's so involved Karen Wilson:: [15:26] bit about that information, it's very involved and that's only a parent interview, because then what I want to do is I also want to speak to teachers, I want to know, what are the teachers observing in the classroom. And oftentimes, I'm speaking to more than one teacher, because inherently in a lot of kids, there'll be one class where they do really well. And then one where they're struggling, particularly if kids are struggling more with reading, one with sciences or more with math, then, you know, speak with language arts teacher and a math teacher, to see if their observations are different in the classroom. Kira Yakubov:: [15:58] Yeah. Karen Wilson:: [15:59] And that also speaks to the extent to which these behaviors and these concerns are showing up in different environments, and how they show up. And then so we're gathering information from parents, we're gathering information from teachers, I'm speaking with them, they're also completing rating forms. So what the rating form tells me is whether or not these parents and teachers are reporting more problems, more behaviors that are typically seen in children of that child's age. And then the child comes in for testing. And that can be anywhere from, you know, six to 10 hours of testing over, you know, two to four days, depending on the age of the child, depending on the concerns. And I'm, you know, talking to the child about their experience, at home at school, what's hard for them, what's easier for them what they like, what they don't like, and then they're doing, they're doing tests, and we're coming in, and they're, we're looking at their general cognitive abilities, their ability to problem solve and think through tasks. We're looking at their academic skills, we're looking at reading and writing and math, all the things that they are asked to do on a daily basis at school. And then I'm going to look at the processes that go into completing tasks. So things like attention, paying attention to things you should versus things that you see, right, those are two different, they're both attention, but they're processed in different areas of the brain, the ability to be able to remember information you see versus information that you hear your ability to process language, how well does a child understand what they hear what is said to them? And are they ability? Are they able to express their thoughts and ideas in a way that comes out the way that they intended? Is their language sequences organized? Are they having trouble finding the right words for things? All of that is important. Because again, we're ruling out is this a language based issue? Is this an attention issue? Is this a reading impairment? Is this a math disability? And so we want to be very comprehensive in our approach. And then we're looking at social emotional functioning, the parents and teachers are completing forms about whether or not they're seeing signs of anxiety or depression or poor self concept. And then the children who come in are also answering questions and completing their own questionnaires, about their feelings about themselves, and about their experiences. And then we put all of that information together to get a nice picture, a neurocognitive profile of that child, their strengths, their weaknesses, areas of concern, and, and then we, from that information, we can determine whether or not there's a neurodevelopmental disorder, if and then what those strengths are, because it's not enough to just identify where the problems are. So, you know, if it turns out that the child does have ADHD, it's important to know that because there are treatments that we can recommend and things that we can put in place at home and at school to support that child. But we also want to know, well, what are the strengths in this child? What are the child's strengths? Because oftentimes, those strengths are things that that child can use to compensate for areas of weakness. So it's just as important to be able to identify the strengths as it is to identify areas of weakness. Kira Yakubov:: [19:11] Wow, that is an incredible process. I mean, that is a lot of data to be collecting. And then, yeah, so it sounds like this is over. I mean, maybe the course of a few weeks before you just get all of this data before you kind of sit and look through and analyze to see what it is. And that's just like, part of the first step is identifying and then being able to think about like, what do we do next? How do we reform everybody now to create like a very safe and supportive environment for this child to thrive and not have low self esteem and not kind of beat themselves up in comparison to their classmates or siblings? Karen Wilson:: [19:51] Right, absolutely. And, you know, part of that process, like I said, you know, when people think about assessment, they think of just the testing piece, but assessment is the parent interview, it's the conversations with the child, it's the testing, it's conversations with teachers, that's analysis of the rating forms. And it's the feedback meeting, it's having that follow up meeting with the family to say, this is what we found. And this is what we're recommending, and having a conversation with the child to say, you know, these are things that you do really well, these are areas where you're so strong, but this is harder for you. And this is why we're gonna get you support in this area, that's often a big relief for kids, because oftentimes, they may not understand why this is so hard. You know, I think about those kids in the classroom, if you think about, you know, entering, i don't know when's the last time you entered an elementary school, classroom, classroom or school, but everybody's work is on the board. And while everybody's on the bullet, everybody's work is put up on the bulletin board for open houses. And kids who struggle with writing are often you know, embarrassed when their work is up there, and they've got their peers have, you know, three paragraphs of text put up on the board, and they've got three lines, right. And so, yeah, it can be some embarrassment about their difficulties. They, you know, a lot of kids who have struggled with reading will say, the most terrifying point of part of their day is when they have to take turns reading out that because they worry that kids will snicker, and they will laugh, they'll stumble over words, and they get embarrassed. And that can create anxiety, it can create sadness, it can create, contribute to a low self concept. And it can make kids feel like they're not smart, and that something is wrong with them. So to explain that to a child, that your brain is just wired differently. But here are areas where you are really strong. And you know, we can provide you support for reading now that we know why this is so hard for you. It's often a big relief for students. Kira Yakubov:: [21:51] Yeah, I can imagine. I mean, it sounds like really playing up the strengths, because that's important. And leaning into that, and using that to help in those other areas. So they're not feeling down and feel empowered, like the child and the whole family. And everybody involved feels a lot more empowered. And it's not walking away feeling kind of sad, or disappointed, but relieving. Like you're saying like, okay, knowledge is power. So you can start doing different things with this information. Karen Wilson:: [22:17] And that's exactly it. And I sat down with parents, you know, probably a month ago, now, and they had a child who was, you know, in middle school, and was getting diagnosed with dyslexia for the first time, and had been brilliantly compensating, by memorizing what words look like, for that long, exceptionally bright kid, but had dyslexia and didn't understand that you just memorize what words look like, didn't know that you had to sound out words, actually said, I thought everybody did that. And the parents said to me during that feedback session, you know, I wish that we had found you, you know, five years ago, right when their son was in second grade. And the father, who was sitting on the call said to me, I wish I had found you 40 years ago, because he realized from my discussion about what his son was experiencing, that he also struggled with the same thing, but didn't have a name for it when he was a child. Kira Yakubov:: [23:14] Sure. I think that's a really interesting part too. Because as you're getting this family history to see if it's hereditary, anybody else in the family has it. And if they've never even had the opportunity to explore this, or know what this is even called, or what this might be like, it's kind of like a shock for everybody involved. They're also getting this new diagnosis, and this new information decades later in their life, Karen Wilson:: [23:38] right, absolutely. Kira Yakubov:: [23:39] while helping their child move through it too. Karen Wilson:: [23:42] yea Kira Yakubov:: [23:42] wow. Karen Wilson:: [23:43] Yeah, I can't tell you how many parents have said, you know, do you do you assess adults? Because when we're going through their child history and explaining why they feel this way, why they're behaving this way, why they're, you know, learning in this manner, and why this is so hard, they realize that, you know, they had the same struggles, but it just was never identified. Kira Yakubov:: [24:03] Wow. So you do such powerful work. I'm so inspired, because this is like Karen Wilson:: [24:06] thank you Kira Yakubov:: [24:07] you see all of it, and bring it together and help so many people through this process. And so I know we touched a little bit on you kind of see kids who have ADHD, Dyslexia, maybe on the spectrum. Are there some processing disorders that maybe people haven't heard of, but are very common for you while you're evaluating children? Karen Wilson:: [24:28] Yeah, I think that there are definitely language language based disorders, which is a processing disorder. So language disorders can be in, in a couple have and people who have language disorders can struggle in a couple of areas. One is just your ability to understand information that you take in, you know, oftentimes they have an understanding what words mean, you know, they may have a more limited vocabulary, they may have trouble kind of organizing their words when they're speaking. Choosing the right word to say when they need to They may seem more shy or more quiet in situations because they spend so much time trying to figure out how to say something, that by the time they get it, the conversation has moved on. And so you know, that can create some anxiety as well. So there's definitely language processing disorders that we see. And you know, ADHD is an attention, processing disorder, it's a difficult. It's someone who has difficulty with processing information, its struggles with the the ability to, you know, persist with tasks, the ability to stay focused over an extended period of time, the ability to inhibit distractors in your environment, and also to manage even complex tasks, because we know the executive functioning system, that process and those processes that are part of that executive functioning system are often impacted in individuals with ADHD also for autistic individuals, and you see some difficulties in mood disorders and anxiety as well. So there's a lot of overlap too in terms of, of processes that are impacted when there's a neurodevelopmental disorder or even mental health challenge. Kira Yakubov:: [26:06] Yeah, and I imagine they're like, you're seeing a lot of overlap that there's going to be comorbidity, right, like someone may have ADHD inattentive, and also be on the spectrum and may experience anxiety too Karen Wilson:: [26:17] Absolutely Kira Yakubov:: [26:17] Is that something you find common? like being able to identify that there are several things happening? And how to like, separate that and treat them separately? Or I'm assuming there might be some overlap in the treatment as well? Karen Wilson:: [26:29] Yeah, there definitely can be some overlap in the treatment. And then we also the timeline in terms of when these behaviors when these challenges started, kind of help us figure out what came first. You know, sometimes, like I said, kids can experience anxiety because of their struggles, right. And then there are other kids who have always been described as anxious kids, they had separation anxiety, when they're in preschool, parents will say, you know, I had to sit in that preschool classroom for the first month and a half that my child started. And so we know that that's a long standing issue. And so again, that's why that family history, and that timeline of difficulties really tells us, you know, kind of what came first, what came second, and also helps us determine, you know, a course of treatment. We know that with neurodevelopmental disorders like dyslexia and ADHD, there's in 40 to 50% of kids, they have something else. So 40 50% of kids with dyslexia also have ADHD. And the reverse is true 40 50 percent of kids with ADHD also have a learning disorder. And so we know that there's a lot of comorbidity. And we know that kids who struggle with learning are at greater risk for mental health challenges, like anxiety, for self concept, and depressed mood. And so and that's one of the reasons why we do these comprehensive assessments, because we want to be able to identify if there is more than one thing going on, so that we address everything. You know, if a child has dyslexia, and we only look for dyslexia, and we miss the ADHD, then, you know, when we're recommending intervention, you know, how are you going to recommend, and we're going to recommend, you know, an hour a day of reading intervention, or two hours, you know, a day of reading intervention for a kid who has undiagnosed inattentive type of ADHD, it's gonna be really hard for that child to pay attention to the intervention. So being able to identify that both are present helps you determine the course of treatment that is most effective for that child and their specific neurocognitive profile. Kira Yakubov:: [28:27] Wow. I mean, that's incredible information. I had no idea the numbers were so high for both of those to be existing at the same time, you're saying it's even higher of the overlap as well Karen Wilson:: [28:38] the overlap between autism and ADHD. They actually, you know, up until more recently, you couldn't diagnose ADHD in autistic kids, because it was so common to be to find inattentive, and attention, hyperactivity, impulsivity. Now you can diagnose both, but I think the research shows that 70 to 80% of autistic kids meet criteria for ADHD. Kira Yakubov:: [29:05] Do you find that parents are like wildly surprised by that, too? I mean, I'm a therapist and I and I'm surprised by that level of, of those numbers and research. Karen Wilson:: [29:14] Yeah, well, they, they see it, they're not surprised because they see it, they see that impulsivity they see the executive functioning difficulty and they see the inattention, anxiety is very high as well. And so knowing that these things coexist and our common, it's helpful for parents, so then they can understand what it is that they're seeing, and then they're more highly motivated to engage in the treatment, that would be appropriate. Kira Yakubov:: [29:39] Sure, that makes sense. And so Karen, would you be able to share a little bit about some of the interventions or like common things that whether it's you or your team, or like other teachers and clinicians can help families kind of do to manage some of this or to like play on the strengths to bring up some of those weaknesses? Karen Wilson:: [29:57] Yeah, I mean, we see kids with so many different presentations of different areas of struggle, you know that they're going to have different interventions. But I can think of, you know, kids with dyslexia, for example, that I mentioned, we know what the research shows, is effective for kids with dyslexia, you know, a multimodal phonics based program is going to have the biggest impact, particularly one that is intensive in nature. And that's typically done by an educational therapist, or someone who has specific training and, you know, this, these multi sensory evidence based approaches to dyslexia. So we know that that is what we would recommend for kids who have that type of learning disorder. We know that for kids with ADHD, for example, that you know, about, you know, seventy to depending on the research study, but 70 to even 90% of kids with ADHD respond to medication, there were various types of medication, I defer to pediatric psychiatrists in terms of when it's appropriate, and who it helps a lot of parents with with the young kiddos don't want to start with medication, which is understandable. And so there, you know, accommodations we can put in place, there'll be there's behavioral support, we recommend working with a cognitive behavioral therapist, who can coach parents on what they can do to support their kiddos at home, you can write a plan for teachers in terms of where that child should be seated in the classroom. You know, how can we minimize distractions around that child's desk and environment, helping the teacher to know that this is an attention issue and impulsive issue and not a child deliberately trying to be disobedient, or you know, disrespectful. So providing some psychoeducation, to parents and teachers, and then also recommendation if a child is is constantly off task? How can that teacher redirect that child without causing the child to be embarrassed in front of his peers, you know, and so all of that is part of the recommendation. So when I think about ADHD, I think about, you know, medication management, you know, cognitive behavioral training for parents, the child having support at home and at school systems in place that support the child. And a lot of times, if kids are taking longer to complete tasks, then extended time, but also guidance in terms of how to use that extended time. Because sometimes if kids have attention issues and executive functioning challenges, they can be given extended time, but no not know how to utilize that, that time well. And so they might need some executive functioning coaching in terms of how to utilize that time. And then also, again, accommodations at school breaking down, you know, large tasks into smaller chunks, getting, you know, stretching breaks and opportunities to, to decompress. So all of those things are all important in terms of, of recommendations, interventions, accommodations and modifications at school, that might be helpful. A lot of kids with ADHD, also have some fine motor issues, because that front part of the brain that's responsible for attention and sustaining focus and inhibiting distractors, and, you know, executive functioning is also very close to the fine motor areas in the brain in that front area of the brain. And so many kids with ADHD also have fine motor or graphomotor issues. So they're, you know, parents will say that their handwriting is really poor, it's illegible. And so oftentimes, they will benefit from occupational therapy that will address those fine motor, fine motor issues. And so that might be a recommendation if appropriate for a child who has both the motor issues and ADHD. Kira Yakubov:: [33:51] Interesting. That's so interesting. So I mean, full disclosure, I have ADHD inattentive type, and I'm super clumsy. And I've seen like through social media, a lot of people say like, oh, I'm clumsy too. And this makes a lot of sense. I just thought, I don't know, like, I get easily distracted by my surroundings. But it sounds like it's a lot more than just that as the fine motor skills that or is it? Could you explain that a little bit more what that means, like, why that might be impacting that? Karen Wilson:: [34:17] Yeah, I mean, in the frontal lobe, there's, you know, neuro chemicals are released norepinephrine, dopamine, and they serve the frontal lobe, they allow the brain to, to focus, direct attention, shift focus from one thing to another, again, to inhibit distractors. But that front part of the brain is also responsible for fine motor coordination. There's a motor strip there. And so if that same area of the brain is also not getting enough dopamine, that it's not only going to impact attention and focus and impulsivity, it's going to impact the ability to, you know, to form letters well, right, that fine motor dexterity is also going to be impacted. Kira Yakubov:: [34:57] Yeah. Interesting. That's so fascinating. Everything about the brain is just so wild. And so if we can shift gears a little bit, I know we've been talking about more so with children, what does this look like for young adults or adolescents who are about to go off to college, especially if they're moving away, like, sometimes it might be a little bit different if they still stay in their, their home that they grew up in, and they're, you know, just commuting to college and classes, but, or for young adults who are like going to move or there's this huge transition and all their patterns and behaviors and habits. Karen Wilson:: [35:32] Right, I mean, again, it depends on that young person's individual neurocognitive profile in terms of what those challenges might be. But for many, again, particularly those students who have had a lot of support at school, and maybe even a lot of support at home, by, you know, an educational therapist and executive functioning coach, you know, accommodations, modifications at school, for many of them, the loss of that structure can can really create problems for them, when they make that transition. It's why it's so important for the preparation for that transition to begin way before 12th grade, right? Way before 12th grade, I want to develop those independent skills, independent living skills, those self advocacy skills are really important. And that's a thing for parents to keep in mind. With disorders like ADHD, you know, oftentimes, there's a developmental delay in the development of specific areas of the brain, particularly the frontal lobe. And we know the frontal lobe is the last part of the brain to mature and develop. And so all of those functions controlled by the frontal lobe, the ability to organize, plan, prioritize, manage your time, you know, you know, sustain your focus over an extended period of time, particularly, when something's not interesting to you, all of those things get better as you get older, you know, your ability to problem solve, decision make, exercise good judgment, all of those things get better as you get older. But keep in mind that there's a delay in the development of those areas of the brain and individuals with ADHD. And again, that's a general term for some individuals that might, you know, they might be more developed than others with ADHD. But they're trying to be as much as a three year delay in the development of the frontal lobe. And so if you think about an 18 year old, going off to college, but if your frontal lobe is really, you know, a 15 year old, then they're going to have more difficutly than their same age peers, in terms of managing those things. And the thing that happens when you go off to college is that not only do you lose a lot of the structure that you had in in high school, now the executive functioning demands of life has have increased considerably. Now you're managing your finances, now you're cleaning a home, now you're figuring out how to get your meals made, because you know, Mama's not there anymore. You know, you're doing your own laundry, right, you're making sure you have clean clothes to wear, you're washing dishes, you're doing all these different things that you may not have done, in addition to, you know, staying on top of your Courseload, making sure you're studying for your test. And to think about all the distractions in college, you know, the parties and the organizations. And now you've got a roommate, and, you know, a residence hall, and you may have had a parent, I've had parents say, you know, I still get my teenager up in the morning to go to school, you know, and now you no longer have that physical person telling you, you know, hey, it's time to go, gotta get going. And so it can be a very difficult time for students who are not prepared for that transition. Kira Yakubov:: [38:43] Absolutely. I mean, those are so many things to juggle. And for anybody at once, it's adulting. Right? One on one, right? It's tough. Having to figure out what is like how to prioritize all of this, what is the sequence to do these things? Like timing them out, managing, and then also creating friends, friendships, right? Like, there's all these different things that are happening. Yeah. And then managing if you have a roommate, and what that looks like, if you're messy, or they're clean, there's Karen Wilson:: [39:12] right Kira Yakubov:: [39:12] a million different things that are going on for somebody during that stage in their life. Wow. Absolutely. Karen Wilson:: [39:19] Absolutely. And then, and that's why the self advocacy skills are so important, because they're, they're high school. For many kids who've had the accommodations. The teachers know, the teachers know that they need extended time, you know, they have an IEP and then they go off to college. And if you're not in a, in a, you know, a hall with, you know, 400 other psych students, the professor doesn't know that you need accomodation. Kira Yakubov:: [39:43] Yeah. Karen Wilson:: [39:43] You have to find your seat in the front of the classroom. You have to register with students with disabilities office, and you have to, you know, let notify the professor that you need extended time, you have to get the paperwork filled out yourself and So there's a lot of self advocacy that needs to take place at college that maybe at this at a level that wasn't needed when a student was in high school. So what I often say to parents is that, you know, this period of between 18 and 25, we call this emerging adulthood, it's a time when brain development is continuing to occur. I mean, the frontal lobes are not fully matured until our mid 20s. And so many students, particularly those who are neurodiverse, who have these learning challenges, continue to need parental and societal support during this time. Kira Yakubov:: [40:36] Yea, that's so important. I'm glad you mentioned that, because we think, or at least, you know, 18 years old, you're an adult, you can leave, do all these things, make your decisions, but you're not even close to having your brain fully developed yet to be responsible. And have the skills and the support to maintain just living and existing a life that is fulfilling and happy and able to juggle all of these things Karen Wilson:: [41:00] Absolutely. Absolutely. And then, you know, if you think about students going off to college, there's also again, and they're impulsive, there's so many talked about all the things you could be doing the parties, but they're also it's a very vulnerable period for, you know, again, those early those young adults, right. And those emerging adults, it's a vulnerable period for their mental health, there's higher rates of loneliness, depression and anxiety during that time. If kids never had those mental health struggles, and they're going to manifest, oftentimes, they manifest right in that early adulthood period. And then we also know that, you know, there's, they're at greater risk for substance use, you know, they're being exposed to things that they may not have been exposed to, when they were younger. And now, and if they've got impulse control issues, and then not a fully developed frontal lobe, where That's where their decision making their judgment is, they're gonna make the mistakes, do things that you know, are not in their best interest. Kira Yakubov:: [42:02] And I think this is so important for people to know, like young adults and parents is that this stage of life, right, while you're figuring all these things out, everything is so new and you're making these mistakes, is to kind of accept where you are, and not have a lot of shame around that. And know that like, part of it is out of your control. And the other part is knowing this information. So you can do the things within your control, and kind of rolling, rolling with the punches while you figure this all out while your brain is still developing, which is really wild to think about, Karen Wilson:: [42:33] right. And then making sure that you have things in place to support you, if you know that you're at risk for anxiety and depression, or you've had that in high school, making sure that you're connecting with a mental health professional at your university, knowing that you know, where the health center is where you can get access to mental health services, knowing that if you if you know that you have executive functioning challenges, you know, connecting with executive functioning coach, and educational therapists who can work with you, particularly during that transition, that first year of university, when you're trying to figure out the lay of the land and manage things that you've never had to manage before. And then making sure that you're engaging in all those self care practices that are so important for functioning, you know, making sure you're getting adequate sleep, you know, we know that the brain needs sleep, right? We need sleep, spend so much of our lives in a state of sleep. And because it's important, we need it for optimal cognitive functioning, we need it for mental health. And then we know that when we're not getting adequate sleep, we're going to be more forgetful, because that's the period of time when we're consolidating our memories. So if a student is at school during the day, and when they go to sleep at night, all of those things that they've been exposed to get consolidated, they go from short term to long term memory when they're sleeping. So if you're getting inadequate sleep, you're going to be if you're getting inadequate sleep, we're going to have more forgetfulness, it's gonna be harder to pay attention in the classroom. So all of those things will be harder, and then you're going to be dysregulated you're going to be emotionally dysregulated because you're not getting enough sleep. So I always say adequate sleep, making sure you're getting enough exercise. mindfulness practices have been really helpful with, you know, helping to address anxiety, stress, lower stress levels, and also increased focus. Kira Yakubov:: [44:22] So it sounds like being super proactive about getting all those supports and taking care of yourself, like physically and mentally to set yourself up for success while you're growing and learning all these different things. Karen Wilson:: [44:34] Yes, absolutely. Kira Yakubov:: [44:35] Awesome. And so Karen, I know we're coming close to an end. Can you share a little bit about your company, Child, childnexus.com That directory because I'd love to hear a little bit more and I'm sure the listeners would love to know about that as well. Karen Wilson:: [44:48] Absolutely. So I started Child Nexus because I was getting so many parents saying you know, I'm not getting adequate support. I don't know where to go to get information about what my childhood Dealing with and how to provide support. And so I wanted to create a platform where they could get reliable information that they can trust. So parents support services, they can access information about attention difficulties, behavioral problems, they can get information about, you know what interventions work, they can get information about how to request a special education assessment through the school, they can get information about how a school assessment differs from a neuropsychological assessment. And then they can connect with providers, occupational therapists, speech and language pathologist, child psychologists, educational therapists, executive functioning coaches, parent coaches, who can help them get their children the support that they need in order to thrive. Kira Yakubov:: [45:43] Wow, that's incredible. So you've created a nice hub. Karen Wilson:: [45:47] Yeah, it's a nice hub Kira Yakubov:: [45:47] For all the support and all the different ways. Yeah. So everyone can get the help they need and the information. Karen Wilson:: [45:53] Yes, yeah. So we provide information we have blogs, on different topics, they can search by topic area based on their the problems or difficulties that their child is struggling with, or they can also listen to our podcasts. We have a diverse thinking different learning podcast, where we invite experts to come in and talk about different things, you know, autism, ADHD, ADHD and girls, autism and girls, language disorder, anxiety, mental health and young people. So we cover all of the things related to struggles that kids who think and learn differently face and how to optimize their cognitive and mental health functioning. Kira Yakubov:: [46:31] That's beautiful. I love that. And so for the listeners, can you share how if they want to get in touch with you or work with you or find your website, anything like that they can reach out to you? Karen Wilson:: [46:40] Absolutely, they can go to childnexus.com That is the hub where they can get all the information. That's where our blogs are. That's where the link to our podcasts are. If they want to join a parent learning group, you know, they've just been their child has just been diagnosed with ADHD or anxiety or dyslexia. And they want to learn more than they can join one of those groups right on the website. And if they want, they don't know what they need, they can book a consultation, a 45 minute consultation and get some answers to their questions. And if they want to reach out to me directly, they can email me at DrKIWilson@childnexus.com. Kira Yakubov:: [47:19] Wonderful. This has been super insightful. All the knowledge and expertise you bring on. I'm really honored to have you on today. Karen, thank you so much for giving us your time and sharing your story with us. Karen Wilson:: [47:30] Thank you so much for having me. It's been such a pleasure, Kira Yakubov:: [47:33] of course ### Listen - [Spotify](https://open.spotify.com/episode/13384529) - [Apple Podcasts](https://podcasts.apple.com/podcast/13384529) - [YouTube](https://youtu.be/m9kM7-GpjlU) --- ## Trust, Trauma, and Technology: An Intimate Chat with Emily Shaw, NP - URL: https://healyourrootspodcast.com/episodes/trust-trauma-technology-emily-shaw - Published: 2023-04-26 - Season 2, Episode 5 - Duration: 47:15 - Category: depression - Guest: Emily Shaw ### Summary Comprehensive exploration of depression beyond sadness, covering various forms, symptoms, and evidence-based treatment approaches for healing. ### Description Depression is much more complex than simply feeling sad. This episode provides a comprehensive look at depression, including its various forms, symptoms, and treatment approaches. Learn to recognize the signs of depression in yourself and others, and discover evidence-based treatments that can help restore hope and healing. ### Transcript Emily Shaw:: [0:00] Want that human contact and I think that that human contact is what's therapeutic. I don't think it'll be as therapeutic for people to interact with an AI Kira Yakubov:: [0:14] Hi, I'm Kira Yakubov, Licensed Marriage and Family Therapist and founder of Heal Your Roots Wellness practice. Every episode, we talk with a professional from the mental health field to learn more about their approaches and specialties, and also their journey of becoming a therapist. In this podcast, we'll uncover a deeper look at the world of therapy from new perspectives. You will meet the therapist of Heal Your Roots Wellness practice, and trusted colleagues from the community tackling mental well being. We're your go to Network for practical and professional insight in mental health. Subscribe for new episode releases every other Wednesday. For today's episode I'm welcoming back Emily Treadgold Shaw, Nurse Practitioner of Psychiatry, and she primarily works with children, adolescents and some adults. Emily, thank you so much for coming back today. Emily Shaw:: [1:08] Thanks for having me back. Kira Yakubov:: [1:09] Absolutely. So if anybody wants to listen in on Emily's first episode, it's in season one where she talks a lot more about how she became a therapist and the work that she does and what she specializes in. But for today, we're going to shift gears a little bit, we're going to talk a little bit about AI and some intergenerational trauma as well. So, Emily, what are your kind of general or broad Thoughts about AI and how that might cross over into the mental health world? Emily Shaw:: [1:38] So I'm kind of this weird luddite where I don't, I sort of tried to minimize the presence of technology in my life anyway. So I knew, you know, it's I feel like it's all anybody's been talking about the past couple of weeks. My husband is a software engineer; everybody at his job is talking about it. I spent the weekend with friends of ours. One of them's in consulting, we talked about it with them. So it's, you know, I have sort of had this like, here we go again, like, Yeah, I think so. I yeah, I mean, I think that, like, for me, personally, it's something that I'm, you know, I think that child psychiatry is probably going to be one of the last fields that it infiltrates, primarily because it's something that's really sensitive, that people aren't going to trust AI to be managing those kinds of decisions. I mean, I think that there are a lot of algorithms already that do like treatment recommendations, or medication recommendations for adult patients, in certain situations, like I had, I was discussing with somebody using an algorithm to make treatment decisions, you know, in a crisis situation, or like an areas that are like overwhelmed or, like slammed. And I think that child psychiatry is probably going to be one of the last areas where this creeps in, at least for me, like I see my patients, I try to see as many patients as I can in person that's sort of minimal right now, because I have a six month old, and I'm trying to spend time with him. But I you know, I do go into the office one day a week, and with younger kids, there's not really a substitute for like getting on the floor with them and like doing like play therapy and cracking out like the doll house or like the crayons or like, having them draw me a picture of their family. You know, it's something that I'm much more concerned, you know, when I think of my adolescent patients, and I think of the impact on them, and I think of I mean, I think there's already a lot of cheating school, I think there was already a lot of cheating with the pandemic and going to remote learning because kids are digital natives, like they know this stuff, so much better than older adults. And I think that there was a lot of stuff that, you know, teachers let slide during the pandemic, understandably. So I think about that. And I think about cheating. And I think that a lot of professors that I've talked to you or like that I've read articles about have said that they're concerned about the impact on like, academic honesty. So I think about my adolescent patients, and I worry that the pressure on them to succeed is so high that they would turn to AI, like, out of desperation, this thing with anybody, like turns to like any kind of like academic dishonesty out of desperation. And I worry about the impact on them of that. And I also, you know, of course, like anytime you're cheating, or anytime you're having like an algorithm or you know, right now sometimes, you know, like, kids will pay another student to do stuff for them. And it's like, if you have an algorithm do it for free. It's like either way, like you're not learning. So I think about that a lot. I also think about the impact on my patients' parents livelihood and my adult patients' livelihoods. So obviously, I think there are a lot of workers, even workers that weren't concerned about being displaced by automation before, that are a lot more concerned about being displaced by this. And I think that the anxiety of that trickles down to kids. And I think that also like obviously, if you're losing your livelihood, like the anxiety that is triggered is going to trickle down to kids also, and like, there's so much about even like really young kids, if you're in an environment where like, all the adults are really stressed, and it's like uncertain and there's stuff happening. I mean, I think that has like a can have like really negative impact on brain development and on emotion regulation and all this stuff. So I think about that a lot too where I, you know, I wish I could be like, I'm sure everyone will be responsible with like adopting this new technology. But like, of course, that's not true. I mean, I think that there are going to be like bad actors in any situation, they're going to be people using it's a tool, you know, they're going to be people using it for good, and they're going to be people using it for not so good. You know, I think that one of the things that apps do, and this is true of like any social media, it's like Facebook, Instagram, Tik Tok, the point is to keep the user engaged and keep the user using the app. And I think that one of the things that drives that engagement is outrage. And, you know, I'm thinking primarily about adults here, but when I think about, like, how vulnerable like kids are, you know, and I'm sort of like, leaving all over the place. But, you know, there's a lot of really negative messaging out there for adolescent boys. And I think that like adolescent boys, and you know, and adult men also, you know, I think are sort of in crisis and sort of struggling, and I think that, like, sometimes they're vulnerable to, like, influenced by someone that speaks to that part of them, that's really angry. And I think that, you know, I worry about AI being used, you know, because like AI has, especially with stuff like ChatGPT, that's like a you know, it's like a predictive language model. It's like, trained on everything that's already out there. But like, a lot of what's already out there is not great, it's like, the stuff already out there is like, really, really toxic and like also like, again, like if the, if companies are trying to make money by keeping people engaged, and one of the ways to keep them engaged, is by making them angry, I worry about the implications where like AI could sort of like, pick up on and I mean, this, not even like a ChatGPT or anything like that. I do mean just like regular, like algorithms, like picking up on like, kids being depressed or angry or frustrated and like, sort of like having Kira Yakubov:: [7:06] manipulating that information Emily Shaw:: [7:07] messaging tailored to them, that like, preys upon that. When they have done studies with, you know, using AI, like in a therapeutic context, like when people know that the, that it's an AI, like, it's not therapeutic, I think that one of the things that is therapeutic about therapy is like building a relationship with a human being that like cares about you. I was trained in like psychoanalytic psychotherapy, because I trained in New York City, and that's sort of the thing that like they hammered into us was like, the therapeutic relationship, it's about like building like, trust. And like, a safe space with like, another human being that you can then like, heal, like some of the time, you know, you can sort of like process some of the things in your life where like, during times that you weren't as safe, in like a safe environment with like a human being that will like listen to you and like empathize with you and like understand what you're going through and like validate your feelings. And like I think that with, this is why I think that it's going to take a long time for AI to break through because like, I think that people want that human contact. And I think that that human contact is what's therapeutic. I don't think it'll be as therapeutic for people to interact with an AI. And because AI is getting so good now, like I cannot even believe I'm like saying this sentence. It kind of reminds me one of the very first chat bots is a long time ago, like decades ago, one of the very first chat bots, the person who did the man who developed it was having his assistant, converse with it. And she felt so deeply that it was relating to her she felt it was so deeply. Like, she felt like it was so deeply relatable that she asked him to leave the room. Eliza, I think was the name of the Chatbot this is again like a long time ago. Yeah. But you know, when it was just like a really basic kind of like mirroring, like what you're saying, but like it sort of like got her to divulge things that like made her uncomfortable. And I think about that, and I think about Sydney and you know, I read that article that was in the New York Times where the journalist was testing Sydney who is like the Bing chatbot or it's what the internal name for the Bing chatbot and they got to a point where the chat bot was saying things like no you know you you didn't have a good time with your wife like you love me and like you want to be with me it was really crazy stuff. It was kind of reminded me of the movie Her. Yeah. Which I didn't think we were so close to at the time I saw it in theaters. But again, I'm like, Oops, like here we are better think about this now. I've been sort of like pushing this away for a lot of the past couple years. Again, because like I try not to use the internet that much. I try to use it as little as possible. Like I feel like it's had a really big negative impact on like my ability to focus and retain information and I've read a couple of books about it and sort of my suspicions were confirmed by like certain like books and articles that I've read that it really like decimates attention. And I'm not someone who has a huge amount of control over their level of attention anyway, under the best of circumstances. So I really try to minimize, like my phone use, I really tried to minimize my internet use, I really again, like I don't do social media like so I've been like pushing this away for years. Like as this technology's gotten closer and closer, I've been like, la, la, la, stick my head in the sand, not think about this, it's not for me, which I think is how like some people have been, I mean, some people are really terrified. I'm not terrified. But I do have sort of a, I try to keep a very open mind about things that could happen. I try to really remind myself of all of the things that I don't know, I really don't know a lot about this technology. And I am open to being shown ways that it can be used for good. And I'm open to shown, being shown, like ways that it couldn't be and I've been sort of pushing it away. And maybe in the past week or so the past week or two. I've been like, I can't push this away anymore. Like it's here. Like, it's, it's here. So I worry about the kids that I work with, they worry about their parents, I worry about my son, of course, because you know, when I worried about this before I knew I made a joke, the last time we were on the podcast about I was pregnant then so about no screens till you're 40. Like, nobody can have, you can't have an iPhone. But I you know, now I'm like, oh my god, this is so much more like, dangerous, right? And it's like, how do you talk to kids about AI? I mean, this is like stuff that I'm going to like expect is going to come up. Like, soon for me, like how do you talk to kids about AI? And I mean, of course, like the kids that I work with, they're like, way up more up on this than I am. And I mean, I've a couple of kids that I work with that have already mentioned Chat GPT and AI kind of stuff. Like, without me prompting them or anything like that. So I exactly it's like, it's it's one of those things. It's kind of like drugs where I'm like, don't assume that your 14 year old isn't using drugs, like you should ask them. Don't assume that your 14 year old isn't secretly communicating with ChatGPT, you should ask them. Yeah, because I, you know, I think that kids are always on the cutting edge of this stuff. And it's also, you know, I'm 33. So I feel like all of a sudden, I went from someone that was adopting new technologies as they came out to now like, you know, when I started working with kids, I was 21 or 22, when I started working with kids, and I didn't feel that at all, like I was behind or that I didn't understand what they were saying. And now, you know, as I'm in my 30s, like, I, it's funny, I was talking to one of my adolescent patients, and he was talking about other kids that have been like, messing with them. And I like, made an offhanded comment about how they were, like, trolling him. And he was like, yes, but no one says that anymore. It was just like, Wow, Okay. I, yeah, I'm getting old. And I have to, you know, sometimes agents will be like, Do you know who so and so is and I'm like, nope, and they're like, it's a YouTuber. Like, how could I not know, like, who this is? So, you know, kids are always like out there. And I mean, that's part of why I like working with kids, because it keeps me on my toes like this. But I am like, Oh, my God, like, I'm old. Kira Yakubov:: [13:21] We are the same age. We are not old. I think you because you work with teenagers it may seem that way. Emily Shaw:: [13:25] That's true. I feel old. That's true. We're not old. Kira Yakubov:: [13:30] Yeah. Emily Shaw:: [13:30] But I do. I do feel very old. Yeah, it's funny with younger kids. You know, sometimes they'll be like, are you 30? Kira Yakubov:: [13:37] As if Emily Shaw:: [13:40] Like, do you remember the dinosaurs? Kira Yakubov:: [13:42] Oh, my God. Emily Shaw:: [13:43] Yeah. So you know, I worry about them. You know, and I think that people were worried about us when stuff like the internet was first coming out. But I think that like, for all the worrying that they did, I mean, I remember adults being like, never give out your address. Never give out your phone number. I never did any of those things. But I think that there were like, other things that they didn't know, were going to happen. That happened and that's what I'm okay. That's like, what I'm like the most afraid of is the stuff that like I can't even anticipate, right. So it's like, I hear stuff about you know, I like think sometimes about like toxic masculinity, like vulnerable young men like and I'm like, Oh, God, this would be so horrible. And I'm like, but that's what I can imagine. And like, what can't I imagine and not that there's going to be this like horrible like doomsday scenario, I don't think it's going to be like that, but I believe it could and I also like, I'm sure that they're like, it's like the internet was positive too like, they were really like, pausing people like we're able to connect you know, people with rare chronic illnesses, we're able to connect with people, other people with that illness, or even like even see now it's like, you know, people with there's so many things about like ADHD and like anxiety and depression out there online that help people feel less alone. And I think that that's like really wonderful. I mean, sometimes my patients will like show me memes that they see about ADHDH, especially about ADHD but sometimes about anxiety or even about psychotherapy, which is really funny. And I'm like, Oh, these, you know, it's like the Same with me when I, you know, I'll see something that really resonates with me too. And like, I feel less alone. So a lot of this is good. But like I just like I'm so you know, I want to be so cautious about this. And there's this, like, there's this sense that I have that like the horse has left the barn ages ago, all of a sudden, like this popped up. And we were like, so not ready for it. Like kind of like we were not ready for like a lot of other things that have happened. And I'm kind of like, I guess this is just how it goes with new technology. Sometimes we're prepared, sometimes we're not, but I just like I worry so much about the impact on kids, kind of like I worry about the impact of everything on kids. But I think that I talked for a long time about my broad thoughts. I rdidn't ealize that I had so many thoughts until I like was talking Kira Yakubov:: [15:51] I didn't want to interrupt you because you were like on a flow Emily Shaw:: [15:53] I'm so sorry Kira Yakubov:: [15:54] No Emily Shaw:: [15:54] Well, I just like I kept thinking of other things. Kira Yakubov:: [15:57] Yeah. So it's totally fine Emily Shaw:: [15:57] Yeah. I mean, I don't know. Well and what I think also, because you work with couples, right? Kira Yakubov:: [16:01] Yea Emily Shaw:: [16:01] So that's another thing that it's like, nobody is going to be able to replicate. Kira Yakubov:: [16:05] Yeah, you touched on like a lot of good things in terms of like, the macro side of it all the way down to the micro. Right. So if we're thinking about, like, from a therapist's perspective, I think that the at least ChatGPT, I could see it being helpful in writing treatment plans, right? Like, Emily Shaw:: [16:22] Yes Kira Yakubov:: [16:23] Use that as like a supplement to a therapist that will help us and in like the crisis situations that you're talking about. Yeah. But like, I don't think that it will take over the therapy world and replace a human the way you're sharing, right? Because people, some people may want to talk to a computer to prompt them. Emily Shaw:: [16:42] That's such a good point. But I think that some people feel safer with that than with a human, Kira Yakubov:: [16:47] which I think is valid, right. And the whole point of the therapeutic experience is to be able to break through whether that's those anxieties, those fear, or the trust issues with another human to build that trust again, and being vulnerable. There's already prompts out there, right? Like, you get text messages, like how'd you feel today? What about this right? Or like if a therapist gives a journal prompt, right? Like, it's a supplement, but it's not. And maybe it will one day. Emily Shaw:: [17:16] Mhm Kira Yakubov:: [17:16] Right? The only way I can imagine it taking over like a human therapist is that if there is like, human looking robot in front of you, that can read your body language, right? Because our intuition is so strong and our ability to do therapy and like, notice if someone is laughing while they're telling the sad story, right? Or we know facts about their mom or dad that is slipping through the cracks a little bit that's reminding us of this that Emily Shaw:: [17:43] yeah, Kira Yakubov:: [17:44] without that context, I don't think a computer AI can do that. Emily Shaw:: [17:49] Yeah, no, I think I think so too. That's so interesting about reading body language, because I do think that there are probably AIs that can read body language now. Kira Yakubov:: [17:57] Yeah. Emily Shaw:: [17:58] And that I mean, right. So much of therapy. This is why I like going to the office, even though you there's a lot of nonverbal communication that you can see obviously on Zoom. Kira Yakubov:: [18:06] Sure, Emily Shaw:: [18:06] but one of the reasons I like going to the office is like you can see somebody's whole body, like you can see are their are their legs like jittery Kira Yakubov:: [18:13] shaking, Emily Shaw:: [18:13] like, there's so much that's unsaid that I use that in that like, that's all information that I use, and I like, but I do think that there are probably programs right now that can read body language who Kira Yakubov:: [18:27] Yeah, like I'm sure, like for the government, NSA, right, all these things that they need. Emily Shaw:: [18:30] Yeah. Kira Yakubov:: [18:31] It's I don't think that they care enough for our general mental health. Emily Shaw:: [18:36] No Kira Yakubov:: [18:36] To have that taken over Emily Shaw:: [18:37] No, nope. Nope. Yeah. Kira Yakubov:: [18:39] Not until it becomes profitable. Emily Shaw:: [18:41] No, exactly. Kira Yakubov:: [18:42] Yeah Emily Shaw:: [18:42] That's the thing. I also, you know, I think that there are, you know, there's a huge gap in like, between, like, need, and, like, it's a supply and demand thing, but there's like a huge mental health need. And there's just like, not enough, like trained mental health professionals like, oh, and it's like, I do wonder, right, where I'm like, who's gonna step in that gap and exploit it? I worry, a lot about that. There was a really good commercial, the one where it's a guy and another guy, and one of them is like, what do you want, you know, and he starts sort of, like, the cameras sort of starts backing up, and he's like, I want a job that I don't hate. You know, I want to not feel like I'm constantly like, on the edge of, and then the other guy cuts in and he's like, no, what do you want to eat? Kira Yakubov:: [19:24] Oh, my bad. Emily Shaw:: [19:25] And then it's like, do you need to talk to someone? And I'm like, No, but like, that was like, I thought that was really funny. And I thought that was a great way to be like, Yeah, we all you know, a lot of us need to talk to somebody. And I feel like it's also like, right, it's that and then there was that big like hustle culture like thing. I feel like that that's kind of like calming down now. And people it's funny I keep like hearing people referring to productivity is like a dirty word. And I remember in my like, my early 20s Maybe when I was like, 24. I remember like listening to all these podcasts about productivity. Kira Yakubov:: [19:52] How to be more productive. Yeah, Emily Shaw:: [19:54] yeah. But like that was really like important to me. And now, I think something I think the pandemic kind of broke me, I forget if I said this the last time that we talked on the podcast, but I think that I was really like, I need to take care of myself so that I can continue to take care of other people. And that was something that people had always said to me, like my mom, and other professionals before that, and I always just, like, brushed it off, I'd always been like, whatever like self care is for wusses like, I'm gonna, like push through this and like be a hero. And I'm like, That's so not okay. Like, it's not okay for anybody to think that. And I yeah, I was so glad to see that like, right women like a gen, not a whole generation younger than us. But even like maybe half a generation feeling empowered to be like no, like, my health and safety is more important than this. I just thought that was awesome. Kira Yakubov:: [20:46] I think this is like a great segue into intergenerational trauma. Emily Shaw:: [20:51] Yeah. Kira Yakubov:: [20:52] Because it makes me think about like, so we have the pandemic, we're somewhere in the midst of towards the end to whatever we are in now. But that first year, especially, is we were all forced, just slow down. I don't think there has been a global movement like that for everyone to have to sit and reflect about their life choices, what they're going through if they want to continue it. And like having that hustle culture makes me think about how many generations of trauma had to endure, whether it's oppression or survival mode, so that we are at a point where we feel guilty or ashamed or like a failure if we're not constantly producing and having some value that's like monetary. Emily Shaw:: [21:40] I know so many people, both like that I work with in my practice, but also people in my personal life that have expressed that like feeling guilty or feeling like feelings of worthlessness associated with like not producing enough or like not sort of like producing enough income or you know, I don't know, yeah. How do you feel like that, like, plays with intergenerational trauma? Because you talked a little bit about, like, oppression and like feeling the need to like, be productive? Kira Yakubov:: [22:06] Yeah. So I mean, I think like through traveling and being in different countries, I do think that American culture is very much the hustle culture. Emily Shaw:: [22:14] Yeah. Kira Yakubov:: [22:15] But like, even coming from like, I was a refugee. My parents were refugees, like, even my husband's parents came from a different country. Like, I think it was still instilled that they didn't even have the opportunity to rest, right? Like, there was no space for them to relax. We're gonna take time off or to think about joy or what they're like what they want to do with their weekend too, right? Like, Emily Shaw:: [22:39] right, yea Kira Yakubov:: [22:39] that's was a silly thought it's, we have to survive, but we have to go, go, go, go. And if you're sitting down, that means either someone's not getting fed, something's not getting done. You might lose your job, your reputation's on the line, which for like communism is huge, because what your neighbors think about you can literally can put you in jail Emily Shaw:: [22:58] It can literally kill you. Yeah, Kira Yakubov:: [22:59] Yeah. So I think that like, and then coming to a country where like, okay, there's not necessarily that happening, but there's still this hustle culture. It's kind of like natural for the next generation to feel like, I have to keep doing things like if I'm not busy. Emily Shaw:: [23:14] Yeah, Kira Yakubov:: [23:14] I am a failure. Emily Shaw:: [23:16] Right. I'm worthless. Kira Yakubov:: [23:16] I'm useless. I'm worthless. Yeah, well, but that's how strong right like that this is passed down that these beliefs and the compulsions, and like our generation has, I don't think we have more anxiety or depression, I think we're allowed to have more of it. And it manifests in such a different way. Like, I talked to my parents, and they're like, there is no such thing as anxiety or depression. Like, you're just like, you're not busy enough, you have too much time on your hands to think and feel about shit. And I'm like, okay, fair because they were in survival mode. They literally didn't have the time to acknowledge it, but they still experienced it. Emily Shaw:: [23:54] Yeah. Kira Yakubov:: [23:54] And so because they weren't allowed to think about it or talk about it Emily Shaw:: [23:58] right, right. Kira Yakubov:: [23:59] If I have it. I'm ungrateful. I don't think about my privileges, right. And then so it creates this next generation of right of hyper anxiety, more depression, low self esteem, shame. Emily Shaw:: [24:12] Yeah. Kira Yakubov:: [24:13] Right. And there's not a space to talk about these things, because you have to kind of just push through and figure it out on your own. Emily Shaw:: [24:19] Yea. You're right that like, right, it's not like it didn't exist, they just like nobody talked about it. So like my mom's side of the family is like Irish Catholic. So like, nobody talks about any of that stuff. So my mom was really like, aware about a lot of that stuff. So she, you know, I remember once she was telling me that her grandmother had had, you know, may have had postpartum depression because like after her second child was born, she like, went away for a while. I'm using air quotes, if you're like, not listening, if you're just listening, you know, and I could see her kind of like, I could see the gears turning in her mind. She was talking about it what she was like, oh, like, that's probably what they called it. When you were having a mental health problem that you just right like, nobody, it's right. It's like either Yeah, it's like, you didn't have postpartum depression. You went away for a while. They're like, yeah, exactly. And it's like, there was no like, space to talk about feelings. There was just like, yeah, exactly. You just had to survive. Kira Yakubov:: [25:11] For listeners, not knowing exactly what intergenerational trauma is, like, maybe we can kind of go over a little bit like what that means and like, how that comes up. Emily Shaw:: [25:21] Yeah. Kira Yakubov:: [25:22] So I think a kind of a broad overview is, if prior generations, like our parents, our grandparents, great grandparents, ancestors, right have been through some kind of traumatic experience, whether that might be some kind of abuse, racial trauma, like being a refugee, like on a global scale, or direct, like something happening in your country, or even just like within the family and the culture, is that the way that people survive, they pass on these maladaptive behaviors on to the next generation. And then they live in a new environment. And they use these coping skills, which are also not very helpful. And they create more maladaptive mechanisms and continue passing this on until someone in the lineage goes to therapy breaks the cycle, right? Is aware of these things. Emily Shaw:: [26:13] Yeah, yeah. I mean, obviously, like the one that comes to mind, like the maladaptive coping mechanism that comes to mind because I'm Irish American is alcoholism, just like sort of the one that like everybody would like, you know, it's like the one that like, would come to mind for a lot of people, but it's right. It's like, it's not talking about it, like not acknowledging it. It's like denial, I guess, is like what the coping mechanism would be, or even maybe sublimation and that like, right, and then like self medicating with substance. So like, not speaking for any individual, but like, I think that, like the rates are higher in that population, or in certain, you know, in certain populations, Kira Yakubov:: [26:47] and I think the cultural context makes such a huge difference with the intergenerational trauma because, right, like if you are coming from a place where there's war, right, like, right now, the war in Ukraine, like there's gonna be a lot of this. Emily Shaw:: [27:00] I know, I think about this all the time, Kira Yakubov:: [27:02] passed down to unfortunately, like people who are experiencing it now. And their children who are really young, and then their children that they're going to have, right, like, it's a ripple effect. And it's part of it stays in our DNA as well. Emily Shaw:: [27:15] Yeah. Kira Yakubov:: [27:15] Right. So Emily Shaw:: [27:15] it's like epigenetics. It does, like literally change Kira Yakubov:: [27:18] literally, absolutely. Right. And like, Emily Shaw:: [27:19] yeah, Kira Yakubov:: [27:20] like, I'm Jewish, and, you know, in my ancestry, there was constantly genocides of wiping out Jewish people. Emily Shaw:: [27:26] Yeah. Kira Yakubov:: [27:26] And, you know, sometimes there's jokes that like, at least like with my family, like, Oh, they're always complaining. They're always asking questions. Everyone has IBS. Right. But like, thinking about how nervous and anxious and stressed you would have to be every day for your life, because you think that someone is going to kill you or torture you? Of course, your stomach is going to be turned inside out. Emily Shaw:: [27:47] Yeah. Kira Yakubov:: [27:48] Right. It's like these things kind of make sense. And then they're passed on, because no one kind of addresses them, or they don't know to address them, or it just becomes the norm of what happens. Emily Shaw:: [27:59] Yeah, I mean, I think that, right, and that's the thing, it's like, after a while, like, the thread of how it got to be that way is lost. And then it just, that's the way it is. And I think that, you know, I think it can be that way with like family secrets as intergenerational trauma, where it's like, you can feel you feel like something is off, but you can't put your finger on it. But like, there's no like space to ask about it, or like talk about it, or like anything like that. So you just kind of want like are going around like okay, like, I guess this is normal. You know, I think that that's like, that's been the case for like lots of people that I've worked with, or like, you know, feeling like something is normal. And then like realizing that it's not like as you know, as you grow up and sort of, like meet other families and like, start to, like, realize that like, oh, like there are things that were tolerated, like in my family of origin that were like that would never have been tolerated, like in other families of origin. And you think that everything, you know, you sort of, like every family is like this. I mean, I know, my family of origin is like pretty conflict averse. So I've spent a lot of time around people whose families at origin were not as conflict averse, and who, you know, there was a lot of shouting and a lot of yelling, just like how they interacted with each other, now go over their houses, and the parents would be screaming at each other and like, screaming at the kids, and I would be like, Oh my god, this is like a war zone. And like, that was like Tuesday. And, and that's the thing. It's like, I don't know, it's that, you know, it's like, the chaos of that has an impact to like, yeah, where it's like, I feel like sometimes the chaos of that has an impact in a way that like people like some people feel like really comfortable with chaos and like when things are like too stable, they'll like just like just mess it up. You know, just to like to like be so they can feel more comfortable. Kira Yakubov:: [29:48] Yeah. So I see this a lot. It's actually interesting, because doesn't always have to be like a huge, traumatic thing. It could just go through the family. So I've had several couples who Were they were heterosexual couples and the female had severe jealousy and trust issues, okay, and the male partner has not necessarily done anything to warrant that, right? Outwardly. And then so we're doing this family work, you know, as couples therapists, we take time to learn about each person's family, like their family, their parents, and sometimes their grandparents. And, you know, we discovered that there was a lot of secrecy around affairs. And you know, this, yeah, this happens in any culture, any class status, right. But like, this particular couple was from an Italian heritage. And within that culture, sometimes there is like an understanding that there will be like a "Goomah", right, like a mistress. It doesn't mean that the wives are okay with it. But it is sometimes, like, ingrained in the culture. Yeah, it's baked in. So imagine, you know, you have a grandfather, or you have like these uncles who you really admire and you love and they're great family members. But then you see the other side of the female family members talking so negatively about not trusting men, they're pigs, they're dogs. Emily Shaw:: [31:10] Yeah, Kira Yakubov:: [31:10] You know, they're good for the family, but they're not good partners. But you but you love them, and you have a partner anyway, right? So like, struggling with trust, or like, this level of vulnerability or intimacy within like, a romantic relationship, too, is that it's trickled down, Emily Shaw:: [31:27] right Kira Yakubov:: [31:28] through the generations too. Emily Shaw:: [31:29] Yeah. No, that's such a good point that like, if in the environment where you grew up, just like nobody trusted men, and it was just this, like, not even an open secret, it was just like, out in the open that like, men are untrustworthy, they're like, gonna, you know, they're gonna betray you like, no matter what you do, like, you can't escape it like, Yeah, I mean, like, who would trust somebody after that. Yeah. Yeah. Kira Yakubov:: [31:47] Right. And so like, that's traumatic to that's like a relational trauma that is passed down until, you know, it takes a lot of work for that particular couple to work through building trust, Emily Shaw:: [31:57] Yea, I can imagine Kira Yakubov:: [31:57] based on this relationship, Emily Shaw:: [31:59] because I think also that then that, like runs up against this, like, I feel like this ideal here that like, if your husband cheats on you, it's your fault. Like, that's because like you were found wanting, like you didn't like satisfy his needs, like you weren't like a patient enough or loving enough or sexy enough, or whatever it's not. So that's the thing. It's also because it's being like taken from this culture, where it's like, you know, like, I don't know that much about it. So I don't want to, like make any generalizations. But it's like, if it's right, if you're moving from a culture where like, this is a thing that happened a lot, then like, you know, everybody just understood that this was what men did, and that it had nothing to do with women. Like, and then it's like, you're moving it to this now this culture where it's like, if this happens, it is your fault. Like, I feel like that, like is really destabilizing and like confusing. Kira Yakubov:: [32:50] Absolutely. Emily Shaw:: [32:50] And ofcourse it's like nobody's fault Kira Yakubov:: [32:51] The context changes. Emily Shaw:: [32:52] Yea Kira Yakubov:: [32:52] Yeah. Emily Shaw:: [32:53] Yeah. Kira Yakubov:: [32:54] And, you know, I, we were talking about this a little bit last night of thinking about whether you come from an individualistic versus collective culture. Emily Shaw:: [33:03] Yeah, Kira Yakubov:: [33:04] right. And like how that also shows up in mental health and therapy, which I think is so important for therapists generally to be a lot more culturally competent, and like sensitive to cultural differences. Definitely. Because I find and like, I also don't want to generalize, right, but like, in the Eastern European culture, at least from my personal experience, Emily Shaw:: [33:24] I feel like that's not a generalization. Like, you're, you're from Eastern Europe. Kira Yakubov:: [33:29] I know Emily Shaw:: [33:30] I feel like it's okay. Kira Yakubov:: [33:31] But like, not everybody, right? Emily Shaw:: [33:33] Like, No , I understand. Kira Yakubov:: [33:34] Not everyone's gonna have the same experience. I have, like, within my own personal but also professional experiences, because I do work with a lot of clients who, whether they are born in Eastern Europe or they came here as children, yeah, is that a lot of the family dynamics are very enmeshed, which is, for people who don't know, it's basically like, kind of like a group think like, everyone's in everyone's business, everyone kind of believes the same thing. The ideals, the narratives, like it's in line. So having someone do something or think differently, or want to be an individual is seen as a threat. Emily Shaw:: [34:13] Yeah. Kira Yakubov:: [34:14] To the family unit. Emily Shaw:: [34:15] Yeah, that's a really good point. Yeah. And I mean, we got we're talking a little bit about this, because like, I like my parents were both born in the United States. So they were you know, and they grew up in like, the 70s. You know, it was very, like, you know, both sort of grew up in this very, like individualistic culture. So, like, I didn't have any tension with that. They were like, You can be whatever you want to be and like you can, you should follow your dreams, go wherever you want. And, like, be whatever you want. And we would never try to stop you and like, Kira Yakubov:: [34:42] yeah, Emily Shaw:: [34:42] you know, what, and when I was a kid, I would be like, well, you know, even like, when I would ask them, you know, sometimes I'd be like, Oh, do we have enough money for this? Or like, oh, like, you know, what are you going to do if this happens? They'd be like, don't worry about it. Like, we're the parents. You're the child like, you don't have to worry about that stuff. Kira Yakubov:: [34:57] Oh, that sounds so healthy. Emily Shaw:: [34:58] I know. Oh, yeah. Yeah, yeah, I give my parents a lot of props. But I think that's a privileged position to be in where I genuinely didn't have to worry about it. Right. So like, I mean, it's very easy to be like, Oh, that's really healthy. But it's like, that was the truth. Like, I didn't have to worry about whatever it was, I mean, like, as long as they were all, like normal requests, or I didn't have to worry about it. And I think that, that, you know, right, I bump up against my so my husband's from Ukraine. And he came here when he was a kid with his parents. And I Yeah, it is like that, you know, just like, the way that we interact with, like, both of our sets of parents is like, really different. You know, I feel like he I remember the first time after, like, he spent time with my parents and me at my parents house, he was like, wow, like, he was a your parent, like, you and your parents are so like, close, like, you know, I felt like, I feel like he almost felt like, we were like, friends, like, he's that just like, isn't, you know, it's like, the relationship that he has with his parents is really different. It's like, there's so much love there. But it's like, not like, it's not like this thing, where it's like, you know, his parents have like, very specific ideas about like, what they want him to do and be, like, aren't afraid to express them. And like, my parents would never, like, try to tell me what, how they thought that I should be. So it's so funny. Because that was like, such a, like, you know, in a blows my mind, like, how different like, that has been. And it's like, right, it's not bad. It's just like two different, like ways of like, two different sort of, like sets of expectations that come like it with like, sort of like the cultural context that like they haven't that we have Kira Yakubov:: [36:37] Absolutely and like not having that cultural context, right? It's so easy for it's so easy to pathologize foreigners or immigrants in their family dynamics. Because if we're looking at it from an individualistic standpoint, these things are wildly unhealthy. And there's like, emotional manipulation and guilt trips and enmeshment. And like, lack of boundaries, or like all these things that would be considered unhealthy and not a safe environment for somebody. Emily Shaw:: [37:10] Yeah, Kira Yakubov:: [37:11] On paper. And for someone who doesn't come from that lens, then when you look at it from the generational trauma and the things that they've been through, it's actually like they needed to be this close to survive. And Emily Shaw:: [37:25] That's such a good point. Kira Yakubov:: [37:26] And they literally lived in the close quarters, like, yeah, I was born in Azerbaijan. And my parents told me like, there were no new developments there. They didn't build new houses or residence, right? Like you lived in this apartment until someone died. And then you had a lottery to, like, get into that new apartment. But everybody lived in like a one to two bedroom apartment. I'm talking about grandparents, parents and their children. Emily Shaw:: [37:52] Yeah Kira Yakubov:: [37:52] So you're physically in a close quarters. And then emotionally, you know, everything about each other because, Emily Shaw:: [37:59] of course, because there's no escaping it. It's like, if you're, you know, it's like, it's not like you're gonna like go up to your room and like write in your diary, right? Like I did when I was a teenager. Yea Kira Yakubov:: [38:08] Like, yeah, I mean, like, right, if you're like, if you're having like, a rough day, like everybody knows. Yeah. And everyone's got thoughts on it. And yeah, because, and there's also like, this really strong sense of what happens to the family stays in the family. Like, you can't tell strangers you can't tell your neighbors you can't even tell your friends. Because there was such a fear and a lack of trust towards other people. Because yeah, it literally could harm you Emily Shaw:: [38:35] It could kill you. Kira Yakubov:: [38:36] It could kill you Emily Shaw:: [38:37] Yeah. no, I even it's funny that you're saying that now. Because like, even like after I was telling that story about how my great grandmother might have had postpartum depression, like maybe like, I just like I shouldn't have said that on the podcast. Because that's like, that's the like, that's Kira Yakubov:: [38:53] Ingrained Emily Shaw:: [38:54] Yeah, it's like, don't talk about that's no. That's private. Like that's not like, but this is also like, How is anybody going to ever talk about postpartum like, postpartum depression if like people aren't willing to be like, I had postpartum depression or my mom had postpartum depression like, Kira Yakubov:: [39:08] yeah, Emily Shaw:: [39:09] yeah, but I think that right I could sort of like almost like feel like the shame of like, I can't believe you like talked about that. Like, and anybody could listen to it. Kira Yakubov:: [39:21] Yeah, I know Emily Shaw:: [39:21] I'm getting like, I feel like I'm like sweating like thinking about it. Yeah, if you're listening don't tell my mom. Kira Yakubov:: [39:32] That's so funny. But like, right, we're in a position now where that for the most part is not something that we have to worry about. Yeah, Right? Like we can openly share our opinions and thoughts online in this kind of way. And nothing really detrimental will happen to us. Emily Shaw:: [39:50] I don't know. So like, I have like a fear I think it's probably like a healthy fear but like I have a fear of part of the reason that I don't do a lot of stuff online is like I have a fear of like making a mistake. And then it being there forever. So Kira Yakubov:: [40:02] sure, Emily Shaw:: [40:02] but you're right. It's like, it's not the consequences. You're not going to be like your entire village shuns you. Right? The consequences are just probably I'm going to get like some kind of mean comment, right? Kira Yakubov:: [40:11] Like mean comment Emily Shaw:: [40:11] Like, I'll go about the rest of my day. Yeah, right. Kira Yakubov:: [40:13] We feel will feel embarrassed. We might feel shame. Emily Shaw:: [40:15] Right, I'll feel shame. Yeah. Kira Yakubov:: [40:17] But everyone in our neighborhood probably is not going to know or come knocking on our door or call the police for something. Emily Shaw:: [40:23] Right. Exactly. Yeah, Kira Yakubov:: [40:24] Unless we're doing something crazy, right? Emily Shaw:: [40:25] Yeah. But even then, Kira Yakubov:: [40:27] yeah, Emily Shaw:: [40:27] I feel like there's like much more of like, a live and let live like situation, again, because like, it's not like this life or death like thing where it's like, if you didn't like, you know, right. It's not this like life or death situation where like, you have to, like rely on your family. And you have to, like, keep everything secret, because it's like, if somebody finds out that, like, you're like, I don't know, like, not the religion that they thought or like, right, it's like, then, you know, you could really, yeah, I mean, like, for years and years, you know, it's like, if somebody found out that you were Catholic, like, in, you know, I mean, in a variety of places, you know, like consequences from that. Kira Yakubov:: [41:01] I think it's like, we can make the choice for ourselves. But it's for other cultures, you making the choice for you reflects poorly on the whole family, and impacts the whole family. Emily Shaw:: [41:11] Yeah. Kira Yakubov:: [41:12] And so I think it's hard for a lot of generations, who went through the real, very real valid threats of that, passing that down on to their children now where that's not as severe having a real struggle with like, figuring out that vulnerability and being able to balance like those boundaries, or like, Emily Shaw:: [41:32] yeah, Kira Yakubov:: [41:32] giving unsolicited advice or like, allowing you to trust other people. Emily Shaw:: [41:38] Right? Yeah, definitely. Like, like, yeah, allowing you to trust other people's a big one. Kira Yakubov:: [41:43] Emily, thank you so much for coming back on. If anybody wants to hear more about the ins and outs of what Emily does, on a professional basis, you can check out an earlier episode from season one. But Emily, can you share where people can reach out to you or find you if they want to work with you. Emily Shaw:: [41:59] So right now Iwork at Integrative Psychiatry of Manhattan, so you can reach me at eshaw@psych-nyc.com. That's my email address. Kira Yakubov:: [42:13] Awesome, we'll put that in the show notes for everybody to find you. Emily Shaw:: [42:16] Awesome Kira Yakubov:: [42:17] So, Emily, thank you so much for being on with us today. Emily Shaw:: [42:19] Of course, It was my pleasure. Thanks for having me back. Kira Yakubov:: [42:21] Of course. ### Listen - [Spotify](https://open.spotify.com/episode/13320971) - [Apple Podcasts](https://podcasts.apple.com/podcast/13320971) - [YouTube](https://youtu.be/vi0jK_D2otg) --- ## Support Systems and Relationships: The Importance of Building and Maintaining Connections - URL: https://healyourrootspodcast.com/episodes/support-systems-relationships-building-maintaining-connections - Published: 2023-04-12 - Season 2, Episode 4 - Duration: 44:08 - Category: relationships - Guest: David Koppisch ### Summary Essential guide to understanding and establishing healthy boundaries in relationships, covering practical techniques for setting limits without guilt. ### Description Healthy boundaries are essential for maintaining good mental health and building strong relationships. This episode explores what boundaries are, why they matter, and how to establish and maintain them in various areas of life. ### Transcript David Koppisch:: [0:00] We just want to get back or I just want to get back to where we were. I just want to get back to where we were. And I remember saying this, and I wasn't sure how this was going to land to one of the couples I said, or I said, Well, maybe we should think not about getting back to where you were, that may not be possible, right? You are different people your years of experiences under the bridge, you're in a different place, you could get to it a different place, maybe a better place, a new place, but it's not going to be what it was when you were dating or that first year of marriage for example. Kira Yakubov:: [0:50] Hi, I'm Kira Yakubov, Licensed Marriage and Family Therapist and Founder of Heal Your Roots Wellness practice. Every episode, we talk with a professional from the mental health field to learn more about their approaches and specialties, and also their journey of becoming a therapist. In this podcast, we'll uncover a deeper look at the world of therapy from new perspectives. You'll meet the therapist of Heal Your Roots Wellness practice, and trusted colleagues from the community tackling mental well being or your go to Network for practical and professional insight in mental health. Subscribe for new episode releases every other Wednesday. Thank you so much David Koppisch for being back on. I know we had you in our last season. And I'm really excited to have this new episode with you today. So thanks for taking the time to be with David Koppisch:: [1:41] Absolutely. It's great to be here. Kira Yakubov:: [1:43] Awesome. So I know when we were kind of discussing different topics and ideas to talk about today. I know you mentioned kind of there's been a trend that you've been seeing with your clientele, specifically with men and kind of relationships. Can you share a little bit more about what that's been like for you or kind of the trend that you've been running into recently? David Koppisch:: [2:02] Sure. So first of all, thanks again for having me. This is a pleasure. And it's always great to talk. So I really appreciate being here. Kira Yakubov:: [2:11] Of course David Koppisch:: [2:12] Well, I think that what I've been seeing lately is we'll see you know how much of a trend it is. But what I have been seeing in several clients lately, particularly men who are in relationships, whether they're in marriages, or whether in long term, living together partnerships, domestic partnerships, long term relationships. Several men coming with some challenges around a couple of different categories. One is, and I'd like to get into this a little bit more. One is what I would call struggles with anxious attachment essentially. So I know attachment theory is widely talked about these days, which is great. It does seem helpful to help some clients sort of explain what it is that they're going through, and what it is that they're feeling. And so what I see in some clients, this sort of tendency to be so preoccupied with the relationship, and so anxious around what the status of the relationship is, and a compulsion that they don't want to have a lot of these men they don't, this is not voluntary, but there's a sort of a compulsion around. And it's, I'm speaking particularly right now of heterosexual relationships. So what is what is she feeling? Why hasn't she called back? For example? Why hasn't she responded to my texts? Why do I feel like I'm always initiating and moving towards and I don't feel that there's a lot of initiation coming back to me. And so it's sort of an obsession and a preoccupation with the level of closeness the feelings of closeness to feelings of connection and often never feeling totally satisfied with reaching a level of connection that feels, you know, feel secure, essentially, maybe for short periods of time. And, you know, what, I've been trying to, you know, have conversations with these clients about a couple things. One is just sort of going back, you know, going back to, again, what was it like, in your household growing up? What did you see between your own parents if you live with both parents? What was your relationship with them in terms of your own attachment to them your own sense of security in terms of knowing or not that they were there for you that even if you were separated, you were safe, they are still going to be there for you when you came back, that kind of thing. And a lot of you know, a lot of men, people haven't really thought about that too much like what happened when I was 5 6 7 8 9 10, in terms of how I felt about and how I felt I was parented how that connects to me now that I'm 30 40 50 60, in terms of my relationships, and most of us haven't thought about that. We've been fortunate enough, you know, to sort of be trained in a lot of that. And so now we think about that, but most folks don't go around thinking about that too much. And so it's helping, helping folks. Okay, let's go back to how the way you relate where that came from, you know, sort of going back to that. And I think, you know, a lot of these men, and again, to talking in this case about about men, primarily, I think there's, there's suffering, you know, I think on the surface, and they are often and it's understandable, they're being told by their partners, or their spouses that this is sort of controlling behavior, because I'm sure it feels like controlling when you're getting what feels like, an unnecessary amount of text messages, you know, how are you? Where are you doing where have you been, I thought you'd be home by now, you know? You said we were going to spend some time together tonight at 10. Well, it's now 10:: [6:37] 02. And, you know, like, where are you? Why are you still busy downstairs, while I'm waiting for you in the bedroom kind of thing, you know, that I'm sure is experiences as controlling, right. And so. But what I see in most of these partners is that they're suffering, they don't want to be this way. Like they don't like being, you know, sort of essentially insecure and always feeling like they have to grasp and reach out and be reassured and that kind of thing. So I can get into more specifics. But that's I am seeing some of that and, and trying to, you know, work with with clients to try to figure that out where it comes from. And I have clients who have said, you know, in which is great self awareness right off the bat, it's important to know where this comes from, not just how can I stop. So Kira Yakubov:: [7:37] The way society in our culture shapes the way in heterosexual relationships, how men and women are supposed to act during dating, or even in long term relationships. Like that the man is supposed to be the one that initiates and puts in more effort and like in the beginning, and that if the woman does that it's seen as clingy, right, like these different words and adjectives get placed on different people based on their gender. But it's interesting, because that anxious attachment style or that need to know like, can you please reassure me that you're still here, or that you still care about me? Right? It's more about the narrative. It's like, if I don't hear from you, or if these particular reassuring behaviors aren't present. And if it's a long period of time, then I'm going to start creating a narrative around, well, they may not care about me, what does this mean? Of course, they don't, this always happens to me, maybe I'm being too clingy, I need to figure out what's going on, I'm gonna reach out, right, like, how can I sue this anxiety immediately in this moment? Through the other person? Yeah. And not necessarily through self soothing? David Koppisch:: [8:46] Yeah. And I think some of that reaching out for reassurance for some, if it's done in a certain kind of way, unfortunately, makes things worse, right? If the if it comes across as again, why haven't you called, I thought you were going to be back, et cetera, et cetera. And that could, you know, trigger something from their partner in something like, you know, why don't you trust me, I told you what I was doing, I don't have to give you a minute by minute update. Or I just I, you know, the mood I was in earlier today, I'm in a different mood now. Like, I don't have to explain, I shouldn't have to explain that, you know, and that can, you know, again, those are very understandable kinds of responses, but that can sort of trigger a, you know, a cycle of some ineffective communication because that that can make the the anxious. Other partner, an anxious partner more anxious or more, you know, feeling more more insecure. I think with you know, so one thing that's been that I've been trying to do with some of these clients is to two things. One is sort of Emotionally Focused, and one is a little bit more cognitively focused. So one is, as you just mentioned, sort of okay, what, when you get this thought of, you know, where are they? Or why didn't they want to do something with me tonight? Or why were they not interested in being intimate tonight? Or whatever the thought is, that triggers some anxiety, helping them think about or helping them identify, Okay, what's, what is the feeling underneath that, and as you just mentioned, you know, for many and makes sense, I think that for a lot of them, it's, it's either it's either, it's loneliness, it's feeling like, they're not close, feeling a little isolated, a little abandon. And sort of understanding that first, and then helping them understand or practice a little bit how to convey that in a way to that's not going to, you know, again, come across as either too needy or too clingy. But coming across, as, you know, this, this is what I'm feeling, as opposed to, why are you doing or not doing that thing that I want you to do? Kira Yakubov:: [11:26] Yeah David Koppisch:: [11:27] That can help, you know, that can help. I think for some men, it's sort of helping them understand a little bit more deeply about what what is going on inside of them. That in of itself, even if they don't always convey that is it can be helpful. I think on the cognitive side, it's sort of like, helping them understand, okay, what is your pattern? Does your pattern seem to be a thought that goes to the worst case scenario right away? Right. So you know, if I came home, and my wife, partner, girlfriend, was not as a effusive or excited or affectionate that I was hoping they would be when I got home. If the thought is, oh, they must be mad at me. Right? Or I must have done something wrong. Or, you know, they're losing interest in me, you know, going going to the worst possible scenario and thinking, okay, what are some alternatives there? What are some other alternative interpretations? Right? Could it be that they just, you know, got a text from work that made them upset, and that's where their mind is, and has nothing to do with you, for example, whatever, kind of other alternative, and there are probably millions of alternatives in between, you know, where they're at, that it's nothing to the worst possible scenario, you know, and helping some with some of those cognitive reframings can can be helpful. Kira Yakubov:: [13:17] And I think it's, I'm glad you say that, that it goes to kind of the worst case scenario. And the worst case scenario involves them, right. Like it's in reference to themselves. It's something is happening that I'm interpreting as not positive, it's could be negative, how is this relating to me? Versus this person just is existing doing their David Koppisch:: [13:35] Right thing. They have their own emotions, feelings, right? Like other things happening in their life. And I'm witnessing it and I can check in to see what's going on for them versus how is this going to impact me directly? Right away. That's a really good point. Right. Kira Yakubov:: [13:53] And it's almost like, and it's like we, I mean, I have a very, I had a very anxious attachment style, especially for romantic. Until, you know, I worked through that with my husband, he has a lot more of a secure one, but it would be I'm experiencing anxiety. And so in order to control that anxiety, I want you to do something different so that I stopped feeling this way. But that gives away our control and power right instead, and then we get angry with them why they keep doing this thing versus like, okay, like, I need to figure out why I'm getting so triggered by this behavior. Why am I making it about me? How else can I self soothe myself and then express? Hey, you know, like, when this happens, I feel disconnected from you. And I need more reassurance during moments like that, if you can provide it. David Koppisch:: [14:44] Yeah, Kira Yakubov:: [14:45] and that takes a long, it takes a lot of practice to go through. David Koppisch:: [14:48] Yeah, it does. And I think it does take both. It does take both partners to kind of work on that together. You know, I think one one thing I have seen with some clients who I'm just seeing them and not the them as a couple, but just the one partner that you know, they can certainly do a lot on their own, but there's only so much they can do. You know, and so there is it sounds like with your personal experience, you know, you you were, you had a partner who you could work with and understood that and helped to make some of those adjustments. I think without that, it can be difficult. And when there are partners who are not in the couples, you know, therapy, if they're not in couples therapy, who are understandably frustrated with their partner's behavior, but just sort of waiting for them to change and sort of like, get back to me when you've changed kind of thinking, you know, and again, I get it. And I think that's, that's, that's difficult. I think some of these clients are running into feeling like, well, I feel like I am trying to work on this. And I feel like I am trying to put some tools into place where I'm, you know, it's simple, as, you know, doing some breathing exercises, before I reach out in an anxious way before it before I go to the worst possible conclusion or, you know, not asking lots of what's wrong questions, you seem upset questions, when you realize that that triggers, you know, kind of defensive responses, holding back on those things. But feeling like their partner isn't recognizing that they are doing some work and making some small changes. And that frustrates them. And so they kind of pull back a little bit, you know, so it is challenging, I think, if the other sort of offended partner and again, understandably so. But if they're not kind of on board with, Okay, how are we going to help this person, my partner, my husband, my spouse, to change this, other than just do it on your own and get back to me when you're all fixed kind of thing? Which I don't want to see that, which I'm sure we've all done, at some point to some level, right. So Kira Yakubov:: [17:28] and, you know, it's, it's very important that you say that, right, because we can do individual work. And we can do so much on our own to work on those behaviors. And a relationship is circular, right? Like it is maintained, the dynamic is maintained by both peoples. So a lot of the time, if someone has an anxious attachment style, they may attract or get into a dynamic with someone who has very much an avoidant attachment. which is going to trigger and keep them in this David Koppisch:: [17:56] Right cycle, which I think at this point, a lot of people have heard that right, like anxious and avoidant, or the pursuer and the distancer, and so they're both insecure attachment styles, right? Like, the best scenario is if you have one of those and meet someone who has a secure attachment, right, so that they can help you heal that. But we it's not like everyone's walking around with the sign on their head that says, that kind of attachment style they have. Yeah Kira Yakubov:: [18:23] so it's important to recognize that, like, when we're feeling anxious, we're so in our body and like, everything feels so uncomfortable that we just want it to stop. And we don't think about how this is impacting our partner, and how that's making them feel, right. So if someone has an avoidant attachment style, someone coming towards you and wanting more and more reassurance is horrifying. It's like, well, I don't know how much I can give you. This is more than I even thought I could provide, like, I need to step back, which like, Oh, crap, now they're like, Oh, don't leave. And even more. David Koppisch:: [18:58] Yeah, yeah. It's wouldn't it be nice if we all knew our own and each other's attached style? I think the good news is I think and I think some research bears this out that you know, that people can, you know, people can change, they can certainly learn absolutely skills and ways of being especially if they're working in conjunction with their partner to, you know, to do that, and for their partner to see that this is not a character flaw or an intentional that it's not intentional, right, that they are just being, you know, a nudge on person on purpose kind of thing, learned behavior that comes from somewhere and that probably was, is served a purpose, you know, a survival purpose in some level, right. And It's not meant to be damaging to the relationship, it just is something that does not work anymore, you know, and needs to be adjusted. Kira Yakubov:: [20:12] So I think it is important to recognize where it comes from. And I love that you say that it's a learned behavior that we develop to survive, right. So a lot of times the environment we have growing up was we pick up those signs. So if we live in a household or an environment where one or both parents or someone in the home is easily triggered, they might go off, they might have a temper, or they're very emotional. Or if you do something that they deem unacceptable, and they immediately kind of withhold their affection in love, you start to pick up on other people's behaviors, nonverbal language, nonverbal body, like cues, right? Like, Oh, mom seems a little off today, I better like stay away, right? Like, we started to learn all these different patterns. And it's the patterns that we look at. And if something is different from the usual pattern, it must be something. So I need to go investigate and figure out what it is and repair it and fix it before it gets worse. David Koppisch:: [21:14] Yeah Kira Yakubov:: [21:15] Right. Like, that's our little kid version trying to like, hold the glue together. So things don't fall apart around us. David Koppisch:: [21:21] Yeah, yeah, it's interesting that you mentioned that I am working with a client who they were the person that had to hold it together. They were the sibling who didn't have as many quote unquote, problems as the other siblings. So they were relied upon maybe not explicitly, but by the parents to be the one to not have any problems, because they're dealing with the other siblings problems. So if you can be, you know, quiet and good and perfect, and don't give us any trouble, that's really going to help the family system here, because we have these other troubles on this on this side. And, and now they are realizing that a lot of things were kept inside because of that, right, a lot of things that they were suffering from and couldn't get out and couldn't express, and couldn't share, because they were not, you know, they were told, essentially, their role was to be the one to hold it all together, and the one to, you know, have have their act together, quote, unquote. And so now they are in adult relationships, where they may have entered into those relationships still in that role, you know, and in some ways, that's the sort of almost caretaking. Right, because they don't have the problems, they take care of others who do have the problems kind of kind of roll. But 5 6 7 8 years down the road that realizing I have needs too, and I really want my partner to meet those needs. And I don't want to be the person who I might have been when we met where I didn't have a lot of needs, because that's how I grew up, you know what I mean? So admitting that I'm learning that and being able to talk about that with their partner to say, Look, I am now realizing that I do need some things where I may have appeared to you when we first got together that I didn't have needs, quote, unquote. And that requires an adjustment. Yeah. Kira Yakubov:: [23:38] Which is wild to think about, right that even from a young age, we learn that like, I may actually have them, right, everyone has those needs, but I can't get them met because of what else is happening at home. So for the greater good, I need to figure out how to deal with it on my own. And they do and so in a lot of ways that can benefit them, right. I mean, a lot of independent people and that are very successful, like they've had to do a lot of this stuff on their own, you know, carry that burden. And so on one hand like, they're very resilient human beings. And on the other hand, they're really suffering alone, and wanting that help, but kind of feeling scared. And I imagine and correct me if I'm wrong, but like, especially for heterosexual relationships, if the man has been in that position, where I'm strong, resilient want, I can take anything, take care of everybody else. And then five years down the line, that relationship is like, hey, I want to soften up I need help. David Koppisch:: [24:35] Yeah Kira Yakubov:: [24:35] and the partners saw them in this way. It's like, oh, things are a little shaky right now. Like I thought you were the one together for us now. I gotta take the David Koppisch:: [24:44] Yeah, Kira Yakubov:: [24:45] pass the baton to me. David Koppisch:: [24:47] Yeah, that's, that's I'm glad you brought that up. That's I have seen that a little bit in terms of couples where that had been the pattern right in their relationship were one and sometimes often it is the male, who has been the sort of, quote person who had it all together. And then all of a sudden, they begin to realize, you know, I don't have it all together, and I have been pretending I've had it all together. And now I, I'm, you know, that you're right, it can, it can be a little shocking to the system, if they were in a, you know, a pattern of being in certain roles. And then sometimes what could happen is, sort of, well, wait a minute, I does this mean, that my needs, if you now are going to be expressing needs, does that mean, my needs are going to be now in the backburner or something you know, and it becomes a little bit of a, like a zero sum game, sometimes with couples, it's like, if one has a need than the other one can't have a need, or that it's on, it has to be put to the side for a while that they both can't, they don't feel sometimes that they have the capacity to both Express and have and deal with needs, it's sort of like, oh, boy, if I now if you're requiring me to sort of attend to you emotionally, I feel like I'm might lose, I might lose something, you know, I might lose what I have been getting from you. So I think it's how it's helping couples think about it's not, it's not either, or, it's not sort of like a scale, that if you put a little bit of weight on one side, and the other side goes, goes, you know, goes up. And I think that's a protective thing, you know, because I think we're all that many of us have a sort of scarcity, like an emotional scarcity mentality, like there isn't enough in the in the relationship for everyone to kind of get their needs met, kind of thing. So I'm Kira Yakubov:: [27:02] Sure David Koppisch:: [27:02] I remember what else I was going to touch on earlier, which was, um, I think this came up in our last conversation around seeing a little bit of a thread a theme in some of the clients I'm I am seeing who are who are males who are in these long term relationships, where this anxious attachment kind of experience is causing some tensions. There's a real lack among some of them in terms of anything meaningful, outside of their relationship with their partner. And it sounds so simple, like, you know, hobbies or, or the relationships or, you know, but it's, it's so it's so it's so clear, with some of them that, not that, you know, getting a hobby, or going out with a friend every other week is going to magically reduce your anxious attachment. But there really is something to that. I'm seeing with some men who when I do ask, so at nights, on the weekends, when you are feeling like you're not getting the kind of response or attention or closeness or interaction or engagement from your partner, and you're feeling anxious and disconnected, and but they seem fine and doing what they do. You know, what do you do? And often the answer is, I don't, I don't know. Like, I don't, I don't know, I sort of, I'm nervous, and I am sort of waiting around for them to kind of turn to me, physically and emotionally. And, okay, you know, what else can you do when you sense when you come home at night? They're not in a place to like, give you lots of attention. What else can you do to occupy yourself, you know, and just sort of working like on some very basic things like how do you spend your time outside of this relationship? So simple, but so important, you know, and I think it's become popular now. It's a very funny Saturday Night Live skit about the man Park Do you notice and so, the man is home all day, and his female partner comes home from work and he has interacted with nobody throughout the day and has been home all alone and so he acts towards her like a puppy would win the puppy spent all day alone. And the spouse the partner, the girlfriend is pretty frustrated with this that she has to be his all. So she takes him to the man park where he can interact with men and socialize And it's pretty funny. But I think it does hit on something that in our culture we do see is, you know, a bit of a of a thing that's happening, you know. So it's a humorous way to kind of talk about it with some, some clients actually. So Kira Yakubov:: [30:21] and you know, that's true. And I know we're talking about it specifically for men, but I mean, obviously, that can happen in any relationship, like, whichever person is, you know, needing more of that or doesn't have as many outside supports, right? Like, I know, for female relationships, a lot of times we, you know, we talk to our girlfriends, like, Oh, my God, this is happening, what should I do? And they talk you off the ledge, they're like, alright, chill, you're being little too much text me if you start to feel anxious, right? Like, I've had clients where it's like, what can I do, instead of hyper focusing on wanting to reach out to my partner, this new person I'm dating, okay, is redirect your energy, and have someone that you can be vulnerable and that you feel safe with to say, like, I'm feeling triggered, I want to express it over here. Even journaling. David Koppisch:: [31:08] Yeah. Kira Yakubov:: [31:09] Right. But I'm curious, especially for some of your male clients, that are still learning to develop those hobbies or other relationships, like do they have someone to turn to? Right to either occupy themselves or to get advice? Or just to like, help them like vent and process and like, cool David Koppisch:: [31:25] Yeah. Some do. You know, and some need some down? help thinking about what that would look like. Yeah, so it's, it is it is a mix. I think it's also for some maybe, feeling like they don't deserve to have that time, like, separate, I think there's a sort of a mix of like, I don't feel like I have another outlet. But I also feel maybe guilty if I do. Use an outlet that's outside of this relationship, because maybe I'm not sure if that's allowed, or if that's what they want me to do, kind of thing. And usually it is usually it is that, that spouses and partners are happy if they're, if their partner, you know, has some Kira Yakubov:: [32:25] that's really sweet go talk to someone David Koppisch:: [32:25] social energy directed somewhere else. And, yeah you know, and then bringing in children, so I am working with Kira Yakubov:: [32:30] And you know, what's interesting to think some couples with little children, right, and it's just about, especially when for couples therapy, when couples so hard. And if there's no family support, or other kinds come in it's, especially if they're stuck in conflict, or in of social supports, these families are these couples are so isolated, and under so much pressure, right, they have a one year old, they have a two year old and there's no family around to help relieve any of the pressure. And so you know, they work, and then they come home, and they take care of their toddler, and then they go to bed, and then they get work and then go home and take care of their toddler and then they go to bed. And this, and this one couple, I've been encouraging them, particularly the male in this couple, because the woman does seem to have a little bit more impetus to to engage socially outside of the of the relationship, but encouraging him to do so. And I just remember this one session where he came in and he said, You know, I've got some exciting news, you know, I I think it was like I met, I met another dad, you know, in the, in the park in the playground when I had my kid. And we actually made a date to meet for coffee. And, and he said it was great, you know, and he was so excited. And it was just it like it's lifted his spirit and it sort of opened up like oh, yeah, like, there is other world and we didn't, you know, being out for 90 minutes while I had coffee with a friend. I think I think his spouse, his partner, watch the baby while he was like it didn't. It didn't destroy them, you know, which they thought it might because they were so again, because they don't have supports. It's like, well, if one person's out of the house, that means the other is watching the child. And after a week of you know, 40 50 hours of work and you know, 20 25 hours of childcare and then on the weekend you're gonna be alone watching your child when your partner's out having coffee, you know, that can that feels like it can cause some tension but, but she was also so excited that he had done that and she was like, This is great. He came this way is that they're looking only from their own perspective back he was in such a good mood and it just sort of changed the course of their weekend, you know for that very little but really critical social outlet that he was able to make happen, you know, so and what they need will be good for them, and what their other partner can do differently to make that happen, versus what would benefit the relationship. David Koppisch:: [35:21] Yeah. Right. Kira Yakubov:: [35:22] And sometimes that does mean what is going to be better for one individual so that the relationship and the connection can be healthy and continue growing. And, you know, that means creating space for a different kind of relationship. David Koppisch:: [35:38] Yeah Kira Yakubov:: [35:38] I know, when we were talking about different things to discuss, but that as we grow, we change as individuals, which means that if we want to continue being in this partnership, our relationship has to grow and shift and change and like morph into something new and different. And if one person or both people aren't on board for that new change, it's going to be really, really tough to to accept this new version of their relationship. David Koppisch:: [36:08] things like, we just want to get back, or I just want to get back to where we were, I just want to get back to where we were. And I remember saying this, and I wasn't sure how this was going to land to one of the couples, I said, Yeah, I said, Well, you know, maybe we should think not about getting back to where you were, that may not be possible, right? You are different people your years of, of experiences under the bridge, you're in a different place. You could get to a different place, maybe a better place, a new place. But it's not going to be what it was when you were dating, or that first year of marriage for example. And so to your point of sort of, like growing and changing, and we're different people, as we grow, we should be growing, we should be changing, can we do that together? Can we get to a new place, you know, the relationship. So this sense of like, I just want to go back, I just want to feel that being in love like we did five years ago. I think there's a little bit of maybe like, and that's totally natural, right. But it's maybe a little bit of like mourning that if it's not there now, but saying, but that doesn't mean you can't get to a new place that may be better than you thought you could ever be, you know, thinking about going backwards? I just I just feel like it's not a it just doesn't feel productive. You know? Kira Yakubov:: [37:49] Yeah. David Koppisch:: [37:50] But to acknowledge that that could that could be set. Yeah, Kira Yakubov:: [37:52] absolutely. And I love that you said morning, because I hear that a lot from couples David Koppisch:: [37:57] you do? Kira Yakubov:: [37:58] Like, I wish we can just go back to the beginning. Why can't it just be like how it was? And when I hear that it's like, oh, they're more like they're grieving. They're grieving that, that version of their relationship, that version of their partner that version of themselves. And, you know, it's like reminiscing wanting to go back to the good old days. But when we're there, we don't recognize it. Right. David Koppisch:: [38:21] Like, or we think it'll last forever. And this is standard or something Yeah, yeah. Kira Yakubov:: [38:26] Yeah, so I think grieving that is, is huge. Now, I think that's talked about a lot. I think we see grieving as, you know, like big losses, like losses up like a death a job, like moving somewhere, like very tangible things, versus grieving like a version of ourselves or our relationship. And knowing like, it's okay to miss that. And it's okay to cherish those memories and that connection, and making sure we create enough space for this new version of ourselves and our partner so we can continue growing. David Koppisch:: [39:00] Yeah. Kira Yakubov:: [39:01] Because if we stay stuck in wanting to go back, then it's just resisting change. Right? And we know that anytime we resist change, it's, it's futile, because it's gonna keep going around us. We're just going to have to catch up to it. David Koppisch:: [39:14] Right. Yeah. And then exploring Well, what is that about? Right? What is making us want to preserve a state of being that might be four or five, 6 10 20 years old? What is that about? You know, what, what are we fearing? I know we're coming up against some time, but I just wanted to mention you had asked about so what are some tools? What are some ways that couples can sort of grapple with these kinds of things? One thing that I've been using a lot lately, which seems to be pretty helpful, I know it's a pretty popular book. It's the Seven Principles for Making Marriage Work, which is from the Gottman research on couples and there are some exercises in that book that I do assign to some couples that are some of them are fun. And so that in and of itself kind of helps if there's tension to sort of gives them something fun to do there are these love map exercises where they sort of quiz each other on how well they actually do know each other, you know? And I think, not that. And there's, there's a lot of exercises in there. And some some are, you know, deeper and more more, a little bit require a little bit more vulnerability than sort of like how well do you know your partner, but they can be really helpful with I've seen with some couples in a sort of reconnecting, right? Oh, yeah, we do actually have a lot in common kind of thing. Oh, yeah, we do really have a story of our relationship that's exciting and fun, and is meaningful to me like that we have forgotten because we've been in tension. And it can, you know, and it can help them off sort of figure out okay, can we do we want to move forward kind of thing? Are some of the things we're identifying in some of these exercises, maybe things that we can't resolve? You know, so I do recommend that, that book and those exercises. Kira Yakubov:: [41:23] So, yeah, I love that. And I was, I was brushing up on on that book, and like the Gottman research, and for the listeners, we've talked about Gottman before, but that him and his wife have done a lot of research with 1000s and 1000s of couples, taping them have conflict and being able to use that data and see, you know, within the first five minutes, they can predict if this couple is going to make it or not, which is wild to think about David Koppisch:: [41:52] it's a little scary. Kira Yakubov:: [41:55] I know. But what was really interesting is remembering back is that they wrote 69% of conflict is perpetual and not resolvable. And that that is totally normal. And okay. And that it's not necessarily that happy couples don't fight, or they don't have these perpetual problems, it's rather, a they have a lot more positive interactions and perspective of their relationship, but also that they've found a way to accept that this is going to be a part of my life, right? It said, like, can you accept these differences? Or these flaws in your partner forever? Right? Because some of this stuff is like it, you know, we can modify how we interact with each other, we can do this, this and that. But like, at the end of the day, like, can I deal with my partner having this? Is this the deal breaker? And if it's no, then it's okay. Like, I gotta choose my battles, got to figure out how to, you know, come down from arguments, but that a lot of this is going to be unresolved, unfortunately. David Koppisch:: [43:02] Yeah, no, that is, that's a pretty amazing statistic. And it's, it's, um, I think it is helpful for for some couples, a lot of couples for them to realize that and it's that maybe it takes some pressure off, that we have to fix all these these things like no, you don't, you don't have to, it's, it's, it's okay, like, you will let you're two different people, you will need to live with some differences, you know, accepting them and not worrying about, oh, we must fix these otherwise, maybe we're not meant to be together. Which is not, you know, which is not realistic. It just reminds me of the, you know, the phrase of you could either be married or you could be right. And which oversimplifies things but there's a lot to be said about that, you know, in terms of letting go of stuff strike some of that sort of keeping score, and some of that fixating on, on some differences that really are not that consequential if you look at the bigger picture. So helping helping clients see that. So Kira Yakubov:: [44:18] yeah, and sometimes the best thing we can do is agree to disagree. Right? Like, I know, it's easier said than done, but no matter I mean, there will be situations, right where if you can verbalize in an effective way and your partner's in the space to hear it and receive it, they can validate that and they can understand it and then there's other times where no matter how much each of you share it, you're just not gonna get it. And that's okay. And it's just like, okay, like, we're just going to respect this difference. And just let it be there. Like we don't have to keep digging at it. Unless it's like, you know, a big decision we have to make like it's imminent happening right now versus like an ideology or an experience. David Koppisch:: [44:59] Yeah. Kira Yakubov:: [45:00] We're just gonna have to let it lie there for some time. David Koppisch:: [45:02] Yeah, there's something else in that book that's really strikes me, which is it's about these unresolvable differences, which is, in their research and their experience, the Gottman's, that partners don't generally change or respond to the thing that their, their partner is asking them to change, or just or, you know, be different on, if they don't feel understood. So sometimes requests are made, you know, about change your behavior, whether it's something as small, as you know, emptying the dishwasher a certain way, or something bigger about relating to, you know, and parenting styles or something like that, that if the partner who's being asked to change or stop a behavior or change, you know, a trait or something, if they don't feel understood in terms of why they do act that way. They are not going to change, like they're not, they're not interested, they're maybe not able to change. And so first, is understanding the partner, before any bid to ask them to adjust themselves can happen effectively. I think that's really interesting. And I see truth in that. So Kira Yakubov:: [46:21] Absolutely. And I saw that it was, I mean, some of these like numbers and statistics are nuts, but it was, if you feel like you cannot influence your partner, David Koppisch:: [46:32] yes Kira Yakubov:: [46:33] then what is like 81% of the time the relationship is doomed, if it like is persists, right? And it's kind of like, what you're saying is if you if what I'm sharing doesn't make a difference, or doesn't impact your behavior, you don't take it into consideration. This is where it becomes you versus me. And less of like, okay, obviously, I don't want you to feel that way. And this is what's been going on. So let's negotiate and you do it more in good faith, right? Like, when you're in good standing with somebody, it's easier to compromise and negotiate versus, well, you don't understand me, you don't care to understand me. So why would I reach out with the same consideration to you, and it might not be conscious, but, you know, internally, we have that stubborn protective side to ourselves like, well, if you're not going to go half the mile, I'm not going to go half the mile. David Koppisch:: [47:23] a lot of protection, a lot of self protection, a lot of Yeah, if I make a step towards you, does that mean I'm losing in some way kind of thing, you know, so I want you to take the first step towards me, kind of dynamic. So Kira Yakubov:: [47:44] sure, David Koppisch:: [47:44] The other thing I just wanted to mention was something I'm seeing with some a lot of a lot of clients and getting males mostly middle aged and younger, you know, young adult, is this. There's a real urgent a sense of urgency around their role as provider. And, you know, traditionally that is, that's obviously been, you know, a role and identity of a lot of a lot of men and marriages and relationships being sort of the financial provider, that kind of thing. Um, it's, it's still, it's still a pretty strong, you know, thread and theme I'm seeing with a lot of men and their anxiety around. You know, if I don't do my job perfectly, I might lose my job, kind of thing. And when asked about like, Well, is there something actually happening at your job? Is there? Did you get, you know, bad review? Are there layoffs, things like that, and often there isn't. But there is this anxiety around that. And I'm curious, I'm not really sure what that's about, I don't know, if it's sort of something related to the pandemic, something related to fears now in the air of, you know, are we moving towards a recession or, you know, that sort of, there's something happening with a lot of men who are seem to be experiencing this sort of anxiety. And I think that also might relate to I don't know what else I have, if that's what I am in this relationship. If something happens with my job, what does that mean for me? I had one client talk about if he loses his he did there was something about layoffs in his company or something like that. And he said, how embarrassing that would be for me, how embarrassing that would be and I just tried to validate that but also say, Well, look, you know, you just opened the headlines and I think I saw the other day something like it was Microsoft or something announces 12,000 layoffs, you know, around the world. It's sort of like, yeah, that's nothing to be embarrassed about like this is beyond your control. It sounds like in this particular incident, but it was really sort of like, I don't know how I could bear that. I don't know how I could talk about that if this happens to me, and it is sort of helping them understand, like, this happens, it happens to people all the time. You know, I was laid off last year. And yeah, it was a shocker. But it was also like, I didn't do any thing wrong in this situation like, this was beyond me. And it was hard at first. It was humbling. And then it was like, oh, maybe this is an opportunity for something new. And so I think there's a lot of, you know, for many folks of all kinds, but to start, I do see this in some men who are in, you know, either marriages or long term partnerships, where there's some anxiety around this provider role and fearing, if that gets, if that's shaky. What does that mean for me? Kira Yakubov:: [51:01] Sure. I mean, it touches on so many parts of our life and aspects, right, like, not just internally of like the identity or this particular role that this person has taken on, like what they provide in the relationship, but like, what are the consequences now, financially and relationally? Like, is my I mean, I've heard clients say, this is my partner still gonna find me attractive, like, I don't feel like a man I won't be able to perform in bed, like a lot of this has come up is that it's so much in intertwined with their manhood. And their female partners are like, I still love you. I care about you. I don't see you in any different way. I mean, sure, we have to figure out different financial source, but we're a team to do that. This isn't like your whole being. David Koppisch:: [51:45] Yeah. Kira Yakubov:: [51:45] And I think it's tough to separate those, right? Because first, it's the shock. And then, you know, try, it's the Stages of Grief within that. But also, once we get through that, as, like you're saying is that it really does open our opportunities to so many things that we would not have ever imagined because the circumstances were never like that before. David Koppisch:: [52:05] Yeah. Yeah. And it is scary. I mean, I don't Kira Yakubov:: [52:06] Yeah. I feel like we could keep talking for hours. want to minimize that. But I do feel like some clients are carrying a burden in that, that maybe they don't have to, or that they don't have to alone for sure. For sure. But and to have the conversation that you just said about, you know, if you are in a good relationship that can be should be a source of getting through this in a way that's not going to sort of threaten your identity existentially and kind of kind of thing. But in terms of the attraction, you know, I, I was working with a client who did go through a period of unemployment and medical issues, and was really just a couple of really bad years where they're incapacitated in terms of not being able to work and provide and even just be physically able to do things in the house because of a health issue. And I know that. We're covered a lot of good stuff. feeling like I am no longer attract, like you said, I'm no longer attractive, because now I'm an I'm a needy, I'm dependent kind of thing. And, and really, and taking a long time to work, work through that and work out of that. To again, accept like, these were things beyond my control. Your partner is there for you. This is not you know, you are not flawed as a human being because these things happen, you know, but there's yeah, there's a lot of shame, I guess, in terms of feeling dependent for a lot of us for of course, yeah. David Koppisch:: [53:58] We'll do it again Kira Yakubov:: [54:08] Absolutely. So David, any any final notes or thoughts you want to share before we kind of close out this episode? David Koppisch:: [54:18] Just thank you appreciate this conversation. I learn from these conversations. I appreciate it. And I hope folks who are listening find these helpful and hope folks will reach out if they you know do want to learn more and are seeking some help. we invite you to reach out. Kira Yakubov:: [54:39] Awesome, thank you so much for being on David. And if anyone is interested with working with David whether it's an individual or a couple you can head over to our website at healyourrootswellness.com schedule a free consultation and we'll see if it's a good fit. ### Listen - [Spotify](https://open.spotify.com/episode/13257413) - [Apple Podcasts](https://podcasts.apple.com/podcast/13257413) - [YouTube](https://youtu.be/0WvMjNKIKiI) --- ## Perinatal Mental Health: Overcoming Shame and Seeking Help - URL: https://healyourrootspodcast.com/episodes/perinatal-mental-health-overcoming-shame-seeking-help - Published: 2023-03-29 - Season 2, Episode 3 - Duration: 50:44 - Category: trauma - Guest: Nicole Bolognini ### Summary Introduction to trauma-informed care, exploring how traumatic experiences affect mental health and relationships, with principles for healing and support. ### Description Trauma is more common than many people realize, and its effects can be far-reaching. This episode introduces the concept of trauma-informed care and explores how traumatic experiences shape our mental health, relationships, and daily lives. Discover the principles of trauma-informed healing and learn how understanding trauma can improve both personal recovery and how we support others. ### Transcript Nicole Bolognini:: [0:00] There's a lot of belief for mothers around having to never complain, to always be grateful and always be thankful and a lot of shame around any struggle in the pregnancy experience to getting pregnant being pregnant postpartum parenting stuff, there's so much shame and there's so much hesitation to ask for help. So a lot of times, they see people coming in who probably needed help six months or a year ago, but they weren't gonna get through it in one way or another. Kira Yakubov:: [0:29] Before we get started, we want to issue a trigger warning. Today's episode includes a discussion of postpartum mood issues, which may include thoughts of harming oneself or others as well as discussion of miscarriage. We understand that these topics can be difficult to hear for some listeners, and we want to make sure everyone is aware before continuing. It's important to have open and honest conversations about maternal mental health and pregnancy loss. And we also want to prioritize the well being of our audience. If you or someone you know is experiencing postpartum mood issues, or has experienced a miscarriage, please know that you're not alone. Help is available and seeking support is a sign of strength. The National Suicide Prevention Lifeline is available 24/7 At 1-800 273 talk, and resources for pregnancy loss support can be found in the show notes. We encourage your listeners to prioritize their own mental health and to seek help if needed. Thank you for listening. Hi, I'm Kira Yakubov Licensed Marriage and Family Therapist and founder of Heal Your Roots Wellness practice. Every episode, we talk with a professional from the mental health field to learn more about their approaches and specialties. And also their journey of becoming a therapist. In this podcast will uncover a deeper look at the world of therapy from new perspectives. You'll meet the therapist of Heal Your Roots Wellness practice, and trusted colleagues from the community tackling mental well being or your go to Network for practical and professional insight in mental health. Subscribe for new episode releases every other Wednesday. So I'd like to welcome Nicole Bollini as our guest today she's a licensed clinical social worker and owner of Skylands wellness practice that focuses on family building yours. So Nicole, thank you so much for being on today. Nicole Bolognini:: [2:27] Thanks for having me. Absolutely. Kira Yakubov:: [2:30] So I like to start all the episodes with really getting to know the therapist and your journey of becoming a therapist. If you can kind of walk us through how did you become a therapist, what made you want to go into this field, Nicole Bolognini:: [2:42] I became a social worker in 2006. I got my master's. And I think I initially went into social work because I wanted to help people. And then as you're studying and learning more about the things you can do, that's sort of how I ended up being a therapist. I worked for a long time with families in crisis and in nonprofit families involved with child welfare. I ended up working for a number of years in a residential treatment center. And so I kind of developed a niche around attachment wounds and family issues and family relationship there. Kira Yakubov:: [3:14] And so what do you focus on now cuz I know you have a lot of specialties, but kind of covers everything in terms of like family planning and different life stages. Nicole Bolognini:: [3:24] So now I focus mostly on perinatal mental health, so pregnancy, postpartum period, and those attachment relationships and parenting issues. I took my experience with attachment and family issues and kind of shifted my focus more toward the caretakers and the parents and those relationships. And so that's generally where I focus now. Kira Yakubov:: [3:45] Awesome. And so is that something that like the rest of your practice focus on, I know, you have several therapists that your practice as well. Nicole Bolognini:: [3:52] So if two other therapists Jessica has a lot of experience with children and adolescents, she works in a school setting during the day, she also has that family therapy background, which is really helpful anytime you're working on relationships. And then Jamie, in my practice, has some DBT training. So she does a lot of work with people on mood issues, life transitions, managing stress, and she also really enjoys working with the perinatal population. Kira Yakubov:: [4:22] Wonderful. So I know you're based in New Jersey, right? We also see clients in Pennsylvania telehealth, Nicole Bolognini:: [4:27] yes, so we're based in New Jersey, I have a license in Pennsylvania. So I can see people via telehealth and we're located relatively close to Pennsylvania so that there are some people of course that travel back and forth for work and will see us in the office at times too. Kira Yakubov:: [4:42] So super convenient for everybody close by in the tri state area. Right? So can you kind of share a little bit of what you see when it comes to postpartum or perinatal, like the most common things that you see whether it's if it's an individual or a couple or family coming in that you work with? Nicole Bolognini:: [4:58] Yeah, so postpartum is issues are commonly depression, anxiety, a lot of birth trauma, which people often will say to me, my birth really wasn't that traumatic but and then they'll tell me all the traumatic things that happened to them. There's a lot of belief for mothers around having to never complain, to always be grateful and always be thankful and a lot of shame around any struggle in the pregnancy experience to getting pregnant being pregnant postpartum parenting stuff, there's so much shame, and there's so much hesitation to ask for help. So a lot of times, they see people coming in who probably needed help six months or a year ago, but they weren't gonna get through it in one way or another. And you also hear a lot about, like you'll hear on social media about postpartum rage. Postpartum rage is usually anxiety, depression, but when you can't lay in bed all day, or you can't cope with your anxiety in ways that would normally be comfortable for you, because you have all these demands, you end up feeling a lot of rage and a lot of irritability and a lot of resentment that other people are getting to rest and you don't get to rest. Kira Yakubov:: [6:06] Yeah, I can imagine, right? I mean, it's kind of feeling like in different circumstance, like just feeling burnt out and not having the space for time to release it. So it does come out as anger and resentment. Plus, you have a little child who is literally relying on you for everything. And if you have a partner not have a partner, depending on the circumstances, that's, that's really heavy to be dealing with, Nicole Bolognini:: [6:27] right. And oftentimes, there's like, I love this kid and I, but they're also driving me crazy. And it's sitting with mixed emotions, right? Or I want to enjoy being a mother. But I also hate this aspect of it. And that can just bring up that intensity of the emotion that can come out as irritability and rage and frustration. Kira Yakubov:: [6:47] And so I know that there are a lot of myths and a lot of misconceptions about postpartum are there something that you see most frequently around that that you would like the audience members to hear, or just people to know. So they have that information and insight. Nicole Bolognini:: [7:01] So one of the main things that I think causes women to hesitate to get help is this fear that people are going to think she wants to harm her child, because the sort of awful news stories about women who do harm their children. And I'm not saying that that never happened, but that is generally not the rule. Most women who are dealing with depression, anxiety, those beliefs are what we call ego dystonic. Right? They don't feel right to them. So it's like I have this intrusive thought about tripping while I hold the baby or I have this intrusive thought that I don't wash the bottle well enough, it's something bad happens to the baby. And I hate that thought I don't like that thought. That's generally what you see when you see postpartum depression, postpartum anxiety, sometimes, on very rare occasions, there is postpartum psychosis. It's extremely rare. It's not something we see commonly, it's something we have to take seriously. And in the case of postpartum psychosis, sometimes you will see women who think that they need to harm their child. But this is really not the norm. And so as professionals, we have a responsibility not to go into like panic mode and call child welfare, if we have a woman who says she's depressed, and she gets these intrusive thoughts about something bad happening to her baby, because most likely, she will be the first one to protect that baby, and wants the best for that baby, and won't get help or won't continue to seek help if she feels like there's any threat to that relationship. Kira Yakubov:: [8:24] Okay, so there's a lot of stigma around that. Where do you think that comes from? Is that some of these rare cases that are like on the news that make it feel like it's like it's happening a lot more than it actually is? Nicole Bolognini:: [8:35] Yeah, I think those kinds of cases get a lot of coverage in the news. Women who harm their children make for a really interesting story, because it feels so strange to most of us, right? Like most of us wouldn't want to harm our children and can't quite understand it. And so there's a lot of curiosity when something like that happens, in all honesty, even in the cases where women do harm their children, if there is postpartum psychosis. They also don't want to harm their children. But they're at a psychotic episode. And so they're not able to think clearly and make clear decision. But I really do think the media coverage, it's not, it's not too interesting to talk about women that are just depressed, and that are sort of trudging through the day. It's not going to get a lot of Watchers or you know, a lot of attention if we talk about those stories, but that's kind of the norm. It's more common to have the postpartum anxiety to just struggle with. I can't let other people hold the baby. I can't leave the house. I don't know how to handle things. I feel overwhelmed. I want to hurt myself. That's a more common concern is that women feel so hopeless about how they feel that they think their children are better off without them there. That's where we really want to make sure we're intervening as early as possible because there's just no need to suffer that way. Kira Yakubov:: [9:50] And that sounds really hard. That sounds really sad and painful to think that your children or your family better off without you Since you're feeling so anxious or depressed or you can't be as present As you feel like you should be, Nicole Bolognini:: [10:01] yeah. And oftentimes, it's really scary to the woman experiencing that to that they're like I I've never thought this way before, I've never had these kinds of thoughts. I don't understand why I'm, I don't feel like myself anymore. Anytime somebody tells you, they don't feel like themselves after the birth of a child or the adoption of a child, it's a good idea to think about screening a little more closely for postpartum depression, postpartum anxiety, or trauma. Kira Yakubov:: [10:26] Yeah. And so I know you mentioned that some of these like traumatic birth experiences, and I don't honestly want to scare people listening, but it's part of the reality for a lot of women that experienced this. I know, you mentioned that they don't even recognize that it was traumatic. But as a, you know, trained professional, you can pick up on that. And so would you feel comfortable sharing a little bit like what would make a traumatic birth experience or what has happened to some women that have some of those symptoms, or things come up after the fact, Nicole Bolognini:: [10:55] anytime, your life or safety or your child's life or safety feels threatened, we can have a pretty significant trauma response. And that can happen often in the birthing experience, not only because we can have real threats to life or safety, but because oftentimes, the focus is on getting that baby out safely. And not on explaining to the mother what's really going on. We all have heard horror stories around birth, there are of course, lots and lots of births that are not horrible, and that are wonderful. Those people are not coming to me for services for trauma, because things were fine. They might come for other reasons. But a lot of times when women come in having had a blood transfusion forceps used in birth, or you know, extremely long, extremely painful labor. They'll say to me, I know, I know, it's not that bad, though. I know people have it way worse. And I will say, well, it is though, right? Like we labor for 36 hours, even if you didn't think you were gonna die, it feels like you're gonna die in that moment. It does not feel like you can go on. And a lot of times that I think the medical community can be dismissive of women like this is normal. This is what happens with all kinds of births. And so there's a lack of comfort, having a nurse in the room that can just explain what's happening, can so effectively mitigate the potential traumatic effects of birth. You know, sometimes nurses come in, and they really save the day, because they're like, Let me hold your hand and tell you what's happening here. But a lot of women don't have that experience. And they sort of feel like, Is the doctor gonna make it in time? Or am I going to, you know, feel every ounce of this pain when I have an epidural, these sorts of experiences can be traumatic for women. Kira Yakubov:: [12:35] Yeah, I can only imagine. I mean, this is a crazy event, right? I mean, it's normal, because we've been doing this since the beginning of time, but to not feel like you're in control of that process or to not have all the information. It's kind of just happening to you. And at that moment. Sounds horrifying. Nicole Bolognini:: [12:51] Yeah. Well, and that lack of control is what makes it more likely to be a traumatic experience, right? Yeah, the same sort of things. As we think about other traumas, what's scary about them is we have no control, we can't protect ourselves. And so when we go into the birthing experience, we have no idea how it's gonna go. And for some women, it goes very, very smoothly, or we have great providers who get us through those difficult spots and make sure we feel safe. And for a lot of women, that just isn't the case. Unfortunately, in the US, we have a high cesarean rate, we have a lot of mortality around birth. And so we know that birth here in the US is not what it could be for women. And sometimes women go in already fearful around what to expect if they've never seen a birth, which most of us haven't, until we can birth ourselves, they don't really know what to expect, right? Kira Yakubov:: [13:38] Why do you think that the medical professionals maybe don't explain as much or they're not as well prepared for some of these births, or these situations for women to know ahead of time? Nicole Bolognini:: [13:48] You know, I think some of it is, you know, they have a job to do, which is to protect life and safety and to get that being safely and there isn't time to explain things. I think some of it can be complacency. They've done it a million times, multiple times a day for many, many years. And they can you know, we as mental health professionals can get complacent too, and forget to explain things. Sometimes. We can just forget that this is the first time this person has done this, even though I've done it 9000 times before, I think we have a medical system that focuses on getting the baby here, but maybe not always on the well being of the mother. And I think this is true postpartum too, right. We have baby friendly hospitals, they're not Mother and Baby Friendly Hospital. That's not the term we're using. And women that sometimes feel like they have to keep the baby in the room with them and they have to nurse and they have to and even if these things aren't working for them personally, they will push themselves to continue because of the messages they get. Okay. Kira Yakubov:: [14:45] I appreciate that. That makes a lot of sense. And so I know for a lot of this postpartum you mentioned that there's postpartum depression, anxiety, rarely psychosis. Is there also OCD and things like that that come up maybe afterwards that they may have never experienced? Before that this is like a new way of processing and viewing the world around them. Nicole Bolognini:: [15:05] Postpartum OCD is fairly common, more common than people realize that having a baby can trigger OCD or it can worsen an existing sort of mild OCD or anxiety you might have had OCD is on that anxiety spectrum. But we see women who compulsively do things like make sure the baby is breathing. And that can feel again, really like you should be doing it right. Of course, you want your baby to be breathing, that's really important. But if you can't sleep at night, because you're checking to make sure the baby's breathing, now, we may have crossed that line into obsessive compulsive behavior, I can't sleep I check it the baby's breathing, I relax a little bit. 10 minutes later, I'm anxious again. And they check again, we can have OCD around cleaning, we can have OCD around avoidance, right, I'm not going to get in the car and drive to baby, I have to check all the tires, I've got to make sure the car seats installed properly, right? Going through these sort of checking behaviors can become really, really distressing for women. Kira Yakubov:: [16:02] Yeah, absolutely. I mean, I don't have any children, I can only imagine where like I've babysat. And I've seen other kids. And it's like every movement that they make you have all these scenarios in your mind that play out how horribly could go. And so having that in your body of that fear constantly takes a toll on anybody dealing with that constantly. Nicole Bolognini:: [16:21] Right? And that's what can make it hard to know whether this is really a mental illness because it feels like I shouldn't be anxious about my kids, I shouldn't be checking things. And if I don't, am I a bad mother. And we can almost not want to let go of that obsessive thinking that compulsive behavior or even just general anxiety, we don't maybe don't want to let go of it. Because it feels like we need to do that to keep that baby. And so that's another reason why a lot of women I don't think it helps right away, because it feels like, No, this is what I should be feeling. I've never had a kid before, but I'm pretty sure I'm supposed to be super, super protective. And then a lot of times, that's when they say, Well, what are the other people that love you and care about you saying, right? Like, if your partner is saying, No, I really think you're maybe a little more anxious, right, or you're checking a little more than you need to or you don't seem like yourself, you're just not enjoying things the way you used to. That might be another red flag that somebody needs to get help. Kira Yakubov:: [17:19] And so I know something that I've seen within my clients, too, as new moms, and you've mentioned it too, is feeling like nobody else can do a good enough job, or you can't necessarily trust anybody else to take care of your baby the way you wouldn't like releasing that control. What are some kind of strategies or things you do to help people through that, because that's a very real fear, right? Like that goes back to the control piece of not trusting anyone else around you to take care of your baby, Nicole Bolognini:: [17:45] one of the things I do is acknowledge that probably nobody else is going to do it as well as you do. Right? If you're the mother, and you know that baby and you've been there from day one, nobody else is going to get it quite right. But are they going to harm your child, right? Who can you trust that wouldn't harm your child, certainly the other parent is somebody we want to be able to help that baby build an attachment relationship with Yeah, I try to share with moms how important it is for kids to have more than one attachment figure to be able to feel safe with other people and to be able to know that they can be taken care of by other people and to be able to know that I can separate from mom and come back to mom and be okay. That's a really important part of that development of attachment. I don't always introduce that right away. Because if it's going to come off as shaming or it's going to come off as something that mom is going to feel guilty about. I don't want to introduce that right away. But if they're open to hearing that, and it feels to them, like maybe this is a problem for me, I might share that information. And I teach women about you know, threat detection systems and our brain right and so feels threatening to you. If it feels dangerous to you to let someone else hold your baby. You're gonna respond to that by not doing that thing because you're smart, and you don't do the thing that is dangerous. But you can override that system if you know that you're not in a dangerous situation, right? If you know you need to go take a nap and take a shower. And that's going to make you a better mother. Yeah, it feels very scary to hand the baby over. Can you kind of talk yourself through that process and call them your threat detection system down? It's not a tiger about to eat us. It's just a scary thing that I haven't done before. Because this baby is new in my life. And I haven't had to hand them over yet. Kira Yakubov:: [19:26] Yeah. So it sounds like kind of challenging those thoughts, right? Like a little bit of that CBT is challenging those thoughts, looking for other things to differentiate between releasing that control, and then kind of calming down their nervous system to get in a place where they can go do whatever else that they need to do to take care of themselves. Nicole Bolognini:: [19:43] Yeah, yeah. So teaching people how to tell when the threat detection system is turning on. And then how to kind of discern whether there really is a threat or not. And if there isn't a threat, how to calm that system down so that you can feel safe doing things and and some of it truthfully, is it exposure, right, but you have to be within a window of tolerance to do that exposure piece. So you can't jump right into, I'm just gonna force myself to do it because you'll go into panic. But if we can get ourselves within that window of tolerance, we can get our clients within that window of tolerance to be able to calm the nervous system enough to be able to say, Okay, I'm going to do this thing, see that it's okay. Actually, baby, we can then start to extend that time that they're separated, if that's a goal for that mother. Yeah, Kira Yakubov:: [20:28] so just practicing because I know how important support is right? Like it takes a village, it takes a lot of people to give you breaks and time off. So not feeling comfortable to let other people take care of your baby means you're not getting any rest, which is also going to cause I'm sure a lot of that anger and resentment and anxiety that we've been talking about too, Nicole Bolognini:: [20:47] right. And this is where that intergenerational attachment stuff comes in. Because if I don't trust other people, is it because I have avoidant dismissive attachment and have been put in situations in my own life and my own childhood where I couldn't trust people, right. And now I have this baby. And I don't know if I can feel safe. And so a lot of times, exploring those histories with parents helps them understand, okay, this is how I got here, and I'm going to do things differently with my child, I'm going to make sure that this kid does trust other people, and is, you know, does feel both competent, but also is able to trust others. Kira Yakubov:: [21:22] I love that you say that, right? Because it is everything that we not everything, but majority of the things we learn about relationships and other people is based on our previous attachments with our caretakers, or parents or family members. So can you speak a little bit more to that attachment style, like what that looks like in counseling or with your clients, if one of the individuals realizes, Oh, I kind of inherited this attachment from my parents or grandparents and now I recognize it. And my partner might have a completely different kind of attachment than I have. Nicole Bolognini:: [21:54] Almost everybody will come in and tell their therapist, I had a great childhood. Everything's wonderful, right? Very, very common, especially in private practice, where you get a lot of high functioning people, if a joke with some of my therapist, friends, but that should be the title of our book, like I had a child, because usually sure you probably did, and you probably very, very loved by your parents. But if you have difficulty trusting other people, if you feel like you can't rely on other people, if you don't like to be around people when you're stressed, you're maybe a little bit more on that avoidant dismissive side of the attachment spectrum. On the other hand, if you can't trust yourself, if you feel like you can't figure things out on your own, if you need someone there with you when you're upset, because you can never kind of calm yourself down, you may be a little bit more on that anxious side of the attachment spectrum. Generally there people are not like all the way one direction or the other, they're pretty secure. But there have been some childhood experiences that have pushed them a little bit more one way or the other, or under different types of stress, they swing one way than the other. And so we wanted people to be able to both regulate their emotions alone, but also regulate their emotions with other people. I do teach a lot of people about attachment and we draw their genogram and social work, we call it a genogram. It's basically a family tree. And we talk about family relationships. And we talk about you know, what happened when you were upset as a child? What if you were afraid? What would happen? What are some of your, you know, sort of big childhood memories, which ones were positive, which ones were distressing. And a lot of times just opening that insight to Oh, like my parents making me scrub the baseboards every time someone came over maybe really, really stressed and made me really feel like my job was to make my parents happy, right. And that's an attachment dynamic that's really important to talk about, and to understand how that plays out in your adult relationships. Kira Yakubov:: [23:44] Wow. So I mean, it really sounds like having a child triggers all all of those attachment things and opens up all these maybe past wounds, or even just the narratives and beliefs that we have about ourselves and the kind of support we need. And like you're saying trust, and how we kind of connect with other people or not? Nicole Bolognini:: [24:02] Yeah, a lot of times, I think it's having a child that gets people into therapy, because it's like, I can get through it for myself. But now I've got this other person, depending on me, and I want to understand why I am this way in relationships, or why I respond this way to other people. And it's both scary parents because it feels like such an important job. But it's also so exciting to be able to kind of look at your own history, understand yourself better. Kira Yakubov:: [24:27] I know you do family therapy, right. So when you have a couple come in, what does that look like for each partner if it happens to be heterosexual or even if it seems sex where the partner isn't the one who carry the child or birth the child like what that looks like, as a couple of dealing with postpartum anxiety, depression, any of that. Nicole Bolognini:: [24:46] So I don't often get couples looking for therapy postpartum because usually the couple is in such like a survival state and first year postpartum. A lot of times they see couples a couple of years down the line. When you know the kids are now kind of slow. Feeling a little better. And they're like, we get to work on ourselves. Because we've really grown apart. I do try to meet with couples together. But also I try to do at least one session alone with each person to try to understand how they relate to other people, right? So I'm always looking through that lens of how do you relate to other people? Can you trust other people? Do you feel competent to regulate your emotions on your own? And where are the wounds? And how are the wounds getting triggered in that couple, right? So where are those interactions hitting a nerve that existed before this couple was ever together? Because oftentimes, that's where we keep getting into the same fight over and over again, because this wound is getting triggered. And the other person is not even aware that that's what's happening. Kira Yakubov:: [25:40] And it's just replaying this dynamic over and over that maybe that person doesn't even recognize it's unconscious, right? Like you said, I think we had a great childhood. But really, it's all of these kind of beliefs or narratives that we have that are resurfacing again, and getting stuck in this kind of cycle with your partner. And now you're in very stressful situation, huge transition. So you are not necessarily relying on the same coping mechanisms that you might have before, Nicole Bolognini:: [26:05] right? Or it's hitting this painful wound, right? Like, if you had a highly critical mother, always told you everything you did was wrong. And then your partner tells you, hey, you know, when you fold the laundry, can you fold it this way? It doesn't matter how loving they said that? Sure, it may hit that wound of I'm not good enough for my mother, and it may trigger a very defensive response or retreat, right, like running away from this, I don't want to deal with this. So I'm gonna back away from this relationship. It's just starting to bring to the surface, where's the pain? They're like, why is this so painful? And how do we manage it differently now as a couple. Kira Yakubov:: [26:42] And so I know that kind of what we were discussing prior is thinking about for medical professionals to screen, right? Screen women after birth a little bit more to recognize that this is an issue coming up. What are some of your kind of suggestions or recommendations for whether it's medical professionals or for women to advocate to see the screen? Do they need this help? Like, are they struggling in a way that warrants like additional counseling or support for them? Nicole Bolognini:: [27:09] Sure. Yeah. So I always think if you feel like things are not right, or you're just feeling off, go talk to a therapist, it's not going to hurt you, it's probably going to help you adjusting to having a baby is pretty much hard universally, for many people that are like, Oh, this was great. This is gonna be challenging. There's that's why people always say, Why is there no instruction book, in terms of screening, you know, prenatally before baby's born? We often aren't screening for anxiety, depression at all. And we should be because many times it crops up in pregnancy, but we are doing medical appointments every month, and then every two weeks or every week until that baby is born. Yeah. And then we don't see that woman again until six weeks after she had that baby. So where is the screening in that window? That's where postpartum anxiety and depression are most likely to come up in that six week window. So some pediatricians will screen at the babies first visit the hospital here in New Jersey, it's a law they have to screen in the hospital when a baby's born. I don't know if that's the case in Pennsylvania, to be honest with you, but important in that process is relationship because many women I work with will tell me Yeah, I lied on that screen. Like I was not about to tell this nurse that I just met. How awful I feel. How do I know she's gonna judge me? How do I know how that's gonna go? Or I don't want to talk about it with her. I don't know her. Yeah. So I think it's really important that ongoing providers like the OBGYN the doula the regular therapist that was seeing that person before are actually not just handing out that that screening whether use the GAD seven or there's the Eaton Burg, postnatal depression screen, you can use you can use the PHQ nine, not just handing the paper but saying, Hey, listen, it's really common one in seven women have postpartum mood issues. Now, if something's bothering you, even if it's not going to show up on the screen, let me know I want to hear about it. And I want you to have help because it doesn't have to be that way. You can actually enjoy this postpartum time. So having some of that dialogue and that conversation with women in normalizing it is a big piece of this. When I was postpartum, I struggled with postpartum anxiety. And some things were said by providers that I was just kind of like, Oh, that is not something you should be saying to women, like, Hey, if you just go on more dates with your husband, you'll be happier. We don't want to tell women that because that's like the last thing they feel like they can do right now. Or some women handle motherhood better than others. This isn't about you're not handling it well or you're weak or there's something wrong with you. This is really about how your brain is wired, how you handled birth, whether you have a pre existing history, there's so many other factors here. It's not about personal weakness or personal strength. Kira Yakubov:: [29:47] Wow. I mean, you like you said it seems like really normalizing it and having that be a huge part of the process for medical providers to have sounds like additional training or just being able to be a little bit more empathetic. For this person who's experiencing this new thing through the, like the beginning to the end of it and afterwards to Nicole Bolognini:: [30:06] write, right, just treating it like any other postpartum complication, this is the most common complication of giving birth is having postpartum mood issues. And so ideally, I would love to see your OB, call you two weeks, and then three weeks after you give birth and do a screening and check in on you. I don't think anyone's gonna listen to me about that. But that's what I would like to see is that, you know, or we're sending those screenings electronically, and we're sending some information out to women saying, Hey, this is what happens postpartum into a lot of women. If this sounds like you, here's some people you can call, right, here's some providers that we trust, because you trust us, you've trusted us to bring your baby into the world. That's a really important relationship. And it's a really useful relationship, in terms of screening. Kira Yakubov:: [30:52] Absolutely. And for them to have like referrals ready to be able to provide these recommendations for, for them to see somebody, right, because even finding a therapist is really hard, right. And if you're a new mom, and you're exhausted, and you have a million things going on, probably don't have the brand like the time or energy to search for somebody and reach out and call and all of these millions of steps to get the support that you need. Nicole Bolognini:: [31:16] Exactly. And as you know, people call they don't get calls back. They people don't have openings, they don't take your insurance, whatever it is, it can be really, really stressful. That is something I really recommend that women outsource. So if you are struggling postpartum, and your husband is worried ask him to make those calls, I get calls from husbands, I'm always happy to talk to them. Of course, I have to talk to mom eventually. Sure. But it's you know, going through all that process of like finding the right provider, if you're overwhelmed, that's a great thing to ask someone to help you with people will always offer almost always offer when someone has a baby, what can I do to help and we all just go Oh, it's okay, we're good. But I really encourage people to take people up on that, like, what can they do to help? Like, can they vacuum for you? Can they make phone calls? Can they schedule the appointment with a pediatrician asked for help. If you if you can think of an idea if you can assign a task. Most people are really, really happy to do that. Kira Yakubov:: [32:15] Okay, that's good to know. And so do you feel like the partner also experiences some postpartum depression or anxiety or anything else, that they're not the ones maybe having the child or having that hormonal change, but it's still a huge life changing stressor? Nicole Bolognini:: [32:31] Yeah, absolutely. So we see a huge number of dads that also struggle postpartum. For dads, a lot of times, they feel like they've got to take care of this family. And so they don't want to complain, right, and I want to add to my, my wife just gave birth that was so difficult, I'm not going to ask her to support me emotionally. There's also a change in that relationship between the partners right now mom is so focused on this baby, that for dad that can feel really lonely. And this, of course, happens in same sex couples too. So just because the birthing parent has the hormonal shift doesn't mean that the other parent can also experience a lot of postpartum mood issues, postpartum distress, even trauma, we definitely have seen partners traumatized by seeing their partner go through, that felt like threatening, so really important that whenever you have a big life change, whether it's adopting a child giving birth to a child, or all of those other things that happened that have nothing to do with children, to remember that it's normal to have an adjustment period. But if you're not recovering from that adjustment period in two or three weeks, then there might be something else going on. Kira Yakubov:: [33:35] Okay, so everybody needs support. Everybody needs help and support to get through this major life transition for them, even though it's a very happy and beautiful moment. Right, like we can have these mixed feelings and contradictory emotions coming up. Nicole Bolognini:: [33:49] Yeah, absolutely. I mean, isn't it true, we all need support at some point in life, right, like, nobody's getting through this alone. So this is a time where accessing that support is really important. Kira Yakubov:: [34:00] Yeah. And do you also work with individuals where let's say they may have had some miscarriages or they're having a difficult time getting pregnant and like what that journey looks like? Nicole Bolognini:: [34:11] Yeah. So that's part of the perinatal experience right I'm miscarriage is still a pregnancy, women still experienced postpartum issues after the loss of a child in addition to the grief and the loss. So infertility similar in that there is just so much grief around that whole process and and often frustration, and often medical trauma, right your body is put through if you are going through IUI IVF treatments, your body is put through a lot of stress. And a lot of times that medical trauma also kind of can get dismissed because it's like, well, this is what you want. You don't have to do it. But you may not feel that way about it right. And so being dismissed in your emotions because especially for the woman who's going to carry that child, there's just a lot of strain put on your physical body In addition to the stress of all the scheduling, and you've got to be at disappointment at this time and just stay, and you cannot change that appointment, and so you've got to find a way to get there and snow storms you got to get there. And during COVID, right, we've had so many women that experience so much stress around just getting pregnant. Kira Yakubov:: [35:15] Wow. That's sad to hear that some medical professionals might say like something so insensitive, like, well, this is what you wanted, or you asked for that. Nicole Bolognini:: [35:24] I think people get it a lot from family members, honestly. I mean, people working in the IVF, you know, reproductive technology community, they kind of get it and are a little more sympathetic, but you'll get family members who will say, Well, you already have a kid like, why are you doing this to yourself, because you're trying for a second with, you know, fertility treatments. Or you could just adopt a you don't have to do the app. And again, we're really dismissing people's experience when we sort of either give them the silver lining, or tell them, you know, why are you not solving the problem the way that I think you should solve the problem, right? Kira Yakubov:: [35:57] Yeah, just questioning their judgment or just feeling really just being really insensitive to their emotions never Nicole Bolognini:: [36:02] aligning right, not aligning with what that person's experience is. Kira Yakubov:: [36:05] Yeah. And so is that something that you also help individuals work through is like families, how they deal with how other people speak to them or treat them through that process? Whether it is they're like struggling to get pregnant, or they are pregnant? Or post alone? Everyone has an opinion on how to be a parent. Nicole Bolognini:: [36:23] Yeah, so I'm a big proponent of like, come up with your canned response. Right. So one of the ones that a lot of the moms they work with get is like, when are you going to have another baby? And I just say, it's really hard in the moment to think of how to respond to that, because it can be an upsetting and distressing question for any number of reasons. So I'll say, you know, like, what could be your canned response? It can be snarky. It can be like, what are you going to have another baby. But it can also be like, actually, we're just really enjoying our time with this one. And we're, you know, we're not really talking to anybody about our plans to have another child. So people can kind of come up with their script. And then just keep saying it. And eventually, a lot of times those family members that will ask every time they see you, they know what you're gonna say. And they'll stop asking, hopefully. So that's one of my strategies. But yes, we definitely need to talk about in therapy, how to deal with relatives, and how to deal with friends that are maybe well meaning or hurtful in their comments. Kira Yakubov:: [37:18] Sounds like setting boundaries, and just having your go to responses. And I like the snarky one. You know, it makes people not asked again, or just a step back to think about, like, probably shouldn't be asking this personal question to someone that you don't really know what they're going through or struggling with. Nicole Bolognini:: [37:33] And it's always okay to just say that to like, I'd rather only answer that question, or that's too personal of a question, or I, you know, not discussing that was people. I think a lot of times, you know, there's this kind of sense that we have to protect everyone's feelings. But if our feelings are being hurt, we can set a boundary. And it's okay to do that. Kira Yakubov:: [37:52] Yeah. And so are there any kind of, I don't want to say common things that you see, but may not be as common for everyone else to recognize, like some of the struggles or things that come up for moms while they're going through this process. Nicole Bolognini:: [38:04] So I don't know if there's any like, main things, I think the experience can be different for a lot of people, bigger things we see with anxiety, depression, or not enjoying things you used to enjoy. not enjoying things at all, feeling like even when you do sleep, you don't feel rested, feeling just a high level of anxiety, high level of panic and anxiety. And panic doesn't have to be about the baby, I've seen a number of women with anxiety about what's happening in the world, right. And it's not about the pregnancy or the baby, but it's like the you know, the world is horrible right now. And that's what my anxiety is about. And that could be postpartum related. Because now your, your view of the world has shifted. So it manifests differently for a lot of different people. But when you don't feel like yourself, when you feel like you can't enjoy things, when you feel like you can't take your baby out and try new things that you wanted to try that you thought you were gonna do, because it doesn't feel right, or does it feel safe? Those are some signs, then to get help. Kira Yakubov:: [39:02] Yeah. And so what kind of made you focus specifically on perinatal? Right, I know you you kind of mentioned some of the different experiences. Why was this something that was kind of special for you that you wanted to really focus in on. Nicole Bolognini:: [39:15] So I went into this in large part because of my own postpartum anxiety. I have three kids. Every time I had postpartum anxiety, it's just the way my brain works. And I felt like and I was handed, you know, therapists, business cards, who were not specializing in those who are not trained in this and I felt like, oh, I don't know, am I going to waste my time going to talk to this person, they're not going to get it. Or they're going to kind of just be like, well, you know, just go take some more walks, right? Like, that's not enough when you're going through that. And so I really felt kind of alone because of my history kind of working with attachment and bonding. I thought how important it is for moms to be okay for parents to be okay because kids are never going to be okay if their parents aren't okay. And That's what made me go on to get the credential the perinatal mental health certification, because I was already working with young families and parents of young children. And now I was like, let me get this certification and really connect more with people in that postpartum period and make sure that they are getting the help they need, and they feel understood. Kira Yakubov:: [40:19] So it sounds like a really safe place with you and at your practice, that you have all this knowledge and training and expertise to specifically help people going through this, Nicole Bolognini:: [40:27] we definitely want to be there for people. And if we aren't the experts that can be helpful. We want to provide those referrals so that people can get connected with somebody who's really going to be able to help them. Yeah. Kira Yakubov:: [40:37] And so I didn't even realize that there was a certification for that. What is like, what does that entail? Is it kind of go through the process of the changes in our bodies and our minds and how to help specifically through that? Nicole Bolognini:: [40:48] Yeah, so Postpartum Support International has a perinatal mental health certification. And it's a great idea if you're looking for a postpartum therapists, or prescriber to look for someone with that certification because it is open to mental health therapists, prescribers and other people like doulas and other people in the field can also get the certification, there is a requirement to take a number of CPUs related to perinatal mental health, there is a test involved, so everyone that has that credential has passed that test. And there's an experience in peace, a certain amount of experience you have to have, and you have to, you know, attest to having done so many hours, which I can't recall how many hours it was now of work in that area in that field. And then we have CEU, as we continue to get to maintain the certification. Kira Yakubov:: [41:35] Okay, that's wonderful. I had no idea. I mean, it's not something I specialize in. So I didn't even realize, but I mean, it's great to know that there is a lot more training and specialty that goes into that for people who are looking for specific help with us. Nicole Bolognini:: [41:47] Yeah, and even for professionals who maybe don't want to specialize in this, but they're had some postpartum parents come in, it's great to just take one of those psi training. Yeah, we're a little bit more about the prevalence and the risk factors and some treatment options. Because they think a lot of you know, a lot of us in the field, do work with postpartum parents without that certification, because no common time to experience stress adjustment issues, mood disorders, those kinds Kira Yakubov:: [42:14] of things. Absolutely. And so I did want to touch on breastfeeding, because I know that there is a lot of myths about that, or a lot of shame or pressure around if a woman should breastfeed or she shouldn't, or at what point kind of to make that decision or to differentiate if that's good for them and their baby, kind of what your thoughts are what you've seen in your practice with that, Nicole Bolognini:: [42:36] you know, we know from research that breastfeeding is good for babies. And we know that that oxytocin release that we get when we're nursing can make us feel good. We know some, there's some research to support that. That research has been sort of exaggerated. degree because there are also many women who experience breastfeeding as painful and difficult and emotionally draining, or something that just isn't going to work for them. And so my emphasis with women is if this is something you want to do, working for you, 100% want to support you. If this is something you want to do, and it isn't working for you, how do we get you the help, you need to get to where you want to be, or to accept that sometimes things happen in that breastfeeding experience that we don't have control over. There is a lot of pressure on women that like, oh, well, if you're not making enough milk, you could have done all these other things. Or if your baby's having allergies, you could give up all of these foods, there has to be a line at which going those extra steps become so detrimental to moms mental health, that it outweighs the positive effects of the breastfeeding. So I really just tried to encourage families to look at the whole picture, not just what's good for the baby, but what's good for the whole family, and what's gonna work for them. And that's going to be very different based on who you are as a person who your partner is, what your baby is feeding, like how easy or hard it is for you to nurse like there are a lot of factors there. And so there's never any judgment, it's just what's going to make sense, I am more interested in developing a healthy attachment relationship between parents and children. And that can be done with or without their breastfeeding. It's not a requirement. And there is some I think sort of like belief like in Attachment Parenting that like this is a big part of attachment. But there are lots and lots of people with healthy attachment who were never breastfed. And it's just not a requirement to get there. It's great if it works. And it's a wonderful way for mother and baby to bond. But there are lots of other wonderful ways for mother and baby to bond to. Yeah, Kira Yakubov:: [44:40] I'm happy to share that because I know that there are a lot of women that might feel some shame around that or other people might give them their own opinions like you should do this instead. So I'm glad that there's a lot of openness around really like what are your specific goals and what's going to work for your family versus like this should be the first thing you try and if it doesn't work, then you go to something else. Right Absolutely. And so I heard um, that you might be more familiar with this, but actually heard that breastfeeding can be painful or difficult if the child if under their tongue, right, there's, I can't think of the name of like this part that attaches it that I never heard of. But I just heard of this through, you know, some of my friends and family members and things that they never knew they were never taught that this could be painful for them, if that's what's happening for the baby. And then not knowing until you know, they went to a doctor did more research and then figured it now, Nicole Bolognini:: [45:32] tongue ties. And also their lip ties and Buechel ties in the cheek that can definitely make breastfeeding more complicated. And some women because of either the shape of their breasts, or the shape of the baby's mouth, can nurse a baby with a tongue tie without an issue, and some cannot. just impossible. And there's different levels of severity to those. What I often if I work with someone while they're pregnant, and they're planning to breastfeed, I generally suggest, find a lactation consultant you like, before you have that baby, you don't need them, then you don't ever use them, but call them up. And one of the things I like to ask lactation consultants that I have worked with is what their approach is to not breastfeeding, right? Are they an all or nothing lactating? There, I don't refer to them. That's fine, if that's what somebody wants. But I'm looking for someone who's going to say, Okay, this is working for you, this isn't working for you, like, let's put all these pieces together, here's some strategies, some things to do, to get the most out of this relationship with your baby, whether it is I want to nurse a little bit or I'm okay with pumping or whatever it is. And I have a couple of lactation consultants that I refer to that I think, are really great with that sort of thing and kind of kind of understand the whole family and what's best for everyone. Kira Yakubov:: [46:46] So kind of on a spectrum, we're going to be creative, we're gonna figure this out. It's not just black and white thinking around it, Nicole Bolognini:: [46:52] right? Because for example, with tongue tight, you can get a tongue tie release. And for some moms, they want to do that because breastfeeding is that important to them. And that's great. If that's the decision you want to make. And for other moms, they don't need to go that far. And if they're pressured to do that, they may do it. But I want that mom to look at what's important to me. This is what I want to do. Do I want to get that tongue tie released? Or am I okay with not nursing and maybe doing some other type of feeding? Kira Yakubov:: [47:18] And so what do you mean by release? Is that like having in the baby's mouth having that like removed or? Nicole Bolognini:: [47:23] Yeah, so they can they either cut it, or they use a laser to open it up so that that baby has more mobility in the tongue to be able to breastfeed? Kira Yakubov:: [47:32] Interesting. There's so many things about being pregnant, having a baby. And afterwards, this whole process that I feel like is not common knowledge or not something that's taught or talked about enough that these are like things that, like women kind of go through after the fact. And after they're researching, they figure it out instead of having this information ahead of time or throughout the process. Nicole Bolognini:: [47:53] Yes, I think that's very true. I think that's why it's so hard to adjust to, right. Yeah, we just, we almost can't explain to people what it's like, if you think it's a good sampling of how parenting will be, because that continues a lot at once when you have a newborn, but there's always new surprises like I compare parenting like to that game, whack a mole, right? When you hit one mole, and then another one pops up, like that's a parenting like, as soon as you figure out how to get that baby to sleep. Now they're going to have some weird reaction to food or some other things going to happen and can be really stressful. Kira Yakubov:: [48:27] So constantly on your toes. It's a never ending cycle of new things popping up and kind of taking these challenges head on. Nicole Bolognini:: [48:34] Yeah, yeah. Kira Yakubov:: [48:36] So Nicole, what is coming up next in your professional life for your practice that you'd like the listeners to hear and know Nicole Bolognini:: [48:42] about? Yeah, so we just opened in December and office in New in, which is in Sussex County in New Jersey, where I have Jessica working, and would like to expand the hours there and bring on another therapist trained in EMDR. We didn't talk about EMDR. But it's one of the therapies that I do and I get people calling and asking for that. So I'm looking for to hire someone that does EMDR to expand the practice there, but just you know, continuing to grow continuing to be accessible to families as a support and advocating for good perinatal care. Kira Yakubov:: [49:17] Wonderful and where can people find you if they want to reach out to work with you or your practice? Nicole Bolognini:: [49:22] Yeah, so the best thing to do is probably go to my website, which is www.Skylandswellness.com Skylands with an S and it's all one word. Kira Yakubov:: [49:30] Awesome. Nicole, thank you so much. You have a wealth of knowledge. This was really awesome to have you on and have your insights. So thank you so much for being a part of this episode. Nicole Bolognini:: [49:38] Thanks, Kira. Was fun to talk ### Listen - [Spotify](https://open.spotify.com/episode/13193855) - [Apple Podcasts](https://podcasts.apple.com/podcast/13193855) - [YouTube](https://youtu.be/S1sdwNC0uHI) --- ## Breaking the Silence: Mental Health and First Responders with Majet Reyes, LPC - URL: https://healyourrootspodcast.com/episodes/breaking-silence-mental-health-first-responders-majet-reyes - Published: 2023-03-15 - Season 2, Episode 2 - Duration: 46:33 - Category: anxiety - Guest: Majet Reyes ### Summary Scientific exploration of anxiety and the nervous system, with evidence-based techniques for managing stress responses and feeling more in control. ### Description Anxiety affects millions of people, but understanding the science behind it can be empowering. This episode explores how anxiety works in the brain and body, examining the role of the nervous system in our stress responses. Learn evidence-based techniques for managing anxiety and discover how understanding your nervous system can help you feel more in control. ### Transcript Elijah Jackson:: [0:00] There's lots of hopelessness and helplessness that comes up sometimes when you're pursuing a major that you're not really invested in, which is why it's so important to think about, you know, is this something that you genuinely have an interest in? If not, you probably shouldn't be pursuing it. Rather than hoping that one day you'll love Kira Yakubov:: [0:21] Hi, I'm Kira Yakubov, Licensed Marriage and it. Family Therapist and Founder of Heal Your Roots Wellness practice. Every episode, we talk with a professional from the mental health field to learn more about their approaches and specialties, and also their journey of becoming a therapist. In this podcast, we'll uncover a deeper look at the world of therapy from new perspectives. You'll meet the therapist of Heal Your Roots Wellness practice, and trusted colleagues from the community tackling mental wellbeing are your go to network for practical and professional insight in mental health. Subscribe for new episode releases every other Wednesday. So welcome back. We have Elijah Jackson here with us again, he joined us last season. I'm so excited to have you back on today, Elijah. Elijah Jackson:: [1:16] Absolutely, it's good to be back. Kira Yakubov:: [1:17] So I know when we were kind of discussing what we wanted to focus on today, we were kind of thinking about what you've been seeing a lot recently, and kind of the presenting issues that are like a lot of clients are coming in with. And we've noticed that a lot of your clients are in that, you know, young adult in college kind of young professional age range and struggling to figure out if this career or this major is the right thing for them, and how kind of family or cultural backgrounds might really influence that decision. So what's that been like for you to kind of see that trend coming up. Elijah Jackson:: [1:53] Most of my clients are actually in college now. And maybe that's just the nature of private practice. More, there are more college kids going through it. So they're more college kids looking for therapists. But I've definitely found that most, most people who are in school or in school have gravitated towards me, which has been really fun. It's kind of it kind of makes me reminiscent of myself back in college and where I was and how lost I was then and kind of trying to figure out what was best for me. And as opposed to what was best or for everyone in my family or managing other people's expectations. So it's kind of that's kind of enlightening and also makes me feel like I'm, I'm loving my job more because I get to help younger people. Kira Yakubov:: [2:49] Oh, that's sweet. And I also remember feeling super lost in college and even just like, going through the end of high school trying to figure out like, what is it that I'm supposed to do for the rest of my life. And I'm supposed to decide this, as a teenager having no life experience, no knowledge, nothing about what would actually make sense for me and my strengths and my personality. Now, that was that wasn't really a well thought through and not a great expectation to have of of teenagers. Elijah Jackson:: [3:23] Yeah, I mean, it's kind of ridiculous that at 18 years old, we're expected to have it all figured out. And you no doubt and you know what you want to do for the next 40 years. I did just doesn't make a lick of sense to me. But I find that the less pressure you put on yourself, the easier it gets. Because people are going to have expectations of you all the time. People are going to, you know, project onto you all the time. So as long as you know, you have your house in order that usually makes the transition through life better. Kira Yakubov:: [4:00] And so it's you know, it's interesting, because when I was thinking back during my college days, I didn't know right, what I wanted to do. And I think it's kind of this like outdated or older generation thinking you have to pick one thing, and that's going to be the thing you do forever, because that's kind of what it was like before, right? Like, a lot of people would say that one actual job for 20 30 40 years. So it wasn't really like, oh, I can try this out for a little bit and then explore a new career later in life. I don't think that was accessible or normal back in the day or for like our parents generation. So I think they're giving that advice from their circumstances and what you know, their lived experience. Versus now it's like, you can have many different careers and different career paths and do multiple things at once and switch it up and that's totally okay. Elijah Jackson:: [4:57] Absolutely. And I think also you know, in terms of like, lots of like, first generations to like, kids who are going to school, their parents didn't have that background. So it's like their parents don't know, necessarily to tell their kids that it's okay to, you know, to move around or to change careers, you know, their, their parents might have high expectations for them, because they're like, Oh, we're shelling out a lot of money for you to go to school, or, you know, we're investing a lot into you. So we want you to do something or so we want you to be the doctor or lawyer. We want you to save the world, or change the world, or at least change us. And then that puts a lot of pressure on kids so like to make up for their parents sins, or something like that. And I find that with most of my clients now, they're when they're navigating majors that are stressing them out, they're navigating majors that were chosen by their parents. So it's kids who went to school to be to be a doctor, when they never wanted to be a doctor in the first place where kids were in law school, when they never wanted to be in law school in the first place. You know, not to say that those are bad professions, those are amazing professions. But if you're not invested into it, if it wasn't your choice, if you don't have any interest in it, then you're not going to probably have a good time. And that's going to make you more stressful. Yeah, you're trying to make something fit that doesn't fit. Kira Yakubov:: [6:25] Yeah. And you know, I was actually thinking about earlier, like, what are these main professions, the most common ones, especially for immigrant families, or, you know, different people of color, that the main jobs that our parents want and expect of us is doctor, lawyer, accountant, engineer, right? Those are the main ones. And it was interesting to think about, because, you know, I think that the intentions from the parents are good, right? They see these careers as very prestigious, they make money, it's a secure job, you know, they're very well respected. And it's very useful in the family to have one or a combination of, of those professions. And like, you know, like you said, you had an especially for those, I feel like, you have to have a lot of passion and desire for that specifically, because all of those careers are hardest shit, like the actual job, but the preparation, the schooling, all of that is so draining, and it takes so much out of you, for you to not even actually like it or want to do, it seems kind of insane. Elijah Jackson:: [7:35] They're, they're going through it in a way that, you know, I could never imagine, you know, I had a hard time when school but you know, to be in medical school in rotations, having people's lives in your hands in a certain way. And you're not even really that invested in the work. It makes it more difficult to feel like you should be there. And they constantly have they constantly have thoughts around. Is this, is this worth it? Am I doing the right thing? Am I cheese taking up someone else's space that deserves to be here more than I do? Because they want to be here. There's so many ambivalent thoughts that come up for them. And it's, it's difficult, it's difficult to navigate, I can only imagine what it feels like to be in that kind of situation. And there's also the added layer of like financial investment, you know, so it's like, these, these programs aren't cheap. You know, lots of his commitments are, you know, something you may have to be paying off in student loans forever. There's also the added shackles of having to navigate the for like student debt. Yeah, you know, once you sign up for it, lots of people feel like they can't stop because they just invested too much into it. So lots of there's lots of hopelessness and helplessness that comes up sometimes, when you're pursuing a major that you're not really invested in, which is why it's so important to think about, you know, is this something that you genuinely have an interest in? If not, you probably shouldn't be pursuing it. Rather than hoping that one day you'll love it. Kira Yakubov:: [9:14] Yeah. And, man, it's so true. Because the the financial piece is heavy, right? And I think a lot of times in any decision we make, right, like, the more time or money we invest in it, even if we don't find it beneficial, or it's good for us, we kind of doubled down like, well, you know, if I already went this far, I might as well keep going instead of kind of stopping and assessing like, let me cut my losses. Because I still have the rest of my life to pivot and do something different or pay this off in some other way. Versus like, let me just push through and try to get to the other side and then you graduate and then you get a job and you push through and and now You're dealing with like chronic depression or anxiety on a regular basis. Elijah Jackson:: [10:05] Absolutely. And so much guilt to you know, there's, I think there's a lot of guilt and shame that comes up for for people who pursue degrees that they don't want. And they feel like they're stuck in this space where you're like, Oh, I am, I don't want to be here. But everyone's telling me that I'm so great and amazing for doing this. And everyone's, like, so proud of me. And I am, I'm not enjoying it. I'm complaining, you know, I'm, you know, punishing myself, I'm making everyone else's day, not good. You know, and there's a lot of, there's a lot of guilt and shame that comes with that. So you, I think it's really important that, you know, when I sit down with clients, I, you know, just I try to normalize that their experiences, okay. Telling them that, sometimes telling them that being in a space, and being ambivalent about it is, you know, stages of change, you know, say that we're allowed to be ambivalent, sometimes we get to a space, eventually, you know, where we feel more secure. And like, we can make a choice to do something different if we want to, but being in a space where we can identify a problem and not really know if we want to change it yet. That's completely normal. Kira Yakubov:: [11:26] And talk about the level of imposter syndrome. Right? I mean, people around you're saying, Yeah, you're doing great, this is incredible. And you're like, Oh, my God, I'm barely trying to keep it together. Like everyone's gonna find out. Oh, my God. It sounds it sounds really tough. And I like the you normalize it because it is the ambivalence, right? I think that's the piece that makes people so uncomfortable. And it's unsettling, because at least if it's a decision that you don't want, you're already in it, right. And like, now you're trying to navigate it versus like, kind of tip toeing the line of which way you should go. It's tough to stay in that ambivalent space, for sure. Elijah Jackson:: [12:07] Absolutely, you put so much stress and pressure on yourself to, to change things overnight. And this goes for anyone, you know, anyone who's experiencing hardship, he's like, even even I put pressure on myself, whenever I see a problem, I'm like, alright, well, this has to be fixed right now. Even though you know, you might not have the knowledge or the time or the energy to put into changing it, there's still that pressure to get it done immediately. Especially, you know, I found like, for for like, immigrant people of color families, there's the, you know, there's the perfectionism aspect as well. So it's like, we want to make sure that you are perfect, we want to make sure that you are the most marketable, you know, you have to work two times as hard to get just a modicum of success, you know, than the average privileged person. You know, we have to make sure that everything that you do is exceptional. And that pressure, you know, that doesn't go unnoticed by my kids, you know, that doesn't go unnoticed by young adults. And usually, it's internalized, it's not processed correctly. And we end up you know, in spaces where we're not acknowledging that we need help, we're not acknowledging that we need support, or that we're even not enjoying what we're doing. We're just forgetting about all of it. And, you know, turning that into fuel. Kira Yakubov:: [13:27] Yeah. That's so true. And I mean, I'm thinking about like, some of my clients and their parents, but also my parents, because you know, I immigrated here and even just bringing home homework, that was an A, it wasn't 100 it was like a 97. And my dad's like, what happened? You couldn't do better? Dad, you know, and having like, that's just a piece of homework, let alone like a career and like everything else, like you're saying, and even being able to not feel safe enough to say like, I don't enjoy this, I'm struggling, I need help. I'm anxious or depressed is like, this is this isn't a real thing. You need to get it together and figure it out on your own. Stop doing all these extracurriculars and focus back on the main goal, which is this career and making money? Elijah Jackson:: [14:18] Absolutely, absolutely. We put so much pressure on ourselves, and students put so much pressure on themselves to, you know, if they're going to do it, we're going to do all of it, you know, I'm gonna have the perfect life. I'm gonna have all the extracurriculars, I'm going to have all the you know, all the friends. So it's going to be amazing. I'm going to do it all and I'm like, hold on, let's go down a bit. Let's focus on what's necessary right now. And then if we have space after that, we have more of a capacity for more, then we can think about more. But, you know, assigning all of these different, you know, responsibilities onto yourself, even though and your first semester of medical school or your first semester of law school. You know, it sounds like Have you taken on way too much too soon? Kira Yakubov:: [15:03] Yeah, that's how we get burnout super quickly. With no end in mind, right? Like the burnout isn't just I'm struggling right now it's I'm struggling, I don't know when it's gonna end. It's much harder to hold on when you don't know when there's an end date to it. Elijah Jackson:: [15:18] Burnout is, I feel like that's probably the number one cause of, you know, midlife crisis. I think people, people work so hard in their younger years, because they're told that they have to work hard in their younger years to make their later years easier. And then they forget that they're people and that they have bodies and that sometimes our bodies have minutes. And it spirals and then they like, they hit like, 30, or they hit 40. And they're like, oh, I don't think I can work for another 30. You know, years, I don't think I can do another 20 years of this. So I think it's really important to reassess early, like, right after you graduate high school, or right, after you graduate college, reassess, what do I really want? You know, what's really important to me? And what do I want to achieve in my life? You know, what are my values, you know, as opposed to what are the values that I was taught. And sometimes it might take some time to figure that out. Which is why I never, I never say it's a bad idea to take a gap year, you know, a little time off and try to do a little self discovery, if it's, you know, if it's within the cards, you know, take some time to focus on yourself, and, you know, explore your own interests, you know, maybe take an internship somewhere, you know, or volunteer somewhere and see and see if you like it, as opposed to just setting these really high expectations of yourself, that sometimes aren't even your own expectations. Kira Yakubov:: [16:55] Yeah. And I love how you express needing to take time to assess on your own, and focus on those morals and values, because I feel like 1819, even 2021, like, really like, all the way up to your mid 20s, you're kind of listening to everybody else around you getting their input getting way too much input. And from, like you said earlier, like people who are projecting, and so that reflection period is so critical, that a lot of I think maybe not a lot of teenagers do because they might not be prompted to do it not recognize that that's like an option, or just rely on everyone else's opinion. But I think like and I love giving this exercise to clients, I usually do it when they're dating, but this applies, like anytime in your life is really assessing, what are your morals and values, right, like having a list of them, picking out the ones that really speak to you making a category for each one and kind of reflecting like you said, Is this my value? Or is this something that's been passed down to me? And like, why is this important? How would my life look? If this wasn't a part of it? Right? Like, what are the consequences of that, and having those real life experiences, those internships are so valuable and priceless? Because, you know, we can be in school and learning and like reading books, and that's just like one level of it, versus going out and implementing it. You're like, whoa, that's not It's not what I signed up for, even though it is what I signed up for. Elijah Jackson:: [18:28] Absolutely. I mean, I know firsthand, that my experience, even in school myself, I had, I didn't know what the hell I was talking about as far as therapy until I started doing, you know, reading all the reading all the books, learning about all the theories, that's one thing, but actually practicing and being in the room with another person. That's a completely different experience. And I even had to, you know, I had to have my own come to Jesus moment where I was like, Oh, hey, this is nothing like there's so much more, there's so much more that's needed, there's so much more that's required, I have to be so much more aware and involved. than then, you know, then my teachers told me that I had to be I have to, I have to think about my own self in the room. And I have to remember that I'm a person too. And I'm not just a you know, a platform. I'm like, this is a lot. So I have to have my own, you know, realization moment. And, you know, thankfully, I came out on the other side with more clarity about, you know, what I want to do, but sometimes people don't have that moment of reflection. They're not given that moment of reflection, because they're told that they have to just keep going, you know, just keep pushing, get through it. You only have a few more years, you know, wouldn't make sense to quit now. Just get through it. When really we need to be maximizing on today, you know, and say, Okay, let's think about what we really What now? You know, let's take a little bit of a break and, and explore what really matters to us, as opposed to, you know, this thing we've been telling ourselves forever. Kira Yakubov:: [20:09] Yeah. And I think some of the best, maybe not the best ways, but one of the some of the beneficial ways to do that is obviously through therapy, right. I mean, I know we're biased, because we're therapists, but you know, having an objective person who doesn't have a stake in the game, it's not your parents, your friends are not going to be disappointed in you or expect anything of you to just let all these thoughts and emotions out. And then also journaling, right, like being able to also express this in a way that is freeing and safe. But I think that's something I wish I had done when I was earlier, when I was early, earlier when I was going through school is because I went originally for accounting. Because my dad said, Oh, you're good at math. And it's a good stable job for a woman and you'll get married and your husband will make the money anyway. So what differences I was like, cool, cool dad. And then, and then I got into college, and I started, you know, going for an accounting major, and then Drexel University, at a Co Op program where I got to do an internship at a tax firm. And that first week, I was like, huh, this is 1,000%, not for me. And there's no way in hell, I can keep doing this for the next two to three years in school, let alone after that. And I wish that I reached out to other people in the psychology field or in the accounting field, who are already working to be like, can you just like, give me an inside scoop of what is your day to day? How do you feel? What are the best and worst parts of your job, or this field? To get more of that insight? Instead of you know, you should just do it, because you're good at it. And I think it's a good thing for your life. Elijah Jackson:: [21:57] Absolutely, absolutely. And also, sometimes making a career out of something that you're really good at usually ends up becoming one of the most stressful things in your life. Like people who, people who are artists than they go to art school, you know, they're trying to make a career out of being an artist, you know, they sometimes they lose their excitement for art, because it just becomes a part of the job. I have a client who is pursuing, you know, a degree in design, you know, and now that they're doing it every day, and it's not so much for fun and creation that's for you know, to try to find a job. It's not as enjoyable to them anymore. So you really have to think deeply about, you know, if this thing that you're doing every day was a job, would it feel fulfilling for you? You know, would it be as exciting for you as it is now, and of course, every day of your life and you're at work isn't going to be amazing. But the majority of it should feel good. If it doesn't, then maybe you might want to reassess, you know, and that goes for anyone with any job. If it's just for the paycheck? Can you do it just for the paycheck job for the rest of your life? You know, yeah, I know I can. I don't think that's sustainable for me now mean, either some kind of some kind of connection to it. Kira Yakubov:: [23:26] I mean, it helps the we're, you know, we're in the field where we literally have to interact with people. And that would be really tough over like, No, I hate this. I don't want to hear about your problems. But that's how I felt about the accounting firm. I was like, I can't do this every day. Like, no way I need more interaction with people. And it's, you know, it's interesting, because I think the more experience we have in something, the more we're able to reassess microcredit, this aspect of this job, or this interaction is I like it. But this other aspect is definitely not going to work for me. So it's even kind of just like playing around with these different things. And thinking about that first and then trying to apply it maybe to a future. Right, like, I mean, so really, it's like just getting to know yourself on a much deeper level. Elijah Jackson:: [24:20] Absolutely, which is why I wish there was more opportunities for, for students in like high school, middle school to explore their interests, explore them in these environments, you know, rather than saying, figure it out on your own, and then you're going to go to your guidance counselor, and tell them what you want to do. I think that instead, there should be actual things in the curriculum, you know, in high school and middle school curriculums to help people think more about their future, in a way, you know, like, I've never got that opportunity in high school and middle school to like, think about oh, wait, actually Want to do? What do you have an interest in? You know, it was more so just what colleges do you want to get into? You know? And what grades do you need to get into this college? You know, and not so much? What what do you actually want to do when you get there? You know, what do you want to explore? What are your interests, and we should have those opportunities to explore those things, you know, young, so that we can get a better idea about what this career entails? You know, because of course, a 15 year old could be like, oh, yeah, I want to be a doctor, that was cool. But then about what it actually means to be a doctor and how much it takes to get there. You know, I know I didn't I, that was the first thing my father told me when I told him I wanted to go to college. He was like, well, you're gonna get a PhD, and you're gonna pay off all our debt. And I was like, that's, that's a lot. So yeah, I mean, expectations or expectations are high. And, you know, we have to make sure it's really for us. Kira Yakubov:: [25:59] Yeah. How do you like to help clients who, whether they've already decided that they want to switch or do something different, and like, having some of these conversations with their parents, particularly from, you know, different backgrounds that aren't just born in America, Elijah Jackson:: [26:19] I always, I always think the most important part is to make sure that we're not absorbing other people's, you know, negativity. So we already know that that's going to be a hard conversation, because parents have high expectations, parents might be living through you in some ways, you know, it's like, oh, I never got to go to medical school, I never got to go to law school. So I want you to do it. So you, you go in against that, going against the grain, and that way, it might cause some tension, and might bring up some things for the parents. So it's, it's best to make sure that you don't internalize and absorb the things that they're saying to you. Because if you go, if you if you're telling yourself that they're correct, and they're right, they're gonna you're doing the wrong thing, you're not going to change, you know, what's gonna feel, you know, you're gonna feel like guilty, that guilt and shame is going to come up again. And you're not going to want to do what's really important to you, you know, to discover what you want to do, you know. So I say that self talk is so important. It informs so much of our decisions. If we're telling ourselves, we're not worthy. If we're telling ourselves, we're doing the wrong thing. We're telling ourselves that we don't trust ourselves, we're not going to act in our best interest, we're usually going to try to stay comfortable, which most times isn't even really comfortable. Kira Yakubov:: [27:51] Sure, that's just familiar. It's just what we're used to. And I think it's, man, it's really tough. I mean, I literally had to have that conversation with my parents. And I've had clients who also, and the biggest thing that helped me was having someone else in my corner, even if it was one person that was like, you know, what, I do think this is a good idea, or I support you trying something different or thinking about it, right? Because, like you said that self talk is really critical. And it's hard. I mean, of course, we're going to question ourselves if we don't have that much experience or knowledge. But having someone else who does support us and has our best interests in mind makes such a huge difference. And I'll never forget this. And I'm really thankful that when I told my parents, like, I don't want to do accounting, this is horrible for me. I want to go into psych, and I want to be a therapist. And these eastern European parents looked at me, like, I just shot them through the heart. I was like, Are you out of your mind? Like, you're the pressure we came to America, we sacrificed so much for you to help quote unquote, crazy people. Like, are you insane? And they were like, totally no, because they were helping me pay for college. And then my one brother was like, you know, what? Do some research, look up what kind of jobs you would you would get that sound interesting, what they would pay and what you would need to do to get them and if you can get that information and share it to me, I'll back you up to the parents. And I did that which was helpful for me to understand. And you know, in my culture, if the man says that you could do something, even if it's my brother, they're like, alright, well, I guess you can do it since he said, it's a good idea, even though it's life. Right? But having someone in your corner makes such a big difference to keep pushing through that resistance from your family. Elijah Jackson:: [29:44] Absolutely supportive, so necessary. If we feel like there's no one really rooting for us, if we feel like there's no one who's telling us even saying I trust you, you know, I trust that you're going to do what's best for yourself. They can make decisions harder. So we Got to make sure that we're creating communities for ourselves that reflect that, you know, we might not always get that support at home. So we have to look for it elsewhere, you know, with our friends or, you know, with our peers in school, you know, with authority figures, like your teachers, and you know, sometimes, you know, sometimes your parents aren't always going to think about, you know, what you want, they're going to think about what they think is best for you. You know, so it's, you got to make sure that you have someone that's that's actually listening to what you're saying, Kira Yakubov:: [30:32] yeah, some kind of mentor or friend or someone in your community. Yeah, that can just provide that positivity in your ear. Elijah Jackson:: [30:39] Absolutely. I know, I had it I had, I definitely as much as I as much as I, I talk crap about guidance counselor. My mom was very supportive. She, every time I came up to her with an interest, she would, she would say, you know, you, you know, you, I trust you I trust, you know, what you're doing, you know, you're, you know, you're doing what's best for you. And that's what matters. So it's good to have those supportive people, especially adults, you know, when an adult tells you that you're that, you know, they trust you and that you're doing the right thing, it kind of kind of makes you feel more motivated. Yeah. Sometimes the kids get it, your peers get it, but not not the adults. Kira Yakubov:: [31:23] Yeah, and then just that boost of confidence, like hearing an adult or hearing someone say, I trust you to make a good decision. It's like, wow, okay, so I want to make sure I make a good decision and think it through and make this person proud. Elijah Jackson:: [31:35] Absolutely. And it's never too late to change, you know, signing up for medical school, or law school, or any of those big ones, that takes a lot of financial commitment. But if still, even then I don't believe that's enough to stay in it forever. Yeah, you can find something else you can pivot, you can choose what's best for you, you know, it's never too late to discover what your niche is. Kira Yakubov:: [31:58] Absolutely. I think especially now, where a lot of people don't stay at the same job for a really long time. Or, you know, they learn new skills where they try different things. Like you're allowed to have different parts of you that develop, and maybe you go into a particular career that you did actually like, and you did want to do, and you have enjoyed it. And now there are certain circumstances in your life, or it's no longer doing it for you, you're allowed to pivot, right, like quitting something is not a bad thing. I think knowing when to quit knowing when to let go is actually super powerful and not a weakness at all. Elijah Jackson:: [32:32] Absolutely. I had peers who have, you know, who have gone into therapy as a second career, you know, they do, they had some kind of like, high profile job, that didn't really feel very fulfilling for them, you know, felt kind of soul sucking in some ways. And then, you know, they're like, I need something that actually makes me feel like I'm contributing to the world. So they would go into social work, or they would go into therapy, you know, where they feel more invested in their communities. It really, it really, you know, it's never too late. And these people, you know, you would think sometimes some people might say, you know, oh, well, why would you wait till you're in your 50s? To do that? I'm like, it's never too late to change. Yeah, you still have a, you still have a very fulfilling life ahead of you, you know, you're never running out of time. And I think, you know, older adults tend to tell themselves that they're always running out of time to do the things that they want to do. No, give plenty of time, you might not be able to act on it right now. Because there are things in the way. But that doesn't mean that won't change in the future. Sure. Let's be patient with yourself. Patience is so important. Kira Yakubov:: [33:34] It is it's very underrated. Because everything takes time, right. And even the way we feel one day to the next about something changes. Like I like to tell clients, especially when they're in certain careers, if they did pick on their own and choose it's, you know, that learning curve is going to take time, or there's going to be certain things in your life that are going to make it harder to show up for work each day. And not seeing all of it in the lens of just this one particular experience or feeling like okay, like, let me write this down in journal and let me think about in a week, when I come back to reread this, do I still feel the same way? Right, or in two weeks, three weeks, because you know, every day we change, and we feel something different? And, you know, we make these assumptions about ourselves. Like if I felt this way this week, then this must be the worst thing in the world. Elijah Jackson:: [34:24] Absolutely. I think. I think it's always whenever we have a bad day, we're kind of like, oh, it's horrible forever. But like, no, it's just today's that, you know, not every day. So sometimes it's important to take a little perspective, like okay, you know, yesterday was bad, but yesterday was good. Or last week was good. I might be having a bad week and now, it might be horrible now, but sometimes you have to take a little perspective and say, not every day was bad, and bad days are almost guaranteed in the future. You can't avoid this is just a part of Life. But was everything? Was everything horrible? I don't think he was dead definitely didn't need to make some changes, you know? Yeah, but I promise you, most times, not every day of your life is going to be horrible. So think more about those good days, too, instead of focusing only on the bad Kira Yakubov:: [35:25] Sure, absolutely. And something that I was just came to my mind when we were talking about more. So like explaining to, you know, those parents and everything is learning is going to be a really tough one, learning to accept that they will be disappointed. And letting it be? Elijah Jackson:: [35:49] Absolutely. I think for, for parents, they do a lot of lots of parents like to live through their kids, you know, so it's like, oh, I created you. So you're kind of an extension of me, and I want to be proud of this extension, I want to, I want this extension of myself to be able to do some of the things that I've never been able to do. And I want them to be secure and happy. And all this. And, you know, sometimes the intention is good. And the most times the attention is good when it comes to parents having expectations. But, you know, they kind of forget that. This extension of yourself that you created, there's also an autonomous being who has to can make their own choices, and you know, they're not tied to you, you know, at the hip, and they're gonna want their own lines. And they're allowed to have that. I've had many conversations with my parents about that. I'm like, Yeah, I get it. You know, you have you have these big goals for me. And I like these goals, I think that they're, they sound good on paper, but I don't know about in practice, you know, so I think I'm gonna try something different. And they're allowed to go through their own, they can go through the motions and feel that grief, you know, that their kid doesn't want to do what they want them to do, you know, you're entitled to your feelings, but that doesn't change the reality that kids should be able to explore what they want to explore. Kira Yakubov:: [37:18] Yeah. And I think a lot of times when parents are super pushy, it goes kind of one of two ways. I mean, honestly, there's a million different ways it can go. But the the most common that I've seen is one is like, Okay, I'm going to do whatever they say anything to make them happy, go through this career, all of this stuff, and they end up being very depressed, have an identity crisis throughout all of it. And at some point, get really ill, right, like, they have to take time off in some way. Or they rebel, like, I'm going to do the complete opposite. Fuck you. Fuck these expectations, I'm going to be my own person, and really go against the grain in some other direction. And sometimes it's good for them. And other times, it's not the best, because, you know, if we're only making a decision based on out of spite to somebody that's not in our best interests, either. Right? Elijah Jackson:: [38:10] I think parents really need to give their kids time to explore their interests, you know? Because even even, you know, you get a lot of pressure at school, like, where do you wanna go to school? You know, what do you want to do? Let's get this, get this paperwork, and let's do this. And then you get the same kind of messaging at home. So I think like, it's really important that, you know, younger people have the the opportunity to explore their interests, and not feel that pressure from their parents, because, you know, they're going to make rash decisions, when they feel pressure, they're not going to be fully confident in what they're doing when they feel pressure, you know, and it's just going to lead to more stress and unhappiness, you know. So I really feel like being a supportive, supportive parents are never bad parents, you know, accepting parents are never bad parents, you know, having having a parent that's going to trust you is a good thing. You know, they may be young, but they are not imbeciles. They understand themselves, they understand what they want. They understand, you know, what they would like their life to look like, you know, they may have like, you know, fantastical, you know, feelings about one certain thing or, you know, they may have a niche interest that you don't understand, but they're still autonomous beings want things for themselves. So parents kind of loosen up the reins. Kira Yakubov:: [39:42] So I feel like this was like a parenting one on one by Elijah. Get it together. Elijah Jackson:: [39:50] Get it together. That'll be my that'll be my tagline. Kira Yakubov:: [39:54] Buddy, so I know we're coming close to an end. Unfortunately, like we can talk about this and other things for a super long time, is there any last like thoughts or anything that you would want, you know, listeners or potential clients to hear about how you show up in the room, particularly around like this topic Elijah Jackson:: [40:13] Get it together. I just think that, you know, don't come to me looking for someone to tell you what to do. I am I have a safe space for you to explore whatever you want to explore. And most therapists should be, you know, I think lots of lots of clients might come to therapy looking for them to answer the big question and give them the key to, you know, the access all of this all of these things, and I'm like, No, we're gonna, I want you to remember that you're in the driver's seat here. You know, this is your life, you know yourself better than anyone. And I'm just a facilitator. You know, I'm here to facilitate the safe space. And I really think it's important that clients remember how you know how strong they are, and how capable they are usually how resilient they are, you know? So if there's ever a problem you're going through, you most likely know the answer. Kira Yakubov:: [41:13] Awesome. Well, if anybody wants to work with Elijah, please head over to heal your roots wellness.com and schedule a console, and we'll see if this will be a good match. But I want to say Elijah, thank you so much for making the time today to talk to me to make this episodes. I hope this really helps a lot of people that might be confused or struggling through their career path right now and it gives them a little bit of insight. Absolutely. Elijah Jackson:: [41:40] Thank you for having me. Kira Yakubov:: [41:42] Of course. All right. It's a wrap. ### Listen - [Spotify](https://open.spotify.com/episode/13130297) - [Apple Podcasts](https://podcasts.apple.com/podcast/13130297) - [YouTube](https://youtu.be/JZDctcDKNIM) --- ## Disrupting Cultural Norms: Mental Health Perspectives on Career Choices - URL: https://healyourrootspodcast.com/episodes/disrupting-cultural-norms-mental-health-career-choices - Published: 2023-03-01 - Season 2, Episode 1 - Duration: 43:21 - Category: relationships - Guest: Elijah Jackson ### Summary Guide to developing emotional intelligence skills for better mental health and relationships, covering emotion management and interpersonal connection. ### Description Emotional intelligence is a crucial skill for mental health and relationship success. This episode explores the components of emotional intelligence and provides practical strategies for developing these skills. Learn how to better understand and manage your emotions while also improving your ability to connect with and support others. ### Transcript Kira Yakubov:: [0:00] Join us for a spicy and unfiltered episode. We talk about porn, sex and how to communicate with your partner about your desires and needs, and how to find fun and informative events in your city surrounding sex. In this episode, we have Maureen McCarthy, Licensed Social Worker and therapist that heal your roots wellness, and our co host, Daniela Galdi. Let's get into it. Maureen, thank you so much for coming back on to join us for another episode today. Maureen McCarthy:: [0:34] Yea, thanks for having me. Absolutely. Kira Yakubov:: [0:37] So we can really jump into anything. Maureen McCarthy:: [0:41] Sex. Daniela Galdi:: [0:43] I was going to say, let's get right into it. Kira Yakubov:: [0:46] Yea Maureen McCarthy:: [0:49] Like that's so broad, though, right? When I was thinking about different things, I'm like, sex. I even talked to other people about it. And like, what do you like to talk about, like with your friends? And I was like, sex, dating, my feelings. I'm like, random things. Daniela Galdi:: [1:09] Yeah, my feelings are top of the list. Always. Like, you don't want to sit here and talk about feelings. I don't know if we can ever be friends. Maureen McCarthy:: [1:19] Yeah, I am that friend. I think that I am like, I think my close friends know that the depths of my mind are very deep. And I think that kind of reflects in the career I chose. And I'm like, Well, I'm a Pisces. So if you're not ready to navigate those seas, then I don't know, this is the destination for you. Daniela Galdi:: [1:43] Oh, I love it. So yes, we're gonna talk about sex. And I will, I will share that like, coming out of like a long term relationship, and now going into dating and like, jokingly saying, like, I'm gonna be abstinent for a very long time. Thinking that like, probably that would have happened, but it is. So you know, the importance of sex in your life. And for intimacy reasons, I am totally seeing the value. Now. I think I took that for granted a bit. You know? Kira Yakubov:: [2:12] and just overall, like, feeling happy. I noticed. Like if there's like a stretch of time where I haven't, and then I do, I'm like, Oh, wow. Like, the clouds look really nice today. You realize just how much pep in your step it gives you. So I'm like, I know, before we hopped on, we were talking about kind of like what we learned or didn't learn in sex ed or even like, from our parents. I gotta say it was like zilch. Like a horrible sex education really was just like STDs. It was STDs and how to put a condom on a penis. And I remember like in my gym class, so it was like the the gym teacher was our sex ed teacher. I don't know if that's like the same as everyone else's school. Daniela Galdi:: [2:57] Yep, that was for me, Kira Yakubov:: [2:58] was that the same for both of you? Daniela Galdi:: [2:59] and a little bit in theology class, which I don't think should have happened. But Maureen McCarthy:: [3:04] I had health class because I went to Catholic school. So not sex ed and that there the that was abstinence base, or STIs? Yes. And, you know, fear, fear base. I remember, like, scary posters that were like, yeah, it was like out of 100 people, it was like, all these stick figures. And it was like, what every fourth person has an STI. So people would be like, 1-2-3-4 you have the STI, and Kira Yakubov:: [3:34] oh my god. Maureen McCarthy:: [3:35] Those are some of my memories. Of Yeah, and it was the gym teacher that was, you know, an older, older guy that probably, you know, just got stuck with it. Kira Yakubov:: [3:51] That's so random. I wonder why they would pick the gym teacher to have this very important part of like education of a child and adolescents life in front of everybody to do that. But like my teacher, they just showed us like childbirth, and just like the horrors and they like really made it seem scary, or the STIs or boys masturbating that was it really like oh, yeah, boys are gonna masturbate that's totally normal. No big deal nothing about girls masturbating or nothing else or about pleasure even Daniela Galdi:: [4:22] No you're so right. I know that I think about it. It was never about a girl masturbating or any female situation of pleasure. It was like went from like, don't do it straight to if you do it and you get pregnant, it's awful. And then they get and get all the in between, basically. Maureen McCarthy:: [4:41] Yes, there was there's no pleasure component that was missed. I really would have enjoyed just learning that. Like bodies don't have to, like look one way and like body hair doesn't have to look One way. Yeah, there's a lot of that. And a lot of shaming, like, you know, when personal details came out about, and these are at the time, you know, your teenagers to people just sharing about, you know, when people would hook up and talking about intimate details, but also shaming for, like, what people did, how they did it, how they looked when they did it, or what they look like. And it's like, that created a lot of, I think insecurities like for me. For sure, Kira Yakubov:: [5:34] yeah, that's a good point about the body hair, because I am Eastern European. And I was very hairy, as an adolescent. And that was not a fun time. For me. Like I got teased for that a lot. And I wish that that was something that they talked about. And then I remember thinking about when I was like, sixth or seventh grade, it was like, You hooked up, or like, she touched someone's penis. And it was like, really like calling her a slot. But it was never about like the boy doing something wrong, or shaming him for doing anything sexual. It was always pointed towards the girls. Daniela Galdi:: [6:05] Can we actually touch on that works? Because now as an adult, going into her late 30s, I had to pause, said that, which is fine. I love aging, actually, but like, going into her late 30s and was talking to somebody the other day? And they said, Yeah, you know, and then that person was a sloth. And I was like, Man, when I was younger, I wish that we had the attitude that we do now. Because are they were they really a slit? Or are they just feel really confident? Wasn't it couldn't have been couldn't have been their choice that like, they wanted to explore this area for themselves, right? And so now as an adult, I'm thinking like, oh, shoot me a slut? And I was like, No, that's so wild! no, get that out of your head. Maureen McCarthy:: [6:56] Yea, I love that you brought that up, because I personally love that word and have identified that way. I've been called that. and various other similar words since a teenager, I think. And then at some point, when I learned about, like, reclaiming certain words and things like that, I was like, I claim that and I love that, whether it's actively true in that moment, or like not, but I think that's often thrown around, along with other words, but again, very stereotypical to do that when it's like, it's not done for, like, it's like a pat on the back for a typical, like, sis, hetero Dude, that's like, awesome, good for you. But, uh, but not not good for her. But I was like, now I'm gonna claim that back because I feel really empowered when I do. And like a pretty powerful woman. And if that intimidates, you know, a man, I kind of like that. Kira Yakubov:: [8:12] I love that . Daniela Galdi:: [8:13] I like that. Maureen McCarthy:: [8:14] Yeah. Kira Yakubov:: [8:17] I used to wonder, right, like, because when we were teenagers, I used to hear that all the time. She's a sloth, she's a sloth. She's a whore, like, just constantly. And then I was like, thinking I was even talking to one of my friends about this looking back of when we might have been promiscuous as teenagers. Right. Part of that was like, we're just exploring, right, and just trying to figure out what we like. And we like somebody else. And we want to express it physically, but also that there was a lot of, like, underlying trauma, outside of that, that's how it was expressed to, or even like, unfortunately, even some sexual assault that it's like, this almost seems like an easier path is to be promiscuous, or just to do that right off the bat as like a protective mechanism. And then after that, being called a sloth and being shamed over and over, and then like repeating that cycle, and then going into college and drinking. And, you know, it's like, it's kind of fucked up, how that path goes, and how other people might perceive it. Until like, maybe you get older or you heal, or you go to therapy and recognize why you might have been doing it. And then I love how you say like reclaiming it, because now it's like, well, now I have sex because I want to because it feels good. And I don't give a shit. If someone doesn't like it, or if they have to ask me like a body count. That's the worst. That was. I used to hate hate when people would ask stuff like that. Daniela Galdi:: [9:39] Why do people ask that? I don't know if I've been asked. Maureen McCarthy:: [9:42] I love if you have not been asked that. Kira Yakubov:: [9:45] Yeah, yeah, Maureen McCarthy:: [9:47] honest. It's been a very long time since I've been asked that and I know it was very popular in high school in to I guess called traditional like college Ah age, or that experience, and then at some point maybe that fell off or I stopped hanging out with people that asked me that. Unless Yeah, like a good friend. I'm we're talking about that. But yeah, when people ask that I always felt like it was coming from the intention of why need to know how many people you've been with? Because I need to determine if you are dirty or not. Or if it was that, you know, you as like a woman were with more people then. Like, a man was that that that wasn't acceptable, or like that wasn't okay. I feel like that was my experience in mostly like sis hetero dynamics as a teenager into like, early 20s. Until somewhere, maybe someone got the memo to stop asking people that. Kira Yakubov:: [11:01] Yeah, absolutely. I know. That was that was teenagers and in college, and I agree, I think it's so they can determine if you're a slut, or if you're a good girl, or if they want to date you like putting a moral value on you based on the number of people you have slept with. is so silly. Maureen McCarthy:: [11:22] Yeah, hopefully, it's like, you know, what we should have been asking was, have you been tested recently? Yeah. Like a forgotten thing? Like asking, asking needs once, you know, if you've been tested conversations around just being having safer sex, that would have been great. Daniela Galdi:: [11:45] Oh, I definitely agree. Because it's not easy to ask those and so much easier going into everything. And then also the idea of like, they talked about protection situations, right. But like the fear that at least I experienced around like actually going and getting those things I still carry with me, I think I might have asked here to actually go buy me some things. Like, I still have that fear around me. And you're so right, you make such a good point marine about like having that those conversations could have been so much more normalized. It could have helped people moving forward into their adulthood. Maureen McCarthy:: [12:26] I think about being in school, and I was afraid to answer a question about like, what the capital of Pennsylvania was, or something, let alone, you know, like having some of those conversations, then, despite being someone that was pretty open about this stuff, very young. But you know, what I think some of the great like sex educators are doing out there. And I love when they make these posts, they have index cards, and the kids are like, write questions about anything, and the questions are so great. It's like, Is it normal for my genitals to have hair on them? Or am I supposed to like giving a blowjob? Am I supposed to do that? And like, these are such great questions that if they came across my mind, I don't know if I would have verbalized that in front of like a class, let alone I wouldn't have had that option in school, because we didn't talk about that, and didn't really talk about that at home, either. So yeah, I think we need all of their arenas to kind of talk about stuff, if that makes sense. Kira Yakubov:: [13:44] Yea, I mean, it's tough because I think talking about in a group setting, in some ways is good, because it normalizes it, and everyone can hear the same information. But I think it's only helpful if it feels safe. Probably like if you're scared to ask or if you're nervous to say something, or there's like people in class or bullying or the teachers coming off in a shameful way, or like, there's clearly a stance they're taking on something, then it's probably not helpful. Right. So and but I love that like writing the questions down, like there has to be this level of like safety to even ask a question and then the teacher has to feel comfortable and equipped to answer it. I don't know that my team and my gym teacher in middle school was equipped to answer the questions that we would have been asking them at all. And like having it talked about at houses is the tough part, right? Like we I think they probably do it in school because it's like General Information everybody should have and that we can't necessarily rely on like parents or caregivers to like, explain that or talk about it because they may not have ever received it or they're uncomfortable with it, or they just don't want to, or they only have a particular stance on it. So I think it is kind of hard to figure out a very inclusive and helpful and beneficial safe way that everyone is getting information and not just leaving it to only at home, because everyone's going to get a mixed bag at that point. Maureen McCarthy:: [15:20] Yeah. And then you know, they're going to be online, looking up some porn, and they're like, fine. Well, I don't know what this is, let me google it. But I can find, Kira Yakubov:: [15:32] yeah, Maureen McCarthy:: [15:32] just, you know, watching porn, just because and things like that. I know I look for I like make anything a window. Like for my kid, if he brings something up. I'm like, the windows opening to talk about this. And not that I tried to turn everything that way. But I do try to look for those windows where it's like, we can have a conversation out of this. So it was like, we have those conversations about porn. And I'm like, Yeah, that's probably gonna come up as at some point, I'm like, so and you're gonna pull it up, someone else is gonna be like, Look at this. And, you know, just, I always look for those, those moments to just kind of take it and have a conversation. And because my kids grown up with me being like that, plus, I think what I do for a living, that's going to be I hope, normal for him, so he can feel comfortable in those conversations. And also be an advocate for people to let alone himself. Kira Yakubov:: [16:44] I mean, it sounds like you are definitely creating that safe open space as a parent, which is awesome. I wish I had something even remotely that look like, Maureen McCarthy:: [16:53] yeah, we even talked about, you know, um like, with him. I've been like, you know, some adults, like don't talk about this stuff. Because they feel really, like embarrassed, they feel really uncomfortable. They don't know what to say. So they either can say the wrong thing, or something that doesn't feel good. And then we're just like, avoid it entirely. Or like, again, I'm just not gonna talk about this. I was. And he that's something he was like, yeah. So I don't know if that's something he experienced, personally, to at some point, I mean, probably. But I mean, he's lived in a household that's had, like, I don't know, like condoms in jars and like lube in the drawers sitting out. Like, it's just like, these are things that like, that don't need to be hidden away. Right. So Kira Yakubov:: [17:50] yeah. And I feel like our generation is probably just gonna do a better job, generally speaking, just because we are like, more normalized to it. Like I'm thinking about on never, ever forget this. This lesson that my mom gave me when I was little, like the sex talk. It was, I think it was like eight or nine years old that came out of the shower, and she like, told me about periods. And then she was like, Okay, this is coming from like a very conservative, Eastern European immigrant. She's like, you are not allowed to have sex before marriage. And I was like, Oh, why? She's like, because it's wrong. I'm like, but you know, you're a kid. Like, why? Why? Why? Why? Why? And so she's like, let me give you let me give you an example. I was like, okay, she's, so she's like, do you know when we go get a carton of milk at the store? And this is back when they used to have a seal under the cap. So she's like, you know, when we go get a carton of milk at the store, and we take off the cap, and if there's no seal, would you drink that milk? I was like, I don't know. Maybe not. She's like, why wouldn't you drink it? I'm like, I don't know. Maybe it's dirty. She's like, Yeah, that's a woman's virginity before marriage. I was like, Oh, my God. So my worth and virginity was compared to a used milk carton and it being dirty. And that just stayed with me for a long time. And till I was like a teenager that my mom and dad were like, once he saw me dating, they're like, "yeah, if you have sex before marriage, you're gonna put us straight to the grave. We will die." I'm like "on the on the moment in the instant?" they're like,"yes." Like okay, cool. So I can't ever tell you anything. Oh, yeah. thick layers of guilt Maureen McCarthy:: [19:38] Yeah, Kira, I think you and I both grew up in. And mind you, I think most of mine came from, like the school because I did have 13 years of Catholic schooling. That was there was so much rooted in virginity that it fed into like that. shame and that guilt and those stereotypes like throughout high school that, you know, it was like, Oh, well, she's not a virgin or she's been with other people and things like that. And it held such a weight, I think in in a lot of different ways and just really spilled into how all these other things were viewed like me as a sexual being. I'm sure it wasn't the only one. Kira Yakubov:: [20:32] No, of course not everyone's experiencing and feeling it. It's just unfortunate that it wasn't as accepted or normalized. And it was just so feared. Daniela Galdi:: [20:48] How do we talk about porn? But like, how does that even happen? Like, what do you how do you even look for it as a person, let alone a child and an adult, a child like not, I shouldn't say a child, but a person who is exploring these things. Kira Yakubov:: [21:28] So I think it's gonna be different between an adult and a kid who's like, exploring and curious and finding things out for the first time. Right? Like, as a kid, if you're going to Google something, and just find whatever comes up, and that's like, your first impression of what's happening, like, you're probably going to take them at face value. Like, this is what people do when they have sex. These are the expectations, especially like, heterosexual porn is going to like, I can't imagine when I was younger looking. I was like, Okay, so the girl is always moaning really loud. From the second she's touched. And she comes in like five minutes. And this, this and that. And the guy does this. And I was like, okay, so I guess that's what's supposed to happen. And like, you go into it, and then you have experiences like, Oh, this is not, this is not lining up the way I thought it was going to. So I mean, I think it's tough. I mean, Renu might have a better handle on how to talk to a child about porn, because I don't have kids. But I would imagine like, giving them that heads up, like, hey, what you see is not necessarily what's real. And to not take that as what's going to happen necessarily, or that you should be doing or feeling or experiencing this is like, I think a huge part of it. And then like not shaming, like, they're going to be curious, right? Like, it's normal and common for kids to seek these things out. So I don't know, Marie, what do you think? Is there more tips on how to like, discuss it? Maureen McCarthy:: [22:58] Yeah, I think all that is really important. And I was trying to recall at least just for that personal conversation I had with my son, whatever, whatever that was it I was like, Oh, the windows open, but I can't recall it now. So when we talked about it. I you know, it was like, you're gonna come across this probably soon, you may have already come across it. And he was like, Yeah, that was like, it wasn't like, you know, maybe some parents present day and past would be like, our get, like, start yelling or oh my gosh, like, No, you can't look at this. And so we talked about that shame piece. Some people watch porn and like porn, and that's cool. That's fine. And some people don't watch it. Some people don't like it and that's fine too. Some people in the porn do that for that third job, and they do sex or believe we even have that conversation. And I think I mentioned that, you know, people that do sex work, catch a lot of heat for that. And I was like, it's their job and they shouldn't be shamed either. So we had that conversation. But also, you know, kind of porn is is something that adults are those are like adults doing that. So we had conversations about it's never okay. Photos, videos of kids, teenagers, like minors to be going around that sidebar. That was a huge thing when I was in high school, just people sending out nude pictures, and it was always of the local girls that got out. And that got out to every single school, public, private, whatever. are so kind of like touched on that, because that was such a big thing too. When since when I was in high school, we had an assembly about it and everything about sexting and things like that. So, um, yeah, I think I tried to like normalize, validate, and just be open to like what he had to say. But I think it was a lot of me talking. And I was like, let me let me just touch on these few things. But I'm always like, you know, if you have any questions or comments, or like, I don't know, something happens, like, feel free to ask me I was like, It's okay. And I was like, in sometimes you might not want to ask me, because I'm mom, you might want to talk to someone else. But that's okay. It was like, as long as you feel like you have someone to talk to. So yeah, I, you know, I think, at least today talking about generations changing to with porn, like, there's a lot more like feminine directed porn. And there's, there's one porn star, I can't recall her name, but she's also like a sex therapist, or she's a sex educator. So don't quote me. But, but she has like both of those, like, informed backgrounds to kind of just bring it all together. And I think she even came out with, like, videos, or well, it's not DVDs anymore. But things you can buy, that are more so it's porn, but it's educational. It's like sex ed, too. And I think that's a really cool concept as well. Like, you're not getting like this. Like, this is directed like this is acting majority of it is like, it's, it's more real. It's like reality based or for people that are curious about like, Well, how do I do this? Or like, what do I do? Like, what am I bought? What's my body? Do my hands do? So there's a lot more out there. That's, it's, it's better information than just all the, you know, homemade videos and things like that. Kira Yakubov:: [27:21] With the scrambled porn on channel 99, Daniela Galdi:: [27:24] you had the Hotbox, you had everything Kira Yakubov:: [27:26] Oh, yeah, catch a boob in the website. But that made me think about, there's this website called O.school that actually does educational videos and prompts and worksheets, which is phenomenal. And I get like an email newsletter, and I think the one was how to talk dirty like during sex, and it gave like, all these different prompts and body parts and what you could say and how to respond. I was like, Wow, that's so awesome. Like, that's, you know, to actually like, teach you to go through it and not just like, watch a porn and like, hear what they say and think that's what you're supposed to say. Maureen McCarthy:: [28:05] I love that website. One and two, I refer to it a lot. Three, did you see they have an orgasm order form, it's like you're ordering takeout, you can tell them if you do not want mayonnaise on your same score. A little extra that it gets down to the point of like, how you want to be touched down to like, level of pressure, or do you like tapping and different motions and things like that. So it's great, I forget in that one, if there's also a piece that kind of ties in with, you know, the dirty talk, because some people definitely, like don't want to be called something certain things or don't want their genitals to be called certain things. And if you do, that's like, the light switches off and it's just like, next thing you know, you're checked out and you're like, I'm gonna need to take a break. So that that was a it's so informative, and anything that's like an inventory or an order form I think is always helpful tools to like, empower and get to know yourself, but also communicate that to a partner. Like, I know I like texted that order form. Before I was like, I know you know a lot of this already but like, here you go, man like I don't like you should send this out to you know that that sex geek in you Daniela Galdi:: [29:44] That is very Kira Yakubov:: [29:45] I love that but I did see, it was like how to tell or show your partner what you want or don't want. Because sometimes we don't even know Right? Like all this is through exploration. Like we might think we might like the This particular thing or think we will, and then when we're actually confronted with it, or we're trying, it was actually kind of my cup of tea. I wouldn't have guessed this. And like having those prompts to even, like, click through like, No, I don't want to try that. I do want to try that I'm open to trying this, this is a hard, no, let's definitely do this. And like showing that to your partner, whoever you're having sex with, I think is like, pretty empowering how you're saying and pretty cool to even like, think about it. And like, have these different ideas to try out. And if you don't feel comfortable, like saying all these things, that's a great way to like, tell someone without saying it, too. And it's great for couples like especially for couples therapy, who are like trying to, whether it's like reconnect, or try something different or explore or even like getting over shame. It's a great way to have like this external prompt to go through things and just talk about it without even trying any of it. It's like what comes up in your mind when you like you see, like, also watching porn together. And like having a whole dialogue of what that means and like getting to know each other better. And like our experiences with it outside of that, so I love that site. Yeah, like, Daniela Galdi:: [31:08] Will you be okay, when you come home and I have a swing installed? Kira Yakubov:: [31:14] Hot wax across the room Daniela Galdi:: [31:18] Dinner's ready, dessert's there, and.... we'll be okay. We need to make sure there's mutual agreement and consent there. Kira Yakubov:: [31:32] It's so funny. Maureen McCarthy:: [31:33] That's so great. I did actually get some lube that they were like, you can put this on ice cream if you Daniela Galdi:: [31:39] Wow want. Maureen McCarthy:: [31:43] I would give them a plug. I can't think of who it is. I don't know if it's it might be Joe, I'm not sure. But, you know, they had like grim brew lay and just all these, like decadent dessert flavors. And it was like It's sugar free too! Cool, multi use. Daniela Galdi:: [32:05] I love that. Kira Yakubov:: [32:06] I remember when I was What year was this think it was like when I was 25 or 26. And like, gotta have a relationship. And I was like, I want to do more stuff alone. Or like some of my friends like didn't want to do certain things, but I wanted to and I was like trying to overcome this, like social anxiety and phobia. So I was like, let me find stuff that's like really gonna make me uncomfortable that I'm just gonna do to get over it. So this is how I torture myself. But so I found this event in Philly. I don't know if they're still doing it because of what happened with COVID and everything. But it was called the erotica, the Erotic Literary Saloon in Philly. And it was like every third Thursday of the month, it was held by a sexologist, and a sex therapist, and she would have people come. And she'd have like, those anonymous questions at the beginning, people would write them down and answer them in the beginning of the event, and then other people would come and they would just read their stories, like their erotic poems or stories, or fantasies. And then people would ask questions, and I thought it was so cool. And I went alone, like, met all these interesting people. And it felt like a community, like if you would have walked in the room, I would have never thought that these 50 people would be friends or talk to each other. But then as the night went on, like, everyone was very welcoming and opening open about it. And so like, drag some of my friends to go after that. And they're like, We don't ever want to do this. But I thought it was awesome. So I don't know if there's other events that either of you have gone to or there's like things like that. That might be I don't know, that were like, kind of uncomfortable or interesting in that way. Maureen McCarthy:: [33:46] Yes, I've been to a fetish con. And I'd also more recently was at I don't know what it would have been called but it was event an event that was at a hotel so like pretty much the one floor of the hotel you would go in a different room and there'd be like a different vendor their. So it's very like intimate to because you'd be with a small group and I was with a good friend and also colleague that is same kind of interest and work with like sexuality and public health and things like that. So we feel very comfortable being with her in those spaces. So the one room you know, you would get like sex toy demonstrations. And someone was able like to try one like if they felt comfortable like in front of you and everybody else felt comfortable in the room. So I thought that was a pretty interesting like experience. There's something about being in those environments where people are so open and vulnerable about something that holds So much like history of shame and guilt and like make yourself small kinds of things that is really empowering. Like anytime I go to any type of conference, whether it's as intimate and open as like that, or if it is more of a professionally, like driven track, I always leave, we're always we'd always walk out me and this friend and colleague and be like, we're so liberated and we're stimulated. Dreaming it like those two words, right? Like, right now. And I definitely miss like those spaces, because unfortunately, I feel like I don't go as much to as many things given, you know, like, COVID, and things like that. Or maybe I'm not aware of as many. But I miss them dearly, because they're just such a great space to experience and not even just your own, but just just seeing other people like experience other things do. It's just so cool. Daniela Galdi:: [36:04] That sounds Kira Yakubov:: [36:04] I love events like that. Daniela Galdi:: [36:07] Yeah, that definitely sounds awesome. I, I would love to experience that. And the only thing I can really think about is like growing up as and going to college board. And then performing is like the performing arts, we have to do a lot of work around like intimacy. And that's really it. But, you know, it exposes you to the feelings around it. I felt like that's what I gained. But in terms of things like sex toys, that wasn't something that was ever you know, that that was unless it was part of the concept, right, but I love that they have events around this. I don't know. I'm so curious now. Like, what? If you feel comfortable sharing? Maureen? Were there things that you remember from it that that maybe you didn't know? Or that just like, intrigued you? Maureen McCarthy:: [36:59] Hmm. I think what was great about like, when I'm shopping, I like a hands on experience. So if I'm being able to, like, you know, you're not online shopping, and you're like, Yeah, this toy looks great. They say it has 10 different speeds. That sounds awesome. Many options, but you don't know, like, what you're not holding it or feeling what, you know, what the sensations are. So just being able to get hands on and like, you know, play with like, the different toys essentially, you know, you could kind of like just mess around with them. And and, I don't know, ask questions and things like that. I feel like in that experience, there was a lot I learned about lube. But then the way that was different, more, so like, ingredient wise, I just remember the brands, especially ones that you know, we're trying to promote if and if it's like edible lube and things like that just like healthy ingredients. And such a key piece about like, knowing what we're putting in our body. Not just like toys and who we're with, but like just like lubes and things like that. I thought that was very interesting to me, because there was like a very big science to it that I was not aware of. So they gave some interesting feedback there regarding ingredients and things like that with lube. Yeah, I'm trying to think of anything else. But I think it's a it's a different experience when it's something hands on versus Okay, I'm gonna Google some things and see what I can find because I want to try something new. It's like, I'm here holding all these toys like pressing all the buttons putting my neck like Man, they're giving us taste tests of all the lubes and like, flavors and arousal gels that you just need a teeny drop of and you could like feel intense sensations. So you're getting this horrible, like engaging all your senses, which is such an important element to sex, let alone life and being present and experiencing it. Kira Yakubov:: [39:32] Absolutely. I love that because it is completely different of Googling something versus being in person. So I know on South Street, at least they used to there's all again, Philadelphia, there's a lot of sex shops on South Street, and a lot of them hold classes, like different kinds of classes and I used to drag my friends to all this stuff. There was one class it was like deepthroating at a deep throat and I went there and like before they had the class they would like you know give you a tour around the sex shop and, like, show you all these different toys and different things. But not even just toys. But there was one where it was like electricity. Like you could have something that was like electricity and like shock you, or like nipple clamps and like things you just might not have ever thought of or you wouldn't Google, but you're like in person and you're feeling it and experiencing it and having those classes, right. It's like kind of silly, but then you're bonding and you're being vulnerable, and like, learning all this new stuff. So I think I love that I think we should, I'm gonna look to see if there's some of the sex workshops around Philly or PA to see if we can post it with us. Because I think it is a great experience. Like, it's a great way to learn great way to bond whether it's with a partner or friends, or if you're going alone to meet other people doing it, and just exploring. So like, you want something to do on a Friday night, go to a sex shop, go through it and find some cool stuff to do. Daniela Galdi:: [40:56] Absolutely, especially with what we were all talking about earlier. And I found myself saying like, there's the fear of rounded and, you know, curiosity, but never feeling comfortable to like speak up about it. But like, I'm very comfortable walking into a class like, that makes me feel, you know, I'm not I'm not walking in there the only one who doesn't go maybe certain things or maybe wants to learn more about certain things, you know. So I love that idea. Because it definitely adds that comfort level. Kira Yakubov:: [41:22] If I find some, will you go with me? Daniela Galdi:: [41:24] Absolutely Kira Yakubov:: [41:24] I'm coming! Daniela Galdi:: [41:24] I would say Maureen, I'm prety sure she's coming too Maureen McCarthy:: [41:32] I miss that stuff. So much. Kira Yakubov:: [41:35] Yeah. Daniela Galdi:: [41:36] Alright, well, if anyone needs us, we'll be in class the next few weekends. Kira Yakubov:: [41:41] And they have them all over. Right. It's not just Philly. I think if you I mean, there's stuff on even Eventbrite because like, since I moved to Florida, like I gotta find different activities and stuff to do and meet people. So I went on Eventbrite, and there was all these different ones. And the one was like, teaching you how to ride like, how to ride on top like a cowgirl. And it said things to bring kneepads and a pillow and I thought that was great. So it's like, even in any city you're in, if you just like Google some of these events, I'm sure that there'll be listed on there. And you can be brave and go and have a good time. Daniela Galdi:: [42:17] I love that. Maybe we should like make kneepads, the new like style trend. So you don't have to be like, Hold on, wait one second, please. Get my knee pads on, I need to practice this. But I thought, and I joke, but you know, you never know somebody might need them. So no judgement, you see someone walking around with them. Maureen McCarthy:: [42:40] We could like the bedazzle them or decorate them. You might lose traction with the beads, but I love some crystals gemstones. Kira Yakubov:: [42:55] Oh, that's so funny. And I remember when I was going through my sex therapy program, there was a portion, I think it was called the Star part of like, the certifications, like sometimes they have some of these workshops, and where they like just show different kinds of porn, and you're watching it in the class with your classmates. So I think even that was a cool experience of watching this near strangers or other people like 10am and wearing all this different stuff and like wanting to come home and like tell all my friends like, you know, it wasn't a what I watched today. Do you ever think about doing that? And they're like, Okay, this is like, we got to stop. This is enough. Maureen McCarthy:: [43:36] That's awesome. You know, when I went to the sex museum, or museum of sex in New York, they the exhibit at that time was like porn throughout the ages. And it was just so interesting to see like the earliest clips, you know, black and white. I mean, extremely taboo at that time. And it was just interesting to even see like, the decor and like what they were wearing. It was, it was pretty, it was pretty neat. They also had jello shots that were like nipples or like food. It was it was so cool. They have like a pop up bar and stuff plus the store. So it was a neat experience. Daniela Galdi:: [44:29] These are definitely great resources that you're both sharing, and I wish that I could not stop thinking like, Oh, my next date. I really do. Like, I don't want to wait till I have a partner I kind of want be like, hey, look, we're taking a trip to New York. And this is what's happening because I'm intrigued. You know what I mean? And, you know, I don't know if I'll do that, but that like events and classes and I didn't even know there was a VM so that's amazing. I think these are so such great resources. Kira Yakubov:: [44:58] There's plenty out there. Maureen McCarthy:: [45:01] Yeah, I would love that to be your next date. Personally, I would love that for you. And if that person was like down with it and excited about it, I would love that person for you. Daniela Galdi:: [45:12] I'm gonna throw it out there one day, and we'll see, I'll wait till the 3rd date. I'll throw that out; see if they bite. Maureen McCarthy:: [45:25] always recommend dates to like a local toy shop or something like that. Regardless of, you know, if the couple is like newer, or just hooking up or married for 30 years, like, um, like, it's fun to see, you know, to watch your partner kind of like what they gravitate towards, or what they're picking up or, you know, like, look at this, like, what about this?I think that that's a great date. Daniela Galdi:: [45:57] I love that. And you're actually reminding me that there is a place in Philly, and I can't remember if it is South Street, but I have to find out and get it in the show notes too. But they do they create like [BDSM] clothes and material and the different types of like, I don't know if they will be called toys, but different types of materials like that, that is available in Philly too there's a shop and it's like, so I remember going in, there was a lot of leather. And I felt that people and I'm not, you know, no stereotype, but really, there was a lot, but it was like, a whole artistry to it. And it was amazing. But also you can get these like custom made, because I imagine that's a situation to like, how you you know how someone buys pants. Right? It's important that it's customized. You're ruining the experience. Kira Yakubov:: [46:47] Yeah Maureen McCarthy:: [46:48] yeah, I think that's a good investment. If you're looking for some, like, you know, which is can be a bit costly. But yeah, some things you know, that are not custom made, or made with like good quality, whether it be toys, or like harnesses and outfits and things like that, you will find will break don't fit your body, right, because it isn't custom made for you or is uncomfortable and irritating, which you know, all that stuff can be can take from the experience too. So that sounds like an awesome place. I guess. Like I go to Philly soon and hit up a couple places. Kira Yakubov:: [47:31] Yeah, but I think anywhere, I'm sure there's places anywhere you go if you just walk, like when my husband and I go traveling when we go to like a different country or different place and have like a big city. And if I see a sexshop like all let's go in to see what kind of stuff they have here. Like, I think the best one so far was in Barcelona, they had these statues and they had all these different kinds of like costumes, and toys and like jewels to put on everything. And I thought a fun one was was was like a butt plug with like a squirrel tail coming out of it Daniela Galdi:: [48:04] That's adrable Kira Yakubov:: [48:11] so I think every place around the world, you know, if it's like a bigger city, or even smaller, they have like some sort of shop or some kind of place where they have some of the stuff because people have sex everywhere. Maureen McCarthy:: [48:24] Yeah, that that'd be interesting to see if they're like kind of what is like, I don't want to say trending, but like or like maybe what's common because I imagine the inventory would probably look different. Or maybe that's my assumption. Based on like, you know, what is selling? That'd be cool. Maybe that'll be that's a bucket list, you know, go to all the different like continents and certain countries or big cities and see see, you could do like dissertation on that. Oh, yeah. Daniela Galdi:: [48:59] Hey, maybe maybe that's something that gets up on the Heal Your Roots Wellness site one day, a little a little tour, a little shop tour of where to go find these things. Resources for this. Oh, just throwing it out there. And then if any of these right and if any of these places or products then want to you know sponsor the podcast. We're not sponsored by any of them right now, but Hey, why not? If it's helping the Kira Yakubov:: [49:28] Listen I'll do a Netflix special traveling around experienced. the world going in different sex shops. If somebody wants to pay me I would be more than happy. You can all come, and it'll be a whole thing. Maureen McCarthy:: [49:40] I'll be a sidekick. Daniela Galdi:: [49:42] Yep, so yes. Okay. These are great ideas. I really hope that we can like put them into play. Kira Yakubov:: [49:47] Yeah. Is a there's a show on Netflix called Somebody Feed Phil. I don't know if you've ever heard of it. It's like everybody. Everybody Loves Raymond is the producer of that. And he just goes around different countries and cities and just eating and Talking about his experience. And so we could totally make that I don't know what we would call it but sex shops and experiences around the world. Maureen McCarthy:: [50:09] I don't know why I'm picturing myself in like, a, like a sidecar with like a helmet on and like we have like, all kinds of toyslike in the trunk that are just like bouncing around Kira Yakubov:: [50:23] And our dogs are with us. Daniela Galdi:: [50:25] I see this and then I see the little like squirrel tail at the ends of like your motor vehicle. we're painting a whole picture here for everyone. Kira Yakubov:: [50:36] Oh my god. Maureen McCarthy:: [50:38] That just kind of seems like life goals. I don't know. It's like, we'll have to start a vision board for this. Kira Yakubov:: [50:45] Yeah, I like this. This is a good idea. And then obviously, we can eat in between all of this so we can add in the food part. Maureen McCarthy:: [50:52] Of course. Kira Yakubov:: [50:53] Thank you so much for being on with us again today. I think this was I think this is going to be a great episode. And a lot of laughs a lot of great insight information. I hope people feel like this was listening to a conversation with a couple of friends just talking about sex and their experiences. So thank you so much for being on Maureen. Maureen McCarthy:: [51:11] Yeah, thanks for having me. I'll talk sex anytime. ### Listen - [Spotify](https://open.spotify.com/episode/13066739) - [Apple Podcasts](https://podcasts.apple.com/podcast/13066739) - [YouTube](https://youtu.be/ZgPUPt4X5WU) --- ## Let's Talk Sex with Maureen McCarthy, LSW - URL: https://healyourrootspodcast.com/episodes/lets-talk-sex-maureen-mccarthy - Published: 2022-12-07 - Season 1, Episode 12 - Duration: 38:55 - Category: therapy - Guest: Maureen McCarthy ### Summary Season 2 premiere focusing on the therapeutic relationship and finding the right therapist fit, with guidance for evaluating therapy effectiveness. ### Description Welcome to Season 2! This premiere episode focuses on one of the most important factors in successful therapy: the therapeutic relationship. We explore what makes a good therapist-client match and how to find the right therapeutic fit for your needs. Learn what to look for in a therapist, how to evaluate whether therapy is working, and when it might be time to make a change ### Transcript Kira Yakubov: 0:00 Join us for a spicy and unfiltered episode. We talk about porn, sex and how to communicate with your partner about your desires and needs, and how to find fun and informative events in your city surrounding sex. In this episode, we have Maureen McCarthy, Licensed Social Worker and therapist that heal your roots wellness, and our co host, Daniela Galdi. Let's get into it. Maureen, thank you so much for coming back on to join us for another episode today. Maureen McCarthy: 0:34 Yea, thanks for having me. Absolutely. Kira Yakubov: 0:37 So we can really jump into anything. Maureen McCarthy: 0:41 Sex. Daniela Galdi: 0:43 I was going to say, let's get right into it. Kira Yakubov: 0:46 Yea Maureen McCarthy: 0:49 Like that's so broad, though, right? When I was thinking about different things, I'm like, sex. I even talked to other people about it. And like, what do you like to talk about, like with your friends? And I was like, sex, dating, my feelings. I'm like, random things. Daniela Galdi: 1:09 Yeah, my feelings are top of the list. Always. Like, you don't want to sit here and talk about feelings. I don't know if we can ever be friends. Maureen McCarthy: 1:19 Yeah, I am that friend. I think that I am like, I think my close friends know that the depths of my mind are very deep. And I think that kind of reflects in the career I chose. And I'm like, Well, I'm a Pisces. So if you're not ready to navigate those seas, then I don't know, this is the destination for you. Daniela Galdi: 1:43 Oh, I love it. So yes, we're gonna talk about sex. And I will, I will share that like, coming out of like a long term relationship, and now going into dating and like, jokingly saying, like, I'm gonna be abstinent for a very long time. Thinking that like, probably that would have happened, but it is. So you know, the importance of sex in your life. And for intimacy reasons, I am totally seeing the value. Now. I think I took that for granted a bit. You know? Kira Yakubov: 2:12 and just overall, like, feeling happy. I noticed. Like if there's like a stretch of time where I haven't, and then I do, I'm like, Oh, wow. Like, the clouds look really nice today. You realize just how much pep in your step it gives you. So I'm like, I know, before we hopped on, we were talking about kind of like what we learned or didn't learn in sex ed or even like, from our parents. I gotta say it was like zilch. Like a horrible sex education really was just like STDs. It was STDs and how to put a condom on a penis. And I remember like in my gym class, so it was like the the gym teacher was our sex ed teacher. I don't know if that's like the same as everyone else's school. Daniela Galdi: 2:57 Yep, that was for me, Kira Yakubov: 2:58 was that the same for both of you? Daniela Galdi: 2:59 and a little bit in theology class, which I don't think should have happened. But Maureen McCarthy: 3:04 I had health class because I went to Catholic school. So not sex ed and that there the that was abstinence base, or STIs? Yes. And, you know, fear, fear base. I remember, like, scary posters that were like, yeah, it was like out of 100 people, it was like, all these stick figures. And it was like, what every fourth person has an STI. So people would be like, 1-2-3-4 you have the STI, and Kira Yakubov: 3:34 oh my god. Maureen McCarthy: 3:35 Those are some of my memories. Of Yeah, and it was the gym teacher that was, you know, an older, older guy that probably, you know, just got stuck with it. Kira Yakubov: 3:51 That's so random. I wonder why they would pick the gym teacher to have this very important part of like education of a child and adolescents life in front of everybody to do that. But like my teacher, they just showed us like childbirth, and just like the horrors and they like really made it seem scary, or the STIs or boys masturbating that was it really like oh, yeah, boys are gonna masturbate that's totally normal. No big deal nothing about girls masturbating or nothing else or about pleasure even Daniela Galdi: 4:22 No you're so right. I know that I think about it. It was never about a girl masturbating or any female situation of pleasure. It was like went from like, don't do it straight to if you do it and you get pregnant, it's awful. And then they get and get all the in between, basically. Maureen McCarthy: 4:41 Yes, there was there's no pleasure component that was missed. I really would have enjoyed just learning that. Like bodies don't have to, like look one way and like body hair doesn't have to look One way. Yeah, there's a lot of that. And a lot of shaming, like, you know, when personal details came out about, and these are at the time, you know, your teenagers to people just sharing about, you know, when people would hook up and talking about intimate details, but also shaming for, like, what people did, how they did it, how they looked when they did it, or what they look like. And it's like, that created a lot of, I think insecurities like for me. For sure, Kira Yakubov: 5:34 yeah, that's a good point about the body hair, because I am Eastern European. And I was very hairy, as an adolescent. And that was not a fun time. For me. Like I got teased for that a lot. And I wish that that was something that they talked about. And then I remember thinking about when I was like, sixth or seventh grade, it was like, You hooked up, or like, she touched someone's penis. And it was like, really like calling her a slot. But it was never about like the boy doing something wrong, or shaming him for doing anything sexual. It was always pointed towards the girls. Daniela Galdi: 6:05 Can we actually touch on that works? Because now as an adult, going into her late 30s, I had to pause, said that, which is fine. I love aging, actually, but like, going into her late 30s and was talking to somebody the other day? And they said, Yeah, you know, and then that person was a sloth. And I was like, Man, when I was younger, I wish that we had the attitude that we do now. Because are they were they really a slit? Or are they just feel really confident? Wasn't it couldn't have been couldn't have been their choice that like, they wanted to explore this area for themselves, right? And so now as an adult, I'm thinking like, oh, shoot me a slut? And I was like, No, that's so wild! no, get that out of your head. Maureen McCarthy: 6:56 Yea, I love that you brought that up, because I personally love that word and have identified that way. I've been called that. and various other similar words since a teenager, I think. And then at some point, when I learned about, like, reclaiming certain words and things like that, I was like, I claim that and I love that, whether it's actively true in that moment, or like not, but I think that's often thrown around, along with other words, but again, very stereotypical to do that when it's like, it's not done for, like, it's like a pat on the back for a typical, like, sis, hetero Dude, that's like, awesome, good for you. But, uh, but not not good for her. But I was like, now I'm gonna claim that back because I feel really empowered when I do. And like a pretty powerful woman. And if that intimidates, you know, a man, I kind of like that. Kira Yakubov: 8:12 I love that . Daniela Galdi: 8:13 I like that. Maureen McCarthy: 8:14 Yeah. Kira Yakubov: 8:17 I used to wonder, right, like, because when we were teenagers, I used to hear that all the time. She's a sloth, she's a sloth. She's a whore, like, just constantly. And then I was like, thinking I was even talking to one of my friends about this looking back of when we might have been promiscuous as teenagers. Right. Part of that was like, we're just exploring, right, and just trying to figure out what we like. And we like somebody else. And we want to express it physically, but also that there was a lot of, like, underlying trauma, outside of that, that's how it was expressed to, or even like, unfortunately, even some sexual assault that it's like, this almost seems like an easier path is to be promiscuous, or just to do that right off the bat as like a protective mechanism. And then after that, being called a sloth and being shamed over and over, and then like repeating that cycle, and then going into college and drinking. And, you know, it's like, it's kind of fucked up, how that path goes, and how other people might perceive it. Until like, maybe you get older or you heal, or you go to therapy and recognize why you might have been doing it. And then I love how you say like reclaiming it, because now it's like, well, now I have sex because I want to because it feels good. And I don't give a shit. If someone doesn't like it, or if they have to ask me like a body count. That's the worst. That was. I used to hate hate when people would ask stuff like that. Daniela Galdi: 9:39 Why do people ask that? I don't know if I've been asked. Maureen McCarthy: 9:42 I love if you have not been asked that. Kira Yakubov: 9:45 Yeah, yeah, Maureen McCarthy: 9:47 honest. It's been a very long time since I've been asked that and I know it was very popular in high school in to I guess called traditional like college Ah age, or that experience, and then at some point maybe that fell off or I stopped hanging out with people that asked me that. Unless Yeah, like a good friend. I'm we're talking about that. But yeah, when people ask that I always felt like it was coming from the intention of why need to know how many people you've been with? Because I need to determine if you are dirty or not. Or if it was that, you know, you as like a woman were with more people then. Like, a man was that that that wasn't acceptable, or like that wasn't okay. I feel like that was my experience in mostly like sis hetero dynamics as a teenager into like, early 20s. Until somewhere, maybe someone got the memo to stop asking people that. Kira Yakubov: 11:01 Yeah, absolutely. I know. That was that was teenagers and in college, and I agree, I think it's so they can determine if you're a slut, or if you're a good girl, or if they want to date you like putting a moral value on you based on the number of people you have slept with. is so silly. Maureen McCarthy: 11:22 Yeah, hopefully, it's like, you know, what we should have been asking was, have you been tested recently? Yeah. Like a forgotten thing? Like asking, asking needs once, you know, if you've been tested conversations around just being having safer sex, that would have been great. Daniela Galdi: 11:45 Oh, I definitely agree. Because it's not easy to ask those and so much easier going into everything. And then also the idea of like, they talked about protection situations, right. But like the fear that at least I experienced around like actually going and getting those things I still carry with me, I think I might have asked here to actually go buy me some things. Like, I still have that fear around me. And you're so right, you make such a good point marine about like having that those conversations could have been so much more normalized. It could have helped people moving forward into their adulthood. Maureen McCarthy: 12:26 I think about being in school, and I was afraid to answer a question about like, what the capital of Pennsylvania was, or something, let alone, you know, like having some of those conversations, then, despite being someone that was pretty open about this stuff, very young. But you know, what I think some of the great like sex educators are doing out there. And I love when they make these posts, they have index cards, and the kids are like, write questions about anything, and the questions are so great. It's like, Is it normal for my genitals to have hair on them? Or am I supposed to like giving a blowjob? Am I supposed to do that? And like, these are such great questions that if they came across my mind, I don't know if I would have verbalized that in front of like a class, let alone I wouldn't have had that option in school, because we didn't talk about that, and didn't really talk about that at home, either. So yeah, I think we need all of their arenas to kind of talk about stuff, if that makes sense. Kira Yakubov: 13:44 Yea, I mean, it's tough because I think talking about in a group setting, in some ways is good, because it normalizes it, and everyone can hear the same information. But I think it's only helpful if it feels safe. Probably like if you're scared to ask or if you're nervous to say something, or there's like people in class or bullying or the teachers coming off in a shameful way, or like, there's clearly a stance they're taking on something, then it's probably not helpful. Right. So and but I love that like writing the questions down, like there has to be this level of like safety to even ask a question and then the teacher has to feel comfortable and equipped to answer it. I don't know that my team and my gym teacher in middle school was equipped to answer the questions that we would have been asking them at all. And like having it talked about at houses is the tough part, right? Like we I think they probably do it in school because it's like General Information everybody should have and that we can't necessarily rely on like parents or caregivers to like, explain that or talk about it because they may not have ever received it or they're uncomfortable with it, or they just don't want to, or they only have a particular stance on it. So I think it is kind of hard to figure out a very inclusive and helpful and beneficial safe way that everyone is getting information and not just leaving it to only at home, because everyone's going to get a mixed bag at that point. Maureen McCarthy: 15:20 Yeah. And then you know, they're going to be online, looking up some porn, and they're like, fine. Well, I don't know what this is, let me google it. But I can find, Kira Yakubov: 15:32 yeah, Maureen McCarthy: 15:32 just, you know, watching porn, just because and things like that. I know I look for I like make anything a window. Like for my kid, if he brings something up. I'm like, the windows opening to talk about this. And not that I tried to turn everything that way. But I do try to look for those windows where it's like, we can have a conversation out of this. So it was like, we have those conversations about porn. And I'm like, Yeah, that's probably gonna come up as at some point, I'm like, so and you're gonna pull it up, someone else is gonna be like, Look at this. And, you know, just, I always look for those, those moments to just kind of take it and have a conversation. And because my kids grown up with me being like that, plus, I think what I do for a living, that's going to be I hope, normal for him, so he can feel comfortable in those conversations. And also be an advocate for people to let alone himself. Kira Yakubov: 16:44 I mean, it sounds like you are definitely creating that safe open space as a parent, which is awesome. I wish I had something even remotely that look like, Maureen McCarthy: 16:53 yeah, we even talked about, you know, um like, with him. I've been like, you know, some adults, like don't talk about this stuff. Because they feel really, like embarrassed, they feel really uncomfortable. They don't know what to say. So they either can say the wrong thing, or something that doesn't feel good. And then we're just like, avoid it entirely. Or like, again, I'm just not gonna talk about this. I was. And he that's something he was like, yeah. So I don't know if that's something he experienced, personally, to at some point, I mean, probably. But I mean, he's lived in a household that's had, like, I don't know, like condoms in jars and like lube in the drawers sitting out. Like, it's just like, these are things that like, that don't need to be hidden away. Right. So Kira Yakubov: 17:50 yeah. And I feel like our generation is probably just gonna do a better job, generally speaking, just because we are like, more normalized to it. Like I'm thinking about on never, ever forget this. This lesson that my mom gave me when I was little, like the sex talk. It was, I think it was like eight or nine years old that came out of the shower, and she like, told me about periods. And then she was like, Okay, this is coming from like a very conservative, Eastern European immigrant. She's like, you are not allowed to have sex before marriage. And I was like, Oh, why? She's like, because it's wrong. I'm like, but you know, you're a kid. Like, why? Why? Why? Why? Why? And so she's like, let me give you let me give you an example. I was like, okay, she's, so she's like, do you know when we go get a carton of milk at the store? And this is back when they used to have a seal under the cap. So she's like, you know, when we go get a carton of milk at the store, and we take off the cap, and if there's no seal, would you drink that milk? I was like, I don't know. Maybe not. She's like, why wouldn't you drink it? I'm like, I don't know. Maybe it's dirty. She's like, Yeah, that's a woman's virginity before marriage. I was like, Oh, my God. So my worth and virginity was compared to a used milk carton and it being dirty. And that just stayed with me for a long time. And till I was like a teenager that my mom and dad were like, once he saw me dating, they're like, "yeah, if you have sex before marriage, you're gonna put us straight to the grave. We will die." I'm like "on the on the moment in the instant?" they're like,"yes." Like okay, cool. So I can't ever tell you anything. Oh, yeah. thick layers of guilt Maureen McCarthy: 19:38 Yeah, Kira, I think you and I both grew up in. And mind you, I think most of mine came from, like the school because I did have 13 years of Catholic schooling. That was there was so much rooted in virginity that it fed into like that. shame and that guilt and those stereotypes like throughout high school that, you know, it was like, Oh, well, she's not a virgin or she's been with other people and things like that. And it held such a weight, I think in in a lot of different ways and just really spilled into how all these other things were viewed like me as a sexual being. I'm sure it wasn't the only one. Kira Yakubov: 20:32 No, of course not everyone's experiencing and feeling it. It's just unfortunate that it wasn't as accepted or normalized. And it was just so feared. Daniela Galdi: 20:48 How do we talk about porn? But like, how does that even happen? Like, what do you how do you even look for it as a person, let alone a child and an adult, a child like not, I shouldn't say a child, but a person who is exploring these things. Kira Yakubov: 21:28 So I think it's gonna be different between an adult and a kid who's like, exploring and curious and finding things out for the first time. Right? Like, as a kid, if you're going to Google something, and just find whatever comes up, and that's like, your first impression of what's happening, like, you're probably going to take them at face value. Like, this is what people do when they have sex. These are the expectations, especially like, heterosexual porn is going to like, I can't imagine when I was younger looking. I was like, Okay, so the girl is always moaning really loud. From the second she's touched. And she comes in like five minutes. And this, this and that. And the guy does this. And I was like, okay, so I guess that's what's supposed to happen. And like, you go into it, and then you have experiences like, Oh, this is not, this is not lining up the way I thought it was going to. So I mean, I think it's tough. I mean, Renu might have a better handle on how to talk to a child about porn, because I don't have kids. But I would imagine like, giving them that heads up, like, hey, what you see is not necessarily what's real. And to not take that as what's going to happen necessarily, or that you should be doing or feeling or experiencing this is like, I think a huge part of it. And then like not shaming, like, they're going to be curious, right? Like, it's normal and common for kids to seek these things out. So I don't know, Marie, what do you think? Is there more tips on how to like, discuss it? Maureen McCarthy: 22:58 Yeah, I think all that is really important. And I was trying to recall at least just for that personal conversation I had with my son, whatever, whatever that was it I was like, Oh, the windows open, but I can't recall it now. So when we talked about it. I you know, it was like, you're gonna come across this probably soon, you may have already come across it. And he was like, Yeah, that was like, it wasn't like, you know, maybe some parents present day and past would be like, our get, like, start yelling or oh my gosh, like, No, you can't look at this. And so we talked about that shame piece. Some people watch porn and like porn, and that's cool. That's fine. And some people don't watch it. Some people don't like it and that's fine too. Some people in the porn do that for that third job, and they do sex or believe we even have that conversation. And I think I mentioned that, you know, people that do sex work, catch a lot of heat for that. And I was like, it's their job and they shouldn't be shamed either. So we had that conversation. But also, you know, kind of porn is is something that adults are those are like adults doing that. So we had conversations about it's never okay. Photos, videos of kids, teenagers, like minors to be going around that sidebar. That was a huge thing when I was in high school, just people sending out nude pictures, and it was always of the local girls that got out. And that got out to every single school, public, private, whatever. are so kind of like touched on that, because that was such a big thing too. When since when I was in high school, we had an assembly about it and everything about sexting and things like that. So, um, yeah, I think I tried to like normalize, validate, and just be open to like what he had to say. But I think it was a lot of me talking. And I was like, let me let me just touch on these few things. But I'm always like, you know, if you have any questions or comments, or like, I don't know, something happens, like, feel free to ask me I was like, It's okay. And I was like, in sometimes you might not want to ask me, because I'm mom, you might want to talk to someone else. But that's okay. It was like, as long as you feel like you have someone to talk to. So yeah, I, you know, I think, at least today talking about generations changing to with porn, like, there's a lot more like feminine directed porn. And there's, there's one porn star, I can't recall her name, but she's also like a sex therapist, or she's a sex educator. So don't quote me. But, but she has like both of those, like, informed backgrounds to kind of just bring it all together. And I think she even came out with, like, videos, or well, it's not DVDs anymore. But things you can buy, that are more so it's porn, but it's educational. It's like sex ed, too. And I think that's a really cool concept as well. Like, you're not getting like this. Like, this is directed like this is acting majority of it is like, it's, it's more real. It's like reality based or for people that are curious about like, Well, how do I do this? Or like, what do I do? Like, what am I bought? What's my body? Do my hands do? So there's a lot more out there. That's, it's, it's better information than just all the, you know, homemade videos and things like that. Kira Yakubov: 27:21 With the scrambled porn on channel 99, Daniela Galdi: 27:24 you had the Hotbox, you had everything Kira Yakubov: 27:26 Oh, yeah, catch a boob in the website. But that made me think about, there's this website called O.school that actually does educational videos and prompts and worksheets, which is phenomenal. And I get like an email newsletter, and I think the one was how to talk dirty like during sex, and it gave like, all these different prompts and body parts and what you could say and how to respond. I was like, Wow, that's so awesome. Like, that's, you know, to actually like, teach you to go through it and not just like, watch a porn and like, hear what they say and think that's what you're supposed to say. Maureen McCarthy: 28:05 I love that website. One and two, I refer to it a lot. Three, did you see they have an orgasm order form, it's like you're ordering takeout, you can tell them if you do not want mayonnaise on your same score. A little extra that it gets down to the point of like, how you want to be touched down to like, level of pressure, or do you like tapping and different motions and things like that. So it's great, I forget in that one, if there's also a piece that kind of ties in with, you know, the dirty talk, because some people definitely, like don't want to be called something certain things or don't want their genitals to be called certain things. And if you do, that's like, the light switches off and it's just like, next thing you know, you're checked out and you're like, I'm gonna need to take a break. So that that was a it's so informative, and anything that's like an inventory or an order form I think is always helpful tools to like, empower and get to know yourself, but also communicate that to a partner. Like, I know I like texted that order form. Before I was like, I know you know a lot of this already but like, here you go, man like I don't like you should send this out to you know that that sex geek in you Daniela Galdi: 29:44 That is very Kira Yakubov: 29:45 I love that but I did see, it was like how to tell or show your partner what you want or don't want. Because sometimes we don't even know Right? Like all this is through exploration. Like we might think we might like the This particular thing or think we will, and then when we're actually confronted with it, or we're trying, it was actually kind of my cup of tea. I wouldn't have guessed this. And like having those prompts to even, like, click through like, No, I don't want to try that. I do want to try that I'm open to trying this, this is a hard, no, let's definitely do this. And like showing that to your partner, whoever you're having sex with, I think is like, pretty empowering how you're saying and pretty cool to even like, think about it. And like, have these different ideas to try out. And if you don't feel comfortable, like saying all these things, that's a great way to like, tell someone without saying it, too. And it's great for couples like especially for couples therapy, who are like trying to, whether it's like reconnect, or try something different or explore or even like getting over shame. It's a great way to have like this external prompt to go through things and just talk about it without even trying any of it. It's like what comes up in your mind when you like you see, like, also watching porn together. And like having a whole dialogue of what that means and like getting to know each other better. And like our experiences with it outside of that, so I love that site. Yeah, like, Daniela Galdi: 31:08 Will you be okay, when you come home and I have a swing installed? Kira Yakubov: 31:14 Hot wax across the room Daniela Galdi: 31:18 Dinner's ready, dessert's there, and.... we'll be okay. We need to make sure there's mutual agreement and consent there. Kira Yakubov: 31:32 It's so funny. Maureen McCarthy: 31:33 That's so great. I did actually get some lube that they were like, you can put this on ice cream if you Daniela Galdi: 31:39 Wow want. Maureen McCarthy: 31:43 I would give them a plug. I can't think of who it is. I don't know if it's it might be Joe, I'm not sure. But, you know, they had like grim brew lay and just all these, like decadent dessert flavors. And it was like It's sugar free too! Cool, multi use. Daniela Galdi: 32:05 I love that. Kira Yakubov: 32:06 I remember when I was What year was this think it was like when I was 25 or 26. And like, gotta have a relationship. And I was like, I want to do more stuff alone. Or like some of my friends like didn't want to do certain things, but I wanted to and I was like trying to overcome this, like social anxiety and phobia. So I was like, let me find stuff that's like really gonna make me uncomfortable that I'm just gonna do to get over it. So this is how I torture myself. But so I found this event in Philly. I don't know if they're still doing it because of what happened with COVID and everything. But it was called the erotica, the Erotic Literary Saloon in Philly. And it was like every third Thursday of the month, it was held by a sexologist, and a sex therapist, and she would have people come. And she'd have like, those anonymous questions at the beginning, people would write them down and answer them in the beginning of the event, and then other people would come and they would just read their stories, like their erotic poems or stories, or fantasies. And then people would ask questions, and I thought it was so cool. And I went alone, like, met all these interesting people. And it felt like a community, like if you would have walked in the room, I would have never thought that these 50 people would be friends or talk to each other. But then as the night went on, like, everyone was very welcoming and opening open about it. And so like, drag some of my friends to go after that. And they're like, We don't ever want to do this. But I thought it was awesome. So I don't know if there's other events that either of you have gone to or there's like things like that. That might be I don't know, that were like, kind of uncomfortable or interesting in that way. Maureen McCarthy: 33:46 Yes, I've been to a fetish con. And I'd also more recently was at I don't know what it would have been called but it was event an event that was at a hotel so like pretty much the one floor of the hotel you would go in a different room and there'd be like a different vendor their. So it's very like intimate to because you'd be with a small group and I was with a good friend and also colleague that is same kind of interest and work with like sexuality and public health and things like that. So we feel very comfortable being with her in those spaces. So the one room you know, you would get like sex toy demonstrations. And someone was able like to try one like if they felt comfortable like in front of you and everybody else felt comfortable in the room. So I thought that was a pretty interesting like experience. There's something about being in those environments where people are so open and vulnerable about something that holds So much like history of shame and guilt and like make yourself small kinds of things that is really empowering. Like anytime I go to any type of conference, whether it's as intimate and open as like that, or if it is more of a professionally, like driven track, I always leave, we're always we'd always walk out me and this friend and colleague and be like, we're so liberated and we're stimulated. Dreaming it like those two words, right? Like, right now. And I definitely miss like those spaces, because unfortunately, I feel like I don't go as much to as many things given, you know, like, COVID, and things like that. Or maybe I'm not aware of as many. But I miss them dearly, because they're just such a great space to experience and not even just your own, but just just seeing other people like experience other things do. It's just so cool. Daniela Galdi: 36:04 That sounds Kira Yakubov: 36:04 I love events like that. Daniela Galdi: 36:07 Yeah, that definitely sounds awesome. I, I would love to experience that. And the only thing I can really think about is like growing up as and going to college board. And then performing is like the performing arts, we have to do a lot of work around like intimacy. And that's really it. But, you know, it exposes you to the feelings around it. I felt like that's what I gained. But in terms of things like sex toys, that wasn't something that was ever you know, that that was unless it was part of the concept, right, but I love that they have events around this. I don't know. I'm so curious now. Like, what? If you feel comfortable sharing? Maureen? Were there things that you remember from it that that maybe you didn't know? Or that just like, intrigued you? Maureen McCarthy: 36:59 Hmm. I think what was great about like, when I'm shopping, I like a hands on experience. So if I'm being able to, like, you know, you're not online shopping, and you're like, Yeah, this toy looks great. They say it has 10 different speeds. That sounds awesome. Many options, but you don't know, like, what you're not holding it or feeling what, you know, what the sensations are. So just being able to get hands on and like, you know, play with like, the different toys essentially, you know, you could kind of like just mess around with them. And and, I don't know, ask questions and things like that. I feel like in that experience, there was a lot I learned about lube. But then the way that was different, more, so like, ingredient wise, I just remember the brands, especially ones that you know, we're trying to promote if and if it's like edible lube and things like that just like healthy ingredients. And such a key piece about like, knowing what we're putting in our body. Not just like toys and who we're with, but like just like lubes and things like that. I thought that was very interesting to me, because there was like a very big science to it that I was not aware of. So they gave some interesting feedback there regarding ingredients and things like that with lube. Yeah, I'm trying to think of anything else. But I think it's a it's a different experience when it's something hands on versus Okay, I'm gonna Google some things and see what I can find because I want to try something new. It's like, I'm here holding all these toys like pressing all the buttons putting my neck like Man, they're giving us taste tests of all the lubes and like, flavors and arousal gels that you just need a teeny drop of and you could like feel intense sensations. So you're getting this horrible, like engaging all your senses, which is such an important element to sex, let alone life and being present and experiencing it. Kira Yakubov: 39:32 Absolutely. I love that because it is completely different of Googling something versus being in person. So I know on South Street, at least they used to there's all again, Philadelphia, there's a lot of sex shops on South Street, and a lot of them hold classes, like different kinds of classes and I used to drag my friends to all this stuff. There was one class it was like deepthroating at a deep throat and I went there and like before they had the class they would like you know give you a tour around the sex shop and, like, show you all these different toys and different things. But not even just toys. But there was one where it was like electricity. Like you could have something that was like electricity and like shock you, or like nipple clamps and like things you just might not have ever thought of or you wouldn't Google, but you're like in person and you're feeling it and experiencing it and having those classes, right. It's like kind of silly, but then you're bonding and you're being vulnerable, and like, learning all this new stuff. So I think I love that I think we should, I'm gonna look to see if there's some of the sex workshops around Philly or PA to see if we can post it with us. Because I think it is a great experience. Like, it's a great way to learn great way to bond whether it's with a partner or friends, or if you're going alone to meet other people doing it, and just exploring. So like, you want something to do on a Friday night, go to a sex shop, go through it and find some cool stuff to do. Daniela Galdi: 40:56 Absolutely, especially with what we were all talking about earlier. And I found myself saying like, there's the fear of rounded and, you know, curiosity, but never feeling comfortable to like speak up about it. But like, I'm very comfortable walking into a class like, that makes me feel, you know, I'm not I'm not walking in there the only one who doesn't go maybe certain things or maybe wants to learn more about certain things, you know. So I love that idea. Because it definitely adds that comfort level. Kira Yakubov: 41:22 If I find some, will you go with me? Daniela Galdi: 41:24 Absolutely Kira Yakubov: 41:24 I'm coming! Daniela Galdi: 41:24 I would say Maureen, I'm prety sure she's coming too Maureen McCarthy: 41:32 I miss that stuff. So much. Kira Yakubov: 41:35 Yeah. Daniela Galdi: 41:36 Alright, well, if anyone needs us, we'll be in class the next few weekends. Kira Yakubov: 41:41 And they have them all over. Right. It's not just Philly. I think if you I mean, there's stuff on even Eventbrite because like, since I moved to Florida, like I gotta find different activities and stuff to do and meet people. So I went on Eventbrite, and there was all these different ones. And the one was like, teaching you how to ride like, how to ride on top like a cowgirl. And it said things to bring kneepads and a pillow and I thought that was great. So it's like, even in any city you're in, if you just like Google some of these events, I'm sure that there'll be listed on there. And you can be brave and go and have a good time. Daniela Galdi: 42:17 I love that. Maybe we should like make kneepads, the new like style trend. So you don't have to be like, Hold on, wait one second, please. Get my knee pads on, I need to practice this. But I thought, and I joke, but you know, you never know somebody might need them. So no judgement, you see someone walking around with them. Maureen McCarthy: 42:40 We could like the bedazzle them or decorate them. You might lose traction with the beads, but I love some crystals gemstones. Kira Yakubov: 42:55 Oh, that's so funny. And I remember when I was going through my sex therapy program, there was a portion, I think it was called the Star part of like, the certifications, like sometimes they have some of these workshops, and where they like just show different kinds of porn, and you're watching it in the class with your classmates. So I think even that was a cool experience of watching this near strangers or other people like 10am and wearing all this different stuff and like wanting to come home and like tell all my friends like, you know, it wasn't a what I watched today. Do you ever think about doing that? And they're like, Okay, this is like, we got to stop. This is enough. Maureen McCarthy: 43:36 That's awesome. You know, when I went to the sex museum, or museum of sex in New York, they the exhibit at that time was like porn throughout the ages. And it was just so interesting to see like the earliest clips, you know, black and white. I mean, extremely taboo at that time. And it was just interesting to even see like, the decor and like what they were wearing. It was, it was pretty, it was pretty neat. They also had jello shots that were like nipples or like food. It was it was so cool. They have like a pop up bar and stuff plus the store. So it was a neat experience. Daniela Galdi: 44:29 These are definitely great resources that you're both sharing, and I wish that I could not stop thinking like, Oh, my next date. I really do. Like, I don't want to wait till I have a partner I kind of want be like, hey, look, we're taking a trip to New York. And this is what's happening because I'm intrigued. You know what I mean? And, you know, I don't know if I'll do that, but that like events and classes and I didn't even know there was a VM so that's amazing. I think these are so such great resources. Kira Yakubov: 44:58 There's plenty out there. Maureen McCarthy: 45:01 Yeah, I would love that to be your next date. Personally, I would love that for you. And if that person was like down with it and excited about it, I would love that person for you. Daniela Galdi: 45:12 I'm gonna throw it out there one day, and we'll see, I'll wait till the 3rd date. I'll throw that out; see if they bite. Maureen McCarthy: 45:25 always recommend dates to like a local toy shop or something like that. Regardless of, you know, if the couple is like newer, or just hooking up or married for 30 years, like, um, like, it's fun to see, you know, to watch your partner kind of like what they gravitate towards, or what they're picking up or, you know, like, look at this, like, what about this?I think that that's a great date. Daniela Galdi: 45:57 I love that. And you're actually reminding me that there is a place in Philly, and I can't remember if it is South Street, but I have to find out and get it in the show notes too. But they do they create like [BDSM] clothes and material and the different types of like, I don't know if they will be called toys, but different types of materials like that, that is available in Philly too there's a shop and it's like, so I remember going in, there was a lot of leather. And I felt that people and I'm not, you know, no stereotype, but really, there was a lot, but it was like, a whole artistry to it. And it was amazing. But also you can get these like custom made, because I imagine that's a situation to like, how you you know how someone buys pants. Right? It's important that it's customized. You're ruining the experience. Kira Yakubov: 46:47 Yeah Maureen McCarthy: 46:48 yeah, I think that's a good investment. If you're looking for some, like, you know, which is can be a bit costly. But yeah, some things you know, that are not custom made, or made with like good quality, whether it be toys, or like harnesses and outfits and things like that, you will find will break don't fit your body, right, because it isn't custom made for you or is uncomfortable and irritating, which you know, all that stuff can be can take from the experience too. So that sounds like an awesome place. I guess. Like I go to Philly soon and hit up a couple places. Kira Yakubov: 47:31 Yeah, but I think anywhere, I'm sure there's places anywhere you go if you just walk, like when my husband and I go traveling when we go to like a different country or different place and have like a big city. And if I see a sexshop like all let's go in to see what kind of stuff they have here. Like, I think the best one so far was in Barcelona, they had these statues and they had all these different kinds of like costumes, and toys and like jewels to put on everything. And I thought a fun one was was was like a butt plug with like a squirrel tail coming out of it Daniela Galdi: 48:04 That's adrable Kira Yakubov: 48:11 so I think every place around the world, you know, if it's like a bigger city, or even smaller, they have like some sort of shop or some kind of place where they have some of the stuff because people have sex everywhere. Maureen McCarthy: 48:24 Yeah, that that'd be interesting to see if they're like kind of what is like, I don't want to say trending, but like or like maybe what's common because I imagine the inventory would probably look different. Or maybe that's my assumption. Based on like, you know, what is selling? That'd be cool. Maybe that'll be that's a bucket list, you know, go to all the different like continents and certain countries or big cities and see see, you could do like dissertation on that. Oh, yeah. Daniela Galdi: 48:59 Hey, maybe maybe that's something that gets up on the Heal Your Roots Wellness site one day, a little a little tour, a little shop tour of where to go find these things. Resources for this. Oh, just throwing it out there. And then if any of these right and if any of these places or products then want to you know sponsor the podcast. We're not sponsored by any of them right now, but Hey, why not? If it's helping the Kira Yakubov: 49:28 Listen I'll do a Netflix special traveling around experienced. the world going in different sex shops. If somebody wants to pay me I would be more than happy. You can all come, and it'll be a whole thing. Maureen McCarthy: 49:40 I'll be a sidekick. Daniela Galdi: 49:42 Yep, so yes. Okay. These are great ideas. I really hope that we can like put them into play. Kira Yakubov: 49:47 Yeah. Is a there's a show on Netflix called Somebody Feed Phil. I don't know if you've ever heard of it. It's like everybody. Everybody Loves Raymond is the producer of that. And he just goes around different countries and cities and just eating and Talking about his experience. And so we could totally make that I don't know what we would call it but sex shops and experiences around the world. Maureen McCarthy: 50:09 I don't know why I'm picturing myself in like, a, like a sidecar with like a helmet on and like we have like, all kinds of toyslike in the trunk that are just like bouncing around Kira Yakubov: 50:23 And our dogs are with us. Daniela Galdi: 50:25 I see this and then I see the little like squirrel tail at the ends of like your motor vehicle. we're painting a whole picture here for everyone. Kira Yakubov: 50:36 Oh my god. Maureen McCarthy: 50:38 That just kind of seems like life goals. I don't know. It's like, we'll have to start a vision board for this. Kira Yakubov: 50:45 Yeah, I like this. This is a good idea. And then obviously, we can eat in between all of this so we can add in the food part. Maureen McCarthy: 50:52 Of course. Kira Yakubov: 50:53 Thank you so much for being on with us again today. I think this was I think this is going to be a great episode. And a lot of laughs a lot of great insight information. I hope people feel like this was listening to a conversation with a couple of friends just talking about sex and their experiences. So thank you so much for being on Maureen. Maureen McCarthy: 51:11 Yeah, thanks for having me. I'll talk sex anytime. ### Listen - [Spotify](https://open.spotify.com/episode/13003181) - [Apple Podcasts](https://podcasts.apple.com/podcast/13003181) - [YouTube](https://youtu.be/CnKaSFzsSE8) --- ## Navigating Substance Use and Recovery - URL: https://healyourrootspodcast.com/episodes/navigating-substance-use-and-recovery - Published: 2022-11-23 - Season 1, Episode 11 - Duration: 52:33 - Category: relationships - Guest: Brooke Aymes ### Summary Exploration of attachment theory and its impact on adult relationships, covering the four attachment styles and strategies for building secure connections. ### Description Dive deep into attachment theory and discover how our early relationships shape the way we connect with others in adulthood. This episode explores the four main attachment styles and their impact on romantic relationships, friendships, and family dynamics. Learn to identify your attachment style and develop strategies for building more secure, fulfilling relationships. ### Transcript Kira Yakubov: 0:00 If you or someone you know is struggling with substance abuse, or in the recovery process, you're going to want to listen to today's powerful episode, featuring Brooke Aymes, owner of Gaining Grace and a Licensed Clinical Social Worker, and Licensed Drug and Alcohol Counselor in New Jersey. We discuss things like navigating substance abuse, the recovery process, family dynamics, and also how to prioritize ourselves and manage boundaries. In this episode, joining me will be co host Daniela Galdi. Let's get started. Hi, I'm Kira Yakubov Licensed Marriage and Family Therapist and founder of heal your roots wellness practice. Every episode, we talk with a professional from the mental health field to learn more about their approaches and specialties, and also their journey of becoming a therapist. In this podcast, we'll uncover a deeper look at the world of therapy from new perspectives. You will meet the therapist of heal your roots wellness practice, and trusted colleagues from the community tackling mental well being or your go to Network for practical and professional insight in mental health. Subscribe for new episode releases every other Wednesday. Brooke, thank you so much for joining us today. Brooke Aymes: 1:19 Yeah, thank you so much for having me. Absolutely. Kira Yakubov: 1:23 So I just want to jump right in. I always like to ask our guests how they became a therapist, like what is your story and journey of getting here? Brooke Aymes: 1:32 Well, I think it's important to know that I was a troubled adolescent. And I think that's important to note because I definitely don't think I would be here without that experience. From ages 16 to 23. I really struggled with unhealthy relationships, substance use. And at the end of 23, I was left with a pretty wicked heroin addiction and left feeling like super defeated, right. And so at 23 I kind of like looked in the mirror and I was like, alright, well, if I'm gonna do something with my life, something has to change. And I need to change pretty much everything. Sure. And I called mom I moved back in with mom, I made the decision to stop using substances and I went back to school. And when I went back to school, I originally went for English. I love to write I'm a writer, I've always written since I've learned to write, I've always had a diary and whatnot, always wanted to be an author. So I thought that was the course that I would take. And I got a bachelor's degree in English. And then I couldn't find a job. So I had this bachelor's degree and I was still waitressing. And I was left kind of feeling the same way like pretty discouraged, pretty defeated, and was unsure what avenue to take. And then I spent a lot of time filling out applications and then I came to a realization that I should probably use my challenging experiences and and bring them some purpose and some value. So I started looking around the school I went got my bachelor's degree from had a pretty cool Social Work program. And so I decided to get my master's in social work and become a licensed therapist from there. And I started my career as a therapist in substance use facilities. And so I got a lot of my experience there and then in 2020, decided to open up my private practice and that's kind of how I came to start gaining grace and where I am now. Kira Yakubov: 3:32 That's incredible. I mean, that takes a lot of yeah, that takes a lot of guts to keep going like after feeling defeated or discouraged multiple times, like in a row with like big life stuff. Brooke Aymes: 3:45 Yeah, I think it's important to note too because I think a lot of people when we get to those places, and we feel those big feelings like feeling defeated or feeling hopelessness, it's hard to see that there could be another avenue or there could still be hope somewhere Daniela Galdi: 4:00 Absolutely. I've been there's like so many times and again like you're said, I commend you so much because the thought of having to what sounds like pull yourself out of the substance abuse to with all the other mental and emotional things that I'm sure you were feeling right like I just I admire you for that because it's hard to pull myself out of days when I'm feeling depressed you know, let alone take that next step to feel better out of something as as strong and addicting addictive as substance abuse and now what like what was it like if it's okay you know, when you had this epiphany of I want to use what happened to me the challenge is to help people Brooke Aymes: 4:45 I it just kind of felt almost like like it was supposed to be I hate using words like should are supposed to because I don't really believe in them whatsoever because it's sometimes I feel like we get lost in them rather than chasing our own hopes and dreams and I really did not want that to happened to me. So a lot of people I know and who have struggled with similar things, or who are in recovery, work in the field to do the same thing to use their experience and find purpose and value in it. And I was like, I'm not going to do that I'm going to follow my dreams and what always was and be a writer and go for English. And then when that wasn't working, it was like, Okay, maybe it's clear that this is not what I'm meant to be doing that I'm really meant to be doing something else. Kira Yakubov: 5:31 That's huge to face that reality. Because that's tough. I mean, number one, I was like an undergrad, I went in for accounting and hated it, and then had to, like, convince my parents for something else and like to start a new vision of your life or path of what you're going to do is, yeah, that's extremely hard. And that takes a lot of guts to do that. You still, if you don't mind me ask, do you still write and like, enjoy that on like the side for yourself? Brooke Aymes: 5:59 Yeah, so I write in a few ways. Right now I have a blog for my practice. So I make sure that I write in there, at least monthly. And then right now I have children, I have an 11 year old and a five year old. And I write to them pretty consistently so that when they're older don't have those things. And the goal is I have a ton of work that I did from when I was younger, the goal is to eventually write a book when I feel like I have more time. And you mentioned broke, like growing up troubled, feeling like a like being a troubled teen. And do you work with teens? Like are you able to recognize this with like families now from what you've experienced, and your education? Yeah, so in the beginning of my career, I worked in substance use facilities, and I also did work in in home. So I would go into people's homes and work with adolescents, and gained a lot of my experience with with adolescents there. And now in my private practice, I really love working with adolescents. And young women, young adolescents struggling with similar things like self esteem or unhealthy relationships, or teetering the line of substance use of my heart is really there and working with them. Because I can relate so much. Kira Yakubov: 7:12 Do you find that families come to you with like, already, their child is struggling with substance abuse, or that's something that's like uncovered through the therapy process that you have with them. Brooke Aymes: 7:24 But so both scenarios have definitely happened. Um, I love therapy for children, even if they're not struggling with really big overwhelming things, because it just gives them an objective person to speak to. So sometimes things will naturally come up in session that they wouldn't necessarily feel 100% comfortable telling mom or dad, just because an objective person that they feel maybe there's no consequences that will come from combining and being right. And then there's also families who reach out like, I found this, this and this, like I think my adolescent might be using, what do I do? And how would we get started? Kira Yakubov: 8:05 And so can you share some tips maybe of what you help those parents or families do when that does come up. Brooke Aymes: 8:12 So it's super difficult, it's actually come up in a lot of my conversations. Parenting in general has come up in a lot of my conversations throughout this week. I'm not sure if it's like the season or school or what. But the main conversation that I've had with parents throughout this week is really looking at a lens of what we can control. And while we cannot control right, so our kids start to gain independence as they continue to grow up, and we're not able to control everything, the same as we can, when they're much younger, right, we can control what they're eating, what they're sleeping, all that kind of stuff. They start to get older, and they start to form their own friendships, their own relationships, whether they're healthy or unhealthy, engaging in things or forming opinions that we might not necessarily agree with. And we don't have any control over that. And that's a really difficult pill to swallow. Especially like when we're concerned about their self esteem or their safety and not really being able to have complete control over that. Um, so I've been talking to parents a lot throughout this week of focusing on okay, I cannot control these things. I can control these things over here. Like I can still control what happens in the house maybe or grades or whatever the case may be, right. So really, for as parents as are focusing on ourself and our own mental health, making that clear line of what I can control and what I can't control. Because fear and anxiety are so big when it comes to our own children, our own stuff gets in the way so fast. So making it a clear line is helpful to say what I can focus on rather than what I can't focus on. And then also really having like those strong boundaries, which is so much easier said than done. The thing with boundaries are one it's hard to form them and to it's hard to remain consistent with them. And that's really the The most important thing when we're talking about boundaries is remaining consistent in them. And it really teeters the line of like tough love, which is very, very difficult when we're struggling with our own anxiety and fear because our child is struggling in a different season of their life. Kira Yakubov: 10:16 That tough love hit hard that you felt my parents growing up being super strict. And I would like go through a million questions to ask you. Because I know you're also a parent and you're in this field, and you're working with parents, what is like the fine line between tough love that's necessary versus being like, an authoritarian parent or too strict or like a helicopter parent? Brooke Aymes: 10:41 Yeah, that's a great question. And it's really like, there's no like, clear line, like, Okay, this is it, right. And unfortunately, just like, there's no book on, like how to be the very best parent, right. And it's very individualized for each person and for each family, because at the end of the day, as parents, we need to be okay, with the decisions that we're making, right? We need to feel okay, with the choices that we had, God forbid anything happened, we need to feel at peace with what we're doing, right. So it's very individualized decision within us, the sessions that I've had with parents, some of the most profound ones have come from shifting our perspective. And what we thought was helping our child is actually enabling them to continue the harmful behavior, right. So maybe I know, my, my, my daughter, who's in early adulthood, maybe she's in her early 20s, she's struggling with active addiction. So I'm gonna let her stay at my house. So she's not sleeping on the street. And I can rationalize that's definitely keeping her safe. She's not sleeping on the street, nothing bad is happening to her. However, it's making her more comfortable and more likely to continue engaging in the harmful behavior because she's continuing to be comfortable. What do you recommend in that situation? To not enable with parents is focusing in on ourselves and what's best for my mental health? Am I okay, when my daughter sleeping in my home and may or may not be under the influence? Or am I full of anxiety, not knowing what I'm gonna wake up to? Can I sleep? Right? So we're having those conversations in what's really best for me more times than not, it's unhelpful to be helping our child in that way. Because it's increasing our own fear and anxiousness. And gets to a point sometimes where it's making our own life unmanageable. We're like almost involved in the chaos of their addiction with them. So we've focused one on our own mental health, and then realize what's helpful or unhelpful, and then have to set boundaries from there on out. And like I said, that's very individualized. It has to be whatever the parent is comfortable with. Kira Yakubov: 12:48 That sounds really tough. That sounds extremely tough. So it sounds like you're helping the parents prioritize themselves over over what their child may need, or their mental health. Brooke Aymes: 13:01 Yeah, it's really interesting, this conversation came up, because I just wrote a blog post about it. And one of the main things in the blog post is taking care of ourselves first, before we can help a loved one that's struggling with addiction. Kira Yakubov: 13:15 So actually goes into another question that I was thinking about earlier that I wanted to ask is, how does the family support someone who is actively going through addiction, right? Because it's we don't want to enable, but we want to provide support. Like I have clients, I don't see clients who are actively through substance abuse or in recovery, but I have a lot of clients who may have family members that just recognizes and like they don't know, what to do, they don't know what level of support is supportive or not helpful. Brooke Aymes: 13:46 Yeah, it also depends, I think, on like, the nature of their relationship, like, am I are they dependent upon me and my husband, our wife, or my mom, or dad or my brother or sister? I think the nature of their relationship really matters when it comes to looking at our own mental health and setting our own boundaries. Because if my husband struggling with an addiction, I might not feel the same as if I'm like, mom or sister of him, right? Um, so I think it definitely depends on the relationship number one, but the main theme is that we look at our own mental health and what's best for us set boundaries that we need to in practicing that Topps love and then also letting them know that even if we have to practice tough love, even if our mom and I have to say that you cannot say here because you're under the influence, please no and I can say this as Mom, please know that. I'm I'm here for you if you want help and if you want support, because I will help you call rehabs. I will help you call therapist whatever it is that you need. I'm here to help you with those things. But I cannot enable this addiction. Daniela Galdi: 14:52 I'm really moved by this. When you're working with these parents. Again, like you said it's tough like I imagined Oh I don't know how I'd control my emotions, I think I'd have a lot of trouble controlling my emotions to just get that point across. So was there anything else that like you suggest there or maybe something in your blog that you touch on with that to, to help those parents who are trying to communicate? Brooke Aymes: 15:19 It is very sad, it's it's difficult work to do. Nobody, nobody has children thinking that they will be in a spa, that their child will be an act of addiction, and that's something that we'll have to go through, right, it's definitely not an ideal situation, it's a very sad, devastating situation. And a lot of times the parent is grieving what they had wanted for their child or what their child could have been, or who their child was in their childhood, right? Because they've like lost themselves in addiction for a little while, and this season. Um, so one of the main things that I also tell them is relatability, and support. So there are a ton of like family groups, there are NAR Anon, there's Al Anon, there's family groups in the community, at local churches, through local nonprofits, pretty much everywhere, and that relatability. And support is so helpful for parents when they're having to make tough decisions and stick to really difficult boundaries, because they can meet other parents who are doing the exact same thing, and have that kind of experience to share with them. Kira Yakubov: 16:23 So back to community community's always really huge in this and having that support. What about on the flip side, though, we're spending a lot of time talking about the family unit outside of the person. But what's it like for you to work with an individual who is in the midst of addiction or struggling? Brooke Aymes: 16:42 I love working with people who are either struggling with addiction or seeking long term recovery from addiction. I love working with those individuals as well. A lot of times, like we talked about briefly and my own experience, a lot of times really uncomfortable, overwhelming feelings come up as a result of addiction, or even their prior to addiction, like feeling hopelessness or feeling defeated. So a lot of times when we are in addiction, we are struggling with low self esteem, or like this feeling of not feeling good enough. And that really prevents us from moving towards our really big goals are kind of like theories what a handicap is right? And when I'm able to work with someone who is trying to overcome addiction, or is who is in recovery from addiction, it's really cool to work with them to shift that thinking for them to start to believe that they are capable of some things that they never thought that they would be capable. Kira Yakubov: 17:48 That's huge. So it's kind of coming back to their self esteem and what they feel like they're like their own abilities to help themselves. Do you find that that? Is there any link or any kind of honestly causes causation, but any correlations, like while we're growing up, if that's like within the family or environment, or just something that we kind of inherited, to have this lower self esteem or this feeling of inadequacy that we are turning to something outside of ourselves to help us move through that? Brooke Aymes: 18:19 Oh, yeah, absolutely. SoI think that addiction comes from a whole like ton of different places. The definition it says genetics, life, circumstances and environment, and then also describes addiction as any behavior that continues despite harmful consequences, right. And so it's saying it comes from genetics, it comes from life circumstances, it can come from environment. And to me that says, it can definitely come from adverse childhood experiences. They're also called aces. And there are a whole a whole wealth of different things, they could be any event that could be traumatic for a child. And that could be like, parents separation, it could be a parent struggling with mental illness in the home, it could be a parent struggling with substances, it could be as big as like neglect and abuse, right. And any of these experiences can impact our overall self esteem and cause us to not feel good enough about ourselves, can give us this core belief of not feeling good enough about ourselves. Some common examples that aren't as extreme that maybe some people have experienced our If our parents had super high expectations of us growing up, and we had difficulty meeting those expectations. Now maybe we've developed a core belief of not feeling good enough. And now that's the lens that we see the world through. Or maybe in high school, our first relationship is a super unhealthy relationship. And our significant other is constantly saying things like we're not good enough or doesn't like this, this and this about ourselves and And now we develop a core belief of not feeling good enough about ourselves. And that's the lens that we see the world through. Kira Yakubov: 20:05 And that paints everything, right like that paints, all our decisions or relationships, how we treat ourselves and other people, too. Brooke Aymes: 20:13 Yeah. And then if we're not feeling good enough about ourselves, someone offers us a joint at the boss side, we're more likely to say yes to try to fit in, we don't feel good enough about ourselves. And then we find relief from not feeling good enough, because we're high. Right? So now I just found the answer. And I'm going to continue to seek that. Kira Yakubov: 20:32 So it feels like the answer the antidote to that helplessness or to the low self esteem. Brooke Aymes: 20:38 Yes, it's temporary relief from those very uncomfortable feelings. And I definitely believe like those adverse childhood experiences lead to addiction, as well as like other mental health disorders, like Generalized Anxiety Disorder, or ADHD or depressive disorders, because then we're struggling with different things, but they're still very uncomfortable symptoms, and then we find relief and a substance. And I was going to say, because you and I have done some work together, you've helped support groups for me in the past, for others on this, and it's come up that, you know, there are different ways that you can see this type of like abuse or substance abuse or addiction, right. So it's, it can be seen in like eating, right, things like that. Are there other other areas that I am asking to identify so that listeners can, you know, pick up on for themselves and maybe it will help to lead them to seeking therapy or some sort of support in that way? So what are some other areas that it can also then show up in our lives as opposed to substance abuse? Yeah, absolutely. Um, so the definition describes it as any behavior that continues despite harmful consequences. I really, I believe that we can get addicted to anything that feels good, right? So if sex feels good, I can get addicted to that or porn feels good. I can get addicted to that. Our relationships, like infidelity, like still continuing to seek attention outside of my relationship, because I'm addicted to that attention, food, gambling, really anything that feels good, it gives us that instant gratification and has potentially made our lives unmanageable, maybe we can't hold a healthy relationship, because we're continuously seeking that attention. Or maybe our credit card debt is getting in the way of our relationship, because we keep shopping, or maybe we've gone through all the money now because we're gambling, any behavior that feels good that we're continuously doing, despite the things that it's doing in our life. Kira Yakubov: 22:44 That's a great definition. I don't think I knew that all the way through is that regardless of the negative consequences, we continue, right? Because negative consequences are supposed to right? stop us from continuing to do something right to reinforce us not to continue. But then there's this other piece that's like, No, we're just gonna keep rolling with this over here, because it feels better. And it's instant release. Daniela Galdi: 23:07 I'm so curious, Brooke, do you have some things that you do for yourself that you'd be open to sharing that helps keep you in this balance in this in this place of boundaries? Do you have anything that you are your go twos for this? Brooke Aymes: 23:23 I really I think the work that I do helps me a lot because I'm constantly talking to people about quieting our mind about practicing self care about setting boundaries, without being kind to ourselves. So I'm constantly reiterating these things. So I think that that's naturally helpful for me. But also, I really love to engage in anything that really quiets my mind. I think that's super helpful. Because a lot of times we just get caught up in the noise of like life and the news and where we have to go next, and what are we going to wear and so if I can quiet my mind, it's super helpful to get relief from that. Also, I think the more we quiet our mind, the more clarity we're able to have on things which is super helpful. And for me, the things that quiet my mind, I love to be in nature, I love to go hiking, I love to be in the woods, sleeping in a tent, I love all those things, because it's just so far away from like society and noise and bones and all that stuff. Um, I love the beach. And really, my kids help with being present in the moment to like running around soccer games and whatnot, because they're, you're fully in on what your kid is doing or not doing, you know. Kira Yakubov: 24:35 So there's just a lot of emphasis on just being mindful and present. Brooke Aymes: 24:40 Yeah, absolutely. And really, a conversation that I have a lot too is sometimes like self care can also feel like Monday and like a chore, right? So something I do for myself is going to the gym, but maybe sometimes I don't always feel like that and then it feels like a chore. And we don't want it to feel like a chore so something that I'll talk to people a lot about is practicing flexibility when it comes to taking care of ourselves? Because we might need different things at different times. And something I'll challenge people to do is to ask themselves, okay, what am I capable of? What am I willing to do? And what's going to bring me the most joy? Right? So maybe I had planned to go to the gym, but maybe I hurt myself, I'm not necessarily capable of doing that. What else am I willing to do that would bring me the most joy, and really looking at taking care of ourselves through that lens? Because I think a lot of times we just get lost and like doing the same old routine and really lose sight of joy, too. Daniela Galdi: 25:36 Yeah, absolutely. We just add it to the list. And you literally took the words out of my mouth, in terms of I was thinking the word like flow, like how can we make things flow and be able to have that flexibility. I love that you said that, because it's so important to be able to adjust, but also then to recognize when these tools that we do practice in like self care and therapy and different types of mindfulness. In knowing what is good for us to bring us back to those places. Sometimes, we might need them. And we've, you know, I can speak for myself or forget to use them, right, in that challenging time. But I've set it in my schedule to do like meditation in the morning. It's like, wait a second, why didn't I stop, take five minutes and go in the other room or like, go outside and just walk around the block? Right, same here. And I can both attest to like the whole nature, like being in nature and everything. And you know, so it's, it's important that you mentioned that about the flexibility and to be able to go with that flow of when we need these things for ourselves. Yes, it's good to get them in our schedule, so that we can become masters of these things, right, and become familiar with them, but at the same time, not to forget that they're there so that they can help us in the challenging times. And bring us back to that clarity you mentioned. Yeah, absolutely. Kira Yakubov: 27:02 I wonder if this is why you call your practice gaining grace, because what I'm hearing is giving yourself a lot of grace, that just came up for me, is like giving yourself that space to like that self compassion, like Yeah, I had this plan that I know this is good for me. But right now, I just, I'm not in a space where I can do it. And instead of beating myself up and feeling like shit, and shaming myself, which I'm sure it gets back into that cycle, it's I'm going to shift gears to what else can I do that's going to be loving, and joyful in this moment. I love that where it came from, I'm curious of gaining grace. Brooke Aymes: 27:36 Yeah, so the logo is like I were always had, and all these like flowers coming out. And to me, it was like all the anxious thoughts coming out. And gaining grace in general, I just really wanted to focus on finding that peace within ourselves, so that we can quiet those anxious thoughts and really, like feel confident in who we are. Kira Yakubov: 27:57 Hmm, I really love that. That all comes together. Yeah. And I love that image, too. I'll have to look at that logo. Because I'm just imagining it, it sounds wonderful. So I know that you kind of touched a little bit on these different mental health issues that may come up that are associated with substance abuse, or addiction, I know that you also work with dual diagnoses is so for the listeners, can you explain what that means? And what that looks like for them? Brooke Aymes: 28:25 So yeah, so again, in Gaining Grace, we definitely focus on dual diagnosis, because I think that mental illness and substance use disorder go hand in hand with one another. Um, a lot of times, we're using substances to self medicate from things, uncomfortable symptoms that we're having as a result of mental ailments. So dual diagnosis would be having a mental illness and a substance use disorder, that would mean like I have generalized anxiety. And then I also have had a substance use disorder, or maybe I've experienced PTSD. And I also have a substance use disorder. Kira Yakubov: 29:01 Okay. Thank you. I appreciate you clarifying that. Yeah. So I also want to kind of touch on the other side, right? When people come out on the other end of going through recovery and getting that kind of support. What does that process look like for some people? Because that sounds just as difficult going through it as maybe the addiction or I don't know. Brooke Aymes: 29:25 Like following through with long term recovery. Yeah. Yeah. So that's definitely difficult for people because change is inevitable, right? And so we're constantly changing as long as we're constantly growing, and life is constantly changing. So what we have mastered before is now different, right? And a lot of people seek relatability and support in their recovery and that is super helpful in recovery that similar to what we talked about with the parents, to have people going through similar life changes as US that can also change as well, right. So I also believe that different things work for us at different times in our recovery. And it's important to be open minded to that. And it's important to be willing to follow through with that. So maybe I go to a treatment program, and I've done church, and I've done the group's at church. And that's really helped me up until this point, but now it's like, nope, my life has changed, there's no longer fitting, right? So where can I find something else that's gonna fit and maybe now it's nutrition and fitness, or working with a licensed therapist to do some different kinds of work. Or maybe now it's going to 12 Step programs and seeking relatability and support there. Kira Yakubov: 30:41 So it sounds like going through the layers of healing, what we needed, then is not going to be the same now. And that's okay. And it's finding different things and different supports to help us move through that Daniela Galdi: 30:51 You just brought to mind, are there any, like misconceptions about recovery that you come across? Brooke Aymes: 30:59 It's not a one size fits all. So like, similar to what we talked about with the parents and being like, very individualized is that for the individual as well, right. So a lot of times, people will say abstinence is the only way. But that might not work for this, this individual, or people might say like, you have to believe in this certain higher power for it to work. But that might not work for this individual, right. And so it's definitely not a one size fits all. And that's why I think it's very important for the individual to like, really practice like self awareness and be in touch with themselves through that mindfulness that we discussed to know like, Okay, what's going to be beneficial for me in this moment? Or maybe I no longer do something that might be beneficial to add back in, you know, Kira Yakubov: 31:45 so it's just catering catering to the person and what they believe in and what makes sense for them in their life. Brooke Aymes: 31:50 Yeah, knowing that the goal is that we're not going back to substances, and that we're going to continue to grow. So how do I continue to do that? What path do I need to take to continue to make that happen? What types of therapy or strategies do you use? Is it a lot of talk therapy do tap into different types of like modalities? Yeah, so I take from a whole on abundance of different modalities, some of the main ones that I focus on the most are CBT. So that's cognitive behavioral therapy, focusing on our thoughts, feelings, and behaviors and how they're all intertwined with one another, I use a lot of MI, which is motivational interviewing, I believe it's very important for me not to be offering advice or suggestions, I believe it's more important for people to be coming up themselves, or what's best for them, and me to be helping them along in those decisions not to be making them for them. Um, and then also, I believe in interpersonal therapy, I use that a lot. And that's really focusing on our body language, and what's happening. So someone's like, saying something and rolling their eyes. I'll point at that and say, like, Okay, well, what's happening here? Kira Yakubov: 32:59 So I know and I don't know if this is a common misconception, but is there? Is there a likelihood of like relapse while we're going through this process? Because I imagine, you know, when we try to make a change, or we try to do something different, that has been something that we've leaned on for a while, it's, it's easy and almost predictable to go back to that default, right? Like, even in any therapy, it's we go back to our old coping mechanisms. Brooke Aymes: 33:25 Yeah, describe it a lot of times as like, as like our blankie. Growing up as a child, this has been our comfort to cope with like really big things like we talked about adverse childhood experiences, traumatic experiences, throughout childhood, struggling with uncomfortable feelings, this has helped us through all of that. So letting go of that, and then trying to live life without it is super scary. Alright, so there's a lot of different things that come up. In that in itself. In long term recovery, we're really unlearning a lot of the things that helped us to survive and starting to learn new coping mechanisms for a whole different life. And that's very difficult. Um, and relapse is definitely something that comes up in that. I think relapse doesn't always have to happen. It does happen sometimes. And I think that when it does happen, it's important to recognize that I like to call it more of like, okay, this was a slip up rather than a relapse, because I think that a lot of times when we choose to go back and pick up the blankie, again, or we choose to relax, we can have increased negative self talk, um, similar to like food or dieting, right? Like if I'm doing so good, eating healthy and going to the gym and then I eat a cheeseburger. I could tell myself Okay, well, all bets are off. Now. I'm just gonna eat everything similar to relapse, it's like, okay, all bets are off. I'm just gonna go all out. You know, like, I can't do this anymore. So I think it's important if we do slip Ah, to really be mindful of our mindset surrounding that to not let that progress into a full blown relapse, we can still be successful and still seek recovery and still be working towards our long term goals, even though we had a slip up. Kira Yakubov: 35:17 I think that's important for a lot of people to hear and recognize to, is to not kind of go down the spiral of shame and like, I messed up this is it, what's the point? And just be like, okay, tomorrow's a new day, and I'm gonna get back on and try again, and restart from there. Daniela Galdi: 35:33 Yeah, it's a great lesson I feel in general, or anyone in recovery, as well, as anyone who's working through something. And I and I can speak from my own experience, even. You mentioned eating, and that's a situation for me, right. And so I've done that several times, where I've just gone down that shame spiral, and had to pull myself back out, it's not always easy. And then also in terms of like, any type of mental illness, like with my, with depression that I manage, like, you know, to kind of beat myself up and not give me that give myself that grace. It's easy to jump back into that unkindness. And so I hope that who's ever listening, you know, they see and hear your story and see and hear all the people that you work with through this and know that give themselves some patients with getting back into the life that they want, and that and the kindness for themselves. I think it's important to mention, because the jump to the shame, or the jump to the negative feelings is quick. But it might take a little bit more time. But it's not impossible to get back to where you want to be. Just leaning into that support, leaning into those tools leaning into that self care again. Brooke Aymes: 36:45 Yeah, really being aware of our thoughts. Kira Yakubov: 36:47 And it sounds like we need extra love even more in that moment from ourselves. But even though might sound counterintuitive, it's like I have to keep myself accountable. I have to be, you know, upset with myself, but it sounds like no, it's almost like giving yourself more love, like, Okay, I'm going to start new, I can continue going through this. Brooke Aymes: 37:05 Yeah, absolutely offering ourselves that compassion and that grace, like, of course, I mess up. I've been relying on this for such a long period of time. And what I'm doing is very difficult. Kira Yakubov: 37:15 So it's validating ourselves in that moment. Yeah, yeah. And so I know this, I mean, the recovery process sounds really tough and trying, are there any tips that you have, or recommendations for people when they are around? family or friends are the same environments where people are still using those substances or alcohol, and they're trying to refrain from it? Brooke Aymes: 37:39 Yeah. So I think first, it's important to practice that mindfulness and self awareness and insight within ourself to know, am I out for going around these people? Or am I out for being in this environment? Do I feel like this is going to be beneficial for my mental health or harmful? It really comes up so often throughout these next few months when we go through the holidays, because a lot of times people will be like, Well, I have to go to my mom's for Christmas, but my mom uses and then I always use, right? And it's really checking in with ourselves and saying, like, well, do I have to go to mom's house this year? Is there something different that I could do instead. So really being mindful in ourselves and what we're up for and what we're not, if we are feeling out for engaging in places or engaging with people who are using that we want to use with having a plan to leave early or having our own car so that we can leave whenever we're ready, so that we don't put ourselves in a spot where we're relying on someone else. Or we could possibly be stuck somewhere that we feel uncomfortable. So having a plan to leave when we're uncomfortable, or when we're ready to leave is also super important as a way to protect ourselves and have boundaries for ourselves. And then also on in recovery from substances. And really anything I always suggest that relatability and support. So having people like if we are at Thanksgiving dinner and a really uncomfortable conversation comes up and we're not able to leave like can we go outside and call a friend? Do we have someone that is supportive of our recovering? Kira Yakubov: 39:16 So it's like, it sounds like everything that's within your control, right? Like, put it back to your power your control and making these decisions and giving you enough freedom to do what you need to do if something comes up for you. Brooke Aymes: 39:27 Yeah, not going back to using substances has to be the first goal. So what is going to help me stay there? Kira Yakubov: 39:34 Okay. Daniela Galdi: 39:35 And I'm glad you brought up about the holidays because I know that was something here really wanted to touch on because they are coming up. It's going to be a few weeks straight through. Right. And, you know, you mentioned about the boundaries and letting people know let's say it is mom or you know, I'm not going to be able to come how do you best communicate that when Maybe there's like an anticipated not so pleasant consequence, you know, people here, you know, maybe they don't want to hear that, and they want them there. And so how do you suggest people handle that? Brooke Aymes: 40:13 Yeah, mom's always gonna want us there. Kira Yakubov: 40:16 Guilt Trip? Yeah. Brooke Aymes: 40:21 When we're having these conversations, it's important that we focus on ourselves, right. And then and when we go into these conversations, it can be, even if we feel like in our recovery, if we feel like it's the truth, like you do this, this and this, and that's why I can't come. Not Not everyone, especially our family members is going to be receptive to hearing. So it's important that we focus on ourselves and, and focus on what's going to be best for us, and then communicate that. And so we can say something like, Hey, I'm not up for coming this year, I got invited to go do this, I'm going to do this. But maybe we could plan to do this on a different day. And maybe that would mean like not going into mom's house. But spending time with mom at a restaurant or somewhere where we might feel safer, you know, or inviting mom to come into our space. So we can be creative. A lot of times too, it's funny around the holidays, because I think that we just get caught up in traditions like, we have to do this because it's the juridische. And are we're supposed to or we should because it's their direction, right. And in early recovery, something that I did, I kind of like looked like, I don't know, if this tradition is going to serve me, well, this year, I think I'm going to do something different. And instead of like having Thanksgiving dinner with my family, I went and volunteered somewhere. And that was kind of like my out like, Okay, I'm gonna go and be of service to people who don't get to have a Thanksgiving dinner with their families, it'll be helpful for me, it'll be helpful for my recovery, right. So that's also something that we can do in our own recoveries is switch it off a little bit like, Okay, if we go to this restaurant, and always drink a ton, and I'm not offered that, like, let's do something different, let's cook at home. Or if we always cook at home and drink a ton of wine, let's go out and do something different. Kira Yakubov: 42:07 So prioritizing ourselves. I mean, like, throughout all of this is prioritizing ourselves, we're not responsible for anybody else's feelings or emotions, or how they choose to deal with it. And I know that's really tough, generally speaking for a lot of people, but especially I'm assuming this process is being really firm in that. And I'm assuming a lot of guilt might come up around having to say no to a lot of important people in our lives and have to set those boundaries. But remember that it's for ourbest Brooke Aymes: 42:37 Yeah, and really, so I talked about boundaries a lot too. And it's very difficult to set them and then be consistent with them, we can shift our perspective and and notice that when we're setting boundaries, we're really being proactive about preserving the relationship. Because if we put ourselves in an uncomfortable situation, and then react, we might cause harm to the relationship. So by protecting ourselves and our mental health and setting boundaries, we're being proactive about preserving the nature of this very importantrelationship. Kira Yakubov: 43:09 I love that you say that, because I think that in a lot of cultures, particularly maybe some immigrant cultures, setting boundaries is like felt and seen as a betrayal, of love and trust. And it's the complete opposite of how you're saying. So I think it's really important for people to hear that and like, have that on repeat that this is actually an act of kindness, and preservation of the relationship, because I care about you, I could just end this all together and not have to deal with it at all, but putting in these parameters to preserve this. Daniela Galdi: 43:40 And it also ties into what you said earlier, it's kind of circling back to the beginning of our conversation about when family members in the opposite end, right when family members are trying to not enable and trying to be there for the person going through the any type of like substance abuse situation. And so it's interesting because it might seem a little counterintuitive, like to me it might seem a little counterintuitive, of prioritizing myself, but then I question for myself, well, how many times that I put someone else's needs in front of mine, and then ultimately was enabling them and not doing what's best and actually doing harm to them and myself, you know, so it's so interesting. It circles back for the person who is in recovery and then also to the family members or friends who are there to help that ultimately, you're both setting those boundaries to prioritize and preserve as you said, to preserve the relationship because you want to see it through on both ends. Kira Yakubov: 44:42 It also sounds like prioritizing the needs of people and not the wants. Right and prioritizing what we need and what someone else needs is really tough when when we want something different and that's not an easy decision to make. Brooke Aymes: 44:54 Yeah, when we feel like caught up and shoulds are supposed to write I shouldn't be having Thanksgiving dinner with my family, even though that might not be best for my overall mental health. Kira Yakubov: 45:04 And so I know we're starting to come to an end is there, I know you've shared a lot of yourself. So I really appreciate that. Is there anything else that you would want to share with the listeners? And maybe that clients don't know about you like a fun fact or something that is kind of cool within your life? Brooke Aymes: 45:20 I think people probably don't know what my clients probably don't know about me is that I'm obsessed with Taylor Swift. A fun fact. Kira Yakubov: 45:30 can you share with the listeners, how they can reach you, your website, your practice, where you're practicing, and all that good stuff so they can get in contact with you? Yeah, absolutely. Brooke Aymes: 45:39 So we're called Gaining Grace. We are based out of New Jersey, so I can facilitate therapy with individuals, family, couples, adolescents, like we talked about in the state of New Jersey. It's all telehealth right now. So anywhere in the state of New Jersey, my website is gainingracellc.com. And then we also have TikTok, Instagram, and Facebook. Kira Yakubov: 46:04 Awesome. And so I know that you mentioned I think it was one of our forums that you are going to start a group therapy. Brooke Aymes: 46:12 Oh, yeah. Um, at the end of January, we are going to start our first group that would be program, it's going to be a six week course. And the goal is to really make therapy accessible to people who might not have insurance or might not be able to afford individual therapy, so we can offer it at a much lower rate, and people still can get access to that relatability and support that we talked so heavily about on this podcast today as being so beneficial for families and individuals. Kira Yakubov: 46:43 Awesome. Thank you so much for the work that you do. It's it's powerful and incredible. And I know when I was in grad school, I was like, Oh, I don't know if I want to touch this because I just it's this it's heavy work and it's powerful work and life and death for a lot of people. So I think I commend you for for having this be your purpose and your calling and helping so many people through this process. Brooke Aymes: 47:04 Thank you. Thank you so much for having me here and for helping to bring light to it. ### Listen - [Spotify](https://open.spotify.com/episode/13829174) - [Apple Podcasts](https://podcasts.apple.com/podcast/13829174) - [YouTube](https://youtu.be/24FSvalER4w) --- ## Mental Health Support for Men - URL: https://healyourrootspodcast.com/episodes/mental-health-support-for-men - Published: 2022-11-09 - Season 1, Episode 10 - Duration: 48:45 - Category: trauma - Guest: David Koppisch ### Summary Examination of intergenerational trauma patterns and therapeutic approaches for breaking cycles of inherited trauma in families and communities. ### Description Intergenerational trauma affects families across generations, often in ways we don't fully understand. This episode examines how trauma is passed down through families and communities, and explores therapeutic approaches for breaking these cycles. Discover practical tools for recognizing inherited trauma patterns and beginning the healing process for yourself and future generations. ### Transcript Kira Yakubov:: [0:00] In Episode 10, we have David Koppisch Licensed Social Worker and the newest team member of heal your roots wellness. In this episode, you'll get to hear us talk about men's mental health, helping them identify emotions and the importance of friendships outside of family. In addition, we also go through what it's like to transition particularly within a career. Hi, I'm Kira Yakubov, Licensed Marriage and Family Therapist and founder of Heal Your Roots Wellness practice. Every episode, we talk with a professional from the mental health field to learn more about their approaches and specialties, and also their journey of becoming a therapist. In this podcast, we'll uncover a deeper look at the world of therapy from new perspectives. You will meet the therapist of heal your roots wellness practice, and trust the colleagues from the community tackling mental wellbeing. Were your go to Network for practical and professional insight in mental health. Subscribe for new episode releases every other Wednesday. Daniela Galdi:: [1:11] Hello, listeners, this is Daniela Galdi, your co host with Heal Your Roots Podcast. Kira Yakubov:: [1:17] This is Kira Yakubov. David, thank you so much for being on today. David Koppisch:: [1:21] Good morning. Thanks for having me. I'm David Koppisch, one of the new therapists with heal your roots wellness. Glad to be here. Daniela Galdi:: [1:28] Congratulations, David are joining this fabulous team, I would love for you to tell our listeners a bit about why you started in therapy. David Koppisch:: [1:38] Well, my journey to therapy, I'm coming to therapy a little bit later in in my career, relatively speaking. So I went to social work school way back in the early 90s. I got my master's in social work from Temple University. And I was primarily interested at the time in what we call into the social work field more macro social work. So I was particularly interested in systems and how systems impacted people and how people's environments and social environments impacted people and how policy impacted people. And so most of my work for almost 30 years in Social Work fields had been in that sort of macro area, right trying to work with groups and communities around how do we sort of change policies and change systems so that people can experience better lives and more equitable experience of life. And so did that for many years, was involved in lots of very interesting campaigns around policy issues here in Pennsylvania, here in Philadelphia, and Pennsylvania, around issues of school funding and criminal justice reform and things of that nature. And through those years, I began to realize that one of the main things that really excited me about that work not only sort of working on some important kind of policy and macro issues, I began to realize that what really excited me and what I think I was perhaps best at in that kind of work was the one on one connections, the building relationships with people, hearing their stories, and really trying to help them sort of turn their own narrative and their own histories of struggle, and an often discrimination and oppression into positive change for themselves, their family, their communities, etc. And part of that work as a community organizer, essentially, is what I was mainly working is was a lot of what we would call one on ones. So our job was to go meet people and talk to people knock on doors, try to get them to talk to us and kind of hear what it was they cared about and whether they wanted to join with others to make some change. And again, as I reflected back on that work after a few decades and realize, boy, that's the part that really turns me on. That's the the one on one connections, the hero again, hearing people's stories and trying to you know, ask the probing question to get folks to sort of open up and move from a place of either, you know, pain and frustration with what was happening in their community or in the world to to action, you know, that was always sort of brewing in the back of my mind, then the pandemic hits, right. It all of us. And like many of us, I began to sort of reevaluate, you know, my relationship to work, and my calling, as it were. And I just began to think, well, you know, what, I never actually pursued clinical work as a social worker, I had my MSW but I said, Well, you know, let me get my social work license at least and let's Have that just to see what might might you know what that might bring later. So that happened, the pandemic sort of unearthed some, or highlighted, I guess, some challenges in my own family, in myself, mental health challenges and mental health challenges and the people around me. And I began to think the calling to do more direct clinical work, sort of grew from that as well, you know, I began to think, Okay. These are some issues hitting close to home. And, you know, given I'm, I'm, in my early 50s, have given my life experience and given my family raising a family experience, I began to think, is there a different way that I could be useful to people is there a different way that I could put my skills to use, and I just sort of felt the calling more and more towards doing doing therapy work. I'll go way back for another influence, if you don't mind. My dad was actually a psychiatrist. He was a family systems psychiatrist, and actually studied under one of the one of the sort of founding fathers of family systems therapy, Marie Bowen. And I remember growing up hearing stories of Marie Bowen, and my dad, you know, meeting him and going to his workshops and trainings and whatnot. And so my dad worked primarily with a work in public health settings, public hospitals, and worked with a lot of folks who were had substance use issues and other challenges and folks coming out of incarceration situations, and then he worked with some families on the side. But that was always in the background growing up in our house, just sort of like it was in the it was in the air, you know. So I think that certainly influenced me going into social work in general. But now, you know, several decades later, more specifically, you know, doing more direct work, doing therapy work directly with with individuals, couples, families. So yeah, so that's sort of part of my journey. Kira Yakubov:: [7:28] So much great stuff there. It's almost like you have all the perfect components, and experiences and backgrounds to be such a great therapist. Even just having that systemic view, like firsthand, being in the community, understanding the culture, understanding how real life things impact an individual or a couple or family, and then being in that room, helping them therapeutically as well, I feel like that's such a beautiful marriage of the micro and macro. And then also, I'm like, fangirling, over here over your dad studying under Bowen, because that was like, in my textbooks in grad school, like, what I refer to my case studies. So I think that is so cool that you were exposed to that. David Koppisch:: [8:13] Yeah, I feel pretty, pretty lucky. And I didn't know at the time, you know, this is like, wow, this is what my dad does, you know, but now realizing that was pretty, pretty special. It was kind of a special time and interesting time, I think, right? In the mental health fields in the late 60s, into the 70s. So yeah, I do feel pretty, pretty lucky that I had that my dad has an influence. And, and I appreciate you saying about the marriage of macro, macro and micro. And that that actually made me think of something that was also part of my thinking in the last five years or so. Having so heavily focused on macro for a good number of years, feeling like as a social worker wanting to round out my practice, you know, to have a more of sort of a 360 view or you know, 360 practice. So, hopefully, that is what I am able to bring into sessions is that is that sort of marriage of some macro understanding and some, you know, systemic understanding and, and the micro one to one work. Daniela Galdi:: [9:27] That's beautiful. I'm so inspired by you, David. I have a question though, if we can share for our listeners a little bit about who your father did study with and who this person is in the mental health world. David Koppisch:: [9:39] So and Kira, please add and I'm sure I'm not going to get it all right. But Marie Bowen is was, you know, is still considered right one of the founders of family systems therapy, he was a psychiatrist. He created an institute which was Since still might be connected with Georgetown University in Washington DC, with others, right, and you know, a lot of these founding names get a lot of credit when it was many people involved, right. But he certainly gets a lot of credit for, at the time, a new way of working with couples and families, a more what we now a lot of us call sort of a more systemic view. And the idea that one person in a family who's experiencing challenges and troubles, the way to approach that person is not just at with that person alone, right? The idea is that everyone, whether the fat, whatever the makeup of that family, whatever the structure, or the what it doesn't, you know, doesn't have to be a nuclear family, any whatever kind of, we all come from some kind of a family. And each of our individual, you know, life experiences and challenges are shaped by that. And if we're going to sort of help somebody address a particular issue, whether it's a substance use issue, or whether it's another kind of mental health issue was that if we're not actually looking at how the family is interacting, and if we're not looking at how patterns of behavior have been passed down from generation to generation, often without us knowing, then we are likely not going to be successful in helping that person and that family kind of addressed their challenge. Kira Yakubov:: [11:34] Yeah, absolutely. And it was what helped me open my eyes up, I mean, grad school alone was like, incredible. But seeing that, I think, correct me if I'm wrong there, but if you remember, but I think that there was studies going on, or there was treatment centers for folks who had schizophrenia. And so they would take them out of their homes, and they would treat them in the facilities. And they would get better, they would have more coping skills. And then when the individual returned back to the family, the same symptoms, the same issues would return. And so the therapists and psychiatrists at the time started to recognize that it's not just the individual that is struggling, this is also a symptom and an expression of what's happening within the family system. Right. So each person plays a role in keeping the system going, whether it is healthy or helpful, or if it's maladaptive. Right, so each person, whether it's one of the parents, or the siblings, or a grandparent, whoever is involved, they all play a role in kind of creating the culture in the family, the rules in the family, how each person feels like they can behave, or what they feel like they're supposed to do within the family structure. So it was really wonderful to kind of see like, okay, it's yes, you can work with one person and help them. But if they return to the same environment, that's creating the need for them to express themselves in this particular way. It doesn't necessarily matter, we need the whole system to be a part of the healing process. And I think that's when they started bringing parents and grandparents, and then recognizing that there's hierarchies within the family. Yeah, so that was really interesting, too, to see that there needs to be a hierarchy within the family. So the parents or the grandparents, whoever the adults were, they need to be on a different level. And they need to be working on the same team and the children, or whoever the younger miners are within the family, or a different subculture of the family. Right. So if one parent aligns with one of the children that totally throws off the hierarchy with the other parent, or with the other siblings, so it was really interesting to see how all this plays into family therapy and helping people out Daniela Galdi:: [13:53] in terms of the interactions and everything. How does that come into play? When you work with individuals now one on one? David Koppisch:: [14:01] Well, I, if it's an individual session, you know, they're coming as an individual, not as a couple or family. I still really try to emphasize with them and you know, get the story from them in the first few sessions about what is what is their family story? How did they relate to their family growing up? You know, tell me that story, what it was like to grow up, what was the what were the interactions? Like, do you have siblings? What were they like? How did you relate to your parents? How do you relate to them? Now? You know, how did they respond to you as a child when you had either, you know, triumphs or or, you know, troubles. And sometimes folks are really eager to talk about that. You know, sometimes people love talking about what that was like growing up and in other times you you get the sense that it's kind of painful for folks to talk about that sort of gently helping people look back and really take a ticket. examine what it was like and what those interactions were like and, and, and what they're like now, if they're adult, you know, adult children, with adult siblings, what are those interactions like now, and help folks to make those connections between their own behaviors, their own thoughts, their own emotional life, and those interactions and those relationships with with family members, even if they're not in the room, and they're not a part of the therapy, the other people and maybe these people are actually some of them might be to see strength to help folks see that those played, and probably still play in a role in how they're living out their lives. Kira Yakubov:: [15:45] Absolutely. And I love that you mentioned what that looks like now, because I like to ask couples or even an individual when they talk about their family want to ask, before you answer this question, how would you describe, let's say your father growing up? And how would you describe your relationship and who he is now, because those two are very different, right? The way I would talk about my dad as a kid versus now. And just recognizing that across the lifespan, we change, right? Like, our behaviors, our opinions, our perspective, how we treat other people changes throughout life. And our parents are humans too. They're also changing and growing. So I love that you mentioned like before, and now too, because that's really important too, is our relationship with, you know, our parents or family now can look very different from before. But those primitive experiences and perspectives can still shape how we interact with the world now, even if that relationship has changed. I know that you have a special interest or some experience working with men and men's mental health. Is there. Is there any kind of approach or something that you find that is the most common kind of topic or something that you go into with men, when you do discuss mental health with them? David Koppisch:: [17:04] I find and, you know, this is my experience. So I'm hesitant to make sort of broad, sweeping generalities, right, but in my experience, and it's connected to my own personal experience, right, I think that Men of a Certain Age, we can sometimes have challenges around a couple things, the sources of a sort of healthy emotional life sometimes can narrow, I think, for some men over time, for a couple of reasons. You know, there's been a lot said and written about male relationships as they get older, right. And so a lot of men, as they get older, sometimes have fewer and fewer relationships, maybe then they did right out of college right out of their 20s or something like that. And a lot of men, you know, sort of find themselves maybe feeling kind of isolated, maybe if they had children, and if their children are grown and out of the house, then there, they start to really feel it. Right. So I think there's one area that I like to talk to men about in terms of like, what is your what's your support? Network? Right, who do you hang out with? Right? If they're in a relationship if they're married their relationship? Who outside of that, right is important to you? Who outside of that are you spending time with? And that's something I do encourage couples in general, sort of, like, try to make time outside of that relationship, which might sound counterintuitive for some of them. But really healthy generally, right? You need to have other sources right of emotional support and emotional connection. So I think, with a lot of men and people in general, but it's a lot of looking at, are they putting some time and energy into cultivating relationships, friendships, in their 40s 50s 60s, etc, that and, you know, you, you, you start to hear that, that sometimes it's a it's kind of a struggle, sometimes for men. So I do like to spend some time there were some men, there is, I think, still sort of a struggle of figuring out making sense of what their relationship and you just mentioned it a minute ago care what their relationship with their father, right. What was that? Like? Do they feel sort of compelled to sort of mimic the way their father was emotionally? Now that they're in adults, or are they feeling like you know what, that doesn't work for me or that kind of masculinity, that kind of fatherhood. That's not that doesn't work for me anymore, but I'm Not sure how else to be? Because that was my only model, for example. So I do I do have those kinds of conversations with clients and figuring out, okay, well, let's let's look at, what are the positives that you've found positive traits, if we're talking about their relationship with their father, let's look at the positive traits, let's look at things that you do want to sort of carry forward, right, and carry to if you have children to your children, or just living out your life, and let's look at what things are not, aren't just not gonna work for you anymore. And it's okay, to sort of separate those, it's okay to sort of be a different kind of man or different kind of father than your father was. So there's a lot of that, I think. I'm just thinking of one one man in particular that I'm working with. And the pattern and I think this is fairly common, the pattern with him is that he feels like, he needs to be taken care of everyone, all the time. And his whole life sort of is consumed by what seems like a never ending treadmill of always worrying about and taking care of other people. And, you know, that has served him and and has served the people around him well, but it he is beginning to see that he is sort of exhausted, right. And he is starting to see that he doesn't have much else outside of worrying about and taking care of and feeling like he has to financially and emotionally take care of, of all these people in his life, from his first marriage and the second marriage, other people in his family of origin. And so helping him sort of think about okay, the role is provider, right, the role which has been key to his identity. How do we preserve that? And how do we help you think about, you know, self care and other things that are going to help you sustain that over time? Because he's starting to realize, like, he's getting rundown, he's getting, you know, he's, he's having physical issues. He's, he's feeling exhausted, and not really making time for himself, essentially, when it comes down to it. So the basics of how, you know, talking with some men about, are you taking five minutes for yourself in the morning, before you jump into work or jumping to doing something for the kids? Or, you know, are you are you literally taking out five minutes? Can you start with that, to begin to build in a practice of taking care of yourself? Daniela Galdi:: [22:48] Hearing that, as a woman, especially, you know, it really adds another element of compassion. And so I really appreciate that we're talking about this today, and that you're able to hone in with men on their health in this manner, and helping them to see that there are different ways that they can take care of themselves. And without any negative feelings towards that any shame any, you know, I feel, and this is just my own personal observation, but the men that I have spoken with, within my work, it's, you know, it can be shrugged off, like, be fine. And it's not always the case, you know, we all need to be able to take care of ourselves and pay attention to our needs, and give it give our needs the attention that will help us to feel all the positive things you were mentioning. So I do have a question for you. In terms of earlier, when you mentioned you transitioned into getting this new degree right, and taking this new chapter in your life, were there things that you leaned into for yourself while taking on this whole new chapter? Going back to school? And all of that? David Koppisch:: [24:04] Great question. The short answer is yes. You know, I think this is one of the wonderful things about therapy, one of the many wonderful things about the work that we are able to do as therapists and it's the privilege that we have of really doing this kind of work because I really do feel like it's a privilege because I think it in other other professions may be similar, but when I'm experiencing doing therapy work is that it can if we are open right as therapists if we are self aware, right, and an open to sort of the, the mutuality, you know, that I think does happen in therapy, whether we acknowledge it or not, and the reciprocity that I am constantly. I sort of want to thank the clients I'm working with because they give me insight. They helped me He reflects on my own, you know, personal relationships in my, my marriage and my relationship with my children and my relationship with others, you know, in helping them sort of look at what's going on in their life. It does, it does sort of make me reflect, oh, okay, you know. So I have continued to learn and continue to have my own insights about, you know, what kind of what kind of spouse? Am I right? And how can I improve? And what are my own emotional patterns or habits or things I learned or didn't learn, you know, growing up that I need to look at right and need to see again, what's working and what's maybe not working, in openness to continually change and get get be, again, a better a better spouse, a better father, a better friend, all of that, right? Yes. It's definitely making making me think about all of that. Kira Yakubov:: [26:07] It's actually funny, I think that I've noticed this trend, the more that I have paid attention to like my ideal client, or the type of presenting issues or, you know, clients that I like to work with is that it almost feels like a parallel, right? Like, these are issues or topics, or patterns that I either also partake in or have partaken in before that I've really worked through like past versions of myself or now, right. And I think that it is such important work. And it's like a constant reminder, especially when I work with couples where I see a similar dynamic, like, oh, I can really see from like, a third perspective on bias, what this is like for each of them. And even thinking about my own relationship, or marriage, right, like, makes me a little bit more compassionate or empathetic, like to see it from different perspectives. So I think it does really help. It helps us as personally and professionally, both ways. So our clients provide a lot for us, too. It's not just a one way street that we're helping. So I definitely agree with that. And I want to go back for a second, when you were discussing kind of the main concerns that come up for men. And so I'm curious of what you're kind of, whether it's theory, or you know, from your own experience, why you think it is that men have a harder time maintaining friendships or relationships outside of the family. And if they're, I'm assuming there might be a lot of maybe guilt or shame around wanting some personal time, or wanting to do something that's fun, outside of the provider role, or identity that they've kind of put themselves into society has put themselves into their family expects of them, right? Like, what that what that might look like, David Koppisch:: [27:54] oh, boy, you know, there's many, many factors cultural value. And again, all of this is shaped by, you know, culture and family of origin and, you know, maybe faith upbringing, if that was present there for a person and what kind of, you know, career they might be in. So there's, you know, many, many factors to, that contribute to, I think, a man sort of emotional and relational health. I do think for some, as you said that that provider role is certainly prominent for a lot of them. So again, if they had been the, or at least one of the main breadwinners in households, right. And if there were children in the households that they were responsible for, or partially responsible for, that, that those two roles can certainly push out much else, right, and become maybe their only identities, right. And when those things change, right, again, if there are children, and those children grow up and move on, that can be a major crossroads for for for a male who felt like, you know, that was their main role, you know, helping them helping bring them up helping put food on the table helped bring money into the household, and now those children hopefully are, you know, on their own. So what is what does that mean, right, if I spent so much time and of course, you know, all parents, I think experiences to some, some extent, but if I spent so much time 20 years, or more, maybe just focused on other people in the family, and now, you know, I find myself I'm 50 or 60 years old, you know, and now what, where do I put my energies, you know, so I think there's some of that, as we know, is therapists and I think as we try to teach folks remind folks that maintaining an emotionally healthy and kind of relationally vibrant life takes time and energy, right? It takes work it takes you have to cultivate these things, you have to put time into reaching out to people, we have to put time into spending time with other folks outside of the household. And you mentioned, you know, maybe some guilt around that, I think it is hard. I think with men's, I'm just thinking of my peers, most of us, you know, our parenting in a different kind of way that our, that our parents did. And I think there was some very positive expectation among a lot of fathers of my peer group of, you know, being more being more involved, right being trying to be more equal in childbearing child trying to be more equal in sharing the work of, you know, keeping up a household raising kids, which is certainly positive. That might have also cost us some challenges around, again, maintaining cultivating other kinds of relationships outside the household. So it has raised some some new challenges for Kira Yakubov:: [31:19] So I'm just thinking about my dad, right? It just makes me think about like, when we came to America, all he did was work that was like, that was it, it was his main role was just to provide to make sure that we were all okay in a country where we've never been in, he never spoke the language didn't know the culture, we're learning this day by day. And he didn't have a lot of friends, I didn't see him hanging out with anybody, he was either working or at home sleeping, or eating or hanging out with us. And that was on repeat, or ever, basically, I mean, we would hang out with other family friends that also had kids. So it was like out of convenience for other family members. But I couldn't say like, I knew who my dad's best friend was, which is so strange, because I think for a lot of women, or even thinking for myself, like going throughout life without a best friend, or without a group of women that I can really bond with. Sounds really hard. That sounds really tough. Even if you have a partner, like just having that outside relationship, how you're saying is so significant to our emotional, relational, mental health, physical health, all of that. So I mean, I, that does add a lot of compassion, empathy for me thinking about that. Daniela Galdi:: [32:31] yeah, and it raises the question for me, David, do you have any suggestions in terms of someone communicating this to their partner? David Koppisch:: [32:41] This need for or this desire for? I need some other friendships? I need some other relationships here. That kind of thing? Yeah, that's a great question. I would say that if a client were to come with that concern, or that question, say, look, I see the need that I really do need to put some time and energy into cultivating, you know, some friendships outside of my household. But I, you know, going back to the previous point, like, but I feel a little guilty, because I know that every hour or two or evening out of the house means I'm not home, you know, helping with the kids or helping my spouse or partner, whatever. So I think I would sort of help that person think through a couple things. One is, do do they think about how, over time, that time spent cultivating these other relationships and these other positive, healthy connections outside the household? How that will sort of yields positive dividends back, you know, in the, in the, in that relationship in that household, right? If they're not already thinking about this, can they think about? Boy, you know, if I go out with this one friend of mine, and we go, whatever we go play tennis, or we go, whatever, you know, whatever the thing is, just to spend some time together, that's going to make me when I come back, feel a little bit more energy than I might have for the kids, for example, that's going to lift my spirits, so I'm going to be in a better mood, that means I'm going to be a better partner, I'm going to be a better spouse. So I think I would help them think about, like how to frame it that way, you know, like I can, I know this is hard and it takes a lot of logistics. Again, if we're talking about a family with maybe young children, for example. It does take work it takes a lot of logistics right for one of the of the couple to be out of the household for for several hours. It does i i remember that. I'm sympathetic to that. And I'm working with a couple right now. Now it's just so hard for them. It's literally just almost it feels impossible for one of them to get out of the house for a few hours, which I don't think I ever would have understood before I had my own shelter. And it wouldn't have made any sense to me. And now that I've been through that I can very much empathize with what they're going through. So we've had this conversation now it's couples therapists we're having, you know, together. And we've had that conversation, okay, and it will be hard, let's, let's help think through. And maybe it's few weeks out, maybe it's gonna take you a few weeks to even think about how one of you can get out for four hours on a Friday night. But let's think of the positive benefits that that might accrue for all of you if you can make that happen. And let's make sure it's it's, it's, you know, roughly equal, right, that both, if it benefits a couple of the partnership, are both able to have those other outlets outside of the house. But I think thinking about this will make me a better you, will you you will like me better, I will be a better partner, I can cultivate some other part of my life, right? Of course, within balance within reason. I mean, there's certainly the opposite problem or challenge that some couples have, right, where one one partner is, is too much having a life outside. And of course, it's a whole other set a whole other conversation. Kira Yakubov:: [36:28] I love that. So it's indirectly right. In the long term, this will indirectly benefit you to Yes, both partners. I love that. That's awesome. But it's good it is it's thinking about long term, right. And it's not just in the now. But like you're saying that it's tough when you have priorities and young children who need you in this moment. And I think that's important too, for helping us not get lost in that one identity. Right? It sounds like having that separate relationship. And having those other friendships outside the home is yes, I might be a father, a provider, a partner, all these things. And prior to all of this, I'm still this other person and have these other interests and have these other friends and can relate to them in such a different way than my partner or kids. So I think that's important too, is helping not lose that other identity, or that other part of you through the process of you know, the lifespan and growing through a family. That sounds really important. I wanted to talk a little bit more about men or individuals who identify as male expressing emotions, because I know you mentioned earlier kind of looking at the relationship that they might have with their father, and whether that is a role or that male script that they also want to take on and embody or not. And if you grew up in a not you specifically, but if someone grew up in a home where their father may not have been very verbal about their emotions, or if they didn't even feel like their father had emotions outside of let's say, anger, right? Or just either between happy or anger, right? I think that I see that a lot. In I don't want to generalize, but a lot in men or older generations, it's either anger or they're happy. And then everything in between is a blur. And so I'm curious of how do you help men work through their emotions, when that was never modeled for them growing up? Or if it was modeled? Not in the most healthy way? David Koppisch:: [38:29] Yeah, that's, that's a great question. I think there's a very simple tool that I often start with, which is the feelings wheel. So maybe some of the listeners are familiar with that. And if they're not, right, it's become a sort of a popular tool. And I, it certainly can help in sessions, right breaking out. And if folks are not familiar with that we can, we can maybe share a link or something to that. But there's there's different versions of the feelings we have, which basically are a chart that give starting with some of those basic emotions, four or five basic, you know, happiness, sadness, anger, but then giving sub variations of all of those and sub sub variations and so you basically have a kaleidoscope of very nuanced identified feelings and showing that visual to a client to say, Okay, it's sounds like I'm hearing, I'm hearing anger pretty loud and clear. That's, that's, that's, that's, you know, that's, that's some I hear that I get that. Let's see if there's something else underneath that. So not to kind of deny the mad or, or say, you know, no, you're not feeling anger, you're feeling these other things, but you say, okay, in addition to that, let's see if this other feelings underneath that and and shouldn't do that. And so showing them that feelings wheel and at first sometimes people are little, it feels a little, I don't know, simplistic or a little, I don't know, juvenile or something. But mostly over time, they're like, Okay, yeah, I haven't never thought of some of those words on this chart to describe what I'm feeling. I never, it never occurred to me to go a little deeper or think a little bit more specifically about this thing that I'm calling anger. And so, you know, so that chart is can be very helpful as a starting point. And then you and then after they can take some time, you know, maybe it gets to, I don't know, maybe the feeling the point was jealousy, or envy or something underneath the anger and say, Okay, well, let's talk about that. You know, let's tell me about what is that like, for you? What does that feel like? So another sort of strategy is kind of connecting. And I think this is, I don't know, if this is maybe harder for men, I'm not sure. But I it's sometimes is feels a little challenging for men to locate that feeling in their body to say, Okay, where are you feeling that? And at first, again, that sometimes feels a little awkward for for, for men, clients that I'm that I've experienced? You know, it's a little awkward to say, Well, where are you feeling that in your body? You know, it feels it's not how we often talk about we were many, most of us were raised to talk, but again, with some with some practice, right? I've seen, you know, they can begin to say, oh, yeah, I, you know, I'm feeling that in my chest, you know, when I see a co worker, appearing, like, they're getting some kind of a promotion that I feel like I should get, and I'm not getting or that I deserve something like that. I say I'm angry. But now I'm realizing it's more about, you know, jealousy, or now I realize it's more about loss, you know, because that was a goal I had, and I'm not getting that position. So it's really about a feeling of loss, for example. Okay, well, where does that Where are you feeling that? Right? Where are you carrying? That? It's often it's, you know, tightness in the chest, or tightness and shoulders. And so then you can, you know, again, begin to say, Okay, well, let's, let's focus on that. So, you know, slow, you know, gentle step by step, not sort of pushing, you know, pushing too fast around, kind of identifying the emotions. For some it might be it feels might feel a little much too much at first. So, you know, slowly inviting them, showing them that visual, having them identify that kind of thing. And then if it is a couple, right, if that's sort of maybe one of the challenges in that relationship is that there's, maybe he is being told that he is not kind of expressive enough and not sharing enough that it's sort of like, okay, now that we have a little better sense of what you are feeling a little bit more nuanced and more specific sense of what is going on inside of you, when your partner says X or does y. Now we can let's practice. How do we talk about that? Right? How can we say that? And how can we identify, and this is a, you know, a big part of, I guess, Emotionally Focused Therapy, you know, so how can we talk to our partners from a position of, well, this is how I'm feeling. versus, you know, well, this is what you did to me, right? Or you, this is what you are? Right, it's, well, this is how I felt, when I heard you say, that, that kind of thing. So hope that answers your, your question there. Kira Yakubov:: [44:10] Absolutely. No, that was a really great breakdown. I mean, it sounds like really taking the time to fill the foundation of emotions, naming them being able to recognize them, then being able to express them in in an effective way, which I wish we were all taught. Right away. I know, we're talking about men specifically. But I think on a grand scheme, I wish we were all taught this because I didn't learn this growing up. I mean, I learned it however, the culture and my family discussed emotions, which we didn't write. So it was I think that this should be a class in like elementary school, right? Like, what are your emotions? How do you acknowledge them? How do you talk about them? I wish I hope that that is something that will soon be implemented in our school system, because I think that's going to be really valuable for people growing up, just having that knowledge that That's such a great Daniela Galdi:: [45:00] perspective, I really hope that we add that into to the curriculums happening, because, you know, we have health class, we have gym, and it makes me think about what David mentioned, like the physiological aspect of like, where are you feeling it to brings in a whole other realm of identification for, for those emotions? And, gosh, I just keep thinking, to your point here, like, how effective could it be to be taught this as children? How to navigate these, how to identify them? In our thoughts, how to identify them in our bodies, and all of that. So I'm really glad that came up. And I mentioned the physiological two, because in episode nine, actually, David, it's interesting, because we talked a lot about like nonverbal communication and things like that. And it parallels so well. So I love that you brought those elements into it as well, that being a strategy that you that you can hone in on as well, for your clients and the couples, David Koppisch:: [46:03] I find that with some of them, and I'm currently working with two, there's a tendency to sort of operate cognitively primarily, right? operate from the head, right. And, you know, from an, from an analytical perspective, right, so talking about what is going on in their life, or with their partner or with their, their, whatever challenges that are bringing them to therapy, purely from kind of an intellectual stance, right, an analytical stance, and it's helping some of the men to sort of not, you know, not dismiss that, but to add to it, an emotional way of looking at what's happening as well. So, and it's very interesting. So I will ask, sometimes, well, how did that make you feel? Or how are you feeling now? What was the feeling like when that happened, or when they sent this to you? And I and I, many, and again, you know, how we were taught or just how we were brought up? I get not a feeling in response to that question, but a but a thought, right? Or an analysis. And so it's like, okay, I hear that. Let's bring it back to the feeling the emotion and again, it's, it takes practice with a lot of folks, right. And it's the sort of like, ABCs, right, affective, behavioral, cognitive, a lot of clients and a lot of men working with so much in the cognitive, right? Well, let's, let's, let's open up a little bit to these other ways of being right. We're not just cognitive, and we're not just emotional, we're behavioral and cognitive and emotional. So let's, let's shoot, let's see if we can give you some more tools to, to, essentially, more, have a more wide experience of your of your life. Right. That's really essentially what's what you're doing. But it's very interesting, you know, how do you feel and you get a? Well, I thought that okay, well, let's try that again. How did it make you feel? Well, I, you know, again, analytical response. So, practice gentle reminders. That's, that's, you know, that's what it takes. For a lot of folks. Kira Yakubov:: [48:40] It's really funny. I'm just thinking next, I have two older brothers. And I mean, I'm the youngest girl. I'm very emotional. I don't know if you guys as the therapist, right. So I'm a lot more in touch with my feelings. And when I would talk to them about things, it would be like, well, this is this is what it is, this is the logic, this is the rationale. A you might feel this, but it is not going to impact the results. So push it away, have a different time for not in front of me. And let's talk about the logistics of this, where it is what it is, right? I'm just being pragmatic about it. And it's so interesting. I'm curious of it. Do you think it's because there is a a discomfort of feeling the emotion associated with the thought or that's more of a protective mechanism? Or they just haven't practice being in the emotion as much because we all feel it? Right. It's just how it comes out. David Koppisch:: [49:29] Great question. I think my conscious that it's the last two things that you said that it's for some, and I you know, everybody's different. So for some it could be protective. Right? Is it and again, this is I think this cuts across all genders. I think there's some protection in sticking with the intellectual way of responding to things right or intellectualizing things. It's a little maybe little distance provides some protection. And that maybe that's a that's an adaptive, you know, technique that that actually might be needed for that person. So you have to think about that. Right. And it's also I think, for a lot of us, that's what we've learned, like you said, learning to be that sort of logical analytical role as a male, you know, these are again, these are careful not making too broad generalizations along gender lines. But certainly that's, that is something that many men, I think, feel like they sort of learned, grew up with, or was expected of them. And I And again, it goes back to the earlier conversation about Yeah, what was what were the role models in the households, right? What was the How did that shape? There? If again, we're talking about male clients, adult male clients? How did growing up? What were the models in that household from parents and other adults? Around emotional expression? Certainly, that is a factor. Kira Yakubov:: [51:12] And I only say taking it, when you hear them, hear some clients sticking with the logic of it, or like, I feel the thought, or I feel this thing? I think it's funny. I mean, it can be any gender, right? It depends on the couple, it could be either way. But I like to ask them, Are we talking logically? Are we talking emotionally right now? Because a lot of times, we use the same words, and we think we know the meaning, right? But we don't. Someone might be talking through their emotions, and someone is talking through the logic, and the words are making, like, I know the words you're saying, but it's not landing, because we're speaking in a different language. Right? So it's like, okay, like, can we have a moment for just the logistics? And keep some of the emotion out? And then can we have a conversation with just the emotions and like, now, how can we blend these in a way that each person has space to bring up whatever is coming up for them? So I like that you bring it back to that? Because it is it's a different language or an experience altogether? David Koppisch:: [52:09] For sure, there's an expression that one of my mentors has used that I think, and maybe it's a popular expression, but when you hear a client say, I feel that dot, dot dot, you know, you're going to get a thought, not a feeling. So I feel that they are ignoring me. Right? I feel that this person didn't deserve the promotion that I got, right? Well, those are not feelings, right? Those are sort of factual statements of, you know, I feel that. So as therapists, I think when some and we all do it, right. I feel that we can pause and say, Okay, let's take that out. And see how we could finish that sentence. Right. I feel sadness, I feel regret. I feel guilt. You know, that. As opposed to, I feel that that generally gets you to a thought, not a feelings. Daniela Galdi:: [53:08] Yeah, that is very interesting. I'm curious, I'm going to be more mindful of that. I'm curious as to how many times I express my feeling, using that I feel that statement, and really tried to pull back and hone in on just isolating it to I feel, insert emotion. It's usually like five emotions. It's not only just thought. Well, this has been amazing, David, and I love the perspective you're giving I love that we were able to learn more about you and your journey and becoming a therapist, your background, Kiera, you, you brought in so much about the dynamic between families. And both of you just going back and forth on that. It's really amazing. And so I just want to take this moment to ask, do you have anything else David, you'd like to share with the listeners either about your approach and specialties? We can even go even personal with? You know, is there something you want to share with them that they might not know about you? That can be golden? No? David Koppisch:: [54:23] Sure. Well, it's related to what we've been talking about. But another area that I'm very interested in working with folks on men, but all clients, this issue of life transitions. Having experienced several in my own personal life, in terms of family life transitions, and work and career change, changes. And I do feel especially now right and it's been a lot of talk around how the pandemic has really forced so many of us to sort of rethink work rethink our Relationship with work. It's a it's been for many people not not all have had the ability to do this. But it's been for many people a chance to kind of re reinvent and try different different things. So I'm very interested in that sort of particular issue with with folks of a doesn't have to be sort of middle age, it can happen in almost any adult age. But the sort of, I feel like I need to make some kind of a work, change career change in my life, and I'm not sure how to go about that I'm afraid to do that. Or I spent 10 years training for this kind of work and have been in it. And now I realize, oh, my gosh, I hate this, right, what what do I do? You know? So, I see, I see a considerable amount of that. Also, again, going back to the sort of people who have had children of a certain age, and maybe they're older, and again, they sort of help support that family for 2030 years doing a certain kind of work, and now they find themselves, Oh, wow, I, maybe I could do something different now. We're all working longer, it seems like that has since been the trend over the last many decades, right? Maybe, maybe some of our parents or grandparents retired at 60, or 65. And I don't know, too many people are able to do that as much anymore. So I think a lot of us are thinking, you know, boy at 50, and this was sort of my experience, right? I could have a whole other, you know, potentially Right? And, and hopefully, we have a long healthy life, you have a whole other career. Now, when that might not have been thinkable, maybe a generation or two ago. Right? So helping folks think through those transitions, right, allowing people to, to imagine a little bit different, a different way of being. And then even very specific within that is, you know, pretty much my whole career is spent has been spent in the nonprofit world, and mission driven sort of values driven people and organizations. And, you know, I think that worlds is also going through a lot of changes. I think that there's a lot of talk about the sort of the way we maybe treat folks who work for those organizations who are tending to get paid less than maybe in the private sector, but because it's mission driven, that's sort of, you know, the reason why we do that work, I think there's been a lot of sort of rethinking and reckoning almost in that in the whole nonprofit sector that I had a lot of first hand experience with. And there was a lot of people, again, with the pandemic, also questioning like, Well, boy, I have I have these values, I want to live out my values and work. I thought it was through this kind of nonprofit work. And now I realize there are just maybe as many frustrations there as I find in other sectors. And now I'm confused. What what do I do so very interested in that whole sphere as well. Kira Yakubov:: [58:16] This has been the fastest hour, I feel like I could talk for another go into more depth. This has been awesome. David, thank you so much for sharing all this valuable insight. Is there. Is there any and you don't have to Is there anything personal that you'd want to share about yourself that clients might not know, or just something fun that you want to let the listeners know about you? David Koppisch:: [58:37] Sure, well, I grew up the youngest of seven children. So big family, and a lot you learn a lot in a big family. Bring those kinds of experiences, to my work as well. Kira Yakubov:: [58:55] Very cool. Thank you for sharing that. That's I had three in my family. I thought that was too much. But Daniela Galdi:: [59:02] all right. Well, David, thank you so much for speaking with us today. And we are so excited to share this episode and then have you back in the future. So before we sign off, if you can just share with our listeners, how they can contact you or get in touch follow along in any way. Please do. David Koppisch:: [59:20] Sure. And thank you both. Thank you Danielle. Thank you Kara. This has been great. It's been a privilege to share and I really thank you both would welcome anyone who wants to learn a little bit more about whether I could be a good fit for you as a therapist, please reach out info at heal your roots wellness.com is probably the best way to to find me. Kira Yakubov:: [59:44] So if anybody wants to read a little bit more about David's bio can head over to www.healyourrootswellness.com Thank you for being here and thank you for listening and I hope everyone has a great day. ### Listen - [Spotify](https://open.spotify.com/episode/13765892) - [Apple Podcasts](https://podcasts.apple.com/podcast/13765892) - [YouTube](https://youtu.be/lRukZ2JjCMQ) --- ## Communication and Connection - URL: https://healyourrootspodcast.com/episodes/communication-and-connection - Published: 2022-10-26 - Season 1, Episode 9 - Duration: 46:22 - Category: therapy - Guest: Joslyn Justi ### Summary Exploration of somatic healing approaches and the mind-body connection, covering body-based therapies for processing trauma and emotional experiences. ### Description Our bodies hold memories and emotions in ways that traditional talk therapy sometimes cannot reach. This episode explores somatic approaches to healing, including body-based therapies that help process trauma and emotional experiences. Learn about the science behind the mind-body connection and discover how somatic techniques can complement traditional therapeutic approaches. ### Transcript Joslyn Justi: 0:01 What's getting brought up for you that is motivating your unhelpful response to this behavior? Because then you really get some more underlying issues that are these maladaptive ways of communicating when we are expressing, you know, tears or yelling or you know, again, other physical responses. Daniela Galdi: 0:22 Welcome back to heal your roots podcast. I'm your co host, Daniela Galdi, health and wellness professional here in Philadelphia. And we have got a nice conversation coming up with our other co host and guest on connections and communications and ways to approach conversations to get deeper into your knowledge of relationships, and the impacts that are connections things like quality time, and assertive communication, and what that all has to do for you with any relationship in your life. So with me is co host and founder of Heal Your Roots Wellness, Kira Kira Yakubov: 1:08 Hi everybody Kira Yakubov here founder at Heal Your Roots Wellness. On our podcast, every episode, we have a therapist in the mental health field and industry that we like to get to know as a person outside the field and their specialties and knowledge within the field. I'm super excited to have Jocelyn juste licensed marriage and family therapist and a therapist that heal your roots wellness. And so this is going to be a really good juicy one. All the good stuff housing that was shared with communication and connection, different ways to effectively work through relationships. So Joslyn, thank you again. Joslyn Justi: 1:44 Yes, thank you, Kira, so much for having me. I'm excited to be here again. And I'm excited to get into some more detail about that connection that Daniela was speaking of, and excited to be here. Thanks for having me. Kira Yakubov: 1:58 So I wanted to start with communication, right. And different ways that even though we might be communicating the words that we're trying to get across that nonverbal body language is super, super important and imperative to think about and be mindful of when we are trying to communicate with whether it's a partner, friend, family member, really anybody that you value, and you want them to hear what you're saying. So Jonathan, do you have any thoughts or anything that comes up at the top of your head about nonverbal communication and things like that? Joslyn Justi: 2:32 Absolutely. I had recently, I had several couples who one partner would come to me and say, they're not getting what my vibe that I'm putting off that I might need help, or that I'm suffering right now. And I asked, I was like, oh, did you articulate that? You know, did you share that with them? Well, no, I did it. But I want them to tell from like my body language, like my face looks kind of sad. My might, my shoulders might be a little more tense, you know, I'm a little more withdrawn. So I think my partner really should be recognizing that. So I was like, Okay, let's take a step back and look at this for a second. One, yes, we cannot read minds at the end of the day, that's where that assertive communication is very important. But then to, it's very important to bring in a mindfulness and self awareness piece as to when these nonverbal cues are getting put off, because maybe some people aren't comfortable, saying, Hey, I'm in a really bad place. I need some support right now. But I'm showing you through my body language. So that's something that I've noticed lately that I've been trying to teach is that mindfulness of like, what to look for. So for example, again, are they looking down at the ground? Are they not making eye contact? Do they appear more withdrawn? Does their is their personality different in any way? Are they throwing off a fatigue vibe? Or? Again, is there any behavior changes, you can see from a nonverbal perspective that I like to point out, Daniela Galdi: 3:54 I was going to ask you if like an eye contact thing is very key to that, because I can imagine and I put myself in that experience, where I have not, I'm very big on looking people in the eye, but then those times where I won't turn my head, right, or I won't absorb what's happening. What What am I actually like, in that sense? What kind of nonverbal cue would that be? To others not to say do that, right? But just to kind of be aware, if they're doing it themselves, Joslyn Justi: 4:26 I would say if it's different than your quote, unquote, normal behavior, normal interaction, so if you like to make eye contact with people a lot, and then one day, let's say you're feeling down and you're just not looking anybody in the eye whatsoever, that's a significant behavioral change, right? It's a different effect. It's a different you're not looking at anybody. So therefore, something might be wrong. You might be stressed. Maybe you're not yourself that day, because again, even the slight little behavioral changes or body language can indicate something's going on. That's different for us. Kira Yakubov: 5:00 So I, I love that you brought that up even just wanting someone to read our mind or expecting them to. And it's like this is where relationships get a little fuzzy around responsibility or accountability, right is that every conversation and relationship it's a two way street. Right? So there's a little bit that each person needs to do or can do to get a message across. Right? So in relationships, we want to attune to our partner, basically, how you're sharing Josten, like, we want to be able to, like, know them well enough that we can read, the behavior is off or different, and be able to check in with our partner. And it's also the other person's responsibility to express like, hey, there's something coming up for me, or I'm upset, or I'm angry with you and not just expect our partner to guess or poke or prod. Right? So both people are kind of responsible for making sure that communication gets across to each other. Daniela Galdi: 5:57 So just how you said that here, is there a way for our listeners that you were, Jocelyn would suggest saying that? And I will preface it with saying with saying like, is it healthy to say? And I'm rolling my eyes? Because probably not. But I can't read your mind, which I've said before, what's the best way to then like a prompt almost in a sense to start that sentence off to express yourself? Joslyn Justi: 6:24 I use I statements, I always go back to our statements, you know, either it's, I want to know what's going on with you, I'm noticing something different for you. You know, or you can say something like, I'm here if you need support right now. So like the responsibility part that Carol was talking about, you put that responsibility in their hands. And it's their responsibility to express if they if something is the matter, because nonverbal cues can can be helpful, right. But we have to be able to articulate or verbally express what's happening in those moments. So I statements, and refraining from blaming language, when you're asking those questions, I think lowers our defenses and can create a more safe space for us to be open with our partners. Kira Yakubov: 7:10 Absolutely. Right. And I think that if we think we get caught up, which is normal, we're human, right, we get caught up in our own experience, and our own feelings of what's going on. And from our perspective of how we feel. So if we see our partner being cold moving away from us, we obviously notice something is off. But if we're like, why are you being cold? Right? Like how do you think your partner is going to respond to that, even if they are being cold and expecting you to mind read? Right, it's still our responsibility to kind of like, gently approached them, like, you know, I'm starting to feel like we're not really talking today, I'm getting a feeling that maybe you're pulling away and like getting that right, or something else going on. Right? We want to leave like an open ended question for them to have an opportunity to share how they're feeling. And not only sure how they're feeling, but like, feel safe to share how they're feeling. Because if we're coming out and like, why are you being so cold and distant from me today? They're gonna be like, oh, probably, because that's how you talk to me. Right? Like, it's a little aggressive or a little hostile. So it's also kind of considering your partner and leaving an open ended question for them to respond to that they feel welcoming to, like, talk back and give a an explanation of what's going on for them internally. How does this show up for you when you have a couple who has very different communication styles? Or they might have the same one, which I feel like sometimes Mike, what has even more? Joslyn Justi: 8:38 Yeah, really depends. So if I have two people who, let's say, are more passive, right, so maybe they're a little bit more indecisive. They they don't like conflict. So they're the avoiders. They won't talk about something, they'll just kind of continue to go about their day. I like to gently challenge that and bring up hey, we need to talk about this. And I like to use the three C's. Even if people are uncomfortable talking about this, as be clear, be concise, be considerate. And it goes a long way, knowing those three C's. So when you have to avoid and people who again, like we said aren't going to bring up conflict, I will sit them down and ask them to hey, let's make some eye contact. I want you to take each other's hands, look at each other in the eye. And I want you to gently express what's going on and what you're upset about. And we're not gonna respond right away, but we're gonna give someone the space to process it so that way, it's reinforced to the speaker that hey, even though I'm very uncomfortable sharing this right now, my partner's giving me good feedback in a safe space, like you were talking about earlier here. So that's where I try to like normalize it and get people to work through the uncomfortable. Kira Yakubov: 9:55 I think it's underestimated how tough it can be for people to share how they feel All, because of wanting to avoid conflict or wanting like perceiving that sharing a feeling that might be, like different than their partner's opinion or how they usually talk, or even just like their usual interaction, sometimes change or anything different, that's not a positive interaction can feel so uncomfortable. And I also think I love that you say like to normalize it. Because anytime we're in a relationship, we're going to have different opinions, we're going to have a different experience. And if we can't express that, then we're not being authentic. And we're probably going to end up pretending and people pleasing a lot. Right, which is his own home, we can go into that topic and like that episode for days and days, and I personally have like, really, really worked on overcoming people pleasing habits and like tendencies and wanting to avoid conflict, because it just feels more comfortable to not do the thing. But like you're saying, it's so important and imperative in any relationship to be able to discuss that. And being able to push ourselves and have like, grow tolerance for discomfort, Daniela Galdi: 11:11 it's definitely a practiced way to communicate is what it sounds like. And also what I heard earlier, and we were talking about the nonverbal situations, you mentioned, Jocelyn about, you know, hold each other's hands. And I wanted you to explain that I caught that. And I thought, oh, that, Oh, that was something in there, that was a little bit more body language. So explain that reasoning. Joslyn Justi: 11:39 The thing about it, right, when when we're holding each other's hands, right, this physical touch, the brain is making these connections. And, you know, typically, whenever we have physical touch paired with verbal communication, and it's a positive place, we're just reinforcing these connections in our brain, that it's a good space, that, hey, I have a safe feeling with my partner, we're holding each other's hands, we're making that connection with each other, while expressing our concerns. So it like counterbalances this discomfort, and then this need to express yourself. So again, therefore, we're more connected and the brain why I just want to continuously, positively reinforce and make new positive connections in the brain, especially when it comes to conflict with couples, that it's okay to do this. And you just feel closer to your partner with that physical touch. So that's where I was kind of going with that. Kira Yakubov: 12:34 I mean, you know what that makes me think of. So for Gottman, the bids for a connection and bids for affection. And so dominant is a researcher, like a couples researcher. And he has a lot of studies and experiments with couples when they're arguing. And he has done so many that he is able to tell within I think it's the first two to three minutes of an argument if it's gonna go well or not. And he can predict if they're going to stay together or get divorced. It's really wild. And so he's able to see this because within the first few minutes of bringing up like a heavy topic or a conflict is how are you approaching each other because the onset is so important. And Josten that you're saying is like having that body language that's showing affection, it just reduces our defensiveness. And it reduces our feelings of being attacked, or feeling shameful or feeling like we want to, like crawl inside ourselves and avoid it or start arguing, right? I think it kind of takes away those fight flight or freeze kind of attributes within our nervous system. Right? Because if we feel like we're being attacked, if we feel embarrassed, if we feel shameful, immediately, all those defenses go up. And we're not actually hearing anything that our partners saying, and having that physical touch to be like, You know what, like, I know, this is a tough conversation. I don't want to do this either. But we should. But I still love you. And I'm still here. And we're going to be able to work through this. It's like, Thank you, okay, like, yeah, this does suck, but we can get through this because we're figuring out together and not against each other. Joslyn Justi: 14:15 I think too, it's you want to genuinely work on that relationship, right? You have this willingness to change and you can take accountability. And those are the things that I think are so helpful in couples therapy, especially because if you don't check those boxes, sometimes, you know couples therapy might not even be appropriate in that time. Because like Kira said, right? You have to make that safe space for your partner and be comfortable doing that work, essentially. Daniela Galdi: 14:43 So hey, there's gonna be a little bit in left field. But when it comes to what you're both talking about, what happens when like emotions come into play. For example, I am a crier, so I can try I, I try to get out, you know, express myself communicate and in the way that you're both saying as as healthy, that I know as healthfully as possible that I know, but I cry. And so what happens when that type of situation happens? I felt in the past that can throw people off. But really, it's just like I released very easily through my tear ducts. And so what how does that come into play when like, an emotion like that, or a physical emotion comes out in that sense, that's almost, I feel automatic for me. Joslyn Justi: 15:41 I don't think that is necessarily a you thing. If I was in a session, and someone started, started tearing up and started crying, and their partner got something activated in them, they got uncomfortable with it, and you were no longer able to communicate about what you were communicating, I would ask that partner like, what is it about this response? What's getting brought up for you, that is motivating your unhelpful response to this behavior? Because then you really get some more underlying issues, these maladaptive ways of communicating when we are expressing, you know, tears or yelling, or you know, again, other physical responses. Kira Yakubov: 16:20 Joslyn, I love how you always take the kind of like, the behavioral approach and like the brain underneath in the moment, I think that totally agree with that being able to kind of check in with the partners see, like, what about these tears are this physical expression of the emotion is uncomfortable, but also want to normalize that, like, it's okay to cry, and it is a natural release of what your emotions are. And I think sometimes tears can It depends how we view or use something, right? Like if it's a natural response, and our partner just kind of like stops and doesn't know what to do with that. And if we start to learn over time, hey, if I cry, I can get this conversation to stop. That is that can be manipulative, right. That's why intention is always so important around behaviors. Because we're kind of using that as a weapon against them. But I cry very easily to right, like my partner knows that and we work through, we don't have to necessarily, like stop the entire conversation and be done. Because they shared something that might have been hurtful for me or might have been hard for me to like swallow hearing, we just need to pause, like take a pause, for a moment, self soothe, and then be able to express what just came up for you to your partner, and still have the space to hear what they brought up. Right? Because sometimes it's tough, because then the focus turns to the person crying, what they're experiencing, being compassionate, right is important to slow down. But it's really important to return back to the initial conversation that we had, so that the other person feels like it's safe to share whatever it is that they need to talk about. Because that could start to make them feel like why can't share tough things because a my partner starts to cry, which is okay, but then I feel bad and making them feel bad. And the conversation doesn't end up going anywhere. Right? So it's kind of making sure you there's space for both people's feelings and emotions. And it's tough in couples therapy, right? Because we have to slow down. And we have to go back and forth. It's a little bit of like this ping pong, of making sure that each person feels heard and like validated in those feelings. So I don't know if that answered your question. I was very wordy response. Daniela Galdi: 18:36 It absolutely did. And I want to recap because you both have so many great points just in these last few minutes just about being intentional, practicing, taking the pause. I love Joslyn earlier earlier you said your three C's. Be clear, be concise, be considerate, and just paying attention to how body language and nonverbal situations are happening and also how you know something like touch can be really effective. Joslyn Justi: 19:07 I just wanted to add in on like go what you said really quick, a good helpful tip is having like a five minute check in. So if you do notice something with the nonverbal or notice something off, have you and your partner just do this five, five to 10 minute check in nothing too elaborate, but it just gives you a nice space to just check in, Hey, are you cool, like what's going on? And if so let's address it real quick and then kind of move on our days that can be super helpful for couples, especially in relationships, Kira Yakubov: 19:40 you know, especially for couples therapy, there's a lot of stigma is that there's something like something has to be wrong. We have to be like in a bad cycle that all we're going to talk about in therapy is the conflict. You know, obviously that is part of it. But I think the other huge part is the goal that sometimes people miss is that this is also that you feel more connected and safe and present with your partner. So it's not always focusing on the conflict resolution, which is important. But it's also focusing on like, how do I feel more closer to my partner? How do I recognize when I am feeling connected? How do I recognize when my partner feels connected? How does that feel? How does that impact my mental health my day to day? So I would love to dive into feeling more connected and being able to kind of differentiate all those different parts together. How do you feel Joslyn? Are you ready for that? Joslyn Justi: 20:32 Oh, yeah, I think there's a lot of I mean, shoot connection means 50 million things in my mind, right. And I think it can mean so many different things to each individual. That's part of that couple systems. So yeah, I'm ready to get into it. Kira Yakubov: 20:52 So how would you how would you define connection? I know there just have a 15 million different ways to like, what would be a couple different things that kind of come up for you thinking about feeling connected? Joslyn Justi: 21:03 Yeah, you know what, I really gave this some thought, because I really I don't, I didn't really think about what connection actually meant to me, right? I'm so used to working with people and doing that, and not really kind of taking a step back to think about it for myself. So what I came up with was, okay, how do I feel connected to my partner? Connection to me is being on a similar page and having this mutual respect and caring for each other's mental and physical and emotional well being. Again, being on a similar page, you want to be on the same page to be connected, but for me, it's being on a similar page. And it's almost this non verbal feeling, you get that, hey, I enjoy your company, I enjoy just sitting here with you. We don't even have to talk. I'm connected to you through that way. And just having a mutual positive feeling towards that person. I think that's where I kind of came up with that connection feeling for me. Kira Yakubov: 22:04 So I actually love that I thought about connection too. Because when I ask couples this, okay, well, how do you know when you're feeling connected to your partner, right? Everyone has a different answer. And so so that way we can give examples to our listeners. For myself, when I feel connected to my partner, it's when we're being silly, right? Like when there's like this positive light, kind of energy in the room between us. And we're on the same page. And we're like, kind of flirty, right? But there's also this like, lack of tension, like an absence of something unresolved, right? Because even if he might be in a good mood, if there's something that either of us might be harboring or holding on to, or that we haven't fully discussed, it kind of feels like there's a block, right? So even though I'm trying to feel connected, I kind of feel disconnected from him. So when we're able to kind of resolve something and then get on the other side, that feeling, sometimes it's hard to put into words, but it's like you said, we're on a similar page. And we're doing things as a team, right? So also having like routines and rituals, I love love having a ritual. So I know that sometimes we think that routines mean, like we're stuck, we're in a rut, it's the same crap over and over again, right. And like, sometimes that can happen. But that's what I like to call them a ritual. So it's like, every day, I know and can rely on the fact that we're going to wake up in the morning, we're going to make coffee, or we're going to take our dog for a walk. And we're going to talk about everything, whether that's life, what we have going on that day, looking forward to future plans, talking about whatever stressful thing we just got over. Right. So it's like having built in time that we've prioritized for each other makes me feel connected. And like I love having that ritual piece to it as well. And sometimes couples, they'll have a consistent ritual. And if it's not intentionally built in somehow into your schedule, then it's so easy for it to just be missed. And there goes the connection walked out the door. Daniela Galdi: 24:07 That's a great perspective. I really love that you added that in about ritual. Because I'm thinking, you know, maybe that's why, like you mentioned your walk in the morning with the dog or a dinner time, right time together for dinner. And, or, you know, like pillow talk right? Adding in that value is such a great point. And I love that you brought up the ritual because as you were both talking, I was thinking and asking myself again, you know what is connection and it aligns really a lot with what you were both saying but finding that like place of peace with each other. And I feel like to piggyback off of what you said Kira when you have that ritual in place and you're both in agreement with it and then on the same similar page of it right, Joslyn like you mentioned, that is where it can be a great spot to start from Finding those places of peace. Joslyn Justi: 25:02 Absolutely. And it feels so easy at that point. You know, it's like Kira said, you can be just silly, you can let that guard down and being goofy and just like, actually like being best friends, basically, you know, we kind of forget that sometimes we add in that friendship component into the romantic one. And that goes such a long way. So I love that I love that connection piece, especially bring humor into your relationships, it can, it can go such a long way. Kira Yakubov: 25:29 Think about like when you're friends with I mean, I know we're all girls here. So like, your closest girlfriends, like there's something about that relationship that is so hard to have matched. But I think underneath it is being super silly with one another, being vulnerable and feeling safe to be vulnerable, having each other's back and knowing that like, regardless of what's going on, this person has my best interest in mind. And feeling open to like feedback and telling each other stuff and whether it is like being able to call each other out on stuff, but you're okay with it. Because you know, this person loves you. And it's not because they want you to feel bad ever. It's like alright, if they're telling me this, then it means, you know, it probably means something serious, I should probably listen to it. Right, but having those similar interests and like being friends, just thinking of each other, right? Like, how do you make your partner feel special and cared for loved on a daily basis? Right? Like, are you thinking about how do I make them feel loved and special every day? And not every single day is going to work? Right? Because obviously we have our own individual things, our work, whether we have kids or their family members, but making sure that that's a thought that goes through our head at least once each day regularly. What do you think Jocelyn has, like, come up for you, too? Joslyn Justi: 26:49 Oh, yeah, cuz I think that's where rituals come into play. Like, for us, no matter what happens. I'm going I am going to get like a hug and a kiss goodbye, right? Like, Hey, have a good day, I love you. And it doesn't matter if we have had the worst fight. It doesn't matter if like, I'm pissed that he left all the lights on. Like, that is our go to like, and so if that were to get disrupted, then we would both be like, oh, man, something is really wrong. But again, I think it's so it doesn't matter what your ritual is, as long as you have something that you can pretty much put into practice that's practical and realistic for your situation, right? I can't emphasize enough what is realistic for your situation. It can create that connection, and it can make you feel loved. And it can make you feel that okay, hey, this person, they do love me, and I do love them. So let's make this ritual consistent. That way we can continuously feel that connection, even when you have your off days, right? Like your said, we're all human, we all have crappy days, that's fine, right? That doesn't matter. But it's your partner that matters, right? You want to put that energy into them. So I think that's where those rituals can just be extremely helpful. Kira Yakubov: 28:04 Awesome. I love that you mentioned having a be realistic, right? Because sometimes we can have very lofty goals for ourselves or relationship like even saying, because I know it's like very common, like, have a date night, have a date night every week. And like, that is not always possible, especially if people have young kids or they're working like our schedules are crazy. adulting is tough. Having a date night every week. While that is a wonderful goal to work towards, it's probably not realistic, right? Like super small, that are everyday things that you can do like greeting and saying goodbye to your partner every day is huge, and physical touch, even if your love language is not physical touch. I do think it's really important that at some point each day, you're showing your partner some kind of physical affection. Because releasing that oxytocin and having Josas how you were saying earlier, like conditioning your brain to know that like, at the beginning of the day, at the end of the night, me and my partner touch, I feel this loving emotion. Even if we didn't get to talk all day, even if we got into a fight. It's like the overarching theme is that we're a team and this is just one drop in the bucket have a bad day. And it doesn't have to mean anything negative about the rest of the relationship. So I like to use this one example of an emotional piggy bank. So I don't know if listeners have heard for emotional piggy bank. So it's thinking about making deposits. Like if you go to the bank, you know, you get paid every week or every other week you make those deposits in and then let's say you get hit with a fee. That feels like oh, it's not great, right? Nobody wants to pay the fee, but because there is a lump sum of deposits in there. It doesn't really take that big of a hit. The account can withstand this fee, kind of like in relationships right if you're constantly depositing these small acts of affection and love over and over When you have a really big fight or when either of you hurt each other, it takes a hit. But the relationship can withstand it because there's been more loving deposits than withdrawals in the relationship. Daniela Galdi: 30:12 That's a great visual. I love that. That's amazing. Joslyn Justi: 30:16 So I had this, I had a couple do this in a session where I was like, Okay, I would like you to sit across from each other, hold each other's hands, and I want you to make eye contact, and I set the goal for five minutes, five minutes might not seem like a lot. However, when you are sitting there holding someone's hand and staring them in the eye, it can seem like an eternity. However, if you can, depending on your threshold, or your tolerance for this, if you can get past that first minute, it was amazing what information came out for this couple, you could tell that they were so connected with each other, because their hands were initially a little tighter. But then I could see them loosening their grip. So to me that that made me think, okay, they're getting more relaxed with each other. And when one partner was like, I don't know what to say. And they tried to kind of pull me into it. They're like, Well, what do you think about this? The other partner is like, No, hey, come back to me like this. We're supposed to be here, right now. I didn't say a word. And it was amazing. Because as soon as this person pulled their partner back in, the conversation was just so positive and helpful. And they were like, I haven't felt this connected, or even looked into your eyes like this in years. And it was just so overwhelming and so powerful that I just can't emphasize emphasize, taking five minutes and doing this maybe once a week, or just practicing to hold each other's hands to look at each other in the eye, because it's so intimate at the end of the day, right? We're in close proximity we're looking at, we're peering into each other's souls, essentially, you know, and again, it might feel a little uncomfortable, but I promise it's not a bad uncomfortable, you can work through it, I've seen it work, get past the first 60 seconds, it's usually pretty good. So that was something that I had find, I had found to be extremely profound. Sorry for Bing. But it was extremely profound. Right now from that story. That's going to make everybody hold my hand now. It was incredible to watch it was and I, I told them, I was like, I appreciated them letting me be part of that moment, right. Like, it took a lot of guts and a lot of vulnerability for them to even do that exercise in front of me. And to me, I was like, You guys are comfortable with me, you're letting me in. And that vulnerability piece is one of the biggest strengths in my opinion as a human being. Because it's tough to get there, right, depending on our past, depending on, you know what vulnerability means to us. But once we get there, it's I just, I don't really have the words to describe how awesome it was to be part of something like that, you know, and I hope people can, you know, get comfortable with that and really practice it because it will help strengthen your intimacy, right, your ability to just share and be present with each other. Kira Yakubov: 33:19 It's that tolerance to be vulnerable, and sit through discomfort, right, like just doing that practice alone. And thinking about like just being in silence to how awkward people feel just sitting in silence with one another. And don't they have to fill the space or there's this expectation of them to say something or that sometimes I find that couples feel like, they always have to be having fun, or they always have to be connecting and doing something. And it's normal and natural for the relationship. I don't know, like when viewers see the video, but to go like this to be connected, and then disconnect and come back and write like when we come back into connect again, I think that those moments how you're sharing are so significant and powerful for the relationship long term, to feel like we can withstand something like if we can sit in silence for five minutes and just stare into each other's eyes and our souls and like, hold our hands and feel our heartbeat and our pulse through our hand. Like we can get through so much crap together. Right? Like I can literally turn and look to you and be like, okay, like you got me like I got this right like, and that's where that nonverbal construct to come in is when we're attuning to our partner and we're both on the same page. So I love that you do that exercise. That's Daniela Galdi: 34:35 phenomenal. It really is. It's making me think to what you just mentioned about sitting with each other. Recently I walked in with my parents. I feel like that's a start to like a bad story, but they were just sitting on the couch but recently, I walked in and married for several decades, and they were both just sitting in the living room with notes. TV, I think might have had their phones in their hands. But they were just sitting there. And immediately I said, Are you to win a fight? What's wrong? Because they just didn't have anything like stimulating happening around them. They were just sitting in the middle of the day together. And they both looked at me and laughed, like, why would why would you think we're fighting? We're just sitting together, right? And it was like, an amazing moments moment to witness. And that made me self reflect like, wait a second, why did I go there with that. But it brings me to the question for both of you of how to tell the difference between feeling connected and disconnected. Joslyn Justi: 35:38 I love that you brought that up, because I love that your parents can just chill there and not really have any external stimulation to be comfortable. So that's something me and my partner do is so we can just, it's awesome to just sit like, we don't have to get into deep conversations. 24/7 a lot of I mean, he, he's a more of the extrovert, and he's more of an introvert. But I think it's a huge strength for couples to be able to just sit with each other. For example, if you're at the kitchen table, if you're just having coffee, if you're just sitting in the house, and you know, doing nothing, essentially, to me that screams, I'm totally comfortable with you, and you're comfortable with me and we can just do our own thing, you know, and not have to be so stimulated. I think it's a huge strength. Kira Yakubov: 36:26 I agree. And I think about when it's almost like when we see I love to people watch, I don't know about the two of you. But like if I'm out at a restaurant, right, and if I see a couple and they're kind of just like just chillin, and they're not really talking, I feel like the younger version of me would have felt like, they must like hate each other. Or like they're in such a horrible relationship, I would never want that. But then like now, as I'm getting older, and I've been in this long term relationship, I can No, it means you're giving each other a break. Like they're allowed to just kind of chill with each other, and enjoy the company and not feel obligated or like forced to fill up the space. But I think it's the intention, right? Like, if both people are comfortable with that, and they know, it's like, we're with each other all the time, or we're just hanging out, I just like being with you. That's great, right? And then there's some times where it might be one person is just like disconnected, like they're floating in a different place in their mind, and the other partner doesn't want to be connected, and they don't know how to reach them. So I think it's really, it depends on the intention, and like how each of the partners within the relationship feel about that kind of time and space. And so I think that kind of reminds me of when you asked that question in your When do you feel connected versus disconnected? It's kind of going back to the Gottman bids for affection. And so bids for affection is basically when you or your partner, right, we make this attempt to feel close to our partner. And that can walk in so many different ways that can be like, Hey, did you see the news today? Or did you hear whatever, right? We're like, Hey, look at this funny meme on my phone. And it might seem super silly, but like that is a reach for you to be involved in this moment with me. And it could be super dumb or like insignificant, but it's the fact that your partner is reaching out for you to connect. And so the way we respond to that is super important, right? So there's turning towards turning away, and then just not even responding. So sometimes you might just not even respond. And that's just like nothing like hey, did you see this? And there's silence and you get nothing? Like, that's really hurtful, right? Like that's kind of like it can feel neglectful, right? And it can remind us maybe when we were younger, like, I couldn't get attention from the people I cared about, you know, like, Screw this, I'm just gonna go do my own thing. What's the point? And if we turn away from our partner, it's like, I'm doing something. Can you see him doing the dishes? Like, why are you coming over here with that dumb stuff about some meme, right? Like that can feel really hurtful to and or feels disconnected like, alright, not gonna ask you or anything today. And then when we can turn towards them. Right? And that can look in two different ways. It can be like, Hey, babe, you know, I want to look at this funny thing. But can you hold on for a second? Because I'm in the middle of something like, okay, or it could be like, show me Let's watch this. Like, let me get into this silly thing with you. Right? Not to like spiral on a tangent like me and my partner. were even going through like, a little bit of a tiff around this when he was trying to get my intention. And I was in the middle of doing something. And I have ADHD like very inattentive, and I'm like, oh, okay, okay. Okay. So I don't forget what I'm doing right now. But that was totally dismissing him, and what he was trying to share. And so what I should have done was pause and say, Hey, hold on a second. Let me finish this thing. I'm done. I'm all yours. What did you want to tell me? So I think the way we react and respond to each other, we can either feel really disconnected, or we can feel super connected by just knowing that the response to each other is going to feel so different. So if that answered your question, I know what I went very wordy with that one. Joslyn Justi: 40:07 No, I like that, because going along with that is making sure that we don't accidentally negatively reinforced anybody when they are making an attempt to come to us, right? Because if we do we put we can sometimes put people in what's called a double bind, right? So essentially, for listeners, that's damned if you do damned if you don't. If I want physical touch, and you try to give me physical touch, but I push you away, like, well, like, here's, why should I try to do this again. So I think that can be sometimes again, being mindful, being self aware can can help with that connection. Daniela Galdi: 40:41 What is an example of positive versus negative reinforcement? For anybody listening, I just want to make sure that it's clear. Joslyn Justi: 40:48 I would say a positive reinforcement would be like here, I said, Hey, not right now, but maybe in five minutes, so that way, you're not invalidating anyone, or having them feel dismissed or disregarded for for their need. Negative reinforcement could be like an example caregiver, I think is like, what do you want right now? I'm busy. Can't you see I'm busy? Right? And it's like, whoa, I'm just trying to share something with you, you know, like, why are you giving me this response. So I think anything that's met with like, a tone, that's feeling dismissive, or invalidating is the negative reinforcement part. Kira Yakubov: 41:25 Thinking about the positive and negative reinforcement, I'm thinking back to when we even learned about this in school, right. And a lot of this is like done every single day, or even with children, while we're growing up is we do positive reinforcement with the intention of increasing a behavior to keep going. And we do negative reinforcement when we want to decrease a behavior from continuing, right. So if you want your partner to keep approaching you, and sharing things about their day, or sharing how they feel, you have to really be mindful of your response to them. So if you're responding in a kind way, or an open way, or patient way, they're gonna be like, Okay, this is safe, they want me to keep doing this, they're gonna continue approaching you. If when they approach you, and you give a nasty remark, or you push them away, or you get annoyed or frustrated, every time, they're going to learn, I shouldn't continue doing this behavior. And we conditioned people in our life like that all the time, without even recognizing it a lot of the time. Because that sometimes it could be subconscious. But it's really like your tone, your body language, your eye, like your eye contact. And the message you're sending, like, is the message you're sending, hey, keep coming and do this, or you're annoying me. So if you if you make the other person feel like they're annoying you, they're more likely not going to keep approaching you. Because why would they? But if the way the message that gets across is this is I love when you come towards me even when I'm busy. And I'll let you know I'm busy. But I like when you do this, they're going to want to keep coming towards you. So I think having that intention, energy expressed between words is important. So that you recognize like, if your partner stopped, oh, we might get into another one of have sex or like if your partner has stopped initiating. And that was kind of what they used to always do. It's maybe thinking about how am I responded to their initiation? If I shut it down every single time and the way I shut it down, makes them feel rejected? They're gonna stop initiating. So I can't necessarily be surprised when that happens. Right? Or if and this is obviously like, talking about sex is you're not always going to want to and it's obviously okay to say no, it has to be consensual, right? But it's just the way that we respond is so important to how behaviors are going to continue or stop continuing. Joslyn Justi: 43:50 You just want to create that positive feedback loop. Because a lot of times cut, that's where couples get stuck is this negative feedback loop because they're just feeding the negativity, or they're feeding these unwanted or unhelpful behaviors, I think, especially during times of conflict or disagreements. So it's like curious if you can build up this tolerance and work through that discomfort and create this new positive feedback loop. That's ultimately the goal. Right? Again, it's not going to be perfect all the time. But what I say is, you know, setbacks are normal, they're going to happen, it's just what you do with those setbacks in those moments, to kind of get back to the positive feedback loop. Kira Yakubov: 44:31 And so what would you say? So I know that we're kind of going on positive and negative reinforcement. What would some quality time look like? Like, is there anything you've suggested for couples for quality time, let's say when they are being intentional, when they do want to be realistic and say, this is the time we're putting each day week month for a relationship. Joslyn Justi: 44:52 And I want just to define quality time, there's uninterrupted quality time, and then there's, you know, just Time spent doing everyday things in the house, right? Like, technically, you're still together if you're, if someone's doing the dishes and somebody is, you know, running the vacuum or something in a different room, yes, you are together, and you might be chillin and watching TV later, yes, you're together. But I'm talking about this uninterrupted quality time, where you are making that connection, and you are feeling connected with each other. So for example, the uninterrupted quality time to me is we're going to sit down and we're going to have a dinner, and we're going to have some conversation around one to three things, you know, it's just us we don't have where the phones are put away. We're not answering emails, there's no external stimulation that could be distracting. It's just me and my partner. So that's, that's very important, again, a big differentiation between just you know, your normal day to day stuff, and again, uninterrupted quality time, that builds connection between the two people. Daniela Galdi: 46:00 I have a question there. How might you respond if a an individual who is a part of a partnership isn't receptive to that? Right, how how has that ever come into play? Where some one of the partners is trying? And then the other person, like, they don't want to? Like, does that happen is that is they're coming back from that? Joslyn Justi: 46:30 I think it depends, really, but I mean, if someone isn't, they don't want to spend quality time with you. I'm not sure how strong that relationship is, at the end of the day, you know, because you want to feel connected. And you might want to step outside, again, your comfort zone to have this uninterrupted quality time with each other. And if you don't, I would just ask, okay, well, what does that say about the relationship? What what does that say about you? What does it say about them? That could be a good opportunity to dive a little deeper if this there's something you know, really going on. But I would ask that person, you know, does this person deserve that they? are they behaving in a certain type of way? That is? Has this disconnect with the quality time? You don't care? What are you? What do you think like? Kira Yakubov: 47:20 Yeah, I think that's a great question. And I do see that come up in couples therapy, or just like, relationships around me, right, is that there's this level of commitment, right? And commitment looks different in every relationship. And I think it's really important in the beginning, when people are dating, is one being self aware about how much connection and quality time do I need in a relationship to feel loved? And how much does my partner need. And if that looks wildly different than in the long term, it may just not work out, it may just be a misalignment, right? Like if one partner is super independent, they love to travel all the time, they like to meet other people, they don't like to be in one spot. They like to have time on their own, which is okay. And they meet somebody who wants to spend a lot of physical time together and quality time together. Over time, that's going to be a conflict, right? If they can't find a compromise in the middle of how they can respect each other's autonomy, but also respected, prioritize the relationship. It's not it may not work out. Right. And so this is a great question, because I'm even thinking about personally, right? Like, my partner has ADHD hyperactive, right. So he needs a lot of external stimulus to focus on one thing at a time, right. And I love to have a lot of attention, undivided attention on me within a relationship. And so when we first started dating, he would have the TV playing, he would have music playing, he would be looking at stuff on his phone, and I would be talking to him and we wouldn't be making eye contact. And I would just feel like, Hello, are you here? He's like, Yeah, I can hear you. I can multitask. And I can't multitask. By hearing sound on the background. I'm like a squirrel, like what? And I lose my train of thought. It took us a while to talk through and like, work that out that it's not because he's not listening. It's that he needs external stimulus to focus on something. And it makes an he understood that it makes me feel unheard if we don't have eye contact, if we don't have uninterrupted time together. And so we figured out a ritual, we're gonna go on a walk every morning, where he is stimulated by walking, looking at the surroundings and we can still talk to each other and we can still meet that need for each of us. So it depends on the willingness to kind of work through that and navigate that versus this is just the misalignment in the relationship like we just need to vacillate different things. Joslyn Justi: 49:57 You also bring up a good point with compatibility. You're right, some people just aren't compatible at the end of the day, and that's okay. But it's it's that self awareness piece. And like you said, like, even looking at the relationship from the very beginning, are, you know, expressing those needs expressing how you receive love, like figuring out like, okay, is this person? Are they going to be able to meet my needs? Are they going to be able? Or am I going to be able to compromise to with them at the end of the day? So again, that can build compatibility peace, can be extremely powerful might not give us the answer we necessarily want. But you have to look at to like, you know, what do i What's my self worth? What do I deserve at the end of the day? So I think that could be a helpful just mindfulness piece right there, too. Kira Yakubov: 50:41 And it's tough because it's basically differentiating between, is this something that we can compromise and navigate through? Or are we asking too much of each other? That is not realistic? And it's just going to cause more tension and conflict at the end of the day? And we can't answer that for couples, only couples can decide that on their own and within the relationship with each other of their level of willingness. And what they're capable of, I think that's important, too, is like, is this partner capable to give me what I need realistically, even if they really want to, are they capable of it, and they may not be, and that it sucks, and it's hurtful, but at the end of the day, I guess it's better to know that ahead of time, and able to amicably step away, like this is a compatibility issue, and go their separate ways and find someone who is more compatible in that way. Daniela Galdi: 51:33 These are really great points you're, you're both making and to sum it up, relationships deserve effort, and work. And it's an important thing I want the listeners to hear. That's where the third party, that's where you all come in the therapists, and IT professionals there to help to work through it to everybody, you know, we're working through it, and it helps to have that third party and, you know, it's okay, I find myself talking with a lot of friends and my own experiences to where, you know, I'll start to compare, and I'll be like, Oh, just, it should be easy. It should be easy. But hearing everything we just spoke about. It can be, but there's a lot of work that needs to go into it in order to find that piece. So I want listeners to hear that and think hopefully, you know, think about hope that that there is hope. But there's also effort that ties in there. And it's it's a journey really is it's it's not a one and done, it's going to continue so that you and your partners can continue to grow. And all the things that you mentioned, I just think are so helpful in in just scratching the surface of identifying that for people. So with that said, Is there anything else either of you want to touch on with connection before we sign off for today, Joslyn Justi: 52:55 you made that comment about it can be easy, but it does take effort. Because you I believe that 100% relationships are awesome, but they do take work at the end of the day. And I think we make a conscious choice to choose every single day, whether we're putting an effort to our partners, whether we love our partners, I think it's a day to day choice. And I think maybe reminding us of that can maybe ease some of the tension or stress that goes into those relationships. And hope I love that you said that like having hope at the end of the day. It's It might sound a little cliche, but I feel like we forget that sometimes in our busy lives is being hopeful. And just the concept of hope, in general, I think can alleviate some tension and, you know, bring us some peace at the end of the day. Kira Yakubov: 53:44 So one thing that I want to add that I have kind of developed with couples, as I've been you know, as a therapist working with couples over the years is having a weekly or bi weekly check it. And so I was able to kind of think about like, what are the most important things that each couple should be discussing on a regular basis and have it become like that routine or ritual is setting aside time or like making that a priority? I think it's when couples like oh, we don't have any time like sure, like people are busy, right? I don't want to invalidate that. And when I've worded like, well, so you haven't prioritized your partnership, then they're like, Ooh, I don't like the way that sounds. Yeah. Because that's what's happening. You're not prioritizing time with your partner. And so the relationship is going to take a hit. And so what I've liked to help couples do is after we kind of build those foundations of communication, it's like Alright, go practice this. And so part of that check in is the first part of it is like, Okay, what's all the good stuff that happened? Like, are we acknowledging and appreciating our partner like this week, I noticed that like you picked up extra chores around the house like that was super helpful, like thank you for thinking of me and making my life a little bit easier. Hear this week, right? Like, share with each other the good stuff that's going on and appreciate one other and acknowledge it. And then the next piece kind of have that check in is like, Alright, is there anything lingering? Have we not discussed something? Have I been feeling a particular way that I haven't had a chance to talk to you about? Or maybe we did. And we need to follow up on that conversation, right, and making sure that feedback is a done in an effective and respectful way. Because how we discuss what our partner to be able to hear what we're saying, and being able to take that feedback and really sit with it for a moment and have a thoughtful response, and being able to come up with a plan together. And then the end of that check in was like, okay, like what's coming up this week? Or next two weeks, right? Like, is there anything super stressful? Do you need extra time here? Do you need extra support? How can we be there for each other looking forward, and let's make sure we schedule the next check in that's on both our calendars to make sure it's a priority. And I think that couples at first kind of like it took some time to like tweak and work this out to make sure it was a good flow. But then once they found a good flow with it, they're like, we love to do this check in, because I wanted them afterwards to pair it with a fun activity. Right? So it's like afterwards, we're gonna go for a walk together, or we're gonna go get brunch, or whatever it is, right? Like, we just prioritize the important stuff, our relationship, and now we're gonna go hang out, like friends and like lovers and enjoy our time. Because I mean, kind of a lot of the point of relationship is like, quality time, and you're spending this with a person, you've chosen to spend your time with somebody else. So it should be fun, right, like a portion of it should be fun and light hearted. So I think, I think for the listeners a huge part is yes, make time for serious conversations. But also, don't forget that it should be fun and easy. The other part of it's time to Joslyn Justi: 56:57 I love how you threw in that positive reinforcement paired up with a fun activity and the jacket. That's that's positive reinforcement in the best example I could I heard? Yeah, that's what that's what we're talking about. Kira Yakubov: 57:11 Thanks, Joslyn. Yeah, it's like so I remember, even after these bad conversa- , or no - I don't want to say bad conversations, tough conversations sometimes Joslyn Justi: 57:18 uncomfortable, discomfort. Kira Yakubov: 57:20 Yeah, like, not something that you love to do. But I know afterwards, like, Alright, once we're done with it, then we can like, go get brunch, like we can go do something fun together. So it is paired, right, like paired with something good for the relationship. So I hope the listeners were able to get some good information and tips from this episode of communication, and connection versus connection. Joslyn , thank you so much for being on again. I feel like we could talk for hours and hours on so many things, millions and millions of things. So I really appreciate you being on today and giving us our time to talk about this. Joslyn Justi: 57:57 Absolutely. Thank you so much for having me back. I love having these conversations. And I love that we have the opportunity to dive a little deeper today and get into a little bit more detail. And I really do hope the listeners can can take some of this and apply it to their own relationships because to me, that's where always the real work happens outside of sessions outside of these times in people's day to day lives. So Kira, thank you so much again, and Daniela, thank you so much for your awesome questions. I love being here. And yeah, hopefully hopefully be back in the future and you know, get into it and talk a little more about those underlying issues. But thank you so much, appreciate it. Kira Yakubov: 58:35 And if anyone is interested in couples therapy and wants to work with Joslyn, head over to healyourrootswellness.com and schedule a call and we'd be we'd love to set you up this ### Listen - [Spotify](https://open.spotify.com/episode/13702314) - [Apple Podcasts](https://podcasts.apple.com/podcast/13702314) - [YouTube](https://youtu.be/DHGON4mktA8) --- ## Understanding Therapy: Insights from 40 Years of Couples Counseling - URL: https://healyourrootspodcast.com/episodes/understanding-therapy-insights-40-years-couples-counseling - Published: 2022-11-23 - Season 1, Episode 8 - Duration: 39:47 - Category: therapy - Guest: Jean Thayer Meston ### Summary Introduction to therapy, breaking down the therapeutic process and explaining what to expect for those new to mental health treatment. ### Description Many people are curious about therapy but unsure what to expect. This episode breaks down the therapeutic process, explaining different types of therapy, what happens in sessions, and how therapy can help with various mental health concerns. Perfect for anyone considering therapy for the first time or wanting to understand more about the healing process. ### Transcript Jean Thayer Meston, LMFT: 0:05 there's a price to be paid when you don't pay attention to emotions. Daniela Galdi: 0:16 welcome back to another episode of heal your roots podcast. I am your co host, Daniela Galdi. I'm so thrilled to be here today to talk with Kira and Jean, who you'll meet in just a second, because they are phenomenal therapists who have been supporting each other throughout their work. Oh, hi, everybody. Kira Yakubov: 0:36 This is Kira Yakubov founder and the therapist at Heal Your Roots Wellness. Every episode, we have a new therapist and practitioner in the mental health field. So we can get to know them more as a person outside of the therapy field, but also what they love to do inside of the field. So today, I'm super excited to have Jean Thayer Meston, Licensed Marriage and Family Therapist with us with over 40 years of phenomenal experience. Thank you so much for being on today, Jean. Jean Thayer Meston, LMFT: 1:05 It's great to be here. Daniela Galdi: 1:07 Okay, so you mentioned you are 40 years in the business. And I know Jean, because Kira has said amazing things about you and gone to you for different types of mentorship. So I would love to hear a little bit more about your background, as well as for the listeners to know you know, what it is that you focus on in your work. Jean Thayer Meston, LMFT: 1:27 I'm going to bring me back if I go too far afield, but I'm thinking about when I was a high school teacher, and I taught American history in a public high school. And then slowly students would start to find me after school or when I was in study hall and they would you know, say can I miss nothing? Can I talk to you about something and then they would tell me the secrets and what was going on in their families and what was going on in their lives. And I realized that I was more excited about helping them and I was about teaching streak. So at the end of my first year of teaching, I applied to graduate school at Rutgers University, since I lived in New Jersey in Counseling Psychology thinking that I would be a high school guidance counselor or counselor counselor. And so I did a master's at Rutgers, then I got my first professional job, which was to being in a counseling center at Gettysburg College. And that was where I realized that if I met with the students individually, I would not have as much impact as I would if I could see them with a parent or a sibling or a partner. And so made me pay attention to marriage and family therapy. And somewhere when I had also when I was at Rutgers, is when I got exposed to working in human sexuality. So the place to train in the United States in 1976 was marriage Council of Philadelphia, which was associated with the University of Pennsylvania medical school. And I got to train there. So it was a one year intensive training in therapy with couples, we would go over to Child Guidance clinic and learn about family therapy. And we were trained in sex education and sex therapy. Whew. So Daniela Galdi: 3:32 you have had a lot of accomplishments. Yeah, that is amazing. I know that I want to know more about the human sexuality part. But Kira, doyou have any questions? Since I know you and Jean have such a close relationship?What is it that you love about the work that she does? Kira Yakubov: 3:47 Yeah, absolutely. So I know, I originally when I started talking to Jean, we were discussing couples work. And my first question usually is for people who aren't guests to come on the show is how did you get into the therapy field and you kind of just really laid it out for us. So I appreciate that. What do you enjoy about couples work? Because I know that you do see a lot of couples and people in marriages. Is there some part or aspects of couples work that you enjoy the most? Jean Thayer Meston, LMFT: 4:18 Well, of course, I love when they start having a mirror held up. They get better. And I think the other thought is it's the gift of thinking systemically so that when I look at a couple I'm not thinking two individuals, I'm thinking about the third part, which is what they create together. So there's the marriage and then there's each of them and to help them think about system the system they're caught in sometimes means that they feel less guilty and are more open and more comfortable. so that they know that I'm not thinking that they're a bad person, I'm saying, actually, when you do this behavior, your wife then reacts to what you did, and said, and then you react to her reaction. And that's what keeps getting over and over again, repeated and repeated. So it's not that you're a bad person, it's that where you came from and where you were raised, you learn certain ways to keep from getting hurt. And unfortunately, our way of not getting hurt hurts our partner, and vice versa. But to think about it, as it's always, I guess, I'm adding a fourth entity to the three, which is this repeating negative cycle that you've been stuck in and not realizing it. And the most common pattern is for one person to be a critical person what we have been Emotionally Focused couples therapy call a critical pursuer, I am a recovering pursuer. Oh my god, I just, it's horrible to think about some of the things I did because I was insecure, and that poor boyfriend's getting all of my my okay. And if you don't talk to me more and express more emotions, I'm going to think you don't like me. And then I'm going to be mean to you, or the most important thing is that someone's going to withdraw. So if I'm pursuing and saying, please pay attention to me, please pay attention to me, it's more likely that he's gonna be Oh, my God, oh, my God, I don't know what she wants. For me. I think I better not say anything, so that I don't do the wrong thing. And there, there's the pattern. So that's the repeating cycle over and over again. So moving ahead, first, we have to help the couple see that this thing is outside of them. Also, they'll begin to figure out from the families they grew up in sort of where it came from. And then beginning to reflect back the deeper emotions. And when the partner hears deeper emotions, they don't do their usual of either shutting down or attacking. And then they start to get better and better. So it's really wonderful when people get better. Daniela Galdi: 7:23 So what you're saying here is that therapy is necessary. And I believe that I think it was heal your roots, your social Heal Your Roots Wellness, social media that you just posted, possibly about. You don't have to wait for something to be wrong to have therapy, or you don't have to wait till it's almost time for a divorce. Jean Thayer Meston, LMFT: 7:44 The sooner people come in, then the better we have better chance we therapists have of making a difference. For sure. It's it's tough. There's something else there's a marriage and marriage therapist, he and his wife, John Gottman, and I can't remember her name right now. But the two of them is Julie. That's right, this Yep. So we've got this negative cycle that keeps repeating over which the couple, they didn't realize they were doing it, they didn't realize they were they knew that they were repeating in the sense that insanity is doing the same thing over and over again expecting a different result. But one of the things that that Gottman pulled out of all of the hundreds and hundreds of studies about the effectiveness or not effectiveness of couples work was the only one that he said, had to do with gender. And that is that in marriages or relationships where a woman feels that she can influence and a heterosexual couple influence her husband, that that reduces the probability of divorce significantly. So if if she feels that if she talks to him from the heart, about how she sees it with the kids, or her job, or his relationship or whatever with his family, and he hears her and can actually be affected by it, that that really helps the relationship. And I'm imagining that in same sex relationships, that we have something going on, I think probably that is not gender related. I think we all want to feel like we can make a difference and that somebody thinks our opinion is to be valued. Kira Yakubov: 9:40 So I know that when we so just for the listeners, Jean is like my mentor, I come to her for mentorship. And so we've discussed many of my clients and couples. And something that I really loved when we talked is when you outline this infinity, right? So if the listeners can imagine an infinity sign that When couples are arguing on top of the infinity sign right is their adult version. This is also how we react. And then when we do something that can trigger or elicit a response from our younger selves and how we might respond. And so if you can explain, because you've explained it so beautifully, that it stuck with me that I told my husband about it, he loved it, the way that you explained it to kind of the listeners of like, what that looks like, when we are in arguments, and there's different parts of us coming through. Jean Thayer Meston, LMFT: 10:33 So listeners, if you in a course, both Kira and I just we're going to use our hands, but think of putting an eight on its side, and then draw a vertical line is that vertical now horizontal line, draw a horizontal line through the eight on its side. And above the line is our conscious adult self. And below the line is often our unconscious child's self. Now, if we put our hand up in to the left, and to that partner, and they say something to their partner on the right, it's good at and the partner responds negatively what the person doesn't see on the right, is how her message goes underneath, and impacts the partner who's heard her speak, or him speak and bad way. And then his adult response and reaction to the child message of a child feelings that came up is to withdraw or pursue with her in a way that she gets hit. So they line up side that goes underneath each of them is where the the message from the adult goes to the kid. And that's part of why we get stuck. Kira Yakubov: 11:52 And a lot of that when you're sharing is from our families, right? Like how we learned or a lot of the triggers or the messages we received early on, right? So I grew up in an immigrant family very conservative, it was very stereotypical gender roles. So I was allowed around a lot of very loud men. And so I didn't have the opportunity to argue back, I would just shut down and like, Okay, I'm just going to be silent here, and then do what I have to do behind the scenes. And so that has carried with me unconsciously, as an adult, when I feel like someone is coming to me or arguing too aggressively, I just shut down. And I kind of go back into that childlike version of myself. And I can see how much that can impact my partner or other relationships. And so I mean, it's really powerful insight to know, this younger version of us that's used to behaving a certain way to protect ourselves. Jean Thayer Meston, LMFT: 12:49 Yep, that is so important. And then our poor partner. And if we pick that up, they don't understand why we just shut down. So they're thinking, Oh, my God, what did I say? What's, you know? Is she mad at me? And of course, we've gone back into that place where the only answer is to be quiet. Yeah. But they think it's their fault. And it's not, it's just they accidentally hit that spot. Daniela Galdi: 13:22 So to let me clarify for you both in terms of reacting, is it? Do you think it's from the behavior of, let's say, the loudness or the tone? Or do is it a play on both the subconscious? What's happened to the child? And then the behavior as well? We're kind of be a combination of both. Is it a combination? Jean Thayer Meston, LMFT: 13:47 I think it is. And I think a really cool thing that's happened. I don't know, the last seven years, let's say is that since the ability to talk with people and scan their brains and have us watch their brains when they speak, we know where in the brain what emotion is coming from where. And it's pretty amazing that that what our brain does, and, and when. So let's say if I get angry because my boyfriend is scared of me and he's shut down. And then I lose control of my bad emotion because my amygdala, that part in the brain that is to save our lives. It's what tells us that we're in danger and we better run or freeze, fight or fight. There we go. So when that flashes, I can't take in anything the boyfriend tells me because he's afraid of my activation and my anger and he's trying to protect himself by freezing. because that's how he survived in his loud, obnoxious family. And here I am, unbeknownst to me duplicating the loud, obnoxious family. So I feel like he's making me into a monster like, I'm this bad person. So I get mad or when he withdraws, which validates, for him, it's a good idea to withdraw his child stone could move, she is dangerous. And it would never occur to him that what's going on inside me as maybe I'm not lovable. My being loud and expressing myself so directly and hotly and sometimes self righteously is scaring him away. Maybe that means that I'm unlovable. And, and he's thinking, Well, I'm not having she's not leaving the room, she's still sort of trying to connect to me. So maybe that means I, it's okay, that I shut down. So this is you can see how we get stuck. We keep doing the same thing over and over. Kira Yakubov: 16:13 And it's these beliefs, right, that we may not even recognize or they're not, they're not like saying it in our head, right. It's not like the voice that is saying this. Jean Thayer Meston, LMFT: 16:23 Well done. I think it's that those old lessons in our family of origin - stimulate the physiology that underlies the behavior, the two behaviors, and there are people it's rare, sometimes people come in, and that's their withdrawal withdrawal couple, they've both sort of given up or they've both kind of taken, let's not talk because them talking could lead to fightin. And so they're very separate. And sometimes, of course, it escalates. And we've got people who do not know how to speak to each other without it's been highly elevated. The new phrase is an effect dysregulation, and we see it in children who are quote, acting out in elementary school, where the that part of the brain that's supposed to save us from death, and bad stuff, flashes, and then I can't hear what anybody says to me. Or I might panic, my heart rate goes up, my breathing goes up. Daniela Galdi: 17:32 That's a great explanation. And I wish that everyone could see me mimicking my inaudible like a lightbulb moment, from everything you're saying. And speaking of the amygdala, I keep giggling to myself, because I'm like, oh, that baby is flashing. Jean Thayer Meston, LMFT: 17:53 Isn't that great? And I had one client one time I love this. And she came in and she said, Well,I had an amygdala hijack. Isn't that great? It's like it made me do it. Yeah. It's not the devil. It's my amygdala. Kira Yakubov: 18:13 And so I know that when you're expressing it's physiologically something happening. It's, for me, at least for listeners who if you've heard of stonewalling or shutting down, right, the intention is important behind the stonewalling I think, for couples to understand or anybody really who's in discussion with somebody else in like a heated situation is that it could be that our body, like you're saying, totally takes over, and I no longer feel safe, I don't feel safe, I feel powerless. The best way that my body knows how to get through this moment, is to be silent, and wait for it to be over. So it's more of a protective mechanism. Versus we have some times when it can be manipulative, is I'm going to actively ignore you and not speak to you. And both of those can be very hurtful for the other partner on the other end. They may not know the intention right away, but it's painfully and deeply hurtful, because if you think about when you're a child, your parent just shutting down and ignoring you altogether. It's I mean, it's hurtful. And so I think having a partner know the intention behind what's happening is important. And so, Jean, do you have any tips for people who do shut down or they Stonewall to move through those moments? Jean Thayer Meston, LMFT: 19:33 Well, I'm gonna maybe add an element. So the you're alluding beautifully and explaining beautifully Garmins Four Horsemen of the Apocalypse, which is criticisms I think that pursuer peace. You know, criticism. The other person, if they feel criticized is going to be defensive. And they're either going to shut down down or they're gonna react verbally back and not you'll have a fight. But let's hypothesize that in cases where you don't go back and have a fight, you're describing your own, you've learned. If I could just be invisible, it'll go better for me. And then that makes the criticize or increase their criticism and distress. In order to get through this, what becomes the Stonewall and the stonewalling. So it's criticism makes offensiveness if the person keeps criticizing, then we're going to build a wall. And then what Gottman suggests is that if that keeps going, that eventually one of them is going to have contempt for the other. And that's the worst if people come in, and every time their partner speaks for other partners rolling their eyes, that usually means they're contemptuous of the partner. And that usually means they're not going to make repair. Kira Yakubov: 21:03 Even going back to like the stonewalling or shutting down is the mindfulness piece in the awareness. Right. So it took me a while to recognize that when I shut down, that is a huge trigger for my partner, right? Like it makes it worse, it doesn't make it better. It makes maybe your experience less uncomfortable, because you're going into your shell and like forgetting about what anyone else is going through in that moment. But it's having like that wise mind that awareness like okay, I'm recognizing I'm shutting down, I'm pushing my partner out. In the long term, this is going to be much worse. So how can I stay in the room? And how can I express like, listen, like, I'm too overwhelmed and too overstimulated to have this conversation. I need a moment, or like asking for that break, or just expressing what you're experiencing, and not getting back into the content of the argument to slow things down. And so have you seen that in person with couples when that you see that moment where maybe one partner recognizes how they're behaving or how they're being defensive and slowing down to stop a cycle. Jean Thayer Meston, LMFT: 22:12 I remember when I was trying to learn not to be defensive if somebody criticized me, which is enormously hard. And I, and this boyfriend at the time was telling me how much his mother hated me and why. Oh, please, oh, that competition? So and I was sitting in denial, I said, Oh, no, no, it's fine. I know. She hates me, I took you away. Right. But after we hung up, and I said, Oh, no, doesn't bother me. The things that you told me that your mother said about me. Like deny, deny, deny. And then when we hang hung up, I had the moment the phone was put down. I had a splitting headache. Splitting headache, deny, deny, deny, but bodies don't let us deny. It was amazing. So I have to say, the denial didn't work. Right. Shutdown isn't working. I let his telling me that. Information hurt me. I you know, she thinks I'm a terrible person. But going back to trying if it's the other way. Yeah, of how to one way with friends. Anyhow, if I get defensive and this was pretty my first step and not being defensive was to say aloud. Oh, that was really defensive, wasn't it? And they go, yeah. All right. So it's like, I have this little wiser version of myself that's outside of me saying, Whoa, that was pretty defensive. And so it's about trying to develop it. There's a approach in therapy, a group approach called Dialectical Behavioral Therapy. And they talk about having a rational mind, which makes sense, you know, the ones based on facts and not emotions, the emotional mind, which is you know, all emotion. And then they talk about developing our wise mind. And wise mind is the combination of both the we don't want to be so rational that we're an automaton and a robot. And emotion is good, it's honest, and it it's important to be expressed and to learn how to express in a way that we don't really hurt other people. We don't want to repress it and suppress it or you'll get a headache like I just described, or irritable bowel syndrome or addiction. There's a price to be paid when you don't pay attention to emotion. So I love this idea about putting them together into one his mind. And that's that's a Marsha Linehan gift from DBT when she created it, and the more we, there's Oh, and another piece about the physiology piece is that studies are showing us that if we could learn to meditate, doesn't mean you go home and brush your legs. When you're having a conversation with your partner. It means once a day or twice a day that you stop, tune into yourself quietly, breathe, and slowly through practicing what's called mindful meditation. You can actually calm your amygdala down. It's wild. You we can actually make a difference. Being a little ADHD loved one I minimize a little. Oh, Jim, is funny and I tell people I flunked my first two attempts at classes in mindfulness meditation, I took three classes, and then I'd make up an excuse and run away. I did two and then three. And then when finally I cried, this is persistence helps. So then I had an opportunity. A person at Penn, Dr. Baime, Michael Baime created a course specifically for psychotherapist and mindfully he taught the foundation course of mindfulness to therapists, it was psychiatrists, marriage and family psychologist. And I got through the whole thing, and I did the homework and, and it really was amazing. So this new knowledge about how our brains work, and also that has helped us begin to understand trauma. And why there's a huge baton, my God having COVID I'll tell you where my brain just went, you describe beautifully. That was beautiful, were self awareness. And then also this piece about a recognizing I can impact the partner. And I don't want to hurt that person. My goal is not to hurt them, but it's unintentional. So you actually start not wanting to do it anymore. Because your partner isn't the person who's hurt you and sent you there, but also that you see his distress. Then when we're activated, when that amygdala has flashed, I don't see anybody's distress. All I'm into is my own distress. And then the piece about heart rate it, it was Gottman, who that is couples were heart rate monitors when he sees them. When their heart rate monitor when their heart hurts for over 110. They're just sitting on the couch, talking about their relationship with Dr. Gottman. They couldn't take in anything that Dr. Gottman said or anything that their partner said. It was like they were unreachable. And so it wasn't even a stone wall. It's just they were so aroused and upset and distressed. That they couldn't do it. So whether we're the pursuer who needs to bring down, bring down that stuff so that I can be there with my partner, or the withdraw or who has to come up. Come up from the safe place. Wait a minute, I have to come out of my room. Here. Yeah. Isn't that cool? Yeah. So the self awareness helps a lot. And then our think our compassion muscles starts to get stronger. I you know, like I would say to people, I couldn't see the distress on my boyfriend's face. He was terrified when I'd be you know, putting them down or getting louder or crying hysterically. I hate to use that word, hysterically, usually would be yet and of course I'd be scared to if I were on the other side of me when I was in that place. Yeah, so if we're if we become the bulldozers, we need to become aware of it and reduce our get our bulldozers smaller and smaller. Right and if we run away and go to our safe room, we gotta kind of like how about we have it three steps away instead of 20? Well, I think one of the ways that us humans try not feel bad is to blame other people for are feeling bad. And I used to make a joke to some of my couples like You do know why we get married? And they say no, why do we get married? And I said, total have someone to blame? When I was single, I just had it all together, right? Because these things don't come up when we're on our own. Or we don't do this to our girlfriends, right? Or yeah, we just don't. So one of the things, so I guess one piece is beginning to use our feelings to go backwards and ask ourselves, what what what is it that I'm trying to put on someone else? And what's going on with me? Not they did this to me, or you made me feel this way. Because usually it's not them. It's something going on with us now. In the meantime, blaming other people can be hurtful to them. It's hurtful to us, because then we won't grow and learn and be better human beings. But it's also hurtful to the people we blame, because we use it the blame as an excuse for not communicating or for being cold, or all the different ways that will show our feelings. So let's say and I'm trying to pick up here with Danielle alluded to, we're going to hurt each other. I mean, we know this from growing up in our families, not that it's but the big, important thing is, is it on purpose. Often we're going to make mistakes, say the wrong thing misunderstand. But we can reflect and go back to the person and say later, oh, you know what, I think I cut you off. I don't think I was paying attention. I'm so sorry. Would you tell me again, what you said on Saturday. So this, we're moving closer to self, this hooking up self responsibility, and the forgiveness piece in order to move forward. It's so important that we learn how to do honest apologies. And now that I think about it last night, I watched an episode of I haven't ever, ever, if any of you watch it, it is about an eastern Indian girl who was growing up in California and she's in high school. It's hilarious. And it's written by Mindy King is that her name? Kira Yakubov: 32:22 Mindy Kaling Jean Thayer Meston, LMFT: 32:22 Oh, guys, you will you will love it. My listeners, if you haven't watched it, it's pretty wonderful. And she has done a girlfriend dirty. This is high school politics when he really was jealous of this. It's the only other Indian girl suddenly comes from a different school system. And of course, that puts Debbie off. So she does all these bad things and is very, very hurtful to the new girl who she buddied up with. And then you watch her go for her attempts at apology. She realizes that she was way out of line and very hurtful. And she tries to make excuses and we watch her go through it. And she goes to her therapist, by the way, who's this classic, funny black woman who calls it like it is? And she sort of scolds Debbie and says no, those aren't apologies what you've just done. So you have to say about what it is that you did, and take full responsibility for it. And you have to say aloud, I see that I hurt you. And I was wrong, who that's a really good one. So that's a healthy forgiveness. Now, when we were talking earlier, I said a nicer way to think of it on the spectrum or continuum of apology slash forgiveness is on one end, it's extreme is I will never ever forgive you. You've hurt me to the core. And I'm just not ever going to forget or forgive. Then we've got over on the other side, and I think I used to do this non assertiveness, Oh, it's okay. It wasn't that bad. Oh, you're forgiven. I would I would soon dismiss somebody trying to think about it. So okay. It's really it wasn't, you know, so neither of those are going to lead to spiritual or emotional growth. So it's that one that Debbie finally got the pattern in the middle, it's wise mind. And recently, I had this, I guess, was the sort of my older my younger brother. So anyhow, if I hurt my brother, he would just ghost me. And I would know that something wrong, not because he told me but because suddenly he's not speaking to me not calling me out in my wife. And I would talk to my two sisters and say, Oh, Larry's ghosted me again, like I'm a victim. This is actually pretty funny now, but I think about it and slowly, I realized, you know what? I'm doing something that hurts him I need. And I did I call them. And I said, Larry, I just want to talk for a moment. And you don't have to answer this right now. But I think that there are things that I do just being me that run over top of you, interrupt you feel condescending, I put my finger on it. And I would love your help, because I hate that I'm doing this. And I'm so sorry that it took this long for me to like, instead of making fun of approach me. Right, right. So it was the best. And he didn't have to wait. And he told me the things that really sort of would make him feel bad. And I said, Thank you so much. It's been great. Daniela Galdi: 35:57 I think that's amazing. And I really commend you gene on doing that. This is something that I talk about a lot when I speak on any type of health situation or wellness issues going on, but practicing vocalizing and that's what I'm hearing from you is the acknowledgement, but the vocal acknowledgement of addressing a situation is what will lead to change. Kira Yakubov: 36:27 Yeah, and I think just coming from a very vulnerable place, it's the vulnerability, right? It's the vulnerability with the apology, and the forgiveness is huge, because, and even with the vulnerability, you have to feel safe enough to share that vulnerability. It's like so many contingencies to get to the meat and potatoes of it. But if you I think if you value that relationship, and you value that connection, you're willing to make yourself feel uncomfortable with the vulnerability to reach that other person to hear what they have to say and what they've been going through. Jean Thayer Meston, LMFT: 37:00 Yeah, it really opens the door to healing and that peace of retiring blame. What's going on? If I'm blaming the other person for my being uncomfortable? Yeah. And if we allow ourselves to think, oh, it's because they're this, then I'm we're never gonna get it. We're not gonna grow. Yeah, and we can do healing and relationships we can overcome. And I think what's hard, we don't see it modeled very well, very often or every any, it's think it's hard to see. Unusual, saying I was wrong is like, huge. It goes against our, I don't know, rugged individualism. Kira Yakubov: 37:49 But even just from I mean, I don't know about other cultures, but especially growing up like an Eastern European culture, like, my parents never apologized. And we never apologize to each other. It was you could you would tell if someone was upset, or if they did something wrong by the behavior, right? Like the, the nonverbal language that was happening. But there was no apology, it was just kind of swept under the rug, or once they fell over it, the behavior change. Oh, and they're coming closer to me now. So I guess I don't want to mess that up. So I'm just going to pretend like it didn't happen either. And I remember when I was older, going through grad school, like learning about all this stuff, I did something that hurt my mom. And I said, I'm sorry. And she's like, you don't need to say sorry, to me, you're my daughter. We don't we don't need to apologize. Like it's fine. It's like No, Mom, we do like, I messed up, you feel bad. I'm sorry. And she was just so uncomfortable with that. So I think even receiving apologies for some people might just feel so off, because we never received it. So we don't know. It's like you don't know where to put your hands in the photo? Like, I don't know what to do with my emotions right now. Because it's awkward. Jean Thayer Meston, LMFT: 39:00 Yes, that's the word somebody could be attempting an authentic apology. And we blow it off, which is no, no, no, they need to have it recognized. And then. So I've learned to say thank you. And it just thank you so much. Daniela Galdi: 39:20 I've been practicing that too - the Thank You piece of it. And it reminds me of something that you both spoke about earlier about when you look at a couple not to look at them as two individuals but them together. Jean Thayer Meston, LMFT: 39:36 This idea about how our culture the first world culture and American culture in particular, perhaps with you know, with 1000s and 1000s of years of understanding that the only way we're going to survive is if we collaborate in a four part of community that we are wired Not to be alone. Hence, this American thing about being the rugged individual rugged individuals are only in smoke cigarettes. Somewhere I have it on my refrigerator that loneliness is the equivalent of 15 cigarettes a day. Is doesn't that? Isn't that beautiful? I mean, there it is. Kira Yakubov: 40:28 And I think a lot of loneliness. So there's different, you know, circumstances and nuances. But I think that when we choose to be alone, there's this history of being hurt, of being abandoned in some way. And there's this level of trust that we have to allow to happen to allow other people back into our heart and life. Right. And I think when I think about trust, especially with couples, we think trust has like this one blanket statement, like I trust you, or I don't trust you. And I think there's like different nuances to it, right? Like, there's, I trust that your intentions are never going to be bad, you might make mistakes and hurt me, but I trust that you will not do something malice. And then there's the kind of trust where I can trust that you're going to have my back, like you're going to show up, when I need you, you're reliable, you're going to be there. And then there's the kind of trust like, I don't want to say adequacy or like, competency, like, I trust that your intentions are good, I trust that you're going to show up, but I don't trust you're going to be able to do it, right. Like even let's, for example, like if I had a flat tire, I can call one of my girlfriends who's never changed his hire, I know that she's going to come, I know that she's going to be there and help me. But she may not know how I don't trust that she'll know how to change the tire. Right? But I trust these other pieces in the relationship. So I think it's interesting to think about, like trust in these different lights and nuances with relationships, and not have it be kind of like a blanket statement. Like, if you broke my trust in one way, it generalizes everything in the relationship. If that make sense? Daniela Galdi: 42:07 It does. And that was a great visual as well. And it makes me think because I know I can I acknowledged and it took me years to acknowledge that I think I only related trust to like not cheating on me in a relationship. And then I really sat with it like wait a second. So I love that you're explaining that about the nuances. Kira Yakubov: 42:29 So is there any tips you have for couples who are rebuilding trust, because trust is it is really tough to rebuild and repair from. Jean Thayer Meston, LMFT: 42:39 I'm thinking of a couple that I saw last year. And he he had an affair. Well, sort of a brief affair, I guess, and how devastating it was to the partner. And yet she was she was amazing. I have to say she really got through it. She really wanted to know what was going on in their marriage that this would happen. And she was able to see her part in it, you know that she had been so involved. They have an autistic child. She in that changed her life. They both worked. But his work was something that couldn't change. And that meant she was doing all of the doctor's appointments, all of the educational things, everything and he was really, she wasn't paying attention to him. And they were able to get to that and she was able to take her part and he was able to see then it was easier for me to stay at work longer. And so they and now they are just I mean that and learning about the cycle and he's withdrawals and all the good things that they came for, but they they did a marvelous job. And what was also kind of cool was in the meantime, that autistic child is now doing really, really well and they've gotten help she needs and she's doing DBT and she's just blossoming. So all everybody. Yeah, I was doing very well for rebuilding trust, because that was big for her then how do I know how I mean? How would I know? And he got you know, he would text if he's going to be late. He would say no to certain things. You know, I gotta be home. You know, it's so he showed that he was trustworthy in small ways, right? Yes. That's right. That's right. And I will say one of the things that's interesting there's a book called The Five Love Languages. So snotty about it. Yeah, like, Oh, what's this pastor and that's probably and it is kinda corny, except it's all based on real research. Like a read on There's no. And I found that I also Yeah, so the five love languages it's there's a reason why it's been on the bestseller list for so long, I should have given it to each of my grandchildren who have gotten married this year. But let them know that I don't want them to have to think about when it gets bad. It was a revelation to one of my clients. He said, Oh my goodness I've been doing to my wife what I wanted her to do for me. Because he was just using his love language like this is what I need. And that wasn't what she needed at all. She needed. quality time together, she needed. Yeah, she wasn't interested in gifts. He would give great gifts, but they were lost on her she because she wasn't getting what she really needed or wanted. Or we got her lovely. So that's a sweet book that I think can be pretty well revelatory. Kira Yakubov: 45:58 So there's a website, you can take a quiz for your love language on there as well. They added in an apology language. This is I think this is almost as important. It as I'll say as important or more important than the love language. But as important. The five types of apologies. The first one is expressing regret, which that one's important for me. accepting responsibility is the next one. Then making restitution, which like making it right, somehow, genuinely repenting. And requesting forgiveness. That's my least favorite. Jean Thayer Meston, LMFT: 46:33 I would put something in what's number one. Kira Yakubov: 46:37 Number one was expressing regret Jean Thayer Meston, LMFT: 46:40 to say specifically, this is what I did. This is Yeah, so express regret. But for what you have to say aloud, I was selfish. I did this till I could show off or I said this bigger, then yeah, then then take responsibility. But But what is you can't just say a blanket. Kira Yakubov: 47:03 Yea, for what? Be specific. Jean Thayer Meston, LMFT: 47:08 So when we when somebody wants to get off the just the I'm sorry Kira Yakubov: 47:11 Yeah, Jean Thayer Meston, LMFT: 47:11 we're gonna take them through the five. Yeah. I'm going to look it up. That's awesome. Daniela Galdi: 47:19 Well, this has just been phenomenal with all of the Insight team that you have shared with us. So now we want to ask you the question that we ask everybody who visits with us? What is something you can share with the listeners that your clients might not know about you? Jean Thayer Meston, LMFT: 47:37 Some people are very surprised to learn that I taught American history in public high school, that my minor was African American history that I was very influenced by the Civil Rights Movement, feminism, gay pride. All of those good things. Yeah. So I think that's because I'm not supposed to have that in the therapy room. So sometimes, if I've seen somebody for a long time, towards the end, I might share some of that, but you let your rebel side know my back. And actually with the two of you I when we were talking earlier, and I actually said aloud, oh Janis Joplin was my alter ego. I remember one time saying that, to me that was on a board for work with gay, lesbian and queer folks. And one of the other persons on the board board, we will walk in and I said something about being a hippie and he was like, what? You were a hippie? And I was like, You didn't know that. I wish I had pictures. I wish I had some of the clothes. Oh, baby. Yeah, it isit is. Kira Yakubov: 48:53 I think that's why we get along. So well. I love speaking to you. But from the beginning is like, I think on my hippie at heart and like, maybe in a past life. And so I love that. Yeah. Jean Thayer Meston, LMFT: 49:04 Isn't that Yeah, we really got that, and I so admired you do we have a similar curiosity about Ha, what's driving this and then translated into something that clients can become mindful of. And again, I want to thank you, all of you, The techs, the two of you, ladies come in with up with the questions and getting the best out of me. I hope. So this has been a delight. Thank you very much. Kira Yakubov: 49:38 Thank you Jean Thayer Meston, LMFT: 49:38 Thank you for having me as a guest. Absolutely. Kira Yakubov: 49:40 Thank you for coming here and being with us. I I love talking to I could talk to you for hours. But I really appreciate you being here. And I think that this is going to be one of the best episodes and I hope all the listeners get to hear all your amazing and knowledgeable insights. So thank you so much. Jean Thayer Meston, LMFT: 49:56 Thank you. Thank you. Thank you. Daniela Galdi: 49:58 Before we go, you could just share how we can contact you and your listener. Jean Thayer Meston, LMFT: 50:01 Ah, thank you. Um, I am mostly doing, but what do you say is telehealth virtual telehealth these days and I don't know if I will be coming back into center city. I hope so because I love being in the city two days a week or three days a week or whatever it was. But you can find me on gene meston.com. That's my website. And I think the URL Yeah, and then Psychology Today has a find a therapist, I'm on there. And I'm now practicing from my home office, which is in Bryn Mawr, PA. So if you put in Bryn Mawr, PA, I'll probably pop up. Yeah, pretty good. Kira Yakubov: 50:47 Well, thank you so much, Jean. Jean Thayer Meston, LMFT: 50:48 Thank you and thank you for that. ### Listen - [Spotify](https://open.spotify.com/episode/12939623) - [Apple Podcasts](https://podcasts.apple.com/podcast/12939623) - [YouTube](https://youtu.be/LyIi6rhlOUQ) --- ## Dating Talk with The Therapy Gal Leeor Gal LMFT - URL: https://healyourrootspodcast.com/episodes/dating-talk-therapy-gal-leeor-gal - Published: 2022-11-09 - Season 1, Episode 7 - Duration: 42:33 - Category: advocacy - Guest: Leeor Gal ### Summary Addressing mental health stigma and misconceptions, exploring how to break down barriers and create supportive environments for mental health discussions. ### Description Mental health stigma remains a significant barrier to seeking help. This episode addresses common misconceptions about mental health and therapy, exploring how stigma affects individuals and communities. Learn how we can all work together to reduce stigma and create more supportive environments for mental health discussions. ### Show Notes https://thetherapygal.com/ ### Transcript Daniela Galdi: 0:04 When we are dating, we are oftentimes constantly thinking about what the other person is thinking of us, rather than what we actually think about them. Welcome back everyone to our next episode with heal your roots podcast. I am your co host, Daniela Goldy. And I am the founder of byvesta agency producer with heal your roots wellness for this podcast, as well as a health and wellness professional. Kira Yakubov: 0:36 Hi, everybody, I'm Kira Yakubov lead therapist and founder of Heal Your Roots Wellness. Every episode we'll be talking to a mental health professional and getting to know them a little bit more as human beings and what they do in the field. Daniela Galdi: 0:50 And today, we have Leeor Gal here with us as our guest. Leeor is a licensed Marriage and Family Therapist and the owner of the therapy gal, group practice located in Pennsylvania. She enjoys creating relatable therapy related videos on both Tiktok and Instagram, and works towards destigmatizing mental health. She also published a journal called empower your mind, which is a 12 week prompted journal that we will definitely be talking about today. And she shares with us that her mission is to prove that therapy can be fun, along with being serious and challenging. And therapy can be for anyone that wants an objective perspective and is looking to grow. So welcome, Leeor , it's so great to have you. I'm so happy to be here. Thank you for having me. Oh my gosh, of course. Okay, so we're just gonna dive right in. And so that was a beautiful bio, and I can't wait to hear more on everything that you do. I know a little bit later, we'll get into also some dating talk, as well. But if you could just tell us a little bit more about yourself so that our listeners can really get to know you. Leeor Gal: 2:00 Absolutely. So hi, everyone, I'm Leeor . I'm a licensed marriage and family therapist. I am currently living locally in Philadelphia, hoping to make a move to New Jersey soon. But as we all know, the housing market is crazy. But I opened up my own practice back in June, and I have an employee and it's it's growing slowly, but it's growing because I've noticed such a need for therapy. And I absolutely love this field. I'm so happy to be in it. I'm just happy to be here on this podcast. Kira Yakubov: 2:41 Oh, thanks for your and congratulations on you opening your practice and expanding. I know that's a very big deal and not an easy thing to do. So congrats on that. That's huge. Daniela Galdi: 2:51 Thank you, thank you. And I was very lucky to have care of on my side throughout the whole process. And I'm sure we will talk about how you and I met, which is like the most crazy experience ever the connections that we had. But it's so important to have connections and support when taking a big leap like that. Kira Yakubov: 3:12 Absolutely. So we'll definitely get into that a little bit later. But I do always love to start off and ask start ask our guests. What got you into the field? Like, is this something you've always wanted to do? Or did you transition to therapy kind of share with us a little bit of your backstory? Leeor Gal: 3:29 You know, I love this question every single time somebody asks me this, because it was completely unconventional how I got into this field, meaning when I say it fell in my lap, it literally fell in my lap. And I know that that's not the answer that most people want to hear. Because a lot of people are like, I thought of this everyone since I was two years old. And I knew that wasn't me. I didn't know that this was for me until I was 2525 years old. So I went to school for four years, I got a communications degree. I worked for a little bit and realize this sucks. Like this is not for me. Not that it sucks for everybody else. But for me, I realized that I wasn't good at it. I didn't find joy in it. So I quit my job and moved back home with my parents. This all happened by the way. Within a day. I was just like, I don't want to do this anymore. I quit my job. This is not a sign up for everybody just do that because I was I was young I had support I couldn't I was able to move in with my parents. I didn't have a lot of bills. So I was able to do that. And I went back to school with the idea of becoming an occupational therapist. And I took bio anatomy stat like I did all of those classes that I And I'd have never taken an undergrad, that's for sure. And I loved it. I took more psychology classes as well, because that's one of the prerequisites for OT. And I applied and I applied, and I applied and was really, really hard to get in to the point where he was like, I don't even know if I really want to do this. So, one day, I was like, Oh, this was a cool program. And it was Jefferson's Marriage and Family Therapy Program. And they reached out to me, I reached out back to them. I interviewed and I got in. And that is how I became nervous. And every, every time I told the story, everyone's like, what? You just decided one day, and I was like, it was the best decision I've ever made in my entire life. That's amazing. Well, they say the things that are meant for us to not not that the process is always easy, but they come it comes to us easily. And it just seems right. And you recognize it. And there's no questioning usually behind it's like, yeah, this is what it is. So I love hearing that. That was what it seems like it felt like for you, along with the process of, you know, am I going to go here? What program? Can I get into what's going to be the best? You know, so what was your experience, like at Jefferson, and then following graduation? Yeah, I think one, one small thing that I want to say is, it wasn't that I just all of a sudden, like, I've never thought of this before. And then I became a therapist, I always knew I wanted to help people. But I never thought that I could sit in front of someone and hear them talk about really hard, difficult things, because I would feel so upset about it. And so I always put being a therapist with the side because I was like, I can't do that. I'm not emotionally equipped to do that. How who am I to help somebody with that. And so when I started doing it, it was such an amazing experience to say like, I don't need to be perfect. In order to be able to do this. I just need to know what I'm doing. I need to obviously get the training for it. And I did love my program at Jefferson, we had an amazing, amazing, amazing practicum we worked with, with women in shelters, we work with so many different types of people. And I because I was in Philadelphia, I got to work with just everybody and everything. And it was in all different, you know, capacities. And especially as a marriage and family therapist, I needed to get, you know, a certain amount of hours of systemic experience, meaning couples and families. And I realized, like, this is such incredible work and something that obviously, everybody can benefit from it. But I really, I really loved my experience in grad school it was, it was definitely a great, great time for me. Kira Yakubov: 8:08 I love that. And I love your original story of that. That wasn't even on the radar really in the beginning. Right? That was like very similar for me. I went to school for accounting, like I was going to be my idea was I'm gonna be a CPA. And it's not because I had like this desire or love for math. Right? It was my parents were like, it was my junior year of high school. And I was like, Dad, I don't know what I want to be. And he's like, Well, I'm Eastern European background. Well, you know, accounting is a stable job for a woman and you're like good at math. So just do that. I was very cool. And I had my internship at a tax firm. And one week later, I came home crying and said, I hate I hate my job. I hate all of this. And then slowly started to shift to psychology. And so I'm curious because we are I know you're also an immigrant and you have Eastern European roots. How did your parents take that when you told them you wanted to be a therapist? Leeor Gal: 9:02 Oh my god, I remember. So first of all, I have a photographic memory, which I only found out recently when my clients are like, how do you remember what I did or war said in that session? I think something's wrong with me. I don't know why. So nothing's wrong with me. I think I just have a photographic memory. So I remember when, when I I didn't tell my parents about it until after my interview and I think I remember if it was right after I even got accepted or it was just after the interview, but I remember walking into their bedroom was like 10pm and this was at the time I was living with them because I had moved back and I was waitressing and I was also nannying at the time. And I was like I'm I'm gonna be a therapist now. So that's so I'm starting Google here. So my my prayer Since we're like, oh, but then so as as Kira, as you just said Eastern European and my, my dad is is Israeli. My dad is doesn't have a lot of opinions as my mom, of course. But my mom was like what? And I was like, but it's a Jefferson. And she's like, Oh, I made the difference. That's a very good school for you I am affected accents. It's like any other department, you but I was like, Okay, well, I guess it's Jefferson, so I must be some great program. And they were very skeptical. They were definitely very skeptical, but they were like, you're gonna pay for it. Like, we're not paying for your school. And I was like, fair. And I did it. And I think they took me seriously because I took out a lot of loans on the program. They were like, You must be very serious about this. And I was like, Yeah, I really am. And now they're like, holy crap. We we can't believe we've been doubted for a second that this would be your calling. Do you see it kind of opening their world to in terms of mental health and seeking professional help? Yes, and no, I think for Kira Yakubov: 11:34 like that mixed review. Leeor Gal: 11:37 But they're very, very supportive of me. And what I do, I think a lot of the times, my parents were more impressed by my social media presence than anything. And like, if I do like a brand deal or something, they're like, our daughter is so incredible, because they paid her to do video. And it's amazing. And I'm like, Okay, but what about my math? On a daily basis, Kira Yakubov: 12:08 no, you run business, this is good. Leeor Gal: 12:14 They all have obviously, all jokes aside, they are very proud. And they're, they're so happy that I've just settled down with something that fits me and they there, they're not worried about it. I can definitely see your passion coming through. And I love that you. So care mentioned a little bit about her accent, as well. You both have that that you can connect on. Here's all the very good at that. But you know, how else did you to connect? How did you become friends? Wow, it's so Kara Oh, my gosh, this is the best story funny. So how I mentioned I nannied, um, the mom that I need for it was amazing. She was the sweetest person in the world. And she knew I was, you know, starting off as a therapist, and I eventually wanted to go into private practice, but I didn't know who to talk to. And she was like, Well, I have this one friend who knows someone that like maybe you can ask her for coffee, and you guys can meet up and curious. Okay, finish the story. I just I love Kira Yakubov: 13:14 telling Yeah, go ahead. Yeah, I'll tell you my take on it was funny. I know. Yeah. Leeor Gal: 13:19 I wonder what your take is. So I reached out to Kira and she was so sweet. So amazing. We met up at Starbucks. And we're talking were like really getting along and connecting and yada, yada. And I remember, like, Oh my God, let me add you on Facebook. And I go on Facebook. And I was like, Wait, we have this mutual friend. And Carrie was like, Oh, who is it? And I was like, Can I can I say the name? I was like Ron, I know Ron. And she was like, That's my fiancee. I was like, No. Kira Yakubov: 14:00 I was like, here we got no, I'm kidding. Leeor Gal: 14:04 It was like, well, Aran's parents, were best friends with my parents growing up. And I was best friends with his sister growing up. And I was like, Wait, you're dating. So crazy. So we have this like crazy connection where I was like, I cannot believe you're about to get married to Aran who was like basically a part of my entire childhood leading up to until I think he went to college and then, you know, people. People didn't go apart. But it was crazy. Kira Yakubov: 14:34 Yeah, that was so climber. I walked in, and I sat down. You're looking at me. And you're like, you look so familiar. I feel like we've met before. And I was like, No, I'm really good with faces. I've never seen you or met you before. I would know. You're like, okay, and then that's what it came off. You're like I knew I saw your face somewhere. And it was on Facebook from a Ron's page. So yeah, that's been funny, but we've been we You've connected and we've stayed in touch since then, just I mean, we're colleagues in the field, right? And we were just killing it. I mean, you're doing a phenomenal job. And like, I love watching your growth, from the beginning process to now because it's been incredible. And like you hustle, and you've been killing it. And I've, like I saw your journal is like that inspiration. Like, I want to start a journal and like, do that, too. So I mean, I think it's everything you'd be doing is really fabulous. And I'm so proud of you. Daniela Galdi: 15:28 Oh, thank you. Thank you. I feel like when if anybody ever doubts me at any point in my life, I have this like, weird thing where I'm like, Well, you know what, I guess I'm gonna have to prove you wrong. So I'll do everything I can to do that. I am raising my hand to that, because I feel that I feel that I'm like, Oh, you just said no, sorry. Now I'm gonna have to do it. Leeor Gal: 15:49 Okay. Right. Yeah, exactly, exactly. So that's probably something I need to work on. But not stuff done. Here we go. Can you tell us more about the journal? Yeah, so the reason behind the journal or the motivation behind the journal is I would have session after session with my clients just either struggling to, you know, process more of what we talk about in therapy during the week, or sometimes even think about topics to talk about, or say, like, I'm good, but then we find that there's a lot of things below the surface. And so I thought, you know, instead of me just telling somebody journal at night, whatever comes up comes up, because a lot of people really do struggle with that. I was like, what if I prompted people? What if I created a journal that not only allows you to include gratitude include, you know, how you self care, which the journal also explains and has inside of it. But also, I divided each w eek to a different theme. And then with an each week, every day of the week, there's a different journal prompt that you get to answer and sort of process and think about what it means to you. And it was all things to my clients that I was like, is, there's clearly a need for it. And people can do this and just sort of have it nearby or have it on their nightstand and check in with it. And yeah, that's sort of what prompted it. That's awesome. Kira Yakubov: 17:35 I love that. And even thinking about journaling. Great. I've, I mean, I'm sure you obviously now tell your clients and have before about journaling. I tell my clients all the time how powerful journaling is. And I think the toughest part of starting from me here, all my clients is I don't know what to write about, or I don't even know where to start, or how do I know how to reflect deeper, right? Like, how do I know how to prop myself to process even further to get to some of those root causes are just like bringing that awareness about what's going on for you. So I love that you use the practical work that you're in, found a need and was like, Oh, let me help people address this. It's awesome. Leeor Gal: 18:15 It's been good to my clients got it and, and they've enjoyed it. 12 weeks. And that's it. Daniela Galdi: 18:23 I love that I applaud you for that too, because it really put a lot of thought behind it and intention. And I love the parts about just taking people into like a deeper self awareness with that reflection that they can do with that. That's amazing. And we'll make sure for anyone listening, we'll make sure we have the link in the show notes as well. So they can check it out too. But let's keep going with this. I mean Kira, what do you I feel like you two colleagues, friends, but like any dying questions that you really want to ask Leeor? Kira Yakubov: 18:57 Well, I know that you know your trainings, marriage and family therapy, but who do you enjoy working with the best? Or what do you feel like your specialty or niches that you are just like? These are my people like these are my aligned clients? This is what I want to focus on. Leeor Gal: 19:11 Yeah, I'm, I'm really glad you're asking me this question. Because a lot of times people think that marriage and family therapists only work with couples and families. And that's really, really not the case. I think most of my client load is actually individuals. The thing that sets us apart and I'll go into my, my, my my niche. But I think that MFTs have this unique perspective that is more systemic as viewing the individual more as a part of their system rather than just the individual. And so whenever I'm working with somebody, I definitely take that lens of what made you who you are today what has molded you what has kept you grounded or made you feel about life, you know, and so I would say My My connection with like couples work and individual work is I really, really enjoy working with individuals around attachments around dating. Just as them as the individual and the relationship. I always invite their partner in if I'm working with an individual, and they're having relationship issues, so I have that training to be able to do that. And I really, really enjoy that I enjoy transitions, like from college to being a young adult in the in the work force, especially because I knew I had such a hard time with it. And I switched around and stuff. So I I really love, you know, working with teenagers and adults and dating transitions. And do you have a favorite like approach or method or philosophy behind this? Yeah. So I think that with each client, there's going to be a different approach. So if I approach somebody with an emotion focused philosophy, which is more emotionally based, I know that, you know, I am there, they vibe with that, meaning they might struggle with emotions, they might need more of that feelings wheel, anybody's fears, but that is just Google, it's really great. I love doing that. But if somebody is like, I know how I'm feeling like that, like, you don't have to explain primary and secondary emotions. To me, I know I read about it, we might, we might need to go, you know, a little bit different of a route. So it's, it's usually very different in terms of the clients that I'm working with. But what I always bring to the table is relatability, meaning I'm not judgmental. Honestly, I've probably done half of this stuff myself. And I like to meet clients where they're at, meaning, am I going to challenge you 100% 100%, but I'm not going to going to push you. So that's my philosophy of like, I'm going to challenge you, but I'm not going to push you because if I push you too hard, you're out of here, and then nobody wins. So I just I like to always check in with my clients, and just kind of, yeah, just feel them out, feel their vibe, and what really they're coming in for Kira Yakubov: 22:34 I love that we have such a similar approach and background. And of course, like the training with being a marriage and family therapist, is that relationships are so crucial to our growth and the fulfillment of our life. And I think sometimes it's hard because especially with dating, right? There's so many myths and like cliches like you have to be whole, you have to love yourself before you can date somebody else and to dig degrees, right? Like, there's a lot of different approaches to take with dating and having relationships be a huge part of the work that we do in those attachments. What do you feel like is a pretty common issue that comes up for your clients around dating? Leeor Gal: 23:20 So I feel like it's always about the games. Everybody feels like everybody plays games. And the more I think about it, the more I wonder if it's gay, or if it's boundaries, or if it's an avoidant attachment versus anxious attachment. I am always noticing everybody being annoyed by games but also playing the game themselves. And I don't have I wish I had like a like a lens to look at everybody and how everybody is but I obviously don't have that. But I'm very intrigued by that because I hear it over and over and over again. They didn't text me back or I'm not doing this or they just ghosted me or you know, they reappeared and data and I'm like, there's a different reason for each person. But it happens a lot and I think if I could take a wild clinical guess I think the dating apps and the availability of finding people in a guy just snapped but in the snap and and having somebody else there that might play a part of I don't need to commit because there are so many other fish in the sea. Daniela Galdi: 24:42 Y'all I am over here taking a hold in my laughter so I'll share with everyone Kira as you know here knows all of this but I'm actually I came into this episode a little nervous because I came from the relation Ship of 12 years and have been single for six months now. And finally feel like, okay, I could hang out with someone go for calling in a date yet, but I could. And so you know, when I hear you say all these things, I'm over here nodding my head like, Yep, I don't want to play the games. But here I am like, Oh, let me post this because maybe that'll get you know, I haven't tried the apps yet. But it's very hard to not internalize everything from somebody else's behavior, right? Because I feel like this is like a very vulnerable time. So to either of you have any thoughts on that on it? You know, is it even healthy to maybe internalize it? I mean, I'm, I'm questioning everything I do. And I try to let go, and then I find myself doing it again. So you know, what do you guys, what do you two think on that? Leeor Gal: 25:59 I think my favorite thing, my favorite response to that question is when we are dating, we are oftentimes constantly thinking about what the other person is thinking of us, rather than what we actually think about them. So there is a phenomenon, of course, where we want to be liked by others, we want to be, you know, whether it's chased or favored or wanted, that we lose sight of, Do I even want them? And going into these situations, whether it's a date, or whether it's the apps or whether it's talking about whatever going into it, like, well, how does this person actually make me feel this accident or making me feel like I have to like, go upside down backwards through loops, just to talk to them or get their attention? Maybe they're not the right person for me. So, always checking in with yourself? Yeah, I understand the internalization of it, of course. But if it's a person that constantly makes you second guess yourself or think some sort of way, maybe, maybe it's not you. Right, maybe it's not them, it's just not a match. Kira Yakubov: 27:14 I love that Leeor. And Danielle, thank you for being vulnerable and sharing that I think that's a really a big deal. So I appreciate that. And I think that's going to be helpful for the listeners also to connect and relate. I remember, when I was dating, and a piece of advice that I heard from somebody that really helped, is I also had like a very anxious attachment, I wouldn't be in my head, like, what are they thinking? What does this text mean? Like interpreting everything down to the team with the final goal of Do they like me? Right? And if they don't, what does that say about me. And this piece of advice I heard is, if you just meet someone, let's say it's a first date, first few dates, and you know, they end things with you and you feel rejected, they didn't really reject all of you, they don't even know you well enough to know anything about you. They just rejected the match. And that's okay, that doesn't mean anything about your worth your self esteem, what you can offer is just the misalignment. And that's okay. And that means that there are misalignment for you, too. I think a lot of dating is going to be rejection, because we only need to find one or two depending on your relationship structure. But not everyone's going to be a match and we don't have to have everyone like us. So I don't know if that was helpful. advice on that questionfor you. Daniela Galdi: 28:35 It was my my sarcastic response in my head was we don't Leeor Gal: 28:42 well, that's valid. That's that's sort of why I think Kira and I both touched on it is and I mean, here, I can't speak for you, of course, but I want to be liked by by everybody. But then I remember if I do that, that means I'm not authentic. Possibly blend in with everybody in this world. Simple. I love that. Thank you for sharing those insights. I don't want this to turn into like, dating one on one for me. But let's for everybody else, what are some some things that you like to approach or some healthy management tools that both of you can share for people in transition? Or you know, specifically with like relation any type of relationships? I think Kira sort of spoke to this a little bit before but the the idea that you need to be fully healed in order to be in another relationship or I always hear these like really random timelines of if you dated for one year, then you need to be single for one month if it was six years, six months. I mean, if it's, and I'm like, where, who, who? Because I like to meet them and I don't know, talk to them because To me, you don't need to be fully 100% healed, because that's impossible. So you will be single forever if that is the motto that you decide to take, because we, as human beings, heal in the context of others. And so, for waiting and waiting and waiting, there's this missing piece for us. Maybe that can be accomplished through another's secure attachment. Right, Carrie, I know you mentioned an anxious attachment 100%. I relate to that. That's why my partner is secure, attached, and he helped me name. It wasn't his choice. But we met, we fell in love. And I got to learn what it's like to feel secure and comfortable with him was I 100% healed when I met healed, quote, unquote, when I met him, you know, am I still know. And I know that I feel comfortable and safe and secure in this relationship. And things will still come up and fights will happen or arguments, but I know that no matter what I can always rely on this person. So in terms of dating, and starting to date, recognizing, like I said before, how this person makes me feel, and what do they bring to me? And yes, sure, what do I bring to them? But again, we're thinking of ourselves, we need to think of ourselves, first of all, do I feel comfortable with this person? Kira Yakubov: 31:35 I totally agree. And I love going into more of that healing part or feeling ready to be in a relationship. Because there, there will be a lot of work we have to do internally and individually, right? Like, there's this duality, like Austin relationships, and us on our own independent and finding a balance between those two is super important in life in general, but especially in romantic relationships. And so we might feel like we're in a good place, like, you know what, like, I get where some of my ships coming from, I've worked on a lot of things, I feel good, I feel ready to date, and then you meet somebody who might be great for you. And that might be a successful relationship down the line. But in the beginning, it's going to trigger all your stuff. And that's okay. And so that's kind of like, Leeor, what you're saying is we heal within relationships, too. There's no amount of work you can do prior that's going to prepare you for the work that has to happen within the relationship. And that person is going to be coming in with their own stuff and their own triggers. Right. So we meet each other where we're at, and we work through that phase together. And something I love to work on with my individual clients who are like, you know, what I'm ready to date or they're dating is creating a morals and values list for themselves about themselves, not necessarily about the person they're looking for, which is helpful down the line sometimes. But more importantly, like what are your values, like what's important in your life that you need, that you just know, you need that is like a non negotiable, that you know, is going to be fulfilling for you. Right? It's like, for example, I really need mental stimulation. And I need a lot of physical touch. And I knew like if those two things are missing, no matter how attracted I was, no matter how, like whatever it is, on paper, they look great, it's not going to be a good fit for me because down the line, it's just not going to be fulfilling. So it's kind of like knowing some of these things about yourself ahead of time. So that when you are dating, it's like does this match with who I am? And not just like the chemistry in the moment? Leeor Gal: 33:37 I think that that sort of also speaks to the games, right? Of an eye being a little hard to get and a little cheeky, or am I completely letting go of all my morals and values in order to match up with that person? Right, like, oh, I don't need a text back. But really, you you do need somebody to check in with you. You need somebody to check in with you. And that's okay. I'm sure there are other people out there that probably feel the same way. Kira Yakubov: 34:08 And that goes into I mean, at least for us I know like the anxious attachment secure attachment avoidant. Right. I think that a very common dynamic that happens is the avoidant, someone who has an avoidant attachment is dating someone who has an anxious attachment. Because the beliefs we have about ourselves in relationships, we live out and confirm them subconsciously. Right? So I mean, if we are, if we grew up with the narrative that I have to earn love, and I have to really put in a lot of work to feel worthy will attract somebody who is expecting someone else to do a lot of the work in the relationship and be chaste. And that confirms that belief over and over again. But guess what? It also confirms the belief that when someone comes too close, I need to pull away and I have to chase Chase Chase, right like we just keep getting stuck in this cycle. So I think for you, you're what do you do when you see this kind of when your clients, whether it's in couples work, which is a lot more interesting or an individual work when you just have the one person with you? Leeor Gal: 35:13 Yeah, so I think the clinical term to this is the intimacy dance of the pursuer and the distancer. And I believe that also comes from Emotionally Focused couples therapy. So, it's, it's definitely something that I oftentimes see. And I think what what is a great tool or a coping skill for this is to first of all, if you're in therapy for the therapist to call it out, right? Like, hey, I'm noticing this. What, please explain to me why this is, you know, what's causing this to happen, where this is coming from. And typically when we understand what has caused our attachment, or what is allowing us to lean in more towards whether being anxious avoidant, secure, you know, whatever disorganized, we can understand how to heal it. And so for me, it's number one, a baseline foundation is, like I said before, what has made you who you are today. And attachment styles are oftentimes created in childhood. But they're not necessarily just an A broken attachment or unhealed attachment with the caregiver. But rather, you can have a secure attachment with your friends and an anxious attachment with a partner and an avoidant attachment with parents. It's what has affected you, how were you more ft, and how people in your life reacted to you growing up. So I always that is my number one technique to understanding and healing attachment wounds, especially in couples, if I'm doing couples therapy, and helping the other person understand each other and sort of just literally drawing it out and explaining this is what's happening. But I don't care if you have a different method and love to hear that. Kira Yakubov: 37:07 Yeah, I mean, that's pretty spot on, right? Like we take a lot of time to explore, you know, those beginning relationships and attachments. And I love that you mentioned, your attachment is, first of all, it's not stagnant. It's not something that's like stuck on you for the rest of your life. And it looks different within different relationships. Right. So I had a lot of secure attachments with my friendships, I could trust that they'll show up for me, I could trust to be myself and share my emotions, right? Like, if I texted them a lot, they knew like, I didn't feel like I'm being needy, because they needed the same amount of attention as I did. Or if they didn't, we just knew and there wasn't a judgement, right? But when you're starting to date, that attachment can look really different. So I think understanding what the emotions are that are coming up for you, what are the beliefs that you have around yourself and other people, and trying to kind of challenge those and poke, poke at the flaws in the thinking, right? Because these are narratives that have just been conditioned, but they don't have to necessarily be true. And accepting that, like, if you have these particular amounts of needs, like that's okay. It might seem needy to someone who a doesn't have the same amount of needs in that capacity, or they're just not willing to provide it. And that's okay. But it doesn't mean that you're needy, just means your needs are going on met. Exactly. We're in differentiation, Leeor Gal: 38:31 right, you're not needy, you just have needs area. Daniela Galdi: 38:36 I love that I love I feel like we need to put that out into the world, you're not needy, you have needs. And it's very real thing, right? It's a real thing, not anything we should feel shame or guilt for. And I believe, I really do feel you both did a great job, like through explaining the attachment styles and the inference with using your examples. But just to briefly recap for the list of there's, if one of you could share maybe an example, maybe let's use texting since it's so common, right? brief examples as to, you know, the different styles of attachments you mentioned, and what that looks like. Kira Yakubov: 39:14 So if we're even using the example of texting, right, let's say you just went on a first date, it went great. Okay, and now the texting, the waiting that all that stuff begins, right, the contact between the people. So I think if you happen to resonate with an anxious attachment style, you're going to be preoccupied, like almost hyper fixated on, are they going to text me should I text them? If I am going to text them? How long should I wait? Is it going to come off to forward? How should I say this? I'm going to text all my friends and ask them what I should say. And then let's say you get a text back or it's been an hour, you might be freaking out like okay, I said the wrong thing. What are they going to say? Maybe they don't like me. It's really just like this preoccupation. It's really this hyper fixation on the other person and what they're thinking about, and how that is going to result. And if they care about me or not, right, it's, it's like this external view of what the other person is looking for and needing and feeling versus our own self. Whereas let's say you might resonate with an avoidant attachment style in dating, it might look like, I can go all day. Yeah, that person was really cool. I really enjoyed their energy, but like, I don't need to talk to them. Today, I'm going to do my own thing. I'm going to, you know, focus on my work, hang out my friends. Oh, yeah, they popped into my head, let me shoot them a text and say, Hey, and they might start texting you back immediately. Like, you just said, Hey, and they text you back. Okay, what's going on, when you want to hang out again, you might feel like, oh, that's like, a little much. Maybe they're kind of clinging, maybe I should take a step back. But I did like them. But let me just take a step back to like, let them know to chill. And if you have a secure attachment, you're probably not thinking of any of those things. Like, I really enjoyed my time with them yesterday, I want to let them know I had fun. I'm going to see when they're free again. And I text them and I go on about my business. And then when they reach back out to me, it's like, awesome, we're on the same page, let's meet up, or they might not be. And like, that kind of sucks. All right, on to the next. There's so I don't know who you are you kind of vibe with that. Or if there's like a different example, you have your own? Leeor Gal: 41:28 No, I fully fully agree with everything that you just said. And I think what's happening with either anxious or avoidant attachment is there's a lot of unspoken things that we assume the other person should know. Meaning, I'm not going to, you know, from an avoidance standpoint, I'm not going to respond so that they know to chill on that saying that I'm doing that with my actions. And instead of that being conveyed to the person that is anxiously attached of, well, okay, maybe we need to like, chill a little bit. They're like, they hate me, I have to make them love me now. So I'm going to pursue them more. And it's not on purpose. And it's not, you know, like, I'm speaking from an anxious perspective, because I was like, it's not out of malice. And and that's the thing, both parties, it's not out of malice intent, it is just this like, non communicative communication, that does not work. It just doesn't, we have to communicate, always. Wow, so interesting. So we're aiming for secure attachment. Kira Yakubov: 42:45 So secure attachment can be built, right. Like I said earlier, it's not something that's stuck on you. And I think it becomes easier to build that when you find someone who does have a secure attachment, or is at least working towards that, or has moved through their own stuff, or at least is aware of what they're coming in the relationship with and can experience and share that with you. Like, I also had a very anxious attachment. And I still do sometimes, right? Like, there's still remnants that come up and trigger me every now and then. But when I met my now husband back then, like he had a pretty secure attachment. And like, that was probably the hardest relationship to start. Because I was like, on guard, I was looking at like, Oh, he's saying all these nice things, he must be lying, or he must be trying to put the charm on me. I'm gonna wait. Right? All these things. I think that one is the toughest relationship, after having so many bad experiences, the healthy one, because now we're expecting it. And the other person is like, No, I'm just here, I just really liked you. I just really enjoy your company, there's nothing extra you have to do not to earn my love in any way. Right? Like it has to be reciprocal, you know, in that way, but it's not games. And there's something that he said, I really love this part, just because for all those listeners who have trust issues based on their past experiences, is a lot of the times I would meet, I would meet people on dates, and they would try to convey like, I'm trustworthy to say that, like, oh, you can trust me, we have all these future plans together before they really knew me. And the beginning, that would be a hook, right? Like, oh, my God, they liked me, because that's what I needed to hear. But then I started to be like, Oh, you don't know me well enough to tell me these things. So then I would be a little thrown off. And then when I met Iran, when I expressed some of these trust issues and fears, he said, Can you just give me the opportunity to prove it to you? And I was like, I like that answer. That's a good answer. Okay, I'll give you the opportunity. You're not trying to tell me that I can trust you. I'm trying to put the charm on you're just trying to you just want opportunity. And so I think kind of looking in the lens of how we were still like how do you feel around the person like is it mixed messages or does it feel sincere and giving it some time? See if the words and actions line up and are congruent to what's going on? Leeor Gal: 45:06 I think you're what you're describing, too, is what is now termed as love bombing. Hmm, yeah, I just met you, but you are the most amazing, awesome person, we're gonna get married and have all these kids and a life and you're like, okay, like, it's been one date, but all right, um, and then it doesn't, it doesn't, they don't show up in that way anymore. And so for whatever reason, that is, you're right, like, allowing somebody and us ourselves as well, of proving our loyalty and our trustworthiness to someone, it's a whole part of the process of dating. Daniela Galdi: 45:54 You too, have both shared so many valuable points, I keep thinking of so many people, I'm like, I'm going to have to send them this. Because we all just sit here this. And it's just, it's amazing to hear that there is there's ease with what you both say, I have to be honest, coming from this perspective of now, you know, newly going into the dating world, and I'm definitely going to say that I have an actual anxious attachment style. You know, so going, going into it all it's, it's, it brings me ease, and hopefully ease for other people hearing that, you know, therapists such as yourselves can help work through this with somebody to just get them back to what I'm hearing is their own needs, right, their needs and being straightforward. And as as honest as possible, and building the practice and the courage to express those needs and express any type of communication and, and so, you know, take away all of these other things that I have also flooded here with before, you know, what if it's love bombing, oh, my gosh, I have to worry about STDs. Oh. So many things come up with dating, I really appreciate what you two both focused on with the attachment style. Because it does feel like you can you can work to understand this to not actually make your mind go on overload with how much goes into now. Just simply finding out if you like the person's company, like to me, that's, that's the main thing is like, we want to know your needs. And first and foremost, do we do we have those in common? Do you understand that? You know, it's, I'm blabbering a little bit now, but it does, it does bring me a lot of ease. Leeor Gal: 47:51 I'm actually really glad that you brought up sexually transmitted infections, I think that that is a huge taboo topic that people are so afraid to bring up. So when we're dating, and we are sexually active with somebody, it is appropriate, not only to ask them if they have been tested, but to tell them to get tested before being intimate with you. It's not worth going through the hassle of things, when it could just be a very simple conversation, whether you guys go together or separate and send each other pictures of the negative test. And if it's positive, thank goodness, we checked it out. But having those hard conversations to when you're dating to protect yourself, your body, your mind, that is more than appropriate as well. Kira Yakubov: 48:50 Absolutely. And those are important, very important conversations in the beginning, that can be super awkward, depending on your level of comfort, the other person's level of comfort, how you just met, right? All of these different factors can make you feel uncomfortable. And I think it's also an opportunity to see how each of you respond and react when there's a tough conversation. I think that's a great way as a stress test, almost like, how does this person react to a request or a need that I have to feel comfortable to continue pursuing this? Right? That's a huge indicator if they are someone who's emotionally safe, or perhaps not at this current time. And I think it's also important to recognize that if someone does have an STI, that doesn't mean they can't be sexually active or they can't be in relationships, right. Like I think it's important to disclose certain information, but for other people to recognize like there's still other ways to go about this. So it's not about if you do have an STI that like this was done, right? For some people that might be you know, a hard line and that's okay, we all have our boundaries, but for other people good okay, like let me do a little little bit of research and like understanding about this, like, maybe it's not as bad as I think or how I was taught, however many years ago when are horrible sex ed in high school or middle school, right? Like, having these conversations about sex is going to be really, really important too. So that's a great feature that I'm glad that you brought up, actually, because it is something that people think about while they're dating. So we are I know you also work with couples. How does this show up in the room for you if there is something going on with intimacy? Or do you work with couples around intimacy? Leeor Gal: 50:34 I do work with couples around intimacy. But if if because I was not sexually trained, meaning I did not specialize in sex therapy. Wow, that was a weird way to put it. But all right. Kira Yakubov: 50:47 [unclear] trained differently. Leeor Gal: 50:56 Yes. As you guys are wondering what we learned in school we are [unclear] trained. No, I'm not, not a sex therapist, because I have been more towards the family route. But so if it is something that feels out of my scope of expertise, I always refer out. But if it is more of communication around sex, or sometimes mismatched intimacy or desire levels, that's something that I think is appropriate. And honestly, something that a lot of couples go through, I would say, probably, every single couple have ever worked with sex and intimacy has been a topic, no matter what, no matter what. So how do I work with that? I mean, again, baseline we start with can you communicate? And then after that, can you communicate about specs? And then after that, what are your desire levels, right? It's not necessarily a drive of like, I like when I think of drive, I think of like, I need this, like, if I don't have this, I'm not gonna survive in this world. Like, I have food drive, like I need food to survive, I have liquid drive, I need water to survive. But sex drive, I mean, the drive to have sex is going to look differently for everybody, because it's not something that we need to sustain, to to live, are going to sustain us living wise. So I think that that is ultimately also some psychoeducation around intimacy and what it means and also what it looks like, is it just penetrative sex? Or is it you know, I like to say all of the bases, right? When we grew up, we learned about first second third, hold on, right. So what does it look like to you, and especially with people with different sexual orientations and same sex couples, or, you know, relationships, different types of relationships, right, it's going to look differently for everybody. So just understanding that just because your best friend had sex six times yesterday, doesn't mean that that's the norm. It's just the norm for them. Daniela Galdi: 53:11 So this has been amazing. We are coming towards the end. A quick question, though, that I want to ask you. Leeor, what is something that your clients might not know about you that you would love them to know? So that they can just, you know, get to know your personalities more or your interests? Leeor Gal: 53:38 I think, you know, because I'm so open on social media. I very rarely, like leave things out. I mean, of course, if it's going to be damaging to my clients, I don't talk about it. 100% but on social media, I'm very open on like, my struggles and like what I go through, but I think what I've noticed is that you will have a very different perspective of who I am versus actually who I am. And it makes me think of I don't know if you guys are on like Tik Tok or Reels on Instagram but of that like sound that's like, never know you're there. Like never let them know your next move or like something like that. And I feel like that's me of like, I wear so many different hats like but that's authentically to who I am like I still own with my morals and values but like I I was the kind of kid that like, I never got a detention but I was 100% rebellious and like I did like not bad things but I wasn't like sitting at home studying and like such a goody goody but this perception of like therapist and to be this like perfect, like, I know how to act and like I'm so amazing at myself care like, Oh no, I just like ever But he else make mistakes, react, rather than respond. And I think that that just I like to say that to remind everybody that we're all in this together like, we're oh my gosh, now I'm thinking of High School Musical because[unclear] they had a great point there because we really are nobody is better than anybody else. We're just all trying to figure it all out. So yeah, I feel like that's, that's it about me is I'm perfectly imperfect. I don't know. Daniela Galdi: 55:43 I think it's beautiful. It's I have to tell you, when I talk, I talk a lot with people about you know, encouraging them to continue with any type of professional help. And I do find myself at times I feel I feel bad because I feel therapists you all do get a lot of pressure put on you and I find myself I try to have your back. I felt you know, like, yeah, okay, well, you know, they might have just been having a bad day they are human you know, because the the slack so so I'm glad that you shared that with everyone have like that real that realness. So thank you for sharing that realness about, you know, there's, there's times that you both are human, although you both I'm assuming do amazing work, although I'm not one of your clients, you know, but you're still you have that there's those imperfections and you're working through it with us, too. Kira Yakubov: 56:41 Right. Leeor Gal: 56:42 Thank you. Kira Yakubov: 56:44 Leeor, thank you so much for being on today. I didn't even realize the time went by cuz I feel like we could have just kept talking about a million other things. I did want to mention real quick about you because I know that you just expanded to another state and other physical locations. So if you want to share with the listeners, how they can reach you and where you're providing your incredible services. Leeor Gal: 57:05 Yeah, absolutely. So we offer therapy and Pennsylvania and New Jersey. We have a physical location in Devon, Pennsylvania, which is on the Maineline if anybody is familiar with that and if you are looking for me just type in thetherapygal.com Gal because my last name is gal so that is the thought behind the name. And I'm also on social media but it's on Tiktok and Instagram is a TheTherapyGal and you can fill out a contact form or give us a call and we will help actually with the best fit therapist. ### Listen - [Spotify](https://open.spotify.com/episode/12876065) - [Apple Podcasts](https://podcasts.apple.com/podcast/12876065) - [YouTube](https://youtu.be/5RsgMm3ntSA) --- ## Movement Integration & Couple Support Through Life Transitions - URL: https://healyourrootspodcast.com/episodes/movement-integration-couple-support-life-transitions - Published: 2022-10-26 - Season 1, Episode 6 - Duration: 37:28 - Category: self-care - Guest: Lindsay Bauer ### Summary Exploration of genuine self-care versus temporary self-soothing, with practical strategies for sustainable mental wellness practices. ### Description Self-care has become a buzzword, but what does it really mean? This episode explores the difference between genuine self-care and temporary self-soothing, helping listeners develop sustainable practices for mental wellness. Discover practical self-care strategies that go beyond bubble baths and face masks to create lasting positive change. ### Transcript Lindsay Bauer: 0:03 When I use yoga for trauma, people can experience and unlock things in their body than just talking about it. Kira Yakubov: 0:18 Welcome back to Heal Your Roots Podcast. I'm Kira Yakubov, Founder and Lead Therapist at Heal Your Roots Wellness. Today's topic will be covering the connections we can make to help improve and manage our health from a mental and physical approach. It'll also take us on a sensitive topic of infertility, quality of life and accepting our worthiness despite challenges. I'm very excited to bring on Lindsay Bauer today. She's the founder of Yogology and a Licensed Marriage and Family Therapist. So thank you so much for being on today, Lindsay. Lindsay Bauer: 0:51 Hi. Thank you for having me. Excited to be here. Kira Yakubov: 0:55 Yes. So what I typically like to ask guests the first time, or the first question really is what got you into therapy, like how'd you become a therapist was kind of like your origin story of this process. Lindsay Bauer: 1:10 So there's many stories. I feel like from different stages of life, it kind of redirected my path and my career, but I will say, My parents divorced when I was 14 has a lot to do with it just because it gave me perspective about relationships. I didn't know it at 14 years old. But my mom says, and I vaguely remember you had at that time, when your parents went through a divorce, and there was custody, you had to go to group counseling. I just remember court ordered it. And I took the stance of helping other children. I remember sitting at a like a big table and kind of saying like, you know, if our parents are happy, maybe this is healthier in the long run. And the counselor had reported that to my mom, and she still brings it up. She's like you were always a little therapist. But I will say when I was in undergrad, I had done, I was a psych major. And none of the classes were interesting me at all, like abnormal psych. I think Industrial Organizational Psych was fascinating. But I just wasn't finding something that I felt a career. And then I took a family theories class, and it had to have been combination of like the professor was amazing. But I did every single reading every single homework assignment, nothing felt dreadful, or like I needed to procrastinate just felt natural. So when I graduated, I was like, Oh, I'm going to look for marriage family therapy programs. So I was in combination of that. That's kind of what led to me becoming a psychotherapist, and not like a psychiatrist, or one of the other avenues in the field. Kira Yakubov: 3:07 I love that, so it was already like a natural part of your being very mature, like, everybody, we shouldn't really we should consider our parents and their happiness. Lindsay Bauer: 3:17 Or just like the health of it. Not every negative thing is the worst case scenario. Like who thinks of that at 14? Kira Yakubov: 3:26 A mature Lindsay Lindsay Bauer: 3:28 A therapist in the making Kira Yakubov: 3:31 That's awesome Lindsay Bauer: 3:32 Yeah, so what was it like for you when you went through grad school for the marriage and family classes because I also did that track and found that to be one of my favorites. Like, I really enjoyed abnormal psych because there was a cool learning about, we learned about like, different famous people throughout history and like they're disorders which was intriguing, but not something I necessarily wanted to do. So I'm curious of what it was like when you did have the the marriage classes because I know you're also a couples therapist. Yeah, I thoroughly enjoyed graduate school. I think it was one of my biggest growing experiences. professionally, personally, I don't know about your program, but we were asked to do a lot of the digging and the deep diving work that we expected to take clients on. And it was life changing. So yes, personally, I think that it was just an experience that I would never ever ever be who I was today or be the therapist I am today without that program. And we took we had a two tracks and I took the track families in conflict. So that talk was specific about blended families, families, fours, etc. So kind of bringing in that marriage component when I work with couples. I think that people It really helps. And that was something I really took from the program was like, Some couples come to me, they've already decided on divorce. Right. So I talked to them about their civil ways to go through divorce. And also how are you going to portray that to your children? Sure. So yeah, I would say that was, that was pretty monumental for me and the program. Kira Yakubov: 5:22 That's really cool. We didn't have a separation in the track for marriage and family therapy. And we didn't talk a lot about, like the divorce process. It was more about the marriage and keeping, you know, couples together. And like family therapy, whether it be like, you know, if there's a child identify patients, stuff like that. So that's really interesting that they really have we went into, like, divorce and blended families and how to go through that process. Lindsay Bauer: 5:50 Yeah, yeah. That's what I found fascinating, too, was like, Hey, we're not going to keep everybody together. Yeah. And that took the pressure off. I remember one of my professors saying, Hey, your goal here is not to make everything feel pretty afterwards or perfect afterwards. In fact, you know, some people are going to come in already with their minds made up that divorce is the only answer. And sometimes that is the only answer. Yeah. So I was glad that they gave us the tools then to equip a family with or when they have chosen to separate hmm. Kira Yakubov: 6:26 And it's fun to use as a deep dive work in grad school, because we talked about this in the last episode, but I laughed because it was like, our own therapy, right? Like you have to be extremely vulnerable and raw. And like, write papers about your own life, your like family of origin. Talk about it in front of your classmates. Yeah, it was like straight up group therapy. In grad school. Lindsay Bauer: 6:48 We had. Did you take a sex therapy track Kira Yakubov: 6:53 So I did postgraduate sex there. But we just have a human like one human sexuality class and grad school. Lindsay Bauer: 6:59 Okay, so we had a sex therapy track, which is not what I was on. Because I did the families in complex. The we still were required every student to do a sex therapy class. And we had to watch porn. Oh, yeah, Kira Yakubov: 7:16 that was fun. Lindsay Bauer: 7:17 That was something else talk about like group therapy, but watching porn together. Quite an experience with with professors in the room. Kira Yakubov: 7:28 That's so funny. I remember when I went through my program, we had to do it. It was like my classes at 9am. And that was like, almost not every week, we would have to do that. But a lot of weeks. I would be like texting my husband, my boyfriend then was like, yeah, we're just watching like anal porn at 9 am. Lindsay Bauer: 7:45 Good day Kira Yakubov: 7:46 Yea, good day. Just assessing. And for the listeners, the reason we do that is basically to normalize different types of sex,,sexuality, orientations. And while you're talking to clients, because it's like, sometimes it could be a taboo topic, or you just feel uncomfortable talking about sex. If your clients are talking about sex, it's going to be really tough to help navigate that if you freeze up or you feel uncomfortable hearing like words like pussy, right? Like, you would have to like, say them over and over. Lindsay Bauer: 8:17 Yea! Kira Yakubov: 8:18 I don't know if they did that in your class. So Lindsay Bauer: 8:19 yeah, the desensitizing basically. So I've had couples or even individuals come in, and they want to talk about their own personal masturbation, I mean, talk about like, vulnerability. Kira Yakubov: 8:31 Yeah. Lindsay Bauer: 8:31 And if I start to get, ooh, they're going to clam up right away, they're going to be out the door, or they're never going to approach that topic again. So it is important that you get comfortable with how you initially feel about sex. Is trauma related to it for you is, is it something that was taboo growing up? And we don't talk about that? Yes. Names for any parts. And, you know, so that was that class was really helpful for that? Because it gives me languages and comfortability to take clients to places that are therapeutic. Kira Yakubov: 9:10 Yeah. And especially if you're working with couples, right, but that's what I found, like, we only have that human sexuality class in grad school, and you work with couples and sex is going to come on. And we can't be like, Oh, I don't work with that. Talk to somebody else when it's so intertwined with your relationship. Lindsay Bauer: 9:28 Relationships Yeah. Kira Yakubov: 9:28 Yeah, absolutely. Yeah. So speaking of that piece of it, I also know that you are a yoga instructor, and that you do a lot of mind and body work. And so I'm curious if you can share a little bit about how you got into that. Lindsay Bauer: 9:42 Absolutely. So I've always had this pool towards yoga. Not as a kid that was I don't think I even know what yoga was as a kid but undergrad, I would play around with who exercises in college regularly. So if I ever did exercise, I would always be pulled towards yoga classes. And that was 2000. And I'm revealing my age, like 2007, eight, and I don't think yoga was as trendy as it is now. So I was just gravitating towards yoga. And then after, after graduate school, we did have illness, like I forget the name of the specific class, but it was like chronic illnesses and therapy, and that instructors started introducing mindfulness and how it can help with illnesses, anxiety, etc. And I remember feeling naturally pulled towards that I remember we'd have to go through scripts and take people through mindfulness exercises, and people just be like, Whoa, see, like, that worked. And so that was another experience where it just felt I was a passionate about it, but I also felt good at it. And when you're good at something you like it better. Kira Yakubov: 11:08 Yeah. Lindsay Bauer: 11:09 Yeah. And then traveling. So I got my yoga teacher training in Bali, Indonesia. That sounds like a dream. It was and it was a month long, immersive program. So when you do something like that, and you're immersed in, it becomes you. And I think when I came back, I was changed. I was like, Yeah, that's exactly when I started a private practice. And said, it's gonna focus on mind body. Kira Yakubov: 11:35 Oh I love that. Lindsay Bauer: 11:36 Yeah. Kira Yakubov: 11:37 That's so cool. How was your experience there for a month? I mean, I'm jealous. I always wanted to go to Bali. Lindsay Bauer: 11:43 It's beautiful. It's so it was very, we were on a schedule training programs. So do I wish that I would have extended and maybe travelled around a bit more to experience Bali as a whole. But we have like days off and we have lunches and stuff and we'd go into a blue the town and just very yoga friendly. Like they had yoga studios all throughout. There's something there's spiritual about Bali, very warming very, like you walk through there just feels like love and beauty the smells. Everything was so floral and green. And oh, I loved it. The food? Not so much. You know, and when I travel food's very important. And I typically fall in love, but I didn't. Kira Yakubov: 12:39 That's okay. Lindsay Bauer: 12:39 Yeah, Kira Yakubov: 12:40 I was about to close my eyes and like, have you paint the picture? Being there, Lindsay Bauer: 12:44 the rice fields, and the cafes where you're overlooking like Land. Kira Yakubov: 12:50 Sounds so nice. Lindsay Bauer: 12:51 It is. It's a beautiful place. Kira Yakubov: 12:54 And I know with yoga, I mean, any kind of like, mind body connection, considering being like, mindful. I know that with trauma work, it's in our body, a lot of it's in our body. And like, while talk therapy has its place, and I think can be super beneficial in recognizing triggers, understanding how to cope and like just having language for what's going on. Have you found that yoga has really helped with working through trauma, just like an experiential part of it? Lindsay Bauer: 13:24 Yeah, absolutely. So I think like, like, like, you're saying how trauma, it gets stored in our bodies. And you ask someone to talk through it. And either they're immediately rushed with triggers, and they shut down, maybe a panic attack, because you ask them money to feel it in their body, it just has a different experience than talking about it. And yoga. So there's, you know, the difference of mindfulness or meditation exercises, which are very beneficial. And then there's yoga, which is a little bit more like movement, meditation. So what I noticed is, when when I use yoga, which I would like to use more of, but when I use yoga for trauma, people can experience and unlock things in their body than just talking about it. So for example, I have a client who carries a lot of trauma in their shoulders. Yeah, you wouldn't if you went into a therapy office, you wouldn't expect to be talking about oh my traumas in my shoulder. But I get this person to think about that. Where do you feel it most like my shoulders are just always tight and it feels so uncomfortable and when I'm triggered, they feel tight. So I focused yoga poses that help release some tension in shoulder areas. So these three specific stretches or poses. So there's a chunk of app, right? Let's go to the ailment, let's go to the area that you're carrying trauma mostly. But then there's also the component of like I said, mindfulness movement. So yoga is meant to like, you move with your breath, you you stay in opposed. And notice everything that comes up in that pose. And what that does is allow you to tune into your body, it allows you to tune into your struggles, it allows you to tune into so many things happening, but it also feels like nothing's happening the same time. So you're in control, interest, and what what happens with trauma were out of control. So you're teaching someone how you can have control again, even in the toughest parts of your body. Kira Yakubov: 15:43 Yeah, that's so beautiful. That's, Lindsay Bauer: 15:47 it sounds like you want do yoga. Kira Yakubov: 15:49 [Laughing] Lindsay Bauer: 15:50 I do too[Laughing] Kira Yakubov: 15:52 As we were to talk about that, like, that's where I store all of my, like, emotional distress. And just regular stress is my shoulders, and my neck. And I recognize that. So like, as I was traveling, I felt like, you know, whenever I'm like carefree, and like, I didn't feel any pain, I was there. And then I came back, and I started doing sessions again. And it's a lot of emotional energy. And I just felt my shoulders lock again. And I was like, Oh, crap, like, I need to stretch, I need to do more yoga. Lindsay Bauer: 16:29 And then it's cyclical, right? So I personally hold it in my shoulder as well. And then I get like, really bad tension headaches. Kira Yakubov: 16:36 Yeah. Lindsay Bauer: 16:36 Or when I sleep, I wake up with a kinked neck. so then there's actually pain, not just Kira Yakubov: 16:40 Yeah, discomfort or achy. But then when you're in pain, or you're achy, you're in a bad mood. And then a bad mood kind of prevents you from doing the things that make you feel better. And then it's, it can be very cyclical. So I just, this is why I love doing mind body because it gives a little extra healing that if it goes missed, it could just keep you in that pattern. You and I met in Center City, Philadelphia, when I was renting space from you. And your office, which was I'm so sad that it's gone to the pandemic and everything but it was such a beautiful space. And you had a dedicated space for doing yoga with your clients. And so I'm curious, do you bring in any of that talk therapy in those yoga sessions? Or is it kind of like separate? Like the boundary between when we're in talk therapy? We're talking when we're doing yoga? That's what we're focusing on? Lindsay Bauer: 17:46 Yeah, so it's yes and no, there have been some clients that have been open to being able to talk through it during happening during the yoga poses. So for example, a client of mine was getting into inversions, and inversions, for a lot of people are a fear Kira Yakubov: 18:07 What is that? Lindsay Bauer: 18:08 going upside down. Oh, yes, man's hand stands. Shoulder Stand, so anything upside down, but I have a lot of props, which can help people get into it safely, and then also feel completely supported when they're in it. But I'm telling you the fear of even kicking a leg up, you know, holding them. Kira Yakubov: 18:32 Yeah. Lindsay Bauer: 18:32 So there are points where have someone almost have a little little mini panic attack And then we talked through it in that Kira Yakubov: 18:37 Yeah. moment, I said, you feeling fear. And how impossible does this feel right now and get through, you know, just talk through it process through it. So I've never really had an experience where we start talking about their parents conflicts and how it felt abusive, and in their relationship during a yoga pose. But things like fear or trauma, or what are you holding on to in this moment? That makes sense. It's not the same as like, talk therapy is like really diving into a past story as much. But it is kind of like, what are you feeling in this moment? Do you struggle with fear through a lot of parts of your life? Do you see? Do you find yourself stopping yourself when you get scared? Wow, Lindsay Bauer: 19:24 yeah, Kira Yakubov: 19:25 I feel like I'm gonna have to like book a session with you after this, but that's wonderful. So it sounds like it's it's not about the past or the future. It's more about like the experience right now. And it's very therapeutic. And like, bringing that connection and having them be aware and move through it and get through it with someone that's there to support them. Lindsay Bauer: 19:46 That's it. Yeah, that's exactly yeah, Kira Yakubov: 19:49 that's awesome. Lindsay Bauer: 19:50 Right. Well, how important is the present moment? Kira Yakubov: 19:52 Yeah. Lindsay Bauer: 19:54 This moment, Kira Yakubov: 19:55 yeah. And so I know as we talked about, you work with couples How How do you do that with couples? Do you do the mind body and yoga work with couples as well? Lindsay Bauer: 20:06 So, I've always wanted to do couples yoga, and I have not. So that is something that I'm still going to work on and expand and kind of fit into my practice in the future. It's a dream. But mindfulness gasps almost every session. So and you probably do this without even knowing but a lot of times with emotion focused therapy (EFT) or Gottman method, there's a lot of stuff with the Gottman method, you know, when there's the shutting down, and then they we instruct the partner who's shutting down or feeling overwhelmed or flooded to do a self soothing exercise; that's mindfulness, right? Or sometimes I see my couple getting into a high conflict, and I can feel the tension rising. And I'll just pause in the moment and we'll do a breathing exercise, or sometimes just my language of can we just pause and what's happening right now for you? A what's happening for you, B? And get them in tune with their emotions? Yeah, take a moment and talk from this calmer place than the escalated place so that that's mindfulness. Are they sitting there meditating together? But I mean, could they? Yes, I've, I've created I've recorded a couple's meditation for couples to use. And so far, it's helped one couple. Kira Yakubov: 21:31 That's cool. Lindsay Bauer: 21:32 Yeah, yeah. So they like hold hands. And they lay or sit together, and then just listen to the guided meditation. Kira Yakubov: 21:39 h, that's so sweet Lindsay Bauer: 21:41 it is really sweet. They there was that it was it was lovely. And they felt super connected. Yeah, there's a part of it where you feel the heartbeat of your partner through your mom. So that kind of connection of the heart. Yeah, combining the heart reduces tension and reduces anger and kind of promotes more love and acceptance with each other. That is so sweet. Kira Yakubov: 22:03 I'm gonna like look at my husband back here and say that we should totally do that. Lindsay Bauer: 22:08 Yeah, I'll send it. Kira Yakubov: 22:09 Yeah, I love that. It's awesome. And so, I mean, I love that you take that approach, because I know a lot of talk therapy is, you know, processing through the motions, like figuring out the cycle that couples gets stuck in, where you're really like, in the moment what's happening right now. And then not even just working through conflict, but like, how can we build more of that connection and vulnerability and love? Which I feel like sometimes I think couples therapy gets a bad rap or like, some of the stigma is, we're only talking about the conflicts so the things that aren't going well. And we do also focus on like, Well, how do you become more connected? How are you intentional about spending quality time being present for each other? Lindsay Bauer: 22:54 Yeah, right. Like, couples therapy is work. Kira Yakubov: 22:58 Yeah, Lindsay Bauer: 22:59 it is a lot of work. But it's also connection. And there's rewards to it. Right? Like couples, sometimes I think, I model or tell clients, when they sign up, I'm like, listen, there will be days that this feels like work, like you will fight in a session. However, there will also be days where you feel like you've learned more about your partner and you feel more connected, or maybe even more in love with them. Imagine. So just there a couple of therapy's rewarding. It's like a little retreat. Kira Yakubov: 23:33 There's definitely sweet parts ofit. For anyone who's listening, thinking. It's hard, but definitely very rewarding and worth it. Lindsay Bauer: 23:41 Correct. Yes. Kira Yakubov: 23:43 So I know that part of kind of what we discussed prior to this is another focus that you have kind of spent some time diving into is some infertility and working with clients who might be struggling with that origins trying to get pregnant and kind of what that looks like and feels like for people. So can you share a little bit about kind of your journey with that? Lindsay Bauer: 24:12 I'll start with why I came to it, why it's something that I specialize in. And that's something that I started opening my practice up to, I went through it and it's it's a long battle. And it does, it feels like a daily struggle, a monthly struggle. Um, so being personally exposed to almost like being personally exposed to my parents divorce, it gives you a strength, it gives you a leg up, it gives you something that you want to spread understanding to other people and as a therapist, I have that platform to do that. And I'm just passionate about this field. So yeah, I'm opening that up for couples. I've seen a couple at this time. So it's still fairly new. But yeah, it's a really trying process. And I also think that I don't know if this is your experience, I don't want to speak for everybody. But I don't think the difficulties of getting pregnant are something that people really talked about. No, you know, so I feel like it's just something that is like a silent suffering, I don't know if people feel ashamed. If there's stigma around, put your news out there a combination of all those things. So I want it to be something where people have a safe place to get the right kind of support, to talk about it in a way that feels therapeutic and healing and, and it can feel so hopeless. So I wanted to provide a place where people feel hope, and not just hope that they're going to get pregnant and have a baby, because nobody can guarantee that in some of these situations, but hope that they're going to be okay, whatever the outcome is, Kira Yakubov: 26:12 I appreciate you sharing that personal piece about you. Because I think it does really help our clients and just listeners to know that, you know, their therapists or who they're seeing is a real human being and go through struggles, and we can be upset or sad and have things happen in our life that are traumatic. And yes, it is difficult for us as well. And it does give us that almost like I wanna say superpower, but it's, it's an advantage to help other people feel like we can relate and really see them. Lindsay Bauer: 26:45 Exactly, and, and in the infertility world. It can feel like you are so isolated. It can feel as if nobody gets you. There's something about it. That's that's just and and a lot of people actually do go through it. Yeah. But there's the support of people who haven't gone through it is just not the same kind of support. Yeah. Like if a friend is has three children of their own, and they're like, you'll be okay, you guys just need to relax and de stress it'll happen, that doesn't feel supportive, it feels like false hope, you know. So that's what I think is really important about the work that I'm doing is I'm giving people reality, but at the same time, helping them to feel hopeful through their own coping mechanisms. Kira Yakubov: 27:44 So for listeners out there for people who want to be supportive to whether it's their family member, or friend, or someone that they love in their life, who might be struggling with fertility issues, because I know sometimes the intention, like even I mentioned that example is the intention is good. The intention is to be supportive and caring. And it doesn't always come across that way. Right. So I'm curious, is there any tips or anything that you would want people to know? So they can support people through this process in an actually like in an actual helpful way? Lindsay Bauer: 28:18 Yes, definitely. So the first thing is, listen, ask the person what they need, don't assume, right? And that's almost with any type of support that you plan to offer. Grief, right? That's another example. You wouldn't go up to somebody and say, here's what you need to do. Even if you are an expert at grief therapy, you still ask somebody, what do you need in this moment? So listen to what they might need, listen to their story, listen to what they're going through. Let them know they're not a burden. Like I said, with infertility, it's an ongoing struggle. It's literally daily, definitely monthly, because every month you're getting news whether or not you conceived. So letting someone know, hey, I'm in the long haul with you. You're not a burden. If you're having a really bad day, and we just talked yesterday, call again today. Right? So listening, letting them know you're in it for the long haul, letting them know that their problems are not a burden. But again, you don't have to be this person's therapist, right? You're not the holder of their entire struggle. So you get to have a boundary to and it's okay to communicate that, Hey, today, I can't talk. I'm taking care of myself. I'm working on my own self care, etc. But, but I'm available tomorrow or the next day or one year available, because you know this, if you're really going to help someone in the most effective way, your cuphas to be full. Kira Yakubov: 30:00 Yea Lindsay Bauer: 30:00 Right. So I would say those are some of the biggest tips do not offer unsolicited advice. Unless you are a fertility doctor. Kira Yakubov: 30:11 Sure - the point of what you're going for the appointment. Lindsay Bauer: 30:14 Correct. Unsolicited advice can feel very. Um, you know, when they say when somebody's crying, don't hand them a tissue box, because you're basically saying like, Oh, that's making me uncomfortable kinda like, clean up. Again, oh. Okay, I'm here with you. I can, I can see you're visibly upset. But sometimes that can come off as you're making me uncomfortable. I can't sit with your sadness right now. Kira Yakubov: 30:50 I don't think anyone really enjoys giving unsolicited advice. Because we're not asking for it. But there's also like an assumption, right? As if, like you don't know, or I know better. Lindsay Bauer: 31:00 Yeah Kira Yakubov: 31:01 or very dismissive. Like, I mean, I really get to the point you're trying to makeacross like, this feels uncomfortable for me to like, go handle that over there because I don't like the way this is making me feel, which I can imagine is going to make someone feel even more shameful or isolated and feel like they can't talk about this. Like, I don't want to make other people feel uncomfortable. They don't know how to help me. I'm just kind of keep this to myself. Lindsay Bauer: 31:27 Yes, exactly. Yeah, yeah. Yeah. So some of the unsolicited advice. That's typical when you for infertility, or people trying to conceive is a lot of like, people who say things like, go upside down after sex. You know, like things on like, how to get pregnant. Really? Like, this is what worked for my partner and I and it's like, that's, that's an example of unsolicited advice. Yeah. Unless this person's coming up to you and saying, Hey, what, what has worked? What did you do? It's just, it can, feel dismissive. Like you said, it feels like, you know, better than they know. And that's just not the case when it comes to infertility. It's such a researched phenomenon that, yeah, it's not going to require an upside down for 15 minutes. I know. That's what my mom said to me Kira Yakubov: 32:28 really? Lindsay Bauer: 32:29 Sorry mom I'm blasting you. like she was like, Well, did you put your legs up? Did you go upside down? And I was like, yeah, for two years; How come it hasn't worked? Kira Yakubov: 32:38 I can also imagine having that like, even if the person has tried all those things. So I almost feel like what's what's wrong with me? Lindsay Bauer: 32:44 Yeah, Kira Yakubov: 32:45 what am I not doing right? Lindsay Bauer: 32:47 Exactly. Kira Yakubov: 32:47 Even those messages might be coming across when people aren't necessarily trying to say that, but it goes back to, you know, the intention versus the impact. Yeah, your intention might be great. And that's lovely. And if the impact doesn't land, really, it's doing more harm than good. Lindsay Bauer: 33:05 Yeah, exactly. Yeah. Kira Yakubov: 33:08 Is there - I lost my train of thought. So I know that we've kind of focused on the individual who is going through the physical process of infertility. But I'm curious of what your experience, whether it's clients, or if you feel comfortable sharing personally, what that's like with a partner, right? Because that's something that the couple is going through, and not just one person, unless it is just one person doing it on their own. Lindsay Bauer: 33:38 Right, which does happen, but for the sake of couples therapy. Well, one of the big things that I work with couples is finances. So if you're lucky, and insurance covers infertility or fertility treatments, then you're still gonna have a financial burden. Trust me. You get with infertility there, you're hit with medications over here and insurances, insurance companies saying, Oh, we don't cover that. But we do cover this, but only after you try three IUI. I mean, there's always loopholes around our medical care, right. And that's the same with fertility treatments. So I do like to prepare couples for their financial expectations moving forward. Are they ready? Have they put money aside? Are they willing to take out a loan? What is in their budget? And how far do they want to go with this? financially and emotionally? There might be a point where they say we're done. We've had this has been too taxing on our savings. This has been too taxing on our marriage. This has been too taxing on our emotions. So talk about your finances, be ready to open that up. And then I also think having timelines with each other is really important and checking in, should we take a month break a year break. And taking a break is not failing at all, it's filling your cup back up, that's like a big thing. Boundaries, so boundaries with who you're bringing into the story and into this journey with you who you're telling. boundary. And this is something personal, like my partner and I had to work a lot on was I, I couldn't be around many women who were having kids kind of go to many baby showers. I I've really struggled with that. And my partner is a super social person, he's super extroverted, gets a lot of fulfillment and his energy, his cup is full when he goes out and socializes. So we had to do a lot of negotiating around how I could take care of myself and how he could take care of himself, but still not do everything separate. Sure. So that's something couples have talked about what's gonna feel healing and supportive for you what's gonna feel healing and supportive for you? Is there a compromise? Can we do this? 70% of the time and the 30% of the time? 50/50? What do you both need here? Kira Yakubov: 36:25 Yeah, Lindsay Bauer: 36:25 so my experience, he was more willing to cut back on some of these events. So I got lucky. Kira Yakubov: 36:36 that's really powerful, though. I mean, I know, I don't have a lot of I don't have this specialty, working with clients who are struggling or going through infertility. So it's not something that I have talked to a lot of clients about. And so it's interesting to hear that negotiation piece, because I mean, it's huge in couples therapy with anything, Lindsay Bauer: 36:54 Right Kira Yakubov: 36:54 But this is like, even more so. Because, I mean, it totally makes sense. It's gonna be hard to be around certain reminders, or certain people or other people's joy and certain things wall, you know, the person is trying to achieve this particular part of their life and journey. Lindsay Bauer: 37:13 Exactly, yeah. And so the boundary piece with with friends and family, too, is in-laws or extended family, right. And I'm a sharer. So my partner wasn't, he was kind of like, we're not going to tell people our journey. And I didn't force him, I promise. But I influenced him. And I said, Can we just go over why you feel resistant towards sharing. And when we kind of dug into that a bit more it was, it was just more that that's kind of how he was raised. That was just something that he was told, like, you don't really talk about your family issues. And when I expressed to him why it was important to talk about family issues, that meant more to him. And so we slowly started exploring. So I don't know if you remember, we did a YouTube video. And when we shared our story, we did a fundraiser. And it was like a beef and beers. We had tons of family, tons of friends show up. And at the end of it, he was on a high. And he said, It's because all these people showed up with support. And we weren't sharing the information. It just felt like we were alone in this because like, we're not alone. There's so many people that want to be there for us. They just don't know how, yeah. So that's something to talk with your partner with is how can how can we feel supported? What would that look like? Sharing or not sharing, because, you know, some people do better without Kira Yakubov: 38:54 You're giving me goosebumps sharing that story. sharing. Because that is so sweet and having I mean, I think in almost every episode, we talk about having a community and how important that is. And being able to share whatever you're going through within your community, whether that's family, friends, co workers, whoever that is a part of your life, and have them show up and be there for you in such a big large setting at once. It's just like so much energy of love. So I think that's so powerful and sweet that you both did that. Lindsay Bauer: 39:27 Yeah, it was special, really special. Kira Yakubov: 39:30 And they get to be a part of your story with that. So pros and cons Lindsay Bauer: 39:32 Oh yeah. And you know how many more people have checked in to see how we're doing? It's tremendous because they're now included in on it. So does it open the door for unsolicited advice? Yes. That's why you choose what's best for you. Kira Yakubov: 39:51 Yeah. And so it's interesting. I'm thinking because I always think from a cultural perspective, just because of my background, and how much I mean even my family or like, people in like the Eastern European community, the first thing they ask, or the second thing they ask if you're a woman is when are you getting married? And then if you're already married, when are you having kids? Why are you not having kids? When you're gonna have a second kid? Everything is revolved around when are you going to have this baby? And I imagine, first of all, it's like such an intrusive question. And so inappropriate, but is like, normalized, it's okay to just ask someone about their personal life in that way. And so I'm curious if you've had clients struggle with that when they don't want to share and people are insistent on asking these types of questions. Lindsay Bauer: 40:43 Oh, of course. I mean, I can't speak to your culture. But even American culture is still like, the woman, her the role of a woman is to be a mother. Yeah. And that's not true. And we get to pick that you know, so. It's absolutely come up with clients actually have a couple right now, where they're, they're trying to figure out their careers, they're trying to figure out where they're living, they have so much ambition, and they're just like, trying to figure out their own stuff. But they do see themselves having a family. But they're facing some pressures of mostly her family. But they're, they're asking questions and like, putting little comments in there kind of like, well, when do we get grandchildren? Right? And, or, Hey, they're going to need cousins soon. They're gonna want to play. So, yeah, it's happening. I think it happens a lot. And it happens. I'm not trying to be like, gender specific here. But it's, it happens a lot more to women. I just feel like, again, that conditioning of hey, Kira Yakubov: 41:57 Yeah. you're a woman supposed to be a mom. Yeah. Right. Um, don't put your career first - what are you doing?Yes. So it do do get that. My, my tips, I guess I could say for someone getting that is, it depends on your relationship and how valuable the relationship is to you. That's a good indicator or differentiator. Yeah. Lindsay Bauer: 42:28 So someone's like, Oh, this is like a second cousin. And I say, that's okay. If you need to cut off from this person. Or if you need to draw a boundary that is pretty hard. Kira Yakubov: 42:40 Yeah. Lindsay Bauer: 42:40 Where you don't even get caught up in these types of conversations, you're allowed to do that. Now, if this is somebody that you value, and you're never going to cut off from your life. It's okay to be open and vulnerable about how much pain that might bring you or how much annoyance it might bring you or whatever you're feeling when they say that. People don't know. Kira Yakubov: 43:02 Yeah, Lindsay Bauer: 43:03 hey, when you say that you're making me feel pressured, you're making me feel less than you're making me feel like my life that I've chosen isn't good enough. Some people might not like, Oh, I just thought it'd be cute to have a grandchild. You know, so yeah, the intent impact the bringing to light, bringing to their attention how they're making you feel and how they're coming off? Kira Yakubov: 43:30 Yeah, that's huge. I mean, I've had to have those conversations with my family, because it was literally, especially I'm in my 30s. And it's like, Oh, my God, clock is ticking. And it's like, you know, a common joke. And it is geared a lot towards women, or who individuals who identify as women, right? Who can have babies is our clocks are ticking and like, oh, especially my culture is like, oh, man can have a baby anytime, right? They can be 60 70. Who cares, but the woman can't. So you need to get on that. And it's just I've had that annoyance since I was young with my family and having to set those boundaries. Yeah, it's tough though, especially when, I mean, I'm sure for American families with immigrant families where boundaries are frowned upon and seen as almost like disrespect for like, almost like a level of betrayal. Like you want distance from me, or I need to stop doing this because you feel this particular way. So I mean, I think that all the tips you've provided insight has been super helpful. Lindsay Bauer: 44:39 Well, can I ask, Kira Yakubov: 44:40 sure Lindsay Bauer: 44:41 did you ever get like backlash when you created a boundary about them asking? Kira Yakubov: 44:46 Yeah, I mean, I've had to reiterate that boundary 100 times. And then and then I just thought I was like, I'm just not going to talk about this. So like, when you asked me, I'm just gonna stop the conversation because we've had this conversation. So it's just not gonna go anywhere. But if you still want to have a conversation with me, don't ask me this anymore. And don't be surprised or upset when I just abruptly stop the convo. And that has helped. Yeah, I think when you put it, sometimes you have to put in more stern boundaries. And people eventually become conditioned to this was your response and they get used to that being your response? And if they want a different response, they'll do something different. Lindsay Bauer: 45:25 Right? Exactly. Almost like on repeat. Oh, not talking about that. Not talking about that. Not talking about that. Yeah. And then they're like, Well, I guess she's not talking about that. Maybe I'll try a new question. Kira Yakubov: 45:38 Yea. Absolutely. But it's tough. I mean, I this is a sensitive topic and a struggle that a lot of people go through. And having people in our life, especially our loved ones not being as sensitive or understanding to that can be really hard. Lindsay Bauer: 45:56 It can be Yeah, I'm, I remember, a lot of I did get like from people who didn't know, didn't know me very well or didn't know what I was going through would ask questions. Like, you know, oh, when are you going to have a baby? Do you guys talk about kids? And of course, while you're going through the struggle, there is this stabbing feeling that's like. Yes, we've talked about it for just many years. Yeah, we're$60,000 in debt. Of course, we've talked about it. But there's a moment where you just quiet yourself. And you're like, Yeah, that would be nice. And we just kind of appease people, you know, but it is helpful. I think it's important for listeners to know and to spread the word that we need to stop worrying so much about other people's bodies, about their future plans about whether or not they want to fit societal roles, like just stay in your lane, focus on your life, and thrive. Kira Yakubov: 47:06 And mind your business Lindsay Bauer: 47:07 and mind your business! Kira Yakubov: 47:09 Absolutely. So I know we're starting to come to an end, unfortunately. But I wanted to ask, is there anything that you would want to share to listeners like outside of this outside of like your role as a therapist or yoga instructor? Anything about yourself that is something fun, or that you like to do outside of work and everything? Lindsay Bauer: 47:30 Yes, sure. Because as you ask that, like, at first, I was like, Oh, my gosh, I will say since the pandemic, I've been a bit of a hermit. And it feels inauthentic. It feels nice. But at the same time, it feels a little like, who am I? Right, but the first thing that came to mind was traveling. I can't tell you how much healing I have done traveling. And it doesn't have to be a yoga training. I have traveled and immerse myself in a new language and been scared shitless I have traveled to places where I looked like no one. I've traveled a place that Oh, it's just that has been my biggest growing experiences and healing experiences and connecting to who I am and who I ever wanted to be. I need to do more of it. I wish like flights and traveling wasn't as bad and difficult as it is. And I wish COVID never happened. But it is what it is. But yes, that's just something that I even say that to clients, you know, sometimes they're like, how do you find purpose? Some of those big questions. I can't tell you how to find it. But I'll tell you something, something that's really worked for me of every single time I've traveled. Not like a weekend getaway. I mean, like those international trips, feeling like the world is way bigger than you and your problem. Kira Yakubov: 49:08 Yeah. Lindsay Bauer: 49:09 Right. Kira Yakubov: 49:10 I agree. I absolutely love traveling, I think being outside of your box and your norm and just being like in a whole different world around different people who live in a very unique way that's not the same and just like learning that perspective and trying food and experiencing the scenes and the weather and getting to know like local people not doing as much touristy stuff. It is healing I think that's like soul journey kind of stuff. Lindsay Bauer: 49:39 Absolutely. Right, right. Like I always imagine if you're going through like a crisis or tragedy that that's something like a reset button when you're ready. Kira Yakubov: 49:52 Yeah, Lindsay Bauer: 49:52 that's not something you just go okay. I'm gonna get my depressed self out of bed and go do it tomorrow. That's not feasible and practical, but when you're ready, it's waiting for you and it's beneficial. Kira Yakubov: 50:04 Yeah. And you learn so much about yourself. Lindsay Bauer: 50:07 Oh, yeah. Oh, yeah. Do you journal when you travel? Kira Yakubov: 50:12 You know, I always think about doing that cause I have so many thoughts and reflections. But I don't end up actually journaling. But I do have these moments, whether it's like, while we're on the plane back or just like sitting and looking at a scene of just like, being really present and embracing that feeling. And like really taking a mental picture, because I love to go back to that in my head later when I come home. Lindsay Bauer: 50:38 Yes, when you come back to the crap, like I need an escape. Kira Yakubov: 50:43 Yeah, my happy place. Lindsay Bauer: 50:45 Exactly, exactly. Kira Yakubov: 50:47 Do you journal while you're away? Lindsay Bauer: 50:48 I do. And I'm not a big journal person. It's always been fascinating. I'm not a I think journaling is very beneficial. And it's just not something I've incorporated. I every time I like pick up a pencil, I'm like, blank, right? Yeah. But when I travel every day, I'm writing now like what happened and who I met and yeah, I have like, books of not, you know? Kira Yakubov: 51:14 Yeah, journal book. Lindsay Bauer: 51:15 Journal Book Kira Yakubov: 51:16 Yeah. Lindsay Bauer: 51:16 Full of my childhood experience. Kira Yakubov: 51:18 Oh, that's sweet, maybe I'll try that. Lindsay Bauer: 51:21 Yeah, Kira Yakubov: 51:21 yeah. And a couple of minutes each day. Lindsay, thank you so, so much for being on today for being vulnerable, sharing your insight and expertise and just being here with us. So I really appreciate it. Lindsay Bauer: 51:35 Thanks for having me and having this podcast and giving people an opportunity to share and we're all learning from each other. Kira Yakubov: 51:42 absolutely is there somewhere where our listeners can find you reached out to you? Lindsay Bauer: 51:49 Absolutely. So I have a website. It is www.LindsayBauermft.com and also my instagram handle is @Yogology that's probably the best way to find out what's going on. I have a newsletter you can even subscribe for free and figure out any happenings or workshops. Yeah, Kira Yakubov: 52:15 perfect. Well, if anyone's listening and wants to reach out to Lindsay, we'll also have it in the info down below after the podcasts. ### Listen - [Spotify](https://open.spotify.com/episode/12812507) - [Apple Podcasts](https://podcasts.apple.com/podcast/12812507) - [YouTube](https://youtu.be/MLNP1lIIpbM) --- ## Exploring Identities with Elijah Jackson - URL: https://healyourrootspodcast.com/episodes/exploring-identities-elijah-jackson - Published: 2022-10-12 - Season 1, Episode 5 - Duration: 45:16 - Category: relationships - Guest: Elijah Jackson ### Summary Comprehensive guide to relationship communication, covering verbal and non-verbal skills, active listening, and navigating difficult conversations. ### Description Effective communication is the foundation of healthy relationships, but it goes far beyond just talking. This episode explores verbal and non-verbal communication, active listening, and how to navigate difficult conversations. Learn practical skills for improving communication in all your relationships, from romantic partnerships to family and friendships. ### Transcript Elijah Jackson: 0:02 Rather than saying, in order for you to feel validated, I have to appear this way. We should be thinking about what is it? What do I need to get myself to feel comfortable where I'm at right now. Daniela Galdi: 0:18 Welcome back, everybody. Hello, hello to all of our listeners. This is Daniela Galdi. I am the producer and co-host of Heal Your Roots Podcast. And I am so happy today because we have our newest member of fuel your roots wellness here to talk with us. But first, we have Kira, the co host, who is also here with us here, go ahead and give them a real Hello. Kira Yakubov: 0:43 Hey, everyone, I'm Kira Yakubov, co-host and therapist and founder of heal your roots wellness. Every episode we talk to a practitioner in the field gets to know who they are as a person and some of their specialties. And I'm really excited for today because we get to have Elijah Jackson. He's part of heal your roots wellness. And I'm just excited to hear his stories today. And so thank you so much, Elijah for being on today. Absolutely. So we had some technical difficulties, but we're rolling through it a lot, just a bit of truth. So I'm really happy to hear. So it's kind of the first thing I asked everybody is Elijah, how did you get into like the mental health field? And when did you know you want it to be a therapist? Elijah Jackson: 1:28 Yeah, so there was a there was a silly answer. And then there's, there's a more seriously answer, which one do you want first? Kira Yakubov: 1:37 I'm always gonna go with Philly first. And then you could totally share the serious one, or which one are you? Elijah Jackson: 1:45 Absolutely. So when I was when I was a kid, my favorite show in the world was sure all of you are familiar with a charmed. But the three and Phoebe the youngest, which was a had an advice column, and she had a degree in psychology. And I was like, I thought that was like the coolest job in the world. I was like, I wanted advice column. I should go to school to be a therapist, and maybe I can have an advice column. And then I like then after doing research, I was like, great. CV shouldn't be giving people advice. That shouldn't happen. I'm gonna go to school and I'm going to do it the right way. Daniela Galdi: 2:32 That is the best response by the way. At the top of everything, all the answers we've heard for this question. Elijah Jackson: 2:42 So I if you if I have one person to thank for my career, it's a Phoebe Halliwell shout out. Daniela Galdi: 2:51 I think that was Alyssa Milano, right? She was always dressing so like, I loved how she dressed to I was like, I was aware that Elijah Jackson: 3:00 she was the coolest one. Oh, that's hilarious. But yeah, the more serious, you know, the more serious kind of like grim version is that I've just always wanted to learn a bit more about myself, you know, I think lots of us go into the mental health field to, to be to figure out our stats, you know, just figure out our traumas, to understand our bodies and brains a little better. And to help understand the people that are in our lives. So it's kind of like, so it's kind of both, you know, I want to figure myself out, as well as figure out some of the people that I grew up with navigated that way. Daniela Galdi: 3:44 Oh, wow. I like your response to. Kira Yakubov: 3:48 And it gets funny and not funny that a lot of therapists like it would probably be cheaper if we just went got therapy instead of becoming therapists. Elijah Jackson: 3:59 Absolutely Kira Yakubov: 3:59 Right, it's part of the same reason I went into like, I had a tough time growing up. And I didn't understand myself and I would just learn more about psychology and human behavior to understand like, why I am the way I am. And I was like, Oh, I can help other people do this, too. So I love it. That was a similar path for you as well. Elijah Jackson: 4:18 So it was the world's most expensive therapy, therapy experience. Daniela Galdi: 4:25 What was one thing that you learned about yourself from going through all of your schooling? Elijah Jackson: 4:32 Yeah, I would say what I learned about myself was that I am extremely hot, I find it extremely difficult to be vulnerable with people. And therapy requires a lot of vulnerability on the therapists part as well. You know, it's not all about the client being able to access certain emotions and feelings, you know, I have to do that as well. And you know, showing up in therapy, you're in the room to, you know, your feelings are coming up as well. And you have to, you have to confront that and process that, in the moment, not make it about you, like therapy isn't for me, you know, I have to go see my own therapist for that. But, you know, remembering that I'm also in the room is really important during the therapy process with the client. You know, in beginning the beginnings of my therapy career, I found it very hard to access certain emotions in the room. Because I was so used to not being vulnerable in that way. Kira Yakubov: 5:36 I really appreciate that that was so vulnerable. Elijah Jackson: 5:40 I've done a lot of work, Kira Yakubov: 5:41 Look at you; check you out. And so I know you are a licensed social worker. And so my license is a little bit different. So I didn't necessarily know the path that social workers that's a take or kind of like, the classes and things you learn. So what was your experience becoming a social worker? And why did you kind of pick that direction instead of any other type of license? Elijah Jackson: 6:07 Yeah, it was a, it was a journey for me. I was actually just talking about this with another client, because they're pursuing a degree and they're very frustrated with, you know, having to be set back and switching switching majors, you know, having that take longer. So my, my experience was also very similar. Or went to school, I was originally a psychology major. And I wanted to, I wanted to get my degree in psychology, I wanted to get a PhD of all things. And I, you know, I was going through it, I did a year at a really expensive school, and then I ended up not being able to afford it anymore. So I went home, and went to community college. And then I was working somewhere, I think it was probably like at DSW, or something. And one of my co workers had a master's in psychology and she was like, please don't do it. You can get the same, you can do the same amount of work, you can, you can work with the same people with a degree in social work. And you'll be able to have a much more well rounded career because you could work anywhere. And that's not to knock the psychology people, you can also do a lot of things with a psychology degree. But I just felt like Social Work fit for for me, because it allowed me to access a lot of different communities that I might not have been able to access it a more specific degree. Daniela Galdi: 7:43 Actually speaking to that, can you share a little bit about the communities that you've worked with? Because I know that you mentioned in your bio about like, working with the homeless community? So tell us more about that? Elijah Jackson: 7:54 Absolutely. It's kind of an all over the place. Both, you know, as far as location and career stuff. I'm originally from the island. So my first experience during this kind of work was with the homeless population on Long Island, and being able to kind of do more hands on stuff, you know, still looping in the therapeutic, the therapeutic work all those interventions, but actually having boots on the ground and being able to, you know, have access to communities that people wouldn't normally have access to being able to see the real the real side of it, rather than just what people see walking past, you know, homeless person on the street. I also had experience working with the New York City child welfare system, which was traumatic. I did a lot of work with foster kids, mostly teenagers and people who are aging out of foster care. So there weren't a lot of resources for them. Most of them were just thinking about trying to graduate high school, let alone their future without certain supports, like family, and lots of lots of trauma, just in general a collective trauma. I worked for a college prep program that focused on getting foster kids into college because statistically, it wasn't something that happened that often. And it was pretty difficult. That was pretty hard. So I never want to do that again. But it was very it was a very formative experience. I did really love being able to, you know, hope help people, help kids access certain things that they might not have, you know, an opportunity to do that. And I ended up in Philadelphia, because New York City got too expensive. And I started working with the substance abuse population and Philadelphia. And that was also very heavy. The fentanyl epidemic and substance abuse is very, very rampant in Philadelphia and all across the country. So being able to also see these people in the throes of their addiction, and allowing myself to be more vulnerable with people and recognized similarity. You know, a person who's in the throes of addiction isn't that different from an average person, they still have the same problems. But it's they're still navigating the same stuff. They just also have a layer of trauma surrounding substance abuse, sort of really did open my eyes to lots of uncomfortable things, but also things that need to be seen and addressed. And it changed my views a lot about, you know, how substance abuse should be, the epidemic should be addressed. Here. Kira Yakubov: 11:20 Wow, that's, that's definitely really deep work. And it's pretty crazy thinking about, like, you know, Maslow's hierarchy of needs, like, you can't even address other stuff on the surface, if you don't have your basics. Like, if you don't have shelter, if you don't have a home, if you don't have food, you don't feel safe in your environment. It's like you can't even talk about like how my relationship feels or how I'm communicating. It's like, no, I got to think about day to day. So that's, that's really heavy. I mean, I commend you for going into that site didn't have the experience, through my training to to work with people that were in those circumstances and situations. Elijah Jackson: 12:02 It was absolutely eye opening. And I really did love, I love the communities that I've that I've been able to navigate. And it really helped me clarify my niche around what I wanted to work with what I wanted to do, what I thought I was capable of also being able to push myself to be able to say, I didn't think I was capable of this, but I actually Oh, Daniela Galdi: 12:25 wow. So that sounds like another something that you learned from, from your work with that? Was it something that you were positioned in? Or was you were drawn to it? And how did you get started doing that? Elijah Jackson: 12:38 Each of those experiences that kind of fell into, I continually told myself that whatever comes my way, I'm going to hop on it and see how I like it. Just to clarify, just to continue to clarify what I want to do you know how I want to the kind of therapist, I want to be the kind of social worker I want to be. So it really, it really was important to me to make sure that I continued to try new things. Kira Yakubov: 13:07 And so I know that you mentioned it kind of allows you to get more into your niche and like figure out who you want to work with the kind of things you want to work with. And so what have you come to now thinking about that, like who would be your ideal client or who you enjoy working with? Elijah Jackson: 13:25 Yeah, I think I've already have, you know, over my very short career, I think that I learned a lot about my own identities and how and how I am impacted by the people that I've worked with. And I really do think that it's important that I continue to work with people that look like me, and other people of color, people with lots of different different intersectional identities, people who, you know, I love working with the LGBTQ community. I love working with bipoc You know, black indigenous people of color. I love working with people who identities are considered minority, you know, and whatever case that might be, you know, ethnically, religiously, whatever the case is, if you're not considered the norm, as they say, then you have a home with me Kira Yakubov: 14:20 Aww Daniela Galdi: 14:22 I love that you have a room with me. I just I wish I could like hug; it was so beautiful. it really is. I love your sincerity with everything Elijah, I think that you know, from a third party, I tried to give this perspective since I'm, I work trying to do my advocacy with mental health. But I learned a lot from like yourselves and here and all the therapists and coaches and people that I work with in this advocacy and just seeing your sincerity is just such a draw to me from that third, you know that outside perspective as someone who's not a licensed therapist or social worker, it's just like so comforting. So I appreciate that so much. But the work that you want, and aim to do and and that you are doing now is just so impactful. And I want to know a little bit more of of a breakdown, or maybe your own perspective, because you shared with us in in the form that we spend to just get to know everybody a little bit more intersectionality of identities. And you know, to me, I was like, wow, like, that's a powerful statement category, right there. Can you share your perspective on that? Elijah Jackson: 15:36 Absolutely. With the intersectioning of identities, I think lots of people view it differently. And my understanding of the intersection of identities or intersectionality of identities, it's just that we're multifaceted beings, we're not defined by one aspect of our lives, you know, we're all impacted by everything that we go through, you know, someone who is black, gay, poor, differently abled, those are all different identities that impact them every second of every day. So it wouldn't make sense to say that I am all just one thing, you know, or they are all just one thing. You are defined by all the stuff that you go through your positionality is, you know, comprised of everything, all the good and bad, you know, all this stuff that you can't control when you can, all of that stuff impacts how you show up in the room. And I think it's important for me, as a therapist, to help clients understand that they're more than just one thing. You know, you're not just a queer person, you're not just Muslim, you're not just, you know, your racial and ethnic identity. There's more to you than that. And, yes, some things are easier to hide than others. But you shouldn't need to think about hiding it in the simplest form, you know, you should be able to say, I'm all of these things. And that's okay. Kira Yakubov: 17:13 I love that so much. And this is when I interviewed you, I was like, oh, Elijah is just so warm, and welcoming. Like, you just provide this sense of safety and opening that I really loved when we even just had the interview. And like even you expressing that everything you say is just so genuine. And like, we don't look the same on the outside. But I would love if you were my therapist. Yeah, and like, you know, therapy seekers. I think the biggest thing that someone wants to know when they're going into therapy is like, can you help me? Can you relate to who I am and what I've gone through? Really like the credentials, all that stuff? Yes, that matters to a degree. But at the end of the day, it's like, we're two people in a room or in a virtual room, like, I need to connect, and I need to know that you're going to be able to help me because I'm not just this one sliver of an identity. It's all these different parts. Yeah, absolutely. Elijah Jackson: 18:13 I think sometimes we, we, I even though I've had this experience, where I've looked for a therapist, and I said, Okay, well, this person isn't going hasn't gone through the same thing that I went through, so they won't know how to help. And that's, and that's not true. I think that just because I don't have the same experience as someone doesn't mean that they can't offer insight or steal helped me navigate my own stuff. You know, we're all we're all too unique to assume that someone is going to have the same experiences as us or to cast out someone because they don't Daniela Galdi: 18:52 the acceptance piece is so prevalent. And I keep thinking, you know, in the other episode, we, we kind of, well, I pegged marinas the sexpert, and I almost want to take like I was wanting to title you as like, Elijah the embracer. Like I'm pacing everybody's differences and similarities and making everybody feel united. So I love that. So Elijah the embracer. My question to you with that is, do you have a certain tool or approach that is like one of your go twos with with anybody that connects with you? Elijah Jackson: 19:35 I think kind of like what Kira said earlier about acceptance, I think is really important to me. accepting people for who they are is like my most powerful tool, my most useful tool, the one that I you know, someone that I pulled from often being able to sit with a person and say, You don't have to explain this to me. You don't have to argue this to me, you know, You don't have to try to convince me that, you know, this is how you need to be, this is why you need to be this way, I am accepting you for who you are, we don't have to go, we don't have to have this discussion, which is something really important, I found that as a tool that I use of queer theory, you know, many people don't know about it, it's the idea of not pathologizing someone's identity, you know, not using them as not using tools or theories to try to, you know, turn a client into an experiment or a study tool, this is a person, their identity is their identity, I shouldn't be trying to, you know, examine this, this is just, they are, you know, if they tell me that this is how they see the world, and I have to respect that. And I can't say, oh, well, because of this book right here, you know, we can't we have, I have to convince you that your identity is wrong. Now, if you believe that you are this way, then as a therapist, I have a duty to respect and accept and validate that. And I think it's important that lots of other therapists adopt that too. We shouldn't be pathologizing our clients. Kira Yakubov: 21:23 Absolutely; that gave me the chills. I mean, I, you know, we take an insurance that we accept, and sometimes it really upsets me and makes me angry, it's really frustrating for the therapists, because we don't always want to give someone a diagnosis, right. Like, if it's like a serious, a serious disorder, or it's a psychotic disorder, like things that are physiologically going on. But it would actually be beneficial to have a diagnosis, this is one thing. But the other thing is, if you're just a person existing in the world, and it's hard, because it is, and you're responding to trauma that's happening around you, and your body is adapting new ways to survive. I don't think that we should be diagnosing people for that, right? Like, you learned how to figure out how to survive in this environment, because you had to. now you're in a new environment. And it's not helpful. But that doesn't mean there's something wrong with you. That means we're shifting into where we live, and who we need to be. Elijah Jackson: 22:27 That's one of the things that I've always told, like, when I was younger, I used to tell myself, I don't need a therapist, because I don't see people I don't hear voice. I don't need to be in therapy, because, you know, I don't have you know, dissociative identity disorder are where do you get the severe disorders? And I, I, I questioned myself a lot growing up, and I was like, well, maybe I shouldn't be in therapy. And then after learning more about actually what therapy does, I'm like, Yeah, I should have been in therapy. It's not, it's not just it doesn't just require a severe disorder to be able to see someone and navigate your life, and work through some of the things that have stuck with you for a long time. Daniela Galdi: 23:15 The word doubt keeps coming to mind. Because for right now, you know, I'm experiencing that a lot. What's interesting is like, I think that it's in me because of those I've surrounded myself with. And so I think about that, and you know, I voiced it outwardly, you know, I do I have gone through anxiety and depression, and I managed that, but I've kind of broken it down recently is like, wait a second, I feel good about myself. It's as soon as I can, there's other, you know, that other noise coming in from others, that kind of beats me down a bit. And so thinking of that is just an example for anyone listening have like, you know, I can't diagnose, right, but I wouldn't say that things I would say that's just, you know, a feeling based on the environment that I'm in like, here, I mentioned about the environment. So like, that's one thing that I'm like, I did not talk to somebody about this big could just spiral. Elijah Jackson: 24:15 Yeah, absolutely. Absolutely. I think if you are someone who experiences how horrible life can be, then you have a right to be in therapy. You don't have to be a traumatized broken down person to go to therapy. You can just be someone who needs support. Absolutely. Kira Yakubov: 24:36 And so it's interesting with all these different identities, right? Like, it's our subjective experience, for the most part, right? Like there's an external expression of who we are that people can kind of see in the label or put us in a box. And I think that, especially with gender, it's very much a subjective experience. And so I'm curious of how that shows up in whether it's your session. maybe some of the experiences you've had with people who have like this discrepancy between the subjective experience they're having, and maybe how people view them on the external Elijah Jackson: 25:10 expression. So many of my clients are questioning their gender feel like, because they're not at one end to the extreme, where it's like, so, you know, I always say gender and sexuality is a spectrum. Everyone falls somewhere on that line, you know, some people are more in the middle, some people are all the way at either, you know, and when some people are more in the middle, or in one of the other gray areas, they feel like, they don't have a right to explore that. They don't have a right to, to think about how they'd like to clarify. What would it take for them to clarify what their gender is, or their sexuality is? Some people feel like, Oh, well, it's not something that's really that deep for me, I just feel sometimes I like to address it, or sometimes I feel more comfortable going back to him rather than she heard. And you know, the discussion of pronouns. And the clothes you wear, how you present your gender, all of that is so fluid. And people think that in order to live life, they have to be perceived one specific way. And rather than saying, This is how I this in order for me to feel validated, I have to appear this way, we should be thinking about what is it? What do I need to give myself to feel comfortable where I'm at right now? You know, maybe down the line, you will want to go? Do you want to go further down that spectrum, and maybe get top surgery, or explore taking hormones, things like that. But right now, where you are? What feels right. And that's a lot that's questions. That's a question that I love to ask my clients. What do you need right now? Maybe it's not in the cards to get top surgery, or bottom surgery for that matter? Or, but how can we get you where you'd be six? You know, what a safety look like right now? Daniela Galdi: 27:21 I absolutely love that. That question. I want to adapt that for myself every day. Like what do I need? What right now? I think that's such a great way to bring us. I mean, clearly, it brings us back to the moment but brings us back to knowing who we are, as well. And so you know, I love that I love that you start with that. I feel like it just simplifies these complexities that I'm sure the people you are talking with or, you know, minds or might be racing with, do you have any thoughts around the idea of like mindfulness to share with with anyone in listening? Elijah Jackson: 28:00 Absolutely. Being present is so powerful. That's one of the things that I've struggled with the most in my life, even just, you know, not even in my therapy work just in my day to day life. Being present, being mindful, is extremely hard. We are always I think as humans, we're trained to be forward thinking. We're trained by our society, whether it be capitalism, or our jobs, whether that's capitalism. All aspects of our lives are pretty much training for us to be forward thinking, from the day that you graduate high school. Even before that, they asked you, what do you want to do for the rest of your life? What's the thing that you what's at 18 years old, we're expected to decide what we want to do until we retire at 65. That's really traumatizing. It's felt scary, and so scary. So we're trained to be thinking in the future, and we're trained to be anxious. And it's important that as as, for me, as a therapist, it's important to help clients slow down to pull you back into reality, you're back into the real world. We don't always have to exist in the future. Yes, we do have to plan for some things. You know, we do have to plan for our futures in some capacity. But we can't do it all. We're not that powerful. I think one of the things that I've learned as a therapist and it's just an individual is that I don't have that much power. I can't control that many things. I can do my best. I can try to show up as best as I can. But for the most part, I'm just coasting along on this on this rock floating through space. Kira Yakubov: 29:47 Right Daniela Galdi: 29:48 Oh, yes. Aren't we all but Kira Yakubov: 29:52 I want to go back to something you said a little bit earlier that came up for me is the way you were describing accepting people and towards the end it was, what would be the safest for you right now. And I think that is so important to consider, especially when we're talking about minorities and cultures, because I think in America, we're a very individualistic society. And a lot of minorities and I'm an immigrant is much more collective. And when we think about how we move in the world and decisions we make, it's we are trained to think about how is this going to impact my family, my community, who I live with how people view me and people who work or identify like me? Absolutely. And that feeling of safety, and making a decision when you live in a community like that? And I'm curious, so what's been your experience with some clients when maybe they are starting to embrace who they are, but their community or their family is not okay with it? Elijah Jackson: 30:53 Absolutely. I think that kind of goes back to what I was saying for about intersectional identities sometimes are just actually identities kind of go against each other. My you know, a client's a client sexuality, my buttheads with their religion, you know, a client's gender identity might buttheads with the culture, you know, so a client who is trying to explore their gender identity, they don't feel right in their body, they want to explore wearing jet other other other gendered clothing. Even though clothing isn't gendered, that's just clothes, just fabric. But as a society, we've assigned meaning to a dress we've assigned meaning to suit. So I think that clients want to explore that feel that, wow, I don't feel safe, wear nail polish at home, I don't feel safe wearing the skirt around my parents, I could be cast out or worse for doing these in my community than these things in my community. So when it comes to exploring our identities, we have to think about safety. First, you know, what's going to ensure that you are going to be safe, until you can get to a point where you can go out on your own and explore your identities. You know, I have so many clients who live in toxic households, and can't explore their identities, and they feel stuck. And it takes a lot for them to really pull themselves back into reality, and say, Yes, I can't do this right now, because it's scary. But I'm working towards a point where I can get away and still explore who I truly am. Sometimes that's, that feels like, you know, that's not enough. But safety matters, above all. You don't deserve to suffer over things that we can't control. Kira Yakubov: 32:58 Powerful. Daniela Galdi: 32:58 Yeah, that was amazing. That's I was just thinking, like, the way that you break that down so that they always have a place of safety within themselves, even if it's not in their surroundings. What's a way that they can explore like, what's a safe way that used to be just to explore, but still withholding that safety within where they are, like living there to say, part of part of what makes Elijah Jackson: 33:31 the internet so powerful, I mean, the internet sucks, and a lot of so much, that's horrible about it. But I will say that lots of clients who cannot access certain communities, in their general area, find those communities online. You know, they're able to find through through apps like Twitter, and Instagram, you know, all those places are toxic, et cetera, et cetera. But you can still find communities with people who identify the same way you do. You can find someone who you can talk to when your parents scary. You can find someone to communicate with when you feel like you're being silenced. You know, I think that community is very important. And if we can't get it in our general vicinity, if we can't get it in our hometown, we have to find it else. Because in order for us to, you know, to be validated, we need a community that looks like us. Our experience is what we experience Kira Yakubov: 34:41 that's so important. I think it always kind of comes down it's tough, because there's always two sides of the same coin. Right? It's we thrive and community we feel connection and I mean, we're social beings, right? Like we're built to last with other people. And then at the same time, if there is a norm around what we're supposed to look like feel like act like, and we don't, a shame comes up and internally. And then two, we can get ostracized from that community that we so desperately need to be a part of to feel like we belong. I just can't imagine the amount of suffering that someone might go through feeling like they have to, like, walk the line between those things. And I'm so glad there are therapists like you, Elijah that, welcome that. And it's like, here's a space to explore that, and be mindful of what I can do right now. And just hold that space for somebody. Elijah Jackson: 35:38 Absolutely, absolutely. Part of you know, I think some people have these ideas around therapy, where it's like, every time I come to therapy, I have to be talking about stuff that really hurts. I happen to be talking about all this, all the trauma and all the all the all the sucky stuff. And I'm like, Well, I guess you should be exploring your traumas, because they need to be explored. But also, we can use therapy to talk about, you know, the fact that you just bought a dress, and you feel really comfortable. You know, we can talk about the fact that, you know, you had your first kiss from a same sex person. And, you know, I think there's so many ways to experience acceptance and validation. And we don't just have to validate the traumatic stuff. Kira Yakubov: 36:23 Having a space where you can have like, someone excited about the news you want to share? That's just as important, I think, Daniela Galdi: 36:29 yeah, I was just going to touch on that. Because the celebration part is what you both mentioned. And that, to me, means so much, you know, to have that person by your side who's like, yes, that's great. And that's regardless if they understand it or not, but they're happy to see you happy and doing what you want, and what has meaning to you, and living living the life that has meaning to you. And, you know, taking action in that way. So having that celebration, and I can attest to going into therapy, I usually recommend that people, you know, they're like, I'm feeling great. I don't know, do I have to go to the session, and I'm like, I always encourage you to keep your sessions because you never know what could come up. But like, just tell somebody something that you know, has your back, you know, just go talk to somebody that you can feel safe with. That's like the key word here. Right? safe and supported with and so you know, I always I always feel like in in my own personal experience, I've done that. And then I shared great things. And then all of a sudden, I was like, it's one of the best sessions because something else came up, I think, you know, because I had, I had let go. And I had let all of those great things come out that it was like, okay, there might have been something else that I never allowed to surface, but then needed some some extra support, you know. So Elijah Jackson: 37:44 that's why I think mindfulness is so important, you know, and mindfulness can be anything, being mindful of what comes up in the moment, being able to process that as it comes by, and being able to say, you know, I'm going to stay present where I am, I'm not going to let these intrusive thoughts are these negative thoughts. Hold me a certain way. I'm going to sit where I'm at, and continue to explore this thing that I'm really excited about, you know, I'm going to continue to sit with what feel what I'm feeling right now. Rather than being pulled aside by my anxiety, or by the things that hurt. Mindful practice can be anything; I just discovered that you can mindfully eat. Kira Yakubov: 38:25 I discovered that too, and it's not fun. Daniela Galdi: 38:34 It's so funny, I've, I've been doing like, Well, I've been trying to practice like consistently like mindful conscious eating. And to your point, yeah, sometimes it's not fun. But definitely, you know, real quick, a quick digression here is like, that shame piece that you mentioned earlier eating is I'm Italian first generation. And so it's such a big practice. And fortunately, my, my parents are understanding about if I'm trying to eat a certain way, right? And then I find that difficult because I feel the guilt and a bit of a shame that I don't want to always go with the traditions because of the way I want to choose to eat. Right. And that's always on me. But that's something with the mindfulness where it's like, once I can accept that for myself, that this is how I'm choosing, and it's my choice, you know, becomes a bit easier to recite that right and like claim it and assert that to somebody else and in a in a graceful way. So to add that in terms of like mindful eating, but just in terms of mindfulness in general when it comes to different cultural things. Elijah Jackson: 39:42 Absolutely. Mindful eating does talk I tried it one it was like, but I guess the idea behind it is like you're supposed to be more conscious of what of what you're putting into your mind. And you know, lots of times People are just they're eating, they're not thinking about it. And then they're not realizing that, oh, I'm full. And I, you know, I don't, I'm still eating because I still have food on my plate, you know, knowing when it means knowing when you're being present in what you're doing, rather than doing things on autopilot. We do that a lot. We're always on autopilot. Because it makes things it makes the time go by faster. But sometimes, we need to be just slow down a little bit. Kira Yakubov: 40:29 So I feel like there could be a whole episode on culture and eating. Because that, and I remember learning about this long time ago, like the way that it even came up, the people eat together. Like that is like a gathering is like when caveman or humans discovered fire. And they would all sit around the fire to be warm and to eat. And you know, you spend time talking, singing whatever, right? You're bonding over eating. I think at least definitely, in my culture, it's so interesting, because there's like this very mixed method between, you need to eat Byron to eating you look, you look too thin, like you're not healthy, like you should eat more. finish everything off your plate, people are starving in the world. And then it's like, looks like you're gaining weight. Who's going to marry you? I'm like, damn, so which is it? Elijah Jackson: 41:23 Honestly, honestly, how many talks you know, there's so much there's so many image, there's some of the toxic messages that you know are perpetuated through culture, through history and through families. And sometimes you get treated like an outcast, when you start to think about Wait, these are the things that we say to each other all the time. This is okay, this baby is your son or your daughter or your or your aunt or uncle, you know, why are we focused on much about what this person's body looks like, you know, or how much they're eating? Why does that? How is that going to impact them getting married and such? And be away? I think it's that's why I think our younger generation is so powerful, because, you know, Gen Z as kooky as they are, they're questioning everything. They're questioning a lot of things, they're starting to do some of the things that we felt a little bit uncomfortable. Kira Yakubov: 42:20 And I think it's so interesting, it's like, because I see things from such a cultural perspective, because of how I grew up. And it's even questioning why things are the way they are. It can be frowned upon and seen as disrespectful and like disobedient or is, you know, like subordinate, like, how dare you ask about this thing. And really, it's like, A, you probably don't want to take accountability for the thing, because I just realized it's kind of shitty, that we've all been doing this for so long. And be it's like, well, now it means if I accept that it was wrong, that means I have to change. And I have to put in an effort to do something differently. And I felt listened to understand your experience. And that's too much work. Elijah Jackson: 43:07 Absolutely. Absolutely. Accountability is hard for older generations. They don't want to they don't want to accept that they've had an impact on you know, how we show up today Daniela Galdi: 43:19 Do you either of you have have to share in terms of like being better about accountability, because I kid you not I was just looking up for myself the other day, two things. One was, how to understand accountability, and then one was working through entitlement. Elijah Jackson: 43:36 For me, I would say that when it comes to accountability, the the main thing that comes up the most is expectation. What do we expect another people? You know, what do our expectations too high? Are we expecting things that people aren't capable of doing? And what do we expect from ourselves? You know, how are we showing up in a way that validates ourselves, but also other people, because we also have to think about the people that we're interacting with as well. And when it comes to accountability, sometimes people's you know, people expect someone to show up a certain way, you know, and or you don't expect anything for of yourself and others. And you're wondering why people are like, No, I need you to respect me, you know, I need you to understand that this is how I am and this is how I show up. And then we then make the requesting like oh, so there is an expectation around how I show up in the room. And I have a duty to either, you know, respect that, you know, and validate that but also question if it's too much, and if someone is expecting something of you, that is too much for you in the moment or doesn't align with how you want to show up how you want to be present. Then you have a right to question Kira Yakubov: 44:59 I love that. I think for me, what comes up is giving and receiving feedback. Because that is a skill on its own, that I was never taught. And so I think even just through the therapy process and working with couples, that's if you want things to be a particular, if you have those expectations, if you want to a certain type of life or quality of life, is considering, like, Can I share this with someone? And am I open to hearing what they have to say about me, if I want my relationship to improve if I want my life to improve my problems to dissipate in some way? Am I open to hearing how I'm getting in my own way. Because if you're not open to hearing how you're getting in your own way, or you're impacting somebody else, you're going to make them the bad guy, and you're not going to change or put in any effort. And then you're kind of in that victim mentality. Elijah Jackson: 45:59 Right Kira Yakubov: 46:00 And so it's, so you have to be and it sucks, right? Like, it's not fun, right? Like, I'm in a marriage, I have other relationships, like, it's not fun, or pleasant or comfortable to hear how your behavior is negatively impacting somebody that you care about. It's not. And if you're not willing to hear how they feel, or the impact it has on them, don't expect this relationship to thrive, or to move somewhere. And like Elijah said, if you feel like, well, maybe these are unreasonable expectations you have of me, then you can't question and say, This is what I'm willing to provide, based on the feedback you gave me. And then they have a decision to continue this or not? Elijah Jackson: 46:43 Absolutely, absolutely. And that also goes, that goes back to, you know, or at least that made me think a lot about readiness, how ready are we to change? Sometimes there are problems that arise and we don't know their problems, or there are questions that we have, but we don't feel capable or ready to address those questions. They're just questions that are popping up for us. That's something that I go through a lot with my clients is, how ready are you to address these problems that are that are popping up in your life? Because it's, it's one thing to just say, yes, the is a problem for me. But it's another thing to say, I'm ready to do something about it, you know, and some clients aren't ready to do something about. So it takes more time. We have to slow down and we have to be more mindful of where we are, and more mindful of our readiness to change. Daniela Galdi: 47:39 It's another great question to add to a little like self check-in that that we've talked about in this episode already. Because it makes me think for myself to you know, how ready Am I had a situation happen? Somebody said to me are you going to therapy, and I will, I will tell you both right now, I'm not at the moment. I'm an avid goer, but I've been taking some time off. And it made me think like questioning myself. Wait a second should I be and I had to kind of pull back and ask why. And that question. I didn't know it came up in this way. But now that you're saying it? No, I'm not. I'm not ready to address it yet. And it will be one of those situations where I would avoid talking circles, right? I'm not not ready to fully go there. But I will be and then I know that therapy is there for me when I'm when I'm staring to confront that situation. Although I do always suggest, like I mentioned earlier continue to go but you know, circumstantial situation. With that said, Elijah, what's one thing that you're comfortable sharing that your clients may not know about? Kira Yakubov: 48:50 Well I wasn't gonna share it then [laughing] Elijah Jackson: 48:58 No, I'm usually pretty transparent in my sessions, but I would say that I'm a big nerd. I do love all things, all things, comic books, all things, you know, all things action. I you know, it's kind of a guilty pleasure of mine. Actually. No, I should take that back. I don't feel guilty about any of my pleasures. But yeah, I do love I do love a good comic book. I love a good comic movie. I can talk about things like the MCU for hours. So yeah, any any, any client who was who loves comics. We can spend hours talking about them Kira Yakubov: 49:43 this one was like, embarrassing, but I guess I shouldn't be embarrassed because it's fine. So when I was younger, I was like, for the listeners, have you guys seen Bob's Burgers? Elijah Jackson: 49:55 That show is awesome. Kira Yakubov: 49:57 Okay, you know, Tina? I am Tina. I was. So when I was younger, like, I don't know, 13 14 years old, I would write these like, romantic encounters of how I would meet somebody and like these erotic stories in my diary. Like a little weirdo. I guess it's not weird for anybody else who does it, but I thought it was a little weird. I would just like fantasize and live in a dream world. Daniela Galdi: 50:25 I love that you're both sharing these please keep going. Elijah Jackson: 50:31 Okay, I didn't write erotic stories. But I did. Kira Yakubov: 50:31 That's all I got. Because as I mentioned, I'm a nerd. I used to create i Even though I was a horrible artist growing up, I did not have that kind of hand eye coordination. I used to create my own comic characters. I used to have whole stories for them. They used to have books growing up, my mom would always find books with the with like, different different characters that I created. And then I always used to tell her mom, I'm gonna put them all together. I'm gonna make comic books. She's like, Okay, I'm waiting. Years and years go by and it never happened. I wish I still had those books. Because it does. It does bring back a lot of fond memories. So it didn't I didn't do any of the erotic stories, but I did create a lot of scenarios you were a sexully charged adolecent as I was Daniela Galdi: 51:26 I feel like I should add to that, but I'm trying to think Kira Yakubov: 51:30 Yea, you had us exposed Daniela Galdi: 51:31 exposing something. I mean, I'm thinking of like one that's not that cool. I mean, but I guess I shouldn't judge. It's like I had a pet rock named Princess. Now my rock has turned into like a crystal obsession, I guess. Because I'm an adult. And I used to in terms of writing, not comic books, not erotic. But I plagiarized as a child and would write down song lyrics in my song book. And these were like my songs and I'm air quoting. And I remember my sister found my book and she was like, you know, these aren't yours. Why are you just writing lyrics to songs it was like Saved by the Bell like when a flyer thing and like, you know, I don't know some other artists in there. And I was like, this is my song book. And I think I convinced myself that like I wrote the song. plagiarize the crap out of them. Kira Yakubov: 52:32 Look at us all just trying to cope as kids Elijah Jackson: 52:37 we all find a way to escape. Escapism is real. Kira Yakubov: 52:42 So as sad as I am to end this episode, Elijah, thank you so much for being on. this was this was a pleasure getting to know you a little bit more here and more about your life and background. So thank you so much for taking the time to be with us. Daniela Galdi: 53:01 This is a by Vesta production. ### Listen - [Spotify](https://open.spotify.com/episode/12748949) - [Apple Podcasts](https://podcasts.apple.com/podcast/12748949) - [YouTube](https://youtu.be/3ejTC5FUYhU) --- ## Adolescence and Mental Health Management with Emily Shaw - URL: https://healyourrootspodcast.com/episodes/adolescence-mental-health-management-emily-shaw - Published: 2022-09-28 - Season 1, Episode 4 - Duration: 41:12 - Category: personal growth - Guest: Emily Shaw ### Summary Personal exploration of mental health journeys, with tools for self-reflection and understanding individual patterns in thoughts and behaviors. ### Description Mental health is deeply personal, and everyone's journey is unique. This episode encourages listeners to reflect on their own mental health experiences and begin to understand patterns in their thoughts, feelings, and behaviors. Discover tools for self-reflection and learn how to become more aware of your mental health needs. ### Transcript Emily Shaw: 0:01 People are just going to respond differently you know what works for one person like isn't gonna work for another person. So like, I find myself like explaining things different ways I find myself pointing different things out, you know, it's not one size fits all. people need like very different approaches. Daniela Galdi: 0:18 adolescence is a time for growth and big changes to the body, social development, and especially mentality. So for this episode today, we cannot wait to dive deeper into mental health. I am Daniella, your co host sitting here with Kira. Kira Yakubov: 0:36 Hi, everyone. I'm Kira Yakubov, founder and the therapist of Heal Your Roots Wellness. And I'm so excited to invite Emily Treadgold Shaw today she is a nurse practitioner in psychiatry. She's currently practicing at integrative psychiatry, of Manhattan, and she happens to be a good friend of mine as well. So Emily, thank you so much for being here. Emily Shaw: 0:57 And thanks so much for having me on, Kira Yakubov: 0:59 of course. So I first want to ask what got you into therapy and becoming a nurse practitioner and to mental health field. Emily Shaw: 1:08 So I it's funny, I knew that I wanted to do this from sort of an abnormally young age, I can remember being 15 and telling one of my friends that I wanted to be a child psychiatrist. And they said, Well, that's a long way off. But I, I just, it's funny, other people were really good at other things. And what I was really good at was talking to people about their problems and helping them really sort through it. And I found out like, oh, like people can pay for this, like I didn't pay any money to just talk to people talk people through their problems and help them. So I studied psychology in college, and then I graduated into the recession. So I went straight to grad school, and I decided to become a nurse practitioner, because I wanted to be able to prescribe medication. But I also really wanted to be able to do psychotherapy, I think it's really important to be able to do both. And I really wanted to do both. I didn't want to lose that talk therapy side. And I also really wanted the flexibility of being able to prescribe when needed. So yeah, so that's sort of how I got into it, I lasered in on it, and at least are done on it at a young age. But I decided, you know, I just kind of like kept going straight through with that I had a really hard time when I was a teenager. And I had a lot of protective factors. So my parents were really great. They loved each other very respectful. They were respectful and honest with me and my brother, it was a lot of warmth and kindness. And I was still like really struggling. So I also really wanted to help kids that might not have come from the same kind of really supportive family of origin. That had, you know, that had more challenges than I had. And I'm really struggling with those. Kira Yakubov: 2:48 I love that. I did not know I wanted to be a therapist, when I was younger. I mean, I did subconsciously. But from my background, my parents were like, oh, you should go to accounting because for a woman. So I love that you actually always wanted to do that. Emily Shaw: 3:05 Yeah, Kira Yakubov: 3:05 Specifically working with kids. Daniela Galdi: 3:07 Now let me ask. What were you guys like as a Emily Shaw: 3:07 Yeah. teenager, because I know, for myself, I was very rebellious. I was, well, I was a good student. So in my mind, it was like, because I'm a good student, I should be allowed to come in when I want. in that sense. But I was very hardworking, very, like, very disciplined in terms of like, if my mom asked me to do something, you know, things like that helpful. But when it came to like, wanting my freedom, that was that was like, Oh, I'm owed this because I'm looking at me, I'm doing so. But I understand now as an adult, that it probably drove my parents through the wall with nervousness, you know, so that was me as a teen. And juggling a lot. And I really think I should have been seeing a therapist, for sure. And not just because I was like had that had that rebellious side but because I did struggle a lot with like depression and not understanding it. I had a lot of insecurities. And you know, kind of get pushed aside is like, I'm shy. I'm shy, but it really was like I'm dealing with all these emotions and thoughts in my head that are unhealthy. So yeah, so with that, so that's kind of that was like me in a nutshell as a teenager, but what about you two? So I was the opposite of rebellious. I was also shy, but I was very, like, I really wanted to get good grades, like really wanted to, like Please, everybody, I want to please my teachers and I wanted to please my parents. And my parents were not that strict. They were really honest with us. They grew up in the 70s. Like they were really, really, really honest with us about the stuff that they were doing. I did not do any of those things [muffled] college. I was also struggling with depression and didn't know it. It was also you know, and it's it's so sad to me now. Oh, if I had asked my parents to go to therapy, I'm sure they would have said yes. I just like I didn't know that I was depressed. I just thought that everybody was sad all the time. And I ended up talking to a lot of my friends. I'm an oldest daughter, and a lot of my friends are also oldest daughters. And we sort of just ended up talking about it amongst ourselves and like trying to support each other, and then being like, well, we can't tell our parents like, then they would be worried. So sad to me now, because that that didn't come. Like for me that didn't come from my parents. And I'm sure if I had ever gone to my parents with a problem, they would have helped me. It was just that, like, I didn't want them to know, I was struggling. And I wish that someone I wish that there had been like someone that had been able to be like, it's okay to ask for help. So I that's like, I think I think that's why I was really drawn to the field. Like I really even at the time, like, even when I was 15. I was like, with no insight. I was like, I want to be a child psychiatrist. I wonder why. I wonder why I had that thought it was, you know, I like I really, I think, wish that someone could help me but like, didn't think that there was like the avenue for that just didn'texist in my head. Yeah, Kira Yakubov: 6:06 yeah. So this is gonna be a sad girl club, because I was also very depressed, and anxious growing up. I mean, there was like, a before and after, like, as a younger kid, I was very outgoing. I wanted to be an actress, I wanted to be like, center of attention, loved it, until it was like approaching adolescence, when I had like facial hair, and my body was changing. And I was like, oh, I want to be hidden from everybody. Because if they can't see me, they can't make fun of me. And I'm just gonna be like, the funny kid in the back like the class clown. So that was like, my way of coping through that. But I had very strict parents, like Daniella, who has immigrated here from Azerbaijan, Eastern Europe, and they did not understand sleepovers, they did not understand really like being sad, because we came to America, and there was like, no war currently happening. So that was, I had everything I needed. So I didn't have a reason, a good enough reason for them to understand why I'm sad or anxious. And I was really shy, too. And I think the way that I dealt with that was okay, like, if my parents aren't gonna let me do this, how can I problem solve and like finagle a way to still get what I want, which is like in social settings, so like, I would sneak out or I would, this is, I don't know, for listeners who are around our age, but caller ID in three way calling. Daniela Galdi: 7:35 Oh, yeah, Kira Yakubov: 7:36 I told this to my parents later on in life. But I would say I'm like sleeping somewhere, I will say I'm sleeping at a friend's house, we're really at the sleeping somewhere else. And then I would call my friend and a neighbor call my parents house and the caller Id would show up so it wouldn't, I found ways around it. And I was also very rebellious. But I just I journaled a lot, or talked to my friends about being sad, or just read a lot of vampire books. And that's something Daniela Galdi: 8:06 This is new that I learned about you. Kira Yakubov: 8:07 Yeah, Daniela Galdi: 8:08 but it was something that you turned to to help manage it. it was your thing, too, was like your Kira Yakubov: 8:11 Yeah, personal thing that you love. You brought up something that comes to mind now, because you mentioned about being the oldest. I know, you're the only daughter. And now while my parents were also immigrants, I do feel like I got a lot of freedom. I'm also the fourth and baby of my family. So what is your perspective? And I'll ask Emily, first, what's your perspective with birth order? And what happens to our mental state or emotional side? Emily Shaw: 8:41 Yeah, there's definitely, I feel like there's stereotypes. There's this stereotype of the oldest child having to feel like they're really responsible. And I definitely felt like I fit that to a tee. Like other people's parents, or my friend's parents, or my parents friends would be like, Oh, you're so mature, you're so responsible. And I feel like that's sort of the stereotype of like, the oldest child like having i It's not I have one brother. But I felt very, like I had to have everything under control. And not because not because anybody told me that, but I feel like oldest children are sort of just like socialized to be, like, hyper responsible. Daniela Galdi: 9:23 And then Kira. What did you experience with that? Kira Yakubov: 9:25 Yeah, I mean, so I'm the youngest of three, and the girl . I have two older brothers, and my oldest brother definitely fit that bill. He was. He was very parentified out of necessity, like we came America. My parents didn't speak English. He was like seven. So he went everywhere with them to translate to set things up. I mean, like adult things to do. So he definitely took on that role. And then I have a middle brother, and then I'm the youngest, and I was definitely treated like the baby. And I think birth order does make a difference within family dynamics for sure. And even though you grew up in the same family in the same house, everyone has a different experience. And everyone's treated a little bit differently based on the birth order, your gender, different things that are going on with you, whether it's like personality or medically, or just like your relationship with each parent is different. So I think all of these factors definitely play into mental health. Daniela Galdi: 10:23 Absolutely, because with me mentioning, being the youngest of four, I was also born a few years later. So I did get I do feel taken care of a lot. But at the same time, and my you know, my mom worked two jobs at times, my dad worked full time job. So I did find myself being responsible, which, if my mom ever listens to this, she's going to maybe laugh when I say this, but she feels bad about it. She's like, I feel like, you know, I wasn't able to be there. But she totally was, I think in me a little bit was like, I need things a certain way. And and you mentioned earlier, Emily about control. And I wonder if that played into like subconsciously, because I was anxious and had all these other feelings. I needed that sense of control for myself, maybe. But I also had to be very responsible at times, because I was a few years behind my sisters. And so it was almost like I got the attention of I feel like a first child at times. So yeah, so it's such an interesting aspect. And I asked that, because I know you both talk, you talk to a lot of family members here, and then Emily working a lot with teens. Kira Yakubov: 11:31 So I'd love to hear what you enjoy the most about working with, whether it's adolescents or teens, and maybe some of the parts that are the toughest. Emily Shaw: 11:40 Yeah, I love adolescents, because they're just discovering everything for the first time, then there's this sense, a lot of times, like when they're doing well, there's a sense of possibility, there's a sense of like, I could be anything or do anything, and I'm just discovering why, like, there's also adolescents will keep you on their toes, they will just be like, you really know what you're doing, you're gonna really have to be you cannot, you can't try to finesse, a kid that much like they will see you right through like, you really have to be at least that I find that I have to really be honest. And that like I like that they keep me on my toes like that. If it is it is really challenging. You know, the challenging thing about working with kids is like, you have to you know, you're also working with parents options, you're also working with the school counselor. A lot of times you're also working with the teachers, tutors, there's just a lot more people that you're communicating with, which is great, because when you get a really great treat and treatment team coalescing around a kid, that's really rewarding, but it's also you know, you're coordinating all these moving parts isn't there's appearance aren't getting along, and sometimes you're getting divorced. And sometimes, you know, they're they have different ideas about what the treatment plan should look like. And it's also, you know, it's hard because kids have very limited control over their environment. And a lot of times, if they're in a really tough spot, that's very hard. Because, you know, you all and I had to like learn to like put like boundaries up and you know, like, learn not to take work home. But it's like, you wish that there was so much more that you can do and you just can't do that much. And as an adult, I feel like sometimes it's a little bit easier, because like kids, they really can't change their circumstances a lot of the time. And that's really challenging. Kira Yakubov: 13:24 So I worked at a high school as an adolescent counselor. Yeah, well, I, it was not my favorite. It was not my favorite position. And I also Emily Shaw: 13:33 Fair. Fair. had to, like reach out to like their individual therapists and things like that. And one of the things that was tough for me that I think is different than when working with adults is kids, they didn't always want to see me, but they had to see me or it was part of their treatment plan that their parents and teachers decided for them. And so I would have kids come down like yeah, I don't want to talk to you like this is super dumb. I don't know, I don't care about you, and he would sit there. And sometimes it'd be like, pulling teeth. And they understand why from their perspective. And from my perspective, and like, it's not always, for me personally, it just didn't feel rewarding or helpful, because I feel like I'm forcing someone to talk to me. And like as a person, I hate feeling like I am forcing anything. I always want people to come like voluntarily. So that was the toughest part. For me working with kids. That's really hard. I have that a lot. And I've had it a lot. Also, I've worked in all kinds of places, and I've worked in an inpatient unit for adolescents also where they definitely don't want to be there. Yeah, so I that's really hard. I actually I think that's one of the things I find more rewarding because sometimes you start out with a really tough kid and they're like, this is stupid. I've been to therapy before and it doesn't work. You know, I don't want to be here. I'm only here because my parents are making me and I'm like, okay, great to let's play Uno. You know, and I always had like, you know, you don't have to say I my first ever therapy client when I was School was a 13 year old girl that would not talk to me, like not a word. But she was like, look away from me. And we like, would just play games. And eventually, she warmed up a little bit. And I also like, I didn't think, of course, I'm like, in school and freaking out, and like, I'm not helping this person at all, like, I'm going to get I'm definitely failing at this. Like, this was such a terrible idea. And it actually like that is now what I find like something like really rewarding is when kids don't want to talk to you. And then eventually, like, if you don't, if you don't push, you know, you gotta like, You got to kind of give them enough space. But like, eventually, like when they start confiding in you like, that's really like, that's also like, extremely rewarding. Yeah, but it doesn't always happen like that. Like, sometimes kids are just like, I don't want to be here. And that's hard. Yeah. It's easier for me now. Because now that I'm in private practice, I have like so much longer, that I can work with this game family. That's actually one of the reasons why I switched from working in. I love working in hospitals. But it's one of the reasons that I switched to I wanted to see kids longer term, I really wanted to see them like evolve. Kira Yakubov: 16:11 Aww Emily Shaw: 16:11 Yeah. Daniela Galdi: 16:12 Is that what you mean by seeing them longer? Like the duration? Was it different when you're seeing them from the hospital or counseling? Emily Shaw: 16:19 Yeah, so when I worked in hospitals, unfortunately, because of the way that insurance is structured. Now, a lot of times if you go to an inpatient hospitalization as a teenager, or even as an adult, you know, it's like a seven to 10 day hospitalization before the insurance company is like. So. So it's hard, you know, you somebody can improve a lot in a short amount of time. But what I really like is seeing that long term improvement over like, weeks and months, and like some of my patients now I've had for years. So I ended up trying to, you know, and a lot of people transition, like, it's really good to work at a hospital right out of school, because you just like use the I learned so much, you see a ton of stuff. But I ended up you know, but it's also really hard. It's like, it's really difficult circumstances, and I just after a while just couldn't do anymore. So it is, you know, it has been really nice to work with kids longer term. Kira Yakubov: 17:10 And so I'm curious of I know, with kids, especially younger, it's like being able to play and do games and stuff. How do you feel like that has changed with COVID and having to do it completely remote. Emily Shaw: 17:21 So I actually was in person, the whole pand-, not the whole pandemic, when the pandemic hit, I was working at a public hospital in the city and we went to all phone and that was really hard. And then my, the job that I had after that I was actually in person. And then now I'm in person I was in person two days a week before I got pregnant. If you're just listening and not watching the video, I am seven months pregnant and enormous Kira Yakubov: 17:47 and grogeous Emily Shaw: 17:50 before I got pregnant, I was going two days a week home three days a week. now I'm going in one day a week. But I usually like reserved my in person slots for like younger kids. I have a couple of like 11 12 13 year old. So I try it's just harder, you know, it's harder. Some kids, some kids are great with technology. Some kids like transitioned, like right away, they were like, you know, is totally fine. We like play, we'll like play drawing games and stuff like that. But it was really hard to transition especially like at the beginning to transition from like seeing kids in my office being able to play with them to like doing all like all over the phone. That was that was really challenging. Being like the flexibility of being able to work from home, but I also like when I see kids, I really like being able to workwith them. Yeah. Daniela Galdi: 18:35 The phone sounds so challenging just to keep something adult's focus, I would imagine. Emily Shaw: 18:39 Yeah. Daniela Galdi: 18:41 Or teenager, an adolescent in that sense. But yeah, that I commend you for that. Because that sounds like that was a lot of extra, possibly in your approaches. For you. Emily Shaw: 18:51 Yeah, it was just it's just harder to keep people engaged. Kira Yakubov: 18:54 Yeah. Emily Shaw: 18:54 Like, there's no way you know, if you can't see them, like there's no way to be like you're watching TV right now. Yeah, so that was that was challenging. Oh, kids, the kids adapted to it really Well. I was really impressed with I mean, the pandemic has precipitated, like a huge, like, adolescent mental health crisis that was there totally there before, but just like sort of like laid bare that adolescent mental health crisis that we were already having. But I was actually really impressed with how resilient the kids that I worked with, were and how like, well, they adapted. Daniela Galdi: 19:27 So you're mentioning that the phone and you mentioned about technology? My question to you is how do you see or what is your perspective on the fact that social media now plays a part with teens? In my opinion, I like the fact that people can learn about mental health I feel like the awareness is heavy. It could just be who I follow, but I'm hoping that it comes across to teens as well. But I also see a downside to it. So what's your both of you that will start with Emily but what your perspective? Emily Shaw: 20:00 Yeah, so I, there's so much good and bad. I see so many teens using it in such a creative way to express themselves. And also, honestly, a couple of my young adult patients have seen things on social media either like about ADHD or about like, complex PTSD. Or they're like, oh, wow, I really relate to the symptoms, and then we talk about it. And that's like, why they came to therapy. That's awesome. I have also had a lot of like, early adolescent girls be like, I have borderline personality disorder. And me being like, No, you definitely don't. Like, I know that you saw a list of symptoms. But that doesn't mean, Kira Yakubov: 20:37 this is just regular. Daniela Galdi: 20:41 Because as an adult, I've also done that to my therapist. I was reading about schizophrenia, and I think I am schizophrenic. And she was like, no. Emily Shaw: 20:52 So I think that like, as long as you have a person that you can talk to about it, that that's great, but that I can, it's very easy for me to see how you could like read a list of symptoms that you relate to, because you were not the developmental, like age target of the symptoms. And you could think that you have like, you could sort of like label yourself with this thing where you're like, Oh, my God, and it turns out to not really be accurate for you. So there's, like, I'm glad that there's so much more like awareness and information, I think that kids do feel so empowered to talk about their own mental health struggles in a way now that like they never did, even when we were kids, which I think is amazing. But I, I also, you know, what's funny is I've been thinking about this for a while, because I'm about to become a mom. So my husband, I were laughing, that, you know, when we talk about the baby, I'm going to be like, no screens til you're 40. So, I know, I'm so glad that I didn't have social media as a child. So like, I got Facebook for the first time I was 16. But it didn't even have the newsfeed back then it was like super, like, it was like a really, really early version, there was no infinite scroll, there was no there was none of the things now that sort of whatever they've engineered to make it, like hit the dopamine part of your brain that makes me want to do it more. And then Instagram didn't come out until I was in grad school, I think, and I'm so glad. Like, that's like, I sort of like think all the time about how, like, grateful I am that I didn't have Instagram or Tiktok when I was in high school. And that makes me really sad. Because I definitely see a lot of the, you know, girls that I work with, but also boys like, also like, even like adult men, like really strong with their body image. And I you know, I really struggled my body image in high school and college without any of those things. So like, I've seen girls really struggle I see boys really struggle there's like this pressure to you know, there's all these like bodybuilder Instagrams, and like, even just, you know, it's a, you have to keep in mind that you're just seeing like a very, like curated, like very, like, you know, nobody is posting their bad angles or their bad days, and you're just I feel like it, people feel really inadequate. And then it also with the, you know, with things like infinite scroll, like, it's so hard to to and even, like, I find it really hard to tear myself away from my phone. And like, I don't use social media at all, like, I'm really, that was like a boundary that I had to set for myself, because I was like, oh, like I am like having trouble, like putting this down to like, as an adult, I had to be like this, like I can't, like, I can't, I don't want, I don't need this to be part of my life. And like, it's fine, because I it's not the primary way that my close friends communicate with each other. But if you're a teenager, you know, I could never say to one of my adolescent patients like okay, well, why don't you just not use you TikTok? It's not realistic, you know, so I have to talk to them about like, meeting, you know, I just sort of meet them where they are. And, you know, parents are freaking out and have to be like, you know, especially like, also, like video games during the pandemic, a lot of the boys and girls that I worked with, were playing a lot of online games with their friends and parents would be really upset because, you know, I had to be like, look like they're not in school, like they can't see their friends. Like, this is like the time that they have to like, relax and like, chat with them, like the way that you talk to your friends. And I don't think they should be doing it 12 hours a day, you know, we can still keep limits on it. But I think that it would be really hard for them to go without any social communication, like that is also not good. So it's about striking a balance. But striking a balance with these things is so difficult. And even it's difficult for adults. So it's like kids have no you know, your prefrontal cortex doesn't finish developing until you're 26. So it's like it's really hard to like self regulate, like social media and video game used when you were an adolescent. So it's difficult and also a lot of the tools that parents use to limit their kids social media use the kids that I work with, they're very like tech savvy. Just get around me like when we were kids even there are some of that yeah, like I remember like Going through VPN at the school by like playing nerdy word games. But this is like how much rebelling I was doing. It was like playing text quiz in the library. But I yeah, I mean, that's the thing is like parents are like, Oh, we have parental controls on the TV, and I'm, like, it doesn't matter, sorry, sorry, but your kid knows how to get around them, and has been getting around them for two years. Kira Yakubov: 25:26 So I dont work with kids now at all. But when I did it, I mean, it's exactly what you're saying. Like the if there's a will, there's a way and like, they, I learned so many different apps they would use to communicate with each other to figure things out, parents would never have a clue. And like you wouldn't know unless you're a kid, or you're like figuring that stuff out. I can definitely see how parents might think that they have certain controls, or they know what's what their kids are watching or doing. And, unfortunately, they may not or may be under estimating their ability to do what they want to do and be able to communicate with their friends. And I'm also very glad that I did not grow up with social media. I mean, we had MySpace when I was in high school. And texting was like a hot mess, like you have to hit the same button like three times to get it. So it wasn't really a lot of texting, there was the AOL and AIM Daniela Galdi: 26:25 I was thinking, AOL, Kira Yakubov: 26:26 yep Daniela Galdi: 26:27 we used to think, like, we used to crack codes for people's passwords. That's how we spend our time trying to try to hack Emily Shaw: 26:37 AIM is how I learned to type a 100 words a minutework, I definitely wouldn't have achieved that without. Kira Yakubov: 26:42 A little bit like shifting gears, so you're a nurse practitioner in psychiatry. So not a lot of people know the difference between a nurse practitioner and a psychiatrist, a therapist. someone could do all the things. So if you'd be able to kind of share a little bit about the differences, that would be great Emily Shaw: 27:05 yeah, okay, I have this conversation with people all the time. So a psychiatrist is a medical doctor that can prescribe medication. And then sometimes they also do psychotherapy, they're licensed to do both. A lot of psychiatrists only prescribe because of the way that insurance is structured, but some do psychotherapy. So I'm a nurse practitioner in psychiatry, which means I got a nursing degree after my two bachelor's degrees, because it took a little longer. So I have a bachelor's in psychology, which you don't need if you want to be a nurse practitioner, but I happen to have two bachelor's degrees. So I went back and I got a second bachelor's in nursing. And then I got a master's in psychiatric nursing. So I'm licensed to prescribe and do psychotherapy as well. The privileges for nurse practitioners are different state to state, where I'm licensed in New York, I basically can do almost everything that a psychiatrist can do. So you have to have a supervising physician for two years of full time work the equivalent of two years and full time, full time work in New York. And then you can practice independently, which is what I do now. But I used to work in Louisiana, and then I had to have a I would have to still have a collaborative position if I were still living there. So it's a little bit different Kira Yakubov: 28:20 Yeah, so licensed therapists, like myself, cannot state to state, like how much supervision you need and what you're allowed to do. But in New York, the laws the parity is pretty good. So I really like a practice, pretty much like the full extent of my licenses, which is great. And then sometimes, you know, a psychologist is usually someone that has a PhD in either clinical psychology or there are different kinds. But in most states that people can't prescribe, but in some some states have prescribing psychologists where you finish your psychology degree, and then you do like a shorter pharmacology degree. That's like, that's new. And it is like, I think gaining momentum in some places. There's a huge shortage of psychiatric providers, and especially for kids. So I was sort of, like whatever we can do to improve access is really good as long as like the, you know, as long as the training is adequate, and like very into like improving access. And then there are therapists that are trained as licensed, licensed clinical social workers. You know, they're like a lot of different ways of becoming therapists. But psychiatrist and nurse practitioners, usually and right, some psychologists can prescribe. prescribe medication. And so it's really great for us to have great connections with nurse practitioners or psychiatrist so we can work together to help clients. And I'm also wondering, so in the moment, or do you see clients only for med management and not therapy, or do you normally do both? Emily Shaw: 29:49 I try to do both. I have. I have a couple clients now they're only therapy. And then I have, I have a lot of clients where I do both and some clients I only do medication management, but usually if they already have an individual therapist. Um, so usually sometimes people will see a therapist for a while. And then their therapist will say, you know, I feel like maybe you should talk to a psychiatrist or a prescribing practitioner. So most of my patients that just do medicine, a digestive medication management with already have a therapist, and then patients that don't, I will usually do some amount of therapy with them. And then especially a lot of my child, adolescent patients, a lot of them are not on medication, some are, but some are not. Some of them. I'm just doing psychotherapy. Yeah, Daniela Galdi: 30:32 it's just so fascinating. What's the range of that diagnoses? I guess it will be called,What is that range that you see? Emily Shaw: 30:43 So it to a lot of stuff right now. in the practice that I work in, I'm seeing a lot, it's a lot of ADHD, a lot of anxiety, a lot of depression. A lot of I, you know, some like obsessive compulsive like PTSD. Some, you know, I have some patients that some patients that have psychotic disorders, not as many as when I was working in hospitals, just because like the population is a little bit different. But there's Yeah, I mean, I also would really enjoy working with patients that are working on like trying to heal from substance abuse. So that's mostly my mostly my adult patients. But I see a lot of that as well. Yeah. Kira Yakubov: 31:25 And so I'm curious for for listeners out there for parents, because I know some parents might feel nervous to have their kids around medication, other parents are all for it. What has been your experience with working with parents, especially when they're under 18 who are bringing their kids in? Emily Shaw: 31:41 Yeah, a lot of parents are really hesitant. And I totally understand that, like, you just want to do what's best for your kid. A lot of parents are like, what if they become addicted to drugs? Because of this, a lot of parents are like, what if they can't stop taking the medication, I think there's a lot of nervousness about like setting them on a path that they're free, they're not going to be able to control kind of like where that goes next. Also, I mean, unless somebody in these medications have risks, like it's not something that I would do lightly, like a lot of my child, adolescent patients are not on medication. I certainly like want to always try everything else. First. There are a couple of things are like, for instance, like, with Attention Deficit Hyperactivity Disorder, there's not a lot you can do with just psychotherapy, like the medications for that are really helpful. And they have the potential to really improve like a lot of kids lives. But I totally understand like parents hesitancy, and you hear a lot of horror stories on the Internet, about ADHD medication, and some of that is, you know, there are like real risks. So I, you know, from a personal perspective, like, I wish that I had had medication, I take medication for depression now. And I wish that I had been able to take it earlier, I got diagnosed when I was 27. I feel like I could have avoided some of the things that happened to me before that, if I had been diagnosed earlier, I mean, obviously, like everything, I'm glad, you know, I am happy with the way that everything turned out in my life. But from sort of, from a personal perspective, a lot of times I think you can alleviate a lot of harm. You know, if you were in pain, like physical pain, like if you work your arm or your leg. The analogy that I use a lot with parents is, especially like parents, especially parents that have kids that have ADHD and don't want to start medication. You know, I say it's a little bit like if your child needed glasses, and you were saying that they just needed to try harder to see better. Like, it's not possible, you know, and they're not lazy. They're not bad kids, like they're trying as hard as they can. They just, you know, their neuro chemistry is like different than other kids. And without medication, it's going to be really hard for them to perform up to their potential. And a lot of times, like kids are losing self esteem. They're like, I'm dumb, like, I can't get this Why is everybody else getting this or getting in trouble. They're like, I'm a bad kid. So like, that's really when I'm like look like we could really prevent like, a not so great outcome in the future by starting medication now. Also. Also, if you're unmedicated for ADHD, your risk factors go up for other like for car accidents for like substance abuse for depression and anxiety. So I really like this is something that I really try to emphasize to parents when I talk to them that like, I know it seems really intimidating and scary and frightening to start medication for your child. But a lot of times it's like, if it's preventing them from like repeating a grade or preventing them from dropping out of high school or preventing him from being like unemployed or underemployed. Like really like the benefits outweigh the risks in so many situations. Kira Yakubov: 34:54 I wish that you existed. Well you did exist, but when I was a kid with my parents and like, as immigrants, especially from where we come from mental health is like not a thing that you really are concerned with or understand. And so I was diagnosed ADHD inattentive type as an adult. And like, as a kid, I, it wasn't detected because I wasn't hyperactive, I wasn't bad in class, I wasn't disruptive, I would just daydream, my head would be out the window, I wouldn't know what the teacher is saying, I would, I would like I would hear, I would forget, and then it would make me feel like I'm dumb, or lazy. And then I did develop depression and anxiety. And I can't imagine if I would have told my parents back then they would have done much not because they don't care. I don't think that they even recognize that there was like resources like that for me. And they definitely would not have put me on medication. Like even now, as an adult, I was like, concerned like to take it, do I not? What is it going to do to me, like, all the same stuff. And I can see the benefits of taking it and the huge difference. And if I was in school, when I was younger, taking medication, I mean, I don't know how they would have turned out, I'm happy with my life now. But I think it would have decreased a lot of the struggling that I went through, and a lot of like, the insecurities that I experienced. Daniela Galdi: 36:20 Absolutely, and hearing, hearing when you say like, as someone who wants to be a future parent, but also recognizes a few things, right. So I recognize that for myself, I love the all natural approach, right. And I also take medicine for my depression. So I also recognize the benefit of medicine, because I had to be explained that this had to be explained to me several times by my doctor, by my therapist of well, you know, I always got the diabetes, you know, the diabetes example, if you had diabetes, you would have to take medicine, right? So you want to just not take it and suffer, right? And while you're taking it, you can also do things in your lifestyle to help it right. So there's also the dependency doesn't have to be there either. Eventually, there's ways to work past it. But right now, you know, right. In those moments, it was it was really helpful to recognize that effect. And so all these things considered, for me myself, one day, when I want to become a parent, hearing, you say, Emily that like, you don't take it lightly. And then hearing both accounts. And I feel I feel similar in the sense of like, as a child, I do recognize that, like, there could have been a lot of help seeking a therapist, possibly the medicine to so hearing all this and then hearing on top of that, like you don't take this lightly, to diagnose the medicine gives me so much comfort. And I just want to put that out there for people because in case we do have listeners who are parents, or you know, there are teens, and they want their teens to listen, because maybe the teen is not comfortable with it. Right? They can know that. It's not just something that's like we are dismissing you, we don't care about you pure pop, pop this pill or whatever you have to do to feel better, like it's not a dismissal is actually a very well thought out process. Kira Yakubov: 38:23 And I also want to say I hear this a lot with adults, because I work with adults is I can even like go through this and explain this and they intellectually understand. And there's like this narrative or belief like, well, then it means I'm weak. Or it means that I can't just do this on my own, like, there's something wrong with me, I should be able to just figure it out, suck it up, do better. And it's like, it's not about motivation. I mean, like part of it, right? But like you said, it's like the brain chemistry, we can't will our way out of brain chemistry. That's just the physiological part of our brain. And I think part of it is the acceptance and working through that shame that like, it's okay, if you rely on this thing. Like that's, I mean, think about like, what do we do every day, like the glasses things was a great example to or if someone like there's a disability, or they need a cane, or if there's not like if it improves your life. It's not a negative thing. And it's not a sign of weakness, it means that actually, I think it means you're pretty courageous to accept all the resources available to you so you can be your best self. Emily Shaw: 39:29 Yeah, I didn't have that much insight about it. inmyself, even when I. I became a nurse practitioner in 2014. And it wasn't until 2017 that I started medication. So even though I knew I remember really vividly, I was in graduate school and I was reading a questionnaire for depression that I was giving to adolescents as I was doing an intake for one of my clinicals and I think it was the back. i But I remember that I was reading these questions like, I feel like it failed. You're I feel like I'm being punished. I feel like I don't look as good as I used to. And I was like, oh no. Because I was, you know, I was really burnt out. And I was really struggling. And it was, literally years later, I was seeing this amazing therapist in New Orleans, when I was living down there, and she eventually, you know, she brought it up to me a couple of times, she tried to be really gentle. She was like, Have you ever thought of it this. I was like, No. And even though it was in the fields, and even though I should have theoretically been able to recognize all the signs, like it was she, she finally had to be like, go to a psychiatrist, do not pass, go, do not collect$200 I don't want to see you again until you talk to someone who can prescribe medication. And then once I started, I was like, oh, like is how other people function. And like, have been, like, managing to do things. Like, they're, like, my entire, like, my entire life. I could have had this. Like, people, sometimes people, you know, there's that saying that doctors make the worst patients. And it's like, sometimes, like, even in the like, even though you're in the field, even though you know, everything, theoretically, should be able to know everything. Like, I couldn't like make the connection. And it's like, you just have this huge blind spot when it's yourself. That's why also a lot of my friends and people I know were really hesitant to get into therapy, because they were like, well, I've read a lot about this, like, I don't think there's anything that like, I couldn't already, like found out find out for myself. And I'm like, No, look, you can't see yourself, clearly, you need someone else, to talk to, to be able sometimes to sort it out for you, and to switch your perspective on it. And that, you know, I'm still I'm so grateful that that happened. And I'm so grateful that I finally accepted help. But it's funny, like I Yeah, it was, it was hard for me to ask for it, even as an adult, Daniela Galdi: 41:48 I can totally relate to that. And in so many ways. And it was actually that moment of, for me, as you mentioned how people are like, well, I can fix it myself, I can fix myself, I've been fixing things my whole life, you know, very independent. And what would happen is I would turn to my friends and family. And I started because guilt plays actually helped me in this sense, because I started to feel like they didn't, they were no longer able to know how to help me like they would multiple times I had people say to me, at my worst moments when things were just I could not cope. And I was turning to them, they would say I don't know how to help you anymore. Right. And so then it was like, you know, like, I couldn't help myself, I was putting this, you know, I say burden, we're not a burden on our support system. But I was I felt like a burden on my friends and family to the point where they're like, We don't know how to help you like we can, I will sit with you. I don't know what I don't know how to help you anywhere. And that was like, my guilt kind of kicked in for putting that on them. But also, it was a, it was a good little kick in the tush of like the there are professionals for everything, including what I'm going through. And I'm, you know, I got I gotta just be brave and do it again. And this was like an again situation, right? Because I have started therapy when I was 24. And just like the year or two after college, and which I feel is like that, if that had to pick an area to like really dive into is like that transition period. I just feel like there's so much there. But I felt that confusion at that time. And so I had been in therapy for a long time. And then I stopped because I felt good. But then years. I let myself go years before starting again. And it had to be all these things. But you know, as you mentioned, I can fix myself, I can do it. I can do it. I can I can apply this which we can. But now with all that, oh, I know with mental health and the work that I do talking with therapists and things like that, I know that that comes into play for management, right? And so yes, we have the capability to cope, to manage to improve, but it's going to be so much deeper to work with somebody to really heal and really get that process going of changing your mind changing the patterns and all that. Kira Yakubov: 44:09 And I appreciate both of you being so vulnerable and honest about this. Because it's true. I mean, even as a practitioner therapist, we in air quotes should know or should be able to diagnose but we're still human beings, right? Like that's why we need an objective third party or you know someone outside of us in our relationship to point to things that ask us questions to look at things in a different way. And we don't have any stake in their decision besides wanting them to do well and having their best interests in mind. And so like yes, having a support system is extremely important and like having community and recognizing that your family and friends are going to be biased and like that's okay. And they're going to see things from their perspective through their lived experiences and what they think you should be doing based on what they think would make you happy, and it may not actually be, what would make you happy. So I mean, I started seeing a therapist once I went to college because of the University Counseling Center. I never went in high school, I never even thought about asking my parents but as soon as I went to college I was like wow, it's free, well, not free. You pay that tuition, and I'm still paying for it, but it's included. And so I would utilize that. And I saw a therapist throughout my entire, basically my entire time at Drexel. And then when I went to grad school, I saw a therapist there too. So it is extremely helpful for anyone. And for therapists too. like, we are not above having our emotions, process and analyze and have a new perspective. Emily Shaw: 45:47 Yeah, when I was in graduate school, they actually were like, we can't make you be in therapy. They were they were very, like it is really important. You know, because especially in child and adolescent mental health is like you're absorbing all this stuff. lot of it was really heavy. So I'm really I started going in grad school. But again, it was there 10 free sessions as part of like the student like health insurance plan. So after that, and I graduated, and I didn't go again, until I would I think I was like 20 21 then and I think I didn't go again until I was 24. And I yeah, I sort of like could have used it that whole time. But I yeah, that actually honestly I'm grateful for that too. Because that sort of gave me this like plausible deniability where I can be like, Well, my school really recommended this. So but I wish I had known that it was okay, just to go. Yes. Daniela Galdi: 46:46 Do you have a favorite approach that you use? Emily Shaw: 46:50 Like a therapy like a favorite therapeutic approach? Daniela Galdi: 46:52 Yeah, Emily Shaw: 46:52 yeah. So that was my training was very like psychodynamic psychotherapy oriented, which is a little bit like old school now. But that's I trained in New York City and New York City is very like psychoanalytic psychotherapy. So I tried now I fold in other I fold in a lot of cognitive behavioral therapy, I fold some Dialectical Behavioral Therapy, which I really love, actually, some of it is just more supportive. But I would Yeah, I would say that sort of, like my training is psychodynamic, but I am it's astuted to my personality, I tend to be a little more reactive. And like, I like to give a lot of direct feedback. So a lot of my patients have said that they've been in therapy before, but the therapist just asked them questions or like, didn't say anything. And I also I have like a negative experience with the psychodynamic psychotherapist, when I was in when I was younger, I had a couple, I've had therapists that trained in all different modalities. But I, and I think that like, anybody can be good in any modality , anybody can bad in any modality. And you should say, it doesn't really sort of depends on the individual. But I will I just, I'm just [muffled] reactive. AndI like to give a lot of direct feedback. And I, you know, I'm, I'm really direct with my patients in a way that I think a lot of them really appreciate. And maybe some of don't appreciate . But I think I tend to be a lot more direct than a lot of other psychodynamic psychotherapist, so I wouldn't say I, you know, I'm hesitant to call myself that because I do tend to be a little more hands on. Kira Yakubov: 48:34 That's actually hilarious, because I was also trained in psychodynamic and I also give a lot of direction. Emily Shaw: 48:40 Yeah, Kira Yakubov: 48:41 I wonder if it's, I think our generation of therapists might be different from the old school ones, where we learned psychodynamic, we might have learned all these different modalities. And we kind of choose to pick and take what we think is helpful to incorporate and not stick solely to one only and do it exactly the way we were taught. Because psychodynamic, I love it. And for people listening that aren't a therapist or the mental health field know the jargon. It's really like processing and being analytical of what's going on underneath what you're presenting with or what you're experiencing to get to like the root cause. And like observing and being reflected like your coping mechanisms, and how different family members and different dynamics in your life impact you and how you view the world. And so there is a lot of therapists that tell me more, and that's it and the other person's like, okay, so like, what do I do with this information? Now? You know, I love that you give the direct feedback, too, because I think it's, I think it's important just how we're having a conversation. Like I think it's intimidating to just walk into a room and then the therapist is sitting in silence and like you just have to start the session. Like what is happening, right now. Emily Shaw: 49:55 Yeah, and I think that's sometimes again, like I've definitely given direct feedback that people were not ready to hear. Kira Yakubov: 50:00 Sure. Emily Shaw: 50:00 So I like it's a learning curve. I mean, I like I wish I could be like, I'm perfect and every session I did the perfect thing for the patient. I have definitely been gotten, I've definitely, like, stepped in it before too. So I it's a balance between, you know, you don't want to, like just put a bunch of stuff on the patient that they're ready to hear. But also it's, you know, when they like it has to be their decision, they have to like, you know, rather than, like cutting to the chase, like it's important for them to like come to the realization. But I think that it's also important that you know, if it's going to take them like two years, and it's really messing up their life, like sometimes I am a little more direct. Kira Yakubov: 50:38 Yeah. Daniela Galdi: 50:39 As the person who is not the therapist, and on the receiving end, I feel I would say that I appreciate that so much. Because I know I like to talk, right? I don't mind. Kira Yakubov: 50:54 You do? Daniela Galdi: 50:55 I do. Funny, when I was younger, I didn't. Right? So this is like a whole as an adult, it's like a whole would be coming for me. But I do I like to talk at the same time. If I went into a session, like, where's your mentioning Kira, Well thats why really old school Psychodynamic Pscyhotherapist that the person is just waiting for you, I would be intimidated off the bat. And I can't even imagine for someone who already isn't comfortable about talking about their mental state, like I will tell you that, you know, I'm happy to share if I'm having a crappy day, you will hear more about it then you want to know, but you know, so on this one, just you both know, at least from my own opinion, I appreciate that so much. And what was actually funny is with with my therapist, I started to recognize her facial expressions. So it was like she I would say there was a directness. And then I miss her expression at times. And I'd be like, go ahead. Just go ahead. You can tell me. would make you lie on the couch, so you can't see them react. Yeah, Kira Yakubov: 52:02 Blank slate Emily Shaw: 52:03 Yeah. And I did have a therapist like that once that did make me lie on the couch, probably cuz I was trying to make him laugh. And he knew and he was like, no, like, you'd be like, you can't like you got to not be able to see me. Yeah, because I think I sort of I tend to use a lot of humor like to cope with stress. And in a way, you know, and it's that like healthy in some ways and unhealthy in other ways. That I think that he Yeah, we started out face to face. And eventually he made me lie on the couch. Because that's like traditionally why. Like that's, you know, it's like an old school in sort of like New Yorker cartoons of the therapists office, or you're lying lying on the couch and the therapist is behind you. That's originally why it's so that you weren't trying to gauge the reaction Daniela Galdi: 52:43 I did not know that. Emily Shaw: 52:44 Yeah, Daniela Galdi: 52:45 I just thought it was to make comfortable setting. You know, this reminds me of two. And this is maybe a little bit of a digression. But I'm learning a lot about EQ and leadership with someone else actually, I'm working with on a podcast. And so they're talking a lot about leadership in it and reminded me a lot of like situational leadership where you can adjust your, your approach to things within the moment of what happens. So with this idea of like situational leadership and adjusting to this scenario, I know you have the skills, right? You're both professionals, you're both trained, but have you experienced this moment where you have to really adjust to the situation and lean on maybe experiential skills or any type of other skills outside of what you've learned professionally. Kira Yakubov: 53:43 I would say my whole job. Emily Shaw: 53:47 There's like, never a dull moment. Yeah, Kira Yakubov: 53:49 I mean, I think it's. so for the EQ is emotional intelligence. I mean, that's really what we're doing the whole time is, a lot of it is reading body language, which was kind of tough during the pandemic, when we went all remote because all you see from a person or a client is basically their neck or shoulders up, and you're missing so much other information that you'd be receiving. So yes, we have all this training all these different methods and theories and techniques. And you really have to be able like to be in touch with your intuition and read body language and be able to feel what someone is experiencing or going through, and how that may not be congruent to what they're saying. So like someone might be telling a horrible traumatic story in their life, and they're smiling and laughing. And so I take a moment to pause like did you notice that this is what your body's doing as you're sharing this? And so it is like every I feel like all of this issue with all the sessions are situational for us to be able to like shift gears, because yes, we have a treatment plan and there's techniques and there's things that we want to do but you can't prioritize I don't know, for me at least I can't prioritize this structure over what's happening right now in this moment with this person in front of me. What do you think Emily? Emily Shaw: 55:09 Yeah, exactly. It's, I would say, at this point I rely more on, like, rely a lot on my experience in terms of like, what patients are going to respond to, from my sense of what they're like. So I find like learning about the world. And like, when you're seeing something like that through a child's eyes, it's like you're getting to see it again, for the first time. That's like, that's something that I'm really excited about. There's so many cool things about our roles. And as an adult, even especially, like, I've had periods of time where I've worked a lot and gotten really, like, you know, forgetting to stop and smell the roses. So I feel like having a kid makes you be so present in the moment. It just forces you to be like, no, like, this is what's around us right now. And this is what we're going to talk about and notice and engage with. So I'm excited to [muffled] Kira Yakubov: 55:57 Aww Emily Shaw: 55:58 yeah, Kira Yakubov: 55:59 I love that Daniela Galdi: 55:59 me too. that was beautiful. Like, can I come. hang out together? Emily Shaw: 56:04 go camping with us Daniela Galdi: 56:04 Yeah. [muffled] Kira Yakubov: 56:10 I think we can kind of start to wrap it up. Emily thank you so much for being on today. It was a blast. I'm glad you were able to join us and I hope you can come on to future episodes. Yeah, anytime. It's just so great. Thank you so much for having me. Daniela Galdi: 56:23 And we're going to make sure that you can connect with Emily in our show notes. There will be a link to to get in touch with her but we will see you in two weeks. Thanks everyone for listening. Kira Yakubov: 56:39 Bye ### Listen - [Spotify](https://open.spotify.com/episode/12685391) - [Apple Podcasts](https://podcasts.apple.com/podcast/12685391) - [YouTube](https://youtu.be/ISagJp22Rog) --- ## Couples Therapy Discussion with Joslyn Justi LMFT - URL: https://healyourrootspodcast.com/episodes/couples-therapy-discussion-joslyn-justi - Published: 2022-09-14 - Season 1, Episode 3 - Duration: 36:54 - Category: mindfulness - Guest: Joslyn Justi ### Summary Introduction to mindfulness for mental health, exploring benefits and practical techniques for incorporating present moment awareness into daily life. ### Description Mindfulness has gained significant attention in mental health treatment. This episode explores what mindfulness really means, its benefits for mental health, and practical ways to incorporate mindful practices into daily life. Learn simple mindfulness techniques that can help reduce stress, improve focus, and enhance overall well-being. ### Transcript Joslyn Justi: 0:02 I really hope that when people hear that, they can just kind of take that sigh of relief and be like, oh, there is a way to get through this there is a way to talk with each other. Daniela Galdi: 0:17 Hello, everyone. Thank you for joining us again on episode three of Heal Your Roots Podcast. I'm your co host, Daniela and I'm here sitting with our other co host, Kira, who is the founder of Heal Your Roots Kira, give him a little hello today. Kira Yakubov: 0:33 Hey, how's everyone doing co host Kira Yakubov. Lead therapist and founder of Heal Your Roots Wellness. For the next few episodes or the few episodes that we're going to have, we're going to take a little bit of time to chat and get to know the therapists at Heal Your Roots Wellness. And then future episodes, we'll be featuring other colleagues in the community and therapists that we know. But for today, I'm super excited to invite Joslyn Justi, a Licensed Marriage and Family Therapist at the practice and also a really great friend of mine. So Joslyn, thank you so much for being here with us today. Joslyn Justi: 1:06 Hi, Kira, thank you so much for having me. I'm super excited to be here. Daniela Galdi: 1:11 That's awesome. I am happy to be sitting with both of you two friends that I love that get to work together. And I can't wait to learn more about how that journey started. But first, let's talk about how it started for you, Joslyn. What's your why when it comes to working within the mental health industry. Joslyn Justi: 1:30 So I'm very big on full disclosure and authenticity in my session. So I like to share this aspect. When I was younger, I saw a mental health professional around the age of 1516. And she was wonderful. She listened to me, she understood what I was going through. And ever since then I just kind of wanted to give back and do the same for somebody else. And that was the catalyst to I want to get into psychology more and I want to study this. And I really want to kind of help people cope through everyday life stressors. Kira Yakubov: 2:03 So what made you kind of go into this specific Marriage and Family Therapy? Because I know we were in grad school together. So we got to learn and do some role plays and laugh together. But what kind of made you want to go into that? Joslyn Justi: 2:17 Yeah, I think I was I got interested in couples specifically after I graduated college. I really enjoyed my human sexuality class in school. And I thought couples therapy would be very fun, very challenging, entertaining, educational, you know it, you know, it is at the end of the day, you're never bored with what we do. We're constantly on the go. And couples therapy is just so interesting, because every relationship is so unique, yet has a lot of similar themes. So I really enjoy talking with couples from walks of life, every walk of life, and helping them strengthen their marriage or relationship and, you know, cope as effectively as possible with stressors. Daniela Galdi: 3:07 Do you notice a common theme within it? Like I know you two are friends. Right? So I want to ask kind of a two part question, which is when it comes down to the relationship part, what elements does friendship play with that? And then after that, I definitely want to hear about how you two became friends and what it's like to be, you know, have this friendship going, especially from working remotely, and having a friendship that's remote. Joslyn Justi: 3:35 I think it's pretty unique. I think here and I have a very unique and special friendship. You know, we bonded in school right away. While I'm under no care, maybe not right away. I think we had a class together. We were kind of acquaintances, see in the hallway, hey, how you doing? And then once we got into our marriage and family therapy course, that's where her and I really started to bond and see that we had similar personalities, we had similar styles and we had so much fun together. I can remember laughing so hard in our roleplay sessions in school. But I think her and I do a very good job at maintaining a professional relationship and a genuine friendship and I think those boundaries are so important to have in order to kind of maintain the friendship so I think we do a great job as hey, we're talking as professionals versus her and I talking is just friends and knock on wood so far. It's been awesome. Kira Yakubov: 4:34 Yeah, I remember those Saturday morning classes for marriage in therapy, specifically once we started getting into like the nitty gritty of learning about couples and how to work with them. And so if anyone's in grad school or is thinking about it, we do a lot of roleplay where we pretend to either be the client or the therapist and then we have them recorded and then our class watches them and get gives us feedback. Daniela Galdi: 5:01 Wow. Kira Yakubov: 5:02 Which sounds terrifying. But it was actually so much fun because the teacher laid down such a wonderful foundation for like trust and safety and like just being goofy. Joslyn Justi: 5:14 She was awesome. She really made it a judge free zone, because it was very terrifying going into oh my gosh, I'm being recorded. I have all these classmates watching me, what are they going to say? How am I going to look and I can even remember being the therapist sitting there. And my stomach was in knots. Because I had this one person who was being very, not aggressive, but pretty intense. And I think everyone could tell and I was kind of freaking out on the inside. But then when I got the feedback, you know, people were like, wow, you seemed very calm. Like, you knew what you were doing. I was like, wow. Okay, so it was a great example of, even if I feel a certain type of way, it might not be coming off that way, which is a huge part of our job, right? We we can't be emotionally reactive, we have to, even if we feel a certain type of way, inside it, anxiety, stress, whatever, we have to maintain that, you know, professional, calm demeanor. So it was extremely helpful. And it was great. Having classmates like Kira, we had another friend who was very close with us. And it just I think helped our not only just build a friendship, but our clinical practice as well. Kira Yakubov: 6:26 And I think it helped us get all the giggles out and like the discomfort and normalize. not being judged, but like being perceived and having and giving feedback. Because you you do feel nervous, like we're still people, they're still impostor syndrome. And like, we might see a certain issue over and over and we feel like we're really good at it. But then something new will come up and you feel like oh my god, I don't know what I'm doing. And those internal doubts, but being able to, like, maintain, like, the separation, like this is me and my stuff. And this is a separate person coming in with something. And I think that class really helped us get vulnerable about our own biases, and like our own family dynamics and growing up. So I thought that that was awesome as like, grad school is you basically go through like a therapy course of yourself in front of all your other classmates. Joslyn Justi: 7:18 Absolutely. It's very raw. Daniela Galdi: 7:21 Yeah, I actually someone who's not a therapist, I've actually always wondered that, like, how much of yourselves? Are you going through the training to help other people? But then what's it doing for you both? Like, what did it do for you both on a personal level, Joslyn Justi: 7:39 I think it really opened my eyes, you know, like Kara, and I come from very different backgrounds. You know, I grew up in a very small town, countryside, you know, we had our milk and eggs delivered to our house. You know, I didn't even know what a row house was until I moved to Philadelphia. And I think that really opened my eyes to see different perspectives, other than kind of what I was, what I saw what I was taught growing up, you know, it really opened my eyes, it diversified my mindset, my perspective, and really made me grow. And I love being able to meet here and hear her background. And it's awesome, because it's so different yet, we just clicked, you know, it was just one of those friendships where you're like, Yep, I'm gonna be friends with you forever. That's awesome. And just, it's great, though, because then if I have a question, I am not hesitant to reach out if I have like a supervision question. Like, as Kara mentioned earlier, you know, sometimes stuff gets brought up for us a lot. And it's great to have that outlet to be like, hey, is this okay? What I did, I was feeling a certain type of way, I'm not really sure how to respond to this person. So as she was stating the imposter syndrome that kicks in, but having that supervision and having that friendship with her really helps to reset that. Daniela Galdi: 9:00 And for anyone listening can can hear that, Kira can you share what impostor syndrome syndrome is? Kira Yakubov: 9:04 Sure. So it is having this typically an inaccurate belief of your own abilities, or your competencies. So even though you might have actual evidence of you know, I've had these achievements, I've overcome these things. There's this doubt and voice in our mind that says, Well, it's because you got lucky. Well, you don't really deserve it. Well, they're gonna find out that you're pretending. And that's the terrifying part is that it feels like you're pretending to put on a show like you know what you're doing, and you're constantly scared, someone's going to find out that it's not real. Which is like a horrible feeling. Right? Like someone's watching over your shoulder. You feel like at any moment, like the charade is going to drop, but you're not actually putting on a charade. It just feels like you are. Joslyn Justi: 9:57 Absolutely. that thought comes across my mind a lot. is, you know, sometimes even with couples, they want this, sometimes they want this instant gratification or the solution to their problems or this fix right away. And in the back of my head, I'll think, do I know what I'm doing? Am I capable of helping this couple. But just like Kira said, it's just those anxiety thoughts, because we have physical evidence to back up, why we're doing what we're doing. And we put in a ton of work and ton of studying, you know, a lot of research, a lot of supervision to get here. Kira Yakubov: 10:34 Have you found there's a certain kind of presenting issues within couples that you feel more confident versus like other ones were some of that not even imposter syndrome? But just like, when we come across something new, that we haven't had as much experience with that comes up? Joslyn Justi: 10:50 Sure, yes, I find myself being receptive and understanding when it comes to communication issues. Or, you know, we my brain runs on this systemic theory, right, kind of like all these connections in our brains, this A means B, B means C, C leads to D, for example. So if couples are arguing, and it's intense, and they're triggering each other, I can pick that apart and create this cycle for them and come in and be like, Okay, here's where we're going to disrupt that cycle. Right? Let's focus on that. So that part I feel extremely knowledgeable about and very confident and helping decrease the intensity or frequency of these arguments. When it comes to infidelity. That can be a very tricky approach because every infidelity can look different. You know, there's, nowadays there's online infidelity, you know, might not be a physical infidelity, but it's an emotional one. And that can be a little difficult to navigate sometimes, because a spouse might feel well, you I wasn't good enough for you. And you were sending your pictures online, why weren't you sending your pictures to me, for example. And that can get a little muddy, because people will respond? Well, it was just a fantasy, it wasn't really real. At the end of the day, it was real, right. But in their mind, it could be them just playing out this fantasy which escapism can be a great coping skill. However, there's a very fine line also. So there's where those waters can get a little muddy for me at times, Kira Yakubov: 12:29 for sure. And I actually like I, this is why I think we vibe so well on the same page, and being able to identify, because we're still people, we're experts in certain areas, but not all the areas and infidelity is tough for me to work through. And it's not the actual piece, it's the rebuilding of the trust, right, like, that's what takes the longest. And that's the most painful part, I think, for a lot of this is deciding, versus like deciding if you're even going to go down that route of rebuilding trust with your partner and what that's gonna look like. But also there's like a certain point where it's like, okay, like, I have to trust them. Now. That's the whole concept of trust. And for me, knowing my own my own personal stuff, and biases, and like, you know, I've had a lot of things happen in my life where I have some trust issues. I don't know if I would be able to do that. Who knows, right? You never know, unless you're under the circumstances. But I don't feel confident helping a couple lead them down a path that I don't feel confident or sure about. So I think in the same way, that's something that I don't necessarily specialize in or advertised, but we as we know, in couples therapy, things will come off, regardless of what they say they're coming in with. Joslyn Justi: 13:48 Oh, absolutely. You know, they can present with something. But in the first session, there can be 10 other different things that pop up. That trust building, reestablishing that trust is probably one of the most difficult tasks that I've come across. Because like you said, you have to decide whether or not you're going to open yourself up and be in this vulnerable space to trust that person again. And that can be very difficult because I've had couples come into sessions, where they're like, Well, how long is this gonna take? Like, what am I expected to do? I just say, look for any opportunity to start trusting again, let's say if one spouse had to go away for the weekend, that would be a great opportunity to say, Okay, I'm trusting you saying you're going here with this person for this objective. And then they come back and then we'll talk about what did that feel like? What did that feel like trusting them to go away for this weekend? Do you feel they were truthful, and we will spend an entire session on that, but it is, it is very tough, but once people can work through those muddy waters, I've seen couples come out even stronger before the infidelity hit even occurred. Sometimes people have to hit rock bottom to start rebuilding and develop a new loving relationship? Daniela Galdi: 15:06 And it's interesting, you mentioned that perspective of hitting rock bottom in order to really prevail in situations because it's similar I feel for individuals and then with couples. My question to you both is, how do you distinguish what to tackle first, infidelity to me sounds like the first thing a biggie. But again, you mentioned about not allowing your own bias to come in, in terms of what you feel is the most important. So from a professional standpoint, what is the first way to distinguish how you'll tackle situations when there's multiple issues at hand? Joslyn Justi: 15:51 For me, it's getting it's first joining with a couple seeing if I'm a good fit for them. The second it is assessing whether or not they are willing to genuinely work on the relationship, because if one person has one foot out the door, it makes treatment more difficult that you know, they're on shore, and I can't be that person who's like, yes, let's work on this because it has to come from them. You know. So I think that's kind of the first step making sure each party is willing to take accountability, they have a willingness to change, and they just genuinely want to work on the relationship. Kira Yakubov: 16:28 Absolutely. And I think that's where it was, that deciding piece, right? Like therapy is not a passive method of working on yourself there. It's not passive, right, like you show up because you decided, something is either going on or I want to learn more, or grow in some area. And that's gonna take time and commitment and practice. But that's emotional practice, or setting boundaries, or whatever that looks like externally. So I agree like choosing and deciding I'm willing to work through this, I don't know what the outcome is going to be, I'm hoping that it will be this, but I'm putting in the work now hoping that this will be worthwhile, and it will end up the way it needs to sometimes couples stay together, sometimes they break apart. Because we're also not here to make sure everyone stays together, right? Like, we want to do what's best for each person individually. And sometimes that means the relationship will work. And sometimes that means like this is not healthy for one or both of the partners. And that will eventually come through based on, you know, exploring their values, the level of commitment they have in the relationship, or just a misalignment of what they're capable of giving each other even if they really really love one another. Joslyn Justi: 17:48 And that is a tricky part for me, is when I have couples come into therapy, and they're like, you know, we're doing this because we're trying to figure out whether we should stay together or not. And so I take a step back and ask myself, Okay, so what's my role in that situation, specifically? Because it's not my job to say, You know what, I think you guys should really work on this. You're a great couple, you should stay together. You know what, I don't think you guys are good together. I think you should both go your separate ways to write it's not my job. But it does get tricky, like, what questions do I ask, you know, what makes the relationship Great? What are you concerned about? How can I help with the process, because it's not a quick fix. It is just I tell people, it's such a process, right? Like, the brain, the body, it's not like when we get a little cut, we can put some Neosporin on that, and it'll heal up real quick. The brain just does not operate that way. And it's a lot more of a dirty, messy pathway to get to this really healthy, relaxing place on the other side, if that makes sense. Yeah, getting back to the couples aspect, though, that is probably something I do find pretty tricky is what is my role in helping these couples decide whether or not they want to stay together? Kira Yakubov: 19:10 And I want to touch back to Danielle's question about it in terms of like the first steps and so obviously, it's joining, seeing if they're committed, they're into it. And then once we get past that part of like, alright, we're all on the same page. Typically, what I like to do is, start at the basics, like how are you even communicating any of these thoughts and feelings to each other? Because being so raw and vulnerable at that point, if we can't even have a conversation, we're not going to be able to build off of that. So taking that time to really build the foundations of that communication with couples. So Joslyn, I'm curious of what does that process look like for you or what's kind of like your your methods or theories of helping couples with communication? Joslyn Justi: 19:57 Well, first, I tried to kind of assess their communication style? Are they assertive? Are they passive? Are they hostile? So once I kind of established that, then I kind of create that circular pattern, as I mentioned earlier, okay? When you're a passive what happens when this person is aggressive? You know, is somebody that distance or someone the pursuer? What does that look like? You know, so we have to identify their communication patterns first. So once we do that, I think it's more, I think it's helpful that I know that they know that. So they're more self aware, which which I had mentioned, in past self awareness, to me is that catalyst to change. So it's helped with communication, if you're not self aware, your communication style, whether it's maladaptive or helpful, there's nothing I can do until you're self aware of your contribution to that communication cycle. So that's where I like to start there. Daniela Galdi: 21:00 Do either of you suggest individual sessions? Joslyn Justi: 21:05 For sure Kira Yakubov: 21:06 Yeah. So that's actually part of our intake process is, when we meet with a couple, the first session will be with both of them, we take that time to learn about the relationship history, what's kind of going on right now a little bit of their background and their life. And then the next two sessions, we see each of them individually once. And for me, I really love to dig into that family background, that upbringing, the relational dynamics, they experience, like throughout their life, different relationships, whether it's friendships romantic, what was school, like what your career like, because we're whole beings, we're not here to like surgically remove one part of you to make your relationship better. It's how is all of your life experiences informing who you are, how you interact with other people and see the world. And then at that point, once we have a full picture, then like, our brains start turning like, okay, like, now I understand why they might be speaking to their partner this way, they remind them of their dad or mom or whoever in their life, this is a reminder. And so we get this full picture that then moving forward, we see the couples like, okay, like, this is the game plan, this is what I'm seeing. Joslyn Justi: 22:16 I was just gonna say I've, I've received a lot of great feedback from couples that they really appreciate that individual time that they get, because they feel that they can just kind of say whatever they want, without judgment or apprehension with their spouse being there. And I think it's just such a great insight into that family of origin that Kira was talking about to get like the full picture. Daniela Galdi: 22:40 And it sounds like everything that is learned through having that joint, the joint sessions also reflects to how individuals can work on themselves, as well. So it goes into ties into their own personal journey with their mental health. And to stay on topic of the relationship aspect. Do you see families together, like, for instance, on a personal note, my mom and I had done therapy together, we did three sessions and and I laugh about it, because it was actually about, we received money for it. It was like a trial. And I feel like I needed it. And I want it to like welcome my mom into this world of having therapy. But for me, it's easy to confront things. And I am I safely assume for her, it might be a little bit more difficult. It ended up being a really eye opening experience for both of us. And when we made a little money when we just fun. But do you see families as well, in that sense? Joslyn Justi: 23:43 So I don't do as much family therapy. As I do couples, I think my my interest got more into couples therapy specifically, I did see some families sporadically. And it's very interesting with families, I think that a therapist needs to be very passionate about that. I think families need to be a therapist need to be very specialized with families because it takes a lot and you really have to have the adequate background to do family therapy successfully because you'd have about 5 6 7 people in a room sometimes to like I've done moms and daughters, you know, dads and sons before. However, I think just personally for me, my passion, my area of expertise gravitates more towards couples. Kira Yakubov: 24:32 Yeah, I agree. So we were trained in it, right. We were trained in marriage and family therapy and, you know, in my internships and like starting out I would see families and it's hard. Like all therapy is hard, but it's really hard managing and maintaining non bias and also making sure that you're balancing the level of have communication and respect and consideration for every single person in the room. And they go through different age groups and generations, which means you're meeting people at different lifespans in one room. And that's a lot of emotions to manage, because one person might be vulnerable and sharing something really important. And that's going to trigger Mom and Dad, and they're going to have their own reaction. And then you're going to respond to that. And then now someone else might not feel safe, because we have to shift gears into being very attentive to one person at a time or two together. So when you incorporate even more people, it just becomes tougher. So it wasn't something I was passionate about in terms of in the room, but having that family theory, and knowing those family dynamics from us learning about and even having some experience and being in our own families, I think is super helpful and necessary for couples therapy. And so I know, Joslyn, you love to talk about like family of origin stuff. So I was curious if you had anything for the listeners so that they can understand when we say like family of origin or family dynamics, a lot of what that would mean for you. Joslyn Justi: 26:12 Right? Yeah, I like talking to couples, especially with family of origin. That's when I start asking them, you know, how did you grow up? Where did you grow up? You know, what, what was your background? Like? What what did you learn about relationships? Or who did you learn relationships from? Was it your mom and dad? Did they get a divorce? Did they stay together? Were you raised by your grandparents were you raised by your aunt, uncle godparents that, it's just it's so important to understand that and for spouses to explore that with each other, because someone might be raised extremely conservative, and someone might be raised extremely liberal, for example. And when you put those two ideologies together, sometimes you could find yourself disagreeing a lot, or not having the tools to communicate based on your differences. So I asked, okay, what was it like being raised by your mom and dad? What did how did you learn to express emotions? Or did you learn that you, you know, did your parents make you suppress them? For example, you know, again, depending on like, the generations that we were raised in, and, you know, I guess how old our parents are, what they learned from their parents, it's, it's like a generational domino effect, right? We learn all these our parents learned from their parents, their parents, learn from their parents, and so on, and so forth. So I think once people get that understanding, it creates this insight, it creates this openness like this, I've seen a lot of the aha moments in couples before it's like, oh, I never really thought about that, that I didn't really learn to express my emotions, because dad said, suck it up. You know, it's just a cliche example. But, you know, it just gives them great insight. So I hope listeners can really take a look into, you know, what did they learn growing up in their families? Kira Yakubov: 27:55 Yeah, I love that. And to add, and to piggyback onto that is thinking about, you know, we developed particular coping skills based on our environment, right. So whatever was going on around us, we adapted and we molded ourselves around that. And so when we leave that environment and our families and whatever the dynamic was there, we carry that we take that into the next relationship, because why would we not like, we have no idea that we're even doing it until we step out and be like, Oh, other people don't act like this, like, your parents don't see things like this for them or treat them this way. And I think going back to what you said is that self awareness is so key to know that like, and to not feel shameful about it, like, Hey, maybe I get defensive and arguments. And I know now why I do that, and where that came from, and why that was necessary. And now I'm recognizing that that's no longer necessary, and is a detriment to my relationship, my romantic relationship. So now I don't have to carry it. Like it's this shameful part of me. It's a behavior that I had to learn to survive where I was. So I think that's also part of this family dynamics is like, when people say like, well, that's just how I am or that's how I grew up. It's like, yeah, that is, and you can change it, or you can modify it if you want to own Daniela Galdi: 29:18 That actually, I'm glad you added on that last part that if you want to, because I'm curious to know, what happens when there's one person in a relationship who has that self awareness is making efforts for those changes, and what happens when the other isn't? And, you know, for example, I know in my past relationships, that's definitely been a situation where I've recognized I come from an Italian family and this was going to be very stereotypical when I say this, but we're very loud at times. I feel like I'm very quiet. But with that said, you know, I never realized that we Yes, we would, we would talk things out and I'm err, quoting talk, because really, it was very reactionary, it would be like zero to 100. Right quickly and lose our patience, right. And so for me, considering myself as a very patient person, normally I would find when I would feel attacked, I would drink, go to that reactionary, raise my voice, snap, you know, and lose that control. But it was called to my attention, that I do that and it made the other person shut down. So, you know, my efforts have been there for myself realizing that like, that was something I never noticed for myself until it's called to my attention. So what happens if there is a relationship where only one it's kind of one sided? Like, what do you what do you recommend for people? How do you How do they keep going? Joslyn Justi: 30:51 Well, I think it boils down to a person's willingness to take that accountability, you know, like you mentioned, when you were aware of it, okay, this happened now, what can I do to like here was mentioned earlier, modify it, you know, or maybe cope more effectively, or, you know, think about my emotion before I react, you know, because you're kind of describing that dis pursuer distance or relationship, right? So the more you would pursue something or react, the further it would drive the other person away, the more they would withdraw. So in theory, once that pursuer stops pursuing and reacting, the distance or should start to come back to the pursuer. If that makes sense. Daniela Galdi: 31:33 It does make sense. And you mentioned going back and our conversation you two brought up when you were in school doing roleplay. With that situation you just explained more on do you use role playing for the couples? Kira Yakubov: 31:49 Yeah, Joslyn Justi: 31:49 sometimes a lot of role reversal. Actually, that's been super helpful. Kira Yakubov: 31:54 Yeah, or even just modeling, how to rephrase something, a lot of times with couples, right, there will be a theme or something that is typical throughout other couples, right. So what I'll see is, one person might be a little bit more logical and rational and their expression thoughts and way of going about life. And they're with someone who is more emotional. And so that's super common, because we're attracted to like someone that's complimentary to us, or whatever we grew up with. And while that has a lot of pros and is helpful in balancing each other, it does have cons because you're going to run into speaking to each other with the same words, but talking in a different language. And so when I think when we see resistance with couples, when one person might be a little bit more willing to be aware and try things versus the other, it's sometimes they really don't understand what the other person is trying to say, or what they mean by the words they're using. So we literally have to slow down and be like, can you actually explain to me like, this might sound silly, but what do you mean, when you say this word? Like, what is actually coming up for your what's your interpretation of what you're hearing them say? And that even within itself as an intervention, right, like will ask, what are you hearing your partner say? And they'll say something and the partner is like, that is not what I said at all, like, what do you mean? Joslyn Justi: 33:16 all the time, Kira Yakubov: 33:17 all the time, and Joslyn Justi: 33:18 it's all the time Kira Yakubov: 33:19 Well, that's what I'm hearing. And that's what our brain is interpreting based on our own emotions and past stuff. So I think it is if we see the only one person is making progress or doing things differently, it might mean slowing down and like really taking apart certain parts like the basic pieces, and or it might mean that this person's not ready yet to confront whatever is going on for them. And that could mean having them do their own individual therapy to get a deeper insight into themselves. Joslyn Justi: 33:57 Absolutely, I would, I would recommend pausing couples therapy, sometimes even, you know, if we're at what we call sometimes an impasse in couples work, you know, I might say, Okay, why don't we pause for a little bit, let's do some your own individual work, self reflect. And then let's follow up in a few weeks to see if this is something you both are ready for, you know, because sometimes couples just aren't, they're not in a space where they're ready, but they might be ready in a month or two, you know, you just you just never know, Kira Yakubov: 34:25 Yea. And so I know we see a lot of couples but I know you also see individuals. is there anything in particular that you like to work with individuals or that you feel like has been whether a strong suit or something you really enjoy specializing in Joslyn Justi: 34:40 you know, it might sound funny but COVID in the pandemic actually did help me find more of a specialty and and what I enjoy working with and I have found I love working with people who are undergoing major life transitions, major life adjustments, anxiety disorders, stress management, And, you know, coming of age also, you know, helping college students because I feel like they were kind of hit the hardest. They didn't get the normal college experience that we did. And everything went online, they didn't get the socialization that we did, they didn't hit some of those major milestones. And they were some of the most stressed out people I have I found during the pandemic. But it did really help, you know, to find what I enjoyed working with and just trying to help people cope as effectively as they can, you know, through fear of the unknown and things that are just so out of their control. Daniela Galdi: 35:38 And Joslyn, do you have any favorite go to tools that you use in those situations? Joslyn Justi: 35:44 Oh, boy,good. Ah, you know, I really appreciate humor, I try to bring a lot of humor into my sessions and a lot of authenticity and say, you know, and to normalize and validate people that comes to mind the most is when because people will think, Oh, am I here that Am I crazy? Am I going insane? I don't think this is right, and really just trying to normalize what they're going through and validate and reassure them, it's okay for you to feel this way. Because of all of these changing circumstances surrounding you right now, it's only normal for us to respond in a variety of ways, right? As long as you're not a danger to yourself or others. For the record, you're not partaking in dangerous behaviors, you're okay. You know, we can work through this. So I think just reassuring individuals, and just validating anything, and everything they feel, really helps them to feel heard. And when you create that safe space for somebody, even when it's an hour, a month, an hour a week, it doesn't matter, they get that full hour to say and do whatever they feel like they need to in order to cope with the rest of the week. Daniela Galdi: 36:59 I can 100% attest to asking my therapist million times am I crazy? Do I have this and that and I just self diagnosed? And she's like, No, no. And so I can completely attest to that. And I love that that's something that you've been able to find a silver lining of with everything with the pandemic is helping people in those transitions. And so do you find that there is a similar thread, aside from COVID, that has happened for them that has initiated their own therapy? Joslyn Justi: 37:41 Oh, I would say fear of the unknown. Being being out of control with certain issues, it's always been a major theme. I think it was just exasperated by the pandemic, a lot more. However, I think major life transitions such as having a new baby, you know, incorporating that into the family system and a couple system. You know, starting college, going to school, these developmental or life stages that we go through, certainly have been a major theme theme throughout my career. And I think Kira you can, you know, share with that those major transitions. I think we all see people who go through them. Kira Yakubov: 38:18 because this is happening to all of us at once. And the major theme that I found, and I don't know if it's just coincidence, or if my interests became more obvious to me, but I found that either it was within couples or one partner, it was these new diagnoses for ADHD. And when I mean new, it doesn't mean they just develop it just means that it was so exacerbated. And because it became so difficult to cope with that they actually seek out therapy, and were diagnosed for the first time in adulthood for having ADHD. And for me, it was like easy to see from a mile away because I have ADHD and so it's helpful for me to identify seeing couples whether it's like the common themes of what they're arguing about or individually when they're coming in with such difficulty in these areas that they said they've always struggled with, but right now it's gotten so much worse. So that's a big theme I've seen throughout all this and because now that you're home with each other all the time, right like Joslyn Justi: 39:31 something I hear all the time I see my spouse every day oh my god. Yeah, actually, I was wondering if I could recommend books to our listeners for ADHD because with piggybacking off what Kara said, ADHD and couples was one of the major things that I have seen so much over the past two years. It's it's been wild, to be honest with you. And like you mentioned, right a lot of adults went undiagnosed because of the generations, they grew up in, in my opinion, but there's this great book called ADHD and us. It's a couple's guide to loving and living with adult ADHD. And it's by Anita Robertson. And you can find it on Amazon, you know, Google, but it's a really great book for couples, because it really helps the other person who doesn't have ADHD, learn how to talk with their partner or engage with their partner who does have the ADHD. Daniela Galdi: 40:28 We'll make sure to add that information too in the show notes. Now, would you recommend both reading it? one person? Joslyn Justi: 40:36 Absolutely. Kira Yakubov: 40:37 Both Joslyn Justi: 40:38 Yep, I've given homework assignments. I'm like, Okay, I want both you to read chapter two together and talk about it, you know, or I might have, okay, this person you read chapter three, and the other read chapter five, for example. But yeah, it's a, I like them both doing it. Because when both people have all the information they possibly can, they can help positively reinforce the behaviors that we're looking for, or the communication styles that we're looking for. So yes, I definitely think both people should read the book. Kira Yakubov: 41:08 Yeah, I love that. I love that you have that workbook, too, because it's so important for both people to know. And I think this is important for people who are considering couples therapy is that you're not coming in, because one of you has a problem, or one of you is the issue, right? Like whatever is happening within the relationship outside of it being abusive, is that this is created in a cycle between two people, it is continuing and is maintained by both people contributing. And so I think that accountability piece you were talking about earlier, so important. And with ADHD, specifically, within couples, there are other issues or other mental health things that might come up because of it, or in tangent with it, for example, anxiety, or depression or eating disorders, substance abuse, because if we haven't been diagnosed, or even if you have as a child, there's this level of feeling like you don't fit in, or there's something wrong with you, or, you know, you have a lot of potential, but you're lazy, or you procrastinate. It's like these messages we receive over and over again, even if they're not meant to hurt our feelings, and it's a playful way they build and build. Like, I remember my dad used to say, if my head wasn't screwed onto my body, I will lose it. And he said it as a joke, but it was for real, like I probably would lose it. And so what do you think has been helpful? Or what do you think some of the common arguments or issues within couples who come in with that, that you've seen, Joslyn Justi: 42:43 I think like you said one partner might feel the other is lazy, they don't contribute. Or they will say one thing but forget to do it, they'll, you know, have do a chore and then forget about it, right? They'll start washing a dish, put it down and go do something else because they get distracted right away. And then the spouse gets upset and yells at them. And then the other partner feels that shame. And then it negatively reinforces Well, if I'm a piece of crap, I can't do anything, right. So why bother? Right? I hear that a lot. So what I say is like, be mindful of how you're talking to your spouse, or your partner, whomever you know, even your child, right. Because if you create that shame for them, that hit that hurts their confidence that hurts their self esteem. So I recommend being mindful. And you know, taking a pause for a minute and saying, Hey, I noticed you got a little distracted today, would you mind maybe finishing that, or I suggest using timers a lot and like a nice noise so that you're kind of combining that condition, that classical conditioning a little bit, and that positive reinforcement. And that can go a long way. If you're your spouse is your cheerleader, at the end of the day. That's what I like to say, you know, so cheer them on. Kira Yakubov: 43:57 Yeah, I love that. Daniela Galdi: 43:58 I love that too. We want to remember that for each other. Kira Yakubov: 44:03 One more. So I thought of this while I was doing my own supervision because we always need mentorship. And we were talking about a couple that I have one partner who has ADHD. And you know I can relate to this to the being adhd with the inattentive type, is that information will just literally leave your brain. Like if it's not front and center or you don't have a reminder, it'll just leave and it's not because you don't care. I want to I want to highlight that if you forget or you weren't able to follow through majority of the time it's not because you don't care about the other person is because your working memory your ability to hold information for a long time is not as developed or it's not working as properly as, I don't know, a neurotypical brain one. And so my mentor helped me with this couple it was a great example of what they can do is if you are requesting something from your partner, instead of just saying, or yelling it through the room, it's literally looking at them facing them making eye contact, touching their hand and asking for it. Because we will remember by feeling and the emotion of things, like I know it's something annoys my partner, that really bothers him, I have to have it as a huge alert in my brain like do not do because this feels horrible. And that remember through the feeling of it, and the experience in my body versus like, Oh, crap, it's on my to do list to do. So I think that's a good thing for couples, or even just anyone who may or may not have ADHD, who has it in their life is to know that there's other ways to communicate it as well. Joslyn Justi: 45:41 Oh, my gosh, we need to make a huge poster board or billboard of that, because I have couples all the time. Like, my spouse doesn't listen to me, they just don't care. It's a huge theme I hear a lot. And I'm so happy that you brought that up. Because I really hope that when people hear that, they can just kind of take that sigh of relief and be like, oh, there is a way to get through this, there is a way to talk with each other. So everyone who's listening, please, please, please take Kira's advice on that. Because honestly, that is going to go such a long way for everybody, especially with couples with the inattentive type. Daniela Galdi: 46:23 Both things that you both said, on that was so perfect, and so ideal because it answered both questions that were in my mind, one was explaining what it is and two was actionable steps to help people who are listening to get themselves to a place where they can communicate with one another. With that said, I'm curious to know, does it help to find when that person takes us up when they put the hand on the person when they look them in the eye when they're making that note? You know, this is what that feeling feels like? Does that build the support within and safety within the relationship? Joslyn Justi: 47:04 I think so like Kira said, Right? When you feel when you have that touch, and it's associated with something gentle, you know, it stimulates the brain and it can it releases those good chemicals that we want, right? The endorphins, the dopamine, the serotonin. And, you know, I suggest a couple sometimes when you're maybe talking about something a little confrontational, I like to put my hand on my chest to indicate Hey, I'm coming from a really good genuine place right now. But I need you to hear this. It's not because I'm being mean, it's not because I'm being, you know, rude or ignorant. I just want you to know, this is how I feel. And I in people have been so receptive to that, because again, I think those hand gestures and body language can just say so much, and indicate that we're coming from a gentle place as opposed to a hostile or confrontational Kira Yakubov: 47:51 one. Daniela Galdi: 47:52 So switching gears a little bit, because we are coming towards the end of our chat, which are our listeners, don't you worry, because Joslyn will be back for many other episodes, because Joslyn Justi: 48:05 I can't believe it's been an hour already. Oh, my gosh. Daniela Galdi: 48:10 And one of the important things that I know you shared with us were boundaries, but boundaries in the workplace. And so since that is along the lines of relationships, and you know, two or more people having to deal with different types of anxieties and their own different illnesses and things like that, or difficulties. How do you apply what you work with, with couples, when it's a workplace situation? Joslyn Justi: 48:38 Well, I think it takes a lot of practice and a lot of years of experience to say, Okay, where's my place that and then what happens when I'm done with work? You know, so I, like I have practiced over the years to try to just mentally shut down or decompress after, like, my sessions, because it can be really tough to not let some of those couple sessions follow you or like, make comparisons to my own relationship. You know, if a couple brings something up, like, oh, maybe that's what's going on, you know, with me and my partner, but it's not, you know, it's just it's not, it's just one of those things that happens, but honestly, I can't stress enough, the importance of that decompression time after work, and a strict boundary for myself. Like, once I'm done with work, I am done with work, I'm not going to answer emails and lock in answer texts. I'm not going to do any of that. And that took a really long time for me to come to a comfortable space like that to be kind of strict with myself and setting that boundary. So I hope that answers that question. Daniela Galdi: 49:40 It absolutely does. And it resonates with me. I remember talking to care about something similar and she said something I'm paraphrasing she said it much more profoundly, but basically along the lines of like, expressing that boundary doesn't make you a bad person. Right. So So I do that as well where I stop right And that's going to help me to work with my clients. Right? For the next day even, you know, making that boundary where I have to shut things down. And I have to stick by that. And at times, I had to explain that to the person if they're not necessarily getting it. And I remember Kira, you know, helping me in that situation where she did mention, that doesn't make you a bad person. Joslyn Justi: 50:24 Absolutely. That's I agree with that wholeheartedly. It's okay to say, No, it's okay to draw that line. Because I think society has told us a lot that, you know, we can't say no, we got to work, we got to work. And it's not the case anymore. You know, we have to be able to decompress, we need to have fun and take care of ourselves and just shut that working brain off. There's just so much more to life than work, you know, as we all have pets, and it's summertime. So everyone, I'm hope everyone's out having a great time. And I know I like to decompress and have a good time after work. So I just can't stress that self care enough. Kira Yakubov: 51:00 Absolutely. And I think that people learn how to treat us and what to expect from us by what we tolerate. Tolerate and so it's actually a gesture of love and care by setting a boundary because people will know like, this is what this person needs in order to fully show up or be present or be able to answer my question or whatever it is based on what they need. And so I know you mentioned like the decompressing and back into our personal life because we are still humans we're not robots. And so I was curious if you wanted to share anything about yourself outside of the therapy world that you enjoy doing or that you really care about. Yeah, Joslyn Justi: 51:46 I will come to mind for me is I love to garden so after I'm done with work, like I will literally just talk to my plants outside. I know it sounds silly, but like I have the best tomato plants going right now. And like all kinds of just like herbs and peppers. But I also love just being outside this past weekend I went to Harrisburg and my my dad kind of that was his first job out of college. So he met all these people in Harrisburg. They're like my second family. And we went on a canoe trip all day Saturday, you know, I was with my brother and a canoe on the river, saw bald eagles saw great blue harrons and it was just gorgeous. And it's just such a nice reset. For me personally, nature is my reset button. And I could go for a walk in the woods, I could just look at my flowers and I'm like, Alright, I'm cool. I'm present and mindful. Nothing else is coming to my mind. So I really do like to do a lot of stuff outside. And you know when I've come to Philly, you know, I would hang out with Kira, I would hang out with a bunch of other friends and it's nice to like go out to old pubs or bars that I used to like in Philly. Or just like hang out, you know, sit on the back porch bullshit. hang out and have a nice time. Lots of laughs laughing is just I love it laughing so hard where your stomach hurts. Kira Yakubov: 53:06 And I think that's why we really vibe and always did is we really enjoyed that nature aspect. And I remember we went camping together. Daniela Galdi: 53:13 I have to hear about this. Oh my god. Kira Yakubov: 53:16 Yeah, there's nature. Nevermind, I won't share that story. Daniela Galdi: 53:22 Alright we can keep that private. Joslyn Justi: 53:25 I know what she's talking about. Daniela Galdi: 53:27 Alright, we'll just leave that at it's a time when you go camping with these two. Joslyn Justi: 53:32 Always good times. Daniela Galdi: 53:34 Well, this has been an awesome time. And so Jocelyn, just share with everybody how they can keep in touch with you. Joslyn Justi: 53:41 Sure, so I am my email address is Joslyn - Joslyn@healyourrootswellness.com. You can also find me on Psychology Today. And Kira is awesome at getting people set up and she's very, very fast and is just such so good at getting people matched up, you know, and she knows my style, and she'll match me up with someone and it's great. You know, she has been so helpful through this process. So, yes, if anyone needs to PsychToday and Heal Your Roots Wellness website, you can find me and my bio on there. Kira Yakubov: 54:21 Awesome. Thanks, Joslyn. You are a phenomenal person and therapist and human being thank you so much for being on today. And I'm really looking forward to some more episodes with you we can dive into some other things. Joslyn Justi: 54:34 Oh, absolutely. Absolutely, Kira. Thank you. It was a privilege to be here today. I really appreciate it and I can't wait to have more conversations Kira Yakubov: 54:42 I'm making a little heart on the other end ### Listen - [Spotify](https://open.spotify.com/episode/12621833) - [Apple Podcasts](https://podcasts.apple.com/podcast/12621833) - [YouTube](https://youtu.be/uOIBdoIisWY) --- ## Affirmative Therapy with Maureen McCarthy LSW - URL: https://healyourrootspodcast.com/episodes/affirmative-therapy-maureen-mccarthy - Published: 2022-08-31 - Season 1, Episode 2 - Duration: 44:29 - Category: development - Guest: Maureen McCarthy ### Summary Exploration of how childhood experiences and early relationships shape adult mental health patterns, providing insights for healing and growth. ### Description Our early experiences shape who we become and how we navigate the world. This episode explores how childhood experiences, family dynamics, and early relationships influence our adult mental health and relationship patterns. Understanding these roots can provide valuable insights for healing and personal growth. ### Transcript Maureen McCarthy: 0:00 You know, when I think of gender expansive, it's so like there isn't any one answer because it's so unique. And it's so personalized to each individual. And I think that's what's so great about, you know, the folks that are in my life and in like my work, they show up and I'm like, You are the expert, you, you know yourself. And I'm not here to tell you who you are. Daniela Galdi: 0:31 Alright, everybody, we are back for Episode Two appeal your roots podcast. And we have here a young, who is the lead therapist and founder of heal your group's wellness. And we also have a part of the practice Maureen McCarthy licensed social workers, we're so excited for you to join here and myself to chat with you about this, the whole premise of heal your podcast, especially for these first few episodes, is to really give the public a chance to get to know all of you all of the therapists with the practice and get to know your interests and your passions and hear a little bit more about you, you know, you on the personal side, which doesn't always happen. So I hope that Kira has decided to really bring you on board and share your voices is each of you have such a specific topic and specialty that you focus on if anyone listen to episode one. And if you haven't definitely do so because we talked with Kira and Aran who is the director of marketing and growth, for heal your roots wellness. But the fact that you're able to share your services among different areas and practices and work with people that you love and resonate with is totally all a part of the value of being a part of feel your roots wellness too, is that they want to really support their therapists. And that's something that we're gonna get into, as well. So I love hearing about that. And Maureen, you also are so not only are you licensed social worker, therapist, you're certified therapist of permitted therapy for transgender communities from Weidner University, please explain what that means to everybody. Maureen McCarthy: 2:16 Sure, um, it was a really great certificate that was partially kind of like online based are also involved a couple of days going to Weidner for like two days of extensive training with the Department of like human sexuality, which was amazing, because there is just really amazing humans and professors there with some great experience and expertise to share. Of course, COVID kind of intervened with that certificate at the time, but we were still able to connect online. So really, we just got a really in depth perspective of working with gender expansive folks. So kind of an umbrella term for trans, non binary people in the community and what affirmative therapy really looks like. So definitely a deep dive of things. And it was amazing experience. And it helps for my perspective. So I could be a more affirming therapist. Daniela Galdi: 3:24 there are so many terms in there. And that's one of the things that I want to get into, there are so many terms that I feel we can touch on, because the language itself. I know it's something that I can assume for all of us we really want people to be aware of. And I have friends in the trans and LGBTQ+ community, who also want everybody to, you know, become familiar with this. Now, Kira definitely jump in because of the fact that you through the practice, you're able to bring in specialists in these types of focuses, right, and affirmative therapy, too. I can't wait to hear more about that. But tell us like, why did you want to go for that? Kira Yakubov: 4:09 Sure. Great question. So when I was in graduate school for marriage and family therapy, I really wanted to work with couples. And we didn't have a lot of classes on sexuality. And so after I graduated, I went to a postgraduate program, council for relationships in Philadelphia, for systemic sex therapy. And through that process, I was just really blown away with the knowledge that we covered. I think that every person should have this experience these classes taught to them, and it was really going into sex, sexuality, gender, and how our culture, our families, society, all these different aspects of our lives as people is dissected and integrated into how we view and experience sex and sexual ality in our own gender. And so I thought it would be really important to incorporate that in the practice. And, you know, we can't know all the things and I can only know and specialized certain parts of certain things, right. So I wanted to make sure that we brought on therapists that had specialized training and focuses on certain things so that we can help a wide range of people. And so when I met Maureen, during the interview, I just was really blown away with her expertise and knowledge, but really her passion behind wanting to work with the trans community and just folks in the LGBTQIA+ community. And I thought that she just had a lot of expertise to bring to the table. And so I thought that she'd be a really great fit for the practice. Daniela Galdi: 5:49 That's amazing. Because even just reading a bit more about, you know, before going into any podcasts, hearing what I know about healing of roots, as well as therapy, and then reading about Maureen, you know, all together, it sounds like you're both really pushing to be able to help people to express their true self. And so, you know, even Maureen mentioned a bit about like, she's into like hair and getting creative with makeup and things like that, as well as rescuing dogs, which we'll also bring up later who says, Yes, I know, we'll all like gush over the love of dogs, which is I know sounds a little off topic. But again, this is really to dive into like, what the therapist and what they love to do and who they are. So the fact that that is such an intentional part of bringing in therapists to the practice. And then it all aligned with the two of you is just like it's such a great foundation for any anybody coming in to work together with you as a client. Now, how did you to connect, though, I love hearing like stories of like, first story like first date stories, even if it's friendship or work related. Kira Yakubov: 7:00 Yeah, so I created a job posting on LinkedIn. And she applied and we have the interview. And I just, I thought she would be a wonderful fit. She just had a lot of great energy. And she's very easy to talk to down to earth and warm. And so I just thought it would be a really great fit moving forward from there. Maureen McCarthy: 7:21 Yeah, there's distant love coming from Harrisburg, PA, which is where I'm at where I'm from. So I was coming from like, nonprofit community mental health realm of like, seven years, I think, again, that was a local, like LGBT health care, kind of like wraparound services type of place. And so I really laid down the foundation of my skills there and just was able to continue, you know, to go to grad school while I was there, and then also do the certificate. And then when I was browsing LinkedIn, and found Kira, I was like, This sounds like a fit to me. And I was at, you know, kind of the crossroads of like, just looking for change, and just seeing what else was out there. And it just kind of all aligned for us, I think. And it seems like it was a really great decision to get on LinkedIn. Daniela Galdi: 8:23 Isn't that great? When just like you're at a crossroads, and you're like, I need to change, and bam, you're like, here's the support that I need. Here is the here are my people, you know, so I feel like that also really aligns with with your specific work within sexuality and gender. Now, you mentioned about the nonprofit but I definitely want you to tell the listeners like where did this passion come from? Where did this support for that community and that love for it come from? Maureen McCarthy: 8:54 When I was in undergrad for social work, I had a gender issues course is what it was called. And it really just kind of like mimicking what you know, like Kira was saying about couples and like sexuality, it just really opened my eyes. And I was so drawn to it like it was just like a magnet and I just wanted to know more and all the things and then I wanted to be like the sexpert of the area and things like that. And I just never stop I just went with it and followed that passion that was there and still is deeply there. Daniela Galdi: 9:39 I kind of want to point you to sexpert now. Can we do that? is anyone else? don't you love that? The sexpert of Heal Your Roots Wellness. So that's amazing. It's a it's a beautiful seems like such a natural path that came for you which is so great. What you mentioned affirmative therapy, and I really just want to kind of discuss a little bit everybody before hopping on, and marine mentioned a really good note of like, their, this can go so deep thinking of so deep into talking about sexuality and gender, and gotta want to stick to like the basics, the 101, of just helping everybody to bring that awareness to the community, and so that they feel as open and expressive as they possibly can. It's hard enough just to go to therapy, sometimes to confront anything that you're feeling, right. But then to also have a stigma behind what you're feeling or not feel as include, as included in, in the world and the public guy with these, these feelings that you're having. I mean, I really, that's really courageous for people to do. So let's give everybody whether you're listening, and, you know, friends or family who are experiencing sexuality and gender, like conflicts for themselves right now, or if you yourself are experiencing that, let's give them an overview of everything. So like from both of you will have marine start first. But I want to hear like your perspective on the idea of that affirmative therapy. You mentioned that I can guess what it is. But I really want to know more about that. Maureen McCarthy: 11:28 You know, a couple things come up for me when you say that, because we were kind of taught when I was doing that certificate for this affirmative therapy. Because it's easy to put affirmative in your bio, right, like as a therapist, but like, what is the action behind it? What is the language behind it? And what is the understanding of yourself and where you come from. The influences that we really talked a lot about social location, which and what informs like our social location will be race, class, gender, religion, and it can be just like, all these things that we came face to face with in this program. So they're like, check your priveledge. And like, let's, let's acknowledge this, what is it, because we do like they do inform our bias of how we interact with the world, we approach people and even as therapists, so it's really important to come face to face with that, no matter how uncomfortable that can be. Because that's really going to help you be a better practitioner to begin with, let alone I think, a better person as well. And then the other piece is just the importance of like the language used, like even with intake forms for clients. And starting off, or, you know, so when you link up like with a client, if it's via telehealth, like utilizing like your name screen to have like your pronouns, asking someone else, their pronouns, and maybe dropping the word preferred, because this is someone's pronouns and their name, not what they prefer, but what they use. So those are some key pieces that come up for me. But I also do want to like, add a note that I'm a cisgender practitioner that is working with gender expansive, folks. So I have a lived experience that is different with these privileges and biases. So what put that note in there as well, and that's important for me to verbalize so that other people know that as well. So and I do the same with my clients as Daniela Galdi: 13:45 I love that explanation. With that said what well. you mentioned about it now, you know, I'm saying announcing and I think that it should be announced. I know we're not supposed to should, but I'm going to should it. So announcing that is is really a valuable tool, as you mentioned for practitioners to use. I remember reading Kira's bio, and it mentions one of the first things is cis gender, and there's a whole you know, it goes right into that identification. And it's important so that people can understand and their preference or who they resonate with when they are looking for a therapist. So the fact that you're already laying it all out for people. I think it's just it's very it's just it's very, not only courageous, but it's also very valuable. So I'm curious if you could tell a little bit more too Kira Yakubov: 14:41 Yeah, in the Council for Relationships programs that I also talk we spent a lot of time evaluating and reflecting on how our own families, cultures, communities, race, religion, ethnicity, all that played into who we are and how we view our own sexuality and gender, but also how we interact with other people, and the biases and assumptions that we might be making. And so coming from an Eastern European background, and as an immigrant, my parents were, along with the culture was very traditional gender roles and very stereotypical gender roles. And when I was growing up, I had a lot of anger. And I would rebel because of how my parents treated us differently based on me being a female, and my brothers, being boys. And even with that, and wanting to make sure that I didn't follow that, I still found myself having these very ingrained, stereotypical gender role beliefs in my own mind. And so it was important for me to first be aware of that, and come face to face with it, but also acknowledge how that can inform how I treat clients and how I view clients and talk to them. So I think it's very important that we check our assumptions. And we treat people with a lot of respect and consideration, knowing that we don't all come from the same background and the same experiences. And so I always want to be conscious of that. And I think that's part of why I made sure to put that I'm cisgender in my bio, because, you know, my lived experience is going to be very different than someone else's. And when you're a therapy seeker, you want to make sure that the therapist you're choosing, you resonate with, and you want to know that parts of who they are in the in their identity, kind of matches with yours, if that feels important for you, and just to make sure that you're choosing someone that you feel comfortable with. So I do think it's important for us to share that with future clients and current clients. Daniela Galdi: 16:46 That's awesome. So before we get into because we are talking a lot about like initial first impressions, especially within, you know, if somebody is interested in seeking therapy or seeking a professional. So I want to dive into that. Before we get into that, though, I want to touch on one more term that you said that I feel, it's just so important for people to understand this language that happens there. Maureen McCarthy: 17:12 So when talking about like gender expansive, or gender diverse, there's a lot of terms out there. And the youth create so many too, and it's always developing. Well, I'll never know all of the all of the terms, no matter how much we're, the youth teaches a lot about identity and stuff. And it's so wonderful and fantastic. But when I, you know, when I think of gender expansive, it's so like, there isn't any one answer because it's so unique. And it is expansive. And it's so personalized to each individual. And I think that's what's so great about, you know, the folks that are in my life and in like my work, they show up and I'm like you are the expert, regardless of the client, like you, you know, yourself, and I'm not here to tell you who you are. So they teach me a lot about their gender or what that looks like their identities, because it is just so unique. And I think folks hear me say that a lot in sessions. Like if I had a penny for every time I said that this house would be filled. But it and I say that repeatedly, because it's true. And I want you know them to know that they they're in control of this journey and what it looks like, like what they want it to look like. So there isn't really like one particular definition to me. Because if you ask the person down the street, they might have such an a different reply. Right. And I think that's what's pretty great about identity and just showing up as your authentic self. Like, it's your you and you're the expert of . Daniela Galdi: 19:01 Now, I know that I tried to teach myself and learn on my own. You are both professionals. And I would I would assume that you have to keep up on what's happening in every element of people's lives. What's going on out there in the world, but I would assume also that you both have done the work to teach yourselves as well. So if somebody is curious and listening to us right now, what can we teach them like? I know I have researched like the difference between gender and sexuality. I have researched pronouns I have researched and then tried to share with people who have not researched and I'd oftentimes gotten in fights with them, arguments with them about how it's just comes down to exactly what you said Maureen like it comes down to the person knowing who they are and just wanting to be able to freely express that without being, you know, without being judged without losing equal rights, human rights. And so what do you feel is a good approach? Both of you? What do you both suggest as a good approach when people are having these conversations with others who might be curious, might not have done the work yet? Or maybe, you know, we don't know, maybe never will. But we hope one day will, what do you suggest in terms of like having those conversations with people? Maureen McCarthy: 20:38 That's a great question. Because there is a difference between when someone is open and wants to learn. And when they are, they're closed off, and they really only want to share what their perspective is with what they think is right, I think it's kind of good to recognize that, because there's going to be a lot of emotional capacity, like spent on trying to educate someone, which truly happens to, you know, like gender expansive folks, a lot. And people, you know, within the LGBTQ community to begin with, that's incredibly draining. So sometimes it's helpful for those that you know, want to learn more in their life to explore like a local LGBT center, they have a lot of resources, there's groups, so there's, there's ways they could get information. But also, maybe it's something that, like a kid could go with their parents, and be able to go to a group and kind of connect and learn that way. And then you know, you have like your national organizations that have informations like PFLAG. Translifeline, transequality.org, like, there's things where you know, that way, maybe it's a parent or partner like, or just a loved one that can kind of go on and take the leadership and the role of you need to educate yourself, because you can't always, you know, rely on this person to give you every piece of information. And that's just incredibly draining. And we need to be mindful of, you know, when we are kind of just relying on one person or even like, tokenizing them, too. And that's not okay. So taking the responsibility to do the work. And, and start. Daniela Galdi: 22:45 Absolutely, I'm glad you mentioned those resources, too. That became something that I was nervous about ever making, you know, a friend, feel tokenized. But being curious, because I wanted to do right by them, and understand. So I'm glad you mentioned about those resources, because we really do have everything at our fingertips. So those are very credible resources that we can all just go Google real quick. So that we're not just making people feel, you know, as as as if they are singled out and have to basically explain who they are constantly, every second of their lives, which I'm assuming they feel. So Kira, do you have anything to add to that, like when having these conversations? Kira Yakubov: 23:31 Yeah, I think Maureen provided a lot of great resources for people to check out to learn more on their own. And I definitely agree, I mean, there's different kinds of conversations to be had. And being able to differentiate where someone's coming from. And their intention behind wanting to have these conversations with certain folks is going to be really important. And so if it is, they are looking to only share their perspective or debate or to prove a point that is going to be draining. And that's not always going to be a productive conversation, especially if it's their theories or perspectives versus your internalized identity and experience, it's going to be difficult to continue that conversation. However, if these are conversations with people in your life, and you care about then I think it's important to recognize if you're the person wanting to learn more, is it do you just want to learn more in general about gender and identity? Because if that is the case, then you know, tapping into those resources going online and finding that information on your own like Maureen shared. If you want to learn more about this specific person in your life, then I think coming from a place of curiosity and respect and making sure that you're not over asking or stepping boundaries, right, making sure that you ask them, you know, I want to be supportive of I want to be in your life and respectful of you know who you are and what you're going through. And I don't necessarily understand all of it is it okay if you share some of your experiences with me or you share what it's like for you or what this means for you, and making sure that you're using effective listening skills. And if they don't want to share respecting those boundaries, too. So it's like any other conversation relationship, and that being respectful using effective communication, and not overstepping people's boundaries about very personal things that they may be going through or experiencing. Daniela Galdi: 25:35 I love that and that's a huge part of the communication of it. You're working with people constantly, whether they're coming in for their sexuality or gender, you know, anything like that, what they're feeling, transitions, self esteem, communication, I feel like it's at the core of all that. So with that said, I want to actually ask your when somebody's starting, what are some of the common themes that you see as to why they want to start, like, if somebody calls for when somebody's ready to take that step, get the professional help? What are normal reasons why. And I asked this, because if anyone's listening, and it resonates for them, that they might think to themselves, if they were hesitant to seek any professional help, okay, yeah, you know what, that sounds a lot like what I'm going through. So maybe it's time for me to take that next step for myself. Kira Yakubov: 26:34 Yeah, so we tried to make the consultation process as streamlined as possible, because it can be scary and difficult to reach out to a therapist. And so in some of those initial calls that I have with folks, you know, they may be coming in with anxiety or depression or insecurities. And they're looking for someone who has background or specialty, in also gender expansive knowledge, or LGBTQIA+ community. And so sometimes it's just understanding their identity, along with the other mental health issues or struggles they may be having. But also, sometimes it can be, you know, they're trying to process this, whether it's for the first time or throughout their life, and they might be, you know, letting other people in about this information about themselves with their loved ones, or their friends, family, coworkers, whoever it is. So having help and support with having those conversations and being able to show up more authentically as themselves in, in their community. But sometimes it will come through as couples counseling, where one partner might have transitioned during their long term relationship. And so that's a big change for for both partners, or whoever, or however many partners are in the relationship. And so being able to process that and understand what that means for each of them. But also for the relationship is going to be important to have a therapist who can hold space for everybody and help guide them through that process. So it's really a wide range of things. Sometimes people are struggling with, you know, some discrimination that they might be having, or how they've been treated, or just their own internalized feelings and experiences about it. So it really is a wide range, I think, if you feel like you need support. And so sometimes it's not, you know, just sexuality or gender concerns, or just anxiety or depression or mental health issues, but really the overlap of those things and how they integrate together. And they're looking for someone to help them kind of piece through all of these things. Daniela Galdi: 28:50 That's amazing. And Maureen, do you have anything to speak to that that you've come across with your work? What what is usually like an initial impetus for people to want to get started or what they might be going through within their own identity or as Kira mentioned, within other relationships and friendships. Maureen McCarthy: 29:09 I have a couple of different experiences because I do like I came from the background of I did a lot of referrals in the past so meaning someone who might be seeking hormone replacement therapy needs to meet with a mental health professional for an evaluation and which is very stigmatizing. So talking about the system's like boxes and hoops people need to jump through and you know, have these very vulnerable and intimate conversations about like their body and how they feel and what is coming up for them. But you know, I sit down with them typically for just like one session and kind of go through just different questions and explore, you know, what's been going on. So people show up for like the referral end of things. So either hormone replacement therapy or surgery. So we've done a lot of that, which is very like, Okay, we know like what we're here for and what we need to do. And pretty straight, straightforward to for the most part. And then some folks just there's something about having a space like Kira to be able to explore because things feel really confusing, really overwhelming. Or there's only so much space up there for these thoughts. And it's so much helpful to verbalize them, but especially with someone who is experienced, competent. And, you know, I always say that, in those sessions, like, I'm not here to tell you who you are, like, you already know that we're just, let's just explore what's coming up. So really, it's a space for exploring how gender and sexuality are, these things are impacting their life, their relationships, and you know, me just kind of being a support along the way. There's just something that I think it's therapeutic for someone being able to just show up as their authentic self, I think we all should be able to do that in life, but I don't think we all get that. Daniela Galdi: 31:22 Okay, so we talked about getting started. And if anyone's listening some things that couldn't possibly resonate with them. As well as just feeling that self confidence and building that to work through any mental illness that might be also associated with your emotional side of feeling that lack of confidence, or wanting to build your self esteem to just step out into your own power and into your own identity of who you are, let alone then having to communicate it to others, which is something that can be helped, and worked through and processed, and supported through therapy therapists, having the professional help there. What else goes from there, like, I just want to hear like inspiring stories about like, Tell me some breakthroughs that you both have experience is going to make a cry because I just want to hear the because I know the power that you both can offer to somebody who is seeking help with you, and the support that you can give them so now I just any inspiring stories that we can share, to know that there to know that there's hope, right to know that there's hope out there that for anyone listening, going through trying to process these things, feeling like they have to hide who they are knowing that on the other side of it, great things will happen. Maureen McCarthy: 32:53 So what comes up for me when you say that, and I was reflecting on this, if you're saying this is trying, you know, pulling for things, but maybe in and I noticed maybe a theme when certain folks were like coming up for me or instances in the past. And what came up is like when someone finds their sense of community, a lot of folks, you know, within the LGBTQ community, choose their family where maybe, you know, their family had abandoned them, or they didn't have a sense of family to begin with. So when there's something about when someone finds like that comfy cozy feeling of home in a group of people that you know, they choose, and I mean, for some folks that's online, or you know, in person. But I think once they feel, find others that are experiencing similar things, have been through things and came out on top or came out with that sense of hope, you know, that you're talking about. It's like, okay, I'm not alone. And you have this group of people behind you that really makes you feel like you can take on these things. Because he's seen the other people made it through. And I think there there's something extremely important about a sense of community, and how that can empower someone and help with their own self image and confidence. Daniela Galdi: 34:30 I absolutely agree. It reminds me of even back to when I was going into high school. And we for me, I always felt a sense of feeling a bit different than what the norm was or person would be right. And I remember my mom's saying to me, you know, you'll gravitate towards your people, that people and vice versa, you'll be drawn to them and they'll be drawn to you and you don't really have to worry about putting in that putting in that I mean anything but yourself because it everybody will come together. And ultimately, that really did happen. And so I tried to think about that. And when you mentioned about community, I always try to encourage that mindset to people that you just show up as yourself and the people are drawn to you something, something, the energy of, you know, an interest that was shared, or something will come up, and then you're able to really go deeper and connect and feel that foundation or support with people that, like you mentioned, sometimes doesn't always come from our family. And in this case, I would have to research more, but I, in my experience, feel people often, that's the hardest part is to talk to their family about their sexuality and at any transition. Kira Yakubov: 35:51 Yea, I mean, I can't necessarily share any specific stories to protect, you know, my clients confidentiality. But I agree with Maureen in terms of when clients find their community and their people. And I think a big part of that is overcoming shame. Because I think in sexuality and gender identity, there's a lot of shame that can be there, or that might be placed on us from society, or our families, these, you know, ingrained messages about who we're supposed to be. And I think the most powerful sessions or transformations for me is watching clients, process that shame and overcome it and feel confident, to be who they are, and empower to be their authentic self. And sometimes that means, you know, releasing some relationships from our lives, whether that's all together or reducing the amount of time we spend with them, or the impact and importance they have on us. So that we can create more space for people who are aligned with who we are. And what we're looking for in life. And being able to find our people in that way, I think is huge. And when you feel confident in yourself, you you're more likely to go out there and be yourself so that you can find your tribe. So I think watching clients overcome shame around that and being able to embrace who they are, is really the most rewarding parts of the therapy process for me as a therapist, Daniela Galdi: 37:22 I love that also the theme of community and finding that that tribe, and that support system and your people and whatever we want to coin and as right. I I think back to the idea that Maureen mentioned about the youth and, and younger generations, I feel very safe with the younger generation that is coming up. By the way, just to put that out there. Like I just feel very confident that they will be directing us in a very expressive, open minded, loving, kind hearted, humane way, so I'll put that out there. But you mentioned earlier Maureen about the youth and how they helped to educate us. And so I feel as though we're gonna have even more welcoming communities, as we become as, as a society we all become, that becomes normalized. The idea of, of not just being female male, not just having partners, monogamous partners, right. That's where I really want to talk about polyamory. And stepping away, I know you both do a lot with relationships, but stepping away from the norm, husband, wife situation, you know, having internal conflicts with each other arguments, emotional situations going on, and then take it a step further to the fact that relationships look different. They're not always monogamous, and what is polyamory? What is that whole world and noting that there also is a community for people who choose to live in that direction. Maureen McCarthy: 39:11 Yea. So polyamory one of like the variations of non monogamy so when we think of non monogamy is kind of like an umbrella term, again, kind of like how I was saying with gender diversity or gender expansive, so polyamory as when there's more than two people involved in like a relationship. And that looks very different to whoever's in the relationship, right? They're in charge of kind of what that looks like and what they want it to look like. So polyamory being one of the terms kind of under non monogamy, but also think of open relationships, swinging. There's a lot of other terms out there as well. But those are probably some of the most common we hear along with consentual or ethical, non monogamy. So all different variations of the term non monogamy, if that answers your question, Daniela Galdi: 40:15 it completely does it completely does and I, you know, I'm glad that there are terms for all these things, because again, I help, I think that that helps people to find their people, right knowing that they can identify towards that. And that takes us back to the whole idea of being open to how you identify yourself, and how you want to give love and how you want to feel loved ultimately. So with that said, I think that that what you gave us was a great explanation of how many options there are. And there is no one way for everybody, figuring out how you want to live life to the fullest, right? Where does self care methods come in to play to make sure that your clients that you are seeing about working through transitions within sexuality, gender, what type of self care? What does that look like for them? Kira Yakubov: 41:13 Yeah, so self care can encompass a lot of things, right, it's not just bubble baths, or, you know, doing something that feels good. It is making sure you're taking care of your whole being, which includes a lot of different aspects of our life, right. So it's kind of like a circle. It's we have our mental, emotional, physical, spiritual, sexual, financial, right, like all of these things that we are constantly trying to juggle, which is you know why adulting is hard. And I think that working through our senses to make sure we're taking care of ourselves is going to be important. So there may be some days or weeks where you're primarily focusing on your mental health, or there's going to be times where you're trying to focus on, you know, your financial and emotional health. And so when we're talking about self care, it's going to be catered to each person a lot, how, you know, Maureen was saying that it's unique to the individual. So I think it encompasses a lot of things. It's not just one size fits all. And so sometimes, we're not always taught the proper anatomy of our bodies growing up. And so even just taking time to look at yourself in the mirror, whether it's naked or in different positions, and then being able to touch yourself in ways that feel safe and pleasurable, is going to be important. And so that can also be you know, taking a hot shower, and being really mindful of how the water is pouring on you. If you're with a partner, you know, being able to share that moment with them. And really being aware of how the sensations feel when you're touching each other, or what you're drawn to more. And so I think it's going to be really intentional about being present in your body and you know, the meaning you have behind it and what comes up for you. And so it's going to be unique, like everything else in cater to yourself. But just making sure that you are giving yourself that space and time to explore and process. And so that also can mean going for walks or journaling or doing other things that you are reflecting on. And so that's why it depends on which aspect of your whole being Are you focusing on when you're thinking about self care, specifically for looking at self care for you know, exploring and processing your sexuality or gender identity, I would say the mind body connection is going to be super important. And also, knowing your body Maureen McCarthy: 43:59 I love the idea of just going to a toy shop, whether you're you go by yourself, you go with a friend for support, you go with a partner or someone that you maybe want to use like these toys or these things, whatever, whatever goodies you get there with because that is something that like you can see what you gravitate towards as an individual. And then if you're there with a partner, like they can kind of like be politically watching you and seeing what you're gravitating towards, or maybe what catches their eye. And I think that's a fun, flirty, curious experience to have. Whether you're solo partner, there's a crew of you, whatever that looks like. Because you do get to see just these different things and touch them and like get your senses engaged in that way. And then you know, decide if There's a certain avenue that you're really drawn towards, and you want to explore more. And whether you purchase things there or not, or you go home and maybe tap into some porn that's geared towards whatever it is you're drawn towards. That's kind of like another option to to, you know, explore what's what's really catching your eye and whatyou find to be enticing. Kira Yakubov: 45:27 Yes, speaking of senses, there's actually another great app for you know, for audible. It's, I'm pretty sure it's called Dipsy. And so it's erotica read out loud that you can listen to by yourself with a partner. And there's like different genres as well. So that's also another great way to tap into your senses to be aroused that I thought would be like a really cool tip for people out there. Daniela Galdi: 45:55 Okay, so now with that said, what do most people feel I mean, the word shame comes up to me what people might feel, who haven't always been encouraged to do this, or for folks who maybe have, again, that shame built around, like being sexual, or seeing yourself as a sexual being or taking part in sexual encounters, right? Where, what benefit of exploring these things? Can we all find? Maureen McCarthy: 46:37 I immediately think of like empowerment, that comes to mind first, because I think there is something empowering when you feel like ready to take charge of your pleasure and like your sex, then you identify what that looks like to you like that desire, the pleasure and the things that you like, because kind of how Kira was saying with, there's so many different things that inform the way we look at things like so like growing up, or families or culture or religion and things like that, that when we learn that it's okay to like, step out of that box. There's a whole other world out there. And I think when that's discovered by folks, it is very empowering. And that's hot to begin with in my opinion. Daniela Galdi: 47:39 That's great. I love that. I love that. All right, I'll take that. That's hot and empowering. Kira, do you have anything you want to add to that? Kira Yakubov: 47:50 So I see a lot of things from a cultural lens because of my specific background and how I was raised. And so what comes to mind for me is feeling deserving and entitled to pleasure. And so that can be modeled or not modeled while you're growing up, even outside of sex and sexuality is, you know, did you see your parents or your family members, feeling like they were allowed to have pleasure or joy or be happy? Or was there a lot of shame and guilt around having that freedom. And so I think that's a big part that we internalize too is, we might experience pleasure, but the relationship or the narrative we have around if we're deserving of it, or if it is acceptable, right? So overcoming that shame is going to be a huge piece in just allowing yourself to enjoy it, and be present in the moment. And you know, we're human beings, our body is built for that, like we have nerve endings, specifically just for pleasure, right? So I think that it's really important that we allow ourselves to experience pleasure and desire and joy in our bodies. And I think that's one of the most beautiful parts about being a human being. So overcoming some shame and just allowing ourselves to feel entitled and deserving of pleasure because you are entitled and deserving of pleasure in your body. Daniela Galdi: 49:20 That totally resonates with me. When you bring it also to the deserving piece, for sure where it's like thinking back ingrained to work, work, work, work work, and then not always necessarily reaping the reward for that but pulling that back even more to be pleasure and deserving and feeling goodness can just happen. It's a part of life and like you said, it's a it's a part of life, just in general and it's like since most beautiful part of life being able to do that. One of the things to which I know is a little bit of a detour of where I'm going with this conversation, but even within heal your roots practice, I know in the first episode, we talked about how for the therapist that is big, like, being able to have that work life balance, where you're enjoying yourself, only supports people to be able to identify and express themselves more and feel that pleasure. So ultimately, I circled back around to say that being part of Heal Your Roots practice, and anyone coming in is going to be orgasmic. So that's what I was doing with that. But no, but I make light of it. But the things that you're both saying, and adding the perspective and insight, feeling of sexuality, and pleasure, and going with the senses, and exploring that world, and then exploring the world of pleasure in many different ways in your life, adding that in, I just think is just so key to bringing mass joy to more people. So thank you both for that. And also, now I get to ask you both to put you on the spot again, with what do you feel you need to be your best self. And now, I'm going to be really tough on you. And I want to hear Maureen, you can start being your best self. I just want like narrowed down to one. One thing. Kira Yakubov: 51:25 Really put us on the spot. Daniela Galdi: 51:26 That's what I'm here for Maureen McCarthy: 51:31 I'm laughing because I will be honest, the first thing that came to mind was space. Kira Yakubov: 51:38 Oh my God, me too. That's creepy. Maureen McCarthy: 51:41 Yeah, space, well, I'll be extra and throw in also feeling connected to myself, like I need the space to do that. And that it's very important to stay connected. Because I have experienced self abandonment in the past and various experiences. I've abandoned myself for other people. And so that is really crucial piece to my overall like well being, and to just thriving, not just kind of going through the motions and living with intention. Daniela Galdi: 52:16 I was just going to be what might that look like? And you mentioned living with intention. But if there's something else too, like, does that look like you scheduling out? Like I know, for myself, I schedule out, you know, I don't reach for my phone to talk to anyone until like eight or 9am in the morning, right? So I make sure I give myself that actual time and space. For you. Maureen McCarthy: 52:42 Yea, space looks like for me. Taking the time, like I do like to be alone, a lot. And but I'm also very social. So there's, but people know, after I'm engaged, I'm hanging out, especially with what you know, we do for a living, I need to like, just be me be my weird self in my space. And let like I think that, for me, it looks like giving myself permission to feel whatever it is I'm feeling and sitting with that. But I think another piece too, I like to try to stay connected to like nature in the environment as well. And a little bit I have to acknowledge, definitely boundary setting. So that is actually a huge piece that even for me as a therapist is very hard to do. So maintaining boundaries, because if I don't maintain my boundaries, I am abandoning myself. And that is how I see that for me. Kira Yakubov: 53:57 You know, I laugh because I really thought about space immediately as well. For me, it's almost like solitude, because I can't have a lot of noise around me or a lot of like things going on, especially if I'm drained or I'm just I need a break or to decompress. I can get overstimulated really easily. So I would say being alone with like, almost silence, like I can lay in a room in silence and just relax and breathe, or be outside and just feel the sunshine for a while and that really refuels me and being able to have my dog there is great, but really just being alone, and not having to talk or hear any sounds or anything like crazy going on around me is really huge for me to just like be my best self after that. And the boundaries piece is so key because when we're trying to do that if people are calling us or trying to pop in to talk to us like that's definitely going and disrupt that. And I think a big part of boundaries is it's for us, but it's also for the other people that we're setting them with. Because it's, it's saying, like, Hey, I love you. And I don't want to present like this towards you if I'm not being my best. So in order for both of us to be happy in this relationship, and for you to get the best version of me, I need to have this like, I need to have this boundary, I need to have this alone time. Especially for therapists, right? Because that's, we take on a lot for other people. So we have to prioritize ourselves too Daniela Galdi: 55:36 now both of you though, with the dogs. We bring this up. are the dogs allowed in your space? Kira Yakubov: 55:42 Yes, always Daniela Galdi: 55:45 And Maureen, tell us to because you said you'd like to get a little like, I want you to like, get weird for a second. I guess it's not so weird. But tell us more about like how your love for we've talked about your passion and your specialty and talking with people about gender expansive types of situations. But now talk about you know, for you, you find a lot of joy with rescuing dogs. Maureen McCarthy: 56:11 Yes, I'm a new foster mom newer. I've always connected with like bully breeds and just rescues and you know, the dogs that are often overlooked, I connected with them at a fairly young age. And, like, I think maybe that's something that just resonated with me because and after I lost my soul dog in March, I was like, I gotta do something I got to foster right away, because you are right, the dog is included in my when I take my space, the dog is in the space. The dog needs to be in the space. That's crucial for me. And so then I shortly after started fostering with just like local humane society. I'm actually in between dogs after having one for three months. But I just put a new application in for a senior pity named Gemma. So to be continued, we'll see. But I'm just fostering because I'm honoring my my emotions, and I'm still grieving my beloved Bob. I'm not quite ready to adopt. But I've always wanted to foster senior dogs. I love senior dogs, and it matches my energy, you know, I can be a bit of a couch potato. So I get a lot of pleasure and enjoyment from life. Like from dogs, you could ask any anyone that knows me, and they'll be like echoing the same sentiments. Daniela Galdi: 57:56 Oh, that's amazing. Sorry about Bob, and at the same time I want to congratulate you for, you know, being inspired to then help the other dogs. And I don't know if either of you realized it, but it parallels the work that you do, in terms of you mentioned, like anyone, any any pup out there who's feeling overlooked, right? So it's really, it's really nice that that purpose seems to have a common thread throughout your life. So that's amazing. And we you know, we have mentioned Hazel, who is Kira's dog , many, many times, and I know how much joy she brings you. So just having that emotional support too from an animal is definitely something that I feel is, is really beneficial for people to consider to have that. And they're perfect for when you do need a little bit of support, but still want your space. Because technically, they're not invading your space. They make exactly they make the space they make it. So this has been wonderful. I wanted to circle back for anyone listening, there's going to be episodes every other Wednesday. And Maureen will definitely be back with us as well, because we've really just scratched the surface on things. And plus, we want to get to know a little bit more about her weirdness that she mentioned. And we want all of you listening to make sure that you really do understand the passion, as well as the intention that is really behind the work that Heal Your Roots Wellness does and the therapists that are a part of it, and that they are there for those who really need support. In whatever way it might be might not be sexuality and gender or transitioning but really any type of struggle or hardship that you might find yourself going through. Or if you just want to find someone to talk to because you know we all have things that we need to get out. as they like to say little things, we, you know, we gotta get that shit out. So for the listeners based on our theme for today about affirmative therapy, about transgender communities about, you know, creating spaces that make you feel safe, help to reduce any type of shame around this. Any last thoughts for LGBTQ+ community ways to help things like that give it all to us. Kira Yakubov: 1:00:31 So I know we talked about finding your community. And I think it's also important to remember that forming friendships and connections takes time. And sometimes we might not feel comfortable in that process, I mean, probably won't feel comfortable in the process, because sometimes it can be really hard to make friends. And so I just want to remind everybody that, you know, give yourself the grace and patience to work through that discomfort and that it will, it will take some time to find those people and find those spaces where you do feel comfortable and accepted. And to not give up because sometimes it's going to take several attempts or different clubs or different you know, communities before you find the people that you feel your best with. Maureen McCarthy: 1:01:19 Yeah, and echoing that maybe a little bit you know, there's if you haven't found them yet, there's people out there whether it be friends, co workers, or you know, even a supportive like therapists that are out there that will you know, help you and support you. And you'll know you found those people when you know, it'll it'll make your heart sing and you'll feel like you can show up as you so if you haven't found them yet they are they are out there and hold on to that hope. ### Listen - [Spotify](https://open.spotify.com/episode/12558275) - [Apple Podcasts](https://podcasts.apple.com/podcast/12558275) - [YouTube](https://youtu.be/J5vI-tlZ7AE) --- ## First Steps into Heal Your Roots Podcast - URL: https://healyourrootspodcast.com/episodes/first-steps-heal-your-roots-podcast - Published: 2022-08-17 - Season 1, Episode 1 - Duration: 32:18 - Category: introduction - Guest: Kira Yakubov Ploshansky ### Summary Inaugural episode introducing the Heal Your Roots Podcast mission, vision for accessible mental health content, and host Kira Yakubov Ploshansky. ### Description Welcome to the very first episode of Heal Your Roots Podcast! Host Kira Yakubov Ploshansky introduces the podcast, shares the mission behind Heal Your Roots Wellness, and discusses the vision for creating accessible mental health content. Learn about the journey that led to creating this podcast and what listeners can expect from future episodes focusing on mental health, therapy, and personal growth. ### Listen - [Spotify](https://open.spotify.com/episode/12494717) - [Apple Podcasts](https://podcasts.apple.com/podcast/12494717) - [YouTube](https://youtu.be/EEeO2-w2mBs) --- # Blog Posts --- ## Trauma & Healing: Faith, Doubt, and Healing: Conquering OCD and Religious Trauma Together - URL: https://healyourrootspodcast.com/blog/trauma-healing-faith-doubt-healing-ocd-religious-trauma - Published: 2026-09-11 ### Summary Exploration of the intersections between OCD, religious trauma, and healing pathways with Dr. Katie Manganello and Caitlin Harrison. ### Content In this episode, Caitlin Harrison and Dr. Katie Manganello join the Heal Your Roots Podcast to explore healing in depth. ### Episode Overview Welcome to a profound episode of the Heal Your Roots Podcast, Season 3, Episode 9, where we explore the intersections of Obsessive-Compulsive Disorder (OCD), religious trauma, and pathways to healing. Join us as we sit down with Dr. Katie Manganello and Caitlin Harrison to discuss the complex relationship between faith, doubt, and mental health recovery. ### Why Healing Matters Healing is a deeply personal process that unfolds differently for everyone. Whether healing from trauma, grief, relationship challenges, or other life experiences, the journey requires patience, self-compassion, and often professional support. At Heal Your Roots, we believe that healing is possible for everyone. By sharing stories, insights, and evidence-based strategies, we hope to inspire and support others on their healing journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Faith, Doubt, and Healing: Conquering OCD and Religious Trauma Together." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on healing. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Faith & Spirituality: Faith, Doubt, and Healing: Conquering OCD and Religious Trauma Together - URL: https://healyourrootspodcast.com/blog/faith-spirituality-trauma-faith-doubt-healing-ocd-religious-trauma - Published: 2026-09-08 ### Summary Exploration of the intersections between OCD, religious trauma, and healing pathways with Dr. Katie Manganello and Caitlin Harrison. ### Content In this episode, Caitlin Harrison and Dr. Katie Manganello join the Heal Your Roots Podcast to explore religious trauma in depth. ### Episode Overview Welcome to a profound episode of the Heal Your Roots Podcast, Season 3, Episode 9, where we explore the intersections of Obsessive-Compulsive Disorder (OCD), religious trauma, and pathways to healing. Join us as we sit down with Dr. Katie Manganello and Caitlin Harrison to discuss the complex relationship between faith, doubt, and mental health recovery. ### Why Religious Trauma Matters Religious Trauma is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like religious trauma in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Faith, Doubt, and Healing: Conquering OCD and Religious Trauma Together." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on religious trauma. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Anxiety & OCD: From Anxiety to Empowerment: A Deep Dive into Postpartum & Perinatal OCD - URL: https://healyourrootspodcast.com/blog/anxiety-ocd-anxiety-empowerment-postpartum-perinatal-ocd - Published: 2026-09-05 ### Summary Dr. Katie Manganello returns to explore postpartum and perinatal OCD, discussing anxiety, intrusive thoughts, and the journey towards empowerment for new parents. ### Content In this episode, Dr. Katie Manganello joins the Heal Your Roots Podcast to explore anxiety in depth. ### Episode Overview In this compelling episode of the Heal Your Roots Podcast, we warmly welcome back Dr. Katie Manganello as we delve into the intricate experiences of postpartum and perinatal OCD. With a compassionate approach, this discussion unfolds the layers of anxiety, intrusive thoughts, and the journey towards empowerment for new parents. ### Why Anxiety Matters Anxiety is one of the most common mental health challenges, affecting millions of people worldwide. While some anxiety is a normal part of life, chronic or overwhelming anxiety can significantly impact daily functioning, relationships, and overall quality of life. Understanding the science behind anxiety, including how our nervous system responds to perceived threats, can help us develop more effective coping strategies and feel more in control of our emotional experiences. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "From Anxiety to Empowerment: A Deep Dive into Postpartum & Perinatal OCD." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on anxiety. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Mental Health & Wellness: OCD and Eating Disorders: Unveiling Treatment Synergies with Dr. Alyssa Hertz - URL: https://healyourrootspodcast.com/blog/mental-health-wellness-health-ocd-eating-disorders-treatment-synergies-dr-alyssa-hertz - Published: 2026-09-02 ### Summary Dr. Alyssa Hertz explores the complexities of treating individuals with both OCD and eating disorders, highlighting treatment synergies and therapeutic approaches. ### Content In this episode, Dr. Alyssa Hertz joins the Heal Your Roots Podcast to explore mental health in depth. ### Episode Overview Join us on this enlightening episode of our podcast as Dr. Alyssa Hertz dives into the complexities of treating individuals with both Obsessive-Compulsive Disorder (OCD) and eating disorders. With her dual expertise, Dr. Hertz highlights the synergies in treatment approaches and provides valuable insights for both professionals and individuals struggling with these conditions. ### Why Mental Health Matters Mental health is the foundation of our overall well-being. It affects how we think, feel, and act in our daily lives. Understanding mental health helps us recognize when we or our loved ones may need support, and empowers us to take proactive steps toward healing and growth. At Heal Your Roots, we believe that mental health awareness is for everyone. Whether you're navigating your own journey or supporting someone else, education and open conversation are powerful tools for reducing stigma and encouraging help-seeking behavior. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "OCD and Eating Disorders: Unveiling Treatment Synergies with Dr. Alyssa Hertz." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on mental health. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Therapy & Treatment: OCD and Eating Disorders: Unveiling Treatment Synergies with Dr. Alyssa Hertz - URL: https://healyourrootspodcast.com/blog/therapy-treatment-ocd-eating-disorders-treatment-synergies-dr-alyssa-hertz - Published: 2026-08-30 ### Summary Dr. Alyssa Hertz explores the complexities of treating individuals with both OCD and eating disorders, highlighting treatment synergies and therapeutic approaches. ### Content In this episode, Dr. Alyssa Hertz joins the Heal Your Roots Podcast to explore therapy in depth. ### Episode Overview Join us on this enlightening episode of our podcast as Dr. Alyssa Hertz dives into the complexities of treating individuals with both Obsessive-Compulsive Disorder (OCD) and eating disorders. With her dual expertise, Dr. Hertz highlights the synergies in treatment approaches and provides valuable insights for both professionals and individuals struggling with these conditions. ### Why Therapy Matters Therapy is a powerful tool for personal growth and healing. Working with a skilled therapist provides a safe space to explore thoughts, feelings, and patterns that may be holding us back. Modern therapeutic approaches offer a wide range of options to fit individual needs and preferences. Finding the right therapist and therapeutic approach can be transformative. Understanding what to expect from therapy helps reduce barriers and encourages more people to seek the support they deserve. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "OCD and Eating Disorders: Unveiling Treatment Synergies with Dr. Alyssa Hertz." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on therapy. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Depression & Grief: Coping Strategies for New Mothers Facing Postpartum Challenges - URL: https://healyourrootspodcast.com/blog/depression-grief-coping-strategies-new-mothers-postpartum-challenges - Published: 2026-08-27 ### Summary Deep dive into maternal mental health covering postpartum anxiety, depression, and practical coping strategies for new mothers navigating postpartum challenges. ### Content In this episode, Dr Brianna Blis and Dr. Sepncer Brown join the Heal Your Roots Podcast to explore depression in depth. ### Episode Overview Navigating Maternal Mental Health: Insights on Postpartum Anxiety and Depression. Welcome to the latest episode of the Heal Your Roots Podcast! In this episode, we dive deep into the complex world of maternal mental health, exploring crucial topics like postpartum anxiety and depression. Our discussion covers a range of vital issues, from the impact of social media on new mothers to practical coping strategies for managing postpartum challenges. ### Why Depression Matters Depression goes far beyond occasional sadness. It is a complex condition that can affect every aspect of a person's life, from energy levels and sleep patterns to relationships and self-worth. Recognizing the signs of depression is the first step toward finding effective treatment and support. Evidence-based treatments for depression continue to evolve, offering hope and healing for those who are struggling. No one needs to face depression alone. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Coping Strategies for New Mothers Facing Postpartum Challenges." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on depression. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Anxiety & OCD: Coping Strategies for New Mothers Facing Postpartum Challenges - URL: https://healyourrootspodcast.com/blog/anxiety-ocd-coping-strategies-new-mothers-postpartum-challenges - Published: 2026-08-24 ### Summary Deep dive into maternal mental health covering postpartum anxiety, depression, and practical coping strategies for new mothers navigating postpartum challenges. ### Content In this episode, Dr Brianna Blis and Dr. Sepncer Brown join the Heal Your Roots Podcast to explore anxiety in depth. ### Episode Overview Navigating Maternal Mental Health: Insights on Postpartum Anxiety and Depression. Welcome to the latest episode of the Heal Your Roots Podcast! In this episode, we dive deep into the complex world of maternal mental health, exploring crucial topics like postpartum anxiety and depression. Our discussion covers a range of vital issues, from the impact of social media on new mothers to practical coping strategies for managing postpartum challenges. ### Why Anxiety Matters Anxiety is one of the most common mental health challenges, affecting millions of people worldwide. While some anxiety is a normal part of life, chronic or overwhelming anxiety can significantly impact daily functioning, relationships, and overall quality of life. Understanding the science behind anxiety, including how our nervous system responds to perceived threats, can help us develop more effective coping strategies and feel more in control of our emotional experiences. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Coping Strategies for New Mothers Facing Postpartum Challenges." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on anxiety. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Relationships & Communication: Cultural Double Standards: Food and Body Image with Allen-Michael Lewis, LMFT - URL: https://healyourrootspodcast.com/blog/relationships-communication-cultural-double-standards-food-body-image-allen-michael-lewis - Published: 2026-08-21 ### Summary Join us for the season finale of Season 3 on Heal Your Roots Podcast, where Kira Yakubov Ploshansky, LMFT, and Dr. Katie Manganello, host Allen-Michael Lewis, LMFT – one of the newest team members at ### Content In this episode, Allen-Michael Lewis joins the Heal Your Roots Podcast to explore relationships in depth. ### Episode Overview Episode Highlights: - Cultural Perspectives on Food and Relationships (0:00): Allen-Michael explores cultural double standards in food and body image, sharing personal and professional insights into addressing these issues in therapy sessions. - OCD, Eating Disorders, and Cultural Differences (8:01): Dr. Katie Manganello discusses the manifestation of OCD in food habits and the pressures leading to eating disorders in children due to parental influence. - Societal Double Standards (13:24): Examination of how men and women are differently judged based on their eating habits and body image, with a focus on societal and familial expectations. - Body Positivity and Internalized Shame (19:48): Discussion on the importance of mindfulness and body acceptance, particularly among younger generations influenced by social media. - Impact of Family and Societal Comments on Body Image (25:41): Insights into how negative comments from family and society can shape one’s self-esteem and body image, with a discussion on the myths around body health and size. - Eating Disorders and Sensory Processing Conditions (33:19): Addressing disordered eating and sensory processing issues such as ARFID and pica, and the associated stigma and shame. - Psychedelics in Therapy (39:26): Exploring the potential of psychedelics in disrupting harmful mental narratives and creating pathways for healing, compared to traditional therapy methods. This episode is a thoughtful exploration of how cultural narratives and personal experiences shape our relationships with food, body image, and mental health. Don’t miss out on this engaging conversation! Tune in now and subscribe to Heal Your Roots Podcast for more insightful episodes on relationships, mental health, and personal growth. Episode Resources: - Follow Allen-Michael Lewis on Instagram @MFTFoodie - Learn more about Heal Your Roots Wellness at healyourrootswellness.com Disclaimer: The content is intended for informational and educational purposes only   Cultural Perspectives on Relationships and Food (0:00) - Allen-Michael Lewis discusses cultural double standards for food and body image in therapy sessions. - He shares personal anecdotes and insights on addressing these issues with clients. - Allen-Michael highlights the impact of food on mental health, often quoting jingles from diet culture. - Kira Yakubov Ploshansky recommends restaurants to Allen-Michael, sparking a discussion on potential affiliate marketing. - Together, they explore how food represents emotional experiences and cultural backgrounds in therapy. OCD, Eating Disorders, and Cultural Differences in Food Habits (8:01) - Dr. Katie Manganello explains how OCD can manifest in food and eating habits. - The discussion covers how parental dietary restrictions can lead to perfectionism and eating disorders in children and teenagers. - Allen-Michael and Dr. Manganello discuss the pressures on kids to have a “weird relationship with food” and the normalization of this behavior in men. - They highlight the double standard in praising male athletes for restrictive diets while criticizing female athletes for the same behavior. Societal Double Standards Around Food and Body Image (13:24) - Kira Yakubov Ploshansky discusses societal double standards in food and eating, noting how men are encouraged to eat more while women are judged for their weight. - Allen-Michael talks about cultural beliefs around food as love and appreciation, alongside the judgment and policing of women’s bodies. - They explore the stigma surrounding the word “fat” and its impact on society, including how children are taught to view and comment on people’s bodies. Body Positivity, Societal Beauty Standards, and Internalized Shame (19:48) - The conversation includes a discussion on mindfulness and body acceptance, encouraging Gen Z to break away from negative self-talk and comparison on social media. - Allen-Michael emphasizes the importance of intergenerational dialogue and support in promoting body positivity and self-acceptance. - They discuss societal pressure on body types in relationships and agree that negative comments based on internalized beauty standards are harmful. Body Image, Eating Disorders, and Food Sensitivities (25:41) - Kira Yakubov Ploshansky discusses the impact of negative comments from family members on body image and self-esteem. - The speakers address the double standard of society’s beauty standards for women versus men, focusing on Hollywood and media representation. - Allen-Michael and Dr. Manganello discuss the myth that bigger bodies are less healthy, citing examples from dance and gym workouts. - They touch on eating disorders, with Dr. Manganello sharing her experience with individuals in smaller bodies struggling with self-care and mental health. - Allen-Michael shares his struggles with eating certain foods due to sensory issues, and another speaker discusses experiences with autism spectrum disorder and food sensitivities. Eating Disorders and Sensory Processing Conditions (33:19) - Kira Yakubov Ploshansky and Allen-Michael discuss disordered eating and sensory processing, including avoidant restrictive food intake disorder (ARFID) and pica (eating non-food items). - They address the shame and stigma surrounding disordered eating and sensory processing, focusing on promoting acceptance and understanding. - The challenges of addressing mental health issues are discussed, emphasizing the need for empathy and understanding. - They stress the importance of recognizing that mental health struggles are ingrained habits and patterns that require support and therapy. Using Psychedelics to Treat Mental Health Issues (39:26) - Kira Yakubov Ploshansky discusses the difficulty of forming new habits and the role of default mode networks in shaping beliefs and narratives. - Psychedelics can disrupt these default modes, creating new pathways for self-perception and potentially leading to lasting change. - Allen-Michael compares narrative therapy to psychedelic-assisted therapy, noting similarities in reframing beliefs and deleting old narratives. - Kira highlights promising results from MDMA-assisted therapy for social anxiety and PTSD, with participants no longer qualifying for diagnosis after six months. - The importance of addressing food and eating habits in therapy is emphasized, urging clinicians to challenge internalized thoughts about food and support clients in developing a healthy relationship with food. This episode offers a comprehensive exploration of cultural narratives and personal experiences shaping relationships with food, body image, and mental health. Listen now for an insightful conversation with Allen-Michael Lewis, Kira Yakubov Ploshansky, and Dr. Katie Manganello. Keywords: cultural perspectives, food, body image, eating disorders, mental health, Allen-Michael Lewis, Heal Your Roots Wellness, mindfulness, body positivity, societal standards, therapy, relationships. ### Why Relationships Matters Healthy relationships are essential to our emotional well-being. Whether romantic, familial, or platonic, the quality of our connections with others significantly impacts our mental health. Learning to communicate effectively, set boundaries, and navigate conflict are skills that benefit every relationship. Understanding relationship dynamics helps us build stronger, more fulfilling connections and break patterns that may no longer serve us. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Cultural Double Standards: Food and Body Image with Allen-Michael Lewis, LMFT." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on relationships. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Identity & Self-Discovery: Embracing Cultural Identity in Therapy with Gabrielle Larin, LMFT - URL: https://healyourrootspodcast.com/blog/identity-self-discovery-compassion-embracing-cultural-identity-therapy-gabrielle-larin - Published: 2026-08-18 ### Summary Exploration of self-compassion versus self-criticism, with practical techniques for developing a kinder inner voice and supportive self-relationship. ### Content In this episode, Gabrielle Larin joins the Heal Your Roots Podcast to explore self-compassion in depth. ### Episode Overview Many of us struggle with a harsh inner critic that undermines our self-worth and mental health. This episode explores the difference between self-compassion and self-criticism, and provides practical tools for developing a kinder, more supportive relationship with yourself. Learn evidence-based techniques for quieting your inner critic and cultivating self-compassion in daily life. ### Why self-compassion Matters self-compassion is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like self-compassion in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Embracing Cultural Identity in Therapy with Gabrielle Larin, LMFT." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on self-compassion. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Trauma & Healing: Communication and Connection - URL: https://healyourrootspodcast.com/blog/trauma-healing-based-therapy-communication-and-connection - Published: 2026-08-15 ### Summary Exploration of somatic healing approaches and the mind-body connection, covering body-based therapies for processing trauma and emotional experiences. ### Content In this episode, Joslyn Justi joins the Heal Your Roots Podcast to explore body-based therapy in depth. ### Episode Overview Our bodies hold memories and emotions in ways that traditional talk therapy sometimes cannot reach. This episode explores somatic approaches to healing, including body-based therapies that help process trauma and emotional experiences. Learn about the science behind the mind-body connection and discover how somatic techniques can complement traditional therapeutic approaches. ### Why body-based therapy Matters body-based therapy is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like body-based therapy in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Communication and Connection." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on body-based therapy. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Mindfulness & Holistic Health: Communication and Connection - URL: https://healyourrootspodcast.com/blog/mindfulness-holistic-health-body-connection-communication-and-connection - Published: 2026-08-12 ### Summary Exploration of somatic healing approaches and the mind-body connection, covering body-based therapies for processing trauma and emotional experiences. ### Content In this episode, Joslyn Justi joins the Heal Your Roots Podcast to explore mind-body connection in depth. ### Episode Overview Our bodies hold memories and emotions in ways that traditional talk therapy sometimes cannot reach. This episode explores somatic approaches to healing, including body-based therapies that help process trauma and emotional experiences. Learn about the science behind the mind-body connection and discover how somatic techniques can complement traditional therapeutic approaches. ### Why mind-body connection Matters mind-body connection is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like mind-body connection in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Communication and Connection." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on mind-body connection. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Relationships & Communication: Pathways to Healing: Trauma, Addiction, and Recovery Strategies - URL: https://healyourrootspodcast.com/blog/relationships-communication-pathways-to-healing-trauma-addiction-recovery-strategies - Published: 2026-08-09 ### Summary Practical strategies for managing holiday stress, family dynamics, and maintaining mental health during the challenging and joyful holiday season. ### Content In this episode, Laura Schneider joins the Heal Your Roots Podcast to explore boundaries in depth. ### Episode Overview The holiday season can be both joyful and challenging for our mental health. In this episode, we explore practical strategies for managing holiday stress, navigating complex family dynamics, and maintaining emotional well-being during this busy time of year. Learn how to set healthy boundaries, manage expectations, and create meaningful holiday experiences that support your mental health. ### Why boundaries Matters boundaries is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like boundaries in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Pathways to Healing: Trauma, Addiction, and Recovery Strategies." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on boundaries. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Family & Parenting: Pathways to Healing: Trauma, Addiction, and Recovery Strategies - URL: https://healyourrootspodcast.com/blog/family-parenting-dynamics-pathways-to-healing-trauma-addiction-recovery-strategies - Published: 2026-08-06 ### Summary Practical strategies for managing holiday stress, family dynamics, and maintaining mental health during the challenging and joyful holiday season. ### Content In this episode, Laura Schneider joins the Heal Your Roots Podcast to explore family dynamics in depth. ### Episode Overview The holiday season can be both joyful and challenging for our mental health. In this episode, we explore practical strategies for managing holiday stress, navigating complex family dynamics, and maintaining emotional well-being during this busy time of year. Learn how to set healthy boundaries, manage expectations, and create meaningful holiday experiences that support your mental health. ### Why family dynamics Matters family dynamics is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like family dynamics in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Pathways to Healing: Trauma, Addiction, and Recovery Strategies." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on family dynamics. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Mental Health & Wellness: Beyond Anxiety: A Deeper Dive into OCD Diagnosis - URL: https://healyourrootspodcast.com/blog/mental-health-wellness-beyond-anxiety-deeper-dive-ocd-diagnosis - Published: 2026-08-03 ### Summary Year-end reflection episode focusing on processing personal growth, acknowledging progress, and preparing for upcoming transitions and changes. ### Content In this episode, Katie Manganello joins the Heal Your Roots Podcast to explore processing in depth. ### Episode Overview As we approach the end of another transformative year, this episode invites listeners to engage in meaningful reflection about their personal growth, challenges overcome, and lessons learned. Kira guides us through exercises for processing change, acknowledging progress, and preparing mentally for the transitions ahead. ### Why processing Matters processing is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like processing in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Beyond Anxiety: A Deeper Dive into OCD Diagnosis." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on processing. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Identity & Self-Discovery: Beyond Anxiety: A Deeper Dive into OCD Diagnosis - URL: https://healyourrootspodcast.com/blog/identity-self-discovery-beyond-anxiety-deeper-dive-ocd-diagnosis - Published: 2026-07-31 ### Summary Year-end reflection episode focusing on processing personal growth, acknowledging progress, and preparing for upcoming transitions and changes. ### Content In this episode, Katie Manganello joins the Heal Your Roots Podcast to explore reflection in depth. ### Episode Overview As we approach the end of another transformative year, this episode invites listeners to engage in meaningful reflection about their personal growth, challenges overcome, and lessons learned. Kira guides us through exercises for processing change, acknowledging progress, and preparing mentally for the transitions ahead. ### Why reflection Matters reflection is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like reflection in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Beyond Anxiety: A Deeper Dive into OCD Diagnosis." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on reflection. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Trauma & Healing: Unveiling Patterns: Understanding Family Dynamics - URL: https://healyourrootspodcast.com/blog/trauma-healing-trauma-unveiling-patterns-understanding-family-dynamics - Published: 2026-07-28 ### Summary Allen Michael Lewis explores family dynamics through genograms, examining intergenerational patterns and their impact on current relationships and mental health. ### Content In this episode, Allen-Michael Lewis joins the Heal Your Roots Podcast to explore intergenerational trauma in depth. ### Episode Overview In this episode we explore the fascinating world of family dynamics and therapy with the insightful Allen Michael Lewis, Licensed Marriage and Family Therapist. Navigate through the power of genograms to understand family patterns, intergenerational trauma, and how these dynamics impact our current relationships and mental health. ### Why intergenerational trauma Matters intergenerational trauma is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like intergenerational trauma in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Unveiling Patterns: Understanding Family Dynamics." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on intergenerational trauma. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Mindfulness & Holistic Health: Holistic Healing: Mind-Body Techniques in Therapy - URL: https://healyourrootspodcast.com/blog/mindfulness-holistic-health-healing-holistic-healing-mind-body-techniques-therapy - Published: 2026-07-25 ### Summary Exploration of mind-body approaches in therapy, focusing on meditation, mindfulness, and body awareness for healing and emotional management. ### Content In this episode, Lindsay Bauer joins the Heal Your Roots Podcast to explore holistic healing in depth. ### Episode Overview This episode delves into the transformative power of mind-body approaches in therapy, emphasizing the significant role of meditation, mindfulness, and body awareness in healing and emotional management. Starting with a focus on how couples can benefit from these techniques, we explore various therapeutic modalities that integrate physical and mental wellness. ### Why holistic healing Matters holistic healing is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like holistic healing in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Holistic Healing: Mind-Body Techniques in Therapy." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on holistic healing. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Identity & Self-Discovery: People Pleasing Origins: Unraveling Childhood and Cultural Influences - URL: https://healyourrootspodcast.com/blog/identity-self-discovery-influences-people-pleasing-origins-childhood-cultural-influences - Published: 2026-07-22 ### Summary Kira Yakubov Ploshansky and Gabrielle Larin explore the origins of people-pleasing behaviors, examining childhood and cultural influences on relationship patterns. ### Content In this episode, Gabrielle Larin joins the Heal Your Roots Podcast to explore cultural influences in depth. ### Episode Overview In this insightful episode of the Heal Your Roots Podcast, Kira Yakubov Ploshansky is joined by Gabrielle Larin, LMFT, to explore the deep roots of people-pleasing behaviors. Together, they unravel how childhood experiences and cultural influences shape our tendency to prioritize others' needs over our own, and discuss pathways to healthier relationship patterns. ### Why cultural influences Matters cultural influences is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like cultural influences in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "People Pleasing Origins: Unraveling Childhood and Cultural Influences." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on cultural influences. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Family & Parenting: People Pleasing Origins: Unraveling Childhood and Cultural Influences - URL: https://healyourrootspodcast.com/blog/family-parenting-people-pleasing-origins-childhood-cultural-influences - Published: 2026-07-19 ### Summary Kira Yakubov Ploshansky and Gabrielle Larin explore the origins of people-pleasing behaviors, examining childhood and cultural influences on relationship patterns. ### Content In this episode, Gabrielle Larin joins the Heal Your Roots Podcast to explore childhood in depth. ### Episode Overview In this insightful episode of the Heal Your Roots Podcast, Kira Yakubov Ploshansky is joined by Gabrielle Larin, LMFT, to explore the deep roots of people-pleasing behaviors. Together, they unravel how childhood experiences and cultural influences shape our tendency to prioritize others' needs over our own, and discuss pathways to healthier relationship patterns. ### Why childhood Matters childhood is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like childhood in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "People Pleasing Origins: Unraveling Childhood and Cultural Influences." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on childhood. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Anxiety & OCD: People Pleasing Origins: Unraveling Childhood and Cultural Influences - URL: https://healyourrootspodcast.com/blog/anxiety-ocd-pleasing-people-pleasing-origins-childhood-cultural-influences - Published: 2026-07-16 ### Summary Kira Yakubov Ploshansky and Gabrielle Larin explore the origins of people-pleasing behaviors, examining childhood and cultural influences on relationship patterns. ### Content In this episode, Gabrielle Larin joins the Heal Your Roots Podcast to explore people pleasing in depth. ### Episode Overview In this insightful episode of the Heal Your Roots Podcast, Kira Yakubov Ploshansky is joined by Gabrielle Larin, LMFT, to explore the deep roots of people-pleasing behaviors. Together, they unravel how childhood experiences and cultural influences shape our tendency to prioritize others' needs over our own, and discuss pathways to healthier relationship patterns. ### Why people pleasing Matters people pleasing is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like people pleasing in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "People Pleasing Origins: Unraveling Childhood and Cultural Influences." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on people pleasing. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Therapy & Treatment: Expert ADHD Strategies for Children and Families with Dr. Jessica Robb Mazzant - URL: https://healyourrootspodcast.com/blog/therapy-treatment-expert-adhd-strategies-children-families-dr-jessica-robb-mazzant - Published: 2026-07-13 ### Summary Dr. Jessica Robb Mazzant shares expert ADHD strategies for children and families, covering assessment, treatment approaches, and family dynamics. ### Content In this episode, Dr. Jessica Robb Mazzant joins the Heal Your Roots Podcast to explore assessment in depth. ### Episode Overview Tune into an enlightening conversation with Dr. Jessica Robb Mazzant about ADHD's nuances in assessment and treatment. With extensive experience and a passion ignited by her early career, Dr. Mazzant brings a wealth of knowledge to this episode. Discover expert strategies for supporting children and families affected by ADHD, including practical approaches to assessment, treatment, and family dynamics. ### Why assessment Matters assessment is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like assessment in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Expert ADHD Strategies for Children and Families with Dr. Jessica Robb Mazzant." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on assessment. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Identity & Self-Discovery: From Anxiety to Empowerment: A Deep Dive into Postpartum & Perinatal OCD - URL: https://healyourrootspodcast.com/blog/identity-self-discovery-anxiety-empowerment-postpartum-perinatal-ocd - Published: 2026-07-10 ### Summary Dr. Katie Manganello returns to explore postpartum and perinatal OCD, discussing anxiety, intrusive thoughts, and the journey towards empowerment for new parents. ### Content In this episode, Dr. Katie Manganello joins the Heal Your Roots Podcast to explore empowerment in depth. ### Episode Overview In this compelling episode of the Heal Your Roots Podcast, we warmly welcome back Dr. Katie Manganello as we delve into the intricate experiences of postpartum and perinatal OCD. With a compassionate approach, this discussion unfolds the layers of anxiety, intrusive thoughts, and the journey towards empowerment for new parents. ### Why empowerment Matters empowerment is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like empowerment in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "From Anxiety to Empowerment: A Deep Dive into Postpartum & Perinatal OCD." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on empowerment. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Identity & Self-Discovery: Cultural Double Standards: Food and Body Image with Allen-Michael Lewis, LMFT - URL: https://healyourrootspodcast.com/blog/identity-self-discovery-standards-cultural-double-standards-food-body-image-allen-michael-lewis - Published: 2024-06-19 ### Summary Join us for the season finale of Season 3 on Heal Your Roots Podcast, where Kira Yakubov Ploshansky, LMFT, and Dr. Katie Manganello, host Allen-Michael Lewis, LMFT – one of the newest team members at ### Content In this episode, Allen-Michael Lewis joins the Heal Your Roots Podcast to explore cultural standards in depth. ### Episode Overview Episode Highlights: - Cultural Perspectives on Food and Relationships (0:00): Allen-Michael explores cultural double standards in food and body image, sharing personal and professional insights into addressing these issues in therapy sessions. - OCD, Eating Disorders, and Cultural Differences (8:01): Dr. Katie Manganello discusses the manifestation of OCD in food habits and the pressures leading to eating disorders in children due to parental influence. - Societal Double Standards (13:24): Examination of how men and women are differently judged based on their eating habits and body image, with a focus on societal and familial expectations. - Body Positivity and Internalized Shame (19:48): Discussion on the importance of mindfulness and body acceptance, particularly among younger generations influenced by social media. - Impact of Family and Societal Comments on Body Image (25:41): Insights into how negative comments from family and society can shape one’s self-esteem and body image, with a discussion on the myths around body health and size. - Eating Disorders and Sensory Processing Conditions (33:19): Addressing disordered eating and sensory processing issues such as ARFID and pica, and the associated stigma and shame. - Psychedelics in Therapy (39:26): Exploring the potential of psychedelics in disrupting harmful mental narratives and creating pathways for healing, compared to traditional therapy methods. This episode is a thoughtful exploration of how cultural narratives and personal experiences shape our relationships with food, body image, and mental health. Don’t miss out on this engaging conversation! Tune in now and subscribe to Heal Your Roots Podcast for more insightful episodes on relationships, mental health, and personal growth. Episode Resources: - Follow Allen-Michael Lewis on Instagram @MFTFoodie - Learn more about Heal Your Roots Wellness at healyourrootswellness.com Disclaimer: The content is intended for informational and educational purposes only   Cultural Perspectives on Relationships and Food (0:00) - Allen-Michael Lewis discusses cultural double standards for food and body image in therapy sessions. - He shares personal anecdotes and insights on addressing these issues with clients. - Allen-Michael highlights the impact of food on mental health, often quoting jingles from diet culture. - Kira Yakubov Ploshansky recommends restaurants to Allen-Michael, sparking a discussion on potential affiliate marketing. - Together, they explore how food represents emotional experiences and cultural backgrounds in therapy. OCD, Eating Disorders, and Cultural Differences in Food Habits (8:01) - Dr. Katie Manganello explains how OCD can manifest in food and eating habits. - The discussion covers how parental dietary restrictions can lead to perfectionism and eating disorders in children and teenagers. - Allen-Michael and Dr. Manganello discuss the pressures on kids to have a “weird relationship with food” and the normalization of this behavior in men. - They highlight the double standard in praising male athletes for restrictive diets while criticizing female athletes for the same behavior. Societal Double Standards Around Food and Body Image (13:24) - Kira Yakubov Ploshansky discusses societal double standards in food and eating, noting how men are encouraged to eat more while women are judged for their weight. - Allen-Michael talks about cultural beliefs around food as love and appreciation, alongside the judgment and policing of women’s bodies. - They explore the stigma surrounding the word “fat” and its impact on society, including how children are taught to view and comment on people’s bodies. Body Positivity, Societal Beauty Standards, and Internalized Shame (19:48) - The conversation includes a discussion on mindfulness and body acceptance, encouraging Gen Z to break away from negative self-talk and comparison on social media. - Allen-Michael emphasizes the importance of intergenerational dialogue and support in promoting body positivity and self-acceptance. - They discuss societal pressure on body types in relationships and agree that negative comments based on internalized beauty standards are harmful. Body Image, Eating Disorders, and Food Sensitivities (25:41) - Kira Yakubov Ploshansky discusses the impact of negative comments from family members on body image and self-esteem. - The speakers address the double standard of society’s beauty standards for women versus men, focusing on Hollywood and media representation. - Allen-Michael and Dr. Manganello discuss the myth that bigger bodies are less healthy, citing examples from dance and gym workouts. - They touch on eating disorders, with Dr. Manganello sharing her experience with individuals in smaller bodies struggling with self-care and mental health. - Allen-Michael shares his struggles with eating certain foods due to sensory issues, and another speaker discusses experiences with autism spectrum disorder and food sensitivities. Eating Disorders and Sensory Processing Conditions (33:19) - Kira Yakubov Ploshansky and Allen-Michael discuss disordered eating and sensory processing, including avoidant restrictive food intake disorder (ARFID) and pica (eating non-food items). - They address the shame and stigma surrounding disordered eating and sensory processing, focusing on promoting acceptance and understanding. - The challenges of addressing mental health issues are discussed, emphasizing the need for empathy and understanding. - They stress the importance of recognizing that mental health struggles are ingrained habits and patterns that require support and therapy. Using Psychedelics to Treat Mental Health Issues (39:26) - Kira Yakubov Ploshansky discusses the difficulty of forming new habits and the role of default mode networks in shaping beliefs and narratives. - Psychedelics can disrupt these default modes, creating new pathways for self-perception and potentially leading to lasting change. - Allen-Michael compares narrative therapy to psychedelic-assisted therapy, noting similarities in reframing beliefs and deleting old narratives. - Kira highlights promising results from MDMA-assisted therapy for social anxiety and PTSD, with participants no longer qualifying for diagnosis after six months. - The importance of addressing food and eating habits in therapy is emphasized, urging clinicians to challenge internalized thoughts about food and support clients in developing a healthy relationship with food. This episode offers a comprehensive exploration of cultural narratives and personal experiences shaping relationships with food, body image, and mental health. Listen now for an insightful conversation with Allen-Michael Lewis, Kira Yakubov Ploshansky, and Dr. Katie Manganello. Keywords: cultural perspectives, food, body image, eating disorders, mental health, Allen-Michael Lewis, Heal Your Roots Wellness, mindfulness, body positivity, societal standards, therapy, relationships. ### Why cultural standards Matters cultural standards is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like cultural standards in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Cultural Double Standards: Food and Body Image with Allen-Michael Lewis, LMFT." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on cultural standards. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Mental Health & Wellness: Safe Exercise During Pregnancy: Myths and Facts - URL: https://healyourrootspodcast.com/blog/mental-health-wellness-safe-exercise-during-pregnancy-myths-facts - Published: 2024-06-05 ### Summary Dive deep into the world of prenatal fitness and nutrition with special guest Amanda Matrisciano, a certified personal trainer with expertise in pre and postnatal training. Timestamps: 0:00 – Introd ### Content In this episode, Amanda Matrisciano joins the Heal Your Roots Podcast to explore health in depth. ### Episode Overview Dive deep into the world of prenatal fitness and nutrition with special guest Amanda Matrisciano, a certified personal trainer with expertise in pre and postnatal training. Timestamps: 0:00 - Introduction to personal training, pregnancy, and nutrition with Amanda Matrisciano; 2:09 - Amanda's journey into personal training and certification in pre and postnatal fitness; 7:43 - Common myths about exercise during pregnancy. ### Why health Matters health is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like health in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Safe Exercise During Pregnancy: Myths and Facts." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on health. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Identity & Self-Discovery: Safe Exercise During Pregnancy: Myths and Facts - URL: https://healyourrootspodcast.com/blog/identity-self-discovery-safe-exercise-during-pregnancy-myths-facts - Published: 2024-06-05 ### Summary Dive deep into the world of prenatal fitness and nutrition with special guest Amanda Matrisciano, a certified personal trainer with expertise in pre and postnatal training. Timestamps: 0:00 – Introd ### Content In this episode, Amanda Matrisciano joins the Heal Your Roots Podcast to explore nutrition in depth. ### Episode Overview Dive deep into the world of prenatal fitness and nutrition with special guest Amanda Matrisciano, a certified personal trainer with expertise in pre and postnatal training. Timestamps: 0:00 - Introduction to personal training, pregnancy, and nutrition with Amanda Matrisciano; 2:09 - Amanda's journey into personal training and certification in pre and postnatal fitness; 7:43 - Common myths about exercise during pregnancy. ### Why nutrition Matters nutrition is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like nutrition in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Safe Exercise During Pregnancy: Myths and Facts." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on nutrition. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Family & Parenting: Safe Exercise During Pregnancy: Myths and Facts - URL: https://healyourrootspodcast.com/blog/family-parenting-safe-exercise-during-pregnancy-myths-facts - Published: 2024-06-05 ### Summary Dive deep into the world of prenatal fitness and nutrition with special guest Amanda Matrisciano, a certified personal trainer with expertise in pre and postnatal training. Timestamps: 0:00 – Introd ### Content In this episode, Amanda Matrisciano joins the Heal Your Roots Podcast to explore prenatal in depth. ### Episode Overview Dive deep into the world of prenatal fitness and nutrition with special guest Amanda Matrisciano, a certified personal trainer with expertise in pre and postnatal training. Timestamps: 0:00 - Introduction to personal training, pregnancy, and nutrition with Amanda Matrisciano; 2:09 - Amanda's journey into personal training and certification in pre and postnatal fitness; 7:43 - Common myths about exercise during pregnancy. ### Why prenatal Matters prenatal is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like prenatal in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Safe Exercise During Pregnancy: Myths and Facts." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on prenatal. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Mindfulness & Holistic Health: Safe Exercise During Pregnancy: Myths and Facts - URL: https://healyourrootspodcast.com/blog/mindfulness-holistic-health-safe-exercise-during-pregnancy-myths-facts - Published: 2024-06-05 ### Summary Dive deep into the world of prenatal fitness and nutrition with special guest Amanda Matrisciano, a certified personal trainer with expertise in pre and postnatal training. Timestamps: 0:00 – Introd ### Content In this episode, Amanda Matrisciano joins the Heal Your Roots Podcast to explore exercise in depth. ### Episode Overview Dive deep into the world of prenatal fitness and nutrition with special guest Amanda Matrisciano, a certified personal trainer with expertise in pre and postnatal training. Timestamps: 0:00 - Introduction to personal training, pregnancy, and nutrition with Amanda Matrisciano; 2:09 - Amanda's journey into personal training and certification in pre and postnatal fitness; 7:43 - Common myths about exercise during pregnancy. ### Why exercise Matters exercise is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like exercise in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Safe Exercise During Pregnancy: Myths and Facts." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on exercise. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Family & Parenting: Coping Strategies for New Mothers Facing Postpartum Challenges - URL: https://healyourrootspodcast.com/blog/family-parenting-health-coping-strategies-new-mothers-postpartum-challenges - Published: 2024-05-22 ### Summary Deep dive into maternal mental health covering postpartum anxiety, depression, and practical coping strategies for new mothers navigating postpartum challenges. ### Content In this episode, Dr Brianna Blis and Dr. Sepncer Brown join the Heal Your Roots Podcast to explore maternal health in depth. ### Episode Overview Navigating Maternal Mental Health: Insights on Postpartum Anxiety and Depression. Welcome to the latest episode of the Heal Your Roots Podcast! In this episode, we dive deep into the complex world of maternal mental health, exploring crucial topics like postpartum anxiety and depression. Our discussion covers a range of vital issues, from the impact of social media on new mothers to practical coping strategies for managing postpartum challenges. ### Why maternal health Matters maternal health is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like maternal health in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Coping Strategies for New Mothers Facing Postpartum Challenges." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on maternal health. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Identity & Self-Discovery: Nourishing the Mind and Body: Functional Medicine and Pregnancy Health - URL: https://healyourrootspodcast.com/blog/identity-self-discovery-nourishing-mind-body-functional-medicine-pregnancy - Published: 2024-05-08 ### Summary Mari Kharroubi shares her journey from overcoming learning disabilities to pioneering holistic approaches in maternal health through functional medicine. ### Content In this episode, Mari Kharroubi, Speech-Language Pathologist & Pregnancy Coach, joins the Heal Your Roots Podcast to explore nutrition in depth. ### Episode Overview In this enlightening episode, Mari Kharroubi, a bilingual pediatric speech-language pathologist and dedicated pregnancy coach, shares her deeply personal journey from overcoming learning disabilities to pioneering holistic approaches in maternal health. Listen as she explains the transformative impact of functional medicine on pregnancy, nutrition, and emotional well-being. ### Why nutrition Matters nutrition is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like nutrition in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Nourishing the Mind and Body: Functional Medicine and Pregnancy Health." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on nutrition. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Mindfulness & Holistic Health: Nourishing the Mind and Body: Functional Medicine and Pregnancy Health - URL: https://healyourrootspodcast.com/blog/mindfulness-holistic-health-medicine-nourishing-mind-body-functional-medicine-pregnancy - Published: 2024-05-08 ### Summary Mari Kharroubi shares her journey from overcoming learning disabilities to pioneering holistic approaches in maternal health through functional medicine. ### Content In this episode, Mari Kharroubi, Speech-Language Pathologist & Pregnancy Coach, joins the Heal Your Roots Podcast to explore functional medicine in depth. ### Episode Overview In this enlightening episode, Mari Kharroubi, a bilingual pediatric speech-language pathologist and dedicated pregnancy coach, shares her deeply personal journey from overcoming learning disabilities to pioneering holistic approaches in maternal health. Listen as she explains the transformative impact of functional medicine on pregnancy, nutrition, and emotional well-being. ### Why functional medicine Matters functional medicine is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like functional medicine in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "Nourishing the Mind and Body: Functional Medicine and Pregnancy Health." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on functional medicine. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Identity & Self-Discovery: OCD and Eating Disorders: Unveiling Treatment Synergies with Dr. Alyssa Hertz - URL: https://healyourrootspodcast.com/blog/identity-self-discovery-disorders-ocd-eating-disorders-treatment-synergies-dr-alyssa-hertz - Published: 2024-04-24 ### Summary Dr. Alyssa Hertz explores the complexities of treating individuals with both OCD and eating disorders, highlighting treatment synergies and therapeutic approaches. ### Content In this episode, Dr. Alyssa Hertz joins the Heal Your Roots Podcast to explore eating disorders in depth. ### Episode Overview Join us on this enlightening episode of our podcast as Dr. Alyssa Hertz dives into the complexities of treating individuals with both Obsessive-Compulsive Disorder (OCD) and eating disorders. With her dual expertise, Dr. Hertz highlights the synergies in treatment approaches and provides valuable insights for both professionals and individuals struggling with these conditions. ### Why eating disorders Matters eating disorders is an important aspect of mental health and personal growth. Understanding this topic helps us develop greater awareness, empathy, and practical skills for navigating life's challenges. At Heal Your Roots, we're committed to exploring topics like eating disorders in depth, providing our listeners with insights, strategies, and support for their personal journeys. ### Listen to the Full Episode This blog post is a companion to the full podcast episode "OCD and Eating Disorders: Unveiling Treatment Synergies with Dr. Alyssa Hertz." We encourage you to listen to the complete conversation for deeper insights, personal stories, and practical guidance on eating disorders. If this topic resonates with you, explore our other episodes on related subjects, and don't hesitate to reach out to a mental health professional if you need support. --- ## Mental Health & Wellness: Understanding Mental Health in Therapy - URL: https://healyourrootspodcast.com/blog/mental-health-wellness-mental-health-therapy - Published: ### Summary Explore the foundations of mental health awareness and how therapy can help individuals navigate their emotional well-being. ### Content This article explores the foundations of mental health awareness and how therapy can help individuals navigate their emotional well-being. ### Key Takeaways - Mental health is just as important as physical health - Seeking help is a sign of strength - Therapy provides tools for lasting change ---