Since You Put It That Way
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Since You Put It That Way
Therapy: What's Good, What's Bad, and How Can We Do Better?
Listen in as Dr. Mary Louder and Dr. Shyamaa Creaven discuss the importance of building resilience as an alternative to therapy, focusing in particular on the roles of community and spirituality in helping people face adversity. They discuss the overdiagnosis of trauma, caused in large part by a broadening definition of trauma, and the possibility of growth after trauma (which is actually more likely than having PTSD!) Get the details in the full episode, and learn all about the five pillars of resilience and how you can apply them to your own life. A great episode!
Intro for "Since you put it that way" podcast.
Outro for "Since you put it that way" podcast
Hi, Dr Mary Louder here, and welcome to another episode of Since You Put It That Way. It's our podcast where we talk about things in the medical and clinical world, and we look at topics from a different perspective that might cause you to say, "Hmm, since you put it that way." Our guest today is Dr Shyamaa Creaven, and she is a psychotherapist in Colorado, and she brings a very unique perspective to trauma, to understanding, you know, the strengths of therapy, understanding how therapy can be a helpful tool--and maybe sometimes it's not so helpful. So this is going to be an interesting conversation that we have together. And I'm so glad that you joined in, and as always, please rate and review and give us feedback on the podcast so we can hear from you and engage in that conversation as well. So thank you for joining us, and without any further ado, here's the conversation that I had with Dr Shyamaa Creaven on Since You Put It That Way.
Mary Louder:Welcome, Shyamaa, welcome to our conversation in the podcast, Since You Put It That Way, so I'm glad that you're our guest today, and I think our conversation is going to be wildly exciting, enlightening and captivating. How's that?
Dr Shyamaa Creaven:Thanks for having me, Mary. Sounds like a setup for disappointment. I hope I can deliver, or that we will deliver.
Mary Louder:I'm sure, I'm sure that we will. So getting into talking about the importance of mental health, the importance of really understanding good quality psychotherapy, therapy, how it works, not just in a primary care in a traditional setting, but really bringing healing to an individual, and really, a person really getting well. I think of the statistics of two things, about 30% recovery rate when we treat folks with depression and anxiety, and that's not a high rate when I look at that. And I also think of the statistic that I've heard that of 100 individuals, one person needs a psychiatrist, 24 people need a therapist, and 75 people need a coach. And so that's kind of something that is used and has piqued my curiosity as I've shaped my practice, my communication, my understanding around this very important topic, because I treat emotions in my practice as you well know, and actually, you know, share our work together as colleagues, and which I'm deeply grateful for. And one of the reasons that I wanted to be able to have a conversation with you and have you on our podcast to interview is because your perspective is just very important, and I think what you have to say is very important, and so, I just want to have that opportunity to have that conversation more in the open and maybe even The Wild West. Who knows. So, share a little bit about your background. How did you get to be the type of therapist that you are? Where did it come from? Etc. Where did you come from?
Dr Shyamaa Creaven:Sure, great. I'd be happy to. Hmm, there's lots of places to start that story. I think I will start it with high school and three authors that stayed with me. One was Viktor Frankl and his book, A Man's Search for Meaning. One was Carl Jung, Memories, Dreams, Reflections, so his autobiography, rather than any of his theory, although his theory was woven in. And then the third book was a book called spiritual emergency, which was looking at psychiatric and clinical data and mapping it on to other traditions, spiritual states or, or shamanic, tantric spiritual states. So those three books in my late teen years were really influential in sparking curiosity and mapped onto things that I was already very interested in. On top of that, I started meditating at that same time at a place called the Vedanta society, which is a Hindu non dual meditation community, a Hindu non dual spiritual community, let's say. So all of those coming together. Pretty agnostic, Southern California upbringing, otherwise, pretty introverted, shy, going my own way, kid, and just started rumbling in me, I would say, and studying psychology, I started by studying anthropology, but studying psychology just seemed much more natural to me given that I was already looking through a particular I would say--for lack of a better word, I don't like using words that tend to be under defined and overused, but already, I would say on some kind of self-formed spiritual path. So psychology just fit as a nice complimentary vehicle in there. I ended up studying abroad. I studied in the University of Brussels, the(??) college, I studied in India, and then finished my degree in the US. I became a psychotherapist, and I became a gestalt therapist, because, again, that seemed like the broadest vehicle for integrating both mindfulness tools, which was a burgeoning field of research, and mindfulness-based approaches. And I'll say my, my particular understanding of how I can be most helpful, I went on to get a PhD in theology, oddly enough, because I started to feel the narrowing, almost the suffocation of the field of psychology, and I'll talk a little more about that, where it's relevant to wherever we go today. And I instead, because I'd been working in the area of trauma--again, another word that's over utilized and under defined or defined in so many different ways that it risks losing its central meaning. You'll find I'm very opinionated on some of these things, by the way--
Mary Louder:That's good! I get paid for my opinion, so I'm, I'm--you're in a good crowd for that.
Dr Shyamaa Creaven:I really wanted to go instead and look at theodicies, so ways that suffering is held or understood in a larger frame, in traditions that have at least for thousands of years, some for hundreds, but often for thousands of years, grappled with what suffering is here in this world. So I wanted to study theodicies, and I wanted to study inter-religious dialogue. Inter-religious dialogue, because I started to feel that even the maps that we were crafting in the field of psychology were, in a way, simply a--a belief system that may or may not map on to the worldview of the person that I'm sitting with and aim to help. So I wanted to understand inter-religious dialogue, to be able to work with within a person's religious or spiritual world, but also to hold more loosely these psychological maps that I had been invested in. So it was a personal challenge, as well as a challenge to myself professionally. And I love that I got a, an interdisciplinary degree in theology. It's served me very well in my practice.
Mary Louder:Well, it's interesting you talk about the mapping of psychology, because, you know, when I, as a physician, would send someone to therapy, I'm always thinking of kind of like cognitive behavioral therapy, because that's what we're trained in. And then, you know, finding when I would say, Well, what kind of therapy does a person do? And so there's as--almost like many, maybe veins or flavors, as there are therapists, perhaps, and even the interpretation of that. And I find that kind of fascinating, and I find sometimes too, and this probably would be a concern or even a criticism, a patient would go out to therapy and come back and like they would say, it doesn't work for them. It doesn't it's not happening. They aren't getting anywhere. And that is, I think, one of the first things that I have a question about, why or have you seen that? In my practice, I rarely see people not get any difference or improvement, but that is how I engage the patient, and also my belief about healing and, and how a person can get well. And so I don't know what your thoughts are on that side.
Dr Shyamaa Creaven:I have a number of thoughts, and I'm going to capture three of them. One is hearkening back to one of my mentors in the Gestalt field. Her name was Laura Perls. She's one of the founders of Gestalt therapy theory. And Laura Perls had this notion, and I think many therapists fit this notion--let's say it--around the genesis of Western psychology and Western psychotherapy, let's put it that way, which is the a therapist should be an incredibly well rounded person. So Laura Perls herself was a classical dancer, had studied philosophy, was deeply involved in cultural movements, and was steeped in the literature of her time, was well read. So she was a very broad person, and she felt that we were to be refining ourselves in quite a large scope to be able to then meet the different, different worlds we're going to encounter that are in our clients as well. And I see that less and less, and I don't mean to denigrate my lovely colleagues or my lovely students today, because they are truly, their heart is in the right place, but I actually feel that we have siloed so much. Right? We've lacked in interdisciplinarity for quite a while now that it's almost--without their knowing it, without us knowing it, in the fields that we're studying and to become good counselors and psychotherapists, we're potentially becoming less and less well rounded. So there's that which I believe in the work that you do, which is holistic and integrative, and in the work that I attempt to do, there's a sense of wanting to think broadly and interact across lines of not just discipline difference, but lines of ideological difference. I want to talk to people who oppose what I'm saying. I want to understand a different point of view, and I see less and less skill in doing that. So that's my second point, which is maybe less and less skill in speaking a lot across lines of difference and differing understanding of what's going on. We even have data that indicates, for instance, and I don't mean to take this politically at all, but that, for instance, at higher and higher levels of education, there's less and less political variant. So we don't even have, let's say, conservatives and liberals speaking to each other at the PhD psychology level. We have a bunch of liberal people all talking about progress. Groovy. I bought them, dug that, but I actually think there's a significant loss and not rubbing up against each other. So that would be number two, and then number three is probably along the lines that you encounter in, in your practice when you refer out to people like me, psychotherapists, which is that there are a lot of different approaches, and what's going to fit what you're noticing in your client and what your client needs the most. You know, is it going to be some cognitive tools? Is it going to be some somatically based, let's say, physiologically bottom up, we can talk a little more about what I mean by that later, type of approach. Is it going to be, you know, something along the lines of a more depth psychoanalytic type approach? And these are all really, really distinct, lovely forms of therapy that fit different needs, goals and clients.
Mary Louder:Okay, so the three things, so thinking about being well rounded, I would agree with that wholeheartedly. And I would say we see that mirrored in medicine, where, you know, I came in, I was considered a non traditional medical student because I had a degree in sports medicine and spinal bio--spinal biomechanics, and I entered during graduate school, I was considered non traditional.
Dr Shyamaa Creaven:And I love what you do, so I'm gonna remember that. Go for the non traditional.
Mary Louder:Yeah, and so, fair to say, I'm probably non traditional from other reasons, but that just happened, they just happened to tag it to my degrees. And so I would agree with that, well rounded. I think that's really important. And then speaking across the lines, you know, I also think that that's super important, because in medicine, what we see is now everybody walks and talks the same way, and that's driven in our world by the insurances, which then has its roots in other, you know, other levels of business and care, and driven by lobbyists and different things, you know, that way. And so that brings it all kind of really narrows and silos things there. And I think the other thing that disrupted our world is the electronic health record. Whoa. Or how fun was the day when you could just walk into the physician's lounge and chat, talk with the internist, talk with the pulmonologist. Hey, there's your favorite cardiologist. You know, there's your cardiothoracic surgeon, there's your orthopedist, and we're all in there getting coffee off to go do rounds, and we touch base on 4, 5, 6, different patients, yeah? And so you've got, you had that communication, you had that well roundedness, and now you just, you pass your patients off to a hospitalist who then has a specialist and sub specialists, and they--then all the communication is electronically, and there's literally no conversation. And so, you know, we so across those lines too, not just politically, but with psychotherapy now there's like layer upon layer of informed consent to even get to communicate. AndI don't know, I'm not able to treat the patient without addressing their emotions. I have come to that conclusion 125%.
Dr Shyamaa Creaven:Yeah, yeah. You know, along the line of what you're naming, and you probably see this in medicine as well. And our fields, of course, overlap in various ways, and our work has been overlapping, which is wonderful and rich--isthat I really enjoy working collaboratively, and I am happy to yield to a different way of understanding or acknowledging something that's going on, and if it didn't get a person fa--more quickly to their goals or to the way that they want to live, I don't need to hold on to my particular map or perspective for a second longer. And so, I will reach out to therapists that are maybe treating someone in a particular way. They're a family therapist or they're a cognitive behavioral therapist, and map in my work to their work. And I find resistance to people doing that. They're just, no, I have this understanding this is what we're working on. Don't sort of contaminate the container. And I'm really excited when I can say, hey, I'll do this little piece, and I'll plug in some EMDR to this pernicious somatic piece that isn't relenting, because I really dig this cognitive piece that you all are working on, and I feel like we could fit together here. And I'm not saying people should have a million kinds of therapists. I just need that sense of collaboratively identifying strengths in each other and being able to yield to whatever's going to work the best, even if it's not my way of understanding the problem.
Mary Louder:Right. Yeah, I think that's--I agree with you fully. And the breakthroughs that can occur often come, I think, from a good team of people working together, but then having that communication amongst one another, and, you know, we started--
Dr Shyamaa Creaven:Humble is right, like the humble communicate--or the maybe, just even the curious, the curious communication.
Mary Louder:Yep, exactly. And then the last thing was, you know, the different approaches to therapy. Well, and you brought up the word Gestalt. In my world, Gestalt goes to after I get all the information, I come up with the direction I think I need to go. What's your Gestalt on this? And I would get asked that all the time in residency, and it's not something our medical school taught because I was an osteopath. So I thought, taught--I thought holistically. I was taught to do that. And I was taught because A.T. Still, the founder of osteopathy, was also a mystic. I kind of ventured into the spirituality at that point, which was fun. But not everybody did, butut then when I get to residency, that was allopathic, and they go, what's your Gestalt? And I go, mmm.. Oh no! I didn't know what to think of that word. So what then is Gestalt therapy from a psychotherapy standpoint?
Dr Shyamaa Creaven:Yeah, sure. Well, Gestalt therapy has a couple roots, and one of them is out of the Gestalt School of Perception, which was in the 19--I want to say, I'm going to get the dates wrong--20s, 30s in Germany, out of what was called the Frankfurt School. So there was this school of perception that was looking at the ways that we perceive and think and relate with the world around us. Wonderful stuff. Still utilized in perception research today, some of their original concepts and methods. One method that they brought in, for instance, was phenomenology and just the ways of tracking experience when we remove or bracket different meaning valiances, different preferences we place on what we're experiencing. So, so Gestalt therapy theory is the practice of Gestalt psychotherapy, and they had to do that because Gestalt psychology was a school of perception, and Gestalt psychologists didn't necessarily want to be associated with therapists, per se, Fritz and Laura Perls were psychoanalysts who were thrown out of analytic society by by Sigmund Freud because of a differing under a Gestalt understanding of the And so, Gestalt is a German word. It means whole, and it's, person. it's an experiential existential psychotherapy, and I find it very effective for working with the here and now in ways that enliven what remains to be acknowledged or worked with from the past, without needing to dig around or bang around in the past. Really what's relevant right now that remains with us that wants a kind of completion. So whole--gestalt also means completion, the ways that we complete experiences. And it came out of research from the Gestalt psychology perception school, where they were looking for something and they found something else, which I always love it when we do that, I'm always very interested when you're looking for this and you find this, because it feels more trustworthy than I'm looking for this, and I find this, right?
Mary Louder:Right. Yes.
Dr Shyamaa Creaven:And they found this so they they were flashing a bunch of images in front of participants, and they found that people remembered the images the longest, not that were the most complete, like house, dog, but the images that were the least complete. There, they worked much longer on things that they couldn't figure out. They remembered much longer. And then as soon as they could figure it out, they could store it. They could set it aside. And early Gestalt therapy theorists extrapolated that to the ways that we linger on things that are incomplete for us. And we can talk about that even in relation to trauma, where it's incomplete until we have a sense that we have survived or that we are victorious, or that we have completed whatever response didn't get to be fully engaged at the moment that we were overwhelmed.
Mary Louder:That's beautiful. I love that, that that's how Gestalt works.
Dr Shyamaa Creaven:Yeah.
Mary Louder:Because you've just defined a treatment, I would use it the word cure. And you know, an approach to anxiety, which is a call for more information. Because you're not feeling safe. You know? And then, so let's go, let's, let's go right to trauma, because that's a big thing right now. You know, pandemic, wars, you know, rumors of wars, hurricanes, you know, finances, people are traumatized. And it also is a, I use the word flashpoint. It's a point where influencers can come in, and they've got, you know, five cures, for the top three traumas. And you know, if you Google trauma care or Google how to treat your vagus nerve, there's all these quick fixes. And this is concerning to me as a physician, because I've never seen a quick fix in that. I've seen a complete fix, but it wasn't quick. Because even if there was a technique that was used that say maybe was in the energetic psychology world, what has been simplified has been completely understood at multiple levels to be able to apply that. So that wasn't quick ever, right? So let's go to trauma in our world together, where we treat our trauma patients together, and where we work in such a way, where you've got complex physical conditions and illnesses, not just--or not only, not, not, not just is not right, but not only depression and anxiety, but you've got that tagged together with the complex medical condition, chronic illness, fibromyalgia, things that we don't have answers for, but we do, because the body does. So walk me through, you know, the flashpoints of trauma. What comes up for you when we think of trauma care currently, your experience where we're going, what's happening?
Dr Shyamaa Creaven:Well, this is going to be one of those places where you and I may diverge and then come back together, because I feel that, in essence, we are, we are similarly orient toward--oriented towards the robustness of the human organism and the human person in in their fullness. And I, I am more and more wary of the use of the word trauma in our society. I'm more and more concerned about, not only semantic contagion and iatrogenic harm, the ways that we can over diagnose trauma and create problems that then, yeah, maybe we can invent a quick fix for the problem that we just created. Because I worry that we're going to start to tell the wrong story about human nature and human capacity. I actually feel that we are well equipped, or have been in the past, and if we're not now, we need to look culturally at why we're not--we're well equipped to handle pretty, pretty challenging situations, pretty extreme situations.
Mary Louder:You mean as humans, right? As humans.
Dr Shyamaa Creaven:Yeah, as humans. And so when we're not meeting that, and we're seeing trauma left, right and center, there are a couple big questions: are we over diagnosing trauma? I'm going to say yes. You can fight me on that if you want, no problem. We can have a fuller conversation. Yes, because we've expanded and dilated what gets caught under the word trauma at this point, it's called concept creep. We've just really stretched the margins significantly. Second is how we lost something in our technological time, a kind of robustness that we would house under the category of resilience, that we want to reinvest in. Rather than then putting our emphasis on trauma, we put our emphasis on the skills, capacities that are getting lost, that we want to reengage or reestablish. People are are getting less and less well the more mental health services we employ in every single environment. And there's a problem there. There's data that shows that as well. Now people could say, oh, well, it's because more and more people feel comfortable to share their mental health distress. I think that the leap is a bit large to be captured by that. So I think that there's, there is some interesting room for the quick fixes, if they're quick fixes that are rooted in, like interpersonal neurobiology data that indicates certain things, like, for instance, for instance, the simple application of interoceptive awareness to a state that we're having changes the state we're having. Right? There's wonderful tools in mindfulness, in interpersonal neurobiology, certainly in your field, and in the methods you've developed, to directly engage distress and watch distress change.
Mary Louder:Right.
Dr Shyamaa Creaven:Right? So I I'm very cautious. I'm likely going to even scrub the word trauma from my website and from my literature, because it's, it's fast going to lose the meaning that I had applied to it and that in my dissertation I applied to it. And because I'm very wary of the story we're telling about who we are and what we're capable of.
Mary Louder:I wish I could fight you on that, because it would be fun, because I love going toe to toe with you in a good way. I can't, because I agree with you. You know, and I thought about the scope creep, and what that means is, basically the diagnosis widens.
Dr Shyamaa Creaven:Widens.
Mary Louder:For our listeners, you know, where trauma was very specifically defined, or PTSD. We now have complex PTSD. We now have mixed PTSD. We now have PTSD with anxiety, with depression. We have all these different nuances. And so we arrive at that by saying there's, I agree, there's more people reporting it, there's more people having it. And I agree that we have resources, and people still aren't well. And--
Dr Shyamaa Creaven:And I think that there's, there's good reason to have a term like trauma. There's good reason for a term like Complex PTSD, but when we're not agreeing on the meaning, and we're pushing all kinds of stuff underneath that--which we are now, you can pick up some of my favorite trauma authors, and they talk about simply jarring experiences as being potentially traumatic. They name things in their list of what is traumatic that are like--people would have coped with half of that and in just an average day and got on with life at another time. So there's, there's some real concern in my, in my view, with my field of psychotherapy, trauma informed psychotherapy and the ways that we might be creating or putting the emphasis in the wrong places in the name of wanting to do a service to people that have suffered grievously and have real physiological remnants of that suffering.
Mary Louder:Right. So actually, I wonder, instead of trauma, is a the word distress more accurate? Because you, we have the stress response, which is supposed to escalate up, take care of what's going on, and then go back down, yeah? And then what happens when a person's autonomic nervous system, their sympathetic nervous system gets switched on, and it's not balanced by the parasympathetic, because they're always stressed, that stays up and kind of goes up and down, up and down, up and down. They're up here. So it's a new homeostasis or a new balance point, let's say even, and they don't get back down to ground zero, ground zero in the relaxation phase of the body is where healing occurs, where you have that deep rest, that deep sleep, where--
Dr Shyamaa Creaven:Physically and psychologically, spiritually, emotionally, right? This integrative healing.
Mary Louder:Exactly. And, and the cortisol is not being pumped out. Stomach juices are not being dried up. Colon is not seizing. You're digesting. All those things that are supposed to happen are happening, because the threat has gone away, because you feel safe. And so what we're being told, though, is that there isn't safety. And what people are experiencing is also not being safe. For example, they go, they don't feel well, and they go to the doctor, and it's, you know, eventually told them it's in their head. Now I literally have this challenge where, and maybe you can really help me understand this, where folks that get, you know, marginalized by the healthcare system. They have a diagnosis that could elude a team of specialists. And in, in my experience, when you look at the complexity, there's always underlying relational issues, emotion, unresolved emotions, perceptions, things where, you know, a complex approach to mental health would be of care for them and a service, and certainly using some energetic psychology treatments, EMDR, TFT, which is tapping, our Self Compassion and Connection, and other things where we can help re-regulate the autonomics to bring them out of that high into more the relaxation, and then you begin to present it to them, and then they don't trust you as the provider of that, because everything around them tells them not to trust and they're not safe. And I think that is part of what you're defining. Maybe that's one end of the extreme of it, but I see that a lot with patients, they go, how do I know to trust you? I don't know that I have an answer for that. But they're also still in front of me, wanting care and services. So I, so I, you know, would ask, Well, why are you here? I don't know what else to ask. I really don't know what else to ask. You know? So I don't know if you've encountered that as a, as a therapist, when people come to you, it's like, I don't know why I'm here. I don't know what you can do. I don't know what I--
Dr Shyamaa Creaven:my first line of--it's not really a line of defense, my first strategy. It's not a strategy either. It's something that grows out of, I would say, a spiritual perspective of mine, which is that they don't need to trust me. If they're willing to engage some of my knowledge and expertise and some of the things I'm going to show them, at the same time that I'm asking them to just try it on or play with it, I'm investing in their trust in themselves. I'm really interested in them trusting themselves. I actually like it when people come back in and say they had some epiphany that I had told them, because it's like, I don't care if they don't ascribe it to me, because they went out and had this experience of themselves based on some of the tools or things that maybe we did or that they encountered in life, and that's--so I think that that, that approach, that it used to be embedded within what we'd call a relational, more of a Rogerian approach to therapy, or a collaborative or co-creative approach to therapy, which is part of the existential therapy that I, is one of the pillars of my work, is to is to really see the fundamental trustworthiness, the fundamental health, the fundamental wisdom of the person in front of me, including what is sometimes called their defensive strategies. And then to point out that the ways that they are going about things are, are not taking them where they want to go. They don't have to actually trust me. They can just try on the things that I offer, and if the things that I offer get them any closer, they can still not trust me. They can still ascribe it to their own great effort or something. It doesn't matter that much to me. It's nice if somebody trusts me or likes that we're doing something together. It certainly makes things go a little faster when we have a trustworthy, collaborative relationship. But them trusting themselves and learning that they are trustworthy to themselves is sort of the heart of my work anyways, when you think about trauma, for instance, and the ways that it can disrupt a person's trust in life, trust in others, and trust in themselves, because they get wary of the signals their body is sending up to them, signals that from a gestalt lens, seek completion, seek a resolution. They are wise signals for the moment they started firing. They are somewhat misplaced in the environments the person is now in. When a person can find those to be trustworthy. You know, that their body is sending them signals that want some resolution, that want some acknowledgement, that needs something. Sometimes, then they're curious about, if I have any ideas about what that could be and how we could get there. And as soon as people see and feel that they're getting somewhere, it's, it's really enough. And I would imagine in your work as well, Mary, because you are, you are exceptional at helping people arrive at results for themselves.
Mary Louder:Yes, and--but I think you described it very well, because I, I teach the patient that their body has the inherent capacity to heal, and you can trust that. And our goal is to align with that.
Dr Shyamaa Creaven:And they can trust you saying that, or they can check it out. They're willing to just entertain it, and watch their body give them that information.
Mary Louder:Yes, and, and then on the, I don't know even if it's the other side of the same coin, it's just on the other side. It's the other side of the fence. We're taught that the doctor-patient relationship is based upon trust, mutual respect and communication, and at the heart of it is trust. And I--huh?
Dr Shyamaa Creaven:I mean, that's an ideal. But then there's, there, there's only a few of, a certain faction of people that we're helping.
Mary Louder:I think that's what I run into. I think that's the very thing that I run into. And honestly, if I can be really transparent, I'm shocked when people don't trust me. I'm like, what else would I be doing but helping you? I mean, it's just, it's like, I mean, that's, you know, that was the oath I took. And that was a sacred oath, you know? And I almost get a little ferclempt about that, because it's, I mean, that's something I take extremely seriously. Now, I don't want them to trust me to the extent that they don't trust themselves.
Dr Shyamaa Creaven:Right. Or sort of the, or sort of the white coat thing where they're supposed to trust you, just because.
Mary Louder:That's right, because they can trust me, that I'm going to walk alongside them and reveal to them, with them, seeing themselves, what their body's saying, what their heart is saying, what their soul is saying, for their journey, what's right for them. Not what's right for me. Someone said recently, well, this is you want to do it this way, because it's your way. And I'm like, no, no, this is what your your tests show, with where your body's requesting. This isn't my way. This is your way forward. And I think that gets, that's totally lost in the western world of medicine, totally lost in the paternalistic approach that still exists in the insurance world that drives the decision-making.
Dr Shyamaa Creaven:It's certainly true that people are more and more suspicious.
Mary Louder:Yeah.
Dr Shyamaa Creaven:Your field, and more recently, my field. And I, I was at a conference a few weeks ago where there's a presentation on a book that just came out called Bad Therapy by an author named Abigail Schreier. And you know, there's pros and cons to that book, from my point of view, although I like--I like that she dared it. I really do. And a number people in the crowd, many of us clinicians, wonderful clinicians, being highly critical of a journalist daring to critique, and somewhat limitedly critique, what we do as therapists. There's a lot of things we do as therapists that she missed, and certain things that she stereotyped that we do as therapists that are just a very small portion of therapy and therapists. Nonetheless, my my biggest statement to the group of people that I was with is that we deserve critique. Everybody has the right to critique us, because everybody is involved in this churning psychological culture and this churning medical culture that we live in. I believe we deserve critique right now from, from every corner. When that can become a robust dialogue, we, we change, we change hearts and minds because we're open and available. And we change. We, we actually have to implement changes as well.
Mary Louder:Yes, yes. I think that's a really good point. So getting, going a little bit deeper, but sideways, a little bit about trauma.
Dr Shyamaa Creaven:Sideways, yeah.
Mary Louder:Yeah. What doesn't to kill you makes you, Kelly Clarkson would say, stronger. That was a hit song that she had, that I love that song.
Dr Shyamaa Creaven:So would Nietzsche. That's how that, spoke by Nietzsche, yeah.
Mary Louder:Yeah. But the, the way the culture right now seems to be what doesn't kill you makes you weaker. I'm going to leave it there for you to step right into that.
Dr Shyamaa Creaven:Yeah, I'd be happy to. That's absolutely the downside of the over, overuse of trauma-informed care and the ways that a good intention may be yielding a bad result, because there is a fragility, then, that we're painting on everything by virtue of considering anything that's somewhat challenging to be potentially causing irreparable harm that then needs experts to come in and solve or needs solutions. Two things come up for me that I, that I want to share with you. One is a stat that I really like, which is that one in four people that go through a discrete traumatic event, and with discrete traumatic event, I'm talking
tight definition of:threat to life, distinct threat to psychological integrity. So those tight definitions, one in four may develop PTSD symptoms--and a little less than one in four, about 20%. And not even necessarily long term PTSD type symptoms, but they will pass the threshold of the, the ordinary stress reaction and they'll linger into a three-prong symptom set. So let's say 20%. My students, when I throw that out in my clinical skills class, when I say when you go through a trauma, how many people get traumatized? I mean, they think it's upwards of like 50% that trauma equals traumatized. A traumatic event equals traumatized. And they're surprised when it's around 18 to 20%. The other piece that I really, really like is that two out of three people that go through a distinct traumatic event, or a series of traumatic events, come out with what, what research is calling post-traumatic growth, and those have five markers to them that are, that are life transforming. Post Traumatic Growth is like life transforming markers. Now it's not to say that us humans have to go through trauma to grow. It's simply to say that we can grow by going through trauma, and we're more likely to than to, than to contract PTSD. Why do we not show that side of the coin? Because it is the other side of coin of the inevitable distressestresses,--high distresses, terrible, egregious, if I could wipe them out, I would, distresses of living a human life is that we are, we are able to grow. And that's where there's a work by a man named, what is his name? Yeah, Khalib. His work is around, the term is called antifragility,fragility, and it's those aspects of life, of organismic life, that not just get--are resilient, not just, don't just weather challenges, but actually grow through challenges. Get stronger through challenges. Our immune system gets stronger through a certain amount of challenge, right? I'm asking you, as the physician, that's--
Mary Louder:Yes.
Dr Shyamaa Creaven:And I noticed that my kids, where they were constantly docs before covid, were constantly telling me that they were getting sick because they were building an immune system. So I'm like, Alright, if they're building an immune system, I'll just give them the herbs and medications that are going to help them get through the symptoms. So, so we used to also look at character as something that grew through challenge. Didn't grow through just like, oh, express your authentic self and let me, let me just give you everything you need. It grew through challenge.
Mary Louder:Yeah.
Dr Shyamaa Creaven:So the human heart muscle gets stronger to a certain extent. And so then there's this other map that I like to use, which is a classic developmental map, which is the level of distress needs to meet the level of support. So high distress, low support, we could have overwhelm. And when we tip into overwhelm is when we tip into traumatic stress type symptoms right? Beyond our capacity to integrate, and we're not finding the supports to do that, and that's internal supports and external supports. Relational supports. High support to low challenge yields low growth. It just, it takes longer, they don't learn it as well. I can see that in my kids. Because I'm still on the tail end of the sort of helicopter parenting, where you just make sure that nothing ever disturbs or harms your kids. So if we put those together, this notion of antifragility and this piece around we need a certain amount of challenge ratioed with a good amount of support, I feel that we have a really nice pro-capacity map for helping people weather difficulty. So what I do with people is, I just, when they've gone through something traumatic in their mind or in--or in mine, like they map on to the symptoms of PTSD. Many people coming in fact, 90% of people coming in nowadays that say they have trauma don't, don't map onto what we would have considered like a diagnostic category, per se, they just feel distressed by their experiences. Which is valid. Which I respect. But it's, it's that softer understanding of trauma--still, increasing support for integrating or digesting or relating with that experience is like the main thing that I want to do, and that's relational, spiritual, integrative. You know, a physician like you that could actually help them understand the innate health in their system, and how even things that seemingly are going awry are actually some part of their body's wanting to correct itself. I might be saying wrong, and I would be--
Mary Louder:No, I think you're saying that right, because the body always seeks a homeostasis.
Dr Shyamaa Creaven:Right. So, same emotionally and and psychically, you know, psyche-wise.
Mary Louder:One of the things in trauma, I'm going to insert here, is they say, well, in trauma, cells are either turned on or turned off. I can't find that in the literature. That's really old thinking, because the--if that's true, we'd've been dead. Soon as we're traumatized, we're dead. So, pardon me being so frank on that one, it's just
Dr Shyamaa Creaven:Yeah. not true. It's, it's homeostasis. The body has this amazing capacity to adapt, and we--this adaptation keeps us alive, and then we're always seeking that safety, and when we find that safety, we relax again. So what you're teaching, and what we would teach would be resiliency. You're correct, finding that safety, finding resources. What are your resources for resiliency. Right. And the thing that we often miss is that many of the resources that were once present, even in much harder times people lived hard ass lives.
Mary Louder:Yeah, they did. Yeah, they did.
Dr Shyamaa Creaven:Right? And is social nets, right? Relational support, so the co-regulatory things that happen in community that are just natural and you almost miss it, until you're missing it. You almost don't know that it's regulating and supporting you until you're isolated in struggle. So increasing social supports, increasing spiritual or religious supports, increasing, of course, capacity to trust your own physiology, your own nervous system, etc.
Mary Louder:Yeah. Now,ow, you mentioned five things in the Yeah. areas of, I think it was in resiliency or the post-traumatic markers or both.
Dr Shyamaa Creaven:Yeah, you want me to talk about those?
Mary Louder:Yeah, yeah, that would be great.
Dr Shyamaa Creaven:I thought you might. And I have a memory wane right now at turning 50, so I wrote them right here.
Mary Louder:Yeah.
Dr Shyamaa Creaven:And this is out of really solid research. This author, Stephen Joseph, is one of them, but we've got Tedisky and Calhoun. We've got research all the way up to date, and the five markers at least are: increased sense of personal strength. Person realizes what they're capable of weathering and living through. Strength and value of relationships, people become deeply aware of the importance of relationships. Greater life appreciation, people can come out of traumatic situations and in awe of life and in awe of the wonders of life and that they get to live on into it. A new sense of purpose or possibility. You look at this with people that overcome trauma, that want to become a therapist, want to become an addictions counselor, there's something--they're rearranging what they think is important in life, not by virtue of grabbing onto that per se, but they're, they're looking for the thing that's going to be more meaningful to do with their lives. And then a discovered or deepened sense of religious or spiritual faith. And there's a quote that I that I really like actually. Let me read it. Let me read it to you. Spiritual and religious struggles are highly correlated with psychological decline or growth, including and especially post-traumatic growth. That's why I would say, at the heart of traumatic struggle, I see it as a spiritual issue, whether it's, whether it's ultimately a person's going to choose anything spiritual or has anything spiritual. In the back of my mind, I'm going, what is going to be, how are these five growth potentials? Which of these is going to be the thread that I pull through with them that's going to become a more meaningful way to house their lives and a more meaningful way to live and a more meaningful way to understand suffering. And sometimes it is people truly turning back towards their faith, pulling their faith through. Some of them were happy to be with a therapist that is ready to center their faith and have that inform and grow and expand around the experience that they went through. But yeah, those post-traumatic growth markers when I when I teach that to my students, first of all, in their, in their third year in a clinical program, they have not learned about post-traumatic growth and, and yet, we have as good of data on post-traumatic growth as we have on many of the kinds of therapies that we apply, because we are a soft science. But also, when I help them identify that even as they're working with distress, they're looking out for, within the distress, the seeds of the growth they can help them pull through. When a person says, I don't know what to believe in anymore, I have lost my faith during this experience, for instance, that is actually a seed of growth. That, that isn't, that isn't them saying, Never mind, then, I'm throwing, I'm throwing in the, they're actually saying, I'm announcing this to you because I want this to grow and move. Right? Or when a person says, like, I've lost all community and I'm so isolated, they're saying to me, I know that community is utterly important. How can you help me pull this thread through?
Mary Louder:Right.
Dr Shyamaa Creaven:So if we're not working with those five threads, at least, then likely growth will happen anyways. But we can actually heighten trauma resolution by pulling those threads through at the same time that we're helping people process or resolve residuals from an experience that they could not digest and integrate on their own at the time.
Mary Louder:This would probably be called a pause cast, because my pause here at this is probably some of the best work that I've ever seen accomplished in my own personal life, was on page 46 of your dissertation. Which is the conclusion that I came to in reading your dissertation, because I was seeking help to help patients. As I was reading your dissertation, I realized some areas of my faith that were gone, some areas of my faith that weren't there any longer. Yeah, seemingly, that's exactly right. And so coming to that conclusion, and then hearing you explain it just now as really a point of growth, not a sense of loss, and then having that opportunity to reinvigorate that in my own personal life was one of the seeds that pulled me through very much, a lot of grief, protracted grief, and some very difficult things that I had faced, you know, that were pretty confounding. And bringing that sense. And so I would throw myself in common humanity there, first as a person and then as a physician, yeah? And I would say understanding that, especially, you know, the bringing to apprec--a sense of a increased appreciation of awe and wonder. Awe, you know, Brené Brown, I love how she describes emotions, and that awe is that sense of so much bigger than ourselves, which brings in that spirituality, and then the wonder is, okay, it's this huge thing. And now I'm curious about that, which causes that digging, causes that exploration, causes that excavation, of where did I diverge? Or where does a person diverge? Where did they lose track of? Where did they fall off of? How do they get back on? Which causes more of that growth and that wonder then brings an underpinning to that awe, which deepens the emotion and connection, not only to self, but then to something greater than ourself in that aspect of spirituality, where you actually then can understand the echoing of the soul. In response to, and out towards something that is greater than ourselves, and the calling and the longing and that responsiveness that goes both directions.
Dr Shyamaa Creaven:Right, yeah, the interplay that, that we are then not alone in this grappling.
Mary Louder:Yeah.
Dr Shyamaa Creaven:Indeed made to grapple with, when we go through a traumatic incident or event.
Mary Louder:So then, should we be able to arrive at a spot? I think of Pema Chodron, where we are comfortable with the, you know, uncomfortable, comfortable with the inconclused, comfortable with the unknown, without it being a resignation to I give up, but within that, having a resiliency of our innermost self as strength in that process.
Dr Shyamaa Creaven:Is that a question or a statement?
Mary Louder:Probably both.
Dr Shyamaa Creaven:Yeah, that sounds like an exclamation mark to me.
Mary Louder:All right, fine. So that's a yes.
Dr Shyamaa Creaven:I mean, but a much less poetic and comprehensive way to say it than you just did, is, I--an author I'm really appreciating, an old instructor of mine, actually named Bruce Tift. He wrote a book called Already Free. It's a Buddhist psychology book. And in it, he talks about the increase in capacity for experiential intensity, and that every moment is an opportunity to increase our capacity for experiential intensity. And that takes a certain amount of resilience. And I'm going to hearken to our friend, our shared friend at this point, Arielle Schwartz, who defines resilience as not a trait. This is her quote now--not a trait that you either have or don't have. Oh, I'm just a resilient person or not, but a set of strategies that can be learned and practiced and engaged deliberately and eventually through--just become sort of somatic and psychic and cognitive memory. We just have those capacities. He talks about increasing the capacity for experiential intensity, not as increasing our ability to like have fun and be groovy and enjoy stuff, but our capacity to stay with the inevitable trials, tribulations, suffering and despair of the world. And when we can stay with that, then we are, not only are we just incredibly resilient, but we are potentially able to be informed by and learn from that as well. So, so helping people stay with their experience, not in, in the moment of a actual trauma happening, the mechanisms we employ to dissociate, depart, shut down, or freeze, our wise mechanisms, they are meant to have us traverse that. After that, when we then contract our world, since we started with trauma, I'll go there again, when we contract our worlds out of, out of the thing that we went through, out of fear, out of some incomplete experience, it's now surging in our soma and our nervous systems, which trauma can do. We are, we are no longer than building the muscle to interact with the difficulties of life. And so helping people reengage that, you know, re-encounter their capacity in smaller doses, in titrated doses, really builds that confidence. You know, one of the Post-Traumatic Growth markers, that confidence in oneself and the ability to stay with difficulty in life.
Mary Louder:With--so then, if--
Dr Shyamaa Creaven:I really went sideways there, I don't even know where--
Mary Louder:No, no, no, that's really good. Because then I think, no, I think it's great. Because I think of like the first seven years of life where we talk about theta waves and kind of the imprint of what we're being told. I wonder if
Dr Shyamaa Creaven:That's a little over my head. Can you we're mixing that up with the events that occur in a distressful way and causing or expanding or creeping that concept of trauma by doing that. unpack that a little?
Mary Louder:Yeah. So, so between ages zero and seven, um, Yeah, in this sort of complex combination of maybe a nervous the brain wave--a lot of the brain waves for a young individual are theta waves that are highly suggestible, like in a hypnosis level of wave. So there's a lot of hypnotic, what's considered hypnotic suggestion of--and they've measured brain waves, so there's been studies on this. And then kiddos just absorb their environment around them, right? And so then they go into the world, and then there's things that are distressful, but in our culture, we might take that and conflate that or expand that into trauma, and because the person hasn't really resolved some of those beliefs of maybe not being good enough, not being heard, not being loved, and then system homeostasis that's at a level of chronic dysregulation, we've just thrown that all in to make a complex trauma for that individual, versus differentiating. Here are some as well as some really pernicious beliefs about the core beliefs that need to be addressed that are not accurate, Right. And I, I don't see that happening. What I see in the, self and worth. And, and here are distressful events that occurred, and because those came together, here we are. our culture is just everybody, like you said, is traumatized, and had this just, you know, lifelong list of things that are traumatic. And I would agree, the body responds to the stresses placed upon it. Wolff's law, the bones get strong by how we use them. Same with the heart muscle, but when we train aerobically, we don't just train the heart, we train the muscles of the skeleton.
Dr Shyamaa Creaven:Yeah, it's all working synergistically together.
Mary Louder:Right. And you need recovery, and we--that's driven by our genes, our amount of recovery that we need. And so it seems really, the more we know who we are, we can work with who we are, which would bring in the idea and the concepts of genomics, you know? Our--do you do, like endurance activities, or are you more of a power person? Do you need longer to recover? Do you--does your training response faster? Is your training response slow? Do you need to go more towards keto, or do you need more towards Mediterranean? We can literally find that in our genes.
Dr Shyamaa Creaven:Wow, wow.
Mary Louder:And it would seem kind of simple to me to follow that, versus saying, here's a good idea, because what gets us into trouble often as humans is, well, it seemed like a good idea at the time, and it really wasn't. And then taking that with an understanding of core beliefs, where you know, the work of resiliency strengthens actual positive core beliefs, and we deal with the core beliefs that aren't true. And I don't even know that I'd call them negative, they're just not true. And then from there, you're creating more of a roadmap that fits that individual as to where they want to go, versus mapping out according to a therapy concept or a physical health concept, or, you know, standard medical care, whatever the heck that means these days, right? Does that make sense?
Dr Shyamaa Creaven:Yeah, you make sense. I'm always learning a lot from you in this particular area. I'm fascinated, find it absolutely exquisite. And then I'm going to use my contrarian mind again to come in with a piece that is a is a concern of mine--not because what you described isn't exquisite and absolutely useful, but because I also worry about the amount of myopic focus on the utter minutia of the self as part of the problem. And so, the more instruments we get for looking at the smallest details and the larger details of us in a world where we're not counterbalancing it with deep, robust engagement with others, social engagement, social commitment, interactions, difficult interactions. We no longer, for instance, have to deal with difficult encounters very much. We can just stay in our little world and, you know, not, not interact as much. We get our food delivered, we get this and that done, etc. There's a way that, there's a way that that could contribute to navel gazing. A whole other level of navel gazing. Not the genomics per se, but this advanced capacity to understand the smallest things that are going on and the largest things that are going on inside without acknowledging--now, what I like about integrative medicine and your holistic approach is the fields around, the ecosystems around are always relevant to how the organism is functioning within. And I think that's a wonderful model. How often, though, do therapists, for instance, say, Oh, you want my help with depression and you want to do some trauma work. Join a club. Where are you volunteering? How many community activities do you do per week? Is there a book club you'd like to be involved in? And I think we need to do a lot more of taking the focus off of certain aspects of the self. So there's a--I think we're in a bind in in our work, because you and I have certain instruments that we can go quite deep and right to the heart of certain things, and then the counter to that is like, and also, eh, yeah, you might have some aches and pains, go out and do something. Or eh, you might be a little stressed, um, go to that family function anyways. Or, you know, this, this counterbalance of, of, doing, autonomy, connection.
Mary Louder:Yeah. I'm hearing this. I'm hearing this. I think this is really, really--
Dr Shyamaa Creaven:I mean, honestly, Mary, I live in a place that's, as, you know, pretty affluent.
Mary Louder:Yeah.
Dr Shyamaa Creaven:I work with clients that are beautiful people that have this allergy and this disorder and this thing and that thing that they spend their whole time engaging.
Mary Louder:The worried well.
Dr Shyamaa Creaven:Yes, and even not so well, but not getting better by all the means they're throwing at themselves. They take a vacation or they volunteer to do Habitat for Humanity, and half the stuff they suffered with didn't go away, but it didn't bother them.
Mary Louder:Right. I think that's a, I think that's a very valid point. And I think sometimes when I'm faced with that, what what I throw out is, well, I'd like to start with the best statistic I have about my patients, that 100% of them die. And they look, and I said, hopefully, just not soon and on my watch, but, you know--or something that I've done. But the point is, like, about anti-aging, if we were, you know--not going there, but bringing that concept in, because you're biohacking. I don't believe in biohacking. I believe in being connected to yourself, because from there, you can go anywhere. And I believe in the fact that if you understand yourself and the body's inherent capacity to heal, you'll get there. Right? Whatever there looks like, needs to be. But the fact that--and then common humanity, we all have similar things we experience, and, and we're in a community of where other people experience things, and we can have empathy. And it's not because we've walked in their shoes, it's because we understand what we feel, therefore we can connect with their feelings. That's empathy, yeah? And so I think that that's really important. And then the concept that the body is always seeking healing and the horizontal with our eyes, and we don't have to watch our cuts heal. We go about our business because the body has--
Dr Shyamaa Creaven:We apply good medicine, and we go about our business well.
Mary Louder:Yeah. And so that's where I think, because my--I, it would be, you know, there's a song that's sung by One Republic, you know, about--
Dr Shyamaa Creaven:I love your references that are like, Oh God, how does she know that song and I don't!
Mary Louder:yeah, it's like, you know, every bone I break, you know, may I break it well, and may it heal well, and every thing I engage, you know, may I, may I have lived my life to the, to the absolute fullest, you know? And somebody said, Well, what if you don't get to where you're going? I said, I'm on the path. I'm there. Doesn't mean I've seen everything yet, but you can, you can put it on my headstone. I, you know, she did it. Whatever, you know, I did it all. And that's actually kind of what that song's about. I did it all. You know--
Dr Shyamaa Creaven:You wouldn't want to miss a thing, right?
Mary Louder:Never.
Dr Shyamaa Creaven:You wouldn't want to miss a thing. You don't want to--I mean, certainly we can talk about experiences we, we wish we hadn't had, but this sense of, like, being in this, this outrageous world, where it's, it's all here.
Mary Louder:Yeah. I want that fully human experience. And that includes, to the extent that you understand emotions, defines the extent and the richness of your experience. So the more that you can define that, and that actually takes you away from navel gazing, takes you into awe, into wonder, into anguish, into grief, into joy, into foreboding joy, into all these different things--
Dr Shyamaa Creaven:That you can live that experience, it is part and parcel of the mix, you can do it, versus ooh, it might traumatize you, or, Oh, we gotta, we gotta resolve it in some way, or we gotta fix it. Now, certainly, we don't want to withhold means of bearing it and means of getting through it, and means of making it better. But, yeah, this, this, like, I think that it circles back to--I want to circle back to two things. One is, I trust this person. I trust that they could bear their existence. I trust they can. And we're going to bring in some things that show them that or support that. But fundamentally, I trust they can bear their existence. They have. They will. The second thing is, you know, when we, when we focus on something, thinking it's it's so difficult, and even that like, it's something that shouldn't have happened, we actually remove ourselves from the human mix in a certain way. I have a client, for instance, that sat with me, and a long time ago, so I think I can name it now, and it wouldn't circle back to anybody in particular, because I've heard this enough--that had, that had gone through an experience that she thought was so devastating, and very few people ever experienced. And when I shared with her the stat of the amount of women that go through that and that she is now part of a community of people that know that experience. She can look into the eyes of other women and be sure by about 30 to 40% that she has lived something they have lived and she is now part of something. It absolutely changed her holding that as a traumatic experience, and instead holding it as a deeply suffering, unifying experience. And that's a different narrative, and that has a different arc to it, and it goes in a different direction.
Mary Louder:It does. And then I do frequently invite people to join humanity. Welcome to common humanity.
Dr Shyamaa Creaven:Welcome to, welcome to, to what people go through at this stage, at this age, with this genetic background, these--your ancestors gave you a lot of, a lot of great stuff. They also gave you this.
Mary Louder:Which is why we're meeting today. Yes, exactly. And so it becomes a part of the story. It doesn't have to be the story.
Dr Shyamaa Creaven:Yeah, fold it in to the, to the outrageousness of getting to be a human.
Mary Louder:Right. It's a huge privilege to be a human.
Dr Shyamaa Creaven:It's exquisite. I wouldn't want to miss it. I wouldn't trade it.
Mary Louder:Yeah, I wouldn't either. I get so excited I want to do it again. And do other things. No 24 of 100.
Dr Shyamaa Creaven:I want to circle back to two things. One is you, you'd started us on some stats around one in 100, 30 in 100 etc. The one in 100 for a psychiatrist, yeah. I believe it. You know, exposure to toxins, epigenetic stuff, etc. Absolutely. Mental illness, part of the mix, got it in my family, grew up in a halfway house, saw it as a pernicious situation that had some systemic elements to it. You know, people that were living on the streets seem to not get the same kind of help as people that were, had more means, and so there was more expression of their mental illness, but definitely one in 24 of 100. I find that a heartbreaking statistic. You 100 needing potentially psychiatric help. Okay. But the 30? Did you say 30 out of 100 needing a therapist? know, I'd like that statistic to be much lower, even if I was out of a job. And I know it's trite to say that, but I mean that, which is that I actually feel that with more social, emotional, spiritual supports from other avenues, that statistic should be much lower. I should be a compen--compendium to that 1% right? The 1% to psychiatrist, maybe 10% to me, that can have some conjunct, conjunctive help, or don't quite need a psychiatrist, because there's so--there's so much better quality stuff to support people in this world than than a therapist an hour or two per week. I just, I wish that we could pull some of that back in that got lost, or invent along the lines that, that supports that, versus my field continuing to grow and more and more people continue. I mean, I have a therapist, my friends have a therapist. Their kids have a therapist. It's great. It's cool stuff.
Mary Louder:It's like Oprah, you have a therapist, you have a therapist, you have a therapist!
Dr Shyamaa Creaven:A therapist for everyone in the room! I don't feel that that's necessary. I really don't. For short periods of time, like my, my role in people's lives should be absolutely time limited. I love it when I could be like, we arrived. You did it. I did it. We collaborated. Great. But there's so many other things increase for people to keep moving with. And ideally, when they leave therapy, they're like, actually, I've got this now. I got that now. I got this now, see you later for a check in, or see an in another expression of who we both are, etc. Because, that, that 24%, I, I--it shouldn't be necessary. The coaching part, groovy. I mean, if there's things to coach people in, there's all kinds of ways that life has become more complex, and there's all kinds of new, new stuff to engage. I dig it. I do. I mean, I think that that coaches sometimes can draw some of that 24%, Psychiatrists maybe could take a couple more and right in the middle can be just like this--I don't know what I'm even saying there, but yeah, that seems too high to me.
Mary Louder:It sounds like you're saying you'd like a vacation.
Dr Shyamaa Creaven:It's true that the pandemic caused a huge wait list and in my particular niche, and that's, that's something that I think is true and real. I don't disregard mood therapy. It's more that I, I feel that other, other social things could be increased to coming around people in society.
Mary Louder:We don't have, we've, we've got artificial--yeah, and, and I think we need to come back for this conversation about--because I think, I think we would have fun with the series called On The Couch, you know, but I think we need to come back and looking at some of the reasons why some of the pillars of support are no longer there in our culture. And even pillars of expectation. And I think that would be, I think we should hold on that, because I think we've got another, we've got a whole other conversation on some of that stuff. But if you're willing to come back, we can, you know, look down the road to do it, because I think this is super important, because I agree that in the resiliency, I think we've really knocked that one out of the park today in a good way. And the five things, if you could, you know, if we could, I actually will take those five--
Dr Shyamaa Creaven:I could send you my notes if you want.
Mary Louder:Please. And because I'm going to include that with some of the, with the, we always give a transcript. But I also want to use those five points of resiliency for people to have a reinforcement with that. But I think that there's a lot more in conversation here to understand how we kind of got derailed with some things, and what we can do to not only build the resiliency, but the stability, you know, and understand a guardrail is just that, it keeps us in the, in, in, in the bounds, and it's okay to hit the guardrail.
Dr Shyamaa Creaven:Yeah, yeah.
Mary Louder:And come on back, yeah.
Dr Shyamaa Creaven:It's okay to suffer. It's okay to be challenged within, within bounds, that we can learn from, cope with, carrying on with, and that we have more capacity to do that than I believe we're telling ourselves right now. I think the final thing I would share then, because I didn't say it, I kept talking about social supports, this, this notion, and I wish I could remember who said it first. Might have been Dawkins, I'm not sure who, but this god-sized hole that is left in the middle of secular society, and the things we put in there that are really inadequate to the task at hand. Psychology is inadequate to the task at hand. We need larger social, spiritual meaning, making frames than than the psychological concepts that we currently have. And yet people are often--I think that's what I meant by my therapist, your therapist, my friends' kids' therapist. If there were people, wise elders that we sat with, spiritual traditions that were trustworthy to us, ways of relating that pulled and expanded us, much less of us would need to be seeing therapists, I believe. And I actually think that we're being placed in a position as therapists sometimes that we have not earned, do not deserve. And I don't mean that we've done it on purpose, although I think maybe sometimes it's done on purpose, because the maps and the, the resources that we have are, are really flimsy compared to the questions people are asking and the resources available in nature and spirituality and in community.
Mary Louder:Yeah. I again, I wish I could find something to argue about, because it's fun. But, but I agree with that, and I think seeing a broader context of, in my world, going this, just beyond what our cells are doing, what our physicality is doing, and the excellence of that, and how robust we are, to really digging into life and all of its meaning and all of its messiness.
Dr Shyamaa Creaven:Yeah, yeah.
Mary Louder:And, and, and connection to ourself and to others and to something much larger than ourself, and--
Dr Shyamaa Creaven:Awe and wonder go, go well with that.
Mary Louder:Yeah, and running that continuum, yeah, running that continuum all day. And knowing that that is the human experience. And so defining the human experience as being human. Let's do it. Let's go be human. So on that, Shyamaa, thank you so much for being here.
Dr Shyamaa Creaven:Pleasure. Pleasure, Mary.
Mary Louder:Thank you for expanding on a lot of really important concepts. And I would like to have you come back and we'll, you know, continue.
Dr Shyamaa Creaven:We can continue.
Mary Louder:Yeah,eah, going from there. So thank you very much. And thanks everybody for listening to this episode of Since You Put It That Way--
Dr Shyamaa Creaven:Oh my gosh. People are listening. That is weird.
Mary Louder:They are. They're listening and they're watching.
Dr Shyamaa Creaven:Here I thought we were just chatting away.
Mary Louder:Yeah, it's exactly how it feels, and that's wonderful. So thank you, and we'll see you on our next episode.
