Your Therapist Needs Therapy 138 - Polyvagal Theory Debunked!?!?!

This week Jeremy tackles the ongoing drama in the world of Polyvagal Theory in the therapy room and online. Jeremy explains why some theories have better scientific data than others, and why therapy as a whole needs to do a better job of holding onto scientific rigour to not lose our professional credibility. Of course, we add the nuance that science cannot be so rigid that it stops being helpful. Jeremy looks at the factors like insurance companies and academia (and capitalism, obvs) influencing what research looks like in the modern psychology world, and offers some hope for more useful, science-backed treatments in the future.

As always, Jeremy has all his practice info at Wellness with Jer, and you can find him on Instagram and YouTube. To show your love for the show you can pick up some merch! We appreciate support from likes, follows, and shares as well! None of my online work would be possible without my media maven Kenny, so check out their work as well at kenlingdesign.com

If you’re looking for a space that holds the art of healing with science-backed methods check out the retreat my great collaborator Emily and I are hosting Rest & Return: A Weekend for Soft Landings. This retreat is designed to let your nervous system settle and come back to yourself. It’s rest, grounding, and trauma-informed connection instead of more noise. 

-----

Podcasts about therapy do not replace actual therapy, and listening to a podcast about therapy does not signify a therapeutic relationship.If you or someone you know is in crisis please call or text the nationwide crisis line at 988, or text HELLO to 741741. The Trevor Project has a crisis line for LGBTQ+ young people that can be reached by texting 678678.

Transcript

Hey, yo.

00:00:07.724 --> 00:00:09.105
What's up, internet?

00:00:10.367 --> 00:00:12.067
Your friendly neighborhood marriage and

00:00:12.087 --> 00:00:14.148
family therapist here, Jeremy Schumacher.

00:00:14.208 --> 00:00:16.230
I'm the Jer in Wellness with Jer.

00:00:16.789 --> 00:00:17.731
Thanks for stopping by and checking out

00:00:17.751 --> 00:00:18.131
the channel.

00:00:18.310 --> 00:00:21.312
Today, we're going to talk about GASP.

00:00:21.632 --> 00:00:25.495
Everyone's favorite trauma-informed theory

00:00:25.574 --> 00:00:26.815
has been debunked.

00:00:27.675 --> 00:00:28.496
Crisis.

00:00:28.977 --> 00:00:30.678
Therapists are taking to the streets.

00:00:31.786 --> 00:00:32.225
They're not.

00:00:32.426 --> 00:00:34.167
They're taking to the internet and arguing

00:00:34.548 --> 00:00:35.709
nonsensically with each other.

00:00:36.969 --> 00:00:40.112
This is sort of niche.

00:00:56.268 --> 00:00:57.689
I'm not a professional content creator.

00:00:57.829 --> 00:00:58.831
I'm a mental health professional,

00:00:58.850 --> 00:01:00.972
which is why I know this is not

00:01:01.072 --> 00:01:02.453
actually as big of a deal as people

00:01:02.493 --> 00:01:02.954
are acting.

00:01:03.533 --> 00:01:05.234
So if you're not in the know,

00:01:05.334 --> 00:01:06.115
if you're not a mental health

00:01:06.135 --> 00:01:06.536
professional,

00:01:06.575 --> 00:01:09.278
if you're not somebody who gets journals

00:01:09.397 --> 00:01:10.679
in the mail like a nerd,

00:01:11.739 --> 00:01:13.240
you might not know what polyvagal theory

00:01:13.460 --> 00:01:13.661
is.

00:01:13.700 --> 00:01:15.121
You might not know what the current

00:01:15.221 --> 00:01:16.462
ongoing drama is.

00:01:16.882 --> 00:01:18.924
I'm going to try to summarize real quick

00:01:18.944 --> 00:01:20.786
without being too jargony.

00:01:21.703 --> 00:01:25.947
Polyvagal theory is a therapeutic idea put

00:01:25.966 --> 00:01:27.647
forth a number of years ago by Stephen

00:01:27.688 --> 00:01:29.289
Porges and other people.

00:01:30.528 --> 00:01:31.489
If that was my last name,

00:01:31.569 --> 00:01:34.132
I would definitely go with porgies because

00:01:34.311 --> 00:01:35.231
it rhymes with corgis.

00:01:35.552 --> 00:01:36.533
But I'm not in charge of names,

00:01:36.712 --> 00:01:38.114
so my last name is Schumacher.

00:01:41.516 --> 00:01:42.876
And basically,

00:01:46.218 --> 00:01:47.920
I wouldn't say it's the cat's meow.

00:01:48.079 --> 00:01:48.721
Arguably, it's

00:01:49.676 --> 00:01:51.317
cbt is still the cat's meow in the

00:01:51.337 --> 00:01:53.200
therapy world because we like to act like

00:01:53.299 --> 00:01:57.004
it's still the in the science that is

00:01:57.144 --> 00:01:58.986
the redheaded stepchild of the scientific

00:01:59.007 --> 00:02:02.730
community um the nothing against

00:02:02.971 --> 00:02:04.653
stepchildren i'm just using that as an

00:02:04.753 --> 00:02:07.777
idiom or gingers although i will make

00:02:07.816 --> 00:02:09.419
jokes about that um

00:02:11.894 --> 00:02:14.756
Yeah, polyvagal theory just says, hey,

00:02:14.896 --> 00:02:16.258
here's how your nervous system works.

00:02:16.358 --> 00:02:17.938
Here's how we can move it.

00:02:18.439 --> 00:02:19.419
You go into fight, flight, freeze,

00:02:19.460 --> 00:02:19.980
or fawn,

00:02:20.480 --> 00:02:22.263
do these different techniques that gets us

00:02:22.423 --> 00:02:24.745
into a different response where we can be

00:02:24.784 --> 00:02:26.406
in rest and digest, right?

00:02:27.086 --> 00:02:29.408
And what happened is some researchers,

00:02:29.489 --> 00:02:30.169
a bunch of them,

00:02:31.210 --> 00:02:33.632
signed onto a paper recently that said,

00:02:34.013 --> 00:02:35.112
yeah, that's not how it works.

00:02:36.237 --> 00:02:40.742
And the very general basic description I

00:02:40.763 --> 00:02:42.544
just gave you still isn't wrong.

00:02:43.284 --> 00:02:45.146
They're just basically researchers are

00:02:45.167 --> 00:02:47.969
saying, hey, the mechanism is different.

00:02:49.325 --> 00:02:50.486
Not that's not what's happening.

00:02:50.768 --> 00:02:52.088
So I didn't even get into the whole

00:02:52.308 --> 00:02:53.971
jargon of like dorsal and some of the

00:02:54.010 --> 00:02:55.772
other stuff because I didn't study

00:02:55.832 --> 00:02:57.114
polyvagal theory.

00:02:58.275 --> 00:02:59.516
I like some of the techniques.

00:02:59.616 --> 00:03:01.859
It pairs well with dialectical behavioral

00:03:01.878 --> 00:03:03.020
therapy, which is what I do.

00:03:03.099 --> 00:03:04.722
I also do collaborative language therapy,

00:03:04.741 --> 00:03:07.405
which very specifically is not real big on

00:03:07.465 --> 00:03:07.944
technique.

00:03:08.806 --> 00:03:11.627
So I'm not somebody who studied this

00:03:11.728 --> 00:03:12.449
extensively.

00:03:12.588 --> 00:03:14.629
I don't have the certificates for studying

00:03:14.689 --> 00:03:15.790
it, yada, yada, yada.

00:03:15.850 --> 00:03:17.733
We will get into why that's the case

00:03:17.812 --> 00:03:19.693
and why something like this doesn't deter

00:03:19.734 --> 00:03:21.335
me as a therapist and also why it

00:03:21.375 --> 00:03:23.056
makes me side-eye a bunch of other

00:03:23.096 --> 00:03:23.556
therapists.

00:03:23.937 --> 00:03:25.157
Welcome to my YouTube channel.

00:03:25.298 --> 00:03:27.278
We go on and on and on about

00:03:27.338 --> 00:03:30.181
things because hard things require nuance

00:03:31.042 --> 00:03:34.444
and not thirty-second clips.

00:03:34.544 --> 00:03:36.406
Internet, figure your shit out.

00:03:37.627 --> 00:03:37.667
Um,

00:03:38.894 --> 00:03:40.436
So my main issue with my fellow

00:03:40.496 --> 00:03:41.137
therapists,

00:03:41.217 --> 00:03:42.359
especially the ones who are coming out in

00:03:42.378 --> 00:03:43.500
defense of polyvagal theory,

00:03:43.680 --> 00:03:47.324
is that we need to be open to

00:03:47.405 --> 00:03:51.349
new science and feedback about things.

00:03:52.031 --> 00:03:53.712
If a mechanism is wrong...

00:03:54.604 --> 00:03:56.826
then we need to update the mechanism,

00:03:57.106 --> 00:03:57.347
right?

00:03:57.387 --> 00:04:00.288
Like we can't be dogmatic about our

00:04:00.329 --> 00:04:02.449
approaches to therapy because that makes

00:04:02.509 --> 00:04:04.451
us closer to a religion,

00:04:04.551 --> 00:04:06.332
closer to pseudoscience than actual

00:04:06.372 --> 00:04:06.793
science.

00:04:06.832 --> 00:04:09.034
And so in order to hold ourselves to

00:04:09.094 --> 00:04:09.814
account and older,

00:04:10.116 --> 00:04:11.757
in order to hold our profession to

00:04:11.817 --> 00:04:12.116
account,

00:04:12.137 --> 00:04:13.758
we need to be able to move and

00:04:13.858 --> 00:04:16.500
update with the science and follow the

00:04:16.519 --> 00:04:18.321
science, not try and dictate it.

00:04:19.161 --> 00:04:19.341
Um,

00:04:20.336 --> 00:04:21.437
This isn't,

00:04:21.456 --> 00:04:23.257
the research doesn't say polyvagal theory

00:04:23.298 --> 00:04:23.918
is useless.

00:04:23.978 --> 00:04:27.081
It says the mechanism as suggested is

00:04:27.161 --> 00:04:27.601
wrong.

00:04:28.523 --> 00:04:28.923
And again,

00:04:29.043 --> 00:04:30.483
I feel pretty comfortable based on reading

00:04:30.504 --> 00:04:32.586
the paper to say like, yeah, definitively,

00:04:32.946 --> 00:04:35.007
some of this stuff is not new.

00:04:35.088 --> 00:04:36.588
This is just the biggest,

00:04:37.089 --> 00:04:38.870
most number of professionals signing out

00:04:38.911 --> 00:04:40.312
of this paper saying, yeah, that's wrong.

00:04:41.721 --> 00:04:43.384
But neuroscientists have not liked

00:04:43.425 --> 00:04:44.005
polyvagal,

00:04:44.165 --> 00:04:47.091
Porges' version of polyvagal understanding

00:04:47.170 --> 00:04:49.875
and therapy specifically for a while.

00:04:49.915 --> 00:04:51.137
Like this isn't new.

00:04:51.197 --> 00:04:52.420
This isn't shocking.

00:04:52.439 --> 00:04:54.824
And I think if you're...

00:04:56.060 --> 00:04:57.721
a critical thinking therapist,

00:04:58.341 --> 00:04:59.362
not a huge surprise.

00:04:59.482 --> 00:04:59.762
Again,

00:04:59.802 --> 00:05:02.023
like this is some stuff where oftentimes

00:05:02.163 --> 00:05:04.963
people are on the cutting edge of things

00:05:05.043 --> 00:05:05.963
or doing research on it.

00:05:06.064 --> 00:05:07.963
And it's really hard to have the right

00:05:08.084 --> 00:05:10.245
experts in the room all working on a

00:05:10.305 --> 00:05:11.324
project at the same time.

00:05:11.384 --> 00:05:14.146
And so sometimes there are hypotheses that

00:05:14.286 --> 00:05:15.067
are disproven.

00:05:15.086 --> 00:05:16.646
Sometimes there are things that we learn

00:05:16.706 --> 00:05:17.247
more about.

00:05:17.706 --> 00:05:19.848
What we're learning about on a level that

00:05:19.968 --> 00:05:21.507
never has existed in the therapy field

00:05:21.548 --> 00:05:23.028
before is the neuroscience,

00:05:23.048 --> 00:05:23.588
being able to

00:05:24.079 --> 00:05:25.401
track and study what's going on in

00:05:25.423 --> 00:05:26.124
people's brains.

00:05:26.665 --> 00:05:28.189
And it's still really hard to study

00:05:28.230 --> 00:05:28.951
people's brains.

00:05:29.432 --> 00:05:29.894
We can't

00:05:30.629 --> 00:05:32.730
cut in and dig around all that much.

00:05:32.970 --> 00:05:34.550
We can more than we used to be

00:05:34.651 --> 00:05:37.552
able to, which was like ice pick lobotomy.

00:05:38.754 --> 00:05:40.314
So technology continues to grow and

00:05:40.355 --> 00:05:43.117
advance and what we learn continues to

00:05:43.156 --> 00:05:43.857
grow in advance.

00:05:44.117 --> 00:05:46.759
And slowly behind that is what we know.

00:05:46.939 --> 00:05:47.860
So we're learning,

00:05:48.180 --> 00:05:49.740
but that learning comes before we know

00:05:49.761 --> 00:05:50.161
things.

00:05:50.261 --> 00:05:53.843
And some of these therapeutic models are

00:05:53.882 --> 00:05:55.444
suggesting a knowledge that just isn't

00:05:55.463 --> 00:05:55.884
there yet.

00:05:56.687 --> 00:05:56.966
And again,

00:05:57.348 --> 00:05:58.629
I don't know that that's on the people

00:05:58.649 --> 00:05:59.591
who are authoring the books.

00:05:59.672 --> 00:06:00.793
I don't know if that's on the publishing

00:06:00.833 --> 00:06:01.213
houses.

00:06:01.634 --> 00:06:01.855
Again,

00:06:02.274 --> 00:06:04.459
I will get into why capitalism has ruined

00:06:04.478 --> 00:06:05.841
this and made this all very bad.

00:06:06.060 --> 00:06:06.442
Shock.

00:06:06.521 --> 00:06:08.024
If you're new to the channel, hey, hi,

00:06:08.124 --> 00:06:09.286
I blame a lot on capitalism.

00:06:09.730 --> 00:06:10.230
I'm not wrong.

00:06:13.473 --> 00:06:15.216
So I'm not really somebody who's saying,

00:06:15.295 --> 00:06:17.598
hey, polyvagal is debunked,

00:06:18.178 --> 00:06:19.939
hence all the exclamation points and

00:06:19.980 --> 00:06:21.963
question marks to highlight that.

00:06:21.983 --> 00:06:23.124
That's not really where I land.

00:06:23.444 --> 00:06:26.247
But I was never a polyvagal advocate in

00:06:26.307 --> 00:06:27.307
the first place.

00:06:28.009 --> 00:06:30.630
I have sent people videos on some of

00:06:30.651 --> 00:06:32.733
the techniques and how they're supposed to

00:06:32.774 --> 00:06:32.973
work.

00:06:33.374 --> 00:06:33.793
Because again,

00:06:33.853 --> 00:06:35.954
I think some of the techniques could work

00:06:35.995 --> 00:06:36.654
for people.

00:06:36.855 --> 00:06:39.216
I do think there is utility in some

00:06:39.255 --> 00:06:42.355
of the tools here as a toolkit,

00:06:42.997 --> 00:06:44.797
not as dogma.

00:06:45.797 --> 00:06:47.317
And I never studied polyvagal well enough

00:06:47.358 --> 00:06:48.737
to be able to explain the mechanism to

00:06:48.778 --> 00:06:50.459
people, right?

00:06:50.559 --> 00:06:51.478
Enough to say, hey,

00:06:51.538 --> 00:06:52.959
here's how we think it works.

00:06:53.278 --> 00:06:54.699
Here's why it might work for you.

00:06:55.079 --> 00:06:57.259
Here's five different options.

00:06:57.560 --> 00:06:58.500
Try two of them.

00:06:59.338 --> 00:07:00.978
It's always sort of been my approach to

00:07:01.019 --> 00:07:01.119
it.

00:07:01.319 --> 00:07:03.139
That's how I am with DBT as well.

00:07:03.220 --> 00:07:05.062
Like, here's the workbook.

00:07:05.182 --> 00:07:06.101
I don't need you to read the whole

00:07:06.141 --> 00:07:06.422
thing.

00:07:06.482 --> 00:07:08.062
I need you to find three to five

00:07:08.103 --> 00:07:10.024
different skills and then practice those

00:07:10.105 --> 00:07:10.685
regularly.

00:07:10.725 --> 00:07:12.305
Make those part of your normal thing.

00:07:12.786 --> 00:07:13.387
Because again,

00:07:14.007 --> 00:07:15.747
I think any therapist who's coming in too

00:07:15.767 --> 00:07:16.829
dogmatic about

00:07:17.949 --> 00:07:19.271
how they do their therapy,

00:07:19.350 --> 00:07:20.911
what is supposed to help people and what

00:07:20.971 --> 00:07:24.033
works, why it works is getting it wrong.

00:07:24.053 --> 00:07:25.795
It's why I see so many people who

00:07:25.975 --> 00:07:28.177
had an EMDR therapist and they hated it

00:07:28.216 --> 00:07:29.538
and they come work with me and they're

00:07:29.577 --> 00:07:31.978
relieved to know that I don't do EMDR.

00:07:31.999 --> 00:07:33.740
And they liked for me to say something

00:07:33.781 --> 00:07:35.822
like, yo, EMDR is not for everybody.

00:07:35.901 --> 00:07:37.182
People either love it or hate it.

00:07:37.262 --> 00:07:38.723
A lot of my clients have hated it

00:07:38.783 --> 00:07:39.244
over the years.

00:07:39.845 --> 00:07:41.545
And the reason I sort of come at

00:07:41.586 --> 00:07:41.865
this,

00:07:42.086 --> 00:07:43.447
if you've listened to my podcast at all,

00:07:43.466 --> 00:07:46.228
you've heard me say this unpopular opinion

00:07:46.389 --> 00:07:47.470
and I'm fairly,

00:07:48.870 --> 00:07:51.790
fairly confident will be proven to be

00:07:51.891 --> 00:07:53.670
accurate in the future that EMDR's

00:07:54.110 --> 00:07:56.012
scientific rigor is not that good either.

00:07:56.591 --> 00:07:57.612
And that's going to upset a lot of

00:07:57.692 --> 00:07:58.612
EMDR therapists.

00:07:58.651 --> 00:08:01.052
They don't like to talk about how EMDR

00:08:01.413 --> 00:08:03.733
does not show much utility against a

00:08:03.812 --> 00:08:07.334
placebo and is no better than an EMDR

00:08:07.374 --> 00:08:07.754
therapist,

00:08:07.774 --> 00:08:08.935
somebody who's trained in EMDR doing

00:08:08.975 --> 00:08:09.735
therapy with a client,

00:08:09.754 --> 00:08:11.574
but not doing the EMDR techniques.

00:08:11.634 --> 00:08:13.935
The only people who are pushing EMDR

00:08:13.956 --> 00:08:15.255
forward as this big,

00:08:16.353 --> 00:08:17.574
wonderful thing are A,

00:08:17.675 --> 00:08:19.255
insurance companies, and B,

00:08:19.315 --> 00:08:21.077
people who study EMDR.

00:08:21.237 --> 00:08:22.798
The institutes that train people to do

00:08:22.899 --> 00:08:27.401
EMDR show not verifiable data because when

00:08:27.603 --> 00:08:28.884
other people test that data,

00:08:28.944 --> 00:08:31.665
it doesn't come back as good.

00:08:31.766 --> 00:08:33.547
Antidepressants are only about as good as

00:08:33.626 --> 00:08:35.107
placebo effects, right?

00:08:35.788 --> 00:08:38.130
AA is significantly worse than placebo

00:08:38.171 --> 00:08:38.571
effects.

00:08:38.610 --> 00:08:40.893
Like we've put a lot of things into

00:08:40.932 --> 00:08:42.994
our culture under the scientific heading

00:08:43.033 --> 00:08:45.255
that are not particularly great.

00:08:46.714 --> 00:08:49.495
And the problem with placebo effect is you

00:08:49.534 --> 00:08:51.556
can't teach it.

00:08:51.655 --> 00:08:53.256
You can't say, Hey, this isn't real,

00:08:53.317 --> 00:08:54.537
but if you pretend well enough,

00:08:54.557 --> 00:08:55.738
your brain will buy into it.

00:08:56.457 --> 00:08:56.677
Right.

00:08:56.937 --> 00:09:00.159
And so CBT has a bunch of issues

00:09:00.299 --> 00:09:03.100
and modern new CBT is much better than

00:09:03.120 --> 00:09:03.900
it was in the eighties.

00:09:03.941 --> 00:09:04.321
But again,

00:09:04.341 --> 00:09:06.201
like part of the reason that it's still

00:09:06.221 --> 00:09:08.003
around is simply because insurance

00:09:08.023 --> 00:09:09.563
companies have agreed to pay for it for

00:09:09.604 --> 00:09:10.024
so long.

00:09:10.083 --> 00:09:11.985
It's not because it's the be all end

00:09:12.044 --> 00:09:14.966
all best outcome based model that doesn't

00:09:15.025 --> 00:09:15.466
exist.

00:09:16.089 --> 00:09:17.649
When we study therapy,

00:09:17.870 --> 00:09:19.410
if there's a heading to take away from

00:09:19.451 --> 00:09:20.873
this video, if there's one takeaway,

00:09:21.232 --> 00:09:24.235
when we study therapy again and again and

00:09:24.294 --> 00:09:24.674
again,

00:09:24.774 --> 00:09:26.035
the thing that shows up is it is

00:09:26.096 --> 00:09:27.817
the relationship between the client and

00:09:27.837 --> 00:09:30.580
the therapist that produces the biggest

00:09:30.840 --> 00:09:31.179
outcome.

00:09:31.320 --> 00:09:34.042
The thing that we can predict successful

00:09:34.062 --> 00:09:36.063
therapy on is the relationship between the

00:09:36.104 --> 00:09:36.484
client

00:09:37.168 --> 00:09:37.849
and therapist.

00:09:38.288 --> 00:09:38.668
That's it.

00:09:38.769 --> 00:09:39.649
It's relational.

00:09:40.070 --> 00:09:42.371
I'm not saying relationships cure people,

00:09:43.153 --> 00:09:43.352
right?

00:09:43.753 --> 00:09:45.033
I do think training matters.

00:09:45.073 --> 00:09:46.434
I do think education matters.

00:09:46.696 --> 00:09:48.596
I continue to carry a license because I

00:09:48.636 --> 00:09:50.258
think that accountability that comes with

00:09:50.278 --> 00:09:52.259
being a licensed professional matters.

00:09:52.299 --> 00:09:54.961
I think those things do matter.

00:09:55.582 --> 00:09:59.745
And human beings are not a car.

00:10:00.306 --> 00:10:01.506
This isn't taking the car to your

00:10:01.547 --> 00:10:02.028
mechanic.

00:10:02.048 --> 00:10:02.528
This isn't

00:10:04.128 --> 00:10:07.149
that exact of a science because we don't

00:10:07.190 --> 00:10:08.951
have the research, the understanding,

00:10:09.010 --> 00:10:11.032
the knowledge base and how our brain

00:10:11.131 --> 00:10:12.072
entirely works.

00:10:12.153 --> 00:10:13.514
It's a very complex thing,

00:10:13.614 --> 00:10:15.073
far more complex than a car.

00:10:17.535 --> 00:10:21.138
So I'm not saying theory and technique is

00:10:21.278 --> 00:10:21.658
useless.

00:10:21.798 --> 00:10:24.539
I am saying therapists over rely on

00:10:24.639 --> 00:10:27.881
theories that are theories and therapists

00:10:27.922 --> 00:10:30.423
who are not great become really dogmatic

00:10:30.442 --> 00:10:31.104
in their approaches.

00:10:31.874 --> 00:10:32.053
right?

00:10:32.354 --> 00:10:35.154
And so if we can't move with the

00:10:35.215 --> 00:10:37.115
science, if we can't follow the research,

00:10:37.436 --> 00:10:39.755
if we can't take correction in how we're

00:10:39.775 --> 00:10:40.356
doing therapy,

00:10:40.397 --> 00:10:42.998
then we're not doing therapy, right?

00:10:43.278 --> 00:10:45.957
We're practicing some sort of perceived

00:10:46.057 --> 00:10:48.479
identity around therapist,

00:10:48.739 --> 00:10:50.059
what type of therapist we are,

00:10:50.559 --> 00:10:53.020
which isn't how healing happens.

00:10:53.821 --> 00:10:54.000
Now,

00:10:56.299 --> 00:10:57.421
I have a lot to say about this.

00:10:57.900 --> 00:11:01.004
There's a lot of reasons how and why

00:11:01.423 --> 00:11:02.404
our profession got here.

00:11:03.025 --> 00:11:04.807
First, we didn't come from a strong,

00:11:04.886 --> 00:11:06.008
strong scientific background.

00:11:06.589 --> 00:11:07.889
You scroll way, way, way, way,

00:11:07.950 --> 00:11:09.211
way down on my YouTube page.

00:11:09.230 --> 00:11:10.893
You'll see my video of the three worst

00:11:10.952 --> 00:11:12.573
therapists and Freud is one of them.

00:11:13.014 --> 00:11:15.096
The father of psychotherapy was a bit of

00:11:15.115 --> 00:11:15.535
a dunce, right?

00:11:15.996 --> 00:11:17.817
I mean, he was a Coke addict,

00:11:17.938 --> 00:11:19.840
so maybe he was really smart before he

00:11:19.860 --> 00:11:20.480
started doing drugs,

00:11:20.681 --> 00:11:21.922
but it seems unlikely.

00:11:22.682 --> 00:11:23.062
Um,

00:11:24.844 --> 00:11:26.725
none of his stuff was scientific it didn't

00:11:26.745 --> 00:11:29.346
pass much rigor his first famous

00:11:29.385 --> 00:11:31.506
generation of students weren't a lot

00:11:31.606 --> 00:11:33.768
better honestly right and the idea that

00:11:33.788 --> 00:11:35.148
people are out here doing shadow work and

00:11:35.168 --> 00:11:36.609
talking about young still drives me a

00:11:36.708 --> 00:11:39.350
little bit batty because y'all that's not

00:11:39.389 --> 00:11:43.851
therapy just isn't right that's lit

00:11:43.892 --> 00:11:48.573
reviews um and i like young for a

00:11:48.634 --> 00:11:50.374
lit review i don't like him for therapy

00:11:51.294 --> 00:11:51.455
uh

00:11:52.461 --> 00:11:53.221
So again, I mean,

00:11:53.562 --> 00:11:55.143
we're not coming from a great historical

00:11:55.163 --> 00:11:55.543
place.

00:11:55.724 --> 00:11:58.385
I think the field as a whole went

00:11:58.405 --> 00:12:01.447
through a shift in the fifties when a

00:12:01.489 --> 00:12:04.071
much more humanist perspective came where

00:12:04.311 --> 00:12:06.251
therapist was less expert and more in the

00:12:06.332 --> 00:12:07.452
room as a real person.

00:12:08.313 --> 00:12:10.475
that's continued to grow and expand and

00:12:11.056 --> 00:12:12.736
again like our technology for what we

00:12:12.756 --> 00:12:13.778
could study with the brain our

00:12:13.878 --> 00:12:15.479
understanding of neuroscience our

00:12:15.578 --> 00:12:17.259
understanding of the brain and body

00:12:17.360 --> 00:12:19.682
connection has continued to grow and shift

00:12:20.121 --> 00:12:22.683
and that's really shaped the field and so

00:12:22.803 --> 00:12:24.865
i've seen people defend polyvagal just out

00:12:24.884 --> 00:12:26.566
of pocket and be like it works great

00:12:26.765 --> 00:12:28.527
my therapy my clients get better therefore

00:12:28.547 --> 00:12:30.249
it must be true this research is wrong

00:12:30.509 --> 00:12:32.309
that's unscientific and anti-intellectual

00:12:33.070 --> 00:12:33.270
uh but

00:12:34.030 --> 00:12:36.092
But so are people who want to just

00:12:36.293 --> 00:12:37.394
simply throw it out.

00:12:37.494 --> 00:12:37.734
Like,

00:12:38.195 --> 00:12:39.596
I think it's one of those things where

00:12:39.655 --> 00:12:41.096
the mechanism can be wrong.

00:12:41.216 --> 00:12:41.476
Great.

00:12:41.697 --> 00:12:43.399
Let's refine the mechanism, right?

00:12:43.418 --> 00:12:45.181
Let's understand what we're using as a

00:12:45.240 --> 00:12:47.523
metaphor or understand explaining

00:12:47.582 --> 00:12:48.682
something that's so complex.

00:12:48.724 --> 00:12:50.184
We don't have a full understanding of it

00:12:50.205 --> 00:12:50.384
yet,

00:12:50.424 --> 00:12:52.527
but let's explain what we do understand

00:12:52.567 --> 00:12:54.087
that's helpful for people that they can do

00:12:54.168 --> 00:12:55.089
something with.

00:12:55.469 --> 00:12:57.910
Let's use that to empower people rather

00:12:57.951 --> 00:12:58.110
than

00:12:59.167 --> 00:13:00.587
Saying like, hey,

00:13:00.768 --> 00:13:03.347
this is able to predict a positive outcome

00:13:03.729 --> 00:13:05.028
if we don't have that research, right?

00:13:05.048 --> 00:13:06.229
Those are different things.

00:13:10.650 --> 00:13:11.230
Talking in circles.

00:13:11.890 --> 00:13:13.172
Freud, not super scientific.

00:13:14.052 --> 00:13:16.575
Early Freud students who became popular in

00:13:16.595 --> 00:13:17.696
their own rights and have schools of

00:13:17.716 --> 00:13:17.936
thought,

00:13:17.975 --> 00:13:19.798
so we have to study in grad school,

00:13:19.837 --> 00:13:21.099
even though they're not scientifically

00:13:21.119 --> 00:13:22.961
validated, not great at science.

00:13:23.301 --> 00:13:26.243
The education system as a whole has really

00:13:26.342 --> 00:13:27.784
let the field down.

00:13:28.365 --> 00:13:30.407
I think in psychology's effort to prove

00:13:30.447 --> 00:13:32.668
itself as a hard science, it's really...

00:13:34.225 --> 00:13:35.126
gotten, again,

00:13:35.187 --> 00:13:36.927
dogmatic and I'm a religious trauma

00:13:36.947 --> 00:13:37.288
therapist.

00:13:37.307 --> 00:13:38.629
So I'll say like, again,

00:13:38.668 --> 00:13:39.948
when things stop being living and

00:13:39.989 --> 00:13:42.030
breathing and updatable and become rigid

00:13:42.051 --> 00:13:42.691
and dogmatic,

00:13:42.711 --> 00:13:44.272
it's when things start to crumble because

00:13:44.351 --> 00:13:46.633
that removes us from lived experience.

00:13:46.712 --> 00:13:48.715
That's what removes us from

00:13:49.900 --> 00:13:51.981
something that could be helpful to people

00:13:52.341 --> 00:13:53.621
here and now, right?

00:13:53.721 --> 00:13:55.982
If I have to cite and quote somebody

00:13:56.023 --> 00:13:58.322
from the eighteen nineties, Freud,

00:13:58.643 --> 00:14:00.864
or even the nineteen fifties, uh,

00:14:01.203 --> 00:14:03.043
that's probably not super relevant today.

00:14:03.264 --> 00:14:04.705
It might inform where we're at today.

00:14:04.725 --> 00:14:06.304
It might be helpful to know that some

00:14:06.325 --> 00:14:07.325
of that historical knowledge,

00:14:07.365 --> 00:14:09.865
but like it's a different thing.

00:14:09.946 --> 00:14:11.645
It's why religion becomes so harmful

00:14:11.686 --> 00:14:13.047
because it becomes dogmatic.

00:14:13.067 --> 00:14:14.267
When it gets too rigid,

00:14:14.307 --> 00:14:16.126
it stops being able to adapt and grow

00:14:16.147 --> 00:14:17.187
with lived experience.

00:14:18.107 --> 00:14:18.207
Uh,

00:14:19.303 --> 00:14:21.404
So I think we can't be dogmatic.

00:14:21.504 --> 00:14:23.385
I don't think like having a positive

00:14:23.505 --> 00:14:25.767
outcome means that our model is

00:14:26.267 --> 00:14:27.148
necessarily working.

00:14:27.248 --> 00:14:28.548
And when we study different models,

00:14:28.587 --> 00:14:30.609
we just don't see a predictive value that

00:14:30.649 --> 00:14:31.889
is able to say, hey,

00:14:31.970 --> 00:14:32.710
here's where we're going.

00:14:33.211 --> 00:14:35.652
The education system really pushes us

00:14:35.831 --> 00:14:37.172
young therapists, not me,

00:14:37.292 --> 00:14:38.052
I'm an old therapist,

00:14:39.078 --> 00:14:40.000
I'm not an old person.

00:14:40.039 --> 00:14:41.321
I've just been doing therapy for a long

00:14:41.360 --> 00:14:41.561
time.

00:14:43.962 --> 00:14:46.043
The pushes us to pick a model.

00:14:46.144 --> 00:14:46.524
And again,

00:14:46.644 --> 00:14:49.787
like your undergrad doesn't really prepare

00:14:49.826 --> 00:14:50.607
you for doing therapy.

00:14:50.687 --> 00:14:52.969
Your grad school teaches you pretty much

00:14:52.989 --> 00:14:54.451
how to do the first two sessions of

00:14:54.490 --> 00:14:55.431
therapy and that's it.

00:14:55.991 --> 00:14:57.732
And so I think a lot of therapists

00:14:57.812 --> 00:14:59.894
come out of grad school and we're not

00:14:59.934 --> 00:15:01.716
super well prepared on how to do much

00:15:01.855 --> 00:15:02.937
of anything.

00:15:04.182 --> 00:15:06.744
um i think younger therapists are way more

00:15:06.783 --> 00:15:10.765
informed than us older and and very much

00:15:10.806 --> 00:15:13.388
the very old therapists ever were um again

00:15:13.548 --> 00:15:16.049
as as the field continues to grow the

00:15:16.070 --> 00:15:18.211
amount of knowledge we have access to the

00:15:18.652 --> 00:15:20.373
technology we have to study the brain not

00:15:20.393 --> 00:15:21.634
just the technology we have to study the

00:15:21.653 --> 00:15:23.715
brain but what students have access to

00:15:23.774 --> 00:15:25.216
while they're learning and growing is

00:15:25.296 --> 00:15:28.658
crazy insane from the rise of the internet

00:15:29.038 --> 00:15:31.720
you know twenty six years ago it hasn't

00:15:31.740 --> 00:15:32.441
been around that long

00:15:33.041 --> 00:15:34.140
The internet has been around longer than

00:15:34.160 --> 00:15:35.302
that, but people's access to it,

00:15:35.581 --> 00:15:37.243
students' access to it hasn't been around

00:15:37.263 --> 00:15:37.682
that long.

00:15:38.462 --> 00:15:38.822
Again,

00:15:38.982 --> 00:15:40.524
our ability to study what's going on

00:15:40.663 --> 00:15:42.804
internally in the brain without it needing

00:15:42.825 --> 00:15:44.125
to be a dead body on a table

00:15:44.206 --> 00:15:45.586
is really, really great.

00:15:49.594 --> 00:15:51.413
I think it will continue to get better.

00:15:51.674 --> 00:15:53.195
And we're going to have these moments.

00:15:53.215 --> 00:15:54.195
We're going to have these events where the

00:15:54.215 --> 00:15:54.894
science says, hey,

00:15:54.934 --> 00:15:56.716
that mechanism is wrong.

00:15:57.296 --> 00:16:00.076
Or that proposed theory gets this piece of

00:16:00.116 --> 00:16:01.256
the theory wrong.

00:16:01.376 --> 00:16:02.697
This thing isn't replicatable.

00:16:02.756 --> 00:16:04.158
This isn't falsifiable.

00:16:04.197 --> 00:16:05.238
It's not good data.

00:16:05.758 --> 00:16:06.918
I think that stuff really matters.

00:16:07.538 --> 00:16:09.778
So we have not coming from a great

00:16:09.818 --> 00:16:12.099
scientific background, Freud, et cetera.

00:16:13.340 --> 00:16:13.559
We have...

00:16:14.379 --> 00:16:16.660
schools of thought really pushing us to to

00:16:16.721 --> 00:16:18.280
pick a thing like i don't know why

00:16:18.301 --> 00:16:19.860
people are doing gestalt therapy i don't

00:16:19.880 --> 00:16:20.740
know why people are still doing

00:16:20.801 --> 00:16:22.761
psychoanalysis y'all out on the east coast

00:16:22.841 --> 00:16:24.221
a one percent of therapists who still

00:16:24.261 --> 00:16:26.163
identify as psychoanalysts like what are

00:16:26.222 --> 00:16:32.604
we doing what are we doing not a

00:16:32.644 --> 00:16:34.605
rhetorical question it's rhetorical in the

00:16:34.644 --> 00:16:36.225
sense that i'm here recording by myself

00:16:36.966 --> 00:16:37.687
But like, again,

00:16:37.967 --> 00:16:39.748
the idea that people are out here doing

00:16:39.788 --> 00:16:42.328
stuff that is specifically not scientific,

00:16:42.369 --> 00:16:44.269
the way that I look at a hypnotherapist

00:16:44.289 --> 00:16:47.071
who's doing therapy and think, nah, bro,

00:16:47.130 --> 00:16:47.850
that's not it.

00:16:49.211 --> 00:16:50.751
We shouldn't be doing things that we know

00:16:50.812 --> 00:16:51.393
are false.

00:16:52.153 --> 00:16:53.653
based on some sort of cult of personality.

00:16:54.434 --> 00:16:55.916
And the current model, you know,

00:16:56.275 --> 00:16:57.996
I don't think Porges really got the cult

00:16:58.017 --> 00:16:58.697
of personality.

00:16:58.736 --> 00:16:59.957
He's not a name that's probably well

00:16:59.977 --> 00:17:01.980
known, but his theory is well known,

00:17:02.399 --> 00:17:03.860
where Bessel van der Kolk is a much

00:17:03.900 --> 00:17:05.582
better option here to talk about his cult

00:17:05.602 --> 00:17:06.261
of personality,

00:17:06.803 --> 00:17:09.964
where The Body Keeps the Score shifted the

00:17:09.984 --> 00:17:11.346
way that we talk about therapy,

00:17:11.806 --> 00:17:13.287
talk about trauma in the field.

00:17:13.727 --> 00:17:15.469
And again, I think for the better,

00:17:16.998 --> 00:17:19.660
I land on to be trauma-informed,

00:17:20.540 --> 00:17:21.642
to work with trauma clients.

00:17:21.842 --> 00:17:23.403
All these things are far more accessible

00:17:23.483 --> 00:17:24.765
now than they ever were before.

00:17:25.265 --> 00:17:26.685
And there are things that van der Kolk

00:17:26.747 --> 00:17:27.186
got wrong.

00:17:27.686 --> 00:17:29.269
Van der Kolk does seem to be open

00:17:29.308 --> 00:17:31.770
to scientific inquiry and updating his

00:17:31.830 --> 00:17:32.291
theories.

00:17:32.632 --> 00:17:33.031
But again,

00:17:33.152 --> 00:17:34.693
it's been a decade since his book came

00:17:34.733 --> 00:17:34.874
out,

00:17:34.933 --> 00:17:36.516
and it's outdated in a lot of ways

00:17:36.635 --> 00:17:36.955
already.

00:17:37.476 --> 00:17:38.616
And that was a pivotal thing.

00:17:39.198 --> 00:17:39.357
Now,

00:17:39.597 --> 00:17:41.539
I don't think he came up with this

00:17:41.660 --> 00:17:42.760
idea all by himself.

00:17:42.840 --> 00:17:44.402
Again, this is an older idea,

00:17:44.442 --> 00:17:46.002
but his book was written in a way

00:17:46.103 --> 00:17:47.845
and with some scientific rigor behind it

00:17:47.884 --> 00:17:50.366
because he had an institute that he could

00:17:50.406 --> 00:17:52.888
study at right away where that was really

00:17:53.048 --> 00:17:53.588
helpful.

00:17:54.109 --> 00:17:55.009
I don't think...

00:17:55.911 --> 00:17:58.292
He needed to be the front and center

00:17:58.313 --> 00:17:58.614
about it.

00:17:58.673 --> 00:17:58.993
And again,

00:17:59.034 --> 00:18:00.315
I think people putting him on a pedestal

00:18:00.335 --> 00:18:01.375
and then it came out that he's an

00:18:01.435 --> 00:18:02.777
asshole and he's not a good person to

00:18:02.817 --> 00:18:03.198
work with.

00:18:03.258 --> 00:18:04.459
And like, again,

00:18:04.499 --> 00:18:06.180
you can be a good researcher and a

00:18:06.240 --> 00:18:07.101
bad boss.

00:18:07.141 --> 00:18:09.843
You can be a great researcher and a

00:18:09.903 --> 00:18:10.703
terrible therapist.

00:18:10.723 --> 00:18:12.205
You can be a terrible researcher and a

00:18:12.266 --> 00:18:13.105
good therapist.

00:18:13.165 --> 00:18:13.366
Again,

00:18:13.386 --> 00:18:14.928
this is where we get some nuance on

00:18:14.948 --> 00:18:16.669
these things is to not put any of

00:18:16.689 --> 00:18:17.849
these people on a pedestal.

00:18:18.330 --> 00:18:19.511
I will say Harleen Anderson,

00:18:19.571 --> 00:18:22.173
who really informed my career is a

00:18:22.233 --> 00:18:22.714
delight.

00:18:24.211 --> 00:18:25.412
They say don't meet your heroes,

00:18:25.451 --> 00:18:27.653
but Harleen is wonderful.

00:18:28.353 --> 00:18:29.473
And I'm being a little tongue in cheek

00:18:29.493 --> 00:18:30.114
about that, right?

00:18:30.153 --> 00:18:31.694
Like all my interactions with her have

00:18:31.714 --> 00:18:32.234
been lovely.

00:18:32.295 --> 00:18:32.755
I'm excited.

00:18:32.815 --> 00:18:34.195
I get to see her in person again

00:18:34.256 --> 00:18:34.556
soon.

00:18:36.115 --> 00:18:36.796
But again, she's,

00:18:37.176 --> 00:18:38.696
her whole model is based on like,

00:18:39.336 --> 00:18:40.557
this isn't about techniques.

00:18:40.577 --> 00:18:41.657
This isn't like, I'm not,

00:18:41.758 --> 00:18:43.338
I'm not needing to teach you a tool

00:18:43.378 --> 00:18:44.278
on how to be helpful.

00:18:45.038 --> 00:18:46.660
And so I think,

00:18:47.239 --> 00:18:49.640
the cults of personality and also like the

00:18:49.759 --> 00:18:53.061
academic rigor needs to be much different

00:18:53.201 --> 00:18:55.942
it's it's too many old white men being

00:18:56.063 --> 00:18:58.384
experts and i'm not saying that old white

00:18:58.403 --> 00:19:01.006
men can't be experts i'm simply suggesting

00:19:01.026 --> 00:19:03.007
that who we have put on pedestals in

00:19:03.027 --> 00:19:05.208
the field has predominantly been people

00:19:05.228 --> 00:19:06.728
who have taken other people's ideas and

00:19:06.748 --> 00:19:08.888
just had access to the scientific rigor to

00:19:09.088 --> 00:19:09.769
get published

00:19:10.490 --> 00:19:12.270
and not published in an academic journal,

00:19:12.451 --> 00:19:14.592
but get published mainstream.

00:19:14.971 --> 00:19:16.153
And that's the big difference, right?

00:19:16.292 --> 00:19:18.894
That's still our society still looks at

00:19:19.453 --> 00:19:21.974
those people as the leading experts in a

00:19:22.015 --> 00:19:23.935
field that is female dominated.

00:19:24.633 --> 00:19:24.833
Right.

00:19:24.913 --> 00:19:26.295
Like there's more female therapists than

00:19:26.315 --> 00:19:26.634
male,

00:19:27.695 --> 00:19:31.000
but not probably more female researchers

00:19:31.059 --> 00:19:32.701
than male and certainly probably not

00:19:32.760 --> 00:19:33.261
published.

00:19:34.242 --> 00:19:35.443
So that's still like, again,

00:19:35.523 --> 00:19:37.246
the sort of the water that we swim

00:19:37.306 --> 00:19:37.425
in.

00:19:37.967 --> 00:19:40.048
I think connection to academia is a

00:19:40.088 --> 00:19:41.911
problem because that's who can get that's

00:19:41.931 --> 00:19:42.971
who can do research.

00:19:43.031 --> 00:19:46.395
But then we're centering college kids as

00:19:46.435 --> 00:19:47.596
our research team.

00:19:47.796 --> 00:19:50.442
basis right one of the the i think

00:19:50.501 --> 00:19:53.488
valid criticisms of best of body keeps the

00:19:53.508 --> 00:19:55.752
score is it's looking at trauma through

00:19:55.772 --> 00:19:56.494
the lens of like

00:19:57.434 --> 00:20:00.857
capital T PTSD and it misses a lot

00:20:00.877 --> 00:20:03.681
of things about complex PTSD because where

00:20:04.040 --> 00:20:06.844
he was studying people was for veterans.

00:20:07.365 --> 00:20:07.644
And again,

00:20:07.984 --> 00:20:09.406
that's gonna skew some of your data,

00:20:09.426 --> 00:20:10.227
that's gonna skew some of the

00:20:10.267 --> 00:20:10.728
understanding.

00:20:11.208 --> 00:20:13.109
Any theory that comes out of that is

00:20:13.150 --> 00:20:15.291
going to work really well for those people

00:20:15.352 --> 00:20:16.953
and it misses an entire swath of the

00:20:16.993 --> 00:20:17.535
population.

00:20:18.234 --> 00:20:19.296
and so i think we need to be

00:20:19.316 --> 00:20:21.176
able to expand some of these things again

00:20:21.217 --> 00:20:22.938
i think this is actually where really good

00:20:22.978 --> 00:20:24.838
science does matter because things need to

00:20:24.858 --> 00:20:28.339
be falsifiable this is research methods

00:20:28.500 --> 00:20:30.361
one-on-one like you need to have a null

00:20:30.401 --> 00:20:32.742
hypothesis not just what is true if my

00:20:33.442 --> 00:20:36.064
hypothesis is accurate but what is what

00:20:36.084 --> 00:20:38.766
happens if my hypothesis is wrong and so

00:20:38.786 --> 00:20:40.125
you need to have data that's falsifiable

00:20:40.185 --> 00:20:42.627
otherwise again we're doing pseudoscience

00:20:42.728 --> 00:20:46.410
at best or religion at worst and so

00:20:47.445 --> 00:20:51.028
certainly with some of the big culty

00:20:51.048 --> 00:20:52.848
personality figures in the psychology

00:20:52.868 --> 00:20:53.088
world,

00:20:53.328 --> 00:20:54.809
we certainly need to be careful of that.

00:20:54.849 --> 00:20:55.890
The people who tend to get the most

00:20:55.970 --> 00:20:58.090
mainstream media are not the people that I

00:20:58.131 --> 00:21:00.873
would want talking for therapy as a

00:21:00.913 --> 00:21:01.313
profession.

00:21:03.626 --> 00:21:05.989
the the way that money is made off

00:21:06.009 --> 00:21:07.528
of research the way that research is

00:21:07.670 --> 00:21:11.352
funded the way that therapists move from

00:21:11.491 --> 00:21:13.873
full caseload of working in like their

00:21:13.972 --> 00:21:16.055
practice to like speaking to our

00:21:16.095 --> 00:21:20.136
multi-millionaires is again like a problem

00:21:21.157 --> 00:21:23.038
and i don't have a fix it's

00:21:24.570 --> 00:21:25.811
The problem is capitalism.

00:21:26.913 --> 00:21:29.094
If somebody were to offer me Joe Rogan

00:21:29.153 --> 00:21:31.736
money to do this and not see clients,

00:21:31.756 --> 00:21:33.497
I would have a hard time saying no,

00:21:34.076 --> 00:21:36.259
because I have kids and I've been doing

00:21:36.278 --> 00:21:38.180
this for a long time and not getting

00:21:38.240 --> 00:21:39.540
ahead because I'm a millennial.

00:21:39.961 --> 00:21:41.261
It would be hard to turn down that

00:21:41.301 --> 00:21:42.163
financial security.

00:21:42.442 --> 00:21:44.424
And I don't want to do this

00:21:44.464 --> 00:21:45.005
professionally.

00:21:45.065 --> 00:21:46.105
I want to do therapy.

00:21:46.165 --> 00:21:47.906
I like sitting in my office with people.

00:21:47.946 --> 00:21:50.588
I like helping people on that level.

00:21:51.210 --> 00:21:52.830
And so, again,

00:21:52.931 --> 00:21:55.593
I think some of it is an over-reliance

00:21:55.633 --> 00:21:56.433
on academia.

00:21:56.554 --> 00:21:58.055
And, again, you're like, but, Jerry,

00:21:58.075 --> 00:21:58.955
you're talking on both sides of your

00:21:58.976 --> 00:21:59.155
mouth.

00:21:59.715 --> 00:22:00.356
I get that.

00:22:00.416 --> 00:22:01.498
That's where the nuance comes in.

00:22:01.518 --> 00:22:02.759
We do need good science,

00:22:02.778 --> 00:22:04.960
but we need good science that's devoid of

00:22:05.401 --> 00:22:08.043
the financial –

00:22:07.268 --> 00:22:10.589
uh repercussions the financial benefit to

00:22:10.750 --> 00:22:13.372
skew your data or to only publish

00:22:13.571 --> 00:22:16.012
promising data when i said earlier that

00:22:16.032 --> 00:22:18.054
like antidepressants aren't that aren't

00:22:18.094 --> 00:22:20.236
more effective than placebo effect that's

00:22:20.276 --> 00:22:22.797
been known information for a long time and

00:22:22.856 --> 00:22:24.057
a lot of therapists don't know that

00:22:24.157 --> 00:22:25.578
because that's only when we do meta

00:22:25.618 --> 00:22:29.500
analyses on all of uh big pharma's

00:22:29.780 --> 00:22:31.582
unpublished studies again when they're

00:22:31.622 --> 00:22:33.103
cherry picking which studies to publish

00:22:33.143 --> 00:22:34.604
and which ones don't we don't get the

00:22:34.663 --> 00:22:36.244
full view of the information

00:22:37.662 --> 00:22:39.703
So, you know,

00:22:39.743 --> 00:22:41.105
like this is a real problem,

00:22:41.525 --> 00:22:43.987
who we put on pedestals,

00:22:44.127 --> 00:22:46.809
who gets the megaphone for the profession.

00:22:47.430 --> 00:22:47.931
And again,

00:22:48.010 --> 00:22:50.252
there's an incentive to have a model that

00:22:50.353 --> 00:22:51.273
prints well,

00:22:51.433 --> 00:22:54.096
to have a model that is publishable.

00:22:54.476 --> 00:22:56.218
And again, I'm talking mainstream there,

00:22:56.298 --> 00:22:58.098
not just in academic journals to have

00:22:58.138 --> 00:23:01.622
something that has fun algorithm or not

00:23:01.682 --> 00:23:02.163
algorithms.

00:23:02.603 --> 00:23:04.282
not anagrams what's the word i'm looking

00:23:04.303 --> 00:23:07.644
for um but you know little mnemonic

00:23:07.663 --> 00:23:09.483
devices where you can remember something

00:23:09.523 --> 00:23:12.384
five love languages still sells pretty

00:23:12.404 --> 00:23:14.644
well even though that's worse than

00:23:14.684 --> 00:23:16.286
pseudoscience it's just religious

00:23:16.326 --> 00:23:21.586
propaganda um right and and so therapists

00:23:21.707 --> 00:23:23.707
come up with models that are weak on

00:23:23.747 --> 00:23:25.907
the science that that don't necessarily

00:23:25.968 --> 00:23:27.728
have um

00:23:28.961 --> 00:23:30.482
an understanding of the scientific

00:23:30.563 --> 00:23:32.163
mechanism by which it works,

00:23:32.505 --> 00:23:32.924
spoiler alert,

00:23:32.944 --> 00:23:34.445
because it's just the relationship,

00:23:34.905 --> 00:23:36.106
but get good outcomes.

00:23:36.247 --> 00:23:37.448
And so somebody who's getting good

00:23:37.548 --> 00:23:39.269
outcomes then writes this thing that's

00:23:39.288 --> 00:23:42.171
very catchy and it's able to be packaged

00:23:42.811 --> 00:23:44.932
in a fun, trendy way.

00:23:45.673 --> 00:23:49.056
And it goes on Oprah or some celebrity

00:23:49.096 --> 00:23:50.916
mentions it in a live stream and suddenly

00:23:50.936 --> 00:23:52.077
we're off to the races, right?

00:23:53.558 --> 00:23:55.839
That often outpaces where the data

00:23:55.960 --> 00:23:56.539
actually is,

00:23:56.579 --> 00:23:58.079
and that is opposite of what it should

00:23:58.099 --> 00:23:58.299
be.

00:23:58.359 --> 00:23:58.861
But again,

00:23:58.941 --> 00:24:00.661
in our current financial situation,

00:24:01.661 --> 00:24:03.622
it's really hard to not sort of have

00:24:03.902 --> 00:24:05.342
money be a driving factor,

00:24:05.402 --> 00:24:12.784
and that makes the science worse.

00:24:12.903 --> 00:24:13.724
As a professional,

00:24:13.825 --> 00:24:15.325
somebody who's spent a lot of time and

00:24:15.384 --> 00:24:17.306
money and energy getting licensed,

00:24:17.346 --> 00:24:18.885
getting trained, having all these things,

00:24:19.865 --> 00:24:21.346
staying up to date on things like

00:24:21.406 --> 00:24:21.807
research,

00:24:23.145 --> 00:24:26.366
I don't want to be chiropractors.

00:24:27.507 --> 00:24:29.048
And this is where a lot of the

00:24:29.107 --> 00:24:30.949
nuance comes in because I have clients who

00:24:30.989 --> 00:24:32.009
go and see their chiropractor.

00:24:32.048 --> 00:24:33.789
My partner sees a chiropractor.

00:24:34.930 --> 00:24:36.891
And I think the science on chiropractic is

00:24:36.931 --> 00:24:37.451
really weak.

00:24:37.510 --> 00:24:39.070
And I think we know it came from

00:24:39.090 --> 00:24:40.612
a place of somebody having dreams about

00:24:40.692 --> 00:24:42.432
ghosts telling them what to do and that

00:24:42.791 --> 00:24:43.492
is supposed to work.

00:24:43.532 --> 00:24:46.574
And that can't work.

00:24:46.773 --> 00:24:48.794
This is why chiropractic does harm.

00:24:48.814 --> 00:24:49.855
This is why people get hurt.

00:24:49.894 --> 00:24:50.355
This is why

00:24:50.922 --> 00:24:52.182
Other professionals don't like

00:24:52.241 --> 00:24:55.703
chiropractic and we can't get so dogmatic

00:24:55.743 --> 00:24:56.624
that we say, hey,

00:24:58.345 --> 00:24:59.865
this person is in pain and this thing

00:24:59.904 --> 00:25:00.605
makes them feel better.

00:25:00.644 --> 00:25:02.046
Let's get curious about that.

00:25:02.086 --> 00:25:03.145
Let's learn more about that.

00:25:03.165 --> 00:25:04.747
Let's see if we can understand where or

00:25:04.807 --> 00:25:05.946
why that's coming from.

00:25:07.086 --> 00:25:08.928
Placebo effect only explains about thirty

00:25:08.968 --> 00:25:09.688
percent of the cases,

00:25:10.028 --> 00:25:11.088
so that can't be all of it.

00:25:12.150 --> 00:25:13.651
The reduction of pain,

00:25:13.791 --> 00:25:16.074
the elimination of a symptom is a helpful

00:25:16.114 --> 00:25:16.394
thing.

00:25:16.433 --> 00:25:18.415
We don't need to be dogmatic and control

00:25:18.516 --> 00:25:19.356
where that comes from.

00:25:19.396 --> 00:25:20.176
We don't need to say, no,

00:25:20.217 --> 00:25:21.798
that's not real for people who are

00:25:21.838 --> 00:25:23.119
experiencing real relief.

00:25:23.820 --> 00:25:24.942
But we also need to be able to

00:25:24.981 --> 00:25:27.344
eliminate as much harm as we can.

00:25:27.384 --> 00:25:29.285
Again, part of carrying our license is

00:25:30.265 --> 00:25:32.708
to not harm people, right?

00:25:32.948 --> 00:25:34.770
That's why we carry malpractice insurance,

00:25:34.790 --> 00:25:36.112
because even with our best intentions,

00:25:36.472 --> 00:25:38.536
things could still go wrong and there

00:25:38.556 --> 00:25:39.916
needs to be some accountability that.

00:25:40.498 --> 00:25:41.499
So, you know,

00:25:42.400 --> 00:25:44.943
we don't want to diminish people's sense

00:25:44.983 --> 00:25:46.105
of relief and

00:25:46.846 --> 00:25:49.247
that relief is anecdotal at best.

00:25:49.307 --> 00:25:51.208
It doesn't necessarily lead to predictive

00:25:51.288 --> 00:25:51.788
outcomes.

00:25:51.868 --> 00:25:54.710
It doesn't lead to an explanation on the

00:25:54.789 --> 00:25:57.050
mechanism in which that relief comes from.

00:25:57.711 --> 00:25:59.132
I have clients who go and see

00:25:59.211 --> 00:26:01.613
acupuncturists and I am skeptical on the

00:26:01.633 --> 00:26:02.273
science of that.

00:26:02.594 --> 00:26:04.454
And that's the thing that's been providing

00:26:04.555 --> 00:26:06.596
relief for millennia for people.

00:26:06.915 --> 00:26:08.616
So like there's something to it.

00:26:09.798 --> 00:26:10.917
Would I feel better if there was a

00:26:10.958 --> 00:26:12.378
better explanation than,

00:26:14.306 --> 00:26:16.468
mystical ancient ways and again i've not

00:26:16.488 --> 00:26:19.470
studied it so i'm sure there are but

00:26:19.670 --> 00:26:21.611
you know we we need to be able

00:26:21.671 --> 00:26:27.035
to look at the mechanism and that matters

00:26:27.675 --> 00:26:28.695
um but that's not the be all end

00:26:28.715 --> 00:26:30.718
all i think again the meaning that that

00:26:30.738 --> 00:26:32.159
clients take from what we're giving them

00:26:32.179 --> 00:26:33.700
but the meaning that we also put into

00:26:33.839 --> 00:26:36.261
our school of thought our identity as

00:26:36.321 --> 00:26:37.942
therapists um

00:26:39.400 --> 00:26:40.881
It's really important that we continue to

00:26:40.961 --> 00:26:42.661
learn and grow in our understanding of the

00:26:42.701 --> 00:26:43.362
nervous system.

00:26:43.382 --> 00:26:45.241
This is an important thing in how we

00:26:45.281 --> 00:26:45.722
exist.

00:26:46.103 --> 00:26:47.623
One of the really bad takes that I've

00:26:47.663 --> 00:26:49.723
seen on this topic is, great,

00:26:49.743 --> 00:26:51.125
now therapists can get back to doing

00:26:51.164 --> 00:26:52.424
psychology because that's what we're

00:26:52.444 --> 00:26:52.865
trained in.

00:26:53.405 --> 00:26:54.726
And the implication being,

00:26:54.766 --> 00:26:56.606
focus on the brain because that's all you

00:26:56.626 --> 00:26:56.826
know.

00:26:56.926 --> 00:26:58.008
Get out of the body.

00:26:58.067 --> 00:27:00.528
Stop doing somatic experiencing.

00:27:01.169 --> 00:27:04.934
And that's bullshit because my child,

00:27:04.954 --> 00:27:05.876
who's five years old,

00:27:05.936 --> 00:27:07.699
understands that his brain is housed in

00:27:07.759 --> 00:27:08.340
his body.

00:27:08.381 --> 00:27:09.663
These are not two separate things.

00:27:09.982 --> 00:27:11.625
The idea that mental health is somehow

00:27:11.826 --> 00:27:13.808
separate from physical health is

00:27:13.909 --> 00:27:14.851
preposterous.

00:27:16.363 --> 00:27:17.643
Do we need to learn more?

00:27:17.682 --> 00:27:18.884
Do we need to continue to grow?

00:27:18.943 --> 00:27:20.663
Should therapists have more training on

00:27:20.703 --> 00:27:22.104
what goes on physically in the body?

00:27:22.144 --> 00:27:23.484
Should doctors have more training on what

00:27:23.505 --> 00:27:24.464
goes on in the mental health?

00:27:24.825 --> 00:27:25.444
Yeah, absolutely.

00:27:25.464 --> 00:27:27.125
These shouldn't be siloed things.

00:27:28.205 --> 00:27:28.506
And again,

00:27:28.586 --> 00:27:30.006
getting dogmatic about it and saying

00:27:30.046 --> 00:27:31.586
therapists stick to the brain is

00:27:31.626 --> 00:27:32.067
preposterous.

00:27:32.126 --> 00:27:34.406
So many of my clients have physical

00:27:34.446 --> 00:27:36.008
symptoms that their doctors are telling

00:27:36.028 --> 00:27:37.147
them are mental.

00:27:38.529 --> 00:27:40.151
It's the expert in the room on the

00:27:40.230 --> 00:27:41.491
mental health side of things.

00:27:41.511 --> 00:27:43.253
This isn't a thing I have an answer

00:27:43.273 --> 00:27:43.433
to.

00:27:43.473 --> 00:27:44.934
It's a physical symptom first.

00:27:45.695 --> 00:27:46.536
So again,

00:27:47.336 --> 00:27:48.778
I think this is really important that we

00:27:48.798 --> 00:27:49.818
continue to learn and grow,

00:27:49.858 --> 00:27:51.299
but not be dogmatic about it.

00:27:52.164 --> 00:27:53.685
part of where I think therapists are

00:27:53.705 --> 00:27:56.008
falling into the dogma of it is that

00:27:56.087 --> 00:27:58.570
therapists are held to this standard that

00:27:58.611 --> 00:27:59.912
a lot of other people aren't.

00:28:00.612 --> 00:28:02.134
We are held to a similar standard to

00:28:02.173 --> 00:28:02.574
doctors,

00:28:02.614 --> 00:28:04.336
but we are not compensated the way doctors

00:28:04.476 --> 00:28:04.635
are.

00:28:05.076 --> 00:28:07.557
We are held to a similar standard to

00:28:07.718 --> 00:28:08.679
high professionals,

00:28:08.739 --> 00:28:08.878
but

00:28:09.640 --> 00:28:12.701
not given that cultural respect,

00:28:13.121 --> 00:28:15.001
but really financial is the big piece,

00:28:15.082 --> 00:28:15.342
right?

00:28:15.422 --> 00:28:18.604
Like we don't have the same tax bracket

00:28:18.743 --> 00:28:19.423
as other people.

00:28:19.443 --> 00:28:20.584
And we're continuing to have to fight for

00:28:20.604 --> 00:28:20.703
that.

00:28:20.723 --> 00:28:22.785
We're continuing to fight to be included

00:28:22.944 --> 00:28:25.526
in payments from Medicaid and Medicare.

00:28:25.546 --> 00:28:27.067
We're continuing to have to fight to be

00:28:27.106 --> 00:28:29.307
able to see clients in the way we

00:28:29.347 --> 00:28:29.788
need to,

00:28:29.847 --> 00:28:31.288
that's helpful in the way we want to

00:28:31.308 --> 00:28:32.048
be reimbursed.

00:28:32.689 --> 00:28:33.950
And so, yeah,

00:28:34.950 --> 00:28:37.152
therapists spend a lot of money on

00:28:37.311 --> 00:28:40.153
trainings and and i think again therapists

00:28:40.493 --> 00:28:43.576
y'all hey hi speaking to my profession

00:28:43.616 --> 00:28:46.959
here we need to be savvier in where

00:28:47.038 --> 00:28:49.621
we are spending our money and getting our

00:28:49.661 --> 00:28:52.983
trainings because things like ifs i'm

00:28:53.003 --> 00:28:56.646
gonna throw emdr in there um polyvagal

00:28:56.666 --> 00:29:00.009
theory art uh accelerated uh resolution

00:29:00.068 --> 00:29:00.509
therapy

00:29:01.029 --> 00:29:02.612
Like if you're having to spend thousands

00:29:02.652 --> 00:29:04.393
of dollars on a training and that training

00:29:04.413 --> 00:29:05.173
has a wait list,

00:29:05.253 --> 00:29:08.156
like skeptical immediately.

00:29:08.738 --> 00:29:10.699
If I found out something really great for

00:29:10.740 --> 00:29:12.221
clients and I went and had it tested

00:29:12.280 --> 00:29:14.522
somewhere and it proved valuable and

00:29:14.563 --> 00:29:15.284
reliable to people,

00:29:16.224 --> 00:29:17.566
I would want to make some money off

00:29:17.605 --> 00:29:17.926
of that,

00:29:17.967 --> 00:29:19.928
but I wouldn't put health and wellness and

00:29:20.189 --> 00:29:21.029
helping people,

00:29:21.049 --> 00:29:22.230
which is my entire profession,

00:29:22.270 --> 00:29:23.132
behind a paywall.

00:29:23.771 --> 00:29:25.095
I wouldn't have people having to sign an

00:29:25.255 --> 00:29:26.978
NDA to be able to take my training.

00:29:27.378 --> 00:29:29.522
That makes me think it's snake oil.

00:29:29.762 --> 00:29:31.226
It has to be.

00:29:33.153 --> 00:29:34.055
right?

00:29:34.075 --> 00:29:35.496
But therapists spend a lot of money

00:29:36.036 --> 00:29:37.457
overcoming their own self-doubt,

00:29:37.557 --> 00:29:38.958
overcoming their lack of training they got

00:29:38.978 --> 00:29:40.618
from their education that they paid a lot

00:29:40.638 --> 00:29:41.219
of money for.

00:29:41.680 --> 00:29:43.340
We have these ideas that we need to

00:29:43.381 --> 00:29:44.020
train, train,

00:29:44.060 --> 00:29:45.182
train more and more and more,

00:29:45.301 --> 00:29:48.703
which is valid because knowledge keeps

00:29:48.743 --> 00:29:49.644
growing and increasing,

00:29:49.724 --> 00:29:51.326
so we should keep growing and increasing

00:29:51.365 --> 00:29:52.067
in our knowledge.

00:29:53.448 --> 00:29:54.488
But when you spend a lot of money

00:29:54.508 --> 00:29:55.648
to get trained in EMDR,

00:29:55.709 --> 00:29:57.210
you're going to use EMDR a lot.

00:29:57.250 --> 00:29:58.310
When you spend a lot of money to

00:29:58.330 --> 00:30:00.511
get trained in brain spotting or in IFS

00:30:00.632 --> 00:30:01.393
or whatever it is,

00:30:01.432 --> 00:30:02.973
you're going to use it a lot because

00:30:04.474 --> 00:30:06.195
Because we as therapists also have

00:30:06.596 --> 00:30:08.718
cognitive shortcuts that we take that are

00:30:08.758 --> 00:30:09.699
based on fallacies,

00:30:09.719 --> 00:30:11.560
that sunken cost fallacy that like if we

00:30:11.580 --> 00:30:12.461
spend a lot of money on it,

00:30:12.500 --> 00:30:14.022
then we must get our money's worth from

00:30:14.063 --> 00:30:14.163
it.

00:30:14.843 --> 00:30:16.664
And I support people doing trainings,

00:30:16.684 --> 00:30:17.285
getting paid.

00:30:17.424 --> 00:30:18.865
I don't think people should be giving away

00:30:18.885 --> 00:30:19.886
their labor for free.

00:30:19.946 --> 00:30:21.647
I'm opposed to that.

00:30:22.608 --> 00:30:26.472
And having seen people early on in their

00:30:26.492 --> 00:30:28.714
profession speak and not be particularly

00:30:28.855 --> 00:30:31.217
impressed or astounded at what they're

00:30:31.317 --> 00:30:33.398
trying to articulate and then see them

00:30:33.459 --> 00:30:35.480
publish a book that hits New York Times

00:30:35.500 --> 00:30:36.922
bestseller and then suddenly they're

00:30:36.942 --> 00:30:38.643
charging people thousands and thousands of

00:30:38.702 --> 00:30:40.203
dollars for weekend trainings.

00:30:40.243 --> 00:30:40.424
Like,

00:30:41.222 --> 00:30:42.124
That's not it, y'all.

00:30:42.163 --> 00:30:43.403
That isn't sustainable.

00:30:43.443 --> 00:30:44.964
That isn't where health and wellness is

00:30:45.005 --> 00:30:45.546
gonna come from.

00:30:45.965 --> 00:30:48.007
And then us therapists who spent all that

00:30:48.047 --> 00:30:50.548
money on those trainings go back and have

00:30:50.628 --> 00:30:51.868
to have that be meaningful for our

00:30:51.909 --> 00:30:52.349
clients,

00:30:52.769 --> 00:30:54.090
which isn't meeting our clients where

00:30:54.111 --> 00:30:54.550
they're at.

00:30:54.671 --> 00:30:56.811
And so I do think there's like a

00:30:56.892 --> 00:30:59.574
cannibalism in the therapy world of

00:31:00.054 --> 00:31:01.634
marketing to other therapists,

00:31:01.976 --> 00:31:03.596
making trainings for other therapists,

00:31:03.636 --> 00:31:05.478
like preying on the idea that especially

00:31:05.518 --> 00:31:07.019
young therapists don't feel particularly

00:31:07.058 --> 00:31:09.259
confident or well-prepared to meet their

00:31:09.299 --> 00:31:10.401
clients where they're at.

00:31:11.340 --> 00:31:13.182
and because we're all strapped for cash

00:31:13.242 --> 00:31:15.305
and we're all worried about money that

00:31:15.325 --> 00:31:17.006
like we need to operate in this way

00:31:17.026 --> 00:31:19.828
that really maximizes our dollars and like

00:31:20.528 --> 00:31:22.131
yeah i don't know i don't have a

00:31:22.151 --> 00:31:24.752
solution other than to not do capitalism

00:31:24.792 --> 00:31:27.275
anymore but like it it is a problem

00:31:27.375 --> 00:31:29.457
i see really good therapists go and get

00:31:29.517 --> 00:31:31.759
trainings and then just do that thing

00:31:31.799 --> 00:31:33.320
that's like a little in my opinion

00:31:33.381 --> 00:31:33.921
questionable

00:31:34.582 --> 00:31:35.723
I've known a lot of therapists who go

00:31:35.763 --> 00:31:37.767
and do EMDR training and then they just

00:31:37.826 --> 00:31:39.568
start doing EMDR because their caseload

00:31:39.588 --> 00:31:41.451
will fill up because clients have grown to

00:31:41.491 --> 00:31:42.753
associate that with some sort of

00:31:42.794 --> 00:31:44.336
scientific rigor that I just don't think

00:31:44.375 --> 00:31:44.836
is there.

00:31:46.115 --> 00:31:49.036
so when good therapists who are good at

00:31:49.056 --> 00:31:51.675
helping people niche down too hard which

00:31:51.715 --> 00:31:53.116
is what we're taught to do which as

00:31:53.176 --> 00:31:54.957
business owners we're told we need to have

00:31:54.997 --> 00:31:57.238
a niche or else we can't sell our

00:31:57.278 --> 00:31:59.657
business in this algorithm driven world we

00:31:59.678 --> 00:32:01.739
have all this pressure to do therapy again

00:32:01.818 --> 00:32:03.239
in a way that isn't what we want

00:32:03.259 --> 00:32:04.818
to be doing a lot of us who

00:32:04.839 --> 00:32:06.599
are in private practice have left

00:32:07.039 --> 00:32:09.161
taking insurance so that insurance

00:32:09.181 --> 00:32:11.102
companies aren't dictating how and when we

00:32:11.122 --> 00:32:12.843
can do therapy but then we go and

00:32:12.863 --> 00:32:14.403
do these trainings that dictate how and

00:32:14.423 --> 00:32:15.804
when we do therapy and it's the same

00:32:15.864 --> 00:32:17.285
thing it's just coming from a different

00:32:17.345 --> 00:32:19.645
source so i think therapists need to be

00:32:19.705 --> 00:32:22.047
a little savvier need to be more critical

00:32:22.146 --> 00:32:23.508
and hold their trainings to the same

00:32:23.548 --> 00:32:25.449
standard that we would hold anything else

00:32:25.469 --> 00:32:27.269
if we want to say we're empirically based

00:32:27.670 --> 00:32:29.230
then we should be empirically based if

00:32:29.250 --> 00:32:31.132
we're evidence-based we should have the

00:32:31.152 --> 00:32:32.991
scientific backing behind that and see the

00:32:33.031 --> 00:32:35.093
results in the room it's both and not

00:32:35.173 --> 00:32:35.634
either or

00:32:36.777 --> 00:32:38.930
Anecdotal evidence isn't the full picture,

00:32:38.970 --> 00:32:39.875
but it's not nothing.

00:32:42.299 --> 00:32:45.060
And so we should want these people who

00:32:45.101 --> 00:32:46.800
are taking thousands of dollars for

00:32:46.840 --> 00:32:47.280
trainings,

00:32:47.300 --> 00:32:49.422
who are raking in millions of dollars for

00:32:49.461 --> 00:32:50.961
speaking tours and book tours and all

00:32:50.981 --> 00:32:51.701
these other things,

00:32:52.542 --> 00:32:54.103
we should hold them to some account.

00:32:54.663 --> 00:32:56.423
We should want them to be able to

00:32:56.463 --> 00:32:57.983
do these things,

00:32:58.483 --> 00:33:00.565
both from it matters in the room with

00:33:00.605 --> 00:33:03.125
clients and that there's academic rigor

00:33:03.164 --> 00:33:04.685
behind it, that it is falsifiable,

00:33:04.726 --> 00:33:05.806
that it is reliable,

00:33:05.965 --> 00:33:07.546
valid information that they're putting out

00:33:07.746 --> 00:33:10.126
and selling to us that we then sell

00:33:10.166 --> 00:33:10.787
to our clients.

00:33:11.881 --> 00:33:16.682
um so i think you know i'm i

00:33:16.823 --> 00:33:18.623
land in the practical space if it works

00:33:18.643 --> 00:33:20.483
for clients then i i want to support

00:33:20.523 --> 00:33:22.605
it um but i come from a the

00:33:22.664 --> 00:33:24.724
where the place i'm at today in my

00:33:24.765 --> 00:33:27.465
profession where i'm at with with how i

00:33:27.506 --> 00:33:29.047
explain things to clients it's about

00:33:29.106 --> 00:33:30.906
health and sustainability what is healthy

00:33:30.926 --> 00:33:32.907
for us today may not be sustainable on

00:33:32.948 --> 00:33:35.108
the long run and so being able to

00:33:36.365 --> 00:33:37.766
balance that practicality,

00:33:38.826 --> 00:33:40.827
that centering of the real life lived

00:33:40.887 --> 00:33:42.148
experience of our clients,

00:33:42.489 --> 00:33:43.628
I do think matters.

00:33:43.690 --> 00:33:47.491
And so outcomes will weigh more than,

00:33:47.511 --> 00:33:49.452
I don't know,

00:33:49.512 --> 00:33:51.753
origin stories than where people are

00:33:51.773 --> 00:33:55.016
getting sort of their information from and

00:33:55.537 --> 00:33:56.958
where that information comes from does

00:33:57.057 --> 00:33:57.397
matter.

00:33:57.518 --> 00:33:59.038
I don't do dream analysis for people

00:33:59.078 --> 00:34:01.480
because I think it's bullshit, right?

00:34:02.260 --> 00:34:03.721
Because dreams are random.

00:34:05.125 --> 00:34:06.807
And we have storytelling brains and our

00:34:06.826 --> 00:34:07.826
brains are really good at recognizing

00:34:07.866 --> 00:34:08.286
patterns.

00:34:08.327 --> 00:34:10.307
We want to start applying patterns and

00:34:10.367 --> 00:34:12.068
stories to this random thing.

00:34:12.088 --> 00:34:13.028
We sure can do that.

00:34:13.088 --> 00:34:14.869
Our brains are pretty good at it.

00:34:16.070 --> 00:34:17.231
And it's bullshit.

00:34:17.431 --> 00:34:19.032
And so you're taking advantage of someone,

00:34:19.612 --> 00:34:19.811
right?

00:34:19.972 --> 00:34:21.512
If I'm doing family therapy with somebody,

00:34:21.592 --> 00:34:23.552
I can explain to them what the theory

00:34:23.592 --> 00:34:25.954
I'm drawing from and I can show them

00:34:26.153 --> 00:34:27.394
research and data on it.

00:34:28.233 --> 00:34:29.735
And I can get research and data to

00:34:29.775 --> 00:34:31.436
say a lot of different things because I

00:34:31.617 --> 00:34:33.018
studied research methods.

00:34:33.057 --> 00:34:34.077
I know how research works.

00:34:34.559 --> 00:34:36.719
I can play with statistics like somebody

00:34:36.739 --> 00:34:37.860
who understands statistics.

00:34:37.880 --> 00:34:40.282
That doesn't mean statistics don't mean

00:34:40.342 --> 00:34:40.983
anything.

00:34:41.824 --> 00:34:44.206
It means that we need to have some

00:34:44.246 --> 00:34:45.626
accountability built into the people who

00:34:45.666 --> 00:34:47.768
can skew and play with these things in

00:34:47.789 --> 00:34:49.489
a way that somebody who hasn't studied

00:34:49.530 --> 00:34:49.650
them

00:34:50.318 --> 00:34:52.619
can't i want somebody who's well read and

00:34:52.719 --> 00:34:54.500
educated and researched to be doing these

00:34:54.559 --> 00:34:56.181
things and i don't want them to have

00:34:56.201 --> 00:34:58.641
a financial incentive to make sure they

00:34:58.681 --> 00:35:01.483
maximize their own benefit right like that

00:35:01.523 --> 00:35:05.164
defeats the purpose so it's basically it's

00:35:05.204 --> 00:35:07.105
hard to be a therapist under late-stage

00:35:07.125 --> 00:35:10.405
capitalism ta-da

00:35:11.721 --> 00:35:12.862
You do that before we started.

00:35:14.804 --> 00:35:15.664
But again, I mean,

00:35:16.105 --> 00:35:17.726
I think it's a both and.

00:35:17.887 --> 00:35:20.630
We have to own that this isn't precision

00:35:21.409 --> 00:35:26.574
surgery we're doing and own that the

00:35:26.594 --> 00:35:27.436
relationship matters.

00:35:27.536 --> 00:35:29.577
I think the relational craft is...

00:35:30.577 --> 00:35:31.639
where it matters the most.

00:35:31.699 --> 00:35:33.940
I think therapy as an art of how

00:35:33.981 --> 00:35:36.181
to be with another person matters more

00:35:36.222 --> 00:35:39.364
than the theory and no theory is

00:35:39.565 --> 00:35:40.085
concerning.

00:35:41.065 --> 00:35:43.268
A theory based on dreams and ghosts and

00:35:43.387 --> 00:35:45.829
whatever else nonsense thing is

00:35:46.329 --> 00:35:46.869
problematic.

00:35:46.889 --> 00:35:49.291
A theory should be falsifiable.

00:35:49.331 --> 00:35:50.652
It should be testable and we should be

00:35:50.753 --> 00:35:52.213
open to learning and growing with it.

00:35:52.273 --> 00:35:52.574
You know,

00:35:52.594 --> 00:35:55.376
like Gottman has great research and I have

00:35:55.396 --> 00:35:57.018
not done a specific Gottman training

00:35:57.057 --> 00:35:58.179
because they charge too much for it.

00:35:59.634 --> 00:36:01.376
because I work with neurodivergent people

00:36:01.416 --> 00:36:02.838
because I work with clients who don't fit

00:36:02.898 --> 00:36:04.842
into this nice little thing.

00:36:04.942 --> 00:36:06.405
If you're selling me a book that says

00:36:06.505 --> 00:36:07.827
all five people fall into these five

00:36:07.867 --> 00:36:09.510
categories, I'm calling bullshit.

00:36:12.224 --> 00:36:13.644
And as a neurodivergent person myself,

00:36:13.905 --> 00:36:15.505
lots of theories and lots of ideas on

00:36:15.525 --> 00:36:16.686
how people work and how brains are

00:36:16.706 --> 00:36:18.108
supposed to work have never fit well for

00:36:18.148 --> 00:36:18.268
me.

00:36:18.688 --> 00:36:21.929
There's nuance in having new modern

00:36:21.969 --> 00:36:23.871
theories approach things as a spectrum,

00:36:24.472 --> 00:36:26.072
as something that is diversified,

00:36:26.112 --> 00:36:29.275
that is not easy to say,

00:36:29.414 --> 00:36:30.715
here's how it's always going to work.

00:36:32.083 --> 00:36:34.903
And the research on studying human beings,

00:36:35.063 --> 00:36:37.164
Homo sapiens, is that in mass,

00:36:37.184 --> 00:36:38.286
we're really easy to predict.

00:36:38.945 --> 00:36:40.527
And that predictability doesn't translate

00:36:40.567 --> 00:36:42.208
to individuals where the variability is

00:36:42.228 --> 00:36:42.688
really high.

00:36:43.288 --> 00:36:44.248
And so we have to be able to

00:36:44.268 --> 00:36:47.070
balance both of those things at the same

00:36:47.110 --> 00:36:48.990
time in real time in the room with

00:36:49.030 --> 00:36:49.550
our clients.

00:36:50.391 --> 00:36:52.632
we can't go too far in either direction

00:36:52.751 --> 00:36:54.432
and say i'm only here with my client

00:36:54.472 --> 00:36:56.193
and i'm going to ignore any science and

00:36:56.233 --> 00:36:58.273
data that makes us bad therapists and

00:36:58.313 --> 00:37:00.715
saying science and data overweigh the

00:37:00.755 --> 00:37:02.356
person in front of me in the room

00:37:02.376 --> 00:37:04.677
with me is also bad therapy it's got

00:37:04.697 --> 00:37:08.157
to be both so i think you know

00:37:08.297 --> 00:37:11.059
therapy works we know that research around

00:37:11.119 --> 00:37:13.860
it is it leads to positive outcomes um

00:37:15.045 --> 00:37:15.826
Not always.

00:37:16.786 --> 00:37:18.987
But with a strong relational rapport

00:37:19.027 --> 00:37:19.949
between client and therapist,

00:37:19.989 --> 00:37:21.188
it does have good outcomes.

00:37:21.208 --> 00:37:23.710
We know that therapy works better than

00:37:23.731 --> 00:37:24.871
just medicine alone.

00:37:25.472 --> 00:37:27.373
And so I think that matters.

00:37:27.572 --> 00:37:29.213
And I think the stories we as therapists

00:37:29.253 --> 00:37:31.034
tell can certainly get inflated.

00:37:32.034 --> 00:37:33.655
And we can have some cognitive biases.

00:37:33.675 --> 00:37:34.996
We can take some shortcuts that get us

00:37:35.056 --> 00:37:37.757
to the wrong identifiable mechanism by

00:37:37.797 --> 00:37:39.099
which therapy was beneficial.

00:37:40.900 --> 00:37:42.141
And I'm not interested in being...

00:37:43.498 --> 00:37:44.380
a snake oil salesman.

00:37:44.400 --> 00:37:47.023
I'm not interested in having a religion.

00:37:47.043 --> 00:37:48.804
I don't want to be clergy selling people

00:37:48.824 --> 00:37:51.387
something dogmatic that provides meaning

00:37:51.407 --> 00:37:52.590
in their life but is based on a

00:37:52.650 --> 00:37:52.989
lie.

00:37:53.090 --> 00:37:54.612
I want something...

00:37:55.663 --> 00:37:56.963
that's helpful to people and is

00:37:57.123 --> 00:37:57.764
replicatable.

00:37:57.824 --> 00:37:59.846
I want something that doesn't require me

00:37:59.945 --> 00:38:01.507
and my specific brain and my specific

00:38:01.547 --> 00:38:02.007
education,

00:38:02.068 --> 00:38:03.469
my specific learning to be the only way

00:38:03.489 --> 00:38:04.208
that you can do it.

00:38:04.670 --> 00:38:06.550
And I think that's what people who are

00:38:06.731 --> 00:38:09.052
selling their system are doing.

00:38:09.112 --> 00:38:10.193
I think IFS,

00:38:10.293 --> 00:38:11.795
when you take it to its full conclusion,

00:38:11.855 --> 00:38:13.036
includes demon possession.

00:38:13.396 --> 00:38:14.757
And I know that's not scientific,

00:38:14.777 --> 00:38:15.398
that's bullshit.

00:38:15.657 --> 00:38:17.539
And people who are spending thousands of

00:38:17.559 --> 00:38:19.059
dollars to get trained in IFS and taking

00:38:19.141 --> 00:38:20.702
years in their career to get trained,

00:38:21.041 --> 00:38:22.262
want it to be meaningful.

00:38:24.264 --> 00:38:26.065
right?

00:38:26.304 --> 00:38:30.628
And no quick, easy, digestible,

00:38:30.949 --> 00:38:32.449
short little snippet makes sense.

00:38:32.489 --> 00:38:34.311
We can't go sort of right-wing

00:38:34.411 --> 00:38:35.572
anti-intellectual and say,

00:38:35.692 --> 00:38:36.532
experts are corrupt,

00:38:36.572 --> 00:38:37.873
therefore throw everything out.

00:38:37.954 --> 00:38:38.893
Science doesn't matter.

00:38:38.954 --> 00:38:39.875
It's all a lie.

00:38:40.534 --> 00:38:40.936
It's not.

00:38:41.056 --> 00:38:42.836
Good science really matters and good

00:38:42.876 --> 00:38:45.099
science is replicatable, right?

00:38:45.978 --> 00:38:48.001
the things we learn and know are because

00:38:48.021 --> 00:38:49.322
we continue to study and update them.

00:38:49.362 --> 00:38:52.164
The reason that polyvagal therapy has been

00:38:52.224 --> 00:38:53.827
debunked, which again,

00:38:53.947 --> 00:38:56.369
isn't news to anybody who's studied it and

00:38:56.389 --> 00:38:57.750
looks at it critically at all.

00:38:58.411 --> 00:39:00.413
Um, it's just that like, yeah,

00:39:00.512 --> 00:39:01.434
the mechanism is,

00:39:01.753 --> 00:39:04.496
is wrong and has been since it was

00:39:04.536 --> 00:39:07.239
first suggested neuroscientists push back

00:39:07.278 --> 00:39:08.601
on this immediately.

00:39:09.360 --> 00:39:09.440
Um,

00:39:10.382 --> 00:39:11.643
But therapists can't be like,

00:39:11.802 --> 00:39:13.483
don't critique my model or you're

00:39:13.943 --> 00:39:15.465
upsetting my expertise.

00:39:15.505 --> 00:39:18.306
You're questioning something that is

00:39:18.365 --> 00:39:19.387
beyond question.

00:39:19.766 --> 00:39:20.067
No,

00:39:20.226 --> 00:39:21.887
we as therapists need to be flexible and

00:39:21.967 --> 00:39:24.748
update our models of knowledge as the

00:39:24.809 --> 00:39:26.090
science dictates that.

00:39:26.409 --> 00:39:28.090
And I think we need to follow science,

00:39:29.152 --> 00:39:30.172
not the other way around.

00:39:30.893 --> 00:39:31.972
We can't have things that aren't

00:39:31.992 --> 00:39:32.653
falsifiable.

00:39:32.713 --> 00:39:34.014
That's a religion then.

00:39:34.074 --> 00:39:35.534
That's blind faith.

00:39:35.554 --> 00:39:37.195
And that's not what this is based on.

00:39:37.215 --> 00:39:38.577
That's not what works.

00:39:39.577 --> 00:39:41.217
So science isn't fake.

00:39:41.257 --> 00:39:43.199
Science is falsifiable and science is

00:39:43.259 --> 00:39:43.900
replicatable.

00:39:44.480 --> 00:39:45.860
And, um, that's,

00:39:46.161 --> 00:39:47.461
that's where we need to be based.

00:39:47.661 --> 00:39:49.463
And we need to be real people,

00:39:49.543 --> 00:39:50.262
not robots,

00:39:50.322 --> 00:39:52.664
not automatons in the room who are saying

00:39:52.704 --> 00:39:53.405
my way works.

00:39:53.425 --> 00:39:54.306
So the problem must be you.

00:39:54.326 --> 00:39:55.827
Um,

00:39:55.887 --> 00:39:57.246
it's okay to say we were wrong about

00:39:57.266 --> 00:39:57.788
the mechanism.

00:39:57.867 --> 00:39:58.688
Let's learn more.

00:39:58.788 --> 00:39:59.068
Let's,

00:39:59.268 --> 00:40:01.550
let's learn what the mechanism actually is

00:40:01.590 --> 00:40:03.911
then let's continue to pursue and grow our

00:40:03.951 --> 00:40:06.193
knowledge so that we can do this.

00:40:06.432 --> 00:40:06.552
Um,

00:40:07.644 --> 00:40:09.728
So I think, yeah,

00:40:09.807 --> 00:40:12.150
it's been debunked as much as it was

00:40:12.190 --> 00:40:13.172
debunked when it first came out.

00:40:13.233 --> 00:40:15.054
I think, again, critically speaking,

00:40:15.094 --> 00:40:16.016
polyvagal theory,

00:40:16.237 --> 00:40:17.918
as Stephen Porges suggested it,

00:40:18.079 --> 00:40:18.239
was

00:40:19.286 --> 00:40:19.905
inaccurate.

00:40:21.106 --> 00:40:24.268
I think his skills and tools will work

00:40:24.427 --> 00:40:26.028
for some people in some contexts,

00:40:26.108 --> 00:40:28.030
and that is worthwhile to maintain and

00:40:28.070 --> 00:40:28.590
continue.

00:40:29.210 --> 00:40:31.632
And we can't slap it onto every single

00:40:31.672 --> 00:40:32.931
problem, every single person,

00:40:33.012 --> 00:40:33.753
every single body,

00:40:33.793 --> 00:40:34.992
because it won't work that way.

00:40:35.012 --> 00:40:36.634
There isn't a school of therapy that will

00:40:36.653 --> 00:40:37.994
work that way.

00:40:38.034 --> 00:40:39.414
We as therapists need to own and be

00:40:39.496 --> 00:40:40.815
open to the idea that different people

00:40:40.835 --> 00:40:41.717
need different types of help.

00:40:41.757 --> 00:40:42.556
And we as therapists

00:40:43.344 --> 00:40:45.407
have a scope of practice and some people

00:40:45.447 --> 00:40:46.648
are not within our scope of practice.

00:40:46.688 --> 00:40:47.128
That's okay.

00:40:47.168 --> 00:40:48.469
That's why we have networks and

00:40:48.489 --> 00:40:50.170
communities of other like-minded

00:40:50.210 --> 00:40:52.072
therapists who can do and work with

00:40:52.092 --> 00:40:55.215
populations that we can't.

00:40:55.394 --> 00:40:57.277
And trainings are too expensive and

00:40:57.297 --> 00:40:58.617
therapists need to be paid more.

00:40:58.777 --> 00:41:00.539
And like, again, I'm anti-capitalist.

00:41:00.599 --> 00:41:02.721
So all of that sort of goes into

00:41:02.782 --> 00:41:06.505
it.

00:41:06.605 --> 00:41:07.905
It's a complicated mess.

00:41:09.793 --> 00:41:10.893
I would love to be at a place

00:41:10.932 --> 00:41:12.554
where like everybody has their basic needs

00:41:12.594 --> 00:41:15.375
met and like clients like meet me over

00:41:15.394 --> 00:41:16.914
their lunch hour and like bring in some

00:41:16.954 --> 00:41:18.434
tamales and I'll help you with your

00:41:18.454 --> 00:41:18.956
problems.

00:41:18.996 --> 00:41:21.456
Like I would love to be paid in

00:41:21.516 --> 00:41:22.697
food instead of money.

00:41:24.657 --> 00:41:27.498
Cause I love food.

00:41:27.538 --> 00:41:30.458
Don't always like cooking though.

00:41:30.539 --> 00:41:31.878
ADHD brain and all that jazz.

00:41:33.380 --> 00:41:33.559
Yeah.

00:41:34.000 --> 00:41:34.280
I don't know.

00:41:36.360 --> 00:41:38.322
there's room for improvement across the

00:41:38.342 --> 00:41:38.583
board.

00:41:38.983 --> 00:41:40.385
I've seen some really bad takes on this

00:41:40.405 --> 00:41:40.806
topic.

00:41:40.965 --> 00:41:43.268
So here's mine.

00:41:45.731 --> 00:41:47.594
And like, if you're like, so Jeremy,

00:41:47.675 --> 00:41:48.356
what do you do?

00:41:48.456 --> 00:41:49.536
Like, you don't have any trainings?

00:41:49.577 --> 00:41:50.938
Like, no, I've done trauma trainings.

00:41:50.998 --> 00:41:52.001
I've done things.

00:41:52.141 --> 00:41:52.201
I'm,

00:41:53.976 --> 00:41:55.336
I won't say deeply immersed,

00:41:55.396 --> 00:41:57.217
but I'm leaning towards the psychedelic

00:41:57.257 --> 00:41:59.777
route as far as not magical thinking and

00:41:59.797 --> 00:42:00.679
won't work for everyone.

00:42:00.699 --> 00:42:02.539
But as far as like a replicatable,

00:42:03.019 --> 00:42:05.440
verifiable, falsifiable tool,

00:42:06.501 --> 00:42:09.521
psychedelics as a form of medicine to seem

00:42:09.581 --> 00:42:11.643
really compelling and has the research

00:42:11.682 --> 00:42:13.364
behind it that I'm looking for to be

00:42:13.423 --> 00:42:13.864
compelling.

00:42:14.545 --> 00:42:16.626
And plenty of snake oil salesmen already

00:42:16.666 --> 00:42:19.070
glommed onto it and gotten way out in

00:42:19.090 --> 00:42:20.992
front of their skis around what it works

00:42:21.052 --> 00:42:22.514
for and who it can be helpful for.

00:42:22.594 --> 00:42:23.094
It's, again,

00:42:23.135 --> 00:42:24.496
going to be a tool in the tool

00:42:24.556 --> 00:42:25.739
belt, not the be all end all.

00:42:26.398 --> 00:42:28.902
So I'm just wary of those things that

00:42:30.664 --> 00:42:32.847
are pseudoscience, pseudoreligion.

00:42:34.844 --> 00:42:36.884
Like AA is both of those things and

00:42:37.364 --> 00:42:39.005
has a shockingly low success rate.

00:42:39.505 --> 00:42:41.864
So we should stop using things like that

00:42:43.545 --> 00:42:44.925
and build better models, right?

00:42:45.545 --> 00:42:47.286
But we need to build better models that

00:42:47.485 --> 00:42:50.967
don't include the financial incentive to

00:42:51.007 --> 00:42:51.666
be dishonest.

00:42:53.666 --> 00:42:56.568
I don't think I offered a fix at

00:42:56.628 --> 00:42:56.788
all.

00:42:56.887 --> 00:42:58.568
Hopefully I offered some nuance though,

00:42:58.588 --> 00:43:01.708
which is what I can do that I

00:43:01.728 --> 00:43:02.349
think is most helpful.

00:43:05.403 --> 00:43:06.764
Okay, bye.

00:43:07.605 --> 00:43:10.465
No, seriously, drop down, like, subscribe,

00:43:10.505 --> 00:43:11.065
do those things.

00:43:11.166 --> 00:43:11.547
It helps.

00:43:12.467 --> 00:43:15.788
And if you want to hear more of

00:43:15.867 --> 00:43:18.650
my pop culture thoughts on why

00:43:19.389 --> 00:43:21.110
representation is wrong in a movie, great,

00:43:21.190 --> 00:43:21.831
I can do more of that.

00:43:22.130 --> 00:43:23.452
Let me know if you like more of

00:43:23.472 --> 00:43:24.711
the straight mental health stuff.

00:43:25.813 --> 00:43:26.652
I'm open to feedback.

00:43:28.054 --> 00:43:29.494
Okay, take care of yourself.

00:43:29.534 --> 00:43:30.175
Take care of somebody else.

00:43:30.235 --> 00:43:30.574
Peace.