Right? Wrong? It's All About Context!

Posted by tonyoverbay

Tony shares how understanding context can help one understand others. Tony references the article "The Importance of Context when Diagnosing Mental Disorders" by Drew Mikita, LPC, Associate Professor https://www.freepsychologyhelp.com/?p=116

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Right wrong content 2022-01-26.mp3

[00:00:15] Come on in, take a seat.

[00:00:21] Hey, everybody, welcome to episode three hundred and five of the virtual couch, I'm your host. Tony Overbay am a licensed marriage and family therapist. A certified mine will have a coach, writer, speaker, husband, father of four ultra marathon runner and creator of the Path Back, an online pornography recovery program that is helping people reclaim their lives from the effects of turning to pornography as a coping mechanism. And last week I did an episode. It was part one of two. Today is not part two that'll be coming in a week from now, but I did part one of two of just how to get the shame out of turning to unhealthy coping mechanisms in general. Yes, we were talking about pornography, but as the feedback that I got attested to that the turning to unhealthy coping mechanisms does fit for anything, whether it's turning to food or your phone or binge watching shows on any of the streaming services. So we've got Part two coming up next week and I have received several questions. So if you have questions, go to Tony over bakam and click on the contact me or contact us or some sort of contact form and feel free to ask your questions. If there are things that I can answer and I will cover those in next week's episode. But today we are going to talk about context and I have been speaking a lot lately and I have been starting most of the talks. I usually have some fun facts about the differences of men and women and how their brain works, and that's always fun because we really do work a little bit differently.

[00:01:42] And I'll give you an example of that. Let me let me talk about one that I share often. Actually, I'll give you a couple. These are really fun. And the first one is neuropsychologist Professor Reuben Gur of the University of Pennsylvania used brain scan tests to show that when a man's brain is in a resting state, at least 70 percent of its electrical electrical activity is shut down. Scans of women's brains showed 90 percent activity during the same state, he said, confirming that women are constantly receiving and analyzing information from their environment. And then my bit that follows is that if I would make the joke that if I'm working with a couple and I've been working with the guy in particular, so when his wife turns to him and says, Hey, what are you thinking? And he says nothing, that there's actual data that shows that he's not really thinking of much of anything that at least 70 percent of his electrical activity is shut down. But the work is done is then he can then turn to his wife and say, And what are you thinking? And then when she says that I'm thinking about all kinds of things, the kids and what's going on and school and schedules and what are we going to do and vacations and that that that is absolutely true, that they're in that same resting state that a woman's brain shows 90 percent electrical activity during that same state, so they are constantly receiving and analyzing information.

[00:02:56] And while I have this up, some notes from one of the talk that I gave recently, here's another one that's pretty interesting, says a study from Stanford University found that when a female was shown an emotional image, nine different areas of her brain lit up while only two lit up in the man. And we have two emotional systems the mirror neuron system or the mass and the temporal parietal junction system, the TPA. So the mirror neuron system is responsible for emotional empathy. It helps one feel what the other person is feeling, and the temporal parietal junction, or the TPA, is responsible for cognitive empathy. It actually helps somebody distance themselves from the perfect from the person's emotions, focusing instead on analytically solving the problem. So cognitive empathy is more of that. What can I do about it? And then the emotional empathy is helping one feel what the other person's feeling. This research said that both sexes start their empathy process in the mirror neuron system, but the male brain quickly switches over to this cognitive empathy part or the temporal parietal junction. And so we see this clash all the time where a woman may tell the man about a problem looking for emotional support, but he unable to actually solve the problem, won't see the value of having a lengthy conversation about it and say, What can I do about it? So I love when you can have the brain science that goes behind this actually one more while I've got you here, this one's this one is one that will typically get a little bit of a laugh.

[00:04:14] A study of adults in the Netherlands monitor the brain activity of seventeen to twenty five year old males and females as they processed white noise and music. So the females had an intense response to both sounds both both the white noise and the music, and the males responded to the music but deactivated to the white noise as if they didn't even hear it. So this may be because during male fetal brain development, testosterone impacts the formation of the auditory system, making it block out unwanted noise and what they call repetitious acoustic stimuli. So this becomes an issue in a lot of relationships male female relationships where and I'm going so gender stereotype here. But again, it's fascinating when you've got some brain science to back it up. But a woman may say something and the guy won't hear her, and she will repeat herself several times, which makes his brain register her voice as unwanted, repetitious acoustic stimuli. So before you know it, it devolves into. He never listens or she's always nagging, and a lot of us will get stuck in this feedback loop of behavior creating this fascinating chicken or the egg scenario.

[00:05:13] Does my mom say the same thing five hundred times to my dad because my dad doesn't hear her? Or does my dad tune her out because she repeats herself and she then? Becomes repetitious acoustic stimuli. That's just fun stuff about the way that we differ. Male and female brains, but where I have been going lately is a an exercise, and I did talk about this on a podcast a while ago. So if you have heard this, feel free to you will know the answer in your head and just say that to yourself. And this exercise is from the book on being certain, believing you are right, even when you're not by Robert A. Burton. I'm going to read a paragraph to you. I'm going to read it at normal speed. This experience cannot be duplicated once you know the explanation, so take a moment to ask yourself how you feel about the paragraph when you hear what I'm about to read to you. So here's the paragraph. A newspaper is better than a magazine. A seashore is better than a street. At first, it's better to run than to walk. You may have to try several times. It takes some skill, but it's easy to learn. Even young children can enjoy it. One. Successful complications are minimal. Birds seldom get too close. Rain, however, soaks in very fast, and too many people doing the same thing can also cause problems. One needs a lot of room.

[00:06:23] If there are no complications, it can be very peaceful. Iraq will serve as an anchor, and if things break loose, however, you will not get a second chance. And if I'm when I just spoke again last night and I did this exercise and then I just say, what does that sound like? And people are just look at me with confusion because it just sounds like a lot of words and pretty much absolute nonsense. Is this paragraph comprehensible or is it meaningless? And your mind is probably trying to sort through possible explanations, even including me? Insane. But I'm assuming that, you know that there's going to be a payoff here. And so if I just give you two words, then see how this whole thing changes. So if I say the words a kite, now, let's read this again. A newspaper is better than a magazine. The seashore is a better place than the street. At first, it's better to run them to walk, and you may have to try several times. It takes some skill, but it is easy to learn even young children can enjoy it. One. Successful complications are minimal. Birds seldom get too close. Rain, however, soaks in very fast. Too many people doing the same thing can also cause problems. One needs a lot of room. If there are no complications, it can be very peaceful and Iraq will serve as an anchor. And if things break loose from it, however, you will not get a second chance.

[00:07:34] So when that simple word kite, the two words a kite, then all of a sudden, now we have context, and when we have context, it makes so much sense. And from the book, he's talking about this feeling of certainty that we want to desperately know and figure things out and be certain. But the whole premise of the book on being certain, which is, he says, believing you were right, even when you're not is he talks about, is there even such a thing as certainty? And that's a phenomenal book. It really is. I like to make the joke that it comes with a free existential crisis, but actually, when you really embrace the concepts that it does, it actually brings some peace, I think. But today I want to talk about context because the reason I've been talking about this so much when I go and speak is because I it seems that when I'm talking, it doesn't matter if I'm talking about people in relationships, so they're trying to understand their spouse. If I'm talking about parenting, where people are trying to know the best way to communicate with their teen, or if I am talking about training businesses on how to better communicate between the staff and leadership and these sort of things. Or if I'm just talking to an individual who feels like something is wrong with them, that we're just missing context so often we're missing context.

[00:08:47] And I think that example shows you that it can with a little bit of extra information than we can add this beautiful thing called context, which can give us more understanding and even more empathy for someone and what their experience is or what they're going through. So I found a really phenomenal article that I'm going to use as my muse today. It's from a website called Free Psychology Help. You can't beat the name of that website, and it is written by a person named Drew Mikita, who is a licensed professional counselor and an associate professor, and this is from September of twenty eighteen. But I love the fact Drew talks about the importance of context when diagnosing mental disorders. So as I love to do, I'm going to read through this a little bit. I'm going to give my own commentary because I've been thinking about this so much as a therapist with people in my office and even as I go about my daily life and I'll tell you, let me give you another example. Last there's a bio. You always have to have someone read your bio, and I make the joke that it is one of the most uncomfortable, awkward moments that a speaker goes through where you give them this bio and we all want to know who we're going to go there and see and hear. So it's not like I'm adding things that aren't true into my bio. But when you put everything together, it can sound a bit pretentious or pompous or arrogant or those sorts of things.

[00:10:01] So I typically am sitting there. I put my head down a little bit, someone's reading the bio and whether the bio says, OK, best selling author or award-winning podcast host and how many episodes. And then typically there's a part that says and he has ran one hundred and hundred and fifty marathons and ultra marathons, including a dozen or more of distances of one hundred mile. Or more? And so you just hear that and some people are thinking, Oh, OK, this guy might have something to say where other people are thinking, Man, this guy probably thinks a lot of himself. But then when I get up there and I talk about even someone reading the bio and you talk about context and you talk about, OK, my ultrarunning, that that was the only way that I felt alive. That was my happy place as I was going through this period of over a decade of being in a job and in a career that I now know that it was just this socially compliant goal that I was doing the whole career in the software industry for over a decade because I felt like I had to or I would let someone down. I would let whether it was my wife down, my parents down or whoever it would be because I just needed to go in there and suck it up and put my 30 years in and then retire whatever that looked like for me.

[00:11:05] But knowing that I was dying on the inside, so I turned to running and then more running and even more running as a coping mechanism. So when you have that context and all of a sudden now I say, OK, one hundred hundred and fifty ultra marathons or marathons that I would go speak often the more that I was on my mental health journey to becoming a therapist and saying that, oh, it wasn't just I'll go out for a run, it was that if I skipped, I would usually take one day off a week. And if I made it two days or three days off for some reason, which was very rare, then I would say that I feel shorter, bolder and I feel like a worst husband, father and you fill in the blank. So those 100 or 150 races were the thing that was always in front of me that gave me the motivation to continue to get up every morning. Well before the crack of dawn, because I had this no impact on my family policy because I also want it to be this best version of myself as a husband or a father. And now we have context. So now, instead of saying, wow, he just really thinks a lot of himself. And I wouldn't go run and take all that time. But now, if we know that, OK, that was the way that I stayed sane until I truly felt like I found my sense of purpose in doing this career that I do now, and we have a little bit more context or the best selling author.

[00:12:14] And I made this joke last night. My book is called He's a porn addict. Now, what an expert and a former addict. Answer your questions. So not ideally, the coffee table book. When I had the author Suzanne Falter on my podcast a few weeks ago, I mentioned I might have mentioned that she sent me an autographed copy of her book about self care for the extremely busy woman. Now I am not an extremely busy woman, but the book was phenomenal. I went through, I read a lot of it and she autographed it and I thought, Wow, if I just send somebody a random that I've been on an interview with or that I have on my show and I autograph my book, he's a porn addict. Now, what an expert, an addict to answer your questions. I am beyond happy and proud of the book because the book it's phenomenal. It really is. But it's not really one that I say, Hey, here you go, because it makes this insinuation. I don't know that maybe I think that they are struggling with turning to pornography is an unhealthy coping mechanism. But if you look at it in the context of over 15 years of work with over a thousand people that have struggled with turning to compulsive sexual behavior as a coping mechanism and being able to help those people become better, better parents better again, typically working with a guy with husband father, they find their career that they like.

[00:13:21] They find peace with their faith. They find a better version of themselves with their health. They find themselves in a better position with their job. And so then the context of that book makes a lot more sense with the work that I do. So this concept of context is just really fascinating, and it goes back to the modality that I love acceptance and commitment therapy where we are all just going through life for the first time. That's what we're doing. This is the first time that I've been on the mic on a Tuesday, January twenty fifth at five twenty six a.m. with you talking to an audience and wondering what you are going to, how you're going to take all this in what you're going to remember if I've said things before. And so I am responding and saying and reacting because I am me, because I'm a human being and I'm a culmination of all of my experiences. I'm three billion neurons that are just walking around reacting to certain situations. I am a product of my nature, my nurture, my birth order, my abandonment, my DNA, my rejection, my hopes, my dreams. And so when I have a thought or a feeling or I take an action.

[00:14:21] The reason I do is because I did, and then we can make sense of things from there. And when someone else says, I wouldn't do that or are you sure you want to do that or why did you do that so often? That's where we feel that psychological reactants or that instant negative reaction of being told what to do and that's built in. It's innate within us and it's there as a protection, and it's because no one truly does understand what I have been through, what you have been through or what anyone's been through. So that's why the the idea of context is so important in helping us understand and have more empathy, sympathy and just to be able to have a better connection with others. Because when we can drop the rope of the tug of war on trying to tell someone what they're doing is wrong or why that I wouldn't do what they're doing, then we can really start to have more of a connection with others. And the reason I wanted to talk about this today and haven't even got to this article yet is because so many of the things I've been talking about on other episodes come into play here. This is where the context of. We're talking about context, but seeking external validation, how often are we just telling someone what we think they should do or what our opinion is or what our experience was about anything because we want that external validation.

[00:15:34] We want them to do what we did so that it will make us feel better about what we did and almost makes us feel subconsciously like we must be right. Or how often are we trying to tell someone what to do, even if we don't know what their situation is because we want them to say, Wow, thank you. You're you're amazing, you're my hero. Because again, we want that external validation, but we need to start with so much more curiosity. And the key to doing that is understanding the context in where someone is coming from and then even knowing at that point, we will still never completely understand what someone else is going through because we've never lived their life, we've never walked in their shoes. There's phenomenal studies on even looking at identical twins. And you can have them view an output, or you can have them view something so they can take an input and then they will have two completely separate outputs, even though these are the most genetically identical people that have probably spent a fair amount of time together than anyone else, and that they will still take in information and then have a completely different output. So let's get to this article today by Drew Mikita, and it's called the importance of context when diagnosing mental disorders. So Drew says that when making a diagnosis of a mental health disorder, it is so important to look at the context of a person's life.

[00:16:46] And while many mental health disorders expand far beyond the everyday circumstances of life and dove into much deeper biological issues, some mental health disorders can be best explained as byproducts of multiple life influences. And I really appreciate the way Drew said that that they are explained as byproducts of multiple life influences because we go through life and then our actions, reactions, thoughts, feelings, emotions are truly these byproducts of the things that we are going through in life. So he says it is a therapist, a mental health professional or other person. Attempting to understand diagnosis in the context of a person's life should be fully understood by any clinician making a diagnosis. He said it's incredibly easy to get complacent and just wave the depression or bipolar or any diagnosis wand. And he says he's such a proponent of waiting on making a diagnosis when possible until more information is evaluated and sometimes a diagnosis absolutely is needed. But then I run into situations where I talk with people who other therapists have just made these broad, sweeping diagnoses of of that person has bipolar disorder, even if they don't really know what that person is going through or that person is a sex addict or that person is has clinical depression without knowing context. Because and then what happens, I think so often is, is then this person, sometimes we hand someone a diagnosis and then they feel like, OK, I'm bipolar.

[00:18:06] I need to go read all the things I can about bipolar disorder. And then we all want to feel like some sort of structure, or we want to feel like we understand we want this certainty. And so then I can only imagine I'm being a little beating around the bush. I'm working with people who have received things like my bipolar diagnoses well long ago in their lives by therapists who just gave them a bit of like a passing a magic wand approach and said, Oh yeah, you're definitely bipolar. And instead of really getting to understand the person and really getting to dig in their deep and understand the context of why they act the way that they do. And then once somebody receives this diagnosis, and again, I'm not A. Diagnoses, I have people that have had some incredible success once they understand the diagnosis. Once I understood my ADHD tend to type with that diagnosis, which I have a literal diagnosis from a psychiatrist and now with my general practitioner and I take medication for it. It has been absolutely life changing, but I am also working with someone right now. Just as an example who was given a bipolar diagnosis by a therapist who feels like really likes to just start by saying, here's the diagnosis. Start doing all the things that have to do with what this diagnosis says, and then we'll try to make sense of things instead of trying to understand the person before making the diagnosis.

[00:19:21] So he does say, says, I'm a huge proponent of waiting. I'm making a diagnosis when possible until more information is evaluated. And yeah, sometimes a diagnosis is needed immediately as lives are in danger. Courts need documentation and immediate change in someone's life as a traumatic nature. But while these do occur for so many mental health professionals, rushing on making a diagnosis is unfortunately it's a very commonplace. So a good professional, as Drew says, spots many disorders immediately when they walk in and the symptoms are indistinguishable and can only be a few things. That's where I talk often about the concept of personality disorders or people that have narcissistic traits or tendencies, or this emotional immaturity that those things are evident almost in the first session when somebody walks in a room, because that's somebody that doesn't really have a true sense of self. And so they need to have this just they have these insecurities. And so they immediately need to feel special or they are shifting the blame, or they're trying to get you to join with them instead of really trying to dig in on what they're in there for. It's always about, or it's often about, Well, where do you where do you meet my wife or where do you see my husband? Those sort of things. So you spot a lot of those things coming in that even the person themselves doesn't really understand that this is what this isn't the yeah, I want to say normal.

[00:20:32] That's such an air quote word. But this isn't the normal way that someone comes in and talks about their anxiety or depression of coming in and saying, Man, I think I'm depressed because let me tell you about my spouse, that sort of thing. So the goal for the therapist, for the mental health professional is to try to gather as much data and truly be the one person that gets to understand all of these thoughts and feelings and emotions that are coming from an individual. I love nothing more, and I had some experiences recently where I've met with someone for a very long time, and then they just upped their game and let me know about so many more things from their past. They give me so much more context. Now, as a therapist, I sometimes make the joke of, Hey, it looks like you buried the lead, and this would have been nice to know months ago. But I also understand that everyone's journey is their journey, and that is based off of all of the things that they've been through. So who am I to say, why didn't you tell me that earlier? Because the person really has to feel comfortable in order to be able to open up and share? So Andrew says he nails that too. He says as all therapists know, you don't get all the information from a client on day one. He said although sometimes sessions are a word vomit of 30 years of pent up emotions and loading but most.

[00:21:38] Recessions are basically interviews between the client and therapist to understand one another. You're starting to build trust, you're starting to build rapport and really getting into the basics, and he said, So I do. I really like the cut of Drew's jib. He says, think of it like a non-sexual first date. Regardless of the information exchanged on day one, more background will be coming in the future sessions. So gathering as much information and context in the life of a person will help ensure the diagnosis is accurate and not just the reflection of a temporary mood. And that's why I think what is so important so certain behaviors do, he says, indicate a specific disorder or category of disorders. However, just because somebody is exhibiting the criteria for a disorder doesn't necessarily mean that he or she has that disorder and that our diagnostic manual, the DSM, does a pretty good job. And, he notes, clarifying that behaviors need to be present for X amount of time, or that diagnosis may be made under certain circumstances. But there are certain times where there can be completely reactions that may seem absolutely. I will just use the word crazy or insane by someone, but then in the context of what that person is going through would make absolute sense. So he's got a case study and I like this, he says. Let's say Timmy comes into my office for an appointment because he's been bummed out.

[00:22:47] He says he isn't sure if he wants to live, has no joy problem sleeping, no appetite. Nothing brings him joy and he just wants to be alone. So Astrue says, sounds like he has major depressive disorder or at least a major depressive episode, and he absolutely meets that criteria. But he says, I better get my diagnosis, wander out and document this. And he says, woo-hoo. He says their partner slow down on your magic diagnosis, diagnosing one a second. All you have. All you've done is identify that Timmy meets criteria of a depressive disorder. But did you ask about the reasons behind these symptoms? And I want you to put yourself in the situation of asking for the reasons behind why someone in your family is acting the way they are, are asking, or the reasons behind why your spouse shows up the way they do. Yet another plug. I'm going to plug my magnetic marriage course, which is coming soon. My four pillars of a connected conversation. My first pillar is that no one wakes up and thinks I'm going to hurt my spouse today. Or there's a reason why people act the way they do, but they may act withdrawn or angry, or because that might be the only way that they feel like they can be heard or understood. And so that can be so important. So, he says, is there anything that's happened in your life that's been hard? He's asking this fictional character, Timmy.

[00:23:56] And how long has this been going on? Timmy responds. And boy, and I want to tell you this is there's so much in this article that I appreciate from from the author Drew. But I feel like this is the part where I just feel like this is one of the things I love about being a therapist, even though the stories can be very sad. But you get these moments often. So, he says. Timmy responds, Well, this week has been rough. My brother died. My wife left me. I got diagnosed with cancer. My dog ran away. I got fired from my job and I need a root canal. So as Drew aptly says, yikes to me might have just had the worst week in the history of the world. So honestly, he should be showing the signs of depression and, he says, induces some kind of depressed just making him up. But I think as mental health professionals, we've all had those clients. I honestly, when people come in and they say it's been a rough week and I had this yesterday and then you say, Hey, tell me about the week, and they say, No, I don't know. I just came out of nowhere. But if you just start to slowly work through the week, there's so often a lot of different things going on, and that's where I jump back into this. You're the only version of you.

[00:24:53] So actually the thoughts and feelings and emotions you have or simply because you are you and you are reacting to these situations because this is the first culmination of all these experiences that you've ever been through at this point in your life. So the first thing to do is to give yourself grace and to say interesting. But those things are happening, and this is the way that I'm showing up, or this is the way that I'm feeling and being able to just just give that context, step outside of yourself and say, OK, look at how I'm feeling based on all these things like that really is interesting, because that's going to start to help us get away from the what's wrong with me story and start to get us closer to the Oh, so let me see what happens, what led to all of these triggers, what led to this bad week and Timmy situation? There are so many things there that he could not have dealt with his brother dying. I don't know about his wife leaving him, but his diagnosed with cancer dog running away, fired from his job needs the root canal. So there are so many things there that you just are going to find yourself feeling and reacting to and being able to just be present and turn toward things that matter to you, or even just accepting that this is going to be a really rough time and grieve grieve like no one's business for a few days to get through those emotions.

[00:26:04] So he says the feelings he's having are normal. Serious, absolutely. And he says he is expected. And he said, in fact, if he wasn't showing the signs, I would be more concerned. This is again where I love the way that drew saying this, because I often say that these are the way this is how you're feeling based on all of your thoughts, feelings, emotions, all those things. And if you didn't feel this way, it would probably mean and I use a lot of humor in my sessions, but I would say, then we're talking, we're looking for psychopathy. Are you a psychopath because you don't have any emotion, even though you just went through all of these things? So to me, it's still going to absolutely need counseling to cope with this life stressors, but at this point? Is a diagnosis really going to be very helpful? Drew says it's a believer that medication is is an option, but maybe one further down the road from four mental health disorders, he said. Which medication requires a diagnosis? In this context, diagnosis may not be necessary. Can we make it through these next couple of weeks and then get into a better place? Because again, that is a lot that he's dealing with. And so in the context of all of it he's dealing with, it makes sense that he's feeling the way that he is.

[00:27:02] So Timmy may need the help from a counselor, but maybe not the diagnosis at this time. Now, if things continue this way, it would likely be that he would need a diagnosis, which is another plug to go seek help, which I was not planning on running the ad right now, but it makes sense. So if you are trying to get through some tough things, you'll see a mental health professional. And if you don't know where to start, go to Betterhelp.com virtual couch and you'll get 10 percent off your first month's treatment. But even if it's just for this situational depression or these things that just happen if it's seasonal affective disorder, if it's things that just come upon and you're not sure if this is something that I really need to take a look at long term, if I need to look for some diagnosis or on the road to medication, or if it's just a lot going on in my life, so go to Betterhelp.com virtual couch and the assessment form there is actually very phenomenal. I feel like this is just me saying this off the cuff, but it worked with so many people that are in the dating world now when they become single or they're in their twenties or whatever that looks like. And so it's such a swipe. Stick with me. I promise this is going to make sense where you have to put three or four pictures up, but once got you by a waterfall, once got you with you, borrow someone's golden retriever.

[00:28:11] It has to have a bandana and then you hold your niece or nephew. And then so you got your pictures and you say a line from a movie. And then now we date and you swipe through and you find people that look attractive and that sort of thing. But there was a time back before the the app version of dating and where people would fill out these extensive reports of their psychological profiles and the dating sites. That was like, I don't know, the Match.com or I don't remember the ones OkCupid or those sort of things that then they made their money and having such an amazing algorithm that the more information they got, they could pair you up with people that then you would feel really a connection to. And then things were a lot easier. So where I'm going with that is just when you are. So where I'm going with that is that I feel like even in this betterhelp.com assessment, because they're starting to become more and more companies that are doing the online therapy that I feel like the intake form from Betterhelp.com is pretty phenomenal and that's their version of their algorithm to be able to figure out the best fit with the counselor. So go to Betterhelp.com slash virtual couch, get 10 percent off your first month's treatment because you deserve to have a higher emotional baseline. What is context? Drew says that context is basically anything that is impacting someone's life, and it includes so many things that will vary from person to person.

[00:29:29] And he just goes through a few of these, and we'll hit these pretty quick factors impacting context on mental health disorders family, he says. Love him or hate him. They're such a huge factor in everyone's life. He said if your family is deceased, that could also be leading to some of your mental health issues or family can play a significant amount of stress. They can also be a huge ally, you know, a person overcome mental health issues. But he said, we inherently so learn so many of our behaviors from our family members through observation. So when we look at abnormal behavior or possible diagnosis, learning about family dynamics can be so important. As a couple's therapist and when I'm teaching my four pillars of a connected conversation, which I promise you is it's phenomenal. We're now going through some testimonials of the last round of my magnetic marriage course with my buddy Preston Pug Meyer, and we have an independent person that's going through the testimonials and it changes marriages. And the biggest reason of that. This isn't trying to run an ad for the magnetic marriage course, but it's because so people don't know what they don't know. And so in the context of family, you only know what you saw modeled by your own parents. Or maybe you have a fictional view of what marriage would look like from a movie or a TV series or that sort of thing.

[00:30:36] So this is where I feel like going to a professional is so helpful to understand what my experience with my family is and how has that affected me? And is it again? He'd use the word sometimes, but is it normal or has my family experience been very unique or different? And that's where a really solid mental health professional who has now seen literally hundreds, if not thousands of people understands a little bit more about what that family dynamic looks like or could look like and why. Then you react or experience things the way you do because you've only had the family experience that you've had. So when people talk about the cliché dad issues, mom issues, those are real. They really are. And so the way that you went through life or the relationship that you had with your parents, one or both really can affect the way that then you see relationships moving forward. So talk about context biology. He says your family and biology may be different if you are adopted. Your family and DNA are not the same. The predispositions of a person have always been important. And he said, Are there any trends in diagnosis? Do you have a family history of depression or a family history of anxiety? The Bessel van der Cook in the book The Body Keeps the Score, and I think I might even quote this wrong now.

[00:31:46] But I believe that the phrase is the neurons that fire together wire together. I believe that was what he says, but the concept of where if someone is constantly feeling this heightened stress that then did they grow up in a home where there was violence, where there was emotional outbursts, where there was yelling, where there was physical violence? And so as a kid that your your cortisol levels are high again, they fire together, they wire together. Are you now predisposed to having higher anxiety? And now when you marry someone else and have kids, then are they going to have a little bit higher of cortisol level? So do we have a family history again of anxiety or depression or ADHD or those sort of things? Home life, I think, goes back to that concept that we were talking about earlier for family. But looking at a person's living situation is crucial if the person at the place where you go through says to recharge and relax, which is home for so many people, is unpleasant, it will impact your mental health. And he talks about sometimes a change in a living situation can really help or eliminate a lot of the symptoms that cause people's mental health issue. And I find that one of the things that I hear often when I'm doing couples therapy is someone may ask, they say, Is it normal for me to feel a little bit anxious when I hear my spouse pull into the driveway? And the truth is, it's not.

[00:33:05] It might be more normal than one would think. But is it healthy? No. And so that's that's your own body saying, OK, if I don't feel comfortable, we need to do something. We need to learn how to communicate more effectively and need to be able to speak my speak, my truths or whatever that looks like. So the home life can play a lot. And in the role of context, I can think of a couple of examples of clients right now that we're roommates after, maybe, let's say, a break up or that sort of thing. And they were in situations that had never been in before. So they did start to feel even more of a sense of hopelessness or anxiety because they felt that they just didn't feel like they had a place, a place to go and relax and be and to lower their stress job. This one is a huge one when it comes in terms of context. How we earn a living is such a part of our happiness and overall mental health. Drew says in particular, in the U.S., we spend more time at our jobs than anything else in our lives. So whether it's supervisors or. Willing customers are not feeling heard or understood or the constant stress and worry you're dealing with depressive issues, all of this and more are reports of job dissatisfaction, and people want to be able to feel a sense of pride or take ownership and things or feel a real sense of purpose.

[00:34:08] And this is why when I talk often about trying to understand what someone's core values are and in an ideal situation, you are working, you're doing a job that is based on a value and you get to use your values and your job. I love nothing more than curiosity, knowledge, adventure, authenticity. Those are some of my my the biggest values that I could live by, that I've had to come to understand. And the more that I get to use those in this context, that knowledge and the curiosity I get to be curious about people that I work with, I get to seek knowledge because the world of mental health is evolving. I still am not trying to talk negatively about other therapists, but I have clients right now that have gone to therapists in the past just to have this. Here's the things I say. Here's the exercises I do, and you just fall in line and you check these boxes and you get your diagnosis. And I don't believe that is, well, that's not the way I operate. So looking at someone with curiosity, trying to understand more about their experiences in context and then using all the latest data, understanding whether it's emotionally focused therapy that leads to the four pillars of a connected conversation, whether it's the nurtured heart parenting approach, whether it's valar stages of faith and helping people through their faith journey or the faith crisis or acceptance and commitment therapy, and continually to really understand and try to learn how to find your sense of purpose and what your values are that the world of mental health is continually evolving, as are we as individuals.

[00:35:26] We do grow, we do change, we go through experiences and then we have new thoughts and feelings, and we want to be able to explore those. We want the safety of being able to explore those with another person, with a partner, with your person, a safe person just being able to to just find purpose in your job and be able to just maybe work some of these values into your job. The next, when he talks about, in terms of context, our relationships, he said frequently people in my counseling office and I would say to myself, I don't think you need to be here as much as your blank needs to be. Your boyfriend, girlfriend, husband can be spouse, you name it sibling. But factoring in relationships is absolutely necessary because the relationships we hold often tell us a lot about ourselves. Again, I can think of client stories every day. I never want to give details, but thinking of someone recently who had been in a relationship where they never they were, their emotions were quite suppressed. It was someone that had extreme emotional immaturity or my client was in a relationship with someone with extreme emotional immaturity, a.k.a.

[00:36:20] narcissistic traits and tendencies. And so she never felt like she could even open up or share her thoughts or feelings or experiences because they were so often get shut. They would so often be told, Why are you even telling me that? Or Your crying is manipulative or there were so many negative things. So this person got to the point where why even say anything? So now is there reentering the dating world? They find themselves aware of wanting a connection, but even then finding people that feel safer to talk to and noticing that they may not be as open or expressive because in previous relationships that wasn't welcomed, it wasn't a safe thing. So our relationships actually do or absolutely play a role in the context. Physical health. I love how he says being in shape is a subjective term. Technically, everyone has a shape of some sort. But looking at overall health, exercise diet can be so insightful and understanding to a person's behavior. I've worked with people that have put on well over 100 pounds when they've become depressed and change in their physical health can absolutely play a role in there. If a person has some sort of an illness or physical disability, it can have an impact on their mental health. So this is where the use of drugs and alcohol and other medications, or things that are used primarily as unhealthy coping mechanisms, can also take a toll on your physical health.

[00:37:28] One of the there's a couple of side effects even to the ADHD medication that I take that people that take it are so familiar with where it. You cannot fall asleep with some of the medications that you're on, so you have to watch when you take it, because if somebody starts to have less and less sleep, then their brain is not doing all of the wonderful things it does during REM and sleep and resetting and refreshing all the chemicals of the brain. So even though it can cause somebody to feel pretty dialed in during the day, be able to complete some projects. If you don't watch out, it can also impact your sleep negatively, or it also removes your appetite so you can find yourself later in the day, almost mimicking this feeling of anxiety. But it's because you didn't feel hungry and didn't eat in trauma, and I'm going to be talking a lot more about trauma in the coming months. I've been doing a couple of pretty amazing trainings that have to do with trauma, acceptance and commitment therapy and trauma, things like that. But experiencing trauma in your life can absolutely have a substantial impact on your overall mental health for years to come if you aren't one who has dealt with that trauma. If somebody threatens or harms somebody close to you or you or things happen like sexual assault, he says. Physical abuse, emotional abuse, car accidents, robberies, the spectrum is so broad, but those things trauma can absolutely impact and give context to why you feel the way that you do.

[00:38:42] He's just got a couple more and then we'll wrap this up. He talks about location. Geographical sadness does appear significant in certain locations. The reasons can be varied, he said. It might not be getting enough sunshine in an area and needing a vitamin D lamp. I just had a client. Tell me about that a few weeks. To go, and I'm still fascinated by these things. Or it could require a complete move around the world just to have a different scenery. I talk about this often. I was never able to go back and find the data again, but I went to a training once where I heard someone talk about that. Moving a change of scenery is not always just a you're running away from your problems that if you are dealing with your problems, that that too often, though, when we go back to the same places, even though we're dealing with doing our work, dealing with their problems, it is that concept of our body keeps the score, our body remembers trauma. And so when we get to a certain area, a certain place around certain people are cortisol levels go up our fight or flight starts to kick in and our amygdala fires up, our prefrontal cortex shuts down. We can't think as logically. So sometimes our brain is thinking it's doing us a favor by saying, I don't like it here.

[00:39:42] So sometimes moving can be an absolute wonderful thing because you have and this is what I heard at the training, and I can't find this to save my life. But now you have new streets, new restaurants, new whether new walking past new churches, new theaters, new stores. And so if you are working on yourself and you are in a new environment, sometimes it can just be a feeling of liberation of sorts so location can really play a role and then culture. This one's just huge. What's normal and acceptable in one culture may not be in another, and he gives the greatest example here, he says. If a person is talking about speaking to and seeing spirits, then that could look like schizophrenia and be an accurate diagnosis by the books for some. Yet in another culture, it may be normal and a normal cultural belief to speak with spirits and doesn't warn. I do a fair amount of theological Christian counseling. People come into my office with specific beliefs, and it is interesting because if they're talking about being moved by the Holy Ghost or understanding or believing that God has given them direction, then if you take that out of context and give that to someone that doesn't have a similar background, then and that's why I liked it. Drew brought this up where it could sound interesting. We'll put it that way. So other factors, he said, there could be all kinds of other factors for context.

[00:40:54] And so he wraps it up with something that is my third pillar and my magnetic marriage course. He gives the Stephen A. Covey seek first to understand, not to be understood. He also says it's attributed to an old Alcoholics Anonymous adage, but my pillar three is to ask questions before making comments. And that is one of the most powerful things that you can do is try to understand context. And I feel like when we even look at context in our own lives, that will help give ourselves a little bit more grace because beating ourselves up was the way this road to happiness, a road to resiliency. Then we would all be pretty amazing right now, and we wouldn't need any help because I feel like we're all pretty good at beating ourselves up. But in reality, the best thing that we can do is understand that in the context of our lives, this is the way we are thinking or feeling or believing and showing up. And that's OK. Because once we stop beating ourselves up, we can take a look with more curiosity at why or how we're reacting in certain situations so that we can then start to move forward moving forward means taking action on the things that matter to me, the things that as I start to differentiate, be my own version of me, that I'm going to get that in validation from others.

[00:42:02] We will still run into plenty of people saying, I wouldn't do that or you should do this or all those adorable things. But in reality, it's your life. You're going through it for the first time. You're having the thoughts, feelings and emotions you're doing because you're you, you're human. And it all makes sense when you take in the context of what you're going through. Thanks for being with me today. Again, if you have questions, thoughts, ideas for an upcoming podcast and hey, the world is starting to maybe open up a little bit more. It's interesting because right before the whole pandemic hit, I was going on the road doing a little more speaking. I just want to I'm doing a lot of speaking here locally. I love that stuff. So if you're interested in having me come, speak to your group, your congregation, your business, your those sort of things, feel free to reach out through the contact form. Contact on Tony over. And I just appreciate you being here. I am blown away every time I look at the stats of the virtual couch or the waking up in our system podcast. Huge things ahead in this year and it is all. So much of it is because of the support of the people that listen to the podcast. So thank you for all you do. Have an amazing day taking us out as per usual as the wonderful amazing, the talented Aurora Florence with her song. It's wonderful. All right, everybody

[00:43:06] Have a great day. We'll see you next time on the virtual couch.

[00:43:13] Compressed emotions flying past our heads and out the other end, the pressures of the daily grind, it's wonderful.

[00:43:25] And plastic waste and rubber ghost are floating

[00:43:28] Past the midnight hour. They push aside the things

[00:43:32] That matter most wonderful. It controls three.

[00:44:13] News of discount price, a million opportunity, but chance is yours

[00:44:20] To take or lose, it's worth.

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