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"If you feel safe and loved, your brain becomes specialized in exploration, play, and cooperation; if you are frightened and unwanted, it specializes in managing feelings of fear and abandonment," says Bessel van der Kolk, author of The Body Keeps the Score (https://amzn.to/3QtMBPG). In today's episode, Tony explores what unresolved trauma can look like in adult relationships and what steps can be taken to overcome trauma and rewire the brain for connection. Tony completes the long-awaited part 2 of his review of "The Body Keeps the Score." You can find part 1 at https://www.tonyoverbay.com/how-trauma-impacts-us-all-the-body-keeps-the-score-review-pt1/ 

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Transcript

Tony: So let me take you back to the summer of 1988. Yes. The year that I graduated high school. The top movies, and I had to look these up, “Who framed Roger Rabbit?”, “Coming to America”, “Crocodile Dundee”. Not part one, no, we're talking part two. “Big”, “Willow”, “Diehard”. And music, George Michael topped the charts with “Faith”, INXS with “Need You Tonight” and Rick Astley was never gonna give you up.

So I was a high school senior. I was growing up in Sandy, Utah, and we had a very late winter and the high school baseball season was gonna consist of probably about a dozen games. So much different than where I live now in California where the baseball season can last all year long. So I was actually looking forward to summer leagues and I had been talking to a couple of college scouts and I was really hoping to be able to play somewhere in college.

And then we head out on a senior trip to St. George where I ended up getting run over by a 20 foot dual prop ski boat and cut up both of my legs and that in essence put a little bit of an end to my baseball hopes and dreams. And then on July 31st, 1988, one of my very best friends, Trent Curl, along with his brother Toby, and Trent's girlfriend, Lisa Warren, who actually had been my eighth grade crush and Toby's best friend Jeremy were killed tragically when their car drifted into oncoming traffic on the way back home from a trip to Jackson Hole. Then a couple of years later, I remember vividly receiving a call from my dad that my brother had passed away. I had just turned 21, so that would've made him 24. And now fast forward to just two or three years ago, my daughter, McKinley, my wife, Wendy, and I were preparing to run a half marathon and we were listening to music and I was playing some Jackson Five. Now don't judge, but this is when little Michael is going all in on who's loving you, which reminded me of another version of that song by Terrence Trent D'arby. Now, Trent, my aforementioned best friend who unfortunately had passed away and my best friend Grant and I wore out this CD of Terrence Trent D'arby, I think it was called, “Introducing the Hard Line” and Terrence's version of “Who's Loving You” came on, and I just started bawling. I couldn't stop and it was out of nowhere. And here we are preparing to run this race and I feel like I'm gonna get dehydrated from the amount of tears that are flowing from my eyes. And it was visceral. It was this gut reaction, and again, it just hit me so hard and out of nowhere. And I pictured my friend Trent, the only one of us with rhythm, singing and dancing to that song.

And then just a few weeks ago, my son, his girlfriend, my wife and I were driving back from Vallejo, California. Where my son's college basketball team had played a game and we passed a sign for Mayor Island. Now it's a naval base and it's where my brother died over 30 years ago. And at the time of his passing, I didn't even know where Mayor Island was. But in 1993 when we moved to California, I didn't even realize that I would be an hour and change from where he died. And so each and every time that we drive to the Bay Area, to San Francisco, to the beach, every time we drive through that area and I pass that sign that says Mayor Island, I'm just hit with these memories of my brother. Or even more recently, just a week ago with my family in town for Christmas, we drove up to the scene of an accident. And I immediately just panic and terror just overcame me. And I had my daughter McKinley with me, and I immediately just asked her if she could pull up find my phone and make sure where all the kids were, because that just brought such a horrific feeling and thought of my daughter Alex, and the ordeal that she went through almost a year ago, and the accident that she is going to be recovering from for the rest of her life.

So today we're gonna talk about trauma. And we're gonna be using Bessel van der Kolk's book, The Body Keeps the Score as our guide because as you can see in each one of these situations, the body really does keep the score and it holds on to certain feelings, thoughts, memories, and emotions, and they can come up out of nowhere. So today in keeping The Body Keeps the Score as our guide, I wanna share some information that I think will help you start to recognize how trauma shows up in your life, and maybe more importantly, as well as what to do. So we're gonna talk about that and so much more coming up on today's episode of the Virtual Couch.

Hey everybody. Welcome to episode 356 of the Virtual Couch. I'm your host, Tony Overbay. I'm a licensed marriage and family therapist and host of the Waking Up to Narcissism podcast as well, which I would encourage you to go listen to this week. You're probably gonna get this Virtual Couch episode on a Wednesday, and my plan on Friday is to release an episode with an amazing woman named Ashley Boyson and she has a very popular Instagram account called The Moments We Stand and I feel like for some reason, I want to say spoiler alert, but I feel like in this day and age, a quick search, a Google search on anybody can find out what the story would be, but she tells a pretty harrowing story of feeling like everything in her life was going perfectly. Five kids, a dream home, her husband's an attorney, and just things had seemed off, but she had been overlooking a lot of red flags. And in the episode we talk about turning red flags yellow. But eventually she learns to find out that he was murdered. And I will leave it there, but it's just not even what you would probably think there and it's one of the first guests, I think when I was doing a little bit of digging before the episode where I could have watched the Dateline NBC of her, or I think maybe the true crime report or the forensic files. But she's an amazing woman with an amazing story and is really doing some great work and helping others go through tragedy and go through trauma.

And that leads a little bit into what we're talking about today. We are talking about trauma and before we jump to the episode, then please just sign up for my newsletter. I think I'm just going down that path. Just go to tonyoverbay.com and sign up for the newsletter and you will not get inundated with information. As a matter of fact, I just haven't put one out for a little while. There's a goal to be more consistent with that, but there's just a lot coming here in 2023. There are a few new podcasts. There's still the magnetic marriage subscription based podcast where you're gonna hear real coaching. There's a revamp, an upgrade to the magnetic marriage course that is coming. And now the course is different from the workshop. If you go to tonyoverbay.com/workshop, there's a $19, everything you didn't know, you didn't know about your marriage and how we show up in marriages and relationships. And that is still available. Again, that's $19 money back guarantee. And that's at tonyoverbay.com/workshop. And I still have the Path Back Pornography Recovery Program and there's actually a discount going for the month of January on that, but act fast. And my social media team, the Amazing Yeah Yeah agency has put some things together there and you can find that on my Instagram account, which is Tonyoverbay, underscore LMFT. And you can also go to Tony Overbay Licensed Marriage and Family Therapist on Facebook. And I'm there on LinkedIn and other places like that as well. So just go find those things and you'll see a lot more content and information about the things that are coming. The most exciting thing though, is a True Crime podcast that I've done with one of my daughters, and it's one of my daughters that has not been on the show. And she's amazing. She's hilarious, and she is a true crime fan. And so she has brought in a very big case from the past. There's a Netflix documentary made of it, and we're gonna talk about that for a few episodes. We've already got those filmed where she's gonna bring the facts of the crime, and I'm gonna talk as much therapy and psychology as I can, and we plan on doing this on a regular basis. So if you go to tonyoverbay.com and sign up for the newsletter, you're gonna find out a lot more about that when those things come out.

So today I want to get to trauma and I'm going to refer to a document and now I look back on this and I did an episode a part one episode on The Body Keeps the Score and it was back in episode, oh, I had the notes, but it was in the 200 and twenties I think. So we're at 356 now. So we're talking a couple of years ago is when I did this and I did something that I do on occasion where I finished that episode, I got through a little bit of the notes that I had on The Body Keeps the Score, and then I looked back at the transcript and I said, okay, we're gonna do a part two, probably a part three, maybe even a part four. Stay tuned. So here we are two years later. Let's get to part two.

But, I also want to share that the notes that I'm referring to, and I believe I shared this back two years ago. I found an amazing, just an amazing book review of The Body Keeps the Score. So I listened to the audio book and it really is, it's a game changer. I know that gets used an awful lot, but the book, The Body Keeps the Score by Bessel van der Kolk is, I feel like a little bit of the bible of trauma in a sense. And this is someone's notes, 10 pages worth of single space notes. And they have just made this available on the internet, but I could not find who created this 10 page document of notes and so I'm gonna refer to that and all credit goes to this unnamed person, but I wanna read the summary that they did and then we're gonna jump down into more of where we left off in that part one.

So I'm gonna jump down into just really getting into more of the, what do we do about trauma? But here's what the person said about their book club notes on The Body Keeps the Score. They said, “My top takeaways from The Body Keeps the Score is that there are many different types of trauma that a person can and most likely will experience during their life, from childhood abuse and or emotional neglect, to an auto accident, war, a terrorist attack, or sudden death of a loved one. Much of trauma is a normal, albeit, uncomfortable neurological response to a dangerous situation, and so once a person experiences a trauma on a subconscious level, their brain, again, on a subconscious level, begins to not only organize their worldview, but also create actions around their response to those traumas in an attempt to keep them safe. So this can lead to a lot of problematic behaviors if the person is trying to numb out or escape from remembering what happened. Or it can lead them to feeling crazy because we are unable to numb out and feel stuck in a state of being hyper aroused, such as feeling chronically anxious or on edge or chronically hyper-vigilant about people and places and things.”

And that might not even seem like it's related to our trauma. So if you are someone that just runs more anxious in general, or somebody that is more depressed than normal or usual. These are things that I feel like, especially as a therapist, that it can be really good to go in and talk through, because a lot of times these things can just be responses to trauma. And trauma, and I love how this person lays that out, that it can be everything from the things that we often think of, childhood abuse, but it can also be emotional neglect. It can also be accidents, car accidents. But that part about emotional neglect, and this is something that I talk so much about on this podcast, is I really feel like we can bless all of our parents' hearts, but I just feel like it's almost impossible to get that right, meaning parenting, because, and I overuse this very simplistic example, but if a seven year old kid asked for a pony for their birthday and they don't get the pony, they don't say, yeah, that was a pretty big stretch because we live in an apartment and there's no room for a pony. The seven year old said, I would like a pony, please. And so in their mind, they have concocted some version of a reality where who knows, maybe they're gonna keep the pony in the bathroom, or maybe they'll just take it out for walks. I mean, people have dogs. Why not a pony? But they've created some sort of narrative that is gonna make sense. So then when they're not given that pony, then they don't just say, yeah, I understand that didn't make a lot of sense. Maybe we don't have the financial means for a pony. And where will we put a pony? In their mind they think, oh, my parents don't like me because I asked for a pony and I didn't get it. Now that's again, oversimplified, but when we really look at the concepts around what abandonment feels like as a kid, it's that we come out of the womb and we utter a small whimper and everyone jumps to attention and takes care of us. And so that's our factory setting. And that's the way that we survive, is that we express our needs and then when we're young, people meet our needs. And as we get older and we start to just go through life, everybody isn't jumping up and down to meet our needs. So then we make these pretty big demands or requests and people don't respond.

Then we can start to feel like what's wrong with me? And we have this default programming of shame because it must be because people don't love me, that I didn't get the pony for my seventh birthday, or that I don't get to eat candy corn for every meal. I mean, it is corn. The word corn is there, so what's the big deal? And so trying to make sense of things when we're a kid, when we don't even know what is going on, in essence, can lead to those deeper feelings of abandonment, which then leads on into that world of attachment. And attachment is what do I have to do to get my needs met? Do I have to be incredibly hilarious and funny? Do I have to be the athlete that gets everyone to notice me? Do I need to be the one who just keeps the peace in the home, or do I need to be the one that always gets bad grades and so everybody puts their attention on me? So there's so many different roles that we almost slide into in order to get our needs met, and we wanna get those needs met because we feel like if we don't get those needs met, we're gonna die.

And so emotional neglect can also feel like trauma. So now all of a sudden we come into our adult years, and if we were that person that was in charge of managing everybody else's emotions, and that was the way that we got our needs met, or that's the way we were noticed or seen, or the way that we felt validated, then we can bring that into our adult relationships. And all of a sudden when everybody is just doing their own thing comes the feeling of trauma or what it can feel like to be, you can be, nobody cares about me, or I'm unlovable. And I feel like if you go back through these Virtual Couch archives in a sense, there's so much that I feel like we've discussed over the last year or two about different things from everything from attachment styles, I mean, look at that concept around an anxious attachment. Here's somebody that, as a kid said, oh, I want love. I really desperately want love. But if their parent, and again, this is a, bless their parent's heart. If their parent is saying, hey, not right now, champ, I got a lot going on. Or, you know, this TV show's about to start, or, I'll get to you later tomorrow. Or, hey, actually you're fine. Don't worry about it. If things aren't really as big of a deal as you think they are, then when the kid is saying, hey, I need connection. I need to know that I matter. And then, again, even when they're doing their best is saying, hey, not right now. But then if the parent all of a sudden is feeling down, sad, and says, man, I really want to feel like I'm a good parent, and they go to their kid and say, hey, come give mom or dad a hug, or, you know, I love you. Right? Or do you see all these things that we're doing for you? So then when the kid maybe isn't necessarily looking for somebody to be there for them, but the parents saying, I'm ready. Come over here, gimme a hug. So we almost have this mixed view of attachment. So now all of a sudden we get into our adult relationships and we say, the only thing I want in life is to be loved. And then someone focuses that bright spotlight of love or attention onto us, and all of a sudden, we feel like, I don't really know how to do this. I mean, this is what I want. And so now we're looking for that external validation and we're telling the person that we've desperately wanted to love us. Well, not that way, maybe do it a different way. 

So we bring all of these traumas, and that may sound like a big word, but for today we're gonna use trauma a lot. But we bring those traumas into our adult relationship. And that's why I feel like this book, The Body Keeps the Score, just hits on so many different levels because then, again, we're talking about everything from childhood abuse, and we can have sexual abuse, physical abuse, but we're also getting into that emotional neglect. And I feel like that is more probably common of a form of trauma that I see in my office than the physical or the sexual abuse. So the author of this paper again says, “We begin to organize on a subconscious level, things into our worldview, and we create actions around our responses to these traumas and in an attempt to keep us safe, but it can lead to a lot of problematic behaviors if we're trying to numb out or not remember what happened. We can feel crazy because we're unable to numb out and we feel stuck in the state of being hyper aroused, feeling chronically anxious, on edge, hyper-vigilant. And we may not even recognize that these are things that are related to trauma,” and they say, “while there is a lot of emotional and physical pain associated with trauma, we can overcome it.”

There's the big takeaway that we're gonna get to today, and this is why this book is so incredible because it gives solutions on how to overcome it. And I feel like as so many things with mental health, the exact opposite of what we're probably doing the most of right now, such as running away from our feelings, thoughts, and, emotions and dealing with them later are feeling like they aren't as big of a deal as we think they are, not the greatest idea for dealing with or processing trauma. So I'm gonna give you some tips on how to deal with that today. So they go on to say that, yeah, “So while there's a lot of emotional and physical pain associated with trauma, we can overcome it. This is done by understanding that what we are experiencing is largely neurological and that we aren't crazy or somehow beyond help. That once we bring awareness to our feelings and our actions and we see them as more of a defense mechanism than something that makes logical sense, then we can start to regain control of our brain, our body, and our life.” So when you start to just look at this, and I love it, it's an acceptance and commitment therapy model of check this out, look at how I'm behaving, that's interesting. So based on these situations, these circumstances that I'm going through at this very moment in time, here's how I react. Because when you can take yourself out of that moment, see yourself in the context of that moment, then we can start to look at, what is the trauma maybe that has led to that response in that moment?

So, the person said, “The big gift in trauma is self-awareness, but it's a gift that we have to work hard at unwrapping,” but then they say, “but boy, is it worth it.” So they go on to say that they hope you enjoy this book as much as I did, and my notes are below. So thank you person who created all of these notes, and if you want a quick recap on the first part of the book, then I do, I highly recommend that you go check out episode 220 something or 200 and something. I'll put a note, I'll put a link to the episode in the show notes. But that's the first part of this episode on trauma. 

So where I'm gonna jump in is we left off on the other episode talking about trauma being misdiagnosed and mistreated and talking about the diagnostic criteria for trauma, so I'm gonna jump into this person's notes right after that trauma is largely neurological, so that's what we talked about a little bit in the opening. So when people are really upset, they often feel like they are losing their mind. Now in technical terms, they're experiencing the loss of their executive functioning. You might hear this from time to time, this loss of executive functioning, because that's a big part of other things such as Asperger's or some of these disorders. And the loss of executive functioning is, in essence the loss of being able to, that executive functioning area is the area where we make sense of things. It's often called our rational brain, our logical brain. So, the brain on trauma. The limbic brain and the visual cortex show increased activation and the speech center shows markedly decreased activation. So the more intense that our emotions are, it activates that amygdala, our fight or flight part of our brain. And so then our rational, our cognitive brain, and I love how Bessel van der Kolk says that our rational cognitive part of the brain is the youngest part of our brain, and it only occupies about 30% of your skull. And its primary concerns with the world outside of us are understanding how things and people work and figuring out how to accomplish goals, manage our time, and then sequence our actions. And I love how he says that's the youngest part of our brain, so intense emotion and this, hyperactivated amygdala, the fight or flight response, now that's the old guard, the OG, that's been there forever, that's there to protect us. So it's this newer part of the brain is the one that says, okay, I think we're safe now, what do you wanna do? And so Bessel van der Kolk says, “The brain is built from the bottom up. So the most primitive part, also known as the reptilian brain, is located in the brainstem just above the place where our spinal cord enters the skull.” And that reptilian part of the brain is responsible for hunger and thirst, pain, breathing, pretty important, ridding the body of toxins, meaning urinating, defecating, poo poo, pee pee jokes. Uh, anybody as a dad that's getting older. The brainstem, the hypothalamus, which sits directly above it, controls the energy levels of the body. 

So again, we've got this very base version of the brain that is eat, drink, pain, react, emote, breathe, poop, pee. And from there we get right above that, the hypothalamus that controls the energy level of the body and it coordinates the endocrine and immune systems and keeps the internal balance that we know as homeostasis. So we go right up from the reptilian brain and we've got the limbic system, or they call it the mammal brain. This is the seed of emotions. This is the monitor of danger, the judge of what is pleasurable or scary, the arbiter of what is or is not important for survival purposes. So the limbic system is shaped in response to experience. So the more that you do, the more that you think and feel, that shapes the limbic system. Again, this mammal brain, so that in partnership with the, you know, as an infant, your own genetic makeup and your inborn temperament, those are what starts to shape what it feels like to be you. So, this limbic system, so that's when I talk about nature and nurture, birth order, DNA abandonment, rejection. Now we're talking limbic system. And so whatever happens to a baby contributes to the emotional and perceptual map of the world that it's developing and that its brain creates. This is where he says, “Neurons that fire together, wire together.” Also known as neuroplasticity. And that's not something that's just set in concrete at birth or at age three, or five, or 12, or 19 or 25.

We've got more and more data that say that the neurons that fire together, wire together, throughout your life. So now if you feel safe, you feel loved, then your brain becomes specialized in exploration, play, cooperation. But if you're frightened, if you feel unwanted, then it specializes in managing feelings of fear and abandonment. So in the book, The Body Keeps the Score, Bessel van der Kolk says, “The emotional brain equals the reptilian brain and limbic system.” So the emotional brain is at the heart of the central nervous system, and its key task is the lookout for your welfare. If it detects danger or there's any special opportunity that you need to be aware of, it alerts you by releasing a little dose of hormones, and the result is a visceral gut sensation, ranging from feeling a little bit queasy to the grip of panic in your chest, and it will interfere with whatever your mind is currently focused on, and it'll get you moving physically and mentally in a different direction. So now, well-functioning frontal lobes are crucial for a harmonious relationship with our fellow human beings. So without flexible, active frontal lobes, people become creatures of habit and their relationships start to become superficial and routine. And then he talks about invention, innovation, discovery, and wonder. They're all lacking when you are just trying to survive. And I see this so often. If I go into the people that are in emotionally abusive relationships and I talk about it, I like to call it, it's a waste of emotional calories and emotional energy when somebody is continually just trying to manage their feelings and emotions and regulate their safety when they're in a relationship with a significant other. Where when people feel safe, then they are free to explore, to play, to be cooperative, and when that is the what it feels like to be you on the inside, then you're more open to invention, innovation, discovery, and wonder. But when you are in this, I have to protect myself, then we never get to those things and it never becomes a, you are the best version of you. So, those frontal lobes, let me go over that quickly. Bessel van der Kolk says, “Our frontal lobes can also, but not always, stop us from doing things that will embarrass us or hurt others. We don't have to eat every time we're hungry or blow up every time we're angry or kiss anybody who arouses our desires,” but he says that, “it is exactly on that edge between impulse and acceptable behavior where most of our troubles begin.” So the more intense that visceral or sensory input from the emotional brain, the less capacity that the rational brain has to put a damper on it. So if you think about that, if you are one who falls prey to impulse on a regular basis, if you can start to see where I'm going here, you can start to relate that to trauma.

And I'm not saying, okay, now, you know, oh my gosh, we gotta dig in there and rewire your entire brain. But sometimes just being aware that, oh, I am a bit impulsive and I get right between that edge of impulse and acceptable behavior. And that is where my trouble begins. And so that visceral or emotional brain, if it is very impulsive, that most likely that's there to protect me for some reason. All of a sudden I feel like I have to impulsively act on something, or maybe I'll never get another chance to do that again, or that's the only time that I feel this sense of adrenaline or rush. So just being aware of that often is part of this road to recovery. So he says, “Past trauma and the ongoing threat perception system of the brain, it affects people's current reactions.”

So this amygdala, the fight or flight part of the brain makes no distinction between past and present, once it's triggered, even if the trigger isn't the same as the original trauma, then your brain is still gonna say, oh, I'm triggered. And it's not trying to say, yeah, but this one doesn't seem as real. So in the book he talks about the challenges, not so much learning to accept the terrible things that have happened, but learning how to gain mastery over one's internal sensations and emotions. Sensing the feelings and the emotions, naming the feelings and the emotions, and identifying what's going on inside of you is really the first step to recovery. And let me talk a little bit about the amygdala and then I'll get away from the brain here and we'll talk more about, I wanna hit a little bit on this concept of mirror neurons, but the amygdala's really important. It's important that our amygdala is working correctly. Bessel van der Kolk says “It's like a smoke detector for danger, we don't want to get caught unaware by a raging fire, but we also don't want to get into a frenzy every time we smell smoke.” So we need to be able to detect whether somebody is getting upset with us. But if the amygdala goes into overdrive, then we may become chronically scared that people hate us or that we feel like they are out to get us.

So our amygdala means well, but if that panic button is stuck on, then that can be something that we're gonna need to work through. And so therapy, and I love that Bessel van der Kolk talks about this, “Therapy only works if a person is grounded in the present moment,” you know he says, can feel their butt on the chair, see the light coming through the window and feel calm and safe. So, “being anchored in the present while revisiting the trauma, that's what opens up the possibility of deeply knowing that the terrible events belong to the past.” And this is one of the most powerful things about talk therapy. And I know that this is so powerful. I see it on a daily basis that when somebody can sit there and they are grounded and they are able to talk and express these feelings and emotions and tell these stories from the past or even things that are going on in the present, or their fears of the future and they can talk about those and express those in a way that is safe and have somebody there that is not trying to tell them, well, why didn't you do this? Or you should do this instead. But when somebody is really there and saying, and then what happened? And tell me what that was like, and how did you feel? That all of a sudden we're grounded, we're anchored in that moment, and we're able to express something scary and we feel safe. And that's starting to rewire or change the neuropathways of the brain. So again, therapy works when somebody's grounded, they're in that present moment. So being anchored while revisiting trauma opens that possibility of deeply knowing that the terrible events belong to the past. If a person's in a flashback or they don't feel calm or safe, if they start to feel defensive or aggressive, and feel unsafe or not believed, then therapy doesn't work and at best it can make a person almost re-traumatized. And that's the part where if, and I'm not trying to say that as a knock on therapist, but I'm trying to say that as a bless the heart of your friends, that if we start to open up about trauma to those and you do not feel believed and you do not feel safe, then again, not only does it not work as a way to help heal, but it can make you almost feel re-traumatized because there's somebody that doesn't believe you.

So I said I would move away from the brain after the amygdala, but Bessel van der Kolk has a great way to talk about the thalamus. “So our thalamus is like a cook. It takes information from all the senses, and then it blends it with our autobiographical memory. So breakdown of the thalamus explains why traumas are primarily remembered not as a story with a beginning, middle, or end, but as isolated sensory imprints, images, sounds, physical sensations that are accompanied by intense emotion, usually terror and helplessness.” And so in the book, the Buddha Brain, the author talks about the mechanisms of memory. And the way that memory works is such an interesting thing where we conjure up an image and then we fill in all the gaps. And it's a more productive use of neural real estate, I believe, the author Rick Hansen said. But that's where we start getting into this concept of confabulated memory, where every time that we recall a memory, then we're gonna fill in the gaps with different details. And then when we put that memory away, now that's the new confabulated memory. So in normal circumstances, Bessel van der Kolk says the thalamus also acts as a filter or a gatekeeper. So he says, “This makes it the central component of attention, concentration, and new learning, all of which are compromised by trauma.” So people that have PTSD have their floodgates wide open, they lack a filter, and they're on constant sensory overload. So in order to cope, they try to shut themselves down and they develop tunnel vision and hyperfocus. And if they can't shut down naturally, they may enlist drugs or alcohol to block out the world. And the tragedy is that the price of closing down includes filtering out sources of pleasure and joy as well. It's as if the brain has to do all or nothing thing, because it's so fearful or afraid of trauma. And Bessel van der Kolk talks about mirror neurons. This is a really interesting concept that there's a belief that these mirror neurons could be the key to all kinds of things in the future. Mirror neurons explain empathy, imitation synchrony in the development of language. “Mirror neurons,” he says, “are like neural wifi. We pick up not only another person's movement, but their emotional state and intentions as well.” So when people are in sync with each other, they tend to stand or sit in similar ways. Their voices take on the same rhythms, but mirror neurons also make us more vulnerable to others' negativity, so that we respond to their anger with fury or we're dragged down by their depression. And because trauma almost invariably involves not being seen or not being mirrored and not being taken into account, then treatment for trauma needs to reactivate the capacity to safely mirror and be mirrored by others, but also to resist being hijacked by others' negative emotions. And he talks about two ways to implement change.

So now we're talking top down or bottom up. “So structures in the emotional brain decide what we perceive as dangerous or safe. There are two ways of changing the threat detection system from the top down,” which he says, “is through modulating messages from the medial prefrontal cortex.” What does that mean? Mindfulness, meditation, yoga. So from the top down, being able to just have that pause and bring in information in a much more calm way. Or he says, “From the bottom up through the reptilian brain, through breathing, through movement, and through touch, which helps recalibrate your autonomic nervous system.” And he goes into a lot of detail about the autonomic nervous system as well as the sympathetic nervous system, the parasympathetic, I'll talk about those two because people have really clever things that they remember with the sympathetic nervous system and the parasympathetic nervous system.

So the sympathetic nervous system acts as the body's accelerator. It includes the fight or flight or what Darwin referred to as the escape or avoidant behavior. Functions with the use of emotions. The parasympathetic or PNS works against emotions and it promotes self-preservation. So functions like digestion, wound healing, exhaling, that helps to calm us down. So, you know, inhaling helps to activate adrenaline. Exhaling helps us to calm down. So you can access your whole, you know, the sympathetic and parasympathetic are part of this autonomic nervous system, and you can access those through breathing, movement, touch. I mean, breathing is one of the few body functions under, it's underneath both conscious and autonomic control. There's a neuroscientist named Paul McClain. He compares the relationship between the rational brain and the emotional brain to that between more or less of a competent rider and his unruly horse. “So as long as the weather is calm and the path is smooth, the rider can feel like they are in excellent control. But then unexpected sounds or threats from other animals can make the horse bolt. So then forcing the writer to hold on for dear life.” So likewise, when people feel like their survival is at stake, or they're seized by rages, longings, fear, sexual desires, they stop listening to the voice of reason. And it makes little sense to argue with them.

 Sometimes this is that, I think I did an episode long ago on the passenger and the rider, and so it's that same thing. So the rider can be in excellent control. You know, the rider is that rational brain. And then the emotional brain is the animal that is being ridden. And then if that animal is spooked, so to speak, that emotional brain, then it can just take off. And that rational brain is literally hanging on there for dear life. So a person who has been in anger management classes, for example, maybe seven or eight times, might extol the virtue of the technique by saying they are great, they work terrific, but then they find out, as long as you're not really angry.

When our emotional and rational brains are in conflict, for example, when we're enraged with somebody that we love or frightened by somebody that we depend on, or we lust after somebody who is off limits, then a tug of war ensues and it gives us a visceral experience. Our gut, our heart, our lungs, they will lead to both physical discomfort and psychological misery. And then the next component that he talks about is adrenaline. So insults and injuries are remembered, the best because the adrenaline that we secrete to defend against potential threats helps us to engrave those incidents into our minds. So how crazy is that? So even if the content of the remark fades, our dislike for the person who made it usually persists. So that adrenaline is a pretty neat thing except for when it's not. So when, when that adrenaline is flowing, you know, and it's there to defend us against potential threats, it's saying, hey, don't forget this guy. And so now you all of a sudden almost have this anchored memory that I don't know if I'd like that person very much. So then when something reminds traumatized people of the past, their right brain reacts as if the traumatic event were happening in the present. But because their left brain isn't really working well at that moment, they may not be aware that they are re-experiencing and reenacting the past.

Because to them, they're furious, they're terrified, they're enraged, they're ashamed, they're frozen. And after that emotional storm passes, then they might look for something or somebody to blame it on. Well, look at what you made me do, and if we're honest, I think most of us have blamed others for our behavior from time to time. But hopefully once we cool down, hopefully we can admit mistakes. But trauma absolutely interferes with this kind of awareness, and that's what I talk often about over in the world of emotional immaturity or narcissism, that it really is, it's a response to childhood trauma where somebody is left without a real sense of self needing external validation and lowered empathy because that trauma interferes with our awareness, people don't experience trauma in the same way. So not everybody experiences trauma in the same way. Some are on hyper alert, some go numb and have decreased activation, blank stares, absent minds. Those are the outward manifestation of the freeze function and so much of how we react to trauma, which survival mode we go into as adults, is how we learn to react to trauma as children. If we numb out as kids, we might numb out as adults, and if we went into fix it mode as kids, or if we had to get our needs met, we had to go juggle or clean the house, we might do that stuff when we're older as well. But after trauma, then many people are either hypervigilant or they're numb. So if they're hypervigilant, then they can't enjoy the ordinary pleasures that life has to offer. And if they're numb, then they have trouble absorbing new experiences, or they may not be alert to signs of real danger. And what Bessel van der Kolk talks about is when that amygdala, what he calls malfunctions, “People no longer run when they should be trying to escape, or they no longer fight back when they should be defending themselves.”

So it can be really challenging to help people deactivate these defense mechanisms that once ensured their survival. So the key about working with trauma is it's not about stopping a behavior like yelling, it's about deactivating a defense mechanism that leads to that yelling. So, to sum this up really quick, it says four main points to know about trauma. “People are patients, but their participants and their healing, and they need to restore their autonomy. Victims of trauma continue to be there instead of here.” So when somebody is in their trauma response, they're there, not here and we need to get them back to here. And you can only be fully in charge of your life if you acknowledge the reality of your body and you're aware of all of its visceral dimensions. And then he also says that “People who suffer from flashbacks,” and I think the vast majority of us do in some form or fashion, maybe that sounds like a dramatic concept, but it's not, “often consciously or unconsciously organize their lives around trying to protect against them.” And this is where I feel like the concepts around we're trying to manage our own anxiety and we do that often through the control of others or trying to control our own environment where in reality when all we're trying to do is control ourselves or others, the truth is there's a lot of disorder or there's a lack of control in the world, and that's where acceptance can come in.

And acceptance can be scary, especially when our body is trying to protect itself by gaining control. So again, they organize their lives, trying to protect themselves. They might work out trying to be strong enough to fend off an attacker or numb themselves with drugs to try to cultivate an illusionary sense of control in highly dangerous situations like bungee jumping and skydiving. Fighting unseen dangers is exhausting and it leaves people fatigued and depressed and weary. And so if the elements of trauma are replayed over and over, then the accompanying stress hormones engrave those memories even more deeply. Again, the neurons that fire together wire together, and all of a sudden then ordinary day-to-day events become less and less compelling. Not being able to deeply take in what's going on around you, it can make it impossible to feel alive. And it becomes really difficult to feel the joy as well as the aggravation of ordinary life. It can be harder to concentrate on the tasks that are in front of you if you're not feeling fully alive in the present. You know? And when you're not, Vessel van der Kolk says, “Not being fully alive in the present, it keeps you more firmly imprisoned in your past.” So there's a lot of different responses to trauma. It can be everything from frantic to collapse. It can be focused, it can depend on your level of danger, but he says that angry people live in angry bodies. That the body of trauma victims are tense and defensive until they find a way to relax and feel safe. And one of the best ways to do that really is to begin by describing physical sensations that are beneath those emotions. The pressure, the heat, the muscular tension, the tingling, the caving in, the feeling hollow. And then work on identifying sensations that are associated with relaxing or pleasure. You know, part of the job as a therapist is to help people become more aware of literally their breathing, their gestures, their movements, paying attention to subtle shifts in your body, such as tightness in your chest or gnawing in your belly, or especially when you talk about negative events that sometimes people claim, well, no, that those things aren't a big deal. The most natural way for human beings to calm themselves when they're upset is by clinging to another person. But this is hard if the person was physically or sexually violated, because they often then are terrified of bodily conduct.

He talks about the power of hitting rock bottom. I think about this often that rock bottom truly is this principle of hindsight. But he says, “Therapy often starts due to some inexplicable or problematic behavior. Not sleeping or eating, fear of others, partner cheating, jumping into the fix of the problem is not the solution. It takes time and patience to allow the reality behind these symptoms to reveal themselves.” So you can't just jump in there and fix something in a session or two, but starting to be aware and knowing that I think I want to get some help is a huge step. And he says, “Many traumatized people find themselves chronically out of sync with the people around them and many find comfort in groups where they can talk about what happened to them with others who have gone through things that are similar.” This often helps alleviate this sense of isolation, but usually at the price of having to deny their individual difference or isolating oneself into a narrowly defined victim group can promote a view of others as irrelevant or at best dangerous.

Which eventually only leads to further alienation. So a lot of times people then stay away from these groups or people that have had similar experiences because their brain tells them stories like, well, I just don't wanna get in there and just complain all the time. And I feel like that's an adorable story that your brain is telling you to keep you away from the unknown, when in reality that unknown is what can heal you. If relationships with people don't help, relationships with other mammals can, animal therapy, it's very real. But talking through things is really important. Sigmund Freud saw or thought that the lack of verbal memory is central and trauma, and that if a person does not remember that he is likely to act it out. I thought that was such a deep thought. Freud said he reproduces it, not as a memory, but as an action. He repeats it without knowing, of course, that he's repeating it. And in the end we understand that this is his way of remembering. As early as 1893, there was a study called The Talking Cure, Freud's and Brewer, the individual hysterical symptoms immediately and permanently disappeared when we had succeeded in bringing clearly to light the memory of the event by which it was provoked. So when the patient had described what that event was in the greatest possible detail and had put that affect into words. So there needs to be, this was a quote from that study. “There needs to be an energetic reaction to traumatic events. And if there isn't, the affect remains attached to the memory and cannot be discharged.” Tears and acts of revenge are how most people discharge their trauma. So if people don't consciously remember, they react. So if you've been hurt, you need to acknowledge and learn how to name what happened to you. 

I'm gonna wrap this up with a couple more things real quick here. In 2002, Dr. Spencer Eth interviewed 225 people who had escaped the Twin Towers. And when asked what had helped them recover the most, the survivors credited acupuncture, massage, yoga, and EMDR, in that order. And massage was particularly helpful among rescue workers. So the survey suggested that most helpful interventions focused on relieving the physical burdens generated by trauma. So trauma makes people feel like either somebody else or like nobody. And people often lose their ability to speak. And in order to overcome trauma, you need to help get back in touch with your body and with yourself because our sense of ourselves is anchored in a vital connection with our bodies. We do not truly know ourselves until we can feel and interpret our physical sensations. And we need to be able to register and act on these sensations to navigate safely throughout life. So if you are unaware of what your body needs, you can't take care of it. If you don't feel hunger, you can't nourish yourself. If you mistake anxiety for hunger, you may eat too much. And if you can't feel when you are full, you'll keep eating. So this is why cultivating this sensory awareness is such a critical aspect of trauma recovery. Traumatized people need to learn that they can tolerate their sensations, that they can befriend these inner experiences and they can cultivate new action patterns. And that's done through everything from talk therapy to yoga, to, as you mentioned, everything from massage and emdr.

But moving forward into healing, no one can treat away abuse or rape, molestation, or any other horrendous event and what has happened can't be undone, and that's not said in a negative way, but what can be dealt with are the imprints of the trauma on the body, the mind, and the soul, so that crushing sensation in your chest that you may label as anxiety or depression, the fear of losing control, always being on alert for danger or rejection, the self-loathing, the nightmares, the flashbacks, maybe the fog that keeps you from staying on task or fully engaging in what you’re doing. Or being unable to fully open your heart to another human being. Trauma robs you of the feeling that you are in charge of yourself. So the challenge of recovery is to reestablish ownership of your body and your mind, and to feel what you feel without becoming overwhelmed or enraged or ashamed or collapsed. So for most people, there's four things. Finding a way to become calm and focused. Learning to maintain that calm in response to images or thoughts, sounds or physical sensations that remind you of your past, or finding a way to be fully alive in the present and engage with the people around you and not having to keep secrets from yourself, including secrets about the ways that you've managed to survive.

And one of the key things of doing this is finding yourself around safe people and also finding out things that matter to you. It goes back to are you acting in accordance, in alignment with your values or are you living a life full of socially compliant goals or doing things that you feel like you're supposed to do or you'll let other people down? Because that feeling that I may let someone else down can absolutely be tied back to some childhood trauma because you're responsible for you and the best way to find out who you are is to start to take action on things that matter to you and see where that takes you. So, welcome to the world of trauma recovery.

If you have questions, thoughts, or any other things that maybe we can address in future episodes, then send me a note contact@tonyoverbay.com or through my website or comment on the post that will go up about this on my social media feeds on Instagram. I would love to get your opinions because trauma can absolutely be overcome, but the exact thing that we often are afraid of, of talking about it and I hope you heard that part where needing to be able to talk about it with people that do feel safe, can absolutely help you move through and pass trauma, and be able to invite it to come along with you while you start to take action on things that matter. And then you really start to find yourself and live this more purposeful, intentional, value-based life. And that's an amazing place to be, rather than wasting all of your time in emotional calories and energy trying to manage your emotions, manage your anxiety, or control your environment. All right, send me your questions and we'll see you next time and taking us out per usual, the wonderful, the talented Aurora Florence with her song, “It's Wonderful”. We'll see you next week and have an amazing time. See you next week on the virtual Couch.

Dr. Michael Twohig joins Tony to talk about his early involvement in the then “new kid on the psychology block,” acceptance and commitment therapy (ACT). Dr. Twohig shares his initial hesitation in embracing ACT and what eventually led him to pursue his Ph.D. in clinical psychology by working with Dr. Stephen Hayes, the founder of ACT. He discusses the differences in using ACT to treat OCD vs. the traditional CBT-based model, and they talk about using metaphor in ACT. Tony shares his experience of how learning ACT changed his therapy practice and his general outlook on life. They discuss the differences between using diffusion in ACT to make room for thoughts and feelings vs. responding to the body’s cues concerning treating trauma. 

They talk about Dr. Twohig’s new online course on ACT and OCD https://praxiscet.com/virtualcouch and the challenges of marketing an online course. Finally, Tony challenges Dr. Twohig to a “try not to laugh” challenge.

Dr. Michael Twohig is a licensed psychologist, a professor at Utah State University, and one of the world’s most published scholars of Acceptance and Commitment Therapy (ACT). Dr. Twohig’s research focuses on using ACT across various clinical presentations emphasizing OCD and related disorders. He has published five books and more than 200 scholarly works and is the former President of the Association of Contextual Behavioral Science, the organization most associated with Acceptance and Commitment Therapy https://contextualscience.org/

You can find out more about Dr. Twohig via his Utah State University page https://cehs.usu.edu/scce/clinicians/twohig-michael or his private practice website https://junipermh.com/team/michael-twohig/

If you are interested in being coached in Tony's upcoming "Magnetic Marriage Podcast," please email him for more information. You will receive free marriage coaching and remain anonymous when the episode airs. 

Go to http://tonyoverbay.com/workshop to sign up for Tony's "Magnetize Your Marriage" virtual workshop. The cost is only $19, and you'll learn the top 3 things you can do NOW to create a Magnetic Marriage. 

You can learn more about Tony's pornography recovery program, The Path Back, by visiting http://pathbackrecovery.com And visit http://tonyoverbay.com and sign up to receive updates on upcoming programs and podcasts.

Tony mentioned a product that he used to take out all of the "uh's" and "um's" that, in his words, "must be created by wizards and magic!" because it's that good! To learn more about Descript, click here https://descript.com?lmref=bSWcEQ

Transcript

Mike Twohig pt 1

Tony: Okay, I will start with the former, I mean, you were so kind to say, call me Mike, but, Dr. Michael Twohig, welcome to the Virtual Couch. 

Mike: Yeah, thank you so much for inviting me. 

Tony: Yeah. I have you on this pantheon of my big gets, so I don't know if you ever get that vibe or, I mean, I don't know.

How do you feel about that knowing that you are one of these world renowned active researchers?

Mike: I don't feel that way in the slightest. So it's, yeah, let me think. Do I ever bump into that? I don't know. I feel like sometimes grad students applying here give me that feeling because they're all excited.

But no, really in my real life I don't really bump into that. And then one of the things about being a faculty member is your life really is kind of between your office and your lab. So that's all you really bump into. So whenever someone's like, oh, I like your work. That is kind of cool because you know, you don't really get to bump into that very often.

Tony: Okay, well, I sing your praises often, and so I'm going to try to be very calm and very collected throughout this interview. So what I'm really curious about, and this one is going to be personal, I just want to know, and then hopefully listeners will enjoy it as well.

I learned CBT out of grad school and I did CBT for a few years and then when I learned act, it really was like the sky's parted and the heavens shown down. And then it's changed my life, my practice, and then most of my podcast is all talking about act.

And then I'm curious, what has your experience been with it? I mean, you studied under Steven Hayes and so I would love to just hear your story about that.

Mike: Yeah, thanks for asking that question because it’s, you know, I feel like I was really lucky, because I didn't plan this, it just, right. Like sometimes things just happen.

So I'll tell you the story. I hope the listeners aren't bored because it's kind of fun. I'm working at the University of Wisconsin Milwaukee with a guy named Doug Woods, who's the best. And we're treating people with Trichotillomania and I remember saying to Doug, you know, I was getting a master's in behavior analysis and I said, Doug, we're doing a good job teaching people how to stop pulling their hair, but they have all this emotion and urges and like there's all this internal stuff and behavior therapy's not like we don't really have a strategy for it.

And he said, you should learn act. And it was interesting because this is like 1999. And I really liked Steve Hayes at the time because he wrote a lot of good behavior analysis theory on language and cognition and how private events work. So I knew of him as kind of like a researcher of behavior analysis. So the two of us in 1999 flew out to Reno and did an ACT workshop and back then they were like 24 hour workshops. Right. It was just ridiculously long and not many people. So we went and I remember being at it and not really enjoying it per se, because it was a little too much.

Because I was a behavior analyst and this [ACT] is like watching your emotions and sitting there and seeing your thoughts floating by. It was out of the world that I lived in. But when I was finished with the workshop, an interesting thing I took away is you can have whatever thoughts or feelings you have, and that's just fine.

And that was what 24 hours taught me. We came back and we integrated act and behavior therapy for the treatment of Trichotillomania. And it clicked really well. And I remember at one point, it clicked well for the clients, I remember at one point Doug Wood says, Mike, you don't know what a good idea this is.

And he's right because I was like 23 at the time. Right? Like, I didn't know that this was a pretty wise career move. So the next step would be, I applied to grad schools and I'm not that great a student. But when I applied to work with Steve, I had done an ACT project in 2001, not many people had done an ACT project. So that's how I got into grad school. And those years from 2002 to 2006 at UNR were super fun years because Steve had just stopped being department head so he had more time. And that's when ACT was in Time Magazine. 

Yeah. And also if you look at like, when the study started coming out, that's when everything was happening. And it was super fun. I just felt like the whole time in the lab was really inspired. You know, we thought we were changing the world.

I never felt like I was at work ever. And then that was my world, behavior therapy and act and I guess it's always stayed that way. Yeah, it's kind of a weird thing because the only therapy I knew how to do was act. So most people I bump into learn traditional CBT then act.

So I had to learn how to do traditional cbt. 

Tony: Okay. Which is funny because, I don't want to talk much at all in this episode, but I really would love, can I lay out what I say about my aha moment of CBT versus act? And I honestly, Mike, I want, I kind of want you to poke holes in it because now I realize I have confabulated this narrative where now I think I've got everything figured out, which obviously means I don't.

So I was a CBT therapist. I was an intern working for my church non-profit. And I had a guy that came in and he was, he had lost like half of his weight and he had social anxiety and I was trying to do the CBT skills of, okay, he walks into a room and everybody turns and looks at him and, and then he feels shame and he leaves and so in the old CBT world those are, that's automatic negative thoughts. That's stinking thinking. And so what are other reasons why they might be looking at you? They might think you look great. They might just turn when a door opens and you know, he would leave and say, yeah, right.

And then he would come back and then he would say, it did not work. You know, and again, start doing the, all right, what's wrong with me? This sounds like a good tool. And then we would come up with other things or other reasons. And I literally then went to an ACT workshop and for me, oh, and I say this often, he's the only version of him that's ever walked the face of the earth with his nature, nurture, birth order, dna, abandonment, rejection, all that.

And so that's how he feels. So I love what you're saying. Right. So then, of course he's going to think everybody's looking at him because he walked around as a 400 pound 12 year old where everybody did look at him. So if he didn't think that it would kind of be crazy, you know? So I started off by, okay, acceptance, that's how you feel.

And then we got into the values, and he had a value of connection and social connection. And so then whether they're looking at him or not, doesn't matter. It's not a productive thought, and he can bring that along with him. And so it was like a game changer. But then I realize now all of a sudden I go black and white, and now I think CBT is horrible and it's almost doing damage.

And because, you know, it says you're starting with your negative thoughts now just change them, you know, just to be happy. And then when I feel like, here's the part I make up, so this is where I want you to poke holes, please. So then the third part is and then if I say to somebody, Hey, how's that working for you, champ?

Then they say, okay, well I already started with broken thoughts and automatic negative thoughts. I can't just change them magically, but that must be my problem. So then I feel like they say, no, it's doing pretty good. And then they leave and just feel like I need to figure this out. And then they leave therapy and then I feel like then they look for the next self-help book or whatever.

And so I felt like ACT was so, I think I've almost demonized CBT, but then I know what act is, what do we call it the next, CBT? So please tell me I'm wrong. So can you explain that and then, and either validate the heck out of me or tell me I'm wrong.

Mike: I think you're on a great track because, you said, here's the part that I'd like you to, double check. The, how is that working for you. And that question, like when you said it, the light bulb, you know, that went off for me is what does that mean to him? When you say, how is that working for you and what do you mean?

When you say, how is that working for you. Because yeah, clients will usually go, how is that working? Am I feeling better? I'm doing air quotes. And an act therapist would say, how is that working for you? Meaning like, how is this working in your life? Are you going in the directions you want to go?

Tony: Yeah. And that's what I feel like was so good. I like your question because if I was saying, how was that working for you? And meanwhile I'm handed a population, and this is funny because I didn't even remember that it was you that I read an article about that helped me here too.

But I was working with people that were struggling with turning to pornography as an unhealthy coping mechanism. And the training I was getting at that time was a lot of, you know, seeing him, do some pushups, behavioral, and then I felt like, ooh, that one's not quite working. And then I think I read something that you did there about, was it mindfulness?

Yeah. And that was, that was also a game changer. And so then it was getting people to start to just take action on things that matter. And right now we're going to not worry about the unhealthy coping mechanism. You know, nothing's wrong with you, you're human. And the more they started doing things of value, then the more they started to feel better and the less they turned to unhealthy coping mechanisms.

And so then, yeah. So I think my, well, how's that working for you? I think, right. I then had, I think the part with trying to identify people's values was a real challenge, you know? 

Mike: Yeah. I think the shift right there, you can say to a client or the two of you, you know, I don't know if this is a listener.

Actually, I told you, two of my friends said something about being mentioned on your podcast, and one is not a therapist and one is a therapist. So, okay. I'll say it for both people or both styles of people that we can work on altering how we feel, or we can work on altering how we live and we're whole human beings and whether you alter either one, it's going to affect all sorts of stuff. So if you change the way you live, you'll change the way you feel. If you could change the way you feel, you'll probably change the way you live. But from the kind of an act or behavior therapy model, we're going to lean on changing the way you live to affect, you know, without the goal of affecting how you feel but it will. So like this client, when he said it's not working. My question would be, well which one are we going to focus on? Are we going to focus on what you feel internally or how you're living? And I say this to clients a lot, that a lot of the things I really care about and a lot of things I work hard on don't feel good. You know, like parenting a team doesn't feel fun. But it's meaningful, it's important, but it's not like, ooh, you know, that was great. Or even the same thing like writing a paper, it's not the same as snowboarding, so like the feeling and the importance of it.

So yeah, it's orienting the client and you to what's meaningful. 

Tony: Well, and what I like about that so much, Mike, is sometimes I think in my head that if a client almost “breaks act” where I think, oh, that was well played. Where if maybe they don't hold a value of, I don’t know, if they almost hold a value of, I know there isn't necessarily in the values list codependency, but I'll get people to say no, my core value is helping everybody else and putting myself second and, and I want to say, but no, that, that one's not cool. But then you know it’s what it feels like to be them. And so I like what you're saying to yeah, that change in behavior, or living by one's, yeah, because I feel like, I don't want to sound arrogant, but I feel like, okay, that is where that person's at right now.

But if I go back to that, how's it working for you? Then sometimes I feel like, oh, okay, they're trying to just adapt or cope with this thing that they don't enjoy. 

Mike: Yeah, and I'll often, like that question, I'll be more precise. I'll say, how's that working to change these thoughts about your self image?

Or I'll say, how's that working to be part of the group?

Tony: Hey. Okay. So speaking of that too, and I know that this is going to feel like five minutes to me of talking with you. I really like the work you've done with ACT and ocd.

I had read Brain Lock I think when I was doing OCD work initially, and I feel now like maybe because I love act so much that I've almost had my own emotion and maturity, black and white, that oh that was bad, and this is good. But how does ACT and OCD stand out from traditional cognitive behavioral therapy?

Mike: So, and this fits with the conversation we were just having. Kind of the easiest way I've found to describe this is like, no matter your theoretical orientation for treating an anxiety disorder or OCD, I like to break it down to what is the outcome you're looking for. Like, how do you and your client agree things are better? What's the process of change? What is it you're trying to instill in the person that would help them be able to do these things? And then what are the techniques you use to instill that process of change? So in ACT, I think the main outcome that we're shooting for is that a person can live sort of a successful and meaningful life.

And I think for those who know ocd, what's missing from that, is any statement about what's happening internally. So I don't need the power or the frequency or the words in the obsession to be different. I just need the person to be able to effectively live when they show up. And then the process of change is psychological flexibility, which is being able to see thoughts as thoughts, emotions as emotions, sensations as sensations.

Allow them to be there and still move in the directions you want in life. Right. So again, nothing needs to change. We just need to not be overpowered by it. And then the techniques we use, what I tell my practicum students is, you know, we teach people how to be psychologically flexible until they kind of get it. And then we start practicing. And those can look like exposure exercises, but as you can imagine, the style is different. We're not watching intensity of internal experience. We're not watching habituation. It's more like, let's practice having what you have, and then we have our own style for doing exposure exercises.

Tony: And can you talk a little bit more about that too? Because I feel like the exposure for the sake of exposure to reduce anxiety and I, boy, I'm wanting to be so emotionally vulnerable here today as I realize, and maybe it's just I have created a narrative in my head of I've had clients that haven't had good experiences with just, okay, let's sit on a dirty floor because you don't like germs, you know?

Right. So can you explain the difference there in act? 

Mike: Okay, there's a couple things. Why don't we start with, when I think about doing an exposure, I would like the exposure to have some tied values. And either that's, that's obvious. For someone with social phobia, we might go talk to people or send a message to someone we haven't, or practice giving a phone call to someone they like, like you can make it values based.

Sometimes it's harder, but then even in that moment, we're going to help the client see how it could be value based. So if we're dealing with a germ phobia or ocd, we might go manipulate a garbage can or go to a bathroom, and then, let's practice having this stuff so that when the real game shows up, you're good at it.

And I'll use a sports analogy of we're just practicing being good at having what you have. And I'll remind the person a lot like when's the situation when this might happen, when you're going to go on a date or go out to dinner or something, and these things are going to show up. I think what stands out to those who maybe do exposure work is I have never had a moment where I would go above and beyond or do those sort of extreme exposures, because I kind of struggle to figure out where those tie to values.

Our outcomes are just fine, but I don't have to lick a gas pump or, you know, like rub my food on the toilet. And I did that work, you know, because I worked in an OCD clinic at the University of British Columbia.

And it can work if the person can engage, it works very well, but they have to be able to engage. Right. So, yeah, I always said, and I'm not knocking that work's great work, right? If you have 10 people, two will do nothing, five will get better. And the other three, kind of putter along, it's like those five who can't do this, they can't get behind the exposure work.

Tony: Okay. You know, I give a story that I think, again, maybe I swing to the extremes, but I've often said, okay, if somebody just lets a spider crawl over you to reduce anxiety, that's ridiculous, it might cause you to disassociate. But if your grandpa leaves you a $2 million spider farm then maybe that might be, you know, a value of financial security for your children, then maybe I'm willing to sit with the spiders. I mean, so is it kind of, we need to find some value if we can?

Mike: I think a value gives meaning to the work. Going back to raising kids, I remember sitting and doing homework with my daughter just many years ago, and she's essentially crying and trying to get away from the table and like everything about it's terrible.

And then I'm being sweet and nice and as helpful as I can be because I can find a value in this that is meaningful to me to help this kid be a decent student so she can do the steps she needs to do and go on and do whatever she wants to do with her career. Like I could find a reason, but if I didn't like this kid or didn't care, some kid screaming at me, it would be hard to find motivation to stay there and be nice.

Tony: Yeah. That makes so much sense. And man, I just, I want to go on a tangent, but I'll get back to the ACT piece, but when you mention one of the things that also I feel like dramatically game changer for me were the concepts of, socially compliant goal and then experiential avoidance. And maybe can you, as an expert in this field kind of speak to how those show up? 

Mike: Yeah. Rules, like when you said a socially compliant goal, rules are really interesting things. And this is a good point for a professional and non-professional that an interesting thing about humans is we decide the way the world works and then we follow that. And the truth is it's never fully accurate. Like it's always, it could be close to the way the world works or it could be totally far. But yeah, that's an interesting thing about human beings is that we'll make this rule about what we're supposed to do and then we'll just keep following it.

And lots of research has said it's really hard to help people do things differently. Like it's hard to create variability and behavior. If someone has a problem or like they have a way of living that's not really functional. Some of that is they've determined how it all works and they've been doing the exact same thing for 20, 30 years.

And part of the therapist's job is to create flexibility in different behavior patterns. And that is tricky. Now the experience of avoidance stuff is just that humans spend a lot of their time working to feel a certain way and I think that's in contrast with doing the things that are important to us.

So one of the lines I say is I think healthy, happy people are probably spending 80% of their day doing things that are important to them. I didn't say fun, I said important. And then people who are maybe less healthy are probably spending 80% of their day working hard to feel good.

And those are like the clients I see. If I say like, what was meaningful to you today? They don't have much. Their whole day was about dodging the anxiety and getting away from stuff that they're afraid of. 

Tony: Yeah. I can launch into a whole thing there where I feel like with the amount of things that we can use for experiential avoidance. Phones, games, unlimited access to downloads of things. I do feel like that's so difficult for people that aren't aware of what is important to them and why I feel like that values work can even be more difficult and yet even more important. And I even, you know, I do a lot of couples therapy, Mike, and I find that I will not do the individual, I won't do the values exercise with the couple in there because boy, you watch even the way that, let's say a guy wants to express that he doesn't necessarily have a core value of honesty. Maybe more of compassion because he grew up in a home where there was brutal honesty and that was harmful. But then if his wife hears that that's not a value. So I feel like just that example, I feel like the dynamic of even trying to get to one's core values or what matters to them can be tricky because I think people are still worried that, I don’t know if you hear this often, but I know I shouldn't care. You know, or I know I'm supposed to care about, I don't know. Do you hear that in the work you do? 

Mike: When I heard you talking about this, one of the things I was thinking about is with my clients, I worry less about having the right values just more like is your behavior about values? And then people get into like, well, I have so many things and I can't balance them all.

And to me that's more of that fusion and rule following that I'm supposed to do this right. And no, we're always wrong. You're always not living your values perfectly, but if you're at least living your values, that's pretty solid. And if you're too heavy in one area and too weak in another area, then you can work at it.

But I'll never,  I'll never balance this out totally. It'll always be a little heavy on work. Yeah. It's just how it’s going to be.

Tony: Yeah. And I like what you're saying because I do find that if I'm kind of bringing somebody from a, they don't know what they don't know to now, they know but don't know how to, in essence. And I love that you bring that, cause I feel like, okay, we have to figure out your values. But then I find that then often, oh, I still need to work on my values, becomes a story their brain is fusing to. I went to a training with a lady about act and she said that at that point she tells a client, just walk outside and begin. I see an animal, I don't like animals. Okay. Well note that. I tried to talk to a stranger, which was fun. Maybe there's, you know, there's something there and I just love that concept. 

Mike: Yeah. I think that's the rule stuff. If I'm going to do this, I need to do this right. Well, you'll never, you can't live right. It is going to be full of errors and mistakes and it's just like how it is being a person on the planet. I was giving a workshop and it's one of the moments it kind of stuck with me. This was a workshop just like a couple months ago, and I'm up there doing a role play and all my students are there and all these professionals are there and the role play is just like going really poorly and not really poorly, but you know, in the poorly category.

And it was in a weird way it was kind of nice. Because it was, that's how workshops will be, you'll be saying really fun, smart things at one point, and then you'll just be stinking and that's life. And I think in a way, it was like a good model for the group. Like yeah, well therapy will sometimes you'll like totally go into a dead end and you just have to walk back and go the other way. 

Tony: Oh I love that. Okay. Over back to the OCD treatment plan, which I love, you've got a course and I want to promote that, in the notes as well. But, you do a lot of metaphors and I have to, again, it's so nice. I feel like you're now my therapist for this. I don't know why I felt this insecurity around dealing with all the metaphors in ACT at first because there's a part of me that felt like this person's paying me large amounts of money for me to tell stories. And now all of a sudden, once I embrace act metaphors, oh my gosh, they're so powerful. And so what has that been like for you? Do you like metaphors? How do you feel they fit in? 

Mike: So what I think is okay, the idea of metaphors goes right back to our rule stuff. Like in act we like to teach experientially versus rules, because then people will originally follow what we said.

So we like to tell a story about it or use a personal example or use a client's life example and sometimes a metaphorical thing describes it better. Like just before I said, you know, I went the wrong way down the alley, and I had to realize, okay, wrong spot. And I had to back out that, that metaphors rich, because we've all felt that, you go down a trail and you're like, uh, this isn't right.

And then you have to like, literally, so there's knowledge that comes with our real life experience. So, I could say, your mind is picking on you like someone picked on you in grade school. It just has more meaning because people got picked on in grade school and they know what that was like and they can link the two.

And I think it's richer than me sort of lecturing on, you know, on what cognition is like. So I think that's the two parts. It's kind of rich and it's not so rule based, but you ask what it's like for me, I think at the beginning I had to use some from the book.

But then now it's just sort of my style and I've sort of also learned, I learned how to make metaphors that match the client's interests, but I've also learned how to use self-disclosure at that safe level. I've already talked about using my kids as examples and no one hears, oh my gosh, what a bad parent. You know? It's a metaphor that I think most people with kids can appreciate. And if you don't have kids, I think you can imagine.

Tony: Yeah, no, and it's funny, I don't think I've been doing this as long as you have, I'm at 17, 18 years. But I feel like even that concept of self-disclosure has been more embraced over the years that when I first started, that seemed like that was taboo, but I feel like it's more of that human experience. And I feel like act makes more room for that, I feel like, than my CBT days. 

Mike: Well, yeah, it'd be weird to be like, oh my gosh, you have these negative thoughts about yourself. So strange. 

Tony: Right, right. Hey, do you have a particular favorite of the metaphors though? I am curious, of course that's me wanting to say, because I do Mike.

Mike: What's funny, my students forever make fun of me that I lean towards sports ones. But that doesn't mean it's right. It's just like I can, I can find so many rich examples and actually we wrote a book and one of the editors was like, how about we take out just a handful of sports ones and we like mix in some other ideas. But with a client, I try to gauge what they're into. And then go that way. 

Tony: I'm laughing because have you ever had those fail? I mean, because I don't know, in the past I felt like I would talk and maybe give one about gardening and halfway through I realize I have no idea what garden, you know, but maybe you plant something and I don't know. You know what I'm saying? 

Mike: I do. I think there's a little skill in just assuming that things work under a natural order and this'll work. I like to have the client help me along. Your favorite, you said you had a favorite though. 

Tony: You're very good, Mike. Because I was going to say, I love the one about you've fallen in a hole and you have a shovel. I love that one so much because I feel like I work with people that are determined to then, no, right. The shovel is an amazing tool by itself, and I am a hard worker. And so I love being able to say, and have clients say to me, and then I went and grabbed my shovel and I dug a little bit more. And then my favorite ever is the, and then somebody hands you the ladder and you try to deal with it. And so that one alone to me was the metaphor that then allowed me to embrace metaphors.

Tony: So do you maybe want to talk about your course a little bit. I mean, have you done courses? Have you done a lot of courses? Is that something you enjoy doing? Or what was that like? 

Mike: Well, yeah, kind of a broader answer. . It's an interesting thing being a professor, because I really enjoy training my students how to do therapy and that includes act, but you know, professors, we're almost taught to not market.

So that's been like a weird thing because I feel like after all these years, I actually do know act pretty well and I kind of know how to teach people how to do it, but I have this like weird emotional reaction that happens when it's like, well, you know, come to my workshop or buy my book. And I've been able to let that go more and more in the sense that this work does good and people, like even if they're very good at therapy, we can get stagnant or stale and coming at things from another perspective can be really useful. ACT is getting big and people want to know, act is big, and people want to know how to do it. I'm really privileged to work at a university where they give me the time to sit and develop things. Like write a paper or writing a book. You know, like if you're a clinician, how do you find the time to write a book? And it's, it's really great that a university's like, that's why, that's what we want you to do. So something like this course, it took me a little bit to, it's an act for anxiety disorders and OCD.

It took me a little bit to sort of wrap my head around like, no, it's okay to create something that is going to get sold. And I think I had to find the value there, which is, I do think this works important and I've spent a lot of time understanding how to do this. And then I start feeling good about getting it out there. And it's a really high, high quality course. And that's another just, it's another great thing. I think it's worth what people have to put into it. 

Tony: And why I'm so grateful for the way you just shared that, Mike, I have a lot of therapists that do listen and I feel like I have a fair amount of life coaches, and I feel like there's a battle between the therapist and life coach, and I talk about this from time to time.

The guy that helped me create my magnetic marriage course, which man, I'm right there with you. I feel like I have this stuff I want to share and I know it can help, right? But then I feel anxiety around promoting it. I feel like I'm being prideful and boastful. And so I will often set the frame up by saying I'm standing in my healthy ego, which nobody else knows what I mean by that, but it makes me feel better because you know, a healthy ego based on real experience and work and that sort of thing, but here's what I think is interesting and I want, I would love your opinion, so I bought courses by other research, Sue Johnson, and I bought Steven Hayes's course, and I've got your course. And then as I was creating a course, I was struggling with the guy that's helped me. He's a very successful life coach named Preston Pugmire, and he kept talking about selling the destination. And do you know this concept? Okay. It's this, I fought him for about a year on this and so, you know, he would say that, okay, if you look at a Delta Airlines commercial, they show the family in Hawaii, so they're selling the destination. This is what you want. But they offer a plane. And basically what he said is what I was saying, well, I've got these, what I call my four pillars of a connected conversation based off of emotionally focused therapy, and here's the nuts and bolts, and here's the emotional bid. And so I'm saying, hey, forget the destination. Let me show you how cool my plane is because I've got these really cool nuts and bolts. Right. And that's what I felt like and then I realized, and I love this, like the courses I've taken from somebody like Sue Johnson and I feel like, oh, as a clinician I'm buying the nuts and bolts.

I want to see how the rivets go into the seats and that sort of thing. And so I found that if I'm trying to get a client to get excited about a course like that, they sit through maybe one section of it and it's like, eh. Yeah. Right? And so it's like, I found, it's a weird balance to try to sell the destination and have this person that I trust help me create it say, nobody cares about your plane. And that's where I'm saying, okay, I need to stand out in my healthy ego as a clinician and say, I think it does matter, but I will try to work some of the destination in the coolest plane that you can get there, you know. So I love your honesty around that because I feel like a lot of the therapists I work with, the first course I ever put out was probably just showing how to make up a bolt, you know, that sort of thing.

Mike: Well that's a really nice point because it's real values consistent because it's like, I don't love writing every paper but while I'm writing them, I usually connect to like, well, this is really cool. I want people to read this. I want this to be out there. And  same, I'm not trying to sell the course here, per se, but it's a neat sort of values analogy, that there's a lot, like, take trichotillomania and ocd, that the course is a non trick, but let's say you know, OCD and panic, if you knew how to treat those well, you will always be busy, you will always have a flow of people, which means there's that many people out there who are looking for therapists and my life, and I'm not knocking any therapists around me, my life is seeing people after they've seen other people. Because, and nothing against the person who worked with them before, sometimes clients need to be in a new spot, but hard panic cases, hard OCD cases, you probably do have to do the best of breed intervention, otherwise you're not going to get the movement. So yeah, that's a nice way of thinking about it. I'm not promising if you learn how to do act for anxiety disorders, you're going to win every time. But I do think this is where the data is today. Like this is well thought out, well researched, it's as good a bed as you can think of right now.

Tony: See, and I love that because I feel like that is healthy ego and healthy ego comes from our actual lived experience. And I had a whole career in the computer industry where I didn't realize, and I didn't enjoy it. It was not value based. I lived for the weekend, but then by the weekend I was so bummed from the week that I kind of didn't care. And I would say, well, next weekend or next, you know, that whole thing. And so I do, I appreciate what you're saying because I feel like from a healthy ego, it's more of like what we feel like inside and I am offering this, so I love that you just shared that because I think that'll resonate with so many people that are listening. And maybe, because I have to bring my insecurities and anxiety and fear of invalidation along with me, maybe, you know, while I put those things out there. So, no, I love that. So would you rather work with OCD than any, any other thing, or is it just something that you have found yourself really good at?

Mike: Okay. Interesting question. I started out working with Trichotillomania. 

Tony: Which by the way, you've mentioned that I know some of my clients aren't going to know, but, so talk about that. 

Mike: Yeah. So, it's a disorder where people pull their hair out and, if you're like, why? I'd say it's really self soothing. We call it egosyntonic. That's a very enjoyable behavior for people. And almost all my clients would say, you know, I would happily pull my hair and then if the next day I came back and all the hair had grown back, I would never be coming in because I enjoy doing it. Okay, but obviously they end up with bald patches and or huge hair loss, it can get pretty extreme and then one of the things that happens is as you pull a lot, the area you pull from starts kind of getting infected and stuff. So then it's almost like you need to pull, because it's like a little infected. So you pull out the hairs that are infected and it feels better.

So you get yourself caught in this trap. Wow. So where this ties into OCD is that was like one of the areas I started and then when I got to UNR to work with Steve, it was like, well, what's, what's the next step? It would be OCD. Like trick and OCD are what we call OCD and related disorders. So then I did my first studies on ACT for OCD, and what's slightly different is clients with OCD come in and they say, I hate this. My life is terrible. Please, please help me stop. And people with trick are like, uh, I know I should stop, but I don't really want to. So there's something about OCD clients that they really want it gone. And that's kind of enjoyable to have clients who are just on the same page as you from day one. I will, and I don't mean this to like pick on the clients, it is a little funny story, but I did an OCD trial followed by a marijuana dependence trial. And I have to, I have to tell you the difference in sort of clients like being on time and not canceling appointments. You know, it's another thing. My clients with ocd, it's kind of easy work. They're on time, they are ready to work and certainly there's hard times, so it's just, the other thing, if I can just kinda keep blabbing, the idea of sticky thoughts is really fun to me. 

So when someone has a really horrible thought and they just feel trapped, I find it really fun disentangling it and helping them find a way to not get pushed around by that thought. And I have a sort of a unique style to myself where that stuff doesn't bother me. So, you know, clients can describe all sorts of stuff, and I like am a hundred percent, that's just a thought. You know what? Whatever this thing is. And, that's been really fun. And learning that skill has generalized to other areas because like really sticky thoughts show up in other disorders. 

Tony: So what's an example, by the way, of a sticky thought? Tell the listeners. 

Mike: Oh. You know, I'll admit I even got caught in it, like, oh, do I wanna share one. So you're from Utah, so do you have some knowledge of the local religion?

Tony: Oh, absolutely, yes. 

Mike: Okay. So, one of the most predominant things in the local religion to Utah is like the importance of family and taking care of your family. So OCD is always going to attack what you care about most. So parents having thoughts about harming their kids is, I don't know, half of what I see. And, they come in and they're like, this is the worst. Like you can't get any worse than picturing seriously harming your own children. I can just hear that and be like, that's an obsession. Let me work with you on what we should do with that. And they're like, but I'm a horrible person. Deep down, I'm a horrible human being who needs to get off this planet? And I'm like, no, you have an obsession. We got it. We'll figure this out. Like, it's okay. And, when I hear someone say their obsession, like just nothing. Like I don't have an emotional reaction because I know it's an obsession.

Tony: Don't you feel like one of the, I love that, because I do talk about, one of my first episodes five, six years ago was on intrusive thought syndrome and at that time, right, I said, we all have them, just because you have them doesn't mean anything, doesn’t mean you're going to do them. And then, thought suppression doesn't work.

And at that time, I actually was speaking to a lot of relief society organizations and I don't know why I found it hilarious, but when I would open it up, I would say, I would kind of share that just for fun and say, how many of you thought about your driving? And man, I could just mm, right over into a tree and you would see the people like yeah, but I've never told anybody. And, I would tell a story about sharing this with my family, and we had a little yorkie at the time, and I was sharing this with one of my daughters. She's like, you ever think about just that you could snap her leg? And I'm like, I have thought that.

And then all of a sudden she's like, okay. And then we go all in on it. And my wife wasn't aware. And so then one night at the dinner table, we're talking about using a watermelon, melon baller. And one of my kids saying, you ever thought about like, that could just be an eyeball, you know, and I could see that, you know?

And my wife, I think she was not up to speed on the conversations, but, so I really like what you're sharing because I feel like being able to express it and having somebody just say, oh yeah. Or I have, or tell me more. There's some pretty cool research, right, that shows that, oh, the scary thing in my head and that person didn't react. Maybe it isn't scary, do you find that's the case? 

Mike: Well, I'll just give, this is a really interesting one. When I worked at the University of British Columbia, they were finishing an intrusive thoughts trial. So they were just treating it like sometimes what people call where you have the obsession and then the compulsion is something you do in your head. You say a prayer, you try to squish the thought, you picture something else. And, it was interesting because the control condition actually got a lot better. I don't know what they did with a controlled condition, but it wasn't supposed to be that useful.

And how we hypothesized it at the end was no one had ever said to these people like, this is just an obsession. This isn’t you. And like half of them walked in and they were just assuming this was a police sting. Like people who wanted to murder or kill or you know, whatever the horrible obsession was and they just assumed they'd walk in and the cops would be there and we were like, no, this is an OCD clinic. You have OCD, welcome to our world. And for a ton of people just hearing like there's a category of people who have really rough thoughts and the truth is the reason they have such rough thoughts is when they first had the initial ones, they tried so hard not to have them that it went out of control. Whereas if you would've been like, that's weird, then it probably wouldn't have grown into anything. But if you tried really hard to get rid of it, yeah, then it just kept growing.

Tony: Well, what I like about that too is one of the things that I, in your treatment program or for OCD, is you and I wrote down a note on this that I like. Can you maybe talk about 95% of life when you don't want it, you can get rid of it. And then that other five, that's, that's good stuff. So I don’t know, can you kinda explain that? 

Mike: Yes. Like in our life, this is you know, second session of therapy. In our life, if we don't like something, we can change it. If you need a haircut, you can get a haircut. If your room's dirty, you can clean it, your clothes look grubby, you can purchase new ones. So then, you know, as you grow up in life, you have thoughts or feelings you don't like, why wouldn't you try to get rid of them? Like everything else in life, if you don't like it, you could get rid of it.

And a lot of times our families are going to say, yeah, that's how it works. But, like right now, if I said, you know, don't think of a pineapple or a pineapple painted blue that someone wrote “you stink” on it. 

Tony: Done, done and done. 

Mike: Right. It doesn't work that way. But if I said, you know, don't touch your keyboard, everyone can do that. That's the difference between behaviors we do with our hands and our feet and attempting to control internal stuff, internal stuff doesn't work that way. And frankly, it might work the opposite way. And then one of the jokes I say in therapy a lot is, this is the reason I have a job. Like, if it worked, you wouldn't need me. But it actually goes backwards, so that's probably why you need me. 

Tony: Well and I find that a lot of things that I feel like in the world of mental health are counterintuitive, which is, I guess I would say that often too, that thank goodness, or I would be out of work but then I know that's humor and sometimes we have to use humor and people, if it's heavy for them, that might sound right. And then, and I feel like that's maybe part of their avoidance is, well I can't, this guy's being silly, or I can't, I can't look at it a different way or somebody, he doesn't understand what it's like. And I don't know, I feel like what do you do with those kinds of situations. 

Mike: Yeah, you don't understand what it's like. I mean, I don't get that as much. I know people get it with other disorders, and I will say from an ACT perspective, if I keep talking about that I have disturbing thoughts, I have frustrated thoughts, I feel overwhelmed. I don't feel good enough like that’s just part of being a human being.

I feel like it's probably nice for a client to see that, you know, my therapist who seems to have it together also doesn't feel smart enough and feels overwhelmed and feels annoyed. And like if he has it, then it may not be so weird that I have it. And I'll definitely stress in my work, it's way more what you do with it than what you have.

Tony: I like that. Yeah. Well, it's funny, the insecurities even, we had a technical glitch there, and we went silent for a while and oh, I was all in my head about, man, this is my one chance and I thought we were vibing and now Mike's never going to come back in and you know, and that whole thing.

And it's funny the way we do that and then I just had to notice that was the thought. You know, that was something. So really quick as well I like that part about trying to control, so we don't do that. I do have one, I have a hypothetical, not even a hypothetical, so I would love your take just as I view you like this world renowned act researcher and knows act so well. And I tell you one thing that my latest kind of aha is I've got somebody, so if I have somebody that is, let's say they're in a job and they don't like their job and I've done, I've had enough of the experiences where I can then maybe have somebody that they feel like they really can't do anything about it, we can work their values into their current job, and then, you know, they might insert a value of humor or a value of connection, or they might go learn other values of curiosity. And I've had some success with that. But then I've also had, you know, I do a lot of work with trauma and I don't if you're familiar with the book The Body Keeps the Score and it's amazing. And so over time, because our emotions are traveling faster than our logical brain.

And you know, that visceral reaction as our brain says, is it safe? And if it's safe, then what do I do with it? And so when people have felt unsafe, that emotional reaction can intensify and they're all up in their amygdala and that sort of thing. So then I'll have people that will be in situations where, in a work situation where, okay, but my blood pressure is rising and I'm starting to have different ailments and then, and in the trauma world we say, okay, that's your body trying to tell you something and we need to listen to it, and maybe that's not the right opportunity for you. And I've been doing so much of the act work where, oh, that's just, you know, these are stories your body, your brain's telling you. And so invite them to come along with you and insert your values.

And so I don't know if you have any thoughts, and I know I'm just springing this on you right now, but it's interesting because act works so well, and now I've had a couple of people that are like, man, I'm still trying to be present. I'm noticing, I'm meditating, I'm working, you know, but I am still, I am still having this visceral gut reaction. And, and so I feel like there's an interesting, I'm not sure which one to rely on, you know? 

Mike: Mm. Well, you tell me if I heard your question right. That if it's like the person's trying to be there for something but it's hard because their internal stuff is so loud. 

Tony: Yeah, well said. 

Mike: And what I'd probably say to that client is, you know, we may have spent 20, 30 years conditioning this to be at this volume. And now that we are not giving it the attention it needs, it's going to scream pretty loud. And I'd say, what do we want? Do we want it quiet or do we want to be in life? Because I'm going to be honest, it's not going to get quiet until you stop caring it's there. 

So if you're always trying to check how loud it is, it's like it knows to put out some noise. So it's like you really just have to shift the game and then, and then we'll see what will happen. Yeah. And it's interesting, the description you gave, maybe we're about the same age. I'm starting to get more and more clients who are like, where do I want my life to go? My career isn't quite what I'm hoping it would be.

Tony: And then I love that because and then when I'm putting out there on my podcast that yeah, I switched after 10 years and now I love everything I do and it's value based and passionate.

And then I'll feel like people will then say, well, yeah, but that was easy. You know? No, it was incredibly uncomfortable. But, I find that then those yeah buts, that's why I call them, the yeah buts from act where, okay, I'm going to take action on this value and then sit back and I'll listen to all the yeah buts. Because it's scary and I think that just people hearing that that's part of the human experience is pretty cool. Hey Mike, I am just grateful for your time. I really am. Thank you. I am going to be very honest and say that I have done something exactly one other time with an interview a few days ago. And I love humor and I feel like that is something that maybe you can identify with as well. Okay. So this is either going to be something I will delete and never use again. I would love to see if you cannot laugh and I'm going to read a couple of my funniest two line jokes ever.

Mike: Okay. Oh, I'm gonna be terrible at it. We'll try. 

Tony: Okay. Let me find one, let me get one here. I've got a couple of them that I think are just hilarious to me and let's alright, so, Dr. Michael Twohig, world renowned ACT researcher, try not to laugh. Just say no to drugs. Well, if I'm talking to my drugs, I probably already said yes.

Oh, that's good. Okay, next. I thought I could get you on that one. Don't laugh yet because this one, I’m Scrolling through them, here it comes. I feel bad for the homeless guy, but I really feel bad for the homeless guy's dog because he must be thinking, man, this is the longest walk ever.

Mike: Okay, you try. I have like two banked jokes.

Tony: Okay. Well this is my second experience and the first person texted me yesterday and said, oh, I want to do it to you now. So, alright, now, this is the first ever experience.

Mike: So there's two fish in a tank. One says, I'll drive you man the guns.

Tony: I don’t even know what that means.

Mike: In a tank.

Tony: Oh, that's even better. I just thought it was complete nonsense. Okay. All right. Okay. 

Mike: How does it go? What did the fish say that swam into the concrete wall? 

Tony: What? 

Mike: Damn. 

Tony: Okay. Okay. Maybe I need to rethink this. I thought I'd be able to do that. Okay. Well done. Those are good enough. So, alright, Mike, thank you so much for coming on and I hope that I can have you on again in the not too distant future. Sneak preview. I meant to even bring this up earlier, I work on some with scrupulosity, which I think is kind of a whole other realm and I would love your thoughts on that. Maybe as just a sneak preview.

Mike: Well yeah and being two Utah based guys, we just skipped right over the pornography stuff.

Tony: Yes.

Mike: Such an interesting,, yeah, I was like, oh, I want to tell you stories about that. Okay. 

Tony: So maybe next time? Okay. Yeah, yeah, we'll do that. So, alright. What a pleasure. I really appreciate the time. This is everything I had hoped it would be and more, so I can't wait to talk to you again. Okay. Right. Thanks Mike. 

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