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Sep 9, 2022

For most, the goal of therapy is to increase your self-understanding. The only way to truly do this is through honest self-reflection.



you're listening to psych with mike for more episodes or to connect with the show with comments ideas or to be a
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mike or like the facebook page at psych with mike now here's psycho welcome into the psych
with mike library this is dr michael mahana i'm here with mr brett newcomb and intern michael
hello again good morning how are you guys doing great you guys are i guess i guess i should say consummate
professionals yes i think you could basically say that you can say i've always said the
shenanigans that were going on before we turned the mics on were
raucous and and then the mic goes on and you guys are like i'm much more well behaved when the
camera is on it's the sunday paper rule never put it in writing unless you want it to end up
in the sunday paper exactly true don't say anything that you don't want somebody to shout with a megaphone
in the local mall yes dear yeah although now malls are
empty yeah going out of business it's amazing so how can the economy
be running so hot and yet have just facilities that sell
stuff going out of business left and right there's this really cool new invention uh came out in the 90s or
something called the internet and uh people what's this internets that you speak of well everybody has a box in
their house and when they get sad or lonely they get on the box for several hours and advertisers show them pictures
and then they buy things for dopamine hits this is it's it's great it's going to be the next big thing i think al gore
had something to do with that did he invent it actually all right i think amazon has had a lot
more to do with al gore mm-hmm with the changes that you're talking about yeah so happy i could support jeff
bezos riding into space he's flying that phallic symbol all the way to the moon
oh jealous we're along for the i am jealous because i want to go to space but i'll never have that kind of money
so i'll miss it by just a couple of of years probably like like
three years after i die space travel will be affordable that i could have done it but i'll be dead well
now you've spoken it and manifested that into the world so that's your own fault so yeah i got
nobody to blame but me so i wish i could be more clear
i do too but i struggle with that you've been telling this
story all day well this
use your words yeah uh uh you've been talking about this phenomenon all day where i will start multiple sentences
and build this large narrative rather than just answer a simple question
and i feel like that uh this subject is very apropos for that
it's a reflection of reality now yeah so i have for the last year
been really really into reading jung so reading original young
like not reading things but one of the things that i was kind of like reading the bible yeah you actually read the
bible or just read stuff people say is in the book exactly yeah right because
i feel like there's a lot of literature out there in psychology which there obviously is
but what happens if you go back and you read the original stuff that the original
person like if i decided that i wanted to be a jungian therapist call myself a union
therapist then the psychoanalytic community here in st louis would say well you can't be a jungian therapist
because you haven't gone through our classes and been officially sanctioned
by us but the truth is how many of them have read jung
jung's original work probably not very many of them they've read a lot of stuff that people have said about jung just
like i feel about heinz kohut a lot of people have read a lot of stuff that peop that that people have said about
heinz kohut but how many people have gone back and actually read heinz kohut's original work so i've really
been trying to pay a lot of attention to jung's original works
and one of the things that that i am very aware of is that a lot of the
a lot of what i think people think they know about jung is not accurate
say more okay so uh young so the the the types that jung
came out with and and that now are manifested in the myers-briggs or are
you know explored through the myers-briggs there's very little of what jung
originally wrote that actually supports that
so that doesn't mean that what the myers-briggs tests is necessarily
wrong but i don't know that jung would have
necessarily supported the myers-briggs in its current
iteration i don't know maybe he would have but it didn't exist when he was
alive and so we don't know what he thinks about it but a lot of people would tell you that
the myers-briggs represents essentially the principles of jung's type typology and
maybe it does i don't know i don't know what young would think about that but i do know that he was very specific about what he
what you're talking about the distinction between the manifestation of his theory yeah
and the origination of his theory and your argument is if you go back and read what he originally wrote
then you have a clearer understanding of his thoughts exactly but as i understand it when
when he wrote this stuff it was coming out of his intellect not scientific experimentation
um brilliant man conceptualized these things wrote them
down the myers-briggs is someone else taking that and trying to interpret it or
develop a mechanism that would evoke it when clients take a test right
so they're not the same thing but they may be different facets of the same diamond
yeah that's a political scientist and you hear it's that we're saying that law is the manifestation of philosophy
but the philosophy is not born to the end of law most of the time yes
got that so one of the things that jung wrote about
that i would like to explore is this concept
of clarity so i sent you guys an article about uh jung's thoughts on clarity and so i
would just ask you what was your guys's thoughts or reflections about that
michael you wanna sure um i have always looked at young's clarity
going back to stoicism right marcus aurelius know thyself um and i think
there is a lot of wisdom in this and how we interpret this and how we can use
this uh to better our lives or to to connect with people around us
um i in my everyday job right as an engineer
i will get into uh not tiffs but uh confrontations with a teammate of mine
because he's very wordy right and the more words he uses the less i understand about what he's actually saying
and i think young's argument here is if you don't know yourself how can
anybody else know you and to get to the point where you can other people can know you or you can
enact that get really deep with yourself and understand what your you are what
your convictions are and what you want them to be um i think there's wisdom in that i also
think there's always some understanding that you even like knowing them knowing them is different than
choosing them and you can do both you can do both
so what would what would you say is the difference between the knowing and the choosing i would say that knowing a
conviction that you currently hold for for example my father is relatively
religious yes he knows that conviction of himself but it wasn't until much
later in his life that he really wrestled with his own faith um that did he choose that
conviction oh i got you himself so you could be brought up in a family where a conviction were indoctrinated into you
and it could be something like racism you could have been indoctrinated into a racist
family and you could have that as a part of you but you hadn't ch chosen it and
then if you actually look back and and at yourself critically and say is this an aspect of my personality that i want
to embrace you could choose not to you could choose to change yes i think young falls in that camp as well not only can
you choose to change but you have a responsibility to make the choice it falls back in that
stoicism or even back to the aristocracy of i have the responsibility of knowing
myself of understanding this philosophy in myself because eventually as a human being or a
member of society i should i need to make the choice
okay i thought you had something but uh so for me this is
from the psychodynamic perspective the real distinction between what they call
catharsis and cathexis so catharsis is the evocation of a strong emotional reaction
cathexis is like an epiphany understanding into the true nature of a thing and
i have always believed that cathexis is the goal of therapy at least for me
if i'm going to go to therapy cathexis is my goal and i try and create cathexis
for my clients but i've had a lot of people tell me that capexis is could be
could be a goal but is not a necessary goal of therapy so do you guys think
that better personal understanding is a required goal of therapy or should
be an expectation of therapy or do you think that just alleviation of symptomology
is the goal or the point of therapy
so i think that depends on if we're talking about therapies and intellectual exercise in this field of study
or if we're talking about what the client coming to see you is hoping to achieve
because they're the ones that get to decide so it's really in service to what the client's
goals are it should be but then there's also a pure intellectual
description that you can buy into as a therapist but i don't think you can impose it on
the client i had i had dinner this week with an uh old friend of mine
who is struggling with some things in her life right now and she was saying i was raised lutheran
i feel these shoulds about how i should be certain ways
and i'm discovering at this point in my life i don't want to be that way and so i'm feeling guilt about it she said talk
to me about guilt and i said my personal belief because i'm not doing
therapy with her so i'll talk more about what i believe with her
is that guilt the feeling of guilt is an imposed script
that was internalized inside you in your early childhood messages that you were given to try to
control your behaviors your options and your thoughts remorse is something totally different remorse
is something comes out of my own personal sense of integrity to be the person i
want to be as i understand it requires me to behave this way think this way feel this way
so if i'm not behaving in a way if i idealize myself for instance this is a good christian
how do i understand the message about christianity in christ i said well you should behave this way
okay so i want to behave this way but then i'm walking through the mall and i see somebody that i immediately just
want to go slap i have a visceral sense of antagonism to this person i don't
know where it came from i just feel it that primitive part of me wants to go punch me in the nose when i recognize that the christian part
of me or the the integrity part of me is saying wait a minute a good christian
wouldn't have those feelings you wouldn't respond to those people what the hell is wrong with you you're a sick person so then i'm in conflict
internally between the person i'm now seeing myself to be and the idealized person that i would wish to be
so what i try to explain to my friend is i make a distinction between feeling remorse if i did or didn't do something
i drive down the highway and these people are standing on the side of the road with homeless signs and little children a woman a man and a couple
little children and i think i can't believe that the city hasn't run
them off they're interrupting traffic it's dangerous they shouldn't be there then i drive half a mile on i think what
if they're really homeless well if those little kids are hungry you got some money you could have given them what's wrong with you you're not a
good person so i get caught up in those conflicts so then i ask myself who do you choose to
be do you choose to be a person who tries to help the downtrodden if so
how do you do that do you support a food pantry do you
support a homeless shelter do you physically go down and cook meal i mean what do you do to say well i'm helping
and then can you discriminate between that and passing somebody on the highway with a
homeless son as as a matter of personal choice so we get into the shoots and what i told
my friend is the way i try to distinguish this with clients who are suffering from this
is can you make a distinction between the have two shoulds and the chooser shoots the behavior may be the same the
visible behavior i'm going to put twenty dollars in a pot somewhere the have to should
if i listen to that and i do it i'm go the way the way i'll know i'm going to
feel resentful and angry the choose to should i'm going to feel good about it because my superhero will
come in and give me an atta boy oh you did the right thing you did what we wanted to do so i try to make the distinction between
the have two shoulds and the choose to show but so then the only way that you can know the difference between the have two shoulds and the choose two shoulds
is to find this clear clarity absolutely which brings us back full circle so i
want to go back though and ask you a question about why i was listening to this well actually let's go to our break and
then we'll come back and i'm going to ask you a question hey brett if you were going to
tell somebody to check out something on the internet to
help them with their mental health what would you tell them i tell them listen to psych with mike why would you tell
them that because it's probably one of the most easily listenable experiences you can have that
will give you information that's useful for a whole spectrum of concerns that
people have i agree and i have actually been told that
by at least a dozen people several of whom were not married to me and some of
them didn't even know me that's amazing that is amazing it's when when we get
that kind of feedback from people it is so incredibly
humbling and overwhelming for me it is for both of us yeah so we really
appreciate it and as always if it's friday it's side with mike [Music]
okay we're back and and so the question that i wanted to ask you is so do you conceptualize guilt as an
external message and remorse as an internal message no uh i conceptualize guilt as an
indoctrinated message okay so but that's what i mean the the the the it's coming from outside the message is coming from
outside originally yeah but i've internalized sure sure yeah yeah okay yeah but but remorse has to
come from inside right for my own developed sense of integrity the person that to be the husband that i want to be
requires me to behave this way and not behave that way so even though
the primitive me may want to behave that way right the chosen me
shouldn't it's a should is it a have to should is it coming from my religious training as a child or is
it a choose to should come into my sense of grown-up integrity i walk this path because i choose to walk this path it
makes me feel better about me so would you would you say that remorse yes is more a function of clarity yes
yes okay because i think that's really helpful when thinking about you know
we've all treated individuals who are sexual abuse surprisers right and we've
always had and we've had we've talked about this multiple times you come to thanksgiving i got to go to belong to
you belongs to the perpetrator and but i think that that's a great way to be able to present that to the
client to say you feel guilty but do you feel remorse so that's what you have to do you have to break up the script that
they've internalized and offer them the option to write a new one right because if you feel guilty
then that's pressure that's coming from you from outside from other members well the rest of the family still wants to
keep the imagery in place and so they're going to be really devastated if you out uncle joe at thanksgiving dinner you
ruined our thanksgiving right and so if i say to the client let's not focus on your guilt let's
focus on your remorse where's your remorse comfort my remorse comes from that i couldn't protect that little girl
my remorse comes from that my other people in my family didn't protect that little girl and so that wouldn't be
remorse that would be anger oh well i mean it could be yeah i mean if if johnny didn't protect
susie i don't own any of that it's regret okay it's really rewarding okay okay yeah yeah yeah yeah yeah yeah i
think is that they're both rooted they both gain power through shame yes both guilt and remorse and
even regret all three gain their power through an unspoken shame yeah but who's right but where's the shame
coming from is it coming from an external message or is it coming from an internal message a whole personal integrity so that's the conversation i
want to have with the client what is your sense of integrity not my
judgment not my external observation saying good girl bad girl but what do you see when you look in the mirror what
do you hear in your head and i think that's what jung was suggesting in the
article about clarity of self-awareness self-perception uh
self-examination michael you were gonna say something no okay so so uh uh
have you ever used that terminology though in therapy i would like for you to have more clarity
no yeah i haven't either no um have you ever conceptualized it that way in a way
that you were aware of i don't know okay because i think i do
that i think i do and i don't know that i ever used the word clarity but it is
i tend to be fairly socratic and you know there's a whole
controversy in psych how should you be so should you teach in therapy or should you let the
client come to their own conclusions and i tend to be more socratic and that's
just how i am and so i know that about myself but i want people to genuinely come to an
understanding of themselves not one that i've
given them or projected on to them but one that they internally believe is true because i don't think you can make
accurate choices about your behavior and how you want to be if you don't understand that so what
i try to talk about a teaching moment what i try to do is teach a client that
words matter and that it's really important if we can get to the manifestation of the script that
they hear in their head what are the words that you hear with my friend what she was saying is i hear should
and so i said could you work on changing every time you hear [ __ ] in your head
stop and say will or won't i should take my friend to dinner
stop and say i will take my friend to dinner this week or i won't take my friend to dinner this week and let that
go and re-script the words you hear in your head because i believe if the script is
rewritten the message changes we find that there's a powerful effect
um this reminds me a lot of uh danny kahneman again right uh danny kahneman and amos tversky have this whole idea of
framing as a language frame yes right and they would say people are much more effective at quitting smoking if they
say oh i'm not a person who smokes right right or i'm not smoking today right yeah you
say you if you pull that into your identity as a person uh it was much more powerful
so if you okay so then that's a choose to sure so so we're focusing on this idea
of clarity when we're we're connecting it to those choose to shoulds
well the clarity comes as young says the clarity comes from self-examination and self-reflection
so when you can examine this the language of the script
then you can edit it to your liking right okay so now
this is kind of blowing my mind but okay so uh one of the things that that we
struggle with in therapy all the time is the client who is struggling to be able
to conceptualize themselves as a good person or a bad person so
using what we're talking about here how how do we apply that to help the
client with that kind of struggle
do you understand what i'm saying i think so i think my approach to that would just simply be to ask them for more clarity
definition of how they experienced them as bad how they experienced themselves as being
bad and unworthy and so what they will tell you is they've had this behavior that behavior or they'll tell you that
their church says they should do this that the shoulds from other message points and then you start to take those one at
a time just examine them where does it come from is that yours do you own that or somebody hand you that well i think
that coming from you know the the old albert ellis kind of rational emotive therapy
you know messaging unconscious self-talk uh that a lot of what i see
as the affliction of our society in in western culture is
unworthiness unlovableness that people are carrying from those pre-verbal years
and that we go go back to we were talking in a previous episode about the
unthought known that we've learned from michael garanzini and that that is one of those
really profound deeply rooted unthought knowns i am unlovable and that you know
looking at this idea of clarity what i would say to that client is what makes you
unlovable is this a message that you've internalized from your environment
if you really believe that about you what is it about you that you think
so the way i understand guaranteeing you used that in connection with something called attachment theory
your ability to have attachments to make relationships to be connected um
a lot of the pain that people experience and the dysfunction that they experience comes from their feeling of
not being securely attached not being safely attached
and so you have to spend enough time to get to that messaging
what did you hear and learn about your worthiness to be
attached about your expectation that you will be abandoned right uh cast out
because you're unacceptable and that didn't come into your head the incident that you
were born right as a tabula raza blank tablet that was written by someone on the wall
you know like the biblical message about the finger of god writing a message on the wall somebody wrote that on your wall can we
examine it can we possibly edit it and if we can
what does that suggest to you right about relationships about self-acceptance about self-worth
because if you got a message from your family of origin from your primary so i
think this is what i believe is that you are born into a family that this family
demonstrates appropriate emotional regulation to you you internalize that
if that message of a regulation but the the the effectiveness of that
internalized process is really based on the extent to which you feel secure and attached and so when you don't have good
secure attachment in those early years it's going to be really really difficult to develop effective emotional
regulation later in life and so then now you're an adult coming to my office
telling me that you don't feel loved and what i'm wanting to say to that person
is where is that coming from if we look at if we go through a process of
delineation to try and figure out clearly where that message comes from from
inside you where do you see yourself being unlovable and and you know clients will
always have examples well you know this person says the messages they were yeah they're exactly
i was just going to say i saw this movie once yeah yeah they're they're but they're all messages it's not an actual
real intrinsically felt kind of thing and so then when we get to the heart of that and and we we
say okay this sense of unlovableness isn't coming intrinsically from you
then i think that it comes back to what michael's talking about with this identity internalization if that's not really
your identity are you willing to now challenge that and reject this idea of
unlovableness in favor of some identity structure that's more congruent with
what you truly see about yourself i think for me that is that is the the
core of this idea of clarity it's the theory is that clarity is the
groundwork earlier you mentioned is should the goal of should one of the goals of therapy
be getting a client to know themselves and we said ultimately it depends on what what are
the goals of this particular client but that has to leave me wondering can you do
work with a client without that level of clarity i think you do have to reach a certain point of clarity with a client
either understanding the messages that they're receiving understanding um the dialogue within themselves
understanding the propensities within themselves um and then additionally finally their convictions right so
that's a great question michael my experience the presenting problem that brings
somebody to therapy is almost never the underlying problem that's causing real difficulty in their life
but if you don't appear to address the presenting problem and make progress with the presenting problem you'll never
get the opportunity to go beneath that so it is a dance that again the therapist is challenged
to track at a existential level and at a superficial
level to keep the client secure
and uh wanting to come back feel good about
what they're getting out of coming to therapy and it's a real challenge sometimes and
you know the the idea of clarity is a spectrum right and so if you're doing
cognitive behavior therapy somebody comes in and says i'm always late to work so we're going to do cognitive behavior therapy to identify why it is
that you're always late to work and you know we identify all of these unconscious self-talk messages you know
like oh i have more time or i you know i i need to eat a good breakfast all these things and then we we you know modify
those so that you're more on time that really isn't getting to oh i was
unloved as a child but it is getting to a level of clarity that is dealing with
that very specific symptomology presentation so yes we always are going
to be working on clarity because there's just no other way to be able to do therapy you can't
get change if you don't work on that process of clarity but my question is
you know are we and i don't want to say disservice because it always does always have to be
with the client but for me psychotherapy is good really really foundational
psychotherapy is a deeper process that does get to that point of cathexis at
least for me that's at least a part of my goal now i'm not going to force that on a client that doesn't want to go
there but i am always looking for the avenues for
what helps me to clinically understand that
individuals process that that that process of catheters more what are you laughing
about i'm sorry i when you said i'm not going to force that on the client i flashed i remember
one time working with a family the mother had lost her cool because she had gotten up
at four o'clock in the morning taking these three kids to six flags and she wanted to ride a particular ride
that they didn't want to ride and she lost it and went in this whole diatribe about i got up at four o'clock in the
morning i drove several hours to get here you're going to write every right out here and you're goddamn going to have fun
so that's where i flashed when he said i'm not going to push that on my client here's your interpretation of reality that i insist you had what you wanted
was the recognition you wanted yes you did that's awesome yeah did i get that did they ride the ride
yes and they cried the whole time nobody had fun
all right that sounds like a good place to uh leave it for today we would really love it if you would go
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and we really appreciate that as always the music that appears inside with mike is written and performed by mr benjamin
the clue and if it's friday it's cycling