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Jul 8, 2022

So upfront I want to apologize for the sound quality (or lack thereof) on this episode. Brett, Michelle, and I just started riffing completely off-topic and unplanned, and wouldn't you know it there was some great content but the sound buggered out on me. I have tried to clean it up the best I can. Enjoy!


What are the major school of theoretical orientation?



you're listening to psych with mike for more episodes or to connect with the show with comments ideas or to be a
guest go to follow the show on twitter at psych with
mike or like the facebook page at psych with mike now here's cycling welcome to the site
with my vibrate this is starting did you want to repeat that no did i edit all your best
no i don't need to people that watch it regularly know that and we are here with mr brett newcomb
hi miss michelle steg how are you doing michelle good for you it's good to have you here again
thank you oh okay i thought you had something no i just i'm happy to be here with two clinicians
that i've trained and mentored through the years to be more like me
does it make you you know what i actually and this is the first time i've ever
thought this how does it make you feel to be in a room
with other individuals that you have trained and to know
is that exactly what i said
no you know one of the reasons that i've agreed to do this podcast that we've done over the last couple of years and we get close and flow
towards me and gold is to make the podcast address itself to
people that are interested in doing therapy as clinicians or
in getting understanding what therapy is like without being in therapy from clinicians
and so we try to have conversations and address those issues so i'm intrigued
with the three of us talking because we've all had similar clinical training
and similar clinical experiences but we have different perspectives on how to do it in the room and so i was hoping we
could kind of talk about some of those differences one of my arguments has always been that
psychologists rewrite the same articles and put different words and
call it something new so it sounds like something fresh is out there it's the same old stuff right
but fundamentally i believe that to be a clinician to do therapy
you have to have a mind map that helps you
understand what everything is going on with people and where the pieces that are out of
focus or that are broken might reside and how to find them and help bring them
into focus help correct them uh that's a clinical challenge yeah and
you have to do it with respect you have to do it with passion uh you have to do it
with consummate attention i i used to for 30 years i taught at university in a
nighttime program from 5 30 to 9 30 at night and i would regularly say to my students because
they'd be great at 5 30 6 6 30 quarter 7 then they start checking their money
they're gone and they'll check their emails and stuff and i would say to them this is what it's like to do there
you have to this opportunity to learn how to discipline yourself to be in the background and pay attention what's going on what people are bringing to you
to consider and they will look at each other what the hell was he talking about yeah i hear all your voices once a week
i swear to that because i on those days where you're tired or you know i was telling you i had an
insane day with my kid and i mean i lived like four days already and then i had to go to therapy
and i but i do i remember that and i hear your voice saying these people are paying you you're on the clock right
you are on the clock their money is worth something and you show up yeah you bring it you bring it you have to worry
about it put your stuff in a box and bring it right yeah right at least i i do passionate believe that
i agree completely i always called that a theoretical orientation that a person has to have a theoretical orientation
and if you don't have a theoretical orientation that you can define then you don't have a theoretical orientation and
it isn't easy in knowledge that was a collective jeff well then people say eclectic and so what eclectic means is
that you have i don't have uh kinds of tools to be able to be
effective in therapy and it's fine to be eclectic as long as you can define it but if you say i'm eclectic and you
can't define it then you don't why is that really important to you because what brett was talking about he
uses the concept of mind map and whether it's a mind map or however you think of it if you don't have some
idea of where you think that human pathology evolves from then you don't
have an idea of how human pathology evolves and if you don't have an idea then you're just shooting in the dark
and if you're getting paid to do it i don't believe that that's how you should
approach i think that you should have a very clear like i can use cognitive
behavioral interventions but my understanding of how human
pathology evolves is through the heinz kohut theory of how
emotional regulation develops through the concepts of idealization twinship
and mirroring and i can explain in great depth and detail what all of those things mean so i would say that i am
psychodynamic very specifically object relations and even more specifically
cohadian within that field of object relations but i use other techniques as well but i
can define what that means for me and you don't have to understand it that way yeah but i have to understand it that
way so that i have a frame of reference to approach when i'm working with a client but you don't need to explain
that to the client well well i think that you're i know getting
off on it when you do this i know uh you need to know that because you're putting yourself in the room saying i
think i can help you the client needs to know i'm going to get heard this is going to be a safe place and this person
can help me they don't need to know your theory and for you to spend i mean to me it's the same conversation as i'm a christian
therapist yeah i work with christians i work with jews i work with catholics i work with arabs it doesn't matter but i don't
proselytize my theory of religion or counseling
and i struggle with that you know i struggle with that because you know my i
have a a a belief that language matters and that
agree if you present the language to the client that that gives them them a basis
to start to use language for themselves they don't have to use the same language that i use but if they don't have a
language then they need to be able to develop a language to be able to start to think about so it's like
metacognition thinking about thinking you have to be able to have the language to do that to be able to do that i can
buy that argument yeah yeah what do you think um i just have here
comes your part stuff right everybody likes to make the part of me party was so a part of me immediately
shuts down when we talk about theories but that's that's just like my stuff i think that's my
system that really um struggled in school to understand the
context of like um it probably had some learning disabilities that went under diagnosed
as a kid or undiagnosed as a kid and so when we start using the language um so
you don't see yourself as an intellectual well and you see this as an intellectual discussion i do and i just
i just shut down and then i then i get also oppositional but she can't count the question
so you're obviously much closer to brett i haven't seen you since the last time
that i had you in class and i was a lot less wrinkled we were trying to we were trying to i was trying to figure out
when that was uh but my recollection of you was as a superior
student and so now i'm hearing you say that you didn't feel that way and i'm wondering
i mean was was my impression because you put a show you know what i'm
saying say it yeah no i'll explain why but that's a fair question yeah so um i
i got my first 4.0 when i went to grad school like i i it was it was like i
found my home but i didn't find i
at that stage of the game i realized how much of an auditory learner i was so
realistically i was not reading the books with the theories and
what i learned to do was sit and master auditory learning and skills of
observation and was able to retain all the information that way through
observation so when i was like spitballing in class and making observations it wasn't bs
it was that i wasn't finding who i was as a therapist through textbooks i was
finding it through my experiences with you in class with you in class and
you talking about caseloads or um you know the group therapy class it was
like that was where i learned to be a therapist when it came
to the theories it was all lost on youtube gotcha in a sense so you can see the modeling and internalize the
modeling correct but you couldn't read the books the script it was very much like a
sensory experience like i could cure the model
experience it see it play out but i i couldn't read the words and so there's
always a party that kind of does shut down when we talk about the truth that's fascinating in part because i've always had the
opinion that good therapists have to be acute observers
and the subset of that is most of them are survivors of one kind of trauma together
because that chatter or channel that's going on in all of us all the time as we scan
uh you have to be able to process and understand and apply yes
and those are clinical skills and what you're saying is you had those when you came to the program
and you use them to develop your clinical clinical skills i believe i mastered that now you are
living i do right right and and i think
yeah very much so like it's a little embarrassing because i don't want somebody to take my license but like
i don't remember reading a lot nobody listens to the show right okay all right then we're safe here
for sure right it was such a sensory experience for me like
um i was i i just i quit fighting the game of the battle of college like i figured out
how i was a good learner and it was through like mastering the art of observation and becoming acutely aware
of subtle shifts and movements and whatever and it shows but but i i hear you
saying that as if it were a deficit but i hear it as a strength
where your strong suit was what you're where your wheelhouse was and then you played to that that just seems smart to
me well i think you know early on when i was early in school like early in my master's it felt like a deficit because
there were all these like cerebral conversations happening because everybody read the book and i'm sitting there intellectual masturbation exactly
exactly what it was and so then i remember sitting there being like feeling embarrassed or self-conscious
like i didn't understand the material and it just clicked one day and i was like stop reading the material and just
absorb because you'll gather everything you need to know from what brett tells you and when you know mike starts to speak
on this and it i i feel like i did i turned it into a real positive i was really insecure about it at first and now
i don't know i think it's kind of my memory skills so then i i feel i'm gonna ask this question
yeah maybe it's a bad reflection on me i didn't teach you ifs i know that no you
did not so so uh so how did you how did you find internal family systems from my own
therapist uh karen grayson so another uh right
so yeah she um we're very ancestors i was literally about to say that yeah um yeah i was doing my own work with her
and then she introdu the world's collided at the same time leading education
and she introduced this to me and my mind exploded because
probably because i'm a visual learner an auditory and when you learn ifs and you learn about parts white its way it's so
beautiful for men because men really struggle right we talked about with having these feelings
they're just these like abstract thoughts that are like floating around and they don't quite know what to do with them and when we talk about parts
it takes feelings and it grounds them and it makes them very it gives them a place to be it
makes them visual and men like visuals and it makes it turns feelings tangible
and it rocked my world it absolutely rocked my world it was
struggling i'm saying that because you're i wasn't struggling in terms of like
being able to identify what my theory was like i can tell you what i pull from and whatnot but
when i found ifs it was like
you know when you fall in love and you're have you been all my life like it
solidified i have art in my office from a client that's um that says we are not just one
we are made up of parts and she drew that for me over 10 years ago
and then i was introduced to ifs and it gave me the language and i was like holy
you know holy i've been doing this this entire time and it just gave me the language right
i did like i am that good i just now have language for it you know yeah so that so yeah i found ifs probably six
seven years ago maybe um yeah just it you know why i really love it is that
it's it's not super clinical i am not
a stuffy like i just i'm not a clinical person um
in therapy because i don't think my clients really care about the clinical side they just want
to get better and they just want to i think it's constant does that make sense of course it makes sense you help me you
know we get better yeah better yeah and so ifs did that for me well i think that that
there are a lot of people i've always said there are two ways you can do therapy you can just alleviate symptomology and feel
better and that is one way you can do it or you can dive into a real headlong if you know
seeking hypnosis and epiphany and genuine self-understanding and i think
that different people have to do it differently and that's why they're different therapists and i don't think that any way is necessarily superior but
i do think that there need to be people who do it different ways because it's going to
reach different people absolutely not every teacher is good for about differently
every student right and i tell people all the time i i am not
for everyone exactly i am direct i can be polarizing at times like i i
but a lot of it comes from the things we learned in class of like
i'm not going to sit here and waste your time i cost a lot of money so we're going to we're going to move and typically by the time somebody's
found me they've heard that reputation but absolutely yeah um but people pay a lot
of money and so let's not waste their time and but a lot of the directness comes from the yelling
stuff of working in the here and now right right so that's all you really
have absolutely because our offices sitting in the room what do we feel what do we have what information what
behaviors here and now are we in touch with not there and then out there somewhere
we can speculate we can anticipate we can plan but all we really have is what's here and if you think about what
we talked about last time in terms of how do you help as we were talking specifically about men but creating that
awareness for men is processing in the here and now and sitting across from a man and going hey i'm holding my breath
right now that tells me you are yeah why why aren't we breathing here's the projective identification
yeah yeah so let's take our break and let's pick this up on your site okay
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friday it's psych with mike okay we're back so uh that here and now
focus that comes from mount yavan which is an existential that's that known as an existentialist
uh is so important
for really any kind of therapy but when you're saying okay we're not breathing
why aren't we breathing and that's a here and now focus then
how where is i where does i at best come into that so it doesn't okay
it doesn't so um i i mean it can
but i find myself just oscillating um when appropriate to so you're not
getting limited by the structure no you are engaged in the process of the
conversation correct so like remember so i said i i have a tendency i have a part of me right that shuts down when we talk
about theories so if someone were to label me as an ifs therapist i'm immediately
going we're not labeling that either that is a very big piece of what i do but if we're
processing and you're now saying like so i'm not breathing that tells me you're not breathing
help me help me understand what's happening here i can say if i want to incorporate ifs i can say because it
happens often i feel like there has been a shift inside of you which tells me a part of
the stuff then can you be aware of that can you check in with your assistant
and tell me what part just stepped in because we were guiding and we were we were moving
and then i said this and there was a shift in your energy which leads me to believe a part again
it's constant teaching of awareness so we mentioned y'all yalum
was a leading author and theorist in the field of counseling
psychology i'm enamored with him in his work one of the things that he talks about
is that all of us and it drives a lot of dysfunctional behavior especially in men
uh having anxiety about death and fear of death uh and as we get older or as
critical events happen in our lives the underlying issue that therapist
needs to be aware of is this person is fear-dying facing their own immortality whatever
that means and i remember because i came to you as a therapist
and i remember getting in touch with that because i turned 74 i retired
couple of friends that died my age good friend of mine committed suicide
and i was really struggling with that i but i hadn't put it in purpose right and i'm sitting in the room with you and
you're inviting me to get in touch with all those feelings and i just started crying
wrong grief of loss and fear and you just very quietly sit there my
wife was placed on me and you were sitting there and you just softly said breathe
just breathe stay here and i couldn't i mean when my chest was frozen my throat was frozen my tears were i mean
like a blubbering child but in a little while it passed and i
could breathe so what you're describing about that isn't a technical theory it's not 10
chapters in a book that you can read and learn how to do right you have to be able to do it on the if somebody walks
in the room and they get in touch with these emotions you have to be able to be present and catch it and catch it and
hold them in a safe holding environment whatever it is when we were talking in the previous episode that we did about
rage yeah same thing a man who's grateful or angry in this moment and you're boiling with
it inside you as the clinician have to be able to sit and say it's okay stay with it
you know i hurt yourself you're not gonna punch the ball you gotta hurt me but you could feel his feelings and then this process was talking about but what
is time right now here now and my
orientation has always been and you know i say this all the time that
really everything comes down to the ability or lack thereof to
emotionally regulate so when i did my dissertation i was doing my dissertation on
substance abuse as an attachment disorder which there's very little information on but i
can make an argument for why i believe that uh and i got one third of the way through it and my
my uh chairperson who did not was not very confrontational uh came to me and
said oh you have to start over because all of this you know information is 20 years old and we want something that's
more recent and so i re did it and i did the biological similarities and
differences of depression and anxiety because i knew that i could get very very current research on that but the
point being that you know for me i've always said no one ever goes to
psychotherapy because they have a problem people go to psychotherapy because a problem that they have has
caused them emotional dysregulation if you can emotionally regulate you don't
need psychotherapy when you can't emotionally regulate the smallest problem in the world can cause you to
not be able to function and so for me it's all about trying to find
where is the dysfunction in the emotional regulation some people have never
been able to emotionally regulate they don't even know what that means they don't even yeah and and so it's all
about trump so to me it doesn't really matter like i have a very clearly
defined process or understanding of how i think
that emotional regulation develops that i can explain to people at great detail and nobody cares brett tells me all the
time nobody cares but it doesn't matter to me how people
come at that but that's the goal is how do i identify
where your emotional regulation breakdown is and how do i help you be able to emotionally regulate better and
when you can do that you don't need me anymore how does your theory though
lead people to the awareness of like needing to um
towards that emotional regulation like where how does that show up in your work
so for me the emotional regulation comes from as i said the co-hunting ideas of
mirroring idealization and twinship so you have a external model when you're
born you don't know how to emotionally regulate you're just emotion you have all of the biological components you have hormones
that get released in your body that change your body and you have emotional responses but you don't have any
self-soothing ability no emotional regulation and so you look to the external examples when the external
examples are good you learn how to emotionally regulate when they're not good or you don't internalize them
efficiently then there's a breakdown in that and so then you grow up and that's where to me
the insecurity comes from so for pj what he said is that that first stage of development is security versus
you know trust versus mistrust that's where security comes from if you don't
have grounded securities because in that very very early model
that wasn't modeled for you and so the process of psychotherapy is about giving
the client an alternative yes yeah okay
okay and so if i can come into that situation consistently enough yeah
and you can do whatever you want you're great it's not me re-parenting you right it's me
facilitating your ability giving you an example right yeah right and then you internalize a
different grown-up yes but but the therapist has to be able to
provide a consistent model for the client to be able to
see that and then internalize that what i call i say that therapists loan
their clients a little bit of ego until the client builds that for themselves
and can carry around with them
so one of the clinical arguments about that is do you as a clinician encourage
codependency of the client on you and there is an argument that can be
made that initially you need them to be dependent on you but you need to teach them how to become
independent in a healthy way exactly i mean when they are they leave but it's free parenting so i mean you
know that all goes into it now but but you know the the for me the difference
is the motivation of the therapist it's all about the counter transference if i feel
intentionally eliciting the dependence because that i get off
a part of the process of re-parenting with no
ego invested in it from my side then it's just a part of the process
well we were talking about that other way here like that constant awareness for clinicians to have the power
differentials that are in that space at all times and so yeah i feel like it's my job to be checking in on a regular
basis and having the uncomfortable conversations and essentially just modeling boundaries and how to
communicate and saying am i still meeting the needs in which you came here is there are you know is there anything
that we are doing that just doesn't feel right for you because people will stay because they want to be pleasing
and you know continue work that's not fulfilling what they need so i think
i think that's a way to to check those power differentials and not create that codependency or the
lasting codependency on the relationship but even when you're talking about these
angry males and so the angry male comes in and they can rage and then you can
sit with that and not react in a way that is cowering or
is submissive maybe for the first time yeah maybe for the first time in their experience that that's ever happened
that's giving them a different dynamic to play off of now i have an alternative
way of being able to understand this anger now can i allow myself to be
vulnerable enough to start to explore that that's the process of therapy right absolutely looking across from a man who
is raging and looking in the eyes and saying i'm not afraid
um when you to square a man up and say you are
not afraid of you can be significant yeah
but i think that that is that's a part of
the therapy experience and not that so so let me just say this start differently like
it's never occurred to me that i'm afraid in therapy like i've always said if i if
i ever went to work and i was afraid i would stop doing it yeah um and so i've never been in a situation where i mean
i've been in a situation point of situations where men have been rageful it's never occurred to me that i have to
say i'm not afraid of you because i just that that's not but i understand how that plays
differently with female therapists and because female therapists are 75 to 80
of the population of therapists the only way men are going to get therapy
statistically is a lot of them are going to be in therapy with females and
you know i so i think that what you are talking about is so salient how is a female going to sit in that and
be able to absorb that anger because of what what so what
is the counter transference for that female when the man is raging
and how do females learn to be able to [Music]
okay so let me ask you a question so do you do you resist
your is there something in you that says oh this guy's angry i should be subservient no i can't because i'm doing therapy or
have you trained yourself not do you understand what i'm saying i think so keep going finish that so do you or do you train yourself to
not be to not have that reaction uh i think not having the reaction comes
from my childhood number one and being around a lot of chaos and like knowing how to navigate that
um but number two um like we said in the last episode like
when i see that anger in that rage i see wounding and i feel compassionate
like i i don't know that i've had to train myself to do that as much as it just
organically is part of who i am i think that
talking about a marital situation when a couple's situation where the man is raising your ability to
experience that and reflect back to him i'm not afraid i'm aware that you're angry but i'm sitting with him and i'm
not afraid he's modeling for him what that's like in his life
other people and particularly women don't react that way but you're also modeling for the woman
who may be seeing this for the first time and may discover that's a thing that she can do absolutely
they both have a learning curve for helping survive his rage well and i'm even was
thinking as we were processing this that it's one thing for a man to come into therapy with another
man and to not have that man experience his rage as
uh yeah but it's a different thing for him to go to therapy with a woman and not
have the woman experience that rage as intimidating and i think both are beneficial both are
necessary for good therapy but go ahead as a flip side of that argument
i've had women say to me you can't know this yeah you can't know this because you're a man yeah and you can't know
what i'm feeling or you can't know what i'm seeing and yet they were experiencing that i want to snow yeah
and it wrote right it doesn't matter which sex if your world view is
people respond to this behavior this emanation from a particular way and you
have something that doesn't do that it's like well what the else going on here well right now i don't know what to
do right you change the script on me yeah exactly which is what you're trying to do absolutely it is
yeah so hopefully that was beneficial for people i think that was another really excellent clinical discussion and
i know that that is the aim uh for mr brett newcomb so i hope that he is just
delighted as always
i'm not gonna go uh as always the music that appears inside with mike is written and performed by mr
benjamin the clue we would love it if you would find us on the interwebs and uh
on apple podcast leave us a comment and a rating but most importantly if you go
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