August 7, 2024 • 46 mins
Unlock the secrets of your personality with the brilliant Dr. Shannon Sauer-Zavala, as we explore the Big Five personality traits and the common misconceptions surrounding them. Forget what you think you know; personality isn't just about your likes and dislikes. Dr. Shannon demystifies the academic definition of personality—how we think, feel, and behave—and shatters the myth that personality is unchangeable. Learn why popular tests like Myers-Briggs and Enneagram fall short in predicting career success, and discover how our personalities can—and do—evolve over time.
What if you could change your personality to better align with your goals and values? Dr. Shannon walks us through practical cognitive-behavioral techniques like self-monitoring and thought re-evaluation that make this possible. By becoming aware of our automatic thinking patterns and challenging them, we can foster meaningful personality changes. Understand the critical difference between thoughts and facts and how this insight can lead to personal growth. This episode promises to equip you with actionable strategies to transform traits that no longer serve you.
Early negative influences can leave lasting scars, but they don't have to dictate your future. Dr. Shannon shares insights on overcoming ingrained beliefs instilled by unsupportive parents or discouraging teachers. We discuss the challenges within the mental health care system, from finding qualified therapists to the rising demand for services. But there’s hope on the horizon: innovative treatments like dissociative anesthetics and intensive exposure therapy offer new avenues for rapid, effective change. Plus, learn about the groundbreaking $5 million NIH grant aimed at personalizing treatments based on personality traits. Join us for a transformative discussion that could revolutionize your understanding of mental health care.
Dr. Shannon's Website: https://www.personality-compass.com/
TedX Talk: https://www.youtube.com/watch?v=VOILa9-1bDs
LinkedIn: https://www.linkedin.com/in/sauer-zavala/
Instagram: https://www.instagram.com/self.made.personality/?hl=en
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Hey everyone, welcome to Exploring Health Macro to
Micro.
I'm your host, parker Condit.
In this show, I interviewexperts from all areas of health
.
This can be from areas that youwould expect, like exercise,
nutrition and mental health,while other topics may be from
areas where you are lessfamiliar.
Today's conversation is allabout personality and what
influences our personality, andhere to discuss that with me is
(00:20):
Dr Shannon Sauer-Zavala.
Dr Shannon Sauer Zavala.
Dr Shannon is a clinicalpsychologist and academic
researcher who's dedicated hercareer to developing
psychological treatments to helppeople recover from mental
health difficulties.
She's also authored three books.
In this episode, we go over thecommon online personality tests
and talk about the big fivepersonality traits.
Which actually has the mostreliable research and validity
(00:42):
when it comes to personality.
Dr Shannon dispels the myththat personality is permanent
and goes over how to nudge yourthoughts, beliefs and actions if
you want to shift yourpersonality.
So I think this will be a greatepisode for anyone who wants to
learn more about themselves andbetter understand how to make
changes in their life,specifically to their
personality.
So, without further ado, pleaseenjoy my conversation with Dr
(01:05):
Shannon Sauer Zavala.
Shannon, thanks so much forbeing here.
Let's start off with the basics.
A lot of this is going to bekind of based around personality
and some of your work there, soI think it'd be great to get a
baseline of understanding whatexactly personality is.
So we're starting with a commondefinition and then we'll kind
(01:27):
of break down some of these moreinteresting aspects that you
spend a lot of your timeresearching and studying.
Speaker 2 (01:33):
Yeah, great, love it.
So I think it can be helpful totalk about what personality is
not first, and so a lot ofpeople think of personality as
your essence, your sense ofhumor, your likes and your
dislikes.
From an academic perspective,that's not really how we're
defining personality, and sopersonality is your
(01:54):
characteristic way of thinking,feeling and behaving.
Speaker 1 (01:59):
Okay, that's a good place to start and I've I've
kind of learned that structurethrough kind of going through
therapy on my own, of like thisis how you need to kind of think
about the tiers of things.
Is there like a hierarchy I'veseen this written out visually
or is it?
You should, if you're trying toaddress personality, you should
start with thinking, or shouldyou start with how you feel?
Should you start behaviors?
(02:19):
Is it different for everyone?
Speaker 2 (02:28):
Yeah, that's a great question.
It is different for everyone.
So one of the things that weknow about cognitive behavioral
therapy right?
So when we're thinking abouttargeting your thoughts and your
behaviors, right, cbt is rightin that wheelhouse.
One thing we know is that, as atreatment package, people tend
to experience relief fromsymptoms of anxiety, depression,
other issues that you might goto therapy for after the entire
(02:48):
package.
But we're not really, we don'treally know who would benefit
from what skills, right?
So, like, are you a person thatwould benefit from cognitive
skills and maybe I'm a personthat would benefit from
behavioral skills, or vice versa?
So it really is different,different for everybody.
Speaker 1 (03:05):
Okay, that's helpful.
So then, understandingpersonality a lot of people and
it's easy.
I think there's a lot ofmessaging around the somewhat
static or definitive nature ofit and it's kind of fun, right,
because I think humans can belike it's a lot to process in
the world, so we kind of usebuckets and categories to
simplify things.
Be like I am this, you knowwhether it's a Myers-Briggs or
(03:29):
an Enneagram or a horoscope,whatever it might be.
Can you discuss the maybe lackof definitive nature around that
and like how dynamic canpersonality really be?
Speaker 2 (03:41):
Yeah, that is a great question.
So I think there's a couplethings to unpack there.
First, is you named a bunch ofdifferent personality
questionnaires.
These are the ones that if youtype into Google personality
test, you're going to seeMyers-Briggs, you're going to
see Enneagram, you might seeDISC, right, and if you work for
any kind of corporation, you'veprobably had your HR department
(04:05):
kind of do team building andhave you take a Myers-Briggs or
a DISC assessment.
(04:25):
Academic settings and inpersonality research are so
different than those that areused by corporate America, by
guidance counselors, to funnelpeople into their ideal roles,
and so the research that doesexist on the well-known, really
easy to get your hands onpersonality questionnaires is
super limited.
There's not a ton, and the datathat do exist kind of show that
these tests don't predictcareer success, which is a real
(04:47):
bummer because that's whatthey're being used for.
So I think it's worth kind oftalking about the limited
research support for thesemeasures, right, and I think you
know you mentioned horoscopestoo, and so I see a lot of
college student patients, a lotof kind of like Gen Z generation
(05:09):
, and you know people will belike I'm an ENFJ, right.
So that means X, y and Z aboutme, and so people do have this
notion that this is who I am andit's static, it's not going to
change.
So I can't do X activitybecause I'm not Y characteristic
enough, and so part of thereason that I started to come on
(05:29):
podcasts is because that's justlike a myth, that I think it's
really self-limiting.
And so what we find is thatacross the population,
personality changes on averageas people age, so people tend to
experience fewer negativeemotions, so they tend to be
less neurotic.
People tend to get moreextroverted, more conscientious,
(05:50):
more open to new experiencesand just more oriented towards
other people, and so that's goodnews.
There's a lot of variabilitythere, so some people change a
ton, so some people change a tonand some people kind of hold
(06:23):
steady.
And what?
Speaker 1 (06:24):
we see now, as we're starting to target personality
in treatment or like withinterventions, is that you can
speed up the process so you cansee like 20 years of personality
change in as few as 20 weeks bytaking intentional actions to
nudge your personalityInteresting.
There's a lot I want to diveinto.
I want to start with this.
You started mentioning somepersonality traits, so the
differences between, like whatyou're going to see from a
Myers-Briggs, for example, enfp,intj, whatever it might be and
then you started mentioning whatI think are the big five
personality traits.
Are those the pillars that yousort of use in the research
(06:45):
setting?
Speaker 2 (06:46):
Yeah, so the big five has probably the most research
support and so I kind of feellike you know the big five needs
like a PR person, becauseMyers-Briggs like when I take
the Myers-Briggs, I find outthat I'm a protagonist and I'm
like, ooh, yes, that suits meyeah, they've got fun, yeah,
they've got fun.
Speaker 1 (07:03):
names too I forgot about that Right.
Speaker 2 (07:04):
And so so I can see why people would gravitate
towards that.
Once you start taking kind ofthe, the different sort of
levels on different traits, andtrying to put them into even big
, bigger, like super categories,like protagonist, that's when
we start to lose validity, losevalidity.
And so the big five, the bigfive is really interesting.
(07:25):
So when psychologists,researchers, were sort of trying
to understand differencesacross people, they actually
just opened up a dictionary andpulled out any words that
described human nature and thenthey tried to group them into
similar categories with similarthemes.
Right so like kind andthoughtful and caring would have
been grouped together.
(07:45):
And basically they found thatas you reduce and you reduce and
you reduce, that you couldn'tget fewer than five categories,
that all of the words thatdescribe human nature can be
kind of summarized by the bigfive.
I'm really creative with ournaming in psychology.
Speaker 1 (08:01):
But effective.
Okay, can you run through whatthose five are?
Speaker 2 (08:05):
Yeah, absolutely so.
Neuroticism is the tendency toexperience negative emotions.
People differ, right.
Some people are you tend to getmore upset, tend to be more
reactive systemally in theirenvironment, tend to take longer
to calm down.
And so, you know, in mypractice I see a lot of people
with anxiety, depression,borderline personality disorder
(08:33):
higher on the neurotic side ofthings.
Then you've gotconscientiousness.
That one is another one thatreally predicts career success.
People that are inconscientiousness tend to make
more money, tend to be moreachievement striving, and that's
on a continuum withdisinhibition, so that's being
more spontaneous, impulsive,maybe not so great at planning.
Then you have agreeableness,right, and so that's like how
(08:54):
well you get along with otherpeople, how much you trust
others, how friendly you are,and that's on a continuum with
antagonism, and that's one thatI think is so interesting
because I there, there areproblems at both sides of the
continuum, right, if you're tooagreeable, your people pleaser
kind of doormat, and if you'retoo antagonistic, then then you
(09:19):
have problems.
Speaker 1 (09:20):
Yeah, you're just a thorn in the side of people.
Speaker 2 (09:22):
Yeah, right, and I mean conscientiousness is like
that too.
If you're too high inconscientiousness then you're
perfectionistic, maybe a littlerigid.
So think in, like poppsychology, introversion versus
extroversion, and so a lot ofpeople think that extroversion
(09:49):
is like how social you are orhow much you enjoy being around
other people, and it's certainlypart of it, but really it's
it's more about um, having likeenergy and a lot of activity and
a lot of excitement andpositivity and so being kind of
a social butterfly life of theparty type of person.
It kind of gets folded in withthat.
But like how traditional orconservative or you know, you
(10:10):
like things how you like them.
Speaker 1 (10:35):
All right.
So I mean you finished withopenness is are people who are
higher in openness?
Are they going to have aneasier time sort of changing
their personality?
Speaker 2 (10:45):
Yeah, I mean I think so right, like I think you know,
when you get too high inopenness there, I mean and this
is true of all, all of thedomains right, too high in
openness, it can kind of be aliability.
You spend so much time likekind of fantasizing about things
you know, or there's just somany things that are interesting
to you that it's hard to thenlike take the leap into anything
(11:05):
.
But yeah, I think there needsto be a certain level of
willingness to believe that justbecause it's always been a
particular way doesn't mean ithas to stay that way.
Speaker 1 (11:16):
Yeah, very much yeah.
So a lot of this is just apractice and balance and, I
guess, understanding kind ofwhere you are along the spectrum
of these various.
So do we have parts of all fiveof these?
In us just at varying degrees.
Okay, that's helpful.
Speaker 2 (11:30):
Yeah, and then so when you think about people
right, like most of us, or manypeople are kind of moderate on
some of them, and then you'resort of usually like kind of at
an extreme on like one of them,and that's the thing that you
would be like oh, like Shannon,she's extroverted Right and
probably wouldn't comment on theother.
Right, but they're there,everyone has a level on each
(11:52):
domain.
Speaker 1 (11:53):
Okay, and then you mentioned nudging personality.
So I'm guessing that's just youdon't want to take somebody and
be like you're just going to bea new person tomorrow.
So can you describe the processof nudging and sort of what
sort of subtle changes you'relooking for?
Like, if this is something thatyou're working on with somebody
, how do you sort of help themsort of stepwise, kind of make
(12:13):
this, this progress?
Speaker 2 (12:14):
Yeah, yeah.
So so it's worth kind of goingback to that definition of
neuroticism, right, yourcharacteristic way of thinking,
feeling and behaving.
And so you know if you maybeare not a particularly
conscientious person, but youstart to tell yourself you know,
if I show up on time to things,that shows other people that I
respect them, right, so you'rekind of changing your thinking.
(12:36):
And if you feel pride when youshow up at like brunch before
your friends get there, and ifyou engage in behaviors that
increase your timeliness, likesetting an alarm or an
appointment reminder, thenyou're starting to embody the
characteristics of a reliable orconscientious person.
And if you maintain thosechanges over time, then in
essence you become moreconscientious.
(12:58):
You've shifted your personalitya little bit.
When you take a personalitytest, you're going to maybe,
instead of you know do you tendto plan ahead and you say
strongly disagree, maybe saydisagree or neutral.
Right, and so you can see howthat that can change over time.
And so usually when I'm kind ofthinking about personality
change with somebody, I firstwant to know, um, like, what's
(13:21):
your buy-in, like, why?
Because making changes in anycapacity is really hard.
And so, like, I likeintroversion versus extroversion
for this, because you know, ifyou are introverted and you have
a job where you don't have tointeract with a ton of people
and you get a lot of fulfillmentover, like through fewer,
(13:42):
closer relationships, and likeit's working for you, then
there's no reason to nudge yourpersonality to be more
extroverted, right.
However, if you're a personthat you know is also really
high in conscientiousness andyou have high achievement
striving and you want to move upin your job, but the next, you
know the next level wouldrequire public speaking, right,
(14:03):
and would require managingpeople, then maybe there's an
incentive to try and nudge your,nudge yourself to be a little
bit more extroverted.
So that's one of the things thatI'm I'm first going to be
looking at when I'm talking tosomebody about potential
personality change is like, whydo it?
Because, again, like, I don'tthink any level of the traits is
(14:24):
inherently better than another.
It really just doesn't match upwith your goals and values.
So that's kind of the firstpiece and then we start to
identify, you know, do you haveany patterns of thinking that
are keeping you stuck in aparticular way of behaving right
?
So you know, if you tellyourself, you know you're
constantly telling yourself likeother people can't be trusted
or other people are only out toget themselves right.
(14:45):
So you know, if you tellyourself, you know you're
constantly telling yourself likeother people can't be trusted
or other people are only out toget themselves right.
They're only out for themselves.
That's probably going to keepyou behaving defensively, maybe
more apt to put a wall up right,and that's going to be, you
know, kind of keep you lower inagreeableness, right.
Or maybe you're the type ofperson that tells yourself I
(15:08):
need the adrenaline of the lastminute to start packing for this
upcoming move.
I couldn't possibly start aheadof time.
Again, that's going to keep youstuck With neuroticism.
It looks like I hate the waythese feelings feel.
It's weak to feel this way.
I should avoid these feelings.
And neuroticism is kind of aninteresting one because the more
you tell yourself you don'twant to have feelings, the more
(15:30):
you have them.
So that one's kind ofcounterintuitive how you would
address neuroticism.
So the thinking right, that'skind of where I might start.
Speaker 1 (15:41):
So you're saying, starting with the why, why that
definitely makes sense becauseyou're also mentioning, like any
sort of change is really hard.
Um, because we just lovehomeostasis.
It's just a great evolutionarykind of trait that we have.
Um, so, yeah, it definitelymakes sense to start with a why,
because it probably needs to bea strong enough why to get the
change to stick over time.
(16:01):
Cause you're just going to wantto keep reverting back to
whatever you've been doing Onthe idea of neuroticism, or
maybe I guess the easier way todo this is through thinking,
feeling and behaving.
I know there's like variouspoints you can kind of latch on
to.
So you as a therapist, becausea lot of this is going to be
(16:22):
like subconscious, right, it'sgoing to be hard for people to
recognize either the thoughts,feelings or behaviors that are
probably detrimental to them.
Speaker 2 (16:30):
So, like?
Speaker 1 (16:31):
what do you try to do through CBT or any other
modalities that you work withwhere you can try to unpack the
the unconscious or subconscious,and I'm never really sure of
the difference between those two.
Speaker 2 (16:44):
Yeah, um.
So in CBT we don't really thinkabout it as being like
unconscious or subconscious,like it's there.
You just maybe aren't reallylike as aware of it as you could
be.
So I mean, most of us have ourthinking all the time.
It's just how much are wepaying attention to what we're
telling ourselves?
Or how much are we taking whatwe're telling ourselves as the
(17:06):
truth versus a thought?
Because when you tell yourselfI need the adrenaline of the
last minute to get started onthis task, that's a thought.
It's not necessarily a fact.
You don't literally needadrenaline to open a book to
study, that's not true.
But people take those thoughtsas truth and they don't really
question them.
And so one of the things thatwe're doing in CBT or in the
(17:28):
cognitive piece is trying to getpeople to slow down a little
bit.
So usually CBT starts withself-monitoring.
I use this like form with threebubbles on it, called three
component model your thoughts,feelings and usually it's like
physical feelings.
So because some people theemotion is really like visceral,
physical, and then yourbehaviors or your urges, and so
(17:48):
we start getting people to kindof track that over the week like
do at least one of these formsa day and just with repetition,
you start to get better atidentifying.
Oh yeah, I just told myselfthis thing that is leading me to
behave in a particular way,that's leading me to react to
(18:14):
other people in a particular way, and so we start to just bring
more awareness to what's there.
We're just not maybe paying asmuch attention to it.
Speaker 1 (18:19):
Gotcha.
Yeah, so that makes sense.
Having like those three bubblesCause I was thinking like this
is something that was tricky forme in the past, where it was
like I didn't know, like Ididn't have the thought or I
couldn't identify the thought,but I would just see the
behavior I'm like why am Ifeeling so much resistance and
like procrastination is just somuch easier without necessarily
(18:40):
having a thought to tie to it?
So that seems like it ties intothe urges category, where
you're like just to find this,acknowledge it, and then, yeah,
so can you describe like from amechanistic standpoint, why it's
so beneficial to write thingsdown, because I've had so many
breakthroughs where I'm likeI've been thinking this for
years, how?
is it going to make a differenceif I write it down or say it
(19:01):
out loud?
Speaker 2 (19:02):
Yeah, yeah.
So one of my former colleaguesat Boston University had this
really cool metaphor for, Iguess, the power of thoughts.
And thoughts are like Dracula,so in the dark of your mind,
where they're just kind ofswimming around, they're really
powerful.
They can be scary, they cankeep us stuck, but when you
(19:23):
expose them to the light of daythey just turn into a pile of
dust, right, it's like oh, whenI say that out loud, I can kind
of see the flaws in that logic.
You know, when I sort ofsubject it to the light of day,
so I think, like that, that canreally, can really help.
I also think that like it canget complicated, right, because
(19:43):
the way that we think is kind ofdaisy, training our thoughts
together, like I think this, andthen that makes me think this,
and then I have a memory of this, and then you know, and so it
can kind of go on and on.
Like that, and when you, whenyou kind of map it out or write
it down, take it, make itexternal to you, it's a lot
easier to see the process.
It's a lot easier to say, okay,this is separate from me.
Now, these are thoughts thatI've written down on this paper,
(20:06):
not something that's like trueof me, and again then we have
that distance.
We can challenge those thoughtsa little bit.
Speaker 1 (20:15):
Yeah, I think that's what's been most beneficial
because, like you, yeah, youjust externalize it, you get it
out, and then the thoughts it'seasier to see, to be like.
The thoughts are not me, thethoughts are just something
that's occurring kind of throughme.
And then, yeah, I just havethoughts all day.
Some of them are great, some ofthem aren't.
Other people have thoughts.
It's like you don't need to putthat much judgment on them.
They're just.
They are just there.
Speaker 2 (20:36):
Yeah, yeah.
And thoughts are like just likeanything a lot.
Maybe your parents, you know,said something to you over and
over again.
You kind of internalize that aslike the truth of the world,
just as one example, and youthink that thought a lot.
When you're in a situation thatyou know that kind of pulls for
(21:01):
that line of thinking, you'regoing to have that thought
because that's the thought youhave in situations like that,
Not because that thought is likethe correct interpretation of
today.
Speaker 1 (21:12):
So I mean, I'm not a parent, but I just immediately
went to that.
I was like, can you?
You could probably use that toyour advantage, right?
Like that's why you say, oh,you're so smart, you're a good
learner, things like that.
Cause I think kids that arekind of conditioned with that
they're more receptive probablyto whatever form of education
they're going to be in Um, and Ithink those stories are really
(21:34):
important.
But at what point do you try toobjectively and like analyze
that?
You know, probably not inelementary school.
You're probably just kind ofliving through like that, that
lived experience, um, but atsome point is it worth like
revisiting those things and belike, is this actually a truth?
Because I mean, you couldprobably just keep yourself
somewhat delusional to youradvantage in this society where,
(21:56):
if you're really convinced thatyou're really smart and you can
kind of do anything, youprobably can like a lot of
people are just kind of likedelusional in their own
self-confidence, even when theymay not have the actual uh
requisite like skillset to kindof back that up.
Speaker 2 (22:12):
Well, right, and I think this like speaks to, um, I
don't know, likeself-fulfilling prophecy or like
, or even really personalitychange.
Right, you are who you act likeyou are, I guess, right.
So, um, yeah, I mean, and Ithink like what you just said
really resonates with me,because, I don't know, I mean I
(22:33):
have successfully gotten a PhDand like have an academic job,
I'm a professor and a therapistand like I am by far not the
smartest person in the room mostof the time, um, but when I was
little, my mom was like you'respecial, you're going places,
and I always thought that I wasright and I'm a hard worker, so
I just could see it as apossibility that I could do
(22:57):
whatever I wanted.
And so this is why I don't likecareer tests or personality
tests that you take when you'rea senior in high school that are
like you'd be a great middlemanager.
You should do that becauseyou're middle of the road
extroverted and middle of theroad conscientious, and it's
(23:18):
like how limiting is that?
Maybe I don't want to be amiddle manager, manager.
And so I think to go back to theoriginal question, which was
when should we start to analyzeour thoughts?
And I would say when you arenoticing interference, when you
are having trouble movingtowards a goal or when you're
(23:39):
noticing a lot of distressthat's getting in the way of
living in accordance with thelife that you want to have,
right, because that's usuallywhen we would recommend like, oh
, maybe you should talk tosomebody, maybe therapy would be
a good fit for you.
Lots of people have anxiety,but it doesn't prevent them from
(24:00):
moving forward in their lifeand they're not that distressed
by it.
It's just there.
I would consider myself aneurotic person.
I feel my emotions reallystrongly.
I think it makes me a greattherapist because I'm pretty
empathetic and when I experiencemy emotions I'm like, okay,
there it is.
It's not really causing me alot of distress and just stop me
from doing anything.
(24:20):
But if your thought process oryour emotions or the behaviors
that you're engaging in andyou're not sure why are getting
in the way of living the lifethat you want, that's probably
when you want to slow it downand figure out okay, like what
am I telling myself?
How's that affecting me?
Speaker 1 (24:36):
That makes sense.
So it has to be hard, hard,like.
So we just explored an exampleof like the positive side of
that, where you know you hadsupport I had support from
parents and then teachers andyou just kind of get that
positive feedback loop.
So how hard is it if very earlyon you don't have supportive or
(24:58):
encouraging parents or you havea teacher who says something to
you in first grade and you'relike, well, that's, this is my
experience with education, justjust kind of hold on to that.
Um, like how detrimental canthat be?
Sort of like years down theline of people Like I.
I'm 35 and I was still kind oftalking to people around my age
and they're like I'm not good atmath and I think they say that
(25:18):
because it looks like how muchmath you have to do every day.
They're like none.
I'm like why do you right?
It's probably something theywere told in elementary school
because they didn't do great onan arithmetic test and they're
holding onto it this many yearslater.
So like how, how hard is it tosort of unwind a lot of that
when you get these really early?
Maybe negative influences?
Speaker 2 (25:37):
Yeah, so hard but not impossible.
And so you know, I've workedwith people that have had
experiences like that right,where they're sort of holding on
to this like one formativeexperience.
I mean, I think about that likeI had a fourth grade teacher be
like you want to be a teacherto me, and I remember being
(25:59):
upset about it at the time but Iobviously didn't affect me that
much.
So things like that like oneformative experience, all the
way to having sort of chronicphysical, emotional and sexual
abuse, like kind of growing upat the home from a parent, right
(26:25):
In's like sort of beingmotivated and, I think, making
changes in how you respond tothe world, how you think about
the world, how you behave in theworld, how you feel about
things that are happening to you.
It's really hard and usually,especially if you're coming from
kind of a deficit based on yourearly experiences, it can be
(26:49):
hard to wrap your head aroundthe notion that when I put
myself out there, when I'mvulnerable, when I, you know,
step outside of my comfort zone,it's going to feel worse before
it feels better.
And I think that's where we getum, that's where I think people
often will stop.
But when we can get people thatare willing to kind of push
through that, um, you know, pushthrough the sandbar or the
(27:13):
barrier or whatever.
That's where we start to.
That's where we can see reallymeaningful change.
Speaker 1 (27:18):
Are there any tools that you have for people, um, or
is it just kind of mentallypreparing them and be like it's
it's not going to feel greatimmediately, like, um, and just
kind of setting that expectation, just because, right, like it's
hard when you hit resistanceand again I kind of already
mentioned, like just going backto whatever the default is.
Do you have tools that you kindof give people?
Speaker 2 (27:38):
Yeah.
So usually at the beginning I Imean I try to do like a lot of
like truth and advertising andtherapy.
So when people are coming inwith difficulties, I am usually
right off the bat being likethis is going to be hard, It'll
be great, I have the treatment,I know it works for some of the
difficulties that you'reexperiencing, but this is going
to be hard.
I'm not trying to just oversellit at the beginning, Like, okay
(28:00):
, this is going to be amazing,it's going to be so great,
You're gonna feel so much better, Right.
And I think some of that is justgiving people I don't know
giving people enough respect toknow that if you explain very
clearly what is going to happenin therapy, what you're going to
ask them to do, that they can.
Well, you don't have tosurprise them with it, right,
(28:22):
you can tell them and they canthink through okay, like, what
are the long and short termconsequences of this?
Is it worth it to me to do thisright now?
And sometimes people are likewell, you know, I'm going
through a divorce or I'm aboutto move states, so maybe I don't
want to start talking to youabout my childhood trauma,
because I don't want to openthat can of worms right now,
(28:43):
Like, and that's, that's like aperfectly respectful decision to
make.
And then some people are likenow is the time, let's do it.
Speaker 1 (28:53):
So I think, um, I kind of want to start exploring
the more like wider, wider areaof, like mental healthcare.
Um, where do you think thingsare going?
And I'm also curious tounderstand.
Another thought I had aroundthis was I wonder if it's harder
now because we've sort of beenconditioned over the past like
maybe 10, I don't know how manyyears, but we've been
(29:15):
conditioned to like for moreshort-term reward and like
delayed gratification is harderwith just the entire society
that we live in.
so I'm curious if like that ismore challenging um your
position now and also like whereyou think mental health is
going or mental health care.
Speaker 2 (29:31):
That's a great question.
So this is something I thinkabout a lot because I think the
state of mental health care isnot great, you know.
So if any of your listenershave tried to find a therapist
or to find a therapist that'sreally well-trained in, like
whatever they want to work on,they probably have experienced
(29:51):
barriers.
You know, whenever I have tofind, you know, I'll have like a
friend from you know that'sliving in like DC or like a
place that I don't live.
It's like Shannon, can you, canyou help me find a provider?
And like, with every possibleadvantage, like they can pay out
of pocket, like they're askingtheir friend that knows people
in the field, right, it canstill be really hard to find
(30:12):
somebody with an opening, and soI think what our field has to
grapple with is how to meet thelike ever rising demand, and so
sometimes people will ask me,you know, do you think that
people have worse mental healththan before?
And I actually don't thinkthat's what it is.
(30:32):
I think we're seeing an intenseor a higher demand for therapy
because people are much morecomfortable talking about
seeking therapy.
It's much more normalized.
I think people are much morecomfortable asking for help or
talking about the fact thatthey're, they are in therapy, um
, and so we're seeing a shift inin the amount of people that
(30:53):
are, that are asking for care,and so there are a couple of
things that I think, um, I don'tknow, our government should do,
I guess, um.
So so one thing is to invest inprevention, right, because all
the stuff that I treat intherapy are waiting until
there's a problem and thenteaching people literally skills
, right, interpersonal skills,skills for what to do when you
(31:15):
experience a strong emotion, howto not procrastinate, right.
These seem like really basicthings that could be taught in
schools, and there's so muchvariability in what happens in
different schools.
So, like my kids, they go topublic school and they're in a
district with like a lot ofdifferent public schools, and in
my kid's school they have thisUL room where they can go and
(31:38):
meditate, they can go take abreak if they need to.
They go there.
I know it's amazing and then,but other schools in the
district don't have that Um, andthere's really no rhyme, rhyme
or reason, really, um, to whycertain kids have access to that
.
So I would like to see that ina more widespread way.
There's evidence that primaryprevention can work.
Um, I'd also like to see um.
(32:00):
I'd also like to see more sortof personalized allocation of
care.
So we know that, like digitalinterventions can work, so
people that do an onlineintervention, where it's all
kind of in a computer program oran app, can get a lot of
(32:23):
benefit.
The problem is that that's notthe appropriate level of care
for some people that have moreserious symptoms, and it's not
like super engaging, as liketalking to a person, so a lot of
people drop out, and so I'dlike to see more sort of nuanced
allocation of like.
I think this would be a greatfit for these people.
They should do that, and thatwould free up space on
(32:45):
clinicians caseloads to helppeople that really do need a
higher level of care.
Speaker 1 (32:50):
That makes sense.
Yeah, just getting theappropriate level of care at the
right time.
Are there like, what does thepipeline look like for
therapists and mental healthprofessionals at this point?
Like, is it a growing field?
Like, I kind of look at themedical field and it's like
nurses are dropping out, doctorsare dropping out.
Is it similar for therapistsand mental health professionals?
Speaker 2 (33:09):
Yeah, I don't know the answer to that question.
I mean, one thing that isreally hard, I think, is that
insurance companies don'treimburse us very well, so you'd
have to have a really bigcaseload if you're taking
insurance to be able, like, livea comfortable life.
And so a lot of people that aregood, don't take insurance, um,
(33:31):
and so they can charge kind ofwhatever, because there's such a
high demand and that reallydisadvantages people that don't
have an extra $400 a week tospend on a session.
Speaker 1 (33:41):
Sure, yeah, there's a huge financial barrier, which
is one of those impossibleproblems to try to solve.
I don't know if you want to getinto this, but do you think,
like I'm, I have so many issueswith the health insurance and
the health care industry ingeneral?
I think the profit motive isjust going to.
(34:02):
The profit motive is doingexactly what it should be doing
at this point.
It's consolidating things, it'sdriving efficiencies, but none
of that is driving betterpatient care.
I hate seeing insuranceinvolved in health in any aspect
.
And yeah, so then insurance issupposed to make it more
accessible for people, but then,like you were saying, the best
providers don't take insurancebecause they don't reimburse
(34:23):
well enough.
It's just like you feel likeyou're living in a crazy world.
Speaker 2 (34:28):
Yeah, it's.
I mean it's really stupid.
And I, you know, in part of myjob I have had the opportunity
to consult in other countries,right.
So I am working on like sort ofa group treatment, an online
companion app through like theNational Health Service in the
UK and it's just amazing howthey train bachelor's level
(34:54):
people under PhD level folks to,you know, so that they have
enough providers to be able toto give good care.
And then also thinking aboutlike group group provision of
services so that more people canget benefit.
Work with the Canadiangovernment to this is actually
wild to develop a preventionprogram for the Mounties.
(35:19):
So all of the cadets intraining for the Canadian
Mounties go through a treatmentto sort of reduce their
neuroticism, essentially sothey're less likely to get PTSD
out in the field after they aredeployed.
Um, so people are thinking likethinking proactively about you
know about some of this.
Speaker 1 (35:39):
Yes, but you mentioned it earlier, where we
wait until things are on fireand then we start to put it out.
Um, it's a very American way,yep.
Speaker 2 (35:48):
Very frustrating.
Speaker 1 (35:50):
Yep, exactly.
Um, do you have any thoughts on, like some of the more uh, I
don't know what the correct termis, but like psychedelic
assisted therapies?
Um, I saw the MDMA treatmentwas just, uh, rejected from the
FDA, but there's ketaminetherapy Um, do you have any
experience with those or justany opinions on them?
Speaker 2 (36:09):
I, so I don't have any experience um like providing
I've had patients that have umgotten ketamine, people with
really treatment as a umresistant depression and like
have sworn by it, life changing.
I mean, I think, as, like anacademic psychologist, I want to
(36:34):
see more research, like I don'twant to see the door closed
because maybe, if, like maybe ifthe studies weren't giving like
the right dose of MDMA, right,or maybe not quite the right we
just haven't figured it out yet,but that doesn't mean we should
close the door on it.
Speaker 1 (36:51):
Yep, set and setting all that yeah, I coordinate with
a few ketamine clinics out hereUm, and yeah, it's just pretty
remarkable um results.
I think it's just somethingwild about being able to like
almost remove yourself, likeit's a dissociative anesthetic,
so you just really removeyourself from your body and the
kind of egoic personality almostthat you end up being so
(37:14):
attached to and people can.
Even just getting a glimpse ofthat can really open up the
possibilities for people thatare very stuck, as you were
mentioning.
Speaker 2 (37:22):
Yeah, I mean, and it's crazy, because what kind of
treatment can you do, like onetime and get?
I mean, I know people will comeback, but it's like the dose
and the frequency is sodifferent right Than like weekly
therapy or like you have totake your SSRI every day for the
rest of your life, versus likehow quickly people can see
results.
Speaker 1 (37:42):
Yeah, it's all very interesting.
And then I guess the otherquestion I had around, sort of
like the structure of therapy,which is what I've been thinking
more about Is there anyresearch behind like the 50
minute or like one hour session,or is that just more of like an
insurance based?
This is sort of a block we'regoing to allocate, or do you
think like three hour sessionswould be more beneficial?
(38:03):
Do you think different timemodalities?
Speaker 2 (38:05):
like three hour sessions would be more
beneficial.
Do you think differentmodalities?
There's research out of um no,I am going to kick myself
because I can't remember whatEuropean country it is but
research looking at like doseand frequency and basically like
um, the studies show that ifyou do say there's like a
treatment, right, that's 12sessions and usually it's
delivered once a week, right, so12 weeks.
(38:26):
But if you do it like atreatment, right, that's 12
sessions and usually it'sdelivered once a week right, so
12 weeks.
But if you do it twice a week,you can get people just as much
better in six weeks.
So, like I think there issomething to be said by
exploring, and so that'ssomething like usually insurance
companies won't pay for twosessions a week, so that's
something that I think islimiting.
Yeah and so and yeah.
So I have seen to like forcertain conditions like panic
(38:50):
disorder and like ocd, there isreally good.
So these are, these areconditions that really benefit
from like what we call exposure.
So it's sort of like you'reafraid of contamination, so
we're gonna make you eat I don'tknow the slice of pizza that's
been lying on the ground for twohours, and so there's a lot of
evidence that doing that in likea massed way, so like in a
(39:13):
shorter period of time, over andover and over again, can be
really beneficial.
So yeah, so I think most of ourtreatments have been tested in
this 50 minute once weekly way.
But as we started tointerrogate that we can see, you
know, that we could actuallyspeed up treatment if we wanted
to.
Speaker 1 (39:33):
yeah, that's kind of what it's getting at.
It's like it definitely worksright.
This structure works, but it'slike you wonder how much, or if
anything, that you're leaving onthe table as far as, like,
potential benefit of differentdurations, frequency, as, you're
mentioning, yeah because youget, you got to think, um yeah,
the, the insurance companies arenot doing it, for they're doing
(39:53):
it for some sort of conveniencesake and some sort of billing
and risk management perspectiveyeah, and so one of the cool
things about being like anacademic treatment developer is
that, um, I can providetreatment however I want in my
studies.
Speaker 2 (40:07):
And so we because we don't take insurance, we just
give treatment away for free.
And so we, you know, we dostudies where we'll compare six
weeks to 12 weeks and then tryto figure out who needs 12 weeks
and who can be done in sixweeks.
Because if we can move peoplethat can move through the
process more quickly, then thatwill open up spots on a waitlist
.
Or we need to move people thatcan move through the process
more quickly, than that willopen up spots on a wait list or,
(40:28):
you know, move people off thewait list faster.
When we think about, like youknow, care in a community clinic
, you know, or so I mean to kindof bring it back to personality
, a little bit like we've beengiving people personality
questionnaires and then givingthem.
So I guess I should back up andsay that there's a lot of data
that suggests that really highor low levels of certain
(40:53):
personality characteristics arerisk factors for different
disorders.
So really low disinhibition isa risk factor for substance use
disorder.
Really high neuroticism is likeyour emotional disorders,
anxiety, depression.
High neuroticism is, like youknow, like your emotional
disorders, anxiety, depression.
So anyway, the idea is thatmaybe we could make care more
efficient by targetingpersonality instead of targeting
symptoms, and so give peoplepersonality questionnaire at the
(41:16):
start and then you know, ifthey are elevated on just
neuroticism, they get theeight-week neuroticism module,
but if they're elevated onneuroticism and disinhibition,
then they get, you know, thosetwo modules.
Speaker 1 (41:31):
So it's all of what they need none of what they
don't like personalized andpotent.
So this is something thatyou're testing currently.
Yeah, Really interesting.
So like there's some researcharound that already, yeah, yeah.
Speaker 2 (41:41):
So I mean so in my like day job, I am a you know am
a treatment developmentresearcher.
And we've tested now ourpersonality-based treatment.
We've tested it with 100 peoplewith borderline personality
disorder.
As kind of like the proof ofconcept, we just got like a $5
million grant from NIH to testthe personalized version of it.
Speaker 1 (42:03):
Yeah, really cool, congrats, thanks.
I'm like really version of it.
Yeah, really cool.
Speaker 2 (42:06):
Congrats, Thanks.
I'm like really excited aboutit because a lot of times when
you apply for money from thegovernment, you have to
basically like bastardize youridea so that they'll be like
cool, we'll give you money.
But we actually do get to dothis like really cool
personality personalizationproject, just as we wanted to.
So I'm very excited.
Speaker 1 (42:24):
Yeah, that's just really exciting.
How many people do you thinkyou're going to be able to
enroll in that, or what's thethe goal?
Yeah, it's 230 wow, isn't itcrazy how expensive things are
yeah, yeah, it's crazy.
Speaker 2 (42:37):
I mean so like for therapy studies, we um for for
therapy studies, we actuallydon't.
We pay participants to fill outquestionnaires, but we don't,
um, we don't like, pay them forparticipating in the therapy,
because the therapy is a goodvalue, right?
Speaker 1 (42:51):
Yeah, that's its own benefit.
Speaker 2 (42:53):
And we want to attract treatment-seeking people
.
Speaker 1 (42:54):
Yeah.
Speaker 2 (42:54):
So most of the costs for a study like what I do,
because I'm not doing brainscans or taking blood or
anything like that, it's allpersonnel you need to pay
therapists.
Speaker 1 (43:03):
Yeah, no, exactly that's what I was getting at.
It's like do you think thetreatment for 200 some people?
Or you think $5 million likethat's a lot of money and
they're like 200 people?
It'd be like, yeah, it's aboutwhat you're going to get.
Speaker 2 (43:13):
Yeah, exactly Right.
But then and this is where Ithink, like prevention, like if
you do the math on preventionwhich I can't do cause I don't
know how to do that but likelike the cost benefit analysis,
right, but like you know, howmuch money do we lose in like
disability and lost wages andlimited like productivity for
(43:36):
gross domestic product or Idon't know economics things,
right, that like, could that $5million be like such a drop in
the bucket compared to all ofthe money that's lost by these
230 people not being at theirhighest potential?
Speaker 1 (43:59):
Yep, yeah, I always think it's weird that this is
the justification we have tomake in America, where it's like
you need to make the thefinancial and capitalistic
justification to do something.
Um, but yes, I, I think, Ithink there is a fair amount of
research around that.
Uh, as far as like lost wages,lost productivity days, not like
time off, um, yeah and I thinkthere's an enormous benefit to
(44:22):
prevention, at least on themedical side.
You see that very clearly.
And also, I want to make surelike I'm only making the
distinction between medical andmental health, because that's
how our healthcare system doesit, but they're obviously super
well intertwined.
So we're kind of wrappingthings up now, but do you have
any closing thoughts that youwant to leave the listeners with
?
This has been a really funconversation, by the way, so
(44:44):
thank you as well.
Speaker 2 (44:44):
I did this.
This has been great.
Um, yeah, I mean from like a apersonality test kind of
perspective, I'd say you know,don't let a personality test
that you took for free on theinternet limit who you can
become right, becausepersonality changes over time
and you actually have morecontrol over the direction you
(45:05):
shift.
You can shift it.
Then I think people give youcredit for.
And then from kind of thetherapy side of things, like I
said before, change can bereally hard.
But I've seen people that werereally suffering, that were able
to kind of stick through thatlike it gets worse before it
(45:25):
gets better phase and are living, you know, a values driven and
very purposeful life.
Speaker 1 (45:31):
Great, I really appreciate it.
I think it's very easy forpeople to sort of get locked
into, like you were saying,those personality tests, and
people can just kind of lamentor lay back on the oh, I'm this
way, I'm that way.
And I think it's reallyrefreshing and encouraging to
hear like you're not relegatedto that specific personality
type.
You can change, evolve throughnudging.
(45:53):
We're going to link to a lot ofyour resources and
congratulations on that grant.
I think pushing this researchforward is really important.
Speaker 2 (46:01):
Yeah Well, thank you so much.
Thanks so much for having me.
Speaker 1 (46:04):
Yep, thank you very much, hey everyone.
That's all for today's show.
I want thank you so much.
Thanks so much forpodcastcom.
That website will also belinked in the description.
As always, likes, shares,comments are a huge help to me
(46:37):
and to this channel and to theshow.
So any of that you can do Iwould really appreciate.
And again, thank you so muchfor watching.
I'll see you next time.
Hey everyone, welcome to Exploring Health Macro to
Micro.
I'm your host, parker Condit.
In this show, I interviewexperts from all areas of health
.
This can be from areas that youwould expect, like exercise,
nutrition and mental health,while other topics may be from
areas where you are lessfamiliar.
Today's conversation is allabout personality and what
influences our personality, andhere to discuss that with me is
(00:20):
Dr Shannon Sauer-Zavala.
Dr Shannon Sauer Zavala.
Dr Shannon is a clinicalpsychologist and academic
researcher who's dedicated hercareer to developing
psychological treatments to helppeople recover from mental
health difficulties.
She's also authored three books.
In this episode, we go over thecommon online personality tests
and talk about the big fivepersonality traits.
Which actually has the mostreliable research and validity
(00:42):
when it comes to personality.
Dr Shannon dispels the myththat personality is permanent
and goes over how to nudge yourthoughts, beliefs and actions if
you want to shift yourpersonality.
So I think this will be a greatepisode for anyone who wants to
learn more about themselves andbetter understand how to make
changes in their life,specifically to their
personality.
So, without further ado, pleaseenjoy my conversation with Dr
(01:05):
Shannon Sauer Zavala.
Shannon, thanks so much forbeing here.
Let's start off with the basics.
A lot of this is going to bekind of based around personality
and some of your work there, soI think it'd be great to get a
baseline of understanding whatexactly personality is.
So we're starting with a commondefinition and then we'll kind
(01:27):
of break down some of these moreinteresting aspects that you
spend a lot of your timeresearching and studying.
Speaker 2 (01:33):
Yeah, great, love it.
So I think it can be helpful totalk about what personality is
not first, and so a lot ofpeople think of personality as
your essence, your sense ofhumor, your likes and your
dislikes.
From an academic perspective,that's not really how we're
defining personality, and sopersonality is your
(01:54):
characteristic way of thinking,feeling and behaving.
Speaker 1 (01:59):
Okay, that's a good place to start and I've I've
kind of learned that structurethrough kind of going through
therapy on my own, of like thisis how you need to kind of think
about the tiers of things.
Is there like a hierarchy I'veseen this written out visually
or is it?
You should, if you're trying toaddress personality, you should
start with thinking, or shouldyou start with how you feel?
Should you start behaviors?
(02:19):
Is it different for everyone?
Speaker 2 (02:28):
Yeah, that's a great question.
It is different for everyone.
So one of the things that weknow about cognitive behavioral
therapy right?
So when we're thinking abouttargeting your thoughts and your
behaviors, right, cbt is rightin that wheelhouse.
One thing we know is that, as atreatment package, people tend
to experience relief fromsymptoms of anxiety, depression,
other issues that you might goto therapy for after the entire
(02:48):
package.
But we're not really, we don'treally know who would benefit
from what skills, right?
So, like, are you a person thatwould benefit from cognitive
skills and maybe I'm a personthat would benefit from
behavioral skills, or vice versa?
So it really is different,different for everybody.
Speaker 1 (03:05):
Okay, that's helpful.
So then, understandingpersonality a lot of people and
it's easy.
I think there's a lot ofmessaging around the somewhat
static or definitive nature ofit and it's kind of fun, right,
because I think humans can belike it's a lot to process in
the world, so we kind of usebuckets and categories to
simplify things.
Be like I am this, you knowwhether it's a Myers-Briggs or
(03:29):
an Enneagram or a horoscope,whatever it might be.
Can you discuss the maybe lackof definitive nature around that
and like how dynamic canpersonality really be?
Speaker 2 (03:41):
Yeah, that is a great question.
So I think there's a couplethings to unpack there.
First, is you named a bunch ofdifferent personality
questionnaires.
These are the ones that if youtype into Google personality
test, you're going to seeMyers-Briggs, you're going to
see Enneagram, you might seeDISC, right, and if you work for
any kind of corporation, you'veprobably had your HR department
(04:05):
kind of do team building andhave you take a Myers-Briggs or
a DISC assessment.
(04:25):
Academic settings and inpersonality research are so
different than those that areused by corporate America, by
guidance counselors, to funnelpeople into their ideal roles,
and so the research that doesexist on the well-known, really
easy to get your hands onpersonality questionnaires is
super limited.
There's not a ton, and the datathat do exist kind of show that
these tests don't predictcareer success, which is a real
(04:47):
bummer because that's whatthey're being used for.
So I think it's worth kind oftalking about the limited
research support for thesemeasures, right, and I think you
know you mentioned horoscopestoo, and so I see a lot of
college student patients, a lotof kind of like Gen Z generation
(05:09):
, and you know people will belike I'm an ENFJ, right.
So that means X, y and Z aboutme, and so people do have this
notion that this is who I am andit's static, it's not going to
change.
So I can't do X activitybecause I'm not Y characteristic
enough, and so part of thereason that I started to come on
(05:29):
podcasts is because that's justlike a myth, that I think it's
really self-limiting.
And so what we find is thatacross the population,
personality changes on averageas people age, so people tend to
experience fewer negativeemotions, so they tend to be
less neurotic.
People tend to get moreextroverted, more conscientious,
(05:50):
more open to new experiencesand just more oriented towards
other people, and so that's goodnews.
There's a lot of variabilitythere, so some people change a
ton, so some people change a tonand some people kind of hold
(06:23):
steady.
And what?
Speaker 1 (06:24):
we see now, as we're starting to target personality
in treatment or like withinterventions, is that you can
speed up the process so you cansee like 20 years of personality
change in as few as 20 weeks bytaking intentional actions to
nudge your personalityInteresting.
There's a lot I want to diveinto.
I want to start with this.
You started mentioning somepersonality traits, so the
differences between, like whatyou're going to see from a
Myers-Briggs, for example, enfp,intj, whatever it might be and
then you started mentioning whatI think are the big five
personality traits.
Are those the pillars that yousort of use in the research
(06:45):
setting?
Speaker 2 (06:46):
Yeah, so the big five has probably the most research
support and so I kind of feellike you know the big five needs
like a PR person, becauseMyers-Briggs like when I take
the Myers-Briggs, I find outthat I'm a protagonist and I'm
like, ooh, yes, that suits meyeah, they've got fun, yeah,
they've got fun.
Speaker 1 (07:03):
names too I forgot about that Right.
Speaker 2 (07:04):
And so so I can see why people would gravitate
towards that.
Once you start taking kind ofthe, the different sort of
levels on different traits, andtrying to put them into even big
, bigger, like super categories,like protagonist, that's when
we start to lose validity, losevalidity.
And so the big five, the bigfive is really interesting.
(07:25):
So when psychologists,researchers, were sort of trying
to understand differencesacross people, they actually
just opened up a dictionary andpulled out any words that
described human nature and thenthey tried to group them into
similar categories with similarthemes.
Right so like kind andthoughtful and caring would have
been grouped together.
(07:45):
And basically they found thatas you reduce and you reduce and
you reduce, that you couldn'tget fewer than five categories,
that all of the words thatdescribe human nature can be
kind of summarized by the bigfive.
I'm really creative with ournaming in psychology.
Speaker 1 (08:01):
But effective.
Okay, can you run through whatthose five are?
Speaker 2 (08:05):
Yeah, absolutely so.
Neuroticism is the tendency toexperience negative emotions.
People differ, right.
Some people are you tend to getmore upset, tend to be more
reactive systemally in theirenvironment, tend to take longer
to calm down.
And so, you know, in mypractice I see a lot of people
with anxiety, depression,borderline personality disorder
(08:33):
higher on the neurotic side ofthings.
Then you've gotconscientiousness.
That one is another one thatreally predicts career success.
People that are inconscientiousness tend to make
more money, tend to be moreachievement striving, and that's
on a continuum withdisinhibition, so that's being
more spontaneous, impulsive,maybe not so great at planning.
Then you have agreeableness,right, and so that's like how
(08:54):
well you get along with otherpeople, how much you trust
others, how friendly you are,and that's on a continuum with
antagonism, and that's one thatI think is so interesting
because I there, there areproblems at both sides of the
continuum, right, if you're tooagreeable, your people pleaser
kind of doormat, and if you'retoo antagonistic, then then you
(09:19):
have problems.
Speaker 1 (09:20):
Yeah, you're just a thorn in the side of people.
Speaker 2 (09:22):
Yeah, right, and I mean conscientiousness is like
that too.
If you're too high inconscientiousness then you're
perfectionistic, maybe a littlerigid.
So think in, like poppsychology, introversion versus
extroversion, and so a lot ofpeople think that extroversion
(09:49):
is like how social you are orhow much you enjoy being around
other people, and it's certainlypart of it, but really it's
it's more about um, having likeenergy and a lot of activity and
a lot of excitement andpositivity and so being kind of
a social butterfly life of theparty type of person.
It kind of gets folded in withthat.
But like how traditional orconservative or you know, you
(10:10):
like things how you like them.
Speaker 1 (10:35):
All right.
So I mean you finished withopenness is are people who are
higher in openness?
Are they going to have aneasier time sort of changing
their personality?
Speaker 2 (10:45):
Yeah, I mean I think so right, like I think you know,
when you get too high inopenness there, I mean and this
is true of all, all of thedomains right, too high in
openness, it can kind of be aliability.
You spend so much time likekind of fantasizing about things
you know, or there's just somany things that are interesting
to you that it's hard to thenlike take the leap into anything
(11:05):
.
But yeah, I think there needsto be a certain level of
willingness to believe that justbecause it's always been a
particular way doesn't mean ithas to stay that way.
Speaker 1 (11:16):
Yeah, very much yeah.
So a lot of this is just apractice and balance and, I
guess, understanding kind ofwhere you are along the spectrum
of these various.
So do we have parts of all fiveof these?
In us just at varying degrees.
Okay, that's helpful.
Speaker 2 (11:30):
Yeah, and then so when you think about people
right, like most of us, or manypeople are kind of moderate on
some of them, and then you'resort of usually like kind of at
an extreme on like one of them,and that's the thing that you
would be like oh, like Shannon,she's extroverted Right and
probably wouldn't comment on theother.
Right, but they're there,everyone has a level on each
(11:52):
domain.
Speaker 1 (11:53):
Okay, and then you mentioned nudging personality.
So I'm guessing that's just youdon't want to take somebody and
be like you're just going to bea new person tomorrow.
So can you describe the processof nudging and sort of what
sort of subtle changes you'relooking for?
Like, if this is something thatyou're working on with somebody
, how do you sort of help themsort of stepwise, kind of make
(12:13):
this, this progress?
Speaker 2 (12:14):
Yeah, yeah.
So so it's worth kind of goingback to that definition of
neuroticism, right, yourcharacteristic way of thinking,
feeling and behaving.
And so you know if you maybeare not a particularly
conscientious person, but youstart to tell yourself you know,
if I show up on time to things,that shows other people that I
respect them, right, so you'rekind of changing your thinking.
(12:36):
And if you feel pride when youshow up at like brunch before
your friends get there, and ifyou engage in behaviors that
increase your timeliness, likesetting an alarm or an
appointment reminder, thenyou're starting to embody the
characteristics of a reliable orconscientious person.
And if you maintain thosechanges over time, then in
essence you become moreconscientious.
(12:58):
You've shifted your personalitya little bit.
When you take a personalitytest, you're going to maybe,
instead of you know do you tendto plan ahead and you say
strongly disagree, maybe saydisagree or neutral.
Right, and so you can see howthat that can change over time.
And so usually when I'm kind ofthinking about personality
change with somebody, I firstwant to know, um, like, what's
(13:21):
your buy-in, like, why?
Because making changes in anycapacity is really hard.
And so, like, I likeintroversion versus extroversion
for this, because you know, ifyou are introverted and you have
a job where you don't have tointeract with a ton of people
and you get a lot of fulfillmentover, like through fewer,
(13:42):
closer relationships, and likeit's working for you, then
there's no reason to nudge yourpersonality to be more
extroverted, right.
However, if you're a personthat you know is also really
high in conscientiousness andyou have high achievement
striving and you want to move upin your job, but the next, you
know the next level wouldrequire public speaking, right,
(14:03):
and would require managingpeople, then maybe there's an
incentive to try and nudge your,nudge yourself to be a little
bit more extroverted.
So that's one of the things thatI'm I'm first going to be
looking at when I'm talking tosomebody about potential
personality change is like, whydo it?
Because, again, like, I don'tthink any level of the traits is
(14:24):
inherently better than another.
It really just doesn't match upwith your goals and values.
So that's kind of the firstpiece and then we start to
identify, you know, do you haveany patterns of thinking that
are keeping you stuck in aparticular way of behaving right
?
So you know, if you tellyourself, you know you're
constantly telling yourself likeother people can't be trusted
or other people are only out toget themselves right.
(14:45):
So you know, if you tellyourself, you know you're
constantly telling yourself likeother people can't be trusted
or other people are only out toget themselves right.
They're only out for themselves.
That's probably going to keepyou behaving defensively, maybe
more apt to put a wall up right,and that's going to be, you
know, kind of keep you lower inagreeableness, right.
Or maybe you're the type ofperson that tells yourself I
(15:08):
need the adrenaline of the lastminute to start packing for this
upcoming move.
I couldn't possibly start aheadof time.
Again, that's going to keep youstuck With neuroticism.
It looks like I hate the waythese feelings feel.
It's weak to feel this way.
I should avoid these feelings.
And neuroticism is kind of aninteresting one because the more
you tell yourself you don'twant to have feelings, the more
(15:30):
you have them.
So that one's kind ofcounterintuitive how you would
address neuroticism.
So the thinking right, that'skind of where I might start.
Speaker 1 (15:41):
So you're saying, starting with the why, why that
definitely makes sense becauseyou're also mentioning, like any
sort of change is really hard.
Um, because we just lovehomeostasis.
It's just a great evolutionarykind of trait that we have.
Um, so, yeah, it definitelymakes sense to start with a why,
because it probably needs to bea strong enough why to get the
change to stick over time.
(16:01):
Cause you're just going to wantto keep reverting back to
whatever you've been doing Onthe idea of neuroticism, or
maybe I guess the easier way todo this is through thinking,
feeling and behaving.
I know there's like variouspoints you can kind of latch on
to.
So you as a therapist, becausea lot of this is going to be
(16:22):
like subconscious, right, it'sgoing to be hard for people to
recognize either the thoughts,feelings or behaviors that are
probably detrimental to them.
Speaker 2 (16:30):
So, like?
Speaker 1 (16:31):
what do you try to do through CBT or any other
modalities that you work withwhere you can try to unpack the
the unconscious or subconscious,and I'm never really sure of
the difference between those two.
Speaker 2 (16:44):
Yeah, um.
So in CBT we don't really thinkabout it as being like
unconscious or subconscious,like it's there.
You just maybe aren't reallylike as aware of it as you could
be.
So I mean, most of us have ourthinking all the time.
It's just how much are wepaying attention to what we're
telling ourselves?
Or how much are we taking whatwe're telling ourselves as the
(17:06):
truth versus a thought?
Because when you tell yourselfI need the adrenaline of the
last minute to get started onthis task, that's a thought.
It's not necessarily a fact.
You don't literally needadrenaline to open a book to
study, that's not true.
But people take those thoughtsas truth and they don't really
question them.
And so one of the things thatwe're doing in CBT or in the
(17:28):
cognitive piece is trying to getpeople to slow down a little
bit.
So usually CBT starts withself-monitoring.
I use this like form with threebubbles on it, called three
component model your thoughts,feelings and usually it's like
physical feelings.
So because some people theemotion is really like visceral,
physical, and then yourbehaviors or your urges, and so
(17:48):
we start getting people to kindof track that over the week like
do at least one of these formsa day and just with repetition,
you start to get better atidentifying.
Oh yeah, I just told myselfthis thing that is leading me to
behave in a particular way,that's leading me to react to
(18:14):
other people in a particular way, and so we start to just bring
more awareness to what's there.
We're just not maybe paying asmuch attention to it.
Speaker 1 (18:19):
Gotcha.
Yeah, so that makes sense.
Having like those three bubblesCause I was thinking like this
is something that was tricky forme in the past, where it was
like I didn't know, like Ididn't have the thought or I
couldn't identify the thought,but I would just see the
behavior I'm like why am Ifeeling so much resistance and
like procrastination is just somuch easier without necessarily
(18:40):
having a thought to tie to it?
So that seems like it ties intothe urges category, where
you're like just to find this,acknowledge it, and then, yeah,
so can you describe like from amechanistic standpoint, why it's
so beneficial to write thingsdown, because I've had so many
breakthroughs where I'm likeI've been thinking this for
years, how?
is it going to make a differenceif I write it down or say it
(19:01):
out loud?
Speaker 2 (19:02):
Yeah, yeah.
So one of my former colleaguesat Boston University had this
really cool metaphor for, Iguess, the power of thoughts.
And thoughts are like Dracula,so in the dark of your mind,
where they're just kind ofswimming around, they're really
powerful.
They can be scary, they cankeep us stuck, but when you
(19:23):
expose them to the light of daythey just turn into a pile of
dust, right, it's like oh, whenI say that out loud, I can kind
of see the flaws in that logic.
You know, when I sort ofsubject it to the light of day,
so I think, like that, that canreally, can really help.
I also think that like it canget complicated, right, because
(19:43):
the way that we think is kind ofdaisy, training our thoughts
together, like I think this, andthen that makes me think this,
and then I have a memory of this, and then you know, and so it
can kind of go on and on.
Like that, and when you, whenyou kind of map it out or write
it down, take it, make itexternal to you, it's a lot
easier to see the process.
It's a lot easier to say, okay,this is separate from me.
Now, these are thoughts thatI've written down on this paper,
(20:06):
not something that's like trueof me, and again then we have
that distance.
We can challenge those thoughtsa little bit.
Speaker 1 (20:15):
Yeah, I think that's what's been most beneficial
because, like you, yeah, youjust externalize it, you get it
out, and then the thoughts it'seasier to see, to be like.
The thoughts are not me, thethoughts are just something
that's occurring kind of throughme.
And then, yeah, I just havethoughts all day.
Some of them are great, some ofthem aren't.
Other people have thoughts.
It's like you don't need to putthat much judgment on them.
They're just.
They are just there.
Speaker 2 (20:36):
Yeah, yeah.
And thoughts are like just likeanything a lot.
Maybe your parents, you know,said something to you over and
over again.
You kind of internalize that aslike the truth of the world,
just as one example, and youthink that thought a lot.
When you're in a situation thatyou know that kind of pulls for
(21:01):
that line of thinking, you'regoing to have that thought
because that's the thought youhave in situations like that,
Not because that thought is likethe correct interpretation of
today.
Speaker 1 (21:12):
So I mean, I'm not a parent, but I just immediately
went to that.
I was like, can you?
You could probably use that toyour advantage, right?
Like that's why you say, oh,you're so smart, you're a good
learner, things like that.
Cause I think kids that arekind of conditioned with that
they're more receptive probablyto whatever form of education
they're going to be in Um, and Ithink those stories are really
(21:34):
important.
But at what point do you try toobjectively and like analyze
that?
You know, probably not inelementary school.
You're probably just kind ofliving through like that, that
lived experience, um, but atsome point is it worth like
revisiting those things and belike, is this actually a truth?
Because I mean, you couldprobably just keep yourself
somewhat delusional to youradvantage in this society where,
(21:56):
if you're really convinced thatyou're really smart and you can
kind of do anything, youprobably can like a lot of
people are just kind of likedelusional in their own
self-confidence, even when theymay not have the actual uh
requisite like skillset to kindof back that up.
Speaker 2 (22:12):
Well, right, and I think this like speaks to, um, I
don't know, likeself-fulfilling prophecy or like
, or even really personalitychange.
Right, you are who you act likeyou are, I guess, right.
So, um, yeah, I mean, and Ithink like what you just said
really resonates with me,because, I don't know, I mean I
(22:33):
have successfully gotten a PhDand like have an academic job,
I'm a professor and a therapistand like I am by far not the
smartest person in the room mostof the time, um, but when I was
little, my mom was like you'respecial, you're going places,
and I always thought that I wasright and I'm a hard worker, so
I just could see it as apossibility that I could do
(22:57):
whatever I wanted.
And so this is why I don't likecareer tests or personality
tests that you take when you'rea senior in high school that are
like you'd be a great middlemanager.
You should do that becauseyou're middle of the road
extroverted and middle of theroad conscientious, and it's
(23:18):
like how limiting is that?
Maybe I don't want to be amiddle manager, manager.
And so I think to go back to theoriginal question, which was
when should we start to analyzeour thoughts?
And I would say when you arenoticing interference, when you
are having trouble movingtowards a goal or when you're
(23:39):
noticing a lot of distressthat's getting in the way of
living in accordance with thelife that you want to have,
right, because that's usuallywhen we would recommend like, oh
, maybe you should talk tosomebody, maybe therapy would be
a good fit for you.
Lots of people have anxiety,but it doesn't prevent them from
(24:00):
moving forward in their lifeand they're not that distressed
by it.
It's just there.
I would consider myself aneurotic person.
I feel my emotions reallystrongly.
I think it makes me a greattherapist because I'm pretty
empathetic and when I experiencemy emotions I'm like, okay,
there it is.
It's not really causing me alot of distress and just stop me
from doing anything.
(24:20):
But if your thought process oryour emotions or the behaviors
that you're engaging in andyou're not sure why are getting
in the way of living the lifethat you want, that's probably
when you want to slow it downand figure out okay, like what
am I telling myself?
How's that affecting me?
Speaker 1 (24:36):
That makes sense.
So it has to be hard, hard,like.
So we just explored an exampleof like the positive side of
that, where you know you hadsupport I had support from
parents and then teachers andyou just kind of get that
positive feedback loop.
So how hard is it if very earlyon you don't have supportive or
(24:58):
encouraging parents or you havea teacher who says something to
you in first grade and you'relike, well, that's, this is my
experience with education, justjust kind of hold on to that.
Um, like how detrimental canthat be?
Sort of like years down theline of people Like I.
I'm 35 and I was still kind oftalking to people around my age
and they're like I'm not good atmath and I think they say that
(25:18):
because it looks like how muchmath you have to do every day.
They're like none.
I'm like why do you right?
It's probably something theywere told in elementary school
because they didn't do great onan arithmetic test and they're
holding onto it this many yearslater.
So like how, how hard is it tosort of unwind a lot of that
when you get these really early?
Maybe negative influences?
Speaker 2 (25:37):
Yeah, so hard but not impossible.
And so you know, I've workedwith people that have had
experiences like that right,where they're sort of holding on
to this like one formativeexperience.
I mean, I think about that likeI had a fourth grade teacher be
like you want to be a teacherto me, and I remember being
(25:59):
upset about it at the time but Iobviously didn't affect me that
much.
So things like that like oneformative experience, all the
way to having sort of chronicphysical, emotional and sexual
abuse, like kind of growing upat the home from a parent, right
(26:25):
In's like sort of beingmotivated and, I think, making
changes in how you respond tothe world, how you think about
the world, how you behave in theworld, how you feel about
things that are happening to you.
It's really hard and usually,especially if you're coming from
kind of a deficit based on yourearly experiences, it can be
(26:49):
hard to wrap your head aroundthe notion that when I put
myself out there, when I'mvulnerable, when I, you know,
step outside of my comfort zone,it's going to feel worse before
it feels better.
And I think that's where we getum, that's where I think people
often will stop.
But when we can get people thatare willing to kind of push
through that, um, you know, pushthrough the sandbar or the
(27:13):
barrier or whatever.
That's where we start to.
That's where we can see reallymeaningful change.
Speaker 1 (27:18):
Are there any tools that you have for people, um, or
is it just kind of mentallypreparing them and be like it's
it's not going to feel greatimmediately, like, um, and just
kind of setting that expectation, just because, right, like it's
hard when you hit resistanceand again I kind of already
mentioned, like just going backto whatever the default is.
Do you have tools that you kindof give people?
Speaker 2 (27:38):
Yeah.
So usually at the beginning I Imean I try to do like a lot of
like truth and advertising andtherapy.
So when people are coming inwith difficulties, I am usually
right off the bat being likethis is going to be hard, It'll
be great, I have the treatment,I know it works for some of the
difficulties that you'reexperiencing, but this is going
to be hard.
I'm not trying to just oversellit at the beginning, Like, okay
(28:00):
, this is going to be amazing,it's going to be so great,
You're gonna feel so much better, Right.
And I think some of that is justgiving people I don't know
giving people enough respect toknow that if you explain very
clearly what is going to happenin therapy, what you're going to
ask them to do, that they can.
Well, you don't have tosurprise them with it, right,
(28:22):
you can tell them and they canthink through okay, like, what
are the long and short termconsequences of this?
Is it worth it to me to do thisright now?
And sometimes people are likewell, you know, I'm going
through a divorce or I'm aboutto move states, so maybe I don't
want to start talking to youabout my childhood trauma,
because I don't want to openthat can of worms right now,
(28:43):
Like, and that's, that's like aperfectly respectful decision to
make.
And then some people are likenow is the time, let's do it.
Speaker 1 (28:53):
So I think, um, I kind of want to start exploring
the more like wider, wider areaof, like mental healthcare.
Um, where do you think thingsare going?
And I'm also curious tounderstand.
Another thought I had aroundthis was I wonder if it's harder
now because we've sort of beenconditioned over the past like
maybe 10, I don't know how manyyears, but we've been
(29:15):
conditioned to like for moreshort-term reward and like
delayed gratification is harderwith just the entire society
that we live in.
so I'm curious if like that ismore challenging um your
position now and also like whereyou think mental health is
going or mental health care.
Speaker 2 (29:31):
That's a great question.
So this is something I thinkabout a lot because I think the
state of mental health care isnot great, you know.
So if any of your listenershave tried to find a therapist
or to find a therapist that'sreally well-trained in, like
whatever they want to work on,they probably have experienced
(29:51):
barriers.
You know, whenever I have tofind, you know, I'll have like a
friend from you know that'sliving in like DC or like a
place that I don't live.
It's like Shannon, can you, canyou help me find a provider?
And like, with every possibleadvantage, like they can pay out
of pocket, like they're askingtheir friend that knows people
in the field, right, it canstill be really hard to find
(30:12):
somebody with an opening, and soI think what our field has to
grapple with is how to meet thelike ever rising demand, and so
sometimes people will ask me,you know, do you think that
people have worse mental healththan before?
And I actually don't thinkthat's what it is.
(30:32):
I think we're seeing an intenseor a higher demand for therapy
because people are much morecomfortable talking about
seeking therapy.
It's much more normalized.
I think people are much morecomfortable asking for help or
talking about the fact thatthey're, they are in therapy, um
, and so we're seeing a shift inin the amount of people that
(30:53):
are, that are asking for care,and so there are a couple of
things that I think, um, I don'tknow, our government should do,
I guess, um.
So so one thing is to invest inprevention, right, because all
the stuff that I treat intherapy are waiting until
there's a problem and thenteaching people literally skills
, right, interpersonal skills,skills for what to do when you
(31:15):
experience a strong emotion, howto not procrastinate, right.
These seem like really basicthings that could be taught in
schools, and there's so muchvariability in what happens in
different schools.
So, like my kids, they go topublic school and they're in a
district with like a lot ofdifferent public schools, and in
my kid's school they have thisUL room where they can go and
(31:38):
meditate, they can go take abreak if they need to.
They go there.
I know it's amazing and then,but other schools in the
district don't have that Um, andthere's really no rhyme, rhyme
or reason, really, um, to whycertain kids have access to that
.
So I would like to see that ina more widespread way.
There's evidence that primaryprevention can work.
Um, I'd also like to see um.
(32:00):
I'd also like to see more sortof personalized allocation of
care.
So we know that, like digitalinterventions can work, so
people that do an onlineintervention, where it's all
kind of in a computer program oran app, can get a lot of
(32:23):
benefit.
The problem is that that's notthe appropriate level of care
for some people that have moreserious symptoms, and it's not
like super engaging, as liketalking to a person, so a lot of
people drop out, and so I'dlike to see more sort of nuanced
allocation of like.
I think this would be a greatfit for these people.
They should do that, and thatwould free up space on
(32:45):
clinicians caseloads to helppeople that really do need a
higher level of care.
Speaker 1 (32:50):
That makes sense.
Yeah, just getting theappropriate level of care at the
right time.
Are there like, what does thepipeline look like for
therapists and mental healthprofessionals at this point?
Like, is it a growing field?
Like, I kind of look at themedical field and it's like
nurses are dropping out, doctorsare dropping out.
Is it similar for therapistsand mental health professionals?
Speaker 2 (33:09):
Yeah, I don't know the answer to that question.
I mean, one thing that isreally hard, I think, is that
insurance companies don'treimburse us very well, so you'd
have to have a really bigcaseload if you're taking
insurance to be able, like, livea comfortable life.
And so a lot of people that aregood, don't take insurance, um,
(33:31):
and so they can charge kind ofwhatever, because there's such a
high demand and that reallydisadvantages people that don't
have an extra $400 a week tospend on a session.
Speaker 1 (33:41):
Sure, yeah, there's a huge financial barrier, which
is one of those impossibleproblems to try to solve.
I don't know if you want to getinto this, but do you think,
like I'm, I have so many issueswith the health insurance and
the health care industry ingeneral?
I think the profit motive isjust going to.
(34:02):
The profit motive is doingexactly what it should be doing
at this point.
It's consolidating things, it'sdriving efficiencies, but none
of that is driving betterpatient care.
I hate seeing insuranceinvolved in health in any aspect
.
And yeah, so then insurance issupposed to make it more
accessible for people, but then,like you were saying, the best
providers don't take insurancebecause they don't reimburse
(34:23):
well enough.
It's just like you feel likeyou're living in a crazy world.
Speaker 2 (34:28):
Yeah, it's.
I mean it's really stupid.
And I, you know, in part of myjob I have had the opportunity
to consult in other countries,right.
So I am working on like sort ofa group treatment, an online
companion app through like theNational Health Service in the
UK and it's just amazing howthey train bachelor's level
(34:54):
people under PhD level folks to,you know, so that they have
enough providers to be able toto give good care.
And then also thinking aboutlike group group provision of
services so that more people canget benefit.
Work with the Canadiangovernment to this is actually
wild to develop a preventionprogram for the Mounties.
(35:19):
So all of the cadets intraining for the Canadian
Mounties go through a treatmentto sort of reduce their
neuroticism, essentially sothey're less likely to get PTSD
out in the field after they aredeployed.
Um, so people are thinking likethinking proactively about you
know about some of this.
Speaker 1 (35:39):
Yes, but you mentioned it earlier, where we
wait until things are on fireand then we start to put it out.
Um, it's a very American way,yep.
Speaker 2 (35:48):
Very frustrating.
Speaker 1 (35:50):
Yep, exactly.
Um, do you have any thoughts on, like some of the more uh, I
don't know what the correct termis, but like psychedelic
assisted therapies?
Um, I saw the MDMA treatmentwas just, uh, rejected from the
FDA, but there's ketaminetherapy Um, do you have any
experience with those or justany opinions on them?
Speaker 2 (36:09):
I, so I don't have any experience um like providing
I've had patients that have umgotten ketamine, people with
really treatment as a umresistant depression and like
have sworn by it, life changing.
I mean, I think, as, like anacademic psychologist, I want to
(36:34):
see more research, like I don'twant to see the door closed
because maybe, if, like maybe ifthe studies weren't giving like
the right dose of MDMA, right,or maybe not quite the right we
just haven't figured it out yet,but that doesn't mean we should
close the door on it.
Speaker 1 (36:51):
Yep, set and setting all that yeah, I coordinate with
a few ketamine clinics out hereUm, and yeah, it's just pretty
remarkable um results.
I think it's just somethingwild about being able to like
almost remove yourself, likeit's a dissociative anesthetic,
so you just really removeyourself from your body and the
kind of egoic personality almostthat you end up being so
(37:14):
attached to and people can.
Even just getting a glimpse ofthat can really open up the
possibilities for people thatare very stuck, as you were
mentioning.
Speaker 2 (37:22):
Yeah, I mean, and it's crazy, because what kind of
treatment can you do, like onetime and get?
I mean, I know people will comeback, but it's like the dose
and the frequency is sodifferent right Than like weekly
therapy or like you have totake your SSRI every day for the
rest of your life, versus likehow quickly people can see
results.
Speaker 1 (37:42):
Yeah, it's all very interesting.
And then I guess the otherquestion I had around, sort of
like the structure of therapy,which is what I've been thinking
more about Is there anyresearch behind like the 50
minute or like one hour session,or is that just more of like an
insurance based?
This is sort of a block we'regoing to allocate, or do you
think like three hour sessionswould be more beneficial?
(38:03):
Do you think different timemodalities?
Speaker 2 (38:05):
like three hour sessions would be more
beneficial.
Do you think differentmodalities?
There's research out of um no,I am going to kick myself
because I can't remember whatEuropean country it is but
research looking at like doseand frequency and basically like
um, the studies show that ifyou do say there's like a
treatment, right, that's 12sessions and usually it's
delivered once a week, right, so12 weeks.
(38:26):
But if you do it like atreatment, right, that's 12
sessions and usually it'sdelivered once a week right, so
12 weeks.
But if you do it twice a week,you can get people just as much
better in six weeks.
So, like I think there issomething to be said by
exploring, and so that'ssomething like usually insurance
companies won't pay for twosessions a week, so that's
something that I think islimiting.
Yeah and so and yeah.
So I have seen to like forcertain conditions like panic
(38:50):
disorder and like ocd, there isreally good.
So these are, these areconditions that really benefit
from like what we call exposure.
So it's sort of like you'reafraid of contamination, so
we're gonna make you eat I don'tknow the slice of pizza that's
been lying on the ground for twohours, and so there's a lot of
evidence that doing that in likea massed way, so like in a
(39:13):
shorter period of time, over andover and over again, can be
really beneficial.
So yeah, so I think most of ourtreatments have been tested in
this 50 minute once weekly way.
But as we started tointerrogate that we can see, you
know, that we could actuallyspeed up treatment if we wanted
to.
Speaker 1 (39:33):
yeah, that's kind of what it's getting at.
It's like it definitely worksright.
This structure works, but it'slike you wonder how much, or if
anything, that you're leaving onthe table as far as, like,
potential benefit of differentdurations, frequency, as, you're
mentioning, yeah because youget, you got to think, um yeah,
the, the insurance companies arenot doing it, for they're doing
(39:53):
it for some sort of conveniencesake and some sort of billing
and risk management perspectiveyeah, and so one of the cool
things about being like anacademic treatment developer is
that, um, I can providetreatment however I want in my
studies.
Speaker 2 (40:07):
And so we because we don't take insurance, we just
give treatment away for free.
And so we, you know, we dostudies where we'll compare six
weeks to 12 weeks and then tryto figure out who needs 12 weeks
and who can be done in sixweeks.
Because if we can move peoplethat can move through the
process more quickly, then thatwill open up spots on a waitlist
.
Or we need to move people thatcan move through the process
more quickly, than that willopen up spots on a wait list or,
(40:28):
you know, move people off thewait list faster.
When we think about, like youknow, care in a community clinic
, you know, or so I mean to kindof bring it back to personality
, a little bit like we've beengiving people personality
questionnaires and then givingthem.
So I guess I should back up andsay that there's a lot of data
that suggests that really highor low levels of certain
(40:53):
personality characteristics arerisk factors for different
disorders.
So really low disinhibition isa risk factor for substance use
disorder.
Really high neuroticism is likeyour emotional disorders,
anxiety, depression.
High neuroticism is, like youknow, like your emotional
disorders, anxiety, depression.
So anyway, the idea is thatmaybe we could make care more
efficient by targetingpersonality instead of targeting
symptoms, and so give peoplepersonality questionnaire at the
(41:16):
start and then you know, ifthey are elevated on just
neuroticism, they get theeight-week neuroticism module,
but if they're elevated onneuroticism and disinhibition,
then they get, you know, thosetwo modules.
Speaker 1 (41:31):
So it's all of what they need none of what they
don't like personalized andpotent.
So this is something thatyou're testing currently.
Yeah, Really interesting.
So like there's some researcharound that already, yeah, yeah.
Speaker 2 (41:41):
So I mean so in my like day job, I am a you know am
a treatment developmentresearcher.
And we've tested now ourpersonality-based treatment.
We've tested it with 100 peoplewith borderline personality
disorder.
As kind of like the proof ofconcept, we just got like a $5
million grant from NIH to testthe personalized version of it.
Speaker 1 (42:03):
Yeah, really cool, congrats, thanks.
I'm like really version of it.
Yeah, really cool.
Speaker 2 (42:06):
Congrats, Thanks.
I'm like really excited aboutit because a lot of times when
you apply for money from thegovernment, you have to
basically like bastardize youridea so that they'll be like
cool, we'll give you money.
But we actually do get to dothis like really cool
personality personalizationproject, just as we wanted to.
So I'm very excited.
Speaker 1 (42:24):
Yeah, that's just really exciting.
How many people do you thinkyou're going to be able to
enroll in that, or what's thethe goal?
Yeah, it's 230 wow, isn't itcrazy how expensive things are
yeah, yeah, it's crazy.
Speaker 2 (42:37):
I mean so like for therapy studies, we um for for
therapy studies, we actuallydon't.
We pay participants to fill outquestionnaires, but we don't,
um, we don't like, pay them forparticipating in the therapy,
because the therapy is a goodvalue, right?
Speaker 1 (42:51):
Yeah, that's its own benefit.
Speaker 2 (42:53):
And we want to attract treatment-seeking people
.
Speaker 1 (42:54):
Yeah.
Speaker 2 (42:54):
So most of the costs for a study like what I do,
because I'm not doing brainscans or taking blood or
anything like that, it's allpersonnel you need to pay
therapists.
Speaker 1 (43:03):
Yeah, no, exactly that's what I was getting at.
It's like do you think thetreatment for 200 some people?
Or you think $5 million likethat's a lot of money and
they're like 200 people?
It'd be like, yeah, it's aboutwhat you're going to get.
Speaker 2 (43:13):
Yeah, exactly Right.
But then and this is where Ithink, like prevention, like if
you do the math on preventionwhich I can't do cause I don't
know how to do that but likelike the cost benefit analysis,
right, but like you know, howmuch money do we lose in like
disability and lost wages andlimited like productivity for
(43:36):
gross domestic product or Idon't know economics things,
right, that like, could that $5million be like such a drop in
the bucket compared to all ofthe money that's lost by these
230 people not being at theirhighest potential?
Speaker 1 (43:59):
Yep, yeah, I always think it's weird that this is
the justification we have tomake in America, where it's like
you need to make the thefinancial and capitalistic
justification to do something.
Um, but yes, I, I think, Ithink there is a fair amount of
research around that.
Uh, as far as like lost wages,lost productivity days, not like
time off, um, yeah and I thinkthere's an enormous benefit to
(44:22):
prevention, at least on themedical side.
You see that very clearly.
And also, I want to make surelike I'm only making the
distinction between medical andmental health, because that's
how our healthcare system doesit, but they're obviously super
well intertwined.
So we're kind of wrappingthings up now, but do you have
any closing thoughts that youwant to leave the listeners with
?
This has been a really funconversation, by the way, so
(44:44):
thank you as well.
Speaker 2 (44:44):
I did this.
This has been great.
Um, yeah, I mean from like a apersonality test kind of
perspective, I'd say you know,don't let a personality test
that you took for free on theinternet limit who you can
become right, becausepersonality changes over time
and you actually have morecontrol over the direction you
(45:05):
shift.
You can shift it.
Then I think people give youcredit for.
And then from kind of thetherapy side of things, like I
said before, change can bereally hard.
But I've seen people that werereally suffering, that were able
to kind of stick through thatlike it gets worse before it
(45:25):
gets better phase and are living, you know, a values driven and
very purposeful life.
Speaker 1 (45:31):
Great, I really appreciate it.
I think it's very easy forpeople to sort of get locked
into, like you were saying,those personality tests, and
people can just kind of lamentor lay back on the oh, I'm this
way, I'm that way.
And I think it's reallyrefreshing and encouraging to
hear like you're not relegatedto that specific personality
type.
You can change, evolve throughnudging.
(45:53):
We're going to link to a lot ofyour resources and
congratulations on that grant.
I think pushing this researchforward is really important.
Speaker 2 (46:01):
Yeah Well, thank you so much.
Thanks so much for having me.
Speaker 1 (46:04):
Yep, thank you very much, hey everyone.
That's all for today's show.
I want thank you so much.
Thanks so much forpodcastcom.
That website will also belinked in the description.
As always, likes, shares,comments are a huge help to me
(46:37):
and to this channel and to theshow.
So any of that you can do Iwould really appreciate.
And again, thank you so muchfor watching.
I'll see you next time.
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