March 26, 2025 • 54 mins
Trauma lies at the heart of most psychological suffering, yet our understanding of it continues to evolve. In this profound conversation with the returning "Mental Men" panel of experienced therapists, we explore how mental health treatment has transformed from psychoanalysis that sometimes minimized real trauma to approaches that honor lived experiences and their lasting impacts.
When Dr. Christopher Gordon underwent psychoanalysis in the 1970s, the prevailing theory suggested psychological problems stemmed from internal conflicts rather than actual traumatic events. "We paid really little attention to actual trauma," he reflects, noting how profoundly this limited understanding affected treatment. Bob Cherney captures the persistent nature of unaddressed trauma with the striking metaphor of "an infection in the soul that festers" when not properly addressed.
The conversation explores grief as a universal human experience that our culture frequently mishandles. We expect people to "move on" within weeks of significant losses, when truly processing grief requires much longer. As Pat Rice eloquently states, "If you live long, you'll have to say goodbye a lot"—pointing to how aging inevitably brings accumulated losses that need ongoing attention rather than quick resolution.
Perhaps most compelling is the discussion around strength versus vulnerability. "Strength is asking for help," challenges traditional masculine norms of stoicism. The therapists explore how protective parts develop to shield individuals from vulnerability but often prevent necessary healing. For first responders who witness what "95% of people never see," this conflict becomes particularly acute as they struggle to maintain professional composure while carrying enormous emotional burdens.
The Mental Men celebrate those breakthrough therapeutic moments when clients suddenly recognize patterns that have eluded them—what Andy Kang describes as seeing "the pilot light of hope come on again." These moments, as Dennis Sweeney remind us, is why addressing trauma matters so deeply: healing becomes possible when we honor both wounds and resilience.
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Episode Transcript
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Speaker 1 (00:03):
Hi and welcome to Finding your Way Through Therapy
.
A proud member of thePsychCraft Network, the goal of
this podcast is to demystifytherapy, what can happen in
therapy and the wide array ofconversations you can have in
and about therapy Throughpersonal experiences.
Guests will talk about therapy,their experiences with it and
(00:24):
how psychology and therapy arepresent in many places in their
lives, with lots of authenticityand a touch of humor.
Here is your host, steve Bisson.
Speaker 2 (00:37):
Alors, c'est le retour des mental men.
It's the return of the mentalmen.
Hi, welcome to episode 197.
If you haven't listened toepisode 196, please go back and
listen to that, because that wasmy course that I did with Lisa
Mustard.
You can get a CU for it whenyou register with her website.
It's on working with firstresponders and helping
therapists work with firstresponders.
So please go listen to that andthen log into Lisa Mustard's
(01:00):
pod course website and then youget your CU for those who need
it, for LMHCs particularly, sothat'll be available.
But on episode 197, thereturning mental men you know
these guys.
They've been, we've beentogether for a long time.
We've had, I don't know, seven,eight episodes.
I stopped counting.
They come in quarterly.
They will not change.
This will not change with therebrand that we're doing.
(01:20):
So here is Dennis, pat, chris,andy and Bob with me.
And here's the episode Getfreeai.
Yes, you've heard me talk aboutit previously in other episodes
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(02:01):
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But it goes above and beyondthat.
Not only does it create aprogress note, it also gives you
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(02:22):
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So that's the great, greatthing.
It saves me time, it saves me alot of aggravation and it just
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Well, hi everyone, and welcometo episode 197.
I told you they would be back.
We were hoping to have anothercohort, but we're going to push
them next time to be here.
But the mental men are back andvery happy to have them all.
(03:50):
We haven't had golf in a whilebecause it's the winter up here
in the Northeast, so we haven'thad a chance to play together
and talk.
But Andy Kang, dennis Sweeney,dr Bob Cherney, dr Christopher
Gordon and Pat Rice, welcomeback to Finding your Way Through
Therapy, thank you.
Speaker 3 (04:08):
Thank you Thanks.
Speaker 2 (04:09):
Thanks, steve.
I was talking beforehand.
We always do thesepre-interviews and what I was
talking about is the rebrand toResilience, development and
Action.
So you guys know on the podcastalready this, but maybe some of
my fellow mental men heredidn't know.
So I was talking about howtrauma has become one of the
emphasis that I want to talkabout, and Chris was bringing up
(04:30):
an excellent point and insteadof me saying, oh, let's ask a
question, I'd like you to pickup, chris, where you were
talking about, especially how,when you started as your own
psychoanalysis psychoanalysisOkay, french-canadian talking,
sorry, but yes, please go ahead,chris, before I humiliate more
(04:52):
my language.
Speaker 4 (04:54):
Well, I was sharing that when I was in I'm a
psychiatrist and when I was intraining in the 1970s, I
underwent psychoanalysis, not asa part of my training, but
really it was more likehigh-intensity psychotherapy is
(05:15):
what I imagined it to be, and soI was experiencing this
treatment modality at the sametime as I was learning about
psychiatry treatment modality,at the same time as I was
learning about psychiatry, andwhat we were talking about was
that back in those ancient times, there was a lot of the
(05:37):
predominant model of therapy waspsychoanalysis, and
psychoanalysis was based on theidea that there were these deep
conflicts in people's minds thatoften arose in childhood but
arose out of like.
The classic example is theOedipus complex, this notion
that the problems in people'slives arose from conflictual
feelings about important otherpeople in their lives, but not
(06:00):
because anything bad happened oranything traumatic happened,
but rather that it was aphenomenon of the person's own
imagination.
And as a result of this, wepaid really little attention to
actual trauma.
You know, actual trauma waslike a screen for the real stuff
(06:23):
, which was an intrapsychicconflict, and I felt like this
was completely off base for mein my own therapy, because my
therapy, I have since learnedhas a lot to do with trauma, and
every year that's gone by thatI've been in practice, I've
become more and more convincedthat trauma is at the heart of
(06:46):
most people's suffering, and ifwe don't open up space for
people to appreciate and exploretheir trauma, we actually harm
people.
So I think you're rebrandingSteve.
That's very exciting and itsort of tracks along with the
(07:11):
path my work has taken over theyears.
Speaker 2 (07:14):
And I think that that's what we were talking
about too, because what I find,particularly with most of my
clients, especially aroundtrauma or even any type of
relationship building, you gotto start with the relationship
building, to go deeper into theconversation and all that, and I
know that Bob was talking alittle bit of the changes as he
goes along too.
So I want to put you on thespot, bob, but you know like I
(07:35):
would like to hear more from youon that.
Speaker 5 (07:38):
Well, it's a wonderful idea and I think it's
so valid because you know bothpersonally through my own
therapy and then professionallyover the last decades,
especially working in communitymental health, I would say at
least 90% of the people that wesee have trauma and, as I have
my practice, I think that thatnumber still stands up with many
(08:01):
people, if not all, and so Iagree 100% and I think that, as
we were talking before, peoplehave a need to discuss some of
the things that have happened tothem earlier in their life, and
I call it, you know, some ofit's family of origin, some of
(08:23):
it is abuse or neglect thathappens as they're growing up
and this forms a, you know, it'salmost like there's an
infection in the soul thatfesters.
If it's not if it's not I wasgoing to use the word exposed
but at least illuminated andbrought to light so that people
(08:47):
can actually discuss it andemote from it.
That's the thing that alwaysstrikes me is how much once you
uncover, or once they allow itto be uncovered, they have.
You know, facing it becomesvery intense emotionally, and I
think that part of it is soimportant in order to allow it
to reduce some of the pressureinternally, because otherwise,
(09:11):
if it doesn't come out or if itdoesn't get addressed at some
level, it's like an infectionthat's going to get worse.
And so I've been struck with itand I think some of the
techniques like EMDR, whichactually kind of goes right to
the heart of it, are reallyvalid and worthwhile.
But there's many ways of doingit.
But some of it has to do with,like Steve said, form the
(09:36):
relationship first, because youwill not have someone expose
their trauma to you if you don'thave a solid therapeutic
relationship, you know, and thetrust and the comfort and the
empathy all combined to makethat happen.
Speaker 6 (09:52):
Section of the soul.
What a phrase.
Yeah, I completely agree.
And I just to jump in here whenyou think about what a child
understands when they're goingthrough their childhood, it's,
it's their picture of normalcy,it's it's what they, how they
(10:15):
understand the world is howthey've experienced it, and so
they don't understand that maybestuff was wrong.
Even if they felt that way atthe time, did they still create
their whole sense of normalcyaround what their experience was
?
And so a lot of times it takesa while to uncover that, oh,
(10:39):
that's where the infection was,or that that the origins of that
were just seemed like the waythings were and the way things
were supposed to be.
And so when you get to trustingsomeone or they're trusting you
to reveal more of those details, that's when you start to have
those kind of eureka momentsabout oh, that's why I've always
(11:02):
felt this way, that's why I'vealways been so nervous, and it's
it's really quite amazing tosee that light go on, but I
don't see how you could ever getto that without discussing what
actually happened to your pointchris right andy.
Speaker 7 (11:19):
You know um, I'll jump in for a second.
It's um.
I was trained by half of thisroom as I got into re-education
in my mid to late 30s andstarted working with Dennis and
Bob and other really giftedpeople, one of which was someone
(11:43):
we all knew and I talked a lotabout because he was really my
mentor, Dick Fleck, the chaplainat the hospital in which we
worked, and he was remarkablebecause, and I think, as I
recall, when we were there,there were two diagnoses given.
I know I got into the fieldjust as dual diagnosis was hot
and taking off and we startedthe Metro West dual diagnosis
(12:07):
task force and things like that.
So it was really the hot buttonfor everybody.
But defining what dual diagnosiswas was very difficult in the
beginning and when I startedworking with you fellows and the
old Start Out program, Startprogram I remember they gave two
blanket diagnoses before peoplebasically were truly assessed.
(12:30):
One was some kind of an accessone, chemical dependency
diagnosis, typically because itwas an alcohol and drug
treatment program, and thesecond was unresolved grief, and
I'm not sure whether Dick wasinstrumental in that or somebody
, but I was profoundly impressedby that.
So when we talk about trauma.
(12:51):
Trauma is the echoes of someloss of innocence and a form of
unresolved grief.
That's the way I was trainedand when this mentor Dick he had
a hip replaced, as we all know,originally, mentor Dick, he had
a hip replaced, as we all knoworiginally.
And when he was out I took overhis groups as just out of
school and everything myselfbrand new, and he had about
(13:11):
three groups and some of hiscaseload temporarily and I'd go
visit him twice a week up at therehab and he'd always say the
same thing what have you learnedthis week, Grasshopper?
It's an old reference that onlythe white hairs will probably
get.
And finally, one day it hit me,and it hit me in conjunction
(13:33):
with my own therapy, which I hadan extraordinary therapist who
specialized in all of this, anEMDR pioneer and other things,
EFT.
But one day I left her officeand we'd connected the dots, as
we did periodically, and Iremember walking out of the
office and over the tea andNewton, thinking to myself no
(13:55):
wonder I did all the things Idid, no wonder I needed sedation
, no wonder it all made sense tome.
I started to make sense and Istopped being that heartbreaking
riddle to myself.
And that's, I think, whattrauma does more than anything,
and as a therapist in dealingwith it.
(14:15):
And I remember saying to him,virtually in that same place, he
said what'd you learn today?
I said it's all grief work,isn't it?
And he said, ah, it's all griefwork, isn't it?
And he said, ah, yes, it's all.
He never told me.
He made me discover it, as mostof you did.
You know, it's all grief workand the worst part of the more
pervasive the trauma, the moredramatic the trauma, the longer
(14:43):
the grief work sometimes.
So the more tricky the griefwork is because it's very
difficult.
And I remember Mike Elkins, inthe training a million years ago
, said you know, if you're notcareful, people that have been
deeply traumatized willhypnotize you to despise them,
because it's how they feel.
They'll invite you to treatthem the way they feel about
themselves.
You know, and kind of in thequantum aspect of it, you know,
(15:06):
we know that the observer of anyreality changes the reality you
observe.
And so we, as professionalobservers and assistants, you
know, we have to be very carefulof that and that's most of our
work is around learningourselves well enough so that we
don't muck it up, you know, andwell-intentioned harm.
(15:27):
I'll end with this is most ofthe lessons I taught my grad
students for many years were themistakes that I made, and I
remember I've said this beforeco-leading groups with Dennis
when I was a student and I'dmake some blunder and something
would go wrong and I'd look over.
He'd be grinning because he knewthat we were going to in his
own way, which was subtle, butbecause we'd have a lot of grist
(15:49):
for our mill of processingafterwards and he told me that
you'll learn only from yourmistakes.
Everything you do intuitivelywell, you really don't learn
from, and I didn't.
I showed up intuitively well.
The rest of it was quite alearning process and I learned
quickly because I had greatteachers, so unresolved grief,
and so we talked in thebeginning about trauma and grief
(16:11):
.
I don't think that they're.
I think they're the same thing,just different stages of it, in
a way.
So what do you guys think?
Speaker 3 (16:17):
One of the first things that I was taught and
learned in my early training,way back in the 70s, was that
it's just critically importantto respect both people's health,
but also to respect what youcan understand is either
pathology or woundedness.
(16:38):
Respect what you can understandis either pathology or
woundedness, and I think thatthe woundedness is really a
reflection of the trauma.
That's an extraordinarilysensitive area, along with being
extraordinarily important, andI think it's important to be
able to give people permissionpermission to be able to go to
the trauma, but also permissionto not go to it if they're not
(16:59):
ready.
I think it can get pushed tooquickly and people actually get
re-traumatized.
And people can re-traumatizethemselves partially well, it's
a defense, but partially as away of both punishing themselves
but also protecting the peoplewho may have perpetrated the
trauma, because that's what theyknow, that's what they were
(17:22):
taught to do.
So I think being able to sitwith somebody and be able to
tell them directly you know, wemay need to go into this in more
detail, we may need tounderstand it and look at it
more closely, but we don'tnecessarily have to there is a
way of being able to work itthrough.
I don't know what the answer isgoing to be right now, but
(17:45):
there is potentially a way andwe'll do that together and I
think that speaks to theestablishment of the
relationship also and I thinkthat, the whole establishing of
the relationship.
Speaker 2 (17:56):
there's a couple of you here who've sent me people
to do EMDR.
One of the things I refuse todo as an EMDR clinician is if
they're not in therapy withsomeone.
I know they got to establish arelationship with me prior to
doing that work so that theydon't run away because it is
difficult work to do the EMDRstuff.
And I think that some peoplelike give me EMDR and solve me.
(18:17):
And there's some other placeswhere they just do EMDR and then
they come back and there's alittle difficulty that wasn't
quite related but it triggeredother stuff and because they
didn't develop the skills orrelationship with a therapist,
it becomes very hard for them tolike, oh I thought I was cured
and then get to the other sidebecause they didn't have that
(18:38):
priming of a relationship withsomeone.
This is my experience.
Speaker 5 (18:42):
Excellent point.
I have two brief comments.
One is the ability to pace theexploration of trauma.
Dennis, you were alluding to it.
So first you have to recognizethat it exists, but that comes
out of the client, that comesout over time as they are
talking, because they'll saysomething and you'll see either
(19:04):
a disconnect or something that achoice keeps on being made
that's wrong or unhealthy.
But the pacing is reallyimportant because you're exactly
right, really important becauseyou're exactly right.
You're going to.
There's times, as we've all seen, where people are.
Literally you know they'll beshaking their head or they'll
say you know you can tell youhave to read the client as
(19:29):
you're sitting with them in away that is holding and
nurturing, but also knowing whento back off a bit and when to
continue exploring.
The second thing is that griefwork.
I just smiled because I haveseveral people that are grieving
their animals right now.
I mean, and I've seen peoplegrieving dogs in particular
(19:49):
because they're so wonderfulcompanions and they provide such
consistent love.
But I'm also realizing that ourculture does not tolerate grief
very well.
People don't want to, you know,okay.
Okay, maybe you'll go to aservice when somebody loses a
(20:09):
relative or another person.
But it's all right, now we gohome and we live our lives.
But it's all right, now we gohome and we live our lives.
(20:46):
But the people that are losingget some resilience so that they
can start to, you know, live ina different way.
Speaker 2 (20:52):
that's healthier different way that's healthier.
I think that you know I do talkabout grief a lot in the
Kubler-Ross stuff and there'sdefinitely been some people who
said it's been disproven.
But what I always say isthere's truth in what they say
and there is.
You know, I think that when Iwork with a lot of first
responders which is somethingyou all know one of the things I
(21:13):
some of the guys like what canI do?
What can I do?
I said go check on them 14 daysafter the service.
Don't, because everyone's goingto be there for the first 14
days.
But there's this you talk aboutour culture.
I think our culture is like ohyou, you, you lost someone.
It's been 14 days.
And I say 14 days, you get thepoint, you're good, now you're
all set.
(21:34):
And I think that what I kind ofpursue a lot of people to, if
they have losses in theirfamilies or whatever check on
them 14 days down, 30 days down,and so on and so forth.
Because that's sometimes wherethe grief actually does occur,
because sometimes, especially ifit's a family member or
whatever, you have to do theservice and all.
You're so into it that youdon't have time to go through
(21:55):
your own grief process serviceand all you're so into it that
you don't have time to gothrough your own grief process.
Speaker 4 (22:02):
So a little bit of what you're saying.
I feel like I'm hearing so muchwisdom in this conversation.
It's just one pearl afteranother and I want to share that
.
For me, one of my greatteachers was Aaron Lazar.
I don't know if you guys hadmuch to do with Aaron, but he
was a marvelous, marvelouspsychiatrist and he was a person
who centered the idea ofunresolved grief in his practice
(22:26):
.
And the beautiful, beautifulthing about centering unresolved
grief is it's sounpathologizing.
You know, grief is a universalexperience of being a human
being and the idea that you havesomehow incarnaled this
experience.
(22:47):
You were not able to face it,for whatever reason.
Fully.
You know, andy, as you'resaying, you know, when you're a
kid you're sort of doing thebest you can with what you've
got.
So this unresolved grief staysinside.
But when Aaron would talk topeople in the patient role, it
(23:08):
was so non-pathologizing, sohumane and so much of what
psychiatry, like the downside ofit, is.
It can be so toxic, it can makepeople feel damaged or broken
or other, and unresolved griefis something that brings us very
(23:31):
, very much together as humanbeings in the human family.
Speaker 7 (23:35):
As I look at this crowd here of seasoned
individuals, the fine print ofthe aging gracefully.
Now, we spend so much time andenergy in our culture trying to
live long and somewhere in theaging brochure graceful aging
brochure in the fine printthere's an asterisk that says be
(23:57):
aware that if you live longyou're going to have to say
goodbye a lot.
And one of the specialties thatcame upon me in my practice and
is going to bring me out ofretirement, I believe because of
the need, is specializing inhelping parents scrape children
when they lose children.
The unspeakable hole thathappens is mostly because one of
(24:20):
my best friends lost a son sixyears ago and we spend hours
every week together and we talkabout it and it's kind of this
mystery that he and he is anexcellent person to help other
people as there's such a network, especially in 12-step recovery
(24:42):
, of parents who have survivedchildren.
The nature of the generationaldisorder is that there's an
expectation and you alluded toit earlier that it's going to
get old, will be done withquickly, you know.
Or if you give it a year or twoand then it, no, it never.
That hole never goes away.
(25:03):
You just have to fill it with.
I heard a wonderful phrase, forit is that the ache you feel
from losing someone close to youis the knowledge that you have
so much love to give them thatyou can't in the way that you're
most familiar with.
So what are you going to dowith the love it's a heart thing
, not a head thing yourheartbreak.
(25:25):
You heal your own heart byfinding another source of love,
which is what dogs and cats andother animals serve for a lot of
people.
As they lose people in theirlife, they sometimes collect
animals.
For a lot of people, as theylose people in their life, they
sometimes collect animals.
I'm guilty.
I've been told I've evolved nowinto being able to handle a cat
.
So you know, I was a dog guyfor many years.
Speaker 3 (25:49):
I'm going to interrupt here and take on an
old role of grenade tossing, ifyou're strong enough.
None of this is true.
What do you mean?
Please explain Well everythingthat you're talking about.
It's just a form of weakness.
If you're strong enough, thenthis is just something that you
(26:09):
get through.
Speaker 7 (26:10):
How about missing a two-foot putt?
I've seen it, I've seen it,I've seen it, I've seen.
Speaker 3 (26:14):
Again, I'm grenade tossing in here but
unfortunately, that's a counterargument that I think needs to
get understood.
Is that you know we're talkingabout?
I mean, potentially we'retalking about boy.
You guys are just sort ofpadding your own nest.
You're giving yourself lots ofwork to do, aren't you special?
(26:40):
But I think that there is this,and it's a Western theory of
what is strength.
It's a matter of addressing,too, that strength is about
being able to engage andtolerate the stuff that you're
not really strong at, and itjust as I hear all of this today
, I mean I truly believeeverything that's being said,
(27:03):
but there is the counterpoint ofwell, no, you just need to be
strong.
Speaker 6 (27:09):
I find that what underlies that particular idea
of toughness as in the, thegrenade lobbed, you must always
be strong and and macho is basicfear.
It's, it's basic fearunderlying, underlying that
that's telling us that, oh we,we shouldn't trust the actual
(27:33):
feelings, we should just put ona face or behave a certain way
because that's what other peopleexpect, slash, that's what's
going to make them comfortable.
A lot of we're reacting toother people, reacting to us, in
grief mode.
You can see the fear in otherpeople's eyes just from the
(27:57):
concept, from the concept ofloss or the concept of that
level of pain.
It's terrifying, and sotoughness is such a great
wallpaper for all of that.
Oh yeah, just suck it up,you'll be fine.
Speaker 4 (28:12):
No, it's been exhilarating to me over the last
few years to learn about theIFS model internal family system
and the idea that we have thesedifferent parts in ourselves.
So if the person isexperiencing this toughness,
that's a part of themselves,that that it deserves to be
(28:35):
heard, empathically understood,and I love that model because
that way there's this sort ofthis maxim.
In IFS there are no bad parts.
So even the storm trooper,super ego guy who's saying don't
be a pussy, fuck ego guy who'ssaying "'Don't be a pussy, suck
(28:58):
it up and be a man".
That part has somethingvaluable if we can open
ourselves up to it.
It's very exciting to me.
It's sort of anti-pathologizing.
Speaker 7 (29:13):
Well, it speaks to intent.
I think that part thestormtrooper is well-intended to
protect you.
Basically go back and informthem.
Thank you so much.
We don't need you now.
You can take a break.
Speaker 4 (29:30):
Or maybe you'd be up for a different job.
A different job Becauseactually you took this on when
you were like 12 years old andyou were looking at the world,
as andy said, through your 12year old eyes and you know
you've got a lot of energy.
Maybe we could.
You'd want to do something elsewith it rather than be the
(29:51):
stormtrooper one thing excitingit's I just want to say one
thing.
Speaker 2 (29:58):
There is someone in this room that has said to me
that strength is asking for help, and it's not the grenade
launching person, but ratherchris gordon, who had said to me
at one point reach out for helpif you need to.
And that's actual strength.
So I just want to jump jump inand give credit to Chris for
that.
Please go ahead, Pat.
I'm sorry to interrupt.
Speaker 7 (30:17):
Well, that's a hard thing for men to do initially
and that's what most of themutual self-help groups do is
teach people how to be very youknow.
They're invited to more easilyask for help and it's rewarded.
It was the whole idea I wasthinking about in our culture.
I was working as a part of apain management team with people
(30:38):
that worked in hospice and youknow it used to be that death in
our society, especially inWestern medicine, was treated
almost as you wanted to de-ex-ex.
Machina, offstage and you know.
And then it sedate people.
The grieving mother would beput on terpenhydrate or Miltown
(30:58):
or something back in the day andsedated until all the dust
settled and that two-week periodthe medicine stopped, the
people left and then theyimplode.
So I've known people that workin hospice and so there's much
more of an honoring of the deathprocess, being a part of it and
(31:21):
having an active role in it andnormalizing it and not
pathologizing it.
And I think even in the bestmedical schools for many years,
chris, you probably could attestto this is that that was seen
as a loss.
That was the enemy.
Death was the enemy.
Death was the enemy.
Yes, the enemy is disease.
(31:41):
Can we do something aboutdisease and prevent it.
Ultimately, we learned that thebest thing you could do about
treating COVID is not to get it.
You know so it was.
So again, grief is inevitable.
It's we're just, I think, justgetting better at normalizing it
and showing people what, as yousaid, steve, and what Chris had
(32:03):
said, is that the strength isin learning how to deal with it
effectively.
Then you have the superpower ofbeing able to really be
effective at helping otherpeople with it, and that's when
the humanitarian aspect of allof this healing really kicks off
, and I think that's a real dealchanger in our society and in
the world today.
Speaker 5 (32:24):
Yeah, I think grief has been stigmatized, and I
think that we're seeing some ofthat just in terms of the
relationships we're forming withother countries, that, for
example, gaza and Ukraine.
The losses that they haveexperienced, it goes beyond
traumatic, it's catastrophic,and we're expecting people to
(32:50):
just keep on going on and atsome point point you can't, and
so now it's a matter of how.
Now, what do we do?
And I think part of our role,as in the helping professions,
is to try to, you know, allowpeople to be who they are at the
moment and work through tosomething.
(33:11):
On the other side, you know, Ireally see a lot of this.
You know, chris, you used theword toxic.
I see a lot of things that haveto do with grief or loss or
abuse.
You develop, you being thechild or the young person, or
whatever.
You develop survival skills.
Right, I can get through this,I will.
(33:33):
You know, I'll get through it.
This is normal, and he saidit's.
You only understand.
You only understand it's normalwhen you start going to other
people's houses and seeing thattheir father doesn't throw the
pizza against the wall when hegets pissed off, you know, when
you bring them into your adultrelationships and you keep on
(33:54):
asking yourself why is it thatyou know these, these women keep
on, you know, leaving me, orwhy is it that this and that
it's?
There is a dynamic that happensand you know, I'm not sure if
it was Pat or whoever, but theysaid we own, we train people how
to treat us by, you know.
You know we're basicallyexternalizing our self-concept
(34:14):
and people respond to that, butit's just.
It's such an interesting thing.
I've done a lot of addictionwork over the years and you know
children of alcoholics if theycan get by, they can get, they
can get through but there'soften a real relationship damage
that has happened that theyneed to address, they, they
(34:35):
should address if they want tohave healthy relationships.
And so that's just one aspectof it.
But those are my thoughts.
Speaker 3 (34:43):
I think it brings in another really complex piece to
the trauma issue, in that, yes,I fully agree that it's
important to be able to addressthe actual fact of the trauma,
to be able to name it whenpossible and to give that its
due.
But still, the dynamic ofexperience and how you
(35:05):
experience and what you do withthat experience is all critical
too in terms of people beingresponsible that, yes, you did
experience this and yes, this isa part of what your life has
been.
This is why you've developedpatterns that you have developed
.
What do you want to do with itnow?
Because you don't have tochange that if you don't want to
(35:27):
, but you also don't have tolive that way if you don't want
to.
So it's about empowering peopleto be able to, giving them some
agency to be able to make adecision about.
I can do this differently, andI think that that's also maybe
another definition of beingresilient is being able to say I
(35:53):
have a choice as to whether Ican change or not.
Given what's given, I can makea change.
Speaker 4 (36:00):
I'd like to introduce an idea here.
If it takes us too far downanother path, we can put it on,
do it in another podcast.
But one of the ideas that I'vefound very valuable in teaching
psychiatric residents over theyears is this idea that when a
(36:23):
person is caught up in arecurrent pattern like Bob was
describing, very often theperson cannot see the pattern.
It just feels like life isunfolding itself.
And you know why are all thesewomen leaving me?
You know, the constant in thatequation is you, but that's not
(36:45):
how it feels.
It just feels like you have badluck in finding bad women.
And one of the ways that I tryto get this across to sometimes
with patients and sometimes withresidents, is the idea of the
problem has no edge.
And the way I like toillustrate this is are you guys
(37:06):
familiar with the idea of themagic eye pictures that just
look like blurs and if you canunfocus your eyes, the thing
jumps out in three dimensions.
Well, you know I think Andy wastalking about eureka moments
that's a eureka moment when yousuddenly realize, holy shit,
(37:28):
that's what's going on here, andI feel like you know that.
For me that's a very vivid ideathat if we're working with a
person on a problem that has noedge in the addiction world.
That would be theirpre-contemplative.
They don't even see the problem.
(37:48):
But when they start to definethat edge, then it gets so
exciting and different thingsbecome possible.
So I just wanted to share thatExcellent.
Speaker 6 (38:00):
I'll take that one deeper, chris, on that example,
if you've ever sat in front ofone of those photos or pictures
and not been able to get it,it's very frustrating, very
frustrating you start to squint,you try really hard to get it.
Yeah, it's very frustrating,very frustrating.
You start to squint, your tryreally hard to get it.
The harder you try, the furtherthe picture goes away from.
(38:23):
Exactly exactly.
So we often find people rightin that exactly, and you know we
(38:45):
have to.
You got to pull them backExactly.
And I said you know, buyingmore guns is not going to make
you feel safer.
And it was this idea of what'sthe edge, where's the what's
enough?
Yeah, what do you think you'reprotecting with your armaments?
(39:08):
You know, and it's just anamazing metaphor, metaphor, but
he's also living it and creatinga whole arsenal around himself
that is ostensibly protectivebut that also then completely
distracts him from what the realfear is.
We had to go through that.
(39:30):
This is more along the lines ofthe grenade concept too, I
think of just, you know, how dowe protect ourselves and what
skills do we have to makeeverything okay day to day?
For this guy it was yeah, armup.
Speaker 7 (39:45):
I think that one of the reinforcing things,
certainly for me, and I bet youguys can identify at some level
is, chris talking about thateureka moment.
Oh, when, when you get theperson, they finally I the first
time I tried those was in aroom full of other people that
had the same one and that wasthe last one to get it.
You talk about increasingpressure, but when someone
(40:08):
actually has that moment infront of you where you start to
see the realization ofself-awareness or a reconnection
to their sense of who theyreally are, whatever it is the
moment, it's like you see thepilot light of hope come on
again.
Yes, and there's nothing in myentire life, personally and
(40:28):
professionally, that is morereinforcing than that.
That's when I think you startto realize my God, this stuff
can, this really matters, itreally works and someone is
coming back into the human race.
I think at that moment andthat's why all of this due
diligence and work, both asindividuals and as helpers and
(40:50):
facilitators, to me is soincredibly worthwhile.
Speaker 5 (40:53):
Amen.
Speaker 7 (40:53):
The pilot light of life, that's a great term.
I had to get away from it, tomiss it.
Speaker 5 (41:02):
I'm ready to go back.
Speaker 7 (41:05):
It's true.
How can I miss you when youwon't go away?
That country song, you know, Isaw such a funny cartoon the
other day.
Speaker 4 (41:13):
This doctor is talking to this really decrepit,
like 90-year-old guys, you know, barely alive.
And the doctor is saying to theguy you know, when you were
young and you did all thatexercise so you could live 10
more years in your life, this isthose 10 years.
Speaker 7 (41:36):
Thanks a lot.
Speaker 4 (41:39):
All that jogging, all that jogging for this.
Speaker 7 (41:41):
Yeah, my dad said he was going to take up jogging as
soon as he saw one laughing youknow what I was thinking, steve,
that that the first responders.
Speaker 5 (41:56):
I just shook my head because the amount of stuff they
see and they encounter and theydeal with and they have to
absorb, it's unbelievable and Ithink you have done a lot of
work with them and I did somework with folks who were first
(42:16):
responders, but it's we have.
Really, I think most of us andthen the general public doesn't
really understand the amount ofpain and suffering and angst and
anger and just whatever youwanna.
There's a lot of emotions, butthey are dealing with it on a
regular basis and I really hopethat they can come in more often
(42:41):
to unload some of that.
And I give you a lot of creditfor working with that population
because they, when I've workedwith them, it takes a while to
get some some trust going.
That's exactly what I was goingto say.
Speaker 2 (42:54):
I think that one of the things that's you know,
first responders want to knowhow you can handle that.
That's the first and foremostthing that I find, and sometimes
it takes six months, a year totwo years to build that
relationship of oh, this personcan handle me, so to speak,
before the actual great work, soso-called worker I know that
(43:15):
was all a lot of work to buildthat relationship, but I was
going to talk about that becausethat's exactly what it is.
It's like those therapeutic ahamoments with them is to realize
that when you have eight to 12major events throughout your
career, 20-year career,nevermind the 3,000 small events
that you had during your careerthe strongest person in the
(43:37):
world will be affected slightly,if not a lot, and some people
handle it well and that's youknow.
We don't want to pathologizeevery single first responders in
the world, however, what'swrong with getting help when you
have something that most peoplelike, I think, my favorite
sentences?
They deal with the 5% of theworld that 95% of the world
(43:58):
doesn't know about, and whenyou're dealing with that type of
environment, you have to showthat you're able to handle it,
because it's very hard.
My work with first respondersand I appreciate Bob for
bringing that up is really about, like you know, what I've
started doing is I do CITtraining here in Middlesex,
massachusetts, for the policedepartments, and one of the
(44:22):
things I do is I do the traumapart and I say, okay, let's do
the ACEs.
If you're not, if you're notaware of the it's a adverse
childhood experiences and Ileave it up there and just say,
hey, look, maybe when you, whenyou meet children, that's what's
going to happen.
I don't throw it up there and ifyou guys know, if you guys are
listening, sorry, I put it outthere so that they start scoring
(44:43):
themselves and they scorethemselves and I always say
afterwards I'm like, all right,just for the record, over four
is usually you gotta have somesort of trauma, ptsd, but
typically first responders haveeight and you see them all drop
their eyes and they they like ohgotcha, so to speak.
And I think that that's why,when you talk about what you
(45:05):
don't know as a child, you growup.
A lot of first responders gointo this field to help people,
just like we do.
And yes, therapists, by the way, I'm sure their numbers are in
the six, seven, eight, also forthe record, but I think that I
want to throw that out, becausethe ACEs stuff has been part of
what, in the last six months,two years, has been a very
(45:25):
transformative work that I dowith my clients.
Speaker 4 (45:30):
That's really great.
I was just reflecting when Iretired from Advocates and I had
been doing that work for like25 years and my first love at
Advocates was the emergencyservice and I love doing
psychiatric emergencies.
(45:51):
People are you know, they're.
They're in a crisis and a littlelove goes a long way and it's
really really great work.
But I know I was feeling and Iwould tell Julie about it I feel
I was feeling like an odoreater.
You know the thing you put inyour sneaker that soaks up the
(46:12):
odors.
I felt like I was sort of likean odor eater, like I just was.
There was so much suffering andit was.
It was kind of it was a heavyweight and when I, when I
retired, it felt like I couldkind of exhale in a way I hadn't
(46:33):
in a long time.
I imagine first respondersexperience something similar.
They respond and they don'thave any idea what they're
walking into and very often it'sa horror show.
Speaker 3 (46:46):
I think the application of the container
theory works there too, becausewe are all containers, yeah, and
you know we take in so much andit's important to know that we
can only take in so much um anduh.
Then it's important to find waysto be able to let that
container empty yes, and uh,that's critical, I think, with,
(47:10):
with, for all of us in our work,but first responders, because
in some ways I think in manyways we are also experiencing a
first responder dynamic in manycircumstances, but an
understanding that we get filledup and when we get filled up it
gets very heavy and it getsvery hard to maneuver.
Speaker 5 (47:33):
I see that First responders move toward.
Speaker 4 (47:36):
they move toward the fire, and that's what we have to
do a lot of the time, too, ismove toward the fire that other
people want.
We just want to get the hellaway from it.
Speaker 5 (47:49):
I'm hopeful that first responders can get some
training in how to prioritizeyour own self-care or as
self-compassion or understandingthat there's a connection
between your past and how thingsare affecting you now.
I mean, I see it at the clinicswith younger clinicians.
(48:12):
See it at the clinics withyounger clinicians.
There's more pressure right nowbecause there's a tidal wave of
need, but it's a matter oftrying to figure out how do I
set limits and sometimes say noor sometimes delegate or
sometimes basically decide thatyou're going to take a little
bit of a break for yourself and,frankly, on a regular basis it
(48:34):
helps because you need to unload.
You know it's almost like whenthe garbage gets picked up.
You know once a week we get,you know the cans are empty and
it's.
I think it's important for usto do that and I've.
What I see with a lot ofyounger clinicians is that you
know, if you're only in thefield a couple of years and
(48:55):
you're already feeling likeyou're getting burned out, this
is something to really becautious about and we I think
first responders probablyencounter that, but I don't know
if the culture of firstresponders is a welcoming kind
of place to unload that.
Speaker 6 (49:10):
That's a really key distinction, isn't it?
It's this we have the abilityto sit and talk and use words to
reason stuff out, and I cancall any of you at any time with
a question or a concern if I'mfreaking out.
I think in that culture it'srare to find that.
(49:34):
I think in that culture it'srare to find that.
I'm sure it exists, but that'sthe overlay of how tough we are,
you know, tends to obscuretheir ability, I think, to do
that.
But they might whisper it inthe bunk after you know, or just
I'm sure they're finding placesto release that.
Speaker 2 (49:54):
But maybe something more programmed and intentional
would be very useful and helpdismantle some of these ideas of
toughness that get in the wayin the community is that you
(50:15):
know, if you address whateverhappened, the event that
occurred within the first sixmonths, it can remain in an
acute stress disorderenvironment and not necessarily
become PTSD.
And I talk about asking forhelp is actually helpful for you
in the long term to keep yourcareer going.
But you know, the sentence Ihear all the time is you know,
one of my least favoritesentence I heard is from
(50:36):
veterans in the first responderworld.
Well, I survived 20 years ofthis stuff, a little bit of that
grenade.
I've survived 20 years.
Why would you need therapy?
I survived 20 years withouttherapy.
Why wouldn't you?
And that grenade that occurseven within the stigmatization
of mental health.
I mean, I can talk for hours asto what goes for first
(50:57):
responders and what they gothrough.
Speaker 7 (50:59):
I actually developed.
It found me especially.
The first responders that Iworked with were people that
were paramedics and emergencyroom people who had suffered
death despite their bestintentions or their expectations
.
There was death there, andoften the supervisor or someone,
(51:21):
because I was always in theemergency room for the psych
stuff.
It was an intimate, smallenough place where I would spend
a lot of time just debriefingthem quickly, and if there was a
suicide on the unit, I was oneof the people that would go in
and just debrief people, justget them talking and normalizing
this.
The fact that, well, I've seenit before, yeah, okay, what'd
(51:44):
you do about it the last time?
And it's not about surviving 20years of survival.
It's living well while you'rebeing affected, and that's the
difference.
And again, I remember my mentorused to do the you know.
I remember his seminars on carefor the caregiver and all of
that.
Are we taking our own advice?
(52:04):
He was a specialist in thesilver rule, not the golden rule
.
The silver rule is treatyourself as nice as those you
truly love, and if you're doingthat, then you're you're going
to keep yourself in the game andin a good, healthy place so you
can then be a good partner athome and a good friend and
(52:25):
whatever, and and uh and goodcompany.
You know, um on the golf courseis all you guys well as we up.
Speaker 2 (52:35):
We're going to wrap up here because we're getting
close to the hour already.
This is an amazing conversation.
Like I said, we're going tobring a colleague hopefully,
next time on, and I could talkabout all this stuff every
single time.
That's why the mental men areso essential, and I think about
the years of experience in thisroom just sitting back.
This is my favorite part, notthat I don't like my other
(52:58):
guests on the podcast.
I sit back and listen to youguys.
I put in my two cents just tobe the hoax and pretend I know
something, and you guys are justabsolutely amazing.
I think that if we talked abouttrauma, grief and first
responders, we'd have 24straight hours and we'd still
have a conversation.
So thank you, guys.
I really truly appreciate it.
Thank you.
Speaker 7 (53:18):
Thank you, Steve.
Speaker 4 (53:19):
Thank you for having us Great conversation.
Speaker 2 (53:21):
Yeah Well, we'll continue.
You guys, you know you'recoming back right.
It's not a question of if, it'sa question of when.
So don't worry, I've got you onthe books already.
Speaker 4 (53:30):
Great, so long guys.
Speaker 2 (53:33):
Well, that concludes episode 197.
Again, the mental men.
Thank you guys.
I can't say enough of having,like I don't know, 200 years of
experience in one room and beingthe kid in the room, which is
perfect for me, so really enjoythat.
But for episode 198, we'regoing to talk about therapy
process.
A lot of first responders mightknow how therapy works.
Speaker 1 (53:56):
It doesn't do what it does do.
So we're going to do that inthat episode and I hope you join
me then.
Please like, subscribe andfollow this podcast on your
favorite platform.
A glowing review is alwayshelpful and, as a reminder, this
podcast is for informational,educational and entertainment
purposes only.
If you're struggling with amental health or substance abuse
issue, please reach out to aprofessional counselor for
consultation.
If you are in a mental healthcrisis, call 988 for assistance.
(54:22):
This number is available in theUnited States and Canada.
Hi and welcome to Finding your Way Through Therapy
.
A proud member of thePsychCraft Network, the goal of
this podcast is to demystifytherapy, what can happen in
therapy and the wide array ofconversations you can have in
and about therapy Throughpersonal experiences.
Guests will talk about therapy,their experiences with it and
(00:24):
how psychology and therapy arepresent in many places in their
lives, with lots of authenticityand a touch of humor.
Here is your host, steve Bisson.
Speaker 2 (00:37):
Alors, c'est le retour des mental men.
It's the return of the mentalmen.
Hi, welcome to episode 197.
If you haven't listened toepisode 196, please go back and
listen to that, because that wasmy course that I did with Lisa
Mustard.
You can get a CU for it whenyou register with her website.
It's on working with firstresponders and helping
therapists work with firstresponders.
So please go listen to that andthen log into Lisa Mustard's
(01:00):
pod course website and then youget your CU for those who need
it, for LMHCs particularly, sothat'll be available.
But on episode 197, thereturning mental men you know
these guys.
They've been, we've beentogether for a long time.
We've had, I don't know, seven,eight episodes.
I stopped counting.
They come in quarterly.
They will not change.
This will not change with therebrand that we're doing.
(01:20):
So here is Dennis, pat, chris,andy and Bob with me.
And here's the episode Getfreeai.
Yes, you've heard me talk aboutit previously in other episodes
(01:41):
, but I'm going to talk about itagain because GetFreeai is
justa great service.
Imagine being able to payattention to your clients all
the time instead of writingnotes and making sure that the
note's going to sound good.
And how are you going to writethat note and things like that.
Getfreeai liberates you frommaking sure that you're writing
(02:01):
what the client is saying,because it is keeping track of
what you're saying and willcreate, after the end of every
session, a progress note.
But it goes above and beyondthat.
Not only does it create aprogress note, it also gives you
suggestions for goals, givesyou even a mental status if
you've asked questions aroundthat, as well as being able to
(02:22):
write a letter for your clientto know what you talked about.
So that's the great, greatthing.
It saves me time, it saves me alot of aggravation and it just
speeds up the progress noteprocess so well, and for $99 a
month.
I know that that's nothing.
That's worth my time, that'sworth my money, you know.
(02:44):
The best part of it too is thatif you want to go and put in
the code Steve50 when you getthe service at the checkout code
is Steve50.
You get $50 off your firstmonth and if you get a whole
year, you save a whole 10% forthe whole year.
So again, steve50 at checkoutfor GetFreeai'll give you $50
(03:05):
off for the first month and,like I said, get a full year,
get 10% off, get free fromwriting notes, get free from
always scribbling while you'retalking to a client and just
paying attention to your clients.
So they win out, you win out,everybody wins, and I think that
this is the greatest thing.
And if you're up to a pointwhere you got to change the
treatment plan, well, the goalsare generated for you.
(03:27):
So getfreeai code Steve50 tosave $50 on your first month.
Well, hi everyone, and welcometo episode 197.
I told you they would be back.
We were hoping to have anothercohort, but we're going to push
them next time to be here.
But the mental men are back andvery happy to have them all.
(03:50):
We haven't had golf in a whilebecause it's the winter up here
in the Northeast, so we haven'thad a chance to play together
and talk.
But Andy Kang, dennis Sweeney,dr Bob Cherney, dr Christopher
Gordon and Pat Rice, welcomeback to Finding your Way Through
Therapy, thank you.
Speaker 3 (04:08):
Thank you Thanks.
Speaker 2 (04:09):
Thanks, steve.
I was talking beforehand.
We always do thesepre-interviews and what I was
talking about is the rebrand toResilience, development and
Action.
So you guys know on the podcastalready this, but maybe some of
my fellow mental men heredidn't know.
So I was talking about howtrauma has become one of the
emphasis that I want to talkabout, and Chris was bringing up
(04:30):
an excellent point and insteadof me saying, oh, let's ask a
question, I'd like you to pickup, chris, where you were
talking about, especially how,when you started as your own
psychoanalysis psychoanalysisOkay, french-canadian talking,
sorry, but yes, please go ahead,chris, before I humiliate more
(04:52):
my language.
Speaker 4 (04:54):
Well, I was sharing that when I was in I'm a
psychiatrist and when I was intraining in the 1970s, I
underwent psychoanalysis, not asa part of my training, but
really it was more likehigh-intensity psychotherapy is
(05:15):
what I imagined it to be, and soI was experiencing this
treatment modality at the sametime as I was learning about
psychiatry treatment modality,at the same time as I was
learning about psychiatry, andwhat we were talking about was
that back in those ancient times, there was a lot of the
(05:37):
predominant model of therapy waspsychoanalysis, and
psychoanalysis was based on theidea that there were these deep
conflicts in people's minds thatoften arose in childhood but
arose out of like.
The classic example is theOedipus complex, this notion
that the problems in people'slives arose from conflictual
feelings about important otherpeople in their lives, but not
(06:00):
because anything bad happened oranything traumatic happened,
but rather that it was aphenomenon of the person's own
imagination.
And as a result of this, wepaid really little attention to
actual trauma.
You know, actual trauma waslike a screen for the real stuff
(06:23):
, which was an intrapsychicconflict, and I felt like this
was completely off base for mein my own therapy, because my
therapy, I have since learnedhas a lot to do with trauma, and
every year that's gone by thatI've been in practice, I've
become more and more convincedthat trauma is at the heart of
(06:46):
most people's suffering, and ifwe don't open up space for
people to appreciate and exploretheir trauma, we actually harm
people.
So I think you're rebrandingSteve.
That's very exciting and itsort of tracks along with the
(07:11):
path my work has taken over theyears.
Speaker 2 (07:14):
And I think that that's what we were talking
about too, because what I find,particularly with most of my
clients, especially aroundtrauma or even any type of
relationship building, you gotto start with the relationship
building, to go deeper into theconversation and all that, and I
know that Bob was talking alittle bit of the changes as he
goes along too.
So I want to put you on thespot, bob, but you know like I
(07:35):
would like to hear more from youon that.
Speaker 5 (07:38):
Well, it's a wonderful idea and I think it's
so valid because you know bothpersonally through my own
therapy and then professionallyover the last decades,
especially working in communitymental health, I would say at
least 90% of the people that wesee have trauma and, as I have
my practice, I think that thatnumber still stands up with many
(08:01):
people, if not all, and so Iagree 100% and I think that, as
we were talking before, peoplehave a need to discuss some of
the things that have happened tothem earlier in their life, and
I call it, you know, some ofit's family of origin, some of
(08:23):
it is abuse or neglect thathappens as they're growing up
and this forms a, you know, it'salmost like there's an
infection in the soul thatfesters.
If it's not if it's not I wasgoing to use the word exposed
but at least illuminated andbrought to light so that people
(08:47):
can actually discuss it andemote from it.
That's the thing that alwaysstrikes me is how much once you
uncover, or once they allow itto be uncovered, they have.
You know, facing it becomesvery intense emotionally, and I
think that part of it is soimportant in order to allow it
to reduce some of the pressureinternally, because otherwise,
(09:11):
if it doesn't come out or if itdoesn't get addressed at some
level, it's like an infectionthat's going to get worse.
And so I've been struck with itand I think some of the
techniques like EMDR, whichactually kind of goes right to
the heart of it, are reallyvalid and worthwhile.
But there's many ways of doingit.
But some of it has to do with,like Steve said, form the
(09:36):
relationship first, because youwill not have someone expose
their trauma to you if you don'thave a solid therapeutic
relationship, you know, and thetrust and the comfort and the
empathy all combined to makethat happen.
Speaker 6 (09:52):
Section of the soul.
What a phrase.
Yeah, I completely agree.
And I just to jump in here whenyou think about what a child
understands when they're goingthrough their childhood, it's,
it's their picture of normalcy,it's it's what they, how they
(10:15):
understand the world is howthey've experienced it, and so
they don't understand that maybestuff was wrong.
Even if they felt that way atthe time, did they still create
their whole sense of normalcyaround what their experience was
?
And so a lot of times it takesa while to uncover that, oh,
(10:39):
that's where the infection was,or that that the origins of that
were just seemed like the waythings were and the way things
were supposed to be.
And so when you get to trustingsomeone or they're trusting you
to reveal more of those details, that's when you start to have
those kind of eureka momentsabout oh, that's why I've always
(11:02):
felt this way, that's why I'vealways been so nervous, and it's
it's really quite amazing tosee that light go on, but I
don't see how you could ever getto that without discussing what
actually happened to your pointchris right andy.
Speaker 7 (11:19):
You know um, I'll jump in for a second.
It's um.
I was trained by half of thisroom as I got into re-education
in my mid to late 30s andstarted working with Dennis and
Bob and other really giftedpeople, one of which was someone
(11:43):
we all knew and I talked a lotabout because he was really my
mentor, Dick Fleck, the chaplainat the hospital in which we
worked, and he was remarkablebecause, and I think, as I
recall, when we were there,there were two diagnoses given.
I know I got into the fieldjust as dual diagnosis was hot
and taking off and we startedthe Metro West dual diagnosis
(12:07):
task force and things like that.
So it was really the hot buttonfor everybody.
But defining what dual diagnosiswas was very difficult in the
beginning and when I startedworking with you fellows and the
old Start Out program, Startprogram I remember they gave two
blanket diagnoses before peoplebasically were truly assessed.
(12:30):
One was some kind of an accessone, chemical dependency
diagnosis, typically because itwas an alcohol and drug
treatment program, and thesecond was unresolved grief, and
I'm not sure whether Dick wasinstrumental in that or somebody
, but I was profoundly impressedby that.
So when we talk about trauma.
(12:51):
Trauma is the echoes of someloss of innocence and a form of
unresolved grief.
That's the way I was trainedand when this mentor Dick he had
a hip replaced, as we all know,originally, mentor Dick, he had
a hip replaced, as we all knoworiginally.
And when he was out I took overhis groups as just out of
school and everything myselfbrand new, and he had about
(13:11):
three groups and some of hiscaseload temporarily and I'd go
visit him twice a week up at therehab and he'd always say the
same thing what have you learnedthis week, Grasshopper?
It's an old reference that onlythe white hairs will probably
get.
And finally, one day it hit me,and it hit me in conjunction
(13:33):
with my own therapy, which I hadan extraordinary therapist who
specialized in all of this, anEMDR pioneer and other things,
EFT.
But one day I left her officeand we'd connected the dots, as
we did periodically, and Iremember walking out of the
office and over the tea andNewton, thinking to myself no
(13:55):
wonder I did all the things Idid, no wonder I needed sedation
, no wonder it all made sense tome.
I started to make sense and Istopped being that heartbreaking
riddle to myself.
And that's, I think, whattrauma does more than anything,
and as a therapist in dealingwith it.
(14:15):
And I remember saying to him,virtually in that same place, he
said what'd you learn today?
I said it's all grief work,isn't it?
And he said, ah, it's all griefwork, isn't it?
And he said, ah, yes, it's all.
He never told me.
He made me discover it, as mostof you did.
You know, it's all grief workand the worst part of the more
pervasive the trauma, the moredramatic the trauma, the longer
(14:43):
the grief work sometimes.
So the more tricky the griefwork is because it's very
difficult.
And I remember Mike Elkins, inthe training a million years ago
, said you know, if you're notcareful, people that have been
deeply traumatized willhypnotize you to despise them,
because it's how they feel.
They'll invite you to treatthem the way they feel about
themselves.
You know, and kind of in thequantum aspect of it, you know,
(15:06):
we know that the observer of anyreality changes the reality you
observe.
And so we, as professionalobservers and assistants, you
know, we have to be very carefulof that and that's most of our
work is around learningourselves well enough so that we
don't muck it up, you know, andwell-intentioned harm.
(15:27):
I'll end with this is most ofthe lessons I taught my grad
students for many years were themistakes that I made, and I
remember I've said this beforeco-leading groups with Dennis
when I was a student and I'dmake some blunder and something
would go wrong and I'd look over.
He'd be grinning because he knewthat we were going to in his
own way, which was subtle, butbecause we'd have a lot of grist
(15:49):
for our mill of processingafterwards and he told me that
you'll learn only from yourmistakes.
Everything you do intuitivelywell, you really don't learn
from, and I didn't.
I showed up intuitively well.
The rest of it was quite alearning process and I learned
quickly because I had greatteachers, so unresolved grief,
and so we talked in thebeginning about trauma and grief
(16:11):
.
I don't think that they're.
I think they're the same thing,just different stages of it, in
a way.
So what do you guys think?
Speaker 3 (16:17):
One of the first things that I was taught and
learned in my early training,way back in the 70s, was that
it's just critically importantto respect both people's health,
but also to respect what youcan understand is either
pathology or woundedness.
(16:38):
Respect what you can understandis either pathology or
woundedness, and I think thatthe woundedness is really a
reflection of the trauma.
That's an extraordinarilysensitive area, along with being
extraordinarily important, andI think it's important to be
able to give people permissionpermission to be able to go to
the trauma, but also permissionto not go to it if they're not
(16:59):
ready.
I think it can get pushed tooquickly and people actually get
re-traumatized.
And people can re-traumatizethemselves partially well, it's
a defense, but partially as away of both punishing themselves
but also protecting the peoplewho may have perpetrated the
trauma, because that's what theyknow, that's what they were
(17:22):
taught to do.
So I think being able to sitwith somebody and be able to
tell them directly you know, wemay need to go into this in more
detail, we may need tounderstand it and look at it
more closely, but we don'tnecessarily have to there is a
way of being able to work itthrough.
I don't know what the answer isgoing to be right now, but
(17:45):
there is potentially a way andwe'll do that together and I
think that speaks to theestablishment of the
relationship also and I thinkthat, the whole establishing of
the relationship.
Speaker 2 (17:56):
there's a couple of you here who've sent me people
to do EMDR.
One of the things I refuse todo as an EMDR clinician is if
they're not in therapy withsomeone.
I know they got to establish arelationship with me prior to
doing that work so that theydon't run away because it is
difficult work to do the EMDRstuff.
And I think that some peoplelike give me EMDR and solve me.
(18:17):
And there's some other placeswhere they just do EMDR and then
they come back and there's alittle difficulty that wasn't
quite related but it triggeredother stuff and because they
didn't develop the skills orrelationship with a therapist,
it becomes very hard for them tolike, oh I thought I was cured
and then get to the other sidebecause they didn't have that
(18:38):
priming of a relationship withsomeone.
This is my experience.
Speaker 5 (18:42):
Excellent point.
I have two brief comments.
One is the ability to pace theexploration of trauma.
Dennis, you were alluding to it.
So first you have to recognizethat it exists, but that comes
out of the client, that comesout over time as they are
talking, because they'll saysomething and you'll see either
(19:04):
a disconnect or something that achoice keeps on being made
that's wrong or unhealthy.
But the pacing is reallyimportant because you're exactly
right, really important becauseyou're exactly right.
You're going to.
There's times, as we've all seen, where people are.
Literally you know they'll beshaking their head or they'll
say you know you can tell youhave to read the client as
(19:29):
you're sitting with them in away that is holding and
nurturing, but also knowing whento back off a bit and when to
continue exploring.
The second thing is that griefwork.
I just smiled because I haveseveral people that are grieving
their animals right now.
I mean, and I've seen peoplegrieving dogs in particular
(19:49):
because they're so wonderfulcompanions and they provide such
consistent love.
But I'm also realizing that ourculture does not tolerate grief
very well.
People don't want to, you know,okay.
Okay, maybe you'll go to aservice when somebody loses a
(20:09):
relative or another person.
But it's all right, now we gohome and we live our lives.
But it's all right, now we gohome and we live our lives.
(20:46):
But the people that are losingget some resilience so that they
can start to, you know, live ina different way.
Speaker 2 (20:52):
that's healthier different way that's healthier.
I think that you know I do talkabout grief a lot in the
Kubler-Ross stuff and there'sdefinitely been some people who
said it's been disproven.
But what I always say isthere's truth in what they say
and there is.
You know, I think that when Iwork with a lot of first
responders which is somethingyou all know one of the things I
(21:13):
some of the guys like what canI do?
What can I do?
I said go check on them 14 daysafter the service.
Don't, because everyone's goingto be there for the first 14
days.
But there's this you talk aboutour culture.
I think our culture is like ohyou, you, you lost someone.
It's been 14 days.
And I say 14 days, you get thepoint, you're good, now you're
all set.
(21:34):
And I think that what I kind ofpursue a lot of people to, if
they have losses in theirfamilies or whatever check on
them 14 days down, 30 days down,and so on and so forth.
Because that's sometimes wherethe grief actually does occur,
because sometimes, especially ifit's a family member or
whatever, you have to do theservice and all.
You're so into it that youdon't have time to go through
(21:55):
your own grief process serviceand all you're so into it that
you don't have time to gothrough your own grief process.
Speaker 4 (22:02):
So a little bit of what you're saying.
I feel like I'm hearing so muchwisdom in this conversation.
It's just one pearl afteranother and I want to share that
.
For me, one of my greatteachers was Aaron Lazar.
I don't know if you guys hadmuch to do with Aaron, but he
was a marvelous, marvelouspsychiatrist and he was a person
who centered the idea ofunresolved grief in his practice
(22:26):
.
And the beautiful, beautifulthing about centering unresolved
grief is it's sounpathologizing.
You know, grief is a universalexperience of being a human
being and the idea that you havesomehow incarnaled this
experience.
(22:47):
You were not able to face it,for whatever reason.
Fully.
You know, andy, as you'resaying, you know, when you're a
kid you're sort of doing thebest you can with what you've
got.
So this unresolved grief staysinside.
But when Aaron would talk topeople in the patient role, it
(23:08):
was so non-pathologizing, sohumane and so much of what
psychiatry, like the downside ofit, is.
It can be so toxic, it can makepeople feel damaged or broken
or other, and unresolved griefis something that brings us very
(23:31):
, very much together as humanbeings in the human family.
Speaker 7 (23:35):
As I look at this crowd here of seasoned
individuals, the fine print ofthe aging gracefully.
Now, we spend so much time andenergy in our culture trying to
live long and somewhere in theaging brochure graceful aging
brochure in the fine printthere's an asterisk that says be
(23:57):
aware that if you live longyou're going to have to say
goodbye a lot.
And one of the specialties thatcame upon me in my practice and
is going to bring me out ofretirement, I believe because of
the need, is specializing inhelping parents scrape children
when they lose children.
The unspeakable hole thathappens is mostly because one of
(24:20):
my best friends lost a son sixyears ago and we spend hours
every week together and we talkabout it and it's kind of this
mystery that he and he is anexcellent person to help other
people as there's such a network, especially in 12-step recovery
(24:42):
, of parents who have survivedchildren.
The nature of the generationaldisorder is that there's an
expectation and you alluded toit earlier that it's going to
get old, will be done withquickly, you know.
Or if you give it a year or twoand then it, no, it never.
That hole never goes away.
(25:03):
You just have to fill it with.
I heard a wonderful phrase, forit is that the ache you feel
from losing someone close to youis the knowledge that you have
so much love to give them thatyou can't in the way that you're
most familiar with.
So what are you going to dowith the love it's a heart thing
, not a head thing yourheartbreak.
(25:25):
You heal your own heart byfinding another source of love,
which is what dogs and cats andother animals serve for a lot of
people.
As they lose people in theirlife, they sometimes collect
animals.
For a lot of people, as theylose people in their life, they
sometimes collect animals.
I'm guilty.
I've been told I've evolved nowinto being able to handle a cat
.
So you know, I was a dog guyfor many years.
Speaker 3 (25:49):
I'm going to interrupt here and take on an
old role of grenade tossing, ifyou're strong enough.
None of this is true.
What do you mean?
Please explain Well everythingthat you're talking about.
It's just a form of weakness.
If you're strong enough, thenthis is just something that you
(26:09):
get through.
Speaker 7 (26:10):
How about missing a two-foot putt?
I've seen it, I've seen it,I've seen it, I've seen.
Speaker 3 (26:14):
Again, I'm grenade tossing in here but
unfortunately, that's a counterargument that I think needs to
get understood.
Is that you know we're talkingabout?
I mean, potentially we'retalking about boy.
You guys are just sort ofpadding your own nest.
You're giving yourself lots ofwork to do, aren't you special?
(26:40):
But I think that there is this,and it's a Western theory of
what is strength.
It's a matter of addressing,too, that strength is about
being able to engage andtolerate the stuff that you're
not really strong at, and itjust as I hear all of this today
, I mean I truly believeeverything that's being said,
(27:03):
but there is the counterpoint ofwell, no, you just need to be
strong.
Speaker 6 (27:09):
I find that what underlies that particular idea
of toughness as in the, thegrenade lobbed, you must always
be strong and and macho is basicfear.
It's, it's basic fearunderlying, underlying that
that's telling us that, oh we,we shouldn't trust the actual
(27:33):
feelings, we should just put ona face or behave a certain way
because that's what other peopleexpect, slash, that's what's
going to make them comfortable.
A lot of we're reacting toother people, reacting to us, in
grief mode.
You can see the fear in otherpeople's eyes just from the
(27:57):
concept, from the concept ofloss or the concept of that
level of pain.
It's terrifying, and sotoughness is such a great
wallpaper for all of that.
Oh yeah, just suck it up,you'll be fine.
Speaker 4 (28:12):
No, it's been exhilarating to me over the last
few years to learn about theIFS model internal family system
and the idea that we have thesedifferent parts in ourselves.
So if the person isexperiencing this toughness,
that's a part of themselves,that that it deserves to be
(28:35):
heard, empathically understood,and I love that model because
that way there's this sort ofthis maxim.
In IFS there are no bad parts.
So even the storm trooper,super ego guy who's saying don't
be a pussy, fuck ego guy who'ssaying "'Don't be a pussy, suck
(28:58):
it up and be a man".
That part has somethingvaluable if we can open
ourselves up to it.
It's very exciting to me.
It's sort of anti-pathologizing.
Speaker 7 (29:13):
Well, it speaks to intent.
I think that part thestormtrooper is well-intended to
protect you.
Basically go back and informthem.
Thank you so much.
We don't need you now.
You can take a break.
Speaker 4 (29:30):
Or maybe you'd be up for a different job.
A different job Becauseactually you took this on when
you were like 12 years old andyou were looking at the world,
as andy said, through your 12year old eyes and you know
you've got a lot of energy.
Maybe we could.
You'd want to do something elsewith it rather than be the
(29:51):
stormtrooper one thing excitingit's I just want to say one
thing.
Speaker 2 (29:58):
There is someone in this room that has said to me
that strength is asking for help, and it's not the grenade
launching person, but ratherchris gordon, who had said to me
at one point reach out for helpif you need to.
And that's actual strength.
So I just want to jump jump inand give credit to Chris for
that.
Please go ahead, Pat.
I'm sorry to interrupt.
Speaker 7 (30:17):
Well, that's a hard thing for men to do initially
and that's what most of themutual self-help groups do is
teach people how to be very youknow.
They're invited to more easilyask for help and it's rewarded.
It was the whole idea I wasthinking about in our culture.
I was working as a part of apain management team with people
(30:38):
that worked in hospice and youknow it used to be that death in
our society, especially inWestern medicine, was treated
almost as you wanted to de-ex-ex.
Machina, offstage and you know.
And then it sedate people.
The grieving mother would beput on terpenhydrate or Miltown
(30:58):
or something back in the day andsedated until all the dust
settled and that two-week periodthe medicine stopped, the
people left and then theyimplode.
So I've known people that workin hospice and so there's much
more of an honoring of the deathprocess, being a part of it and
(31:21):
having an active role in it andnormalizing it and not
pathologizing it.
And I think even in the bestmedical schools for many years,
chris, you probably could attestto this is that that was seen
as a loss.
That was the enemy.
Death was the enemy.
Death was the enemy.
Yes, the enemy is disease.
(31:41):
Can we do something aboutdisease and prevent it.
Ultimately, we learned that thebest thing you could do about
treating COVID is not to get it.
You know so it was.
So again, grief is inevitable.
It's we're just, I think, justgetting better at normalizing it
and showing people what, as yousaid, steve, and what Chris had
(32:03):
said, is that the strength isin learning how to deal with it
effectively.
Then you have the superpower ofbeing able to really be
effective at helping otherpeople with it, and that's when
the humanitarian aspect of allof this healing really kicks off
, and I think that's a real dealchanger in our society and in
the world today.
Speaker 5 (32:24):
Yeah, I think grief has been stigmatized, and I
think that we're seeing some ofthat just in terms of the
relationships we're forming withother countries, that, for
example, gaza and Ukraine.
The losses that they haveexperienced, it goes beyond
traumatic, it's catastrophic,and we're expecting people to
(32:50):
just keep on going on and atsome point point you can't, and
so now it's a matter of how.
Now, what do we do?
And I think part of our role,as in the helping professions,
is to try to, you know, allowpeople to be who they are at the
moment and work through tosomething.
(33:11):
On the other side, you know, Ireally see a lot of this.
You know, chris, you used theword toxic.
I see a lot of things that haveto do with grief or loss or
abuse.
You develop, you being thechild or the young person, or
whatever.
You develop survival skills.
Right, I can get through this,I will.
(33:33):
You know, I'll get through it.
This is normal, and he saidit's.
You only understand.
You only understand it's normalwhen you start going to other
people's houses and seeing thattheir father doesn't throw the
pizza against the wall when hegets pissed off, you know, when
you bring them into your adultrelationships and you keep on
(33:54):
asking yourself why is it thatyou know these, these women keep
on, you know, leaving me, orwhy is it that this and that
it's?
There is a dynamic that happensand you know, I'm not sure if
it was Pat or whoever, but theysaid we own, we train people how
to treat us by, you know.
You know we're basicallyexternalizing our self-concept
(34:14):
and people respond to that, butit's just.
It's such an interesting thing.
I've done a lot of addictionwork over the years and you know
children of alcoholics if theycan get by, they can get, they
can get through but there'soften a real relationship damage
that has happened that theyneed to address, they, they
(34:35):
should address if they want tohave healthy relationships.
And so that's just one aspectof it.
But those are my thoughts.
Speaker 3 (34:43):
I think it brings in another really complex piece to
the trauma issue, in that, yes,I fully agree that it's
important to be able to addressthe actual fact of the trauma,
to be able to name it whenpossible and to give that its
due.
But still, the dynamic ofexperience and how you
(35:05):
experience and what you do withthat experience is all critical
too in terms of people beingresponsible that, yes, you did
experience this and yes, this isa part of what your life has
been.
This is why you've developedpatterns that you have developed
.
What do you want to do with itnow?
Because you don't have tochange that if you don't want to
(35:27):
, but you also don't have tolive that way if you don't want
to.
So it's about empowering peopleto be able to, giving them some
agency to be able to make adecision about.
I can do this differently, andI think that that's also maybe
another definition of beingresilient is being able to say I
(35:53):
have a choice as to whether Ican change or not.
Given what's given, I can makea change.
Speaker 4 (36:00):
I'd like to introduce an idea here.
If it takes us too far downanother path, we can put it on,
do it in another podcast.
But one of the ideas that I'vefound very valuable in teaching
psychiatric residents over theyears is this idea that when a
(36:23):
person is caught up in arecurrent pattern like Bob was
describing, very often theperson cannot see the pattern.
It just feels like life isunfolding itself.
And you know why are all thesewomen leaving me?
You know, the constant in thatequation is you, but that's not
(36:45):
how it feels.
It just feels like you have badluck in finding bad women.
And one of the ways that I tryto get this across to sometimes
with patients and sometimes withresidents, is the idea of the
problem has no edge.
And the way I like toillustrate this is are you guys
(37:06):
familiar with the idea of themagic eye pictures that just
look like blurs and if you canunfocus your eyes, the thing
jumps out in three dimensions.
Well, you know I think Andy wastalking about eureka moments
that's a eureka moment when yousuddenly realize, holy shit,
(37:28):
that's what's going on here, andI feel like you know that.
For me that's a very vivid ideathat if we're working with a
person on a problem that has noedge in the addiction world.
That would be theirpre-contemplative.
They don't even see the problem.
(37:48):
But when they start to definethat edge, then it gets so
exciting and different thingsbecome possible.
So I just wanted to share thatExcellent.
Speaker 6 (38:00):
I'll take that one deeper, chris, on that example,
if you've ever sat in front ofone of those photos or pictures
and not been able to get it,it's very frustrating, very
frustrating you start to squint,you try really hard to get it.
Yeah, it's very frustrating,very frustrating.
You start to squint, your tryreally hard to get it.
The harder you try, the furtherthe picture goes away from.
(38:23):
Exactly exactly.
So we often find people rightin that exactly, and you know we
(38:45):
have to.
You got to pull them backExactly.
And I said you know, buyingmore guns is not going to make
you feel safer.
And it was this idea of what'sthe edge, where's the what's
enough?
Yeah, what do you think you'reprotecting with your armaments?
(39:08):
You know, and it's just anamazing metaphor, metaphor, but
he's also living it and creatinga whole arsenal around himself
that is ostensibly protectivebut that also then completely
distracts him from what the realfear is.
We had to go through that.
(39:30):
This is more along the lines ofthe grenade concept too, I
think of just, you know, how dowe protect ourselves and what
skills do we have to makeeverything okay day to day?
For this guy it was yeah, armup.
Speaker 7 (39:45):
I think that one of the reinforcing things,
certainly for me, and I bet youguys can identify at some level
is, chris talking about thateureka moment.
Oh, when, when you get theperson, they finally I the first
time I tried those was in aroom full of other people that
had the same one and that wasthe last one to get it.
You talk about increasingpressure, but when someone
(40:08):
actually has that moment infront of you where you start to
see the realization ofself-awareness or a reconnection
to their sense of who theyreally are, whatever it is the
moment, it's like you see thepilot light of hope come on
again.
Yes, and there's nothing in myentire life, personally and
(40:28):
professionally, that is morereinforcing than that.
That's when I think you startto realize my God, this stuff
can, this really matters, itreally works and someone is
coming back into the human race.
I think at that moment andthat's why all of this due
diligence and work, both asindividuals and as helpers and
(40:50):
facilitators, to me is soincredibly worthwhile.
Speaker 5 (40:53):
Amen.
Speaker 7 (40:53):
The pilot light of life, that's a great term.
I had to get away from it, tomiss it.
Speaker 5 (41:02):
I'm ready to go back.
Speaker 7 (41:05):
It's true.
How can I miss you when youwon't go away?
That country song, you know, Isaw such a funny cartoon the
other day.
Speaker 4 (41:13):
This doctor is talking to this really decrepit,
like 90-year-old guys, you know, barely alive.
And the doctor is saying to theguy you know, when you were
young and you did all thatexercise so you could live 10
more years in your life, this isthose 10 years.
Speaker 7 (41:36):
Thanks a lot.
Speaker 4 (41:39):
All that jogging, all that jogging for this.
Speaker 7 (41:41):
Yeah, my dad said he was going to take up jogging as
soon as he saw one laughing youknow what I was thinking, steve,
that that the first responders.
Speaker 5 (41:56):
I just shook my head because the amount of stuff they
see and they encounter and theydeal with and they have to
absorb, it's unbelievable and Ithink you have done a lot of
work with them and I did somework with folks who were first
(42:16):
responders, but it's we have.
Really, I think most of us andthen the general public doesn't
really understand the amount ofpain and suffering and angst and
anger and just whatever youwanna.
There's a lot of emotions, butthey are dealing with it on a
regular basis and I really hopethat they can come in more often
(42:41):
to unload some of that.
And I give you a lot of creditfor working with that population
because they, when I've workedwith them, it takes a while to
get some some trust going.
That's exactly what I was goingto say.
Speaker 2 (42:54):
I think that one of the things that's you know,
first responders want to knowhow you can handle that.
That's the first and foremostthing that I find, and sometimes
it takes six months, a year totwo years to build that
relationship of oh, this personcan handle me, so to speak,
before the actual great work, soso-called worker I know that
(43:15):
was all a lot of work to buildthat relationship, but I was
going to talk about that becausethat's exactly what it is.
It's like those therapeutic ahamoments with them is to realize
that when you have eight to 12major events throughout your
career, 20-year career,nevermind the 3,000 small events
that you had during your careerthe strongest person in the
(43:37):
world will be affected slightly,if not a lot, and some people
handle it well and that's youknow.
We don't want to pathologizeevery single first responders in
the world, however, what'swrong with getting help when you
have something that most peoplelike, I think, my favorite
sentences?
They deal with the 5% of theworld that 95% of the world
(43:58):
doesn't know about, and whenyou're dealing with that type of
environment, you have to showthat you're able to handle it,
because it's very hard.
My work with first respondersand I appreciate Bob for
bringing that up is really about, like you know, what I've
started doing is I do CITtraining here in Middlesex,
massachusetts, for the policedepartments, and one of the
(44:22):
things I do is I do the traumapart and I say, okay, let's do
the ACEs.
If you're not, if you're notaware of the it's a adverse
childhood experiences and Ileave it up there and just say,
hey, look, maybe when you, whenyou meet children, that's what's
going to happen.
I don't throw it up there and ifyou guys know, if you guys are
listening, sorry, I put it outthere so that they start scoring
(44:43):
themselves and they scorethemselves and I always say
afterwards I'm like, all right,just for the record, over four
is usually you gotta have somesort of trauma, ptsd, but
typically first responders haveeight and you see them all drop
their eyes and they they like ohgotcha, so to speak.
And I think that that's why,when you talk about what you
(45:05):
don't know as a child, you growup.
A lot of first responders gointo this field to help people,
just like we do.
And yes, therapists, by the way, I'm sure their numbers are in
the six, seven, eight, also forthe record, but I think that I
want to throw that out, becausethe ACEs stuff has been part of
what, in the last six months,two years, has been a very
(45:25):
transformative work that I dowith my clients.
Speaker 4 (45:30):
That's really great.
I was just reflecting when Iretired from Advocates and I had
been doing that work for like25 years and my first love at
Advocates was the emergencyservice and I love doing
psychiatric emergencies.
(45:51):
People are you know, they're.
They're in a crisis and a littlelove goes a long way and it's
really really great work.
But I know I was feeling and Iwould tell Julie about it I feel
I was feeling like an odoreater.
You know the thing you put inyour sneaker that soaks up the
(46:12):
odors.
I felt like I was sort of likean odor eater, like I just was.
There was so much suffering andit was.
It was kind of it was a heavyweight and when I, when I
retired, it felt like I couldkind of exhale in a way I hadn't
(46:33):
in a long time.
I imagine first respondersexperience something similar.
They respond and they don'thave any idea what they're
walking into and very often it'sa horror show.
Speaker 3 (46:46):
I think the application of the container
theory works there too, becausewe are all containers, yeah, and
you know we take in so much andit's important to know that we
can only take in so much um anduh.
Then it's important to find waysto be able to let that
container empty yes, and uh,that's critical, I think, with,
(47:10):
with, for all of us in our work,but first responders, because
in some ways I think in manyways we are also experiencing a
first responder dynamic in manycircumstances, but an
understanding that we get filledup and when we get filled up it
gets very heavy and it getsvery hard to maneuver.
Speaker 5 (47:33):
I see that First responders move toward.
Speaker 4 (47:36):
they move toward the fire, and that's what we have to
do a lot of the time, too, ismove toward the fire that other
people want.
We just want to get the hellaway from it.
Speaker 5 (47:49):
I'm hopeful that first responders can get some
training in how to prioritizeyour own self-care or as
self-compassion or understandingthat there's a connection
between your past and how thingsare affecting you now.
I mean, I see it at the clinicswith younger clinicians.
(48:12):
See it at the clinics withyounger clinicians.
There's more pressure right nowbecause there's a tidal wave of
need, but it's a matter oftrying to figure out how do I
set limits and sometimes say noor sometimes delegate or
sometimes basically decide thatyou're going to take a little
bit of a break for yourself and,frankly, on a regular basis it
(48:34):
helps because you need to unload.
You know it's almost like whenthe garbage gets picked up.
You know once a week we get,you know the cans are empty and
it's.
I think it's important for usto do that and I've.
What I see with a lot ofyounger clinicians is that you
know, if you're only in thefield a couple of years and
(48:55):
you're already feeling likeyou're getting burned out, this
is something to really becautious about and we I think
first responders probablyencounter that, but I don't know
if the culture of firstresponders is a welcoming kind
of place to unload that.
Speaker 6 (49:10):
That's a really key distinction, isn't it?
It's this we have the abilityto sit and talk and use words to
reason stuff out, and I cancall any of you at any time with
a question or a concern if I'mfreaking out.
I think in that culture it'srare to find that.
(49:34):
I think in that culture it'srare to find that.
I'm sure it exists, but that'sthe overlay of how tough we are,
you know, tends to obscuretheir ability, I think, to do
that.
But they might whisper it inthe bunk after you know, or just
I'm sure they're finding placesto release that.
Speaker 2 (49:54):
But maybe something more programmed and intentional
would be very useful and helpdismantle some of these ideas of
toughness that get in the wayin the community is that you
(50:15):
know, if you address whateverhappened, the event that
occurred within the first sixmonths, it can remain in an
acute stress disorderenvironment and not necessarily
become PTSD.
And I talk about asking forhelp is actually helpful for you
in the long term to keep yourcareer going.
But you know, the sentence Ihear all the time is you know,
one of my least favoritesentence I heard is from
(50:36):
veterans in the first responderworld.
Well, I survived 20 years ofthis stuff, a little bit of that
grenade.
I've survived 20 years.
Why would you need therapy?
I survived 20 years withouttherapy.
Why wouldn't you?
And that grenade that occurseven within the stigmatization
of mental health.
I mean, I can talk for hours asto what goes for first
(50:57):
responders and what they gothrough.
Speaker 7 (50:59):
I actually developed.
It found me especially.
The first responders that Iworked with were people that
were paramedics and emergencyroom people who had suffered
death despite their bestintentions or their expectations
.
There was death there, andoften the supervisor or someone,
(51:21):
because I was always in theemergency room for the psych
stuff.
It was an intimate, smallenough place where I would spend
a lot of time just debriefingthem quickly, and if there was a
suicide on the unit, I was oneof the people that would go in
and just debrief people, justget them talking and normalizing
this.
The fact that, well, I've seenit before, yeah, okay, what'd
(51:44):
you do about it the last time?
And it's not about surviving 20years of survival.
It's living well while you'rebeing affected, and that's the
difference.
And again, I remember my mentorused to do the you know.
I remember his seminars on carefor the caregiver and all of
that.
Are we taking our own advice?
(52:04):
He was a specialist in thesilver rule, not the golden rule
.
The silver rule is treatyourself as nice as those you
truly love, and if you're doingthat, then you're you're going
to keep yourself in the game andin a good, healthy place so you
can then be a good partner athome and a good friend and
(52:25):
whatever, and and uh and goodcompany.
You know, um on the golf courseis all you guys well as we up.
Speaker 2 (52:35):
We're going to wrap up here because we're getting
close to the hour already.
This is an amazing conversation.
Like I said, we're going tobring a colleague hopefully,
next time on, and I could talkabout all this stuff every
single time.
That's why the mental men areso essential, and I think about
the years of experience in thisroom just sitting back.
This is my favorite part, notthat I don't like my other
(52:58):
guests on the podcast.
I sit back and listen to youguys.
I put in my two cents just tobe the hoax and pretend I know
something, and you guys are justabsolutely amazing.
I think that if we talked abouttrauma, grief and first
responders, we'd have 24straight hours and we'd still
have a conversation.
So thank you, guys.
I really truly appreciate it.
Thank you.
Speaker 7 (53:18):
Thank you, Steve.
Speaker 4 (53:19):
Thank you for having us Great conversation.
Speaker 2 (53:21):
Yeah Well, we'll continue.
You guys, you know you'recoming back right.
It's not a question of if, it'sa question of when.
So don't worry, I've got you onthe books already.
Speaker 4 (53:30):
Great, so long guys.
Speaker 2 (53:33):
Well, that concludes episode 197.
Again, the mental men.
Thank you guys.
I can't say enough of having,like I don't know, 200 years of
experience in one room and beingthe kid in the room, which is
perfect for me, so really enjoythat.
But for episode 198, we'regoing to talk about therapy
process.
A lot of first responders mightknow how therapy works.
Speaker 1 (53:56):
It doesn't do what it does do.
So we're going to do that inthat episode and I hope you join
me then.
Please like, subscribe andfollow this podcast on your
favorite platform.
A glowing review is alwayshelpful and, as a reminder, this
podcast is for informational,educational and entertainment
purposes only.
If you're struggling with amental health or substance abuse
issue, please reach out to aprofessional counselor for
consultation.
If you are in a mental healthcrisis, call 988 for assistance.
(54:22):
This number is available in theUnited States and Canada.
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