Episode Transcript
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SPEAKER_00 (00:00):
Welcome to the CBT
Dive.
This is the podcast thatdemystifies cognitive behavioral
therapy.
I'm psychotherapist and hostRahim Thawar.
In each episode, I walk a guestthrough applying CBT skills to
real-world situations.
(00:25):
Hello, Hale.
Welcome to the CBT Dive.
How are you today?
I'm doing great.
How are you?
I'm doing good.
I'm doing good.
Ale initially came to Canada tolearn English at age 16.
Then he went straight intouniversity, began doing a
program in criminology, butdidn't enjoy it as much as he
thought he would, but alsocouldn't afford it.
(00:47):
The international fees are quitehigh.
He saved money and eventuallydid a program as a med tech
assistant and then worked inhealthcare settings and is now
in a community-based healthcenter.
And of course, Ali and I havemet just through healthcare work
here in Toronto.
Before this recording, we weretalking about situations that
(01:08):
bring up difficult feelings.
And you had identified that it'soften with your mom, right?
She's somebody who's, I guess,been a big part of your life.
And as you've gotten older, youhave a strong reaction whenever
she calls.
(01:28):
So tell me a little bit aboutyou and your relationship with
your mom.
Yeah, so I think, like, we getalong great.
And, like, growing up, becausemy dad used to be, he used to
be, like, 28 years her senior.
So to our...
When I was in high school, thenmy mom was like his primary
(01:52):
caregiver.
Even though I offered to stay,my dad didn't want me to see him
deteriorate.
And then after my dad died andthen she sent me here, she's
like, oh, I want you to gothere, have a better life and
blah, blah, blah.
I just feel like there's aconfusion of roles.
Okay.
(02:13):
So that's good context.
So thank you for that.
So now we're thinking aboutyou...
in a typical day here in Torontoand you get a call from your mom
and your immediate thought isthat your mom is calling and
she's going to ask for money.
(02:35):
When I get a voice note onWhatsApp, that's when I know,
especially when she sends itlike five minutes after we talk
or like the next day.
Ah, okay.
Tell me, what are the feelingsthat come up for you when this
happens?
I hear that there's anger there.
That's one of the things you hadmentioned.
What's another feeling thatcomes up?
(02:57):
Like confusion, I guess.
Like I get very conflicted,confused.
I imagine there is, because it'sa pattern, there's frustration?
Yes.
I feel like unheard, no matterwhat I say.
Yeah.
What I give is never enough.
(03:18):
There's always something more.
And, like, it's just that notunderstanding that I have a life
here.
Like, I don't live to give hermoney, you know?
Right.
Right.
Do you feel sadness?
I feel like at the beginning Idid feel sad for the situation.
But now, not really.
(03:41):
I feel like the other feelingsare stronger.
Okay.
Okay.
Is there a small part of youthat's, when you get the voice
note, that you're like curiousor hopeful that it'll be
something else?
Very little, but yes.
Okay.
All right.
(04:01):
This is a good list of feelings,I would say.
I'm going to ask you to ratethese feelings on a scale of 1
to 10.
10 means that they're the mostintense.
So this is when you get thevoice note.
Where is your...
experience of anger on a scaleof 10?
I think frustration will be 10.
Okay.
(04:22):
And angry would be 9.
How would you rate unheard?
8.
8, okay.
Yeah.
And then confusion, 7.
And then misunderstood, 6.
SPEAKER_01 (04:38):
Okay.
SPEAKER_00 (04:40):
Sadness will be like
3.
UNKNOWN (04:44):
Okay.
SPEAKER_00 (04:45):
And then hopeful
one.
Yeah.
Curious two.
Okay.
The next column is aboutbehavior, right?
And I'm wondering, what do youdo when you receive this voice
note?
I've done it all.
Like, if I get, like, two voicenotes in the same week, I will
(05:08):
delete it.
Or, like, I will just startlistening and then...
If I start feeling my chesttightening up, then I just stop
listening.
The tightening of the chest,that's like a strong physical
reaction, huh?
SPEAKER_01 (05:28):
Yeah.
SPEAKER_00 (05:29):
Yeah.
I'm moving over to the nextcolumn, which is about automatic
thoughts.
These are things that you'rethinking about in this
situation.
So what's going through yourhead?
Even if it's not money, likeliterally she will call me...
And, like, I get a sense she'llbe like, oh, can you get me
this, like, Michael Kers purseand send it to me?
(05:51):
And I'm like, ah.
Or she just dumps all this stuffthat she's going through
because...
I'm the only one that listens,even though she has like four
siblings.
I can be her son.
I can be her confidant.
I can be her friend.
I can just be all these thingsto her.
(06:12):
Because it's just too much.
Okay.
I'm curious about yourcuriosity.
Because there's a hint.
There's a part of you that feelslike, huh, I wonder if she's
going to...
Share something different.
She's going to have a differentpattern.
So my mom's a lawyer.
So over the years, she has hadsome like big, big war cases.
(06:37):
I'm always hopeful thatsomething will come through for
her.
Because I feel like she needs itat this stage in her life.
So I'm hoping that it will belike, you know what, I won the
case or they pay me, blah, blah,blah.
Something like that.
That she'll be self-reliant in away.
yeah okay i am going to gothrough these and ask you some
(07:00):
follow-up questions and thefollow-up questions are they're
intended to get a little bitdeeper into the automatic
thoughts so i'm trying to figureout what does each of these
things mean or what's theimplication of them so for
example my mom will ask formoney right If that's true, what
(07:26):
will the consequence of that be?
So, when I first came here, Iwould rely on her for money.
When I just started working,like, I was barely making any
money for me.
Yes.
Yet, I was stressing out as to,like, how do I send her money?
You've given me some historythat suggests that you'll be in
a precarious position again.
(07:48):
Yeah.
And then it's like, now, it justimpacts...
what I share with her.
So if your mom asks for moneyand you were to give it to her,
then what happens?
There was like a couple ofmonths that she was literally,
(08:12):
Rahim, asking me for money everyweek.
And I've sent like$5,000 in thespan of three months.
And then I was like, this is notokay.
So I came up with this, like,okay, I'll send you$400 the 19th
of every month.
And that's it, right?
So we've been doing that sincelast summer.
(08:33):
But then lately, She was like, Isend her the money, the 19, and
on the 20th, I get a voice note.
It's like, oh, can you send mean extra 100 or an extra 150?
And then I talk to my cousinsthere.
Yeah.
And like what she tells me andwhat my cousins tell me are like
two different things.
(08:54):
Every time that she calls methat she's struggling...
I will talk to my cousins andthen I'm like, is she really
traveling?
She's like, no.
Like, listen, your mom owns herapartment.
She lives alone.
She's like, I see her shopping.
She goes to the casino.
But she doesn't tell me allthese things.
In the past, when you were in aprecarious position because you
would send her more, how bad didyour own precarity get?
(09:22):
Like, did you go without food?
Yeah, like there were times thatall I had in the food was like
Nutella and like sandwich bread,right?
And then I will pay more moneyto get to work than I will make
at work, right?
I think this dovetails into thenext thought you had, which is
she has unrealistic expectationsof me.
(09:45):
What are her expectations ofyou?
My life is to provide for her.
So she sees you as an extensionof her, like her.
Yeah.
You take care of her.
When you try to tell herotherwise, like this is not
possible or I can't do this.
Why don't you ask other peoplefor support?
(10:07):
What does she say?
She has this facade, which Ijust find very annoying because
they're all doing the same.
Because when I talk to mycousin, we're all going through
the same thing.
Like I told her, I'm like, finda job, like any job, like go
work at a salon, you know.
I mean, she was a lawyer, right?
Granted, it's very difficult tofind jobs if you're not
(10:30):
connected to the government.
And it's very difficult forpeople to have funds and money.
But I told her, I'm like, if Isend you this, maybe just find
any job.
And then she's like, after beinga lawyer, how dare I be a
receptionist at a hair salon?
So she feels a bit demoralized.
Yeah.
If this dynamic were tocontinue, what would happen to
(10:56):
your relationship?
I don't know, because I want herto come here.
Because I mean, like she'sgetting old.
I'm not moving back home.
She's alone.
SPEAKER_01 (11:05):
But
SPEAKER_00 (11:07):
I just cannot do
everything for her.
For example, the governmentopened this application for
people from Venezuela to come asa permanent resident.
Right.
So I sent her the applicationlike three months ago and I'm
like, can you start working onit and do it?
Nothing happened, nothinghappened, nothing happened.
So our last big fight, I wasjust like, I send you this for
(11:28):
you to come here.
At least you can come for alittle bit, get used to it.
And then she didn't do anything.
And then I had to start doingit.
And then when I request thingsfrom her, it takes her so long
that now they closed theapplication and she couldn't
apply.
When I told her the applicationwas closed, he's like, oh, do
you know somebody in immigrationthat you can call and they can
put one?
(11:48):
I'm like, it doesn't work likethat here.
Like I can't bring chocolates toan immigration officer.
And like...
I'm hearing a kind of resentmenton your end about doing this,
having a caretaking role, whilealso leaning into the reality of
(12:10):
maybe having a caretaking role.
Do you think that eventually hercare will fall on you?
Yes.
But the thing is, she needs tohelp me take care of her.
And When she uses you as asupport and not other people,
(12:32):
I'm trying to figure out why doyou think she does that?
I don't know because it's likeevery time that I think I talk
to her friends, I'm like, oh,your mom talks like you're doing
this amazing work in Canada.
So I think she has built me up.
here like i think how peopleknow me back home here is not
(12:55):
who i am i don't know who thatperson she's telling everybody i
don't know who that person isyeah so i think she needs to
like keep up with whatever shesaid so it's like then she
doesn't have anybody that shecan say like you know what this
is not working blah blah blahYou did mention actually that,
(13:16):
you know, other people say she'sdoing okay.
And she goes, you mentioned theword casino.
And I wondered if she has likedifficulty with impulse control
or spending too much.
Yeah, always.
Since I was a kid, my mom hasnever been a good...
(13:37):
She doesn't know how to save,and I think that comes because
my grandfather was so stingy.
He was rich, but he wouldn'tgive you$0.20 for a chocolate
unless you go to the second-handstore.
And then he lived in a12-bedroom house.
So she lived a very shelteredlife.
So when she came out, everymoney she made, she would spend.
(13:59):
And I think that was myresentment.
Mm-hmm.
(14:23):
When that happened, she's like,oh, I want to take you on a
trip.
And I'm like, mom, why don't yousave this money for a rainy day?
And then she's like, when youmake this kind of money, then
you can spend it however youwant.
She feels criticized.
Yeah.
So then I'm just like, I think Icarry that because I'm like, we
wouldn't have to be goingthrough this at all.
(14:45):
Yeah.
And so you...
you've kind of got a judgment ofher, which is fair, which is
that she should be moreconscientious or more
responsible, yeah?
Well, I learned from herexperiences, you know what I
mean?
What have you learned from herexperiences?
(15:08):
To save money?
Like, I don't think...
I will not want to go throughwhat she's going through.
If you are the son that can'thelp her, right?
Let's say somehow you can't.
What will that say about you?
(15:28):
I don't think I will feel like afailure because probably if I
can't support her, I'm probablystruggling with other things
that I can think about her.
But I don't know if she would dotaking different actions because
I wasn't there.
Okay, so that's kind ofinteresting because you're
(15:48):
sayingโ you're kind of sayingI'm curious if she will be more
self-reliant if I don't help.
Yeah.
And that makes sense to mebecause I think a lot of people
do worry like if there's anunderlying habit, am I enabling
(16:12):
that habit?
Mm-hmm.
Okay.
UNKNOWN (16:14):
Yeah.
SPEAKER_00 (16:15):
I'm trying to figure
out here, what thought in this
column stands out to you asbeing the most salient or the
most prominent?
I've learned a lot, but shecan't seem to learn these
things.
Yeah, I feel like that one.
Okay.
I'm trying to figure outwhere...
The feeling of being unheardfits into this, actually.
(16:39):
Sometimes I feel like shedoesn't hear what's going on in
my life to care enough asidefrom her own stuff.
And when she doesn't care about,it's not you as a human, but
like your achievements or what'sgoing on in your life.
Yeah.
(16:59):
I'm guessing that hasn't alwaysbeen the case or has it?
No, no.
Like, before, like, when I leavethat home, it's just like, you
know, if I had, like, acompetition, she will come, she
will ask me what I'm doing, shewill be interested in what's
happening in my life.
And what change do you think?
(17:21):
I guess a distance.
And then I think after a while,like, for example, in my role,
like, she doesn't reallyunderstand what I do, so I don't
really talk much about it.
And, like...
She doesn't make efforts toreally understand what I do.
So then I just stop puttingefforts as well to explaining
(17:43):
it.
Yeah.
Okay.
I'm going to return to thesethoughts here.
And the one that I just addedwas she doesn't care about my
life or my achievements.
Is that one prominent?
(18:04):
Yeah, that one that she needs toappear financially stable drives
me mental.
So I will say maybe more so.
Okay.
Now, these are three verydifferent thoughts.
And they're all quite prominent.
(18:27):
Now, you've already given memany points.
many pieces of evidence thatsupports this idea.
So when we take a thought that'sbolded here, we want to evaluate
it.
Now, I'm going to admit thatthis thought record hasn't gone
(18:50):
in the direction I thought itwould.
Normally, We would use a thoughtrecord where the difficult
feelings come up for you, andthen we identify an unhelpful
thinking pattern that resides inyou, right?
(19:11):
And then we want to evaluate anythought pattern that's
unhelpful.
to try to come up with analternative way of thinking.
But your thought isn't aboutyou.
If you said, I'm unable tobudget, then we would say,
what's the evidence for that?
What's the evidence against?
How do we think about itdifferently?
But your key thought is aboutthe other person.
(19:36):
So you put me in a difficultposition in the middle of a
recording.
We're going to turn this into aproblem-solving...
Okay, which is also a cognitivebehavioral therapy tool, but
it's used for when things aremore factual and there isn't,
(19:57):
it's not driven by unhelpfulthinking style.
So because everything you'resaying and thinking is just
pretty well factual in thiscase.
So I'm going to say, I want toknow here, the next column I'm
going to say is objective.
And then I'm going to saypossible objective.
(20:18):
solutions, and then evaluation,and outcome.
Thank you for complicating mylife, Ale.
You're welcome.
But, you know, I think we'reexperiencing the complexity
(20:40):
right now of which direction togo in, even therapeutically, in
the same way that I think youexperience confusion with your
mom.
Right?
That parallel is not lost on me.
So, as we approach...
This problem that you have tosolve, what is your objective?
(21:02):
What do you want to achieve?
What is the goal here with mom?
I want her to have a stablelife.
What does that include?
That includes she has sufficientmonthly income, a safe space to
live, health care, and like...
(21:24):
Something to do to occupy hertime.
Okay.
And what is your objective interms of your relationship with
her?
I think I want us to get to knoweach other now as opposed to how
I was when I left.
(21:45):
Okay.
We've got two big objectives.
One is about mom havingstability.
The other is about therelationship.
What are...
Possible solutions.
So you've already mentioned someof them.
Yeah, like her coming here.
Yeah.
(22:07):
If she came here, what wouldthat look like?
Where would she live?
Would she live with you?
Like, I think to start and thennot.
Okay.
What are other parts of thesolution?
What's another solution?
(22:28):
I think if she can find a job athome that is, like, secure,
like, that's not depending onthe government and who's in
power and, like, all that.
Yes.
And you're saying even if it'snot in her field?
Yeah.
In terms of, like, the adultrelationship...
(22:53):
Is there anything that couldfoster that in the present
moment?
To be honest, until the firstone is not kind of happening, I
will find it difficult to get tothe other one.
But one thing that could help islike if we are like in real life
meeting as opposed to throughthe phone.
And do you visit?
(23:15):
No, no, I don't have my passportto go home.
Oh, okay.
So seeing each other inperson...
Could help.
But when we get to evaluation,we'll know that that's not
possible because of thepassport.
But is she able to come hereeven as a tourist?
Yeah, yeah.
All right.
Now we're going to look at thesepossible solutions, right?
(23:38):
And I want us to evaluate them.
So how realistic is it and howpossible is it?
So her moving to Canada, whatwould that require?
Like an implication toimmigration?
Mm-hmm.
And is it simple because youwould be her sponsor?
(23:59):
Well, the one that they closed,I didn't have to be her sponsor.
She could have been here as apermanent resident, but she lost
her time.
So I'm hoping that they willreopen that pathway because I
don't want to be her sponsor.
Uh-huh.
So this works if...
(24:20):
the non-sponsorship optionreopens.
Otherwise, what happens?
Like, I mean, like, I think as arefugee, she could come.
Okay.
I don't know if she'll like it,but that she can go back home,
(24:42):
that's the only thing that Ithink she will say no.
Mm-hmm.
And I think that's it.
if she did come here, do youthink, like, she'd be able to
stay with you, find work, andthen live on her own?
Yeah, like, I think...
(25:05):
Like, I think leading to hermoving here, if she could come
sporadically just to meetpeople, meet the Latin
community, and kind of startbuilding her own community...
that will work.
And does she have a desire to dothat?
(25:25):
Like, she didn't until thisyear, the first time that she's
actually like, oh, you knowwhat, I'm thinking about it.
But before, she didn't want tocome here.
Ah, okay.
So there's some optimism growinghere.
SPEAKER_01 (25:40):
Okay.
SPEAKER_00 (25:43):
So, the first
solution, mom can move to
Canada, stay with me at first,and then be on her own.
When we evaluate it, like, canit work?
How realistic is it?
What are the differentdimensions?
Well, this works if thenon-sponsorship option reopens.
She'll say no to the refugeeclaim option.
And this would require her toslowly build community through
(26:04):
tourist visits, which she'ssomewhat open to.
Okay.
Now, what about find a job backhome?
Like, it seems like it'sobjectively hard.
Yeah, like, it's just difficultto find a job unless you work
(26:26):
for the government.
And, like, she doesn't want towork for, like, a corrupt system
and, like, contribute to thatunless she opens a business, but
she needs money to do that.
And I don't know what businessare there to be open in that
country just now.
Right.
So she doesn't have many joboptions there.
(26:47):
No, not right now.
Not right now.
You said, like, maybe she couldget a job at a hair salon, for
example.
Would that give her enough moneyfor stability?
No.
Okay.
I mean, like, on top of what Isend her, I think she'll have
money to, like, do whatever elseshe needs.
Not the...
(27:08):
How do you call it?
The utilities and, like, thingslike that.
Now, you want us to have anadult relationship.
Seeing each other in personcould help.
You can't go there, but she cancome here.
Is that right?
Yeah.
When might that happen?
Because that's like a separategoal, it seems.
(27:28):
I think I'm hoping this year.
The only thing is like I have topay for everything for her.
Right?
Where she stays, where we go,her expenses and everything.
Yes.
So I need to figure that out.
But I'm hoping to bring her hereat some point.
But she needs to do stuff to gether visa to come here.
(27:50):
Right?
Is that something you can do onher behalf?
Like I can do part of it, butlike going to Venezuela to this
office to whatever, take herpicture with her thing that she
needs to do?
Yes.
Yeah.
Okay.
I can see why you've been sofrustrated.
Right?
Because I'm looking at theevaluation and And seeing each
(28:18):
other, so for the secondobjective, I want us to have an
adult relationship based on whowe are now.
Seeing each other in personcould help.
This seems a bit grim, to behonest.
It's tentative at best.
(28:38):
So in terms of an outcome,looking at that bottom one, I
think the outcome is like I mayor may not have the adult
relationship I want.
In terms of her not being ableto save or doing something
(29:02):
around spending, you want her tohave stability.
And one of your solutions islike that she could move here.
And I'm trying to figure out, doyou think this is viable?
Do you think eventually it'llhappen, but it'll just take a
long time?
Okay, so the idea could happen,like I'm sure of it.
(29:22):
Okay.
But it's just her, I don't thinkshe grasped the idea of what it
means to live here.
And I'm not talking about...
like the paperwork and all ofthat.
You mean like the culture?
Yeah, like the social aspect,the isolation, the winters, her
(29:43):
not knowing anybody, hersiblings are not here, I'm
working every day of the week.
I think that reality, that'swhat I need her to understand
what that means.
And that's why I want her tobuild her own community that's
not, so she doesn't feel alone.
Hmm.
Okay.
(30:04):
Realistically, do you thinkshe's more employable in Canada
than she is in Venezuela?
Like, I mean, here she canfreaking work at the dollar
store.
Like, I don't know.
Like, I don't think she could dolaw here.
But, I mean, like, she takessome courses and volunteer,
like, at a law office as aparalegal.
Like, or supportSpanish-speaking clients to read
(30:28):
documents over.
Just things like that.
Her employment...
opportunities are kind of scarcein both places.
Okay.
Now I'm thinking for you, right?
(30:51):
All of this, like employmentopportunities are scarce in both
places.
I may or may not have the kindof relationship I want with her.
These are like truths or hardrealities.
When we think about this couldeventually happen, but it will
take a long time for her toappreciate the gravity of the
move.
What does this require of you?
(31:12):
Of me?
Yeah.
Like, I think just do theapplication, pay for the fees,
tell her, spoon feed her whatshe needs to do, and then kind
of plan ahead what's going tohappen next.
when she's here, so she has areality of what will happen and
(31:36):
how it will happen.
Yes.
And I think you're going to befrustrated the whole time.
Yeah.
Which is not, like, nobody wantsthat, but I'm...
Yeah, like, I think...
Yeah, I think what we did now,because she started an
(31:58):
application now, so I told hersave everything so we don't have
to redo it.
But I just think applying forimmigration is just stressful no
matter what.
Yeah.
And you've already started towork on some boundaries with
her.
And...
(32:21):
I think you're starting to facethe reality and the grief in a
way of not being able tonecessarily help her.
Yeah.
Like she might not havestability in the way that you
imagine.
Yeah.
And then I think the way that Iimagine is like how I grew up.
(32:42):
And then I think the way shethinks of stability is like how
it was before.
So I think it's just changing...
westability means now you knowso we've come to the end of what
was a thought record but thenturned into a problem solving
worksheet and it's not like ahuge shift however we went from
(33:14):
my mom can't save spending givesher happiness to to I want her
to have stability.
The big solution is she comes toCanada.
And overall, the outcome seemsto be like her options, none of
them are great.
There's a comprehensionchallenge on her part to
(33:37):
appreciate all the steps, theprocess, the experience.
And we come with this like,okay, I'll need to shift how I
think about stability.
Because stability might not meanher taking care of herself.
It might mean her slowlyunderstanding what I've been
saying for a long time.
(33:59):
Where does that leave you?
How do you feel at the end ofthis?
I don't know if you feel anybetter.
You might not.
Now?
I don't know.
I think it just confirms whatI've been thinking.
Yeah.
Yeah.
Yeah.
It confirms what you've beenthinking and it's kind of
(34:22):
painful.
Yeah.
Do you think going through thisprocess helps you reshape what
you think your goal is with momor how you're going to approach
her or gives you any additionalinsight into where it's going,
this relationship?
(34:44):
Yeah, I think so.
I think, you know, I was prettylenient with all the things
around immigration and theprocesses.
So I think that has to change.
And then now I need to- Bylenient you mean you were laid
back?
Yeah, like I would be like, thisis the application, go fill it,
(35:05):
figure it out, send it back tome, you need to do this, this,
this.
I'm like, you have 20 cousinsthat live there, they all speak
English, they can read, ask themfor help.
So that never happened.
So I think now I have to be moreof like a coordinator of
everything.
Yes, this is your otherpart-time job.
You're going to have to be thecoordinator.
(35:26):
Yeah.
And then just give her homeworkand be like, do this homework by
this day.
I need to grade it.
And like, I think that's how Ineed to start doing things.
And that way your frustrationdecreases because she's not
disappointing you each time.
Right.
Okay.
Ale, thank you for participatingin this process.
(35:51):
We left with some hard truths.
I usually...
hope that we leave on a moreoptimistic note um but this is
heavy so thank you for for yourtime and for being here um thank
you yeah you're very welcomeanything else you want to say or
ask about cbt before we beforewe end today no i think It has
(36:14):
been great.
I think you gave me some insightas to some of next step and
maybe how I've been doing thingsthat increases my frustrations.
And then maybe something that Ican do to decrease the
frustration.
Sure.
So thank you.
Thank you.
And that's the CBT dive fortoday.
Thank you for joining us as wedemonstrate therapy skills for
(36:37):
the real world.
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The CBT dive is intended foreducational purposes only and
not as a replacement forindividual therapy.
See you next time.