September 9, 2026 • 44 mins
This is the final discussion in which we "break our silence" as the click-bait headlines like to call it, on our final thoughts about diagnoses and why we believe that they have caused more harm than good. Due to the nature of separating an entire discussion into two parts after the fact, this episode jumps into the discussion pretty quickly.
Recommendations (Part 2)
Holidays (09/09/26):
Recommendations (Part 2)
- Abraham: Flip 7 (https://theop.games/products/flip-7?srsltid=AfmBOope-f-q_QElBRFFD56xiHxlsBbWULVkkXJHpef6OiYa02WlmfZW)
- Shane: Show Me the Body - Alone Together (https://open.spotify.com/album/2itfvUrApVCygurzgNzXJg?si=miioVowrRBSO26h1soi8lw)
- Stu: https://www.youtube.com/@jetlagthegame, Call out Purple Hat DBT theses and dissertations, The Orphans of Davenport (https://wwnorton.com/books/9781631494680), genArete (https://genarete.org/)
Holidays (09/09/26):
- Teddy Bear Day
- Sudoku Day
- Wienerschnitzel Day
- Weirdos Day
- Falsely Accused Day
- International Fetal Alcohol Syndrome Spectrum Awareness Day
- International Box Wine Day
- Day to Protect Education From Attack
- Emergency Services Day
- Barlow, D. H., & Nock, M. K. (2009). Why can’t we be more idiographic in our research? Perspectives on Psychological Science, 4(1), 19–21.
- Beck, A. T., & Alford, B. A. (2009). Depression: Causes and treatment. University of Pennsylvania Press.
- Beck, A. T., Davis, D. D., & Freeman, A. (Eds.). (2015). Cognitive therapy of personality disorders. Guilford Publications.
- Beck, A. T., Emery, G., & Greenberg, R. L. (2005). Anxiety disorders and phobias: A cognitive perspective. Basic Books.
- Beltz, A. M., & Gates, K. M. (2017). Network mapping with GIMME. Multivariate behavioral research, 52(6), 789-804.
- Birkhoff, G. D. (1931). Proof of the ergodic theorem. Proceedings of the National Academy of Sciences of the United States of America, 17, 656-660.
- Brown, T. A., Campbell, L. A., Lehman, C. L., Grisham, J. R., & Mancill, R. B. (2001). Current and lifetime comorbidity of the DSM-IV anxiety and mood disorders in a large clinical sample. Journal of Abnormal Psychology, 110(4), 585–599. https://doi.org/10.1037/0021-843X.110.4.585
- Clark, L. A., Watson, D., & Reynolds, S. (1995). Diagnosis and classification of psychopathology: Challenges to the current system and future directions. Annual Review of Psychology, 46, 121–153. https://doi.org/10.1146/annurev.ps.46.020195.001005
- Fried, E. I. (2015). Problematic assumptions have slowed down depression research: why symptoms, not syndromes are the way forward. Frontiers in psychology, 6, 309.
- Fried, E. I., & Cramer, A. O. (2017). Moving forward: challenges and directions for psychopathological network theory and methodology. Perspectives on Psychological Science, 12(6), 999-1020.
- Galizio, A., Frye, C. C., Haynes, J. M., Friedel, J. E., Smith, B. M., & Odum, A. L. (2018). Persistence and relapse of reinforced behavioral variability. Journal of the experimental analysis of behavior, 109(1), 210-237.
- Galatzer-Levy, I. R., & Bryant, R. A. (2013). 636,120 Ways to Have Posttraumatic Stress Disorder. Perspectives on Psychological Science, 8(6), 651-662.
- Glick, I. D., Murray, S. R., Vasudevan, P., Marder, S. R., & Hu, R. J. (2001). Treatment with atypical antipsychotics: New indications and new populations. Journal of Psychiatric Research, 35(3), 187–191. https://doi.org/10.1016/S0022-3956(01)00020-6.
- Hayes, S. C., Wilson, K. W., Gifford, E. V., Follette, V. M., & Strosahl, K. (1996). Experiential avoidance and behavioral disorders: A functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64(6), 1152-1168.
- Hofmann, S. G., Curtiss, J., & McNally, R. J. (2016). A complex network perspective on clinical science. Perspectives on Psychological Science, 11(5), 597-605.
- Hofmann, S. G., & Hayes, S. C. (2019). The future of intervention science: Process-based therapy. Clinical Psychological Science, 7(1), 37-50.
- Hofmann, S. G., Meur
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:03):
You're listening to Why We Do What We Do. Welcome
to Why We Do What We Do. I am your
still reeling in the diagnosis stew, but not S-T-U, S-T-E-W, Abraham.
Speaker 2 (00:26):
And I'm your purple hat host, Shane.
Speaker 1 (00:30):
We are a psychology podcast. We talk about the things
that humans and non-human animals do. And this one's a
little bit unique in that we had recorded a discussion.
We decided to call that discussion and knew that we
had a second part. So we paused that discussion. We
did a part two. But the part two went really long,
like much longer than we were thinking it was going to.
(00:51):
By the time we were at the point where we
would have just called it another episode, we didn't realize
how far from the end we still were. So we
just kept recording. And so then that part two was
twice the length of part one. And we decided, let's
actually just chop this up so that there are about
three equal length parts. But we didn't know that when
we were recording. So we kind of had to interrupt
(01:12):
the end of the second part to create an ending.
And now we're bringing that next, the second half of
the second part to create a third part. If you're
following all of that crazy logic.
Speaker 2 (01:23):
So many parts.
Speaker 1 (01:24):
So many parts to create a new beginning. So that's
why we're here. So if you're joining us for the
first time, welcome. This is maybe not the best place
to jump right in. Nevertheless, I'll do our best to
describe what we've talked about in the first couple of parts.
And we'll segue then into the abrupt transition. into this
latter discussion for concluding our time with Dr. Stu Law
(01:47):
discussing diagnoses. Do they do more harm than good? Is
there anything that you'd like to add before we start our,
I guess, recap?
Speaker 2 (01:56):
No, I think we're ready.
Speaker 3 (01:57):
Okay.
Speaker 1 (01:58):
I will say, if you'd like to support us, you
can join us on Patreon, leave us a rating and
a review, like, subscribe, and tell a friend. And I'll
talk more about those things at the end of this discussion.
And at the end of this discussion, we'll do our
sort of normal wrap-up things with information about supporting us,
as well as our recommendations, which Dr. Sula will give
his recommendations in this part, because we thought this was
(02:19):
going to be the end. I think that's all the
things to say about that. Oh, it is a day today.
It is a day of the week.
Speaker 2 (02:27):
Yes, it is.
Speaker 1 (02:28):
As a day of the week, the day of the
week specifically being when this publishes, September 9th, I'll go
ahead and just quickly say that happy Teddy Bear Day.
Speaker 2 (02:36):
Yes, happy Teddy Bear Day. It's also happy Sudoku Day.
Speaker 1 (02:39):
I love Sudoku. I really do. It's Wienerschnitzel Day, which
I almost spelled correctly on my first try without double checking.
Speaker 2 (02:47):
I'm so proud of you.
Speaker 4 (02:47):
I mean, German, those types of languages are very tough
on spelling. It's Weirdos Day. So if you celebrate, enjoy that.
Speaker 1 (02:57):
Yeah. Weird Owls Day, maybe. It is Falsely Accused Day.
We did an episode on false confessions a long time ago,
which maybe that falls in line with that, but I'm sure.
Speaker 2 (03:07):
Yeah, it feels like it aligns.
Speaker 4 (03:08):
It is International Fetal Alcohol Syndrome Spectrum Awareness Day.
Speaker 1 (03:11):
It's a lot of words. That one's very important. Probably
worth doing a full discussion on, fetal alcohol syndrome at
some point.
Speaker 2 (03:16):
Yeah, for sure.
Speaker 1 (03:17):
It is inter... Boy, actually, speaking of diagnoses, and we're
like in an episode of diagnoses, but that one, more relevant. Yeah.
It is International Box Wine Day, for those of you
who celebrate in that way.
Speaker 4 (03:29):
Yeah, as opposed to bottled wine. It is a day
to protect education from attack.
Speaker 1 (03:34):
Oh, boy. We need more of these days. Yes. Agreed.
particularly in the United States, where education is on the
verge of being abolished.
Speaker 2 (03:42):
Yeah, yeah, yeah, yeah, yeah.
Speaker 1 (03:44):
All right. It is also Emergency Services Day. Emergency services
protect our education from our current administration.
Speaker 2 (03:51):
Yes, please, please, please, please, please.
Speaker 1 (03:53):
All right, we'll do our best to recap what we've
discussed in these previous couple segments. So the primary thesis
that we're sort of getting after here is sort of
what is a diagnostic system as it relates to things
like mental health and psychology and understanding cognitive issues, if
you will. And the.
(04:14):
Talking a little bit about the history of this idea
of something like the DSM, which is the primary United
States version of a manual for diagnosing specific conditions. And
what that does for us. I think one of the
things we pointed out is that like with these diagnoses,
we have the problem that they don't necessarily tell us
(04:36):
what to do about them. So a diagnosis does not
inform an intervention. And in most other cases, medical, mechanical, plumbing,
what have you, like a diagnosis also tells you in
part what the solution probably is. And that just is
not very much the case in psychology.
Speaker 3 (04:54):
Right.
Speaker 4 (04:54):
One of the issues that comes up in the DSM
so often, and we talk about it all the time
is like, there's just issues with overlap. So when we
kind of talk about this stuff, you're going to find that,
what might be better explained in one situation may not
actually capture what's going on for somebody. And so then
you have some overlap with other diagnoses and then you
have this issue or this problem of comorbidities that occurs
(05:15):
where now you've got somebody who has multiple diagnoses that
all don't really answer the question of the concern that's
occurring for that person. And you have these overlapping symptoms,
overlapping circumstances, and it creates a lot of problems for someone.
Speaker 1 (05:30):
There's such a lack of specificity in some of these
that two people at the same diagnosis might have zero
amount of the same symptoms. And that seems to indicate
that there's, it's the diagnosis, the diagnostic net is too
broad or in many ways it's too narrow. Like there
are two, it's too difficult to reliably produce a descriptor
(05:52):
of what someone is experiencing in this and trying to
do this in this way, because there's so, so, so
many variables that, to try and account for that this
particular system has not produced very meaningful outcomes. And we
do get into some of the ways that there is
utility in the system, because it's not to say it's
all useless. There's a reason this has existed and a
(06:13):
reason that it persists, because there are things in here
about it that do work. But I think, yeah, the
fact that you can have such wide variety in a
single diagnosis that doesn't It overlaps a lot with other diagnoses.
It doesn't necessarily tell you what the treatment is. And
you might have multiple people, the same diagnoses with completely
different symptoms makes it feel like a system that's not
(06:33):
doing very much for us. And I think that's the
central thesis of our discussion here is this is not
helping as much as it is possibly helping. causing some issues.
And one of those issues as well being things just
like people who get committed to the diagnosis that ends
up actually reducing their access to less restrictive environments because
(06:53):
they are sort of written off or pigeonholed into this
is who you are, immutable characteristic, full stop. Therefore, you
do not qualify for access to Other things that most
people have access to.
Speaker 3 (07:08):
Yeah.
Speaker 1 (07:08):
And then people believe it. Like they believe that about themselves,
that they're like, I don't deserve to do or be
these things because I have this diagnosis. It's who I am. And,
and that I think is counterproductive to how we would
like to generally treat people who show up in the
world in a slightly different way. And to that point,
one final note, I'll end on his wrap up for
myself is this idea that like normal is not a thing.
(07:30):
There is no such thing as a normal way to think.
There is no such thing as a normal way to be.
There is no such thing as a normal way to
have cognition. There are pathological ways for those things to exist,
but there are not normal ways for those things to exist.
There's just a huge diversity and variety in how people
show up in the world cognitively, mentally, behaviorally, and that
(07:53):
that's okay. That is just the way that human beings
and non-human beings are. Is there anything else you'd like
to add for the wrap-up that I maybe missed?
Speaker 2 (08:00):
No, I think that covers it. I think it sounds
like diagnoses are a problem.
Speaker 1 (08:06):
Which I think we're making that case. And as I said,
we'll get to, I think in this discussion, what aspects
of it are still beneficial. But all right. So I
think we've done the things. We mentioned how to support us.
We talked about the holidays. We've recapped our previous episodes.
Is there anything that I'm missing or you'd like to
add before we make our awkward transition into the middle
of the conversation that we cut in half from last week?
Speaker 2 (08:28):
No, I think let the awkward parts of this rain.
I think it'll be good.
Speaker 1 (08:32):
So take it away with the transitions.
Speaker 2 (08:34):
Here we go with the thing.
Speaker 1 (08:43):
All right, let's get into another concern here that I,
we've sort of already alluded to this, but this idea
that like diagnoses become identities. This fact that like you
pointed to, there are people who like sometimes there is
relief from having a label. But there's also the other
side of this coin that is the, I now am
(09:04):
limited in the things that I can do, I can experience,
I can be because of my label. And people choose that.
And then there's the like, I need to live into
the reality of how I understand my label to be
a limiting factor for me. And that the language around
this drives their behavior in a way that I would
(09:26):
argue is has them have less access to the kind
of quality of life they might otherwise have chosen for
themselves than they would have if they'd never received that label.
Like if they had believed for themselves that I can
be anything I want to be, I can have whatever
life I choose to be, versus I am a person
who cannot succeed because of my diagnosis, or I can
(09:48):
only succeed in a limited capacity. That to me, I
think I find very troublesome about this system. And definitely
one of the places where I see it doing more
harm than it might be doing good.
Speaker 3 (09:59):
Yeah, I think that it's not a net negative per se.
I think these things can be good or bad, right?
And you might think of these in terms of like
cognitive fusion. So like a process of thinking of oneself
in one particular way. Fusion can be good. Fusion can
be like, I'm a dad and that's really important part
of my identity. And that's how I go about facing
(10:20):
the world. But there are lots of ways and it's
easy to imagine. And I've seen a lot of, okay,
we need to get you out of the frame of
mind that you can't read because you have dyslexia or
you can't get out of bed because you have depression.
And we have to like break the fusion between this
thing as an identity. And this thing as something that
(10:43):
you're dealing with that isn't part of who you are,
but part of how you're interacting with your environment. I
have an example that's kind of, you know, it feels
almost like feels a little incendiary, but I don't, you know,
I think if you boil it down, it's actually really
compassionate from my view. And it is, I worked with
a school and they had a, the saying of the
(11:05):
school was autism is not an excuse for lowered expectations. Ooh, girl,
like it. I mean, I just like, I was, I
remember thinking like, how did you even get away with that? Right. Like,
and that feels, I, I tend to agree with it
in the sense that, um, In that one, people tend
(11:27):
to take this biologically deterministic view. So too do professionals
who work with that person, right? Like, so the person
themselves can be biologically deterministic about, I can't do this
because my biology won't let me. so do other people
who work with them. And that's a limiting factor. And
so I tend to look at that saying as like,
(11:49):
we are going to hold ourselves accountable and we, you
should expect great things out of your son or daughter
when they attend our program, because we're going to hold
ourselves to account because we think that although autism is
a thing and we interact with it in some way,
and it has some pragmatic utility as a term, We
also are going to push, right, when we're going to
(12:10):
like see where the boundaries of this thing are. And
we are accountable to the student, not just existing in
this school and not hitting other kids, but thriving and
learning and growing. And I think part of the, you know,
the other side of that biologically deterministic thing. implication of
a protocol for syndromes approach to mental wellness is a
(12:32):
lot of people can give up on you and nobody
blames them. Nobody says like, you know, like, Oh, my
kid can't read because he has dyslexia. The teachers can't
teach him. That's just, that was just never going to happen. Yeah. Whereas,
you know, you being in the business that you're in,
you've probably met what, like 65 kids with dyslexia and
I can't imagine it's ever amounted to much. Because you're
(12:53):
accountable to like, what do I need to do to
move this kid forward based on the things that I'm
seeing at the level of the individual? It's never, and
I can tell you this for sure. It's never been
an excuse as to why you're not making progress, right?
It's never been, we're not making progress because dyslexia. And
that's not to say that dyslexia isn't like descriptive of something,
(13:13):
but it's not getting you off the hook as a practitioner.
And I think that has happened as a byproduct of
this approach and this stance.
Speaker 1 (13:23):
Yeah, yeah. It definitely does seem to in a lot of...
And including the people who have the diagnosis themselves, thinking, again, now,
this is a can't for me. I'll never be able to.
And yeah, you're exactly right. Of all the people I've
met with dyslexia diagnosis, there are... Boy, I'm gonna get
myself in some hot water here. But maybe two that
(13:46):
I felt like actually... that was descriptively predictive of their
struggle to acquire reading skills. It did not mean that
they couldn't acquire reading skills. It just meant it was
a lot more challenging than other that I have faced,
despite the many people who have had those diagnoses where
it was like, here's structured reading curriculum. Oh, they're reading
just fine. Great job done. But there was maybe two
(14:09):
where I was like, oh, we actually need to do
quite a bit more work to identify what are the
steps that need to work for this individual to help
get them to the point where they're reading more effectively.
Speaker 3 (14:19):
Yeah.
Speaker 1 (14:20):
Than they currently are, I guess. And, and at the
point that gets them to the point where this is
just a, it feels easier to them and it's not
much of a struggle, but the people around them often
have that very limited, like, well, but does this work
with kids with dyslexia? I'm like, does science work? Yes,
it does. It still works. Yeah. Like when we, when
the process, we take the process based approach, It works.
(14:42):
It just does. So, and actually I feel like that
in the sake of time, I think we need to
sort of segue and collapse a couple of discussions into one,
which is the sort of, is there a way out
of this? And where do we go from here? And
we've been talking about it this whole time. And I,
but really quick devil's advocate thing I want to throw
in there is the, that I, if we have time,
I'd love for you to maybe provide a counterpoint to this.
(15:05):
is I think there is a very realistic argument that
a lot of people who are very pragmatic would make
about the diagnostic system, which is that the diagnostic system
creates a pathway by which people can get access to
services that they would otherwise not have access to and
would potentially benefit from. Yeah, and I.
Speaker 3 (15:26):
Don't disagree with that. I don't think that these systems
are without their utility. I mean... If you get a
couple of drinks in me and I say they have
done more harm than good, it could be close, right?
It could be kind of close. And that is to
say that they have done good. And I think that
if we can get some compassion and a way forward
(15:47):
for people, that certainly has happened inside of the system, right?
And if these diagnoses are a way to get people
into programs that are effective at treating what's happening, then great.
So yeah, I don't necessarily disagree with that statement, but
I would say that when you're in the chair, when
you are the practitioner and you've learned person has XYZ disorders,
(16:12):
I tend to call those things minimally orienting to issues
of cancer. I need to know about 500,000 more things
about you, about your culture, about your household, about the
expectations that you're under, about your reinforcers, about a billion
other things that that I need to figure out about
you before I'm able to leverage an effective treatment. So,
(16:35):
you know, again, when somebody asks online, what's an effective
treatment for dyslexia? The only answer is I don't know
for that person, but there's a lot of questions that
I would have you ask that are going to get
you closer to an effective solution. And so, yeah, it's
a fine starting point. And if, if these things lead
(16:56):
to effective interventions and, I tend to think that those
effective interventions are going to be more process-based. And in
my experience of effective clinicians, they are. But if it's
what gets a foot in the door, great. But there's
also sort of downfalls to that. Like autism means God
knows what right now. Because just logically, any compassionate psychologist
(17:20):
who wants a person to receive effective treatment or effective
access to some service, call it autism. And that is
a rational thing to do.
Speaker 1 (17:29):
Yeah, it's practical.
Speaker 3 (17:31):
As such, if you tell me that I'm meeting with
a new client today and all I know about them
is that they have autism, I don't know about that person. Like,
it could mean any number of things. And, you know,
so I tend to say, like, these things can be
minimally orienting at their best. Awesome.
Speaker 1 (17:50):
That makes a lot of sense. And ads are minimally
useful at their best. Okay, let's go ahead and let's
try and wrap this one up essentially with a discussion
of like, as you said, more harm than good doesn't
mean zero good. It just means that we feel like
(18:10):
the weight of the problems that have been created is
greater than the weight of the solutions that have maybe
been created. But that being said, there is probably a
way we can continue to move forward as a field,
as a country, as a species to help ourselves, help
each other with some of these approaches. So let's enumerate
(18:32):
a few of those approaches and what that would look like.
Speaker 3 (18:35):
So something to be on the lookout for, it's newfangled
and it's in a very small pocket of the science
right now, but I think it's going to grow in popularity,
is science. Idionomic approaches to psychological distress. So idio again
means starting at the level of the individual. So if
you remember that ergodic theorem thing, you cannot start at
(18:55):
the level of the collective. and boil it down to
the level of the individual that is mathematically incorrect to
do every time. So if you work with individuals, you
can't do that. You have to start at the individual level.
And then what behavior analysis has struggled to do is
then translate that thing into something that is a broad
principle that other people can then draw from and adapt
(19:16):
their practice around. But that is those limiting factors and
the kinds of things that kept us from being able
to do that, I tend to think are becoming less
frequent or less problematic, let's say. So there used to
be statistical models that, you know, again, statisticians revolved around
selection at the level of the population. That's kind of
(19:38):
built into statistical models. But there are statistical models that
are coming out that start at the level of the individual.
For example, group iterative multimodal estimation or GIMI is one
that tries to group populations together somewhat organically. So I
only say that you're a member of this population and
that this treatment will be effective for you when you've
(20:00):
demonstrated to me that you are a member of that
population according to the processes. So... That sounds crazy, but
I'll give you an example that came out of our lab.
One of my colleagues, Dr. Brandon Sanford, did a study
on burnout. Burnout, as you might imagine, although it's not
a true blue DSM diagnosis, is something that you could reasonably,
(20:24):
in the field of psychology, ask the same kinds of
questions of. Does ACT work for burnout? Right. And we
treat it as one thing. And then we say there's
some kind of treatment or some model or set of
protocols that we can throw at that thing that then
allow us to be more effective at orienting to it. Well,
Brandon asked a different question. He said, we're going to
take a bunch of people who report having burnout and
(20:46):
we're going to ask the question, are they the same?
And is their process the same? And would we be
right in prescribing a similar treatment to them? Right. And
so he grabbed a bunch of people with burnout. And
one of the things that kind of sucks about process-based
stuff is that you need a lot of data points
at the level of the individual. So you need like
time series stuff. So he had all these people install
(21:07):
apps on their phone and the app would ask them
things like three, four times a day. Like, how are
you feeling? How was your night? How did it prepare
you for this morning? What are you thinking? What are
you looking forward to? Right. All these kinds of random
questions that are designed to sort of understand the process
of burnout that they're experiencing. And across 36 people, there
(21:28):
were very few people who had similar kinds of burnout
to our point. This is what we might expect. And
their process of burnout was unique to them. But I
think what was somewhat surprising to us is if you
just look at it logically, what might be therapeutic to
one person could be counter-therapeutic to another person. So let's
take two people. We've got rick and rick is claiming
(21:52):
he's experiencing burnout what he has a really stressful job
he goes to work he puts his head down he
does everything he can he's he's on a path he
believes in what he's doing he likes his company he's
living he's serving his values and then when he comes
home he has too many beers he unwinds in ways
that are unhealthy let's say he drinks too much smokes
(22:15):
weed and plays video games in a way that is
hurting his relationship with his family, right? Let's say that
he's saying like, oh, hell yeah, I'm burnt out. I
wake up, I'm tired, right? It very logically could end
up in a space where he's identifying this as burnout.
My job is burning me out and I have to
come home and engage in this ritual that, you know,
is pushing me up from the things that are important
(22:37):
to me. Well, values clarification might be really effective for Rick,
did I say? For Rick, right? But like Rick might
need some values clarification. Like, hey, I know you feel
or like some cognitive diffusion. Like, I know you're saying like,
I have to unwind. You do not have to unwind
in this way. And it's putting you on a path
and it's having you interact with a process that is
(22:59):
pushing you away from the things that are important to you.
And it's going to lead to bad outcomes soon if
it hasn't already. And then you have Susie. And Susie
is going to work and she's at a dead end job.
She doesn't work that hard. She mails it in. She
knows what's important to her. She understands very clearly what's
important to her. And that's part of what's burning her
out because she recognizes her job as dead end. It
(23:22):
is not leading to fruitful things. She feels patronized by
the tasks that she does every day. She feels like
she's capable of more and she wants to change the world.
But she's in a space where that's not possible right
now because financial constraints, family, those kinds of things. Now,
if you were to do the same treatment that you
did with Rick, I would argue that that's likely to
(23:42):
be counter therapy. with Susie. If you were to do
values clarification with somebody who's experiencing burnout as a function of,
I don't get to do the things that are important
to me ever. And you sit them down for like
half an hour and you're like, let's do values. They're
just going to be more present with like, oh yeah,
I really want to do this, but that's unavailable to me.
(24:02):
And so like, what is therapeutic for one person could
be counter therapeutic to another. And when you average it out,
It looks like this thing is a net positive for
most people, but oftentimes when we look at those kinds
of studies, there's like probably 40% of people for which
they experienced negative outcomes or it was counter-therapeutic. That's very
(24:24):
common in that kind of literature. So I forgot what
the original question is, but I think that paints the
picture of like, you can't call burnout one thing. If
you don't understand at the level of the process, you
risk doing things that are explicitly counter-therapeutic. And those things
are available to us now. So like we used to
listen to the radio and the radio kind of sucked.
(24:46):
You recommended Protest the Hero. Protest the Hero was maybe
on the radio like a handful of times on some
like armpit stations, you.
Speaker 1 (24:53):
Know, like something alternative and hard to find.
Speaker 3 (24:56):
Right. Like, but most of the, if you want, if
you're into metal, guess what? You like Metallica and Nickelback.
Like that is, that is what's available to you on
the radio. And that is not something that would satisfy you, right?
But now we live in an era where listening to
the radio, I can't imagine what I would do if
I walked into a car and somebody listened to the
radio still. What are you doing? There's so much more
(25:19):
ways to tailor the things that are important to you
to the things that scratch that itch. So we live
in a world where the expectation of tailoring things to
the individual is not crazy anymore. it used to be
kind of crazy because it just seemed impractical. It still
is somewhat like the dropout rates of idiot. Idiomic studies
(25:41):
is really high. A lot of people are like, fuck this.
I got to check in on my phone every day.
That sucks. I'm going to, so like the attrition on
studies like that goes up and there's challenges to be
had here. But what you end up with at the
end of the day, if you do it right is,
you know what? Susie's like, I'm calling this burnout because
I'm not contacting values. She looks a lot like, you know,
(26:02):
this person over there, the rock, right? She looks a
lot like the rock and the rock is experiencing something
different as well. And Gaston over here, he looks more
like Rick. And if we put them in a group together,
they would actually have a lot of overlap in terms
of the kinds of treatment processes that would be effective
for them both. And so it's not that we can't
(26:23):
lump people together and we can't treat people as populations.
It's just that we have to do so starting at
the individual level. And we have to demonstrate that they
are part of the same group. We can't just say population.
But you can go bottom up. So that's what I'm
pushing for in the field is more studies, more things
that hold the level of the individual sacred, and then
(26:47):
try to move things into more broad principles. And, Statistical models, algorithms,
as you can imagine, just like your standard nod to
AI these days is something that is magically going to
solve this problem for us. Maybe, you know, like there
are ways that we can hold the level of the
individual sacred and boil it up to the level of
(27:09):
the individual. We're getting much more sophisticated at that. And
that's true in medicine too. So precision medicine is not
a crazy idea. It used to be we treat cancer
at the level of the population. It's not crazy to
go to certain places and find that they're not interested
in treating cancer. They're interested in treating your cancer. And
they measure different things and they look at different processes
(27:30):
and they want to see how you're responding and what
you're doing that's specific to your biology. This notion of
like starting at the level of the individual and holding
that sacred is not crazy. I'm not that far on
an island. I am on an island and I do
sound pseudoscientific at times, but there is a pretty substantial
evidence base that I think is coming on like a
(27:51):
freight train. And I think fence fits modern sensibilities and
modern technologies in such a way that this isn't a
crazy idea.
Speaker 1 (27:58):
Yeah. Here's an ad for that. Yeah. All right, we're back.
I think we're getting close here, too. Would it be
fair to say in your description of process-based approach, help
people wrap their head around what that actually means, that
(28:19):
what we're talking about here is that it is looking
at a variety of factors and allowing it to be
dynamic so that whatever you are assessing, whatever you're trying
to introduce as an intervention, whatever Like they essentially roll
with the changes as they happen. It's not just administer
this thing and it just does what it does. It's
(28:39):
like as this intervention is doing this thing, all of
a sudden a new way that this person is presenting
is starting to show up. And so we can either
ease back on something or we can push harder on
something or we can introduce something new. But it's looking
at like how is this– The process is that it's
(29:00):
individually tailored to you, and it's individually tailored to you
in a dynamic way that adjusts as needed in an
ongoing way. And obviously, the goal is to, as much
as possible in most things, to fade that out. That
what we want to have happen is you only have
this process in as long as you need that process.
For some people, that might be a really, really long time.
(29:20):
But for some people, it might just be like once
you've gotten sort of on a slightly different trajectory, all
the sort of natural things in your world pick up
from there and they'll kind of carry it forward without
you really needing me anymore. And then most people will
fall on some spectrum of that where it's like indefinite
need for continued support versus the individual. But point being that. like,
(29:40):
it's essentially custom tailored to identify variables that are relevant
in a dynamic way. Does that sound like an appropriate
way to describe that?
Speaker 3 (29:49):
Yeah. And to put it very loosely, I've used a
couple of metaphors. They're imperfect. One is we don't, in psychology,
you don't make sweatpants that are designed to fit. everybody
or like have three sizes, right? You got, or even
five sizes. You are a tailor. Your job is to
tailor something to somebody's tastes and to their measurements. And
(30:10):
that is a very different game. The other analogy is
if you were a chef, you are not cooking out
of a recipe book. You are like on top chef
or chopped where you're given a set of ingredients that
is unfamiliar and foreign to you. And your job is
to make it make sense, knowing what you know about food. Right.
It's not like you turn everything into lasagna because you
(30:33):
have a recipe for lasagna. You're not going to do
very well on those shows if that's how you treat
your approach. And I would argue the same is true
of good psychologists. In my experience, good psychologists get weird
ingredients and they're like, oh, I know what, you know,
in the same way that a chef understands that. Like.
Acid cuts fat, you know, like and here's how if
(30:56):
you were to whip this, it would create some effect
that is nice. Right. And fits well with this thing.
It feels less sciencey. Right. When you're not giving a
just oddly, it feels more artsy fartsy like you're doing
something artistic. But I would argue that those things are sciencey, too.
They're just not what we're used to being science. We're
(31:17):
used to, so, you know, one thing my advisor said
at a recent conference was we're used to asking the
question about evidence-based practice, but we need to start asking
about practice-based evidence. So basically like we sort of know
that psychologists do a lot of things at the level
(31:37):
of process. It's not crazy. to say like we adapt
and change to our people. We just need scientific bodies
of evidence that support that way of doing things. And
that is what's lacking. And I think that we're entering
an era where that is very much possible, both in
scary ways and in cool ways. And I'd like to
(31:59):
see more of it. And for those members of your
audience that are behavior analytically minded, I think particularly so
because you already kind of have an affinity and you
already kind of If I can make the assumption, you've
already kind of detected there's something wrong with going top down.
You know, like when you have a person in front
of you, you are problem solving, you are changing, you
are dynamic and you are interacting with a dynamic system.
(32:22):
And that's what's exciting about the science to you. If
I can be so bold as to assume that about you.
Speaker 1 (32:28):
I would say that one of my favorite things about
my job is when it's, The data will tell you
one thing, but just like sitting across from somebody and
interacting with them and saying, oh, I see. I think
I see what you're doing here that's gotten in the way.
And like I could tell from the data that things
aren't going the way that it would like ideally they'd
be going. But I can't tell what that thing is
until I've observed. And now I can say, OK, let's
(32:50):
try a slightly different approach to this this way and
then see what happens. And that's the like the fun
part is the like I want to. I think I'm
gleaning something from our interaction here that tells me that
I sense where a deficit might exist or where just
a slightly different amount of coaching or approach to this
(33:10):
could actually make the difference for you and being able
to get over the sort of threshold that you seem
to be stuck at. And yeah, and I think that
that was a very, very, very difficult skill to train.
Speaker 3 (33:20):
It is.
Speaker 1 (33:21):
That comes from a ton of experience and like coaching
and feedback and collaborating.
Speaker 3 (33:25):
I have to believe it's possible. I think we haven't
done it. We don't have a lot of effective strategies
for teaching it and we haven't felt an imperative to
teach it. But I think if we do, there are
ways forward. It's not like, I think there's a tendency
to go towards... Like there are people who get it
and people who don't. I don't think that that is true.
(33:45):
I think there are ways to get people to see
these things. And, you know, the old unks of behavior
analysis that are like, you need to shape a chicken
before you can work with a kid. You know, like
they have some there's some sense to that.
Speaker 2 (33:59):
Right.
Speaker 3 (34:00):
Like the ability to shape the ability to move with
and adapt and adjust and. and be amenable to and
be the thing that's needed in that moment is, is
a skill and it is a difficult skill to your point. And,
but I think where I tend to disagree with colleagues
and other people is in the notion that I believe
it is deeply teachable.
Speaker 1 (34:20):
Yeah.
Speaker 3 (34:21):
It's just, we're not used to doing it that way.
Speaker 4 (34:23):
Yeah.
Speaker 1 (34:25):
I do think it's, um, I just think it's difficult
to do. Yeah.
Speaker 3 (34:30):
And it also, I mean, it creates a level of
expectation for the job that I think is a little scary, right?
Like the idea that you take your problems home with you,
that you think about what you could do next, that
you're ready for some inevitable turn in your session next. Like,
I think people who are good, in my experience, they
(34:51):
have that burden and they have to find ways to
unburden themselves of those things. Because, you know, if... If
we live in a world of interactional determinism, there's always
a way forward. And if it's not happening, it's your fault, right?
And that is heavy. And that's something you got to
put down sometimes. And I think that that is a
(35:12):
challenge that we face as well.
Speaker 1 (35:14):
Very fair. Is there any sort of closing things you'd
like to leave with before we sort of transition to
our closing?
Speaker 2 (35:23):
You're a chef.
Speaker 3 (35:24):
You don't cook out of a cookbook. Remember that and
you're going to be okay.
Speaker 1 (35:28):
Very nice. All right, very good. Well, so that's the
argument there. Thank you, everyone, for listening. We'll go ahead
and let's... Let everyone know that we're going to be
doing some recommendations at the end of this, which is
a fun thing that we do just to recommend some
fun things because it's fun. And I'm also going to
go through our credits and everything and ask you to
support us in various ways. So ready, set, go. If
(35:50):
you'd like to support us, you can join us on Patreon.
If you do that, you'll get bonus content, ad-free content,
early episodes, and I will shout out your name in
the list of people who have taken the leap to
support us. So a giant shout out and thank you to...
Mike M, Megan, Mike T, Justin, Kim, Brad, Stephanie, Brian, Kiara, Charlie,
and Michael for all of your support and helping us
be a podcast. We appreciate it.
Speaker 2 (36:11):
Yes, you all are the best forever.
Speaker 1 (36:12):
Thank you to my team of people for without whom
I could not make this podcast writing and fact checking
from Shane and myself. And thank you for joining us
again for part two today, Stu.
Speaker 3 (36:21):
Yeah.
Speaker 1 (36:22):
Our social media coordinator is Emma Wilson. And our person
who managed to stitch together all of this content into
a cohesive unit is Justin, who is the best ever.
And we appreciate you. Thank you, Justin.
Speaker 2 (36:30):
Justin's the best too.
Speaker 1 (36:31):
And of course, thank you everyone for listening. All right.
I think that is what I have to say before
we transition to our recommendations. Oh, there's other ways to
support us. I sort of skimmed past. You can leave
us a rating and review. Those are free. You can like, subscribe,
tell a friend. And if you'd like to offer some
constructive criticism, you can email us directly at info at WWD,
WWD podcast.com. If you'd like to just tell us how
(36:52):
much you suck and how much you hate us, go
ahead and go to your nearest garbage can and yell
into it as long as you like, as loud as
you like. And I will get just as much out
of that. Otherwise, I look forward to hearing from people
and you can reach us on the social media platforms.
Now I think we're ready to transition to recommending some things.
Speaker 2 (37:07):
I like it.
Speaker 1 (37:07):
All right, let's do it. I'm recommending a card game.
This is not the heaviest game in the world. This
is a game called Flip 7. It's fairly new on
the scene. It has really sort of... It has gained
(37:29):
popularity at remarkable speed, which is kind of a red
flag sometimes. But it is a sort of push-your-luck style
card game.
Speaker 2 (37:37):
Sort of.
Speaker 1 (37:38):
It has like... You could see the DNA of Uno
in it, if Uno was a good game, and DNA
of Blackjack a little bit. The premise of the game, essentially,
is that there are a variety of cards that are
worth points. There are 12-12s, 11-11s, 10-10s, et cetera. But
if you ever get dealt a duplicate card, you bust
and you're out. But as long as you don't get
(37:59):
dealt a duplicate card, you can stop receiving cards at
any point. And then you get to keep all those points.
That's the gist of the game. It's really straightforward. Everybody
gets a turn. You get to hit or stay. And
then everyone just keeps going until either everyone is out
or everyone has stayed. And then you get to add
up your points. And it's trying to get to the
first person to get to 200 points over several rounds,
which only actually takes about 30 minutes, maybe even less.
I've definitely played this game with like 13 people in
(38:21):
like 20 minutes. So it really doesn't take long to do.
Plus it has these action cards. You can force people
to draw cards or force them to stay. They're kind
of fun. And some cards that also make your points
worth more points, which is also fun. There's also Flip
7 with a Vengeance. It's just a much meaner version
of the game. It's okay. If you like being mean
to people, then probably it's up your alley. Otherwise, they're
really cheap. It's only like 10, 15 bucks maybe. And
(38:43):
it's really small. It's just a deck of cards. And
it can play up to 17 people in a single go.
So it's very accommodating in that way. So it's a
recommend because I think that if you're going to pick
up a silly, easy, quick card game that accommodates a
lot of people, you could do a lot worse than
Flip 7. Substantially, substantially worse. A lot worse, like Uno.
But that is the game I'm recommending. Stu, do you
(39:06):
have a recommendation you'd like to share?
Speaker 3 (39:08):
Yeah, I got a bunch. I don't think you can
play Flip 7 with me because every time I flip
a card, I say, I'm going to bust!
Speaker 4 (39:15):
That's too bad.
Speaker 1 (39:18):
Challenge accepted.
Speaker 3 (39:19):
Don't play with me. So my recommendations, I'm going to
make a bunch just cause I'm not here that often.
Speaker 1 (39:24):
I'm only here.
Speaker 3 (39:27):
Okay. One recommendation I have, it's a YouTube channel. It's
also on that. It's like kind of the flagship show
of that kooky thing. Nebula that like YouTube, but for creators, yada, yada.
Speaker 2 (39:40):
Okay.
Speaker 3 (39:41):
It's called jet lag, the game. It's a bunch of
dorks that I love and they're very endearing and they're
very funny. And they have a travel game where they
make board games out of traveling. So they play connect
for across the U S by like flying and taking
different forms of transportation. And you conquer a city by,
or you conquer a state by like entering that state
and then completing some challenge. And then Texas turns yellow. Right.
(40:03):
And so yellow versus red. And so they're playing connect
for across the U S they play hide and go
seek in Japan. So one person gets like six hour
headstart and then, They get to go anywhere in Japan
and hide in any place that's publicly available. And then
the other guys seek them out and it's a good time.
And it gives you a good sense of like how
(40:23):
traveling works in different places because they have to do
things like go to grocery stores and ride the train.
So it's one of my favorite travel shows. My next
recommendation is if you see a thesis or a dissertation
that reads to you as what you will now call
purple hat DBT. call them out and say, that's a
Purple Hat DBT thing. Yuck.
Speaker 2 (40:42):
Yucky.
Speaker 3 (40:43):
And so we need to ask better questions so that
the science of psychology doesn't take 8 billion years and
we're not asking questions like, does ACT work if you're
in a rocking chair? So some signs that you might
be looking at Purple Hat DBT is they open with,
such and such has worked a million times with a
million things, but does it work with Y? That is
(41:05):
the sign that you are maybe looking at a Purple
Hat DBT study. I'm going to recommend a book called
The Orphans of Davenport. And then the last thing is
a little shameless self-plug of Generate. So in Generate, especially
if you're behaviorally minded, we built an assessment that we
(41:27):
think adheres to these modern sensibilities that have been talked
about a little better than assessments that are on the market.
So I would make the claim that behavior analysis, while
it has some good instincts about keeping the level of
the individual sacred. It has fallen into a pattern of
responding to the medical model that it is finding itself
(41:47):
a part of. And I think that is despite a
lot of the ways that we talk about our noble
pursuits inside of it. So if you want a system
that supports you in saying, I'm not trying to make
your kit normal, we have one. And it's generate, but misspelled. Yeah.
Speaker 1 (42:06):
All right. I have all those links. Thank you. All right, Shane,
what are you recommending?
Speaker 4 (42:10):
I'm going to recommend a record that just came out
this year by a band called Show Me the Body.
And the album is Alone Together. This is a three
piece out of New York. And they're super interesting because
they're considered a post hardcore band, but they pull a
lot of influences from like metal and punk and hardcore.
They definitely have punk sensibilities in that they are very
much doing their own thing. but it's a three piece
(42:31):
and the lead singer plays a banjo and it's, uh,
it doesn't sound like a banjo. It sounds like an electrified, uh, something. And, um,
it's just a super interesting, this new record is just
super interesting, super dynamic. It's a little bit out of
the box for what people are listening to these days.
Like I can't like really pinpoint another band that sounds
like this band and go like, Oh yeah, they sound
(42:53):
like this.
Speaker 2 (42:53):
Like they kind of are very much their own thing.
So I don't know. It's worth, it's worth giving a listen.
If you want to hear something that's like kind of
like unique.
Speaker 1 (43:00):
Fun.
Speaker 3 (43:01):
Yeah.
Speaker 1 (43:01):
All right. So that's flip seven, the card game for me,
this YouTube jet lag, the game, and then calling people
out for purple hat, DBT theses and dissertations, and then
the orphans of Davenport and the generate assessment tool from Stu.
And then show me the body album alone together from Shane,
our recommendations. Thank you so much again for joining us today, Stu.
(43:23):
We appreciate having you here and all your time that
you spend with us this morning.
Speaker 3 (43:26):
Thanks for having me.
Speaker 1 (43:27):
Thank you all for listening. Is there anything I missed
or you'd like to add before we say our goodbyes?
Shane or Stu?
Speaker 3 (43:32):
Nope. Okay.
Speaker 1 (43:34):
All right. Then this is Abraham.
Speaker 2 (43:36):
This is Shane.
Speaker 3 (43:36):
Stu!
Speaker 1 (43:39):
We're out.
Speaker 4 (43:40):
Bye.
Speaker 1 (43:41):
You've been listening to Why We Do What We Do.
Speaker 3 (43:44):
You can learn more about this and other episodes by
going to www.wwdpodcast.com.
Speaker 1 (43:50):
Thanks for listening, and we hope you have an awesome day.
Speaker 3 (44:08):
Thanks for watching!
You're listening to Why We Do What We Do. Welcome
to Why We Do What We Do. I am your
still reeling in the diagnosis stew, but not S-T-U, S-T-E-W, Abraham.
Speaker 2 (00:26):
And I'm your purple hat host, Shane.
Speaker 1 (00:30):
We are a psychology podcast. We talk about the things
that humans and non-human animals do. And this one's a
little bit unique in that we had recorded a discussion.
We decided to call that discussion and knew that we
had a second part. So we paused that discussion. We
did a part two. But the part two went really long,
like much longer than we were thinking it was going to.
(00:51):
By the time we were at the point where we
would have just called it another episode, we didn't realize
how far from the end we still were. So we
just kept recording. And so then that part two was
twice the length of part one. And we decided, let's
actually just chop this up so that there are about
three equal length parts. But we didn't know that when
we were recording. So we kind of had to interrupt
(01:12):
the end of the second part to create an ending.
And now we're bringing that next, the second half of
the second part to create a third part. If you're
following all of that crazy logic.
Speaker 2 (01:23):
So many parts.
Speaker 1 (01:24):
So many parts to create a new beginning. So that's
why we're here. So if you're joining us for the
first time, welcome. This is maybe not the best place
to jump right in. Nevertheless, I'll do our best to
describe what we've talked about in the first couple of parts.
And we'll segue then into the abrupt transition. into this
latter discussion for concluding our time with Dr. Stu Law
(01:47):
discussing diagnoses. Do they do more harm than good? Is
there anything that you'd like to add before we start our,
I guess, recap?
Speaker 2 (01:56):
No, I think we're ready.
Speaker 3 (01:57):
Okay.
Speaker 1 (01:58):
I will say, if you'd like to support us, you
can join us on Patreon, leave us a rating and
a review, like, subscribe, and tell a friend. And I'll
talk more about those things at the end of this discussion.
And at the end of this discussion, we'll do our
sort of normal wrap-up things with information about supporting us,
as well as our recommendations, which Dr. Sula will give
his recommendations in this part, because we thought this was
(02:19):
going to be the end. I think that's all the
things to say about that. Oh, it is a day today.
It is a day of the week.
Speaker 2 (02:27):
Yes, it is.
Speaker 1 (02:28):
As a day of the week, the day of the
week specifically being when this publishes, September 9th, I'll go
ahead and just quickly say that happy Teddy Bear Day.
Speaker 2 (02:36):
Yes, happy Teddy Bear Day. It's also happy Sudoku Day.
Speaker 1 (02:39):
I love Sudoku. I really do. It's Wienerschnitzel Day, which
I almost spelled correctly on my first try without double checking.
Speaker 2 (02:47):
I'm so proud of you.
Speaker 4 (02:47):
I mean, German, those types of languages are very tough
on spelling. It's Weirdos Day. So if you celebrate, enjoy that.
Speaker 1 (02:57):
Yeah. Weird Owls Day, maybe. It is Falsely Accused Day.
We did an episode on false confessions a long time ago,
which maybe that falls in line with that, but I'm sure.
Speaker 2 (03:07):
Yeah, it feels like it aligns.
Speaker 4 (03:08):
It is International Fetal Alcohol Syndrome Spectrum Awareness Day.
Speaker 1 (03:11):
It's a lot of words. That one's very important. Probably
worth doing a full discussion on, fetal alcohol syndrome at
some point.
Speaker 2 (03:16):
Yeah, for sure.
Speaker 1 (03:17):
It is inter... Boy, actually, speaking of diagnoses, and we're
like in an episode of diagnoses, but that one, more relevant. Yeah.
It is International Box Wine Day, for those of you
who celebrate in that way.
Speaker 4 (03:29):
Yeah, as opposed to bottled wine. It is a day
to protect education from attack.
Speaker 1 (03:34):
Oh, boy. We need more of these days. Yes. Agreed.
particularly in the United States, where education is on the
verge of being abolished.
Speaker 2 (03:42):
Yeah, yeah, yeah, yeah, yeah.
Speaker 1 (03:44):
All right. It is also Emergency Services Day. Emergency services
protect our education from our current administration.
Speaker 2 (03:51):
Yes, please, please, please, please, please.
Speaker 1 (03:53):
All right, we'll do our best to recap what we've
discussed in these previous couple segments. So the primary thesis
that we're sort of getting after here is sort of
what is a diagnostic system as it relates to things
like mental health and psychology and understanding cognitive issues, if
you will. And the.
(04:14):
Talking a little bit about the history of this idea
of something like the DSM, which is the primary United
States version of a manual for diagnosing specific conditions. And
what that does for us. I think one of the
things we pointed out is that like with these diagnoses,
we have the problem that they don't necessarily tell us
(04:36):
what to do about them. So a diagnosis does not
inform an intervention. And in most other cases, medical, mechanical, plumbing,
what have you, like a diagnosis also tells you in
part what the solution probably is. And that just is
not very much the case in psychology.
Speaker 3 (04:54):
Right.
Speaker 4 (04:54):
One of the issues that comes up in the DSM
so often, and we talk about it all the time
is like, there's just issues with overlap. So when we
kind of talk about this stuff, you're going to find that,
what might be better explained in one situation may not
actually capture what's going on for somebody. And so then
you have some overlap with other diagnoses and then you
have this issue or this problem of comorbidities that occurs
(05:15):
where now you've got somebody who has multiple diagnoses that
all don't really answer the question of the concern that's
occurring for that person. And you have these overlapping symptoms,
overlapping circumstances, and it creates a lot of problems for someone.
Speaker 1 (05:30):
There's such a lack of specificity in some of these
that two people at the same diagnosis might have zero
amount of the same symptoms. And that seems to indicate
that there's, it's the diagnosis, the diagnostic net is too
broad or in many ways it's too narrow. Like there
are two, it's too difficult to reliably produce a descriptor
(05:52):
of what someone is experiencing in this and trying to
do this in this way, because there's so, so, so
many variables that, to try and account for that this
particular system has not produced very meaningful outcomes. And we
do get into some of the ways that there is
utility in the system, because it's not to say it's
all useless. There's a reason this has existed and a
(06:13):
reason that it persists, because there are things in here
about it that do work. But I think, yeah, the
fact that you can have such wide variety in a
single diagnosis that doesn't It overlaps a lot with other diagnoses.
It doesn't necessarily tell you what the treatment is. And
you might have multiple people, the same diagnoses with completely
different symptoms makes it feel like a system that's not
(06:33):
doing very much for us. And I think that's the
central thesis of our discussion here is this is not
helping as much as it is possibly helping. causing some issues.
And one of those issues as well being things just
like people who get committed to the diagnosis that ends
up actually reducing their access to less restrictive environments because
(06:53):
they are sort of written off or pigeonholed into this
is who you are, immutable characteristic, full stop. Therefore, you
do not qualify for access to Other things that most
people have access to.
Speaker 3 (07:08):
Yeah.
Speaker 1 (07:08):
And then people believe it. Like they believe that about themselves,
that they're like, I don't deserve to do or be
these things because I have this diagnosis. It's who I am. And,
and that I think is counterproductive to how we would
like to generally treat people who show up in the
world in a slightly different way. And to that point,
one final note, I'll end on his wrap up for
myself is this idea that like normal is not a thing.
(07:30):
There is no such thing as a normal way to think.
There is no such thing as a normal way to be.
There is no such thing as a normal way to
have cognition. There are pathological ways for those things to exist,
but there are not normal ways for those things to exist.
There's just a huge diversity and variety in how people
show up in the world cognitively, mentally, behaviorally, and that
(07:53):
that's okay. That is just the way that human beings
and non-human beings are. Is there anything else you'd like
to add for the wrap-up that I maybe missed?
Speaker 2 (08:00):
No, I think that covers it. I think it sounds
like diagnoses are a problem.
Speaker 1 (08:06):
Which I think we're making that case. And as I said,
we'll get to, I think in this discussion, what aspects
of it are still beneficial. But all right. So I
think we've done the things. We mentioned how to support us.
We talked about the holidays. We've recapped our previous episodes.
Is there anything that I'm missing or you'd like to
add before we make our awkward transition into the middle
of the conversation that we cut in half from last week?
Speaker 2 (08:28):
No, I think let the awkward parts of this rain.
I think it'll be good.
Speaker 1 (08:32):
So take it away with the transitions.
Speaker 2 (08:34):
Here we go with the thing.
Speaker 1 (08:43):
All right, let's get into another concern here that I,
we've sort of already alluded to this, but this idea
that like diagnoses become identities. This fact that like you
pointed to, there are people who like sometimes there is
relief from having a label. But there's also the other
side of this coin that is the, I now am
(09:04):
limited in the things that I can do, I can experience,
I can be because of my label. And people choose that.
And then there's the like, I need to live into
the reality of how I understand my label to be
a limiting factor for me. And that the language around
this drives their behavior in a way that I would
(09:26):
argue is has them have less access to the kind
of quality of life they might otherwise have chosen for
themselves than they would have if they'd never received that label.
Like if they had believed for themselves that I can
be anything I want to be, I can have whatever
life I choose to be, versus I am a person
who cannot succeed because of my diagnosis, or I can
(09:48):
only succeed in a limited capacity. That to me, I
think I find very troublesome about this system. And definitely
one of the places where I see it doing more
harm than it might be doing good.
Speaker 3 (09:59):
Yeah, I think that it's not a net negative per se.
I think these things can be good or bad, right?
And you might think of these in terms of like
cognitive fusion. So like a process of thinking of oneself
in one particular way. Fusion can be good. Fusion can
be like, I'm a dad and that's really important part
of my identity. And that's how I go about facing
(10:20):
the world. But there are lots of ways and it's
easy to imagine. And I've seen a lot of, okay,
we need to get you out of the frame of
mind that you can't read because you have dyslexia or
you can't get out of bed because you have depression.
And we have to like break the fusion between this
thing as an identity. And this thing as something that
(10:43):
you're dealing with that isn't part of who you are,
but part of how you're interacting with your environment. I
have an example that's kind of, you know, it feels
almost like feels a little incendiary, but I don't, you know,
I think if you boil it down, it's actually really
compassionate from my view. And it is, I worked with
a school and they had a, the saying of the
(11:05):
school was autism is not an excuse for lowered expectations. Ooh, girl,
like it. I mean, I just like, I was, I
remember thinking like, how did you even get away with that? Right. Like,
and that feels, I, I tend to agree with it
in the sense that, um, In that one, people tend
(11:27):
to take this biologically deterministic view. So too do professionals
who work with that person, right? Like, so the person
themselves can be biologically deterministic about, I can't do this
because my biology won't let me. so do other people
who work with them. And that's a limiting factor. And
so I tend to look at that saying as like,
(11:49):
we are going to hold ourselves accountable and we, you
should expect great things out of your son or daughter
when they attend our program, because we're going to hold
ourselves to account because we think that although autism is
a thing and we interact with it in some way,
and it has some pragmatic utility as a term, We
also are going to push, right, when we're going to
(12:10):
like see where the boundaries of this thing are. And
we are accountable to the student, not just existing in
this school and not hitting other kids, but thriving and
learning and growing. And I think part of the, you know,
the other side of that biologically deterministic thing. implication of
a protocol for syndromes approach to mental wellness is a
(12:32):
lot of people can give up on you and nobody
blames them. Nobody says like, you know, like, Oh, my
kid can't read because he has dyslexia. The teachers can't
teach him. That's just, that was just never going to happen. Yeah. Whereas,
you know, you being in the business that you're in,
you've probably met what, like 65 kids with dyslexia and
I can't imagine it's ever amounted to much. Because you're
(12:53):
accountable to like, what do I need to do to
move this kid forward based on the things that I'm
seeing at the level of the individual? It's never, and
I can tell you this for sure. It's never been
an excuse as to why you're not making progress, right?
It's never been, we're not making progress because dyslexia. And
that's not to say that dyslexia isn't like descriptive of something,
(13:13):
but it's not getting you off the hook as a practitioner.
And I think that has happened as a byproduct of
this approach and this stance.
Speaker 1 (13:23):
Yeah, yeah. It definitely does seem to in a lot of...
And including the people who have the diagnosis themselves, thinking, again, now,
this is a can't for me. I'll never be able to.
And yeah, you're exactly right. Of all the people I've
met with dyslexia diagnosis, there are... Boy, I'm gonna get
myself in some hot water here. But maybe two that
(13:46):
I felt like actually... that was descriptively predictive of their
struggle to acquire reading skills. It did not mean that
they couldn't acquire reading skills. It just meant it was
a lot more challenging than other that I have faced,
despite the many people who have had those diagnoses where
it was like, here's structured reading curriculum. Oh, they're reading
just fine. Great job done. But there was maybe two
(14:09):
where I was like, oh, we actually need to do
quite a bit more work to identify what are the
steps that need to work for this individual to help
get them to the point where they're reading more effectively.
Speaker 3 (14:19):
Yeah.
Speaker 1 (14:20):
Than they currently are, I guess. And, and at the
point that gets them to the point where this is
just a, it feels easier to them and it's not
much of a struggle, but the people around them often
have that very limited, like, well, but does this work
with kids with dyslexia? I'm like, does science work? Yes,
it does. It still works. Yeah. Like when we, when
the process, we take the process based approach, It works.
(14:42):
It just does. So, and actually I feel like that
in the sake of time, I think we need to
sort of segue and collapse a couple of discussions into one,
which is the sort of, is there a way out
of this? And where do we go from here? And
we've been talking about it this whole time. And I,
but really quick devil's advocate thing I want to throw
in there is the, that I, if we have time,
I'd love for you to maybe provide a counterpoint to this.
(15:05):
is I think there is a very realistic argument that
a lot of people who are very pragmatic would make
about the diagnostic system, which is that the diagnostic system
creates a pathway by which people can get access to
services that they would otherwise not have access to and
would potentially benefit from. Yeah, and I.
Speaker 3 (15:26):
Don't disagree with that. I don't think that these systems
are without their utility. I mean... If you get a
couple of drinks in me and I say they have
done more harm than good, it could be close, right?
It could be kind of close. And that is to
say that they have done good. And I think that
if we can get some compassion and a way forward
(15:47):
for people, that certainly has happened inside of the system, right?
And if these diagnoses are a way to get people
into programs that are effective at treating what's happening, then great.
So yeah, I don't necessarily disagree with that statement, but
I would say that when you're in the chair, when
you are the practitioner and you've learned person has XYZ disorders,
(16:12):
I tend to call those things minimally orienting to issues
of cancer. I need to know about 500,000 more things
about you, about your culture, about your household, about the
expectations that you're under, about your reinforcers, about a billion
other things that that I need to figure out about
you before I'm able to leverage an effective treatment. So,
(16:35):
you know, again, when somebody asks online, what's an effective
treatment for dyslexia? The only answer is I don't know
for that person, but there's a lot of questions that
I would have you ask that are going to get
you closer to an effective solution. And so, yeah, it's
a fine starting point. And if, if these things lead
(16:56):
to effective interventions and, I tend to think that those
effective interventions are going to be more process-based. And in
my experience of effective clinicians, they are. But if it's
what gets a foot in the door, great. But there's
also sort of downfalls to that. Like autism means God
knows what right now. Because just logically, any compassionate psychologist
(17:20):
who wants a person to receive effective treatment or effective
access to some service, call it autism. And that is
a rational thing to do.
Speaker 1 (17:29):
Yeah, it's practical.
Speaker 3 (17:31):
As such, if you tell me that I'm meeting with
a new client today and all I know about them
is that they have autism, I don't know about that person. Like,
it could mean any number of things. And, you know,
so I tend to say, like, these things can be
minimally orienting at their best. Awesome.
Speaker 1 (17:50):
That makes a lot of sense. And ads are minimally
useful at their best. Okay, let's go ahead and let's
try and wrap this one up essentially with a discussion
of like, as you said, more harm than good doesn't
mean zero good. It just means that we feel like
(18:10):
the weight of the problems that have been created is
greater than the weight of the solutions that have maybe
been created. But that being said, there is probably a
way we can continue to move forward as a field,
as a country, as a species to help ourselves, help
each other with some of these approaches. So let's enumerate
(18:32):
a few of those approaches and what that would look like.
Speaker 3 (18:35):
So something to be on the lookout for, it's newfangled
and it's in a very small pocket of the science
right now, but I think it's going to grow in popularity,
is science. Idionomic approaches to psychological distress. So idio again
means starting at the level of the individual. So if
you remember that ergodic theorem thing, you cannot start at
(18:55):
the level of the collective. and boil it down to
the level of the individual that is mathematically incorrect to
do every time. So if you work with individuals, you
can't do that. You have to start at the individual level.
And then what behavior analysis has struggled to do is
then translate that thing into something that is a broad
principle that other people can then draw from and adapt
(19:16):
their practice around. But that is those limiting factors and
the kinds of things that kept us from being able
to do that, I tend to think are becoming less
frequent or less problematic, let's say. So there used to
be statistical models that, you know, again, statisticians revolved around
selection at the level of the population. That's kind of
(19:38):
built into statistical models. But there are statistical models that
are coming out that start at the level of the individual.
For example, group iterative multimodal estimation or GIMI is one
that tries to group populations together somewhat organically. So I
only say that you're a member of this population and
that this treatment will be effective for you when you've
(20:00):
demonstrated to me that you are a member of that
population according to the processes. So... That sounds crazy, but
I'll give you an example that came out of our lab.
One of my colleagues, Dr. Brandon Sanford, did a study
on burnout. Burnout, as you might imagine, although it's not
a true blue DSM diagnosis, is something that you could reasonably,
(20:24):
in the field of psychology, ask the same kinds of
questions of. Does ACT work for burnout? Right. And we
treat it as one thing. And then we say there's
some kind of treatment or some model or set of
protocols that we can throw at that thing that then
allow us to be more effective at orienting to it. Well,
Brandon asked a different question. He said, we're going to
take a bunch of people who report having burnout and
(20:46):
we're going to ask the question, are they the same?
And is their process the same? And would we be
right in prescribing a similar treatment to them? Right. And
so he grabbed a bunch of people with burnout. And
one of the things that kind of sucks about process-based
stuff is that you need a lot of data points
at the level of the individual. So you need like
time series stuff. So he had all these people install
(21:07):
apps on their phone and the app would ask them
things like three, four times a day. Like, how are
you feeling? How was your night? How did it prepare
you for this morning? What are you thinking? What are
you looking forward to? Right. All these kinds of random
questions that are designed to sort of understand the process
of burnout that they're experiencing. And across 36 people, there
(21:28):
were very few people who had similar kinds of burnout
to our point. This is what we might expect. And
their process of burnout was unique to them. But I
think what was somewhat surprising to us is if you
just look at it logically, what might be therapeutic to
one person could be counter-therapeutic to another person. So let's
take two people. We've got rick and rick is claiming
(21:52):
he's experiencing burnout what he has a really stressful job
he goes to work he puts his head down he
does everything he can he's he's on a path he
believes in what he's doing he likes his company he's
living he's serving his values and then when he comes
home he has too many beers he unwinds in ways
that are unhealthy let's say he drinks too much smokes
(22:15):
weed and plays video games in a way that is
hurting his relationship with his family, right? Let's say that
he's saying like, oh, hell yeah, I'm burnt out. I
wake up, I'm tired, right? It very logically could end
up in a space where he's identifying this as burnout.
My job is burning me out and I have to
come home and engage in this ritual that, you know,
is pushing me up from the things that are important
(22:37):
to me. Well, values clarification might be really effective for Rick,
did I say? For Rick, right? But like Rick might
need some values clarification. Like, hey, I know you feel
or like some cognitive diffusion. Like, I know you're saying like,
I have to unwind. You do not have to unwind
in this way. And it's putting you on a path
and it's having you interact with a process that is
(22:59):
pushing you away from the things that are important to you.
And it's going to lead to bad outcomes soon if
it hasn't already. And then you have Susie. And Susie
is going to work and she's at a dead end job.
She doesn't work that hard. She mails it in. She
knows what's important to her. She understands very clearly what's
important to her. And that's part of what's burning her
out because she recognizes her job as dead end. It
(23:22):
is not leading to fruitful things. She feels patronized by
the tasks that she does every day. She feels like
she's capable of more and she wants to change the world.
But she's in a space where that's not possible right
now because financial constraints, family, those kinds of things. Now,
if you were to do the same treatment that you
did with Rick, I would argue that that's likely to
(23:42):
be counter therapy. with Susie. If you were to do
values clarification with somebody who's experiencing burnout as a function of,
I don't get to do the things that are important
to me ever. And you sit them down for like
half an hour and you're like, let's do values. They're
just going to be more present with like, oh yeah,
I really want to do this, but that's unavailable to me.
(24:02):
And so like, what is therapeutic for one person could
be counter therapeutic to another. And when you average it out,
It looks like this thing is a net positive for
most people, but oftentimes when we look at those kinds
of studies, there's like probably 40% of people for which
they experienced negative outcomes or it was counter-therapeutic. That's very
(24:24):
common in that kind of literature. So I forgot what
the original question is, but I think that paints the
picture of like, you can't call burnout one thing. If
you don't understand at the level of the process, you
risk doing things that are explicitly counter-therapeutic. And those things
are available to us now. So like we used to
listen to the radio and the radio kind of sucked.
(24:46):
You recommended Protest the Hero. Protest the Hero was maybe
on the radio like a handful of times on some
like armpit stations, you.
Speaker 1 (24:53):
Know, like something alternative and hard to find.
Speaker 3 (24:56):
Right. Like, but most of the, if you want, if
you're into metal, guess what? You like Metallica and Nickelback.
Like that is, that is what's available to you on
the radio. And that is not something that would satisfy you, right?
But now we live in an era where listening to
the radio, I can't imagine what I would do if
I walked into a car and somebody listened to the
radio still. What are you doing? There's so much more
(25:19):
ways to tailor the things that are important to you
to the things that scratch that itch. So we live
in a world where the expectation of tailoring things to
the individual is not crazy anymore. it used to be
kind of crazy because it just seemed impractical. It still
is somewhat like the dropout rates of idiot. Idiomic studies
(25:41):
is really high. A lot of people are like, fuck this.
I got to check in on my phone every day.
That sucks. I'm going to, so like the attrition on
studies like that goes up and there's challenges to be
had here. But what you end up with at the
end of the day, if you do it right is,
you know what? Susie's like, I'm calling this burnout because
I'm not contacting values. She looks a lot like, you know,
(26:02):
this person over there, the rock, right? She looks a
lot like the rock and the rock is experiencing something
different as well. And Gaston over here, he looks more
like Rick. And if we put them in a group together,
they would actually have a lot of overlap in terms
of the kinds of treatment processes that would be effective
for them both. And so it's not that we can't
(26:23):
lump people together and we can't treat people as populations.
It's just that we have to do so starting at
the individual level. And we have to demonstrate that they
are part of the same group. We can't just say population.
But you can go bottom up. So that's what I'm
pushing for in the field is more studies, more things
that hold the level of the individual sacred, and then
(26:47):
try to move things into more broad principles. And, Statistical models, algorithms,
as you can imagine, just like your standard nod to
AI these days is something that is magically going to
solve this problem for us. Maybe, you know, like there
are ways that we can hold the level of the
individual sacred and boil it up to the level of
(27:09):
the individual. We're getting much more sophisticated at that. And
that's true in medicine too. So precision medicine is not
a crazy idea. It used to be we treat cancer
at the level of the population. It's not crazy to
go to certain places and find that they're not interested
in treating cancer. They're interested in treating your cancer. And
they measure different things and they look at different processes
(27:30):
and they want to see how you're responding and what
you're doing that's specific to your biology. This notion of
like starting at the level of the individual and holding
that sacred is not crazy. I'm not that far on
an island. I am on an island and I do
sound pseudoscientific at times, but there is a pretty substantial
evidence base that I think is coming on like a
(27:51):
freight train. And I think fence fits modern sensibilities and
modern technologies in such a way that this isn't a
crazy idea.
Speaker 1 (27:58):
Yeah. Here's an ad for that. Yeah. All right, we're back.
I think we're getting close here, too. Would it be
fair to say in your description of process-based approach, help
people wrap their head around what that actually means, that
(28:19):
what we're talking about here is that it is looking
at a variety of factors and allowing it to be
dynamic so that whatever you are assessing, whatever you're trying
to introduce as an intervention, whatever Like they essentially roll
with the changes as they happen. It's not just administer
this thing and it just does what it does. It's
(28:39):
like as this intervention is doing this thing, all of
a sudden a new way that this person is presenting
is starting to show up. And so we can either
ease back on something or we can push harder on
something or we can introduce something new. But it's looking
at like how is this– The process is that it's
(29:00):
individually tailored to you, and it's individually tailored to you
in a dynamic way that adjusts as needed in an
ongoing way. And obviously, the goal is to, as much
as possible in most things, to fade that out. That
what we want to have happen is you only have
this process in as long as you need that process.
For some people, that might be a really, really long time.
(29:20):
But for some people, it might just be like once
you've gotten sort of on a slightly different trajectory, all
the sort of natural things in your world pick up
from there and they'll kind of carry it forward without
you really needing me anymore. And then most people will
fall on some spectrum of that where it's like indefinite
need for continued support versus the individual. But point being that. like,
(29:40):
it's essentially custom tailored to identify variables that are relevant
in a dynamic way. Does that sound like an appropriate
way to describe that?
Speaker 3 (29:49):
Yeah. And to put it very loosely, I've used a
couple of metaphors. They're imperfect. One is we don't, in psychology,
you don't make sweatpants that are designed to fit. everybody
or like have three sizes, right? You got, or even
five sizes. You are a tailor. Your job is to
tailor something to somebody's tastes and to their measurements. And
(30:10):
that is a very different game. The other analogy is
if you were a chef, you are not cooking out
of a recipe book. You are like on top chef
or chopped where you're given a set of ingredients that
is unfamiliar and foreign to you. And your job is
to make it make sense, knowing what you know about food. Right.
It's not like you turn everything into lasagna because you
(30:33):
have a recipe for lasagna. You're not going to do
very well on those shows if that's how you treat
your approach. And I would argue the same is true
of good psychologists. In my experience, good psychologists get weird
ingredients and they're like, oh, I know what, you know,
in the same way that a chef understands that. Like.
Acid cuts fat, you know, like and here's how if
(30:56):
you were to whip this, it would create some effect
that is nice. Right. And fits well with this thing.
It feels less sciencey. Right. When you're not giving a
just oddly, it feels more artsy fartsy like you're doing
something artistic. But I would argue that those things are sciencey, too.
They're just not what we're used to being science. We're
(31:17):
used to, so, you know, one thing my advisor said
at a recent conference was we're used to asking the
question about evidence-based practice, but we need to start asking
about practice-based evidence. So basically like we sort of know
that psychologists do a lot of things at the level
(31:37):
of process. It's not crazy. to say like we adapt
and change to our people. We just need scientific bodies
of evidence that support that way of doing things. And
that is what's lacking. And I think that we're entering
an era where that is very much possible, both in
scary ways and in cool ways. And I'd like to
(31:59):
see more of it. And for those members of your
audience that are behavior analytically minded, I think particularly so
because you already kind of have an affinity and you
already kind of If I can make the assumption, you've
already kind of detected there's something wrong with going top down.
You know, like when you have a person in front
of you, you are problem solving, you are changing, you
are dynamic and you are interacting with a dynamic system.
(32:22):
And that's what's exciting about the science to you. If
I can be so bold as to assume that about you.
Speaker 1 (32:28):
I would say that one of my favorite things about
my job is when it's, The data will tell you
one thing, but just like sitting across from somebody and
interacting with them and saying, oh, I see. I think
I see what you're doing here that's gotten in the way.
And like I could tell from the data that things
aren't going the way that it would like ideally they'd
be going. But I can't tell what that thing is
until I've observed. And now I can say, OK, let's
(32:50):
try a slightly different approach to this this way and
then see what happens. And that's the like the fun
part is the like I want to. I think I'm
gleaning something from our interaction here that tells me that
I sense where a deficit might exist or where just
a slightly different amount of coaching or approach to this
(33:10):
could actually make the difference for you and being able
to get over the sort of threshold that you seem
to be stuck at. And yeah, and I think that
that was a very, very, very difficult skill to train.
Speaker 3 (33:20):
It is.
Speaker 1 (33:21):
That comes from a ton of experience and like coaching
and feedback and collaborating.
Speaker 3 (33:25):
I have to believe it's possible. I think we haven't
done it. We don't have a lot of effective strategies
for teaching it and we haven't felt an imperative to
teach it. But I think if we do, there are
ways forward. It's not like, I think there's a tendency
to go towards... Like there are people who get it
and people who don't. I don't think that that is true.
(33:45):
I think there are ways to get people to see
these things. And, you know, the old unks of behavior
analysis that are like, you need to shape a chicken
before you can work with a kid. You know, like
they have some there's some sense to that.
Speaker 2 (33:59):
Right.
Speaker 3 (34:00):
Like the ability to shape the ability to move with
and adapt and adjust and. and be amenable to and
be the thing that's needed in that moment is, is
a skill and it is a difficult skill to your point. And,
but I think where I tend to disagree with colleagues
and other people is in the notion that I believe
it is deeply teachable.
Speaker 1 (34:20):
Yeah.
Speaker 3 (34:21):
It's just, we're not used to doing it that way.
Speaker 4 (34:23):
Yeah.
Speaker 1 (34:25):
I do think it's, um, I just think it's difficult
to do. Yeah.
Speaker 3 (34:30):
And it also, I mean, it creates a level of
expectation for the job that I think is a little scary, right?
Like the idea that you take your problems home with you,
that you think about what you could do next, that
you're ready for some inevitable turn in your session next. Like,
I think people who are good, in my experience, they
(34:51):
have that burden and they have to find ways to
unburden themselves of those things. Because, you know, if... If
we live in a world of interactional determinism, there's always
a way forward. And if it's not happening, it's your fault, right?
And that is heavy. And that's something you got to
put down sometimes. And I think that that is a
(35:12):
challenge that we face as well.
Speaker 1 (35:14):
Very fair. Is there any sort of closing things you'd
like to leave with before we sort of transition to
our closing?
Speaker 2 (35:23):
You're a chef.
Speaker 3 (35:24):
You don't cook out of a cookbook. Remember that and
you're going to be okay.
Speaker 1 (35:28):
Very nice. All right, very good. Well, so that's the
argument there. Thank you, everyone, for listening. We'll go ahead
and let's... Let everyone know that we're going to be
doing some recommendations at the end of this, which is
a fun thing that we do just to recommend some
fun things because it's fun. And I'm also going to
go through our credits and everything and ask you to
support us in various ways. So ready, set, go. If
(35:50):
you'd like to support us, you can join us on Patreon.
If you do that, you'll get bonus content, ad-free content,
early episodes, and I will shout out your name in
the list of people who have taken the leap to
support us. So a giant shout out and thank you to...
Mike M, Megan, Mike T, Justin, Kim, Brad, Stephanie, Brian, Kiara, Charlie,
and Michael for all of your support and helping us
be a podcast. We appreciate it.
Speaker 2 (36:11):
Yes, you all are the best forever.
Speaker 1 (36:12):
Thank you to my team of people for without whom
I could not make this podcast writing and fact checking
from Shane and myself. And thank you for joining us
again for part two today, Stu.
Speaker 3 (36:21):
Yeah.
Speaker 1 (36:22):
Our social media coordinator is Emma Wilson. And our person
who managed to stitch together all of this content into
a cohesive unit is Justin, who is the best ever.
And we appreciate you. Thank you, Justin.
Speaker 2 (36:30):
Justin's the best too.
Speaker 1 (36:31):
And of course, thank you everyone for listening. All right.
I think that is what I have to say before
we transition to our recommendations. Oh, there's other ways to
support us. I sort of skimmed past. You can leave
us a rating and review. Those are free. You can like, subscribe,
tell a friend. And if you'd like to offer some
constructive criticism, you can email us directly at info at WWD,
WWD podcast.com. If you'd like to just tell us how
(36:52):
much you suck and how much you hate us, go
ahead and go to your nearest garbage can and yell
into it as long as you like, as loud as
you like. And I will get just as much out
of that. Otherwise, I look forward to hearing from people
and you can reach us on the social media platforms.
Now I think we're ready to transition to recommending some things.
Speaker 2 (37:07):
I like it.
Speaker 1 (37:07):
All right, let's do it. I'm recommending a card game.
This is not the heaviest game in the world. This
is a game called Flip 7. It's fairly new on
the scene. It has really sort of... It has gained
(37:29):
popularity at remarkable speed, which is kind of a red
flag sometimes. But it is a sort of push-your-luck style
card game.
Speaker 2 (37:37):
Sort of.
Speaker 1 (37:38):
It has like... You could see the DNA of Uno
in it, if Uno was a good game, and DNA
of Blackjack a little bit. The premise of the game, essentially,
is that there are a variety of cards that are
worth points. There are 12-12s, 11-11s, 10-10s, et cetera. But
if you ever get dealt a duplicate card, you bust
and you're out. But as long as you don't get
(37:59):
dealt a duplicate card, you can stop receiving cards at
any point. And then you get to keep all those points.
That's the gist of the game. It's really straightforward. Everybody
gets a turn. You get to hit or stay. And
then everyone just keeps going until either everyone is out
or everyone has stayed. And then you get to add
up your points. And it's trying to get to the
first person to get to 200 points over several rounds,
which only actually takes about 30 minutes, maybe even less.
I've definitely played this game with like 13 people in
(38:21):
like 20 minutes. So it really doesn't take long to do.
Plus it has these action cards. You can force people
to draw cards or force them to stay. They're kind
of fun. And some cards that also make your points
worth more points, which is also fun. There's also Flip
7 with a Vengeance. It's just a much meaner version
of the game. It's okay. If you like being mean
to people, then probably it's up your alley. Otherwise, they're
really cheap. It's only like 10, 15 bucks maybe. And
(38:43):
it's really small. It's just a deck of cards. And
it can play up to 17 people in a single go.
So it's very accommodating in that way. So it's a
recommend because I think that if you're going to pick
up a silly, easy, quick card game that accommodates a
lot of people, you could do a lot worse than
Flip 7. Substantially, substantially worse. A lot worse, like Uno.
But that is the game I'm recommending. Stu, do you
(39:06):
have a recommendation you'd like to share?
Speaker 3 (39:08):
Yeah, I got a bunch. I don't think you can
play Flip 7 with me because every time I flip
a card, I say, I'm going to bust!
Speaker 4 (39:15):
That's too bad.
Speaker 1 (39:18):
Challenge accepted.
Speaker 3 (39:19):
Don't play with me. So my recommendations, I'm going to
make a bunch just cause I'm not here that often.
Speaker 1 (39:24):
I'm only here.
Speaker 3 (39:27):
Okay. One recommendation I have, it's a YouTube channel. It's
also on that. It's like kind of the flagship show
of that kooky thing. Nebula that like YouTube, but for creators, yada, yada.
Speaker 2 (39:40):
Okay.
Speaker 3 (39:41):
It's called jet lag, the game. It's a bunch of
dorks that I love and they're very endearing and they're
very funny. And they have a travel game where they
make board games out of traveling. So they play connect
for across the U S by like flying and taking
different forms of transportation. And you conquer a city by,
or you conquer a state by like entering that state
and then completing some challenge. And then Texas turns yellow. Right.
(40:03):
And so yellow versus red. And so they're playing connect
for across the U S they play hide and go
seek in Japan. So one person gets like six hour
headstart and then, They get to go anywhere in Japan
and hide in any place that's publicly available. And then
the other guys seek them out and it's a good time.
And it gives you a good sense of like how
(40:23):
traveling works in different places because they have to do
things like go to grocery stores and ride the train.
So it's one of my favorite travel shows. My next
recommendation is if you see a thesis or a dissertation
that reads to you as what you will now call
purple hat DBT. call them out and say, that's a
Purple Hat DBT thing. Yuck.
Speaker 2 (40:42):
Yucky.
Speaker 3 (40:43):
And so we need to ask better questions so that
the science of psychology doesn't take 8 billion years and
we're not asking questions like, does ACT work if you're
in a rocking chair? So some signs that you might
be looking at Purple Hat DBT is they open with,
such and such has worked a million times with a
million things, but does it work with Y? That is
(41:05):
the sign that you are maybe looking at a Purple
Hat DBT study. I'm going to recommend a book called
The Orphans of Davenport. And then the last thing is
a little shameless self-plug of Generate. So in Generate, especially
if you're behaviorally minded, we built an assessment that we
(41:27):
think adheres to these modern sensibilities that have been talked
about a little better than assessments that are on the market.
So I would make the claim that behavior analysis, while
it has some good instincts about keeping the level of
the individual sacred. It has fallen into a pattern of
responding to the medical model that it is finding itself
(41:47):
a part of. And I think that is despite a
lot of the ways that we talk about our noble
pursuits inside of it. So if you want a system
that supports you in saying, I'm not trying to make
your kit normal, we have one. And it's generate, but misspelled. Yeah.
Speaker 1 (42:06):
All right. I have all those links. Thank you. All right, Shane,
what are you recommending?
Speaker 4 (42:10):
I'm going to recommend a record that just came out
this year by a band called Show Me the Body.
And the album is Alone Together. This is a three
piece out of New York. And they're super interesting because
they're considered a post hardcore band, but they pull a
lot of influences from like metal and punk and hardcore.
They definitely have punk sensibilities in that they are very
much doing their own thing. but it's a three piece
(42:31):
and the lead singer plays a banjo and it's, uh,
it doesn't sound like a banjo. It sounds like an electrified, uh, something. And, um,
it's just a super interesting, this new record is just
super interesting, super dynamic. It's a little bit out of
the box for what people are listening to these days.
Like I can't like really pinpoint another band that sounds
like this band and go like, Oh yeah, they sound
(42:53):
like this.
Speaker 2 (42:53):
Like they kind of are very much their own thing.
So I don't know. It's worth, it's worth giving a listen.
If you want to hear something that's like kind of
like unique.
Speaker 1 (43:00):
Fun.
Speaker 3 (43:01):
Yeah.
Speaker 1 (43:01):
All right. So that's flip seven, the card game for me,
this YouTube jet lag, the game, and then calling people
out for purple hat, DBT theses and dissertations, and then
the orphans of Davenport and the generate assessment tool from Stu.
And then show me the body album alone together from Shane,
our recommendations. Thank you so much again for joining us today, Stu.
(43:23):
We appreciate having you here and all your time that
you spend with us this morning.
Speaker 3 (43:26):
Thanks for having me.
Speaker 1 (43:27):
Thank you all for listening. Is there anything I missed
or you'd like to add before we say our goodbyes?
Shane or Stu?
Speaker 3 (43:32):
Nope. Okay.
Speaker 1 (43:34):
All right. Then this is Abraham.
Speaker 2 (43:36):
This is Shane.
Speaker 3 (43:36):
Stu!
Speaker 1 (43:39):
We're out.
Speaker 4 (43:40):
Bye.
Speaker 1 (43:41):
You've been listening to Why We Do What We Do.
Speaker 3 (43:44):
You can learn more about this and other episodes by
going to www.wwdpodcast.com.
Speaker 1 (43:50):
Thanks for listening, and we hope you have an awesome day.
Speaker 3 (44:08):
Thanks for watching!
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