What Trauma Therapy is Really Like | Dr. Jacob Ham, Elizabeth Ferreira, Being Well

0:00 Hello and welcome to Being Well.

0:01 I'm Forest Hansen.

0:02 If you're new to the podcast, thanks for joining us today.

0:05 And if you've listened before, welcome back.

0:08 I am so excited to tell you about today's episode.

0:11 I have been really looking forward to this.

0:14 Today we did something that we've never done on the podcast before.

0:17 Elizabeth joined me for a guest conversation.

0:21 She was a little nervous about it.

0:22 She did fantastic during this whole thing.

0:25 And if you're not familiar with her, Elizabeth is

0:27 an associate sematic therapist and she's also my fiance.

0:31 And we were joined by a very special guest, Dr.

0:33 Jacob Hal, who is an incredible expert on trauma and complex PTSD.

0:40 I mostly got to be a fly on the wall while Dr.

0:43 H and Elizabeth talked about being a trauma therapist.

0:47 Uh what is it like to sit with clients?

0:50 How have they been changed by the work that they do?

0:52 What are some of the major themes that tend to come up over and over again?

0:56 They really talked a lot about establishing relationship

1:00 and what it's like to be in that relationship

1:03 with another person who is processing some of the hardest

1:07 things that a person can process in life.

1:10 And I think that this is a conversation that of course you will get an enormous

1:13 amount out of if you're a clinician

1:16 or if you're interested in therapy in general.

1:19 But I also think there's a lot here if you're just a person

1:22 who's trying to deal with this kind of material in your own life.

1:25 Uh I'm not a therapist, but I feel like I learned a lot from Dr.

1:28 H and Elizabeth today.

1:30 And this was just such a cool experience.

1:32 It was a very unique conversation.

1:34 They they they have kind of a similar vibe

1:36 and they really just sat in it with each other.

1:38 I don't know if that's their nature as people or if

1:41 that's the way that this kind of work changes you.

1:44 I suspect that it's a little bit of both.

1:46 and I was pretty quiet for most of the conversation.

1:50 Episodes of the podcast are typically edited for clarity and length.

1:54 And this episode is mostly unedited in part

1:58 because there was just such a natural

2:00 flow to the conversation that I wasn't even really sure where to put the edits.

2:04 It was extremely organic and I just really hope you enjoy it.

2:09 So here is my conversation with Dr.

2:12 H and Elizabeth.

2:14 So, Elizabeth, how are you doing today?

2:16 I'm really anxious, but I'm hanging on.

2:21 I'm grounding down staying in my body.

2:25 I'm really excited for this.

2:26 We've never done a guest interview with Elizabeth before,

2:30 but today we're joined by one of my all-time favorite guests on the podcast, Dr.

2:34 Jacob H.

2:35 Dr.

2:35 H is a licensed clinical psychologist

2:37 and associate clinical professor in the department

2:40 of psychiatry at the Icon School of Medicine at Mount Sinai.

2:43 and he's also the director of the center for complex trauma there.

2:46 You might also be familiar with Dr.

2:47 H if you read Stephanie Fu's bestseller,

2:50 What My Bones Know, a memoir of healing from complex trauma.

2:53 Dr.

2:53 H was the clinician that she worked with in that book.

2:56 So, Dr.

2:57 H, thanks for doing this with us.

2:58 How are you doing today?

2:59 It's so good to be back.

3:02 Thank you for having me again.

3:03 And I too am super nervous for some reason.

3:07 But I

3:07 Yeah, it's really interesting that that both of you have been like mentioning

3:10 that as part of this process where Elizabeth

3:13 expressed some nerves to me even over email.

3:15 You did.

3:16 Um I don't know.

3:17 Do you have any idea why that is?

3:19 Was Elizabeth, were you nervous before I said I was nervous?

3:24 Yes.

3:24 Or Huh.

3:25 Interesting.

3:29 Yeah.

3:28 I think part of my nerves is like I still

3:34 feel pretty young in my work as becoming a therapist,

3:39 but also working towards, you know, specializing in CPTTSD.

3:43 And I've been really lucky that in basically all my associate uh journey so far,

3:50 like that's the population I've been able to work with.

3:53 And so I feel like I've just been sort of in this big bubble of it.

3:59 And I think part of why I'm nervous is because the longer I've done this work,

4:05 the less I feel capable about talking about it.

4:09 It's almost like I struggle more and more to really define

4:13 or find words that fit in what is like happening in the room.

4:19 And I think part of my nerves is, "Oh my god, we're supposed to talk about it."

4:30 That is really cool to me because it should

4:33 be really hard to describe what happens in the room.

4:36 I think we not we're not trained very well for that.

4:43 Mhm.

4:41 And that's all I've been doing.

4:44 So, we'll have to I would love to talk about that kind of stuff because

4:50 my area of focus is really on what happens in the room moment to moment.

4:58 Yeah.

4:58 And yeah, I think that's where all the work happens,

5:01 but it's hard to be trained in it and it's hard to understand it too.

5:07 And that's why I'm really excited about this training community

5:10 that I'm trying to launch this year at some point.

5:14 because all we're going to do is just

5:17 practice moment to moment material with each other.

5:23 Yeah.

5:21 And it's not it it really is uh practice.

5:26 There's no shortcut to figuring out how to do this.

5:29 And I didn't feel like I got it until uh more than 10

5:33 years after I started like 10 years after where you are in your career.

5:40 Wow.

5:39 And even when you do get it,

5:41 like part of when Force and I were talking about what to talk about,

5:46 um part of the things that I was thinking

5:48 about talking about though I don't know how yet is,

5:52 um how exciting this past year has been for me

5:56 as a therapist because I've learned so much new material from the work.

6:00 I feel like the thing that helped me to get so

6:05 to learn faster and faster is to um one let my mistakes beat

6:11 me up and hurt a lot and to not let them um

6:18 make me tight in what I try to do in the room too.

6:22 But you also need a lot of support and you need someone

6:25 to like cry a shoulder to cry on after you mess up.

6:29 Yeah.

6:28 And you need to feel like it's normal stuff to happen.

6:34 And then um and you almost have to forget everything you've

6:37 learned cuz in the room you shouldn't be thinking about that stuff.

6:41 You should just be in the moment.

6:44 And then and then everything you learned

6:46 and then you'll start to organize what you've learned

6:50 into very very practical momentto moment material that I can hopefully maybe we

6:54 can get to some of that stuff but it's really hard to explain.

6:58 And what I would also encourage you to do is to start writing.

7:01 Oh, I do.

7:03 Okay, good.

7:04 I write a lot.

7:05 Like uh journaling about it or what?

7:08 What do you mean by that?

7:09 No, write to your clients.

7:13 I I do that.

7:16 Okay.

7:15 I have a I have a secret space that I I write all the things I wish I could say.

7:21 Oh, interesting.

7:23 And then I look at it and I see what can I actually say in real life.

7:27 What's funny is that in my supervision of people,

7:32 usually after they tell me what's going on in the therapy,

7:37 then the answer is you you should just say that to them.

7:42 And the more and more you trust what comes up for you and the more

7:45 you hone that craft of speaking what you're saying in a way that is helpful,

7:54 the work becomes liberating.

7:56 energizing because you're using your whole self.

8:00 Like I think that we get tired

8:02 because we're holding ourselves down or compartmentalizing ourselves.

8:07 But if you learn to hone all of yourself as part of the tool to use,

8:12 then you're just energized and flowing.

8:16 I'm excited.

8:17 Yeah.

8:18 No.

8:18 Um, this is really affirming cuz I've been in my own bubble thinking I'm just

8:25 like a cook like like cooking and I'm like I have no idea what's happening here,

8:30 but it seems to be working.

8:31 Um, yeah.

8:34 Like, so I'm I'm very open about this, but I also have complex trauma.

8:42 And so there are parts of me that can

8:45 almost always relate to people I'm working with.

8:50 And it feels like there those parts of me like kind

8:56 of show up in the room that resonate at like the same experience

9:00 with my clients and it creates um not just I understand you

9:09 cognitively but like I know what this feels like in this experience.

9:15 And the more and more I've done this work,

9:19 the more I've been I disclose that in the room like I kind of join and I share.

9:26 And it's been a journey because I can get

9:31 very activated or triggered depending on what shows up.

9:36 And my practice has been to always make sure

9:39 I'm a few steps ahead of whoever I'm working with.

9:44 Um, so if something shows up and I

9:47 feel my own material really coming into the room,

9:52 I go, "Ooh, that's kind of interesting." And how do I hold that?

9:56 And how do I hold the other person?

10:00 And how do I kind of even use that as a part of the tool?

10:04 Yeah, you spoke it very clearly.

10:06 That's the art.

10:07 Every time it happens, you have to ask that question.

10:09 And there's no right answer for that.

10:11 Mhm.

10:12 And I've spent years playing with more disclosure and less disclosure.

10:21 Yeah.

10:20 And seeing what it does to my attention,

10:23 whether it's with the client still

10:25 or whether it whether I become distracted myself.

10:31 Mhm.

10:32 And again, there's no right answer

10:33 because each moment requires a different thing.

10:36 Yeah.

10:37 And certain people want more disclosure and other

10:40 people really don't want it because it interferes.

10:44 It does feel like you're taking your attention away from them.

10:48 And so the only real solution is to keep wondering is this the right move?

10:53 Is this working?

10:54 And I and to invite them to be wondering too.

11:00 Yeah.

11:00 So it's completely consensual moment to moment and co-created what's happening.

11:06 That's how I describe it.

11:08 It's cocreated and I tend to ask like I will

11:12 be like hey I'm noticing something I could talk about it.

11:17 Do you want to know?

11:18 Like I give them the opportunity to kind of define how much

11:22 of me do you want to show up in the room right now?

11:25 Yeah.

11:25 I I do the exact same thing.

11:27 But what I also know is that no one is ever gonna say no.

11:31 I don't I really don't care what you have to say.

11:33 So they they always politely say yes.

11:36 So I don't know what the workound is yet for that.

11:39 I've had people say no.

11:40 I've had people go ah maybe later.

11:44 That's cool.

11:45 That's when you really know that the work

11:47 is good and the relationship is strong cuz

11:51 and and like I will be on the wrong path

11:53 and they'll be like no that's not what I'm talking about.

11:55 you this is what I really want you to pay

11:57 attention to and then it just reggrounds me in

12:00 I I don't want to interrupt your guys flow here because you're you're

12:03 just in such a good spot but you said something a second ago Dr.

12:06 home that I was really interesting interested in and really curious about.

12:11 You talked about the feeling of having made a mistake and needing

12:16 like somebody to talk to or I forget what your exact phrase

12:19 was like you know a shoulder to cry on whatever it is

12:21 after you feel like ah I just really messed up in there.

12:24 I don't know if I've ever heard uh two therapists talk to each

12:29 other about that feeling of like messing up with a client in that kind

12:32 of a way and having it be a really emotionally meaningful experience

12:36 for them and processing around it or thinking about it, relating to it.

12:42 And I I just think that for people who go to therapy,

12:44 it could be kind of meaningful to hear for starters

12:46 that their therapists care that much uh to be impacted in that way.

12:50 And um yeah, I don't know if that's something that you want to want

12:53 to talk about or share about or you guys could kind of explore together,

12:56 but I just thought it was a really interesting thing to say.

12:59 I can I can say that in training we really encourage it.

13:05 We we have like students at all levels of training that come through

13:11 our our hospital system and um I will tell them in the beginning of the year

13:17 if you if you like try to impress me with all the amazing work

13:22 you're doing then I'm going to want to knock you down a few levels.

13:26 But if you come in and tell me about what you're struggling

13:29 with then it's going to make me want to root for you more.

13:33 And so I encourage them to actually talk

13:36 about that their their growth edges I guess.

13:40 And then when we start supervision especially in a group format we will

13:45 um I'll say okay what are the highlights or heartaches for this week

13:48 and we'll start we'll figure out what moments or clients need our attention

13:54 from what pulled us emotionally whether to celebrate or to feel bad.

14:02 That's where all the learning.

14:03 That's where all the work is.

14:04 That's where the ruptures are happening.

14:05 That's where the trauma is showing up.

14:08 Yeah.

14:08 I'm I'm a bit of an anarchist.

14:10 I I feel like I strive for the mistake.

14:14 Like the way I think about it is I'm in my associate ship.

14:17 I work under my supervisor.

14:18 I'm the safest I will ever be right now.

14:21 So, why not swing big and try to make as many mistakes as possible?

14:27 Um, and what I have found is that when I just accept

14:32 that like I'm going to make all of these mistakes and how

14:35 exciting that I get to make a mistake is that's when

14:39 the work gets really alive in the room even with the client.

14:43 Um and then you know inside of myself it

14:47 gives me a moment to even notice what is

14:53 important that I look at inside of myself when

14:55 it's like ooh I made a mistake like ooh what's

14:59 happening here and then how do I how do

15:02 I show up because I think for some people

15:05 at least people who I work with there's not

15:09 that much experience of somebody owning the mistake of saying,

15:16 "Oh, yeah, that was me.

15:17 My bad." Like, how do I understand you

15:21 better and understand how to be with you better?

15:24 Yeah.

15:24 Those are beautiful moments cuz the repair feels so good.

15:31 Mhm.

15:30 It makes me think about how um

15:36 the the opposite experience when someone's demanding an apology.

15:40 Mhm.

15:41 And there have been times when I will say, "I honestly can't give you one.

15:45 It doesn't feel right to me to give you one.

15:48 I can't.

15:49 It feels like I'm colluding with something." And and then I will say, "Now,

15:54 I could be wrong because I could be so defensive

15:57 right now that I'm intellectualizing and going clinical on you.

16:00 Or it could be that there's really something

16:02 here that we should be looking at." And so

16:06 I just kind of like I feel like in my book I've been playing with this visual

16:11 of like therapy is like playing a card game or poker but at every turn we just

16:19 lay all our cards down on the table and try to figure out what the best move is.

16:22 And the goal isn't to win.

16:24 It's to just keep the game going for as long as possible.

16:28 Yeah.

16:29 you said something that I'm I was like

16:32 and but now I'm having a hard time remembering it.

16:36 Oh, this is funny.

16:37 This is why I'm forgetting it.

16:39 So, what you just named is right at my clinical edge

16:44 at the moment is when the client's demanding an apology and I'm like, ooh.

16:51 And I'm I tend to dissociate cuz that's also

16:55 a very tricky place for me with my own trauma.

16:58 So when I'm being confronted, um,

17:02 younger therapist Elizabeth would just be like, "Oh yeah, I'm so bad.

17:06 Yeah, fall on the sword." Like, "Yeah, deepest apologies.

17:09 That was my fault." And now I'm I'm noticing I'm at the like

17:16 shaky edge of I don't really want to give you an apology,

17:22 which is spooky to say, and then why do I not want to give the apology?

17:27 And then I I still get pretty fuzzy.

17:31 Like I can get pretty dissociated even just holding it.

17:35 Yeah.

17:36 Like I'm always remind like we play with powerful forces in this space.

17:42 Yeah.

17:42 It's happening.

17:43 Like it's so cool.

17:44 As I talk about it, my going away part starts to show up and I'm like

17:51 I think we're at the heart of working with CPTTSD right now.

17:58 Mhm.

17:57 It always gets hairy.

17:59 That trauma always comes into the room.

18:03 Yeah.

18:03 And no amount of training,

18:04 no manual will ever teach you what to do in this moment.

18:10 And it really is as simple as helping some helping the therapist

18:16 stayed where you are like the way that you are doing right now,

18:21 not dissociating and just trying to feel as much as you can.

18:27 And then figuring out a way to name what's inside of you

18:32 or what's inside of them or what's happening between the two of you

18:37 in a way that's heartfelt,

18:40 a little heartache and still um fighting for the connection to persist

18:51 instead of like disappearing on each other.

18:54 That's really hard to do.

18:58 Yeah, you're you're naming my stuff very accurately,

19:02 which is my clinical edge at the moment is to be able to lean

19:08 in and confront that really uncomfortable moment of like I hear you demanding

19:15 something from me and I there's a part of me wants to slow

19:20 down so that we really pay attention to why this demand is showing up.

19:24 But yet for me my the past infiltrates the present for me because

19:30 when I used to do that as a child like confront it meant disconnect.

19:37 So, this is why this is such like the edge for me clinically.

19:44 And I'm I'm kind of in this um like I have to dig my way

19:51 through all of this sort of jello to kind of get get to the other person,

20:00 right?

19:59 And then in your own in your own self,

20:04 the next steps would be two possible paths.

20:07 One would be to do the inner child work with the timid,

20:11 the scared girl who still has this desire to stand up for herself.

20:17 And even the word confront is very interesting.

20:20 But I don't want to get too linguistic about this, but the flavor

20:24 of it is still there's aggression or fear of conflict in it.

20:27 Mhm.

20:28 The other path after you help reintegrate her is to um

20:36 it's it's this the difference between fighting against versus fighting for.

20:43 Mhm.

20:42 And when you have this strong parental maternal sense of like no,

20:48 we're going to do this because I'm not willing to lose you.

20:53 Mhm.

20:54 So, you're going to we're going to have a hard conversation right now.

20:57 So, it's not confronting.

20:59 It's like it really is like advocating,

21:01 championing for something that you really care about.

21:06 And you can't force that reframe.

21:10 I think you have to every one of us has to do

21:12 both at the same time or whichever one needs more attention.

21:15 Maybe you can just snap into no you this this matters.

21:19 We're not going to let trauma interfere with our connection right now.

21:22 Or if it's here, we're going to we're going to, you know,

21:27 look at it, but it's not going to take over.

21:31 Mhm.

21:31 And that's like a that's like a firm limit setting that if you work with kids,

21:37 families, or couples, you learn to do more because they're they come in and they

21:42 want you to be strong enough to maintain safety for them.

21:48 Yeah, I find that I know what you're

21:52 talking about because with couples I can do it.

21:55 With couples, this does not really show up as much, which is interesting,

22:01 but it shows up more individually because the like

22:05 attention or the focus is like um all on me.

22:13 I am the couple.

22:14 Yes.

22:15 And then it's like

22:19 yes

22:19 and and so but I know what you mean about like

22:22 the being with and the kind of in pursuit of maintaining

22:27 the connection and like I'm not going to let either of us

22:33 run away from this moment like no let's let's go for it.

22:36 Let's I'm going to hang on to you and you hang on to me.

22:41 Yeah.

22:41 And I think this is a nice moment where

22:43 we can like bring in the general the the clients

22:45 who are listening in in these moments when

22:50 uh someone might feel the need for an apology.

22:55 Then what I tell my clients is um to that we're not trying

23:02 to say it's either or that it's your stuff or what's really happening

23:06 like I I really made a mistake or it's your stuff coming up

23:10 but I feel like there has to be a sequence of actions taken first.

23:14 We have to inquire about whether your stuff is activated and we

23:21 have to do the work to kind of mend or hold that stuff.

23:26 And it takes some of the edge off of what's happening in the moment.

23:31 And then we can do the repair that still needs to be done in the present moment,

23:36 but it'll be done with more grace or clarity or compassion towards each other.

23:42 Otherwise, you're just on a war path to try

23:44 to write wrongs that you've experienced your whole life.

23:48 And even an apology now won't necessarily satisfy

23:52 the depth of that hurt that's been activated.

23:59 And it's really hard.

24:00 It's hard.

24:01 It's hard for people,

24:02 especially when they're so used to uh fighting for their lives,

24:07 fighting for a voice.

24:11 And so it can take I have people where it

24:14 takes a year of fighting until they're like, "Wait a minute.

24:18 Are you Is this one of those moments when you you're

24:20 saying that maybe it's not just something didn't just happen between us?

24:24 Like it could be it's so hard.

24:28 It's and it feels like um reality is taken off from underneath their feet.

24:33 Like they can't trust anything they see anymore.

24:37 It makes them feel more unsettled and unsafe

24:41 cuz they don't know where the enemy is anymore.

24:43 I'm really lucky because some people I've working

24:47 with have been for three or four years.

24:50 So our relationship, clinical relationship is really strong and there

24:59 is this really wild chaotic space when

25:10 they come in in that moment of I don't know what up is down.

25:15 I feel so unsafe.

25:17 There's something I need to communicate with you.

25:21 and there's enough of their own awareness to even kind of be

25:28 where I'm at a little bit at the moment of like,

25:30 oh, I can feel my stuff and yet I feel the stuff I need to do.

25:36 Um, and sometimes I've been in the moment um,

25:44 with people I work with where we both get to own,

25:47 yeah, this is really scary and I'm okay with it being scary.

25:51 I'm still here.

25:52 I'm not going to jump out of this.

25:55 So, we're both scared.

25:58 Now, what?

26:00 I think you've already reached the end cuz

26:03 it's no longer a you versus me anymore.

26:05 It's like we're both like feeling overwhelmed.

26:11 Mhm.

26:10 And then there's nothing to do but to grieve

26:15 at at that point to feel the the heartache of that moment.

26:20 That's what I'm always afraid to actually name when

26:23 people ask me about the work is the grieving part.

26:27 Like I cry with my clients and they cry with me and It's funny.

26:36 There's a part of me that's wanting to show up to be like,

26:39 but I don't put my stuff on them.

26:43 Um, but no, there's there's there have been moments

26:50 where I feel I'm really seeing the other person.

26:56 And the only way that happens is when they really see me in return.

27:01 like there's an opening that happens.

27:04 So, as much as I'm seeing them,

27:06 they're also seeing me and at times we grieve for each other.

27:11 There were two different threads there.

27:14 The first one when you said um that little guilty critical part that says

27:20 that you're putting your stuff on patients clients

27:24 and then the coexperience of humanity, shared humanity.

27:31 Which way do you want to go?

27:33 Let's go into the the guilty part.

27:37 Okay.

27:37 Let's go where I'm having the hardest time staying present.

27:41 That's perfect because that's all that's always the first guardian at the gate.

27:49 Yeah.

27:49 And the hardest one to pass.

27:52 Um, my first gut reaction was a little railing against anger about

28:03 the way that supervision and training

28:05 happens because um it's very fear-mongering.

28:12 It's all about like it almost feels like

28:14 policing and it feels like like uh Yeah.

28:21 And it it makes you so tight.

28:24 And as a traininee, I was I was so distracted

28:28 by the image or the sense of my supervisor watching over my shoulder.

28:35 I most of my mistakes and I made a lot of mistakes

28:40 as a earlier in my training was because I was trying

28:44 to impress my supervisor who wasn't even in the room and supervisions

28:49 would be about talking about what happened the week before and then

28:52 they would give some suggestions about how to look how to think

28:56 about it and then I would be so eager to implement

28:59 those the next week but it's like that river's already passed

29:02 like there's no way I it would be an artificial misatuned intervention.

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30:36 One of my trainees said that one of their supervisors had

30:41 told them this incredible thing that I have now taken for myself,

30:45 which is that in supervision with me,

30:48 what I encourage the trainee to do is to follow their instincts.

30:54 And then supervision is for trying to make sense of why

30:58 that was the right move to really trust that your body's much wiser

31:04 than everything you've learned in grad school and then to um just

31:11 you're just honing your instrument that's all and making it more therapeutic.

31:16 So even even this co- experience of grief like

31:22 there are ways that I've done it where it

31:25 I did have I I would share my stuff but then as I got better at I would

31:30 say you have no idea how much I relate to this and then I would just leave it

31:33 at that and I would be acknowledging that it's

31:35 here but I wouldn't necessarily have to say it.

31:39 Mhm.

31:39 Yeah.

31:39 that that moment of crying, I'm in them.

31:42 I'm thinking about what that's like for me.

31:47 And I so want them to see it, but but not in an artificial way,

31:53 but in a in a way of protect of enhancing

31:56 the safety of the moment cuz it's so vulnerable.

32:01 It's also really interesting cuz people will get uncomfortable.

32:05 They might some of them will say like they will feel like

32:08 taking care of you or they'll feel that so they'll try to take

32:12 care of you or they will feel it and want to resist it

32:15 and say like enough like whatever

32:18 it's and that becomes interesting material too.

32:21 Mhm.

32:22 But then with other people,

32:24 they're so grateful for that form of witness, witnessing.

32:31 And you really do have to be tracking whether or not.

32:35 Well, no, it's not whether or not.

32:37 It's both when your stuff comes up and you hold your inner child

32:41 in your arms as you're as you're gazing upon your patient or your client.

32:45 And so it's just adding more and more layers of complexity

32:49 to your experience and more ability

32:50 to hold layers of complexity in your experience.

32:54 Also along with crying, the other thing that I've added to my repertoire

32:59 of shared humanity is is literally dry heaving.

33:05 like literally throwing up in the sessions

33:08 when we're going over incredibly difficult,

33:11 gnarly abuse stories that are like beyond

33:15 the pale of what anyone should ever experience.

33:17 And it will make you nauseiated.

33:20 And this woman, woman, one of the first times I did it,

33:22 she's like, "Oh my god, thank you so much." Yeah.

33:26 I was like, and I'm like like wiping my mouth.

33:30 But yes, it was like that, right?

33:32 It was gross, right?

33:33 what happened.

33:35 Yeah.

33:35 What I what I can add to that is I'm I'm

33:37 having a moment of feeling pretty grateful for my own supervisor.

33:44 Um because I don't feel like I have to impress her.

33:48 I feel like I come in raw and bleeding and I'm like,

33:51 "Here's all my that's coming in and I did this and uh

33:56 and maybe I can name something pretty vulnerable for me, which is,

34:16 I feel like my training in my supervisor really encourages me

34:21 to return to my gut feeling to kind of trust what I'm doing

34:29 and the the guilty part or the parts that can be like are

34:35 a part of my own way that I have protected my own self.

34:44 So it takes me actually a great deal of effort to allow somebody else

34:53 to really see me and to allow my authentic emotional expression to come out.

35:01 So at times I feel like I am digging through

35:05 something to really be able to meet in that moment.

35:11 And for me sometimes it there there

35:15 are two processes happening at the same time.

35:17 I am holding the agony of my client and then I am

35:24 holding my own agony in in how to remain relational and remain connected.

35:33 I still have those moments too especially

35:35 when hard things are happening in my life.

35:37 So it never goes away.

35:38 It's not just because you have a history of it.

35:40 It's just because you're going to have hard times in life, too.

35:46 And you do get better at it.

35:50 Like, it's so it's so anxietyprovoking to be in the beginning

35:54 of this cuz it's so harrowing like and complex traumas.

36:00 It's it means that the relationship is going to be super messy and ex either

36:08 explosive or full of ruptures and withdrawals

36:12 and difficulty getting them to engage with you.

36:16 And people are always impressed that this is the kind of work we like to do.

36:29 I don't want to console you about this.

36:34 It there is a pull like a natural pull to be like, "Oh, you'll be fine.

36:37 You'll be okay or whatever." But I like how you're holding it now.

36:42 There is a there's the right level

36:46 of tenderness towards the process that you're in.

36:49 It feels like Mhm.

36:54 So the like the the seeds have been planted

36:58 in the right soil and there's just patience to let that grow.

37:04 Mhm.

37:06 That feels right.

37:08 There's no need to rush this.

37:12 How's that as a response?

37:15 It feels good cuz that's something

37:17 my supervisor says is we're just planting seeds.

37:20 Like we're planting seeds right now.

37:25 And I don't feel there really is something to be soothed.

37:30 I've entered this seat as becoming a therapist almost exactly

37:34 at the same time I started to do my own trauma work.

37:38 So it has been a consistent parallel process for me.

37:42 So my own inner work is a part of the work.

37:50 And even though at times I'm confronted with things where I go,

37:53 "Holy this is um I get excited about it because I've had the experience

38:02 of as soon as I learn to hold

38:08 myself better and with more accuracy and attunement,

38:14 the better I can do that with somebody

38:17 else." And I get excited because it's like,

38:21 oh my god, like another entire like world has opened up.

38:26 What's in here?

38:27 So, I'm driven more by the curiosity of it

38:30 rather than the discomfort of being in it, if that makes any sense.

38:39 it I you're lucky to already have that attitude

38:47 and like I didn't get that way until much later I

38:50 don't think and even with that attitude like I get

38:56 the like the I don't know if I can swear here.

39:01 Yeah, go ahead.

39:02 I I get the kicked out of me on a regular basis.

39:07 Yeah.

39:06 And it happens in waves.

39:08 It happens in like three month cycles and right now I'm in a consolidation cycle

39:12 where the last year was like brutal but but I learned so much from it.

39:19 So I do I try to welcome the growth

39:24 that's about to happen but it still is devastating.

39:30 It's so hard.

39:31 It's so hard to feel like you you failed.

39:34 You've hurt someone.

39:36 he disappointed someone like you think it's bad being a new therapist.

39:42 Try being a a a known therapist where

39:45 people come and expect like something better than

39:48 average and then you you mess up or you disappoint and like it's a longer fall.

39:54 Mhm.

39:55 But then I learned that it just burns off more stuff, you know,

40:00 like whenever I at some point whatever notoriety I was getting made my ego

40:09 way too big and it was really it really messed up my practice.

40:13 And then letting that hurt or letting

40:16 those mistakes purify me made me so much better.

40:23 And I was so grateful to have had that chance to burn off more ego like stuff.

40:29 But it's still like, you know, 9,000 degrees 9,000 degree crucible.

40:36 It's like the best way to look at it.

40:38 It's a crucible.

40:40 You know, that tempering of steel to purify it.

40:45 And I do wish that I had a support system around me

40:48 where we could all just commiserate about how hard the work is.

40:52 I didn't.

40:53 But

40:55 I'm mindful of you, Forest.

40:57 I feel like we've been locked in.

41:03 I mean, there's so much here.

41:04 Um, for starters, this has been totally great for me and to be just

41:08 a fly on the wall for for you guys to to talk about this.

41:12 Uh, and I think it's been certainly for me just fascinating to to hear.

41:18 Um, what's standing out to me as you're talking is

41:22 just what you said when we first started this, uh, Jacob,

41:26 how attentively how how closely you're listening

41:32 to what's happening in the moment with the person

41:35 in front of you and how that's really I

41:40 don't quite know the right way to put it,

41:41 but I guess like the focus of the work.

41:44 Um because most of the time when you particularly when you read

41:48 and this might get a little too abstract here but when you read

41:50 about therapy or you read about therapeutic approaches like you know ACT CBT

41:55 IFS whatever somebody's doing in the room there's a lot of talk about

41:59 the therapeutic relationship and how important it is but the way it's

42:03 often framed is the therapeutic relationship is what lets you get the treatment

42:08 in and the treatment is the CBT or the ACT or the IFS

42:12 or the whatever and the relationship is

42:15 the container that lets you deliver that treatment.

42:18 That's like the structure of it.

42:20 Um, that's not how you guys are presenting the work that you're doing.

42:23 You're presenting it as like the relationship is the treatment,

42:26 for lack of a better way of putting it.

42:28 How you're you're talking about the repair moment

42:33 and the moment where you fall apart with your client

42:35 and they see you cry or you dry heave

42:38 in front of them or whatever it is that you're doing.

42:40 And it's because you're just kind of there

42:42 with them to some extent as they're going through it.

42:46 Um, and we were doing that, you know,

42:48 around a campfire 10,000 years ago or whatever.

42:52 Uh, so there there's just something in that that's really standing

42:55 out to me in how you guys are talking about this.

42:58 And I I don't know if I have access

42:59 to like quite the right language to describe it.

43:03 Um, but it seems so distinctly different from the way when I talk to an expert

43:09 in one of those other modalities that they

43:12 kind of talk about the technique of the work.

43:15 Um, one framework I have is that all those manualized

43:19 ideas are actually deeply embedded in what we're doing.

43:26 Mhm.

43:25 And I probably could pull out the threads

43:29 of the techniques that are in the moment to moment material,

43:36 but I also think that it's important to think about making a manual.

43:43 Like who makes a manual?

43:44 What's the process of making a manual?

43:47 One, you're usually like someone who's been doing the work for a long time.

43:51 Well, there's a couple of ways.

43:53 And so the first way is from doing the work for a long time.

43:57 And you're like, "Oh my god, I've learned so much and I want to be

44:00 able to share it with the next generation." And here,

44:04 what are the things that I see that I'm doing that I

44:07 haven't been able to put words to like Elizabeth was saying.

44:11 But then once you do that, then it becomes dogma and it's stiff.

44:15 It's not built into the bones of of your work.

44:18 you're learning it from the outside and you're trying

44:21 to give someone a shortcut to practicing the right skills,

44:25 but it should be I I think that it has to be um in the interactions.

44:32 Although more behavioral therapies try to avoid

44:37 the the relational part and just give the knowledge.

44:43 Um, and I really do feel mixed about that because

44:46 I I can see the merits of that for some people,

44:49 the more dogmatic didactic forms of therapy.

44:54 Um, and then the other ways that I've seen people make manuals is um is

45:00 the industrial commodification way where they've been trained

45:05 in a bunch of things and they're like,

45:06 "Oh, I like this from this and this from that." and then

45:08 let's just rearrange it and repackage it and call it something else.

45:14 And that is also valid.

45:17 I feel like even in my work, I'm I've um I carry of like five or six different

45:25 schools of therapy that I really like and that fit my personality.

45:29 And I feel like it's the therapist's job to be upfront about how they work,

45:35 what and how they like to practice so that they can draw in the right

45:38 kind of clients and patients who fit how they want to heal too or grow.

45:43 And if I think about who's listening,

45:46 it does make me want to answer this this other question,

45:51 which is that a lot of people reach out and say, "Hey,

45:54 where do I find either someone who works like you

45:57 and what exactly do you do again?" Or they ask like,

46:02 "I want I'm looking for someone who does EMDR

46:04 plus a little IFS and a little sematic work.

46:07 Do you know anyone?" Or as if that's going to be the answer.

46:13 And so in a way I do want the world to stop doing that.

46:18 And at the same time it still is useful but it's not the real thing.

46:23 And it but then I don't know what the real answer is.

46:28 And if I I don't know if we talked about MMA and UFC before it.

46:33 Uh I don't think so last time.

46:34 I don't think we used it as a metaphor.

46:36 It might have crept in there but you mind if I do that?

46:38 Yeah.

46:38 Go ahead.

46:38 Totally.

46:39 Hey there.

46:40 Thanks for watching and sorry for the brief interruption.

46:42 But it turns out that over 60% of the people

46:44 watching this right now are not subscribed to the channel.

46:47 So, if you could just take a moment to hit the subscribe button,

46:50 it would really help me out.

46:51 I'd appreciate it a lot.

46:52 All right, back to the show.

46:54 In the early days of the UFC, it was always like, you know,

46:58 fighter one who's like studies jiu-jitsu versus fighter 2 studies

47:01 judo and let's see which style is going to the win.

47:05 And then like maybe in UFC 50 plus,

47:10 I don't remember when they stopped doing that because everyone was,

47:13 you know, a little tie boxing, a little striking, a little grappling,

47:17 a little wrestling and and then it just keeps growing.

47:21 It just keeps morphing like it's such

47:23 an alive thing and everyone gets to witness it.

47:29 I I wish that therapy had that forum for practice.

47:33 I mean, we have it individually, but then we can't share what we're learning.

47:38 That's the hard part.

47:40 And the other thing that I the other lesson I learned

47:45 from that is that once you get to a black belt,

47:48 that just means you're qualified to compete.

47:50 Or not even some guys wear like purple belts in certain things,

47:55 but it just gives you the qu it gives

47:57 you like a it's your ticket into the the ring,

48:00 but it doesn't mean that you're going to be that good at it.

48:04 And so like just because someone's been certified or trained

48:08 in a certain way doesn't mean that they're good at it.

48:11 So stop privileging the model and work with the person that's in front of you.

48:18 That's why you have to just go try them

48:20 out and see if they're good enough for you.

48:23 They don't have to be the best.

48:24 They just have to be the right person for you at that stage of your growth.

48:28 And it's okay to outgrow them and move on to something else.

48:32 And I have plenty of patients who come and they

48:35 they will see me and they'll add a EMDR person

48:39 or a sematic person or hypnotherapist or do all kinds

48:44 of other stuff on top of what they're doing with me.

48:51 I totally agree.

48:51 And the way that I can talk about this is through metaphor.

48:57 I think being a therapist, I view it as you're you're a painter.

49:03 And why would you limit the amount of colors you have on your palette?

49:07 Like CVT is a color, IFS is a color.

49:10 Like there's all these different mediums you can you have access to, but the art

49:15 of therapy is is the style of the painting that you create.

49:20 And people can, you know, make copies of Van Go and all of that, but they're

49:26 not enjoying the process of creating that painting.

49:30 Like the the only way you can like move the brush in just that way.

49:38 Um, and I find it almost impossible when

49:44 people reach out to me over email and go,

49:48 "Who works like you?" And I'm like, I have no idea.

49:52 For one, I'm still figuring out what my style is.

49:56 I'm just throwing stuff at the wall.

49:58 I'm figuring out how I work.

50:00 Yeah.

50:00 I don't know.

50:01 It changes every 3 to 6 months.

50:03 So, it's a very it it feels very challenging that question.

50:08 Um, and and also the image changes depending on who I'm with.

50:14 The style is slightly different.

50:17 Um, some people I work with, we barely do any sematic work at all.

50:24 Other people I work with, that's the whole thing.

50:27 Um, and I think with trauma, what I've learned is you have to stay flexible.

50:34 like you have to remain uh open and willing

50:40 to learn a a different medium or a different style

50:45 cuz then you're you you practice being unlimited and what

50:51 I've experienced in tiny tiny amounts is if I

50:57 get too committed to I'm a somatic therapist whatever

51:01 that means I don't know now um I can't see

51:07 as much of the other person because I'm trying

51:09 to like put it all through just that one tiny frame.

51:13 But if I let that go and I'm like, well,

51:16 there's all these other frames that you could also

51:19 apply to this and then the technique kind of disappears.

51:23 And if I go back, I can I can do a session

51:26 and then I could tell you all the kind of this is here,

51:29 this is what I did here, and blah blah blah.

51:31 But in the room it it's not I'm not thinking about it.

51:34 It's not the technique isn't present.

51:37 And what you said reminds me of how

51:40 like nowadays I've become so either reductionistic

51:44 or essentializing that I feel like all my work

51:48 is just about helping people not be tight.

51:54 Cuz even asking do you do like what kind of work do you do?

51:59 Like what's the technique?

52:00 That's a tight question.

52:02 And if you can just become supple and open,

52:09 then the next bit of your own work is right there in front of us.

52:16 It's always the next step that needs to be taken.

52:18 And it's really pretty simple.

52:21 And then it's not about the framework.

52:24 It's about like, okay, do I know how to help you to take this next step?

52:28 And it's often about like it's it's often just about like can I breathe,

52:35 can I allow, accept, tremble, cry, uh uh see my whole self?

52:49 And then and then people get overwhelmed and tight and they're like,

52:54 "Okay, now what do I do?

52:55 Cuz this is too much." like how do I like uh come back from this?

53:01 How do I what what do I do?

53:02 What's my homework?

53:03 How do I like Yeah.

53:04 Yeah.

53:05 recover.

53:06 And then again, okay, breathe, relax, ask your body what it wants next.

53:12 And it'll say ice cream or chips or a a bath.

53:17 And you're like, good.

53:19 It's not rocket science.

53:22 It's really just about constriction, which makes us want answers.

53:25 and clear solutions and then supple surrender to I don't know process

53:34 the universe whatever your inner intelligence is

53:37 telling you is needs to happen next.

53:42 Well, I'm I'm going to ask a what helps question which, you know,

53:46 the last time we did this doctor got me into a lot of trouble.

53:49 So, I'm ready.

53:51 I'm I'm going to answer it.

53:53 I promise.

53:54 No, no, no.

53:54 It's it's totally great.

53:55 I I'm not trying to create like a universal theory of anything here.

53:59 Uh but I think that what you were saying there

54:01 about that feeling of like openness and relaxation is is such

54:06 a cool way in to so many of the little

54:10 things that I feel like you guys have been talking about.

54:12 Um, if you think about going all the way back to when you were talking

54:16 about like an asking for an apology

54:18 or like a really pointed request from somebody,

54:21 uh, or when Elizabeth was talking about, okay,

54:24 we had this repair moment and early on I felt

54:26 like my only option was to just go belly up.

54:29 Um, or to not repair at all to be like, you know, screw you.

54:32 Like those are the two choices.

54:33 It's very like black and white thinking in that way.

54:36 um or hey uh last time uh years ago when we talked about this we talked a lot

54:41 about cognizing and the the problems with abstraction

54:44 and those kinds of like very technical top downy models.

54:49 I think all of those things have a bit of a shared

54:51 feeling um of like kind of tightness or contraction or um

54:56 forward pointedness you know that feeling of like really sitting forward

55:00 in the chair as opposed to kind of sitting back in the chair.

55:03 Um, and so maybe that's I I don't know.

55:06 I'm trying not trying to like explain to you guys what you do.

55:08 I'm really more asking here.

55:10 Uh, maybe that's kind of part of what you're looking for.

55:12 It's just that how do we increasingly sit in a way

55:16 where you feel kind of more open and more flexible?

55:19 Um, and maybe there's a little bit more of like

55:22 a don't know mind kind of associated with it.

55:24 I'm sort of feeling that too in it.

55:26 Um, and maybe that's actually sort of the I don't know,

55:30 target's not quite the right word,

55:32 but what you're what you're looking for, where you're trying to get to.

55:36 I think that's all it is.

55:39 Now, as soon as I say that with conviction,

55:42 then the counterpoint that I always come

55:45 up with is not everyone's ready for that.

55:48 And people are at an earlier stage where they do need training wheels.

55:51 they need the how-tos and the structure.

55:55 And I don't know whether that's true.

55:59 Um actually and then I was going to say that um then usually I

56:08 suggest they go somewhere else with to find

56:12 someone who likes giving tips and skills.

56:18 Um, but then I think about my patients who ref

56:24 who keep arguing with me cuz I will say, "No,

56:28 I'm not going to tell you what to do." And then they will say,

56:31 "No, you need to tell me.

56:32 I really need to know what you think." And then they do

56:36 it in such a sweet way like like some people will say

56:39 like my mind just needs something concrete which is such a loving

56:45 a self-aware uh way to ask for a need to be met.

56:51 Then I know that it's the right thing and then

56:53 I say okay let me break it down for you.

56:55 This is what you're doing.

56:56 This is what you're missing about what you're

56:58 seeing and and I think this is what you should be doing with your life

57:02 or this is the decision I think you should make.

57:04 And then they're like, "Thank you." And then they're like, "I disagree with you,

57:07 but" and then then, you know, like they still want to make their own decisions.

57:13 So it doesn't hurt to give the advice because it

57:16 just becomes part of the fodder of the process for them.

57:21 So you don't have to I we we as therapists

57:24 don't have to be afraid of even going in that route.

57:28 You just have to be open to whether or not it's landing for them or whether,

57:32 you know, they're like, "No,

57:34 please stop giving me advice or tell me what to do." Yeah.

57:37 My I know what you you mean.

57:39 There's always the moment where they're like, "Well,

57:44 just just tell me like or how do I fix the fixing part rolls in and okay,

57:50 what am I supposed to do with it?" And I I I I really make it difficult,

57:58 I think, uh for them to get a straight answer from me.

58:03 Like it has to be said to me in a specific way for me to go, "Oh, okay.

58:10 I'll I'll say it, but I always preface with, but you're probably not

58:14 going to remember this next time when we meet." And then I say it,

58:19 and then they're like, "Oh." and it just passes by.

58:25 Yeah, it's a very rich moment.

58:27 And the more we slow down and really understand where it's coming from for them,

58:33 it it's so beautiful sometimes,

58:36 like sometimes it becomes I didn't ever have parents who cared enough

58:41 to to know what was going on in my life and give me advice.

58:45 And other times it is um just I'm so

58:48 anxious I can't even think straight or it's like

58:51 I just need to I just need some to feel

58:54 like someone's with me on this in this process.

59:00 Mhm.

59:01 And yeah and and then to try it and say like okay what was that like?

59:07 I just gave you the advice you asked for it.

59:09 Was that did it feel good?

59:11 What and I'll say like did that feel right to me too?

59:14 And then we fold it into the way we work.

59:17 How do you guys feel about uh answering a question from a listener?

59:22 Oh wow.

59:22 Cool.

59:23 Yeah.

59:23 So I think that this could actually be a good way in here.

59:26 We've talked a lot about the practice of therapy and I

59:29 think that there are things in here that hopefully are

59:32 helpful for people uh in terms of thinking about their own

59:35 process with whatever it is that they're they're dealing with.

59:38 Uh but also what you guys mentioned is that um

59:42 it can be difficult to sometimes talk about things

59:44 because you want to protect your clients and you

59:46 don't want to get too specific about any individual case.

59:49 So sometimes a question is kind of uh helpful for this cuz it gives you

59:52 something to just explore together and I'm

59:54 really curious to hear you guys do that.

59:56 So here's the question.

59:58 I'm 50 years old and I'm still trying to figure

1:00:00 out how to let go of some old stuff.

1:00:03 I'm also reaching the period in my life where you just start losing everybody.

1:00:08 I'm afraid to open myself up because I've been hurt in the past

1:00:12 and I know that more grief is to come in the future.

1:00:15 I try telling my therapist to just brainwash me.

1:00:19 They think I'm kidding, but I'm kind of not.

1:00:22 I want to dump my garbage and be less empathic actually and less sensitive.

1:00:27 And it sounds like a joke even as I'm writing it.

1:00:30 But I don't feel like these are traits that are serving me.

1:00:34 So my question is, how can I brainwash myself?

1:00:48 The the the feeling of that question is sweet and adorable.

1:00:56 It's not a real question.

1:00:57 It's a very complex question actually cuz I don't think they mean it literally.

1:01:04 They know they're being there's a little self- aacing facitiousness in it,

1:01:08 but there's still this real poignant yearning to be free

1:01:12 of all the suffering that they can't be free of.

1:01:15 So I want that person to sit in the felt sense

1:01:22 of asking that question first for as long as they can tolerate.

1:01:27 And oh, I know what's going to happen next.

1:01:30 There's going to be a pull towards grieving more,

1:01:33 but then the desire to be done with it.

1:01:36 They're going to be right back in that dilemma.

1:01:38 I've suffered enough and it doesn't seem to end.

1:01:43 I'm tired of suffering.

1:01:45 Then you stay there and you stay there and at some point clarity does come.

1:01:55 At some point, if the fatigue is the true self, then the body will just say,

1:02:01 "I really need a break." And it'll be it'll be said

1:02:05 with such poignency that there's nothing to do but say, "Oh, let's go.

1:02:09 Let's go to King Spa together." I know.

1:02:12 I don't know if you guys have a King Spa out out there.

1:02:15 I don't think we do out here, but I've never been either,

1:02:18 but it's this outrageously enormous building of Korean spa.

1:02:23 It's like a It's like a Disneyland for spa treatment or something.

1:02:27 I I don't know that I'm thinking about going.

1:02:30 And as the break, the need for rest is acknowledged.

1:02:34 Then the need for grieving can also percolate.

1:02:38 And they they take turns.

1:02:41 And then in each moment, you just have to know which one is more alive.

1:02:46 And then see whether you're willing to do the thing

1:02:49 that's most alive with as much love as you can.

1:02:54 And either way is great.

1:02:56 When a person says that they've been hurting for so long

1:03:00 and it doesn't seem to end to me that I don't

1:03:02 believe that that feels like what the mind says when it's

1:03:06 trying to convince the body to be done with this process.

1:03:10 And it also signifies that the pain is feeling overwhelming.

1:03:14 But it could be overwhelming because

1:03:15 they're clenching too tightly as it's happening.

1:03:19 and if they just were to relax into it that it would pass through them faster.

1:03:26 So that's the complexity of the moment that I would

1:03:31 be thinking about and I wouldn't know how it would land,

1:03:34 but I'm ready to see it move one way or the other and then

1:03:39 feel whether or not it feels right and resonant with the person's true self.

1:03:45 and I would just ask them to stay there as long

1:03:48 as we can until their body knows which way to go.

1:03:52 Did that make any sense?

1:03:55 Mhm.

1:03:55 I I think so.

1:03:55 That piece in particular about I want to be less empathic and sensitive.

1:04:02 And that's something, Elizabeth,

1:04:03 that I feel like I've heard you mention occasionally both

1:04:06 in your own life and also in work with clients,

1:04:09 like the desire to feel less in that way.

1:04:11 Mhm.

1:04:12 Um, and I don't know if I you have any feelings about

1:04:15 that or if there's anything that that kind of like wakes up for you.

1:04:18 Yeah.

1:04:19 What with that question?

1:04:30 From my own experience,

1:04:31 I think there's some pain that is so big it takes two bodies to hold it.

1:04:39 So there's there's a big grief that I'm hearing can't be grieved alone.

1:04:47 And so my kind of thing is like, okay, how do we make the grief so enticing?

1:04:55 Like how do we make this space so fun and playful

1:05:02 and interesting that you want to play with me in it?

1:05:07 like you'll let me play with you with this grief, with this sensitivity,

1:05:12 with this suffering until you play with it so long that you realize,

1:05:17 oh, this isn't so bad.

1:05:21 Um, it it hurts less actually.

1:05:27 And and in that you let me take some of it with you.

1:05:37 And in there we can get curious about the weight of being so sensitive.

1:05:48 and giving a space to talk about all the things you

1:05:54 really feel that maybe you feel too silly or odd talking about.

1:06:01 And so it's easier to be like,

1:06:03 just hypnotize me and cut it off so I don't have to feel it.

1:06:05 It's like, well, okay.

1:06:06 Well, I'm I'm interested.

1:06:09 What's the taboo in all of that that you don't want to actually like talk about?

1:06:14 And in there, I I find a lot of play.

1:06:17 like I I kind of I think that's sort of what it's growing into me

1:06:20 as my therapeutic superpower is I can um

1:06:25 always find the play in something absolutely terrible

1:06:29 in the middle of um in the middle of the experience

1:06:32 of the grief it is there's no shortcut there's no way around how brutal

1:06:39 it is and so there are sometimes when it's just flooded flooding

1:06:43 through and overwhelming and you're right that it takes two bodies to hold.

1:06:48 That's a beautiful phrase and it reminds me of this other experience I

1:06:53 had where I was porously processing someone

1:06:57 else's grief and someone else held me

1:07:00 as that was happening and I was able to uh let it coarse through me

1:07:09 and then afterwards this uh I heard this voice in my head start to sing,

1:07:16 you have to be held to behold.

1:07:18 be held to behold over and over and again.

1:07:21 And it yeah, it it made me um appreciate that my needs have to be met too.

1:07:32 I have to take care of myself as I'm taking care of others.

1:07:36 like there's just this infinite layer

1:07:38 of like holding and beholding that's happening between

1:07:45 us all in this jewel net of Indra idea too if I'm going to use

1:07:50 a Buddhist idea what was the other thing oh the playfulness thing the image

1:07:58 that I often have is that um there are some people who are just

1:08:01 definitely afraid to go there and I too am still afraid to touch some

1:08:06 traumas in my life and I brace and um when I'm with patients who

1:08:13 are um kind of very ambivalent about entering that they the image that I

1:08:21 often see is that we're in the in the entry entrance to a hedge maze.

1:08:26 It's like the Minotaur's maze.

1:08:29 And for some reason they start talking about how lovely

1:08:32 the hedges are or like how square it's been cut or whatever.

1:08:37 And uh sometimes I will say you're talking about the hedges again.

1:08:43 Yeah.

1:08:42 If I feel like pressing kind of pushing them into the maze.

1:08:47 And then other times um I will say it but not

1:08:52 to push but to acknowledge that this is hard and this is enough.

1:08:57 Even standing here is enough and we can either stay here

1:09:01 or we can change topics and you can feel if you Oh,

1:09:07 the other beautiful thing about co-miserating with people is that you

1:09:11 can feel when they have had enough cuz you've had enough.

1:09:14 Mhm.

1:09:15 And then you can go onto something light and it's a it's like a little

1:09:20 bit of a you're holding hands and winking at each other as you're moving there.

1:09:24 Like decades ago, I had this girl

1:09:27 who we would alternate sessions where one session

1:09:30 would be hard conversation and then the other

1:09:33 session she was like a teenage girl.

1:09:35 We she would ask me,

1:09:36 "What do you think about this purse?" And then she would like Google

1:09:39 bags and then I would try to give her my best advice about handbags.

1:09:44 Mhm.

1:09:44 And it was so sweet cuz I knew what

1:09:46 she was doing and she knew what she was doing, but we didn't have to say it.

1:09:51 And it Yeah.

1:09:53 It was like, okay, yeah, we can do this.

1:09:56 This feels regulating.

1:09:57 And there was such agency in the implied agency in the fact that she was like,

1:10:01 okay, I got to ask you about this bag.

1:10:03 And it can happen very more quickly than, you know, alternating sessions.

1:10:07 It can just happen in moments.

1:10:09 And then I say, you know, you just change topics.

1:10:11 And she's like, I know, leave me alone.

1:10:12 and I'll just like I want to keep

1:10:14 talking about this and I'm like okay that's fine.

1:10:18 It's sweet when it's so collaborative.

1:10:20 I think that as we wander toward the end here unfortunately and you know

1:10:25 I feel like we could easily do this for another hour or two here.

1:10:29 Uh, something that I'm I'm curious about because we've mostly focused

1:10:33 this on people who who do this work are kind of like peeling back

1:10:39 the curtain on what you're thinking about or exploring or feeling or relating

1:10:44 to as you're there with another

1:10:46 person who's doing something that's very difficult.

1:10:49 Um, and it's to some extent kind of the unexplored country in therapy.

1:10:58 We've learned a lot more about these things over time,

1:11:01 but it it just feels more artistic to me when you guys

1:11:07 talk about it than when I hear people talk about therapy in general.

1:11:11 And one of the things that I was really wondering about,

1:11:13 and maybe it's a place where we could end today,

1:11:15 is how do you feel like you've been changed yourself by doing this?

1:11:20 I think that the Buddhists were right

1:11:22 that the the whole like polishing the mirror metaphor.

1:11:26 It's nothing but a destructive act of of ego.

1:11:31 Destroying the ego.

1:11:33 It's brutal.

1:11:34 Becoming a good therapist is brutal if you don't hide from the real work.

1:11:39 Um but in that what's left is is presence polished presence.

1:11:49 um aliveness, like really being able to mirror an experience

1:11:56 that is so universal and so individual at the same time.

1:12:02 Um what's changed for me, I feel like I've uh realized my purpose in life

1:12:09 in a way that I fought for many years.

1:12:12 Like if you if I think about how I left the monastery or chose

1:12:16 not to go into the monastery because of my immigrant needs to be a doctor.

1:12:20 I ended up still being a monastic by the end.

1:12:24 And the practice I'm not on a mountaintop.

1:12:26 I'm just in an office,

1:12:28 but it's easier for people to reach me than having to climb the mountain.

1:12:33 Um, it really does feel like a like a meditation practice

1:12:40 like a it's like a not a sitting doing nothing meditation.

1:12:44 It's like a walking and breathing and connecting while being

1:12:49 nobody meditation or being everybody and or and anybody meditation.

1:12:57 It overtrains my ear and not and my mouth is a little atrophied.

1:13:01 So, I'm not good with people outside of a therapy context.

1:13:10 I imagine my homunculus and it's like just all ear and heart and no

1:13:15 cocktail whatever part of the homunculus represents

1:13:19 the cocktail version of myself is completely atrophied.

1:13:23 I'm so grateful for it.

1:13:27 Like we can't help but grow through the through the work.

1:13:30 I was just imagining whoever's listening to this and I was

1:13:34 in a moment praying that this conversation helped them in some way.

1:13:38 I had a supervisor, one of my first supervisors like give me this phrase

1:13:45 as a reflection and it has stayed with me throughout my entire process so

1:13:52 far which is he told me he's like you dance in the chaos

1:13:57 of creation and I feel like this work has made me a much better dancer.

1:14:08 Um, I've I've become more liberated in my kind

1:14:12 of excitement and and play that can kind of come up.

1:14:18 Like I I find the maze in the minotaur to be the playful thing.

1:14:23 I'm like, "Oo, how fun.

1:14:24 We're about to be destroyed and then what's going to happen?"

1:14:28 Like I cuz I've done it so many times that I'm like,

1:14:33 "Oh, this is going to be great." and they're going,

1:14:35 "What?" And I'm like, "Oh, don't worry about it."

1:14:42 So, it's it's made me, I think,

1:14:46 even inside of myself, even when things are absolutely terrifying,

1:14:51 and I'm in my own parts that go can sometimes say something like,

1:14:58 "Are you freaking kidding me?

1:15:00 Another growth moment." and to have a louder side of me go like,

1:15:06 "Yeah, and how exciting.

1:15:09 Um, life's about to get so much bigger.

1:15:12 There's going to be so much more um that you get to dance in." That's so cool.

1:15:17 That would be the ideal supervision for you, you know,

1:15:20 like someone who's just like can't wait

1:15:23 to see what dance movie you pull out next.

1:15:29 Or that's the spirit you should surround yourself with as you learn to grow.

1:15:36 This has been really fantastic for me.

1:15:38 I hope that you guys have also enjoyed it.

1:15:40 I've loved listening to everything that you've been talking about and uh Dr.

1:15:43 Hal, as always, I really, you know, appreciate your time.

1:15:46 Thanks for doing this with us.

1:15:48 Thank you.

1:15:49 I really do hope it's useful for your listeners.

1:15:53 Yeah, I I try to forget about it as we're doing

1:15:55 it because I want to just get lost in what's happening,

1:15:57 but I knew that you were watching over us, too.

1:16:00 So, thank you for that.

1:16:01 Oh, it's very sweet and I really appreciate that.

1:16:05 I love today's conversation with Dr.

1:16:07 Jacob and Elizabeth.

1:16:09 And to be honest, I really don't know how to recap this one.

1:16:13 It's very difficult to look back over

1:16:16 my experience of it and give you this really

1:16:20 clearly defined narrative thread that that pulls it

1:16:24 all together with some nice takeaways for the future.

1:16:27 particularly if you're somebody who is yourself working through

1:16:30 some of the things that they talked about today.

1:16:32 And there were some moments during the conversation that for me were really just

1:16:35 deeply touching and very emotional like when

1:16:37 Elizabeth was talking about that that desire

1:16:41 to to have less sensitivity when she was talking about being a sensitive person

1:16:44 and relating to that with a client and and it was just very touching.

1:16:49 It was very affecting and I think that that's most of what

1:16:52 I'm going to take from this conversation is the feeling of it.

1:16:54 Kind of like I said during that moment with Dr.

1:16:56 how it feels like so many of the themes are tied together by this idea

1:17:01 of creating openness and curiosity and less uh this or that thinking, you know,

1:17:07 less I have to either go belly up when I repair with somebody or I

1:17:11 have to fight them about it and more ability to live in the middle.

1:17:16 And it's funny how even as I'm doing this recap right now,

1:17:18 I'm noticing myself like watching myself more

1:17:21 and uh not wanting to generalize so much.

1:17:25 I think that that's some of like Dr.

1:17:26 H coming in and sort of floating over my shoulder as I'm recording this.

1:17:30 But thematically, what you often see with people

1:17:32 who've gone through these kinds of experiences

1:17:35 is that there isn't so much of that hanging out in the healthy middle there.

1:17:40 There was more polarization inside of the family system

1:17:43 or they weren't allowed to express themselves at all.

1:17:46 So repair was just only belly up.

1:17:48 Uh Elizabeth talked with me a lot about

1:17:50 that in terms of her experiences when she was growing up.

1:17:53 she only had one option which was to just kind of submit.

1:17:57 And I think people can really empathize with that.

1:18:01 And it's hard to appreciate how difficult it is

1:18:05 to gain a new relational move with another person

1:18:09 to gain the move of hanging out in protest

1:18:13 for a little while or saying to the clinician,

1:18:16 "No, I disagree with that." or expressing hurt

1:18:19 and frustration related to something that happened in the room.

1:18:23 Something I I was occurring to me during the conversation

1:18:26 and there wasn't quite the right moment to mention it is

1:18:28 that there are a lot of people who have never been

1:18:31 able to say that to the person that they feel wronged them.

1:18:36 And so just the opportunity to express that can

1:18:40 be such a powerful moment in a person's

1:18:43 life and it can really help them reclaim the sense of oh wait I'm allowed to do

1:18:49 that and that's part of why that relational dynamic

1:18:52 with the therapist is so important in trauma treatment

1:18:55 because you're you're creating a space where somebody can

1:18:59 risk this um incredibly scary movement with another person,

1:19:06 they can risk relationship where for most people who have complex PTSD,

1:19:12 relationship is how the hurt got in.

1:19:15 And so, it's this incredibly brave move on the client's part

1:19:20 to open themselves up to that kind of vulnerability with a therapist.

1:19:24 And as I hope that people really got and heard from Dr.

1:19:27 H and Elizabeth, therapists really value that.

1:19:30 They appreciate that.

1:19:30 They understand the the poignency and the vulnerability and the responsibility

1:19:39 of the seat that they're in and it messes them up.

1:19:43 I I don't know another way to put it.

1:19:44 I've had so many experiences with Elizabeth where she comes home after a day

1:19:49 of working with people and she is so affected by the work that she's been doing.

1:19:55 And that's real.

1:19:57 and learning how to how to process the feeling of, "Wow,

1:20:00 I really messed up in there." Or like, "Wow,

1:20:02 I wish that it had gone differently with the client." And I I

1:20:06 hope that people listening to this really

1:20:09 take that feeling of like common humanity.

1:20:11 You know, your therapist is a person, too,

1:20:12 and they're thinking about all of this stuff, too.

1:20:14 And it's actually leaning into that relational space that often

1:20:18 makes the work go so much better and be so much richer and uh creates a lot

1:20:24 of opportunities for people to really get a different experience.

1:20:27 I hope you enjoyed the conversation.

1:20:29 Something that Dr.

1:20:30 H mentioned again uh after we stopped recording to Elizabeth and me

1:20:33 is how he is trying to put together this training platform for clinicians.

1:20:37 It's a little unclear the exact form that it'll take.

1:20:41 he's still working on it and he said something like it'll be

1:20:43 about 6 months from when we post this episode that that is

1:20:47 going to be live but as we learn more about it

1:20:49 we will pass it along to people who listen to the podcast.

1:20:52 I know that that's something that a lot

1:20:53 of clinicians would be interested in and I

1:20:56 think it's great that he's offering tools

1:20:58 to to give people more support who do this work.

1:21:00 Also, I just want more like Dr.

1:21:02 H content in the world.

1:21:04 Uh, I wish there was more of his stuff that was out there cuz he

1:21:07 just has such a unique perspective and is such a unique person doing this work.

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