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as with all podcasts you can click on

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the timestamp in the description or over

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here you can see the timestamp to skip

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this intro

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lillian dindo is a professor of

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psychiatry at the baylor college school

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of medicine and a researcher as well as

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popularizer of the psychotherapeutic

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technique or way of life depending on

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how you look at it called acceptance and

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commitment therapy which we call act

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therapy if you've watched the recent

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carl fristen episode which is linked in

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the description then you'll see that i

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consider that one to be the most

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important episode of all the theories of

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everything podcasts and that's in

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particular because it serves as a

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cautionary tale of what serious

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examinations into consciousness and

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reality altering theories can cause in

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one's mind and it's not pleasant you may

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have heard me use the term abignosis

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which is what i think science will

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develop to merging the inwardly

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experiential knowledges with the

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outwardly objective knowledges broadly

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speaking on the toe podcast one of the

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eventual goals is to take a syncretic

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approach to both the east and the west

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which are ordinarily kept separate what

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i like about lily and dindo is that the

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act therapy that she advocates for not

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only helped me during recent extreme

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psychological turmoil but simultaneously

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it serves as a bridge between the

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philosophies of the east and the

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practices of the west now if you're

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interested in the philosophies of the

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west and the practices of the east then

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you can watch the recent ahlmass episode

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linked in the description as well my

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name is kirchey mungle and i'm a

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filmmaker

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podcaster slash person investigating

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theories of everything from a

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theoretical physics perspective but as

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well as understanding the philosophies

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of consciousness and what role

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consciousness has to fundamental reality

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recently there's been a video released

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on this channel called a crash course on

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theoretical physics which was the

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longest time that i've spent on any

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single video on this channel if you're

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interested in salvator pius's ideas on

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quantum gravity or extra dimensions or

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what it means when a physicist

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quote-unquote sets c to equal one to

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equal h-bar then do consider watching

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that as it's the lesson that i wish i

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had when i was going to university by

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the way my background is in mathematical

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physics and the math in this video is

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aimed at the high school level there are

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plenty of myths in physics that are

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dispelled there as well as well as

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general tips on learning mathematics and

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physics feel free to share that to

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someone who's interested in physics and

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mathematics this work was only able to

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be done because of brilliant and the

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patrons now with regard to brilliant

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they're the sponsor of this episode

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brilliant is a website and an app that

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has interactive learning experiences

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with regard to math science and

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engineering they have lessons on

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information theory on group theory and

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special relativity group theory by the

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way is what's being referenced when you

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hear that the standard models quote

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unquote internal gauge symmetries are u1

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cross su 2 crosses su 3 and so on at

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some point soon i'll be speaking to

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chiara marletto on constructor theory

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and that is heavily predicated on

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information theory and so i took

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brilliance course and it made it

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extremely lucid why the formula for

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entropy is the way that it is visit

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brilliant.org toe to get 20 off the

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annual subscription i recommend you

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don't stop before at least four lessons

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and i think you'll be greatly surprised

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at the ease at which you now can

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comprehend subjects you previously had a

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difficult time grocking now if you enjoy

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witnessing and engaging in real-time

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conversation with others on the topics

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of consciousness psychology physics

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religion then check out the description

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for a link to the theories of everything

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discord and subreddit there's also a

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link to the patreon that is

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patreon.com if you'd like to support

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this podcast as the patrons and the

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sponsors are the only reason that i'm

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able to put out videos of this quality

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in this depth such as the crash course

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on theoretical physics as this is what

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i'm now able to do full time thanks to

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your support

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thank you and enjoy professor one of the

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reasons i was and am excited to speak

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with you is because when one goes about

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this project of questioning what reality

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is and consciousness and so on which is

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essentially what concerns this channel

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it can be destabilizing there can be

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existential dread and what i found that

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helped me was something called act

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therapy an approach called act and i was

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searching for more information about it

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a few months ago and your name kept

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popping up over and over and since then

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i think i've watched all of the material

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that has you online

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so i'm super excited to speak with you

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about act and why don't you start off

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with what is act what does it stand for

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what is it and how did you become

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interested in it

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okay

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um

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so act is stands for acceptance and

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commitment therapy and

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act as a psychological treatment

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approach it evolved out of the

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behavioral analytic tradition

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and it focuses on teaching skills for

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living effectively even in difficult

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circumstances

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so act actually is more than just a

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therapy it's a framework for living well

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and unlike a lot of treatment approaches

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or protocols that are tied to specific

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symptom presentations or disorders

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act is actually applicable to virtually

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all people

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regardless of circumstances culture

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complaint

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and i think part of the reason for that

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is the premise from which it begins so

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act begins

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with this fundamental understanding

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that pain

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grief

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loss disappointment

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fear these are inevitable features of

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living a human life

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and

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is not the elimination of these

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experiences or symptoms

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but instead

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a wholehearted pursuit

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of living a valued life

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valued life areas like relationships

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meaningful work

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education personal growth

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even in the presence of difficult

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emotional experiences and thoughts

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so the emphasis on the heart of act is

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creating this life

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um a worthwhile life that you want both

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now and in the future

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so

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act

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you know doesn't believe that people are

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broken or that they have illnesses

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just that they're stuck in

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understandable patterns that aren't

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working for them based on

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their history what they've been through

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and so act gives people the tools to

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deal with

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the opportunities and the difficulties

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that life throws our way

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um

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and in a

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nutshell it helps us accept things that

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are really difficult to control

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and teaches us to commit to doing the

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things that we deeply care about

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so in a nutshell

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that's that's what act has

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you know um

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is about and

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i got into it when i was in graduate

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school and i had learned you know all

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these other models of therapy

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and to be perfectly honest i wasn't

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for example traditional cognitive

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behavioral therapy um interpersonal

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psychotherapy

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and

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they were fine they were great you know

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but it didn't personally resonate with

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me you know it was like i'm the expert

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and i'm going to treat this person in

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front of me using this intervention

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and i remember opening up

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you know starting to study act and

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opening up the book

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you know for for the class and

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there was this sentence in the first

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paragraph of the

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main act textbook

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and that

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the end of that paragraph said

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the single most remarkable fact of human

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existence

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is how hard it is for human beings to be

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happy that sounds extremely eastern is

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this influenced by eastern approaches

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it's absolutely

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so the other thing it says is suffering

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is a basic characteristic of human life

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and it's absolutely influenced by

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eastern philosophy so it has you know

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there are six processes in act

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and again unlike other treatment

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approaches it was built from the bottom

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up and so

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there were lots of clinical

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science studies being done even before

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act was presented as a treatment model

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and so it pulled from things that were

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found to be effective and from the

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eastern tradition for example we know

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that mindfulness is effective

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um and that this basic premise that

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suffering is

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you know

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a part of the human condition and so

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act certainly has parts of the eastern

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tradition but it's not only that

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act as an exposure therapy but it's not

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just an exposure therapy

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act as a behavioral activation therapy

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but it's not just a behavioral

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activation therapy it pulls in

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different processes that have been shown

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to work

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over time and puts them into a treatment

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package

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is it fairly new

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it is not fairly new

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the first textbook

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description of act came out in 1999

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so act as a package came out in 1999 but

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the developers of act had been

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researching

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for about 20 years beforehand

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the different processes like you know

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thought suppression you know we know we

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we know one of the most consistent

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findings in psychology which is hard to

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find

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is that thought suppression even though

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it works really well in the short term

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it actually leads to a rebound effect

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in the long term you know so

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trying to push down thoughts trying to

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distract from thoughts trying to run

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away from thoughts

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very effective in the short term but in

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the long term actually has a rebound

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effect so the developers of act had been

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researching these processes for a few

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decades before they came out with the

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treatment model in 1999.

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between 1999 and now the research

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literature on act has completely

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exploded

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there are over 300 randomized control

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trials right now of act

288
00:10:31,110 --> 00:10:29,120
and in general a recent meta-analysis of

289
00:10:32,470 --> 00:10:31,120
the meta-analyses

290
00:10:34,069 --> 00:10:32,480
has shown

291
00:10:36,389 --> 00:10:34,079
that it's either equivalent to other

292
00:10:38,710 --> 00:10:36,399
gold standard treatments

293
00:10:40,069 --> 00:10:38,720
or in some cases can be more effective

294
00:10:41,030 --> 00:10:40,079
more effective

295
00:10:46,710 --> 00:10:41,040
and

296
00:10:48,710 --> 00:10:46,720
difficulties you mentioned earlier that

297
00:10:50,550 --> 00:10:48,720
people go through so i imagine one may

298
00:10:53,350 --> 00:10:50,560
be obsessive thoughts what are some

299
00:10:54,870 --> 00:10:53,360
other examples of illnesses or

300
00:10:57,030 --> 00:10:54,880
if one doesn't want to consider them

301
00:10:59,110 --> 00:10:57,040
illnesses or whatever you would like to

302
00:11:01,030 --> 00:10:59,120
call them what are some examples of

303
00:11:05,430 --> 00:11:01,040
distresses that people go through that

304
00:11:11,670 --> 00:11:06,470
um

305
00:11:12,829 --> 00:11:11,680
life i mean

306
00:11:15,590 --> 00:11:12,839
everyone

307
00:11:19,430 --> 00:11:15,600
who's got a pulse is going to be

308
00:11:21,430 --> 00:11:19,440
rejected at some point no matter how

309
00:11:24,389 --> 00:11:21,440
wonderful and and intelligent and

310
00:11:26,069 --> 00:11:24,399
beautiful and successful you might be

311
00:11:27,750 --> 00:11:26,079
you're still going to be rejected by

312
00:11:29,030 --> 00:11:27,760
people in your life you know and that's

313
00:11:31,590 --> 00:11:29,040
gonna hurt

314
00:11:33,670 --> 00:11:31,600
we're all gonna have an illness in our

315
00:11:35,670 --> 00:11:33,680
life we're all gonna face

316
00:11:39,030 --> 00:11:35,680
a medical illness that's gonna challenge

317
00:11:42,069 --> 00:11:39,040
us we are all going to face heartbreak

318
00:11:44,949 --> 00:11:42,079
uh the loss of people we love

319
00:11:48,389 --> 00:11:44,959
in anything that you care about there's

320
00:11:51,190 --> 00:11:48,399
the flip side that it comes with pain

321
00:11:52,230 --> 00:11:51,200
if you have a child you know

322
00:11:59,590 --> 00:11:52,240
that

323
00:12:01,750 --> 00:11:59,600
comes intense anxiety

324
00:12:03,910 --> 00:12:01,760
about their well-being and their health

325
00:12:06,389 --> 00:12:03,920
and their future right

326
00:12:07,750 --> 00:12:06,399
and so in act they have this saying in

327
00:12:11,269 --> 00:12:07,760
your pain

328
00:12:13,350 --> 00:12:11,279
you find your values and in your values

329
00:12:15,110 --> 00:12:13,360
you find your pain

330
00:12:17,670 --> 00:12:15,120
and that means that anything you care

331
00:12:20,069 --> 00:12:17,680
about if you care about a friend

332
00:12:22,470 --> 00:12:20,079
and you care about a friendship and

333
00:12:24,470 --> 00:12:22,480
you're betrayed

334
00:12:26,069 --> 00:12:24,480
right and so

335
00:12:28,550 --> 00:12:26,079
the natural thing like let's take that

336
00:12:30,629 --> 00:12:28,560
for an example you have a friend really

337
00:12:33,430 --> 00:12:30,639
good close friend

338
00:12:34,949 --> 00:12:33,440
and you were betrayed or you felt

339
00:12:36,470 --> 00:12:34,959
rejected

340
00:12:39,670 --> 00:12:36,480
the easy thing to do would be to

341
00:12:42,790 --> 00:12:39,680
withdraw not talk about it withdraw shut

342
00:12:44,949 --> 00:12:42,800
them out of your life right

343
00:12:46,310 --> 00:12:44,959
and you can also avoid future

344
00:12:48,230 --> 00:12:46,320
friendships

345
00:12:50,470 --> 00:12:48,240
for example because you feel like you've

346
00:12:53,829 --> 00:12:50,480
been rejected and you've been

347
00:12:56,069 --> 00:12:53,839
you know you don't trust and so

348
00:12:57,829 --> 00:12:56,079
it applies to any of life's difficulties

349
00:12:58,870 --> 00:12:57,839
you know going to grad school you have

350
00:13:00,790 --> 00:12:58,880
to be

351
00:13:02,150 --> 00:13:00,800
going to any actually you know

352
00:13:04,550 --> 00:13:02,160
educational

353
00:13:06,470 --> 00:13:04,560
program it's not easy

354
00:13:09,110 --> 00:13:06,480
you have to face criticism you have to

355
00:13:11,590 --> 00:13:09,120
face difficult challenges how do you

356
00:13:13,110 --> 00:13:11,600
face those challenges do you withdraw or

357
00:13:15,030 --> 00:13:13,120
do you face them

358
00:13:16,710 --> 00:13:15,040
so when you ask me like what are the

359
00:13:18,069 --> 00:13:16,720
challenges

360
00:13:19,590 --> 00:13:18,079
i think

361
00:13:22,069 --> 00:13:19,600
there's really far

362
00:13:24,949 --> 00:13:22,079
it's anything in life that

363
00:13:27,670 --> 00:13:24,959
is gonna gonna hurt sometimes

364
00:13:29,750 --> 00:13:27,680
and also opportunities you know when

365
00:13:31,190 --> 00:13:29,760
someone says to me like you just said to

366
00:13:33,269 --> 00:13:31,200
me will you come

367
00:13:35,670 --> 00:13:33,279
do this interview

368
00:13:38,230 --> 00:13:35,680
it would really be much easier and less

369
00:13:40,629 --> 00:13:38,240
anxiety provoking to say no thank you

370
00:13:43,910 --> 00:13:40,639
right much easier

371
00:13:46,389 --> 00:13:43,920
but over time if i keep doing that

372
00:13:48,629 --> 00:13:46,399
number one i never learn how to cope

373
00:13:51,670 --> 00:13:48,639
with my anxiety

374
00:13:53,910 --> 00:13:51,680
number two my anxiety starts actually

375
00:13:55,990 --> 00:13:53,920
seeping into other areas because i never

376
00:13:57,829 --> 00:13:56,000
learned how to cope with it

377
00:13:59,590 --> 00:13:57,839
and number three

378
00:14:02,949 --> 00:13:59,600
my world's getting smaller because i'm

379
00:14:04,230 --> 00:14:02,959
not doing something i care about

380
00:14:06,550 --> 00:14:04,240
this latter part sounds like the

381
00:14:08,150 --> 00:14:06,560
exposure therapy aspect but if you were

382
00:14:09,750 --> 00:14:08,160
to avoid it well that's going to make it

383
00:14:12,230 --> 00:14:09,760
worse and if you were to encounter it

384
00:14:15,829 --> 00:14:12,240
voluntarily slowly incrementally on your

385
00:14:18,949 --> 00:14:15,839
terms then it increases your resilience

386
00:14:21,350 --> 00:14:18,959
so are you feeling anxiety right now

387
00:14:22,870 --> 00:14:21,360
i'm definitely feeling anxiety right now

388
00:14:25,269 --> 00:14:22,880
um

389
00:14:27,829 --> 00:14:25,279
my heart like so what is anxiety right

390
00:14:29,269 --> 00:14:27,839
and if you disentangle anxiety what is

391
00:14:34,949 --> 00:14:29,279
it

392
00:14:38,230 --> 00:14:34,959
the physical

393
00:14:40,470 --> 00:14:38,240
like my heart's definitely racing a

394
00:14:42,629 --> 00:14:40,480
little bit more than maybe the norm

395
00:14:45,110 --> 00:14:42,639
i can feel my throat like a little bit

396
00:14:47,189 --> 00:14:45,120
constricted you know i feel a little bit

397
00:14:49,189 --> 00:14:47,199
shaky so those are the physical

398
00:14:50,949 --> 00:14:49,199
sensations right

399
00:14:51,829 --> 00:14:50,959
then there's the thoughts

400
00:14:56,230 --> 00:14:51,839
now

401
00:14:58,389 --> 00:14:56,240
there aren't a lot of thoughts going on

402
00:15:00,310 --> 00:14:58,399
but in general like the thoughts are

403
00:15:01,670 --> 00:15:00,320
like before i came in

404
00:15:04,069 --> 00:15:01,680
oh my god am i going to know how to

405
00:15:05,750 --> 00:15:04,079
answer this is oh i have to blow this am

406
00:15:06,629 --> 00:15:05,760
i going to sound stupid right i mean

407
00:15:08,389 --> 00:15:06,639
it's

408
00:15:10,949 --> 00:15:08,399
these are the thoughts

409
00:15:14,389 --> 00:15:10,959
and then the third piece is

410
00:15:16,710 --> 00:15:14,399
the behavioral like urge that you have

411
00:15:17,910 --> 00:15:16,720
that comes with an emotion

412
00:15:20,629 --> 00:15:17,920
you know that's a component of the

413
00:15:22,949 --> 00:15:20,639
emotion and when it's anxiety the

414
00:15:25,430 --> 00:15:22,959
behavioral urge is to run

415
00:15:27,269 --> 00:15:25,440
right it's to say not gonna do this

416
00:15:29,110 --> 00:15:27,279
because if i run

417
00:15:31,430 --> 00:15:29,120
in the short term

418
00:15:32,629 --> 00:15:31,440
my anxiety goes down

419
00:15:35,990 --> 00:15:32,639
right

420
00:15:39,670 --> 00:15:37,750
what i've learned to do

421
00:15:42,069 --> 00:15:39,680
and i've had panic attacks by the way

422
00:15:45,030 --> 00:15:42,079
and i learned and i you know i've run

423
00:15:47,269 --> 00:15:45,040
away many times

424
00:15:49,509 --> 00:15:47,279
but what i've learned to do is when i

425
00:15:52,150 --> 00:15:49,519
notice my anxiety well let me ask you

426
00:15:54,870 --> 00:15:52,160
this kurt let's say that i noticed my

427
00:15:57,350 --> 00:15:54,880
heart racing and my throat constricting

428
00:15:59,910 --> 00:15:57,360
and i start saying to myself

429
00:16:01,110 --> 00:15:59,920
this is terrible you cannot do this this

430
00:16:03,749 --> 00:16:01,120
is terrible

431
00:16:06,069 --> 00:16:03,759
this is the worst thing this is awful

432
00:16:09,509 --> 00:16:06,079
why am i like this why after 20 years do

433
00:16:10,949 --> 00:16:09,519
i still get this way it's so ridiculous

434
00:16:12,389 --> 00:16:10,959
get with it

435
00:16:13,670 --> 00:16:12,399
what do you think will happen to my

436
00:16:16,310 --> 00:16:13,680
anxiety

437
00:16:17,990 --> 00:16:16,320
it won't go away it may increase and

438
00:16:19,509 --> 00:16:18,000
especially if you leave in that

439
00:16:21,269 --> 00:16:19,519
situation once it'll make it much more

440
00:16:23,990 --> 00:16:21,279
likely for you to leave again and so

441
00:16:27,350 --> 00:16:24,000
avoidance will increase as well

442
00:16:30,230 --> 00:16:27,360
both yes so actually if i respond

443
00:16:31,269 --> 00:16:30,240
to the physical sensations

444
00:16:35,269 --> 00:16:31,279
with

445
00:16:38,949 --> 00:16:35,279
rejection and why and this is awful

446
00:16:41,110 --> 00:16:38,959
then it actually increases the anxiety

447
00:16:43,749 --> 00:16:41,120
so now when i notice my heart racing and

448
00:16:45,910 --> 00:16:43,759
my throat constricting i say okay

449
00:16:47,829 --> 00:16:45,920
your heart's racing okay your throat's

450
00:16:49,990 --> 00:16:47,839
constricting

451
00:16:52,230 --> 00:16:50,000
and this is important like this is

452
00:16:54,470 --> 00:16:52,240
important for me to do so

453
00:16:55,910 --> 00:16:54,480
you know i can be with this that's the

454
00:16:59,350 --> 00:16:55,920
value part

455
00:17:01,829 --> 00:16:59,360
exactly it's you connect it the values

456
00:17:05,909 --> 00:17:01,839
piece is what makes it worthwhile like

457
00:17:07,990 --> 00:17:05,919
why would i put myself in this situation

458
00:17:09,829 --> 00:17:08,000
well i'll put myself in this situation

459
00:17:12,309 --> 00:17:09,839
because it matters to me because this is

460
00:17:14,949 --> 00:17:12,319
something i care about you know

461
00:17:17,669 --> 00:17:14,959
so it provides the motivation it

462
00:17:19,590 --> 00:17:17,679
provides the why for why i should do

463
00:17:21,750 --> 00:17:19,600
this values are

464
00:17:23,270 --> 00:17:21,760
the purpose behind

465
00:17:25,990 --> 00:17:23,280
why you might do things that are

466
00:17:27,990 --> 00:17:26,000
uncomfortable or difficult so

467
00:17:30,310 --> 00:17:28,000
there's number one

468
00:17:32,549 --> 00:17:30,320
you know just noticing my okay like my

469
00:17:35,270 --> 00:17:32,559
heart's racing okay

470
00:17:36,870 --> 00:17:35,280
that's okay you know my throats go okay

471
00:17:37,590 --> 00:17:36,880
my throat's constricting that happens

472
00:17:40,070 --> 00:17:37,600
when

473
00:17:42,390 --> 00:17:40,080
i go running that happens

474
00:17:44,070 --> 00:17:42,400
in many situations

475
00:17:46,549 --> 00:17:44,080
but sometimes i interpret it as

476
00:17:48,470 --> 00:17:46,559
dangerous and sometimes i interpret it

477
00:17:50,549 --> 00:17:48,480
as pleasant

478
00:17:51,430 --> 00:17:50,559
but the physical sensation itself is the

479
00:17:52,470 --> 00:17:51,440
same

480
00:17:55,430 --> 00:17:52,480
and so

481
00:17:58,150 --> 00:17:55,440
it's like now i can say okay i'm okay i

482
00:18:00,070 --> 00:17:58,160
can i can have this anxiety and still

483
00:18:01,590 --> 00:18:00,080
commit to doing this because it matters

484
00:18:03,750 --> 00:18:01,600
to me

485
00:18:05,990 --> 00:18:03,760
is it exactly the physiologically the

486
00:18:07,669 --> 00:18:06,000
same so i hear this plenty that people

487
00:18:09,350 --> 00:18:07,679
will say excitement and anxiety are two

488
00:18:10,789 --> 00:18:09,360
sides of the same coin except it depends

489
00:18:12,549 --> 00:18:10,799
on the interpretation you place on it

490
00:18:14,950 --> 00:18:12,559
one is positive but i don't know is that

491
00:18:17,590 --> 00:18:14,960
actually true if one was to examine all

492
00:18:19,750 --> 00:18:17,600
of the biomarkers could one in a blinded

493
00:18:21,110 --> 00:18:19,760
study determine dispassionately this

494
00:18:22,470 --> 00:18:21,120
actually this person's going through an

495
00:18:25,190 --> 00:18:22,480
anxious emotion whereas this one's going

496
00:18:26,470 --> 00:18:25,200
through an excited emotion

497
00:18:27,430 --> 00:18:26,480
crazily

498
00:18:29,110 --> 00:18:27,440
yes

499
00:18:30,549 --> 00:18:29,120
they're the same

500
00:18:32,470 --> 00:18:30,559
there's this um

501
00:18:33,990 --> 00:18:32,480
and i you might want to cut this off

502
00:18:35,190 --> 00:18:34,000
from the video

503
00:18:36,470 --> 00:18:35,200
sure sure

504
00:18:39,029 --> 00:18:36,480
you might want to cut this off but

505
00:18:43,510 --> 00:18:39,039
anyways there's a there's a study

506
00:18:44,470 --> 00:18:43,520
um by some famous sex therapists and

507
00:18:47,430 --> 00:18:44,480
they

508
00:18:50,630 --> 00:18:47,440
did a biomarker study actually

509
00:18:52,789 --> 00:18:50,640
where they hooked up people who were

510
00:18:54,230 --> 00:18:52,799
you know like um blood

511
00:18:57,270 --> 00:18:54,240
you know

512
00:19:01,110 --> 00:18:57,280
electrodermal response heart rate few

513
00:19:04,710 --> 00:19:01,120
other biomarkers and they found that the

514
00:19:06,470 --> 00:19:04,720
biomarkers were exactly the same or

515
00:19:08,630 --> 00:19:06,480
similar enough i guess so that's

516
00:19:11,590 --> 00:19:08,640
statistically significant

517
00:19:13,270 --> 00:19:11,600
that people having an orgasm were

518
00:19:14,870 --> 00:19:13,280
indistinguishable from people having a

519
00:19:16,549 --> 00:19:14,880
panic attack

520
00:19:17,990 --> 00:19:16,559
right so well that's extremely

521
00:19:20,870 --> 00:19:18,000
interesting

522
00:19:23,190 --> 00:19:20,880
right and so you know the heart racing

523
00:19:25,110 --> 00:19:23,200
throat constricting like feeling like

524
00:19:26,950 --> 00:19:25,120
whoa right like

525
00:19:28,789 --> 00:19:26,960
they were indistinguishable

526
00:19:32,470 --> 00:19:28,799
on the electrodermal response and on the

527
00:19:34,390 --> 00:19:32,480
heart rate and and other um biomarkers

528
00:19:39,190 --> 00:19:34,400
so

529
00:19:41,270 --> 00:19:39,200
distinguishable actually okay now

530
00:19:43,590 --> 00:19:41,280
in a meta manner we've gotten to the why

531
00:19:45,190 --> 00:19:43,600
of act that is why should people who are

532
00:19:47,830 --> 00:19:45,200
listening slash watching to this care

533
00:19:51,110 --> 00:19:47,840
about act so the value of act let's get

534
00:19:52,549 --> 00:19:51,120
into the what of act what is act

535
00:19:54,390 --> 00:19:52,559
can you break it down step by step how

536
00:19:56,789 --> 00:19:54,400
does someone go through the process of

537
00:20:00,870 --> 00:19:58,710
how does the person go through the

538
00:20:02,950 --> 00:20:00,880
process of act well it depends it

539
00:20:05,270 --> 00:20:02,960
depends which um

540
00:20:07,270 --> 00:20:05,280
way you do it right so which treatment

541
00:20:08,789 --> 00:20:07,280
delivery format

542
00:20:11,350 --> 00:20:08,799
you're doing and so it could be

543
00:20:14,310 --> 00:20:11,360
one-on-one therapy it could be workshops

544
00:20:16,310 --> 00:20:14,320
it could be online you know okay i'll

545
00:20:17,909 --> 00:20:16,320
give you an example for me i was dealing

546
00:20:20,630 --> 00:20:17,919
with the obsessive thoughts that came

547
00:20:22,630 --> 00:20:20,640
from rumination of what the heck is

548
00:20:23,750 --> 00:20:22,640
reality and then questioning my own

549
00:20:26,630 --> 00:20:23,760
and then

550
00:20:27,990 --> 00:20:26,640
i started to use one of the analogies

551
00:20:29,750 --> 00:20:28,000
what's great about act is that it has

552
00:20:31,510 --> 00:20:29,760
these visual analogies yeah so one of

553
00:20:33,990 --> 00:20:31,520
them is thoughts as if they're

554
00:20:36,149 --> 00:20:34,000
passengers on a bus and you're the

555
00:20:38,310 --> 00:20:36,159
driver of the bus and if you were to

556
00:20:40,310 --> 00:20:38,320
simply quiet the thoughts or tell them

557
00:20:42,950 --> 00:20:40,320
to shut up or go away or be distressed

558
00:20:44,470 --> 00:20:42,960
about them and place an undue amount of

559
00:20:47,190 --> 00:20:44,480
attention to them then they become a bit

560
00:20:49,750 --> 00:20:47,200
louder much like an obstreperous

561
00:20:51,909 --> 00:20:49,760
audience member would become more

562
00:20:53,590 --> 00:20:51,919
agitated the more that you speak to them

563
00:20:55,430 --> 00:20:53,600
perhaps what you should do is simply

564
00:20:56,789 --> 00:20:55,440
acknowledge their existence say oh i see

565
00:20:58,390 --> 00:20:56,799
that you're there which is why by the

566
00:20:59,750 --> 00:20:58,400
way i want to get to is acknowledgement

567
00:21:01,590 --> 00:20:59,760
a better term than acceptance but we can

568
00:21:02,789 --> 00:21:01,600
get to that later that's a very good

569
00:21:04,630 --> 00:21:02,799
question

570
00:21:06,070 --> 00:21:04,640
because accepting to me seems to take

571
00:21:07,669 --> 00:21:06,080
those thoughts on and say oh no your

572
00:21:10,070 --> 00:21:07,679
reality should be questioned and perhaps

573
00:21:11,990 --> 00:21:10,080
so and so is not true so anyway that's a

574
00:21:13,430 --> 00:21:12,000
very important question and i hope we

575
00:21:14,710 --> 00:21:13,440
get to it we'll get to look at this

576
00:21:16,470 --> 00:21:14,720
written down

577
00:21:18,870 --> 00:21:16,480
and so

578
00:21:21,270 --> 00:21:18,880
then i would view those thoughts as

579
00:21:23,029 --> 00:21:21,280
visually as passengers on a bus and i

580
00:21:24,789 --> 00:21:23,039
would say okay well i'm going to direct

581
00:21:26,310 --> 00:21:24,799
this bus where my values are and

582
00:21:28,390 --> 00:21:26,320
initially i missed out on the values

583
00:21:30,230 --> 00:21:28,400
portion so it wasn't as effective until

584
00:21:31,830 --> 00:21:30,240
i because then where am i going with the

585
00:21:33,590 --> 00:21:31,840
bus that to me is where the values come

586
00:21:35,110 --> 00:21:33,600
in and why should i even go there so

587
00:21:36,789 --> 00:21:35,120
initially i missed out on the values

588
00:21:38,149 --> 00:21:36,799
that later when i added that it became

589
00:21:40,470 --> 00:21:38,159
more

590
00:21:41,270 --> 00:21:40,480
effective for me okay so that's how it

591
00:21:42,549 --> 00:21:41,280
worked

592
00:21:44,789 --> 00:21:42,559
for me

593
00:21:46,390 --> 00:21:44,799
and i think initially before that i was

594
00:21:47,270 --> 00:21:46,400
doing something that didn't work which

595
00:21:49,590 --> 00:21:47,280
you mentioned earlier thought

596
00:21:50,789 --> 00:21:49,600
suppression i did i had a rubber band on

597
00:21:52,710 --> 00:21:50,799
anytime i would have these thoughts that

598
00:21:54,310 --> 00:21:52,720
would give me anxiety i would do the

599
00:21:56,630 --> 00:21:54,320
self-administered adversive therapy

600
00:21:58,630 --> 00:21:56,640
which i thought worked for thoughts and

601
00:22:00,549 --> 00:21:58,640
it apparently doesn't it rebounds later

602
00:22:02,470 --> 00:22:00,559
maybe initially works but so i stopped

603
00:22:04,310 --> 00:22:02,480
that and found act and then i

604
00:22:05,190 --> 00:22:04,320
saw some success so that's my personal

605
00:22:07,430 --> 00:22:05,200
case

606
00:22:08,789 --> 00:22:07,440
with act so given that

607
00:22:09,990 --> 00:22:08,799
that's what i mean can you take us

608
00:22:11,430 --> 00:22:10,000
through an example of how someone

609
00:22:13,510 --> 00:22:11,440
listening may employ this in their own

610
00:22:14,710 --> 00:22:13,520
life and perhaps how one should apply it

611
00:22:16,470 --> 00:22:14,720
in their own life is too broad and maybe

612
00:22:17,510 --> 00:22:16,480
you just want to take a specific example

613
00:22:19,029 --> 00:22:17,520
and say

614
00:22:22,230 --> 00:22:19,039
you understand

615
00:22:24,230 --> 00:22:22,240
so i'll start broad and maybe go a

616
00:22:27,669 --> 00:22:24,240
little more narrow but tell me if this

617
00:22:29,590 --> 00:22:27,679
is the wrong direction

618
00:22:32,630 --> 00:22:29,600
so i'll share the

619
00:22:35,990 --> 00:22:32,640
kind of key features right

620
00:22:39,029 --> 00:22:36,000
first of all a rich and meaningful life

621
00:22:41,750 --> 00:22:39,039
and act is about what you want

622
00:22:43,669 --> 00:22:41,760
not what you don't want

623
00:22:45,909 --> 00:22:43,679
it's about going for something that you

624
00:22:49,029 --> 00:22:45,919
value and care about rather than

625
00:22:51,750 --> 00:22:49,039
escaping from or avoiding experiences

626
00:22:54,630 --> 00:22:51,760
that you don't want okay

627
00:22:56,310 --> 00:22:54,640
and so for example

628
00:22:58,470 --> 00:22:56,320
patients will come in or people will

629
00:23:00,950 --> 00:22:58,480
come in and they'll say

630
00:23:03,510 --> 00:23:00,960
i don't want to feel anxious anymore

631
00:23:06,830 --> 00:23:03,520
i don't want to feel pain anymore i

632
00:23:09,830 --> 00:23:06,840
don't want to feel sadness or guilt

633
00:23:12,549 --> 00:23:09,840
anymore people are quick

634
00:23:15,110 --> 00:23:12,559
and automatically will tell you all the

635
00:23:16,230 --> 00:23:15,120
things that they don't want

636
00:23:22,310 --> 00:23:16,240
and

637
00:23:24,630 --> 00:23:22,320
society is like okay well don't let's

638
00:23:26,710 --> 00:23:24,640
figure out how you can not feel this way

639
00:23:30,789 --> 00:23:26,720
right let's figure out how you can not

640
00:23:36,070 --> 00:23:33,110
act will say well okay

641
00:23:37,990 --> 00:23:36,080
if you weren't in pain what would you be

642
00:23:40,310 --> 00:23:38,000
doing instead

643
00:23:41,430 --> 00:23:40,320
if this pain were not getting in the way

644
00:23:43,750 --> 00:23:41,440
of living

645
00:23:45,029 --> 00:23:43,760
as it is right now what would you be

646
00:23:47,669 --> 00:23:45,039
doing

647
00:23:49,590 --> 00:23:47,679
if you weren't so anxious

648
00:23:50,390 --> 00:23:49,600
what would you be doing

649
00:23:52,950 --> 00:23:50,400
right

650
00:23:55,029 --> 00:23:52,960
if you weren't so guilt-ridden

651
00:23:57,110 --> 00:23:55,039
what would you be doing you're trying to

652
00:24:00,310 --> 00:23:57,120
get away from

653
00:24:02,470 --> 00:24:00,320
symptom focus to

654
00:24:05,510 --> 00:24:02,480
what do you want to be doing in your

655
00:24:07,669 --> 00:24:05,520
life if those things were not there

656
00:24:10,310 --> 00:24:07,679
so that's the first thing

657
00:24:12,310 --> 00:24:10,320
then there's the issue of how to manage

658
00:24:15,269 --> 00:24:12,320
emotions and thoughts

659
00:24:16,710 --> 00:24:15,279
and our society has trained us to kind

660
00:24:19,430 --> 00:24:16,720
of think

661
00:24:21,750 --> 00:24:19,440
or to to respond to emotions and

662
00:24:22,950 --> 00:24:21,760
thoughts that we don't like by pushing

663
00:24:25,110 --> 00:24:22,960
them away

664
00:24:27,350 --> 00:24:25,120
right if i tell my friend

665
00:24:28,470 --> 00:24:27,360
i feel really anxious

666
00:24:29,669 --> 00:24:28,480
what's the first thing they're going to

667
00:24:30,870 --> 00:24:29,679
say kurt

668
00:24:32,870 --> 00:24:30,880
about what

669
00:24:34,630 --> 00:24:32,880
if i tell a friend i'm like

670
00:24:35,909 --> 00:24:34,640
i'm sorry they may say what are you

671
00:24:37,510 --> 00:24:35,919
anxious about

672
00:24:39,110 --> 00:24:37,520
okay they might say what are you anxious

673
00:24:40,950 --> 00:24:39,120
about and i'll say i'm really anxious

674
00:24:43,350 --> 00:24:40,960
about giving this talk

675
00:24:45,510 --> 00:24:43,360
then what what will they say

676
00:24:46,710 --> 00:24:45,520
oh don't worry about it you'll do fine

677
00:24:49,269 --> 00:24:46,720
you go girl

678
00:24:51,110 --> 00:24:49,279
yep exactly don't feel anxious you're

679
00:24:53,110 --> 00:24:51,120
fine right

680
00:24:55,990 --> 00:24:53,120
don't worry about it you're you're fine

681
00:24:57,029 --> 00:24:56,000
it's like so all the implicit messages

682
00:24:59,750 --> 00:24:57,039
we get

683
00:25:02,149 --> 00:24:59,760
is don't feel that way right or if or if

684
00:25:04,630 --> 00:25:02,159
i'm saying i feel really sad right now

685
00:25:06,630 --> 00:25:04,640
don't feel sad it's gonna be fine

686
00:25:08,630 --> 00:25:06,640
right

687
00:25:11,110 --> 00:25:08,640
we are taught even all the

688
00:25:13,430 --> 00:25:11,120
advertisements about antidepressants

689
00:25:14,789 --> 00:25:13,440
anxiolytics are you anxious

690
00:25:16,789 --> 00:25:14,799
are you sad

691
00:25:21,990 --> 00:25:16,799
this can take it away

692
00:25:24,230 --> 00:25:22,000
been programmed to think it's not okay

693
00:25:25,669 --> 00:25:24,240
to feel this way

694
00:25:27,110 --> 00:25:25,679
and so

695
00:25:29,510 --> 00:25:27,120
the problem

696
00:25:33,029 --> 00:25:29,520
is that both emotions

697
00:25:35,750 --> 00:25:33,039
and thoughts things inside our body

698
00:25:38,549 --> 00:25:35,760
that people cannot see

699
00:25:40,710 --> 00:25:38,559
are mostly involuntary

700
00:25:42,950 --> 00:25:40,720
these are mostly conditioned or

701
00:25:45,909 --> 00:25:42,960
programmed responses

702
00:25:49,909 --> 00:25:45,919
to certain circumstances in our life

703
00:25:51,990 --> 00:25:49,919
and the idea in act is to simply notice

704
00:25:54,230 --> 00:25:52,000
them for what they are

705
00:25:57,190 --> 00:25:54,240
and not struggle against them so let me

706
00:25:58,630 --> 00:25:57,200
give you two examples number one if i

707
00:26:00,230 --> 00:25:58,640
say and i'm going to give you a very

708
00:26:03,750 --> 00:26:00,240
benign one

709
00:26:05,669 --> 00:26:04,789
lamb

710
00:26:08,789 --> 00:26:05,679
one

711
00:26:11,590 --> 00:26:08,799
red white and

712
00:26:13,269 --> 00:26:11,600
i don't know this part blue

713
00:26:15,110 --> 00:26:13,279
blue

714
00:26:17,110 --> 00:26:15,120
one two

715
00:26:18,950 --> 00:26:17,120
three

716
00:26:21,269 --> 00:26:18,960
that's programmed

717
00:26:22,830 --> 00:26:21,279
if i tell you kurt

718
00:26:26,230 --> 00:26:22,840
do not say

719
00:26:29,430 --> 00:26:26,240
lamb after mary had a little

720
00:26:31,190 --> 00:26:29,440
could you not think lamb

721
00:26:33,269 --> 00:26:31,200
could you do that

722
00:26:35,590 --> 00:26:33,279
i mean i can't i don't know i imagine no

723
00:26:37,590 --> 00:26:35,600
i imagine the answer is no okay mary had

724
00:26:38,870 --> 00:26:37,600
a little think of something else

725
00:26:40,149 --> 00:26:38,880
panda

726
00:26:43,430 --> 00:26:40,159
okay

727
00:26:45,590 --> 00:26:43,440
i'll come back to that you will always

728
00:26:48,230 --> 00:26:45,600
always have lamb in your head

729
00:26:50,070 --> 00:26:48,240
because our brain does not work by

730
00:26:53,110 --> 00:26:50,080
subtraction

731
00:26:56,070 --> 00:26:53,120
our brain works by addition

732
00:26:59,029 --> 00:26:56,080
so trying to undo something is

733
00:27:01,110 --> 00:26:59,039
impossible actually

734
00:27:04,149 --> 00:27:01,120
if i told you right now

735
00:27:06,950 --> 00:27:04,159
um a good friend of yours just got into

736
00:27:09,029 --> 00:27:06,960
an accident

737
00:27:11,110 --> 00:27:09,039
what would that trigger for you i feel

738
00:27:12,470 --> 00:27:11,120
anxious

739
00:27:14,070 --> 00:27:12,480
and

740
00:27:16,549 --> 00:27:14,080
worried

741
00:27:18,310 --> 00:27:16,559
could you undo that

742
00:27:19,029 --> 00:27:18,320
i don't know some of the buddhists say

743
00:27:21,269 --> 00:27:19,039
that

744
00:27:23,669 --> 00:27:21,279
with enough mindfulness training one can

745
00:27:25,510 --> 00:27:23,679
get to a point where

746
00:27:27,350 --> 00:27:25,520
stimuluses no longer provoke you at

747
00:27:29,430 --> 00:27:27,360
least not to the same degree

748
00:27:31,510 --> 00:27:29,440
i've seen some video online of a monk

749
00:27:33,669 --> 00:27:31,520
self-alighting so setting oneself a

750
00:27:35,190 --> 00:27:33,679
light it's calmly and then just dying i

751
00:27:38,310 --> 00:27:35,200
don't know how the

752
00:27:44,390 --> 00:27:39,990
so

753
00:27:47,430 --> 00:27:44,400
what you learn is

754
00:27:48,710 --> 00:27:47,440
how to respond to these things in new

755
00:27:51,430 --> 00:27:48,720
ways

756
00:27:53,269 --> 00:27:51,440
it's not that they stop showing up

757
00:27:56,310 --> 00:27:53,279
they still show up

758
00:27:58,149 --> 00:27:56,320
but when they show up and you're not as

759
00:28:00,310 --> 00:27:58,159
consumed by it

760
00:28:02,630 --> 00:28:00,320
your attention is not so narrowly

761
00:28:05,350 --> 00:28:02,640
focused on it

762
00:28:07,350 --> 00:28:05,360
it doesn't have as much of an impact on

763
00:28:08,470 --> 00:28:07,360
you right

764
00:28:09,750 --> 00:28:08,480
so

765
00:28:12,789 --> 00:28:09,760
if i'm

766
00:28:14,310 --> 00:28:12,799
so i see this for example in a lot of my

767
00:28:16,549 --> 00:28:14,320
pain patients or

768
00:28:17,350 --> 00:28:16,559
my chronic medical condition patients

769
00:28:19,909 --> 00:28:17,360
like

770
00:28:23,269 --> 00:28:19,919
their life has been so

771
00:28:25,190 --> 00:28:23,279
fixated on the medical condition on the

772
00:28:27,269 --> 00:28:25,200
pain on

773
00:28:30,070 --> 00:28:27,279
you know getting things you know getting

774
00:28:31,909 --> 00:28:30,080
the right meds getting this getting that

775
00:28:35,110 --> 00:28:31,919
that they've lost track of the rest of

776
00:28:36,870 --> 00:28:35,120
their life and they're depressed

777
00:28:38,630 --> 00:28:36,880
they're not focused on their family as

778
00:28:40,389 --> 00:28:38,640
much they're not focused on their career

779
00:28:42,950 --> 00:28:40,399
as much they're not focused on things

780
00:28:46,389 --> 00:28:42,960
that bring them joy

781
00:28:48,710 --> 00:28:46,399
it's like they're narrowly fixated on

782
00:28:51,029 --> 00:28:48,720
one aspect of their life which is the

783
00:28:54,549 --> 00:28:51,039
condition or the illness or the

784
00:28:57,110 --> 00:28:54,559
medical problem and i'm saying step back

785
00:28:58,789 --> 00:28:57,120
and recognize that there is more to you

786
00:29:00,389 --> 00:28:58,799
than that

787
00:29:02,310 --> 00:29:00,399
but if this is the only part you're

788
00:29:05,350 --> 00:29:02,320
going to fixate on of course it's going

789
00:29:08,149 --> 00:29:05,360
to like consume you

790
00:29:10,870 --> 00:29:08,159
and paradoxically occur

791
00:29:13,269 --> 00:29:10,880
the more you open up your life

792
00:29:14,870 --> 00:29:13,279
and do things like these patients with

793
00:29:16,950 --> 00:29:14,880
medical conditions

794
00:29:19,510 --> 00:29:16,960
when they stop fixating just on the

795
00:29:21,029 --> 00:29:19,520
medical condition and start doing other

796
00:29:23,830 --> 00:29:21,039
things again

797
00:29:26,630 --> 00:29:23,840
paradoxically the pain goes down

798
00:29:29,590 --> 00:29:26,640
it's the same thing with anxiety

799
00:29:32,310 --> 00:29:29,600
when you start engaging in life more

800
00:29:33,830 --> 00:29:32,320
and you allow the anxiety to be there

801
00:29:36,909 --> 00:29:33,840
without it being kind of the thing that

802
00:29:39,909 --> 00:29:36,919
drives whether you do something or not

803
00:29:41,269 --> 00:29:39,919
paradoxically the anxiety goes down a

804
00:29:42,549 --> 00:29:41,279
question that occurred to me is when you

805
00:29:44,549 --> 00:29:42,559
were mentioning that you were feeling

806
00:29:46,230 --> 00:29:44,559
anxiety and by the way i i'm extremely

807
00:29:48,070 --> 00:29:46,240
nervous generally when i'm doing these

808
00:29:49,830 --> 00:29:48,080
interviews as well

809
00:29:51,830 --> 00:29:49,840
and also being interviewed for sure and

810
00:29:53,269 --> 00:29:51,840
extreme oh my god i don't i generally

811
00:29:54,389 --> 00:29:53,279
say no to people interviewing me so i

812
00:29:56,149 --> 00:29:54,399
don't have as much courage as you

813
00:29:58,149 --> 00:29:56,159
perhaps i should muster some what

814
00:30:00,549 --> 00:29:58,159
occurred to me was does this technique

815
00:30:01,750 --> 00:30:00,559
can i say something sure sure

816
00:30:04,389 --> 00:30:01,760
perhaps

817
00:30:06,950 --> 00:30:04,399
you will choose to muster some you don't

818
00:30:10,310 --> 00:30:06,960
have to do anything right it's

819
00:30:11,190 --> 00:30:10,320
even that subtle comment about perhaps i

820
00:30:13,510 --> 00:30:11,200
should

821
00:30:15,590 --> 00:30:13,520
you don't have to do anything

822
00:30:18,630 --> 00:30:15,600
do you choose to is there something

823
00:30:21,430 --> 00:30:18,640
about it that matters to you in that

824
00:30:24,710 --> 00:30:21,440
it's a very different experience to say

825
00:30:25,830 --> 00:30:24,720
i have to do this versus i'm choosing

826
00:30:27,909 --> 00:30:25,840
this

827
00:30:28,870 --> 00:30:27,919
willingly

828
00:30:31,269 --> 00:30:28,880
even

829
00:30:32,549 --> 00:30:31,279
if it's going to elicit anxiety in me

830
00:30:34,230 --> 00:30:32,559
that's great that may help me in the

831
00:30:35,190 --> 00:30:34,240
future or i may choose to allow that to

832
00:30:37,190 --> 00:30:35,200
help me in the future i don't know

833
00:30:39,269 --> 00:30:37,200
what's the right response to that but

834
00:30:41,190 --> 00:30:39,279
regardless where i was getting it was

835
00:30:44,230 --> 00:30:41,200
does this technique simply allow you to

836
00:30:45,909 --> 00:30:44,240
cope or does it ameliorate the anxiety

837
00:30:48,830 --> 00:30:45,919
because those are two different issues

838
00:30:52,630 --> 00:30:48,840
yeah absolutely they are and

839
00:30:55,830 --> 00:30:52,640
um that's the paradox of this

840
00:30:59,830 --> 00:30:55,840
although act does not aim

841
00:31:04,230 --> 00:31:02,549
it's asking you to willingly sit with so

842
00:31:07,350 --> 00:31:04,240
that's the term i use instead of

843
00:31:10,149 --> 00:31:07,360
acceptance because i'll tell you why

844
00:31:13,430 --> 00:31:10,159
if i'm willing to have the anxiety

845
00:31:14,470 --> 00:31:13,440
that's instead of acceptance if i'm

846
00:31:17,510 --> 00:31:14,480
willing

847
00:31:20,710 --> 00:31:17,520
to have the anxiety in service of

848
00:31:23,029 --> 00:31:20,720
something that matters to me right

849
00:31:25,350 --> 00:31:23,039
that's the goal the goal is me being

850
00:31:27,430 --> 00:31:25,360
willing to experience something

851
00:31:29,990 --> 00:31:27,440
difficult because it's in service of

852
00:31:33,630 --> 00:31:30,000
something that matters

853
00:31:36,950 --> 00:31:33,640
but when i do that repeatedly

854
00:31:39,269 --> 00:31:36,960
paradoxically my anxiety goes down

855
00:31:41,590 --> 00:31:39,279
it's not the goal the goal is not to

856
00:31:43,590 --> 00:31:41,600
reduce my anxiety the goal is

857
00:31:44,789 --> 00:31:43,600
for me to live a life that's meaningful

858
00:31:46,549 --> 00:31:44,799
and rich

859
00:31:49,830 --> 00:31:46,559
but what's paradoxical and what all the

860
00:31:51,669 --> 00:31:49,840
research is showing is that

861
00:31:53,990 --> 00:31:51,679
when you do that

862
00:31:55,590 --> 00:31:54,000
actually anxiety goes down

863
00:31:58,070 --> 00:31:55,600
and i'll give you examples from my

864
00:32:00,630 --> 00:31:58,080
studies because so i'm funded by the

865
00:32:01,669 --> 00:32:00,640
national institutes of health and the va

866
00:32:08,230 --> 00:32:01,679
department

867
00:32:11,029 --> 00:32:08,240
and nih and the va

868
00:32:13,990 --> 00:32:11,039
for a long time has focused on symptom

869
00:32:15,669 --> 00:32:14,000
reduction right so when i apply for

870
00:32:17,909 --> 00:32:15,679
grants i say

871
00:32:20,950 --> 00:32:17,919
i'm going to do this act intervention

872
00:32:23,590 --> 00:32:20,960
and i'm going to explore whether this

873
00:32:26,310 --> 00:32:23,600
reduces depression and anxiety

874
00:32:27,590 --> 00:32:26,320
right i say that in the grant actually i

875
00:32:30,310 --> 00:32:27,600
want to make sure

876
00:32:32,789 --> 00:32:30,320
i reduce depression or anxiety

877
00:32:35,509 --> 00:32:32,799
but when i'm actually in the treatment

878
00:32:37,509 --> 00:32:35,519
actually doing the treatment i don't say

879
00:32:39,509 --> 00:32:37,519
that ever

880
00:32:41,590 --> 00:32:39,519
not once do i say

881
00:32:43,430 --> 00:32:41,600
okay you know you guys

882
00:32:44,710 --> 00:32:43,440
met criteria for depression which they

883
00:32:47,269 --> 00:32:44,720
all do

884
00:32:49,669 --> 00:32:47,279
to be in the study for example and my

885
00:32:50,630 --> 00:32:49,679
goal is for you not to meet criteria i

886
00:32:53,190 --> 00:32:50,640
never

887
00:32:54,789 --> 00:32:53,200
say anything about that

888
00:32:56,789 --> 00:32:54,799
it's it's a

889
00:32:59,750 --> 00:32:56,799
political decision it's a funding

890
00:33:02,549 --> 00:32:59,760
decision that i put it as the outcome

891
00:33:04,230 --> 00:33:02,559
but paradoxically the intervention even

892
00:33:06,389 --> 00:33:04,240
though i never talk about reducing

893
00:33:08,230 --> 00:33:06,399
anxiety and depression

894
00:33:10,549 --> 00:33:08,240
i talk about helping them live a rich

895
00:33:12,710 --> 00:33:10,559
and meaningful life and to let them

896
00:33:14,230 --> 00:33:12,720
explore their emotions and not be afraid

897
00:33:17,430 --> 00:33:14,240
of them

898
00:33:19,750 --> 00:33:17,440
but most of my studies i have found

899
00:33:22,310 --> 00:33:19,760
significant reductions in depression and

900
00:33:24,549 --> 00:33:22,320
an anxiety and improvements in meaning

901
00:33:26,870 --> 00:33:24,559
and purpose

902
00:33:28,070 --> 00:33:26,880
is that too complicated no no so first

903
00:33:30,070 --> 00:33:28,080
there are quite a few thoughts that

904
00:33:31,909 --> 00:33:30,080
occur so one is we mentioned the eastern

905
00:33:33,430 --> 00:33:31,919
approach this to me sounds like the

906
00:33:35,350 --> 00:33:33,440
merging of the western approach of

907
00:33:36,470 --> 00:33:35,360
bearing one's cross so it doesn't matter

908
00:33:37,750 --> 00:33:36,480
that you're going to feel the suffering

909
00:33:39,029 --> 00:33:37,760
you do it anyway because there's a

910
00:33:40,389 --> 00:33:39,039
higher value

911
00:33:43,190 --> 00:33:40,399
and then the other thought that occurs

912
00:33:45,110 --> 00:33:43,200
to me is that it's extremely interesting

913
00:33:47,590 --> 00:33:45,120
how often that happens in different

914
00:33:49,430 --> 00:33:47,600
aspects of life where if your aim is to

915
00:33:50,789 --> 00:33:49,440
reduce something or to attain something

916
00:33:52,389 --> 00:33:50,799
you don't get it

917
00:33:53,990 --> 00:33:52,399
but if you take a route where you're not

918
00:33:56,549 --> 00:33:54,000
supposed to care about what you want you

919
00:33:58,310 --> 00:33:56,559
end up getting it so for example with in

920
00:33:59,669 --> 00:33:58,320
relationships if you desperately want

921
00:34:01,990 --> 00:33:59,679
that person you try to please them you

922
00:34:04,710 --> 00:34:02,000
end up not doing so and if you are in

923
00:34:05,830 --> 00:34:04,720
business and you try to get money often

924
00:34:08,550 --> 00:34:05,840
it doesn't work out you have to be

925
00:34:09,909 --> 00:34:08,560
passionate about the product and so

926
00:34:11,829 --> 00:34:09,919
it's just interesting how that work you

927
00:34:13,990 --> 00:34:11,839
don't get what you want by trying to get

928
00:34:16,470 --> 00:34:14,000
what you want

929
00:34:18,550 --> 00:34:16,480
well i think what you're describing is

930
00:34:19,470 --> 00:34:18,560
the difference between

931
00:34:21,190 --> 00:34:19,480
being

932
00:34:23,589 --> 00:34:21,200
goal-oriented

933
00:34:25,430 --> 00:34:23,599
versus value-oriented

934
00:34:29,190 --> 00:34:25,440
right

935
00:34:30,230 --> 00:34:29,200
let's say my goal is to get into medical

936
00:34:32,230 --> 00:34:30,240
school

937
00:34:34,389 --> 00:34:32,240
and i'm like i need to get into medical

938
00:34:36,950 --> 00:34:34,399
school no matter what you know pressure

939
00:34:38,869 --> 00:34:36,960
from family whatever it is like

940
00:34:41,349 --> 00:34:38,879
that's a goal i can check it off the

941
00:34:44,790 --> 00:34:41,359
list right

942
00:34:47,589 --> 00:34:44,800
but what's the value behind that

943
00:34:50,310 --> 00:34:47,599
is it to help people is it to you know

944
00:34:51,589 --> 00:34:50,320
is it a selflessness thing what is the

945
00:34:54,950 --> 00:34:51,599
value

946
00:34:57,910 --> 00:34:54,960
behind getting into medical school

947
00:34:59,349 --> 00:34:57,920
and if you if you focus on that

948
00:35:00,829 --> 00:34:59,359
then let's say you don't get into

949
00:35:02,790 --> 00:35:00,839
medical school

950
00:35:04,630 --> 00:35:02,800
right

951
00:35:06,710 --> 00:35:04,640
then you say well what was the value

952
00:35:08,710 --> 00:35:06,720
behind that was the value behind that

953
00:35:11,349 --> 00:35:08,720
helping people

954
00:35:13,510 --> 00:35:11,359
are there other ways that i can help

955
00:35:15,829 --> 00:35:13,520
people there are many other ways that

956
00:35:17,670 --> 00:35:15,839
you can help people right you can go to

957
00:35:18,550 --> 00:35:17,680
pa school you can go to nursing school

958
00:35:21,270 --> 00:35:18,560
you can

959
00:35:22,390 --> 00:35:21,280
join a non-profit that focuses on these

960
00:35:24,310 --> 00:35:22,400
things

961
00:35:26,150 --> 00:35:24,320
and so

962
00:35:29,510 --> 00:35:26,160
when you're focused

963
00:35:32,630 --> 00:35:29,520
when when your values are clear

964
00:35:34,470 --> 00:35:32,640
then you're more about the process

965
00:35:36,150 --> 00:35:34,480
you're more about

966
00:35:38,950 --> 00:35:36,160
the experience

967
00:35:40,710 --> 00:35:38,960
versus if you're goal oriented you just

968
00:35:41,750 --> 00:35:40,720
want to get there and check it off the

969
00:35:45,589 --> 00:35:41,760
list

970
00:35:47,430 --> 00:35:45,599
you're like well what's next

971
00:35:49,109 --> 00:35:47,440
let me say in other words and let me

972
00:35:50,550 --> 00:35:49,119
know if this is correct so that i make

973
00:35:52,630 --> 00:35:50,560
sure that we're on the same page goal

974
00:35:55,510 --> 00:35:52,640
versus values is akin to when sometimes

975
00:35:57,349 --> 00:35:55,520
people say you shouldn't be

976
00:35:59,030 --> 00:35:57,359
objective oriented versus process

977
00:36:00,710 --> 00:35:59,040
oriented

978
00:36:02,470 --> 00:36:00,720
is it akin to that or is that different

979
00:36:04,390 --> 00:36:02,480
that's it's kind of similar yeah it's

980
00:36:05,510 --> 00:36:04,400
very similar okay so that's a great

981
00:36:07,349 --> 00:36:05,520
question right there are you coming up

982
00:36:08,550 --> 00:36:07,359
with them are you realizing them so are

983
00:36:10,390 --> 00:36:08,560
you making them

984
00:36:12,069 --> 00:36:10,400
are you uncovering what was there anyway

985
00:36:14,790 --> 00:36:12,079
that's a sub question that doesn't sound

986
00:36:16,550 --> 00:36:14,800
like an easy process so how can you help

987
00:36:17,589 --> 00:36:16,560
someone through that process what tips

988
00:36:19,430 --> 00:36:17,599
do you have

989
00:36:22,069 --> 00:36:19,440
for people to realize their own values

990
00:36:23,670 --> 00:36:22,079
in the example you gave the

991
00:36:24,870 --> 00:36:23,680
potential was that i want to help people

992
00:36:26,550 --> 00:36:24,880
that's why i want to go to medical

993
00:36:27,990 --> 00:36:26,560
school but it also may just be i want

994
00:36:29,829 --> 00:36:28,000
the status but i think i want to help

995
00:36:31,270 --> 00:36:29,839
people or i want the money but i think i

996
00:36:33,030 --> 00:36:31,280
want to help people or actually this was

997
00:36:34,710 --> 00:36:33,040
instilled in me as a child and it's

998
00:36:36,150 --> 00:36:34,720
actually not my own i don't even care

999
00:36:37,670 --> 00:36:36,160
but that takes to me that sounds like

1000
00:36:39,829 --> 00:36:37,680
that may take months or even years of

1001
00:36:43,270 --> 00:36:39,839
therapy so how does one streamline that

1002
00:36:45,349 --> 00:36:43,280
approach to get to one's values

1003
00:36:47,109 --> 00:36:45,359
that's a really good question and i

1004
00:36:49,750 --> 00:36:47,119
actually struggled with this

1005
00:36:52,550 --> 00:36:49,760
for a long time actually like

1006
00:36:54,550 --> 00:36:52,560
you know it seemed like such a broad

1007
00:36:55,750 --> 00:36:54,560
question to me like what are your values

1008
00:36:58,310 --> 00:36:55,760
well

1009
00:37:01,109 --> 00:36:58,320
it's tough right um

1010
00:37:03,030 --> 00:37:01,119
and i remember like having this aha

1011
00:37:03,990 --> 00:37:03,040
moment you know

1012
00:37:05,349 --> 00:37:04,000
and

1013
00:37:08,630 --> 00:37:05,359
well there are many ways to get to it

1014
00:37:11,109 --> 00:37:08,640
but i had this aha moment which broke

1015
00:37:12,870 --> 00:37:11,119
down values into like

1016
00:37:14,950 --> 00:37:12,880
how do i want to be

1017
00:37:17,270 --> 00:37:14,960
in this moment

1018
00:37:18,950 --> 00:37:17,280
how do i want to be like okay i'm with

1019
00:37:22,310 --> 00:37:18,960
you right now kurt

1020
00:37:24,950 --> 00:37:22,320
so i check in with myself and i say what

1021
00:37:28,710 --> 00:37:24,960
do i want to be how do i want to be in

1022
00:37:30,230 --> 00:37:28,720
this moment with this person you know

1023
00:37:32,790 --> 00:37:30,240
so it makes it a little bit more

1024
00:37:34,630 --> 00:37:32,800
concrete to me you know

1025
00:37:36,230 --> 00:37:34,640
but it's also that

1026
00:37:37,910 --> 00:37:36,240
but it also needs to be a little bit

1027
00:37:40,870 --> 00:37:37,920
more broad and i'll give you a very

1028
00:37:45,430 --> 00:37:40,880
personal example from my life like

1029
00:37:47,109 --> 00:37:45,440
um so i'm you know i'm a working mother

1030
00:37:48,470 --> 00:37:47,119
and

1031
00:37:51,990 --> 00:37:48,480
balancing

1032
00:37:53,270 --> 00:37:52,000
my career with being the kind of mother

1033
00:37:56,630 --> 00:37:53,280
i want to be

1034
00:37:57,670 --> 00:37:56,640
can be very challenging you know

1035
00:38:00,550 --> 00:37:57,680
and so

1036
00:38:02,310 --> 00:38:00,560
for example i go to work let's say from

1037
00:38:05,589 --> 00:38:02,320
eight to five

1038
00:38:07,270 --> 00:38:05,599
and as i get up off my desk

1039
00:38:09,990 --> 00:38:07,280
um kurt

1040
00:38:12,069 --> 00:38:10,000
and i'm walking out the door right

1041
00:38:13,349 --> 00:38:12,079
there's a lot of anxiety

1042
00:38:15,670 --> 00:38:13,359
because

1043
00:38:17,829 --> 00:38:15,680
my colleagues are still there i still

1044
00:38:19,670 --> 00:38:17,839
have a lot of things on my to-do list

1045
00:38:20,550 --> 00:38:19,680
right i have a lot of things on my to-do

1046
00:38:23,670 --> 00:38:20,560
list

1047
00:38:26,870 --> 00:38:23,680
my career is very important to me

1048
00:38:28,790 --> 00:38:26,880
um and so when i get up at 5 00 pm to

1049
00:38:30,310 --> 00:38:28,800
leave and all my colleagues are still

1050
00:38:31,670 --> 00:38:30,320
there and my boss is still there and i

1051
00:38:33,349 --> 00:38:31,680
still have a lot of things on my

1052
00:38:35,910 --> 00:38:33,359
checklist

1053
00:38:37,109 --> 00:38:35,920
i'm anxious

1054
00:38:39,829 --> 00:38:37,119
and

1055
00:38:43,670 --> 00:38:39,839
i connect with

1056
00:38:48,150 --> 00:38:43,680
the value of what i want to be as a mom

1057
00:38:50,310 --> 00:38:48,160
and i want to be a mom that's available

1058
00:38:51,349 --> 00:38:50,320
for a certain number of hours every

1059
00:38:53,349 --> 00:38:51,359
night

1060
00:38:56,150 --> 00:38:53,359
with few exceptions

1061
00:38:59,109 --> 00:38:56,160
because that matters to me

1062
00:39:01,750 --> 00:38:59,119
so i carry the anxiety i have about my

1063
00:39:03,190 --> 00:39:01,760
career but what helps me walk out the

1064
00:39:06,310 --> 00:39:03,200
door

1065
00:39:09,750 --> 00:39:06,320
is see is kind of knowing that my son is

1066
00:39:12,790 --> 00:39:09,760
on the other side right

1067
00:39:14,870 --> 00:39:12,800
so sometimes it's just a matter of like

1068
00:39:17,190 --> 00:39:14,880
you know filling out questionnaires or

1069
00:39:18,870 --> 00:39:17,200
like just you know people asking you

1070
00:39:21,109 --> 00:39:18,880
certain questions about what are your

1071
00:39:23,349 --> 00:39:21,119
priorities in life right

1072
00:39:26,310 --> 00:39:23,359
but i see a lot of people just

1073
00:39:29,109 --> 00:39:26,320
on automatic pilot right on automatic

1074
00:39:30,470 --> 00:39:29,119
pilot doing things like they always have

1075
00:39:32,870 --> 00:39:30,480
staying at work

1076
00:39:34,710 --> 00:39:32,880
long hours barely seeing their parent

1077
00:39:36,630 --> 00:39:34,720
you know their children

1078
00:39:39,430 --> 00:39:36,640
and they say

1079
00:39:42,550 --> 00:39:39,440
they say like for example the patient

1080
00:39:44,470 --> 00:39:42,560
that like works double shifts

1081
00:39:46,150 --> 00:39:44,480
then goes to the bar

1082
00:39:48,069 --> 00:39:46,160
takes out a picture of his children and

1083
00:39:52,550 --> 00:39:48,079
shows the people at the bar like here's

1084
00:39:54,790 --> 00:39:52,560
my child and love my child so so much

1085
00:39:56,790 --> 00:39:54,800
goes home hungover

1086
00:39:59,270 --> 00:39:56,800
and when the kid comes to talk to him

1087
00:40:01,430 --> 00:39:59,280
pushes him away like no no not now i'm

1088
00:40:05,030 --> 00:40:01,440
hungover

1089
00:40:06,790 --> 00:40:05,040
we can talk about what matters

1090
00:40:09,349 --> 00:40:06,800
right i can say

1091
00:40:11,510 --> 00:40:09,359
my son matters i can say

1092
00:40:13,670 --> 00:40:11,520
my parents matter to me

1093
00:40:16,390 --> 00:40:13,680
my sister matters to me

1094
00:40:18,470 --> 00:40:16,400
but if i don't put it into an action

1095
00:40:20,950 --> 00:40:18,480
it means nothing

1096
00:40:23,190 --> 00:40:20,960
it doesn't mean anything

1097
00:40:25,510 --> 00:40:23,200
and so

1098
00:40:27,510 --> 00:40:25,520
let me give you another example sure

1099
00:40:28,710 --> 00:40:27,520
kur if i asked you

1100
00:40:31,670 --> 00:40:28,720
if i said

1101
00:40:33,589 --> 00:40:31,680
there's a building on fire outside and i

1102
00:40:35,510 --> 00:40:33,599
want you to run into it

1103
00:40:36,630 --> 00:40:35,520
what would you say to me

1104
00:40:37,990 --> 00:40:36,640
no no

1105
00:40:39,190 --> 00:40:38,000
thank you you would say no appreciate

1106
00:40:41,829 --> 00:40:39,200
that

1107
00:40:44,470 --> 00:40:41,839
thanks for the offer yeah yeah

1108
00:40:47,510 --> 00:40:44,480
what if i said to you

1109
00:40:48,790 --> 00:40:47,520
a loved one you have is in that building

1110
00:40:55,349 --> 00:40:48,800
yeah

1111
00:40:56,710 --> 00:40:55,359
wife i'll go in a second

1112
00:40:59,990 --> 00:40:56,720
okay

1113
00:41:02,069 --> 00:41:00,000
it shifted from an automatic no

1114
00:41:04,069 --> 00:41:02,079
to an automatic yes

1115
00:41:07,109 --> 00:41:04,079
because there was the why

1116
00:41:09,270 --> 00:41:07,119
the question is why would i go in there

1117
00:41:12,710 --> 00:41:09,280
what would be the purpose

1118
00:41:13,829 --> 00:41:12,720
and the purpose is your partner right

1119
00:41:15,670 --> 00:41:13,839
right

1120
00:41:17,990 --> 00:41:15,680
and so when you're is it going to be

1121
00:41:19,589 --> 00:41:18,000
easy is it going to be non-threatening

1122
00:41:20,870 --> 00:41:19,599
it's going to be awfully hard and it's

1123
00:41:22,470 --> 00:41:20,880
going to be life

1124
00:41:26,069 --> 00:41:22,480
threatening right

1125
00:41:27,990 --> 00:41:26,079
and yet you are willing

1126
00:41:31,109 --> 00:41:28,000
to experience

1127
00:41:33,910 --> 00:41:31,119
the fear the dread the anxiety that it's

1128
00:41:35,270 --> 00:41:33,920
going to take to get into that building

1129
00:41:37,109 --> 00:41:35,280
because there's something there that

1130
00:41:38,630 --> 00:41:37,119
matters to you

1131
00:41:40,790 --> 00:41:38,640
so that's

1132
00:41:42,950 --> 00:41:40,800
the acceptance piece acceptance is not

1133
00:41:45,109 --> 00:41:42,960
just saying oh okay i accept i accept

1134
00:41:48,309 --> 00:41:45,119
you know what i feel here

1135
00:41:51,349 --> 00:41:48,319
it's that i'm willing to feel what there

1136
00:41:53,190 --> 00:41:51,359
is as i move towards something that

1137
00:41:55,510 --> 00:41:53,200
scares me

1138
00:41:57,430 --> 00:41:55,520
earlier we had a little discussion about

1139
00:41:59,910 --> 00:41:57,440
should versus values and you were saying

1140
00:42:02,870 --> 00:41:59,920
kurt talk well we didn't explicitly have

1141
00:42:04,790 --> 00:42:02,880
this discussion but you said perhaps you

1142
00:42:06,150 --> 00:42:04,800
shouldn't think in terms of should i

1143
00:42:08,230 --> 00:42:06,160
know that's paradoxical but you

1144
00:42:11,430 --> 00:42:08,240
understand what i mean that in terms of

1145
00:42:13,829 --> 00:42:11,440
thinking of choice it's better and i'm

1146
00:42:16,550 --> 00:42:13,839
unclear how values don't imply it should

1147
00:42:18,390 --> 00:42:16,560
so if you have a high value

1148
00:42:20,309 --> 00:42:18,400
to me a should comes in

1149
00:42:21,910 --> 00:42:20,319
because it's you're doing what's right

1150
00:42:24,550 --> 00:42:21,920
now it's what you're saying that the

1151
00:42:26,550 --> 00:42:24,560
value is somehow internal and the shirt

1152
00:42:29,750 --> 00:42:26,560
is somehow external and it should come

1153
00:42:31,349 --> 00:42:29,760
from should it should come from you or

1154
00:42:33,190 --> 00:42:31,359
i it's a bit difficult for me to say

1155
00:42:34,790 --> 00:42:33,200
without using the word should so yeah

1156
00:42:36,550 --> 00:42:34,800
hopefully you understand the question i

1157
00:42:38,870 --> 00:42:36,560
mean it could be just an issue of

1158
00:42:42,309 --> 00:42:38,880
linguistics right like it could be just

1159
00:42:44,950 --> 00:42:42,319
the terminology we're using but

1160
00:42:47,829 --> 00:42:44,960
values are freely chosen

1161
00:42:50,950 --> 00:42:47,839
from from an act perspective values are

1162
00:42:53,109 --> 00:42:50,960
freely chosen it's not what

1163
00:42:55,910 --> 00:42:53,119
our parents tell us

1164
00:42:57,589 --> 00:42:55,920
we should want it's not what i feel

1165
00:43:00,150 --> 00:42:57,599
society

1166
00:43:03,430 --> 00:43:00,160
wants me to say right

1167
00:43:04,870 --> 00:43:03,440
in the definition of values it is freely

1168
00:43:07,990 --> 00:43:04,880
chosen

1169
00:43:09,030 --> 00:43:08,000
and one indication

1170
00:43:11,750 --> 00:43:09,040
that

1171
00:43:13,750 --> 00:43:11,760
someone is not living a life

1172
00:43:14,630 --> 00:43:13,760
that's consistent with kind of what they

1173
00:43:17,109 --> 00:43:14,640
want

1174
00:43:20,790 --> 00:43:17,119
is there's a lack of vitality like you

1175
00:43:23,109 --> 00:43:20,800
don't sense vitality in what

1176
00:43:25,510 --> 00:43:23,119
someone is doing right

1177
00:43:28,870 --> 00:43:25,520
it feels more like it's

1178
00:43:30,950 --> 00:43:28,880
being imposed that it's like i have to

1179
00:43:32,870 --> 00:43:30,960
do this right or

1180
00:43:34,390 --> 00:43:32,880
i don't want to be doing this or you're

1181
00:43:37,270 --> 00:43:34,400
just not

1182
00:43:39,510 --> 00:43:37,280
you're not vitalized right

1183
00:43:41,030 --> 00:43:39,520
so back to my example with work

1184
00:43:42,950 --> 00:43:41,040
sometimes i feel like giving personal

1185
00:43:43,990 --> 00:43:42,960
examples helps if it's too much tell me

1186
00:43:46,309 --> 00:43:44,000
but like

1187
00:43:47,990 --> 00:43:46,319
no the more personal the better

1188
00:43:50,550 --> 00:43:48,000
you know every time i get really

1189
00:43:52,950 --> 00:43:50,560
frustrated with my job

1190
00:43:56,470 --> 00:43:52,960
with my work with my career

1191
00:43:58,390 --> 00:43:56,480
i step back and i ask

1192
00:44:00,870 --> 00:43:58,400
do i choose this

1193
00:44:03,349 --> 00:44:00,880
no one's forcing me to do this work i

1194
00:44:05,990 --> 00:44:03,359
don't have to do this work

1195
00:44:08,710 --> 00:44:06,000
do i choose this work

1196
00:44:11,750 --> 00:44:08,720
and that helps me a lot with the full

1197
00:44:14,150 --> 00:44:11,760
recognition that i choose a package

1198
00:44:15,750 --> 00:44:14,160
that i can't just choose the things i

1199
00:44:16,550 --> 00:44:15,760
like

1200
00:44:18,470 --> 00:44:16,560
and

1201
00:44:20,630 --> 00:44:18,480
throw away the things i don't like

1202
00:44:22,470 --> 00:44:20,640
because everything we have in our life

1203
00:44:23,910 --> 00:44:22,480
is a package of

1204
00:44:25,670 --> 00:44:23,920
you know the things you like and then

1205
00:44:27,109 --> 00:44:25,680
the things that you have to do because

1206
00:44:28,230 --> 00:44:27,119
you know it's part of the broader

1207
00:44:29,670 --> 00:44:28,240
package

1208
00:44:31,910 --> 00:44:29,680
so maybe that's kind of what you're

1209
00:44:33,829 --> 00:44:31,920
talking about with this should like okay

1210
00:44:36,150 --> 00:44:33,839
doing this work i really have to write

1211
00:44:38,710 --> 00:44:36,160
certain notes and i have to like do all

1212
00:44:39,670 --> 00:44:38,720
this bureaucratic crap bureaucratic

1213
00:44:42,630 --> 00:44:39,680
stuff

1214
00:44:48,390 --> 00:44:46,069
that said do i choose the package

1215
00:44:50,710 --> 00:44:48,400
that this as a package

1216
00:44:52,550 --> 00:44:50,720
is something i care about

1217
00:44:55,109 --> 00:44:52,560
that working with these patients doing

1218
00:44:57,349 --> 00:44:55,119
this research makes this other tough

1219
00:44:59,109 --> 00:44:57,359
stuff worthwhile

1220
00:45:00,630 --> 00:44:59,119
interesting

1221
00:45:02,630 --> 00:45:00,640
one of the reasons i was bringing that

1222
00:45:05,270 --> 00:45:02,640
up is because

1223
00:45:07,190 --> 00:45:05,280
i know there's a heavy emphasis on an

1224
00:45:09,190 --> 00:45:07,200
internal locus of control it's called

1225
00:45:11,190 --> 00:45:09,200
internal locus of control i believe

1226
00:45:13,750 --> 00:45:11,200
and then that to me sounds like to get

1227
00:45:14,870 --> 00:45:13,760
philosophical like the humanist movement

1228
00:45:16,630 --> 00:45:14,880
and then

1229
00:45:18,390 --> 00:45:16,640
that stands in contrast to religious

1230
00:45:20,069 --> 00:45:18,400
movements especially of the west

1231
00:45:21,670 --> 00:45:20,079
where the west is more about there are

1232
00:45:24,230 --> 00:45:21,680
some commandments you should follow you

1233
00:45:26,950 --> 00:45:24,240
need to follow but then to many people

1234
00:45:28,870 --> 00:45:26,960
their religion is what they value so

1235
00:45:30,950 --> 00:45:28,880
their value comes with the shoulds in

1236
00:45:33,270 --> 00:45:30,960
that case and then our is one to say

1237
00:45:34,870 --> 00:45:33,280
well if you're christian or if you're

1238
00:45:36,870 --> 00:45:34,880
muslim or jewish because those are the

1239
00:45:38,150 --> 00:45:36,880
western traditions if you're those then

1240
00:45:39,829 --> 00:45:38,160
perhaps

1241
00:45:42,390 --> 00:45:39,839
you need to abandon your religion in

1242
00:45:43,510 --> 00:45:42,400
order to properly apply act therapies

1243
00:45:45,030 --> 00:45:43,520
that you have the internal locus of

1244
00:45:46,710 --> 00:45:45,040
control it comes from you it doesn't

1245
00:45:47,829 --> 00:45:46,720
come from god you choose it no i don't

1246
00:45:48,710 --> 00:45:47,839
think that was what was lurking

1247
00:45:52,150 --> 00:45:48,720
underneath

1248
00:45:55,829 --> 00:45:52,160
i don't think so i think if you choose

1249
00:45:57,430 --> 00:45:55,839
a spiritual like a spiritual tradition

1250
00:45:59,510 --> 00:45:57,440
you're choosing that you're choosing the

1251
00:46:01,670 --> 00:45:59,520
past right it's like stepping

1252
00:46:03,670 --> 00:46:01,680
yeah again like you're you're talking

1253
00:46:05,190 --> 00:46:03,680
again about a very concrete thing that's

1254
00:46:07,670 --> 00:46:05,200
like more goal

1255
00:46:08,550 --> 00:46:07,680
like that okay so i'm going to church

1256
00:46:10,470 --> 00:46:08,560
check

1257
00:46:11,589 --> 00:46:10,480
right that's a goal i'm going to go to

1258
00:46:14,309 --> 00:46:11,599
church

1259
00:46:15,829 --> 00:46:14,319
check and goals can be very valuable to

1260
00:46:16,710 --> 00:46:15,839
like tell you if you're on the right

1261
00:46:19,510 --> 00:46:16,720
path

1262
00:46:22,390 --> 00:46:19,520
towards something you value right

1263
00:46:24,870 --> 00:46:22,400
but the broader value if someone is

1264
00:46:26,870 --> 00:46:24,880
you know maybe religious now some of

1265
00:46:29,030 --> 00:46:26,880
them are of course some people are doing

1266
00:46:30,470 --> 00:46:29,040
it out of compliance right

1267
00:46:34,150 --> 00:46:30,480
absolutely

1268
00:46:35,430 --> 00:46:34,160
doing it because spirituality is a

1269
00:46:36,710 --> 00:46:35,440
broader

1270
00:46:39,510 --> 00:46:36,720
domain

1271
00:46:41,510 --> 00:46:39,520
is valuable and the specific

1272
00:46:43,190 --> 00:46:41,520
goal if you want or package that they

1273
00:46:45,349 --> 00:46:43,200
choose is

1274
00:46:46,710 --> 00:46:45,359
a christian or jewish or muslim right

1275
00:46:48,230 --> 00:46:46,720
like

1276
00:46:51,030 --> 00:46:48,240
the broader thing is that they are a

1277
00:46:54,230 --> 00:46:51,040
spiritual person and

1278
00:46:57,109 --> 00:46:54,240
that the goal they have is to fulfill

1279
00:46:59,430 --> 00:46:57,119
certain obligations within that

1280
00:47:02,710 --> 00:46:59,440
spiritual tradition it's like

1281
00:47:05,829 --> 00:47:02,720
me i love what i work or what i do

1282
00:47:07,750 --> 00:47:05,839
and as part of that i have to i

1283
00:47:09,270 --> 00:47:07,760
actually have to do certain things like

1284
00:47:11,990 --> 00:47:09,280
check you know i have to do certain

1285
00:47:14,230 --> 00:47:12,000
trainings i have to fill certain cmes so

1286
00:47:16,390 --> 00:47:14,240
on so forth some bureaucratic it's the

1287
00:47:18,069 --> 00:47:16,400
values part that's

1288
00:47:20,550 --> 00:47:18,079
that you don't have to

1289
00:47:22,470 --> 00:47:20,560
that you that that's chosen

1290
00:47:23,829 --> 00:47:22,480
the goals are the kind of the posts

1291
00:47:25,829 --> 00:47:23,839
along the way that you can say okay

1292
00:47:28,230 --> 00:47:25,839
check did that i know i'm on the right

1293
00:47:30,069 --> 00:47:28,240
track i understand yeah

1294
00:47:32,230 --> 00:47:30,079
what separates people

1295
00:47:33,990 --> 00:47:32,240
for who this works for

1296
00:47:36,230 --> 00:47:34,000
quickly or

1297
00:47:38,309 --> 00:47:36,240
plenty from those who

1298
00:47:40,230 --> 00:47:38,319
it takes a longer time to work for it

1299
00:47:42,550 --> 00:47:40,240
works less for is it their temperament

1300
00:47:44,470 --> 00:47:42,560
is it their attitude is it

1301
00:47:46,069 --> 00:47:44,480
the application of a certain technique

1302
00:47:47,270 --> 00:47:46,079
the amount that they stick with it for

1303
00:47:48,870 --> 00:47:47,280
example yeah

1304
00:47:51,030 --> 00:47:48,880
that's a really good question and i

1305
00:47:53,670 --> 00:47:51,040
think it's it's complex it's hard

1306
00:47:56,230 --> 00:47:53,680
because for decades

1307
00:47:58,790 --> 00:47:56,240
in our field we have been trying

1308
00:48:00,790 --> 00:47:58,800
to do these matching studies right where

1309
00:48:03,190 --> 00:48:00,800
okay we're gonna match this kind of

1310
00:48:05,190 --> 00:48:03,200
person with this kind of therapy

1311
00:48:06,630 --> 00:48:05,200
you know um

1312
00:48:08,230 --> 00:48:06,640
like this person would do better with

1313
00:48:09,829 --> 00:48:08,240
this therapy this person would do better

1314
00:48:11,349 --> 00:48:09,839
with this therapy and

1315
00:48:13,270 --> 00:48:11,359
despite

1316
00:48:15,510 --> 00:48:13,280
millions of dollars being you know

1317
00:48:17,109 --> 00:48:15,520
committed to this kind of research

1318
00:48:19,990 --> 00:48:17,119
we don't really have a good answer to

1319
00:48:21,910 --> 00:48:20,000
that question not just for act but for

1320
00:48:24,230 --> 00:48:21,920
really a lot of the therapies like we

1321
00:48:25,910 --> 00:48:24,240
have not been able to figure out what's

1322
00:48:27,589 --> 00:48:25,920
what's the thing that

1323
00:48:29,910 --> 00:48:27,599
you know matches people like why would

1324
00:48:32,150 --> 00:48:29,920
this work for someone

1325
00:48:33,589 --> 00:48:32,160
that said

1326
00:48:35,910 --> 00:48:33,599
in the meta-analysis of the

1327
00:48:37,750 --> 00:48:35,920
meta-analysis of act studies and some of

1328
00:48:41,670 --> 00:48:37,760
the comparison studies

1329
00:48:43,030 --> 00:48:41,680
what we know or what we found is that

1330
00:48:46,230 --> 00:48:43,040
people who have

1331
00:48:47,190 --> 00:48:46,240
suffered longer tend to do better in act

1332
00:48:49,349 --> 00:48:47,200
right

1333
00:48:50,630 --> 00:48:49,359
and people who have

1334
00:48:52,069 --> 00:48:50,640
complex

1335
00:48:54,309 --> 00:48:52,079
difficulties

1336
00:48:57,750 --> 00:48:54,319
tend to do better with act why do you

1337
00:49:00,309 --> 00:48:59,589
it's a good question

1338
00:49:02,150 --> 00:49:00,319
so

1339
00:49:06,069 --> 00:49:02,160
my thought on this and i don't know that

1340
00:49:10,790 --> 00:49:08,470
but in act there's a very key concept

1341
00:49:11,670 --> 00:49:10,800
called creative hopelessness

1342
00:49:14,549 --> 00:49:11,680
okay

1343
00:49:17,750 --> 00:49:14,559
and the idea behind creative

1344
00:49:20,710 --> 00:49:17,760
hopelessness is

1345
00:49:22,390 --> 00:49:20,720
okay like let's say you have anxiety

1346
00:49:24,790 --> 00:49:22,400
right

1347
00:49:26,470 --> 00:49:24,800
and i ask the person

1348
00:49:29,030 --> 00:49:26,480
who has anxiety

1349
00:49:31,990 --> 00:49:29,040
how long have you had this

1350
00:49:35,349 --> 00:49:32,000
and they'll say 15 years what have you

1351
00:49:38,790 --> 00:49:35,359
tried well i've tried alcohol

1352
00:49:40,230 --> 00:49:38,800
i've tried drugs i've tried medications

1353
00:49:41,430 --> 00:49:40,240
i've tried

1354
00:49:43,589 --> 00:49:41,440
avoiding

1355
00:49:46,390 --> 00:49:43,599
i've tried deep breathing

1356
00:49:47,109 --> 00:49:46,400
i've tried meditating like i've tried it

1357
00:49:50,630 --> 00:49:47,119
all

1358
00:49:52,950 --> 00:49:50,640
okay and how has that worked

1359
00:49:54,309 --> 00:49:52,960
um hasn't worked in terms of reducing

1360
00:49:55,270 --> 00:49:54,319
the anxiety

1361
00:49:57,270 --> 00:49:55,280
okay

1362
00:49:59,270 --> 00:49:57,280
and and how has it worked in terms of

1363
00:50:01,349 --> 00:49:59,280
like where you are with your life and

1364
00:50:02,710 --> 00:50:01,359
how big your life is

1365
00:50:04,470 --> 00:50:02,720
and they'll say

1366
00:50:06,549 --> 00:50:04,480
oh maybe

1367
00:50:08,230 --> 00:50:06,559
it's it's really kind of gotten smaller

1368
00:50:10,710 --> 00:50:08,240
in my life

1369
00:50:13,190 --> 00:50:10,720
so what we do with creative hopelessness

1370
00:50:15,750 --> 00:50:13,200
is explore with the person

1371
00:50:18,150 --> 00:50:15,760
how long they've had the problem

1372
00:50:20,069 --> 00:50:18,160
all the techniques they've used

1373
00:50:22,790 --> 00:50:20,079
and if they've gotten anywhere with

1374
00:50:23,510 --> 00:50:22,800
these techniques in the long term

1375
00:50:25,750 --> 00:50:23,520
and

1376
00:50:27,589 --> 00:50:25,760
what what what the result is is the

1377
00:50:29,109 --> 00:50:27,599
patient being like oh my gosh i've been

1378
00:50:31,190 --> 00:50:29,119
doing this for

1379
00:50:33,670 --> 00:50:31,200
years and years and years and i'm worse

1380
00:50:36,069 --> 00:50:33,680
off than when i started

1381
00:50:37,430 --> 00:50:36,079
this it's called creative hopelessness

1382
00:50:40,790 --> 00:50:37,440
because

1383
00:50:43,349 --> 00:50:40,800
there's a hopelessness to it but in that

1384
00:50:46,309 --> 00:50:43,359
moment it gives you the opportunity to

1385
00:50:47,670 --> 00:50:46,319
say okay i think i need to try something

1386
00:50:49,829 --> 00:50:47,680
different

1387
00:50:51,910 --> 00:50:49,839
this has not worked

1388
00:50:53,990 --> 00:50:51,920
it's like it's like up in front of your

1389
00:50:55,990 --> 00:50:54,000
face that it has not been working you

1390
00:50:57,430 --> 00:50:56,000
know you've laid it out and that

1391
00:50:59,030 --> 00:50:57,440
everything you've been doing has not

1392
00:51:00,630 --> 00:50:59,040
been working

1393
00:51:03,109 --> 00:51:00,640
and so

1394
00:51:05,190 --> 00:51:03,119
the creative part is that there's this

1395
00:51:09,990 --> 00:51:05,200
pivotal moment

1396
00:51:11,270 --> 00:51:10,000
i've seen it happen countless times i

1397
00:51:13,430 --> 00:51:11,280
see it in my

1398
00:51:14,950 --> 00:51:13,440
you know my participants my clients eyes

1399
00:51:18,069 --> 00:51:14,960
like there's a pivotal moment that's

1400
00:51:21,670 --> 00:51:18,079
like oh my gosh this is not working

1401
00:51:22,470 --> 00:51:21,680
so i need to try something else right

1402
00:51:24,950 --> 00:51:22,480
for

1403
00:51:27,990 --> 00:51:24,960
this sometimes requires

1404
00:51:29,829 --> 00:51:28,000
a long time of suffering right like so

1405
00:51:31,990 --> 00:51:29,839
that's why sometimes i think it

1406
00:51:33,589 --> 00:51:32,000
resonates because

1407
00:51:35,670 --> 00:51:33,599
for some people they've tried for

1408
00:51:37,430 --> 00:51:35,680
example distraction and it's worked

1409
00:51:39,510 --> 00:51:37,440
temporarily and they've only had it for

1410
00:51:40,390 --> 00:51:39,520
a few months and they're good to go

1411
00:51:42,549 --> 00:51:40,400
so

1412
00:51:45,109 --> 00:51:42,559
you know it's fine

1413
00:51:47,670 --> 00:51:45,119
but for people who've had it for a while

1414
00:51:51,670 --> 00:51:47,680
this resonates there's this pivotal

1415
00:51:53,670 --> 00:51:51,680
moment where they're like ah okay

1416
00:51:55,030 --> 00:51:53,680
okay it sounds like they've tried plenty

1417
00:51:57,270 --> 00:51:55,040
and then they're thinking well i need to

1418
00:51:59,349 --> 00:51:57,280
try something new but that something new

1419
00:52:01,510 --> 00:51:59,359
could be almost any of the therapies

1420
00:52:03,430 --> 00:52:01,520
that are tried and you said that act

1421
00:52:05,670 --> 00:52:03,440
seems to work better for these people

1422
00:52:07,829 --> 00:52:05,680
who have tried plenty already so what is

1423
00:52:09,589 --> 00:52:07,839
it because if it's this pivotal moment

1424
00:52:11,750 --> 00:52:09,599
then would that pivotal moment not apply

1425
00:52:14,309 --> 00:52:11,760
to any of the other therapies that they

1426
00:52:17,670 --> 00:52:14,319
could try that are new any new therapies

1427
00:52:19,750 --> 00:52:17,680
i mean again act is

1428
00:52:21,910 --> 00:52:19,760
it tends to be equivalent to other gold

1429
00:52:24,230 --> 00:52:21,920
standard ah right right right

1430
00:52:25,990 --> 00:52:24,240
so it's not i'm not saying it's better

1431
00:52:28,870 --> 00:52:26,000
and i'm not i'm not sure it's conclusive

1432
00:52:31,430 --> 00:52:28,880
that it's better for these people

1433
00:52:34,230 --> 00:52:31,440
but act is one of

1434
00:52:36,069 --> 00:52:34,240
it is the only therapy actually like

1435
00:52:37,990 --> 00:52:36,079
scientifically based one that's been

1436
00:52:40,150 --> 00:52:38,000
examined with you know randomized

1437
00:52:43,750 --> 00:52:40,160
controlled trials that has such a heavy

1438
00:52:46,390 --> 00:52:43,760
focus on the the values and it's it's

1439
00:52:48,549 --> 00:52:46,400
and it's also built on all these you

1440
00:52:50,710 --> 00:52:48,559
know basic science studies showing that

1441
00:52:52,309 --> 00:52:50,720
like thought suppression doesn't work

1442
00:52:54,150 --> 00:52:52,319
distraction doesn't work they come in

1443
00:52:56,870 --> 00:52:54,160
the rebound effect

1444
00:52:59,349 --> 00:52:56,880
but again the values piece is what

1445
00:53:00,390 --> 00:52:59,359
provides the motivation to to do the

1446
00:53:01,750 --> 00:53:00,400
hard work

1447
00:53:04,549 --> 00:53:01,760
right so

1448
00:53:07,270 --> 00:53:04,559
the woman who has had panic attacks for

1449
00:53:08,390 --> 00:53:07,280
10 years and barely leaves her house

1450
00:53:09,750 --> 00:53:08,400
anymore

1451
00:53:10,790 --> 00:53:09,760
okay

1452
00:53:15,589 --> 00:53:10,800
and

1453
00:53:18,230 --> 00:53:15,599
to reduce the panic attacks

1454
00:53:20,309 --> 00:53:18,240
works for a bit not too long

1455
00:53:21,829 --> 00:53:20,319
and she's you know not leaving her house

1456
00:53:23,990 --> 00:53:21,839
very much anymore

1457
00:53:26,630 --> 00:53:24,000
her daughter is graduating

1458
00:53:28,870 --> 00:53:26,640
and this requires her to go

1459
00:53:31,430 --> 00:53:28,880
sit in a building with or in an

1460
00:53:33,349 --> 00:53:31,440
auditorium with hundreds of people like

1461
00:53:35,510 --> 00:53:33,359
the most stressful thing for someone

1462
00:53:37,510 --> 00:53:35,520
like this

1463
00:53:39,990 --> 00:53:37,520
what would motivate her to do this work

1464
00:53:45,990 --> 00:53:44,309
as her as her daughter is on the stage

1465
00:53:47,670 --> 00:53:46,000
and she looks up

1466
00:53:52,150 --> 00:53:47,680
into the seats

1467
00:53:57,670 --> 00:53:55,109
right you make the values

1468
00:53:59,990 --> 00:53:57,680
front and center for the mom

1469
00:54:02,230 --> 00:54:00,000
do you want your daughter to see you

1470
00:54:05,109 --> 00:54:02,240
there

1471
00:54:06,390 --> 00:54:05,119
would you be willing to experience

1472
00:54:07,589 --> 00:54:06,400
that

1473
00:54:10,470 --> 00:54:07,599
feeling of

1474
00:54:12,309 --> 00:54:10,480
overwhelming fear and anxiety if it

1475
00:54:13,829 --> 00:54:12,319
means that your daughter for the rest of

1476
00:54:17,510 --> 00:54:13,839
her life will say

1477
00:54:22,069 --> 00:54:20,150
so values make it worthwhile and it's a

1478
00:54:24,390 --> 00:54:22,079
really important aspect and so like a

1479
00:54:28,390 --> 00:54:24,400
lot of the traditional

1480
00:54:30,470 --> 00:54:28,400
cbt have now incorporated values into

1481
00:54:33,750 --> 00:54:30,480
their treatment models because we're

1482
00:54:35,990 --> 00:54:33,760
finding it's such a powerful piece right

1483
00:54:38,150 --> 00:54:36,000
but values have always been the heart of

1484
00:54:39,190 --> 00:54:38,160
act

1485
00:54:41,589 --> 00:54:39,200
have you

1486
00:54:45,109 --> 00:54:41,599
found any studies that demonstrate

1487
00:54:46,710 --> 00:54:45,119
whether act works for suicidal ideation

1488
00:54:48,230 --> 00:54:46,720
or other

1489
00:54:50,870 --> 00:54:48,240
i think you call them distressors before

1490
00:54:52,150 --> 00:54:50,880
or but i'm not sure other because we

1491
00:54:53,990 --> 00:54:52,160
don't want to call them illnesses but

1492
00:54:57,270 --> 00:54:54,000
other and nor do we want to call them

1493
00:54:58,790 --> 00:54:57,280
disorders per se but issues other issues

1494
00:55:00,790 --> 00:54:58,800
maybe psychosis schizophrenia

1495
00:55:03,910 --> 00:55:00,800
derealization

1496
00:55:06,150 --> 00:55:03,920
so what's really interesting is

1497
00:55:08,790 --> 00:55:06,160
like i said there's over 300 randomized

1498
00:55:11,670 --> 00:55:08,800
controlled trials on act

1499
00:55:14,309 --> 00:55:11,680
and they range from mental health

1500
00:55:17,109 --> 00:55:14,319
conditions like depression anxiety

1501
00:55:20,309 --> 00:55:17,119
psychosis trichotillomania there's a

1502
00:55:22,790 --> 00:55:20,319
huge range of mental health conditions

1503
00:55:25,430 --> 00:55:22,800
it's been effective in a huge range of

1504
00:55:26,870 --> 00:55:25,440
medical conditions diabetes multiple

1505
00:55:28,150 --> 00:55:26,880
sclerosis

1506
00:55:29,750 --> 00:55:28,160
cancer

1507
00:55:32,829 --> 00:55:29,760
cardi car

1508
00:55:35,589 --> 00:55:32,839
heart failure a lot of those

1509
00:55:37,670 --> 00:55:35,599
hiv and in terms of the outcomes are

1510
00:55:39,270 --> 00:55:37,680
different right it's like getting back

1511
00:55:42,150 --> 00:55:39,280
into care or

1512
00:55:44,069 --> 00:55:42,160
cancer-related anxiety or

1513
00:55:46,069 --> 00:55:44,079
okay just to be clear you're not saying

1514
00:55:48,549 --> 00:55:46,079
employ act in order to induce your

1515
00:55:50,470 --> 00:55:48,559
cancer to a state of remission

1516
00:55:53,430 --> 00:55:50,480
no it's like for things related to it

1517
00:55:56,870 --> 00:55:53,440
like cancer related anxiety or for in

1518
00:55:59,990 --> 00:55:56,880
the in the heart failure patients it's

1519
00:56:01,670 --> 00:56:00,000
improving behaviors that would

1520
00:56:03,670 --> 00:56:01,680
um improve actually your health

1521
00:56:06,230 --> 00:56:03,680
condition right

1522
00:56:08,710 --> 00:56:06,240
um migraines it's been helpful for

1523
00:56:11,510 --> 00:56:08,720
migraines because migraine is a very

1524
00:56:13,270 --> 00:56:11,520
similar condition right the more you

1525
00:56:15,349 --> 00:56:13,280
struggle that you're getting headaches

1526
00:56:17,349 --> 00:56:15,359
the more you're gonna get headaches

1527
00:56:19,750 --> 00:56:17,359
and the more you avoid life because of

1528
00:56:21,829 --> 00:56:19,760
fear of getting headaches the more

1529
00:56:23,750 --> 00:56:21,839
um sensitive you become to things that

1530
00:56:27,510 --> 00:56:23,760
trigger headaches

1531
00:56:30,470 --> 00:56:27,520
and also it's been used in a range of

1532
00:56:31,750 --> 00:56:30,480
life things like chess performance

1533
00:56:33,190 --> 00:56:31,760
stigma

1534
00:56:34,230 --> 00:56:33,200
prejudice

1535
00:56:35,589 --> 00:56:34,240
um

1536
00:56:41,430 --> 00:56:35,599
rowing

1537
00:56:42,630 --> 00:56:41,440
enhancing sports performance for example

1538
00:56:44,870 --> 00:56:42,640
um

1539
00:56:46,470 --> 00:56:44,880
how about learning in general so for

1540
00:56:48,309 --> 00:56:46,480
example in this channel learning math

1541
00:56:50,150 --> 00:56:48,319
and physics

1542
00:56:52,390 --> 00:56:50,160
i don't know if i've seen a study on

1543
00:56:53,829 --> 00:56:52,400
that that doesn't mean it doesn't exist

1544
00:56:55,670 --> 00:56:53,839
um

1545
00:56:57,510 --> 00:56:55,680
could you imagine how it could be used

1546
00:56:59,510 --> 00:56:57,520
to enhance learning or would it just be

1547
00:57:01,190 --> 00:56:59,520
if some anxiety was holding you back

1548
00:57:03,190 --> 00:57:01,200
from learning we addressed that and then

1549
00:57:04,630 --> 00:57:03,200
the learning i think so i think it would

1550
00:57:06,710 --> 00:57:04,640
be more like

1551
00:57:09,829 --> 00:57:06,720
how do you become more present focused

1552
00:57:12,549 --> 00:57:09,839
when you're studying how do you you know

1553
00:57:14,470 --> 00:57:12,559
not let anxiety and difficult thoughts

1554
00:57:17,670 --> 00:57:14,480
get in the way because

1555
00:57:20,230 --> 00:57:17,680
you can over think you can worry so much

1556
00:57:22,549 --> 00:57:20,240
that it gets in the way of how you do

1557
00:57:23,510 --> 00:57:22,559
so you would address that part of it you

1558
00:57:25,030 --> 00:57:23,520
know

1559
00:57:27,109 --> 00:57:25,040
like in the medical conditions we

1560
00:57:30,150 --> 00:57:27,119
address treatment adherence

1561
00:57:31,510 --> 00:57:30,160
with our diabetic patients for example

1562
00:57:33,430 --> 00:57:31,520
because patients don't want to think

1563
00:57:34,870 --> 00:57:33,440
about their condition they won't take

1564
00:57:36,789 --> 00:57:34,880
their medications because the

1565
00:57:39,589 --> 00:57:36,799
medications remind them of how sick they

1566
00:57:42,069 --> 00:57:39,599
are right it's an avoidance strategy

1567
00:57:43,910 --> 00:57:42,079
and so you're telling them to face

1568
00:57:45,589 --> 00:57:43,920
this thing that's scary to them because

1569
00:57:47,750 --> 00:57:45,599
actually in the long term

1570
00:57:48,549 --> 00:57:47,760
it will help them with their condition

1571
00:57:50,630 --> 00:57:48,559
right

1572
00:57:53,349 --> 00:57:50,640
so there's a lot of treatment adherence

1573
00:57:55,030 --> 00:57:53,359
things that act works on because a lot

1574
00:57:56,789 --> 00:57:55,040
of

1575
00:57:59,470 --> 00:57:56,799
difficulty with treatment adherence is

1576
00:58:03,190 --> 00:57:59,480
due to avoidance it's uncomfortable it's

1577
00:58:03,990 --> 00:58:03,200
inconvenient it's anxiety provoking

1578
00:58:06,069 --> 00:58:04,000
um

1579
00:58:08,390 --> 00:58:06,079
act has also been used in works

1580
00:58:11,270 --> 00:58:08,400
workplace stress and burnout among

1581
00:58:12,309 --> 00:58:11,280
medical professionals

1582
00:58:14,390 --> 00:58:12,319
um

1583
00:58:16,309 --> 00:58:14,400
but you ask oh i know what you asked me

1584
00:58:19,349 --> 00:58:16,319
about does it work for psychosis which

1585
00:58:22,069 --> 00:58:19,359
reminded me and now i'm jumping back

1586
00:58:24,710 --> 00:58:22,079
so act is listed as an empirically

1587
00:58:26,789 --> 00:58:24,720
supported treatment by

1588
00:58:27,910 --> 00:58:26,799
the american psychological association

1589
00:58:28,950 --> 00:58:27,920
and other

1590
00:58:32,069 --> 00:58:28,960
um

1591
00:58:33,430 --> 00:58:32,079
important boards for five conditions

1592
00:58:34,870 --> 00:58:33,440
for depression

1593
00:58:37,430 --> 00:58:34,880
anxiety

1594
00:58:39,589 --> 00:58:37,440
ocd psychosis

1595
00:58:42,390 --> 00:58:39,599
and chronic pain

1596
00:58:45,510 --> 00:58:42,400
now it's been tested in

1597
00:58:48,150 --> 00:58:45,520
dozens of other conditions but to reach

1598
00:58:49,510 --> 00:58:48,160
the scientific rigor to be listed

1599
00:58:51,270 --> 00:58:49,520
you have to have a certain number of

1600
00:58:53,430 --> 00:58:51,280
clinical trials and they have to be from

1601
00:58:56,230 --> 00:58:53,440
independent labs and

1602
00:58:58,630 --> 00:58:56,240
you know so there has to it's um

1603
00:58:59,829 --> 00:58:58,640
it's a very rigorous thing to get listed

1604
00:59:02,789 --> 00:58:59,839
on that but

1605
00:59:04,390 --> 00:59:02,799
imagine it's actually listed

1606
00:59:06,549 --> 00:59:04,400
as an empirically supported treatment

1607
00:59:09,990 --> 00:59:06,559
for psychosis

1608
00:59:11,670 --> 00:59:10,000
and so yes it works for that more in

1609
00:59:14,710 --> 00:59:11,680
terms of

1610
00:59:16,710 --> 00:59:14,720
not reducing symptoms per se

1611
00:59:19,750 --> 00:59:16,720
but learning to live

1612
00:59:22,950 --> 00:59:19,760
with them more effectively and

1613
00:59:30,309 --> 00:59:26,549
in the first study of psychosis

1614
00:59:33,829 --> 00:59:32,069
and getting back to the question of is

1615
00:59:35,829 --> 00:59:33,839
acknowledgement a better term than

1616
00:59:37,910 --> 00:59:35,839
acceptance because acceptance has the

1617
00:59:40,230 --> 00:59:37,920
connotation that you should accept the

1618
00:59:42,549 --> 00:59:40,240
thought like go with it

1619
00:59:44,549 --> 00:59:42,559
believe it even

1620
00:59:47,190 --> 00:59:44,559
so it's not what it should be called

1621
00:59:49,270 --> 00:59:47,200
it's what works right it's what works

1622
00:59:51,349 --> 00:59:49,280
that said

1623
00:59:52,150 --> 00:59:51,359
i don't use the term acceptance in my

1624
00:59:56,390 --> 00:59:52,160
work

1625
00:59:58,710 --> 00:59:56,400
you know when we're writing about it

1626
01:00:01,510 --> 00:59:58,720
but in the like day-to-day interactions

1627
01:00:03,270 --> 01:00:01,520
with my patients or with my clients i

1628
01:00:06,069 --> 01:00:03,280
don't use the term acceptance because

1629
01:00:08,390 --> 01:00:06,079
it's a very loaded actually actually

1630
01:00:10,950 --> 01:00:08,400
term like they take it as like just suck

1631
01:00:13,990 --> 01:00:10,960
it up and accept it you know

1632
01:00:15,109 --> 01:00:14,000
and that's definitely not the intended

1633
01:00:18,390 --> 01:00:15,119
message

1634
01:00:19,430 --> 01:00:18,400
acknowledge is a much better term i

1635
01:00:21,670 --> 01:00:19,440
think

1636
01:00:23,910 --> 01:00:21,680
the thing that acknowledge

1637
01:00:25,750 --> 01:00:23,920
doesn't get into i think

1638
01:00:28,390 --> 01:00:25,760
although it might i just haven't thought

1639
01:00:30,789 --> 01:00:28,400
about it enough but

1640
01:00:33,190 --> 01:00:30,799
acknowledge is a really good one

1641
01:00:35,030 --> 01:00:33,200
i think what willingness does as an

1642
01:00:35,910 --> 01:00:35,040
extra step

1643
01:00:39,349 --> 01:00:35,920
is

1644
01:00:41,190 --> 01:00:39,359
connects it to the value because

1645
01:00:43,430 --> 01:00:41,200
are you willing

1646
01:00:46,150 --> 01:00:43,440
to feel this way

1647
01:00:48,549 --> 01:00:46,160
or to have these thoughts

1648
01:00:50,630 --> 01:00:48,559
in service of something important to you

1649
01:00:52,710 --> 01:00:50,640
would you be willing to experience fear

1650
01:00:54,309 --> 01:00:52,720
and anxiety

1651
01:00:55,670 --> 01:00:54,319
if it means you'll be at your daughter's

1652
01:00:58,950 --> 01:00:55,680
graduation

1653
01:00:59,670 --> 01:00:58,960
would you be willing to experience all

1654
01:01:01,589 --> 01:00:59,680
the

1655
01:01:03,910 --> 01:01:01,599
difficulties

1656
01:01:05,670 --> 01:01:03,920
of graduate school if it means that

1657
01:01:07,349 --> 01:01:05,680
you'll get to do what you want to do at

1658
01:01:10,150 --> 01:01:07,359
the end right

1659
01:01:11,990 --> 01:01:10,160
so the willingness piece for me connects

1660
01:01:14,549 --> 01:01:12,000
it to the other side

1661
01:01:17,030 --> 01:01:14,559
which is a critical one but certainly

1662
01:01:19,030 --> 01:01:17,040
acknowledge is much more i think

1663
01:01:21,430 --> 01:01:19,040
compassionate than

1664
01:01:22,789 --> 01:01:21,440
accept

1665
01:01:25,030 --> 01:01:22,799
one of the questions i have and it's

1666
01:01:26,950 --> 01:01:25,040
more of a philosophical one is

1667
01:01:29,589 --> 01:01:26,960
determining whether

1668
01:01:32,390 --> 01:01:29,599
an issue is a psychological

1669
01:01:33,349 --> 01:01:32,400
problem or a physical one so for example

1670
01:01:37,270 --> 01:01:33,359
for me

1671
01:01:39,990 --> 01:01:37,280
for a series of weeks i was waking up

1672
01:01:42,069 --> 01:01:40,000
soon after going to sleep

1673
01:01:44,789 --> 01:01:42,079
terrorized by something by

1674
01:01:46,870 --> 01:01:44,799
a dream and feeling horror as they woke

1675
01:01:48,549 --> 01:01:46,880
up and then it turns out as soon as i

1676
01:01:50,470 --> 01:01:48,559
started sleeping on my side all of that

1677
01:01:52,470 --> 01:01:50,480
went away and it's because i have a mild

1678
01:01:54,230 --> 01:01:52,480
sleep apnea that i didn't know about and

1679
01:01:56,789 --> 01:01:54,240
this is common in people who have sleep

1680
01:01:59,270 --> 01:01:56,799
apnea your mouth your throat closes and

1681
01:02:01,510 --> 01:01:59,280
so you wake yourself up and because it

1682
01:02:03,910 --> 01:02:01,520
triggers a certain reflex you wake up in

1683
01:02:06,309 --> 01:02:03,920
fear and you think or i thought that i

1684
01:02:08,789 --> 01:02:06,319
need to go to see sigmund freud or carl

1685
01:02:11,349 --> 01:02:08,799
jung to resolve childhood issues that

1686
01:02:13,750 --> 01:02:11,359
are coming up in my dreams but it all

1687
01:02:16,069 --> 01:02:13,760
went away when i slept on my side

1688
01:02:17,990 --> 01:02:16,079
so that was a physical problem that i

1689
01:02:20,390 --> 01:02:18,000
thought was a psychological one so how

1690
01:02:22,470 --> 01:02:20,400
does one go about determining when a

1691
01:02:24,470 --> 01:02:22,480
problem requires a physical intervention

1692
01:02:26,230 --> 01:02:24,480
versus a psychological one so let's call

1693
01:02:28,390 --> 01:02:26,240
that question number one and then

1694
01:02:30,549 --> 01:02:28,400
a sub to that question 1a is how does

1695
01:02:32,309 --> 01:02:30,559
one determine whether an intervention

1696
01:02:34,549 --> 01:02:32,319
such as running or exercise like a

1697
01:02:37,190 --> 01:02:34,559
physical one in this case that the lack

1698
01:02:39,190 --> 01:02:37,200
of it is the cause for the issue

1699
01:02:41,190 --> 01:02:39,200
versus the addition of it abates the

1700
01:02:42,470 --> 01:02:41,200
underlying problem so are those two seen

1701
01:02:45,030 --> 01:02:42,480
as the same

1702
01:02:47,349 --> 01:02:45,040
this is an ideological question so it's

1703
01:02:48,870 --> 01:02:47,359
more philosophical about

1704
01:02:51,190 --> 01:02:48,880
how does one determine whether the

1705
01:02:53,750 --> 01:02:51,200
presence of something

1706
01:02:56,230 --> 01:02:53,760
is the cure for the predicament versus

1707
01:02:57,990 --> 01:02:56,240
the lack of it being the cause of the

1708
01:02:59,910 --> 01:02:58,000
problem let me know if that was clear

1709
01:03:00,710 --> 01:02:59,920
because i can restate that

1710
01:03:02,549 --> 01:03:00,720
well

1711
01:03:05,670 --> 01:03:02,559
the question is a hard one and i won't

1712
01:03:07,349 --> 01:03:05,680
answer it directly what i will say is

1713
01:03:10,710 --> 01:03:07,359
that

1714
01:03:13,109 --> 01:03:10,720
mental health and physical health issues

1715
01:03:14,829 --> 01:03:13,119
are intertwined and

1716
01:03:17,910 --> 01:03:14,839
play a very strong

1717
01:03:19,510 --> 01:03:17,920
bi-directional effect on each other

1718
01:03:22,230 --> 01:03:19,520
so for example

1719
01:03:23,430 --> 01:03:22,240
people who have when you do longitudinal

1720
01:03:26,470 --> 01:03:23,440
studies

1721
01:03:29,270 --> 01:03:26,480
people who have depression

1722
01:03:31,990 --> 01:03:29,280
are at much higher risk

1723
01:03:35,829 --> 01:03:32,000
for cardiovascular disease

1724
01:03:37,670 --> 01:03:35,839
and migraine and a range of physical

1725
01:03:39,990 --> 01:03:37,680
health problems

1726
01:03:42,069 --> 01:03:40,000
and the reverse is true

1727
01:03:45,510 --> 01:03:42,079
patients with migraine and

1728
01:03:47,829 --> 01:03:45,520
cardiovascular disease ms

1729
01:03:49,670 --> 01:03:47,839
are at much higher risk for mental

1730
01:03:51,190 --> 01:03:49,680
health difficulties like depression and

1731
01:03:52,870 --> 01:03:51,200
anxiety

1732
01:03:55,029 --> 01:03:52,880
so it's

1733
01:03:57,029 --> 01:03:55,039
they're very bi-directional and

1734
01:03:58,710 --> 01:03:57,039
longitudinal studies have shown this and

1735
01:04:01,029 --> 01:03:58,720
people have spent a lot of time trying

1736
01:04:03,430 --> 01:04:01,039
to figure out which comes first and

1737
01:04:05,029 --> 01:04:03,440
it differs for different people

1738
01:04:06,950 --> 01:04:05,039
i think the important thing to know is

1739
01:04:09,430 --> 01:04:06,960
that they do

1740
01:04:11,109 --> 01:04:09,440
influence each other you know

1741
01:04:13,109 --> 01:04:11,119
i'm not

1742
01:04:16,870 --> 01:04:13,119
sometimes targeting both is the best

1743
01:04:18,069 --> 01:04:16,880
strategy like let's take migraines right

1744
01:04:20,390 --> 01:04:18,079
stress

1745
01:04:22,470 --> 01:04:20,400
so migraines are triggered by many

1746
01:04:23,430 --> 01:04:22,480
things it's triggered by certain foods

1747
01:04:24,870 --> 01:04:23,440
it's

1748
01:04:26,950 --> 01:04:24,880
triggered by certain

1749
01:04:27,750 --> 01:04:26,960
changes in elevation

1750
01:04:31,029 --> 01:04:27,760
um

1751
01:04:32,789 --> 01:04:31,039
but it's one of the main triggers of

1752
01:04:33,670 --> 01:04:32,799
migraines is stress

1753
01:04:34,710 --> 01:04:33,680
right

1754
01:04:36,950 --> 01:04:34,720
so

1755
01:04:38,950 --> 01:04:36,960
if you address the stress

1756
01:04:41,349 --> 01:04:38,960
you might minimize the number of

1757
01:04:44,470 --> 01:04:41,359
migraines that doesn't mean that

1758
01:04:47,510 --> 01:04:44,480
migraines are not a true neurological

1759
01:04:49,589 --> 01:04:47,520
condition because it is the brains

1760
01:04:53,109 --> 01:04:49,599
of patients with migraine

1761
01:04:54,549 --> 01:04:53,119
even outside of a migraine episode

1762
01:04:57,190 --> 01:04:54,559
their brains are different from people

1763
01:04:58,309 --> 01:04:57,200
who don't have migraines right

1764
01:05:01,109 --> 01:04:58,319
and so

1765
01:05:03,190 --> 01:05:01,119
would that person benefit from both

1766
01:05:05,589 --> 01:05:03,200
a preventive or acute migraine

1767
01:05:07,589 --> 01:05:05,599
medication and

1768
01:05:10,230 --> 01:05:07,599
stress relieving strategies

1769
01:05:12,150 --> 01:05:10,240
probably absolutely actually

1770
01:05:14,390 --> 01:05:12,160
same thing applies for cardiovascular

1771
01:05:17,750 --> 01:05:14,400
disease right

1772
01:05:20,829 --> 01:05:17,760
people who have depression are two times

1773
01:05:22,789 --> 01:05:20,839
more likely to

1774
01:05:24,870 --> 01:05:22,799
die from

1775
01:05:26,950 --> 01:05:24,880
cardiovascular disease than people

1776
01:05:28,870 --> 01:05:26,960
without depression right

1777
01:05:31,029 --> 01:05:28,880
is that the cause

1778
01:05:33,190 --> 01:05:31,039
it's hard to say right but does it

1779
01:05:34,630 --> 01:05:33,200
impact it absolutely

1780
01:05:37,029 --> 01:05:34,640
so maybe that's a different way to

1781
01:05:38,549 --> 01:05:37,039
answer your question sure and can we end

1782
01:05:39,589 --> 01:05:38,559
on the visual just one more visual

1783
01:05:43,029 --> 01:05:39,599
exercise

1784
01:05:45,510 --> 01:05:43,039
one more visual well there are many um

1785
01:05:47,510 --> 01:05:45,520
but one like the bus driver for example

1786
01:05:50,870 --> 01:05:47,520
that's very similar to the bus driver

1787
01:05:53,510 --> 01:05:50,880
but i do individually with my patients

1788
01:05:55,910 --> 01:05:53,520
it's called the lifeline you know and i

1789
01:05:58,069 --> 01:05:55,920
get and it's a physical one in the sense

1790
01:05:59,990 --> 01:05:58,079
that i stand next to them and then i say

1791
01:06:02,150 --> 01:06:00,000
something like

1792
01:06:04,630 --> 01:06:02,160
what is something that you really care

1793
01:06:06,069 --> 01:06:04,640
about that you haven't been doing

1794
01:06:08,230 --> 01:06:06,079
you know and

1795
01:06:10,069 --> 01:06:08,240
so maybe someone will say to me like i

1796
01:06:11,910 --> 01:06:10,079
want to go out more with friends but i'm

1797
01:06:13,589 --> 01:06:11,920
too anxious

1798
01:06:15,750 --> 01:06:13,599
and then i'll really get at i'll say

1799
01:06:17,190 --> 01:06:15,760
well tell me why that matters to you you

1800
01:06:19,270 --> 01:06:17,200
know why

1801
01:06:20,390 --> 01:06:19,280
why do you even care about that

1802
01:06:21,910 --> 01:06:20,400
well because

1803
01:06:25,510 --> 01:06:21,920
you know i want to have friends and it's

1804
01:06:28,630 --> 01:06:25,520
important and i really care about people

1805
01:06:31,270 --> 01:06:28,640
and so i'll i'll put a sticky note on a

1806
01:06:32,470 --> 01:06:31,280
door which is a little bit far away from

1807
01:06:34,549 --> 01:06:32,480
us you know

1808
01:06:37,349 --> 01:06:34,559
and i'll say what's one step that you

1809
01:06:38,470 --> 01:06:37,359
can take what's one small thing you can

1810
01:06:41,190 --> 01:06:38,480
do

1811
01:06:44,549 --> 01:06:41,200
that can move you closer to this

1812
01:06:49,829 --> 01:06:47,029
they might say something like

1813
01:06:51,990 --> 01:06:49,839
ask someone on a date or they might say

1814
01:06:53,910 --> 01:06:52,000
something like uh say yes to an

1815
01:06:55,349 --> 01:06:53,920
invitation right

1816
01:06:58,470 --> 01:06:55,359
and i'll say great and i'll put that

1817
01:06:59,270 --> 01:06:58,480
sticky on the door next to the value

1818
01:07:01,349 --> 01:06:59,280
like

1819
01:07:03,829 --> 01:07:01,359
want to have more social interactions i

1820
01:07:06,630 --> 01:07:03,839
want to ask someone on a date

1821
01:07:08,789 --> 01:07:06,640
so then i say okay

1822
01:07:10,390 --> 01:07:08,799
let's let's think about walking towards

1823
01:07:12,549 --> 01:07:10,400
that let's imagine that you're about to

1824
01:07:14,710 --> 01:07:12,559
go ask someone on a date

1825
01:07:16,870 --> 01:07:14,720
tell me what what shows up for you like

1826
01:07:19,029 --> 01:07:16,880
what thoughts pop up

1827
01:07:20,630 --> 01:07:19,039
like you're not good enough or you're

1828
01:07:21,589 --> 01:07:20,640
gonna look stupid

1829
01:07:23,910 --> 01:07:21,599
you're

1830
01:07:25,029 --> 01:07:23,920
you know not lovable enough like what

1831
01:07:27,430 --> 01:07:25,039
shows up

1832
01:07:29,670 --> 01:07:27,440
so i guide them but they start like

1833
01:07:31,190 --> 01:07:29,680
telling me some thoughts and i say okay

1834
01:07:32,390 --> 01:07:31,200
and what shows up in your body as you

1835
01:07:33,430 --> 01:07:32,400
think about

1836
01:07:35,510 --> 01:07:33,440
going

1837
01:07:37,510 --> 01:07:35,520
to ask someone on a date

1838
01:07:39,829 --> 01:07:37,520
and they'll say oh like anxiety like my

1839
01:07:41,589 --> 01:07:39,839
heart's racing you know so i'll stick

1840
01:07:44,630 --> 01:07:41,599
sticky notes

1841
01:07:45,589 --> 01:07:44,640
on their body that has all these things

1842
01:07:47,349 --> 01:07:45,599
like

1843
01:07:49,589 --> 01:07:47,359
heart racing

1844
01:07:51,109 --> 01:07:49,599
she's gonna reject you you're gonna look

1845
01:07:54,870 --> 01:07:51,119
like a loser

1846
01:07:56,549 --> 01:07:54,880
this is terrible i can't handle it right

1847
01:07:59,109 --> 01:07:56,559
but when you

1848
01:08:01,029 --> 01:07:59,119
write it out and it's like outside your

1849
01:08:02,950 --> 01:08:01,039
head and you're putting it on a sticky

1850
01:08:04,789 --> 01:08:02,960
note on their body

1851
01:08:06,950 --> 01:08:04,799
first of all you you're kind of

1852
01:08:09,190 --> 01:08:06,960
disentangling a little bit the monster

1853
01:08:11,349 --> 01:08:09,200
that comes as a flood

1854
01:08:14,150 --> 01:08:11,359
and then i ask the person to start

1855
01:08:15,510 --> 01:08:14,160
walking with me towards

1856
01:08:18,870 --> 01:08:15,520
that

1857
01:08:19,829 --> 01:08:18,880
be doing

1858
01:08:22,470 --> 01:08:19,839
right

1859
01:08:24,789 --> 01:08:22,480
and as they are walking i start yelling

1860
01:08:26,470 --> 01:08:24,799
out all these things at them

1861
01:08:29,430 --> 01:08:26,480
you're going to blow it you're going to

1862
01:08:31,349 --> 01:08:29,440
be rejected it's going to be terrible

1863
01:08:34,870 --> 01:08:31,359
you're going to panic

1864
01:08:36,950 --> 01:08:34,880
and as i do that i turn them around

1865
01:08:40,709 --> 01:08:36,960
so that they stop walking towards their

1866
01:08:42,309 --> 01:08:40,719
value and start walking away from it

1867
01:08:44,470 --> 01:08:42,319
and then i say

1868
01:08:46,390 --> 01:08:44,480
how does it feel to walk away from that

1869
01:08:48,789 --> 01:08:46,400
thing that matters to you

1870
01:08:51,110 --> 01:08:48,799
they'll say it's a relief like because

1871
01:08:53,189 --> 01:08:51,120
i'm i stop i stop yelling at them as

1872
01:08:55,349 --> 01:08:53,199
well like their mind stops yelling at

1873
01:08:57,110 --> 01:08:55,359
them they've dodged a bullet

1874
01:08:58,229 --> 01:08:57,120
and i'll say okay

1875
01:09:00,630 --> 01:08:58,239
that's right

1876
01:09:02,470 --> 01:09:00,640
you've dodged a bullet

1877
01:09:04,470 --> 01:09:02,480
but what about that thing that matters

1878
01:09:06,149 --> 01:09:04,480
to you that thing that you really want

1879
01:09:08,229 --> 01:09:06,159
to do

1880
01:09:09,189 --> 01:09:08,239
and you'll be like well it's still far

1881
01:09:11,749 --> 01:09:09,199
away

1882
01:09:14,070 --> 01:09:11,759
right and i keep doing this

1883
01:09:16,709 --> 01:09:14,080
and like walking

1884
01:09:18,309 --> 01:09:16,719
and then turning him around walking and

1885
01:09:19,749 --> 01:09:18,319
like yelling these things that are on

1886
01:09:21,910 --> 01:09:19,759
the sticky note

1887
01:09:24,789 --> 01:09:21,920
and turning him around

1888
01:09:26,470 --> 01:09:24,799
until the last time or the final round

1889
01:09:29,669 --> 01:09:26,480
what i'll do is

1890
01:09:31,910 --> 01:09:29,679
i will walk with him all the way to the

1891
01:09:32,870 --> 01:09:31,920
sticky note have him grab the sticky

1892
01:09:36,149 --> 01:09:32,880
note

1893
01:09:37,349 --> 01:09:36,159
even though the thoughts are still there

1894
01:09:39,749 --> 01:09:37,359
right

1895
01:09:42,950 --> 01:09:39,759
he was willing to walk towards that

1896
01:09:44,309 --> 01:09:42,960
thing that mattered despite

1897
01:09:46,229 --> 01:09:44,319
all these difficult thoughts and

1898
01:09:49,829 --> 01:09:46,239
emotions that showed up

1899
01:09:52,309 --> 01:09:49,839
and then i'll say what does it feel like

1900
01:09:54,550 --> 01:09:52,319
to actually get there

1901
01:09:55,350 --> 01:09:54,560
and they'll always say like that feels

1902
01:10:01,510 --> 01:09:55,360
like

1903
01:10:02,870 --> 01:10:01,520
the fear win i didn't let my mind win i

1904
01:10:05,510 --> 01:10:02,880
didn't let

1905
01:10:08,229 --> 01:10:05,520
my emotions win i i let the thing that

1906
01:10:10,790 --> 01:10:08,239
matters when

1907
01:10:12,390 --> 01:10:10,800
i like that so the reward the reward

1908
01:10:13,510 --> 01:10:12,400
trumps the relief

1909
01:10:15,590 --> 01:10:13,520
correct

1910
01:10:17,510 --> 01:10:15,600
interesting because of time constraints

1911
01:10:19,590 --> 01:10:17,520
the last three questions were answered

1912
01:10:21,910 --> 01:10:19,600
over email and so i'll read them aloud

1913
01:10:25,030 --> 01:10:21,920
here question number one how much of a

1914
01:10:27,110 --> 01:10:25,040
role does belief slash hope play in act

1915
01:10:29,270 --> 01:10:27,120
that is to say when a patient believes

1916
01:10:31,270 --> 01:10:29,280
quote unquote that the treatment will

1917
01:10:33,030 --> 01:10:31,280
work or hopes that the treatment will

1918
01:10:34,790 --> 01:10:33,040
work or trusts that the treatment will

1919
01:10:37,990 --> 01:10:34,800
work then i imagine it would increase

1920
01:10:40,149 --> 01:10:38,000
its efficacy lillian states the placebo

1921
01:10:42,550 --> 01:10:40,159
effect is a real thing

1922
01:10:44,310 --> 01:10:42,560
hope is an important aspect of change it

1923
01:10:47,430 --> 01:10:44,320
helps if a person has trust in the

1924
01:10:49,669 --> 01:10:47,440
provider and in the treatment for sure

1925
01:10:51,750 --> 01:10:49,679
question number two what about finding a

1926
01:10:53,990 --> 01:10:51,760
purpose slash thinking the negative

1927
01:10:56,550 --> 01:10:54,000
thought understanding where it came from

1928
01:10:58,310 --> 01:10:56,560
and its reason and realizing it's not

1929
01:11:00,630 --> 01:10:58,320
needed but was trying to be helpful in

1930
01:11:03,669 --> 01:11:00,640
its own way for example saying to

1931
01:11:05,590 --> 01:11:03,679
oneself yes i see you anxiety and i

1932
01:11:07,110 --> 01:11:05,600
understand how you're trying to protect

1933
01:11:09,510 --> 01:11:07,120
me when i was younger that's how you

1934
01:11:12,630 --> 01:11:09,520
came about but i'm still going to ask

1935
01:11:14,470 --> 01:11:12,640
that guy out on a date anyhow lillian

1936
01:11:17,189 --> 01:11:14,480
answers yes this is something we would

1937
01:11:19,990 --> 01:11:17,199
do an act for sure our mind is often

1938
01:11:21,990 --> 01:11:20,000
trying to protect us so thanking it and

1939
01:11:24,070 --> 01:11:22,000
telling it where the thought originated

1940
01:11:25,430 --> 01:11:24,080
and that the context is now different

1941
01:11:28,470 --> 01:11:25,440
and that the thought is no longer

1942
01:11:30,790 --> 01:11:28,480
helpful is an act consistent move

1943
01:11:33,189 --> 01:11:30,800
the last question question number three

1944
01:11:34,630 --> 01:11:33,199
generally in studies one excludes people

1945
01:11:36,709 --> 01:11:34,640
with comorbidities because it

1946
01:11:38,709 --> 01:11:36,719
complicates the issues however it seems

1947
01:11:41,510 --> 01:11:38,719
like fewer and fewer people are those

1948
01:11:43,189 --> 01:11:41,520
who just have an isolated condition that

1949
01:11:45,189 --> 01:11:43,199
is to say greater and greater numbers of

1950
01:11:47,669 --> 01:11:45,199
people suffer from multiple issues

1951
01:11:49,430 --> 01:11:47,679
rather than just one thus these studies

1952
01:11:51,030 --> 01:11:49,440
don't necessarily reflect treatment

1953
01:11:53,990 --> 01:11:51,040
strategies that work for the majority of

1954
01:11:55,990 --> 01:11:54,000
people how does one overcome this flaw

1955
01:11:57,910 --> 01:11:56,000
that is not reflecting a patient's true

1956
01:11:59,110 --> 01:11:57,920
set of symptoms in the way studies are

1957
01:12:01,750 --> 01:11:59,120
designed

1958
01:12:03,669 --> 01:12:01,760
lillian answers most of my work has been

1959
01:12:05,510 --> 01:12:03,679
with people who have comorbidities

1960
01:12:07,590 --> 01:12:05,520
increasingly people are looking at

1961
01:12:09,830 --> 01:12:07,600
samples that generalize more to the

1962
01:12:11,590 --> 01:12:09,840
larger population

1963
01:12:13,110 --> 01:12:11,600
professor thank you so much i think

1964
01:12:15,590 --> 01:12:13,120
that's a great note to end on i think

1965
01:12:17,350 --> 01:12:15,600
that's extremely inspirational

1966
01:12:19,110 --> 01:12:17,360
great i'm glad

1967
01:12:21,270 --> 01:12:19,120
it was really nice to be here thank you

1968
01:12:22,950 --> 01:12:21,280
for inviting me i appreciate it i

1969
01:12:24,630 --> 01:12:22,960
appreciate you coming out and thank you

1970
01:12:28,310 --> 01:12:24,640
so much

1971
01:12:31,990 --> 01:12:30,229
the podcast is now finished if you'd

1972
01:12:35,110 --> 01:12:32,000
like to support conversations like this

1973
01:12:36,470 --> 01:12:35,120
then do consider going to patreon.com

1974
01:12:39,270 --> 01:12:36,480
c-u-r-t

1975
01:12:41,830 --> 01:12:39,280
j-a-i-m-u-n-g-a-l

1976
01:12:43,669 --> 01:12:41,840
that is kurt jaimungle it's support from

1977
01:12:45,510 --> 01:12:43,679
the patrons and from the sponsors that