Ep 114: Not All Therapy Are Created Equal with Thomas Whitfield
Art by @morelaaand
All mental health providers are not equal. That doesn't mean good or bad, but simply different training, specialties, and personalities. In this episode, Effy Blue and Jacqueline Misla sit down with Dr. Thomas Whitfield to discuss the best way to find a therapist for your sexual and mental health needs.
They explore everything from key phrases to google, the distinction between the types of therapies, and some controversial therapeutic methods for addressing sexual trauma.
As mentioned on the episode;
Waking Up The Tiger - Peter Levine
Episode 92: Trauma, Sense of Safety and the Soma with Rida Kıraşı
To find more about Thomas Whitfield and his work visit his website www.SexEdByThomas.com and on IG and Twitter @twhitfieldphd.
To find more about Effy Blue and Jacqueline Misla, follow them at @wearecuriousfoxes, @coacheffyblue, and @jacquelinemisla on Instagram.
If you have a question that you would like to explore on the show, reach out to us and we may answer your question on one of our upcoming episodes. Leave us a voicemail at 646-450-9079 or email us at listening@wearecuriousfoxes.com
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TRANSCRIPT:
Thomas Whitfield
You know, it's like going to a bar and ordering a drink and not liking the drink, you don't never drink again, you go to a different bar, you try different bartender, you try different drinks, nothing like drawing therapy and drinking together.
Effy
Welcome to the Curious Fox podcast, for those challenging the status quo in love, sex, and relationships. My name is Effy Blue.
Jacqueline
And I'm Jacqueline Misla. And today we're talking about therapy, specifically how to find the right therapist, which can be particularly difficult if you want to talk about things like non monogamy, sexuality, or sexual trauma. This is a continuation of our dialogue about mental health in honor of Mental Health Month. And in last month's episode, you and I talked about how to identify self care practices that meet our emotional, physical, mental, social, spiritual, and even practical needs.
Effy
And we shot all over but for the best part of the hour,
Jacqueline
that was actually really all we did.
Effy
Really well, we did. But ya know, we were just upset with the fact that bubble baths have become synonymous with self care, and they're just aren't and they shouldn't be. However, therapy can be synonymous with self get, of course, you need to take care of yourself in a way that is the best for you. And therapy is definitely an important tool in that, I would say, would you?
Jacqueline
Yes, I would. If you subscribe to our newsletter, then you got our digest for March. And in there, we include not only some of the work that we do, but we include what we're watching what we're listening to what we're reading, and included a tick tock video of someone essentially sitting down for a first date, and being like, Hi, are you in therapy now? Alright, thanks. It's nice to meet you. And I feel like that is that's it that feels accurate nowadays, it's like, have you processed your trauma and attachment? No. All right. It was really nice meeting you. Thank you have a good move on.
Effy
I like that. Right. I would much prefer that as a first question, then what do you do? Which is like one of my pet peeves a question? Like, what do you do? I'm like, I know I do well.
Jacqueline
I really like that I'm gonna do pretty well.
Effy
So that I like, how's your therapy going? Or have you done any therapy is a good good putter equally as awkward as far as I'm concerned?
I feel like at least you're going somewhere with the therapy person. Yeah, we both had our therapy journeys. Yes, I had taken a break from mine. A while ago, actually, I got to a place to my therapist, where we just weren't seeing eye to eye, let's say, and I had to do the most uncomfortable thing, which is to fire your therapist. And it's kind of painful process because you can't really just fire them, you kind of have to do like this exit sessions, sort of make sure that you know, like, you ended up in a good way, which is good for your mental health as well. Right. And it's also good practice, because for somebody who's avoidant like me, what I wanted to do is, like, fire her and never see her again. And that's right, which is exactly the thing I'm trying to get over. So she was like, Well, I understand your concerns. Like, it takes about two sessions to exit this, this relationship. And so I was like, okay, every part of my being is saying, fuck that. I'm out of here. But the right thing to do since I'm in therapy and trying to get better is to actually like, you know, work on the exit.
Jacqueline
Yes, it's a conscious uncoupling. Right? Exactly, exactly. So
Effy
instead of firing my therapist, I consciously uncoupled from my therapist, which, you know, is a great thing to do. And then I was, I was like, I'm gonna take a break from therapy. I love it. Look at me, and then that that high lasted about two weeks before I just became a riddle and all the things that I'm riddled in. And I was like, Okay, I shouldn't really take a break from therapy. I'm not quite there. And I wanted to try something different because I was I had got to a place where I was a little frustrated with talk therapy, also known as top down therapy. And I've been doing it for I've lost count for many, many years. And I just wanted to take a break from that modality and I wanted to find something that is going to bring me the relief that I want and growth and healing that. And I'd be speaking to riddle, riddle crushy he was on Episode 92, she talked about feeling safe and secure and going through the body sensation, sensations to actually do some trauma healing therapy called somatic experiencing, which was developed by Peter Levine, who wrote the book, waking up the tiger, which is a great book, if you're dealing with good trauma, I thoroughly recommend it. And somatic experiencing is what they call bottom up therapy. So you work in the body rather than in the mind. So it's not like cognitive therapy is like the opposite of cognitive therapy, right? Instead of going through your thoughts, you go through the bodily sensations. And it's been fascinating. I've been doing that now for a couple of months. And it's like the opposite of what I'm used to. You don't go in with story, you don't go with your thoughts. You don't go in with your beliefs, but you start with a sensation in the body. So even if you're saying like, how, you know, how are you feeling? So when when the therapist says, How are you feeling today? She's not really asking how you're feeling like feelings, but she's asking you like the the sensations in your body? And that's where you start. Oh, interesting, right? And so, you know, if I say something like, Oh, I feel sad, she doesn't ask me the story behind sadness. She'll say, Where do you feel it in your body? Right. And then you kind of have to, we don't have to do anything. But the way that works is that you say you do like a body scan at this point, I've sort of got used to it. So it which is super interesting. So you kind of just like find the feeling in your body as a sensation. When you work with that sensation, and you use the sensation to then flashback into the first time you might have had that sensation, or another time you had that sensation, and then you sort of go back there and essentially rewire some of the memories. And that process helps you process them. And you push them to processing the whole thing through your body memory, which I think absolutely fascinating. I am, like, totally sold right now. And it's it's opening doors for me that talk therapy just could.
Jacqueline
That is incredibly fascinating. I agree with you, particularly because and we talk about this often, I have always lived in my head and make a conscious effort to now be in my body. And similarly, when I was doing some bioenergetics and Reiki practices, and I was asked the same questions about where do I feel it in my body? And what is the texture of it? And what's the color of it? And, and truly, I was trying to be open minded, but also felt like oh, that's kind of woowoo it doesn't have a color like I don't know, but then it totally had a color in my mind. texture. You know, he would like press on it. And I would start to like sob and he was like, What are you thinking about? And like my mother? Like, actually, it worked right off. I know that I know that. This should not be shocking, but it felt shocking. And so yes, I really I have been sold, I need to get back to it. I continue to default to them to the mind. And so I agree I am past talk therapy at the moment I am solution orientated, movement orientated. And constantly in the pursuit of trying to find the right match, which is actually what we want to talk about today.
Effy
Mm hmm. It's hard. It's a hard quest to find the right match. It is
Jacqueline
it completely is again, it's like, it's like that date. Tiktok. It's like finding a partner. Yes. Because you have to be really vulnerable with the person you have to you and I were talking about this a little while ago about whether I could have a therapist that I was attracted to. Because I was like, Alright, do I want to ugly cry in front of you? Like is that the thing? Am I going to feel comfortable, like truly telling you all of my terrible secrets, or things that they're not terrible, but I'm thinking that they're terrible, which is why any therapy? So yeah, there's a lot to consider. And so some time back, we spoke with Dr. Thomas Whitfield about how we can go beyond talk therapy and find the modality that centers around our needs. Thomas is best known for his YouTube channel called shit. They won't tell you in sex ed. He is relationship advice column and GET OUT magazine, his podcast, the lunchbox lessons, and he also happens to be a researcher and therapist and content creator who specializes in cognitive behavioral therapy and sexual health. His research has been published in numerous international scientific peer reviewed journals, and has been funded by the National Institute of Mental Health.
Effy
Yes, Thomas is awesome. So let's just dive in.
Jacqueline
We are very ready to be having this conversation with you today. Thomas. It takes so much work to get to a point to sit in a room and have a conversation with someone. And yet for many of us who've gone through the journey of therapy particularly, and we've been talking about that a lot of the last few months as things as anxiety has risen, depression has risen, as folks have are trying to navigate through social distancing. And yet still we find ourselves or at least I have found myself in rooms with people who I thought, did you go through the process? of training? Like, what happened that led you here to this moment? So anyway, I just want to I want to know, um, yeah, we want to get some learn a little bit more about, you know, how you've been doing quarantine and things like that. But I, I think that it further illustrates that, A, it takes a long journey to get to a place of really being prepared to be in the room. And sometimes that's just not enough. And so I'm interested in this conversation exploring what else we should be looking for to make sure that we find the right folks. Yeah, yeah, I
Thomas Whitfield
think that's a really good point. And I have had experiences like that, where I've been in a therapy with someone for a first or second session, and been like, What the fuck is going on? Like, I like feeling a ton of their projection onto me feeling like diagnosed and judged right away and not heard or seen. And I do think that some of that, I think a good amount of that has to do with the therapist with their personality, there are generally kind of two reasons that people go into therapy. One is because they've already figured themselves out, and they want to help other people. And the other one is that they want to figure themselves out and think that they will be able to figure themselves out by kind of pushing the focus or lens on other people so that they're, they're not seen for who they really are. Another aspect of it, though, is that a lot of times when people are looking for a therapist, it comes down to who can I afford, and who can take my insurance, and not a lot of thought might be given into the type of therapy that they are going for. And a lot of people think that like any talk therapy is talk therapy, and it's all the same. And there are a ton of different schools of therapy.
Effy
Absolutely. And as a, as a coach, I kind of see the other end of this actually. So because I specialize in ethical non monogamy a lot of the time, the clients that I'm getting have been through the mill, they have bounced around therapists. And they've either found that therapists are pathologizing, their desire for anything different than the status quo, or they're ignoring it. And kind of just like handling other things, when they sort of saying like, this is a part of my decision, like this is what I want to do, I want to I want to I want to do to therapy in the context of this decision. And they bounce around and eventually end up working with me. And what I you know, and I have to make the distinction between like coaching and therapy and help them navigate a space where they can find a therapist that can support them, while they can find a coach who can help them guide through the decision to open up a relationship and the horror stories I hear of what they've been told. And I think, Jackie, you have some horror stories of your own. As you know, as you found, as you're looking for your therapist, personally, I consider myself very, very lucky. Many, many years ago, when I needed a therapist, I didn't even know I needed one, I went to my GP because I was you know, I was tired. And I felt like I couldn't connect. And I wanted to sleep a lot, essentially all the symptoms of depression at the time, I had no idea. And I was very lucky that my GP kind of said, You know what, I'm just talking to this person and gave me a referral. And that person was incredible. She was a lifesaver at the time, I had hit rock bottom. And she she was there for me. We work together for many, many years, initially twice a week for many, many years. And I healed and found myself and learn all about emotional regulation. And I got to tell my story and over and over again. And I thought that's what happens. I thought that that was normal, like you find a therapist, and then it's a really good experience. And then when I started my coaching practice, it was just horror stories.
Jacqueline
I want to note to your point, the distinction between therapy and coaching. And Thomas, I'm interested in your perspective here. So my graduate education is in social work. And so I'm a social worker, and yet I don't practice one on one therapy. Instead, I do coaching. And part of the distinction for me was that as I was exploring, possibly going into therapy or being a therapist, I found that the way my personal approach was much more one of what are we going to do about it? So less around, let's reflect certainly let's look back, let's uncover let's discover, but now let's create a plan. And let's go through that plan together. And and I realized that that was much more of a coaching mindset of working with someone potentially on guiding them through next steps. And frankly, I think as you know, I'm always kind of an out of the box person and thinker. I also just didn't want to be held by the limitations of what was combined in inside of within therapeutic practice. So I want to start with that question in terms of the distinction between coaching and therapy. And then I want to ask a little bit about your origin origin story. So let me ask that question. First. Thomas around what your thoughts around the distinction between coaching and therapy
Thomas Whitfield
So to be entirely honest with you, I'm not super familiar with what falls into the category of coaching. But sort of what you're describing is very similar to cognitive behavioral therapy. So as a cognitive behavioral therapist, so like, in the first sessions, I'm setting up with the client, like, what are we here for? Like, what is our goal? What is it that we want to do? Okay, what would it look like if you had that, and then coming up with a plan to get them to that goal. So then I dive into more of like the cognitive restructuring aspect of it. So with cognitive behavioral therapy, the model is essentially that we have experiences that happen to us, we have events that happen, and we have thoughts about that event, we have feelings about that event. And then we have behaviors about that event. And these three things are interconnected and all affect each other. And ultimately, our behavior is what affects our outcome, our goal? So I'm always thinking in that model, but always like, what is it that your goal is and how can I help you get there? Or what do we need to do to help you? And that's sort of like CBT, in a nutshell. So I'd actually be curious to learn more about like, how coaching looks different than that. Yeah, so
Jacqueline
it's a great question. And, honestly, in the way that you describe CBT, it makes me think I want to explore that now for myself, I think I've been going to therapy, and I'll talk a little bit about that. But really, I've been doing much more of a mind body focus. And that was because so much of my trauma left me disconnected from my body, and really left me living in my head, I kind of described it as, you know, cartoon version of a little person that lives in my brain. That just is like taking care of the mechanics of my body. And I have been doing a lot of work to like, I've been crying a lot and like things like that. And I'm like, and I've been saying, the first few months, I was like, I've never cried this much. This is not like me, this is not like me, I was like, Oh, these are feelings. What I'm doing right now is feeling oh, that's what's going on? Oh, I was like, just PMS last four months, like I don't understand. I was like, Oh, these are feelings. And so really, I've been working with folks who do more bioenergetics and things that are really related more to my body. And I think that now that I've been able to have that connection, I am actually ready to start transitioning back to thinking about behaviors to your point, how are my feelings and my trauma and all those things manifesting into the narratives that I'm telling myself? And how are those narratives and showing up in my behavior? With coaching, it's a similar process, except that at least for me, there's less investigation around like, we get a sense of why things have happened, and what's going on and what those mean, but there's really much more planning around what happens next. And for me, in particular, I do a lot of work with folks around change management and navigating through career pivots. And so that's where a lot of our focus now I'm interested with you fe, what does that look like for you in terms of distinction, what have you heard around what people are getting from you versus a therapist, and vice versa.
Effy
So frankly, I, I'd like to combine a bunch of, I always keep my ear on the ground for what kinds of therapies out there therapy modalities out there. And I like to get myself educated and informed of the modalities of structures, how they work, and incorporate some of them in my coaching. Because I think you are ultimately dealing with people you are ultimately dealing with behavior and goals. I think the big difference that I would say it's about how much story you allow, you make room for I should say how much story you stole backstory or story you make room for in sessions. So I think with coaching, you kind of very forward facing and you you make plans and you sort of execute, execute, execute. And I think therapy holds a little bit more space for story, like what's going on with people and all the other stuff. That's, that's surrounding it. And for me, I tried to sort of hit that balance of, okay, we have an idea. So we're, you know, the work that I do is around relationship by design. So we think about, what do we want a relationship to look look like? And what are the what's in the way of getting us there? What are some of the skills that we need to learn to get us there and kind of work on that stuff. And then I like to incorporate when you talk about what gets in the way. That's kind of when you're running into the sort of the therapy realm, right? If there was nothing in the way and it was a matter of execution? I think that's coaching, right? You're just like, Okay, I need to get from A to B, here are my steps, help people execute, make lists, you know, have some deadlines, hold them accountable. You know, give them some resources like bang, bang, bang, that's like, for me, that is pure coaching, right? But when you're dealing with things like relational stuff with change, there's a lot more, you know, a lot more story that comes up. And I think when you talk about what's in the way, then you're looking at, oh, feelings, behaviors, thoughts, reframing your unpacking reprocessing, that kind of that's kind of where the therapy side of it comes up. How does that resonate with you, Thomas?
Thomas Whitfield
I think that makes a lot a sense, I think that that clarifies it. The, I think the interesting thing with something like cognitive behavioral therapy, as opposed to an older therapy, like psychodynamic, which is Freudian, like Freudian is therapy is all about bringing your unconscious awareness into your conscious awareness. So a lot of that is about going through your dreams about things that happened in the past, and then just sort of moving forward. Whereas cognitive behavioral therapy is very much in the here and now and I with my patients, I am very much like, they will sometimes start to go off on stories, and I'm like, hang on, we set up an agenda for today. Like is, is this story something that you want? Do we want to spend the next 10 or 15 minutes going through this? Or do we want to go back to this thing that you said was really important to you before? And I'm constantly doing that with patients, which right now, it does not sound very empathetic at all, but in the room, you know, it is. But it's very much like, okay, let's set our agenda. This is what we're going to do today. And then as if other things come up, and it's important, we can give that time, but it isn't with cognitive behavioral therapy, it is not free flowing, come in, sit down, what is it that you want to talk about today, and I did see a therapist that was psychodynamic like that for about 10 years. And I loved her and she changed my life. I also, you know, started going to see her when I was 19. And I did not know any difference. And then when I actually started going to school and studying psychology, I was like, Oh, I think there are other modalities that might actually be better for me or more effective for what I wanted. So I think that there's a big differentiation there between being someone who wants to explore your past and wants to explore the inner workings and understand how the things that have happened to us affect who we are now versus people that are like, I just want things to be different in my life right now. And I don't want to go through all of the old stuff, I want to be making changes now. And it's not that one is right or one is wrong. But if you are someone who wants to make changes right now with what's going on in your life, then going to a psychodynamic therapist is probably going to feel very unfulfilling. Similarly, if you want to tie back all of the loose ends of your life and like really understand why you are the way you are and potentially go to therapy for a very long time, going to a cognitive behavioral therapy is going to be terrible for you and you're going to hate it.
Effy
Yeah, that's super helpful. Yeah, I found similar similar to you, Thomas, my first experience with therapy was psychodynamic. It worked for me because I needed to make sense of what was going I need to tell my story and like you said, make sense of it all and like have have somebody hear it and hold space for it. And at the you know, after similar to your years and years of it, I felt great like you. And then I felt like great and heard and made sense of my story. And I was ready for change in healing. And for that I switched to a different modality that was more trauma focused, and that's very doing less talking but more doing so I you know, it's a combination of parts work. So it's very similar tuned into family systems, which is, you know, you imagine yourself having these parts that activate and and drive your psyche and also EMDR, which is very much I call it biohacking is like bio magic, it makes you like process memories, traumatic memories. So I think for me, the combination, like building on top of one to the other was really helpful. And the reason why I'm mentioning it is because it might not also be a matter of just one and done, you might need a combination of modalities to get you to where you might want to be.
Thomas Whitfield
Yeah, I think that's a I think that's a great thing to point out because had I not had the kind of psychodynamic base of those 10 years of therapy, I would maybe not be so open to cognitive behavioral therapy now because they're, you know, I had a lot of things happen in my childhood that I needed to process I had attachment issues, and this therapist was able to become sort of a mother figure for me. And you know, from an object relations attachment standpoint, like that was very healing for me, and very necessary at the time.
Jacqueline
I'm interested in your journey and how it from the 19 year old going to therapy for the first time to now for accessing your doctorate, and exploring and discovering cognitive behavioral therapy, and some controversial sexual trauma healing work. When I was doing my my graduate work in social work, one of my thesis was around why do people go into social work in therapy? And a lot of that and you referenced it earlier was people really trying to find healing for themselves, people trying to navigate through their own trauma, finding the lessons in that and wanting to explore that even more for themselves or help other people. So I'm interested if that was also your story.
Thomas Whitfield
So So kind of when I was nine years old, almost 10, we were all eating dinner. And myself, my dad, my mom and my two sisters, middle of Michigan, standard middle class white family, and my mother got up from the dinner table, walked outside and just like passed out on the back deck. Like my sister started screaming, we all sit up, didn't know what was going on. She woke up, went to the doctor a couple days later, and found out that she had a VM, which is artery vein malformation, if you've ever watched the show Six Feet Under, this is what Nate has around season three, I like to throw that out for the older listeners who know what Six Feet Under is. And she had to have brain surgery to have this mass removed from her brain, it was not a tumor, but it was essentially veins and arteries that have kind of knotted together. And they went in and cut that out of her brain. And what that actually did was changed who she was, essentially, she went from being a very like loving, caring mother to someone who was more detached from her emotions, like to different music, like to different food, her and my father ended up getting out of force shortly after, kind of, I mean, not even kind of flipped my world upside down. And at that point, probably the best thing that my parents ever could have done or ever did for my sisters and I, they've sent us to a therapist. And we went back and forth through different therapists all growing up, starting from the age of probably 11. And then I came out when I came out as gay when I was 15. And my mom was like, we need to take you to a therapist, I think that she just didn't know what to do. The goal of that therapy was never to change my sexuality. But for me to have someone to talk to, and my mom just did not know how to navigate those waters. So again, healthy decision by my mom, I don't, you know, I actually think that's great when you're a parent, if you can say like, I don't know what to do here. So I'm going to hand you over to someone that I think understands this better. And I wish that more parents would do that, as opposed to trying to kind of be an expert all the time. You're here. I mean, it's impossible to be an expert on everything. And that is sometimes what parents try to do. And there's pressure put on them to do that. But anyway, so I started seeing this therapist, I went for, I don't know, maybe a year or so. And then I moved to New York City. The week after I graduated high school, I was going to the School of Visual Arts for film and video, I really wanted to direct music videos, I actually just loved music and found out that the process of filming things is a pain in the ass. And I was like, Oh, I hate I hate all terrible.
So I went through this really jarring breakup. I think that at that point in my life, I was very insecurely attached. Because all while growing up, there had been a lot of fighting between my sisters and my mom and I had kind of become physical fighting verbal, verbal abuse, and I had become sort of the peacemaker. I was always trying to make people laugh and get attention and look over here, look over here. So you can ignore this other elephant in the corner and not fight. It was my way of finding safety. So I had gone through this breakup when I moved to New York City, and suddenly I was here new no one was in school had like two friends because I just moved here within this huge city for a town of 3000 in Michigan, potentially, like the largest jump that you could, that you could make. And I felt very alone. And I found myself on the subway or standing waiting for the subway and just having thoughts about wanting to jump in front of it about just not knowing how to deal with my emotions, not knowing how to deal with the pain, not knowing how to deal with the fact that I just suddenly felt utterly alone and had no one to take care of me and no one to turn to. So I started asking friends, like, is there a third? Do you know someone? Can I go to someone? And that was when I started seeing this woman Margaret Kurzman in New York, who I believe is retired now. I went into her office and she was like, what brings you in and I was like, I keep having thoughts that I'm gonna hurt myself and like I don't want to and I just I need things to change. And then I fell in love with therapy. So I started seeing this therapist, and then I, I dropped out of film school and I was like, I hate this. I can't do it. And then I started doing some modeling. I went to an acting studio for a couple years. And then I started bartend or started bartending at a new place when I was 26. And I met this person there that had just turned 40 And he was telling me about how he was like excited about this audition that he had and getting back into modeling and I just I vivid I remember having this thought of what if I'm 40, and still bartending am I going to be satisfied and happy with that. And there's nothing wrong with bartending it for the rest of your life, if that's what you want to do, and that's what you love. But I knew that if I stayed on the path that I was, I was not going to be happy. So I was like, Okay, I need to go, I need, I just, I need to finish getting my bachelor's, I have two years down, I need to do this. And I originally went back for English. And then I took a intro to psych class, and everything just kind of clicked. And I was like, I've been going to a therapist, since I was 10. Like, this is what I need to be doing. Like this, like, I kind of reflected and I was like, I've always been obsessed with people's stories, into music, in books, in acting, it's all about understanding other people's experiences. And as I was healing myself, I started studying psychology and I it just clicked for me, it was like, all of the pieces of the universe just sort of fell together. And I was like, Oh, this obviously makes sense. This thing that I was maybe afraid of, is clearly what I'm supposed to be doing.
Jacqueline
I love with those moments to your point of when it clicks. When you try different things. You know, some of my clients, we talk about playing like the hot and cold game, like when you were a kid, and someone would hide something, you'd walk around the house and you're like, you're getting cooler or you're getting warmer. And then those moments where you're like traveling around, you're bartending, you're modeling, you're going to this school or that, and then something happens, and suddenly it feels hot in your body. And you're like it clicked. And that's what I'm supposed to be doing. And so from there, how did you then define? I'm interested, actually, and as you explain, this was what some of the different modalities of therapeutic practice are and how you found yourself. So as to CBT, how did you decide? This is actually what makes sense for me and my work?
Thomas Whitfield
Yes, that's great. Let me step back one, one thing, because there's one thing that I forgot to say that I think may sit with some people listening to this is, I also noticed that in my personal life, I was trying to recreate the relationship that I'd had with my mother, where I had been sort of the caretaker and wanting to fix people and change them and help them. And I noticed that that's what I was trying to do in my dating life. And I was like, Oh, well, that's, that's not going to work. I'm going to keep doing the same thing. But I can't ignore this part of myself that is so innate to who I am. So how can I take this thing that I see as my biggest weakness and turn it in to my biggest strength? Because I for so long was like, Oh, well, I need to stop doing that I have to stop doing that I need to ignore this part of myself that wants to help and change people. And then I was like, Wait, maybe I don't have to ignore that maybe I just need to use that for people that want help. And for people that want to change, as opposed to me trying to push it on people. So I think that that was kind of another one of those Aha, sort of come to Jesus moments where I was like, Oh, this thing that I'm saying, I hate about myself that I view as a huge weakness. Maybe this is actually a big strength, and I just need to look at it differently.
Jacqueline
That's powerful, that awareness is really powerful.
Effy
Yeah, that is powerful. And, and that resonates with me so much. That is pretty much the the origins of the pivot to why I went from a very corporate world and advertising to what I do now. And it was that realization that I was doing the work anyway. And I was doing it to people without consent, who are just doing it to people who are in my life. And because I you know, in my own relationships, in my my friendships, and without really them asking just from this place, like that's just what I want to do in the world. And that's what I do. And going into coaching meant that I could do the thing that, like you said, came naturally to me, I can get paid for it. And I could do with people who want it. And I could do it in a way that is contained, and really makes an impact with people rather than rather than forcing it down people's throats when they don't really want it. And that was a big realization and change for me as well. So it really, really resonate. Thank you for sharing that
Jacqueline
here. We may need to do just, we may need to have you back and do a whole other episode around. How does one compartmentalize those pieces, because I think same is true for me. I mean, I work with folks around navigating through change in strategy and coaching all the time. And that is because, again, my history, my trauma around being feeling like the only adult in the room and feeling like I have to be in charge, I have to plan everything, I have to see things 10 steps ahead and prepare for the worst. And I now get paid to do that for organizations and for companies. They pay me to strategize and look ahead and but I would do that in my personal life and constantly be planning on behalf of my partner and my family and and it has been a challenge for me over the years to separate out those pieces and to see that something that I am so successful at in my professional life is actually not very helpful or not when people want my personal life. So we may need to come back and have a whole nother conversation just about that. There is
Effy
the archetype of the wounded healer. You know, that's one of the archetypes that that come was up in in literature, the idea that, you know, the wounded person heals themselves and from that place tries to heal whoever is coming out with the same same struggles. So I think here we are, the three of us are, I think, resonating with this idea of the wounded healer.
Jacqueline
And so so let's go back to the question around CBT. Why that as opposed to some of the other modalities and some of the things that you may be exploring now, because I think that you, you've talked a little bit about that you have found something that you love, but you're also now starting to get curious about other things that people are trying and practicing.
Thomas Whitfield
Yeah. So when you are going through graduate school, you kind of jump off and do all of these different externships. So around your your third year, usually third year, some people do it their second year, you start to apply for positions at different hospitals at different therapy centers at community centers. And each place has a different type of therapy, that they sort of practice that they model that they train you in. And this is your chance to go out there and explore different types of therapy with different populations and see how they work. So for example, I worked at the Albert Ellis Institute, which specializes in which specializes in Rational Emotive behavioral therapy. I mean, it's basically the same thing as cognitive behavioral therapy, they would not want me to say that, but it's a case. You know, Albert Ellis and Beck were like hand in hand and it's very, very, very similar. And then I also did an externship out at a Psychiatric Center in Brooklyn, which was the majority of homeless people that had had psychotic breaks, some people that had been in prison for, for murder. And there they were practicing psychodynamic therapy. And my my teaching, there was psychodynamic. And just in my experience, I sort of clicked in with cognitive behavioral therapy, which had been at a different placement. And I found that within that modality, I felt the most comfortable and the most active. So I am a, I'm a very active sort of like chatty person, it is difficult for me to just sit and listen to someone for 45 minutes. And sometimes that is what psychodynamic therapy can be. And if we were to look at therapies on a spectrum, we would have something like psychodynamic on one end and cognitive behavioral on the other. And there are a lot of different therapies in the middle. But that's kind of why I keep coming back to this juxtaposition. I can't just sit there, I have to be being active with the person. And that is another aspect of my personality, that I could try to ignore that if it's a pain in the butt, or I could just go into a type of work that says, This is great, this is exactly what we need. And what I found with cognitive behavioral therapy is that I would see very fast changes with a lot of my patients. And that just feels very, very, very fulfilling. And I feel like I'm able to quickly help them to change their life. And I mean, it's a dopamine bump, it feels a little bit like a high when a patient comes in, and they're like, I have to tell you, this thing happened. And this is how I handled it differently. Like I, you know, I want to jump up and down.
Effy
I think that's a similar feeling. I don't know if it's the same for you, Jackie, but with the coaching as well, because you're you're defining your goals, and you're getting people that and they are working through it and you see progress. And I definitely I know that I feel better about my work when I work with people who are when I see progress. So with some people, they do need to be heard, and I hold space for that. And it's just not the same feeling as let's get you to the next spot. Let's get you to in this case, the next stage, you know, let's have let's have you have that conversation with your partner. Let's, you know, let's let me moderate this, like one part that you're trying to navigate or negotiate. So that that being dynamically a part of the process is definitely a plus for me too.
Jacqueline
Yeah. And I find that finding a therapist or coach is similar to dating, right, you got to go through some first dates to figure out if there's value alignment if the energy is aligned, and I remember when so just a little bit of history and context for myself. I was married to my ex husband, for we were together for about 11 years. And towards the last year of our relationship, I was actively trying to open up that relationship I've always identified as non monogamous without knowing what that language was. I always knew from early adolescence that just being with one person felt limiting, and in every relationship since then, had tried to introduce that idea and no one was ever interested in that. And I thought that that would be different with my ex husband and there were some other things that gotten in the way of of our relationship and US thriving in that way. We make better friends now than we do married couple but towards the end of that relationship started to go to therapy, and it was clear early on that the therapist I mean, she essentially said that this non monogamous fantasy of mine was really a distraction. And that I should be anytime that I was spending trying to pursue something else really should be focused on my husband and my marriage, and really trying to repair that. And I felt unseen. And I felt villainized for something that felt like it was always a part of me. And that took me on a therapy therapeutic detour for a very long time, I really lost trust in therapists and in other people and trusting my story. And it wasn't until more recently, where I started to do some work with a bio energetic therapist who really helps me again, reconnect with my body. But I'm going to be going through that process. Now, again, Tom has to like look for somebody to really now talk about behavioral changes. And my daughter, I have a nine year old was recently diagnosed with anxiety, separation, anxiety, generalized anxiety, and I'm now going to be going through the process again for on her behalf of finding a therapist to work with her. So I'm interested in how does one find the right therapist, how does one find someone that really aligns with who they are and what they need?
Thomas Whitfield
I think that part of that is, knowing what it is that you want. And being very clear about that from the beginning, when you do meet with someone, because in this situation that you're describing, it sounds like her, her treatment was obviously not for you, you guys, were not going to connect with the same goal. And it's really important with therapy, in my view, that you have the same goal as the person that you're working with. Otherwise, it's just, it's too difficult. It's like trying to build a house with someone. But you both have different blueprints. And you're like, this is like we're not building, we're not working on this together, we're not making the same house, you're telling me everything I'm doing is wrong. And I'm telling you, everything you're doing is wrong. And that can kind of be what it's like. So I think the first thing is figuring out what it is that you want, which can be really difficult, I would say 90% of the time when we're in a first session, I will ask someone what brings them in, and they'll be like, I'm not happy. And it can be okay to be in that place. But you, I would recommend before you start looking for a therapist taking some time to to write down your thoughts about like, why are you not happy? What is it about your life that you are specifically not happy about. And then there are five ways to solve every problem, any problem you can think of in the entire world, you can either change the situation, so do like some sort of problem solving, you can change how you feel about it. So you can change how you view it. You can, of course, now I'm blanking.
These are the keys, you have to know these. You can do nothing and stay miserable. You can learn a radical acceptance, accept what's going on, or you can make the situation worse, those are the five anything that you can come up with, those are really the only five things that you could do. So once you have an idea what it is that, you know, say maybe you're unhappy about, you can think of okay, how would I want this to change? You know, number one, is this something I have control over? If I have control over in some way, what would I want to change about it? Is it that you don't have control over it and you want it to just not bother you as much is it that you want to be angry about and not do anything, those are the most difficult people to work with the people that come into therapy and want to change the world but not themselves or change someone else and not themselves. Unfortunately, like I don't, I don't have a magic wand. I don't know, a therapist that does if I could wave one, I would love to just like change people's worlds for them. Unfortunately, that's just not how it works. So once you kind of look at your problems, you can say, okay, these are my options. And then once you've kind of maybe thought about, okay, this is what I would like to do, then you can kind of start picking the modality that might be good for you. So for example, if you are someone who wants to change how you feel about a situation, cognitive behavioral therapy would be great for you. We're going to talk target your feelings and your thoughts and how your thoughts affect your feelings. 100% going to be a lot of cognitive work and then behavioral as as the name would imply. And then let's say that you want to accept a situation, because there's nothing you can do about it or nothing you want to do about it. You just don't want it to bother you so much. An example of that might be perhaps you are the caretaker of someone who is chronically ill, and you find yourself constantly getting frustrated with having to do things for them. Perhaps you're in a situation where you can't pay someone to do it for you, you what you need to do or what would probably be preferred is to feel differently about it or except that it's going on accepted that this is my role, and I am not going to allow it to ruin my life. So then Something something like Acceptance and Commitment Therapy might be good for you. Because what that is, is about figuring out what your values are, and then living in a value directed way, and accepting the circumstances of what's going on right now. You know, that is one way of kind of jumping into it. And then a lot of Googling, when you when you see words on a therapist profile, and you don't know what it means, Google it to see what it is. Because unfortunately, with the United States and medical care, a lot of therapy comes down to who can I afford and who's in network. But if you, for example, one site that I always recommend to people is going to psychology today.com, which I'm sure you're both familiar with. In the top left corner, there's a find a therapist button, you click that button, you put in your zip code, you can put in your insurance, you can put in the gender, the age, the race of a particular therapist, if that is important to you, and the type of therapy that they do. And it will give you their photos, their phone numbers, little bios that they have, that they have produced themselves, I think that that is a great way to see who a therapist is. Because you can tell a lot from a photo, if you're looking at a photo on the internet, you have no idea what they're like in their room. But it can kind of give you a little bit of an idea of what to expect as opposed to just cold calling. But even on Psychology Today, you know, it goes into details as like sex therapy. So that is one place that I think is really helpful to go. But first understanding what it is that you want to change and thinking about like how would I maybe want this to be different. And that can be a really good jumping off point for figuring out sort of where what direction you want to go in.
Effy
So I have a question about different modalities of therapy. So as you I do agree with you Psychology Today is a great resource for this. I often point clients in the in the same direction. I think finding a therapist in especially with a resource like Psychology Today is relatively simple. However, I think finding the right modality is a little tricky. Because it's there's a professional angle that to really understand you know, a therapy modality, you kind of have to understand background of psychology, human mind, how feelings and behaviors and, and thoughts connect, you need to understand why a therapy might one one type of therapy might work better than another one. Do you have any tips on like figuring out the modality part of it?
Thomas Whitfield
Yeah, I mean, I think that is, that is tough, because it is this realm that people kind of think that therapy is one thing. And it requires some background research for the individual. And I mean, I hate to say it, but I think one of the best ways is like googling types of therapy and just reading like little paragraphs about what each one is, and seeing if there's one that resonates with you, that doesn't mean that you are going to hit a bull's eye on the first try or the first person you go to, but it definitely makes you a little bit closer to hitting that bull's eye. I also think that when you call to make an appointment, being very clear, like this is what I want to work on, does this seem like it would be the right type for what you guys do there, because most places have websites that you can look at to get some ideas of what is going on there. So it does require some background and I think, honestly, some googling of, of terms. And a lot of therapists, you know, we'll do a first session that sort of like an intake that you maybe don't pay for that you just kind of want to figure out, is it a good match? And I think it's important that when you go to those you go in with an open mind, and you're very clear about this is what I want to do. Is this the type of work that you do, because I have had people come to me and say I want to do XY and Z and I'm like, You know what, that's not in my wheelhouse. That's not really, really what I do. Let me tell you what I do. This is why I don't think that's a match for what you've said, here are some people that I think would be a really good match for you. Because therapists also like don't want to be pulling people's tails to to get them to do the work. Like therapists want to enjoy their job, as well. So I think that a lot of therapists are very willing to be like, You know what, that's not my thing. I'm going to send you somewhere else. Like I have had some training and eating disorders. If someone came to me wanting to work on an eating disorder, I would send them somewhere else. I don't I don't specialize in that.
Effy
Yeah, yeah. And hopefully they will those first contacts they have are with therapists are informed and willing to point people in the right direction like you are, because I think that's also a feature of a good therapist to say, You know what, I'm not the right person for you. Let me think of who I can point you towards. I think that's a pathway that you can follow as well. And I don't think that's that's common either. It's not it doesn't happen that often. People either say Okay, well, let's just go and start, or they just say, I don't cover that best of luck, if you can, if you come across somebody who will then refer you to somebody else. Awesome. Thank you for doing that worked on this. Yeah, and
Thomas Whitfield
I think we're going to talk about this a little bit more in the workshop next week about what some of those like specific modalities are. And I'll give like, more nuance to definitions and and examples about exactly what those sort of look like. Because, I mean, like, I hate to say Google it, but I mean, even if you google it there, you're still going to come up with like, 60 different modalities. And you're absolutely going to be like, what, what the heck is all this I don't know what all this is, I don't know what this means. And it can be very overwhelming. You know, I would also recommend to people that like, you know, you go for more than one session, because things are not always exactly as they appear in the first session. But don't stay in it for too long, if it doesn't feel right to you. But also recognize that like, that is only one person and one type of therapy, and it may just not be a match for you. And that doesn't mean like all therapy is crap, or walk away from all therapists or that it's not going to work for you. You know, it's like going to a bar and ordering a drink and not liking the drink, you don't never drink again, you go to a different bar, you try different bartender, you try different drinks, nothing like drawing therapy and drinking together.
Jacqueline
With it, there's two things that are standing out about what you're sharing. One is, and this is a common theme in the curious Fox world, but about knowing thyself, that it always starts first with understanding who you are, what you need, what you want. That's the key to a thriving relationship, that to a great job and some of the work that I do and right to finding the right therapist, I think that what I also hear you talking about and what's resonated for me specifically is likely we treat our physical health different than our mental health. But we just did an episode recently about religion and sexuality. And I shared a little bit about how when I was struggling with the cognitive dissonance around what my body wanted, and what religion said was possible for me and what I should be feeling shame around, that I experienced a lot of anxiety and depression and talked to my parents and said, I want a therapist. And what they did was pray for me. And that I in that moment realized in my young age that had I come to them with a broken arm, we would have gone to the right professional to help heal me. And yet when I shared with them that I was struggling mentally that they prayer was the answer. And I think that that is often the case as well, when it comes to our physical versus our mental health is that when we go to the doctor, we don't say something hurts, I just want it to stop. And we have we would describe out where does the pain? How did that happen? What I wouldn't go to, you know, a chiropractor, if I had a foot pain, like I would find the right doctor and I would explain what was going on. And yet there's something different about our mental health to your point, where we just find the person who is closest to us that that takes our insurance. And then we sit down and say that we're not happy. And it does take more work than that. And I think it is important for us to think about our mental health in the same way that we do our physical health.
Thomas Whitfield
I actually really love that analogy. Because if you'd like you wouldn't just go in and be like, something's broken, fix it. And we do have people that come in and sit down and are like, I'm sad, fix me. And it's like, well, it's gonna need some more information.
Effy
I know that we're going to go into details on some of these therapy modalities and options in the workshop in more detail. However, I do feel passionate about, about this podcast being a real resource for people and that there's good takeaways and things that they can action. So without sort of going into too much details, is there any way to give people guidance on maybe the difference of the most common therapy modalities out there for the sort of most common struggles or any kind of groups of therapy that they can think through to get them started in their Google search that you want to throw out there, maybe three or five, maybe some of the very conventional common ones, and maybe a couple of sort of controversial but effective ones that just to get people to start their search.
Thomas Whitfield
So absolutely. So if you want to explore your past and how it's affecting the present, psychodynamic usually is going to be a longer course of therapy, if you're having a lot of interpersonal issues. So a lot of issues with getting along with other people, perhaps in a relationship perhaps with people in general friends, something like interpersonal therapy is really great for that. If you are maybe someone who thinks that you have borderline personality disorder, so if you have a lot of contention in your relationships, you find yourself getting very aggravated, very frustrated frequently, maybe sometimes the lashing out at people Dialectical Behavioral Therapy is really the first line of treatment for that for anxiety related disorders. So things like general anxiety, any phobias, any things in OCD, things that like cognitive behavioral therapy are great for that you're going to be doing exposures, which exposures You to the stimuli that you're afraid of, or that you're nervous of, and then slowly over time desensitizes you to it so that it doesn't have the same effect on you any sort of behavioral activation for depression, which is a big part of cognitive behavioral therapy. So CBT is really great for anxiety in general and for depression, trauma. So sexual trauma, that is something that I've started working with over the last two years. And there are three modalities that I do with that there's written exposure therapy, cognitive processing, therapy, and prolonged exposure therapy. And those are extremely effective, also can be really controversial, depending. And I can tell you a little bit more about those if you would like. And then there's, of course, couples therapy, if you are in a relationship, and there are a ton of different types of couples therapy. So there is emotion Focused Therapy, which is going to be about emotionally connecting with your partner, there is a Mago therapy, it has a psychodynamic feel to it, because a lot of it is about like bringing up the past of your life and understanding the past of your partner and how that affects your relationship to gather. And then there's also solution focused therapy, which can be for individuals or couples, which is literally about problem solving, and just figuring out an issue and how to move past it. And then Acceptance and Commitment Therapy we talked about a little bit. Yeah, so in a nutshell, those are, those are some of the like, the big ones, the couples therapy thing is interesting, because a lot of times with couples therapy, one person will be really into it. And the other person is like, oh, go if you want me to go for a couple like that, I would recommend like solution focus therapy, because if you try to take someone into a Mago, which I might be saying incorrectly, therapy, that person that you're pulling into it is going to hate it, and then you're going to hate it because they don't want to be there. And for that to work, you both have to really be involved and want it. And with emotion focus therapy, I think that's sort of the middle ground, people have to come into it willingly and be willing to explore how they see the world and how they see each other and how they connect. Was that helpful?
Effy
I don't think that resource is out there in the way that you just put it out there. That is one of the best resources that I've heard on how you go about finding therapists out there. And I've been doing this for many, many, many years. And I think that was so so helpful. So thank you so much.
Jacqueline
Yes, as you were sharing that I was thinking about like five people I want to send this podcast episode to as soon as it's mine was like listen to this fart because No, it's it because it really is I agree with you. And And shame on me for being you know, in kind of in social work and mental health, and really not even myself understanding or allowing myself i think that i because of my personal experience, did box everything up together and then eventually looked outside of therapy to find support. And I'm really ready to do to venture back in. And so I think that the way that you've described, it really does help me rethink about the way that I want to navigate the next steps of my therapeutic journey. So I appreciate that. That was really fantastic.
Effy
Yeah, I actually want to since we're listening, in essence, we were listening. And I want to add something in there that I've recently been working with, which is into family systems into family systems has nothing to do with family. And the people thing is family therapy, it essentially is great for trauma therapy. And it looks like acknowledges that there are different parts of us that have decided to cope with certain situations in a certain way. And then they become act when we're activated. When we're triggered, they come into play, and they start sort of driving your psyche, they start making your decisions. And it makes a distinction between yourself, which is you're sort of in DBT, they would call that your wise mind your sort of self with a capital S like your present tense today, versus the parts that are probably created earlier in your life during developmental times, often due to trauma, and they get triggered. And they think that they are kind of responding to something that happened in the past, but they're they're coming forward and taking charge. And ifs kind of recognizes the parts and helps you deal with them and reconcile them and helps them manage them. So there's another type of therapy, especially if you're dealing with trauma, I recommend people do some research around.
Jacqueline
And Thomas when you were talking about trauma you referenced a few points like this may become more controversial. Can you talk about what makes a particular therapy controversial? Because I, I think that when some people think about that they may think unsafe and I should not explore and I don't believe that that's what that means. So I wonder if you can give some context around that.
Thomas Whitfield
Yeah. So there are the three treatments that I do for PTSD. And keep in mind that there is a difference between having a diagnosis of PTSD and having trauma in your past. Now Every one who has been through trauma would meet the diagnostic criteria for PTSD. And the treatments that I'm talking about specifically with this are for people who meet the diagnostic criteria for PTSD. So there are are three, there's written exposure therapy, which is a five session therapy, where someone comes in, and you give them writing prompts to discuss or to write about their traumatic experience. And what they will do is in the first session, they are writing it in first person fully engulfed in the emotion of the trauma from the beginning to the end. And then the next session, it's looking back on that and how do you think it affects you today? And then you slowly move towards, towards like, how do you think this is going to impact your future? So they write for 30 minutes, and then you discuss with them sort of like what was that like for you what was going on for you without them ever having to actually tell you about their trauma, so they're still processing it, but they don't have to tell you exactly what it is. So there are sort of three levels to these treatments. And I will put this as sort of the first level like it's a little bit surfacey. But it's really for people who want to go in but are apprehensive and want to be working on their trauma. Along with this, we also use the PTSD checklist, which is I believe, 20 items on a scale of zero to four max score of 80. And this is all assessing different responses that they have throughout throughout a week in between sessions. So things like nightmares, flashbacks, anxieties, staying away from people, reminders of past events. And when we think of PTSD, we're really thinking about people where not only have they been through trauma, but that it is really impacting their ability to function, they're not able to go to school, not able to go to work, not able to leave the house not able to see other people, it has to be impacting you in such a way that it is almost immobilizing in some sense. And the people that I've done this work with really are people that are coming in that are like, I leave my house once a week, and it's only because I have to to go to the grocery store, you know, I can't go places where there are new people around. So it's more than just being a little bit on guard when you're out in public. It is you know, walking around a grocery store with a cart in front of you, even if you're only getting a gallon of milk so that you can make sure that there is no one else around you. Or if they come around you, you can swing that card around and hit them because you feel like you are hyper vigilant and afraid at all times. So so that's sort of written exposure therapy, and we do this PTSD checklists every week. And what we expect to see within all of these modalities is we expect the score to go up in the beginning, and then come back down. And to get back to your initial question is, why is it sometimes controversial, because there's this fear that in doing PTSD treatment, that you're going to re traumatize people and that you're going to make their trauma worse, I have not had that experience. But I think that there are, you know, certain things that you do to try to make sure that that's not going to happen. And part of that is continually checking in with the person making sure that this is what they want to do. You're not forcing them to do anything that they don't want to do, and that you are also giving them some relaxation techniques before you begin this work. So that when they do become very emotional when they're not in therapy, and they're not focused on this work, they have ways to regulate their emotions and bring themselves down. But there have been numerous articles that I've seen on the internet about how people think that these particular three therapies are terrible, and re exposing people to trauma in the work that I have done. I have never seen such fast changes in people in any type of work that I've done. But the written exposure therapy is is less controversial, I would say. But then we get into things like prolonged exposure therapy, which is generally about 12 sessions. The sessions lasts anywhere from 90 minutes to two hours. And what the person does is they come in, they bring a tape recorder, they record the entire session as homework, they have to listen to the entire session every week. But what we also do is a trauma narrative, which is about 20 minutes where they sit and they close their eyes, and they tell their story in first person of the trauma happening from beginning to end. So if this is someone that was sexually assaulted or raped, they are starting from a few minutes before that happened and going through the entire story reliving it until they are out of that situation until they are mentally out of that event that happened and you do this every session. Part of their homework is to listen to that 20 minute section every single day between sessions is like, if you just look at it on its face, you're like, that sounds horrifying. What this actually does is often when we have traumas in our lives, they become fragmented. If you think back to any memory that you have, you often have like a specific moment that you think about, if I were to think about an argument that I've had with my father, you know, I instantly think about that moment where we were yelling at the top of our lungs, I don't think about that conversation that we had after where we figured things out, and it was fine. And I'm not trying to conflate like rape and an argument with a parent, I have not been sexually abused or assaulted, thankfully, so I am not able to use that as an example from my own personal experience. But what happens is that with our memories, and with trauma, they become fragments, and we only see part of it. And with something like prolonged exposure therapy, what that does is it helps you to take this trauma that happened, and put it in the form of a book. And a book has a beginning, a middle, and an end. So then when you think back to that trauma in the future, you're seeing the full story, not just that worst part in the middle, that was the most horrifying experience of your life. And when I was learning to do this type of therapy, I was like, this is going to be rough, I'm just going to sit there while this person is shaking and crying and just sit there. And that's what you do. You You know, you offer encouragement, and you say you're doing great, keep going, keep going. And what that also does is builds up a resilience in the person to know like, I can get through this, I can push through these emotions, I can think about this event and and habit not destroy me. And what you see with this is again, you see that curve or people symptoms initially get worse, and then come shattering down. One patient that I have I miss or had I miss her so much. She had had an experience where her boyfriend attacked her and tried to murder her, he raped her in the middle and then tried to murder her. And at one point, he had poured a, like a sober chemical on her. And she could no longer like do dishes, do laundry, because she would get that smell. And that smell was a trigger for her of how this person had tried to literally murder her that she was at the point in her life where she was not going outside not interacting with people not having sex with her partner that she was in a long term relationship with. I just cut off from the world and extremely depressed. So we did the prolonged exposure therapy. The first session, you know, she was shaking could hardly get through it. There were moments where I could not tell what she was saying because she was so in her throat and in her emotions. And then in between sessions we also did in vivo exposures, which is when you start to practice some things that you've been afraid of before. So for this particular person, because they had been attacked, they kept their curtains closed all the time. So one of their exposures was to open the curtains for 10 minutes a day. And allow yourself to sit there knowing that they're open, and don't do relaxation exercises. Don't do breathing exercises, don't ignore it. Allow yourself to feel that anxiety and that fear for those 10 minutes and record your experience. Three sessions later, she had her windows open, she was going outside she started going for walks at night she started engaging in sex with her partner enjoying it, her depression scores dropped her PCL score, the PTSD symptoms just dropped. I think we only worked together for about five sessions. And by the fifth session when she came in to tell her trauma narrative. She had her eyes closed, she was experiencing the whole thing, but it was like she was just telling a story. And it was no longer controlling her life. And I think that's probably one of the most beautiful experiences that I've had with it. I haven't had any that have gone terrible. I've had some where maybe the person didn't improve as much as I would have hoped. But I haven't had any where someone has been re traumatized. And I think that part of that is the therapeutic alliance, them trusting you being able to create a safe space for the person. This is not work that you want to do with a therapist that you don't like, this is not work that you want to do with a therapist, you don't trust. This is not work that you want to do. I mean just for someone you don't feel comfortable with. And I feel you know, I feel very fortunate when people let me in and share their experiences with me. I've had people you know, take me through their trauma narrative and then be like I I've never told that to anyone in my entire life, the only other person that knows is the person that raped me. And it's like, what is that like for you to be in this room with me right now and know that like, I know, and being a, like, I'm a guy, I'm six foot, I'm 200 pounds like I could, I could physically be intimidating to a female who has been sexually assaulted or raped. And for whatever reason, I've been able to build an alliance with people to where they trust me and are able to do do that work. So with prolonged exposure therapy, and written exposure therapy, those are often for a specific trauma that has happened if you're someone that has been exposed to multiple traumas, something I would recommend is cognitive processing therapy, or more complex PTSD would be cognitive processing therapy, because what that is, what cognitive processing therapy is going to do is going to help you find stuck points in your trauma narrative. So it's not the retelling of that you do do a writing in the form of a trauma narrative. And then you go through it with the therapist. So this is sort of the in between one and you pick out your stuck points, which might be beliefs that you have because of your trauma. So like, because I was assaulted or raped. I can never trust a man, I am never safe. That's like, okay, so that becomes part of your belief pattern that you can never trust a man that you can never be safe. Is that always true? How do you feel when you tell yourself that that is true? And I think that that can sometimes be more effective for people that have multiple, multiple traumas. There we go, what is that word?
So I think that what a lot of it comes down to is how much is it affecting your current life? How much is it affecting your ability to function in society? So for example, I would describe myself as someone who has been through trauma because of my childhood. However, I do not have symptoms of PTSD. So I don't have flashbacks. I don't have nightmares. I don't have intrusive thoughts. It doesn't stop me from going to work. It doesn't stop me from interacting with people. I don't have any suicidal ideation based on that trauma. Similarly, the word triggered gets thrown around a lot. And as someone that works with people who have PTSD, it's like, okay, you were uncomfortable for a minute. We can call that a trigger. But like, when you're working with someone who has PTSD, and they're triggered, they are like, on the floor, crying, shaking cannot move, which is different than like, I'm a little bit uncomfortable right now, which is not to downplay anyone's trauma or anyone being triggered, because that is an unpleasant experience. But there is a there is a variation in unpleasant experience. And it's it's really that that complex PTSD, where it is one instance on top of another that triggers another event, and then they're just they're stacked up. And it's really difficult to kind of untangle it and figure out where to jump in. So often with something like that, I will start with someone like you've had all these different events happen, what is the one that sticks out to you the most, because often these often these things are like a knot. And if you can find one thread, you can make that knot a little bit looser. So sometimes by targeting one issue it can have it has a rippling effect. So if you are someone who has had some trauma in the past, but you're able to function more or less, like your life is fine, and it doesn't get in the way, like maybe it brings you down sometimes you have some anxiety, you do not need a you do not need one of the therapies that I've been talking about. If you are someone who is really impacting your life on a day to day basis, and you're having a difficult time functioning, whether it's work or relationship, then one of these might be more for you.
Jacqueline
That was a really important explanation, I think because I've heard folks go through some version of comparative suffering or comparative trauma that I was sexually harassed, but I wasn't raped. So the fact that I, you know, I'm experiencing this, I shouldn't be because it wasn't that or when I was younger, I was emotionally abused, but no one ever hit me. So I really shouldn't. And there's a judgment placed on comparing the event or the experience that and what I hear you saying is we really should be looking at what the impact of that was that if the impact of that sexual harassment or that emotional abuse leaves me feeling stuck and stopped, and it's impacting my life, whether or not it is as big as I think it should have been. So you know, that I think a rape was worse or that I think physical abuse was worse. That is actually not what we should be looking at to whether or not it's trauma. It sounds like it's the impact of that experience. It's our current life that will impact whether or not we should go to therapy and the type of therapy we should explore.
Thomas Whitfield
Yeah, 100% it is about how it is impacting your life. As another example, like you could have a family member that dies that maybe you are extremely upset about. Someone else could know that person and be like, Oh, good, I'm glad they're gone. Same event happened, two very different responses. And that can happen whether it's sexual harassment, sexual assault, rape car accident, I've worked with people who have been in like major car accidents who have had PTSD from it, and it's about what happens to you, when it comes up for you as opposed to what it was that are the details of a, b, c, d happen, because in therapy, a and b Don't always equal c.
Effy
We've covered so much ground as I say.
Jacqueline
To find out more about Thomas Whitfield and his work, visit his website, sex ed by thomas.com. And on IG and Twitter at T Whitfield, PhD. And if you want to watch the virtual workshop where Thomas does a deep dive into different forms of therapy, and provides actionable tools to finding the right fit, you can watch the recording of the workshop on our Patreon. As a Patreon member, you will have access to all of our video recordings from our in person virtual events and conferences, podcasts, extras and early episode drops. Be sure to like review and share this podcast it really does make a difference. Hashtag change the noise. And if you have questions that you would like us to explore on the show, you can give us a call and we may play your question and answer it in one of our upcoming episodes. You can call us at 201-870-0063. And as always, you can reach out share ideas tell us which episode has helped you on your journey. Or just let us know that you're listening by emailing us at listening at we're curious foxes.com
Effy
This episode is produced and edited by Nina Pollack, who is an essential part of our mental health in making weekly podcasts. Our intro music is composed by dev Sahar, we are so grateful for that work, and we're grateful to you for listening. As always stay curious friends.
Jacqueline
Lulla Lulla I don't know if you can hear sirens.
Effy
I hear New York. Curious Fox podcast is not and will never be the final word on any topic was solely aimed to encourage curiosity and provide a space for exploration through connection and story. We encourage you to listen with an open and curious mind and we'll look forward to your feedback. Stay curious friends. Stay curious, curious, curious and curious. Stay curious. Stay curious.
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