E132 - Does Acceptance Lead to Change? (Acceptance & Commitment Therapy w/Dr. Joe Oliver)

Dr Joe Oliver is a consultant clinical psychologist and founder of Contextual Consulting, an organisation providing training, supervision and therapy in acceptance and commitment therapy (ACT). 

He is also an associate professor and overall programme director for the University College London CBT for Severe Mental Health Problems post graduate programme.

He has written 6 ACT books, and has his own Youtube channel dedicated to discussing ACT and related topics. 

Interviewed by Dr. Alex Curmi. Dr. Alex is a consultant psychiatrist and a UKCP registered psychotherapist in-training.

If you would like to invite Alex to speak at your organisation please email alexcurmitherapy@gmail.com with "Speaking Enquiry" in the subject line.

Alex is not currently taking on new psychotherapy clients, if you are interested in working with Alex for focused behaviour change coaching , you can email - alexcurmitherapy@gmail.com with "Coaching" in the subject line.

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Transcript

Welcome back everyone. One kind of therapy we've never discussed on the podcast before is acceptance and commitment therapy. With us to talk about that today is Dr. Joe Oliver. Dr. Joe Oliver is a consultant, clinical psychologist. He's the founder of Contextual Consulting, an organization providing training, supervision and therapy in acceptance and commitment therapy.
He's also an associate professor and overall program director of the U-C-L-C-B-T for severe mental health problems post-grad program. He's written six a CT books. He has his own YouTube channel dedicated to discussing acceptance and commitment therapy, and we're very pleased to have him with us today.
Joe, thank you so much for joining me. Alex, thanks so much for having me on the, on the show. It's great to be here. As I told you offline, my knowledge about a CT is quite poor. I'm excited to learn more about that today. I've been watching some videos on your YouTube channel. Maybe you could start, I, I'm actually quite curious where does.[00:01:00] 
A CT come from in the history of therapy, in the lineage of therapy, very, very short history that psychotherapy has. How and when did a CT come about? Yeah, okay. That's a good question. I think I, I always like to start with history, right? Knowing history just gives me a sense of where's it's come from.
Yeah, it's a lineage is a really nice way to put it. So, one starting point, a peculiarity about it is that the, it's known as ACT rather than a CT, which is, well, you'll hear a little bit about why that was done, but it's kind of different to most other therapies which have their acronyms, uh, C-F-T-C-B-T, so on and so forth.
But this is the one that's chosen to be a little bit different in that regard. So the lineage, and it's a good point you make, that psychotherapy is not really that old, is it a hundred years or so? Maybe 150 if we're lucky. So the, the act tradition goes back to, uh, the early days of, of behaviorism and behavior and analysis.
So the, the days, and you know, the origins. From when behavior analysis came about, which was, you know, [00:02:00] a, an approach, a scientific endeavor, looking at helping to, helping people to have more, uh, input you could say, into their own behavior, to shape up and modify and move their own behavior. And, and of course for those in helping prof professions to, to help and move and shape other people's behavior.
Uh, so behaviorism then, you know, developed in the 1950s and 1960s and was quite revolutionary in a, in a lot of ways, which is to say not necessarily better or worse than anything else, but it was quite different from other approaches such as psychoanalysis or psych or psychodynamic approaches. And I think shone a really interesting light, you could say on the sort of the prism of, of what it means to be human.
Just a very different way to look at it. And one of the things that evolved out of behaviorism was a, a deep interest in and thinking and thought from this tradition and then all sorts of approaches like cognitive. Behavior therapy or cognitive therapy evolved. And then [00:03:00] more recently was a, uh, another evolution or another change that's been called another wave by some people, which was the, the third wave of, of, uh, uh, behavioral approaches of which act was one, acceptance and commitment therapy.
And this third wave is really interested in, uh, rather than you could say changing or seeking to change internal experiences, developing and helping people, uh, have a stance of, of acceptance towards. Towards internal experiences, being very mindful in the present moment and helping, uh, to, uh, modify and adjust, uh, in terms of the stance towards our experience and with a, with a key focus on values, which is to say helping people move towards what's important to them in their lives.
I guess that's a little whistle stop tour of the history these from, from behaviorism and these, this first wave of behaviorism, second wave, the cognitive wave. And the third wave is the, the approaches that have been very interested in this, this idea of [00:04:00] acceptance and present momentness and I, I guess that developmental trajectory makes sense because I suppose one of the critiques of behaviorism is that it's a little bit too superficial to see everything in terms of someone's behavioral inputs and outputs.
Uh, a lot of people I've, I understand, found that to be a little bit reductive. So as you go from first wave behaviorism to second wave, CBT, where you're thinking about someone's thoughts and emotions. Now third wave, you're talking about acts, the therapy we're discussing today and we're talking about values.
I'm actually quite excited by that because I think values are so important in, in therapy, but they're very rarely talked about. I think you talk about values a little bit in humanistic therapies and existential therapies, although often not explicitly. And I've done a whole humanistic training. I think act might be the first kind of therapy I've come across, which explicitly talks about values.[00:05:00] 
Is, is that what drew you to working with this model? It was one of the things. It's, uh, curiously, there's, there's a couple of things that drew me to it. One was my sort of nerdy geeky interest in, uh, in the science and the theory and the theory of human language relational frame theory. We can get onto that maybe a bit later.
Actually what personally drew me to the model, uh, was this idea of acceptance. It's such a funny term that it was, it was, um, I dunno if you're the same, but, or I'm sure other people are, but maybe therapists in general. But I think we sort of get drawn to the approaches that resonate. Right. And there was something for me about this idea about I don't necessarily have to change things on the inside until I can go out and, and do things and, and lead my life, for example.
And I felt like it was probably sort of speaking to a, a version of me that was younger in my, uh, late twenties, early thirties, and was struggling with different things or struggling with anxiety. And there was this kind of like always a sense like, I need to not be anxious and then I can go out and live and do things.
And the acceptance model that, or acceptance based models [00:06:00] emphasizes this idea that we don't necessarily have to change, but sometimes a lot of the, the problems that we face comes when we're overly focused on that change, trying to eliminate or not have those experiences. And we get ourselves stuck. And of course.
It's kind of peculiar thing that happens when one, or at least I found that I just had a little bit more space from that, which is of course, you know, it brings up values, types of questions. Like, okay, if I'm not struggling, if I'm not just focusing on not having anxiety, like what do I want about a do then or in the presence of things that are difficult or, or stressful or painful?
Like, how do I choose to be with myself and how do I choose to act? Which again, you know, like sort of values questions and they're kind of nice questions and you know, I, I know lots of therapies have their way of asking those questions, but act, I guess is, you know, has it sort of front and center, center in the model and, and goes for those things pretty, uh, pretty quickly.
I, I resonate a lot with what you're saying. What I'm understanding is that often we [00:07:00] want to change aspects of our psychology, like, oh, we want to be less anxious. Or someone else might say, I want to be more happy. But often it's quite hard to induce those changes directly. Often those changes, like being less anxious, being more happy, are more of a byproduct of the things we do and other things, which may seem on the surface unrelated.
So are you saying that act would promote kind of a philosophy of trying to go out and live in accordance with your values and then internal shifts can happen as a consequence of that? Do I, do I have that right? That's a nice way to put it. Yeah, absolutely. Rather than the other way around, which is po possibly maybe a common sense way of looking at it like perhaps a, a, at least a Western cultural ideal that happiness is good or we, once we feel happy, then life will be good.
Or to do things I need to feel confident or to connect with other people. I need to feel strong or not sad. It's kinda an idea that my internal world needs to be [00:08:00] aligned in a certain way and then I'll be able to go out and do things. Which, you know, you can sort of, it makes some sense in a way, like I can get the I understanding of where that has come from or why someone might kind of get caught with that, that idea, just the obvious problem comes about like, well, what do you do if you are sad?
I. Or if you've lost, you've lost someone close to you and you, you are grieving. Or if you're going through a stressful time and you're feeling the anxiety that, that anyone experiences or, or if you go to do public speaking and your heart starts racing. 'cause you worry about things falling apart and the normal, natural things of life.
And if my mind goes, I must not have those experiences before I take action, then. I'm gonna, if I adhere to that rule, my life will get slowly, slowly, increasingly smaller and get quite tight and narrow. So the, the act idea, it's not, obviously just act, but the, the sort of, the principle underneath that is let's develop a different way of being with those experiences.
And at the same time ask myself the question like, [00:09:00] what matters, what's important? Like, what do you want to do? And there's a, there's a very active part to that. Like that's sort of, what do you want to do? Like, that's a, an interesting question, but there's another part too is like, how, how do I want to be with those experiences?
You know, those difficult experiences, painful ones, or maybe if I'm honest with myself, experiences I don't really want, like, how can I skillfully be with those experiences? I don't get myself caught up and tangled up in knots. Why do you think we fall into the trap in the west of thinking we have to be a certain way internally before our life can look a certain way externally?
That's a big question. I think there's, um, there's, there's probably I think a lot to that. Clearly there's a societal thing and there's societal messages about what success looks like or what, you know, uh, how we should be. Um, and I can see there's evidence to suggest social media compounds that it's not all, you know, it's not, social media's bad always.
Sometimes it can be incredibly helpful. [00:10:00] Uh, but there's aspects to it. That sort of promoter version of, of life and living that's, you know, happy and the absence of, of negative thoughts and experiences. There's another piece I think that's part of that, that's also, that that's very easy to compare our insides what's going inside with other people's outsides.
And if we live in a culture that doesn't easily communicate or doesn't, uh, rapidly do that, then we can be left with this feeling like this thing on the inside is different to what everyone else has. Like therefore everyone else is, appears to be evidently happy or fine. And I'm not, 'cause I can feel myself on the inside.
So then as a result of cultural messages and you know, I don't know, ideas, it can then rapidly turn into this relationship that we have with our internal experiences that may be kind of problematic. Yes. And I think in keeping with that, the other problem we have culturally in the West I think, is that things have gotten so good in so many different respects that we've [00:11:00] lost the sense that life is really difficult and we're bombarded by messages that suggest explicitly and implicitly that life can be really easy breezy if you reach a certain level of success, which I think is really kind of an illusion.
'cause often you look into the lives of people with a lot of success and find out things aren't as rosy as they appear from the outside. And so every time we run into the everyday humdrum ups and downs of life, the randomness, the bad luck, whatever you want to call it, that there is the unpleasantness of that.
Then there's this additional layer people seem to run into of not only is life hard, but my life being hard is yet another piece of evidence of my failure. And I think, so we have this compounding problem, which I guess the, the, the, the tonic for that I've seen in my life is Eastern philosophy where like, you know, rule one of Buddhism is life is suffering.
So you have [00:12:00] to have this understanding that there's this base layer of, of, of difficulty to life. And it sounds like act kind of incorporates that with the acceptance piece because presumably the things we're gonna be accepting other things which are a little bit difficult to accept, A little bit unpleasant.
Yeah, precisely that. Yeah. Doesn't it just flip things on its head, doesn't it, when you, when you sort of approach life, like it sounds so counterintuitive. It just, it's so sort of, uh, the opposite in terms of the sort of the meme or the idea about what life should be about. But it just flips things. When we say we come from a baseline life, life is difficult.
And then okay. We can, I don't know, sit with that knowledge and, and allow that to sort of permeate and percolate through. And then sort of like, and then what, which is a nice thing, but there's something I find so paradoxically peaceful about that message, like, life is difficult. And I think it's just like what you're saying there, there, what it does is strips out this idea that this really insidious idea that life shouldn't be [00:13:00] difficult, that life's easy, that it's, it's straightforward and everyone else is having a breeze.
And if you just be like everyone else, it should be fine. But when we sort of lean into that place of, yeah, things are difficult, it's ha hard, life is incredibly complicated. It's filled with loss and pain and suffering and, uh, complexity. And we're constantly getting things wrong. However, we look at it, we're missing out on opportunities.
We're making decisions, the wrong decisions all the time. That's, that's life. And it's not in like a, there's a doom and gloom ness to it, but it's not in a, in a way that's like a, there's that invitation to really lean into and make a breathe into this knowledge of this is the reality of, of human existence.
And when we do that, that's when some really interesting things open up some really cool new possibilities that I think are, are really exciting. And that's the, that's the sort of the paradoxical bit of that piece of wisdom, I guess. And yeah, you're absolutely right. There's a deep resonance [00:14:00] with Eastern philosophies that I think this has, you know, been a fascinating piece of the evolution of behavioral therapies of how that this is, I guess, influenced thinking around it and has sort of permeated through in a way that perhaps hasn't always in, in western psychologies and western understandings of, um, uh, of mental health.
So it's, it's a fascinating time I think. Yeah, and I, and I think often psychotherapists, I think psychotherapists in many ways have become like the priest class of western society, given that major religion has declined quite a bit. And people often look to psychotherapy for some sort of spiritual guidance or, or guidance as to how people can find meaning in their life.
Just reflecting on the, the, the last point about culture, it's like if, if you think life is easy, then you expect to have it all. Like you expect you can have a, [00:15:00] anything you might want. And as soon as you can accept that life is difficult, that's when you have to start triaging, right? You have to be like, what's important?
You have to start prioritizing. And to me, that's where the values come in. 'cause values, in other words like what do I care about, implies a priority. If I value honesty, that means I devalue deception. So it means I have to dispense with the parts of myself that might be prone to dishonesty. So, so there's something about coming from this human humble place of life is difficult that says, now I have to, because life is difficult, I have to choose certain priorities, choose certain values, which seems like, you know, we can overemphasize the sacrifice part, but, but, but what's lying underneath that, of course, is what are the real strong pillars that I want to, to build my life around?
And an important question that that comes out of that, that, you know, what, what do I want to build my life around? Like, what, what does matter? [00:16:00] It's, um, this has been maybe a little bit poignant for me, Alex. I, I turned 50 on Saturday and 50 feels Congratulations. Thank you. I've made it halfway. Well, halfway.
That's optimistic, isn't it? Half century at least. There's something about that. I think that, uh, this. At least in my mind there's, there's something about like this sort of idea of time running out. And, you know, it doesn't have to be 50 or whenever it could be any age. We sort of get this sort of feel like, 'cause you know, life on this planet is short.
Uh, it's limited. And I think that's part of the, the human existence is that this realization, we do have to make decisions about how we spend our time. We're not gonna able to do everything. And what are the things that most important to us in this time, and how do we ensure that what we're doing in this moment is reflective of the things that we know?
Bring us, uh, what are the words? Things like, uh, joy, perhaps equanimity. Peacefulness, purpose, meaning. One of the things I've, I, [00:17:00] I don't know, I've got better at is that for is just catching my busy problem solving slightly judgmental, critical mind that says to me, Joe, you should be doing more. You should be climbing mountains and achieving more and more.
And it's, you know, this constant sort of sense time's running out. You gotta do more. Just being a bit gentler with myself just to say that, that answering that question, I think, you know, what is purposeful doesn't mean I have to pack my life with lots and lots and lots more. You know, I don't have to go out and get a jet ski and kind of go zooming off on the seed, you know, to fulfill that.
Often in my experience, par again paradoxically, it's just, it's actually sort of less like I, that I do less, less stuff. Uh, I spend my time sort of just prioritizing maybe a small handful of things or activities or relationships or, or things that are, you know, just happen to be important for me, you know.
And I, it's a sort of weird thing, isn't it? When time's running out, it's easier to sort of do that if you've got like a hundred years ahead of you than whatever's everything's possible. When time is a [00:18:00] little less, then you have the, it's like a gift to be, to just distill down into the, to sort of just the, the handful of things, a gift to invite yourself to answer that question in that way.
Well, lots of people, you know, forget about mortality, understandably, because it's not someone, it's not something someone wants to keep at the front of their minds a lot. But the stoic philosophers actually had made a practice of keeping death in mind. So they used to do like death me meditations, I think that was called like Memento Maori or something like that.
Keeping death at the front of your mind because that helps you shape your priorities and values. And same with the existentialists where they, you know, often I. The often existentialism is viewed kind of pessimistically from the outside. 'cause it's like, oh, you're thinking about death and, and your, your very human predicament.
But it can be quite optimistic in the way that we've said, because if you understand that life is limited, then that kind of kicks your brain into [00:19:00] action. Okay, what do I really want out, out of this, out of this limited life? One of the, one of the neat things I like about the ACT approach is that because it's beha a behavioral approach, it's fundamentally behavioral.
Like it's, it might look on the outside, sort of a little, kind of fluffy and whatnot, but when you dive into it, it's, it's deeply behavioral. And of course then asks questions like, how does that get translated into, into meaning, into action? Like, what does that look like? How does, how do we start shaping up and influencing people's behavior?
Uh, or how, you know, how do I influence my own behavior? So then I, the, one of the things I really value about asking people about purpose and meaning is that, 'cause I think it's easy for people to go, well, you know, I value, what do I value? I value creativity or I value my family, I value my friends. And that's understandable and that's giving you a sense of, of domains.
But what I really want to hear about is how do we allow that to influence your behavior moment by moment. So for example, if I was talking with a client, say, [00:20:00] who was struggling with something really painful, say for example, self-criticism or feeling really sad and low, that rather than values being abstract thing I'll get round to doing in the future, but I, I might be asking them questions like, what could you do?
Like if you had your values front and center right now in, in this moment with me. 'cause your mind is like super critical and you're feeling this deep well of sadness. And if we were just to, if I was to like invite you to bring a key value in, into this moment. And I would, I'd be a less abstract than that.
I'd kinda have like a clear sense, if they had a value about saying, being a good parent, I'd say, what would that look like right now if this value was speaking to you and just sort of influencing you, guiding you and suggesting, uh, how you might be with yourself in this moment. Like, I wonder what that value might say.
And in that way, kind of allow values to sort of come up in those moments. 'cause the other thing I think it's really easy from my experience, you know, in doing therapy and personally, like values sort of get pushed aside. It's like, oh gosh, I'm too stressed, or I'm feeling [00:21:00] too upset, or whatever, to think about what matters.
But that's exactly the time to be asking those questions. Like, you know, another nice question is if you were being with yourself in a way that reflected your own values, if you're holding yourself, treating yourself in that way, how would that look? You know, as client might say, well, if I could, I would probably treat myself with kindness and care.
Okay, great. And we, we have a sense now 'cause kindness and care is an important value. Like what would that look like? How would we enact that? How can we together kind of build ways to, to develop those strategies? And that's, I don't know, that's when I sort of, you can, I've seen like the power of values that are really come into play.
And I think that's really what, what, that's the essence of psychological integration. You know, a lot of therapies talk about psychological integration as this thing to strive towards. How do you become kind of integrated personality? And I don't think I can think of a better way than reflecting on what your values are.
Trying to get a sense of that, even if it's a bit low resolution at first. And then how do [00:22:00] these values actually translate into my day-to-day life again? Like, okay, I value. Honesty, but I lie all the time. That's not, that's not an integrated way of being, right? So you have like, okay, you have to sit down and be like, okay, I value honesty, so what would a more honest life look like?
Or I, I value family and close relationships. What does my life look like if I translate that into behavior? And again, I think ACT is the only therapy I've come across, which makes this explicit, so I'm very happy to, to hear about it. Do you, do you, is it common for you to find that your clients often don't have a strong sense of what their values are going into therapy?
I. Yes. Um, I guess the way to answer that was, it depends, probably a rule of thumb would be the, the more difficult and bigger the problem or issue is the client is, therefore the more likely there's, they'll have less of a sense of values, you know, on one end of the continuum. When I've done coaching work, for [00:23:00] example, which is maybe something, you know, I don't know, a little lesser people in coaching typically would come with problems that are less stuck and entrenched.
It might be quite common in the very first session to really dive into values and ask about what's important. In, in my work though, for example, with people, like young people with psychosis, we said before we started, like I'd worked a lot in, uh, national health services, community teams, inpatient wards. I, I found typically we would find people there would, would not have a strong sense of values.
And they just, there's a number of reasons for that. One would be often, you know, if they've experienced huge amounts of trauma, I. Disruption, family issues. It, it just, they're not environments that allow a person to start to answer the questions about what's important to me. Like, what are the things that I like in life?
You know, there's of course an identity question in there. It's sort of connected to who am I and what are the things that, that I'm about. The other thing, of course, is that, that even if they do have an understanding, they might be very [00:24:00] cautious about enacting upon those who am I to ask for what I want in life?
Or every time I've wanted something good for me. It's never worked out. It's only ever bought me pain and suffering, so I don't want to go anywhere near things that are good for me. You know, those questions then can be. Hard, incredibly painful and might even be a question that sort of is posed, but unfolds over time.
So the whole course of a, you know, a, you know, a number of therapy sessions, you know, I don't know, like tons and tons, you know, it could be six, 12 months. And that towards the end that that question can really start to be actually answered, you know, in a, in a real meaningful way. What are the best ways to help people kind of answer this question of what do I care about?
Y you could, one way, you know, asking the question. I probably don't use the word so much of, of values, 'cause I dunno if it's got a lot of currency with a lot of people. I think people kind of get [00:25:00] purpose or meaning. I might ask you if, you know, if I was to ask you, Alex, like what are the times in life where you feel most, I dunno, vital, engaged and connected with you and yourself and, and people around you Would, you know, those times?
Yeah, but, 'cause I've spent a lot of time thinking about it and yeah, so I mean, I, I like, and this values question to almost like walking along the beach with a metal detector where you're, you know, in life you're thrown in lots of different situations, especially as a child. Lots of situations, lot of your choosing and some things are gonna feel really aligned with you, naturally and connected as you implied with your question.
And some things aren't. Uh, I was never gonna be a poetry person 'cause for whatever reason, poetry just doesn't get my sense of fascination going. But something about psychology does, uh, something about talking about psychology or learning about is [00:26:00] really in a, in an involuntarily, in an involuntary way, engages my sense of meaning and fascination.
And I think I. Everyone's gonna have their things which jump out at them and which for them gives them that spark. So usually what I recommend, especially to young people, is just try a whole bunch of different stuff and kind of watch out for that felt sense in your body even of like, wow, I really like this.
I would do this for free. I just feel so happy. Or you used the word peace before equanimity. I feel really at peace right now. Um, I feel like I could do this all day, that kind of thing. So I definitely recommend for if you're, if you really don't know what your values are at all that kind of experimental approach, and then you can kind of get like a low resolution view.
Like for me it says, you know, I, I trained as a doctor and there's something about many aspects of being a doctor, which went for [00:27:00] me, I think. So then of all the different specialties, I chose psychiatry. And then with that, within psychiatry, I really liked psychotherapy, so I kind of doubled down on that.
So this kind of, you can imagine like these Russian dolls where you're kind of getting smaller and smaller, more and more specific. So that's usually the advice I give to people about how to go about it. Yeah, that's great. You'd make a good actor therapist, Alex. That's perfect. Yeah, I love what you're saying there.
'cause the thing I really like what you're saying is there's like tons of wisdom packed into that. The bit I like though I hear you saying is like listening to your body, that's so important. Like, and it's not always easy for some people, you know, I dunno. Trauma history or history of sexual abuse or all the things that interfere with connecting with body.
And that's why clearing the decks and therapies to be able to do that is so important. But that's a key skill. And also like you, what you said, there's go out and try a whole lot of things. Go and experiment and I, I love that idea 'cause that's, wasn't that cool. If we can say to our young people, just go and try, try lots of different things out and at the same time listen to your body and let that [00:28:00] answer emerge, which says to you, yeah, these are the things that are, that really are good for you.
This is the things that resonate with you. You know, it's a bit sad because I don't think our educational systems always match up with that. Uh, and people are expected to make decisions really early on before they've already had a chance to experiment. The other thing I do when I'm working with people is, it's interesting, like when I was listening to you talk, then I could sort of see your enthusiasm for this.
It was like, wow, I was shining through is like, you obviously, you kind of thought about it and you know, you've, uh, talked about there's no doubt lots, but I can just feel that enthusiasm myself. I could feel myself get excited. It's like, wow, that's really cool. I can see, you know, you, you know that Russian doll metaphor and you get 'em narrowed down.
It's like, all right, I'm, I'm learning something really important about you and it's another thing I often would do in therapy. I've sort of been listening to myself and, you know, the times often when people are talking about values and I'm starting to feel something emotional on the inside, typically are those times I'm resonating with them talking about something important.
The opposite, of course would be if someone is talking about like, yeah, my family isn't important to me, my work [00:29:00] isn't important to me. And on the inside I'm just like, yawn, dry, dusty. I'm like, you what's, you know, that's an interesting therapeutic process. Like it probably says to me, we're not getting down to business here.
You're giving me something. 'cause maybe you want to say, this is what you think I want to hear, or you should say this, but I don't really feel like I'm getting you showing up in the room. That's a really important point. And I think one thing to note about values is that very often we have values inherited from other people, often our parents or teachers or siblings that aren't really our own.
In other words, we're told what we should care about rather than what we actually care about. And that can hugely distort the trajectory of someone's life. Like someone always wants to be a. A doctor instead they became a lawyer and they just hate being a lawyer. But in their family, being a lawyer was the thing you had to be.
So in gestad psychotherapy you call [00:30:00] that an interject, this kind of internalized, uh, belief that isn't necessarily aligned with who you are. So I guess that's part, that must be part of the ACT process is that kind of decontamination of what's I, what do I care about versus what I was told to care about.
Sure. Yeah, definitely. So the piece there about helping people to develop that clarity, I like that word. That's a, that's an interesting metaphor. You using this sort of decontamination, which is, so I should say decontamination is actually lifted from transactional analysis. Aha. Okay. You're right. Which is this, if anyone knows anything about ta, there's this like parent ego, state, adult and child, and there's thought to be at times contamination between the ego states.
Basically what you think. Um, parts of yourself are contaminated, so to speak, with, with outside influences. So if there's a task there, like a developmental task of getting some fidelity, as it were, [00:31:00] to, to values, there's a piece there that requires mm-hmm. From an act perspective at least, of being able to connect in and, and listen deeply to our emotional and body state, the things that will give us information about what's important to us.
At the same time though, there's that piece, and I guess it's sort of, I don't know much about TA or decontamination, but that does strike me as a kind of potential parallel, which is to say that we, from an ACT perspective, we're also looking to. Tune into and become more mindfully aware of our mind at work, uh, which is to say the ways in which rules that emerge, either from our developmental experience or cultural history and the way that we, we respond to these rules or cognitions, thoughts, beliefs, in very literal ways that interfere with our ability to, to take action towards chosen values or limit ourselves, uh, in terms of like, I have to be a certain way [00:32:00] or, uh, I can't upsetting anyone else, or I can't do a certain activity if I'm feeling a certain way.
So helping to notice those rules or respond more effectively to those, to those rules and thoughts. So you're talking about this kind of over-identification with the sort of ups and downs of our minds at any given time, like how minds will drop, thoughts of, oh, I don't want to do this. You over-identify with this thought.
This is scary. You over identify with that thought. And I guess what I see really commonly in terms of when I'm working with people for behavior change is just that sense of like, I know I kind of should do this behavior, but I don't feel like it right now. How, how, how do we deal with that? How, how do we start to help people, uh, distance themselves a bit from that?
Yeah. It is such a common one, isn't it? I think, uh, I can't think I might better relate to that myself when I think about all the things that, uh, through I've, [00:33:00] um, I've had an injury, uh, recently on my shoulder, so, uh, I can't play, I can't play Paddle. Have you come across paddle before? It's like an, uh, it's incredibly popular sport around where I am anyway.
It requires, it's, there's a sort of gentleness to it, but it does require sort of a certain mo. Anyway, long story short, I've injured, had to go to physio. Physio said, you know, Hey, you need to do surprise, surprise some resistance exercises with a rubber band as physios always do. I knew it was coming and I've had that repeatedly, that experience.
I'll, oh, it's like, you know, eight o'clock at night and I was like, oh, I haven't done my exercises. And it's like, I know I should do my exercises. It'll be good for my shoulder. My physio said I want to get back to playing, but I don't want to because I want to sit on the couch and just relax. 'cause this has been a busy day.
And who on the. Planet of the Earth couldn't relate to that in some possible way. Right. And, you know, it's such a, such a human experience and kind of unpacking that there's a, it's, it's good because it's just so normal. It's just so human. And it goes from all those sort of like, you [00:34:00] know, I don't know, stuff like doing exercises for, for my, you know, for my physio rehab through to all sorts of things.
Like to telling my partner that I love her, for example, and my mind go, oh, don't say that. That's a weird thing to say. Or she's gonna, I dunno, she will think it's strange. Or, or, you know, real men don't kind of say these kind of things or whatever. Ridiculous stuff, you know, that might get in the way of a, an incredibly profound, important move in terms of us taking action.
So well, and again, there's many ways to deal with it. An act approach would be to do a few different things there. And there's many ways I could do that. One of first, first of all would be kind of notice that thought and action. So with my rehab, thought it would be. I don't wanna do this. I, I wanna sit on the couch.
And kind of what's happened there is, you know, it's, there's a process that's happened. This thought has emerged along with, you know, many other, probably in, you know, within the last five minutes, dozens, potentially hundreds of thoughts over the day. Thousands of [00:35:00] thoughts. And this is one that's, that I've allowed to influence my behavior.
This is the one that I've chosen. This is gonna determine what I do next. And so there is an over-identification, attachment or act would call it an effusion. Like, this thought becomes me, this is a truth that this is the right thing to do. And that may be the right thing to do, but it might not be either.
And imagine I could just, if I could slow that process down for a second, and it's not always easy 'cause it's often happening so fast. But if I could slow it down and just sort of have that thought there with me a bit, slow it down and pause and say, and the thought comes out, I don't wanna do this. I, I just wanna sit on the couch.
I'm too tired or I just still it down. I'm too tired. I could just allow that thought to be there. Just, you know, notice it, ah, there's that thought saying, I'm too tired. And rather than the thought, you know, if I had my hands to represent, like being right up here, I'm too tired, I'm gonna block out and, you know, influence you, I just pop it out in front of me.
Go, ah, there's that thought. I'm too, [00:36:00] I'm noticing I'm having a thought that I'm too tired. What a weird thing to say. But you know, I can do that if I want. Right? Slow everything down, mindfully. Just take my time with this. And as I create a little space from this thought, the thought is there, and here's me noticing it.
I'm different to my thought. My thought is not me. Uh, it doesn't have to be in charge of me and tell me what to do. Maybe it does, but you know, at this moment I can just have some space. And if I was like putting this down to kinda like, you know, ultra slow, I could even ask myself, what do I want in this moment?
Okay, maybe I do want to kind of have a rest on the couch. It has been a busy day and I also want to get my exercises done so I can keep my, my arms strong. So I wanna play paddle, you know, that kinda weird pickleball kind of game. And so I get to, then I get to have a say about what I do, not just the thought that happens to pop up in the moment.
And I get to sort of say, well, you know what, okay, I'll get the exercise done and then I'll have a rest afterwards. 'cause these, both of these things happen to be important. But this particular thought is, I'm not gonna let that, you know, determine, boss me around, govern [00:37:00] my actions or behavior. 'cause gosh, this is so one of many hundreds of thoughts, right?
Why that one? Absolutely. I mean, having, having a human mind is kind of like sitting in an office and you're the CEO and all day, like you have an insubordinate employee, like bursting into the office and saying random things, which are unhelpful a lot of the time. Like, you're too tired or you'll never make it.
Or like self-critical thoughts, judgmental thoughts about other people. I think. I think the most common trap people fall into is they identify with that employee bursting into their office and not as the CEO. So I think there's, there's a ton of ways to do this therapy meditation coaching, but I think what's essential for people to have a little bit more control of their lives is to start to cultivate the CEO kind of mindset of, I am in charge.
I make decisions. Sometimes there are hard decisions. I'm not the employee bursting into my office saying something unhelpful. [00:38:00] I think it's very hard to enli eliminate that thing happening entirely. Although I think you can reduce it a lot with time and practice. But the key is not to over identify with it and to be like, okay, I'm having your, your mind for whatever reason that I'd be curious to speculate about why your mind just kind of at random is always spontaneously producing all these thoughts is the first thing you realize when you start meditation.
I sit down to meditate. I'm told to focus on my breath and thought comes in when what, what am I gonna have for lunch? Or what am I gonna talk to my partner about? Or how am I gonna solve that problem on my Excel spreadsheet? And, and you need to, you need to detach from that. 'cause very rarely is it helpful.
And even if it's helpful, it's kind of, it's too scattershot and random to, to lend itself to kind of a, a, a, a well lived life. That's a great metaphor. You're good with metaphors, Alex. This is like, you're peppering them here. Thank you. I really like that one. And you're absolutely right. You know, the, the [00:39:00] meta meditation, anytime one sits still, that's when we get to really experience our, the full force of our minds and just the bizarreness or the randomness or just the connectedness, it's just like, it just doesn't take, it takes hardly anything for connections just to start kind of whirring away.
And before we know it, we're, we're, we're lost and we're pulled off in all sorts of places. The thing I like about your CEO metaphor is this idea that. We do have a bit of choice, like we do have, say, uh, it's not the, the particular thought on that particular moment who might come in, in that sort of very anxious, panicked, stressed, or commanding, bossy, bullying way, whatever it is, where the, the thought that is looking to influence our actions that we have that space to, to do something different.
And that's certainly one of the powers of all the skills that mindfulness meditation teaches, is helping to slow that process down, uh, to become more observing of it. It's become more aware. Certainly not, well, I guess you know, it, it [00:40:00] does seem like the research indicates that some people with extensive training, maybe in certain context and moments have perhaps.
F uh, frequency of fewer thoughts. But it's not really the point though, right? It's not to have less thoughts. It's like, it's more to when I'm stressed out, I'm freaking out and the kids are yelling at me, I'm late for work. What do I do in those moments? My mind is saying, you're gonna, you're gonna be late.
You won't get the kids to school on time. You're a terrible parent. You know, you're useless is always what happens then. Like, imagine that's the time where, for me personally, I most need those abilities, not where I'm sitting in a cave on a mountaintop and it's all peaceful and calm. It's like those moments of real life where I like, I need an ability so that, uh, that employee doesn't come bursting in and starts governing and taking over.
Like, I can have those thoughts and with a bit of, um. Spaciousness I can go. Great. Thank you. I appreciate you trying to help and trying to get things on track again. But if I was to try and ask [00:41:00] myself the question like, what kind of parent do I wanna be, you know, I wanna be a parent that's is, uh, is relatively as calm as possible is, is helps, gets the kids there models and demonstrates kinda love, care, and attention, then allow that to influence my behavior.
Yeah, I, I think if there's levels to this process, I think probably the first level is just that awareness of you have this voice and not identifying with it and not really, and realizing that, that this voice isn't entirely you. It's kind of like a part of you and there's other separate parts of you.
And then I think the second step is to detach from that more and more. So it has, the negative stuff has less, you're less reactive to it, you less identify with it automatically and therefore influences your behavior less automatically. I think there is an aspect where perhaps you can lessen the thoughts with a lot of training, but I think maybe the more realistic goal is actually that the, I do think those voices can become more helpful over time and less [00:42:00] overtly bullying or tyrannical or judgmental or negative.
And that's where I really value, like aside from therapy itself, which I think can be useful. Like often if someone goes to therapy, they can internalize the voice of their therapist. So instead of having like the sort of abusive father's voice in their head, for example, they have a helpful voice. Uh, but also practices like journaling I think can be very useful with journal where you literally write, correspond with yourself or using your phone to actually talk to yourself.
I find those kinds of techniques in my experience personally with my clients, actually really helps to mean that even though, even if those voices come up, they're slightly more likely to be a bit more helpful, a bit more compassionate. I'm curious if act sort of incorporates any of those kinds of ways of working.
You are, you're talking about ways in which we can foster a, a healthier relationship with ourselves. So rather [00:43:00] than a, a relationship that's perhaps characterized by disorganization or randomness or constant fighting or relationships. Relationships. So there's aspects and parts of ourselves that is, uh, more settled, kinder.
Not to say that that means that we always have to be at one with ourself at all times. And there's, there's not scope for any, any difficulty, but a bit more where we can be, be listening to ourselves more, more clearly and, and taking, taking some, um, you know, advice from those different parts as is needed.
So those kind of dialoguing approaches, um, you know, also in my experience, super, super useful. Anything that allows us to be able to bring the kind of a, sort of internal world and, and bring it outside, uh, so we can see it more clearly. Someone once, a good friend and colleague of mine once described as sort of like these internal experiences has been like a bit like a barrel full of eels and we kinda look down on it.
You can sort of see it and you can get a swirling nature of it all, but it's hard to do [00:44:00] anything with that. It just moves, moves so quickly and fluidly. So writing things down just allows a, a sense of, of spaciousness and distance from, from that aspect of ourselves, or talking with a therapist or, uh, making a note on our phone.
I, I'm assuming probably I'm a little cautious about this, but probably AI is gonna have a big say in all of this. I'm cautious just because. Uh, it's, it's, I don't know, a little unknown at this point, but I just, I think those kind of things you're describing then, you know, carefully done in the right context could be super enormously helpful.
Uh, having a, a way to be able to voice and, and internal experiences back and, and then have, have someone or something else, uh, respond in a way, just about to hear those things back a little bit, shape up a bit, develop a different perspective. So rather than the swirling barrel of eels, we can't really get a grasp on, we can just slow things down in a careful and considered way.
And then, you know, that's the, those are the places when we're gonna able to respond hopefully more [00:45:00] effectively, more and align with our values. Yeah. And there's, so there's something about behavior you said that act as fundamentally a behavioral approach. I'm always sympathetic to behavioral approaches because there is something about doing an action in the world, which helps to decrease that swearing complexity of our mind.
You know, you do something. It doesn't work. It doesn't work well. You at least know what to, what not to do. You know, you, you, you take all of the complexity and the overthinking and the overanalyzing and be like, okay, I tried this. This is what happened. And all of a sudden your consciousness can kind of contract around what didn't quite work.
And then obviously it's really beautiful when the opposite happens, you do something maybe unexpectedly, it works, and all of that swirling this for a moment falls away and you're like this, like this worked, like the, the first time, I don't know, you're seeing someone in a therapy session and they have like a really cool [00:46:00] insight about themselves and like they know it and you know it and you're kind of like locked on in that moment.
And all of that sweating consciousness complexity falls away in that moment. Like, okay, there's something about what I did here, which worked. That's the beauty of trying all those different behaviors. They take all that mess, you know, people spend so much time thinking. What should I do? What if I do this?
What are the pros and cons? And I, and I, again, going, we, we don't want to, uh, overly criticize Western culture, but we live in a culture which allows for an action. That's the problem with technology. Even ai, which you mentioned, it allows us to take a backseat and think and overanalyze and plan where we, I, I really think we should be doing and experimenting, albeit in a safe way a lot more.
Mm-hmm. Uh, I couldn't agree with you more. There's so much of, uh, I think psychological problems come from that. Yeah. Inaction, not [00:47:00] always, but there's a large part of it. But then in action can happen in so many ways, right? It's like the people's response to stuff that shows up on the inside is to try and.
Not kind of like res move through it in a way that's, uh, of an outside action, but to go up in their heads and figure it out and plan it or ruminate on it. Try and, uh, worry about it, predict and, and, and take it away somehow solve the equation of our, of our internal world, which is of course an impossible task.
There's a Kelly Wilson, it's sort of paraphrase. I, he's one of the, one of the early originators of, of acceptance and commitment therapy, and he's a psychologist. He's now retired, is, is in the works in the States. But he was, he sort of talks about this idea that, which I've always really liked, which is imagine we could respond to, uh, difficulties in pain.
I'm kind of paraphrasing a bit here. Rather than respond to those, those things that show up on the inside rather than like a maths equation that we could respond to it as if it was a beautiful sunset or a beautiful piece of music. Which is to say that if we could find a [00:48:00] way to appreciate those things, have a stance towards those experiences, which, you know, had some.
Potentially the things that I imagine like is connection or compassion or kindness rather than trying to eliminate. And I go up in my head and trying to figure it out. Like if I was in the world gathering experience, uh, doing more. Yeah, absolutely. I like, I love what you're saying there. You know those moments that, you know, in therapy where people are talking and they, they have an experience and it's like, that's amazing.
You've got some real data here. This is cool. Now we, we, we've got an understanding whether it's good or bad is not really the point. It's like actual data rather than just this head stuff, which is trying to predict and, you know, figure things out. You know, let, let's work with the stuff right in front of us.
Let's try and kind of build towards ways in which you can get these actual experiences and, and figure things from there, rather than trying to model everything. If, if someone was struggling with certain issues and they were considering [00:49:00] psychotherapy of some form, I. What might be the indicators or the red flags that like act might be the therapy, the choice of therapy for them?
There's a few ways to answer that. One would be an evidence one of course, in terms of what act has been, has good evidence for like chronic pain, for example, good evidence for, uh, psychosis, trauma, anxiety. It's, it's, it's workplace stress. Interestingly, uh, resilience, wellbeing are, are, are good places and there's probably something in there, which is it being a model whereby it's helping people to who, who struggle a lot, who are, who inclined to try and get rid of experiences and get caught up in like, for example, pain or physical health problems you can see are classic examples like how could one not struggle with pain?
How could one not just be, uh, focused on trying to eliminate that experience given that everything we do about pain is to try and reduce it. And our treatments for it are largely about reducing it. And then what does one [00:50:00] do when those things don't work? And any person in their right mind would try and continue to do that in some way.
Uh, and then, you know, what does one do then when those things aren't working, how do we help a person respond effectively in that incredibly tight spot and not do things to make the problem worse? Do things that allow them to, to have a life that's meaningful and purposeful. So you can sort of maybe hear some of the things I think then that, that sound like where an act model could be super useful, where there's lots of struggle, uh, where it's very Mindy and heady, where there's a place where values are gonna be really, really important.
You could probably say that, or it sort of points to a lot of things. But, you know, those are the, there are particular issues I think where, uh, that stands out more. And if someone did act therapy, would there be, for example, much of a focus on the past childhood? Similar to Psychodynamics, say, is it sort of disregarded entirely or is it somewhere kind of in between where we try and get a sense of how [00:51:00] early experiences might have had an effect, but not maybe dwelling on them?
Some people seem to fear that a lot about therapy in general. That therapy is all dwelling on childhood, which I think is a misconception I'm keen to dispel, but what sort, what sort of acts? Um, posture towards early life experience. Yeah. I'm glad you're dispelling that. Yeah. 'cause it does put a lot of people off.
And I guess if you thought that's what therapy was about, I guess understandably, of course it's not act, the sort of, the annoying answer would be it depends, which is to say that, that the, for some intervention, some issues, then it, it might not be relevant. For me, and most, I think, act people would say to, to have a good understanding of where someone's coming from.
And a functional, you can understand how this, this issue works. You just have to know their backstory. You have to know where this stuff originates from. But we talked about the start by history, right? Like straightaway. What is, what's an, you know, therapeutic approaches origin story without knowing that backstory, [00:52:00] that's so hard to know here and now.
Like, why does someone respond to this particular problem in such a way? Like why is, uh, sadness so aversive for them? Why do they have this story about, uh, anxiety? Like where do they get their identity from? Like why is, why can they just not have this experience? And those are questions that can only. My experience be answered by a good exploration of where they've come from and, and what their developmental history has been like, their learning history, you know, typically family of origin, but not only all those experiences that come to, to the right here and now.
I, I think all good therapies do this, right? Which is to say understanding someone's history in order so that the practitioner can help the person. The here and the now and act would certainly fall into that camp. If it wasn't, if it wasn't useful, then it, it might be something that was, was not focused on, but everything is about helping the person, the here and now change, flourish and grow.
And if that's needed, then absolutely. That's part and parcel of the approach. Yeah, it's [00:53:00] always so strange how you hear a lot of influencers, often influencers more in the business space. People are very like pragmatic and disciplined will talk about how therapy is just about dwelling on the past. And how that doesn't make any sense because the past won't, you know, during, in the past won't help you solve your problems.
But of course, just taking a, a few moments of, you know, a few hours even to think about your past, how it's affected you, is gonna be so crucial to understand each, your blueprint, how it's shaped, how you see the world now, how you perceive the world differently from someone else, and how you might be able to perceive the world differently in the future, where you to bring new experiences in into your life.
Yeah, absolutely. Totally agree. Yeah, that's interesting. I, I mean, in my experience, most people do want to talk about that. They kind of sense that, that there's a story they kind of want to get to go through and understand. Usually when people say, Nope, absolutely not, I'm not [00:54:00] talking about my past then, you know, okay, I'll remember that and I'll kind of, I'd like to understand more about why that's such a no-go area.
Yeah. It's a bit like when someone. Says they don't want to use the treadmill because they get outta breath straight away. That means you really need to use the treadmill. So similarly, if you can't talk about your past at all, 'cause it's so painful, that's a sign. Maybe you need to start unpacking it a little bit.
It's usually a good sign. Absolutely. Yeah. Um, you wrote a book about self-esteem. I'm really interested, that's another topic, you know, where sometimes people will sort of debunk this idea of self-esteem, self-esteem being too wooly, or a sign that we're Molly coddling people. What do you see as the place of like good self-esteem in someone's like psycho, in someone's psychology?
I. If we could've, we would've called the book. I can't, I couldn't think of a snappier title, but about self-acceptance. Self-esteem is such a NN or it's a naughty topic. The self, you know, it comes from all the self-esteem research and [00:55:00] programs back in the eighties that try to boost people's self-esteem.
And it turns out we are pretty good at doing that. The problem we didn't really ask ourselves is what happens when you do boost people's self-esteem? And what you get is a bunch of narcissists, people are internally focused, who don't focus on cooperation, community building, caring, co compassion. Those are the things that get stripped out if we focus exclusively on making an individual feel better about themselves.
The other kind of downside is that any self-esteem boosting is really brittle because, you know, I can look at myself in the mirror and say, I'm a great person. I'm a fantastic, I'm strong. And for 10 minutes I'll believe that. And you know, I'll score on my score to say my self-esteem is high. As soon as something goes wrong, then that, that falls apart.
I get a message from my boss to say, you, you've, your performance has been terrible, or have an argument with my wife to say, you're a horrible person. Then suddenly that thing just falls apart and I feel even worse than I was because what's wrong with me? Why can't I have high self-esteem? So that the kind of, you know, the [00:56:00] approach in our book was about how do we develop a healthier relationship with ourself, with our and our self?
Kind of like is this idea of this piece of like this identity, like who we see ourselves to be, uh, and a healthy sense of self would be an identity or identities, this fluid and flexible. If I was to ask you, Alex, like, who are you on Sunday morning? Who are you on Friday after work? If you've had a few drinks, if you drink, or who are you on a first date or, or who are you when you meet your parents?
You know, of course we have different aspects of ourselves, right? That we, they're fluid and they change. Typically the thing that, you know, when we're talking about the self-esteem or self-identity, or self problem is when people are like really rigid and stuck. I, and this is who they are across all situations, and it'll be something like a negative evaluation about themselves.
I'm a bad person, I'm worthless, I'm horrible, I'm less than, I'm invisible. Or the kind of the, the sort of the, [00:57:00] the narrative, the verbal language based narrative that tries to summarize and encapsulate their whole personality. You know, there's a simplicity to it, of course, right? Like as if we could just capture one person in three words, right?
And yet it tries to do that and tries to, you know, help. It's trying to consolidate, distill down someone and make life sort of simpler in a weird way. And, and yet of course in an incredibly destructive and painful way. So there's a self, there's, there's a sort of destructive, self-critical stuff. And then I, there's also like injunctions, like I must be, like, I must achieve a hundred percent every time.
You know, I or I, I must, uh, take up as little space as possible to say like, you know, if I'm, if I'm a bad person, there's a whole lot of things that flow out of that, doesn't it? Immediately, if I'm bad or you are good, then I, I must always hide myself away. 'cause Alex is gonna see I'm bad. I can't let him see who I really am, or I'm bad.
I've gotta try and prove my worth and I'll talk myself up on how great a psychologist I am and, you know, and how terrible you [00:58:00] are and, you know, all those kind of very inal blunt ways that some, you know, people can interact socially. You know, you can sort of sense the self story in the back driving things.
A bit of this then, you know, this work from an act perspective is unsurprisingly helping people to see this thing in operation. To, to notice it, understand where it came from, understand why it does what it does, you know, the protective nature of it or the kinda trying to help helpful nature of it, uh, to see it happening and then develop a, a healthier relationship with it.
I, you know, not, it automatically I can find, I hear myself sort of talking about it and, you know, often we try and develop a metaphor with this, like, to give this, this thing, this narrative, a bit of a character, like develop a sort of an identity around it. So rather than just this dry, dusty, verbal label, you know, this, this thing that's in your life that's like, you know, gives you guidance or suggests you or to you, hey, you should do or holds you back or, you know, like I had someone describe it once.
Paraphrased a bit, but uh, like [00:59:00] he was very worried about, uh, money was like the, and was very anxious. Was the anxious accountant, was their kinda self story always kinda very guiding them or the, uh, critical protector, always super critical, but always, you know, very protective and keeping them in their, in their place.
Uh, so, you know, helping them to be, have a relationship with this thing isn't always the go-to. I don't always turn to this thing and say, Hey, what should I do now? What, what's my next move? So we're useful to identify those patterns and flexibility. You know, we do fall into rigidity and we do start, often people compare down and think of themselves as like just one thing, or they have to be one thing all the time.
But of course what makes human beings, human beings is we are adaptable. We can go into different situations and be different things. Obviously we want to achieve some sort of integrity. Having maybe some consistency of values, but integrity doesn't mean that you can't adapt yourself to a different, to the needs of a different situation.
Talking to your [01:00:00] parents is very different to being on a first day probably for most people. Yeah, for most people. I do like to think about the differences between self-esteem and narcissism. I think you're right. There's a, it's semantically very complicated. I, I like the word self-esteem, but I, I mean, I, I wrote a whole essay that I put on the podcast about self-esteem and why it's different from like good, healthy self-esteem, how that's different from narcissism.
And I think for me it comes down to good self-esteem is an ability to appraise yourself in terms of your strengths, but also your weaknesses and your flaws. Being able to challenge yourself, but also being able to accept yourself wherever you happen to be. Whereas narcissism to me is this kind of, uh.
Usually core insecurity around which there's this inflated sense of, I'm amazing, I'm special, I'm entitled, I have the right to this, I have the right to that. That's usually how I hold a distinction in my mind. [01:01:00] Alright. Um. So a while ago it was an interesting study, which I think sort of captures a bit of this, which is about, in a nutshell, it was a really interesting study.
I've not seen this design before, but the, uh, therapist and clients got paired up together and clients, patients were asked to rate the therapist in terms of their effectiveness and ability to be helping. And, you know, they were given kind of like, um, a whole set of ratings and I can't remember what, in terms of how helpful this person was, how good, how good they were at their job.
And this, the study essentially looked at to try and kind of see who the best therapists were, uh, in terms of those that were most helpful. And there's a couple of really interesting findings. Uh, one that sort of developed a couple of subsets of these, uh, uh, therapists. One that was a bit counterintuitive was that the therapists who were rated as most helpful, uh, were those that doubted themselves the most.
And to my mind, I was like, initially that didn't make sense, but I thought about it and I thought, actually that does make sense. And I think it's pointing and talking to what you are talking about there, like people who have an ability to hold all parts of themselves and not. [01:02:00] Unrealistically, dismiss the negative, have a sense of self-doubt, and therapy is complex, it's volatile, it's uncertain, right?
So self-doubt is gonna be a big part of that. And then they identified this like, I don't know, super group, uh, the subgroup of like super effective people. And those are the ones who both self-doubt. Uh, and were the ones who, uh, were kindly compassionate towards themselves. So it wasn't like a self-doubt of sort of self-flagellation.
I'm terrible and might always get this wrong. It was like, uh, I'm uncertain here, but I also will just be, you know, kind as I'm going through this, this difficult, uncertain experience. Yeah. And that's the challenge is to how, how to ban those and then be like, okay, what's the next step, you know, towards what I want.
Uh, we're out of time, but Joe, it's been wonderful to talk to you. I think there'll be a lot more things I want to talk to you about, so we're gonna have to have you back at some point in the future. But Hunter then, thank you very much for spending some time with me today. Thanks, Alex. It's been really nice talking with you.
Thanks so much.