 Psychology in Seattle.  Hello and welcome to Psychology in Seattle.  I'm your host, Kirk Honda, licensed therapist.  It's just me today, by the way.  You can like us on Facebook.  You can subscribe to us on iTunes.  You can review us on iTunes.  It's always nice when people do that.  You can also find us on the Cairo website, that's K-I-R-O.  You can also subscribe and comment on YouTube, if you like.  You can send us emails at contact at psychologynseattle.com.  That's contact at psychologynseattle.com.  We always love hearing from our listeners.  If you like the show and you want to show your support, please keep the ship afloat by donating at psychologynseattle.com.  You can go to our website and click on the donate button and donate some mula.  It's always nice when people put their money where their mouth is, so to speak.  Today's music is provided by Breadknife Incident, whose music is available on iTunes.  It's a little bit of a shameless plug.  It's the band that I'm in.  Our second album is actually not yet on iTunes.  I keep forgetting that there's like a two-month lag time or something when you submit stuff to iTunes.  You know, between the time that you submit it to the time it's actually available.  I'm guessing that our second album will be on iTunes in, let's see, I don't know, mid-August of 2012.  And you can also support us by telling friends about us, particularly if they're in the field.  Okay, today I thought I would present a recent time that I was on the Bill Radke treatment on the radio.  For those of you who have listened to previous episodes would know that I've done this a few times.  So this is another, I was on another episode of the Bill Radke treatment on KIRO here in Seattle.  And I thought I would present it.  I have permission to do so from the radio station since I'm affiliated with the radio station through mynorthwest.com.  And I would present some excerpts and then I would chime in like I normally do.  I was asked to come on the show actually with a lot of time in advance.  The other times that they've asked me to come in on the show, they literally asked me the day before.  and I have no time to research anything or I have very little time I should say.  I get quite nervous about that because I like to be thorough and I would like more time to do research.  This time they gave me almost a week maybe like five days and it happens to be about something I know a lot about so I actually didn't have to do any research ironically.  But it was a little confusing going into it.  So they first said, the producer asked me if I'd come on the show and talk about cognitive behavioral therapy, which I said, sure.  And then I asked, well, who else is going to be on the show?  I was just curious to see if I should be prepared for something.  And they said, well, someone's coming on the show who specializes in the treatment of smoking cessation and weight loss.  And I thought, oh, OK, well, that's interesting.  So that'll be a specific application of cognitive behavioral therapy.  So I replied back, and this is over the span of some days, and I said, okay, well, so is it gonna focus on smoking cessation and weight loss?  Because that's quite different than the general topic of cognitive behavioral therapy.  And of course, as I think back on this, I'm talking to people that aren't in the field, so they don't even necessarily know what I'm asking.  Now that I think about it, which explains their response, they said, well, we're gonna be focusing mainly on behavioral therapy.  And I said, okay, well, that's good to know.  And then when I showed up, it turns out that they wanted to talk almost exclusively about cognitive therapy, which is not behavioral therapy and general cognitive therapy.  So I think once you listen to the excerpts, you'll realize what Bill Radke was thinking and why he had the topic.  So that'll, I think, become a little bit more clear.  Bill is a good guy.  I really enjoy talking with him.  He's sort of a famous local radio host.  He's been on local radio talk show programs for a long time.  Originally, he was on KUOW of people in the area, I'll remember, which is the radio station that was housed at University of Washington, which is where I went to school.  Ironically, I found it recently that he is the older brother of one of my good friends from college, which my friend's name was Radke, and I can't believe I didn't connect the two since Radke is an unusual last name, and they look identical, so I don't know why I didn't draw the connection, but I just recently drew the connection.  But anyway,  In this episode, he shows that he can really be vulnerable, which I think is a commendable quality to have in a radio host.  He's willing to put his own life out there as an example for people to think about.  One thing I realize about being on the radio is that many people listen to the radio because people will call me and post on Facebook that they heard me on the radio.  People that I haven't heard from in years will say, oh my god, I heard you on the radio and I realize that, wow,  A lot of people still listen to the radio these days.  You know, people just turn on the radio and listen to it at work and this sort of thing.  I was a little less nervous this time being on the radio.  I know I've talked previously about being quite nervous.  One time I nearly even fainted while I was the very first time I was on the Bill Radge treatment.  And the very first question he asked me, I literally had tunnel vision and a light head as I was answering the question and I felt myself passing out.  I was that nervous.  In this most recent time on the Bill Raggy treatment, I actually was less nervous.  I didn't feel like I was going to faint, but I think I lost a few IQ points due to nervousness, and we'll see about that once we start listening to it.  I'm curious to see how dumb I sound this time.  So let's just get into it.  Here we go.

 Hey, welcome to the weekend.  I'm Bill Radke.  Your brain is playing tricks on you.  And that's why you need counseling.  This is the Bill Radke treatment.  I really feel like everybody ought to be in counseling.  Have a counselor.  You can call it a counselor.  You can call it a therapist, an analyst, a life coach, a social worker, a trusted advisor.  It could be your spouse or your friend.  Although I'm not sure that your spouse or your friend will tell you what you really need to hear, but we'll get into that.  Let me tell you my story and why I want to talk about this topic of the way your brain fools you here on this edition of the Radkey Treatment.  So here's my story.  I, from the time I was, I don't know, a teenager, I guess, I always wanted to be married and have kids.  I just knew I wanted to have kids.  fast forward to like two thousand four so i'm fast approaching forty years old and i'm still single i have broken up with a series of women over my whole life fantastic people who i love dating but every time i would get to this point of but is this the one is this really it am i really you know am i really in love is this the ultimate and i could never like be sure that and so i'd break up and move on uh... so i was in the midst of yet another one of these uh... breakups  with a fantastic person named Sarah Bowen, and a friend of mine, as I was talking to a friend about my frustration, and she said, you really ought to go see this person.  The name is Cynthia Orr.  She's a counselor.  She was in Seattle over on Eastlake at the time.  She was a licensed mental health counselor.  And I said to this friend, whoa, whoa, whoa, whoa, I'm frustrated.  I'm not crazy.  You know, that was my real mental health counselor.  Wait a second.  But I did agree to go see Cynthia and sat down in her office and we talked and we ended up talking over a period of months.  And I can't capture it right here in a few minutes.  But basically, once I got talking, it turned out what I found out is that, man, I got a lot of theories.  And so do you, all of you, anyone listening?  Some conscious, some unconscious, you have stories that you've constructed that you tell yourself of how the world is and how you are.  And so we, over time, got into my stories.  So just as an example, the idea that, well, if I marry the wrong person, I won't be happy.  Okay, that's a theory.  So this counselor, therapist, she would say, really, if you marry the wrong person, you won't be happy.  Are you positive of that?  I say, well, I'm not positive.  I mean, it seems right.  She says, OK, so you're not positive, but you believe it.  And how do you react when you believe it?  Oh, geez, you know, I get worried.  I get frustrated.  I probably afraid of making a mistake.  Probably makes me edgy.  You know, I sometimes wonder if I kind of unconsciously even pick fights.  And, well, geez, I'm still single.  Like, all this is pouring out of me.  So she's just listening to all this.  One story after another, if I don't have a wife and kids, I won't be loved.  Eventually that sort of came out in our conversation.  I'll have a live a life without love.  Really, you know, are you sure of that?  And how does believing that affect you?  What would life be like if you had the thought, but you didn't really attach to it.  You didn't necessarily believe it.  Wow, what would that be like?  And what if you're right, Bill, she would ask, what's your worst case scenario?  What would actually happen if you didn't have a wife and kids?  step by step.  Play it out for me.  What would that horrible life be like?  And could your theory be completely wrong?  We're just sort of blue sky, we're just talking in an office.  What's an example of why the opposite could be true?  Things like this, just really very skeptically questioning my stories and my theories.  So now, I didn't have any name for this at the time.  I think  that this is something that is called cognitive therapy.  Now, as a hero, as I wait into dangerous waters, as I bring a couple of experts in, Kirk Honda is a marriage and family therapist, a faculty member at Antioch, a host of the Psychology in Seattle podcast, and I think my most frequent return guest, because I just love talking to you about stuff.  Hey, Kirk.  Thanks for having me.  So, first of all, am I basically on track that this is something that's called cognitive therapy?

 Yes, the way you describe Cynthia's approach to your issues is classic cognitive therapy style.

 Okay, so we're going to get into this and you know how our listeners might or might not benefit and how much merit there is to this and I want to know what you think.  Also with us is somebody who I met what, like a week ago?  Yes.  At a children's birthday party, I'm hanging out next to the inflatable bouncy house, and my kid's jumping up and down, and her kid's jumping up and down, and we got to talking.  This is Erin Lavery, a Lear Well-Being, and your job is to help people quit smoking.

 So you and I were chit-chatting, well, how do you get people to quit smoking?  Says, stop that, quit bouncing like that.  Anyways, so how do you help people quit smoking?  And you were telling me that among other things, you use cognitive therapy.  It's like, there's that phrase again, I thought, really, cognitive therapy in smoking cessation, what do you mean by that?  How do you do that with clients?

 Well, cognitive behavioral therapy is used as part of our coaching to help people look at the unhelpful thoughts that make them continue to smoke.  So usually when people have a behavior ingrained over time that's not helpful for them, there has to be some kind of thought that's continuing that behavior.  Otherwise, why would you keep doing something that you know could potentially kill you?

 Well, people like Sigmund Freud didn't they used to say, well, because of your unconscious desires and you know, psychoanalysis is about like uncovering your father's this and that.  But this is more the idea that it doesn't that kind of leave behind that old psychoanalysis and say, let's just forget about your past.  Let's just talk about what you believe.  Is that fair?

 Cognitive behavioral therapy is much more focused on the here and now than a lot of other like psychodynamic schools of therapy.

 Alright, so let me chime in here for a second and comment on some things that have already transpired.  First off, I want to say that Erin Lavery was a lovely person.  We talked before and after the recording and she's a lovely person and I actually have invited her to come on the show to talk about smoking cessation and her weight loss coaching programs.  I think those are two interesting topics to talk about.  But let me comment a little bit on her comment that cognitive behavioral therapy is about the here and now, and that psychodynamic therapy is not about the here and now.  This is a common belief among professionals in our field, and it is in general true, I would say.  It's a good, in a nutshell, summary of the two, but it's actually, in my opinion, inaccurate.  And here's my justification.  Cognitive therapy is often about the here and now, but it can be about the past.  People will come into therapy and the cognitive therapist will say, well, so what thought contributed to that issue?  And what changes can you make to your thoughts that will help you reach your goals?  That's about the here and now, so to speak.  That's what I think Erin is referring to.  But cognitive therapy can go into the past regarding your core beliefs.  Some cognitive therapists will say, well, what are a lot of your automatic thoughts based on?  For instance, if you have someone that frequently distrusts other people, they think, well, I can't trust other people, and that's a problem for them.  Well, the cognitive therapist, after a lot of investigation, might discover that a lot of different automatic thoughts about distrust in other people, that these thoughts are actually based on a core belief that was developed early in life, and that addressing those early experiences and trying to rethink the conclusions that were made upon those early experiences would be useful.  So cognitive therapy can involve the past, at least in how I understand it.  And I should disclose that I'm not a cognitive therapist.  I'm not a purist.  So some cognitive therapy purists might be disagreeing with me at this point and feel free to email me if you disagree.  But as far as I understand it, cognitive therapy can involve the past.  It often doesn't involve the past.  At least in the beginning, very much so, starts with the present.  Now, psychodynamic therapy is very complex.  I'll just start by saying that.  And there's really no way I'm going to be able to describe the variations of psychodynamic therapy and all the various philosophies within psychodynamic therapy.  So maybe that's for another episode, which I would actually love to do.  So maybe I'll do that.  But I'll just discuss a couple points.  Classic psychodynamic therapy was definitely about investigating the past, investigating how the past affects the present and the future.  how your past relationships were internalized and how your current relationships are reenactments to some extent of these past relationships and I'm summarizing it quite a bit.  It could be argued that psychodynamic therapy has always had an element of the here and now, but in a different way than cognitive therapists practice.  Psychodynamic therapists are often interested in the relationship between the therapist and the client.  That's what makes psychodynamic therapy different from other forms of therapy, among other things.  But it very much can be about the here and now.  The therapist can ask the client, how do you feel towards me right now?  The therapist can ask that about the client's feelings about the therapist.  Now, the idea is that the past relationship difficulties are being reenacted within the therapeutic relationship, so it is a reference to the past, but it's dealing with the present, and the healing and the reworking occurs between therapist and client in the here and now.  Some psychodynamic therapists like myself actually operate within the here and now quite often, but it's relational and it's referencing the past, but it's addressing the present, if that makes any sense.  I hope I'm explaining that well.  The other thing I wanted to chime in about was that she mentioned that she's a coach.  Her organization coaches people.  They employ coaches.  They don't have therapists who do therapy or counselors who do counseling.  They are coaches and coaches are very different from therapists, but they are similar in a lot of ways too.  And I just thought I would comment on a little bit.  Now, this is not an area of expertise of mine.  I definitely know what therapists and counselors and psychologists do, but I'm not very familiar with coaching, but I think I'm familiar enough to talk about it in this way.  Basically, the differences between coaches and therapist, counselors, psychologists is that coaches don't have a formal education process as far as I know.  They also, according to the limited research I just did on the internet right now, don't have a cohesive set of ethics.  I think that in the future we will probably see the coaching world develop their own ethical codes and maybe even their own certified education programs and maybe licensure and that sort of thing the way that therapists and counselors and psychologists do and social workers.  But at this point the industry is fairly unregulated as far as I can tell.  I think anyone can call themselves a coach and market themselves as such whereas  today in probably every state in the union you cannot call yourself a marriage and family therapist without having done a number of things education wise experience wise supervision wise and all that kind of stuff so there's that difference now to some people that they might say wow that's pretty dubious why would you go see a coach who may or may not have any education or any experience or any regulating body or any ethical codes well the benefit to seeing a coach is that my guess is is that coaches charge less  and so it can be more pragmatic for some people.  If they want to, say for instance, quit smoking and a therapist charges $120 an hour like myself and a coach charges $20 an hour and they can get the same product from both, then obviously they'd say, well, I'm going to go to the coach.  Another benefit, I think, to coaching, it seems, is that they do very specialized work, but they only do that one thing.  And if you want that one thing, then you will get a focused specialist.  So if you're looking for a smoking cessation coach, and that's all that they do all week long, then they're going to have a lot of expertise in that.  Whereas if you go to a therapist that does lots of different things, and smoking cessation is one of the literally hundreds of things that they do,  then maybe they don't have as much expertise in it.  Of course, the downside to coaching that I mentioned earlier is that there's less regulation and the standards are lower.  Another reason I think why some organizations might hire coaches as opposed to therapists is that, and this is totally a guess on my part, I'm totally theorizing,  is that the organization can have more control over the product with a coach as opposed to a therapist because the coach they can control more.  Again, this might not be true, but my impression of therapists like myself is that when organizations try to control us and try to get us to do certain things, when we don't like things, we push back.  In justification for not doing what an organization wants us to do, we'll say, well, we have certain ethical codes we have to uphold and you are asking me to do something that is going to make me break my ethical codes and you can't do that to me.  And I went to school for a long time and I know what I'm doing and you can't tell me what to do.  Now, I'm framing it as sort of a defiant teenager, but I think that that is a good thing.  Honestly, I see organizations asking therapists and counselors to do a lot of things that therapists and counselors should push back on.  So there's that, but I think that coaches probably don't push back that much if a  organization says okay we want you coaches now to limit your sessions to five minutes my guess is I don't know my guess is the coaches will say okay if that's what you're paying me to do then fine if you said that to a group of therapists  and counselors and psychologists and social workers, they would say, nope, not going to do that.  That's just not going to happen.  You can't squeeze more money out of this situation just for your own greedy motivations.  Whereas coaches, my guess is, they wouldn't have a problem with that.  They're probably a lot more flexible.  So when an organization is developing a smoking cessation program and they look at the pros and cons of coaches and therapists, they probably think, oh, coaches look a lot more suitable.  And they probably are.  in my opinion, especially if they're really focused in their expertise.  It's hard to say what coaching is because there's probably thousands of people coaching people in the United States right now and they're probably all doing various different things, but I think the expectation of coaching is that it's very goal-oriented  And if, for instance, someone comes in and says, I want to lose weight, and then they start talking about their past and their childhood and whatnot, I think the expectation is that the coach will say, that's for therapy.  If you want to do that, go talk to a therapist.  What we're going to do here is we're going to be very pragmatic and we're going to talk about losing weight and we're going to talk about your diet.  We're going to talk about your behavior.  We're going to get you exercising.  and it's a lot more prescriptive, it's a lot more goal-oriented, which can be quite a benefit to people, I think.  And again, there are some forms of therapy that are highly goal-oriented, just like the way I describe the coaching situation.  I think another difference in general with coaching is that they're freer with their modality.  Counselors and therapists, psychologists, social workers are pretty likely to say, okay, I want to meet with you once a week and we're going to have a 50 minute session once a week and we're going to meet in my office.  And in between our sessions, I'm not going to communicate with you.  I want you to wait until our session to talk with me next.  Whereas I think coaches have a much more flexible way of approaching the treatment of the goal.  They will meet with people very briefly.  They will talk with them on the phone.  They'll communicate over email.  They will even text their clients reminders.  And they're a therapist that do this, but they're pretty rare, honestly, I would say.  I think in the future, what we'll see is therapist, counselor, social workers, and psychologists actually doing some of these things more and more.  There definitely are some people that are doing them now, but I think we're gonna see a movement in this direction because I think it could be very useful.  It's not useful for all forms of therapy, but I think for some people, they could benefit from their therapist instead of seeing them only 50 minutes  at one, you know, on one day they might benefit from having 10 minutes of communication spread out over five days.  In our therapy culture we have this expectation that you go to a session for an hour and then you wait a week and then you see them again and it's kind of an arbitrary system.  I think that that model is very useful but why are we applying that model to every single issue and why are all therapists with various different ways of doing things, doing that model  So I think that coaching is fine, but I think we need to be careful because if the general public considers coaches to be the same as therapists, then I think we have a problem.  And I don't think coaches are trying to move in on therapy.  In fact, I think most coaches  that I've met really respect therapy quite a bit.  They understand that there are some issues that they run into they really should refer to a therapist and I think they often do and it's probably not true the other way around.  I don't think there's a lot of therapists that will refer to coaches and that's probably sort of an elitist thing on the part of my industry.  But I think we need to be careful as a society about this coaches versus therapists thing because I think we need to help the public understand the difference and what each is for and what each is an expert in because I could see how some people could consider coaches to be like therapists and to have the same expertise and the same competence and they often don't.  And vice versa, I suppose.  One could say that therapists shouldn't work with people with smoking cessation if they don't have a lot of experience in it.  And I would agree with that.  Alright, so let's get back to the Bill Radke treatment where we were talking about smoking cessation and cognitive therapy.

 Cognitive behavioral therapy is much more focused on the here and now than a lot of other like psychodynamic schools of therapy.  And the way we use it is we help people identify what those thoughts are that might be continuing that behavior of smoking.  For example, a lot of people might believe that they can't cope with stress in their life.  if they don't smoke.  And if they continue to believe that, knowing that there is stress in life, they're going to continue to smoke.  So we can help them identify, maybe that isn't true.  Maybe that doesn't have to be true for them.  And if so, what would that do for them in their life?

 So how would you break down someone's idea that, well, if I don't smoke, I'm not going to be, that's how I cope with stress.  If I don't smoke, I can't cope with stress and my life would get worse.  How would you attack that?  Or I guess I question them about that theory.

 One example of how to approach it is to ask the person how true that is for them.

 Yeah, that's like the first thing this counselor asked me.

 Kirk, same idea with you?  Right.  Another thing maybe you're getting to this, Aaron, is to look for evidence, to analyze evidence, to say, okay, well, what's your evidence that your brain will break, for instance, if you stop smoking?  Yeah.  What's your evidence?  And when you start getting into it, the client realizes they don't really have any real evidence.  They just have this as an invented thought.  And that will perpetuate their smoking.  And so when they get rid of that thought, it'll be more likely that they'll stop smoking.

 Absolutely.  Absolutely.  So the idea is a lot of times we do these sorts of things like smoke because of these beliefs.  And so if you help break down the beliefs, if you help create some flexibility with the beliefs, they have less control over you and you're able to think in new ways, in ways that will actually help you reach your goals.

 Okay, well, an invented thought.  Isn't that what our brains have adapted us to do?  Yeah, we don't know exactly what's going to happen in the future, but you use common sense, you use everything you've ever noticed about life, and you put together, you can call it an invented thought, but isn't that sort of, aren't I supposed to listen to my own wisdom, like, right, listen to the voice inside of me?  Aren't I supposed to trust that?

 Right.  So we get into philosophical territory that we don't have time for today, and I could talk forever about this because it's philosophically very interesting to me.

 Really?  I didn't know we were going to get into philosophy.

 It has to do with cultural constructions.  It has to do with, well, it just has to do with so many things.  But anyway, yeah.  It's an adaptive mechanism that we invent thoughts that are based on reality that help us cope with the future.  That's a good thing that we do, but sometimes people get stuck on a particular thought that isn't helpful to them.  Another thing to think about is, we're talking in terms of accuracy of thought, but another thing to think about is whether it's helpful or not.  For instance, it could have been accurate, Bill, that if you married the wrong person, you would be unhappy.  That could have been accurate, but was that helpful for you to ruminate on  years before you even met the person that you would eventually marry and be unhappy with.  You know what I'm saying?  Yeah.  So helpfulness and accuracy are two different things.  All right, so let me chime in a little bit here and talk about what I was referring to when I was talking about the various philosophies involved in this discussion.  And I don't have time to go all into them all here and they can get quite sophisticated and obscure and I'm not quite sure I could even wrap my mind around them enough to just spit them out of my mouth right now.  One of the things that needs to be considered when we're talking about cognitive therapy I think is  The idea that if you change your thoughts, you can change everything.  That's what cognitive therapy purists would say.  They would say, well, for instance, you have a thought that you are a bad person.  Well, change that thought and say you're a good person and then that will change everything for you.  Now, cognitive therapists wouldn't say it that simply and they're not naive, but  In general, that's the philosophy behind cognitive therapy, and cognitive therapy purists will stick to that, and will say, well, we just have to keep at it, and then if you keep changing your thoughts to be more helpful, more in line with your goals, then you're going to change.  I mean, I'm very supportive of cognitive therapy and actually use it quite a bit, but the limitation is that sometimes when you run into things with people that are quite stubborn in their psyches, merely changing their conscious thoughts or the thoughts they have control over will not change them.  For instance, I've had clients that have been through very difficult experiences as children and to simply change their thoughts about it would miss the core issue, which is the trauma that they went through.  And so cognitive therapy would continue to address their thoughts and say, okay,  You have a thought that you feel victimized right now or you know previously and you just need to change you just need to change that thought and You need to have a more positive thought that would be helpful now I could see that for some people that might be useful But in my experience with with clients healing has to occur relational healing has to occur processing of the feelings and an experiential therapy must take place and  That doesn't necessarily have to happen in therapy.  People can direct, I think, their own experiential healing and existential healing.  But without that, I think real change is not likely to occur.  And to some extent, it's a little demeaning to someone to say that their problems are due to their thoughts.  as if they are doing something to themselves.  If someone grew up in a difficult family that had a lot of difficult times and their current difficulties are based on these past difficult experiences, to say to that person, well, you need to change your thoughts.  And the reason why you're having trouble is because you have bad thoughts.  Now, a cognitive therapist wouldn't say it that way, but the implication is there and it's a little bit of a blaming of the victim.  For instance, let's say you have a woman who was brutally raped as a teenager.  And when she engages in sexual activity with her partner, she has flashbacks, PTSD flashbacks, and she becomes very agitated and afraid and re-experiences this rape when she's having sexual experiences with her partner.  And the cognitive therapist, and again, cognitive therapist out there, please tell me if I'm wrong, but my guess is that a cognitive therapy purist would say, well, perhaps if you changed how you saw the situation, you would have a different situation.  You know, the client comes in and says, I want to be able to have sex with my partner without having this flashback.  the cognitive therapy purist would say, well, just stop thinking about the past.  You're not being traumatized in the present.  So stop doing that.  And again, I'm probably missing something and I'm sure cognitive therapists would have a problem with what I'm saying, but maybe not.  I don't know.  So it's a little bit of a blaming of the victim.  It's saying, well, it's your fault that you're feeling bad and you need to just change your thoughts.  And instead of healing from that experience, it can actually be a potential retraumatization of the abused victim by telling them that it's their fault.  Another criticism of cognitive therapy, cognitive therapy was introduced in a time when it was politically advantageous to the powers in place in America.  When the masses started rising up in the 60s and were really questioning the establishment,  People were saying the reason why I feel bad, the reason why I feel depressed, the reason why I'm anxious is because of the way the system is oppressing me and many other people.  And so we need to get together and fight back and get our power back in our society.  And cognitive therapy was introduced politically to some extent to basically blame the victim and say the reason why you're depressed is not because of society.  It's because of the thoughts you have.  You just need to be more positive.  And so through cognitive therapy, the masses become more sedentary and less rebellious and call for less social change.  If, for instance, someone's depressed and they go to a cognitive therapist, the cognitive therapist, at least at first, is not likely to take into consideration the person's context.  For instance, let me give an example.  Let's say you have a Somali immigrant who lives in South Seattle.  and is experiencing a lot of racism in the community and is experiencing a lot of oppression.  A lot of people are looking at this Somali immigrant and saying things like go home or what's wrong with you or your only career in life is going to be a taxi cab driver.  Why go to school?  You know, just the various different ways that oppression occurs in someone's daily life.  And that person goes into therapy and says, man, I feel really down.  I'm depressed.  I feel like my life is going nowhere.  And the cognitive therapist would first start looking, well, what are your automatic thoughts?  And the person would say, well, I feel like I'm not a good person.  Like I can't do anything right.  And the therapist would say,  Well, let's change your thoughts and and and they would be compassionate and they'd be nice They would be a nice therapist, of course They wouldn't belittle the client in any way, but they might miss the contextual fact that the person is experiencing oppression on a daily basis and to merely change the person's thoughts misses the cause of the problem which is society which other forms of therapy are more likely to address now how do you address society and therapy is something that  We should talk about in another podcast.  So I'm not saying that cognitive therapists got together and said, hey, let's introduce a therapy to oppress the masses.  It wasn't that at all.  I'm quite convinced that cognitive therapists did not intend on creating a therapy that would proliferate and have the unintended consequence of suppressing collective movements against the powers that be.  But things tend to emerge within history that are useful for the powers that be.  Sometimes certain movements occur and the ones that favor the people who are in power, or the systems I should say that are in power, tend to last longer than the ones that directly oppose the systems of power.  And again, I'm not talking about some elitist group of people in a room saying,  let's encourage cognitive therapy to exist.  It's not that at all.  I really don't think that is the way society works.  Things tend to emerge, they evolve, and they get adopted, and then before you know it, there's a new trend, and it just seems to be occurring.  And in American culture, we have a certain system of allowing certain groups of people to have power.  And if various different movements occur within psychology, within therapy, it's, in my opinion, more likely that the movement that doesn't directly oppose the systems of power will last longer.  It's not to say that we can't create change in the systems of power in our society, but it's just much harder.  So cognitive therapy was introduced in the 60s and had the unintended effect of supporting the systems of power.  And that might be one reason why it was adopted and why it lasted, because it didn't butt up against the systems of power.  other forms of therapy, other theories at the time and now that exist regarding people and their context that when someone's depressed, we might want to look at their context.  We might want to look at the fact that the systems of power are set up  To oppress this person and therefore they're depressed when a psychotherapy comes out then incorporates that it's going to butt up against the systems of power and it's going to be harder to proliferate that philosophy through psychology So that is my point and I'm sure you're all thinking I'm a communist socialist what they call it a red or a pinko what they call communist I don't know  I don't know what I am.  All I know is that oppression exists and it's unfair and it creates psychological symptoms that I see in my clients and in myself and other people.  So I think it's a reality.  Okay, let's get back to the Bill Radke treatment.

 I think all of us, like I said at the very top, I feel like everybody ought to have a counselor because everybody ought to have a skeptical question or saying, really, that's your theory?  Are you sure?  What's your evidence, as you said, Kirk?  How does it affect you that you believe that?  How's it affecting your life?  So, Aaron, in the example of smoking, what would be a typical example of a person you talk to who smokes because they're stuck on a story, a theory?

 Well, one common situation is a lot of times we'll work with parents, say a mother, and you can hear that their lives are very busy.  You can hear their children in the background.  It's pretty noisy.  You have to pause every once in a while in the conversation so that they can tell their kids to stop hitting each other or break up a fight.  So you can tell that they're under a lot of stress and then they share with you additional stressors, maybe financial stressors, negative living situation, that sort of thing.  An interesting part about tobacco cessation is you're trying to help people overcome a very difficult challenge in their life at the same time as all these other challenges are going on.  And it is very tempting to try to expand the scope and help them deal with their living situation or their financial situation or their challenges parroting their kids.  And you have to make sure you stay focused on what the story is regarding their tobacco cessation.  And keep in mind that  Regardless of what stressors or what challenges a person has, ultimately they are able to quit tobacco.  They do have the strength within them and that the best way we can help them do that is stay focused on that and know that for them.

 Right, so one of the strengths and weaknesses of cognitive behavioral therapy is that it's very goal-oriented.  So someone says, I'm coming to therapy to quit smoking, but then the conversation wanders to their childhood.  The cognitive behavioral therapist directs the conversation back to the goal.  That's a strength because it focuses on goals and is more likely to achieve the goal in all likelihood.  It's a weakness because you might not take the full person into consideration.  You're really trying to focus strategically on one thing.  Alright, so let me chime back in for a second here.  Actually, it's not just for a second.  That's a lie.  I'm probably going to chime in for like 20 minutes, as I usually do.  I said something again that is incorrect.  Again, being on the radio makes me kind of dumb and I say stupid things.  I said that one of the benefits of cognitive behavioral therapy is that it focuses on the goal and what I said in the radio broadcast was in cognitive behavioral therapy because it focuses on the goal it is more likely to achieve the goal and that is not what I believe.  There are people who I'm sure believe that but I do not believe that.  In certain circumstances for certain goals and certain clients, it might actually achieve the goal faster to focus on the issue through cognitive behavioral therapy.  But in other situations, cognitive behavioral therapy will not help with the goal.  For instance, with the previous example of someone who was raped as a child,  and grows up and says and starts experiencing flashbacks while having sex with their partner and they go to therapy and they say I don't want to have flashbacks anymore and the cognitive therapist says well you just have to change your thoughts and the behavioral therapist might say well you maybe just need to have sex in a different way or you need to do different things to build up to the sex for for some  clients, my guess is, is that would be missing the point and would not actually reach their goal at all if they addressed it cognitively or behaviorally.  And that a more psychodynamic approach or a trauma focused approach would actually help them reach their goal by going to the past by healing from the wound.  The person would actually have overall less symptomology regarding that trauma.  And one of those symptoms is having flashbacks while having sex with their partner.  So by actually not focusing on the goal that the client brings in, by focusing on healing the original wound, you might actually create change overall for the person.  And that is a very simplistic way of saying it.  And, you know, for the sake of time, I'll just, I'll just put, I'll just say it like that.  All right.  So let's get back to the Bill Radke treatment.

 Yeah, in fact, how can you help somebody stop smoking if you don't have the ability to address the real big, huge, thorny underlying issues that are the reason they do all kinds of things besides smoke?

 It isn't an easy game to play.  It is not easy work.  However, we believe... Yeah, it's not easy.  However, we ultimately come from a place of believing in the strengths of the individual.  And we do believe that every person we work with ultimately has the power within themselves to resolve their problems, to access the help they need in order to be able to do that.  And we believe that one of the best things we can do is focus in on something that we know is the leading cause of preventable death in the United States.  This is something that could shorten their lifespan and prevent them from being able to address those other things.  And this is something we know we can help with.  So if we laser in on that and help them with that, that can not only increase the quality of their life, save them a lot of money if they're struggling with financial issues, but also give them a new idea of what they are capable of doing.  hear something they did in their life.  They quit tobacco, which is, I think we can all agree, extremely hard.  Yep.

 My dad never did it and he died, you know, at age 80.  And 80 is pretty good.  He could have done better if it wasn't for the three packs.  He died, you know, a couple of months ago.

 Right.  Right.  Exactly.  And that gives them the possibility to see themselves in a new way.

 Yeah, so what is the advantage of cognitive behavioral therapy for a smoker over other more common smoking cessation approaches?

 Well, probably is the most common approach, right?

 It's definitely one of the most common.  He didn't know that.

 Yeah.  I don't know.  I just... What other approaches would you think?  Well, it just sounds so profound and thinky to be talking about people about their mental errors, you know?  I don't know.  I guess I just would have figured, well, Twitter...  You know, move this pencil around, chew gum instead of... Well, that's a behavioral technique.

 So that's the behavior side of the cognitive behavioral technique.

 Oh, okay.  So I opened this show up with my own story of why I got really interested and fascinated, which I am, by cognitive therapy.  Kirk, you wanted to be a therapist and ask me more.

 Ask you.  Yeah.  So you mentioned before we pressed record that you were being a cognitive therapist to your daughter.  She had some erroneous thinking.  Why don't you tell us about that?

 Yeah, and maybe that's why I even got in the mindset of probably even talking to you.  But we talked a little bit at the party where we met Aaron, that once you get interested in something, you find yourself kind of asking people those type of questions.  So like a week or two ago, I was out pulling Ivy off my trees in the backyard, and my five-year-old daughter, Susanna, was in the yard trying to build a fort.  She gets frustrated at some point and just kind of collapses in frustration and says, I can't do anything right.  And man the bells went off for me because I've been through this experience of like having some theories of life exploded by a good counselor and and and part of the thing that I got to was our brain just we tell each other stories That's what makes us human practically  And then we attached to the stories and believe them whether they're helping us or not.  So I stopped what I was doing.  And I sat down with Susanna on the sport court.  You know, I said, why do you what do you mean you can't do anything right?  You know, is that true?  And we sort of got into.  And so pretty soon she's telling me because I'm asking for evidence, as you said, Kurt.  So pretty soon she's telling me that, well, you know, examples of things she actually has done right, right?  You know, the sound of music recital that she had just done where she knew all the words or whatever it is.  Like, oh, I guess it's not true that I can't do anything right.  So, and I said, well, how did you react when you believed that you couldn't do anything right?  Oh, I was sad and I was  It felt frustrated, all that stuff.  So then we started talking about the idea that you can think things that aren't true, which from a five-year-old's point of view blew her away, that your brain would think things that aren't true.  So that's to me like, oh god, I'm being a cognitive therapist for my kid.  Does that sound right?

 You totally screwed her up, Bill.  I'm really sorry to tell you.  No, that's great.  It's perfect.  She says something and you immediately think, that is not a helpful thought to think.  It could be accurate.  It could be inaccurate.  It doesn't really matter.  You as a father, a loving father said, that is not a helpful thought for her to think, to think that she can't do anything right.  And so you go to her and you say, let's look at this, you know, and you really engage with her.  Cognitive therapists are often seen as cold and computer-like, but they're not in general.  They're usually very warm.  And so you sit down with her and you talk with her and you say, you know, why is that, that you think that?  Let's look at the other evidence.  And what you're trying to do is you're trying to write a core belief if we're gonna use cognitive therapy lingo.  You're trying to create a core belief, a foundation, if you will, upon which a lot of thoughts are generated from, that she is a good person, she's capable, and she can do things well.  All right, so let me chime in here for a second.  I said that cognitive therapists are often seen as computer-like, but they are actually usually very warm.  I actually don't know that.  I think I was saying that because I was nervous, and again, when I'm nervous, I lose some IQ points.  There are two different things that I'll say regarding this warm versus computer-like cognitive therapy thing.  There are certain kinds of cognitive therapy that prescribe a very computer-like way of addressing clients.  And some therapists, too, are from other schools of thought who are very cold and not very warm.  Not that they're mean.  Well, I guess some therapists might be mean.  But there are some therapists who have personalities  or they believe that being distant and not very warm is actually helpful.  And I would say that that's probably true for them.  I would like to think that I am a warm person and have a lot of compassion for people and I like to incorporate that into my therapy with clients.  I'm not saying my form of therapy is superior.  I would not say that these less warm forms of therapy are not helpful.  It just depends on the client and on the goal that the client brings into therapy.  So there's that.  I also know that some cognitive therapists are really quite warm, particularly contemporary cognitive therapists.  They might ascribe to the point of view that they can conduct pure cognitive therapy while being compassionate and empathetic and while making the client feel heard and making the client feel as though the therapist cares.  So there's a wide range of cognitive therapists and honestly, I actually don't know of anyone who practices pure cognitive therapy while excluding all other kinds of therapy.  Another thing that I just want to mention was that a friend of mine who heard me on the radio when this was broadcast over the air texted me and said, you say, hmm, too much.  And I didn't know what they meant by that.  I thought they meant that I said, um, too much, which I would say is probably true.  But they said, no, you say, hmm, too much.  And I thought that's an unusual thing to hear.  So, in the bit that we just listened to, I actually heard what this person was talking about.  When Bill and when Aaron talk, I often say, hmm, mm-hmm, mm-hmm, mm-hmm.  You know, I'm listening.  The problem with that is that over the radio, when you have a microphone very close to your mouth, the mm-hmm is very loud and perhaps interferes with the broadcast.  Whereas if you were in the room with us, the mm-hmm would be much less in volume, I think.  So I guess we'll see how often I say mm-hmm, because I haven't said it that much yet.  All right, let's get back to the Bill Radke treatment.

 Why do we believe stories or theories that aren't working for us?

 Well, this is where my psychodynamic bent comes in a little bit in terms of how I see people.  And I think that, and maybe cognitive therapists believe this too, I'm not sure, that our early childhood, our early life shapes the way that we see the world and shapes the way we see ourselves.  And so if in general we see ourselves as an incapable person,  when we are challenged later in life, then we tend to see evidence of that and continue to build that story.

 And it seems to confirm what we already think we know about ourselves.

 That's right.  That's right.  So for your daughter, for instance, in the future, she can build upon this core belief that she is capable and that will help her later in life.  Whereas if you ignored her in that moment and she had the opportunity to build this negative story about herself ongoing, then that would have a different effect later in life.

 Yeah, honestly, my dearly departed dad basically taught me often that I was a screw-up, you know?  That's like, that's the best.  He did his best.  But I think that... Do you have a box of tissues, please?  You know what I mean?  I think it's pretty deep.  Like, I was hearing when she said I can't do anything right, I was hearing, wow, I believe that crap too about myself.  And it doesn't mean that I'm... No, Bill, you do everything right.  You know, I'm not saying that we have no weaknesses and everybody's perfect, but...  But it's dangerous.

 Does that plague you today?  Does that voice come out of your head?  Like, I can't do things.  I'm not good at things.

 Absolutely.  You know, I mean, I'd be lying if I said it was like I am a work in progress.  And I'm also lazy and I'm busy, right?  And so I feel like if I were really on it, I would do this work every day.  It's, you know, I could be my own therapist.  This is where I started the very beginning of the show.  Everybody needs somebody to counsel them.

 It's gonna be you.  So let's do it, Bill.  So a therapist, cognitive therapist would key in on that word that you just said, I'm lazy.  Yeah.  What does that mean?  Are you just saying it lightly or are you really saying that about yourself?  Because that's a strong statement.  Because lazy could be reframed as, I like to have my leisure time.  I like to relax.

 So here's a great example.  I can imagine people listening to this saying, does everybody have to walk on eggshells around themselves?  If you're lazy, you're lazy.  Admit it.  You see what I'm saying?  Where's the tough love?  Nobody's lazy.  You can reframe that.

 Well, responsibility is something that we all need to take.  We all need to take responsibility for something if we're procrastinating or something.  Sure.  But if we're talking about a thought that is debilitating us, because often the thought I am lazy will lead to bad things in your life, will lead you to be even more lazily, make you procrastinate even more.  And so to release them from that label will sometimes make them more productive.  You know, if that's where you're going.

 You could even just reframe it to say something along the lines of, I'm not a lazy person, but maybe I'm not being very productive today.  And then you can behave in a way that's more consistent with who you believe yourself to be.

 All right.  So let me chime in here again for a second.  I said something that I didn't like just then.  I said, and maybe cognitive therapists believe this too.  I'm not sure.  Actually, I know the answer to this.  I'm quite sure that cognitive therapists understand that the past affects the current core beliefs.  So I'm not sure why I said that in the moment again.  And also, I'll just tell you a little secret.  When I'm recording the podcast on my own or with my co-hosts, Umberto and Mandy, when I say something stupid, I actually just delete it from the podcast.  I'll re-listen to the podcast and I'll say, boy, that sounded really dumb.  I'll just take that out.  So when I'm on the radio, I don't have that luxury.  So there you go.  A little look down the curtain on that one.  Another thing that I'll point out is that I'm an integrated therapist, so my main theory is psychodynamic, but I actually ascribe to many other belief systems and therapies.  For instance, cognitive therapy, behavioral therapy, narrative therapy, a lot of family therapies, a lot of systemic philosophies.  multiculturalism, feminism.  All of these things inform among others, existentialism.  Let's see.  There's a lot of humanistic things that influence me, experiential things.  And within family therapy, there's a whole long list of structural and strategic.  And even within strategic therapy, there's a lot of different personalities that I often reference.  And  So, there's a lot of different philosophies and language systems in my brain.  So, because I'm not a purist, I end up talking in this sort of jumbled philosophy language.  So, in the previous bit, I actually was speaking the language of psychodynamic theory, I was speaking the language of cognitive therapy, and I was speaking the language of narrative therapy, all within the same sentence sometimes.  So I just wanted to point that out.  For instance, I was talking about psychodynamic ideas of the past affecting the present.  I was also talking about cognitive therapy, about the thoughts that you have, and I was also talking about narrative therapy in terms of the stories we tell ourselves.  Narrative therapy can be quite complex and philosophically difficult to understand sometimes because it's quite a paradigm shift into what family therapists like to call postmodernism.  In the previous segment, I said that labeling oneself as being lazy can lead to bad things, and I don't really like that phrase, but basically what I was getting at was when you label yourself lazy, you can become depressed perhaps, you can have low self-esteem, and you can think, well, that's just who I am, I'm lazy.  So the narrative that you're lazy can actually lead to more and more quote unquote laziness.  So that's basically what I meant by that.  The other thing that I wanted to mention on the show, but again knew that I didn't have time for,  was that in American culture, we value some things over other things.  We privilege some things over other things.  And one of the things that we privilege in American culture is hard work.  We privilege working long hours.  We privilege being rich.  We privilege pulling yourself up by your bootstraps and that sort of thing.  And there's nothing wrong  with those things.  Of course hard work is gratifying and when you need to put food on the table hard work is necessary.  But I think in our culture we sometimes take it a little too far and end up creating inflexibilities in our society that make it difficult for some people to cope.  In Seattle, there's a lot of technology firms and there's a lot of medical professionals and I see a lot of people working at, for instance, Microsoft who will work 60 hours a week, 70 hours a week.  And when I say, why are you doing that to yourself?  They'll say, well, it's what everyone does, and it's the only way to get ahead.  And you just won't get a promotion unless you quote unquote prove yourself.  And the way that I see this personally is that our culture promotes this problematically, one.  And two, corporations love this.  Basically, they get more bang for their buck.  They don't have to pay the employees anymore and they work twice as hard and twice as much, so they, of course, encourage it.  And then what happens is when you, as an organization, reward people who overwork themselves by promoting them, then those people who get promoted are those people who work too much.  And then those people then proliferate their attitudes toward the people that they hire and say, well, I only want people who overwork themselves.  They wouldn't see it that way.  But I see this often.  And I'm not saying that working a lot is a bad thing.  I'm just saying that when a culture like ours promotes one thing over another, then for those people that might benefit from a more balanced life by working less,  they end up feeling oppressed and they end up feeling like that isn't an option and they push themselves to work too much.  So when Bill Radke brought up the word lazy I wanted to talk about how in our culture it promotes a certain way of thinking that people end up labeling themselves and other people as lazy when in fact they might actually just be more balanced and not fitting into the cultural norm of working a lot and perhaps too much.  Alright let's get back to the Bill Radke treatment.

 Well, I seriously don't understand why more people, maybe you can't afford a therapist.  This is not an ad for therapy.  I just feel like, like I said, it could be your best friend.  It could be yourself if you get good enough.  But I really wish the world, at least our corner of it, would be more skeptical about their own thoughts, their own theories.  So, I really appreciate you coming in and maybe we planted the seed.  Maybe it's smoking, but if it's not a dependence on smoking, couldn't this be a stand-in for being dependent on a lot of other ways of thinking?  Well, as you said, right?

 Absolutely.  I think if once you come from the lens of listening for what people's core beliefs are, what are their thinking errors or what are their beliefs that shape their behaviors, you'll start to hear it in your spouse, your friends, your kids, everywhere you go.  And it's amazing once you can identify those and see how people behave consistent with them.  It's really a remarkable way to see the world.

 in my opinion.  If it's not smoking, what are you hooked on?  And it might just be your stories.  We've been talking with Aaron Lavery from the Quit for Life program, part of a company called Aleer Wellbeing.  Aaron, thank you.

 Kirk Honda, Marriage and Family Therapist, faculty member at Antioch, host of the Psychology in Seattle podcast.  Always great to talk to you.

 This is the Bill Radke treatment back at you again a week from now.  You're listening to the all-new 97.3 Cairo FM weekends driven by Cooney Westside Infinity and Linwood and CooneyInfinity.com.  This show is produced this week by Jason Entebbe and Marcia Davis and Aaron Rose.  We'll be back next week by the way the music on today's show performed by the Dandy Warhalls off their new album, This Machine.

 Alright, so that was me on the Bill Radke treatment.  When I listened back to what I think, it wasn't so bad.  I edited out quite a bit, honestly.  I thought I would introduce a new segment called Shoutouts or Psychology in Seattle Shoutouts where people send in different things that they would like us to give shoutouts to.  So if you have a business or a band or your mother that you want us to give a shoutout to, just email us and let us know that you would like us to give a shoutout.  Particularly, if you have a psychology business, a therapy business, a counseling business that you would like us to give a shout out to, please email me and I will give it a shout out in all likelihood.  Now, if we get a billion responses, then we don't have time for everything.  So, of course, if you donate money, then that'll buy you a shout out, I guess.  I'm joking.  Actually, maybe not.  Alright, well that does it for another episode of Psychology in Seattle.  Thanks for joining us and please, please take care of yourself because you're worth it.  You know, you're worth it.  That must be her.