Wise Counsel Podcasts

An Interview with Ari Tuckman, Psy.D., MBA on Adult ADHD. Mental Help Net (www.mentalhelp.net) presents the Wise Counsel Podcast (wisecounsel.mentalhelp.net), hosted by David Van Nuys, Ph.D. Dr. Tuckman, a psychologist in private practice in West Chester, PA specializes in the treatment of adult ADHD (attention deficit hyperactivity disorder), characterized in children by hyperactivity, impulsivity and inattention. Most people outgrow the hyperactivity component of this disorder, but impulsivity and inattention problems may linger into adulthood, resulting in lost opportunities and poor educational, occupational and social functioning. The diagnosis is often missed in adults who are instead regarded as lazy or selfish. Functional problems associated with ADHD appear to be neurological by nature, manifesting as executive function disturbance. Aspects of executive dysfunction include impairments of prospective memory, sense of time and poor response inhibitution secondary to an impaired ability to efficiently appreciate the consequences of behavior; all types of meta-awareness which normally serve to keep people oriented regarding the responsibilities they are expected to meet. Dr. Tuckman's Integrative Treatment for Adult ADHD is comprised of four treatment componants: 1) education about the nature of deficits associated with ADHD, 2) medication (usually a stimulant) to boost executive functioning, 3) coaching (e.g., identifying distractions and removing them, and using external supports like clocks, alarms and signs to prompt behavior and stimulate awareness), and 4) psychotherapy to boost self-esteem and motivation and address mood and anxiety problems.

An Interview with Robert Fancher, Ph.D. on Cultures of Healing. Mental Help Net (www.mentalhelp.net) presents the Wise Counsel Podcast (wisecounsel.mentalhelp.net), hosted by David Van Nuys, Ph.D. Dr. Fancher is known for his 1995 book, Cultures of Healing, which is notable for its criticism of the cognitive-behavioral school within clinical psychology, which he understands to be based on a provincial vision of the scientific enterprise; one more concerned with engineering outcomes than with understanding the natural world. Dr. Fancher finds that many psychological scientists and therapists simply swallow, unquestioningly, cultural traditions about the nature of the world and the best ways to study it that they are taught in school, and go on to simply repeat these understandings, believing them to be Facts, rather than a particular and biased understanding of the true and ultimately unknowable underlying world. Therapists embeddedness and lack of ability to criticise their own undersandings blinds them to the fact that they have worldviews (one among many), and that these worldviews both have ethical ramifications that need to be explored, and also bias their interpretations. Many therpists do not attend to their role as moral agents with values and agendas that necessarily influence their clients. Therapists are taught to be value-neutral towards their clients, but this is both an impossible and absurd stance, and also sometimes a damaging one (e.g., when therapists do not take an ethical position towards their clients unethical behavior).

An Interview with George Bonanno, Ph.D. on Bereavement, Grief and Resilience. Mental Help Net (www.mentalhelp.net) presents the Wise Counsel Podcast (wisecounsel.mentalhelp.net), hosted by David Van Nuys, Ph.D. Dr. Bonanno describes lessons learned from his 30 year research career studying bereavement (grief in response to the death of a significant other). His findings debunk many grief myths that are widely held, including the notion that grief is always a drawn out process, and that it proceeds as a predictable series of stages. In reality, many people get over their losses fairly quickly. Rather than stages, the typical experience is more like periods of sadness that gradually get less intense. It is also the case that people normally experience intense happy emotions during bereavement as well as sad ones, moving back and forth between the two, with both emotions tending to be intensely felt but brief in duration. The more that people smile early on during bereavement, the faster they tend to recover their equilibrium. In many ways distraction and avoidance end up being better ways of managing intense grief than involved grief-focused conversations. Distressed people can become sensitized by such conversations and end up having a worse outcome than they otherwise would. Involved grief-focused discussion can be useful as a componant of psychotherapy for people displaying complicated (non-remitting) grief. Formal therapy is generally not indicated for normal grief. However, it can very useful for grieving people to have the opportunity to talk with an understanding and caring family member or friend if they desire it.

An Interview with Kirk Schneider, Ph.D. on Existential-Humanistic Psychotherapy. Mental Help Net (www.mentalhelp.net) presents the Wise Counsel Podcast (wisecounsel.mentalhelp.net), hosted by David Van Nuys, Ph.D. Drs. Van Nuys and Schneider discuss recent developments of Existential-Humanistic Psychotherapy, an approach founded by Rollo May and developed by May and James and Elizabeth Bugental. Dr. Schneider has become a champion of the approach since the passing of the founders, and notes it has opened up to embrace the use of techniques drawn from other schools while retaining its intense focus on the existential anxieties (e.g., the fear of death and the various ways that symptoms develop to ward off awareness of death) and the development of clients' sense of here-and-now presence and freedom through the therapists' careful, client-focused empathic attention, genuineness and ability to create a safe environment.

An Interview with Mary Forsberg Weiland on Modeling, Addiction and Bipolar Disorder. Mental Help Net (www.mentalhelp.net) presents the Wise Counsel Podcast (wisecounsel.mentalhelp.net), hosted by David Van Nuys, Ph.D. Ms. Weiland, formerly a successful fashion model and wife of rock star Scott Weiland (singer for the popular 1990s rock band Stone Temple Pilots), recounts her life growing up in in San Diego in a chaotic family environment featuring povery, frequent moves, divorce and remarriage, depression, and delinquency; her early and sudden success as a fashion model; more depression; her very intense and volitile marriage to Scott Weiland; their drug addiction problems; and her very public manic episode in which she burned her husband's clothes and damaged a hotel room. Though embarrassing, this episode resulted in her acceptance of treatment for bipolar disorder, an action which she credits with completely transforming her life and reducing her misery. Through her book, she hopes to share her experience with others so as to reduce the shame and stigma associated with addiction and bipolar disorder diagnosis and treatment.

An Interview with Nancy Rappaport, MD. on Coming to Terms With A Parent's Suicide. Mental Help Net (www.mentalhelp.net) presents the Wise Counsel Podcast (wisecounsel.mentalhelp.net), hosted by David Van Nuys, Ph.D. Dr. Rappaport, a Child Psychiatrist, talks with Dr. Van Nuys about her process of coming to terms with her mother's suicide (an event that occurred when Dr. Rappaport was 4 years old). This process started in earnest when she became a mother and concludes 18 years later in the form of a book. She started out writing letters to her absent parent, and later started digging for information to fill out her very incomplete knowledge, incorporating material from her mother's papers and the recollections of her mother's friends, family and associates. She describes how her understanding of the suicide evolved over time from an initial 'magical thinking' position of believing she had helped to cause it to occur, to her later appreciation of her mother from an adult perspective, and her suspicion that her mother may have had Bipolar Disorder.

An Interview with Charlotte Reznick, Ph.D. on Helping Children Cope with Anxiety and Stress. Mental Help Net (www.mentalhelp.net) presents the Wise Counsel Podcast (wisecounsel.mentalhelp.net), hosted by David Van Nuys, Ph.D. Dr. Reznick, a child educational psychologist and author, talks with Dr. Van Nuys about her counseling work with children which heavily utilizes playful imagery techniques as a means to help children cope with various anxieties. In a series of anecdotes drawn from clinical experience, she describes various techniques, including encouraging children's development of imaginal "helpers" (in animal or wizard form) which function as wards against fears, as sleep aides, or as translators through which difficult-to-process messages can be filtered. Adults wondering how such imagery might work to benefit young children need look no further for an illustration than the recent (2009) film adaptation of Where The Wild Things Are which features a similar set of imaginal helpers and a young child using them to work through a difficult home life.

An Interview with Pat Bracken, MD, Ph.D. on Post-Modern Psychiatry and the Social Context of Trauma. Mental Help Net (www.mentalhelp.net) presents the Wise Counsel Podcast (wisecounsel.mentalhelp.net), hosted by David Van Nuys, Ph.D. In this episode of the Wise Counsel Podcast, Pat Bracken, MD, Ph.D., expresses concern that in the rush to become more empirical that resulted in the ascendency of the modern pharma-centered, biologically-anchored psychiatry paradigm, psychiatry has lost interest in addressing important philosophical and existential questions, such as the nature of a patient's experience of meaning (as in the meaning of life) and how meaning relates to the treatment of trauma. In Bracken's view modern psychiatry views mental diagnoses such as PTSD as individual problems to be fixed through application of various techniques such as medication and cognitive therapy. His own experience working with traumatized Ugandans in the wake of the Amin regime suggested differently to him, namely that in some cases it best to focus on restoring societal and cultural order. By repairing the fabric of reality for traumatized individuals, you help restore their sense of the meaningfulness of life in a way that cannot be accomplished by treating them in isolation.

An Interview with Joel Paris, MD. on Treatment of Borderline Personality Disorder. Mental Help Net (www.mentalhelp.net) presents the Wise Counsel Podcast (wisecounsel.mentalhelp.net), hosted by David Van Nuys, Ph.D. BPD involves a chronic pattern of unstable relationships, impulsivity and emotional instability often accompanied by cutting (self-harm behaviors) or suicide attempts. The causes of BPD are not completely understood, but likely involve a complex inter-relationship between inherited biological vulnerability and life circumstance. Dr. Paris' message is one of optimism: Good treatments specifically targeted to BPD now exist that been demonstrated effective with clinical trials. Dialectical Behavioral Therapy (DBT) is one, and Mentalization Therapy is another. These treatments involve talk-therapy with a strong educational componant (designed to help patients learn coping skills), the validation of patients' inner experience, and a push to engage work and social relationships. Drugs are not generally helpful when treating this diagnosis and in some cases can be harmful. Most people who receive these treatments will experience an improvement in their functioning within a year, and across the lifespan, many people with BPD tend to improve with age anyway.

Dr. Goldstein, a clinical psychologist and regular contributor to Mental Help Net, is on his second career, his first having been sales. He talks about how he came to a realization that his efforts to secure financial success were ultimately seen to be unfullilling as he considered them from an end-of-life perspective. This realization pushed him to change careers go back to school and become a psychologist, and to focus on mindfulness, which, hot topic that it has become, is also an expression of and a set of techniques for achieving a balancing, clarifying and meaningfully-present perspective on life. Drs. Goldstein and Van Nuys talk about how the pressure of mondern life pushes people to become less present and mindful, and how it takes deliberate practice to push back against this tide. Time management is less important than attention management, Dr. Goldstein contends. It is all to easy to react to seemingly urgent needs or to engage in escapist distraction. Harder to accomplish but ultimately better for you is to create a space where you can be thoughtfully proactive so as to plan for how to make your life better. Mindfullness practice helps people create and maintain this proactive space, which is part of why many businesses and business people are now pursuing mindfulness practices in the workplace. As the interview winds down, Dr. Goldstein describes some of the formal mindfulness practices and how they help people recognize and overcome common mental traps (also known as cognitive distortions) such as catastrophization.

Jon Frederickson, MSW talks about Experiential Psychodyanmic Psychotherapy, which is based on Freud's original conceptions of repression and transference, but presented in a shortened, and far more active and experiential format than has been characteristic of traditional Psychoanalysis. Frederickson is quite comfortable describing what experiential therapists do using cogntive and neuroscientific concepts. His major criticism of cognitive therapy is that it is too superficial with regard to describing what is actually happening during effective therapy dealing as it does with the cognitions (defenses) that drive avoidance and dysfunctional emotion, but not the underlying and primary emotional states that are avoided in the first place, which need to be felt in order to be unlearned. The experiential dynamic therapist seeks to understand the client's responses as falling into three categories: a feeling (avoided or not), anxiety in response to a feeling, and defensive behaviors undertaken to escape from the anxiety, and further seeks to help the client become more aware of how their particular version of this chain of emotion and avoidance functions.

An Interview with Daniel Sonkin, Ph.D. on Domestic Violence. Mental Help Net (www.mentalhelp.net) presents the Wise Counsel Podcast (wisecounsel.mentalhelp.net), hosted by David Van Nuys, Ph.D. Dr. Sonkin describes his career working with victims and perpetrators of domestic violence and how his understanding of domestic violence has been influenced by attachment theory. He offers a definition of violent and controlling behavior, clarifies that the incidence of violence is not related to wealth or poverty (it's common at all levels of society) and (except for the most extreme forms of violence) also equally perpetrated by both men and women. He describes the two strongest childhood predictors of later adult violent tendencies: viewing of caregiver violence and insecure attachment. He relates attachment status to peoples ability to self-regulate emotions which is the basis of this association. He makes clear that help is available for both victims and perpetrators of violence and describes some of the resources available to help with this process including group and individual forms of therapy.

Dr. Ekman talks about his research career studying expressions of emotion, his invention of a facial expression coding system capable of revealing people's hidden emotions with good accuracy, and the use of this system by various law enforcement systems to help them tell when people are lying. Drs. Van Nuys and Ekman discuss the applicability of this coding system to psychotherapy and wonder about why so few psychotherapists have become interested in using this system to better gain insight into their client's inner worlds. Dr. Ekman discusses his conversations about the nature of human emotion with the Dalai Lama. The interview concludes with Dr. Ekman's thoughts on some important areas of further emotion research he believes should be explored.

In this edition of the Wise Counsel Podcast, Dr. Van Nuys interviews Dave Herz and Leslie Potter of Vive Inc., a therapeutic mentoring and parent coaching service. Based in Boulder, Colorado, Vive serves families with teens in crisis using a creative and variation on an intensive outpatient model. Three therapists engage with family members. A mentor works with the teen, a parenting coach works with the parents and one who works with the family system in a supervisor role. Through this entire process, the Vive team members emphasize what they call a heart centered model, which is very much in the spirit of the Rogerian conception of unconditional positive regard and the client-centered approach.

In this edition of the Wise Counsel Podcast, Dr. Van Nuys interviews Gail Steketee, Ph.D., MSW on the topic of Hoarding and OCD (Obsessive-Compulsive Disorder). Hoarding (filling a home with clutter to the point where clutter takes over the house) is a surprisingly common behavior, but it is only recently that serious research attention has been brought to bear upon it. Dr. Steketee describes some of the recent findings from the research, among them (surprisingly) that hoarding is probably not best considered a subtype of OCD. The interview touches upon diagnostic and measurement issues associated with studying this problem, as well as information on the cognitive behavioral therapy protocol which has been shown effective in treating hoarding.