400: Mystery Question & Rapid Fire Q&A

Full Transcript

[00:00:00] All right, hello friends of all varieties. This is episode 400. Thank you very much for joining me today. I can’t believe it, 400 episodes. Sometimes I forget just how long I’ve been doing this. I started the show back in 2016. At the time, I was living in a different place and I was in a whole different situation. I was thinking about it. And if I look back at pictures from when I started the podcast, I probably don’t even look like the same person anymore. Honestly, I’ve changed a lot. Even in terms of just physical appearance and such, the grays certainly are part of that, as well as other, you know, physical attributes. I didn’t have all these tattoos that I have now, which you obviously can’t see if you’re listening to the podcast, but it’s been a long time. And some of you have been listening since the very first episode. And I just want to give, as always, a really special shout out to you guys for that. I [00:01:00] greatly appreciate you. You are amazing. And I honestly can’t believe that some of you have been here for all of these years. As well for the new people listening, I have a special appreciation for you too. If you sought me out from my books, if you searched for a topic on iTunes or whatever podcast player, if you came across this from something somebody shared, thank you. I very much appreciate you as well. I’m really grateful. This is episode 400. So usually at the benchmarks, I like to do things a little bit differently. So for this episode, I want to do something of a different type of episode. The things I’m going to do are, first, I want to talk about a few goals that I have for the podcast moving forward, because I think that milestones like this are a great time to look back and reflect and also look at the future. Then I have some questions from the hardcore self help Facebook group that I’ll answer rapid fire style. So not too much [00:02:00] preparation, not a huge outline like I might normally have, more off the cuff. So yeah, let’s just get into it. Speaking of the group, one of the goals that I have for the podcast moving forward, and just my brand, the Duff the Psych brand in general, is to do better about engaging and fostering the community. That’s really important to me. Like I said, I appreciate you guys, but I want to be connected to you more. If you go over to facebook.com/groups/hardcoreselfhelp, or you just search for it, there’s a private Facebook community with over four and a half thousand members. So plenty of people there and the group has gone through different phases over the years. I’ve had different vibes and different ways of engaging with it. But recently, if I’m being honest, it’s been much less active and a lot of that is on me. So I want to fix that. I want to be more present and more engaged. So now is a good time to check it out. If you haven’t joined the group, there’s a little application process. I try to be careful about not admitting people who are there to try to sell you things or promote their own [00:03:00] stuff. It’s important to me that it’s a really safe and good community. I’m also not afraid to ban people from the group if they’re being inappropriate, not being respectful to people, things of that sort. So if you head over to there, I encourage you to join. And yeah, I want to put more effort into connecting and making that a more vibrant community. So now’s a good time to check it out. The next goal I have is to improve the quality of the podcast. I’m sure that this does not matter to the vast majority of you. I know that for most people who listen to podcasts, as long as the audio quality isn’t intrusive and distracting, you don’t really care. But to me, I would like to improve my editing as well as the sound quality. I’ve been doing some experiments with different editing software and techniques lately. And I’m not quite satisfied, there’s been some experiments where, you know, certain episodes. I’m like, Oh, that wasn’t so good, but I want to get to a place where I feel personally proud of the quality. I just want to level up a little bit. And so again, that’s on [00:04:00] me. That’s something that I’m working on. And if any of you out there are more particular about audio, if you are editors yourselves, if you’re audiophiles, if it’s something that’s important to you. Please never be afraid to reach out with feedback on specific episodes, things that you’ve noticed. That all helps me get better. On that note, I’ve also been paying more attention to editing and such, which means that I have noticed I have a terrible tendency to include filler words and vocal tics. I didn’t think I was this bad, but I’m currently using one editing program. It’s called Descript, and what it does is it allows you to edit the video or audio as if it were a text file. You have a full transcript, and if I want to erase a portion of it, I just erase the words. I can move things around with the text. And so when I’m looking at the text file for this. I say, you know, you know, you know, and, um, or, uh, just so fucking much. I have driven myself crazy and it’s funny because I’ll go through and I’ll record an episode. Like that was great. I think I did really well. And then I look back at the text. I’m like, Oh my God, Robert, every other sentence is like, um, well, you know, it’s just, you know, uh, So I would very much like to train myself to do better with that. That’s just going to be on my side, paying attention to it. And I have a little bit more feedback now that I’m looking at the transcripts. So it’ll just be a process of essentially putting myself through some training to not use as many vocal tics. I hope that that is something that you can benefit from as well. As I’ve mentioned a few times recently, I have a bunch of cool interviews queued up covering all sorts of topics. I’m talking black representation in nerd culture. I’m talking grief and silent grief. I’m talking aging as a woman going into middle age and looking for [00:06:00] confidence, intimacy, all sorts of really cool stuff. I am proud of the interviews that I’ve done in the past. It’s been quite a while though. I haven’t been doing interviews for a good, I don’t know, years, I guess. And I think that I have the capacity to be a really good interviewer. Some of that comes from my therapy background. Some of it comes from just my love of conversation. And I’m just looking forward to, you know, honing my interviewing skills. There are some really awesome interviewers out there. Um, the dude from Hot Ones comes to mind. I’m blanking on his name. Uh, Tim Ferriss from The Tim Ferriss Show. There are a lot of interviewers out there that I really like. So I want to be a type of interviewer that I would be appreciative of if I was on the outside. So I’m just looking forward to working on that. And I hope that it’s not too much of a learning curve to get back into it. The last goal that I have for the podcast is simply to get my numbers back up. A little behind the scenes peek for you: listenership for podcasts across the board, not just my show, but it’s way down compared to where it was a few years ago, especially [00:07:00] during the pandemic. When a lot of people were spending more time at home, there was a bit of a spike at the beginning of it. Things changed throughout the course of the pandemic, but over the past few years in general, podcast listenership is way down. And my show has been hit particularly hard by this. I’m talking a reduction of listenership by like half or so. It’s a little disheartening for me personally. And this is just, you know, from the ego side as a creator, this is something you always have to contend with. But if I look at the graph for my downloads or listens over the years, there’s a rise, rise, rise, rise, rise, and then it like shoots down and that’s hard to see. Truly for me, the impact that I care the most about is the individual level. When I get individual feedback from you guys saying, Thank you for answering my question. This made such a big difference, blah, blah, blah. That stuff is awesome. That’s really what I thrive on. But in terms of making sure that there are a good number of questions coming in from you guys, the [00:08:00] listeners and enough listenership for advertisers to keep coming in so that I can continue justifying making the show financially and get the support that I need for things like hosting the occasional equipment, stuff like that. I do want to get back into growing. So that’s on me, but one way that you can help with that is by sharing the show and reviewing it anywhere that you listen to the podcast. I always really appreciate that. So if you haven’t yet, now’s a great time. Okay. So that’s enough from me and my goals. Let’s take a quick break. And then we’re going to jump into those rapid fire questions. Today’s episode is brought to you by BetterHelp. So the year is halfway over. Can you believe that? Time is absolutely flying. I hope that there are some things that you’re proud of yourself for in 2024 so far. It’s also a good time to reflect on what you still want to accomplish. When life moves fast, it’s so important to take the time to celebrate your wins and of course, make whatever adjustments are needed. As you move forward into the rest of the [00:09:00] year, there are many ways to do this. Journaling, talking about it with loved ones, talking to yourself out loud in the shower like I do, and therapy is also an amazing tool to take stock of your progress and set achievable goals for the rest of the year. If you’re thinking about giving therapy a try, check out BetterHelp. It’s entirely online and designed to be suited to your schedule. Just fill out a brief questionnaire and that will get you matched with a licensed therapist. You can switch therapists at any time for no additional charge. So take a moment to reflect with BetterHelp. Visit betterhelp.com/duff today and get 10 percent off your first month. That’s betterhelp. H E L P. com/duff. All right. So I wanted to start with this really good question that I got from the hardcore self help Facebook group, Zoe wrote, I remember posting way back when you were celebrating that you had a hundred members in this Facebook group, I insisted you invite all of us out for drinks or some such nonsense. You’ve been a steady constant in our lives for a while now, Duff. And I know we all thank you for your effort and time and heart. [00:10:00] Thank you. Now, my question, what has been the most memorable or impactful question you’ve received and why? This for a moment stumped me, but then I realized it’s actually very easy to answer. I actually have a recording of the most impactful question that I’ve ever been asked, which I got recently. So I’m going to play that for you right now. So yes, I got this recording on my contact page. If you go to duffthepsych.com and go to the contact page, you can leave a recording for a question if you want to. And I got this last week. I think I have no idea who this is. I have no idea who the hell sent this in. Yeah, your guess is as good as mine. Obviously it’s a troll. This is, uh, not something that could have happened because I’ve never been to the Philippines, even if I have wanted to, [00:11:00] haven’t had the chance. So yes, I do not have a long lost son out there, but thank you for the great content. I appreciate that. Truthfully though, I couldn’t begin to say what the most impactful question has been that I’ve been asked. I thought about it for a while and there’ve been so many amazing ones. It’s hard to pull out specific examples, but there are sort of different genres of questions that I get. I really love the ones that are super vulnerable. The ones that say, Hey, I’ve never told anybody this before, but X, Y, Z, or I don’t have anywhere else to ask this. So X, Y, Z things that are very, very deeply personal that people ask. I feel extremely honored to be trusted with those ones. And there are a great number of questions that are like that, that I’ve answered over the years. There are also questions that prompt me to learn more. This podcast has been an amazing platform. And sometimes people ask me, you know, are you going to continue the podcast? Does this make sense? I did it again. I did the, [00:12:00] you know, I’m going to keep catching myself on that. People ask me though, if this still makes sense for me to do, you’ve been doing it for so many years, it takes up time. And one of the things that is a benefit aside from just being able to connect with you guys and answer really great questions is this serves as a prompt for me to keep myself sharp because people ask questions that I don’t always know the answers to. And that means that I go and I do some clinical research, or I go out there and ask questions, and that helps me as a clinician and as a psychologist remain sharp. One cool thing is that the way that psychology licensure works now, it used to be that you had to do all of your continuing education through courses, so CEUs. Now you can use other things as a platform for that learning. You still have to do some formal CEUs, but I actually use the podcast now and my research for this as part of my Continuing education, which is awesome because this actually is one of my biggest forms of continuing education. [00:13:00] So, yes, there are amazing questions that prompt me to learn more, and I really like those ones. And then, of course, there are questions that are just infinitely relatable, right? When someone goes to Google and asks, What’s the difference between borderline personality disorder and bipolar? I have an episode on that. Someone goes to Google and asks, What is ECT? Or is ECT dangerous? Or how does ketamine therapy work? I have episodes on these things, and I’m really, really happy to be able to be a resource in that way. So, Zoe, I can’t give you a direct answer to that. I don’t know what the most memorable question is, but I’ve gotten a lot of great questions. So thank you for asking that one. Next question is from Ray or Rye. I’m sorry. I don’t know how you pronounce your name. R A I. And they ask, so my psychiatrist just told me I have an official diagnosis of bipolar, but that was from a long time ago. Are they able to reverse it? Also, I think the only reason they diagnosed me with that is because they wanted to prescribe me mood stabilizers. I’m just curious how often that [00:14:00] happens and what would happen if they decided I wasn’t actually bipolar. Sorry if that didn’t make sense, but let me know if you have any questions. Thanks for taking my suggestion. Hey, really good question. And yes, this is super common. One issue that I have with health care here in the United States, I’m not exactly sure how it plays out in other countries, is the what you call problem list. If you’re in, say, a health care network and you ever get an after visit summary or paperwork on yourself, you might see an active problem list and that will have problems, essentially any diagnosis you’ve ever been given. And I have a big problem with the fact that that’s not revised very often because yes, diagnoses, whether they’re medical or mental health should be revised and they can be reversed or revised. You should always be looking back about whether the diagnosis that you got is still appropriate, whether it’s relevant to you now, and whether it was actually accurate in the past. I would say that [00:15:00] bipolar is one that is particularly common to be misdiagnosed. There are a lot of things that, especially if you were diagnosed by, say, a primary care doctor or a nurse practitioner, like psychiatric nurse practitioner, somebody that doesn’t necessarily do very thorough assessments and may not deal with bipolar in terms of treatment. Very often they might say, Oh yeah, it seems like you have these mood swings. That looks like bipolar to me. Let’s put that in your charts so that we can get you the medication that you need. Just like you said, you know, to be prescribed mood stabilizers, even if the mood stabilizers helped, maybe you weren’t bipolar. Maybe it was something else that you were going through. Maybe it was a different diagnosis. And in my practice, I like to revisit this. I’ll say, Hey, I’m seeing here in your chart from your medical provider, there’s a diagnosis of OCD or bipolar. Can you tell me a bit about that? And often people will go, there is, I don’t know about that. And I’ll say, okay, well, let’s dive into it a little bit. [00:16:00] Do you ever have experiences where you are feeling very energized? You maybe don’t sleep for a week at a time. You’re on the go. Your thoughts are moving really fast. Maybe you’re engaging in impulsive behaviors, et cetera, et cetera. And they go, no, that’s never happened to me. Um, I get distracted sometimes and I’m often depressed, but I haven’t ever had anything like that. And if that’s true, then that precludes them from a bipolar diagnosis. Pretty much if they never had a manic phase, then they’re not bipolar. So I’ll talk to them about that. And, in my own reporting, I’ll say there’s a history of this in the records, but this doesn’t seem to fit for this person. Perhaps this other diagnosis is more appropriate. So, yes, to answer your question, it is possible to reverse that and it should be revised and reversed. What I would say is that it’s probably best to talk to your psychiatrist about this and just ask them about it. Say, I see that I have a diagnosis of bipolar, uh, or you told me that I have a diagnosis of bipolar. Can you [00:17:00] tell me about where that comes from? Can we revise that? Or can we revisit that? Just ask to kind of go through the criteria together. I’ll often break out the DSM with a patient of mine and go through it and actually talk about what it looks like and see if that fits. So I’d encourage you to ask them if they can do the same for you, if they can go through it with you. And provide you some education about why they think you have bipolar, and if they don’t, you can ask, is there any way for you to make a note of that or remove that? There are different ways to do this. Let’s say that you did meet criteria in the past for a given disorder like bipolar. You can say that it’s in remission, like full or partial remission, or if it’s not an appropriate diagnosis, you can just remove that from the problem list. This is obviously going to be different depending on what provider, what system you’re within, but I think addressing this with them and asking them to pay some attention to it and educate you about it, have a conversation about it is totally okay. So hopefully that answers your question. It’s a really good one. I think a lot of people are [00:18:00] in a similar situation. I see it all the time. So thank you for asking it. All right. Next question comes from Becca. Becca writes, I’ve had the same therapist for about three years. She’s really nice and I appreciate her flexibility. All virtual appointments, allows texts, and she even offers to provide accountability like a coach, checking to see if I follow through with things I say I want to do. But sometimes it feels like she just agrees with me too much and isn’t challenging me. How do I know whether she’s just agreeing with me to make me feel good, or if she’s agreeing with me because I’m actually right? For example, discussing a conflict that I had with a coworker. Thank you for this one. It sounds like you have a good therapist. It sounds like she’s super accommodating and really empathetic, which is nice. Empathy meaning reflecting back how you’re feeling about something and also giving you unconditional positive regard, essentially being on your side regardless of whether your therapist exactly agrees with you or not, they’re there to support you. And what you’re talking about, the sort [00:19:00] of, pitfall of agreeing with you too much, that’s absolutely a pitfall that therapist can fall into. And in my experience, it’s something that tends to develop over time. When you become more comfortable with somebody, you’ve been working with this therapist, you’ve been working with her for three years, which is a substantial amount of time. And I’d say it’s pretty common to sort of fall into a more friendly pattern with your therapist, where you’re just catching up, you talk about what’s going on, you talk about your goals, but there is less of that direct challenging or teaching you coping skills. It becomes maybe a little bit less nuts and bolts and functional than it is more of a supportive environment. So I think that’s a common thing. And of course, some people just have more of an empathetic style. Maybe your therapist has more of a humanistic approach. And so this would be more consistent with that. But I would encourage you to ask her about it. Just ask her about it. Say, Hey, I was just curious, I come up with these [00:20:00] scenarios or I bring up these things that have happened in my life and you’re great. You’re always on my side. I feel very supported by you. I was wondering though, I feel like sometimes I’m not always in the right and I don’t feel like you’re challenging me very much. Is that because you just want to support me? Is that because I am typically in the right? What do you make of that? And just open up a conversation about it. If you do feel like you need a little bit more of a challenge, you can also say that, say, I appreciate the support that you give me and I wouldn’t change that. Can I also ask that you challenge me, if you feel like I need it, push back where you need. I’m, I’m not afraid of that. And I think it would help me grow basically just sort of laying the seeds to say, Hey, I could use another type of support if it’s relevant. And I think a simple conversation like that could go a long way. I will also say that therapy. It varies from person to [00:21:00] person. I have seen a few people for a number of years, but I try to make a point to always check in to make sure that we’re still being productive. I don’t want to fall into that sort of holding pattern where things are just supportive, check in, and we’re not seeing a lot of change in the outcomes. And when we’re not seeing a lot of change in the outcomes, I try to address that. I say, Hey, look, it feels like we are maybe a little bit stuck here. What do you think we should do about that? Is it coming to the point where we need to make a bigger change? And of course, it’s always possible that your sort of phase with this therapist is coming to an end and maybe you need to start working with somebody else. It’s not a personal attack on the therapist. There’s nothing wrong with that, but sometimes getting a new set of eyes and starting a different leg of your therapy journey is appropriate. I don’t think you need to jump to that. I’m not saying that this sounds like a bad situation and you need to jump ship, but it’s something you could talk to your therapist about. And if you feel that you need a new, fresh perspective, you’re well within your rights to go seek [00:22:00] that out. So another really good question. Thank you, Becca. And one more question. I lost who asked this one. I’m going to click right now so I can get the name. This is from Lakota Lakota writes. Hi, Robert. I’d be interested in hearing your thoughts about regression and trauma therapy and how folks who feel like they’ve lost progress can either cope with the fact that they have to do the work all over again. And Or regain the progress and confidence they’ve gained throughout their treatments. I hope this makes sense. Yes, this definitely makes sense. And it’s super, super, super, super, super common in trauma therapy. Trauma therapy is not easy, right? If it were, everybody would be doing it that has trauma. If it were simple, people would be healing from trauma easily on their own. And that’s not the case. The way that I always put it is trauma happens because you’ve endured something that humans aren’t supposed to go [00:23:00] through. So of course you don’t know exactly how to deal with it. And sometimes it’s like peeling back the layers of an onion. When you expose another layer, you can get a resurgence of symptoms. You can get this burst of symptoms. So don’t beat yourself up for feeling like you’ve lost progress. You haven’t. This isn’t the case. And this is a long period of time. And the line of progress, it isn’t straight. It’s almost never straight. It’s not just this upward trajectory. There are ups and downs and ups and downs, and it’s normal to have this happen. The way I see it is it’s pretty similar to other types of exposure work for anxiety, where maybe you’re working through a courage ladder step by step and you are facing your fears. You’re getting exposure to things that make you anxious. And once you master a certain step. You’re going to move up to the next step and that’s going to be more challenging and you might feel like you’re all the way back to square one, but you’re not. It’s cumulative. You’re working on your ability to tolerate these sensations. You’re working on your bravery. You’re working on [00:24:00] your understanding of your own anxiety. Same thing happens here for trauma work. You might feel that you’re regressing when in fact this is just a cumulative process where you are gaining more exposure to these things. You’re struggling through it, but you’re sticking with it. So if you can keep working at it, that line, I said it’s up and down, it’s not linear. But over time, when you start to zoom out and look at that line, it is going to look more linear. It is going to look more straight because over time, all of those ups and downs are going to start to wash out because inevitably you’re moving toward progress. So keep approaching this. Don’t start avoiding because you feel discouraged, but it’s totally okay to recognize I’m going through a hard time right now. I need to chill a little bit because this hurts. I’m not functioning well in life with the amount of stuff that’s being pulled up and you can rest for a little bit before. Jumping back in and continuing to challenge yourself as much as you have been you’re not doing anything wrong You’re still making progress in what you’re talking about is [00:25:00] a totally normal experience. So thank you for the question. And that’s it. That’s what I’m going to do for today. A few rapid fire questions. Again, if you want to be part of the group that gets a little bit more exclusive access, join the hardcore self help Facebook group. And to everybody listening, take a moment. Pat yourself on the back. You’ve been an amazing part of this show. It’s because of you guys, your questions, your support that this is possible. So thank you. And I hope you enjoy the next 100 episodes, not going anywhere. I’ll see you for the next one.

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