Latest / Why We Do What We Do / Diagnoses: More Harm Than Good? With Dr. Stu Law pt. 3

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Diagnoses: More Harm Than Good? With Dr. Stu Law pt. 3 · Why We Do What We Do

• 0:03
  Speaker 1: You're listening to Why We Do What We Do. Welcome
• 0:16
  Speaker 1: to Why We Do What We Do. I am your
• 0:19
  Speaker 1: still reeling in the diagnosis stew, but not S-T-U, S-T-E-W, Abraham.
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  Speaker 2: And I'm your purple hat host, Shane.
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  Speaker 1: We are a psychology podcast. We talk about the things
• 0:33
  Speaker 1: that humans and non-human animals do. And this one's a
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  Speaker 1: little bit unique in that we had recorded a discussion.
• 0:41
  Speaker 1: We decided to call that discussion and knew that we
• 0:43
  Speaker 1: had a second part. So we paused that discussion. We
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  Speaker 1: did a part two. But the part two went really long,
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  Speaker 1: like much longer than we were thinking it was going to.
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  Speaker 1: By the time we were at the point where we
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  Speaker 1: would have just called it another episode, we didn't realize
• 0:56
  Speaker 1: how far from the end we still were. So we
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  Speaker 1: just kept recording. And so then that part two was
• 1:02
  Speaker 1: twice the length of part one. And we decided, let's
• 1:05
  Speaker 1: actually just chop this up so that there are about
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  Speaker 1: three equal length parts. But we didn't know that when
• 1:11
  Speaker 1: we were recording. So we kind of had to interrupt
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  Speaker 1: the end of the second part to create an ending.
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  Speaker 1: And now we're bringing that next, the second half of
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  Speaker 1: the second part to create a third part. If you're
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  Speaker 1: following all of that crazy logic.
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  Speaker 2: So many parts.
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  Speaker 1: So many parts to create a new beginning. So that's
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  Speaker 1: why we're here. So if you're joining us for the
• 1:28
  Speaker 1: first time, welcome. This is maybe not the best place
• 1:31
  Speaker 1: to jump right in. Nevertheless, I'll do our best to
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  Speaker 1: describe what we've talked about in the first couple of parts.
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  Speaker 1: And we'll segue then into the abrupt transition. into this
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  Speaker 1: latter discussion for concluding our time with Dr. Stu Law
• 1:47
  Speaker 1: discussing diagnoses. Do they do more harm than good? Is
• 1:51
  Speaker 1: there anything that you'd like to add before we start our,
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  Speaker 1: I guess, recap?
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  Speaker 2: No, I think we're ready.
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  Speaker 3: Okay.
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  Speaker 1: I will say, if you'd like to support us, you
• 2:01
  Speaker 1: can join us on Patreon, leave us a rating and
• 2:03
  Speaker 1: a review, like, subscribe, and tell a friend. And I'll
• 2:06
  Speaker 1: talk more about those things at the end of this discussion.
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  Speaker 1: And at the end of this discussion, we'll do our
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  Speaker 1: sort of normal wrap-up things with information about supporting us,
• 2:14
  Speaker 1: as well as our recommendations, which Dr. Sula will give
• 2:16
  Speaker 1: his recommendations in this part, because we thought this was
• 2:19
  Speaker 1: going to be the end. I think that's all the
• 2:21
  Speaker 1: things to say about that. Oh, it is a day today.
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  Speaker 1: It is a day of the week.
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  Speaker 2: Yes, it is.
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  Speaker 1: As a day of the week, the day of the
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  Speaker 1: week specifically being when this publishes, September 9th, I'll go
• 2:33
  Speaker 1: ahead and just quickly say that happy Teddy Bear Day.
• 2:36
  Speaker 2: Yes, happy Teddy Bear Day. It's also happy Sudoku Day.
• 2:39
  Speaker 1: I love Sudoku. I really do. It's Wienerschnitzel Day, which
• 2:44
  Speaker 1: I almost spelled correctly on my first try without double checking.
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  Speaker 2: I'm so proud of you.
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  Speaker 4: I mean, German, those types of languages are very tough
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  Speaker 4: on spelling. It's Weirdos Day. So if you celebrate, enjoy that.
• 2:57
  Speaker 1: Yeah. Weird Owls Day, maybe. It is Falsely Accused Day.
• 3:01
  Speaker 1: We did an episode on false confessions a long time ago,
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  Speaker 1: which maybe that falls in line with that, but I'm sure.
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  Speaker 2: Yeah, it feels like it aligns.
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  Speaker 4: It is International Fetal Alcohol Syndrome Spectrum Awareness Day.
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  Speaker 1: It's a lot of words. That one's very important. Probably
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  Speaker 1: worth doing a full discussion on, fetal alcohol syndrome at
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  Speaker 1: some point.
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  Speaker 2: Yeah, for sure.
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  Speaker 1: It is inter... Boy, actually, speaking of diagnoses, and we're
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  Speaker 1: like in an episode of diagnoses, but that one, more relevant. Yeah.
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  Speaker 1: It is International Box Wine Day, for those of you
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  Speaker 1: who celebrate in that way.
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  Speaker 4: Yeah, as opposed to bottled wine. It is a day
• 3:32
  Speaker 4: to protect education from attack.
• 3:34
  Speaker 1: Oh, boy. We need more of these days. Yes. Agreed.
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  Speaker 1: particularly in the United States, where education is on the
• 3:41
  Speaker 1: verge of being abolished.
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  Speaker 2: Yeah, yeah, yeah, yeah, yeah.
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  Speaker 1: All right. It is also Emergency Services Day. Emergency services
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  Speaker 1: protect our education from our current administration.
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  Speaker 2: Yes, please, please, please, please, please.
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  Speaker 1: All right, we'll do our best to recap what we've
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  Speaker 1: discussed in these previous couple segments. So the primary thesis
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  Speaker 1: that we're sort of getting after here is sort of
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  Speaker 1: what is a diagnostic system as it relates to things
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  Speaker 1: like mental health and psychology and understanding cognitive issues, if
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  Speaker 1: you will. And the.
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  Speaker 1: Talking a little bit about the history of this idea
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  Speaker 1: of something like the DSM, which is the primary United
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  Speaker 1: States version of a manual for diagnosing specific conditions. And
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  Speaker 1: what that does for us. I think one of the
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  Speaker 1: things we pointed out is that like with these diagnoses,
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  Speaker 1: we have the problem that they don't necessarily tell us
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  Speaker 1: what to do about them. So a diagnosis does not
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  Speaker 1: inform an intervention. And in most other cases, medical, mechanical, plumbing,
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  Speaker 1: what have you, like a diagnosis also tells you in
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  Speaker 1: part what the solution probably is. And that just is
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  Speaker 1: not very much the case in psychology.
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  Speaker 3: Right.
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  Speaker 4: One of the issues that comes up in the DSM
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  Speaker 4: so often, and we talk about it all the time
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  Speaker 4: is like, there's just issues with overlap. So when we
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  Speaker 4: kind of talk about this stuff, you're going to find that,
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  Speaker 4: what might be better explained in one situation may not
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  Speaker 4: actually capture what's going on for somebody. And so then
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  Speaker 4: you have some overlap with other diagnoses and then you
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  Speaker 4: have this issue or this problem of comorbidities that occurs
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  Speaker 4: where now you've got somebody who has multiple diagnoses that
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  Speaker 4: all don't really answer the question of the concern that's
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  Speaker 4: occurring for that person. And you have these overlapping symptoms,
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  Speaker 4: overlapping circumstances, and it creates a lot of problems for someone.
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  Speaker 1: There's such a lack of specificity in some of these
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  Speaker 1: that two people at the same diagnosis might have zero
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  Speaker 1: amount of the same symptoms. And that seems to indicate
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  Speaker 1: that there's, it's the diagnosis, the diagnostic net is too
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  Speaker 1: broad or in many ways it's too narrow. Like there
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  Speaker 1: are two, it's too difficult to reliably produce a descriptor
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  Speaker 1: of what someone is experiencing in this and trying to
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  Speaker 1: do this in this way, because there's so, so, so
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  Speaker 1: many variables that, to try and account for that this
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  Speaker 1: particular system has not produced very meaningful outcomes. And we
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  Speaker 1: do get into some of the ways that there is
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  Speaker 1: utility in the system, because it's not to say it's
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  Speaker 1: all useless. There's a reason this has existed and a
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  Speaker 1: reason that it persists, because there are things in here
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  Speaker 1: about it that do work. But I think, yeah, the
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  Speaker 1: fact that you can have such wide variety in a
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  Speaker 1: single diagnosis that doesn't It overlaps a lot with other diagnoses.
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  Speaker 1: It doesn't necessarily tell you what the treatment is. And
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  Speaker 1: you might have multiple people, the same diagnoses with completely
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  Speaker 1: different symptoms makes it feel like a system that's not
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  Speaker 1: doing very much for us. And I think that's the
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  Speaker 1: central thesis of our discussion here is this is not
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  Speaker 1: helping as much as it is possibly helping. causing some issues.
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  Speaker 1: And one of those issues as well being things just
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  Speaker 1: like people who get committed to the diagnosis that ends
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  Speaker 1: up actually reducing their access to less restrictive environments because
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  Speaker 1: they are sort of written off or pigeonholed into this
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  Speaker 1: is who you are, immutable characteristic, full stop. Therefore, you
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  Speaker 1: do not qualify for access to Other things that most
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  Speaker 1: people have access to.
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  Speaker 3: Yeah.
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  Speaker 1: And then people believe it. Like they believe that about themselves,
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  Speaker 1: that they're like, I don't deserve to do or be
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  Speaker 1: these things because I have this diagnosis. It's who I am. And,
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  Speaker 1: and that I think is counterproductive to how we would
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  Speaker 1: like to generally treat people who show up in the
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  Speaker 1: world in a slightly different way. And to that point,
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  Speaker 1: one final note, I'll end on his wrap up for
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  Speaker 1: myself is this idea that like normal is not a thing.
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  Speaker 1: There is no such thing as a normal way to think.
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  Speaker 1: There is no such thing as a normal way to be.
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  Speaker 1: There is no such thing as a normal way to
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  Speaker 1: have cognition. There are pathological ways for those things to exist,
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  Speaker 1: but there are not normal ways for those things to exist.
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  Speaker 1: There's just a huge diversity and variety in how people
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  Speaker 1: show up in the world cognitively, mentally, behaviorally, and that
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  Speaker 1: that's okay. That is just the way that human beings
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  Speaker 1: and non-human beings are. Is there anything else you'd like
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  Speaker 1: to add for the wrap-up that I maybe missed?
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  Speaker 2: No, I think that covers it. I think it sounds
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  Speaker 2: like diagnoses are a problem.
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  Speaker 1: Which I think we're making that case. And as I said,
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  Speaker 1: we'll get to, I think in this discussion, what aspects
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  Speaker 1: of it are still beneficial. But all right. So I
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  Speaker 1: think we've done the things. We mentioned how to support us.
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  Speaker 1: We talked about the holidays. We've recapped our previous episodes.
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  Speaker 1: Is there anything that I'm missing or you'd like to
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  Speaker 1: add before we make our awkward transition into the middle
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  Speaker 1: of the conversation that we cut in half from last week?
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  Speaker 2: No, I think let the awkward parts of this rain.
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  Speaker 2: I think it'll be good.
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  Speaker 1: So take it away with the transitions.
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  Speaker 2: Here we go with the thing.
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  Speaker 1: All right, let's get into another concern here that I,
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  Speaker 1: we've sort of already alluded to this, but this idea
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  Speaker 1: that like diagnoses become identities. This fact that like you
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  Speaker 1: pointed to, there are people who like sometimes there is
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  Speaker 1: relief from having a label. But there's also the other
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  Speaker 1: side of this coin that is the, I now am
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  Speaker 1: limited in the things that I can do, I can experience,
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  Speaker 1: I can be because of my label. And people choose that.
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  Speaker 1: And then there's the like, I need to live into
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  Speaker 1: the reality of how I understand my label to be
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  Speaker 1: a limiting factor for me. And that the language around
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  Speaker 1: this drives their behavior in a way that I would
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  Speaker 1: argue is has them have less access to the kind
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  Speaker 1: of quality of life they might otherwise have chosen for
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  Speaker 1: themselves than they would have if they'd never received that label.
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  Speaker 1: Like if they had believed for themselves that I can
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  Speaker 1: be anything I want to be, I can have whatever
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  Speaker 1: life I choose to be, versus I am a person
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  Speaker 1: who cannot succeed because of my diagnosis, or I can
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  Speaker 1: only succeed in a limited capacity. That to me, I
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  Speaker 1: think I find very troublesome about this system. And definitely
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  Speaker 1: one of the places where I see it doing more
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  Speaker 1: harm than it might be doing good.
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  Speaker 3: Yeah, I think that it's not a net negative per se.
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  Speaker 3: I think these things can be good or bad, right?
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  Speaker 3: And you might think of these in terms of like
• 10:08
  Speaker 3: cognitive fusion. So like a process of thinking of oneself
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  Speaker 3: in one particular way. Fusion can be good. Fusion can
• 10:14
  Speaker 3: be like, I'm a dad and that's really important part
• 10:17
  Speaker 3: of my identity. And that's how I go about facing
• 10:20
  Speaker 3: the world. But there are lots of ways and it's
• 10:23
  Speaker 3: easy to imagine. And I've seen a lot of, okay,
• 10:27
  Speaker 3: we need to get you out of the frame of
• 10:29
  Speaker 3: mind that you can't read because you have dyslexia or
• 10:32
  Speaker 3: you can't get out of bed because you have depression.
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  Speaker 3: And we have to like break the fusion between this
• 10:39
  Speaker 3: thing as an identity. And this thing as something that
• 10:43
  Speaker 3: you're dealing with that isn't part of who you are,
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  Speaker 3: but part of how you're interacting with your environment. I
• 10:49
  Speaker 3: have an example that's kind of, you know, it feels
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  Speaker 3: almost like feels a little incendiary, but I don't, you know,
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  Speaker 3: I think if you boil it down, it's actually really
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  Speaker 3: compassionate from my view. And it is, I worked with
• 11:02
  Speaker 3: a school and they had a, the saying of the
• 11:05
  Speaker 3: school was autism is not an excuse for lowered expectations. Ooh, girl,
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  Speaker 3: like it. I mean, I just like, I was, I
• 11:15
  Speaker 3: remember thinking like, how did you even get away with that? Right. Like,
• 11:18
  Speaker 3: and that feels, I, I tend to agree with it
• 11:23
  Speaker 3: in the sense that, um, In that one, people tend
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  Speaker 3: to take this biologically deterministic view. So too do professionals
• 11:33
  Speaker 3: who work with that person, right? Like, so the person
• 11:35
  Speaker 3: themselves can be biologically deterministic about, I can't do this
• 11:39
  Speaker 3: because my biology won't let me. so do other people
• 11:43
  Speaker 3: who work with them. And that's a limiting factor. And
• 11:46
  Speaker 3: so I tend to look at that saying as like,
• 11:49
  Speaker 3: we are going to hold ourselves accountable and we, you
• 11:51
  Speaker 3: should expect great things out of your son or daughter
• 11:55
  Speaker 3: when they attend our program, because we're going to hold
• 11:57
  Speaker 3: ourselves to account because we think that although autism is
• 12:01
  Speaker 3: a thing and we interact with it in some way,
• 12:03
  Speaker 3: and it has some pragmatic utility as a term, We
• 12:07
  Speaker 3: also are going to push, right, when we're going to
• 12:10
  Speaker 3: like see where the boundaries of this thing are. And
• 12:13
  Speaker 3: we are accountable to the student, not just existing in
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  Speaker 3: this school and not hitting other kids, but thriving and
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  Speaker 3: learning and growing. And I think part of the, you know,
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  Speaker 3: the other side of that biologically deterministic thing. implication of
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  Speaker 3: a protocol for syndromes approach to mental wellness is a
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  Speaker 3: lot of people can give up on you and nobody
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  Speaker 3: blames them. Nobody says like, you know, like, Oh, my
• 12:37
  Speaker 3: kid can't read because he has dyslexia. The teachers can't
• 12:39
  Speaker 3: teach him. That's just, that was just never going to happen. Yeah. Whereas,
• 12:44
  Speaker 3: you know, you being in the business that you're in,
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  Speaker 3: you've probably met what, like 65 kids with dyslexia and
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  Speaker 3: I can't imagine it's ever amounted to much. Because you're
• 12:53
  Speaker 3: accountable to like, what do I need to do to
• 12:56
  Speaker 3: move this kid forward based on the things that I'm
• 12:58
  Speaker 3: seeing at the level of the individual? It's never, and
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  Speaker 3: I can tell you this for sure. It's never been
• 13:03
  Speaker 3: an excuse as to why you're not making progress, right?
• 13:07
  Speaker 3: It's never been, we're not making progress because dyslexia. And
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  Speaker 3: that's not to say that dyslexia isn't like descriptive of something,
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  Speaker 3: but it's not getting you off the hook as a practitioner.
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  Speaker 3: And I think that has happened as a byproduct of
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  Speaker 3: this approach and this stance.
• 13:23
  Speaker 1: Yeah, yeah. It definitely does seem to in a lot of...
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  Speaker 1: And including the people who have the diagnosis themselves, thinking, again, now,
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  Speaker 1: this is a can't for me. I'll never be able to.
• 13:34
  Speaker 1: And yeah, you're exactly right. Of all the people I've
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  Speaker 1: met with dyslexia diagnosis, there are... Boy, I'm gonna get
• 13:42
  Speaker 1: myself in some hot water here. But maybe two that
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  Speaker 1: I felt like actually... that was descriptively predictive of their
• 13:52
  Speaker 1: struggle to acquire reading skills. It did not mean that
• 13:55
  Speaker 1: they couldn't acquire reading skills. It just meant it was
• 13:58
  Speaker 1: a lot more challenging than other that I have faced,
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  Speaker 1: despite the many people who have had those diagnoses where
• 14:02
  Speaker 1: it was like, here's structured reading curriculum. Oh, they're reading
• 14:05
  Speaker 1: just fine. Great job done. But there was maybe two
• 14:09
  Speaker 1: where I was like, oh, we actually need to do
• 14:10
  Speaker 1: quite a bit more work to identify what are the
• 14:13
  Speaker 1: steps that need to work for this individual to help
• 14:15
  Speaker 1: get them to the point where they're reading more effectively.
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  Speaker 3: Yeah.
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  Speaker 1: Than they currently are, I guess. And, and at the
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  Speaker 1: point that gets them to the point where this is
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  Speaker 1: just a, it feels easier to them and it's not
• 14:25
  Speaker 1: much of a struggle, but the people around them often
• 14:29
  Speaker 1: have that very limited, like, well, but does this work
• 14:32
  Speaker 1: with kids with dyslexia? I'm like, does science work? Yes,
• 14:35
  Speaker 1: it does. It still works. Yeah. Like when we, when
• 14:39
  Speaker 1: the process, we take the process based approach, It works.
• 14:42
  Speaker 1: It just does. So, and actually I feel like that
• 14:45
  Speaker 1: in the sake of time, I think we need to
• 14:47
  Speaker 1: sort of segue and collapse a couple of discussions into one,
• 14:49
  Speaker 1: which is the sort of, is there a way out
• 14:51
  Speaker 1: of this? And where do we go from here? And
• 14:54
  Speaker 1: we've been talking about it this whole time. And I,
• 14:56
  Speaker 1: but really quick devil's advocate thing I want to throw
• 14:58
  Speaker 1: in there is the, that I, if we have time,
• 15:01
  Speaker 1: I'd love for you to maybe provide a counterpoint to this.
• 15:05
  Speaker 1: is I think there is a very realistic argument that
• 15:09
  Speaker 1: a lot of people who are very pragmatic would make
• 15:12
  Speaker 1: about the diagnostic system, which is that the diagnostic system
• 15:17
  Speaker 1: creates a pathway by which people can get access to
• 15:20
  Speaker 1: services that they would otherwise not have access to and
• 15:24
  Speaker 1: would potentially benefit from. Yeah, and I.
• 15:26
  Speaker 3: Don't disagree with that. I don't think that these systems
• 15:29
  Speaker 3: are without their utility. I mean... If you get a
• 15:32
  Speaker 3: couple of drinks in me and I say they have
• 15:34
  Speaker 3: done more harm than good, it could be close, right?
• 15:38
  Speaker 3: It could be kind of close. And that is to
• 15:41
  Speaker 3: say that they have done good. And I think that
• 15:44
  Speaker 3: if we can get some compassion and a way forward
• 15:47
  Speaker 3: for people, that certainly has happened inside of the system, right?
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  Speaker 3: And if these diagnoses are a way to get people
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  Speaker 3: into programs that are effective at treating what's happening, then great.
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  Speaker 3: So yeah, I don't necessarily disagree with that statement, but
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  Speaker 3: I would say that when you're in the chair, when
• 16:06
  Speaker 3: you are the practitioner and you've learned person has XYZ disorders,
• 16:12
  Speaker 3: I tend to call those things minimally orienting to issues
• 16:16
  Speaker 3: of cancer. I need to know about 500,000 more things
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  Speaker 3: about you, about your culture, about your household, about the
• 16:25
  Speaker 3: expectations that you're under, about your reinforcers, about a billion
• 16:29
  Speaker 3: other things that that I need to figure out about
• 16:32
  Speaker 3: you before I'm able to leverage an effective treatment. So,
• 16:35
  Speaker 3: you know, again, when somebody asks online, what's an effective
• 16:38
  Speaker 3: treatment for dyslexia? The only answer is I don't know
• 16:42
  Speaker 3: for that person, but there's a lot of questions that
• 16:46
  Speaker 3: I would have you ask that are going to get
• 16:48
  Speaker 3: you closer to an effective solution. And so, yeah, it's
• 16:52
  Speaker 3: a fine starting point. And if, if these things lead
• 16:56
  Speaker 3: to effective interventions and, I tend to think that those
• 16:59
  Speaker 3: effective interventions are going to be more process-based. And in
• 17:03
  Speaker 3: my experience of effective clinicians, they are. But if it's
• 17:07
  Speaker 3: what gets a foot in the door, great. But there's
• 17:10
  Speaker 3: also sort of downfalls to that. Like autism means God
• 17:14
  Speaker 3: knows what right now. Because just logically, any compassionate psychologist
• 17:20
  Speaker 3: who wants a person to receive effective treatment or effective
• 17:23
  Speaker 3: access to some service, call it autism. And that is
• 17:27
  Speaker 3: a rational thing to do.
• 17:29
  Speaker 1: Yeah, it's practical.
• 17:31
  Speaker 3: As such, if you tell me that I'm meeting with
• 17:34
  Speaker 3: a new client today and all I know about them
• 17:36
  Speaker 3: is that they have autism, I don't know about that person. Like,
• 17:40
  Speaker 3: it could mean any number of things. And, you know,
• 17:44
  Speaker 3: so I tend to say, like, these things can be
• 17:46
  Speaker 3: minimally orienting at their best. Awesome.
• 17:50
  Speaker 1: That makes a lot of sense. And ads are minimally
• 17:52
  Speaker 1: useful at their best. Okay, let's go ahead and let's
• 18:03
  Speaker 1: try and wrap this one up essentially with a discussion
• 18:05
  Speaker 1: of like, as you said, more harm than good doesn't
• 18:07
  Speaker 1: mean zero good. It just means that we feel like
• 18:10
  Speaker 1: the weight of the problems that have been created is
• 18:13
  Speaker 1: greater than the weight of the solutions that have maybe
• 18:15
  Speaker 1: been created. But that being said, there is probably a
• 18:20
  Speaker 1: way we can continue to move forward as a field,
• 18:24
  Speaker 1: as a country, as a species to help ourselves, help
• 18:29
  Speaker 1: each other with some of these approaches. So let's enumerate
• 18:32
  Speaker 1: a few of those approaches and what that would look like.
• 18:35
  Speaker 3: So something to be on the lookout for, it's newfangled
• 18:39
  Speaker 3: and it's in a very small pocket of the science
• 18:41
  Speaker 3: right now, but I think it's going to grow in popularity,
• 18:43
  Speaker 3: is science. Idionomic approaches to psychological distress. So idio again
• 18:50
  Speaker 3: means starting at the level of the individual. So if
• 18:52
  Speaker 3: you remember that ergodic theorem thing, you cannot start at
• 18:55
  Speaker 3: the level of the collective. and boil it down to
• 18:58
  Speaker 3: the level of the individual that is mathematically incorrect to
• 19:01
  Speaker 3: do every time. So if you work with individuals, you
• 19:04
  Speaker 3: can't do that. You have to start at the individual level.
• 19:07
  Speaker 3: And then what behavior analysis has struggled to do is
• 19:10
  Speaker 3: then translate that thing into something that is a broad
• 19:13
  Speaker 3: principle that other people can then draw from and adapt
• 19:16
  Speaker 3: their practice around. But that is those limiting factors and
• 19:20
  Speaker 3: the kinds of things that kept us from being able
• 19:22
  Speaker 3: to do that, I tend to think are becoming less
• 19:26
  Speaker 3: frequent or less problematic, let's say. So there used to
• 19:30
  Speaker 3: be statistical models that, you know, again, statisticians revolved around
• 19:35
  Speaker 3: selection at the level of the population. That's kind of
• 19:38
  Speaker 3: built into statistical models. But there are statistical models that
• 19:41
  Speaker 3: are coming out that start at the level of the individual.
• 19:44
  Speaker 3: For example, group iterative multimodal estimation or GIMI is one
• 19:50
  Speaker 3: that tries to group populations together somewhat organically. So I
• 19:55
  Speaker 3: only say that you're a member of this population and
• 19:58
  Speaker 3: that this treatment will be effective for you when you've
• 20:00
  Speaker 3: demonstrated to me that you are a member of that
• 20:03
  Speaker 3: population according to the processes. So... That sounds crazy, but
• 20:08
  Speaker 3: I'll give you an example that came out of our lab.
• 20:10
  Speaker 3: One of my colleagues, Dr. Brandon Sanford, did a study
• 20:14
  Speaker 3: on burnout. Burnout, as you might imagine, although it's not
• 20:17
  Speaker 3: a true blue DSM diagnosis, is something that you could reasonably,
• 20:24
  Speaker 3: in the field of psychology, ask the same kinds of
• 20:26
  Speaker 3: questions of. Does ACT work for burnout? Right. And we
• 20:31
  Speaker 3: treat it as one thing. And then we say there's
• 20:33
  Speaker 3: some kind of treatment or some model or set of
• 20:35
  Speaker 3: protocols that we can throw at that thing that then
• 20:37
  Speaker 3: allow us to be more effective at orienting to it. Well,
• 20:40
  Speaker 3: Brandon asked a different question. He said, we're going to
• 20:43
  Speaker 3: take a bunch of people who report having burnout and
• 20:46
  Speaker 3: we're going to ask the question, are they the same?
• 20:48
  Speaker 3: And is their process the same? And would we be
• 20:51
  Speaker 3: right in prescribing a similar treatment to them? Right. And
• 20:55
  Speaker 3: so he grabbed a bunch of people with burnout. And
• 20:58
  Speaker 3: one of the things that kind of sucks about process-based
• 21:00
  Speaker 3: stuff is that you need a lot of data points
• 21:02
  Speaker 3: at the level of the individual. So you need like
• 21:04
  Speaker 3: time series stuff. So he had all these people install
• 21:07
  Speaker 3: apps on their phone and the app would ask them
• 21:10
  Speaker 3: things like three, four times a day. Like, how are
• 21:12
  Speaker 3: you feeling? How was your night? How did it prepare
• 21:15
  Speaker 3: you for this morning? What are you thinking? What are
• 21:17
  Speaker 3: you looking forward to? Right. All these kinds of random
• 21:19
  Speaker 3: questions that are designed to sort of understand the process
• 21:23
  Speaker 3: of burnout that they're experiencing. And across 36 people, there
• 21:28
  Speaker 3: were very few people who had similar kinds of burnout
• 21:31
  Speaker 3: to our point. This is what we might expect. And
• 21:34
  Speaker 3: their process of burnout was unique to them. But I
• 21:37
  Speaker 3: think what was somewhat surprising to us is if you
• 21:39
  Speaker 3: just look at it logically, what might be therapeutic to
• 21:43
  Speaker 3: one person could be counter-therapeutic to another person. So let's
• 21:47
  Speaker 3: take two people. We've got rick and rick is claiming
• 21:52
  Speaker 3: he's experiencing burnout what he has a really stressful job
• 21:56
  Speaker 3: he goes to work he puts his head down he
• 21:58
  Speaker 3: does everything he can he's he's on a path he
• 22:00
  Speaker 3: believes in what he's doing he likes his company he's
• 22:03
  Speaker 3: living he's serving his values and then when he comes
• 22:06
  Speaker 3: home he has too many beers he unwinds in ways
• 22:11
  Speaker 3: that are unhealthy let's say he drinks too much smokes
• 22:15
  Speaker 3: weed and plays video games in a way that is
• 22:18
  Speaker 3: hurting his relationship with his family, right? Let's say that
• 22:22
  Speaker 3: he's saying like, oh, hell yeah, I'm burnt out. I
• 22:24
  Speaker 3: wake up, I'm tired, right? It very logically could end
• 22:27
  Speaker 3: up in a space where he's identifying this as burnout.
• 22:30
  Speaker 3: My job is burning me out and I have to
• 22:32
  Speaker 3: come home and engage in this ritual that, you know,
• 22:34
  Speaker 3: is pushing me up from the things that are important
• 22:37
  Speaker 3: to me. Well, values clarification might be really effective for Rick,
• 22:42
  Speaker 3: did I say? For Rick, right? But like Rick might
• 22:46
  Speaker 3: need some values clarification. Like, hey, I know you feel
• 22:48
  Speaker 3: or like some cognitive diffusion. Like, I know you're saying like,
• 22:52
  Speaker 3: I have to unwind. You do not have to unwind
• 22:55
  Speaker 3: in this way. And it's putting you on a path
• 22:57
  Speaker 3: and it's having you interact with a process that is
• 22:59
  Speaker 3: pushing you away from the things that are important to you.
• 23:01
  Speaker 3: And it's going to lead to bad outcomes soon if
• 23:03
  Speaker 3: it hasn't already. And then you have Susie. And Susie
• 23:08
  Speaker 3: is going to work and she's at a dead end job.
• 23:10
  Speaker 3: She doesn't work that hard. She mails it in. She
• 23:13
  Speaker 3: knows what's important to her. She understands very clearly what's
• 23:16
  Speaker 3: important to her. And that's part of what's burning her
• 23:18
  Speaker 3: out because she recognizes her job as dead end. It
• 23:22
  Speaker 3: is not leading to fruitful things. She feels patronized by
• 23:25
  Speaker 3: the tasks that she does every day. She feels like
• 23:27
  Speaker 3: she's capable of more and she wants to change the world.
• 23:29
  Speaker 3: But she's in a space where that's not possible right
• 23:31
  Speaker 3: now because financial constraints, family, those kinds of things. Now,
• 23:36
  Speaker 3: if you were to do the same treatment that you
• 23:39
  Speaker 3: did with Rick, I would argue that that's likely to
• 23:42
  Speaker 3: be counter therapy. with Susie. If you were to do
• 23:44
  Speaker 3: values clarification with somebody who's experiencing burnout as a function of,
• 23:49
  Speaker 3: I don't get to do the things that are important
• 23:51
  Speaker 3: to me ever. And you sit them down for like
• 23:53
  Speaker 3: half an hour and you're like, let's do values. They're
• 23:55
  Speaker 3: just going to be more present with like, oh yeah,
• 23:59
  Speaker 3: I really want to do this, but that's unavailable to me.
• 24:02
  Speaker 3: And so like, what is therapeutic for one person could
• 24:06
  Speaker 3: be counter therapeutic to another. And when you average it out,
• 24:11
  Speaker 3: It looks like this thing is a net positive for
• 24:13
  Speaker 3: most people, but oftentimes when we look at those kinds
• 24:16
  Speaker 3: of studies, there's like probably 40% of people for which
• 24:20
  Speaker 3: they experienced negative outcomes or it was counter-therapeutic. That's very
• 24:24
  Speaker 3: common in that kind of literature. So I forgot what
• 24:28
  Speaker 3: the original question is, but I think that paints the
• 24:30
  Speaker 3: picture of like, you can't call burnout one thing. If
• 24:34
  Speaker 3: you don't understand at the level of the process, you
• 24:36
  Speaker 3: risk doing things that are explicitly counter-therapeutic. And those things
• 24:41
  Speaker 3: are available to us now. So like we used to
• 24:44
  Speaker 3: listen to the radio and the radio kind of sucked.
• 24:46
  Speaker 3: You recommended Protest the Hero. Protest the Hero was maybe
• 24:49
  Speaker 3: on the radio like a handful of times on some
• 24:51
  Speaker 3: like armpit stations, you.
• 24:53
  Speaker 1: Know, like something alternative and hard to find.
• 24:56
  Speaker 3: Right. Like, but most of the, if you want, if
• 24:58
  Speaker 3: you're into metal, guess what? You like Metallica and Nickelback.
• 25:01
  Speaker 3: Like that is, that is what's available to you on
• 25:03
  Speaker 3: the radio. And that is not something that would satisfy you, right?
• 25:08
  Speaker 3: But now we live in an era where listening to
• 25:11
  Speaker 3: the radio, I can't imagine what I would do if
• 25:14
  Speaker 3: I walked into a car and somebody listened to the
• 25:15
  Speaker 3: radio still. What are you doing? There's so much more
• 25:19
  Speaker 3: ways to tailor the things that are important to you
• 25:21
  Speaker 3: to the things that scratch that itch. So we live
• 25:26
  Speaker 3: in a world where the expectation of tailoring things to
• 25:30
  Speaker 3: the individual is not crazy anymore. it used to be
• 25:34
  Speaker 3: kind of crazy because it just seemed impractical. It still
• 25:36
  Speaker 3: is somewhat like the dropout rates of idiot. Idiomic studies
• 25:41
  Speaker 3: is really high. A lot of people are like, fuck this.
• 25:43
  Speaker 3: I got to check in on my phone every day.
• 25:45
  Speaker 3: That sucks. I'm going to, so like the attrition on
• 25:48
  Speaker 3: studies like that goes up and there's challenges to be
• 25:50
  Speaker 3: had here. But what you end up with at the
• 25:53
  Speaker 3: end of the day, if you do it right is,
• 25:55
  Speaker 3: you know what? Susie's like, I'm calling this burnout because
• 25:59
  Speaker 3: I'm not contacting values. She looks a lot like, you know,
• 26:02
  Speaker 3: this person over there, the rock, right? She looks a
• 26:05
  Speaker 3: lot like the rock and the rock is experiencing something
• 26:08
  Speaker 3: different as well. And Gaston over here, he looks more
• 26:12
  Speaker 3: like Rick. And if we put them in a group together,
• 26:15
  Speaker 3: they would actually have a lot of overlap in terms
• 26:17
  Speaker 3: of the kinds of treatment processes that would be effective
• 26:20
  Speaker 3: for them both. And so it's not that we can't
• 26:23
  Speaker 3: lump people together and we can't treat people as populations.
• 26:27
  Speaker 3: It's just that we have to do so starting at
• 26:29
  Speaker 3: the individual level. And we have to demonstrate that they
• 26:31
  Speaker 3: are part of the same group. We can't just say population.
• 26:35
  Speaker 3: But you can go bottom up. So that's what I'm
• 26:38
  Speaker 3: pushing for in the field is more studies, more things
• 26:42
  Speaker 3: that hold the level of the individual sacred, and then
• 26:47
  Speaker 3: try to move things into more broad principles. And, Statistical models, algorithms,
• 26:54
  Speaker 3: as you can imagine, just like your standard nod to
• 26:57
  Speaker 3: AI these days is something that is magically going to
• 27:01
  Speaker 3: solve this problem for us. Maybe, you know, like there
• 27:04
  Speaker 3: are ways that we can hold the level of the
• 27:06
  Speaker 3: individual sacred and boil it up to the level of
• 27:09
  Speaker 3: the individual. We're getting much more sophisticated at that. And
• 27:12
  Speaker 3: that's true in medicine too. So precision medicine is not
• 27:14
  Speaker 3: a crazy idea. It used to be we treat cancer
• 27:18
  Speaker 3: at the level of the population. It's not crazy to
• 27:21
  Speaker 3: go to certain places and find that they're not interested
• 27:24
  Speaker 3: in treating cancer. They're interested in treating your cancer. And
• 27:27
  Speaker 3: they measure different things and they look at different processes
• 27:30
  Speaker 3: and they want to see how you're responding and what
• 27:32
  Speaker 3: you're doing that's specific to your biology. This notion of
• 27:36
  Speaker 3: like starting at the level of the individual and holding
• 27:38
  Speaker 3: that sacred is not crazy. I'm not that far on
• 27:42
  Speaker 3: an island. I am on an island and I do
• 27:44
  Speaker 3: sound pseudoscientific at times, but there is a pretty substantial
• 27:49
  Speaker 3: evidence base that I think is coming on like a
• 27:51
  Speaker 3: freight train. And I think fence fits modern sensibilities and
• 27:54
  Speaker 3: modern technologies in such a way that this isn't a
• 27:57
  Speaker 3: crazy idea.
• 27:58
  Speaker 1: Yeah. Here's an ad for that. Yeah. All right, we're back.
• 28:09
  Speaker 1: I think we're getting close here, too. Would it be
• 28:12
  Speaker 1: fair to say in your description of process-based approach, help
• 28:15
  Speaker 1: people wrap their head around what that actually means, that
• 28:19
  Speaker 1: what we're talking about here is that it is looking
• 28:23
  Speaker 1: at a variety of factors and allowing it to be
• 28:27
  Speaker 1: dynamic so that whatever you are assessing, whatever you're trying
• 28:30
  Speaker 1: to introduce as an intervention, whatever Like they essentially roll
• 28:34
  Speaker 1: with the changes as they happen. It's not just administer
• 28:37
  Speaker 1: this thing and it just does what it does. It's
• 28:39
  Speaker 1: like as this intervention is doing this thing, all of
• 28:44
  Speaker 1: a sudden a new way that this person is presenting
• 28:47
  Speaker 1: is starting to show up. And so we can either
• 28:50
  Speaker 1: ease back on something or we can push harder on
• 28:52
  Speaker 1: something or we can introduce something new. But it's looking
• 28:55
  Speaker 1: at like how is this– The process is that it's
• 29:00
  Speaker 1: individually tailored to you, and it's individually tailored to you
• 29:03
  Speaker 1: in a dynamic way that adjusts as needed in an
• 29:06
  Speaker 1: ongoing way. And obviously, the goal is to, as much
• 29:10
  Speaker 1: as possible in most things, to fade that out. That
• 29:13
  Speaker 1: what we want to have happen is you only have
• 29:15
  Speaker 1: this process in as long as you need that process.
• 29:17
  Speaker 1: For some people, that might be a really, really long time.
• 29:20
  Speaker 1: But for some people, it might just be like once
• 29:21
  Speaker 1: you've gotten sort of on a slightly different trajectory, all
• 29:24
  Speaker 1: the sort of natural things in your world pick up
• 29:26
  Speaker 1: from there and they'll kind of carry it forward without
• 29:29
  Speaker 1: you really needing me anymore. And then most people will
• 29:32
  Speaker 1: fall on some spectrum of that where it's like indefinite
• 29:36
  Speaker 1: need for continued support versus the individual. But point being that. like,
• 29:40
  Speaker 1: it's essentially custom tailored to identify variables that are relevant
• 29:46
  Speaker 1: in a dynamic way. Does that sound like an appropriate
• 29:48
  Speaker 1: way to describe that?
• 29:49
  Speaker 3: Yeah. And to put it very loosely, I've used a
• 29:52
  Speaker 3: couple of metaphors. They're imperfect. One is we don't, in psychology,
• 29:56
  Speaker 3: you don't make sweatpants that are designed to fit. everybody
• 29:59
  Speaker 3: or like have three sizes, right? You got, or even
• 30:02
  Speaker 3: five sizes. You are a tailor. Your job is to
• 30:06
  Speaker 3: tailor something to somebody's tastes and to their measurements. And
• 30:10
  Speaker 3: that is a very different game. The other analogy is
• 30:14
  Speaker 3: if you were a chef, you are not cooking out
• 30:16
  Speaker 3: of a recipe book. You are like on top chef
• 30:19
  Speaker 3: or chopped where you're given a set of ingredients that
• 30:23
  Speaker 3: is unfamiliar and foreign to you. And your job is
• 30:25
  Speaker 3: to make it make sense, knowing what you know about food. Right.
• 30:29
  Speaker 3: It's not like you turn everything into lasagna because you
• 30:33
  Speaker 3: have a recipe for lasagna. You're not going to do
• 30:36
  Speaker 3: very well on those shows if that's how you treat
• 30:38
  Speaker 3: your approach. And I would argue the same is true
• 30:41
  Speaker 3: of good psychologists. In my experience, good psychologists get weird
• 30:45
  Speaker 3: ingredients and they're like, oh, I know what, you know,
• 30:48
  Speaker 3: in the same way that a chef understands that. Like.
• 30:52
  Speaker 3: Acid cuts fat, you know, like and here's how if
• 30:56
  Speaker 3: you were to whip this, it would create some effect
• 30:59
  Speaker 3: that is nice. Right. And fits well with this thing.
• 31:03
  Speaker 3: It feels less sciencey. Right. When you're not giving a
• 31:07
  Speaker 3: just oddly, it feels more artsy fartsy like you're doing
• 31:10
  Speaker 3: something artistic. But I would argue that those things are sciencey, too.
• 31:15
  Speaker 3: They're just not what we're used to being science. We're
• 31:17
  Speaker 3: used to, so, you know, one thing my advisor said
• 31:21
  Speaker 3: at a recent conference was we're used to asking the
• 31:25
  Speaker 3: question about evidence-based practice, but we need to start asking
• 31:28
  Speaker 3: about practice-based evidence. So basically like we sort of know
• 31:35
  Speaker 3: that psychologists do a lot of things at the level
• 31:37
  Speaker 3: of process. It's not crazy. to say like we adapt
• 31:41
  Speaker 3: and change to our people. We just need scientific bodies
• 31:45
  Speaker 3: of evidence that support that way of doing things. And
• 31:49
  Speaker 3: that is what's lacking. And I think that we're entering
• 31:52
  Speaker 3: an era where that is very much possible, both in
• 31:56
  Speaker 3: scary ways and in cool ways. And I'd like to
• 31:59
  Speaker 3: see more of it. And for those members of your
• 32:02
  Speaker 3: audience that are behavior analytically minded, I think particularly so
• 32:05
  Speaker 3: because you already kind of have an affinity and you
• 32:07
  Speaker 3: already kind of If I can make the assumption, you've
• 32:10
  Speaker 3: already kind of detected there's something wrong with going top down.
• 32:13
  Speaker 3: You know, like when you have a person in front
• 32:16
  Speaker 3: of you, you are problem solving, you are changing, you
• 32:18
  Speaker 3: are dynamic and you are interacting with a dynamic system.
• 32:22
  Speaker 3: And that's what's exciting about the science to you. If
• 32:25
  Speaker 3: I can be so bold as to assume that about you.
• 32:28
  Speaker 1: I would say that one of my favorite things about
• 32:30
  Speaker 1: my job is when it's, The data will tell you
• 32:33
  Speaker 1: one thing, but just like sitting across from somebody and
• 32:36
  Speaker 1: interacting with them and saying, oh, I see. I think
• 32:38
  Speaker 1: I see what you're doing here that's gotten in the way.
• 32:41
  Speaker 1: And like I could tell from the data that things
• 32:42
  Speaker 1: aren't going the way that it would like ideally they'd
• 32:44
  Speaker 1: be going. But I can't tell what that thing is
• 32:47
  Speaker 1: until I've observed. And now I can say, OK, let's
• 32:50
  Speaker 1: try a slightly different approach to this this way and
• 32:53
  Speaker 1: then see what happens. And that's the like the fun
• 32:56
  Speaker 1: part is the like I want to. I think I'm
• 33:00
  Speaker 1: gleaning something from our interaction here that tells me that
• 33:04
  Speaker 1: I sense where a deficit might exist or where just
• 33:08
  Speaker 1: a slightly different amount of coaching or approach to this
• 33:10
  Speaker 1: could actually make the difference for you and being able
• 33:12
  Speaker 1: to get over the sort of threshold that you seem
• 33:14
  Speaker 1: to be stuck at. And yeah, and I think that
• 33:17
  Speaker 1: that was a very, very, very difficult skill to train.
• 33:20
  Speaker 3: It is.
• 33:21
  Speaker 1: That comes from a ton of experience and like coaching
• 33:24
  Speaker 1: and feedback and collaborating.
• 33:25
  Speaker 3: I have to believe it's possible. I think we haven't
• 33:28
  Speaker 3: done it. We don't have a lot of effective strategies
• 33:31
  Speaker 3: for teaching it and we haven't felt an imperative to
• 33:34
  Speaker 3: teach it. But I think if we do, there are
• 33:37
  Speaker 3: ways forward. It's not like, I think there's a tendency
• 33:40
  Speaker 3: to go towards... Like there are people who get it
• 33:43
  Speaker 3: and people who don't. I don't think that that is true.
• 33:45
  Speaker 3: I think there are ways to get people to see
• 33:47
  Speaker 3: these things. And, you know, the old unks of behavior
• 33:51
  Speaker 3: analysis that are like, you need to shape a chicken
• 33:54
  Speaker 3: before you can work with a kid. You know, like
• 33:57
  Speaker 3: they have some there's some sense to that.
• 33:59
  Speaker 2: Right.
• 34:00
  Speaker 3: Like the ability to shape the ability to move with
• 34:02
  Speaker 3: and adapt and adjust and. and be amenable to and
• 34:06
  Speaker 3: be the thing that's needed in that moment is, is
• 34:09
  Speaker 3: a skill and it is a difficult skill to your point. And,
• 34:12
  Speaker 3: but I think where I tend to disagree with colleagues
• 34:16
  Speaker 3: and other people is in the notion that I believe
• 34:19
  Speaker 3: it is deeply teachable.
• 34:20
  Speaker 1: Yeah.
• 34:21
  Speaker 3: It's just, we're not used to doing it that way.
• 34:23
  Speaker 4: Yeah.
• 34:25
  Speaker 1: I do think it's, um, I just think it's difficult
• 34:27
  Speaker 1: to do. Yeah.
• 34:30
  Speaker 3: And it also, I mean, it creates a level of
• 34:32
  Speaker 3: expectation for the job that I think is a little scary, right?
• 34:36
  Speaker 3: Like the idea that you take your problems home with you,
• 34:39
  Speaker 3: that you think about what you could do next, that
• 34:42
  Speaker 3: you're ready for some inevitable turn in your session next. Like,
• 34:47
  Speaker 3: I think people who are good, in my experience, they
• 34:51
  Speaker 3: have that burden and they have to find ways to
• 34:54
  Speaker 3: unburden themselves of those things. Because, you know, if... If
• 34:58
  Speaker 3: we live in a world of interactional determinism, there's always
• 35:01
  Speaker 3: a way forward. And if it's not happening, it's your fault, right?
• 35:06
  Speaker 3: And that is heavy. And that's something you got to
• 35:09
  Speaker 3: put down sometimes. And I think that that is a
• 35:12
  Speaker 3: challenge that we face as well.
• 35:14
  Speaker 1: Very fair. Is there any sort of closing things you'd
• 35:19
  Speaker 1: like to leave with before we sort of transition to
• 35:22
  Speaker 1: our closing?
• 35:23
  Speaker 2: You're a chef.
• 35:24
  Speaker 3: You don't cook out of a cookbook. Remember that and
• 35:26
  Speaker 3: you're going to be okay.
• 35:28
  Speaker 1: Very nice. All right, very good. Well, so that's the
• 35:32
  Speaker 1: argument there. Thank you, everyone, for listening. We'll go ahead
• 35:34
  Speaker 1: and let's... Let everyone know that we're going to be
• 35:38
  Speaker 1: doing some recommendations at the end of this, which is
• 35:40
  Speaker 1: a fun thing that we do just to recommend some
• 35:41
  Speaker 1: fun things because it's fun. And I'm also going to
• 35:44
  Speaker 1: go through our credits and everything and ask you to
• 35:47
  Speaker 1: support us in various ways. So ready, set, go. If
• 35:50
  Speaker 1: you'd like to support us, you can join us on Patreon.
• 35:52
  Speaker 1: If you do that, you'll get bonus content, ad-free content,
• 35:54
  Speaker 1: early episodes, and I will shout out your name in
• 35:56
  Speaker 1: the list of people who have taken the leap to
• 35:58
  Speaker 1: support us. So a giant shout out and thank you to...
• 36:01
  Speaker 1: Mike M, Megan, Mike T, Justin, Kim, Brad, Stephanie, Brian, Kiara, Charlie,
• 36:06
  Speaker 1: and Michael for all of your support and helping us
• 36:09
  Speaker 1: be a podcast. We appreciate it.
• 36:11
  Speaker 2: Yes, you all are the best forever.
• 36:12
  Speaker 1: Thank you to my team of people for without whom
• 36:15
  Speaker 1: I could not make this podcast writing and fact checking
• 36:17
  Speaker 1: from Shane and myself. And thank you for joining us
• 36:19
  Speaker 1: again for part two today, Stu.
• 36:21
  Speaker 3: Yeah.
• 36:22
  Speaker 1: Our social media coordinator is Emma Wilson. And our person
• 36:24
  Speaker 1: who managed to stitch together all of this content into
• 36:26
  Speaker 1: a cohesive unit is Justin, who is the best ever.
• 36:28
  Speaker 1: And we appreciate you. Thank you, Justin.
• 36:30
  Speaker 2: Justin's the best too.
• 36:31
  Speaker 1: And of course, thank you everyone for listening. All right.
• 36:33
  Speaker 1: I think that is what I have to say before
• 36:35
  Speaker 1: we transition to our recommendations. Oh, there's other ways to
• 36:38
  Speaker 1: support us. I sort of skimmed past. You can leave
• 36:40
  Speaker 1: us a rating and review. Those are free. You can like, subscribe,
• 36:43
  Speaker 1: tell a friend. And if you'd like to offer some
• 36:45
  Speaker 1: constructive criticism, you can email us directly at info at WWD,
• 36:49
  Speaker 1: WWD podcast.com. If you'd like to just tell us how
• 36:52
  Speaker 1: much you suck and how much you hate us, go
• 36:53
  Speaker 1: ahead and go to your nearest garbage can and yell
• 36:55
  Speaker 1: into it as long as you like, as loud as
• 36:56
  Speaker 1: you like. And I will get just as much out
• 36:59
  Speaker 1: of that. Otherwise, I look forward to hearing from people
• 37:02
  Speaker 1: and you can reach us on the social media platforms.
• 37:03
  Speaker 1: Now I think we're ready to transition to recommending some things.
• 37:07
  Speaker 2: I like it.
• 37:07
  Speaker 1: All right, let's do it. I'm recommending a card game.
• 37:20
  Speaker 1: This is not the heaviest game in the world. This
• 37:24
  Speaker 1: is a game called Flip 7. It's fairly new on
• 37:26
  Speaker 1: the scene. It has really sort of... It has gained
• 37:29
  Speaker 1: popularity at remarkable speed, which is kind of a red
• 37:32
  Speaker 1: flag sometimes. But it is a sort of push-your-luck style
• 37:36
  Speaker 1: card game.
• 37:37
  Speaker 2: Sort of.
• 37:38
  Speaker 1: It has like... You could see the DNA of Uno
• 37:41
  Speaker 1: in it, if Uno was a good game, and DNA
• 37:45
  Speaker 1: of Blackjack a little bit. The premise of the game, essentially,
• 37:49
  Speaker 1: is that there are a variety of cards that are
• 37:52
  Speaker 1: worth points. There are 12-12s, 11-11s, 10-10s, et cetera. But
• 37:56
  Speaker 1: if you ever get dealt a duplicate card, you bust
• 37:57
  Speaker 1: and you're out. But as long as you don't get
• 37:59
  Speaker 1: dealt a duplicate card, you can stop receiving cards at
• 38:02
  Speaker 1: any point. And then you get to keep all those points.
• 38:05
  Speaker 1: That's the gist of the game. It's really straightforward. Everybody
• 38:07
  Speaker 1: gets a turn. You get to hit or stay. And
• 38:08
  Speaker 1: then everyone just keeps going until either everyone is out
• 38:10
  Speaker 1: or everyone has stayed. And then you get to add
• 38:12
  Speaker 1: up your points. And it's trying to get to the
• 38:14
  Speaker 1: first person to get to 200 points over several rounds,
• 38:16
  Speaker 1: which only actually takes about 30 minutes, maybe even less.
• 38:19
  Speaker 1: I've definitely played this game with like 13 people in
• 38:21
  Speaker 1: like 20 minutes. So it really doesn't take long to do.
• 38:25
  Speaker 1: Plus it has these action cards. You can force people
• 38:26
  Speaker 1: to draw cards or force them to stay. They're kind
• 38:29
  Speaker 1: of fun. And some cards that also make your points
• 38:31
  Speaker 1: worth more points, which is also fun. There's also Flip
• 38:34
  Speaker 1: 7 with a Vengeance. It's just a much meaner version
• 38:36
  Speaker 1: of the game. It's okay. If you like being mean
• 38:38
  Speaker 1: to people, then probably it's up your alley. Otherwise, they're
• 38:41
  Speaker 1: really cheap. It's only like 10, 15 bucks maybe. And
• 38:43
  Speaker 1: it's really small. It's just a deck of cards. And
• 38:46
  Speaker 1: it can play up to 17 people in a single go.
• 38:48
  Speaker 1: So it's very accommodating in that way. So it's a
• 38:51
  Speaker 1: recommend because I think that if you're going to pick
• 38:53
  Speaker 1: up a silly, easy, quick card game that accommodates a
• 38:56
  Speaker 1: lot of people, you could do a lot worse than
• 38:58
  Speaker 1: Flip 7. Substantially, substantially worse. A lot worse, like Uno.
• 39:02
  Speaker 1: But that is the game I'm recommending. Stu, do you
• 39:06
  Speaker 1: have a recommendation you'd like to share?
• 39:08
  Speaker 3: Yeah, I got a bunch. I don't think you can
• 39:10
  Speaker 3: play Flip 7 with me because every time I flip
• 39:13
  Speaker 3: a card, I say, I'm going to bust!
• 39:15
  Speaker 4: That's too bad.
• 39:18
  Speaker 1: Challenge accepted.
• 39:19
  Speaker 3: Don't play with me. So my recommendations, I'm going to
• 39:22
  Speaker 3: make a bunch just cause I'm not here that often.
• 39:24
  Speaker 1: I'm only here.
• 39:27
  Speaker 3: Okay. One recommendation I have, it's a YouTube channel. It's
• 39:30
  Speaker 3: also on that. It's like kind of the flagship show
• 39:33
  Speaker 3: of that kooky thing. Nebula that like YouTube, but for creators, yada, yada.
• 39:40
  Speaker 2: Okay.
• 39:41
  Speaker 3: It's called jet lag, the game. It's a bunch of
• 39:43
  Speaker 3: dorks that I love and they're very endearing and they're
• 39:45
  Speaker 3: very funny. And they have a travel game where they
• 39:48
  Speaker 3: make board games out of traveling. So they play connect
• 39:51
  Speaker 3: for across the U S by like flying and taking
• 39:54
  Speaker 3: different forms of transportation. And you conquer a city by,
• 39:57
  Speaker 3: or you conquer a state by like entering that state
• 39:59
  Speaker 3: and then completing some challenge. And then Texas turns yellow. Right.
• 40:03
  Speaker 3: And so yellow versus red. And so they're playing connect
• 40:06
  Speaker 3: for across the U S they play hide and go
• 40:08
  Speaker 3: seek in Japan. So one person gets like six hour
• 40:11
  Speaker 3: headstart and then, They get to go anywhere in Japan
• 40:14
  Speaker 3: and hide in any place that's publicly available. And then
• 40:18
  Speaker 3: the other guys seek them out and it's a good time.
• 40:21
  Speaker 3: And it gives you a good sense of like how
• 40:23
  Speaker 3: traveling works in different places because they have to do
• 40:25
  Speaker 3: things like go to grocery stores and ride the train.
• 40:27
  Speaker 3: So it's one of my favorite travel shows. My next
• 40:31
  Speaker 3: recommendation is if you see a thesis or a dissertation
• 40:34
  Speaker 3: that reads to you as what you will now call
• 40:36
  Speaker 3: purple hat DBT. call them out and say, that's a
• 40:40
  Speaker 3: Purple Hat DBT thing. Yuck.
• 40:42
  Speaker 2: Yucky.
• 40:43
  Speaker 3: And so we need to ask better questions so that
• 40:47
  Speaker 3: the science of psychology doesn't take 8 billion years and
• 40:49
  Speaker 3: we're not asking questions like, does ACT work if you're
• 40:51
  Speaker 3: in a rocking chair? So some signs that you might
• 40:55
  Speaker 3: be looking at Purple Hat DBT is they open with,
• 40:58
  Speaker 3: such and such has worked a million times with a
• 41:01
  Speaker 3: million things, but does it work with Y? That is
• 41:05
  Speaker 3: the sign that you are maybe looking at a Purple
• 41:07
  Speaker 3: Hat DBT study. I'm going to recommend a book called
• 41:11
  Speaker 3: The Orphans of Davenport. And then the last thing is
• 41:15
  Speaker 3: a little shameless self-plug of Generate. So in Generate, especially
• 41:22
  Speaker 3: if you're behaviorally minded, we built an assessment that we
• 41:27
  Speaker 3: think adheres to these modern sensibilities that have been talked
• 41:30
  Speaker 3: about a little better than assessments that are on the market.
• 41:33
  Speaker 3: So I would make the claim that behavior analysis, while
• 41:37
  Speaker 3: it has some good instincts about keeping the level of
• 41:40
  Speaker 3: the individual sacred. It has fallen into a pattern of
• 41:44
  Speaker 3: responding to the medical model that it is finding itself
• 41:47
  Speaker 3: a part of. And I think that is despite a
• 41:50
  Speaker 3: lot of the ways that we talk about our noble
• 41:54
  Speaker 3: pursuits inside of it. So if you want a system
• 41:56
  Speaker 3: that supports you in saying, I'm not trying to make
• 41:59
  Speaker 3: your kit normal, we have one. And it's generate, but misspelled. Yeah.
• 42:06
  Speaker 1: All right. I have all those links. Thank you. All right, Shane,
• 42:09
  Speaker 1: what are you recommending?
• 42:10
  Speaker 4: I'm going to recommend a record that just came out
• 42:12
  Speaker 4: this year by a band called Show Me the Body.
• 42:14
  Speaker 4: And the album is Alone Together. This is a three
• 42:17
  Speaker 4: piece out of New York. And they're super interesting because
• 42:20
  Speaker 4: they're considered a post hardcore band, but they pull a
• 42:23
  Speaker 4: lot of influences from like metal and punk and hardcore.
• 42:26
  Speaker 4: They definitely have punk sensibilities in that they are very
• 42:28
  Speaker 4: much doing their own thing. but it's a three piece
• 42:31
  Speaker 4: and the lead singer plays a banjo and it's, uh,
• 42:35
  Speaker 4: it doesn't sound like a banjo. It sounds like an electrified, uh, something. And, um,
• 42:40
  Speaker 4: it's just a super interesting, this new record is just
• 42:42
  Speaker 4: super interesting, super dynamic. It's a little bit out of
• 42:45
  Speaker 4: the box for what people are listening to these days.
• 42:47
  Speaker 4: Like I can't like really pinpoint another band that sounds
• 42:50
  Speaker 4: like this band and go like, Oh yeah, they sound
• 42:53
  Speaker 4: like this.
• 42:53
  Speaker 2: Like they kind of are very much their own thing.
• 42:56
  Speaker 2: So I don't know. It's worth, it's worth giving a listen.
• 42:58
  Speaker 2: If you want to hear something that's like kind of
• 42:59
  Speaker 2: like unique.
• 43:00
  Speaker 1: Fun.
• 43:01
  Speaker 3: Yeah.
• 43:01
  Speaker 1: All right. So that's flip seven, the card game for me,
• 43:04
  Speaker 1: this YouTube jet lag, the game, and then calling people
• 43:07
  Speaker 1: out for purple hat, DBT theses and dissertations, and then
• 43:10
  Speaker 1: the orphans of Davenport and the generate assessment tool from Stu.
• 43:15
  Speaker 1: And then show me the body album alone together from Shane,
• 43:19
  Speaker 1: our recommendations. Thank you so much again for joining us today, Stu.
• 43:23
  Speaker 1: We appreciate having you here and all your time that
• 43:25
  Speaker 1: you spend with us this morning.
• 43:26
  Speaker 3: Thanks for having me.
• 43:27
  Speaker 1: Thank you all for listening. Is there anything I missed
• 43:28
  Speaker 1: or you'd like to add before we say our goodbyes?
• 43:30
  Speaker 1: Shane or Stu?
• 43:32
  Speaker 3: Nope. Okay.
• 43:34
  Speaker 1: All right. Then this is Abraham.
• 43:36
  Speaker 2: This is Shane.
• 43:36
  Speaker 3: Stu!
• 43:39
  Speaker 1: We're out.
• 43:40
  Speaker 4: Bye.
• 43:41
  Speaker 1: You've been listening to Why We Do What We Do.
• 43:44
  Speaker 3: You can learn more about this and other episodes by
• 43:46
  Speaker 3: going to www.wwdpodcast.com.
• 43:50
  Speaker 1: Thanks for listening, and we hope you have an awesome day.
• 44:08
  Speaker 3: Thanks for watching!