UP NEXT ON "CYCLE OF HEALTH."

>> TONIGHT'S TOPIC, PSYCHO THERAPY.

HAVE YOU SEARCHED FOR A THERAPIST ONLY TO FIND ALPHABET SOUP FOR THEIR SPECIAL AT THISES.

CBT, DBT, ISTDP, EMDR--WHAT DO THEY ALL MEAN?

WELL TONIGHT WE'RE JOINED BY THREE PANELISTS WHO WILL EXPLAIN WHAT ALL OF THESE ACRONYMS STAND FOR.

>> THERE ARE SOME ELEMENT THAT CUT ACROSS ALL THE DIFFERENT THERAPIES.

THESE ARE THE COMMON FACTORS BECAUSE THEY'RE COMMON TO ALL GOOD THERAPY.

8.

♪ ♪ >> HELLO AND WELCOME TO CYCLE OF HEALTH, I'M DR. RICH O'NEILL.

TONIGHT'S TOPIC: PSYCHOTHERAPY.

HAVE YOU EVER SEARCHED FOR A THERAPIST ONLY TO FIND ALPHABET SOUP FOR THEIR SPECIALTIES?

CBT, DBT, ISTDP, EMDR--WHAT DO THEY ALL MEAN?

WELL TONIGHT WE'RE JOINED BY THREE PANELISTS WHO WILL EXPLAIN WHAT ALL OF THESE ACRONYMS STAND FOR, WHAT EACH TYPE OF THERAPY IS BEST SUITED FOR, AND WHAT THEY HAVE IN COMMON.

LET'S MEET OUR GUESTS.

DR. DEBORAH POLLACK: CLINICAL PSYCHOLOGIST AND ASSISTANT PROFESSOR OF PSYCHOLOGY AT UTICA UNIVERSITY MS. TRACEY MUSARRA MARCHESE: EMDR THERAPIST AND TRAINER, AND PROFESSOR OF SOCIAL WORK AT SYRACUSE UNIVERSITY DR. BETH HURNY-FRICANO: DIRECTOR OF CLINICAL SERVICES AT ARISE WELL FOLKS, WE'VE HEARD THAT IN THE HANDS OF A WARM, EMPATHIC, WHAT ARE THE ESSENTIAL THINGS FOR SUCCESSFUL TREATMENT IN THERAPY?

>> WELL, ACTUALLY, THE RESEARCH SHOWS THAT THERE ARE SOME ELEMENTS THAT CUT ACROSS ALL THE DIFFERENT TYPES OF THERAPIES, AND SO WE CALL THIS THE COMMON FACTORS BECAUSE THEY'RE COMMON TO ALL GOOD THERAPY.

AND THE RESEARCH ALSO SHOWS THAT THE BEST THERAPISTS ARE REALLY GOOD AT DELIVERING THE COMMON FACTORS REGARDLESS OF THE TYPE OF THERAPY THAT THEY PRACTICE.

SO SOME OF THE COMMON FACTORS THAT HAVE BEEN THE MOST RESEARCHED ARE THE THERAPEUTIC ALLIANCE, THE QUALITY OF THE RELATIONSHIP BETWEEN THE THERAPIST AND THE PATIENT; EMPATHY ON THE PART OF THE THERAPIST TOWARDS THE PATIENT; AND ONE THAT I REALLY LIKE IS AGREEMENT ON GOALS AND TASKS OF THE THERAPY.

SO IT TURNS OUT, IT IS ACTUALLY IMPORTANT FOR THE THERAPIST AND THE PATIENT TO AGREE ON WHERE THEY ARE HEADED AND HOW THEY'RE GOING TO GET THERE.

AND SO IF YOU GO TO THERAPY AND KIND OF JUST VENT AND TALK WITH NO DIRECTION, THAT'S ACTUALLY NOT AS EFFECTIVE.

>> SO HOW DO YOU FOLKS GO ABOUT SETTING SOME KIND OF INITIAL AGREEMENT?

>> WELL, WE LISTEN TO OUR CLIENTS.

AND WE LISTEN TO WHAT THEIR CONCERNS ARE.

WE ARE LISTENING TO THEM IN EXPLAINING WHAT THEY THINK THEIR PROBLEMS ARE AND WHERE THEY WANT TO GO, WHAT ARE THEIR GOALS IN LIFE.

WE ARE ALSO WATCHING THEIR BODY LANGUAGE WHEN THEY TALK TO US.

WE ARE LOOKING FOR NOT ONLY THE THINGS THAT ARE BEING SAID, BUT THE THINGS THAT AREN'T BEING SAID THAT MAYBE ARE PART OF THEIR STRUGGLE.

AND SO THAT WE CAN WORK WITH THEM TO FIND OUT WHAT IS BEST GOING TO WORK FOR THEM.

>> AND OFTEN SUGGESTING CERTAIN DIRECTIONS BASED ON THEIR COMMENTS AND WHAT THEY HAVE HAD TO SAY AND WATCHING THEIR BODY LANGUAGE IN RESPONSE TO WHAT EYE MIGHT HAVE SUGGESTED, YOU CAN GET A SENSE OF WHETHER OR NOT THAT IS LIKE A HOT TOPIC OR SOMETHING THAT IS GOING TO TAKE SOME TIME TO GET THROUGH.

>> SO SOME KIND OF EMOTIONAL DEPTH TO THAT TOPIC AND ANYBODY ELSE WANT TO ADD ANYTHING?

OKAY.

SO THAT SOUNDS LIKE A GREAT START.

SO LISTENING TO YOUR CLIENTS.

WHAT A NOVEL IDEA GIVEN WHAT WE SEE IN THE WORLD THESE DAYS.

SO TELL US ABOUT CBT.

>> OKAY.

>> SO CBT, COGNITIVE BEHAVIORAL THERAPY IS ABOUT COGNITIONS, OUR THOUGHTS AND BEHAVIOR AND THE BRIDGE BETWEEN THE TWO OF THOSE BASED ON THIS MODEL IS HOW WE FEEL.

AND SO THE PREMISE FOR THE MODEL IS THAT IF WE-- WE ALL HAVE THOUGHTS IN RESPONSE TO LIFE'S STRESSORS, DAY TO DAY, BIG EXPERIENCES, LITTLE EXPERIENCES.

SO IF WE LOOK AT-- IF WE WORK WITH SOMEBODY ON THEIR INITIAL THOUGHT REGARDING A STRESSOR OR STIMULI, AND HOW THEY FEEL, THE FEELING ASSOCIATED WITH THAT THOUGHT, THE IDEA IS THAT YOU CAN THEN CHANGE THEIR BEHAVIOR IN RESPONSE TO IT.

SO, FOR EXAMPLE, IF SOMEBODY HAS A NEGATIVE THOUGHT AND REACTS IMPULSIVELY WITH AN IMPULSIVE BEHAVIOR, THERE IS A FEELING SOMEWHERE IN THE MIDDLE OF THAT.

>> DRIVING THE IMPULSIVE BEHAVIOR.

>> YES, AND SO IF YOU WORK WITH THE PERSON TO IDENTIFY THE SPECIFIC THOUGHT FIRST THAT THEY HAD.

AND THEN WHAT FEELING DID IT INVOKE.

AND THEN THAT LED TO A CERTAIN BEHAVIOR.

AND SO IF WE CAN WORK ON CHAIB CHANGING THOUGHTS AND OUR ASSOCIATED FEELINGS, IT'S LIKELY THAT WE WILL BE ABLE TO HELP THEM CHANGE THEIR BEHAVIOR.

>> SO IT MIGHT BE THAT SOME THOUGHTS ARE NOT SO REALITY BASED.

>> RIGHT.

>> AND YOU ARE WORKING TO IDENTIFY THOSE AND HAVE THE PERSON TEST THEM OUT WITH YOU?

>> YES.

AND SO IT'S REALLY INTERESTING THOUGH, IN THE BEGINNING, TO REALLY HAVE THE PATIENT IDENTIFY THEIR THOUGHT.

THEY HAVEN'T BEEN ASKED THAT BEFORE IN TERMS OF A SPECIFIC-- WELL WHAT WERE YOU THINKING?

WELL I WAS REALLY MAD.

WELL THAT'S A FEELING.

WHAT WERE YOU THINKING?

AND DISSECTING IT DOWN TO THAT LEVEL AND THEN ALMOST, YOU KNOW, DRAWING A VISUAL.

THIS THOUGHT LED TO THIS FEELING, RESULTING IN THIS BEHAVIOR.

AND THEN PRACTICING DIFFERENT SCENARIOS WHERE THE THOUGHT, THE FEELING AND THE BEHAVIOR WOULD BE DIFFERENT.

BASED ON THE SAME STIMULI OR STRESSOR.

>> GREAT.

SO EMDR.

TELL US ABOUT EMDR.

>> SO EMDR STANDS FOR EYE MOVEMENT DESENSITIZATION AND REPROCESSING.

IT'S A MODEL THAT IDEALLY LOOKS AT A PERSON'S CURRENT SYMPTOMS AS A REPRESENTATION OF DYSFUNCTIONALLY STORED PAST MEMORIES.

AND SO LET ME GIVE YOU AN EXAMPLE.

I'M SITTING HERE AND I'M TALKING WITH YOU.

AND YOU ARE PROCESSING THE INFORMATION THAT I'M TELLING YOU AND IT'S GOING TO GO INTO WHAT I LIKE TO REFER TO AS YOUR MENTAL FILING CABINET.

IF YOU NEED THE INFORMATION LATER, YOU CAN BRING IT OUT, IF NOT, IT STAYS IF THE FILE CABINET.

EVEN IF YOU ARE LEARNING SOMETHING NEW, YOU MIGHT TAKE SOME OF THE INFORMATION IN YOUR FILE CABINET AND USE IT TO MAKE ACCEPTS OF THE INFORMATION YOU ARE LEARNING.

IDEALLY OUR MEMORIES GET PROCESSED.

THEY GO INTO THE FILE CABINET.

WHEN WE HAVE TRAUMAS, FOR LACK OF A BETTER TERP, TRAUMAS CAN BE MAJOR LIFE EVENTS, LIFE THREATENING EVENTS, BUT TRAUMAS CAN ALSO BE JUST DISTRESSING LIFE EVENTS THAT PEOPLE EXPERIENCE OVER THE COURSE OF THEIR LIVES.

>> YOU MENTIONED BIG T. TRAUMA AND LITTLE T TRAUMA.

>> LIFE THREATENING EVENTS ARE BIG T TRAUMA BUT EMDR WORKS ON LITTLE DISTRESSING LIFE EVENTS THAT HAPPEN TO US THROUGHOUT THE COURSE OF OUR LIVES.

>> AND THEY DISRUPT OUR PROCESSING?

IT DOESN'T GET STORED RIGHT?

>> EXACTLY.

SO WHEN WE ARE HAVING THIS DISTRESS THAT NATURAL INFORMATION PROCESSING SYSTEM GETS DISRUPTED.

AND THAT MEMORY, INSTEAD OF PROCESSING, GETS FROZEN.

AND SO UNFORTUNATELY, IT GETS FROZEN WITH ALL OF THE NEGATIVE THOUGHTS THAT WE HAVE AT THE TIME, EVEN THE IMAGES THAT OF WHAT IS GOING ON AROUND US, THE BODY SENSATIONS AND THE EMOTIONS SO THOSE ARE THE THINGS THAT SET US UP FOR BEING TRIGGERED LATER IN LIFE.

AND SO-- >> SOMETHING SIMILAR WITH SOME LOOK ALIKE TO THE PAST HAPPENS?

IT TRIGGERS THE SAME EMOTIONAL AND THINKING RESPONSE?

>> EXACTLY.

AND THOSE TRIGGERS COULD BE THE PHYSICAL SENSATIONS, THEY COULD BE THE EMOTIONS, THEY COULD BE THE THOUGHTS.

ANY OF THOSE COULD BE THOSE THINGS THAT COULD TRIGGER THAT RESPONSE.

SO IF IT'S HELPFUL, I'LL GIVE YOU AN EXAMPLE.

>> YEAH, GO.

>> SO IF EVERY TIME I GO TO A STAFF MEETING, AND I'M WITH MY COLLEAGUES, AND NOTHING BAD IS HAPPENING, ALL OF A SUDDEN I'M FEELING MORE AND MORE ANXIETY AND IT HAPPENS EVERY TIME I GO INTO ME STAFF MEETING.

>> WHAT I'M I'M JUST WORRIED THE BAD DOUGHNUTS ARE GOING TO COME?

>> EXACTLY.

IF I WANT TO FIND OUT WHAT IS CAUSING THIS, AND I GO TO AN EMDR THERAPIST, THE EMDR THERAPIST IS GOING TO TRY TO FIND OUT WHERE IN MY PAST, WHERE IN MY MEMORY THAT DIDN'T GET PROCESSED IS INFLUENCING THIS TRIGGER SO LET'S SAY BY MEANS THAT WE USE IN EMDR, WE FIND OUT THAT IN SECOND GREAT I WAS IN CLASS AND MY TEACHER YELLED AT ME FOR NOT KNOWING THE RIGHT ANSWER TO A MATH QUESTION.

AND I WAS HUMILIATED AND MY HEART WAS RACING AND I WAS REALLY ANXIOUS AND I WAS THINKING TO MYSELF, YOU ARE SO STUPID, RIGHT?

WELL, NOW I'M IN MY STAFF MEETINGS AND I'M STARTING TO FEEL SOME OF THOSE SAME RESPONSES.

>> SOME KIND OF EVALUATION MIGHT HAPPEN THAT WOULD BE SIMILAR.

>> THAT GETS TRIGGERED.

SO WHAT WE WOULD WORK ON, WHAT WE WOULD TARGET WITH THE EMDR PROCESSING PART OF DESENSITIZING IS THE MEMORY FROM SECOND GRADE AND WE DO THAT THROUGH EYE MOVEMENT, WHICH IS THE EM PART OF THE EMDR WHERE I MIGHT ASK A CLIENT TO FOLLOW MY FINGERS AND MOVE THEIR EYES BACK AND FORTH.

LIKE REM SLEEP HE WOULD DREAM, WITH WE PROCESS INFORMATION AT NIGHT WHEN WE ARE SLEEPING.

>> SO THIS DOES SOMETHING IN YOUR NEURONS UP THERE UP HERE?

>> AND ONE OF THE THEORIES ABOUT HOW EMDR WORKS IS THROUGH THE REM SLEEP HYPOTHESIS THAT WHEN I DO THAT SAME EYE MOVEMENT, BUT WHEN YOU ARE FOCUSED ON THAT MEMORY, YOU CAN THEN PROCESS THE MEMORY MUCH AND SO WHAT HAPPENS IS THAT MEMORY THAT WAS FROZEN BECOMES UNLOCKED AND IT'S ABLE-- WITH ALL OF ITS EMOTIONS, BODY SENSATIONS AND ALL OF THAT GETS TO BE PROCESSED LIKE IT SHOULD HAVE AT THE TIME WHEN IT HAPPENED BECAUSE IT DIDN'T HAVE THE CHANCE.

IT CAN THEN ACCESS THE INFORMATION FROM THE MENTAL FILE CABINET THAT IT NEED TO FINISH THE PROCESSING AND GOES INTO THE MENTAL FILE CABINET LIKE ALL THE OTHER MEMORIES.

THE BEST PART IS THAT ONCE THAT HAPPENS, NO MORE TRIGGERS.

>> THAT'S GREAT.

THESE ARE TWO WONDERFUL DESCRIPTIONS.

THEY'RE GETTING PUT IN MY FILE CABINET RIGHT NOW, SOME OF THEM ANYWAY.

>> CAN YOU TELL US ABOUT THE LONGEST ACRONYM, ISDTP.

TELL US ABOUT THAT?

>> IT STANDS FOR INTENSIVE SHORT-TERM DYNAMIC PSYCHO THERAPY.

IT'S A TYPE OF PSYCHO DYNAMIC THERAPY THAT HAS BEEN AROUND FOR 100 YEARS GOING BACK TO FRIED.

-- ALL THE WAY BACK TO FREUD AND LIKE OTHER PSYCHO DYNAMIC THERAPIES, WE LOOK AT UNCONSCIOUS PATTERNS OF BEHAVIOR THAT USUALLY GOT SET UP IN FOLKS CHILDHOOD AND THEIR FAMILIES OF ORIGIN AND THEY CONTINUE TO REPEAT THOSE PATTERNS OF BEHAVIOR INTO ADULTHOOD.

HOWEVER, THE PATTERNS WERE MORE ADAPTIVE IN THEIR CHILDHOOD ENVIRONMENT AND AS YOU BECOME AN ADULT, THEY'RE LESS ADAPTIVE AND ACTUALLY TEND TO CAUSE PROBLEMS, PROBLEMS IN RELATIONSHIPS OR MAYBE EVEN SYMPTOMS LIKE ANXIETY AND DEPRESSION.

>> SO YOU LEARNED A WAY OF BEHAVING TO ADAPT TO YOUR FAMILY AND NOW IT DOESN'T WORK SO WELL WHEN YOU ARE SITTING WITH YOUR BOSS OR YOUR COLLEAGUES.

>> EXACTLY.

SO, FOR EXAMPLE, IF YOUR FAMILY WAS VERY CONFLICT RIDDEN, ONE WAY TO ADAPT TO THAT WOULD BE TO BECOME MAYBE MORE PASSIVE AND COMPLIANT LIKE NOT ROCK THE BOAT.

BUT MAYBE THAT'S NOT WORKING SO WELL AT WORK WHERE YOU NEED TO ROCK THE BOAT SOMETIMES.

YOU NEED TO STAND UP FOR YOURSELF.

MAYBE WHEN CONFLICTS HAPPEN AT WORK, YOU GET A LOT OF ANXIETY.

SO WHAT I ISDTP THERAPISTS HOPE FOLKS SEE IS HELP SEE THE PATTERNS OF BEHAVIOR BECAUSE THEY'RE OFTEN UNCONSCIOUS, HELP PEOPLE IDENTIFY WHAT ARE THE CAUSE NOW.

THEY WERE ADAPTIVE AT ONE POINT BUT NOW THEY'RE CAUSING PROBLEMS.

AND THEN REALLY ENCOURAGE FOLKS TO USE THE HEALTHIER PART OF THEM TO LET THE PATTERNS GO.

AND WHEN THEY'RE WORKING ON LETTING THE PATTERNS GO, THEY OFTEN HAVE TO FEEL SOME NEW FEELINGS THAT THEY HAVEN'T REALLY LET THEMSELVES FEEL FOR A LONG TIME AND THOSE NEW FEELINGS CAN OFTEN BRING UP A LOT OF ANXIETY AND SO THE ISDTP THERAPIST HELPS REGULATE THE ANXIETY SO THEY CAN START TO TOLERATE LONGER AND LONGER EXPOSURES TO THOSE FEELINGS WITHOUT GETTING TOO ANXIOUS.

AND IN THAT PROCESS, EVERYTHING STARTS TO CHANGE AND SHIFT.

>> WHAT ABOUT DBT.

I BELIEVE IT'S A SPECIAL BRANCH OF CBT.

CAN YOU TELL US A LITTLE BIT ABOUT DBT?

>> DIALECTAL BEHAVIOR THERAPY IS A SUBSET OR A FORM OF COGNITIVE BEHAVIORAL THERAPY THAT SPECIFICALLY LOOKS AT-- IT'S VERY STRUCTURED TO AND HAS VERY STRICT GUIDELINES ABOUT HOW THE THERAPY IS CONDUCTED.

BUT THE IDEA IS THE FOCUS ON EMOTIONAL DYSREGULATION AND REGULATION.

THAT'S THE KEY-- >> EMOTIONAL DYSREGULATION AND REGULATION.

INSTEAD OF OVERWHELMED BY YOUR FEELINGS.

>> YES.

AND THE INABILITY TO FUNCTION BECAUSE OF DYSREGULATED EMOTION.

>> FLOODED.

>> YES.

AND SO THE THERAPY INVOLVES HELPING THE INDIVIDUAL LEARN TO REGULATE THEIR EMOTIONS, WHICH THEN ULTIMATELY INFLUENCES AND IMPACTS THEIR BEHAVIORS.

AND THAT'S HOW IT IS RELATED OR A SUBSET OF CBD.

>> -- CBT.

>> HOW DO YOU FOLKS MATCH PEOPLE WHO COME INTO THE OFFICE--Y I GET PEOPLE STOPPING ME ALL THE TIME SAYING YOU ARE A THERAPIST, RIGHT?

WHO SHOULD I GO SEE?

HOW DO YOU FOLKS HANDLE THAT?

HOW DO YOU... YOU WERE GOING TO SAY SOMETHING?

>> I THINK THAT THERAPY AND THE TYPE OF THERAPY IS UNIQUE TO THE CLIENT AND IF CLIENTS CAN, OR A POTENTIAL CLIENT CAN RESEARCH DIFFERENT TYPES OF THERAPY, MAYBE CALL AROUND AND ASK SOME THERAPISTS TO EXPLAIN WHAT THEY DO, CAN BE REALLY HELPFUL.

I WOULD SAY THAT IF SOMEONE IS GLOWING TO RESEARCH, NOT TO GO ON SOCIAL MEDIA TO DO THAT, NO THE TO LOOK ON YOUTUBE TO DO THAT BUT TO LOOK AT REPUTABLE WEBSITES OF THE DIFFERENT TYPES OF THERAPIES THAT ARE OUT THERE AND SEE IF IT SEEMS LIKE SOMETHING THAT MATCHES WHAT THEY ARE LOOKING FOR OR MATCHES THEIR STYLE.

>> LIKE AN EMDR OR CBT SPONSORED WEBSITE OR INSTITUTE OR NATIONAL ORGANIZATION.

>> YES.

IT OFTEN STARTS WITH JUST PICKING UP THE PHONE AND MAKING AN APPOINTMENT AND THEN TALKING TO THE THERAPIST ABOUT WHAT THEY'RE LOOKING FOR, WHAT THAT THERAPIST COULD OFFER AND TRYING TO FIND A MATCH THAT WAY BECAUSE AS WE GO BACK TO THE COMMON FACTORS THAT WE STARTED WITH, THAT THERAPEUTIC ALLIANCE IS REALLY REALLY CRITICAL.

AND THEY MAY HAVE-- THE PATIENT OR CLIENT MAY HAVE A SET TYPE OF THERAPY IN THEIR MIND THAT THEY WANT BUT IT OFTEN STARTS WITH THAT VERY FIRST FORMING OF AN ALLIANCE WITH SOMEONE WHO IS JUST WILLING TO LISTEN AND HELP THEM GET WHERE THEY NEED TO BE.

AND THAT OFTEN ENDS UP BEING WHERE THEY STAY IF THAT RELATIONSHIP IS WORKING WELL.

>> SO WHAT ABOUT ASKING YOUR FRIENDS AND FAMILY OR-- >> I THINK ACTUALLY THAT'S A GREAT WAY TO FIND A THERAPIST, IS TO GET THOSE WORD OF MOUTH REFERRALS FROM FOLKS THAT YOU TRUST, AS THEM ABOUT THEIR EXPERIENCE WITH THAT THERAPIST.

I THINK THAT'S BETTER THAN, YOU KNOW, KIND OF GOING ONLINE AND LOOKING THROUGH PROFILES.

LUCKILY THESE DAYS, THE STIGMA AROUND MENTAL HEALTH AND THERAPY IS A LOT LESS THAN IT USED TO BE SO I FIND THAT PEOPLE ARE QUITE OPEN TO TALKING ABOUT THAT THEY ARE IN THERAPY.

SO YOU KNOW, ASK THEM WHO THEIR THERAPIST IS AND WHAT THEIR EXPERIENCE HAS BEEN LIKE.

>> DEFINITELY MORE CONVERSATIONS THAN IN THE PAST.

I THINK THERE IS STILL A LOT OF STIGMA OUT THERE THAT WE NEED TO ADDRESS AND CONTINUE TO ADDRESS.

BUT THAT HAPPENS ONE CONVERSATION AT A TIME REALLY.

AND THEN THAT WORD OF MOUTH IN TERMS OF HOW POSITIVE THAT THERAPEUTIC RELATIONSHIP WAS AND YOU BUILD ON THAT.

>> WELL, FOLKS, WE'VE HEARD THAT IN THE HANDS OF A WARM, EMPATHIC GENUINE THERAPIST, MANY DIFFERENT APPROACHES WILL LIKELY BENEFIT CLIENTS WHO THROW THEMSELVES INTO THE WORK.

BUT WHAT IF YOU HAVE A FAMILY MEMBER WITH NO AWARENESS OF THEIR SIGNIFICANT PSYCHOLOGICAL PROBLEMS.

WE TALKED TO DR. JAVIER AMADOR, WHO CONFRONTED THIS PROBLEM AS A YOUNG MAN, BECAME A PSYCHOLOGIST, PROFESSOR AT COLUMBIA UNIVERSITY AND SPENT MUCH OF HIS LIFE RESEARCHING AND DEVELOPING AN APPROACH TO THIS AGONIZING ISSUE.

LET'S TAKE A LOOK.

>> GOOD DAY AND WELCOME TO CHECK UP FROM THE NECK UP.

A NEW MONTHLY SHOW ON COMMUNITY MF WCNY,I'M YOUR HOST Dr. RICH O'NEILL.

OUR GUEST FOR THIS EPISODE IS Dr. XAVIER AMADOR, A CLINICAL PSYCHOLOGIST AND FORMER PROFESSOR OF PSYCHIATRY AT COLUMBIA UNIVERSITY AND AUTHOR OF THE BEST SELLER "I AM NOT SICK.

I DON'T NEED HELP! "

AND WE HAVE ANOTHER GUEST, PHIL, WHO IS THE FATHER OF A YOUNG MAN WITH SCHIZOPHRENIA, WHO HAS USE WHAT HE HAS LEARNED FROM Dr. AMADOR IN HIS RELATIONSHIP WITH HIS SON.

SO, Dr. AMADR, LET'S START OFF WITH A QUESTION ABOUT HOW COMMON IS IT FOR PEOPLE WHO HAVE A SERIOUS MENTAL ILLNESS TO NOT HAVE ANY AWARENESS OF THE FACT THAT THEY HAVE A SERIOUS MENTAL ILLNESS?

>> THAT'S A GREAT FIRST QUESTION.

THE RESEARCH IS RELIABLE AND ROBUST.

HALF OF ALL PEOPLE WITH SCHIZOPHRENIA AND RELATED ILLNESSES LIKE BIPOLAR DISORDER DON'T UNDERSTAND THEY'RE ILL BUT IT'S NOT DENIAL.

OVERWHELMING THEIR IN THE MAJORITY OF CASES, IT'S ACTUALLY ANOTHER SYMPTOM LIKE A HALLUCINATION OR TONGUE TWISTER.

IT HAS A TONGUE TWISTER OF A NAME.

ANASIGNOSIA.

IT LOOKS LIKE DENIAL BUT IT IS NOT DENIAL.

>> WHEN YOU SAY DENIAL, YOU MEAN THE PERSON IS JUST OUT AND OUT SAYING I DON'T HAVE THAT PROBLEM.

THEY'RE AWARE OF THE PROBLEM.

THEY'RE JUST BLANKING IT OUT.

>> WELL, THOAF REPRESSED THE KNOWLEDGE.

DEEP DOWN THEY UNDERSTAND THEY'RE ILL.

IF WE JUST EDUCATE THEM AND CONVINCE THEM AND SHOW THEM ALL THE EVIDENCE-- >> RATIONALLY TELL THEM HERE IS THE PROBLEM.

>> EXACTLY AND LAY OUT THE EVIDENCE THAT WE SEE THAT THEY'RE MIL MENTALLY ILL, THEY'LL STOP HIVE LIFE.

>> THAT'S IS NOT THE PROBLEM.

>> WE WOULDN'T NEVER TELL THEM TO STOP HALLUCINATING BECAUSE IT'S NOT UNDER THEIR CONTROL.

THIS UNAWARENESS OF ILLNESS IS JUST LIKE AN HALLUCINATION OR DELUSION OR DISORDERED SPEECH.

>> IT'S A NEUROPSYCHIATRIC, A PROBLEM WITH THE BRAIN.

>> EXACTLY.

>> DOES THIS RING TRUE FOR YOU, PHIL?

IS THIS THE KIND OF SITUATION YOU DEALT WITH.

>> ABSOLUTELY.

EXACTLY WHAT WAS HAPPENING IN OUR SITUATION.

BUT WE DIDN'T KNOW IT.

AND AT FIRST IT DEFIES ALL LOGIC AND EVERYTHING THAT ANY FAMILY OR CAREGIVER PEOPLE WHO SUPPORT LIVING WITH PEOPLE WITH MENTAL ILLNESS WOULD THINK.

SO IT WAS UNBELIEVABLY CONFOUNDING AND CREATED JUST ONE ONE SATISFACTORY CONFLICT AFTER ANOTHER IT WAS DRIVING OUR SON AWAY.

WE READ Dr. AMADOR'S BOOK, COMPLETELY CHANGED OUR APPROACH.

>> SO Dr. AMADOR, I UNDERSTAND YOUR WORK GREW OUT OF YOUR OWN EXPERIENCE WITH YOUR BROTHER, OR DEALING WITH THE SAME KIND OF THING.

>> ABSOLUTELY.

EXACTLY WHAT HAPPENED WITH PHIL AND HIS SON HAPPENED WITH ME AND MY BROTHER HENRY HEN HENRY WAS EIGHT YEARS OLDER THOUGH AND WHEN HE BECAME ILL AND STARTED HEARING VOICES AND DEVELOPED THESE STRANGE IDEAS, THESE DELUSIONS, I TRIED TO REFLECT ALL THAT BACK TO HIM.

DON'T YOU THINK IT'S UNUSUAL THAT YOU ARE NOT WELL IF YOU ARE HEARING VOICES.

AFTER SEVEN YEARS OF ARGUMENT AND MY BROTHER BEING INVOLUNTARILY ADMITTED SEVERAL TIMES A YEAR, I LEARNED A DIFFERENT APPROACH WHICH I, FRO THAT BASIC FUNDAMENTAL APPROACH, DEVELOPED THE APPROACH THAT PHIL WAS TALKING ABOUT, WHICH IS THE LEAP APPROACH.

>> THE LEAP.

TELL US WHAT THAT STANDS FOR.

>> LISTEN, EMPATHIZE, AGREE, FIND AREAS WHERE YOU CAN AGREE AND THAT'S WHAT YOU P, THAT'S WHAT YOU PARTNER ON.

LISTEN, EMPATHIZE, AGREE AND PARTNER.

WHEN YOU LISTEN AND EMPATHIZE AND FIND AREAS YOU CAN AGREE ON, AND IT'S NEVER GOING TO BE THAT THE PERSON HAS MENTAL ILLNESS.

IT'S GOING TO BE OTHER THINGS.

THEN YOU CAN BEGIN TO PARTNER AND ENGAGE YOUR LOVED ONE OR WORE PATIENT IF YOU ARE A HEALTHCARE PROFESSIONAL LIKE WE ARE, IN TREATMENT.

YOU CAN ENGAGE THEM IN TREATMENT.

AND THERE IS A LOT OF RESEARCH ON THIS.

IT'S NOT JUST MY CLINICAL EXPERIENCE OR MY FAMILY EXPERIENCE WITH HENRY WHO ACCEPTED TREATMENT BY THE WAY AND STAYED IN TREATMENT THE REST OF HIS LIFE, NEVER BELIEVING HE HAD SCIZ SCHIZOPHRENIA.

NEVER BELIEVING IT, HE STAYED IN TREATMENT.

>> YOU STARTED TO DO LEAP WITH YOUR BROTHER HENRY.

>> YES.

>> YOU WERE DEVELOPING IT AND YOU STARTED TO DO IT.

AND IT NEVER ACTUALLY PERSUADED HIM BECAUSE HE HAD THIS NEUROCOGNITIVE INABILITY TO RECOGNIZE, TO BE AWARE OF HIS ILLNESS.

>> WHICH GENERALLY DOES NOT RESPOND TO TREATMENT, EVEN WHEN THE OTHER SYMPTOMS GO AWAY: SO WHEN I ASKED HENRY ONCE, SO WHY DO YOU ACCEPT TREATMENT?

I SAID DO YOU THINK YOU HAVE SCHIZOPHRENIA.

HE LAUGHED AND SAID NO.

I SAID WHY ARE YOU IN TREATMENT.

WHY YOU ARE YOU GOING FOR THESE INJECTIONS.

YOU KNOW WHAT HE SAID?

I DO IT FOR YOU.

SO IT'S REALLY ABOUT CREATING THESE MOMENTS OF THE PERSON WITH THESE MOMENTS WHERE THEY FEEL UNDERSTOOD.

THEY FEEL LISTENED TO.

THEY'RE NOT BEING TOLD THEY'RE ILL.

THEY'RE BEING TOLD THAT SOMEONE WHO LOVES THEM WOULD LIKE THEM TO TRY SOMETHING.

NOT NN WHO LOVES THEM TELLS THEM THEY NEED TO DO SOMETHING.

NO, I'D LIKE YOU TO TRY THIS IF FOR NO OTHER REASON, DO IT FOR US.

IF YOU SAY IT'S FOR THE PERSON FOR MENTAL ILLNESS, YOU'VE LOST THEM.

THEY KNOW THEY DON'T NEED IT AND THEY'RE NOT MENTALLY ILL. >> HOW DID IT WORK OUT WITH YOUR FON, PHIL.

>> CONSISTENTLY CONTINUOUSLY USING THESE TOOLS OF LISTENING AND EMPATHIZING, WORKING TOWARDS SOME AGREEMENT AND PARTNERING.

WE REBUILT A RELATIONSHIP ALMOST BRICK BY BRICK.

BUT WE REBUILT IT AND TODAY HE IS DOING REALLY WELL.

HE IS WORKING.

HE IS ACCEPTING MEDICATION OF HIS OWN ACCORD.

AND WE HAVE A GREAT RELATIONSHIP WITH HIM, WHICH I THINK IS ABSOLUTELY THE FOUNDATION OF ALL OF HIS HEALTH TODAY.

>> WHAT A WONDERFUL NOTE TO END ON, GENTLEMEN.

I WANT TO THANK YOU FOR BEING HERE WITH US.

DEAR LISTENERS, YOU HAVE BEEN LISTENING TO CHECK UP FROM THE NECK UP ON COMMUNITY FM, HAVE A GREAT DAY EVERYBODY THAT'S ALL THE TIME WE HAVE, I WANT TO THANK OUR GUESTS... DR. DEBORAH POLLACK: CLINICAL PSYCHOLOGIST AND ASSISTANT PROFESSOR OF PSYCHOLOGY AT UTICA UNIVERSITY MS. TRACEY MUSARRA MARCHESE: EMDR THERAPIST AND TRAINER, AND PROFESSOR OF SOCIAL WORK AT SYRACUSE UNIVERSITY I'MER TO FOR MISPRONOUNCING YOUR NAME.

DR. BETH HURNY-FRICANO: DIRECTOR OF CLINICAL SERVICES AT ARISE IF YOU'D LIKE TO SEE MORE OF OUR PROGRAM AND EXTRAS, VISIT OUR BOOKS, REFERENCE, ET CETERA, VISIT OUR WEBSITE, WCNY.ORG/CYCLEOFHEALTH.

TO HEAR OUR NEW COMPANION COMMUNITY FM RADIO SHOW, CHECK UP FROM THE NECK UP, VISIT WCNY.ORG/COMMUNITYFM.

FOR CYCLE OF HEALTH, I'M PSYCHOLOGIST DR. RICH O'NEILL.

THANKS FOR CHECKING IN.

♪ ♪