52: When Mindfulness Doesn’t Work with Dr. Raquel Martin

Have you ever been told to “do a mindfulness practice” only to find that it doesn’t work? Let’s talk about some alternatives to mindfulness that can help with unhelpful thoughts and negative feelings. I’m joined by Dr. Raquel Martin, a psychologist who’s here to discuss this hot topic in the current “therapy talk.” She may sound familiar to you if you’ve listened to my audiobook, How to Keep House While Drowning, as she wrote the section about caring for black hair when you might be struggling.

Show Highlights: 

●      How Dr. Raquel defines mindfulness

●      How mindfulness helps us distance ourselves from unhelpful thoughts and negative feelings

●      Why it’s helpful to think, “This is just a thing”

●      Why mindfulness is not the best fit for everyone

●      How a “stress kit” can be helpful

●      Why deep breathing is not the regulation answer for everyone

●      How alternatives to journaling can be beneficial without “writing”

●      Why therapy and coping skills must be customized to the individual

●      The difference in rules and boundaries

●      How different our world would be if people received mental health support

●      Why compassion and understanding are the keys in understanding a person’s mental health struggles and individualizing their treatment

 Resources and Links:

Connect with Dr. Raquel Martin: Website, Instagram, TikTok, Facebook, and Mind Your Mental Podcast

Connect with KC: Website, TikTok, Instagram, and Facebook

Get KC’s book, How to Keep House While Drowning

We love the sponsors that make this show possible! You can always find all the special deals and codes for all our current sponsors on our website: www.strugglecare.com/promo-codes

• Transcript

  KC Davis 0:05

  Hello you sentient balls of stardust, welcome to struggle care, with your host, KC Davis. That's me. And this is the podcast that probably knows that you are sick of hearing about mindfulness. And so we're going to talk about mindfulness, but in a way that maybe won't make you feel sick of it, because we're actually going to talk about some alternatives. And why you maybe have been told a bunch to do mindfulness, and it's not working. So I have with me here today, the great Dr. Martin, Dr. Martin is amazing. Don't let her tell you anything different. And she actually if you've ever listened to the audio book for how to keep house while drowning, you'll recognize her voice because she wrote the portion of my book about how to care for your black hair. When you might be struggling. I figured I could probably not cover that subject, as well. So Dr. Martin, thank you so much for being here.

  Dr. Raquel 0:55

  Oh, yeah, definitely. Thank you for having me. We really agreed on this like one topic, because I was just like, one thing I'm not going to do is tell you, you have to journal. Absolutely,

  KC Davis 1:05

  Yes. Oh, I'm so excited. So Dr. Martin, you are a psychologist. For anyone listening that doesn't know, I'm a therapist. And I feel like mindfulness has been like the hot topic in therapy for a while now. And I have to say that there are aspects of mindfulness that have been kind of game changing for me. But at the same time, it now feels like it's become like the panacea to all ILS. And I feel like it's like closely getting a little pop psychology II where like, just meditate, just journal, just be mindful. But I'm sure there are people listening that maybe don't even know what mindfulness is. So what definition would you give to someone just like a lay person that didn't know what mindfulness was?

  Dr. Raquel 1:47

  I typically talk about it in terms of like, it's the whole movement of being more aware of what's happening in the present moment, as well as like, instead of focusing on the intrusive thoughts that are happening outside, and the reason why a lot of times I feel like it's also been done wrong is because people will talk about tasks, like journaling, as like being in the present moment, but then they'll give them journal prompts, where you're meant to discuss like, how did I respond to something that happened like hours ago, which is not what mindfulness is, right? Like when you when one aspect of when we get trained it and when I knew that I was like, I'm gonna learn about this, but it's gonna be a strong though, for me, when I integrated into my own therapeutic technique, is we did tasks such as mindful eating, when all you're supposed to do is focus on like, chewing the reason? How are you feeling chewing? The reason? What is the texture in chewing the reason? What is the taste and chewing the reason? Like, what is the sound of hear you chew the reason, right, and doing that same thing when you are processing like your thoughts as they come in the moment, not like, Oh, I'm feeling stressed out. And it happened as a result of this 20 minutes ago, I'm currently feeling stress. And the stress in my body feels this way in that way, and things of that nature. And I do feel like it's very helpful for other people. However, it just never really resonated with me. And I also felt like, the way that I got education about it previously, is not the way I see it used by a significant amount of clinicians. And that's why I'm like, you know, I don't know if I am wrong about this, or if the general public is wrong about this, but either way, like, I'm just not going to, like, we get to choose what modalities we focus on the majority of the time, and people come to me for very specific thing. And I just found as though, you know, it's different when I give tasks such as let's look at your racial identity development and do journaling tasks. But that's not a mindfulness task. That's a, we're talking about processing the way this your development has dealt with everything. That's not mindfulness. And I've also felt really gross about it lately, because when I look at different clinicians of like color, and like indigenous background, stuff like that, they often talk about the way that it's been gentrified, and that it kind of is used inappropriately, so that also has made me not want to, you know, use it as a technique, because they mentioned a lot about like, well, this actually isn't anything different than what has been used in other cultures. However, the way it's been repackaged, is really inappropriate. And it's stealing from like native and indigenous culture. So that's always given me an IQ of about it as well, because none of my professors have ever been, who tried to discuss it native or indigenous, or like people with the golden majority. And yet, they're teaching me about this method. And I'm just kind of like, if you want to teach me about CBT, fine, but we're totally disrupting the whole education from the individuals that should be coming from.

  KC Davis 4:25

  Yeah, it is definitely an Eastern concept versus a western concept. And I think what I've seen also happen is that, as a therapist, and particularly like, as a white female therapist, so much of what I was taught was that like, the main problem in a person's psyche, is like the way they're thinking about things. And so my experience with a lot of therapists is that whatever modality they're using, and I've had it with a lot of different ones, they approach it as if like, okay, Casey, like your suffering will go away. If you could just master this modality and that only works with people where the only stressors in their life are like, the way they're thinking about things, right? Like not actual, I don't have enough money. There's some conflict with my spouse, I'm experiencing, you know, prejudice, like real things that like might not go away. And I will say that I'm with you. Like, I don't think people talk about what mindfulness is, I appreciate the definition of like, observing yourself in the present moment without judgment. Like, I think that can be really helpful. And I appreciate when people talk about like observing your thoughts, like clouds in the sky, because I will say that the way meditation was taught for a long time was about like clearing your mind. And I can't do that. And so when somebody was like, no, no, it's not about clearing it. It's just about like, watching it as it goes by. However, I will say the only thing that's ever for me, I felt like was like, what mindfulness could do is that I was thinking about this the other day, like, for a long time, when I experienced distress, it was like two layers. So there'll be like the primary distress of like, I'm angry at my spouse, but then there'd be like, this secondary, like, almost like meta distress of like, and I'm upset that I'm upset about it. Or like, I'm angry that I'm angry. I'm sad, that, you know, may or may be like, wake up in the morning, and you're like, I'm just feeling sad today. And I don't know why. But then there'd be like, a second layer of like, and I'm really sad that I'm sad. I'm not supposed to be sad. There's nothing wrong. Why am I feeling this way, and feeling as though like, there's always something wrong. And I will say that, like, I think it's not that I don't get SAD and MAD and feel depressed some days. But I feel like, I've learned how to not have that second layer. So like, I can beat wake up and be sad, and then be like, Alright, I'm sad today. Like, that's a thing. And it may not be there tomorrow. And it's kind of like, appreciating the impermanence of like, I may not be angry tomorrow, I won't feel like this forever. But it's also like, okay, for me to feel like I don't enjoy it. It's still distressing. But I'm not like distressed about being distressed, as if there's something wrong with it as if it's going to be permanent, as if I need to frantically figure out how to change it. And I don't genuinely like don't hear practitioners talk about that aspect, which to me was like the part of mindfulness that was helpful.

  Dr. Raquel 7:22

  Yeah. And you know, it's funny, because like, at one, like you're talking about the distancing aspect of it, right. Because like with mindfulness, you're supposed to like, distance yourself from the unhelpful thoughts and memories and just acknowledge them. But even the way that you discuss it is more helpful than the way I've heard other people discuss it, right? Because when you're distancing yourself from it, you're trying to do the same thing we do with like, not using diagnoses as adjectives, right? Like, you know, I am angry about this, I'm not an angry person, I am angry about this. And I'm not going to be angry permanently. Because it's not an aspect of my personality. I'm not defining myself as an angry person, I'm angry at my husband, and I will likely not be angry at him later. And if I am angry at him later, maybe I will not be angry. I have later on after that. But I'm not an angry person. Like, it's not a part of my personality. It's not an adjective that describes me, right? And most of the time when they're what I've seen people talk about it, it's kind of like what you mentioned, they're like, distance yourself from it. Right? Okay.

  KC Davis 8:16

  But that's not what I feel at all. I feel like I'm bringing it closer, because to me, there's distress from tried, like, I don't need to feel this way. I shouldn't feel this way. I don't want to feel this way. How can I get this feeling away? Something's wrong, how do I fix it? And to me, it's like, the opposite of distancing. It's like, I'm sad. And I, I'm gonna bring that in, like, I don't have to be afraid of it, or run from it, or panic about fixing it, because it's a temporary feeling, you know, of today, or like, it's a human feeling at least. So there's like, there's distancing and that, like, I'm seeing that, that, you know, things always change, Nothing stays the same. And so like, this negative feeling will change. But it's like, but I'm actually bringing, I'm like, not afraid, like, did you ever read is I don't, it might have been a Rumi poem, but where he talks about inviting all of your feelings in I have it, and he's like, let them come in. I'll look it up.

  Dr. Raquel 9:07

  Because to me, what you're describing makes me think more of like, Have you heard of like, the rain technique, like the you know, you recognize you acknowledge? Yeah, it's like, I did a video on it, where I use like a little Wayne song because he has a song where it's like, make it rain. I'll send it to you. But it's like, you recognize the emotions. And in the video I talked about, like, I was doing acting like I was working on an assignment. And then somebody came in, which was me, and I was like, you know, I came here to ruin your day. You know, I'm, I came here to ruin your day. And I look at the emotion and I'm just like, Oh, that makes sense. I'm feeling stressed out because I'm doing this assignment. As a result, I feel overwhelmed. And my emotion is like, well, I just came here to shut it down. Are you going to stop working and focus on me? And I said, Well, I'm acknowledging that your president I'm not really going to take you out of the room anxiety. I am feeling anxious because I'm in an anxious you know, situation. So like, go sit down in the corner. I see you. I get the church here, and I'm still just going to continue to work in and deal with that, right? Because you're recognizing the emotion, you're acknowledging where the emotion comes from. You're not identifying with it as like your individual, like you're an anxious person. And you're moving forward. You're like immutable trait. Yeah, it's just like, it's, and I think that's what like most people do, they'll be like, Oh, I'm an anxious person. Because it's like, no, it's like, I'm feeling just because I'm dealing with this. This is how it is, and doing it without like, having to dismiss it. Like, I'm not feeling that I'm fine. Like, it's not toxic positivity. Exactly. And that's why I go more so according to like the rain man, because the first one is recognize that is present. You know, I'm totally for the whole aspect of it, you know, you gotta like CBT is what insurance wants us to see us do. So we're like, looking at the cognitive distortions. And we're combating it with journaling and investigating where it came from, and what are things that support this thought versus go against this thought, and that's all well and good. Like, sometimes that will be helpful for people. However, sometimes, for a lot of people, it's just as helpful to be like, this is the emotion, you know, this even just identify, oh, I'm feeling upset, or I'm feeling distressed, or I'm feeling like this really took a bite out of who I am as a person and acknowledging that recognizing it. And then also not identifying with it, right, like I'm recognizing it, I'm acknowledging where it came from, from investigating it. I'm also like, the most important part to me of the array method is like non identification. Like I'm not identifying like, this is a key part of my personality.

  KC Davis 11:21

  So that's exactly this poem, I found that you want to hear it. It's called the guest house and it's a Rumi poem. It says this being human is a guest house. Every morning, a new arrival, a joy, a depression, a meanness, some momentary awareness comes as an unexpected visitor, welcome and entertain them all. Even if they're a crowd of sorrows, who violently sweep your house empty of its furniture, still, treat each guest honorably. He may be clearing you out for some new delight, the dark thought, the shame, the malice, meet them at the door laughing and invite them in. Be grateful for whoever comes because each has been sent as a guide from beyond.

  Dr. Raquel 12:00

  I feel like that's perfect. And that whole poem, it doesn't say anything about this is a good thing. This is a bad thing. This is just a thing. It's just a thing. That should be the title of this. This is just the thing. It's just a thing, episode.

  KC Davis 12:15

  I also think what a lot of clients have when they hear this kind of talk about like, Okay, here's that feeling the feelings not forever. My first thought is like, there are people who are in circumstances that maybe they don't see them changing quickly, or they have been feeling this distressing feeling for so long. And they're going, How is this any help to me? Like, I have been depressed for three years, How is this any help to me, I have been in a marriage where my spouse does not respect me, but I don't see a way out right now I have been in a place where I am in poverty and will be so for the future. Like, this is not a feeling that will I'm not wanting to laugh at the you know, in the morning, because it's gonna go like it's gonna be here forever. So I want to I'm curious those thoughts, and then I want to hear about you. And this whole conversation started because you made this brilliant Tiktok, where you talked about how you talk about mindfulness as an offering, and that for some people, it's not a good fit, and you actually have alternatives that you offer, which I really appreciate. But let me let's do a quick little break. And then we will come back.

  Okay, so first of all, what would you say to people who are listening that are like, well, this is all good, and well, but like, my shirt has been shipped for quite a long time. Now, most of the time, I want to refer them to kind of like your stuff. But I'm always like, I always say,

  Dr. Raquel 13:37

  I'm like, I'm the monarch of meeting you where you're at, we're going to use what works and not use what doesn't work, right. I mean, it's difficult with social media, because some people will see stuff, and they're like, that doesn't work for me. And I'm always like, then this wasn't for you. And that's okay. It's important to realize everything isn't for you. But sometimes when I'm talking about one, I try to look at whether it's an internal thing or an external thing, right? Because that's the biggest thing. So many times I feel like therapy can be dismissive, if you don't have an appropriately trained person, where they're telling you to think happy thoughts and focus on what's happening in the moment, and not also thinking about what we brought into the room with us in that moment. Right. The reason why I feel like some people at the Global majority don't resonate with the way mindfulness is taught when it's taught in an inappropriate manner is because it completely disregards the aspect of oppression that we have to reside in, right, like I can talk about in this very same moment, like feeling a certain way and acknowledging that and then I'll leave and go to work, where I am, you know, the victim of like institutional oppression and internal questions, stuff like that, right? So when we're identifying skills, I typically say use what works and doesn't don't use what doesn't work. And I look at different aspects of it. One of my patients who I feel like she was very sensory person, and she was like me in a job where there's so much gray, like, there are so many where we have so much gray. So in talking to her, I was like, you know, it occurs to me that we have some similar aspects of our careers. And some of the coping skills I use are very, like black and white, they very much have an endpoint and that

  It helps me because my job doesn't have an endpoint. So how would you feel about some things that we look at Gatti towards certain senses? And she said, that seems good. And I was like, Okay, I crochet because I love the feeling of yarn. And I love the fact that if I mess up a knot, or if we even see if it's a knot, I can kind of just take it out and keep going. And the sensory aspect of just the tactile response of yarn like suits me. So we kind of spent some of the session like going over that, like, do you think that is helpful? You also mentioned that you're very sensory with scents as well, like, you know, when it comes down to it, how do you feel about you know, carrying around like a little aromatherapy spray, we created like what we created for her that was helpful was like a little pack, you know how everyone used to have those like makeup bags, I was a member of Ipsy for a little bit, so I had a ridiculous amount of makeup bags is when they used to send you makeup every month. And I gave her some because like Why pay for it, I said you can use a Ziploc bag, but I was like, I also got the so just take these makeup bags, and we created a kit that she would take with her it was kind of like her stress kit, right. And we put a lot of sensory stuff in it that she kind of resonated with. So we put like funny memes that she liked, like the visual aspect of it. We put like an aromatherapy thing in it, because like the scent aspect of it. And we also talked about the possibility of crocheting. But a lot of times when we look at skills to help us to help us in the moment, I think it's also helpful to look at things that bring you something that your typical wife doesn't bring you, right, like our job is very gray. So I'm like maybe it'd be a stress relief to have something that is concrete, where it's like this has an end date and a start date, right. It's one of the reasons why I like baking, I like baking more than cooking. Because cooking, you can kind of like play around with it and you can still come up good baking is very much controlled. And in a world where I'm dealing with so much lack of control, I like baking more. I like knowing that like, don't use a leveler use room temperature ingredients, just knock this out black and white. And I think sometimes when we're talking about coping skills, we also need to look at skills that give us something that are typical life doesn't like some people who have like, really concrete jobs may resonate more with like little art stuff that's like, oh, you know, like, I use the colors. And it turns out the way it turns out, it's meant to be that way. And when they go to work, it's very much this is the answer. But when they chill, and they're just doing watercolors, it's like, you know, happy trees or stuff like that. And then also look at it from a sensory perspective, a lot of us are really sensory, like a lot of us thrive off of like certain scents and tastes and touches and smells and stuff like that. How do we put that in your coping? What do we do with your Coping kit? Right? If you're more visual, how do we make your environmental just like you need like a more visually stimulating thing, when we're talking about panic attacks one time, like one of the stressors dealing with the symptoms, but one of the things that also stresses people is thinking that they're about to have another panic attack. Like when you mentioned your emotions on not only the emotion, I'm feeling bad about feeling that emotion, right. And it made me think of panic attacks because one of the stressors is the physiological symptoms. But another one is they stressed out about not knowing when the next panic attack is going to happen. Right? It's coming right it's coming don't have a panic attack. Now don't have it now don't have it. Now lock it down, lock it down. Just it's a very like it's a cognitive thing. And when I treat panic attacks on our treating patients, like when there's symptoms or like an increased heart rate, I make them have an increased heart rate. And then I let you know that you can bring yourself down like one of my patients had panic attacks, he said, every time I have an increased heart rate, I start thinking I'm going to have another panic attack, and then it makes it worse. So I'm like, Cool. So you're going to run around the building a couple of times, you're going to have an increased heart rate. And we're going to work on the ways that help you bring it down. Because there's only so many ways I can make you not you know, we can't really make you not have a panic attack. But what I can do is empower you to realize that when this happens, when I started had an increased heart rate in Dr. Martens office, I brought it down this way, right? Some people are more cognitive,

  KC Davis 18:30

  When even that permission of like, I'm allowed to have a panic attack right now. Like I'm allowed to like I can have one right here. Well, I'd be embarrassed probably have I been embarrassed before? Yep. Did I survive? Absolutely. But I'm allowed to have like, that's all right, I'm gonna find a good place to sit down. Like I'm allowed to have one right now. Because it is like so much of that panic. I think that's so true. And I can't remember who said this, but it maybe you saw it, but it was someone talking about like breathing. Like we hear that a lot. That's like a thing to talk about, right? Like, take deep breaths to calm down, take deep breaths to go grounding. And I remember hearing a therapist say like, you can't just go around telling everyone to take a deep breath, because for some people, that's going to be like more triggering to them. And she was talking about trauma patients, which I found really interesting. I hadn't thought of that before. Because for me, I'm always just thinking about, like, when we start to panic or get dysregulated you know, we're often like that prefrontal cortex where we do the thinking gets sort of goes offline, because we're gonna start to go into fight or flight. And the benefit of like breathing exercises is that you slow the heart rate down and you're like bringing enough oxygen to your brain that it cues that prefrontal cortex to go back online. But I thought she had a really good point where she was like, you know, for a lot of trauma patients, having them stop and do deep breathing. And I don't remember why she said that, but she was like, it is not helpful, like they need a different way to regulate. And I just always appreciate hearing someone say like, yes, because it's always like

  Some new thing, right isn't usually not new. But it's like new to popular psychology. And we realize how valuable it is. But then like, it reaches a point where it becomes the pop psychology and then it's like, everyone everywhere is just saying like this will solve it, just do this, just do this, just do this.

  Dr. Raquel 20:15

  And it's ridiculous, right? Because it's also like a thing of the time's right? Because there's so many people looking on the interwebs, because they don't have access to like services. And you mentioned this too, like, I very much feel like you can work on your healing and not have that help of a clinician, because most of you can't find a clinician totally understand that. But it gets so diluted, like it gets so diluted. And when people say there's one right way to do it, I'm always like, you know, use what works and don't use what doesn't work, right. Like one person, like I saw, they're like, I really resonate with journaling, but I just really don't like writing stuff down. Like I like the processing of it. I don't like writing stuff down. I said, do a voice memo. What you don't have to physically write I'm like, No, you could do a voice memo, you could do a voice memo. You can journal with pictures and identify like, don't feel bad, because you can't write it don't write, you can still process whatever.

  KC Davis 21:02

  I've heard people say that they when they got a journal that had the dots instead of the lines, that that was so helpful, because it felt like there wasn't yes, there wasn't this expectation that you write. And it's also helpful because it's not a blank page. And you're like, Well, I can't draw and it's like, okay, just connect the dots like, because I'm not like a good artist. But I would sit there and like make little trees out of the dots. And then I can write something. But then I don't feel it's just it's this very back when I had a workbook for a little while that was online. But that's when I did like free form pages. I always use dotted paper, like dotted graph paper. I know, I think that's helpful. I like that. That's very helpful. And you know, like, it's another aspect of like, maybe where you're at, right, because like some people can freeform right, I get that. Some people like prompts. So one post, I was like, ask your clinician knows your goals as much as you do. So if you're good at freeform, that's great. You can also ask them for some prompts that you feel like goes towards your goals. And they because I'm guarantee you they have questions that you can ask yourself that they want you to ask yourself that you could just answer is well, I had a client one time that we were processing a lot of trauma. And she didn't want to write about it, because she would have flashbacks. And so what we did was, each week, I gave her a question. And she would actually draw pictures as a response. So your question would be like, you know, how has therapy felt for you so far. And she would get the whole week to sort of think about it sit in it, and she would bring back a picture. So like she would bring back a picture of, you know, herself naked have stuck in the mud. And there were birds flying around and like so she didn't have to go to this place of thinking about such concrete words and memories and emotions, that she would kind of get thrown into a flashback, she could just sort of Intuit it. And then in the session in the safety of the session, we would look at the artwork. And I'd say, tell me about this. And she would describe the artwork. And that was the way that she was able to talk about what her experience was. And we did a lot of that with like, in the moment stuff like how is therapy felt for you so far? And what are you afraid of going forward with therapy? So we did a lot of like, meta expression about the therapy process before going into, you know, how would you draw your relationship with your mom, or some big, huge, whatever, but it was very, very cool. And like, at one point, I asked her like, what is it like to have a flashback? What is it like to have this trauma, and she would draw these pictures of herself like going about everyday life. And then there was like the shadow world that was always like on the periphery of her vision. And, you know, at one point, she had this beautiful picture of a closed door that she had locked in chains around it. And there were like, tentacles coming out of the sides. And she was like, if I open it, it'll be over. And each picture like, I was able to ask a question that was like a genuine like, I want to understand this more. And then she could go in her own way and process that. And we didn't have to do you know, tell me about it and do some deep breathing and and all that stuff that is can be super helpful, but shouldn't be like you said it shouldn't be that like prescription for everyone.

  Dr. Raquel 24:25

  Yeah, and think about like how powerful that is, right? Because a significant amount of my training is like trauma. And when we had to do like work with people on TF CBT, which, and they have to do their narrative, right. When we're working with children. We also allow them to like draw pictures. And it's one of the reasons why what some of the helpful things I did get from trauma focused cognitive behavioral therapy, is that when we did our training, the person who trained us was very much like this is because we were also working in a center where we also did an integration with the justice system. So not only am I working with them as the clinician, but I prepped, you know, everyone had an open case and I pray

  Have to my client for the case like we would walk through everything very much like how it should be if you decide to go through like with the whole judicial process, your psychologist talks to the district attorney talks to the officer talks to like everything like that was my job as well. It's like, I'm not only here for you, this is the process, Oh, I feel uncomfortable at the courtroom. Let's go. Let's go see it beforehand. That's how it should be. So I love when it's done right. Most of the time, it's not. But one of the things they told us is like when it comes to the narrative, the reason why people want us to like put it into the court case and stuff like that, it's because they think it's really like they're going to tear it apart piece by piece. We do not care as clinicians about what every single fact is, with this individual sharing their narrative. Because we are, and this is why I focus more on impact and not intent. Right? I am not a lawyer. If you feel as though something was, you know, like forever, like something like that. That's what it is. I do not care about facts without like, when we're discussing the narrative. It's your experience, you know, like, it's not about like, well, we're going to tear this apart in court to know about fact, by fact, oh, to me, the only fact that matters is the aspect that my patient felt this is truth. I don't care about the facts. The fact is, whatever my patient tells me, because that's what they felt. And that's what they experienced, right. And think about like the salience. And this is why a lot of people miss this as like licensed clinicians who are talking about this, because yes, we do get educated on this thing. But I would say the most salient aspect that I get is when I have a patient, and we go over crocheting, or when you have your patients, right, and it's like, oh, I can tell you what we can do piece by piece. But I can also tell you, this reminds me of this one patient I worked with who had really resonated with him to draw it, right, like practicing. Educating is one thing like having the degrees and certifications is the one thing, but most of it is when we're like off the cuff, giving everyone that the honor and the therapy that they deserve of case conceptualization and customizing it to you, and discussing what resonates with you and your individual skills, right to know that like, this also may be helpful for you. Because we get so much from our clients, right? Like Oh, aren't made work for you. But a voice memo may work for you. One of my patients does free guided freehand and writing out the prompt of once we come up with a prompt every single week. Some people do dots, some people do lines, and we get that from working with people. And that's why it's like, I think it's why both of us don't resonate when they're like everyone do this. We don't do that for all patients, because they're not.

  KC Davis 27:28

  And it's the difference I think between like a good therapist and a great therapist are like good therapy and great therapy is that some therapists are kind of one trick ponies. And that's fine. It really is like, if that's like this is my one approach. But if you're going to do that, then you have to be proactive about screening your patients and telling them point blank refer out.

  Yeah, I'm a CBD person, or I'm a DBT person. And like, this is what it is. And this Atlin let's make sure you're a good and I've talked about this before, there was a therapist that I worked with that he did things a certain way. And before he would even take me on he was like I need to screen you because if you've got a B, C, D, E, F, G, I don't do that, this will not be an appropriate process for you. And I think there are other therapists that have decided to have a more eclectic sort of toolbox, about things that work. And like, you know, same personality no matter what, like my personality is the same. But like, we can do art, or we can do CBT. Or we can talk about this or like I don't think that I was taught enough about like exposure therapy. I mean, so much of, you know,

  so much when we think about like distress tolerance. Because no matter what's going on, even if the things in your life can't change, like we can all reduce the amount of suffering in our life by increasing our distress tolerance. And I think that, you know, mindfulness says the way to do that is to sit in that feeling and feel that feeling and just embrace that feeling. But for some people, that's too much. Like they're going to be so flooded with that feeling that just skipping right to sit in that feeling and watch the clouds go by or whatever is like too much, as opposed to like, let's like you said where it was like run around the block. Like let's think of an environment that might bring this feeling on and then how could we experience it with safe risk? And because you usually only think about this with like, oh, agoraphobia, where it's like take one step out the door. Now take two steps, but like we can do this with other emotional distress, whether it's panic attacks or loneliness, right, like let's schedule a night to be lonely but only for a few minutes and then you go do something like thinking about like, that same feeling of I'm okay, like there is a central tree trunk that like runs through my being that I know that I'm okay. Even if like the wind is blowing, even if I'm experiencing really distressing feelings, symptoms, like there's this internal sense of

  have, like I can create enough safety to storm.

  Dr. Raquel 30:03

  So that makes a perfect point. But it also makes me think about that's why you're like the theory you came up with. That's why it's the theory you came up with. Because it It very much is an aspect of training. Right? I remember reading, there was someone who commented something on one of your page, and they were talking about boundaries. And you mentioned you're like, I actually see boundaries as a very different as a different aspect than most people because I was significantly trained in the aspect of boundaries, right? That's why when I came on my boundaries video, I was like, I have to send this to you first. Because like, I feel like this is what you say all the time. And nobody ever like verbalizes it right, right. Because you always talk about like boundaries are everyone I feel like who's trained in it gets it boundaries are guiding my behavior rules are guiding someone else's behavior. Like when I tell my students and said, Listen, my boundaries that I do not reply to emails over the weekend or after five, your boundary can be whether or not you do the same. But I'm telling you can send that email whenever you want. I'm not giving you a rule on this, my boundary is I'm not replying at this certain time I'm guiding my behavior, I'm not guiding your behavior, right. And that's it makes sense as to how you your theory is very much like this, you know, my boundary is when it comes to this space. If it doesn't serve me, I am not going to keep a space. I am not going to keep this under this ridiculous rule regarding folding clothes, or, you know, cleaning up the whole house at once. Because it doesn't serve me that's my boundary. Right? And very much saying that resonates with you, right. And I did a significant amount of training in trauma. And there is a lot of exposure in that piece. Right? There is a lot of I always say impact is more important than intent as someone who has to work with people on the impact that someone else's choices had on them, right. And that's why a lot of times, I'm always like, listen, I focus more on impact than intent. I also focus on some semblance of like, what the exposure is and what the distress tolerance is, as well, like when people say, I had no choice, that's not true. You just have to choose between one sucky choice and another choice, right, we have to decide which one distresses you more, a lot of times people will think like I have a it's a, you know, a very good decision or a very bad decision. But that's not what you're getting. In this scenario, you have to deal with some BS that someone put on you trauma stole your choice in that aspect, we have to, you know, like deal with some form of exposure. And then when we're dealing with distress tolerance, we go with like, you know, the whole ladder, the hierarchy, like what's going to make you less uncomfortable as we get up. Because no matter what, when I'm dealing with racism related stress, like you still have to go to work. I can't say that you can't go to work, you can't just leave this country. So let's figure out like how we deal with it. But it very much, you know, this is why I always thought maybe we could do another topic. This is why I always talk about like, you get so much salience from working with people who have made it a choice to streamline their training, I'm okay with knowing a lot about a little, because it really does help the individuals to to understand that right, like one of my favorite therapists, Colby Campbell, she mentioned, you know, everyone deserves therapy, everyone does deserve therapy, everyone deserves that space to resonate with taking the time to sit and deal with like what happens even if you know, the world is telling you to get rid of something that you stressed out about last week, therapy is one of those relationships, that is not really reciprocal. And all relationships are meant to be reciprocal. But I say that that's the power of therapy. It's like, yeah, you can ask me about my day, you also don't have to, I deal with you in the moment. And then I also case conceptualize with you, we also go over your plan or lack of plan, whether you want that or not. And I'm dedicated to you in that space. That's why we pay for like, specify people. And people will use therapy, like you need therapy as like an abrasive statement. And it's really like you deserve therapy. We all deserve a space.

  KC Davis 33:45

  The world would be so different if like if universal health care included therapy, because you deserve that. I would love someone to do like a study I read recently, there was a there was a school, I remember it was a little town, I think it was a school. And they did a study, they took all of the smartphones, away from the teachers and the students for a year. They all agreed voluntarily to do this. And they followed them over the year and checked back in to see like, how was your life and they reported some really interesting findings about the benefits that they found that year by not having smartphones. Now I don't I mean, I'm not one for like demonizing smartphones, but I wish that they would do that, like with therapy, like pick a school pick, you know, and decide this cohort of children will have therapy for the rest of their life and follow them and see how different you know, their life and the impact of the people around them would be if they were consistently supported in that way.

  Dr. Raquel 34:44

  That is amazing. And as someone who's currently writing grants for their lab next year, I don't know if they will be therapy, but I wonder if I could see if because I suppose it was a black identity development like what would it look like if we worked with the population and we follow them for Fortis

  Six years, and we specifically focused on socializing them appropriately.

  Ooh, if this comes out, you will definitely be in the acknowledgments. Yeah.

  KC Davis 35:12

  Thank you. Well, here's the thing is that it makes me think about the amount of studies and nonprofit initiatives out there that have this sort of like, Oh, if we just gave everybody, you know, like, they had the one where they, they were over, they were in a country in Africa, and they gave everyone D warming medicine. And they were like, it's, that's it. Now we're gonna go to school more, and they do this more, they do this more. And then you see all these studies about what if we give kids laptops in school? Or what if we had to? And they're playing with all these different variables? Like, what if we gave free lunches? What if we had this universal income? What if we had, you know, what if we did uniforms versus no uniforms? What if the teachers reflected who the students were, and I think all those variables are important. But I think it would be fascinating to see if the only variable that changed was that some of these children received mental health support, like maybe not direct therapy, but some sort of social emotional learning.

  And support, how different that would be, I like,

  Dr. Raquel 36:17

  love that full stop. That sounds amazing, because I think you could go into schools where they're already doing that, like my kid goes to a school where they do a lot of social emotional learning, but like, it's also like a private school, you couldn't say, oh, all of this is different, because they live because Piper learned that in the second grade, because the kinds of parents that send their kids to those kinds of schools are already doing that work at home. So you can't really and they probably have more money. And so all of these outcomes, you can't really attribute to that the school was that they had social emotional learning, because, well, there's money. There's your parents doing social, emotional, there's difference in the kinds of parents that send their kids. And I just think that would be so powerful. And I'm like, on the camera, and it's but it's kind of just like when I think I look up at someone who's not there, but like, that's a really good point. Okay. I mean, I hope you do it now. Yeah, well, I'm currently like writing grants to like, figure out what am I going to do for my lab in the fall? And that's a very good point, because I was going to try to work with this school. That's like a private school. But the reason why would have been helpful because they're very much like a blue.in, a red state, because I'm in Tennessee. So it would have been easier to get the buy in. However, just like you mentioned, that's not really helpful, right to show the efficacy of the actual program. Because if I'm dealing with the school, that's the blue dot and the red state, I mean, of course, they're going to be like, yes, how many parents moved to that area, because they wanted that for their kids. And those kinds of parents are already socializing their kids differently at home, versus going to another one and being like, oh, no, I was set up to fail. Okay, like this could have gone really bad. And it didn't. And what you're mentioning is like, kind of like what we discuss, kind of, to me, it makes me think about your work too. And like the work that I do as well, because the biggest thing I think people are missing are like perspectives. And I always say we're only as educated as the narratives that are shared, because more narrative shared or more perspectives, right. And what you're saying when it comes to longitudinal research is we get more information and more perspective. But as clinicians, we very much are like focused on the qualitative good clinicians, in my opinion, we're very much focused on the quality of what is shared, right? I don't care if I heard 50,000 stories that said this one thing worked, that one person who it didn't work for, we're coming up with another plan for them, right? It's very much the difference between quality and quantity, we get so many things about these methods. And that's kind of like with the mindfulness thing, too, right? It's like, well, this helps so many people, but it doesn't help my person, the quality of what they're sharing.

  KC Davis 38:41

  And if it's not helping them like and this was one thing that really changed for me, because I was very much brought up in learning to treat addiction. And I have lots of thoughts about the way we treat addiction in this country. But one of the things that was taught to me early on, was that like, if a client isn't getting it, then that client must just be unwilling, they must not want to be sober, they must be unwilling to do and so what happened was, we had all these that we were so niched down and like this is my one approach, that we could completely excuse our failures, or and something, it wasn't like, Oh, I did a bad job. But it was, hey, that didn't work. And some of that responsibility is on me not to blame me. But to go. Now I want to figure out what to learn and grow as a profession, to figure out other ways that I can help when this doesn't seem to be working for them. Because it's easy to write off a client as well, that didn't, they just weren't willing, they didn't want it badly enough when it's like, I mean, and maybe there are definitely people out there that don't want to get sober or that just want to play games or just want to whatever, but I should at least be able to offer them different approaches and modalities and things or refer them to somebody with a different modality. Because even if that is where they are, there are still modalities that can reach that person where they are and help them change.

  Dr. Raquel 40:00

  and my thoughts about that are twofold. One, you're at least as a psychologist, we're putting this environment we're supposed to know so many things. And they make it such a competitive environment when it's like cognition that I think there's some aspect of shame with clinicians when they feel like they have to refer someone out. Like they don't want to acknowledge that they don't know something. Because I mean, honestly, academia is very, it's very much like a shameful, like place like you didn't do a presentation, you didn't do this publication, you chose a B paper and stuff like that, like that's an issue. But it also made me think because I love group therapy as well of Yalom, who is like always lionized as this amazing group therapist, but I'll never forget when I, we were in class, and they were discussing how he decided that it was time to address and I forget the word that he mentioned, the client who was coming in late two sessions, like sometimes they were coming late to group sessions. And they were saying, clearly, they were avoiding being engaged in the session. Clearly, they don't want to heal. And I think that it is time that the rest of the group addresses this person's I forget what the word was, but aggressive address, basically, their lack of dedication or resistance, their resistance, it was resistance, and we need to address the resistance. And I remember when we're talking about in a class, that's interesting, because myself, I automatically go in, and this is coming from Community Mental Health and like dealing with people where it's just as simple as it's never a question of like, Are you paying for session? It's always like, Oh, I know, you're paying for session like nobody can, you know, you know, it's never that right? Me, I would automatically going to, Oh, I wonder if there's some resources I can do to help you come on time. I wonder if we need to, like, see if this group is for you. And maybe we can switch to a different day or time. Like I automatically went, in my mind when we're hearing the summary about Iago, who is just like the genius of all group therapy, we all have to learn about him. I automatically went to let me check in with the patient and make sure everything's okay, and see if there's something that I need to do to like help. Can I link you up with some resources? Do you need like a capsular was one of the places I worked at gay free capsules, if you came to therapy? Is it some family stressor? Like do you also need individual therapy, usually in group and this person automatically wit to like, attack him, he is disrespecting your time he comes to session late. He's not respecting the group. And I was like, it's so interesting. And you know, moral law. That's the thing. We jump right to moralizing the behavior, right? And I go to like, How can I help? What's going on? Like the same way, I had a student who kept falling asleep in my class, and it was this semester, and afterwards, I was just like, can I talk to you after? And he was like, Yeah, and you could tell he was already set up to be like, about to get in trouble. And I was just like, is everything okay? And he was like, I worked the night shift. And I come into class. And I know, I need to be present for the class. And I don't want to be marked absent. And I was like, Okay, well, I think you missed this. During our first week. I said, but I said, Listen, I don't do that when it comes to being present. I was like, it's very much a choice. And I said, also, I said, Honey, if you're sort of like, this is my honey, if you're not conscious, you're not President.

  You know, so I was like, you know, I just want to make sure everything was okay. I don't do that whole aspect of you can only have this amount of absences because you're an adult I but I do want to say that if you have questions about an assignment, a lot of times people ask them during class. So in order to accommodate that, if you can come to class once a week, make that the day if our class is on Thursday, review something on Wednesday, so you can ask me because you don't have two days to ask me because you can't come to the Monday class. That's what your shift is. But I automatically went to like, are you okay? Is everything okay? You know, like not, Oh, my God, my lecture is so boring. Like, when I can't believe they fell asleep. I was like, Honey,

  I know you were working on work.

  KC Davis 43:30

  I used to remember, did you ever this happened to you in school where like, if you yond there was always a teacher that was like, Am I boring? You Miss Davis, like, and I remember always thinking like, it's like now that you mentioned it. I remember thinking people don't yawn because they're bored, dumb as they yawn because they're tired. And that has nothing to do with you. I'm tired. So I just always thought that but yeah, I think and I know people are afraid like, well, you know, we have to hold people accountable. And that's true. But I also know that like, as someone's provider, I am best able to hold someone accountable from a place where they have experienced compassion and accommodation from me, because they're going to take me more seriously when I tell them. This is actually something that like, you might need to just do it. And then because I've believed them about their abilities and their limits, they go, maybe she's right, maybe I am capable of this. And she's not just someone that runs over the top of me and tells me every time that I should just be able to do it. She has recognized the times when I truly need accommodations, I truly need some grace. And so if she maybe maybe in this instance, there's enough trust there for me to go. Maybe she sees something I don't maybe I can do it.

  Dr. Raquel 44:44

  Because in that instance, you're modeling an appropriate rate relationship, right? Because it's, yes, we have all this training, but it's also the aspect of like the therapeutic alliance between you and your clinician. It's just as important to have that alliance with you and your clinician, right, because I believe in the whole Have you heard of like the dodo

  word theory where it's like, it came from Alice in Wonderland. And there was this race or something. And one person was like first and second, or third or 45th. And they were like, who won? And they were like, We all won. It doesn't, you know, everybody won, and it wasn't about. And then they say like, that's the same thing with therapeutic modalities. They're like, one of the things is, yes, some of these things work for people. But some of the aspect is like the therapeutic alliance that you have with someone by modeling appropriate relationships, like, like you mentioned, like by modeling compassion, that they see how they can be treated in an appropriate manner that they feel empowered to advocate for themselves. So it's kind of like, is it the fact that who won the race or we all won the race, it just matters that you cross the finish line? Is it CBT? Is it a CT? Is it DBT? ESG? Is it that LMNOP? You know, or is it just the fact that this person is clinician who was trained in different modalities and understood understands what I need in that moment in terms of the therapeutic alliance? Right? Because when it comes down to it, and when I'm like, training students, and they're like, you know, what's the best method? I'm like, Well, when you think of assessment, because we always start with assessment and trying to see what happens, you are the best, you are going to be the gold standard in terms of whether I'm using like a Beck Depression Inventory, or something like that, you're the assessor, right, because you are taking in information. That's why we constantly have to be educating ourselves, right and correcting ourselves, you are taking an education, and you decide if the root of that problem is attachment, you decide if the root of that problem is racism, you decide if the root of that problem is lack of knowledge around a skill, a skill, or empowerment and stuff like that. But that assessment comes from you. It doesn't come from the checklists, it comes from the fact that you educated yourself on these theories. You educated yourself on current events, you educated yourself on the narratives of other people. And you realize, like from my assessment, for my case, conceptualization, that's what we get. And I feel like a lot of people miss that in therapy, they think we're just talking and it's like, yeah, I would I'm be real with you. One. I don't talk that much in session. I think people assume because I'm a talkative person. It's like definitely a different person. Social media is not session me. And also because social media is not therapy. And it's also the fact of like, we do therapy, and then we case conceptualize, and then we help like with the plans, and then we check in like, the 15 minutes that shall see us or not the 50 minutes that I think about my clients, or my clients, like, are you serious, we would never make any progress. You know, I'm just like, I'm checking in on everything. So I think I feel like that's what a lot of people get wrong about therapy. And I think that's why they get it wrong with mindfulness too, right? Like thinking this works for so many people. Therapy is very much I shouldn't say boutique, because to me, that feels very luxurious. But it's very much like individualistic to you. Right? Like, I'm gonna be the expert in the room when it comes to psychology, but you're the expert in the room when it comes to you. And the same way, like your mental health is a fingerprint, your treatment plan is a fingerprint. Right? So if it doesn't work for you, we won't do it. Like, don't keep trying to make it work. Right. Like, oh, I kept trying mindfulness, I kept trying it. Why, you know, there's like 50 million trillion other things that could possibly help you, you know, like,

  let's go, like, Oh, it didn't work. Cool. Let's find something else. I always say like, let's figure out from a different perspective, but it's like if your sensory will go according to the senses. If your drum or cognition like when it came to panic attack somebody, some people do better with sour candy. Some people do better with naming a person from every single letter of the alphabet. That's sensory taste, that's cognition of thinking, some people can't think in that moment. So we do something else. Some people don't want to do diaphragmatic breathing. So it can helpful for them to have a stress ball. Some people do better with F it opposite action, you know, like, it's like, I feel like people, you don't need to feel the need. And this is where we both agree, like you don't feel the need to to put yourself in this box. Just because a skill doesn't work for you. Self Assessment is also helpful. Right? Like, if you feel like it doesn't work. You don't have to assume you're doing it wrong. You can just say that this isn't for you, and come up with something else because we have a million trillion ways to help you. And that's my job as a clinician anyway to be like, Hey, not Oh, I didn't do my homework. If you even do homework not you're being resistant, like okay, well, sometimes when people when I when people tell me they haven't done their homework one, I might have missed the mark on the homework two, homework isn't helpful for you. Three, you may have felt overwhelmed, I might have jumped the gun, or for you just didn't feel like it. All of these are valid. If you didn't feel like it. We're not doing it. Like it's just it's boutique shouldn't sound luxurious. But like, I really wish people understood that like self assessment word is just as helpful. We actually ask you to do it. So many people think, Oh, I saw this video. And it made me think I had ADHD, you'll think you'll go to a clinician, I'll be like, it was just a video or is that a different aspect of like information. It's not only about peer reviewed journals, blogs are helpful. Podcasts are helpful if you see yourself in this than you see yourself. And that's it. Let's go from there.

  KC Davis 49:35

  I love it. Thank you so much. This has been such a great conversation. And I feel like every time we talk, it's like, I feel like I could talk for hours fireworks.

  I really hope that you write the grant for that. That'd be so interesting.

  Dr. Raquel 49:48

  It's such a good idea. That was such a good idea though. Because so many times we're pinpointing one message but what you mentioned with longitudinal that's so it makes more sense.

  KC Davis 49:58

  Well and I'm developing a curriculum I'm for struggle care philosophy for like groups. So if you want to throw in some life skills things in there as as mental health help, we should link up on that.

  Dr. Raquel 50:10

  You don't have to threaten me what a good time. Right like

  KC Davis 50:14

  so where can people find you if they want to follow you on social media?

  Dr. Raquel 50:18

  On Instagram? I'm Raquel Martin, PhD are a qu e l Martin PhD on Tik Tok. I'm Raquel Martin, PhD on Facebook. I'm Raquel Martin, PhD. My website is Raquel Martin phd.com. I have a podcast where we're probably going to switch it out pretty soon. So mind your mental podcasts. We have two seasons. Next year, I'm actually going to be transitioning more to like a question answer portion because I really just want to be able to off the cuff answer stuff like I really just want to be like the black non problematic. You know, Frasier, Dr. Frasier,

  and with the podcast, I was just like, I like what I did with it. And I feel like I've reached my ceiling on it. So I kind of just wanted to switch it up. But the podcast is out there now. It's always gonna be out there. It's two whole seasons. Focusing on black mental health. The first season is very much interviewing people where they share their narratives about mental health to kind of like normalize like, it's different for everyone. This person's depression is different. And on the second season, just like bite sized episodes on like, Hey, are you ready for change or not? If you're not, it's cool show.

  KC Davis 51:17

  And we'll put all of those in the show notes. So thank you again and everybody out there. I hope you have a good day. Be a little gentle with yourself today. And try not to be too distressed about being distressed with you.

  Transcribed by https://otter.ai