I’ll admit, also learn how to effectively conduct their practices so that not only can they do a good job of providing therapy, but they can also eat and pay their rent as well. Frankly, a lot of mental health providers are live check to check, there are basically four different views in the field of psychology. They are the biological view the analytic view the cognitive perspective and the behavioural approach and, and each one of them view mental health differently, in other words how they determine what the problem is.

Dr. Larry Waldman (06:09):

And of course, therefore then they view the treatment in a different way as well. And so I contend that if you’re going to be a successful therapist or clinician, you need to be fully versed in these four areas. Now this sometimes is my first and second lecture when I do adjunct teaching, I know we don’t have that time that kind of time. So’m going to, give of course an abbreviated…….the Biological view of course, is more actually, in your vein to, to some degree, although I understand you’re a naturopathic physician, but the biological view is basically the realm of the psychiatrist physician, or nowadays the nurse practitioner. And again, in a nutshell, the biological view argues that what mental health issues, are basically biological, physiological, genetic in nature, perhaps they’re a chemical imbalance within the brain for want of a shorter term here.

Dr. Larry Waldman (07:33):

And, that’s their view. And therefore the treatment from that perspective of course, is a prescription medication. That’s the biological perspective, the analytic view or psychoanalytic view as it’s sometimes called, or sometimes the Freudian view was, first, purported by Freud in the late 18 hundreds. And in his view, basically the analytic view basically is that mental health issues are essentially are the unconscious unresolved concerns that the child had and now are manifesting themselves in their adulthood. So for instance, if a patient is, let’s say depressed the, analytic therapist instead of……… Unless they’re a physician and some, analysts are physicians unless they’re a physician, instead of giving them a pill, an antidepressant, for example, take the view that the reason this person is depressed is that there’s something back in their childhood that that was never dealt with unresolved.

Dr. Larry Waldman (09:00):

So hypothetically let’s say this child grew up in a home, which was chaotic. Let let’s say the, the parents argued frequently. Maybe mother perhaps was depressed herself and so on. And so therefore this child grew up in an environment where at any moment at any time something could happen, you know a pot could be thrown across the room. Somebody could have a temper tantrum, a door might slam or, and so on. And so the child then came to view their world as a dangerous place. And as a place that that could change on a dime where they have no control at that they’re insignificant and so on. Well, you can see if that’s what this child learned, and by the way, given their life at that moment, that’s not unrealistic. They have, an accurate view of what it was, what was going on, but what happens you see, as the child develops this life view and then carries it on into their adulthood.

Dr. Larry Waldman (10:27):

So now when they’re a teenager or a young adult in the back of their mind, you can’t trust anybody. You’re always on the lookout. Something could happen at any time. You’re not likely to take a risk because, Oh my God, you know, I don’t have control. And you can see now where someone who is thinking believing in this manner has high potential to be depressed. I mean, I don’t matter. I don’t have control of my life or my world, anything that happened at any time, of course, that even sounds like anxiety too. Doesn’t it? And so on. So that’s the analytic perspective. Now, the treatment, is what is referred to in that vein catharsis, which is to make that person realize why they believe the way they do and take them back to their childhood and get them to understand that they’re depressed because of these unconscious thoughts and feelings that they don’t want.

Dr. Larry Waldman (11:39):

The next view is the cognitive view. Now these last two views, the cognitive view and the behavioural view are sometimes referred to as contemporary perspectives because they came up, they came about much later. Obviously the biological view is a thousand years old. You know, we’ve been giving, herbs and, you know, Aristotle was giving herbs to people, you know, way back when and so on. And of course, as I said, Freud’s work was in the late 18 hundreds in the early 19 hundreds. We come to two contemporary views, the cognitive view it takes a little more of a simplistic approach and basically argues that what we think determines how we feel,

Dr. Larry Waldman (12:39):

How many times have you sat across from someone? And in the course of the conversation, they put themselves down three or four times, they’ll kind of flippantly say I was never good at that. Or I don’t know, I’m just not good with numbers or things like that. And what that reflects of course, is that basically the way they see themselves, the way they think about themselves indicates They don’t have very good self esteem. they don’t see themselves as having any strengths and so on. And so therefore again, from the, from the cognitive perspective, someone who is depressed is someone who is thinking, you know, basically the glass is half empty. I like to use the term there. They have a bad case of stinking thinking, right. As I like to refer to. Now the treatment in that case of course, is to get the person to understand that what they’re doing is basically negatively coaching themselves. I mean, for instance, a classic example, I’ve heard dozens of my clients, say this let’s say they’re about to do something maybe on a blind date, let’s say they they’re just fixed up or maybe a job interview. What do you ever want? well, they’re about to do this. They’re about to walk into the, either the room or the cafe, you know, to meet this person or to meet their interviewer. And what are they thinking?

Dr. Larry Waldman (14:30):

I think, you know, they’re thinking, Oh boy, I’m probably going to screw this up. You know, I never do well in these kinds of situations., I don’t really have that much to offer. I don’t know why I even thought about doing this. It’s probably going to fail anyhow, and you can see they’re already set up. And of course, what happens when you walk into that interview or you walk into that first date and you’re thinking along those lines, of course, it’s already failed. You’re going to fail. And then of course, when you walk away from that interview or a date, and you walk back to your car, you get in your car and you go, I knew it. See, so it’s a trap that people are into and they can’t get themselves out of it because they keep, again, this stinking thinking.

Dr. Larry Waldman (15:25):

Finally, probably the most contemporaneous view is known as the, behavioural view this came about in the mid twenties or so it was popularized by Fred Skinner. And so you you’re familiar with him, you know, with the, with the the red box and so on. But, basically what behavioural psychology talks about is who we are, what we become is a function of our behaviours and the consequences to those behaviours. So if someone is depressed, well, what’s been happening is they’ve been doing things, you know, and, and maybe, and often failing at them. And, so therefore, they continue to engage in self defeating behaviours.

Dr. Larry Waldman (16:28):

II’ve had many individuals who that I work with and so on. And, you know, and often I’ll say that, you know, you’re doing a good job of depression. you’re staying up late, you’re sleeping through the days. So you’re mixing your days and nights up around, you’re eating junk, You’re not answering the phone. You’re not socializing. When, you go out, you don’t smile. You don’t even brush your teeth. You know, you wear old clothes and so forth. You know, you look and act like you’re depressed. So you’re doing depression. I use behavioural psychology, particularly when I work with parents, because it’s, it’s the easiest, if you will, to comprehend and to implement.

Dr. Larry Waldman (17:26):

So for example I’ve been told many times by parents. I have to tell my child five times before they do something. I’m sure many parents can relate to that.

Dr. Manon (17:42):

and I think I know where you’re going with this.

Dr. Manon (17:45):

And my response to that is I wonder what your child has learned by your first request. And they often give me that puzzle look. And I said, well, you know, from a behavioural or learning perspective, what you’ve taught your child is that the first time you asked them to clean your room, means you don’t really have to go and clean your room because there’s four more requests coming. So why in the world would you bother tuning into the first one parents unknowingly many times put themselves in these situations where they’re sending messages and they’re teaching messages to their kids that are working against them.

Dr. Larry Waldman (18:33):

So, again, from a behavioural perspective, when I work with someone and I believe that the behavioural perspective is appropriate for this case I’m going to help this person do non depressive kinds of behaviours. I’m going to teach them to smile. I’m going to teach them to sleep in normal hours. I’m going to teach them to get some exercise. I’m going to teach them to eat appropriately. I’m going to teach them, to engage themselves and so on. And it’s a funny thing, how that works, behaviours have a model, which I like very much, and that is it’s easier to behave your way into a new feeling and to feel your way into a new behaviour. Oh, I like that. It’s easier. It’s easier to behave your way into a new feeling than what most people try to do is to feel their way into a new behaviour.

Dr. Larry Waldman (19:44):

The best way to change your feeling now is to behave differently. .

Dr. Manon (19:51):

So then, so these are the four ways now………….. I would imagine that it’s important for the clinician or the doctor to, first want to know that they all exist, and to determine which one suits best, the type of clients you have in front of you. Absolutely. Absolutely.

Dr. Larry Waldman (20:23):

No question about it. If the, if the patient comes in for instance, and you can tell they’re very intelligent and they live a lot in their head. And so on, you know, if I start, if to take a behavioural approach and say, well, you know, if you just went, made an effort to smile more and say hello to people, you know, things could change. They look at what I’m saying you to tell me to smile!!!!!!!!! And it wouldn’t work. Okay. Now there is someone who probably is right for the analytic approach. For example if I have a woman in my office and she says, you know, I don’t understand, but I keep choosing the wrong men immediately. That’s an analytic approach waiting to happen because, you know, odds are, there’s some father issues going on there, either an absent father or clearly some disharmony or early on in her life.

Dr. Larry Waldman (21:47):

Freud said, you know, the first relationship we have is with our opposite sex parents not to mention our same sex parent. So, you know, if, if I get a question like that, then I’m probably going to take that approach, frankly, if the client is not terribly bright, I mean, they’re, not a scholar or whatever. The analytic approach talking about unconscious things that we may not be aware of. And as someone who has got a low average IQ, what is that? That’s voodoo, that’s smoke and mirrors. That’s not right. You know, they would rather have something very direct, like either the behavioural approach or how about a pill won’t that make me better? And so, yes, the astute therapist has to basically size the patient up and determine, you know, which format or maybe formats that you can mix them.

Dr. Larry Waldman (22:58):

If you will, you can use one or two, maybe not at the same time. But you can use one or two, but it’s up to the therapist to find the right one. Now, unfortunately, if the therapist is not well trained and they only know one, well, then that’s what you’re going to get like it or not.

Dr. Manon (23:21):

So, in a sense what I’m hearing you say is that it’s good for the patient or the client to somehow be informed about the type of therapist that they’re going to go to. It’s like, you know, You’re not going to ask a butcher what the right vegetables are to eat. It’s not going to be the same thing. So you have to align with the type of therapy that makes that you feel resonates with you on some level, you really make a good point.

Dr. Larry Waldman (23:58):

As a matter of fact on my, website, which happens to be top Phoenix, psychologist.com I have listed or I’ve placed about 40 of my articles, which are available for download and so on. And some of those articles have to do with finding the appropriate therapist. And, and I think an astute patient ought to at least call the office and find out what kind of therapy does Dr. Jones or mrs. Jones or whatever practice. And so you may not have to talk directly to the clinician. I would think the office manager might know or should know and so on. But yes, the truth of the matter is, you know, when you walk into a therapists office, the average person doesn’t know what they’re going to get.

Dr. Manon (25:12):

And, many people are frankly pretty naive in this arena. I mean, I’ve had cases where people were frustrated and they’ve come to me and say, well, you know, I saw Dr. Smith, you know, my husband and I saw Dr. Smith, you know, a couple of months ago for marital counselling, all he wanted to do is give us a pill. Well, he’s a psychiatrist, not that many psychiatrists are versed in marital therapy. They have pretty much one tool, which is the prescription pad By the same token. I’ve had people come into my office and say, I want you to write me a prescription for an antidepressant and I’ll go, I’m sorry. But as a psychologist at this point that’s not what we do. I can help you work with this. I think I can help you, but I don’t write prescriptions for pills. So a lot of people truthfully don’t know the difference between a psychiatrist and a psychologist let alone the different perspectives.

Dr. Manon (26:25):

I think we cut out slightly, but just to make sure I heard you properly many people don’t know the difference between psychologists and psychiatrists and let alone the four types of psychologists that one could go see.

Dr. Larry Waldman (26:40):

Now just to muddy the picture…… I’m actually in four States now Illinois, Louisiana, New Mexico. And one other that I can’t remember actually now have allowed psychologists with training to dispense a psychotropic medication.

Dr. Manon (27:14):

Just curious, because I am a naturopathic physician. And one of the things that we do is is gut health. And we know a lot of neurotransmitters are made literally in the gut. And that of course affects the mind. How well versed do you feel that in general psychologists are aware of that biological option because of course we have drugs that can, you know or the goal of it is to modulate through neurotransmitters and then there’s, what’s coming to be much more known now, is that really a lot of it is from the gut, which also affects your anxiety levels, your depression, all of that. How how common is that, that knowledge?

Dr. Larry Waldman (28:21):

Well I think most experienced clinical psychologists have some familiarity with that. In fact, in my practice I used to get calls from GPS all the time asking what medication would I recommend? Of course I would tell them that look, you know, I’m not an MD and so on. And they say, I know, but you work with this all the time. Now I worked with psychiatrists both in the hospital setting and in my own outpatient, in my building. In fact, there were two psychiatrists, you know, in our building. And by the way, I don’t want to go on record suggesting that, you know, I don’t believe in medication at all. That’s not the case. I mean, I’ve had, you know, I’ve had cases where the person, my patient comes in for the first time and they are so anxious.

Dr. Larry Waldman (29:26):

I mean, they’re wringing their hands, you know? And so on that, that it’s immediately apparent to me that they are in no way ready to deal with any kind of talk if you will. Yeah. and that they’re going to need some medication, you know, to, to get some of this anxiety under control so that they could benefit from some psychotherapy down the road. So if someone is extremely depressed, extremely anxious, extremely obsessive compulsive hallucinating then clearly there’s we need a psychiatrist or nowadays sometimes a nurse practitioner. Absolutely. But it doesn’t, it shouldn’t end there. And unfortunately this is me on the soap box, but I, I believe that, you know, that giving a pill in some cases is very appropriate for the situation, but it shouldn’t end there, you know, and the research certainly backs it up that the research is very clear, you know, that a combination of the appropriate medication and psychotherapy is often the best way to treat most mental health disorders.

Dr. Manon (30:56):

From the patients I’ve seen over the past 30 years, I feel that way as well. I do feel like sometimes it’s like an emergency stop so that you can get to the real cause and find out what that real cause is. And I think it’s definitely you know, a good system to figure out what the best approach is on one level. And sometimes the cause can be the gut, The fact that there’s just, they’re eating horrendous foods. They’re not eating at all properly. Sometimes that is the cause and sometimes it’s also the autonomic nervous system they’re in like constant stress and they can’t shut down. And so, some of the work I do physically, which I did not know when I started my practice, I thought I was doing a purely physical type of therapy.

Dr. Manon (32:00):

And I thought,I’m just dealing with pain, that’s it. And I didn’t realize the impact that pain could have on the whole person. And I didn’t also realize how, when you change the pain, the body will actually express all by itself. What’s going on, you know? and so I see that it’s really very connected. And when I moved my practice into Nova Scotia, I had a lot of psychiatrists, psychologists therapists, referring patients for the physical piece, even though none of us really understood why it was beneficial,, and I think now the science is explaining it through the Vegas nerve. Like now we’re starting to understand, but I certainly felt I could see the, the advantages, but I had no real understanding, you know, why there’s an impact there, you know? So how have you seen in your experience with any and I’m not sure it’s all physical therapies that work either.

Dr. Manon (33:10):

I have not done a study on this, but I’m just curious, have you noticed any changes? I mean, exercising is one type of thing, but let’s say some of the patients who have, you know shortness of breath and other signs that easily get them anxious when you relax their entire body, it’s like they, their posture changes. Then you think, ah, the posture, well, that’s like a, behavioural change, but now made possible because the body’s relaxed. So it’s like a chicken and the egg kind of thing, but positive, you know, and it’s not something you’ve seen or a even a consideration.

Dr. Larry Waldman (33:55):

well, yes. And, and I think again new experienced clinicians, you know, are very familiar with this mind body connection. And many times I would I’d make recommendations like Yoga. Exercise join a gym . .

Dr. Larry Waldman (34:24):

I am a certified fitness provider………..I would hear what people’s diets are like and so on. some people, Oh, I remember I have clients who were struggling with anxiety, but in the course of a day, they, they would consume a pot of coffee and, and a six pack of diet Coke. Well, that’s enough caffeine to choke an elephant. What does caffeine do? Of course, it heightens the body? It can generate anxiety on its own. And, and no one ever addressed that with that client and so on. So yes, taking a look at what we eat and how we sleep and how we exercise and things like that are all important.

Dr. Manon (35:41):

And what would you say? currently we’re in a situation where there’s a significant increase in suicide and depression just because of the pandemic, what is your recommendation or is there any take home messages that could, but you could see would be fit without it being like prescriptive in that sense, but I know it’s always individual, but, but there’s a lot of people that have been deeply triggered by that.

Dr. Larry Waldman (36:22):

And, it’s true that some people are struggling. But it’s, it’s back to basics. I mean, I’ve had some friends I can see, they probably have gained 10 pounds this month. So they’re bored, and, you know, food, you serves certain comforts food, make you feel better for the moment, of course, until you step on the scale or you can’t get your pants on anymore. And so on. But it gets back to basics. I used to, you know, I used to go to the gym four times a week and do two yoga practices a week, which I can’t do anymore. So, you know, I was up at five 30 this morning and took a 12 mile bike ride.i behaved my way into another feeling. You see? because when I came back from that bike ride, how did I feel? I was darn glad I did that. But had I given in, you see, try to feel my way into the new lane. I wasn’t going to feel my way into that behaviour. because my feeling was telling me stay in bed. But instead I did, what I know was the right thing. I needed that aerobic exercise.

Dr. Larry Waldman (38:22):

And while I’ve done several hundred yoga practices in a class, you know, I can do a yoga practice on my own. So we’ll do things like that as well. Plus my wife got some of those bands, you know, those are not barbells, but you know, they can work just as well. So it’s doing the things we know are right and sticking with it, despite the tough times, eating right, sleeping. Right. And, and getting on the phone, calling a friend, use the zoom. And, so on infact after this, my, wife informed me, we’re going to have a happy hour with three other couples on a zoom thing. So there is going to be, you know, this social connection,

Dr. Manon (39:16):

Well, that’s what you have to do. I think it’s a good suggestion. I love that statement. I’d never heard of it, but it’s easier to behave your way to a new state rather than feeling yourself into it. And I think it’s really a good way to stop excuses. because if you’re going to make a behavioural change, if you make that decision and know that the feeling may not go with it. I think there is a confusion that the feeling is always aligned with the behaviour.Its not the feeling can trick you.

Dr. Larry Waldman (40:09):

You said something that just triggered me i have a couple of rocks…..circular rocks and I painted the letters T O I T on it T O I T because when I be sitting across from a patient and I would recommend something, you know, like some more exercise or eating differently or something along those lines. And I would hear, well, you know, doc, I’ll get around to it. I say just a minute and I’d reach in my drawer and I’d hand him one of these rocks. And he would look at me or she would look at me and say, what is that? And you, and I said, well, you said you would do it ,when you got around to it…..there it is. It’s round. It says” to it “and you know, something many times they’d smile and go, all right. And they they would go forward. The point is, again, you have to act it and then you’ll feel it now again….

Dr. Manon (41:23):

Thats the behaviours to me talking.We’re good. So you also said that this is very important for the healing journey also of the practitioner I’m imagining because part of the practitioner is healing while they’re in practice. I don’t think we can exactly do one without the other entirely, but can you expand a little bit more on that statement that it’s important that the practitioner understand, which is the better journey. I think that’s what you were saying. I was thinking you were going somewhere else with that, which intrigued me, but that’s okay. That’s fine. So do you have anything else that because our time’s wrapping up and anything else you wanted to share.Anything that you…….have a million books, tons of resources.

Dr. Larry Waldman (42:35):

I’ve written seven self help books, if you will. The first one is “who’s raising whom” and that’s, that was back, quite a while ago, but it’s been revised. And, and let me tell you it’s as relevant today as it was 25 years ago and where I teach parents using behavioural psychology, how to more effectively manage their child’s behaviour within the home. The followup book to that was “coping with your adolescent” and essentially it’s using similar kinds of theory now with the team, you know, rather than with the child. And of course you need to act differently, when you’re trying to manage a team and of course, with a child the third book was” how come I love him, but can’t live with him.”

Dr. Larry Waldman (43:38):

That’s my marriage manual, and I talk about very important topics. Like, why marriages fail, how to maintain a marriage, why second marriages fail more frequently and things along those kinds of lines, just for fun. why is it that you can love and not live with? Well, I think in a nutshell, the first reason is that we choose too quickly, don’t do our vetting. If you will, too many people fall in love with love. And, and they’re already emotionally committed , by the second date, if you will, or they’ve already slept together and so on and now you know, they’re already committed and, and they haven’t even determined if there’s a good value match, does this person have the same kinds of values? Do they have the same kinds of interests? How do they manage your money? What kind of parent are they going to be? How willing are they to compromise and all those important things that make up a good marriage? That’s all by the board because they’re really good in bed.

Dr. Larry Waldman (45:12):

So enough on that, I guess the fourth book is the graduate course you never had. And that’s the book I wrote to help clinicians learn how to develop, manage, and market a successful private practice. And in fact, I do a lot of speaking across the country, for mental health associations, teaching therapists, how to do that. the fifth book actually is related very much to what we’re talking about here today. That, book is entitled “too busy, earning a living to make your fortune.” And the subtitle is discover the psychology of achieving your life goals. And in that I talk about the seven basic reasons why we fail to achieve our life goals. And then what I do is I attack each of those reasons from each of the four perspectives. So it really does get at the four views we defeat ourselves with that’s one of them, of course, we don’t think we deserve it.

Dr. Larry Waldman (46:26):

And then the other one I’m curious…….the next one is overcoming your “negotia phobia “and that one I coauthored with a business analyst. And basically what that talks about is, is if you think about it, life is a series of negotiations. You negotiate with your children, with your team, okay, with your partner, with your boss, with your coworkers. So when you buy a car et cetera, et cetera so we’re negotiating all the time and it’s important that we know how to do that. And finally the book that just came out a month ago is entitled “love your child more than you hate your ex.” Now this gets back to all of the forensic work I did in the family law arena. And, I talk about, you know, trying to have what I call a healthy divorce, if you will.

Speaker 3 (47:30):

Yeah. I think that’s a very important thing. I think we often, you know, when I see couples……….. My website is top Phoenix psychologist, all one word.com. And you can buy my books there or through Amazon. Of course, you’re welcome to download my articles. And frankly, if you want to send me an email and follow up on something, I said, I’m more than happy to do that. My email address is Larry. We’ll put that in the in the contact information, everything will be there. So I really appreciate the time that you given me here. And I think it’s, I think this is an interesting topic and I believe an important one. I absolutely, think it is very important to get clear on what the, the goal is, but also the method that is most aligned with you. So. Well, thank you very much.

Dr. Manon (48:37):

Well, thank you for the opportunity.

 

Thank you for joining us. For more information, go to DrManonBolliger.com.