[JOE SANOK] A new year, a new you, yeah, how about a new year, a new private practice? If you’re ready to start a private practice this year, or maybe you just got one going and you’re thinking, did I do it right, how do I do it right, how do I leave this full-time job, I have a 28-step checklist just for you to walk you through the initial steps of starting a practice. Just head on over to practiceofthepractice.com/new. Again, that’s practiceofthepractice.com/new. This is the Practice of the Practice Podcast with Joe, session number 841. I’m Joe Sanok, your host, and welcome to the Practice of the Practice Podcast, where we are helping people to start, grow, and scale their private practices every single day. We want to address the mental health issues of our nation and of our world by helping you create a thriving, amazing practice that mirrors your heart and your values and all that you want your business to be. We cover all sorts of business advice, clinical advice, we have all sorts of really interesting people on the show. Like episode 833, we had Harvard psychiatrist, Dr. Palmer talk about the keto diet in relation to mental health issues. We talked about money scripts on the third of January that came out, episode 834. We talked about advertising episode 836 and 837 was quarter a quarter planning to reach your goals this year, so tons of amazing episodes that we’ve had recently. A bunch coming up, we’re going to be focusing in the next month after we do some of these, Ask the Experts on starting a private practice and focusing in on really, how do you start a practice. If you have a solo practice, what do successful solo practices do? What is it that really differentiates the people that grow quickly from the people that don’t? That’s going to be coming up. Today though, we are doing a little behind the scenes where you get to hear our Ask the Expert, which we do every single month with our membership communities, and specifically on how to have strong relationships and do amazing couples counseling with the one, the only, the never replicated, Dr. Julie Schwartz Gottman. I mean, come on. So we had Julie in for Ask the Expert and folks got to hang out with her and talk with her. I spend about 10 to 15 minutes at the front end interviewing our experts and then after that, people just get to ask questions. It’s a great way for you to connect with people that would often cost thousands of dollars an hour but when you’re in a membership community of ours, you just get to come in for free. Without any further ado, here is Dr. Julie Schwartz Gottman. [JOE] Well, I just need to say I have loved getting to know Dr. Julie Schwartz Gottman through having her on the podcast, through emails. I would now consider her a friend. We were planning to actually come up and hang out on Orcas Island with Julie, but my vaccination schedule got all messed up and so my girls and I couldn’t come hang out up there. But even just the fact that Julie invited me to come up and hang out with her and John was just like, made my heart so full. She actually recommended this book, which I’ve been reading every morning, called My Grandfather’s Blessings, and it’s just been such an amazing morning meditation. If you don’t know Dr. Julie Schwartz Gottman, she has done amazing work behind couples and research, and I’m sure that many of you are big fans of hers. Julie, welcome. So glad that you’re with us. [JULIE SCHWARTZ-GOTTMAN] Thanks Joe. I am really thrilled to be with all of you again, and I’m really so excited that all of you out there in the virtual world can actually perform technology, which is something that I’m impaired at so I always have to get help. You guys are wonderful, and I really, really appreciate you coming into this chat. I think it’s really going to be great. [JOE] Awesome. Well, Julie, let’s start with this first question that came in, what problems typically arise with couples dealing with or infertility? [JULIE] All right, so with infertility, typically what happens, depending on what infertility is that people are depressed, one, two, they’re not quite sure how to talk about the fact that they can’t have children, or at least temporarily they can’t have children. There may be multiple miscarriages, there may be alterations in somebody’s actual physiology or body that needs to take place that is scary, that is challenging. The biggest problem, I think is for people to be able to talk to one another about it. They need to be able to have what we call stress reducing conversations. What that means in the Gottman Method is one person is the speaker, the other is the listener and what the listener is really doing is asking big open-ended questions of the speaker to really find out how they’re feeling deep inside about their temporary, hopefully inability to have a child and what the alternatives might be, what their feelings are about artificial insemination or in vitro fertilization and so on. So that people can not only express their thoughts and their ideas, but also their feelings, the other person the listener also really needs to empathize. It works a little bit better if you’re really zooming in on the questions regarding emotion for this. So the listener is asking, what’s the most upsetting thing about this for you? What’s your worst case fantasy here? I want to hear it. And then really empathizing with the person’s answers and really zeroing in on the emotions of the other person and not trying to minimize those, not trying to reassure the person right out of the emotions. Those emotions are real and they’re valid. So really naming the feelings, then empathizing with them and saying, it makes a lot of sense that you’re feeling that way, et cetera and then changing roles so that the other person also has a chance to be asked questions about how they’re doing, how they’re feeling, and to receive empathy, love, comfort. The empathy has to go both ways. One of the things that often comes up in this is one or the other of them feels like a failure, especially if the physiology points of finger at one partner or the other as being deficient in some way. So you really want to be sure that that pocket of painful shame has been opened up, shared, and then the other person can perhaps offer reassurance, they’re not blaming them, they’re not holding them accountable, that this is a shared issue. It’s something between them. So that type of conversation is super, super important. Then looking eventually after dealing with the feelings of it, looking at alternatives and being very straightforward and honest about their feelings about those alternatives and what they’re willing or not willing to do. [JOE] Sort of a follow-up question that goes with that is, how do you handle it when one spouse wants to quit trying for a baby and the other does not? [JULIE] Again this is what we call a dream within conflict conversation. A dream within conflict conversation means one person, again, is the speaker, the other is the listener. They each have their positions. They’re not in persuasion mode at this point. So the dream within conflict exercise has six questions that have to do with your beliefs, your ethical guidelines, childhood history, and how that may be influencing your position, what makes your position so important to you, your feelings about it, your ideal dream about it, and if there’s some underlying life purpose within your position on the issue. So the listener simply asks the questions in the dream within conflict conversation, listens deeply to the other without bringing up their own point of view until it’s their time to be the speaker. Hopefully there’s much deeper understanding on compassion that emerges from that conversation. And it needs to go for a long time. These are not terse quick little answers that the speaker is providing. Once they both hopefully obtained more understanding of the other, then perhaps they can work on what we call the two Oval Compromise Method. In that exercise, they each first list what they cannot compromise on in their position, absolutely no compromise, what they’re inflexible about, a core need maybe or a core dream. Then in, they draw actually what looks like a donut on a piece of paper. Each of them does that. In the inner circle, it’s what’s inflexible in the outer circle what’s more flexible. That may have to do with things like time, money spent, duration, the nitty gritty details of what a compromise might involve. Then they share with each other what they’ve written and address particular questions that are part of that exercise after sharing their two circles with each other. Those questions have to do with what things do we have in common here? What goals do we have? What values do we have? And by addressing, there’s about, I don’t know, seven or eight questions. They’re just discussing those together, not on one side or the other, but just together their answers. Hopefully they reach some compromise in terms of what makes the most sense given hopefully, compassion feeding in to the dynamic between them from the preceding dream within conflict exercise. [JOE] Thank you for that. So the next question submitted says, tell me more about how you design and run your marathon sessions for couples. What factors influence those who sign up for those and what level of training is required for offering those? [JULIE] Okay. Well, what marathon sessions are typically three consecutive days with one couple, about five to six hours a day with breaks during each, each day, like bio breaks morning, afternoon, and a lunch break for an hour. Typically, what we do is we have couples who sign up. It can be any couple, can be any couple and the training needed for that, if you’re doing Gottman Method, you need Gottman Method. So maybe through level three, I mean, you certainly don’t have to be certified to do this. It helps because with certification, of course, you’ve got consultation with our master trainers. You really get the methods down. You really know what you’re doing once you go into this work. Marathon therapies are very intense. But the great thing about them, God, I love doing marathon work, is that you’ve got momentum. Each exercise or each piece of work builds on the next, on the next. So you don’t have a lot of intervening events, crises, kids’ problems, and so on from one week to the next and you don’t have to cut people off after an hour and a quarter or an hour and a half long session. You can just keep moving so you can process a regrettable incident that may take four hours and you’ve got the time. So you begin, as we always do, we send the questionnaires to the couple first. They fill those out, and we do that over our Gottman Connect platform. They register, each person registers, each partner fills out the questionnaires and they’ll go, those come to you and you have those before you even begin. They’re all scored. So you’ve got them all scored, you’ve got the strengths and challenges all scored before you even begin so you’ve got an idea of what’s going on. Then in that first session, as you’re getting to know them, the first day you’re doing the oral history interview, their narrative and the oral history interview. Then you’re taking them into the rating, the two 10-minute conversations, their ratings of those conversations, your little checklist. That happens in the first morning typically. Then you take a break for lunch, we usually take an hour and during that time, you get, you fill out your little clinician’s checklist, press a couple buttons, and you’ve got your reports so that when they come back they can access their couple’s report on their computer and you’ve got yours. Then you talk about treatment planning and begin treatment in the afternoon. Then typically you’re working on conflict management through day one, day two. Oftentimes, you’re processing regrettable incidents. It really depends, we treat affairs through marathon work, though it may need more follow-up than just that three-day marathon. And so you’re working on the primary challenges this couple is facing but you have time to really go deeper and deeper. I always counsel people at the beginning, especially given the ones that we get for marathons who are often just broken, so broken that they may not be able to fix everything in three days, but they are getting 15 hours of assessment and therapy, which gives them a big boost. It’s that booster rocket at the beginning, which takes them off into a different trajectory and then you do follow-up depending on what their needs are. Maybe one session an hour and a half or a two hour session a month from now, or two months from now whatever they like, just see how it goes. You can do marathon work with people all over the world, virtually through this platform, which is very fun, unless they’re in Australia. Then the timing is ridiculous. [JOE] Yeah, I had some consulting clients in Australia, and I’m just like, I just can’t do it. Unless you want to get up in the middle of the night to talk to me. So I’m going to jump ahead to one of the questions that came in later, but it’s, because it’s connected to what you just said, so the online assessment tool is unique and usually very helpful. However, I’ve found giving feedback on it incredibly difficult, especially when individual scores indicate deeper pathologies with one partner. I often find that it gives the other partner something to throw at the first one. I’m really struggling with this dynamic in one of my couples, although the first one is finally seeing the need for individual therapy, and I’ve made a referral. So what are your thoughts on that, on how to give more feedback on the assessment? [JULIE] First of all, we’re going to be making an instruction video on how to give feedback and if you look at the manual, there’s a manual that you get online that comes with the program to instruct you about everything, if you read that carefully, that can help. But really giving feedback is, it follows the same principles as giving feedback when you’ve taken a Gottman training. So typically in our Gottman training, after you’ve done assessment in that third session, let’s say, or third hour of meeting with a couple you are telling them what are the strengths and challenges of their relationship of the dynamic between them? Now, when somebody has greater pathology you, it has to be handled very carefully. What I’m always doing is I typically say that pathology is the third party in the relationship that’s messing up the dynamic between the couple. For example, if somebody has PTSD, well, PTSD is the third party in the relationship. When PTSD, I always speak of it neutrally in the third person, when it shows up in the relationship, it’s affecting both of them. But together, if they’re a team together, then they can minimize the impact of that third party problem that is influencing the dynamic between them. So I’m always emphasizing between, between, between, as opposed to, you’ve got PTSD, that’s a problem, go to therapy. I don’t do that. I would recommend, I mean, to see how some of this is handled, at least with PTSD, we have an online training called Treating Affairs and Trauma, TAT and it’s such a cool workshop. I love it. So it’s online filmed workshop, and it shows how one can deal with a pathology like PTSD. If somebody is borderline, I’m not going to be talking about that person being borderline, what I’m going to be talking about is that person’s struggle with abandonment, let’s say and how terrified they are of it and the terror of abandonment is the third party in the relationship. So you have to really finesse it. I often do not refer people for individual treatment. I do couples therapy for addiction, for PTSD for depression, for borderline or narcissistic personality stuff. I’m doing almost everything in couples, so you can too. If you want to. [JOE] Great. is there a networking or supervision option for therapists who primarily use the Gottman Method, but who are not yet on the certification path? [JULIE] I wish there were, but there are, there isn’t officially at this point. Because we don’t, we are ready have our master trainers working awfully hard and our consultants working awfully hard with the folks in the certification track. So I don’t, I’m sorry, I don’t think there is. The only thing I could recommend is read, read, read. If you read all of our stuff, my last book the 10 Principles for Doing couples Therapy has cases in it of all kinds. John and I, are currently revising our marriage clinic book, a huge undertaking. We’ve got to finish it by January and that’s the name, will include absolutely everything in the universe about what we know. That’s the old one. That will include everything too. That’ll be coming out in, I guess, about a year and a half [THERAPY NOTES] As a therapist. I can tell you from experience that having the right EHR is an absolute lifeline. I recommend using Therapy Notes. They make billing, scheduling, note taking, telehealth and e-prescribe incredibly easy. Best of all, they offer live telephone support that’s available seven days a week. You don’t have to take my word for it. Do your own research and see for yourself. Therapy Notes is the number one highest rated EHR system available today with a 4.9 out of five stars on trustpilot.com and on Google. All you have to do is click the link below or type promo code [JOE] on their website over at therapynotes.com, and receive a special two-month trial absolutely free. Again, that’s therapynotes.com and use promo code [JOE] on the website. If you’re coming from another EHR. Therapy Notes will also import your demographic data quick and easy at no cost, so you can get started right away. Trust me, don’t waste any more of your time and try Therapy Notes. Just use promo code [JOE] at checkout. [JOE SANOK] All right, next question. Julia, are you and John continuing research? If so, what are the new research questions you’re trying to answer? [JULIE] Oh, thanks, that’s the best question in the universe. Oh yes, of course, we will never stop researching. Did you know that there is a junkie of the research variety? So John is a research junkie. He has to keep doing research. Here’s what we’re researching now. We’re researching the treatment of affairs, so controlled study with a delayed, a control group of delayed treatment and we created a model for treating affairs. Let’s see, I think that’s in what makes love last. So that model we are researching now, so we are studying the effectiveness of that. We tried to get a replication of our treatment for domestic violence, situational domestic violence in Oregon, but man, we were not able to get it past some of the legal community. There was a, there were a bunch of judges and legal people that really loved it and wanted us to do it. There were a few that didn’t, because they didn’t believe there was such a thing as situational domestic violence, which of course there is. They fought hard, and so we weren’t able to get that through but we’ll probably still work on that. Let’s see, Carrie Cole’s dissertation, so she is studying the effects of psychological abuse, mental abuse. We also just completed a study of 40,000 couples worldwide that are going into therapy with our assessment questionnaires that they all took, 40,000 of them. We’re just producing some of the results of that now. We’ve written a couple of papers on that, and it’s astounding what all of you beloved clinicians have got to work with because they’re much, much, much worse off than we thought. They are not represented at all by the typical couples therapy researchers subjects. They’re much, much sicker than that, much more troubled and distressed and with much more individual pathology. Anyway, if you feel challenged, you rightfully should do so. [JOE] All right. Next question is how to help the couple when one spouse is being dragged to couples counseling. [JULIE] Okay, well, first of all, you totally validate the partner’s feeling that they don’t want to be there, that it feels really awful to reveal your dirty laundry in front of somebody, especially when that somebody is a total stranger and you don’t blame them a bit for not wanting to be there. So you give them lots of emotional validation as well as thank you for the courage to show up. The other, the person who wanted to come can say, I need your help for me, I need your help for me because I’m unhappy and I would really appreciate your support to help me be happier. It can be something like that. So the other person sees it, the non-volunteer can see it as a gift they’re giving to their partner. Then you just bend over backwards to empathize with the non-volunteer to start building trust right away. You’re empathizing deeply, deeply, deeply with that person so that they feel seen, they feel heard, they feel understood and witnessed because non volunteers, what they feel, what they fear is being nailed. So you don’t nail them, you empathize with them. You empathize with both. [JOE] Awesome. Amy, go ahead. [AMY] What are, what would you say are steps to working with couples premaritally? [JULIE] Okay, have you heard of our book Eight Dates: Essential Conversations For a Lifetime of Love? [AMY] Yes. [JULIE] Okay, so one of the things I do it depends on whether the couple has been living together, whether the couple, how long they’ve been together. I’ll usually give them at least the questionnaires, the assessment and maybe the whole thing, the assessment, just to see how they’re doing and get a read for what might help them as they prepare for marriage. I typically give them that book, I have them go through each chapter, we talk about the chapters, but also if there are problems that show up in the assessment I will do therapy with them just like I would do therapy for a married couple. Because usually they’ve had some fights, they don’t know how to deal with their fights, and they’re in the honeymoon period right now, but you just wait till you have kids and then done, done, done, terrible things will happen. Don’t say that. But I also asked them again, through the Eight Dates book, I asked them how much have they shared about their future dreams going deep? How much have they shared about spirituality? How if they plan on having kids, have they really talked about how they like to parent and what they follow in terms of beliefs about parenting and so on. I’ll really help them to explore both through the book and my own questions, all those deeper layers of what it means to be married including how do you build trust, how do you build commitment, what are you most comfortable with in interpersonal, in together time versus autonomy and so on. How about work family balance? So you address all of those questions and usually people are excited and happy and they may not have thought about this stuff yet. They may just be in love biochemically. So you help them explore the real foundations of what a relationship can be. Speaker 5: Okay, my question has to do with when you’re counseling, and it’s their second marriage, how do you help them from bringing issues of the first into the second? [JULIE] Well, first of all you totally validate that they are going to be bringing first marriage issues into the second Speaker 5: Yeah. [JULIE] Absolutely, guaranteed, they will be. So you basically, what I’ll do is look at the triggers for them. For example, if they have a bad fight or a regrettable incident you use the exercise the intervention, the aftermath of a regrettable incident, which is a five-step process and step three of that process as you’re helping them understand what went wrong in their communication there. Step three is about triggers. Triggers are defined as feelings that come up during this incident, that date from before the relationship. They originated before this current relationship. So where do they come from? Well, they may have come from that first marriage. A classic example is if they, if there was infidelity in the first marriage and they were betrayed, they’re going to be looking for this current partner to betray them every minute of the day. They’re going to want to see their phone, they’re going to want to see their email and so on. Transparency in a case like that would really be helpful so that this person can separate out what happened in the first marriage from this current partner and how trustworthy they actually are. What really helps is, number one, it’s basically a two-step, maybe a three-step process, one identify what are the triggers that are going to trigger stuff from the first marriage and what’s the story within that from the first marriage. Two, separate out the fact that that was in the first marriage, and this is a different marriage and three how is this partner different from the first partner? How are they different? I’ll often have people look into the eyes of the second person, their current partner, look into the eyes, do those look like the eyes of your first partner? How are they different? How are the words of this partner different from the word, of this current partner, different from the words of the first partner? Speaker 5: Is there a good way to encourage the second partner to handle the feelings of maybe resentment that they’re doing work on a relationship that they were not a part of in the first place, the example, like with infidelity? You to think that I need to show you transparency and when I’ve done nothing wrong? [JULIE] Yes. So what I say is that every person faces challenges in their life. Everybody has challenges, everybody has negative experiences. The fact of the matter is that you married a person who has scars, just like you probably have scars from other sources. What you got to do is love the scars. If you love through those scars then the person will eventually see how different you are, how loving, how loyal you are from the first person. But the other thing that you have with somebody who is scarred, like this, is greater sensitivity, greater ability to love, even though they’re afraid and much more gratitude when they see there is loyalty, much more gratitude. So hang in there, soon, you’ll be the object of a lot of gratitude. [JOE] Oh, wow, such great advice. My last question to you, Julie, a lot of the work that I do is around how when we slow down, we optimize our brain for creativity and productivity. I would just love to hear, like, in your personal life, how do you think about slowing down? How do you think about not always working? I think when you’re a creative person, there’s that tendency to just work, work, work and think about work and all these other things, but I imagine you have some habits that we could learn from that help you slow down. And we’d just love to hear how do you frame that out in regards to your work life balance? [JULIE] Well, first of all, get a puppy. One of the things we’ve always had a dog and we lost a dog a year and a half ago. I can’t live without a dog and so we got a puppy. It’s the most energetic, playful Welsh Corgi you’ve ever seen. So one of the ways of slowing down is getting a puppy and having to walk your puppy every day, having to train your puppy, having to play games with your puppy. I think, and I’m being a little facetious here, but you have to first of all really, really value your body, not just your brain, but your whole body. John and I devote at least an hour, maybe an hour and a half to staying healthy and fit every day. That is really important in giving your mind a chance to just breathe a little bit and oxygenating your mind too, a little better. Another thing is going into nature. I cannot survive without wilderness. I have to have wilderness around me. That’s how we ended up on Orcas Island. So taking yourself outside, even if it’s in a city is fine but get outside, take yourself away from the screen. I know that this last year has been a great hardship for all of you guys as it has for everybody and one of the things that’s just crucial when you’re doing Zoom meeting, after Zoom meeting or whatever it is taking a break and going outside and looking at the sun, looking at the sky, looking at the ground, the earth. Sometimes if it’s dry, I’ll lie down on the earth just to heal the energy of the earth and soak it into my body and soul. If you have a partner or a puppy or a cat or any bunny rabbit or anything, cuddle, cuddle, cuddle, cuddle. Remember we’re talking about love with our couples, but it really helps to receive love as a therapist also. So let yourself soak up love even from a tree outside as much as possible, because we all need it. [JOE] Let yourself soak up love. What great words, Julie. Thank you so much for being our expert. Thank you so much for being a friend. I can’t wait for me and the girls to come visit you on Orcas Island and go kayaking with you. It’s going to be amazing. We’ll make it happen. Thank you everyone for coming, for showing up for yourselves, for showing up to learn. This is such an amazing community. Thanks so much for hanging out with us. Hope you had as much fun as I had hanging out with Julie. Tomorrow, or not tomorrow, the next episode we’re going to be doing another Ask the Expert. We’re going to have John Lee Douma on talking about what it takes to succeed. He wrote a book recently that was all about the pillars to success that are uncommon to the average person, so we’re going to be talking about that in the next episode. Also if you’re looking for a community of people that can surround you, help you grow we have small groups, we have things like Ask the Expert, we have times that I’m directly consulting with the group and we also have our consultants helping out. If you’re a solo practitioner and saying I’m ready to really grow this thing, I’ve been limping along a little too long, we’re going to be opening up Next Level Practice in March. We’re going to have some open houses ahead of time so you can learn about it before those doors open. If you want to get on that waiting list over at practiceofthepractice.com/invite, that would be awesome. That way you can get all the emails, you won’t miss that launch, you can get the help that you need as a solo practitioner. Also, we could not do this show without our sponsors. Our sponsors help really us be able to do such creative and innovative shows here. Therapy Notes is our sponsor today. They are the leading electronic health records out there. Use promo code [JOE] at checkout to get some free months and they’ll also help you transition from your current EHR. Thank you so much for letting me into your ears and into your brain. Have a great day. We’ll talk to you soon. Bye. Special thanks to the band Silence is Sexy for your intro music. This podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. This is given with the understanding that neither the host, the producers, the publishers, or the guests are rendering legal, accounting, clinical, or other professional information. If you want a professional, you should find one.