• Visit Robyn’s website and connect on Facebook, Instagram, and LinkedIn.

Joe Sanok 00:00:00  I'm so excited to introduce you to the best website designers out there. We have a brand new partnership with session sites. It is where good therapy meets brilliant design, and they get your website switched over or built in less than two weeks. They fine tune your messaging, use science backed user experience methodology, and work exclusively with mental health professionals. In fact, new clients right now are going to get three free therapy marketing strategy calls with their creative director of session sites. If you book today, you're not going to want to miss this. Head on over to session sites.com/joe again that session sites.com/joe get the website of your dreams today session sites.com/joe. This is the practice of the practice podcast with Joe Sarna accession number 1185. I'm Joanna, your host, and welcome to the practice of the Practice podcast, where we help you build a thriving private practice that you absolutely love. we're doing our Brighter Brain series. and the idea is just, you know, let's let's think about our brains a little bit. Let's think about how we're working with people, about our own brains.

Joe Sanok 00:01:28  just, just optimizing that brain to make it even better. so I love doing this show because I get to talk to so many different interesting people. today we have Robin de Walser, who is a PhD and is director of tlhe Consultation Services and works at the National Center for PTSD. She is the co-director of Bay Area Trauma Recovery Clinical Services and assistant professor at the University of California, Berkeley. As a licensed psychologist, she maintains an international training, consulting and therapy practice and is an expert in acceptance and commitment therapy. Robin, welcome to the practice of the Practice podcast.

Robyn D. Walser 00:02:07  Thank you Joe. Thanks for having me on the podcast. Happy to be here.

Joe Sanok 00:02:11  Yeah, yeah. Well, this is part of our Brighter Brain series. And you have the lens of trauma and treating trauma and just everything trauma. When you hear about making your brain a little bit brighter. how does trauma impact that? What comes to mind for you?

Robyn D. Walser 00:02:30  Well, certainly, treating trauma is going to be very valuable. The, there's research that shows that, you know, trauma has impact on the brain and that if you get treatment, things are likely to be a lot better for you.

Robyn D. Walser 00:02:48  so, yeah, I think that there's no doubt that cortisol gets dumped into your body and all these systems work together, and there's some changes in, a brain that happened that I think can be overcome if you get the treatment. And so that would be my strong recommendation in that area.

Joe Sanok 00:03:11  So, Robin, I know you're an expert in acceptance and commitment therapy. let's just think through because, you know, sometimes you you're in grad school and you learn these different modalities, but you don't keep up with what maybe they are. So to get people on the same page around what is an act? What does that look like? what would you want us all as listeners to know kind of going into this conversation?

Robyn D. Walser 00:03:34  Well, the the really nice thing that I like about acceptance and commitment therapy is that it's trans diagnostic. And one of the things that people think of when they think of trauma is they think of post-traumatic stress disorder or PTSD. Like that's kind of the first thing that pops into their head.

Robyn D. Walser 00:03:52  But in fact, there are many fallouts from a traumatic experience ranging from depression and anxiety. Substance use. Eating disorders. Like, there's a lot of different things that can happen for individuals. Post trauma and Act has the ability to work with all of those different experiences and isn't just about fear reduction, it's about life expansion. And so one of the things that I really appreciate about it is that it goes beyond treating just the symptoms of PTSD and expands into all of the struggles that people might encounter post trauma, and then looks at how to help people build and broaden their lives according to what they value, what they care about, and what meaning they want to create in their lives.

Joe Sanok 00:04:46  Yeah. Now, for for clinicians, what are kind of some of the starting principles of act that, that we'd want to make sure that we're on the same page as we talk about.

Robyn D. Walser 00:04:58  It's a very different approach from what people might tend to think as a typical psychotherapy. So it's grounded in what's called functional contextual ism, which is an approach that focuses on the whole human being in a context with their learning history.

Robyn D. Walser 00:05:19  And so it's interested in what's happening with your body. It's interested in your thoughts. It's interested in, your emotions. And it looks at the individual fully. And it's not just targeting a thought like, let's eliminate what so-called dysfunctional thoughts. it's really looking at how do we help you learn to inhibit avoidance responses so that you can live your life more fully? And I think that many of the current approaches are more have more of a mechanistic quality. That's like, let's go in and fix what's broken. And we would take the approach that nothing's broken. You just have a learning history that's led to these struggles, and we're going to help you learn some new things so that these struggles are no longer impacting you the way they once did.

Joe Sanok 00:06:24  Yeah. how did you get into act.

Robyn D. Walser 00:06:28  Well actually it was a little bit accidental. I was interested in trauma and I went to graduate school, to work with a particular professor who happened to be in the same graduate school as Stephen Hayes, who was the developer of Act.

Robyn D. Walser 00:06:44  And I attended one of his workshops that he did at the beginning of each year when new students came in and I was just completely, bowled over and the the work that we did in that workshop really helped me look at human behavior in a completely different way, and I found it personally helpful and was just struck by the idea that human beings are not broken beings. They're, beings that are larger than their experiences. We can observe and witness and be mindful of what's happening to us. And we don't have to stand against ourselves. We don't have to be our own enemies if we have what's labeled as negative thoughts or cognitions. that's pretty. That's pretty mind blowing for some folks. It's like, oh, I, I learned this, I learned to have these kinds of thoughts. I didn't want them. I wasn't seeking them. I wasn't wishing them upon myself. I didn't, want this struggle. But because of the way the social world works, which says you need to be happy in order to be acceptable and be okay, or you need to have good feelings or a good brain in order to be okay.

Robyn D. Walser 00:08:06  That really sets people in a position of, because you feel this, there's something wrong with you, and what act does it says, know you're feeling this as a natural consequence of what's been happening in your life. And what a what a relief for folks who, you know, think that they're broken, damaged, no good. that's not actually the stance act takes. And so we're helping people open up to their experience, witnessing it for what it is experiencing, and noticing that they are an experiencer that experiences flow through them. They don't have to be the experiences themselves. Does that make sense?

Joe Sanok 00:08:51  Yeah, yeah, I think it it pushes back against so much of kind of the programming that some people, have received where you know you're bad. You need to like, you know, fix it. Also, the medical model that you know is so obsessed often with just like, what's the pain? And here's the pill, to fix it instead of, you know, the long term acceptance of ourselves.

Joe Sanok 00:09:12  And that I liked how you said, you know, we're beings having experiences greater than ourselves or something along those lines. that just seems to to resonate.

Robyn D. Walser 00:09:23  I quite like it. And it's we're experiencing beings having experiences. So, you know, if you look at your internal experience, if you observe it from the perspective of I hear now, experiencing what you realize is that these experiences rise and fall, even quite painful ones and even physical pain itself. So, you know, a lot of trauma survivors have both emotional and physical pain and people who are struggling in general, frankly. And their their first inclination is to run from it. And that makes sense. The problem is, is that we get into places where we're paradoxically, increasing the problem in different ways. If I'm feeling anxiety, for instance, and my first inclination is to escape it, get away. I don't like it. It's it's too much. And all the kinds of things that you might say about it, then you, you run and, leave the situation now and for now, you've got two problems instead of one.

Robyn D. Walser 00:10:36  It's one is the anxiety and two is the fight with your anxiety. And so, you know, people end up living very small lives to try to control their internal experience, not recognizing that the very control itself sort of blocks or stunts the ability of that experience to rise and fall, to flow and come and go as it comes and go. So if you just slow down and watch, what you'll see is there. Ich comes and goes, your sensation in your stomach and your fluttering heart rises and falls, and the intrusive thoughts come and go and there's no needle need to battle with them, because the battle itself instantiates the problem.

Joe Sanok 00:11:23  Well, I would love for you to, walk us through maybe some of the techniques of act that, that help in regards to just either mindsets or that therapists. and of course, I know that we need to have lots of training. We need to make sure we go go to the source and read your books, things like that. But are there things that, listeners could take away that, that without the deeper training yet what would be applicable to their sessions?

Robyn D. Walser 00:11:49  Yeah, for sure.

Robyn D. Walser 00:11:50  And one thing that I do want to just mention here is I know we're not talking a lot about the brain, but act approaches. what's happening with people at all levels? So their biological functioning, their psychological functioning, their emotional functioning, and of course, the work that you're going to be doing is going to be impacting what's happening in the brain. And so I'm I'm sensitive to the podcast series here. And I know we're talking more about, the clinical work, but biology absolutely participates. And we want to be sensitive to that and what's happening with people at that level. so when I think about what to what you're doing in sessions to help people arrive at a place where they're no longer avoiding their internal experience, I want to do things like help them see that they have a mind, that they are not their mind like we are beings with a mind and so we can diffuse from thoughts and fusion with thoughts like two things coming together and being one. And part of what we're doing in that work is diffusing.

Robyn D. Walser 00:13:09  We're helping people see that they are two things. And one quick way to look at this is if I were to hold up a cup, let's say, and a point to it, there's two things to pay attention to. One is the word cup and the object that it refers to. And so if we were to diffuse a little bit here, we'd see that there's two things. Not one, there's the object and the sound cup. And we can relate to ourselves in that same way. There's a me here. And words that I say about myself that my mind has learned to say. There's two things. There's me and the words right. And so you get just a little bit of separation. It's, it's like a, an awareness of thinking, so you can help people to diffuse through a number of different. Diffusion techniques. And then one of the main things we want to do is help people, people open up to their experiencing and to see the cost of control, how it's interfering with their lives and interfering with creating meaning.

Robyn D. Walser 00:14:19  So we might do interventions where we have someone recall something painful, sit in with that pain, noticing its rise and fall. Being mindfully aware of where you feel it and experience in your body. Noticing what their mind is saying about it, and just allowing. I can give a specific example of something like that if you if you'd like. Joe.

Joe Sanok 00:14:47  Yeah, that'd be wonderful.

Robyn D. Walser 00:14:48  So one thing that we do that's helpful with this is called physical sizing. And so we'll have the client will evoke this emotional state for the client, which is, you know, often about something painful. But you can also do it with joy, by the way. part of the work here, in doing this kind of process of opening up to experiencing and something that I really appreciate, is that as human beings were not very good at suppressing one emotion. So if I don't like anxiety and I'm trying to suppress anxiety, what I end up doing is shutting the whole system down. I have to close in and hold tight on the whole system.

Robyn D. Walser 00:15:36  So in that process, I also cut myself off from joy. So opening up and allowing and being in the moment helps you be more context sensitive and experience the joy that might be there. So in the work that we're doing in this emotional processing piece, peace. We're wanting people to be open to the full range of emotional experiencing, so that joy can be more likely, be a part of their life as well. So with the physical izing exercise, part of what we're doing is helping to create that space and we'll get people into the evoke the emotion that's painful or joyful, as noted. And then we'll have them imagine that they could pull it out of their body and visualize it before them, noticing what the what the shape it takes size, color, texture. Is it an object? Is it a person? And we'll have them notice the whatever image and then also their reaction to the image. And often the reaction is one of get it away from me. Because those first images about pain quite often are, you know, images of a big black swirling cloud or, or tornado or something that feels scary and hard.

Robyn D. Walser 00:16:59  And then, you can have them pull that second emotion out. The reaction, the fear of the fear, so to speak, and give that an image. And then you can do another and another and what you quite often land on. And this happens, in my experience very often, is that they land on a place of compassion where they see the the pain that the person is, is experiencing, and then they have a compassionate response to the fear of the fear, and then you invite them to bring those physical manifestations back into their body, holding them with compassion, noticing that they don't have to run or fight with them. And so that's an example of of one exercise that we might do to help people open up to their experience.

Joe Sanok 00:17:54  Yeah that's great. Something always comes up when you're running a private practice. Well, gusto. Payroll and HR services can make it a little easier. Gusto is designed for you, the small business owner. They take the pain out of running a business, automatically calculating paychecks, filing payroll taxes, setting up open enrollment.

Joe Sanok 00:18:22  Gusto. Does it all want more time tracking health insurance for a one day onboarding? Commuter benefits offer letters, access to HR experts. You get the idea. With gusto, you can focus on the joy of running your private practice. It's super easy to set up and get started, and if you're moving from another provider, gusto can transfer all your data for you. Here's the best part because you're a listener, you get three months totally free. All you have to do is go to gusto.com/joe again. That's gusto.com/joe I'm telling you you're going to love gusto. Get started today. Well, and I'm wondering, you know, being that you work at the National Center for PTSD, you're also an assistant professor. you've got your practice. You're doing like, you know, international trainings. I imagine you have a pulse on trauma in regards to kind of what's what's happening or what people are talking about. Different than a lot of people. What do you see? Maybe that's, either shifting in the world of trauma or maybe that people are open to or discussing that maybe 10 or 15 years ago people weren't talking about as much.

Robyn D. Walser 00:19:33  Well, there has definitely been a shift, and people are much more likely to recognize the impact of trauma and know that it's okay to get treatment, and there's really good treatments out there. So for instance, you know, you've got things like prolonged exposure and written exposure are therapy. These are really nice treatments that approach the avoid the avoided event like an intrusive memory. And they work quite well to help people basically learn not to run, not to avoid. And I like to surround those interventions with acceptance and commitment therapy. So I use that as a base and then bring in exposure to the traumatic event to help people both learn how to be with all emotions that they're experiencing and specifically the traumatic event. And so thinking about how to get a broader take on what's happening for trauma survivors is also something that seems like it's starting to reveal itself more and more. It's not just about symptom reduction, it's about living well and actually finding ways to thrive and create meaning for yourself. And I'm seeing this leak more and more into the trauma world, which has been so super focused on.

Robyn D. Walser 00:21:04  Let's just get rid of the very much inside the medical model. Let's just reduce the symptoms. But trauma impacts relationships. It impacts, families and work and, you know, spirituality. And so I think symptom reduction itself is not enough. And I hope as we move forward and thinking about treating trauma, that we broaden our approach to it, not just living inside the medical model and thinking more about what creates wellbeing for people as well. And, that, you know, inviting joy as well as not running from the the painful events, the. And if I can just add one more thing and this is actually probably something that I think is a little more challenging as trauma has become more, in the public eye and people are thinking about getting treatment, the word itself has sort of spread across different kinds of experiences that I do not think are trauma. And so, and get the word gets used very loosely, like I've had, you know, teenagers say things to me like, I was traumatized because my mom took my phone away for 24 hours, you know? And so the word gets thrown around very loosely and, you know, emotional, difficulties inside of families or, you know, moms and dads or, people criticizing family members or having harsh words and yelling at them isn't necessarily a trauma, but the way the word gets used, it's as if it is a trauma.

Robyn D. Walser 00:23:01  And so I just want to remind therapists out there that, you know, not everything that people encounter that's difficult is traumatic. painful, yes. But that we kind of need to get clear on what's trauma and what isn't. And that's just a thing. I've also been noticing that's been happening with the recognition of trauma is that now everything's a trauma. If I could be a little bit sarcastic about it, Joe.

Joe Sanok 00:23:26  Yeah. And I think that, Yeah, people will say big t trauma, a little t trauma. They'll say, you know, PTSD, they'll say complex trauma. And then I think the average person, there's just all these ways that people talk about it that are just not, they're not what the actual clinical definition is of it or kind of the treatment that we're doing.

Robyn D. Walser 00:23:46  Agreed. Agreed.

Joe Sanok 00:23:48  Well, in part of what you're saying, it's interesting. We've done now twice. We've done some series on psychedelic assisted therapy. And I remember one of the guides that I interviewed talking about a mantra that she does with her clients where it's be here, stay here, don't conclude.

Joe Sanok 00:24:04  And so in the psychedelic journey, when they're digging in to to tough work or, you know, there's the scary monster or whatever it is to to go through that, to go into it because, you know, running away from it never, you know, serves you. and it's so interesting when there's things that different modalities have discovered, you know, maybe with some influence from each other, but oftentimes without, you know, like that where you were saying, like, go through the tough things and, you know, go into these tough, discussions or, tough memories. it's interesting how much overlap there often is.

Robyn D. Walser 00:24:38  Oh, yeah. No, I'm glad you brought up the psychedelic work. There are some pretty fascinating things happening in this area with the treatment of trauma. And, you know, the data is new and there's some, It's promising. Like there's some promising data. I don't think it's quite ready for prime time yet. They need more, some more trials. But there's certainly some fascinating stuff happening.

Robyn D. Walser 00:25:09  And part of the way I'm conceptualizing what's happening there is that your people are opening up and witnessing their experience. Like you said, from a position of you are here now, you're not there then anymore. The trauma isn't happening. And if I think about, you know, psychedelic therapy and maybe it's what it's doing in terms of processing emotional experiences that are painful is that it helps people be more allowing. I think about the same thing with eMDR, like the bilateral, stimulation is kind of a rhythmic opening, altering the your state of being a little bit so that you are letting the experiences flow. And I think it can create this sense of, like conscious awareness of experiencing, which is such a powerful part of acting in in my opinion, I'm the strongest intervention when you think about perspective taking or self as contexts that when you become conscious and aware that you can make choices and that you can experience these things, which I think the psychedelic work is doing that, just doing it quicker, probably because, you know, you're opening up more quickly than you might in just an, induction or evoking something in psychotherapy.

Robyn D. Walser 00:26:40  But you do have to there are folks who don't have good experiences. And so I really think if you're going to look into this kind of treatment that you want to work with somebody who who has done it a lot and they know what they're doing and, can support you through that kind of process if you choose to go that direction.

Joe Sanok 00:27:02  Yeah. Well, the last question I always ask, Robin, is if every private practitioner in the world were listening right now, what would you want them to know?

Robyn D. Walser 00:27:10  I think that I would want them to know that we can be people who support living meaningfully. Life is so short. It's so short. You know, we're here for 80 years and it's a blip in time. And so what you do with that time matters. And if we can offer something to our clients that's about tasting life. Yes, the painful stuff, but the joyful stuff too. And really opening up to the idea that life isn't just about feeling good, and it's about living meaningfully and living well in the short time that we have.

Robyn D. Walser 00:27:55  So I guess I would hope that every clinician would consider, Existence and what we do with our time here on Earth. And so that that's what I would that's what I would say.

Joe Sanok 00:28:11  So wonderful. If people want to read your books, if they want to connect with you, where should we send them.

Robyn D. Walser 00:28:16  Robin walser.com. You can find my, my website on the internet.

Joe Sanok 00:28:23  Awesome. Thank you so much for being on the practice of the practice podcast.

Robyn D. Walser 00:28:26  Thank you again for inviting me. Happy to be here.

Joe Sanok 00:28:36  We'll go take some action with today's show. and you know, if you've missed any of our other shows, we had our better mental wellness series all last month. month before that, we had our marketing month. So all sorts of things to help you in your private practice and in your life. thanks so much for hanging out with us today. And you know, we couldn't do this show without our amazing sponsors like gusto. You know, gusto. You know, as a small business owner, for me, paying and taking care of the team and getting, you know, the benefits and taxes and all of that stuff is just really hard to figure out sometimes.

Joe Sanok 00:29:13  So gusto makes it way easier. And right now, our listeners are getting three months totally free. Just head on over to gusto.com/joe is where we run our payroll again. That's gusto.com forward slash. Joe, thank you so much for letting me into your ears and into your brain. Have a great day. I'll talk to you soon. Special thanks to the band Silences Sexy for that intro music. And this podcast is designed to provide accurate and authoritative information in regard to the subject matter covered. It is given with the understanding that neither the host, the producers, the publishers or guests are rendering legal, accounting, clinical or other professional information. If you want a professional, you should find one.