• Visit Dr. Lissa’s website and connect on Facebook and Instagram. Listen to her TEDx talk.

Joe Sanok 00:00:00  You're someone with a vision for your practice, for your side hustle, and for your personal journey. But when it comes to establishing your path and how to get to where you want to be with your practice, things get a little messy. You're also someone who'd prefer to go in person instead of to groups and listening to everyone else's story. To me, it sounds like you could benefit from one on one consulting with our experienced practice of the practice consultants from 595 a month and up. You can work with a consultant that will give you more direction and practical, tried and tested tips matched to you and your goals. For more information, visit practice of the practice. Com forward slash apply. Again, that's practice of the practice. Com forward slash apply. This is the practice of the practice podcast with Joe Santos. Session number 1227. I'm just an actor host. And welcome to the practice of the Practice podcast. I hope you are doing awesome today. I hope your spring time is treating you well.

Joe Sanok 00:01:13  and that maybe you have some trips planned or you're planning for, you know, summer coming up. It's really speeding along here. so I hope that things are great in your world, you know? In this podcast, we help you build a thriving private practice you absolutely love. and part of that is to really dig into some, some issues and some topics that maybe we don't always dig into as deeply as we can do on a podcast. And that's why I'm so excited today to have Doctor Lisa Rankin, MD, who is a mind body medicine physician, author of seven books and the founder of Whole Health Medicine Institute and also the nonprofit Heal at Last. She's an artist who reaches radical remission, trauma informed medicine and spiritual healing. She teaches memoir writing for therapeutic purposes in addition to being an educator of internal family systems. Her Ted talks have been viewed over 6 million times, and she starred in two national Public Television specials. Lisa, welcome to the practice of the practice podcast.

Dr. Lissa Rankin 00:02:11  Thank you. It's a pleasure to be here.

Dr. Lissa Rankin 00:02:13  Thanks for having me.

Joe Sanok 00:02:15  Yeah, I'm so excited to have you. You know, it's it's always interesting when different things line up, just personally with my life. So as we were talking before we started rolling, we're talking about all the different directions that we could go, as I do with every guest. We were talking about relational trauma, dysregulation of trauma, and in the body. We talked about just like spiritual recovery. We talked about narcissists. I mean, there's a lot going on in your professional world that in the last few years I've dealt with through through a divorce and through my own medical issues. So I hope you can solve it all for me today.

Dr. Lissa Rankin 00:02:49  I have a bit of professional ADHD, as you can tell.

Joe Sanok 00:02:53  Well, that's I love that. Well, tell me about right now. What's what's some of the work that's lighting you up right now? I know part of it you might be working on, You know, your future book that comes out in a year, and we don't have to dig too far into that.

Joe Sanok 00:03:04  We'll have you back on the show. But tell us a little bit about just right now what's lighting you up. And then we can talk about kind of your broader scope of work.

Dr. Lissa Rankin 00:03:11  Well, you know, my, my next I'm working on my next book with my partner, Doctor Jeffrey Reddick. He's a Harvard psychiatrist. and so, you know, that's a lot of our focus right now is sort of working on trying to make sense of the physical health impacts, the nervous system dysregulation caused by relational trauma, particularly oppressive relationships or narcissistic relationships with, you know, people who give more than they receive in their relationships and, you know, kind of have these non reciprocal, partnerships or work relationships and such, and get sick. And because we're both medical doctors, we're really interested. Both of us have been researching radical remission for between the two of us 33 years. And we were doing our research independently. We just met about five and a half years ago and realized that both of us independently, had come to the conclusion that people who had these sort of seemingly miraculous recoveries from, quote unquote, incurable medical conditions often had been in oppressive relationships and found a way to either change the way they showed up in the relationship or left the relationship, and then their bodies sometimes had very rapid recoveries.

Dr. Lissa Rankin 00:04:32  and, and we thought over and over again. And so when we realized that we had both kind of made that, you know, made that observation independently, we decided to write a book about it together. He called his his one of his patients, called it the Selfish Bitch Project. And one of my patients called it becoming an equitable. So it's like.

Joe Sanok 00:04:55  Oh, it's great titles. How are you guys going to name this book?

Dr. Lissa Rankin 00:04:58  We don't know. You know, this is my eighth book, and every one of my books, like the title, came to me first, and then I had to build the book from the title. And this is the opposite. It's like I've built the book. I'm almost done with it, and I still don't know what the title is.

Joe Sanok 00:05:14  well, I'm sure it'll come to you. I mean, those are two great titles right there. So, yeah, they definitely would stand out in the market. Market?

Dr. Lissa Rankin 00:05:21  Yeah. They don't want the Selfish Bitch project because it's also for men.

Dr. Lissa Rankin 00:05:24  You know, men absolutely wind up in you know, and so and becoming unforgivable. Well, maybe maybe.

Joe Sanok 00:05:33  Yeah. I mean, I think it was Marie Forleo that had a book. I forgot what it was called, but it had a really, like, abstract word that her grandma had said, like everything was everything is. I'll have to look it up and I'll bring it back in the episode. but you know, that idea of the relationship informing your body seems to go against, on the surface. So much of what Western medicine has taught us. tell me what you see actually happening in the body. being, you know, a doctor being, you know, in this work, doing research, you know, in communities and your partner as well. what are you seeing that maybe challenges that Western model of the body and the relationships being very separate from one another?

Dr. Lissa Rankin 00:06:18  Yeah. Well, you know, my my, clinical work with that all began in back in 2009 when I had left the hospital and I started an integrative medicine practice, just like, you know, a cash pay integrative practice, so that I could spend a full hour with my patients.

Dr. Lissa Rankin 00:06:34  And by the time these patients came to see me, I had just moved to Marin County, which for any of you who don't know it, it's like health nut central and I had been working on the front lines in, you know, really high risk populations in the inner city of Chicago. I was working with Somali refugees on the Mexican San Diego border. I was their ob gyn, and many of them had female genital mutilation. So really high risk populations. And then I moved to Marin, and opened this sort of practice for the privileged. And these people had seen the best doctors at UCSF and Stanford, and they'd seen their acupuncturist and their natural path, and they were taking 100 supplements and working out with their personal trainer and eating their raw vegan diet. And they were literally the sickest people I'd ever seen. and it didn't make any sense to me. And so kind of the results of my observations there were published in mind over medicine, which is the New York Times bestselling book that I wrote that got turned into a public television special.

Dr. Lissa Rankin 00:07:36  and the relational aspects of that were really evident from the very beginning there that many of these people, since I was a gynecologist, I was just seeing women. And many of these women were married to these, you know, Silicon Valley CEOs, really wealthy, really successful, really narcissistic individuals, and they were being coercively controlled in these relationships. And when we were doing some of the trauma screening and then trauma recovery work, sometimes their symptoms would be going away in like three months. And they credited me and I wasn't doing anything. I was just asking good questions. So that kind of began, a whole area of my interest and research into, the relational impacts on the physical body. I did a Ted talk about loneliness as a public health issue and was working with the our current surgeon general, Vivek Murthy, who, you know, right at the beginning of the pandemic, sort of announced loneliness as a public health issue and wrote a book called together and then, boom, we're in social, you know, we're in social isolation in 2020, in lockdown.

Dr. Lissa Rankin 00:08:46  so I'm interested in it in sort of the personal to the collective level of, you know, basically relationships can be medicine or poison to our bodies, depending on how they impact our nervous systems. In fact, that's one of the one of the working titles is medicine or Poison. You know how relationships can make you sick or help you heal. and so, you know, that's been a lot of what I've looked at, particularly through the internal family systems model, is how do we make our relationships medicine? and I'm really interested in sort of the poly vagal theory, aspect of that sort of the, you know, a lot of people with severe trauma, their safety, danger compasses are backwards and they feel safe around dangerous people, and they feel threatened around safe people. And so reorienting that compass and so, of course, that creates even more trauma. When you feel safe around dangerous people, you're going to just build on the trauma. The relational trauma is going to get worse over time as you continue to choose unsafe people to get close with.

Dr. Lissa Rankin 00:10:04  So you know those. And then, of course, that leads to loneliness, because then people become so frightened of relationships because their compass is backwards.

Joe Sanok 00:10:15  And how does ifs kind of intersect with, with that poly theory and kind of what you're talking about is happening in the body.

Dr. Lissa Rankin 00:10:24  Yeah. Well, so from the poly vagal perspective, you know, we're looking at attachment styles, right. Attachment relationships. And when we have a healthy secure attachment style then we're able to be in that ventral vagal, socially connected tend and befriend natural self-healing aspect of the nervous system that is really good for the body's recovery. It's really good for mental health recovery. It's really good for physical recovery. and so when we look at internal family systems, we're doing parts work. We're looking at the parts, for example, that prevent us from being in a ventral vagal parasympathetic state in that natural self-healing state. So for example, if we're dissociated because of relational trauma, then we're disembodied. We're dissociated. These are parts, of course.

Dr. Lissa Rankin 00:11:24  that will put us more in a, dorsal vagal state of the nervous system, for example, the shutdown, collapse, the most severe threat, sort of the freeze or sometimes the fawn, trauma response. And that is extremely, extremely detrimental to the body for the nervous system to be in that dorsal vagal state. And then, of course, we have sort of the middle state, The fight or flight. Sympathetic stress response, which again also difficult for the body to engage in self-healing when we're in fight or flight or when we're in freeze or fawn. And I love ifs as part of the antidote to that of getting to know those parts. Getting to know the parts that fight. Getting to know the parts that that flee, that freeze. And all of the constellations of parts inside that make up these different stress responses. And of course, part of the orientation of internal family systems is to reconnect and reunite these sort of disintegrated parts of us with what we call self energy and internal family systems, the sort of the part that's not a part, the aspect of being that can't be broken, that can't be traumatized, that is, you know, if you have any spiritual inclination, every religion and spiritual community has a different name for, you know, Christ consciousness, Buddha nature, your higher self, your divine spark.

Dr. Lissa Rankin 00:12:54  you know, whatever you want to call it in ifs. We call it self. And so that attachment relationship going internal between self and the wounded inner children, or the protective parts that try to protect those wounded inner children, can be part of reorienting those attachment relationships to create earned secure attachment that can lead to that ventral vagal parasympathetic response that will, can, can sometimes quite quickly turn around certain kinds of physical illnesses, depending on how long they've been there, how entrenched the the damage is in the body. and it's it's just been really amazing to work with people in that way. I personally, at this point think it's medical malpractice, for example, to give somebody oncology treatment without also doing a really thorough, trauma screen, not just for adverse childhood experiences or ace traumas, but for relational trauma, for developmental trauma, for, you know, heartbreak.

Joe Sanok 00:13:59  You know, it's so interesting how often guests on this show, it's like the universe, the energy of the self, the ego, whatever is lining up these guests just to have me work on myself.

Joe Sanok 00:14:11  you know, in 2021, I left a pretty toxic marriage, and, my ex, ran off with her surf instructor and, you know, left the kids with me, and they don't get to. They only see her, you know, maybe once a month. I'm interested. Thank you. I'm interested in, you know, and I don't want to label her a narcissist. I don't know, I don't know enough about her to give her any labels. But I do know that, you know, in retrospect, I gave up a lot of myself to be the the over, the overcompensating adult, the one that did a lot of the the working the like, keeping track of the kids and, you know, those sorts of things that you were mentioning, you know, in regards to just like.

Dr. Lissa Rankin 00:14:54  The over.

Joe Sanok 00:14:54  Functioning myself, over functioning, over functioning and, you know, it's like so when someone can have a clean break, with someone, that's one thing. but then, you know, I want to to the best of what her ability is, be a good co-parent.

Joe Sanok 00:15:11  and so for people that have to continue to deal with someone, like, my therapist has talked a lot about gray rocking and, like, being is is boring as a gray rock and to, you know, just only give the information that's needed. The only thing we really have to talk about is the kids, their schedules, a handful of things, you know, like that, like they left their coat, you know, at your house, that kind of thing. yeah.

Dr. Lissa Rankin 00:15:32  What are their or these slightly more cheerful yellow rock, I don't know, have you heard about.

Joe Sanok 00:15:36  So tell me about yellow Rock. And also tell me, like what? What is a healthy way? Because it's interesting you bring up also the medical side because, you know, I'm type one diabetic. that's been a long process that, you know, I think, you know, I ended up having thyroid cancer also. So there's something going on there, where they're connected in the endocrine system, but, you know, slightly after everything resolved, with, with the divorce and all that, I got salmonella in Mexico and two and a half years later, I'm still dealing with that.

Joe Sanok 00:16:05  And miraculously, a day after mediation and some things that were really big got solved, a lot of those symptoms just disappeared the next week. And it's like, as you say this, I'm like, WTF? Like, that's not happening, right? So so dissect that for me. Tell me, tell me what's going on.

Dr. Lissa Rankin 00:16:24  Well, you know, I'll go backwards a little bit. So the, the book that I'm working on now, the untitled, mystery book, begins with the story of The Giving Tree. Did you ever get indoctrinated with this story when you were a child?

Joe Sanok 00:16:37  Yes, it's. Yes, I know that story well, but maybe for those that haven't heard it, if you can get a summary, that'd be wonderful.

Dr. Lissa Rankin 00:16:43  So, sure, it's written by Shel Silverstein. And, you know, I was Jeff and I, my partner and I were both raised in pretty fundamentalist Christian churches, and I think it was common in some of those environments to sort of use this book as a way to teach, good boys and girls, particularly good girls, how to behave in relationships.

Dr. Lissa Rankin 00:17:05  And so in this book, the the tree is a is a female and the boy is this young male, and the boy goes to the tree and, you know, he wants to eat her apples and pick her fruit and enjoy her branches and climb all over her. And they have this very sweet relationship when he's a child, you know, between the boy and the tree. And as he gets older, he gets less interested in the tree, but he's basically exploiting her over time. You know, he he comes back and she wants him to play on her branches and eat her apples. And he says, no, I just want money. And she says, okay, well, you can take my apples and take them to the market and sell them. And so he does that and then he comes back and she wants him to play and he says, no, I don't want to play, but I just want a house. Can you buy me a house? And she's like, no, but you can cut down my branches.

Dr. Lissa Rankin 00:17:53  And anyway, long story short, she ends up a dead stump and he's an old man, like sitting on her. And we're supposed to believe that the tree is happy. The tree is happy from having been a sacrificial martyr that ends up dead. And, you know, we're pushing back against that. We don't want to, like, upset sacred cows, you know? but but that's what we both have seen in our medical practices over and over, is that these people that are just like, take everything in the name of unconditional love, and you don't have to be grateful and you don't have to give back. And of course, if you show up in the world that way, there are people that can be quite ruthless, that are more than happy to just be like the boy. They're more than happy to just take. And you know, that might again, a lot of spiritual and religious indoctrination kind of bolsters that. It like the the thought process processes will support that that that is what it means to be a good little Christian girl for example.

Dr. Lissa Rankin 00:18:55  or even separate from the religious indoctrination, just the gender, the gender conditioning. That's what a female does in a patriarchal culture, for example. And of course, now that women have more power, there are more and more women that maybe are taking on the role of the boy and men who are maybe acting more like the Giving Tree. Like maybe in your situation. But what we you know, what that story doesn't talk about is what does that do to the nervous system? To feel. Yeah, to be exploited, repetitively and often people were exploited in childhood to set them up to think that's normal. So yeah, we're really making a case for one of the working titles of the book is an IFS term, which is you turn your you turn. sometimes we have to do that instead of putting all of our attention on the outside, coming back to the inside, into our parts to be like, what are my parts inside need? And so it's not surprising to me that you went through that.

Dr. Lissa Rankin 00:19:57  And all of the stress of the mediation and all of the conflict, especially for people that are more conflict avoidant because conflict was maybe dangerous or unsafe in their past lives or in their present lives. And then all of a sudden you take away all that conflict and the symptoms improve. That's not surprising.

Joe Sanok 00:20:16  Now, you had said instead of gray rocking, I think it was yellow rocking. Also, tell me, tell me about yellow rocking.

Dr. Lissa Rankin 00:20:22  Yeah, yellow rocking is like gray rock, which basically just means like you're just boring. They can't get a rise out of you with positive or negative things, because people who are higher on the narcissism spectrum or in language have sort of a constellation of parts that kind of create the symptomatology of of narcissism. They will. They will get narcissistic supply, even if the attention is negative. So even if they're just getting a big rise out of you, that is still attention if they're for their attention seeking parts. So if you're if they're not able to actually get much attention from you, no matter how egregious the behaviors.

Dr. Lissa Rankin 00:21:05  they get bored. So gray rocking is just being flat as a board or flat as a rock. Just gray rock. Yellow rock is a little sunnier. because again, if you're co-parenting with somebody, you're going to have to see this person. Your kids are going to see you around them. it's just kind of gray rock with a smile, you know, a fake smile, maybe. You know, you're sort of gaslighting your own parts a little bit if you're doing that sometimes, but to just kind of keep the peace for the sake of the family. And that is one of the most difficult situations when it comes to how to deal with a relationship like that is when you you can't go. No contact. That's not an option. You have to. If you are co-parenting, then, you know, you you have to face that person. And for a lot of people, even just the the kids, the, the passing over of the kids is activating to the nervous system. so being able to work with the parts that especially if there was any narcissistic abuse in the past, in childhood.

Dr. Lissa Rankin 00:22:14  if sometimes if we can go back and kind of reclaim and heal and integrate and bring back into present time the parts from the past that may have been overpowered or repressed, then at least those younger parts that are much more, sensitive and reactive. If we can take care of those parts, then often the ex is not so activating to the nervous system. So we do have some we can't control how the X is going to behave, but we can have some agency over healing past narcissistic abuses. Even in the relationship. You know, the past might be 19, you know, 2021, not necessarily just childhood, but if but often people who choose relationships like that, there are multiple relationships that fit that pattern in the past. I don't know if that's your situation, but sometimes doing that ifs work on the the, the wounded children inside of us that learned how to fawn or to over function or to, take on responsibilities that really are not, not equal, not fair and not yours. that in a in and of itself is a trauma response, the sort of fawning behavior.

Joe Sanok 00:23:34  Yeah. For me it's interesting because in very few areas of my life do I do that. And I think that it's interesting because you talk about being raised, in a, you know, pretty extreme version of Christianity. I forget exactly how you phrased it, but I was raised Catholic and then became evangelical late in high school and went through a phase of that, and so took on a lot of that purity message. And I think that for me, being a in a lot of ways, a natural and cultivated leader, like I had a lot of great mentors. And, you know, I was always taught by my parents to stand up for myself. And, you know, even though I was getting these messages from Catholic school, my parents kind of undermined them at times, too. And so, I feel like in a lot of ways I had a very healthy and nuanced childhood where I could speak up, and then it's like I got this message of like, the worst thing is to get divorced and to admit that maybe you married the wrong person.

Joe Sanok 00:24:26  and so it was everything I read was, you know, I mean, I went through the Gottman certification and all these things, you know, for myself and for my clients to be like, okay, I need to do the 5 to 1 ratio. I need to recognize the four horsemen. I need to do all these things that, you know, sex starts in the kitchen. Okay. I will I will make sure the kitchen is clean. So it's like the achiever side of me, I think is more, what definitely came out. And just like if I follow this formula, then it'll work out, more than kind of fawning over someone and being conflict avoidant.

Dr. Lissa Rankin 00:24:58  Yeah, I have a part like that, too. That's like, give me all the gold stars so I can get it right.

Joe Sanok 00:25:03  And well, my.

Dr. Lissa Rankin 00:25:05  Dad.

Joe Sanok 00:25:05  Is a behavioral psychologist that worked in the schools, and one of my earliest memories, I was probably three years old, was, finishing a star chart for going to bed correctly and then going and buying a little kid sword.

Joe Sanok 00:25:17  And it's like so much of that, my undoing has been realizing, you know, they weren't just saying you're only loved for your achievement, even if that's what my takeaway was. you know, I have my own therapy to work through with all of that. but no, I get it. The gold stars for sure.

Dr. Lissa Rankin 00:25:33  Yeah, yeah, yeah, I, you know, that's why one of the couples therapy models that I really respect and appreciate is Terry Real's model because he takes on, you know, his a lot of couples therapy models basically treat the couple as kind of equals, like you're responsible for what's on your side of the street and you're responsible for what's on your side of the street. And that doesn't necessarily acknowledge, for example, things like coercive control. when one party is really disempowered and oppressed and another party is very controlling and oppressive. you know, Terry Reels model the relational life therapy. The therapist takes sides with the oppressed and stands up against the oppressor in a compassionate and trauma informed way.

Dr. Lissa Rankin 00:26:25  You know, his specialty is kind of patriarchy and the narcissistic, imbalances of power that can show up in, in romantic relationships. So you know that it's it's different because again, I love the men's work. My partner and I are actually reading their new book fight right right now. which is great. It talks about the 5 to 1 ratio and all the things that you're talking about there. You know, five positive ways of showing up in conflict. which I really appreciate because it's not just praise and cherish your partner. It's things like validate what they're saying, mirror and witness what they're experiencing. You know, say good point or that's fair or, you know, things like that to actually validate them when they're protesting something. but, you know, some people that are high on the narcissism spectrum, they will they will fight that tooth and nail. They will they do not like to hold be held accountable. They don't like to admit when they're wrong. They struggle with expressing remorse or admitting when they've made mistakes.

Dr. Lissa Rankin 00:27:36  and they will pull all the narcissistic defenses, which again in ifs are parts. you know, the the davo, the deny attack, reversed victim and offender, all the projection and displacement and blame shifting. And it can be very difficult for the if somebody doesn't have a lot of ego strength to be able to continue to sort of hold them to account. So sometimes in couples therapy, you know, somebody needs to kind of have their side so that they don't just get bulldozed.

Joe Sanok 00:28:14  Listen, I didn't take insurance in my counseling practice because I had no idea how to handle it. The process of accepting insurance outside of a group practice can be tough, but most people looking for mental health care want to use their benefits to pay for sessions. If you're like me and you feel a little scared about taking insurance, or you just want to make it easier on yourself and you're interested in seeing clients through insurance. Alma can help. They make it easy to get credentialed with major insurance plans at enhanced reimbursement rates.

Joe Sanok 00:28:43  They also handle all the paperwork, from eligibility checks to claim submission and guaranteed payment within two weeks. Plus, when you join Alma, you'll get access to time saving tools for intake scheduling, treatment plans, progress notes and more in their included platform. It's going to make it so much easier for your team, so you can spend less time on administrative work and more time offering great care to your clients. Visit alma. That's. Hello all! To get started. Now, before I ask the next question, I did look up that that Marie Forleo book that has the unique title is everything is Figure Out table.

Dr. Lissa Rankin 00:29:27  oh, I like that.

Joe Sanok 00:29:28  Yeah. Yeah. So that was a term that her grandma would say. and yeah, I couldn't remember at the beginning of the episode. you know, this this last section. We've probably got five minutes or so left. I would love to get a little bit more personal. So you said, you and your partner were raised in a highly religious home.

Joe Sanok 00:29:44  You've also talked about a little bit of your own development in regards to reading together and things like that. I would love to take all this knowledge that you've learned and sort of like the doctor treat the doctor. so what do you what do these habits look like for you? What's been helpful for kind of undoing and reforming the way that you were raised? just like what is your weekly or monthly or yearly habits look like in regards to enacting these things that you're talking about?

Dr. Lissa Rankin 00:30:11  No, that's a great question. I you know, I was lucky in that my religious indoctrination was much milder than my partner's. He was raised in the cult, and then ended up in an Eastern Orthodox cult. So he kind of went cult cult hopping as people who were raised in cults often do. Mine was I had three Methodist ministers in the family, and my mother's His view of Christianity was very fundamentalist, but I had the other ministers in my family and other family members who were social justice activists and very liberal, and kind of pushed back against my mother.

Dr. Lissa Rankin 00:30:45  So I had I had other influences, and I left the church when I was 18 and have considered myself a spiritual being, but outside of any organized religion since I went to college. so for me, it was it was a lot easier. But I definitely had, I shared with my partner the sort of trauma symptom of, you know, spiritual bypassing, if you want to call it that, the, the spiritualized, conflict avoidance or conflict avoidance and holy drag, if you will. in if's we call it self like parts, parts that sort of masquerade as self and kind of inflate us by, you know, convincing us that we're extra spiritual, you know, in the way that we avoid conflict. So I have been lucky to have really good therapy from both internal family systems and advanced integrative therapy, and then also relational life therapy with a couples counselor that Terry Real picked for Jeff and I. and so part of part of our part of my practice, now that I'm in a partnership with somebody who was in an extremely oppressive situation, is like, we're doing a lot of relational healing, which, man, if you want to, you know, if you want to pursue your awakening path, like go be a monk in a cave and it's a thousand times easier than trying to do it in a relationship.

Dr. Lissa Rankin 00:32:16  So but that's that's a path that is, you know, maybe a quicker and more difficult path of recovery and awakening. That is definitely my preferred method. But for me, part of what that looks like at the sort of, really practical level is I have a parts processing partner. Her name is Emma in the UK. We've been doing this for, I don't know, seven years. I've been an IFS practitioner for over ten years now and an IFS teacher since 2019. and I wrote I wrote about it in mind over medicine. I wrote about it in my last book, Sacred Medicine, and it's sort of the the cornerstone of the sort of treatment aspect of the book that I'm working on now. So that daily, daily, ifs meditation practice of sort of going inside and checking with my parts and then reporting on those parts with my parts processing partner, who then mirrors and validates my parts, and then she does her processing with me, and I mirror and validate her parts. She just got married last month and credits our parts processing, practice with her ability to get married for the first time.

Dr. Lissa Rankin 00:33:26  to be able to have a successful marriage. and it's definitely been part of the practice of making me able to be in a relationship with somebody like Jeff, who is a severe trauma survivor. And, you know, it's it's it's challenging when you are when you're raised more securely attached and you're trying to attach to somebody with, in his case, disorganized attachment. so I do my own personal practice. Like I kind of think of it like fractals. It's like me inside with my parts and then going outside in a therapeutic space with my parts processing partner. This is part of what I teach in my online programs now, is teaching people how to do parts two parts, processing with another person as a form of relational healing and as a health equity kind of, orientation, because it costs nothing for me and I to do this with each other. and, and we do it in between therapy sessions. And then, you know, Jeff and I have our own practice. We do what we call cafe time every day, and we get our coffee and we read our books.

Dr. Lissa Rankin 00:34:31  You know, we read all the therapy books. We read all the. Like I said, we're reading fight right right now, the new book. and we, we read them personally. Like, how does this apply to us individually? How does it apply to us as a couple? And then, you know, we're teaching some of that material to other people. Like I'm about to teach a class in January. I know this won't come out until after that called Healing Through Relationship. And then I'm going to be starting a continuity program. The working title for that is Love School. for people that are in an ongoing, attempt to use their relationships as their trauma healing, like as the portal, as both a sanctuary and refuge, but also a crucible, like an alchemical, catalyst for bringing up all the unhealed parts, as our partners tend to do, to help us identify the parts in us that still need self to parts. Connection.

Joe Sanok 00:35:28  Healing so amazing.

Dr. Lissa Rankin 00:35:31  I don't know what else.

Joe Sanok 00:35:32  So many great resources.

Dr. Lissa Rankin 00:35:34  Yeah, I spend a ton of time in nature. I was going to say the other personal processes. I. I spend a ton of time in nature.

Joe Sanok 00:35:41  And define a ton of time.

Dr. Lissa Rankin 00:35:44  2 to 3 hours a day. yeah. Outside on the beach, hiking in the mountains, sitting in my backyard. yeah. I live on highway one in California, with redwoods and mountains and ocean and wild animals in a very rural area. We don't have a gas station or a grocery store anywhere in half an hour. So, yeah, that's another huge part for me. Is that sacred holding space of nature? that allows my parts to kind of come to the surface more readily. I'm not. I don't do well in cities.

Joe Sanok 00:36:28  how much of that? So I'm wondering how much of that do you think is like a natural kind of introversion that you need that downtime or like, I know my partner Claire, like, she's definitely a highly sensitive person and needs that, like recuperation time. How much of it do you think is that or do you think most humans need a lot more time in nature? Maybe it's both.

Dr. Lissa Rankin 00:36:49  Yeah. I mean, it's it's I think it's both. I, I enjoy being around people. I definitely sort of get drained when I'm around. A lot of people, cities are just too much chaos. I was in San Francisco yesterday and it's just like, oh yeah, this is I get easily overstimulated. so it being in nature just helps me slow down the pace. And it's also, I can tell the state of my nervous system shifts when I'm in New York City, for example, or when I'm walking on a trail in, you know, my backyard. so I do think most humans are I think a lot of humans are unaware. They're they're lacking in what we call introspection. They're not necessarily semantically aware when they're nervous. System is in a fight or flight sympathetic response or a dorsal vagal freeze or fawn kind of shut down. I'm very sensitive to that. I can tell when my nervous system gets jacked up and I'm uncomfortable with that sensation, and so I can feel my whole system sort of drop into this, whether I'm with somebody in nature or whether I'm by myself.

Dr. Lissa Rankin 00:38:04  It's like this intimate relationship because I've lived here 16 years. I know all the flowers. I know all the animals, I know the ocean. I know the mountains. Like I'm very much an animist in my spirituality. So I feel like part of my own attachment style is it's really easy for me to attach to nature in ways that's much simpler than the attachments that I create with humans? I think a lot of people with their own trauma, can relate to that. Right. It's it's a it's a safe attachment. so my nervous system can really drop into this space where I'm not disconnected. I don't feel lonely. I feel very, connected. I feel connected to self. I feel connected to nature. I feel connected to whatever you'd call God. And then my I, it makes it easier for me to feel like I can feel connected to my parts in a compassionate and generous way. And then I feel more resourced to come back into relationships with other people. In this generous way. That's not overgenerous.

Dr. Lissa Rankin 00:39:09  That's not giving Tre generous, but is more reciprocal generosity.

Joe Sanok 00:39:15  What would you say to people that either I don't want to say push back, but that they, that they think they can't do 2 to 3 hours a day of time in nature that they can't, you know, spend that much time with themselves, whether it's because of phase of life. Maybe they have young kids and they're really busy with that phase of career. They're just getting started or career shifting or, that that they would say, well, well that's that's great that you can do that. but that's just not realistic for myself. I think sometimes when I hear those kind of pushbacks, there are there is truth in there. But then there's also limiting beliefs as well. Like, what would you say if someone kind of pushed back in their mind thinking, well, there's no way I could do that.

Dr. Lissa Rankin 00:39:55  Well, it's totally valid. It's totally valid. It is absolutely a sign of my privilege and also a sign of my priorities.

Dr. Lissa Rankin 00:40:03  I used to work in a hospital. I was on call every third night. I worked 72 hour call shifts. I was living in a big city. I had two houses and two mortgages and a 401 K. I don't have any of that anymore. I don't own any properties. I don't have a 401 K. I have opted to live much more simply and earn much less money. in order to prioritize that lifestyle, I used to feel trapped. I didn't. I've never lived with anybody who's paid my bills. I was the full time provider in my 13 year marriage with my, my daughter and her father. And after our divorce, I was the one sort of paying for private school and paying alimony and all of that. So I, I've never had, like, somebody else, taking care of me financially in order to just give me that kind of lifestyle. But I have chosen a lifestyle, that allows me that kind of thing. And I absolutely understand not everybody has that choice, and not everybody wants to choose that choice.

Dr. Lissa Rankin 00:41:08  They maybe are choosing financial security or homeownership or, you know, more professional, ambition or things like that. So I think the one of the things that I really, came to recognize when I was in my integrative medicine practice, which I haven't been working clinically since 2010. Just part of why I can do that, is that a lot of times when you said the limiting beliefs, a lot of times when we think we don't have a choice, we actually do. The cage door is open. We just might have to make sacrifices that some of our parts might not want or let us make. And that's totally fine. And that's again why ifs can be such a useful tool when we're not sure. For example, if someone is in has chronic illness and thinks maybe part of it is relational trauma, for example, and they're thinking, gosh, that sounds great. Spending all this time in ifs, meditation, parts processing, going out in nature or whatever. But, I don't have the time for that.

Dr. Lissa Rankin 00:42:16  this is where there's an IFS practice called the conference table that I really appreciate. where, for example, I could ask inside, okay, who has an opinion about how much time we should be productive earning money and how much time we should be focusing on recovery, healing, nature, whatever. And you can just line, line the parts up on both sides of the table. And self is sitting at the front of the table like, like a mediator would to give voice to all the different parts and hear them out. They all think they all have good intentions for you. They all have a protective purpose and they're all worth listening to. So I don't even like saying like limiting beliefs, because that feels sort of insulting to some of my parts that hold those limiting beliefs. Like for those parts, those beliefs are fact. You know, they're they're like when I believed that I couldn't leave the hospital. Like that was a limiting belief. It turned out not to be fact, but the parts of me on the side of the table That said, I could not leave the hospital, were extremely dominant in my system because just practically speaking, for example, I had to pay $120,000 malpractice tale in order to quit my job.

Dr. Lissa Rankin 00:43:34  So I would not only lose my income, I'd have to come up with $120,000 in cash, and I still had medical school debt, so my financial parts were saying, that is not an option to quit your job as a doctor. and I had no no vision, even no potential on the horizon for how to make money in any other way. so that felt like fact in my system, but in actuality, it wasn't fact. I had choices, but I had to make sacrifices that some parts of me really didn't want to make.

Joe Sanok 00:44:10  Man, I feel like we could go on for another hour. Lissa, the last question I have for you is if every private practitioner in the world were listening right now, what would you want them to know?

Dr. Lissa Rankin 00:44:20  That's such a good question. I don't want to waste it with something not important enough. I guess the. You said every private practitioner. Well, first of all, if anybody listening is not familiar with internal family systems, the the most valuable nugget of that I think, is approaching your clients, even your most poorly behaving behaviors of your clients through the lens of understanding that it's a survival style, that those behaviors are coming from parts that are trying to protect people from being overwhelmed by, you know, feelings of helplessness, hopelessness, worthlessness, powerlessness, those really intolerable feelings that we that our most wounded inner children hold.

Dr. Lissa Rankin 00:45:10  And when we can approach them in a genuinely non pathologizing way, like to me that's the how of self-compassion. And we can as practitioners, we can hold that self energy to entrain that kind of self-compassion in our clients. And that can be such a game changer.

Joe Sanok 00:45:27  So great. If people want to follow your work, if they want to learn more about your books, where should we send them?

Dr. Lissa Rankin 00:45:33  My main website is just my name. Lisa Rankin. Com Lisa rankin.com. And I also have a Substack where I'm specifically I'm releasing two books that I've written but not published. for my paid subscribers. And I also have an unpaid offering there at Lisa Rankin, MD. And that's all about boundaries and spiritual bypassing and things like that. So I do a lot of writing.

Joe Sanok 00:46:00  So awesome. Well, thank you so much for being on the practice of the practice podcast.

Dr. Lissa Rankin 00:46:04  My pleasure. Thanks so much and thanks for sharing so much about what you're going through. I hope I'm keeping my fingers crossed for you and all your parts.

Speaker 3 00:46:12  Thank you.

Joe Sanok 00:46:20  You know, today is such a great example of how, you know, a podcast is obviously for the listeners in some ways that it's, you know, helping you out. But, you know, lately, just the amount of times the guests have just been so informative to me personally, you know, a podcast can not just only change kind of the direction of your, your own career, but also just you as a person, to have access to just top thinkers that are doing amazing things in the world. if you're interested in starting a podcast or just learning more about podcasting, we have a bunch of free resources over at podcast Fool.com. that will be really helpful for you if you're thinking about starting a podcast or getting support around your podcast. Thank you so much to alma for being our sponsor today. You know, I wish alma had been around when I had my private practice. I had no idea what I was doing. That's why I didn't take insurance. But if alma had been there, I would have.

Joe Sanok 00:47:16  And there's no reason that as a clinician, you should be spending hours on paperwork to bill for insurance or not knowing for sure that you'll get reimbursed for sessions with your clients. If you're interested in seeing clients through insurance but don't want to navigate the process and paperwork on your own, alma can help. They make it easy to get credentialed with major insurance plans at enhanced reimbursement rates and a guaranteed payment within two weeks. Visit alma. That's. Hello alma to get started. 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. Silence is 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.