#179 Hour of the Heart: Connecting in the here and now. With Ben Yalom

00:00:00: And so, isotherapists will very often just sort of say, hey, whoa, hold on, you know what, I think I made a mistake.

00:00:06: Or, you know, I think I should have asked you a different question earlier because it would have taken us into some territory that might have been more interesting.

00:00:13: And almost every time that admission, that process of saying, you know, I think I could have done better, it's almost always beneficial.

00:00:25: Welcome to HealthWise, the health and longevity podcast brought to you by Sunday Natural.

00:00:29: My name is Jason Raffington and in this podcast we explore what it truly means to be healthy.

00:00:35: Together we'll dive into topics like medicine, exercise, nutrition and emotional well-being, always with a wise perspective on what genuinely benefits us.

00:00:47: We spent much of our lives living under a necessary delusion that we have time.

00:00:51: time to call, to repair, and to have the conversation that we keep postponing.

00:00:57: But beneath the emails, the notifications, and distractions, one truth remains.

00:01:01: Our lives are finite, and that finiteness is what gives our interactions meaning.

00:01:06: So if you had just one hour to truly meet another human being, how would you spend those sixty minutes?

00:01:12: My guest today has been exploring that exact hour, not as a thought experiment, but as a clinical reality.

00:01:18: Ben Yolom is a practicing psychotherapist, an award-winning writer and the former artistic director of San Francisco's Fools Fury Theatre Company.

00:01:26: He joins us to discuss Our of the Heart, connecting in the here and now.

00:01:31: Ben co-authored this book with his father, Irvin D. Yolom, the world-renowned psychiatrist and best-selling author.

00:01:37: As Irvin entered his nineties facing memory loss and the isolating constraints of the pandemic, he reinvented his practice one last time.

00:01:45: He moved away from long-term treatment and began offering one-time single session consultations.

00:01:51: Our of the heart chronicles those one-time encounters and explores how, when the clock is ticking, the most sophisticated tool a therapist has is not a textbook or a diagnosis, but real connection.

00:02:02: Welcome, Ben.

00:02:03: Thank you for being here.

00:02:04: Oh, thank you so much for having me.

00:02:07: Ben, we usually start with a question related to Sunday.

00:02:10: So my question for you is, do you also write on Sundays?

00:02:16: No, not usually.

00:02:19: In large part because my family won't allow it.

00:02:24: Small children and they demand my attention, but sometimes when I'm on deadline I sneak off.

00:02:29: Okay, I think that's good.

00:02:30: I think it's good to have at least one day off and not have seven days a week of writing or being busy.

00:02:37: Great.

00:02:37: Then let's talk about the book.

00:02:40: So how did these, how did the one session premise come to be and what was the deeper intention of making that the core of the book?

00:02:50: Well, as you mentioned, my father in his late eighties began to experience memory loss and he became aware that he couldn't reliably recount details about his clients and conversations they'd had in previous therapy sessions.

00:03:09: And he realized that ongoing therapy at that point would be sort of an irresponsible choice on his part.

00:03:21: But from my perspective, there were two counter impulses that were playing there.

00:03:28: One was curiosity.

00:03:31: as to what he could do in terms of a short-term encounter with patients, what would be helpful, what would be useful.

00:03:38: And I should add, he's always been very much a therapist of meaning, of big issues, so generally opposed to short-term therapy in the modalities that proliferate short-term manualized therapies.

00:03:53: So this was an experiment, what could be done.

00:03:57: And I think the other reality was that he didn't want to stop being a therapist.

00:04:02: He didn't want to stop doing therapy.

00:04:04: that was core to his identity.

00:04:07: And he still felt that he could be very helpful to people and that he had a sort of an unprecedented degree of expertise.

00:04:13: So those two things led him to this experiment.

00:04:20: And as has been his want throughout his career, he then wanted to See what he could learn from this experience and share that with young clinicians with people wanting to be better at their craft and people interested in going into having therapy.

00:04:37: So it became.

00:04:39: the writing came second out of the experiment that he was doing.

00:04:45: Yeah, I think you you and your father you stress this in the book as well that this is not Way to or this is not recommended for other therapists to to copy this style of therapy that this is not something that is Yeah, the ideal scenario, but as you mentioned there were reasons why he started Yeah, conducting therapy in that way.

00:05:06: So maybe for the listeners, maybe you can explain what like.

00:05:10: give an example of one of the sessions, because every chapter in the book is one session between your father and the patient, or as he calls them, fellow travelers, which I really like.

00:05:22: Maybe you can also explain why he calls them that.

00:05:25: And yeah, explain to us what the person came in with and how your father conducted this one session, this one encounter.

00:05:33: Sure.

00:05:34: Well, first, let's talk about that terminology.

00:05:37: In the US, Psychiatrists refer to the people who come see them as patients.

00:05:44: Therapists, psychologists, marriage and family therapists refer to them as clients.

00:05:51: And I don't like either frame.

00:05:55: Either did my father, does my father.

00:05:59: Patience implies that there's something wrong with the person who comes to see you and that we as a doctor, as an expert, are going to fix that.

00:06:09: Clients to me implies a purely commercial transactional relationship.

00:06:16: Neither of those fit what my father and I and many others feel is really the ideal relationship, the healing relationship, which is one authentically between two human beings.

00:06:30: My father likes the phrase fellow traveler as do I, although it's hard to use constantly in the terminology, but I think the idea is look, we are both human beings on this journey of life.

00:06:48: And I as therapist, maybe I've seen certain things that you haven't seen or that I can point to some guideposts or some ideas, but My knowledge of the world is not in some way superior to your knowledge of the world.

00:07:05: But we together are looking at what's going on for you.

00:07:10: So that's the provenance of that terminology.

00:07:15: So in these sessions, what my father began by trying to do was to see how much can I help and how can I help this person in this very limited period of time.

00:07:26: And the goal is not, as you say, to sort of solve all their problems or to put this forth as a complete form of therapy.

00:07:37: There are some people who focus on single fashion therapy and there are some things that can be done, but I think it depends very much on what the person is coming in for help with.

00:07:48: So I think the first thing that my father was trying to do is help people figure out really what they're coming in with and any therapist and probably anybody who's really been in therapy for a significant period of time will tell you that on some way the issue that they ended up really getting at really working towards was not necessarily what they thought it was at first or it had more facets to it.

00:08:21: So trying to help people identify really what's going on for them.

00:08:26: And also what many of these stories do is my father is sort of helping people realize that longer-term therapy might be good for them and helping them find referrals to the right kinds of therapists to help them in their situation.

00:08:42: But I'll give you an example of one of the stories.

00:08:47: My father's main approach to actually doing therapy is to work in what he calls the here and now and that is to say that the relationship between myself and my client is really not only the most important aspect of therapy but it is the place where change can happen.

00:09:09: So he will do what we would call in the field process work and that is our conversation, if you and I are having a conversation, has sort of two main components to it.

00:09:24: The first we would call content, and that is, what are we talking about?

00:09:27: What's the story?

00:09:28: What are you relating to me?

00:09:29: And that's what most people talk about most of the time.

00:09:32: The process is to observe how we're talking together and what might be going on, what might we glean from the way we talk to each other, not necessarily from specifically what's being said.

00:09:45: So in one of the stories in the book called No Second Dates, a woman comes to meet with my father for problems that she's having in relationships, in relationships in general, and particularly in finding a romantic relationship.

00:10:04: And as the conversation begins, my father's trying to get information from her about what her life is like, who she is, what happens when she tries to go out on dates with people, and the pattern that she has told him is that she will often have first dates.

00:10:22: But then nobody will call her back.

00:10:24: There are no second dates in her relationship.

00:10:28: And my father continues to ask in to try and understand what's going on.

00:10:31: And she starts to become a little evasive.

00:10:35: She won't really tell him anything.

00:10:37: He sees this as a certain type of deflection or evasion.

00:10:42: And she starts to become annoyed with him because he keeps asking.

00:10:45: And she keeps saying, well, why are you asking so much about what's going on between the two of us right now, because that's where he starts to focus on.

00:10:54: What does that have to do with anything with what I've come to you to talk about?

00:10:59: Why do you keep asking about how you and I are doing?

00:11:02: And she gets increasingly annoyed.

00:11:04: And my father is encouraging this.

00:11:06: Great.

00:11:06: Tell me that you're annoyed.

00:11:08: That's useful.

00:11:11: And finally, she sort of says, well, what's going on here?

00:11:13: And he says, well, look, here's what I think.

00:11:16: is happening.

00:11:17: We might look at the relationship, the conversation that we're having right now, the process of it in particular, as what he calls a social microcosm.

00:11:26: That is to say that the relationship that she is having with him, the way that she is interacting with him, right now is a reflection or a recreation of the way that she responds to other people in the world.

00:11:41: And specifically, We could then look at this in terms of the encounters she has with dates or potential partners.

00:11:52: And she's getting increasingly annoyed, but she starts to understand a little bit about what she's saying.

00:11:57: He says, listen, I keep asking you to give me more of yourself, to tell me more about yourself.

00:12:04: And you keep deflecting my questions.

00:12:07: And can you imagine what it would be like if I were somebody who was out on a date with you and My goal here was to try and understand if you were a person who might be a good long-term partner for me, might be someone I would want to spend my life with.

00:12:26: But each time I ask you something, you are very stingy with your response.

00:12:31: You won't really tell me anything that reveals anything about who you are and who we might be together.

00:12:40: little by little, the light bulb sort of goes on in her head and she says, so you're telling me that part of what's going on is I'm not showing anything to these men who might be potential partners and my dad sort of nods and little by little, she starts to have this dawning realization that she has played a role in pushing people away even as her goal is to welcome them in.

00:13:07: And that's a big realization for her.

00:13:11: And that's the kind of work that can have a really dramatic effect in a very short term.

00:13:17: My father, of course, has sixty years of skill in doing this, so I sometimes will have a somewhat similar encounter in therapy, and this particular interaction of defensiveness and being a bit closed off is actually something that I see quite often.

00:13:36: I can't.

00:13:37: have this miraculous result in in fifty minutes.

00:13:41: It takes much longer, but that's the benefit of his decades of experience.

00:13:47: Yeah, I can imagine it's not uncommon that people have trouble opening up in the beginning, especially if they don't know the therapist yet.

00:13:54: I mean, your father is pretty well known, and I guess most people who came to work with him in these one-hour sessions already knew about him.

00:14:01: Maybe you read a couple of his books and maybe also knew like how he worked.

00:14:07: But this is really interesting, this idea of this microcosm between therapist and patient.

00:14:14: So there's also this saying how you do anything is how you do everything.

00:14:18: So this is kind of a reflection.

00:14:20: if she's behaving this way with him, then it's similar with other individuals.

00:14:27: Could you say that these sessions are especially useful for certain people and maybe not for others.

00:14:34: So who are they for and who are they not for?

00:14:36: I mean, you already mentioned this is an experiment.

00:14:38: It's not for everyone.

00:14:40: It's not to be copied.

00:14:41: But it's, yeah, but was there like a pre selection process where your father said, okay, this person is probably not really suitable for this kind of experiment?

00:14:52: You know, I don't know exactly to what degree he was sorting through people came to him who came to my senses that he wasn't, but that when it came to writing stories about these encounters that he had, he's certainly going to be very selective there about which encounters he had with people he thinks are good teaching tools, because he's always writing with an eye towards teaching, and then also which are just good stories from a literature and narrative perspective.

00:15:25: But I would say in general, so... My father's area of therapy and mine is similar not the same and many many people Are doing what we would call existential or existential humanistic therapy and The goal one of the goals here is a rich exploration of the person's life on a deep level.

00:15:50: so if What you're coming into therapy for is a very specific problem that might be Fixed easily or you're looking for a relatively quick and easy fix for it.

00:16:05: That's purely behavioral then this approach towards human challenges maybe isn't quite the most efficient for you.

00:16:17: I don't know if that's quite answers the question, but that's that's the way I would look at it.

00:16:24: You know if you're coming in because you want to stop smoking For instance, this is probably not the most effective approach.

00:16:31: Now on the other hand, if you're really interested in why am I so hooked on smoking, what's underneath that?

00:16:37: Is it purely a habit or chemical habit?

00:16:41: Or is it tied to anxiety or a feeling of emptiness and you want to actually go deeper and unearth those things, then this type of approach is probably more suitable for you.

00:16:53: Which runs counter to the idea of doing this in one hour, but again, this is not a motive therapy that we're trying to sell here.

00:17:00: Yeah, you also mentioned earlier that your father would then refer The patients or the clients slash fellow travelers to other other therapists for a longer term therapy, right?

00:17:13: Absolutely

00:17:13: not only this one session because he knows that for some individuals for some topics or issues, longer term therapy is the way to go.

00:17:22: Absolutely.

00:17:23: Now there are a couple of stories in the book where his intervention with the person somehow fulfills a need that they just needed to hear this from him or they needed to have a realization and they don't necessarily follow up for ongoing continuous therapy.

00:17:45: But that's pretty rare that somebody has a huge light bulb moment and everything's fine.

00:17:51: Ideally that's the case, but yeah, I imagine that's the exception.

00:17:55: wouldn't that be nice?

00:17:56: so we could really bottle that and so.

00:17:59: So I'd like to zoom in on the period when you and your father were writing the book together because it gave you a uniquely intimate vantage point on what was changing both personally and professionally.

00:18:11: so during that period and perhaps even before you witnessed his gradual memory decline up close.

00:18:19: So how did that shape the way you thought about identity and professional ethics?

00:18:23: So whether you should still see patients, what's responsible practice at this stage and how much of the continuing was actually for the patients versus, yeah, the difficulty of letting go?

00:18:37: Yeah, yeah, that's a really good question.

00:18:39: And I don't think I don't think, well, I know that he was not unaware of this dynamic going on and we try to cover it quite directly in the book.

00:18:54: He writes throughout the book there's sort of a second stream of thought going on which is him recounting his memory loss and as somebody who has studied the human mind for It may be years to see the deterioration that many people experience but from the inside I think is quite interesting from the inside and from the vantage point of somebody who's been an absolute observer of the human mind all this time.

00:19:22: And there are points in the book where he realizes, for instance, he sees a client, a patient who he had seen years ago and knows he should recognize them, knows he should know more about them, but says can't remember.

00:19:36: and has to grapple with whether or not to tell them that, whether it's going to be more useful for them to have him be transparent versus might it be damaging for them or disappointing for them to know that he doesn't remember them.

00:19:54: So my role in all of this, he wrote most of the stories or all of the stories as a intended to be a book.

00:20:07: But when he got to the end, which included him realizing that he had finally had enough memory loss that he shouldn't be doing therapy anymore and he should hang it up, he had this nice stack of stories and then gave them to me to read through.

00:20:22: and they just weren't a book.

00:20:24: They were a lot of interesting stories.

00:20:26: They were sometimes quite repetitive because the one hour session, the structure is a little more repetitive than many others.

00:20:34: But also his memory by that point had gotten fragmented enough that he couldn't hold on to all, it was about fifty stories, forty-five, fifty stories at the time.

00:20:44: He couldn't hold on to all of them in his mind at the same time.

00:20:48: So as you may know, thinking about a book structure, you have to be able to think about the whole thing and think about what parts at the beginning communicate to what parts later on and what threads and themes are going through them.

00:21:04: So we decided after some time that I should be the person to help him write this into a book form.

00:21:12: And in part that's because we've worked together quite a bit over the years.

00:21:16: I've been the editor, either official or unofficial of a number of his books.

00:21:20: And also I'm a writer and was becoming a therapist at the time.

00:21:26: And of course, also just a deep personal relationship.

00:21:30: And again, parts of this book are very personal.

00:21:33: about his experience, not only about the teaching stories.

00:21:37: So all that said, I took on, let's help turn this stack of stories into a book.

00:21:44: And I began to select which of the stories seemed most interesting as stories, which of them fit best in terms of creating the threads of his work and his theories, and really introducing him in some ways to a new generation.

00:22:02: of readers.

00:22:04: So I wanted to sort of give an overview of his theory work and show it in process.

00:22:12: And over the course of the two years that I worked on the book, his memory continued to decline.

00:22:18: So we had to find new ways as we went along to collaborate and for him to, well, teach the reader, but also teach me a great deal as we went through this process.

00:22:31: What would you say?

00:22:32: who was the main target group?

00:22:33: So who's this?

00:22:34: who's this intended for?

00:22:36: Well, it's an interesting question because his work for the last almost four decades now has been on the borderline between being teaching material for therapists and aspiring therapists, but also for a more general public.

00:22:53: Certainly people who are interested in therapy.

00:22:59: and to some degree interested in philosophy as much of his work has been tying philosophy and therapy together.

00:23:07: This book in particular I think leans a little bit more towards the aspiring therapist than it does to the general public.

00:23:18: But I do think if someone is interested in how the mind works and how therapy as a process works, I still think it could very much be taken on by more general leaders.

00:23:30: And I think that's where his, the most important work he's done in his life in some ways has been to demystify therapy and take it from being sort of this secretive niche thing that may have a lot of stigma attached to it.

00:23:47: to being the stuff of popular life and of popular literature.

00:23:54: And think about all the TV shows and movies over the last couple of decades that feature therapists or feature the stories of therapy.

00:23:59: And he really was the first person to popularize this.

00:24:05: Yeah.

00:24:06: So in this one hour format, what would you say should a therapist focus on and what would be neglected or not focused on?

00:24:15: because obviously you have to prioritize you don't have much time and usually I guess in therapy you would start talking about the history of the person and really get to know the person in front of you.

00:24:25: but now you would have to decide what's the most important.

00:24:28: So what would you say?

00:24:29: Absolutely.

00:24:30: So it's right there in the title.

00:24:33: It's hour of the heart.

00:24:36: My father's feeling is that building intimacy between the therapist and the fellow traveler, whoever the person who comes to seek help is the most important thing.

00:24:50: How do we build a real connection in this time?

00:24:53: And for most, for the majority of people who come to see him, and I think it's probably a majority of people who are seeking therapy, in general, underlying what's going on for them is a need for connection, a desire for greater connection with other people.

00:25:12: And to be seen fully as who they are.

00:25:17: So what my father starts experimenting with is a continuation of what he's done throughout his career, which is how do we have a real authentic encounter here in the moment between the two of us in the room.

00:25:32: And this does a number of things.

00:25:36: I'm leaning into the camera right now so that you and I can feel more intimate.

00:25:41: It allows the person who may have a lot of trouble opening up to other humans, to friends, to potential friends, to their family, it allows them to experience what it is to have a real moment or a real fifty minutes of encounter with somebody who's very interested and open with them.

00:26:03: It also allows vulnerability and My father's approach to doing this in this very brief period of time is to allow himself to be very vulnerable and open with the other person.

00:26:20: And this goes against sort of what the mainstream of the teaching of psychotherapy has become over the years, which is this idea that the therapist remains somewhat distant and that I'm going to learn a great deal about you.

00:26:36: In this session, but I'm not going to tell you anything really about me about how I feel about my experience in the world.

00:26:44: We would call that.

00:26:44: technically we would say that I self disclosure would be the terminology for me sharing with you of my experience and My father has felt for decades that this is a huge mistake in the way that most therapists are taught, which is to avoid self-disclosure.

00:27:04: It's not about you, the therapist, it's about the client or the person who comes to see you.

00:27:09: And in fact, of course, the main measure that we have to keep is, is it useful for the client?

00:27:18: But my father's feeling and mine is that my disclosing, my revealing things about myself is often in the best interest of the client.

00:27:31: Because in part, I'm allowing you to have this real experience with me, but also by opening up to you, I'm modeling for you.

00:27:41: I'm showing you what it's like to open up and that usually a therapist is held in a certain degree of regard, has given a certain amount of respect or expertise by the person who comes to see them that you wouldn't come see me.

00:27:58: generally if you didn't want to have that.

00:28:03: And if I as somebody who is respected and admired on some level can open up myself, then that shows you that there's not a lot of danger necessarily for you in doing the same thing.

00:28:19: Yeah, that's what you mentioned earlier about the terminology of Yeah, seeing the the patients as fellow travelers it puts you or your father more eye to eye with them.

00:28:30: and also you mentioned vulnerability and I think this is what I really noticed in the book both Kind of behind the scenes when you wrote about his his inner thoughts about whether he should continue Practicing or not.

00:28:43: so this was kind of him showing vulnerability and admitting to himself that There might be a problem that maybe it's unethical to continue, but also while working with patients, when he opened up about his condition or about his family, what happened in your family.

00:29:00: And I think this was really interesting because also for me, I always was under the impression that therapists are kind of like this blank screen.

00:29:11: As a patient, you're the person sharing all these things and you wouldn't really know anything about the private life of your therapist.

00:29:19: But as you said, obviously, a therapist sharing should only occur when it's actually helpful for the patient.

00:29:26: I mean, the therapist using an hour to talk about their vacation is probably not the best use of the time, even though it might be interesting.

00:29:34: Yeah, and well, and that's where, you know, there has to be a great awareness and you're always calibrating that a little bit.

00:29:38: And certainly, I've told stories about my life in therapy that may have gone over the line of, was this really helpful?

00:29:47: I don't know, but I'm constantly trying to find that right thing.

00:29:52: You know, you mentioned the blank screen idea, and this I think is really important if we look at historically how we got into this place.

00:30:01: So just to note, Freud, way back at the very beginning, the Freudian model of psychoanalysis posits that the therapist should remain a blank slate, a blank screen, and that it's by watching how the patient projects onto that blank screen that we learn about them.

00:30:23: And so that was really the dominant origin model for therapy, and it has remained in many ways up till now, a hundred and fifty years later almost.

00:30:40: And my father's experience was that early on in his training he was made to do three years of analysis as part of his training.

00:30:49: So he went every week, four days a week, six hundred sessions with a traditional psychoanalysis to basically sit there while he lay down on the couch over there and she gave him nothing of herself.

00:31:03: for all this time.

00:31:03: And my father says two things about that.

00:31:05: He says, one, there were one or two times when she revealed something about herself as a person, not necessarily intentionally, but inadvertently, and that those were the things that were most helpful to him in all of this three years of work.

00:31:19: And that mostly what he learned in those three years was how he did not want to be as a therapist.

00:31:25: So his work for decades has been a counter to the traditional psychoanalytic model.

00:31:31: Yeah,

00:31:33: and you mentioned earlier that in some sessions you may have overshared, but maybe it was helpful.

00:31:40: But what I noticed also in the book that your father took risks.

00:31:45: So he didn't always know that it was the best course of action.

00:31:48: And as you mentioned earlier as well, it kind of demystifies this idea of therapy.

00:31:52: You have this all knowing expert.

00:31:54: At least people always have this impression, I think.

00:31:57: But the book at least showed to me that there is also a real person sitting across from the patients, and he doesn't have all the answers.

00:32:06: And sometimes it is experimentation to see what works and what doesn't work.

00:32:10: So I think this was, at least for me, very interesting to see, to look behind the screen, so to say.

00:32:17: No, and I think that's very, I think it's useful for clients to experience that.

00:32:21: But I was actually just writing something about this this morning, or yesterday morning.

00:32:27: which is for the therapist, for people who want to be therapists, this is incredibly important because nowhere in all the textbooks that we encounter and all the articles that we read.

00:32:40: Does anybody say oh look you're gonna mess up or you're not gonna know Which direction to go.

00:32:47: sometimes and often you're gonna pick the wrong way might not be disastrous, but you pick a piece of Conversation that's going on and you think I'm gonna ask that question.

00:32:57: you ask that question and ten minutes later or sometimes the next session you realize that was actually not very helpful or There was something more important that I should have followed.

00:33:08: And so, isotherapists will very often just sort of say, hey, whoa, hold on, you know what, I think I made a mistake.

00:33:15: Or, you know, I think I should have asked you a different question earlier because it would have taken us into some territory that might have been more interesting, that might have been more helpful to you.

00:33:26: And almost every time that admission, that process of saying, you know, I think I could have done better, it's almost always beneficial.

00:33:38: Maybe on the one hand it lowers slightly the layer of the level of admiration or confidence that the person who comes in wants to have in you, but over time it almost always benefits because it adds a sense of, oh, we are both fallible human beings.

00:33:59: It allows me to show vulnerability.

00:34:03: And then ultimately, You know, this I learned as a theater director.

00:34:07: Being able to come in and say, yeah, I don't know.

00:34:09: I don't know if I did great there.

00:34:10: Let's try something else.

00:34:11: Loosen things up.

00:34:12: It makes it more flexible and I think it empowers the other person to say, oh, yeah, you know what?

00:34:19: Maybe this is what's really important to me.

00:34:21: And I can say as a therapist, oh, yeah, really?

00:34:23: OK.

00:34:24: You know more about it than I do.

00:34:25: What's important to you?

00:34:26: Let's go find out.

00:34:28: Yeah, so you mentioned your background in theater and I think there are some.

00:34:32: there are probably some some parallels because in both theater and therapy You're trying to create connection really quickly either with the audience or with the patient.

00:34:42: So how or based on your experience in both theater and therapy What would you say builds trust fastest?

00:34:49: I mean your your father did these one-hour sessions and he's trying to be in the here and now Were there other or other other ways that you would think of that build trust fast?

00:35:00: Well, I'm going to pick up the question from the theater side of things.

00:35:05: I think there are a few other things you can do in therapy, but but really there's something about that direct, authentic, trustful relationship.

00:35:14: The question about theater is very interesting.

00:35:17: First, I should say that in my background in the theater, my work, I was for twenty plus years, this was my my work.

00:35:26: It's not quite mainstream theater necessarily.

00:35:30: We worked, my company Fool's Fury and many of the theater companies out in the world that I most admire are working on sort of the edges of what can one do in the theater world that you can't do on television or on a screen.

00:35:44: And for me that meant always being very transparent about the theatricality.

00:35:51: of the event, and by that I mean actors appear on stage.

00:35:58: They are both simultaneously the characters that they're representing in the play, the characters they're manifesting, but they are also real-life human beings who are there in front of you, in front of the audience, who are performing as those characters.

00:36:14: So one thing that my work usually did is very much acknowledge that duality.

00:36:25: So in a way that's sort of like a therapist saying well look I'm both this expert and I'm just another human being and we're struggling through life together.

00:36:33: and so in the theater often it would be for instance instead of having all the tech happening off stage like there's music and there's lights and everything I might have a lighting console set up on stage and somebody could be acting and then take a moment and just walk over and switch the lights on and the audience gets to see very transparently.

00:36:57: That's the technology of the stage is happening and we're not hiding it.

00:37:01: We're not pretending it's the Wizard of Oz man behind the curtain doing all of this.

00:37:07: It's really just people.

00:37:09: Making this exhibition happen.

00:37:11: So that's one technique that I would often use in many different formats.

00:37:15: the form would change with every play.

00:37:19: But transparency that it's that we're both human beings making something.

00:37:22: and for the characters the imaginary characters happening

00:37:26: Yeah, that makes sense to me.

00:37:28: So in your father's session, he's always, like we mentioned this before, so he's trying to connect in the here and now.

00:37:34: So he's asking some version of this, like what's happening between us right now.

00:37:39: And this kind of... centers the person in the conversation.

00:37:43: And I wonder how people can use this in everyday life, because I think we've all been in these situations where we're arguing with someone and we bring up things from the past, or we talk about things that haven't even happened yet, but we're projecting into the future and get upset instead of being right here right now.

00:38:02: So is there a way that we can bring ourselves back?

00:38:06: Well, it's tricky.

00:38:07: And the reason it's tricky is that this, if you remember earlier, I talked about how we focus on the process in the therapy room, and that is what's happening, what's the dynamic that's happening in the conversation here.

00:38:20: And that is something that's very hard for people to do in real life situations often because it feels, it can feel intrusive, it can, one can feel put on the spot.

00:38:33: We're just not used to doing that.

00:38:35: With others.

00:38:36: so if I were to think about I really want to talk about how Jason and I communicate.

00:38:41: well Jason you might not feel like you'd signed up for Putting our interactions and your own behavior under the microscope like that.

00:38:50: And so I might start in Jason.

00:38:51: Do you know when you do this?

00:38:53: It makes me feel like this and you might be like, yeah, I don't care or So it is a little tricky.

00:39:02: I think it requires a certain degree of buy-in from the other person you're speaking with to think about if they want to have that conversation or a conversation on that level.

00:39:18: Now, you can always do that for yourself.

00:39:23: That is to say, why do I always respond to this way when somebody or Jason in particular starts to talk about X, Y, or Z?

00:39:34: So that's helpful.

00:39:36: But if you're close to somebody and you want to talk to them about how the two of you talk or how the two of you interrelate, it probably most of the time requires some sort of invitation to the other person to say, hey, I really don't like it how you and I sometimes get into this dynamic.

00:39:58: Would you be willing to look at this with me?

00:40:00: I don't have the answers, but I know there's something uncomfortable or something that feels like it's going on wrong there.

00:40:05: And this can have in the situation

00:40:08: where

00:40:10: you can actually have this conversation and you get to some agreement.

00:40:14: It can be extremely powerful, but it's not necessarily easier, comfortable.

00:40:18: I'll give you an example.

00:40:20: I had a friend who I was very close friends with into my early twenties and then at some point we we fell out of touch and I think I really sort of cut them off at one point because there was something that was going on that was very uncomfortable for me and it's the only time in my life that I've really done that to anybody.

00:40:37: but years later I saw them again and I was reflecting back on what why I had made this choice and it seemed like well maybe maybe I was mature enough to get past that at this point in my life.

00:40:52: And I approached him and I said, hey, would you be willing to have a bit of a conversation?

00:40:57: And I took some responsibility for having made that shift.

00:41:03: I also said, well, look, there are things you do that make me feel this way.

00:41:06: So it's both of us.

00:41:09: But it was an incredibly healing moment for us.

00:41:14: And we've managed to sort of pick up a deep.

00:41:18: relationship again since then.

00:41:20: It took some some building but that was very much an intentional way of sort of looking at our dynamic and so it can have powerful outcome.

00:41:33: but it's not an easy thing to do always.

00:41:35: Yeah I can imagine and I think it makes sense to not surprise somebody with a heavy topic.

00:41:41: just because I am ready to talk about something it doesn't mean that the other person is ready.

00:41:47: at that moment.

00:41:47: so maybe in relationships I can imagine that maybe scheduling certain points to check in or points of time to check in might be useful and say for instance every Saturday evening or maybe not Saturday but whatever like any day we take five to ten minutes and then we say what's on our mind but obviously do it in a constructive way and not this blaming and then you did this and you whatever.

00:42:11: so yeah I can imagine that that might be a good idea.

00:42:14: Yeah, and I think what happens often is you're looking for patterns, or we do this, it seems like we always fall into this, and so I do a lot of work with couples, and that's, you know, it's often very much about a pattern of how we fall into this without even noticing that we do it.

00:42:32: And I did, I've heard this recently from colleagues and I've read an article about it the other day, how?

00:42:39: close friends seeking counseling in the way that a couple might seek counseling is sort of becoming a thing and it's fascinating and it's also very helpful when you're having a sort of process level conversation to have a third neutral third party to help keep it on track.

00:42:56: Yeah I can imagine.

00:42:58: I do want to touch on a topic that I guess most people don't really like to talk about, especially in Western cultures, and that is mortality and grief.

00:43:08: Now, your father has actually spent many years writing about or working with themes of mortality and grief.

00:43:15: And as a person, as a developing therapist and as a co-author, I wonder what you have learned about mortality that maybe you want to carry into your life and into your clinical practice.

00:43:29: Yes.

00:43:32: My father, so the other main thread of his work for decades, has been existential thought and how to use existential thought as a therapeutic tool or as a fabric of therapy.

00:43:48: And he wrote a book in, I believe, in nineteen eighty called existential psychotherapy, which has sort of been the Bible for people with a philosophical lens on psychotherapy for many decades now.

00:44:03: And in that book he identifies, he's looking back at philosophy, primarily Western philosophy for the previous hundred years or so, starting in Kierkegaard and moving forward to identification of what he calls the four existential givens that people grapple with.

00:44:28: underneath on the level of deep questions about what it is to be human that manifest in various anxieties in life.

00:44:37: Very briefly, the four that he identifies are dealing with mortality, dealing with existential isolation, the fact that on some level, as close as I might be with you or my wife or my father and my mother were together for sixty-seven years, on some level, one is still alone in the universe.

00:44:58: grappling with meaning which we could frame as saying we as humans are innately seekers of meaning.

00:45:07: and in a universe where as Nietzsche once famously wrote God is dead if there's no set meaning for how to live in the world that's ordained by a supreme being that we are meaning seeking beings living in a universe without meaning and that's an essential paradox that haunts human existence.

00:45:35: And then, ultimately, finally, freedom.

00:45:37: And that one always sounds a little paradoxical.

00:45:40: But if you have no predestined meaning, you have choices of how to live your life and what moral code you want to follow and how you want to behave with other people, how do you make choices?

00:45:53: You have an infinite number of choices.

00:45:55: OK.

00:45:56: So that's the large existential framework.

00:46:01: Mortality is primary among those.

00:46:06: As you said at the very beginning of our session, the intro, you said, well, life gains meaning because it's limited.

00:46:15: Time limits our world, and therefore... that causes things to be meaningful.

00:46:22: And yet the idea of mortality, the idea that we are all going to die, and that is the only thing we are certain of, is terrifying for many of us, or it causes huge concern.

00:46:33: And my father's therapeutic approach to that would say, even many, many things in your life that you don't think are tied to thoughts of death are underneath wellings up of existential anxiety.

00:46:49: And we can chart that through people's lives of when periods are likely to happen that this is going to come up.

00:46:54: I won't dig into that deeply right now, but if you can, we can take it on some faith that lots of our challenges and anxieties in life are tied to our ultimate mortality.

00:47:09: How do we work with that?

00:47:10: How do we accept that?

00:47:13: How do we work with it?

00:47:15: And the first thing is to start to bring it to light, to start to acknowledge that things that we have in our lives might be tied to that.

00:47:26: And one of the ways that I think it affects me in my life most is I am not terribly, for reasons I'll discuss in a minute, I'm not really afraid of dying, but I am afraid of like not getting to do things I wanted to do or not completing things that seemed important to me.

00:47:45: That's generally how it happens for me.

00:47:49: But even things like a choice of what career to take or a choice of who to marry.

00:47:54: You know, on some level, those choices are difficult because you only get one shot at it because you have limited time.

00:47:59: You can't, if you had unlimited time, you could do one career and then you go back and do another, but you can't.

00:48:07: So that's sort of the way things seemingly unrelated, I would say, tie to mortality.

00:48:15: But the the terror of death as he puts it sometimes is More.

00:48:23: it's higher on the surface than that.

00:48:25: It's more immediate and concrete and as you noted we in our culture Have a very strange relationship with death.

00:48:35: I don't know exactly how it is in Germany that I know.

00:48:39: in American culture we we largely sort of deny the existence of death.

00:48:45: We're like, the one thing that we're absolutely certain that we pretend doesn't exist.

00:48:49: Doesn't make much sense.

00:48:51: We, you know, things in Western tradition we don't talk about.

00:48:55: dying.

00:48:55: When people do die, we have these ceremonies in churches and synagogues, but particularly think about sort of mainstream Christian culture here where people get embalmed and you go see the body and it looks like nothing's happened to it, maybe a little plastic, but other than that, or you bury them away right away, you never see.

00:49:16: the body, people are afraid to talk about it.

00:49:18: We come up with these euphemisms for how to talk about people who have died.

00:49:22: We say they've gone to a better place or they were unalived.

00:49:29: That's a gen alpha thing.

00:49:33: And we never allow ourselves to contemplate our mortality directly.

00:49:42: And I think this is very damaging for us as a culture.

00:49:46: We fill instead voids that might come up or fear that might come up around this with buying new things.

00:49:52: And I see all of that as sort of a denial of death to use the famous phrase.

00:50:02: You had asked me, sorry, I went off on a little bit of a tangent

00:50:06: there.

00:50:06: Well, directly related.

00:50:07: But you had asked me how that affects me and how I bring that into my world.

00:50:12: Right.

00:50:13: I had, in this particular way, I've realized in the last couple of years, I had a very strange upbringing.

00:50:22: And by that, I mean, look, my father is deeply invested in all of these things around death and mortality and existentialism.

00:50:31: It also happens that the time period in which he wrote this book, Existential Psychotherapy, when he was really focused on this, was when I was six, seven, eight years old.

00:50:44: And dinner table conversation.

00:50:46: in my house.

00:50:49: I have three older siblings, but they're much older.

00:50:51: So most of them were out of the house by then.

00:50:53: So it was me and my mother and my father.

00:50:55: And this was a conversation that was going on at dinner.

00:50:57: all the time was thoughts about philosophy and death and mortality and with my mother.

00:51:03: How did that translate into literature?

00:51:07: This was just the air in a sense that I was breathing.

00:51:11: So

00:51:11: you grew up with it.

00:51:13: I grew up with it.

00:51:14: And in the, you know, twenty years ago, my dad or fifteen years ago wrote a book called Staring at the Sun, which was about directly relating to death.

00:51:24: And in it, he talks about many of these phrases or deep philosophical ideas that mostly coming from Greek philosophy.

00:51:37: That were ways that he thinks that he found helpful in dealing with that.

00:51:42: things like The idea that why should I be afraid of death?

00:51:46: where death is I am not and where I am death is not.

00:51:51: It's a useful phrase, but for most people reading read this book there in their thirties or forties They're like wow, it's an interesting idea.

00:52:00: Maybe I can think about it a bit or it comes across on some social media posts.

00:52:04: I remember my father sitting with me on my bedside when I was four or five or six years old and explaining this to me.

00:52:12: And so it's you know, it's just embodied in me and I I do think in a sense this You know, there's the myth the Greek myth of Achilles whose he was dipped in this cauldron of protection and therefore was impenetrable his whole life except for his Achilles heel.

00:52:37: In some strange way, I was sort of dipped in the potion of existentialism.

00:52:44: So these thoughts are troublesome to me sometimes, but I always just sort of like, yeah, but that's, I learned that when I was three.

00:52:53: Yeah, thanks for sharing that.

00:52:55: I mean, as uncomfortable as this topic is I think I believe that grappling with it can be very instructive and like you said we don't talk about it in our culture.

00:53:06: and yeah I think that is a mistake.

00:53:09: so yeah

00:53:10: I do too and I do think that that you know in some areas it's changing slightly but that's a very small subset of the culture.

00:53:20: So I want to switch gears a little bit and talk about some more takeaways from the book for both therapists and the general public.

00:53:28: So like we said, these sessions are unconventional and they're not meant to replace ongoing therapy.

00:53:33: Still, what do you think therapists can learn from this approach that translates into everyday practice for them, something that we haven't mentioned yet?

00:53:41: Yeah, well, I mean, I think the biggest one is already on the table, if you will, which is to refocus on some level your idea, you as a therapist, of how you can be helpful to others away from, depending upon what your practice is, but away from a manualized step of challenges of what's, if I do this and this and this, then suddenly my patient is going to get better to realizing that It's this relationship.

00:54:18: It's what's going on between the two of you that has this healing effect.

00:54:25: There's all sorts of research around aspects of this but I think to just really focus in on what's the relationship and then whatever modality you're practicing in some way can be improved by building this solid relationship, and I think the relationship needs to be built on a degree of authenticity between the two of you.

00:54:56: That would be one, the biggest takeaway.

00:55:00: The sort of corollary takeaway to that would be, look, revealing things about yourself as a human being is not something that you should avoid.

00:55:11: Every therapist needs to find out First of all, as we said, how to determine if that's going to be helpful for the client.

00:55:20: That has to be the guiding star of why you do this.

00:55:26: But then also testing what you're comfortable with revealing about yourself.

00:55:32: And if it's very little, then perhaps you need to stretch that your own comfort level, your own window of tolerance, if you will, to learn that.

00:55:44: And then I think there's, you know, the first thing that people push back on often with that is, wow, that's difficult, or that's uncomfortable for me as a therapist.

00:55:55: You know, to which I would say that's the job.

00:55:58: And that it's not stressed that way, it's not taught that way as the job, but it really is.

00:56:03: Is how do you become more able to be empathetic?

00:56:09: And that's empathy.

00:56:11: As far as I'm concerned isn't simply me hearing about what's going on with you and saying, oh, yeah, I can understand that I feel badly.

00:56:18: that's.

00:56:19: that's sympathy a real empathy, which is this?

00:56:24: It's become this catchphrase that is losing all meaning because we use it so much.

00:56:28: But really it means being able to be there with the other person and feel what they are feeling and that is of course uncomfortable.

00:56:38: but we try to get our clients, patients, fellow travelers to open up, to experience discomfort, to live with it rather than flee from it.

00:56:50: And in order to do that, we as therapists need to do the same thing.

00:56:57: You mentioned earlier already that therapy still carries stigma for many people.

00:57:03: So what do you wish the average person understood about therapy?

00:57:06: And what would you say to someone who maybe feels hesitant or even ashamed to start?

00:57:11: Because I can imagine that many, many people would benefit from it and some are considering it, but they're still kind of worried.

00:57:17: Oh, what might other people think if they find out?

00:57:20: Or what do I think about myself if I admit to myself that I need therapy or that I should go to therapy?

00:57:26: one to me is more interesting.

00:57:28: I hear that more often.

00:57:30: The first one is true as well, but I think our culture is changing certainly for younger kids and younger people with social media and people talking about their challenges a lot.

00:57:41: In fact, in many cases with younger... people, I almost get people who want to come in and tell me all their diagnoses and it's almost a badge of honor or something they're proud of, or it's become an identity conclusion.

00:57:54: I'm ADHD, therefore I behave this way.

00:57:59: But that has problems as well.

00:58:05: But the big thing that I would say is this, two points.

00:58:10: The first is, if you seek therapy that has a certain degree of depth, sort of what we're talking about here, what's really happening is you're getting an opportunity to learn more about yourself.

00:58:23: And you'll learn things that are helpful to you in terms of how you want to behave in the future.

00:58:30: But you'll also learn other things on deep, what's important to you, what's valuable to you, maybe help clarify some of your ethics about how you want to behave with other people.

00:58:43: And I just imagine whenever I meet somebody like wouldn't it be helpful to you to know more about yourself?

00:58:54: Aren't you curious about yourself?

00:58:57: I'm not everybody is but most people you phrase it in that way they're like yeah okay I do want to learn that.

00:59:04: so it's not about saying you've got it.

00:59:06: it's not about diagnosis.

00:59:07: it's not about saying you have this problem.

00:59:10: it's about saying that's a challenge that you might have and let's find out what that can show us about yourself and maybe ways that we can help deal with whatever this challenge is.

00:59:22: So that's what I would love people to feel like.

00:59:26: therapy is an opportunity to work with somebody who really has the best intentions for you on what can you learn about yourself and how you want to be in the world.

00:59:38: And the other thing that I would say is much of mainstream psychology and mental health almost the industrial mental health structure, if you will, places the problem, whatever problem you're experiencing, really internal to you.

01:00:01: So it says, you're struggling with this, there must be something wrong with you.

01:00:05: Let's then excavate it and try to cure you of the problem.

01:00:11: And many of us in the therapy world are looking at this differently.

01:00:16: Which is to say your context who you interact with in the world what experiences you've had in the world what your network of people and support and challenge is Just as important if not more important to some thing that it lives within you that is working correctly or incorrectly and The way that you interact and the challenges you face are not a sign of that you are somehow flawed, but they are the outcome of how you interact and how the world is interacted with you, and that we can look at that, kind of understand that, try to take this culture of blaming every individual for what are often societal problems, and try to tease those things apart a little bit so that, you know, often what you're facing are not dramatic psychological diseases or injuries, but just problems of regular living and how you frame your response to that.

01:01:22: And that can be freeing and helpful to remove blame from oneself in that way.

01:01:29: It's not to say we're not responsible for our actions, but it is to say that we live in a context and we respond to the context of all the things around us.

01:01:38: Yeah, I like both of the points that you brought up, like the idea of getting to know ourselves better makes total sense because we live like we have so many habits we have so many patterns and we don't notice them anymore because it's just so normal for us.

01:01:54: so I think it makes sense to have like a third party look at us from the outside and maybe help us see it actually what's going on like the habits that we're that we have or the patterns that we're that we're following every day without actually noticing without noticing them.

01:02:11: So maybe for someone who still finds the idea of going into an office and sitting across from someone who finds that idea kind of intimidating, maybe, I think the idea of Zoom calls or online therapy is an option.

01:02:25: Maybe we can just briefly, before we wrap up, talk about what benefits that might have.

01:02:31: So because I can imagine some pros and cons, like on the one hand it's maybe less intimidating because you're still in your home.

01:02:38: But on the other hand, I can imagine that maybe some of the the cues that you would give off are lost.

01:02:44: For instance, like right now, the way we're talking, we're only seeing like half of our bodies.

01:02:49: I don't know if you're tapping your foot nervously or whatever, you know, like there's some there are some some cues that are not not seen on camera.

01:02:58: So what do you think about the idea of online therapy?

01:03:01: Yeah, that's a great question, particularly in the sort of post-COVID time when the majority of the sessions I see are online now.

01:03:09: I've been pleasantly surprised by the efficacy of online therapy.

01:03:15: I think some things are lost, as you say, body language is lost quite a bit, and I'm very attuned to body language generally.

01:03:24: But I think the pros probably outweigh the cons.

01:03:27: In other words, there's a. There's a lowering of the sort of barrier to people.

01:03:33: It's so much more convenient.

01:03:35: People don't have to take multiple hours out of their day to drive somewhere or go to an office.

01:03:41: It's less intimidating.

01:03:44: And as I say, I've been pleasantly surprised working with individuals in particular that we can have a pretty intimate experience just you and me and the screens between us.

01:03:55: We're all used to living with screens much of the time.

01:04:00: It maybe raises the bar for my attention as a therapist a little bit because it's easier for me to get distracted sitting in my room and looking at all my stuff.

01:04:09: But again, it works pretty well and I would much rather that it's easier for people to access help.

01:04:17: With couples, and I see a lot of couples, I think it's not as good.

01:04:24: I certainly insist that my couples be whenever possible in the same place.

01:04:29: So they're not, we're not calling in from multiple locations because seeing how they're relating to each other spatially body language is really important.

01:04:38: And a lot of that gets lost.

01:04:41: And then people do groups online.

01:04:44: And again, I think it's better that you do a group online that you not do a group.

01:04:50: But I think a huge amount is lost.

01:04:54: in terms of body language and in terms of what it is, how people are willing to speak to one another when they're actually there in person.

01:05:01: So overall, a good thing, particularly as our lives are more and more online to begin with, but not quite the same.

01:05:11: Yeah, but I can imagine that instead of not going at all, if the barriers of entry are lower for people when they can do online therapy, I think that's definitely a good idea.

01:05:22: I think so.

01:05:23: And even on an economic level, there's the benefit to somebody not needing to take hours out of their day, drive across town, etc.

01:05:34: It also makes it more possible for therapists financially in that you don't have to rent an office or you don't have to see all your clients every day in a rented office.

01:05:44: Maybe you have one or two days a week where you have a designated office and then maybe you work out of your home.

01:05:51: That's been the case for a lot of people right

01:05:54: now.

01:05:55: So yeah, Ben, thank you so much.

01:05:57: This was really interesting.

01:06:00: Maybe you can tell us again the title of the book where people can find it and also where listeners can find out more about you and also work with you because you also do online sessions, right?

01:06:10: I do online sessions.

01:06:12: I do workshops in embodied experience that combine my theater work and my therapy work.

01:06:19: That's what I'm really passionate about myself these days.

01:06:22: So I'm reachable on internet.

01:06:29: My website is yalamtherapy.

01:06:34: And Instagram is also yalamtherapy.

01:06:37: The book is Hour of the Heart.

01:06:39: Here's the paperback just came out in English.

01:06:43: You can get it anywhere.

01:06:44: books are sold.

01:06:45: I know you have a large German audience.

01:06:47: Here it is in German.

01:06:48: I won't try to pronounce it.

01:06:50: German is terrible.

01:06:52: And yes, I would love to work with people if you're interested and follow up with questions if you have them.

01:07:04: Amazing.

01:07:04: Yeah, we'll definitely link to your website and your social media account in the show notes.

01:07:08: And yeah, again, thank you so much.

01:07:12: Absolutely.

01:07:13: Thank you for having me.

01:07:14: Take care.