264: How to Get Laid! (With a Little Help from the Five Secrets of Effective Communication)

10/18/21 • 69 min

2 Listeners

Feeling Good Podcast | TEAM-CBT - The New Mood Therapy

How to Get Laid! (With a Little Help from the Five Secrets of Effective Communication)

One of our top TEAM-CBT teachers and therapists, Thai-An Truong, LPC, LADC from Oklahoma City, is featured in today’s podcast. Thai-An is the owner of Lasting Change Therapy, LLC, a TEAM-CBT group practice in Oklahoma that focuses on using TEAM-CBT to help women overcome depression, anxiety, and relationship problems, so they can live happier lives and have more satisfying relationships. She is passionate about working with postpartum women after overcoming her own personal struggles with postpartum depression and anxiety. She is also passionate about spreading TEAM-CBT and training therapists in this awesome treatment approach.

Thai-An suggested a podcast on how one could use the Five Secrets of Effective Communication to deal with critical comments from your spouse or partner during marital conflicts. She submitted specific examples from several troubled couples she has worked with, and Rhonda submitted an example as well.

Wife continues to bring up things that needs to be addressed, e.g., baby's medical needs, how he needs to set boundaries with his mom, precautions to take because of the pandemic.

Husband says: "All you do is talk about stressful things. You don't even care about being romantic anymore."

Wife’s typical response: "How can I be romantic with you when you aren't doing what you need to for our family?"

Sex often comes up with every couple, and the criticism is typically from the husband, as in the first couple and this second couple as well.

Husband says: "You never want to have sex. It's like we're roommates instead of husband and wife."

Wife’s typical response: "I'm tired, and I can't just get in the mood when you haven't been nice to me all day."

This couple had been trying unsuccessfully to have a baby.

The wife was very critical of her husband and said: “If it wasn’t for you, I’d have a baby. I should have married someone else."

Husband’s response: He said nothing and walked away.

Infidelity: In this couple, the wife had an affair three years ago and the husband continues to bring it up when they get into arguments.

Husband says: "Oh, you say I'm so bad because I did x. How about you cheating on me? You're the one who did the worst possible thing, and I can never trust you again."

Her typical response: "It's been 3 years, why can't you just let it go so we can move on with our lives? I'm tired of you throwing this shit in my face all the time."

During the podcast, we critiqued the responses to the criticisms in these four cases, using the EAR algorithm. It was easy to point out that the responses of the partner who was criticized typically failed in all three categories:

No effective E = Empathy.
No effective A = Assertiveness.
No effective R = Respect.

We also spelled out the consequences of these responses to criticism, and showed how the respondents were actually forcing their spouses to treat them in exactly the way they were complaining about.

Then we used the “Intimacy Exercise” to practice more effective responses, based on the Five Secrets. This is, by far, the best way to learn the Five Secrets.

Your Turn to Practice

Now, here’s another example that Thai-An provided, and you, the listener, can practice with it. This wife was talking about how her friend had hurt her feelings. The husband typically goes into the advice-giving and problem-solving mode.

Her criticism: "You suck at listening. I don't need you to fix it."

His typical response: "I'm just trying to help."

First, see if you can explain why the husband’s response was ineffective, using the EAR acronym.

Ask yourself:

Did he use E = Empathy and acknowledge how she was thinking and feeling?
Did he use A = Assertiveness and express how he was feeling at that moment?
Did he use R = Respect to convey some warmth, respect, or love during the heat of battle?

Next, ask yourself about the consequences of his response. What will his wife think? What will she conclude? How will she feel? How will she likely respond to his defensiveness?

Finally, put yourself in his shoes and see if you can write out a more effective response, using the Five Secrets of Effective Communication

Thanks!

Rhonda, Thai-An, and David

How to Get Laid! (With a Little Help from the Five Secrets of Effective Communication)

Wife continues to bring up things that needs to be addressed, e.g., baby's medical needs, how he needs to set boundaries with his mom, precautions to take because of the pandemic.

Husband says: "All you do is talk about stressful things. You don't even care about being romantic anymore."

Wife’s typical response: "How can I be romantic with you when you aren't doing what you need to for our family?"

Sex often comes up with every couple, and the criticism is typically from the husband, as in the first couple and this second couple as well.

Husband says: "You never want to have sex. It's like we're roommates instead of husband and wife."

Wife’s typical response: "I'm tired, and I can't just get in the mood when you haven't been nice to me all day."

This couple had been trying unsuccessfully to have a baby.

The wife was very critical of her husband and said: “If it wasn’t for you, I’d have a baby. I should have married someone else."

Husband’s response: He said nothing and walked away.

Infidelity: In this couple, the wife had an affair three years ago and the husband continues to bring it up when they get into arguments.

Husband says: "Oh, you say I'm so bad because I did x. How about you cheating on me? You're the one who did the worst possible thing, and I can never trust you again."

Her typical response: "It's been 3 years, why can't you just let it go so we can move on with our lives? I'm tired of you throwing this shit in my face all the time."

No effective E = Empathy.
No effective A = Assertiveness.
No effective R = Respect.

We also spelled out the consequences of these responses to criticism, and showed how the respondents were actually forcing their spouses to treat them in exactly the way they were complaining about.

Then we used the “Intimacy Exercise” to practice more effective responses, based on the Five Secrets. This is, by far, the best way to learn the Five Secrets.

Your Turn to Practice

Her criticism: "You suck at listening. I don't need you to fix it."

His typical response: "I'm just trying to help."

First, see if you can explain why the husband’s response was ineffective, using the EAR acronym.

Ask yourself:

Did he use E = Empathy and acknowledge how she was thinking and feeling?
Did he use A = Assertiveness and express how he was feeling at that moment?
Did he use R = Respect to convey some warmth, respect, or love during the heat of battle?

Next, ask yourself about the consequences of his response. What will his wife think? What will she conclude? How will she feel? How will she likely respond to his defensiveness?

Finally, put yourself in his shoes and see if you can write out a more effective response, using the Five Secrets of Effective Communication

Thanks!

Rhonda, Thai-An, and David

Previous Episode

263: OCD in Kids, Featuring Dr. Taylor Chesney

Photo features Taylor and her husband, Gregg, who is an ER / ICU physician in NYC.

263: OCD in Kids, Featuring Dr. Taylor Chesney

Rhonda starts this podcast by reading two incredible endorsements from fans like you. Thanks so much for the many kind and thoughtful emails we receive daily!

Today’s podcast features Dr. Taylor Chesney, the founder and director of the Feeling Good Institute of New York City. Taylor was a member of my Tuesday training group at Stanford for several years during her doctoral training in psychology. Then she and her husband, Gregg, who is an ICU / intensive care unit doctor, returned home to NYC where she opened her clinical practice.

We have featured Taylor on a number of two previous podcasts: Corona Cast 4 (published 4-09-202) and Corona Cast 6 (published 4-30-2020). We always benefit greatly from Taylor’s wisdom, warmth, and superb teaching. Taylor specializes in TEAM-CBT for children and teens, and tells us today about the upsurge in OCD (Obsessive-Compulsive Disorder) in young people, and how she approaches this problem using TEAM-CBT along with some family therapy.

Taylor describes OCD as a pattern of intrusive thoughts, fears, and images that trigger feelings of anxiety. In addition, the patient engages in a series of repetitious, supposititious behaviors in an effort to avoid the fear. Sometimes the parents may get caught up in the child’s fears as well and engage in the compulsive rituals as well.

The fears Taylor sees in children are similar to the fears reported by adults with OCD, such as the fear of contamination, and the compulsive habit of repeated handwashing, and more. But especially common in kids are fears that loved ones, like parents, won’t come home or will be hurt.

Common OCD rituals in children include wanting things to be a certain way; for example, organizing your desk meticulously, arranging your pencils, and so forth. The patient often feels that he or she can’t stop or something terrible will happen.

Another common fear is getting sick, and needing repeated reassurance that the food the child is eating is safe.

David asked about the Hidden Emotion Model that is common and often helpful in adults with OCD, or any anxiety disorder. For example, if a child fears that a parent will be hurt, might this suggest that the child has repressed angry feelings toward the parent?

Taylor confirmed that this dynamic was, in fact, common in children as well as adults with OCD. She emphasized the need for an alliance with the parents as a part of the treatment team. This might include urging the child to express his or her anger, wants, and so forth.

Taylor speculated that the increase she’s seen in OCD may be the result of the COVID pandemic, and the uncertainty we all feel. Children have a great need for love, empathy, structure, and certainty, and OCD is just one pattern that the increase in anxiety can take.

At the start of treatment, Taylor does an initial intake session with the parents, followed by two sessions with the child, and in both cases attempts to empathize and form an alliance via the Five Secrets of Effective Communication. She also wants to find out who the “patient” really is. Who is asking for help? Is it the child? Or the parents?

She also wants to know who will do the work of the therapy. If the child doesn’t see the OCD symptoms as a problem, she will work with the parents.

Sometimes there’s a mismatch as to what the problem is. The parents might want the child to get help with procrastination on schoolwork or household chores, but the child might want help with shyness and relationships with other kids.

She describes how she uses TEAM to show the child that his or her symptoms reflect his or her core values, but that they can turn down the intensity of the fears using the Magic Dial. She emphasized a role for psychoeducation in the treatment as well, explaining the evolutionary and protective role of anxiety. It’s just that sometimes the volume gets turned up to unnecessary levels.

She said that the parents are a huge part of the treatment, since the problem “lives in the house,” and the parents may fear what might happen if the child does not engage in the rituals.

And, of course, Exposure and Response Prevention are important keys to successful treatment, just as they are in adults.

Taylor described a compelling example of a teenager with an intense fear of vomiting in the middle of the night, who had resorted to a variety of rituals including avoiding dinner, secretly sleeping in his bathroom just in case. and more. Together, she guided him in the creation of a hierarchy of exposures as well as Positive Reframing of his symptoms. He successfully completed his treated in just six sessions.

Taylor offers a 12-week introductory course on TEAM-CBT with children and adolescents, and is a superb and highly est...

Next Episode

265: Loving Luscious Leeches, Featuring Drs. Danielle Kamis and Matthew May

Podcast 265: An Extreme Leech Phobia: Once Bitten, Twice Shy!

Today’s podcast features the treatment of an extreme leech phobia in real time, using live leeches. Dr. Danielle Kamis, a clinical psychiatrist practicing in Los Altos, California, is our courageous patient, and Dr. Matthew May, a frequent guest on the Feeling Good Podcast, conducts the treatment, while David and Rhonda observe and comment.

If you ever saw the famous Humphrey Bogart movie, “African Queen,” you know how terrifying leeches can be. But why in the world would anyone working in downtown Los Altos, California, need or want treatment for a leech phobia?

Danielle is an extremely brave and adventuresome young professional woman who loves traveling to remote places around the world (Danielle is an extremely brave and adventuresome young professional woman who loves traveling to remote places around the world. She has had a keen interest in global health work and has spent a significant amount of time doing research with indigenous population in the pre-Andes mountains of Argentina. She has also spent time living with tribes deep in the Amazon forest as well as the jungles of Sumatra. These experiences have transported her back in time to better understand the core components of humans in our most natural state.

She described a terrifying experience while exploring in a jungle in Sumatra, where the leeches not only invade the water, but can also drop onto you from trees. After hiking through the beautiful, lush landscape for some time, Danielle began screaming and sobbing in terror when she noticed that her foot was bleeding because of a leech that had just detached itself. This was understandably embarrassing, and she realized that she needed to overcome this fear before going on another jungle adventure.

In today’s therapy session live leeches will be placed on Danielle’s skin, and she will be encouraged to surrender to the anxiety and make it as intense as possible, rather than running away or trying to control or avoid it. This is an extreme form of exposure called “flooding.” It can be incredibly effective, and often works quickly, but requires great courage on the part of the patient and therapist, as well as a high degree of therapist skill.

To prepare for today’s exposure session, Danielle obtained four live leeches, which she kept at her apartment. She said that even looking at the leeches slithering around in the water and thinking about them biting her made her fear instantly jump to 9.5 on a scale from 0 (not at all) to 10 (the most intense anxiety).

She asked Matt if he’d be willing to do the leech exposure first. Matt agreed, since we never ask our patients to do anything that we wouldn’t do, ourselves. This modeling by a trusted friend or therapist can be a useful tool in the treatment of anxiety.

Danielle carefully removed one of the leeches with a spoon and placed it on Matt’s forearm. After crawling around for a minute or so, the leech attached itself and begin to engorge itself on Matt’s blood.

Danielle watched in fascination and fear, and then it was her turn. She bravely placed a second leech on her forearm. She was afraid it was going to be extremely painful, but was surprised when it was just a mild feeling of sandpaper on her skin. Over a period of about ten or fifteen minutes, with episodes of nausea and profuse sweating, Danielle’s anxiety gradually dropped from 9.5 at the start all the way to 1, and she felt triumphant.

You can see some photos and videos of the session here, including our lunch prior to the session at the Phoa Cabin in downtown Los Altos. It is a favorite local spot that features tremendously tasty Vietnamese food. (LINK)

Teaching points in today's TEAM-CBT session include the following:

Avoidance is one of the major causes of all forms of anxiety. When you avoid or try to escape from your fears, they will always intensify.
Exposure is a powerful treatment tool for anxiety, but is not a treatment per se, and there are many additional tools with powerful anti-anxiety effects. I (David) use at least 40 tools in the treatment of anxiety, but exposure must always be included in the mix. It is probably impossible to cure any form of anxiety without exposure.
All patients and most therapists resist and fear exposure. Patients fear exposure because of the intense anxiety they must endure and their belief that something terrible will happen if they don’t avoid their fear, and most therapists are also afraid that the patient is too fragile, or the procedure is too extreme, and something terrible will happen. However, I (David) have never had a bad outcome when using exposure. I am convinced that poor therapy skills, and not exposure, cause negative outcomes in the treatment of anxiety.
Excellent empathy is ex...