Dr. Diana Hill:

How do you know when you need a therapist and what are some

Dr. Diana Hill:

What should you look for when it comes to finding a therapist?

Dr. Diana Hill:

And when should you seek a higher level of care?

Dr. Diana Hill:

That's what I'm going to talk about today with Dr.

Dr. Diana Hill:

Nicole Siegfried on Your Life in Process.

Dr. Diana Hill:

As a therapist, sometimes I need to refer clients to a higher level of care.

Dr. Diana Hill:

And until now it's been difficult to find programs that are evidence-based

Dr. Diana Hill:

And that's why I'm so excited to be sponsored by Lightfully Behavioral

Dr. Diana Hill:

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Dr. Diana Hill:

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Dr. Diana Hill:

They treat wide variety of diagnoses, including mood disorders, anxiety

Dr. Diana Hill:

health organizations that is built around process-based therapy, which is a

Dr. Diana Hill:

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Dr. Diana Hill:

All female executive team brings over 70 years of experience and

Dr. Diana Hill:

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Dr. Diana Hill:

Hi, this is Diana.

Dr. Diana Hill:

And this podcast is about living well, living psychologically flexible,

Dr. Diana Hill:

And I think a lot of us right now are feeling far from thriving.

Dr. Diana Hill:

We're mentally exhausted as we've been sustaining a heightened degree

Dr. Diana Hill:

This pandemic has been.

Dr. Diana Hill:

Incredibly challenging.

Dr. Diana Hill:

There was a New York times article that came out recently

Dr. Diana Hill:

. Asking therapists about some of the common reasons why people are coming

Dr. Diana Hill:

forefront of people's minds and one in four therapists said that suicidal

Dr. Diana Hill:

In general folks reported that they're feeling stuck and stagnant

Dr. Diana Hill:

the wait-lists are full and they themselves have been impacted by the

Dr. Diana Hill:

So if you're experiencing mental health problems right now, I just want

Dr. Diana Hill:

And today I get a chance to talk with Nicole Siegfried, who is

Dr. Diana Hill:

She's a licensed clinical psychologist and serves as an Adjunct Assistant

Dr. Diana Hill:

And she's worked in mental health for over 20 years and has

Dr. Diana Hill:

Nicole believes that recovery is possible for all individuals

Dr. Diana Hill:

In this conversation, we talk a lot about some of the reasons

Dr. Diana Hill:

especially when you need it most.

Dr. Diana Hill:

And we go through some of the characteristics of what

Dr. Diana Hill:

You may be surprised by some of them.

Dr. Diana Hill:

And then go on to talk about some different treatment options.

Dr. Diana Hill:

And stay tuned to the other side of this conversation with Nicole,

Dr. Diana Hill:

Just a reminder with your daily practice, you can get a download of a PDF

Dr. Diana Hill:

if you go to the show notes and click on the link there, every single episode has

Dr. Diana Hill:

so that you can build these processes, these psychological processes into your

Dr. Diana Hill:

So I'll see you on the other side with that and enjoy my

Dr. Diana Hill:

Take two with Nicole Sigfried we, we tried to record this a week ago and we both

Dr. Nicole Siegfried:

Yes.

Dr. Nicole Siegfried:

Which is neither of us is boring.

Dr. Nicole Siegfried:

So, um, we want to talk about this in a much more relatable way that people

Dr. Diana Hill:

I think that sometimes therapy and the idea of therapy

Dr. Diana Hill:

And so I think we had those hats on and we were trying to explain these

Dr. Diana Hill:

And what I'm hoping that we can do today is take a macro level, look

Dr. Diana Hill:

How do you know, if you need to go to therapy in the first place, and then

Dr. Diana Hill:

And how do you know if you need more than So that's sort of big picture.

Dr. Diana Hill:

Uh, but before we do that, I wanted to ask you a question that you asked me

Dr. Diana Hill:

And I think it's because I just love your program so much, but you sent out

Dr. Diana Hill:

And then you can ask me, ask me mine.

Dr. Diana Hill:

But one of them was what is your walk-on song?

Dr. Diana Hill:

And another one was what was your first job?

Dr. Diana Hill:

So I'm curious about that for you, Nicole.

Dr. Nicole Siegfried:

Speaker:

Oh, those are both good.

Dr. Nicole Siegfried:

Speaker:

Well, so my walkup song, you and I were talking about this earlier that

Dr. Nicole Siegfried:

Speaker:

And so if I'm thinking about.

Dr. Nicole Siegfried:

Speaker:

Seeing a client or I'm doing clinical work.

Dr. Nicole Siegfried:

Speaker:

My walkup song for that is going to be something much more compassionate

Dr. Nicole Siegfried:

Speaker:

And so for that, I, what comes to me, which I feel in my heart is one of

Dr. Nicole Siegfried:

Speaker:

And I think that song just really exemplifies this idea of.

Dr. Nicole Siegfried:

Speaker:

How things are around us are very beautiful.

Dr. Nicole Siegfried:

Speaker:

If we take the time to take them in, um, I myself have trouble with that at

Dr. Nicole Siegfried:

Speaker:

And, and so it's a good reminder to me of taking a breath before session

Dr. Diana Hill:

And when you told that to me at first, you were worried

Dr. Nicole Siegfried:

Yeah.

Dr. Nicole Siegfried:

Yeah.

Dr. Nicole Siegfried:

Well, because it's hard.

Dr. Nicole Siegfried:

I think I have to sometimes keep this in check.

Dr. Nicole Siegfried:

I am really optimistic person, but sometimes, you know, when you're in

Dr. Nicole Siegfried:

pain, it's hard to be in the presence of someone that, um, has a lot of hope

Dr. Nicole Siegfried:

And so I always want to be able to balance.

Dr. Nicole Siegfried:

Being hopeful because I have hope for each client that sits before me and being

Dr. Nicole Siegfried:

So, um, I wanted, I want the song to kind of put me in that

Dr. Diana Hill:

And it's interesting because some of the research on

Dr. Diana Hill:

So you want a therapist that's hopeful and also for you to have hope for the

Dr. Diana Hill:

And we can talk more about that, but, so, and then what was your first.

Dr. Nicole Siegfried:

It's so funny that you asked this because.

Dr. Diana Hill:

It's embarrassing.

Dr. Nicole Siegfried:

Well, mine's really embarrassing.

Dr. Nicole Siegfried:

We just talked about this on one of our team calls.

Dr. Nicole Siegfried:

And so my first job was as a dancer singer in a theme park, um, sort

Dr. Nicole Siegfried:

So that was my first job.

Dr. Nicole Siegfried:

So it's, it was an unusual.

Dr. Diana Hill:

Yeah.

Dr. Diana Hill:

And then usually one, it probably says something about you

Dr. Diana Hill:

So you're the clinical, you're the Chief Clinical Officer.

Dr. Diana Hill:

Yeah.

Dr. Diana Hill:

You know, large treatment, uh, behavioral health program lightly, and

Dr. Nicole Siegfried:

yes.

Dr. Diana Hill:

There you go.

Dr. Diana Hill:

Well, Yeah.

Dr. Nicole Siegfried:

for sure.

Dr. Diana Hill:

Those two questions, uh, sort of like a

Dr. Diana Hill:

the.

Dr. Nicole Siegfried:

Yeah.

Dr. Diana Hill:

My walk-on song and actually learned, just

Dr. Diana Hill:

Cause my kid plays baseball and they actually this.

Dr. Diana Hill:

They actually play a song while they go out onto the field

Dr. Diana Hill:

And it's kind of to pump you up and remind you in some ways what

Dr. Diana Hill:

And.

Dr. Diana Hill:

The one that I sent you was about compassion.

Dr. Diana Hill:

And it's a great song called Compassion by Luicinda Williams,

Dr. Diana Hill:

But the song that actually just came to me as you were speaking, is a

Dr. Diana Hill:

And it's a chant and in the chant, Twameva she chants to the mother, the father, the

Dr. Diana Hill:

And I, when I think about therapy, I think about therapy as being so

Dr. Diana Hill:

the room between me and my client and a lot more about just this huge,

Dr. Diana Hill:

And I feel like, especially right now, we need, we need all those people right now.

Dr. Diana Hill:

We need our mother or sister or friend, everybody involved in

Dr. Nicole Siegfried:

Yes.

Dr. Nicole Siegfried:

Yes.

Dr. Nicole Siegfried:

Um, yes.

Dr. Nicole Siegfried:

In fact, I mean, it's the, we talk about the COVID pandemic,

Dr. Nicole Siegfried:

And.

Dr. Nicole Siegfried:

For many reasons.

Dr. Nicole Siegfried:

Um, our mental health is in the worst place that it's been as

Dr. Nicole Siegfried:

Um, and so one of the things that's really interesting about that is that

Dr. Nicole Siegfried:

So, I think like in 2018, 2019, that the three, let me think of this.

Dr. Nicole Siegfried:

Right?

Dr. Nicole Siegfried:

The three main causes of death for young adults were what some people have referred

Dr. Nicole Siegfried:

And so that was kind of leading up to the pandemic.

Dr. Nicole Siegfried:

And then the pandemic was sort of a flame that ignited those things into somewhat

Dr. Nicole Siegfried:

And people much smarter than I am.

Dr. Nicole Siegfried:

If you have dug into, like, what are all of the reasons for that?

Dr. Nicole Siegfried:

What has, what has led up to that?

Dr. Nicole Siegfried:

What has gotten us where we are in.

Dr. Nicole Siegfried:

In my mind.

Dr. Nicole Siegfried:

I just think of it very simply as, um, it's simply that we're in pain,

Dr. Nicole Siegfried:

And that by itself wouldn't be a problem.

Dr. Nicole Siegfried:

Wouldn't be problematic, but it's the way that we deal with that pain.

Dr. Nicole Siegfried:

That's getting us in trouble.

Dr. Nicole Siegfried:

And when we look back.

Dr. Nicole Siegfried:

, where we are just in the evolutionary process, you know, our ancestors

Dr. Nicole Siegfried:

And that's, what's been passed down generation to generation.

Dr. Nicole Siegfried:

Although that's good.

Dr. Nicole Siegfried:

It makes great problem solvers.

Dr. Nicole Siegfried:

It's not exactly helpful in tenderly holding our emotional pain.

Dr. Nicole Siegfried:

It's almost as though we were having, uh, a collision of sorts of where our.

Dr. Nicole Siegfried:

Advancements in our cognitive abilities.

Dr. Nicole Siegfried:

Our problem solving abilities are really, , interfering with our ability to thrive.

Dr. Diana Hill:

I heard Steve Hayes and he has this wonderful

Dr. Diana Hill:

And I'll put it in the show notes where he was speaking to a large

Dr. Diana Hill:

And in it, he said that psychopathology is energy misdirected, and that

Dr. Diana Hill:

to connect and belong yearnings to feel good, but we get narrowed in

Dr. Diana Hill:

And that's what I think we're finding right now is that many people are

Dr. Diana Hill:

And in a lot of ways, like how do you, how do you cope with this?

Dr. Diana Hill:

But we actually really need to be able to do is to adapt.

Dr. Diana Hill:

We need to be able to have cognitive flexibility and self-compassion and find

Dr. Diana Hill:

But what we tend to do is to kind of silo off and do sort of these old ways

Dr. Diana Hill:

it's addictions or isolation or it's other types of experiential avoidance that just

Dr. Diana Hill:

And I know that for myself, because certainly I've seen that.

Dr. Diana Hill:

During the pandemic, I've seen my own mental health kind of decline.

Dr. Diana Hill:

And really probably at its Nadir point was summer 2020, like, like many people.

Dr. Diana Hill:

And it's interesting because I, I reached out to some therapists, friends asking

Dr. Diana Hill:

And what would they think would be, you know, suggestions for

Dr. Diana Hill:

And one of them responded back just by saying.

Dr. Diana Hill:

I just think you're lucky if you can find a therapist at this point,

Dr. Diana Hill:

So there's like the barriers to treatment to getting treatment.

Dr. Diana Hill:

And then there's also just the barriers of access to treatment.

Dr. Diana Hill:

In particular, certain groups have a lot less access to therapy and

Dr. Nicole Siegfried:

Absolutely.

Dr. Nicole Siegfried:

I love what you said about this idea of our core yearnings and that

Dr. Nicole Siegfried:

And I think about that too.

Dr. Nicole Siegfried:

I, I love the way that Steve Hayes describes it.

Dr. Nicole Siegfried:

And, and when I think about, um, sort of how we got there, It's it's this idea

Dr. Nicole Siegfried:

with the evolutionary history of where we are emotionally, because

Dr. Nicole Siegfried:

And that was evolutionarily, adaptive so much so that, like, we just

Dr. Nicole Siegfried:

That is just really at the heart of being human.

Dr. Nicole Siegfried:

Connect with others.

Dr. Nicole Siegfried:

And what makes sense to me is that that has been thwarted in many

Dr. Nicole Siegfried:

And then, like you said, we try to then, um, cope with that or

Dr. Nicole Siegfried:

Um, in other situations in terms of like problem solving or thinking it through,

Dr. Nicole Siegfried:

And where it really catches up with us is, like you said, when

Dr. Nicole Siegfried:

I mean, so if we think about it, in terms of our ancestors, those ancestors

Dr. Nicole Siegfried:

part of a support group, we're much more likely to survive because there

Dr. Nicole Siegfried:

And so we really, um, you know, that those skills, I suppose, have been passed down.

Dr. Nicole Siegfried:

Been thwarted a lot by just our society, but also by COVID.

Dr. Nicole Siegfried:

But then when we try to go and ask for help and to seek treatment,

Dr. Nicole Siegfried:

And the way we get tripped up, we get in our heads and we say things

Dr. Nicole Siegfried:

Or you should, um, be able to think this through or, um, just don't think

Dr. Diana Hill:

I think another one is, is what will people think.

Dr. Diana Hill:

Like, what, what will people think if I ask, if I say this is really how,

Dr. Diana Hill:

actually that, you know, we, we, we lie as, as a, as a species.

Dr. Diana Hill:

We lie all the time, every day we're, we're lying.

Dr. Diana Hill:

And actually there's some research that shows.

Dr. Diana Hill:

Our lying, prevents, um, real sort of connection between our

Dr. Diana Hill:

Cause we don't want to know, and we lie to ourselves, but I know, you know,

Dr. Diana Hill:

ups and downs over the course of my life and my own mental health, that's

Dr. Diana Hill:

And I know that for my clients too.

Dr. Diana Hill:

I mean, I, I know that every session that I'm in, there's

Dr. Diana Hill:

And actually I have a good, um, therapist, friend, Meg McKelly that

Dr. Diana Hill:

What is it that you felt like couldn't say because we even lie to our therapists.

Dr. Diana Hill:

Even if we can get to therapy, we don't tell the truth.

Dr. Diana Hill:

And that's part of our, our, our, again, that like that yearning, gone wrong

Dr. Diana Hill:

And what if people saw like really how I really am doing, which I

Dr. Diana Hill:

Folks are not doing well it's, , we've been bombarded for, you know, we're

Dr. Diana Hill:

And people are exhausted.

Dr. Diana Hill:

We've been hypervigilant for a long time.

Dr. Diana Hill:

We're tired of being hypervigilant.

Dr. Diana Hill:

Our lives have been kind of sent sideways.

Dr. Diana Hill:

The ways that we connect, we can't connect our travel plans, our vacations, our, um,

Dr. Diana Hill:

Um, or really having a, holding a lot of the impact and it's tiring

Dr. Nicole Siegfried:

I think that one of the other things that is so scary

Dr. Nicole Siegfried:

Being able to connect to your therapist or to really open up into, to say the thing

Dr. Nicole Siegfried:

Is that not only are you afraid?

Dr. Nicole Siegfried:

Like what are they going to think?

Dr. Nicole Siegfried:

But what if they can't hold it?

Dr. Nicole Siegfried:

What if they don't really, they still can't see you.

Dr. Nicole Siegfried:

They don't.

Dr. Nicole Siegfried:

Yeah, they can't validate what you've gone through.

Dr. Nicole Siegfried:

And so I know personally that is something that is a fear of mine.

Dr. Nicole Siegfried:

Um, you know, in my own therapy.

Dr. Nicole Siegfried:

It's, it's so isolating to hold on to things, but it's even more isolating

Dr. Nicole Siegfried:

And that, that is it's just vulnerable and it's risky.

Dr. Nicole Siegfried:

And so in seeking therapy, that is.

Dr. Nicole Siegfried:

That's like the, you know, the, the biggest risk you can take, because

Dr. Diana Hill:

Oh, my gosh, you just hit the nail on the head.

Dr. Diana Hill:

I, in my reach out to therapists, I also reached out to a friend of mine.

Dr. Diana Hill:

Who's been in therapy for a long time and asked her about like what

Dr. Diana Hill:

And I asked her what, you know, what are the signs of a good therapist?

Dr. Diana Hill:

And she sent me actually the signs of when to run from her therapist.

Dr. Diana Hill:

And one of those, one of those.

Dr. Diana Hill:

When you say something to a therapist and they cringe or

Dr. Diana Hill:

And for her she's she struggles with, um, she struggled with postpartum depression.

Dr. Diana Hill:

And there's a lot of things that show up when you have postpartum depression

Dr. Diana Hill:

Like, I feel like I could harm my baby.

Dr. Diana Hill:

I have worries about that.

Dr. Diana Hill:

Or I feel like I can't take care of my baby or I feel like I don't love my baby.

Dr. Diana Hill:

Right.

Dr. Diana Hill:

And what if you were to tell that to someone and they can't hold.

Dr. Diana Hill:

And I think that's where a psychological flexibility on the part of the therapist,

Dr. Diana Hill:

Like you need to have a therapist that can stay with you, be present

Dr. Diana Hill:

And if you're someone that is supporting another person,

Dr. Diana Hill:

It looks scared, but like say, okay, you know, here we are.

Dr. Nicole Siegfried:

Speaker:

I can hold your pain.

Dr. Nicole Siegfried:

Speaker:

And sometimes when, when we're talking about emotional pain, it feels too

Dr. Nicole Siegfried:

Speaker:

Cause if you then say you, you reach out and you risk trying to share it with

Dr. Nicole Siegfried:

Speaker:

I mean, the damage that that can do just feels irreparable, um, or I

Dr. Nicole Siegfried:

Speaker:

a therapist to be able to hold that, but just we as human human to human

Dr. Diana Hill:

Hi folks.

Dr. Diana Hill:

I want to tell you about a few live events that I'm offering

Dr. Diana Hill:

I'm going to be at insight LA on February 11th, online

Dr. Diana Hill:

If you are a mental health practitioner, join me at PESI for their Body Image

Dr. Diana Hill:

And then finally, I'm offering a workshop with Praxis, continuing

Dr. Diana Hill:

So you can join me there.

Dr. Diana Hill:

You can check these all out on my event page at Drdianahill.com.

Dr. Diana Hill:

So let's talk a bit about, like, how do you know if you should seek therapy

Dr. Diana Hill:

I mean, that's a lot of times we say like, oh my gosh, my sister needs a therapist

Dr. Nicole Siegfried:

Um,

Dr. Diana Hill:

someone else in doing it?

Dr. Diana Hill:

And then how do you know if you need it or someone.

Dr. Nicole Siegfried:

Well, first of all, one of the things

Dr. Nicole Siegfried:

The majority of people who are really struggling and who need therapy, the

Dr. Nicole Siegfried:

And that is so discouraging to me because we know that early intervention.

Dr. Nicole Siegfried:

Can is really key in trying to create a life of well-being a life worth living.

Dr. Nicole Siegfried:

And so that time, it just feels like last time.

Dr. Nicole Siegfried:

Um, and so I always want to be able to talk to people to say, if you're

Dr. Nicole Siegfried:

That's your indicator.

Dr. Nicole Siegfried:

If you're having to have the discussion with yourself, that is your indicator.

Dr. Nicole Siegfried:

My husband and I are both psychologists.

Dr. Nicole Siegfried:

And so we joke all the time that our kids are either really well adjusted

Dr. Nicole Siegfried:

, but they, they both are, they wouldn't mind me sharing this.

Dr. Nicole Siegfried:

They both have been in therapy and after they went, they said, This everyone

Dr. Nicole Siegfried:

And what a world we would live in, if that were the case, you know, um, more

Dr. Nicole Siegfried:

even more so, so my first, um, thing I would say to people is if you ask

Dr. Nicole Siegfried:

Then the answer is probably yes, and we all can benefit from it.

Dr. Nicole Siegfried:

And in many ways, , there are times when our struggle, , it becomes at

Dr. Nicole Siegfried:

Uh, necessity is it is a true necessity to seek treatment.

Dr. Nicole Siegfried:

And that's when your symptoms really start to interfere with the life that you want.

Dr. Nicole Siegfried:

And I know that, that I, I, you know, I think about how long I've sought

Dr. Nicole Siegfried:

And I've thought about it just even in thinking about this

Dr. Nicole Siegfried:

I got help.

Dr. Nicole Siegfried:

And how long, how many times I talked myself out of it and with really,

Dr. Nicole Siegfried:

And, um, how many times I really wish I would have gone sooner.

Dr. Nicole Siegfried:

And so, um, when you really feel like it's interfering with your life and the

Dr. Nicole Siegfried:

And in some ways that's as simple answer.

Dr. Diana Hill:

And our approach to therapy is so

Dr. Diana Hill:

You know, it used to be sort of like either you have the diagnosis or you've

Dr. Diana Hill:

But I think that therapy now is a much broader umbrella where it certainly can

Dr. Diana Hill:

you're struggling with severe depression or anxiety, that's interfering with

Dr. Diana Hill:

And, and it's really narrowing your life.

Dr. Diana Hill:

Then you need to have treatment that, that you, you, you don't do this on your own

Dr. Diana Hill:

Right.

Dr. Diana Hill:

And so, and getting an evaluation and getting treatment that matches.

Dr. Diana Hill:

What, what you're struggling with.

Dr. Diana Hill:

So evidence-based approaches and there are, there is a difference between

Dr. Diana Hill:

that will, that will target your specific struggles and the goal isn't

Dr. Diana Hill:

But really the goal is about how to live a fulfilling life and

Dr. Diana Hill:

And I would say that is the goal of all therapy, really to help humans flourish.

Dr. Diana Hill:

And what does it mean to flourish for you in your.

Dr. Diana Hill:

Which is why I'm super excited about, you know, these process-based

Dr. Diana Hill:

And that act is one of them of looking at the underlying processes to living well.

Dr. Diana Hill:

And what, what are the processes have changed that.

Dr. Diana Hill:

Really promote our optimal wellbeing.

Dr. Diana Hill:

And then what are the processes that we get entangled in that keep us stuck?

Dr. Diana Hill:

And those very same processes are probably going to be the ones that

Dr. Diana Hill:

So that's kind of interesting, right?

Dr. Diana Hill:

It's sort of like that, monster is in your, in your head sort of

Dr. Nicole Siegfried:

And just talking to you, I'm thinking about this sort of

Dr. Nicole Siegfried:

the ways that we were talking before of how we've evolved as humans to be these

Dr. Nicole Siegfried:

And so you're setting up all of these diagnoses and symptoms and these

Dr. Nicole Siegfried:

checklistsand trying to identify an underlying disease really falls into that.

Dr. Nicole Siegfried:

And I think misses the, um, misses the point of emotional

Dr. Nicole Siegfried:

And so.

Dr. Nicole Siegfried:

I agree with you.

Dr. Nicole Siegfried:

I think what's beautiful about the process based approaches is instead

Dr. Nicole Siegfried:

checklists, it looks more at what are the processes that you're

Dr. Nicole Siegfried:

And what are some processes that you can engage in that

Dr. Diana Hill:

Absolutely.

Dr. Diana Hill:

And there's now some cool emerging research behind it.

Dr. Diana Hill:

So, uh, Steven Hayes, who's one of the co-founders of act and Stephan Hoffman

Dr. Diana Hill:

death star from star wars where it's going to like, have like this big

Dr. Diana Hill:

I think it was like 55,000.

Dr. Diana Hill:

Research studies and looked at what is it in therapy when somebody is changing,

Dr. Diana Hill:

And those are the processes.

Dr. Diana Hill:

So for example, if you go on vacation and you come back from

Dr. Diana Hill:

There could be a lot of reasons why it could, because you've got

Dr. Diana Hill:

It could be because you stopped drinking coffee and you

Dr. Diana Hill:

It could be because you got away from work.

Dr. Diana Hill:

Maybe you had a better night's sleep.

Dr. Diana Hill:

Those would all be potential processes that could contribute to you feeling

Dr. Diana Hill:

That help people promote the help people change.

Dr. Diana Hill:

And there's a lot of them in act.

Dr. Diana Hill:

We look at six of them in particular, but there's a lot of them, but they really

Dr. Diana Hill:

And I'd love for you to talk a little bit about, um, some of those

Dr. Nicole Siegfried:

Yes.

Dr. Nicole Siegfried:

Well, and you said it in a really good way in terms of the ways that

Dr. Nicole Siegfried:

Um, the ways that we conceptualize.

Dr. Nicole Siegfried:

Who we are ourselves and the ways that we interact with one another.

Dr. Nicole Siegfried:

And so we've really, um, extrapolated in some ways, or maybe even simplified

Dr. Nicole Siegfried:

And the ways that we look at it are in terms of processes, change associated

Dr. Nicole Siegfried:

And so with that, being able to attend to the present moment rather than being

Dr. Nicole Siegfried:

compassion for your thoughts and being able to separate from your thoughts

Dr. Nicole Siegfried:

We were talking about that in terms of this core yearning for belonging

Dr. Nicole Siegfried:

And so if we can develop toward developing interpersonal connection

Dr. Nicole Siegfried:

principles of creating a life that's driven by your values, more so than

Dr. Nicole Siegfried:

And so emotion, flexibility, and rather than.

Dr. Nicole Siegfried:

Um, emotion, uh, avoidance and dysregulation.

Dr. Nicole Siegfried:

And so we boiled it down to those four categories instead

Dr. Diana Hill:

And you could see how something like that would be helpful

Dr. Diana Hill:

There's a degree of mindful self-compassion to acknowledge,

Dr. Diana Hill:

This is anxiety provoking.

Dr. Diana Hill:

And this isn't, you know, this is a normal response to an abnormal situation.

Dr. Diana Hill:

And I need to have some, you know, self compassion and common humanity about

Dr. Diana Hill:

Uh, and then being able to know our values to live from our values and that

Dr. Diana Hill:

on what are some effective ways to deal with anxiety, or maybe start a

Dr. Diana Hill:

And ultimately also find that connection with people.

Dr. Diana Hill:

And break down these barriers to us, having to be in our hiding holes with

Dr. Diana Hill:

We have to keep those under wraps, but really opening and allowing for our

Dr. Nicole Siegfried:

Absolutely.

Dr. Nicole Siegfried:

Absolutely.

Dr. Nicole Siegfried:

And that combination can really then lead to wellbeing.

Dr. Diana Hill:

So, okay.

Dr. Diana Hill:

So we've talked a bit about what some of the barriers are to

Dr. Diana Hill:

What treatment could look like.

Dr. Diana Hill:

And I will say with those processes, those could show up and ACT, but

Dr. Diana Hill:

And, um, the therapists that have a theoretical orientation and sort

Dr. Diana Hill:

processes underlying wellness, and maybe understand some of the research are

Dr. Diana Hill:

But I want to talk to you a little bit because you've

Dr. Diana Hill:

know, this, isn't your first rodeo in terms of developing treatment

Dr. Diana Hill:

And I'd love for us to talk about like how to find a good therapist,

Dr. Diana Hill:

And I want to talk about that from two different angles.

Dr. Diana Hill:

One from the angle of actually what the research says, and then another, from,

Dr. Diana Hill:

And I can even share some more of what, some of what my friends

Dr. Nicole Siegfried:

Yes.

Dr. Nicole Siegfried:

Well, you and I we've talked about this before that, when we look at

Dr. Nicole Siegfried:

therapy, a lot of times it boils down to aspects of the therapeutic

Dr. Nicole Siegfried:

A lot of the weight in the effectiveness of psychotherapy.

Dr. Nicole Siegfried:

And so a lot of times I think that people may look for someone who has a lot of

Dr. Nicole Siegfried:

And although you definitely want someone who, um, has good, um,

Dr. Nicole Siegfried:

You also want someone who is relatable, someone where you're going

Dr. Nicole Siegfried:

And sometimes that's hard to know, um, you know, looking at psychology

Dr. Nicole Siegfried:

which it feels a little bit like, um, uh, online dating or something,

Dr. Nicole Siegfried:

I said, okay, I'm going to take the step to see to see as a therapist.

Dr. Nicole Siegfried:

Um, and now I'm going to go see that person.

Dr. Nicole Siegfried:

You have to be willing to either, if it, if you didn't feel like it worked

Dr. Nicole Siegfried:

Um, a lot of times, Um, people get discouraged with that first appointment

Dr. Nicole Siegfried:

And so I always tell people, give it a second appointment a chance

Dr. Diana Hill:

Yes.

Dr. Diana Hill:

So certainly the therapeutic relationship is like central and

Dr. Diana Hill:

You want to trust your therapist, want to feel like you can open up,

Dr. Diana Hill:

You want to feel empathy and care and your therapist just needs to

Dr. Diana Hill:

So if there's some, like, you know, that's just one of the

Dr. Diana Hill:

Predicts better therapy.

Dr. Diana Hill:

And like I said before, psychological flexibility of the therapist,

Dr. Diana Hill:

call non-specific factors, but it's actually quite specific there it's

Dr. Diana Hill:

And yes.

Dr. Diana Hill:

Experience does not necessarily map on to outcome.

Dr. Diana Hill:

Neither does degree.

Dr. Diana Hill:

Neither does gender.

Dr. Diana Hill:

Neither does age.

Dr. Diana Hill:

Those things don't necessarily predict the, um, effect

Dr. Diana Hill:

And another aspect that's kind of interesting about therapist is that

Dr. Nicole Siegfried:

That's very validating to me.

Dr. Diana Hill:

Validating.

Dr. Nicole Siegfried:

Yes.

Dr. Nicole Siegfried:

But what that says to me is that people who may experience more self-doubt

Dr. Nicole Siegfried:

And so what to me might be, you said that your friend gave you a list of like, when

Dr. Nicole Siegfried:

behind their name, and hasn't really engaged in trainings or any updates, you

Dr. Nicole Siegfried:

learners who are keeping themselves um, competent and on the cutting

Dr. Nicole Siegfried:

And I think it's those individuals who experienced self doubt that

Dr. Nicole Siegfried:

Steve Hayes says that experience predicts constant.

Dr. Nicole Siegfried:

It's not competence and it's not even just an adage.

Dr. Nicole Siegfried:

It's the research shows this.

Dr. Nicole Siegfried:

And the reason is that experience can sometimes occur in a silo.

Dr. Nicole Siegfried:

And when that happens, you're not necessarily getting feedback

Dr. Nicole Siegfried:

And so maybe those individuals who experienced self doubt are more likely to

Dr. Nicole Siegfried:

And so that would be someone you would want to look for I think in a therapist.

Dr. Diana Hill:

Another aspect that I think is really important is the therapist

Dr. Diana Hill:

And privileged and power in the therapy room, privilege and power and contextual

Dr. Diana Hill:

So.

Dr. Diana Hill:

For a long time therapy has been very individualistic in nature.

Dr. Diana Hill:

Right?

Dr. Diana Hill:

Kind of like it's about how you're thinking and it's about how you're

Dr. Diana Hill:

impact of things like oppression or stigma or all these other contextual

Dr. Diana Hill:

Maybe you're in a workplace environment that's really

Dr. Diana Hill:

Right.

Dr. Diana Hill:

And.

Dr. Diana Hill:

Also how that shows up in the therapy room.

Dr. Diana Hill:

So one of those, the other run thing that my girlfriend said was I run,

Dr. Diana Hill:

Because there's a positionality there of putting yourself in a position of power.

Dr. Diana Hill:

And I think it's so important in therapy.

Dr. Diana Hill:

There's many layers of power there's power differentials that we can

Dr. Diana Hill:

client of color there's privilege and positionality in that dynamic, And

Dr. Diana Hill:

If I have all my credentials on the wall and I'm coming in as an expert,

Dr. Diana Hill:

And it's so important that it's the client's goals and it, what the

Dr. Diana Hill:

Not the therapist.

Dr. Diana Hill:

So that's another thing that you kind of can, it's sort of maybe

Dr. Diana Hill:

Pretty, I mean, there's, some of these are kind of intuitive, um, senses of how you

Dr. Diana Hill:

Um, like, social action, are they putting themselves in.

Dr. Diana Hill:

In that, in that way, that's indicates that they may be that

Dr. Nicole Siegfried:

Absolutely.

Dr. Nicole Siegfried:

There may be studies that have been done on this, but in terms of like getting

Dr. Nicole Siegfried:

desk, and maybe your chairs up higher and there's this lower, I mean, all of

Dr. Nicole Siegfried:

, reflect maybe some of the more inflexibility or

Dr. Nicole Siegfried:

And so it may be that in those situations, that's like a boundary

Dr. Nicole Siegfried:

And so it, that armor though blocks connection.

Dr. Nicole Siegfried:

And we're talking about really creating a culture at Lightfully that, that

Dr. Nicole Siegfried:

When I think about therapy and we were talking about being seen before.

Dr. Nicole Siegfried:

And I think about this too, for employees, I think.

Dr. Nicole Siegfried:

Our client to come in.

Dr. Nicole Siegfried:

I went employees to that work with us to feel that way that they feel

Dr. Nicole Siegfried:

And so being able to take into account our own privilege, our own lens through

Dr. Nicole Siegfried:

our clients or allowing them to feel seen, um, is of utmost importance

Dr. Diana Hill:

It's, it's an ICU.

Dr. Diana Hill:

I care about you.

Dr. Diana Hill:

And also I think there's something in therapy.

Dr. Diana Hill:

That's about.

Dr. Diana Hill:

And I'm not gonna let myself get entangled in it.

Dr. Diana Hill:

Probably, I think one of the best therapists that, um, I know I will

Dr. Diana Hill:

of my really good friends, she's actually a sports psychologist and

Dr. Diana Hill:

She's worked with like athletic, the Olympic teams,

Dr. Diana Hill:

As a therapist, you need to have this sort of view where there's enough distance

Dr. Diana Hill:

And you have to have that awareness.

Dr. Diana Hill:

So it's like, I see you.

Dr. Diana Hill:

And I see myself and I see the pattern between us and I see my own

Dr. Diana Hill:

And you're juggling all of this at once.

Dr. Diana Hill:

And it does take a level of self.

Dr. Diana Hill:

So one of the things that I look for in therapist is I want a therapist

Dr. Diana Hill:

I don't want to know exactly.

Dr. Diana Hill:

You don't have to tell me all the details, but you've been

Dr. Diana Hill:

We don't want that, you know, TMI in therapy.

Dr. Diana Hill:

You don't want to have an over disclosing therapist, but you

Dr. Diana Hill:

They've been through something in their life, or they've

Dr. Diana Hill:

So they.

Dr. Diana Hill:

I speak from a place of greater depth and also know their own patterning

Dr. Nicole Siegfried:

Yes, yes.

Dr. Nicole Siegfried:

Yeah.

Dr. Nicole Siegfried:

They have to be willing to do the same work that we're asking our clients to do.

Dr. Nicole Siegfried:

And, um, that to achieve that level of self-awareness that we're

Dr. Diana Hill:

Okay.

Dr. Diana Hill:

So we want to talk about, I wanted to talk to you about three things, like,

Dr. Diana Hill:

How do you find a therapist?

Dr. Diana Hill:

And I will put a list of some of these on, in the show notes, so that you'll be

Dr. Diana Hill:

And then the third thing that I wanted to talk to you about is something.

Dr. Diana Hill:

Very personal to me, which is something that I care a lot

Dr. Diana Hill:

So once a week therapy isn't enough and somebody needs

Dr. Diana Hill:

It's like a super hard thing to do into a higher level of care.

Dr. Diana Hill:

So I'd love to talk about the different types of levels of care.

Dr. Diana Hill:

And the reason why this is important to me is I've been on the side of clients

Dr. Diana Hill:

I've experienced it from the realm of running a IOP and seeing just the magic

Dr. Diana Hill:

treatment that just, you take out, carve out that space to work really deeply

Dr. Diana Hill:

And I've also experienced it as a teenager.

Dr. Diana Hill:

I was in a residential treatment and I attribute that time

Dr. Diana Hill:

And I'm so ever grateful to a residential treatment for being able to help me.

Dr. Diana Hill:

It wasn't the whole recovery process, but really get me started

Dr. Nicole Siegfried:

Well, I love the way that you're saying that.

Dr. Nicole Siegfried:

I think that a lot of us bring our own, um, the reason a lot of these things are,

Dr. Nicole Siegfried:

And, um, I told you this before that I'm also recovered from, um, an eating

Dr. Nicole Siegfried:

And It was very vulnerable that we talked about this earlier,

Dr. Nicole Siegfried:

And there were times along the way that my own thinking

Dr. Nicole Siegfried:

And so, so after you reach out and let's say you're in outpatient therapy, And

Dr. Nicole Siegfried:

A lot of times, if we get tangled up with our thoughts again, around that process,

Dr. Nicole Siegfried:

So we tell ourselves things like this should have worked.

Dr. Nicole Siegfried:

There's something I'm fundamentally flawed.

Dr. Nicole Siegfried:

There's something wrong with me that this isn't working.

Dr. Nicole Siegfried:

I'm not trying hard enough.

Dr. Nicole Siegfried:

I'm a failure.

Dr. Nicole Siegfried:

And that kind of keeps people stuck when really the.

Dr. Nicole Siegfried:

The real answer is that once a week, isn't what you needed.

Dr. Nicole Siegfried:

I use examples all of the time.

Dr. Nicole Siegfried:

If someone were to say, you know, you're supposed to take aspirin, Three times

Dr. Nicole Siegfried:

It wouldn't, it wouldn't work and you really just needed the

Dr. Nicole Siegfried:

And so in this situation, the person might need a different dose of

Dr. Nicole Siegfried:

And so a larger dose of treatment is exactly like you said, it's, it allows

Dr. Nicole Siegfried:

Um, and to set aside time where you can really accelerate the

Dr. Nicole Siegfried:

I tell clients that they get to decide, of how many.

Dr. Nicole Siegfried:

The doses, the dose is that's one of the things that they are in charge

Dr. Nicole Siegfried:

to get, things accelerated to where then you can come back into life and start

Dr. Nicole Siegfried:

For many people, that road looks very different.

Dr. Nicole Siegfried:

Some people spend longer in the residential side of things.

Dr. Nicole Siegfried:

And other people, have more of like a day treatment kind of option

Dr. Nicole Siegfried:

Like you talked about before, like an intensive outpatient where it just

Dr. Nicole Siegfried:

a week where they're able to be back in life, but having the structure to

Dr. Diana Hill:

And what I want to say about that is that you don't have to

Dr. Diana Hill:

So there's.

Dr. Diana Hill:

Like inpatient where you're in a hospital and that would

Dr. Diana Hill:

If you were having, you know, medication issues, psychosis, suicidal ideation,

Dr. Diana Hill:

Right.

Dr. Diana Hill:

And then there's residential treatment as the next level down

Dr. Diana Hill:

And then there's intensive outpatient programming and then maybe group

Dr. Diana Hill:

And you don't need to know because what you do is you make a phone call to a

Dr. Diana Hill:

They do a full assessment on you.

Dr. Diana Hill:

And in this really full detailed assessment, they give you a

Dr. Diana Hill:

You are free to choose.

Dr. Diana Hill:

You are not forced.

Dr. Diana Hill:

You are always free to choose what treatment option is best.

Dr. Diana Hill:

But they'll give you recommendation based on a lot of experience with a

Dr. Diana Hill:

And I would recommend folks, like if you're concerned about somebody else.

Dr. Diana Hill:

If you feel like maybe you need a higher level of care, or if you're a therapist

Dr. Diana Hill:

Because I think also that's the other thing is sometimes it's a therapist.

Dr. Diana Hill:

We also need to say like this isn't working anymore.

Dr. Diana Hill:

I care about you.

Dr. Diana Hill:

And because I care about you so much, I want you to get more treatment.

Dr. Diana Hill:

Pass this podcast.

Dr. Diana Hill:

Because sometimes it's just helpful to hear these different options and it can

Dr. Diana Hill:

more about different levels of care, learn more about getting therapy, learn

Dr. Diana Hill:

So we hope that you pass this on to folks that you think would benefit from this.

Dr. Diana Hill:

And there's no forcing.

Dr. Nicole Siegfried:

You don't have to be 100% ready to change.

Dr. Nicole Siegfried:

I think that's another reason people wait to, to seek help.

Dr. Nicole Siegfried:

And so you can just have the idea of.

Dr. Nicole Siegfried:

That thing you want things to be different and that's enough to reach out.

Dr. Nicole Siegfried:

You can come in in a state of ambivalence.

Dr. Nicole Siegfried:

In fact, the majority of people do..

Dr. Nicole Siegfried:

And that's what we work through with people.

Dr. Nicole Siegfried:

When they come in this database, ambivalence that they may be

Dr. Diana Hill:

Yeah, there's a whole therapy approach just to that

Dr. Diana Hill:

So if you've got a good treatment center or a good therapists, they'll,

Dr. Diana Hill:

Absolutely.

Dr. Diana Hill:

Okay, Nicole.

Dr. Diana Hill:

Well, thank you so much for spending time with us today.

Dr. Diana Hill:

You're such a wealth of information and such a delight and, um, What a wonderful

Dr. Diana Hill:

We need our family and we need each other.

Dr. Diana Hill:

We need ourselves, we need our highest selves to get through this thing.

Dr. Diana Hill:

And, we hope that this podcast is helpful to you.

Dr. Diana Hill:

And if it is, please share it, please pass it along.

Dr. Diana Hill:

In today's discussion with Nicole Siegfried.

Dr. Diana Hill:

We talked a lot about internal barriers to seeking therapy, things

Dr. Diana Hill:

And I want to say that there's awesome.

Dr. Diana Hill:

A lot of external barriers to seeking therapy in terms of access to therapy,

Dr. Diana Hill:

has been telemedicine and teletherapy, which has allowed more people to gain

Dr. Diana Hill:

So it's not all bad news.

Dr. Diana Hill:

Nicole and I also talked about characteristics of a good therapist,

Dr. Diana Hill:

If you go down to this week's Daily Practice and click on that, you can

Dr. Diana Hill:

includes things like psychological flexibility in a personal skills,

Dr. Diana Hill:

You want a therapist that shows hopefulness and uses evidence-based

Dr. Diana Hill:

And has a healthy amount of self-doubt.

Dr. Diana Hill:

Nicole described some core processes and thriving that map onto the

Dr. Diana Hill:

Areas that she talked about were mindful self-compassion, your ability to step

Dr. Diana Hill:

Those are some of the key processes that Hayes and colleagues have found

Dr. Diana Hill:

And then finally, we talked about how to find a higher

Dr. Diana Hill:

And what are the different types of levels of care.

Dr. Diana Hill:

For this week's homework, I want to take on a central theme of today's

Dr. Diana Hill:

So here's what I want you to do.

Dr. Diana Hill:

It's quite simple, but powerful.

Dr. Diana Hill:

Number one, choose a problem that you could use some help with that maybe

Dr. Diana Hill:

now, because you've been entangled in thoughts about needing to do it on your

Dr. Diana Hill:

And I want you to practice some acceptance, practice, some mindful

Dr. Diana Hill:

Talk to somebody about it.

Dr. Diana Hill:

And then number two, reach out and offer help to somebody

Dr. Diana Hill:

It can be in the form of a phone call, a walk, a meetup, but try to embody

Dr. Diana Hill:

We can be good support systems to each other.

Dr. Diana Hill:

We can practice our interpersonal skills, our awareness of our own

Dr. Diana Hill:

And some degree of humility.

Dr. Diana Hill:

Okay.

Dr. Diana Hill:

So try out those two things this week.

Dr. Diana Hill:

Let me know how it goes for you.

Dr. Diana Hill:

I want to know.

Dr. Diana Hill:

And remember that experience does not equal competence.

Dr. Diana Hill:

So I need to know your feedback on what is helpful to you and what is not

Dr. Diana Hill:

So send me your feedback at podcast@YourLifeinProcess.Com.

Dr. Diana Hill:

Take care.

Dr. Diana Hill:

Thank you so much for listening to this episode of Your Life in Process.

Dr. Diana Hill:

When you enter your life in process, when you become psychologically

Dr. Diana Hill:

If you like this episode or think it would be helpful to somebody, please leave

Dr. Diana Hill:

have any questions, you can leave them for me by phone at (805) 457-2776 or by

Dr. Diana Hill:

This podcast is for informational and entertainment purposes only.

Dr. Diana Hill:

And it's not meant to be a substitute for mental health treatment.