Thoughts on Record: Podcast of the Ottawa Institute of Cognitive Behavioural Therapy

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Shame is among the most powerful of human emotions and can drive a number of both functional and dysfunctional behaviours.  Sheila Rubin, MA & Bret Lyon, Ph.D., join us for a comprehensive discussion of many of the themes in their new book Embracing Shame - How to Stop Resisting Shame & Turn it into a Powerful Ally.  In this discussion we cover: 

• why they wanted to write this book
• a theoretically driven and evolutionarily informed definition of shame
• shame as a "binding" emotion that helps to de-intensify emotional reactions to stressors 
• common reactions to shame (anger in, anger out, avoidance, withdrawal)
• healthy vs. unhealthy shame
• shame as potentially a developmental wound and how this manifests in adults
• working with clients who harbour shame but who are emotionally over-regulated
• diagnosing the impact of shame within interpersonal interactions

Sheila Rubin, MA, LMFT, RDT/BCT, and Bret Lyon, PhD, SEP, are co-creators of the Healing Shame–Lyon/Rubin Method and founders of The Center for Healing Shame. Through their in-person and popular online trainings, they have taught hundreds of psychotherapists throughout the world how to more effectively identify and work with shame. They live together in Berkeley, CA. For more, visit healingshame.com. 

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Happiness is an elusive and frequently controversial topic of discussion.  Dr. Jeff Perron joins us for an extensive discussion of some of the themes he is exploring in his new substack project: The Psychology of Happiness.  In this discussion we cover:

• working within a workable & reasonable definition of happiness given the realities of the human condition 
• the tension between schema-driven behaviours and values 
• blending schema and values-orientated principles to create a pathway to happiness & well-being 
• considering whether there is a room for clinicians to be perhaps more directive around the selection of values from an evidence-based perspective
• considering values from the lens of so-called "luxury beliefs" and evolutionary pressures (reproduction, safety & attachment etc)
• can values reflect adaptive schemas (in contrast to having only purely maladaptive schemas)
• brief thoughts on helping clients to understand their schema landscape and the value of integrating mode work into the treatment plan 
• the importance of the "vulnerable child" being present in therapy as well as developing a healthy adult in parallel
• the challenge of deploying self-compassion and to move through potential stuck points 
• resolving conflict between values and how to accurately map behavioural investment into one's values 
• guiding principles for implementing values 

Dr. Jeff Perron is a Clinical Psychologist and Author of The Psychology of Happiness, a Substack with over 15,000 subscribers. He is a Clinical Associate of the Ottawa Institute of CBT.  He writes detailed guides that explain evidence-based concepts associated with mental well-being and happiness. In his clinical work, he has spent years helping professionals align their lives more closely with their goals and values, supporting them in moving away from unnecessary suffering and towards meaning and fulfilment. Dr. Perron holds a PhD in Clinical Psychology from the University of Ottawa. He also holds an MBA from Wilfrid Laurier University and in the past has worked in the corporate strategy world.

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For many clinicians body dysmorphic disorder or BDD is shrouded in mystery and can be an intimidating and tricky presentation to try and conceptualize and treat.   Physician, scientist, educator, and author, Dr. Katharine Phillips,  who has spent her career caring for patients, mentoring/teaching, and conducting groundbreaking scientific research on BDD joins us for a discussion in which we cover:  

• what BDD is and how it affects individuals
• subtypes of BDD
• the special concern around insight in BDD
• developmental experiences and factors related to temperament that might predispose someone towards BDD
• the current gold standard treatment for BDD,  the typical response rate and the role medication can/should medication play in the overall strategy  
• challenges issues related to differential diagnosis
• advice for family members concerned about a loved one with suspected or confirmed BDD

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Dr. Phillips graduated with honors from Dartmouth College and Dartmouth Medical School. She did her psychiatry residency at McLean Hospital/Harvard Medical School. She is currently Professor of Psychiatry, DeWitt Wallace Senior Scholar, and Residency  Research Director at Weill Cornell Medical College.

Dr. Katharine Phillips is a physician, scientist, educator, and author who has spent her career caring for patients, mentoring/teaching, and conducting groundbreaking scientific research on body dysmorphic disorder (BDD) and other psychiatric disorders. Her research studies on BDD have identified and elucidated many aspects of this common and severe disorder, and she has developed and tested treatments, both medication and therapy, for BDD. Her scientific studies on BDD were continuously funded by the National Institute of Mental Health for more than 20 years.

Dr. Phillips has received many honors and awards for her research, clinical work, and other academic contributions. Her awards include a Special Presidential Commendation from the American Psychiatric Association and the Outstanding Career Achievement Award from the International BDD Foundation for her research studies on BDD.

Dr. Phillips has more than 350 scientific publications (original scientific articles, reviews, letters, and book chapters). She has written or edited 11 books on BDD and other topics, including the first book on BDD. Dr. Phillips has given more than 600 international, national, and local presentations for professionals, including more than 130 Grand Rounds.

Dr. Phillips has served on many national boards and committees. She is an elected Fellow of the American College of Neuropsychopharmacology and a Distinguished Life Fellow of the American Psychiatric Association. She is a member of numerous editorial boards, the American College of Psychiatrists, and the Scientific Advisory Boards of the Anxiety and Depression Association of America and the International BDD Foundation. From 2002-2006 she chaired the National Institute of Mental Health's Interventions Research Review Committee (Scientific Review Group).

To disseminate information about BDD and other topics, Dr. Phillips has done more than 500 media interviews. She has been interviewed by the New York Times, London Times, Wall Street Journal, Los Angeles Times, Washington Post, Boston Globe, Time Magazine, Newsweek, CNN, the BBC, National Public Radio, and many other media outlets. She has appeared on the Oprah Winfrey Show, 20/20, Dateline NBC, the Today Show, and Good Morning America.

https://www.katharinephillipsmd.com/

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Hello everyone - hope you are well!  We just wanted to quickly let you know that we’ll be taking a scheduled break for the rest of the summer and will be back with new episodes in the early fall.

It’s been a real joy recording and putting out the podcast - we’re so grateful to each and every guest for their contribution to the path that we’ve been on with the podcast which is basically trying to get just a little bit closer to coming to grips with the unbelievably complex reality of the human experience.

At last count there were over 3 million active podcasts on the Apple podcast platform - that is, of course, an absolutely huge amount of content to choose from.  We are so delighted & humbled by the number of listeners who have chosen to devote a little bit of their bandwidth to the content that we have been producing.  We have seen quite a sizable growth in the podcast over the past 8 months and we want to thank you for your support.  If you’re relatively new to the podcast, we hope you are enjoying the content we have to offer. 

If you have been enjoying the content, leaving a review on Apple podcasts would be tremendously helpful - it’s a major benchmark that helps potential guests gauge the podcast and I can tell you for a fact that the warm feedback to date has really helped with the growth of Thoughts on Record – we’re a relatively small, independent podcast and having solid reviews really helps potential guests cut through the noise of the countless invitations they receive.  It’s also a great way for us to get feedback and to get a feel for how the content is resonating.  Passing the podcast along to a friend or colleague is also always appreciated. 

If you have comments or feedback, you can always reach us at [email protected] – we’d love to hear from you with any suggestions for guests or topics you might have!  I’ve really enjoyed interacting with those who have reached out so keep the emails coming!

Well, that’s it for now - looking forward to picking up the conversation in the fall!

Take good care,

Pete, on behalf of the OICBT
www.ottawacbt.ca

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Strength in vulnerability combined with an internal sense of safety are among the most powerful psychological tools that one can curate to promote wellness and healthy boundaries.  Four-time Olympian, speaker & author, Silken Laumann, joins us for a very special discussion where we cover:  

• a brief overview of Silken's story and her rise to prominence nationally and internationally
• finding an "extra gear" with respect to performance and the balance between connecting with the reality of one's situation & processing difficult emotions while remaining goal driven
• the importance of vulnerability with respect to promoting and maintaining mental wellness as well as connection with others
• Silken's perspective on the impact of adverse early life experiences on the formation of self-esteem, coping, attachments, detection of threat etc.  
• the challenge (and sometimes imposibility) of maintaining attachments with important figures in our life and the critical importance of boundaries
• navigating guilt that can arise from detaching from significant others who are felt to present a challenge to one's own wellness 
• the power of an apology
• pros and cons of using intensive/high-level exercise/activity to assist with emotion regulation & growth of self-esteem
• why Silken has taken such a strong stance around being vulnerable in sharing her story and how it informs the ethos of her charity Unsinkable
• Silken's lens on cultivating vulnerability in the service of sharing your story and what must be in place psychologically for this to be a safe, healthy & healing process 
• the importance of clearly and honestly assessing one's needs in the service of self-care
• an overview of Silken's charity, Unsinkable, and it's core of storytelling
• the myths and realities of the mental health of elite athletes 
• the perhaps unexpected challenge of achieving great success early in life and the challenge of transitioning out of elite athletics 

Four-time Olympian Silken Laumann is one of Canada’s most inspirational leaders, a best-selling author, and a child and mental health advocate. Silken’s Olympic story is legendary and inspirational. As reigning world champion, Silken fought back from a devastating rowing accident, to win a bronze medal in the 1992 Summer Olympics in Barcelona.  In her best-selling memoir, Unsinkable, Silken shines a spotlight on all the obstacles she has encountered and overcome. Silken speaks candidly about her athletic success and triumph over physical adversity, but also the intense personal challenges of her past and the fierce determination she applies to living a bold and successful life today. Silken is the founder of Unsinkable, a multimedia non-profit organization that uses story-telling and lived experience to move people further along their mental, physical and spiritual journey.

https://www.weareunsinkable.com/

Host note: A very special thanks to Jennifer Elia for facilitating this conversation!

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Despite being among the most common of mental disorders that a clinician is likely to encounter, major depressive disorder presents both the client and therapist with a considerable amount of complexity and nuance to navigate with respect to conceptualization and treatment.  Leading international expert in major depressive disorder, Dr. Keith Dobson, joins us for an in-depth exploration of depression where were cover:  

• a brief overview of what  depression is and how it affects individuals
• features of depression to be aware of that do not necessarily fall within the diagnostic framework but that would nonetheless be useful for clinicians to keep in mind when assessing clients
• how depression is conceptualized from a cognitive behavioural perspective
• the developmental experiences that might predispose someone towards depression
• consideration of “at-risk” temperaments associated with development of depression 
• the evolutionary origins of depression 
• exploring the concept of complicated grief vs. depression 
• some of Dr. Dobson's reflections on the conceptualization of depression based on his extensive experience in studying depression 
• gender and depression
• challenges related to differential diagnosis 
• discussing medication with client in the context of psychotherapy 
• depression in the context of trauma 
• gold-standard psychotherapy for depression and the integration of stepped care principles 

Dr. Dobson's is a Professor Emeritus of Clinical Psychology at the University of Calgary, where he has served in roles such as Head of Psychology and Director of the Clinical Psychology program. His research has focused on both cognitive models and mechanisms in depression, and the treatment of depression, particularly using cognitive-behavioural therapies. He is also a Principal Investigator for the Opening Minds program of the Mental Health Commission of Canada, with a focus on stigma reduction related to mental disorders in the workplace. Further, he has written about developments in professional psychology and ethics and has been actively involved in various organizations, having served as President of the Canadian Psychological Association, the Academy of Cognitive Therapy, the International Association for Cognitive Psychotherapy, and the Canadian Association of Cognitive Behavioral Therapies. He has also received numerous prestigious academic awards and was recently named as an Officer of the Order of Canada.

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Many clinicians pride themselves on practicing within an evidence based framework; however, within psychology the influence of pseudoscience and pop psychology has been at times problematic and even harmful.  Psychologist, professor & author, Dr. Hupp joins us to discuss his recently edited book Investigating Pop Psychology: Pseudoscience, Fringe Science & Controversies.  In this conversation we cover:   

• why Dr. Hupp wanted to put together this book
• the state of psychology & clinical psychology as a science considering recent challenges around the so-called replication crisis
• consideration of potential factors that have contributed to the evolution of pseudoscience in psychology, including human factors
• the quality of the information landscape (news, social media, click bait) at the present time and how this might contribute to the propagation of pseudoscience
• exploring the potential impact of "pop psychology" on the current research funding landscape
• when misinformation in the sphere of pop psychology goes from being light entertainment to being potentially harmful
• features of human psychology that make us predisposed to fall for pseudoscience, including confirmation bias
• what clinicians should keep in mind with respect to the critical consumption of information
• differentiating between pseudoscience and when the scientific method is employed in more “fringe” areas
• advice for those who want to study within a fringe area
• readily recognizing false claims/charlatans/hidden agendas etc.
• Dr. Hupp's favourite examples from the book that illustrate the principles discussed 
• balancing exploring novel areas of investigation that could yield fascinating results while remaining firmly grounded in scientific principles, critical thinking, testable hypotheses - when it might be worth taking “flyers” on strange or novel ideas

Stephen Hupp, PhD, is a Licensed Clinical Psychologist and Professor of Psychology at Southern Illinois University Edwardsville. His books include Investigating Pop Psychology (with Richard Wiseman), Investigating Clinical Psychology (with Jonathan Stea), Pseudoscience in Therapy (with Cara Santa Maria), and Dr. Huckleberry’s True or Malarkey? Superhuman Abilities: Game Book for Skeptical Folk. 

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Dr. Daniel Z. Lieberman returns for an encore discussion on Thoughts on Record to discuss his most recent book Spellbound, which explores the untapped potential of our unconscious minds. In this conversation we cover:

• defining of our conscious and unconscious minds
• why Dr. Lieberman wanted to write this book
• getting to know what wants, needs & agendas our unconscious mind might have
• unpacking the wisdom of fairy tales about the unconscious
• shadow work: what the shadow is, the Jungian notion of shadow work and the value it might have through the lens of your book
• what are archetypes, why do we have/need them and “where” do they reside within the structure of the psyche of the unconscious mind  
• the notion of the fascination with someone being perhaps, in part, related to our seeing a universal archetype in that person
• why integration such an important process for adults to engage in
• the gift and burden of awareness 
• leveraging the desires of the unconscious as a compass with respect to where to take one’s life
• knowing when we have aligned vs misaligned the will of our unconscious and conscious mind

Daniel Z. Lieberman, MD is a Clinical Professor of Psychiatry and Behavioral Sciences at George Washington University, where he has earned awards for both teaching and research. He studied the Great Books at St. John’s College and attended medical school at New York University. He is the coauthor of the international bestseller The Molecule of More, which has been translated into 20 languages, and the author of the recently published, Spellbound: Modern Science, Ancient Magic, and the Hidden Potential of the Unconscious Mind. Dr. Lieberman has published extensively in peer-reviewed journals and leading psychiatric textbooks, and has provided insight on psychiatric topics for the US Department of Health and Human Services, the US Department of Commerce, and the Office of Drug and Alcohol Policy.

https://www.danielzlieberman.com/

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Despite anxiety in social situations being a fairly normative experience, we know that the symptoms and disability associated with social anxiety disorder can be very life-limiting when it comes to important aspects of life such as establishing a romantic relationship, professional advancement and overall quality of life.  Internationally recognized expert on cognitive behavioral therapy for social anxiety disorder, Dr. Richard G. Heimberg, joins us for an in-depth discussion in which we cover:  

• what social anxiety disorder is and how it affects people  
• an evolutionary lens on social anxiety disorder
• the developmental experiences that might predispose someone towards social anxiety disorder
• temperament & genetic factors associated with development of social anxiety disorder
• prevalence rate across gender   
• features of social anxiety disorder to be aware of that don’t necessarily fall within the diagnostic framework but that would nonetheless be useful for clinicians to keep in mind  
• challenges related to differential diagnoses including shame/social withdrawal in depression and avoidant personality disorder
• subtypes of social anxiety disorder
• barriers to accessing treatment for clients with social anxiety disorder (e.g., managing the first contact with the clinician)
• the current gold standard psychotherapeutic treatment for social anxiety disorder
• individual vs. group therapy for social anxiety disorder 
• comorbidity with substance use disorders 
• medication in the overall treatment of social anxiety disorder, including specific implementation within the context of psychotherapy  
• the special concern around "Zoomers" and social anxiety owing to increased screen time, social isolation (especially during COVID)
• what is cutting edge in the current understanding and treatment of social anxiety disorder

Rick Heimberg, PhD, is an internationally recognized expert on cognitive-behavioral therapy (CBT) for social anxiety disorder. He is the Thaddeus L. Bolton Professor Emeritus in the Department of Psychology and Neuroscience at Temple University, where he founded and directed a specialty social anxiety clinic, and he was previously Professor in the Department of Psychology at the University at Albany of the State University of New York. He is past president of the Association for Behavioral and Cognitive Therapies and the Society for a Science of Clinical Psychology. He is a recipient of Lifetime Achievement Awards from the Association for Behavioral and Cognitive Therapies, the Academy of Cognitive and Behavioral Therapies, and the Philadelphia Behavior Therapy Association, as well as awards from the Anxiety and Depression Association of America, the American Society for Group Work, Temple University, and from Florida State University (where he earned his doctoral degree in 1977). Together with his colleagues, postdoctoral fellows, and doctoral students, he has published more than 500 articles, chapters, and books on understanding and treating anxiety, including Managing Social Anxiety: A Cognitive-Behavioral Approach, which was released in its third edition in November 2019 (coauthored with Debra Hope and Cynthia Turk). Dr. Heimberg has also been widely recognized for his commitment to the education and training of doctoral students in clinical psychology. He received the Outstanding Mentor Award from the Association for Behavioral and Cognitive Therapies and similar awards from the Society of Clinical Psychology, the Society for a Science of Clinical Psychology, and the American Psychological Association of Graduate Students.

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Diagnostic frameworks like the DSM are often regarded as definitive, having an almost canonical-like quality.  On the other hand, there are many in the field who have become increasingly critical of the DSM and its shortcomings.  That said, the DSM has been quite helpful in a lot of ways with respect to organizing our thinking around mental illness as well as facilitating research.  Professor Dr. Miri Forbes joins us for a discussion of some of her research examining symptom overlap and repetition among DSM diagnoses.  In this discussion we cover:     

• Dr. Forbes' long-standing interest in symptom level structure of psychopathology
• general thoughts on the nature of mental illness vs. normal and expected reactions to psychosocial stress
• the major concerns that have coalesced around the DSM model of psychopathology 
• a description of HiTOP - a alternative diagnostic framework
• the phenomenon of diagnostic inflation
• a review of key questions addressed in recent research by Dr. Forbes and colleagues including:  1) How many distinct symptoms comprise the hundreds of diagnoses defined in DSM-5?  2) What proportion of these symptoms repeat across multiple diagnoses and/or chapters?  3) What patterns are evident in the symptom overlap among diagnoses within and between different chapters? 4) Are some chapters of psychopathology more prone to symptom repetition than others? 5) which symptoms show the greatest non-specificity as indicators of varied manifestations of psychopathology? 
• Conundrums around the search for biomarkers relative to our diagnostic systems and circular reasoning inherent in this
• the primacy of the DSM framework relative to other systems available
• the need for more continuum based perspectives to be integrated into existing  and emergent diagnostic frameworks 

Miri Forbes is an Associate Professor in the Centre for Emotional Health and School of Psychological Sciences at Macquarie University in Sydney, Australia. Dr Forbes was awarded her PhD in Psychology in 2014, and went on to do postdoctoral fellowships at the University of Minnesota and Macquarie University, before receiving back-to-back fellowships to fund her own program of research. She is a member of the Executive Board of the international Hierarchical Taxonomy of Psychopathology (HiTOP) Consortium and a member of the Executive Committee of the Centre for Emotional Health. Dr Forbes' current research focuses on improving our understanding of the empirical structure of psychopathology based on the specific patterns in which symptoms of mental disorders tend to co-occur.

https://miriamkforbes.academ