A Word To The Wise
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A Word To The Wise
144. Our Personality Determines How Successful We Are Ft. Dr. Shannon Sauer-Zavala
Dr. Shannon Sauer-Zavala, a clinical psychologist and academic researcher, has dedicated her career to developing psychological treatments to help people recover from mental health difficulties. She has focused on proven strategies to shift the personality traits that put people at risk for anxiety, depression, substance misuse, etc. But you don’t need to be struggling with your mental health to take advantage of what the science of personality change has to offer.
What if, instead of letting a personality test tell you what you'd be good at, you identified the life you want and shaped your personality to make those dreams more likely. Dr. Sauer-Zavala and I discuss proven strategies to nudge your personality traits for success.
Where to find Dr. Shannon Sauer - Zavala:
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Hello everyone and welcome back to the A Word to the Wise podcast, a space where we curate conversations around mind, body, spirit and personal development. I'm your host, jumi Moses. On the show today is Dr Shannon Sowers-Avala. She is a clinical psychologist and academic researcher who has dedicated her career to developing psychological treatments to help people recover from mental health difficulties. She has focused on proven strategies to shift the personality traits that put people at risk for anxiety, depression and substance misuse.
Speaker 1:But you don't need to be struggling with your mental health in order to take advantage of what the science of personality change has to offer. What if, instead of letting a personality test tell you what you've been good at, you can identify the life you want and shape your personality to make those dreams more likely? Well, in my conversation with Dr Sour Zavala, we discuss proven strategies to nudge our personality traits for success. Is personality static or is it more dynamic than we actually think it is? Let's get into the show, shannon. Welcome to A Word to the Wise. Thank you so much for being here. How are you today?
Speaker 2:I'm great and I'm so excited to be here.
Speaker 1:Thank you for having me. Yes, I am so excited to speak with you right, because we're going to be diving into the mechanics of personality and just your work in the mental health field and you know what you've kind of like come up with or what you've been a lead developer in in terms of, you know, short-term intervention personality difficulties. So I'm excited to address all of that. But first I want to start with a fun question, and that is do you have a life motto?
Speaker 2:Maybe yeah, I don't know that I have it developed as like a, you know like a quip or a sort of a short motto, but I guess my, my sort of like North Star has always been, you know, if someone tells me I can't do something, then it is like my life's work to prove them wrong. So I I think I operate a lot on spite motivation.
Speaker 1:And I respect that and I think that kind of goes into this what we're going to talk about today in terms of, like, being able to shape our personality and kind of, you know, change the way we normally do things to fit a different box. So I think it's fair to ask as well so do you feel like that model has kind of shaped a lot of your work around personality and the mechanics of personality?
Speaker 2:Yeah, definitely, I think I didn't realize it at the time. I was doing, you know, kind of starting this work and as I have started thinking about how I would communicate some of our findings and some of what I've been working on to just like actual people not other academics who read, you know, like the three other people that read the academic articles that I write, you know and have been reflecting a lot on sort of my growth as a person. I think I think, yeah, I think a really important thing for me personally and professionally is that we don't have to stay in boxes just because we started in a particular place your background right.
Speaker 1:So you've been a clinical licensed clinical psychologist for over 15 years and you're also an associate professor of psychology at the University of Kentucky. What drew you to psychology?
Speaker 2:Yeah, yeah. So I think I've always been a really empathetic and sort of sensitive person and I think, you know I sort of fell into psychology such that I was not a really great student in high school and certainly in early college, except that I took this like intro to psychology class my freshman year. It was at 8 am. I don't know how I because I was not a good student and did not go to class most of the time, but never missed a psychology class I think it must've interest, interested me and I I did well on the first exam and apparently the sort of a rite of passage exam and most people don't do well in the TA was like you should seriously consider, um, majoring in psychology. And I was like, okay, and I think like that became part of my identity and, you know, really did well in those classes, probably because they really interested me, like trying to understand why people do what they do.
Speaker 2:And then after I graduated from college, I worked at a residential treatment program, no-transcript, and when I went to graduate school I thought, you know, I want to be a clinician, I want to provide therapy to people.
Speaker 2:And as I um, you know, as I kind of progressed through my program, realized like I could have a bigger impact by um, by doing research and um particularly like the applied research that I do.
Speaker 2:So I'm a treatment development researcher and really my goal is to make mental health treatment more accessible. So anyone that's ever in the US like tried to access mental health care knows it's like either very expensive or, if you are using your insurance, there's really long wait lists and so like what the heck, how can we make? How can we make the system better? And so my goal has been to develop treatments that are more potent, so that they're more efficient, so that they can be personalized and so that they're easier for clinicians to use, and I think all of those things together will help people get better faster and that will move people through the waitlist faster. So so I think it's been kind of a little bit of a winding road in terms of like I saw myself as a clinician and I certainly have a private practice and really love working with people, but see research really as a place to make a bigger impact.
Speaker 1:Yeah, I appreciate that, because the accessibility of mental health care just especially in terms of finances, you know it can be a roadblock for a lot of people. So I love what you're talking about just being able to create something that's more accessible and can really help people get to the root of some of the mental health issues that they have. So, as you were going through your journey and, like you know, from clinician to now doing like applied research, when did you realize that, okay, I need to actually zero in on personality, because people think of personality as static oh, this is just who I am Right. When did you realize, like, actually there's something here that I need to zero in on a little bit more and do a little bit more research?
Speaker 2:Yeah, yeah. So when we start from this problem of like treatment not being accessible, I start to think about like, how, like, why, and the way that our system is sort of laid out right now is that, like, if you go to therapy and you're going to use your insurance, you have to get a diagnosis, and there's, you know, a lot of them, maybe 80, a hundred different diagnoses, and the way that our system and our treatment research has worked until like pretty recently, has been, you know, one protocol or one manual, one treatment for each disorder, and so that's a lot of. You think about it as like a clinician, right, like that's a lot of different treatments to learn and so, and also like there's a lot of similarities across these different disorders, right, so we can differentiate, say, social anxiety from generalized anxiety, which is like worrying, from panic disorder, but they actually share a lot in common. And so I think what drew me to personality research was, you know, so kind of separate from the treatment literature. There's all this research on personality that shows that, that it can kind of serve as a vulnerability to a range of different mental disorders, and so you know, kind of thinking about like could we go to the root of the problem, right, like the vulnerability factors, rather than kind of playing whack-a-mole with the different symptoms or different disorders. And I think that that's that's how I got interested in personality.
Speaker 2:You know, for my postdoc I worked at Boston university with Dave Barlow, who is a you know kind of a you know famous person in in in psychology and we were working on a treatment called the unified protocol and that treatment is a treatment for neuroticism or negative affectivity.
Speaker 2:That's one of our personality domains and we find that people that experience negative emotions more frequently, more intensely this is just a biological difference they are more vulnerable to develop anxiety, depression, eating disorders. It's not set in stone, right, like, if you're a sensitive person, it doesn't necessarily mean that you're going to, you know, have an anxiety disorder disorder. It just means you have a taller task of coping when stuff comes up and sometimes it's harder for people, um, so yeah, so that's how I kind of came to personality as a way kind of the root of the problem or the vulnerabilities that could become our treatment targets and that would sort of reduce, instead of 80 different manuals, um, down to like combinations five, because there's like we talk about like, what personality is there's like five broad domains that kind of cover it that we can talk about potentially being prone to certain, like you know, mental health.
Speaker 1:I don't want to say like issues per se, but being prone to having some mental health difficulties around certain things, and sensitivity being one of the things that you know. People who have that, who are more sensitive, could, you know, have a little bit more anxiety, and I can raise my hand for that. I'm very sensitive, very like empathetic, and anxiety something that overthinking, and anxiety is something that I've struggled with, gotten a lot better, but I struggled with that for some time. Okay, so what is personality? Let's get into it right. What is personality and what are those you know? Like you said, you can break that down into five different buckets.
Speaker 2:Yeah, so one of the most like robustly researched like theories of personality or models of personality is called the five factor model or the big five, and so basically the way this was developed it's pretty crazy actually. Like as early as the 1930s, like psychologists kind of like poured over literally the dictionary and pulled out any words that that kind of like described human nature, and then they, they like took those words and tried to reduce them into as many or into into smaller and smaller groups and basically when they got to these five overarching domains of personality, they just couldn't like combine them anymore. And this like sort of dictionary approach has been replicated in like tons of different languages and cultures. So it kind of is showing that there is this sort of universal thing or these universal five factors that keep like getting reproduced. And as we have gotten like more sophisticated in our like statistical abilities, we can see that replicated in like data too.
Speaker 2:So the five personality domains are neuroticism, which I already mentioned, that is, the tendency to experience negative emotions, extroversion versus introversion, or detachment and extroversion.
Speaker 2:A lot of people think about it as like your sociability, but really it's kind of broader than that.
Speaker 2:It's like your excitability and energy and being sort of social and outgoing is part of that. Then we've got conscientiousness, and this is like your achievement, striving, your organization, your follow through kind of on a continuum with, like being more spontaneous, being less of a planner. Then you have agreeableness, right, and so that is like your tendency to be you kind of a team player, to be caring, to be empathetic, to be you know to be, to be empathetic, to be you know to be kind of go with the flow, versus being maybe more assertive all the way down to maybe being a little bit like forceful. And then, finally, openness, which is just your, your like interest in aesthetics or you know philosophy, right, some people love to just kind of like debate the meaning of life. Those are people really high in openness, or people that are really imaginative, and then you know, then there's more closeness where people are like, yeah, imagination kind of a waste of time, like tend to be more conservative or traditional.
Speaker 1:Um, and there you have it, five domains of personality is it possible for people to have a mix and match of like a couple of these different buckets, like agreeable and like openness, for example? I could see a lot of people having that, and then some people call themselves like an outgoing introvert. I call myself that. Where it's like in certain, you know, in certain dynamics or in certain situations, I'm a little bit more extroverted, I have a lot more energy, but I do need my time to kind of retreat into myself so I can kind of like go back and forth. So is it possible for people to kind of have a mix and match of these different types of, you know, personality buckets?
Speaker 2:Yeah, yeah. So so everybody has all five. Okay, that makes sense If you think of it as like I don't know, with a mixer board with like five, um, you know five domains, like we can sort of like raise this or lower the slider, basically depending on like. I mean, each individual person has their own kind of profile, right. So you know a person, a person can be high in neuroticism, experience a lot of negative emotions and also be high in extroversion, lots of positive emotions, you know, kind of up and down, or they could be high in neuroticism and low in extroversion and that's more of like, kind of like low energy, sort of depressive.
Speaker 2:You could be low in neuroticism, not feel a ton of negative emotions, and you could be high in extroversion or you could be right in the middle on everything. And so when you describe, like you know, extroverted, introvert, a lot of times when we, when we can't put anybody into a box, they're like right in the middle, right, people that can kind of. You know, in some situations I can be more outgoing and in other situations I like my quiet time versus somebody that like, like, would really low in extroversion, would like really be like a home body kind of situation, whereas, like I know, people that are so extroverted that they like I mean I think they really you notice it during like COVID lockdown where they're just like climbing the walls because they're not getting that stimulation, and so everybody has, like different combinations of these traits.
Speaker 1:Oh, okay, I get it now.
Speaker 1:So it's, it's kind of, those are the different.
Speaker 1:So if there's, if personality is a spectrum, right, all of those things fall within a spectrum and some people have certain elements dialed up, other people might have it dialed down or it might just be at different levels, depending on you know where that person is in their life. And I think that feeds into the next question, which is I used to think of personality as static, but the way you just described it, it means that there are certain moments where, again, you know, using the extrovert versus introvert example, there's certain moments where I dial up extroversion and I might be coming off like, oh, I thought Jimmy was introverted, but it seems like she's more extroverted, and that might happen for a period of time. So it might seem like I'm having some sort of personality shift or I can make my personality more malleable, like personality is not static, right? So can we talk about that a little bit more, because I feel like that's so interesting I've never thought about it that way that personality can be a little bit more dynamic and not static.
Speaker 2:Yeah, yeah, and I think that that is like how we were all really taught to think about personality and I think, in a lot of ways, like makes us really precious about it, like, oh, like my, it's who I am, you know, it's my essence. And you know, when we think about personality with this like big five or five factor model, you'll notice that, like, what's not in there are your tastes, your sense of humor, your values, right, and I think those are the things that make you you, um, when we're talking about the five factor model of personality, we're basically talking about, like your characteristic way of thinking, feeling and behaving, kind of in response to the world. And when we think about personality, we again we're like oh yeah, personality, that's my essence, it's unchangeable. But, like, we change how we think about things, we change our perspective all the time. We develop new habits and change our behavior all the time, and you know we change how we feel about certain things all the time.
Speaker 2:So when you think, when you kind of break down that definition of personality, like, yeah, it makes sense that we could, we could change those things, right, and if you change the way that you think about other people, like you know, if you started out being like you know, oh, you can't trust anybody.
Speaker 2:But then, like, through experience, you know, maybe learn that you can, right, you're going to start to fill out those bubbles on the personality questionnaires differently, right, if you maintain those changes over time, then like, but in essence you've changed how you're responding and what you look like on those personality domains. And when we look at research right across the population, we see that people, like kind of at the group level, on average people tend to get less neurotic over time. They tend to get more extroverted, more agreeable, more open and more conscientious. Some people change a ton and some people stay pretty static, but like my, you know, kind of like intervention work shows that we can take like kind of 20 years of personality change and we can see similar effects in like 20 weeks just by people taking these intentional actions.
Speaker 1:Wow, the word, the keyword there is intentional, because I feel like you have to almost be conscious of how you are interacting with the world, because that's a lot of what kind of makes up our personality as well. To your point, and I want to talk a little bit about you, because you say that you would describe yourself when you were like a teenager, much younger, as, quote unquote lazy, right. But here you are a successful, academic, right. I don't, when I think about people who are in academia, I don't correlate that with laziness at all. Like one of my sisters, she's in academia and she's on the grind so much research, so much work that they have to do. So can you just talk a little bit about that? Because I know, I thought that was a powerful example about kind of you know, I don't want to say mending your personality, but kind of tapping into maybe stronger elements that could propel you forward and, you know, into the successful career. Can you talk about that a little bit?
Speaker 2:Yeah, yeah, absolutely so. So I think, like I, when I was much younger, it was pretty low in like what we would call conscientiousness, right, our sort of like, um, you know, our ability to be planful, our ability to be reliable, to follow through, Um, I like I mean a good example like in high school I like rarely attended math class. My junior year failed and had to repeat it the following year. Um, you know, and in college, like I mean, aside from like being really narrowly focused on my psychology classes, I mean just, you know, oh, I don't feel like going, like really didn't apply myself and um, I think that also kind of. So there's that piece of me. But then there's also the like, I don't know, maybe it's like a little bit of antagonism, like low agreeableness, where I'm just, like you said, I can't do that, you know. That I think sort of made me have really big goals or see myself kind of achieving a lot, but like I didn't have the conscientious personality to actually do that Right. And so, going back to that idea of like intentionality, I think that, like we, we have to kind of have goals or values that are really important to us. That's going to be the motivation to like take these intentional actions to shift our personality traits, because it's hard and so you have to have some buy in to do it. And so basically for me, like I mean I started to tell you about this a little bit already I, you know, I did well in my very first psychology class and the TA was like you should major in psychology and I started to see myself as like I'm good at psychology and that made me. That was like reinforcing to me. It felt really good and whenever there's like a reward for doing something, it increases the likelihood that you're going to do the behavior again. It's like kind of basic psych 101.
Speaker 2:So, um, so I was like showing up to those classes and performing well in those classes and I started to see myself as like somebody that could help others who might be struggling in those classes. Um and so that sort of like snowballed this like very narrow, conscientious behavior in this one area. Then, um, you know, I sort of was like I'm going to go to graduate school for psychology and shared this with one of my professors and she was like, yeah, that's great and I think you could do it because you're doing so well in your psychology classes and I don't think you'll get in because your overall GPA is not good enough. And so that was like really like embarrassing and like I felt so guilty that I had like wasted this opportunity. And so experiencing negative emotions can be a very powerful like reinforcer too, because we're really motivated to reduce those, and so I sort of took that guilt right. The function of guilt is to tell you, oh, don't do that again, like that was bad when you did that before.
Speaker 2:So, um, so I started to really apply myself in my other classes and saw, oh, like these conscientious behaviors that I had developed for psychology, like actually I could expand, that I could do that in other places.
Speaker 2:And so I started to see myself not just as like I'm'm good at psychology, but more like good at school, like I'm smart, I can actually do this.
Speaker 2:And so eventually, like I mean, I didn't get into graduate school the first time I applied, applied my senior year, but, like after my like second semester of senior year, had gotten my GPA up enough to be, like you know, somewhat competitive.
Speaker 2:And when I finally did go to graduate school, it just got like exponentially more things you had to keep track of and you know, I got my very first planner and, you know, I think, like graduate school is like a place where that characteristic of like I need to prove myself to people, I think like it like rewards that.
Speaker 2:And so there are these things that don't really matter in the real world but matter a lot in academia, like publications and grant funding, and as you get those things, it's like you get this respect and recognition and that was a really powerful motivator. And then finally, like now, as like a faculty member and like a mentor, I have graduate students of my own. I know that like they need me to respond, like give them feedback on their drafts and answer their emails quickly, because they need to kind of like build their resumes, and they see me as this, like competent person, a good mentor, and I want to live up to that standard Right. So. So that kind of keeps me moving in that direction, and so I think it's funny because it started off as this like very small thing where I like did well on one exam, but that like kind of started this upward trajectory of change.
Speaker 1:Yeah, like a snowball effect, which I think it's powerful, what you just kind of talked about, right, because you started to believe in yourself, right, it's like someone planted a seed. Hey, you're really good at this, you're really good at the psychology thing, and you're like, huh, I am and you like went with it. And I think a lot of times to your point, like that positive reinforcement is the motivating factor for people to continue to like move forward in a different trajectory. And the more you kind of lean into something I think it's called neuroplasticity, right, so your mind started to feel like, oh, I'm capable, I'm competent, I can do this, I'm smart enough, kind of like almost training you to be more of a go-getter rather than just, I guess, flowing, going with the flow, which I don't think there's anything wrong with that, but with everything there's balance, right, if you go with the flow too much, then things never get done. But if you're able to kind of balance that, obviously then you know things are better. So I really liked that you said that.
Speaker 1:It also made me think about people, for example, who might be trying to get a little bit more fit. Right, you first start off at the gym and you're like I literally cannot lift any weights, but you're like you know what, I'm going to stick with it for a month and then in that month you realize that you're getting stronger and that just makes you want to keep going and going, and going. So I think I think that's awesome. But I also want to ask, you know, for example, for people who have ADHD, I don't know if that's considered a personality trait, but I know that that is like a mental. I don't even know if that's a mental health issue, but I do know it's some sort of cognitive issue that, you know, does not allow people to focus the way they want to focus, and people have, you know, talked about how, like that kind of hinders them from going for their goals and all of that stuff. So how does your work kind of does your work address ADHD related, you know, cognitive symptoms?
Speaker 2:Yeah, so. So in my experience, like just like providing therapy to people with ADHD, a lot of times there's like two things that are happening. There's like the ADHD, which is like a cognitive piece and I would not describe that as personality and then there's like an, you know like there's like an anxiety right, and an identity piece right, and that's the piece that's like well, I have ADHD, I can't like this underlying cognitive issue. And then I'm like adding kind of I'm elaborating on it, and so I think, like with some of the like sort of personality change, like sort of reducing neuroticism, like increasing confidence, like we can take the edge off some of that, so that, like you know, like if you've ever tried to study something when you're really anxious about it, it's really hard right. So, like you know, like if you've ever tried to study something when you're really anxious about it, it's really hard right. So like, add that to like having an attentional issue and it's it's really tough. So if we could take away the anxiety piece and it's just the attentional issue, that's going to make it a little bit easier.
Speaker 2:Um, the personality change strategies that that, like I think about in in my work, are not going to address the cognitive piece. Um, that like I mean, and really the like first line treatment for ADHD is medicine. I'm, one of my kids has ADHD and like I have seen firsthand, like as we have, you know, we sort of like resisted putting her on medicine at first. But she was like I'm trying so hard and it's still not working. And when she said that right, like that's not a conscientiousness issue because she's really trying so hard, it's like, uh, you know, like a a cognitive issue. And when we got her on medicine you could see that conscientiousness sort of like bloom yeah, that makes sense.
Speaker 1:I I see what you're saying there. Because ADHD is such a cognitive issue, the strategies for, like, the strategies that you have related to personality, may or may not be effective. How does personality impact mental health? Like, if I came to you with an issue and let's say I was having a moment of depression or I was struggling with anxiety, how would you, how would the the notion of personality, how would you help me through that? By zeroing in on personality?
Speaker 2:Yeah, yeah so. So a lot of times when people come into the clinic, they are coming in with more than one mental health diagnosis, and that's because there is more that's similar about different diagnoses, like anxiety and depression. They tend to like come together, and so so the way that I would think about that with personality is that I would think that the person kind of has like a vulnerability right, that they might be sort of like higher on that neuroticism dimension and that just means that they're more sensitive, right, that they experience negative emotions more, more strongly. And so what can happen you know, this is just specifically for neuroticism, but, like, what can happen is that when we experience our negative emotions really strongly and we find them uncomfortable, right, like I mean, it's not that pleasant to be sad all the time or to be sad at all, right, or to be anxious when we experience those emotions and this happens, I think, more when people are more sensitive is that they develop these beliefs about emotions that are like I shouldn't be feeling this way, this is so uncomfortable, I can't stand this. Those are like sort of perceptions about yourself, about the emotions, right About really. I mean, I don't use the word neuroticism when I'm doing treatments Just talk about, like, how you relate to your negative emotions and so, instead of working on like your like depression per se or your like anxiety per se, we're talking broadly about your relationship with your emotions and what we find is that, like on the on the you know, I'm kind of like the downward spiral side what happens is somebody experiences their emotions really strongly, they don't like them very much, they have these negative beliefs about them and then they engage in avoidance right, avoidance for depression looks like I withdraw socially, right, because, like, it really sucks to try to be social when you're not really feeling it and that makes you feel worse in the short term, right.
Speaker 2:So people will like sleep a lot or, you know, withdraw socially. Avoidance and anxiety can look like a lot of different things, right. So in like social anxiety, it's like oh, like they might judge me, so I'm not going to go to this thing or I'm not going to participate in this meeting. In like generalized anxiety, it could look like like over researching thingsresearching things, over-planning, like double-checking your email a million times, right, and basically, when you avoid, it makes you feel better in the short term, right, but it backfires in the long term right Because, like, when you leave the party, when you're socially anxious, it confirms the belief that, like, feeling anxious is dangerous, that parties are dangerous. So the next time you encounter a situation like that you're going to feel even more anxious.
Speaker 2:And so that's this idea that, like the more we have negative emotions like that's kind of the starting point but like the more we find them aversive and the more we avoid them, it leads to what we call rebound effects, where you just basically experience negative emotions more frequently and more intensely. So that's like maintaining your neuroticism. The way to break the cycle is to not avoid, right? So you have to and you know we're not necessarily talking about like, oh, go to parties, although that might be part of it it's like we have to learn that it's okay to experience emotions and kind of welcome them. And it's sort of this paradox where the more you're like cool with feeling, the more you're okay with being a sensitive person, the less interfering it is and actually the the less frequently you experience negative emotions.
Speaker 1:Yeah, that that makes a lot of sense. And also, I think sometimes, when it comes to you know, this is just who I am like. I'm someone who typically has anxiety. I'm someone who can be a little neurotic. In certain moments, it becomes a self-fulfilling prophecy that, even though people don't like these negative emotions, it's become a part of them and they feel like it's their identity or it's part of their identity, become a part of them and they feel like it's their identity or it's part of their identity. And, you know, although people want better for themselves, a lot of times people are afraid of change. Like, if I stop being anxious, who am I without anxiety, right? So can you talk about that a little bit? You know, do you encounter people who are kind of potentially resistant to, kind of, you know, making their personality a little bit more dynamic, because they're afraid that they're going to change and lose an essence of themselves?
Speaker 2:Yeah, yeah. So a lot of times we I know we use this phrase in therapy like the devil you know, versus the devil you don't. And so it's like doing these, these kind of like therapeutic activities they're basically called exposures and you like go and put yourself in situations that bring up those emotions, you can practice like tolerating them. Essentially that is hard, right. And like, because you don't have a lot of experience not being anxious or neurotic, you don't know that it's better on the other side and like most people have figured out how to like function, how to kind of white knuckle it through, and so they, they it's like the devil they know, right, and there's no guarantee that it's going to be better on the other side. So I think that that's that's. I mean, I think that is a really important piece.
Speaker 2:Another thing that sometimes comes up, depending on, like the nature of someone's anxiety, right. So this comes up a lot with like perfectionism and anxiety, where it's sort of this double edged sword because it it like is so uncomfortable and you're putting so much effort in, you know you're staying late at work, or, like you know, when I work with college students, it's like the amount of effort and angst that goes into like an online discussion post that is worth like one point because other people are going to see it right. Like people are really scared to let go of some of that perfectionism because it has gotten them good outcomes in the past and they don't know without actually testing it out. Like if you did 80% of the like good job that you're doing right now, first of all, no one would notice and it would still be high quality and still give it an A or still get a pat on the back or whatever. Right and so. But it's so scary to try that.
Speaker 1:Yes, I can relate to that. When I had to, those discussion forums were so anxiety provoking because you're just like, if I was just handing it into my professor, I wouldn't overthink it, I'd be confident. But when, like, tons of other people are reading it, especially your colleagues, your classmates, you're like, oh my god, I hope they don't think I'm dumb. Um, or is this good enough? You know, you, and also it's a competition thing. You want to sound like the smartest in the room and or on the discussion forum. There's so much that goes into it. Um, but, yes, I, I agree with that. And now I want to talk a little bit about the short-term intervention personality difficulties to address common mental health problems, and you call that COMPAS. So can you talk about, yeah, can you talk about COMPAS and like what that means and why this is effective in short-term intervention personality?
Speaker 2:Yeah. So COMPAS is like if you really squint your eyes is an acronym for cognitive behavioral modules for personality symptoms, like if you really squint your eyes is an acronym for Cognitive Behavioral Modules for Personality Symptoms, so like you really have to force it, but it's kind of there. And so basically, compas was developed or at least we started developing COMPAS as a treatment for borderline personality disorder. And so BPD is like a really stigmatized condition that like kind of the prevailing wisdom about the disorder is that it needs really intensive care. Like often people are in and out of the hospital and when you are being treated outpatient you need to be seen at least twice weekly and you need access to your therapist after hours. And I've already mentioned that we have like such a tight crunch on like therapist availability that like people needing a lot of care just makes it even the accessibility piece even harder, right, and that, like for BPD, there's this thought that you needed specialist care. But one of the things that like myself and like I mean lots of people in the field, have noticed is that there's so much variability in this condition where, like yes, there are people that absolutely need this really high level of care. There are also people that, like, could be better in like an 18 week outpatient program. And so this is where, like, I started to expand from just like treatment for neuroticism, for anxiety and depression, right To thinking about, like, well, what are other domains of personality that are relevant for mental health? And so BPD has been described as a disorder of negative emotions, right. So that neuroticism piece of like antagonism so sort of having and antagonism is such a bad sounding word and it makes it sound like it's a person's problem but like, really what it refers to is like difficulty trusting other people, and people with BPD have often, you know, they have like a higher likelihood of having having experienced abuse as a kid, right, and so like, yeah, trust issues makes perfect sense. And then a disorder of disinhibition, so low conscientiousness, and really this is like impulsivity, so just kind of acting on impulse.
Speaker 2:And so we developed modules for neuroticism, for antagonism sort of increasing your ability to trust people and for disinhibition, like how do we get people to feel, you know, to be more conscientious and less impulsive? And basically what this looks like is we start out by helping people identify their values, what's important to them, and so like, for me as a therapist. I don't. I don't ever want to come into a session with a new client and kind of be like this is the life you should want or that you should have. Right, that's gotta be really values driven and like it's also a motivator, because once we identify what's important to a particular person, we can then sort of say, well, are your actions living up to those values? Like, here's your buy in to make these changes, because these are the things that you care about. And then you know, as the name suggests, cognitive behavioral modules, we've got cognitive skills and so here we have people you know.
Speaker 2:In the neuroticism module we have people identify their sort of beliefs about emotions like, oh, it's not okay to feel that are leading to that avoidance. In the antagonism or trust module we have people kind of identify their beliefs about trust. Often it's really black and white. You either can trust somebody or you can't, and really that's not the reality. So we try to get people to think a little bit more flexibly.
Speaker 2:Here we do this exercise called dimensions of trust, where we have somebody identify a person in their life and then rate them on. Like you know, would they pay money back? Can you trust them to not talk about you behind your back? Would you let them babysit you? Would you ask them to pick you up from the hospital or from the airport? Would you, you know, do you trust them to be like supportive, emotionally, when you tell them that something's going on right? Are they? Are they going to be like that's stupid, who cares right? Or are they going to validate you?
Speaker 2:And a lot of times, what people find is like, oh, either actually people are more trustworthy than I thought or I can you know it's not black and white Like I can trust this person picking me up from the airport, but like I wouldn't share my darkest, deepest secret with them.
Speaker 2:And then thinking for disinhibition. Right, like we identify whether there are like self-limiting beliefs, like things like I need the adrenaline of the last minute to get things done. Like that's a belief that's not like a reality of the last minute to get things done. Like that's a belief that's not like a reality. And so we challenge some of those things and then the behavior change module is testing some of those hypotheses that we have oh, people can't be trusted. Well, yeah, why don't you do an activity where you share something personal with somebody in your life and see what happens right. And then if they, you know so kind of pushing people to, you know in neuroticism, experience emotions and see that they can tolerate them, trust people, and see if they can, you know if that improves their relationships and you know, delay gratification in the disinhibition module and see that you can like tolerate that, like angst of not doing it right now. The second, so that's, I mean, that's it sort of in a nutshell.
Speaker 1:Yeah, as you were talking, I was thinking again this whole notion of, I think, a lot of people in this world. In certain things we see things in black or white. Okay, this person can be trustworthy, this person can't be right. And, like you said, sometimes people can be trustworthy in terms of, like you know, I, they will pick you up from the airport. If you call them, they will show up, but maybe if you send them ten dollars they might not pay you on time, right? So, like there's a spectrum, it's not always a hundred percent, because when people think about trust it's like I need to trust you on every single thing, and sometimes not being able to trust that someone might show up to an event doesn't mean, for example, does not mean that they're inherently untrustworthy. That's just probably not where they shine.
Speaker 1:So it kind of also speaks to this idea of, like expectations and people, we all have to adjust our expectations depending on who we're dealing with. So I really liked that example that you gave. That makes a lot of sense. The other thing I want to touch on really quickly because you brought it up briefly, but I always have to ask this question is this notion of mental health medication right, and I don't personally think mental health medication long will it last? Is it kind of like, oh, someone can take medication forever and never feel depressed, for example? So I've always been kind of skeptical and had this idea that it might be more of a placebo effect. But I just want to hear from you, as a professional, your take on mental health medication.
Speaker 2:Yeah. So I think a couple of things that you mentioned that I want to respond to. So so first of all, I'm a psychologist. I don't prescribe medicine but of course, like I am working with people that are have beliefs about medicine, and so there's often like a couple of camps, right, there's like, yeah, I'll do anything that'll help. I don't know I'll be on this for the rest of my life and that's fine. It's just a pill I take in the morning, no big deal.
Speaker 2:Then there are people that are like I never want to do that. And then there are people that are kind of in between, that are like I'm really struggling right now and actually what the research anxiety is like starting an SSRI, like a Prozac or Paxil, zoloft kind of situation and doing like targeted cognitive behavioral therapy at the same time, because it like facilitate, you're better able to use the behavioral skills if you have a little bit of a boost from the medicine. And then people often will taper off after they get the skills on board because they can keep using the cognitive behavioral strategies. That's like has a little bit more long-term effect. My understanding is that for most people medicine continues to work if you continue to take it. But then if you stop taking it right, it's not like you, it's not like it changed anything in your brain such that it fixed anything right. Whereas, like therapy skills, like once you learn them and if you keep practicing them, like you know them, you keep knowing them. So so, yeah, I think, like in my professional experience, there are people that respond really great to behavioral treatment alone and a lot of times people who have been resistant to medication. When I'm working with them and it's we're just not, it's not clicking, or it's really hard for them.
Speaker 2:Like this comes up a lot with the cognitive piece. Like some people that I work with, I'll be like, okay, so you're worried about X. You know like, could you think about it like this? And they'll be like, yes, but and then like 13 more negative thoughts will pop up in its place. People that have some of those difficulties often when they take, when we can kind of get them to take an SSRI, to consult with a psychiatrist, or even their their like GP. You see this huge improvement in their ability to use the skills because they it's just like, not this onslaught of negative thoughts anymore, the medication can be really, really useful.
Speaker 2:So so I think like there really isn't a one size fits all answer to medicine. It's sort of like working with professionals to figure out, like, what is going to be the best combination of treatment for you and then just to like make a note about placebo effect. The placebo effect is so powerful it is crazy, and it is for every medicine that you take, um, like psych medicine or not Right Like there are these studies that show that if you take a blue placebo, you sleep better and if you take a red placebo, you rate you like you rate your pain as lower and for. So, for all medicines that you take, there's like the medicinal effect and the placebo effect. And like the placebo effect is cool because it like makes people feel better. So, so, like I don't necessarily have a problem with that and I think it's like you know, we can get people to feel like more better if we have placebo plus active.
Speaker 1:Yeah, that makes sense, you're right. We have placebo plus active. Yeah, that makes sense, you're right. I think, like you said, all medication or the notion of taking medicine has like it has a placebo effect because you feel like you're taking something that's going to make you feel better. So, inherently, you do actually end up feeling better because you trust that is going to make you feel better. The other question I have for you is does your work consider trauma? Because I do know and I do believe that trauma impacts personality, also affects mental health. So does your work account for trauma?
Speaker 2:Yeah, yeah, it absolutely does so. So when we think about like neuroticism, when we think about disinhibition, those tend to be like more biological and we know the biological factors, like we know that like certain experiences can turn on certain genes, right, so like you could become more sensitive, so like I think that's that's like super true. More sensitive, so like I think that's that's like super true. Where we I mean where, at least in the borderline personality disorder treatment, where we talk a lot about childhood trauma or like relationship trauma or early experiences. That comes up a lot when we're talking about that like antagonism or trust, and so we spend a lot of time basically like validating why you're doing what you're doing right now, and so a lot of like bad behavior in relationships, like seeking reassurance or spreading or being like I'm gonna break up with you before you break up with me, or like not sharing personal stuff, right, like there's a function to that that is very powerful and it's like you've been hurt in the past and you are protecting yourself, and so we work really hard to to really validate that and you know to not be like, oh well, you know, stop doing that, right, we help people kind of understand the function of that behavior for them. And then we sort of work to develop this like kind of I don't know like the notion that like it makes sense that you're using those protective behaviors because you've been hurt in the past.
Speaker 2:And if you continue to use those behaviors, sort of like indiscriminately with everybody, you won't be able to like form lasting quality relationships. It becomes really hard. And so how do you? How do you open the door a little bit, you know, to try with certain people? And you know, then it is that snowball effect where, like, maybe you do have a friend who you know, all right, fine, I'll ask them to pick me up from the airport, and then they show up, and then you're like, okay, I didn't expect them to show up, but they did. You know, maybe I could tell them that I had a hard day at work and see what they do, right, and so in the same way, in the same way like I described my path, kind of, like, you know, reinforcing that conscientiousness, you're kind of doing the same thing with trust in relationships, and it can be as fast or as slow as someone feels comfortable going.
Speaker 1:Yes, and one thing I've noticed and maybe it's just me, but I don't think it is I feel like when I look at my parents' generation and how they ask their friends for certain favors and ask them to show up for them in certain ways, they really don't blink an eye, right? It's an easy ask, yes, the person can say no. It's not like the person always shows up. But I feel like with our generation, we tend to struggle with asking people for help, right? It makes me think about just relationship dynamics and expectations and how we kind of relate to people in this digital age. Right, what is should be expected from someone who's part of your community, part of your family, part of your friend group, versus what shouldn't be expected, right? So I think a lot of people feel alone and I think that's also what's causing a lot of like mental health and uptick in mental health issues. So, yeah, that's that. That was a good point.
Speaker 1:And there was something else I wanted to ask you. Ok, yes, I want to know what you feel like the future of mental health care is going to be. Where do you see it trending into?
Speaker 2:You know, one thing that we have seen is that there's been an increased demand in, you know, in need for mental health treatment, which, like is either you know people are really struggling or is like there's just like less stigma and people feel more comfortable asking, which is cool, and I think it's probably some combination of both and like the kind of depressing fact is there will never be enough mental health providers to to meet the need. And so I do think that, like, as a field, like we need to be thinking, like as a mental health care field, we need to be thinking about, like alternative ways to deliver therapy. You know, are there ways to build into schools like preventive skill building, right? Like are there ways to I mean cognitive behavioral therapy, like I mean I shouldn't say this since it's my profession, but it's like not that hard actually and in the global mental health like research community, like people will go into like countries that have basically like no resources and train people with less than a high school education to provide, like that are just respected in the community to provide CBT and they see huge effects. So, like anyone can do it, kind of. And so could we, you know, could we think about like who can teach skills right, like so. Could we, you know, could we think about like who can teach skills right, like so that we're sort of and then you know, taking advantage of self-help or technology to be able to provide kind of a lower level of care for people that maybe don't need like a one-on-one therapy with, like a psychologist? So I think being creative about delivery methods is going to be really important.
Speaker 2:I know we touched about this already, but I think, like being a mental health provider and providing like research-based care the way that it was tested in academic settings in the clinical trials is incredibly cumbersome because there's 50 different treatment protocols and you just can't learn them all, and so I do think that like a simplified system with fewer treatments that can address more conditions so that therapists can get better at providing treatment, I think that's going to be really important.
Speaker 2:And then I think, like to the bigger part of your question. I think I don't know like the example I'll give is that like there was a study that came out during the pandemic that was like comparing gold standard cognitive behavioral therapy for depression in kind of a low SES area to just giving people a thousand dollars and you know what worked better to treat their depression? Giving people a thousand dollars, um, and so. So all that is to say that, um, you can't think your way out of not having the resources to live your life right. And if there is like sort of, if there are structural, like like racial, sexist, like classist, um barriers, I mean you can't like think your way out of those problems. And so I think that's like, that's like the bigger kind of societal piece yeah, that's correct.
Speaker 1:You can't think yourself out of those issues because, yeah, it's a lot of times, in a lot of situations, it's better to have just more money, um or more resources that's funny, you can't feed your kids or you can't buy your kids a new backpack for school like that's depressing. Yes, right, and the and the. The problem this how to solve that? The solution for that isn't therapy it could be part of it but the real solution is getting those resources, getting more money so you can feed you and your children.
Speaker 2:So that is a societal level like why, it's hard for certain people to like have those resources systematically.
Speaker 1:Yes, exactly, exactly, that's a huge piece and part of the conversation.
Speaker 1:Yeah, because those things it's kind of I think it's called Maslow's hierarchy of needs, right? And if your needs are not met at a certain level like if you can't feed, if you're struggling paycheck to paycheck, and then there are other barriers of entry, like you said racism, sexism, all the isms out there yeah, that could create lots of depression, anxiety and all these other issues that go beyond personality, go beyond cognitive behavioral therapy, and it goes to the root cause of being able to live a healthy, balanced life where you feel like you can thrive, right. So, yeah, that makes a lot of sense. Well, this has been a great conversation. I think we can. We could have gotten deeper into a lot of these different subjects that we touched on, so I probably have to have you back on the podcast, but wanted to end with final words of wisdom to the listeners. It could be about what we've been talking about or something completely different that you just kind of keep in your back pocket as you go through life.
Speaker 2:Yeah, I think that sort of my worst to the wise is kind of a combination of my sort of research and personal experience with personality change and my sort of like antagonistic, like you don't, can't tell me what I can do, kind of streak, and it's basically like don't let a personality test put. I can do kind of streak and it's basically like don't let a personality test put you in a box and limit you and dictate who you can become. You can take intentional action. You can identify like the life that you want and you can take intentional action to cultivate the traits that would make it more likely that you get there.
Speaker 1:Yes, I agree, those personality tests. I've always struggled to take them because I'm like I don't know how to answer this question. You know, I feel like it's constantly changing. So yes, I agree with you. That was awesome. Where can people find you if they want to learn more about your work or just follow you on social media?
Speaker 2:Yeah, yeah, absolutely. So probably the most direct way with like all the resources is is my website, and that is wwwpersonality-compasscom. And then I am on all the socials. I'm on Instagram at selfmadepersonality. I'm on Twitter at Sours of Allah, which is my last name. I'm on LinkedIn, for some reason. So, yeah, you can find me on all the places.
Speaker 1:Awesome. Thank you so much, Shannon, for stopping by the show.
Speaker 2:Yeah, my absolute pleasure. Thank you so much for having me.
Speaker 1:You can follow A Word to the Wise on Instagram and TikTok at A Word to the Wise Pod. We're also on YouTube at A Word to the Wise Podcast. Please be sure to subscribe If you are enjoying the show. Please rate, leave a review, share and subscribe wherever you listen to podcasts. Till next time, peace and love, always, always, always.