Transforming Personality Traits for Personal Growth with Dr. Shannon Sauer-Zavala

Transcript

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Hey everyone, welcome to Exploring Health Macro to Micro.

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I'm your host, parker Condit.

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In this show, I interview experts from all areas of health.

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This can be from areas that you would expect, like exercise, nutrition and mental health, while other topics may be from areas where you are less familiar.

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Today's conversation is all about personality and what influences our personality, and here to discuss that with me is Dr Shannon Sauer-Zavala.

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Dr Shannon Sauer Zavala.

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Dr Shannon is a clinical psychologist and academic researcher who's dedicated her career to developing psychological treatments to help people recover from mental health difficulties.

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She's also authored three books.

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In this episode, we go over the common online personality tests and talk about the big five personality traits.

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Which actually has the most reliable research and validity when it comes to personality.

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Dr Shannon dispels the myth that personality is permanent and goes over how to nudge your thoughts, beliefs and actions if you want to shift your personality.

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So I think this will be a great episode for anyone who wants to learn more about themselves and better understand how to make changes in their life, specifically to their personality.

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So, without further ado, please enjoy my conversation with Dr Shannon Sauer Zavala.

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Shannon, thanks so much for being here.

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Let's start off with the basics.

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A lot of this is going to be kind of based around personality and some of your work there, so I think it'd be great to get a baseline of understanding what exactly personality is.

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So we're starting with a common definition and then we'll kind of break down some of these more interesting aspects that you spend a lot of your time researching and studying.

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Yeah, great, love it.

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So I think it can be helpful to talk about what personality is not first, and so a lot of people think of personality as your essence, your sense of humor, your likes and your dislikes.

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From an academic perspective, that's not really how we're defining personality, and so personality is your characteristic way of thinking, feeling and behaving.

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Okay, that's a good place to start and I've I've kind of learned that structure through kind of going through therapy on my own, of like this is how you need to kind of think about the tiers of things.

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Is there like a hierarchy I've seen this written out visually or is it?

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You should, if you're trying to address personality, you should start with thinking, or should you start with how you feel?

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Should you start behaviors?

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Is it different for everyone?

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Yeah, that's a great question.

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It is different for everyone.

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So one of the things that we know about cognitive behavioral therapy right?

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So when we're thinking about targeting your thoughts and your behaviors, right, cbt is right in that wheelhouse.

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One thing we know is that, as a treatment package, people tend to experience relief from symptoms of anxiety, depression, other issues that you might go to therapy for after the entire package.

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But we're not really, we don't really know who would benefit from what skills, right?

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So, like, are you a person that would benefit from cognitive skills and maybe I'm a person that would benefit from behavioral skills, or vice versa?

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So it really is different, different for everybody.

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Okay, that's helpful.

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So then, understanding personality a lot of people and it's easy.

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I think there's a lot of messaging around the somewhat static or definitive nature of it and it's kind of fun, right, because I think humans can be like it's a lot to process in the world, so we kind of use buckets and categories to simplify things.

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Be like I am this, you know whether it's a Myers-Briggs or an Enneagram or a horoscope, whatever it might be.

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Can you discuss the maybe lack of definitive nature around that and like how dynamic can personality really be?

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Yeah, that is a great question.

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So I think there's a couple things to unpack there.

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First, is you named a bunch of different personality questionnaires.

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These are the ones that if you type into Google personality test, you're going to see Myers-Briggs, you're going to see Enneagram, you might see DISC, right, and if you work for any kind of corporation, you've probably had your HR department kind of do team building and have you take a Myers-Briggs or a DISC assessment.

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Academic settings and in personality research are so different than those that are used by corporate America, by guidance counselors, to funnel people into their ideal roles, and so the research that does exist on the well-known, really easy to get your hands on personality questionnaires is super limited.

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There's not a ton, and the data that do exist kind of show that these tests don't predict career success, which is a real bummer because that's what they're being used for.

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So I think it's worth kind of talking about the limited research support for these measures, right, and I think you know you mentioned horoscopes too, and so I see a lot of college student patients, a lot of kind of like Gen Z generation, and you know people will be like I'm an ENFJ, right.

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So that means X, y and Z about me, and so people do have this notion that this is who I am and it's static, it's not going to change.

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So I can't do X activity because I'm not Y characteristic enough, and so part of the reason that I started to come on podcasts is because that's just like a myth, that I think it's really self-limiting.

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And so what we find is that across the population, personality changes on average as people age, so people tend to experience fewer negative emotions, so they tend to be less neurotic.

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People tend to get more extroverted, more conscientious, more open to new experiences and just more oriented towards other people, and so that's good news.

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There's a lot of variability there, so some people change a ton, so some people change a ton and some people kind of hold steady.

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And what?

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we see now, as we're starting to target personality in treatment or like with interventions, is that you can speed up the process so you can see like 20 years of personality change in as few as 20 weeks by taking intentional actions to nudge your personality Interesting.

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There's a lot I want to dive into.

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I want to start with this.

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You started mentioning some personality traits, so the differences between, like what you're going to see from a Myers-Briggs, for example, enfp, intj, whatever it might be and then you started mentioning what I think are the big five personality traits.

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Are those the pillars that you sort of use in the research setting?

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Yeah, so the big five has probably the most research support and so I kind of feel like you know the big five needs like a PR person, because Myers-Briggs like when I take the Myers-Briggs, I find out that I'm a protagonist and I'm like, ooh, yes, that suits me yeah, they've got fun, yeah, they've got fun.

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names too I forgot about that Right.

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And so so I can see why people would gravitate towards that.

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Once you start taking kind of the, the different sort of levels on different traits, and trying to put them into even big, bigger, like super categories, like protagonist, that's when we start to lose validity, lose validity.

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And so the big five, the big five is really interesting.

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So when psychologists, researchers, were sort of trying to understand differences across people, they actually just opened up a dictionary and pulled out any words that described human nature and then they tried to group them into similar categories with similar themes.

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Right so like kind and thoughtful and caring would have been grouped together.

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And basically they found that as you reduce and you reduce and you reduce, that you couldn't get fewer than five categories, that all of the words that describe human nature can be kind of summarized by the big five.

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I'm really creative with our naming in psychology.

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But effective.

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Okay, can you run through what those five are?

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Yeah, absolutely so.

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Neuroticism is the tendency to experience negative emotions.

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People differ, right.

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Some people are you tend to get more upset, tend to be more reactive systemally in their environment, tend to take longer to calm down.

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And so, you know, in my practice I see a lot of people with anxiety, depression, borderline personality disorder higher on the neurotic side of things.

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Then you've got conscientiousness.

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That one is another one that really predicts career success.

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People that are in conscientiousness tend to make more money, tend to be more achievement striving, and that's on a continuum with disinhibition, so that's being more spontaneous, impulsive, maybe not so great at planning.

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Then you have agreeableness, right, and so that's like how well you get along with other people, how much you trust others, how friendly you are, and that's on a continuum with antagonism, and that's one that I think is so interesting because I there, there are problems at both sides of the continuum, right, if you're too agreeable, your people pleaser kind of doormat, and if you're too antagonistic, then then you have problems.

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Yeah, you're just a thorn in the side of people.

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Yeah, right, and I mean conscientiousness is like that too.

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If you're too high in conscientiousness then you're perfectionistic, maybe a little rigid.

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So think in, like pop psychology, introversion versus extroversion, and so a lot of people think that extroversion is like how social you are or how much you enjoy being around other people, and it's certainly part of it, but really it's it's more about um, having like energy and a lot of activity and a lot of excitement and positivity and so being kind of a social butterfly life of the party type of person.

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It kind of gets folded in with that.

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But like how traditional or conservative or you know, you like things how you like them.

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All right.

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So I mean you finished with openness is are people who are higher in openness?

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Are they going to have an easier time sort of changing their personality?

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Yeah, I mean I think so right, like I think you know, when you get too high in openness there, I mean and this is true of all, all of the domains right, too high in openness, it can kind of be a liability.

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You spend so much time like kind of fantasizing about things you know, or there's just so many things that are interesting to you that it's hard to then like take the leap into anything.

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But yeah, I think there needs to be a certain level of willingness to believe that just because it's always been a particular way doesn't mean it has to stay that way.

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Yeah, very much yeah.

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So a lot of this is just a practice and balance and, I guess, understanding kind of where you are along the spectrum of these various.

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So do we have parts of all five of these?

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In us just at varying degrees.

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Okay, that's helpful.

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Yeah, and then so when you think about people right, like most of us, or many people are kind of moderate on some of them, and then you're sort of usually like kind of at an extreme on like one of them, and that's the thing that you would be like oh, like Shannon, she's extroverted Right and probably wouldn't comment on the other.

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Right, but they're there, everyone has a level on each domain.

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Okay, and then you mentioned nudging personality.

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So I'm guessing that's just you don't want to take somebody and be like you're just going to be a new person tomorrow.

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So can you describe the process of nudging and sort of what sort of subtle changes you're looking for?

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Like, if this is something that you're working on with somebody, how do you sort of help them sort of stepwise, kind of make this, this progress?

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Yeah, yeah.

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So so it's worth kind of going back to that definition of neuroticism, right, your characteristic way of thinking, feeling and behaving.

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And so you know if you maybe are not a particularly conscientious person, but you start to tell yourself you know, if I show up on time to things, that shows other people that I respect them, right, so you're kind of changing your thinking.

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And if you feel pride when you show up at like brunch before your friends get there, and if you engage in behaviors that increase your timeliness, like setting an alarm or an appointment reminder, then you're starting to embody the characteristics of a reliable or conscientious person.

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And if you maintain those changes over time, then in essence you become more conscientious.

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You've shifted your personality a little bit.

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When you take a personality test, you're going to maybe, instead of you know do you tend to plan ahead and you say strongly disagree, maybe say disagree or neutral.

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Right, and so you can see how that that can change over time.

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And so usually when I'm kind of thinking about personality change with somebody, I first want to know, um, like, what's your buy-in, like, why?

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Because making changes in any capacity is really hard.

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And so, like, I like introversion versus extroversion for this, because you know, if you are introverted and you have a job where you don't have to interact with a ton of people and you get a lot of fulfillment over, like through fewer, closer relationships, and like it's working for you, then there's no reason to nudge your personality to be more extroverted, right.

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However, if you're a person that you know is also really high in conscientiousness and you have high achievement striving and you want to move up in your job, but the next, you know the next level would require public speaking, right, and would require managing people, then maybe there's an incentive to try and nudge your, nudge yourself to be a little bit more extroverted.

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So that's one of the things that I'm I'm first going to be looking at when I'm talking to somebody about potential personality change is like, why do it?

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Because, again, like, I don't think any level of the traits is inherently better than another.

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It really just doesn't match up with your goals and values.

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So that's kind of the first piece and then we start to identify, you know, do you have any patterns of thinking that are keeping you stuck in a particular way of behaving right?

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So you know, if you tell yourself, you know you're constantly telling yourself like other people can't be trusted or other people are only out to get themselves right.

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So you know, if you tell yourself, you know you're constantly telling yourself like other people can't be trusted or other people are only out to get themselves right.

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They're only out for themselves.

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That's probably going to keep you behaving defensively, maybe more apt to put a wall up right, and that's going to be, you know, kind of keep you lower in agreeableness, right.

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Or maybe you're the type of person that tells yourself I need the adrenaline of the last minute to start packing for this upcoming move.

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I couldn't possibly start ahead of time.

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Again, that's going to keep you stuck With neuroticism.

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It looks like I hate the way these feelings feel.

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It's weak to feel this way.

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I should avoid these feelings.

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And neuroticism is kind of an interesting one because the more you tell yourself you don't want to have feelings, the more you have them.

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So that one's kind of counterintuitive how you would address neuroticism.

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So the thinking right, that's kind of where I might start.

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So you're saying, starting with the why, why that definitely makes sense because you're also mentioning, like any sort of change is really hard.

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Um, because we just love homeostasis.

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It's just a great evolutionary kind of trait that we have.

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Um, so, yeah, it definitely makes sense to start with a why, because it probably needs to be a strong enough why to get the change to stick over time.

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Cause you're just going to want to keep reverting back to whatever you've been doing On the idea of neuroticism, or maybe I guess the easier way to do this is through thinking, feeling and behaving.

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I know there's like various points you can kind of latch on to.

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So you as a therapist, because a lot of this is going to be like subconscious, right, it's going to be hard for people to recognize either the thoughts, feelings or behaviors that are probably detrimental to them.

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So, like?

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what do you try to do through CBT or any other modalities that you work with where you can try to unpack the the unconscious or subconscious, and I'm never really sure of the difference between those two.

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Yeah, um.

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So in CBT we don't really think about it as being like unconscious or subconscious, like it's there.

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You just maybe aren't really like as aware of it as you could be.

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So I mean, most of us have our thinking all the time.

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It's just how much are we paying attention to what we're telling ourselves?

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Or how much are we taking what we're telling ourselves as the truth versus a thought?

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Because when you tell yourself I need the adrenaline of the last minute to get started on this task, that's a thought.

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It's not necessarily a fact.

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You don't literally need adrenaline to open a book to study, that's not true.

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But people take those thoughts as truth and they don't really question them.

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And so one of the things that we're doing in CBT or in the cognitive piece is trying to get people to slow down a little bit.

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So usually CBT starts with self-monitoring.

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I use this like form with three bubbles on it, called three component model your thoughts, feelings and usually it's like physical feelings.

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So because some people the emotion is really like visceral, physical, and then your behaviors or your urges, and so we start getting people to kind of track that over the week like do at least one of these forms a day and just with repetition, you start to get better at identifying.

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Oh yeah, I just told myself this thing that is leading me to behave in a particular way, that's leading me to react to other people in a particular way, and so we start to just bring more awareness to what's there.

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We're just not maybe paying as much attention to it.

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Gotcha.

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Yeah, so that makes sense.

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Having like those three bubbles Cause I was thinking like this is something that was tricky for me in the past, where it was like I didn't know, like I didn't have the thought or I couldn't identify the thought, but I would just see the behavior I'm like why am I feeling so much resistance and like procrastination is just so much easier without necessarily having a thought to tie to it?

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So that seems like it ties into the urges category, where you're like just to find this, acknowledge it, and then, yeah, so can you describe like from a mechanistic standpoint, why it's so beneficial to write things down, because I've had so many breakthroughs where I'm like I've been thinking this for years, how?

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is it going to make a difference if I write it down or say it out loud?

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Yeah, yeah.

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So one of my former colleagues at Boston University had this really cool metaphor for, I guess, the power of thoughts.

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And thoughts are like Dracula, so in the dark of your mind, where they're just kind of swimming around, they're really powerful.

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They can be scary, they can keep us stuck, but when you expose them to the light of day they just turn into a pile of dust, right, it's like oh, when I say that out loud, I can kind of see the flaws in that logic.

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You know, when I sort of subject it to the light of day, so I think, like that, that can really, can really help.

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I also think that like it can get complicated, right, because the way that we think is kind of daisy, training our thoughts together, like I think this, and then that makes me think this, and then I have a memory of this, and then you know, and so it can kind of go on and on.

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Like that, and when you, when you kind of map it out or write it down, take it, make it external to you, it's a lot easier to see the process.

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It's a lot easier to say, okay, this is separate from me.

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Now, these are thoughts that I've written down on this paper, not something that's like true of me, and again then we have that distance.

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We can challenge those thoughts a little bit.

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Yeah, I think that's what's been most beneficial because, like you, yeah, you just externalize it, you get it out, and then the thoughts it's easier to see, to be like.

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The thoughts are not me, the thoughts are just something that's occurring kind of through me.

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And then, yeah, I just have thoughts all day.

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Some of them are great, some of them aren't.

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Other people have thoughts.

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It's like you don't need to put that much judgment on them.

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They're just.

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They are just there.

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Yeah, yeah.

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And thoughts are like just like anything a lot.

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Maybe your parents, you know, said something to you over and over again.

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You kind of internalize that as like the truth of the world, just as one example, and you think that thought a lot.

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When you're in a situation that you know that kind of pulls for that line of thinking, you're going to have that thought because that's the thought you have in situations like that, Not because that thought is like the correct interpretation of today.

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So I mean, I'm not a parent, but I just immediately went to that.

00:21:16.289 --> 00:21:17.292
I was like, can you?

00:21:17.292 --> 00:21:21.386
You could probably use that to your advantage, right?

00:21:21.386 --> 00:21:25.685
Like that's why you say, oh, you're so smart, you're a good learner, things like that.

00:21:25.685 --> 00:21:35.145
Cause I think kids that are kind of conditioned with that they're more receptive probably to whatever form of education they're going to be in Um, and I think those stories are really important.

00:21:35.145 --> 00:21:40.371
But at what point do you try to objectively and like analyze that?

00:21:40.371 --> 00:21:42.076
You know, probably not in elementary school.

00:21:42.076 --> 00:21:50.510
You're probably just kind of living through like that, that lived experience, um, but at some point is it worth like revisiting those things and be like, is this actually a truth?

00:21:50.510 --> 00:22:11.721
Because I mean, you could probably just keep yourself somewhat delusional to your advantage in this society where, if you're really convinced that you're really smart and you can kind of do anything, you probably can like a lot of people are just kind of like delusional in their own self-confidence, even when they may not have the actual uh requisite like skillset to kind of back that up.

00:22:12.505 --> 00:22:19.683
Well, right, and I think this like speaks to, um, I don't know, like self-fulfilling prophecy or like, or even really personality change.

00:22:19.683 --> 00:22:24.410
Right, you are who you act like you are, I guess, right.

00:22:24.410 --> 00:22:58.390
So, um, yeah, I mean, and I think like what you just said really resonates with me, because, I don't know, I mean I have successfully gotten a PhD and like have an academic job, I'm a professor and a therapist and like I am by far not the smartest person in the room most of the time, um, but when I was little, my mom was like you're special, you're going places, and I always thought that I was right and I'm a hard worker, so I just could see it as a possibility that I could do whatever I wanted.

00:22:58.390 --> 00:23:09.315
And so this is why I don't like career tests or personality tests that you take when you're a senior in high school that are like you'd be a great middle manager.

00:23:09.315 --> 00:23:19.827
You should do that because you're middle of the road extroverted and middle of the road conscientious, and it's like how limiting is that?

00:23:19.827 --> 00:23:30.040
Maybe I don't want to be a middle manager, manager.

00:23:30.060 --> 00:23:32.307
And so I think to go back to the original question, which was when should we start to analyze our thoughts?

00:23:32.307 --> 00:23:54.727
And I would say when you are noticing interference, when you are having trouble moving towards a goal or when you're noticing a lot of distress that's getting in the way of living in accordance with the life that you want to have, right, because that's usually when we would recommend like, oh, maybe you should talk to somebody, maybe therapy would be a good fit for you.

00:23:54.727 --> 00:24:04.012
Lots of people have anxiety, but it doesn't prevent them from moving forward in their life and they're not that distressed by it.

00:24:04.012 --> 00:24:06.205
It's just there.

00:24:06.286 --> 00:24:08.044
I would consider myself a neurotic person.

00:24:08.044 --> 00:24:09.432
I feel my emotions really strongly.

00:24:09.432 --> 00:24:17.022
I think it makes me a great therapist because I'm pretty empathetic and when I experience my emotions I'm like, okay, there it is.

00:24:17.022 --> 00:24:20.349
It's not really causing me a lot of distress and just stop me from doing anything.

00:24:20.349 --> 00:24:34.236
But if your thought process or your emotions or the behaviors that you're engaging in and you're not sure why are getting in the way of living the life that you want, that's probably when you want to slow it down and figure out okay, like what am I telling myself?

00:24:34.236 --> 00:24:36.104
How's that affecting me?

00:24:36.787 --> 00:24:37.368
That makes sense.

00:24:37.368 --> 00:24:42.006
So it has to be hard, hard, like.

00:24:42.006 --> 00:24:56.251
So we just explored an example of like the positive side of that, where you know you had support I had support from parents and then teachers and you just kind of get that positive feedback loop.

00:24:56.251 --> 00:25:07.087
So how hard is it if very early on you don't have supportive or encouraging parents or you have a teacher who says something to you in first grade and you're like, well, that's, this is my experience with education, just just kind of hold on to that.

00:25:07.628 --> 00:25:09.211
Um, like how detrimental can that be?

00:25:09.211 --> 00:25:11.965
Sort of like years down the line of people Like I.

00:25:11.965 --> 00:25:20.645
I'm 35 and I was still kind of talking to people around my age and they're like I'm not good at math and I think they say that because it looks like how much math you have to do every day.

00:25:20.645 --> 00:25:21.166
They're like none.

00:25:21.166 --> 00:25:22.489
I'm like why do you right?

00:25:22.489 --> 00:25:28.316
It's probably something they were told in elementary school because they didn't do great on an arithmetic test and they're holding onto it this many years later.

00:25:28.316 --> 00:25:34.712
So like how, how hard is it to sort of unwind a lot of that when you get these really early?

00:25:34.712 --> 00:25:36.563
Maybe negative influences?

00:25:37.825 --> 00:25:41.412
Yeah, so hard but not impossible.

00:25:41.412 --> 00:25:51.551
And so you know, I've worked with people that have had experiences like that right, where they're sort of holding on to this like one formative experience.

00:25:51.551 --> 00:26:02.573
I mean, I think about that like I had a fourth grade teacher be like you want to be a teacher to me, and I remember being upset about it at the time but I obviously didn't affect me that much.

00:26:02.573 --> 00:26:37.309
So things like that like one formative experience, all the way to having sort of chronic physical, emotional and sexual abuse, like kind of growing up at the home from a parent, right In's like sort of being motivated and, I think, making changes in how you respond to the world, how you think about the world, how you behave in the world, how you feel about things that are happening to you.

00:26:37.941 --> 00:26:58.751
It's really hard and usually, especially if you're coming from kind of a deficit based on your early experiences, it can be hard to wrap your head around the notion that when I put myself out there, when I'm vulnerable, when I, you know, step outside of my comfort zone, it's going to feel worse before it feels better.

00:26:58.751 --> 00:27:04.630
And I think that's where we get um, that's where I think people often will stop.

00:27:04.630 --> 00:27:14.083
But when we can get people that are willing to kind of push through that, um, you know, push through the sandbar or the barrier or whatever.

00:27:14.083 --> 00:27:15.425
That's where we start to.

00:27:15.425 --> 00:27:17.531
That's where we can see really meaningful change.

00:27:18.800 --> 00:27:35.730
Are there any tools that you have for people, um, or is it just kind of mentally preparing them and be like it's it's not going to feel great immediately, like, um, and just kind of setting that expectation, just because, right, like it's hard when you hit resistance and again I kind of already mentioned, like just going back to whatever the default is.

00:27:35.730 --> 00:27:37.330
Do you have tools that you kind of give people?

00:27:38.298 --> 00:27:38.378
Yeah.

00:27:38.378 --> 00:27:44.240
So usually at the beginning I I mean I try to do like a lot of like truth and advertising and therapy.

00:27:44.240 --> 00:27:56.571
So when people are coming in with difficulties, I am usually right off the bat being like this is going to be hard, It'll be great, I have the treatment, I know it works for some of the difficulties that you're experiencing, but this is going to be hard.

00:27:56.571 --> 00:28:03.762
I'm not trying to just oversell it at the beginning, Like, okay, this is going to be amazing, it's going to be so great, You're gonna feel so much better, Right.

00:28:04.503 --> 00:28:19.923
And I think some of that is just giving people I don't know giving people enough respect to know that if you explain very clearly what is going to happen in therapy, what you're going to ask them to do, that they can.

00:28:19.923 --> 00:28:28.405
Well, you don't have to surprise them with it, right, you can tell them and they can think through okay, like, what are the long and short term consequences of this?

00:28:28.405 --> 00:28:30.991
Is it worth it to me to do this right now?

00:28:30.991 --> 00:28:47.512
And sometimes people are like well, you know, I'm going through a divorce or I'm about to move states, so maybe I don't want to start talking to you about my childhood trauma, because I don't want to open that can of worms right now, Like, and that's, that's like a perfectly respectful decision to make.

00:28:47.512 --> 00:28:51.510
And then some people are like now is the time, let's do it.

00:28:53.660 --> 00:29:00.953
So I think, um, I kind of want to start exploring the more like wider, wider area of, like mental healthcare.

00:29:00.953 --> 00:29:03.749
Um, where do you think things are going?

00:29:03.749 --> 00:29:05.885
And I'm also curious to understand.

00:29:05.885 --> 00:29:22.352
Another thought I had around this was I wonder if it's harder now because we've sort of been conditioned over the past like maybe 10, I don't know how many years, but we've been conditioned to like for more short-term reward and like delayed gratification is harder with just the entire society that we live in.

00:29:22.712 --> 00:29:29.913
so I'm curious if like that is more challenging um your position now and also like where you think mental health is going or mental health care.

00:29:31.161 --> 00:29:31.982
That's a great question.

00:29:31.982 --> 00:29:40.449
So this is something I think about a lot because I think the state of mental health care is not great, you know.

00:29:40.449 --> 00:29:52.113
So if any of your listeners have tried to find a therapist or to find a therapist that's really well-trained in, like whatever they want to work on, they probably have experienced barriers.

00:29:52.113 --> 00:30:00.826
You know, whenever I have to find, you know, I'll have like a friend from you know that's living in like DC or like a place that I don't live.

00:30:00.826 --> 00:30:03.041
It's like Shannon, can you, can you help me find a provider?

00:30:03.041 --> 00:30:30.511
And like, with every possible advantage, like they can pay out of pocket, like they're asking their friend that knows people in the field, right, it can still be really hard to find somebody with an opening, and so I think what our field has to grapple with is how to meet the like ever rising demand, and so sometimes people will ask me, you know, do you think that people have worse mental health than before?

00:30:30.511 --> 00:30:32.141
And I actually don't think that's what it is.

00:30:32.401 --> 00:30:40.049
I think we're seeing an intense or a higher demand for therapy because people are much more comfortable talking about seeking therapy.

00:30:40.049 --> 00:30:41.494
It's much more normalized.

00:30:41.494 --> 00:31:02.167
I think people are much more comfortable asking for help or talking about the fact that they're, they are in therapy, um, and so we're seeing a shift in in the amount of people that are, that are asking for care, and so there are a couple of things that I think, um, I don't know, our government should do, I guess, um.

00:31:02.167 --> 00:31:19.304
So so one thing is to invest in prevention, right, because all the stuff that I treat in therapy are waiting until there's a problem and then teaching people literally skills, right, interpersonal skills, skills for what to do when you experience a strong emotion, how to not procrastinate, right.

00:31:19.304 --> 00:31:28.082
These seem like really basic things that could be taught in schools, and there's so much variability in what happens in different schools.

00:31:28.082 --> 00:31:40.426
So, like my kids, they go to public school and they're in a district with like a lot of different public schools, and in my kid's school they have this UL room where they can go and meditate, they can go take a break if they need to.

00:31:40.426 --> 00:31:41.249
They go there.

00:31:41.249 --> 00:31:51.866
I know it's amazing and then, but other schools in the district don't have that Um, and there's really no rhyme, rhyme or reason, really, um, to why certain kids have access to that.

00:31:51.866 --> 00:31:54.689
So I would like to see that in a more widespread way.

00:31:54.759 --> 00:31:57.124
There's evidence that primary prevention can work.

00:31:57.124 --> 00:32:00.145
Um, I'd also like to see um.

00:32:00.145 --> 00:32:08.143
I'd also like to see more sort of personalized allocation of care.

00:32:08.143 --> 00:32:24.436
So we know that, like digital interventions can work, so people that do an online intervention, where it's all kind of in a computer program or an app, can get a lot of benefit.

00:32:24.436 --> 00:32:39.809
The problem is that that's not the appropriate level of care for some people that have more serious symptoms, and it's not like super engaging, as like talking to a person, so a lot of people drop out, and so I'd like to see more sort of nuanced allocation of like.

00:32:39.809 --> 00:32:42.217
I think this would be a great fit for these people.

00:32:42.217 --> 00:32:49.640
They should do that, and that would free up space on clinicians caseloads to help people that really do need a higher level of care.

00:32:50.730 --> 00:32:51.333
That makes sense.

00:32:51.333 --> 00:32:54.280
Yeah, just getting the appropriate level of care at the right time.

00:32:54.280 --> 00:33:00.030
Are there like, what does the pipeline look like for therapists and mental health professionals at this point?

00:33:00.030 --> 00:33:01.494
Like, is it a growing field?

00:33:01.494 --> 00:33:05.914
Like, I kind of look at the medical field and it's like nurses are dropping out, doctors are dropping out.

00:33:05.914 --> 00:33:08.342
Is it similar for therapists and mental health professionals?

00:33:09.230 --> 00:33:11.894
Yeah, I don't know the answer to that question.

00:33:11.894 --> 00:33:27.207
I mean, one thing that is really hard, I think, is that insurance companies don't reimburse us very well, so you'd have to have a really big caseload if you're taking insurance to be able, like, live a comfortable life.

00:33:27.207 --> 00:33:41.132
And so a lot of people that are good, don't take insurance, um, and so they can charge kind of whatever, because there's such a high demand and that really disadvantages people that don't have an extra $400 a week to spend on a session.

00:33:41.672 --> 00:33:49.178
Sure, yeah, there's a huge financial barrier, which is one of those impossible problems to try to solve.

00:33:49.178 --> 00:34:00.387
I don't know if you want to get into this, but do you think, like I'm, I have so many issues with the health insurance and the health care industry in general?

00:34:00.387 --> 00:34:02.433
I think the profit motive is just going to.

00:34:02.433 --> 00:34:05.880
The profit motive is doing exactly what it should be doing at this point.

00:34:05.880 --> 00:34:10.097
It's consolidating things, it's driving efficiencies, but none of that is driving better patient care.

00:34:10.097 --> 00:34:14.820
I hate seeing insurance involved in health in any aspect.

00:34:14.820 --> 00:34:23.920
And yeah, so then insurance is supposed to make it more accessible for people, but then, like you were saying, the best providers don't take insurance because they don't reimburse well enough.

00:34:23.920 --> 00:34:27.902
It's just like you feel like you're living in a crazy world.

00:34:28.844 --> 00:34:29.326
Yeah, it's.

00:34:29.326 --> 00:34:30.349
I mean it's really stupid.

00:34:30.349 --> 00:34:37.289
And I, you know, in part of my job I have had the opportunity to consult in other countries, right.

00:34:37.289 --> 00:35:04.346
So I am working on like sort of a group treatment, an online companion app through like the National Health Service in the UK and it's just amazing how they train bachelor's level people under PhD level folks to, you know, so that they have enough providers to be able to to give good care.

00:35:04.346 --> 00:35:10.119
And then also thinking about like group group provision of services so that more people can get benefit.

00:35:10.119 --> 00:35:19.382
Work with the Canadian government to this is actually wild to develop a prevention program for the Mounties.

00:35:19.382 --> 00:35:33.371
So all of the cadets in training for the Canadian Mounties go through a treatment to sort of reduce their neuroticism, essentially so they're less likely to get PTSD out in the field after they are deployed.

00:35:33.371 --> 00:35:39.210
Um, so people are thinking like thinking proactively about you know about some of this.

00:35:39.851 --> 00:35:44.536
Yes, but you mentioned it earlier, where we wait until things are on fire and then we start to put it out.

00:35:44.536 --> 00:35:48.500
Um, it's a very American way, yep.

00:35:48.780 --> 00:35:49.702
Very frustrating.

00:35:50.081 --> 00:35:50.862
Yep, exactly.

00:35:50.862 --> 00:35:59.242
Um, do you have any thoughts on, like some of the more uh, I don't know what the correct term is, but like psychedelic assisted therapies?

00:35:59.242 --> 00:36:08.333
Um, I saw the MDMA treatment was just, uh, rejected from the FDA, but there's ketamine therapy Um, do you have any experience with those or just any opinions on them?

00:36:09.077 --> 00:36:25.298
I, so I don't have any experience um like providing I've had patients that have um gotten ketamine, people with really treatment as a um resistant depression and like have sworn by it, life changing.

00:36:25.298 --> 00:36:51.280
I mean, I think, as, like an academic psychologist, I want to see more research, like I don't want to see the door closed because maybe, if, like maybe if the studies weren't giving like the right dose of MDMA, right, or maybe not quite the right we just haven't figured it out yet, but that doesn't mean we should close the door on it.

00:36:51.809 --> 00:37:01.722
Yep, set and setting all that yeah, I coordinate with a few ketamine clinics out here Um, and yeah, it's just pretty remarkable um results.

00:37:01.722 --> 00:37:16.248
I think it's just something wild about being able to like almost remove yourself, like it's a dissociative anesthetic, so you just really remove yourself from your body and the kind of egoic personality almost that you end up being so attached to and people can.

00:37:16.248 --> 00:37:22.490
Even just getting a glimpse of that can really open up the possibilities for people that are very stuck, as you were mentioning.

00:37:22.992 --> 00:37:29.280
Yeah, I mean, and it's crazy, because what kind of treatment can you do, like one time and get?

00:37:29.280 --> 00:37:42.099
I mean, I know people will come back, but it's like the dose and the frequency is so different right Than like weekly therapy or like you have to take your SSRI every day for the rest of your life, versus like how quickly people can see results.

00:37:42.800 --> 00:37:44.074
Yeah, it's all very interesting.

00:37:44.074 --> 00:37:57.454
And then I guess the other question I had around, sort of like the structure of therapy, which is what I've been thinking more about Is there any research behind like the 50 minute or like one hour session, or is that just more of like an insurance based?

00:37:57.454 --> 00:38:03.338
This is sort of a block we're going to allocate, or do you think like three hour sessions would be more beneficial?

00:38:03.338 --> 00:38:05.570
Do you think different time modalities?

00:38:05.791 --> 00:38:08.384
like three hour sessions would be more beneficial.

00:38:08.384 --> 00:38:09.630
Do you think different modalities?

00:38:09.630 --> 00:38:26.188
There's research out of um no, I am going to kick myself because I can't remember what European country it is but research looking at like dose and frequency and basically like um, the studies show that if you do say there's like a treatment, right, that's 12 sessions and usually it's delivered once a week, right, so 12 weeks.

00:38:26.188 --> 00:38:27.697
But if you do it like a treatment, right, that's 12 sessions and usually it's delivered once a week right, so 12 weeks.

00:38:27.697 --> 00:38:33.813
But if you do it twice a week, you can get people just as much better in six weeks.

00:38:33.813 --> 00:38:41.530
So, like I think there is something to be said by exploring, and so that's something like usually insurance companies won't pay for two sessions a week, so that's something that I think is limiting.

00:38:41.530 --> 00:38:46.119
Yeah and so and yeah.

00:38:46.179 --> 00:38:54.538
So I have seen to like for certain conditions like panic disorder and like ocd, there is really good.

00:38:54.538 --> 00:38:57.672
So these are, these are conditions that really benefit from like what we call exposure.

00:38:57.672 --> 00:39:17.936
So it's sort of like you're afraid of contamination, so we're gonna make you eat I don't know the slice of pizza that's been lying on the ground for two hours, and so there's a lot of evidence that doing that in like a massed way, so like in a shorter period of time, over and over and over again, can be really beneficial.

00:39:17.936 --> 00:39:27.521
So yeah, so I think most of our treatments have been tested in this 50 minute once weekly way.

00:39:27.521 --> 00:39:33.025
But as we started to interrogate that we can see, you know, that we could actually speed up treatment if we wanted to.

00:39:33.045 --> 00:39:34.713
yeah, that's kind of what it's getting at.

00:39:34.713 --> 00:39:36.505
It's like it definitely works right.

00:39:36.525 --> 00:40:06.876
This structure works, but it's like you wonder how much, or if anything, that you're leaving on the table as far as, like, potential benefit of different durations, frequency, as, you're mentioning, yeah because you get, you got to think, um yeah, the, the insurance companies are not doing it, for they're doing it for some sort of convenience sake and some sort of billing and risk management perspective yeah, and so one of the cool things about being like an academic treatment developer is that, um, I can provide treatment however I want in my studies.

00:40:07.478 --> 00:40:10.355
And so we because we don't take insurance, we just give treatment away for free.

00:40:10.355 --> 00:40:20.273
And so we, you know, we do studies where we'll compare six weeks to 12 weeks and then try to figure out who needs 12 weeks and who can be done in six weeks.

00:40:20.273 --> 00:40:25.780
Because if we can move people that can move through the process more quickly, then that will open up spots on a waitlist.

00:40:25.780 --> 00:40:30.583
Or we need to move people that can move through the process more quickly, than that will open up spots on a wait list or, you know, move people off the wait list faster.

00:40:30.583 --> 00:40:43.221
When we think about, like you know, care in a community clinic, you know, or so I mean to kind of bring it back to personality, a little bit like we've been giving people personality questionnaires and then giving them.

00:40:45.112 --> 00:40:56.675
So I guess I should back up and say that there's a lot of data that suggests that really high or low levels of certain personality characteristics are risk factors for different disorders.

00:40:56.675 --> 00:41:00.632
So really low disinhibition is a risk factor for substance use disorder.

00:41:00.632 --> 00:41:05.650
Really high neuroticism is like your emotional disorders, anxiety, depression.

00:41:05.650 --> 00:41:09.690
High neuroticism is, like you know, like your emotional disorders, anxiety, depression.

00:41:09.690 --> 00:41:31.210
So anyway, the idea is that maybe we could make care more efficient by targeting personality instead of targeting symptoms, and so give people personality questionnaire at the start and then you know, if they are elevated on just neuroticism, they get the eight-week neuroticism module, but if they're elevated on neuroticism and disinhibition, then they get, you know, those two modules.

00:41:31.231 --> 00:41:33.295
So it's all of what they need none of what they don't like personalized and potent.

00:41:33.295 --> 00:41:34.898
So this is something that you're testing currently.

00:41:34.898 --> 00:41:36.862
Yeah, Really interesting.

00:41:36.862 --> 00:41:41.159
So like there's some research around that already, yeah, yeah.

00:41:41.219 --> 00:41:46.452
So I mean so in my like day job, I am a you know am a treatment development researcher.

00:41:46.452 --> 00:41:50.576
And we've tested now our personality-based treatment.

00:41:50.576 --> 00:41:54.177
We've tested it with 100 people with borderline personality disorder.

00:41:54.177 --> 00:42:03.264
As kind of like the proof of concept, we just got like a $5 million grant from NIH to test the personalized version of it.

00:42:03.284 --> 00:42:04.626
Yeah, really cool, congrats, thanks.

00:42:04.626 --> 00:42:05.467
I'm like really version of it.

00:42:05.467 --> 00:42:06.148
Yeah, really cool.

00:42:06.307 --> 00:42:06.827
Congrats, Thanks.

00:42:06.827 --> 00:42:15.635
I'm like really excited about it because a lot of times when you apply for money from the government, you have to basically like bastardize your idea so that they'll be like cool, we'll give you money.

00:42:15.635 --> 00:42:22.318
But we actually do get to do this like really cool personality personalization project, just as we wanted to.

00:42:22.318 --> 00:42:23.635
So I'm very excited.

00:42:24.250 --> 00:42:25.534
Yeah, that's just really exciting.

00:42:25.534 --> 00:42:29.096
How many people do you think you're going to be able to enroll in that, or what's the the goal?

00:42:29.096 --> 00:42:37.585
Yeah, it's 230 wow, isn't it crazy how expensive things are yeah, yeah, it's crazy.

00:42:37.684 --> 00:42:42.862
I mean so like for therapy studies, we um for for therapy studies, we actually don't.

00:42:42.862 --> 00:42:51.025
We pay participants to fill out questionnaires, but we don't, um, we don't like, pay them for participating in the therapy, because the therapy is a good value, right?

00:42:51.045 --> 00:42:52.755
Yeah, that's its own benefit.

00:42:53.050 --> 00:42:54.182
And we want to attract treatment-seeking people.

00:42:54.648 --> 00:42:54.769
Yeah.

00:42:54.949 --> 00:43:03.394
So most of the costs for a study like what I do, because I'm not doing brain scans or taking blood or anything like that, it's all personnel you need to pay therapists.

00:43:03.775 --> 00:43:05.541
Yeah, no, exactly that's what I was getting at.

00:43:05.541 --> 00:43:08.302
It's like do you think the treatment for 200 some people?

00:43:08.302 --> 00:43:11.726
Or you think $5 million like that's a lot of money and they're like 200 people?

00:43:11.726 --> 00:43:13.606
It'd be like, yeah, it's about what you're going to get.

00:43:13.809 --> 00:43:14.954
Yeah, exactly Right.

00:43:14.954 --> 00:43:58.847
But then and this is where I think, like prevention, like if you do the math on prevention which I can't do cause I don't know how to do that but like like the cost benefit analysis, right, but like you know, how much money do we lose in like disability and lost wages and limited like productivity for gross domestic product or I don't know economics things, right, that like, could that $5 million be like such a drop in the bucket compared to all of the money that's lost by these 230 people not being at their highest potential?

00:43:59.487 --> 00:44:08.961
Yep, yeah, I always think it's weird that this is the justification we have to make in America, where it's like you need to make the the financial and capitalistic justification to do something.

00:44:08.961 --> 00:44:13.981
Um, but yes, I, I think, I think there is a fair amount of research around that.

00:44:13.981 --> 00:44:24.954
Uh, as far as like lost wages, lost productivity days, not like time off, um, yeah and I think there's an enormous benefit to prevention, at least on the medical side.

00:44:25.014 --> 00:44:26.418
You see that very clearly.

00:44:26.418 --> 00:44:36.391
And also, I want to make sure like I'm only making the distinction between medical and mental health, because that's how our healthcare system does it, but they're obviously super well intertwined.

00:44:36.391 --> 00:44:42.431
So we're kind of wrapping things up now, but do you have any closing thoughts that you want to leave the listeners with?

00:44:42.431 --> 00:44:44.896
This has been a really fun conversation, by the way, so thank you as well.

00:44:44.916 --> 00:44:45.677
I did this.

00:44:45.677 --> 00:44:46.418
This has been great.

00:44:46.418 --> 00:45:05.655
Um, yeah, I mean from like a a personality test kind of perspective, I'd say you know, don't let a personality test that you took for free on the internet limit who you can become right, because personality changes over time and you actually have more control over the direction you shift.

00:45:05.655 --> 00:45:06.717
You can shift it.

00:45:06.717 --> 00:45:09.402
Then I think people give you credit for.

00:45:09.402 --> 00:45:17.603
And then from kind of the therapy side of things, like I said before, change can be really hard.

00:45:17.603 --> 00:45:30.760
But I've seen people that were really suffering, that were able to kind of stick through that like it gets worse before it gets better phase and are living, you know, a values driven and very purposeful life.

00:45:31.822 --> 00:45:33.085
Great, I really appreciate it.

00:45:33.085 --> 00:45:43.956
I think it's very easy for people to sort of get locked into, like you were saying, those personality tests, and people can just kind of lament or lay back on the oh, I'm this way, I'm that way.

00:45:43.956 --> 00:45:51.039
And I think it's really refreshing and encouraging to hear like you're not relegated to that specific personality type.

00:45:51.039 --> 00:45:53.791
You can change, evolve through nudging.

00:45:53.791 --> 00:45:58.523
We're going to link to a lot of your resources and congratulations on that grant.

00:45:58.523 --> 00:46:01.059
I think pushing this research forward is really important.

00:46:01.949 --> 00:46:02.713
Yeah Well, thank you so much.

00:46:02.713 --> 00:46:03.617
Thanks so much for having me.

00:46:04.150 --> 00:46:07.072
Yep, thank you very much, hey everyone.

00:46:07.072 --> 00:46:08.233
That's all for today's show.

00:46:08.233 --> 00:46:09.253
I want thank you so much.

00:46:09.253 --> 00:46:10.514
Thanks so much forpodcastcom.

00:46:10.514 --> 00:46:12.235
That website will also be linked in the description.

00:46:12.235 --> 00:46:38.255
As always, likes, shares, comments are a huge help to me and to this channel and to the show.

00:46:38.255 --> 00:46:39.438
So any of that you can do I would really appreciate.

00:46:39.438 --> 00:46:40.280
And again, thank you so much for watching.

00:46:40.280 --> 00:46:40.961
I'll see you next time.

Transforming Personality Traits for Personal Growth with Dr. Shannon Sauer-Zavala

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