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Automatic TRANSCRIPT

The one thing that the research shows clearly in terms of the benefits benefits of therapy in other words. What is it about a given therapist that increases the probability that professional is going to be effective? Have good outcomes and most of the research shows that the thing the necessary ingredient that distinguishes someone who is effective versus. Not so much is deep. empathic atonement so no matter. What kind of therapies being used to have that empathic attuned other person in the room with you seems to be the sort of secret sauce? The magic ingredient that makes treatment Effective and that is categorically. been my experience so I'm not surprised by that. Found the finding now that still doesn't mean that Just empathy is all you need right. You need a certain kind of treatment and there are many treatments out there now. That are so called evidence based and so let's just talk About not just the treatment but also how to navigate the system generally speaking the way. No one whenever does this but the way it ought to be done. It should be done properly is you. I realize you're having symptoms If those symptoms are causing you difficulty the functioning which is sort of the threshold between you know just being miserable or having the blues and really. They're being medical problem. Trouble functioning and workers worker school relationships your cognitive functioning your legal functioning your work putting all those areas school functioning. Something's not going quite right. And you'd have some symptoms symptoms. That is a marker for medical treatment. I think you should always start with your primary caretaker and have a medical evaluation because I cannot tell you how how frequently psychiatric symptoms are the presenting manifestation of medical problems so the first thing is to rule out a medical problem. Then we'll have that ideally because again one of the problems with mental health services in this country has had. Who Do you go to how do you? How do you know what's not good? It's a pretty random process. I actually spoke about this at length yesterday. And a podcast called whiskey ginger with Andrew Santino. You like whiskey ginger. I love that show. You're a very a funny guy. He's very funny. He's a good interviewer too. So we get into some heavy stuff and so again you can hear more about that whiskey ginger and so then I I in my mind the way to do this properly as the primary caretaker refers you to a psychiatrist psychiatrists than does does a diagnostic. workup a medical psychiatric workup and comes up with a framework of diagnostic impressions. To help us understand what's going going on with you when you know. One of the things in medicine is if you don't have a diagnosis. You don't have a treatment. The treatments that we use are studied in the context of a particular diagnosis so up the treatments treatments are applied without the diagnosis. You're not likely to have a good outcome. So first and foremost does is. They're accurate. Diagnosis in is this an evidence based treatment for that diagnosis. Oh so proper diagnosis and treatment. Then that because the contrast are physicians they should make a decision as to whether or not pharmacotherapy. It'd be appropriate then. Ideally yeah that's a Kayak will refer you to the type of therapist you need. Cognitive behavioral therapies are very effective these days dialectical behavioral therapies for people that have personality analogy issues emotionally focused therapies for couples and people that serve longer term exploration difficulty accessing feelings regulating emotions. You may be referred specifically to Mutual Aid Society peer base things which are evidence based treatments and they are free. And they're on every corner things. I Dan twelve step that kind of thing. Then they're sort of many many other categories out there like if you say failure pharmacotherapy there might be trans cranial magnetic stimulation relation where these magnets to to raise the chemicals in the region of the brain associated with depression extremely effective therapies with almost no side effects. Or are you going to be said for mindfulness. RPM again a train. You at mindfulness or do you need physical Rehab and just get yourself mobile. They're all kinds of ideas about how to optimize mental health intervention. Do you need vocational rehabilitation. Should you be changing your work is there. Are there problems in a relationship where you need to have somebody come in and Brealey sort out. What's going on into personally or in the family dynamics so there's a lot of ways to approach these things and the professional should be making the decisions? The individual trying trying to navigate this. I'll be willing. It would be