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Judye Hess, Ph.D. - Guest
Judye Hess, Ph.D., has worked with families since 1974 when she began her family therapy career at Worcester Child Guidance Center in Worcester, Mass. In 1977, Judye moved to the west coast and found a home at Xanthos, a family counseling center in Alameda, CA, where she worked for the next three years. In 1984, she began teaching at the California Institute of Integral Studies, where she was on the core faculty and taught family dynamics, couples counseling and group process until 2015. She is the author of Core Focused Family Therapy: Moving From Chaos to Clarity and she is now Professor Emerita from CIIS, and since then has maintained a private practice, seeing couples and families of adult children exclusively. |
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W. Keith Sutton, Psy.D. - Host
Dr. Sutton has always had an interest in learning from multiple theoretical perspectives, and keeping up to date on innovations and integrations. He is interested in the development of ideas, and using research to show effectiveness in treatment and refine treatments. In 2009 he started the Institute for the Advancement of Psychotherapy, providing a one-way mirror training in family therapy with James Keim, LCSW. Next, he added a trainer and one-way mirror training in Cognitive Behavioral Therapy, and an additional trainer and mirror in Emotionally Focused Couples Therapy. The participants enjoyed analyzing cases, keeping each other up to date on research, and discussing what they were learning. This focus on integrating and evolving their approaches to helping children, adolescents, families, couples, and individuals lead to the Institute for the Advancement of Psychotherapy's training program for therapists, and its group practice of like-minded clinicians who were dedicated to learning, innovating, and advancing the field of psychotherapy. Our podcast, Therapy on the Cutting Edge, is an extension of this wish to learn, integrate, stay up to date, and share this passion for the advancement of the field with other practitioners. |
Keith Sutton, Psy.D.: (00:24)
Welcome to Therapy on the Cutting Edge, a podcast for therapists who want to be up to date on the latest advances in the field of psychotherapy. I'm your host, Dr. Keith Sutton, a psychologist in the San Francisco Bay Area, and the Director of the Institute for the Advancement of Psychotherapy at the Institute for the Advancement of Psychotherapy. We provide training in evidence-based models, including family systems, cognitive behavioral therapy, emotionally focused couples therapy, eye movement to sensitization reprocessing, motivational interviewing, and other approaches through live in-person and online trainings, on demand trainings, consultation groups, and one-Way mirror trainings. We also have therapists throughout the Bay Area and California providing treatment through our six specialty centers, each grounded in evidence-based approach with our Lifespan Centers, Center for Children and Center for Adolescents, where all the therapists are working systemically. Our Center for Couples, where all the therapists are using emotionally focused couples therapy and our specialty issue centers, our Center for Anxiety, where all the therapists are using CBT and EMDR for trauma.
Keith Sutton, Psy.D.: (01:26)
And our center for ADHD and oppositional and Conduct Disorder clinic, where we're integrating those four approaches. In the institute. We have our licensed experienced therapists, and for those in financial need, we have an associated nonprofit Bay Area community counseling where clients can work with associates, psych assistants, and licensed clinicians who are developing their abilities and expertise. Additionally, as part of our nonprofit, we also have the Family Institute of Berkeley, where we provide treatment training and one-way mirror trainings in family systems. To learn more about trainings, treatment and employment opportunities, please go to sfiap.com and to support our nonprofit, you can go to sf-bcc.org to donate today to support access to therapy for those in financial need, as well as training in evidence-based treatment, BACC is a 501C3 nonprofit, so all donations are tax deductible. Today, I'll be speaking with Judy Hess, PhD, who's worked with family since 1974 when she began her family therapy career at Worcester Child Guidance Center in Worcester, Massachusetts.
Keith Sutton, Psy.D.: (02:31)
In 1977, Judy moved to the West coast and found a home at Zant Thoses, a family counseling center in Alameda, California, where she worked for the next three years. In 1984, she began teaching at the California Institute of Integral Studies, where she was on the core faculty and taught family dynamics, couples counseling, and group process until 2015. She's the author of Core Focused Family Therapy, moving from chaos to clarity, and she is now Professor Emeritus at CIIS and since then, has maintained a private practice seeing couples and families of adult children exclusively. Let's listen to the interview. Hi, Judy. Welcome.
Judye Hess, Ph.D.: (03:11)
Thank you. Thank you, Keith. Appreciate being here.
Keith Sutton, Psy.D.: (03:15)
Judy, I'm so excited to talk to you. I've known you for a long time as a member of the Association of Family Therapists in Northern California. You've been providing family therapy and also you are teaching family therapy for many years at California Institute for Integral Studies, and I was always so impressed one of your teaching techniques, and I might be getting this wrong, but would be that you would have the students bring in their family to do a family session or if their family couldn't come in kind of doing a role play with the family, but basically you're teaching family therapy through doing live sessions.
Judye Hess, Ph.D.: (03:53)
Exactly, yeah.
Keith Sutton, Psy.D.: (03:54)
Yeah, I'm so interested to hear about your work and your thinking. We're actually gonna have you do the one-Way mirror training for Our Family Institute of Berkeley, which is over Zoom, which is accessible all over. But before we even get into that, I'd like to find out, I am always interested in kind of, you know, how you got, doing what you're doing, kind of the evolution of your thinking and, and how you got to this work.
Judye Hess, Ph.D.: (04:17)
Sure, sure. Great. Okay. Well, let's just start with me, being born into a family with a psychoanalyst father and a sister who soon became a clinical psychologist and a psychoanalyst herself. And so I just got so interested in psychology, I used to watch these, you know, programs, mental health and illness programs with my dad when I was like 10. And somehow I just, there was a movie called Sneak Pit back in the day, and I just remember, “Oh my God, I wanna learn more about this, it’s just too amazing.” But I, you know, I studied, I went to grad school, learned all the different ways to do therapy. However, this was back in the seventies, and there was no class in family therapy. That was before it really got, you know, on the map. And so, when I graduated, well, when I was doing my dissertation, I was also part-time working at a youth guidance center in Worcester, Massachusetts, where actually Freud gave his first talk at Clark.
Judye Hess, Ph.D.: (05:49)
Yeah. And so when I was–it was a youth guidance center. I was kind of doing it for a part-time job for money and experience, but I was not into the kids and adolescents part of it, so I thought, “I don’t know how I'm gonna pull this off,” but I just turned out I had a wonderful supervisor, a guy named Elliot Brown, and he had just graduated from the first family Therapy Institute in New York, the Ackerman Institute that trained family therapists. And he, so we were talking, I said, “Well, I don't know. I'm not really into doing this play therapy or whatever.” And he said, “We'll see the whole family then.” And I, that was really the first thought. “Are you kidding? What am I gonna do with all these people?” He said, “Don't worry, just you'll tape it and we'll go over the tapes together and it'll be fine.”
Judye Hess, Ph.D.: (06:53)
Give it a shot. And that was the beginning. And I just immediately fell in love with this process. And it just, you know, I had been, you know, into couples and groups and things like that, but it just felt like coming home. And it was also what I found was very healing for me because my family wasn't the most highly functional, you know, I mean, educationally yes. But, all other kinds of stuff there. And I just felt like when I was working with these families, I would be healing myself. And I mean, how good is that? I'm getting free therapy and I'm helping other people. And it was more, it was like a passion. I just absolutely loved it. So, I mean, I felt like, okay, this is the way that I'm gonna go.
Judye Hess, Ph.D.: (07:59)
And I, when I moved out to California, I started working at a family counseling center called Zans in Alameda. And, it was one of those places where you didn't get very much money, but you got the experience and you could sleep late because the class sessions were from 12 to 8. So it was perfect and pretty close to my house. So I did that for three years. And during that time, I began studying with Alan Leviton, who was the former–I don't know if he was the first president of AFTNC, I'm not sure. But early on he was there, and he was a great fan of Whitaker and Satir. And he actually had a workshop with Whitaker down in Santa Cruz. And I, I mean, I sat there and had a conversation with Whitaker, you know, how cool is that?
Judye Hess, Ph.D.: (09:08)
And it was, I just felt like, yeah, I am at home and this is where I belong. And so then I got a job at California Institute of Integral Studies, called CIIS here. And I got a–I had to do an interview in which I did a role play with a family, and they just said, “Okay, you're hired.” And so this was, just beyond my wildest dreams that I could actually do this for as long as it was going to be. And so I started teaching there, and as you said the format was to have the students bring in their families if they could, or even a brother, sister, whatever, or we do the role plays. But when people would role play the family members, they would talk to the family member on the phone beforehand and ask that person all kinds of questions so that they could really get into the part.
Judye Hess, Ph.D.: (10:29)
And then when we would do the session and that person might say something, the role player that registered to the central figure, as, “Did my sister tell you that?” And so it was–there was a, you know, a validity too, it wasn't just somebody making up what they thought was probably good for a mom or something, but it was really–it was so powerful. And I–we could only do one session because it's therapy and you know, the dual relationship thing. And they were allowing me to do a demo. So this was called “Demo.” And the people were–it's a very experiential school.
Keith Sutton, Psy.D.: (11:22)
I was gonna say CIIS is known for being very experiential, very kind of mixing of Western and Eastern and so on here in San Francisco.
Judye Hess, Ph.D.: (11:33)
Absolutely. And that was perfect for me because I was already going to SLN and loving that whole experiential thing. So anyway, then when the families would come in, it was incredible because they would be witnessed by the group, and then afterwards the group would give feedback. It's kind of like a reflecting team. Yeah. And I mean, they were taught not to say, “You were so controlling.” You know, that they could say, “Oh God, you know, I just wish my family could do this and be so open.” And so the families just felt really wonderful and supported. And here they're paying exorbitant fees for their kids' education, and they're actually saying, “Oh my God, is this what they do?” And it was a charm. And I just worked there for 30 years.
Judye Hess, Ph.D.: (12:42)
It was, you know, I used to say to people, I would do this job even if I didn't get paid. And it was true, I just really enjoyed it. Part of the thing that was really influential was I would, when the real family came in, we would tape them. And then I had one of my students who was totally fascinated by what I was doing. And he got all these tapes and he had taken all my classes, couples in groups, so he knew my way, and he put them together, the examples from the real cases with the ideas that I was trying to promote. And it came into a book Wonderful. Which is called Core Focus Family Therapy. That was in 2008, and it became the textbook for the class.
Judye Hess, Ph.D.: (13:53)
And it's a very user-friendly book. It's like, this could be good for somebody who's done this for a while, and it could be someone who's brand new. Like, what do I do? It's very, how to step one, step two. So one of my little things–recommendation testimonials. Right. Said–I think it was Marty Kirschenbaum said–no, Dan Weil, he said, “This should be required for every student of family therapy ever.” And so that just–it just shaped my career completely.
Keith Sutton, Psy.D.: (14:43)
So, can I ask you about your style–and I know now you're not teaching and you've got a private practice, right? And you're working with families, and particularly one of your areas of specialties is adult children. Is that right?
Judye Hess, Ph.D.: (14:57)
Yes. Exactly. Yeah.
Keith Sutton, Psy.D.: (14:59)
So, I'm curious about your strategies kind of in working, especially doing these, you know, kind of one-time–kind of interventions with these families and so on. What was your focus or goal, or kind of, were you just kind of going with the process and then kind of seeing what came out of there more of a structural way? Or did you have kind of a direction that you were shooting for? Tell me a little bit about the thinking there.
Judye Hess, Ph.D.: (15:30)
Yeah. Well, like I said, Whitaker and Virginia Satir were my models because they were very experiential. The critics of them say they're just shooting from the hip. But to me, that meant using your intuition. And so that's what I felt was the most helpful thing. And part of what I–a chapter in my book is like, “What are the qualities for becoming a poor focused family therapist?” And so it's not like anybody can do it. You have to have certain qualities of communication, style, openness, and warmth, but still being able to confront the truth. One student had written about the book, about my style. She said, “It’s love and truth.” And so I would say those are my overall guiding principles to let them know I'm on their side.
Judye Hess, Ph.D.: (16:40)
Of course I'm trying to get the focus off the identified patient. And I have a whole chapter on that of, “How do you do that?” “What kind of interventions?” Like, for instance, most families walk in, why are you here? “Janie, Janie, Janie, Janie,” and then, you know, it sort of is counterintuitive because some person would just say, “Oh, okay, well, let's talk to Janie, what's going on?” And make that assumption that, yes of course they all said it must be true Janie's the problem. So that is the total opposite of what we want to happen. We want to give the family the truth, which is a very hard truth to swallow. That this is not just about Janie, there's other problems going on in the family. Now, I'm not gonna say that's the way it is. I'm gonna ask, maybe not the parents, but maybe the siblings, “Are there any other issues that you see in the family?” And try to expand the space of what people are looking at. What did I call it? Increasing the surface area of the problem.
Keith Sutton, Psy.D.: (18:08)
Nice.
Judye Hess, Ph.D.: (18:09)
And so–I have a whole list of things to do. Shifting the conversation to get it off the identified patient, giving space for other people to talk about problem areas, and–but still to validate that the parents aren't crazy. This kid's getting in trouble. You have every right to be worried about his behavior. And there's also something else. So we're not criticizing or challenging, we're really just saying, “And there's more.” And it's amazing.
Keith Sutton, Psy.D.: (18:51)
Yeah. I like the idea of expanding the space. Because–
Judye Hess, Ph.D.: (18:54)
Expanding the space.
Keith Sutton, Psy.D.: (18:56)
Context and how all these pieces of the puzzle are kind of fitting together rather than just in isolation the IP. Right? I think in a brief strategic family therapy call–they call it kind of spreading the IP hood, you know.
Judye Hess, Ph.D.: (19:09)
Yeah. Exactly. Exactly. And–
Keith Sutton, Psy.D.: (19:12)
Everybody has a little piece of this puzzle. Yeah. Very cool.
Judye Hess, Ph.D.: (19:18)
Right, right. It's–I would say that it's almost–it's organic. As soon as you start to ask the other people in the family, “Well, what do you see?” And the 5-year-old could say, “Well, mommy and daddy fight all the time.” And you're off and running because parents–they've been afraid to say that to the parents. So all of a sudden they have this forum where they can tell their truth, and then another one will pop in, “Well, I have–you know this and this problem.” And then it be the thing we don't wanna do is jump in to make it the parent's fault. Yeah. That's also another thing that people who don't know how to do this might do. Okay. Well, “What are you doing to make Janie act out in this way?”
Judye Hess, Ph.D.: (20:19)
Because I think family therapy is a risky thing for people. I really do. They're petrified. I mean, even the students would be, “What? I'm not gonna bring my family in. You kidding?” And then after a while, they saw how it all happened and was so healing that, you know, they were lining up to do it. But just the gut feeling is “I've been hiding stuff from my parents and family for years. I'm not gonna go and talk about stuff.” And then they've–but once given a chance, you know, you take the cork out and it all spills out into the room. And then we do–okay, one other thing.
Keith Sutton, Psy.D.: (21:12)
Perfect. I was gonna ask, once you've now expanded and everybody's putting out all the pieces of these puzzles, what next?
Judye Hess, Ph.D.: (21:19)
What next? Okay, good. I'm glad you asked. The next step, and I call this like a three step method–first there's a check-in where we just ask, “Hi, how are you? What's your job? Do you like it? What grade are you in?” You know, just really simple things. And so they start to feel comfortable. Whitaker used to call that the anesthesia before the surgery.
Keith Sutton, Psy.D.: (21:50)
Oh.
Judye Hess, Ph.D.: (21:51)
So you're letting them feel a little bit more comfortable because they're often really on edge. And “Okay. I can talk to this person, doesn't have fangs, and maybe I can say something.” And then once we do the check-in–and this is what I tell students while they're doing the check-in, “I'm looking for which dyad do I think it would be good to start working with.” And that's when we get into the heart of this, which is I call, “The direct interaction.” And–in a class, what I might do now if I'm teaching is say, “Okay, while you're watching the check-in, think about which two people you might want to have–do a separate dyad.” And then afterwards people say all kinds of things.
Judye Hess, Ph.D.: (22:57)
“I'd have the parents.” Well, no, and I usually say–and not, “Don't just go for the parents.” So they come up with different things, and then I can kind of accept them. “Oh, yeah. That would be good.” Like, well, if there's like–okay, so we have a teenage girl and a mom who are always fighting with each other. If we do a direct interaction with the two of them, they're just gonna be fighting and everyone's gonna say, “This stuff doesn't work.” So we try to find something that is real, but still doable. Where something actually could get resolved, let's say. And you can kind of tell when people are checking in, right. Just how open they're gonna be. Let's say it's, even a sister saying, “Well, yeah, I used to be really close with my brother, but, you know, as soon as he got to be friends with these other boys, he just won't include me at all.”
Judye Hess, Ph.D.: (24:08)
Okay, so maybe–and the brother says, “Well that's 'cause you're always a pest.” So we–maybe that's a safe one to start with. And so we would have–I mean, in the old days, we would have people move their chairs so that they would be looking at each other directly. I think Uch Mnuchin did a lot of chair moving. And so then they would–they're having the direct interaction and you just kind of let it go. If it's working, let's say, the girl, the young girl is, you know, saying, “I just really miss you.” See, the idea is to get to the vulnerability, be behind the defenses, because, you could go unitl the cows come home with defensive behaviors. It's not gonna work. People–just human beings, they're not gonna feel safe.
Judye Hess, Ph.D.: (25:14)
So we–if it looks like she's gonna be able to be vulnerable, then we have a chance for the boy to be. However, if he's not, if he jumps in, which he very well could with, you know, like that, “Well, you're just a pest and we don't want you,” okay. “But, John, you said you did want to have some healing happen in this family, and I hear that your–you agree, you and your sister used to be closer. And is there a part of you that would–that misses that closeness, that would like to feel close again?” “Well, maybe,” and then what I might do if nothing else is working is, “Can we go back to a time when you two were close, and just tell me about what did–were you, you know, going biking together?”
Judye Hess, Ph.D.: (26:14)
“Were you having ice cream? What do you remember that was a good time?” And the–I'm the guide. And, depending on how sophisticated the people are, they'll either pick it up and just go right for it, or–I'll, you know, have to work a little harder, but then other people see what's going on. And again, they go, “Well, that looked like it worked. Yeah, well, as a matter of fact, I'm having trouble with my son too,” and then maybe we do a mother son or a father son. And then it just takes off from there. And yeah.
Keith Sutton, Psy.D.: (26:58)
So you're kind of starting off just a little like, “Hi, how are you doing?,” like, kinda anesthesia before the surgery, and then you're kind of spreading the IP hood, like finding out what's going on a little bit. And you're kind of assessing for, you know, who's open. You might not go for the hottest kind of piece of the system that's struggling, but you might kind of look for a dyad outside of that central, you know, kind of stuck conflict and then get a little work going, which might be some of the–I'm thinking like low hanging fruit that you could do something with. And then that gets going, which then brings about maybe some openness from the others, or some hope or some sense of potential that this could be helpful. And then kind of working with those different dyads.
Judye Hess, Ph.D.: (27:48)
Exactly. Exactly. It's pretty simple. I mean, it's simple, but not easy. But you can learn these steps pretty well. And then if you have the basic personality, I mean, there's some people that's just not the way they are. I mean, they might be much more thinking types than feeling types, and maybe they would be more into the structural strategic, “Oh, let's see, if I do this here, it'll work.” But this is more for people–it’s sort of a right brain mixed with left brain, you know, it's both like people say it's thinking and feeling. Whereas some of these people are just, like Satir. I don't know if that's a fair criticism, but it's all about feeling. And, you know, “How do you feel, how do you feel?” People get really tired of that. So I can sort of flip into just saying, “Well, look, you know, if you want this to change, this is what you're gonna have to do. And look at the effect it's having on your whatever sibling.”
Keith Sutton, Psy.D.: (29:07)
Yeah. That's some of the truth part.
Judye Hess, Ph.D.: (29:10)
What's that?
Keith Sutton, Psy.D.: (29:10)
That's some of the truth part you'll get?
Judye Hess, Ph.D.: (29:16)
Yes, right. Exactly. And then just to finish off, that is the last thing, which is the checkout. And that–I mean, the check-in is important because maybe that's going to be the only time that person gets to talk in that session. Whereas, at least they, “What did I come here for? Nobody asked me anything.” And then we do that at the end too. “What was important for you and what stuck out for you?” And then let's say somebody does–“Well, it was all about my sister. I didn't get to talk at all.” “Okay. Thank you, Sally, for saying that, because next time I am making a note of it that we're gonna start with you and, you know, you are important and your feelings” and all that. So, yeah.
Keith Sutton, Psy.D.: (30:11)
Wonderful. Now, tell me, I know for a lot of folks, family therapy can be very intimidating because they're afraid to have, you know, so many people in the room together and it might get out of control or whatever it might be. Can you speak to that or how you think about that, or what you do if it's getting heated, or so on?
Judye Hess, Ph.D.: (30:34)
Well, I am–I've come to the conclusion, not hardcore, but that people tend to be either more interpersonal or more intrapsychic. And this kind of work, I think the people that are scared of it are more of the intrapsychic. I mean, that's where they go with their comfort is just talking to one person because they don't get so overwhelmed. And doesn’t mean there's plenty of individuals that need help, so that's great. But, over the years, I've just realized that that's not what I wanna do. I wanna do, you know, short term, maybe three months, six months, three sessions, maybe one session. I mean it all–when I heard students saying, you know, “I've been in individual therapy for five years, and when I just got out of that session, it is more helpful than any of that.” And I really–I thought, “Okay, he's not the only one,” you know. And of course that's not gonna be for everybody. And of course, his five years of individual has probably helped him get to the point where he can, you know, really get into the family therapy. So, yeah. And I don't, I mean, I have met people–“No, I love both equally,” and that's fine too. But–
Keith Sutton, Psy.D.: (32:18)
When managing kind of–a family where there's some escalation or so on. It sounds like one you're kind of maybe picking, not necessarily the most entrenched kind of dyad. But yeah. What if things start kind of escalating or so on, do you have any kind of strategies or ways you think about, kind of, dealing with that?
Judye Hess, Ph.D.: (32:43)
Yeah. Well, I think–well, I could probably go into this later. I don't know if we'll have time, but how I moved on to working with adult children.
Judye Hess, Ph.D.: (33:00)
Rather than kids, not that adult children can't have screaming fights with their family members, but it's, you know, they're saying that they know we speak the same language. Yeah. I can–if I can reason with them, it seems to calm itself down. And I mean, even with couples, I'll see if, you know, couples that they could start screaming each other. And I, you know, “Hey, you guys, I can't work when I can't hear both of you. You're interrupting each other.” I just put it on me. “I just can't do my job. So if you can't try to, you know, be a little calmer about it, I wanna hear your feelings.” But, it could be–it used to be my office, you know, the, “You could wake my whole other colleagues up here.”
Judye Hess, Ph.D.: (34:03)
And so it seems like that it doesn't come up at–it did when I first worked with teens back at Xanthos. And, you know, it was a long time ago. I'm not sure exactly what tap I took. I do remember people getting mad. And sometimes I remember even standing up, like, “They're not listening to me. I'm–I have to really make myself, you know, a force in this family.” “Look, we can't do that. I wanna hear what you have to say. We all wanna hear what you have to say, but, you've gotta do it at a, you know, a tone that we can deal with.
Keith Sutton, Psy.D.: (34:53)
I think too that, you know, it's also right–the therapist, as a family therapist, you need to be active. You need to be containing the family and creating safety versus maybe just hanging back and following, you know, along so that there's this kind of piece that's necessary in helping to contain as well as–yeah, like you're saying, different ways of kind of intervening. But I think part of what I'm hearing too is that as you got going along right, there's more confidence or more ability to kind of feel, you know, that grounded. And I think for students, sometimes it's a little overwhelming for them to have more than one person in the room or so on. But with time and practice, it gets much easier. Tell me–
Judye Hess, Ph.D.: (35:40)
And also to recognize the power that you have. If you go, “Oh my God, this family, they're all screaming, what do I do?” You've lost them. But if you can somehow either fake or really feel like “I'm the one who's in charge here.”
Keith Sutton, Psy.D.: (36:00)
Kind of like a leadership position.
Judye Hess, Ph.D.: (36:02)
Exactly. Exactly. Yeah. I'm gonna–I'm running the show and I do have people that come in and they wanna run the show, not screaming, yelling, but interrupting me and saying–or I'm talking to one person and then that other person jumps in to say–to be helpful to explain. “Well, you see, the thing is when she was ten–,” and I have to say, “Okay, we'll let her tell us the story.” And sometimes they're just so compulsively helpful that it's–I have to tell them a few times, I asked, you know, Sarah and I really wanna hear it from Sarah. And I was just–I remember this guy said, “Well, time is of the essence, and I was just helping you get more information.” I said, “We got all the time in the world.” Yeah. So, I’m hopeful.
Keith Sutton, Psy.D.: (37:02)
Great. Well, tell me about–the work with adult children because I think a lot of times–people think of family therapy, they think of kids, they think of teenagers. Tell me about your kind of move into that area.
Judye Hess, Ph.D.: (37:16)
Oh, sure. When I got out–when I stopped teaching, I wanted to develop a private practice, which, you know, I didn't–I had saw clients, but it was like, I never advertised it. It was just like, “Hey, I have a full-time job at CIIS of getting paid enough. I don't really need to, and I hate marketing anyway. I don't need to do that. Whoever comes to me, great.” I saw what I was just doing private practice that I needed to reach out more. And I was starting to get families of you know, with young kids. And I just realized I've spent 30 years doing family therapy with adult children who happen to be grad students, which you don't always get. And I said, “That's–that's what I'm good at.”
Judye Hess, Ph.D.: (38:26)
I don't have kids. I don't know, you know, is that unusual for a three-year-old? You know? So, that's–I just thought I better go with my expertise. And then when I started advertising as a family therapy with adult children, I just started getting a lot of calls. Evidently you could–people haven't caught onto that one yet. I'm sure they will. But, that they–if they plug that in, that they're probably gonna find me. And so it's–I mean, a lot of these families aren't the calm, sophisticated families I would get with the grad students. But, at least I feel like I'm in the league of comfort. “Yeah, I know what I'm doing.” Maybe they're a little bit further out in some way.
Keith Sutton, Psy.D.: (39:31)
Talk about like–what are the common things that people are coming to you for? Or is there, you know, I know that there's been a lot of talk about families and cutoffs and so on. You know, that I've had families where there was the parent who is going into, you know, kind of their seventies or so on, and wanting to kind of get closer to the kids, repair some of the past, or I've had family conflict where two siblings got into it. And then, you know, it's very hard for the whole family to get together anymore. What are people usually coming in for?
Judye Hess, Ph.D.: (40:07)
Well, that is such a common thing that I don't think I even realized while I was seeing the students and their families for just one time. Because if the parents were gonna come, they probably had some kind of a decent relationship. But I get calls now from people who haven't talked to their families for four years. And either sometimes it's the adult child who feels like the parents cut them off. Other times it's definitely the parents who feel like their child cut them off. And I would say it's probably more the parents that have that feeling that “We gave you everything. You don't even talk to us, you won't even answer or call.” And they're just bereft. And I just came across a person who was in the Bay Area who specializes in estrangement with families.
Judye Hess, Ph.D.: (41:17)
It's a guy named Josh Coleman. And evidently he had a daughter who was in that situation where he was struggling because there was a cutoff from her. And he just has outlined things that I sort of knew intuitively. But–like what the issues are spelled out clearly is it, you know–I mean the typical first thing I would, you know–I was so controlled by you for all those years. Now I'm a free person. I'm gonna do what I want. And then there's always money issues I really wanna separate, but I still am financially dependent on them. There's–and then it could be a gang up, just like it, it would be with an IP, “Oh, we are all close together. Just, Joe is the bad one.”
Judye Hess, Ph.D.: (42:24)
And so sometimes I will even see the “bad one” individually to find out, well, what I know you think it's all your parents hate you and the family won't invite you to functions. And it's all that. But is there anything that you feel like you are doing that is keeping that dynamic going? And, you know, they're usually very attached to blaming the family, but, they, you know, everybody wants to be connected. Even if your parents were abusive you want to–even if you don't want to see him more than once every five years, there's still, I think, a basic human need to feel like there is, I'm recognized. I'm a person. I'm seeing somebody right now, and that's his goal. He's like in his forties. And he came, “what I just want is to be validated by my family.”
Judye Hess, Ph.D.: (43:30)
Because they think he's a, you know, a loser. And so now I'm doing a combination of individual and then the father and that family is the one that's a little bit more receptive. So doing some sessions with him and then to, and then I can see it, I can see what the “IP” does to push the father away. Father is like, “I love you so much.” And I was like, “Oh, I don't believe you.” You know? I said, “He's just gonna clam up.” You know, I tell, I give them a strategy. You know–I even said, “Even if you don't feel it, let's just be strategic about it.” You know, somebody said that to you. What would you do? Well, I'd probably back away too. And so we–I kind of–a lie with them too, you know, like, at least you've got me. Yeah. And I understand what you're saying. I hear you're having a really tough time there. And we have to look at what you're doing to maintain that too. And so that's one piece.
Keith Sutton, Psy.D.: (44:43)
–being seen and that vulnerability. And I worked with one adult child and parent. And, you know, when she would feel seen by the mother, I'd explore what was going on. And she said, you know, I feel love. And then when I asked about the emotion, she said, I feel fear. Like her reaction was fear, right. Feeling that love, because then, right. She could be hurt. She didn't wanna have that hope or so on. Because it can be scary to potentially get that, but also get let down again. Because people aren't perfect. And especially if that's been such a painful thing that you've kind of built up a wall to kind of protect yourself and stuff.
Judye Hess, Ph.D.: (45:26)
Exactly, yeah.
Keith Sutton, Psy.D.: (45:29)
And so you might do just like a separate session with the dad and the son, or would you have the other family members there kind of witnessing?
Judye Hess, Ph.D.: (45:37)
The family in this case, the family would not come in. The father was the only one. And it–I mean, I do believe the adult child that the father is dominated by the mother. And the mother wouldn't even want to know that the dad was coming in. So it will probably be a little while. And when I ask the father well, do you think we could get your wife in here? Well, no. She’s very fragile and I think she would be upset. She doesn't sound very fragile. She's controlling the whole family. But in his mind she's the boss, so it will be slow. But, the first time I met with this, the “IP,” that's what he wanted. He chose me because I knew about families. And he wants an ally. And I am his ally. I don't, you know, he doesn't really wanna be challenged, so I have to do it really softly. But, yeah, when I–it's like the proof is in the pudding when I see dad crying, and you're not even moved by–I said, “You know, you can't make yourself cry.” Yeah.
Keith Sutton, Psy.D.: (46:58)
I see what's going on in the process there.
Judye Hess, Ph.D.: (47:00)
Yeah. Yeah.
Keith Sutton, Psy.D.: (47:03)
Yeah, so there's some kind of wanting to be seen or maybe changing that narrative of, you know, the IP being seen as no good. Or there's the estrangement, oftentimes parents, you know, wanting to get back relationships with their adult children that they might not have. And then you said sometimes the parents–any other kind of areas that come up often with these adult families?
Judye Hess, Ph.D.: (47:33)
Well, if–I'm trying to–I mean–I'm trying, in this case, I'm trying to get the family to go along with the kid or kid. And when it's the other way around I need to emphasize that this isn't just for the parents. This is that there's–if it comes out, I can build on it. But there's an emptiness when you feel cut off, especially when you know your siblings, they have a family event, you're not invited that okay, you can live a thousand miles away. That's fine. You can build your own life, that's great. But is there something in it for you to have to have their love back? And often there's so much love there that they just felt like in, or, and especially these days, I don't think this would be the case a hundred years ago, but for sure individuation has just become, especially in this country, I think a I can do what I want, I'm free. And it's not about taking care of the family, and of course you have to do all these things. So it's kind of hard on the parents. They don't have that, you know, thing over there, that they might have kids anymore.
Judye Hess, Ph.D.: (49:15)
And Yeah, go ahead.
Keith Sutton, Psy.D.: (49:17)
I say one of the areas that I've run into is when there's conflict between siblings or something. Say one sibling doesn't get along with the others, you know, husband or wife or so on. And then–or we've got two siblings that can't stand each other. Or maybe they got political differences, maybe they got beef, whatever it is. And the parents are wanting to try to bring everybody together. But it's like to–they're, they almost won't even sit at the dinner table together. What–do you have any thoughts on, kind of, those situations?
Judye Hess, Ph.D.: (49:50)
Actually–yeah, there is this family that I was seeing that this–yeah, the sister was just the most intolerant of the brother who was the IP. And she–I had them all come to the first session and she just, “I don't know what we're doing here. This is just making things worse. I'm a nervous wreck. It takes me an hour to get over this after I–you know, come into these sessions.” So, okay, well, you know, we could work with that. And so we saw, just the family without her. And I guess there's an assumption that if people are missing out on that family and they know that they're probably being talked about, they wanna come in and hear it. And sometimes they will, sometimes they won't. I think the fact that this sister was digging in so much was–she was sort of like the one that was picked from the family to really set the boundaries.
Judye Hess, Ph.D.: (51:15)
Yeah. The parents were more wishy-washy. And she was capable of saying, no, he did this. And I can't forgive him. And always afraid he's going to do that again. And we have, I mean, what I was really hoping for was to have the brother and sister come in together. It never happened. She just wasn't gonna do it. And then there was–so we would meet without her, and then there was a younger brother, and he was also, you know, so get rid of this, “My older brother, he's terrible. He beat me up when I was five years old. I'll never forgive him.” And so he didn't wanna come. So I said, okay, well, and then I just had a feeling that maybe if the target person could just be alone with the parents. That without these two emissaries keeping it all in place, that maybe something would happen. And so we had it all set up. And guess what?
Keith Sutton, Psy.D.: (52:35)
They showed up.
Judye Hess, Ph.D.: (52:37)
They canceled. They never canceled.
Keith Sutton, Psy.D.: (52:39)
Oh, okay. They canceled.
Judye Hess, Ph.D.: (52:41)
Yeah. So, I mean, that told me interesting, they don't wanna do that. They don't want to be just there with the kid. They need the siblings to support so that they don't look like the bad guys. And so I have to say, you know, “Sometimes it doesn't work. It's not a miracle. But–and you have to just deal with that. You could try as hard as you want.” It's gonna just like individual therapy, you know, it just doesn't always work. We don't have those, I mean, maybe AI's gonna do better, but–
Keith Sutton, Psy.D.: (53:17)
Well, I remember, yeah–coming home during grad school and being with my family over the holiday and being like, “Whoa, what could I imagine that I would like,” you know, work with a family like this and change everything. But really, yeah. It is a partnership between the therapist and the clients. And really they're going to make the changes themselves if they are help too, or wanting to, or the bound–the barriers are getting in the way. I find too that a way to engage people, like in those situations where they're not wanting to come in–is if I can say, you know, if I can get them on the phone and just say, “I just wanna get your perspective on this person because I wanna do some work on this person.” And basically get them complaining.
Keith Sutton, Psy.D.: (54:02)
And once they get–”And they did this–and he was like this to me when I was a kid and a brother–,” and, you know, and I don't, by the end of the conversation usually you're like, “Okay, I'll come in.” Because it's more, right. It's helpful for me because I'm getting the information. They're a really great resource, but also the person is feeling seen and heard, and so feeling like, “Okay, maybe this person could actually do something here.” And then kind of bringing together the them in that way, kind of. But yeah, that's–it's a lot and it's a lot to juggle and, you know, kind of, sometimes it doesn't work out and sometimes that you're kind of touch on an area that's a little tough and everybody's like, “Oh, let's scatter here.” You know?
Judye Hess, Ph.D.: (54:47)
This was also, you know, kind of an alcoholic-ly oriented family, and there was so much going on that nobody really did talk about. But I did have a long conversation on the phone with the father after that. And the wife was going to an AA person and her idea was, look, maybe we should just go to that person. And I said, you know, “That would be totally fine with me. I just don't want things left unresolved. I know you were all trying hard and, you know, maybe that is just somehow gonna work better.” And he, you know, he thanked me and I just felt like, okay, I didn't–I don't wanna just drop. You don't wanna come back–”Okay, bye.” You know?
Keith Sutton, Psy.D.: (55:42)
Of course, of course.
Judye Hess, Ph.D.: (55:44)
Want to get some resolution there. So we'll see. I'd need to write these people's, you know, all the people that did, you know, that weren't satisfied and write them a year later. Did that ever, did that therapy help? I don't really think that's appropriate but, I'm always curious.
Keith Sutton, Psy.D.: (56:05)
So, this is great. It's so great to hear about your work, and I think this area of working with adult children is so significant. I–your book sounds like a really great resource, and we will link to it on the website. And I'm really looking forward to the training you're doing. I know you're doing a training for the Association of Family Therapists Northern California in November, like a two hour workshop that's free. And I forget if that's gonna be in person or on Zoom, but usually it's also available on Zoom. So that's something that folks could check out. And then we're also going to be doing that–the 10 session one way mirror with the Family Institute of Berkeley. So, that would–that'll be really interesting, looking forward to it.
Judye Hess, Ph.D.: (56:45)
Yeah, that's very exciting. I've never done that before. So, when you talked about New Frontiers, that's one of my new ones. And I'm always up for a challenge.
Keith Sutton, Psy.D.: (56:59)
Well, thank you so much for taking the time today. This is great. It's wonderful to hear about your work.
Judye Hess, Ph.D.: (57:04)
Great, great. It is so easy to talk to you too, so thanks for having me.
Keith Sutton, Psy.D.: (57:11)
Okay. Take care. Bye-bye.
Judye Hess, Ph.D.: (57:13)
Okay, bye-bye.
Keith Sutton, Psy.D.: (57:15)
Thank you for joining us today. If you'd like to receive continuing education credit for the podcast you just listened to, please go to therapyonthecuttingedge.com and click on the link for CE. Our podcast is brought to you by the Institute for the Advancement of Psychotherapy, where we provide trainings for therapists and evidence-based models through live and online workshops, OnDemand workshops, consultation groups, and online One-Way Mirror trainings. To learn more about our trainings and treatment for children, adolescents, families, couples, and individual adults with our licensed experienced therapists, in person in the Bay Area, or throughout California online and our employment opportunities, go to sfiap.com. To learn more about our associateships and psych assistantships and low fee treatment through our nonprofit Bay Area Community Counseling and Family Institute of Berkeley, go to sfbacc.org and familyinstituteofberkeley.com. If you'd like to support therapy for those in financial need and training and evidence-based treatments, you can donate by going to [email protected]. BCC is a 501C3 nonprofit, so all donations are tax deductible. Also, we really appreciate your feedback. If you have something you're interested in, something that's on the cutting edge of the field of psychotherapy, and you think therapists out there should know about it, send us an email. We're always looking for advancements in the field of psychotherapy to create lasting change for our clients.
Welcome to Therapy on the Cutting Edge, a podcast for therapists who want to be up to date on the latest advances in the field of psychotherapy. I'm your host, Dr. Keith Sutton, a psychologist in the San Francisco Bay Area, and the Director of the Institute for the Advancement of Psychotherapy at the Institute for the Advancement of Psychotherapy. We provide training in evidence-based models, including family systems, cognitive behavioral therapy, emotionally focused couples therapy, eye movement to sensitization reprocessing, motivational interviewing, and other approaches through live in-person and online trainings, on demand trainings, consultation groups, and one-Way mirror trainings. We also have therapists throughout the Bay Area and California providing treatment through our six specialty centers, each grounded in evidence-based approach with our Lifespan Centers, Center for Children and Center for Adolescents, where all the therapists are working systemically. Our Center for Couples, where all the therapists are using emotionally focused couples therapy and our specialty issue centers, our Center for Anxiety, where all the therapists are using CBT and EMDR for trauma.
Keith Sutton, Psy.D.: (01:26)
And our center for ADHD and oppositional and Conduct Disorder clinic, where we're integrating those four approaches. In the institute. We have our licensed experienced therapists, and for those in financial need, we have an associated nonprofit Bay Area community counseling where clients can work with associates, psych assistants, and licensed clinicians who are developing their abilities and expertise. Additionally, as part of our nonprofit, we also have the Family Institute of Berkeley, where we provide treatment training and one-way mirror trainings in family systems. To learn more about trainings, treatment and employment opportunities, please go to sfiap.com and to support our nonprofit, you can go to sf-bcc.org to donate today to support access to therapy for those in financial need, as well as training in evidence-based treatment, BACC is a 501C3 nonprofit, so all donations are tax deductible. Today, I'll be speaking with Judy Hess, PhD, who's worked with family since 1974 when she began her family therapy career at Worcester Child Guidance Center in Worcester, Massachusetts.
Keith Sutton, Psy.D.: (02:31)
In 1977, Judy moved to the West coast and found a home at Zant Thoses, a family counseling center in Alameda, California, where she worked for the next three years. In 1984, she began teaching at the California Institute of Integral Studies, where she was on the core faculty and taught family dynamics, couples counseling, and group process until 2015. She's the author of Core Focused Family Therapy, moving from chaos to clarity, and she is now Professor Emeritus at CIIS and since then, has maintained a private practice seeing couples and families of adult children exclusively. Let's listen to the interview. Hi, Judy. Welcome.
Judye Hess, Ph.D.: (03:11)
Thank you. Thank you, Keith. Appreciate being here.
Keith Sutton, Psy.D.: (03:15)
Judy, I'm so excited to talk to you. I've known you for a long time as a member of the Association of Family Therapists in Northern California. You've been providing family therapy and also you are teaching family therapy for many years at California Institute for Integral Studies, and I was always so impressed one of your teaching techniques, and I might be getting this wrong, but would be that you would have the students bring in their family to do a family session or if their family couldn't come in kind of doing a role play with the family, but basically you're teaching family therapy through doing live sessions.
Judye Hess, Ph.D.: (03:53)
Exactly, yeah.
Keith Sutton, Psy.D.: (03:54)
Yeah, I'm so interested to hear about your work and your thinking. We're actually gonna have you do the one-Way mirror training for Our Family Institute of Berkeley, which is over Zoom, which is accessible all over. But before we even get into that, I'd like to find out, I am always interested in kind of, you know, how you got, doing what you're doing, kind of the evolution of your thinking and, and how you got to this work.
Judye Hess, Ph.D.: (04:17)
Sure, sure. Great. Okay. Well, let's just start with me, being born into a family with a psychoanalyst father and a sister who soon became a clinical psychologist and a psychoanalyst herself. And so I just got so interested in psychology, I used to watch these, you know, programs, mental health and illness programs with my dad when I was like 10. And somehow I just, there was a movie called Sneak Pit back in the day, and I just remember, “Oh my God, I wanna learn more about this, it’s just too amazing.” But I, you know, I studied, I went to grad school, learned all the different ways to do therapy. However, this was back in the seventies, and there was no class in family therapy. That was before it really got, you know, on the map. And so, when I graduated, well, when I was doing my dissertation, I was also part-time working at a youth guidance center in Worcester, Massachusetts, where actually Freud gave his first talk at Clark.
Judye Hess, Ph.D.: (05:49)
Yeah. And so when I was–it was a youth guidance center. I was kind of doing it for a part-time job for money and experience, but I was not into the kids and adolescents part of it, so I thought, “I don’t know how I'm gonna pull this off,” but I just turned out I had a wonderful supervisor, a guy named Elliot Brown, and he had just graduated from the first family Therapy Institute in New York, the Ackerman Institute that trained family therapists. And he, so we were talking, I said, “Well, I don't know. I'm not really into doing this play therapy or whatever.” And he said, “We'll see the whole family then.” And I, that was really the first thought. “Are you kidding? What am I gonna do with all these people?” He said, “Don't worry, just you'll tape it and we'll go over the tapes together and it'll be fine.”
Judye Hess, Ph.D.: (06:53)
Give it a shot. And that was the beginning. And I just immediately fell in love with this process. And it just, you know, I had been, you know, into couples and groups and things like that, but it just felt like coming home. And it was also what I found was very healing for me because my family wasn't the most highly functional, you know, I mean, educationally yes. But, all other kinds of stuff there. And I just felt like when I was working with these families, I would be healing myself. And I mean, how good is that? I'm getting free therapy and I'm helping other people. And it was more, it was like a passion. I just absolutely loved it. So, I mean, I felt like, okay, this is the way that I'm gonna go.
Judye Hess, Ph.D.: (07:59)
And I, when I moved out to California, I started working at a family counseling center called Zans in Alameda. And, it was one of those places where you didn't get very much money, but you got the experience and you could sleep late because the class sessions were from 12 to 8. So it was perfect and pretty close to my house. So I did that for three years. And during that time, I began studying with Alan Leviton, who was the former–I don't know if he was the first president of AFTNC, I'm not sure. But early on he was there, and he was a great fan of Whitaker and Satir. And he actually had a workshop with Whitaker down in Santa Cruz. And I, I mean, I sat there and had a conversation with Whitaker, you know, how cool is that?
Judye Hess, Ph.D.: (09:08)
And it was, I just felt like, yeah, I am at home and this is where I belong. And so then I got a job at California Institute of Integral Studies, called CIIS here. And I got a–I had to do an interview in which I did a role play with a family, and they just said, “Okay, you're hired.” And so this was, just beyond my wildest dreams that I could actually do this for as long as it was going to be. And so I started teaching there, and as you said the format was to have the students bring in their families if they could, or even a brother, sister, whatever, or we do the role plays. But when people would role play the family members, they would talk to the family member on the phone beforehand and ask that person all kinds of questions so that they could really get into the part.
Judye Hess, Ph.D.: (10:29)
And then when we would do the session and that person might say something, the role player that registered to the central figure, as, “Did my sister tell you that?” And so it was–there was a, you know, a validity too, it wasn't just somebody making up what they thought was probably good for a mom or something, but it was really–it was so powerful. And I–we could only do one session because it's therapy and you know, the dual relationship thing. And they were allowing me to do a demo. So this was called “Demo.” And the people were–it's a very experiential school.
Keith Sutton, Psy.D.: (11:22)
I was gonna say CIIS is known for being very experiential, very kind of mixing of Western and Eastern and so on here in San Francisco.
Judye Hess, Ph.D.: (11:33)
Absolutely. And that was perfect for me because I was already going to SLN and loving that whole experiential thing. So anyway, then when the families would come in, it was incredible because they would be witnessed by the group, and then afterwards the group would give feedback. It's kind of like a reflecting team. Yeah. And I mean, they were taught not to say, “You were so controlling.” You know, that they could say, “Oh God, you know, I just wish my family could do this and be so open.” And so the families just felt really wonderful and supported. And here they're paying exorbitant fees for their kids' education, and they're actually saying, “Oh my God, is this what they do?” And it was a charm. And I just worked there for 30 years.
Judye Hess, Ph.D.: (12:42)
It was, you know, I used to say to people, I would do this job even if I didn't get paid. And it was true, I just really enjoyed it. Part of the thing that was really influential was I would, when the real family came in, we would tape them. And then I had one of my students who was totally fascinated by what I was doing. And he got all these tapes and he had taken all my classes, couples in groups, so he knew my way, and he put them together, the examples from the real cases with the ideas that I was trying to promote. And it came into a book Wonderful. Which is called Core Focus Family Therapy. That was in 2008, and it became the textbook for the class.
Judye Hess, Ph.D.: (13:53)
And it's a very user-friendly book. It's like, this could be good for somebody who's done this for a while, and it could be someone who's brand new. Like, what do I do? It's very, how to step one, step two. So one of my little things–recommendation testimonials. Right. Said–I think it was Marty Kirschenbaum said–no, Dan Weil, he said, “This should be required for every student of family therapy ever.” And so that just–it just shaped my career completely.
Keith Sutton, Psy.D.: (14:43)
So, can I ask you about your style–and I know now you're not teaching and you've got a private practice, right? And you're working with families, and particularly one of your areas of specialties is adult children. Is that right?
Judye Hess, Ph.D.: (14:57)
Yes. Exactly. Yeah.
Keith Sutton, Psy.D.: (14:59)
So, I'm curious about your strategies kind of in working, especially doing these, you know, kind of one-time–kind of interventions with these families and so on. What was your focus or goal, or kind of, were you just kind of going with the process and then kind of seeing what came out of there more of a structural way? Or did you have kind of a direction that you were shooting for? Tell me a little bit about the thinking there.
Judye Hess, Ph.D.: (15:30)
Yeah. Well, like I said, Whitaker and Virginia Satir were my models because they were very experiential. The critics of them say they're just shooting from the hip. But to me, that meant using your intuition. And so that's what I felt was the most helpful thing. And part of what I–a chapter in my book is like, “What are the qualities for becoming a poor focused family therapist?” And so it's not like anybody can do it. You have to have certain qualities of communication, style, openness, and warmth, but still being able to confront the truth. One student had written about the book, about my style. She said, “It’s love and truth.” And so I would say those are my overall guiding principles to let them know I'm on their side.
Judye Hess, Ph.D.: (16:40)
Of course I'm trying to get the focus off the identified patient. And I have a whole chapter on that of, “How do you do that?” “What kind of interventions?” Like, for instance, most families walk in, why are you here? “Janie, Janie, Janie, Janie,” and then, you know, it sort of is counterintuitive because some person would just say, “Oh, okay, well, let's talk to Janie, what's going on?” And make that assumption that, yes of course they all said it must be true Janie's the problem. So that is the total opposite of what we want to happen. We want to give the family the truth, which is a very hard truth to swallow. That this is not just about Janie, there's other problems going on in the family. Now, I'm not gonna say that's the way it is. I'm gonna ask, maybe not the parents, but maybe the siblings, “Are there any other issues that you see in the family?” And try to expand the space of what people are looking at. What did I call it? Increasing the surface area of the problem.
Keith Sutton, Psy.D.: (18:08)
Nice.
Judye Hess, Ph.D.: (18:09)
And so–I have a whole list of things to do. Shifting the conversation to get it off the identified patient, giving space for other people to talk about problem areas, and–but still to validate that the parents aren't crazy. This kid's getting in trouble. You have every right to be worried about his behavior. And there's also something else. So we're not criticizing or challenging, we're really just saying, “And there's more.” And it's amazing.
Keith Sutton, Psy.D.: (18:51)
Yeah. I like the idea of expanding the space. Because–
Judye Hess, Ph.D.: (18:54)
Expanding the space.
Keith Sutton, Psy.D.: (18:56)
Context and how all these pieces of the puzzle are kind of fitting together rather than just in isolation the IP. Right? I think in a brief strategic family therapy call–they call it kind of spreading the IP hood, you know.
Judye Hess, Ph.D.: (19:09)
Yeah. Exactly. Exactly. And–
Keith Sutton, Psy.D.: (19:12)
Everybody has a little piece of this puzzle. Yeah. Very cool.
Judye Hess, Ph.D.: (19:18)
Right, right. It's–I would say that it's almost–it's organic. As soon as you start to ask the other people in the family, “Well, what do you see?” And the 5-year-old could say, “Well, mommy and daddy fight all the time.” And you're off and running because parents–they've been afraid to say that to the parents. So all of a sudden they have this forum where they can tell their truth, and then another one will pop in, “Well, I have–you know this and this problem.” And then it be the thing we don't wanna do is jump in to make it the parent's fault. Yeah. That's also another thing that people who don't know how to do this might do. Okay. Well, “What are you doing to make Janie act out in this way?”
Judye Hess, Ph.D.: (20:19)
Because I think family therapy is a risky thing for people. I really do. They're petrified. I mean, even the students would be, “What? I'm not gonna bring my family in. You kidding?” And then after a while, they saw how it all happened and was so healing that, you know, they were lining up to do it. But just the gut feeling is “I've been hiding stuff from my parents and family for years. I'm not gonna go and talk about stuff.” And then they've–but once given a chance, you know, you take the cork out and it all spills out into the room. And then we do–okay, one other thing.
Keith Sutton, Psy.D.: (21:12)
Perfect. I was gonna ask, once you've now expanded and everybody's putting out all the pieces of these puzzles, what next?
Judye Hess, Ph.D.: (21:19)
What next? Okay, good. I'm glad you asked. The next step, and I call this like a three step method–first there's a check-in where we just ask, “Hi, how are you? What's your job? Do you like it? What grade are you in?” You know, just really simple things. And so they start to feel comfortable. Whitaker used to call that the anesthesia before the surgery.
Keith Sutton, Psy.D.: (21:50)
Oh.
Judye Hess, Ph.D.: (21:51)
So you're letting them feel a little bit more comfortable because they're often really on edge. And “Okay. I can talk to this person, doesn't have fangs, and maybe I can say something.” And then once we do the check-in–and this is what I tell students while they're doing the check-in, “I'm looking for which dyad do I think it would be good to start working with.” And that's when we get into the heart of this, which is I call, “The direct interaction.” And–in a class, what I might do now if I'm teaching is say, “Okay, while you're watching the check-in, think about which two people you might want to have–do a separate dyad.” And then afterwards people say all kinds of things.
Judye Hess, Ph.D.: (22:57)
“I'd have the parents.” Well, no, and I usually say–and not, “Don't just go for the parents.” So they come up with different things, and then I can kind of accept them. “Oh, yeah. That would be good.” Like, well, if there's like–okay, so we have a teenage girl and a mom who are always fighting with each other. If we do a direct interaction with the two of them, they're just gonna be fighting and everyone's gonna say, “This stuff doesn't work.” So we try to find something that is real, but still doable. Where something actually could get resolved, let's say. And you can kind of tell when people are checking in, right. Just how open they're gonna be. Let's say it's, even a sister saying, “Well, yeah, I used to be really close with my brother, but, you know, as soon as he got to be friends with these other boys, he just won't include me at all.”
Judye Hess, Ph.D.: (24:08)
Okay, so maybe–and the brother says, “Well that's 'cause you're always a pest.” So we–maybe that's a safe one to start with. And so we would have–I mean, in the old days, we would have people move their chairs so that they would be looking at each other directly. I think Uch Mnuchin did a lot of chair moving. And so then they would–they're having the direct interaction and you just kind of let it go. If it's working, let's say, the girl, the young girl is, you know, saying, “I just really miss you.” See, the idea is to get to the vulnerability, be behind the defenses, because, you could go unitl the cows come home with defensive behaviors. It's not gonna work. People–just human beings, they're not gonna feel safe.
Judye Hess, Ph.D.: (25:14)
So we–if it looks like she's gonna be able to be vulnerable, then we have a chance for the boy to be. However, if he's not, if he jumps in, which he very well could with, you know, like that, “Well, you're just a pest and we don't want you,” okay. “But, John, you said you did want to have some healing happen in this family, and I hear that your–you agree, you and your sister used to be closer. And is there a part of you that would–that misses that closeness, that would like to feel close again?” “Well, maybe,” and then what I might do if nothing else is working is, “Can we go back to a time when you two were close, and just tell me about what did–were you, you know, going biking together?”
Judye Hess, Ph.D.: (26:14)
“Were you having ice cream? What do you remember that was a good time?” And the–I'm the guide. And, depending on how sophisticated the people are, they'll either pick it up and just go right for it, or–I'll, you know, have to work a little harder, but then other people see what's going on. And again, they go, “Well, that looked like it worked. Yeah, well, as a matter of fact, I'm having trouble with my son too,” and then maybe we do a mother son or a father son. And then it just takes off from there. And yeah.
Keith Sutton, Psy.D.: (26:58)
So you're kind of starting off just a little like, “Hi, how are you doing?,” like, kinda anesthesia before the surgery, and then you're kind of spreading the IP hood, like finding out what's going on a little bit. And you're kind of assessing for, you know, who's open. You might not go for the hottest kind of piece of the system that's struggling, but you might kind of look for a dyad outside of that central, you know, kind of stuck conflict and then get a little work going, which might be some of the–I'm thinking like low hanging fruit that you could do something with. And then that gets going, which then brings about maybe some openness from the others, or some hope or some sense of potential that this could be helpful. And then kind of working with those different dyads.
Judye Hess, Ph.D.: (27:48)
Exactly. Exactly. It's pretty simple. I mean, it's simple, but not easy. But you can learn these steps pretty well. And then if you have the basic personality, I mean, there's some people that's just not the way they are. I mean, they might be much more thinking types than feeling types, and maybe they would be more into the structural strategic, “Oh, let's see, if I do this here, it'll work.” But this is more for people–it’s sort of a right brain mixed with left brain, you know, it's both like people say it's thinking and feeling. Whereas some of these people are just, like Satir. I don't know if that's a fair criticism, but it's all about feeling. And, you know, “How do you feel, how do you feel?” People get really tired of that. So I can sort of flip into just saying, “Well, look, you know, if you want this to change, this is what you're gonna have to do. And look at the effect it's having on your whatever sibling.”
Keith Sutton, Psy.D.: (29:07)
Yeah. That's some of the truth part.
Judye Hess, Ph.D.: (29:10)
What's that?
Keith Sutton, Psy.D.: (29:10)
That's some of the truth part you'll get?
Judye Hess, Ph.D.: (29:16)
Yes, right. Exactly. And then just to finish off, that is the last thing, which is the checkout. And that–I mean, the check-in is important because maybe that's going to be the only time that person gets to talk in that session. Whereas, at least they, “What did I come here for? Nobody asked me anything.” And then we do that at the end too. “What was important for you and what stuck out for you?” And then let's say somebody does–“Well, it was all about my sister. I didn't get to talk at all.” “Okay. Thank you, Sally, for saying that, because next time I am making a note of it that we're gonna start with you and, you know, you are important and your feelings” and all that. So, yeah.
Keith Sutton, Psy.D.: (30:11)
Wonderful. Now, tell me, I know for a lot of folks, family therapy can be very intimidating because they're afraid to have, you know, so many people in the room together and it might get out of control or whatever it might be. Can you speak to that or how you think about that, or what you do if it's getting heated, or so on?
Judye Hess, Ph.D.: (30:34)
Well, I am–I've come to the conclusion, not hardcore, but that people tend to be either more interpersonal or more intrapsychic. And this kind of work, I think the people that are scared of it are more of the intrapsychic. I mean, that's where they go with their comfort is just talking to one person because they don't get so overwhelmed. And doesn’t mean there's plenty of individuals that need help, so that's great. But, over the years, I've just realized that that's not what I wanna do. I wanna do, you know, short term, maybe three months, six months, three sessions, maybe one session. I mean it all–when I heard students saying, you know, “I've been in individual therapy for five years, and when I just got out of that session, it is more helpful than any of that.” And I really–I thought, “Okay, he's not the only one,” you know. And of course that's not gonna be for everybody. And of course, his five years of individual has probably helped him get to the point where he can, you know, really get into the family therapy. So, yeah. And I don't, I mean, I have met people–“No, I love both equally,” and that's fine too. But–
Keith Sutton, Psy.D.: (32:18)
When managing kind of–a family where there's some escalation or so on. It sounds like one you're kind of maybe picking, not necessarily the most entrenched kind of dyad. But yeah. What if things start kind of escalating or so on, do you have any kind of strategies or ways you think about, kind of, dealing with that?
Judye Hess, Ph.D.: (32:43)
Yeah. Well, I think–well, I could probably go into this later. I don't know if we'll have time, but how I moved on to working with adult children.
Judye Hess, Ph.D.: (33:00)
Rather than kids, not that adult children can't have screaming fights with their family members, but it's, you know, they're saying that they know we speak the same language. Yeah. I can–if I can reason with them, it seems to calm itself down. And I mean, even with couples, I'll see if, you know, couples that they could start screaming each other. And I, you know, “Hey, you guys, I can't work when I can't hear both of you. You're interrupting each other.” I just put it on me. “I just can't do my job. So if you can't try to, you know, be a little calmer about it, I wanna hear your feelings.” But, it could be–it used to be my office, you know, the, “You could wake my whole other colleagues up here.”
Judye Hess, Ph.D.: (34:03)
And so it seems like that it doesn't come up at–it did when I first worked with teens back at Xanthos. And, you know, it was a long time ago. I'm not sure exactly what tap I took. I do remember people getting mad. And sometimes I remember even standing up, like, “They're not listening to me. I'm–I have to really make myself, you know, a force in this family.” “Look, we can't do that. I wanna hear what you have to say. We all wanna hear what you have to say, but, you've gotta do it at a, you know, a tone that we can deal with.
Keith Sutton, Psy.D.: (34:53)
I think too that, you know, it's also right–the therapist, as a family therapist, you need to be active. You need to be containing the family and creating safety versus maybe just hanging back and following, you know, along so that there's this kind of piece that's necessary in helping to contain as well as–yeah, like you're saying, different ways of kind of intervening. But I think part of what I'm hearing too is that as you got going along right, there's more confidence or more ability to kind of feel, you know, that grounded. And I think for students, sometimes it's a little overwhelming for them to have more than one person in the room or so on. But with time and practice, it gets much easier. Tell me–
Judye Hess, Ph.D.: (35:40)
And also to recognize the power that you have. If you go, “Oh my God, this family, they're all screaming, what do I do?” You've lost them. But if you can somehow either fake or really feel like “I'm the one who's in charge here.”
Keith Sutton, Psy.D.: (36:00)
Kind of like a leadership position.
Judye Hess, Ph.D.: (36:02)
Exactly. Exactly. Yeah. I'm gonna–I'm running the show and I do have people that come in and they wanna run the show, not screaming, yelling, but interrupting me and saying–or I'm talking to one person and then that other person jumps in to say–to be helpful to explain. “Well, you see, the thing is when she was ten–,” and I have to say, “Okay, we'll let her tell us the story.” And sometimes they're just so compulsively helpful that it's–I have to tell them a few times, I asked, you know, Sarah and I really wanna hear it from Sarah. And I was just–I remember this guy said, “Well, time is of the essence, and I was just helping you get more information.” I said, “We got all the time in the world.” Yeah. So, I’m hopeful.
Keith Sutton, Psy.D.: (37:02)
Great. Well, tell me about–the work with adult children because I think a lot of times–people think of family therapy, they think of kids, they think of teenagers. Tell me about your kind of move into that area.
Judye Hess, Ph.D.: (37:16)
Oh, sure. When I got out–when I stopped teaching, I wanted to develop a private practice, which, you know, I didn't–I had saw clients, but it was like, I never advertised it. It was just like, “Hey, I have a full-time job at CIIS of getting paid enough. I don't really need to, and I hate marketing anyway. I don't need to do that. Whoever comes to me, great.” I saw what I was just doing private practice that I needed to reach out more. And I was starting to get families of you know, with young kids. And I just realized I've spent 30 years doing family therapy with adult children who happen to be grad students, which you don't always get. And I said, “That's–that's what I'm good at.”
Judye Hess, Ph.D.: (38:26)
I don't have kids. I don't know, you know, is that unusual for a three-year-old? You know? So, that's–I just thought I better go with my expertise. And then when I started advertising as a family therapy with adult children, I just started getting a lot of calls. Evidently you could–people haven't caught onto that one yet. I'm sure they will. But, that they–if they plug that in, that they're probably gonna find me. And so it's–I mean, a lot of these families aren't the calm, sophisticated families I would get with the grad students. But, at least I feel like I'm in the league of comfort. “Yeah, I know what I'm doing.” Maybe they're a little bit further out in some way.
Keith Sutton, Psy.D.: (39:31)
Talk about like–what are the common things that people are coming to you for? Or is there, you know, I know that there's been a lot of talk about families and cutoffs and so on. You know, that I've had families where there was the parent who is going into, you know, kind of their seventies or so on, and wanting to kind of get closer to the kids, repair some of the past, or I've had family conflict where two siblings got into it. And then, you know, it's very hard for the whole family to get together anymore. What are people usually coming in for?
Judye Hess, Ph.D.: (40:07)
Well, that is such a common thing that I don't think I even realized while I was seeing the students and their families for just one time. Because if the parents were gonna come, they probably had some kind of a decent relationship. But I get calls now from people who haven't talked to their families for four years. And either sometimes it's the adult child who feels like the parents cut them off. Other times it's definitely the parents who feel like their child cut them off. And I would say it's probably more the parents that have that feeling that “We gave you everything. You don't even talk to us, you won't even answer or call.” And they're just bereft. And I just came across a person who was in the Bay Area who specializes in estrangement with families.
Judye Hess, Ph.D.: (41:17)
It's a guy named Josh Coleman. And evidently he had a daughter who was in that situation where he was struggling because there was a cutoff from her. And he just has outlined things that I sort of knew intuitively. But–like what the issues are spelled out clearly is it, you know–I mean the typical first thing I would, you know–I was so controlled by you for all those years. Now I'm a free person. I'm gonna do what I want. And then there's always money issues I really wanna separate, but I still am financially dependent on them. There's–and then it could be a gang up, just like it, it would be with an IP, “Oh, we are all close together. Just, Joe is the bad one.”
Judye Hess, Ph.D.: (42:24)
And so sometimes I will even see the “bad one” individually to find out, well, what I know you think it's all your parents hate you and the family won't invite you to functions. And it's all that. But is there anything that you feel like you are doing that is keeping that dynamic going? And, you know, they're usually very attached to blaming the family, but, they, you know, everybody wants to be connected. Even if your parents were abusive you want to–even if you don't want to see him more than once every five years, there's still, I think, a basic human need to feel like there is, I'm recognized. I'm a person. I'm seeing somebody right now, and that's his goal. He's like in his forties. And he came, “what I just want is to be validated by my family.”
Judye Hess, Ph.D.: (43:30)
Because they think he's a, you know, a loser. And so now I'm doing a combination of individual and then the father and that family is the one that's a little bit more receptive. So doing some sessions with him and then to, and then I can see it, I can see what the “IP” does to push the father away. Father is like, “I love you so much.” And I was like, “Oh, I don't believe you.” You know? I said, “He's just gonna clam up.” You know, I tell, I give them a strategy. You know–I even said, “Even if you don't feel it, let's just be strategic about it.” You know, somebody said that to you. What would you do? Well, I'd probably back away too. And so we–I kind of–a lie with them too, you know, like, at least you've got me. Yeah. And I understand what you're saying. I hear you're having a really tough time there. And we have to look at what you're doing to maintain that too. And so that's one piece.
Keith Sutton, Psy.D.: (44:43)
–being seen and that vulnerability. And I worked with one adult child and parent. And, you know, when she would feel seen by the mother, I'd explore what was going on. And she said, you know, I feel love. And then when I asked about the emotion, she said, I feel fear. Like her reaction was fear, right. Feeling that love, because then, right. She could be hurt. She didn't wanna have that hope or so on. Because it can be scary to potentially get that, but also get let down again. Because people aren't perfect. And especially if that's been such a painful thing that you've kind of built up a wall to kind of protect yourself and stuff.
Judye Hess, Ph.D.: (45:26)
Exactly, yeah.
Keith Sutton, Psy.D.: (45:29)
And so you might do just like a separate session with the dad and the son, or would you have the other family members there kind of witnessing?
Judye Hess, Ph.D.: (45:37)
The family in this case, the family would not come in. The father was the only one. And it–I mean, I do believe the adult child that the father is dominated by the mother. And the mother wouldn't even want to know that the dad was coming in. So it will probably be a little while. And when I ask the father well, do you think we could get your wife in here? Well, no. She’s very fragile and I think she would be upset. She doesn't sound very fragile. She's controlling the whole family. But in his mind she's the boss, so it will be slow. But, the first time I met with this, the “IP,” that's what he wanted. He chose me because I knew about families. And he wants an ally. And I am his ally. I don't, you know, he doesn't really wanna be challenged, so I have to do it really softly. But, yeah, when I–it's like the proof is in the pudding when I see dad crying, and you're not even moved by–I said, “You know, you can't make yourself cry.” Yeah.
Keith Sutton, Psy.D.: (46:58)
I see what's going on in the process there.
Judye Hess, Ph.D.: (47:00)
Yeah. Yeah.
Keith Sutton, Psy.D.: (47:03)
Yeah, so there's some kind of wanting to be seen or maybe changing that narrative of, you know, the IP being seen as no good. Or there's the estrangement, oftentimes parents, you know, wanting to get back relationships with their adult children that they might not have. And then you said sometimes the parents–any other kind of areas that come up often with these adult families?
Judye Hess, Ph.D.: (47:33)
Well, if–I'm trying to–I mean–I'm trying, in this case, I'm trying to get the family to go along with the kid or kid. And when it's the other way around I need to emphasize that this isn't just for the parents. This is that there's–if it comes out, I can build on it. But there's an emptiness when you feel cut off, especially when you know your siblings, they have a family event, you're not invited that okay, you can live a thousand miles away. That's fine. You can build your own life, that's great. But is there something in it for you to have to have their love back? And often there's so much love there that they just felt like in, or, and especially these days, I don't think this would be the case a hundred years ago, but for sure individuation has just become, especially in this country, I think a I can do what I want, I'm free. And it's not about taking care of the family, and of course you have to do all these things. So it's kind of hard on the parents. They don't have that, you know, thing over there, that they might have kids anymore.
Judye Hess, Ph.D.: (49:15)
And Yeah, go ahead.
Keith Sutton, Psy.D.: (49:17)
I say one of the areas that I've run into is when there's conflict between siblings or something. Say one sibling doesn't get along with the others, you know, husband or wife or so on. And then–or we've got two siblings that can't stand each other. Or maybe they got political differences, maybe they got beef, whatever it is. And the parents are wanting to try to bring everybody together. But it's like to–they're, they almost won't even sit at the dinner table together. What–do you have any thoughts on, kind of, those situations?
Judye Hess, Ph.D.: (49:50)
Actually–yeah, there is this family that I was seeing that this–yeah, the sister was just the most intolerant of the brother who was the IP. And she–I had them all come to the first session and she just, “I don't know what we're doing here. This is just making things worse. I'm a nervous wreck. It takes me an hour to get over this after I–you know, come into these sessions.” So, okay, well, you know, we could work with that. And so we saw, just the family without her. And I guess there's an assumption that if people are missing out on that family and they know that they're probably being talked about, they wanna come in and hear it. And sometimes they will, sometimes they won't. I think the fact that this sister was digging in so much was–she was sort of like the one that was picked from the family to really set the boundaries.
Judye Hess, Ph.D.: (51:15)
Yeah. The parents were more wishy-washy. And she was capable of saying, no, he did this. And I can't forgive him. And always afraid he's going to do that again. And we have, I mean, what I was really hoping for was to have the brother and sister come in together. It never happened. She just wasn't gonna do it. And then there was–so we would meet without her, and then there was a younger brother, and he was also, you know, so get rid of this, “My older brother, he's terrible. He beat me up when I was five years old. I'll never forgive him.” And so he didn't wanna come. So I said, okay, well, and then I just had a feeling that maybe if the target person could just be alone with the parents. That without these two emissaries keeping it all in place, that maybe something would happen. And so we had it all set up. And guess what?
Keith Sutton, Psy.D.: (52:35)
They showed up.
Judye Hess, Ph.D.: (52:37)
They canceled. They never canceled.
Keith Sutton, Psy.D.: (52:39)
Oh, okay. They canceled.
Judye Hess, Ph.D.: (52:41)
Yeah. So, I mean, that told me interesting, they don't wanna do that. They don't want to be just there with the kid. They need the siblings to support so that they don't look like the bad guys. And so I have to say, you know, “Sometimes it doesn't work. It's not a miracle. But–and you have to just deal with that. You could try as hard as you want.” It's gonna just like individual therapy, you know, it just doesn't always work. We don't have those, I mean, maybe AI's gonna do better, but–
Keith Sutton, Psy.D.: (53:17)
Well, I remember, yeah–coming home during grad school and being with my family over the holiday and being like, “Whoa, what could I imagine that I would like,” you know, work with a family like this and change everything. But really, yeah. It is a partnership between the therapist and the clients. And really they're going to make the changes themselves if they are help too, or wanting to, or the bound–the barriers are getting in the way. I find too that a way to engage people, like in those situations where they're not wanting to come in–is if I can say, you know, if I can get them on the phone and just say, “I just wanna get your perspective on this person because I wanna do some work on this person.” And basically get them complaining.
Keith Sutton, Psy.D.: (54:02)
And once they get–”And they did this–and he was like this to me when I was a kid and a brother–,” and, you know, and I don't, by the end of the conversation usually you're like, “Okay, I'll come in.” Because it's more, right. It's helpful for me because I'm getting the information. They're a really great resource, but also the person is feeling seen and heard, and so feeling like, “Okay, maybe this person could actually do something here.” And then kind of bringing together the them in that way, kind of. But yeah, that's–it's a lot and it's a lot to juggle and, you know, kind of, sometimes it doesn't work out and sometimes that you're kind of touch on an area that's a little tough and everybody's like, “Oh, let's scatter here.” You know?
Judye Hess, Ph.D.: (54:47)
This was also, you know, kind of an alcoholic-ly oriented family, and there was so much going on that nobody really did talk about. But I did have a long conversation on the phone with the father after that. And the wife was going to an AA person and her idea was, look, maybe we should just go to that person. And I said, you know, “That would be totally fine with me. I just don't want things left unresolved. I know you were all trying hard and, you know, maybe that is just somehow gonna work better.” And he, you know, he thanked me and I just felt like, okay, I didn't–I don't wanna just drop. You don't wanna come back–”Okay, bye.” You know?
Keith Sutton, Psy.D.: (55:42)
Of course, of course.
Judye Hess, Ph.D.: (55:44)
Want to get some resolution there. So we'll see. I'd need to write these people's, you know, all the people that did, you know, that weren't satisfied and write them a year later. Did that ever, did that therapy help? I don't really think that's appropriate but, I'm always curious.
Keith Sutton, Psy.D.: (56:05)
So, this is great. It's so great to hear about your work, and I think this area of working with adult children is so significant. I–your book sounds like a really great resource, and we will link to it on the website. And I'm really looking forward to the training you're doing. I know you're doing a training for the Association of Family Therapists Northern California in November, like a two hour workshop that's free. And I forget if that's gonna be in person or on Zoom, but usually it's also available on Zoom. So that's something that folks could check out. And then we're also going to be doing that–the 10 session one way mirror with the Family Institute of Berkeley. So, that would–that'll be really interesting, looking forward to it.
Judye Hess, Ph.D.: (56:45)
Yeah, that's very exciting. I've never done that before. So, when you talked about New Frontiers, that's one of my new ones. And I'm always up for a challenge.
Keith Sutton, Psy.D.: (56:59)
Well, thank you so much for taking the time today. This is great. It's wonderful to hear about your work.
Judye Hess, Ph.D.: (57:04)
Great, great. It is so easy to talk to you too, so thanks for having me.
Keith Sutton, Psy.D.: (57:11)
Okay. Take care. Bye-bye.
Judye Hess, Ph.D.: (57:13)
Okay, bye-bye.
Keith Sutton, Psy.D.: (57:15)
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