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Laura Patracek, Ph.D. - Guest
Laura Petracek, Ph.D. is a clinician psychologist, speaker, and the author of the Anger Workbook for Women: How to Keep Your Anger from Undermining Your Self-Esteem, Your Emotional Balance, and Your Relationships. Dr. Petracek has over 30 years of experience, specializing in Dialectical Behavior Therapy (DBT) and other evidence-based therapies for alcohol/substance use, mood disorders, and anger dyscontrol issues. Her other areas of expertise are working with children and adolescents with ADHD, Oppositional Defiant Disorder, Autism Spectrum Disorders, and other learning disabilities. She is also a past clinician at San Quentin Federal Prison, and currently in the process of writing the book Pain is Inevitable; Suffering is Optional: Dialectical Behavioral Skills for Alcoholics & Addicts. |
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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 Desensitization and 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 an 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; and our center for ADHD and Oppositional & Conduct Disorder clinic, where we're integrating those four approaches.
Keith Sutton, Psy.D. (01:31):
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-bacc.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 501(c)(3) nonprofit, so all donations are tax deductible.
Keith Sutton, Psy.D. (00:37):
Today, I'll be speaking with Laura Petracek Ph.D., who is a clinical psychologist, speaker, and the author of "Anger Workbook for Women: How to Keep Your Anger from Undermining Your Self-Esteem, Your Emotional Balance and Your Relationships." She has over 30 years of experience and specializes in dialectical behavioral therapy and other evidence-based therapies for alcohol and substance use, mood disorders, and anger dyscontrol issues. Her other areas of expertise include working with children and adolescents with ADHD, oppositional defiant disorder, autism spectrum disorder, and other learning disabilities. She's a past clinician at San Quentin Federal Prison, and currently is in the process of writing the book, "Pain is Inevitable; Suffering is Optional Dialectical Behavioral Therapy Skills for Alcoholics and Addicts." Let's listen to the interview.
Keith Sutton, Psy.D. (01:26):
Well, hi, Laura. Thanks for joining us today.
Laura Petracek, Ph.D. (01:29):
Thank you, Keith. Thanks for having me.
Keith Sutton, Psy.D. (01:31):
Definitely. So, Laura, we've known each other for some time, we had shared an office together for many years in San Francisco.
Laura Petracek, Ph.D. (01:42):
Yes.
Keith Sutton, Psy.D. (01:42):
And I've seen, you know, some of the books that you had in the office of one particularly you authored, and you came to some of the workshops that I had, and now we're working together as part of the Institute. And I wanted to bring you on to learn a little bit more about, and kind of share with others, your work and, you know, working with this number of different topics. I mean, you've done some work with families and with relationship violence, you've authored a book on women and anger, you're also in, you know, in the middle of another book on working with substance abuse and integrating some DBT work and so on. But to start with, I'd love to just hear, you know, I know actually bits and pieces that we've talked about of your background and your work and so on, but yeah, would love to hear kind of how you got where you are now and kind of the, you know, evolution of your work and your thinking and such. But yeah.
Laura Petracek, Ph.D. (02:43):
Okay. I mean, how far do you want to go back?
Keith Sutton, Psy.D. (02:47):
Wherever you feel like the story begins?
Laura Petracek, Ph.D. (02:49):
Okay. Well, sometimes I wonder if I chose this field or it chose me. I entered rehab when I was 17 years old.
Laura Petracek, Ph.D. (03:03):
And my family was totally against it. I luckily had someone who helped me get emancipated as a minor to sign myself in treatment. And so separating from my family and getting clean and sober was the first huge step of my journey into recovery and into health.
Laura Petracek, Ph.D. (03:25):
Mental health, physical, social. And then from there, I started-- there was a two-year program for chemical dependency in Minneapolis. So I went through that program. I got my certificate. I continued to get my bachelor's degree in psychology, and during my senior year when I was about, I guess, a little over four years sober, I didn't really know what was happening. Although I knew I was feeling worse and worse, and my therapist kept asking, you know, are you suicidal? Are you depressed? And then I called my sponsor like three in the morning, one time. And she took me to-- I told her, I didn't want to go to a psychiatric ward because unfortunately my aunt had hung herself in a psychiatric ward. So, she took me to a rehab and there they did testing and found out at that time it was called manic depression.
Laura Petracek, Ph.D. (04:28):
And so I was diagnosed with manic depression, put on lithium. Although initially I had a lot of resistance because at that time in AA, you weren't-- you know, this is 45 years ago. You weren't considered clean and sober if you were taking medication. So that was a big struggle for me. But then by Tuesday night women's group came in, they were kind of my adopted family of choice and they said, "Look, you can't leave unless you take your-- we still see you as sober". And I celebrated my three, actually it was my third year, my three years, and they got me a nice t-shirt. And so, you know, I continued on into individual therapy. I was recruited from New York City from a program that was called Sapo House. And, oh, I came out as a lesbian in recovery.
Laura Petracek, Ph.D. (05:24):
And, I think that had a lot to do with my, you know, my drinking and drug career was all of four years. So I think that's why I escalated so quickly along with there's a huge family genetic component too. Coming from alcoholic family,
Keith Sutton, Psy.D. (05:41):
Because you weren't out at the time or you weren't?
Laura Petracek, Ph.D. (05:43):
I think, no, I wasn't out, but also I was from an alcoholic family, so that escalated things as well. And so I was recruited to be director of the program at age 22.
Keith Sutton, Psy.D. (05:59):
Oh, wow.
Laura Petracek, Ph.D. (06:00):
I kind of bit off more than I could chew. I wasn't quite ready, but boy, I learned quick; I mean, I was younger than all the staff members.
Keith Sutton, Psy.D. (06:11):
What was the program?
Laura Petracek, Ph.D. (06:12):
It was called Sapo House. It was a drug and alcohol program for lesbian women.
Laura Petracek, Ph.D. (06:18):
Yeah. But it was really, what should I say? It was very challenging. It was very eye-opening, working with the African American community, Latino community, basically for the first time. Our Latino community really opened my eyes, working with women, you know, who grew up in poverty. So a lot of cultures and situations that I hadn't worked with as a clinician. And then from there decided I want to be in private practice. I entered what's called the Gestalt Associates for Psychotherapy in New York City. It was a four-year therapy training program. And it was like one of the best decisions I made. I really learned how to do therapy at that, because they did videos and one-way mirrors and it was really a very intensive, excellent program. So I did that and my social work at the same time simultaneously. And then I got my LCSW, had got a full practice going. I was working at a school that didn't take long. I got tons of referrals.
Laura Petracek, Ph.D. (07:34):
And so then I did that for a number of years, and then this was when the Adult Child of Alcoholic and Codependent was really prominent in the therapy community, recovering community. And I had sent out letters all over the country wanting to set up a center with someone else, focusing on that. And I met a therapist in Seattle, so he and I started the program, Pacific Center Northwest.
Keith Sutton, Psy.D. (08:07):
Oh wow.
Laura Petracek, Ph.D. (08:08):
For people in recovery.
Laura Petracek, Ph.D. (08:13):
So we had tons of workshops. We offered tons of workshops. Individual group therapy. At that time, now I'm supervising interns. So it was, it was really an exciting time. So I was in a relationship for nine years with someone in New York, and then when I wanted to move for this next venture, she-- anyway, we split up, and then I moved to Seattle, and I met someone there, and she was also in the field. But then I wanted to go get my PhD. I sometimes say in the rooms of AA that school became my drug of choice. So anyway, and then the center, well, there was, that's a long story there, but, so that was kind of phasing out for different reasons. And then I heard about the program at CIIS and decided, "Oh, that's where I want to get my PhD."
Keith Sutton, Psy.D. (09:24):
In California.
Laura Petracek, Ph.D. (09:26):
Institute of Individual Studies. Right. So then I moved here and pursued my doctorate degree. Let me see. And then I met my future wife soon after, like maybe a year. No, no, I wasn't even finished. I was doing my pre-doc, no post-doc.
Laura Petracek, Ph.D. (09:50):
So I graduated in '96 with my PhD. Did my post-doc at the Golden Gate Medical Examiners, where I learned a lot about testing people coming in for SSI evals.
Keith Sutton, Psy.D. (10:03):
Disability in general.
Laura Petracek, Ph.D. (10:05):
Yeah. Any kind of disability you could think of. And this is kind of a funny little story there, so-- and I know, you know, this as psychologist, like you're working fulltime, an internship, and then you got to type up stuff at night. So, I guess I had fallen asleep, my partner's like, and we looked at my report, and it was like Joey XYZXYZ. And then it said-- and then I walked to the ATM. I must have been dreaming and I had a whole other story, but anyway.
Keith Sutton, Psy.D. (10:43):
Yeah.
Laura Petracek, Ph.D. (10:44):
Yeah, so finished that. Oh, let me see, got married, had a child, started working in a program out in Marin, the Marin Center for Women. So I was director of that program, and let me see. So doing a lot of chemical dependency. Also, that was when I started doing trauma work, which was pretty new at that time. A lot of women in recovery, as you know, are well aware of experienced trauma. So, there wasn't exactly training, but I sought out different supervisors that I had read that had worked with trauma to--
Keith Sutton, Psy.D. (11:38):
And you were saying new at that time, like the field of trauma was developing more?
Laura Petracek, Ph.D. (11:42):
Yeah, it was developing more, but it was still really in its infancy. I mean, this was '99. So, yeah. So, let's see. Then working, learning, taking all these workshops. I worked in forensics for a while at forensic psychology, worked at San Quentin State Prison. I set up their whole-- so it's interesting, when I started there, they only offered individual therapy. I said, "What about groups?" The groups-- because it was really run on a psychiatric model. And so I developed their whole group work program. So CBT groups, DBT groups, parole planning groups, parenting groups. So like, 10 different groups and it really flourished very well. And I really enjoyed at that time, now I'm supervising doctoral interns and doing the-- that's kind of my, that was my baby. And so I-- that was pretty much focus. Yeah. And then let me see. Oh, and during this time I have a small practice on the side. I kind of always have-- not like in New York, I had a full practice, but I found that trying to-- it just didn't work with having a child, and I didn't want to work evenings. And at that time, it seemed-- it was very challenging to get people to come before five. So, I just decided to get a regular job. So that's why I only had a few clients for quite a long time, so I could be at home or pick her up after school, that sort of thing. Yeah. And, so then fast forward into 2007-- no, 2017-- my daughter graduated from high school, and she went to college across the country. We were very close, and it was just a huge loss for me, her leaving. I sank into such a despair. It was really not good. So I increased therapy for once week to twice a week, and my psychiatrist worked with me on my medication, and then they suggested, or he suggested kind of a newer alternative to deal with depression called TMS-- transcranial or transmagnetic cranial system, something like that.
Keith Sutton, Psy.D. (14:49):
Yes. I always forget the acronym too while we're talking.
Laura Petracek, Ph.D. (14:53):
Unfortunately, this totally backfired for me.
Keith Sutton, Psy.D. (14:59):
Transcranial magnetic stimulation.
Laura Petracek, Ph.D. (15:01):
Yes, that. Thank you. I was back east with my wife, or at Lena's volleyball tournament, and I told Margo something's terribly wrong. Something is really wrong. And it was probably the 12th session I had, or the 12th treatment I had had. So it flipped me into a-- or triggered me into a full-blown manic episode. And it just scared-- I mean, here we are 3000 miles away from all my support. From my partner, my wife's support, you know, I didn't want to tell my daughter; she's in the middle of this huge tournament.
Keith Sutton, Psy.D. (15:47):
Yeah.
Laura Petracek, Ph.D. (15:49):
So as soon as I got home, you know, I saw my therapist, I saw my psychiatrist and then I told him, like, "Look, this. I've been fine on lithium since I'm, you know, what, 21? And now I'm 59 and never. So, this is directly related. I know it is." And then I did some research, and I don't know, that's kind of a whole other story. It turns out only the machine is approved by the FDA. It's not approved to work for bipolar, especially bipolar disorder. Yeah, so I took-- I went on disability. My therapist suggested I go through the Kaiser DBT program for emotional regulation. And then during this program, Marsha Linehan has this saying, but they also have this in 12-step. I don't know who said it first. But, "Pain is inevitable. Suffering is optional." I said, "Oh, that's what they said. That's from AA." And then just a light bulb went off, like, "Oh my God, there's so many people in the program who suffer from mental illness or mental health issues." And, I mean, here we are, years later, it's still, unfortunately, not talked about or not encouraged to be talked about, and these folks are really suffering. You know, thinking, oh, I just have to do another step, and then I'll, you know, I'll be better. Like one guy I met had said, "Oh, a sponsor told me to do the four-step five times and that's going to solve my anxiety problem." I said, "No, that's not." And he's not a therapist, so that's another issue too. But I thought- and so I just kind of let that percolate for awhile and then went back to work. And then the pandemic came about a year after I went back to work, and I was like, "Ugh." And I worked for the school, so I was not laid off, but there wasn't really any work. And that's when I thought, "Oh, I want to write this book." So I think this would be really valuable, you know, connecting the DBT skills with the corresponding step and like a first-step concepts with several DBT skills.
Keith Sutton, Psy.D. (18:31):
Yeah.
Laura Petracek, Ph.D. (18:31):
And so that's how I'm going through the whole book.
Keith Sutton, Psy.D. (18:35):
Oh, very good.
Laura Petracek, Ph.D. (18:36):
That's my outline for the book. You know, first I talk about my own story, just like I shared with you, you know? Pretty briefly, only a few pages. And then I go on to, you know, talk about my years in recovery and how-- wow. Even though it's funny, I've taken-- I was looking through my files, I've I started in, I think it was 2004, taking DBT workshops. So I've taken DBT training for, I don't know, like what is that? 15, 16 years. But it's different being on the professional side.
Keith Sutton, Psy.D. (19:18):
You know, well, it's actually, I was wondering about that, because I know in my own experience, you know, as therapists, we also have life and life happening. And, you know, we have periods where things are kind of running smooth and periods where we go through difficult times in our own life. And I think that it, at least, I don't know, it sounds like, you know, I've also had the experience where I get so much more insight into sometimes the experience with my clients, or also about kind of applying some of the things that I've learned or even used with my clients in such a deeper way than, maybe, than ever before. And kind of like you're saying, like having the training and knowing it and using it, but then when you go through that experience, or having a crisis, or whatever it might be, and then actually kind of integrating it, it's just a more deeper experiential experience of using these tools, these kind of modalities of helping.
Laura Petracek, Ph.D. (20:16):
Yeah. And I think, I mean, that's totally right on because I, you know, a couple of clients I'm working with through IAP, had bipolar, but they're not familiar, you know, they're in-- not individual, but I forget the name of the group at Kaiser, but it's not-- oh, it's IOP, so it's not DBT. But it's mainly processed and they're not really learning a lot of skills. So I'm teaching them DBT along with their, you know, going to this IOP group and seeing the psychiatrist, and I'm-- you know, they're finding it helpful. And then I've been talking to, you know, different people in the program about my book and they're like first readers. And you're saying they think this is going to be really invaluable because, like, AA, you know, is dated in a sense, it's 80 years old. A lot of the language, especially when I worked in the prison, they're like, "Dr. P, what does this say?" So they, you know, it's not really reader-friendly, so to speak. And, there's certain tools from each step, which is helpful, but now it's 80 years later, there's so many more tools.
Keith Sutton, Psy.D. (21:45):
Yeah.
Laura Petracek, Ph.D. (21:46):
So why not integrate that into the steps, or at least do a parallel process? Which is kind of what I've done. I've done different graphs, and then I explain the parallels, and then I give examples. And then I offer-- then I'm teaching the DBT skills, because those are relatively new or new for folks.
Keith Sutton, Psy.D. (22:12):
Well, a lot of with the 12-steps, you know, is also that, you know, the first step is that it hasn't been working, trying to figure this out on my own or do it my way. So I really need to kind of realize that I am powerless and accept that and just kind of go on the track here and kind of follow the steps and, you know, kind of do it this other way that has worked for other folks, which I think is great. And so it sounds like you're taking what has been working for 80 years, you know, in these different steps and so on. And then also kind of enhancing it with also the research on, you know, kind of, the behavioral therapy research and techniques, and so on, that can actually kind of enhance that work.
Laura Petracek, Ph.D. (23:02):
Right. And I found through my research for this book. So, Bill W., who's like, you know, one of them two major people at start AA--Bill W. and Dr. Bob--he went through a debilitating depression for almost four years. He actually worked with Carl Jung, very briefly.
Keith Sutton, Psy.D. (23:26):
Oh, wow.
Laura Petracek, Ph.D. (23:27):
And at the end of-- well, he wasn't finished with therapy, but he said, "I really feel there needs to be a component, of--," he didn't say therapy. What was the word he used? A component of introspection, psycho-- not analysis, but psychotherapy, for lack of the term at that time, that really would complement the steps. So he really was, in a way, to me, talking about adding something like DBT to the 12-steps. Because here's someone who was like the father of AA, he did all the steps and he was suicidal.
Keith Sutton, Psy.D. (24:18):
Yeah.
Laura Petracek, Ph.D. (24:19):
And, you know, that's not discussed, it's-- you just do these steps and you get to step 12 and you're happily ever after--not quite so simple, but kind of along those lines. And this story is not really well known about him.
Keith Sutton, Psy.D. (24:37):
So funny, actually-- I don't know if I've ever told you, I know we've talked about that I have family that are very involved with 12-steps and I think very highly of the 12-step work. My uncle actually wrote and published a book called, "The Writing of the Big Book. I don't know if you've--which is actually the story of the, you know, the-- basically The Writing of the Big Book and, Bill W. and Dr. Bob's experience as they're kind of putting together, and he had manuscripts with notes and so on from it that he worked off of and research, but that's so interesting.
Laura Petracek, Ph.D. (25:13):
I really love to, and your uncle's name, Keith?
Keith Sutton, Psy.D. (25:17):
It's William Sthaberg.
Laura Petracek, Ph.D. (25:21):
S-H-A-B as in boy?
Keith Sutton, Psy.D. (25:22):
S-T-H-A-B-E-R-G.
Laura Petracek, Ph.D. (25:27):
Okay. Great, I'm going to-- I want to--
Keith Sutton, Psy.D. (25:31):
Yeah, that would be so interesting.
Laura Petracek, Ph.D. (25:33):
More--
Keith Sutton, Psy.D. (25:33):
I'll get you guys in touch, the conversation because I--
Laura Petracek, Ph.D. (25:37):
Oh, great. I would really appreciate it because yeah, this is what's--
Keith Sutton, Psy.D. (25:43):
That's part of the intent of The Big Book.
Laura Petracek, Ph.D. (25:46):
Yes. And that-- but yet that intent, that's where it stayed unfortunately. And even today, you know, I'll celebrate 46 years this September. Even today at meetings, someone will say, "Oh, I'm, you know, maybe not suicidal, but oh, I'm just really depressed," or, "Oh, I'm really anxious." And some people recommend outside help--thank you. But some people say, "Oh, you know, I felt like that. I just call people." And I-- and not that that doesn't help. You know, take a warm bath.
Keith Sutton, Psy.D. (26:31):
Some of those things can be very helpful--
Laura Petracek, Ph.D. (26:32):
Yeah, they're tools--
Keith Sutton, Psy.D. (26:32):
Kind of low-level using those tools and you--
Laura Petracek, Ph.D. (26:37):
But a lot of people could really benefit. I remember I went to this one conference, and I was talking to this woman, and her husband was MIA for a long time. And then she said he had quit taking antidepressants, and he killed himself like six months later. And he stopped taking them because he felt like he wasn't truly sober. And I said, "Oh, that's just so maddening to me that this is still--there's still this stigma." So I think that's also a big reason I wrote the book, not just the stigma of mental health and AA, but also, you know, society as a whole. And also about mental health practitioners not talking about, if they're in recovery for mental illness. That's a big no-no, or whatever. So, you know, for all these reasons, that's why I'm writing this book, and I think it's great because of that word is perfect, what William said--the intent was also to have this parallel psychotherapy dialogue or material, and it's not there.
Keith Sutton, Psy.D. (27:50):
Yeah, definitely. And I'm wondering too about-- can you tell me a little bit about your last work too? Because I know that you also, you know, did your book on women and anger--
Laura Petracek, Ph.D. (28:03):
Oh, right, sure.
Keith Sutton, Psy.D. (28:04):
And I'd be interested in, kind of, yeah, how your thinking or writing is evolving. And I know we were talking too, that you had worked with actually one of the other folks that I interviewed, John Hamel, and has worked around relationship violence. Can you tell me a little bit about that and how that kind of plays into the evolution of your thinking and work?
Laura Petracek, Ph.D. (28:25):
So I did my pre-doc in Seattle, at Harborview Hospital in their anger management and psychiatry program. And at that time, I hadn't decided on what I was doing my dissertation on, and my supervisor, Dr. Mayero, said, you know, "We're getting a lot of calls from women." Because it was strictly-- their program was just for men, the anger management side. The mental health was separate, but anyway, he goes, "I wonder if you, you know, how would you feel about starting a women's group, and maybe you could do, you know, do your research on that, your--dissertation on women in anger.
Keith Sutton, Psy.D. (29:07):
Yeah.
Laura Petracek, Ph.D. (29:07):
And I said, "Oh, I think that's a great idea. I love the idea." And so we were on the third floor, and the second floor of the hospital was the STD unit. And so this woman had found out that her boyfriend had given her STD, and when she found that out, she kind of went ballistic on him. So security was called--
Keith Sutton, Psy.D. (29:33):
Oh wow.
Laura Petracek, Ph.D. (29:33):
And they brought her up to the third floor where I was, and said, "Who-- we're looking for Dr. Petracek?" And they-- so she was my first client. And I got several clients directly just from the hospital. Like, one time there was like a little fender bender outside, and the two folks went-- you know, going on at each other, "It's your fault! It's your fault!" And so, security brought the woman upstairs.
Keith Sutton, Psy.D. (30:04):
You're a go-to person to--
Laura Petracek, Ph.D. (30:08):
And then, luckily-- or I'm not sure if the right word is, but my sister who's an art therapist, also lived in Seattle. And I asked if she could come, like once every, I don't know, four weeks, to do an art therapy part of the group. And so, that's in my dissertation as well. And also in my book that I found art therapy is definitely a good tool, it's a therapeutic tool--a way for women to express themselves, where maybe their verbal aspect or writing it just still doesn't get it out. Actually, I had women pick up photography and they would bring in their pictures to express how they felt, or writing/journaling was a big thing. And I didn't, you know, I wasn't really quite sure.
Laura Petracek, Ph.D. (31:10):
I mean, I had different books I used for the men in their anger program, but there was nothing for women. And so, what I initially did was just, so you know, like, here, let's say this is the anger workbook for men. And then I just kind of cut and paste the anger workbook for women and then Xeroxed pages. And I'm like, "No." This is different clinically from what this-- my research is showing for women than for men. And so then I started gearing my group manual differently. So, for example, for men, the issue is primarily power and control, but that's not it. For women, I mean, that's one of them, but I also found 13 other major triggers for women in their anger, which had nothing to do with power and control. It had to do with, for example, when they see someone, you know, if their child is being hurt by someone. If they're feeling-- if there is some sense of injustice, if they feel disrespected. I can't remember all off the top of my head. Yeah, so then from there--
Keith Sutton, Psy.D. (32:36):
Based on some research that you were doing?
Laura Petracek, Ph.D. (32:38):
Yeah, this is on my research.
Keith Sutton, Psy.D. (32:39):
Yeah, yeah.
Laura Petracek, Ph.D. (32:40):
Yes.
Keith Sutton, Psy.D. (32:41):
Tell a little bit about that.
Laura Petracek, Ph.D. (32:42):
Okay. So, my research-- I was very familiar with the research on men and anger, but there wasn't a lot about women in anger. So I, you know, read all I could. And then, at first, it was kind of a Likert scale. Like, I was okay. So this one, I was angry because, you know, Johnny disrespected me, my husband said the food smelled terrible, or whatever. And so then, mine was a qualitative dissertation. So, at this time, what's it called? CPSS? The software was pretty new--
Keith Sutton, Psy.D. (33:22):
Or SPSS.
Laura Petracek, Ph.D. (33:23):
Oh yeah. SPSS. Thank you.
Keith Sutton, Psy.D. (33:25):
I remember that from grad school. Lots of time with that SPSS. Yeah, go on.
Laura Petracek, Ph.D. (33:30):
Oh, okay, so you know what I'm talking about. So then putting all the info in, the different words, and then at the time, I was actually teaching and I just kind of holed myself up in my office for a month. I just would go out to vending machines, or they didn't have DoorDash at the time, but maybe walk down the street, but I thought I have got to live and breathe this dissertation to get it done. And so, that's what I did. And then I just had all this research all over. And so then, finding out more about women in anger, they had ex-- a lot of the literature was about women who kill, or women who were really, really violent, you know? They didn't really have more of a, I don't want to say minor, but kind of an in-between type of anger. You know, and then they had the passive, you know, type of expression of anger for women, but they didn't really have a middle ground. So this is where I focused a lot on. And--
Keith Sutton, Psy.D. (34:36):
And so, is this quantitative work that you did that came up, that kind of decipher those 13 kind of--
Laura Petracek, Ph.D. (34:42):
Well, the qualitative, yes.
Laura Petracek, Ph.D. (34:46):
Yeah, that's exactly right. Yeah. So just, you know, through all these interviews--like, I don't know, it was probably 200 or 300 interviews--and then putting them in, so to speak, and then-- or inputting the data. And so, yeah, this is what came out.
Keith Sutton, Psy.D. (35:06):
Oh, great.
Laura Petracek, Ph.D. (35:07):
And so, wrote my dissertation, graduated. And at this time, though, I'm still primarily in the field of chemical dependency at Marine Center for Women. And then I came across John Hillel's work, I don't know, on the internet, because one day I was like, "There's got to be-- who else in the field is doing this?" So then he and I met, and he said, "Oh, well, I'm sorry to do research that, you know, it's not just men who are getting angry." I said, "Oh, I could tell you all about that," you know?
Keith Sutton, Psy.D. (35:43):
Sure.
Laura Petracek, Ph.D. (35:45):
And then he and I started actually doing workshops together. We did trainings around the state.
Laura Petracek, Ph.D. (35:51):
And then, he ended up writing his book first, that was more on a professional side. I decided to write mine on the-- through Springer publication. Springer wanted me to publish a book, but on the professional end, and I was torn, I was like, "Err," so I decided to do on the-- for the lay person.
Keith Sutton, Psy.D. (36:19):
Yeah.
Laura Petracek, Ph.D. (36:20):
And then his career really took off in that direction. And, you know, now my daughter's getting older, it just didn't work. I, you know, that's why I said I had got like a 9-to-5 job.
Keith Sutton, Psy.D. (36:34):
Sure, sure. Yeah.
Laura Petracek, Ph.D. (36:36):
And you know, Margot, also my wife, had a 9-to-5 job. It just wouldn't have worked for-- I mean, I would've liked to have continued, but it just wasn't feasible to travel and do workshops--
Keith Sutton, Psy.D. (36:54):
But I think, yeah. I mean--
Laura Petracek, Ph.D. (36:55):
I really loved it. It's great.
Keith Sutton, Psy.D. (36:57):
I had that same thought or feeling about traveling and doing workshops and so on. It's like. Really, what is, what's most important right now? And yes, kids also, and--
Laura Petracek, Ph.D. (37:06):
Yeah, so you understand, and even now, it was funny. I was talking to Margo when I was driving from school and I said, "How are these parents doing this? They're starting--I mean, at least over on this side of the East Bay--school's starting at 11 and they're done at 2." And she's like, "Can you imagine when we were raising Leah, like how that would work with either one of us?"
Keith Sutton, Psy.D. (37:28):
Oh my God.
Laura Petracek, Ph.D. (37:29):
So, yeah.
Keith Sutton, Psy.D. (37:29):
During this pandemic, yeah. People are figuring out or making it work. Yeah, it's the same kind of thing--we've got that too. It's like schools are open for like two and a half hours, and it's like so much time, even just driving back and forth for that time.
Laura Petracek, Ph.D. (37:41):
I know, but I did end up, you know, being able to-- I mean, John and I still did some work, you know, our kids, we ended up becoming friends, and my daughter and I would go over to his kid, his daughter-- they were at the same age. No, his daughter, Aviva, is probably a couple years older, but anyway, we spent a lot of time, you know, hammering out this work and writing, and it was really an exciting time.
Keith Sutton, Psy.D. (38:15):
Now I'm going to circle back--if you don't mind--to the, again, the focus of the book, of that, you know, that pain is, you know, that-- and the way I've thought about it or heard about it is the idea of primary pain and secondary suffering, that, you know, that yeah, the pain is inevitable. There's nothing you can do about, like, you know, the hurt, the sadness you'll feel when a loved one passes away, or the stress, you know, in going for that job interview, or so on. But there's that kind of secondary aspect of the way we think, or talk to ourselves about it, and kind of, you know, yeah, saying that, you know, like, "Oh, you're not going to do this," or "Why'd you screw up that way?," or, you know, like, "Oh, you know, that things are never going to be okay again," you know, and particularly the cognitive therapy aspect really kind of maintains it.
Keith Sutton, Psy.D. (39:05):
And I'd be interested to look up to, I mean, you know, the way that I've actually--where I've located that is in really in Eastern philosophy. And, you know, my undergrad minor was in Eastern philosophy. And in Buddhism, that kind of idea that, yeah, there is that primary pain that we feel that pain and being able to accept that pain and be with that pain and suffering, as well as the positive feelings and so on, and letting them all be, is kind of what we need to do in life. But the attempt to kind of get away from that pain, or feel like that's wrong, or it's not supposed to happen, or so on, is wherein lies the problems.
Laura Petracek, Ph.D. (39:43):
Right, and you're so right on about that. Because even though that's that third piece, the Buddhist piece, is sometimes referenced to DBT. It really is from Buddhism--the mindfulness, the acceptance, you know, like you're saying, that really does come from Buddhism or originated there. And so the piece-- how they, you know, they-- it's basically what you talked about: pain is inevitable, okay. And the suffering is optional does bring in that CBT component, you know. Okay, so, you know, your wife left you or your husband left you. Okay, that's really painful, but now, What are you saying? So looking at thought records, what are you saying to yourself? So "the suffering is optional" is about, you know, how people make it so much worse by what they're saying to themselves. And so doing that CBT component is big in terms of that particular saying, you know, what are you saying to yourself? Yeah.
Keith Sutton, Psy.D. (40:54):
And I'm wondering--it sounds like you were kind of inspired by this, and I mean, you---this is part of the title of your new book. And through your experience in the DBT part, can you say about why, of all the pieces, that one kind of rose to the top?
Laura Petracek, Ph.D. (41:08):
I think it rose to the top because I was like, "That's from AA!"
Keith Sutton, Psy.D. (41:16):
So, there was this kind of cross-over between the two, and--
Laura Petracek, Ph.D. (41:19):
Yes. And then I---of course there's a cross-over!
Keith Sutton, Psy.D. (41:23):
Oh.
Laura Petracek, Ph.D. (41:24):
Cross-over! So that's really what started my mind clicking, is like, "Hey-," at first I was like, "Hey, she's stealing that from my AA," and then I'm realizing, "Wait, there's so much cross-over." And this would be so beneficial for people in 12-step.
Keith Sutton, Psy.D. (41:44):
Yeah.
Laura Petracek, Ph.D. (41:45):
So that's where it really--yeah. That's where that sentence-- and then what light bulb went off about the cross-over.
Keith Sutton, Psy.D. (41:52):
Yeah, definitely.
Keith Sutton, Psy.D. (41:55):
And it's so nice that there's a number of, you know, folks I've been interviewing for this podcast, and, you know, a theme I keep hearing is a lot of folks trying to find out, "How do we get these kind of tools, these kind of evidence-based approaches, things like that, that we know help to the masses, to, you know, people--everybody has the time or the money for, you know, doing the therapy work, or, you know, whatever it might be?" So kind of really, how do we, you know, disseminate and make that available? So that's great that you're, you know, because AA is great--it's free, it's a community for folks that are, you know, that have that resource available. And so it's nice to kind of, you know, additionally give more tools and have something that can be easily accessible.
Laura Petracek, Ph.D. (42:41):
Right. But what you just brought up is ia really interesting point: evidence-based. So originally, I was going to do my dissertation on the 12-step program. What-- and try to find quote, you know, they say, "It works if you work it," what's it? What, you know, h my God. I could not believe the pushback I got.
Keith Sutton, Psy.D. (43:07):
Wow.
Laura Petracek, Ph.D. (43:08):
You can't study the-- I mean, I just talked to different people in my different groups, and the resistance was incredible. And so, that's another reason I do want to study after this book is done. You know, my hope is, is that a 12-step program will use---or a 12-step group will use---my book, like they're using it, like there's 12 Steps in Agnostic. So they use that particular book, or 12 Step in, I don't know, something else, but they-- or like the Buddhist, what's his name-- and they use his book in 12-step meditation meetings. So I would like to study, how is this helping, so people using DBT skills-- is this helping? Because, as you well know, 12-step is not evidence based.
Keith Sutton, Psy.D. (44:08):
Yeah, yeah.
Laura Petracek, Ph.D. (44:09):
And there's no--not that there's no way--but there's-- it's very hard to get in to see what's actually working or not working--
Keith Sutton, Psy.D. (44:18):
Sure, sure.
Laura Petracek, Ph.D. (44:19):
To measure that out so--
Keith Sutton, Psy.D. (44:20):
Well, yeah. There's some research on kind of pre- and post-, I think, or whatever time in, or so on, or doing the steps, but not necessarily like deconstructing the process, you know, of the research of what is work.
Laura Petracek, Ph.D. (44:31):
Yeah, exactly.
Laura Petracek, Ph.D. (44:33):
That's-- exactly. So, that's why I abandoned that idea. I was like, "Well, it's too bad, because it does need to be researched." But anyway, I am hoping to do some research to make it--not make it--to have it be-- I mean, DBT is evidence-based, but more now the combination--is that evidence-based to work with? Alcoholic addicts?
Keith Sutton, Psy.D. (45:02):
Well, thank you so much for taking the time, and, you know, I--I know you're doing such great work in the clients that you're working with through the Institute, and the children, and the couples, and the families, and the individual adults. And so, it's nice, you know, we've talked, of course, and shared cases and so on, but it's great to really hear kind of this, you know, all these aspects and how that plays into the way you're thinking and working and really trying to further the field. So I really appreciate you taking the time today.
Laura Petracek, Ph.D. (45:30):
Great. Thanks Keith. Thank you so much for listening and your unconditional regard. I really appreciate it.
Keith Sutton, Psy.D. (45:38):
Great. Well, thank you so much. Take care.
Laura Petracek, Ph.D. (45:41):
Take care.
Keith Sutton, Psy.D. (45:42):
Bye.
Laura Petracek, Ph.D. (45:42):
Bye.
Keith Sutton, Psy.D. (45:45):
Thank you for joining us today. If you'd like to receive continuing education credits 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 in evidence-based models through live and online workshops, on-demand 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 sf-bacc.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 BACC’s website at sfbacc.org. BACC is a 501(c)(3) 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 Desensitization and 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 an 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; and our center for ADHD and Oppositional & Conduct Disorder clinic, where we're integrating those four approaches.
Keith Sutton, Psy.D. (01:31):
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-bacc.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 501(c)(3) nonprofit, so all donations are tax deductible.
Keith Sutton, Psy.D. (00:37):
Today, I'll be speaking with Laura Petracek Ph.D., who is a clinical psychologist, speaker, and the author of "Anger Workbook for Women: How to Keep Your Anger from Undermining Your Self-Esteem, Your Emotional Balance and Your Relationships." She has over 30 years of experience and specializes in dialectical behavioral therapy and other evidence-based therapies for alcohol and substance use, mood disorders, and anger dyscontrol issues. Her other areas of expertise include working with children and adolescents with ADHD, oppositional defiant disorder, autism spectrum disorder, and other learning disabilities. She's a past clinician at San Quentin Federal Prison, and currently is in the process of writing the book, "Pain is Inevitable; Suffering is Optional Dialectical Behavioral Therapy Skills for Alcoholics and Addicts." Let's listen to the interview.
Keith Sutton, Psy.D. (01:26):
Well, hi, Laura. Thanks for joining us today.
Laura Petracek, Ph.D. (01:29):
Thank you, Keith. Thanks for having me.
Keith Sutton, Psy.D. (01:31):
Definitely. So, Laura, we've known each other for some time, we had shared an office together for many years in San Francisco.
Laura Petracek, Ph.D. (01:42):
Yes.
Keith Sutton, Psy.D. (01:42):
And I've seen, you know, some of the books that you had in the office of one particularly you authored, and you came to some of the workshops that I had, and now we're working together as part of the Institute. And I wanted to bring you on to learn a little bit more about, and kind of share with others, your work and, you know, working with this number of different topics. I mean, you've done some work with families and with relationship violence, you've authored a book on women and anger, you're also in, you know, in the middle of another book on working with substance abuse and integrating some DBT work and so on. But to start with, I'd love to just hear, you know, I know actually bits and pieces that we've talked about of your background and your work and so on, but yeah, would love to hear kind of how you got where you are now and kind of the, you know, evolution of your work and your thinking and such. But yeah.
Laura Petracek, Ph.D. (02:43):
Okay. I mean, how far do you want to go back?
Keith Sutton, Psy.D. (02:47):
Wherever you feel like the story begins?
Laura Petracek, Ph.D. (02:49):
Okay. Well, sometimes I wonder if I chose this field or it chose me. I entered rehab when I was 17 years old.
Laura Petracek, Ph.D. (03:03):
And my family was totally against it. I luckily had someone who helped me get emancipated as a minor to sign myself in treatment. And so separating from my family and getting clean and sober was the first huge step of my journey into recovery and into health.
Laura Petracek, Ph.D. (03:25):
Mental health, physical, social. And then from there, I started-- there was a two-year program for chemical dependency in Minneapolis. So I went through that program. I got my certificate. I continued to get my bachelor's degree in psychology, and during my senior year when I was about, I guess, a little over four years sober, I didn't really know what was happening. Although I knew I was feeling worse and worse, and my therapist kept asking, you know, are you suicidal? Are you depressed? And then I called my sponsor like three in the morning, one time. And she took me to-- I told her, I didn't want to go to a psychiatric ward because unfortunately my aunt had hung herself in a psychiatric ward. So, she took me to a rehab and there they did testing and found out at that time it was called manic depression.
Laura Petracek, Ph.D. (04:28):
And so I was diagnosed with manic depression, put on lithium. Although initially I had a lot of resistance because at that time in AA, you weren't-- you know, this is 45 years ago. You weren't considered clean and sober if you were taking medication. So that was a big struggle for me. But then by Tuesday night women's group came in, they were kind of my adopted family of choice and they said, "Look, you can't leave unless you take your-- we still see you as sober". And I celebrated my three, actually it was my third year, my three years, and they got me a nice t-shirt. And so, you know, I continued on into individual therapy. I was recruited from New York City from a program that was called Sapo House. And, oh, I came out as a lesbian in recovery.
Laura Petracek, Ph.D. (05:24):
And, I think that had a lot to do with my, you know, my drinking and drug career was all of four years. So I think that's why I escalated so quickly along with there's a huge family genetic component too. Coming from alcoholic family,
Keith Sutton, Psy.D. (05:41):
Because you weren't out at the time or you weren't?
Laura Petracek, Ph.D. (05:43):
I think, no, I wasn't out, but also I was from an alcoholic family, so that escalated things as well. And so I was recruited to be director of the program at age 22.
Keith Sutton, Psy.D. (05:59):
Oh, wow.
Laura Petracek, Ph.D. (06:00):
I kind of bit off more than I could chew. I wasn't quite ready, but boy, I learned quick; I mean, I was younger than all the staff members.
Keith Sutton, Psy.D. (06:11):
What was the program?
Laura Petracek, Ph.D. (06:12):
It was called Sapo House. It was a drug and alcohol program for lesbian women.
Laura Petracek, Ph.D. (06:18):
Yeah. But it was really, what should I say? It was very challenging. It was very eye-opening, working with the African American community, Latino community, basically for the first time. Our Latino community really opened my eyes, working with women, you know, who grew up in poverty. So a lot of cultures and situations that I hadn't worked with as a clinician. And then from there decided I want to be in private practice. I entered what's called the Gestalt Associates for Psychotherapy in New York City. It was a four-year therapy training program. And it was like one of the best decisions I made. I really learned how to do therapy at that, because they did videos and one-way mirrors and it was really a very intensive, excellent program. So I did that and my social work at the same time simultaneously. And then I got my LCSW, had got a full practice going. I was working at a school that didn't take long. I got tons of referrals.
Laura Petracek, Ph.D. (07:34):
And so then I did that for a number of years, and then this was when the Adult Child of Alcoholic and Codependent was really prominent in the therapy community, recovering community. And I had sent out letters all over the country wanting to set up a center with someone else, focusing on that. And I met a therapist in Seattle, so he and I started the program, Pacific Center Northwest.
Keith Sutton, Psy.D. (08:07):
Oh wow.
Laura Petracek, Ph.D. (08:08):
For people in recovery.
Laura Petracek, Ph.D. (08:13):
So we had tons of workshops. We offered tons of workshops. Individual group therapy. At that time, now I'm supervising interns. So it was, it was really an exciting time. So I was in a relationship for nine years with someone in New York, and then when I wanted to move for this next venture, she-- anyway, we split up, and then I moved to Seattle, and I met someone there, and she was also in the field. But then I wanted to go get my PhD. I sometimes say in the rooms of AA that school became my drug of choice. So anyway, and then the center, well, there was, that's a long story there, but, so that was kind of phasing out for different reasons. And then I heard about the program at CIIS and decided, "Oh, that's where I want to get my PhD."
Keith Sutton, Psy.D. (09:24):
In California.
Laura Petracek, Ph.D. (09:26):
Institute of Individual Studies. Right. So then I moved here and pursued my doctorate degree. Let me see. And then I met my future wife soon after, like maybe a year. No, no, I wasn't even finished. I was doing my pre-doc, no post-doc.
Laura Petracek, Ph.D. (09:50):
So I graduated in '96 with my PhD. Did my post-doc at the Golden Gate Medical Examiners, where I learned a lot about testing people coming in for SSI evals.
Keith Sutton, Psy.D. (10:03):
Disability in general.
Laura Petracek, Ph.D. (10:05):
Yeah. Any kind of disability you could think of. And this is kind of a funny little story there, so-- and I know, you know, this as psychologist, like you're working fulltime, an internship, and then you got to type up stuff at night. So, I guess I had fallen asleep, my partner's like, and we looked at my report, and it was like Joey XYZXYZ. And then it said-- and then I walked to the ATM. I must have been dreaming and I had a whole other story, but anyway.
Keith Sutton, Psy.D. (10:43):
Yeah.
Laura Petracek, Ph.D. (10:44):
Yeah, so finished that. Oh, let me see, got married, had a child, started working in a program out in Marin, the Marin Center for Women. So I was director of that program, and let me see. So doing a lot of chemical dependency. Also, that was when I started doing trauma work, which was pretty new at that time. A lot of women in recovery, as you know, are well aware of experienced trauma. So, there wasn't exactly training, but I sought out different supervisors that I had read that had worked with trauma to--
Keith Sutton, Psy.D. (11:38):
And you were saying new at that time, like the field of trauma was developing more?
Laura Petracek, Ph.D. (11:42):
Yeah, it was developing more, but it was still really in its infancy. I mean, this was '99. So, yeah. So, let's see. Then working, learning, taking all these workshops. I worked in forensics for a while at forensic psychology, worked at San Quentin State Prison. I set up their whole-- so it's interesting, when I started there, they only offered individual therapy. I said, "What about groups?" The groups-- because it was really run on a psychiatric model. And so I developed their whole group work program. So CBT groups, DBT groups, parole planning groups, parenting groups. So like, 10 different groups and it really flourished very well. And I really enjoyed at that time, now I'm supervising doctoral interns and doing the-- that's kind of my, that was my baby. And so I-- that was pretty much focus. Yeah. And then let me see. Oh, and during this time I have a small practice on the side. I kind of always have-- not like in New York, I had a full practice, but I found that trying to-- it just didn't work with having a child, and I didn't want to work evenings. And at that time, it seemed-- it was very challenging to get people to come before five. So, I just decided to get a regular job. So that's why I only had a few clients for quite a long time, so I could be at home or pick her up after school, that sort of thing. Yeah. And, so then fast forward into 2007-- no, 2017-- my daughter graduated from high school, and she went to college across the country. We were very close, and it was just a huge loss for me, her leaving. I sank into such a despair. It was really not good. So I increased therapy for once week to twice a week, and my psychiatrist worked with me on my medication, and then they suggested, or he suggested kind of a newer alternative to deal with depression called TMS-- transcranial or transmagnetic cranial system, something like that.
Keith Sutton, Psy.D. (14:49):
Yes. I always forget the acronym too while we're talking.
Laura Petracek, Ph.D. (14:53):
Unfortunately, this totally backfired for me.
Keith Sutton, Psy.D. (14:59):
Transcranial magnetic stimulation.
Laura Petracek, Ph.D. (15:01):
Yes, that. Thank you. I was back east with my wife, or at Lena's volleyball tournament, and I told Margo something's terribly wrong. Something is really wrong. And it was probably the 12th session I had, or the 12th treatment I had had. So it flipped me into a-- or triggered me into a full-blown manic episode. And it just scared-- I mean, here we are 3000 miles away from all my support. From my partner, my wife's support, you know, I didn't want to tell my daughter; she's in the middle of this huge tournament.
Keith Sutton, Psy.D. (15:47):
Yeah.
Laura Petracek, Ph.D. (15:49):
So as soon as I got home, you know, I saw my therapist, I saw my psychiatrist and then I told him, like, "Look, this. I've been fine on lithium since I'm, you know, what, 21? And now I'm 59 and never. So, this is directly related. I know it is." And then I did some research, and I don't know, that's kind of a whole other story. It turns out only the machine is approved by the FDA. It's not approved to work for bipolar, especially bipolar disorder. Yeah, so I took-- I went on disability. My therapist suggested I go through the Kaiser DBT program for emotional regulation. And then during this program, Marsha Linehan has this saying, but they also have this in 12-step. I don't know who said it first. But, "Pain is inevitable. Suffering is optional." I said, "Oh, that's what they said. That's from AA." And then just a light bulb went off, like, "Oh my God, there's so many people in the program who suffer from mental illness or mental health issues." And, I mean, here we are, years later, it's still, unfortunately, not talked about or not encouraged to be talked about, and these folks are really suffering. You know, thinking, oh, I just have to do another step, and then I'll, you know, I'll be better. Like one guy I met had said, "Oh, a sponsor told me to do the four-step five times and that's going to solve my anxiety problem." I said, "No, that's not." And he's not a therapist, so that's another issue too. But I thought- and so I just kind of let that percolate for awhile and then went back to work. And then the pandemic came about a year after I went back to work, and I was like, "Ugh." And I worked for the school, so I was not laid off, but there wasn't really any work. And that's when I thought, "Oh, I want to write this book." So I think this would be really valuable, you know, connecting the DBT skills with the corresponding step and like a first-step concepts with several DBT skills.
Keith Sutton, Psy.D. (18:31):
Yeah.
Laura Petracek, Ph.D. (18:31):
And so that's how I'm going through the whole book.
Keith Sutton, Psy.D. (18:35):
Oh, very good.
Laura Petracek, Ph.D. (18:36):
That's my outline for the book. You know, first I talk about my own story, just like I shared with you, you know? Pretty briefly, only a few pages. And then I go on to, you know, talk about my years in recovery and how-- wow. Even though it's funny, I've taken-- I was looking through my files, I've I started in, I think it was 2004, taking DBT workshops. So I've taken DBT training for, I don't know, like what is that? 15, 16 years. But it's different being on the professional side.
Keith Sutton, Psy.D. (19:18):
You know, well, it's actually, I was wondering about that, because I know in my own experience, you know, as therapists, we also have life and life happening. And, you know, we have periods where things are kind of running smooth and periods where we go through difficult times in our own life. And I think that it, at least, I don't know, it sounds like, you know, I've also had the experience where I get so much more insight into sometimes the experience with my clients, or also about kind of applying some of the things that I've learned or even used with my clients in such a deeper way than, maybe, than ever before. And kind of like you're saying, like having the training and knowing it and using it, but then when you go through that experience, or having a crisis, or whatever it might be, and then actually kind of integrating it, it's just a more deeper experiential experience of using these tools, these kind of modalities of helping.
Laura Petracek, Ph.D. (20:16):
Yeah. And I think, I mean, that's totally right on because I, you know, a couple of clients I'm working with through IAP, had bipolar, but they're not familiar, you know, they're in-- not individual, but I forget the name of the group at Kaiser, but it's not-- oh, it's IOP, so it's not DBT. But it's mainly processed and they're not really learning a lot of skills. So I'm teaching them DBT along with their, you know, going to this IOP group and seeing the psychiatrist, and I'm-- you know, they're finding it helpful. And then I've been talking to, you know, different people in the program about my book and they're like first readers. And you're saying they think this is going to be really invaluable because, like, AA, you know, is dated in a sense, it's 80 years old. A lot of the language, especially when I worked in the prison, they're like, "Dr. P, what does this say?" So they, you know, it's not really reader-friendly, so to speak. And, there's certain tools from each step, which is helpful, but now it's 80 years later, there's so many more tools.
Keith Sutton, Psy.D. (21:45):
Yeah.
Laura Petracek, Ph.D. (21:46):
So why not integrate that into the steps, or at least do a parallel process? Which is kind of what I've done. I've done different graphs, and then I explain the parallels, and then I give examples. And then I offer-- then I'm teaching the DBT skills, because those are relatively new or new for folks.
Keith Sutton, Psy.D. (22:12):
Well, a lot of with the 12-steps, you know, is also that, you know, the first step is that it hasn't been working, trying to figure this out on my own or do it my way. So I really need to kind of realize that I am powerless and accept that and just kind of go on the track here and kind of follow the steps and, you know, kind of do it this other way that has worked for other folks, which I think is great. And so it sounds like you're taking what has been working for 80 years, you know, in these different steps and so on. And then also kind of enhancing it with also the research on, you know, kind of, the behavioral therapy research and techniques, and so on, that can actually kind of enhance that work.
Laura Petracek, Ph.D. (23:02):
Right. And I found through my research for this book. So, Bill W., who's like, you know, one of them two major people at start AA--Bill W. and Dr. Bob--he went through a debilitating depression for almost four years. He actually worked with Carl Jung, very briefly.
Keith Sutton, Psy.D. (23:26):
Oh, wow.
Laura Petracek, Ph.D. (23:27):
And at the end of-- well, he wasn't finished with therapy, but he said, "I really feel there needs to be a component, of--," he didn't say therapy. What was the word he used? A component of introspection, psycho-- not analysis, but psychotherapy, for lack of the term at that time, that really would complement the steps. So he really was, in a way, to me, talking about adding something like DBT to the 12-steps. Because here's someone who was like the father of AA, he did all the steps and he was suicidal.
Keith Sutton, Psy.D. (24:18):
Yeah.
Laura Petracek, Ph.D. (24:19):
And, you know, that's not discussed, it's-- you just do these steps and you get to step 12 and you're happily ever after--not quite so simple, but kind of along those lines. And this story is not really well known about him.
Keith Sutton, Psy.D. (24:37):
So funny, actually-- I don't know if I've ever told you, I know we've talked about that I have family that are very involved with 12-steps and I think very highly of the 12-step work. My uncle actually wrote and published a book called, "The Writing of the Big Book. I don't know if you've--which is actually the story of the, you know, the-- basically The Writing of the Big Book and, Bill W. and Dr. Bob's experience as they're kind of putting together, and he had manuscripts with notes and so on from it that he worked off of and research, but that's so interesting.
Laura Petracek, Ph.D. (25:13):
I really love to, and your uncle's name, Keith?
Keith Sutton, Psy.D. (25:17):
It's William Sthaberg.
Laura Petracek, Ph.D. (25:21):
S-H-A-B as in boy?
Keith Sutton, Psy.D. (25:22):
S-T-H-A-B-E-R-G.
Laura Petracek, Ph.D. (25:27):
Okay. Great, I'm going to-- I want to--
Keith Sutton, Psy.D. (25:31):
Yeah, that would be so interesting.
Laura Petracek, Ph.D. (25:33):
More--
Keith Sutton, Psy.D. (25:33):
I'll get you guys in touch, the conversation because I--
Laura Petracek, Ph.D. (25:37):
Oh, great. I would really appreciate it because yeah, this is what's--
Keith Sutton, Psy.D. (25:43):
That's part of the intent of The Big Book.
Laura Petracek, Ph.D. (25:46):
Yes. And that-- but yet that intent, that's where it stayed unfortunately. And even today, you know, I'll celebrate 46 years this September. Even today at meetings, someone will say, "Oh, I'm, you know, maybe not suicidal, but oh, I'm just really depressed," or, "Oh, I'm really anxious." And some people recommend outside help--thank you. But some people say, "Oh, you know, I felt like that. I just call people." And I-- and not that that doesn't help. You know, take a warm bath.
Keith Sutton, Psy.D. (26:31):
Some of those things can be very helpful--
Laura Petracek, Ph.D. (26:32):
Yeah, they're tools--
Keith Sutton, Psy.D. (26:32):
Kind of low-level using those tools and you--
Laura Petracek, Ph.D. (26:37):
But a lot of people could really benefit. I remember I went to this one conference, and I was talking to this woman, and her husband was MIA for a long time. And then she said he had quit taking antidepressants, and he killed himself like six months later. And he stopped taking them because he felt like he wasn't truly sober. And I said, "Oh, that's just so maddening to me that this is still--there's still this stigma." So I think that's also a big reason I wrote the book, not just the stigma of mental health and AA, but also, you know, society as a whole. And also about mental health practitioners not talking about, if they're in recovery for mental illness. That's a big no-no, or whatever. So, you know, for all these reasons, that's why I'm writing this book, and I think it's great because of that word is perfect, what William said--the intent was also to have this parallel psychotherapy dialogue or material, and it's not there.
Keith Sutton, Psy.D. (27:50):
Yeah, definitely. And I'm wondering too about-- can you tell me a little bit about your last work too? Because I know that you also, you know, did your book on women and anger--
Laura Petracek, Ph.D. (28:03):
Oh, right, sure.
Keith Sutton, Psy.D. (28:04):
And I'd be interested in, kind of, yeah, how your thinking or writing is evolving. And I know we were talking too, that you had worked with actually one of the other folks that I interviewed, John Hamel, and has worked around relationship violence. Can you tell me a little bit about that and how that kind of plays into the evolution of your thinking and work?
Laura Petracek, Ph.D. (28:25):
So I did my pre-doc in Seattle, at Harborview Hospital in their anger management and psychiatry program. And at that time, I hadn't decided on what I was doing my dissertation on, and my supervisor, Dr. Mayero, said, you know, "We're getting a lot of calls from women." Because it was strictly-- their program was just for men, the anger management side. The mental health was separate, but anyway, he goes, "I wonder if you, you know, how would you feel about starting a women's group, and maybe you could do, you know, do your research on that, your--dissertation on women in anger.
Keith Sutton, Psy.D. (29:07):
Yeah.
Laura Petracek, Ph.D. (29:07):
And I said, "Oh, I think that's a great idea. I love the idea." And so we were on the third floor, and the second floor of the hospital was the STD unit. And so this woman had found out that her boyfriend had given her STD, and when she found that out, she kind of went ballistic on him. So security was called--
Keith Sutton, Psy.D. (29:33):
Oh wow.
Laura Petracek, Ph.D. (29:33):
And they brought her up to the third floor where I was, and said, "Who-- we're looking for Dr. Petracek?" And they-- so she was my first client. And I got several clients directly just from the hospital. Like, one time there was like a little fender bender outside, and the two folks went-- you know, going on at each other, "It's your fault! It's your fault!" And so, security brought the woman upstairs.
Keith Sutton, Psy.D. (30:04):
You're a go-to person to--
Laura Petracek, Ph.D. (30:08):
And then, luckily-- or I'm not sure if the right word is, but my sister who's an art therapist, also lived in Seattle. And I asked if she could come, like once every, I don't know, four weeks, to do an art therapy part of the group. And so, that's in my dissertation as well. And also in my book that I found art therapy is definitely a good tool, it's a therapeutic tool--a way for women to express themselves, where maybe their verbal aspect or writing it just still doesn't get it out. Actually, I had women pick up photography and they would bring in their pictures to express how they felt, or writing/journaling was a big thing. And I didn't, you know, I wasn't really quite sure.
Laura Petracek, Ph.D. (31:10):
I mean, I had different books I used for the men in their anger program, but there was nothing for women. And so, what I initially did was just, so you know, like, here, let's say this is the anger workbook for men. And then I just kind of cut and paste the anger workbook for women and then Xeroxed pages. And I'm like, "No." This is different clinically from what this-- my research is showing for women than for men. And so then I started gearing my group manual differently. So, for example, for men, the issue is primarily power and control, but that's not it. For women, I mean, that's one of them, but I also found 13 other major triggers for women in their anger, which had nothing to do with power and control. It had to do with, for example, when they see someone, you know, if their child is being hurt by someone. If they're feeling-- if there is some sense of injustice, if they feel disrespected. I can't remember all off the top of my head. Yeah, so then from there--
Keith Sutton, Psy.D. (32:36):
Based on some research that you were doing?
Laura Petracek, Ph.D. (32:38):
Yeah, this is on my research.
Keith Sutton, Psy.D. (32:39):
Yeah, yeah.
Laura Petracek, Ph.D. (32:40):
Yes.
Keith Sutton, Psy.D. (32:41):
Tell a little bit about that.
Laura Petracek, Ph.D. (32:42):
Okay. So, my research-- I was very familiar with the research on men and anger, but there wasn't a lot about women in anger. So I, you know, read all I could. And then, at first, it was kind of a Likert scale. Like, I was okay. So this one, I was angry because, you know, Johnny disrespected me, my husband said the food smelled terrible, or whatever. And so then, mine was a qualitative dissertation. So, at this time, what's it called? CPSS? The software was pretty new--
Keith Sutton, Psy.D. (33:22):
Or SPSS.
Laura Petracek, Ph.D. (33:23):
Oh yeah. SPSS. Thank you.
Keith Sutton, Psy.D. (33:25):
I remember that from grad school. Lots of time with that SPSS. Yeah, go on.
Laura Petracek, Ph.D. (33:30):
Oh, okay, so you know what I'm talking about. So then putting all the info in, the different words, and then at the time, I was actually teaching and I just kind of holed myself up in my office for a month. I just would go out to vending machines, or they didn't have DoorDash at the time, but maybe walk down the street, but I thought I have got to live and breathe this dissertation to get it done. And so, that's what I did. And then I just had all this research all over. And so then, finding out more about women in anger, they had ex-- a lot of the literature was about women who kill, or women who were really, really violent, you know? They didn't really have more of a, I don't want to say minor, but kind of an in-between type of anger. You know, and then they had the passive, you know, type of expression of anger for women, but they didn't really have a middle ground. So this is where I focused a lot on. And--
Keith Sutton, Psy.D. (34:36):
And so, is this quantitative work that you did that came up, that kind of decipher those 13 kind of--
Laura Petracek, Ph.D. (34:42):
Well, the qualitative, yes.
Laura Petracek, Ph.D. (34:46):
Yeah, that's exactly right. Yeah. So just, you know, through all these interviews--like, I don't know, it was probably 200 or 300 interviews--and then putting them in, so to speak, and then-- or inputting the data. And so, yeah, this is what came out.
Keith Sutton, Psy.D. (35:06):
Oh, great.
Laura Petracek, Ph.D. (35:07):
And so, wrote my dissertation, graduated. And at this time, though, I'm still primarily in the field of chemical dependency at Marine Center for Women. And then I came across John Hillel's work, I don't know, on the internet, because one day I was like, "There's got to be-- who else in the field is doing this?" So then he and I met, and he said, "Oh, well, I'm sorry to do research that, you know, it's not just men who are getting angry." I said, "Oh, I could tell you all about that," you know?
Keith Sutton, Psy.D. (35:43):
Sure.
Laura Petracek, Ph.D. (35:45):
And then he and I started actually doing workshops together. We did trainings around the state.
Laura Petracek, Ph.D. (35:51):
And then, he ended up writing his book first, that was more on a professional side. I decided to write mine on the-- through Springer publication. Springer wanted me to publish a book, but on the professional end, and I was torn, I was like, "Err," so I decided to do on the-- for the lay person.
Keith Sutton, Psy.D. (36:19):
Yeah.
Laura Petracek, Ph.D. (36:20):
And then his career really took off in that direction. And, you know, now my daughter's getting older, it just didn't work. I, you know, that's why I said I had got like a 9-to-5 job.
Keith Sutton, Psy.D. (36:34):
Sure, sure. Yeah.
Laura Petracek, Ph.D. (36:36):
And you know, Margot, also my wife, had a 9-to-5 job. It just wouldn't have worked for-- I mean, I would've liked to have continued, but it just wasn't feasible to travel and do workshops--
Keith Sutton, Psy.D. (36:54):
But I think, yeah. I mean--
Laura Petracek, Ph.D. (36:55):
I really loved it. It's great.
Keith Sutton, Psy.D. (36:57):
I had that same thought or feeling about traveling and doing workshops and so on. It's like. Really, what is, what's most important right now? And yes, kids also, and--
Laura Petracek, Ph.D. (37:06):
Yeah, so you understand, and even now, it was funny. I was talking to Margo when I was driving from school and I said, "How are these parents doing this? They're starting--I mean, at least over on this side of the East Bay--school's starting at 11 and they're done at 2." And she's like, "Can you imagine when we were raising Leah, like how that would work with either one of us?"
Keith Sutton, Psy.D. (37:28):
Oh my God.
Laura Petracek, Ph.D. (37:29):
So, yeah.
Keith Sutton, Psy.D. (37:29):
During this pandemic, yeah. People are figuring out or making it work. Yeah, it's the same kind of thing--we've got that too. It's like schools are open for like two and a half hours, and it's like so much time, even just driving back and forth for that time.
Laura Petracek, Ph.D. (37:41):
I know, but I did end up, you know, being able to-- I mean, John and I still did some work, you know, our kids, we ended up becoming friends, and my daughter and I would go over to his kid, his daughter-- they were at the same age. No, his daughter, Aviva, is probably a couple years older, but anyway, we spent a lot of time, you know, hammering out this work and writing, and it was really an exciting time.
Keith Sutton, Psy.D. (38:15):
Now I'm going to circle back--if you don't mind--to the, again, the focus of the book, of that, you know, that pain is, you know, that-- and the way I've thought about it or heard about it is the idea of primary pain and secondary suffering, that, you know, that yeah, the pain is inevitable. There's nothing you can do about, like, you know, the hurt, the sadness you'll feel when a loved one passes away, or the stress, you know, in going for that job interview, or so on. But there's that kind of secondary aspect of the way we think, or talk to ourselves about it, and kind of, you know, yeah, saying that, you know, like, "Oh, you're not going to do this," or "Why'd you screw up that way?," or, you know, like, "Oh, you know, that things are never going to be okay again," you know, and particularly the cognitive therapy aspect really kind of maintains it.
Keith Sutton, Psy.D. (39:05):
And I'd be interested to look up to, I mean, you know, the way that I've actually--where I've located that is in really in Eastern philosophy. And, you know, my undergrad minor was in Eastern philosophy. And in Buddhism, that kind of idea that, yeah, there is that primary pain that we feel that pain and being able to accept that pain and be with that pain and suffering, as well as the positive feelings and so on, and letting them all be, is kind of what we need to do in life. But the attempt to kind of get away from that pain, or feel like that's wrong, or it's not supposed to happen, or so on, is wherein lies the problems.
Laura Petracek, Ph.D. (39:43):
Right, and you're so right on about that. Because even though that's that third piece, the Buddhist piece, is sometimes referenced to DBT. It really is from Buddhism--the mindfulness, the acceptance, you know, like you're saying, that really does come from Buddhism or originated there. And so the piece-- how they, you know, they-- it's basically what you talked about: pain is inevitable, okay. And the suffering is optional does bring in that CBT component, you know. Okay, so, you know, your wife left you or your husband left you. Okay, that's really painful, but now, What are you saying? So looking at thought records, what are you saying to yourself? So "the suffering is optional" is about, you know, how people make it so much worse by what they're saying to themselves. And so doing that CBT component is big in terms of that particular saying, you know, what are you saying to yourself? Yeah.
Keith Sutton, Psy.D. (40:54):
And I'm wondering--it sounds like you were kind of inspired by this, and I mean, you---this is part of the title of your new book. And through your experience in the DBT part, can you say about why, of all the pieces, that one kind of rose to the top?
Laura Petracek, Ph.D. (41:08):
I think it rose to the top because I was like, "That's from AA!"
Keith Sutton, Psy.D. (41:16):
So, there was this kind of cross-over between the two, and--
Laura Petracek, Ph.D. (41:19):
Yes. And then I---of course there's a cross-over!
Keith Sutton, Psy.D. (41:23):
Oh.
Laura Petracek, Ph.D. (41:24):
Cross-over! So that's really what started my mind clicking, is like, "Hey-," at first I was like, "Hey, she's stealing that from my AA," and then I'm realizing, "Wait, there's so much cross-over." And this would be so beneficial for people in 12-step.
Keith Sutton, Psy.D. (41:44):
Yeah.
Laura Petracek, Ph.D. (41:45):
So that's where it really--yeah. That's where that sentence-- and then what light bulb went off about the cross-over.
Keith Sutton, Psy.D. (41:52):
Yeah, definitely.
Keith Sutton, Psy.D. (41:55):
And it's so nice that there's a number of, you know, folks I've been interviewing for this podcast, and, you know, a theme I keep hearing is a lot of folks trying to find out, "How do we get these kind of tools, these kind of evidence-based approaches, things like that, that we know help to the masses, to, you know, people--everybody has the time or the money for, you know, doing the therapy work, or, you know, whatever it might be?" So kind of really, how do we, you know, disseminate and make that available? So that's great that you're, you know, because AA is great--it's free, it's a community for folks that are, you know, that have that resource available. And so it's nice to kind of, you know, additionally give more tools and have something that can be easily accessible.
Laura Petracek, Ph.D. (42:41):
Right. But what you just brought up is ia really interesting point: evidence-based. So originally, I was going to do my dissertation on the 12-step program. What-- and try to find quote, you know, they say, "It works if you work it," what's it? What, you know, h my God. I could not believe the pushback I got.
Keith Sutton, Psy.D. (43:07):
Wow.
Laura Petracek, Ph.D. (43:08):
You can't study the-- I mean, I just talked to different people in my different groups, and the resistance was incredible. And so, that's another reason I do want to study after this book is done. You know, my hope is, is that a 12-step program will use---or a 12-step group will use---my book, like they're using it, like there's 12 Steps in Agnostic. So they use that particular book, or 12 Step in, I don't know, something else, but they-- or like the Buddhist, what's his name-- and they use his book in 12-step meditation meetings. So I would like to study, how is this helping, so people using DBT skills-- is this helping? Because, as you well know, 12-step is not evidence based.
Keith Sutton, Psy.D. (44:08):
Yeah, yeah.
Laura Petracek, Ph.D. (44:09):
And there's no--not that there's no way--but there's-- it's very hard to get in to see what's actually working or not working--
Keith Sutton, Psy.D. (44:18):
Sure, sure.
Laura Petracek, Ph.D. (44:19):
To measure that out so--
Keith Sutton, Psy.D. (44:20):
Well, yeah. There's some research on kind of pre- and post-, I think, or whatever time in, or so on, or doing the steps, but not necessarily like deconstructing the process, you know, of the research of what is work.
Laura Petracek, Ph.D. (44:31):
Yeah, exactly.
Laura Petracek, Ph.D. (44:33):
That's-- exactly. So, that's why I abandoned that idea. I was like, "Well, it's too bad, because it does need to be researched." But anyway, I am hoping to do some research to make it--not make it--to have it be-- I mean, DBT is evidence-based, but more now the combination--is that evidence-based to work with? Alcoholic addicts?
Keith Sutton, Psy.D. (45:02):
Well, thank you so much for taking the time, and, you know, I--I know you're doing such great work in the clients that you're working with through the Institute, and the children, and the couples, and the families, and the individual adults. And so, it's nice, you know, we've talked, of course, and shared cases and so on, but it's great to really hear kind of this, you know, all these aspects and how that plays into the way you're thinking and working and really trying to further the field. So I really appreciate you taking the time today.
Laura Petracek, Ph.D. (45:30):
Great. Thanks Keith. Thank you so much for listening and your unconditional regard. I really appreciate it.
Keith Sutton, Psy.D. (45:38):
Great. Well, thank you so much. Take care.
Laura Petracek, Ph.D. (45:41):
Take care.
Keith Sutton, Psy.D. (45:42):
Bye.
Laura Petracek, Ph.D. (45:42):
Bye.
Keith Sutton, Psy.D. (45:45):
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