|
Lynn Lyons, LCSW - Guest
Lynn Lyons, LCSW is a psychotherapist, author, and speaker with a special interest in interrupting the generational patterns of anxiety in families. Lynn is the co-author with Reid Wilson of Anxious Kids, Anxious Parents and the companion book for kids Playing with Anxiety: Casey's Guide for Teens and Kids. She is the author of Using Hypnosis with Children: Creating and Delivering Effective Interventions and has two DVD programs for parents and children. Lynn also hosts her own podcast, FlusterClux, where she helps parents and families with anxiety. She is in private practice in Concord, New Hampshire where she sees families, and she speaks regularly to parent groups, schools, and clinicians. |
|
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. (02:20):
Today I'll be interviewing Lynn Lyons, LCSW, who is a psychotherapist, author, and speaker with a special interest in interrupting the generational patterns of anxiety and families. Lynn is the co-author with Reed Wilson of Anxious Kids, Anxious Parents, and the companion book for kids, Playing with Anxiety: Casey's Guide to Teens and Kids. She's the author of Using Hypnosis with Children, Creating and Delivering Effective Interventions, and has 2 DVD programs, Her parents and Children. She also hosts a podcast Flusterclux for parents to help families with anxiety. Lynn is also in private practice in Concord, New Hampshire, where she sees families and she speaks regularly to parent groups, schools, and clinicians throughout the country. Let's listen to the interview.
Keith Sutton, Psy.D. (03:04):
Hi, welcome Lynn . Glad you could join us.
Lynn Lyons, LCSW (03:07):
Well, thank you for having me. I'm happy to be here with you.
Keith Sutton, Psy.D. (03:10):
Sure. So, I had, you know, learned about your work a couple years ago, and I do cognitive behavioral therapy as also working with family systems and really loved your integration of the two approaches in your book Anxious Kids, Anxious Parents. It's been really helpful, I refer to clients that also I did your 24-hour kind of certification training on pesi and such. And I've gotten some consultations around some difficult cases with you. So, I would love to, you know, hear more about the kind of your work and particularly too, I'd love to hear about the kind of your background and how you got to the work you're doing. I know that you also trained in hypnosis and institute and so on. So yeah, tell me a little bit about it.
Lynn Lyons, LCSW (03:55):
So, I am a social worker by degree, so I started off in a social work program and got my master's in that. And I always say to people, that was a great place to get a degree, but all my learning started after that. Not all my learning. I had some great supervisors, but-- so this is my-- gosh, I finished my master's in 1990, so this is my 31st year being in the field.
Keith Sutton, Psy.D. (04:22):
Wow.
Lynn Lyons, LCSW (04:22):
My first job out of-- well, it's funny because when I started graduate school, I was sure that I wanted to work with kids. I thought, "Oh, I want to work with kids". So, I got my first placement. I worked in this large agency on the south shore of Boston, and at that point I was 22, so I was barely not more than a kid myself.
Lynn Lyons, LCSW (04:42):
And I thought, "These kids are really hard to work with". And so my second year, I worked with adults and I thought, "You know what? Adults, like they speak English better than, you know, than the little kids". And so, I really sort of let go of this idea that I was going to work with kids. I do think it had a lot to do with the fact, like I said, that I was a kid myself at that point. When I got out of graduate school, my first job was in inpatient psychiatry, which was a really interesting job. It was-- I worked in the unit that was called the short term unit, which meant that we took people that were in crisis, but they weren't there necessarily for very long stays. So there was a lot of assessment. We did detox for people that were coming in with substance abuse issues.
Lynn Lyons, LCSW (05:38):
It was a teaching hospital, so we're seeing college kids that were sort of unraveling unfortunately. So, it was a very intense environment, very fast paced, but pretty cool, actually. I had an amazing mentor there. The chief psychiatrist on the unit was just a great guy-- worked with medical students and residents, which was also interesting because again, I wasn't really much older than a lot of them. But it was really interesting. The other interesting thing about that is that I was working in inpatient psychiatry, so for your listeners that are a little younger than I am, they may not be aware of this, but in the late eighties and then in the early nineties, that was the whole period of repressed memories and the satanic sexual abuse thing, which if you're interested in finding out about that, it really should be looked at as a cautionary tale that's probably been repeated multiple times. But just a lot of crazy stuff was happening in the mental health field, a lot of therapy that did damage truly, but I was--
Keith Sutton, Psy.D. (06:58):
Right, unearthing those kinds of repressed memories, or those forgotten memories or so on. And that oftentimes some of those memories had not actually happened.
Lynn Lyons, LCSW (07:06):
Yeah. Yeah. Most of the time actually, but just a lot of-- there was a lot of-- and I think it was sort of much more of an illustration of social forces, right, that how many people jumped on that bandwagon and the lack of critical thought that went into things. So, working in inpatient psychiatry during that time, you know, you heard things like-- I mean multiple personality disorder was sort of as common as generalized anxiety disorder, right, that it was just so common. And so, a lot obviously has changed since then. But very interesting looking back, being in that environment, which was something. And then I left that job. We, you know, my husband was in graduate school, so we moved, and I started working in outpatient therapy, working for an employee assistance program, doing a lot of help with people who were-- I worked in a very industrial small city, so it was people from Harley Davidson and Caterpillar and all these big manufacturing companies using the agency for employee assistant, also very eye-opening for sure.
Lynn Lyons, LCSW (08:24):
And was there, so that was down in Pennsylvania and then moved back up to New Hampshire. I'm from New England and I've lived in New England my whole life, except for that brief foray down to Pennsylvania. Had two kids, took a little time off, and worked part-time. You had mentioned that I am trained in hypnosis. I was doing a lot of childbirth work using hypnosis for childbirth, which was really cool and fun. And then probably when my boys were, you know, still little, I started working again and-- I would say actually, if I were to offer some advice for people thinking about career trajectory, is that when you take a pause, which two kids allowed me to do, when I went back into practice, I really thought very specifically, very consciously about what I wanted to do--
Keith Sutton, Psy.D. (09:21):
Set some boundaries.
Lynn Lyons, LCSW (09:23):
Yep, and in terms of, you know, what boundaries I wanted to have around my professional life, what did I want to deal with? What did I not want to deal with? What interested me, what didn't interest me? So you don't need to have two kids to have that conversation with yourself, you could also just have that conversation with yourself and really think about what works for you. So that's when I really started very consciously working with families more, thinking about anxiety more. Kind of-- I got some good advice. I was going to present at this national conference, and I didn't know what I was going to present on. And one of my mentors said, "You know, think about something that's really-- that you really like to do, because if this goes well, that's what people will begin to know you for". And I did a presentation on anxious families, and here we are.
Keith Sutton, Psy.D. (10:24):
Oh, wow.
Lynn Lyons, LCSW (10:24):
So that's kind of how it all unfolded and over the last-- I don't know how many years-- 15 years now or so, that's really been sort of my specialty, my expertise.
Keith Sutton, Psy.D. (10:35):
And how did you end up gravitating towards families? You know, a lot of people, especially, you know, using cognitive behavioral therapy-- and I'd love to hear about, you know, how you got involved in cognitive behavioral therapy-- but, you know, a lot of them folks do it kind of individually, and they're usually doing the individual work with the kids with CBT and not necessarily kind of looking at the systemic aspects and so on. Although, you know, there's been a lot of research that particularly if a parent also struggles with anxiety, there's much higher likelihood for relapse--
Lynn Lyons, LCSW (11:06):
Right.
Keith Sutton, Psy.D. (11:06):
You know, of the child's anxiety. So that's, you know, I was really like-- how you involved family because I feel like it's such a big piece that's sometimes, oftentimes missed in, in treatment of children with anxiety.
Lynn Lyons, LCSW (11:18):
Yeah. So it probably has something to do with the fact that I was trained as a systems person, right. So if you're in social work school, they're really having you look at the big picture, and sort of look at cultural influences and community influences. I think when I was in graduate school, I wasn't really thinking of it in that way, because I didn't, part of social work school that I didn't really gravitate toward was sort of policy, you know, you could get a degree in policy, and I was like, "Oh, yuck!", but in terms of family work and that kind of stuff, it sort of made intuitive sense to me.
Lynn Lyons, LCSW (11:56):
And you know, if you are working a lot with adults, which I was, and then you move into working with kids, what happens is you're working with adults and they're saying, you know, "I'm really struggling", and then they'll call you five years later and say, "I saw you for my anxiety, and now I'm a mom. Can you work with my child?" And so unless you're really not paying attention, you're seeing that this is a really family thing. And so, the idea of that sort of family approach and that systems approach really made sense to me. And I think, as I was working with families-- honestly, I think there are a lot of stipulations, for lack of a better word, and a lot of even rules or expected things that we are taught as therapists that didn't make sense to me. And I thought this idea that you shouldn't work with different people in the family, you know, like, well, if you're working with the parent, you shouldn't work with a child. I always thought, "Well, gosh, they all live together."
Keith Sutton, Psy.D. (13:11):
Yeah.
Lynn Lyons, LCSW (13:11):
Parents are really teaching the children things, and I really understand a lot about how this mom or dad operates, and now they're asking me for help with their child. Why would I not step into helping the child because I've got all this information about how this family works already? Right, so it just sort of made intuitive sense to me.
Keith Sutton, Psy.D. (13:32):
Yeah, I got first interested in families working at team shelters that I worked at, and where the kids would come in, we'd have them for a couple days, and then the family would come in. And I quickly learned that when you put the kids back in the context of the family, a lot made sense. So, as well as some of the maladaptive patterns. And so got really interested in family systems and then worked in a drug and alcohol outpatient program that was very systemically oriented, kind of all prior to grad school. But yeah, I mean, with a systems approach, I find it really nice because I can go between working with the kids, working with the couple, working with the parents, you know, sometimes doing some individual work, say a parent maybe has some trauma or so on and be able to work at those kind of multiple levels because they're all intertwined.
Keith Sutton, Psy.D. (14:17):
And oftentimes, when the family has a good relationship with you, they want you to help out with these other aspects rather than try somebody new. And also you can hold all of that stuff where I think some clinicians sometimes are concerned about that you wouldn't be able to hold the space for the child and the parent at the same time, or the couple or so on, and really-- but yeah, no, so it's great that you got that initial kind of training and thinking in systems approach and particularly the social work background. I think really, you know, it's about that, about kind of connecting to the different levels. How about with the-- because I know also-- I forgot, who did you train with the hypnosis? Was it Michael Yako?
Lynn Lyons, LCSW (15:00):
Michael Yako.
Keith Sutton, Psy.D. (15:01):
Yeah. And I know that Eric, you know, the Ericksonian Institute, very systemic. Was there any of that piece in there, or-- and I know you-- I think one of your earlier books, or your first books was on working with children and using hypnosis. Is that right?
Lynn Lyons, LCSW (15:15):
Yeah, that's actually my third book. So that was the last book that I wrote, but my books were Irish triplets. I did three books in three years.
Keith Sutton, Psy.D. (15:23):
Oh, nice.
Lynn Lyons, LCSW (15:24):
I actually was-- I had the contract for writing the first book right. When "Anxious Kids, Anxious Parents", and then the companion book for kids came out. And then I wrote that book last, but it was right, you know, bang, bang, bang. Yeah, so I have-- so Michael Yako, if you don't know of him, you should. He's one of the best, sort of clinicians in the treatment of depression. And he also is just one of the world's most renowned experts in using hypnotic strategies. And so, I met him-- actually, it was when I was in Pennsylvania and I had a friend who I worked with named Jay. And Jay was putting on this training with Michael, and at this point, you know, I was still-- how old was I at that point? --26. And he said, "I'm putting on this training, it was like a four-day training with Michael. And so, I think you would like what he has to say". So, I went to this first four-day training, and I was just hooked, because the way he talked about conceptualizing a problem, right, very strategic, also pretty systems oriented, was so different.
Lynn Lyons, LCSW (16:50):
So even though I was a social worker, and even though I had this family sort of systems, you know, perspective, it was still very psychodynamic. My training was very psychodynamic. And so, he was talking about it in such a concrete way. And then the way that he integrated hypnosis, right? So for anybody who's listening to this, hypnosis is not a therapy. Hypnosis is a way to deliver therapy. I always say it's the tray on which I put the hor d'oeuvre. And so, it is not this stand or in my opinion, shouldn't be this standalone thing that you do hypnosis. It's a way to integrate it into your treatment. I was just listening to somebody give this really awesome workshop on chronic pain, and he was working, showing some videos of working with these clients, and he called it active meditation, right, which is just a way of, you know, making it more palatable, poor hypnosis freak out about the word, but it-- so I started training with Michael, so that would've been way back, you know, I don't even remember the year.
Keith Sutton, Psy.D. (17:58):
Sure.
Lynn Lyons, LCSW (17:59):
But I continued to go to trainings with him, and he actually has been an incredibly wonderful mentor to me. I've known him for over two decades now. So, he really taught me about using hypnosis, but probably more importantly than that, really about how to think about interrupting patterns and how to really target what you want to go after in a family. What's the pattern that you need to interrupt, and how do we figure out in a complex problem or in a family system or within an individual, how do we go after that? Hugely influential in my work, because if you know, are familiar with the way that I talk about anxiety, I'm much more interested in how anxiety works in a family, how it invades a family, how it is contagious in a family. The why part of anxiety is usually not that hard to figure out. And you know, so many people spend time thinking about, well, "Why is she anxious about this?" Right, that's not a hard question to answer when it comes to anxious kids. So much more important to me is how do we teach the skills that this family needs in order to interrupt this pattern? And that comes directly from Michael.
Keith Sutton, Psy.D. (19:25):
Oh, great. And yeah, what is it-- what can you give me an example of like, what the-- you know, the influence of hypnosis? I don't know if in language or in any techniques that you use in your work. You know, because I myself have-- I think I did one of the brief Erickson conferences. I did a two-day in hypnosis. So, I just got a little flavor of it. I would love to do more. One of my colleagues, Jim Klein, who is a clinical director for Jay Hale and CLI Madonnas uses it a lot and so many of the greats, you know, kind of, learned the Erickson approach. But yeah, what is it?-- it's still this kind of, you know, abstract thing for me. Yeah.
Lynn Lyons, LCSW (20:03):
So I think, you know, and what I talk about, and when you're working with children in particular, the goal is not for me to do hypnosis. And a lot of people-- poor hypnosis gets such a bad rap, you know, in TV and movies. I remember if you've seen the movie "Get Out" and they had this hypnosis part. Just, oh gosh. It just makes me cringe the way that it's talked about. But really what it is, if we had to define it, and many people have tried to define it, and there's all sorts of different definitions of it. But what it means to me, is that how am I going to get you into a focused state of attention in which I am going to harness, and this is how I talk to kids about this, I am going to harness the power of their imagination, and I am going to help give them an experience that really illustrates for them the mind body connection, and really illustrates how powerful the imagination is in creating symptoms in their body, how powerful the imagination is in terms of the stories that we tell ourselves.
Lynn Lyons, LCSW (21:50):
You know, anxiety is so much about the story and the narrative, oftentimes passed down from family right. A story of danger, a story of rigidity, a story of perfection, a story of incompetence, whatever it may be. So if I'm doing hypnosis with someone, all it really is, is that I am taking my approach to worry, which is worry, shows up and creates this story for you, and it has this process that it does, and it's basically saying, "You can't handle it!" How am I going to take the story of worry, and present it in a way that engages you, that captivates you, and that may be a little bit different than the way you've heard it in the past, so that I can suck you into, you know, in a-- I guess, suck you into a different story. Pull you into a different narrative. So--
Keith Sutton, Psy.D. (22:15):
Kind of gets connected to that, or like almost like a reframe or kind of like a--
Lynn Lyons, LCSW (22:19):
Yeah. Yeah.
Keith Sutton, Psy.D. (22:19):
The thinking around it in a way that's kind of vibrant or illustrative or something that stands out. I guess it's memorable almost.
Lynn Lyons, LCSW (22:27):
Right, yeah. Something that is novel in some way, something that sort of gets your attention, because the cool thing, if you think about it, think of the message. So, whenever I'm doing hypnosis and whenever I'm doing treatment with an anxious child or an anxious family, there's always something that I'm trying to deliver. There's always a message that I'm trying to deliver and a skill that I'm trying to teach. So, I'm going to come up with any way that I can to deliver that message, to amplify that skill that I want to teach, to help show them where the gap is, and then how can we create a different experience? So storytelling, of course, is sort of the human tradition. Right, so Ericksonian hypnosis, you made mention of Ericksonian hypnosis, and that's based on the work of Milton Erickson. It really is a much more informal hypnotic process. It has a lot to do with storytelling and language and metaphors and being creative in really cool ways. Versus if you think of-- sometimes people have ideas of more authoritarian or direct hypnosis, you know, "I will count down from 10 and you'll do this".
Keith Sutton, Psy.D. (23:41):
Yeah. Yeah.
Lynn Lyons, LCSW (23:42):
So, I'll give you an example. Little, not so little, but still a little girl came to see me and she has a condition that requires that she have an injection once a week. And she's a worrier. She's anxious. I knew her before that. I know her family. Right. There's anxiety in the family. And so she really needed help being able to tolerate this injection. She said that the injection only hurt for two to three seconds, but it was the anticipation of it. And she would always-- she has it on Friday nights. And it was, you know, just sort of ruining her day as she was--
Keith Sutton, Psy.D. (24:23):
Yeah.
Lynn Lyons, LCSW (24:23):
So, I want to give her a skill, I want to give her a strategy of managing this injection in a way that doesn't become so intrusive into her little life. Because the injection itself takes two to three seconds. So, we made a recording together, I just used her mom's phone and made a recording. And in that situation, I am trying to convey to her that she has the ability to disconnect from this sensation for a moment, that she doesn't have to be overly focused on getting this shot, that she doesn't have to be overly focused on the sensation that if it is a period of time, that's two to three seconds, albeit it's unpleasant, right. Who-- you know, be weird-- I told her it would be weird if you were like, "Yay, I get to have a shot". How do I teach her a skill that allows her to contain it, in a way, so that she has the shot over here for two to three seconds and the rest of her can live her life.
Lynn Lyons, LCSW (25:32):
And it becomes this little thing rather than this big thing. So if we look at what the message is that I want to convey, the message is, "This is something that you're going to have on Friday nights, and we can either focus on it and amplify it in a way that it becomes this huge thing you have to deal with, or we can contain it and give you some skills so that you're going to have it and it's going to be done with, and the rest of your-- all the other hours and seconds and minutes of your day are going to be free of this". So that's what we're working on. Yeah.
Keith Sutton, Psy.D. (26:08):
So it's like not hanging overhead.
Lynn Lyons, LCSW (26:11):
Right.
Keith Sutton, Psy.D. (26:11):
That's kind of this, put over in its place, and again, just, you're not saying it's not going to hurt or anything like that, but it's again, separate from the main focus.
Lynn Lyons, LCSW (26:21):
Because worry, when you worry about something, right, it's an overestimation of the problem and an underestimation of your resources to deal with it, right. That's what-- great definition from David Barlow. So, she's got this problem. It's not like we're going to say, "Shots are great", but she needs to have the shot. She knows she needs to have the shot. How are we going to frame it up in a way that makes it more manageable to her? So again, hypnosis is just a way for me to deliver that message and a way for me to convey that to her--
Keith Sutton, Psy.D. (26:52):
And is there something you're doing in delivering the message, or are you like telling a story or so on? Or is it just the way you talk about it kind of as--
Lynn Lyons, LCSW (26:59):
Yeah. I mean, I think it's, you know, it's, first of all getting her focused, right. So, which is not a hard thing to do with a kid, you say, sit back and, you know, sometimes they close their eyes and sometimes they don't. And I really just want you to focus on my words. And I-- it played around a little bit with-- it told her that I had this secret power secret that I didn't want her to tell anybody about, but where I turn up gravity a little bit, and so I'm going to turn up the gravity and let's see if we can feel the sensation. So, I'm playing around with altering sensations, using her imaginary, so I'm planting that seed of the ability to alter sensations, and then talk about-- you know, told her a story actually of another kid that I saw who actually was being treated for leukemia. And this, little girl would go and fly around London during her chemo treatments so she could leave her body in the hospital and then go fly around London--her choice--and wouldn't it be interesting if she could come up with a way to use her imagination that would allow her to tolerate what she needed to get through.
Lynn Lyons, LCSW (28:07):
And so, it's just storytelling, right. And I use a lot of stories, I use a lot of metaphors, you know, I've got an analogy for anything. But it's the language, and then I record it. I always record the sessions that I do, and then she is now practicing listening to it. So, she goes and she listens to it, and dad gets the shot ready, and then when she's ready, dad comes in and gives her the injection. You know, we talked-- I talked to her more recently about-- dad said it, you know, it's really helpful when her leg is really loose, you know, muscles really loose. So, we just talked about imagining the difference between a stick of butter that just came out of the refrigerator and a stick of butter that's sitting on the counter during the summer.
Keith Sutton, Psy.D. (28:58):
Yeah.
Lynn Lyons, LCSW (28:58):
How easy it is to just take your knife and get that stick of that butter that's soft and, you know, playing around with that.
Keith Sutton, Psy.D. (29:05):
Right through it. Yeah. Yeah. It's almost like a voluntary dissociation.
Lynn Lyons, LCSW (29:10):
Well, yeah. And you know, that's one of the qualities of hypnosis is that it's dissociative in a good way, right.
Keith Sutton, Psy.D. (29:17):
Definitely. Yeah, great. Very neat. And tell me a little bit about the, your-- how you got involved with, you know, cognitive behavioral therapy and kind of your use of CBT and you're thinking about CBT and kind of how you- yeah.
Lynn Lyons, LCSW (29:34):
Well, the reality of it is that, if you were working in the mental health field, at the time when managed care came in, that you damn well better learn about cognitive behavioral therapy because that's what everybody wanted you to do. So, it was sort of like, that was what we were going to do, whether we liked it or not. It does, you know, it fits with sort of my pretty concrete approach to things. I think that there are some things about cognitive therapy, CBT with kids that I don't do actually. Cognitive therapy and CBT-- and definitely if you were to, you know, somebody were to say, "Well, where do you really-- how do you describe yourself--if you had to pick one thing?" You know, I'm definitely a cognitive and behavioral, but I'm not into the content and I think that that's one of the things that's a little different, particularly with worry. I think that the thing that I found is not helpful, is a lot of the discussion that happens, providing evidence to support the thought or not support the thought. What's the likelihood of that happening versus the likelihood of that not happening? The reason I think I've moved pretty far away from that, and really much more into a process approach than a content approach is because a lot of the things that I see that kids worry about are very likely to happen. So, if you are dealing with somebody who's got social anxiety, their big fear, their big worry is that they're going to embarrass themselves, or that people are going to judge them. That's going to happen, right. If you're dealing with a kid who's got an emetophobia, fear of vomiting, that's going to happen. If you're-- you know, a lot of kids now during all this COVID time, really worrying about getting sick or people die, that's going to happen. So, it just stopped making sense to me, to have these discussions about what's the likelihood of that happening--
Keith Sutton, Psy.D. (31:39):
Yeah, the odds are so on, yeah.
Lynn Lyons, LCSW (31:41):
Yeah, right. When so much of what I was talking about, the likelihood of it happening was pretty darn high. So I had to find a way to shift out of that. I found that a lot of discussions that I was having with kids, turned into "Yeah, but" discussions. And parents instinctively do want to offer evidence to the contrary, right? So, "Mom, I don't want to go to school, everybody's going to be laughing at me", and that the parent immediately wants to say, "Oh, well, nobody's going to laugh at you. Or everybody's worried about their own stuff, they're not paying attention to you". And I thought, "If that worked, then why are they coming to see me?" If all of that content-based reassurance or that examination of the evidence was working so well, why wasn't it working so well? So, it's not that it doesn't help some people, but when you're working with kids who have worries about ubiquitous problems, I'm not going to focus on the content. And I think--
Keith Sutton, Psy.D. (32:49):
This is where you get into-- you know, which is really stuck with me, which I use a lot with my clients about that, you know, anxiety wants certainty.
Lynn Lyons, LCSW (32:58):
That's right.
Keith Sutton, Psy.D. (32:59):
And that, you know, that aspect of, you know, even all that, you know, let's look at the odds, things like that, but it doesn't get certainty.
Lynn Lyons, LCSW (33:07):
Right.
Keith Sutton, Psy.D. (33:07):
You know, the thing-- the bad thing can happen. And so, we need to embrace uncertainty.
Lynn Lyons, LCSW (33:13):
That's right.
Keith Sutton, Psy.D. (33:13):
Rather than try and reassure that the bad thing won't happen.
Lynn Lyons, LCSW (33:17):
That's right. Right. And that's the trap you get into, right? So if you've got somebody who's afraid of vomiting, and we can say, well, as long as you don't eat too much, or as long as you do this, or as long as you do that, they're seeking certainty. So then what happens? They start coming up with their safety behaviors to prevent the bad thing from happening, but we can't say to a kid, "Oh, you'll never throw up", or "Nobody will tease you, or your plane won't crash", right? So the content is so minimal to me, because I'm really looking at, like you say, that quest for certainty and comfort. And so, I call it doing the disorder. Whenever an adult is working with a child, be the school or a parent or a clinician, and the goal is to try and create certainty and comfort. They're working for the anxiety disorders.
Keith Sutton, Psy.D. (34:15):
Yeah.
Lynn Lyons, LCSW (34:16):
Right, they're-- the anxiety disorder is saying, "I demand certainty and comfort, so I need you adults, to make that happen". And it just backfires. Schools, I do a lot of work in schools, and unfortunately schools are absolutely putting things in place for anxious students that support the disorder.
Keith Sutton, Psy.D. (34:40):
Yeah, and inadvertently reinforcing the avoidance despite-- and that's actually the way I oftentimes, when I recommend your book, I describe it, is that, you know, as parents, we care about our kids. We're trying to take care of them, but sometimes as we're trying to be helpful and take care of them, we sometimes inadvertently reinforce the avoidance out of no malice or anything like that, or just trying to help. But sometimes then it can actually kind of feed the anxiety and gets stronger as we're trying to actually address it and help the kids and support them in overcoming it.
Lynn Lyons, LCSW (35:13):
Right. Well, and the thing about avoidance that's so tricky is that it works like a charm.
Keith Sutton, Psy.D. (35:20):
Yeah.
Lynn Lyons, LCSW (35:21):
If you're a parent and you've got a little child that you love and they're distressed and you help them avoid this thing, and then they're not distressed anymore, right? Of course, you're going to do that because you want your kid to feel okay. And I talk a lot about emotional management, whether it be anxiety or worry or anger or whatever, and that the only way that you practice emotional management is that you've got to be allowed to experience the emotion. And worry is going to my--
Keith Sutton, Psy.D. (35:53):
Muscle.
Lynn Lyons, LCSW (35:54):
Yeah.
Keith Sutton, Psy.D. (35:55):
Yeah.
Lynn Lyons, LCSW (35:56):
Yeah. So, how do we let our kids, within a loving and supporting and caring environment, how do we allow them to feel distress or uncertainty or discomfort or sadness or heartbreak or whatever, and teach them that they can get through that. Because, and you know, in extreme situations, you've got parents that are very intent on not letting their children feel any distress. It's called parental experiential avoidance, actually. And it's one of the ways in which parental control shows up and we know that parental control is unfortunately a little fast track into anxious kids. So, being able to talk to parents about how counterintuitive it feels to allow your child to feel these things, but that's part of equipping them with this really important emotional management skill.
Keith Sutton, Psy.D. (36:56):
Yeah. Where's that from? The parental experiential avoidance term.
Lynn Lyons, LCSW (37:01):
Lynn Lyons, LCSW: (37:01)
That was, oops, sorry. That was-- so some research has been done, and I can send you the link to one of my favorite articles about it. But they were looking at, you know, it was\ very interesting because they were looking at-- these researchers were looking at parental control, but they smartly said, "Well, there's a lot of reasons that parents control."
Lynn Lyons, LCSW (37:25):
So you could have, you could have a high degree of parental control and create an anxious child, but it could be because the parent is narcissistic and controlling, or it could be because the parent is whatever and controlling. So they said, let's sort of pull this apart a little bit. And they found this subgroup part of parental control that really said the parent is trying to avoid their own distress and avoid the distress of their child. And that was just, in terms of anxiety, that was a really important thing to look at. I'll send you the link.
Keith Sutton, Psy.D. (38:05):
That'd be great, yeah. So, this makes me think of a couple things. Yeah. Sometimes the way I use the metaphor of like-- with avoidance as if I ask the kids and the family sometimes, have you ever gone to a restaurant at the beach where it says, you know, "Don't feed the seagulls", and there's a seagull over there, and you think like, "Oh, I'll just give it one french fry, then it'll go away, what's going to happen?" And I say, you know, every time we're avoiding saying, "Oh, well, we just won't go to that party", or "Oh, you know, like, I'll help him with, you know, kind of deal with that situation", or kind of, again, we're just kind of feeding the seagull and they oftentimes want more and more. More aggressive and try to steal the food off your, you know, table or so on.
Lynn Lyons, LCSW (38:42):
Yep.
Keith Sutton, Psy.D. (38:42):
And so those kinds of pieces play in, and I think, you know-- also what you're mentioning with the control aspect, the other way I oftentimes conceptualize it is that, you know, when we get anxious, we get more controlling.
Lynn Lyons, LCSW (38:53):
That's right.
Keith Sutton, Psy.D. (38:54):
Because we're trying to get certainty.
Lynn Lyons, LCSW (38:55):
That's right.
Keith Sutton, Psy.D. (38:56):
And sometimes, you know, that certainty kind of, you know, attempt at it again, thus becomes the problem. You know, you try to get that. That's interesting, yeah. And I, you know, I also think too about that experiential avoidance. I oftentimes use that clip from Brené Brown. There's a little, you know, from her TED Talk, it's a little cartoon of a bear going down into the hole and just that kind of piece that to truly have empathy, we have to feel that same feeling and engage with what that has felt like. But sometimes that can become ultimately dysregulating, so then the person tries to fix or make it better or so on, because they're dysregulated. And so, part of the work is helping the parents to sit with that discomfort.
Lynn Lyons, LCSW (39:43):
Yeah.
Keith Sutton, Psy.D. (39:44):
That piece of the "Yes, but" too, I oftentimes-- I do a little exercise for the, you know, coping thoughts and the automatic thoughts almost like a gestalt-like kind of side to the chair. And I help parents understand that it's kind of like motivational interviewing, that we all have ambivalence, and when the parent takes one side of the ambivalence, they're going to get "Yes, but yes, but"--
Lynn Lyons, LCSW (40:03):
That's right, that's right.
Keith Sutton, Psy.D. (40:04):
So instead, they need to make room for those kind of deep, dark thoughts and be able to tolerate sitting there with them around that, because then they can kind of climb out of that hole together.
Lynn Lyons, LCSW (40:15):
Yeah, we do a lot with anxiety, when people are dealing with anxiety, we do a lot to get rid of it.
Keith Sutton, Psy.D. (40:25):
Yeah.
Lynn Lyons, LCSW (40:26):
Right. And that backfires, right. There's where you get the "Yeah, but", the more you try and not think about it, the stronger it gets. Right? We're very big on elimination strategies. I think a lot of what's done with anxious kids is really based on elimination strategies. And so, there's a real discomfort, like you say, with people sitting with those uncomfortable emotions that the thing I say all the time is that I couldn't do my job without the two words, "of course". Of course, you feel worried about this. Of course, you feel uncomfortable. This little girl has to get a shot on Friday nights. Of course, she doesn't want to.
Lynn Lyons, LCSW (41:03):
But what we tend to do is we tend to jump in and try and figure out, well, how can we get rid of these feelings rather than either normalizing them or helping people problem solve, or, you know, what's the skill that you need in order to manage these feelings when they show up? What's the skill that we want to teach you? Sometimes it's being able to ask for help. Sometimes being able to, you know, I was just doing one of my consult groups this morning and one of the therapists said, you know, "I just want to throw this out there, is anybody else having a hard time doing this job? Because I feel like I'm just exhausted". And of course, all of us were like, "Yes!", you know, so we didn't try and take it away from her.
Keith Sutton, Psy.D. (41:52):
Sure.
Lynn Lyons, LCSW (41:53):
But her just saying it out loud and all of us saying, "Of course you feel that way", really made her feel better. So we've gotta really pay attention in what we're doing right now with kids and teens. What is absolutely disturbing to me and frustrating to me, is how much we are pathologizing the normal experience of relationships and disappointment and fear and worry, how we're teaching these kids pathological language, how we have created a culture in which their identity is really wrapped up in these permanent labels that we're giving kids. It really is troubling to me.
Keith Sutton, Psy.D. (42:40):
Yeah. Rather than like, "I have anxiety", or it's like it's a part of me, or it's something that's about my personality rather than it's something that, you know, may have--
Lynn Lyons, LCSW (42:49):
Even worse than that, I have a brain that is permanently-- has a chemical imbalance, so I will have depression for the rest of my life because I have this disease.
Keith Sutton, Psy.D. (42:59):
Yeah. Yeah.
Lynn Lyons, LCSW (43:00):
Why would you say that to a 12-year-old? Say it to a 32-year-old, right. But that's the language that they have been given.
Keith Sutton, Psy.D. (43:10):
Taking in or yeah.
Lynn Lyons, LCSW (43:11):
I think it's, you know, that the goal is to get rid of these feelings or to have these feelings, or to accept that there's nothing I can do about those feelings. And those are the two very prominent messages that kids are picking up right now, and we need to do a much better job with that.
Keith Sutton, Psy.D. (43:31):
Yeah. I mean, this takes me into the next, you know, kind of the last topic I was interested in is about exposure. And I know that for myself, you know, it was hard to sit and do exposures and kind of learn, and it really wasn't intellectually, I watched this great series obsessed from A&E with real clients and real therapists actually going through exposure work. And I ended up flying out to get training from Edna Foa, and exposure with response prevention. But that, you know, that's such a key piece of learning how to sit with anxiety and be able to kind of ride that wave and really make contact and feel it. And I was just interested about your work, and I know I remember a comment that you had made in one of your trainings about kind of the hierarchy and kind of how you do that maybe a little differently than others and kind of an exposure hierarchy. I could speak--
Lynn Lyons, LCSW (44:18):
So I don't generally do-- you know, I think hierarchies are fine.There's some research to show that we don't really need to use hierarchies. I think that sometimes when we're using hierarchies with clients, we're sort of setting them up. I'm very, very aware of the messages that you give to clients. And if I am being careful and I am being cautious, and I am like-- and if I say things, well, "I don't want to do something that's going to overwhelm you, I have now said we're going to over, you know, we're going to get to that". So I'm very much into saying, "So we're going to do some exposure, so let's come up with some experiments for you to do this". And sometimes I'll say, "So that might be an easy, a medium, or a hard on right. Should we go for a hard one?" I just don't have it so high that we have to--
Keith Sutton, Psy.D. (45:12):
Not like, "let's stay away from that". Like, you know, that's going to be that or too much, but more like, you know, kind of where you want to go in.
Lynn Lyons, LCSW (45:19):
Right, yeah. And the other thing too is that I'm all about being on offense. So one of the things that happens sometimes when we do exposures is that we think, "Okay, so I'm going to do this easy exposure, and I have to, the child has to get to a point where they feel comfortable with that level so that we move up to this level", right. There's that word comfort again. And it really is much more about tolerating it. And if you look at some work that's done with exposure work with OCD, right? It is one of the things that some people are moving away from, it's this idea that you do these exposures so that you get habituated to it so it doesn't bother you anymore, okay. Often it doesn't happen. Go over here, right. We want to do exposures so that you feel uncomfortable and you say, "This is how I'm supposed to feel, and it's okay, and I can tolerate it".
Keith Sutton, Psy.D. (46:12):
Yeah, the goal is not necessarily to get rid of the anxiety--
Lynn Lyons, LCSW (46:15):
Correct.
Keith Sutton, Psy.D. (46:16):
Be able to kind of have that confidence that I can go towards anxiety and, you know, it may feel discomfort and you're going to come out on the other side and so on. Yeah.
Lynn Lyons, LCSW (46:26):
Yeah, so as soon as we start talking about doing exposures, and the goal is to create, I hear this sometimes, you know, we need to create a sense of calm confidence. I'm like, "good luck with that", right. It's really what we want to do is we want to normalize that when you're going in for a job interview or you're speaking to people that you don't know, or you're going in for an injection or whatever, that it's okay that you have both a desire to do this because it's something that you want, and I talk about helping kids to find a want to, and that also you're going to have your worry, which hangs around, right? The goal is not to please worry, and it's not to convince worry not to show up, it's to say, "I knew it was going to show up, and I'm familiar with you, and it's nice to see you". And as I step into this exposure, I'm going to bring with me an attitude, right. That says, "bring it on, let's go". I know you're going to show up, let's have at it. It's all this calming down that we talked about, right.
Keith Sutton, Psy.D. (47:29):
I like the term you used, the moment of goodbye for the separation anxiety that like, anxiety and worry is going to come in, we're going to-- we'll be seeing it at the door, and it's just, you know, rather than let's-- we're going to do all these things so it doesn't come around or we don't feel it, it's just kind of accepting and going towards it.
Lynn Lyons, LCSW (47:47):
Yeah, I mean I talked to little kids, you know, with separation anxiety, and I say, I have the moment of goodbye when I say goodbye to somebody that I love. When I say goodbye to my kids and send them back to college, I have a moment of goodbye. And I sit in the airport, I watch moments of goodbyes and moments of lows, and I see all this emotion that people feel, so you're going to have some feelings and it's okay rather than this. And again, this is where the "let's provide evidence and the reassurance", like you know your mom is going to come back for you, you know your mom is always going to be safe, blah, blah, blah. All right. Let's just talk about the big feelings that show up when you say goodbye to somebody, and let's make that okay.
Keith Sutton, Psy.D. (48:26):
Yeah. So, you know, the last little bit here, the interest in-- what are you working on now or what are you interested in now? Kind of where--
Lynn Lyons, LCSW (48:37):
I am thinking a lot about prevention. I'm thinking a lot about how do we move, you know, one of the things I said recently and then it got quoted, which is fine, is that we're doing a really good job of teaching our young people how to talk about mental illness rather than talk about mental health. So, I think that we got a lot of fire extinguishers that are going around trying to put out the fires after they're set, and we're not really paying too much attention to the arsonists. So, I'm talking a lot about certainly with anxiety, talking a lot about the achievement culture and how this is set up for kids, that they are getting a mixed message. We're saying to kids, "oh, why are you so anxious?" And also, "if you get a perfect score on your SATs, then we will reward that". Kids are very confused by that. We've done that to them. They didn't make up this system, we did. So I'm talking a lot about prevention, I'm talking a lot about the helping young people recognize the active process of emotional management rather than this passive, "oh, it just happened to me".
Keith Sutton, Psy.D. (49:48):
Yeah.
Lynn Lyons, LCSW (49:49):
A huge emphasis on connection, which through this year, we've all certainly seen the impact that has on us. Just so much about skill building. I think it's very clear to me with young people. If we think about what we've done with kids on the spectrum over the last 15 or so years, really very concretely talking to them about social skills, I think that a lot of kids could use that training. How do you set boundaries? How do you advocate for yourself? How do you-- you know, when to share something and when not to share something. Yeah, so a lot of prevention and a lot of I want to normalize all this stuff rather than have it in such pathological terms. I think mental health awareness is great, but I think that it's really gotten pretty pathological, and I'd like to see us pull back from that a little bit.
Keith Sutton, Psy.D. (50:52):
Yeah, yeah, yeah I think that's great. I think that piece, you know, that prevention and really kind of building those skills and that kind of emotional health piece is, you know, emotional, mental health and all those aspects are so important. That's great, that's wonderful.
Lynn Lyons, LCSW (51:08):
Yeah.
Keith Sutton, Psy.D. (51:09):
Okay well, thank you so much for taking time and speaking with us today. And you know, I love your work and love, you know, telling people about it and getting it out there more. So I really appreciate your time. Thank you so much.
Lynn Lyons, LCSW (51:21):
You're very welcome. If you want to, my project throughout this pandemic has been the start of the podcast Flusterclux, with an “x”. So, if people are listening and they want to check that out, we're going to-- we start our third season, not that a podcast season has any, you just make it up.
Keith Sutton, Psy.D. (51:42):
Yeah, right.
Lynn Lyons, LCSW (51:43):
But talking about emotional management and the parental role and all of this, it's a good free resource for people to check out.
Keith Sutton, Psy.D. (51:51):
Okay, great. Perfect. I'll link also on our webpage.
Lynn Lyons, LCSW (51:55):
Fabulous.
Keith Sutton, Psy.D. (51:55):
Great. Well, thank you so much. I appreciate you, appreciate having you.
Lynn Lyons, LCSW (52:00):
I'm so delighted that you invited me, Keith, thanks for having-- thanks for inviting me on.
Keith Sutton, Psy.D. (52:04):
Take care.
Keith Sutton, Psy.D. (52:05):
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. (02:20):
Today I'll be interviewing Lynn Lyons, LCSW, who is a psychotherapist, author, and speaker with a special interest in interrupting the generational patterns of anxiety and families. Lynn is the co-author with Reed Wilson of Anxious Kids, Anxious Parents, and the companion book for kids, Playing with Anxiety: Casey's Guide to Teens and Kids. She's the author of Using Hypnosis with Children, Creating and Delivering Effective Interventions, and has 2 DVD programs, Her parents and Children. She also hosts a podcast Flusterclux for parents to help families with anxiety. Lynn is also in private practice in Concord, New Hampshire, where she sees families and she speaks regularly to parent groups, schools, and clinicians throughout the country. Let's listen to the interview.
Keith Sutton, Psy.D. (03:04):
Hi, welcome Lynn . Glad you could join us.
Lynn Lyons, LCSW (03:07):
Well, thank you for having me. I'm happy to be here with you.
Keith Sutton, Psy.D. (03:10):
Sure. So, I had, you know, learned about your work a couple years ago, and I do cognitive behavioral therapy as also working with family systems and really loved your integration of the two approaches in your book Anxious Kids, Anxious Parents. It's been really helpful, I refer to clients that also I did your 24-hour kind of certification training on pesi and such. And I've gotten some consultations around some difficult cases with you. So, I would love to, you know, hear more about the kind of your work and particularly too, I'd love to hear about the kind of your background and how you got to the work you're doing. I know that you also trained in hypnosis and institute and so on. So yeah, tell me a little bit about it.
Lynn Lyons, LCSW (03:55):
So, I am a social worker by degree, so I started off in a social work program and got my master's in that. And I always say to people, that was a great place to get a degree, but all my learning started after that. Not all my learning. I had some great supervisors, but-- so this is my-- gosh, I finished my master's in 1990, so this is my 31st year being in the field.
Keith Sutton, Psy.D. (04:22):
Wow.
Lynn Lyons, LCSW (04:22):
My first job out of-- well, it's funny because when I started graduate school, I was sure that I wanted to work with kids. I thought, "Oh, I want to work with kids". So, I got my first placement. I worked in this large agency on the south shore of Boston, and at that point I was 22, so I was barely not more than a kid myself.
Lynn Lyons, LCSW (04:42):
And I thought, "These kids are really hard to work with". And so my second year, I worked with adults and I thought, "You know what? Adults, like they speak English better than, you know, than the little kids". And so, I really sort of let go of this idea that I was going to work with kids. I do think it had a lot to do with the fact, like I said, that I was a kid myself at that point. When I got out of graduate school, my first job was in inpatient psychiatry, which was a really interesting job. It was-- I worked in the unit that was called the short term unit, which meant that we took people that were in crisis, but they weren't there necessarily for very long stays. So there was a lot of assessment. We did detox for people that were coming in with substance abuse issues.
Lynn Lyons, LCSW (05:38):
It was a teaching hospital, so we're seeing college kids that were sort of unraveling unfortunately. So, it was a very intense environment, very fast paced, but pretty cool, actually. I had an amazing mentor there. The chief psychiatrist on the unit was just a great guy-- worked with medical students and residents, which was also interesting because again, I wasn't really much older than a lot of them. But it was really interesting. The other interesting thing about that is that I was working in inpatient psychiatry, so for your listeners that are a little younger than I am, they may not be aware of this, but in the late eighties and then in the early nineties, that was the whole period of repressed memories and the satanic sexual abuse thing, which if you're interested in finding out about that, it really should be looked at as a cautionary tale that's probably been repeated multiple times. But just a lot of crazy stuff was happening in the mental health field, a lot of therapy that did damage truly, but I was--
Keith Sutton, Psy.D. (06:58):
Right, unearthing those kinds of repressed memories, or those forgotten memories or so on. And that oftentimes some of those memories had not actually happened.
Lynn Lyons, LCSW (07:06):
Yeah. Yeah. Most of the time actually, but just a lot of-- there was a lot of-- and I think it was sort of much more of an illustration of social forces, right, that how many people jumped on that bandwagon and the lack of critical thought that went into things. So, working in inpatient psychiatry during that time, you know, you heard things like-- I mean multiple personality disorder was sort of as common as generalized anxiety disorder, right, that it was just so common. And so, a lot obviously has changed since then. But very interesting looking back, being in that environment, which was something. And then I left that job. We, you know, my husband was in graduate school, so we moved, and I started working in outpatient therapy, working for an employee assistance program, doing a lot of help with people who were-- I worked in a very industrial small city, so it was people from Harley Davidson and Caterpillar and all these big manufacturing companies using the agency for employee assistant, also very eye-opening for sure.
Lynn Lyons, LCSW (08:24):
And was there, so that was down in Pennsylvania and then moved back up to New Hampshire. I'm from New England and I've lived in New England my whole life, except for that brief foray down to Pennsylvania. Had two kids, took a little time off, and worked part-time. You had mentioned that I am trained in hypnosis. I was doing a lot of childbirth work using hypnosis for childbirth, which was really cool and fun. And then probably when my boys were, you know, still little, I started working again and-- I would say actually, if I were to offer some advice for people thinking about career trajectory, is that when you take a pause, which two kids allowed me to do, when I went back into practice, I really thought very specifically, very consciously about what I wanted to do--
Keith Sutton, Psy.D. (09:21):
Set some boundaries.
Lynn Lyons, LCSW (09:23):
Yep, and in terms of, you know, what boundaries I wanted to have around my professional life, what did I want to deal with? What did I not want to deal with? What interested me, what didn't interest me? So you don't need to have two kids to have that conversation with yourself, you could also just have that conversation with yourself and really think about what works for you. So that's when I really started very consciously working with families more, thinking about anxiety more. Kind of-- I got some good advice. I was going to present at this national conference, and I didn't know what I was going to present on. And one of my mentors said, "You know, think about something that's really-- that you really like to do, because if this goes well, that's what people will begin to know you for". And I did a presentation on anxious families, and here we are.
Keith Sutton, Psy.D. (10:24):
Oh, wow.
Lynn Lyons, LCSW (10:24):
So that's kind of how it all unfolded and over the last-- I don't know how many years-- 15 years now or so, that's really been sort of my specialty, my expertise.
Keith Sutton, Psy.D. (10:35):
And how did you end up gravitating towards families? You know, a lot of people, especially, you know, using cognitive behavioral therapy-- and I'd love to hear about, you know, how you got involved in cognitive behavioral therapy-- but, you know, a lot of them folks do it kind of individually, and they're usually doing the individual work with the kids with CBT and not necessarily kind of looking at the systemic aspects and so on. Although, you know, there's been a lot of research that particularly if a parent also struggles with anxiety, there's much higher likelihood for relapse--
Lynn Lyons, LCSW (11:06):
Right.
Keith Sutton, Psy.D. (11:06):
You know, of the child's anxiety. So that's, you know, I was really like-- how you involved family because I feel like it's such a big piece that's sometimes, oftentimes missed in, in treatment of children with anxiety.
Lynn Lyons, LCSW (11:18):
Yeah. So it probably has something to do with the fact that I was trained as a systems person, right. So if you're in social work school, they're really having you look at the big picture, and sort of look at cultural influences and community influences. I think when I was in graduate school, I wasn't really thinking of it in that way, because I didn't, part of social work school that I didn't really gravitate toward was sort of policy, you know, you could get a degree in policy, and I was like, "Oh, yuck!", but in terms of family work and that kind of stuff, it sort of made intuitive sense to me.
Lynn Lyons, LCSW (11:56):
And you know, if you are working a lot with adults, which I was, and then you move into working with kids, what happens is you're working with adults and they're saying, you know, "I'm really struggling", and then they'll call you five years later and say, "I saw you for my anxiety, and now I'm a mom. Can you work with my child?" And so unless you're really not paying attention, you're seeing that this is a really family thing. And so, the idea of that sort of family approach and that systems approach really made sense to me. And I think, as I was working with families-- honestly, I think there are a lot of stipulations, for lack of a better word, and a lot of even rules or expected things that we are taught as therapists that didn't make sense to me. And I thought this idea that you shouldn't work with different people in the family, you know, like, well, if you're working with the parent, you shouldn't work with a child. I always thought, "Well, gosh, they all live together."
Keith Sutton, Psy.D. (13:11):
Yeah.
Lynn Lyons, LCSW (13:11):
Parents are really teaching the children things, and I really understand a lot about how this mom or dad operates, and now they're asking me for help with their child. Why would I not step into helping the child because I've got all this information about how this family works already? Right, so it just sort of made intuitive sense to me.
Keith Sutton, Psy.D. (13:32):
Yeah, I got first interested in families working at team shelters that I worked at, and where the kids would come in, we'd have them for a couple days, and then the family would come in. And I quickly learned that when you put the kids back in the context of the family, a lot made sense. So, as well as some of the maladaptive patterns. And so got really interested in family systems and then worked in a drug and alcohol outpatient program that was very systemically oriented, kind of all prior to grad school. But yeah, I mean, with a systems approach, I find it really nice because I can go between working with the kids, working with the couple, working with the parents, you know, sometimes doing some individual work, say a parent maybe has some trauma or so on and be able to work at those kind of multiple levels because they're all intertwined.
Keith Sutton, Psy.D. (14:17):
And oftentimes, when the family has a good relationship with you, they want you to help out with these other aspects rather than try somebody new. And also you can hold all of that stuff where I think some clinicians sometimes are concerned about that you wouldn't be able to hold the space for the child and the parent at the same time, or the couple or so on, and really-- but yeah, no, so it's great that you got that initial kind of training and thinking in systems approach and particularly the social work background. I think really, you know, it's about that, about kind of connecting to the different levels. How about with the-- because I know also-- I forgot, who did you train with the hypnosis? Was it Michael Yako?
Lynn Lyons, LCSW (15:00):
Michael Yako.
Keith Sutton, Psy.D. (15:01):
Yeah. And I know that Eric, you know, the Ericksonian Institute, very systemic. Was there any of that piece in there, or-- and I know you-- I think one of your earlier books, or your first books was on working with children and using hypnosis. Is that right?
Lynn Lyons, LCSW (15:15):
Yeah, that's actually my third book. So that was the last book that I wrote, but my books were Irish triplets. I did three books in three years.
Keith Sutton, Psy.D. (15:23):
Oh, nice.
Lynn Lyons, LCSW (15:24):
I actually was-- I had the contract for writing the first book right. When "Anxious Kids, Anxious Parents", and then the companion book for kids came out. And then I wrote that book last, but it was right, you know, bang, bang, bang. Yeah, so I have-- so Michael Yako, if you don't know of him, you should. He's one of the best, sort of clinicians in the treatment of depression. And he also is just one of the world's most renowned experts in using hypnotic strategies. And so, I met him-- actually, it was when I was in Pennsylvania and I had a friend who I worked with named Jay. And Jay was putting on this training with Michael, and at this point, you know, I was still-- how old was I at that point? --26. And he said, "I'm putting on this training, it was like a four-day training with Michael. And so, I think you would like what he has to say". So, I went to this first four-day training, and I was just hooked, because the way he talked about conceptualizing a problem, right, very strategic, also pretty systems oriented, was so different.
Lynn Lyons, LCSW (16:50):
So even though I was a social worker, and even though I had this family sort of systems, you know, perspective, it was still very psychodynamic. My training was very psychodynamic. And so, he was talking about it in such a concrete way. And then the way that he integrated hypnosis, right? So for anybody who's listening to this, hypnosis is not a therapy. Hypnosis is a way to deliver therapy. I always say it's the tray on which I put the hor d'oeuvre. And so, it is not this stand or in my opinion, shouldn't be this standalone thing that you do hypnosis. It's a way to integrate it into your treatment. I was just listening to somebody give this really awesome workshop on chronic pain, and he was working, showing some videos of working with these clients, and he called it active meditation, right, which is just a way of, you know, making it more palatable, poor hypnosis freak out about the word, but it-- so I started training with Michael, so that would've been way back, you know, I don't even remember the year.
Keith Sutton, Psy.D. (17:58):
Sure.
Lynn Lyons, LCSW (17:59):
But I continued to go to trainings with him, and he actually has been an incredibly wonderful mentor to me. I've known him for over two decades now. So, he really taught me about using hypnosis, but probably more importantly than that, really about how to think about interrupting patterns and how to really target what you want to go after in a family. What's the pattern that you need to interrupt, and how do we figure out in a complex problem or in a family system or within an individual, how do we go after that? Hugely influential in my work, because if you know, are familiar with the way that I talk about anxiety, I'm much more interested in how anxiety works in a family, how it invades a family, how it is contagious in a family. The why part of anxiety is usually not that hard to figure out. And you know, so many people spend time thinking about, well, "Why is she anxious about this?" Right, that's not a hard question to answer when it comes to anxious kids. So much more important to me is how do we teach the skills that this family needs in order to interrupt this pattern? And that comes directly from Michael.
Keith Sutton, Psy.D. (19:25):
Oh, great. And yeah, what is it-- what can you give me an example of like, what the-- you know, the influence of hypnosis? I don't know if in language or in any techniques that you use in your work. You know, because I myself have-- I think I did one of the brief Erickson conferences. I did a two-day in hypnosis. So, I just got a little flavor of it. I would love to do more. One of my colleagues, Jim Klein, who is a clinical director for Jay Hale and CLI Madonnas uses it a lot and so many of the greats, you know, kind of, learned the Erickson approach. But yeah, what is it?-- it's still this kind of, you know, abstract thing for me. Yeah.
Lynn Lyons, LCSW (20:03):
So I think, you know, and what I talk about, and when you're working with children in particular, the goal is not for me to do hypnosis. And a lot of people-- poor hypnosis gets such a bad rap, you know, in TV and movies. I remember if you've seen the movie "Get Out" and they had this hypnosis part. Just, oh gosh. It just makes me cringe the way that it's talked about. But really what it is, if we had to define it, and many people have tried to define it, and there's all sorts of different definitions of it. But what it means to me, is that how am I going to get you into a focused state of attention in which I am going to harness, and this is how I talk to kids about this, I am going to harness the power of their imagination, and I am going to help give them an experience that really illustrates for them the mind body connection, and really illustrates how powerful the imagination is in creating symptoms in their body, how powerful the imagination is in terms of the stories that we tell ourselves.
Lynn Lyons, LCSW (21:50):
You know, anxiety is so much about the story and the narrative, oftentimes passed down from family right. A story of danger, a story of rigidity, a story of perfection, a story of incompetence, whatever it may be. So if I'm doing hypnosis with someone, all it really is, is that I am taking my approach to worry, which is worry, shows up and creates this story for you, and it has this process that it does, and it's basically saying, "You can't handle it!" How am I going to take the story of worry, and present it in a way that engages you, that captivates you, and that may be a little bit different than the way you've heard it in the past, so that I can suck you into, you know, in a-- I guess, suck you into a different story. Pull you into a different narrative. So--
Keith Sutton, Psy.D. (22:15):
Kind of gets connected to that, or like almost like a reframe or kind of like a--
Lynn Lyons, LCSW (22:19):
Yeah. Yeah.
Keith Sutton, Psy.D. (22:19):
The thinking around it in a way that's kind of vibrant or illustrative or something that stands out. I guess it's memorable almost.
Lynn Lyons, LCSW (22:27):
Right, yeah. Something that is novel in some way, something that sort of gets your attention, because the cool thing, if you think about it, think of the message. So, whenever I'm doing hypnosis and whenever I'm doing treatment with an anxious child or an anxious family, there's always something that I'm trying to deliver. There's always a message that I'm trying to deliver and a skill that I'm trying to teach. So, I'm going to come up with any way that I can to deliver that message, to amplify that skill that I want to teach, to help show them where the gap is, and then how can we create a different experience? So storytelling, of course, is sort of the human tradition. Right, so Ericksonian hypnosis, you made mention of Ericksonian hypnosis, and that's based on the work of Milton Erickson. It really is a much more informal hypnotic process. It has a lot to do with storytelling and language and metaphors and being creative in really cool ways. Versus if you think of-- sometimes people have ideas of more authoritarian or direct hypnosis, you know, "I will count down from 10 and you'll do this".
Keith Sutton, Psy.D. (23:41):
Yeah. Yeah.
Lynn Lyons, LCSW (23:42):
So, I'll give you an example. Little, not so little, but still a little girl came to see me and she has a condition that requires that she have an injection once a week. And she's a worrier. She's anxious. I knew her before that. I know her family. Right. There's anxiety in the family. And so she really needed help being able to tolerate this injection. She said that the injection only hurt for two to three seconds, but it was the anticipation of it. And she would always-- she has it on Friday nights. And it was, you know, just sort of ruining her day as she was--
Keith Sutton, Psy.D. (24:23):
Yeah.
Lynn Lyons, LCSW (24:23):
So, I want to give her a skill, I want to give her a strategy of managing this injection in a way that doesn't become so intrusive into her little life. Because the injection itself takes two to three seconds. So, we made a recording together, I just used her mom's phone and made a recording. And in that situation, I am trying to convey to her that she has the ability to disconnect from this sensation for a moment, that she doesn't have to be overly focused on getting this shot, that she doesn't have to be overly focused on the sensation that if it is a period of time, that's two to three seconds, albeit it's unpleasant, right. Who-- you know, be weird-- I told her it would be weird if you were like, "Yay, I get to have a shot". How do I teach her a skill that allows her to contain it, in a way, so that she has the shot over here for two to three seconds and the rest of her can live her life.
Lynn Lyons, LCSW (25:32):
And it becomes this little thing rather than this big thing. So if we look at what the message is that I want to convey, the message is, "This is something that you're going to have on Friday nights, and we can either focus on it and amplify it in a way that it becomes this huge thing you have to deal with, or we can contain it and give you some skills so that you're going to have it and it's going to be done with, and the rest of your-- all the other hours and seconds and minutes of your day are going to be free of this". So that's what we're working on. Yeah.
Keith Sutton, Psy.D. (26:08):
So it's like not hanging overhead.
Lynn Lyons, LCSW (26:11):
Right.
Keith Sutton, Psy.D. (26:11):
That's kind of this, put over in its place, and again, just, you're not saying it's not going to hurt or anything like that, but it's again, separate from the main focus.
Lynn Lyons, LCSW (26:21):
Because worry, when you worry about something, right, it's an overestimation of the problem and an underestimation of your resources to deal with it, right. That's what-- great definition from David Barlow. So, she's got this problem. It's not like we're going to say, "Shots are great", but she needs to have the shot. She knows she needs to have the shot. How are we going to frame it up in a way that makes it more manageable to her? So again, hypnosis is just a way for me to deliver that message and a way for me to convey that to her--
Keith Sutton, Psy.D. (26:52):
And is there something you're doing in delivering the message, or are you like telling a story or so on? Or is it just the way you talk about it kind of as--
Lynn Lyons, LCSW (26:59):
Yeah. I mean, I think it's, you know, it's, first of all getting her focused, right. So, which is not a hard thing to do with a kid, you say, sit back and, you know, sometimes they close their eyes and sometimes they don't. And I really just want you to focus on my words. And I-- it played around a little bit with-- it told her that I had this secret power secret that I didn't want her to tell anybody about, but where I turn up gravity a little bit, and so I'm going to turn up the gravity and let's see if we can feel the sensation. So, I'm playing around with altering sensations, using her imaginary, so I'm planting that seed of the ability to alter sensations, and then talk about-- you know, told her a story actually of another kid that I saw who actually was being treated for leukemia. And this, little girl would go and fly around London during her chemo treatments so she could leave her body in the hospital and then go fly around London--her choice--and wouldn't it be interesting if she could come up with a way to use her imagination that would allow her to tolerate what she needed to get through.
Lynn Lyons, LCSW (28:07):
And so, it's just storytelling, right. And I use a lot of stories, I use a lot of metaphors, you know, I've got an analogy for anything. But it's the language, and then I record it. I always record the sessions that I do, and then she is now practicing listening to it. So, she goes and she listens to it, and dad gets the shot ready, and then when she's ready, dad comes in and gives her the injection. You know, we talked-- I talked to her more recently about-- dad said it, you know, it's really helpful when her leg is really loose, you know, muscles really loose. So, we just talked about imagining the difference between a stick of butter that just came out of the refrigerator and a stick of butter that's sitting on the counter during the summer.
Keith Sutton, Psy.D. (28:58):
Yeah.
Lynn Lyons, LCSW (28:58):
How easy it is to just take your knife and get that stick of that butter that's soft and, you know, playing around with that.
Keith Sutton, Psy.D. (29:05):
Right through it. Yeah. Yeah. It's almost like a voluntary dissociation.
Lynn Lyons, LCSW (29:10):
Well, yeah. And you know, that's one of the qualities of hypnosis is that it's dissociative in a good way, right.
Keith Sutton, Psy.D. (29:17):
Definitely. Yeah, great. Very neat. And tell me a little bit about the, your-- how you got involved with, you know, cognitive behavioral therapy and kind of your use of CBT and you're thinking about CBT and kind of how you- yeah.
Lynn Lyons, LCSW (29:34):
Well, the reality of it is that, if you were working in the mental health field, at the time when managed care came in, that you damn well better learn about cognitive behavioral therapy because that's what everybody wanted you to do. So, it was sort of like, that was what we were going to do, whether we liked it or not. It does, you know, it fits with sort of my pretty concrete approach to things. I think that there are some things about cognitive therapy, CBT with kids that I don't do actually. Cognitive therapy and CBT-- and definitely if you were to, you know, somebody were to say, "Well, where do you really-- how do you describe yourself--if you had to pick one thing?" You know, I'm definitely a cognitive and behavioral, but I'm not into the content and I think that that's one of the things that's a little different, particularly with worry. I think that the thing that I found is not helpful, is a lot of the discussion that happens, providing evidence to support the thought or not support the thought. What's the likelihood of that happening versus the likelihood of that not happening? The reason I think I've moved pretty far away from that, and really much more into a process approach than a content approach is because a lot of the things that I see that kids worry about are very likely to happen. So, if you are dealing with somebody who's got social anxiety, their big fear, their big worry is that they're going to embarrass themselves, or that people are going to judge them. That's going to happen, right. If you're dealing with a kid who's got an emetophobia, fear of vomiting, that's going to happen. If you're-- you know, a lot of kids now during all this COVID time, really worrying about getting sick or people die, that's going to happen. So, it just stopped making sense to me, to have these discussions about what's the likelihood of that happening--
Keith Sutton, Psy.D. (31:39):
Yeah, the odds are so on, yeah.
Lynn Lyons, LCSW (31:41):
Yeah, right. When so much of what I was talking about, the likelihood of it happening was pretty darn high. So I had to find a way to shift out of that. I found that a lot of discussions that I was having with kids, turned into "Yeah, but" discussions. And parents instinctively do want to offer evidence to the contrary, right? So, "Mom, I don't want to go to school, everybody's going to be laughing at me", and that the parent immediately wants to say, "Oh, well, nobody's going to laugh at you. Or everybody's worried about their own stuff, they're not paying attention to you". And I thought, "If that worked, then why are they coming to see me?" If all of that content-based reassurance or that examination of the evidence was working so well, why wasn't it working so well? So, it's not that it doesn't help some people, but when you're working with kids who have worries about ubiquitous problems, I'm not going to focus on the content. And I think--
Keith Sutton, Psy.D. (32:49):
This is where you get into-- you know, which is really stuck with me, which I use a lot with my clients about that, you know, anxiety wants certainty.
Lynn Lyons, LCSW (32:58):
That's right.
Keith Sutton, Psy.D. (32:59):
And that, you know, that aspect of, you know, even all that, you know, let's look at the odds, things like that, but it doesn't get certainty.
Lynn Lyons, LCSW (33:07):
Right.
Keith Sutton, Psy.D. (33:07):
You know, the thing-- the bad thing can happen. And so, we need to embrace uncertainty.
Lynn Lyons, LCSW (33:13):
That's right.
Keith Sutton, Psy.D. (33:13):
Rather than try and reassure that the bad thing won't happen.
Lynn Lyons, LCSW (33:17):
That's right. Right. And that's the trap you get into, right? So if you've got somebody who's afraid of vomiting, and we can say, well, as long as you don't eat too much, or as long as you do this, or as long as you do that, they're seeking certainty. So then what happens? They start coming up with their safety behaviors to prevent the bad thing from happening, but we can't say to a kid, "Oh, you'll never throw up", or "Nobody will tease you, or your plane won't crash", right? So the content is so minimal to me, because I'm really looking at, like you say, that quest for certainty and comfort. And so, I call it doing the disorder. Whenever an adult is working with a child, be the school or a parent or a clinician, and the goal is to try and create certainty and comfort. They're working for the anxiety disorders.
Keith Sutton, Psy.D. (34:15):
Yeah.
Lynn Lyons, LCSW (34:16):
Right, they're-- the anxiety disorder is saying, "I demand certainty and comfort, so I need you adults, to make that happen". And it just backfires. Schools, I do a lot of work in schools, and unfortunately schools are absolutely putting things in place for anxious students that support the disorder.
Keith Sutton, Psy.D. (34:40):
Yeah, and inadvertently reinforcing the avoidance despite-- and that's actually the way I oftentimes, when I recommend your book, I describe it, is that, you know, as parents, we care about our kids. We're trying to take care of them, but sometimes as we're trying to be helpful and take care of them, we sometimes inadvertently reinforce the avoidance out of no malice or anything like that, or just trying to help. But sometimes then it can actually kind of feed the anxiety and gets stronger as we're trying to actually address it and help the kids and support them in overcoming it.
Lynn Lyons, LCSW (35:13):
Right. Well, and the thing about avoidance that's so tricky is that it works like a charm.
Keith Sutton, Psy.D. (35:20):
Yeah.
Lynn Lyons, LCSW (35:21):
If you're a parent and you've got a little child that you love and they're distressed and you help them avoid this thing, and then they're not distressed anymore, right? Of course, you're going to do that because you want your kid to feel okay. And I talk a lot about emotional management, whether it be anxiety or worry or anger or whatever, and that the only way that you practice emotional management is that you've got to be allowed to experience the emotion. And worry is going to my--
Keith Sutton, Psy.D. (35:53):
Muscle.
Lynn Lyons, LCSW (35:54):
Yeah.
Keith Sutton, Psy.D. (35:55):
Yeah.
Lynn Lyons, LCSW (35:56):
Yeah. So, how do we let our kids, within a loving and supporting and caring environment, how do we allow them to feel distress or uncertainty or discomfort or sadness or heartbreak or whatever, and teach them that they can get through that. Because, and you know, in extreme situations, you've got parents that are very intent on not letting their children feel any distress. It's called parental experiential avoidance, actually. And it's one of the ways in which parental control shows up and we know that parental control is unfortunately a little fast track into anxious kids. So, being able to talk to parents about how counterintuitive it feels to allow your child to feel these things, but that's part of equipping them with this really important emotional management skill.
Keith Sutton, Psy.D. (36:56):
Yeah. Where's that from? The parental experiential avoidance term.
Lynn Lyons, LCSW (37:01):
Lynn Lyons, LCSW: (37:01)
That was, oops, sorry. That was-- so some research has been done, and I can send you the link to one of my favorite articles about it. But they were looking at, you know, it was\ very interesting because they were looking at-- these researchers were looking at parental control, but they smartly said, "Well, there's a lot of reasons that parents control."
Lynn Lyons, LCSW (37:25):
So you could have, you could have a high degree of parental control and create an anxious child, but it could be because the parent is narcissistic and controlling, or it could be because the parent is whatever and controlling. So they said, let's sort of pull this apart a little bit. And they found this subgroup part of parental control that really said the parent is trying to avoid their own distress and avoid the distress of their child. And that was just, in terms of anxiety, that was a really important thing to look at. I'll send you the link.
Keith Sutton, Psy.D. (38:05):
That'd be great, yeah. So, this makes me think of a couple things. Yeah. Sometimes the way I use the metaphor of like-- with avoidance as if I ask the kids and the family sometimes, have you ever gone to a restaurant at the beach where it says, you know, "Don't feed the seagulls", and there's a seagull over there, and you think like, "Oh, I'll just give it one french fry, then it'll go away, what's going to happen?" And I say, you know, every time we're avoiding saying, "Oh, well, we just won't go to that party", or "Oh, you know, like, I'll help him with, you know, kind of deal with that situation", or kind of, again, we're just kind of feeding the seagull and they oftentimes want more and more. More aggressive and try to steal the food off your, you know, table or so on.
Lynn Lyons, LCSW (38:42):
Yep.
Keith Sutton, Psy.D. (38:42):
And so those kinds of pieces play in, and I think, you know-- also what you're mentioning with the control aspect, the other way I oftentimes conceptualize it is that, you know, when we get anxious, we get more controlling.
Lynn Lyons, LCSW (38:53):
That's right.
Keith Sutton, Psy.D. (38:54):
Because we're trying to get certainty.
Lynn Lyons, LCSW (38:55):
That's right.
Keith Sutton, Psy.D. (38:56):
And sometimes, you know, that certainty kind of, you know, attempt at it again, thus becomes the problem. You know, you try to get that. That's interesting, yeah. And I, you know, I also think too about that experiential avoidance. I oftentimes use that clip from Brené Brown. There's a little, you know, from her TED Talk, it's a little cartoon of a bear going down into the hole and just that kind of piece that to truly have empathy, we have to feel that same feeling and engage with what that has felt like. But sometimes that can become ultimately dysregulating, so then the person tries to fix or make it better or so on, because they're dysregulated. And so, part of the work is helping the parents to sit with that discomfort.
Lynn Lyons, LCSW (39:43):
Yeah.
Keith Sutton, Psy.D. (39:44):
That piece of the "Yes, but" too, I oftentimes-- I do a little exercise for the, you know, coping thoughts and the automatic thoughts almost like a gestalt-like kind of side to the chair. And I help parents understand that it's kind of like motivational interviewing, that we all have ambivalence, and when the parent takes one side of the ambivalence, they're going to get "Yes, but yes, but"--
Lynn Lyons, LCSW (40:03):
That's right, that's right.
Keith Sutton, Psy.D. (40:04):
So instead, they need to make room for those kind of deep, dark thoughts and be able to tolerate sitting there with them around that, because then they can kind of climb out of that hole together.
Lynn Lyons, LCSW (40:15):
Yeah, we do a lot with anxiety, when people are dealing with anxiety, we do a lot to get rid of it.
Keith Sutton, Psy.D. (40:25):
Yeah.
Lynn Lyons, LCSW (40:26):
Right. And that backfires, right. There's where you get the "Yeah, but", the more you try and not think about it, the stronger it gets. Right? We're very big on elimination strategies. I think a lot of what's done with anxious kids is really based on elimination strategies. And so, there's a real discomfort, like you say, with people sitting with those uncomfortable emotions that the thing I say all the time is that I couldn't do my job without the two words, "of course". Of course, you feel worried about this. Of course, you feel uncomfortable. This little girl has to get a shot on Friday nights. Of course, she doesn't want to.
Lynn Lyons, LCSW (41:03):
But what we tend to do is we tend to jump in and try and figure out, well, how can we get rid of these feelings rather than either normalizing them or helping people problem solve, or, you know, what's the skill that you need in order to manage these feelings when they show up? What's the skill that we want to teach you? Sometimes it's being able to ask for help. Sometimes being able to, you know, I was just doing one of my consult groups this morning and one of the therapists said, you know, "I just want to throw this out there, is anybody else having a hard time doing this job? Because I feel like I'm just exhausted". And of course, all of us were like, "Yes!", you know, so we didn't try and take it away from her.
Keith Sutton, Psy.D. (41:52):
Sure.
Lynn Lyons, LCSW (41:53):
But her just saying it out loud and all of us saying, "Of course you feel that way", really made her feel better. So we've gotta really pay attention in what we're doing right now with kids and teens. What is absolutely disturbing to me and frustrating to me, is how much we are pathologizing the normal experience of relationships and disappointment and fear and worry, how we're teaching these kids pathological language, how we have created a culture in which their identity is really wrapped up in these permanent labels that we're giving kids. It really is troubling to me.
Keith Sutton, Psy.D. (42:40):
Yeah. Rather than like, "I have anxiety", or it's like it's a part of me, or it's something that's about my personality rather than it's something that, you know, may have--
Lynn Lyons, LCSW (42:49):
Even worse than that, I have a brain that is permanently-- has a chemical imbalance, so I will have depression for the rest of my life because I have this disease.
Keith Sutton, Psy.D. (42:59):
Yeah. Yeah.
Lynn Lyons, LCSW (43:00):
Why would you say that to a 12-year-old? Say it to a 32-year-old, right. But that's the language that they have been given.
Keith Sutton, Psy.D. (43:10):
Taking in or yeah.
Lynn Lyons, LCSW (43:11):
I think it's, you know, that the goal is to get rid of these feelings or to have these feelings, or to accept that there's nothing I can do about those feelings. And those are the two very prominent messages that kids are picking up right now, and we need to do a much better job with that.
Keith Sutton, Psy.D. (43:31):
Yeah. I mean, this takes me into the next, you know, kind of the last topic I was interested in is about exposure. And I know that for myself, you know, it was hard to sit and do exposures and kind of learn, and it really wasn't intellectually, I watched this great series obsessed from A&E with real clients and real therapists actually going through exposure work. And I ended up flying out to get training from Edna Foa, and exposure with response prevention. But that, you know, that's such a key piece of learning how to sit with anxiety and be able to kind of ride that wave and really make contact and feel it. And I was just interested about your work, and I know I remember a comment that you had made in one of your trainings about kind of the hierarchy and kind of how you do that maybe a little differently than others and kind of an exposure hierarchy. I could speak--
Lynn Lyons, LCSW (44:18):
So I don't generally do-- you know, I think hierarchies are fine.There's some research to show that we don't really need to use hierarchies. I think that sometimes when we're using hierarchies with clients, we're sort of setting them up. I'm very, very aware of the messages that you give to clients. And if I am being careful and I am being cautious, and I am like-- and if I say things, well, "I don't want to do something that's going to overwhelm you, I have now said we're going to over, you know, we're going to get to that". So I'm very much into saying, "So we're going to do some exposure, so let's come up with some experiments for you to do this". And sometimes I'll say, "So that might be an easy, a medium, or a hard on right. Should we go for a hard one?" I just don't have it so high that we have to--
Keith Sutton, Psy.D. (45:12):
Not like, "let's stay away from that". Like, you know, that's going to be that or too much, but more like, you know, kind of where you want to go in.
Lynn Lyons, LCSW (45:19):
Right, yeah. And the other thing too is that I'm all about being on offense. So one of the things that happens sometimes when we do exposures is that we think, "Okay, so I'm going to do this easy exposure, and I have to, the child has to get to a point where they feel comfortable with that level so that we move up to this level", right. There's that word comfort again. And it really is much more about tolerating it. And if you look at some work that's done with exposure work with OCD, right? It is one of the things that some people are moving away from, it's this idea that you do these exposures so that you get habituated to it so it doesn't bother you anymore, okay. Often it doesn't happen. Go over here, right. We want to do exposures so that you feel uncomfortable and you say, "This is how I'm supposed to feel, and it's okay, and I can tolerate it".
Keith Sutton, Psy.D. (46:12):
Yeah, the goal is not necessarily to get rid of the anxiety--
Lynn Lyons, LCSW (46:15):
Correct.
Keith Sutton, Psy.D. (46:16):
Be able to kind of have that confidence that I can go towards anxiety and, you know, it may feel discomfort and you're going to come out on the other side and so on. Yeah.
Lynn Lyons, LCSW (46:26):
Yeah, so as soon as we start talking about doing exposures, and the goal is to create, I hear this sometimes, you know, we need to create a sense of calm confidence. I'm like, "good luck with that", right. It's really what we want to do is we want to normalize that when you're going in for a job interview or you're speaking to people that you don't know, or you're going in for an injection or whatever, that it's okay that you have both a desire to do this because it's something that you want, and I talk about helping kids to find a want to, and that also you're going to have your worry, which hangs around, right? The goal is not to please worry, and it's not to convince worry not to show up, it's to say, "I knew it was going to show up, and I'm familiar with you, and it's nice to see you". And as I step into this exposure, I'm going to bring with me an attitude, right. That says, "bring it on, let's go". I know you're going to show up, let's have at it. It's all this calming down that we talked about, right.
Keith Sutton, Psy.D. (47:29):
I like the term you used, the moment of goodbye for the separation anxiety that like, anxiety and worry is going to come in, we're going to-- we'll be seeing it at the door, and it's just, you know, rather than let's-- we're going to do all these things so it doesn't come around or we don't feel it, it's just kind of accepting and going towards it.
Lynn Lyons, LCSW (47:47):
Yeah, I mean I talked to little kids, you know, with separation anxiety, and I say, I have the moment of goodbye when I say goodbye to somebody that I love. When I say goodbye to my kids and send them back to college, I have a moment of goodbye. And I sit in the airport, I watch moments of goodbyes and moments of lows, and I see all this emotion that people feel, so you're going to have some feelings and it's okay rather than this. And again, this is where the "let's provide evidence and the reassurance", like you know your mom is going to come back for you, you know your mom is always going to be safe, blah, blah, blah. All right. Let's just talk about the big feelings that show up when you say goodbye to somebody, and let's make that okay.
Keith Sutton, Psy.D. (48:26):
Yeah. So, you know, the last little bit here, the interest in-- what are you working on now or what are you interested in now? Kind of where--
Lynn Lyons, LCSW (48:37):
I am thinking a lot about prevention. I'm thinking a lot about how do we move, you know, one of the things I said recently and then it got quoted, which is fine, is that we're doing a really good job of teaching our young people how to talk about mental illness rather than talk about mental health. So, I think that we got a lot of fire extinguishers that are going around trying to put out the fires after they're set, and we're not really paying too much attention to the arsonists. So, I'm talking a lot about certainly with anxiety, talking a lot about the achievement culture and how this is set up for kids, that they are getting a mixed message. We're saying to kids, "oh, why are you so anxious?" And also, "if you get a perfect score on your SATs, then we will reward that". Kids are very confused by that. We've done that to them. They didn't make up this system, we did. So I'm talking a lot about prevention, I'm talking a lot about the helping young people recognize the active process of emotional management rather than this passive, "oh, it just happened to me".
Keith Sutton, Psy.D. (49:48):
Yeah.
Lynn Lyons, LCSW (49:49):
A huge emphasis on connection, which through this year, we've all certainly seen the impact that has on us. Just so much about skill building. I think it's very clear to me with young people. If we think about what we've done with kids on the spectrum over the last 15 or so years, really very concretely talking to them about social skills, I think that a lot of kids could use that training. How do you set boundaries? How do you advocate for yourself? How do you-- you know, when to share something and when not to share something. Yeah, so a lot of prevention and a lot of I want to normalize all this stuff rather than have it in such pathological terms. I think mental health awareness is great, but I think that it's really gotten pretty pathological, and I'd like to see us pull back from that a little bit.
Keith Sutton, Psy.D. (50:52):
Yeah, yeah, yeah I think that's great. I think that piece, you know, that prevention and really kind of building those skills and that kind of emotional health piece is, you know, emotional, mental health and all those aspects are so important. That's great, that's wonderful.
Lynn Lyons, LCSW (51:08):
Yeah.
Keith Sutton, Psy.D. (51:09):
Okay well, thank you so much for taking time and speaking with us today. And you know, I love your work and love, you know, telling people about it and getting it out there more. So I really appreciate your time. Thank you so much.
Lynn Lyons, LCSW (51:21):
You're very welcome. If you want to, my project throughout this pandemic has been the start of the podcast Flusterclux, with an “x”. So, if people are listening and they want to check that out, we're going to-- we start our third season, not that a podcast season has any, you just make it up.
Keith Sutton, Psy.D. (51:42):
Yeah, right.
Lynn Lyons, LCSW (51:43):
But talking about emotional management and the parental role and all of this, it's a good free resource for people to check out.
Keith Sutton, Psy.D. (51:51):
Okay, great. Perfect. I'll link also on our webpage.
Lynn Lyons, LCSW (51:55):
Fabulous.
Keith Sutton, Psy.D. (51:55):
Great. Well, thank you so much. I appreciate you, appreciate having you.
Lynn Lyons, LCSW (52:00):
I'm so delighted that you invited me, Keith, thanks for having-- thanks for inviting me on.
Keith Sutton, Psy.D. (52:04):
Take care.
Keith Sutton, Psy.D. (52:05):
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.