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Michael Ungar, Ph.D. - Guest
Michael Ungar, Ph.D. is the founder and Director of the Resilience Research Centre at Dalhousie University where he holds the Canada Research Chair in Child, Family and Community Resilience. In 2022, Michael was ranked the number one Social Work scholar in the world in recognition of his ground-breaking work as a family therapist and resilience researcher. That work has influenced the way human development and organizational processes are understood and studied globally, with much of Dr. Ungar’s clinical work and scholarship focused on the resilience of marginalized children and families, and adult populations experiencing mental health challenges at home and in the workplace. In addition to providing consultation to international NGOs like the Red Cross and Save the Children, government agencies in more than a dozen low, middle, and high income countries, and educational institutions at all levels of study, Dr. Ungar’s research has also influenced the HR and corporate social responsibility initiatives of Fortune 500 companies like Unilever, DHL and Cigna. Michael’s work emphasizes how to use the theory of resilience to increase both individual and institutional agility during crises, with numerous organizations having adopted his concept of resilience as a negotiated process that enhances wellbeing and social responsibility. He is the author of over 250 peer reviewed articles and book chapters and 17 books. His blog, Nurturing Resilience, can be read on Psychology Today’s website. |
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W. Keith Sutton, Psy.D. - Host
Dr. Sutton has always had an interest in learning from multiple theoretical perspectives, and keeping up to date on innovations and integrations. He is interested in the development of ideas, and using research to show effectiveness in treatment and refine treatments. In 2009 he started the Institute for the Advancement of Psychotherapy, providing a one-way mirror training in family therapy with James Keim, LCSW. Next, he added a trainer and one-way mirror training in Cognitive Behavioral Therapy, and an additional trainer and mirror in Emotionally Focused Couples Therapy. The participants enjoyed analyzing cases, keeping each other up to date on research, and discussing what they were learning. This focus on integrating and evolving their approaches to helping children, adolescents, families, couples, and individuals lead to the Institute for the Advancement of Psychotherapy's training program for therapists, and its group practice of like-minded clinicians who were dedicated to learning, innovating, and advancing the field of psychotherapy. Our podcast, Therapy on the Cutting Edge, is an extension of this wish to learn, integrate, stay up to date, and share this passion for the advancement of the field with other practitioners. |
Keith Sutton, Psy.D. (00:24):
Welcome to Therapy on the Cutting Edge, a podcast for therapists who want to be up to date on the latest advances in the field of psychotherapy. I'm your host, Dr. Keith Sutton, a psychologist in the San Francisco Bay Area, and the Director of the Institute for the Advancement of Psychotherapy. At the Institute for the Advancement of Psychotherapy, we provide training in evidence-based models, including Family Systems, Cognitive Behavioral Therapy, Emotionally Focused Couples Therapy, Eye Movement Desensitization and Reprocessing, Motivational Interviewing, and other approaches through live in-person and online trainings, on demand trainings, consultation groups, and one-way mirror trainings. We also have therapists throughout the Bay Area and California providing treatment through our six specialty centers, each grounded in an evidence-based approach, with our Lifespan Centers, Center for Children and Center for Adolescents, where all the therapists are working systemically; our Center for Couples, where all the therapists are using Emotionally Focused Couples Therapy; and our specialty issue centers, our Center for Anxiety, where all the therapists are using CBT and EMDR for trauma; and our center for ADHD and Oppositional & Conduct Disorder clinic, where we're integrating those four approaches.
Keith Sutton, Psy.D. (01:31):
In the institute, we have our licensed, experienced therapists, and for those in financial need, we have an associated nonprofit, Bay Area Community Counseling, where clients can work with associates, psych assistants, and licensed clinicians who are developing their abilities and expertise. Additionally, as part of our nonprofit, we also have the Family Institute of Berkeley, where we provide treatment, training, and one-way mirror trainings in family systems. To learn more about trainings, treatment, and employment opportunities, please go to sfiap.com and to support our nonprofit, you can go to sf-bacc.org to donate today to support access to therapy for those in financial need, as well as training in evidence-based treatment. BACC is a 501(c)(3) nonprofit, so all donations are tax deductible.
Today I'll be speaking with Dr. Michael Unger who is the founder and director of the Resilience Research Center at Dalhousie University, where he holds the Canada Research Chair in Child, family and Community Resilience.
Kieth Sutton, Psy.D: (02:33)
In 2022, Michael was ranked the number one social work scholar in the world, in recognition of his groundbreaking work as a family therapist and resilience researcher. That work has influenced the way human development and organizational processes are understood and studied globally. With much of Dr. Unger's clinical work and scholarship focus on the resilience of marginalized children and families, and adult populations experiencing mental health challenges at home and in the workplace. In addition to providing consultation to international NGOs like the Red Cross and Save the Children government agencies in more than a dozen low, middle, and high income countries, and educational institutions at all levels of studies. Dr. Unger's research has also influenced the HR and corporate social responsibility initiatives of Fortune 500 companies like Unilever, DHL and Cigna. Michael's work emphasizes how to use the theory of resilience to increase both individual and institutional agility during crises with numerous organizations having adopted his concept of a resilience as a negotiated process that enhances wellbeing and social responsibility. He's the author of over 250 peer reviewed articles and book chapters, and 17 books. His blog, nurturing Resilience can be read on Psychology Today's website. Let's listen to the interview.
Kieth Sutton, Psy.D.: (3:48)
Well, hi Michael. Welcome. Thanks for joining today.
Dr. Michael Unger: (03:51)
A real pleasure, Keith. It's great.
Kieth Sutton, Psy.D: (03:53)
Yeah. So I'm so excited to have you. We had met at a after conference some years ago, the American Family Therapy Academy, and got to talk about your work. Particularly, I'm so interested in the work that you do 'cause you do, writing, and work around resilience. And I think this is such an important topic and there's a book that you've written, particularly one of the areas, my focus is teenagers and adolescents, and there's a book called Too Safe For Their Own Good: How Risk and Responsibility Helps Teenagers Thrive and Change in the World, the Science of Re Resilience and True Path to Success. Sorry, did I just mix those two titles?
Dr. Michael Unger: (04:34)
No, those are two different titles. Yes. Yeah, Too Safe For Their Own Good.
Kieth Sutton, Psy.D: (04:40)
Lemme lemme redo that little part.
Dr. Michael Unger: (04:42)
Major World as a second.
Kieth Sutton, Psy.D: (04:44)
Sure. Yeah. Two, safe for their own Good. How risk and responsibility helps Teenagers thrive. Sorry, I'll, I'll edit that a little bit later. Okay. And just very interested in this topic and so I wanna hear all about this, but first I always like to kind of get a sense of, you know, how you got to doing what you're doing, the evolution of your thinking.
Dr. Michael Unger: (05:09)
Well, when I began to work, I was working in a lot of youth in juvenile corrections settings and sort of in child welfare settings, et cetera, et cetera. And you know, you begin to see a pattern if you go looking for it, in terms of unexpected outcomes. Better than expected, especially with teenagers. And I remember getting curious about not just the predictors of psychopathology, but also what was going to predict this pathway to wellbeing even coming out of very, very difficult situations of adversity. We were just beginning to, you know, understand ACEs and there was a whole sort of idea of this. I first latch onto the idea of empowerment, you might remember that. You know, that was the big buzzword at one point, and then there was this kind of movement. There was a group of scholars who were, I was doing my PhD and, there was a group of scholars like Michael Rudder and Maston Norman Gomez and, Ruth Smith, who were also of talking about this concept of resilience. And it, in a sense, empowerment was subsumed as one of the potential qualities. It was usually going by something like self efficacy, power and control experiences, and that type of thing. So I got, I got a little bit interested in this idea that maybe there is a whole group of people who are trying to predict not just the, if you know, the way I like to say this is, you know, if you look at the Ace Adverse Childhood Experience studies, they've been able to predict the negative outcome. They say, if you look at, Vince Val's work or whatever, and it says, you know, 50, 49% of people with this number of ACEs tend to predict that particularly negative outcome. But at the top of the bar graph, there's this massive sort of, you know, null hypothesis, which is that like something like 51% of people with ace scores over four. In those original studies don't develop some of the expected outcomes like depression.
Dr. Michael Unger: (07:01)
So you begin to say, okay, so what's going on here? What are those protective mechanisms operating and why don't we talk more about those? Because, you know, I think that so much of our attention goes to suppress the disorder. And I'm sure you've seen this with adolescent just because you've got them on a medication, the ADHD is treated, they are now better regulated in school, they're less explosive, they're less anxious, all of those are wonderful outcomes. They're not sustainable unless you also create a network of friends, ability, a sense of purpose and place, and connections to culture, and all these other things which we know create a sustainable, clinical outcome from some of those other things. In other words, they say, symptom free is not necessarily well.
Kieth Sutton, Psy.D: (08:06)
Yes, yes. Yeah. Sometimes I talk about with clients is trying to help 'em go from bad to good to great.
Dr. Michael Unger: (08:12)
Yes. Yes.
Kieth Sutton, Psy.D: (08:13)
And that's a second order change, right, kind of systemically too, right, that kind of, so that things have shifted so that they're more likely to continue to progress positively rather than just kind of a lack of symptoms.
Dr. Michael Unger: (08:27)
Absolutely. And I think what's probably distinguished my work over the years, Keith, has been that I got all the family therapy certifications, supervisory with MFT and all that, all those sort of stuff, right, I've got all that. But when I began to work more and more clinically with these ideas, I was, I'm now a researcher and a research scientist. I began to find that there was this, kind of gap in our understanding of what it is that makes it possible for us to help people find these other systems that are actually gonna support their wellbeing. And so as the last sort of, you know, I’ve been at this now for 20 plus years, and what I've seen is a steady emergence of a conversation moving the resilience field away from a purely psychodynamic or intrapsychic focus.
Dr. Michael Unger: (09:26)
Invulnerable child or the, this notion of individual psychological wellbeing, to now a much more multi-systemic understanding. I have to tell you a funny little story about this, because I was pushing this now for quite a few years. And, at one point I was very honored to have dinner with Sal Minuchin back a few years ago before he passed. And I remember us having this kind, he was familiar with some of my work. And he kind of shook his head. He said, you know, I don't know, Mike, how do you keep all these systems going? How do you concentrate on all these, you know, now you're talking about not just family systems, but economic and social and peer and community, and how do you, how do you work with all these systems?
Dr. Michael Unger: (10:18)
And he was like, oh, this just, it just seems daunting. And I answered back to him, I said, but Sal, you were the one that brought psychiatry from a single system individual focus into more the family focus…In a sense, I was just standing on his shoulders adding to the storyline. He had already sort of broken that barrier between the intrapsychic and the intrinsic and the extrinsic factors. So that's really been, I think, where the field's going now. You know, that gets pretty abstract as a definitely, you know, a certain, epistemological orientation to this work and all that kind of other stuff. But from a clinical point of view, of course it has, it really does have implications for the way we approach the work we actually do, especially with teenagers.
Kieth Sutton, Psy.D: (11:08)
Yeah. Tell me about that. How does that play out in your work with a teenager or a family?
Dr. Michael Unger: (11:16)
Well, let me, lemme give you an example. I was doing a, a consult recently with a large school board, And they were very, very troubled by this child who has just turned 10 years old, and for several years, he'd been in the same school, the elementary school, and had been badly dysregulated. Now, the backstory of the child is; father was in jail for many, many years. There was serious domestic violence in the home, mom had a severe addictions issue, and though child welfare was periodically involved, given there were some foster places, but mostly the boy had been maintained in his own home. In this chaotic environment, he had found, he had been consistently at one school and that school had adapted the curriculum and the educational assistance and had been able to get some of the social and emotional learning lessons into him.
Dr. Michael Unger: (12:08)
So he was, you know, learning to self-regulate a little bit when he flared up in terms of his impulsive disorders and all this kind of stuff. Very much, I'm sure, you know, anyone familiar with that profile of child would be able to imagine what's going on in the classroom. The thrown desk behavior. you know, we've seen that. When he was just turning 10, his mother and I say this very, I mean, I don't wanna sound insensitive in any way, but it was very expected that she would eventually overdose and pass. And so I was consulting because they were, now, trying to figure out what the case plan would be for the boy. Because neither parent was there now, and the whole issue of what are you gonna do?
Dr. Michael Unger: (12:52)
And, there was a few things that we talked about that I don't think they were, as I asked them questions, not just about the psychopathology and the grief and the negatives, but I also asked them about how's he functioning in the day-to-day, and what has he consistently done? And they talked about creating a very consistent environment in the classroom, and a continuity of care plans, et cetera, et cetera. And they actually said this was, and I wanna be very cautious about this because I mean, these are all these anomalies that you see inside these lived lives. But the boy was actually calmer almost. And I think when they sort of said that they hadn't realized that they'd actually been seeing that, because of course, I think what's happened is that the boys, this worst case fright of my mom would be dead on the couch when I come home after school was removed.
Dr. Michael Unger: (13:39)
And so you had, you had a sort of a child very vulnerable, but also looking for connections elsewhere and continuity. Along comes child welfare and they're gonna place him in a foster placement and they put him in a foster home or whatever. And, but the school, he continues to go to the same school. And I blurted it out at this large team meeting, I said, blurred it down and said, wow, that's amazing that the social workers thought to maintain attachment continuity, a holding environment, which was very adequate, a space that knew this kid, et cetera, et cetera. And the school shook their head. This was coming from the principal now. No, no, Mike, you don't understand. They placed him in a foster home halfway across the city. We pay for the Uber twice a day to bring this kid to our school.
Dr. Michael Unger: (14:27)
We pay out of our parent recreation funds, you know, those PTA. And I thought to myself, okay, so, if I can say it, but how could we, with all our knowledge of protective mechanisms and attachment disorders, and trauma, how could a system have placed them in a foster home and not provide it the Uber themselves? Thinking about the cost, I mean, you and I both know the cost benefit analysis this. I think that's crass, and I know I'm not trying to be, I'm not trying to be crass about this in any way, but, just if, the senior managers wanted only the argument on money, then this child will not likely escalate their behavior. And perhaps maybe just maybe have the protective mechanisms place. So the conversation now shifts from just a purely intrapsychic treatment plan, talking about, you know, housing, continuity of attachments, transportation systems, and I'm gonna argue that even if you're an office-based clinician and I do this work, you can still think about and ask questions around those particular dimensions of a person's life. So that we are talking about the social and physical ecologies that create the protective mechanisms. And it's not random. That I think with resilience, people just think, oh, it's random.
Kieth Sutton, Psy.D: (15:59)
Sure.
Dr. Michael Unger: (16:00)
But there are repeating patterns that we see in, especially in adolescence, for some of the factors that, you know, we, we could actually focus on.
Kieth Sutton, Psy.D: (16:08)
So you kind of went beyond just the intrapsychic to more of also looking at systemically and larger systems. And in this case, for example, this child, which when his mother passed away and he was alone, in some ways, he was out of that terror of worrying that she was gonna die. And, that's speculation of why maybe he felt more calm. But then the system really also stepped in to maintain those attachments, those relationships, the continuity to the peer group and so on. And all the, like learning that had gone on to help support this child by, you know, having him continue in the school despite the, the barriers of needing to, you know, be transported across the city or so on, and really stepping up. So not only might there be some intrapsychic kind of factors that are playing into potential resiliency and decrease of pathology, but also there's this kind of buffer by kind of helping, creating this context that also helps him to, withstand or overcome all the difficulties that are falling upon him.
Dr. Michael Unger: (17:18)
Absolutely. And I think what the study of resilience is now getting at, so I'm obviously a research scientist, a large part of my, 'cause I run studies all over the globe, and we look at populations of young people mostly, and looking at context specific, culturally specific variations and what those protective mechanisms are. . . But there are repeating trends in those, especially for teenagers. And for instance, if you're going to intervene, one of the very first questions I found very useful when I'm working, working with a teen is to talk about their routines. . , what are their rituals, their routines in their day, their week, their year, their month, and how are those supported? Because there is something, and I think the, the research is emerging on this a little bit, that if we wanna stimulate optimism or a positive future orientation, it doesn't come from just self affirmations in front of a mirror.
Dr. Michael Unger: (18:10)
It actually comes from the, living in a predictable environment that cues us that if I got through yesterday and I did, you know, X, Y, and Z and I repeat X, Y, and Z today, then I've set my cognitions, if you will, into that mode of saying, this is going to, I'm gonna get through the day. Yeah. So, so we begin to have this dance between things. So routines, right? I often look for in my young clients, so I'll often look for aspects of, consequences or accountability depending on how you want to put it. Not punishment. We're always looking at how can you scaffold an experience so a young person can fix their own mistakes. And this comes directly out of our studies. So we would literally go around the globe and find young people who are doing much better than expected in rural Thailand.
Dr. Michael Unger: (18:57)
With disabilities in India, children, who are living in townships in, South Africa. . , or for that matter here in Canada, whether it's an indigenous child or a child living in urban poverty. We would always be looking for like some of, what are some of these factors that might help us to understand what does a child need? This is, this is a really weird thing, Keith. 'cause I go all around the world, right? And that book, you know, Too Safe For Their Own Good came outta the fact that I would literally come back from like, you know, rural wherever. And I'd then be working with families here in Canada, and they'd be going, “oh, no, no, my daughter, my daughter has, oh, she can't go out after 6:00 PM” She, she didn't exercise any autonomy of decision making power.
Dr. Michael Unger: (19:41)
If there's a routine, I'm gonna impose it, you know? I'm the one whos gonna pack her soccer gear. There's no responsibilities, no accountability, no consequences. For her actions. So we were literally undermining the resilience based on what I'm seeing from the work I was doing, globally. But once you get, it's routines and consequences, and then you know, then there's a few others like obviously parent or caregiver child connections. And you know, I wanna negotiate that a little bit. 'cause I mean, as I've seen with, aboriginal peoples in Australia and, and having been the guest of their communities there and having it explained to me what, you know, who is the caregiver. And we are sometimes knotted into ourselves, and somehow it has to be that biological mother, the biological father has to do
Dr. Michael Unger: (20:30)
All that heavy lifting. And that is probably an anomaly globally, I would say it applies to 1 billion of the 8 billion of us on this planet. . . so I'm always sort of thinking about how could we get a caregiver functioning? How can we also create networks of other social relationships? So I'm very big on, even in a very anxious child . , that was a small task that they could kind take on at the school. They don't have to do a public talk or be front and center. The one I actually really love is, my son a few years back was a dj. It was kind of cool. But I really admired him that he would often ask, when he DJ'ed, high school dances and stuff, he'd often ask for these really anxious shyer kids to assist him and carry the big speakers and be, these kids would never feel comfortable being in the front.
Dr. Michael Unger: (21:24)
But by giving them a, a defined well-meaning and important, this . also echoes some of the work by Bruce Ellis and the States and University of Utah, this idea that we want kids to have these, not just in a positive experience, but one that brings with it another of the factors, it's a positive identity, decision making, control. . coming back to my theme of efficacy. So you're suddenly looking at these through those relationships, whether it's with a caregiver or with a wider social network of peers, but you're always trying to think of how to Velcro. I think we make a, you know, I always think that the categorical mistake of trying to instill resilience to single factor models, and the one I always, the one I drives me a little bit loopy is, the self-esteem workshops for girls .
Dr. Michael Unger: (22:15)
We have 45 minutes of lunch hour, we're gonna take a bunch of girls. We're gonna, empower them through a conversation and teach them...it's not gonna work. The outcome, those things are terrible unless it stimulates a social network. Plus it also gives those young women a sense of safety and purpose. . , if it doesn't build a social network, if it doesn't, kind of give them a routine to their day. Then that's the group that should be hosting the international Women's Day marches. And we should be using that intervention as a catalyst to get many more of these factors, including, by the way, one of the factors that we see globally, of course, is social justice. Is this idea that it is possible, there is the rare person who in the most deprived environment, rises above it.
Dr. Michael Unger: (23:09)
Those icons of, capacity. Always, I don't know what to do with that. I don't know what to do with Nelson Mandela. I admire, and I sit there and I watch. But how do you, how do you translate that into us ordinary folk? Because for every one of them, there's 10,000 that's succumb. My research is about why don't we just talk about the 9,999 and see what they're actually doing to cope. And that opens up a conversation which is much more contextually, the way I like to say, resilience is this pattern of navigation to the resources you need and negotiation. . and the negotiation for what you need to be given to you in culturally, relevant ways.
Kieth Sutton, Psy.D: (24:01)
Okay. So these kind of aspects that play in that are, these kind of factors that are related to resiliency, like the routines, the rituals, the consequence, the accountability, the kind of caregiver child connections, which are influenced by cultural and social, these are, are there kind of a number, like a list of aspects, or are there just too many to even list of these kind of major factors that play into resiliency? Because I think it's such an important subject. Even thinking back on my own growing up, what was it about the people that made it through difficult times and the people that didn't make it through difficult times? What was the difference? Because, you know, oftentimes, and like when I work with parents and they're kind of struggling with their child with substance abuse, and they're deciding should I intervene or not, it's like, we don't know right? Oftentimes It's a gamble. Your child may become an addict, your child may not have a problem, be able to moderate, they might become an addict and get clean and then kind of rise from there. We actually have a hard time predicting of what that's gonna look like. So how do we help guidance?
Dr. Michael Unger: (25:12)
And, and that's actually where I think where the science of resilience is moving. And in fact, if I might distinguish it from positive psychology, I use a lot of the literature, Martin Seligman. I mean, it's not like I'm absent from, in fact, I go to positive psychology conferences the whole bit. But, but there is a distinguishing difference. And that is the science of resilience is
Dr. Michael Unger: (25:46)
Yeah. So I will attend, lots of positive psychology conferences and admire the work. Absolutely. And I'm learning, but, the study of resilience is much more about matching the right protective factor to a particular risk profile.
Dr. Michael Unger: (26:01)
And and so when you're asking me, are there, you know, is there a, Anne Maassen often talks about a short list of factors. I would totally agree with that. That, if you have to do something, routines, accountability or consequences, parent or caregiver of child relationships, a network of other social relationships. If you look at, positive identity, power, and control, if you look at sensible longing, and that faith or spirituality as well, a sense of cohesion, all that type of stuff. Basically human rights that you're being respected. You know, if you go through some of those key factors, you do sort of end up with a core list, that's a great place to start. I read a lot about this on my blog and everywhere else, but, but then if you wanna be honest and a little more sophisticated, we have, a little while ago we did a search of, what are actually some of the most predominant resilience predictors that we have science on.
Dr. Michael Unger: (27:01)
And we were to identify 52 factors. With a relatively good science underneath them. Now, you know, we had to conflate some, and some maybe stood, like 52 isn't really the number. It could be 55, it could be 48. But there seems to be something there that we were able to distinguish. And then we developed a program called R2. And what what I kept getting asked about was, could you develop a curriculum whether I'm an employer looking to through my HR department or a human service organization working with inner city, folks who are really struggling with issues of violence and trauma or, the educational institutions. And this is interesting. What we do then is we take out the list of 52
Dr. Michael Unger: (27:50)
And we do a Delphi process in which we say, okay, which of these 52 factors are most relevant to this particular population that you have in your region? Now, we also have standardized versions of these that are free for downloading off off my website. They're all there. But sometimes people say, well, I want a more tailored approach. . . So for instance, like when we were working with inner city families in Memphis through a program there, what they identified as one of the key strategies for resilience was of course transportation systems. . housing, things like that. How do you work? If I'm a clinical therapist, how do I work with housing? . , how do I do that? But let me walk you through a series of questions that you can ask.
Dr. Michael Unger: (28:34)
You can ask, we'll say, I understand you're thinking about moving. Okay, where are you gonna move? I'm gonna move. Oh, we have an opportunity to get a little bit better apartment. It's out in the suburbs. So I say, well, there's some science on that that says, how long is your commute gonna be to your workplace if you do have a job? Or how long is it gonna be a commute to your friends and your social network, your extended family? You may be getting a better household, but at what consequence to the other resilience factors which are predictive of wellbeing. . . And I think sometimes we can have that. I mean, if a person wants to move. They move. I get that. Are they fully cognizant that they actually by, focusing on one system, in this case, housing .
Dr. Michael Unger: (29:17)
or one system of, I'm gonna leave that relationship, which is one as well. But do they understand the cascade effect on other co-occurring systems? . . And what I do think is a conversation that we can have. because there's embedded protective mechanisms. and often, I jokingly say, not with so much teenagers, but with adults, I'll say things like, if you're gonna divorce and change your job, my suggestion is do one or the other, but not both at the same time. . Because, you probably wanna change your job, get resettled and turf the partner. Right. You you don't wanna necessarily be that dysregulated
Kieth Sutton, Psy.D: (29:53)
And blow up everything at once.
Dr. Michael Unger: (29:55)
Yeah. You know, you want those protective mechanisms as long as it's, as long as obviously you're not in danger of violence. And I mean, obviously this
Dr. Michael Unger: (30:03)
Goes almost without saying here, but my point being is that even something like housing or transportation or location, there are cascades of either, there's trade-offs and there's either . virtuous cycles or negative cycles that occur as a consequence of your particular decision. And I think sometimes we, like the boy who needed the taxi, foster care. But it wasn't his risk factors went up dramatically on the location of the foster home. It was not a psychological intervention. Stabilizing him. It was a taxi. . intervention. Now I know we're clinicians. We're often office based. But we can advocate and also we can teach people to advocate for themselves. I can work with a teenager and say, what do you want?
Dr. Michael Unger: (31:01)
what kind of placement would you particularly like? And would it be useful to invite your social worker to a joint meeting so I can help advocate for your voice? I won't speak a lot. Rehearse it. We'll practice it. We'll write a letter. . , there's so many of the tools that we have that could, I almost think of it as like a child has a little voice knob right on their chest or their throat. I'm reaching across very gently and it's kind of turning their volume up. . and hopefully the volume down on all the professionals in the, in the case.
Kieth Sutton, Psy.D: (31:36)
I was gonna say too, that I worked in some teen shelters and residential treatment programs prior to graduate school. So that hands-on work is so important. And I think, some, some therapists don't do that work or they feel like, oh, that's elsewhere or so on. But sometimes working on helping your client find a job or helping them kind of coordinate with the school or so on, has such a major impact, rather than just talking about the depression, about not having a job or whatever it might be. And, you know, those factors, sometimes we might be working on the content of some of these things, but also we're working with the process. So it's still part of the therapy rather than something completely different or like, oh, that's social work, or whatever it might be. That, unfortunately some therapists kind of create a delineation between, what we do and what other people do.
Dr. Michael Unger: (32:30)
And, and I would say that the science of resilience, is about understanding the risk profile, and then finding the right set of protective factors, which will be the most responsive. So, I was recently doing more one-on-one clinical work with a 17-year-old who was, had an addictions issue . He was about to lose his grade 12, he was probably not gonna graduate and et cetera, et cetera. And a lot of our conversation was about simply helping him to find the protective factors which were available to him. He loved to weld. He was a good welder. . . And he found his identity wrapped up in that particular activity. And so a lot of our conversation, rather than just focusing on the fact that he didn't get outta bed that morning, it was much more around Wow.
Dr. Michael Unger: (33:23)
how did that affect your hope to be, to get your red seal papers . and be a professional welder, which would, you know, make you a great deal of money. Which is wanted, so he could own the kind of, he had this, mythic truck that he wanted to buy. Now I know this is very gendered and everything else, but it wasn't for me to judge. This is all what he wanted.So a conversation is about putting in place the structure, including whether or not he wanted his mother to wake him. He had a very serious relationship with a girlfriend. There was a sort of a set of very heteronormative practices and aspects to his life as well. .
Dr. Michael Unger: (33:59)
But all of them were potentially supports or catalysts that could be brought into the conversation. and I know you do a lot of family work as well, and at one point, I even had the girlfriend show up and just and just say, when you look at your fellow here, what do you see? What do you think he's good at? And creating that sustained narrative of another course. And in a sense, I'm not saying it was perfect. I mean, he continued to, use heavily, but he moderated a bit. .he continued to see that the consequences to his actions with regard to his educational pathway. And he also began to find alternatives. I mean, one of the things he did was he actually found a way to do a lot of welding for small bits of money.
Dr. Michael Unger: (34:46)
And I said, well, that's great. So now you're really showing an attachment to it. I mean, even if school doesn't work out right now, at least this will get you ready. So when you're 21 years old, you can enter, at least in the system I'm in, you can enter the college system without a high school leaving certificate, you don't actually need it. Once you're 21, you can go back. And I mean, why shouldn't I tell 'em that? And you know, I'm sure people would say, Oh, you don't tell him that because he’ll drop out. He was already dropping out. So let's give him a course, a plan. his identity, another protective wrapped up in this capacity. And the way he talked about what he could do and say, yeah, this, you know, they were building go-karts and they didn't know what they were doing. And so now there was other things I did as well. . , to be fair, his father had suicided when he was three . . And so the history, the family had a long, I mean, but if you notice, if you notice, I didn't start by telling you that.
Dr. Michael Unger: (35:43)
I started by talking about how could this boy maintain routine attachment, a positive, a powerful identity, relationships and everything else. And then I'm telling you, and yes, there was a lot of stuff around leftover from his father's suicide, And the impact that has and his mother and everything else. And the mother was obviously deathly worried about her son and mental health problems. . other things. But all of that was not the only focus. We did talk about his father. We talked about what his father would think about his welding interest. We talked about what his father would have wanted for him. We talked about what he knew about his father as a person, as a man when he was alive. And . , I had the mother come into some sessions and talk through some of the information that he didn't totally have, so that his father became much more re well-rounded In his life. so there was the terrible loss. . . But there was also a story of, there was something there. Other than that, in my dad's story In a sense, following Michael White's work, of course. I mean, obviously I'm repopulating I'm remembering. I'm bringing in other people's stories into that Intimate situation. But because I know in my studies of resilience that those patterns of relationship tend to be predictive of better mental health and better coping When under acute or chronic stress.
Kieth Sutton, Psy.D: (37:05)
Yeah. So you're kind of expanding that narrative, expanding that relationship that he had to his father, even though his father wasn't alive anymore.
Dr. Michael Unger: (37:14)
Exactly.
Kieth Sutton, Psy.D: (37:16)
And it sounds like too, that this kid had direction, he had a potential future, he had something that he felt good at or, interested in, or such so it sounds like that that existed while at the same time he was struggling with substances. And so that sometimes when, when somebody, for whatever the situation is, is not stopping their use or whatever it might be, that sometimes that competing kind of future, and then the substance getting in the way of the future, sometimes almost, leads to change rather than if the person has no sense of future or whatever might be going on. I actually worked with a college student who struggled with alcoholism. She wasn't gonna quit. She wasn't gonna change any of it. We worked on it. But the more she got connected to her future, the more she felt not good about what she was doing to herself. And eventually that created a crisis, which then led her into treatment. Because rather than just focusing on the symptoms, the symptoms and symptoms we're also looking at her life path. And that's what kind of created this cognitive dissonance between where I wanna go with my life and what I'm doing with my life currently.
Dr. Michael Unger: (38:30)
And, and if I might, Keith, that's brilliant. And if I might, if you can, Velcro multiple systems chain to that. So, you know, it's one thing to say, I believe in you and you're gonna make a great change, That's relatively narrow. But if you have some other witnesses to that change, or you create an opportunity, or you help find the funding, or you say
Dr. Michael Unger: (38:53)
Look, the more there's a catalyst effect of multiple factors, I like to think of them as, dominoes. I mean, we're often Maslow's hierarchy of needs.
Kieth Sutton, Psy.D: (39:05)
In this case too. This is actually what that crisis is what led her to then reach out and talk to her parents and actually admit that there's this problem going on. And they got her into treatment, and we had been working so long on trying to get her to engage her system, but she didn't want to, it was a secret and there was shame and so on. So yeah, that actually even led then to engaging the system and really kind of, creating that shift. So I think yeah, you're totally right with that aspect of kind of even beyond just the individual therapist that can we engage the other parts of their lives to help support that change?
Dr. Michael Unger: (39:40)
And it's interesting. A couple of things in terms of if people want to dig a bit deeper, I recently published an edited volume. It's pretty academic, so it's pretty heavy reading, but it's See 39 chapters of different people from different disciplines, from engineering to psychology, to epigenetics to computer science, quite a range. And I asked them to just talk about resilience from their perspective of their discipline, but also to link it to other, so, the person who did, computer infrastructure resilience also mentioned the need to think about urban planning and the psychology of the people using the computers. And if you wanna talk about architects, Terry Peter's paper in there about super architecture, how architecture can trigger elevated positive feelings. . , we can talk about epigenetics, of course, as a response to stress and all this kinda stuff.
Dr. Michael Unger: (40:30)
So that was, you know, that was sort of one emerging conversation that I do think we really need to think more and more about. You know, the desk I'm sitting at, the room I'm in, the social relationships, and the proximity I have or don't have to positive associations and the opportunities. I've seen the very best schools that I've seen work with teenagers are often those that are focused on multiple systems. So they're not just, you know, say we're gonna provide you with a therapist once a week, we're gonna send you up to the hospital. They're actually also adapting the child's, you know, is the bean bag chair at the back of a classroom. So they can better separate, there's a positive attitude towards them if they're two lgbtq+ sort of thing.
Dr. Michael Unger: (41:15)
There's all these aspects which signal a child, and there are, you know, positive affirmations of who they are and what they need.. So there's that conversation very much more and more looking at multiple systems. And even as a clinician, I am saying, we can engage, we can ask about do you have a quiet space at home, to regulate. Do you have the supports? Are there extended family members that you could reach out to on the weekends if home is too chaotic or dangerous? Is there a teacher or a classroom you could go that the bullies won't find you in the classroom? We can begin to think about triggering the cascade of positive protective factors in people's lives. And I'm not coming up with that randomly. These are actually based on examples out of our research.
Kieth Sutton, Psy.D: (42:06)
I was gonna imagine too that right, the role of learned helplessness plays in so much. And so as a therapist also helping the child, adolescent, the adult, be able to maybe see some of those resources that they might not be seeing because they're just feeling collapsed. And I know with the cognitive behavioral therapy research, also looking at the aspect for adolescents and with depression and the lack of problem solving abilities and so on. And sometimes having that help with a therapist, but again, not just intrapsychically, but also to be able to reach out and make those other connections or create that movement or that job. Or like you're saying, like finding ways to, engage with the environment that might be protective.
Dr. Michael Unger: (42:53)
Absolutely. But I will say this though. There is this, if I could characterize the field of resilience going from sort of more individually focused mechanisms to more social mechanism, then more social and ecological mechanisms and an evolving conversation about services and designs, and then into this more bigger multi-systemic thinking that is there. What I've actually been writing on lately, I recently just, a book will come out the next a few days called The Limits of Resilience. And the reason I did that was because I felt like the term is getting misconstrued to mean all kinds of things that we overlook. And the sort of a couple of examples that I would give is, at the community level, community that rebuilds . , they've been wiped out by a climate related emergency event like a hurricane. This keeps bashing the homes.
Dr. Michael Unger: (43:51)
I remember this, this mayor talking about the resilience of his community. 'cause they were rebuilding their massive homes right. Back where they were. And I wanted to say, look, this is a corruption of the idea of resilience. Mm. Resilience is an informed pattern of coping mechanisms. So that is not an informed, no. I realize there are some populations that don't have a, they cannot relocate. This was not the case. These were Mansions worth 1, 2, 3 million. And I realized that contrast with sometimes people feel a very strong sense of connection to place and everything. And that is a protective mechanism as well. Going back, what is your risk profile? What is the right outcome and what is the right protective factor? So sometimes relocating is actually the right resilience mechanism.
Dr. Michael Unger: (44:41)
Even if it compromises some of these other systems. And of course the other one, which I think for, I know you work a lot with adolescence and . , there is a concept of resilience, which is this idea of wear and tear allostatic load that when when we're exposed to constant bombardment of stressors, we might look, great, I think we all have those kids that they are just shining. They are, wow. I can't believe you're getting outta the bed in the morning and doing what you're doing. This is a a remarkable story. But what we also know is it's often those kids get to college . and then just implode. . . And a lot of it we're now understanding is the toll that takes at almost a genetic level. How that triggers a set of biological genetic processes when you're exposed to that level continue is stress. . . So you might adapt, temporarily, but its not necessarily a sustainable, so the real conversation about resilience then has to constantly be a dance between helping people navigate and negotiate for what they need, but never assuming the story is complete.
Dr. Michael Unger: (45:58)
I think there's a bit of a hands on, oh, they got to college, yay. Success. And they have a lousy relationship, they can't form this, they drop out, they lose, and that's probably 'cause I think we just didn't think about the other systems or the load on them over time, maintaining that level of functioning
Kieth Sutton, Psy.D: (46:20)
Well. And I think this is also the area to, of like the ideas of success and like, yeah, Seeing a kid being successful, getting the grades or something, even though they're going through all these things, doesn't necessarily mean that there's not other areas that they're struggling or other areas that they're needing support or so on. Because sometimes the focus is so much on these kind of particular, kind of tangible things like how many friends or grades or so on. but instead kind of really looking at a holistic picture about, does the, does the person have the ability to cope? Can they take risks and turn to others be vulnerable and, and all these kind of pieces to be able to get that support when they need it.
Dr. Michael Unger: (47:03)
That's absolutely the case that you really do need to think about which constellation of factors might be most, efficacious in that particular, for that particular outcome. And if I might, even outcomes become, certainly in our work, 'cause we work across so many different spaces and places around. I do find that that notion of what is a successful child is highly negotiated. And I think we forget that. So when when I see a book like by Amy Lunn Chuel, the, Yale law professor wrote, the Battle of the Tiger Mother or Tiger, something like that. And she's in a sense, extolling this hypervigilant parenting style. And so essentially equating that the only child that's successful is the one who's performing a cello concert or a violin concert on at Carnegie Hall.
Dr. Michael Unger: (47:54)
It just, sorry, I have to say this, it repulses me. It's so incredibly classist. And so the person who drove you to Carnegie Hall, that taxi driver. The person who mopped the floor or polished the piano, or sold the tickets or designed the poster. They're all dismissed as unsuccessful. . . And I just find the whole, this negotiation that I think sometimes we just don't open enough space for kids to come into our safe spaces as clinicians and say, tell me, so a kid who wants to weld, I wanted him to finish high school. I never held back from saying that. I said to him, finish school, you're gonna earn a lot more money, is with your papers if you get to college, it's no doubt.
Dr. Michael Unger: (48:41)
When he kind of showed some ambiguity about that, I said, well, let's brainstorm another path. You still like to be a welder, so let's figure out how to bring that identity, sustained identity. You're struggling with some drugs right now, but also, let's come up with a second, an alternative path. So you could choose. And then also, what do you think your father would've preferred you do? . . And what do you think your father, what did you learn from what your father experienced? And how vulnerable are you to, and mentally, blah, blah. You can see conversation is definitely, but the definition of success, in fact, whenever somebody brings to me a, I'm doing a lot of case consults with systems, and they'll say, they'll use a word like success…can we just pause there for a second?
Dr. Michael Unger: (49:20)
What?I have no idea what you mean. I don't know what that means. And they said, well, success, you know, like… But tell me, am I in an indigenous community in the far north? Am I in a, urban, very wealthy community and with private schools in Toronto? Where exactly am I and where, what is this word, Success? What is this word? Resilience. What is a protective mechanism? What is a relationship look like? And so I guess what I'm finding is my humility, if I have to say what thing I've learned from my studies of resilience, I work with a lot of very smart people all around the world. Dr. Linda Theron at University of Pretoria is one of the shining lights in this, Michelle Grossman at, deacon in Australia, a variety of others, all crowd. And they just keep showing me, that there are many different pathways to a successful life depending on your history of immigration and, your life history, your family's story, your proposition, these things accumulate, I guess.
Kieth Sutton, Psy.D: (50:31)
Yeah, definitely. Yeah. And I think that the piece that it makes me think about is that, you know, there's all these different ways that success, what might be success and all these different kind of paths, and like that kid you're talking about makes me think about motivational interviewing that rather than you having a particular idea of what is the right thing to do, and kind of just pushing on that, being able to give your opinion and collaborate at the same time of creating space for maybe that's not the right path. And how do we look at all of those together and kind of come together rather than you saying this is the right path. And then kind of making that your push in therapy to get him to do the thing that you believe is the most correct thing, rather than having a sense of respect for the client's own experience and being open-minded to that maybe there is this other path that you haven't necessarily considered. And working with that.
Dr. Michael Unger: (51:25)
I mean, we're doing studies now like, one of our studies I was on, we know a lot of children go through the child welfare system and end up homeless. But not just homeless, but houseless. There's a lot of different terminology there, but there's so much studies on the kids who fail out, who become, what are the predictors of homelessness. So we started a few years ago a study that where we asked a different question. We said, well, a lot of kids don't end up in that precariously housed situation. What other predictive factors that occur in what sequence? For what profile of child while they're still being served by the, you know, child welfare and community services. And as almost obvious as that question is, there is almost no research that answers that question.
Dr. Michael Unger: (52:13)
We tend to only look at homelessness after it occurs and not the predictors of stable housing for the kids in the protection.
Dr. Michael Unger: (52:21)
So we've been very much about looking at these protective mechanisms in these situations you know, looking at when they occur. . , I'll give you another small example. We have another interesting study with Ukrainians. You're seeing a lot of Ukrainian youth coming in as immigrants. In Canada, we have a special temporary visa in the United States. . , they have the same visa for, Haitians. So I don't know if it's applied to Ukrainians, but we have it in Canada. Same idea. They get a three year temporary visa to come, they can work and live, and then after three years they can sort of trigger permanent residency or something like that. But let me ask you a question. If a Ukrainian kid comes to Canad, and you're not here as a permanent refugee, but you're under a temporary visa,
Dr. Michael Unger: (53:06)
How does that change your mindset in terms of when you're on social media? Do you connect with your friends who are still back in Poland and Ukraine and elsewhere? Or do you make a bigger effort to learn the language, the local language, and actually integrate? So suddenly bilingualism is a protective factor, but only if you're in a permanent situation, you perceive that your future is here, your media accounts, your language engagement, your engagement at school, you're picking up a new sport. . , all of that stuff is gonna hinge on the visa. And we, well, wait, you think kids think of that? Well, we're doing the research to see what does a temporary visa do in terms of your sense of safety, permanency engagement.
Kieth Sutton, Psy.D: (53:49)
Well, how much are you really gonna kind of dig in or you know, kind of invest in your current community or whatever it might be? Or how much are you gonna keep invested in the other community that would, if you feel like you're gonna eventually be going back to.
Dr. Michael Unger: (54:03)
I'm always, I'm working with people with severe addictions issues, whatever. I'm always wondering not just what's causing that, but how would life work without. I mean, obviously these are the solution focused stuff that, years and decades ago, but you're always asking, so if you weren't using on Saturday night, where would you be?
Kieth Sutton, Psy.D: (54:19)
Yeah.
Dr. Michael Unger: (54:20)
Kids that I work with, that's often the, you know, when I've worked with kids coming out of detention and I say, okay, so Saturday night your entire extended family uses, your peer network uses, and we've just dried you out, and now you're gonna be released. And remember when you drink, you get violent and all this kind of other stuff, blah, blah, blah. So on Saturday night, what's your plan? I'm stunned that the youth workers and often the probation officers and everything, no one has actually come up with a plan for Saturday night
Kieth Sutton, Psy.D: (54:46)
And leave that part out in rather than just, again, kind of decreasing the symptoms, also looking at what's gonna replace it, what's gonna be kind of, that direction or that kind of potential future.
Dr. Michael Unger: (54:56)
And then from our work, it has to have enough cache. So you can't just simply say to the kid, sit in your basement and play game. You gotta say something like, don't you have an uncle who has a whole bunch of, side car, they used call ATVs, they're…
Kieth Sutton, Psy.D: (55:13)
Four wheelers or something like that
Dr. Michael Unger: (55:14)
Four wheels. Yeah. Doesn't your uncle do a lot of sort of outdoor stuff and head to the cabin and, go deer hunting in the fall and all this kinda stuff? A these are very rural examples, right? I'm not trying to say you talk to a kid in downtown Boston or San Francisco,
Kieth Sutton, Psy.D: (55:31)
Something that's a bit more robust, right? 'cause there's a relationship there. There's something more than just sitting by yourself playing video games.
Dr. Michael Unger: (55:37)
That, and unless you find that, my experience doesn't change.
Kieth Sutton, Psy.D: (55:40)
Yeah. Well, hey, Michael, this has been wonderful. I just think the work that you're doing is so great and really just expanding beyond just kind of symptom reduction, but also, right, these protective factors and how do we help kind of strengthen, like you're saying to help clients, kids, kind of being more resilient and making through, and also looking at how that looks for them within their cultural context, within the community that they live in. It sounds like you're doing amazing work. I really appreciate this. Thank you so much for taking the time today.
Dr. Michael Unger: (56:13)
Thank you for the questions. Wonderful opportunities to share. Yeah, great to reconnect.
Kieth Sutton, Psy.D: (56:18)
Great. You too. Take care. Bye-Bye. 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 https://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 https://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 https://sf-bacc.org and https://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 https://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):
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Today I'll be speaking with Dr. Michael Unger who is the founder and director of the Resilience Research Center at Dalhousie University, where he holds the Canada Research Chair in Child, family and Community Resilience.
Kieth Sutton, Psy.D: (02:33)
In 2022, Michael was ranked the number one social work scholar in the world, in recognition of his groundbreaking work as a family therapist and resilience researcher. That work has influenced the way human development and organizational processes are understood and studied globally. With much of Dr. Unger's clinical work and scholarship focus on the resilience of marginalized children and families, and adult populations experiencing mental health challenges at home and in the workplace. In addition to providing consultation to international NGOs like the Red Cross and Save the Children government agencies in more than a dozen low, middle, and high income countries, and educational institutions at all levels of studies. Dr. Unger's research has also influenced the HR and corporate social responsibility initiatives of Fortune 500 companies like Unilever, DHL and Cigna. Michael's work emphasizes how to use the theory of resilience to increase both individual and institutional agility during crises with numerous organizations having adopted his concept of a resilience as a negotiated process that enhances wellbeing and social responsibility. He's the author of over 250 peer reviewed articles and book chapters, and 17 books. His blog, nurturing Resilience can be read on Psychology Today's website. Let's listen to the interview.
Kieth Sutton, Psy.D.: (3:48)
Well, hi Michael. Welcome. Thanks for joining today.
Dr. Michael Unger: (03:51)
A real pleasure, Keith. It's great.
Kieth Sutton, Psy.D: (03:53)
Yeah. So I'm so excited to have you. We had met at a after conference some years ago, the American Family Therapy Academy, and got to talk about your work. Particularly, I'm so interested in the work that you do 'cause you do, writing, and work around resilience. And I think this is such an important topic and there's a book that you've written, particularly one of the areas, my focus is teenagers and adolescents, and there's a book called Too Safe For Their Own Good: How Risk and Responsibility Helps Teenagers Thrive and Change in the World, the Science of Re Resilience and True Path to Success. Sorry, did I just mix those two titles?
Dr. Michael Unger: (04:34)
No, those are two different titles. Yes. Yeah, Too Safe For Their Own Good.
Kieth Sutton, Psy.D: (04:40)
Lemme lemme redo that little part.
Dr. Michael Unger: (04:42)
Major World as a second.
Kieth Sutton, Psy.D: (04:44)
Sure. Yeah. Two, safe for their own Good. How risk and responsibility helps Teenagers thrive. Sorry, I'll, I'll edit that a little bit later. Okay. And just very interested in this topic and so I wanna hear all about this, but first I always like to kind of get a sense of, you know, how you got to doing what you're doing, the evolution of your thinking.
Dr. Michael Unger: (05:09)
Well, when I began to work, I was working in a lot of youth in juvenile corrections settings and sort of in child welfare settings, et cetera, et cetera. And you know, you begin to see a pattern if you go looking for it, in terms of unexpected outcomes. Better than expected, especially with teenagers. And I remember getting curious about not just the predictors of psychopathology, but also what was going to predict this pathway to wellbeing even coming out of very, very difficult situations of adversity. We were just beginning to, you know, understand ACEs and there was a whole sort of idea of this. I first latch onto the idea of empowerment, you might remember that. You know, that was the big buzzword at one point, and then there was this kind of movement. There was a group of scholars who were, I was doing my PhD and, there was a group of scholars like Michael Rudder and Maston Norman Gomez and, Ruth Smith, who were also of talking about this concept of resilience. And it, in a sense, empowerment was subsumed as one of the potential qualities. It was usually going by something like self efficacy, power and control experiences, and that type of thing. So I got, I got a little bit interested in this idea that maybe there is a whole group of people who are trying to predict not just the, if you know, the way I like to say this is, you know, if you look at the Ace Adverse Childhood Experience studies, they've been able to predict the negative outcome. They say, if you look at, Vince Val's work or whatever, and it says, you know, 50, 49% of people with this number of ACEs tend to predict that particularly negative outcome. But at the top of the bar graph, there's this massive sort of, you know, null hypothesis, which is that like something like 51% of people with ace scores over four. In those original studies don't develop some of the expected outcomes like depression.
Dr. Michael Unger: (07:01)
So you begin to say, okay, so what's going on here? What are those protective mechanisms operating and why don't we talk more about those? Because, you know, I think that so much of our attention goes to suppress the disorder. And I'm sure you've seen this with adolescent just because you've got them on a medication, the ADHD is treated, they are now better regulated in school, they're less explosive, they're less anxious, all of those are wonderful outcomes. They're not sustainable unless you also create a network of friends, ability, a sense of purpose and place, and connections to culture, and all these other things which we know create a sustainable, clinical outcome from some of those other things. In other words, they say, symptom free is not necessarily well.
Kieth Sutton, Psy.D: (08:06)
Yes, yes. Yeah. Sometimes I talk about with clients is trying to help 'em go from bad to good to great.
Dr. Michael Unger: (08:12)
Yes. Yes.
Kieth Sutton, Psy.D: (08:13)
And that's a second order change, right, kind of systemically too, right, that kind of, so that things have shifted so that they're more likely to continue to progress positively rather than just kind of a lack of symptoms.
Dr. Michael Unger: (08:27)
Absolutely. And I think what's probably distinguished my work over the years, Keith, has been that I got all the family therapy certifications, supervisory with MFT and all that, all those sort of stuff, right, I've got all that. But when I began to work more and more clinically with these ideas, I was, I'm now a researcher and a research scientist. I began to find that there was this, kind of gap in our understanding of what it is that makes it possible for us to help people find these other systems that are actually gonna support their wellbeing. And so as the last sort of, you know, I’ve been at this now for 20 plus years, and what I've seen is a steady emergence of a conversation moving the resilience field away from a purely psychodynamic or intrapsychic focus.
Dr. Michael Unger: (09:26)
Invulnerable child or the, this notion of individual psychological wellbeing, to now a much more multi-systemic understanding. I have to tell you a funny little story about this, because I was pushing this now for quite a few years. And, at one point I was very honored to have dinner with Sal Minuchin back a few years ago before he passed. And I remember us having this kind, he was familiar with some of my work. And he kind of shook his head. He said, you know, I don't know, Mike, how do you keep all these systems going? How do you concentrate on all these, you know, now you're talking about not just family systems, but economic and social and peer and community, and how do you, how do you work with all these systems?
Dr. Michael Unger: (10:18)
And he was like, oh, this just, it just seems daunting. And I answered back to him, I said, but Sal, you were the one that brought psychiatry from a single system individual focus into more the family focus…In a sense, I was just standing on his shoulders adding to the storyline. He had already sort of broken that barrier between the intrapsychic and the intrinsic and the extrinsic factors. So that's really been, I think, where the field's going now. You know, that gets pretty abstract as a definitely, you know, a certain, epistemological orientation to this work and all that kind of other stuff. But from a clinical point of view, of course it has, it really does have implications for the way we approach the work we actually do, especially with teenagers.
Kieth Sutton, Psy.D: (11:08)
Yeah. Tell me about that. How does that play out in your work with a teenager or a family?
Dr. Michael Unger: (11:16)
Well, let me, lemme give you an example. I was doing a, a consult recently with a large school board, And they were very, very troubled by this child who has just turned 10 years old, and for several years, he'd been in the same school, the elementary school, and had been badly dysregulated. Now, the backstory of the child is; father was in jail for many, many years. There was serious domestic violence in the home, mom had a severe addictions issue, and though child welfare was periodically involved, given there were some foster places, but mostly the boy had been maintained in his own home. In this chaotic environment, he had found, he had been consistently at one school and that school had adapted the curriculum and the educational assistance and had been able to get some of the social and emotional learning lessons into him.
Dr. Michael Unger: (12:08)
So he was, you know, learning to self-regulate a little bit when he flared up in terms of his impulsive disorders and all this kind of stuff. Very much, I'm sure, you know, anyone familiar with that profile of child would be able to imagine what's going on in the classroom. The thrown desk behavior. you know, we've seen that. When he was just turning 10, his mother and I say this very, I mean, I don't wanna sound insensitive in any way, but it was very expected that she would eventually overdose and pass. And so I was consulting because they were, now, trying to figure out what the case plan would be for the boy. Because neither parent was there now, and the whole issue of what are you gonna do?
Dr. Michael Unger: (12:52)
And, there was a few things that we talked about that I don't think they were, as I asked them questions, not just about the psychopathology and the grief and the negatives, but I also asked them about how's he functioning in the day-to-day, and what has he consistently done? And they talked about creating a very consistent environment in the classroom, and a continuity of care plans, et cetera, et cetera. And they actually said this was, and I wanna be very cautious about this because I mean, these are all these anomalies that you see inside these lived lives. But the boy was actually calmer almost. And I think when they sort of said that they hadn't realized that they'd actually been seeing that, because of course, I think what's happened is that the boys, this worst case fright of my mom would be dead on the couch when I come home after school was removed.
Dr. Michael Unger: (13:39)
And so you had, you had a sort of a child very vulnerable, but also looking for connections elsewhere and continuity. Along comes child welfare and they're gonna place him in a foster placement and they put him in a foster home or whatever. And, but the school, he continues to go to the same school. And I blurted it out at this large team meeting, I said, blurred it down and said, wow, that's amazing that the social workers thought to maintain attachment continuity, a holding environment, which was very adequate, a space that knew this kid, et cetera, et cetera. And the school shook their head. This was coming from the principal now. No, no, Mike, you don't understand. They placed him in a foster home halfway across the city. We pay for the Uber twice a day to bring this kid to our school.
Dr. Michael Unger: (14:27)
We pay out of our parent recreation funds, you know, those PTA. And I thought to myself, okay, so, if I can say it, but how could we, with all our knowledge of protective mechanisms and attachment disorders, and trauma, how could a system have placed them in a foster home and not provide it the Uber themselves? Thinking about the cost, I mean, you and I both know the cost benefit analysis this. I think that's crass, and I know I'm not trying to be, I'm not trying to be crass about this in any way, but, just if, the senior managers wanted only the argument on money, then this child will not likely escalate their behavior. And perhaps maybe just maybe have the protective mechanisms place. So the conversation now shifts from just a purely intrapsychic treatment plan, talking about, you know, housing, continuity of attachments, transportation systems, and I'm gonna argue that even if you're an office-based clinician and I do this work, you can still think about and ask questions around those particular dimensions of a person's life. So that we are talking about the social and physical ecologies that create the protective mechanisms. And it's not random. That I think with resilience, people just think, oh, it's random.
Kieth Sutton, Psy.D: (15:59)
Sure.
Dr. Michael Unger: (16:00)
But there are repeating patterns that we see in, especially in adolescence, for some of the factors that, you know, we, we could actually focus on.
Kieth Sutton, Psy.D: (16:08)
So you kind of went beyond just the intrapsychic to more of also looking at systemically and larger systems. And in this case, for example, this child, which when his mother passed away and he was alone, in some ways, he was out of that terror of worrying that she was gonna die. And, that's speculation of why maybe he felt more calm. But then the system really also stepped in to maintain those attachments, those relationships, the continuity to the peer group and so on. And all the, like learning that had gone on to help support this child by, you know, having him continue in the school despite the, the barriers of needing to, you know, be transported across the city or so on, and really stepping up. So not only might there be some intrapsychic kind of factors that are playing into potential resiliency and decrease of pathology, but also there's this kind of buffer by kind of helping, creating this context that also helps him to, withstand or overcome all the difficulties that are falling upon him.
Dr. Michael Unger: (17:18)
Absolutely. And I think what the study of resilience is now getting at, so I'm obviously a research scientist, a large part of my, 'cause I run studies all over the globe, and we look at populations of young people mostly, and looking at context specific, culturally specific variations and what those protective mechanisms are. . . But there are repeating trends in those, especially for teenagers. And for instance, if you're going to intervene, one of the very first questions I found very useful when I'm working, working with a teen is to talk about their routines. . , what are their rituals, their routines in their day, their week, their year, their month, and how are those supported? Because there is something, and I think the, the research is emerging on this a little bit, that if we wanna stimulate optimism or a positive future orientation, it doesn't come from just self affirmations in front of a mirror.
Dr. Michael Unger: (18:10)
It actually comes from the, living in a predictable environment that cues us that if I got through yesterday and I did, you know, X, Y, and Z and I repeat X, Y, and Z today, then I've set my cognitions, if you will, into that mode of saying, this is going to, I'm gonna get through the day. Yeah. So, so we begin to have this dance between things. So routines, right? I often look for in my young clients, so I'll often look for aspects of, consequences or accountability depending on how you want to put it. Not punishment. We're always looking at how can you scaffold an experience so a young person can fix their own mistakes. And this comes directly out of our studies. So we would literally go around the globe and find young people who are doing much better than expected in rural Thailand.
Dr. Michael Unger: (18:57)
With disabilities in India, children, who are living in townships in, South Africa. . , or for that matter here in Canada, whether it's an indigenous child or a child living in urban poverty. We would always be looking for like some of, what are some of these factors that might help us to understand what does a child need? This is, this is a really weird thing, Keith. 'cause I go all around the world, right? And that book, you know, Too Safe For Their Own Good came outta the fact that I would literally come back from like, you know, rural wherever. And I'd then be working with families here in Canada, and they'd be going, “oh, no, no, my daughter, my daughter has, oh, she can't go out after 6:00 PM” She, she didn't exercise any autonomy of decision making power.
Dr. Michael Unger: (19:41)
If there's a routine, I'm gonna impose it, you know? I'm the one whos gonna pack her soccer gear. There's no responsibilities, no accountability, no consequences. For her actions. So we were literally undermining the resilience based on what I'm seeing from the work I was doing, globally. But once you get, it's routines and consequences, and then you know, then there's a few others like obviously parent or caregiver child connections. And you know, I wanna negotiate that a little bit. 'cause I mean, as I've seen with, aboriginal peoples in Australia and, and having been the guest of their communities there and having it explained to me what, you know, who is the caregiver. And we are sometimes knotted into ourselves, and somehow it has to be that biological mother, the biological father has to do
Dr. Michael Unger: (20:30)
All that heavy lifting. And that is probably an anomaly globally, I would say it applies to 1 billion of the 8 billion of us on this planet. . . so I'm always sort of thinking about how could we get a caregiver functioning? How can we also create networks of other social relationships? So I'm very big on, even in a very anxious child . , that was a small task that they could kind take on at the school. They don't have to do a public talk or be front and center. The one I actually really love is, my son a few years back was a dj. It was kind of cool. But I really admired him that he would often ask, when he DJ'ed, high school dances and stuff, he'd often ask for these really anxious shyer kids to assist him and carry the big speakers and be, these kids would never feel comfortable being in the front.
Dr. Michael Unger: (21:24)
But by giving them a, a defined well-meaning and important, this . also echoes some of the work by Bruce Ellis and the States and University of Utah, this idea that we want kids to have these, not just in a positive experience, but one that brings with it another of the factors, it's a positive identity, decision making, control. . coming back to my theme of efficacy. So you're suddenly looking at these through those relationships, whether it's with a caregiver or with a wider social network of peers, but you're always trying to think of how to Velcro. I think we make a, you know, I always think that the categorical mistake of trying to instill resilience to single factor models, and the one I always, the one I drives me a little bit loopy is, the self-esteem workshops for girls .
Dr. Michael Unger: (22:15)
We have 45 minutes of lunch hour, we're gonna take a bunch of girls. We're gonna, empower them through a conversation and teach them...it's not gonna work. The outcome, those things are terrible unless it stimulates a social network. Plus it also gives those young women a sense of safety and purpose. . , if it doesn't build a social network, if it doesn't, kind of give them a routine to their day. Then that's the group that should be hosting the international Women's Day marches. And we should be using that intervention as a catalyst to get many more of these factors, including, by the way, one of the factors that we see globally, of course, is social justice. Is this idea that it is possible, there is the rare person who in the most deprived environment, rises above it.
Dr. Michael Unger: (23:09)
Those icons of, capacity. Always, I don't know what to do with that. I don't know what to do with Nelson Mandela. I admire, and I sit there and I watch. But how do you, how do you translate that into us ordinary folk? Because for every one of them, there's 10,000 that's succumb. My research is about why don't we just talk about the 9,999 and see what they're actually doing to cope. And that opens up a conversation which is much more contextually, the way I like to say, resilience is this pattern of navigation to the resources you need and negotiation. . and the negotiation for what you need to be given to you in culturally, relevant ways.
Kieth Sutton, Psy.D: (24:01)
Okay. So these kind of aspects that play in that are, these kind of factors that are related to resiliency, like the routines, the rituals, the consequence, the accountability, the kind of caregiver child connections, which are influenced by cultural and social, these are, are there kind of a number, like a list of aspects, or are there just too many to even list of these kind of major factors that play into resiliency? Because I think it's such an important subject. Even thinking back on my own growing up, what was it about the people that made it through difficult times and the people that didn't make it through difficult times? What was the difference? Because, you know, oftentimes, and like when I work with parents and they're kind of struggling with their child with substance abuse, and they're deciding should I intervene or not, it's like, we don't know right? Oftentimes It's a gamble. Your child may become an addict, your child may not have a problem, be able to moderate, they might become an addict and get clean and then kind of rise from there. We actually have a hard time predicting of what that's gonna look like. So how do we help guidance?
Dr. Michael Unger: (25:12)
And, and that's actually where I think where the science of resilience is moving. And in fact, if I might distinguish it from positive psychology, I use a lot of the literature, Martin Seligman. I mean, it's not like I'm absent from, in fact, I go to positive psychology conferences the whole bit. But, but there is a distinguishing difference. And that is the science of resilience is
Dr. Michael Unger: (25:46)
Yeah. So I will attend, lots of positive psychology conferences and admire the work. Absolutely. And I'm learning, but, the study of resilience is much more about matching the right protective factor to a particular risk profile.
Dr. Michael Unger: (26:01)
And and so when you're asking me, are there, you know, is there a, Anne Maassen often talks about a short list of factors. I would totally agree with that. That, if you have to do something, routines, accountability or consequences, parent or caregiver of child relationships, a network of other social relationships. If you look at, positive identity, power, and control, if you look at sensible longing, and that faith or spirituality as well, a sense of cohesion, all that type of stuff. Basically human rights that you're being respected. You know, if you go through some of those key factors, you do sort of end up with a core list, that's a great place to start. I read a lot about this on my blog and everywhere else, but, but then if you wanna be honest and a little more sophisticated, we have, a little while ago we did a search of, what are actually some of the most predominant resilience predictors that we have science on.
Dr. Michael Unger: (27:01)
And we were to identify 52 factors. With a relatively good science underneath them. Now, you know, we had to conflate some, and some maybe stood, like 52 isn't really the number. It could be 55, it could be 48. But there seems to be something there that we were able to distinguish. And then we developed a program called R2. And what what I kept getting asked about was, could you develop a curriculum whether I'm an employer looking to through my HR department or a human service organization working with inner city, folks who are really struggling with issues of violence and trauma or, the educational institutions. And this is interesting. What we do then is we take out the list of 52
Dr. Michael Unger: (27:50)
And we do a Delphi process in which we say, okay, which of these 52 factors are most relevant to this particular population that you have in your region? Now, we also have standardized versions of these that are free for downloading off off my website. They're all there. But sometimes people say, well, I want a more tailored approach. . . So for instance, like when we were working with inner city families in Memphis through a program there, what they identified as one of the key strategies for resilience was of course transportation systems. . housing, things like that. How do you work? If I'm a clinical therapist, how do I work with housing? . , how do I do that? But let me walk you through a series of questions that you can ask.
Dr. Michael Unger: (28:34)
You can ask, we'll say, I understand you're thinking about moving. Okay, where are you gonna move? I'm gonna move. Oh, we have an opportunity to get a little bit better apartment. It's out in the suburbs. So I say, well, there's some science on that that says, how long is your commute gonna be to your workplace if you do have a job? Or how long is it gonna be a commute to your friends and your social network, your extended family? You may be getting a better household, but at what consequence to the other resilience factors which are predictive of wellbeing. . . And I think sometimes we can have that. I mean, if a person wants to move. They move. I get that. Are they fully cognizant that they actually by, focusing on one system, in this case, housing .
Dr. Michael Unger: (29:17)
or one system of, I'm gonna leave that relationship, which is one as well. But do they understand the cascade effect on other co-occurring systems? . . And what I do think is a conversation that we can have. because there's embedded protective mechanisms. and often, I jokingly say, not with so much teenagers, but with adults, I'll say things like, if you're gonna divorce and change your job, my suggestion is do one or the other, but not both at the same time. . Because, you probably wanna change your job, get resettled and turf the partner. Right. You you don't wanna necessarily be that dysregulated
Kieth Sutton, Psy.D: (29:53)
And blow up everything at once.
Dr. Michael Unger: (29:55)
Yeah. You know, you want those protective mechanisms as long as it's, as long as obviously you're not in danger of violence. And I mean, obviously this
Dr. Michael Unger: (30:03)
Goes almost without saying here, but my point being is that even something like housing or transportation or location, there are cascades of either, there's trade-offs and there's either . virtuous cycles or negative cycles that occur as a consequence of your particular decision. And I think sometimes we, like the boy who needed the taxi, foster care. But it wasn't his risk factors went up dramatically on the location of the foster home. It was not a psychological intervention. Stabilizing him. It was a taxi. . intervention. Now I know we're clinicians. We're often office based. But we can advocate and also we can teach people to advocate for themselves. I can work with a teenager and say, what do you want?
Dr. Michael Unger: (31:01)
what kind of placement would you particularly like? And would it be useful to invite your social worker to a joint meeting so I can help advocate for your voice? I won't speak a lot. Rehearse it. We'll practice it. We'll write a letter. . , there's so many of the tools that we have that could, I almost think of it as like a child has a little voice knob right on their chest or their throat. I'm reaching across very gently and it's kind of turning their volume up. . and hopefully the volume down on all the professionals in the, in the case.
Kieth Sutton, Psy.D: (31:36)
I was gonna say too, that I worked in some teen shelters and residential treatment programs prior to graduate school. So that hands-on work is so important. And I think, some, some therapists don't do that work or they feel like, oh, that's elsewhere or so on. But sometimes working on helping your client find a job or helping them kind of coordinate with the school or so on, has such a major impact, rather than just talking about the depression, about not having a job or whatever it might be. And, you know, those factors, sometimes we might be working on the content of some of these things, but also we're working with the process. So it's still part of the therapy rather than something completely different or like, oh, that's social work, or whatever it might be. That, unfortunately some therapists kind of create a delineation between, what we do and what other people do.
Dr. Michael Unger: (32:30)
And, and I would say that the science of resilience, is about understanding the risk profile, and then finding the right set of protective factors, which will be the most responsive. So, I was recently doing more one-on-one clinical work with a 17-year-old who was, had an addictions issue . He was about to lose his grade 12, he was probably not gonna graduate and et cetera, et cetera. And a lot of our conversation was about simply helping him to find the protective factors which were available to him. He loved to weld. He was a good welder. . . And he found his identity wrapped up in that particular activity. And so a lot of our conversation, rather than just focusing on the fact that he didn't get outta bed that morning, it was much more around Wow.
Dr. Michael Unger: (33:23)
how did that affect your hope to be, to get your red seal papers . and be a professional welder, which would, you know, make you a great deal of money. Which is wanted, so he could own the kind of, he had this, mythic truck that he wanted to buy. Now I know this is very gendered and everything else, but it wasn't for me to judge. This is all what he wanted.So a conversation is about putting in place the structure, including whether or not he wanted his mother to wake him. He had a very serious relationship with a girlfriend. There was a sort of a set of very heteronormative practices and aspects to his life as well. .
Dr. Michael Unger: (33:59)
But all of them were potentially supports or catalysts that could be brought into the conversation. and I know you do a lot of family work as well, and at one point, I even had the girlfriend show up and just and just say, when you look at your fellow here, what do you see? What do you think he's good at? And creating that sustained narrative of another course. And in a sense, I'm not saying it was perfect. I mean, he continued to, use heavily, but he moderated a bit. .he continued to see that the consequences to his actions with regard to his educational pathway. And he also began to find alternatives. I mean, one of the things he did was he actually found a way to do a lot of welding for small bits of money.
Dr. Michael Unger: (34:46)
And I said, well, that's great. So now you're really showing an attachment to it. I mean, even if school doesn't work out right now, at least this will get you ready. So when you're 21 years old, you can enter, at least in the system I'm in, you can enter the college system without a high school leaving certificate, you don't actually need it. Once you're 21, you can go back. And I mean, why shouldn't I tell 'em that? And you know, I'm sure people would say, Oh, you don't tell him that because he’ll drop out. He was already dropping out. So let's give him a course, a plan. his identity, another protective wrapped up in this capacity. And the way he talked about what he could do and say, yeah, this, you know, they were building go-karts and they didn't know what they were doing. And so now there was other things I did as well. . , to be fair, his father had suicided when he was three . . And so the history, the family had a long, I mean, but if you notice, if you notice, I didn't start by telling you that.
Dr. Michael Unger: (35:43)
I started by talking about how could this boy maintain routine attachment, a positive, a powerful identity, relationships and everything else. And then I'm telling you, and yes, there was a lot of stuff around leftover from his father's suicide, And the impact that has and his mother and everything else. And the mother was obviously deathly worried about her son and mental health problems. . other things. But all of that was not the only focus. We did talk about his father. We talked about what his father would think about his welding interest. We talked about what his father would have wanted for him. We talked about what he knew about his father as a person, as a man when he was alive. And . , I had the mother come into some sessions and talk through some of the information that he didn't totally have, so that his father became much more re well-rounded In his life. so there was the terrible loss. . . But there was also a story of, there was something there. Other than that, in my dad's story In a sense, following Michael White's work, of course. I mean, obviously I'm repopulating I'm remembering. I'm bringing in other people's stories into that Intimate situation. But because I know in my studies of resilience that those patterns of relationship tend to be predictive of better mental health and better coping When under acute or chronic stress.
Kieth Sutton, Psy.D: (37:05)
Yeah. So you're kind of expanding that narrative, expanding that relationship that he had to his father, even though his father wasn't alive anymore.
Dr. Michael Unger: (37:14)
Exactly.
Kieth Sutton, Psy.D: (37:16)
And it sounds like too, that this kid had direction, he had a potential future, he had something that he felt good at or, interested in, or such so it sounds like that that existed while at the same time he was struggling with substances. And so that sometimes when, when somebody, for whatever the situation is, is not stopping their use or whatever it might be, that sometimes that competing kind of future, and then the substance getting in the way of the future, sometimes almost, leads to change rather than if the person has no sense of future or whatever might be going on. I actually worked with a college student who struggled with alcoholism. She wasn't gonna quit. She wasn't gonna change any of it. We worked on it. But the more she got connected to her future, the more she felt not good about what she was doing to herself. And eventually that created a crisis, which then led her into treatment. Because rather than just focusing on the symptoms, the symptoms and symptoms we're also looking at her life path. And that's what kind of created this cognitive dissonance between where I wanna go with my life and what I'm doing with my life currently.
Dr. Michael Unger: (38:30)
And, and if I might, Keith, that's brilliant. And if I might, if you can, Velcro multiple systems chain to that. So, you know, it's one thing to say, I believe in you and you're gonna make a great change, That's relatively narrow. But if you have some other witnesses to that change, or you create an opportunity, or you help find the funding, or you say
Dr. Michael Unger: (38:53)
Look, the more there's a catalyst effect of multiple factors, I like to think of them as, dominoes. I mean, we're often Maslow's hierarchy of needs.
Kieth Sutton, Psy.D: (39:05)
In this case too. This is actually what that crisis is what led her to then reach out and talk to her parents and actually admit that there's this problem going on. And they got her into treatment, and we had been working so long on trying to get her to engage her system, but she didn't want to, it was a secret and there was shame and so on. So yeah, that actually even led then to engaging the system and really kind of, creating that shift. So I think yeah, you're totally right with that aspect of kind of even beyond just the individual therapist that can we engage the other parts of their lives to help support that change?
Dr. Michael Unger: (39:40)
And it's interesting. A couple of things in terms of if people want to dig a bit deeper, I recently published an edited volume. It's pretty academic, so it's pretty heavy reading, but it's See 39 chapters of different people from different disciplines, from engineering to psychology, to epigenetics to computer science, quite a range. And I asked them to just talk about resilience from their perspective of their discipline, but also to link it to other, so, the person who did, computer infrastructure resilience also mentioned the need to think about urban planning and the psychology of the people using the computers. And if you wanna talk about architects, Terry Peter's paper in there about super architecture, how architecture can trigger elevated positive feelings. . , we can talk about epigenetics, of course, as a response to stress and all this kinda stuff.
Dr. Michael Unger: (40:30)
So that was, you know, that was sort of one emerging conversation that I do think we really need to think more and more about. You know, the desk I'm sitting at, the room I'm in, the social relationships, and the proximity I have or don't have to positive associations and the opportunities. I've seen the very best schools that I've seen work with teenagers are often those that are focused on multiple systems. So they're not just, you know, say we're gonna provide you with a therapist once a week, we're gonna send you up to the hospital. They're actually also adapting the child's, you know, is the bean bag chair at the back of a classroom. So they can better separate, there's a positive attitude towards them if they're two lgbtq+ sort of thing.
Dr. Michael Unger: (41:15)
There's all these aspects which signal a child, and there are, you know, positive affirmations of who they are and what they need.. So there's that conversation very much more and more looking at multiple systems. And even as a clinician, I am saying, we can engage, we can ask about do you have a quiet space at home, to regulate. Do you have the supports? Are there extended family members that you could reach out to on the weekends if home is too chaotic or dangerous? Is there a teacher or a classroom you could go that the bullies won't find you in the classroom? We can begin to think about triggering the cascade of positive protective factors in people's lives. And I'm not coming up with that randomly. These are actually based on examples out of our research.
Kieth Sutton, Psy.D: (42:06)
I was gonna imagine too that right, the role of learned helplessness plays in so much. And so as a therapist also helping the child, adolescent, the adult, be able to maybe see some of those resources that they might not be seeing because they're just feeling collapsed. And I know with the cognitive behavioral therapy research, also looking at the aspect for adolescents and with depression and the lack of problem solving abilities and so on. And sometimes having that help with a therapist, but again, not just intrapsychically, but also to be able to reach out and make those other connections or create that movement or that job. Or like you're saying, like finding ways to, engage with the environment that might be protective.
Dr. Michael Unger: (42:53)
Absolutely. But I will say this though. There is this, if I could characterize the field of resilience going from sort of more individually focused mechanisms to more social mechanism, then more social and ecological mechanisms and an evolving conversation about services and designs, and then into this more bigger multi-systemic thinking that is there. What I've actually been writing on lately, I recently just, a book will come out the next a few days called The Limits of Resilience. And the reason I did that was because I felt like the term is getting misconstrued to mean all kinds of things that we overlook. And the sort of a couple of examples that I would give is, at the community level, community that rebuilds . , they've been wiped out by a climate related emergency event like a hurricane. This keeps bashing the homes.
Dr. Michael Unger: (43:51)
I remember this, this mayor talking about the resilience of his community. 'cause they were rebuilding their massive homes right. Back where they were. And I wanted to say, look, this is a corruption of the idea of resilience. Mm. Resilience is an informed pattern of coping mechanisms. So that is not an informed, no. I realize there are some populations that don't have a, they cannot relocate. This was not the case. These were Mansions worth 1, 2, 3 million. And I realized that contrast with sometimes people feel a very strong sense of connection to place and everything. And that is a protective mechanism as well. Going back, what is your risk profile? What is the right outcome and what is the right protective factor? So sometimes relocating is actually the right resilience mechanism.
Dr. Michael Unger: (44:41)
Even if it compromises some of these other systems. And of course the other one, which I think for, I know you work a lot with adolescence and . , there is a concept of resilience, which is this idea of wear and tear allostatic load that when when we're exposed to constant bombardment of stressors, we might look, great, I think we all have those kids that they are just shining. They are, wow. I can't believe you're getting outta the bed in the morning and doing what you're doing. This is a a remarkable story. But what we also know is it's often those kids get to college . and then just implode. . . And a lot of it we're now understanding is the toll that takes at almost a genetic level. How that triggers a set of biological genetic processes when you're exposed to that level continue is stress. . . So you might adapt, temporarily, but its not necessarily a sustainable, so the real conversation about resilience then has to constantly be a dance between helping people navigate and negotiate for what they need, but never assuming the story is complete.
Dr. Michael Unger: (45:58)
I think there's a bit of a hands on, oh, they got to college, yay. Success. And they have a lousy relationship, they can't form this, they drop out, they lose, and that's probably 'cause I think we just didn't think about the other systems or the load on them over time, maintaining that level of functioning
Kieth Sutton, Psy.D: (46:20)
Well. And I think this is also the area to, of like the ideas of success and like, yeah, Seeing a kid being successful, getting the grades or something, even though they're going through all these things, doesn't necessarily mean that there's not other areas that they're struggling or other areas that they're needing support or so on. Because sometimes the focus is so much on these kind of particular, kind of tangible things like how many friends or grades or so on. but instead kind of really looking at a holistic picture about, does the, does the person have the ability to cope? Can they take risks and turn to others be vulnerable and, and all these kind of pieces to be able to get that support when they need it.
Dr. Michael Unger: (47:03)
That's absolutely the case that you really do need to think about which constellation of factors might be most, efficacious in that particular, for that particular outcome. And if I might, even outcomes become, certainly in our work, 'cause we work across so many different spaces and places around. I do find that that notion of what is a successful child is highly negotiated. And I think we forget that. So when when I see a book like by Amy Lunn Chuel, the, Yale law professor wrote, the Battle of the Tiger Mother or Tiger, something like that. And she's in a sense, extolling this hypervigilant parenting style. And so essentially equating that the only child that's successful is the one who's performing a cello concert or a violin concert on at Carnegie Hall.
Dr. Michael Unger: (47:54)
It just, sorry, I have to say this, it repulses me. It's so incredibly classist. And so the person who drove you to Carnegie Hall, that taxi driver. The person who mopped the floor or polished the piano, or sold the tickets or designed the poster. They're all dismissed as unsuccessful. . . And I just find the whole, this negotiation that I think sometimes we just don't open enough space for kids to come into our safe spaces as clinicians and say, tell me, so a kid who wants to weld, I wanted him to finish high school. I never held back from saying that. I said to him, finish school, you're gonna earn a lot more money, is with your papers if you get to college, it's no doubt.
Dr. Michael Unger: (48:41)
When he kind of showed some ambiguity about that, I said, well, let's brainstorm another path. You still like to be a welder, so let's figure out how to bring that identity, sustained identity. You're struggling with some drugs right now, but also, let's come up with a second, an alternative path. So you could choose. And then also, what do you think your father would've preferred you do? . . And what do you think your father, what did you learn from what your father experienced? And how vulnerable are you to, and mentally, blah, blah. You can see conversation is definitely, but the definition of success, in fact, whenever somebody brings to me a, I'm doing a lot of case consults with systems, and they'll say, they'll use a word like success…can we just pause there for a second?
Dr. Michael Unger: (49:20)
What?I have no idea what you mean. I don't know what that means. And they said, well, success, you know, like… But tell me, am I in an indigenous community in the far north? Am I in a, urban, very wealthy community and with private schools in Toronto? Where exactly am I and where, what is this word, Success? What is this word? Resilience. What is a protective mechanism? What is a relationship look like? And so I guess what I'm finding is my humility, if I have to say what thing I've learned from my studies of resilience, I work with a lot of very smart people all around the world. Dr. Linda Theron at University of Pretoria is one of the shining lights in this, Michelle Grossman at, deacon in Australia, a variety of others, all crowd. And they just keep showing me, that there are many different pathways to a successful life depending on your history of immigration and, your life history, your family's story, your proposition, these things accumulate, I guess.
Kieth Sutton, Psy.D: (50:31)
Yeah, definitely. Yeah. And I think that the piece that it makes me think about is that, you know, there's all these different ways that success, what might be success and all these different kind of paths, and like that kid you're talking about makes me think about motivational interviewing that rather than you having a particular idea of what is the right thing to do, and kind of just pushing on that, being able to give your opinion and collaborate at the same time of creating space for maybe that's not the right path. And how do we look at all of those together and kind of come together rather than you saying this is the right path. And then kind of making that your push in therapy to get him to do the thing that you believe is the most correct thing, rather than having a sense of respect for the client's own experience and being open-minded to that maybe there is this other path that you haven't necessarily considered. And working with that.
Dr. Michael Unger: (51:25)
I mean, we're doing studies now like, one of our studies I was on, we know a lot of children go through the child welfare system and end up homeless. But not just homeless, but houseless. There's a lot of different terminology there, but there's so much studies on the kids who fail out, who become, what are the predictors of homelessness. So we started a few years ago a study that where we asked a different question. We said, well, a lot of kids don't end up in that precariously housed situation. What other predictive factors that occur in what sequence? For what profile of child while they're still being served by the, you know, child welfare and community services. And as almost obvious as that question is, there is almost no research that answers that question.
Dr. Michael Unger: (52:13)
We tend to only look at homelessness after it occurs and not the predictors of stable housing for the kids in the protection.
Dr. Michael Unger: (52:21)
So we've been very much about looking at these protective mechanisms in these situations you know, looking at when they occur. . , I'll give you another small example. We have another interesting study with Ukrainians. You're seeing a lot of Ukrainian youth coming in as immigrants. In Canada, we have a special temporary visa in the United States. . , they have the same visa for, Haitians. So I don't know if it's applied to Ukrainians, but we have it in Canada. Same idea. They get a three year temporary visa to come, they can work and live, and then after three years they can sort of trigger permanent residency or something like that. But let me ask you a question. If a Ukrainian kid comes to Canad, and you're not here as a permanent refugee, but you're under a temporary visa,
Dr. Michael Unger: (53:06)
How does that change your mindset in terms of when you're on social media? Do you connect with your friends who are still back in Poland and Ukraine and elsewhere? Or do you make a bigger effort to learn the language, the local language, and actually integrate? So suddenly bilingualism is a protective factor, but only if you're in a permanent situation, you perceive that your future is here, your media accounts, your language engagement, your engagement at school, you're picking up a new sport. . , all of that stuff is gonna hinge on the visa. And we, well, wait, you think kids think of that? Well, we're doing the research to see what does a temporary visa do in terms of your sense of safety, permanency engagement.
Kieth Sutton, Psy.D: (53:49)
Well, how much are you really gonna kind of dig in or you know, kind of invest in your current community or whatever it might be? Or how much are you gonna keep invested in the other community that would, if you feel like you're gonna eventually be going back to.
Dr. Michael Unger: (54:03)
I'm always, I'm working with people with severe addictions issues, whatever. I'm always wondering not just what's causing that, but how would life work without. I mean, obviously these are the solution focused stuff that, years and decades ago, but you're always asking, so if you weren't using on Saturday night, where would you be?
Kieth Sutton, Psy.D: (54:19)
Yeah.
Dr. Michael Unger: (54:20)
Kids that I work with, that's often the, you know, when I've worked with kids coming out of detention and I say, okay, so Saturday night your entire extended family uses, your peer network uses, and we've just dried you out, and now you're gonna be released. And remember when you drink, you get violent and all this kind of other stuff, blah, blah, blah. So on Saturday night, what's your plan? I'm stunned that the youth workers and often the probation officers and everything, no one has actually come up with a plan for Saturday night
Kieth Sutton, Psy.D: (54:46)
And leave that part out in rather than just, again, kind of decreasing the symptoms, also looking at what's gonna replace it, what's gonna be kind of, that direction or that kind of potential future.
Dr. Michael Unger: (54:56)
And then from our work, it has to have enough cache. So you can't just simply say to the kid, sit in your basement and play game. You gotta say something like, don't you have an uncle who has a whole bunch of, side car, they used call ATVs, they're…
Kieth Sutton, Psy.D: (55:13)
Four wheelers or something like that
Dr. Michael Unger: (55:14)
Four wheels. Yeah. Doesn't your uncle do a lot of sort of outdoor stuff and head to the cabin and, go deer hunting in the fall and all this kinda stuff? A these are very rural examples, right? I'm not trying to say you talk to a kid in downtown Boston or San Francisco,
Kieth Sutton, Psy.D: (55:31)
Something that's a bit more robust, right? 'cause there's a relationship there. There's something more than just sitting by yourself playing video games.
Dr. Michael Unger: (55:37)
That, and unless you find that, my experience doesn't change.
Kieth Sutton, Psy.D: (55:40)
Yeah. Well, hey, Michael, this has been wonderful. I just think the work that you're doing is so great and really just expanding beyond just kind of symptom reduction, but also, right, these protective factors and how do we help kind of strengthen, like you're saying to help clients, kids, kind of being more resilient and making through, and also looking at how that looks for them within their cultural context, within the community that they live in. It sounds like you're doing amazing work. I really appreciate this. Thank you so much for taking the time today.
Dr. Michael Unger: (56:13)
Thank you for the questions. Wonderful opportunities to share. Yeah, great to reconnect.
Kieth Sutton, Psy.D: (56:18)
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