Rethinking Borderline Personality Disorder and Dialectical Behaviour Therapy

[00:00:00] Bronwyn: Hey, mental workers, you're listening to the Mental Work Podcast, your companion to early career psychology. I'm your host, Dr Bronwyn Milkins. And today we are talking about dialectical behavior therapy, which is originally for borderline personality.

We're going to talk about honest reflections with our, I was, in my mind, I had favorite guests, but I feel like Maybe that's like a Freudian slip

[00:00:31] Matthew: I'll take that!

[00:00:31] Bronwyn: Look I have many favorite guests, but one of them is Matthew, so we're here with Matthew Jackson. Hi, Matthew. Welcome back.

[00:00:40] Matthew: Don't me cuddling myself after that compliment.

[00:00:44] Bronwyn: Welcome back to the podcast. And Matthew is, is the perfect person really to talk about this topic. You're an intensively trained DBT therapist. Is that right?

[00:00:54] Matthew: Correct. I went through all of that, like, pain and training just to, uh, kind of work within the DBT framework. So I'm a perfect person for this.

[00:01:04] Bronwyn: Absolutely. And Matthew, could you just remind listeners who you are and what your non psychology passion is?

[00:01:10] Matthew: Yes. So I am Matthew. Um, I'm a registered psychologist. Uh, my out of psychology passions are things like drag, or, um, plants. I, I kind of mix or oscillate between the two.

[00:01:26] Bronwyn: Yeah, they're, they're, they're seemingly from different worlds.

[00:01:30] Matthew: Can you imagine though, if I like, turned up to a session or something, dressed in drag, but all of it was like made out of plant or something. That'd be kind of cool.

[00:01:38] Bronwyn: I think that would be a great concept.

[00:01:41] Matthew: Nature.

[00:01:42] Bronwyn: Yeah, I think you should do a photo shoot with that.

[00:01:45] Matthew: Oh my god, I would love that as like a kind of like a mindfulness for myself, I guess. I like that.

[00:01:51] Bronwyn: Yeah, that'd be so cool. And you could have leaves for hair and it could be cool and

[00:01:57] Matthew: Do you know what? Although I'm not an art therapist, I feel like I should like really get involved into this in an art therapy lens. This could really be good for me.

[00:02:05] Bronwyn: Look I'd support it. Like that's, that's another domain that you need to buy. Like, uh, dragarttherapist.com.

[00:02:13] Matthew: I forgot about the domains! I need to put that on my to do list and get to it straight away.

[00:02:19] Bronwyn: So, listeners, this episode, just to give you an overview, we're going to go through what DBT is, what BPD is, we're going to talk about some of Matthew's reflections and controversies about DBT, some misconceptions about DBT. When to use DBT and when not to, and just some advice for early career psychologists who are interested in DBT, and I think a bit more understanding of borderline personality as well. Right, Matthew?

[00:02:50] Matthew: Correct, yes.

[00:02:52] Bronwyn: Great. Let's start off with what is dialectical behavior therapy for someone who has never heard of it before?

[00:02:59] Matthew: I would describe DBT as an intensive treatment that is made up of individual therapy, Skills group work, there's the opportunity to access phone coaching as well to help with uh, skills practice uh, in the moment, generalizing that skills practice. Uh, and then it's also made up with a team that has like therapy for the therapist, which is probably one of my favorite components of it.

It is a therapy that was designed for suicidal and parasuicidal individuals and was then expanded to borderline individuals, by Marsha Linehan, somewhere in the 80s, I forget what year it was now. Um, and we are on the second edition of her treatment, and the treatment itself has so many different components to it. It's quite complex in that sense. There's components for the client, there's components for the therapist, and then there's like the relational components. So, it's quite intensive in that sense.

Uh, but in a kind of quick summary, it's a behavioral treatment that enables the therapist to help the client build a life that's worth living for them.

[00:04:18] Bronwyn: Yeah, that's, that's the key thing, right? It really is building a life worth living.

[00:04:23] Matthew: Yeah, that's the overarching goal in DBT. Whilst clients might have individual goals, therapists might even have goals for their clients, the overarching goal that we all agree on is that there is a life worth living and our aim is to build that for each person.

[00:04:39] Bronwyn: I'm interested to know, what was your personal motivation for getting trained intensively in DBT and what did that involve? What was, so how many hours of intensive training did you do and why? Why would you want to do this?

[00:04:51] Matthew: So, I was asked to do it because of the clinic that I was working at at the time. I ultimately chose to be trained in it because I quite liked how the therapy itself fit my personality. I found that I could be quite, compassionate. Um, and also theatrical. I found that I could use my humour to help people, or kind of use the relationship in a way, to help people get to where they need to be. And I also liked that it, um, it was behavioural and had a whole like, uh, basket or like trunk full of skills that I could lean back on, um, if I ever really needed for my clients.

So there was that kind of push for me to do it. Um, the intensive training itself, I mean, I've seen, um, little brief seminars and workshops here and there. I think that they capture a really good look into what DBT is. If you're wanting to get a kind of complete look into DBT, um, or to be formalized, formally trained, I you do have to be intensively trained through, uh, Behaviour Tech, who's like Marsha's company, or Marsha Linehan, the creator, it's her company. Um, and I did that, I think it was for a year and a half,

[00:06:15] Bronwyn: Wow.

[00:06:16] Matthew: A year and a half or two years, something along those lines.

[00:06:19] Bronwyn: Ooh.

[00:06:20] Matthew: It's a lot, it's weekly, so there's, kind of like uni, so there's lectures, readings... there is a team meeting every week, um, where all members of the DBT team meet together. We discuss clients and how you're going with the training.

And then at the end, there's kind of like an exam, if you will. It's not really that formalized, but it's kind of like that, just to test your knowledge. Um, and then you do a meeting, a team meeting with Marsha's peoples, and you have to present a client to them. Uh, I was unfortunately chosen as the person in the group to do that. It was nerve wracking.

[00:07:03] Bronwyn: Yeah.

[00:07:04] Matthew: Get critiqued, you have to provide a case formulation on a client, and by the way, the DBT case formulation is like 40 something pages long, so it's a lot of... it's a lot. Yeah, and then, um, uh, you are videotaped in this team meeting and it gets sent to teams around the world and they provide you with feedback on, you know, on your DBT ness.

So it's, when it says it's intensive, it's intensive. It's not, yeah, I don't say that lightly. It was a lot of work. Um, that did have a lot of payoff. I'm going to be honest. It, it did help me to understand not the separate components, but how, yeah, like how the, how the components form the whole, and then how I can help that or help use that with my clients.

So, I don't regret doing the intensive training, even though it was expensive and long, it was worth it in the long run.

[00:08:01] Bronwyn: Mm. I really like how it's like you're an intensively trained DBT therapist. I find that very validating of the intensiveness of it to put it in the title.

[00:08:09] Matthew: Yes, and I get to use that under my name as well, as like a title, so it's very like, ah...

[00:08:16] Bronwyn: yep.

[00:08:17] Matthew: ...thank you, well done, it's like a little kind of, yeah, self pat on the back.

[00:08:21] Bronwyn: No, well done. It does, it does sound very rigorous.

[00:08:24] Matthew: It is, and I think, from my knowledge on this, it's changed, I haven't looked at it in like three years, but I think I'm just one step above, kind of like, Marsha's People's level. Like you have to do a certain amount of recordings and then another exam, you have to do like a mindfulness retreat, there's a few other things.

Um, I'm just like one step, like just one more step and I'm kind of, yeah, at that, that final big level. Um, so it's, it's not for the faint of heart and at the same time I learned a lot not only about the therapy, but also in working with borderline individuals, I'm using little rabbit ears here.

[00:09:04] Bronwyn: Yes.

[00:09:05] Matthew: um, as well as actually I learned a lot about myself, like a lot, especially around mindfulness. So I, I don't regret it. It was like a mini psych course, if you will.

[00:09:15] Bronwyn: Wow. That's so interesting. Yeah. I'm really glad that we've got you on to talk about this then. And one thing that I realized that I needed to ask you was, could you tell listeners what the dialectical means in dialectical behavior therapy? Because I think this is something that people are like, what, what is that?

[00:09:33] Matthew: I love this question. Can I present it to you like I do with clients?

[00:09:37] Bronwyn: Yeah. Please do.

[00:09:38] Matthew: Okay, so pretend, pretend we're in a group room and there's like yourself and nine other people and I'm presenting to you, okay? In case you couldn't tell, I'm theatrical.

So, dialectics, or thinking dialectically, is kind of like a seesaw, or like a judge's weight, right? You have two opposing sides, and that's essentially what dialectics are. We're trying to observe the opposing sides, and in doing so, find a middle path between the two. So, for example, the opposing sides might be that I like tomatoes and you hate tomatoes. And we need to figure out, in order to like, keep our relationship, how can we find a happy medium to where we're not fighting about tomatoes, or I'm not trying to throw your tomatoes out after you've just paid 30 for them at shopping or something.

Um, I'm using a strange example, I think, but nonetheless, it fits. And again, so we're not only trying to find that middle, but we're also trying to acknowledge that halfway point in between, like, relationships. is not 50 50 either. Sometimes it's like, you know, 60 40 or 70 30 and we're just trying to find that balance between opposing forces, between black and white, right and wrong, good and bad. We're trying to find the, uh, medium between the two.

[00:11:02] Bronwyn: Um, so that we can maintain our relationships and overall have that life worth living.

[00:11:08] Matthew: Yeah, you got it, right? It's like we're, like, balance, flow, um, interpersonal effectiveness, motion regulation, life worth living... all of that comes from, um, finding the middle path in between dialectics or in between two opposing sides.

[00:11:26] Bronwyn: Yeah. Cause if I keep on insisting, if I like tomatoes and I keep on insisting that you should like tomatoes, we're probably not going to get very far.

[00:11:34] Matthew: Yeah, exactly. I don't know why I chose to do the tomato example, but I'm gonna let that go. Um, yeah, exactly, right? Like if you're trying to convince me that I'm wrong and tomatoes are amazing, I'm probably gonna feel over time like, oh, you don't get me or you don't want to hear me. Oh, I'm sick of this. And now I'm going to stop talking to you.

[00:11:54] Bronwyn: Yeah.

[00:11:55] Matthew: And so now we have a breakdown in relationship, or, or we can be dialectical, and I can accept that you like tomatoes, and that I don't like them, and maybe you can accept over time that you like them, I don't, and we can figure out when it comes to tomatoes, How we can have a friendship.

[00:12:13] Bronwyn: Yeah. I'm so glad I can still be friends with you even though you don't like tomatoes.

[00:12:18] Matthew: Yeah, I'm so, I'm sorry to break the news, but I'm not a tomato fan. So I'm also glad that we still get to have a relationship.

[00:12:25] Bronwyn: Yeah, I think that's a really nice way of explaining dialectics. Um, another way I've heard it explained is like that you can hold two things in mind at the same time. It's like, this can be true and this can be true. Could you just speak to that?

[00:12:42] Matthew: Yeah, so in DBT, we want to observe language like either or, that idea of like, I'm right or you're right, and instead make it an and. So it's like, I'm right and you're right. We're both right at the same time, we can hold two different opinions, two different ideas, two different emotions at the exact same time. Even within ourselves.

So, if I forget about our example for a minute, and I just think about myself, I can feel both happy and sad at the exact same time. It doesn't have to be just happy, or just sad, and neither is more valid than the other. They're both valid at the same time, they both make sense at the same time, so we also in dialectics want to observe that like, either or language, like that *but* language, and move into more *and* I am feeling both happy and sad.

[00:13:39] Bronwyn: I love that. And it's like, even in the relationship context, it's like, I could still feel angry or notice anger in response to somebody else and still try and understand their perspective.

[00:13:51] Matthew: Totally, right? I recently, um, had to explore myself, uh, within supervision with a client of like, I can still validate this person, I can still work with this person. and not like them,

[00:14:05] Bronwyn: Yes, lovely example.

[00:14:07] Matthew: Right? I can still validate the pain that this person's going through and empathize with them and not agree with the way that they're handling the situation.

[00:14:18] Bronwyn: So DBT has a lot to offer us. I, I am a fan of DBT. I have not been intensively trained. I would say I do a version of DBT that is DBT Lite Pro. Like plus, in that I really like the skills of DBT. And I think this is how a lot of private practitioners would take it. So we say the Marsha Lineham book, and we say the worksheets and the exercises, and then we look at those and we're like, I'm going to pick out one of these.

And I know that that's not the full DBT model. Does that annoy you that we do that? Okay. Sure. Just wanted to check.

[00:14:55] Matthew: I appreciate you checking and we could be dialectical with this.

[00:14:59] Bronwyn: Yeah.

[00:15:02] Matthew: Um, we, I, it doesn't bother me. I think that, there's things that like, uh, extenuating factors that come into that, right? Like the workplace, um, the client themselves, maybe they don't need a full like DBT intensive program. Maybe what they're needing is just the skills, or maybe, maybe you don't need it, or there's not the time limit for it.

So I, yeah, it doesn't like offend me or upset me. I kind of think like whatever works for you and the client, that's fine. That's all fine.

[00:15:29] Bronwyn: Oh, that's good to know. Cause literally I have done therapy with someone just using the stop skill and noticing and validating emotions. Just those two skills.

[00:15:38] Matthew: some of my favourites.

[00:15:42] Bronwyn: Yeah. So I'm really pleased to hear that. Thank you.

[00:15:44] Matthew: Yeah, of course! Sometimes I think that um, even like that skill around mindfulness of current emotions, which is essentially just observing and describing your emotions and creating space for them. Not that DBT came up with that, but nonetheless, um, I tend to think of that as like my go to skill.

[00:16:03] Bronwyn: Yeah. I love that one.

[00:16:04] Matthew: It's, it's like my go to in a session where someone's like, I'm feeling this and I don't want to feel it. Okay, well I'm going to ask them to observe where in the body they're feeling it, so that over time they can become more comfortable to it through exposure.

[00:16:19] Bronwyn: Yes. No, 100%. No. Yes. I think I use that skill with everyone. Yeah.

[00:16:27] Matthew: Of course, I guess the other side of that dialect too is if you were doing a comprehensive treatment program, then yes, we might have to have like the training involved, all four components or all four parts of the model. Like it might have to be a lot more intensive. So I guess it's like, yeah, again, depends on like your needs, the client's needs, organizational needs.

[00:16:52] Bronwyn: Thank you. Okay. So tell me about some of your reflections that you've had about DBT as a therapy.

[00:17:01] Matthew: So some of these reflections I think I've made from my own experience and some are made from just in consultation with colleagues, even people who aren't necessarily DBT trained. I think that, DBT is kind of a controversial treatment. I think it has a, or at least this is what's been said to me, it's got a view or an interpretation of it being a cult.

Um, and to be honest, I think it kind of is. I'm going to lean right into that. I think it is kind of a cult and I don't know, I think like really any therapy is kind of a cult. I think psychology is kind of a cult, really.

[00:17:44] Bronwyn: Well, what makes you say that?

[00:17:47] Matthew: I think it's the idea of like, to, to be in the like club, to be in the DBT club. You've got to be, you know, intensively trained and have all these hours met and all these requirements. And, you know, you've got to have, um, you know, borderline clients and Um, all these, you know, kind of war wounds and stuff like that.

Um, and so in that sense, yeah, it kind of does look like a cult. Like, there's that, like, um, indoctrination, I guess. And at the same time, Uh, I think psychology is kind of a cult. Like, it has rules to get into it. There's like certain things that we all sign off on, you know, and say yes, we'll abide by this, and if not, we'll be kicked out.

And there's certain ways of like thinking and behaving. So I think like, the profession itself is kind of like cult like, not just DBT. You could argue that things like schema and act are cult like.

[00:18:41] Bronwyn: Oh, totally.

[00:18:42] Matthew: Yeah, and so I think that like, any therapy itself is, is kind of like that. Um, I tend to think of any treatment, um, I guess in the sense of like, if it works, then it works.

So, if it's working for the client, do that, right? Like, if it's not harming the person, if it's not harming you, if it's not harming the profession or the public, etc, then do what works. So if it's DBT, do that. If it's not, then don't. And I definitely have been known, I'm revealing a secret, um, I definitely have been known to, um, be a little bit more eclectic.

I'm not strict DBT. Uh, there are certain people who I think I kind of need to be, that's what they're needing in the moment. And there are some people who I've been seeing for quite a period of time and they don't They don't necessarily need like stage one DBTs we refer to it, so they don't need like all the skills, they don't need the like hardcore intensive individual work, they're not needing this and that, they're needing a little bit more of that stage two which is like trauma processing.

It's more schema kind of work. So, um, I think it's also about going, yeah, like with the client and their needs and client centered as well.

Um, yeah.

[00:20:04] Bronwyn: so have you noticed, and I've noticed this with a few other therapies, which is why I ask, I think sometimes with particular therapies, therapists can get into this mindset where it's like, this therapy is the one true therapy to rule them all. And we shall use this one true therapy with all clients, far and wide. And I'm wondering if that's how it is in DBT land.

[00:20:34] Matthew: I'm laughing because I haven't heard of, I haven't seen or heard of that relationship between psychology and Lord of the Rings and I love it.

[00:20:42] Bronwyn: I just made that.

[00:20:45] Matthew: That really got me. That's amazing. I really love that. Um, I will compose myself. Uh, yeah, totally. I think there is that perception, right? And I think a lot of, um, DBT therapists, uh, and I've definitely done this in the past. I'll put my hand up, have perhaps lent on the therapy too much. And what I mean by that is they haven't perhaps observed or listened in the moment to what a client's actually needing. And they're just leaning on, well, this is the next step in therapy. Well, this is the next stage. This is part of the model. We just moved to that perhaps rather than, you know, kind of being flexible and like, okay, we can add this and we can add that in. There is this like dbt is like the savior and anything goes wrong. I'll fall back on it and I'll preach dbt or... I've even seen it like in meetings and stuff, um, actually it happened recently come to think of it, uh, where something was kind of brought to, to my attention and a few other people's attention. Oh, okay. Um, and I can't kind of disclose it just for confidentiality reasons, um, but something was brought to my attention and the response was like, well, that's DBT. I was like, ooh, that sits really uncomfortably, uncomfortably with me because that's kind of not right. And then I was like, oh wait, dialectic.

Um, and at the same time, uh, yeah, I think there is that kind of like, Saviour must worship DBT and Marsha, um, DBT is the one true ring to rule them all, um, all other therapies are like, you know, insubordinate or something compared to it, um, which I kind of hate. like that.

[00:22:33] Bronwyn: Yeah, I hate it too. And it's interesting how there is a bit of that in a lot of therapies. I'm thinking, so I'm trained in EMDR and schema therapy, and I do see some echoes of that in those therapeutic groups. So with EMDR, it's like if something, if the client is not responding, it's like we need to do EMDR harder or better rather than considering, I wonder if a different therapy or a different approach would be suitable for this client.

[00:22:59] Matthew: I really love that reflection. You prompted something, uh, like a reminder within myself. Part of DBT, one of the four components is like team consults, like therapy for the therapist. And one of the agreements that DBT therapists agree on is that like therapists are fallible. Like we all make mistakes. And that essentially clients can't fail therapy. The therapy fails.

[00:23:26] Bronwyn: Wow. Yes.

[00:23:27] Matthew: Right.

[00:23:27] Bronwyn: That's a good agreement.

[00:23:29] Matthew: Uh, thank you, because I agree on that one.

[00:23:32] Bronwyn: Yeah. Yeah.

[00:23:33] Matthew: right, in the sense of, if we take it from what you were talking about, like with EMTR, for example, of like, we're just gonna go harder, right, like, push, push, push, harder, go, go, go. In DBT, we say, hmm, the therapy's not working, right, it's not that the patient isn't trying hard enough.

I'm sorry, I work in a hospital setting, so patient just comes straight out of my mouth. Um, it's not that the person isn't trying hard enough, or that they're lazy, or that they're stupid, or, um, you know, we've gotta go harder. It's that the therapy's not working, what part of therapy is not working?

[00:24:10] Bronwyn: Yeah, no, I love that because it assumes that the person, they want to build a life worth living.

[00:24:17] Matthew: It's one of the assumptions. I can't remember how many there are in DBT. Don't ask me. Naughty, naughty.

[00:24:23] Bronwyn: That's right.

[00:24:24] Matthew: But it's one of the, again, this is the complexity part of DBT. There's so many different components. Therapists have agreements. We have our own assumptions such as we are fallible. We are going to make mistakes. Clients, also have assumptions such as people want to get better.

Like that's one of the assumptions we believe is that all people want to get better,

[00:24:47] Bronwyn: Yep.

[00:24:48] Matthew: Right? No matter if, um, they come to group 20 minutes late.

[00:24:53] Bronwyn: Yep.

[00:24:54] Matthew: um, and you know, you have that thought of like, oh, they're like, I don't want to be here. You know, No, the therapy's failing. The person's not failing, the therapy's failing that person, right?

And it's part of those, again, it's coming back to what you're saying, it's part of that assumption of like people want to get better, right? Sometimes, sure, people might need to like kind of try harder or think about how they might be able to apply a technique in different areas of their life, not just one area. And at the same time people don't just come to therapy for the fun of it.

[00:25:27] Bronwyn: No. Yeah.

[00:25:28] Matthew: Generally speaking, people generally, generally, people don't just come to therapy because they're like, I'm kind of bored on a Thursday afternoon. Why not do this? People want to get better.

[00:25:41] Bronwyn: They do. I really like that assumption. And I'll stay out of talking about borderline because I like the assumption because borderline folks, people are assigned to that diagnosis. Quite often they are assumed to be resistant or not trying or any of those, I guess, negative judgmental type words. Um, but let's stay on the DBT for now.

[00:26:03] Matthew: I want to get into that. I want to...

[00:26:08] Bronwyn: we will, we will.

Um, but just, I guess, finishing off that conversation... it's that there can be this, this cult like attitude towards these therapies, but as you've observed in your own clients, like a person centered approach seems to work very well.

[00:26:28] Matthew: Completely. And I guess DBT at its heart is a, is a behavioral treatment. And The behavioral components can be so helpful for people, regardless of diagnosis, by the way, like, um, I'm happy to, like, send research to anybody who needs it. I technically have to have it on my USB ready to go. Um, uh, it's a behavioral approach and it works on everything, everyone, anytime, anywhere, um, just like any other behavioral approach would.

And DBT also has other components to it. Like one of the Massive, one of the, like, largest components is actually got nothing to do with behavior. It's actually got to do with validation and acceptance.

[00:27:13] Bronwyn: Yes.

[00:27:15] Matthew: DBT I think also has that, um, judgment, it also has that perception perhaps, that like this is a really harsh treatment, it's not gentle, it's not compassionate towards people. Um, and I would totally disagree with that actually, because as a DBT therapist... yes, I am coming to the treatment room, I am coming to each person with a lens of change and, on my other eye, is a lens of validation, right, is a lens of acceptance of this person has been through a lot and I need to sit with that, I need to provide empathy to them, I want to do that with them, I don't want to just change everything.

So, there is that other perception that DBT is like really harsh and um, yeah, too behavioral and that's actually incorrect. Um, half of DBT is behavior and the other half is validation.

[00:28:12] Bronwyn: Yeah, I agree that that, that is the perception actually that I've heard of DBT and I think it's really important to couch it with the validation. So a DBT therapist, correct me if I'm wrong, I might be wrong, but they're not, they might hold in their mind that there is this dialectic that this person has been through, through an incredibly rough time in their life.

They have endured trauma that other people should not, nobody should have endured, yet here they are, and now we are learning the skills so that they can make their life worth living. But you're not going to sit down with a client and be like, I know it's been hard, but you need to make sure that you use the skill.

[00:28:52] Matthew: Oh my gosh, can you imagine saying that?

[00:28:56] Bronwyn: Ok good.

So you've got the dialectical in your head but you're not going to be an arsehole to your patients. Yes. Okay. Great.

[00:29:07] Matthew: Um, being an arsehole is like anti psychology.

[00:29:11] Bronwyn: Yes.

[00:29:11] Matthew: Right? It is the opposite of being a psychologist.

[00:29:15] Bronwyn: Yep. Great.

Good. Good.

[00:29:17] Matthew: Yeah. And, um, one of the things I love about DBT is that, um, when we think of validation, it's not just like, okay, go validate, right? In DBT, validation has six levels.

[00:29:29] Bronwyn: Oh crap. I did not know that.

[00:29:31] Matthew: Yeah. Like we've got six levels from level one, which is, um, like eye contact, eye contact, nodding, right? All the way to level six, which is known as equality.

[00:29:43] Bronwyn: Wow.

[00:29:44] Matthew: Um, how do I want to explain equality? Equality is essentially communicating to somebody that, oh, they're normal, right? They're not crazy or weird or, uh, messed up, right? Um, that they're not, oh, what's the word I hear often from clients? Um,

[00:30:00] Bronwyn: lost cause. Um,

[00:30:03] Matthew: right, lost cause. So that like, equality level is communicating to somebody that like, this isn't the end, you are normal, you have a place on this earth, I understand you because we are humans, you're not a lost cause, right. Like, what you experience is horrible and terrible. And I'm here, I'm in this with you.

So there's the six levels of validation, and then there's other components to validation too, like we validate only what's valid. Right, so, um, for example, what's valid is that like, um, if somebody was really mean to you and horrible and they, like, picked on you and bullied you, you know, feeling like scared and apprehensive, not wanting to, like, be around people, that's valid.

Right, and we validate that, not necessarily just in level 1, but we work our way up the levels so that the individuals are able to see that like, Oh, again, I'm not weird. What I experienced prompted me to respond this way. This is why I react like that. Oh, okay. I get it. Right. And then from there, then shifting your dialect towards change.

Right. So it's not just like, yeah, that must have really sucked. What do we do about it? Right. That's kind of a little bit asshole.

[00:31:28] Bronwyn: Yeah, no, I agree. No, thank you for clarifying the, the therapist's approach to, to people in DBT.

[00:31:36] Matthew: Yeah. There's that. Like, I guess like in summary, it's radical genuineness. Right, being really reciprocal with people, being down to earth and real, right, talking to people like they are, a person, and eventually moving towards change.

[00:31:52] Bronwyn: (Sequence 2 starts here) Yes. Mm. I love that. Yeah. It's so, it's really, it reminds me of the ACT approach and in ACT, um, it's fellow traveler and it sounds like that with DBT as well. So we're not above our patients, we're a fellow traveler in this thing called life. Yeah.

[00:32:10] Matthew: I had to have a conversation with one of my clients um, that I have actually no idea how to solve this problem for you. I was like, I have no clue because I haven't even asked, like, my inner wisdom, my wise mind, I haven't even asked them. I have no idea how to solve this. This is like, how do you solve that?

So yeah, like, removing that, like, mysticalness that, like, DBT has all the answers, it's the one ring.

[00:32:35] Bronwyn: Yeah.

[00:32:35] Matthew: Yeah. No.

[00:32:38] Bronwyn: No, wonderful.

And on the idea of rigidly applying DBT, I just wanted to point out that I do think, uh, and the research shows that a person centered approach where you use that radical genuineness and you go with what's working for the client and you assess what's working and what's not working, you try different approaches, works as good as any other therapy approach.

Um, but also if we rigidly apply DBT, sometimes it may be causing harm or just not getting good outcomes to clients. And the, and the thing that I'm thinking of with this is that, are you aware that there's a neurodivergent workbook for DBT?

[00:33:21] Matthew: Yeah.

[00:33:23] Bronwyn: Okay. And so, yeah, so I wanted to point that out because sometimes, um, if we rigidly apply, say the interpersonal skills to folks who are neurodivergent and we're like, okay, you need to make eye contact or you need to be speaking in this way. It may not be recognizing that person's uniqueness as a person and the ways that feel very comfortable for them, which we, maybe neurotypical should be adapting to, and that their mode of communication is fine. It's just not that they're facing barriers in a world built for neurotypical folk. So if we try as a DBT therapist to be like, no, you need to make eye contact, that may cause a lot of undue stress for that client.

[00:34:09] Matthew: Completely.

[00:34:10] Bronwyn: Yeah. Okay, cool.

[00:34:12] Matthew: There is, yes there's that workbook. There's also, um, like an adolescent workbook, which, um, and there's a, another separate, um, adult, more kind of neurotypical workbook as well, but it's just It's a worksheet, it's written in a very different way, and I

[00:34:30] Bronwyn: Is that the green one?

[00:34:32] Matthew: Yes, thank you! Can, the name has escaped me, I've got it on my USB. Um,

[00:34:37] Bronwyn: I just, I just know it as the green book.

[00:34:38] Matthew: The green one!

[00:34:39] Bronwyn: I'll link to it in the notes. I've got the chapters and it's got, because the first chapter is like, make your own distress tolerance, like And it goes through all the five senses and stuff. And I love that chapter.

[00:34:50] Matthew: Yes, so I personally approve of that book,

[00:34:53] Bronwyn: Oh, great.

[00:34:54] Matthew: Love it, yes, I use it with clients, I've used it on myself. I, um, like that particular book, because it's, it's the same sheets, it's just written in a different way, um, and in my own language, I feel like it's in layman's terms, and I really like that, um, and then, even again, there's different forms of DBT, so there's radically open DBT.

[00:35:15] Bronwyn: Yeah. I've heard of that.

[00:35:16] Matthew: Um, yeah, and that, um, was sort of designed for more overly controlled people, whereas traditional DBT's for under controlled people.

[00:35:24] Bronwyn: Oh.

[00:35:25] Matthew: Like, um, by people I mean personality types.

[00:35:28] Bronwyn: Yeah, gotcha.

[00:35:29] Matthew: and, uh, a lot of my, actually a lot of clients, um, I, I will kind of use more RO sheets sometimes, um, just because the, the way that it's worded or the activities, fit with their brain. And I, I think like as a psychologist, um, I'm not in the game to be like, you need to conform to me. As a queer person, that doesn't work for me either.

[00:35:56] Bronwyn: Yeah.

[00:35:58] Matthew: So for me, it's more like, okay, cool. This is the therapy that, um, I think would work the best for you. We agreed on it. Right. So if this particular sheet doesn't work for you, that's fine. I'll find another one. Like I'm going to find something that works for you, your brain, your lifestyle, because that's radical genuineness. That's That's equality. That's level six validation.

[00:36:19] Bronwyn: Nice. really good to hear. So maybe, maybe this is a broader lesson that sometimes people's perceptions of therapies. They might come from a perspective where they could learn, they could consider learning more about the therapy to see whether that's accurate or not.

[00:36:34] Matthew: I totally agree. And I actually really love the way you said that.

Um, I've said it in the work, one of the workplaces that I do work at, um, I've said it to students or, um, provisional psychologists, like, um, if you can ask our manager to sit in on the dbt groups, um, even if it's, you know, just kind of taking like notes and observations. Sit in and get a feel for it, if everybody agrees to it, including the clients, even sit in on like a one to one individual session and Get a feel of like, um, of what dbt looks like and the dance, the movement, the flow of dbt to understand like, is this for you? But also to challenge any perceptions.

[00:37:19] Bronwyn: Yeah, no, I think that would be really good because I have sat in, I used to work at a private hospital and I must admit, before I sat in on a group, I think I did have a negative perception about DBT and I was like, okay, today they're going to talk about wise mind. It's just going to be pros and cons, and there's a whiteboard and, and it's going to be just like very, you know, didactic.

Um, but it wasn't like that at all. It was really lovely actually and it was really heartfelt and it was really emotional and engaging. And yes, like the, the session I sat in on was the one that they were showing clients... I'm not quite sure what the skill is, maybe you can help me out, but it's where you get ice and it must be a crisis skill. And you show clients that you can put like ice on your face, like ice water, and it helps produce like, is it like a vasovagal, vagal response?

[00:38:12] Matthew: You got it. You got it.

[00:38:15] Bronwyn: Um, yeah, but it was, it was, um, it was using that, but then also talking about like, when we might use this skill brought up a lot of really good questions. And I think that's really good things from the group and it was really, there was a lot of validation. There was a lot of, so it was like using the skill as a spring pad to talk about things that were happening in the patient's lives and really foster those group dynamics.

[00:38:40] Matthew: You got it, right?

Like, honestly, one of my favorite, you totally correct on the skill. It's a tip skill if anybody's listening. Um, you explained incredibly well. Um, and, and also like it, um, The freezing cold water also activates like the human dive reflex. There's a whole thing on it.

[00:38:58] Bronwyn: That's so cool.

[00:38:59] Matthew: And it's really cool, actually. We could probably spend a whole session on, um, the stress tolerance skills.

Actually I have to teach them tomorrow to clients, so that would actually be very helpful for me too. uh, but the group space itself is probably one of my favorite components because yes, there is like a teaching skills, teaching component to it. And at the same time, it's up to the therapists themselves on how they want to teach it and so I like a more like fun jovial as I teach it let's practice it kind of way and in doing so people as you described really well people bring up like oh I just realized I could use that skill when this happens oh that would be so helpful and then like kind of fleshing that out with people and... and, um, I've seen other people kind of, you know, jumping in and saying like, oh, I've used that before and it worked really well. Or like, I didn't, it didn't work well. Oh, I'm wondering why, you know, like just being able to explore it on a process level, but also by creating that like community feel. It's so cool. It's fabulous, it's wonderful.

[00:40:11] Bronwyn: Yeah. No, awesome. Okay. Is it alright if we do the Is it okay if we do a topic change now into Borderline Personality Disorder?

[00:40:22] Matthew: Let's do it.

[00:40:23] Bronwyn: Okay, so I'm just going to say it then as a way of prompting this conversation. I don't use the words Borderline Personality Disorder in my own practice. How do you feel about that?

[00:40:39] Matthew: Yeah, I don't really either.

[00:40:41] Bronwyn: Yeah.

[00:40:42] Matthew: So, um, the way that I feel about that is, yep, yep, I'm on the same page with you.

[00:40:48] Bronwyn: Yeah. Okay. Okay. And how has training in DBT and just your own thoughts about Borderline Personality, how have they changed and how do you think of it now?

[00:40:59] Matthew: Yeah, so I think, um, there are some clients who I've observed definitely want that kind of diagnosis. It provides meaning, it provides an explanation to their experience. Um, and then in those cases I'm more than happy to use the term borderline.

Um, right, and if you look at like a lot of the research, we're still using that term borderline, you know, Marsha's original book, um, it's called CBT for BPD, I think it is, um, it's the like black and red one, um, you know, she refers to individual, like the borderline individual, um, it is still like language that we use, and if somebody wants to use it, I'm fine with it, I'm flexible, let's go for it.

In my head, however, clinically, I know it's in the DSM as a personality disorder, I see the nine symptoms, I'm constantly aware of the research, old and new, emerging. I don't know if I necessarily, in my own mind, conceptualize it as a personality disorder. For me, I use that terminology of like complex trauma or like complex PTSD, which might be controversial in its own right.

Uh, at the same time, it's kind of what it is, like when you flesh Borderline out and look at the history of sometimes one episode of trauma, but usually it's actually quite consistent. Um, uh, and the symptoms that come from it, like difficulty regulating emotions, right? Um, difficulty in interpersonal relationships, like keeping relationships but maintaining meaningful relationships, feeling empty, like, you know, risk.

These are sort of symptoms, if you will, that are also aligned with trauma, as well as a few other presentations too. so yeah, in my mind, if somebody wants me to use that term, happy to, Um, if I'm like, you know, really pushing for a diagnosis with a psychiatrist or something because I know it's going to help this person, sure, happy to write that as the word. And at the same time, I guess because I'm aware of the stigma that's associated with the term Borderline Personality Disorder, for me in my head I'm like, mmm, Complex Trauma.

[00:43:24] Bronwyn: I want to speak to that point about the stigma towards the words borderline personality disorder because it is documented. I've seen several research studies where they have presented health practitioners with vignettes and they'll present the same vignette but just change the diagnosis. So they'll be like this client has borderline personality disorder or depression and then they'll ask questions of the practitioner like how likely is it that you would administer care to this client if they were self harming? How much blame would you have towards the client if they express suicidal ideation., and there's significant differences between these two diagnoses that health practitioners can blame patients more for their self-harm their less likely to administer pain relief to patients with borderline personality disorder and they're more likely to dismiss complaints that the patients have that they're being treated, um, in a negative way or that they would prefer different treatment.

So it really is a term that is laden with a lot of stigma, which has practical negative outcomes in some cases, not all cases, but some cases for patients.

[00:44:37] Matthew: Completely agree with that, right, even even just from like, um, a practical working with people. Um, working with consulting, you know, colleagues, there is that perception of like, oh, they're borderline, right?

Or like, um, oh, they're just being dramatic. So if I think about what you're speaking to in regards to like less likely to provide medications, et cetera, et cetera, or pain relief, there's that, oh, they're just being dramatic, but like, it's not, it's not real, it's not serious. They're, they're overdramatizing it, um, that, that. That's just reinforcing the stigma, right? Like, if we look at borderline, again I'm using these like little rabbit quotations.

[00:45:15] Bronwyn: Yeah.

[00:45:16] Matthew: Um, if we look at borderline, if we look at an individual who grew up in a household whose needs were not met, who were perhaps taught or even actually told... I have a lot of clients who, um, can actually recount when, They were told that, like, what they feel is incorrect and not to say anything, right?

So let's, let's imagine we're growing up in that environment, we're told that what we feel doesn't matter, it's incorrect, it's wrong, it's abnormal, you're shameful/ Uh, seen not spoke, what's that saying, be seen not heard, you know, those types of things. You're going to grow up then throughout the rest of your childhood, adolescence and adulthood, you're going to want to ask yourself, well how do I get my needs met? I mean, this is like basic schema work now, you know, like, how do I get my needs met? Maybe maybe I actually do need to shout.

[00:46:08] Bronwyn: Yes.

[00:46:09] Matthew: Maybe the only time when my caregivers or anybody in my life listened to me was when I shouted, or I cried, or I threw myself on the floor, or I threatened injury to myself. Maybe that's what I need to do then, in this setting, to get what I need. And I think it's incredibly harmful for psychologists, really anybody in health actually, but we're talking about psychologists here. Um, I think it's really harmful for psychologists to have that frame of mind that reinforces the stigma of, oh she's being dramatic, or he, they, whoever, they're being dramatic, oh god they're so annoying, just ask what you want, what do you mean?

They were never told, they were not allowed to do that as children, so what? You're expecting something that they can't do, and it reinforces the stigma, and ugh, I could keep going on.

[00:47:01] Bronwyn: Oh and no. And just to add to that as well, from an attachment perspective, a lot of folks who have been diagnosed with borderline personality, the people who were supposed to be safe in their lives were the people who were dangerous or did not provide care and were unsafe. And so some things I've seen or heard have been like health professionals might say, but I offered them help and they declined or they said go away. That makes perfect sense from an attachment perspective that you can't trust the person who was supposed to be safe.

So you're going to have this want for help, but when you might be offered help, it's going to be scary. You're not sure you can trust it. So you might decline that help. And then you might go back and be like, I want help. And so when I look at it from that perspective, I'm like, that's not a personality disorder. That's a understandable way of coping with an incredibly difficult situation.

[00:47:55] Matthew: I, to speak to that further, to extend on what you're saying, that's DBT terminology now, um, to extend on that, I'm thinking about, like, a client who, um, very poor relationships with males or male presenting individuals due to trauma. And when I would. Attempt to provide them with care, I'd be met with a lot of anger lot.

And at first I thought, I'm really scared. What am I doing wrong? And then after seeking some consultation, after seeking supervision, uh, and looking at it from like an attachment perspective, from a trauma perspective, having that like trauma informed lens, um, I was able to really kind of quickly, uh, figure out, oh yeah, that's right. This person has trauma with males. They're threatened by me potentially. Oh yeah, that makes sense, doesn't it? It's, it's not, it's not their fault. It's how their brain survived. That's right. Cool.

You know, so I, I'm on the same page with you. I agree with you that like, sure, we can come at it from the lens of like, you know, a borderline is a personality disorder. Um, personality is wavering. It changes over time. We know that, um, in the research and at the same time... we can think of it from that lens, or we have the opportunity to think of it from a lens of like, well, this person grew up in this way or had these experiences. This is their attachment, as you were saying really well, um, their attachment style, sorry. Um, so that's actually helping me to understand these symptoms a lot better than, well, they're just dramatic. They just want attention.

[00:49:44] Bronwyn: Yeah. It's such. Yeah. I just prefer not to think of my clients as like defective or drama queens or anything like that. Like it's just, uh, just such a unhelpful, not nice language to say the least.

[00:49:58] Matthew: Imagine if there was a swap of roles. And we were, we were the client. We were the borderline.

[00:50:04] Bronwyn: Yeah.

[00:50:05] Matthew: Again with the quotations,

[00:50:06] Bronwyn: Yeah.

[00:50:07] Matthew: but like, I should, I just have to do that, um, and then imagine if we heard therapists speaking about us like that, that we, yeah, right. That we're

[00:50:19] Bronwyn: I would feel so hurt.

[00:50:20] Matthew: Right?

[00:50:20] Bronwyn: Yeah. Yeah.

[00:50:22] Matthew: Because we're normal, we're humans, we have emotions, we've had shitty upbringings. Like, doesn't it make sense?

[00:50:30] Bronwyn: Yeah.

[00:50:31] Matthew: what, I've been to seminars that aren't even DBT related, right? I've been to seminars with psychologists and you know, there's that like icebreaker period getting to know people, um, and I tell people that I work like within DBT, I work with this type of population, blah blah blah, um, and I usually get the like, oh, how do you do it? That's usually the response I get.

And I've come over time, I've come to the conclusion that I actually kind of need to feel sorry for these therapists, Like I, I, I kind of can't get angry at them, they're not able to be... they're not able to hold the same lens that you and I are able to hold, and others who are listening. There really is this judgment of like, ew, it's me versus them. Right? There's something wrong with them. Ew! Like if you're a borderline... quotations again... um, if you're a borderline, like there's something wrong with you. And you know, again, you're just doing it for attention. Like help yourself. Get over it. You know, I feel really sorry for people who view a human being as like what it says in a book.

[00:51:36] Bronwyn: Uh, yeah, me too.

[00:51:37] Matthew: you know, on like, I don't know how many pages, you know, BPD fits over, let's say 4 or 5, like, viewing a person, like deducing them to like 4 to 5 pages, that's really sad to me that you don't get to, right, that you don't get to, like you're robbing yourself of an opportunity to work with and deal with be involved in... be in the life of somebody who can actually really impact you and change your world in amazing, beautiful ways and you get to help them heal. You get to help them heal their inner child and I don't necessarily do DBT here but nonetheless.

[00:52:13] Bronwyn: Yeah.

[00:52:14] Matthew: You get to help them, and instead it's like yeah but these four to five pages tell me that they're like um, you know, defective or something...

[00:52:23] Bronwyn: Yeah. No. And just to speak to that, um, the reward of working with people who have this diagnosis or these set of difficulties and background, it can be a long term relationship. I've worked with many of these, um, people who have these difficulties and it can be challenging, but I find it quite easy, actually, to maintain empathy for my clients when I view it from this lens and I try and connect with their vulnerable child who has been invalidated, who has been ignored, rejected and being able to hold them in mind.

And I think it's worth pointing out as well that... I can't remember the exact research, but I think it is that a substantial proportion of folks who are diagnosed with BPD lose their diagnosis within five years when they receive the right support.

Um, And I tell clients this because I'm like, it's not hopeless. You, you can't, these can be changed and we can help heal.

[00:53:28] Matthew: I would love to extend on that as somebody who has been intensively trained for, it's going on five years, I'm nearly at the five year point. I have some of those clients who I've been seeing now for five years and they don't meet criteria for BPD.

[00:53:45] Bronwyn: Amazing.

[00:53:46] Matthew: Do not meet criteria and that I think speaks to like, I think that speaks as an anti to the judgement of like, well, this is why it's a personality disorder and you'll be affected for the rest of your life. Like, I'm sorry, but there's research proof, I have literal proof in a number of clients, like I don't know how people, you know, um, but also, and I, I don't know if this helps, um, listeners, uh, of course keeping you in the guidelines of confidentiality, um, I've worked with clients over the five years now who now allows themselves to feel love, is in a relationship.

I've had clients who were on the brink of ending their lives. I've had clients who were actually in the ICU once or twice. Um, they now are in relationships, have children, have careers, have no attempts. I, um, have worked with people who, um, unfortunately have, um, been arrested, um, because of their work within DBT, have not had any involvement with, like, police or law, anything like that in the last, like, three to four years. Like, there is a lot of joy. That you will get out of working with, uh, individuals who have a diagnosis of borderline or complex trauma, whatever, right? There's a lot.

I am known, it's kind of a little joke at my workplace, um, I'm known to cry, um, in groups or in one to ones when somebody has a moment of healing or, I've seen people, um, pat themselves on the back, like literally. Right? Like, these, these are not individuals who are like, there's no hope for them. They're a lost cause. I've heard that too. That irritates me. I'm getting angry actually. Um, um, These are individuals who are not that.

These are humans like me, you, Bron, and every listener. We are human beings and these individuals who meet criteria whatever deserve the exact same amount of respect and care that we do. Okay, I need to stop. I'm actually getting angry.

[00:56:08] Bronwyn: Amen.

[00:56:09] Matthew: [Laughter]

[00:56:10] Bronwyn: What would you say then, Matthew, to a listener who, um, cause I did, I felt scared cause I'd heard the stigma. What would you say to a listener who feels scared about seeing clients who have the diagnosis of borderline personality disorder?

[00:56:28] Matthew: I would say that it's okay to be scared. I too was scared. There is sometimes, I've been doing this for 5 years now, and there's some cases that I, I work with, and I think ooooh, ooooh, okay, this person's pushing me, ooooh, I don't know, I don't know if I'm actually any good right now, like, a lot of that fear will come up naturally in any treatment, working with any presentation, and that that's okay.

I would say from that, to observe that fear and seek consultation or supervision with a therapist who's trained in DBT, right, because they're the individuals to lean on. They're the ones who like, they get it, they've done the hard yards or whatever the hell that even means. Like, they have the experience, they've got the knowledge, they're the people who you can, like if I think about my DBT support network, I fall back on them like, there's no tomorrow. I even did last week, had like a full cry moment, where I was like, I'm not helping this person, and rah, rah, rah, um, uh, and there was that fear, and it was like, I need to fall back on my team.

So if you're feeling scared, that's normal, it's okay, find your DVT support network. We, there's heaps of us in Australia, you will find us.

[00:57:45] Bronwyn: Awesome. Would they just like post on the Facebook like, I'm looking for a DBT supervisor or would they like call a hospital?

[00:57:54] Matthew: So, I would say, do you know what? That's got me thinking. Is there actually a forum for a DBT support network? Maybe that's something I need to get involved in.

[00:58:05] Bronwyn: I don't think there is...

[00:58:07] Matthew: I don't think there is.

[00:58:07] Bronwyn: ...one Australia. if anybody is listening and they run it, let me know, um, um, but come across it.

[00:58:16] Matthew: No, there is for people who are intensively trained, like I'm part of national forum and we can kind of link each other, um, but not necessarily, um, for people who are not intensively trained.

Um, maybe that's something to start actually, um, I would definitely say looking at forums. You're more than welcome to ask me, DBT therapists in Victoria, some in, um, Queensland and Sydney as well. Um, I just noticed I gave you a state and a city there, how interesting. [Laughter] Um, that I could perhaps recommend.

Um, otherwise I'm personally halfway through my supervisor training. So at some point time, we'll become a supervisor myself and would be more than happy to provide supervision or consultation to, um, to any type of psych who wants to work within the DBT framework.

[00:59:07] Bronwyn: Wonderful.

Matthew, is there anything that we haven't touched upon in this discussion about DBT or borderline personality disorder that you wanted to leave listeners with?

[00:59:20] Matthew: Look, I think we've covered it. I would say, DBT is cool. Please give us a go. I would also say that individuals who meet criteria for Borderline or Complex Trauma, Complex PTSD, are humans. That's what I would say.

[00:59:38] Bronwyn: Yeah. I think that's a wonderful thing to remember. And yeah, listeners, I really like DBT as well. I use it all the time. If I do EMDR, I'll also be using DBT skills. And I just use that as I need as well. I use it really frequently when I'm talking with people about assertiveness.

And I use the stop skill like all the time. So like stop is stop, take a step back, observe how you're feeling, your surroundings. And I say proceed with the values based action, but I don't think that's the actual thing. I think I've changed it and modified it over time. Sorry, DBT. Yeah, I think I was like, I don't like this P.

[01:00:23] Matthew: I love that. That's gold. I like that.

[01:00:25] Bronwyn: Sorry, everyone.

[01:00:26] Matthew: No, it's awesome. I mean, it's essentially like what, like, P traditionally stands for proceed mindfully.

[01:00:32] Bronwyn: Oh, okay. Gotcha.

[01:00:33] Matthew: And if like the mindful thing, um, that doesn't just mean like with present awareness, mindfulness can also be like valued actions, right? yeah, totally. So it can totally incorporate your values. So yeah.

[01:00:47] Bronwyn: Thank you. Awesome.

Well, listeners, thank you so much for listening. It's been a pleasure to have you on, Matthew, as well. I'm so glad that we could talk about this topic. I think it'll be really valuable for early career psychologists and just something that I think we've all faced people talking about borderline personality or DBT, and this can really bust some myths and misconceptions around it. So thank you.

[01:01:10] Matthew: Thank you for having me. I hope that everybody enjoys this particular podcast and um, has heaps of questions to the point where we need to do a part two.

[01:01:19] Bronwyn: Yes, I hope so too.

Listeners, if you do have any questions, feel free to DM me on the socials. So I'm on Instagram and Facebook. You can also email me at mentalworkpodcast@gmail.com. And if you know someone who would love this episode, please let them know, share it and tell them via word of mouth. It's the best way to get the podcast into new ears.

And I hope you have a good one and I'll catch you next time. Bye.