Episode 43

July 21, 2023


#43 | Dr. Avigail Lev | Cultivating Meaningful Relationships

Hosted by

Tony Siebers Bina Colman
#43 | Dr. Avigail Lev | Cultivating Meaningful Relationships
Parent Projects - Aging In America
#43 | Dr. Avigail Lev | Cultivating Meaningful Relationships

Jul 21 2023 | 00:58:57


Show Notes



Today, our Guest is Dr. Avigail Lev, a licensed clinical psychologist based in San Francisco, California. Her areas of specialty include ACT & Schema Therapy, Couples Therapy, and Personality Disorders, and has already co-authored 3 books on those subjects. Her goal as a therapist is to provide her patients with the tools to choose the actions and behaviors that express their deepest values. “In the face of distress or other challenges, living from your values will enable you to lead a meaningful life and to be the person you want to be.

Schema Questionnaire: https://bayareacbtcenter.com/relationship-schema-quiz/

CBT Quizzes: https://cbtonline.com/quizzes


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00:00 – Intro

01:22 – Welcome to the Show

02:51 – Introduction to Dr. Abby Lev

04:15 – Abby’s Call to Action

06:29 – Schemas

08:44 – ACT Treatment Acceptance and Commitment Therapy

12:17 – ACT in a Parent Project

15:17 – ComForCare Ad

16:18 – Schema Common for Caregivers

21:28 – Obligations

25:10 – Understanding Each Person’s Autonomy

29:53 – Social Need vs Obligation

31:40 – Sibling Consideration

35:37 – What Can We Do?

42:36 – Pros and Cons of Understanding our Schema

48:33 – Parent Projects Connect Ad

49:03 – Recap

52:17 – What Do I Need from this Experience

57:28 – Final Thoughts

58:48 – Outro



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Episode Transcript

Speaker 0 00:00:00 But I'm gonna say something controversial here, is that we actually don't have a responsibility to take care of our parents. We, as parents, always have a responsibility to take care of our children because we've decided to bring them into this world. But in reality, we don't have a responsibility or an obligation to take care of our parents. Speaker 2 00:00:25 As our parents grow older, it can be difficult to guide them through their golden years, while still respecting their autonomy and fitting it into our already complex lives. Welcome to the Parent Projects podcast, where our guest chair, practical wisdom to tackle the issues that impact adult children of aging parents. I'm Tony Seas. Thanks for joining us today. Speaker 3 00:00:49 You know, if you've ever been on an airplane for the captain, come over the top and those, those instructions a thousand times. It says, if you're traveling with another one, uh, with a, usually a little one, uh, and the oxygen mask deploy, you wanna put on your own oxygen mask first and then help that other loved one, and that self-care, and that thinking is something that's absolutely counter to our instinct. But once the, the captain hears it, we're like, oh, yeah, that makes a lot of sense. Today we're gonna break down with Dr. Abby Lev, uh, who is a licensed clinical psychologist or psychotherapist, and she's, she's an author, she's a mediator, international speaker. We're gonna break down self-care. We're gonna get a great understanding and how we can keep ourself out of, uh, guilt and fear driving the actions that are doing, understanding and acceptance of those things. Speaker 3 00:01:40 And we've got some practical tips in how to move forward today on the Parent Projects podcast, which starts right now. Hey, welcome. In this week, uh, you know, one of the, the top things that we hear is the difficulties when you're going through a parent project is those difficulties and breaking free of the guilt and the fear that's related, uh, to the transaction or, or to the, to the project here and today, Dr. Abby Lab, Abby Lab's gonna work with us to understand why that is. Why do we do that? Why, why is that something we fall into? What are practical things that we can do to combat that? Dr. Lev, thanks so much for joining us here on the Parent Projects podcast today. Speaker 0 00:02:22 Hi, Tony. I'm happy to be here. Speaker 3 00:02:25 So, you know, we're, I'm gonna, I, I don't really want to, I wanna dive into this. One of the, um, well, you've got, obviously you've got books that you've written against, uh, dealing with acceptance and commitment therapy, or act as, as one of these core things that help us break through those, the schemas that lead us to get stuck in guilt and fear and, and other things. And I think we're gonna, I, I'm really looking forward to unpacking that today. Practically, what does that look like? What does it mean at a high level? Can you give us, can you give us a background of kinda you, and, and how did you come into understanding this acceptance and commitment therapy and what the application is with how we handle tough problems? Speaker 0 00:03:09 Yeah. I think from a very young age, I was very curious about human behavior, what drives people, what brings people joy, what makes people happy? How do we live a fulfilling life? We only live once, and how do we make this a meaningful, fulfilling, purposeful experience? And so I've always been very curious about that. And act is a type of treatment that honors the fact that we all have pain and suffering, and that we have certain conditioning and programming, uh, set by our parents and the larger society that we have to kind of break through to get to our authentic selves and our true values. Speaker 3 00:03:57 And, and in breaking through that is a, that's an understanding of, of self just of, of, of self and where your place is, right? It's a, it's a heightened level of a maybe just awareness for your own sake of walking into a situation, but then also that beyond maybe mindfulness, maybe how you might be able to help others because you understand where you are at. And so you can do that in a safer position. Am I, am I grasping all that? Speaker 0 00:04:24 Yeah. I think that we all have developed core beliefs. We've developed stories and narratives about ourselves through our early childhood experiences with our parents, and in the larger society and with our friend group. And these beliefs that we've developed about ourselves, others, and our relationships now shape our current behaviors. So if, for example, our mom was, was unavailable and very abandoning, we've developed a story about ourselves that people will leave us and people won't be there. And then we develop certain coping behaviors. So maybe we start clinging or seeking excessive reassurance. We do certain behaviors when we're triggered. And what happens is that those same behaviors we learned in childhood to avoid this pain actually create a self-fulfilling prophecy and exacerbate the same pain over and over again in our adult relationships. Speaker 3 00:05:18 Wow. Well, wow. So you've, you've used a term schema for that, or that we've got schemas. Can can you break that down for us? Speaker 0 00:05:27 Sure. A schema is a core belief. So I've developed a core belief about myself and others. Now, when this belief gets triggered, it brings up a whole experience, automatic thoughts, feelings, memories, urges. So we know that when we're triggered, it's kind of like, ugh. It's like a whole physiological experience that shows up for us. And we have learned certain behaviors to do. We've learned what it's like, what we could do with our mom, with our dad, with our siblings, yeah. To manage this pain. Yeah. And so we use these old behaviors, and those behaviors end up confirming our deepest fears. The very thing that we try to avoid those behaviors then elicit over and over again. Speaker 3 00:06:09 So to try to, um, to also grasp this, it, sometimes the extremes of one might kind of help understand, would it, would it be accurate to go, I, if I've got a phobia of dogs because of something that happened when I was younger, off of that, I'd have this whole filling prophecy. I'm, I'm, I've been, you know, you're not, I'm not that person, not afraid of dogs, they're afraid of getting bit by a dog from something else that happened, but they built this narrative in their head about where this is gonna go. So is that is kind of an extreme of where ischemic could take you? Speaker 0 00:06:39 It's very similar to that, except we have to add a whole story about the dog, right? So, sure. Yeah. When get triggered, right? When we get triggered in our current relationships, I, I wonder if you've noticed, it's almost like we're doing time traveling. When our core belief gets triggered, we transport back to an earlier time when we were little and helpless, and we're just reacting. And those reactions end up confirming the same thing that we fear, Speaker 3 00:07:05 Which, which explains, you know, in emergency management, you see people, when things really crunch in an emergency situation, they tend to respond in a much like not to where their age would be or where things are. They're there, it's like, the instinct isn't even what I'd normally expect an instinct to be. It might not make sense. They're, they're all over because there could be this schema that's sitting back there for that particular thing that's been triggered. And so now I'm really dealing with that 14 year old mind, or that seven year old mind, and then what narratives it's worked through. Great. Okay. I, I think I can, I can grasp around that. So then talk to us about, um, just the, the high level precepts then of, of act as it starts applying to how, how, how would through act, I guess, break that down, and then how, how does it approach a schema? Speaker 0 00:07:53 Yeah. So, uh, for example, if I'm afraid of dogs, when I see a dog, I'm gonna have lots of difficult thoughts, feelings, and sensations that bring up a lot of fear around this dog. And act says that this fear makes sense, and it was adaptive because at some point, whatever happened to me with a dog would make sense that I would avoid this fear. But the dilemma is that the more I try to avoid that fear, the more I avoid dogs. And I try not to think about dogs or see dogs. Speaker 3 00:08:26 Sure, yeah. Push dogs away, Speaker 0 00:08:28 The more afraid I become. Yeah. And so act as a treatment that what I really love about ACT is that it felt to me at the time, radically different than all other therapies, where other therapies want us to feel better, to get better, to fix something, to have positive thoughts, acceptance and commitment. Therapy wants us to figure out what matters. What do we wanna be about? What is in our control? How do we move towards those things that matter, and the thoughts, feelings, sensations, the internal experiences that try to influence us and stop us from moving towards what matters. We do experiential exercises to help accept those, to sit with those, to embrace those, to build a compassionate and loving space for all of those experiences. Because the more able we are to sit with those experiences, the less influence they have on our actions. So if I'm willing to tolerate guilt, if I'm willing to notice where is this guilt in my body? What is this? Like, what do I tend to do when I feel guilty? The more space we make for it, the more able we are to commit to what matters and the less influence guilt has on our actions. Speaker 3 00:09:39 You know, this seems to be the, the times around us and what we're formed, the, the, the pedagogy we're dropped into of life of just, just how society's working tends to kind of provide constraints around us. The, you know, bookends or they, it's, it's the pool we're swimming in, whether we like it or not. So I, I can see very much in today's world that this is, this is approach. This approach could be really, really successful in a time because it's, you know, people are, there are many other similar things you're working on that are working off the similar type of mindfulness experiences, right? So you're getting little successes and, and or reinforcements of how you might utilize mindfulness to bridge through a problem or of other things. And this, at this particular time, that sounds really, really valuable for us in society, for where we're at. Speaker 3 00:10:29 Versus maybe when I look at my grandparents' time, they were motivated more to, to not understand themself, but by this is my responsibility. They're, they are, they were forged in these things. And so they would set this aside in order to plow through and to go. But in today's society, that doesn't work really well with everything you've been given. Where so much is really I to be realistic, everything, every message around us is telling us it's about us and, and what we should be doing and what, how everything should relate to us. So it would make sense that we're going to need to do this in a healthy way. We're going to need some tools that meet us where we're at and right. And walk us through. That's, that's, that's really, really fascinating to see come together. What is, um, so now we look at a parent project, which is a very, it's a in, in, within the context of our time today and our time in history at this particular time, we have usually two working parents. Speaker 3 00:11:26 You have family that you're working through. The most of us that are dealing with a family, you know, with a parent project tend to be between the ages of 45 to 65 when that starts setting in for that, right? Usually a working mom who's got a kids to deal with and parents to deal with and life. And even after you've dealt with the passing of this loved one, after your, this five year or seven or eight year run, um, you still need to turn around and you still got like two decades where you have to form other young people <laugh>, and you gotta, right. And you're expect, and our longevity is going on. So it's not like, oh, now I've got another 10 years before I'm gonna go through it. Now. It's like, well, given away scientists coming at us, I might live another 35 years after I've dealt with this. Speaker 3 00:12:14 Or, you know, or something to that nature. Right? So, um, so as we start looking at that kind of picks up the value proposition of doing this in a healthy way, right? Of, of stepping up and understanding how the heck am I gonna help mom and dad, but do this in a healthy way? I, what, what is just in general for psychotherapy, are you guys as psychotherapists, do you see, is there, i, I mean, is this something you're also seeing? Is the silver tsunamis hitting ground right. Or is it starting to hit, you know, landfall and more and more people are dealing with parents? Are you, are you seeing an application of this more often than we have before? Speaker 0 00:12:52 Certainly time I have changed and, and it's, it's, things are different in the sense that the, uh, generations before us kids would be able to leave the house, uh, earlier. Uh, and now kids are staying at home later and later, and they are more dependent on their parents, and it takes them longer to, uh, have their own financial independence and autonomy. And so that phase is lasting longer. Yeah. Now also, we are living longer, and so this phase is lasting longer. So that in between phase where we're taking care of both, this is, uh, one of the times where that is at its peak and we're still, I guess, um, negotiating what that looks like for us. Speaker 3 00:13:42 Yeah. Well, we're gonna, we're gonna take our, our first break here in a second. And when we, uh, when we come back from this break, um, I'd, I'd like to dig into that. I'd like to, you know, you join us as we sit down with Dr. Abby Lev, and we're gonna now start talking about this time when it's really coming at you, it's hitting you from both sides. What are ways to start putting this acceptance and commitment therapies into place, uh, to help you understand how to work your way through a parent projects? Stay tuned. We'll have you right back here on the Parent Projects podcast right after this. Speaker 4 00:14:16 Sometimes Speaker 5 00:14:17 I'd like to smack old age, Speaker 0 00:14:18 Right in the Speaker 4 00:14:19 Kisser. Speaker 6 00:14:21 I always get the best parking spot. Speaker 4 00:14:24 I think she needs a little more help. Monday, Speaker 7 00:14:28 What I really need is a boyfriend that can drive at night. Speaker 5 00:14:32 I can make a fashion statement out of anything. Speaker 8 00:14:35 I will be fabulous. Speaker 4 00:14:37 I have a little crush on my pharmacist. With Comfort Care at your side, you can live your best life possible. We know families can't be there 24 7, which is why we can help with as much or as little home care as you need from medication reminders and meal prep to everyday chores and errands, so you can live in your own home on your terms. Speaker 5 00:14:59 I wouldn't let aging stop me from being me. Speaker 4 00:15:02 Call Comfort for Care Now and let us create your personalized care plan and find the perfect caregiver match. Speaker 9 00:15:08 Can you show that number again? She was texting Speaker 4 00:15:11 Together with Comfort Care, you can both live your best life possible. Speaker 3 00:15:16 And welcome back. This week we're sitting down with Dr. Abby Leb. She's a licensed clinical psychologist. She's an author, mediator, and international speakers and executive coach. She's outta the California Bay area and, um, with, with Bay Area C B T Center. And today, you know, Abby, Dr. Or Dr. Lev, we've, um, we, we, we talked about in that first segment, let me, there you go. We talked about in that first segment, um, just, just those principles of a c t and what, what's used to push us through schema. We recognize coming out of it that this is one of those times in life where you've got multiple groups of people to care for. You've got children that you have this responsibility for. And the reality is you've got parents that you actually have a responsibility for. And as we see you, you and I have talked previously, you know, offline, we both, we all see and recognize that the government's probably going to struggle in most countries, keeping up with the sheer flow, going into entitlement space systems, which will require families to step in. Speaker 3 00:16:18 Um, but this is a time, so you've got that extra pressure that's coming on us. There's a lot of great, we've also talked before, we both were two people who find value in pressure, time, heat, and we're informing and making better versions of ourself and where we come out of it. Uh, I'd love to talk through upfront, uh, what are, how about these top schemas? It is, I, I can't tell you how easy it is to say, not only is our average audience, the average person who steps up 90% of the time, it's the oldest daughter, she's a working mom, she is, um, you know, 50 to 45, 50 to 65. She's, these things are pretty darn predictable. What is is the schemas that we see on these, you, you've mentioned a couple of these. What what are the most common that we see that we can just kind of be aware? Speaker 0 00:17:09 Yeah. Well, one of the most common schemas that I see, uh, in women is the self-sacrifice chema. And I have, uh, the schema questionnaire on my website at bay area cbt center.com, and I've seen 40, 50,000 of these schemas. And one of the most common ones for women is self-sacrifice. And one of the most common schemas across all, uh, gender and countries and everything is, uh, perfectionism unrelenting standards. So we live in a society that's putting a lot of pressure on us to meet very high standards and expectations. Speaker 3 00:17:51 Yeah. Yeah. I, I mean, not to, to cut you off in that, but this is part of that and how this looks. There's a reality when we're helping organizations, part of what we do at parent projects is, is we go to help families through that side, because this is something you might do once to maybe four times if you do your parents and then your spouse's parents or your significant other, the opportunity of you being perfect at it is like next to zero, right? There's just, that's not realistic. But in a schema that doesn't, like you said, that doesn't, that doesn't, it doesn't have to make sense because it's a narrative you've told yourself. Right? Speaker 0 00:18:27 Certainly, schemas don't make sense. They are a visceral experience and something that we've, you know, felt in, in our lives. And they do come from a justifiable place. I mean, the world does put, I mean, this society puts a lot of pressure on us to succeed, to achieve, to be perfect. So, uh, it makes sense that we developed these, these beliefs and it's, it's important to be able to recognize how these beliefs impact our actions and what are the experiences of the feelings that we need to make space for. So if somebody has a perfectionism schema, we really need to learn how to tolerate feelings of disappointment and feelings of not good enough. So, got it. We don't have to continue to attempt to do things perfectly because it will ultimately be disappointing. And another schema that is common, uh, for, for people who are in a caretaking position or people who have some codependent tendencies, is a subjugation schema. Speaker 0 00:19:31 And what's interesting there is both people with a subjugation schema and a self-sacrifice schema tend to put other people's needs above their own, but it's driven by different thoughts and feelings. So the person that has a self-sacrifice schema, they're avoiding feelings of guilt. They don't wanna be selfish. They, they have a lot of empathy, and they're, they're feeling bad for the other person. And guilt to drive them to put themselves last and to not prioritize themselves. Now, somebody with a subjugation schema, they feel helpless, they feel powerless, they feel like they don't have a choice. And so they put other people's needs above their own, um, more driven by fear. They are avoiding fear, fear of punishment, fear of retaliation. Or even, um, in your response, you had said that we have a responsibility to take care of children and to take care of our parents. Speaker 0 00:20:25 But I'm gonna say something controversial here, is that we actually don't have a responsibility to take care of our parents. We, as parents, always have a responsibility to take care of our children because we've decided to bring them into this world. But in reality, we don't have a responsibility or an obligation to take care of our parents. So if we're doing that out of subjugation or feeling like we have to, it's gonna feel radically different than if we recognize that we're doing it out of our free choice, out of our values, to be loving, to be caring, to be generous, to be, uh, affectionate, to contribute. When, when, when we feel like we do something out of obligation, it feels forced and it feels confining when we recognize our freedom to choose, and we could notice the values that we wanna move towards, then that that whole experience changes and it becomes much more empowering. Speaker 3 00:21:25 And so, and, and I want to drive on that. What I hear off of that is, technically you have a legal obligation in our society. Well, and whether that obligation comes from legal or whatever the precept might be, I guess might be a whole nother circumstance to discuss. But, um, but that same legal obligation that you have as a parent to take care of, of somebody under the age of 18 that's not able to care for themself, that legal obligation isn't the, it's not the same legal ob obligation when you're looking at dealing with your parents. The legal obligation in that particular case is to, to do no harm, which is a very different thing than actually proactively jumping after that. So, and what I also hear you doing to be very clear, right, is, is that you're, you're not saying that that's not an instate to move to where I heard you go with that is this is you wanna move to the end state, not out of a guilt and a fear pushing down on you. There really isn't a real obligation that comes off of that. You simply wanna do it because that's the better version of yourself that you move into, or the positive aspects that you want to achieve as you pull yourself through this thing. And in doing that, you'll probably find a healthier way, you will find a healthier way of doing that, rather than this ob obligatory, uh, side in which you're, you know, you're kind of trying to push through. Am I, am I somewhere close? Speaker 0 00:22:47 Yes, you're you're very close. Yes. Ok. It's like, sometimes I give my clients who have a subjugation schema this cuz when we believe that we are subjugated or powerless over things or obligated towards things, right, it really takes away our free choice. Speaker 3 00:23:04 Well, you know, Speaker 0 00:23:06 I, I give my clients this, this metaphor. I say, I really love eating chocolate. I love chocolate cake. But if you tell me, Hey, we're gonna go to this factory and it's full of chocolate cakes, but you have to eat every single chocolate cake there suddenly, my own joy of how happy I would be to go and eat this chocolate cake is now it has a very different flavor. Because as soon as you have to do something, it no longer has the same feelings of, of joy or, or pleasure that it could be given you when you recognize that you are a free being, moving towards something because it matters to you, not because you have to. Speaker 3 00:23:42 Right. And, and there is a, there is a great truth to that. I think when we sit down and we come into the liberty, the inalienable liberties and rights in which, especially in our country, but in general, we've, we've, you know, enlightened thinkers have come to understand. Now you can really pick into that, you know, there is one, one aspect of, there's many aspects of this, but, but one aspect that really pushed on top of me here is you were saying that it takes away from us. But when you look at, when you take on the obligation and you act within that, and like, I really feel some level, we're kicking a door in, we are kicking a door in here. And what we say here, but I really mean this, you're not just dealing from you here. You almost remove the autonomy and the dignity out of the other person, out of your parent. Speaker 3 00:24:30 It is genuinely their responsibility to take care of themselves first. And to be on that and to be thinking into those things. And if you go into it that, that with, with a misguided perception that that is yours and therefore you are the pre like you're driving where that is, that might lead you to overpower their autonomy and their actually, what, what is, what truthfully is their liberty in this Right? And what it is that they have. Um, and, and yeah, I can, especially when the emotions are really flying, Gil and Pier can get you, they can get you to be blind to a lot of stuff, a lot of stuff, and you'll miss cues and not understand. And then when you're talking about delivering any kind of service servitude to somebody who is in a vulnerable population, really, if you have to think about what, what's the likelihood that they're gonna stop you? They're in a, they're in a vulnerable position. They're going to, they need what they can get, and they're probably likely to maybe take more than they should. Or, you know, maybe, maybe that wouldn't put that into check. But I'm, I'm kind of running far down that line. I, I'll, I'll get back over my skis here, <laugh> and I'll back up a bit. Um, the, go ahead. Speaker 0 00:25:52 I think you're just making the point that actually the, our parents could feel subjugated in that position. Certainly you feel a level of subjugation and helplessness and losing your autonomy that you used to have. It is a subjugating experience, right? And so if your parent has a subjugation schema and they're feeling really helpless and, and out of control and powerless Yeah. And you have a subjugation schema where you feel obligated and helpless and powerless. Now, if you don't have good boundaries and a sense of what is yours and what is theirs, then you're right. What, what you just described can happen because you're not separating your feelings, needs and values from their feelings, needs and values. Speaker 3 00:26:37 Well, and let's, let's be honest, the massive, the massive evolution of technology and change at such a fast pace has led us to really grow up in two very different worlds, right. Uh, of what's been around us. And so the opportunities of, and it, and it doesn't exactly cultivate great conversation. It should be a no-brainer that we as parents will talk with our recognizing that a single event in our life, a single medical event, can easily wipe out everything that we're able to save. Right? It, it's, it's logical that it would make sense that we're going to have an impact on, on their feeling of financial responsibility at some point in time, and that we would have a conversation with them about that. Yet, 95% of us will never have that conver our their parents aren't having that with us. Even though that we're dealing with that frustration and trying to, to deal with this off the cuff as fast as possible, chances are we're gonna do the exact same thing, <laugh> when we turn around and talk to our kids or lack thereof and not talk to them. Speaker 3 00:27:42 Um, it's not one thing, an acceptance where society is at that that a that act can be a good way to get through it. I think you also have to accept it. Society hasn't really built a great bridge to date between the generations. Um, and that is, I think in, in some other episodes coming up here, we're gonna talk with some folks that actually have phenomenal technologies that they're using to bridge, which is not a crack, it's a, it's, it's, it's not a CVOs it's a stinking canyon between the life experiences coming up. So whereas my schema might be, you know, self-sacrifice and my dad's schema might be self-sacrifice because of what we grew up in, the experiences that, that develop those schemas for us, we might think we understand what's going on and we are not postured well to talk about that particular thing. And, uh, and it, it can lead to a lot of problems. Um, okay, I'm off, I'm off the soapbox from that love. I love the application though. I, I know you, you, you really did it. It's a controversial thing to state that, Speaker 0 00:28:50 Right? That it's, Speaker 3 00:28:52 That it's not an obligation. There is clearly a social need, but a need is not an obligation. Speaker 0 00:29:01 Well, the parents has a need, they need support and they need to be taken care of. Right. It doesn't mean that you have to do that. Right. But you probably, when you see your parents suffering or needing support, there's probably a part of you, if we removed this feeling of obligation, there's a part of you that you would connect with that wants them to have like a good rest of their lives. Right? Like a good death. We all, we deserve a good life. We all deserve a good death. And even a, as children experiencing our parents' death, we deserve a, a good experience or a, a validating experience of going through the grieving process. That's why noticing our schemas and the thoughts that our mind is trying to sell us, when we could get right, when we could distinguish between the obligation or the fear or the guilts that, that we're not doing emotionally driven behaviors. Speaker 0 00:30:01 When we could handle all those emotions, then we could identify what, what matters to us most. What what are the values that we wanna move towards? What kind of daughter, like when I'm on my deathbed and I'm facing my myself, what kind of daughter did I wanna be? Did I wanna be loving? Did I wanna be patient? Did I wanna be cooperative? Did I wanna be supportive? And what behaviors did I do that moved me towards being that type of daughter? And that's not about what my parents think about me. That's what I, it, it's a's for me, it's not for them. Speaker 3 00:30:35 Yeah. What are the relationship, what's the, the interaction with siblings and other things, you, these other people that are sit close by with you? What's the considerations to think about that when, when we're, when we're working, uh, through this type of situation? Somebody who's got, you know, maybe we had similar but not identical what they had similar, you know, situations in life and now we've gone and lived stations totally separate for 20, 25 years trying to come back together with this. What, what, what's the interaction there we should be thinking about when we look at this? Speaker 0 00:31:08 Yeah. You know, sometimes as siblings can have very similar schemas because they've grown up in the same home, sometimes siblings could have complimentary schemas. So if I have a perfectionism schema and I want to do everything perfectly, maybe, um, maybe my brother or my sister has a failure schema and they feel like they can't ever do anything. Right. Or maybe if I have a self-sacrifice schema and I feel a lot of responsibility for taking care of my parent, maybe my sibling has an entitlement schema and they feel like I should be taking care of the parents. Yeah. Yeah. So we wanna be thinking about how core beliefs are like lenses. They're like a pair of sunglasses and we view the world through these lenses. And so within family dynamics, there's a way in which, you know, the more I take on something, it could lead to somebody else taking it on less. There's a way in which we impact the homeostasis of the group dynamic. Speaker 3 00:32:07 Yeah. What, what is a, um, okay, let's get a little practical here. Let's get, let's break this down. That is, that is that context that you set, and it is a, that is a master's degree conversation above. Like, I, I can, I'm, I'm tracking that. I'm gonna bring this down to home for a family, right? What I hear in that saying too is that we each have our own baggages were coming through, maybe they were equally formed a lot of times siblings might compliment or, so I think of, as you were saying that I was thinking of, of the old Brady Bunch, Marsha, Marsha, Marsha, right? Where there's like this, like this Yeah. This like natural back and forth and, and that that really plays, you know, you've got that the, the siblings will also play off of each other as they're developing their own schema. Speaker 3 00:32:55 I hear other things where we talk about, well, you're really a lot of what your trauma, what your childhood trauma was, and that's, that's kind of what you're working through the rest of your life to try to figure out where all of these things are. I, I I, that what I hear it resonates in from this is, yeah, if that childhood trauma started a schema informed you into that particular direction, you're gonna need some self-awareness as to, Hey, what is this thing? Because a practical advice, which I expect we're gonna jump into now, is how to get yourself some oxygen first and how to breathe before you go act on all of these things. And, and one of the first things great counselors talk with us about on this show and in others are, but it's okay to feel the way you feel. Give yourself some, give yourself a break <laugh>. Speaker 3 00:33:38 Like, there's a reason you feel this way, you have this organic mechanism that functions this way, except where that's coming from a second. That doesn't mean you have to act out on what it's gonna tell you to do in that moment, but to get to that moment, what you have to be able to do is, is breathe, right? You've gotta be able to give yourself some oxygen and make sure you've accounted for your situation. Just like that pilot is saying, look, you gotta put your own mask on first so that you're in a position to assess what's going on or the way that you and I learned through, you know, brownies or girl scouts or boy scouts or anything growing up, or those first aid classes at the pool that said, Hey, when you see that person going there, you don't just run in to do that. Speaker 3 00:34:21 You stop, you look around and you make sure you're not gonna become a part of the exact same problem that that person just was a part of. Right? The electricity in the pool or the, you know, something like that. So what are some things we can do we, when we recognize this moment, like, is this done? Is this a point of recognition like, oh, well, you know, with this knowledge I recognize I'm in this schema and I need to back from that here. Or is this is the best way to, you know, move forward from here? Is it about I should set some routines in my life that make space for these oxygen breaks? Speaker 0 00:35:03 Well, we certainly don't equal our trauma, right? We don't equal our conditioning. So understanding our conditioning is for the purpose of creating mindfulness so that we notice what our autopilot is. Yeah. And the more we're aware of what our autopilot is, then we could recognize moments of choice. Moments of choice to do something different. So if I notice that, my inclination is that if the plane is crashing, instead of putting the mask on myself, that I put the mask on others while I'm suffocating, and I start noticing that I'm not really, uh, I don't do a service to myself because my needs are not getting met and I don't do a service to other people because how can I really take care of them if my own tank is not full, if I'm kind of drained of my resources, how would I really be effective at nurturing or taking care of others? Speaker 0 00:36:03 So the dilemma is that when we have this insight, certainly I'm a cognitive behavioral therapist, so we do not believe that insight leads to behavioral change. We all know what it's like to know that we're doing something that's not helpful, and we continue to do it over and over again. Yeah. It's very hard to change our behavior. So act helps us first identify and clarify our values. So we may ask, what do we may think about our own funeral, or we may think about our parents' funeral. Uh, what would we want our parents to say about the kind of daughter, son that we were? What would we want our friends to say about the type of daughter or son or mother that we were? We, we get very clear on what we want to stand for and what truly matters to us. And values are a free choice. Speaker 0 00:36:56 They're not about what we have to do, they're about what we most want to do. So they're a free choice. And values are a hundred percent in our control goals, not so much in our control. Other people's behaviors, not in our control. What we wanna stand for, what we wanna be about in our life is always 100% in our control. Now, if I notice that I have a self-sacrifice schema and I want to start doing different behaviors, I need to clarify what are my values in those specific moments? When are the specific moments that I need to put the mask on myself? So we may say, what kind of thoughts and feelings come up for you around taking care of your, of, of your parents? And what has come up for you this week? What challenges? And maybe they have certain thoughts like, I must be available all the time. Speaker 0 00:37:48 My, my mom is suffering and I'm a bad daughter, or I'm not doing enough. Yeah. And I may ask them, when you have the thought, when your mind tells you that you're not doing enough, this would be an example of an unrelenting standard schema, perfectionism schema. I would say, what does that stop you from doing? Has that thought ever stopped you from doing something important in your relationships and any relationship with your parents, with your children? Because their schemas impact all of our relationships. Yeah. And maybe you notice when I tell myself that I am not doing enough, it stops me from being compassionate with myself. It stops me from being assertive. It stops me from being flexible. It stops me from taking care of myself. And then I would say, well, the next time that your mind tells you that you're not doing enough, what do you want to do in that very moment? What value do you wanna move towards? And then we decide a very specific behavior that they want to do with that automatic thought. Then we also bring up what are the experiences, the emotional experiences that would come up as barriers that might try and stop you from moving towards this value. Maybe there's feelings of guilt, maybe there's feelings of shame, maybe there's, um, feeling of disappointment. And then we would do some exercises, some experiential physiological exercise with the body. Somatic techniques. Speaker 3 00:39:16 Yeah. Speaker 0 00:39:17 Vagal techniques to activate the vagus nerve to bring up self-compassion and loving kindness so that we make space for guilt, for shame, for disappointment. We may do emotion exposure. I'll ask you, where in your body do you feel this guilt right now, most intensely, what is this? Like what color is it? What size is it? What shape is it? What urge does it bring up? But the goal is to connect automatic schema driven thoughts, feelings, and sensations with specific values. And then those are cues. Your guilt is a cue to stand up for yourself, to be assertive or maybe to say no. The next time you notice this experience in your body, it's telling you to say no, we help replace these automatic behaviors. Yeah. With a new values based behaviors Speaker 3 00:40:07 That are much healthier and, and can, and help your body be able to endure not only what's in front of you at the moment, but drive, you're now being proactive. Really, it's oversimplify and I know it oversimplifies, but now you're being proactive instead of reactive in your response. Correct. You are proactively applying in this Yeah, yeah. Into something that you want to be, a cognitive thing that you're trying to achieve from that thing. And in the reality that makes space, I really do that. I think that's going to make a lot of space for the fact that that person's a human being with their own set of things that they're trying to accomplish within that. And then that's not you just accepting that as your obligation to, in, in order to, to go do. It's not, you might be somebody who wants to accomplish that for them or help them accomplish those things. Speaker 3 00:40:53 But as you said, that's, it's not technically, it's not your obligation to do that. And so if you were to take those on, what you might be doing is misinforming them from taking their own responsibility that they need to be doing, to fix some of these things, and to get themselves in a way that actually can fix the problem because they're in front of you, you're at the end of the whip, you're just catching up to it. Way after all of that's gone through the, the sooner that the, that everybody can get proactive about how they're handling it, the better. But then again, you're probably dealing with someone with some level of diminished capacity or at least time to be able to, to come to grips with some of those things. So what's, um, I, you know, I have 1, 1, 1 question that that might come up. It would be, uh, when you're looking at the schema of like self-sacrifice, what is the role of like a patriotism or something? Like, are there, are there there positive elements that, that also come into that? How do you explain that so that it doesn't totally pull everything apart and someone doesn't just throw the baby out with the bath water, but at the same time can understand what that you know, that there are positive things that influence us to be the where we are. And it's kind of a mashup here. Speaker 0 00:42:08 Well, I wanna make sure I understand your question. We'll see, because schemas are core beliefs. It's not a moral issue. It's not positive or negative. They are what they are. It's not saying that this is a bad thought or this is a good thought, or this is a good belief. What it's about is recognizing that we have all our belief systems have been constructed in a context. Yeah. And we have been conditioned throughout our lives. Lots of society tells us lots of stories about the right thing, the wrong thing, the fair thing, the, this thing. But then there's a part of us that is the watcher, the observer that makes our own choices, that recognizes our freedom, and that recognizes our responsibility that all of us are gonna die one day. You know? And what do we wanna be about in our life? What is, and so the idea here is that when we can make space and notice all of our internal experiences, thoughts, feelings, sensations, and urges, we create this behavioral freedom. Speaker 0 00:43:12 Like you said, we're no longer reacting. We're no longer, you know, driven by these unconscious processes. We now are making, uh, intentional and conscious choice to move towards what really matters. Yeah. And there's lots of research that shows that values help motivate people to do new behaviors. They're a huge motivator. And values lead to us having a meaningful and and satisfying life. That the only thing in our control really is our values. We don't have control of when our parents die or when we die or what our death will look like. But we always have control about how we wanna be. Do I wanna be critical when I'm dying? Do I wanna be mad at everybody? Do I wanna be resentful? Do I wanna be appreciative? Do I wanna give gratitude? And we notice it's not because that's what I have to do to live a good life. It's what I choose to do because I only have this one life. And when I notice that I have this choice, and I come up with my own system of why I wanna move towards something, what matters to me outside of the rules of what should be, that's when I connect with my authentic self. That's when we all connect with what truly matters for us. What makes us unique is this free choice to choose our attitude, to choose what we wanna be about. Speaker 3 00:44:35 Well, and that, that then gives you that ability, ironically enough, it then gives you the ability to achieve, like stepping back. You're going to, you're, but you're, you're achieving for that is it also could open up your mind. I think of, you know, I'm a former police officer and one of the things that, that we learn in law enforcement is when you, when you flip on, when you turn on those woowoo lights and that siren, your, the world literally comes like literally gets black. You get this tunnel vision that comes, everything gets very focused as you're working through something to that nature. And, and we're taught a tech, we're taught different techniques, both when you're, when you're, you know, same similar type of thing tends to happen too. When adrenaline's pushing and, and you have to draw a weapon. All of this comes down. It gets very focused. Speaker 3 00:45:22 It's what the body just humanly does. And so we learn to turn our head just from time to time. You'll see police officers in that thing, if they're extinction doing it, they turn their head in, man, it's crazy. All of a sudden everything opens back up. Your peripheral vision comes back to you at that moment when you're able to work. And now you're making, you're, you're taking the physiologically taking con back control of the body to be making decisions instead of that instinct. So sometimes our instincts, the protective mechanism to focus on, you better get here, or this dinosaur is going to eat you. Or right there, like this, this bear is going to eat you right at that, at that other side. Not a dinosaur. I get it everybody, but I'm on the other side. We saw 65 million, I saw 65 the other night. Speaker 3 00:46:05 So it's just sticking in my head, <laugh> the, uh, but, but to the same side of that, there are things that we can do in this that can combat that. So that now we're making those proactive, and, and by taking that moment to do something which seems very unproductive, we are able to totally conquer something much more productive or understand maybe more importantly. And when we, when we come back, I wanna talk about it. Maybe more importantly, understand if we're not the best one that should do that thing, maybe we're maybe, realistically I shouldn't be doing this. I think that that's, that's really where we want to talk about when we, uh, when we come back. So I'm gonna have you hold up with us. We're gonna, we're gonna have one quick segment on the backside. We'll start to wrap some of those concepts. And if you are, um, if you're joining us, uh, for today's show here, don't, you don't want to go away, the wrap up of this is gonna be awesome. Speaker 3 00:46:59 As we land the plane with Dr. Abby Leb. We're talking through Understanding Act, its ability to help us understand the schemes when we're tackling family caregiving, how to recognize where you're at and begin these action not from a false narrative of obligation of what sits over you, but instead of that proactive, just a sense of accomplishment to help you get through this in a healthy way. Be a great caretaker and probably leave a little bit of gas in the tank for your families. Stay tuned for us at the Parent Projects podcast. We'll be back right after this. Speaker 10 00:47:31 If you're caring for aging parents, you need parent projects connect. Here's why. First you get access to a Verified business network, so you're only working with the most trustworthy vendors who won't take advantage of your situation. Second parent projects guides you through modules and tasks on health, financial, real estate and medical decisions. So you're always prepared for what's next. Third, you can invite family members into your project so your family is in the know and working together. Get started with a free 30-day trial [email protected]. Speaker 3 00:48:01 Hi. Welcome back, everybody. This week we are sitting down with Dr. Abby Le. We've been talking about, uh, the role, uh, that that act can play, and that's acceptance and commitment therapies. It's just one of those models, but we're really, we're, we're challenging a lot of the common held beliefs of what maybe obligation might be when we're working through a parent project and healthy ways to get a stock of ourselves, really where we need to go. Uh, and then tackling it in a healthier environment where, um, a c t just said, you know, Dr. Leviev a c t just happens to be one of those, these, these methodologies. I'm sure there other come out here. This is in particular what you do. You've done a great job of kicking a door open, uh, <laugh>. And, and, and it would require somebody to really intently listen to all of what you're saying. Speaker 3 00:48:53 Um, and, and not to take something out of context from that, but I wanna, I wanna recap the start this last as we land this plane. The last side, the last, you know, um, the biggest takeaway from here, which is just because this thing needs to be done, particularly taking care of a parent doesn't mean it's your obligation. In fact, when we look down to it from a legal perspective, unless you're obviously, if you're named, if you are the person who's signed up for that, you've come down and you may, you may have a legal law, there may be a legal obligation, but generally taking back, and that may need to be accounted for. But taking aback the flow of emotions, that form of, of why you do what you do and what you're about to do, that doesn't come from a place of, of a real obligation. Or it comes oftentimes from your schema, from your, from something that's maybe developed over time in your lifetime. And it's worthy of taking a moment, taking in some oxygen, understanding where it came through so that the response that you give or how you act or advise, even maybe it's a light lift, maybe it's a heavy lift, is coming from a healthy way and is coming from a way that is proactive and not just reactive across the board. Am I, am I tracking Speaker 0 00:50:09 Right? Well, if we're doing something from guilt and obligation, we may miss what truly matters to us. So if I were one of the listeners and my parents were, you know, sick and on their way to passing, and I'm trying to connect with helping them, but also I would encourage you to think about what do you wanna be about? What are your needs regarding saying goodbye to your loved one? Are there things that you would regret? Not saying, not doing, not asking. So it's not, and you know, Speaker 3 00:50:47 That's, I I, that's what your parent wants, like, correct. Like that's what the parent actually wants to have. But for whatever reason, that gets lost, Speaker 0 00:50:56 Totally lost. If you're coming from rules of what you have to do, you're driven by guilt obligation. It, it, it's, it's, it's, um, stops you, it, it constricts you in your freedom of, wow. Like, this is it, this is your only chance to say goodbye. This is your only chance to grieve your parent. And this moment is really important. It's important for them, and it's important for you. It's important for you to know whether there's anything you would regret not saying, not doing, not asking for. So that, that's a part of putting on the mask. That's a part of checking in. What do I need from this? I'm not the one dying, but this relationship is dying and I have needs in this relationship too. And it's very, it's a very important experience for us when our parent dies. So it's okay to take care of others and still ask yourself, what do I need from this experience? What would I regret not giving to myself during this time? I, Speaker 3 00:51:58 Well, and I, and I'm going to guarantee nine times out of 10, it is exactly what your parents want. Speaker 0 00:52:06 Absolutely. Speaker 3 00:52:06 Coming outta this. They don't, they just don't want, in fact, that's the reason that the conversations don't happen for so long. I don't wanna bother them. I don't come from this. It, it could go so much different when that conversation to your, to your mom or your dad is, this is the person I wanna be in life. Right? I wanna be the one that does this thing for you. I've decided I am somebody who, what legacy means to me is I want my children to see me do this because this is how I want to be remembered. Not because that expectation for them to figure out their own life and where that goes, this is who I want to be, right? And therefore, any way you can help me pull or pour into you in doing these things that fulfills me and, and there, that that is a, a healthier way to tackle it. And that's, I could, I could think of very few moms who wouldn't want to hear that coming from one of their kids. Right. Speaker 0 00:52:57 Or who would want their child to do something driven from obligation rather than anything other from some connection that they have to you that you guys could get curious about. Speaker 3 00:53:08 Yeah. Yeah. What that is a beautiful, it is a beautiful, it is a true, it, it speaks into a great level of, you know, we talked in the show too that no, that look of humanity. Remember, they, they've, they've, it is an, your parents also have this inalienable, you know, right. To life, liberty and pursuit of happiness, which we recognize here in our, in our country is unalienable rights. They've got that too. That hasn't gone away. And, and if we go running into it too far or too fast of not even understanding ourself, there's a good chance we're gonna step all over theirs. And that's exactly one of the things that causes them to bristle and to work is that I think we all understand. I, and we don't, most of us understand that we're all going to die. It is our shared fate as human beings for our species and what we do. Speaker 3 00:53:58 Right. And, and coming to grips with, with that is I tend to find it's less about autonomy and less about what's in front of it. It's actually tends to be more about, well, it's legacy and my understanding of life and what my perspective and purpose of life was, where it was, what, to the degree, somebody's able to understand that. It seems to me that they're easier to understand and accept death as it comes and enter that, um, in, in a little, in a slightly different way. Or make decisions that are easier for others to understand around them as opposed to wiggling through it, making it difficult and, and is hard. Um, this is, this has been great. What is look more on a c t talk, talk to us about, um, acceptance, uh, commitment therapy or finding you or getting more information on this. Where, where can people read more about this and you Speaker 0 00:54:48 Yeah, you could visit my website, bay area cbt center.com. And I also have another website called cbt online.com where we have, um, lots of videos and audio exercises, self-compassion, and even, uh, some worksheets for you to fill out, to figure out your values and to figure out your schemas and all of these kind of fun things. So you could find me in there. Speaker 3 00:55:20 I, I love that. And, and I'm gonna, I'm gonna put out C B t cuz there's a lot of, of initials that come through and acronyms off of that. This is cognitive behavioral therapy, correct? Yes, yes. Yeah. This is, this is not some different version of, of oils or other things that might come out there to, to kind of help you work through something. Okay. <laugh>. Right, right. Brilliant. I, we've actually, we've used cbt, uh, we've used it for kiddos that are processing and working through, um, you know different stuff, the alpha, beta and the gammut, and just getting that understanding too of them in different forms of, of psychotherapy to understand how their brains work and come to a mastery and an understanding of their own brain. So, uh, hi, a big fan of that. That's great for people to find you out there, you know, parting shots. What else, what else can we be thinking about? Again, in the context of, I got a parent project, I'm running through it, I've got other family members to my left and right who are also trying to figure themselves out. Mom or dad, probably trying to figure themselves out if we're lucky at the same time. Any, any parting shots about best ways to communicate about this type of a topic between each other? Speaker 0 00:56:26 That's a whole other segment, right, because I, I love non-violent communication and I think that non-violent communication provides us with a whole language. When we learn non-violent communication, it teaches us about ourselves, about our own needs, about our boundaries. So we connect with ourselves and we connect with others. And so I'm a big proponent of nonviolent communication and it is extremely effective with families, friends, at work. It's really magical. And also in relation to this idea that we're all going to die, um, I think that existentialists believe that the more aware we are of our own death, the more likely it is that we'll create a meaningful life. And so we take that as an opportunity, as an opportunity to connect with our values and what matters and what we want our life to stand for. Speaker 3 00:57:25 I don't think I could say it better than that. That was a phenomenal way to tie a bow around it. Uh, Dr. Abby, I just, I really appreciate you. You're brilliant. Really well, uh, communicated, and I can't thank you enough for sharing your time, talents, and treasures with us here. Thanks. Speaker 0 00:57:42 Thank you. It was my pleasure. Thanks for having me. Speaker 2 00:57:50 Well, that's it for team this week, and thanks for joining us. If you've enjoyed the content, remember to subscribe and to share this episode on the app that you're using right now. Your reviews and your comments, they really help us expand our reach as well as our perspectives. So if you have time, also drop us a note. Let us know how we're doing for tips and tools to clarify your parent project, simplify communication with your stakeholders, and verify the professionals that you choose. You can find us on YouTube, follow us on Instagram and Facebook. Thanks again for trusting us. Until our next episode, behold and be held. Speaker 11 00:58:22 Thank you for listening to this Parent Projects podcast production. To access our show notes, resources, or forums, join us on your favorite social media platform or go to parent projects.com. This show is for informational and educational purposes only. Before making any decisions consulted professional credential in your local area. This show is copyrighted by Family Media and Technology Group Incorporated and Parent Projects llc. Written permissions must be granted before syndication or rebroadcast.

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