368: A Strange Paradox

A Strange Paradox--

The Incredible Impact of Compassion + Accountability

Featuring Adam Holman, LCSW

We want to remind our listeners about the upcoming Mexico City TEAM intensive from November 6 – 9, 2023, organized by Level 5 TEAM therapist, Victoria Chicural, and Level 4 TEAM therapist Silvina Bucci. The Intensive will be held in a beautiful part of Mexico City (Sante Fe) at the Hotel Camino Real. There will be lots of opportunities to practice every aspect of TEAM-CBT along with many excellent, internationally renown TEAM-CBT trainers.

I (David) will do a keynote address on Day 1,  On Day 2 Rhonda and I will do a live TEAM demonstration with a volunteer attending the conference. On Day 3 everyone will have the opportunity to practice the TEAM model from start to finish.  And on Day 4 Leigh Harrington and I will answer questions about the TEAM treatment model.

This promises to be an Intensive not to be missed!  To learn more and register, please visit their website: https://teamcbt.mx,

Today we are joined by Adam Holman, LCSW, whose podcast 288 on April 22, 2022 was a big hit. He shared his strategies for working with kids with video game addictions, and his no-nonsense, patient-focused approach made good sense and resonated with many of our podcast fans.

Today, he talks about what he calls a “Strange Paradox,” which is:

If you treat people like they’re fragile, they act and behave like someone who’s fragile. If, in contrast, you hold them accountable, with compassion, they will discover their strengths.

He began by commenting on hearing David talk about how therapists often get hypnotized by our clients without realizing it. When that happens, we buy into the clients’ beliefs that they’re helpless and hopeless. And, I (David) might add, worthless.

When that happens, we start to treat them as if the beliefs are true, further proving to them that they’re helpless, hopeless, and worthless. This became incredibly evident after Adam had a unusual encounter with a child  while on a hike with his partner near Prescott, Arizona.

The child was shrieking in terror at the top of his lungs. As they got approached the child, they saw that he was paralyzed by fear of a swarm of flies near his head. They also realized that his family had already walked past, and were about 45-seconds down the trail, hoping that he would become brave and walk through the flies and catch up with them.  But that clearly wasn’t happening.

Adam walked past the flies and stood next to him before saying, “I know you’re scared, that’s okay. I just walked past the flies and it’s safe. You can walk through.” Then, the boy immediately stopped crying and walked past the flies on his own.

The boy willingly chose to walk past them the moment that his suffering was acknowledged. He heard the message that there was nothing wrong with him or the fear that he was feeling.

In other words, the acknowledgement of his fear send the message: “It IS scary, and you can do it. You’re capable of doing scary things.”

And he immediately found his courage and became capable.

Adam continued:

My partner and I began thinking about the suffering that the boy had experienced in that moment, and how little he needed in order to become strong and courageous. We felt close to the boy, and talked about our own suffering, and our parents’ suffering that was passed on to us.

We cried for three hours that day and began to think about all the suffering in the world. It felt incredibly relieving, I felt so connected to all of the people in my life, and naturally began thinking more about the suffering experienced by my clients.

I realized that with many of them, I’ve just given in to listening without holding them accountable. I had been standing next to them, but I was treating them as if they could not walk past the flies.  . . . I loved your podcast on stories from the 60’s, especially your experience when you were crying for hours when driving through the Nevada desert.

All the same kinds of feelings bubbled up in me. I saw that his parents were just doing what they’d learned to do; to try to discourage the uncomfortable feelings by walking away from them. Unknowingly, this was sending the message that he isn’t strong enough and that he is weak for feeling so fearful.

Like many of us, they had learned that it’s not okay to suffer, that experiencing feelings like fear is not acceptable. This, ironically triggers more suffering because you learn to avoid and fear your negative feelings, and you don’t gain the courage to sit with your painful feelings and the feelings of others You can say (to the little boy), it’s okay that you’re suffering and afraid, and that’s not a problem.

I related to that boy. My dad was very critical, and would berate me for feeling anything other than happiness. Feelings like fear or sadness were signs of weakness, and eventually I stopped realizing that I was even feeling them.

Then my feelings came out in the form of a lot of anxiety that I was avoiding, and the avoidance of that anxiety didn’t allow me the opportunity to see that I had strengths.

Rhonda, Adam and David discussed the role of tears in healing. Rhonda mentioned the immense value of exposure in recovery from anxiety, as opposed to avoidance, and the importance of making her patients accountable.

David mentioned that our field is based on the idea that your negative feelings, like depression, or fear, show that there’s something “wrong” with you, like a “mental disorder,” so you need to be fixed, by some pill, or some new school of psychotherapy. But if you’re trying to “fix” someone, you’re giving them the message that they’re “broken.”

TEAM, in contrast, is based on the opposite idea, that our negative thoughts and feelings will always be the expression of what’s right with us, and not what’s wrong with us. “Getting this,” which may not be easy at first, can paradoxically open the door to rapid change, just as we saw with the frightened boy that Adam encountered on the hike.

Finally, Adam discussed how he ended up applying what he realized to a client he had been working with. The client was diagnosed with “Treatment-Resistant OCD,” and had years of therapy and medication that had not brought him to much relief. Adam had been working with him for a few months and they were able to recognize some outcome resistance.

Outcome resistance is when the client has one or many good reasons not to give up their symptoms. Specifically, this client had an intense fear of rejection, and was making sure that his appearance was absolutely perfect in order to prevent rejection.

Adam discusses sadness and frustration over the term “Treatment Resistant”, noting that it often keeps people feeling more stuck. Once the client saw this, he decided that they wanted to go forward and let go of his compulsions and agreed to include exposure in his treatment. This would mean that he would have to let his appearance be imperfect, and allow himself to feel anxious. Thinking back on the treatment, Adam realized that he had been providing listening and support without making the patient accountable and insisting on exposure.

The next session, Adam recognized that just like the boy, he needed to treat his client with compassion and accountability. Adam re-invited the client to address the OCD and offered the gentle ultimatum, reminding the client that in order to go forward, we’re going to have to do exposure.

The client agreed, then started to hesitate as a result of his fear when he realized that the exposure would be taking place right at that moment. Adam messed up his own hair and invited the client to do it along with him.

Adam reiterated that getting over it requires the use of exposure. The client then messed up his hair, and expressed feeling anxious for a few minutes before erupting into laughter. Then the client proceeded with his day without fixing his hair. He also decided to do more exposure on his own after session without giving into the anxiety.

When he returned for the next session, he explained that his compulsions were gone for the first time in his life. The moment he was treated with compassion and accountability, he also found the strength to recover.

So, what’s the bottom line? When working with your own fears, or the fears of your clients or friends, two things are required. First, respect and compassion can help you accept your fear without feeling broken, or ashamed, or less than. And second accountability can give you the courage to confront your fears for the first time, and make the magical discovery that the monster really had no teeth!

This is one form of enlightenment, going back 2500 years to the teachings of the Buddha on the “Great Death” of the “Self.”

Thanks for listening today!

Adam, Rhonda, and David