https://youtubetranscript.com/?v=5CzqknLnC4M
Hello everyone. I’m frequently humbled and touched, motivated and encouraged when people contact me by email or texting or commenting or they greet me on the street and tell me that my work has been transformative for them. If this has been the case for you and also if you want to share it with other people, please consider supporting my work by joining my Patreon community. All financial support goes to the Vervecki Foundation where my team and I are diligently working to create the science, the practices, the teaching and the communities. If you want to participate in my work and many of you ask me that, how can I participate, how can I get involved, then this is the way to do it. The Vervecki Foundation is something that I’m creating with other people and I’m trying to create something as virtuously as I possibly can. No grifting, no setting myself up as a guru. I want to try and make something really work so that people can support, participate and find community by joining my Patreon. I hope you consider that this is a way in which you can make a difference and matter. Please consider joining my Patreon community at the link below. Thank you so very much for your time and attention. Welcome everyone to another Voices with Vervecki. I’m excited to have Peter Zablinski on again. This is his second time. Last time he was here we explored the interrelationships between what was happening in psychotherapy and some of my work and I found it really interesting and powerful. I was excited to hear, we were talking just before we turned on everything, I was excited to hear that Peter has another case to bring to us and again I’m going to allow him to present that and then we’ll enter into how does it interact with some of my work. Peter suggested there might be some important connections between what’s being disclosed in this case study and DLogos and therefore mental health and so I’m really looking forward to this. Welcome again Peter, could you just reintroduce yourself again briefly? Sure, so I work in Canada as a psychiatrist and I mostly focus on private practice where I get to do my dream job and I’m really blessed because I don’t think everybody ends up in their dream job but I can honestly say that I am there. I found it a bit difficult for me to kind of find my way or find where I fit within mainstream psychiatry within the hospital system and so during my training I found myself particularly attracted to psychotherapy because this is where I found perhaps that I could bring a little bit more creativity or a little bit more of my own authentic aspects of myself to the work and I’ve got nothing against science and I’ve got nothing against more of the institutionalized psychiatry which I think offers a lot of important value to people and to society but for whatever reason I found myself drawn to do more psychotherapy where I had more independence and sure enough when I graduated about 10 years ago now I’ve been doing full-time private practice and seeing individuals and couples in psychotherapy and I do a few other odds and ends but it’s been really fulfilling because I was the guy who growing up I’d go to a party and I’d kind of find one person and we’d get into the corner and just have a nice more connected more deeper conversation. I always enjoyed kind of these kinds of philosophical or deeper conversations and what I was thrilled I think about discovering psychotherapy is that here’s a place where a vocation where I can be paid quite generously for doing what I really enjoy and sure enough it seems to be healing so I’ve always found that quite fascinating and I suppose that’s a big part of what we’re going to be exploring today because as I’ve been following you and following your work I’ve found that you’ve provided a lot of the language for what I’ve intuitively felt is going on and a lot of the mainstream scientific paradigm or mainstream psychological paradigm didn’t seem to offer me something that was sort of congruent with what I experienced in my better sessions, sessions that felt very healing for my patients and sure enough I felt a bit healed myself and it was a little bit transgressive it’s like well wait a minute am I supposed to be feeling better? Am I supposed to be feeling like my own personal development is tied into this patient’s therapy? How can I get to build the government for this? I was almost like feeling like this is too good to be true so again that’s another way of saying why this is my dream job so there’s a little bit about me and a bit more about how come I feel like your work has been so meaningful and so exciting for me to follow and by the way I just want to say I’ve been watching after Socrates and I just got through episodes 10 A and B and I just want to congratulate you like I thought there was some really powerful moments that you captured there and I’m just really thrilled to be watching you and really excited to see what’s coming next. Well thank you and I owe a lot also to Chris Master Pietro and Guy Sengstock and Taylor Barrett they really made those episodes sing. They will be also back at later episodes. You’re coming up soon there’s a series within the series where Chris and I talk about Socrates and Kierkegaard dialogically so looking forward to that. You said that last time it was you know quite interesting isn’t right the word we bordered on being thrilling when you were sort of opening up like this sort of shared mystical experience you’d had with a patient and you’ve got another case you want to bring forward and then you and I will enter into a dialogue about it so please why don’t you move into that. Let me start by just really acknowledging and thanking my patients. Some of the feedback that I received from our previous video and from that conversation was that there was a bit of focus on me perhaps too much focus on me. It was a shared experience is how I framed it and yet I worry or some of the people who viewed it worried that there was a little bit too much focus on me and this was a sacred story you might say a really vulnerable horrific story of trauma that I shared about a patient and if me sharing my patient’s story here comes across as exploitative or if it’s a you know a matter of me joining John Verbeke on voices and getting clicks and getting likes that is not what this is about and I’d be really worried if that were the case. Really what I hope to to use this as is a forum to put forward these stories as beautiful as possible so that the patients who have agreed and given me consent and in fact have collaborated with me to produce the story and to bring it here today that they that that their story will give them more meaning their experiences will will possibly be able to put out into the world so that others can learn and so that others can benefit from that so I really just want to start with a deep gratitude for all my patients for everything that they’ve been through because my goal is not to use that for my own betterment but for if hopefully this doesn’t sound grandiose or naive but for the betterment of all or perhaps so that you and I can explore how we can you know make things better in the mental health system or you know for people out there in general who are dealing with the mental or with the meaning crisis. Well said. Thank you for saying that. Very well said. So today I’ll be telling you about a story about David and David is a white male who is raised in Canada about my age and who is currently married he has a child and he works for the government and we’ve been working in psychotherapy weekly for not quite 10 years but perhaps eight and again working as a psychiatrist in Canada just want to appreciate that I’ve had the privilege of engaging in these long-form conversations with people over many years about the deepest darkest details of their life so again so much appreciation for the position that I’m in and the system that that pays me to do this amazing work. So we’ve been going for eight years and initially he started off as a very disconnected person very disconnected from himself from the world from relationships and what I want to tell you about is so the first half of our conversation I’m imagining I’ll be giving you more or less sort of a background on him and please yeah and then as we go I’m going to tell you about a very powerful experience that unfolded over several months within the last one year where we had a very powerful connection and his healing seemed to be intertwined with my personal development or like I want to call it the development of my personal like my moral integrity actually and the simultaneity or the sort of the resonance between those two processes made it feel like one process so that to me is the point that I really want your help to draw out if you can help me with that in the second half of our conversation. Of course. So as I said my age came to me about eight years ago and interestingly enough he presented or a colleague referred him for CBT which you know if I can just make a quick cheap joke at the expense of CBT often CBT is conducted for 12 or 18 sessions or something like that and initially that was my intent but as it turns out that was not at all the modality that would have been appropriate for him and sessions and sessions started going by and I realized we’re not doing CBT. The first indications that I got that he’s somebody who needs something more something deeper was just how pleasant and wonderful it was to sit in the room with him. He’d kind of float into the room and kind of make himself settled in the couch and check in with me so sincerely but like it was a bit disarming because he’d be like how are you doc and I’m like wait a minute aren’t I supposed to be the one who’s asking you how you’re feeling but he was asking it and it seemed like it was so important to him that I’d be okay and I almost felt a little bit of a discomfort with how comfortable he was making me feel. There was something odd about that and it turned out that there was lots to explore there and as he told me about his early life like there was lots I mean some of the stuff it feels like he can’t make up so let me get into some of that. He grew up in a Christian family no longer identifies as Christian. His father had this sort of simmering anger and occasionally it would blow up. His father one time had a suicide crisis and he David recalls his father raging through the house and threatening to find a gun which apparently was in the house somewhere and commit suicide with it. So he remembers being really terrified about setting his father off or putting any sort of pressure on him making his needs known whatsoever. His father also had this tendency to download beliefs onto him and tell him this is the way it’s going to be this is what I want you to think. So he had this very sort of like a lot of incentives to kind of involute and manage his emotions manage his stress and he learned how to do so in really interesting ways. He did this thing called cocooning that he calls cocooning where he’d sit cross-legged over a vent in his room and put a blanket over his body and he basically sit there until he was kind of numb out or he would be out of touch with his body or out of touch with his stress. So that was meditation or if that was some sort of effective physiological control or if that was really just the beginning of some severe dissociation or dissociative tendencies that he learned early on and practiced thoroughly from an early age. The other thing to say about his early years, oh I should also mention yeah his sister had a severe anxiety disorder so he watched his parents dealing with her being hospitalized a couple times so again his MO in his youth was I’m not going to make my needs known I’m not going to have needs I don’t want to put anything more on my parents more than they already have on their plate. And then there’s his childhood best friend Richard and I’m using pseudonyms to disguise the identity of my patients of course. So Richard was a young man they would they would or a boy I suppose when they were childhood best friends and they’d lie on a hilltop and watch the clouds pass by and talk about their conception of the world and dream into their future together and they came up with some pretty odd ideas. Together they were they they wove together this understanding that that humans are really just machines we’re just we’re just wet robots more or less driven by selfish genes you know and we’re just sort of making our way around the world exploiting each other pushing each other around the social domain you know if you’ve got part and if you’ve got physics that are kind of deterministic particles pushing each other around well the social world is is really just an analogy of that where people are just deterministically putting force on each other manipulating each other using contrivances and justifications as Greg Henriquez would say using justification systems. Right. And then you have institutions the educational system for example and this is no better this is uh this is woven from the same corrupted fabric according to David and Richard that there’s nothing but human power and selfishness at play so all these institutions are corrupt the whole world is just a place where people are just trying to get stuff out of each other before their short time on this world is snuffed out world is snuffed out and so there you have it right quite a nihilistic viewpoint of what the world is um and so finally what they cooked up was a was a plan for Richard to murder David now turns out that Richard is a psychopath and he grew up to to be I think we we had this confirmed but essentially he they would torture each other uh but the way that I would frame it is that it seemed that Richard was usually the one who was more in the position of inflicting pain upon David and again David practiced dissociation he would they would cut each other they would choke each other things like this and he he was he had a remarkable capacity to not feel any pain um the plan was for Richard to murder David and the two of them kind of um envisioned this as the fulfillment of their greatest potential Richard would be the embodiment of the cosmic force of destruction and David would be the embodiment of the cosmic force of creation and of course destruction would win over creation and as Richard murdered David that would be the prelude to a to a further uh series of murders the plan was for Richard to essentially become a serial killer wow so not the usual uh childhood dreams that the two shared very disturbing very disturbing you know um but so interesting too because when I when I hear about his conception of reality I think there’s a lot of people who actually go around with a similar idea that that that it’s mostly determinism that’s going on and that any consciousness that we have is like an epiphenomenon and that our institutions are corrupt and in fact I hope that you know second half of our conversation we’ll talk a little bit about I don’t want to go so far as to say that our that the the institution of mental health is corrupt but like this is a bit of a sneak preview because what I’m hoping to talk about is how there is something about our mental health system that potentially blocks out or brackets out the possibility for doctor and patient to connect in a deeply connecting manner like like I wonder if the conditions for D logos are positively you know if the mental health system might create conditions that are hostile to D logos it’s a thought anyway so um well so the day that Richard sent an MSN message to David that I’m going to commit or I’m going to come over and murder you now this is when David had his first panic attack he um his parents noticed that they ended up calling the authorities Richard was taken away and that was essentially the last they really exchanged words um so his best friend was sort of whisked out of his life um his parents and he never really talked about it further he was close with Richard’s family but they never talked about it further it just sort of like there was a hard cut off there um and he was sent to counseling and he was told that you’re not okay and you need to talk about this um but he really felt like parents uh adults in his life did not understand him and this sort of cemented the the belief in his mind that I don’t go to I don’t go to people for emotional nurturance uh adults don’t understand me I need to figure things out for myself and keep my needs to myself right um as another example of this he he had a meeting with the superintendent around this time who informed him that Richard was actually going to be reintegrated back into the school system where David was attending David attempted to explain how he was convinced that he’d be murdered if this was were the case superintendent said it’s out of my hands you know the decision’s been made so so there you go so Richard ends up going back to the same school as David you know what they kept their distance from each other and sort of spotted each other from across the schoolyard but their friendship never resumed and eventually Richard was was as far as we can tell in a in a in a uh ended up in the legal system shortly thereafter where to take you from here so let me tell you about what our initial sessions were further with myself and David so he first as I was telling you was uh this incredibly like kind courteous polite almost to to to the nth degree and I kind of didn’t know how to how to how to deal with that but over time he started actually disclosing a little bit more as a as a some of the details of his childhood that I’m telling you now that it took it took a couple years before many of these details started coming out which essentially means I think that he was developing slowly developing comfort with putting his needs on me or you know allowing my feathers to be ruffled so first his priority was to look after my comfort at all costs but then he was allowing himself to experiment a little bit more with with self-revelation right right any questions so far so far this is enthralling keep going yeah good so um um all right oh uh the other thing I should mention is that he uh I don’t want to go back and forth in time too much but uh work was always a challenge for him as you can imagine he struggled with authority figures yeah yeah and having ambiguous expectations at work was very very stressful for him so he worked in the school system at uh at one point but he much preferred working um for a grocery store where his job was much more algorithmic and he knew exactly what he needed to do to do his job well but working in the school system he ended up actually working with troubled kids whose some of their parents were abusive he needed to be involved with cfs and as I was mentioning to you he had deep suspicions about any system any information so cfs child and family services he felt or what he saw according to his experience is that this was a bunch of uh white uh you know teachers or school staff who would be calling um these these this social workers and the children mostly indigenous would be um taken out of a chaotic home environment and placed into another chaotic you know foster care environment where where um according to David it seemed like much of the abuse just continued or took on another form so he felt like he was involved in a in a in a work um a workplace um you know his workplace expectations were essentially impossible to uh to satisfy so he found that work exceedingly difficult uh exceedingly stressful and he was on the edge of burnout for quite a while so this was a lot of the work that he and I were doing in some of our early years when he transitioned to a government job that where expectations were much more clear things really improved for him in terms of his job stress yeah so moving on uh he continued to give me more and more sort of dark material and if you you know hearing what his early childhood years were like you I’m sure you can imagine that there’s quite a lot of darkness that he had internalized so um one day he brought a dream to me in the dream he walks into his childhood home and goes into the basement and there he finds Richard’s body uh and it’s sort of like a movie like um if you press play and there’s this freeze frame of Richard’s body having just committed suicide uh having uh sustained a shotgun blast at close range and so I’m going to spare you the gory details but essentially his dream was was extremely disturbing extremely gruesome and and it’s it’s pregnant with with meaning if you think about uh if you think about sigman freud’s you know dream analysis um for example he would say that the home generally represents this is probably an oversimplification but the the home represents the self and here’s richards dead body or it’s sort of suspended halfway between death and life suspended in time in the in the basement of his childhood home and uh and children from the from the neighborhood collect into the house and they’re trying to come downstairs so david goes up and tries to shield them from this horrific sight so that’s the dream david also shared with me a uh fantasy and when i say fantasy i mean an image that came to him not necessarily correlated to intent to take action but my fear was that it would translate into action so what i mean by fantasy is simply uh an imaginary scenario and in the imaginary scenario he’s committing suicide in front of his family by this point he had a wife and a child and um you know uh it was time for me to start seeking out supervision to put it in a nutshell the the heaviness and the darkness of the material that he was presenting to me gave me this sort of inchoate kind of fear and long gone were the days where i was it was so comfortable and and he was so gentle on me in our early days and i was starting to feel like i was carrying this heaviness but really unclear what to do with it or how to help him with it because how do you talk somebody out of this how do you how you know what are the psychotherapeutic techniques to techniques for dealing with this you know i’m a reasonably uh well-trained expert you know but i have never read anything like this or perhaps it happened upon something like it but it’s like am i supposed to deal with this like me i can’t like hand them off to another sub specialist so i was sort of stuck with this guy and a bit terrified um and my um my supervisors and my you know i presented him as a case to some supervisory groups and um often people were kind of i don’t know if revulsed is the right word but at least anxious and maybe even a bit questioning of why are you seeing this guy so long term like you know if you do cbt with somebody you’re just in and out and you kind of help them and then you move on but here you are getting entangled in this interminable you know it’s been many years and it’s sort of disturbing and like is he going to attack you peter do you think you’re safe right so i was getting this kind of feedback from supervision and wasn’t feeling that that was extremely helpful so anyway i found myself a little bit alienated from my own social group from my own peer group and thrown in with with david that much more so but it felt like the stakes were rising and my lack of clarity but what to do was becoming more and more acute and worrisome but it was becoming existential i mean what i mean by that is i could read about the theory in textbooks but what was happening was really just between him and i and it was very real so i was needing to be present in the moment and just sort of live uh live the best i could and work with him um one really helpful thing though that did come from my supervisory experiences was the diagnostic impression that this might be schizoid personality disorder maybe not a well-known topic so perhaps i’ll just explain that a little bit but the root word of schizoid it really it resembles schizophrenia what those two conditions have in common is the conception of a schism yeah it’s um so a separation and this actually fits really well because he was so dissociated from his body so out of touch with reality and so out of so he felt so much exiled from from the social world um i didn’t fill that part in too much but he really struggled with with personal relationships and connecting with people and anything like an authentic manner so um so schizoid personality disorder seemed to really fit the bill and when i presented this to him this was this is now a year and a half ago so after about six or seven years of therapy i presented this diagnostic impression to him and he found it to be a revelation and uh when you when you taught about anagoga in in awakening from the meaning crisis i felt like i had very much saw him engage in an anagonic anagoga ascent as he learned about schizoid personality disorder from the textbooks so felt himself reflected in that developed a sense of inner coherence as that happened and he was better able to see into reality more clearly or read in more depth and in more detail about what schizoid personality disorder is and so he suddenly engaged in this pretty significant i want to say though um temporary improvement but there was like this flash of like improvement oh really yeah yeah he really seemed to um uh things seem to get a lot better really quickly and he described as a truth bell so this is a term that i think is uh uh really really uh helpful for david what a truth bell is is a sense of resonance that rises up from within the body like a bell ringing resonating and why truth because he gets the impression that what’s going on or what he’s learned or what he’s in touch with is real or true um but you know he’s always lived in such a way that his thoughts were very much um internal and reality was very much external so he’d sort of like see himself almost like a marionette and his mind could like pull the strings and force his body into action or if he’d learn information he’d kind of assess whether it correlates to his uh you know framework of understanding and so he’d have the sort of correspondence epistemology if you will but this felt like this was the beginning of a contact epistemology right right where he um could touch reality and he could feel reality resonating up through him and it was self-evidently true because of the bodily experience that credentialed it right not like a rational judgment right right you’re reacting to that yeah well i’m um yeah i’m uh right it’s good eh well yeah i mean it’s um it gives real content to the proposal of anagage right and how it can really uh potentially transform people so please continue good well i’m getting towards the end of part one um so that’s a that’s uh some background on david and some of our early years of work together and in part two uh we we end up having a pretty significant conflict and resolution uh reconciliation um where i hope that you and i might interact a little bit more here because things start getting a little bit more complex and interesting i think but uh okay so on to part two um david started explaining to me that he’s really struggling with his daughter gabby and he said you know i don’t know if i’ve explained to you enough how much rage i have for is her and suddenly uh getting a little nervous you know he had my attention but he’s like you know sometimes i feel myself dissociated watching myself take action uh but in a disembodied kind of way uh as if i have no control over myself uh and i said well you better tell me a little more so the example he gave me i won’t get into detail because i’m reluctant to kind of get into a discussion about uh um what constitutes harm harm or or where’s the threshold where risk of harm to a child um means that i as a professional and obligated to sort of trigger uh you know a report to child and family surfaces but this was very suddenly the horns of the dilemma that i found myself skewered upon oh um which was a terrifying moment yes you know at first i wanted to say ah you know i know david’s a good father i know he’s trying hard i’ve known him for six years um you know i’m continuing to engage in psychotherapy and sort of downplaying this that’s probably the way to go because you know there’s a positive ripple effect when you see person in psychotherapy their relationships improve they’re better able to be loving and caring for others around them so there was a part of me that just wanted to be faithful that what we’re doing is the good is the right stuff let’s not get into this too much right right but you know but i but i but i had a dilemma because as a um because i’m i’m uh you know registered with the college of physicians and surgeons of manitoba there’s certain professional expectations and in fact duties that um that constrained me so um so so i gathered a little bit more information because we need to find out if there’s harm coming to the child but essentially without getting to the detail uh he illustrated that there there might be and i’ll just sort of read it vaguely yeah um but i was left quite um concerned and i had a lot of questions um but i also felt like i was a little bit out of my specialty area because i work as a general adult psychiatrist so i don’t actually deal with too many scenarios where children are involved and dealing with cfs is part of the work so i called a colleague and my colleague honed in on this term harm he said what’s that you think that there may be harm well why don’t you just tell you what peter why don’t you just call cfs you know what they’ll probably do is they’ll come in they’ll do an assessment uh you’re you’re probably a bit too biased to really know what’s going on so is david so this objective third party will come in everything’s probably going to check out okay and they’re probably just going to put in place some parenting supports and that’s probably exactly what david needs and you know john it just sounded so tempting and it sounded so reasonable yeah i’ll just call them yeah i’ll just call them um but you know what what happened next maybe differentiates me from what many of my colleagues might have done um because instead of just calling i called david and i got on a zoom call with david and i said you know based on the information you gave me i think i should call and he said well doc you’ve ruined my life uh yeah i know all about cfs and i know that what you’ve just done is going to ruin my daughter’s life and it’s going to ruin my life so you know thanks a lot so he hangs up um suddenly and he’s never been angry at me before so like this was this was a calamitous development for our relationship and i was i was a little scared i don’t know exactly what i was scared of because i certainly wasn’t the one vulnerable here but like my heart rate was up and i’m like oh man this is uncomfortable what’s going on i’m doing a lot of talking here but i hope to yeah no that’s good that’s good keep going keep going well somehow um he agreed to continue to do sessions but he was understandably extremely angry extremely threatened and extremely upset that i would even suggest that i would call cfs and he challenged me at first he was saying you know what do you know about cfs he’s like i i received days and days of training in this stuff and i worked with this stuff in depth and at length what do you know about cfs and i said oh and i was just sort of honest and vulnerable with him i’m like uh you know i attended a few lectures about it i don’t recall too clearly so truth be told i called a colleague he’s like oh you talked to a colleague eh he’s like when i’ve reported people to cfs i’ve done so after extremely detailed questioning and you know um you know i’ve done so he was essentially accusing me of you know poor quality work or um you know being impulsive and um like the nature of our relationship had shifted seriously you know i was like wow uh we used to be really connected and things were really you know that that moment of anagoga you know it was mere months prior to uh to this moment and i was like wow i’m not going to do this because here i am feeling the need to call cfs but i’ve kind of asked for his permission which was an awkward thing to do uh but then there’s what i would generally say is the case for me which is that i’ve got a deep faith that um engaging in psychotherapy in this sort of human existential kind of open way of thinking about the future and i’m not sure that i’m going to be able to do that because i’ve been thinking about it for a long time but i’ve been thinking about it for a long is ultimately probably in his best interest and in his daughter’s best interest so like what have i done if i do call cfs at this point i thought to myself i will sever the relationship you know completely uh in a way that cannot be recovered um so but i wasn’t i didn’t want to be too quick to kind of decide oh no this rule doesn’t apply to me right in fact i had a colleague who recommended i call it’s like if i choose if i decide that i’m above the law in this case what does that make me you know so i i had to be like really thoughtful about this um yeah so this was really tricky and um i have a spiritual practice that i engage in in the mornings tends to involve yoga or meditation but around this time i started taking up prayer uh which is something that i’ve not been super comfortable with in the past i i don’t tend to enjoy um petitioning you know a divinity for favors help me you know help me with this help me with that um but for whatever reason you know the lord make me an instrument of your peace that prayer came to me and i found it really powerful to recite that prayer and to to uh sort of ground myself in it around this time and the last few lines of that prayer involve uh they go for it is in giving that we receive it is in pardoning that we are pardoned and it isn’t dying that we are born to eternal life somehow those lines really grabbed me um i found there to be something really powerful about that and i realized as i was reflecting that i needed to actually forgive david and i think he needed to forgive me too and i think it needed to be a bi-directional simultaneous thing because why did i need to forgive him because because i was scared of him because he was angry at me because i was doing my best and i thought that i was sort of staying within my lanes and following my procedure as best i could while remaining attuned to him i was doing the best i could but here he was giving me so much flak and pushing me away and making me feel really insecure in my professional identity and you know dealt my dealt my uh my intentions so i felt like i actually needed to kind of put down my defensiveness and forgive him in order to continue to work with him at this point and certainly he needed to forgive me because he basically saw me as richard he basically saw me as richard i think yeah yeah as about to kill him as about to kill his family like i was on the on the cusp of just executing him that’s really how he saw it um he saw me as the superintendent i said it’s out the the situation is out of my hands uh he he’s been exposed to this situation way too much throughout his life and he had like an allergic reaction to this sort of power this sort of any any sense of like a top down unilateral action that was put on him or like an interpersonal like expectation that i this is what’s going to happen to you he would have like an allergic reaction to that based on his past experiences yeah yeah of course so this was really interesting because um what it enabled us to start to do as we miraculously continued our sessions and continued to reflect um it enabled us to sort of parse out between who i am as a person in my wholeness if you will versus my psychiatric role which maybe we can call that a fragment of my identity but we were able to actually very clearly distinguish between those two and um you know when i was having some confusion about my role it was because i wasn’t sure where is my where’s the center of my being is it in my psychiatric role or is it in my personal human connection with this man um right and so i’d have sort of this confusion about where my allegiances lie if you will right and uh thankfully he and i were able to to get into a lot of depth about this um he actually asked me to teach him how to forgive and again this was uh um this was spurred on by his uh by his wife gloria who initially encouraged him to seek therapy in the first place but here she was encouraging him now to continue to maintain this relationship with this therapist that he’s been in a relationship with for seven years don’t just drop it and uh learning to forgive could be a really important uh really helpful thing yeah so so you know uh uh really good on david to continue to expose himself to this uh very challenging time where he was very much threatened by me but allowing not not just not allowing himself to just face that fear but to even express anger towards me so it was a part of me that was really proud of him it’s like you’ve never been able to do this for years like good for you you’re standing up to me you know part of me was like really proud of him while at the same time i was empowering and fear a little bit and kind of you know feeling anxious about how i was uh how i was doing but it was an interesting moment because um again this differentiates me from what i think many of my colleagues would do because i was kind of looking up to him at some point i was like he has the ability to forgive me like he has the power in some way in that respect hey and usually when we think about the medical model we think of an active doctor a passive patient and the treatment kind of ushers downhill towards the patient so it’s strange that the patient had the had the upper hand of course we’re moving more into an era where there’s more patient-centered care but i hear a lot of lip service about that and i don’t actually see that taking place very much um so i think this was yeah this was me really trying to to treat him as a human and i felt that we were leaving the roles of doctor and patient behind and we were getting more into an existential mode of therapy or it’s even kind of wrong to call it therapy at this point this was him and i continuing in the structure that had been set up through the system through our therapy but we were but i felt like we were inhabiting it or seeking to inhabit this space in more of a whole or human manner right do you have any thoughts or questions here no i just i want i’m wondering um yeah i’m wondering what’s happening between the two of you like what’s the nature of the discourse between you then like it’s shifting off of therapy into something else like is it becoming more like properly dialogical like what’s going on in the in in the interaction yeah yeah yeah sure let me tell you a bit more about how he was seeing me at this time and some of the feedback he was giving me so um so he was he was saying that he was looking to uh to work on forgiveness and um but he was afraid because he said that in the past it’s been too common all too common for him to be told what to do or what role to adopt and therefore he’d become the slave and the other would become the master you know talking with his wife gloria she had criticized him for too often just forgiving and forgetting uh just being really way too quick to give people grace um but in my case he was asking me i thought in a very mature manner he’s like you know there’s a part of me that wants to forgive you but um i know that if i did that it would be my usual way of forgiving right and it would be façade you know it would be just too much like forgive and forget like nothing happened right and there’s another part of me he was able to uh insightfully say that it is not about to forgive you whatsoever that’s quite angry at you and still is is interested in maybe getting up and just walking out and not continuing this therapy at all um so so here he was expressing his anger and in fact reflecting about it um and he was asking me to forgive him and i realized that this was such a strange situation for me to be in because i’m simultaneously the one who caused him the harm or i was about to cause him harm um but at the same time he’s asking me to forgive him it’s like this must be like you know dante’s inferno where the this the spoiler at the end of uh the inferno part of of the divine comedy is that uh virgil and dante get out of hell by traversing the body of the devil himself and i felt very much like david was was doing that that he was actually going right into the heart of darkness coming right to the person who was on the cusp of hurting him and asking you please teach me how to forgive you and i realized what a what a strange position that i that i find myself in yeah so i was trying to share with him about that i was trying to self-disclose and i was saying for example you know i don’t think it’s up to me to tell you to forgive me and in fact if i told you to forgive then that would we be playing into some of your old dynamics so i think that i am worthy of forgiveness so i hope that i am but ultimately it’s up to you and all i can do is just show you that i’m still here i’m still willing to talk things through and um you know but i but i realized that at this point i hadn’t yet told him that i’m not going to call cfs i think it was still a part of me that was hanging on to that card um and i thought to myself boy um should i should i tell him that i won’t call because i don’t know that i want to promise that if there’s additional information that’s revealed maybe at some point i will need to right so i didn’t want to reassure him don’t worry i’m not going to do that but how do i ask how do i teach him about forgiveness if i if i don’t tell him that it’s going to be okay and again i i realized that i think i needed to lead with forgiveness i needed to to really just um sink into vulnerability with him um i just want to think for a moment about where to where to go next just in the interest of time okay um yeah so um yeah forgiveness it was really tricky uh so as i was saying i was uh doing praying in the morning and uh doing meditation and uh really uh digging deep and trying to figure out how do i how do i lead him uh while being the one who caused him so much trouble well eventually we got to a point where um i started to realize that the psychiatrist and peter were these two different parts that he was seeing the psychiatrist is the one who’s unforgivable and peter is the one who can be maybe too easily forgiven and i realized that i was actually seeing myself more clearly but through his eyes empathically through his eyes and i think that simultaneously he was seeing himself more clearly through my eyes right right like in other words he was able to see that despite the fact he’s putting his needs on me and causing me trouble and expressing anger towards me i’m still there with him so there’s something called care that might involve tolerating a person even when they’re giving you trouble this was this was the beginning of him and i sort of simultaneously kind of interacting but in a way where i could see myself through him and he could see himself through me and i feel like something dialogical was starting to happen here because we were getting somewhere that neither of us could have gotten to on our own sounds like it yes um and in fact i did a lot of reflecting about what is this medical system that i’m a part of that is so full of principles and and rules and you know algorithms and if i get this information then i’m triggered to sort of do this action and this top-down unilateral action can can usher forth through me as a as a cog in a machine and i suddenly he helped me really reflect that it’s like boy i’m really part of this big machine that can be very decontextualizing by that what i mean is man doesn’t seven years matter like doesn’t seven years of therapy with this guy tell you something and isn’t it possible that there’s some circumstances where a blanket policy ought not apply of course that i think so so and and this might feel a bit controversial or scandalous to say this in the fate if i’m talking to the college or if i’m talking to my various you know licensing bodies like you don’t talk this way to your superiors but but this is what i think is powerful about the story i realize that my priority is to him and uh and to his daughter of course but to the well-being of the person not just following the rules this is i think a lot of trouble has has happened in the past when people blindly follow the rules without reflecting about you know what what is the outcome that’s popping out of the end of my action yeah so he could see that um but you know there was a while though where he was realizing that we were just too intellectualized we were talking about forgiveness in a little bit too much of a content-focused manner and one day he just sort of hit me a little bit more personally and he said you know i think i need you to feel bad and i was taken aback and i said uh you know let me reflect on that one for a bit but you know i can i can tell you what i think the structure of forgiveness might be or the importance of uh how forgiveness is something that happens rather than than an action i can talk about the the hierarchy of you know this forgiveness or neither forgiving nor forgetting then there’s forgiving and forgetting but then like you know we can talk about forgiveness but not forgetting so there’s like a kind of a structure that i that i could talk about but ultimately he wanted to kind of get past all the intellectualization and he said doc i think i just need you to feel bad and i was kind of again thrilled by his insightfulness but also a little bit worried about it because uh you know it’s pretty uncomfortable anyway i found myself doing an imaginal exercise one day i was at the cabin blessed to have a cabin that i have access to with my in-laws and my mother-in-law picked up my child i have a two-year-old and she walked through the cabin with him and walked out the door and i watched as his head was bobbing up and down through the screen door and i was imagining this was cfs apprehending my child i was imagining my child being walked out of my life and um you know it’s it it kind of brings up an emotion even as i think about it or as i bring it up here um but like this was me like putting myself in i think in david’s shoes and really letting myself experience from a perspectively what the threat is what it really means for a child to be taken out of your life and are they going to know me what’s going to happen to them are they going to grow up okay and it breaks my heart to think about how often you know uh people’s family structures are disrupted and children have lives that are that are not as um you know the quality that i’m able to offer my children so i so i had that experience and and i brought this back to david and i said to him this is what i went through uh and in fact as i was telling him about this experience a bit of a tear was welling up in my eye and he saw it and he said there that’s it that’s what i needed and he said thank you very much he said that’s exactly what i needed so i think in that moment um like forgiveness was seated in his heart and i think that he could see that perhaps i was forgivable um prior to that moment i had told him i’m you know you decide whether i’m forgivable or not forgiveness is not something that i’m going to tell you to do but because in that moment i think what he realized was that intuitively spontaneously within him it was revealed to him that perhaps i can be forgiven now what does it mean for him to forgive me here’s the feedback that he gave me prior to that he had seen me categorically like he had sort of seen me as either the psychiatrist who was not forgivable whatsoever or like a fragment or something like that but here he suddenly saw that i’m a whole human he suddenly saw that he could relate to me in this this open way um without without me being kind of associated with a simple feeling of approach or avoid without me having uh without having a whole host of expectations that are attached to how i’m coming across to him he suddenly i think was able to see me as a whole human which means that um there was an openness there was the possibility of spontaneity there was the possibility for us to to to navigate and do things in a customized way in a way where care means that i’m attuned to you not that that i’m using my knowledge of you to control you or to or to plant it cause you harm so that’s that’s sort of um we’re getting to the end here um i mean the last part of the story just to put the cherry on top is he watched the video of you and i talking about another case and when he watched that video he was bowled over so he was actually literally in his kitchen fixing himself a sandwich or something and he literally fell to the floor and it hit him like a pile of bricks he’s like oh my gosh dr chaplinsky is a person who is caring and invested in his patients and that’s available to me and i’ve been rejecting it up till this up till now so it was at that moment that he realized that you know forgiveness is possible and i think forgiveness really hit him like literally um later and this is the final piece of my presentation to you today but later i was telling him you know david uh it feels like we had been through quite a conflict and and we’ve really worked our way through a powerful reconciliatory process uh and i have to admit that like it’s been a pleasure and an honor to to to work with you through all of this um but i also have to admit that there’s been times where my ego perhaps or the role that i was tempted to play got in the way of of our work and that literally may have caused you harm and his feedback to me was doc don’t worry about it uh don’t be too hard on your ego i need that too i need the whole of you ego and all so that was a moment where i felt like he he granted me such such a beautiful i i don’t know what to call it grace or forgiveness but uh the connection between him and i at that moment felt like it transcended the like the simple definition of doctor patient relationship um i felt like i learned a lot about my moral integrity but where there’s plate there’s ways where the system kind of constrains me to take action and i’m willing to abdicate my responsibility or turn a blind eye to what the outcome might be but he helped me reflect about that gathering my moral integrity i think and um the final thing i’ll say is that his mental health improved substantially after this he felt never more like himself he still struggles socially but he has more plans to interact more with people socially he has plans to rise the ranks of his job and to become more productive that way his relationship with his daughter is extremely connected and powerful at this point i didn’t talk much about his relationship with his wife or their their sexual problems but there were significant problems there and that’s improved uh immeasurably so again it feels like we’re now again in another um anagogic process both of us both of us in an interconnected way and i feel like what’s happened for him is this really robust healing experience that is intrinsically connected with my wholeness experience and and the interweaving of the two for me is where where the action is the simultaneity of those two is what i think uh is that’s what i think i mean when i want to say that dia logos can be healing for sure wow that was that was really wonderful yeah i’m so i’m first a couple sort of explica question requests for explication when when david was recognizing you as a whole being what was going on reciprocally in him i think that his schism was closing up yeah yeah that’s what i think yeah because i think he would adopt part object relations without getting into it in too much detail i think there was like a part of him that would see me as a part and there’d be a simple feeling of affect valence that would unite us so if i’m a good guy then i’m forgivable and he and he’s just this forgiving kind of pathetic creature but if i’m bad but i’m not forgivable and he’s this angry kind of like he’s this monster right and so he would fragment just alongside the way that he would see the fault lines fragment within me so as he saw my wholeness gather then i think he also developed greater integrity within himself simultaneously yeah that’s what i that’s what that’s what my sense was so i see that you know um there’s a differentiation process you sort of and then he allows you to integrate complexify in fact in some way and that that allows him to also i mean so he these things get first of all differentiated so they’re not confounded and then they get reintegrated in a clear way and then the two of you were sort of resonating that and so it’s interesting he has sort of a preliminary anagogy about himself but with sort of just the the abstract knowledge and then that sort of i think sounds like it sort of primes him um and of course there was there needed to be an event that moved it um into interpersonal as opposed to uh just sort of um i don’t know what to call it cognitive anagogy with the world or something like that or with himself yeah can i can i suggest anagogy with himself and the world but then between what happened between him and i it might have been something like agape i don’t know i was gonna say yeah yeah i think a gothic relationship developed between him and i love again a taboo word but i feel like i was interested in how am i relevant to him and he i think was realizing how i am relevant to him how he can be relevant to me yes exactly i think that’s great and that’s what i wanted to i mean i’m glad you said that because it shifts into this interpersonal anagogy but the anagogy is agapic and it’s healing and it’s person making and you both get caught up in that you become uh i mean if a person is an integrated moral agent you’re becoming more of a person i don’t mean any insult there right and but in the same thing for him he’s also like you’re you’re you’re doing you’re doing this and i was also intrigued about how you know this imaginal thing you did actually helps afford you uh getting that resonance going it’s starting to establish that preliminary affinity there’s a lot to be learned um so i mean my first response is i just see a i mean i hope it’s not just projected but you reached out to me too i see a lot of the stuff about anagogy the imaginal and agape at work in this process i’m wondering what’s happening also with you when you were praying is this an imaginal thing for you or do um was that opening up and becoming dialogical like what was going on there in the prayer and um did it was there any sense that the praying afforded you getting into this relationship with david oh yeah no question that that’s a great question um because i saw that what i was doing was self-sacrificial in a way again i think a lot of my professional kind of um leanings would get me to stay in the power position and not not allow any vulnerability to be present but what this prayer i think is so helpful in in in establishing is that there’s a deeper power than just grabbing power you can tap into a deeper power if you lead with forgiveness that makes you forgivable right and the last line is it isn’t dying that you were born to eternal life so what i what that helped me give me the courage to do was to expose myself to him in a vulnerable way where where it’s like you know what i screwed up like i made a mistake and i went too far i’m sorry you know um i was tempted to do something that could have caused you harm and i and i deeply apologize for that you don’t hear doctors saying that kind of thing too much i’m not trying to throw my profession under the bus but um i i do think that in fact some of the colleagues that i presented this case to have wondered if i’m too self-effacing if i’ve been a little bit just throwing myself throwing myself under the bus but this prayer i think helped me do so in a balanced manner where i was able to engage in self-sacrificial love not just by you know going out mindlessly immolating myself in a field but in a productive way where i put my ego and my role as a psychiatrist in service of his betterment so therefore like lowering lowering my status to a position and ordering it properly i think to help uh in service of his healing whereas there was the risk that my role as a psychiatrist because it there tends to be a lot of power at play in that could have literally caused him an iatrogenic event you know the allergic reaction where he’d react against the power so sorry that’s a little bit wordy but i think that helped me ground into that let me let me try in my own words and see if i’m getting it um there’s a sense in which what the prayer is doing imaginably is it’s putting you it’s putting you prospectively present to a power greater than you and this incident you talked about vulnerability but it’s it sounds more like humility to me there’s a humility that comes in and a recognition of of something greater than yourself needs to be at work in this situation and so you reorient that way because of that and then that um that opens you up to possibilities that were otherwise on unavailable to you is that is that a good way of putting it absolutely grant that i may not so much seek to be consoled as to console to be understood as to understand to be loved as to love grounding myself in this prayer really just offered me a lot of resource to give yes uh but but like i think that’s that is humility but it’s not like oh i’m so humble it’s like no no that’s not what you’re enacting humility right yeah humility is a proper proportioning to uh uh to reality um so do you still carry that sense of that not as an idea but a sense of presence of that larger um i don’t know what metaphor you use that but the greater power uh do you still that do you still feel tethered to that um is it still present in you or was it only in this case or has it is it percolated out into your life in general uh the previous case i presented to you john launched me on an adventure where it’s like oh my gosh i can tap into this greater power to do yeah yes in my mental health work oh the case i presented with you today with david feels like it steps along that journey and i feel like i’m deepening into this and like you know my meditation practice i’m falling off the wagon and getting back on and i’m a father of two children and i’ve got a third of the way so it’s like getting up in the morning and and it’s hard to drink enough coffee to make that meditation happen on a regular basis and with prayer i’m kind of on and off but like i would say that in general i would say that i’m quite devoted and if i do fall off the wagon i get back on it so in general um i want to say that i am deepening it more and more into this sense and it’s hard to put into words exactly what it is yeah but you know as um you know i’m raised catholic and i have significant christian kind of leanings it’s in my bones so it’s easy for me to say that my relationship with god i’ll put it in those words uh is is deepening um over time but you know i really appreciate eastern spirituality yoga i have i’m not trying to pin you to anything that’s not that’s not my concern my concern is i want to understand the what’s happening you know your phenomenology your cognition what’s going on for you and i understand what you mean when you say it’s in your bones and so that’s the language that’s indispensable for you just articulate and keep this in mind for yourself i get that yeah art but i’m just wondering because it sounds to me um that there’s a ritual element entering into the therapy therapy um so a ritual is a practice that goes broadly and deeply right into your life and levels of your psyche and it sounds like there’s certain cases where it’s taking on this ritual component yeah let me talk about yoga for a sec because i think that’s been very helpful too in yoga i see this resonance between focal awareness and allowing um a single instruction to to to uh like a hologram like extend its way throughout the entire practice so a teacher has told me for example when you inhale or when you exhale express your the your big toe into the ground but when i when i’m putting my focus there i’m also aware of my arm stretched into opposite direction yeah and i’m noticing at the same time this attention here and this distance and pulling there and so in yoga practice i’m constantly kind of allowing myself to exist between these extremes and feel the pull in opposite ways but maintaining attunement on the breath so this is how i feel like that ritualistic element helps me maintain attunement on david yes and here’s all this like distraction and all these pulls and pushes and discomfort and pain and alarm but it’s like how but the maintaining the attunement and and and being devoutly focused on like like it’s like prayer actually doing therapy i think yes i’m maintaining my priority on this guy and wow is it can you imagine that the mental health system itself can interfere with that so it’s like that was a very tough distraction to to keep out of the way and to maintain my attunement to him and i’d say that ritual has really helped me um yeah yeah maintain that as a devotion right i can see that that’s powerful that’s very powerful yeah yeah that’s yeah it’s an embodied imaginal thing that then is transferring and this in these powerful ways for you that’s very powerful um well so we’re almost out of time but what what do you think what do you think would need to happen to allow psychiatry or at least the psychotherapeutic dimension of psychiatry to properly appreciate and proportionally appropriate this into it into itself that’s a huge question and i have no idea how to answer it thoroughly but i was losing some sleep last night in anticipation of this conversation and can i share with you what came to me in the middle of the night yes please again i watched episode 10 a and b where you did that amazing um example of uh dialectic and the dialogos with the proposer the listener the herald yes scribe and the herald yeah we’ve changed the name to the herald to the vibe describing the vibe uh describing the vibe yeah so just let me offer this uh i imagined i imagined that dialectic and to dialogos be carried out along the theme of what is the mental health system designed to do virtuously in the best sense what is it there for what is the virtue that the mental health system is supposed to do but then there’s a fifth role and the fifth role is the iconoclast right right i’ve been reading ivan illic recently uh i’m not sure if you’re familiar but but he he was an iconoclast who was who was a catholic priest but very critical or very cautious about how the corruption of the best is the worst so he saw that christianity which he was committed to pass a shadow and and there was a great evil that is possible when a great good is is brought into the world yes so the iconoclast would be the fifth role where there’s a reflection that’s done of here’s the best that the mental health system can offer and and we can induce that out of each other but the iconoclast will point out what is the nature of an institutionalized bureaucratized system and how is how does it for forbid uh certain virtues from expressing themselves right right i just think that more attention needs to be paid to that about how the the nature of a big system can actually bracket out the humanity of the humans involved yes when there’s too many algorithms too many rules too many regulations too much bureaucracy this is a huge problem everyone’s getting choked out by bureaucracy and everybody hates it i don’t know who’s enjoying themselves these days but nobody seems to know how to stem the tide but what we need is more room for the humans the site what is psychiatry greg henriquez goes on about this there’s a there’s a conceptual corruption in the in the field of psychology no one knows what psychology is yes no one knows what psychiatry is do we know what the psyche is this thing that we supposedly are doing medicine on and trying to heal we need to i feel like we need to bring something like a fellowship or a dialectic into d logos into the heart of the structure of psychiatry and that’s my grandiose vision that pops into my mind at 3 a.m. no i mean i i thank you for sharing that i think the way things are ramping up in our society negatively and the threats i think i don’t think that’s too grand of a vision we very much i would just recorded a video with with guys sandstock christopher mastiff peatro and karenna and about the circling into dialogous workshops and the vision about if we can get this kind of stuff into like education and government and bureaucracies that are supposed to be in the service of human beings yes in one sense it’s grandiose but another sense it’s there’s no viable alternative and so we i think we need to uh really try to not impose but don’t try to propose and get people to appreciate uh the need for this in a way so that they willingly adopted um i think that that’s that’s the answer and i did a dialectic into dialogous workshop at the beginning of february with you and the group and a big plug to everybody listening like it was fantastic can’t say can’t speak highly enough about it really loved it um and um i don’t think it would be like here’s what i would say i think we’re in a famine there’s a wisdom famine as you say and this thing can really catch and i think that’s all we can rely on it’s it’s the it’s the uh it’s it’s uh uh the herman eunuch of beauty you know if this shuts out like a truth belt for people they’ll just know it’ll be credentialed by their own resonance like this is what i need this is beautiful this is wonderful and when people see that like it’s just going to spread in a way that you can’t even control or that you can’t take credit for even uh but it’s good and people will see that and it’s my intention to help you spread that as much as i can so i feel like that’s a big part of what what brought me here uh i’m trying to encourage you in your work because i’m so i’m so thankful for it and i’m also really pleased to benefit from it and i hope to help uh in any way i can thank you peter i think that’s a really good place to end our time together fantastic