Psychiatry & Psychotherapy Podcast - The Unconscious

Episode Date: February 22, 2020

This week I interviewed Dr. Joel Weinberger and Dr. Valentina Stoycheva who recently published the book "The Unconscious: Theory, Research, and Clinical Implications ." We discussed their book and even their unconscious reasons for writing a thrilling, deep dive into the unconscious. This book was graduate level in detail, deep, thoughtful, articulate, sometimes very theoretical, and definitely worthy of reading and contemplating. By listening to this episode, you can earn 0.75 Psychiatry CME Credits. Link to blog. Link to YouTube video.

Hello and welcome to the Psychiatry and Psychotherapy Podcast. I'm here to talk about getting rid of burnout, increasing job satisfaction, and feeling like an expert in what you do. One thing that created a lot of burnout and angst for me was trying to get continued medical education right at the last minute. So why not join the CME membership and do CMEE while listening to this podcast? Go to Psychiatrypodcast.com, sign up, sign in, take the test, and the certification is email to you in seconds. Welcome back to the podcast. I am here with Dr. Joel Weinberger and Dr. Valentina Stoyceva. And they have recently written a book together called The Unconscious, which is a pretty deep dive into the history of the unconscious and all of the modern scientific studies on the unconscious.

and then kind of bridges into that into a application of how to apply it into more of a psychotherapy. So it is fantastic having you guys on, and I'm excited for this conversation. Hi, how are you? Thank you for having us. So I'd like to hear first, like the elevator pitch. Like, let's say you're in the elevator and you're just, someone has asked you, like, oh, you're written a book. What is your book about? Like, what would you, what would you say? everything you ever wanted to know about the unconscious from philosophy to history to old research and new research and psychotherapeutic implications nice so what what i think would be helpful is

maybe define the unconscious first how do you define it yeah and that's so simple the way i would define the unconscious is pretty much most of what's going on inside your head most of the time which would be stuff, well, technically, obviously you're not aware of it or you're not aware of its significance and implications. It's pretty much everything we do other than when we're focused and actively thinking about something. Okay. So I have to ask, what is your unconscious reasons for working on the unconscious? I'll tell you my conscious reasons. When I first entered grad school, you know, back during the Revolutionary War, they denied the existence of the unconscious. That was the modal position at the time. And I remember thinking to myself,

this is nuts. How can they do this? So that got me wanting to study it. And it also got me looking at history and philosophy because the, when you deny something obvious, it's got to be some assumptions that are built into the culture. So I started looking at that kind of stuff. And then I started actually studying it. And then one thing led to another. And then also in psychotherapy, you know, we think everyone is screwed up. But we didn't evolve to be screwed up.

So how did that happen? And that led me to think more about the unconscious and why we are the way we are. And my unconscious reason is probably because I'm anti-authoritarian. and oppositional, and they said it didn't exist, so I said it did. That's good. So pre-Froid, what were people saying about the unconscious? Well, if you go all the way back, feel free to jump in, if you go all the way back to Descartes, I think that's when the trouble started, so to speak.

Until then, the unconscious was your mystical connection with God or it wasn't even thought about. And then Descartes said, I think, therefore I am, and said there's only two things in the universe, which is your mind and your body. And I think, you can't say I think, but I'm not aware of thinking, therefore I am. So the mental became identical with consciousness, and there's only two things. So if it's not consciousness, then it's the body. It's physical. And unconsciousness was just ruled out of court. Hmm. And were there any, like, other philosophers that you feel like were more accurate to the current understanding?

Plenty of them. But they were of secondary influence, I would say. And those that talked about the unconscious. Schopenhauer talked about the unconscious. Hegel talked a little bit about the unconscious. But that was not the modal view. The modal view was there's two things and therefore there's no such thing as the unconscious it's physical it's nervous system activity and I believe that was Joel I think Pascal yeah and one of the reasons for me is that in my heart I'm a trauma therapist and I work a lot with all kinds of early childhood adulthood trauma experiences and that's where I really have beef with Descartes for for postulating this distinction

between mind and body, and we do know that it's not as distinct, it's not as different. They're very intertwined. And I think it was Nietzsche who said, if you stare, I'm going to butcher the quote a little bit, but if you stare for too long in the abyss, the abyss stares at you. And to me, that was always a very good description of difficult, traumatic experiences in how they affect us and how we sometimes a lot of the times do not understand fully how they affect us, we can name the symptoms, but there's all of these bodily experiences that happen, and we have these automatic ways of responding. And we do talk a lot in the book about

automaticity. And we don't know that we don't know. We also don't know that we're not aware of what's going on. So that was an area, which I felt really drawn to and exploring that. Yeah. Tell me, like, it seems like what happened was you have these sort of analytic minds that talk a lot about the unconscious, and then you have these behavioral people and cognitive, people kind of like pushed it down. And then it's almost as if later on these cognitive therapists kind of rediscover the unconscious. I don't know. Would you say it differently? No, they've reinvented the wheel. So I think you have it dead on. That, you know, Freud was nonsense and so. silly, so we're getting rid of him. And then you start to see actual human beings behaving in ways that can't be explained through what they tell you they're doing it for. So you start to reinvent all kinds of mechanisms for it, and they call the mechanisms. And what you end up with is the unconscious back again through the back door. To be fair, the Freudian stuff was all focused on

conflict and so on, or mostly focused on it, and the cognitive people mostly focused on the normal or what we call the normative unconscious. So I don't want to make it sound like they didn't contribute. Okay. Thorically, that's happening. And how would you define like normative unconscious? Okay, so normative unconscious is just you function all the time. You and I are talking now, for example.

At least I hope we are. And you're consciously saying things to me and I'm consciously saying things to you. But did you have a little guy in your head that's telling you what to say and are you aware of it? You're about to say before you say it. You're not. You're kind of conscious of what you just said after you said it, and yet it's coherent and yet it comes out. So the unconscious is working on your language.

The unconscious is you're having an affective reaction to me that you're not aware of into Valentina and we're having similar reactions to you and we're not aware of any of it. But it's normal because we're trying to read you, not because we're manipulative, but that's what human beings do. And you're trying to read us and we're trying to be interesting and you're trying to be interesting and none of this is going on at a conscious level. But it's normal. And also at the same time,

our brains are such big pattern reading machines that we're constantly trying to look for the patterns around us. And that's also happening under the surface and affecting the moves that we make, whether it's behaviorally, whether it's our thought processes, and it's all going on under the surface. So one of the things that,

if you're on social media, Chen Z talks about is vibe check. Have you heard of that? Have you heard of that term? Vibe check. It's like it's like a, it's like the instant sort of first reaction that you have when you meet someone. It's like what is this person's vibe? Is it a good vibe? Is it a bad vibe? So I've been I've been posting it on TikTok a little bit about vibe check and some people say their vibe check is dead on and they need to listen to it more. Some people say their vibe check is sometimes off. And some people say their vibe check is sometimes off. and they sometimes end up in relationships that are destructive for them. Do you have any thoughts on the science of vibe check? Yeah, they're both true. Both of those statements are true. The data are, for example, that you can show a 30-second clip of a professor teaching a class

with the sound garbled, so all you see is the person sitting there going blah-da-da. And that will predict the ratings of the professor at the end of the semester, which is quite depressing for me when I'm teaching a class. So there's your vibe check. And you know that your first impressions are almost impossible to undo. But where do they come from? They come from something called implicit learning, which is your history. And so they can be off, but they're built to be on.

So it depends on your history. So both those statements are true. That you should pay attention to them, but you should also pay attention to whether you're getting them right more often than you're getting them wrong. And if you're getting them wrong, you should examine what's going on. If you're getting them right, that God bless you. Yeah. Yeah. And I think that's one of the biggest values of therapy or what therapy brings to the table is we learn how to explore where these cognitions and these experiences and these effective reactions and these quick judgments.

Because that's, I think, what you mean when you say vibe check and I will look it up. It's a very quick instant judgment that we make. And in a lot of ways, intuition is compiling of prior implicit knowledge. You know, your 10,000 hours or more of something that you have now learned, you have established patterns. If you grew up in an environment where a loud voice was very quickly associated with danger of some sort, that's going to keep playing out. You may not even know that you're having a physiological reaction way before you have a thought formed in your mind. It holds for politics. It holds for interpersonal attraction. I'm sure your audience, if they think about it and you, when you met someone, you knew immediately whether you liked them or not, then they had to prove you wrong from that point on or, you know, confirm what you originally thought. In politics, we like a politician as though that should matter, as though we're going to hang out with them. You know, this guy I could have a beer with, but this guy's a little stiff, and she's, she hector's, but she's nurturing.

None of that should matter, but it's exactly what you're calling a vibe check. Yeah. So how are our brains adapted to a world that no longer exists? They're not. They're adapted to the Pleistocene era, which is when we evolved. A simple example is that we all like sweets and salty foods. and fatty foods because when we evolved, those things helped us to survive. You know, we needed to eat fruits.

We needed calories. And in our ingenuity, we created all of these things on steroids. So now we have candies and we have potato chips. And they're not adaptive. But we were built to like them. And so we like them. Psychologically, we're built to live in small family-type groups. And guess what?

We don't do that anymore. and there's a million other examples of those things. So for the most part, they kind of work, but they can go very badly off in certain situations. So, yeah, I was curious. I read that you put a quick citation to Junger's book Tribe, and I'm curious if you have any other deeper thoughts about the idea that we were sort of built for this tribe,

and then it's like we're looking for this tribe, but most people don't have a tribe anymore. they see people they don't even know most days you know and to think that like 10,000 years ago like every person that you saw every day was the same 50 people and you knew your role and you knew your job and you knew like what you did was necessary for survival of the tribe so you were integrated into it you had a part part of that tribe and I'm curious like how the unconscious relates to that so I think this is a very very important concept and again I go back to my background in working in trauma, but the data speaks for itself. It's when people are mostly traumatized,

when people are mostly stressed. That's when this reliance or the ability to connect with others helps in the recovery process. Trauma in and of itself is a breakdown of some social connection or construct. Even as the book Tribe talks about, even if it's a natural disaster, How we recover from it has a lot to do with who's around us to support us. Are we going through the experience together versus doing it alone? And I think speaking to the unconscious and to the concept of embodied cognition that we talk about a lot in the book is we are biologically wired to seek comfort. And what's the first way, the earliest way that we get comforted is through touch,

through hugging. That's how infants are comforted. by their caregivers. And so we fall back down on the ladder of what's the earliest experiences. And they are pre-verbal. Hence, they are pre-conscious in a way. Yeah, I was going to talk about kind of the normative, but dark side of it. We're built to categorize us and them.

And it's for the reasons that you talked about, David, that we lived in these small family units. And by the way, if another family unit showed up, that was not a good thing because resources are limited. It's the same with animals, right? A second set of wolves shows up. The first set of wolves is not happy. And so we don't have the us versus them tribal categorization anymore.

So we need to create us versus them now. And that leads to all kinds of phenomena like prejudice and bigotry and so on, because we're built to make in us versus them. The harmless version of it is kind of sports teams. I don't know if you're a fan of any team, David. I am. I'm a fanatical fan of the New York Yankees. And to me, they're us.

I never met them. I don't know them. They don't live in the Bronx. I think they're my team because I grew up in the Bronx. But they did not. And yet, I connect with them. That's the tribalism in modern times. That's my Pleistocene heritage,

saying that I'm somehow connected to a bunch of people that don't know me and will never know me. That's good. Yeah, sports is totally that embodiment. Yeah, I'm thinking about especially in like South America how the soccer is, or they call it football, you know, how it's so, I mean, people live for that. And people live for it here.

You know, it's where people put their attention. Okay, tell me about this embodied cognition. Like how do you define that? How does that fit into the unconscious? Okay, so I hope I don't get too deep into the weeds here. So as we evolve, the first thing that evolves are sensory kinds of functions. We've got to take in information. Motor kinds of functions, we've got to do stuff.

Later on, the higher functions get built in. But what evolution does is evolution is opportunistic. It doesn't build necessarily a whole new piece of your brain. it takes advantage of the pieces of the brain that are there already. And so when you say embodied cognition, what you really mean is the same circuits that fire when you're sensing and moving are firing when you're thinking and feeling. I'll give you a couple of examples. I'm talking to you now and your audience can't see me and I'm moving my hands. This has nothing to do with my speech.

But the motor circuits having to do with movement of my hands are the same circuits that. that have to do with me talking. So therefore, they're all going on together. Likewise, we say when someone is a nice person, we say they're warm. Well, they don't have a higher temperature than we do or their temperature didn't go up. But what actually happens, the same circuits

that fire for warmth, physical warmth, fire for psychological warmth. And there are data that show that when you're feeling friendly, you'll actually estimate the temperature in a room to be higher than when you're feeling unfriend. And then there's a wonderful experiment by John Barge, who's at Yale, who actually, all he does is have people hold either cold beverage or a hot beverage. And I won't get into the details of the study. But after they hold a warm beverage, they rate people better.

They think the other people are nicer. And when they hold a cold beverage, they rate people more negatively. It's literally embodied in a concrete way. It's the same neural circuits. And in case you're wondering how that applies also to, prejudices and stereotypes. I think it was John Barge also who did a very interesting experiment where they had people unscramble words and basically the words related to the elderly, either words like Florida or a walker. And when people left the lab where they were unscrambling

those words, he had an accomplice of the experiment literally timed them with a stopwatch. And people walked slower. Walked slower, yeah. Without even realizing it. That priming effect is really powerful. Yeah, my favorite stuff is the whole time, actually. Yes. Wow.

I'm thinking, like, so if you're listening to this and you're single, you probably want to go on a date to get some, like, coffee or some tea, something warm, you know. Meet them at the door with, I mean, that's the whole, like, you know, hospitality is, you know, of having tea together. or? And then you want to take them to an adventure park and put them on a roller coaster because we have this phenomenon of, we call it effective primacy, which is feelings come first in the body. And if someone is excited on a roller coaster, they tend to read that as excitement for the sake of attraction, for reasons of attraction.

So warm coffee and a roller coaster. There you go. Politicians know this intuitively. So they'll hand people a warm cup of coffee if they meet them at like a subway station or a train station. And then the people will like them more. Huh. Wow. I find it really interesting. You do some consulting work for like political people on like the unconscious, Dr. Weinberger.

Is this kind of some of those things that you're talking about that you look, you watch them and you see what they're doing and how that sort of unconscious, how those unconscious things are playing out? What does that look like usually? I do some of that, but I actually do it empirically. I do research where I actually get people to watch the politician or read about the issue. And then I have a way of assessing what the strength of various unconscious associations are to that. So I'm going to try and explain unconscious associations. If I say the word knight to you, something pops into your head. I don't know what it would be, David.

So I'll just ask you, Nike. Black Cat. Okay, so did you think about that? Did you say, well, it's night, it's dark, cats are dark sometimes, so therefore else, no, it just popped into your head. Yeah. So when you see a politician or you see an issue or you see a product, any kind of stimulation, an associative network will be triggered, connected to that. And it can be measured. And if I get the whole constellation of associations, I can get how you perceive night, in this case, or I can get how you, uh, perceive night in this case.

or I can get how you perceive a particular politician, and then I can rank order the associations and say, this is the top association to this issue or this politician. This is the second strongest association. And I can also get what you called, what did you call it with the vibe check? We can measure the immediate positive and negative reaction. By the way, they're separate.

You can be positive and negative to the same person. And the way I try to explain that to somebody is think of who you care about most in the world, get that person in your head, and now think about who you had your biggest fight with in the last month. And my guess is it's the same person. Because it's not a continuum. More positive means less negative. They're separate. So you measure that. And what you have now for the politician or the product is positivity, negativity is one larger than the other, or both high or both low.

you have the set of associations, so you can kind of tell the unconscious story and the affective punch that this product or person or politician or issue is having. So we do that. Yeah. Do you ever read like micro-expressions on the audience? Is that one of your tools? I read that when I do psychotherapy. Reading micro-expressions and interactions is hard because the interactions are short. You know, it's not really polite to stare at some people. face to look for them, whereas in psychotherapy, you are looking at each other. They have, the data usually slows down the expressions. What they do is they'll film it, the video it, and then slow it down so you can spot them.

That's the work of Ekman. No, I don't do that in my consulting. How do you feel like micro-expressions relates to the unconscious, or do you have any thoughts on that? well again because everything is embodied your your affect is going to have an effect on on your physical position on your facial features it's not just your expression it's it's how you hold your body you know when you're upset you're more stiff when you are relaxed you're you're more comfortable with somebody things of that sort so um it's

It's all unconscious. It's even to the point if you force yourself to smile, you'll actually feel happier. It's really weird. And if you force yourself to frown, you'll actually feel less happy. And these things are involuntary. It's not like you've decided. I think I'll be happy, so I'll smile. You're smiling now.

I'm working on it, yeah. Yeah, well, you know, I study micro-expression as part of my research interest. I built an app to teach people how to read micro expressions. And so I've always thought about how, like, to me, that's the gold standard for implicit bias, especially like the EMG studies looking at the microexpression, where they look at like, you know, does this person experience disgust towards, you know, various maybe taboo subjects or that's kind of where my interest meet yours probably. along with the psychotherapy.

But they're not aware. The people who are showing the micro-expressions are not aware of doing this, I presume. I wonder if actors are aware, actually. You know, I have a theory, because I did some YouTube sort of breakdowns of different acting scenes. And my theory is that people who are watching good actors act

do not see the micro-expressions, but they can tell that the person is embodying the acting. Whereas if you watch like a bad actor, their micro expressions do not match the content at all. And I don't think you can fake the micro expressions. So in acting school, at least what I've heard from some of the top acting programs like at like NYU, for example, they don't try to get people to flash expressions. What they try to do is try to help them imagine the scene in their mind, not use their own historical information of the scene, but to sort of create it in their mind, like as we would do in an empathic immersion

as someone's story in therapy. That's the method, isn't it? Don't they call that the method? Yeah, I believe so. It's interesting. I think there is some data around, I can't quote any studies at the moment. I can't remember it, but I remember reading about really good actors, the more immersed they are in their craft.

They have higher levels of dissociation, which is the unconscious process in the mind where you, it's not simply compartmentalization. It's basically being into realities at the same time sometimes. And so it's very possible that this is something that they become more and more trained in or harness that natural capability of the brain and then are much more able to be themselves while at the same time really truthfully become their character. and that way you're raised in some way the micro expressions, you know, the mismatch in the micro expressions. Yeah, so that's good. So I think when I think of like implicit bias, that's what I think of in particular.

I don't know if you have any thoughts on implicit bias and how implicit bias sort of has informed your understanding of the unconscious. Well, unfortunately, implicit bias is ubiquitous. It's everywhere. And it's because of a phenomenon that we talk about in the book called implicit learning. It's all over. I could show you children's movies. In fact, I show this to my class. I warn them in advance. I'm going to ruin all these children's movies for you because they contain bias in them. And they're not aware of it. I don't think that the creators

of the movie said, let us foment bias and keep it going. It's just in their heads and out it comes. So, for example, if you look at cartoon heroes, and I'll just mention too, Dumbo and Happy Feet, the character mumbles, they have blue eyes. Now, elephants don't have blue eyes. They just don't. And every other elephant does not have blue eyes. The villain never has blue eyes. And in Happy Feet, the penguin mumbles, the hero, he too has blue eyes. And also, by the way, a white face, all the other penguins have black faces. And again, I don't think that the creators of these cartoons decided they're going to teach people to be. implicitly biased. They themselves are implicitly biased. They thought, oh, this looks better,

this is cuter, or whatever they thought. And then kids pick it up because they pick up everything. And we grow up and we end up with all of these biases. Do you have any good ideas on how to change that process or how to help people be less biased? Step one is to be aware. But step two would require an acknowledgement that this is happening and a concerted effort to do something about it. And we don't do step two because most people will deny. You know, you hear people say, I don't have a prejudice bone in my body. As soon as you hear that, you've lost it's over because we all have prejudice bones on our body, not because we're evil people, but because that's how we learned growing up. And if we're not

going to acknowledge that and then think about what to do about it, then it's never going to go away. So I wish I could give you the panacea and in six months all prejudice will be eliminated, but that's not going to happen. It'll be a gradual process. And I'm afraid David, you and me and maybe, Belle, she's younger, are ruined already. And all we can do is kind of try to be aware of it and acknowledge it when it happens or when someone points it out to us. Yeah, I think that's good. I think it's good to know that you are biased and good to know that you're probably more biased than you realize.

Because not knowing that you don't know is worse than knowing that you don't know or knowing that you know. You'll rationalize it. You'll say, well, look at this other person how badly they behave towards me without realizing that you may have instigated it with your own bias. Or that, you know, if I'm going to do a job interview with somebody, I'm from the Bronx in case you can't talk from absent and if someone comes in for the job interviews from my old neighborhood and you know has the same ethnicity as I do I'm going to get along with them better in all probability and if I'm not aware of that that's who I'm going to hire and you end up with you know biased hiring which we have

it's normal it's it's part of being human but you got to be aware of it and then that's the only way you you can do something about it you know men want to hire men and Caucasians want to hire vocations, not because they're bigoted, but because they feel more comfortable. And the whole us versus them thing that we talked about earlier and the training we had implicitly as kids and on and on we go. And there are so many studies at this point done about people evaluating pictures of better looking people as more likable, warm competence and all of that, all of these positive attributes that you don't.

You don't know because you're looking at a picture. Yeah. A picture. And we also don't know that we have these implicit biases in ratings. So we're seeing ourselves the questions. Well, let me jump on that one, if I may. It's not a coincidence that movie stars are abnormally good-looking. Their roles don't require that they be abnormally good-looking.

It's that we like looking at good-looking people. So when they're on the screen playing people that don't have to be good-looking. we like to look at them. And then there's a study that has shown that colleges that ask for photographs, because they think they're humanizing the applicants, end up with a better-looking student body than causes that don't. And I doubt that the admission officer is saying, you know, he's kind of hot, let's let him in, and she's cute.

I just think that what Valentin is talking about is happening. You just have this implicit, positive feeling towards them and all other things being equal, and sometimes not, you're going to let them in. And while was that, there was a study on dating apps, most people, most people look at the pictures and keep scrolling or stop and look at someone's profile because of the pictures. I think those apps like Tinder, I think, and there's this other ones. They literally swipe pictures left and right. So that's a bet. It's good to be good looking.

Well, I think I see that on TikTok. There's definitely a bias towards attractive people. TikTok. Like if if you're really, really attractive, you're just going to have so much more, you know, positive attention. And because the, the, this, this new app is so geared towards, uh, viral, you know, think if you watch the full video all the way through, it's a whole lot more likely that the video is going to go viral. And so really it kind of feeds into our, it shows our unconscious a little bit. Social media exposes our unconscious, you know, our unconscious biases. So, you know, and then people kind of can complain like, oh, why is, you know, this person getting all this attention?

Like, what have they done? You know, and it's like, well, there's some unconscious stuff there that's driving people to have interest in these people. It was a wonderful study in science, either the last year or two years ago, where they were trying to create an AI, artificial intelligence, that could have a conversation. And they just had it like pick up words and how to converse from the internet. And after a while, the AI became biased, became sexist and racist. And why? Because that's what it picked up in everyone's language. So now you have a bigoted robot, so to speak.

And obviously the robot is not motivated to be bigoted. It just picked up statistically how people talk. And, you know, it's not overtly bigot. It's subtly big in it, but it was. So that to me is like the study that proves it all. Here's another interesting snippet. Can you think of all of the computer softwares or phone softwares that are sort of at our disposal, the series and the Cortanas and Alexis?

What gender are they? They're female. Our home, so to speak, servants are female. And I think there was this macro computers in Silicon Valley that was the smartest, biggest computer in the world. That was a male computer. He had a male voice. See, I'm even saying he, even though it's an it.

Male voice. Yeah. Yeah. So those are really interesting things. But they do teach us, again, implicitly. If I'm a kid and I'm used to talking to Alexa at home, Alexis female. I want to make sure we get to what you guys want to really talk about, like, the important sort of things that you wanted to convey in this book. One thing that I noticed was you talk a lot about, like, okay, towards the end, towards the, you know, psychotherapy, listening to patients nonverbals, listening to their associations as being two kind of things.

would you say that those would be sort of some of the things that kind of came out as you kind of dug into this over and over again? Or are there other things as well in the therapy's sort of connection of the unconscious? I want to, I'm glad you asked that. I want to say one thing that a lot of therapists, I think, are unaware of and made a lot of misunderstanding between patients and therapists. And it's this. There's a model of how we explain behavior called attribution theory. and there's a bias built into it that's unconscious. And the bias simply is this.

When you behave, when another person behaves, it's because of your personality, because of your character. But when I behave, it's because of the situation. So a simple answer is someone cuts you off on the highway. They're a jerk. They're an a-hole. You cut someone off on the highway while you were in a hurry. They were driving too slowly and so on and so forth.

So now your patient comes in and describes an incident, which she or he explains in terms of the situation. and you say, well, you see you're actually an angry person and you're not aware of it. And then they get upset with you and feel misunderstood. Now, you may be right or they may be right, but the point is that those biases are built into us and they need to be explored. I, as a therapist, have to be aware that I'm prone to attributing my patient's behavior to their personality.

And I tell the patient that she or he has to be aware that they're prone to attributing their behavior to the situation. So we need to explore it further. I'm not necessarily right, but she also is not necessarily right. And then I would agree that we're looking for associative networks, we're looking for non-verbals, we're looking for embodied stuff, we're looking for unconsciously expressed affect. But that one, I tell them right off the bat,

because that leads to so many misunderstandings and hurt feelings. I see that as well. A lot of people think as soon as they break up with their spouse, oh, my spouse is a narcissist, which sometimes is true. But sometimes it's because it's like what you're saying. It's like they're attributing how they were behaving due to personality. Would that be an example of that? Yeah, well, that's also an example of cognitive dissonance, which is unconscious as well. So it's both. So cognitive dissonances, well, let's see. I said I liked them, but they don't want to be with me or I don't want to be with them. So I guess they were jerks all along. As opposed to, I was the jerk. What am I doing with this person?

Or how did I make this mistake? Or worse yet, they rejected me and they're nice people that makes me the inferior one. So that kicks in. And then on top of that is the attribution that whatever went wrong must be due to their personality, because what I did was entirely due to the situation and rational and good. So both things are kicking in for that one. I make a joke that all previous boyfriends and girlfriends were jerks. It's amazing.

That only the last one is not a jerk. Yeah. You said unconsciously expressed affect. What's the best way to get access to that in your mind? Looking at the person, the non-verbals, the behavior, you know, someone tells you I'm not angry, makes a fist, they're angry. You know, the joke that I like to tell is if someone says, you seem upset. And person goes, I'm not upset.

Yeah. Yeah. I'm frustrated. Right. Yeah, right. Whatever the socially acceptable word is in their mind in that moment. I think it's also really important. One thing I ask a lot is what's going.

on in your body right now. Because that's a very good clue. That gives you a very good clue. And then we do so much psychoeducation because we get all of us, all of us human beings get so implicitly are explicitly taught about what's acceptable to feel, what feelings are acceptable to express. You know, think of a kid who got taught very early on. You're not sad. You're hungry. Let's go we think about what happens in adulthood. And so it becomes so disconnected with our feelings. So I do a lot, I do a lot of psychoeducation about what each feeling actually looks like or feels like in your body.

Where is it in yourselves, so to speak? So getting access to that unconscious affect is, in my mind, through the body because, again, the thoughts are embodied. They're in your body as well. That's how they're connected with your emotions. Yeah, Dr. Stoacheva, since you do trauma work as well, I think a lot of times dissociation is there in the memory, you know? So in the memory of the trauma, they're dissociated. But then there seems to be affect that's untapped into.

So is that kind of some of the work that you're doing with the trauma work? You're looking for that sort of unconscious affect that was never maybe expressed during the trauma? Yeah, so I look a lot at what we call primary emotions versus secondary emotions. And a lot of the times people will come in, especially in trauma. I mean, shame is a very big one. Shame, feelings of inferiority. And then the thoughts that people come in with, I'm not good enough. It's my fault. And sometimes things are their fault, but we get really stuck in our affect. And I do look a lot at what's the primary affect because what's the primary emotion? Is this just tremendous sadness at a loss or just a lot of fear and sheer terror? Those are usually feelings that get dissociated. And the earlier the trauma in someone's life, the more likely they are to have dissociated certain experiences. I've had people come and tell me really horrific stories of childhood abuse and say, I wasn't scared. I feel okay. And, you know, through here,

feeling, it's possible to feel okay now, and that's the goal, and that's what we work for. But most likely, you are not just scared. You were terrified, and so much so that if your body couldn't escape, your mind escaped, and that's how dissociation. I mean, dissociation is a natural process. We all do it. If you're driving down the highway and you know the route and you've driven there a thousand times, you're going to daydream. That's normal dissociation. It's when this normal process in the mind gets hijacked in the surface of survival or psychic survival in the traumatic experience, that's when we usually have dissociation. And it is an unconscious process. We don't really have control over it at the time. Yeah. And Dr. Weinberger, I want to, I want to sort of see

what else is floating to the surface of your mind. Like, are there other thoughts that you have that you really want to put out there on the importance of the unconscious or how you use it, any pearls that you want to put out there for our for this group a pearl on demand uh so i think that i want people to recognize it's not bad that things are unconscious it just is because we have this thing that if i'm not consciously aware of or in control of this is somehow a bad thing and actually the unconscious helps us if you're doing a million things at the same time you know you're you're talking you your regulating temperature, you're doing eight million things and you have when you know what you're going to do next.

If they were all conscious, you would just melt into a puddle. So the unconscious is helping you most of the time. It's a good thing. It's adaptive. Your intuitions mostly are good, as you asked earlier on. Your gut checks are usually good. So I think the pearl I would like to give is that the unconscious is not a bad thing. The unconscious is largely a good thing.

that sometimes can cause you problems and that those problems can be addressed. And psychotherapy is one way to address them. But except that this helps us function. It's adaptive. It's there for a reason. Great. And Dr. Stoichever, can I ask you the same thing? What other pearls do you have that you want to just put out there?

I guess I'll throw in a rather controversial pearl here. And for some, it might not be a pearl exactly. but I'm in favor of longer-term therapy. And I do understand, and I am trained in shorter-term evidence-based so-called therapies, and they're very useful. And I know that probably certain people will not like what I say right now, but just the nature of embodied cognition, the nature of unconscious processes, necessitates that we work for a long time.

The older knowledge doesn't ever fully disappear when we learn new coping skills or new ways of understanding problems. They need to be practiced and practiced and over and over again. So to borrow and to twist Freud's idea of making the unconscious conscious, we then have to make the conscious unconscious so that we really start utilizing these better, healthier coping skills automatically. Until then, our go-to will be the other less healthy, less healthy, less helpful ways of dealing with problems that brought us to therapy in the first place.

And maybe booster sessions, maybe longer-term treatment. I really want to destigmatize being in therapy for a longer period of time rather than the, you know, 12 sessions that are recommended by certain treatments, because it does take time. Yeah. And one of the things I would desire is to kind of encourage providers to also get their own therapy and to really dive in. I think it's a tragedy when I meet a provider that's never been in their own sort of therapy. They've never done their own work.

It can be incredibly important. So if you're listening to this and you're like, you know, I really haven't done therapy. And maybe what would you say to that person without shaming them too much? Well, I wouldn't shame them. I would say that therapy is a way of getting. more in touch with who you are and behaving more adaptively, it doesn't mean that there's something inherently wrong with you any more than if you have something physically you're wondering about that you shouldn't go to a doctor because after all, it'll remit on its own. And you can probably

live your life without going to therapy, but it could be helpful. And you probably have lifetime experience and practice and behaving a way that's not optimal. Maybe you learned it in a different place or at a different stage in your life, and you can do better. So why wouldn't you? Yeah. And also as a therapist specifically directed to the therapist, I kind of feel like it really can help you explore your own unconscious processes

towards even your own patients, towards your own work as a clinician, and that can always be helpful. And it's supportive for you as a patient. as doing the job that you're doing, in doing the job that you're doing. Yeah. Yeah. I think it keeps you from getting burned out as well.

And it keeps you from, I think it allows you to really thrive and enjoy the work that we do. And it brings a lot of meaning to the work. So it's kind of something that I repeat throughout my podcast, the importance of doing your own work, doing your own therapy. And, okay. Well, as we wrap things up here, hey, it has been a true place. pleasure. I feel like we've only hit the tip of the iceberg. I mean, this book is truly, it's truly a very cohesive, very well-written. It's easy to read, actually. So it's not like some psychotherapy books that are just really difficult to read. So I'd recommend that if you

enjoy this conversation, you check it out. There'll be links in my show notes to it. And yeah, it's been, it's been great having you guys on. Thank you very much for having us. All right, take care.