The One You Feed - From Benches to Breakthroughs: A New Approach to Mental Health with Dixon Chibanda

Episode Date: May 23, 2025

In this episode, Dr. Dixon Chibanda explores from benches to breakthroughs: a new approach to mental health. He explains why storytelling, radical empathy, and solving daily-life problems often outperform medication-first approaches; how three simple steps—opening the mind, uplifting, strengthening—turn elders into community healers; and why hope, not symptom checklists, is the truest measure of success. Along the way, you’ll hear how ancestral wisdom blends with clinical science, how labels can hinder more than help, and how the very grandmothers Dixon trained ended up transforming him. Key Takeaways: Discussion on anxiety and its management through personal values and positive actions. Importance of human connection and storytelling in mental health care. Overview of the Friendship Bench initiative and its origins in Zimbabwe. Role of trained grandmothers in providing mental health support within communities. Need for accessible mental health care and addressing social determinants of health. Integration of Western psychiatric principles with African cultural practices. Significance of empathy and nonverbal communication in building therapeutic relationships. Training process for grandmothers in cognitive behavioral therapy and effective communication. Use of support groups to foster community and shared healing experiences. Emphasis on the power of storytelling and vulnerability in the therapeutic process. If you enjoyed this conversation with Dr. Dixon Chibanda, check out these other episodes: Why We Need to Rethink Mental Health with Eric Maisel Insights on Mental Health and Resilience with Andrew Solomon For full show notes, click here! Connect with the show: Follow us on YouTube: @TheOneYouFeedPod Subscribe on Apple Podcasts or Spotify Follow us on Instagram  See omnystudio.com/listener for privacy information.

Hi everyone. One of the things that I know many of you struggle with is anxiety. And very recently I shared some tips on managing anxiety in our newsletter. Specifically, I shared a practice on clarifying your values. In the practice, you write down one or two of your core values and then identify one action step that aligns with them. I find that taking one positive action towards things that matter to me really helps reduce anxiety. Also, I have a reflection question.

What positive experiences have you had today that you could focus on instead of your anxiety? Every Wednesday, I send out a newsletter called A Weekly Bite of Wisdom for a Wiser, Happier You. And in it, I give tips and reflections like you just got. And it's an opportunity for you to pause, it, I give tips and reflections like you just got. And it's an opportunity for you to pause, reflect, and practice. It's a way to stay focused on what's important and meaningful to you. Each month we focus on a theme. This month's theme is anxiety. And next month we'll be focusing on acceptance. To sign up for these bits of weekly wisdom, go to GoodWolf.me slash newsletter.

Human beings will connect if there's genuine expressed empathy, which is anchored in deep storytelling. Welcome to The One You Feed. Throughout time, great thinkers have recognized the importance of the thoughts we have. Quotes like garbage in, garbage out, or you are what you think ring true. And yet, for many of us, our thoughts don't strengthen or empower us. We tend toward negativity, self-pity, jealousy, or fear. We see what we don't have instead of what we do. It's a heartbreaking truth.

Someone can know they need help, even want help, and still not get it, simply because they can't afford the bus fare. Today's guest, Dr. Dixon Chibanda, lost a patient to suicide for that very reason, a loss that changed the course of his life. Out of that heartbreak, he started something quietly radical, the friendship bench. Now, grandmothers trained in basic therapy offer life-changing care from wooden benches

across Zimbabwe and increasingly the world. In this conversation we explore how Dixon weaves clinical science with ancestral wisdom and how human connection, not just diagnosis, can unlock healing. We talk about the power of storytelling, the danger of labels, and how even Dixon himself was transformed by the very grandmothers he trained. I'm Eric Zimmer and this is The One You Feed. This is an iHeart Podcast. Why is a soap opera western like Yellowstone so wildly successful?

The American West with Dan Flores is the latest show from the Meat Eater Podcast Network. So join me starting Tuesday, May 6th, where we'll delve into stories of the West and come to understand how it helps inform the ways in which we experience the region today. Listen to The American West with Dan Flores on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. In 2020, a group of young women found themselves in an AI-fueled nightmare.

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I'm Michael Kassin, founder and CEO of 3C Ventures and your guide on Good Company, the podcast where I sit down with the boldest innovators shaping what's next. In this episode, I'm joined by Anjali Sood, CEO of Tubi. We dive into the competitive world of streaming. What others dismiss as niche, we embrace as core. There are so many stories out there, and if you can find a way to curate and help the right person discover the right content,

the term that we always hear from our audience is that they feel seen. Listen to Good Company on the iHeartRadio app, Apple podcasts, or ever you get your podcasts. Hi, Dixon. Welcome to the show. Thank you, Eric. Thank you for having me. I'm excited to have you on. We're going to talk about your book called The Friendship Bench, How 14 Grandmothers Inspired a Mental Health Revolution, and talk about this movement in general, which I think is one of the more beautiful things

I've read in a long time. But before we get into that, we'll start like we always do with the parable. And in the parable, there's a grandparent who's talking with their grandchild. They say in life, there are two wolves inside of us that are always at battle. One is a good wolf, which represents things like kindness and bravery and

love. And the other is a bad wolf, which represents things like greed and hatred and fear. And the grandchild stops, they think about it for a second, they look up at their grandparent and they say, well which one wins? And the grandparent says, the one you feed. So I'd like to start off by asking you what that parable means to you in your life and in the work that you do. Thanks, Eric. For me, it means being constantly immersed

in the stories, the lives of the people who have shaped my journey, not only around the work that I do at Friendship Bench, but in my career as well. So in this particular instance, that would be, I guess, the 14 grandmothers that I started this project with. They have profoundly influenced the course of my life and career. Beautiful. Why don't we start with you telling us about the friendship bench for people who aren't familiar with it. Great. So the friendship bench in essence is really a brief psychological therapy or talk therapy that is evidence-based, but is delivered by trained community grandmothers. It started off in Zimbabwe.

The trained community grandmothers who are trained in the basics of what we call cognitive behavioral therapy, are located a wooden park bench in their community. We facilitate referrals to the bench of people who are lonely, people who are depressed, and those referrals can come through social media, through schools, through the police station, you know, in cases of, for instance, intimate partner violence. And the grandmas on the bench provide this structured therapy, usually four to six sessions. And after those sessions on the bench, people are then encouraged to join a support group

in their community. So that in essence is what the friendship bench is in a nutshell. Let me set the table a little bit for listeners here. You were a psychiatrist in Zimbabwe. And I think you at one point quoted a statistic like it was something like one psychiatrist for every several million people in the world, right? And that obviously is problematic. And as an attempt to try and solve this problem a little bit, to try and say, how can we actually provide more care to more people? You, through working with different people, came up with this idea that these grandmothers who are not trained psychiatrists, trained psychologists in the

academic sense that we normally would think of them, but they were trusted members of the community that they could, with a little bit of training, provide really good support to the members of the community. Yes, so you know during my formative years of you know working in a large hospital as a psychiatrist, I lost a patient of mine to suicide. Erica was her her name. I write about Erika in my book. Erika had been under my care for just over two years when she took her own life. And I distinctly remember the day that Erika's mother called me to tell me that Erika had taken her own life. Erika had hang herself from a mango tree in the family garden. I was devastated, Eric, but I think what really hit me hard about Erika's death was the fact that both Erika's parents knew that Erika needed help and Erika herself knew that she needed help,

help. And Erika herself knew that she needed help, but they didn't have the equivalent of 10 US dollars to get onto a bus to bring Erika to the hospital where I worked. Erika's parents were literally trying to save up for bus fare to bring Erika, who was severely depressed, she'd had a relapse to the hospital. And it was during that process of trying to save up the equivalent of 10 US dollars that she actually took her own life. And so that story hit me so hard. And at the same time, I kind of got into this soul-searching journey. And I realized then that I needed to find a way of making it possible for people to get evidence based care or talk therapy from the community where they lived as opposed to coming to the hospital. And so that was really the beginning of the idea of Friendship Bench. So, Friendship

Bench was born out of a tragic event. Talk to me about the origins. How did you arrive at this idea? Well, after the loss of Erica and getting into, I think I actually got into a depression myself, you know, in this soul-searching journey, trying to figure out what to do with my life, with my career as a psychiatrist

and talking to a lot of people. I then realized that actually one of the most reliable resource that we have in communities across the world are grandmothers. And I realized from talking to people that grandmothers are like the custodians of our local culture and wisdom and knowledge. And I thought, how about if we could train grandmas in the basics of cognitive behavioral therapy and provide them with the skills to reach out to those in their communities who need therapy. And so that's really how it started. And in my book, I talk about the first 14 grandmothers,

because when I started this project, it was just the 14 grandmothers that I had. Of course, now we have in Zimbabwe alone, we have over 3000 grandmas and we have a presence in many different parts of the world. But I'm just kind of zeroing in on the first 14. And it was those first 14 grandmas that really helped me to understand the power of human connection and the power of embedding healing in stories. And so this is how Friendship Bench really started and it's been shaped by those 14 grandmas. At the moment there are only six of them left,

but it's just really been a tremendous learning opportunity for me both as a psychiatrist and as a human being. I think that's the beautiful thing. Well, there's many beautiful things about this, but one of them is that you brought, okay, I've got a psychiatrist, Western-trained view of mental health. And so I'm bringing that to the table,

the cognitive behavioral therapy part that you're talking about. But they met you with lots and lots of their own ideas and own wisdom that emerge out of the actual culture. And I think it's the combination of those two things coming together is part of I think probably what makes it so successful. If you had just said everybody do CBT, that may not have been really nearly as effective. On the other hand, if it had only been the contributions of individual grandmothers without a little bit of guidance in mental health practices, but when they both came together,

you created this thing that seems really special. Yeah, yeah. That is so right, Eric. I often refer to the journey of the Friendship Ben bench as striking a balance, you know, equipoise between Western models of care and African cultural heritage and bringing all of that together in a way that produces the results that are acceptable, not only within an African context but in a Northern Hemisphere context as well. I'll give you an example. When I first started Friendship

Bench with the first 14 grandmothers, naturally being a psychiatrist, I thought this whole model would be based on the principles of DSM-5, where you focus on a diagnosis, you focus on the symptoms, you come up with a diagnosis, and then you establish a treatment plan. And the grandmas were like, no, you need to focus on the story because human beings connect through stories and through those human connections, that's when healing begins to emerge. And so with time, I realized that we had to find a way of connecting stories and DSM-5 and really creating a sort of way of harmony between the two, if you like.

And my journey has consistently been about that. And I'll just share one more example about this sort of equipoise. When I started Friendship Bench, I, being a psychiatrist, I wanted to call the initiative the mental health bench. I was thinking as a psychiatrist and the grandmas were like, that's not really going to work in this community. And I resisted. And interestingly, Eric, when we started with the mental health bench, nobody actually wanted to come and sit on a mental health bench until we changed the name to Friendship Bench.

And all of a sudden, everybody wanted to sit on a Friendship Bench. And I learned my first big lesson, the names that we ascribe to things can make or break those things. So I really became sensitive to the language that we use around mental health. And I also realized that a lot of what we use

as professionals can fuel stigma in mental health. So we really have to be careful with labeling people. There's room for that, but oftentimes what is more important is the story that people bring to the bench, not the diagnosis. So a big part of what made this work in Zimbabwe was that these grandmothers were steeped in a culture that they could bring to the table. And I'm curious about what do you see in more westernized places where the culture has evolved

in their lifetime a lot, it's very very different or there isn't the same cultural reference point and there isn't necessarily the same respect for the elderly that there might be in places that are a little bit more traditional. What do you see as you try and take this different places? Erik, you know, when we first started taking Frenchie Bench to different parts of the world, our hypothesis was the Northern Hemisphere, particularly the developed countries, would be very different. And I am increasingly surprised at how similar communities are across the world and how people, even in Washington DC or in New Orleans or in London, in Germany, these are

places where we're introducing friendship bench. You find that intergenerational connectedness when given the right space is extremely powerful because the elderly or the grandmas are addressing loneliness through this work. Young people by engaging and interacting with the grandmas, are addressing this sense of belonging, which a lot of our young people have lost because our world has become so disconnected. We're always in front of our devices. But when you bring the two together,

you have this amazing intergenerational connectedness which is so powerful. So actually, you know, there's a lot more that connects us as human beings across the globe than separates us or divides us. Last year in October, we were in El Salvador and we were pleasantly surprised to see that the way people relate to the elderly, the way people connect with their grandmas is no different than in Zimbabwe or in Tanzania or in Liberia and all these other places where we're doing this model. So I really think at the very core of what we do, the most fundamental human connection that we see is stories. All human beings across

the globe connect through stories. It doesn't matter which culture you're coming from. And that's fundamentally what French Bench brings, that connecting human beings through stories. I'm glad that your hypothesis and mine were similar about how this would work in the Western world. And everything you're saying makes sense, right? I think we do know universally that one of the most healing things that can happen is simply one person really listening to another. A lot of modern studies, you know, trying to figure out like what therapy is most effective. And it seems like the answer often is the one which the person has the best rapport

with a therapist leads to the best outcome. Like that's the single most important thing. Yeah. I want to ask a question about stories. So when you say stories, there's obviously the stories that the client comes with. I don't know what you what do you call people who come to the friendship bench for help? Well, it's you know, it depends where you are in Zimbabwe. They because it's, you know, it's just an affectionate way of referring to them. But in New York City, for instance, people who came to the bench were called clients or benchers, you know, it varies. Yeah, I like grandchild. So the grandchildren come, and there's obviously

the story that they bring. But there's the stories that the grandmothers bring. And I'm curious, does that emerge completely organically out of each grandmother's experience? Or are there connective healing stories that are taught to grandmothers that are part of what they use? Yeah, that's a great question. So when we train the grandmas, we lean into their stories. As you may imagine, someone who has lived for several decades has a rich history,

has a rich lived experience. These grandmas, I like to say that they carry the battle scars of life with grace and dignity, and they bring those battle scars to the bench. And one of the things that I learned as a psychiatrist is the importance of sharing your own story as a way of connecting with clients. Naturally, you have to respect certain boundaries as you do so, you know,

but the grandmas bring their own stories. But what we emphasize is the use of empathy or expressed empathy, which is the ability to make people feel respected and understood when they open up to share their stories. We emphasize, you know, nonverbal communication, respected and understood when they open up to share their stories. We emphasize nonverbal communication, the use of eye contact, the use of silence as a tool.

You know, most human beings feel extremely uncomfortable when there's silence. In fact, for a lot of people, silence makes them feel kind of awkward. But with the Friendship Bench, the first level training is really all about using all of those sort of intuitive, non-verbal strategies that you can use to engage with other human beings. It's really, as you say, Eric, it's about building that rapport. We call that the therapeutic alliance. That is the most important part of the work that we do at Friendship Bench. And that's what we really emphasize in the first level training. You know, our training has three levels, level one, two, and three, yeah. How much training does a grandmother go through before she's sort of put on a bench?

That usually varies depending on the level of education of the grandma. The more educated, the less time they may need. Okay. So we work with grandmas who have minimal education in Zimbabwe. Most of them have the equivalent of junior school education. And it takes a month for them to be able to understand the basic components of the therapy, which is problem solving, behavior activation, activity scheduling, and psycho education. Those are the active ingredients of a friendship bench. And anchored in all of that is that the rich storytelling component, their ability to get people to feel comfortable

with feeling vulnerable. Again, that was one of the big lessons I learned from the grandmas. If there's one thing we do at the friendship bench is make people feel comfortable to feel vulnerable because it's through that vulnerability that they share their stories and it's through that sharing of story that connects and the healing process begins. Yeah, so we train for a month. But after the month of training, they are then encouraged to have practical exercises under supervision, and that supervision can be under a clinical psychologist or a mental health nurse.

And then once they go through that supervision and they pass that supervision They are then allowed to see clients on their own. But again, it varies depending on where we're training I mean we recently trained folks in in London and that training only took seven days because the people we were training already had some experience of counseling. Yeah. This, in my mind, is similar to an emergence we're seeing in the West, at least a little bit more of, which is peer support. The purest model of it is the one that I sort of came of age in, which was 12-step programs. I'm a recovering heroin addict.

And so, you know, that's obviously all peer support. There's no training. There's no, there's just nothing. It's just, you just all end up in a room and there's a few guidelines and hopefully it all goes well. I also think though that there's more of a peer support movement emerging where people are trained a little bit

to provide a little bit more support than they might know how to do natively. Now in a lot of those, what ends up being part of the binding connection is that for me, if I'm going to a 12-step meeting and I'm talking about addiction, I'm talking about addiction with other addicts. If somebody is giving peer support for bipolar, as an example, they share that in common. Is there any attempt to put certain people with certain grandmothers based on life experience? Oh yeah, we have that. You know, over time what we've done is the grandmas amongst themselves

have become experts of very specific issues. You would have grandmas who just focus on clients who come to the bench with intimate partner violence issues. Got it. You have grandmas who focus on people who are living with HIV because the grandma herself is living with HIV. So yes, we do that exactly. But ultimately, regardless of that peer-to-peer component, human beings will connect if there's genuine expressed empathy which is anchored in deep storytelling. Amy Robach and TJ Holmes here.

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we've seen this in our programs we do, connection around certain values or wanting to improve or be different can happen amongst very disparate people given the right environment. One of the things I thought was very interesting was you say in the book that most people coming to the bench don't want treatment for depression. They want treatment for their problems with money and people. I think in the Western world, we tend to suddenly go, oh, you're feeling that way. You have depression, so we're going to treat the depression.

And it seems like there was a very clear orientation from the beginning that very often the reason they feel lousy is they have legitimate life problems. Yeah. And any attempt to help them needs to be rooted in helping them address the actual problems. That is so true. You know, and interestingly, when I first started Friendship Bench and I write about this in the book, you know, I wanted to focus on the symptoms, like hey, because the grandmas were

taught how to use screening tools, like the PHQ-9, which is used globally. And I was emphasizing focusing on those symptoms, and it was the grandma who were like, those symptoms actually happen as a result of the social determinants of health, like intimate partner violence, poverty, living with HIV. And so that becomes the focus. And when you address the problem, as you rightly say, the symptoms get better. So you don't have to worry about the symptoms. Focus on the issues that people bring to the bench.

And that is what we really focus on. Although we can, for instance, establish that a person might be going through a social issue and as a result of that, they have major depression according to DSM-5, we certainly do that, but we also understand that that depression is largely fueled by those social circumstances that need to be addressed. Right, because you have a process in which a grandmother very early in the process can say, hey, this person needs more care than we're going to be able to provide here, or we need to refer them on if there's more serious psychiatric disorder. And I think you're not saying that there's not a place for westernized approaches to

medicine where we use certain medicines, you know, antidepressants or other things to treat people. It's just that I think we've gotten things in a lot of cases backwards here in that I think the way most people are treated for depression or anxiety today is they go to their primary care doctor usually and say, oh, I'm depressed and they get an antidepressant or a lot of primary care doctors these days hand you some version of that screening question you're talking about. You fill it out and you may leave with a prescription. And there are some ways in which I think that this filtering down to primary care physicians has been of value for our society, but there are plenty of ways in which I think it is

problematic. And I think the problematic thing is, to your point, it's worth trying to address the global situation first, like in someone's life. It's the same sort of thing like trying to ferret out whether what somebody is dealing with is natural grief over something and when does it turn into depression and you know, tweezing these things apart is not simple. Yeah, it definitely is not simple and this is why at Friendship Bench, we use algorithms, we use these screening tools. For instance, a common phrase that we use is red flag to identify clients who might be severely depressed or suicidal. You know, when clients present with

such severe symptoms, they are stepped up, you know, to see a grandma who is more experienced. And normally what would happen is that, for instance, I'll give you a classical example, someone comes to the friendship bench and they're suicidal. They respond yes to the question on suicidal thoughts, which is question 11 on our screening tool. If a grandma who is engaging with that client is not comfortable with dealing with suicidality, she will refer to the next level, to a grandma who actually focuses on that. And that grandma will use a more precise screening tool to establish whether those suicidal thoughts

are really serious or not. Very basic questions, you know, have you thought of when you would do it? How would you do it? The usual stuff that any therapist will kind of ask. But in all of that, there's still the person's story. And what we find at Friendship Bench is that, you know, over 80% of the people presenting with suicidal ideation

crying out for help. And when you give them that space to genuinely share their story, healing begins. We discourage our grandmas from immediately referring unless somebody is a genuine red flag. And the other thing about Friendship Bench, which I have to just mention, Eric, if you don't mind, is that everything that we do at Friendship Bench is rooted in rigorous research. We have over a hundred peer-reviewed scientific publications, including clinical trials, which show that

these grandmas are effective therapists. So it's not just something that we just wake up and think about like that. We actually test all these things through these rigorous studies which are published in peer-reviewed journals, scientific journals. Yeah, I think that's a really interesting part because that's not how it started, obviously. It started as an experiment, right? Like you're like okay let's go oh yeah do this but since it's gone on and been successful enough in a eye test sort of way like looking at it like hey wow this seems to really be working you were then able to say all right now

let's apply academic methods of research to this to see is it really and the answer seems pretty convincingly that indeed it is. I wanted to ask you about, there's three steps that you address in the book. And I'm not even going to attempt to pronounce these words, because I butcher English words on a regular basis. But the three steps are opening the mind, uplifting and strengthen. And I was wondering if you could speak the, I assume there's Zimbabwean words for them. And then tell us about what each of those are. Yeah. So the first level training is called opening the mind in the local language that is Kufra Pforwa. And essentially these terms or the pillars of the friendship bench, really terms that the grandmas conceived.

And all I did was put them together, but these were ideas based on the wisdom and knowledge that these grandmas have that have defined the program. So opening the mind or Kuvura Pfungwa, as we call it in Shona, literally means creating space for people to feel comfortable to share their stories, for people to feel comfortable with being vulnerable. And that is really the first level. And that is achieved by using some of the earlier terms I shared, like expressed empathy. I'm now using the English equivalent, expressed empathy, which is really making people feel respected and understood using eye contact,

using nonverbal communication, using silence as a tool. All of that is embedded in that first level training because we strongly believe at Friendship Bench that when you make people feel comfortable in that first level where their mind is opened, they then begin to see things that they were not able to see prior to that. And that's when healing begins. In a lot of therapies out there, Eric, we measure success on the basis of reduction of symptoms, which is the most sort of common thing when you're thinking of clinical psychiatry or psychology based on DSM-5 or the ICD-10.

At Friendship Bench, we measure success based on hope. Yes, we do have all these other screening tools, but for us, success is when we instill hope in a person. And oftentimes, when you instill hope, you haven't necessarily removed all the symptoms of the depression, but that hope makes a person feel that they can carry on. They still have a chance. And so we focus very much on that element. And that is built in that level one with Kuvra Pfugwa, opening the mind. And the level two is the uplifting level. And that is where we begin to go into some of the more structured components of how to use screening tools to identify people who are genuinely suicidal or who are psychotic and need to be referred to a psychiatrist

or people who have severe depression and may benefit not only from the talk therapy but also from an anti-depressant. And then level three is now the structured therapy around problem solving, behavior activation, and activity scheduling. So this is how the training actually runs. And if you ask me based on the years of working with the grandmas, I still think that first level training of opening the mind is the most important because that really sort of creates that space for healing. One of the things that you talk about is that the grandmothers described this to you, which was that clients get overwhelmed by multiple problems. And so part of what they do is help

clients focus on one problem at a time. Say more about that. Yeah, you know, typically people who come to the friendship bench have numerous challenges. So for instance, I can give you an example, and this is a real life example. You know, a woman comes to the friendship bench, she's feeling suicidal because she's unemployed, she's HIV positive, she's in an abusive relationship, she has no money to send her child to school. So she's just completely overwhelmed with all of these challenges and she comes to the bench and what typically happens is she opens up to the grandma, she shares, she talks about all of these things, all the issues that are affecting her in her life.

And what we've found over the years is oftentimes when people have numerous challenges, they struggle. They actually struggle to figure out which of those problems to start working on. And that is something that the grandmas sort of work with a client on. And we use a term called the ping-pong to describe the interaction between

the grandma and the client. Because often when the grandma summarizes, which is part of the problem solving, the grandma will summarize the story. And again, that summary of the story is an indication of being anchored in the present. So we test the grandmas in terms of their ability to reflect back to the client what they've heard. And that is so powerful because it makes a person realize that someone is listening to me. Anyway, so when the grandmas reflect the story, the grandma will then say, so which one of these would you like to start working on? Your average client will say, I don't know, you decide, you tell me which one I should start working on. And we always train our grandmothers never to select the problem.

The grandma simply throws it back to the client, you know, by saying something like, you know, I wouldn't possibly be able to stand in your shoes. I'm here to help you select one problem." And so you have this exchange which can take 30, 40 minutes until a client suddenly decides, you know, I want to focus on making sure that my child goes to school. And then the grandma will say, all right, if that's what you want to focus on, let's work on that. And the interesting thing, Eric, is that people that come to the bench will select problems to focus on, which I as a clinician, as a psychiatrist, may think, this doesn't make

sense. Like for instance, if someone is HIV positive, my instinctive focus should be, hey, we need to put you on medication for HIV, you know? So in this particular case, this woman is HIV positive, but she is interested in focusing on getting her child to school. And when you deep, deep her into the story, you find that if she gets her child to go to school, she will then have time to go to the primary healthcare facility and address the next problem. And so we never actually assume that what we think is the biggest problem is what we

should tell the client to focus on because clients will always come up with something which is completely out of the box in terms of what they think is a priority. And so that's the level two. And then after that, when a problem is selected, they will then brainstorm together for solutions. And we train the grandmas on how to use what we call the smart action plan, which essentially stands for coming up with something that's specific, measurable, achievable, realistic and timely, you know. And so the grandmas have to go through all of that. Because, you know, when you come up with a solution, the more it addresses the smart sort of elements, the more likely it's going to work, you know. Yeah.

So in a nutshell, you know, those are some of the components that we kind of focus on. Yeah. I'm a big believer in that a lot of the value that we can offer to people is helping them create a plan that will work. Often think of it in this way, you've probably heard of like the trans theoretical model of change, the stages of change model, right? And it posits that there are at least three steps before the action step, right? And it posits that there are at least three steps before the action step, right? There's a pre-contemplation, there's a contemplation, there's a planning, but all of this immediately try

and jump right into the action step. That is so true. Which usually doesn't end well because there's no good coherent structural plan and so, you know, having the grandmothers deliver that is really valuable. I want to talk for a minute about how the grandmothers helped heal you. Yes, you know, I shared earlier on about the loss of Erica, my patient who took her own life by suicide. And I hadn't actually shared Erika's story with anyone. I kept it inside me because I was struggling with the guilt, you know, and the feelings of imposter syndrome.

Even after I'd started working with the grandmas, you know, but, you know, over the first year or two of working with the first 14 grandmothers and watching them interacting with clients, I began to realize that I needed to open up about my own pain, about my own story, and it wasn't planned at all. It actually happened one morning when we were having a debriefing session and I write about it in the book. I only started talking about my pain, the loss of Erika.

And it was the response from the grandmothers that really kind of made me realize how powerful what they were doing was because after I shared my story and I cried in front of the grandmothers, you know, what they did was they broke down into a song. They started to sing this song, this soothing Shauna song, each one of those 14 grandmothers just knowing where to place her voice. And they sang that song for me, which was almost like 10, 15 minutes. And after that, they prayed for me. That is all they did, Eric. They sang and prayed for me while I was in the middle, them in a sort of circle and you know I just broke down but when it was all over I felt this sense of immense relief and after that I was able to share Erika's story.

And then, you know, I subsequently went on to talk about Erika at TED in New Orleans. And I think that was only made possible because the grandmothers had taught me about, you know, the power of being comfortable with being vulnerable in situations like that. So, yeah, that was really a powerful moment for me. MUSIC Amy Robach and TJ Holmes here. Diddy's former protege, television personality, platinum selling artist, Danity King alum Aubrey O'Day joins us to provide a unique perspective on the trial that has captivated the attention of the nation.

Aubrey O'Day is sitting next to us here. You are, as we sit here, right up the street from where the trial is taking place. Some people saw that you were going to be in New York and they immediately started jumping to conclusions. So can you clear that up? First of all, are you here to testify in the Diddy Trial? Aubrey will offer her opinions and expertise based on her firsthand knowledge

from her days on Making the Band as she emerged as the breakout star. The truth of the situation would be opposite of the glitz and glamour. It wasn't all bad, but I don't know that any of the good was real. I went through things there. Listen to Amy and TJ Presents, Aubrey O'Day covering the Diddy Trial on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts. Hey, I'm Dr. Maya Shankar. I host a podcast called A Slight Change of Plans. I started this show because unexpected change comes for all of us,

and there's no set playbook for how to deal with it. I have all of this psychological baggage that I'm carrying with me, and the last thing I want to do is to pass that on to my daughter. So I have to figure this out. This is this puzzle of my trauma. I have to figure it out, and I have to figure is to pass that on to my daughter. So I have to figure this out. This is this puzzle of my trauma. I have to figure it out and I have to figure it out now. Join me this season when I talk to Amanda Knox about her choice to reconnect with the prosecutor

who helped put her behind bars. This is not about him. This is about me and what I am capable of giving. And I know that I am capable of being kind to this man. And by God, I am going to do it and no one can stop me. Listen to a slight change of plans on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hey, it's Jay Shetty, and I'm thrilled to announce my first ever on purpose live tour podcast or wherever you get your podcasts. conversations to spark learning, experience growth and build real connections. I'll also guide you through live meditations, share groundbreaking

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here and Karen here, and we have neither of them. But what I'd like to do is I'd like to read a listener question that we got. We've recently started taking in some listener questions and I'm trying to get them answered in various shows. Now again, I think this is only going to be so useful because there can't be the back and forth that we might want. But I'm going to read the question and I just wonder if you could sort of give us a sense of how a

grandmother might approach this. Sure, sure. All right. Okay. This comes from Karen. Karen says, about five years ago, I divorced from my ex of 40 years and I felt liberated and tried loads of new things. However, recently, I met and fell in love with a married man. It was intense for both of us, but it ended when he was caught between two lives, he had other issues, and he took an overdose. He survived, but the next day he decided to return to his family and immediately cut off all communication with me.

Since then I have been completely stuck. I've tried to go back to my life and put energy into it, tried to get out and about, but it's not working. I feel completely without energy and self-belief and I've withdrawn from work. I've tried so many things. I've also been doing some therapy and I'm reading a lot, but I'm still really stuck. So any suggestions would be extremely helpful. If a grandma was listening to this story, the response, I didn't mention this, but this is something we train all our grandmothers to always start off by saying,

would you like to share your story? So let's say this story has been shared. As a grandma, I would want Karen to tell me more. I would say, Karen, I would like you to share more. Start from wherever you want to start, but I would like to know a little bit more so I can be in a better position to help you. So I would then listen to Karin. And by listening to Karin, you can see where the emphasis is. She might subconsciously not know where the emphasis should be, but as we tell our stories, the

areas that are really hurting us the most tend to emerge. You tend to see these patterns in the story as it's coming out. And we trade the grandmothers in what we call the rule of three. What are the three most salient features of the story that are coming out? And so those three most salient features are, in this case, I wouldn't know what they would be. The grandma would at some point then say, if I heard you correctly, you are struggling to come to terms with this breakup. It's affecting your sleep. It's affecting the way you are struggling to come to terms with this breakup. It's affecting your sleep.

It's affecting the way you are interacting and relating with other people in your life. Would you like to share more? And you see where it goes. So it's really Eric about tapping into a story which has not yet been told, but it's there inside her because what she's shared is very much the surface. There's a deeper element in those different components of a story that need to come out

and as it comes out, so does the healing element. So I would encourage Karen to share more. That's what I would do. The other thing is the grandmas don't tell you what to do. Friendship bench is not about telling you what to do, but it's about unpacking what's happening and you realizing on your own as you unpack, you hit that aha moment and you're like, oh my goodness, this is what it is. That's what normally happens.

And the other thing as well, before I forget, apart from doing all of that, a grandma would also intuitively ask the questions that are part of our screening tools, to establish whether Karen is actually struggling with major depression, or she's struggling to come to terms with her loss, but she's not clinically depressed. So that's also important. Yeah, because there's elements in this story that could point towards that potentially. If

you've sort of grieved the loss, but you're really still stuck with no energy, no self-belief. I'm not saying that Karen is depressed. I'm certainly, I'm not even grandmother level trained. So I will stay far away from the DSM-5. I can say from my own experience, however, that describes often for me what depression has looked like. I've dealt with the initial thing, but something about that shock sent my, in my case, my depression prone system into a spiral. There is another term that comes out of your languages, Shona? Shona, yes.

I'm not going to attempt to say this either because I'm glad I didn't try before because I was so far off, it might have been embarrassing. What is thinking too much in Shona? Thinking too much in Shona is Kofungi-Sisa. I would have been closer on that one. Talk to me about why that was part of what the grandmothers identified and why that was a key part of the therapy. So one of the things that we've done at Friendship Bench, as we expanded, Friendship Bench as we expanded, we validated screening tools, we came up with the most appropriate terms, and the whole process of coming up with the term

Kofungi-Sisa involved not only discussing with the grandmothers but with clients as well. To come up with a common terms that resonated with both grandmothers and clients. And we found that Kofungi-sisa, very often when it was serious, severe Kofungi-sisa, had the elements or symptoms of your DSM-5 criteria for depression. And so that's why we shifted to the term Kofungi Sisa, which resonated with the community. But then our Kofungi Sisa has different levels.

This Kofungi Sisa, which is really like your DSM-5 major depression, which needs attention more than just what the grandmothers can give, you know, maybe medication and stuff like that. But the mild, moderate versions of depression could then be handled. So, Kofungi-Sisa really is a reflection of how people identify the emotional struggles, which I guess we could say are linked to the DSM-5 diagnosis of depression and anxiety as well, you know, together with ICD-10. Yeah. Back to your point about the mental health bench versus the friendship bench,

terms that resonate with our lived experience are always so helpful, you know. I think the Western term that we might use for that, that I know a lot of people listening to this show and people I've worked with have identified with is the term rumination, right? It's you just going around and around the same thoughts again and again. It's not like

you're thinking too much in novel and creative ways. It's just you're thinking about the exact same thing again and again and again and again. That's exactly what it is. Yeah. You know, and we always place a timeframe to it as well, you know, just like in DSM-5, if you had these symptoms for more than two weeks, you know, so Kufungi-Sisa, which is like for a day or two, it cannot meet diagnostic criteria of DSM-5 or ICD-10, you know, so duration is also important. So it sounds like the initial friendship bench lasts, did you say, six weeks? Yeah. And then you encourage people to go into sort of an ongoing support type group? Yeah, so what we do is after the experience on the bench, folks are encouraged to join

support groups. So in essence, you know, it's a little bit like you have people who've had the same experience on the bench, they've gone through those three levels of opening the mind, uplifting and strengthening. They are then brought together in smaller groups. You know, often these are groups of 15, 20, maximum 30 people in a community. And they then use the same skills that they got from the bench to collectively address larger issues that they may be facing. But here's the beauty of what happens in these circles or support groups. Every member of the circle, it's a little bit like AA

actually, every member in the circle has an opportunity to share how they're doing and what they're struggling with and what they think is a priority issue for them. And so each group has what we call a talking piece. So only the person who has the talking piece can speak. And so after everybody has shared, what then happens in these groups is they collectively decide on which problem or problems they want to focus on.

It can be a problem that a single person is facing or it can be a problem that several people are facing and they collectively bring their resources together, their wisdom together. And sometimes the problem could be something that is financial and they all get together to help each other. So these support groups have been running for more than 10 years, some of them. And so it's really a powerful way of sustaining the model after a session's on the bench. Yeah. And that makes a lot of sense to me because a question I was going to ask, and then I

remembered that you have these support groups, was lots of people, if I use Western experience, go to a therapist six times and they still got a long way to go after the end of those six sessions. And my experience is that true change happens little bit by little bit, right? That's the way most change happens. And one of the things that stops a lot of change is that we get discouraged partway through or we just sort of slide off paying attention to it. And and so for that reason, you know, support groups or communities of practice or different things like that are are real ways to in essence, keep going, keep making improvement beyond

just working with a therapist. And one of the things I've thought that I found in my own life is really interesting is I have had a fair amount of healing that has happened by talking to a trained therapist. I have probably – no, not probably – I have definitely had more healing happen in group dynamics. There is something about that that a lot of us don't want because we're nervous about it. But my experience has been it's incredibly powerful to have that group dynamic. It brings something else to the table that you don't get when you're just talking with one other person.

Oh yeah, that is so true, Eric. What I think happens, that is what I've observed at Friendship Edge, is it helps to build that sense of community, that sense of belonging, which is so powerful. When you have that sense of belonging, you then get hope. You have hope. I just want to read a sentence to you and let you reflect on it as a way of heading out of here. You say at the core, the model is anchored in the power of storytelling, which we've talked about, to transform us from the inside out and the belief about empathetic presence. But this is what I love. It says it can create a ripple effect of healing, beauty, and goodness. Say anything you would like in response to that as a way of wrapping up. Well, in essence that makes us comfortable with feeling vulnerable in the presence of other people and that's really sort of the foundation of healing.

That's beautiful. And there is no doubt that what you've done has created a ripple effect of healing, beauty, and goodness and addressing a problem that our world really does have, which is lack of availability to getting help with our struggles. And so it's a beautiful thing you've done, and I genuinely appreciate you joining us on the show.

Thank you for having me, Eric. Thank you very much. Thank you so much for listening to the show. Thank you for having me, Eric. Thank you very much. Thank you so much for listening to the show. If you found this conversation helpful, inspiring, or thought-provoking, I'd love for you to share it with a friend. Sharing from one person to another is the lifeblood of what we do.

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