Modules 15 Transcripts Compassionate Inquiry Master Class

Module 1: An Introduction to Compassionate Inquiry
Gabor Maté
Rich Simon (00:00:11):

Welcome everybody. My name is Rich Simon, I'm Editor of Psychotherapy Networker, and I would like to
welcome you to this Master Class on Compassionate Inquiry with Gabor Mate who will be our guest
today. Over the last several years, they haven't been very many new faces in Psychotherapy whose work
has attracted as much attention as our guest here this morning. His focus on trauma, his focus on
attachment, his focus on seeing the issues that people bring into therapy in this larger social context,
have attracted a lot of the attentions, it's a viewpoint that really adds something to the kind of the
range, the perspective of psychotherapy. So over the next several installments, you're going to see
Gabor at work and see what a Compassionate Inquiry looks like and in our conversation today, you're
going to get an overview.

We're going to talk about Compassionate Inquiry, where it came from, what distinguishes it from some
other models of Psychotherapy, which is the emphasis of this way of working and enough said in
preliminary comments. So welcome Gabor, great pleasure to have you with us this morning.
Gabor Mate (00:01:45):

Thank you Rich, it's just good to see you again.

It's always good to see your fantastically interesting brooding face, whether it's on the symposium stage
or in the magazine or right in front of me here this morning. So I'm already feeling in sync, the mood for
the conversation has already been set as far as I'm concerned. So Compassionate Inquiry, tell us where
did this come from? What was the inspiration for developing this particular method? I don't think you
call it a therapy model, but you'll explain to us how exactly we would understand what Compassionate
Inquiry is about.

I call it an approach, it's not a modality and it's an approach. I don't set it up in distinction or in
competition with other modalities. It's just an approach that anybody can learn and apply, no matter
what particular technique they're using, but know there's also techniques involved. Now, how it evolved
has to do with the medical system here in Canada, I'm a physician, at least I'm a retired now, but I was a
physician for 32 years.

Although they don't teach you this in medical school, it became clear to me over the years that, no
matter what issues people came in with, whether it was mental health issues, ADHD or depression or
psychosis or bipolar illness, anxiety or whether it was medical issues, such as chronic autoimmune
conditions like multiple sclerosis, colitis, Crohn's disease, scleroderma, chronic psoriasis, asthma, chronic
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recurrent eczema, malignancy, that in virtually all cases there was a significant contributions of the
personality traits that people had and the onset of their illness and further more a real contribution of
stress in their lives to the onset of their illness.

Then of course, these personality traits I found out through my own inner work and therapeutic work
that I had to undergo for myself and other reading that I've done and including from many of the great
teachers that you've presented at your conferences, Bessel van der Kolk, Peter Levine, Dan Siegel and
others and broader reading, these personality traits did not represent the two characteristics of the
individual, but actually they were defensive or coping patterns developed in childhood. In other words,
what I was noticing is that the coping patterns that people adapted in childhood then becomes a source
of dysfunction and pathology for them later on. A co-presenter last year at the Networker Conference in
Washington was Richard Shorts, Dr. Richard Shorts and I didn't find out about his work until a couple of
years ago, but his work comes closest, because he identified these personality patterns for example, I
noticed that people in autoimmune disease tend to be self suppressors, repressed anger, tend to be
very nice and so on. Well, Richard would identify these as protectors and we can talk about that. Or if I
was working with addictions, then he would see the addictions of the firefighters trying to soothe the
pain or get rid of the stress.

What I'm saying is that over the years I found out that his psychological patterns at a lot to do with the
illness of any kind other, which means when it comes to the healing, you can't just address the body in
separation from the mind, you have to look at them both and nothing in medical training prepares you
for that. When people go see specialists, those issues are not addressed in any way at all and the
problem that I was working in Vancouver is that the psychological issues needed to be explored, but by
who? Now, private therapists cost money and that's not covered in the Canadian Healthcare System.
Psychiatrists are covered, but my dilemma was, as a physician, I always used to say some are facetiously,
but with a lot of truth, that there are two kinds of psychiatrists, those that are good and those are
available and the ones that are available are not good and the ones that are good on not available, and
this is not a knock on individual psychiatrists, it has to do with the training of psychiatrists. They just
don't get the whole mind body unity and they get no training in trauma for the most part.

These days in Biological Psychiatry, if I needed somebody to prescribe medications for psychosis or
bipolar illness, by all means I had lots of good psychiatrists specialists to refer to, but when it came to
talking with people, exploring the deeper issues that might be informing or evoking their physical or
mental health issues, there was nobody to refer them to and my clients could not afford a private
therapist. Therefore I had to develop a private therapy practice myself. Literally, it was forced upon me.

So you had been practicing for many years. You were aware that you weren't touching some aspect of a
mind body that was crushing, weren't quite sure how to do that your training is not as a
psychotherapist, it's a family physician. As soon as you began to try to expand your perspective and try
to bring a more of a psychological mind, body perspective into the work, how did you start? How did
you begin to try to develop what has become your approach or your framework?
Well, again, I can't separate the person who is unprofessional, excuse me. In my mid fifties, I was
diagnosed with ADHD, first self diagnosed, which I'll not go into the details but then officially diagnosed
and I never bought into the idea that this is some kind of a genetically inherited disorder. I understood
that they have some minds tuning art, were actually defense techniques. They were responses of stress
and I had to do my own work. There was a lot of stress, there's a lot of depression, anxiety and my own
life so I went to therapy myself. I began to see the sources of that in my childhood and my infancy and
then I began to see the same thing with my clients.

As I did the reading, I read Alice Miller's work on childhood trauma, work of age illness, Ahmed Ali on
the development of the personality and the psyche and the separation and the Western mind of the
psychology and the spirituality. So I began to then seeing the social anxieties and economic stresses on
people, affecting their emotional states. So, I just began to develop a holistic view that I didn't theorize
about. It was just kind of what I absorbed as I was doing my work and so-

Did it put influence on you as you were doing it in addition to your personal experience?

Well, the therapy that I had of course was a big influence, my reading, as I mentioned, then I had an
opportunity in 1997 or six, I think, I traveled from Atlanta to go to Seattle, which is close by to
Vancouver to hear a doctor's Dan Siegel and Allan Schore talk about brain development and that just
opened in my eyes. I didn't know, we've got this brain, but it's not a genetically determined organ, it's
actually developed in interaction with the effective emotional environment and that just was a
revolution, man. It totally fit in with my intuitions, but I had no evidence for it until I heard those two
guys.

Then I began to be aware of the work of Peter Levine and Trauma, Bessel van der Kolk and Trauma, I
began to write my own books, had to do a lot of research. So it just all came together and the biggest
teacher was my clients, because believe me as a raw psychotherapist with very little or no training at all,
I made lots of mistakes. But you know, there was something about just my willingness to listen to people
that made them keep coming back. So they taught me, they just taught me.

One of the things how you describe your interest with Compassionate Inquiry is all about is that it's an
attempt to address this disconnect, that most of us have, between who we purport to be in the world,
how we present ourselves, and something that's more authentic inside and that's what you're trying to
get at. That's sort of a little nebulous as I'm describing it, but how would you describe? What is the core
principle of Compassionate Inquiry?

Well I think it was Peter Levine who once said that the essence of trauma is disconnect from yourself
and I wish I had said it, but I think he said at first.
But you said it nicely and then in your own way.

Okay, good. I'll take a credit for something. So that disconnect leads to a lack of understanding and
compassion for the self. So even though Compassionate Inquiry is a therapeutic method, really what it's
about is training people, inviting people to be compassionate and curious about themselves. So the
success of the program is manifested when a client, when they have an issue come up, can be just
curious about themselves in a compassionate way. So typically people say, "Why did I do that?" Well,
"Why did I do that, it's not a question, it's a statement. It says I'm an idiot for having done that, or I'm a
bad person, I haven't done that. Now, if I was talking to you and if I spoke to you in an accusatory,
judgmental fashion, would you really be open to sharing your stuff with me?

I mean, Stephen Porges beautifully points out, you'd go from the social engagement motor to an extent
of defensive flight or fight, possibly freeze mode or the same thing with the self. So "Why did I do that?"
Once it becomes, "I wonder why I did that," Now you have space to look into something. So that's
what's called compassionate curiosity and that's what Compassionate Inquiry invites, is the evolvement
of that compassionate curiosity towards the self of the client.

The key there is inquiry. What's the focus of the inquiry as far as you're concerned? How would you
describe it?

What inquiry is, what do I believe? What is my core belief? So not what do I believe consciously, but
what is the core belief that's driving my behavior? So, I'll give you an example. Excuse me, I'm just the
tail end of a pretty bad laryngitis, so you'll hear me coughing every once in a while. But don't worry, I'm
not infectious. So you're not going to get the virus.

One of the advantage of being in the digital age.

So I was in London last year in England and I gave some lectures, I speak to 1,500 people and success
and what can I say? I don't cook my own horn, but I'm an effective speaker and audiences respond very
well and lots of great feedback, so I think I'm pretty good guy. Then I go into this clothing store where
I'm under somewhat rushed conditions having to go to an interview, and ended up being accosted by
the security people as I leave the store being accused of having stolen something, getting accused of
shoplifted a shirt, which I had not. But all of a sudden my self image is challenged. How do I respond
with the rage and the disdain and aggression. So an issue that could have been resolved rather rapidly
and quite amicably, all of a sudden it becomes inflamed into a situation.
So, then I have to look at myself afterwards and say, "Well, okay, why did I do that?" My initial response
was, of course to blame to them, how dare they accused me. But really what it came down to is, they
were just doing their job. They may have had a misperception, but they have the right to their
misperceptions, like we all do. Who was I, what did I believe about myself at that moment?

Well, what Compassionate Inquiry tells me, what I believed about myself was that I was my guilty little
kids self, who was defending himself against an accusation and that's what had me behave the way I
was. You can only do that if you get compassionate about yourself, if you're not defending yourself
against the other person and if you're not accusing yourself either. I could've said, "What an idiot I was,
to behave that way," and maybe for a while I did, but I very quickly came back to, and once I looked at it,
it just became funny. The whole thing just became really a humorous thing.

There are two things that are striking about Compassionate Inquiry. One is about the process itself from
the point of view of the client, whoever's the acquirer who's coming in and we'll get to that in a moment
and we'll see a lot of that at work. The other that's very striking to me, that gets almost equal attention
in your writings about Compassionate Inquiry rather is the stance of the listener, the therapist, whatever
we would call that. What's important there, what is it that when you do your trainings and when you're
helping people to develop some command of this approach, this way of looking at themselves and
others, what makes for this kind of compassionate listening that seems to be at the heart of what you're
doing?

Well, first of all, I'm not the first one to point out, excuse me, that the most important aspect of the
therapeutic process is not the modalities, is not the technique. It's actually the quality of presence, the
quality of the relationship and as Stephen Porges so beautifully put it, we have to create and safety and
safety he says, it's not about the lack of a threat, it's about the presence of connection. So many
professionals don't understand that, they're well meaning, they're well intentioned, they're well trained,
but they don't understand connection or the importance of it.

So that creates an invisible wall and I've had so many clients tell me that they've been to a lot of
therapists and then doctors and so on, and they just never felt safe enough to open up. So the first thing
is to establish that safety, which you do so, to connection. Now, connection with who? This is where...

And how?

... and how, yeah. Well the how is really a question of who, and the question is who are we being? So
who am I being in relationship to the client? Am I this expert with this knowledge and this commitment
to heal the other person? Or am I present as a human being, being to be open and vulnerable myself
and not be attached to my role and so that's the first thing, is who am I being. Just how comfortable am
I in my own skin? So when I do the training with people for Compassion Inquiry, they often come
thinking that they're going to learn this modality and technique and which they are, but really the
biggest part of the work is themselves, trying to see who's showing up here and that who then, if it's a
genuine present human being. That's 50% of all of it right there and that's done in the first minute. It can
be done in the first minute depending on just how you show up. So hardly show up-

[inaudible 00:19:56].

Sorry?

What's that first minute like? What's going on? That's so important.

Establishing the contact, giving a sense that the client is really welcome. It doesn't matter what they
think about themselves, doesn't matter what they've done in their lives, what they haven't done, they're
just welcome to show up exactly as the way they are and that you're willing to look at them with
absolute openness and non-judgment. These are the things to remember, these are qualities that we
cultivate in ourselves largely by doing our own self work and so I can't even say, it's my method here, it's
my modality here. We really emphasizes the importance of self work as much as the importance of any
particular technique or steps or modalities. Just being aware of yourself and who's showing up here.

You see what strikes me is I've learned more about what you do, is how attuned you are to the quality,
the way in which the therapist ego and all kinds of subtle ways enters into that relationship and can
create a sense of non-safety. I just recently had experienced, I was doing some work with a therapist
and what kept coming up, they had such an investment in my seeing things in a particular way, that I
found myself asking is that for my benefit or for theirs? What's happening there and what I find very
interesting and refreshing and really hasn't been expressed in quite the way that you do, that how this
ego shows up. The need to prove something to the client, the need for the client to change, all the
different ways of the therapist is in these often very subtle ways is trying to be validated. Talk a little bit
about that, how you see that and how the therapist's own ego gets in the way.

Well, I couldn't be happier with your question because I think it goes to the very core of what happens.
Two things come to mind. One is, let me tell you, one of my early cases in my medical practice, it shows
up so beautifully. There was this a woman that was dealing with certain issues in her life, but I was so
keen on... when I was early in this kind of work, I had certain theories as to why everybody was sexually
abused and I was always disappointed when I couldn't find sexual abuse, because now, how do I to
explain it? So there's a woman who was coming for counseling came in one day and told me that she
had this dream, about me.

Now, I actually used to deliver a lot of babies in those days as a family practitioner and her dream was
that she was pregnant and she was actually on the delivery table and she's about to deliver this infant
and I was there and I wanted so much to deliver the baby and then have her hold this baby. But all of a
sudden she got off the delivery table and ran away as fast as she could. I just laughed and laughed and
laughed and I said, "Congratulations, that's such a great dream, because I'm working so hard to make
you give birth to yourself, that I want something to happen here and as soon as you sense that I want it
to happen more than you want it to happen, the best that you can do is to runaway."

So I thought that was a brilliant dream and that dream taught me a lot, because yes, that was so intense.
That was so... What's the word I'm trying to use? Compulsively wanting to teach this woman's
something. It's not so much that I wanted to prove something to her or did I really want to prove
wanting to prove something to myself, my worth as a therapist, maybe I wanted to give birth to myself,
but I was imposing all this stuff on the client. It's not that, having seen that example, I learned the lesson
fully, I can still fall into that trap of wanting to prove something and this is part of my training is, what I
do notice is that whenever I'm trying to do that, there's tension inside me

So that when there's tension inside me in response to a client, my mantra is wherever there's tension, it
requires attention and so that internal tension that I have, which comes up precisely of the dynamic of
wanting something to happen for the client. When I notice that tension in myself, that's what I go to
attend to. Well, what am I trying to coerce really essentially this client into.

Prove myself in some way.

Yeah. It's to, I need to be right or maybe I'm afraid that if I don't get this point across, the therapy won't
be successful, but it's all about my fears. It's got nothing to do with the needs of the client. It's all of a
sudden the client has no space to be themselves and that's, I think, something of what you might've
experienced recently and clients pick it up.

I certainly, this was a lovely person who's empathic, a lovely soft, honest, was so helpful, but there was
something that she was determined to teach me, whether I felt like I needed to learn it or not and it was
a very small thing. As she was lovely and all other kinds of ways, and it closed the door, her
determination to teach me this thing changed the whole character of the relationship.

Well, you say it was a small thing, but really it wasn't.

I don't know. No, I'm saying it in sort of two ways, emotionally for me it was used in terms of someone
who's been watching the conversation, just might've noticed how therapists conduct it.

So I'm curious, how did you respond?
I responded by closing off, so I had just a few moments before she had looked at me with such a warmth
and understanding and I felt her attunement and her very sincere intention to be helpful to me. Then it
shifted from that in a sense like I was in something with her together, to she had discovered a storyline
for my life and she was going to teach me what that storyline was.

So do you mind if I asked you a question about that?

Yeah, sure.

So this is not a critical question. It's really a question of inquiry.

Yeah.

I'm not saying what you should have done, I'm just asking what might've kept you from saying, "You
know what, I'm sensing some pressure from you right now, to get something that makes me feel
uncomfortable, then it actually makes me want to close off and it's interfering with what you're trying to
do, which I know is unhealthy." What would keep you from saying that?

I think what kept me from saying it, my guess is, it keeps clients from saying this very often to their
therapist. The therapist is so well intentioned. They're trying so hard and they're giving as much of their
attention as they're aware of and so it feels ungrateful and defensive in order to it to resist that in any
way. So the first impulse is, well, let me just give this moment, this particular quality of the relationship.
I'm going to give it the benefit of the doubt. It's me. This is my problem. This isn't our problem. This isn't
something that's getting the way it's me, and maybe this is a part of why I'm talking to this therapist in
the first place.

But it is.

The ability that you just demonstrated of taking a step back from this because this is something that you
understand very, very well, express it in the terms that you just did.

You just told me about your childhood.
Yeah.

Because what you were doing-

Is if I had a choice, right?

Yeah, you had a choice. Notice what you did there is... and this is why the therapist has to be so aware
of themselves. If that therapist had been aware of their own body at that moment, they would have
noticed some tension inside them and that should have been a warning sign to them or could have
been. What you did-

I was aware of that inside me where a few moments before I was feeling like, "Wow, I'm on a healing
journey here, I'm feeling attuned and understood and let's go wherever this is going. I want to be there."

Wow and that lasted two seconds and but notice what you did is, you started taking care of her. You
started protecting her.

Yup.

So now this is a Compassionate Inquiry encounter I would ask you, so this dynamic of you taking care of
somebody who is supposed to be taking care of you, how far does that go back?

I mean, you named it, that's my family story. We want to spend the rest of the time talking about my
family. I'm more than happy to do that, but I think it one, it gives me a sense of kind of the inner life of
Compassionate Inquiry and also this seems so much really different approaches, different ways of
thinking about therapy, that there's a particular point of emphasis that really sets them apart. This
particular aspect of Compassionate Inquiry, that delicate play of, ego and letting that go and really being
able to and it's not an easy thing to do in all the subtle ways in which that manifests itself. It seems like
Compassionate Inquiry is, I was so impressed with how attuned that your approach of the various
things, that it's very attuned to, that particular element that can be expressed in what to me seems such
subtle ways. My story was told in that in some ways, I don't know why there are more threads to it than
just that, but that's a main theme. That's a major theme for me.

So the essence of this Compassion Inquiry is to get to the heart of things very quickly, because that little
vignette that you depicted caused me this story of your childhood and once you attuned to seeing that.
The other part of this, to go back to your original question, the therapist has to notice in themselves that
drive and if I was working with your therapist, I would ask her, "Well, when was the first time that you
felt it essential that you get somebody to see the truth of things," or they would say, "Oh yeah, I wish
my parents had." This is where all of a sudden her childhood shows up and confronts your childhood,
now you've two children.

That's right. Is it the first time in history that has happened?

Yeah, first time. No, it happens to me in therapy, when we are working with people, it happens to me.
So the emphasis for me is to train a therapist into noticing that in themselves and to be compassionate,
be curious about it. Why was I doing that? Now, my imitation to you is, my guess is that your therapists
could probably handle it, so that if you actually trust them, like this person and they're working with
them, it'd been beneficial to you. Now's the time to test the relationship and I don't mean testing it in a
challenging way, but just to see, how dynamic is it? Is it willing to grow? Is it willing to deepen, is willing
to develop? So next time you see her, you can say, "Well look, so and so, here's what happened for me."

At the time, my response was my default response, we just to close down, what really had I been
present, I would have said to you and then say what it was like for you and then see what happens.
Now, if she's worth her salt, she's going to thank you from the bottom of her heart. If she isn't, she's
going to get defensive and make it all about you and then you've learned something.

That's great and that makes so much sense. Again, the thing that has impressed me about your work
and your particular way of dealing with situations like what I'm trying to describe is the subtle dynamics
of the helping relationship. That can make it hard to talk about elements like ego, like the therapists
need for something to happen and then particularly that need to teach, whether the client is ready for
that or attuned to the teaching and something gets off. So it seems like for me, this whole dialogue that
this process of dialogue that you've developed is as much as anything I have come across a way of
excavating all these threads that get in the way of what we call the helping relationship.

Excavating is a wonderful word because sometimes I call it the archeology of the mind and you actually
are excavating. You're looking at the artifacts guards that are lurking in the shadows that are the
remains or the bequests of childhood experience and often multi-generational trauma. Once we unearth
them, once we escalate them, now we can look at them, we can brush off the sand and the dust and the
particles and you just look at, well, what's actually there again in a compassionate way.

As we said at the beginning there's so much overlap between many different approaches and models,
whatever it is that people talk about. If I might ask this and I think this is probably not a question that
you particularly welcome... but I'm going to ask you anyhow, is so why do we need Compassionate
Inquiry? Don't we know this? Isn't there so many common elements in what you're demonstrating, what
you have put together with the various people that you've mentioned and lots of others? Why do we
need yet another approach to psychotherapy?
I never said we needed anything. I never said anybody needed Compassion Inquiry. What actually
happened was that, that's not for me to say whether somebody needs it or not, it really is not. What
actually happened was that over the years as I developed this method and then I became better known
and I wrote books and started teaching, talking.

Not a method, an approach.

Sorry?

Not a method, an approach.

An approach, yeah. Thank you. So then people get asking me, "Can you teach us what you do?" They just
seem to like what I was doing, whether it was in small group seminars or larger groups, "Teach us what
to do," and I said for years and years, "I don't know how to teach it. I never developed it in the first
place. I just do what I do," and I really had this question, "Is it just a gift that I have? I'm pretty quick to
getting down to the core issues with people or is it something that's actually teachable?" and I kept
saying it's teachable and I said, "No, it isn't," and literally what would happen was that about three or
four years ago, people that had worked with, they said, "Well, come to Toronto and teach it. We'll set up
a program, we'll, organize it," and I said, "Okay, and what should we call it?" I said, "Well, let's call it
Compassionate Inquiry."

I'm telling you history here, as God wrote it, my honest hope was that nobody would show up and I
wouldn't have to exposed my incompetence at teaching this thing that couldn't be taught. Well, 350
therapists did show up, with another 150 on a waiting list and I actually had to do it and it worked and
you'll see some of it in the video clips that we'll be showing in the following weeks. It actually worked.
I'm not the one who decided that anybody needs it, people requested it. Then working with people
closely, they said, "Well, can we develop a program out of this?" So then we developed a program, but
I'm more of a doer than I am a organizer or even a... I mean, if I look at somebody like people like Dan
Siegel and Dick Schwartz, as far as I understand those guys, they're so methodical, they're so organized,
me, I'm just sort of more go with my intuition and so I did. So other people have to work with me to
make this teachable. So that's what we developed here and so it's not like for me to say that anybody
needs it.

Got you. Going back to this kind of the shift of, here's something that you find that you're doing, you
recognize there's a need with your patients. You realize that something's been overlooked in medical
treatment, you get curious about that, you develop various ways of responding to it. It happens, it feels
natural to you, for various reasons because you have a great need to spread this into the world, but you
find yourself in the role of the teacher. So what did you discover that there is to teach? Other than
watching someone to whom this comes from everything that you've described, relatively naturally and
it's evolved out of your life experience and your studies and so forth. But what is it that you wound up
discovering or deciding that you need to teach people in order to engage in this process?

Well, again I have to emphasize that it was in collaboration with others, that we developed the teaching
trajectory. They watched me do it and they say, "Here's what you're doing," and so, "Yeah, that's what
I'm doing." So, it was a really a collaborative process towards something that-

They taught you what you needed to teach?

They taught me what I was teaching, basically and it's not like it sprang from my head, the famous image
of Athena, which is the goddess of wisdom springing from the head of Zeus. This did not spring from my
head. It really was a Coke start of me and then systematized in collaboration with other people, but
once we've done that, there's a number of points that, let me focus on this.

So the process that people go through as they become exposed to your approach and they recognize
and they internalize kind of the really the heart of the matter. What happens? I imagine most of the
people who have come to you for training are already therapists and familiar with some method, what's
the path that they tell you or that you observe that's different? What's the distinctive path of becoming
someone who's can really use this approach in a way that's very sensitive and helpful to people?

Well I know I should be saying something here very profound so that people can, troop to my colors
and, "Oh yeah, this is different. This is great." But I don't dwell so much on the differences in myself and
others. I just do what I do and if people find that attractive and interesting and helpful, that's great and
if they don't, well that's just as fine as well. But what do we teach? So we teach what are these certain
four basic pillars you might say. There is the external conditions which is simply that we have to
maintain, you have to maintain safety, confidentiality, you have to be aware of potential triggers, not
just for the client but also for yourself, so that we don't get into that kind of scenario that you described
with your therapist.

We have to work hard or at least be mindful of maintaining the client as much as possible in that social
engagement mode that Stephen Porges describes, because that's the only mode, the image, this
learning and development and growth and restoration actually take place. Then we focus on the
qualities of the therapist that are necessary to maintain those conditions, presence of self-awareness,
playfulness. I mean, you'll notice in some of my videos, I really play with people, I just don't much so
serious and play, of course it's very important because it's one of the first thing that we do as human
beings.
So there's the external conditions, there's are qualities of the therapist that we focused on. What are
the qualities that have to show up if you're going to do this work effectively? A lot of emphasis is on self-
work and getting to know this method or approach, you really need to work on yourself. I keep
emphasizing that and then there's 21 specific therapeutic skills that are pretty straightforward, not
unique to what I do. I just think they're essential. So it's not like, "Oh, I've discovered the wheel." It's
just, "I have a particular form of wheel and it looks like this." So these are the therapeutic skills that
develop and you doing the training, you keep honing those skills.

Then finally the certain stepping stones, that you learn and how I envision those stepping stones is, if
you're in a muddy field, it's not like there's that's step one, step two, step three, step four, I don't want
the 17 or 18 of these stepping stones that we teach, but it's not like if you go from one to the next, it's
not sequential and in a kind of a preordained fashion. If you're in a muddy field, you'll step on whichever
is closest and which is the one that's going to support you most. So you'll be using the stepping stones in
a very dynamic and creative and individual fashion, according to the requirements of the situation.

Now, the essence of it all and I think what does distinguish this method or this approach, and I hope I'm
not saying so egotistically but this is the feedback I get. It's like you get to the heart of the matter very
quickly. It doesn't take a lot of sessions, because people bring their full selves to the session. So every
time they open them up, every time when you listen to their voice, when you look at the facial
expressions, when you notice the body language, when you notice them protecting you, for example
rather than speaking for themselves, they're showing up what happened to them. They're manifesting
the reasons why they came to you, not just in the story they tell, but just a how they tell it and who they
are being moment to moment. So we pay close attention to that and we invite the patient to be aware
of it as well.

Then of course, the fundamental belief is, is that, which is what I began with this discourse with is that,
what drives people are hidden stories that they're not aware of. So our intention is to bring those
hidden stories to the surface as quickly as possible.

Here's what strikes me as I see you work it's much of what you just described, the sense that it's there.
It's right there. It's the heart of the matter, it's not that far away. It's not some longterm excavation and
so there's something about the rhythm of the session, something about you and your particular kind of
a brooding intensity that I think makes this model fit for you and gets people to respond to you, but that
how very quickly you move into a core territory with people with questions and with this quality of
listening.

Yeah. I think that's the essence of it.

Inquiry is a piece of it, but it's the compassionate listening that feels like that's so much of the fuel for
what happens.
Compassionate and attuned listening, not that you can have one or the other, but really listening and
noticing and seeing what you'll see me do in these clips, I know that you've chosen for these
demonstrations over the next several modules, is I don't dwell too much on people's stories. I don't, in
fact, I tell people almost from the beginning, "Look, I'm going to interrupt you." Now, sometimes I listen
for quite a bit of time, as you'll see, but sometimes, I'll interrupt it very quickly. It just, whatever the
situation requires. It's just also very spontaneous. We do people no favor when we simply validate their
stories, because their stories is what have them struck in the first place. We validate people's emotions,
they're genuine, but then what is the story that is generating the emotion?

Unless the person begins to take responsibility for the narrative that unconsciously they're telling
themselves, now they're on the path to freedom. I personally had the experience Rich since I've seen
you, I'm having a deep experience that this brooding quality of mine that you referred to, I went to the
Amazon to take part in some plants ceremonies and these healers who never heard of me, they're not
impressed with my work in the world. They took one look at me and I said, "You know, there's
something dark and dense in you and you must had a scare," They don't even speak English, they said,
"You must had a scare." These are native healers in the rainforest and they say, "You had a scare early in
life, then you still under the effect of it and our work with you is not to help you help others, but to help
you clear those energies," and what I got is that whatever happened to me happened.

As a one year old infant under the Nazis story, that was what I made it mean, about myself in the world.
I'm the one who did that. If I'm the one who did it, I can undo it but there's freedom in that. This is
something that I intellectually understood before, obviously is the essence of therapy, isn't it? Any
essence of good therapy is, but what happened, happened, but you're the one who made it, made it
mean, what'd you think it means? So it's really helping people get down to the meanings that they've
created out of their lives to get them to see that in their lives.

Again watching your work, what stands out is this relationship to the story. So, other kinds of ways of
approaches to therapy, you really get into that story, you have to relive that story. It's a very emotional
process and can be cathartic and elaborate and all kinds of ways. That's not what I see in what you're
doing. You're changing people's, you're making them aware of the story and there's a certain distance
that is maintained in the process that seems very important to the particular way that you do your work.
Does that seem right to you?

Well it's interesting that you noticed that because your team sent me the clips that you and I will be
examining in detail over the next weeks and I'm watching myself work and on the face of it, I'm not
looking like a very compassionate guy sometimes, there's this distance, but then-

This is compassionate, where's the compassion in this guy? The compassion is not there, but it's
expressed in a very interesting way.
Well, that's the whole point is less compassion. I've distinguished a number of levels of compassion and
the first ordinary level is you're suffering and I feel bad that you're suffering. That's just normal,
ordinary, essential compassion. Then, there's what I call the compassion of understanding. It's not
enough that I feel bad that you suffer, I also understand why you suffer. So that's different from just
feeling bad for you, it's actionable, but let's look at what is it that's creating the suffering. The third level
of compassion, in my scheme of things, is a compassion of recognition where I recognize that there's
nothing about you that isn't in me at the same time. A lot of professionals don't get there, but once you
see that it changes the game.

The fourth level and I'm guilty in my own way interpreting a AJ armors here is what I call the compassion
of truth, where I'm not concerned about how the person feels. I'm concerned that they get to the truth
of what's making them feel the way they do and that's what you see me doing. So that first level of
compassion, "Oh my God, you're feeling bad," sometimes that's necessary, it's not that I don't exclude it
but really my commitment is.

It's not that interesting or important that you disregard it, but yes. In a way Compassionate Inquiry, it's
surprising you're prepared to see a certain kind of work and then you do things and it's like this guy does
not seem very, very compassionate and also that word suffering, the two things that are going on
because it does seem to me that, what you communicate and why you can get away with a times
moving quickly or being a little bit brusque or let's get to the heart of the matter, is it seems like you
really do understand suffering ,you communicate that to people. That's really at the heart of what
people are coming to therapists for, for whatever reason there's a suffering in their life. They don't quite
understand it, that they don't really know how to deal with it and they're hoping that this therapy will
be a place where they'll find some better way.

Well, many of the examples like all the examples that you will be using these video clips, they take place
in front of large numbers of people. So somebody comes up with some very deep issues and you'll see
them in states of upset, but they're doing this in front of 80 or sometimes students, 50 people and I
don't necessarily come across this sort of a compassionate nurse. So, what does it take for them to
come up and do that in front of all those people at tremendous degree of trust and so that goes back to
the very essence of what are the conditions we have to create. If you create a condition of trust, then I
can be as interrupted and as sharp as I need to be, they're going to take it well, because they trust that
this is for their benefit.

So they still have to establish that, there's no caution that you can just go in there and start acting like a
Buccaneer, there has to be a Psychotherapy Buccaneer, there has to be basis of trust. That I would say is
the essence of it and I'd say that I do that and that's what then allows me not to be as quote unquote
compassionate as one might expect. At times I may fail at that in which case-
Not an easy to come off sort of. It reminds me of something that Carls Roger once said, he said that the
things that a therapist does or the qualities that they have, that make them effective are often or
perhaps usually not something that they're terribly aware of, because they come so naturally to them or
unconsciously. So, it seems to me that part of what happens, and again, we're, I hope building people's
interest in seeing this process in action and we will and we're not just going to be talking about it and
that's what the master class is about. But if there's something very enigmatic about how Compassionate
Inquiry, especially how you execute it.

I don't know if this is a approach that everyone can be very effective with, but with a somewhat
deadpan way, somewhat removed quality in certain ways of very intense kind of listening in a sense like
you've done this one once or twice before you inspire a lot of confidence, it works. To give you the
benefit of the doubt that even though you may have time look a bit removed or even doer that, that's
part of the interest is in terms of a spectator. It's of interest to see how that plays itself out and the bond
that you're able to develop with clients.

Well I think first of all, you have to have confidence in yourself. You have to need to trust your own gut
feelings and your own insights, number one. Number two, you have to pay a lot of attention to yourself
throughout the process. What I can tell you, I had this conversation with Peter Levine once and I said,
"Peter, out of a hundred people that you train, how many get it," is somewhat expensive and he said,
"Maybe 50 and 20 really get it." Another 30 or 40, maybe, get it enough and then there'll be 20% that
just don't get it at all. What I can tell you with, I don't know what my numbers are, but I suspect it's not
unsimilar except that so much of the work is focused on the therapist themselves.

That there's a lot of clearing before you even start working. Like the online training that I do with
Compassion Inquiry, it's got eight modules three to three times and the first time it's all about you as a
person, not about what you do with clients. Now, what I can tell you is that the people that have taken
the program, whether in person or online, I get so many, so much feedback saying thank you after the
first session. My work with clients has taken a totally new direction and it's so much more effective and
people are telling me that. Their clients are telling them how much more effective all of a sudden they
become. So I have confidence that it works.

What do you make of that? So something is happening, maybe they can articulate it, maybe they can't,
can you articulate it? What is it that you think the role is a complicated, obviously it's a whole bunch of
things, but if there were one or two things that really have an impact on your trainees, what are they?

Well, first of all, we help them remove a barrier that was erected by their own unexamined stuff. Their
own unexamined stuff, created a barrier between themselves and their clients an invisible barrier and in
the form of an old TV commercial and invisible shield that all of a sudden it's not there.

An invisible shield.
So all of a sudden the client experiences, the therapist is being much more present. Secondly, the
therapist is all of a sudden more efficient. Now they have a set of questions they can ask and
observations they can make, before they wouldn't have asked and observations that would not have
arrived at, but just makes the interaction much more efficient. So those are the two main things. The
rest of it is in the details though I hope to share with our audience over the coming weeks, but that's the
essence of it. Is a barrier that will evaporate or at least loosened considerably and secondly, efficiency in
terms of getting to the heart of the matter much more quickly.

So we just have a few more moments here. There's just one or two questions and we'll give people at
the end here just a little bit more of a preview of what they can expect in these remaining modules. So
when you're thinking about Compassion Inquiry, what's going to be striking to people who maybe see
some other master classes? It's very brief, these installments, it happens very quickly, don't take a lot of
time and which is very interesting quality that we'll be talking about. You've already indicated number
reasons, why that is. So in practice, when people become practitioners of Compassionate Inquiry, what
does it look like as a therapeutic practice? Relatively, is it an any briefer? Is the fundamental process of
over time very dramatically different than other modes of psychotherapy?

I'm not in a position to say that yet because first of all, I haven't researched it, I haven't studied it. I
haven't sent out questionnaires, number one. Number two I've only been teaching it for a couple of
years so that there's no way for me to tell you. I don't want to make claims that I can't back up. What I
can tell you, is that the feedback from the people taking the course and then we're applying it is nothing
short of, enthusiastic and appreciative. Now. I also get some negative feedback sometimes, but not
negative. People say this could be different, this could be deeper or this is, maybe it doesn't work so
well. So I get that sometimes.

But overall the feedback we're getting is just overwhelmingly positive and beyond positive. People say
it's life changing so that's what I can tell you. I'm just reporting the facts in terms of this curtail the
course of therapy or whatever. Look, my approach is, what I tell people that I train is this, is your job is
to get yourself fired as soon as possible, but fire for the right reasons. Fired because the client says,
"Okay, you know what? I've got it. I can not live my life and apply this Compassionate Inquiry to myself
in a way that no need to come and see you any more to do it." That's the purpose of it is, is to eliminate
the need for you as soon as possible.

We're almost out of time, if looking ahead here to the, these modules, we're going to see you in action
or see with different kinds of clients, what would you hope for the people, the students in this course of
what it is that's going to gel with them? What is it that they'll take away from this that is any different?
Again, I guess this is the kind of question in your answer, but I'm going to ask it anyhow. That's any
different than if they do a Dick Schwartz in parts work, or they do Dan's mindfulness stuff or Bessel's or
whoever else, what's the kind of the distinctive gift that this kind of work can offer people who really for
who are drawn to it?
Well, so I'm assuming that some of the people watching might be inspired to actually take the course
over the longer period of time, which is available online, but many will not have the time to that. So
questions, what would they get out of it? What I'm hoping they'll get out of it is the teaching about how
to listen, just a particular way of listening, a particular way of listening that sometimes imply silence and
sometimes implies very quick intervention, but they're both forms of listening, they are both forms of
experiencing the client as they're experiencing themselves.

Then certain key questions that you'll see me asking repeatedly and some point is rather funny, I think
of the third or fourth session where we get people to see that, that particular way of functioning and
even showing up in that person moment reflects long and grain patterns that they can actually let go of.
So I think that people will get some sense of the kind of questions I ask and the kind of observations I
make that'll help facilitate that process and make it more streamlined and more efficient.

As you can see with me, moments here.

Yeah, and just the whole idea and so I think they'll get that even if they don't need to train in the whole
thing, they'll get that sense of it's possible to do it this way and that's going to make their work more
satisfactory and effective.

Okay. All right. So for now we're out of time. I think you've gotten people a sense of what they might
expect. I invite those of you who've listened to this to join us in the Venn tricks, explore what this thing
called Compassion Inquiry, which we've talked about, giving them some brief demonstrations here,
what's like an action, Gabor.

No, Rich, if you can spare me a moment, I have a question for you. Is that okay? I'm just curious about
something.

Is this going to stop me in my tracks or is this going to penetrate to the very heart of me?

No, I don't know.

I'm looking forward.
Maybe. A number of times, like three or four times you've referred to this dull aspect that I have. So I'm
just curious about that, did you experience to me is dull in this conversation?

No. So, as you remember me posing that, I was... what is it? the Mick Jagger arrests. So that was all
based on not really knowing you, the way you show up in your mugshots and also something in my
interaction, but I was very taken by something. The brightness in your eyes even right now. So
something really important has happened in your life and I'm very curious to continue to see your work
and to feel more of a connection between the two of you. I'm talking to a certain degree to the in the
past tense, so I'm glad that I can identify that.

The reason I mentioned it is because it's not that it doesn't bother me. No, it doesn't bother me. I'm just
curious because sometimes people will watch me online and somebody will say, "What a bright light
soul he is." and somebody will say, "What a depressed, traumatized person he is," and you know what?
They're both right...

Both right.

... and it's always the question of the screen through which you're viewing the other. Some people's
screens let in one aspect and they see that, then they mistake that for the whole thing and other
person's screen will allow in some different aspects, and they'll think that's the whole thing, but actually
both of them are seeing some aspect of reality, but not seeing the whole thing

Lets take shots with these certain emphasis. If we have time, maybe we'll do some work about my
perception and how it's changed, whatever.

We cam do them.

It's of some interest or relevanT, but very good to have this conversation with you and to feel it is quite
different. So you're native healers or however else that you're doing in your life, some interesting things
are happening for you. So I feel privileged to be able to be part of that in some way and just to observe
it, see how it's happened.

Well, without me to play any puns on you, but that was a rich conversation. Thank you very much.
That was Gabor conversation for me. So for now, goodbye to you until we meet again and to all of you
and I hope you look forward to the rest of this master class, those of you out there, as much as I do. See
you soon.

Bye, bye.

Bye, bye.
Module 2: “I Just Can’t Stop”:
Compassionate Inquiry with Addictive Behaviors
Gabor Maté
Welcome, my name is Rich Simon. I'm your host for this mater class on compassionate inquiry with
Gabor Mate. Welcome Gabor.

Nice to be here again.

Okay, what we're going to be able to, in this master class, in the particular format of the master class is
to really watch in-depth the work of a clinician, a master clinician who we've chosen for that series. And
so, what you're going to be seeing is bits of a session that Gabor has done, and we're going to break the
session up into clips, and talk in detail about each of them. What was going on for the therapist, what
the goals were at different points, certain points that really are noteworthy. And take us really inside the
mind of the therapist as their experiencing the session. So, Gabor, what do you wan to tell us about
perhaps this series because we're going to see four different clips of you at work, and then this
particular session that we're beginning with.

So these clips were filmed at trainings that I've done for therapists and counselors. Compassion Inquiry
courses that go over two days in front of a large audience, and for all the clips except today's, you're
going to see people come on stage, and talking with me in front of the other participants. And each of
these clips will illustrate different aspects of my Compassionate Inquiry approach. Now, today's session,
is from a different course, which is called Beyond Addictions, which is for people who actively are
addicted, and they come to work with me on their addiction issues and to get some training in yoga that
will support their recovery.

So, this first participant today is one of those clients who herself is facing a substance issue as she will
explain very clearly. And then, you'll see my interaction with her. Now, as we move into this first clip,
what I invite the watchers, the observers of this interaction, our audience, Rich, to notice is the voice of
the individual. I think it's very important to pay attention to the voice and the body language, and all the
non-verbal aspects of a person's communications. And so, that's very important in this first clip. Then
there's the content. That's the only introduction I'll make. I'll make comments about it further after we
watch the clip.

And the only thing I would add to that is the audience will be particularly aware of voices because on
camera we'll just see Gabor, and the woman who he's interviewing is not on camera. So, we'll be
particularly tuned to her voice.
And this is the only example of that. In all the other clips that we'll watch in subsequent weeks, you'll
see both of us. But in this one, to preserve the anonymity of these people who are in substance
addictions we did not film their faces.

Okay. All right. Let's move on and see the first clip of this series. Here we go.
Elizabeth (00:03:52):
Hi Dr. Mate.

Gabor.
Gabor.

Yeah.
Speaker 4 (00:03:53):
[crosstalk 00:03:53]. Get closer.
Okay. I've been drug addict since I was 13, 14.

Okay.
15 years ago I became a really hard drug addict. I've tried very hard to get over it. I've been in the detox
21 times, and I've been in five treatment centers, 21 recovery houses. And I just keep slipping back. And
even during this, I've had several relapses. Just now even, just last week, I relapsed, had a bad relapse. I
almost feel like I'm a split personality. My name's Elizabeth and it's just like there's one Elizabeth who
makes green drinks in the blender, who does kundalini yoga, who doesn't tolerate too many toxins in my
environment. I try to make sure that there's not contaminating influences in my environment like bad
violent TV, and bad things to read.
I've been to university. I have a degree. But yet, you can find me in the back alley downtown east side,
and this time I felt like I was just this close to having a heart attack, and I couldn't make myself stop. I
couldn't do it. I just couldn't do it, as long as I had money, I just kept plugging my card into the machine,
and just kept ongoing until every last available fund was gone. I know I'm going to kill myself, and I don't
understand why I just can't stop when I know better and I know. I've done it before, but it just doesn't
last. I do feel completely ashamed of myself, and my entire life.
I was brought up in a good family. My father is a surgeon. My mother is a professional musician. And
yet, I had a baby when I was 19, and the most shameful thing I've done in my life is I left him with his
father, and didn't bring him up. And I'm heartsick over that. I left him so that I could become an actress,
and I never became an actress. Well, I sort of did, but only to half measures. My dad paid for me to go
through university, then he paid for me to go through film school, and I never made anything of myself
and now, here I am, I'm 56 years old, and I don't have a job. I can't even get a job. I have all this
education behind me. I just feel so much shame and disgust about myself in my life. I don't know if
there's anything you can say to help me.

What would you like help with?
Getting beyond my addiction.

Okay.

Gabor, you introduced this session by talking about and focusing on the quality of the voice of this
client. Talk to us about that. What is there about the quality of her voice, and why is that so significant?

Well, if I'm teaching it to you here, I would ask you first of all what you noticed about the voice? Is there
anything that strikes you about it? Maybe not, but what struck you about it?

She's at the edge of emotion. At any moment, she might start sobbing, so it starts from the get-go, and
there's something very intense going on for her.

Remember how old she said she was?

Yes, in her 50s, so she has a much younger voice. She does not sound like somebody who's in their 50s.

She sounds like a little girl.
Yeah.

Okay, that's the first thing to notice. Is that she's going from her little girl self. What is the aim of
therapy? I mean, have we ever asked ourselves? What is our intention in doing therapy with people?
Well, the essence of trauma, for me very simply put, is you get disconnected from yourself in the
present moment. So, the intention of therapy, as far as I'm concern, is to bring people into the present
moment, connect them to themselves. So, I'm hoping by the end of this session, I'll be talking to
somebody much more present and much more themselves. So, in this case, I'm starting to talk to a little
girl here.

Now, there's an interesting study that was done in England a couple years ago, 2017 actually, that
showed people tend to change their voices depending on who they're talking to, and how dominant
they feel. So this little girl is talking to me like I'm the dominant adult, and she's clearly worried about
being judged or not understood, and so that's where she's coming from. So, that's the first thing to
notice is just who's talking to you.

And we here so little of your voice. This is the masterclass world record for the sparsity of the therapist
contribution to the session. Is this unusual for you in a first session to be so quiet?

It's situational. So in this case, I wanted this person to be really heard and to have her perceived being
heard, have her understood that she's being heard, that's the first thing. The second thing is I really
wanted to attune with her. I can get just a sense of whom I'm talking to. There's another bit of research
that was done also two years ago, that they hooked up therapist and clients to electrical conductors'
measurements, which measures the activity of the sympathetic nervous system. And they found that
they both had positive emotions when there was concordance. In other words, when their sympathetic
nervous systems were in sync. And they also found that it was most difficult for them to be in sync when
their therapist was talking. So, when a therapist is listening, they're more in sync than when a therapist
is talking. Now, this 56 year old little girl that's talking to me really needs to feel safe, really needs to feel
connected with, really needs to feel that I'm in sync with her. Hence, my prolonged listening in this case.

So, as you're sitting there, and this is not your usually first session. As you're sitting there and this client,
this 56 years old client who sounds like a little girl. What's going on for you? Beyond listening to her
voice, and just trying to set a certain kind of atmosphere that she could move into a certain consonance
with herself. What's going on?

Well, I'm already thinking she is judging herself very harshly. The followup to that you'll see in the next
little clip that we have, but here I'm really just, like I said, I wanted to create safety for her, attune with
her, be in sync with her, and also give me a chance to evaluate just whom I'm talking to right now.
Yeah. So, you're taking her in because under certain circumstances, the silence of the therapist would be
very anxiety provoking.

Right.

But not with this particular client.

Not with this client. And also, of course, again, she's in the context. She's seen me work with other
people already in this workshop so by the time she volunteers she probably has a certain degree of
safety. I'm pretty confident about my approach with people so that I don't worry too much about if I
listen too much, how will that make her feel? If it feels right for me to listen, I just listen. And if it feels
right for me to interrupt, then I interrupt. And so, there's no... Again, this is an approach that I have, it's
not a modality that you always listen or that you always interrupt. It's an approach.

Yeah. And at the certain point, I'm not exactly... you can talk about what the cue is that you make your
minimalist contribution to the conversation. What happened at that point that made you decide that,
okay, [inaudible 00:15:33].

I wanted to, at some point, I think the only thing I say in this clip is well what is your intention? What
would you like to get from his session? Because she is downloading her story, and she's expressing her
anguish and her despair and her fear. But I want her to identify, well okay, what is it that you want to
get from this session? What is your intention here?

Yeah.

She needs to identify that for herself. As soon as she identifies that, she bringing in a different part of
herself. It's no longer just a desperate child going in to be heard, it's not a person who says, "Okay, this is
my problem in life. This is what I want help with."

Yeah.

I want her to identify that. That may seem obvious, but I wanted her to consciously identify it because
then that's the goal we're going to work towards. I'm going to ask you to identify a goal, and we're going
to work towards that goal.
Right. And so, it's an intuitive process. There was a certain point where, okay, I've downloaded the story,
I get a sense of her as a person who knows the moment where she needs to take some agency, not just
tell her story, but to really make a decision about what does she want out of this session.

Agency I think actually crucial here and so we want the client to [inaudible 00:17:01] to whatever degree
as soon as they can possibly do so. And then you want to build on that, you want to help reinforce their
sense of agency as the session goes on.

And so, is this... As you were saying before, you're attuning to the client. Is it common for you to have
such a long period at the beginning of the session where you're silent, and the client is telling you his or
her story?

You know what, I've never studied myself, so I don't know. But it's not uncommon. Again, it's just
whatever feels right to me in that moment. I don't have a recipe for it, but it's not unusual. But other
times, at the very beginning of a session, I'll tell somebody, "You know what, you have to understand
something with me how I work with people. I'm very direct and I interrupt a lot." So that may be okay
with you, it may not be okay. I want you to feel free to tell me when it's okay, when it's not okay. But I
may do that, so I warn them. I tell them that I'm quite direct, and interventionist sometimes in my
approach, but sometimes I just sit back and listen.

Yeah. So there's no said structure, there's a process of attunement, and you [crosstalk 00:18:36].

That's exactly it. It's a process of attunement and it's based on that attunement that I then, if I'm preset,
I mean not physically, but then I can decide, do I intervene here? Do I keep listening?

Okay.

The attunement is the issue.

Yeah. Okay. So you've asked her the key question here, and let's go ahead and see what happens. Let's
look at the next installment of this session. Okay?

Okay. If I told you that you should be ashamed of yourself or you're a total fuck up. That you came from
a good family who offered you many advantages, but you squandered and threw everything away, and
then you had a child that you abandoned. And despite all the benefits that the universe has showered
upon you, you wasted your life and that you should be ashamed of yourself. If I told you that, would you
turn to me for help? Would you trust that I could help you from that position?
Maybe you would say, it's not too late, you can turn your life around, I don't know. Would you?

If I judged you with having fucked everything up, and that you should be ashamed of yourself, would
you trust me to help you?
Maybe not. I don't know.

You wouldn't. So from the stance that you're taking to yourself, you can't help yourself. From the
position of self judgment, and condemnation that you're stuck in for the moment, you can't help
yourself. You understand that?
Yeah, I think I do.

There's a teacher that I have who says that, "Only when compassion is present, will people allow
themselves to see the truth." I'm not going to tell you that you're a fuck up. I'm not going to buy into
your story the way you told it. If you want my help, you're going to have to open yourself to the
possibility of a different story about you. In which case, you're not somebody who needs to be ashamed
of themselves. Are you open to that possibility?
Yes.

Okay. Are you open to the possibility that there's another way of understanding your life?
Yes.

Okay. Should we try to look at it from the other angle then?
Okay.
The thing that strikes me most about this, the clip that we just saw, is the pivot. And how quickly you
pivot from her story of the misfortunes of her life and her difficulty into something entirely different.
Talk to us a bit about that. The pivot that you make, and how that changes the whole setup of the
atmosphere of the session.

Well, it goes back to what I said in the beginning is that the essence of trauma is disconnection from the
self in the present moment. In her case, that disconnection shows up in a form of severe judgment
about herself. And a real lack of understanding of why she actually might be using. Now, Dick Schwartz,
our friend Dick Schwartz, at this point might want to talk to that judgmental part or the part that's being
judged here. Me, in this case, I just go right in there and I say, "Well, look, from this attitude, from this
perspective that you have on yourself where you condemn everything you've done in your life, and
you're not curious about it. You're not compassionate towards yourself, you can't help yourself nor
could anybody help you who had that attitude towards you. And so, are you willing to take a different
perspective? Are you willing to take on a possibility?"

What I'm actually trying to do here, what I'm intending to do here is to incite or evoke her own
compassionate curiosity towards herself. I want her to engage with me in a compassionate inquiry as to
what's really going on for her, what happened to her. And how this substance use may have been
perfectly natural response to what happened to her. But for that, she has to notice just how judgmental
she's being and so I have to ask her, are you willing to drop that for the purpose of this conversation?
Are you willing to drop the judgment and curious towards yourself? Are you willing to [crosstalk
00:24:30]?

You're inviting her into a different world.

I'm inviting her to a different worldview. I wanted her to inhabit a world in which she can be looked at
with some love, which she's not at this point capable of doing for herself. That's the invitation.

What are you... We can't see this, but as you shift into this very different tone, and the session really
shifts here, what's going on with her? What's her immediate response? What's your sense of...

You can hear that if you're paying attention to the voice. In this clip, when I stop talking with her, all of a
sudden you get more of an adult voice talking back to me. In other words, she's coming back more to
herself in the present moment, which is my intention with her.

Right.
You can hear the little girl in the beginning, and then as I invite her to step into a different world as you
say, a different voice shows up. So, now she's more herself.

Or she has more agency [crosstalk 00:25:50].

Yeah, she's not making a choice. She says, "Yes. Okay. I'm willing to look at it from a different
perspective. She has more agency. And that shows up in the strengths of her voice. If you saw that clip
again, if you just paid attention to that, you can hear the strength in her voice, and that's what I saw in
her body language as well.

Now what about your voice? As you're in this session, as it's evolving, do you have a sense of this? It
seems from what we've been talking about up to this point, it's intuitive for you. You're not critically
thinking about that but what's your experience?

Well, when I watch myself, I do notice that at a certain point I soften. I say, "Well, I'm not going to judge
you. I'm not going to call you a fuck up. At that point, I notice a softening in myself.

And so, at this point, in terms of your sense of the session, where are you? Do you have a sense of
where you want go in a session like this or again is it you're just following a flow as it evolves.

Well, again, keep in mind that my intention is to bring this person into a present moment relationship
with herself. I want her to find her true adult self with compassion for herself. That's my intent all the
way through. Everything else follows. So, what we'll see in the next clip is then we're going to look at her
substance use from a different perspective. And maybe I can talk about that after we've watched the
next clip, but actually to give you a hint, I validate peoples drug use. I validate people's addictions. Not
the form of it, not the impacts of it, but the intent of it. And the intent of an addiction is always very
benign and very loving. That's where I'm going with this.

Okay. What a great segue.

Yeah.

Let's move into the next clip, see how you do it.
Okay. So what are you addicted to?
Crack, cocaine.

Crack, cocaine, so what does it do for you? It does something for you, otherwise, you wouldn't do it. So,
what does it do for you? What does it give you that you like temporarily, what does it give you?
A lift. It makes me feel good.

Well, take me inside that for a minute. So just say more about that. What is that lift? What is that good
feeling?
A rush of adrenaline.

Okay. Excitement?
Hmm?

Excitement?
Excitement. Yeah.

Okay.
Yes.

Can you understand why a human being might want excitement?
Why I would want excitement?
Why a person might want excitement.
Yes, yes.

Why would they want that?
If they feel their life lacks-.

Right.
Lacks excitement, lacks-.

Vitality.
Vitality, yeah.

All right, okay. So you're just looking for vitality, right? Anything wrong with looking for vitality?
No.

No. The real question is why do you need to do it that way? Okay. And so, do you think that the first
moment that you were conceived or the day that you were born, you lacked vitality?
No.

Okay, so somewhere you lost vitality. So let's looks at what happened. Okay?
Okay.
Tell me what about your family.
About them now?

No.
Or back then?

Back then. Yeah.
Well, I was the first born. My dad was going through medical school so he wasn't around very much.

Okay, he wasn't around very much. What does that mean? For your experience?
I really, really loved my dad very much. I always wanted him to be there, and he never was. I used to
throw myself, grab his legs, and cry and beg him to stay, and he would have to peel me off of him. He
would just have to peel me off of him. To leave, to go.

Okay, so what message did you get?
That I wasn't worth it.

Right.
Yeah. And then my mom, I felt like she was really jealous of me. When he was there, she didn't want me
to take up any time with him because it was hers.

Okay. So you were a threat to your mother?
Yeah.

How did that make you feel?
Well, to tell you the truth, I felt like my dad wanted to be with me more than he wanted to be with her,
and it made her so sad. I almost wanted to help her, but I felt like she was... This is a little bit later, but I
remember feeling like she dressed so frumpy, and never did her hair or anything, she was very
depressed. And only if I could help her do her hair or I remember she gave us some... She threw on the
floor one time where she goes, "Dad forgot my birthday," and she threw some coins on the floor. Sorry.
And she said, "You kids go down and buy me a birthday present." And I remember, I knew exactly what
we were going to get, and we went down and got red lipstick.

Okay, okay. So-
We got red lipstick because I thought maybe she looked better he would come home more.

Okay. So, it became your responsibility to take of the relationship between your parents.
Yeah.

What did that make you? It made you into the mother.
Yeah. Sort of.

Sort of? Who's job is it to take care of the other? The parents or the child's?
Me-

Who's job is it in the family to take of the other? The parents or the child's?
The parents.
You became the parent.
Yeah, but in every other way, I was always in trouble. I always did everything wrong. I was always being
punished.

I got that. But can you see how you took on a parenting role from your mother very early.
Yeah.

As I was watching that, I was thinking how this way that you primed us to really focus on voices, the
quality of voices. The thing that struck me is how the rhythm and the pace of the session changes so
abruptly. And that suddenly we're moving so quickly into the heart of her addiction, and the motivating
force behind it rather than that being an elaborate story and an extended exploration you're just going
for it.

Yeah, it's a very direct approach. It really does not need to be any more convoluted than that. The thing
with most addiction treatments is that they see the addiction as the problem. And so, it's all about how
do we get rid of the addiction. But for me, it's not about that at all. For me, the addiction is a secondary
problem. The primary problem is what the person is missing in their lives. So in this case, it's the vitality.
And so, there's an immediate value to that because as soon as somebody realizes, "Oh, I had a good
reason, a valid reason for looking for vitality." In her case, peace of mind in another case, pain relief,
whatever it was, control, companionship. Whatever it is that people are looking for through their
addictions.

Then all of a sudden, that helps to diminish the shame quotient. All of a sudden, they're not just screw
ups who made terrible mistakes. But they were people who really needed something in life. Now they
need to understand and what they needed in life are essential human qualities like vitality is an essential
human quality. It's not a luxury, it's really core. So, oh, then the inquiry opens is to how did I lose that
vitality? What happened to it? And so, that already feeds or supports that compassion that I was talking
about right from the beginning. I want that person to take a compassionate look at themselves. What
happened? What happened to me? Not what did I do wrong, but what happened to me? How do I lost
that?

[inaudible 00:36:50].
And then you go into their childhoods, and it's right there. She hasn't looked at it that way before, but as
soon as she looks at that same narrative about her life that she may have told before but from a point of
view of, "Oh, what happened to me? How did I lose the vitality?" It becomes very clear.

Right. And the tone of the conversation changes and you're kind of in a different space. What's
interesting for me is you're calling it directness, but at a certain point you interrupt her later in your
inquiry. I got it. We don't need to go through this territory, let's really move on to something that's more
at the heart of the issue.

Well, yeah. And so, although in the beginning, I spent all this time just listening. Once I got that
relationship going with her where we're exploring something together we don't need the details of the
story. I don't have to keep listening. We don't do people a whole lot of favors by indulging them in their
stories. Especially, she was about to go into a story of self judgment again about how I was a bad kid and
I was... Okay, I got it. You got punished but those [crosstalk 00:38:12]. What was going underneath all
that for you?

And you're attuned, so you feel at that stage, we can make that kind of a shift, and we can begin to
move more quickly through the session.

Well, again, you see it's the quality of attunement, which I don't always achieve by the way. But it's what
the intention is. When I'm confident in the quality of the attunement then I can do almost anything
because it's... I'm not doing it. It's just happening in the service of the intention that we mutually set for
this session. I know that the client will be okay with it. That's why it's not so much the method that
matters but the approach. And that's why the attunement, and the trust of the client is so important.
[crosstalk 00:39:13]. And in subsequent sessions in the next few weeks, you'll see just how bold I am in
interrupting people, and just cutting through their stories. To their benefit, and to their appreciation.

So, you move very quickly with the dynamics of her family issues she's growing up, and the relationship
with her father and the mother and if you had a stopwatch on, it would seem like you probably just
moving quickly in a way that it's five minutes, something that might take five sessions by somebody else
doing therapy in a different way.

Yeah, I wonder why it's necessary to have five sessions to establish the obvious. Now, it may be
necessary, I'm not saying it never is. It may be because not only do I have to know what's going on with
the client, they have to know what's going on with them, so it may take them awhile to get it. So, it may
take legitimately take five sessions, but generally in my hands it doesn't. I'm much more interested in
bringing them into the present moment, and not so much get stuck in the story but to deal with the
resonance of that story as it shows up in the present moment because the story happened, it happened.
Nothing that you and I will ever do with a client that will make the story unhappen. But how they relate
to that story, that's what needs to change. It's a variable, but I don't necessarily want to spend a whole
lot of time for their sake on just allowing the narrative to unfold in great detail.

And so, these shifts happen very quickly in the session as we're seeing it and your style as a therapist.
So, at this point in the session, what's happened? You talked about the voice, and how important it is to
listen closely to the voice of your client. What are you hearing from what she's saying, how she's
responding to this very abbreviated version of her life story?

Well, great question. But you know what? I don't know that I can answer that right now. But my sense is
that she's moving, she's more and more with the adult. She's more and more with the adult. Now, in the
beginning when she's like, "I love my father. He had to scrape me off his legs." She's still in that little girl
thing. But then as you go on again, she becomes more and more the adult.

And part of this is your tone, and so you're not encouraging her to go and tell that story to you. You're
moving along.

I'm not encouraging the child. The child has already been heard. Now she needs to, for her progress,
move into the adult that is capable of taking care of the child.

Yup. So there's the assumption that people have or this client in particular but I'd imagine it's not this
client, that people are more resourceful than they may present themselves in all kinds of situation but in
particular in therapy.

Absolutely. And I think Dick Schwartz talks about self leadership. The capital self that is just there. That is
just a given. It's there, I don't have to create it. She doesn't have to create it, it's there. And the thing is
to connect with it as smoothly, and as efficiently as we can so that self shows up to support the
traumatized little girl. It's not about... I don't know if every therapist gets that. My sense from
observation, and anecdotally is that too many therapists keep the client dependent on them. They are
the adult self. Now, that's fair enough. We have to hold our clients like their parents didn't hold them.
That holding is what then allows that real stuff to show up, but the aim is not that I keep holding them.
The aim is that part of themselves that can hold them, that's what shows up as soon as possible, and as
strongly as possible. And I don't think it need to take as much time as sometimes we have seen.

[crosstalk 00:44:30].

As you say, it's right there. It's right there for all of us.
The term use efficiently. It's not what the therapist often use, but in watching you work, again, it seems
so efficient. We're moving so quickly through life history, through these shifts in the client's relationship
to the problem. It's going, the rhythm of your sessions is very striking.

Well, people have called it laser like. It really is. It's like seeing very clearly to the very heart of
something. This is why I was asked to teach this course is because people just, "How do you do that?
How do you get so quickly to something that so important?" And then we can move on from there. But
it doesn't need to take a long time. I really think it doesn't need to take a long time, at least not the way
I work with people.

At the network, we're working on an issue on grief therapy. Usually grief therapy is brought up in
different terms. It's solution oriented therapy. All kinds of variations of that. This is a different kind of
grief therapy. A kind of going forward, and just moving very quickly through what seems like
complicated issues when you first look at it, but watching you at work they don't seem so complicated.

I really do think that we complicate things too much. We theorize too much. I think whether your
Freudian or a Jungian or whatever you are, I think there's way too much theory in the way, and I think
it's all very simple. People are traumatized. In that trauma, they get disconnected from themselves in
the present moment, that's what happens. Everything else is super structure that we add on to that, but
that's the basic fact. So once you realize that, you just go there.

Go for it.

You just go for it. Again, it depends on what your intention is as a therapist. What my intention is as I
said last week is to get myself fired as soon as possible.

Mm-hmm (affirmative). Yeah.

Which means that self that we've been talking about shows up for the clients sufficiently, that it can
guide them, and so I don't have to. But if they have to keep coming back, and coming back that's okay
too as long as you keep moving forward. It's not just a static thing of me listening to their stories and
empathizing without their self being strengthen. I don't care if people feel better. I mean, inevitably,
they do but my intention is not that they should feel better. My intention is that they should be there
for themselves.

Yeah.
Sometimes that means getting in touch with a lot of pain.

Now, she's presented herself initially, she's an addict. She's been through 21 different treatment
programs and so on. And you're associated with addiction treatment, but there's after that first few
minutes of the session, there's really no discussion of addiction as the issue.

Well, the addiction shows up again, I think in the... towards the end of this conversation as we'll see a
little bit later. But the problem with all these treatment programs is they focus on the addiction. They
don't deal with the trauma. Instead, addiction is a secondary phenomena, trauma is the primary
phenomena. Trauma is that lost of self. And so, to keep focusing on the behavior is to ensure that you're
going to have to go through 21 different treatment programs, and another 21 after that. As long as you
don't address the fundamental issue, which is the lost of that self. Of course, you're going to keep
pursuing the addiction to give you that vitality or that love or whatever qualities you lost.

Okay. So, we're telling a family story. She's describing how she became the family caretaker. In kind of a
hallmark of what you do is you transform the family story. You reframe the story that people are telling
about their childhood. Let's look at the next clip, and see how you do that.

Anybody ever touch you sexually when you were a child?
Yeah.

They did. Okay. Who was that?
It was a stranger on a subway.

How old were you then?
I was 10.

Just happened that one time?
Just the one time.

That's the only time it ever happened?
Yup.

And who did you speak to about it?
Well, I was in Boston and-

Who did you speak to about it?
I was with my girlfriend. We were on the subway, and I told her. Well, she knew because she was there
when it happened.

Yeah. And who else did you speak to about it?
She told her mom.

And who did you speak to about it?
Nobody. I didn't want to tell anybody.

Okay. Right. Now, if you had a 10 year old daughter that it happened to, who would you want her to
tell?
I would want her to tell me.

And if you had a 10 year old daughter who this happened to, and you found out that it happened but
she didn't tell you, how would you understand that? Why she didn't talk to you?
I would want to know why she felt she couldn't-

How would you understand it if she didn't talk to you? How would you explain it? My daughter didn't
talk to me. How come?
I wouldn't know how to understand why.

Well, there's some reason.
She must've not trust me.

Right. Therefore, you didn't trust your parents.
No.

Okay. Tell me again, what a wonderful family you had. Your father peels you off his leg, and you get the
sense that you're not wanted and not worth it. Your mother is jealous of you, and you believe you have
to take care of her emotional needs. Somebody sexually bothers you and you don't trust your parents
enough to tell them about it. Are you describing a wonderful childhood?
No.

What are you actually describing?
Sad childhood.

Right.

So, you've heard the story previously from this session about her wonderful family life. You're not
buying it. Where do you go from there? How do you make this pivot?
Well, there's one more item here that we have to cover. Which is, again, the shutting down of self. Very
commonly people will have very difficult experiences that they never shared with their families. And so,
I just asked her, so say, I go through a usual [inaudible 00:52:50] of were you ever bullied, sexually
touched, ever hit, anything like that. So, in many cases, there was such incident or often more than one
incident. The key thing here is not that somebody sexually touched her. That can happen to anybody on
the bus or public transportation. The key thing is that she didn't tell anybody, which is a sign of being in
trauma or disconnection from the parents, and therefore, from herself.

And so, you'll notice when I asked her, "Did anybody ever touch you." Yes, the voice again becomes the
little girl. Then I ask her, who did you talk to about it and then she said nobody. She still in that little girl
mode. To some extent if you listen to her voice. And then I turn it around, I don't ask her how did you
feel? How did it feel not to tell anybody? And the reason I don't ask her that is people don't know how
they felt because by that time they shut down their feelings. So she may not have any recollection of
how she felt.

So, I create hypothetical scenario, which I often do and I say, if they have children, I'll ask them what
would happen if this happen to your child? If they don't have children, if you did have a child. That's
what I ask her. If you did have a child, and this happened to her, who would you want her to tell? And,
right away, her voice becomes strong and she says, "I'd want her to tell me." I want that adult who just
showed up then to show up for her child self. So, the adult that just shows up in response to her
hypothetical child, I want that adult to show up for herself, the child part. That's why I employ that.
That's why I don't ask them directly how do you feel? I ask them, "What would your child feel if they
didn't trust you? What would be a life for them? How would you understand why they didn't tell you?
Well, they didn't trust me."

And that shifts the family story quite dramatically as we move from child self to adult self.

That's right. That's right. Once you can see what happened to the child, that actually invites the adult
because it's the adult who's not looking at it. The problem is that people view their own childhood not
through their own eyes, but through the eyes of the adults that they grew up with. So, in the eyes of the
adult that she grew up with, she was this bad kid that needed to be punished and all that. If your own
adult self can show up, then all of a sudden, she can just see that she was this [inaudible 00:55:57],
desperately wanting her father, wanted to make her mother feel better. Didn't trust them enough to tell
them about this frightening experience. I wanted to get that, that was her childhood. I wanted to get it
because that invited that adult self to come in and take care of that child, which is what we want.

And that reconnection with that adult self to feel that-
Exactly. I wanted her both to feel what the child didn't allow herself to feel, but I wanted her to feel that
in the presence of a compassionate adult. It makes the feeling safe. Now, in the first place, I'm that
compassionate adult, and in the second place and then primarily she needs to become that
compassionate adult for herself.

Okay. In some ways, that's kind of your basic goal is that reconnection.

That is the goal. I mean, if that isn't the goal of therapy, I don't know what is. I think that is... I think any
good therapist goal is to promote that reconnection.

So, as we move into the last clip that we're going to look at, what is it that... What remains to be done
here? What is it that you've [inaudible 00:57:29] you've achieved, your notion [inaudible 00:57:32] this
goal. What else is important here? What are we about to see in this last clip?

Well, now we comeback to the substance use. Now, my intention is to help her see that it's that
troubled little kid who lost her vitality who needs to keep using the cocaine. In other words, all of a
sudden, I wanted her to see that same behavior that she condemned in the beginning and fears to see
that it's just the plea for help of a desperate child. And I want her to see that from a point of view of the
compassionate adult. In other words, I want to really promote, and make solid the attitude of
compassionate curiosity towards herself. Which I believe once that's present you just won't have to use
anymore. Or when she does use and relapses, she'll take a different attitude towards herself.

Yeah. All right. So, we're about to come full cycle here for this session. Let's take a look at it, and see
what happens.

Can you see how you would've lost your vitality?
Yeah.

That's all. You're still trying to make up for it. So, there's two parts of you. Like all of us, there's two parts
of us. There's that adult self with the knowledge and the awareness and the green drinks and all that
kind of stuff. And there's this desperate kid. And it's the desperate kid who's punching the money
machine until the funds run out. Now, and you spend all your time condemning that kid, judging her,
being ashamed of her. How are you going to help her from that position?
I can't.
What are you going to have to do for that kid?
Hold her I guess.

Yeah. You're going to have to love her. And you're going to have to love her. It doesn't matter how many
times she fucks up. So if you relapse tonight because this conversation brings up too much pain for you,
you're going to have to love that kid. Yeah, I get it kid, your pain is so much right now, you just need to
escape.
Yeah, this last relapse was on my mom's birthday.

Okay. Where nobody got her a gift, right?
I gave her a gift.

No, no, no, you did. I know I'm talking about all those years ago.
Oh, the one I got the red lipstick for her.

Can you see why that might bring up a whole lot of anxiety for you on your mother's birthday?
Yeah.

Can you be compassionate towards that anxiety?
Yeah. But I love her now. She's not mean anymore. She's changed.

She never was mean. She was just anxious.
Yeah. Yeah, I know, that's true.

And it's not a question of whether you love your mother or not. It's a question of whether you love
yourself or not.
Yup.

So, look, I don't want propose to solve your problems with this conversation. I just want to reorient you.
What have you got from this conversation, if anything?
That there literally actually is two sides of me. The adult side that is okay and functioning in this world
and everything, and that child part of me that didn't get cared for. That got made to be a parent when it
wasn't appropriate. That I didn't trust my parents enough to tell them when I was sexually-

Threatened.
... threatened, and that part of me is still crying out for healing.

Crying out for relief. Yeah. And you've been ashamed of that part.
Yeah.

You've been judging that part.
I've condemned that part of me.

You've condemned that part.
And that I can't get better that way.
Right.
Until I have some compassion for that part of me.

Yeah.
And when I have some compassion for that part of me, I can maybe heal that part of me.

Yeah. And the first way to compassion is understand when she wants to use. I get it kid. You just don't
feel alive.
I understand why she wants to use.

Yeah, absolutely. It's the only way she learned to cope.
But I have learned, there are other ways to cope.

That's fine. You have, but she hasn't. Okay, so you're going to have compassion when she's in that
mode.
But I don't want her to use.

I got that.
She might make both of us die.

Well, I know but when you notice that urge to use, be compassionate towards it. Don't make it wrong.
Understand it and then see what happens. See what happens to that part of you that's so desperate if
you can treat her with compassion. Just begin with that.
Okay.

I get it. You're so desperate again. Just start with that, see what happens.
Okay.

Okay?
Okay.

Thank you.
Thank you.

So we've been through quite a journey with this young sounding but 56 year old woman. As you
mentioned a while ago, that we'd comeback at the very end to addiction, which is what she had talked
about just to begin the session. And she's incorporated... One of the things of listening to this session,
watching it, is how much she has incorporated of what you've said. So, as you're listening to her do that,
what are you thinking?

Well, as I watch this, I'm just so pleased for her because if you noticed, when I ask her, well what if
anything did you get from this session. There's just marvelous shift in her voice. She also was very quiet
and very calm and very present. And she's not anxious, she's not trying to please me at that point
because her voice wouldn't be like that. She just becomes very grounded.

Grounded.

This is what I saw, this is what I recognize. This is what I now understand about myself. I know I get why I
was using, and that as long as I judge myself, I can't heal. For this part to heal, she needs to be loved.

Yeah.
It's not a question of controlling the behavior, it's a question of actually holding the child that needs to
use. And from that holding, she'll find she won't need to use if she can do that for herself consistently.
She made need a lot more support to do that but that's the first step. And, really, I was impressed with
her how quickly she came to that point where that true grounded adult self actually showed up and
talked abour herself so lovingly, and so compassionately with such understanding. That's what I got from
that session. And again, all the time that she's talking, her voice remains quiet and calm, if anything, it
becomes even calmer as she goes on. In contrast to the voice that first began her narrative at the
initiation of the session. So, I would say that's great. Now, one comment I'll make is I talked to her about
there's these two parts to us, Dick Schwartz would say there's probably 85 parts to us.

That's right. [inaudible 01:07:40].

But that's okay. In this case, those are the two parts that I wanted to... I'm not doing parts work here.
I'm just honing in on what I think is core, and what's core for me is this desperate child self was totally
bothered and ashamed of herself. And then there's this present grounded adult who can actually take
care of that child.

Who's emerging.

That's emerging and it's emerged. At least at that moment, it's fully there. I don't imagine it will stay
fully there. It hasn't for me so far in my life, so I doubt it will happen for my client either, but at least
she's in touch with it.

Do we have any ideas? I don't know how long ago this session was recorded, how she's doing? What
happened after the session?

I don't know because I didn't run that course. I just came and did my teaching, but I had the same
question this morning, so I can find out because I know people that know her.

Okay.

So, perhaps by... It my take a week to find out because the people that run the course, she's in China
right now teaching Beyond Addictions actually in China, I think. But I will find out for you.
So, we've been through this whole journey with this woman who has a problem with addiction, is this a
different journey, therapeutic journey for people with addiction problems and people with other kinds
of problems? Or is this the healing journey as far as you can tell?

The healing journey is always to move into that grounded present adult self. I mean that's the healing
journey. Really, this is where, again, I evoke Dick Schwartz's work, him and I are so much on the same
page when it comes to say illnesses, auto immune diseases, cancer, or whether we talk about
depression or anxiety or anything else, or addiction. In my view and in his, these all have their origins in
coping mechanisms. And then coping with deep loss of self, deep loss of essential qualities of the self, so
the journey is to always comeback to that. The presenting problem, you might [inaudible 01:10:19]
different language, different presenting problems, but ultimately it's the same approach. How did you
get disconnected? How did this particular modality help you smooth or ease the pain of disconnection?

In her case, the loss of vitality. Well, the cocaine gives her vitality. Now, there's always a loss. There's
always a compensation for the loss. That compensation then becomes a problem. It may even lead to
mental or physical pathology, but then we think the pathology, the physicians for the most part, and
many therapists as well, at least in the addiction field believe that it's the pathology that's the problem.
But the pathology really itself is a symptom of a deeper problem, which is the disconnection. That's
really the approach.

You do a lot of training. A lot of workshops. What do you find is the hardest part of beginning to work in
this way? Whatever we call it, it's not a method, a lot of it is, you don't have a terminology for it,
[inaudible 01:11:35], but what's the hardest thing for them to grasp and to be able to embody
themselves?

Well, there are... you've seen me use some of the techniques like the asking about who did you talk to is
a key technique that I use? It's one of them. It's not that it doesn't have techniques, but the
fundamental issue to go back to our conversation about attunement is the attunement. And what keeps
people from being attuned, what keeps therapists from being attuned is when they have an agenda for
the client. Rather than allowing it from emerging, they tell me they want to teach the client. I'm prone
to that sometimes. And what keeps them also from attuning is when their own stuff gets triggered and
they don't recognize it.

And so, that in my training, a lot of the initial work with the therapist is actually this kind of an approach,
apply to themselves. I want them to apply to themselves before they apply it to others. That's what gets
in the way is the non grounded self of the therapist themselves. As I know from bitter experience
myself, that's always the first step is applying this to yourself.

And so, is there a particular kind of client or situation where you tend to, even at this point, you get
stuck? These are very difficult cases for you to deal with?
Yeah. Where I get stuck is with people who are passive aggressive, and especially if it's a woman who is
passive aggressive. Now do you think I may have mother issues, maybe. Not so much anymore because
once I notice the reaction in myself and I can take responsibility for it, I don't get stuck in it. But I used to
be triggered and sometimes it would bring up parts of me that I didn't know existed. I've learned a lot
from my clients over the years.

Yeah.

And at times, I've had to go back and say, even a year or two later, you know what, I'm sorry, something
happened there and I made it about you, but really it was about me. I think that... I've done that even
with people that I wasn't in contact with anymore. Once I realized it... those were the baby steps I had
to take, this is some of the learning that I've had to do. But for me, that was sort of a salient trigger is
somebody who is passive aggressive where I sense the aggression, but they're not stating their anger,
and they're me somewhat to make them feel better. At least that's my sense. That would drive me into
unconsciousness.

And been triggered. Yeah.

Well, unconscious and triggered is being unconscious, that's what I mean by that.

That's right. So, we're going to be seeing more of your work in the remaining weeks of the course. For
now, you've shown us at least one variation on the healing journey. It really gives a perspective on your
model and how you work. I look forward to seeing other healing journeys on the weeks to come. Thank
you very much. Your work is just really fascinating to see. I look forward to seeing more of it.

Well, thank you and it's actually instructive for me to watch this along with you, and have you help me
dissect exactly what is it that happens, so thank you.

And thanks to all of you out there in our master class audience. I look forward to seeing you in the
weeks to come.
Module 3: “Why is This Doing This to Me”:
Understanding the Roots of Anxiety & Panic
Gabor Maté
Rich Simon (00:11):
Welcome everybody. This is installment three of our webcast, Introduction to Compassionate Inquiry
with Gabor Maté, and he's here with us. Gabor, how are you?
Gabor Maté (00:25):

Very well, thank you.
Rich Simon (00:27):

A sunny day out there, a rare sunny day.

It's a beautiful sunny day in Vancouver today, yes.
Rich Simon (00:33):

Great. All right, let's get right into it. So, we're going to see another example of your work, another
demonstration interview that you've done. Tell us about it. What should we be looking for in this
interview?

This conversation took place on stage at an event where I was teaching compassionate inquiry to several
hundred therapists in Toronto. And a young woman, I believe she was in her 30's, who comes up on
stage. Her issue is anxiety that she doesn't understand the source of, and it's related to her medical
history. She underwent some severe pelvic and abdominal medical issues. And then in the wake of that
develops anxiety, which she has no way to understand it. And most typically, the medical profession
deals with it by giving her pills, which itself is not a bad thing to do if she needs them for functioning. But
there was no attempt to deal with what the source of the anxiety might be. So this is what she comes to
talk to me about. So that's the introduction to what's about to follow.
Rich Simon (01:46):

Okay. Let's just take a look and we'll talk about it afterwards. Here we go.

So just sit down, and your name again is Eleni.
Eleni (01:58):
Eleni.
So you're Greek?
Eleni (02:00):
Yes.

Okay, well there's the problem right there.
Eleni (02:14):
Thank you.

Go ahead.
Eleni (02:14):
So I had emergency surgery, and I was in excruciating pain when I came out of it. To the point where I
can still remember. Anyway, so that happened, and then three weeks later I couldn't deal with anything.
So outside stress that came in, I had a panic attack, and I went into derealization.

Which means?
Eleni (02:50):
I was somewhere, but I wasn't sure if I was really there or if I wasn't. And I wasn't sure if what I was
saying, I was really actually saying it, or I was thinking it.

Okay.
Eleni (03:04):
So it was almost dream-like, and the room or the space I was in became 3D, almost.

Yeah.
Eleni (03:12):
So I went to the hospital, because I thought, okay, this is not, I don't know what's happening to me. They
said it's anxiety. So, I couldn't believe it, because it felt like I was going crazy. And the feeling of the
anxiety was so strong that I wanted to end it. End the anxiety in any way.

By killing yourself?
Eleni (03:38):
Yes.

Okay.
Eleni (03:40):
So I never made an attempt, but I thought about it. I just want it to go away. So I got on medication, and
it stabilized, and after I felt well-

Can you say what medication it was? Do you remember the name?
Eleni (03:52):
... Which one?

Is it an antidepressant?
Eleni (03:52):
Citalopram.

So it was an antidepressant, one of the SSRI's. Yeah, okay.
Eleni (03:58):
Yeah, so I got on that. And then at some point I was like, wow, I feel great. Not great. I feel like there's a
switch, and I can never be myself again.

Yeah, you felt like yourself again.
Eleni (04:12):
No, I didn't feel like myself, but I felt better.

Oh, you felt better, okay.
Eleni (04:15):
After that panic attack, I felt, to this day, I don't feel like I am myself. But I said to my doctor, "Listen, I
can't be taking these pills all the time. They're giving me headaches. My jaw locks at night. I can't deal
with it. I want to cut down." I cut down, and a week later the anxiety came back.
Mm-hmm (affirmative).
Eleni (04:38):
So I had to go back on it. But I don't know where the anxiety's coming from, and I don't know how to
deal with it.

Is it there now?
Eleni (04:50):
Right now?

No, in general in your life?
Eleni (04:53):
Anxiety?

Yeah.
Eleni (04:54):
Well because I cut down, yeah. And then I'm trying to slowly go back off the meds, so I can find relief.

Okay, so tell me what you call the anxiety. So what do you feel in your body?
Eleni (05:08):
It's the feeling that you know when you go to pay for something, and you realize after you have
consumed it that you've left your wallet at home?

No, I don't.
Eleni (05:28):
No? That's never happened to you?

No.
Eleni (05:31):
Okay. It's the feeling when you are about to fall, and you're not sure if you're going to catch yourself. It's
that heightened like, but it's there all the time.

Okay. All right. And you have no idea where this comes from, and that's what you're trying to find out?
Rich Simon (05:58):

So Gabor, this young woman comes up on stage, you try to get her to clarify her questions. Take us into
what you are thinking about, what's your experiences, you're trying to formulate how you're going to
approach her. How you think you can help her in this, formulate her issue.

Yeah well, the first thing is just, I establish the safety and the connection. So you notice I'm playing with
her quite a bit.
Rich Simon (06:29):

Mm-hmm (affirmative)

Which I just sensed that she needed to relax a bit and to feel connected. So I think play is really
important. I think in therapy we don't play enough, so I introduce a bit of that here. But what's in the
back of my mind is that she had these medical issues, which require surgical intervention, and then she
develops this anxiety. My assumption always is that under both of those factors, both the medical issue
and the anxiety are not spontaneous. So, they're not just events that happened to her out of the blue,
but they're both expressions of her life. This is my general assumption. So I don't look on either physical
disease or mental illness as entities in themselves. But I see them as a process. And a process is not an
intrusion on somebody's life, they're an expression of somebody's life. So that's the underlying
assumption, is that something has been unmasked here. That this anxiety for example is not something
necessarily new. But it's maybe something that she's kept at bay until now. And so this is ongoing with
this, this is the course of this in her life is where I want to take her.
Rich Simon (07:54):

Yup, yup. Okay. And so you're reading the situation and you're feeling, you've established a connection.
You play with her a bit about being, is there a history of antipathy between the Hungarians and the
Greeks?

Actually not, no.
Rich Simon (08:20):

No.

It was merely a joke. The funny thing is, you'll see that this game continues throughout the interview.
[inaudible 00:08:32]
Rich Simon (08:36):
Okay. At this point having this wee bit of conversations, what do you feel like you found out?

Well I already know that she's traumatized.
Rich Simon (08:48):

Yeah.

Um, and she doesn't have to tell me that she is. Because then again I see the both the diverticulitis that
she suffers from and the pelvic issues that she has, and the anxiety as expressions of trauma.
Rich Simon (09:05):


And so it's just a matter of, does she want to go there?
Rich Simon (09:10):

Yeah.

But she needs to explore that.
Rich Simon (09:14):

Okay. All right well, let's go there. Let's take the next step in the interview.

And you have no idea where this comes from? And that's what you're trying to find out.
Eleni (09:29):
I want to find out what it is. Why it's doing this to me. And I want to find out how to get over it, and
move on with my life and go back to what I used to be.

All right. So, why it's doing this to me. Okay.
Eleni (09:47):
Now notice how you formulate that question. Why it is doing this to me. So there's an it, and it's doing
something to you.
Eleni (09:56):
Yeah.

What if there's no it?
Eleni (10:00):
I'm doing it to myself.

It's a process inside you. So what is the meaning of this process inside me.
Eleni (10:08):
What is the meaning of this process inside me.

Because there's no it, you got that?
Eleni (10:11):
Okay.

All right. So, the question is, does it express something about your life experience? So there's two
hypotheses here okay, we can work with. Maybe there are others. One is that just that as a result of all
these surgeries and medical issues you just, maybe always been very healthy and your self image is
being healthy.
Eleni (10:40):
Yes.

And then you had this near catastrophe with your perforated bowel, and before that the uterine
problems. And you just were knocked off your perch. Okay. And that feels very insecure to you.
Eleni (10:56):
Yes.

Also you became very vulnerable. You realized that you weren't that safe in the world, and as solid in
the world as you thought you were.
Eleni (11:03):
Right.

So is that a possibility?
Eleni (11:03):
Yes.

That it's a trigger, that was the trigger?
Eleni (11:08):
Yes.

Okay, great. So how does that feel to you? Not having this solid-
Eleni (11:16):
Well I'm at peace with it now.

... Yeah.
Eleni (11:19):
And I figured that I'm not invincible.

Okay.
Eleni (11:25):
I can get sick. Before I thought I couldn't get sick.

You thought that.
Eleni (11:30):
Yeah, I thought nothing can touch me.

Okay.
Eleni (11:34):
But-

Let's stop there. Was it always, was it ever true that nothing can touch you?
Eleni (11:42):
... What do you mean by that?

Is it ever true of a human being? That nothing can touch them.
Eleni (11:52):
No. I guess not. But I felt that way.

I know you felt that, but I'm asking, is it ever true?
Eleni (12:00):
No.

Of any human being.
Eleni (12:01):
No.

Yourself included.
Eleni (12:03):
No.

No, okay. Why would a person develop that belief?
Eleni (12:09):
I don't know.

Hmm?
Eleni (12:11):
I don't know.
Well, did you hear anything here in the last two days that may give you a clue?
Eleni (12:26):
No.

No?
Eleni (12:27):
I don't know.

How are you doing right now?
Eleni (12:32):
You're giving me anxiety.

I am giving you anxiety?
Eleni (12:36):
I'm giving myself anxiety.

So give it back to me then. Anxiety is coming up for you?
Eleni (12:45):
Yeah.

Because I asked you a question.
Eleni (12:49):
I don't know.

I mean I asked you a question and then anxiety comes up for you, right?
Eleni (12:57):
Yeah.
Rich Simon (12:59):
Okay we're back. So you're watching this session, watching yourself. What are you seeing? What are you
noticing about the process of the session, maybe there's something you may not have noticed at the
time.

So she pretty much sees anxiety as something that's happening to her. Why is it doing this to me? Is it an
it. And then she says to me later on that I am giving her anxiety. As if it's some kind of solid entity that
somehow enters her from the outside. And we encourage this very often in therapy, or in so many
medical language. We talk about people, you have anxiety disorder. Or you have depression. Or you
have cancer. Or you have endometriosis. Well, that assumes that there's a solid entity called anxiety, or
cancer, or endometriosis, or depression that then is a separate individual. So there's the I, I have
anxiety. It implies that there's such a thing as anxiety outside of me. I have a TV set, that TV set is an
object. It's not me. I have it, I can give it away, I can throw it way. But these entities that we diagnose as
disease processes, they're not separate solid entities, they're processes that happen inside us. So my
method is always to right people to recognize the process within themselves. That's the first point.
Rich Simon (14:43):


And the second point is that she like so many other people that come to us for therapy, they have this
idealized view of the past. I think I was functioning just fine and then this thing happened. I just want to
go where I was before. But what they don't recognize is that the way they were before was actually
inauthentic. That they coped, but they weren't really living. They like to think of themselves as their
previous coping, effective, functional selves. But they don't realize that underneath that functionality
and underneath that coping, there was deep seeded issues, which then, it's those issues that manifest in
the problem. Whether they manifest in physical problems like endometriosis or fibroids in the uterus. Or
whether they manifest in diverticulitis, or both. Or whether they manifest as anxiety, those issues were
there all along. So to go back to the previous self is an impossibility, because the disease or the
diagnosis, or the mental health issue has blown the cover. It's not a question of going back to their pre-
disease self. But to see what was really going on and actually how to move forward. And learn from the
experience. So that's my method here, that's my approach here.
Rich Simon (16:15):

What's striking here in contrast to the interview we saw in the previous moment, was in that moment
you spent a long time listening to that client, taking in her story. Here you get there pretty quickly, and
you're giving it a structure and you're talking about the two hypotheses. You're setting up a way of
thinking about this. What was going on for you that made you decide that was the appropriate way?

Well partly it's context. So the first [inaudible 00:16:52] that we saw occurred at a course about
addiction. And the people there, the participants were lay people. Elizabeth was the woman who I was
talking with. The people at this workshop are therapists. And they came to get training on
compassionate inquiry. So, I adjust my approach based on how I am talking to.
Rich Simon (17:17):
Yeah.

I just sense that Eleni here, she's needed the help. [inaudible 00:17:23] I could give it to her. She doesn't
need a lot of listening, just so that she could tell her story and feel heard and received. Eleni in this
workshop, when she comes on stage, is already more confident that she's going to get the help she
needs without me having to hold her for that long.
Rich Simon (17:44):

Right. Okay. So it's interesting that there's a way which you frame the problem. Frame the way for Eleni
to look at things. It's almost philosophical. When you say, and you're talking about her sense of
invulnerability. And you say, "Is that ever true for any human being?" So that's a pretty broad,
philosophical way of looking at the issue. What are you thinking here in terms of setting it up, and giving
her a different viewpoint on what she's going through?

Well it may appear philosophical, but really it's very practical. It's just a false belief. No human being is
ever invulnerable. Or invincible is the word she uses. And if somebody believes that they are it's clearly a
coping mechanism. And it's some kind of defense against vulnerability. Virtually everything that we see
in our offices that people present to is come out of some defense against vulnerability. Vulnerability is
from the Latin word vulnere, to wound. How are we not vulnerable? Why would they believe that.
Rich Simon (19:15):

Yeah.

Only because they had to develop that coping pattern. So, it's maybe a philosophical question, but it's
also a deeply therapeutic question. And why would we develop the idea, the belief, that they are
invulnerable, invincible, they can't be touched, nothing can touch them. And by the way, it's a belief I
used to have. I used to believe that everybody could be stressed and I couldn't. And clearly it was a
coping mechanism.
Rich Simon (19:48):

Okay. So at this point it's clear to you what the next step is, where you want to go in the interview?

Yes, I want to be helping her become interested in inquiry about the source of that belief. And that,
again this is my view, those beliefs always, those core beliefs always develop in childhood. That it's some
kind of a defensive manifestation. That I already see, question is, is she willing to see it, and is willing to
go there.
Rich Simon (20:23):

Okay.
And then notice of course as soon I asked her the question, she says, "You're giving me anxiety." Of
course I'm not giving her the anxiety, but it brings up anxiety for her. So already, what is that about? So
that's already a pointer that she's agitated by this issue. That there's something there that is troubling to
her. And that's what my question was eliciting.
Rich Simon (20:50):

Okay.

I don't set out to make people anxious.
Rich Simon (20:56):

Right.

But I also don't shy away from asking questions that bring up anxiety. Because that anxiety is rich
material, it's a sign that there's something there worth looking at.
Rich Simon (21:07):

And you made a point already about, establish this atmosphere of safety and comfort in this very first
session. And now moving more closer to the heart of the matter. Okay. All right well let's see where this
goes next. Anything that we should be looking for in this next part of the session?

I think it's kind of self explanatory, we'll talk about it afterwards.
Rich Simon (21:36):

Okay. Let's go there.

Tell me about the anxiety that you experienced just now. Can you tell me about it.
Eleni (21:44):
Yeah. Like I'm going to fall and I can't catch myself. Hot, heat, pressure. Almost like heartburn.

Okay. Anything familiar about any of that?
Eleni (21:50):
Are you trying to go back to childhood trauma?

Who, me?
I just asked you a question, is there anything familiar?
Eleni (22:02):
Yeah, yeah it's familiar okay. So-

It's familiar.
Eleni (22:29):
... Yeah I'm Greek, I got slapped around a little bit. That was the way we were raised.

Wait a minute, wait a minute. I said right in the beginning, the problem is you're Greek and you didn't
believe me.
Eleni (22:45):
Yup.

Okay, so tell me a little bit more about being Greek and being slapped around, okay?
Eleni (22:51):
Well you did something bad you were slapped around.

Like what kind of bad things did you do?
Eleni (22:57):
Skipped school.

You skipped school, what age?
Eleni (23:02):
I don't remember, maybe 10, 11.

Let's say 10, okay.
Eleni (23:11):
Okay.
Now slapped around is an interesting phrase.
Eleni (23:15):
Yeah.

What did the slapping around look like?
Eleni (23:19):
Sorry?

If I saw what happened, what would I be seeing? What do you call being slapped around? If I was there-
Eleni (23:25):
You'd see a parent slapping a child.

... Slapping how?
Eleni (23:29):
Like this.

Okay. Once, twice?
Eleni (23:37):
Every time you did something bad. And even in school, they slap you or hit you.

Now, when you hear the phrase slapping around what is the resonance of that? As opposed to if I said,
"I was hit a lot."
Speaker 4 (24:00):
[inaudible 00:24:00] In my opinion.

Sorry, go ahead Eleni.
Eleni (24:07):
I don't know.
If I said to you, "I was slapped around. I'm Greek, I was slapped around." Or if I said to you, "I was hit a
lot when I was a kid." Do you see a difference in the two phrases.
Eleni (24:19):
Yeah.

What's the difference?
Eleni (24:23):
One is just, I don't know. It's the intensity I guess.

There's a difference in the intensity.
Eleni (24:29):
Yes.

Which is more intense?
Eleni (24:31):
Hit.

Which is more real?
Eleni (24:33):
Hit.

Yeah.
Eleni (24:35):
Okay.

So you minimize.
Eleni (24:38):
Yes.
I'm Greek, I was slapped around.
Eleni (24:40):
Yes.

Not, I was a sensitive kid who was hit a lot.
Eleni (24:46):
Yes, only reason I say that is because-

No, the only reason you said that is because you're in denial. You're in denial of the impact.
Eleni (24:53):
... I'm in denial.

Of the impact. Okay.
Eleni (24:56):
Okay.

If you saw me hitting a child you wouldn't call it, "Oh he's Hungarian, he's slapping his kid around." You'd
say, "That man is hitting his child." Would you?
Eleni (25:14):
I don't know. I guess.
Rich Simon (25:16):

All right, so here she teases you a little bit as you begin to take her into her childhood. Possibility of
childhood trauma. And you tease her right back. Do you ever find, is childhood trauma, is that inevitable
in all the cases that you see? Do you ever not go there?

No. I never not go there.
Rich Simon (25:43):

All right.
Because well you remember you and I had a conversation a few weeks ago, and you made a certain
comment. And I said, "This just tells me about your childhood." And that had to do with how you were
relating to your therapist. So, it all leaves childhood imprints. They're always 100% of the time childhood
imprints. That's my basic awareness. And notice what happened in this case, she's experiencing this
anxiety in the middle of this conversation. So I said, well let's go to your body. I think it's very important
to get people aware of their bodies. So I said, "Well what's happening in your body." She said, "You're
making me anxious." "What's happening in your body?" Well there's heat and so on.

And then I ask, "Is this familiar to you." And then she wants to deflect that and she says, "Are you trying
to say it's childhood trauma?" And then you start that funny exchange. But she already knows, because
these sensations that she's experiencing with the anxiety, they're familiar to her from her childhood.
And then right away she goes to her childhood experience. But she goes to it in a certain way. She says,
"I was Greek, I was slapped around." In other words she in minimizing. And in the next session, you
actually see, not the next session but the next segment.
Rich Simon (27:10):

Yeah.

You see how she feels about it, because I asked her certain questions that we needed to put her in touch
with her feelings. She's still trying to distance herself from what she feels. "I was Greek, I was slapped
around." She says, "When I was bad." Now bad is whose point of view? The child's point of view, or is it
the adults point of view? In other words she took on the point of view of the adult and labeled herself as
bad, which is another way of justifying having been hit. This whole segment really is about unpacking
the defense that she's constructed on how she actually suffered. And that's really all there is to it. She
just needs to get in touch with the reality of what happened.
Rich Simon (28:05):

Yeah.

We're still asking ourselves, why would she have developed this idea that she is invincible and
invulnerable? And can't be touched?
Rich Simon (28:15):

Yup.

And she goes there very quickly. You notice how quickly she goes there.
Rich Simon (28:19):

Yeah, yeah. So is that, at the very end of the session just you give her a label. Denial. That's a big step
that most therapists feel, is the client ready for that? It's seen as something that can arouse a lot of
defense mechanisms. Yet you go right there.
I just call it as I see it. I have tremendous trust in my clients. I really do think that if they feel safe they
can handle it. They're not going to be shocked by it. I don't have to pussy foot around too much. Now
depends on the situation.
Rich Simon (29:07):

Yeah.

You can't be brutal or aggressive about it either. But in this case I'm just calling on it. And you'll see,
because in the next segment, I won't give you a preview of it, but I actually take her to a place where she
actually gets how painful it was.
Rich Simon (29:31):

I'm sorry say it again.

I actually get her to see how painful it was.
Rich Simon (29:35):

Yeah.

The experience. And that's what she really needs to get. Because she gets how painful an experience it
was, and everything she's constructed around it is a denial. Then she can see where the anxiety came
from.
Rich Simon (29:49):

Yeah.

Is what the intention of this conversation was. Is it that gave me this anxiety. Where did it come from?
Why is it doing it to me? Well, she's taken inside herself and her real experience and she'll get it like
that.
Rich Simon (30:09):

And there's also this sensitivity to language, and the nuance of language. The difference between
slapped around and hit. And enabling her to see the difference between those two things, those two
statements.

I pay a lot of attention to the language people use.
Rich Simon (30:28):
Yeah.

That's one of the important stepping stones in my work. Freud once said that there are no random
events in adult life. The words that people use are always very revelatory of the internal process. And
sometimes when my clients will be like that, they'll say, "Oh I used the wrong word." I say, "No you
didn't use the wrong word. You used exactly the word that expressed your internal view of things." Now
her internal view of things is to minimize her experience. I'm Greek, I was slapped around. Just normal.
And the word slapped around itself. And then once I ask her she says, "Well no, hit is the reality. Hit is
the intense reality of it." And that's what she needs to get.
Rich Simon (31:27):

And she goes with it, she doesn't push. Doesn't push back against it. Okay, yeah you're right. And says,
intensity is her word to describe the difference between using those two terms. Yup.

That's totally accurate.
Rich Simon (31:42):

Yup, okay. So you've, at this point it seems like you've established the foundation. From some
mysterious thing happening rooted in her life experience and so on. So let's just go ahead and see what
the next step is in your interview and see where it goes. Okay.

Come on, so do you have children?
Eleni (32:12):
Yes.

How old?
Eleni (32:15):
Eight, four and two.

Well let's take the eight year old okay.
Eleni (32:18):
Sorry?

Let's take the eight year old.
Eleni (32:20):
Yes.

And my guess by the way is the hitting didn't start when you were 10 years old. When did it start?
Eleni (32:26):
I don't know.

Can you make a guess?
Eleni (32:29):
Probably nine, 10.

Sorry?
Eleni (32:32):
Probably nine, 10 years old.

Before then you weren't hit at all?
Eleni (32:35):
No, not really. Maybe a little bit.

Little bit.
Eleni (32:42):
Yeah a little bit. Because the person that hit me-

So when was the first time that you would have been hit? How old would you have been?
Eleni (32:49):
That I remember?

Make a guess.
Eleni (32:55):
I can't remember the first time.

You can't, I'm just asking making a guess. Roughly how old would you have been?
Eleni (32:59):
Probably nine, 10.

But you say you were hit before then a little bit. What I'm asking is, how old would you have been the
first time you were hit?
Eleni (33:06):
I don't remember.

I know you don't remember. I'm asking you to guess.
Eleni (33:09):
Four, five.

Okay is that a fair estimation?
Eleni (33:14):
Sure.

Okay. How old are your kids?
Eleni (33:17):
Eight, four and two.

Let's start with the four year old then, okay?
Eleni (33:21):
Yes.

Boy or girl?
Eleni (33:23):
Girl.

What's her name?
Eleni (33:26):
Christina.

Christina. Do you hit her?
Eleni (33:29):
No.

Why not?
Eleni (33:34):
Because I love her.

Yeah. And being hit means? If you hit her that means you didn't love her.
Eleni (33:46):
No.

So why wouldn't you hit her?
Eleni (33:50):
Because I'm angry.

Hm?
Eleni (33:55):
Maybe because I'm angry.

Why would you not hit her? Why would you not hit her?
Eleni (33:59):
Oh why would I not hit, because I love her. And I don't want her to be in pain.
So hitting a four year old causes pain.
Eleni (34:07):
Of course.

And you want to know why you're anxious.
Eleni (34:11):
Yes.

How would your daughter feel if she didn't know when next you're going to hit her?
Eleni (34:25):
When next I'm going to hit her?

How would your daughter feel, how would Christina feel if she didn't know?
Eleni (34:31):
Anxious.

And you want to know why you're anxious.
Eleni (34:35):
But no one's hitting me. I just can't under-

No one's hitting you now.
Eleni (34:41):
... Yeah.

But you asked about the source of it.
Eleni (34:46):
Okay.
The cause of it.
Eleni (34:47):
Okay.

Okay. Can you see how you would have had a lot of anxiety as a kid?
Eleni (34:54):
Yeah.

Can you see that you developed a belief, what would be one protection against that anxiety is the belief
that I can't be touched. Nothing can touch me.
Eleni (35:03):

That's why you believe that.
Eleni (35:06):

Guess what happens when you get sick?
Eleni (35:11):

That defense is now destroyed.
Eleni (35:23):
Wow. Okay now how do I go back to normal?

You were never normal to start with. You were Greek.
Eleni (35:42):
Thank you I'll take that as a compliment.
Rich Simon (35:46):
Wow so that's almost like a classic moment of discovery in therapy. Almost too good to be true. You do
something at the very beginning of the session you do something interesting. I imagine this is
characteristic of how you often handle things. Some therapists might set up some dialogue with the
inner child, or have some kind of experiential interplay. And where you go, you take her into her
experience as a mother in relationship to her own child. So talk about that. And how you use that, when
you use that.

Because people that have been traumatized as this person has been, take on the view of the adult. From
the adult point of view not much happened. People say that, a little bit she says when she was small. But
that's an adult point of view. What does it feel like to a small child? If I asked her what did it feel like for
you she would not be able to remember. Now the reason she couldn't remember is because the way she
dealt with her emotions as a child was to suppress them. And then cover them with this veneer of
invincibility. You ask somebody, "What did it feel like?" Most of the time they're not going to be able to
tell you.

You get them to do an experiment, imagine your child in that situation. All of her paternal, all of her
parenting instincts, her maternal instinct come into play. She totally empathetic and attuned with her
child, if her child was experiencing that situation. In order to get her to experience, all she has to do is
imagine her child in that situation. All of a sudden all of her love and all her protective instincts, and all
of her empathy with her child arise. And now she can actually get what her own experience was. Now
you know there's nothing wrong with going to the inner child. I mean I may do that sometimes. But just
that this is a very efficient way of, and notice that she tears up.
Rich Simon (37:54):

Mm-hmm (affirmative) yeah.

Why wouldn't she hit her? And she tears right up. She gets the sadness of it, and the pain that she
experienced. That she's not able to get as long as I'm just talking about her.
Rich Simon (38:10):


As soon as you bring in her child it becomes very clear to her as to what was her own experience. It's a
very simple method. Whenever people are in denial of their experience, or when they minimize their
childhood experience I just bring this in. And it's very efficient, and it's very effective. And being
emotional, it's very penetrating actually.
Rich Simon (38:36):

Yeah well clearly here. So do you ever do inner child work, is there some circumstances, perhaps if
they're, I guess if they're not, they don't have kids of their own. Would be one circumstance.
You know even when they don't have kids of their own, all I have to do is get them to imagine a child.
They'll always know a child. I'll say, "Do you know any children?"
Rich Simon (38:59):

Yeah.

Do you know any kids that age? Have any kids that age? And I get them to a very specific, I get them to
imagine the child. Like in this case I don't just ask, "Do you have a child?" I say, "How old is she, what is
her name?" I really want her to see that child. And so that usually works for most people. Now, they'll
have some contact with some child. Cousin, grandchild, niece, nephew, daughter, son of a friend. Now,
again I'm not saying there's anything wrong with inner child. I may go there sometimes.
Rich Simon (39:35):

Yeah.

I just find this is very quick and effective. And also it allows them to see through their denial. Even here
there is a fair bit of resistance. I can't remember, I can't remember, I can't remember. I say, "I'm not
trying to get you to remember. Just trying to get you to guess." She's clearly reluctant to go there, but
it's too painful for her, until she does go there. So, I just find a rapid way to get them to get in touch with
the actual feelings of the child, which is what this exercise is all about. If that takes going to the inner
child, that's fine.
Rich Simon (40:24):

And also you give a lot of attention to the age of, she has three kids. And you move her to the, you focus
her on the experience of the youngest child. You keep asking about what age, and presumably the
further back, the younger the experience of whatever happens to be the trauma, the more powerful it is
for the client.

That's the case, but also in this situation she has three children. I think she said eight, four and two. And
when I said, "Guess when you were first hit." She said four or five. And that's why I went with the four
year old. I said, "Well okay let's think of her being hit." And then she gets it right away, she just gets it.
Rich Simon (41:15):

Right. She has her wow response. So let's put this in context, here you're doing a demonstration
interview for mental health professionals. You're trying to cover a lot of ground in a short period of time.
And then at the end of this session, which seems for her in so many ways revelatory. She says well
basically, "What do I do now?" So if you're looking at where is she, have you accomplished what you set
out to do? You're not trying to give her a whole course of therapy. But where is she in the process as far
as you can tell?
Yeah. So first of all this is a sped up version of what I'm doing in an office. Again I'm in front of 300
people, so I don't have to be as deliberate and full as I might be. But you set out the intention of the
session at the beginning. What is it you want to find out? She wants to find out what is the role of this
anxiety, this it. Why is it doing it to me? So I don't know how long this whole thing takes. All together
what, 15, 16 minutes. We go from why is it happening to me, to we're getting that this is a process that's
been inside her since childhood. And we get that moment of revelation now. It's not necessarily always
the best for me to provide that revelation, because I don't know tells her. When you see why you might
develop that perspective, that you can't be touched. And she goes. Well it actually it would be more
powerful to guide her there herself. To get her to come up with that. In this case it was effective. But I
don't necessarily recommend always doing it that way. You might really want to give the client time to
develop that, to come to that epiphany herself.
Rich Simon (43:27):

Yup.

So, I don't want to confuse these training videos with what you might do in an office. But it's
demonstrating an approach.
Rich Simon (43:39):

So if you were the therapist and you have the time and whatever, you're seeing her regularly, help,
whatever it is you might do. How do you envision a full course of therapy? Where would you go with
her, if you were not just doing a demonstration interview?

This is a segment that takes about a quarter of an hour. I could get to the same place with somebody in
an office easily within half and hour to an hour.
Rich Simon (44:10):

Right.

I would give them more space to come to this realization themselves. Now as to where she goes from
there, she doesn't need to go anywhere from there. She just needs to hang around, needs to hang out
with what she just realized. She needs to realize that if I was to take this conversation further, where I
would take her, where I would guide her is, okay I get it. You have this coping mechanism. All that
happened was that with this illness, and the surgeries, this coping mechanism, this beliefs that I had that
I was untouchable has been blown out of the water.

You know what, that's not a belief that really served me in the first place. Except as a defense in
childhood. And I'm not that child anymore, so I don't have to believe that anymore. In fact she got off
her medications pretty quickly after that. There might be another session. How to incorporate, integrate
this realization into my present life as an adult. Which would mean allowing the anxiety when it arises,
not making it mean anything, recognizing that its a body memory of something that happened long ago.
Recognizing that I don't really need this coping mechanism, if I can let go of it. That might be another
session.
Rich Simon (45:44):

So it's not as if this is an endless process as far as you're concerned.

I think I said to you, I see my job as to get myself fired as quickly as possible.
Rich Simon (45:59):

Uh huh, right.

I frankly, this is my bias. But when I think of people being in therapy for years, and years, and years, and
years, and years I wonder what's going on. Now, I can see people intermittently in therapy. I might need
to go to talk to somebody right now. Like last year I called Dick Schwartz and I said, "Can you talk to
me?" And I've done the same for him sometimes. So we never get past the point where we need some
debriefing and some processing. But I'm talking about years of psychoanalysis and years and years
drilling over the same issues. I just think that's just inefficient and really it lacks methodology. It lacks an
approach that can penetrate to the heart of an issue.
Rich Simon (46:56):

Yeah, okay. All right so maybe this is a good time to stop. We'll come back in our next installment, and
we'll see another aspect of your work. So last thing is, what is it, as you watch this again and put it in the
context of the range of things that you do, the approaches you take. The kinds of clients you treat. As
you're watching this what's distinctive for you about this? What stands out to make you choose this
particular interview as something that you wanted to show with us in this master class?

Well first of all, it becomes an another acute issue. An acute problem, it's anxiety. And then they're
confused about where it's came from. So, set the intention. What are you trying to get from this
session?
Rich Simon (48:00):


At the end of the session you want to be able to say we achieved or we didn't achieve. And they're both
okay. You're not really going to get there. But keep the intention in mind. This person wants to know
where the anxiety came from. That's the intention. So set an intention, agree upon an intention.
Establish safety and if it was already there, you're standing up in front of 360 people. And then I played
with her a little bit, to further establish contact. And to make it lighter and not to make it a heavy thing.
Attention to body language. Not attention to body language, but inviting her to experience her body.
The heat and the tension she experienced. Body awareness, that's important. Pay attention to language.
When she says, "Why is it doing this to me?" I call her on that. When she says, "I was Greek, I was
slapped around." I call her on the language. When she says, "I was hit a little bit." I call her on that little.
I want people to realize what they're doing with their words. Their words are designed to bring them
closer to themselves or to keep them separate from their own experience.

And to experience the actual emotions that would have been there in the first place. In this case I did
that by [inaudible 00:49:43] her own child. Asking her to imagine her own child in that same experience.
And then at a certain point I come back to the original intention, can you now see this anxiety is not new
for you, number one. You can see that. And then can you see why in the face of that kind of anxiety as a
child you might have developed a belief, a protective belief, that I can handle anything and I'm
untouchable.
Rich Simon (50:16):

Yeah.

Those are the stepping stone in this case.
Rich Simon (50:22):

Okay. So, the time for this [inaudible 00:50:29] is just about up. We'll see next time. We'll see now that
you've laid out the stepping stones, we'll see another case, a contrasting case and see what happens in
that process. So look forward to looking at that case with you. For now, thank you.
Module 4: “I Need to Protect Myself”:
Compassionate Inquiry with Abusive Relationships
Gabor Maté
Rich (00:11):
Welcome everybody to this the fourth installment of our masterclass with Gabor Mate on
compassionate inquiry. Gabor, welcome.
Gabor (00:23):
Thank you, nice to be back.
Rich (00:25):
So, we're going to see another example of your work today, and we'll see a clip in just a few moments.
Anything you want to say? What should we be looking for in this particular session, and what made you
choose, of all the clips you had, what made you choose this particular one to include in this masterclass?
Gabor (00:48):
I wasn't aware that I was the one that made the choice.
Rich (00:50):
Oh no.
Gabor (00:55):
I felt we sent a bunch-
Rich (00:56):
You let your clients get away with that?
Gabor (00:59):
No, no. But the truth of it is, I probably was involved in sending you a number of selections, and I think it
was somewhat mutually decided. So I might as well ask you, What is it that compelled you to choose this
one?
Gabor (01:14):
Why I would choose it? Why I might have selected it?
Rich (01:18):
Mm-hmm (affirmative)-
Gabor (01:19):
Again, here is somebody that... This is a therapist. This is again in front of a group of therapists.
Sometimes I invite people to bring up therapeutic challenges, and sometimes I invite them to bring up
their personal issues. So that's what happens in this case.
Gabor (01:38):
I'm talking, and people ask a question, and then I'm just on a sheer hunch, I'll say, Well, do you want to
come up in front of the audience and talk about it?
Gabor (01:48):
And in this case, she is wondering... Authenticity is a big message in my work. I think what happens is
that our authentic selves get shut down pretty early in life, and they're replace by ego and personality
and compensations and adaptations of all kinds, which we take to be ourselves, and then people are no
longer who they really are.
Gabor (02:16):
This particular participant has a certain dilemma, and wish to explain. She wants to know, is her
response authentic? I think I chose this one because of this issue of what's underneath our sense that
we might not be authentic? Who are we really? Which part of us is choosing a particular response?
Rich (02:42):
Great. Okay, well, you got my attention. Let's take a look at this clip.
Joanne (02:49):
So, I do come from a background of [Big T 00:02:53], and your question was really relevant for me,
because I know that I spent my whole life being really well-defended: withdrawal, avoidant detachment.
I've reached a place at the loving age of 59 of being happy. I've found some joy, and I'm doing pretty
good, but I guess what happens for me is, the doubt is really strong sometimes, because I know I can slip
into that pattern, that defense so quickly.
Joanne (03:35):
In my family, the themes are addiction and violence. So I guess the question is, that I ask myself all the
time, is when I withdraw from harmful behavior, is that my authentic? Is that authentic? Am I being the
real me by protecting myself from really abusive behavior? I open, and I'm speaking specifically about
my brother who I describe as a raging alcoholic... I open and I go in for an authentic conversation, as I've
been able to have one in the past five years.
Joanne (04:36):
Then he's like a scorpion. Voop! And he gets me.
Gabor (04:42):
Well, I'm just trying to decide where to go with you with this. Did you want to come up for a couple of
minutes?
Joanne (04:56):
Absolutely.
Gabor (04:57):
Okay, well let's do it. And your name?
Joanne (05:05):
Joanne.
Gabor (05:05):
Joanne, okay.
Rich (05:09):
Well, this woman is very different kind of participant, let's call her a client, than in the previous session
that we saw last time. We saw how you attuned with Elena in the last session. What's going on? How do
you feel like you're... as you're experiencing this, what's the challenge of attuning with this woman?
Gabor (05:40):
Well, when I watch myself, she's asking her question, and the camera's only on me. She's not on camera
in the beginning. I noticed, I rather like what I'm doing here. I'm looking at her. I'm maintaining eye
contact. And then I notice when she talks about violence and addiction in her family, I don't know if
shudder is the word, but I give a body response. I'm really getting the suffering there.
Gabor (06:10):
So the first point here is just to attune. And then as she's talking to me, I'm thinking, what is she actually
wanting to know here. She sets up the problem: her brother is a raging alcoholic, and she wants to know
if she's authentic in withdrawing from him. Now that may seem like a strange question, because it's
perfectly reasonable to withdraw from a raging alcoholic who's making your life miserable. But it's not
as easy as it seems on the surface, because the question is not, Is it right to withdraw. It's a question of
who is withdrawing.
Gabor (06:55):
Now there's a spiritual teacher, Ramana Maharshi, who question always is, Who am I? So really the
question that Joanne is struggling with is, Who am I when I'm withdrawing? Is it my authentic need for
self-protection, which is entirely appropriate, or is it some other part of me that's withdrawing?
Gabor (07:20):
So it's not a question should she withdraw or should she not, it's a question of who am I when I'm doing
it. And she senses that she's not being authentic. Otherwise, she wouldn't be asking the question.
Rich (07:31):
Gabor (07:31):
So that's what I'm hearing as she's talking to me. Now where I go with this, I don't know. I just said to
her, Well, I don't know. Come on up, and let's see what happens. And that's really how I enter every
encounter, is, I don't know, but let's see what happens. And that's what I call a compassionate inquiry.
That's the curiosity part. I don't necessarily know. I don't necessarily what I'm going to do, what I'm
going to say. Let's just have an encounter and see what emerges. So that takes confidence in two
entities: one is confidence in myself that I'll be up to it. And that if I'm not, it's okay. It's okay if nothing
happens. Number one.
Gabor (08:20):
Number two, I have confidence in the client. That there's a process in the client that wants to unfold.
And so if you provide the right environment for it, that unfoldment can occur. So that's what's
happening for me, as I'm listening to her, and as I invite her up to talk to me.
Rich (08:38):
Okay, let's just go and see what happens.
Gabor (08:41):
So, let's not get theoretical. Let's just go into the situation. A recent situation with your brother, and just
tell us what happened, okay? Use the mic.
Joanne (08:59):
Yeah, okay. Recent. In order to speak about the most present. I need to speak just a little bit of the
pattern.
Gabor (09:11):
No, you don't.
Joanne (09:11):
No? Okay. So most recently I gave him some money, and the very next day, he left messages on my
phone, calling me everything in the book. So, I don't listen to the messages anymore. I delete. I used to
listen to them and go through a lot of anger and a lot of pain-
Gabor (09:36):
So that's a story. I'm just asking, what happened? So you lend him money, and then he called you and
insulted you.
Joanne (09:45):
Yes.
Gabor (09:46):
Okay.
Joanne (09:46):
Yes.
Gabor (09:47):
So keep the mic up. So what's the problem?
Joanne (09:54):
The problem is that I've chosen not to have a relationship with him now.
Gabor (09:58):
And so what's the problem?
Joanne (10:00):
The problem is that I'm wondering... if my choice is the healthiest choice or the right choice for me.
Gabor (10:16):
What are you feeling about that?
Joanne (10:17):
I feel like it's the right choice. I feel like it's the right choice.
Gabor (10:23):
No, that's not a feeling. That's an opinion. What are you feeling about it?
Joanne (10:26):
Sad, however-
Gabor (10:29):
No.
Joanne (10:30):
Yeah?
Gabor (10:35):
Sad does not tolerate a however after it. Okay? You feel sad.
Joanne (10:41):
I do. I do feel sad, but I also feel, and this is not a feeling, it's a belief, I need to protect myself.
Gabor (10:49):
You absolutely have to protect yourself.
Joanne (10:49):
Pardon?
Gabor (10:55):
You totally have to protect yourself. Of course. So I'm asking you, what's the problem?
Joanne (11:06):
The problem is that I'm not 100% sure that I'm not fooling myself. I'm not 100% sure that because my
defense is so strong and because I'm so good at existing without the relationships of the family, that I
wonder if there's something that I haven't discovered.
Rich (11:34):
You talked about how direct you are in therapy, and here's a particularly good example of being direct
and very quickly responding to things that you feel are getting the interview off-target. So talk to us
about it. What's going on inside you, and is telling you that you really need to give some structure here,
or you need to redirect this particular woman in this exploration?
Gabor (12:14):
Well, so first of all, she herself is an experienced therapist, and she can take it.
Rich (12:20):
Gabor (12:23):
I have to gauge who is ready for what. But I get with her, she's a strong woman. She wants help, so I'm
going to give it to her the most efficient way I can within a limited space of time in front of 350 people.
So again, we have to keep the context in mind.
Gabor (12:44):
But in general, I think we sometimes let people talk too much, in a sense. Not that it's too much for us to
listen to, but it takes them off topic. It takes them away from what they really come for. So with her, I
just really want to drill down what is the issue here?
Gabor (13:00):
So I keep asking her, what's the problem? I'm not saying there's no problem. I'm saying, what is the
problem from your perspective? What is the issue you're trying to uncover? What is your dilemma here?
Gabor (13:14):
The fact that she wants to protect herself, that's not a problem. The fact that she feels sad, that's not a
problem. Of course, she feels sad. What is the problem? So again, that question, what's the problem is
not a challenge. It's an inquiry. What is the problem?
Gabor (13:32):
Now, in the beginning, she starts telling a long story about the past, and so when I say, No. That's not
necessary. Let's just look at the actual situation that occurred recently, and let's [crosstalk 00:13:41]
Rich (13:40):
...look at the actual situation.
Gabor (13:48):
Let's look at the actual situation, what really happened.
Gabor (13:51):
Now, when I ask people what happened, often they start saying things like, Well, he abused me. He did
this. I said, that's not what happened. What happened was is that you said such-and-such, and they said
such-and-such. So let's look at what actually happened. Everything else is interpretation. It might be
accurate interpretation, but it's still interpretation.
Gabor (14:15):
So what actually happened, so I just find that important. So I go there with her. And then she says, "I feel
that..." I said, that's not a feeling. Now, I'm not a language dictator, but especially in therapy, when
people say that, they say, "I feel I did the wrong thing," I say, that's not a feeling. That's a belief. It's a
perception. Or I feel they were very arrogant.
Gabor (14:46):
I say, that's not feeling. That's an interpretation. That's an opinion. And the reason it's important to
make that distinction is you want people to get to what they actually feel, because our actions and our
thoughts are really feeling-driven. We think we're thinking creatures. We're actually feeling creatures
with words. So what you want to help people do is to get to as quick as possible what is it that they
actually feel.
Gabor (15:18):
So that's why I make those interventions. I want them to drop story, and history, and interpretation. Just
be in the present with what's actual. And I want them to be in touch with the actual feeling. So that's
what that conversation was about. And again, having to identify what is the issue that they're trying to
understand here. So what is the problem here.
Rich (15:48):
Right. Right. So she describes, at least alludes to her feeling of sadness, however. And then [inaudible
00:15:59] does not tolerate a however.
Gabor (16:04):
Yeah. Emotions are just what they are. As soon as you say however, it's the intellect coming in, and that
dilutes and takes away from the emotions. So that's why I said, sad does not tolerate a however. It's just
there. It just is. And you have every right to the sadness. There's no however here.
Rich (16:28):
Right. As the therapist, the observer, the participant in the conversation, when do you know that the
client is into the realm of real feeling, rather than judgment, interpretation, and thinking about?
Gabor (16:48):
Well, there's always body language, and in this case, she actually identifies the feeling. It's sadness. And
then she moves right out of it, and goes into the however. I said no. Don't go there.
Rich (17:06):
Right. In a sense, that capsulizes what you do in a variety of ways, is you're always asking that question,
at least in this early phases of these interactions.
Gabor (17:25):
Yes.
Rich (17:25):
What's the problem? What's our contract here about what we're going to be working on?
Gabor (17:31):
Exactly, yeah.
Rich (17:34):
Okay.
Gabor (17:34):
And as you will see, there's a mixture of emotions here, and that's what her problem actually is.
Rich (17:45):
Okay. Let's just see what happens in the next step. Let's look at the next clip.
Gabor (17:54):
Why are you doubting yourself so much? Here's a guy that you lend money to, and then he insults you.
Joanne (17:59):
Yeah.
Gabor (18:00):
What would you tell your friend to do?
Joanne (18:04):
Yeah.
Gabor (18:05):
Hold the mic up.
Joanne (18:07):
Well, yeah. Not to lend money, number one. And number two, not to... stay away from that person.
Maybe. I don't know. So there we go. I'm not 100% sure.
Gabor (18:21):
Yeah... keep the mic up.
Joanne (18:24):
Okay.
Gabor (18:24):
The reason you're not 100% sure is because you have other feelings here, not just the sadness.
Joanne (18:30):
Okay.
Gabor (18:31):
The sadness you can just live with. It's sad. It is sad that you're disconnected from your brother. That's
just objectively sad. Anybody would find that sad. Okay? There's nothing wrong with that feeling. But
the problem is you have mixed feelings, and you haven't identified the other feelings.
Joanne (18:52):
Oh, anger is a big one.
Gabor (18:54):
Okay, so you have anger.
Joanne (18:55):
[crosstalk 00:18:55] pain. I know the pain-
Gabor (18:57):
So you have pain and anger, yeah. Okay. What are you angry about?
Joanne (19:15):
So to go... the anger is frustration-
Gabor (19:19):
No, what are you angry about?
Joanne (19:22):
I'm angry that he just won't smarten up.
Gabor (19:25):
Oh, so you're angry that he's an addict?
Joanne (19:27):
Pardon?
Gabor (19:27):
You're angry that he's addicted.
Joanne (19:29):
I'm angry that he's an addict, yes. Yes. Yes, I guess, yes.
Gabor (19:31):
So, why are you angry because he's an addict?
Joanne (19:49):
Because of how harmful and hurtful it is to everybody.
Gabor (19:58):
It's his life.
Joanne (19:59):
I know. My son is also an addict.
Gabor (20:01):
Hold on. Does he have the right to live his life?
Joanne (20:04):
Yes, he does. Yes.
Gabor (20:05):
Why are you angry because your brother's an addict? I'm asking you, why are you angry because your
brother's an addict? I'm not saying you shouldn't be angry. I'm asking you why you are angry.
Gabor (20:13):
What's it like for you to watch him?
Joanne (20:33):
The anger comes from me not being able to have a connection with him.
Gabor (20:39):
Okay. So you have pain at not being able to connect with him. All right. Now, what does that mean
about you, that you can't have a connection with him?
Joanne (21:07):
It means that I am healthy.
Gabor (21:15):
You're healthy?
Joanne (21:16):
Yeah, I think.
Gabor (21:17):
No, no, no, no, no.
Joanne (21:19):
No?
Gabor (21:20):
Then you wouldn't be angry about it. Why would you be angry about being healthy?
Joanne (21:27):
No, I mean not having the connection?
Gabor (21:29):
What kind of a person... Who are you that he doesn't want connection with you? What does that say
about you?
Joanne (21:44):
That I'm not important enough.
Gabor (21:46):
Right. That's what you're angry about.
Joanne (21:48):
Yeah.
Gabor (21:49):
Okay?
Joanne (21:49):
Yeah.
Rich (21:52):
What's interesting for me about watching this particular clip, it seems like it gets to the heart of
compassionate inquiry. She keeps saying things that seem perfectly legitimate about her anger, about
her various reactions to her brother. The kind of thing that many clients might say to a therapist, and
you keep challenging her, and instead of being defensive, she actually explores with you what's going on
for her, because there's some undercurrent of this sense of compassion. Not that she shouldn't feel any
of these things, but these questions are coming from a viewpoint of a compassionate helper.
Rich (22:46):
So it's sort of a perfect encapsulation of what compassionate inquiry is supposed to be about.
Gabor (22:52):
Well, yes. She's the one who's making her withdrawal from her brother a problem. That's what she's
presenting with.
Rich (23:02):
Right.
Gabor (23:03):
So that's what we're wanting to unpack here.
Rich (23:05):
Yeah.
Gabor (23:06):
So that's the intention here. To go back to your question as to why I might have chosen this one, it's
because... Again, this is a short segment. Nobody should think that this is how they should do therapy all
the time. It's a short segment to indicate a particular aspect of my approach.
Gabor (23:36):
What's salient here for me is that there's a statement in the course of miracles where they say that
nobody's upset about what they're upset about. I may be paraphrasing, but basically nobody's angry
about what they're angry about.
Rich (23:59):
What they think they're angry about?
Gabor (24:00):
That's the point. Nobody's angry what they think they're angry about. There's healthy anger, but that's
just in the moment. That's just a boundary defense, and then it's over. Any anger that we carry is not
about what we think it's about. So I'm here, I'm doing her the favor of let's look at what your anger is
really all about. And then maybe then, you can decide how to withdraw or where to withdraw from your
brother.
Gabor (24:27):
So we begin by validating the sadness, and she herself very quickly wants to talk herself out of it. No, it's
sad. It's sad that you have no contact with your brother. Anybody would feel sad.
Gabor (24:39):
Then she gets in touch, oh yeah, there's other feelings here. Pain and anger. Now, this section is not the
only way I could have gone with this. I could have actually gone into her pain more deeply. I could have
invited her to get into her body and experience the pain. What does that feel like? How familiar is it?
What might be source of it? And all that. The way we went here is not the only way to go. But I chose to
go the way I went because I wanted to get her to the source of her anger, which is what's really creating
the problem for her with her brother.
Gabor (25:24):
When she said that it's hurtful to be yelled at, to watch somebody cause so much pain to the family, I
could have done more to validate that as well. But again, I'm sticking to my intention. I'm sticking to
what I took to be her intention, which is to understand her reaction to her brother.
Rich (25:47):
Right.
Gabor (25:47):
In a longer session, we would have gone into all of those things perhaps.
Rich (25:52):
Right. The shift where it seems like you're feeling like here's [inaudible 00:26:04]. Here's where the
exploration needs to go, is with the question of what does that mean to you?
Gabor (26:13):
Yeah, I'm going with the original intention of the session.
Rich (26:20):
Right. But specifically, that's the tool that you're using. That particular question of bringing it back to
her, not just the expression of the feelings. It's, so, he's an addict. So, whatever... until finally you've
located the arena from which the conversation needs to take place. So, what does that mean for you?
Gabor (26:51):
So the fact that somebody close to you is an addict, there's any number of potential responses to that.
You know? So it's her particular response that we're interested in, and so that's what this is about. Her
mixed feelings about it. She wants to help her brother. She feels sad about it, but she's also got pain,
and she's also got anger. So let's look at what's really going on.
Gabor (27:23):
Again, it's going back to what I said at the beginning. It's not about is she doing the right thing in
withdrawing. It's who is withdrawing, and with what perspective.
Gabor (27:34):
So, if she is going to withdraw, I want that to be an authentic withdrawal, and if she's going to stay in his
life, I want that to be an authentic staying in his life. So it's not the what to do, it's who's doing it. That's
what we're trying to get to here.
Rich (27:54):
Right, and so that term authentic that is often made fun of as a therapy word, that has some real
meaning for you?
Gabor (28:09):
To me, it's the deepest meaning. I think that all told, the self, that's where the real authentic comes
from. It comes from the self. And the question is are we being ourselves? If we're being ourselves, we're
going to make the right decisions, and we're going to feel okay about our decisions. We might feel
sadness, but we're going to be okay with that sadness.
Gabor (28:38):
So if I'm authentic, I may leave a relationship. If I'm authentic, I may stay in a relationship. But the
question always is, who's leaving and who's staying? Is it the authentic me that leaving? Is it the
authentic me that's staying? Or is it just some defensive response that's staying or leaving.
Gabor (29:02):
When I define the purpose of therapy, basically I see trauma, which I know we might all have different
definitions of trauma, but for me the core trauma is not what happened to us, but what happened
inside us. And what happened inside of us is that we lost contact with our true selves in the present
moment.
Gabor (29:32):
So the purpose of therapy, as far as I'm concerned, is to help people be in touch with themselves in the
present, which means that their responses and their reactions should not be driven by what happened a
long time ago, or what they made themselves believe about themselves a long time ago.
Gabor (29:55):
As you can see with Joanne, her belief is she's not worthy.
Rich (29:59):
Mm-hmm (affirmative)- not important. Yeah.
Gabor (30:00):
Not important enough, yeah.
Rich (30:04):
Yeah. So you're not reluctant to make statements like, the reason is... or to make pronouncements
when you're in a way about... you're offering your interpretations into the conversation about what's
true or what's not true. What's the motivation? You're very direct about that.
Gabor (30:31):
Well, I am, and most of the time, that's good. And sometimes it's not so good. And if it isn't good, then I
have to clean it up. But I'm not afraid to go there. And I see the role of the therapist really... What is it
that we want clients to do? What is the purpose?
Gabor (30:50):
Well, we want them to see themselves as they are. Who are we then? Well, we're then a mirror. We're
the mirror they're looking in.
Gabor (31:02):
If somebody could have seen them and reflected their true selves back to them when they were small,
they wouldn't be in your office in the first place. That's the basic wound, is we weren't seen, and
therefore we couldn't see ourselves. So we lost sight of ourselves. We get confused.
Gabor (31:22):
So then our job is to be as clear a mirror as possible, so that means we have to do a lot of work on
ourselves, because a smudgy, mucked up mirror is not going to give a very accurate reflection.
Gabor (31:39):
So as long as I am fairly clear, I can be confident that what I mirror back is going to be an accurate image
of that person so they can see themselves. So that's where my feedback comes from.
Gabor (31:50):
Now, it doesn't always work, and the reason it doesn't work, because I may not be so clear myself. I may
be triggered. Maybe there's something about that client that I want to fix that I haven't fixed in myself.
Gabor (32:02):
What we haven't talked about is that when I trained people in compassionate inquiry, a lot of the initial
work is about looking at their own stuff, so by the time they come to this kind of a session, they can be
as clear as possible.
Gabor (32:19):
Not only is it looking at and resolving and dealing with their own stuff, it's also keeping themselves clear.
And keeping myself clear means I got to do my work constantly. It's not like my work is over, and okay,
did it. I understand.
Gabor (32:35):
No, I got to do my yoga every day. I have to do my meditation every day. I have to... whatever issues
come up in my life emotionally, I have to deal with them on a daily basis. Then I can be clear enough to
go into a session and be confident for the most part I'm mirroring what that client needs to see about
themselves.
Rich (33:01):
Yeah, and if you're not clear, that stance, that directness can-
Gabor (33:10):
Be hurtful. It can be hurtful.
Rich (33:11):
It can be very hurtful, yeah. And not particularly helpful to the client.
Gabor (33:16):
Well, absolutely. It's never helpful to hurt a client. It's okay for the client to experience pain, but I should
not be the... and if pain comes up because of something I say, that's perfectly okay with me, as long as
I'm coming from an authentic place.
Rich (33:39):
Yeah.
Gabor (33:39):
But if the pain is coming from my in-authenticity, that's my responsibility to clean that up every time.
And generally I find, by the way, that most of the time that happens, it's a reason for me to reflect on my
own process and what I brought to the session. My method in that sense is a bit more risky, because it's
not as formulaic.
Gabor (34:11):
If there was a formula to follow, I can just follow the formula every time, and that kind of keeps it safe,
but I also think this method, at least in my hands and in the hands of people that I train, it can also lead
to some very dramatically powerful results.
Rich (34:28):
Okay, well, let's go to the next clip and see what some of those results are. Let's take a look.
Gabor (34:39):
Now, Joanne, is this the first time in your life that you've had an experience where you wanted contact
with someone, but you weren't important enough in their eyes.
Joanne (34:57):
No, it is not.
Gabor (34:59):
Okay, so how far does that go back?
Joanne (35:04):
Well, definitely before language.
Gabor (35:08):
Before language?
Joanne (35:09):
Yes.
Gabor (35:11):
Your anger has got nothing to do with your brother. So here's the question about anger again. The
anger's perfectly valid, but the story is not. You're not angry because of your brother. You're angry
because you don't experience yourself as important enough, is your problem. Don't try to work on your
brother or deal with it. Deal with your own unimportance. And then if you want to approach your
brother from that position, once you find your value and are grounded in your value-
Gabor (35:51):
Your value.
Joanne (35:53):
Yeah.
Gabor (35:53):
Your worth. Then you can approach your brother. Right now, you're using your brother to try to make
yourself important. And he says, "Fuck you."
Joanne (36:04):
Right.
Gabor (36:05):
As he should.
Joanne (36:07):
Right.
Gabor (36:07):
It's not his job to make you important. Are you with me?
Joanne (36:11):
Yeah, totally.
Gabor (36:12):
Okay, great. Thanks.
Rich (36:15):
Well, that's about as direct as it gets.
Gabor (36:18):
Yeah.
Rich (36:20):
Is that kind of putting it together, that kind of directive statement to a client, is that typical of the work
you do that's... Like you're really saying, Here's what's happening. Here's why. This is your brother's
perfectly justified in saying, "Fuck you" to you?
Gabor (36:48):
Yeah. You see, Joanne here wants to know her authentic self in response to her brother, and that's what
my purpose is to help her achieve.
Gabor (37:09):
Now, this anger that she has, the chronic anger that she has, she thinks it's about one thing. The spiritual
teacher A. H. Almaas has got this theory of holes, where we're born with certain essential aspects,
including value for example, or clarity or courage or insight or... strength. And then as childhood occurs,
we're robbed of these essential qualities. We essentially have to suppress them in order to survive in
our environment.
Gabor (37:54):
And then when something happens, and where that essential quality is suppressed, we develop a hole,
and then we try and cover that hole with a whole set of behaviors and adaptations and so on. And when
something happens in life that uncovers the hole, we can't stand it.
Rich (38:18):
Gabor (38:20):
So we get upset. So Joanne's brother's role in her life is to uncover her hole where she lost self-value,
where she lost worth. Now, she wants to be both protective of herself and compassionate to her
brother.
Gabor (38:41):
Compassionate to her brother doesn't mean that she has to give him money or even talk to him. She just
wants to be compassionate, from an authentic place. And she also wants to protect herself.
Gabor (38:57):
Once she does some work on her value, which I'm just suggesting that she does, and if I was working
with her, that would be the next session.
Gabor (39:09):
If she comes from a position of recognizing her own value, or at least being aware that she doesn't value
herself, then she'll know what to do about her brother. What would somebody who was worth
something, how would they approach their brother?
Gabor (39:25):
They wouldn't approach him needing him to validate her to prove her value. They would approach him
as somebody who's got an issue that I may or may not want to deal with.
Gabor (39:40):
So again, this is in the context of a training session. I'm showing people where to go with this. This is not
a therapy session in the sense of this is me sitting in an office with a client for an hour. But yet that
directness, if I believe that the person can handle it, and they can learn from it, I'll employ it every time.
Gabor (40:06):
So that's what happened in this case.
Rich (40:08):
And so, take it the next step. You were mentioning this a moment ago. If you are working with a woman
and you're continuing to have this conversation, where would it go? How would help her to establish
her relationship with her brother and other people in her life, based on her own sense of self-worth, her
value? [crosstalk 00:40:32]
Gabor (40:32):
Well, my first intention is not to help her establish a relationship with her brother. She already has a
relationship with her brother. My intention here is to help her establish a relationship with herself.
When she is in contact with herself, she will know exactly what to do about her brother. I don't have to
do anything there at all. If she wants advice, I can give it to her. But really, she will know what to do
when she's in touch with her own value, her own worth. Or when she's aware that she's not in touch
with her value.
Gabor (41:08):
Right now, not only she is not in touch with her value, she doesn't even know that she's not in touch
with her value, so she's acting blindly, and that's what plays into the dynamic between her brother.
Gabor (41:22):
Look, Rich, it would have been very simple for me to give her advice right from the beginning. I could
have said to her, Look, it's perfectly valid for you to withdraw from your brother and not to give him
money, and not to listen to his messages. Nothing wrong with that.
Gabor (41:37):
But she wasn't looking for advice as to what to do. She wanted to know, Am I being my authentic self?
But as long as she's not aware that's she's actually covering up her lack of self-worth with her behavior,
she's not being her authentic self. So that's my only intention here is to get her to see that she's not
being authentic, and how she's not being authentic, and what's underneath all that, which is the loss of
self-worth.
Gabor (42:07):
That happened a long time ago, and it's got nothing to do with her brother.
Rich (42:10):
But my question was, if you were working with her as a therapy client, in concrete terms, where would it
go? What would you be doing together?
Gabor (42:24):
What would be the next step?
Rich (42:26):
Yeah.
Gabor (42:30):
Okay, it's a good question. I might begin by asking where else in her life this lack of self-worth shows up,
because it's not going to be just in one context. It's going to show up in her relationship to other people,
probably in her relationship to work, and including, and saliently, in her relationship with her brother. So
I'd just get her to talk about that a little bit. How is this showing up in your life?
Gabor (43:01):
Just get her to see it. And then, very likely, she'll experience some emotions around it, and then I would
take her into her body. When I say, take her into her body, I would invite her to check in with her body,
and what are the emotions, and where is this lack of value happening. And people usually identify some
place in their belly, just kind of an emptiness or an aching or something. And then I'd get her to pay
close attention to that, just observe it, for as long as necessary.
Gabor (43:44):
And almost inevitably, something will emerge. So it's a question of looking at this dynamic in her life,
then what arises in her body about that, and then inviting her to really pay attention to her body
experience.
Rich (44:01):
Mm-hmm (affirmative)- okay. And so as you're looking at yourself in these various sessions, and the side
of yourself that emerges as a therapist, at least in relationship to these particular clients that we're
highlighting in this course, what do you see? Is that Gabor? Is he much different than the way you see
yourself in your ordinary relationships? Is there the therapeutic persona? Is that no different than the
side of yourself that I might see in your every day relationships?
Gabor (44:51):
Should I invite my wife into this conversation?
Rich (44:54):
She'd be the expert on this. She's probably give us the most interesting answer.
Gabor (44:59):
Well, the answer is that... Eckhart Tolle somewhere talks about how people can actually channel being in
their work, but not so much in their personal relationships, and I think a lot of us experience that. We're
probably more insightful, more compassionate, more present, when we do the work than we happen to
be in our personal lives, and that's the biggest spiritual work for me, and the biggest psychological work
for me, has actually been in my marriage relationship.
Gabor (45:36):
Where everything that I want to be and sometimes manifest quite well in my professional work, all of a
sudden disappears. Now, the last thing that any of my family members want me to do is to practice
compassionate inquiry on them. It's totally uncompassionate to practice compassionate inquiry with
people in your life.
Rich (46:03):
Yeah.
Gabor (46:06):
But when I see myself as being present, and attuned, empathetic, compassionate, insightful... no, that's
not necessarily... You know, I have to say, the older I get, the more I'm capable of being that way in my
personal life, but that's ongoing work. That's ongoing work.
Gabor (46:35):
And again, keep in mind that these sessions are like demonstrations. They're not me engaging with a
client over time. When I engage with people, it's usually longer than this. It's not these 15 minute
segments. It's a longer process. I allow more space, sometimes, for their body experience than I might
here. I might give them more space to flounder a bit in their own confusion, so that they can experience
that. Be a bit less directive. So this is a training session. I'm showing people certain techniques or certain
approaches here.
Gabor (47:14):
But by and large, it does, I think in a skeletal form, it does represent my work with people.
Rich (47:25):
Yeah, all right. Well, for now, let's leave it at that. I appreciate your directness both as a therapist and in
just our conversation.
Rich (47:42):
We have another installment of this masterclass coming up. I very much look forward to seeing that and
being part of it with you.
Gabor (47:52):
Likewise, thank you.
Rich (47:53):
Take care.
Module 5: “It’s OK to Tune Out”:
The Secret Language of ADHD in Compassionate Inquiry
Gabor Maté
Rich (00:00:11):
Welcome everybody. I'm Simon, I'm your host for this master class on compassionate inquiry with Gabor
Maté. And speaking of Gabor Maté, hey Gabor, how are you?
Gabor Maté (00:00:24):

Hi Rich, I'm great, thank you.
Rich (00:00:27):
So this is the fourth and final clip that we'll be looking at an example of your work in this series. And this
about your work with a young woman with ADHD. So let's talk a little bit about ADHD and your thinking
about it, and also you have some personal experience with ADHD. So set a frame for us. Tell us what
your take on it and your experience with ADHD and what you've learned?

Well, I'm just so enthusiastic about the subject that you may have to interrupt me a few times, Rich. I
was in my early to mid 50s. I was working as the medical coordinator of the palliative care at Vancouver
Hospital looking after terminally ill people. And one day the social worker in the unit, a 38 year old
woman, asked to have coffee me. And she told me she'd just been diagnosed with adult ADHD, about
which I knew nothing. I was a typical physician. I knew nothing about it. But within five minutes of the
conversation I intuited why [inaudible 00:01:36] asked to have coffee with me, because everything she
said about herself pertained to me as well, the short attention span, the tuning out, the disorganization,
the poor impulse control, difficulty being still. And so like many adults I self diagnosed and was
subsequently seen by a psychiatrist and was formally diagnosed, and I was given medication. So I
became very interested in the ideology and the causation of this particular area of disorder, especially
since it was burgeoning. The numbers just were going up and up and up.

What I never bought into was the medical mantra that this is heritable genetic disorder. In fact, they
ADHD the most heritable mental health disorder that there is, which I think is scientific nonsense. So I'll
very quickly tell you my take on ADHD. And I believe this is true for all mental health disorders, this is
the essence of my work, is that they all begin as a reaction, as a response to the environment, and they
also always have a coping function. So I would make the argument that anybody looking at anxiety or
even psychosis, there is some coping function to it. Now, the hallmarks of ADD are tuning out, poor
impulse control, and plus or minus hyperactivity.

If you look at the tuning out, very simply, it is not a disease. We all have the capacity to tune out. For
one thing, we have to, because there's way too much information hitting our nervous system at any one
time, so we just can't attend to it all. But more specifically, it's when we're stressed and there's no
remedy. If I can't leave the situation, that stresses me, and if I can't change it, how does my brain deal
with it? One of the ways it deals with it is to tune out.
Rich (00:03:34):
Something we're seeing in the United States Senate right now, a large sample.

We could talk about all the trauma in the US Senate, yeah. But I tell you, you're looking at a lot of
traumatized people there. You can see the trauma in their faces and their demeanor, but that's another
subject. But in the White House you have a person with very clear ADHD. That guy can't pay attention
for more than a couple of seconds. He can't read a memo. He's never probably read a book in his life. If
you read his biography, you get that. Anybody could make that diagnosis. Now, in other words, what I'm
saying is that the tuning out is a response to stress. But when? If early in childhood and in infancy the
environment is stressed as it was in my case being a Jewish infant under the Nazis in Hungary, and my
mother is grief stricken, her parents have died in Auschwitz, she doesn't know whether we're going to
survive. I don't have to go into the whole picture again. Of course I'm tuning out a lot. But when am I
tuning out? When my brain is developing.

So then the tuning out becomes programmed into the brain. So it starts as a coping mechanism, now
becomes a long term deficit. And furthermore, we know, that the neurotransmitter circuitry of the brain
develops in interaction with the environment, so the endorphins, the internal opiates, the serotonin, the
oxytocin that helps in relationships for example as Stephen Porges and other people have shown. All
these circuits in interaction with the environment. So does the dopamine circuitry of incentive and
motivation. So how do we treat ADHD? We treat them with dopaminergic medications, medications that
elevate the level of dopamine, for example ritalin or dexedrine, other stimulants.

Now, people say therefore that proves it's a biological genetic disorder. No, it doesn't. It's biological, but
the biology is determined by the early environment, so that what I'm saying about ADHD is that it's a
response to the early environment during the period of brain development when both the tuning and
the neurological circuitry of the ADHD brain are potentiated by what happens early in childhood. And if
you ask why we see so much more now, it's because the conditions under which parents are looking
after their kids are getting more and more stressed. And the more stressed the parents, the more
stressed the kids, the more dysfunction you're going to see, the more coping dysfunction you're going to
see.

So that's what's happening. That's why we're seeing so much ADHD. In other words, what I'm saying is
what we've got is a socially engendered, stress mediated brain response, not a genetic disease. Now,
there may be genetic predispositions, but nobody inherits ADD. People may inherit predispositions in
the form of heightened sensitivity, but a predisposition is not the same as a predetermination.
Rich (00:06:54):
So if I might ask, so in your particular case, you've gone through 50 years. You've never associated
yourself with that diagnosis. And so what sense did you make of what you later came to think of as
ADHD? What behavior patterns- [crosstalk 00:07:18]

Well, my poor impulse regulation. The first book I wrote was on ADHD, the American title is Scattered,
Canadian title is scattered minds. And if you look at my diaries, in typical fashion, ADD people will keep
diaries. They'll begin them, but they won't finish them. So I have in my closet, pointing to it, I have six
diaries, six black books, each of them with three or four pages. These are all diaries I began, after a week
I would abandon them, and a year later I'd start another one. But if you read them, what you find is a
man in his 40s who says, "I'm unfulfilled in my work. I'm successful, but I feel there is a potential that I
haven't even tapped into yet."

But I'm not saying this with positive intention. I'm saying this with frustration and resignation, and I'm
depressed a lot of the time. My marriage is under great stress. My kids are afraid of me. Why? Because
the poor impulse control. So I would be loving one minute, then rageful the next. So I'd talk about my
Jekyll and Hyde ways of being with my kids. My crazy humor that just jumps all over the place that even I
don't get it sometimes. I was talking to a very famous American comedian yesterday. And he's got
ADHD. And I said to him, "I think 100% of comedians are traumatized and 80% of them have ADD." And
he says, "Yeah, I agree with you."

And so all these patterns. The tuning out, the absent mindedness, the difficulty concentrating when I
wasn't interested in something. You might say, "You went to medical school." Yeah, I went to medical
school. But I went to medical school in my late 20s. I always wanted to be a doctor, that was always my
lifelong intention, but I really couldn't do the studying in my early 20s to get through the science
courses. So it showed up in many ways in my life. And it was once I got to understand my mind a little bit
that I could start to write books.

I always wanted to write. I'm a writer. Quite apart from being a medical doctor, I'm a writer. But I could
never write, except short newspaper articles. I could always work under the pressure of a deadline.
That's difficult with the ADD brain. All my university essays were done from midnight to 8:00 in the
morning the day they were done.
Rich (00:09:44):
Concentrates the mind like the prospect of imminent execution.

That's exactly right. And that's what it took for me. So these were all the patterns that I self recognized.
And once I began to understand my own mind and deal with it, now I could actually-
Rich (00:10:01):
So did medication play any role in how you changed your way of responding, if I may ask?
As I describe it-
Rich (00:10:15):
You seem like you invite this kind of question.

No, it's fine, yeah. No, I write about it. So as I say in my book on ADD in the first chapter, typical poor
impulse control, I took ritalin on the very day I first heard about ADD. And I took it on a higher than
recommended initial dose. I just self medicated. You're not supposed to do this. But as a doctor you can.
And I'm quoting myself. I say I immediately felt present and full of insight and love. And I went home
and my wife said, "You look stoned." And that was my introduction to ADHD medication. Subsequently, I
did see a psychiatrist who prescribed dexedrine, dextroamphetamine sulfate, which is another
stimulate, elevates dopamine levels. And I took that for quite a while, and it helped me focus. And as I
also say, it made me a much more efficient workaholic because I could get a lot more things done.

In other words, the medications, they can help you focus. They can't help you deal with your lifelong
patterns of emotionally driven, trauma driven patterns. So that's a whole other thing, is that for me
ADHD and the healing from it is not a question of taking pills. It's a question of resolving trauma.
Rich (00:11:38):
Okay. So let's shift to talking about this clip and this young woman that you work with who has been
diagnosed with ADHD. So what should we be looking for in this? Set the scene for us. This is a
demonstration interview, large audience. What is it we should be looking for in this clip?

Sure. So again, this is a two day course on compassionate inquiry. Several hundred participants in
Victoria, British Columbia. This young woman is one of the participants. She asks a question which then
leads me to invite her on the stage so we can have a conversation. And now the intention here, as it
really is in this whole approach, is to bring people or to guide people to self compassion. So her core
issues, which are identified right from the beginning, or mostly from the beginning but throughout is,
number one, self flagellation, self loathing. She beats herself up, number one, which is very typical of
people with ADD, but of traumatized people in general.

John Ratey, one of the psychiatrists who are experts on ADD, with whom I don't agree in many ways, but
I also have learned a lot from him, he said that, "I'm sorry," is the commonest phrase in the ADD lexicon,
this constant apology, this beating up of the self. So that's a major issue for her that I'm helping to guide
her to look at, number one. Number two, her tuning out, which crops up throughout this particular ...
She tunes out right onstage, [inaudible 00:13:18] conversation about that. And then number three, the
issue of what she calls the shutdown of her heart, which is another dynamic for which she flagellates
herself. So my intention here it's to guide her to look at all those three dynamics, the tuning out, the self
flagellation, and the heart closing down with compassion and understanding.
Rich (00:13:43):
Okay. Let's go ahead. Let's see how this interview begins.

And your name again?
Renee (00:13:51):
Renee.

Greta?
Renee (00:13:53):
Renee.

Renee. Okay, hi.
Renee (00:13:55):
Hi.

So what's up? (silence)

Okay, so just before you think, check in with yourself right now. Okay? Just tap in. What's happening?
Renee (00:14:16):
Nerves.

Great. Fear? Can you identify the fear?
Renee (00:14:25):
So many people watching me.

There are, aren't there? And the fear is-
Renee (00:14:40):
I'm going to mess up.
Okay. And if you mess up, then what's the consequence?
Renee (00:14:50):
I will beat myself up.

You what?
Renee (00:14:54):
I will beat myself up over it, because I do it a lot.

You will be in trouble you said?
Renee (00:14:59):
I will beat myself up.

You'll beat yourself up.
Renee (00:15:01):
Yeah.

So who are you afraid of?
Renee (00:15:04):
Me.

Nothing to do with them, right?
Renee (00:15:06):
No.

Okay, great. So you're afraid of yourself because you beat yourself up a lot.
Renee (00:15:12):
Okay. So why don't you just own it and say to them, "Hello, everybody. What I'm about to tell you is that
I'm really afraid of messing up, because if I do I'll be very hard on myself." How about you just telling
them that?
Renee (00:15:34):
What?

How about you just telling them that? Just own it. That's how it is. "I'm really afraid of messing up or
thinking that I'm messing up because I'm very hard on myself."
Renee (00:15:42):
I'm really afraid of messing up, and I'm really hard on myself.

Okay. How many can relate to that? Just a few people. Okay. All right. Go ahead. So let's make room for
that fear here. As a matter of fact, again, if I asked you, "How did that help you survive?" what would
you say?
Renee (00:16:10):
How has fear helped me survive?

How did that fear of messing up and that beating yourself up, how did that help you survive? Because if
you're doing it, there was a good reason for it, because you're not stupid. Your system is very wise. If
you learned to be hard on yourself, it's because there was some value in it. So how might that have
helped you at some point?
Renee (00:16:38):
Well, like I was saying earlier, I never feel like I'm supposed to be here. And being hard on myself pushes
me to do something about it.
Rich (00:16:49):
Gabor, watching this clip, this is kind of a fundamental approach that you take. And I think all of the clips
that we've seen you take what seems like a problem and so quickly and directly switch the problem into
a survival strategy of some kind. Is that how you see it? And say a little bit about how that fits into your
overall approach.

Sure. So pretty much everything, I may have said earlier, pretty much every mental health issue people
face begins in real life, and it begins as a response to real life circumstances, and begins usually as a
coping mechanism. So she's already got that intellectually by the time she comes onstage here. So her
fundamental issue that she identified before she came onstage is that she doesn't belong, and this
feeling that she doesn't belong. Now, you see that's not surprising given her history that she'll tell later.
The self beating up, which is again common in all traumatized people, has a purpose. And it is a survival
purpose. And I can put that on two levels. One is that she says if she's hard on herself, that means she'll
work harder to belong and try and deal with this issue of not belonging. She'll try and make herself
acceptable and good for people so they'll accept her.

So that's got a function. That's a got a real coping value it, number one. Number two, and this didn't
come up on our conversation but it comes up often, if a child is facing adverse circumstances, parental
stress, abuse, whatever it is, there's basically two things she could decide. One is that the parents don't
love her and that they're dangerous or they don't understand her and she's all alone in the world. So
there's something wrong with the parents. Or she can decide, "There's something wrong with me."
Now, which of those two beliefs would you say is more conducive to survival in childhood? That the
parental world is all screwed up, or that I'm screwed up?
Rich (00:19:24):
I think we know the answer to that one, yeah.

Absolutely. It would be absolutely unbearable for the child to realize at age three or two or five that the
parents are screwed up, they don't understand, or they don't know how to love her, connect with her.
They may love her, but they don't know how to love her the way she needs to be loved. That would be
devastating for a child to recognize. Therefore, as a survival mechanism, she comes to the conclusion
that, "There must be something very wrong with me." So this is what I'm saying. It all begins as coping.
Rich (00:19:56):
So two things are going on here. So that's the framework. The problem is in a sense a solution, and
that's part of the approach, that's the cognitive framework you work from. And there's thing young
woman and you, and working out what kind of relationship the two of you are going to have and how
that is going to shape the nature of this conversation. So what's going on for you as you're just
responding to her, taking in how she's presenting herself, what she's saying, just the nonverbal element
of it? What are you picking up on, and just sort of what's going on intuitively for you at the very
beginning of this interview?

So what's happening for me is that I'm seeing a younger version of myself with the self critique, the
tuning out, and just the uncertainty. So I see that right away, number one. Number two, I want to make
contact with her. But primarily, I want her to make contact with herself. So before she starts talking,
before we start talking about the cognitive issue, I invite her to check in with her body, that's the first
thing I do. And then right away she gets in touch with what she calls nerves, which then we identify.
What's the fear? And the fear of course is that she'll screw up and she'll beat herself up. So my
additional approach is always to bring people or to guide people to connect with themselves as to what
is true for them at that moment. Not necessarily what is ultimately true, but what is true for them at
that moment. And in helping them make contact with themselves, I also trust that that will help for
them to make contact with me
Rich (00:21:59):
Yeah. Okay. So this is moving very quickly. It appears as if she's been in therapy, she's gone over this
territory intellectually as you said a moment ago. She gets it. She understands-

No, she has not been in therapy, she has been at my course for a day.
Rich (00:22:19):
Oh, which is even better than being therapy, okay.

Yeah, yeah. By the way, when people do come to this course, again, without sounding too grandiose
hope, people say being two days in that course is two years of psychotherapy, which I think is not
enough of a compliment, because I think it's more like five or 10 years of psychotherapy, but that's
another issue, depending on who the psychotherapist is.
Rich (00:22:46):
Right. [inaudible 00:22:47] Okay. So we'll take a look at the next clip and see where you're going to go
with that. Anything that you want to say about ... Given what you've just said and given how you've
tuned into her, what is it that we should be looking for in this next clip?

Well, so what we're going to see next are two manifestations of her ADD, which are not unique to ADD.
The tuning out, but also the physical hyperactivity, her feet just jumping. Which is typical Peter Levine
stuff. Peter's somatic experiencing and how trauma is the freezing of the fight or flight response. She
just wants to escape, which, that's exactly what a kid under a stressed situation would want to do. And
that's programmed that into her body, and she even recognized it herself. Which then leads me to kind
of an intervention that may surprise some of your audience.
Rich (00:23:56):
Great. Great lead in, let's take a look.

So since who you are is not supposed to be here, therefore you have to produce something or deliver
something to justify your existence. Is that what you're saying? You have to be good for people, you
have to be acceptable somehow, yes, no?
Renee (00:24:27):
I'm not sure what you're saying. I'm tuning out.

You're tuning out a bit. Okay, great, thank you. Then let's just come back to the body then for a minute.
(silence)
Renee (00:24:37):
Now what?

Hm?
Renee (00:24:54):
Now what?

You tell me know what. What is there now? What is there now? What is there now? That's the now
what, okay?
Renee (00:25:08):
Tears.

Fear. Okay.
Renee (00:25:11):
Tears.

Tears, yeah. Check in with your body. Is there sadness for you there?
Renee (00:25:21):
There's anxiety.

Anxiety? Okay.
Renee (00:25:24):
And sadness.

Sadness, okay. Any physical sensations?
Renee (00:25:29):
Sweaty.

Sweaty, okay. Anything else in your belly, your chest, your throat?
Renee (00:25:35):
My feet.

Kind of restless?
Renee (00:25:37):
Yeah.

Okay. Your feet are restless?
Renee (00:25:46):
I guess so. They keep wanting to run.

Do you dance at all?
Renee (00:25:53):
No.

You're not a dancer?
Renee (00:25:55):
No.

You don't like dancing?
Renee (00:25:59):
I don't know.

What's that?
Renee (00:26:01):
Sometimes.

Do you feel kind of imprisoned, kind of stuck?
Renee (00:26:13):
Yeah.
Yeah. Is that how it feels?
Renee (00:26:20):
Yeah.

Yeah?
Renee (00:26:20):
Yeah.

You want to break out of jail?
Renee (00:26:25):
Should I?

Would you like to break out of jail?
Renee (00:26:29):
I don't know. I don't know what you're-

You don't know what I'm talking about right now, do you?
Renee (00:26:35):
No.

Okay. I'm just looking at your restless feet. And that's what an escape ... Your body just wants to escape.
So sometimes it's just good to move.
Renee (00:26:54):
I'm not going to dance.

You're not going to dance? You don't have to. You don't have to dance. You can join if you want, but the
rest of us are going to dance. So just give me one second here.
Renee (00:27:13):
This is like my worst fear.
Rich (00:27:17):
It looks like things are going to take a fun turn. Describe what happens, because this is in between clips.
But paint the scene for us.

Sure. So just to go back over the clip to begin with, she recognizes her tuning out. And then she says,
"Now what?" So I immediately, my method then is to bring her back to the body. So I pay a lot of
attention to people's language, and you may have noticed what. So when she says, "Now what?" She
may think she's asking me a question as to what do to next. But I just turn it around. I say, "Well, okay.
What are you experiencing now? That is the, 'Now what?'" So let's come back to her body. So she
recognizes her anxiety again, her sadness, and also the restlessness. Now that need to escape, that
restlessness, it's always when we feel imprisoned. When do we need to escape? It's when we feel
imprisoned. Now you probably know the book by Alice Miller called The Drum of the Gifted Child.
Rich (00:28:34):
Sure.

It's one of the seminal books in the child trauma literature, it's the one that woke me up in a lot of ways.
But the German title of the book is actually much more accurate. The original German title was Prisoners
of Childhood. So in that sense, we're all prisoners of childhood.
Rich (00:28:52):
Much better title.

It's a much better title. The Drum of the Gifted Child really should be translated as The Drum of the
Sensitive Child. And when we talk about sensitivity, that may be the only genetic thing here. The higher
your genetic sensitivity, the more you're going to feel the environment, the more you're going to suffer
if circumstances are adverse. So that's the inherited trait here. You didn't inherit depression, you didn't
inherit ADD, you inherited sensitivity. So The Drum of the Sensitive Child. But the original title is
Prisoners of Childhood. Well, as I told you in my first session, part of my method is just to play with
people. And so again, this ADD mind of mine, I make all these associations. So Prisoners of Childhood,
she's a prisoner of childhood, she just wanted to escape. So that brings up for me Jailhouse Rock by Elvis
Presley. So I said, "You don't have to dance, but we're going to." I wish you could see it.
Rich (00:29:54):
I wish so too.

Because now there's 300 people ... I suppose you can't play it because of copyright reasons maybe, but-
Rich (00:30:04):
In the eventual version of this we'll see if we can insert some of that. But go ahead.
Well, because now you see 300 people, and within a minute she jumps up and she starts jumping
around. It's wonderful to see that.
Rich (00:30:16):
All right!

Yeah. Right onstage.
Speaker 4 (00:30:35):
Everybody let's rock. Everybody in the whole cell block was dancing to the jailhouse rock. Spider Murphy
played the tenor saxophone. Little Joe was blowing on the slide trombone. The drummer boy from
Illinois went crash, boom, bang.

So that's what happens right after this. Now, why do I do that? First of all, I want to give her some
physical release. It's a bit of Peter Levine moment. I want to give her a way to release some of that
energy that she's been storing up. I also just wanted to relax, it was just playing here, it's all okay. So
that's what this sequence is about. Again, to summarize, it's about checking with her language. "Now
what?" "Well, what is going on with you now? That's the, 'Now what?' What's the body telling you? Let's
play a little bit, let's release some of that energy." That's what happens here.
Rich (00:31:25):
It's also interesting, the flow of this particular clip, it begins with, you're giving her an observation, your
observation about justifying your existence. It's sort of a little high order, it's sort of an intellectual kind
of response. And she just doesn't go with it, she's not quite sure what you're saying at that point.

Which is all the more interesting because she's the one who actually first said it. She said this beating of
the self was a way of functioning in a higher way to make her belong, make her acceptable. So all I'm
trying to do is to mirror back to her what she told me. But-
Rich (00:32:10):
And you put it in your language, and you lose her. And then your response to it is, "You're tuning out,"
and then you thank her, which completely changes the mood around this and changes your relationship
with her in that moment.

So first of all, I'll challenge your language a little bit. I don't lose her, she's not mine to lose. She just
tunes out. And people tune out precisely because my formulation of my mirroring back to her of what
she told me is difficult for her, so she tunes out. What I thank her for is acknowledging that she's tuning
out. That's a great step for her. Now she's not pretending. She says, "You know what? I tuned out." I
said, "Great. That's really good to know." And then you see that coming up throughout the conversation.
And my job there is to simply welcome the tuning out and make room for it.
Rich (00:33:22):
[crosstalk 00:33:22] physical. So getting underneath the words, and then the focus from that point on is
the focus on the physical, her body, and then the feet, the restless feet.

And to de-stigmatize the tuning out, not to make it wrong.
Rich (00:33:38):
Right, "Thank you." Yeah, "Thank you."

Exactly.
Rich (00:33:43):
Yeah, yeah. Okay. And then so there's this wonderful group expression of energy, and it's always fun.
Everybody has the freedom to do something, it all resonates. And so there's a possibility that comes out
of that, that excitement, the kinetic energy in the room. And let's see where you go with it.

So that restlessness, okay. How are you feeling by the way?
Renee (00:34:28):
What just happened?

Sometimes you've just got to move. Give yourself permission to move. Let's talk about what you want to
talk about, okay?
Renee (00:34:47):
I guess what triggers all of this, the reason why I was attracted to your books and stuff in the first place
was my ADHD. And reading your book on it, I connected to that little brief part in there where you
talked about adoption. And I was adopted, and it put everything together for me kind of, and so that's
what I want to talk about.

So go ahead.
Renee (00:35:18):
How do I get started?
What is the issue for you around? Is it the not belonging, is that what it is?
Renee (00:35:24):
Yeah.

Okay.
Renee (00:35:25):
And the not feeling like ... It came up again when we did the triad exercise where on the outside it
probably wasn't detectable, but I felt really like it wasn't my place.

Did you acknowledge that?
Renee (00:35:38):
What?

Did you acknowledge that?
Renee (00:35:41):
I pushed it away.

Okay. So you didn't acknowledge it. You didn't say to the people that you-
Renee (00:35:48):
No, I don't think so.

Okay, great. That's fine. That's what you did because that's what you've been doing all your life, is kind
of faking it, right?
Renee (00:35:57):
Yeah.

Pretending that it's not there.
Renee (00:35:59):
Yeah.
So inside you're with it, but on the outside you're just pretending to be somebody else, right?
Renee (00:36:05):
Or just withdraw and be really quiet.

Or you withdraw so that you don't have to, okay, fair enough. So first of all, just check in with yourself
on that issue of not belonging. Is it present with you this very second? And before you answer, don't go
to the automatic yes.
Renee (00:36:26):
I was going to.

Yeah, don't, or the automatic no either. So neither deny it nor jump to it right away. It's actually
investigation, a real look at the self, a real allowing yourself to experience the moment and coming from
the present moment. So what we want is your honest answer, not the answer that's going to make
everybody feel good or you look good or me feel like a brilliant therapist, we just want the truth. Fair
enough? Can you commit to speaking the truth?
Renee (00:36:59):
Yeah, I think so.

Okay, great.
Rich (00:37:01):
As I watch the session, and particularly the way that we're breaking down your session, you can really
get a sense of the therapy's a kind of a dance, and the nonverbals between the client and the therapist.
So there's a shift for me in this particular clip. You're always playful in some way. With this client you're
particularly playful, and you're sitting cross legged on your chair. It reminds me a little bit of Martin
Short's Jiminy Glick. And then at this point you shift, and the group is dancing, and everybody's a little
breathless. And then you're focusing in. Your position changes and you focus in, you feel like we're
moving into the next phase of this conversation. So what's your experience as you're going through all
this.

So as I think you seem to suggest, now there's a shift and a sense that she's ready now to look at her
core issue. Now, the core issue was of not belonging. "So now that we've played, now that we've
established a relationship, now that you feel more comfortable in front of this large group, let's talk
about what really matters to you." And then she goes into the, as you see, she goes into not belonging.
She begins with the fact of her adoption. The thing about adoption is that adoption's a major risk for all
kinds of mental health problems. So kids who are adopted I think have ... If you have ADD, your chance
having been adopted is something like eight times that of the average. So people have much higher risk
of ADD, they have double the risk of suicide, a heightened risk of anxiety, depression, and so on.

Now, the genetic minded fundamentalists would say that's because it's dysfunctional people with all
these conditions that give up their kids for adoption. But there's another way to look at it, which is that
the adoption process itself is traumatogenic in a certain sense in that, number one, we now know that
the brain develops in interaction with the environment beginning in utero. And any woman, as you'll
hear her story in the next segment, any woman who gives up her baby for adoption is by definition a
stressed woman. So she's a single mom, or in her mother's case a teenage mom, unsupported and so
on. So the hormones of stress are affecting the baby for nine months throughout fetal development,
number one.

Number two, there's a major blow that happens that the child sustains right at birth, which is separation
from the birth mother. So we're just setting the stage. So she's identifying she's read my book on ADD,
she read the passages about adoption, and she wants to address that. So that's where we're going next.
But again, what I do with it is rather than address the issue intellectually, I'm going to say, "Well, what's
happening for you right now in the present moment?" So that's where we're going next with this, is just
again, "I want you to tap in. Tell us where you are right now. Nevermind the intellectual questions or the
therapeutic questions as such, just what is happening for you right now?"
Rich (00:40:47):
And that's a hallmark of how you're working. You're trying to block automatic response. You keep
bringing people back into the present moment, whether through focusing on their body or just
supporting them and being direct about what's going on, and not just sort of getting caught up in the
automatic mechanisms of conversation.

That's right.
Rich (00:41:13):
Yeah. So we're setting the stage here. Anything that we should look forward to in this next clip?

I think it'll speak for itself and we can fruitfully discuss it afterwards.
Rich (00:41:32):
Okay, great. All right. Let's do it.

So on the issue of not belonging, I'd like you to have a really good look around at this group. Are you
looking at them? Yeah?
Renee (00:41:43):
I think so. There's a lot of them.

So tell them the truth. "At the present moment, I believe I don't belong here with you," or, "At the
present moment I believe I do belong with you."
Renee (00:41:59):
Does it have to be that simple?

No, you just say it however it is for you. But tell them, checking in with them, actually being present to
them, present with you, and whatever is true for you, you just say it.
Renee (00:42:16):
This is not an accurate representation of real life, but I do at the moment feel like I belong here.

Okay, great. Where did that first part of the statement come from? I know you're speaking your truth,
but all I asked you was, "At the present moment, what is the case?" That's all I asked, right?
Renee (00:42:46):
Because I feel like I've been here before where I felt like I belonged for a moment, and then it's gone
generally.

Oh. So Renee, what is true for you then is that at the present moment, "I do feel or sense that I belong
with you, but I'm afraid that that's not going to stay with me." Is that what is the case?
Renee (00:43:08):
That's true, yeah.

"Because when I felt that way before, it never lasted."
Renee (00:43:16):
Right.

Is that the case?
Renee (00:43:17):
Yeah.
So that's your truth. So how about now, instead of saying it's not a representation of real life, own your
fear. So just tell them again if it's true for you at the present moment.
Renee (00:43:29):
At the present moment, I feel like I belong. I'm in the appropriate place. I fear that I'm going to lose this
sense as I always have.

In the past, yeah. Okay. Fair enough. So let's acknowledge the fear, because it's there, it's genuine, and
it's rooted in lifelong experience. And just acknowledge it, but leave it aside for now. Check in with the
part that is sensible of belonging at the moment if you can. Just breathe with it a bit. Are you able to be
in touch with it?
Renee (00:44:32):
Hm?

Are you able to be in touch with it? Did you just tune out again?
Renee (00:44:36):
I did just tune out again, yeah.

Okay, great.
Rich (00:44:41):
So the dance continues.

Yeah.
Rich (00:44:44):
Your posture, you've changed. We're moving into something. It's becoming more intimate. You're really
focusing very closely on this statement, that you unpack the statement that she makes, which seems like
a very, a kind of a nuanced statement about, "I feel present, but this is not an accurate representation of
where I am." And then you take that, with your usual sensitivity to language, and then you unpack it in a
different way.

Yeah. So she makes the statement, "I do belong at present, but this is not a representation of real life."
So she makes a distinction between the present moment and real life. Now, what is actually true for her
is not some philosophical statement about real life. What is true for her is her fear of losing this sense of
belonging. So again, my work is to help her identify what's happening in the present moment, because
for me, trauma work isn't about [inaudible 00:46:07] change the past. But it's about dealing with the
energies, recognizing the energies that we carry in the present moment based on our past experience.
Her energy is that of fear. Now, she translates that fear into some global statement about life. "This is
not representative of real life." Well, no, that's not true. What is true is that she's afraid of losing this.
Rich (00:46:32):
In that moment.

In that moment. So I always want people to experience themselves in the moment, because once they
experience themselves in the moment, then they belong. The whole not belonging has to do with the
inability to experience ourselves in the present moment. And I've had great teachers, and some of them
presented at the same conference last year that I spoke at, Dick Schwartz being one of them. And so I
would say Dick Schwartz talks about self leadership, about the self coming in to lead all the different
parts of us. And her sense of belonging, that's an aspect of her true self, but she doesn't believe in it. She
believes more in the reality of the loss of self. So all I'm trying to do here ... Not all I'm trying to do. But
what I'm trying to do here is to help her experience her true self.

And so there's a sense of belonging and of the genuine fear that I have. That's what's real right now. So
that's what this conversation is about. So it's really about the energies that we carry from our past
experience. We can't change what happened, but we can certainly change our relationship to those
energies.
Rich (00:48:11):
And the other thing that strikes me about it is that for you, this idea of belonging, having a sense of
belonging, it's not a concept. It's not a intellectual idea, but it's an experience of the present moment. If
someone is in that moment, that's where belonging is rooted.

Exactly, that's exactly it.
Rich (00:48:40):
And then the moment you ... we don't see it, but we see your face, you begin to say you're losing her,
she's tuning out. You immediately call that to her attention and you try to bring her back in her
connection with you.

Well, again, I would say to you I'm not losing her. I know what you're referring to, but that way of
putting it, if you look at the language it's like she's somebody that I have and I can lose. No, that's not
what's happening. It's a dynamic process, and at some point she tunes out, which is part of the process
and it's an honorable part of the process. That tuning out we've already identified played an important
function in her life, and it keeps showing up, and every time it shows up we name it.
Rich (00:49:37):
I think that's what you're pointing out to me, that's a really important distinction between the nervous
therapist who feels like he's losing a client at a certain point, and going with the flow of it and just seeing
what's happening, and your ego is invested. It's not about you, it's about your recognizing what's going
on with the person that you're working with.

Well, yeah. That doesn't mean I can't show up the other way as the nervous therapist as you call it. But
no, here I'm actually really okay with her tuning out. I don't take it personally. It's not a comment. It's
just a manifestation of the dynamic between us at that particular moment. We just call it and we just
come back, that's all.
Rich (00:50:27):
Yeah. It's the natural flow of what seems to be happening right there.

Exactly.
Rich (00:50:34):
All right. So the session, it's seeming more and more focused and more attuned. Let's see what happens
next.

Well, let's go back then. First of all, your mom adopted you. Do you know the story at all?
Renee (00:50:56):
Yeah, I do.

The story was? Gave you up for adoption is what I meant, yeah.
Renee (00:51:06):
My biological mother?

Yeah.
Renee (00:51:07):
She and I are friends.

You're friends now?
Renee (00:51:10):
Yeah.

So what was the story?
Renee (00:51:11):
It was an open adoption. Her story for her?

Yeah. What kept her from keeping you?
Renee (00:51:20):
Well, she wasn't ready, prepared. She wasn't with my father, she has a lot of trauma in her life and she
actually, she had been abused. And she told me that when she was pregnant with me she confronted
her abuser. Something came over her and she felt the need to confront her abuser, and so I feel like that
probably ... her pregnancy for her was probably just a lot of trauma visiting.

A lot of stress.
Renee (00:52:01):
A lot of stress, yeah, with her family pressuring her to keep me and her father not accepting that I was
going to be adopted.

Okay. So that really the womb in which you were gestated was almost like a battle ground.
Renee (00:52:18):
A what?

A battle ground.
Renee (00:52:24):
I never looked at it that way before.

There were conflicting things going on.
Renee (00:52:25):
Yeah.
She couldn't believe she could handle being a parent, but she was under pressure. So there was a lot of
conflict already that you were experiencing in the moment.
Renee (00:52:37):
Yeah.

And then she gave you up.
Renee (00:52:40):

How old were you? Right at birth?
Renee (00:52:48):
At birth, yeah.

And so your family of adoption got you right at birth.
Renee (00:52:50):
Yeah.

And what was your experience in that family?
Renee (00:53:01):
I know you're not asking me how great my parents are, they are.

No, I'm not asking how great your parents are. I'm asking what your experience was.
Renee (00:53:12):
Not feeling like I belong.

Okay.
Renee (00:53:17):
I had a sense at a really young age that I was an alien or something, I just didn't ... It was an open
adoption, and I knew my parents. They visited me all the time. I understood what the situation was, but
I still felt like it was off and it wasn't right. I wasn't-
Okay. So let me run through the usual questions. Probably the answers are no, but just nobody sexually
abused you?
Renee (00:53:52):
No.

Okay. No drinking in your family?
Renee (00:53:55):
No.

Nobody hit anybody?
Renee (00:53:57):
No.

You were not hit?
Renee (00:53:58):
No.

You were not bullied?
Renee (00:54:01):
In my family?

No, in your childhood.
Renee (00:54:11):
I mean, I feel like because I'm hesitating it's yes.

Yes?
Renee (00:54:18):
I guess so, yeah. I felt bullied as a child, but I wasn't picked on at school or anything. But I felt bullied by
my close friends as a young kid, yeah.
Okay. How did you feel at such times?

And who did you speak to?
Renee (00:54:35):
No one.

Okay.
Rich (00:54:37):
There's a rhythm to your work, I guess most therapists' work, of this intense focus in the moment and
the pulling back, getting a story, and then putting those things together is a bit part of what the art of
therapy is about. So here you're into that aspect of you're listening to her story and the style and rhythm
of how you're talking to her keeps her from getting lost in the story. It's sort of like you're looking for key
elements and, "This is important material, but let's not get lost in that."

Well, keeping in mind that the core issue that she identified was a sense of not belonging. Now, in
connection with that, three other issues arose. The self flagellation, the tuning out, and the closing of
the heart that you'll see in the final section. But the core issue is the not belonging. And so in telling the
story of her mother's pregnancy, she's already tapping into ... And as I'm watching this, Rich, I realize I
might have done more with this. Because I might have asked her, "How do you think that the infant in
utero would feel about belonging with all this conflict going on?" That may be an obvious point, but I
kind of slide over it. I could have, in retrospect, done more with it. But what is emerging is that her sense
of not belonging, it originates back in the womb, and her narrative makes that clear.

Now then, moving forward, I then asked her, "How did you feel in your family of adoption?" And her
response was interesting. She said, "You're asking me to tell you how great my parents were." Now, I
asked nothing oft sort. I asked her, "What is your experience?" But what that shows is her difficulty, as
are all traumatized, is to stay with their own experience. She thinks she's being asked about her parents.
She's not being asked about her parents. She's being asked about her own particular experience. So
that's what I take her back to.
Rich (00:57:15):
That's right.

"What was your experience?"
Rich (00:57:16):
[crosstalk 00:57:16] You're challenging or redirecting. She has an expectation of what should be
answered here, and you want to make sure that she hears what you're actually asking and focusing in
rather than your expectations.

Yes. Now the final point about this clip is a key question that I have. Sometimes you go through the ACE
questionnaire. You ask people, there's childhood experiences, "Were you
physically/sexually/emotionally abused? Did parents beat each other? Any violence in the home? Any
alcoholism?" All that. None of that happens, so people think, "Well, I wasn't traumatized." The key
question, "Did you ever feel sad or bullied or lonely or alone or whatever?" "Yes." "Who did you speak
to?" The answer 1000% of the time is going to be nobody. Or, "I spoke to my teddy bear." Or, "I talked
to my friends," maybe. But usually it's going to be nobody. That is the key issue, the sense of not
belonging. When a child cannot share themselves with anybody, of course she's not going to have a
sense of belonging.
Rich (00:58:43):
And by asking that question in that way, you're underlining something about your relationship with her.
"This is a place where we can talk about the thing that you weren't able to talk about as a child."

Absolutely. And of course, any good therapist will tell you that, that in this relationship you create the
conditions that, had they been present in the first place, the client wouldn't be in your office in the
second place.
Rich (00:59:15):
But the striking thing is how quickly you go there. When you ask that question, it's a very powerful
question. It communicates that you understand something about the client's experience that almost by
definition they really haven't talked about.

Yes. And I mean, there are many methods or working, mine is one of them amongst many valid ways of
working. But one essential feature of it is it is quick. I do think, and I keep stressing this, that therapy
need not be as complicated as you make it out to be. And I think the principles are very straightforward
and we can get there if you pay attention to the body, if you pay attention to language, if you create the
safety and we create relationship I think we can get there very quickly.
Rich (01:00:18):
Yeah. Okay.

And if we trust ourselves and if we trust the client.
Rich (01:00:26):
Yeah. Let's move it along, let's see where you go, where the two of you go.
I definitely felt a big disconnect from my adoptive parents.

You felt a big disconnect?
Renee (01:00:40):
Yeah. I feel like I rejected them, yeah.

And how do you feel about that?
Renee (01:00:53):
Guilty, horrible.

Let's just deal with that for a minute. Because I think that the big problem of you not belonging is
actually with yourself.
Renee (01:01:08):
I can see that, yeah.

Yeah. So if I came to you and if I told you the same history about myself that you told me about yourself
and I said, "I rejected my adoptive parents and I feel guilty, horrible about that," what would you say to
me based on what you've learned here so far? Let's see what a student you are. What would you say to
me?
Renee (01:01:44):
I feel you.

Hm?
Renee (01:01:46):
I feel you.

Yeah. But that's not good enough. You feel me, yes, but how would you help me understand why I might
have rejected my adoptive parents. And you've seen me do this, and it's okay if you can't think of it.
Renee (01:02:05):
Because it was a coping mechanism that you developed at the time because you needed it at one point.
Exactly. And how did that serve you at that time? How did it protect you at that time?
Renee (01:02:23):
Sorry, I tuned out.

You didn't understand the question? Or do I need to repeat the question?
Renee (01:02:26):
I forgot the question.

Okay, great. Can we make room, first of all, for the fact that you're going to tune out every once in a
while. Can we just accept that that's going to happen?
Renee (01:02:37):
That what?

That you're going to tune out every once in a while. Can we just accept that that's part of our process?
Renee (01:02:43):

And you're not even doing it, are you?
Renee (01:02:45):
What?

You're not doing it, you're not tuning out. It's doing itself, isn't it?
Renee (01:02:50):
Yeah.

You're not even doing it, your mind is just doing it, your brain is doing it. So can we say, "Thank you
mind. Thank you brain."?
Renee (01:02:59):
Yeah, thanks.
As long as we just make room for it and acknowledge it every time it happens, then we just move on,
right? Nothing wrong.
Renee (01:03:08):
I still don't understand why I did that thought. I don't understand how it helped me.

Yeah, I know. We'll come back to that. At this point I just want to make room for the fact that
sometimes you're going to tune out, and then we're going to just go back over it again. That's perfectly
okay. Yeah?
Renee (01:03:21):
Yeah.

All right. If I took my fist, which I'm not going to, but if I took my first, I smashed you right in the heart, if
I bruised your heart and you had to be with me, what would you then do to make sure that I don't
bruise you again?
Renee (01:03:53):
I'd try to figure out why you did it and then prevent it.

No two year old can figure that out.
Renee (01:03:59):
Oh. I'm two?

You're two months old. You're two days old. And you've just been bruised in the heart because when
your mother gave you to these strangers, that bruised your heart. This bruised your heart. How are you
going to protect yourself?
Renee (01:04:27):
Tuning out.

You couldn't. You're going to have to stay there. Physically you couldn't leave I mean, could you?
Renee (01:04:36):
Yeah.
Could you leave as a two day old?
Renee (01:04:37):
No, but I said tuning out.

Tuning out, yes. And what would you do with your heart to protect it?
Renee (01:04:45):
Ignore it.

No.
Renee (01:04:48):
Not to protect it?

Ignoring it won't help you protect it. Well, all right, not to play with words, you're going to have to close
it. You're going to have to shut it right down, because when it's open it's going to be bruised. But once
you shut it down, it means that it doesn't matter what kind of love is coming towards you, you're not
going to let it in. Because the first time you let it in, you got really bruised. Are you with me?
Renee (01:05:33):
Sometimes.

Not were you with me two seconds ago, I'm asking, "Are you with me?" That's in the present moment.
Are you getting why you might have shut down your heart?
Renee (01:05:43):
What?

Are you getting why you might have shut down your heart?
Renee (01:05:48):
I feel like it's happening now.

[inaudible 01:05:48] shutting it down? Good. Excellent. Because this is painful. So your heart is just
doing what it knows how to do.
Rich (01:06:02):
As I watch how you work, it keeps reminding me of something we do at the magazine all the time, which
is edit. Pay very close attention moment by moment to a word, is it needed? Or how do you clarify a
point? Or where you feel like a writer has gone off track. And so part of this economy of your style as a
therapist is your, and I don't mean this in a sense of a purely intellectual exercise, but you're an editor.
You're moving through her story. And sometimes we can move through the story very quickly. And then
you get to a certain point where there's some belief, there's some blurriness, there's some something
that's getting in her way of a kind of presence and authenticity that's your goal. I don't think I've seen
someone work who seems like such an editor of the sessions in that sense, and it's part of the economy
of this style.

Yes.
Rich (01:07:14):
This is my trade, so I'm seeing something in how you work that reminds me off what working on a
magazine and being an editor is like.

Great. So when I watch that segment I see what you're seeing. But I also see how my own stuff gets in
the way in this one. So there's a Chinese saying which says, "Learn from the teachers by negative
example." So here's some positive teaching, but there's also a very important negative teaching, in other
words, what not to do. And as I watch this clip I get it. I do something here that I would not recommend
we do. So then I have to ask myself-
Rich (01:08:00):
This, by the way, is what I love, that you're bringing this up and this attitude that you have towards you
work. But I'm sorry, go ahead.

Well, yeah. But then if I'm consistent about it I'm going to ask myself compassionately, why did I do it?
So let's go through it. She talks about she rejected her family of origin and she feels horrible she says. "I
feel guilty about it." Those are the words she uses. Now, one more time, there's the lack of self
compassion. So this is where I turn it around and this is where I say, "Well, okay, if I came to you, what
would your attitude be towards me? Would you also call me guilty and horrible?" And she says, "No. I'd
say, 'I feel you.'" In other words, I very often do this. I ask the client to plug somebody else into their
situation and right away the attitude becomes compassionate towards that other person, the same
compassion that they can't give themselves. Which, we inquire as to, "You can be compassionate with
me but not with yourself." So that part is good. That turnaround. But then I do something here where I
get didactic I noticed. I'm no longer inquiring or guiding an inquiry, I become didactic.
Rich (01:09:31):
You become the editor, the yes and no editor of how one talks about, interprets an experience.
And from a guide in inquiry and from a partner in that inquiry, now I become a teacher. I switch roles.
And I don't notice myself doing it when I'm doing it, because if I did that would have stopped, but as I
watch the clip. So I start then talking about ... And what I say is totally true. "Your heart was bruised.
Your shutting down was a natural response to heart being bruised, because being given away by your
birth mother is a bruise to the heart." And so that's great teaching and it's not wrong to proceed that
way. But I could have, instead of telling her I could have said, "Well, how do you suppose you might
have felt? What do you think your heart would have felt?" That would have been a more skillful way of
approaching this. You see what I'm saying?
Rich (01:10:47):
I see what you're saying, and what you're pointing out now is something that you often do, and it's part
of the economy of working in front of a large audience and trying to move through a story in a different
way, that you'll tell somebody to give a yes or no, or disagree with a particular way they're interpreting
their experience in a very direct way. So it's a fine line, isn't it?

It's a fine line. But in this case I veer to the side of didacticism versus inquiry. And I don't recommend
that. And so then when I'm watching this clip this morning with you, Rich, I'm asking myself, "Well, why
did I get didactic all of a sudden?" Because I'm injecting my own experience into it, because I was
separated from my mother, I was given away at a certain point and my heart shut down, and not being
able to receive love when it's coming towards me from my spouse or from the world, and just not
receiving it, that's been my dynamic. In other words, at this point I have to confess ... Not confess. It's
not a confession, just an acknowledgement, as I'm watching this clip I'm over identified with this client.
And that over identification then moves me from the partner in inquiry to a didactic teacher.

What I'm saying is true, but I'm not doing what would most help the client at that point. So let this be a
lesson in how a reasonably skilled therapist can over identify and at that point take up too much space,
rather than allowing the client to go through the experience themselves. So that's what happened here.
It's a good lesson.
Rich (01:12:39):
Yeah. Because it can be a very fine line, it can be very nuanced, because we could go back to these other
clips and see moments. And from my viewpoint, they're usually productive for the client. The clients go
with you. And they could make that step, they could discover something on their own without the yes or
no, without the direct challenge that you often make. So I get that as well, yeah. And I think every
therapist in some way, I think because it's more nuanced, it's more moment by moment, it's more
apparent to you in how you work which side of this line you're on.

Truth is, I've watched this clip a number of times and I haven't been comfortable with my approach at
the end. But only now in having to watch it with you in the context of commenting on it did I actually
tap, "What was I actually doing? Oh, I was over identifying and I wasn't attending to my over
identification."
Rich (01:13:53):
That's right. So you were uncomfortable with something, it wasn't quite clear what that was watching it.

Until now.
Rich (01:13:59):
Right, yeah.

That's right, that's right.
Rich (01:14:05):
All right. So we're coming to the conclusion of this session. Let's see what happens.

So let's put your attention on your heart. Just put your attention on it right now if you could do that,
okay? I'm going to ask you two questions. Are you with me now?
Renee (01:14:35):
I think so.

Okay, great. I'm going to ask you two questions. Don't think about it. Either something comes up for you
or something doesn't come up for you. What would your heart say if you asked it, "Why are you shutting
down right now?" What would your heart say?
Renee (01:15:00):
Because I'm scared.

Okay, great. And if your heart said to you, "I'm shutting down right now, Renee, because I'm scared,"
what would you say to it?
Renee (01:15:23):
"I'd like you not to do that, please."

No. That's not going to help it. If you wanted to help your heart, not to get it to behave better but to
actually help it, what would you say to it?
Renee (01:15:38):
That it's okay.
It's okay. You'd say to it, "I feel you."
Renee (01:15:47):
Yeah.

Okay. You'd say to it, "Sweetheart, you shut down all you need. You'll open again, and I'll be here
waiting for you."
Renee (01:16:04):
Yeah.

Would that feel right to you to say to your heart?
Renee (01:16:09):
That it can shut down when it needs to?

Yeah.
Renee (01:16:18):
I think that would be a much different approach than I would have taken before and a maybe better
one.

Well, it's compassionate one. It's the only one that makes any sense actually, so don't make it wrong.
Renee (01:16:30):
So I let it shut down?

Yeah. And that also means you're not going to beat it up anymore for shutting down. Guess what it's
going to do if you beat it up?
Renee (01:16:44):
It's going to stay shut.

Even more. So that's all. So give yourself permission to tune out. And by the way, I still tune out. I've
written the book on ADD, but I still tune out. It's just hard for me to stay present. Not in this situation,
but in other situations. And I just accept that.
Renee (01:17:10):
What do I do when I need the information that's being presented to me and I'm tuning out?

Then you say, "I'm sorry, I tuned out. I need to hear that again." Just make room for all that. Give
yourself permission to be the way it is. There's a good reason why it is the way it is. The problem is not
that you tune out. The problem is that you beat yourself up for doing it. The problem is not that you
have a sense that you don't belong, the problem is you beat yourself up for it. So just see what happens
if you're able to develop some compassion towards all that. Are you with me at the present moment?
Renee (01:17:57):
No.

You're not?
Renee (01:18:00):
Just like two seconds I wasn't there.

Okay, great. All right. Are you present now?
Renee (01:18:06):
Yeah.

I'm just going to ask you before you finish, did you get something here or did you not? And I want the
honest answer.
Renee (01:18:16):
Yeah. Yeah.

Good. Tell us what you got.
Renee (01:18:22):
I got that I need to give myself permission to tune out and not fight it, to let my heart close, which I had
never considered before. But to remind myself that it's okay and that it'll still be here when I come back.

Exactly. Okay?
Renee (01:18:45):
Yeah.

Good for now?
Renee (01:18:46):
For now, yeah.

Okay. How are you feeling?
Renee (01:18:49):
Better.

All right. Thank you.
Renee (01:18:52):
Thank you.
Rich (01:18:54):
Now that was a lovely conclusion to that session. It's hard not to feel that something has shifted for this
client. What was interesting to me, there's a certain point where you're talking about how she can
communicate with her own heart that sounds to my ear didactic. There's a yes, there's as no, that you're
teaching her, you're the guide, you're not sort of on a journey with her. Which seems, in terms of how
the session goes, it seems like that was very useful. For you as you watch that, what's your reaction? Do
you feel like that's too didactic? Would you have preferred to have done it in some other way?

Well, so part of the issue, and at some point you notice me look at my watch, and there's also a clock
onstage, this is a workshop. I'm working on schedule. So I need to move through this session. So that's
part of the dynamic here. Having said that, in this clip as opposed to the previous clip where I
appropriately critiqued myself for my didacticism, in this one I do some teaching but I like what I'm
doing. Because I think now we have a relationship where there's a kind of a discipleship, and discipleship
only in the sense of she's following me for the most part. Not that she's my disciple, but disciple simply
means a follower. In this exchange she's following me. There's nothing wrong with me being a guide and
a teacher at this point.
Rich (01:20:42):
As long as feel attuned.

As long as there's an attunement there and as long as I'm not forcing it, yeah. And so I like the exchange
here. And actually, if I look at her responses, she owns it when she tunes out, but at the same time she
gets what I'm saying. She verbalizes it in her own language and she seems energized about it. So yes, I
like the way the session concludes. Had I had more time I might have spent some more time inquiring.
But given the context and given the original intention, which is to help her deal with her lack of self
compassion, I think we've come a fair way within a fairly short period of time.
Rich (01:21:33):
Right. So in practice, if we're to describe what you do, compassionate inquiry is a big part of it. And
there's also compassionate inquiry and guidance.

That's right, that's right. And what I'm going to leave the client with is this compassionate curiosity
about their own process. So whereas there's the automatic program self condemnation, and I talk about
this sometimes, I talk about you can say to somebody, "Why did you do that?" And I may have said this
in a previous session, I forget. But that way of framing it, "Why did you do that?" That's not a question,
it's a statement of disapproval. You shouldn't have done it. But what if I said, "Tell me, why did you do
that?" Now it becomes an inquiry. So I want to leave people with that sense of compassionate curiosity.
When they see themselves behaving in ways that no longer serve them, do the actual, "Oh, okay. Let's
be curious about it." That's my unspoken agenda, is to bring people to the point of compassionate
inquiry, compassionate curiosity towards the self. And once they do that, everything becomes a lot
easier.
Rich (01:23:06):
And the other element is compassionate challenge. So you're not Rogerian, you're not reflecting back.
You frequently are responding with yes, no, and that can in a way, I imagine, sometimes clients recoil
from that. They feel too challenged by that, or you're disapproving of them, and a lot of that is your own
stuff. When you're attuned to your own stuff, as you talked about so openly, you're much less likely to
cross that line.

Exactly. So again, it's not what we say or do that matters so much, it's who we're being when we're
doing it.
Rich (01:23:57):
That's right.

So if I have the relationship of trust and safety, if in Stephen Porges' terms the ventro-vagal apparatus,
the social engagement apparatus is online I can say to a person, "You know what? No, that's not the
right way to look at it." But if that is not established and I say the same thing, now they perceive
criticism and attack. So again, so much of it is based on what you called before the unspoken or the
nonverbal text of what's happening between us. And as long as that safety and connection is there, I'm
very free to say, "Hold up. Let's look at it differently." And so I sometimes make short shrift of people's
stories if I feel that the stories are getting them away from themselves. Sometimes I'll listen for a long
time, like the very first clip we did.
Rich (01:25:01):
The first one, sure.

Yeah. I just listened for a long time. But once I perceive that the relationship, the contact is established, I
can be much more interactive and much more assertive and trust that that's going to move the process
forward efficiently.
Rich (01:25:16):
And be the consummate therapeutic editor.

Exactly, yeah. I like the way you put that, thank you.
Rich (01:25:23):
All right. Well, thank you. Thank you for showing us your work, thank you for just presenting this
perspective on psychotherapy. We will encourage people who have been watching these sessions and
have been part of the class, get your questions together. We're going to have a Q and A session, it will
be scheduled. Everyone who's been here who's been able to watch your work will have an opportunity
to ask you questions. As a final thing, in terms of people developing their capacity to do this kind of
work, have some thoughts in terms of as a trainer, what have you find particularly important that you
want to pass along to students and people, what they call compassionate inquiry or whatever they call
it, what's really important about doing this work?

Well, that has to do with work on oneself. I think the biggest work we do is on our own self. You may
want to include this or not, but we do offer this course online, and we offer it in two formats. One is a
yearlong intensive training with eight modules that are covered three times, interactive facilitated work.
It requires a lot of commitment, three or four hours a week for a year. And the first eight weeks, the first
eight modules, the first time people find it very hard because they ain't learning theory, they're working
on themselves in way that most programs don't demand. But it's also proportionately rewarding as the
feedback is what we get from all over the world.

The other format that's going to be offered very soon is a much shorter course, it's not facilitated, you
do it on your own. It covers a lot of the same material. Again, it's not interactive, but it's for people who
have less time but are interested in this material and want to go into deeply without facilitation. That
will be available as well. So those are the two formats in which people can pursue this training. I
sometimes offer it in person, but as I'm in the middle of a two book contract and just heavily ensconced
in manuscript writing, I don't think I'm planning to do this for another year or two. So right now, it's
online, it's available.
Rich (01:28:01):
Great. All right. So thank you so much for showing us your work and participating in this master class.
Reminder again to everyone, you're going to have a chance to ask Gabor your questions. The scheduling
for that final installment of this course will be coming to you. Thanks again.

Thank you, Rich, take care.
Rich (01:28:25):
Bye, bye.

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Modules 15 Transcripts Compassionate Inquiry Master Class

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Module 1: An Introduction to Compassionate Inquiry

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Gabor Mate (00:01:45):

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