What Is Therapy Actually Like? A Conversation with My Former Therapist

Dustin Grinnell - 1 (00:00:00 --> 00:01:30)
I'm Dustin Grinnell, and this is Curiously.

Over the past 10 years, I've written novels, short stories, and many articles and essays. The research I did to create all this work brought me into many conversations with incredibly interesting people with fascinating expertise and personal stories. Unfortunately, only small pieces of these tape-recorded conversations made their way into the published essays articles, and books. I didn't like the idea that all of these interesting conversations were just sitting on my hard drive, locked away forever. So I decided to create a podcast to expose my conversations to the world.

Why not keep doing what I'm doing and let others come along for the ride? On this podcast, I go wherever my curiosity takes me. That's why I named it Curiously. It's a clunky adverb, and we don't use the word often. That's kind of why I like it.

But I think I like it most because curiously is kind of how I am. Who I am, and so the word stuck. In this first episode, I talk with my former therapist, John Grillo, a licensed social worker and psychotherapist. In our conversation, we explore what therapy is, some common misconceptions, whether it can work for everyone, and much more. John and I spent years working together and have always had a good rapport, so this was a fun conversation with a lot of interesting takes on therapy.

I I think both regular everyday people and therapists alike can get something from it. Enjoy.

Dustin Grinnell - 2 (00:01:34 --> 00:01:36)
John Grello, welcome to the podcast.

John Grillo (00:01:36 --> 00:01:38)
Thanks, Dustin. Thanks for having me.

Dustin Grinnell - 2 (00:01:39 --> 00:01:56)
So I invited you here to talk about the practice of psychotherapy because you are a licensed social worker and a psychotherapist with a specialty in psychoanalytically informed psychotherapy. And you were also my former therapist.

John Grillo (00:01:56 --> 00:01:57)
That's right.

Dustin Grinnell - 2 (00:01:57 --> 00:01:58)
We worked together for—

John Grillo (00:01:58 --> 00:02:00)
Now that I think about it, I am.

Dustin Grinnell - 2 (00:02:01 --> 00:02:06)
Some fond memories we created together. 5 years, was it?

John Grillo (00:02:06 --> 00:02:07)
That sounds about right. Yeah.

Dustin Grinnell - 2 (00:02:08 --> 00:03:37)
I was more or less like a low-key, like, hypochondriac worrying about various aches and pains. And I was— I had some anxiety. And that's how we met. And I think it was last year around this time when we officially discontinued therapy. So we had a, we had a good run.

We had 4 or 5 years and we unpacked all the, the things that may have been contributing to the anxiety and the psychosomatic symptoms. And so I was really inspired by the recent documentary on Netflix called Stutz, and the actor Jonah Hill actually interviewed his therapist. And I thought it was a very touching and very kind of educational documentary. And I think all of these things sort of inspired me to want to circle back to you and talk about psychotherapy. So I really appreciate you being willing to do that.

John Grillo (00:03:37 --> 00:05:12)
I wanted to be an academic. I was interested in religion, spirituality, religious experience, and also history. So I actually enrolled at Union Theological Seminary in New York City, and I started studying church history. And my focus in that degree program was in monasticism, specifically like in the Eastern Roman Empire, the period of late antiquity. And what was interesting to me about that was that it was very psychological.

Like those Eastern ascetics, they incorporated a lot of like Greek philosophy into a lot of their writings, and it is very psychological. While I was there. At Union, they also had a psychology and religion department. And so that was where I took my first class in psychology. The faculty there, their focus seemed to be on a lot of Jungian psychology and Jungian psychoanalysis.

Dustin Grinnell - 2 (00:05:14 --> 00:05:15)
Completely relate.

John Grillo (00:05:16 --> 00:08:20)
So after that, I moved to the Boston area. And that's where I got my first job in the mental health field. I started working for a— there are a number of companies in the area that are service contractors for the Department of Mental Health. And so I started working for one of those companies and I worked in group homes for like residential treatment for people with major mental illness. So that was my first sort of very intense exposure to to the world of mental health, like actually working with it.

It was my first exposure to major mental illness. And so for, if your listeners don't know what I'm referring to with that, when we're talking about major mental illness, we're talking about like schizophrenia, schizoaffective disorder, like psychotic disorders, bipolar disorder, sort of like the kind of the major type bipolar 1, that kind of thing. After a couple of years in that role, doing that kind of work. I think all along the way I was more interested in psychotherapy, and I think the work in settings like that is really important. Like, people who receive treatment in those residential programs, they need committed staff.

And the unfortunate fact is, like, a lot of the work there is, is not very well paid. So after a couple of years, I was like, this isn't going to work long term, so I need to go back and get a credential. So I then enrolled at Boston College to get my MSW, to get some more specific academic training in the field of social work and learning some more solid clinical skills and getting into psychotherapy. So after I graduated and was working on getting licensed, I was working in addictions treatment, maybe not really by choice. It was— it's useful experience, but it's really tough work.

So I did that for a few years, and then I think where I started getting into actually practicing psychotherapy in the way that I had wanted was I began working at a community mental health clinic in Brookline as a staff therapist. That was a good experience. That was the place where I felt like I was really doing what I wanted to do. Unfortunately, the clinic sort of imploded. After exactly 1 year of getting hired there.

Dustin Grinnell - 2 (00:08:22 --> 00:08:38)
And it sounds like in your description of your work history, there was always a draw to work in the clinical side, to work with patients, to be face to face, to be a little bit less academic and research-oriented, to actually sit with someone and talk about their problems.

John Grillo (00:08:38 --> 00:09:23)
And yeah, I remember at the end of my MSW, I became briefly delusional again, and I applied to law school. I thought I might, I thought I might try to do a PhD in psychology. And I actually like, you know, did a little tinkering around with some applications, but then I realized like, oh, you know what, given where I am sort of in my life course, I'm facing the prospect of like not graduating probably for another 7 years because that's how psychology programs work. Very possibly having to really sort of give up on clinical work, on doing psychotherapy because doctoral-level programs are so research heavy. And also facing the prospect of like not having my first real job as a psychologist. Until I was like 45.

Dustin Grinnell - 2 (00:09:24 --> 00:09:27)
Right, halfway through your natural lifespan.

John Grillo (00:09:27 --> 00:09:28)
Right.

Dustin Grinnell - 2 (00:09:29 --> 00:09:50)
Um, I have to say, this is, uh, fascinating for me, and in general, because as part of the therapeutic process, clients, patients, are generally— don't know the biographical details of their therapists, and that's for good reason. Uh, I wonder if you could kind of explain that reason. For 5 years You knew everything about me.

John Grillo (00:09:50 --> 00:09:50)
Yeah.

Dustin Grinnell - 2 (00:09:50 --> 00:09:59)
In some cases more than I knew about myself. And I knew nothing about you. And that was deliberate. And I wonder why that was.

John Grillo (00:09:59 --> 00:10:44)
Yeah. This is something that is always present in the therapeutic relationship because the therapeutic relationship is this very strange animal. It's sort of unlike any other relationship that you'd have. Elsewhere in your life. So it's, it's a relationship in which, like you said, there's this high level of intimacy, right? There's this high level of self-disclosure that you do with your therapist. And that's in order to do therapy. Like, the therapist needs to know a lot about you and lots of details about your life and about your thoughts and feelings and everything like that. But it's also a completely one-sided relationship. And another weird feature is that it's an artificially constructed relationship, right?

Dustin Grinnell - 2 (00:10:45 --> 00:10:55)
You're a 50-minute entity and you go into a room and you both sit down and then you get up after 50 minutes and you go back to your life. It's this construct.

John Grillo (00:10:55 --> 00:12:16)
[Speaker:BEN] Right, right. And I think it's important for therapists to be able to acknowledge just how weird it is to work like this. So in terms of the reasons why it kind of has to be this one-sided, I think there's actually like a lot of different reasons. When the patient comes into therapy and comes into the therapeutic session, what they're really there to do is talk about themselves. If the therapist in the session is engaging in a high level of like self-disclosure of like, you know, really personal stuff, that could be a little bit overwhelming for the patient. There might be details about the therapist's life that the patient doesn't want to know about. I think one example that gets used a lot, like in training, are issues around like, um, if a patient is having struggles in, in life, for instance, like financial struggles, and the therapist discloses a lot and it becomes clear to the patient the therapist is like perhaps a quite well-to-do person, that can inject this sort of negative dynamics around perhaps envy jealousy. It can create distance. It can create a feeling in the patient. And the patient may not be wrong about this, but the patient may feel like the therapist is not able to actually, like, understand where I'm coming from.

Dustin Grinnell - 2 (00:12:17 --> 00:12:34)
Yeah, I got the sense always that, you know, you were this blank slate and then whatever I said, it wouldn't matter either way. And that was the environment that you maintained. Every once in a while, I wanted to just ask you what your favorite color was or something. What is it, by the way?

John Grillo (00:12:34 --> 00:12:35)
It is green.

Dustin Grinnell - 2 (00:12:35 --> 00:12:36)
Wow. Fascinating.

John Grillo (00:12:39 --> 00:13:08)
But with all that said, there's a range of stances that therapists have. Some of them are very strict in kind of disclosing nothing about themselves, absolutely nothing about their personal lives. And sometimes that discipline extends to even their own kind of spontaneous reactions in the sessions. They're reluctant to sort of at times share their own thoughts or, or feelings with the patient about something that's coming up in the therapeutic session. And then there are therapists that are they're more relaxed.

Dustin Grinnell - 2 (00:13:09 --> 00:13:52)
[Speaker] One thing that I always liked about your style was that you were educational. You were always willing to share insights and theory with me. I mean, like, I have a science background. I'm a very curious person. And I felt like I was always putting you on trial every once in a while where I would say like, what are we doing here?

Like, how does this actually work, you know? And sell me on this process. I guess maybe I'm just very practical or something. I always wanted to know what are the mechanics and what's the theory behind it? And you always were willing to share that with me.

John Grillo (00:13:52 --> 00:14:56)
Yeah, I think it's important that there be sort of a balance because the therapy session shouldn't turn into like a lecture or like a seminar on psychoanalytic theory or something like that. But I also think that there is a really, really important place for psychoeducation. Like any sort of explanation that a therapist does about technique or theory, any explanation of like why we do the things we do, why things have to work a certain way in therapy, that's all psychoeducation. Other things that are included in that is like anything that you would share with the patient about certain mental health conditions, like this is how mood disorders work, these are the treatments that are available. That's all psychoeducation. I think that stuff is, is actually really important. I think it gives the patient a sense of— helps them to understand what's going on. Again, like I said, therapy is a really weird thing, so it can help people, I think, feel more settled if they understand why things are happening the way they are.

Dustin Grinnell - 2 (00:14:56 --> 00:15:57)
Yeah, that certainly was the case with me. I just felt like it was less of a black box and it made me more comfortable to self-disclose. I guess one of the things that I found most appealing about doing an episode about therapy in general is that I've encountered many people in my life, family, friends who have this kind of aversion to the concept. I've heard people say it's a waste of time, it's self-indulgent, and it flat out just doesn't work. And I was wondering what your— you're not here to defend therapy, but I'm wondering what your response is to that stance that it's self-indulgent, it doesn't work. Because from my perspective, I might go as far as to say it's kind of a godsend. You know, it really does help people know themselves better and overcome problems and things. And that way it's sort of a public good, I think. But what's your response to people who think it's just a waste of time?

John Grillo (00:15:58 --> 00:16:20)
I would say that any therapy that is working in the way that it is supposed to work will never be a waste of time. As long as both therapist and patient are kind of engaging in the process on the right footing and, you know, have established a good rapport, a good working relationship, and there's honest effort being made, it will yield results.

Dustin Grinnell - 2 (00:16:21 --> 00:16:30)
But what if you can't even get there? What, you know, engage with the process? How do you tell someone who's unwilling to engage with the process to kind of convince them that it's worth it, it's worth your time?

John Grillo (00:16:32 --> 00:16:56)
If I were speaking to a hypothetical person who was like very doubtful about therapy or was kind of anti-therapy or had sort of hostility toward it, I would probably start wondering about like what they actually, think about like what goes on in therapy, it would raise a question in my mind about whether they have some real misconceptions about what therapy actually is.

Dustin Grinnell - 2 (00:16:57 --> 00:17:14)
And what is it? What do you do? You go in a room and you talk about yourself and your past and your thoughts and your feelings, and you pull it all apart and you make a story out of it. And yes, why is that good? Why does that work? Why does it make you feel better?

John Grillo (00:17:15 --> 00:17:52)
Well, a definition that I have come up with about, like, you know, what is therapy is when we're talking about individual therapy, I would say it is two people coming together at regular intervals to have conversations in order to try to solve the problems of living. That is what we're trying to, trying to do. And so Some of the things that you mentioned, for instance, like the construction of stories, not just any old stories, but like, like truthful stories. That's a critical part of the therapeutic process, I think, in the service of trying to solve some sort of a life problem.

Dustin Grinnell - 2 (00:17:53 --> 00:20:08)
I know that when we met, I was having my struggles with self-concept.

Identity issues, who I was, what I wanted in life. I think I remember I asked you once, I put you on the spot. I said, you know, if you were at a conference and you were talking to one of your coworkers or colleagues, you know, what would you, what would you say Dustin's problems are? And you thought for a moment and said, I think Dustin needs to figure out who he is and what he wants. So this is fundamentally an identity issue.

Um, and I think in working together, we churned up a lot of details that were then sort of stitched together into a narrative. And that narrative was like, I was born here, I was raised by these people, I interacted with this socioeconomic class, I was from this part of the world, and so on and so forth. And we created a narrative about why I had gone on this year-long trip to leave the workforce and why I started to develop low back pain and why, you know, I started to have these hypochondriacal symptoms. And I remember just slowly feeling a sense of control over the details as we started to churn them up and then throw them into a narrative. I remember thinking, oh, now I know why that happened.

Now I know why I felt anxious. And I remember once you said, you used the word got sick. And I had never used those words before because I had always thought of sickness as physical sickness. You know, I strained my knee or I have a terrible headache. But mental health.

John Grillo (00:20:09 --> 00:22:13)
So to use a more— and reflecting on more extreme situations is a good way to illustrate concepts sometimes. So if you're working with someone who has experienced trauma, it's like serious psychological trauma, especially if it's early life trauma or it's repeated over a long period of time or something like that. One of the things that you'll see as a therapist is you're trying to even like a the basic kind of assessment sessions when you're trying to just collect the basic facts of a person's life, you'll notice that is a very hard thing to do. So there can be problems with memory, like a person might not actually be able to sort of like remember everything that happened, or they may have real difficulty being able to put life events in order. And the life story under those conditions will have these radical discontinuities in them.

So certain life events, again, we're talking about like under conditions of sort of traumatic experience, traumatic stress, those traumas will have this like feeling of kind of like existing outside of the rest of the life story. And that creates some kind of follow-on psychological problems. Like it's a type of compartmentalization. I think most people would say that it arises out of a need to sort of protect the self, protect the ego. To compartmentalize experiences that way, but there's always a trade-off with these sorts of defenses.

Dustin Grinnell - 2 (00:22:13 --> 00:22:24)
And in the therapeutic process, the point is to kind of pull them back into the life story, those split-off traumas, to pull us— look at them in the light. And what is the benefit of doing that?

John Grillo (00:22:24 --> 00:22:38)
Because I think being able to tell a story about what has happened is a way of rendering those incomprehensible experiences comprehensible. It then becomes easier to live with some of those things to whatever extent, like—

Dustin Grinnell - 2 (00:22:39 --> 00:22:41)
They're not boogeymans anymore.

John Grillo (00:22:41 --> 00:22:41)
Exactly.

Dustin Grinnell - 2 (00:22:41 --> 00:23:18)
They're out in the open. And I noticed even, even now speaking about my experience and experience with anxiety and hypochondria and low back pain, 5 years ago when we met, I wouldn't have been able to speak with such— so clinically about it and so objectively about it. I was too bound up. In the kind of trauma of it. You know, I didn't really— I hadn't made sense of it. And I will say that, yes, pulling it into your life story, that happened, you know, whether you like it or not, it happened. And pulling into your life story and letting it be less of this compartment makes you feel much better.

John Grillo (00:23:18 --> 00:24:04)
Yeah. Being able to tell the coherent story like this happened, then this happened, then this happened, like joining up that chain of cause and effect. In your life, but then also being able to recognize yourself all along the way. Like, that was me, and then that was me. Sometimes if there are those sort of radically compartmentalized experiences, memories, there can also be this peculiar sense of kind of disidentification with it. Like, I know intellectually that was happening to me, but like, it doesn't really feel like it was me. I think in general, that's not kind of not really what we're going for. That does not create or contribute to like a stable sense of oneself and one's identity.

Dustin Grinnell - 2 (00:24:05 --> 00:24:47)
You know, so much of the process is, you know, I remember using it, you used a phrase once, let sleeping dogs lie, right? It's, you know, there's pain that's happened and what possible good could come out of exploring it? You know, that seems to be, at least in the circles I've run in and where I grew up, that seems to be the kind of the mainstream the official narrative, like let sleeping dogs lie, you know. That seems to be, to me, like one of the biggest barriers to just getting in therapy. It's like, what possible good could it be to go back to that painful shit and explore it? Like, I don't want to be there, and what good could it be? So what is your response to that basic, very healthy almost, objection?

John Grillo (00:24:47 --> 00:26:36)
I would acknowledge some of the misgivings that are present there. I think this is an important piece of psychoeducation that therapists do need to really not skip over. Simply rehearsing the past, so just sort of like rehashing painful memories, that in and of itself is not therapeutic. So there may be some way in which, like if the patient, for instance, has never disclosed something before, and they're— they just kind of— just kind of go through it. There can be a sense of relief around that because there's an unburdening or catharsis maybe. But when going back to explore past pain, it's really important that we kind of know why we're doing it, because remembering something and talking it over in a therapy session always involves some level of re-experiencing. So if we're talking about something painful or traumatic from your past, you are going to remember what happened, and you're going to feel some of those feelings in the session. The hope is that by going through that in a safe place with a safe person, the, the therapist, it's a little bit easier to do that. But we always want to go back to those things with the idea of like, we are trying to understand something. We are trying to make sense of something in a way perhaps that you haven't been able to before. To build it into that life story, gain some insight into what has happened, or be able to tell, you know, if it's something that you feel particularly bad about, you've made sense of a traumatic experience in a particular way, and perhaps that original story that you told yourself about the event perhaps leaves you with some guilt or whatever. We want to examine that. Like, is that actually the right story to tell about what happened?

Dustin Grinnell - 2 (00:26:37 --> 00:26:58)
Yeah, I always felt like we were insight hunting, and, you know, every 10 or so sessions there would be an insight that was really useful that, like, cut across all the other sessions, you know. And it would be this kind of, um, I guess you would call it a breakthrough, but they weren't like Good Will Hunting, you know.

John Grillo (00:26:58 --> 00:26:59)
That's right.

Dustin Grinnell - 2 (00:26:59 --> 00:27:14)
We worked virtually for a very long time, so I couldn't hug you. Cry on your shoulder. They see you as a father figure. But when the insights come, they sort of reconfigure the way you look at things in your own mind.

John Grillo (00:27:14 --> 00:27:15)
Yeah.

Dustin Grinnell - 2 (00:27:15 --> 00:27:28)
And when they happened, I would have this new way of looking at myself. And, you know, I wish they came like every 15 minutes, but they just don't, you know, they take a while.

John Grillo (00:27:28 --> 00:27:37)
I do have to explain lame too. I have to, I have to give sort of a disclaimer sometimes, like, I cannot promise breakthroughs every session. I simply can't.

Dustin Grinnell - 2 (00:27:37 --> 00:27:41)
No, there's no way to deliver them or, uh, manufacture them.

John Grillo (00:27:41 --> 00:27:41)
Nope.

Dustin Grinnell - 2 (00:27:41 --> 00:28:35)
And you, you get to them. I think that's the thing about therapy that seems maybe to, to the outsider or the inexperienced, it's just, it seems so haphazard and undirected. You know, you're just in there and we would come into a session and we'd come into it talking about nothing that has to do with anything sometimes. And then all of a sudden we'd be in it. You know, we'd be like, oh, remember that session like 3 or 4 times ago when we were talking about mom or dad or talking about that experience at work?

What if that has something to do with what's happening right now? And you're like, oh, okay, that is interesting. And then, you know, we'd sort of dig into it. And then you'd come to this conceptualization of what you're going through right now and you say, oh, I'm feeling this way because of that. And that thread is really therapeutic.

John Grillo (00:28:35 --> 00:29:23)
Yeah. Yeah. And that type of experience is— I think that's one of the things that we're hoping to promote in a more kind of like non-directive, slightly more freeform kind of therapy, like psychodynamic psychoanalytic psychotherapy is, which is your specialty. That's my, that's my specialty. That's how I'm trained.

Other therapies like cognitive behavioral therapies and therapies related to that intellectual tradition, that psychology, they can be a lot more structured. Sometimes they're even manualized. So like we have, we know kind of like in advance for these 12 sessions, we know exactly what we're doing. But having the absence of an agenda allows for those sort of like spontaneous insights like that. It allows for things to just like pop into your head and then we can work on it.

Dustin Grinnell - 2 (00:29:23 --> 00:30:14)
Right. That appealed to my constitution, which is this total freedom to go anywhere. And a lot of times we would, uh, maybe this is my fault, but I would drive us into these like nonsensical humorous places. And I think a big part of maybe why the therapy was so effective, it's like I actually just liked you as a person. I just thought you, you cared, which is— I could detect that you cared.

I thought that was huge. And you're funny. I have this dry kind of sense of humor and sarcastic and, and you're fast. And I knew going into a session that I would probably be talking about stuff that's probably painful or stuff that's just hard, that's sort of incomprehensible that I don't have words for. And that's actually really hard to— it's hard to find words for things.

John Grillo (00:30:14 --> 00:30:14)
Yeah.

Dustin Grinnell - 2 (00:30:14 --> 00:30:19)
Because part of the whole process is like, how do we develop a language around this?

John Grillo (00:30:19 --> 00:30:19)
Yeah.

Dustin Grinnell - 2 (00:30:19 --> 00:30:22)
And develop a language system and get the vocabulary.

John Grillo (00:30:22 --> 00:30:32)
Yeah. That's actually super important. The relationship between language and thought, talking and thinking, because whatever you can't talk about in your life, you also can't think about.

Dustin Grinnell - 2 (00:30:32 --> 00:30:33)
Wow.

John Grillo (00:30:33 --> 00:30:34)
To a certain extent.

Dustin Grinnell - 2 (00:30:34 --> 00:30:37)
Totally. Because that's your inner voice. That's your—

John Grillo (00:30:37 --> 00:30:37)
yeah.

Dustin Grinnell - 2 (00:30:39 --> 00:30:40)
Do you have an example of that?

John Grillo (00:30:40 --> 00:31:53)
Like we even use that in kind of everyday language when we're trying to really emphasize that something is like so bad. It was like an unspeakable act that happened. Like it's so bad we can't even bring ourselves to talk about it. That's not a very concrete example. That's a little more general.

There's sort of like this literal truth to it. Some things that can happen to people are so bad they can't bring themselves to talk about it. And if you can't do that, then all of the feeling that's associated with those memories, with those experiences, remains in a sort of unprocessed state, meaning that the feelings remain intense and overwhelming. So whenever they do come up, if you do experience some kind of an intrusion of of one of those memories, it's going to be crazy. It also kind of links up to that comprehensibility piece.

Dustin Grinnell - 2 (00:31:53 --> 00:31:56)
Because coming to terms is the ultimate objective.

John Grillo (00:31:56 --> 00:31:57)
Yeah.

Dustin Grinnell - 2 (00:31:57 --> 00:32:08)
It's kind of know how to explain it, like a hypothesis for why it could have happened, how it happened, and then what it possibly, what impact it had on you.

John Grillo (00:32:09 --> 00:32:26)
Yeah, yeah. That's all of the sort of the framework of meaning around experiences that we human beings, we need to be able to explain things. We just, we need to. And when we can't, we, suffer for it, I think.

Dustin Grinnell - 2 (00:32:28 --> 00:32:46)
And to what degree does— I guess I'd use the word courage— kind of play into this? I mean, there's a very good reason in almost all cases we don't want to look at the darkness. Does it take a certain level of courage to kind of get into it?

John Grillo (00:32:47 --> 00:34:26)
But every now and again, as a therapist, you might encounter a patient who's like really sort of phobic about any kind of exploration. And while in some cases that is understandable, like I was saying before, remembering things involves a certain level of re-experiencing. So if the patient has some painful shit in their past, like, and then you're, you know, you're in session, be like, okay, tell me about your pain. It's like you have to understand like why they might experience some reluctance to do it. But sometimes with the most phobic patients, there are also some of those misconceptions operating.

Like, if I open something up, what's going to happen? They'll have some kind of catastrophic fantasy about what might happen to them if they get into something or they unearth and discover something about themselves that they, like, didn't know before. Sometimes that's linked to some notion of, like, repressed memory. I'm a little bit on the fence about how much I believe in these like deeply buried memories that the person can be totally, totally unconscious of. But sometimes as a sort of a reassurance when we're doing this sort of exploration in therapy, I use the metaphor of like the cluttered closet.

Dustin Grinnell - 2 (00:34:26 --> 00:34:27)
You threw it in there.

John Grillo (00:34:27 --> 00:34:28)
You threw it in there.

Dustin Grinnell - 2 (00:34:31 --> 00:34:33)
And what's the benefit of having a clean closet?

John Grillo (00:34:34 --> 00:34:38)
Well, again, you understand. You understand what's in there. You can find your shit.

Dustin Grinnell - 2 (00:34:38 --> 00:34:46)
Right. You know where the, you know, the old soccer jersey is and you don't have to walk around in everyday life thinking, Damn it, where's that jersey?

John Grillo (00:34:46 --> 00:34:53)
You know, or being terrified that you'll like, you know, find the jersey unexpectedly one day, right?

Dustin Grinnell - 2 (00:34:53 --> 00:35:12)
You know where everything is. You know where everything is. And then like your past and trauma and biographical details, the metaphor extends that it's good to know where everything is. It's good to have a clean closet in your background, in your psyche. So you're essentially cleaning in your psyche.

John Grillo (00:35:13 --> 00:35:18)
Yeah, yeah, I do sort of see my role as being somewhat janitorial. Really?

Dustin Grinnell - 2 (00:35:19 --> 00:35:31)
Yeah, yeah. But how so? You know, you're, you're kind of pulling things out and presenting it. You're kind of organizing, you may be cleaning dirty areas. Like, what, what is, how do you take that metaphor on the way?

John Grillo (00:35:33 --> 00:35:58)
Yeah, yeah. Like, it's my approach. And I think anyone else who practices a psychoanalytic psychotherapy is like this, cognitive therapy is like this. These are problem-focused therapies. I need a problem in order to be able to understand what we're working on, to be able to organize my thinking in working with a patient. So I think the focus on problems is kind of what gives me that janitor sort of feel.

Dustin Grinnell - 2 (00:35:59 --> 00:37:03)
You'll have to update your LinkedIn page. Therapist, change catalyst, janitor of the psyche. I find that the usefulness of metaphors here to help understand the concepts that we're talking about is helpful. And I remember another one you said once. I think I, you know, I had this conception of therapy as being very self-improvement oriented.

I have this kind of self-help bent to me for whatever reason. So I latched on this idea that like, I want to be a better person for this. And so I thought about the idea of self-actualization and we're climbing the mountain of self-actualization. And, you know, if we're fully analyzed, I'll reach the top of the mountain. I remember what you said in response to that was like, I would rather not climb the mountain.

I'd rather play in the mud. Something to that. Yeah. And I remember it being kind of hit me and I thought, oh yeah, no, we're just going to be talking about that. Actually, explain what you mean by that.

John Grillo (00:37:04 --> 00:37:10)
So yeah, I don't remember the specifics of the conversation. So I won't like, you know, I won't—

Dustin Grinnell - 2 (00:37:10 --> 00:37:12)
I burst into tears after you said that.

John Grillo (00:37:14 --> 00:37:38)
It was a terrible talk about a mess. But I do remember you making some sort of flippant remark like that. But I think I think I had the sense in that moment, I think we were talking about something that you found like kind of boring, like relationships or something like that. And you were like, relationships are boring. I don't want to talk about that. I want to climb the mountain.

Dustin Grinnell - 2 (00:37:39 --> 00:37:41)
Yes, exactly. Exactly. Yeah.

John Grillo (00:37:42 --> 00:38:01)
And, you know, I said it in sort of a joking way, but like what my thought was is like oftentimes the types of things that you might be the least interested in talking about, or rather the most interested in not talking about, may actually be the most important things for us to talk about.

Dustin Grinnell - 1 (00:38:01 --> 00:38:02)
Right.

Dustin Grinnell - 2 (00:38:02 --> 00:38:19)
And I knew I had my own aversion to doing that. I almost felt like it was perhaps a universal experience to like enter into the therapeutic session and be like, I know exactly what we're going to— what we should talk about. And I have every intention of not going anywhere near it.

John Grillo (00:38:20 --> 00:38:21)
Right, right.

Dustin Grinnell - 2 (00:38:21 --> 00:38:31)
And I would circle around it and I would use humor and I would misdirect. And you saw through that bullshit. You pulled it, you know, you knew it was there.

John Grillo (00:38:31 --> 00:38:47)
And there's a kind of an interesting, like, emotional processing thing that I think can happen sometimes. Whenever someone is complaining of boredom, that always causes my bullshit detector to start ticking because I don't think boredom is actually real. I don't think it's a real feeling.

Dustin Grinnell - 2 (00:38:47 --> 00:38:49)
Boredom, you mean boredom, how so?

John Grillo (00:38:49 --> 00:39:01)
The feeling that people commonly describe as boredom is I think they're always talking about something else, like in the absence of stimulation or distraction or something like that.

Dustin Grinnell - 2 (00:39:02 --> 00:39:06)
If I'm bored in a relationship or bored at work or bored in the session or what do you?

John Grillo (00:39:07 --> 00:39:48)
Yeah, there's always something else going on. Like the issue is not that like the session is like uninteresting or like I don't wanna talk about my relationships 'cause relationships are boring. This is my own, like, personal pet theory, but I believe that much more kind of serious, more intense feeling is becoming converted into a sense of boredom. So someone who's complaining of boredom is probably in reality complaining about, like, anxiety or frustration or something painful that they don't really want to think about. They don't really want to talk about, but they also are kind of out of touch with the feelings associated with whatever the thing is that's threatening to intrude into their consciousness.

Dustin Grinnell - 2 (00:39:48 --> 00:39:53)
Right. So you hear boredom and that's a— what is the expression of the coal mine?

John Grillo (00:39:54 --> 00:39:55)
The— oh, the canary in the coal mine.

Dustin Grinnell - 2 (00:39:55 --> 00:39:59)
Sort of canary in a coal mine or smoke. Where there's smoke, there's fire.

John Grillo (00:39:59 --> 00:40:02)
Yep. Canary's dead. What are we doing?

Dustin Grinnell - 2 (00:40:04 --> 00:40:26)
Right. We're about to have a cave-in. So I always had this sense in therapy that you knew things that I did not know, which is that you're seeing the subtext of whatever I'm saying. So if I say I'm bored here at work or whatever, like, I don't know, it's just like I'm not into it. You hear that in a different way than someone else may hear it because you're trained to hear that.

John Grillo (00:40:26 --> 00:41:33)
So yeah, yeah, it's not so much that I know things that you, that you don't know, because this is one of those misconceptions that maybe kind of freaks people out about therapy, that therapists have this like sort of quasi like clairvoyance. We don't. We're not lie detectors. Like a patient can, you know, lie all the way through therapy and I may never discover like the lies or whatever. But yes, we, we are trained about how to listen to certain things. And maybe this will help to clarify kind of like the boredom thing. Like if you're talking about being bored at work or bored in a relationship, talking about the boredom, it's been my experience that that actually doesn't lead anywhere. It's a lot more productive to talk about the other feelings that the boredom might be masking. Like, are you feeling very frustrated? Are you feeling unfulfilled? Are you feeling in some way like scared or anxious in your situation? If we talk about those more serious, more intense feelings, then we can kind of talk about more solutions because we'll have a clearer understanding of what's really going on for you in a situation.

Dustin Grinnell - 2 (00:41:33 --> 00:42:22)
And so, like, if you were to be talking with a friend and you'd be— you express the same sentiment, you know, I'm bored at work, you could spend the next hour talking about that boredom and it wouldn't be therapeutically impactful versus, you know, doing that in the session. You can instantly go to the place where it needs to go. And in doing so, you can almost like dissolve the byproduct, which is boredom. Later on. And does that happen? It's like, if you, in your mind, you're like, oh, it's not about boredom, it's potentially, since I know about this work situation, about disempowerment or whatever. And so then you just burrow right into that, and the patient doesn't even sort of understand, doesn't need to understand what you did there. But now we're in it. Now you've started the conversation on that. That happens to be useful.

John Grillo (00:42:22 --> 00:42:30)
Yeah, we've accessed something that's a lot more emotionally alive and it will tell us a lot more about your real situation.

Dustin Grinnell - 2 (00:42:31 --> 00:42:33)
Why can't we do that on our own?

John Grillo (00:42:34 --> 00:42:40)
So this goes to the self-analysis question that you had talked about, which is a really interesting question.

Dustin Grinnell - 2 (00:42:41 --> 00:42:41)
Yeah.

John Grillo (00:42:42 --> 00:44:04)
Because I think self-analysis actually is super important. So maybe I'll talk about the situation where, like, where a person is in therapy and there's a need to do, like, a certain level of self-analysis. That's kind of the ideal situation where in the therapy session, patient and therapist are working together to generate insight, understanding around some kind of life problem. It is important that the therapy kind of generalizes outside of the treatment room, because I've absolutely experienced this with patients where, you know, we seem to be doing like this phenomenal work and having all breakthroughs and all that happy stuff in therapy, but then like absolutely nothing is changing in that patient's life, even perhaps after, after like years of work. And in a situation like that, one of the things that may be happening, something that perhaps explains why what we're seeing with that is that the therapy has become sort of compartmentalized in the patient's life, has been sort of cabined off So the patient has the ability to do this deep reflection on their experience and use their strengths, and they're able to develop these phenomenal insights. But because of the fact that therapy is compartmentalized, it's not actually doing anything for them outside of the therapy.

Dustin Grinnell - 2 (00:44:04 --> 00:44:08)
It's like they've come to all these very important realizations, but they're not being applied.

John Grillo (00:44:09 --> 00:44:36)
Right. So I think self-analysis in this situation where a patient is in therapy the psychological work needs to continue outside of session. Some therapies deal with this by literally assigning homework, like worksheets and stuff. I personally hate homework, so I don't want to inflict that on my patients, but I will sometimes give them assignments about like, please think about this, or like, you know, jot down some notes, uh, any further thoughts you have.

Dustin Grinnell - 2 (00:44:36 --> 00:45:05)
And I would do that. I would, uh, you know, have an Evernote as a software program I have on my phone, and I have a therapy folder and then notes. And I— and you would say, you know, think about, uh, if any feelings come up after this session, think about it. And I would write some things down throughout the week. I would have an insight while I'm walking or working or whatever, and I would bring that back in. And it was more grist for the mill. Yeah, yeah. So that, I guess, is the, the process carrying over outside of the session.

John Grillo (00:45:05 --> 00:46:34)
Yeah, yeah. And I believe that that's very necessary part of the work of psychotherapy. So the other type of situation where someone doesn't want to go into therapy at all, doesn't want to work with a therapist, and only wants to work alone, whether it's through journaling or the assistance of like self-help materials of, of some kind. So with that, that's fine. I won't say that that's bad, but there are limitations that are associated with that. I tend to think that without working with another person ever, you're only going to be able to get so far because at some point you are going to run into your own defenses. And some of those defenses, in the sort of classical psychoanalytic view, some of those defenses operate unconsciously. You have a certain interest, a certain motivation, whether that's sort of like a narcissistic kind of ego protective interest in not knowing something about yourself. And if that's the case, then like, it doesn't matter how much journaling you do, like, you'll never really be able to get around it. So in cases like that, you need the help of, of another person and a relational situation, because essentially a therapist, having that sort of outside perspective, someone who's outside of your own mind, therapist might be able to see something about you that you are not and will present it to you or make a confrontation of some kind.

Dustin Grinnell - 2 (00:46:35 --> 00:46:54)
Right. And, you know, I've— I think I've seen this before where someone is engaging in the consumption of lots of self-help material, you know, in the form of books and videos and things like that, but nothing's changing in their life. You know, it's like there aren't these concrete changes.

John Grillo (00:46:54 --> 00:46:55)
Happening.

Dustin Grinnell - 2 (00:46:55 --> 00:47:16)
Yeah. And it strikes me that that's kind of the situation we're talking about, is that there's these unconscious forces that are preventing real analysis. And it's almost like the self-help material is this emotional fuel, just makes you feel good, and, and it sort of paves over what really would lead to meaningful change.

John Grillo (00:47:16 --> 00:47:22)
Yeah, yeah, absolutely. It's a little bit— I guess it's a little bit of a —like pseudo-therapy.

Dustin Grinnell - 2 (00:47:23 --> 00:47:24)
It's almost like self-soothing.

John Grillo (00:47:24 --> 00:47:59)
It is self-soothing. And again, there's—in the world of self-help literature, some of it's okay, some of it's pretty good, some of it's kind of bad. But in general, what concerns me about self-help and what makes me think that it's actually not a replacement or a real alternative to like actual psychotherapy for mental health concerns is that it almost doesn't matter kind of what sort of self-help you're looking at. Always going to be too simplistic to deal with real human problems. Like, life is hard. Life is complicated. It's ambiguous. In reality, there aren't easy answers for anything.

Dustin Grinnell - 2 (00:47:59 --> 00:48:05)
And that's why I almost felt, having worked with you, I really can't read self-help anymore. I don't know why.

John Grillo (00:48:05 --> 00:48:08)
I don't have any problem with it. I ruined it for you.

Dustin Grinnell - 2 (00:48:08 --> 00:49:05)
I won't speak ill of of it. But I can't watch Deepak Chopra without kind of rolling my eyes a little bit. I just— it doesn't ring true anymore. It doesn't. I feel like the problems are more complex than are being portrayed.

I feel like in a lot of cases, the guru, if you will, is speaking of their own experience and what worked for them but isn't universal, maybe. Yeah. And I actually feel more often now I have gravitated toward the humanities and the arts and literature. I think literature is really where the kind of human problems are being worked out. We're seeing the human condition and we're seeing a story that represents the complexities of the situations that encounter someone living a human life.

John Grillo (00:49:05 --> 00:49:08)
You're talking about fiction? It's probably fiction.

Dustin Grinnell - 2 (00:49:08 --> 00:49:18)
Yeah. I feel like maybe even in cinema where, you know, just a good movie is to me a little bit more helpful.

John Grillo (00:49:18 --> 00:49:26)
Yeah, nobody likes flat, simple characters. Everybody likes complicated, right? You know, kind of convoluted stuff.

Dustin Grinnell - 2 (00:49:26 --> 00:49:30)
Even Walter White in Breaking Bad, you know, very complex. Is he good?

John Grillo (00:49:30 --> 00:49:31)
Is he bad? We don't know.

Dustin Grinnell - 2 (00:49:31 --> 00:49:41)
He's pretty bad. And he was always doing it for himself, by the way. It wasn't for his family. But yeah, continue. Sorry. No, no, no.

John Grillo (00:49:41 --> 00:50:12)
So while self-help might be able to help some people with some things, if you have kind of like a circumscribed kind of problem, maybe you'll find something useful there. And in which case, you know, take what's useful from it. But a lot of people who come to see me, their problems are a lot more complicated because their lives are complicated and they're going to need something that's more tailored and that kind of honors the complexity of what they've been through, what they're dealing with. Right.

Dustin Grinnell - 2 (00:50:12 --> 00:50:35)
I remember once you said something that I— that stuck with me about what we're doing here in therapy. And you use the word clarity, you know. I remember it was something like the whole point of doing this is so that we can live like in the moment. Yeah. And not live from the past or Mm-hmm. What did you mean by that, to live in the moment? Like, that's kind of like the objective.

John Grillo (00:50:36 --> 00:51:08)
Yeah, the way that I kind of understand that is to be able to, like, as you go through your life, to be able to see things for what they really are and to be able to deal with them as they actually are, not conditioned or distorted in some way by some of these unconscious forces. Now, that's— it's never perfect. Like, we're always seeing things and dealing with things like through lenses of various kinds. But I think sometimes, like, past experiences can severely distort perception and decision-making in the way that we respond to things.

Dustin Grinnell - 2 (00:51:08 --> 00:52:01)
Yeah. And to make it personal, I guess, is— or to give a concrete example, I think once we talked about— in all of our sessions, it was always like dealing with the absurdities of working for corporate America and like dealing with the hierarchical nonsense and and how it kind of deforms people, I don't know, and causes all sorts of emotional disturbances. And in my case, it was anger. It was frustration. I was frustrated with an imaginative boss or authoritarian. You were so frustrated. Yeah, I got pretty fired up. Yeah. But I always remembered we would kind of maybe go back to childhood experiences and, you know, what was my household like in one parent versus the other parent. And there were some styles of parenting that were perhaps a little authoritarian in themselves, you know. They were very controlled.

John Grillo (00:52:01 --> 00:52:04)
Maybe, maybe we just don't know.

Dustin Grinnell - 2 (00:52:06 --> 00:52:26)
And so what was I triggered in these sessions? And, and that goes to this idea of clarity, which is like seeing it for what it is, you know. I felt a little bit more in control of myself when I understood the source of the anger. And I wasn't sort of unconsciously just reacting. Right.

John Grillo (00:52:26 --> 00:52:55)
And, you know, in your case, something else that I do want to be clear about is like what you're describing is an interpretation, right? That kind of linkage between the past and present experience is an interpretation. What that does not mean is that your present experience is that doesn't mean that it's just— it's purely your stuff and there's nothing— there's no objective basis for you reacting that way. Essentially, it's all in your head.

Dustin Grinnell - 2 (00:52:55 --> 00:52:59)
That's not what that means. In some ways, it was objectively annoying.

John Grillo (00:52:59 --> 00:53:22)
It was objectively annoying, yes. You objectively had a terrible boss. But what I think what past experience did for you is it created sort of a hypersensitivity. To this particular theme. So when these things would really happen in your life, you always were hyper-aware of them. Yeah.

Dustin Grinnell - 2 (00:53:22 --> 00:54:28)
Dictators don't respond well to— I think that kind of hierarchical environment tended to just be naturally triggering in my perspective. I think you said once it was like for some people people, it's that kind of hierarchy can create a feeling of safety. But for me, it created a feeling of like, I don't know, just like outrage. Yeah, being told what to do and how to do it and, you know, that type of like— yeah, yeah. So we have like a few minutes left, and I guess one of my questions is broadening the conversation beyond maybe my experience, or I just wanted to kind of enlarge the conversation to our era, you know, our time period. There are time periods that came with certain psychological problems. Yeah. By virtue of sociological or political forces, etc. Have you noticed themes in your work? Have you noticed common issues, psychological disturbances of our time?

John Grillo (00:54:29 --> 00:55:23)
Is there something popping out? Where do you even start with that? This is a hard question to answer because like, I feel like on this point, I'm a little bit clouded. Like, am I actually talking about like what I'm really seeing in my work or am I highly sensitive to certain things in my work because of the fact that I'm actually completely freaking out all of the time about the state of the world? But I think there are some unique things about our era that are impacting people in a general sense. There is the sort of the permacrisis or the polycrisis or however you want to describe it. Like we're now in a period where we can talk about the end of the world due to climate change, in case you're not clear about that. We talk about the end of the world in totally non-hyperbolic terms. That's sort of like the civilizational thing that we're facing. Right.

Dustin Grinnell - 2 (00:55:23 --> 00:55:28)
It's not in the abstract. There's sort of a concrete mechanism for which our species becomes extinct and potentially— Yep.

John Grillo (00:55:28 --> 00:55:36)
At some point, Earth itself will lose the ability to support life, at least complex civilization like as we are used to it.

Dustin Grinnell - 2 (00:55:36 --> 00:55:41)
We have minds and hearts and we find this to be an existential threat.

John Grillo (00:55:41 --> 00:55:43)
Some of us find it distressing.

Dustin Grinnell - 2 (00:55:45 --> 00:56:09)
I think some of us, we don't. Agree on the facts. And so in a sense, it could be quite helpful, um, to have the wool pulled over your eyes, you know. You— if you don't accept a certain amount of facts, you— yes. But for those who, I guess, understand the crisis, the magnitude of the crisis, this is an existential problem. This is a big psychological issue that you have to manage. Yeah.

John Grillo (00:56:10 --> 00:56:43)
And I think there are real generational differences with this. I think young people are wrestling with this in a way that like our parents just don't have to. And I still think they sometimes don't get it. I'm very frustrated by conversations sometimes with that generation. But yeah, the world I think is changing at what feels like an accelerating pace. I mean, I think people might push back on that sentiment and say like the world has always been crazy. Like it's just sort of crazy in new 21st century ways. But like, I don't know, I feel like things are different.

Dustin Grinnell - 2 (00:56:44 --> 00:57:03)
And this presents a problem because we need to have a sense of meaning in our lives. And that dread that we have to deal with if we accept that body of facts is— what does it do to us? I mean, we're anxious. Yeah, it's an age of anxiety in a way. Yeah, it really is.

John Grillo (00:57:03 --> 00:57:39)
I mean, it has a lot to do with conception of the future. We need to be able to imagine the future in some way. And if we're talking about these like global cataclysms that keep happening. I mean, like remember we just had a plague that killed probably a million Americans. Like no one's really talking about it. So like this is— that's an example of like the ground shifting under our feet. And, you know, like what do you do if you're a person who's made very anxious by these things and trying to live in a world where there's a lot of denial of these kinds of things? What do you do?

Dustin Grinnell - 2 (00:57:39 --> 00:58:15)
I mean, for me, it's invent your own meaning. You know, it's trying to kind of accept this troubling reality, but go forward nonetheless. What are you going to do? You got 80 or so years and you do the best you can. Do what you can. Yeah. Amidst the very large problems that are beyond yourself. That are— that's one thing I always liked about your, your process, which is that it wasn't just about your own personal experiences. It was what are the sociological and economic and political forces acting on you?

John Grillo (00:58:15 --> 00:58:19)
The world is always crashing into the treatment room. Right.

Dustin Grinnell - 2 (00:58:20 --> 00:58:24)
And to deny that would be denying the context in which the problems are happening.

John Grillo (00:58:24 --> 00:58:30)
Yeah. And I don't, I don't think you're doing any of your patients any favors by trying to do that. Right, right.

Dustin Grinnell - 2 (00:58:31 --> 00:58:40)
Well, it's been a very fascinating and fun conversation. And thank you, John Grillo, so much for coming on the podcast to talk. Thank you, Dustin.

John Grillo (00:58:40 --> 00:58:41)
Thank you for having me.

Dustin Grinnell - 1 (00:58:42 --> 00:58:50)
Thanks for listening to this episode of Curiously. I hope you enjoyed this conversation with John Grillo. Stay tuned for more conversations with people I meet along the way.