Join Mike, Morgan, and Melissa for part two, as they round out their conversation on women's mental health. Emphasizing the need for specialized treatment approaches that consider gender differences, this episode centers on treatment and the unique dynamics encountered in therapeutic settings. Gender affects the motivations for seeking therapy, the dynamics between patient and therapist, as well as the differing approaches adopted by practitioners, as it becomes vitally important to recognize the influences of gender on mental health and treatment.

Mentioned This Episode:

EMDR: Eye Movement Desensitization and Reprocessing

DBT: Dialectic Behavior Therapy

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Welcome to A PsychoDelicious Conversation on mental health issues and trends from two local mental health professionals in the greater Lansing area. I'm Michael Stratton, lmsw.

And I'm Morgan Bowen, dnp, pmhnp. And we're here to provide you with a deep dive into the human experience of consciousness and beyond. Our aim is to be educational and entertaining.

So just kick back and open your ears and your minds.

Hey, I'm Michael Stratton.

And I'm Morgan Bowen.

And we have with us

Melissa Black.

And we've been talking about women's mental health. This is part two of a two part series in A PsychoDelicious Conversation.

Which is not enough. We need more time.

We need more time. Yeah. So you're directed to listen to the first part before you listen to this part.

This part generally, we try to talk about treatment and treatment considerations, all that kind of stuff. So one thing that was interesting to me and I'm gonna go first with this if you guys please share. I thought about it.

In my lifetime I've had two male therapists and two female therapists. And I was thinking about, you know, the differences in them.

And I felt in some ways as a guy, I felt better understood by the male therapists and more challenged by the female therapists. I think I also got more out of seeing female therapists because I. The underlying theme was like, do better.

Yeah, I mean, there was a lot of empathy too.

But the first time I ever sought therapy, I was 16 or 17. My mom was seeing someone at Delta Waverly and so I got matched with a dude therapist there. And I think I saw him three to five times.

I can't remember. Teenage hood is hazy, but what stuck out is. He asked me what my fantasies were.

And when I heard the word fantasy come out of this like mid-40s to early 50s guy's mouth and I'm this teenager. It was very weird. But I also was like, I don't know if this is just how I am or if medicine, sexual fantasies or. No, just.

He just said fantasies, like life or I don't know what, like you even.

Wanted to be when you grow up, that kind of a thing.

We could have been.

He could have used it. It was just the word.

It was the word.

He could have said, what are your dreams? What are your go. Right.

It was poor word choice. WC word choice.

It might have been very deliberate though. I mean, it could have been creepy.

It could have been. I didn't keep going and then avoided it for a really long time. But when I Was, let's say, oh, goodness, 32, 33.

I got hooked up with a male psychologist who was really able to do focused skills based, like, anxiety work with me, and he did not react.

If I had an emotional, you know, upset, or I had had a crisis that week at that point in time, it was really helpful because he could say, yep, and that's going to be okay, and we're going to focus on these skills. However, looking back, I could also see how that might have been problematic for someone who was not able to, you know, regulate to that level.

But I. I've also had the same amount of female therapists, and I. I do feel like I've had more progress with the female therapists that I've worked with and, like, stuff from the past.

I've had most. I think I've had all female therapists. No.

When I was in high school, I saw a male therapist, but my dad was a psychiatrist, so I think I associated, you know, when he picked people.

Out for you to see.

He did, actually, when I was younger. So. What was his name? Terry Stein, I think, was his name. Does that ring a bell?

It's a familiar name.

Yeah. So this is probably in 92 or 3, maybe.

That was the first person I ever saw, but that was more of a function of a choice of my parents versus, like, my, you know, it wasn't going to work. I was going to be a. And I think I sat silently through the whole thing, and he asked me questions, and I was determined to not.

Answer that as I'm sitting here.

I think that it may have been deliberate that they paired me with a male therapist because I had a very, like, complicated father situation in my life. So it may not have been random, but still very fuzzy.

And then when I sought out therapists, and I'm trying to think of the first time, but, you know, I've had three, four, and they've always.

I've always asked for a female therapist, but, you know, I've been thinking of going back to therapy recently because everybody around me has messed up and I need to learn how to deal with them, which is a good reason. It's a. Yeah.

I don't have much to dive into.

But I'm thinking I should change it up and go, yeah.

As I mentioned in the last episode, I've only saw therapy one time. That was mainly to get myself to the other side of depression. And I did intentionally seek out a female.

And the reason I did that is just I feel more comfortable talking with females on a general basis, but you're also talking to somebody who was primarily raised by his mother and grandmother. So females have just always been a part of, I guess, people that I can talk to, safe people.

However, I will say that if I was to return this next time around and I've considered just doing it just to, you know, see a therapist for a while and talk through different things. I actually was considering going to a mail this time, mainly because I just wanted to see the contrast.

And it's kind of interesting that you had the insight that you did about males versus females.

Yeah.

As a therapist.

Yeah, yeah, yeah. The first therapist I saw was a male and I wanted to see a male at that point.

And a lot of what he was pushing me towards was to make a stronger connection with my own father and making suggestions, you know, why don't you have lunch with your dad? Or what do you and your dad do together? Have you thought about this or that, that kind of thing?

And what I learned from that was that my dad was pretty distant and just didn't have much capacity for much of a connection, really, because I made a lot of efforts, but that was what it was. And then the second therapist I saw was shortly after I got sober and it was marital therapy. My wife would just, every time just say.

She just pointed me. This is what he did this week. And it was just non stop of just like, oh, go. So I was always. Anyway.

Now did you say, was that therapist male? Female.

That was a female. Okay. Yeah, she was pretty tough, but overall helpful. And I had some EMDR with a female therapist who was really helpful. Outstanding.

And then a couple of other therapists. Now I think about it, I had five therapists. A couple of other transitional periods of my life post divorce, you know, where. What am I doing?

What's going on? What's happening? That was. There was a guy who was just really empathetic like that and just kind of reflecting a lot.

And he had a great way of putting things. He. One thing that he did too is that he would always take both sides of things. I really learned a lot of that.

You know, on the one hand you're thinking this, but on the other hand you're thinking that. Never telling me what the answer was, but just reflecting it back to me.

Yeah, I'd say my therapist was really good at that, which is also why I wanted to seek out a female therapist. Just, I felt like they'd be a better listener, you know. Is that true?

I don't know, but I think there's some data that backs that up. We talked about the differences in the last episode about women and men.

Men are very visual, so they'll notice it more in, like, visual cues and images. And women are. And this I could be totally, like, over. I'm.

I'm very much generalizing, but there is something between men's visual cortex and then women's auditory processing that, like, they're very different from each other.

I think it's also what you're open to, just what you're used to having. Because, you know, I mean, the idea of going to therapy is talking about things that are uncomfortable and hidden.

And I want to say that, you know, the concept of. And, you know, truth be told, I did women's studies and gender studies quite a bit when I was. When I was a young lad in my first degree.

But misogyny cuts both ways, you know, so that this concept of a woman, it's not necessarily misogyny. Stereotypes of gender cut both ways. So the idea that a woman.

Woman is more introspective and murky and deep and, you know, emotionally, I don't know, keyed in versus a man is definitely, I would say definitely for sure a stereotype. Perhaps it's true. I mean, how would we know that for sure?

I interpreted as yelling.

She very strongly told me at our last session that if I wasn't going to divorce my husband, there was nothing that was ever going to get better in my life. And then she discharged me.

Wow.

Pretty definitive.

I'm going to tell you what. So I don't.

I wish I could quote what this study was, but somebody had actually done brain scan studies of couples in counseling together when they were having arguments. It might have been Gottman. I'm not sure.

But one of the things that they showed is that women had more access to their frontal lobes than men did, that men were like screaming monkeys and. And that they would do that freeze flight or flight thing and women would be able to key in more on. No, no, this is the issue.

We're talking about this issue. And mental identify it in a much more primal, primitive kind of way.

Yes.

And so when I was doing couples work, it would be a lot of that kind of like really slowing the process down to say, can you hear what she's saying, can you repeat what she's saying? And almost always it would be a very distorted perspective of she's saying this about me. She's saying she's destroying this.

I don't think she used those words. Listen again, just see if you can repeat the actual words she's saying. You know, I know this is hard, da da da. You know, that kind of thing.

In terms of treatment approach, like when you're working with a woman versus a man, do you take into account gender or you know, a conception of gender identity when sort of constructing a treatment approach or not so much.

Well, first of all they come for different reasons.

I've had women specifically come because they said I had a very conflicted relationship with my father and because I am the age I am which is, which is older. I'm the on the older side. We've made that point. You make it yourself. I know now I used to make it, now I make it, but I did.

Yeah, it's not, I'm not self deprecating.

I don't think, because I think that there's, I think that there is a, the projection is different, you know that I think people that had a bad relationship with their father or fathers that were distant or whatever, if they're exposed to an older male who basically gets them that understands that can repeat back. You know, this is what I'm hearing you saying makes sense that you're feeling that way. Have you thought about it this way? That's like gold to them.

They're just like oh my gosh.

Well personally that was my experience when I did see that male therapist as an adult. I mean it clicked some things with the dad stuff that even though we were doing focused anxiety work, something did shift in my brain that has held.

Do you think there's a reparenting? I mean this concept of reparenting through therapy. A lot of potential issues come from primary relationships.

Either seeing the interaction between caregivers parents or your interaction with. And that if that's at the base of issues then there's a re parenting role for a therapist to do.

I was just talking with someone last week about Harry Potter, the first book of Harry Potter. And in the scene with Hagrid when Hagrid goes to get Harry and bring him to the school and Harry's like what's this all about?

And Hagrid looks at him, he says, harry, don't you know who you are? You're a wizard. That's what good therapy is. This is. Don't you see who you are.

I love that.

Don't you get it? Don't you get this is.

And that's why I love when people come to me and I say, before we talk about your problems, I want to find out, what do you love? You know, what do you love doing? What are you really good at? When does time disappear for you?

Because they'll basically say, here's the solution to my problem now. Now I'm going to tell you my problem. And the trick is to get him into that solution, into that space. Don't you see who you are?

I think that's the magic juice.

I love that. I was talking about a therapy interaction I had with a woman therapist. I was living in Chicago and we were talking about my childhood.

Not in a way to kind of mine for things, but she noticed that the way that I talked about my family was very much not one sided, but my conflict was typically with my dad, you know, growing up, and that my mom was kind of this savior, protector. And so it was just this whole dynamic throughout. And I always saw that as in very black and white thinking, I think.

And then she pointed out to me through a series of sessions that that in and of itself is a dysfunctional dynamic that was.

Would they fight through you?

Yes. Yeah. Yeah. Well, not necessarily, but somehow. Yeah, and somehow I would kind of insert myself.

Not insert myself, but I saw myself as like a mediator, as somebody who needed to.

And I think it did come from a place of thinking that it was my fault that they were, you know, that there was such conflict or that there was fighting and there were issues. You know, I've talked about being gay and my father not being a huge fan of that when I was younger. And so that was a lot of the dynamics.

So I did think, you know, I know now from doing this therapy that I saw that as my fault. And so. But it really took her. I mean, she. Lori Griffo, Dr. Lori Griffo is a wonderful therapist, but she said all of that was wrong.

Like they should not. None of that should have happened. She said none of that should have happened.

That is not the way a parent, you know, parents should concede that was not your fault. This was a function of their relationship. They weren't working to help you.

They were working to try to change you to fit something that they had already constructed. And it was just a total frame switch. That really changed a lot for me. Just changed a lot for me.

Shifted the whole thing. Now, we don't always do group therapy in the second part, but Just to let you know, the other thing I did look up before this.

Who shows up for therapy? And women are more likely to show up for therapy 2 to 1 on the basis of 2 to 1. And what do you think about that?

I mean, I guess there's a couple ways to look at that.

There are so many ways to look at it. The first thing that popped into my mind is women. You know, we're raised to always, we have to fix ourselves, we have to fix how we look.

We have to fit this, we have to fit that. Now there's. There's that maybe subconscious or unconscious part of it, I think, for a lot of folks.

But I also think that, I mean, women have that motivation of, like, people want to get rid of. They want to deal with their trauma. Like, now that I think trauma has been more in just the atmosphere and.

We have swung to the other side.

Yes.

We are mining for trauma.

Yes. Which, you know, if you don't got.

Trauma, get you some.

Which, like that has, you know, that. That can be good and bad, but, like, the idea that you can heal is new. Oh, we can feel better. We can reduce our response to triggers.

That's what comes up a lot when I'm talking with folks. For sure.

What.

What popped into my head when you said that was that a lot of times I'll see women coming in order to fix themselves in some way, and men will often come in trouble.

Yeah.

Yes. Crisis.

I've got a problem here. There's. I'm in trouble. So it's absolutely.

I never would have saw a therapist if I hadn't gone through a period of depression. I mean, I just. I never thought about it before. And this is probably the first time in my life where I go, maybe.

I could stand to do this outside of just what. I'm depressed.

So.

Yeah, yeah, yeah. You know, but then I got you.

Guys and I don't have to do this.

My current therapist has worked with, like, internal family systems with me, and learning about the internal family systems has, like, really blown my mind as well.

This seems to be taking over the nation. Well, at least this community.

But what you.

Go ahead.

Yeah.

What you described, though, with the therapist that you saw, that is very much like, very consistent with, you know, some of the things that I've reprocessed using some of those structures. But just learning about, oh, this was to maintain the family system system or the vision of the family system.

So, Melissa, as a nurse practitioner, in terms of the way that you work, do you do a lot of Therapy as well as medication adjustment.

So I like, I do supportive therapy within the medication appointments. You know, I don't like, market myself as like a primary therapist in any way.

Like, I'm not performing internal family systems or doing any like, psychological specialized. But I do like psychoeducation, mindfulness, basic CBT skills. But I do a lot of listening and a lot of validation.

There are some folks that I'll see for longer. They're comfortable talking to me. A lot of times it's an older person, like, I don't want another copay. Please don't make me talk to someone else.

But I definitely, when I'm doing a medication appointment and if they're going through something or something doesn't feel well, it's extremely important to me to know what else is going on in their lives.

To know, is this a medication issue or are the meds fine and they really need to reach out to their therapist, you know, or do a partial program and get some more support that way. Because I don't assume, oh, well, this must be a med side effect. Okay, here's your new prescription.

I always like to say too, as I'm also a nurse practitioner and when somebody is in therapy, I mean, I, you know, it's always, almost always good to, you know, be in therapy if somebody is, especially initially when I'm seeing them, usually there's some problem or crisis of that medication will play a part in, but it's likely not going to be the entire answer. But I do like to know. So it's important for. To prevent role confusion. Right. So my primary.

The reason that we're seeing each other is primarily for medication management. And I just don't have the time within this appointment.

Nor do we see each other frequently enough to do the type of therapy that Michael Stratton does.

Yes.

But I do like to know what kind of approach the therapist has, because we can maybe like, if somebody's in a DBT type of therapy or cbt, we can maybe echo some of the themes of that. If somebody's having an issue that they talk about, you know, tell me, let's think about this in kind of a cognitive behavioral way or so we can.

I see myself as reinforcing or supporting. Absolutely.

Absolutely. Well, and sometimes with the listening, a lot of folks are looking to hear that this isn't weird. Other people have reported this.

Oh, maybe I know someone who would fit that really well to help them with that issue. I see, like more of like a resource person. Like, I'll listen. I'LL help assess. But like, let me get you to who you need to get to.

Now there must be types of therapy that are very gendered, like very female.

Forward. I was just thinking like DBT for instance. I would imagine that I don't know what the percentage is. I would guess 80% are female.

What I know is that the DBT residential programs only admit folks who were born female. So.

Okay, okay.

There aren't enough males to warrant getting.

You know, way more than 80% then. So DBT is dialectical behavioral therapy.

It's usually used with people who have the categorization of borderline personality disorder, which are people that are incredibly sensitized to the way the world lands on their nerve endings.

Very likely to be reactive, very likely to act in, like, not act out, act in against themselves, self harm, self harming behaviors or things of that sort. And a lot of the DBT stuff is about skill building and relying on skill building in a group session. And the way the therapist reacts is differently.

Much more like a. Like an AA sponsor of like I want you to be calling me. I want you to call me a couple of times a week at least.

And if you're not calling me, it's an issue. You know, this is something we got to talk about.

So I would never. Professionally, I just cannot do that.

Yeah, some people love that.

Like the middle school girls who are going through these different crises of adjustment. I really wish there was DBT mandatory group for all middle schoolers. Yes, well, emotional regulation. You can do it.

The game. I mean emotional regulation is at the base of mental health development. I think our country should like, you know, I'm being superlative.

But teaching emotional regulation, modeling emotional regulation, guiding folks through emotional regulation is, I mean just so incredibly important.

I knew somebody who is. They were impressed by a therapist. They said, this therapist is working with a 12 year old borderline. I said that's redundant.

Yes, yes.

Every 12 year old. The borderline. Anyway. A psycho delicious conversation is meant for educational and entertainment purposes only.

It is no substitute for therapy and should not be treated as such. If you feel a need for real therapy, you should consult your local provider, Google therapy or therapists in your area.

Check with community mental health or a suicide hotline if you are feeling suicidal.

Mike and Morgan welcome your questions, feedback or dilemmas. Feel free to send us an email at a psychodelicious conversationmail.com that is a psychodelicious P S Y C H O D E l I c ious conversationmail.com.

The views expressed on this podcast are solely the opinions of Mike Stratton and Morgan Bowen and do not reflect the views or opinions of any site broadcasting this podcast. Replication of this podcast without written permission is strictly prohibited.