How ACT can guide us inside and outside of therapy (with Denver Simonsz)

[00:00:05] Bronwyn: Hey, mental workers. You're listening to the Mental Work podcast, the podcast about working in mental health for early career mental health workers. As always, I'm your host, Bronwyn Milkins, and today we are talking about how Acceptance and Commitment Therapy can not only shape how we work with clients, but also how we navigate our own careers as therapists.

In this episode, we'll explore how ACT can be a compass for early career psychologists in both clinical work and in our personal lives. Here to help us out with this topic is our guest, Denver Simmons. Hi Denver.

[00:00:35] Denver: Hi, how are you?

[00:00:36] Bronwyn: I'm really good. How are you going?

[00:00:38] Denver: I'm good. I'm good.

[00:00:39] Bronwyn: It's such a pleasure to have you on the podcast. Maybe you could start us off by telling listeners who you are?

[00:00:44] Denver: Yeah, so I'm a psych of 18 years came into the industry back in the bad old days when you just did the four plus two, no, such thing as five plus one. Um, I've been a supervisor now, like board approved. For about 10 plus years, uh, I've been using ACT for about 16. Um, currently I mostly treat first responders at the clinic, and then the rest of the time I work from home and I supervise prov psychs and gen psychs, uh, a lot of early career psychs looking to kind of navigate not just clinical work, but also the industry and self-care and how to do good CPD, that sort of thing.

Outside of professional life, I live a very simple life. It's just me and my wife. Two dogs got a baby on the way, and, uh, I like gaming, walking in the bush, the gym in my free time.

[00:01:34] Bronwyn: Lovely. What breeds are your dogs?

[00:01:37] Denver: Uh, okay, so I've got a Jack Russell, um, Pug Cross and a Chihuahua dash hound cross. So they're two little yappers.

[00:01:46] Bronwyn: Wow, those are interesting breeds.

[00:01:48] Denver: Yeah. Yeah, they're um, they're very, um, small dog syndrome breeds.

[00:01:54] Bronwyn: Totally. Absolutely. And congratulations on the baby on the way as well. That's exciting.

[00:01:58] Denver: Thank you.

[00:01:59] Bronwyn: I guess one thing that stands out is this Acceptance and Commitment Therapy that seems to be a thread throughout your career. And for listeners who may be new to Acceptance and Commitment Therapy, and we're just gonna shorten that to ACT, can you give us a quick overview of what it is?

[00:02:14] Denver: Yeah, no problem. Uh, so ACT as a kind of therapy. It's all about psychological flexibility. So this ability to actually lean into your experiences, stay present with them, the difficult thoughts, the difficult emotions, instead of avoiding and suppressing and fighting them.

But the thing we do with ACT is we do that in service of what matters. So it's not just something you do because it helps with symptoms. It's something you do in service of a values driven life. That's the ACT way of thinking about what matters.

And there's this kind of core idea in act that a lot of our pain and our suffering isn't just the pain itself, it's the struggle with the pain. So the struggle with the anxiety causes, uh, additional problems to the anxiety itself. So ACT teaches you to accept and work with what's going on in your life rather than trying to run from it so much.

[00:03:08] Bronwyn: That's a really beautiful way of describing it. Could you just give us an overview of when ACT came into popularity?

[00:03:14] Denver: I, I've always wondered that because I noticed the, different therapies that seem to kind of have their like, um, day in the spotlight sort of thing. Like, you know, like you'll see EMDR get real popular. You'll see like IFS get really popular. I don't actually know... I suspect ACT was really popular maybe around the time that I was getting into it, 'cause that's how I found out about it. I think every person that's, um, done ACT training in Australia has probably done one of Dr. Russ Harris's trainings, yeah. He's probably single handedly responsible for a lot of the ACT, and that's what happened to me in 2009, I went to one of his workshops just, just outta curiosity. I, I didn't hear anything about ACT that made me want to go. I just was doing my CPD for that year. Um, and I saw it get pretty popular around then.

I don't think it's as popular now. I mean, that's just my opinion. I don't know if I just live in a bubble. So I, I suspect it was popular or more popular back, back then, 2009, 2010. Less so now. People definitely know what it is, but I often, when I'm supervising early career psychs, I'll say, you know, what are you looking for with CPD? They'll say, oh yeah, I see you do the act thing. Yeah. I wouldn't mind learning more about that. And I'm like, oh, so you haven't learned that yet? Okay, cool, let's, let's dive into it.

[00:04:31] Bronwyn: Yeah. That's super interesting. So you came across Acton about 2009. I came across ACT in about 2009. Then as well, I read the Happiness Trap and that was my first exposure to it. Yeah, and I loved it, I loved that book. I'm curious what drew you to act and wanting to adopt it.

[00:04:47] Denver: Um, yes, I, I read the Happiness Trap, but after the Russ Harris workshop, he was plugging it at the workshop, and it was, it's a great book. Like it was, I was like, whoa, okay. That's got some different ideas in there.

But, um, the thing that stuck with me with ACT was it was one of the first times I went to a therapy workshop where I was really interested in applying it to myself. Like I really wanted to go home and. You know, I read the Happiness Trap and I was like, oh my goodness, like, I want to do this mindfulness stuff on myself. I wanna try accepting emotions more. I want to see progress in my life as being more about living a values driven life than a life free of pain or a life free of, you know, difficult emotions that pretty much no one likes, like anxiety.

So that was the thing that kinda hooked me. Um, obviously, you know, it was evidence-based and it, it seemed to work really well with clients, but it was also a therapy where I actually wanted to learn more on a personal level and, and try things and, and I did so many courses and I just deep went deep into it.

Um, so yeah, I think that's what it is. If I'm really honest, I think it was like, okay, it's a great thing to add to therapy, but also the hidden benefit was, it was a great thing to add to my personal life.

[00:06:00] Bronwyn: And were there other approaches that you had tried beforehand? Like what really gripped you about ACT as opposed to being like, you know what, this doesn't resonate with me as much as CBT or something else?

[00:06:11] Denver: Yeah. I, I, I was, um, one of those like early career psychs that I wanted to learn everything, which I think is a very early career psych thing to do is like, okay, I need to learn the alphabet of therapies, DBT, CBT, narrative, solution focused, brief, blah, blah, blah, blah, blah. I did, I did all that stuff. Um, and I was really lucky when I did my internship, my supervisor was the head of like a counseling portfolio in New South Wales Health. So he would like say, oh, go and shadow this site at this clinic, or go to this site in the hospital and shadow this, and they all had slightly different approaches. So I got a good like, selection of stuff, but none of them were doing ACT.

The thing I, I noticed with ACT was I liked motivational interviewing. I liked that sort of ability to kind of roll with things and, and not be... not see the client as like resistant as much. Like they had this way of sort of, you know, being like, okay, people are gonna have barriers, kind of, yeah, let's get on with it. But what I liked about ACT was it was really explicit about doing things with a clear idea of what motivated the client. Like I love the values component. Um, I know other therapies, of course, we, a skilled therapist is asking about a client's motivations, but I like that ACT had a, like a very obvious right there values, figure out what's important to the client because I think when you do that, it gives you so much more leverage in therapy. It gives you direction in therapy that you wouldn't always have.

Sometimes I think what early career psychs, um, or just psychs in general think they need to do is to become the one driving everything, you know, the expert. Um, I'm gonna come in and tell you what's good for your depression, and I'm meant to do that because I'm the psychologist. And that, I mean, to some degree there, there's a bit of truth to that, but you can go a long way by simply understanding what motivates a client, period. Like why are they even here in the first place? Plenty of clients turn up saying like, ah, I didn't really want to come here, you know, but I'm such a grump around the kids. You go, oh, okay. So I'm getting a bit of an idea of what could move the needle for this client.

So that, that really, um, hooked me. The mindfulness stuff really hooked me 'cause mindfulness was only just starting to kind of boom again. I know it had a boom before that with John Kabat-Zinn and all these like, kind of pioneers. But the mindfulness stuff was really interesting to me. The idea that, um, I'd been into meditation and things before, but I, I don't know why, just the way they had explained it to me and ACT in that framework really landed for me of like, oh, I'm not, I'm really not trying to always get my mind to be clear and, um, free of things. Uh, there's a great, like Pema Chödrön quote, um, she's not an ACT person, she's a Buddhist nun, but she says like, you know, you are the sky and everything else is the weather, and, um, mindfulness helped me kind of experience that, like this idea that I could sit and watch and just be present with these experiences, you know, that I, that are going through me, and it gave me a, a wider view of myself and my experiences as well. So I think that really hooked me as well.

[00:09:23] Bronwyn: That was a big hook for me as well, actually. I loved the concept that I didn't have to struggle with my mind and I didn't have to have the goal of being thought free as well, like you just described. Whereas with previous things that I had read, the goal was be thought free and try and reason or argue or debate with your thoughts, and I loved that ACT, it just completely like, oh, I don't have to struggle with these thoughts. I can actually just like have a handshake with them instead of an arm wrestle kind of thing. It was awesome.

[00:09:53] Denver: Yeah, you can take 'em along for the ride. I always like that idea that I, I'm anxious and I can still go and connect with the people I care about. Um, I'm feeling sad and I can take the sadness with me and, um, go and do something where I could also experience happiness. This sort of nuanced picture of our internal world... you aren't just like one thing or another. You aren't just experiencing just one thing all the time. That, that was nice, um, for me to kind of look at and, and it was a great way to formulate with clients too, to sort of go, yeah, like a client that says they're depressed is not, that's not everything. It's not their entire identity. Yes, their experience feels like that that's all there is, but it's interesting when you dig in to see, yeah, there are moments of like sunshine and like there are things that are helpful to kind of look at.

But we don't even have to grasp onto them tightly either. We don't have to go, oh, no, let's just try and have all the positive thing. Let's only talk about the positive things. We can talk about the nuance in service of, um, getting a little peace and a little perspective and helping ourselves move closer and closer to what's important to us.

[00:11:04] Bronwyn: You mentioned before how early career psychs might be trying to get training in the alphabet soup of therapies, and you're stuck with ACT for, I guess, most of your career now, and I just wondered whether you've had time, so you've sat there and been like, maybe I need to get another letter.

[00:11:19] Denver: Yeah, all the time. And I still do other CPD by the way. Like I, um, uh, I try to, like, I, I kind of break my CPD up like this, like I, I go a bit of a formula. It's like we got 30 hours, you know, if you are happy with what you're doing, um, and you wanna maintain what you're doing, two thirds of that time, just do, just dive deeper into what you're doing, and a third, a bit of experimentation, something outside of your, you know, your typical lane.

If you're not happy with what you're doing, flip the formula. Just do a, you know, a third of your hours doing maintenance, you know, keeping up your CBD or whatever you're into. And then two thirds of exploration.

So I've been pretty happy with what I'm doing. So I typically do like two thirds, you know, just maintaining whatever skills I have, diving deeper into that. I treat PTSD, so I do anything around that. I do anything around ACT, I do anything around supervision that, that sort of meets that, and then I just try and do something a little different, um, on the outside.

So yeah, I do have that. I just, what I try to do and what I think things like Active helped me to do is, like stop notice. Like why? Like why am I doing that?

[00:12:28] Bronwyn: Yeah.

[00:12:29] Denver: it just industry nonsense or um, is it imposter syndrome or is it my values? Is it, or is it like in ACT they talk about workability all the time. So is this a workable way to meet my, my values or is it just box tick, like me going, okay, if I learn another therapy, then I can put on LinkedIn, then I have a new certification, everybody, and everyone goes, congratulations, and, and I don't really grow or I don't really get much out of that.

Um, but if I do it in service of one of my values, which is curiosity, I feel good about it. Like I go, oh, this is great. Like I learned something else. I'm not really gonna use that necessarily, but it, it's expanded my, my views on things. Um, and sometimes I'm wrong, sometimes it does change my mind. I did my supervisor training like that many years ago where I was a gambling counselor and we had to do a bunch of training in gambling counseling, like a diploma of some sort, I think it was. So I easily got my, you know, CPD training hours up that way, but I remember thinking like, I want to do something outside of this. And I saw this board approved supervisor training. I thought I'm already sort of mentoring one of these, um, psychs at the time, who was a counselor at the time, but about to get a provisional, um, reg. So I thought, oh, well, maybe I can support her. And I did it on, on, not on a whim, but just, oh, that looks interesting. And then I did the training and went, wow, I really like this, and I, I see why it's here and why it's good.

So sometimes you can, um. If you do things for the right reason, it pays off, but if you're just ticking boxes, it really does. I mean, you might make yourself feel good in a meeting when you say, I can do all these therapies, but can you like, can you remember the training you did four years ago just to tick a box? Probably not.

[00:14:11] Bronwyn: Totally. I really love how ACT shapes how you are in your career as well. I'm really hearing the 'inservice of' and that central principle coming through there. Now, one of the reasons why I asked you on the podcast was because you are a prolific LinkedIn poster. I hope you don't mind prolific LinkedIn poster, is that okay? Yeah, totally. And I really love how sensible, is that a good compliment? Sensible, your posts are like it's not, um, 'cause I think early career psychs as a bunch, I think we're highly conscientious, we wanna do things right. Um, we might also feel a bit pressured and pulling in different directions. And I think you offer really consistent, grounded, um, advice and, and hints and tips.

In one of your posts that stood out to me, you mentioned that you made the decision to leave a workplace and you viewed this as an act of self-care, and I'm wondering how applying ACT principles informed this decision. And maybe you could share a bit around this experience.

[00:15:12] Denver: Yeah. Um, absolutely. So I got a, a, an example of like in my career where I was doing things that weren't values based, like I was chasing the wrong things. And so basically I was working for this company and I'd been working on a promotion for about two years. Um, they were sort of saying, yeah, you know, it could happen, it might not. We'd have to change positions or create a position for you, blah, blah, blah.

And as I was approaching that promotion actually happening, I was ignoring a lot of things. I was ignoring that I was overworked. Um, I was ignoring all the to- toxic, like office stuff that was going on, office politics and all the nonsense. And I was ignoring that, that was affecting me in a way that made, staying there not workable. Uh, I had some things I had to own up to as far as like I was just working too hard, but also the environment and some of the decisions from management and things, you know, that, that was part of why that all happened.

So anyway, I I, I finally get the promotion, I get this juicy pay rise, and I just felt nothing like, I just felt absolutely nothing. There was no, like, 'whee' the first time the, like, payslip came in and I saw the extra, you know, dollars in there? I just went and I was just so obvious to me. I was like, oh, what have I done? Um, and, and it was obvious that, you know, that was not a values-based decision. I was chasing things and I was fused things that I just, I didn't really care about them, but I was using them to avoid, you know, connecting with what was actually happening inside of me, which was I was heading to towards burnout.

So I think, you know, if, if, you find yourself in those situations, one of the ways to kind of tell that that's happening is when you connect with your values, it doesn't make your life look easy. When I made the decision to leave, it was a decision based on, I looked at things and I went, I don't think this environment's gonna change, and I don't think as one person, I can fix that. I need a break from this, I need to go and reset. And that didn't make the feelings go away. That didn't make all the, you know, anxiety and stress and all that go away. In fact, in some ways it increased that temporarily because I was like, oh God, what am I gonna do next? Like, what? You know, and I've worked all this time for that and now it's gone.

And, but, but values gave me the direction, the focus in that moment, it gave me the kind of reason, if you're gonna suffer, at least suffer in service of something you care about, not in service of something you don't. And for a lot of us pay rises and, um, fancy new titles, they're workable in a very finite context. I want a pay rise. Who doesn't, right? I would love a fancy title, who doesn't? But what am I willing to do for that? You know, what is that in service of? Most of the time it's not in service of values for people. It's, it's just a practical consideration everyone has to have.

Um, so when you can do that, when you can connect with your values, when you can understand that, oh, I'm getting fused with some things I don't care about, you get a choice in that moment, you get to sort of, Russ Harris talks about the choice point. It's like that moment going, oh, I could go down this path where I'm hooked and I recognize that path and, and I could slip down it real easy, or I could take this other path that I've gotta work on and kind of like forge a bit, but as I'm going along that path, I'm connecting with my values. I'm, I'm closer and closer.

So, yeah, I, I think that's something I always encourage, you know, psychs when I'm supervising them to think about is like, you know, why are you doing what you're doing?

[00:18:50] Bronwyn: Mm. Values provide a really clear compass and a really clear direction. And like you say, it might not be easier, the path that you choose, the feelings might not go away. In fact, they may increase, um, but at least if you're going to suffer, like you say, you get to choose the direction of that and what you're doing.

[00:19:06] Denver: Yeah, exactly right. And it does transform, and I'm not trying to like, this might sound like a bit, what's the word? When, when you love suffering? I can't remember what that word is, but it, it's not that, it's, it's just saying that like in life there is suffering and sometimes we'll find ourselves suffering and then stop and be like, why, why am I doing this? Like, I don't even care about all this.

And you, and you know, if you're a psych, you've probably counseled people who have turned around and looked at their life and gone, oh my god, I'm like a CEO of a company, or I'm, I've climbed the ladder, or I've. I've done all this study, and I don't even like this, I don't even care about it. Like, I did it for the money, but I did that in my twenties and now I'm 40 and I'm like, what am I thinking? Like I want to connect with family more, I wanna have a better lifestyle... So yeah, having that compass and, and checking in with it is, is so key for a, you know, fulfilling life.

[00:19:56] Bronwyn: Totally. And I think a lot of early career psychs, they can go down an opposite path where they fuse with some thoughts along the lines of, maybe I'm not cut out for this role. Maybe it's me that's the problem here, rather than considering their work environment, um, whereas you offer a different perspective of that. I'm just curious what you think of these early career voices that might be, uh, that we might be gripping onto.

[00:20:20] Denver: Yeah, I mean, totally understandable though, right? Because think about what influences you up to that point. You go to school, then you go to uni, it's all kind of prescribed learning and you are kind of taught that... um, and, and, and this is true as well, that there is a legitimate pathway to becoming a psych, right? You do this study, you pass the subjects, then you become an intern or prov psych, then you pass that, you get your registration number, now you're a psychologist.

And that doesn't help you determine though, um, just as meaningful questions about like, am I ready? Am I good enough? Do I enjoy this? Uh, is this my calling? Is this something I care about? You cannot go and do a subject for that. You cannot get AHPRA to, um, tell you that, that that's different, yeah, different pathway, right? Um, so yeah, you can understand how people get fused with that, and they start to think it's a 'them' thing.

But in ACT, like we're very interested in context. Um, there's no... in ACT there's no, okay, this value is the value you should be doing. It's better than this other value. Uh, this action is just inherently better than that action. I mean, there are some exceptions to that rule, but we're always looking at it in context, right? Um, so for example, compassion, you would think there's no way to criticize compassion, and I guess there isn't, but there is a way to criticize how you go about connecting with compassion. Um, there's a term in like the meditative kind of, um, practices, idiot compassion where you just, you know the term, right? Like you, well, you know, we're all human beings and so I'm gonna let, uh, this incredibly awful person, um, being leadership, it's like no, um, no.

Uh, so, so what happens, I think fairly career psychs and it can happen to later career psychs too, is we do this thing of like, okay, I value compassion, that's one of the reasons why I'm doing the work. It's my values in action, without looking at the context, right? So if you had one psychologist that said, I value compassion, another one says the same thing, the first one works 40 hours, see, uh, sorry, 40 clients a week. I'm just making this up, but, um, that doesn't mean they have more compassion or they've connected more with compassion because of that, that that's a really unworkable way to do things, 'cause they're probably that flogged by the end of the week. If they try to do that for a year, they'll probably burn out.

[00:22:55] Bronwyn: Yeah.

[00:22:56] Denver: The second psych might say, I value compassion, but I wanna do this in a workable way. I'm gonna do 20 clients a week, plus my internship stuff and okay, that's a bit tough, I'm gonna talk to the boss about, can I have Friday, just do paperwork. This is workable, right?

Um, but when prov psychs get into the industry, uh, early career psychs, they often think, like, if they can't handle the 40 client week or if they can't even handle the, you know, the 25 client, the 20 client week, this is a real problem with themselves and they haven't looked at, the environment makes things workable or not. If your organization is underpaying you, undervalue you under supporting you. Um, but what do you think will happen, right? It, it doesn't matter if the work is compassionate in action, it will kind of constrict your life in a way that, um, makes it unworkable. So, so we gotta think about the environment as a way of thinking about, how do we do what matters in a way that's workable or sustainable, might be another word.

[00:24:02] Bronwyn: Yeah, it's a really, it is a compassionate way of looking at it to ourselves rather than trying to force ourselves into boxes, which cause us to burn out. It's really looking at that in a kind way and in service of the values, like is something that we can keep coming back to how do I do this in a way that supports that without, I guess increasing my own suffering unnecessarily. Um, and I think that's really nice way of looking at it.

[00:24:25] Denver: And I think like the other thing to consider is values aren't just like in isolation.

[00:24:30] Bronwyn: Yeah.

[00:24:30] Denver: I can value compassion, but I can also value fairness. And if I value fairness, then what on earth am I doing, um, being underpaid and seeing 40 clients a week and being expected to put together social media posts for the company and da, da, da, da. So, you know, it's, it's again, a workable view of values is a balanced view where you consider a bunch of values. You know, if I care about my relationship with my wife, that's what matters to me, and I'm coming home from work and I'm flogged, and I can barely talk to her and I'm grumpy, well, okay. Something's gotta shift, right? Yeah.

[00:25:05] Bronwyn: Yeah, I was just curious how you worked this out for yourself. Because one thing I've noticed with early career psychs is we don't really have a good barometer of what's normal. So we might go into our first job and they're like, okay, you're seeing 40 clients a week and you'll be paid peanuts, um, instead of pay and yep. That sounds good to you, right? Um, you know, we don't really have a sense of what's normal, so I wondered how you worked that out.

[00:25:27] Denver: Um, the hard way. Yeah, I didn't come and I always am very honest with, um, people I supervise that unfortunately a lot of the knowledge that you have when you're considered senior in this industry, um, is just hard won. And one of the reasons I like writing on LinkedIn and doing the newsletter and doing things like this is I'm hoping other people don't have to do it as hard and that they can say, hang on, wait a second, yeah. If I'm working for $35 an hour and I'm seeing, you know, 40 clients a week, and um, they're giving me like some rubbish CPD and my supervisors keep changing every, you know, two months 'cause they leave the company, that's not a... that's not a rite of passage, that's just a crappy company, and it's just people being careless with your wellbeing.

Um, so yeah, I did learn a lot of the hard way. But I mean, the things that did help a lot, I had, I have always had good supervisors. I did not realize that supervision, if you read the AHPRA guidelines, supervision includes the entirety of psychological practice or it can.

[00:26:39] Bronwyn: Yeah.

[00:26:40] Denver: So that means, you know, like a lot of people will go to supervision initially just talking about client stuff. Uh, I'm not saying, you know, you go in and, and, um, get therapy off your supervisor, but you know, a lot of, um, navigating the psychological practice element is navigating the profession. It's like, you know, your supervisor will teach you things, like you'll go to supervisor and say, look, this GP was so rude to me, like, but I do need to, you know, communicate with them 'cause client's at risk and they might say, okay, here's how you'd word a letter, make sure you know, ask, you know, some tips on how to handle something that you think, oh, okay, I should have just known that. No, we all learn that on the job. We all learn that by often running to a senior psych or a supervisor be like, "I don't know what to do".

Um, and so I didn't know though. I did that a lot with the clinical stuff, I was very happy to learn all that. I didn't know it was okay or I didn't feel okay to just go up to people and be like, I don't know, like if this is the line of work I want to do, uh, I would do it in dribs and drabs, but I, I was sort of a bit self-conscious. I didn't wanna seem like an idiot early on, right. Whereas when I'm supervising early career psychs, I'm like open to that. I'll actually say like. You know, we're developing as a professional here as well as, you know, getting better at clinical work. 'Cause, because psych work isn't all just therapy, right? Like I've done case management, um, plenty of people do report writing, some people do these sort of blended roles, some people do more educational roles... they're all legitimate psych roles. There's no like job that is the pinnacle of being a psychologist. So people often see the private practice psych as the pinnacle of psychology and certainly the Instagram psych looks like that too, right? Swanning into a beautiful clinic and like holding a cup of coffee and like writing notes all neat. I mean, I wish they could see what we actually do when the cameras off just pulling your hair out, you know, why is the internet down? Like, um, I've gotta call that GP, but he never picks up and, you know, all that sort of stuff.

So I think it's, it's really helpful for early career psychs to have supervisors, peers, mentors, so just talk, you can talk about all like how do you navigate like talking to the insurance company or how do you navigate getting more clients? It's all, to me, part of skilling up as a psychologist and in a way it's a kind of self-care too. Like you, you hold onto a lot of this stuff early on 'cause you feel like an idiot asking and you feel like you should know, and that is a burden you bring with you for the rest of the day and into your sessions. If you can alleviate that or would learn to work with that better, you'll notice, like, wow, you're starting to flow a little bit more with the other work. So yeah, I learned the hard way. I hope other people do not.

[00:29:25] Bronwyn: Totally. Absolutely. It's really refreshing to hear you talk about supervision as involving, not just talking about client cases, 'cause I think a lot of early career psychs, that's the style of supervision they are exposed to. It's like we just have enough time to talk about two, maybe three of your cases today, and that's it.

I remember myself feeling like, am I a weirdo for asking my supervisor if I can talk about my feelings and reactions to clients? Like, I thought that was weird, um, but it was hugely beneficial. And then as you say, there's another dimension where you can talk about your professional identity and your development and your space in this career, um, which I think is awesome. So thanks for offering that.

[00:30:03] Denver: Yeah, no no. That I think it's right. And I think you're right. I think, I think, I mean, maybe I'm biased 'cause I'm old now and I, and, but I do, I do think one of the things that did get lost... like way back, my, my supervisor was like an old school psych, he was into psychodynamic and stuff like that. They were way more into, you know, looking at therapy as a two-way street, as in you, you are not getting therapy as the therapist, but you need to be aware of what you are bringing into sessions. You need to be aware of, you know, cultural biases and, and you can see that sort of being acknowledged sort of in the, uh, AHPRA stuff now, the, the guidelines and stuff.

But what that means, you know, like if you, if you wanna be culturally sensitive and safe, how do you do that without understanding what you bring to the table? Do you know what I mean? Like, it, it, a simple example is in supervision, you might talk to psychs and they feel stuck with a client and you say, okay, what is the client doing? But also what are you doing? What are you bringing in that might be curating the stuckness? Sometimes it's as simple as the early career psych saying, and by the way, when I say early career psych, a lot of these problems still continue into your, you know, into my 18 years as a psych, that's why we have supervision. That's why we have CPD. You do not ever get to just rest on your laurels in this profession.

[00:31:26] Bronwyn: It's been a lesson we've, uh, we've collectively learned on the podcast through talking to guests and their experienced psychs, and they'll say to me, Bronwyn, these are problems that I still have. And I'm like, oh, you mean they don't go away? Like, you're not transcendental at this stage? And I'm like, no, unfortunately not. So yeah, go on.

[00:31:41] Denver: Yeah, exactly. You still get nervous when there's high risk clients. You still, feel silly when you have to be on a case conference and a, you know, GP or psychiatrist talks down to you, you like, you're a human being, right. But you learn to navigate that stuff better. You learn to not hold onto it as much. You learn to not see it as some central part of your identity,

So I was talking about, you know, an easy example is about the two way street of, you know, therapy is, if you're an early career psych and you have that pressure to do all the things all at once, you know, in your initial assessments is, is one of the places that I see it the most... you're gonna do, risk assessment, plus history taking, plus psychoeducation, you're gonna explore the entire model of whatever you're using. You're gonna build rapport, you are gonna give them the perfect homework, but you're also gonna demonstrate those techniques in the session, and they're gonna stick and they're gonna understand and it's gonna relieve them, and they're gonna walk away feeling really happy. You're gonna do all of that in an hour, uh, and you're gonna do it all really well.

You know, like you are. Fused with an idea there that is not workable. There are obviously things that you need to pay attention to, you know, risk being one of them, but you cannot do all of the stuff all at the time in every session, you know what I mean? So psychs can even just bring in things that are like, you know, not worldview stuff, but these beliefs that you, you go, where did, where did that idea come from? It's like, I don't know, and it's like, okay, well let's notice it, let's, um, work on what's reasonable, what's helpful, um, let's come up with something that's gonna help us move forward there. That can be helpful, like when people say like, oh, you know, supervision isn't therapy, I agree, but it doesn't have to be, it doesn't to be helpful and, and you don't have to do something like therapeutic to be able to reflect on yourself in a way that helps the work.

[00:33:33] Bronwyn: We just recorded a podcast episode on implicit bias towards people with disability, and it was really interesting. The guest had conducted a study of Australian people and had given them an implicit association test to see what biases they have towards people with disability, specifically on measures of, I guess incompetence and warmth versus coldness. And she found that around 80% of the sample had moderate to severe negative biases towards people with disability, the combination of incompetent and cold came out really strongly.

And you know, if you ask those people explicitly, they'd probably say. I feel really positively towards people with disability, and so I guess like by sharing that, what I'm trying to say is that I completely agree that it's important to talk about how we feel in supervision because we might not be aware of it, or it can be something to talk about that might be interfering with our processes in therapy.

[00:34:27] Denver: Yeah, exactly. I, I, I started in, um, drug and alcohol counseling and Aboriginal health, so aboriginal health, but I was funded to do drug and alcohol counseling. And sometimes I'd go to like psych meetings and I'd feel like the odd one out 'cause I'm, I'm. You know, we had, I was working pretty differently, very holistically and learning a lot from, um, the community, and it was interesting to see like really educated people that, uh, no judgment, 'cause that could have been me, when we were doing, sometimes at workshops we were doing like a case study and we had to, you know, comment on things and if the client, the sort of imaginary client was Aboriginal, some of the answers I'd be like, oh my goodness, like, oh no.

Uh, and, and, and not just the, the, you know, the cultural stuff. Also like AOD work. There's some people that hold these views about drugs. Like, you go, what? What? Um, they just hadn't, they just hadn't thought it through or they hadn't done the work to go, oh, I haven't really thought about, like, that assumption about a drug user. Yeah, or, or they had really naive views about drug use, like, yeah, you know, like everything will be fine and like they'll be right and they just gotta stop drinking.

So, so it can be as simple as that. It can be as simple as like recognizing that, oh, actually I don't know as much about this as I thought I did. I think supervision's great for that. Sometimes, you know, you're in supervision, you go, yeah, I gotta do some extra reading, I did not know that, oh, okay, right. Uh, that, that's a good thing. But early career, whenever you have that moment, you go, oh, oh no, not another thing. I dunno. I'm terrible.

[00:36:00] Bronwyn: I know right.

[00:36:01] Denver: I, I suck. You know, like, and I just will tell people, like, uh, if you asked me to talk about eating disorders for an hour, a field, I've never worked in, and I think are very specialized, like, you know, people that work in that area, you know, hats off because they, they know their stuff, they dive in, they can't just casually do that. I don't, I don't believe anyway, from you know, talking to psychs that, that work with eating disorders.

I, I would, I would sound like an idiot if you asked me to talk for an hour on eating disorders and I've been a psych for 18 years, so early career psychs sometimes have this idea like, oh, they're a psych of like 20 years, they know all these things... actually, no, like, you're probably more likely, I hope you are to admit, I actually don't know,. I think you should probably see it on psych or, I, I don't know, let me go find out.

Early on you'll sometimes be scared and pretend like, yeah, okay, yeah, yeah. And then think, and run to your supervisor and go, I don't know what to do. Um, yeah. I guess the further you get, I hope the more comfortable you just get with going, oh, I didn't actually know that, or, I don't know much about that.

[00:37:05] Bronwyn: Yeah, and maybe that reflects something I wanted to ask you about, which was there's often a pressure on therapists to be overly agreeable or accommodating with clients. And I reckon... I reflected on this and I reckon what tripped me up early in my career was the concept of, um, unconditional positive regard. And I was like, well, if I'm doing Rogerian principles, then everybody's A-OK. You're cool, I've got, I've got positive regard for you and you and you. Um, so how does ACT help you navigate situations where you might disagree with a client?

[00:37:35] Denver: Yeah, so I'll, I'll admit something. I've never enjoyed challenging clients. Like I've never enjoyed that moment where you're like, okay, I'm gonna have to say something here that might cause a rupture. You know, I, I, I don't pretend that I'm like, ah, yes, okay, now here's what we're gonna do. But I recognize the importance of it because... let's to say from a values perspective, I value honesty. Just from a practical point of view, you'll never completely agree with all your clients. So being authentic and open about that, um, often means going into awkward territory, but also it's helpful your client experiences someone who's not just this kind of like, I don't know, just fake perfect psychologist that agrees with everything they say.

So the ACT lens on that is I can simultaneously do what works and is helpful, connect with my values, and accept the fact that I feel awkward or anxious or, you know, just funny when I do it and still have that work and still have that go down well. So if I'm supervising and I kind of notice that, I often say to people like, it's okay if you do that and you continue to do that and feel awkward, but let's work on the behaviors that work. Let's work on keeping it value space, in that if they are willing to get out there and experience the discomfort and do what works and do what's kinda right by their values, there's also a, a, a better chance that they'll get better at doing that, so that when they disagree with clients, when they challenge clients, it's done in a way that's extra in line with their values. If they wanna be really kind, they'll get it better at being kind and firm, rather than just being clunky and awkward and then ripping through the conversation and going, oh, I hope that lands. Um, so, you know, with ACT it's like, it, it's not a barrier to feel anxious. You don't have to get rid of that first. You can keep that, see it as one of the unwelcome visitors in the kind of the party, and, um, off you go.

[00:39:41] Bronwyn: Yeah, it's it- even you talking about it, I noticed that I still feel anxious. It's like, it's one of those things that don't go away when you think of challenging clients. Like why do you think that's important to do that though in a therapeutic context?

[00:39:55] Denver: Well, I think, I think it's honest, like I really do. I, I think it's honest and also I will challenge clients when it's in service of the therapeutic goals. I don't need to always challenge them on other things. Like if I disagree with them, I'm, I got plenty- I'm not religious. Um, I used to be highly religious and I left that, so I've got some really religious clients. I mean, I don't need to jump in and like be like, well actually... um, that's not important.

Uh, so it's, it's always good to, to think about challenging. It's like what again? In context, in service of what? As soon as you think about in service of what, it becomes clear why it needs to be done or not needs to be done. So if a client is, let's say a client's, you know, tends towards being really depressive... so you might have three sessions where things are picking up and it's great, and then in the fourth one, there's this sort of pattern where they come in and go, you know, stuff it, I'm sick of it, it's not gonna work, and they're just doom and gloom about everything. Challenging does not mean you have to be like, right, you know, let's, you need to do behavioral activation. It can still be super kind, super compassionate, heavy on the empathy, and yet, why did we turn up in, why are we doing this? Right, to move you forward.

In an ACT perspective, I'll often encourage people to think about challenging as... your client has, has hired you or they've, they've, they've worked with you so that you can help them connect with what they care about in life. So if you want to challenge a client, you can actually leverage their own, um, most valued things in that moment. I don't mean manipulate, I mean like remind, so you can, you can say look, yeah, like I'm hearing you, it sounds like it is just unbelievably difficult right now to see the value in getting outta bed. Like you came in here, so congratulations, thank you, like... now, I remember what you said last session, which was, you had been doing this work that has been difficult and it helped you connect with a sense of independence and freedom that you had... you have always valued, but you had missed for a long time. You know, is it possible to start reconnecting with that again, even if your mind is screaming at you or a part of your mind is screaming at you to just shove your head under the blanket and just not come out.

You can challenge like that too, right? It's important because it's in service of like what we turned up to do, right? We, we, they turned up to do this, so, okay. I don't even have to be harsh about it. I can say, you know, is this, is this possible? Let's reflect, let's notice that, hey, there is this part of your mind that does this actually pretty frequently. Let's not judge that, let's not say whether that's right or wrong... but there is this other part that got you here, can we tap into that to move us towards a more values driven life. And if, if for now, what that means is you just keeping turning up here, cool, let's be explicit about it.

So it, it, you know, the challenging becomes really important because barriers are a part of treatment, addressing barriers is always a part of treatment. Every psych probably feels the same way, which is, oh no, we were going so well, like, I don't want barriers. I just want to keep going. Yeah, okay, not the real world. So I, that's the other thing I'll often say, in supervision is addressing barriers in treatment is often frustrating, but it is the treatment.

Um, there's this, I don't know where I heard this, but there's this like story about a guy and he's like complaining to his wife about his job and all the BS that's happening at work. And he says, you know, once that's all done, then I can get back to the work. And she's like, no, that is the work. And it's, it's like that in therapy, right? Like the barriers is the work, just as much as anything else is just as much as a session that goes swimmingly. So when you can see that you don't judge yourself as a therapist, early career going, I suck because this time the client turned up and he was really depressed. Yeah, that's his diagnosis.

[00:44:02] Bronwyn: Yeah, absolutely. It's, and I guess, uh, it's like if we're avoiding doing challenging because we wanna avoid those icky feelings that's not in service of the client and what they wanna get out of therapy as well.

[00:44:14] Denver: No, and it's not a service of us usually, if we really look at it either. Like-

[00:44:17] Bronwyn: Yeah, like, we've got our own reasons for wanting to, we wanna help usually.

[00:44:22] Denver: I want, to get better at being a psychologist, right? I cannot do that by avoiding the difficult things that turn up as a psychologist. I mean, that is how you get, that's how you grow. You don't grow from having the most wonderful experiences all the time, there's no growth to be done there. I mean, if being a psychologist was like, every session just high fiving your client on the way out the door, like, please, um, you know, I would do it for free, probably!

[00:44:48] Bronwyn: Yeah. No, absolutely. I- I would too. Yeah, no, totally.

Um, Denver, this has been such a great conversation. One question I ask, um, more. Experienced psychologists who come onto the podcast is, I guess along the lines of like early in our career, we can feel like there is so much to learn and sometimes it's so overwhelming and we can be like, why am I doing this? And I wondered for you, what keeps you going in this profession and this line of work?

[00:45:14] Denver: Yeah, I, I often joke with colleagues and early career psychs when they're having a moment of like, I just, I should have gone and worked in the mines. I'm like, I think I have that thought like once a week.

Because it's, it's like, uh, you, you're a human being, your mind is gonna go, here's some imaginary easier solution. Who knows if it even is, right? Um, so first of all, I just, I accept that these kind of thoughts will turn up and I go back to the values. I mean, I probably sound like just, you know, some sort of ACT robot right now, but I go back to why I got interested in this. I've always been curious, what psych hasn't, um, uh, you know, it, it's a way to act on compassion that's like consistent. Um, it, I love learning, so I mean, you're always learning as a psych. And maybe one day I won't be a psych, I don't know. But for now, um. It kind of meets my needs in that, that respect.

What has changed though for me as um, someone who's been doing it for 18 years, is I won't do all of that unless the conditions are right. So that's the thing that's keeping me doing it now is the conditions are right, is I'm in private, I'm learning new things about running businesses and things like that. That is, that sort of is keeping me interested. I think that, um, for a lot of us, if we don't have that sense of growth or that sense of learning something new, it also starts to make us feel... star-, so there's like psychs that feel burnt out, and then there's psychs that feel kind of like, what's the word they use? There's another- languishing is the word they-

[00:46:54] Bronwyn: Oh, is it? Okay, languishing is good.

[00:46:55] Denver: Yeah. Well, you're just at a job where you're like. What is the meaning of life? Like, why do I do this? You know, you're just having, you're sitting there just going, I'm getting paid to just sit here because this client nohow and you know, eh, or I'm doing this with my eyes closed 'cause I've been doing this work for the last 10 years.

Yeah, I think what, what brings me back? Is it still interesting enough? Um, it's still a chance for me to, to do things that are in line with values like compassion. But also the conditions are good. If they're not, I'm gonna change the conditions. And if I just can't, like if longer term I just find that psych work is not for me, I'm open to the idea that I stop doing it, which is like, it felt so taboo the first time I've had that thought. Oh my goodness. No, you just stick in your career for the rest of your life. But I often ask people to kind of evaluate that when sometimes I meet psychs, uh, when I'm supervising that are really actually considering leaving. And I usually find that they're just not able to get in touch with their values. A lot of times that has to do with conditions. Um, so yeah, I I do it because of my values, but I also do it 'cause the conditions are right.

[00:48:07] Bronwyn: Yeah, no, that's a really great way of describing it. Denver, what do you hope listeners will take away from our conversation today most of all? Or what do you want to leave them with?

[00:48:16] Denver: There's a lot of things I think that you can do as a psychologist that will make you suffer. Um, committing to behaviors that just aren't workable is one of them, and it's rife in our industry. We, we let things like imposter syndrome guide us rather than looking at things like our values and our conditions, getting the right people around us, getting the right work conditions, getting the right pay, and um, and and treating that as just as important as like the, you know, the degree or the, uh, the registration number.

And the other thing I would say to people is, especially early career, it's a marathon, not a sprint. Like, give yourself some grace, like give yourself some time. Um, enjoy the rest of your life. You're never gonna get to a point where you, you get to put your life aside and then it comes back. You'll, you'll almost always regret not having a life in service of work. So, so really think about it as a marathon and how you're gonna maintain yourself over the long haul.

[00:49:14] Bronwyn: Yeah. No, that's so beautiful. And it's, it's a really refreshing perspective as well because as we talked about, psychologists, we're just so prone to thinking, what's wrong with me? What have I done wrong? And rarely do we consider the context that we are working in. So thanks so much for explaining ACT to us and how it guides your life and how it's guided your career. It's been, it's been great. Thank you.

[00:49:34] Denver: No worries. Happy to be here.

[00:49:37] Bronwyn: And listeners, thank you so much for listening to this episode. If you enjoyed it, make sure you put it in somebody else's ears. It's the best way to get the podcast out there. That's a wrap. Thanks for listening to Mental Work. I'm Bronwyn Milkins. Have a good one, and catch you next time. Bye.