Why Therapy Fails Autistic & ADHD People! (And How To ACTUALLY Heal) | Dr Judith Mohring

0:00Dr Judith Mohring:Ultra running shoes are all about space. The space to go further. To feel better. To do something you never thought possible. And this space starts with Ultra Fit. Unlike traditional running shoes, Ultra Fit gives toes more room to move naturally. So every step is strong, balanced, and comfortable. Whatever you're lacing up for, stay out there. With Ultra. Shop now at ultrarunning.com. That's A-L-T-R-A running dot com. Those of us with ADHD may find it harder to switch out of this part of the brain called the default mode network. This reflection on our role in the world, reflection on our emotions, our relationships with others.

0:40Looking back and thinking, did I say the right thing in that situation? How would I do it better next time? Why do some people spend years in therapy and still feel exactly the same? Therapy isn't really so much about knowledge. It's more about the experience of being together, being connected and feeling things together in a safe way. And if you have masked for a very long time, you may be very good at not feeling and your therapist may not pick up on that. If you've spent decades becoming the person everyone else needed you to be, how do you find your way back to yourself? Gosh, that takes us back to the beginning, doesn't it?

1:13The kind of how... Can I have just a second of your time? If this podcast has helped you understand your brain or made you feel less alone, can you do me one favour? Can you hit the follow button? And I'll repay the favour by continuing to book the best and most exclusive conversations on this topic. Please enjoy the episode and always remember, you're not broken, just different, and you have always been enough.

1:39Judith, welcome back. Thank you so much, Alex. It's really great to be back. Thank you. Today's episode is all about why therapy sometimes fails people with ADHD and autism. And I know that's a bold statement because I know therapy helps a ton of people. But I've spoken to a lot of people in the ADHD chatter community who have said that they've been to therapy. And even though they've learned a great deal about how their brain works, they don't feel any different. And I think that really led me to ask a bigger question. And that's that after all of the knowledge that I have about ADHD, I know my traits, I know my coping mechanisms.

2:18but do I know who I actually am underneath? Who am I when I stop masking? And I think lots of people listening will have the same question about themselves. So I suppose to start with, before we get started, as a Cambridge educated psychiatrist yourself, and as someone who has helped thousands of people with ADHD, if someone is sat opposite you and they say they don't know who they really are what do you hear it's such a huge question and i'm really glad you asked it because i think we're going to have a great discussion um and my experience is it's really common for people to say i'm not sure who i am it's a really lovely therapeutic question um and it's the beginning of a i'm going to use the word journey i know it's a cliche but we might come back to different models of what a journey is whether it's a map whether it's a boat whether it's a mode of transport, because we're going to talk about movement, both as emotion and also about escaping being stuck today.

3:23And so if somebody's coming in and that's the beginning of their process of saying, I don't know who I am, then it's just a really great place to begin, I think. So let's begin. Yeah, let's do it. I mean, I think to expand on that point, I think I want to show you something. And we've got two jars on the table in front of us, And I'm going to hold this one up first. This one is labeled as understanding. This has got a ton of stuff in it. And this is what I think many people who perhaps listen to this podcast or read books, they understand about ADHD, they understand about dopamine, rejection sensitivity, masking, trauma, their nervous system, maybe their childhood, attachment styles, perfectionism, maybe anxiety, and addiction.

4:11But for some people, the emotion never gets processed. It just gets filed away as, okay, I understand that. And I think the next jar on the table, this one's called healing. And I think there's an assumption that if you fill up the understanding jar, that the healing jar automatically fills up. But why might that not always be the case? Because they're two different things. I mean, I'm really, really glad that you started with the understanding one because so many of us will rush to knowledge. And I think it represents one of the ADHD strengths I'm discovering from my work with lots of adults with ADHD in groups.

4:50And what I've learned is many of the adults that work in the groups with me and the team really are brilliant at learning, really curious. And so it's like, I'm playing to my ADHD strengths. Give me the knowledge. Let me understand why, why, why, why, why. And I love that.

5:09It's is a brilliant thing to start with, but it's not going to get us to over there. And can I pick up your understanding, John? Yes, please do. Sorry, I'm going to try and pick it up. Yeah, let me know. Yeah, thank you. Because when we have the understanding, and this is where I began, I talked to people about how I started my ADHD journey, thinking I know a lot about ADHD because I train with the UK Adult ADHD Network. I'm an expert in ADHD. And I thought, I understand ADHD. Why am I not able to get myself better? You know, physician, heal thyself and all that stuff. and it was essentially i've got all this knowledge but i need to get it out and i need to kind of put it in sequence almost as if we're kind of doing a map yeah so it's like you know you start with all this understanding but actually what you've got to do is go which bit am i going to start with first and it varies from person to person but it's like you've got to kind of start over here and go well let's get the bits out and let's actually walk this walk let's do the journey these are going to blow everywhere see that one says trauma it might be that somebody chooses to start with their dopamine it might be that somebody chooses to start with more of a knowledge-based process but in essence what we're doing when we're working therapeutically with with somebody whether we're working in group or individually is we're walking the walk together so we're not just sitting on our own with a big jar of knowledge and not unpacking it and going well I know everything now we're unpacking it and going well now that I know that how does that relate to me what does that mean and how can I process that with another human being because that's how we gradually move towards self-acceptance and self-knowledge and I'm not sure healing exists as a destination I think it might be a bit like the odyssey where we're heading off for some kind of mythical island and I wonder if where we're going might be self-acceptance self-understanding and more of an ability to be with ourselves but it is totally about mapping it out and going right okay here's another step on the on the journey how do I move forwards rather than being stuck back here going, I know everything there is to know and why am I not here?

7:08It's a different process. Wow. Yeah. It's so interesting. I think we were speaking off camera and as conditions, as humans, we're almost conditioned to think that everything that has a start has an end. And if something isn't working, then there must be a fix to it. It's almost like, okay, you know, the TV isn't working, let's go fix it. Or the car's broken down, let's take it to a mechanic and we'll get it sorted. But you're saying that in order to heal as a human being who has all of this trauma perhaps and a load of understanding it's more of a journey to get from that state of of recognizing and understanding how you work to truly believing and recognizing that you are on a path to feeling healed yeah that it's much more of a kind of process rather than a single well when i know this then it will all be better so i think we get also get a little bit caught up in i talk about the pill paradigm where if i take an antibiotic my infection goes away.

8:01If I take a Valium, I feel relaxed. If I take my ADHD medication, I feel I can focus. Those things may all be true, but that's not the same as then going, what is the journey that I'm going on therapeutically or philosophically in terms of coming to know who I am in the world? And that really, really takes time, whether you do it through therapy or whether you do it in other ways. Understanding therefore clearly isn't all that you need. I'm sure there's many people listening and watching this podcast who recognize and understand that they perhaps have various challenges with addictions or they are impulsive.

8:39But are you saying that knowing exactly why you behave doesn't stop you from sometimes feeling like you're trapped? Very much so, actually. I think just coming back to that, this sort of knowing and also being trapped is often an early experience where you're like, okay so I know all this now that's great and yet I'm stuck or trapped and that's very much coming back to this this kind of understanding knowledge thing where it's like well I know all this now but what does it actually mean um and it's how do we then move forward um and one of the I guess one of the problems with this kind of the understanding model is that understanding is a starting point it's the awareness so we talk in our model about awareness and regulation that we need to know what's going on and be able to pause and raise our awareness and then we can begin to make choices about what we do next but until we understand and we're aware often we can't necessarily have the capacity to make those next choices so the knowledge is a great starting point but it is only a starting point that's around awareness and understanding and then it's about how can i make it safe to move forward because there's often really good reasons why you might not want to move forward because you know we picked out the trauma piece there might be painful you might need a safe relationship to explore that in so we shouldn't be unkind to ourselves if we're feeling stuck it seems to me that lots of humans perhaps we we take the path of least resistance whatever is going to be the most emotionally painless experience that's the road that we take like subconsciously.

10:16Could it be the case that so many of us have become so good at analyzing ourselves, that we're very good at zooming out and perhaps over intellectualizing what we're going through? We're very good at intellectualizing ourselves that we actually stop feeling ourselves. And what What I mean by that is we stop experiencing the pain, the love, the emotion. Is that possible, that you're just so good at intellectualizing and understanding your brain that you've actually stopped feeling yourself? We talk about intellectualizing as almost a defense mechanism, as a way of retreating into logic and thought as a way of keeping feelings at bay.

11:06And feelings are called feelings because they hurt. So they can lift us up, but they can also drag us down. And so it's very rational to go, look, actually, right now, I'm going to go into this kind of prefrontal cortex, cognitive, linguistic, logical, rational response. And that's okay some of the time, but it is about having the balance between the intellectual and also the more emotional. and many of us get to the stage particularly if there's a lot that has gone on where we may very well not want to dip into feeling because there's a lot to process or we can't speak the language that our emotions are trying to speak so the the intellectualization can become a pattern that we get stuck in definitely this is where it gets so interesting and i think i've never related to anything more i saw a piece of content and it said living inside your own head like experiencing the world almost like you are inside your own head and you're looking out through your eyes as if they were a pair of windows and you're able to be in your head and you're able to process social encounters but then you walk away from that and you find yourself like even though you've experienced the emotion you've experienced the humor or the anger or the jealousy in a particular moment you're analyzing it inside your own head to the point where it's overwhelming but is is analyzing emotion like that is that the same as processing the emotion um gosh so i don't know if I have a definition of processing emotion beyond what I've learned from doing therapy and being in therapy.

12:53And I suppose I think when we're thinking about emotion, we might think about it. We might ruminate on it. We might use words to analyze it. We might use words to name it. But then as we process it, we might experience it and let it in. And we might begin to have a feeling. And feelings tend to occur within the body. we may or may not know what our body's doing but we may get some kind of internal sensation so it's not just up here processing emotion is like allowing lightning to pass through you and be grounded so i'll often say when we really process emotion we have to allow the energy to pass through and allowing that to happen safely and i use the lightning metaphor there as a kind of as a real kind of idea that actually can take time to allow us to ground difficult things and takes practice to connect the different bits um and learning to do that takes time which comes back to this idea it's a process processing is a process you can't and you can't do it on your own you generally need other people to help you co-regulate that's so funny i i almost think that i am obsessed with processes to the point where it's like i i truly believe that i would reach the criteria for an autism assessment.

14:09I'm going through that process now, but I'm very, very analytical to the point where I understand my emotions. I over-intellectualize them, but I always wondered, is that a defense mechanism? Can I almost be hiding behind over-processing them and therefore not wanting to actually face them? Wow. Look, I think we're all very different in that some people will really feel the feelings. they'll have a natural capacity to you know I sometimes feel that feelings are like water kind of springing up into the soul yes and some people really kind of feel that they feel the joy bubbling up they feel the sadness bubbling up and others don't so much and others also can feel it bubbling up but it gets stuck so we all vary some of us will have a sense of being stuck there's something that we want to express others will have a feeling that you go inside and there's not not much there Yeah, the inner experience of emotion is really variable, I think.

15:05So who knows, Alex? I don't know what lies in the future, but you may find there are kind of wells of emotion that you tap into that you never knew you could. I don't know how unique that experience is of feeling something analytically, like being very aware that you've just been to an event, you came across as a bit awkward, and you're able to see that, but you don't necessarily feel it. How common is it to, is the brain making a conscious decision to think about a feeling rather than just feeling the feeling? There are reasons why we might make a conscious decision to think about a feeling rather than feeling it.

15:49Definitely. So sometimes we defend ourselves for good reason. Defenses exist for a reason. So if something difficult's happened, and maybe it reminds you of something difficult from the past, you might very well switch to analysis because it's useful because actually you're defending yourself for a reason we talk a lot in the groups i run about procrastination and actually just had a group talking about procrastination and why were we procrastinating and half the examples when we actually dug into why people were procrastinating there was a strong emotion to do with loss or bereavement so actually we were procrastinating for good reason and i think the same is true of kind of intellectualization sometimes retreating to the intellectual is a hugely safe thing to do when actually moving towards the emotional is either unknown territory or feels dangerous and it's the unknown I mean I mentioned maps and things I think one of the things that's so difficult about this sort of conversation work is that we're talking about how we map our inner experience and that's almost a philosophical question I want to get a little bit deep here and just really zoom in.

16:52So as we know, ADHD brains, we can overthink the world. I think many of us are guilty of overthinking. But sometimes that overthinking can often turn inwards. Why do you think having ADHD makes everything we're speaking about today even harder? I think, you know, I've mentioned strengths a few times throughout this episode. And I think it's because, as we know, those of us with ADHD may find it harder to switch out of this part of the brain called the default mode network, which is where many of these things sit, this reflection on our role in the world, reflection on our emotions, our relationships with others.

17:32So sort of looking back and thinking, did I say the right thing in that situation? And that imagination that goes with that and thinking, well, how would I do it better next time? And we know that when people develop conditions like OCD, there are differences in the default mode network and the way that it functions. And certainly in those of us with ADHD, it's harder sometimes to switch out of default mode back into the, nevermind what I did yesterday, I must get on with my laundry. That's harder. It's like, we just get caught up in the, I wonder what he did think. Oh shit, I missed the train.

18:02So it's probably to do with slight differences in neurobiology. Yeah, gosh. You would think I'd be better at that by now, the whole washing machine thing. I woke up this morning, walked past my washing machine, and it was full from yesterday's cycle. What a surprise. Even though I do the washing machine of woes in this podcast every single week, I still fall victim to out of sight, out of mind. So I did something last week. I changed a bed at home. I was like, I've made the bed, I've made the bed. Look, go me, I've made the bed. I can't do this. I've made the bed. And then my daughter came in and went, that's my bed, Len.

18:33And I'm like, is that yours? My goodness. Amazing. Anyway, it's clean. It's on the wrong bed. Oh, good. It's nice to know. even people who talk about adhd day in and day out we still fall victim to some of the challenges which i think it's quite soothing in a way well i think it's that whole step stool analogy that if you're not very tall you're always going to need a step stool to reach for the top shelf and it doesn't matter how many times you go to that top shelf you're still going to need the step stool and you might become a specialist in different step stools and you might have lots of different ones and go this one folds this one's like this i've got a wooden one over here that i've just painted you get really into the kind of detail and then obviously you get a bit bored because you have ADHD and you forget steps still, you still can't reach the top shelf.

19:11So I think it's forgiving ourselves for the fact that no matter how much you know, these are not easy things to just fix. It's not like a kind of, oh, I can fix it. It's like, no, this is, it's not hardwired. You can change things a bit. There is neuroplasticity, but certain things may always be a struggle and that's okay. Yes. Forgive yourself. Yeah. Please. You know, we're not all brilliant at making beds or remembering where the laundry is. I used to get so frustrated at basic memory slip-ups, like what we just spoke about, forgetting the washing machine after the cycle's finished. I used to analyze, or try to, analyze why.

19:48And I think I got the diagnosis of ADHD, and now I've spoken to hundreds of experts on the topic. And it opens a bigger question. Do you think people with ADHD, do you think we have a natural pull towards analyzing ourselves i i suspect so i suspect so and i think it's again going back to the groups we run we often um look at the strengths throughout and there's these strengths in kind of reflection learning curiosity and that is helpful for some things but maybe less helpful if there's a thing that you think oh i'm this is what's wrong with me i must analyze and come up with a perfect plan to make it better and then i'll be i'll be perfect and I talk about people with ADHD can be a bit like dream polishers we'll have this amazing dream of one day I will know that the laundry's done and where the bed linen is and whose belongs to who and the bed will be perfectly made or whatever it is it's kind of dream polishing we're good at process we're good at imagining what will be perfect but then the actual doing of it's much harder yes I have a dream that I will buy a notebook and I will still be using it in four months time or I'll buy that new domain and in six months it will still be active I'll still be paying for it but probably just would have abandoned the business idea well yeah and that's but that's okay because again it's those strengths things there are certain strengths that come with these particular executive function struggles so we've just been doing the executive function group and we've been talking a lot about the things that we all find difficult and a lot of us are really strong in imagination a lot of us are really interested in learning and we're really curious but then actually the implementation of the plans you know the planning is good the execution is more tricky and it's almost like there's too much imagination in relation to the other things and that's just the way we are you think getting an adhd diagnosis later in life does that make the sort of self-analyzing stronger um i'm not sure if it makes it stronger because i think actually when we're younger we tend to be very self-conscious it's a normal part of adolescence to be really hyper aware but i think what it can do is it gives you more material to analyze and that can mean that the process of kind of now it all makes sense and kind of going oh and that oh oh and that crikey also that all of those moments those light bulb moments there are more of them so then you might look back and go so I left every job so I sacked myself from jobs so I moved house 17 times in six years so I didn't manage to complete this exam that exam I failed exams repeatedly so I had to repeat okay so I've never been able to go to the gym you know those are just my examples it's like so many things that you look back on because it's this whole lifetime of just ah that little micro screw up or that little micro excitement that was all all the way through is that was ah it's how I am I once bought a um chest of drawers on the way to work and I rang my boyfriend and went morning I bought a chest of drawers he went it's quarter past nine in the morning how have you managed that I went well there was a market and I saw this lovely chest of drawers.

22:53Then I got talking to the man. It was really nice. And it's really gorgeous wood and it's been beeswaxed. And it's like, oh my Lord. It's like that chain of events that takes you off on a bit of a side quest. Major side quest. Get home with the chest of drawers and you're like, oh, I didn't buy the milk that I went out for. What milk? Oh, yeah. Oh, milk. Oh, yeah. Sorry. So sorry. I think what this leads on to is you sort of get to a diagnosis, a place of understanding. And I think lots of people who listen to this podcast will have heard the term hyper-focus. And I think many people associate that with being able to zoom in on a project and work for four hours with intense focus.

23:36But that hyper-focus, what happens when that turns inwards? It can be crippling. I think it can make us very self-aware very self-critical we see a lot of you know in the groups of lots of adults talking about the experience of being constantly almost hyper vigilant around I'm doing it wrong I've done this wrong I've too much I've said too much oh my god I've done it again so it can be quite crippling um and it can also get us feeling really really stuck um and because humans exist in relation to each other it can mean it's harder for you to take in the good from other people because you're so busy thinking about yourself or it can mean it's harder for you to connect with others because you're busy and it's not a sort of narcissistic sort of obsession with self it's more a kind of self-critical like oh am I getting it right um so I think it can be quite tricky when the hyper focus is extended to the self I think you've said something which opens up almost a Pandora's box of discussion and struggling to connect with other people.

24:39And people with ADHD, I think, are experts at artificially connecting with other people. They put on this character called normal. They can go to a social event. They can be in a relationship, but it might not actually be themselves who is underneath the mask that is actually connecting with the person that stood right in front of them. How can years of masking teach people to disconnect from what they're actually feeling? Can the mask be so thick that your emotions are completely trapped deep inside you? I'm going to slow right down and go right back to the beginning of that question. And you may need to ask me the question again, because you're talking about lots of really interesting things in the Pandora's box.

25:30and the first piece is around this idea of sort of disconnect from emotion and not connecting. And I suppose my experience of working with lots of adults with ADHD is that sometimes we actually really connect, but it's almost nonverbal. We can feel a huge amount in the relationship or in the atmosphere, but we may not be able to put it into words or know what it means. and it's not quite the same as what's coming in the actual spoken language or the behavior so sometimes people neurodivergent people both those with autism and they actually have a huge hugely developed sixth sense a sense of what's going on here um and so we've got to work with that and hold a space for that and that can be super distracting and then we've also got to work with the and yet this is what we are doing now and in this room we are doing this so now we are in a cocktail party and I must talk to you and yet instinctively I know that you are very uncomfortable and I'm not sure why is it me and I think that's hugely distracting and it makes it very hard to be fully present with yourself or with the other um I suppose that's one of the first things I want to say we often think we're not good at emotion but it may actually just be that there's a lot of emotional experience going on the surface and we don't yet know what can be brought in so sometimes a person with autism might be criticized for being too honest but they're simply saying what they feel yes or sometimes the person with adhd might be criticized for being distracted but they're holding something that others may not be does that make sense it does yeah it makes total sense i think i relate to it you sort of you you've got the sixth sense you're able to pick up on energy that perhaps many people miss you can notice a shift in someone's tone or you can detect if someone's not being genuine i think it can give you a great sense of judge of character.

27:26If you walk into a party, for example, and you're having a conversation with someone and there's a part of your sense that you think that person over there, I haven't spoken to them yet, but I can tell they don't like me. If you're constantly scanning the room, maybe subconsciously, and you're totally aware of everyone's opinion of you because you just have this instinct, can that be a blessing or a curse?

27:52Dr Judith Mohring:ultra running shoes are all about space the space to go further to feel better to do something you never thought possible and this space starts with ultra fit unlike traditional running shoes ultra fit gives toes more room to move naturally so every step is strong balanced and comfortable whatever you're lacing up for stay out there with ultra shop now at ultra running.com that's a l t r a running.com it's it's an awful lot to process it can be a blessing so um you know in certain fields of work it's thinking back to kind of working as a clinical psychiatrist which i used to do a lot of you'd work with people and you'd have a sort of felt sense which you would then offer as something that could be interpreted and worked with and saying i'm feeling this i wonder is that true is that right um so the felt sense can be a real blessing but where it's a curse or where it's difficult is it's an awful lot to process and we haven't talked so much about burnout today but I know we we know burnout's a huge issue processing all of that sensory information and trying to bring it into consciousness or not is a lot of work it's exhausting it's really really exhausting and also checking the facts as well something you mentioned about I know that person doesn't like me we might go into a situation and see that somebody's having an emotional response and assume it's to do with us, but it may not be.

29:15So it's kind of, there's just so many different layers of kind of processing that have to take place and that's really exhausting. So sorry to interrupt your hyper focus, but I promise it's worth it. Our sponsor is Timo, the best organizational tool for neurodivergent people. Timo wasn't named iPhone app of the year in 2025 by Apple for no reason. It's the ultimate planning partner, gently helping you turn the chaos in your head into a day that actually feels doable. A day you might even look forward to. Timo is designed by Neurodivergent Brains for Neurodivergent Brains. And you can tell, it supports the stuff ADHD brains can find hardest.

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30:31Give it a go and use the link in my bio for 30 % off. Just a note though, the code only works in the web browser, not in the smartphone app. Back to the episode. I think we've covered pretty well why people with ADHD feel trapped inside their own head. I think this begs quite an uncomfortable question. Why do some people spend years in therapy and still feel exactly the same? It is a really, really good question. And I think it speaks to the fact that therapeutic relationships are really important. So finding a therapist who you trust is important because we talked about understanding which we might call knowledge and therapy isn't really so much about knowledge it's not about knowing stuff it's more about the experience of being together being connected and feeling things together in a safe way and if you have masked for a very long time and I know this myself from being in therapy you may be very good at not feeling and your therapist may not pick up on that so you need a therapist who can help you kind of take off the mask and this is particularly difficult if you're clever so lots I mean not just clever but there are lots of people who are good at masking you don't have to be clever to do it sorry that sounded bad but um I know myself from having worked you know sometimes people are kind of clever and good at masking it can take some time to really a create the safety psychologically and emotionally and b to to actually do that little shift because now we're moving away from this is what i know and knowledge is power and that feels quite powerful and now we're moving into and how do we feel together what does this mean to be together and to be related in this way so so interesting is there a danger that therapy could just become another intellectual exercise.

32:23I spoke to a man and he said a psychologist once told him that he didn't feel his emotions, he thought them. And he said that he went into a therapy session with a 60-page document that he had written before the assessment. He had completely, at least in his mind, he had understood what his issues were. He knew he was an addict, He knew he was depressed. He knew the theory, but he went in 60 pages and he described everything in his brain very analytically. Does that actually do anything helpful? Is there a risk that it's just overanalyzing and therapy really needs to work like we were speaking earlier?

33:07It's like starting that journey towards the healing rather than over-intellectualizing everything. You told me that story earlier and I was left with a really sad feeling, a really strong feeling of sadness because what I was hearing was someone who was working very hard on their own to try and solve the problem and coming to the therapist almost, well I've solved the problem, the algebra, the formula's done, the algorithm's written, I'm no further forward. and the sadness comes from all those lonely hours that person spent possibly i mean look possibly it was enjoyable the pursuit of the knowledge the the writing of the algorithm the creating the formula but the isolation that comes from that the idea that we might solve our problems entirely on our own and how it disenfranchises the therapist and the client because like if you know the answer how can I help you?

34:04What are you here for? Is that the difference between a therapist and a good therapist? What does a good therapist look for if they're trying to see perhaps if someone is overanalyzing their situation rather than actually healing, apart from bringing in a 60 page document? It's funny, it really moves me almost in this relationship to go, I wonder if through the podcast, you and I are trying to understand our own ADHD. Yes. Whether this podcast is, because I often think we do our own work through the, through the, through the actual work that we do, we're doing our own work. And so the therapist is the one who brings the attention, the focus to right now.

34:48So in this conversation, perhaps you're doing some work about, what does it mean to analyze versus to feel? What do you think? I always find myself almost like a fly on the wall in my own lived experience all of the time like in this conversation I'm thinking does she like me am I am I listening enough am I responding appropriately is it when's it my turn to talk there's an undercurrent of anxiety which I'm super aware of and I'm I take steps to manage it I'm consciously doing breathing exercises when you're speaking very subtly but i'm aware of it yeah it's all coming from an intellectual base i'm not feeling the anxiety i'm very aware that it's there yes and for so for me there's the recognition that this is a conversation which is observed and filmed and therefore we have to be thoughtful about the people who will hear it but also about the safety of each other within this environment.

35:53So it is, I suppose, the piece, the therapist that works effectively is the one that allows their client to shift slightly, that encourages the client to observe what's going on in the here and now. And what I heard you saying was in the here and now, this process is difficult in some ways because of the the need to to perceive and to regulate and to pause and to yeah all of those different things going on at once so so interesting yeah I mean you've really really made me think and I think everything we've covered so far really is explaining why some people get stuck what we're going to discuss next is actually life-changing earlier you said something that really stuck with me you said healing doesn't actually begin in the mind so where does it actually begin um I guess what I mean by that is that healing is a kind of whole body process and we've been talking a little bit around the difference between knowing and feeling and the difference between thinking and experiencing emotions and emotions are experience very much within the body so we don't have emotions up here we tend to have them here but learning to feel them here is a process and it's a practice it doesn't for most of us i don't think it comes completely naturally and off camera we were talking about something called interoception is that what you mean by that feeling your your body and being in touch with it so it's really interesting because interoception um is a an emerging term i'm not an expert in it but my understanding is it's to do with being able to perceive physical processes so how easy is it for you to for instance instead of just counting your heart rate like this to feel your heartbeat how is it easy is it for you to feel um that you're hungry or that you need the low or that you're thirsty or that you're short of breath um but i think what we're talking about here is a step almost beyond that which is how easy is it for you to experience a feeling in the body and then be able to say I my heart rate is up am I anxious or have I just been for a run and those are two very different situations and if I am anxious is it because I'm afraid or is it because I'm in danger and again those are two different so there's so many layers and when I've read some of the literature on interoception it's very often kind of given as quite basic is how can you perceive your heart rate it's like well i can perceive my heart rate but what does it mean so moving on from that does that also relate to emotions like can you feel massively oh you're feeling something i know this is sadness i'm feeling that because i've just been broken up with yes is that yes is it a case of you can feel your emotions within your body whilst still not necessarily actually feeling them?

38:58Yes. So this is where we get into the real therapeutic work. Yes, this is good. The best therapists I've met are the ones that can slow right down and co-regulate. I talked about lightning earlier. Emotions are energetic. Our brains are basically electrical organs, electrochemical organs. Our bodies are energetic and this is energy, sort of emotional energy flowing through us and it can feel really painful. Feelings are called feelings because they hurt. They can bring us joy. They can bring us sadness. So to be able to be with another human with whom you can share that feeling and co-resonate to start with means to feel it together and then to begin to ground it and go, ah, okay.

39:51So we may be both, you and I might both be feeling anxious because we're recording a podcast. Yes. Yet simultaneously we're safe. How does a therapist put out the signals that tells that person that they are safe in that room? By finding safety in their own body, first of all. By noticing what's going on. So when we're with another person, by noticing what's mapped onto our bodies. by picking up on the cues from their client, by pausing for long enough to allow things to settle because the mind rushes forward. It doesn't want to sit with this difficult feeling for good reason because it may be painful or may feel unsafe.