Exploring Advanced MI Concepts with a Clinical Director in Behavioral Health (Part II)

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We hope you found value in part one of this podcast. Thank you for joining us for this second segment. We talked about motivational interviewing in behavioral health and so much more. You can find it here.

Welcome to today’s episode of The Communication Solution podcast with Casey Jackson, John Gilbert and Danielle Cantin. We love talking about Motivational Interviewing, and about improving outcomes for individuals, organizations, and the communities that they serve.

Today we continue with our very special guest, Aly Gibson, the director at Frontier Behavioral Health, a community behavioral health organization. We continue to talk with her about Motivational Interviewing concepts.

In this episode, we discuss:

• Getting behavior in line with values
• Developing different pathways in the brain
• Acknowledging other people’s experiences
• Looking at trauma from a power and privilege perspective
• Delivering MI concepts on a broader scale
• The thinking Cortex part of our brain.
• Focus and motivation
• Stress and ambivalence
• Using MI on yourself
• Getting clear on who you are
• Cultural differences
• How does communication impact the human brain
• Difficulty maintaining access to a naive brain
• Reflective listening and empathy skills
• Aligning behavior with values
• Moving forward vs. staying stuck
• And so much more!

You don’t want to miss this one! Make sure to rate us or share this podcast. It would mean so much to us!

This is part two of a two-part podcast. Thank you for listening to the Communication Solution Podcast with Casey Jackson and John Gilbert. As always, this podcast is all about you. If you have questions, thoughts, topic suggestions, or ideas, please send them our way at casey@ifioc.com. For more resources, feel free to check out ifioc.com.

Want a transcript? See below!

We hope you found value in part one of this podcast. Thank you for joining us for the second segment. Hello and welcome to the Communication Solution Podcast with Casey Jackson and John Gilbert. I’m your host. Danielle Cantin here at the Institute for Individual and Organizational Change, otherwise known as IFIOC. We love to talk about communication. We love to talk about solutions, and we love to talk about providing measurable results for individuals, organizations, and the communities they serve. Welcome to the communication solution that will change your world.
Oh, I love that. I love that you’re a mix of all of it. And it is, I laugh sometimes cuz there’s a couple of phrases I keep reminding myself of. Feels ain’t real. . Yeah. Really? Yeah. Aren’t real. And so I have to remind myself of that and then I also love that. Okay, cool.
Danielle, this is awesome. That sucked. And, you’ve got 10 minutes to have like a full on pity party. . Yes. And like putting it in a container of time or something can remember. I’m so glad I’m not the only person that does that. I literally am like, okay, timer set. Okay. Yes. And we’re done. Like, let’s move forward.
That reminds me of a one-liner and a conference. I heard, there was this activity we did. The facilitator said, we’re gonna allow you to whine, but we don’t allow you to marinate in it. So and I lo I just love that, that it’s like, yeah, you can, you can get it out and then you’re done. Like there’s no marination.
So I just thought that’s that same construct about Yeah, acknowledge it, it’s real. Now let’s start getting, you know, where do you wanna go from here, kind of. , but, and, and this is the thing I wanna just wrap into it in terms of I want to continue to not minimize people’s experiences because the link that I continue to make to the brain science side of it is when there is so much stress and pressure and, and trauma neurochemically, it is so hard to get up into the executive function.
So it’s not just like, do, do, do, do, do. Oh yeah, that happened to you, but you know, back on your horse. It’s not minimizing on that level, the level of mindset it takes. But I also think it’s how we know that restorative process, reparative process, herbs, it, her, or, heals is repetition, repetition, repetition, repetition.
So when every day you’re just trying to go, but how do I get my behavior in line with my values? But how do I get my behavior in line with my values? But how do I get my behavior in line with my values? You’re developing a new neural network. That when stress and trauma comes, you’ve got a freeway to hop on to get out of, you know, the rubble.
And so I by no stretch want to minimize stress and trauma and pressure that people experience, but part of this process, . And when you think of MI for sustained long-term behavior change is you’ve gotta develop a different neural network, a different pathway in your brain that, how do I get out of the rubble when rubble happens?
And it, and just because that exists doesn’t make it simple. It doesn’t make it less painful. It doesn’t mean there’s not legitimate resistance and sustain trauma there. But if you’re trying to move forward in your life, if you don’t have a freeway to get onto, that really makes it extremely complex.
So, you know, that’s interesting because I like that you brought it back to the science of it. I’m always fascinated by, you know what I’ve learned from you and you know, so many of us are in a trauma state in general. Yes. The entire world from a worldwide pandemic. Still. Yes. And, and then we all have all of our individual traumas.
And some people measure those, right? Like, well, that’s not, yes, that wasn’t that big of a deal. It could be my pen broke. It could be so many different things. And of course it could be really, really huge things. And so the fact that motivational interviewing addresses that and helps people in a state brain science state right in of trauma.
Yes. To let them choose that other path, but it’s repetition that’s gonna help. You know, I turn the line on. Yeah. I think the other thing I need to acknowledge, and then AlI know you’ll have a ton of thoughts about any of this stuff, is I think the biggest thing I need to knowledge right now is just how lucky I am with the power and privilege that I have as a white.
Because when I step back and look at the trauma, I just really, I continue to have this need inside my brain to continue to acknowledge, to not minimize other people’s experiences. And I’m in a place of power and privilege, which has allowed me to stay more in my executive functioning and not from a cultural perspective where I’ve been abused or marginalized for so many, you know, since birth, that it is much easier for me.
So I think it’s, it’s, it could be trite for me to say it really is that simple. . Structurally it is simple, but actualizing that is extremely complex and so I need to get out of a, a, a privileged white male perspective and also be able to go, yeah, it, you’re right. You have been able to have these things, but you also were ahead of the line gender-wise.
You’re ahead of the line race wise, you’re ahead of the line. So many other ways that of course it was easier for you to do that. Even though I’ve experienced all my own trauma, in my life, it’s, it’s just completely different when you put it into cultural context and, and we’ll look at it from a power and privilege perspective as well.
So. , which I’m sure Ally, you have hundred thoughts on. Yeah. Well, I was thinking about since the training with you, I, there’ve been two huge kind of buckets, different buckets that I’ve been thinking about, and one of ’em I keep going over is like, okay, for the general population, for people who don’t have an MI background and motivational interviewing in behavioral health.

Motivational interviewing in behavioral health

How, how do we get these simple Yeah. Very complex things delivered to them without saying, Hey, can you go see Casey and John? You know, like, I, like, I can’t take all my friends and all the people I know who are experiencing ambivalence and funnel them to someone who does mi. And so I was just thinking about like, how do we deliver these concepts on a broader scale?
Is there a way to do that? You know? But I went back to kids. You know, I’m a mom. I have two kids, and I’ve really attached onto like Dan Siegel’s stuff, whole brainchild stuff to try to, like you said, deepen those neural pathways. Like I may not be able to. All the people that come to me in their life with ambivalence, be able to direct them where they need to go and give them the quick rundown of values and all of that stuff.
But what I can do as a parent is I can start to help my kids spend less time downstairs. Yes. And really grow that pathway upstairs. Yes. So that when they do have issues that are huge downstairs, brain issues. They are like, Hey, look at that stairway. I can go upstairs and solve from there. And so I was thinking about the broader population and like you said, just the amount of stress and trauma across cultures, across our general population over the last three years.
Yes. , they’ve spent so much time downstairs. What’s something we could give to people to help them strengthen that executive functioning, that neuroscience piece that’s attached to motivational interviewing? Cuz again, it’s very real. It’s the science piece of it. Yes. They, it’s so, so real. And there’s a way out.
This Danielle, what she’s talking about with upstairs, downstairs, with the whole brain is that downstairs is when I’m talking about fight, flight, freeze and make my little fist. You know that reptilian brain, the limbic brain, you know, that just brain’s been around for 500 million years. That part of the brain, and then we just got our 3 million year old brain.
That’s the, the. Thinking Cortex part of our brain. We just think of the strength of that and stress and trauma. And so that’s when allie’s, it, i l the, the way that Siegel simplified it was just upstairs brain, downstairs brain. So that’s what Allie’s talking about with that. Awesome.
So yeah, I just keep thinking about how do you. , how do you get, and again, I know you can use motivational interviewing to help people, and if every person that stopped by my door or called me after work, during work, I mean, I would have no gas in my tank. Right? Like, I can’t, I couldn’t manage at all.
But what, how do we help people see this piece of it and kind of open their eyes and maybe we can’t, right? Like, How I wish this would elaborate, and I know it can be used by all other kinds of practitioners, and I think there’s, there’s certain circles of the health and wellness space who are really, you know, have adopted motivational interviewing, have even, brought this focus piece in stuff like that.
But how could we get this across different? , I don’t know, different providers for all sorts of different issues so that people feel like they have more good days than bad. They are able to solve issues on their own. They’re using, you know, they’re, they’re calming that primal functioning with that executive functioning.
Yes. . That’s just what I keep going back to is like, I wish there’s a book, a single book that someone could read and just move through, you know? Cause sometimes I all have friends that are like, Hey, I’m kind of struggling with this. I know that you. Have followed a nutrition plan for years. How can you, can you help?
And I basically just give them like, okay, let me tell you about motivational interviewing. I have five minutes, but you gotta find some focus. That’s your problem. . It’s like, that’s not helpful, that’s not accurate empathy. But I’m, I don’t have time to help you find your focus today. Like so. But I just, sometimes when people are having ambivalence or issues, I’m like, you should look at focus, motivation, interviewing and go find your.
Yeah, find someone who can help you find your stuff, you know? So that’s what I kind of just keep coming back to. It’s interesting because, one of the newest things be since Daniel’s, you know, been on the team just even recently, she’s really been focused on us doing this thing called Be the Change. So now I’m gonna do my first training for people on how do I apply it in my own personal life.
And so it’s kind of that range of, yeah, the concepts are there. And again, you know what I see? We train so many different organizations, it’s. Mind blowing to me. Just even this last week’s trainings, I’m just still kind of teetering from, and because the diversity at which you can help people heal, like you were saying, Allie, it doesn’t really matter the profession because we’re dealing with humans in most industries every day, and motivations and method of communication that helps heal, it helps people move towards who they want to be.
It helps resolve their stress and ambivalence. So they can get clarity and, and improve the quality of their life if that’s what they choose to do. So, so there’s the thought of how do I orchestrate the conversation? But even this, this week in training, almost every week in training, Peop, especially new trainings, people will come up to me and say, Hey, how do you use this on yourself?
Can you use MI on yourself? Can you, am I yourself? And it’s like the, the constructs, yes. I mean, of course there’s gonna be all the people in the MI world that say, well, you can’t mi yourself, but. I live by the tenants of motivational interviewing every single day for myself, and it’s drastically improved the quality of my life.
You know, and that’s so, it’s like, yes, we may not be able to put quotes around Aming ourselves, but can we get clear about what our values and goals are? Can we acknowledge where the stuckness is? Can we acknowledge where the resistance is and then make a concerted effort to go and with all of. Capacity that I have, I’m going to try to focus on the change and the commitment and move steps forward towards who do I want to be?
Who do I wanna be in on my life? And so it’s more like, who do I want to be than, where do I want to be? And the clear eye about who I want to be helps me understand where do I want to be? You know, should I stay in this relationship? Is this a career that I really want? Who do I want to? . And I think when you start to focus on that, it starts to untangle our American culture perspective is that our job defines us or the number of kids that we have or our gender defines us or these things that we, everything tries to define us.
And the people that inspire us the most are the people that get, are very clear about who they are and stay who they are in spite of all circumstances. Those are the people that tend to inspire. and, and I think that’s where you can see all these different constructs kind of coalesce, into a process.
And for me it’s why motivational is so, it it really gives me a scaffolding to understand all these different theories and self-help and, and therapeutic approaches and, and how we live life. There’s just, for me, it just, it really does start to set up a structure or organizes things in my brain in a.
Clear and concise way that consistently works, and it’s backed by, you know, massive data. And as soon as you look at the ways of introducing mi in different constructs and motivational interviewing in behavioral health you’ve got all these other theories that are out there that actually support each other. You know, I was just telling, so I just, oh, I was telling, talking to somebody yesterday.
I used to, to work with Jose, Guama, who’s, on faculty at Pepperdine right now. He and I were talking on my drive home yesterday too. , and I’ve really been into this thing about we need to be so aware of cultural differences of gender, difference, of bias, all these different things. We have to be aware of it.
And inside that vessel is a human brain . So it’s a, it’s a human brain, so we need to be aware of the vessel, but the human brain, we know how language impacts the human. and, and language is language. So it’s not just mainstream American English. We just know how language impacts the brain and with neurolinguistics and, and things, which neurolinguistics is not motivational interviewing.
But when you just look at some of these theories, it’s like, well, they’re just, some of these things are just reset in different ways because there’s all these inspirations from different people around the world, but when you get back to it, it. The human brain , and you’re talking about communication and how does communication impact the human brain?
How does my own bias impact how I communicate? How does my own bias impact how I listen? Because there’s different listening styles. You know, the listening styles is not part of motivational interviewing, but when you’re thinking about communication, how could it not be part. Communication, like an effective communication method.
So the complexity of all these different things still can boil down to is my behavior in align with my values ? So, so it, it just, that’s where I can get so complex and just almost impossible. Get your hands around and then also be able to be consolidated into, when I feel heard and understood, I can breathe a little bit better.
When I can breathe a little bit better, I can look at what my dilemma. , when I look at my dilemma, I can, I can get clear what my values are, and when I get clear what my values are, I can ask myself, what would it take for you to take one step in that direction? And that, that’s going from kind of the, you know, meta to the micro.
It’s just, and that’s, that’s, that’s my obsession with motivation. . Wow. I’ve got, I’ve got a couple thoughts a, I’d love to hear your feedback on. I feel like you just covered a lot, Casey , there’s, there’s a couple things that stood out to me. One is, how you are so into learning everything about the brain and all of the other different theories and modalities, which makes sense to me cause I’ve heard.
So many people that you’ve trained say that you’re different. You’re just, you’re different in terms of training, motivational interviewing, and it feels like you pull in some other things that kind of refine, refine it or make it, make it yours in a way. You mentioned you created Focus Mountain, which is huge.
I, everybody I interact with brings that up. Your teachings around that, but you mentioned too, and there’s other things like Simon. Golden circle his why. Yes. And I’m like, I’m really familiar with that. And I’m like, what you do is different. And it kind of came out for me in, in everything you just said in Be the change.
And I’m like, yes, it’s a being this, it’s who you are. Yes. It’s not where you wanna be, this piece of the equation, but the crux of everything is who do you wanna be at the end of the day. Yes. It’s just so cool. So I’m super extra excited about the be the change now, , it’s just everything you say. You know, it, it, it’s interesting to you, it, it’s interesting when you say that, Danielle, because I, what I’ve tried to do, and John and I have had these conversations multiple times, is one of the hardest things for us in doing curriculum is to try to maintain access to a naive brain.
Because every time we evolve our curricul I actually had this conversation with, Allie and her team when I was doing the train the trainer for them in terms. The more they learn, the more they want to teach. But the, what you want to teach is so far beyond what a naive brain that’s never experienced MI is.
And, and so there was a period in time where we just had to pump the brakes at IFIOC because we, we had drifted so far from our original trainings and people liked the trainings, but they weren’t getting some of the foundational things. And then again, going back down to the mi, the minutia, when I was talking to, to Jose about this.
Because he, this, he’s teaching counseling theory at Pepperdine and is weaving some MI stuff. And so he and I are having this conversation and he, he wanted some, some tips on this and he’s, and I was saying, you know, here’s the ways I’m teaching empathy. And he said, Casey, they can’t do a reflective statement.
I will teach them and tell them how to do a reflective statement, students at Pepperdine, and they’ll still ask questions and like, and so it helps me to hear. When we’re talking these lofty geek motivation and constructs that it really is hard for people in our culture, especially, and he said it’s, it’s worse with the social media culture, is they don’t understand what empathy is like.
They can’t, they can reflect how they feel about a situation, but it’s so self-centered and I think it’s partly from the covid. I think it’s partly from the immersion in social media. That they can only talk about their own brains. They have a hard time going into what could possibly be going on in somebody else’s brain.
It’s all projection. There’s no true accurate empathy and it was just like, that is fascinating and it makes sense when you step back for a minute, you know when kids had hadn’t been going to school and we’re going online like they didn’t have that and everything’s on the phone, you know, it’s just, wow.
I’d never even thought that They don’t have the capacity cuz they. Their friend didn’t wipe out on a bike and they run over to help ’em up and, you know, and run and get the parent, you know, it’s, they don’t do that as much anymore. You know, , that’s just the way we were raised was, that’s where empathy comes from.
But if you’re not having human interaction and your friend’s not wiping out on a bike or, you know, it’s just, it’s, it’s, somebody breaks up with somebody and there’s just revenge. There’s not empathy. It’s just, it’s just fascinating. Is that, are you retooling the way you look at teaching empathy because of.
what I told him, as I said, what really helped me is it helps my brain go back to naive brain and I said the, the difference between what he’s teaching and I’m teaching is he’s teaching new clinicians that are young college students. and he’s just saying the generation generational difference. And I said, and I am drifting away from teaching quote unquote reflective listening and open-ended questions because people have been in field for 20 years, just want to stick their finger down their throat.
If I start to teach about the ORs, because they’re like, I learned this in grad school. You know, and they think that’s am I, and they try to reduce it to that. And then I spend more time trying to untangle that construct when I’d rather teach them about what is high accurate empathy. , and if you’re doing high accurate empathy, they’ll be reflective listening in there.
But the cons, what is, what is ours, Casey? The open-ended questions, affirmations, reflections, and summary statements. I mean, that’s . The fact that you’ve known me this long and don’t know those, I can probably, I’ll get kicked outta mint. Actually, listening to this, they’ll kick me out. The fact that
you, you’re forgetting Casey, that I’m, I’m doing, I listen as a listen. So I know who’s listening that doesn’t know what yours is. Yeah. So it, yeah. So the open-ended questions, affirmation, reflections, summary statements are, are, are, micro skills. They’re just skills that every practitioner. should have needs to have if they’re going to, if they’re gonna work in human service at all.
There’re skills that everybody should have and they are the basics of motivational learning. It’s just literally MI 1 0 1 is people need to walk away knowing what the OR skills are. But since I teach so many, Professionals that have been in the fields for years, it, it can feel condescending in some ways, or redundant or I literally can see their brains shut off and, and reach for their phone to do something else while I would teach ours.
And I just think that’s not a good use. But it’s, if I launch out of the gate talking high accurate empathy and then start to show them videos and have them try to practice, they realize they’re not as skilled at that as they think they. And as they get more skilled at understanding empathy, then they get better at reflective listening.
So it’s just, it’s just different ways of training, just different ways of teaching the same constructs, and it’s all motivational interviewing from that lens. . So, and I think one of the things, and I know we talked with you about this, Casey, that, that we’re running into with this accurate empathy piece too, and just, you know, the last however many years is people are so concerned that, you know, if somebody’s topping talking about, topic or an issue that maybe they don’t align with or in society is seen as, you know, something they shouldn’t align with.
If I give a reflection, They’re gonna think I’m in agreement with them and, and we go with this a lot. And, and so then to like, kind of tie to what we were talking about earlier, but if you have really strong values and a really strong identity, then you know where you are. Yes. Right. So it’s, you know, there.
There have been times where I think of reflections I’ve given and someone’s like, oh, you totally get, get it right. And it’s like, well, actually it has nothing to do with me. I don’t agree with you. I don’t totally get it. But I’m so clear on my identity and my values in that it doesn’t matter. Like I don’t lose sleep over it.
I don’t sit in my car and go, God, I hope they don’t. that I agree with them. I hope I don’t think one minute about it cuz I know where I’m at right. And I know who I am and so I, that’s something that keeps coming up with our newer, greener people we train is this idea of like, okay, accurate, empathy’s cool and all.
And I don’t want those words coming outta my mouth cuz they may think so again, emotionally driven. Yes, they may think I’m A, B, C, and D or that I agree with this. And so that’s been a really interesting thing to navigate. Training, you know, newer people as well, is people are very, very cautious about, what’s coming out of their mouth and the perception of the person across from them, which is interesting because it, I can go empathetic with that.
And what I think of is why, if you’re getting to a better outcome, why do you care if they think you agree with them or don’t agree with? because that, oh, they agree with me, is a blip on the radar of an MI potential conversation. Use motivational interviewing in behavioral health. And what it is, is it’s so focused on the individual. They’re not really focused on you.
So why are you focusing on you? Because it really is. So if in that moment Danielle thinks I agree with her and she continues to talk about her life and. Split second, she thinks, oh, we’re on the same page, and she keeps talking about her life, and I stay focused on motivation. We can keep her brain focused and can help her get her behavior aligned with her values.
Where, where was that blip on the radar? What, what impact did that really have on do you think she’s gonna go home and go, oh, Casey agrees with me. Casey agrees with me. She doesn’t care. No, she’s not gonna think about you at all. She’s gonna, she’s not gonna about, she has her own life and people tend to be more self-centered.
So why They’re, we’re egocentric enough to think, oh my gosh, if they think I agree with them, that’s gonna over influence their life. And I think, well then you’re not an equa poise and you’re too involved in their life. So it’s, it is fascinating, but, , it’s, I do have that empathy for more of a naive brain that it’s just like the, when your brain has not experienced it consistently, it is hard to make it second nature.
And when it, when you do it consistently, it becomes second nature, you think, boy, that was a lot of wasted energy, which goes back to the original thing we talked about, the start of the podcast of it is amazing how much time we put into things that aren’t gonna yield a positive outcome. , it’s putting your foot in the right, it’s in the right direction.
We’ll get you one step closer. And even if you are climbing up the mountain and you take a step, it doesn’t mean you don’t take a step forward towards the top of the mountain and your foot ends up in some brambles or you twist your ankle. I mean, just because you’re moving forward does not mean that there’s not stuff that happens.
So it’s that same thing, that it’s not this, once you’re there, it’s this perfect path. You’re still walking up the mountain, but you can. You know, trip and fall and break your leg and, you know, and, and fall forward and break your leg. Life still happens. It doesn’t make it perfect because we, you know, you operate from this mindset and you’re still walking and you’re still walking.
That’s the piece I come back to is, and you’re still moving like forward. You’re doing actionable things moving forward instead of staying stuck in this weird momentum in your brain. Love it. Allie, thanks so much for, this is just, this was just. This is what I love about what I do. I , I never know what it’s gonna go.
I, my brain is working a million miles an hour, which is always fascinating when I do that on a Friday that it’s like, I wish this was a Monday because I’m so lit up right now. . Yeah, . Thanks for having me. It’s great. I could talk for hours. Well, you know that, but . Awesome. Danielle, any thoughts as we’re wrapping up?
No, I just, I wanna thank you both so much. It’s so great to listen to the deeper conversations and then also your, both of your abilities to, kind of come back and, and go back to the, the starting point for someone, someone new like me. And, and for our listeners too. So all of the listeners out there, thank you so much for joining us.
Allie Gibson, you are awesome. Thank you Casey, as always. And, tune in. You guys, share your thoughts with us. You can email casey @ifioc.com. Let us know what you’re thinking, any ideas for topics and guests, and keep tuning in. Thank you so much. We’ll see you guys next time. Excellent. Thank.
Thank you for listening to the Communication Solution Podcast with Casey Jackson and John Gilbert. As always, this podcast is about empowering you on your journey to change the world. So if you have questions, suggestions, or ideas, send them our way atCasey@ifioc.com. That’s C A S E Y IFIOC.com. For more information or to schedule a training visit i f ioc.com Until our next Communication Solution podcast, keep changing the world.