Search
  • curt348

073 - Mandi Freger

Updated: Aug 26

Mandi Freger joins us to talk about Energy Psychology Techniques and Applied Behavioral Analysis. She talks about polarized thinking, rationalized thought and approaching the world with an intentionally different point of view. She talks about improved assessments and diagnosing, tracking effective treatment outcomes and the evolving strategies for the behavioral health field. Enjoy!


The Illuminate Recovery Podcast is about Mental Health, Mental Illness, and Addiction Recovery. Shining light on ways to cope, manage, and inspire. Beyond the self care we discuss, you may need the help of a licensed professional. Curt Neider and Shelley Mangum are a part of Illuminate Billing Advocates (illuminatebilling.com). They are committed to helping better the industry and adding value to the lives of listeners by sharing tools, insights, and success stories of those who are working on their mental health.














https://anchor.fm/illuminaterecoverypodcast/episodes/073---Mandi-Freger-e165k3m


Transcript (no grammar):


mandy fritter joins us to talk about energy psychology techniques and applied behavioral analysis she talks about polarized thinking rationalized thought and approaching the world with an intentionally different point of view she talks about improved assessments and diagnosing tracking effective treatment outcomes and the evolving strategies for the behavioral health field enjoy welcome to the illuminate recovery podcast we shed light on mental health issues mental illness and addiction recovery ways to cope manage and inspire beyond the self-care we will discuss you may need the help of a licensed professional my name is kurt knighter i'm a husband father entrepreneur a handyman and a student of life i avoid conflict i deflect with humor and i'm fascinated by the human experience and i'm shelley mangum i am a clinical mental health counselor and my favorite role of all times is grandma i am a seeker of truth and i feel like life should be approached with tremendous curiosity i ask the dumb questions i fill in the gaps the illuminate recovery podcast is brought to you by illuminate billing advocates make billing and collections simple with leader in substance abuse and mental health billing services verification and analysis of benefits pre-authorizations utilization management accurate claim submission and management denial and appeal management and industry-leading reporting improve your practice's cash flow and your ability to help your clients with eliminate billing advocates today i am super pleased to to be able to have a conversation with mandy fridger mandy has a lot of initials behind her name but she's an lpc she's not your typical counselor she's in a rare position of gaining experience early on in the first generation of of energy psychology leaders in the field mandy now has over 20 years of experience making making her a masters of art and using energy therapeutic techniques with her clients mandy also has the opportunity to assist in teaching these techniques to much more seasoned clinicians who are joining in the ranks of the expansion of the field of energy psychology before the turn of the century mandy thanks so much for being on today with us um super excited to have you yeah thanks for having me let's let's talk right let's talk well you know so you're you you use some interesting you're involved in some interesting things one is that you it sounds like you have a pretty heavy background with autistic um spectrum type of disorders and that and then you also and so you do the um you know the aba excuse me aba approach but then you also do this energy psychology piece which a lot of people may not know what that is and so maybe talk a little bit about give a little background because i would people always like to know where you come from and kind of what drives you and so give a little bit of background and then how your career evolved into these techniques and approaches that you utilize sure yeah i feel like i talk about my background and evolution quite frequently but i do think it's important so people understand where i'm coming from and you know what exposure i had and my first exposure as a clinician i have to give all the credit to my mentor dr gregory nick casilla he's a clinical psychologist in the pittsburgh region where i'm from and where i practice and i wouldn't be where i am without him but he back in the day when i was just you know getting out of out of school i was at an interesting position in my life where i had some some personal things going on and i literally just had to get a job and pick a job and start working after i graduated i did and then that job led me to dr nicosia's practice in pittsburgh and i was working before i got him i was working with adults um who were in residential facilities that had head trauma or head injuries on very um on the the continuum and so um his practice he did a lot with forensic evaluations a lot of people were in accidents did have head injuries and other physical issues and head trauma and little did i know that i was you know kind of plot you know somebody said hey what about this job it wasn't like posted or anything and i applied and i just had to go through you know 100 candidates or anything it was like a word of mouth thing and i lo behold i was you know it worked i was a match in his practice super early on in my career and so he said okay well you can help me do reports and evaluations and neuropsyc testing and then he said and then we're gonna we're gonna do some some pst work and i said what's that and then he said well this is really at the time i don't know that we coined the term as heavily as we do now but it's an intervention under um the guise of energy psychology so he was teaching and training all over the country and he said i need somebody i might set up my seminars and do the administrative piece so i would go with him and i got to help him um teach and and do some practicums after you know some time after i learned the techniques and that's where you mentioned in my bio about where i sort of was an interesting position back then um you know we were pretty judged by age and experience and so here i was like 20 you know 23 24 you know trying to assist seasoned practitioners in the field with this new technique and um you know no one really asked me how old i was but you could just tell it's like how long have you been doing i got that a lot how long have you been doing this oh you know it really wasn't that long but it was something that was really natural to me and i understood so for me i learned these like non-traditional techniques first because my graduate experience wasn't super technique heavy back then so this is where i think i'm a little bit backwards generationally for how i learned um so this was really cool it was interesting it made sense to me and then after i i left his practice after a while and i started to get into autism and working with uh spectrum disorders people said oh you know they were talking about the traditional interventions like cognitive behavioral therapy and aba and i'm like why would you do that and this is not for spectrum disorders necessarily but for trauma anxiety and i'm like that's so slow i just couldn't i couldn't rectify it in my head because again it's like i was sort of raised different in that non-traditional way so let me just fast forward a little bit when i left the practice of just doing energy psychology mostly um i got a different type of job and i quickly was promoted to a supervisor but i did have to work with kids who were diagnosed with it was autism at the time now we call it autism spectrum disorders and i remember asking and i said no i'm not that's not my thing and and i and i i like to tell this story because i hear this from clinicians all the time today especially outpatient therapists like i don't know anything about that that's a whole different skill set you know it's really specialized i just don't do that so they said well we'll teach you and i said yeah okay so i really learned from a lot of the line staff who were who were actually taught um like second generation from the lobos institute in california and for those of you who don't know that name out there really he was the one that put in into place really structured aba or applied behavior analysis training and this still today is is really the most effective um training for skills with those diagnosed with spectrum disorders i want to talk a little bit about that later because i was thinking about some of the counterpoints about aba so i thought that might be helpful to know so i started to learn this and um i'm like okay this is still i have way more questions than solutions for this and i found out that i started to think very differently about using aba that i don't i felt like i was the only one asking more questions more and more questions and like my mentors in autism were pretty clear-cut about some things and i'm like yeah but this this is different now this doesn't go this way but then what happens with this so i i kind of dubbed myself the black sheep like i was just sort of out of the box thinking with this and um fast forward in my career little did i know there was a position locally coming and the cleveland clinic has a center-based program and they were interviewing for a director and i thought you know i know i think differently about this disorder and treating this and if i'm a match i'm a match if i'm not i'm not and i went into the interview and i'm like you know they ask you typical questions like what would you do if this right right here and now with the problematic behavior and my answer is always in to this day and even with clients or it's not about here and now let's back up this is what this is the anesthesia this is way before we even get to this point let's let's see what we can do and so to me the answers were pretty simple and apparently it resonated because i got the position and i learned a lot and i'm really grateful for that position but i um really learned when i was at this center um a lot about staff and which leads me into the caregiver part of my career caregivers from your parents their teachers there anybody in the community who works with the population again the asd population as we call it now and what i noticed with my staff and i had this opportunity it was different than any other supervisor position i had before because i was in a center-based program now and i had staff pretty much nine to five-ish every day five days a week and i haven't have cameras in my office and really this was for safety for the kids but um it also helped me in teaching and training a lot of these refined skills and aba again if it was that easy and clear-cut to just learn in a week we wouldn't have advanced programs in bcba that's the advanced training to be able to be a behavior specialist influence these programs types of things going on it's really nuanced and there's an art to this there's you can learn some techniques but when you're in the moment have to apply it you have to make different choices for the betterment of the individual so i learned from my staff by watching them that i could tell when they were getting upset or overwhelmed and it wasn't necessarily with the kids in fact almost never it was with the kids because i had a really stringent screening process again it came from cleveland clinic about who was a right fit for these types of positions to work with these kids all day the different kind of personality it's a different job it's not for everybody and so i would ask my staff i'd be like hey guys how are you doing oh we're great you know and they were fantastic at their jobs so they they looked great they looked great in the cameras i mean there were flawless technique wise but one day i could see them kind of you know in the cameras after the kids left so i went how's everything going again great i'm like come on if you don't tell me i can't help you so we're doing we're doing great at work we love our jobs it's just when we go home we feel you know pretty snappy or exhausted or can't give our families or whatever and i said okay this is an aba program but i know you guys know that i have a background in energy therapies and pools i said are you up to try some interventions for yourself and they said yeah sure go for it so i i implemented a pilot study that was very messy i would love for someone to replicate this because they were just you know it was it was messy it was pilot but a free in a post survey that i made up that was probably mistake number one we'd be in the director you know all kind of those biases with research but the long and the short of it was i gave them one breathing exercise that's specific to energy psychology under the umbrella of those techniques and let me just say energy psychology is sort of the name of a field where there's many many techniques that can fall under this film i'm not going to go into specific techniques today because that'll be a little bit too too much but when i gave them one type of breathing exercise i said okay for the sake of the study you can do this it was it's two minutes you can do this in the morning when you get to work you can do it sometime on your break or before you leave and then all you need to commit to is two minutes at home and i said okay great so they did this and they did it over eight weeks and on my quality of life assessments they improved their quality of life at work at home generally but the real big takeaway from this for me and what led me to say light bulb this is what needs to happen for parents too is that they recognized when they started to shift internally when they were working with the kids and they called it flip the switch now in some of the technical techniques in energy psychology we call that a reversal on someone there's different levels of them but they called it flipping the switch and they describe that as i'm working with the kid i'm focused and again for many people listening if you think about your job when you're sort of in the zone and when you're productive and getting a lot of work done versus those days where you can't focus and you're just you know i have to come back to this and i'm falling asleep or i want to you know open another tab or something they used to call that flipping the switch when they would start the zone out and they knew they needed to flip the switch back to focus so what they learned to do was they learned when their thoughts started drift out here again uh-oh flip the switch and come back in so they didn't need the breathing exercise over the time it was just an intense mindfulness that they applied to this to know when hey pull it back a little bit and this was fascinating for me because as far as energy technique goes and being able to use these tools for people who aren't trained and i'm doing them for years this is super advanced to be able to do so i was really impressed i mean i just had a stellar group of they were young women most i don't think i had an email staff at the time but they were just you know phenomenal people so they really understood this concept and how to stay centered grounded whatever word you want to put on it so i thought maybe i should be translating this to the parents because in my energy lens i could see where the drains were happening i could see the parents escalate with the kids i could see the overwhelm in the family system you know all of these things you know if a parent with a child with a spectrum disorder would come into an outpatient setting which is rare and i can talk about that too um you know that's just tired i'm overwhelmed and we might think oh i but you do what you would do with anybody and just treat that so i thought these tools are quick and that's the missing piece for these parents there are many books out there for caregivers that talk about um taking time for yourself and you know we have hear that proverbial work life balance all the time but for this population that's almost even um more saddening to hear those ideas for interventions because they're not realistic for the time that they need to interact or manage or keep their child safe you know these kids have a lot of different types of behaviors and some of them quite frankly are unsafe especially when kids are younger and don't have the tools yet that they need to be monitored literally every second so i thought hey these tools are quick they're a lot of bang for your buck so to speak why not start to work with caregivers so when i left the center i went out on my own and i've been in private practice now for about six years and i remember meeting with um the liaison for one of our commercial insurance companies in pittsburgh it's a really big company and i remember telling her that this is what i'm doing this is what my interest is is specializing working with parents in outpatient boy almost no one on our panel does this and she said i can find a couple behavior specialists but not licensed professional counselors social workers you know in that realm that are on our panel to do this and i said well it's taken a lot of years to figure out how to do this 20 years ago when i started with spectrum disorders there's a lot more community-based intervention and stuff that would come into the homes and even the insurance reps would be like hey i don't know that outpatient's appropriate for this population so that stigma sort of develops along the way too that well our patient can't work for you know kids or young people diagnosed with an autism spectrum disorder so this is kind of where my journey led me now to outpatient and i i still work with adults who are not diagnosed with spectrum disorders who are struggling with anxiety depression trauma who are attracted to the energy techniques and then i i have another niche that i work with as parents and young people who are diagnosed with spectrum disorders and people ask me all the time how do i integrate my two philosophies how do i use energy psychology techniques in aba let me talk about aba a little bit i'm gonna sidebar because um one of the things i did want to mention today and this is it's i'm going to tie it back to this conversation but we as americans are getting a lot of mixed messages especially in the past couple years which has led many to very polarized thinking and we can approach the world either in a polarized way and that may generalize right to all other areas of our life that it's either this way or this way or we can have a worldview and adopt a worldview where there's some in between or i call it the gray and for kids diagnosed with spectrum disorders this polar thinking is really comfortable because of the way their brain is structured for those of us who are not diagnosed with autism spectrum disorders i call us nss non-spectrum spectrumers because we're a continuum the population is a continuum our continuums overlap i don't like the word neurotypical i don't think anyone would what that would that would be you know as more advanced as our technology you know gets i'm sure we're like oh that person doesn't look like that one and we've been typical so i don't like that but for us who are not diagnosed you know that moving toward gray thinking and non-polarized thinking usually comes from a place of our emotions or i say emotional mind right whether it's fear or excitement or this is what i feel therefore this is my decision and i just want to say that this mechanism is different from those who are diagnosed with spectrum disorders who appear to have this polarized thinking versus people who who are not diagnosed this population and i don't mean this to be offensive but the reality is we need to talk about this neurology about what it what it is and this this black and white polarized thinking is very formulary and when this gets disrupted in the autism spectrum disorder population that's where you see behaviors right escalation anxiety because it doesn't compute and i don't know what to do and i'm overwhelmed it's less of an anticipatory fear or pulling information together like we may do as non-spectrum spectrumers make a more polarized decision so i hope that that clarifies a little bit but to go back to aba and why it's so important and why it's so structured is because it speaks to this processing mechanism this formulary way of thinking and aba should look different for different phases of development when people think about aba and this i mentioned low bossy and techniques earlier people think that this looks like a therapist and a young child sitting in a table because we see these pictures everywhere and just asking them to touch blue or hand them the right color or say this number a very very basic design for aba and really aba is just a style of teaching teachers in public education settings for nss for the non-spectrum spectrum population are teaching in a systematic way the same way that aba does they check for mastery they repeat the information all of those things that's the tool so aba is sort of the transportation device it's not necessarily always about the content and i think that that's a misconception that the public has that it's just basic this i tell you this you tell me this and it's so super controlled the reason it's super controlled when kids are young is because they need to internalize the formula kids that aren't diagnosed with spectrum spike you know spectrum spectrum is over here their brains are programmed to learn this what we call incidentally or by watching other people watching other kids we know the research shows that the spectrum brain does not learn that way so this is why aba is so popular we're feeding them and teaching them the script that these kids are just learning by watching following along and testing hypothesis right like the terrible is right can i do this can i get away with it well let's see what happens this population doesn't have those metacognitive skills yet to do that and so i think a lot of the misconceptions about aba come down to not understanding the neurology and not understanding the piece of that the executive functioning and again you know in every field and every discipline you're going to have much better aba therapists than other therapists and it is very difficult to for an aba therapist not to get into a polarized way of thinking again and assessors like we struggle with this all the time and how to like not let our emotions get in the way and be able to fairly see some gray and different avenues and this is imperative for a behavior specialist or those developing the plans working with these kids with autism spectrum disorders or therapists or parents to be able to understand the art of implementing aba this isn't a spoon fed technique like math it is the basics are math but then how we make the decisions in the moment like i said earlier are really up to the skill and neutrality and the energy field of the therapist or caregiver i love the way you kind of go through all of those different aspects and tie it all together because and i love the gray area right because nobody is the same and you're right you know we we know these commonalities about people on the spectrum you know and who deal with the spectrum we understand you know the way their brain functions or doesn't function but there's no you know one shoe fits all they all have a little that's why it's a spectrum because they're all in a different place on that spectrum you said something that i thought was caught my attention and i want to make sure i understood what you said is that these kids who are on the spectrum and they're working with them and they're doing the aba techniques and training and teaching them these um social skills that they're not able to pick up you know by trial and error um and what you said was that they don't have the the ability for magna cognition metacognition yet so talk about that piece so what you're saying is at some point they're able to capture that and be able to learn how to do that what's that look like yeah with a lot of work and that's really my area of passion so most of the young adults teenagers that i work with now i'm moving them into that area so let's talk about what executive functioning is first because i mentioned that term those are the cognitive processes that we all do every day to assimilate information to interact with others basically everything we do and there are a lot of different areas of executive functioning when we can assimilate all of those parts together then we can do what we call like a self-check we can figure out what we know what we don't know we can look at the world perhaps through someone else's eyes maybe a good practical exam example of metacognitive use or implementation would be i have to get my mom a birthday present oh i'll get her a dog okay so let's look at that that thought process right if this is you know a young person who curiously wants a dog right they think okay well i want this therefore they want this or i really want this so maybe i'm if i get it my mom won't won't hate it and then i'll love it so i benefit so that line of thinking is not staying person outside and look to see how emotional i was too i'm excited because i want the dog so whoa our emotions are running high so if we take ourselves outside of this lens if we really want to think about mom what we would say is hmm i wonder what mom would like not what's easiest for me not what i want not what's cheapest not not what's the most convenient but what would she like okay well she would like a vacation to hawaii but you know i'm only 22 and i really can't afford that so what else what other kinds of things does she like going through this type of reasoning process involves attention these are the parts of executive function it involves attention it involves problem solving and it involves past saliency which means picking out the important parts um it also has to do with inhibition right oh i'm just going to jump to that dog because i'm excited now let me take a step back and there's a few more pieces of cognition that fall into that but when you put all those together you have a clear ability to be able to see lifethrough another's lens do a self-check and really self-monitor is what metacognition is in a in a nutshell so for me the challenges is moving these kids one of the critiques of aba that i just read and preparing for this today was that this actually came up this week too in a session about kids that are then they get sort of um dependent on positive reinforcement they're looking for an extrinsic reward well i like to help families move off of this extrinsic motivation and get the kids more intrinsically motivated the reason we don't do that right from the start with kids with respect from disorders because if you think about that that intrinsic motivation involves heavy mastery of metacognition and this has to be taught which means all of those other pieces of metacognition have to be relatively mastered this is why this is so complicated this is why this delivery system of aba starts out with these big concrete reinforcements this is why when you see a five-year-old getting a half a gummy bear every 15 minutes and nutritionists will say that's terrible you're just stuffing the kid full they need to start pair a high motivator to understand and learn the idea of motivation and reinforcement and then after they get old enough after they have enough language then we can move them from having this conversation about intrinsic motivation but guess what when we're intrinsically motivated us nssers are we really you know is this like you know it's the age-old question and or the social work programs right is altruism you know is there such thing as true altruism what really drives us and this is where i pull my aba back even with my clients who are not diagnosed that we have our own mo we have our own motivation for what we want on any level whether it's our basic needs whether it's what we want out of you know our family relationships our friends relationships what we expect we have an internal drive these kids have that too we just have to help them and this is where the art comes in it's not just like okay i'm going to teach you intrinsic motivation now we have to help them understand how their behavior affects people around them and write that inhibition piece when it's appropriate to um if they're intrinsically motivated to get what they want what's appropriate to say that or not and then how to get those needs met and to move away from the tangible and that's really hard i mean if i ask my clients that are adults who are not diagnosed you know why do you go to work and they're gonna speak for money that's a tangible reward that's what we're you know some of the critics of aba are saying move them off that but in reality that's life and that's kind of how life works you know if you ask someone who might be pretty established like um someone who's followed uh cubbies the leadership right examples you say you know what what are you um how did you get to this place in life and a lot of people say i had goals if that's not an agenda or motivation or you know a sort of some sort of extrinsic word i don't know what it is so to me there's a fine line between an extrinsic reward and an intrinsic motivator to get that reward i mean quite frankly i'm teaching the kids practically how any other adult would think if they say well i don't want to work i said well you need to get money look what you can do with money you know one of my kids says well i don't know if i'm going to be able to afford my specialized diet well you know what if you keep heading down that you know career path that you're doing so well at you're going to be able to right so that can start to generate and make the formulary for the intrinsic motivator for these kids so this is so complicated but it takes a lot of thought and metacognition on the part of the therapist to be able to put yourself in that kid's shoes or that young person's shoes really figure out how they think not analysis for that paralysis i know we kind of use overuse that term on the the internet but try to see how they make connections to things know their preferences and then when you can put yourself in their perspective it's easier to find things that resonate to teach them how to move from this phase to the other phase another big key piece for this are the people around them right teenagers are still living with their parents so this is a lot of the work that i do with parents families caregivers guardians to help them really understand what i'm talking about you know this is making sense to you you're a clinician you know you're well trained in this but most parents who aren't have not really thought about you know this is the way my child thinks differently oh yeah now that you're saying it i see how they do this but i never really thought about it well it probably didn't have all the information to think about it that way and now it makes sense this is hard when we move into sort of the ex the um out the realms on the outside life domains for kids and when other family members try to offer support or are friends and they kind of say the wrong thing at the wrong time because they don't have a good foundation of what i'm talking about either and this is another issue that i talk about with parents in outpatient and a lot of parents will come to me and say you know i want you to see my father's diagnose with a spectrum disorder and outpatient and i usually say well my protocol is as i start with you first because there's a lot of psychoeducation that needs to happen a lot of the families and parents that i work with have been through the gamut with maybe they have a good understanding of it um but they've they've been parsolated in their understanding about this executive function piece so i like to pull all that together and quite frankly when the parents are on board with their skill level and their willingness is usually high unless they're burnt out which then comes into the energy piece which i help them with we strengthen their resilience they have the tools and things actually start to go much better at home you know despite the child's product she did nothing no intervention with the child yet and i just work with parents i already see progress when that happens with everything i'm talking about i love the way you've brought all of these different approaches together and and the structure of the aba which is necessary like we all need structure right um and then the being able to that's the the i'll use this word the beauty because i think you know the spectrum people on the spectrum there's a beauty to them because they the way they think might be different the way they process might be different but oh they have strengths that i do not have right there are some that could sit down and do data entry and get just so much pleasure out of that and and you know hurtful things that other people say they don't even process that right it doesn't even affect them there is a skill set that they have that part of me says i don't really want to take that away from them right um that that there's a place for them in our in our society when we understand when we're educated and when we understand how to integrate with them and and work with them i think um i think that on a lot of things i think that about people that are you know that deal with um uh adhd you know and they've got that activity stuff or inactivity there's there's there's value in that right it's like how do we hone it in how do we get it going in the right direction because man i wish i had your energy you know and so i i think changing the way we think about those and i i'm going to use this in quotation marks disorders i really don't like to say that people have disorders but it is it is it infringes on their capacity to function and so when they have the help that they need and and the you know the approaches that you're putting together are incredibly successful and i can tell by the way you're talking about them and the success that you're seeing so i just i love that piece i am i'm i'm wondering i know you talked about this you know that energy psychology is quick and that it's very effective and it's fast and you talked about you know doing the study with some of your staff members and teaching them just simply breathing techniques and i'm imagining you know that that one breathing technique maybe that was the only intervention that you studied at that moment in time um but if it's so quick and so effective it and my thought my mind went there is um i'm sure that people are listening they're gonna go hey wait wait wait go back go go back i want to know what that breathing technique was right and so it might be fun to to just if it's something we could do in the time frame that we have to just briefly talk about what it is and and how it can benefit us so there are layers as i said earlier of energy psychology and it's an umbrella right if you think of a whole bunch of different techniques under there the first techniques i learned and i don't necessarily think they were because it was the primacy effect of the first but they appear to me to be the strongest and the quickest and i again i come from the background dr nicosia taught me thought field therapy this was a meridian based energy therapy and people usually will hear it called tapping so eft is another tapping therapy eft was sort of like a son of thought field therapy but thoughtful therapy was the original meridian technique and what i'm saying meridians some of you out there might have heard of acupuncture where you get needles stuck in different places to help pain or release disturbance we don't use needles but we do use those invisible energy pathways and we either tap or touch them the reason i think that these interventions under the guise of thought field therapy were so effective is because dr callahan who who originated these therapies came up with a concept which was called a psychological reversal and i see that this concept is not as directly targeted in other energy psychology techniques but to me that's the key in these holding and the treatments holding for longer periods of time and a person developing resiliency over time in my mind if someone comes to therapy and i've had this experience over the past six years in outpatient my goal as a therapist was never to keep somebody in therapy longer than they needed to be and i'm going to teach you these tools so that you can use them at home and when you need them at your own pace so i describe these sort of foundational rules to correct any of these reversals as sort of like you're stretching before you're running the race you really need to get your mind body energy sort of in alignment your antenna needs to be straight up not crooked as doctor think as you used to say that's how i first learned it um but but get us more center so that we can use our minds the way that you know to our maximum effectiveness and again lots of other tools out there will work but what i traditionally see is they have a really great impact at first and then a couple days or a week or so later you know it kind of creeps back a little bit right and this is sort of the phenomenon that we see with traditional even cognitive behavioral therapy right we talk we talk we talk hoping to decrease the somatic you know response and disturbance and fatigue that and then it's released well for those therapists out there who use this have you ever had a client where you know talking and talking and talking only creates more talking and talking and talking about the same issue and the behaviors become harder to change to me that's oh red flag there's a looping mechanism going on which again we refer to it in this field as a reversal and two breathing exercises i think are foundational for getting the system ready for one for treatment and then two managing and maintaining a state of homeostasis so that those reversals don't happen again and keep happening so what causes one of these reversals these big and scarier verses they're really not that big and scary because the cool thing is is they can be corrected in like two minutes we've all experienced the bigger kind right the bigger kind feel like when we're just having a bad day when um we get out of bed on the wrong side we just hit snooze too many times we're running late we're tripping over our pants and then what happens and then we oh crap we're going to be late and i have this meeting today and then our emotions and minds start to poop they just creep up and then it feels like it takes a while to be able to regroup and for something to go right so that's the long way around having to regroup when at that point when i hit snooze as soon as i get to work i do a two minute breathing exercises my brain is like right back where it should be why we think these work is a couple different things and why these two in particular exercises i think are effective um the number one reason is because they're not just deep breathing deep breathing right we have research to show that that's effective but these integrate the body which means that we either sit in a crossed up position or we're crossing the midline of the body while we're addressing um also the top and the bottom of the brain so while we're doing these breathing exercises so to speak we're talking to all four quadrants of the brain [ __ ] the left we're talking to right talking to top and bottom in the design of how these are done so that's the first thing the second thing is just under the guise of energy psychology techniques we think we don't know how all these tools work specifically but we think and suspect that it helps to deactivate the amygdala which is the part of the brain that is responsible for our fight flight and freeze response or polyvagal theory for you those of you out there who work with us and we're seeing this a lot out there you know even on linkedin we're seeing a lot of trauma informed care and polybagel theory and why this is so important to understand well what can happen and i see this just across pretty much in american society in general outside of the autism spectrum realm is that we're conditioning ourselves as americans to stay so activated we're crossing that threshold of fight and flight most of the time and that primal brain of ours was not developed to do that most of the time it was for when we were you know proverbially chased by uh the saber-tooth tiger right they're meant to be activated in bursts and so the bigger better faster stronger mentality the fastest the access to social media the computer our attention spans shortening what's next i can't sit though for five minutes i don't have plans this weekend all of that lends to helping that fight and flight creep up and so this we think helps when we're saying to the top bottom left that helps deactivate that and let's i always say rational mind come forward even though emotional and rational mind are not steadfast you know parts of the brain they're fluid but this deactivates the emotional mind and activates rational now let me say one other thing about fight flight and freeze for those of you who are not familiar with that is that when we're in those states science shows that our emotions are in high gear and we can't think rationally so let's let me pull this back to kids with the spectrum disorder right when they they tend to a lot of them who get upset gets hit super fast it's like a 0 to 10. a lot of them and so when parents try to use logic and talk to them what do you think happens they can't hear it and this is crisis management 101 for those of us who are therapists when somebody is that upset trying to provide them high instruction high direction it's not the time we just what are we taught to do be present and just hold the space have a safe space for the person which energetically is really us holding our own alignment to help that alignment realign which there's a cost to that i'm not probably gonna have time to do that today and i'm going down a rabbit hole but but the energy psychology techniques are fast because they go right to that and i'm seeing this more and more in traditional with traditional americans that most of us are over activated anyway so let's bring this back to the parent or the caregiver who's who has a child with a spectrum disorder like i said earlier these kids are incredibly sometimes active to the point that they're unsafe and you know what does the parent have to do i have to stay on high alert to keep my kids safe so if that isn't screaming activate i don't know what is that's exactly the design there's a safety threat a potential safety threat i'm not going to get eaten eaten but my child might get hurt if i am not activated over time this crashes and people become exhausted so this population in particular is a great match for these energy goals specifically these couple breathing exercises i have the one on on youtube the second one i have i don't think i have and i'll tell you why in a minute but we could do it together if you'd like and that's the one i used in the study because this is it's two minutes two to five minutes for these breathing exercises it's fast for this population but it's also again the most bang for their buck be able to reestablish their field quickly bring this down so they can help intervene with their kid in the best way that they can we teach this again or we're taught this as therapists and how to de-escalate crisis situations in a roundabout way without a breathing exercise but just take a deep breath stand back little tiny you know successive approximations on how to do this to get better at it as a therapist and you know this to me parents need this more than anything parents have any kids really because you know kids are the they're the people that are the closest to our heart and really they trigger our emotions more than anybody and so that piece trying to separate what your child needs versus what you want them feel is critical for the skill development especially for kids who are diagnosed with effect from disorders oh absolutely i love the way you talk about you know the technique to try and get the four different quadrants of the brain to communicate because the opposite of that when when you know you're in that heightened emotional state is that your executive brain shuts down right when we're in survival mode we don't need to think we need to act right we got to have our adrenaline pumping and our muscles ready to act and so it shuts down different parts of our brain and then they don't interact they don't talk but when the right brain can talk to the left brain it can say uh you know we might be overreacting a little bit and the left brain can go yeah logically i can see that and and so it starts to interact right so what you're talking about is absolutely imperative because those are normal natural functionings of the brain to protect us and when we can calm it and relax it then our brain starts to function again and we have that executive brain come back online and it doesn't feel near as hard or near as traumatic when it's back online which is all about slowing it down and and being present right that grounding you're talking about so i love the concepts they absolutely go with and that's the thing i love about therapy is that so many of the approaches they're all really anchoring in the same place right they're really all trying to accomplish basically the same thing only they talk about a little bit differently or they approach it a little bit differently but ultimately it's to get us to to perform at our maximum ability right and to be in this homeostasis place so i love that about you know talking about different approaches and what we've talked about today and maybe if you've got a video on youtube maybe that's something that you can share with our listeners today as we talk about you know as we as we end up and and talk about you know how they can get a hold of you because obviously i can tell you've got a lot of wisdom and a lot of understanding about not only the spectrum disorder but about you know trauma and anxiety and depression and all of those things that come along with that and so people are going to want to talk to you and reach out to you um and so we'll definitely want to get your contact information um i am i'm curious um i uh i've heard in the past i've had somebody say this and it's not it's not i don't think it's research based so i can't say that it was but whoever who i was talking to seemed to have some pretty good grounding in the autism world um and they suggested that by the year somewhere in the future we're going to have a significant more population of autism people on the spectrum and and learning how to manage that and help them with that what do you see the future of autism and spectrum disorders and managing of that yeah there's a lot to this and i have a lot of thoughts about it let me back up and first say that i think we're getting better at assessment and diagnosis which if you look back at old footage which again if i'm speaking to clinicians who have seen this in their graduate studies old footage of psychiatric institutions and you look around at the behaviors and how people are acting a lot of them are in diapers a lot of them are engaging in repetitive behaviors a lot of them cannot talk you know so we used to back in the day call this mental retardation which i think if we had more information at the time i think you know it was it was sort of that was black and white thinking and classification of a person's functionality at the time that was the best that we could do then right you either can go to school function and you have daily life skills or you're profoundly affected with these things and can't therefore you're in an institution so i don't know that we had enough information or knowledge and not say that people there weren't truly if we and we probably didn't have the technology either to do the mris to look at the brain because we can do genetic testing and we can do mris to identify the brain the you know traditional differences in the brain um with those who are diagnosed and the genetics now certainly didn't have the genetics back then so i think that there was um a lot of people went under the radar because we didn't have the information and i also think people that again i don't like this term this high functioning low functioning autism term but people who would have been able to have the life skills to go to school who might have been diagnosed might have been the kids that we thought were just quirky or different but the difference in society back then 70s 60s 80s things were more black and white they were more structured you had a one-track path a life i mean i even remember my mom saying you know if you were a woman sadly enough you would you were a secretary you could be a teacher maybe a therapist but housewife was usually the target you know for women so i mean this is like 40 50 years ago it's not that distant past and you know men had jobs they went to work there wasn't all this you know life just wasn't as complicated so there was a lot more formulary of life so i think that a lot of those people probably might have been diagnosed if we would have had more information did anybody ever out there ever have a professor in school in higher education that was super just had to be this way couldn't be that way no in between and wow they're mean they can't talk to you they can't you know the social skills were lacking too i'm not suggesting that everybody who has those behavior characteristics might have a spectrum disorder but they could have they could have so to answer your question i think it the rates are increasing one because we're just getting better at diagnostics two we are finding out there's a genetic component and so genetically right if we're reproducing more i mean law of averages we're going to have more people that are diagnosed if the population is going up um and then those who might have gone under the radar right that have kids i don't know where this came from autism i mean a lot of the times the parents that i work with will tell me that they've had their own mental health struggles at some point who have a child diagnosed on the spectrum so again maybe this was sort of under the radar at the time as far as treatment goes a part of my mission is really to work without patient therapists i have a consulting practice that i use for a lot of different things but really what i like to do is meet with outpatient therapists say you can support this population outpatient you don't have to be an aba expert you just need a couple big pieces of information to use the tools you have to support the parents to be able to know when the parents need validated when they just need to express themselves because they're getting a lot of mixed messages this is no different than i'll think about this we'll say to therapists out there now who clients who you might have gotten that are new this past year and a half that have come in who have been overwhelmed with the kovitz situation for whatever reason there's just a lot of different that we don't have nobody taught us how to deal with coped specifically in graduate school right we have to pull from the tools that we have and what we know to use to be able to help these populations and and if you can get a parent of a kid who has a spectrum disorder and outpatient go for it because again time management for them is really hard theyare the people when they say i don't have time they realistically probably don't so any way that you can get them to help support i would say go for it and i think that that piece is lacking because when we hit adulthood with this disorder services decline what i would love to see happen and i hope it's going in this direction is a lot more grant funded assisted living facilities and what i'm saying assisted living i don't mean um what anything what might pop to mind for each individual out there but really like apartment complexes who have like like the dorms with ras and so they have different levels of support depending on the person's need but they're not completely alone and without support based on whether you know they can have the funds to be able to know how to use uber or not but i think grant funding for these programs is going to be the way to go i think these are gaining momentum more in the west i'm in pittsburgh and pennsylvania in the western part of the country but this is going to be a high need because the kids when i started when these bursts of you know assessments and diagnostics will come out they're agent now they're over 21 and so that's the question where where can they live how they they can integrate in society but not like perhaps the level that everybody else can and they do need some support and their parents are aging so i'm hopeful that this is coming down the pike but in the meantime there's still this clinical gap in treatment and again i go back to outpatient therapists adults who have spectrum disorders are sometimes hard to engage in treatment because let me go back to that metacognition piece why don't why do i need to be here right think about when somebody makes a decision to come to treatment they think long and hard about what they need why they think that they're not feeling well what they can gain from this you know as far as a person with a spectrum disorder one it's very hard for them to make a mind-body connection this isn't everybody but for a lot of them and two i don't understand how you're going to help me because that didn't go well it just needs to change and i can't move past it and in my experience until they have another experience that contraindicates that experience then it's wiped out so it is very tough and again when we look at individual rights and advocating you know if somebody who's 25 and older has a spectrum disorder and their family says they need to see you and they say i don't need to be here you know we have to honor that so i think that some creative um way and i don't know what the solution is for encouraging treatment in this but maybe it's workforce based somehow maybe it becomes part of work programs that are like an eap kind of support for this population again those people would have to disclose their diagnosis whether they choose to do that an employment setting is up to them and that's another thing that i talk about with my young people you know how do we move forward as an adult with this diagnosis obviously it doesn't define you but it's some time when it you know where's the gray with this when do we need to talk about this and when do we need to talk about you other than this piece of view yeah there's so much involved this is so complex and you know involves so many aspects of life and living and i love i can tell that you're like we gotta find solutions like there's there's these gaps and there's these places where they need help and we can do this as you know as this population starts to come into adulthood and and then there's a lot of them there now right and and so you bring up just a tremendous amount of information and ideas that will be very helpful and i can tell you're such an advocate in this arena so i love the work that you do mandy i love that you've been on on the episode today and shared so much really really valuable information um maybe before before we end let's um i know you like to do the uh the consulting and training and teaching others to understand some of the things that you understand why don't you share some some of your contact information and where they can find out more about you yeah i think the majority is on my website so we'll go for that first it's www and it's just my first and last name mandyfridger.com it's mandy with an i mandy i and then fridger like refrigerator f-r-e-g-e-r dot com there's links to my youtube channel and my facebook which i post mostly the similar content on both of those i think youtube's the easiest access um i also usually you know cross-reference my podcasts on youtube too so if you're interested in hearing more my consulting practice like i mentioned earlier i do like to work with therapists and other professionals i do have this other niche about peak performance too so i find myself working with executives consulting in this whole energy dynamic when we have you know different energies in the workforce how we manage that how we use our own tools for resilience and i also work with athletes so the consulting practice is really kind of cool it gives a whole bunch of different twists on i still incorporate behavior aba and energy tools because they they're hand in hand i say to my energy colleagues because they say no behavior aba is bad i say if you don't think you're trying to change behavior you're using the ep tools then you really think again because you are everything behavior in my counseling practice i'm licensed in pennsylvania and so i'm doing all telehealth now i was probably about 50 percent telehealth before covet started and so i you know generally have a lot of gen z's and millennials and they love it it's easier for them my office was in the city so it was a lot of traffic to get to and you know now from the convenience of home it seems to be real comfortable for the people that i work with so yeah my contact information is on my website and you know more videos i have lots of snippets on youtube which i'll just point out when i was talking about the executive functioning i do have a little series i tried to keep them to about five minutes to break this down again if you think boy i'd like to know more about executive functioning because i do think that's a key piece that's misunderstood that i would refer you to my youtube channel the breathing exercise on my youtube channel is called collarbone breathing and this is the most comprehensive exercise this is the only one i have online because i am 95ish percent sure that people should not have adverse reactions to this one this is a very comprehensive exercise this is why i don't have 100 videos in you know with small snippets of techniques because i also think that this is another um a problematic area where someone might dive into something and the body's energy system is very complicated for the the person with you know not so high of a pressure problem some of these tools are great for and they can be you know really a quick fix but for more complicated issues i'm comfortable with that one on my website it's a little bit involved but i do it along with you and again it addresses top bottom left and right of the brain so i think that that one's effective my youtube channel is under amanda it's the only thing that's i branded as amanda and i don't know why but everything else is mandy everywhere but that was wow so much so much information i love it i love it i'm going to go check you out as well as i'm sure a bunch of our listeners so mandy thanks so much thanks so much for sharing oh it's been incredible thanks for having me

11 views0 comments

Recent Posts

See All

Am I getting the right number of authorizations?

Successful billers in the substance abuse and mental health sectors can get you a two metrics really quickly: 1) Average reimbursement rate by level of care depending on the insurance company; and 2)