Ask Dr. Rick About:


Is your work considered a part of Positive Psychology?

People sometimes loosely locate my work in this territory. Still, the way I would describe it is that I emphasize building psychological resources, based on using positive neuroplasticity to change the brain for the better, that people can use for healing old pain, being more effective in daily life, having more satisfying relationships, experiencing more well-being, and – if they like – growing in their own chosen spiritual practice. This approach is always grounded in realistic thinking, not “positive thinking,” and a fundamental self-reliance.

How did you get interested in your work?

Probably like many people, I had a sense as a young child that there was a lot of unnecessary unhappiness in my school, my family, and out in the world. But I didn’t know what to do about it. Then as I got older and learned about psychology, brain science, and contemplative wisdom, I became excited about the practical tools they offered for using the mind alone to change the brain for the better.

The brain is the final common pathway of all the causes streaming through us to make us happy or sad, loving or hateful, effective or helpless – so if you can change your brain, you can change your life. I have personally gained from these methods (my wife of 30 years says I have become nicer – which could be the toughest test!), and have seen many others get many benefits as well.

Can we actually change our personalities in major ways?

The basic features of temperament or personality are not very plastic, and tend to endure over time. I’m still a fundamentally watchful, shy, introverted, inclined toward anxiety kind of guy – just like I was in high school.

But how we relate to our core personality can change dramatically over time. For example, shyness – social anxiety – may still arise, but alongside it we can cultivate self-confidence, an internal sense of allies, self-acceptance, distress tolerance, dis-identification from the shyness, and other resources so that how we feel and how we act in a socially challenging situation would be much better.

If you could design a program to create a major psychological/personality change, what would it look like?

If I was going to take your challenge and design a program for a major psychological makeover, it would have these elements:

  • Understanding, accepting, and fully experiencing whatever it is that the person wanted to change. Otherwise, what you resist, persists.
  • Releasing, working through whatever was significantly extreme, pathological, or neurotic in what they wanted to change.
  • Growing the “and also” aspects of their personality that are natural antidotes for or resources for the thing they wanted to change. My framework of three needs/systems addressed through antidote experiences has been very helpful to me here. For example, let’s say with shyness, I think of this as involving both the safety and the connection needs we have – and thus involving both the Avoiding and Attaching systems of the brain. So I’d look for ways to cultivate “and also” strengths inside such as feeling protected, determined, relaxed, loved, and worthy.

What evidence or experience do you have to support your claim that you really can change your life for the better?

There is tremendous evidence in published studies on psychological practices or interventions of various kinds – including the kinds I mention, notably relaxation and positive emotion practices – that they do lead to significant improvements in mental health indicators of various kinds: improvements that do change lives for the better in meaningful ways.

  • There is also tons of evidence in research studies about the effects of frequency of spaced practice and the effects of personal effort. One implication is that for people who do not experience a benefit that changes their life in a meaningful-to-them way, are exceptions to that rule because they did not actually practice whatever it was (e.g., mindfulness, gratitude) a few times a day, day after day after day.
  • Distinct from published research, I’ve received many anecdotal reports that my statement was true for them. This is evidence of a kind.
  • I have personally experienced that my statement is true. An N of 1, for sure, but still definitely the evidence of my own experience.

As a personal detail, I worked for a year for a mathematician who did probabilistic risk analyses, and it was a fascinating consideration of levels of evidence for propositions about reality. As is increasingly noted in the scientific community, including the life sciences and social sciences, the dichotomous true/false distinction of “statistical significance/non-significance” is mathematically silly. The crux is how much uncertainty we have about propositions. Then the question becomes, to what extent do certain kinds of evidence reduce uncertainty. By the definition of information, relevant information of any kind reduces uncertainty.

Information comes from many sources, most of which are not randomized control group double-blind studies. For example, roughly half of the methods used routinely in medical settings do not have a study behind them, but they are within the standard of care because there are other kinds of evidence for their legitimate use.

Research suggests that people who use positive affirmations feel the gap between where they are and where they want to be, making them feel worse. Do you have an explanation for the seeming discrepancy this and your work?

I know about this research, and it’s interesting. I think it reveals a fairly narrow and specific phenomenon in which people who are relatively unhappy think about something positive and then feel worse because the gap between their current state and where they want to be is highlighted.

For this to occur, the “happiness intervention” must be ineffective, otherwise their mood would be lifted and the gap would close between their current state and where they want to be. So what this research actually means is that affirmations are not very effective, at least the way they were done in the study and others like it, and that we need to make effective efforts in the mind to increase happiness (broadly defined).

The sort of skepticism about making deliberate efforts to nudge the mind in a happier direction that is implicit in this study and in related critiques of trying to be happy must also be considered in light of the thousands of studies (plus personal experiences) showing the general effectiveness of interventions to increase positive states and decrease negative ones. It’s interesting that dozens of these intervention studies are published every month – reducing anxiety, increasing self-compassion, regulating anger, increasing gratitude, etc. etc. – and we never hear about them. But let one study appear from a – ah – grumpier perspective, and it’s in the news. This is what’s particularly curious to me, the investment in skepticism about and frank dismissal of deliberate efforts to increase mental health and happiness.

I was wondering how you would describe your therapeutic orientation?

I started out in the human potential movement, then got a near Master’s in Developmental Psychology, then a Master’s in Clinical Psychology with an emphasis on family systems plus Jung, then a Ph.D. in Clinical Psychology from the Wright Institute which was heavily psychodynamic. Plus along the way, I got a lot of training and education in Buddhist psychology, especially its Theravada roots. In a weird way, all these diverse influences were helpful. I suspect that like a lot of therapists, I think developmentally and psychodynamically, and act in a cognitive-behavioral way in a field of attention to the relationship between the client and me – while hoping for a measure of luck and grace!

Can you recommend any work on the neuropsychological or neurophysiological aspect of meditation?

I’ve drawn on several studies to inform my own work and understanding on the neuropsychological aspects of meditation. These include:

I’ve also found the work of Judson BrewerBritta Holzel, and of course Richie Davidson to be solid sources, as well as the book Altered Traits by Davidson and Daniel Goleman.

From a neurological perspective, are there any connections between concussions and a negative emotional personality shift?

There are several interventions and treatments that might help in this situation:

  • An up-to-date assessment with a neurologist
  • Cognitive rehab programs with a neuropsychologist such as this
  • Get an assessment from a functional medicine practitioner to ensure there are no other significant causes of the negative emotions other than the concussion, such as issues at school, an underlying health problem (e.g. allergies, etc).
  • Focus on deliberately practicing “taking in the good” by allowing and internalizing the small, authentic, emotionally positive experiences several times a day
  • Consider talking with a licensed health professional about the possibility of trying nutraceuticals (nutritional supplements such as 5-HTP) or medication
  • It can also help to ask the person suffering from the negative personality shift what they think would make their life better and happier.

Which is the better approach for people suffering from trauma or oppression: a “top-down”, “positive psychology” approach that deals with mind, or a “bottom-up”, “somatic” approach that deals with the body?

For sure, experience, learning, residues of racism, trauma, etc. are all stored in the body, usually involving the nervous system, often entwined with other systems (e.g., musculoskeletal, immune).

Some of this learning – broadly defined, including the acquisition of learned helplessness, internalized oppression, insecure attachment, etc. – can be clustered in meaningful ways, such as all the various internalized consequences of oppression.

We can get at that material through various psychological (i.e., mental) interventions including bringing awareness to aspects of the body. Some of these interventions will be “top down,” like focusing on unearthing needlessly self-critical thoughts. Other mental interventions will be “bottom up,” like sensing into the pelvic floor and relaxing and releasing buried tension there. We can also get at this material through behavior, in other words, through action – including moving the body, power-posing, yoga, psychodrama, etc., and through hitting the streets, demonstrating, speaking truth to power.

Mental interventions can improve the effectiveness of behavioral interventions, and vice versa. Behavioral interventions are not better than mental interventions and mental interventions are not better than behavioral interventions. And many general-purpose mental and behavioral interventions (e.g., developing self-compassion) that are not specifically targeted at a particular “cluster” or kind of material (such as the impacts of oppression) may still help develop psychological resources (inner strengths) that are useful for that particular material.

People who single out any one of these factors of healing and growth as “not as good as” another kind of factor are missing the point. For a particular individual with a particular issue in a particular situation at a particular time: a particular package of methods could well be optimal – perhaps more tilted toward mental interventions or more tilted toward behavioral interventions. But the value of those particular interventions for that particular person does not mean that there is anything wrong about the other interventions or that they are not useful.

“Positive psychology” has not systematically swerved away from dealing with oppression any more than family therapy, humanistic psychology, or psychoanalysis has swerved away. Fields of psychology or mental health or human potential or spirituality have a general focus by their nature. Critiquing them for not focusing on a specific issue such as oppression is misguided.

To address oppression, we need to deliberately focus on it and bring to bear all the methods, all the factors, listed above, as well as many more at the level of relationships, groups, and societies. I think this is what we should focus on! Roll up our sleeves and use all the tools and get to work!

Regarding work about ``power of the sub-conscious``, ``positive visualization``, or the ``law of attraction``, how do these ideas relate to – or compare with – what you have learned or even proved in the science of positive neuroplatiscity?

Let’s think about it at two levels: (1) what’s called the “natural frame” of ordinary reality and (2) whatever may lie outside of it, which I’ll call the supernatural.

Inside the natural frame, there is lots of evidence that imagining our goals and having related experiences can build up inner resources, woven into our body (mainly the nervous system), that can help us achieve our dreams. Of course, we need to take skillful action as well. Think of the old line: “genius is 10% inspiration and 90% perspiration.”

As to whatever might be supernatural, my personal opinion is that there are such factors, and who knows, it could be helpful to a person to open to, invite, and draw upon such forces.

This said, I think that most if not all of the factors that shape a person’s life are to be found inside the natural frame – and there is plenty of opportunity there for psychological healing, everyday well-being and effectiveness, self-actualization, and spiritual realization. So personally that’s where I focus – including in my own practices of imagining and giving myself over to that which calls my heart.

Can you explain what you mean by “ego proximal and ego distal?”

This is a general notion in psychology. The short explanation is: Imagine your psyche/mind as like a big field with “you” – the central core of your sense of I and me – at the center. In this field are all kinds of sub-personalities, tendencies, qualities . . . such as friendliness, cruelty, fascination with motorcycles, role as a parent, craving for chocolate, mysterious deep wellsprings of wisdom, sexual kinkiness, enjoyment of cooking, commitment to exercise, fear of spiders…on and on and on it goes.

We are multitudes! (adapted from Whitman) In the field, the closer that psychological quality is to the core “you,” the more you are identified with it, and the more it feels like “me.” This is “ego proximal.” The farther away the quality is in the field, the more it is “ego distal.”

A good way to help yourself to heal and function and grow is to nudge some of your qualities more toward the periphery so they don’t have so much power in your life, like regarding a harsh inner critic as “not-me, I have this but it’s not that I am this.” And to draw some of your qualities closer to yourself so you are more identified with them, given over to them, integrating them, lived by them.

Do you have any suggestion on where to study for an advanced degree in Counseling Psychology?

Work backwards from the result you want. Specifically, do you want to get a license to practice psychotherapy/counseling? If you don’t want to get a license, you can get just about any kind of MA or PhD that interests you. If you want a license, then you need to make sure that the institution and degree will qualify you for the license (along with supervised hours and passing a test).

Unless you have clear reasons not to, I’d encourage you to get a license. Then you are in the mainstream of mental health providers, also with access to insurance reimbursement for your clients. If you are aiming for a license, here are some suggestions:

  • Check the requirements in the province(s) or state(s) in which you want to practice. They can vary.
  • Degree programs that qualify people for a license are pretty standardized, so the apparent differences between programs are less important – except that it’s really important that your school have strong support for helping their students get access to internships, which is generally 3000 hours of supervised experience.
  • Since these programs are pretty standardized, a smart strategy is to surrender to their requirements, just get through them, and use them as the platform for more specialized interests.
  • Once you are licensed, and even before that, clients do not generally ask what the name of your degree is (counseling psychology, clinical psychology, somatic psychology, etc.), so this is of less importance.

Can you offer some insight or guidance on how I should pursue a career/graduate work/degree in neuroscience and psychology?

My own path has included a solid PhD in clinical psychology, and then a lot of self-study in neuroscience and contemplative practice, and then a fair amount of developing material at their intersection.

A key question to start with is whether you want an academic career or a clinical one, or a hybrid (hybrids are often the most fun). Or to put it very pragmatically, what sort of training is going to land you a tenure track appointment as an assistant professor somewhere you’d really like to work, or – alternately – give you the education and training that will enable you to pass the licensing exam as a psychologist (or neuropsychologist)? Or enable you to do both?

As to details, I actually know very little about the specifics of different programs. My intuitive encouragement is to aim high, and be willing to work hard for a few extra years: those costs will be amortized across the length of your career while the benefits of that extra work will compound exponentially. Sometimes it makes sense to do a mainstream program while building up your particular interests on the side. If you are an undergraduate looking to get into a graduate program, know that getting involved in research is critically important to being admitted to many graduate programs. So I’d look for any practical way to get involved in research opportunities at your college.

A key point if you are interested in preserving the option of a clinical practice: check the licensure requirements for the state(s) you want to be able to practice in, and make sure that your program will fulfill them. For example, many states are moving toward requiring American Psychological Association (APA) approval for PhD and PsyD programs that will count toward licensure.

Should I go directly into a PhD program in psychology and skip the masters?

PhD programs are generally a 5-year process, including the dissertation, compared to 2 years for an MA. After either degree, you’d have to acquire 1500 supervised hours, which adds at least a year before you can take the licensing exam; it’s a slog, no way around it.) If you did an MA and then transferred into a doctoral program, you’d probably be able to shave a year or so off of the duration of that program (for ~ 6 years total instead of ~ 5 if you went directly into a doctoral program).

Public universities are very competitive at the doctoral level in psychology. Independent colleges (like CIIS in San Francisco) are more willing to take in people who can pay their higher tuitions.

Summing up, if you want to be a “Dr.”, the most direct path would be to get a PhD or PsyD from an accredited college, and get started as soon as possible.

For me, I am very glad to function at the doctoral level. The licenses (Masters or doctoral) usually have the same scope of practice, but the clout and standing you have in the real world are pretty different.

Dr. Ramani Durvasula is a licensed clinical psychologist, author, and expert on the impact of toxic narcissism. She is a Professor of Psychology at California State University, Los Angeles, and also a Visiting Professor at the University of Johannesburg.

The focus of Dr. Ramani’s clinical, academic, and consultative work is the etiology and impact of narcissism and high-conflict, entitled, antagonistic personality styles on human relationships, mental health, and societal expectations. She has spoken on these issues to clinicians, educators, and researchers around the world.

She is the author of Should I Stay or Should I Go: Surviving a Relationship With a Narcissist, and Don't You Know Who I Am? How to Stay Sane in an Era of Narcissism, Entitlement, and Incivility. Her work has been featured at SxSW, TEDx, and on a wide range of media platforms including Red Table Talk, the Today Show, Oxygen, Investigation Discovery, and Bravo, and she is a featured expert on the digital media mental health platform MedCircle. Dr. Durvasula’s research on personality disorders has been funded by the National Institutes of Health and she is a Consulting Editor of the scientific journal Behavioral Medicine.

Dr. Stephen Porges is a Distinguished University Scientist at Indiana University, Professor of Psychiatry at the University of North Carolina, and Professor Emeritus at both the University of Illinois at Chicago and the University of Maryland. He is a former president of the Society for Psychophysiological Research and has been president of the Federation of Behavioral, Psychological, and Cognitive Sciences, which represents approximately twenty-thousand biobehavioral scientists. He’s led a number of other organizations and received a wide variety of professional awards.

In 1994 he proposed the Polyvagal Theory, a theory that links the evolution of the mammalian autonomic nervous system to social behavior and emphasizes the importance of physiological states in the expression of behavioral problems and psychiatric disorders. The theory is leading to innovative treatments based on insights into the mechanisms mediating symptoms observed in several behavioral, psychiatric, and physical disorders, and has had a major impact on the field of psychology.

Dr. Porges has published more than 300 peer-reviewed papers across a wide array of disciplines. He’s also the author of several books including The Polyvagal Theory: Neurophysiological foundations of Emotions, Attachment, Communication, and Self-regulation.

Dr. Bruce Perry is the Principal of the Neurosequential Network, Senior Fellow of The ChildTrauma Academy, and a Professor (Adjunct) in the Departments of Psychiatry and Behavioral Sciences at the Feinberg School of Medicine at Northwestern University in Chicago and the School of Allied Health at La Trobe University in Melbourne, Australia. From 1993 to 2001 he was the Thomas S. Trammell Research Professor of Psychiatry at Baylor College of Medicine and chief of psychiatry at Texas Children's Hospital.

He’s one of the world’s leading experts on the impact of trauma in childhood, and his work on the impact of abuse, neglect, and trauma on the developing brain has impacted clinical practice, programs, and policy across the world. His work has been instrumental in describing how traumatic events in childhood change the biology of the brain.

Dr. Perry's most recent book, What Happened to You? Conversations on Trauma, Resilience, and Healing, co-authored with Oprah Winfrey, was released earlier this year. Dr. Perry is also the author, with Maia Szalavitz, of The Boy Who Was Raised As A Dog, a bestselling book based on his work with maltreated children, and Born For Love: Why Empathy is Essential and Endangered. Additionally, he’s authored more than 300 journal articles and book chapters and has been the recipient of a variety of professional awards.

Dr. Allison Briscoe-Smith is a child clinical psychologist who specializes in trauma and issues of race. She earned her undergraduate degree from Harvard and then received her Ph.D. in clinical psychology from the University of California, Berkeley. She performed postdoctoral work at the University of California San Francisco/San Francisco General Hospital. She has combined her love of teaching and advocacy by serving as a professor and by directing mental health programs for children experiencing trauma, homelessness, or foster care.

Dr. Briscoe-Smith is also a senior fellow of Berkeley’s Greater Good Science Center and is both a professor and the Director of Diversity, Equity, and Inclusion at the Wright Institute. She provides consultation and training to nonprofits and schools on how to support trauma-informed practices and cultural accountability.

Sharon Salzberg is a world-renowned teacher and New York Times bestselling author. She is widely considered one of the most influential individuals in bringing mindfulness practices to the West, and co-founded the Insight Meditation Society in Barre, Massachusetts alongside Jack Kornfield and Joseph Goldstein. Sharon has been a student of Dipa Ma, Anagarika Munindra, and Sayadaw U Pandita alongside other masters.

Sharon has authored 10 books, and is the host of the fantastic Metta Hour podcast. She was a contributing editor of Oprah’s O Magazine, had her work featured in Time and on NPR, and contributed to panels alongside the Dalai Lama.

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