Dr. Caroline Fleck
speaker
364 appearances
2 recordings
2 series
first heard May 2025
last heard May 2025
Dr. Caroline Fleck’s voice in public audio — every appearance, attributed to the second.
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Yeah. Well, so a negative attention is positive attention feels really good. But on that spectrum, I would say acceptance. Now, that's really yummy. Right. So if we were to kind of put these things on a scale because praise and all that, that's a judgment. But it also is contingent upon you meeting or exceeding someone's expectations. All right.
So you can get really into like facade making, especially with like social media. You're filtering this. You're filtering that. You're getting all this praise. But it's somewhat empty because it's not you. that the person truly quote unquote likes or appreciates or whatever. It's this version of you that you've created that's being reinforced.
And then you're reinforced for distorting more and more. And it's just there's this hollowness. There's this emptiness to that type of connection because it's not you that's accepted. It's not you that's appreciated. It's the version you've created.
It is for all of the above. So there's a really interesting kind of backstory to validation, which is that it came out of a treatment, at least the skills that I teach. They were developed in a treatment for borderline personality disorder, which is a pretty severe psychological disorder. And up until the 90s, we had no treatment for this population.
So folks with BPD are highly stigmatized in the mental health field, and I think just in popular culture, in part because some of their external behavior can look and feel very aversive. So folks who are self-harming, folks who are what many would consider manipulative to try and get their needs met. And there's all of this externalizing behavior
This person kind of oscillates between loving and hating you. And there's these extremes at either end. And it can make for, as a therapist, a very difficult, quote unquote, patient.
Yeah.
What, if you're borderline?
Yeah, so it's more in the emotional experience beneath that. So there's this profound sense of emptiness, loss of identity kind of at the core, an inability to regulate anger. Emotional dysregulation is at the core of the disorder. And so there's a lot of often self-harm in an attempt to regulate emotion, which then graduates at some point to suicide attempts or suicide threats.
And this is a serious situation. This is a deadly condition. And for the longest time, even to this day, I meet tons of therapists who say they will not work with borderlines because they don't want to be, quote unquote, sued or harassed or X, Y, or Z. So just really ugly stuff out there around how we talk about and have historically treated this group.
And up until the 90s, like I said, we had no interventions that worked. This was just kind of like a life sentence if you were diagnosed with BPD. And it wasn't until we developed these validation skills, okay, finding a way to see the kernel of truth in someone's experience and communicate that, communicate some degree of acceptance while also pushing hard for change, right?
So when we combine this approach of acceptance and change, whoa, not only could we treat BPD, but the entire field of clinical psychology was revolutionized. And very few people outside of the field realize what that was and the effect that it had. It's really weird. It's like this secret that no one talks about.
Yeah, that's right. So up to that point, we had a lot of behavioral treatments, think reinforcement, shaping, right? Or cognitive behavioral treatments, which focus not just on changing how you behave, but also how you think. Those are very change-focused approaches, which works well if you want change and if you're willing to take feedback.
If you don't, if you don't trust your own capacity for change, if you don't trust the person across from you, or I don't know if you're an adolescent or somebody who's just like pretty resistant to a lot of what's coming in, it's not going to work. It just won't, okay?
And what we found is that when we combine some degree of validation or acceptance, when we emphasize that as much, if not more than change, people end up making pretty big transformations. Yeah, so the message is in DVT or at least in this treatment for BPD is I'm doing the best I can and I need to do better. So it's being able to hold those two things simultaneously
that is um that's where kind of the magic happens that's so cool yeah it is cool is there not the concern though that that might bleed into normalizing sure dysfunctional harmful behaviors absolutely i don't validate um experiences that aren't valid so for instance um I can validate why somebody would want to abuse substances.
I can totally validate why someone who came from a family in which drug abuse was pervasive, was all they saw, And it's now functioned to help them get through life and be more social and be more extra. I can validate all of the reasons why that person would want to use substances. And at the same time, I can say, I don't agree with that behavior. It's not effective for you. It's not working out.
So on some level, I have to be able to validate why you're in this situation, why you want to do what you're doing, if I'm actually going to challenge that behavior. Otherwise, I don't get it.
Yes, that's exactly right. I actually think of... An example of validation came from my daughter. So if she's wanting to use, so she wants a smartphone, all right? She's 11, and I'm a psychologist, so she's not getting a smartphone right now. If she was to come at me as she does and says, all my friends have smartphones, it's so unfair, you don't get it.
All these kind of common arguments that I've heard from her over and over. I'm not really... She's not going to change my opinion. However, if she came to me and said, I understand your concerns. In fact, I read this study and this study and this study, which says that these are the effects of smartphones on kids. And I totally understand that you as a parent are in a really hard place here.
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