Alex Danvers, MD (Host): Welcome to Behind the Miracle, the Sierra Tucson podcast where we talk about the science and stories behind the miracles that we have here at our residential treatment facility for mental health.

Today, I am joined by Chris Bradshaw. Chris Bradshaw is a Licensed Associate Counselor right now and Chris Bradshaw is in the middle of finishing his PhD in Psychology. We're going to talk a little bit about his approach to therapy, which has an existential humanistic flavor to it. And a little bit about some of the conversations he's been having with his mental health colleagues on men's mental health recently. So Chris, yeah, welcome to the program.

Chris Bradshaw, LAC: Thank you, Alex. I'm happy to be here. This is interesting and fun.

Host: Yeah. Great. So, let me just start by asking you, what's your backstory? What got you into mental health?

Chris Bradshaw, LAC: Yeah. Well, I think like a lot of folks that work in mental health, you know, I had some different challenges growing up. It wasn't always easy and I also am someone that has probably always had an interest in being of service, connecting with others, "helping" in some way. And I've also always been very curious about us as humans and why we do what we do and how we impact each other.

But the actual plot points are I did a master's degree in literature and, at the time, didn't really have the confidence to teach and wasn't sure I wanted to. I was working in a law firm doing legal editing, big law firm, kind of like a factory doing the same type of legal editing over and over. And it wasn't for me. Some of my colleagues loved it and had that mindset. So, I decided to join AmeriCorps, which is kind of like the Domestic Peace Corps. Through that, I just ended up working in a school system and meeting some counselors and getting on the path to being in behavioral health, mental health. So, I've been in the field now for about 15 years and I've had management positions and clinical positions and that's basically how it happened.

Host: Yeah, I mean, that's a big jump from law clerk or a law firm associate to English degree to mental health. I feel like when I was in grad school, I used to think of psychology as science done by English majors.

Chris Bradshaw, LAC: Sure. Yeah.

Host: You know, because there's like a lot of that more scientific thinking in psychological research and in psychology. There's also a rich vein of kind of deeper philosophical thought. That kind of in-depth analysis that you give to a character, you can give to a real person to try and understand what's going on with them.

Chris Bradshaw, LAC: Absolutely. I mean, I remember I read Dostoevsky's Crime and Punishment in high school and it was like, "Wow. Okay. So, this is something totally different," like this is really kind of what can go on in folks' heads, particularly when they're struggling. And, you know, what does it mean to be a human? Why do we struggle? And, yeah, I guess it's really literature that first got me interested in psychology.

Host: Yeah, I remember reading Crime and Punishment as well, and I think there was kind of a movement in literature to be more psychological to have novels that were a little more deeper, and I think the way that characters were portrayed. So, just one more question, kind of on your background, right? So, you have been doing counseling for quite some time. You've actually been a supervisor of counselors. And now, you're in a PhD program for Psychology. What made you think, "Oh, I want to get that last level degree"?

Chris Bradshaw, LAC: Yeah. And just to clarify, so I'm a licensed associate counselor. I'm going to be kind of graduating to licensed professional counsellor pretty soon. But for the majority of my career in mental health, I worked as a behavioral health technician, which I think a lot of states have. But in Arizona, you can work in a counseling role at facilities that have independently licensed counselors if you're supervised by them in certain ways and you do certain things. And we have positions like that at Sierra Tucson, like the residential therapy staff. So, I've been in the field for 15 years, but I haven't been licensed as a counselor for that long. That's been a shorter period. I mean, I figured I only live once that I know of. I'm open and maybe hopeful, maybe that's another question, whether how many lifetimes I really want.

Host: Oh, this is a great segue into some of the existential perspective. Yeah.

Chris Bradshaw, LAC: Yeah, that's a whole 'nother thing. So, I figured I want to go as deep as possible. And, you know, with the PhD in Clinical Psychology, you kind of do more of everything. Like, you do a lot more of the interventions. You do more about research, more about ethics, more about multicultural concerns. And I'm 45, and it's been five years in the program now. And I just wanted to sink my teeth into it as much as possible and satisfy some of my nerdiness, I guess.

Host: No, I totally get that. I think that's something I can definitely relate to, if wanting to really go in deep and make sure you understand all the details. I was wondering if maybe your interest in existentialism and this kind of existential humanistic perspective was something that guided you in your grad school. I know you're at Saybrook University, which I believe was founded by an existential humanistic psychologist. One of the founders was Rollo May, is that right?

Chris Bradshaw, LAC: Yes, that's right. Yeah, it is. So, I encountered motivational interviewing in my work in behavioral health, which is an approach that I like. And it's founded in humanistic psychology, this idea of the relationship being really important, empathy, that people are oriented towards growth. You create the right environment. I mean, it's all stuff that sounds kind of like standard therapy, but it kind of actually hasn't always been. And when I found out what that was actually grounded in, and I'd read some existential philosophy and things like that, so that did influence my choice of school.

Host: Yeah. I mean, maybe this is a good moment to step back. And you sort of said the humanistic perspective is one that is oriented more towards the relationship, forming a strong bond between the therapist and the client. But what is the existential part of that for you? Or how do you think about existentialism?

Chris Bradshaw, LAC: it's kind of a big word that when I work with clients here at Sierra Tucson, sometimes they're really excited about it. And then, sometimes they're kind of scared of what is that, you know, and I've had some law enforcement clients, because at Sierra Tucson, we see a lot of veterans and first responders. We see a wide range of people. And I remember I had an individual that is in law enforcement that he ended up really loving the existential group therapy. But at first, he said, "I wasn't sure if I should go because I think of existential threat in law enforcement. It's kind of what we know."

Host: Oh, yeah. It means the most dangerous thing.

Chris Bradshaw, LAC: It's the most dangerous thing, yeah. Then, I had someone think it was the extraterrestrial group. So, that got interesting, but it wasn't. But it's basically our existence as human beings. What are some of the big things we encounter, or the deep things we might be encountering and not always be aware that we're encountering. And so, this is a lot of what I'm going to say, existential therapy is pretty open-minded, and it's pretty diverse. And there are some core ideas. So, this is my take on it. I'm not claiming that this is the take on it. But we encounter things as human beings, like sometimes we're anxious about having free choice, and sometimes we have this need to make meaning. You know, we experience things and we immediately start telling ourselves a story about it for better and worse. We have this ability as human beings to take our suffering and make an empowering meaning out of it. I've had a lot of clients who've said that as they got some of the symptoms down and work through some of the deeper issues, their depression actually gave them a little bit more empathy or got them in touch with their natural limits as human beings. So, kind of these big questions of we know we have a limited amount of time to live, maybe most of us try not to think about it too much, but we have a limited amount of time and we have things that really matter to us and yet, we have things that can hold us back, things that can distract us. We want to be more present with our loved ones, but we know sometimes we're distracted. All of that can create some anxiety, can create some guilt. So, we're kind of looking at stuff like that as well as questions like what is the meaning of my life? What is my purpose? How does my suffering tie into that? We look a lot at presence. What does it mean to be able to be present with myself and with others? Yeah, I could go on and on, but those are some of the big questions.

Host: This question of meaning is really important. And from what existentialism-- I took a class in this in college once, but from what I recall is there's kind of big emphasis on people's ability to create their own meaning. And the sort of philosophical approach has different types of ramifications. But when you talk about it in terms of therapy, especially therapy for people who maybe have had traumatic experiences, it seems like being able to build that story and search through your experiences to sort of say, "I'm going to find what's meaningful. I'm going to find the kind of purpose to my life and the kind of story that helps me understand myself, you know, as a good person, as a person who's growing, as a person who's worthy. It seems like it would be a natural fit to deal with these kinds of issues.

Chris Bradshaw, LAC: Yeah. I'm glad you mentioned that. So with trauma, I mean an aspect of most trauma healing is kind of looking at the narrative around the trauma. We experience something, I experienced a traumatic event, it has physical ramifications, emotional, and then also, sometimes unconsciously, it changes my story about myself or my story about the world. What I guess would maybe make that existential would be how does this fit in with what matters most to me? I've been through this trauma. What is the general trauma of being a human being? That's one way. So, there is an element of like zooming out. I actually have that question for you, like if you had to say, is there a general trauma or wound of being a human being, what do you think it might be? Not to overuse the word trauma or minimize when we go through, I've got a fairly high ACEs score, so I'm not trying to minimize that, but what's the general wound of being a human being?

Host: I think knowing that we're talking about existentialism and knowing kind of what I know, it feels like the fact that we all know that our life is finite, you know, that this is the only life we get as far as we know. Glad that you're open to more. A lot of us are.

Chris Bradshaw, LAC: Semi-open.

Host: Semi-open. Yeah. But we all have a kind of limit in the amount of time we get here, at least.

Chris Bradshaw, LAC: Yeah, definitely.

Host: And so, we're born into this condition, I guess. Yeah, it's not infinite. We can't just have infinite redos. We do choose a path and that closes off other paths, you know?

Chris Bradshaw, LAC: Yeah. I resonate with that. And another thing that's been talked about in some existential circles is this idea of the trauma of birth, meaning you go from the womb to this place of unitary, having your needs met. I mean, I know that there can be stressful situations as a mother's pregnant and in a high stress situation. You go from that out into the world, into kind of chaos. And so, then we always have this balance of a need for security, a need for growth, a need for oneness, and then we're expanding out into--

Host: So, your leading question was, you wanted me to say being born.

Chris Bradshaw, LAC: No, no, no. I think about the one you mentioned more often. In existential psychology, there's this saying that death is the end physically, but it's the beginning psychologically, meaning like a skillful relationship with literal death, but also with our limits as humans, we can make the most out of each moment. It's that saying live each moment like it's the last.

Host: Right, right. Yeah. And I think that kind of popular culture, that's kind of like part of how we think about things and maybe we don't think of, "Oh, that's an existential saying," but it kind of comes out of that or connects to that movement.

Chris Bradshaw, LAC: And it's one of those sayings too, that it's like, if you really sit with it and really meditate on it, it gets more interesting versus some things we hear them like I'm kind of obsessed with this idea of what's the difference between knowing things in quotation marks and then they really sink in.

Host: Right. It's like one thing you're like blasting this on the speakers down the highway, "Yeah, live like it's the last day of your life."

Chris Bradshaw, LAC: Yeah. But when you really sit with that, what does that really mean? And what implications does that have if you're in conflict with another person? If you're in conflict with someone, but you're in touch with that, it could actually help resolve somehow.

Host: Yeah. With the existential perspective, I want to hit this kind of men's mental health and maybe there's a nice tie in, but I have a final question I wanted to ask you. Do you think that it's really helpful for certain types of people or certain types of problems or where do you it kind of fitting the most naturally in mental health?

Chris Bradshaw, LAC: Yeah, I mean, what some of the most renowned psychotherapy outcome researchers say, and some of their research has shown, is that existential and humanistic therapies may be kind of the core of therapy in general. And I guess I could talk about the specifics of like kind of why they say that. But I think for me, it's kind of a core, it's kind of like a foundation, but that doesn't mean that I talk about death with everybody or that I talk about finding this passionate purpose or something. But I'm looking for, if not necessarily a direct discussion of death, but a discussion of their relationship with their certain limits and for certain reasons. So, I think in that sense, I'm kind of always doing existential therapy. I mean, it focuses on the therapeutic relationship, being fully present, how we make meaning, what is our sense of purpose? It focuses on emotion and emotions between therapist and client and how to use those therapeutically.

But I think the folks that I do tend to, in terms of the name existential therapy, when they see it on their schedule, like it's here at Tucson, I think folks that tend to get interested, a lot of creative folks get interested, folks that are dealing with major life transitions, including kind of like retirement age or people that have had close calls with death. People that are drawn to the idea of finding something they're passionate about that matters most to them, that gives their life meaning. Sometimes folks that have like a spiritual component, you know, where they're also thinking of things kind of cosmically, like our life as humans on earth. There's our day to day, and then there's our life on earth as humans, and those types of things. So, I think folks like that get interested. So, I also practice other forms of therapy, and they're informed by existential therapy in a certain way.

Host: Yeah. I mean, it sounds like your take is these are the big questions, right? And so, they're kind of going to be at the core of finding yourself as a person, finding healing. But then, it sounds like also the type of person who would be maybe naturally more open to having these big question conversations are maybe the people who more naturally gravitate towards it in therapy.

Chris Bradshaw, LAC: Yeah, they gravitate towards it. It's interesting because there's a big difference between how existential therapy actually plays out and then when I'm talking about it.

Host: Sure.

Chris Bradshaw, LAC: Because a lot of these things might not even be talked about directly.

Host: So, you're not quoting philosophers back and forth.

Chris Bradshaw, LAC: Yeah, right. Exactly. It's not like as soon as you sit down, let's talk about death.

Host: Right. Yeah. Well, I mean, before we get too much further, maybe we can jump in a little bit with our kind of second theme, which is men's mental health. And I feel there's been a lot of conversation about this recently in general in the U.S. and about how overall trends for mental health, especially among young people are low, but also especially among men and young men. I feel like since you've had a couple of recent panel discussions with other therapists on this, do you have any general thoughts about what might be going on or what are some of the kind of maybe particular challenges that you see as a therapist in men right now?

Chris Bradshaw, LAC: Yeah. Thanks for bringing this up. So, I kind of fell into this by accident, because I had colleague, he's a social worker, Dr. Chris Duessing. He's a doctorate level social worker in Philly. And he reached out to me. He was like, "Hey, do you want to do a panel on men's mental health?" And I love working with him, and it's like one of the cool things about the online space, is get to meet all these cool people from all over the world and find these fun friendships. But I was kind of ambivalent about the topic, because I've had mixed relationships with my own experiences as a man. You know, sometimes I even don't like the label. You know what I mean? It hasn't always been a great experience for me growing up as a man. And so, I was kind of like, "Yeah, men's mental health." But the more I looked into it, I thought, "Yeah, it's worth talking about." Because, I mean, just some basic statistics from places like Centers for Disease Control, National Institute of Mental Health is that men do complete suicides, I think, at about three times higher the rate of women, and I don't know if they've tracked all the gender expressions, I think they probably have. And I know like individuals that are trans have a high rate too. And I haven't compared to everybody, but men have this high rate of completing suicide and also, according to a lot of studies, tend to access mental healthcare a lot less often.

Host: Yeah.

Chris Bradshaw, LAC: And I think, I mean, overall, my experience in Arizona has been that most clients I've worked with have been women, but there are a good amount of men as well. And there's other things that come up in terms of what men are facing. I mean, there's a lot of talk about toxic masculinity. And I've certainly experienced that directed towards me. And I had to deal with bullying growing up and had to learn how to fight and different things, which is part of my ambivalence, is sometimes feeling like I didn't fit into the mold of being a "man" of what society wanted sometimes.

So, several therapists got together and we've been doing these Zoom, I call them conversation events. It's basically like we promote it on social media. We have a panel. We typically start out with each panelist. We'll talk for about three or four minutes on their initial thoughts. Then, the panel talks for about half an hour amongst each other, and then we open it up to attendees, and we all have a dialogue. And a lot of women have attended, including some women therapists who tend to work primarily with men, and they've given their perspective and I'm saying men but I include really, I mean, anybody that identifies as a man. And it was interesting because part of the barrier to me for wanting to do the panel was kind of like, I had this thought of, "Am I allowed to talk about the challenges of being a man?" I didn't have that thought, because I feel like there's awareness of the damage that men can do. And yet, I thought an important thing to do is to talk to men directly. And there's a lot of men being pulled into online, young men in particular, being pulled into kind of toxically masculine circles and being kind of radicalized in a way.

Host: I feel like you're bringing up a lot of good themes here. But maybe, it's even good to pull back for a minute and just think about, you know, it seems like the kind of core issue around men's mental health, is really about the way our culture sees men and the kind of ideals that we have for men. And I think, yeah, maybe that's some of the same issues that you describe. You said, "Oh, I didn't really like being like a man." But it's more like, or at least from my perspective, I kind of had a similar thing. I didn't think of myself as a man's man, but I thought of myself maybe as a creative type man or like a different vision of masculinity, or maybe somebody who's a little bit more intellectual, but doesn't put in as many hours at the gym, whatever.

Chris Bradshaw, LAC: Right, right.

Host: I think. I don't know, maybe it's worth talking about how those expectations come up in therapy and for men.

Chris Bradshaw, LAC: Yeah. I mean, I've had very young and older men at Sierra Tucson who have felt limited by what the culture was allowing them in terms of that, in terms of what range of emotions are they allowed to express or experience. I think there's cultural things for all gender identifications around that. I think our culture has a certain amount of toxic positivity and a certain amount of like everyone's supposed to be confident and assertive and positive all the time. But I think there's that aspect and then there's pressures around a whole range of things around masculinity. I think emotional expression, I think career focus, achievement-oriented. And yet, you know, something we've talked about is what does it mean to be masculine? Are there multiple ways? Is masculinity limited to men or not? What does that all mean? And then, we talk a lot of practical reasons. So, why are men accessing mental healthcare less often? And what can we do about it? And there's some practical ideas around that for therapists in terms of how they market themselves, how they describe their services, and what their waiting rooms are like. You know, the APA put out some guidelines around sometimes going out into the community to talk to men directly about therapy in a way that's makes it sound less intimidating.

Host: Right. Yeah, I mean, it feels like, in every conversation we're having about it, we're not just sort of saying the words we're saying, but we're also kind of reacting to the norms and the expectations that are out there in society that we all know, right? If somebody says, pull a guy off the street, "What is a man's man like?" "Well, he doesn't really like to talk about his feelings," so that's just like something that we have to react against even if, probably, we were to survey a bunch or talk to a bunch of younger boys. They'd be like, "Oh yeah, I have feelings. You know, it's no problem, I know what they are. But we learn over time, the norm is to not talk about them.

Chris Bradshaw, LAC: Yeah. And it's interesting for me to talk about the pluses and the minuses of all these things, right? Because when I free associate on masculinity, I think of the ability to do violence or aggression. But then, there is a need in society for people that can do violence. Sometimes, like if your town is invaded or something, you need people and you see in other countries when they're invaded, everyone typically takes up arms, right? So, it's obviously not limited to men. But the average man is probably a little better at doing physical violence, and there's a need for it. So then, there's also sometimes a need to not be overwhelmed by your emotions or to not express them. So, it's kind of like we can do a lot of overcorrections. I think we could say violence should in no way be associated with masculinity. But it's like we'll be saying that as long as we're not invaded.

Host: Right.

Chris Bradshaw, LAC: Then if we're invaded, we want people to associate it with violence.

Host: Yeah. And I think maybe one way that I would even think about that is that you brought up this term of toxic masculinity. There's this idea that there's these set of traits that are really negative, where there's this kind of aggression and this kind of one upsmanship.

Chris Bradshaw, LAC: And control too.

Host: Control and domination, but maybe there's a positive side to that type of identity. Maybe there's a place where that identity feel like a protector. And if we kind of lean into the right parts of it, it's not toxic anymore. It's, "Hey, no, I've got your back. I've got this group's back. And I'm going to make sure that everybody's feeling safe."

Chris Bradshaw, LAC: I'm so glad you mentioned that because that ties right in with what an existential psychologist might say about toxic masculinity, is that it's really polarized masculinity. So, polarization is like what Kirk Schneider says, is the fixation on one point of view to the utter exclusion, complete exclusion of competing points of view. So, toxic masculinity is masculine. Anything "feminine" is out. And it's not only women, it's men that are softer or more receptive or more soft-spoken or whatever. It's excluded and it comes from a place of terror, like existential dread, typically. And what we know from Freud and stuff is that that means underneath all that, there's a longing for the opposite. So, if you're a toxic, polarized man who totally wants to exclude the feminine, then that means deep down they long to join with the feminine, to be nurtured by it, to be protected. It's that hidden thing underneath there. So when you think about there sometimes is a need, if there's a mortal threat, then you probably do want to control the threat, right? If there's a vicious wild animal that was loose at Sierra Tucson running around inside, they would probably try to get it to go in one room and close the door, right? They'd probably try to control it and contain it. So, that's what a lot of these toxically masculine men talk about, and you see a lot of the famous ones online. I'm not even going to mention the names because it's like, why even promote? But they're online, and a lot of what they talk about is controlling women and manipulating them and controlling them. Why is that? Typically, when someone has an intense need to control, they're typically terrified on some level.

Host: Yeah. I'm glad that you're bringing in kind of the existential point of view and kind of how these two things connect. Because I was kind of hoping we would get to point where we can say maybe one lens that we can see this kind of difficulty that people, that young men and men in general, are having with masculine ideals. One way that we can kind of handle it and analyze it and maybe work through it is through these questions of existential meaning and identity.

Chris Bradshaw, LAC: Yeah. So, let's say I was working, I don't know that I have, but let's say I was working with one of the famous toxically masculine people. They're probably also fairly high in narcissism and sociopathy, maybe even sadism, something. So, I don't know that they would really ever end up in the people that are really driving it. But part of what I would be looking at is, so obviously the feminine probably makes this person really anxious on some level. I don't know, I've experienced that at times when I've been around men who are I would say probably on the toxic side of that, they're kind of uncomfortable, they're uncomfortable with people that they see as the other typically, if you think of the bully and all that stuff. So, what I would be thinking is how can you gradually over time help this person become present in the anxiety they feel when they open up to the other gradually? Because it creates a lot of anxiety. It's like the same thing if you have one polarized political position and you're talking to someone to the opposite pole, what they sometimes don't realize is that they're making each other anxious on a deep level. What the existentialists say is that anxiety is a bridge to greater meaning if you can cross it. So, the existentialists say anxiety is sometimes a good thing. If you're stuck in this toxically masculine view and you're anxious by the idea of respecting the feminine, if you can gradually lean into it, you can become a more full human. But if you maintain, if you remain a toxically masculine male, you're not even a full human because you have femininity in yourself.

Host: So, it's kind of a perspective that if something's making you anxious, that doesn't necessarily mean it's dangerous. It means maybe you need to explore more what's going on, and why are you having that response?

Chris Bradshaw, LAC: Yeah. And some folks might need medication because it's too intense, or trauma therapy to get at the root of when the anxiety became too intense. But if we try to eradicate anxiety, then we really miss an opportunity, according to the existentialists, to have a more meaningful charged life with juice to it, where you can confront things that make you scared and you can get energized by them versus kind of cower.

Host: Yeah. So, we're getting towards the end of our time. I like the idea of leaning into anxiety giving your life a little more juice. I think that's kind of a nice way to think about it. Is there anything else that you want to say before we wrap up here?

Chris Bradshaw, LAC: Well, you've almost convinced me that if there are more lives, then I might want to partake.

Host: Okay. . Okay, good. Yeah. Is that like a big challenge for existentialists to try and convince each other to embrace life?

Chris Bradshaw, LAC: No, I don't think so. I think, well, like the next lives, what if we had multiple lives?

Host: Yeah. Cool. Okay. Well, yeah, it's been great talking to you. I really appreciate as usual hearing your thoughts on therapy on existentialism and on the work that we do here at Sierra Tucson. So, thanks, Chris Bradshaw.

Chris Bradshaw, LAC: We're not going to end with a lightning round of what is the meaning of life?

Host: Okay. Is it food? A good night's sleep?

Chris Bradshaw, LAC: Well, I was going to say to serve others. But sure, Alex, if it needs to be...

Host: I immediately think of the things that would make me happiest right now, because I'm living in the moment.

Chris Bradshaw, LAC: Yeah. We need the yin and the yang of that. Okay, so both. So, food and a good night's sleep, and then also to be of service to others. That's the whole thing right there. Your needs, your physiological needs, pleasure, but then also, it can't only be pleasure because then we get unhappy, right?

Host: Right. Happiness isn't just the moment.

Chris Bradshaw, LAC: There you go.

Alex Danvers, MD (Host): Yeah.

Chris Bradshaw, LAC: There you go. We solved it.

Host: Okay. Hey. Oh, that's pretty good. Yeah. Maybe we can put that in the teaser for it that we solve the meaning of life at the end.

Chris Bradshaw, LAC: Chris and Alex fixing a broken world.

Host: All right. Well, thank you, Chris, for fixing a broken world with me. And this has been Behind the Miracle, the Sierra Tucson podcast. And please check us out next time. Thanks for listening.