6– ACT-ing on self-help, with Dr. Michael Levin | Day 12

March 23, 2020 Episode 6
6– ACT-ing on self-help, with Dr. Michael Levin | Day 12
Show Notes Transcript Chapter Markers

Michael Levin is an associate professor in the Department of Psychology at Utah State University and a leading ACT researcher. In this episode below Wyatt and Michael discuss his work on how to translate the skills that people typically learn in traditional, therapist-guided ACT into an online self-help format so that everyone can learn at their own pace in the privacy of their homes, which is vital during these times of Covid-19.

USU ACT Research Group:

ACT Guide Self-Help Program:

It's Monday, March 23, 2020. Over the weekend, I was trying to figure out what the next couple of months of life are going to look like for me. And and as I find new routines, I'm both feeling more settled and more aware of how being isolated is going to affect me. Luckily, on Friday, I interviewed psychologist and researcher Dr. Michael Levin. The focus of this installment is his research into self-help resources. We talk about the tools he's helped develop, what to look for in self-help materials, how different generations interact with his online resources, how people respond to therapy over video conference, and a lot more. There are links to Mike's resources and the description. I've been lucky to have projects and things to keep me busy during the shutdown, but I've also had some moments where I felt that the darkness of our current situation. Later I'll share a happy memory that's been helping me get through it. But for now, my name is Wyatt Traughber, you could be scraping down your acoustic popcorn ceiling, but you are listening to this instead.

Here's my Web chat conversation with Dr. Michael Levin.

So this is on March 19th and my name is Michael Levin. I am an associate professor in the Department of Psychology at Utah State University. Awesome. So but I want to focus on the self-help aspect of your work. Why are effective self-help tools important?

So I'm really passionate about increasing people's access to mental health supports. There's so much psychological suffering in our culture and in our society and across the world. First and foremost, I always recommend that people see a therapist. And when they're not able to, right now, there's a lot of videoconferencing options available to see therapist through that format because we know that these resources can really improve people's lives. But I've gotten very interested in self-help because many individuals, for a lot of reasons, aren't able to get that help or they're getting that help, but they could use additional supports. And that's really where I see self-help fitting in is as an additional resource that people can access to further improve their lives, because we have these skills that we know can improve mental health but that people don't always get access to. And I think that's heartbreaking when you think about the amount of suffering that's out there and that we've got these tools that we know can improve people's lives. So when I think of self-help, I think of things like a book or it could be a website or an app. But in those cases, they're teaching these skills that we do in therapy, but in a more self-paced way so that you learn on your own time, at your own pace how to practice these different psychological skills, whether you're dealing with depression, anxiety, substance use problems, eating concerns. There's a variety of different types of problems and targeted skills, as well as really broad skills that you could put into practice.

So I've listened to a few audio books from the self-help section, but there is still this thought in my head that it's basically me walking down the aisle of Barnes and Noble and seeing the self-help section and just kind of like rolling my eyes, So what self-help material should I take seriously and what deserves that eye roll?

And maybe to start just to speak broadly about this, I mean, I really think that part of our challenge is that we've got these skills that we know can improve people's lives. But psychology is something that everyone's interested in and everyone has opinions about because we've all got something between our ears and thoughts about how to manage our own psychology.

But some skills and some strategies are more or less helpful. And really, we need research to figure that out. If we just go by gut sense, we can come up with some strategies that aren't useful or maybe even harmful. And certainly when we look at the self-help book library, just at any Barnes and Noble store, things like that, there's that mix and there's not really a vetting of what's going to be useful versus not helpful or even harmful. And there really are some things that that are problematic and they'll actually make problems bigger. So what I really recommend for people is to go to the evidence based resources. The simplest way to do that is to look for some of the therapies that are well studied and therefore the skills you're learning are really based on a well validated set of methods that are going to be truly helpful for you. I recommend looking for cognitive behavioral therapy or other types of modern CBT like dialectical behavior therapy, acceptance and commitment therapy, or also mindfulness has been found helpful for a lot of problems as well. I've got some different links that I can share so I could give those maybe we could post them online for some some of our more vetted resources that are out there.

Can I have you defined what acceptance means, what commitment means, and I guess what therapy means.

Sure thing. So if you break down ACT into those pieces of it, acceptance has to do with more accepting our internal world.

We can get stuck when we're trying really hard to not think and feel what we're thinking and feeling. And when we don't give space for us to have the psychological experiences we have, things tend to get worse. We tend to get more stuck and we do things that take us away from what really matters. And so if we can instead make room for what's there in a self compassionate way, not wallowing in it, not giving in to those things, but really just noticing for what they are like, gosh, I'm feeling sad right now or anxious or I'm having this thought that, you know, I should give up on this thing. If we just notice that as what they are, these experiences coming up. But they don't have to drive our behavior. That's acceptance. And it really brings us into commitment, which is OK once we've made room for those things in a meaningful way, how do we commit to doing the things that really matter to us? And that's the ultimate goal of ACT, is to help people make commitments to move towards the things that matter to them, not even specific objectives or goals. As, for example, it's not I'm going to lose ten pounds in the next few months. It's more about committing to a value, a process like I'm going to take better care of myself and then finding all these different moment by moment ways you can do that. And the therapy piece of it is really about practicing these structured skills, either working with the therapist or you can do it on your own through some of these self-help resources. But it's about an intentional practice to improve your mental health and wellbeing.

A lot of times people throw around the term Cognitive behavioral therapy, acceptance and commitment therapy. What are the differences between those and what would make one approach more helpful for one person than another?

So some of it really comes down to, in my opinion, preference. So if you check out a few books and you find one clicks with you more, I would say go with that one as long as it's within that evidence base set. Because really the most important barrier that I see when we're talking about, like, these really effective methods out there is just finding something that clicks for people that they stick with. Because we all have books that are on our bookshelf that we're not reading. So the idea is really just sticking with it and putting it into practice. That's something we lose when we're not working with a therapist. So it's really important to think about how am I going to really stick to this routine and get through it? So. So I recommend in large part look for what clicks for you within these effective evidence based strategies.

So you're researching these self-help strategies. What does that research look like? Who are you working with and how are you measuring these things?

So for about the past decade, we've been looking at how we can take, particularly act, as this modern cognitive behavioral therapy into an online format so that we can increase people's access. A lot of our research is focused on college student mental health, there significant mental health challenges that come up. It's a developmental period where people are struggling with a lot of life changes, becoming more independent, thinking about your career path, who you are in relationships. And we just know a lot of mental health problems develop in that time period. So we've looked at especially creating programs that can help people with a wide range of concerns; depression, anxiety, stress, improving relationship, functioning, eating concerns, a wide range of different challenges people might have. And we look at how using these types of programs can lead to improvements in our mental health, which we find time and time again with this idea of ACT, what we're teaching our core set of strategies when it's helping people be more mindfully aware of the present moment, just being aware of what's happening here and now and then learning how to open up to the difficult thoughts and feelings that come up with being present in our lives and most importantly, helping people to do what matters to them in their life.

Can you give me an example of some skills in ACT that help people stay in the moment?

So when this becomes really relevant to me right now and thinking about our current challenges with coronavirus is this idea of values. So we often build our lives around sort of specific activities. So for me, I really enjoy climbing, going to teach classes, I go out to restaurants and in many of those things are possible right now. And it's really important that we social distance and for the public health and for our own individual health. And so it starts to get really challenging because it's like, OK, all these things that matter to me, I'm not able to do anymore. And what's cool about values? Are there more about these abstract principles or these guides for living rather than about specific activities? And so some things that will do an ACT are, for example, help people think about not just like what are the specific things that you like to do, but really underneath that, what matters to you? What do you want your life to stand for and what do you want to be about in your day to day choices? So we'll have people write about their values and think about how they can link those values to action. So maybe for me, climbing is about connecting with the community, growing as a person, challenging myself. So I'm not able to climb right now. But then I started to think, what can I do? Well, stay in touch with the climbing community. There's really interesting posts happening and being able to watch people who've done outdoor climbs, doing palates and finding other ways to challenge myself. And so that's something I really encourage people to think about broadly. And certainly something our program focuses on is helping think about what really matters to me about my actions and what are other ways I can move towards those things.

I have kind of a weird question at the moment, but looking at the way me and the people in my family, we all are very much good in crisis. We are very good about like, well, this is the way it is, just like but we're good at putting on a good, happy attitude. And so there's a lot of crazy things that I wish weren't happening. But like right now I'm feeling a little more alive than I normally am when things transition back into normal, normal in air quotes, whatever that means. How do I proceed when things go back to normal?

That's interesting. And I think that people are having a variety of different reactions during this time. When I think about it, the most important thing is to give space for us to feel what we feel and to recognize that this is a very abnormal time and that a lot of different reactions are going to come up and we need to be compassionate to ourselves about that. Like, what would you say to a friend going through this? And can we be like that to ourselves? One way I think about it is that our emotional reactions and our emotional world is really in reaction to what's happening in our lives. So, for example, we're working with people with depression. It's like, let's look at some of the loss in your life and the things that are missing in your life. And it makes sense. You feel sad because you just lost your job because you're not able to connect with people that matter and it makes some space for that, but not to wallow in it more to make space for it and then figure out what you want to do. I sometimes think of emotions is like a smoke alarm in your kitchen. And so if you had a fire in your kitchen, the smoke alarm going off, it's like, well, what do you want to do? And where we often get stuck is we focus on the smoke alarm. We're like, oh, there's something wrong with my smoke alarm. What's happening right now? We've got a fire in the kitchen, we're not able to put it out in a lot of ways, and so it's kind of just making room for things, being challenging and then finding ways to be compassionate and finding ways to be effective in that chaos.

Yeah, and I guess that it makes sense that I personally I feel more alive or whatever metaphor I want to use because I was really ready for a change. And then I just interviewed Alexis Ault because she's a geologist here with you. And I kind of asked her how she was going to take advantage of this break. And the experience she shared with me was very much just her trying to mitigate all the things she has to deal with. And in that, I was just kind of like, oh, yeah, Wyatt, this is like a real crap storm for most people out there. So I think that really makes sense with what you told me about. It's a reaction to what's happening in your own life.

And that's interesting to hear that. And I think other people resonate with that, too, that for some people it's like, oh, like it's kind of like this moment, like what do I want to be doing? And and being more intentional, which I think is so cool.

I mean, when we're intentional in our lives and we really think about what do I want to be doing, what do I need to be doing, things get in perspective. And then I think that's the kinds of stuff that, for example, in ACT we really try to support is just being more intentional with whatever we do during our day.

Are there any tools or practices that are useful for most people? I know a lot of things feel very specific to people's problems, but what can most people benefit from?

We have one program that I'd want to mention called ACT Guide. And so this is based on the research that we've been doing for over ten years now, where we've looked at how to create these skills and make them available in a self guided format. It does cost ten dollars for a six month subscription and that just really pays to keep it running. I'm really passionate about trying to make the stuff as accessible as possible and it pays for a grad student to to continue to manage it. But that's like a 12 session program and it runs through a variety of different skills. Takes about eight weeks to complete like reading a book, but again, getting you through some of these different strategies.

So it just kind of like what is in this online interface that people interact with? Is it a to do list and some readings and some videos? What would my experience be logging into the ACT program?

Yeah, so it's a combination of the audio guided mindfulness exercises or worksheets where you think about, for example, well, what are some of the ways I'm getting stuck with my thoughts and how can I use this idea from ACT to get a little more unstuck from them? We focus a lot on practicing strategies in between sessions. So you kind of, you know, learn some strategies, practice them for a few days and then come back to the program, and really walk you through these ideas, like noticing thoughts as just thoughts, reducing their control over you, how to make room for difficult emotions in a self compassionate way, and how to identify what really matters to you and then take some concrete steps towards those things that are important to you.

So you said that some things you don't have evidence based research for. And that makes me think of back last year, some time somebody realized that there isn't an evidence based research that flossing is healthy for your teeth. Is there any stuff out there that like, you know, is good and, you know, it's helpful, but you just can't study it in the psychology world?

I love that example. And that's something I sometimes worry about, is we get in this mindset of like, well, this specific app hasn't been tested, but it's teaching skills we know are helpful.

I would say that it's definitely a mixed bag. There are apps out there that when I review them they are pretty weakly linked to things that we know are helpful or they're not done very well. So I do think that it's worth being mindful of what you're using. But that said, I think a well developed mindfulness app or a CBT based app, you're probably going to have a pretty decent program. And I'll share from a website where they do a very good job vetting those apps so you can do a quick search on there. You can look by specific problems and see what's going to be a good fit. It's called Cyber Guide, but I'll share the link.

What other tools have you helped develop?

One of the things I get real excited about with these kind of core strategies like mindfulness, like the skills in Act or in CBT, is that they really can help with a wide range of different struggles that people have. Sometimes they take some tweaking. And if you have a specific challenge like eating disorders or OCD or addictions, I recommend looking for something more tailored to that because there's just some specific behavior change strategies you want to be mindful of. But underneath it, there's often this core set of strategies like how do you respond in this more compassionate way to your emotions? How do you respond to your thoughts without them dominating your life? How do you get moving in things that matter? And so we've looked at this with a number of different problem areas.

So with depression, anxiety, with managing weight concerns or weight, self stigma. So when people start to judge themselves about their weight in a way that just kind of makes the problem bigger and the more stuck in their life. We've also been looking at it with collaborators in areas like with cancer patients who are struggling with a number of challenges, particularly in this time, a lot of anxiety and challenges with care. We've been also looking at that in more of a telehealth way. So through video conference with individuals with OCD or OCD related types of problems, particularly as Mike Twigg as the co-director of our research group. And that's actually another resource I really like to have people be aware of now is that you can work with a therapist through video conference and we find the evidence shows time and time again this has been well studied, that you can get therapy through video conference. It might not be ideal for your personal preferences, but that the core of what you're going to be getting in therapy can be the same through video conferencing. Many providers are offering that now. So it's another resource to be considering.

I don't particularly love video conferencing. What are some of the things you're missing out on when you video conference with somebody versus being in person?

I think that more people would benefit from therapy than go to get help. I mean, a lot of people see therapists. It's very common. And people who see therapists get a lot of benefits from it. But there are some people who don't see a therapist and would really benefit from it. They're struggling in their life right now. There's very practical barriers that might get in the way. There's other barriers that come up around cost. Just "I have a lot of things happening in my life. Do I have time for one more thing?" And I really recommend to those people to consider taking a bit of extra time, a bit of extra money in this case, you know, probably doing it through telehealth, but taking some of that time, even even if it does take away from other challenges because there's so much you're dealing with, could really make you more effective in the rest of your life. And just prioritizing yourself and taking care of yourself, I think is is really key. You don't do that enough. So it's more about this idea of of knowing that there are resources there and considering if it's something that can be useful to you. There's also these self guided resources which can give kind of like a low intensity option. So maybe you don't have time right now to see a therapist, but you can learn some skills you might learn in therapy and then see if that's useful. Maybe that's enough for you, but maybe it might give you more momentum where you start thinking, gosh, I want to dig into this more and I want to work with someone because I think that can really help in your research.

Have there been any interesting or unexpected things you've learned in your research about this?

One of the things that jumped out to me the most is we call it the Field of Dreams problem. So, you know, if you build it, they will come. I learned pretty quickly that that's not true, that if we make these technologies and, you know, even just in a study, roll it out, people don't necessarily come and use this technology. When we start looking at, for example, surveying college students, we see that there's a good portion of students, maybe about 20 percent, that would not be willing to see a therapist, but would like to use the self guided resources. So there's a chunk of people that I think we're expanding the reach of services. But for many people, they would rather see someone in person than use a self guided resource. Right now, that might be less of an option. I think there's going to be really long wait lists and less accessibility of providers, but there are these other types of tools that people can use. So I would say that what I found is that, OK, we can build these resources, but that it will take some intentionality from people to actually adopt them and use them.

You know, you might be seeing an app and thinking, gosh, I might use that, maybe even bookmark it. And it's really about, OK, how do you get from there to really putting this into practice? And I think then we have to take it as seriously as we take. Starting an exercise regimen or working on mental health with a therapist is like, OK, this is the thing I'm going to do if I'm going to commit to it, really making sure I build that structure so I stick to it because I've been surprised at how hard engagement can be.

Do you think that having people pay for it helps them engage with it more meaningfully? There's a lot of things for free and we're used to Google Drive and all those free services we have and we don't appreciate them because we haven't had to pay for them. Do you think making people pay for, like ACT online is part of making them feel committed to it? Or is that just me making stuff up?

I think that's a great question. Right now, with fantastic support from President Cockett, we've been able to make ACT free for all USU students. So we're going to have data on that soon in terms of just starting to look at what that engagement look like to the users who end up paying. I think that it could potentially be helpful. Maybe a part, though, is just because if it's free, like I've downloaded stuff for free and then had no intention of actually using it, I'm just like "Hey what's this?" and I'll download it. So some of it's just that, like, you get people who who probably weren't intending to use it that are downloading free stuff. But I do think what maybe the payment does, just being really intentional about that choice, like, you know, you want to walk into a gym and just pay, you know, however much money to start a gym membership and not be thinking about it like, you know, you would it would be kind of an intentional choice. And we find even when you pay money, you don't necessarily stick to these things. We know that gym memberships is part of economics. . But really, like, I think paying some money to use an app or in another way, finding just some way to make an intentional choice about saying, like, I am really going to do this. I think that matters a lot.

Yeah, I remember canceling a gym membership and when they're like, why are you canceling? Like, because I'm not using it and she just goes "that's a good reason." I haven't gone to therapy yet, but I know that I would benefit from it. But I also know that, like, I guess at least for me, it's paying money. It's like, OK, now make that money worth it. So you mentioned that President Cockett supporting this act online. What are the other ways that you have brought people to this resource?

What we know in the research is that, not surprisingly, bringing back social connection can help. That when we do things and other people are aware of it, they're supportive of us doing it and they're holding us accountable, we're going to be more likely to be able to stick to it. And so there's these kind of coaching protocols where someone can help walk you through and help you stick to it. And so we study that and found some benefits from from having a coach. And we're in the process of starting up a study with support from USU to create and evaluate some of these kind of coaching protocols to see if we can do a better job of that. So I think that's another piece of this. And something we need to figure out is how to help people stick to these programs by bringing some social presence back into these self-help resources, but in a way that won't recreate the same problems. You know, we need to make this really scalable and accessible to people.As

 As you have been trying to get people to use this, have you noticed any interesting differences between getting young people on board versus like older people?

This is something we were wondering about. So working with Dr. Beth Fouth, we were evaluating a more targeted program, a version of our guide for caregivers of individuals with dementia, which in some cases would be an older caregiver. And this has also come up with other colleagues in areas like with cancer. And so at first I thought that this might be a substantial barrier, but I think that we've all been adjusting to living in a more digital age. And so I've been regularly surprised at how much our older samples in more targeted studies in older populations have done really well at using these programs and navigating them. I do think that when we work with those older populations, just making sure they have the supports to know how to use the technology. I think that also just means picking technologies that are concrete and easy to use, which I'd recommend for easier for our younger populations as well. In fact, I think college students are so savvy, for example, with this type of technology that if you have a really convoluted program, they're the first to point it out like this is kind of hard use. 

So I can, I think, working with caregivers of people with dementia that would really help them feel seen. And I know that an important part of therapy is just making people feel seen and understood a little bit. How do you do that within the interface or is that something that interface can't handle?

So with the book, you can get some of this kind of self validation and recognition that, hey, I'm not alone in this. Other people struggle with it and books can describe it. But an online program allows is some ability to really, like, apply those concepts to yourself in a structured way and get feedback. And so we were able to make it more interactive so people can talk about, yeah here's some more specific struggles or here's some values that really matter to me and we're going to work with you on those values, much more close to what we do in therapy, obviously not tailored in the way you can talk to someone one on one, but providing that more interactive feel so that hopefully it feels more tailored and personalized to you. And so you feel more seen now.

So privacy, like in our current digital age, is like a biggish issue. What is is this ACT interface? Is it kind of like social media? Is it more like a private journal?

The best metaphor I think of is really kind of like an online book, much more interactive than a book. But you wouldn't share your book with other people. Other people wouldn't be able to see it on their own. But you could if you wanted to, certainly you could give someone your login or show them. I typically don't recommend it, not because they think it's like bad to be open about your mental health, but more just like I recommend you go through this program for you and don't be thinking about what would someone say if they saw this, like, really kind of go through it and work with the thoughts and feelings you're working with, the values that matter to you. We even will literally say, like, if it was just between you and you, what would you be about? So I take social approval off the table and what do you really want to be doing? So I think of it kind of in that way, there are some types of programs and resources are more based on things like social media. I think social connections are a really powerful resource, but I would recommend to be careful and make sure that you know how your data is being used, how it's being shared. You know, where is this going to go if I share something, those kinds of things.

So are you guys able to collect some data from the online interface? And if so, how are you benefiting from that data?

So right now, the program does collect data. And if people are interested, we have a privacy statement that walks through how this data is handled and how it is being used. Right now we are keeping an eye on the data from this idea of program evaluation. One thing I like is with the book, you put a book out there, you know, people buy it and you don't really know anything else. Maybe Amazon reviews, but that's a very selective sample with the website. We can actually see like how much are people engaging with the program? We handle the data very, very carefully. Privacy and confidentiality is so important. You know, this is all about getting something out there to help people. You know, it's part of my role, but my main role is research. And so this is kind of a separate thing about really getting things out there to help people. First and foremost is protecting people's data. But we have gotten a sense we're starting to be able to look at what does engagement look like. And one of the things that's jumping out to me is that there is a problem where some people will start using a program and then fall off. And we kind of know that's just an issue with online programs and that's allowing us to start thinking about some modifications. How do we bring in coaching, and what are other ways that we can make this more engaging for people?

Yeah, I'm all about sharing data when it can help make something better and more useful for everybody. But it's just like I don't want to get more targeted ads for something I am not planning on buying anyway.

What research questions are you in the process of trying to answer or that you would like to tackle soon?

We're focusing on a few things. One with support from Dean Foley and their College of Education and Human Services. We've gotten fantastic support and I've been working with Dr. Gretchen Peacock, as well as Dr. Michael Tuig on how do we adapt this ACT guide program for younger populations. So we're in the process of creating a version for adolescents so that we can give another resource for people in high school looking to improve their mental health in a self guided way. So we're currently developing that program. We're also looking at how we can otherwise use ACT with people who struggle with more targeted problems, a big one that's been a problem called trichotillomania or compulsive hair pooling. So Michael Tuig is a leading leading expert in trichotillomania and he's received gender support from the Husband Foundation to test that in a video conference format. So we're looking at how we can provide act through telehealth for adolescents with trichotillomania. And they're now looking at how we can do that in a website format, so another version of ACT guide for that targeted problem. So we're increasingly orienting to how do we continue to expand access to these core skills we think can improve mental health and get them out there to people that need it?

Are you doing anything to make the best of this break we are in?

So I say right now I'm more in a situation of just trying to keep my head above water, we are in that part of the semester. I'm trying to be especially mindful of being there for my students and thinking about what they're struggling with. We had an earthquake on top of everything else and dealing with a lot. So trying to try to be present and available for people. I'm really into some new rules. I'll be starting as editor in chief fir our primary journal for that for ACBS, the Association for Contextual Behavioral Science. So that's starting to take a lot of my time. So probably like many academics, I'm feeling more like there's a little bit more of a hold and a limited bandwidth. But it's nice when we study things like therapy because you learn a lot of skills. I certainly don't always apply it to myself, but I'm trying to remember, like, hey you know some things about this. And if you don't have the bandwidth, you got to take care of yourself and just do what you can. And so practicing a lot of acceptance.

Now, is there anything from your perspective as a psychologist, as we can imagine the other side of this break, what things we might benefit from?

Oh, from in terms of having gone through this? 

Yeah, like what we might either collectively or individually.

I think a better appreciation of our current cooking skills and ways to improve them. That's definitely one that I'm running into. I do think there's this interesting process that might come out. There's this idea of like resilience and growth that can happen after dealing with really challenging experiences and that there's, I think, opportunities for people to learn, grow and change as a result. It's definitely making lemonade out of lemons. But, you know, there's this opportunity to think about, gosh, where am I spending my time? What is important to me, how do I navigate things with family now that we're in tight quarters? And so I think there's opportunities to grow if we're mindful of those opportunities.

Thank you. Thank you so much for your time. I'm excited to put this together so we can get it out to people.

All right, that was my conversation with Dr. Mike Levin and, you know, I think we learned that you got to figure out what will work for you and what you can stick to. For me I have ADD if you're in the same club. I really loved the book: Smart but Stuck Emotions in Teens and Adults with ADHD by Thomas Brown. He's a psychologist and he profiles about 10 different patients he's worked with who have ADHD. And so you kind of get to hear their experiences as well as the tools they used to live in effective life. And I was just really validating. I also logged on to Dr. Levin's act guide. I haven't gotten far, but there was an intro, video, some questionnaires to help me understand how I'm doing. And it seemed like a really welcoming website. Just make sure that you have some time to really get started and do things right. I truly wish you the best in making lemonade out of lemons we've been given.

I know it's going to be difficult. And here's the memory that's been helping me get through this. When 9/11 happened, I was in fourth grade and we were sent home and school was cancelled and there was nothing on TV except for news. Well, except for Channel 31 and it was really fuzzy. I'm pretty sure is the Friday after. And my mom had ordered pairs for canning weeks before. And they had arrived and they were ripe and they were ready to be canned and and by canned I mean quartered and peeled and packed into a mason jar ready to be sealed. She sat on the couch and we were watching fuzzy reruns of Bewitched and I Dream of Jeannie. And, you know, my mom's amazing at peeling pears so quick and efficiently and I wish I could do it like her. And after she was done with each slice of pear, she would drop it into the ice bucket, into a bowl of ice water. I was sitting on the floor next to that bowl of ice water. I would reach my hand and I'd pull out a slice and I would eat it. I'd probably eat one for every four she dropped in. And I remember that was the first moment that things felt like they were going back to normal. And because my mom wouldn't be canning pears if the world were coming to an end. And I just think back to that memory and it makes me feel calm and it makes me feel loved. And it's the reason why pears are my favorite fruit.

That's my memory that's been helping me get through some darker moments. I hope that you have a memory that helps you get through it.

Thanks for listening to this episode of Instead. Try to share it with a friend. It was edited by Nick Vasquez and Me Wyatt Traughber as part of our work in the Office of Research at Utah State University.

Increasing access to mental health support
Preference and commitment is key
The ACT Program
Optimism and a short story about pears