228 Transcript

Dr. Jeremy Sharp Transcripts Leave a Comment

[00:00:00]  Dr. Sharp: Hello, everyone. Welcome to The Testing Psychologist podcast, the podcast where we talk all about the business and practice of psychological and neuropsychological assessment. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner, and private practice coach.

The BRIEF-2 ADHD Form uses BRIEF-2 scores to predict the likelihood of ADHD. It is available on PARiConnect-PAR’s online assessment platform. Learn more at parinc.com.

Hey everyone. Welcome back. My guests today really need no introduction. I will introduce them, of course, for the formality of it, but my guess is that the vast majority of you have used at least one of the instruments that these guys are responsible for developing and evolving over the past several years.

Dr. Seth Grossman and Dr. Robert Tringone [00:01:00] are two of the lead psychologists of the Millon Personality Group, which is the entity now overseeing the development and continuation of Dr. Theodore Millon’s unique theoretical conceptions of personality and, of course, his instruments.

They’re the chief co-authors of the MCMI-IV and MACI-II respectively and contributors to other tests and publications in this arena. They’re both working clinicians who regularly integrate assessment and treatment. As students and later collaborators with Dr. Millon, they come to the podcast to shed light on some of the most overlooked parts of the Millon Inventories: the theory, its usefulness, and understanding the developmental challenges and lifespan conflicts inherent in so many psychological difficulties. They are also going to tell a few stories about working with Ted Millon, who was larger than life, but very [00:02:00] attuned humanist.

So as I alluded to, there is a lot of content in this episode. We start talking about Dr. Millon’s personality and his legacy. We talk about the origin and evolution of his theory of personality. We spend a good bit of time tying the theory both to the instruments and then translating the results to clinical practice, including how to make sense of the interpretive report and other notable factors to consider as we interpret this data.

So Seth and Robert are very personable, easy to talk to, and just have a wealth of information to share with us. So if you’re doing any kind of personality assessment with adults or teenagers and adolescents, I think there’s a lot to take away from this one.

I won’t keep you in [00:03:00] suspense any longer. Let’s jump to my conversation with Dr. Seth Grossman and Dr. Robert Tringone.

Dr. Sharp: Seth, Robert, welcome to the podcast.

Dr. Seth: Thank you, Jeremy. Thanks for having us.

Dr. Sharp: Yes, I am honored to have you guys. When you reached out, I think I did a little happy dance here in my office. I looked around and was like, “These guys really want to come on the podcast?” I have been using these Millon instruments for years, and y’all’s work has really been pretty important in my own and many other psychologists’ lives. So, like I said, I’m [00:04:00] just honored to have you here and excited for this conversation.

I know that we have a lot that we can dive into. I want to start just with maybe a little context if you could call it that. Y’all have a unique situation and that you both have had a fairly close relationship with Ted Millon, and his influence is a big part of this story. So I wonder if we might just start sharing a little bit about him and your relationship with him and how that plays into the rest of what we’re going to talk about today.

Dr. Seth: I think that Ted Millon was probably of all the influences of all the people that you would think of as academic heads who were almost untouchable. He was very interpersonally engaged with the [00:05:00] people that he worked with. Particularly, there were select students for one reason or another that he really attached to and saw promising and felt like we were the people that would really engage with his ideas.

So, it was a real pleasure to be able to work with somebody who was that much of a master in that much of a human being. Robert proceeded me a little bit, so I’m going to pass it off to him to tell a couple of his stories first. And I’ve got a few of my own. So please take it away.

Dr. Robert: Sounds good. That’s right. I was a graduate student and had the great opportunity to be a graduate student of Ted’s. I remember that I was intimidated by him before I even met him because he sent a letter to the incoming graduate students and said, these are the books that I want you to get for my [00:06:00] course. And they were his books, the disorders book, the first edition, and some others.

And the reason I was intimidated, it’s like, I just went through four years of undergraduate psychology courses and took many and never heard Ted’s name. And I said, what’s going on here? And I took a trip because I’m from Long Island, I took a trip into Manhattan to Barnes and Noble because we didn’t have Amazon and so forth in those days. So I take the trip to Barnes and Noble in Manhattan. And I inquired, “Do you have these books by Dr. Theodore Millon?” And they said, “Yes, come with me.”

So we left the main area of Barnes and Noble and we went into the back and all of a sudden there were shelves of his books in the back. And I said, “What is going on? How could I not know about Ted?” But it was just a remarkable way [00:07:00] to start trying to get my bearings on what happens here and how big he was in the field. And then, in meeting him in my first year of graduate school, he was in my mind, intellectually intimidating and also physically. He was about 6’4.

So, you would look up at Ted and you would listen to Ted and he had the baritone voice. And you were mesmerized by what you were hearing. And from early on, I remember thinking to myself, this is really incredible. I’m beginning to see how I can look at people and how I can begin to formulate how things are going for them and how to help.

Over the years, it was incredibly rewarding to sit side by side with him talking either about clients because he was my supervisor from time to time. He was my [00:08:00] dissertation chair and we collaborated for DSM on the pre-adolescent inventory on the MACI-II and those side by side conversations. And just how attuned he was to me, to my family. He was just a warm and welcoming person over the years. It was a rough start on my end to feel so intimidated, but then to find out that he was so down to earth and took me under his wing over the years was an incredible relationship. I’m always grateful for it.

Dr. Sharp: Yeah, he sounds like a larger-than-life personality just from what you’ve said so far. And it really sounds like an ideal situation as a grad student, I think. At least from myself, I know I was looking for that and hoping for that. It [00:09:00] sounds like you got it.

Dr. Robert: I was very fortunate. He was always encouraging. And whatever meetings we had, whether it was supervision, dissertation, data analysis, it always ended with “onward and upward” always been a positive search for more knowledge, for more information, and just in life. “Okay, that’s where we are right now. Let’s keep moving onward and upward.”

Dr. Sharp: You need to hear that as a graduate student. And what about you, Seth?

Dr. Seth: I was just thinking with that onward and upward, that’s also, oftentimes when you knew suddenly the conversation was over.

Dr. Sharp: Okay. That’s the signal.

Dr. Seth: Every so often it was. We were in the middle of something quite heavy, but he had something else to do or that’s all he had to say about the subject, and “Okay, onward and upward.”

My story with him was, is a little bit different than most graduate students. And [00:10:00] that is because we had a family connection from way back. He was not only my mother’s professor in her graduate experience. She didn’t go on to become a psychologist. She stopped at the master’s level, but this was back when he was an assistant professor at Lehigh University back in the 60s and also was her clinical supervisor at a State hospital nearby.

So this was a long-time family friend. I got to know this man throughout my childhood but didn’t know that he was really particularly any sort of a big deal. He had moved on to Chicago by that point. I was still in Pennsylvania. Every so often he would visit our hometown. My mom was one of the stops that he would make to say hello. And indeed there was a 6’4 huge man to me, a 5-year-old, who was saying, “Hey, look, I just learned how to play Checkers.” And his first words to me there were, [00:11:00] “Well, you should learn how to play Chess.” I was like, “But I’m 5 years old.”

So time to time he entered my life. One of the next big ones was when I was in college. My undergrad was not in psychology. It was actually in theater and I was fashioning myself to be the next great Arthur Miller, the next great director, and writer of our time. I was directing my first play. That’s something that I had written, but something I had found about a father and son relationship where the father was institutionalized, and the suggestion was he was schizophrenic. And his son who was a theater director was coming to take him out for the day to take him to a show to try to connect with his father.

I didn’t know much about psychology at the time, but I had an inkling that just somebody with psychosis was not the whole story for this particular character. And one day I was talking to my mother about that, and she said, “You should call my friend.” [00:12:00] And had she not more or less forced me to do it, I don’t know that I ever would have, but I ended up calling Ted Millon and discussing what ended up being the schizotypal personality and got to start to understand, okay, there’s more to it than that. A lot of what the person’s expression isn’t necessarily just this loss of reality, it’s who they are and how they relate to that loss of reality. And it really fed my understanding of that.

And then flash forward, some years later, I had decided to change course and go into something ordinary and reliable like psychology, not really the case, but it’s a…

Dr, Sharp: You called it.

Dr. Seth: That’s what I thought it was going to be. Interesting how that’s turned out. But once again, Theodore Millon enters my life. It’s 1995 and he says to me, ” You should come to my workshop in New York City. It’s APA. I’m going to be doing a day-long workshop.” I ended up going, not knowing much of [00:13:00] anything about anything, two classes in on my masters. He had just published Disorders of Personality, 2nd Edition I believe, or he was about to. And he had just changed everything from the bio-social learning theory over to evolutionary theory.

And he began talking about this starting off the day by saying, “Everybody sit down. We’ve got a hell of a lot to get to.” And we did. And within the first 20 minutes, questions were being asked, people were scratching their heads. And to me, I don’t know if it’s just me, but to me, I understood what was going on. And I was answering these questions in my head.

Dr. Sharp: It just clicked.

Dr. Seth: Yeah, not much had really clicked yet in psychology at that point for me, but that did. The way that he was talking about personality and the way that basic motivations, which I’m sure we’ll talk a lot more about, it’s the theory behind the tests, how that really gets into who the person is. And then I said, yeah, I [00:14:00] think I know what I’m doing for the rest of my life…

Dr. Sharp: That’s amazing.

Dr. Seth: … after I was listening to that. And then, as the years went on, got to Miami, Florida, got to his home, got to look at… Robert and I talked about this before the interview, …the environment that we were in, not just at the university, but at his house, of not just psychology, but all of the sciences, all of the arts, just a rich environment. Classical music playing everywhere that you walked. When he invited me in, I looked around, I went to what I think was really kind of the dining room area looking at all these different art books. And I felt almost like there’s a presence of Ted behind me watching me look at this. And in fact, I turned around, and then there was a sculpture, which was a bust of his head. And I said, “This is unique. This is like nothing you could possibly even dream up.”

Dr. Sharp: Yeah, that’s one way to put it. I’m trying to think how I would even [00:15:00] react in that. I mean, it sounds like you are in a movie set like he’s a character or an archetype or something.

Dr. Seth: I think that’s largely. I really do. We could probably spend the entire hour and a half just talking about what the experience was like.

Dr. Sharp: Oh, I bet.

Dr. Seth: Easily. This is just scratching the surface of the kind of an experience that this was.

Dr. Sharp: Right. What an experience as grad students and early career folks.

Dr. Robert: I would agree. Sculptures around the property, within the house. Art everywhere, drawings, paintings, the classical music in the background, and he had his own library. It was a separate building. I’d never seen that many books in one place besides a library or Barnes and Noble. There it was. And books from 100 years before in different languages [00:16:00] that he had read. It was an incredible experience to have.

Dr. Sharp: A true academic. That’s amazing.

Seth, this might be a bridge to jumping into some of the theory, but I wonder if you can remember back in that workshop that you spoke of when you said that it was just clicking in those first 20 minutes, can you remember anything about what he was saying or the nature of the theory that you said, oh yeah, I get this. This makes sense?

Dr. Seth: Yeah. He tied it into the idea of evolution against something I knew absolutely nothing about at the time, other than the basic argument that you’d hear every so often about Darwin and monkeys versus intelligent design, which wasn’t even called that at the time. It was just probably what most of us were brought up with.

Never really thought of it as an application to a lot of other sciences. And what he was talking about, this is where we [00:17:00] segue into what the theory is, was how it was that we shared motivations with pretty much the entire natural world that lives, that a couple of basic imperatives, which he admitted some of the concepts he borrowed from Freud and from other places, but the unfinished project of Freud, formulated together to basically show how a person and their personality is constructed and how they deal with the world around them.

I think I just recently listened to another podcast where one of our contemporary colleagues was answering the very basic question of what is personality. And answered in the way that I think it’s often spoken about today, which is, just everything about you. That’s not really operational. What was really operational about this was that he outlines in the theory three basic motivating forces that follow the idea of how it is that a person first [00:18:00] survives and then adapts to their environment and then ultimately faces the question of, how do I prolong those like me because I’m not going to live forever, replication?

So at the first level, you have, do you try to get everything you possibly can out of life or do you try to play it safe, which is a basic pain versus pleasure idea. Then once you have resolved that for yourself, of how it is that I’m going to stay alive or try to get as much out of life, then I have to adapt to an environment in some way. Do I try to make an environment my own, act upon it, or do I just fit into the best fit that I can possibly find? And that’s more of a passive role, so active versus passive. And then ultimately the basic question of how am I going to nurture? I got to nurture myself. I got to nurture others.

And when he put that all together, he used a lot more words than I [00:19:00] just did. And one of the things I’m really trying to do in my career, and when I try to work with these ideas is to shorten that as much as possible and make that as relatable as we can.

I started to realize you put all these pieces together, almost like a color wheel in a way depending on where somebody lies on any one of these elements. It’s like they’re kind of careful. So they’re sort of pain-oriented and they’re always scouting their environment to make sure that they’re going to be safe. So it’s very active. You have something that’s sort of like the avoidant personality. Or if you have the same thing, you’re very geared towards that pain orientation and instead, you take on the attitude of, I’m just going to have to put up with this because you can’t escape. That’s more of a melancholic or depressive personality.

And then what I often talk about, I have a profile that I’ve made up that I use in my training but I’ve seen this person many [00:20:00] times in practice is, what if you have somebody who’s got both an active and a passive orientation, they’re conflicted on that level? Well, then you have somebody who is probably going to some level, maybe not to a psychotic level, but to associate, to pull away, to not really know what to do with themselves. And that’s the person who walks through life and has avoidant but also depressive characteristics, not necessarily a diagnosis on either direction. They could be, but depending on where they are and how strong that orientation is.

But somebody who is going to have a lot of difficulties because they can’t really gear for themselves whether they should be defending or whether they should just be letting things go, and it becomes something of a mess and assessment becomes identifying that, therapy becomes what do you do about it.

So to me, I didn’t understand all of that when I sat there in that first lecture way back when [00:21:00] but I was kind of getting the bare bones of that at the time of this really tells a lot about people. I imagined, if you put that into operation, that’s going to mean a lot.

Dr. Robert: If I can add, and that was well done Seth, to outline the polarities. Around that time, maybe just two years before that, Ted had outlined what he saw as the structure of clinical science, which was then referred to as personology, which had four components to it. And I like how Seth had mentioned that some of Ted’s ideas have become unique because he synthesized from so many different areas, whether some of the ideas of Freud because Freud had similar polarities that he talked about but dealt with instincts instead.

I think of the example that Seth just gave, Karen Horney in terms of whether somebody moves towards someone, [00:22:00] moves away from someone or against someone, these can be found in different components here. The idea that he was taking evolutionary ideas and then trying to have personolgy or psychology become part of the sciences and how that becomes the second component of these four parts of first being the theory, the second being the taxonomy that other sciences were more mature than psychology, especially in terms of personality that you wanted to learn how could you look at the same areas, the same domains across all of the subjects, these being people, rather than other areas of science that looked at other entities, but you would look at them according to certain domains. So those ideas were in the early 90s and then were explained and broadened in the disorders book second [00:23:00] edition.

And the third part, of course, is now that you have a theory and you have a taxonomy, and these are the entities that you’ve wanted to find. Now we go into the instruments. How do we operationalize these constructs, these entities so that we can measure them?

And finally, what Seth was alluding to before is, okay, now that you have all this information and you have measured and identified how someone may be in different areas, it becomes, how do we intervene? How do we make a difference in their lives?

Dr. Sharp: Yes. Just going back a little bit, I love the idea of touching on each of those and I know we’re going to spend a lot of time on the instruments and how to apply them and so forth, but can y’all think back or were there conversations with Ted about how or why he arrived at the theory the way he did? I mean, why out of all the ways to [00:24:00] conceptualize personality, why these evolutionary principles and how did he get there?

Dr. Seth: I don’t know if he ever really gave so much of a roadmap to exactly where he went from psychology to evolution other than it was a sister science and it was more mature and also explained that his rationale for it was that it encompassed everything about personality. If you think about that active versus passive modality, and you think about what happens in a rain forest for the different trees and how they defend themselves. Some of them have spikes, some of them excrete a poison, some of them excrete a little milk and that feeds ants, the ants guard the trees. That’s a passive orientation as opposed to as active as the plant life can be, and some of them may be more so if you’re talking about fly traps and so on, but most of them are relatively [00:25:00] passive, but some of them have their own way of surviving by an active mode like that, by doing something that directly affects the predator, same with personality.

So it had a lot of those parallels, but I think one of the most important elements to think about with that though, is that if you try to operate from just within psychology proper and organize your whole theory around, let’s say your favorite school. Let’s say it’s interpersonal. Let’s say it’s psychodynamic. Let’s say it’s behavioral. Whatever it is, you’re organizing around just one of those branches. And then you’re sort of adding in either an integrative or an eclectic way, all right, I’m behavioral but I also include some psychodynamics in what I do, or I’m very rigid and I admit that sometimes people have a way of thinking about things. So I add some cognitive work into that.

But if you’re coming at it from evolution, and I have [00:26:00] the giveaways that I gave you, the PDF that I guess we can have to accompany this podcast, I have one of the slides that show how there’s the evolution in the center of it. And from there, you can organize all the different elements of what we consider to be our schools of thought in psychology rather than center on any one of them. And that gives you the flexibility that somebody might be left-brained and intellectual and linear in the way of thinking. And that might be the best way to intervene in certain ways because it’s the language that they speak, but then you can sort of begin to get the right brain in and reconnect some of the split-off effects if that’s the way that particular person is.

And that’s very different from somebody else who might be much more emotional, much more abstract, much more right-brained and [00:27:00] there, you’re going to try to get some logic and rationale into something that might otherwise be just very affective and very chaotic.

So you’re not subscribed to it by the basis of what your basic belief is. You’re more subscribed to who the person is or the way Ted used to say it, the theory of the person. So, that’s what evolution gives you, or finding something that’s outside of psychology proper in this case, it is evolutionary theory and it brings you closer to the person I think.

Dr. Sharp: Well said. Yeah, it seems like it frees us up a little bit to operate outside the balance of specific orientations, which I think we can all agree is nice sometimes. It’s hard to live with those bounds. Goodness. I remember we had a hell of a time during our oral exams in grad school because we had to defend a particular theoretical orientation and it was [00:28:00] always this process of mental gymnastics to fit our clients into a particular orientation.

Dr. Seth: One of those all additional lines. Yeah.

Dr. Sharp: Sure.

Dr. Robert: Ted did have a funny line at one time. And because he incorporated so many different schools all within these 8 domains, we would have conversations and he would encourage students to read as much as possible. He did not want people just to get locked into his way of looking at things. He thought that it was so important to understand an individual from different perspectives and then to figure out, and in which instance, which particular theoretical approach or formulation would apply best.

What was funny was that he said, essentially, I can’t remember it verbatim, but basically that everyone would be right some of the time, but he thought that he would be right more of the time.

[00:29:00] Dr. Sharp: He sounds a modest individual. That’s great. 

So one of the things that you said in some of the notes I wanted to elaborate on a little bit if you could, and that’s the idea that you said that he believed that personality is, you’ve phrased it as the psyche’s immune system. Can you say more about that? That’s a really interesting concept.

Dr. Seth: That’s directly from him as well. He often led workshops where he began with this metaphor of describing developments in medicine and what we roughly call modern medicine, which would put us back in the mid-1800s or so starting off with symptom control. And that most of the medicine was directed at and conceived of as dealing with symptomology.

And then he jumped right to the idea that that’s where we are here in psychology. That we deal with anxiety [00:30:00] and depression and post-traumatic stress disorder and somatic symptomology, and everything is syndromes. And that we’re not really looking at the bigger context. And then he would go on to describe the medicines’ recalibration and looking at infectious microbes as well as lifestyle behaviors. And that gave you more of the context.

By then, you’ll start to see that first, he was talking about access one and symptomology, and then as the metaphor continues, you start to say, Hey, that’s the old Axis III and Axis IV. When we used to think of things as Axis, which was really influential in having DSM–III and DSM-IV go that direction. And now it’s no longer the case, but we still think of it that way in this school of thought. So there’s the medical and the psychosocial component of it.

And then he said, well, what about when we looked at Madison and said, what do you do about this problem? And he pointed very clearly [00:31:00] to the evolution, if you will, of HIV in the last part of the 20th century, that all of a sudden we were dealing with something where it wasn’t just the symptomology and it wasn’t just the environment and the microbes, but the body’s inability to be able to deal with any of that. And he said, we knew what the immune system was, but the immune system was never so important as when we started to look at this particular problem and see how that related to all of the problems.

And then he proposed that in psychology, the appropriate place for personality is looking at it as though that is the psychological immune system, how a person deals with things, how they interact with their environment, how they decide what’s important and what’s not important, how they deal with other people, all those different elements of how personality expresses is how a personality defends itself and acts as its own immune system. That’s where that idea came from.

And so [00:32:00] when you look at it MCMI-IV or you look at MACI-II, you look at on the same page, not only the symptomology but also who that person is and how they deal with that symptomology. So there’s that interaction of what you’re dealing with and what your immune system is, which in this case is personality.

Dr. Sharp: Sure. Thanks for diving into that. That resonates. I appreciate the explanation.

I’m really excited to dive into the instruments themselves and start to bridge the gap between theory and practice. So, I’ll ask a very general question and hope that y’all can take us in the right direction, but where does that even start? I mean, where did you start or did Ted start with taking this theory and then turning it into these instruments that we know today?

[00:33:00] Let’s take a quick break to hear from our featured partner.

The BRIEF-2 ADHD form is the latest addition to the BRIEF family of assessment instruments using the power of the BRIEF-2, the gold standard rating form for executive function. The BRIEF-2 ADHD form uses BRIEF-2 scores and classification statistics within an evidence-based approach to predict the likelihood of ADHD and to help determine the specific subtype. It can also help evaluators rule in ADHD and rule out other explanations for observed behaviors. Please note that the BRIEF-2 parent and or teacher form scores are required to use this form. The BRIEF-2 ADHD Form is available on PARiConnect- PAR’s online assessment platform. You can learn more by visiting parinc.com\brief2_adhd.

All right, let’s get back to the podcast.

Dr. Robert: Well, that part of it actually predated [00:34:00] both of us.

Dr. Sharp: I see.

Dr. Robert: The MCMI-I was published in 1977.

Dr. Seth: And that’s not even the first of that instrument. There was something called the MISRI, originally. The Millon Illinois Self-Report Inventory. When he was in Chicago…

Dr. Sharp: That’s a terrible name.

Dr. Seth: It was awful. As you can imagine, this was geared directly to the academic community. This wasn’t going to be published. And a publisher would say, there’s no way that’s going out that way. We’re talking about the early to mid-1970s. This is post his writing, my Modern Psychopathology which is really what put him on the map. That was his original psychopathology textbook that really introduced a lot of the ideas and formulated what were existing personality disorders, which of which there weren’t that many of them in a new way, and then [00:35:00] introducing a pretty good set of them as well through that bio-social system.

And then ultimately not being able to have a clean way of representing those and MMPI or a Rorschach, and then leading us to the first for the MISRI, which we know how that worked out. And then ultimately the MCMI to try to reflect what was in that theory. And I don’t think that initially it was intended to be so much a commercial test. I think there must’ve been some idea about that, but the original intent really was as a research instrument.

Dr. Sharp: I see. I feel like the Millon instruments that are fairly well-established are, but correct me if I’m wrong, do not hesitate to do that, have the reputation of certainly being geared more toward assessing psychopathology or more severe [00:36:00] folks. Was that the intent going into it or was there any, as far as y’all know, any discussion around, like, how do we measure normal “personality” or non-pathological personality. I’m curious how that all shook out, or if it was deliberate.

Dr. Robert: You want to talk a little bit, Seth or?

Dr. Seth: I can as well. So just pass off when you would like to.

Dr. Robert: I’ll offer my thoughts and Seth can follow up. I always look at the instruments as a family of instruments. And they really started off as clinical instruments with a strong research component initially, so that we had the MCMI and then we had the MAPI, which is the Millon Adolescent Personality Inventory, which was a predecessor of the MACI- the Millon Adolescent Clinical Inventory. But they started off as clinical instruments to be used [00:37:00] in clinical settings.

And then as the theory evolved and so forth, Ted did develop an instrument called the MIPS is the acronym there. And that’s based more on normal personality and trying to define how these constructs and concepts could apply in different types of settings. So I think within the family, we have these different measures. How we look at it clinically, the instruments do identify issues that may represent vulnerabilities, susceptibilities for people. How is it that when I work with adolescents, some can face very similar circumstances within their families? Let’s say there is something going on. There could be separation, divorce. And then how is it that one adolescent moves through it never untouched by something like that, but is able to [00:38:00] manage, to stay on track and to move through life and so forth and somebody else could be virtually devastated by it and lose sight of their future and what their goals are and so forth? And it comes down to…

Sometimes we can have people experience something similar across the board, but they’ll react to it very differently. And those are the personality patterns that we’re looking at as to which ones may be able to manage those types of circumstances and keep going and which others will really struggle at that point in time.

We’ve also looked at it, and then Seth can step in, in terms of the model has changed over time from prototypes to subtypes and then to dimensions. And that, from my vantage point, I think Ted had this too. He talks about that. The healthier personalities are more adaptive and more flexible. And it’s [00:39:00] not just within the polarities that there’s this balance of 50/50, but that depending on what the environment is that someone finds themselves in, how well can they adapt to it so that they can maximize their games from their successes from that, and just sometimes manage situations?

Sometimes one environment may require us to be more assertive. Another environment may require us to sit back and reflect on things. Different relationships that we have with different people. How do we manage each of those in our closest relationships to work and colleague relationships and so forth?

So, we look at it along a continuum as well. So for adolescents, in particular with me, I may identify that somebody has a particular personality pattern or a particular personality type. We don’t diagnose personality disorders for adolescents with the [00:40:00] MACI or MACI-II. So we will look at it in terms of, okay, these may be issues that are going on that are perpetuated in some manner, but depending on the environment, any personality pattern or type can be adaptive. And to understand that, where can it be applied in an adaptive way?

So I think we have things covered both clinically, through normal, through adaptive to maladaptive is how I see it. And that there are no specific cutting points to define one has crossed the threshold but to be able to see things as broadly as possible that there may be difficulties, but sometimes those things that are the very difficult traits in one setting can sometimes be adaptive in another one.

Dr. Sharp: Well said. Awesome. Anything to add to [00:41:00] that, Seth?

Dr. Seth: Sure. In the most recent variations of the instruments, and this really goes along with the changes in the theory, those differing levels of adaptiveness represented by higher and higher scores on the instruments, they’ve been set out more in ranges now, so that there’s at a point where a pattern is identifiable. Once we have something that says that this is a person who does show some sort of traits within this particular spectrum, say the compulsive spectrum or something like that, we’re not diagnosing a compulsive personality disorder. We’re saying that there are some characteristics here that say that this is something of that pattern.

Somebody in that earlier range, what we look at as a base rate of 60 to 74, that’s really an adaptive pattern, but we also know that if they get stuck, if they get out into a place where their [00:42:00] personality might be getting them in a little bit of trouble, probably we’re going to be looking at that area.

So it’s in the range of what we would say, somebody who might seek services and what they might be having difficulty with. And as you go further and further up the base rate scores, you’re going to see more constriction. You’re going to see more of that non-adaptiveness, more of that inflexibility that Robert talked about, and on an onward up towards where you may really be looking at more personality disordered kinds of characteristics.

I wanted to add just an anecdotal piece here that what Robert said reminded me of a therapeutic assessment I once did on a first responder in her later 20s who was doing a therapeutic assessment with me to really understand a little bit more about this very dysfunctional family she had come from and why she [00:43:00] was so afraid, but sometimes so angry.

We did a lot of different instruments within the context of that. And one of them was the MCMI-III at that time. And most of her highest scores were up in the 2A, 3, like avoidant, depressive, dependent kinds of characteristics. And then she had a 6B which was in that 60-ish range, which we didn’t at that point characterize as it’s something really to look at more interpretable. But I did. I looked at that and I said, look, let’s try to figure this thing out.

Dr. Sharp: And what’s that 6B for someone who doesn’t know?

Dr. Seth: I’m sorry. My bad habit. Sadistic.

Dr. Sharp: Got you. Just making sure.

Dr. Seth: And it had switched over to the MCMI-IV. There was forceful and then there was sadistic and there was sort of a point where one switched over to the other. Now, it’s more in those ranges. But at this time we looked at it, which was not as high of a score, but it was the next highest up from the others. [00:44:00] And she said, I think that’s sort of just like my prickly outer shell. And I said, “what do you mean by that?” She said, “When I don’t like something, I can be pretty mean. When I don’t like what’s going on around me, I need to protect myself.”

And we looked at that and said, that as an adaptive characteristic, as something that you can say, doesn’t just happen, but that you have some more conscious control over, could really be something quite useful for you in your life. And how does that then affect some of the other scales and some of the other characteristics that we were talking about? And it was really productive to be able to look at something that we would usually think of as, oh, that’s a bad characteristic. It’s not better good and enough itself.

Dr. Sharp: That’s a great example. And I think we can maybe use this as a springboard to a discussion of how to interpret these instruments because I think a lot of us, we take our crash course in grad school, we give a few of these and then [00:45:00] unless you really dwell on these instruments and spend time getting to know them, which granted, everybody should like you’re going to do them. But I think a lot of folks end up just looking down the scales or the subtypes or dimensions. And we kind of look and eyeball it, and oh, sadistic, like you said, that’s got to be bad in some form or fashion without necessarily diving into it and thinking, how does this integrate with the rest of the profile? I think that’s a challenge for a lot of folks if they aren’t.

Dr. Seth: Most people aren’t really encouraged to think of it that way. I think that the way that it’s trained and usually when you have your objective personality class, you have the vast majority of it’s spent on the Minnesota Instruments. And then some introduction to the PAI, some introduction to the Millon instruments, usually just the MCMI. And [00:46:00] maybe if you have time, a few of the others that are, at one point or another, they were more in Vogue. Like when I was going through the school, California was still kind of [/].

So, there’s not much more time than to say, here’s something that adds incremental validity. If you think that you are dealing with somebody with borderline personality disorder, well, Hey, give them more. Hey, look, it lit up or didn’t. And I think in large part it’s because a lot of the professors themselves have never really been introduced in that way, how all these things really work, but everybody is introduced the thing against it.

I use the Minnesota instruments quite frequently, often in concert with Millon’s, but that’s where most of the time is spent. And there’s not a lot of time spent on this theory. And I don’t know that there’s an easy solution to rectify that within training other than to have training available later on [00:47:00] to catch up. But yeah, like you’re saying, most people just think of that here are these scales that seem to match with the DSM and you know what to do then.

Dr. Sharp: Yeah.

Dr. Robert: I will add that what we’re looking at ideally is for students and clinicians to learn the theory in terms of these polarities. But at the same time, I still borrow from the biopsychosocial component of it. And in terms of what are the reactions, interactions between parents and children. And that there are a couple of components here that I would want to point out for listeners. And that is that Ted actually has a stage theory component to the theory, and those are neuro-psychological [00:48:00] stages of development. In particular, the first two are similar to others, such as Freud and Erickson related to attachment, related to sensory-motor autonomy, things like that. And then there are other stages and they’re not clearly defined or demarcated, but that they overlap with one another.

But the bio component is the child is going into this world with certain predispositions. The parents have their own predispositions and expectations. And off we go. There are these dyadic interactions that are taking place. And things are being processed and things are being retained initially pre verbally. And then they develop into verbal interactions. And then the world expands beyond just the immediate family to extended family, to the social world and peers, and so forth.

And all of the interactions are going on and certain features [00:49:00] of one’s personality may be more successful or met with better success than others. And it depends in terms of how someone’s expectations develop, how they see the world, how they see themselves in the world. And it gets down to also the child and parenting, in particular, and then as they get older into the social world, once again.

A colleague and I, Neil Baki, he and I go back to our first days together in graduate school. We were in the same year and we worked side by side and he takes credit for it and should get credit for the instrument, in particular, I’m going to reference, which is the Parenting Styles Self-Assessment instrument that we developed. It is a true/false inventory that we wanted to measure and operationalize the ideas that Ted had outlined as to what type of environment creates, adds to certain personality patterns.

[00:50:00] So we operationalized what he had written in the disorders texts, and then had children take the Millon pre-adolescent clinical inventory, which has seven emerging personality patterns. And then the parents or the guardians would take the other instrument and then we would align them and see what the correlations were. And we would look at things clinically because if parents or guardians or attuned to who their son or daughter is, then things can go pretty smoothly. But sometimes you have mismatches. There aren’t good fits between the child’s emerging personality and the parents preferred style of parenting.

And when there are mismatches, it can lead to difficulties along the way, maybe related to what we then see as anxiety, sadness, anger, and [00:51:00] things along those lines. So, for students and clinicians to understand that the theory tells us how what we are seeing in the profile may have been developing up to this point in time, what could be going on between the child and adolescent and his or her guardians and parents, and to be listening for how the patterns are perpetuated.

Because one of the things that Ted would emphasize in supervision all the time would be, now that we know where we are at this point in time, and yes, we can address the more frequent presentations of anxiety, of sadness, of how do we deal with anger and frustration and so forth, but if you just deal with the latter, there’s a good chance that somebody is going to come back at a later point in time at another developmental stage, because it’s still the underlying personality [00:52:00] that’s in interacting in the world, that there may have been a reset through therapy to deal with those certain syndromes or symptoms that have emerged, but helping the person and the parents and guardians to understand this is what’s going on. This could be ways to address so that certain things could be potentially modified, not changed or anything, from a submissive type to more of a spirit of type, but there can be shifts and there can be, again, the developing of greater flexibility into interacting in different situations more effectively.

But the idea that I often listen for what parents are saying and the very subtle and subliminal ways in which they’re communicating certain things versus more overt ways in which they’re communicating things, but looking how those interactions can potentially perpetuate what’s going on.

[00:53:00] And we’ve talked quite a bit about the submissive dependent part of the perpetuating patterns. There will be that there is often a lack of self-confidence. There is a lack of autonomy and a reliance on other people. We would want to address those types of things so that they felt more confident about themselves, could identify their own strengths, would be willing to take chances, take risks to push themselves a little bit to see how far they can take it and how independent and how self-reliant they can become not to erase any sense of dependency and so forth. Nothing inherently wrong. It’s just a matter of striking that balance.

Again, I usually work with children and adolescents and look at, in particular, the transitional phases are the most important points in their lives and how as we’re finishing one phase, are we preparing them for what lies ahead and then helping them to adjust, work forward, become more [00:54:00] effective in their worlds, develop a greater sense of self and so forth.

So to me, it’s beyond those base rate scores. It’s beyond the interpretive reports that when Ted read wrote them were so eloquent, mesmerizing again, in their own way with the language and have your dictionary nearby sometimes, What did that word mean? But it really is about, this is the person as we see the history leading to what we see in the present. And then we can anticipate where things could potentially go in the future and how we want to intervene.

Dr. Sharp: Yeah. Well, I appreciate you giving an example or some examples from that developmental perspective. I’m curious from the other side, further down the road, Seth and this might be more of your territory, but if you could [00:55:00] possibly outline an ideal use or process for administering and interpreting something like the MMCI. How should we be going through that process? I hope that question makes sense. I’m trying to think of the best way to ask it, but for someone who really knows it.

Dr. Seth: Sure. There’s an interpretive sequence. And then kind of like if, yeah, I think this might relate to a lot of people who could be listening. In the preface to Irvin Yalom Existential Psychotherapy book, he talks about his wife and him taking a cooking class and reading ingredients lists, and doing the directions. And then there’s a special something that the cook puts in.

I’ve tried in the Essentials of MCMI-IV Assessment book to give some hints to that. And that is to try to tie the theory into [00:56:00] this interpretive sequence to try to make it something that is really resonant for the person. Listening to Robert speak about the developmental aspects of it makes me realize that I have not yet scratched the surface and I’ve done a lot of scratching. There’s a lot there. And it all does tie together in this theory. And if you have the bandwidth and you have the ability to really do deep dives into the theory, by all means, do them.

I’ve liked to be able to try to capture as much of that at a user-friendly level as possible. So the way that I go through something like an MCMI, and I think it’s very similar to how you go through MACI because there’s a lot of the same components. The MACI actually has a couple of additional sections that the MCMI doesn’t actually. One is called the express concerns, which is more about what happens at this particular point in development, typically in a child adolescent’s life. Whereas the MCMI, the front page really just tells you [00:57:00] the symptomatology. And before that tells you the personality patterns as well as validity information.

So I look at the validity information. I look at critical items. I make sure that we’re talking about something that’s more of a secondary intervention rather than tertiary, where we have to say, okay, we have to have close the books and make sure this person is okay.

But assuming that we’re valid, assuming that we are diving into the dynamics of who this person is, I start off with the three more pathological patterns that are: schizotypical borderline and paranoid, which are a little different than the others. They’re not comprised purely of just those motivating aims that I talked about earlier. They are breakdowns in the personality structure. Each one gives you some hint as to like [00:58:00] what might be going on in terms of how difficult his personality could be. It’s beyond what we could really talk about here to really get into that, but just suffice it to say, you have an idea of how cohesive the personality is, or if there’s really a fault there that you’re going to have to watch and see how that color arises other parts of it.

You look at that first and then you look at the more basic patterns. Once you have that down, you go to the facet scales, which we haven’t really talked much about that end of the theory, but that is where we really get specific about behaviors, thought patterns, interpersonal kinds of dynamics, inner psychic dynamics, and biology. And all of that is put together in this great big platform of comparability between each one of the personality prototypes or spectra as we call them now, and each one of those characteristics. Then go back into the symptomatology.

So it’s really a multiaxial assessment. [00:59:00] But I focus probably most of my time on the personality patterns themselves and going into the theory. And this is where I say, here’s the little extra that is there and you need to know how to do it on sort of a basic level. And I discovered quite by accident. I think I’ve told you in our preparatory meetings that I have a story of the very first time I gave an MCMI-III. And this is where I discovered how to do this completely by accident.

So, to go back in time, I’m a post-doc. I’ve been at a college counseling center for both my internship and my post-doc, as well as much of my practicum time. And we had a neuropsychological component, and that’s really where the only testing was going on. And most of the time we’re using the MMPI for those cases.

So, I had never actually given an MCMI to anybody other than people I was related to, if you know what I mean. And I think everybody knows what you mean when you’re going [01:00:00] through your training that way. And we got a referral from judicial services that there was the student that got themselves in trouble in a cultural class, particularly in an African new world studies class where this student who is an older person returning student had gone in and more or less started using racial epithets and started a more or less our race riot, and was given a chance to come to us for anger management.

And at that time, a relatively new school counseling center that had an internship and a postdoc, but it hadn’t really established itself as APA and all the criteria and all these things yet. So my supervisor and I were kind of winging it in walks, somebody who is in the process at this point, I’m not even sure if they were to present today, this would be better defined, but male transitioning to [01:01:00] female at the time in a mid-transition joint, still identifying as male still. At that point, we weren’t talking pronouns, but use male pronouns, which is why it’s confusing when I tell it in today’s context to keep vacant mind.

This person was very defensive and was very hostile towards us at first until we assured them that we were on their side and that the only thing that was going to be reported to the university was they came and they were cooperative. And that’s all they ever needed to know. Then we got much more of the backstory and I could easily go into what Robert was talking about in terms of all these developmental points of difficulty.

Most probably the thing that stood out the most was that this person’s mother who was the only one who really stayed [01:02:00] very loyal and very supportive in the context of a very conservative upbringing in the Midwest for this person who was going through things beyond that, also a lot of substance abuse that had happened in the past brought to this point. And then we had cooperation. We had rapport and me as a Malani who was working on the facet skills at the time and knew this instrument inside and out and never actually give it, it was more than willing to say, let’s get a solid measure. Let’s do this. So I got to give an MCMI.

Finally, I gave this person the MCMI. They went back to my supervisor’s office. I came back out looking over the results and the next thing that I knew they were here in my hand, and then they weren’t in my hand because this person had grabbed them from me. I was looking through the results.

Now, the key elevations there. The highest one was 6A-anti-social, the next [01:03:00] highest, almost as high was 8B masochistic. How do you put antisocial and masochistic together? And then the third, which was in a range that was approaching pathology was 2A avoidant personality. Antisocial, masochistic, avoidant, which this person who was very intelligent was very upset about. Why is this thing calling me antisocial? You’re going to call me a criminal and go back to the authorities. I’m going to get in trouble. I’m going to get kicked out of school, on and on and on and on and on. And it’s also masochistic. What does that mean? Are you getting into my fetishes now? What is that?

Thinking as quickly as I could, I said, hold on a second, give me back with that paper. And let’s put this on the table and I’m going to do something for you. And I covered everything up except for 6A- Antisocial. Then I covered up antisocial and I said, let’s just forget about that for the moment. Okay. Let’s forget that label. And let’s just say, this is everything that I could possibly say [01:04:00] about you. And he’s like, yeah, but there’s so much other stuff. You’ve got to talk about my fetish. And I said, don’t worry about your fetishes just for now. Let’s just look at this one part of you. And I said if this was everything I could possibly know about you, and then I thought theory, right? Where’s the theory on this? This is anti-social is an active self-orientation.

I try to get as much as I can for myself. And it doesn’t matter what it costs me. A lack of orientation towards pain assuming that things could possibly be damaging even to the self, translate that into therapeutic language. You don’t want to use too much theoretical stuff. You want to try to say, “I would say that maybe you’re the kind of person who wants what you want and we’ll probably stop at nothing to get it.” And that forced the reaction of, “Yeah, doesn’t everybody have that part of themselves?” Yeah. It’s kind of a normal thing, except that it’s pretty pronounced here. Well, that’s not everything that’s about me.[01:05:00] I said, no, of course not.

And we went over to 8B- masochistic and I said, well, here masochistic is described as a reversal on pain-pleasure so that you seek out things that are actually pretty bad for you and you do it in kind of a passive way. So you just let these bad things happen, which when you boil that down, comes down to how deserving do I really feel? I said, here’s a part where maybe you don’t feel like you deserve much of anything. And he said, well, how does that go together?

Dr. Sharp: Great question.

Dr. Seth: How is it that I could be like, I want whatever I want. And then he goes, oh, I do want whatever I want. And I don’t feel like I deserve it. I said, where do you go? And he said, “Well, you know what I do, I just get the hell away from people.” And I said, let’s talk about 2A- avoidant. And we start to talk about that. And that experience was really striking for me because I wasn’t talking about really any of the labels we use. I wasn’t talking about a [01:06:00] diagnosis. We were having a therapeutic dialogue and that has always stuck with me.

And that’s kind of where I started off saying, there’s a new way to look at this. I don’t think it’s so new. I think people must’ve discovered something like this before, but I’m going to try to systematize this and I’ve tried to do that over the years. It’s very hard to put into an evidence-based methodology because there are so many components to it. There are so many different ways.

And you think about what I was saying about the color wheel. In your typical color wheel, there’s some variant of red, blue, and yellow, and you put them all together and you get the whole spectrum of how many thousands of colors that we are able to detect by the human eye. Here, you have 15 colors, 15 personalities, how many different possibilities are there, then what could that possibly mean for each one? And not that you’re going to get two identical profiles and [01:07:00] they’re going to be the same person because they won’t be

Dr. Sharp: Well, I think you’re speaking to… well, there’s this translation piece, like translating all the scores, the profile into something meaningful. And when I think about that, I have to bring up the interpretive report. So that’s y’all’s attempt to somehow synthesize all this information and explain it in a way.

So I’ve run into people who live by that interpretive report, like Alma, I think we all know this is not the right thing, but, you know, copy and paste it into whatever document. But then, I’ve run into people who throw the whole thing out, and they’re like, “I don’t know what to do with this or this isn’t accurate or right.” And then, people live in the middle. And so I’m curious for y’all being so close to these instruments and the development of these [01:08:00] reports and everything…

Dr. Seth: I mentioned, we wrote the most recent versions.

Dr. Sharp: Right. You wrote the most recent versions of these reports. What did we do with these interpretive reports? Is it the Bible? Is it not the Bible? Do we stick by it? How do you conceptualize those?

Dr. Robert: I like the reference.

Dr. Seth: I like the Bible reference in a way, in not so much that it’s any kind of gospel, but the idea that the way to really interpret any kind of a gospel of that sort is to listen to the story that’s there and then apply it to the circumstance that you have. But not as this is a literal translation of what’s going on right here.

More so, this puts you in the ballpark. This gives you some ideas about who this person is and what dynamics may be at play here. So it kind of orients you. It focuses you in a way [01:09:00] to be able to say, this is an example of what these characteristics might be like. And this is why I like a collaborative approach, actually kind of putting myself in the position of here’s the expert on this person and pointed to the person, I’m the expert on the test that doesn’t make me the expert on the person.

I’m going to give you some examples of what a lot of people look like when they score this way. What do you relate to? What makes sense to you out of what I’m saying? And Robert, I think I cut you off at the beginning. So, I’m going to let you…

Dr. Robert: bullet points. No, I did have two points to that.

One is, I think that it is important for people to realize that interpretive reports are really probabilistic statements. So we are taking what we understand clinically from the theory from research and incorporating it into when we have this type [01:10:00] of a profile, this appears to be what many of the features traits and so forth would be. That’s aspect number one.

Number two, I would say that because these reports are computer generated and I’ve written this a number of times and referenced this a number of times that the computer doesn’t know the context within which this profile has been generated. Now we can try as best we can to understand what the motivations may have been for somebody to create this profile.

 Often in the past, when I taught the Millon Inventories would say, objective measures require someone. It’s not just true false. There are thresholds that each person has in mind as to, I often lose my temper as a made-up example. What does that mean?  Often? You know, somebody who loses their temper [01:11:00] on a daily basis may not actually interpret it because to them, that’s not often. Somebody who loses it once in a while may say, oh, I’m so uncomfortable losing my temper that I think I lose it more often than I should. And they then endorse that type of item.

We, with the MACI-II to eliminated what was called modifying indices of disclosure, desirability, debasement as to what somebody’s motivations may have been and made all these adjustments behind the scenes and so forth, but never knew the context of it. So I thought it was important with a new instrument to create a way in which we handed it back to the clinician to decide what do you think?

You know the circumstances that you are sitting with this person and you know the story as much as possible at that point, does the interpretive report fit with what you have found out about this person? Does it help you [01:12:00] understand what’s been going on with this individual?

I think the third point I would add would be that when the MCMI first came out all those years ago, the interpretive reports were something new because there was integration of scale configurations. It wasn’t just one scale is elevated, let me tell you what this scale means. Oh, this scale is elevated. Let me tell you in a separate paragraph, what this tells us. Ted had done so much of that work behind the scenes by cooperating what were identified as prototypes and then the second or third highest elevations then would create subtypes.

And that we would be able to have a more refined interpretation and something that was already synthesized by him, by the theory. And then with the newer instruments, now we have all these facet scales that further refine the [01:13:00] personality pattern interpretation. So we can go in so many different directions with each of the components, but it’s so enjoyable to have an opportunity to talk about it and to have people hopefully listening out there and saying, I’m intrigued by all of this. It’s not just a fancy printout. And there really is so much to this. It gives me a moment to stop and think about how this can help.

Dr. Sharp: I’m glad that you highlighted that because I think to a lot of us who don’t know how these reports are generated, this is going to be wildly offensive but I trust that we have some rapport here, it seems it’s like a horoscope or something like or astrology, like, how did this happen Where are these conclusions coming from? [01:14:00] I mean, of course, we know there is science behind it and it’s rigorously developed. But to hear more of that process is super helpful.

I do have a question though, and this might be a hard question, so y’all can get mad at me if you want. I think I can handle that. But the question is, so given that there is it sounds like a lot of the interpretation and application rests with the clinician in being able to understand the context and synthesize context with results and so forth. Do you recommend that people lean on that interpretive report or should we just get really good at looking at the score report without the interpretation and not even mess with the parts that might not be applicable? Does that make sense as a question?

Dr. Seth: Yeah, and I think my gut reaction on that is, [01:15:00] related to how familiar and how comfortable are you with how the test actually works. What the theory is. How much you understand about it. You don’t have to have an encyclopedic knowledge of Disorders of Personality, third edition, to be able to use it. I do think to be effective with it, you’ve got to understand the basics of how the theory works and be able to at least draw some references from that. But aside from that, if you’re relatively new and you want to get more of a flavor and get the colorization of who you might be assessing, what you might be looking at, use and read the interpretive reports because they’re designed to put you in the ballpark and have at least a point of comparison to say, now here’s what we would be looking for with this kind of a scale configuration and these are some of the characteristics that might be there.

There are two parts to it. There’s the [01:16:00] description of the personality and then there’s also the treatment guide. And there’s more than that as well. There’s also, how does that work with the other elements of the test, like symptomatology, and for the MACI- the expressed concerns. But I think the two big parts are the characterization and then the treatment guide, and I’ll speak just to the MCMI.

The treatment guide, I tried to fashion after what I was talking about. I tried to set it so that I gave some description of theoretical elements in the first two paragraphs and then moved into what I thought would be a probable treatment course. The MACI-II, I think Robert worked from a slightly different paradigm but has a lot of similar elements to it, I think as well.

Dr. Robert: I would say that my ideas were to say, okay, now that we have this information about who this adolescent is, I would address, initially this is what it is about this. Maybe the challenges of establishing rapport. [01:17:00] This could be somebody who quickly establishes rapport, but don’t be lulled into thinking that everything’s going to work out just fine.

Different styles have different ways of reacting to, adapting to new environments. But in addressing the polarities, then getting into some of the domains in terms of what different strategies might someone apply. If someone is elevated on the inhibited avoidance scale, there should be some dimension of, we have to address the tendency to withdraw socially.

But it’s not simply just throw them in social situations that they’re not well equipped to handle just yet. And they’re certainly not comfortable in dealing with them. How do you strategically address that? How do you then gradually get them to something like an individual therapy would likely be helpful? And at some point in time, they probably [01:18:00] could benefit from a group therapy experience.

And then as often as possible, I go to the self-perpetuating processes, watch for this. How can we address this? So that in the end, this becomes someone who is much more comfortable being themselves and feeling that they are understood and that they are preparing themselves for life that is ahead. So trying to address all of those areas in those treatment guides. So I think it helps to bring it all together to say, yeah, a lot of research goes into the scales and understanding the constructs, and then it’s okay, hey clinicians here, these are some ideas. And they’re always expressed as ideas and possibilities rather than setting people up. Oh, if you don’t do it this way, [01:19:00] then you’re not practicing properly.

So these are considerations for that. And the treatment guides are really treatment considerations. That’s why that section on the emphysema on the MACI-II actually is identified as treatment considerations.

Dr. Sharp: Sure. Yeah, I really those sections or that section in each of the corresponding instruments. It’s always been helpful. I use that information quite a bit. So I appreciate y’all putting the time and energy into it.

Speaking of time, our time has flown by. I feel like we have barely touched on everything that we could, but my hope is that we’ve dug a little bit deeper for a lot of folks and have helped people understand where all of this [01:20:00] is coming from, the theory and then some of the application and how to use these instruments. I really love them. And that’s why, again, I was so thrilled that y’all reached.

Dr. Seth: Great to know. And we’re really appreciative of the opportunity to be able to talk about this because I think any talk about this is more than what people tend to get in training nowadays.

Dr. Sharp: I think you’re right.

Dr. Robert:  It’s been a great opportunity. We’re trying to get the word out. The pandemic shut everything down. I enjoy, as I’m sure many clinicians enjoy, that face-to-face, we’re in the same room type of connectedness, and in many instances for certainly for 2020, it was taken away from us. But this is a way for us to reach out and we’re always open to people reaching out to us. If there are questions, then we’re open to that. And sharing [01:21:00] what have enjoyed being a part of for our professional lives and having such an incredible person in our lives who then had confidence in us that we would be able to follow through. And everything, I can think I can speak for Seth, everything is about his legacy and making sure that it lives on.

Dr. Sharp: Well, that’s the part of the story I think that I really tune into is the personal component. Then your relationship with Ted and how that has just shaped, of course, the professional piece, but the two of you.

Dr. Seth: This has been what really makes it unique.

Dr. Sharp: It is unique. It really is.

Well, I appreciate that. We’ll put the resources that you mentioned in the show notes. We’ll put your contact info if you’re okay with that.

Dr. Seth: Sure, it’s fine. I want to just say audibly, [01:22:00] www.millonpersonality.com is the home of the Milan Personality Group that’s printed on the title slide of that packet that I gave you and home for all things. We’re always in touch with the family who runs the Millon Personality Group. And we’re always looking forward to hearing from people who are interested and reaching out to others. And again, spreading the word. You want to make sure that this is a legacy that really continues to serve the world of psychology.

Dr. Sharp: I love that. I think that’s a great note to end on. Let’s do that. Well, thank you guys again. I really appreciate it.

Dr. Seth: Thank you.

Dr. Robert: Thank you, Jeremy.

Dr. Sharp: Thanks for listening everybody. I hope you enjoy this one. I really liked talking to those guys. I feel like we could talk forever. To be honest, they are so knowledgeable and just easy to talk to. It was a really fun interview for me to really bring to life instruments that we’ve been using for a long time. I really loved the Millon [01:23:00] instruments and it was cool to be able to dig into the weeds a little bit and really get to know Seth and Robert a little bit.

All right. If you are looking to grow or evolve or advance your practice, I would invite you to check out the upcoming cohorts of the Beginner Practice Mastermind and Advanced Practice Mastermind. You can get more information at thetestingpsychologist.com/advanced or thetestingpsychologist.com/beginner and schedule a pre-group call to see if it would be a good fit. I would love to chat with you.

That’s it for today, everybody. I hope everything’s going well. We’re heading back into the fall, which if you work with kids usually means getting busy. So hang in there. Hope your schedules are dialed in and you’re ready to roll. Take care. I’ll talk to you next time.[01:24:00]

The information contained in this podcast and on The Testing Psychologist website is intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for professional, psychological, psychiatric, or medical advice, diagnosis, or treatment. Please note that no doctor-patient relationship is formed here. And similarly, no supervisory or consultative relationship is formed between the host or guests of this podcast and listeners of this podcast. If you need the qualified advice of any mental health practitioner or medical provider, please seek one in your area.[01:25:00] Similarly, if you need supervision on clinical matters, please find a supervisor with expertise that fits your needs.

Click here to listen instead!

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.