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Dr. Sharp: [00:00:00] Hello, and welcome back to The Testing Psychologist podcast. I’m Dr. Jeremy Sharp. This is the podcast where we talk all about the business and practice of psychological and neuropsychological assessment.

Glad to have you back with me today. My guest today is Dr. Julie Cradock O’Leary. Julie is a licensed psychologist. She practices in Anchorage, Alaska. She got her BA in psychology and theology from King’s College. Then got her master’s and Ph.D. from Fuller Theological Seminary.

She, like I said, is in private practice and her specialties include psychodynamic and inside-oriented therapy for adults and adolescents. She does play therapy with kids and works with individuals across a lifespan with abuse and neglect. She also does testing and assessment. But one thing [00:01:00] that we are really focusing on here during our interview is Julie’s work with shame.

Shame has been her primary clinical and research specialty over the years. And Julie, along with Nancy Thurston is the co-author of a projective measure of shame called the Thurston Cradock Test of Shame. It’s published by WPS. And we talk a lot about the Thurston Cradock Test of Shame as well as shame in general and why it’s an important construct to worry about in an assessment. So I hope you’ll enjoy this wide-ranging interview with Dr. Julie Cradock O’Leary.

Before we get to the interview, I would like to let y’all know that we will be recruiting once again for a Beginner Practice Mastermind Group and an Advanced Practice Mastermind Group. You may have heard me talk about these on the podcast before but [00:02:00] these mastermind groups are basically group coaching experiences where you get the benefit of 4 to 5 other psychologists who are really focused on testing. You get all the support, all the vicarious learning, and also individualized attention every other group or so to focus on problems that you are struggling with in your practice.

If that sounds interesting to you, you can find more details at testingpsychologist.com/consulting. And on that site, you can look, there’s a page for beginner practice mastermind and advanced practice mastermind. These groups will get started probably in late September. If you’re interested in those, just shoot me a message via the website and we’ll see if it’s a good fit for you.

For now, I will take you to my interview with Dr. Julie Cradock O’Leary.

Hey, y’all welcome back to The Testing Psychologist podcast. This is Jeremy Sharp. Like you heard in the introduction, I am here with Julie Cradock O’Leary. Julie is a clinical psychologist. She’s in private practice up in Alaska. She is also a co-author of the Thurston Cradock Test of Shame.

We’re going to be talking about all sorts of things today. Shame, of course, I think is going to be a primary topic and we’ll also talk about her measure and how that might be helpful in assessment. But for now, Julie, welcome to the podcast.

Dr. Julie: Thank you.

Dr. Sharp: Thanks for being here. We should probably say, this is an in-person interview number two of The Testing Psychologist. I’m honored [00:04:00] to have you here in person.

Dr. Julie: Thank you. It’s great to be here.

Dr. Sharp: Yeah. It’s always funny when these things work out, but we have managed to somehow work out schedules. You were in Denver from Alaska and I am here and available and so we’re just making it happen. So super cool.

Dr. Julie: Yes.

Dr. Sharp: I’m excited to get started. I first heard of your measure and of you through the interview with Raja David when we talked about therapeutic assessment. I think a lot of listeners recognize that there was a pretty big response to those episodes and he connected me with two great folks- you being one of them. He talked about the test of shame a little bit as part of the therapeutic assessment process. So, I have all questions about that, but before I totally bombard you with that, can you just tell us a little bit about what your life looks like these days in [00:05:00] terms of clinical versus research and how you got where you are right now?

Dr. Julie: Yes. Right now, I’m in Anchorage, Alaska, in private practice. I’m a clinical psychologist. The bulk of my work is therapy and some assessment. I also do quite a bit with the test in terms of consultation with professionals who are giving the test and who would like some assistance with scoring and interpretation. And I also do some training and workshops. And also I love working with graduate students who are interested in using the test for research.

Dr. Sharp: I got you. How does that show up in real life? How do you get connected to students who might want to use the test and train them?

Dr. Julie: It’s largely through conferences or workshops where I may meet up with a student who’s attending, for example, society for personality assessment, or maybe a faculty member and pass my name along, give me a call. And then certainly [00:06:00] within therapeutic assessment, the test has been used quite a bit in that. That has generated some interest.

Dr. Sharp: Yeah. The way that Dr. David spoke of it, it’s maybe gaining some traction or has lots of traction as a primary measure in the therapeutic assessment world.

Dr. Julie: Increasingly so, and I should say Dr. Stephen is really an expert on shame and he gives wonderful workshops that I’ve actually had the privilege of attending, in Austin, Texas, in Anchorage recently, as well as in Tokyo. And he’s really pivotal in spreading the word about shame and how it’s such a key component of our work.

Dr. Sharp: Yeah. I’m really excited to dive into that and start to wrap my mind around how that might show up. Are you primarily working with kids these days or adults or both?

Dr. Julie: It’s a pretty even split between kids, teens, and adults. It varies a little bit from time to time but works with the whole [00:07:00] age range, all individual therapy at this point.

Dr. Sharp: I got you. Okay. And then assessment-wise?

Dr. Julie: Yes, primarily children, but also some adults and teens.

Dr. Sharp: Oh, okay. Very nice. How did you get where you are with this, this whole topic? We were talking just for context before we started to record about how I was joking Brene Abraham is the only other person I know of who’s really making a career out of shame research. I’m just curious, how do you go down this path in the first place and get interested in this?

Dr. Julie: Okay. I’m going to say this part which some people might laugh about but I would say my first introduction to shame were some super annoying bullies in elementary school. A lot of us have had early experiences. That was my first exposure to shame, I would say. And professionally, I started graduate [00:08:00] school in 1993 at Fuller in Pasadena, California, and I was really fortunate to meet Nancy Thurston, who was also my faculty advisor.

And she had a shame research team that I joined and she had worked with some individuals previously who had trained with Gershen Kaufman. Who’s one of the big theorists on shame written some books and is really well known. And Nancy had had this idea of a projective measure of shame, which was also really intriguing to me. And we can get into the details of projective measures versus questionnaires. I’m sure we’ll hit that topic.

But I started working on her team with her and long story short, we had in about 1997, we had done a pilot study with an initial set of cards for the test of shame and that generated some good data that led us to further refine the test develop it further and do a larger scale study. And it was accepted [00:09:00] for publication by Western Psychological Services. And 10 years ago was published. That’s the real readers’ digest version of how it all came about, but it was really an exciting time.

Dr. Sharp: Yeah. I mean, I can’t imagine as a graduate student being able to develop a measure, like an actual measure that goes to publication. I know that there are people out there that do it obviously.

Dr. Julie: Yes. But sometimes I wonder how it all came about, I don’t even remember now if I was assigned to Nancy or what, but it was just wonderful and she was great to work with and was supportive of me as a student and in being involved in the process. That might be partially why I really enjoy working with graduate students. It’s a tricky time as you remember. A vulnerable time when you’re really stressed but you can really do some exciting research. And I’m thrilled we have students [00:10:00] even now starting new projects with the test.

Dr. Sharp: It’s got me thinking back to my shameful experiences in graduate school. There’s a meta-level to it.

Dr. Julie: Exactly. It’s everywhere.

Dr. Sharp: it is everywhere. Is that something that you were always interested in? I mean, did you go into graduate school thinking I want to work on this? I want to work with her or did grow on you?

Dr. Julie: No. It just came together. I don’t quite know how I think I was primed for shame as an interest. My interest initially was working with teenagers and giving them positive experiences because adolescents can be challenging with feeling self-conscious and peer pressure. I think I was primed for shame but didn’t really have the words for it or the understanding.

This research team was pivotal and I think the idea of a [00:11:00] projective really made much intuitive sense to me that asking someone about their shame on a questionnaire is just not as effective as it could be but learning more about projectives or now their performance-based measures, going at it in a different way is just much more effective.

And I also like the creativity of that test in my occasional free time I enjoy creating art. And I think that it was a synergy of it made so much intellectual sense. And then just from a gut instinct, having had some unfortunate experiences. I wouldn’t be likely to admit to someone that I’d been bullied and didn’t feel good about myself. If I was sitting across from a psychologist who has a clipboard and is writing down everything I say it’s a setup but [00:12:00] it was great.

Dr. Sharp: Yeah. Well, and it certainly has led you down what seems like a really pretty meaningful path. Has turned into this amazing thing.

Dr. Julie: Absolutely.

Dr. Sharp: I have a lot of questions about the test and how you developed it and everything in that world. But I don’t know much about shame certainly as a construct. I’m just curious about that. How do you define it if that’s the right way to approach it?

Dr. Julie: It is. It’s most simple, I usually have this really long definition of shame that I read at workshops and it’s really excruciating to read it because it has all these really painful words. But the simplest way to describe shame is first actually I’ll describe guilt because guilt and shame are often used together or interchanged, and they’re really different, [00:13:00] guilt is feeling bad about something you’ve done or not done. If you think about it, it’s a little more distant from who you are.

We can’t see because this is a podcast that I moved my arm out. It’s a little bit more distant from yourself. It’s a behavior and shame is feeling bad about who you are at your core. It’s feeling defective, deficient, not good enough, you’re not measuring up and it’s actually probably the most painful emotion there is. It’s very disintegrating for some people.

And so it’s important to note that because often the way we can identify shame is not by someone saying they have shame because imagine if you’re feeling so inadequate, you’re not going to express that directly to someone. We more often notice shame in the ways that people try to protect themselves from it or defend themselves. Often scrambling to [00:14:00] write yourself after you’ve been knocked over emotionally

Dr. Sharp: Yeah. Then how do you even start to measure something that people don’t talk about?

Dr. Julie: Which is the dilemma, that led to Nancy’s original idea for this projective measure because the existing measures for years were questionnaire-based. And even today there are no other performance-based measures of shame. If you can imagine some of the tests are, I guess I used to call them paper and pencil measures. They’re often on the computer now but they ask questions where you respond with a true or false, or maybe a Likert scale response.

Or there are some tests that are more scenario-based where it will describe a shameful scene and then you’re to pick how you might respond A, B, C, D, E. The problem with [00:15:00] those approaches is that they’re fairly face valid, it’s obvious to your client what you’re asking about. If it’s obvious to them, then they’re able to modify or modulate their responses. If they don’t wanna be too vulnerable, they’re not going to admit to as much shame.

That’s a problem and there’s some research out there talking about the problems of these measures with regard to that It brings us to the Thurston Cradock Test of Shame. And it’s a little awkward because I would love to be able to talk more about it. But since the podcast is available to the public I can’t release very much information because it would compromise the integrity of the test.

People would know how it works and then they wouldn’t respond and then we’d have another problem. I have a big asterisk here, if you could see it that Nancy and I would both love to work with [00:16:00] professionals about the test and explain how it works. And we certainly do consultation and all things.

We have a website and I’m sure you have a little…

Dr. Sharp: Yeah, we’ll do show notes.

Dr. Julie: perfect. We can certainly let you know more about it, but in a nutshell, what I can say is the test captures the shame experience in a way that these other questionnaires do not. It’s a card-based performance measure. We’re able to look at the shame that someone experiences and then what they do with it, how they manage it, how they protect themselves from it, and how they defend against it. It really is more of a comprehensive snapshot of how an individual experiences shame as opposed to a score or a fixed number that explains if is someone shame-prone or guilt-prone. It has a lot more useful [00:17:00] data.

Dr. Sharp: Yeah. Can you say more about that distinction? You would call it more of a snapshot versus.

Dr. Julie: I guess it’s more of a, the data you would get from the test would help you understand how a client would manage shame in their everyday life and in their relationships. And even within their own mind, there’s a lot of components of shame that some are interpersonal, like who you’re interacting with, but a lot of it’s intrapsychic most of us have f an inner critic that can get kicked up.

A lot of the shame phenomenon happens within our own minds and our own experiences. It gives information that helps illuminate what happens to people.

Dr. Sharp: Yeah, absolutely. Do you find that it changes over repeated administrations? Do you have any information on that?

Dr. Julie: [00:18:00] I do not, but that would be fascinating.

Dr. Sharp: Yeah. I wonder.

Dr. Julie: Yeah. It’s fascinating because so much of when shame becomes problematic really toxic it’s after repeated experiences of being rejected and not having shame repaired or addressed with someone. It’s a sense of the self that over repeated experiences of that becomes more entrenched. So it becomes less of a state shame of a situational experience of shame to a trait shame, more of a dynamic that’s embedded in your personality.

And so we have not, but if you’d like to do some research, we could yeah, it would be great. No, I think it would be really good to see. And it’s interesting because even the assessment process and the therapy process can be very pivotal in healing some of the shame. Shame can be repaired only with another person [00:19:00] present, to be able to talk about those aspects of yourself that you feel so badly about.

If you have a safe trusted person to help you through that. And we’re in a position as psychologists and in terms of therapy or assessment to really help people understand themselves better in a kind way. I think the old way of assessment could be so shaming and very distant and could make the shame experience worse.

But I guess ideally if someone administered the test and they would provide feedback, they would do so in a kind way that maybe at the next administration, there would be a difference, but I don’t know. I think we’ll have to study that.

Dr. Sharp: Yeah. That’d be fascinating. You said a lot of things actually in that little section that caught my attention one being that you can’t [00:20:00] really heal shame without another person present. Is that, I mean, I guess that makes intuitive sense, but is that something that y’all have found in your research, or is that a well-established idea?

Dr. Julie: It’s a well-established idea. I believe that shame is such an isolating painful experience and the nature of shame makes you want to hide and withdraw from people. And of the ways, we see shame as a classic shame reaction is when someone looks down or looks away they disengage from eye contact.

Because the last thing you want is to see someone seeing you when you’re in that state of I’m defective, I’m not good enough. And really it’s in a relationship and in being with somebody else that is trustworthy, ideally, this happens like with a parental figure when you’re young, if you’ve made some mess as a kid or made [00:21:00] a mistake and your parent hollers at you or you’re running out into the street and the parent yells and you come back. Some kids with repeated experiences and especially if they have an insecure attachment dynamic will assume that they’re bad kids.

And tragically, a lot of parents will say, you’re a bad girl. You’re a bad boy. As opposed to that was the wrong choice or that behavior was bad. And so it really, children will tend to make it about them. And if you have a parent or later, maybe a teacher or another adult or a spouse that can say that wasn’t a good choice, that wasn’t good behavior, but this is why I yelled, I love you and you’re not bad and really help you through that and sit with you as you cry or feel remorse, it can be tremendously healing.

But so often our repeated experiences of shame [00:22:00] go underground and it just becomes a vague sense of I’m not good enough.

Dr. Sharp: Right. Has your work in this area changed your parenting at all?

Dr. Julie: I would say what’s interesting. I became a parent long after I had started this and this work. My daughter’s 40, so it was five years before the test came out. But I do think about it a lot and actually, it’s so it’s interesting. Shame is so tricky because I think we all have shame to some degree, and shame about certain things. And I certainly know what my like hot-button issues are.

And so I’m mindful of that in her as well as in the clients I work with. Hopefully, we’ll get into this too. Much of working with shame is being aware of your own issues around it and being able to go there. I would like to think it has enhanced my parenting, but sometimes [00:23:00] it’s funny because my daughter’s a different person, so she experiences things differently than I do. And so it’s, yeah. Some events that would have been upsetting to me just aren’t to her.

Dr. Sharp: That’s right. I suppose that’s true. Our kids are different people.

Dr. Julie: And hopefully, if we’ve done our own work with each generation everyone’s moving further along.

Dr. Sharp: Yeah. Do you find that you talk to your kids differently or are more careful? I mean, I think just being a psychologist. Many listeners know I’m married to a therapist.

Dr. Julie: Oh, me too. Yes. Our poor children.

Dr. Sharp: That’s right. That thing it does again for better, for worse make it something where we are highly vigilant to parenting or just language and [00:24:00] how that might impact our kids. Do you find that you have an extra layer on top of that with this shame work that you’ve done?

Dr. Julie: I think so. My daughter just finished middle school. She’s going to high school. And I know my husband and I have been amazed at like the lack of middle school drama that she had and the lack of like bullying and stuff. And we’d say like what’s it like, and there has been a refreshing lack of it, which is so good, but it’s like we were primed given the experiences we had or saw when we were young anticipating that.

So it’s lost now what your exact question was, but I think I’m a little extra vigilant, but she grounds me back down about it. she’s fine.

Dr. Sharp: It’s a two-way street. They influence us and vice versa.

Dr. Julie: Yes, exactly.

Dr. Sharp: Yeah. So you [00:25:00] mentioned the element of needing to do our own work around shame to be able to work with our clients. Can you say more about that?

Dr. Julie: Yeah, I’ll step back even further and say, in our field of psychology, which is not that young not that old, but it hasn’t been until maybe about 40 years ago that shame has been parsed out from guilt, just even in the literature, even in the research. So it’s recent. I think as a field, we don’t really want to go there as a shame. That’s my thinking here.

Because if you talk to somebody about your shame and you have shame yourself or just low self-esteem or guilt or any of these what I would call a family of self-conscious emotions, you risk data coming up that bumps up against your own stuff. And that happens with all [00:26:00] issues. Family dynamics, when you’re working with clients, that’s why therapy and supervision are so important in training and beyond in consultation. But I think we can, without realizing it, prevent clients from speaking up about things, because we are not ready to hear them.

Does that make sense? We could just not notice clues that they’re a shame, all at an unconscious level. But it’s incredible I think when you can go there and I remember in graduate school, I had the experience in some ways, and I’ve talked to some other colleagues about this, where I was in my own therapy through graduate school.

And sometimes I felt like I was just a few miles ahead of what my clients were. And I remember my therapist saying it’s because your capacity to go to certain places is growing. And it really in understanding yourself, you can be [00:27:00] that much more effective. And certainly, with shame, the tendency to want to hide those aspects of ourselves is key, which is why I started out by saying like my first experience of shame or bullying was in elementary school. I’d had some of those experiences. And so I knew what some of those feelings were like, and I can use that by understanding how I managed it then and what it was like, and how it carries through to today.

Dr. Sharp: Sure. I think that’s fascinating. And it just makes sense, even as we were looking through the cards, we got to look at the cards. I was thinking back and it’s almost immediate. Where you’re bringing up certain experiences for my life and wow I was just thinking, oh, Hey, can see how this could be the real deal to stir up some of those things.

Dr. Julie: Yeah. And I think shame is so relatable to [00:28:00] people, whether they realize it or not we have a lot of that in life, so it’s a normal experience you had of that is.

Dr. Sharp: Yes. I know.

Dr. Julie: Just thank you just to be a psychologist with you right now. I mean, it is really common, which is part of what’s so important for evaluators and therapists to validate some of that. It’s understandable you would want to hide, you would want to not feel that painful feeling that’s normal and understandable your defenses are there for a reason.

Dr. Sharp: thing. Yeah, of course. Do you find any differences across demographics for shame in terms of male, female, younger, or older?

Dr. Julie: It’s interesting, some of the cards are more anecdotally, we’re still doing a lot of research and there’s so much to look at including everything you said there, there is a project coming up, looking at older adults and shame, which [00:29:00] would be interesting but typically, we’ve had a lot of people describe guy shame as related to performance-based and athleticism.

And I think females have more interpersonal dynamics shame, but that’s not been, I don’t have hard data to support that that’s more anecdotal, but I think we all experience shame very differently. And there may be many women who are a lot more athletically achievement-oriented and for example, if they don’t do well in a sports game, they might feel ashamed or something or don’t make the team or something like that.

Dr. Sharp: Yeah. I’m so curious about all of this. It’s funny. This whole other world that, I mean the area that we have not taken a close look at. Fascinating. [00:30:00] I am curious how this shows up in the assessment process, right? And maybe at the risk of being reductive and hopefully not defensive. Why is it important? Why is it important to include this in some assessments?

Dr. Julie: I have my favorite quote of shame, which is cut along and I won’t read it to you. But my other favorite quote is, Helen block Lewis called shame, the sleeper, and psychopathology. This is a pretty provocative statement, but I believe it to be true as does Nancy as do a lot of shame theorists. Shame is often a component of depression, anxiety, substance abuse, eating disorders, and impulse control, all diagnoses as well as interpersonal difficulties people have.

That they come to us for therapy or assessment. And [00:31:00] some of the things that you might think about, oh, is shame a component. If someone comes in and they have themes of achievement or feeling like a failure, maybe at work or with academics or perfectionism extreme focus on physical appearance, interpersonal difficulties, if there have been breakups, sometimes people will have repeated job experiences that are disappointing or relationships maybe that are playing out some shame dynamics there.

As well as issues with authority figures, sometimes authority figures you project onto the authority figures that they’re judging you. Sometimes they are judging you. But I would say shame is very often in the mix and if we don’t look for it and evaluate it we might be missing a key piece that would explain other symptoms.

Dr. Sharp: Yeah, that makes sense. And I’m just thinking really, I’m just firing off of top of my head here, but I mean, [00:32:00] is there anyone that does not have some degree of shame about something, or are there individuals who go through life for whatever reason and they emerge into adulthood unscathed?

Dr. Julie: I would say it’s pretty rare to not have any shame you have your people that have no shame would be more like sociopaths. They have no, okay. No sense of shame. There’s that category, but also people may have lower levels of shame that maybe they had, there are no perfect parents and I often say to parents in my practice you don’t need to invent ways to, A, you don’t need to be perfect. There are no perfect parents and B you don’t need to invent ways to demonstrate to your kids that you’re not perfect because those will happen.

It’s more about talking through and the repair and I’m sorry, I made a mistake or I’m sorry I yelled at you. I [00:33:00] was frustrated explaining all of that, but there are people who have parents or other adults or peers that can help them repair those experiences where you might feel rejected or that you’ve done something wrong, it doesn’t transfer right into therefore I’m a bad person.

Steve Finn has really helped me understand a nuance with shame and guilt where he says, if you can move from shame to guilt, that’s a developmental achievement. And I think when you’re little, you might assume that you’re bad if you’ve had bad behavior, but if that can be addressed in a healthy way and repaired, then you can move to guilt and you’re going to forget things.

You’re going to make mistakes and then you can make amends for it and say, I’m sorry. And move forward. And it doesn’t get you at that deep level where you are emotionally in a puddle on the floor, like where you just feel [00:34:00] decimated by shame as some people really do. A little tiny thing, like being a minute late for an appointment or forgetting to send someone an email can devastate some people who are primed for this intense shame due to previous experiences.

Hopefully with the increase of interest in shame and yes, Brene Brown has done tremendous work in making it more of a topic in popular psychology to be able to talk about it, we can address this at an earlier level.

Dr. Sharp: Yeah. That’s the idea. Well, so I’m thinking about the test, and is this something that you can use with kids or adults or both?

Dr. Julie: I would say with kids you want to as with any instrument like this a performance-based measure, you need to interpret things accordingly to a child. If you have a child who doesn’t have a very large [00:35:00] vocabulary, you want to modify your interpretation, but you can. You certainly experience shame and yeah.

Dr. Sharp: Yeah. What are some assessment scenarios where it might be helpful to pull in this measure?

Dr. Julie: I would say if you feel like you’re not quite getting a full picture, which I know is super vague, but we’ve had some cases where this test has really been the key piece in explaining symptoms that otherwise were really confusing based on testing data. And certainly, if you have any of those issues of depression, anxiety, and all the things, I already mentioned that there may be a component of shame and someone is basically how they’re coping with their shame, how they’re defending against it either by withdrawing, maybe an extreme form of withdrawal with shame might be depression. If it just might be the [00:36:00] underlying piece that could explain it. I think that that is key.

Dr. Sharp: I’m just thinking about folks probably like myself who if you’re not steeped in this area, what are some things we might see that are triggers or flags to say, oh, this is maybe a time that you could look into shame.

Dr. Julie: Yeah. I would say certainly if you’re hearing things like someone talking about, no, one’s really going to come in and say, hi, I’m Julia. I have shame. It’s very unlikely, but if someone comes in and they’re describing a sense of not measuring up and comparing themselves to other people or having chronic, like interpersonal difficulties or problems at work and you think they may be experiencing some low self-esteem, some shame, those [00:37:00] self-conscious emotions, that that would be an indicator.

The other thing is sometimes you notice the shame in your office, not by that sort of deflated, like averting the gay response, but in other ways where someone is just having a very sharply different emotional experience. Like you might be saying something and someone suddenly almost turns on a dime and they’re mad, or if they put you down, some people you’ll see it basically in how they defend against shame.

One way, if you think about bullies, many people talk about the shame that bullies cause, but that’s not fully understood is that a lot of bullies actually experience shame themselves. In order to cope with it, they basically, put someone else down. They temporarily feel powerful. And I’ve had experiences where people will come into my office and it’s so tricky with assessment because we, psychologists, we have the tests, [00:38:00] we have the knowledge, that’s why people are coming. Hopefully, we have the knowledge, we know how the tests work. The tests can be really mysterious and intimidating for clients.

And people are coming in wanting your help, but it’s difficult. They feel vulnerable. And if they’re prone to shame they may cope with that by sitting on a couch, covering themselves with a pillow, and looking to the side, not making eye contact. I’ve had people talk about the pictures on my wall and criticize pictures on my wall. Or, yeah, I’m very pretty on time, but if I’m late, they might criticize that. And that’s odd, that’s not really socially appropriate. I always wonder what’s going on there. Y

Or to get a sudden angry response to something it’s a sign that something deeper has been triggered maybe shame. I don’t want to say it’s always shame but I think we need to have in the back of our minds that the vulnerability that clients have come [00:39:00] in and really the power differential setup of completing these tests and you then being told what’s what the problem is.

And then all that, it’s just a scary setup for people. And if they’re already feeling like there’s something wrong with them, they can really be in a state of scrambling, which is especially important, if you have clients completing tasks, like the WISC or the WAIST, if they’re managing or trying to manage their shame. And a test is being timed and they’re getting anxious and they’re not performing well, that’s really going to impact their scores, their subtests.

And so to be attuned to that, how they’re doing in the process of the subtest, what their experience of the tests are like and maybe to ask that to say like, it’s okay, and you can tell me what did you think about that test? What was that like? And I always let kids [00:40:00] know with the WISC that everyone has the experience that the subtest start off easier and they get increasingly harder because if you don’t often they think that they’re not smart enough and it can kick up tremendous shame that then bleeds over spills over into the next few subtests. And so I found that to be a helpful heads up that I give that kids refer to later. And when I do that, kids tend to have much better frustration tolerance.

Dr. Sharp: Absolutely. I think about, yeah, what a cruel joke it is to play on people, to come into an assessment. And if we didn’t give that disclaimer, that would be really disconcerting.

Dr. Julie: And I know a lot of people don’t and it’s a mystery like the old analytic way of the blanks slate and that stance of can be very intimidating and undoing for someone that is [00:41:00] already fearful of finding out there’s something wrong. They already think there’s something wrong with them. If they have shame. And the notion of being judged, we’re evaluators which is just one step away from judges, like we’re yeah. I mean, not quite, but it’s in someone’s mind who’s feeling that way. It’s really hard.

And then if you think about too with parents, I often experience this. Parents are very anxious when they bring their kids in to be evaluated because they’re the parent and they don’t know what’s wrong. And it’s tough. And my heart goes out to them. I mean, it is hard when, and I know as a parent, I can’t figure everything out for my own child but it’s hard bringing your kid in. Some parents will come in and in the first appointment for an assessment, tell me what’s wrong, tell me what the problem is because they’re the expert. But then because it’s hard for them to not be the expert in some way.

Dr. Sharp: It’s everywhere.

Dr. Julie: It is. [00:42:00]

Dr. Sharp: Yeah, again, I’m just aware of the parallel process, thinking through all these places where it’s ins and outs.

Dr. Julie: Yeah, it’s tricky. It’s like I’m opening a can of worms here with like, oh, shame could be everywhere, but once we start to notice something might be shame it’s really helpful and empowering because then we can ask the questions or shift our stance or move towards someone and ask a question that might be more reassuring or say a comment that might address their shame.

Dr. Sharp: Yeah. We’re talking about what happens if this comes up in the testing environment. So let’s stay with that for a second. Anything in particular that you have found would be helpful to say to someone if they’re going down the same spiral and you recognize that?

Dr. Julie: I think it’s important to [00:43:00] validate what their experience and feelings are, that this is a really difficult process. And to really say, you’re sitting across from me, you come to me because I supposedly have the answers. Yes, I have this training, but it must feel really vulnerable. I mean, vulnerable is, I think that’s a Brene Brown word. I use it a lot because I think it’s a more neutral word that explains, they may have shame. It may not be related to shame, but vulnerability is so relatable.

And then to say, if you’re vulnerable, of course, you are wanting to not feel that way, and your attempts to feel better, make a lot of sense. Of course, you’re turning away you’re covering your face with a pillow. This is really hard. Let’s take a break, and just really normalize that experience and not have them feel like they have to sit in it for the purpose of the assessment. [00:44:00] Silence in therapy or assessment can be excruciating for someone with the shame.

Dr. Sharp: Oh gosh. Yeah, that is unknown where they can project, whatever they want.

Dr. Julie: Exactly.

Dr. Sharp: I’m just considering all the, like all the processing speed subtest or the time things in particular and how many individuals that I’ve probably labeled anxious. You can tell somebody’s anxious but how many times there is some deeper shameful response right underneath that? I would assume then sticks with you more.

Dr. Julie: Right. And I might say something like, sometimes people, the timing makes a lot of people anxious. Sometimes people wonder if I’m writing stuff down. Am I going to be comparing you to other people? Some people worry about that just to normalize it. And certainly, debriefing [00:45:00] afterward is useful, and in the feedback session and report writing, sometimes the reports themselves, traditional reports can be very hard for clients to read that can communicate another layer of I’m giving you this report, but it’s still hard to read because you don’t know what I’m talking about dynamic.

And therapeutic assessment has this lovely way of doing reports where it’s not a report. It’s a letter. It’s much more personal. And I know that’s very different from traditional assessment, but I think traditional assessment can learn a lot from that the personal touch and softening some things I can’t tell you how many, especially parents will bring in reports that are like 20, 25 pages long and hard for me to understand. And it’s hard for them to say, like, I still don’t know what’s wrong. It’s painful.

Dr. Sharp: [00:46:00] Yeah. Because then I’m sure that stirs up some internal sense of I’m not intelligent. Why don’t I get this?

Dr. Julie: I mean, it could, for some people who have a stronger sense of self and maybe don’t have as much shame or have worked through shame, they can say like, well, clearly, this report’s written by someone who knows this lingo, but I don’t know it, but I got maybe the gist of it in the assessment feedback. So I’ve got it. Other people might sit with I’m stupid. I don’t understand this.

Dr. Sharp: I feel like these, I don’t know what it is this time. Oh, I’m trying, I can’t think of the right word, but all the signs are pointing toward the right. Simpler reports basically. I did that interview or that series of interviews with Roger where we talked about the letter and really speaking directly to the client and then attended a workshop at this conference probably a month [00:47:00] ago on simple report writing and now you’re saying it again. It’s just got me thinking, like, we got to do something.

Dr. Julie: And it’s so hard because it’s some assessments we give a ton of tests. There’s so much data to synthesize, but yeah, you need to balance, is it useful or not? How can it be communicated?

Dr. Sharp: Yeah. Let’s pivot just a little bit and talk about when you would actually bring in your measure to an assessment that you’re doing and how does that fit with traditional assessment by which, I mean, maybe I’m biased in that term, but like a neuropsychology evaluation versus therapeutic assessment, or can you just do it with a therapy client? I mean, I’m just very curious about applied cases.

Dr. Julie: All of the above, actually. Definitely, if you think shame could be a component within neuropsychology, especially explaining some of the performance on different tests [00:48:00] and maybe what was happening, you could see what was happening with the client during the administration. I’m not a neuropsychologist, so it’s a little bit beyond my scope here, but I would say it could be used in any assessment, but also yes, within therapy, I’ve given it at the beginning of therapy and the middle of therapy.

And then actually, the test can also be used, as Rodger mentioned, I believe as an intervention, I learned a lot from therapeutic assessment in terms of that using tests in a creative way to really help the client. So that has really opened up doors for me in how to use it.

Dr. Sharp: I’m thinking about these different diagnoses that we work on. I work with kids primarily or only really, but many of our other psychologists work with adults. [00:49:00] I think about those triggers that I was asking about earlier. Depression, certainly anxiety, PTSD, and traumatic experiences. Like any of those could be assigned to say, Hey, why don’t you dig in and assess this shame specifically and see what’s going on there? Then I guess from that point, of course, very data-driven, outcome-driven then it’s like, what do we do with that? How do you integrate this into assessment results and what’s the value add for treatment or whatever else you do after the testing?

Dr. Julie: Often when I have, therapists consult with me in scoring and administering the test and then discuss the case overall and the other data. Typically it adds a piece, at least in the case I’ve had, it adds a [00:50:00] piece that was unknown before. Sometimes it’s about shame. Recently I had a case where it was less about shame, but the response to the test clarified how thought processes and how someone managed affective stimuli.

I don’t think they had a tremendous amount of shame, but it was just a fascinating set of data that fit in nicely with the Rorschach data. Sometimes the test results are very in sync with the Rorschach. Sometimes it’s very different from the Rorschach and MMPI. We had a case last fall where this test was the key factor in the family assessment that was done that wouldn’t have been understood had we not done it. The data was very hard to put together.

That was an example of shame was a key underlying piece that wasn’t accessible through other tests. There are some [00:51:00] scales like on the MMPI and Vista and where Rorschach you can maybe get an inkling of shame, but this allowed for more information to come forward. And then it also becomes an easier way to talk about issues of shame. I think clients are very inclined to talk more about this test.

I know in therapeutic assessment, sometimes they’ll pull out and do an extended inquiry with the Rorschach but I’ve found people can really reflect on this test pretty easily. They can also help them understand their results and be a transition to the results of an assessment.

Dr. Sharp: Yeah. So you might revisit with a client and say, oh, do you remember that card where, and then you responded blank. Tell me more about that. Or how do you see that in your life or something like that? That is really [00:52:00] interesting. I don’t do any work with projectives so put that out there. I may have said that. But the part that appeals to me, one of the parts is that it is a lot easier to anchor the client’s assessment experience.

Unlike block design maybe, or one of the processing speakers, sub-tests where it’s like why does this matter? But with these types of measures, you really can go back with clients and they can say, oh yeah, exactly. I remember that. And that stirs this up.

Dr. Julie: And then it can relate to, say you’re testing a child who has ADHD and feels like they’re not doing well in school, and what do their peers think of them? And they get teased. And then they can understand how perhaps the shame experience compounds their ability to focus and concentrate. And it can [00:53:00] be really relieving in a sense to have an answer that’s a deeper level answer than a diagnosis or I think particularly, I know I’ve said this several times to validate that defenses are there for a reason.

We may not need them for our whole lives and the way we thought we did when we were younger. But that shame is a powerful feeling that gets kicked up, been a lot of environments and a lot of the same things that people come to us for help with. But they just don’t realize it.

Dr. Sharp: Yeah, exactly. I’m just thinking about how it’s a key component of mini-presenting concerns for folks. Is there anything else you might be able to say about the test I don’t know what we’ve covered, it’s a card-based projected measure. I’m not sure if there’s anything else you could share [00:54:00] about how it’s scored or what a clinician might glean from it is it similar to any other measures that we use?

Dr. Julie: I would say it’s similar to the TAT the Roberts, tell me a story, those tests. Similar in format to that. It’s tricky. There’s such a dilemma not being able to say too much, even though I would love to. But certainly, I think if anyone had any more specific questions, I’d be happy to answer those as would Nancy I’m sure to help with some consultation about how the test would be useful in specific cases. And certainly, we have professionals that ask for consultation they’ve administered the test and want help to see, one of the things that’s funny that people have tended to do is they don’t give any information about the client.

They just send me the protocol. So it’s been this game with some repeat clinicians to [00:55:00] see what can be gleaned without having filled in the data about who this person is and it’s interesting what you can see and how it does or doesn’t fit with the testing data.

Dr. Sharp: Yeah, I bet. I’m fascinated. I want to take this test and see have someone tell me, to solve some of my internal half-jokes. You mentioned you do training you do consultation. What format does that take and how might people find you get in touch with you?

Dr. Julie: Nancy and I have a website testofshame.com. And again, you’ll see the website is vague by design because it’s a public website, but it has a list of some upcoming workshops or some recent workshops. It’s not exhaustive because the website’s rather recent but [00:56:00] where we’ve presented and then information about how to connect with us to do consultation or training. So typically, someone will contact me and say, I have a case, then that I schedule a time.

They send me the information from the test and then I do scoring and interpretation and get it back to them. And then we can even schedule a time then to go through how I’ve done the scoring. Some individuals will learn at a workshop how to do the scoring interpretation, others it’s more the individual consultation. I see. And I think Nancy has a similar format and that’s how you can learn.

And of course, you can just buy the test through the Western Psychological Services website and teach the test to yourself. But more times than not psychologists will contact and say, Hey, I want some of the more advanced interpretation is a little, which trickier, but [00:57:00] everything, the manual contains a lot of information about how to do the scoring. So it’s a pretty detailed manual.

Dr. Sharp: Sure. And at this point, do you have any accompanying texts or essentials of the test of shame?

Dr. Julie: Good question. Yes, we are talking about a case book. The manual has several cases, I believe eight cases in the manual are illustrative examples of scoring interpretation. But yeah, we are planning a case book to be even more detailed than that.

Dr. Sharp: Yeah. Very cool. I think I should have asked before we totally wrap up are there any folks where this would not be an appropriate measure?

Dr. Julie: Good question. I would say if people are very activated in their shame. [00:58:00] You may want to wait until they’re in a stronger place. We’ve had one of them, I remember we had one of our research participants who were unable to complete the test. I think they got to card three and had to just stop because it was so, I mean, some people are just not to sound scary, like it’s too activating, but if someone’s so in touch with their shame and it’s too painful, they’re not going to be able to manage the test just like the Rorschach might be difficult for them if they’re too activated.

But otherwise, I think you could start with it and see how it goes. But I don’t think, I can’t think of anyone that it would be inappropriate for. If someone has a child who doesn’t have a very extensive vocabulary, you just need to interpret accordingly. Someone not very verbal would be tricky.

Dr. Sharp: Yeah, of course. I [00:59:00] was just considering, what was I considering? I totally lost my train of thought. Oh my gosh. Maybe it’ll come back. Okay. Oh, this is what it was, I was thinking about, we talked earlier about repeated administration and so forth. I wonder about the utility or the validity of like a pre and post, after an EMDR treatment or something, or after a specific set of a course of intervention.

Dr. Julie: That’s yeah, no, that’s really interesting. Another piece I don’t quite know how this popped into my head. I think when you pause for a moment, that is my, if I could design the next research project, it would be looking at couples because I don’t work with couples myself. But some people consult with me on shame with individuals and what’s so [01:00:00] fascinating to me is how couples come together and end up activating shame in the other through their defenses.

One person withdraws, which makes someone feel abandoned and then they become more domineering to get the attention back. And then that person feels ashamed because they feel bullied. It goes like a hot potato in couples. And for people who do couples assessments, I think this would be especially interesting just to explain why people behave the way they do. I often use this analogy of long division where at least I know with my daughter if you just give an answer to a math problem, but you don’t show your work, you don’t get credit, but if you show all of your work and even if you make a mistake somewhere along the line, you get partial credit.

And I think interpersonally, we need to show our work and why we respond and react the way we do what the context is, and what got triggered. And that can be such an important part of a couple’s work. [01:01:00] And for a couple to understand how one person’s withdrawal, oh, that was because I felt activated and ashamed and I needed to regroup my spouse may be perceived that as being as withdrawal of intimacy or something like that.

And then they get triggered and then in their reacting back one in contact, it feels bad to the person who’s been ashamed. And it just once you can understand how those dynamics happen, it clarifies a lot because otherwise we’re just left bumping up against each other’s defenses.

Dr. Sharp: I know it gets messy. I’ve talked, I think before on here about how in my former life was a couple’s counselor and my modality was emotionally focused therapy for couples, which I mean, so that resonates really strongly with the EFT approach. I was even thinking about sometimes I’ve heard of couple’s therapists [01:02:00] almost using the adult attachment interview as an intervention itself to see your partner go through those questions.

And I wonder about that with the test of shame, what it would be like as an intervention in a couple’s session, to see your partner again, like go through the cards and I wonder if that would lend for some couples maybe would lend just the depth of understanding that they might not otherwise get.

Dr. Julie: Absolutely. No, that would be really interesting. And someone mentioned, actually, I did a training last Friday and someone asked about there’s this notion of a consensus Rorschach where people members of a family come up with a response together. And the question was asked, what if there was a consensus, TCTS, which was interesting. I’d never thought about that before. There’s a lot of possibilities just getting into the process.

Dr. Sharp: Yeah. Super cool. Well, it’s clear that you are doing some really good and really [01:03:00] important work.

Dr. Julie: Thank you. I love it. It’s weird to love, shame, but I love the potent. I know it’s a strange person, but I don’t really love shame, but I love the potential for healing shame and understanding it better. It’s become quite a passion of mine.

Dr. Sharp: Yeah. Well, we need people doing that work. I think because like you said, it’s universal. For the most part, a lot of people are carrying shame that they need to work through probably. So again, if people want to reach out to you and find you is it best to do that through the website? Or do you have like a personal anything that you want to share?

Dr. Julie: I think the website the information will come to Nancy and me, and we’ll be able to get back to you quickly and answer your questions and it would be, we love that. Testofshame.com and there’s a link there to the link on Western Psychological [01:04:00] Services website as well to purchase if you’re interested.

Dr. Sharp: Very cool. Well, I can tell you that you’ve already made some fans just by virtue of not selling it through Pearson because people are not too happy with Pearson right now.

Dr. Julie: Oh goodness.

Dr. Sharp: The fact that they can go to a non-Pearson website is probably, in your favor.

Dr. Julie: Got it. Heard that.

Dr. Sharp: Okay. Stick with WPS.

Dr. Julie: Yes. No, they’ve been great.

Dr. Sharp: Thank you so much all for making this happen, making the time driving up here, this is really great to be able to sit across from you and talk through something that’s so important to you. And I think too many other people.

Dr. Julie: Thank you. Okay, so I’m going to say this. Thank you so much for The Testing Psychologist. I had not heard about that until Rodger had told me. And the whole mission of starting this, I mean, coming out of grad school, you know how to do a lot of these things, but not how to set up a practice. It’s really [01:05:00] difficult and could be for some people shaming. I mean, it’s hard to do it. So this is really useful to provide resources for professionals and for us to rely on each other for assistance and support is great. So I love it.

Dr. Sharp: Thank you. I do appreciate that. It’s always good to hear. Well, until our paths cross again.

Dr. Julie: Sounds good. Thanks so much.

Dr. Sharp: Hey, y’all thanks again for tuning into my interview with Dr. Julie Cradock O’Leary, that was really interesting for me. Clearly, you can tell that, Julie feels very passionately about this topic and it’s really dear to her and very important in the clinical process. At the same time, certainly not something that I would really ever think to formally assess. Hope that you took away some good information from this interview.

Like I said at the beginning, I am going to start recruiting again for my Beginner Practice and Advance Practice Mastermind Groups. Likely to start in late September, [01:06:00] if you are interested in a group coaching experience, I would love to talk with you and see if it’s a good fit. You can go to thetestingpsychologist.com/consulting and schedule a phone call to talk about the mastermind group.

In the meantime, take care. And I will talk to you next time.

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