The TeleWellness Hub Podcast

EP 83. From Hollywood to Healing: Leo Massey's Journey into LGBTQ+ Affirming Therapy and the Power of DBT

• Martamaria Hamilton • Episode 83

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This episode features a deep dive into Dialectical Behavior Therapy (DBT) with therapist Leo Massey, exploring how this effective modality empowers individuals to manage their mental health. Listeners gain insights into DBT's structure, skills, and the importance of seeking help from a supportive therapist.

• Overview of Leo's journey from entertainment to mental health
• Explanation of DBT and its primary components
• Discussion of skills taught in DBT
• Importance of phone coaching and real-time support
• The value of collaborative care in mental health
• Encouragement for seeking help and establishing trust with therapists

In New York City (or Maryland and New Jersey for virtual sessions) and want to book an appointment with Leo? Find him here: https://counselingcentergroup.com/therapists/leo-massey/

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Speaker 1:

Welcome, friends, to the Telewellness Hub podcast, a space where listening is not just a simple passive act. It's an act of self-care. I'm Marta Hamilton, your host, and today you are getting to hear directly from Leo Massey. Leo is an LGTBQ plus affirming and identifying male therapist who is comprehensively trained in DBT, emdr and utilizes CBT, act and exposure therapy. He helps individuals facing challenges around anxiety, depression, borderline personality disorder, gender dysphoria, trauma, ptsd, self-confidence, adhd, antisemitism and autism spectrum disorder. Welcome, leo, thank you so much for joining us today.

Speaker 2:

Of course. Thank you so much, Marta, for having me on this podcast. I appreciate it.

Speaker 1:

I'm very excited. You know, I randomly approached Leo on social media in a message. I was just really intrigued and I just really was drawn to the content that Leo was sharing with others and before hitting record, I talked about. You know, sometimes the world can feel very overwhelming. I think right now there's a lot going on.

Speaker 1:

I'm sure there's often a lot going on and to be scrolling on social media and see something that really speaks to the light of the world, like Leo, just seemed like a light was sharing, just sharing really helpful, inspiring insight for others. And I thought you know what I want to talk to this person and get to record and share with the world so that hopefully, this can be a light and just really amplify all the work that Leo's doing with clients, so that people can get an inside look of what that might look like for themselves in terms of seeking therapy and working with a therapist like Leo. So thank you so much for joining and before we get started into some questions I'd love for you to share with us why do you do the wellness work that you do?

Speaker 2:

Yeah, so a little bit of background. I actually used to work in entertainment, so I was in the entertainment industry, filmmaking industry and specifically, yeah, so I was actually working at talent agencies, talent management companies, and I realized when working in that industry in Hollywood, there were a lot of people. I was actually working at talent agencies, talent management companies, and I realized when working in that industry in Hollywood, there were a lot of people I was coming face to face with that I recognized needed certain mental health assistance, needed mental health help, whether it was substance use, depression, debilitating anxiety, anger management or even just suicidal ideation, especially working in that field with very intense hours and restraints, and it just gets to people. So I think it was one day, if I recall correctly, that I was actually speaking with a um, an actor, and we were talking about they just got back from war, they were a veteran and they were telling me more about their ptsd and what they were experiencing. And I remember actually wanting to talk more with them about that subject matter rather than trying to help them get this next big role on some TV show or movie. Oh, wow, so I was realizing I'm much more interested in this and flash forward.

Speaker 2:

You know I made then the career pivot from entertainment to the mental health field. You know I applied to Columbia School of Social Work, got in and then I applied to the DBT program, which we'll get into a little bit, is dialectical behavior therapy, and I remember actually being in entertainment. I was going down a rabbit hole looking into just different modalities, different therapy that people utilize, and I came across DBT and then more googled it. You know I looked up the founder, creator, marshall Linehan, and how it pulls from cbt, and then I saw celebrities that have utilized it, like Pete Davidson, zina Gomez, and I was like wow, this, this modality, is just part of this really big third wave and it's making splashes and people are really enjoying the skills that come with it, which, again, we'll get a little bit into. But yeah, so that's how I got into it.

Speaker 1:

Wow, you know, you don't typically hear that path in terms of entering mental health from the entertainment world, but that's so fascinating.

Speaker 1:

I can see how. I think it's interesting. You pointed out that conversation where you wanted to explore more about that person's you know mental health journey and how that really just catapulted. You just never know in a conversation with someone what kind of an impact it really has, and I think that's what's so special about our field that human connection element. I think it's just incredible. I you know you're mentioning DBT and you know researching it and the modality and as a therapist myself, it is a really specialized field and training. So I think if you're interested in DBT, you're listening, you're interested in DBT and we'll talk a little bit about what that is. Definitely finding a therapist who has background in training and like passion, like Leo, for this field right, they're researching, they're training, they're diving into it because it is really a specialized approach approach. So if you don't mind sharing, can you give a little brief overview to listeners of what dialectical behavior therapy or DBT is and how it's different from other approaches in therapy?

Speaker 2:

Arta, I thought you would never ask. I am happy to tell more about DBT and talk your ear off about it. I always tell people whenever I talk about DBT, I feel like I'm doing some sort of consultation, because people ask oh, I don't know what DBT is Like, tell me more. Yeah, you know. 15 minutes later they're like I'm in, I've invested, I want to learn more. So, yeah, it derives from CBT, which, for those who are listening, may be familiar with cognitive behavioral therapy.

Speaker 2:

It initially, like I said, was created by Marsha Linehan around 40, 45 years ago. However, it's been perfected over the years, been revised, there's been adaptations. It was initially created for the purpose of helping people with borderline personality disorder, helping to treat individuals with those symptoms, whether it's interpersonal dysregulation, cognitive dysregulation, emotional, some sort of dysregulation that comes up and happens throughout their day-to-day life, and over the years of perfecting the modality and research, people have found that it has been helpful for individuals also with debilitating anxiety, extreme depression, suicidal ideation and also many other mental health concerns, including ADHD, substance use, disordered eating. There's I always say there's like an A to Z in terms of adaptations. There's adaptations of DBT that are just used widely for individuals for these concerns and I will say just to give you briefly, in a nutshell, what it actually is. It is very much a treatment that helps equip individuals with more adaptive coping strategies and mechanisms and provides the psychoeducational aspect of this is why you behave this way, this is why you think this way, this is why you're experiencing these, these urges, these reactive behaviors.

Speaker 2:

And going back to the skills, these are skills that you can use. So, and people always say you know d, dbt it's the skills. However, it's more than just the skills. It's the process of monitoring those target behaviors, those behaviors that individuals come to therapy wanting to work on minimizing. It's making sure that they're working toward their long-term goal. And just to go briefly down that rabbit hole of, again, what is DBT? There are five modes and functions in DBT and it's very much individual therapy, skills class component, phone coaching, consultation team and then DBT case management, and I'll go briefly through each one. But individual therapy is very much where we work one-on-one with the individual client and we make sure that those target behaviors that they came to therapy working to want to minimize are being worked toward. You know, people are putting in the effort, they're utilizing those skills, whether it's DBT skills, or maybe pulling in adaptive skills that they've used throughout their lives thus far.

Speaker 2:

And pinpointing and this is an important one pinpointing a target or a specific life worth living goal in DBT meaning this ultimate goal that they want to work toward, what's bringing them into therapy, what's motivating them to make these changes right now and right here? So that's very much in a nutshell what happens in individual therapy. We're going through this diary card, which is where we list all this information, including also if there's been any emotional changes day to day throughout the week, if that individual has experienced urges of any sort, if they're taking their medication. We monitor everything on that entire diary card. Then there's also the skills class component, which is where we're going through the DBT manual, the four specific modules of mindfulness distress tolerance, interpersonal effectiveness and emotion regulation.

Speaker 2:

We're going through the DBT manual, the four specific modules of mindfulness distress tolerance, interpersonal effectiveness and emotion regulation. We're going through these in a class format, talking about specific skills to help you cope through specific situations. If, say, someone's at a 10 out of 10 in terms of feeling that level of dysregulation, maybe it's utilizing a distress tolerance skill, Maybe it's utilizing an emotion regulation skill when they're at maybe a six or seven. So that's in a nutshell again what happens in the skills class component. And I say skills class because it very much is a class component, not a group, Even though people still say group. However, there's not really a processing aspect to it. It is very much we're going over homework, we're incorporating mindfulness, and then we're going to delve into didactics, the new content that we'll be learning. So that's skills class, and then phone coaching is actually a great resource for clients to use that are getting into that headspace of I need resources and I don't know what to do.

Speaker 2:

I'm at that 10 out of 10, which you may have worked with clients that have been there right.

Speaker 1:

Yeah.

Speaker 2:

Yeah.

Speaker 1:

I mean it happens, Real life happens. There's a lot of life that happens between sessions, right so?

Speaker 2:

Exactly, yeah, exactly. And for me in DBT world they have that resource of okay, let me text my therapist, let me reach out and I'm letting them know. I'm highly dysregulated. I'm in this 10 out of 10 that we've talked about before in sessions. I'm not sure what to do and I'm having these urges, whether it's self-harm, lashing out at my roommate, throwing things, getting angry and just acting on that. So we'll talk about that in film coaching and, in a nutshell, it is very much ensuring skills generalization in that environment throughout their day-to-day life, because we want to make sure that the skills that they're learning are being applied.

Speaker 1:

Right.

Speaker 2:

Yeah, so that's very much the film coaching aspect. And before we get to the other two, I want to ask any questions or how does this sound? Yeah.

Speaker 1:

Well, I love that. Just to point out, it's very empowering because I think sometimes people we wonder I hear this a lot, maybe you've heard this a lot, and I think the mental health crisis in the United States points to this that sometimes, feeling like you can access care or there's a stigma around getting help, and what I love about what you're sharing is you're not pointing out anything like this is what's wrong with you. This is an incredibly empowering opportunity. You're learning skills. You are applying there's insight, it's it's self-directed um in terms of being able to monitor, to be able to feel empowered. And you've got your. You've got your support system. You you've got someone to turn to.

Speaker 1:

Uh, I just have to point that out because I think that's important to really highlight in terms of this process and specifically with the DBT right A lot of mindfulness, a lot of self-awareness and skills that you can apply in everyday life. I think that's really important to highlight and you know you mentioned I love the A to Z in terms of being able to apply this to a lot of different scenarios. So, like for real quick, before we go into the other ones, if, if there, if there is someone that maybe is listening and maybe regardless of whether they're facing mental health challenges or not, can you share an example of maybe like a DBT skill? I love that you even mentioned you know a skill zero to 10, where am I at Just being able to be aware of how they're feeling internally? Can you share an example of a DBT skill that listeners could start using today, even just to really be in terms of their emotional well-being?

Speaker 2:

Definitely. I'm glad you brought that up. So there are also just backing up. Tbt loves acronyms, so I will share a skill. It is in that acronym format. The skill that I'm going to share is from the distress tolerance module, which we very much reserve for those 10 out of 10 situations in terms of I'm at my highest peak in terms of distress and we also sometimes call these these emergency skills. So this skill itself it's the acronym is tip.

Speaker 2:

T-i-p-p stands for tip the temperature. For t I intense exercise, p pace breathing, and then second P is paired muscle relaxation. So there's two P's, t-i-p-p, and it very much is one of my favorite skills, if not my most favorite, and one of the most helpful for so many people out there. Even if you're not a DBT client and this is what I love about DBT DBT skills are they're skills that anyone can use. You don't have to be in this dysregulated state, you don't have to fulfill the BBT criteria. These are skills that the average person can use when they're noticing that they're reaching their threshold for getting emotions regulated.

Speaker 2:

So going back to TIP is very much again. Starting off with that T is tip the temperature. So it first starts off with activating the parasympathetic nervous system with tipping the temperature and these other ones included in the acronym. Sympathetic nervous system with tipping the temperature and these other ones included in the acronym, however, with tip the temperature. What you want to do is and it's going to sound strange for people that are listening You're going to want to yeah, you're going to grab a bowl of ice water and you're probably thinking what are we doing here?

Speaker 2:

What is this therapy?

Speaker 1:

Yeah, what's happening yeah?

Speaker 2:

I love that. Yeah, it's.

Speaker 2:

it sounds unorthodox and it very much is, and it works you're grabbing a bowl of ice water and if you're familiar with the dive reflex it's kind of similar to that. Right before you know if you've seen divers or if you've dived yourself into um a body of water, you're right. Before you touch the water, your body goes completely calm, it goes relaxed. So that's what we're trying to activate and the cold water itself helps. So it's not only the position that we're putting our face into the cold water that activates this parasympathetic nervous system and signals to our brain that we are wanting to calm our body down physiologically, signals to our brain that we are wanting to calm our body down physiologically. However, it's also the cold water that activates that as well.

Speaker 2:

I always think back to some people right before they go to sleep at night. They want to make sure that the thermostat is set to a really low temperature because people enjoy sleeping in colder temperatures. You can't sleep when it's really hot or stuffy in a room. People enjoy that. It activates that calmness in their body, that parasympathetic nervous system. So that's what very much tipping the temperature does.

Speaker 1:

Interesting yeah. I have seen people do that for purposes of maybe vanity for their skin too. So maybe that's like a double benefit.

Speaker 2:

No, I'm glad you brought that up, Marta, because it does help your skin as well, which is funny, it doesn't hurt, it could only be, good, yeah, but there is a lot just in terms of the nervous system and temperature just being able to activate.

Speaker 1:

What an easy thing that you can do in your own home. Just grab that bowl of ice and you're right. Even in the hospital when you have a baby, I'm thinking I'm a mom, right. So they tell you, like, set the temperature super, like it's 65 or something is the ideal temperature for a baby. You know to how we're wired right to have a cooler temperature as being helpful for us, for sleep, for calm.

Speaker 2:

So that's awesome? No, it's, it's incredible. And even if you don't have that resource a bowl of water you know, I've had phone coaching calls where I asked someone what you're supposed to do on phone coaching calls is, first of all, where are you physically, what are the resources you have in your environment? Yeah, and I've heard stories of people telling me that there was someone they're working with.

Speaker 2:

They were driving on the highway and they were experiencing this dysregulated state and the therapist hopped on the call with them and they said you know what? What did you? What are you doing right now? Where are you? What do you? What do you have in your resources? They said I'm on the highway. I don't have any resources. I'm in my car. And the therapist pushed back and they said well, okay, look around, what do you have in your car? And they said I see a water bottle. So and you might be thinking, I know where you're going with this and they use the water to activate T and tip tip of the temperature. They T and tip tip of the temperature. They decided to face their head down and pour water all over their face just to even activate it a little bit, to deregulate them or deescalate the situation. Bring them back to that regulated state.

Speaker 1:

Yes.

Speaker 2:

Yeah.

Speaker 1:

Yeah, that's wonderful. Yeah, just being able to use the resources. I'm sure I was thinking like if you're at the airport or wherever you are, you can access like that cold water bottle or what. What? Yeah, that's exactly yeah, incredibly empowering.

Speaker 2:

Okay, so that's the tea and tip, yeah yes, yes, that's the tea and tip, and I'll go into a little bit in terms of ipp. However, intense exercise also you doing jumping jacks, doing pushups that also does similarly with tip, does you know? It activates that part of your body. And then pace breathing is it's doing similarly, tip it's, you know, calming your internal system. And pace breathing, I will say, with paired muscle relaxation is also helpful, you know, doing both at the same time, even even if you can do one without the other. However, together I find them personally more helpful where you're breathing in, maybe breathing in for five seconds and then breathing out for seven and just having your your in-breath shorter than your out-breath. Yes, and then paired muscle relaxation in terms of clenching your fists, like these, and then releasing when you're doing your out-breath, so it's it's helpful yeah, that's awesome.

Speaker 1:

Yeah, I could see how that's so beneficial Really bringing in. I love that there's acronyms, so you have an easy way to remember, I am not a DBT specialist.

Speaker 1:

I've done some training in it and really like more mindfulness-based stress reduction. There's a lot of overlap of tools, but those things that you mentioned I mean incredibly empowering and I think that's the key and I have this disclaimer on the podcast right, like this is not, this is not medical advice for you. Like, if you think this is something that you could benefit from, you know, talking to a therapist for your specific recommendations and there's an, you know, like you know Leo mentioned, there's a process right of education and meeting individually, but just having those tools and knowing that they're out there and things that you could do everyday life, I mean for your nervous system, because we are very wired to be active and in flight or fight, just the way the world is. So it's wonderful that there are these tools available to us.

Speaker 2:

It's so true. And I want to get to the next question and I want to tell you about the last two components, because I think we took a little break. Yeah, and it's a lot. So, like I said, every time I bring this up in console with a potential client, they're like, wow, there's so much, this sounds amazing and they need it all. So, yeah, so we talked about individual, we talked about skills group, we talked about phone coaching. Yeah, exactly, the last two are very much DBT, case management, which, in a nutshell again, is wanting to get in touch with other providers on the individual's care team to provide collaborative care. We want to know what the psychiatrist knows, what your nutritionist knows, what your neurologist knows, et cetera. We want to get in touch with all the providers and, similarly, they want to know what we know, what we're discussing.

Speaker 2:

If for instance if there is self-harming behavior or if you've disclosed something to another provider and of having a suicidal thought or, you know, taking certain medication. Even you know it's wanting to have that collaborative process. So that's very much DVT case management. And then there's I love that because mental health and physical health.

Speaker 1:

I mean you, you, you there's such an overlap and the collaborative approach is so key, just for integrated health. I there's such an overlap and the collaborative approach is so key, just for integrated health. I love that.

Speaker 2:

Exactly, and I'm sure, even being a therapist yourself, you know you're wanting to get in touch with other providers.

Speaker 1:

Absolutely, absolutely, yeah. What's going on with blood work medication? Yes, exactly.

Speaker 2:

Exactly. It's funny that they even include this because it's like, well, this should go without saying that you know, you'd want to know what's happening, yes, in other realms yes um, but yeah, that's very much that component. And then there is the last one consultation teams, consultation teams, it for us at the practice I work at, which is the counseling center group no-transcript what can we do to improve this? And it's improving motivation for the clinicians. They feel as though, okay, I know what I need to do in order to move forward with this client.

Speaker 2:

Now you know what I need to do to make this progress yeah, yeah, no, that's wonderful.

Speaker 1:

And how could people get in touch with you? So where, where do you see clients? You mentioned the group. I'm curious how can people get in touch with you and, um, where, where are you licensed so you can see, or where do you which clients out of what states and where do you work with?

Speaker 2:

great question. So I am licensed in new york, new jersey and maryland and, yeah, I'm providing virtual telehealth therapy, and then also in person in midtown, midtown Manhattan, right next to Grand Central, actually.

Speaker 1:

Okay, wonderful, wonderful In terms of just anyone out there who has been thinking about seeking out some help. Maybe they're not in those states, but they are thinking about seeking out help, and maybe in DBT and I know there's. I feel like I have so many more questions to ask. So I love that the passion is there and I I think this is a really important topic. I think that's why I had so many questions and I think there's so much value that you can offer people and I'm just grateful that you shared your insight with with us today. It's like making you're making an impact on many clients and just in this recording too. So I'm so grateful. If someone were thinking about getting help, like what, what, what, what would you share to them? Cause I see you took a leap of faith in terms of diving into a mental health field, changing course, and I don't know any kind of just words of insight, just in terms of encouragement for seeking that support.

Speaker 2:

Definitely, definitely. So, yeah, I mean, I, I very much. I work with the LGBTQ community, I work with the neurodivergent population and so, with that being said, I think that if you're wanting to seek mental health help right now, my advice is to find someone that you're able to be open with, able to experience that vulnerability with, able to be open with, able to experience that vulnerability with, because that I think it starts with that for me at least, that's my belief is that it starts very much with that you know that spark and then turning that spark into something else in terms of rapport, and then opening up and wanting to make progress, wanting to challenge yourself and grow, and you know work toward the specific goals.

Speaker 1:

Yeah, yeah, I love that you highlight that. Thank you so much, leo, for joining us and for being a part of our wellness journey.

Speaker 2:

Of course. Thank you, Marta, for having me.