Integrating Technology and Psychology: A Conversation with Dr. Sera Lavelle

Hey, everyone. Welcome to the Meaningful Revolution Podcast. I'm your host, Sean Butner, and in today's episode, we are talking with special guest Dr. Sarah Lavelle about psychology and AI. So, Dr. Sarah Lavelle is a PhD and renowned clinical psychologist and leading figure in the field of integrative therapy. She's the owner of New York Health Hypnosis and integrative therapies in SoHo and integrative EMDR practices dedicated to offering innovative mental health solutions. Additionally, Dr. Lavelle is the co founder of BIA Better Eating, an app designed to transform eating habits through the application of psychology, which we talk about in a whole bunch in today's episode. Her work emphasizes a holistic approach to mental wellness, integrating traditional therapy techniques with technological innovations to address a wide range of psychological issues. So we had a really amazing conversation. I know you guys are going to love it. So let's get into this episode of the Meaningful Revolution podcast. Hey, Dr. Sarah Leville. Welcome to the Meaningful Revolution Podcast and. And jumping right into it. I'm really excited for our conversation today because we were exchanging information and I was doing the research. For this episode, we're going to talk about psychology and technology, which are two of my passions, something I really love and I'm really curious. Just for the audience, could you maybe tell a quick story on why you're passionate about using technology in your. In with your psychology practice and adjacent to it? Right. We'll get into that distinction, I hope.

Yeah. I don't know if I could do it quickly, but I'll try. Oh, what? When I think about what it really inspired me to integrate technology was I was working with eating disorders. I've worked with eating disorders for so many years. But one thing people don't realize is that the more it's the only disorder where the more rapport you have with your therapist, the less likely you are to tell them honestly what you're doing because you want them to like you. You get ashamed with what you're doing. So maybe in the first session they'll be like, yeah, I ate this, I did that, I did that. And then later on you're like, do I really want to tell my therapist? When I first went virtual with the pandemic, I started noticing people open up a lot more. There is actually something about me feeling less real. At the same time, a friend of mine who was going through a breakup introduced me to this app that it was back then, it was like a chatbot that you could talk to at all times about your breakup. Now him being male, he was too embarrassed to talk to his friends about his breakup, but he liked talking to this chatbot. And I had this thought, I'm like, wow, wouldn't this be great to have something that my patients could have at all times that they could chat with about their eating and about how they're feeling, what's prompting them? Because I can't be there in the moment. And sometimes you're not really ready to even tell your therapist. And this is a way for them to almost practice talking to their therapist in between sessions and get this kind of ongoing learning. So what I love about it is that it's almost like an extension of me, that I can be there at all times and yet they're not afraid to talk about things.

Right on. That's super fascinating. I love that. And I can understand, like, the more you like someone, the more you want to be seen favorably by them. And so I never really thought about that in terms of what I do as a coach. And it'll be interesting question for my wife later who's also a therapist. But I love that. So I guess. So you have an app. Maybe that would be the next best thing to get into naturally. Could you explain what via better eating is and how it's adjacent to your practice, not part of your practice, and how that works together?

I'd love to. I mean, right now we're in beta, so it's actually not even on the app store yet, but we do hope to get it there in within two months. So we really want to test it, make sure it's functioning exactly what we want it to do. Right now it's interesting because there are a lot of apps out there that are mental health apps and there are a lot of apps out there that are weight loss apps. Now I'm somewhere in between. My idea is that anybody who's struggling with food, not necessarily the eating disorder, but most people who struggle with food, it's something psychological. And I feel like the whole industry makes it sound as if it's a problem with math. Like they just need to track their calories better. Right. But nobody who eats well naturally is sitting there tracking their calories. And in fact, tracking your calories or your food leads to eating disorders. So really what happens is most people already know how they want to eat, but they have hard time implementing it for a variety of psychological reasons. So this is an app to make you lose weight. I call it an app that helps you heal your relationship with food using three different very research, evidence based techniques. Within psychology that are known to work. Right. One is motivational interviewing, another is teaching mindful eating techniques. And the third is hypnotherapy, which people don't often know a lot about hypnotherapy, but there's tons of research showing that the addition of hypnotherapy to any other form of therapy is extremely helpful in teaching people body awareness, boldness signals, helping a person not eat when it's compulsive. So you're really helping a person learn to identify their patterns, figure out what's really going along with them, and gradually changing their mentality around food. So it's not going on a diet. It's actually learning to think completely differently. And it's. You're doing this through ongoing interaction. It is built on an AI, but it's an AI that only gets information from what we feed into it. So we fed it. Every blog I've ever written, every talk I've ever done, the techniques that I use in my real therapy sessions, the kind of things that I say to my patients. So it wouldn't sound like chatgpt talking to you. It would sound like somebody who genuinely knows you because it's learned the more you interact with it, the more it knows you and it knows what your problems with eating are and it knows how to solve your specific problem.

Right on. That's awesome. It seems like maybe a different way to frame the app. It's a mindset changing.

Yeah, absolutely. That. Yep. It's exactly what we say. Everything else is behavioral change. That's great. But how are you going to change your behaviors if you don't change your mindset?

So there's so much fascinating about this. And I've actually been training a chatbot for my coaching practice too.

Oh.

Which has been very weird and surprisingly connective. I asked it about grief and it was. It surprised me with what it came back from the content I had and just how inquisitive it was. So you have this app you have this constant update for or potentially like a little assistant in your ear helping you manage maybe moments when you have an intrusive thought, I'm sad. I should eat all the cookies. Which is very basic. Or exactly.

Though.

Okay. Have people been really resistant to using an app versus calling a therapist or being more in a clinical. I'm not sure if that's a good question or not, but yeah.

Oh, it's a great question. I see them as very. That they work. It's not. One's not a replacement for the Other by any means. I see them as both aiding each other. Right. One is going to be something that you could use all the time, but you're not going to get in as much depth. And what you actually find is once you practice talking to the app all week, it makes your therapy sessions more effective. Because now you've already talked about it, you're ready to talk to your therapist about it. No, I see it as an extension of the therapy sessions. But we're also very clear that we're not a replacement. In fact, the first thing you read is that this isn't a replacement for therapy. And it actually detects if this isn't just a problem with eating, that if this is more of an eating disorder, it'll help you geolocate a therapist in your area and remind you, like, hey, this, I think you actually need more help outside this. So it can help the average person who's struggling with food, but it'll also help detect when your problem is more health than BIA is able to provide.

Awesome. So I'm fascinated by this. SO one I love. So my idea of how AI is going to be impacting the world is it's going to be situations like this where it's an assistant or Steve Jobs said something like, the computer is a bicycle for the mind. This is like an automobile where I think you have this extra level of contact or these cool use cases. So with that in mind, how do. How did you think through putting in those guardrails of. Because I think based on some of the things I read, the app's more like a coach and then you're a therapist. So it's like a coach therapist combo. Right. So how do you. How did you guys. Or how did you folks figure out how to have the AI be like, hey, I need. I got. This is beyond my pay grade. Talk to a specialized person that can really take care of you in the way that you need.

It's really interesting with AI, right? Because it used to be when you programmed like a chatbot, that wasn't really generative AI it was more just chatbot. You had to choose the word binge or the word eating disorder or. But AI now could be able to tell from the conversation if it's more of a binge. You don't might not have to say that word. But for instance, it would flag you whether you said I binged or whether you said, well, I ate so much that I felt sick after. And I've been doing this daily. And I worry that I have a Problem like you could pick up from the conversation. You of course guide it. What you do is. So we have something called the vector database. Now there's AI and it pulls from normally all the information. We have a separate vector database. That's what's ours is proprietary. Right. And you load into it a lot of examples and of things that might a person with an eating disorder might say. And then it learns the general. Like the general kind of things to look for. It doesn't have to be so specific anymore, like binge throwing up, restricting. It doesn't have to be these specific things. You give it this overall context and it pulls it from this vector database. And based on teaching it, you're like training the AI. Okay.

Right. Like an assistant. Okay.

Yeah. Cool. Well, like a therapist. Right. It's when you think about it, you're going through your PhD program or you're going through your master's program. It takes a while until you start to just detect what kind of things people are saying that would lead you to think maybe this person has an eating disorder. But after practicing for a while, you naturally know. And in many ways the AI is almost getting a PhD or it's almost getting. It's learning on its own. What are the kind of things you should say? Right. It's the same thing with addiction. An addiction specialist would be able to tell if person's an addict, even if they're not saying so specifically because they'd know these kind of subtle behaviors that an addict does.

So it's really trying to train it to figure out that nuance using generative language stuff. We'll call it the black box stuff because nobody really cares what happens behind the scenes. But that's cool.

Yeah. But you also think of it as level of care. So yours is a coaching practice. And I think the AIs are on this level. In my psychology practice, we're once a week psychotherapy. Sometimes people are need more help than once a week psychotherapy. We need know as therapists when they need an iop. Right. Like an intensive outpatient program. People in IOP know when, hey, they're actually ready to just step down. Or they know if a person needs to go inpatient. Right. I almost see it as a continuation. There's like inpatient IOP weekly therapy and things that are more interactive self help or fall into that coaching category.

Right on. Yeah. It's like a continuity of caring. I like that idea of, yeah, we'll bump you up or bump you down as you need.

Yeah. But not pretending that hey, you need higher than this, but we'll pretend we can solve it. Which I see that as a problem in the field right now, that there's a lot of AI that's created by people who are app developers who don't really understand mental health and pretending that it can be a cure all for things. Right. You're seeing this a lot. And that does scare me to have people who might not understand mental health creating mental health apps.

Yeah. I guess as you've been working through that first level of care. Right. So I've had. I've heard arguments in like the medical field adjacent that giving people acts like it's the WebMD effect, where having access to someone that might be talking with you could. Maybe this is an apt analogy, but you have more access to get potentially diagnosed. Or hey, you might want to look into this to talk to somebody higher. That it causes people to believe they have stuff they don't. Trying to phrase that properly, you get. Understand what I'm saying?

Yeah. So you want to eliminate type A and type B errors. Right. You don't want to create this kind of, oh, I read about ocd and maybe I have that initial go to the doctor. But then there probably is a portion of people who read it. WebMD wouldn't have otherwise go to the doctor, but because it prompted them, they actually did find out they had cancer. We're never saying that we know that you have this and we might not be able to detect everything, but we can say, hey, this is looking like something. Right. And that you may. Maybe it's a good time to evaluate if you have something more going on.

If somebody was looking at a mental health app for particularly OCD or eating disorder or anything else, do you have a sense on how someone might evaluate if it's a good caring force in the world or something that. That might lead them astray?

I think any app that doesn't recommend that you see a real therapist and call. I, I think there's a real danger in something calling itself a virtual therapist is. I, I think to me that's a red flag. Right. I do think you should see who the creators of the app are. If they're saying, hey, I'm Dr. So. And, and the app is pretending like it's a doctor, and yet you see it wasn't created and they don't even have anybody on their team that was a doctor, I'd be very wary of that. It could be created by two tech people, but that are like, hey, we, we have all these advisors that are the best of the best and we're really sound and we have clinical research. I might, I might go for that. But any app that I think would say, hey, I could just cure your ocd. And you. And almost suggest that you don't need to see a professional at that point or any disorder of those kinds. I'd be skeptical of that at this point. I don't know that AI couldn't get there. But there is still the value of seeing a person in person. Right. Just having eyes on you. Right. Are we going to get to the point that the AI will call 911 if they detect things that could happen? But right now we're just in the starting. We're at starting gate of the AI journey and people are trying to get to the finish line before we even understand its capabilities. And I, I don't. I think we need to be. Work proportionally to where we're at with the technology.

I love that answer. And I, I agree with you. I, I feel that it's not going to be like, did you ever see the movie her, like a few years ago?

Yeah.

We're not at that level of AI where it knows everything about you and is very, like, almost seems like a real person. Relationships are super important, and it'll make your time, your personal and facetime more valuable as these things come out as my guess for the future, my educated guess, but.

So I think being a human has positives and negatives. Right. And I think you could use the adaptive qualities of AI and the adaptive qualities of being a real person, and they could work really hand in hand. So I'm very much a relational therapist, which means being vulnerable. With me as a therapist, I see that as a tool of teaching them how to be vulnerable in front of a real human being. And then they can take that and model that out of the real world. You. You can't do that with an AI. But what if the AI could help you learn how to be vulnerable with the machine? Because you're not even ready to be vulnerable with your therapist. And then being with therapist helps you be vulnerable with your relationship. Right. So it could almost be a precursor. Then that and then out into the real world. Yeah.

That's awesome on that thread practically. I know that app's in beta, so you've probably done some testing, still figuring stuff out. Things could change. All the disclaimers. But how are you. Are you seeing that people are more. You mentioned earlier in the conversation that people tend to be a little bit more ready to be vulnerable after having that voice in their ear that vo. Has that been like 100% the case? Is it mostly the case? Is there not enough data to actually show?

I, I've had people, yeah. Tell me that they've had these major breakthroughs in therapy in like using the app and they just can't wait to tell you in therapy. And it's. You could talk to it at any time and then you have this sudden realization and then. Yeah, I do think it is. And actually the research does say that any of these apps that are self improvement apps tend to lead you towards therapy, not become a replacement for it. Right. It could be the, the. I think the hardest thing about being a therapist in general is the barrier to going. A lot of times the people that need the therapy the most aren't going to be the ones who seek it. And I think anything that could aid to being more likely is huge.

Yeah, that's pretty, pretty okay. Yeah, that's great. So I'm also like, the question that came up is access to things like therapy or coaches that help you figure out if you need to go to therapy or not. So as you're able to cast a wider net to potentially help more people, how do you think about, if you think about it as that continuity again, you have probably a larger group of people maybe interacting with a eating coach to try to pick up if there's issues or not. If the coach is, hey, this is above my pay grade, make sure you go to a therapist. Like, how are you thinking about the impact of having a bigger reach? Is that. Have you thought about that at all?

I think, yeah, I think accessibility is key. There's so many times that there's like a shortage of therapists and I think that it's also just we are limited by. You get me 45 minutes a week. So it's. There's more accessibility in terms of just one person, in addition to it being able to reach thousands of people who could use it. Right. And then hopefully you're reaching people who might otherwise be doing something that's not the best. There are a number of apps that I think promote restriction and make people more likely to have eating disorders than if they never did it at all. And I'm not going to name names of the apps that I think do that, but I think, I think it'd be fair to say that it's well researched, documented that any technique that promotes restriction is more likely than not to lead to an eating disorder. And there are plenty of apps out there that cause you to be hyperfocused on the calories, hyperfocus. Feeling like you've done a good job if you haven't eaten all day. And that. That make matters worse. If I can create an app that not just helps people change their relationship with food, but actually maybe takes them away from something that could be detrimental to me, that's success in general.

Yeah. So I wonder. It almost is. We know that. So I'm a systems guy by trade. So the adage is garbage in, is garbage out. So you want to make sure the quality of the inputs are high. And someone that builds an AI coach like you did, that has the education, the expertise, the scientific data to back up someone who as probably an ethical person would say, hey, if this changes, I will change the thing, I will change course.

Exactly. If we found anything in the data, we would change course immediately.

So how do you, I guess we. This is maybe a bigger, like world question. How do we handle as a society, competing expertise? So if you had a different, if there was a different school of thought in helping people with eating problems, how does that, how does the layperson determine what is the best way? I don't know if that's a interesting question.

I do think, I do think that there should be more regulations on things. So, for instance, you know this. You're a coach and your wife is a therapist. Right. But you would never call yourself a therapist. Right. Because. Yeah. And in your own words, why would you never call yourself a therapist? Why would you never use that term?

Because I am not qualified to handle particular, especially like when it comes to traumas or there are things that I feel the focus of a coach is to look forward. If you're looking at back or being drawn back, like, that's a whole different skill set that requires special handling. Right. That's.

Yeah. And you're not trained in diagnosing. You're not trained in the ethics of, hey, this diagnosis versus that yours. It's not any less valuable. It's just a different group of people. It's a different set of problems, a different group of people and different solutions. Right. You could have somebody who's severely depressed and you could still coach them the same way that you could be a meditation teacher to somebody who's depressed. It just, you could help somebody with their career who's depressed. But you're not saying, I'm treating depression. Now, any app that's calling it self, a therapy app, it's somewhat illegal. Right. You can't legally call yourself a therapist. Why can an app legally call itself a therapist. The state of New York, the state of the. Every state has boards that says that you cannot use the term therapist unless you are licensed in one of, however the state defines it, categories of mental health counseling psychology, lcsw. It has to have these years of training. You have to take ethics tests every year. You have to do all these different things to call yourself these things. But apps right now there. There's really no safeguards on that anybody can call themselves. And it's now if there's. They're abiding by those things, it's created by psychologists. But even I wouldn't call my app. I wouldn't call this. I wouldn't say it's a virtual therapist. It's not diagnosing, it's not treating disorders, it's not doing these things. So you have to think it's the same thing of WebMD says we're providing information. But WebMD wouldn't say, I, I can guarant. If you go on here, I can diagnose your ca. That you have cancer. Right. So if an app is doing the mental health equivalent of that, I'd be very skeptical.

I think the core of the problem where we're talking about two different things. From someone that is certified and because of your credentials, obviously the thing you create is also going to be associated with those credentials. But it is very important, I think, to say that it's a coach versus therapy again.

Yeah. So for instance, I was approached by somebody saying, hey, you're a psychologist who does hypnosis in New York. Could I use your name for my app? Because I want to be able to say that my app cures depression and anxiety and stuff through hypnosis. So could I use your name? I said, no. And he's like, hypnosis does cure depression. Hypnosis does cure, like, you can't make these claims in an app. Also, hypnosis scripts are created for individuals knowing that person. One hypnosis script. So here's an example with something with hypnotherapy. Just illustrate a point. Okay? So somebody suffering from anxiety. A lot of times you'll want to do like a safe space script, right? Say it's a layperson who isn't trained in psychology. They might just go online and see there's this one kind of famous like, like safe feeling script that's all about like how a child feels with their mother. Now am I going to use that script with a patient that I know intimately who was abused by their mother? Right. If you don't have the mental health training, you might just do these things and not have the knowledge to differentiate. Hey, this thing might feel really good with some for somebody, but it might be really tight for somebody else.

Yeah, having that context and again, that human touch is so important to get the particular help you need or the particular results that you're going after just now.

I don't know. Could AI eventually look over your history, what's triggering for you? No, it's not like it's. I don't know, I just don't think we're there yet that you know anything. That's a hypnotherapy app. You have to just make it very generalizable and try to not make it triggering in any way. But then because of that it's not going to be, it's not going to be tailored in the same way as your, your therapist would tailor a hypnotherapy session for you, knowing you Right. Again, who knows, maybe it could eventually. But we have a hypnotherapy component within the app and it is tailored to a. Help a person with body awareness to help a person notice hunger signals and satiety signals. It's tried and true in sessions, but we wouldn't put anything specific for a person. It would make a more generalizable. If that makes sense.

Yeah, that's interesting. I guess it leads into like, how do you, how are you thinking or feeling that this type of technology is going to change the field of psychology or the work that you do going forward outside of this continuity of health?

If anything, I think it's going to change the field tremendously. I think, I hope that people stop thinking of it as a replacement for therapy and as opposed to it being a supplement. The same way that I might tell in between sessions, I naturally give my patients a lot of good books to read. That doesn't mean these books are replacing the therapist, but maybe that we could find. It could be that you don't have to see your therapist quite as often and it could be that people who are on the verge of needing a therapist, it could be preventative to them needing a therapist. Right. They're not in a full blown anxiety disorder, but they're on the cusp experiencing some anxiety. The self help, it's enough to keep them from getting there. But I would hope then that actually people would start respecting the field more because they'd see, look, this is for lighter problems, but when you actually have something going on, it's you really need to maybe not in person but it should be a real person and it should be an expert.

Yeah. So it, it's actually in a way could be a champion for how psychology or therapy can help you using some of the things that super tailored, kind of general for people that aren't in a severe case, a lot of conditions. But I. That's awesome. Here's another question. When we were exchanging emails before that I sent that might be prudent how like social media has really impacted how we our psychology and day to day lives in a very more meaningful way than I think a lot of people understood. And as a technologist in a previous life following how there's been a lot more people being like there's a lot of things we should be worried about in this. One of the things we've highlighted repeatedly here is AI is not a replacement for therapy. There's no therapy app that's going to be as great as a human. Do you in a maybe like a broader sense think that we might have a similar moment with this? Oh, I remember the other question. But these AI tools that help us live potentially better.

I do think so. I don't think that there are like, I also want to say in this that I don't. I think there could be ways that AI is better. Right. Say, say we could get to a place that we. Through the app, you're better at detecting imminent suicidality. That's in some ways it's like a computer beating a person at task. It's such a, it's such a hard thing for a person. It's say a person's like, I've had a bad day. Sometimes I don't even feel like being here anymore. You can't as a psychologist call 911 at that point. That's like a gray area and it's. But you could probably create an algorithm that detects the amount, the exact number of times they bring it up, ask the exact right questions. That probably has less room for error than a human being. So, so I don't think that there aren't ways that it could be better than human. I think in terms of like relational therapy, that's what can't be replaced. The idea that you have to be vulnerable with a human being and that vulnerability helps you be vulnerable. In real life, the AI doesn't allow you to be vulnerable. But there's positives and negatives of being vulnerable. Right. Maybe you're not ready to be vulnerable. It helps you be vulnerable. Those aspects. But, but in terms of like things like diagnosing, detecting like anything that's the more mechanical aspects of therapy, that it could get better than us in that.

Okay, right. On the previous question I was thinking about, it was more of a statement of thinking of this as a tool to enhance human ability as a therapist, as a coach, as a coder, as a pharmacist or all those types of things.

So enhancing the therapist ability or enhancing or it actually does help with self improvement.

I think it's trending towards. If you're a carpenter, you could use a hammer or a hammer gun. Right. There's a upgraded version of.

Yeah, I think something about the. I think there's that quality in the app in itself. Right. In the fact that it's ever present. So one thing we do with the app, and again, even the initial launch, it won't do this as well as we, we plan it to do it in the future. It'll start to be able to detect when during the day, for instance, you're really struggling and you'll get a notification on your phone that's, hey, you know what? It's around lunchtime. I know this is the day, the time of day that you tend to struggle the most. Or it could say, hey, it's not that it's lunchtime. This is the day you have your daily check in with your boss. And that tends to trigger you this, that triggering you right now. So that kind of ongoing notification I do think could like really amplify the effects of things. Right. That you're not just doing it when you feel like it and putting it off because you don't feel like it, it's checking in with you. And how much more powerful. For instance, if I could check them with my patients all the time, that that would be more powerful. So an app doing that I think is also really powerful.

Yeah. Maybe another illustration of how this is a tool can make your job, you more effective at your job. If you have someone that come into the app as a scenario and they're talking with it for a month or two and then something gets triggered where it's like, hey, you need a little bit more dedicated, focused, quality attention on this particular issue. Would the app be able to provide a report to you as the therapist saying, hey, this is set intend to be triggers. We talk a lot about the boss, we talk a lot about this other trigger and it seems to be a stress eating situation and it gives you a history or something helpful to be like, hey, I know there's HIPAA stuff that probably makes this.

No, exactly. But that's Something we very much thought about in future iterations. Right. Is that idea that a person could choose that. Of course, there's a lot of HIPAA considerations. Right. Even the therapist asking you, can I get access to that? Might. They might feel pressured into it or. But I think without taking those limitations in, do I think just an overall opportunity for that? Absolutely. Think about it. Like, sometimes in therapy sessions, they'll want you to read their journals. They'll be like, oh, I journaled this. Could you read it? Or they'll want to write an email between sessions that you have great understanding because they. They're not sure if they want to talk about it, but it's already there. I think that could be a lot of insight because people also forget what they actually did in a given week, especially with eating. I've had periods where I can think of somebody in particular. She's like, if you. There was food you wanted to cut down on, what do you think that would be? She was like, pasta. Okay. How often do you think you eat pasta? I don't know. Once or twice a month. Okay, what did you eat yesterday? Pasta. Okay. What about the day before that? Okay, that was Tuesday. Actually. It was pasta. Okay, what about three days ago? That was Monday. Wait. Yeah, I did have pasta again that day. So it's actually. Getting those data points can be helpful, but not in a way that I want them to track those things, because I think the act of tracking itself, but more general that we can notice overall themes when they're naturally talking.

Yeah. In a way, like the tool checking in on. Hey, what did you have for lunch today? Just give me a quick thing. I'll keep. I'll track everything else beside that. Just let me know. So you don't have. It's out of sight, out of mind. I don't know.

Yeah, it's kind of. I wouldn't ask. I wouldn't ask people what they ate because I think it gets too much into that kind of food journaling, food tracking. But saying, how are you feeling right now about what you ate? I think could be very different. Were you happy about your last meal? So what we do is we think in terms of mood tracking and emotion tracking and trigger tracking as opposed to specific foods. Right. And in terms of were you happy with what you ate or. It doesn't really matter because if you're happy that you ate a donut, that's very different than if you're unhappy if you ate a donut. Right. It is. So a calorie counting app would look at those the same. Whereas I look at those very differently. Say, it's like you've actually say that same donut like you told yourself that morning, I'm absolutely not having a donut today. And you do it. That's very different than being like, I've lost some weight, I'm feeling good. Like today I feel like having a donut. Right. It's. We can't look at it so black and white. Right. But you can track your moods and how you're feeling. And if several days you've been eat. You've been fe. Like almost intentionally eating poorly because you've been stressed. In my mind, your food, like the what the actual food choices isn't. Doesn't really matter. It's that you knew you did something that was not in line with your intentions because of stress.

So I'm curious. This is in the context of eating and food habits, but ultimately, as a therapist, as a coach, as a medical professional and so on, the idea is to move people into change, which is very fascinating to me. Would you. If somebody was like, I want to make this change in my life, whether it's pick a topic, would it be the same recipe to get awareness about how you're showing up for that change? Protect potentially, I want to start a. I want to change my career, but I'm afraid of all these different things. So I just am miserable continuing to do what I'm doing to motivate me to change. Is that how are you feeling about not submitting resumes or.

Yeah, that. That kind of question you just asked. Right There is motivational interviewing. Right. Is like this. How would you feel? How much would your, like, how much would your life change if you actually submitted those resumes? And what you'll find is like a lot of apps on eating are CBT based, which with cbt, what you'll find is it's effective when a hundred. A person's already a hundred percent committed to change. However, most people in general aren't a hundred percent committed. They're half thinking about it. Whereas motivational interviewing, like that style of questioning you said, actually prepares a person to be a hundred percent ready for change. There's a big difference between saying, okay, you want to work out, we're going to set goals and make a plan. You're going to do it this many times a week and putting that plan into place. And they'd be like, oh, why didn't you follow that plan? Or you didn't follow the plan. I gave you the plan. You should follow the plan. Right. That's like behavior, that's behavioral coaching. Right. Mindset coaching is. Okay, let's envision how would you feel at the end of the week if you did do that? Okay. Maybe we actually want to modify it. Maybe you'd actually be feeling sore if you did that much. Okay. What do you think is preventing you from doing that right now? And like it's motivational interviewing is this style of questioning that does promote change and that tends to be longer lasting because the idea as well is after you're asking these people these questions, they start asking themselves these questions. Okay.

So self coaching. That's cool. If so switching gears on that a little bit. If you're in an organization and we're trying to shift how a culture works in a company, say like we're switch my. In my world, it's. We used to do this software, we're doing this software now. You think you just turn down the other thing and people are really happy and ready to get at it and people get attached to how they used to do things and that kind of matter. If you're talking to like managers or leaders on how to make change, is it same just ask the. Asking those motivational interviewing type questions or are there other ways you might approach that?

If you're talking about like a manager wanted to get their employees to change. Sure.

Yeah.

Okay. Yeah, I think so as well. Right. Say you have an employee that's, you know, that's not getting their work done as opposed to just setting up like weekly goals, which you should do. Right. I'd want to get insight into. What do you think's keeping you from reaching those goals? What? Is it that it's too much work for you? Is it that you're finding yourself getting distracted? Is it that anxiety is getting in your way and then you address whatever that that hindrance is as opposed to just trying harder and harder to set those goals. Right. Or very behavioral would be. Okay, we're setting these goals. You're punished if you don't do them. You're rewarded if you don't, if you do. Right. But you could do that over and over again. But if you can't get to the root at what the problem is, all the rewards and punishment in the world's not going to change it.

Yeah. So one of the takeaways you're hoping the audience would get today is to stop thinking that you shouldn't start unless you're going to be successful.

Absolutely. Yeah. Yeah. That's a, like a big question about change. People say, they'll say, I don't want to do it because I don't know if it's going to work. But nobody ever knows if something is going to work. Right. You just have to start blindly as long as you feel good enough about it, and then keep changing until it's right. And that's the main takeaway. I think people can apply to everything in life, that you don't need to be confident something's going to work in order to take the first step. Because I just don't think there's anybody in the world that can be confident that something's going to work right. People just do it. Right.

I'd say in my life, 99.95% of the time, when I start something, the initial idea, the first step is not the right one, but it's that, oh, that's. You don't do that. What else could I do? And that's. I think we're learning happens. And part of being resilient is being a little bit okay with not getting it right the first time. Like, it's just part of the problem.

Yeah. Like, I always love this quote. I forgot it was at one of the books I was reading about business and creating apps, and it said if. If you're not embarrassed of the first version of your product, you probably waited too long.

Yeah, definitely. Yeah. There's a power in being in motion. And just maybe you could speak to motivation and change. Like, there's. There's those internal questions that. From motivational interviewing. Wow. How do I feel about this? How do you maybe address, like, wanting to change? Some people don't want to change. Is that something you can help with, or is that something that they have to find for themselves?

That's a hard one. Right. I once used to do this exercise to help determine. Right. Where you close your hands, because it's okay, I want to change versus I'm comfortable with who I am. So there's two ways to look at that. Right. I want to. If you're obsessively saying, I want to change, I want to change, I want to change, maybe you do need to work on being more comfortable in where you are. Right. But if you're saying, I'm comfortable with where I am, but you're not making change, is it that you're in denial? And I would actually have people, like, focus on the change they want to make, and they're not sure they want to change and focus on, okay saying over and over, I'm comfortable where I am. I Comfortable where I am. I want to change. I want to change. And, oh, let your hands. Every time you do it, like, the more one feels real, the more you shift your hands and your body starts to tell you, is it that you actually really want to make a change or is it that you're actually comfortable where you are and you don't want to change because you're actually pretty content?

Yeah. And so by figuring that out, it's like trying to suss out, am I putting pressure on myself to make a change that I'm not, I don't really believe in, versus something that I am actually committed to. Is that kind of the crux of it?

Yeah, it's think about a person who goes overboard with plastic surgery and they keep wanting to make a change and keep wanting to make a change. Like, that does show a little bit. Not that you can't have some plastic surgery and that it brings something positive for you. But we all do have a stereotype of somebody who. It's like you could tell they're just not happy with who they are. And maybe that person does need to focus on, like, how could I focus on just being happier with who I am and where I'm at? Right. But then there. There's also the opposite. Right. Of, oh, no, I'm fine how I am when you can really tell, like that there's like a cracking below the surface that they're not.

Okay. Yeah, I gotcha. Awesome. All right, before we wrap up, I would love to hear your thoughts on what really struck you about our conversation today. What did you really love or feel excited about or any insights?

I think you just add such great questions. It's the things that are on everybody's mind right now. Like, where is the place for AI? Is it going to take over? Is it not going to take over? Should it take over? Should it not take over? Like, what holds people back from change? I think you really hit on a lot of topics that people are really curious about and just a little fascinated by, but also a little scared of.

It's because that's me. I'll admit that. Where can the good folks follow up with you if they want to check out the Be a better eating app for themselves or a family member or just learn about your practice or yourself a little more.

Yeah. So if you want to learn about Be a better eating and even getting on our wait list for when we launch our app, please go to BIA Bettereating.com that just B e A than better B e T e R than eating. Com. Our therapy practice is located in New York City, but we do work virtually. So for anybody who's actually interested in our style as a group of therapy, it's nine of us clinicians that really love what we do. We work a lot more integratively. We do incorporate things like hypnosis and mindfulness and mind motivational interviewing. We think of ourselves as the therapists who are very devoted to making change. Not we're not the most. We're not going to say we're the most dedicated to diagnosing, even though we diagnose. That's not our strong point. Our strong point is figure out where you're stuck and how you want to change. And that's New York Health hypnosis. So just n y health hypnosis.com awesome.

We'll have those links in the show notes, too, if you didn't catch that, because they are fairly long. And Dr. Sarah Lavelle, thank you so much for being on the show today. Like I said, we did cover a lot of topics, but yeah, it was a very fun conversation. So thank you.

Yeah, thank you so much for having me. I can't wait to see how it turns out.

You got it. All right.