Episode 1: Kim Barthel
Learn more with Kim at Relationship Matters
Transcript:
♪♪ ♪♪ ♪♪
Amy: Hi, and welcome to OT Mentor Moments Podcast, where we explore advanced occupational therapy practice, mentorship, and the work that we can all do to become the best version of ourselves. I'm Amy Lewis, and I love the profession of occupational therapy, particularly pediatric practice. Over my career, I have had the great fortune to have some amazing mentors who have helped me to grow both as a clinician and as a person. Mentor Moments is my way of paying it forward by sharing their wisdom with all of you.
I'm starting this Mentor Moments Podcast with an incredibly inspiring occupational therapist, Kim Barthel. Kim is a Canadian OT who travels around the world lecturing, mentoring therapists, and supporting clients. She has extensive training in trauma-sensitive practice, pediatric neurodevelopmental treatment, sensory integration, attachment theory, autism, fetal alcohol spectrum disorder, addiction, and mental health. Kim co-authored a Canadian national bestseller, Conversations with a Rattlesnake, Raw and Honest Reflections on Healing and Trauma. There are so many wonderful things that I could say about Kim and her clinical reasoning and her treatment skills, but I think that the most important thing that you will hear in this conversation is summed up by her mission to support the conscious evolution of the human spirit. That's who Kim is to me, and I'm excited to share her with all of you. So here she is a few years ago, sharing her time and thoughts with me.
Amy: Hi, Kim, and welcome to my very first podcast.
Kim: It's an honor and an anxiety-producing experience to be a part of your very first podcast.
Amy: Well, there are several reasons that you're my first guest, and I haven't shared those with you until today. So I'll start off with the first one that you may or may not remember. I'm guessing you don't, because you meet lots of people, but two or three years ago, when I met you for the first time, you were actually the first person who suggested that I start a podcast.
Kim: I do not remember that!
Amy: Yes, yes. That was back when I suggested that you should start doing some online courses. And yeah, you know, here everything's happening. It just took me a little bit longer to get started than it did you. So that was my first reason, but there are other reasons that you just were the perfect person for summing up what I would like for this podcast to be about. So that's going to start with me asking some questions of all my guests about their mentors, because one of the themes of this podcast is going to be mentors and mentorship. So I would love to start with asking you just to share with our audience who some of your mentors have been.
Kim: I think when you ask that question, and I connect to the question from the perspective of impact, the order of sequence becomes different than the timeline. And if I think about a person who had significant impact, not only on my professional mind, but on my entire life and well-being, it would be Reggie Boehme. She was a neurodevelopmental treatment instructor, OT instructor, who made you believe in you, but also inspired you to want to be your best self, which included looking at the hard parts of yourself. Reggie, in spite, in addition to, not in spite of…in addition to being an NDT instructor, she had survived polio as a child and treated people with neurological challenges with mostly only her upper extremities. She lived in a body that demanded connection to it. And this was a mindset shift for so many of us who were mentored by her to begin to understand the impact of emotion on the body. I would say that she was my introduction to mind-body practice in reality, not conceptually, in reality. She was a living model of that work. Her desire to understand the unseen was the invitation to begin to look at things like fascia. Fascia way back in the 1980s. Fascia as it impacts motor control, energy work, craniosacral therapy, breath work. These were the concepts that she brought to life. And not only living in a body with disability, she also experienced cancer and trauma and started to, without saying it in the way that we say it today, but she's always sitting on my shoulder, would have seen how we see it now, this linkage between what happens in our cells and what happens in our hearts.
Amy: That's amazing. And she is one of the reasons that you came to mind at first, because you tell a story about her giving you some advice, I believe during an evaluation of your NDT skills. Would you mind sharing that story with us today?
Kim: If I'm thinking of the one that the story that you're telling or you're thinking of, one of the things that she said to me, which was, and Amy, correct me if this is not the story you're thinking of and we can edit it out. So the story I'm thinking of is when I was treating with her, I had an intuition about a particular aspect of a client related to something that was unknown to me. And she said to me, Kim, that's not within your clinical reasoning. And I said, I think this is an intuitive hit. And her encouragement was to begin to go and explore that elsewhere as an aspect of the pragmatics of the clinical reasoning that we bring to the table. So in a way, she was a catalyst for me to start to expand my exploration into the world of craniosacral, into the world of intuitive information and thinking, and the spiritual and energetic aspects of health and wellbeing. And you might be thinking of another story.
Amy: I was actually thinking of the story of the child that you were working with who was frustrated with their inability to move.
Kim: And keep going, you got it.
Amy: And her advice to you, I believe the story (the way I remember it) is that you said to this little boy, something to the effect of “that's okay, you're doing great”. And she stopped you and said, no, that's not okay. And told you that, or maybe she stepped in, I believe, and did the treatment herself and allowed this little boy to move in a way that got his frustration out and allowed him to express how frustrating it was to be in a body that didn't want to respond.
Kim: Smiling, I'm smiling, I'm smiling. So this young man, he was coming to the therapy process from a place of pleasing others and wanting us to be happy with him. And in the observation of his frustration, I did what we call shore you up, be a cheerleader. And that, in Reggie's words, was dismissive and missing the aspect of the body's holding posturally of those emotional experiences. And she demonstrated in that beauty, you've described it so beautifully, the capacity to what we call holding space. In the validation of his emotion, his true authentic emotion of anger, of sadness around his performance and capacity, he was able to be met and felt by another person. And in that state, I watched his body change in front of my eyes. His hand, which was typically held in such a tight manner, was a compensation. So interesting, if I think back to what it looked like right now, it looked like a fist, like a punching fist. And in our neurodevelopmental treatment view, that the fisted hands are seen as a motor compensation for inability to have stability in muscles around the shoulder and elbow. And the fisted hand was contributing to and being contributed to the anger that was held in his body. And when the emotion flowed, his hands were open and relaxed. And the part of your story that you remind me of to say is, I remember saying to her at the end of this demo, which by the way was my final demonstration to become an NDT instructor (Very memorable. Very memorable). I said to her, I want to know how to do that right now, right now. And that's where the door began to open to the things that I love to talk about even today. I think the other story I told is important as well, because feedback that we get from mentors isn't always in the form of encouragement. Just like this young man in the demo who was experiencing an authentic feeling, that feeling needed to be met. And mentors give us the opportunity to feel felt when the work is done in a way that has the deep intention to support the other to find themselves in a way that captures their personal passion. And feedback sometimes evokes negative activation or perceivable negative activation of rejection or scolding or not good enough, or excuse me, all of these pieces of ourselves that sit there. And in the beautiful, secure space of a mentorship, to make room for that to happen is actually very meaningful. Absolutely. And so her feedback about “I don't agree with you, or I don't think that that's part of what's happening here” at the time that felt dismissive, and what it helped me do was find me in here. And it is possible to love, respect and hold in your heart, your mentor that you revere, and also find yourself, which mentors, if they are true to their intent, that's what they want to have happen.
Amy: Absolutely. Yeah, it makes me think of several things. One of them I have heard you say when people will come to you with the often heard, “I have a child that” that you know when the statement starts with that part of the sentence that your answer is often something to the effect of, well, I don't know a lot about that child, but I do know something about you. And I believe that that is one of the things that I want to talk about in this podcast is the effect of mentorship and having mentors who can not only impart great knowledge, which I want to be as a part of this podcast as well, but also having mentors who can hold space and see the therapist is doing the best that they can and help them see room for improvement.
Kim: You know, it's even the room, that word room for improvement. One of the things about me is my deep pickiness for words and semantics. And why? Why? Because words have vibration and they connect into our historical trauma. They tap into our emotional landscape, and they tap into our potential. And so it's kind of an interesting conversation to think about the incongruence between the concept of doing the best you can with what you have and room for improvement. So improvement implies that something is not working, right? Right. And when you're doing the best that you can with what you have, you do what you know until you know how to do something else. Yes. And this mentorship allows for evolution. And in the mind of the mentor, there's no destination. And there is no actual right way. It's an opening of a space that is very creative without an instruction to it. And that's really hard to do as a mentor when perhaps you have your own technique that you want to share with another person.
Amy: Right, right. That sort of brings me to one of the other things that inspired me to reach out to you as my first guest. And that is a course that I recently took from you. The title of it was NDT, which is neurodevelopmental treatment for those who don't know, for ASD, the autistic spectrum disorder. And this course provided videos to watch ahead of time about this technique that you have spent many, many years learning how to do. And it's a technique that takes a commitment of training for anyone who undertakes that. But this course was more of an introduction to that work in this particular population. And when we came for the one-day onsite part of the course, you asked everyone to go around the circle and say what they were looking to get out of that day. And maybe you remember details that I don't remember exactly, but I know the feeling that I got from what everyone was saying they wanted to know. And that was, I want to know what to do. And I told this story to someone else who does a lot of mentorship. And she said, oh my goodness, when you even say that out loud, anxiety comes up for me as an instructor to have all those people in that class wanting to know what to do with this information that has taken me years to learn and put together and they want to know what to do in one day. But I told that person that luckily I know you well and I was kind of smiling inside because I thought, that's not what they're going to get exactly from Kim today. They're going to get things to do, but that's not all they're going to get. And then at the end of the day, you went around and asked everyone to say what they had gotten out of the day. And it actually, you might be able to hear it in my voice. It actually made me a little emotional to hear that down to every person the answer was, “I learned that it's about me and how I am being and showing up. It's not about what I do. It's who I'm being.” And I just was blown away that in one day of talking about treatment and demonstrating NDT techniques with a child in this space, that they walked away with this really deep understanding of how working on ourselves and doing the work that allows us to show up as our best selves is the most important thing that we could do.
Kim: Wow. I don't know what to say to that. And it's with gratitude that that was your experience as it matches my intention. And all that we are speaking about is that art of readiness to help people explore safely. And I don't know if you put that on a brochure if people would sign up to do that. Some would.
Amy: Right.
Kim: But not everyone would think that is a valuable use of their professional development.
Amy: Right. Right. Working on ourselves sometimes happens more easily when someone comes through the back door or comes alongside rather than coming at you and saying, you need to change and I'm gonna tell you how to do it.
Kim: Certainly didn't work for me.
Amy: I think of another statement that I am attributing to you. It could have been someone else, but I think that you were the one who said this maybe in your trauma sensitive practice course. And that is that this work that we do on ourselves and this alludes to the statement that you made earlier about me misstating the statement that you made in that class was the work that we do on ourselves is subtractive. And I know what you mean by that. And I loved it. And I wonder if maybe you could put some words around that for someone who has not done as much exploration into that kind of understanding.
Kim: I have a confession. That is not my language.
Amy: Oh!
Kim: However, I am interested in exploring this concept with you. So first of all, the word subtractive doesn't land for me. Okay. So let's talk about what that means and unpack it a little bit. What does it mean to you, that word?
Amy: I think that for me, it means the same thing that I hear people say when they say that we don't need to fix ourselves and that it's not about adding tools or changing who we are, that it's more about unlearning the things that are keeping us from who we're meant to be, maybe.
Kim: Beautiful. That was a very exceptional definition. And now I understand what you mean.
Amy: Well, I apologize for the misattribution.
Kim: It's fine! The words that I talk about, thanks to my friend and colleague, Hillary Leroy is self-compassion. Yes. Over and over, every hour of every day. And the intent of self-compassion in that subtractive process that you just described, in that need for self-care, in that need for self-regulation, right? In that need for peace in my heart, it's being in alignment with what is and evolving towards a new way of expanding. To me, that's the definition of healing. So when I find something in me that is uncomfortable, then that's a gift, an opportunity to spend some time with that feeling. And in that time, which sometimes is only 20, 30 seconds, there is a neurochemical connection to that activation that has arisen. And in that connection is the beginning, I think, of acceptance. And when I can take that potential acceptance, I say potential because I'm thinking about myself and often I'm working on the same thing for, I don't know, five, six years. So it's on a continuum of acceptance. And when I'm connecting to that possibility of acceptance, there is a shift. There's a shift in the chemistry. There is a shift in my breath. There is a shift in the autonomic nervous system. There's a shift in the muscles and there's a shift in the energy in how I relate to the world around me. And so that inner process is a heck of a lot of work. And it is, in fact, a doing. It's just a very invisible doing because it's all happening inside. And the outside feels different, looks different, is met differently because of that inner landscape shift. And this is, I guess, what I mean, what you mean by subtractive is that place of being okay here, which is definitely not a passive thing. It is a profound transformational thing of being in congruence with your pieces of you, your parts of you that are undiscovered, are not, they're not our favorite parts about ourself. And finding a home for them in our being and how that is such a freeing place to come from. And I do really feel that this concept of inner work is misunderstood as such a passive thing that doesn't translate. That is definitely not my experience.
Amy: Right, it takes a lot of work. When I heard you speaking, it made me think, as far as the work being subtractive, I think about how self-compassion could be seen as the ability to take away our own judgment of ourselves. And I think it's so important that people hear what you were just saying about how the ability to have self-compassion changes everything on a neurological level. It changes the chemistry. It changes everything. Because I think that before I did work for myself to find self-compassion, I really believed that I needed to be self-critical and I needed to judge myself to change. Like, how else was I going to motivate myself and make these things happen unless I criticized myself a lot? And I think that knowing now that this state-dependent functioning requires that we be able to have compassion for ourselves to shift is just such an important piece to me.
Kim: It is. I can so resonate with what you have said about the function of criticism. I believe for myself that I grew up in a family that believed exactly that, that this idea of being your best self could only happen if all of your failings were illuminated. And that was a value system to be the best, to be good enough, to do a good job. Those attributes were placed on things for me as a child as simple as setting the table. And how deep those threads of thinking infiltrate our entire being in positive and negative ways. You mentioned motivation and striving and thriving. Everything is on a continuum. And this is the trickiness of all of these things is they're not black and white. If I think of qualities on a seesaw and I put thriving on one end and striving on the other end, then there is stress in the middle that creates anxiety, can create anxiety and depression. But if I bring them close together, they can support each other where the striving, especially if it's fueled by passion and enthusiasm and desire for more, you can hear it in my voice, which is how I feel about so many things, that pushes you towards thriving. Then sometimes you hit your head against the edge of the wall and it's like, okay, that was a little too much. And now I need to go back. And it's that mindful state of awareness of those parameters within that allow you to be fluid in how you experience these complexities within us. So motivation does come from, I don't wanna use the word criticism, but it does criticism and judgment. Are important qualities. They also provide discernment. What is in my best interest and what isn't.
Amy: I think when I hear judgment, I equate that with assigning valence. And I think I might disagree with you a bit about the judgment piece because I believe that we can have awareness that is neutral. Meaning that I can have awareness that this thing that I'm doing isn't helpful for a client or isn't helpful for me without judging myself, without criticizing myself. So I feel like you know, there is that ability to have awareness without judgment, and that's where some compassion comes in.
Kim: Again, we're back to this idea of words ,
Amy: Exactly
Kim: And you know this whole thinking about judgment is something I've thought about a lot because my daughter, historically (I'm gonna be very vulnerable here right now) has called me the high priestess of justice. And in my sense of passion around especially things that I perceive as human injustice social injustice and I can be very passionate about that (and you see how I avoided the word judgment… and In its true form the word judgment is different than the word criticism and judgment In in its definition is a cognitive construct of appraisal)
Amy: Right
Kim…and doesn't have an emotional valence as you say, right? And what we have equated with self-judgment, self-criticism is we've made those two things the same and Anytime we are in Valence (I love that word valence) of a neurochemical experience that is oppressive that is minimizing, dismissing we are creating internal shifts of chemistry into the stress continuum.
Amy: Right
Kim: and that's where it becomes negative. But if I judge myself in the way, we're talking about judgment, “You know Kim You're you didn't the way you brush your teeth today you kind of missed that spot and You know, you need to be aware that that is a vulnerable place in your mouth” That could be a non-valence appraisal. That is helpful, right? So we're really talking about instead of a word we're talking about valence. Yeah an Activation that comes with a concept or a word that hits us in a place that is all about the invitation to sit in there a little bit longer. Right and just understanding that that is a physiological process that valencing I think is incredibly important and helps to validate the need for this work for all of us this work on ourselves. And it's so true Amy, you know you and I we may say things to people as (I'm sure this happens all day long) with one intent that is so loving in intent and its impact is different, right? You know that intention versus impact and that speaks to the valence for the other. And of course in in healthy mentorship and communication you want to check out intent versus impact but the ability to understand the impact that a word or a look or an experience or a conversation is having on me is mine.
Amy: Right. And I think that's one of the things that makes a lot of the ways that people are currently getting mentorship less effective. I do a lot of, as you know, reading questions on Facebook and sometimes answering them when I have an opportunity and what I see is that the people who are asking questions and the people who are answering them don't have a relationship, right, and they don't have any way of knowing how the other person is going to receive what they're saying. And so sometimes those comments and questions can end up doing more harm than good.
Kim: I feel this is very interesting in that I have a mentor and she is a very seasoned clinician she a current current mentor. And we had this early conversation in our first couple sessions of the difference between supervision and mentorship and so I remember how that conversation arose. We were having a dialogue around a particular clinical systems context that I was struggling with and she said, “ah you don't want supervision, you want mentorship” and the light bulb went on for me that there was a difference and I said “Tell me what you mean by that. She said well supervision is giving you feedback about what you're doing. Mentorship is evolving into your greater self.” And so I think again the words matter and what I think we're seeing in places like social media is advice.
Amy: Right
Kim: Which is so different than the potential for unpacking mentorship, which is why I have the resistance that I do, as you said earlier, when I get the “I have this kid that” particular emails is that I am worried, like you, of harm. It hurts my gut when I feel that I think it's more the it's not in alignment with my value system of Give the man a fish feed him for a day teach a man to fish feed him for a lifetime. And yet I'm also aware that if somebody sends me an email or if you get a Facebook that you could teach a workshop to each question and that's not what we're gonna do In our work as unpaid people sitting on social media answering questions. Today anyway Maybe in my retirement. I might like to do that, but not yet. So it's, you know, it's a that's a balance of boundary as well. What am I going to give away and how do I help at the same time?
Amy: Yes, absolutely. When you were defining those words Supervision Mentorship I also think about another version of that word though and That would be reflective supervision. And so I feel like that maybe is bringing that piece of mentorship that working on yourself and clinical practice together and I have found it really interesting to notice that many professions many psych professions, people who are working with mental health, require that people have supervision and OT does not require reflective supervision. And I think that that is something that we are really lacking in our field is mandated reflective supervision.
Kim: Completely agree There are so many Things I can say about that in agreement from here to the moon in and it never ends.
Amy: Right.
Kim: It never ever ends because You will always encounter experiences that activate you or that need more problem-solving or need a broader perspective.
Amy: And I’d say any time that we get activated it's an opportunity to learn something about ourselves.
Kim: You bet! Yeah. Yeah, I love the idea of reflective practice period right where there's you know that's built into your practice every day and I just want to add one more word in there and that's coaching. And coaching is yet another model semantic of a style of mentorship and it's deeply embedded in tracking so a mentor who is gifted in coaching will track not only the content but the way that the mentee the collaborative conversation is unfolding and so there's more process in it. And so I feel that there are different layers of skills from advice to supervision to mentorship and I love reflective mentorship. To even this layer of skill set that is somewhat psychotherapeutic in nature.
Amy: Yes, right. Yeah, and when we are working in this mental health model, which I Guess we could argue that we're always working in a mental health model, we really could benefit from having those skills and that help from others. I wanted to end our podcast or move towards the end and I want to say first of all that I will certainly be asking again for you to come back on here because you named one mentor and one set of skills and you went exactly where I wanted you to go today but you also have a tremendous amount of knowledge in so many areas of practice that I will definitely be asking you back to speak about some of those others other areas of practice. And because some of our episodes will be more about practice and the details and clinical reasoning and you know, all of these things that I have taken so many courses from you and learned so much about. But as we get towards the end of this podcast I wanted to ask you something a little bit personal and that is to think about what it is about you one thing (maybe there could be many), but one thing about you that at some points in your life, you might have considered to be a weakness or something that you needed to improve. But that now you realize the other side of that coin is that it gives you one of your superpowers.
Kim: hmm In a quick reflection to that answer I think it what comes out quickly here without contemplation is one of the perceptions that I had of, and we've already touched on, it was a pervasive sense of insecurity and not good enough. And In that space of not good enough (and it still exists) there is angst and shame and I can think of countless examples of we call it in my house “bad girl”, moving into the space of the bad girl, and that shadow that lives in my essence. I just turned 60 this year it's still there and it is there in a softer way that enables me to feel that I can enter into conversations that I would have previously perceived as risky or rebellious or dangerous I would have even put those labels on it with less worry about being a bad girl. I didn't say no worry, less worry. And so there's a greater degree of that pioneering spirit within me is a duality because it takes courage. And that barrier was always that not good enough and I think that that not good enough is also that place of questioning and curiosity and so if I put that quality into balance, which I guess I'm starting to do as you ask the question, it enables me to write blogs like I just wrote like “Calm is Overrated” or say things from places with a little bit more settledness within rather than writing something or saying something with a company in terror. I mean I've always been able to do it but that's with sacrifice and I think what is evolving is more ease.
Amy: Wonderful
Kim: Wow, thank you for asking that question.
Amy: I think we bring pieces of ourselves that could be viewed as negative to the life that we need and the work that we do and when we learn how to See that thing without judgment. It can be our superpower So I really appreciate you being vulnerable and sharing that with us
Kim: Thank you for starting this amazing conversation and dialogue and podcast and it'll be exciting to follow along and listen to the evolution of your conversations across time. So thank you for having me .
Amy: Before we go I would like for you to tell people just a little bit about what you're doing and where they can find you.
Kim: Great. So our website company is called Relationship Matters and The website is called www.KimBarthel.ca and what are we doing? We're jumping all over. Throughout the pandemic, we were full online and we are now full in person. So back to traveling and speaking and sharing and mentoring in person across the world and getting ready to get back into that airplane.
Amy: But you still have a lot of your online offerings available, correct?
Kim: They will be there in perpetuity.
Amy: Yes, wonderful. Yes. I'm so glad that that came out of this pandemic and everything that we have experienced is making some of your work as well as others more widely available because you can't be everywhere all at once, right?
Kim: Correct. And I think if I have to think about my favorite creation, I mean, there's a lot of them. The hottest topic right now is the Psychosensory Intervention, which is the immersion of psychotherapeutic practice together with the mind-body concepts of sensory integration and neurodevelopmental treatment for a wide population in mental health. And also Neurobiology Matters. That was another favorite of my creation in that that is something that informs everything that I think about.
Amy: It's too hard for me to pick a favorite. I appreciate all of them and I appreciate all of the work that you and Bob and Hillary do. And I look forward to learning again from you very soon.
Kim: Thank you, Amy Lewis.
Amy: Thank you, Kim Barthel!
I am so grateful to Kim for starting this podcast with a compassionate conversation that highlights why mentorship is one of the most important things that we can do for ourselves. I hope that you enjoyed this hopeful conversation. I look forward to many more opportunities to learn from Kim and hope to have her back to dive into practice in later seasons. Join us for the rest of this season of Mentor Moments as we meet other mentors and explore this incredible job of being a pediatric occupational therapist.
♪♪ ♪♪ ♪♪