“(Emotionally) Support the Troops” – Transcript

[SOFT MUSIC]

ART NEZU
I think that psychology now has a huge amount to offer. But again, I think a big thing that I would be concerned about would be suicide.

MAURICE BAYNARD
Welcome to Drexel’s 10,000 Hours podcast. Our goal is to mine the stories behind our region’s innovators, inventors, and thought creators. We’ll be talking to experts in subjects from fashion to neuroscience to find out where their passion for work, and inspiration for ideas comes from. I’m your host, Maurice Baynard.

[SOFT MUSIC]

MAURICE
Art and Christine Nezu are a husband and wife research team who teach in Drexel University’s Department of Psychology. They run the Nezu Stress and Coping Lab, as well as the New Beginnings project, which focuses on skill-based training for US veterans, National Guard, and Reserves. Together, they developed a treatment called emotion-centered problem solving therapy, which has been adopted by the Department of Veterans Affairs, and the Department of Defense as an evidence based program.

MAURICE
I’m going to start with our normal opening, and say Arthur and Christine Nezu, welcome to the 10,000 Hours.

CHRIS NEZU
Thank you.

ART
Thanks. Please call me Art.

MAURICE
Art it is.

ART
Thank you.

CHRIS
And Chris.

MAURICE
So that was– my very first question was, how do people refer to you collectively?

ART
Oh.

CHRIS
That’s a great question.

ART
That’s kind of a joke between us.

CHRIS
What a great beginning. Some of our students over the years have referred to us as the Nezus. And we have always laughed at that because we thought it may sound like the Flying Wallendas.

MAURICE
I love it.

CHRIS
Yeah.

MAURICE
Right.

ART
Where’s my trapeze?

MAURICE
What do you call a group of Nezus?

CHRIS
Right. The Nezus.

MAURICE
The Nezus. OK. So the Nezus it is. I’m really interested in your life before the two of you met.

CHRIS
OK.

MAURICE
Where’d you grow up? What did you do in high school? What did you major in at college? And how did you end up in science?

CHRIS
Who’s want to start?

ART
You.

CHRIS
OK. Well, I grew up in North Jersey in an area just outside of Manhattan known as the New Jersey Meadowlands.

MAURICE
Know it well.

CHRIS
And I went to a public high school, came from a rather small town. And I was very interested in a combination of things that were not particularly academic in high school, so that I was a captain of the cheerleading squad. And then in my extracurricular activities, I took karate, and I was a lifeguard, and all of that. So I got to do sports type of things. But my other love in high school was the theater. And so I was in school plays, and I headed the stage crew association. And that led me to go to college to major in fine arts theater. And that was–

MAURICE
Where’d you go?

CHRIS
And I went to Fairleigh Dickinson University. And it took me quite a while to get through school because during that time, before I met Art, I became a mother three times over. And so I was a single mom, trying to go to school, and trying to get things done. And so it took me, if I put together my undergraduate and my graduate training, about 15 years to get my PhD.

MAURICE
That’s an incredible story. What was it that made you stick with it?

CHRIS
Well, I guess some ambition.

MAURICE
Yeah. [INAUDIBLE] you get side-lined?

CHRIS
Right. And I got sidelined in terms of my interest area, because as I said, I was involved in theater and fine arts, and that’s where my I receive my degree. But I had to take an undergraduate class in psychology, as all you know liberal arts majors do.

MAURICE
Absolutely.

CHRIS
And I realized that what I loved about theater was directing, and understanding human dynamics, and plays, and human drama. And that psychology gave me a real understanding of that. So I took every single psychology course that my undergraduate degree would allow. And I ended up minor thing in that. So that when it came time to go to graduate school, I knew I wanted to be a clinical psychologist.

MAURICE
That’s an incredible story. So Art.

ART
Her story is better than mine.

MAURICE
Yours doesn’t start in North Jersey?

ART
No.

MAURICE
OK.

ART
Actually, I was born in Harlem. And my family, at that time, moved to Queens when I was just before preschool. And then grew up in Queens, and went to public school, and that’s Brooklyn Tech. And my older brother went to Brooklyn Tech. And subsequently, my much younger brother went to Brooklyn Tech also. But part of it was that I was interested in science. Thought that I might become an architect. But I really love science and engineering. But I think one of the things was, in addition to being that kind of math, science geek, there was a tendency for me to always play that game. What do you think is that person’s story? So with my friends, we would be sitting, having lunch, or in the subway. I bet you I can tell that story better than you can. And that was always that interest in people.
And given that my ethnic, racial background is– I’m third generation Japanese. But both of my parents were part of the whole concentration camps during World War II. Such that my dad was in the service, but my mom was in one of the internment camps. The unfortunate thing– there’s a lot to be proud of, in terms of that. But, again, the concern is– so, a lot of the stuff that we hear about how veterans and service members these days are treated, again, hearkens back to some of those things. Like, my dad would have been somebody that, when he went back to visit his family at the internment camp, was treated poorly, and all of the discrimination. He, just like most of everybody from World War II, never wanted to talk about it. So I’m a kid growing up in America. There’s these toy soldiers. There’s cowboys and Indians. I wanted to play with them. I asked my dad a whole lot of questions. And he just didn’t want to answer any of those things. It was quite a while before I realized, he did get a Purple Heart, and the reason why was that he actually lost an eye, and he had an artificial eye. And I didn’t really realize that, and just always asked him about that. And he was, again, very, very reticent.
So there was always this tendency for me to think about wanting to be with people, to help them, looking at vulnerable populations. And I think that kind of spoke to what I’ve done throughout my whole career. But one of the things that helped me in engineering high school was to make me decide, I don’t want coming engineer. So I went to college from the very, very beginning deciding that I wanted to become a psychologist. I majored in psychology. Straight from undergraduate, I went to a PhD program, got my degree really soon. So I was one of those people that went fast track, and I was–

MAURICE
It’s the exact opposite story.

ART
In a way. And luckily, I didn’t have three kids before that.

CHRIS
Now he does.

ART
Now we do.

CHRIS
Well, now you do.

ART
Because I have adopted them.

MAURICE
It’s a gaggle of Nezus, by the way.

CHRIS
It is a gaggle of Nezus.

ART
And so that was something that I’ve always realize that I wanted to be. So looking back, I don’t have any regrets about my education, or anything like that.

MAURICE
So there the two of you are. You both have your PhDs.

CHRIS
Not yet. Mine, not when we met.

ART
Well, no.

MAURICE
No.

CHRIS
I had a master’s degree. I wasn’t at the PhD level yet.

MAURICE
OK. And so where do you actually meet? Everyone loves a great origin story.

CHRIS
OK. We met working on a special project, a grant, that was not a heavy research grant. It was what was called like a clinical demonstration type of grant. That was at Fairleigh Dickinson University. And what this grant did was, it created these kind of SWAT teams that sent behavioral psychologists into the community to work with families of people who had been de-institutionalized, who had intellectual disabilities, and severe behavior problems from years in an institution. And this team went in, and worked with either their parents, foster parents, their caregivers, their group home staff, and taught them ways to help people with their behavior other than pharmacological ways– more of what you would say behavioral ways. And so we were working. I was working on that project. Art was part of the division that was that created that project. And we were working on that together when we met.

MAURICE
So how did the experience working together on that project, and in the population lead to collaboration between the two of you?

CHRIS
Well, for one thing, that group was a very kind of collaborative type group of people that relied on each other because we were dealing with some very difficult problems together. We became friends. And we were good friends and colleagues for about four or five years before we got together romantically.

ART
Before we even dated. And by the way, this June, it will be 36 years that we’re married.

MAURICE
That’s incredible. Congratulations.

CHRIS
Thank you.

ART
Thank you very much.

MAURICE
So talk to me about the work that you do now, and how your focus has changed.

ART
Well, like I said before, Maurice, that our entire careers has always tended to be focused on which population or problem tends to be something that makes people very vulnerable to a lot of things? But one of the things that has occurred about, I would say, maybe a decade, maybe 11 years ago, is that– we’re also kind of known for co-developing a particular kind of psychosocial intervention that teaches people coping skills, and how to deal with stress. And the Department of Veterans Affairs came to us, and said we know about your program. It’s evidence based. It has a lot of research behind it. But one of the things that the VA is really pushing for is to adopt as many of the interventions, the psychosocial interventions that exist, that have lots of science behind it. What they were looking for us to do was to do something having to do with individuals that were more recently deployed and came back, and who were vulnerable to PTSD, depression, suicide, et cetera. Such that it was a little bit more of a treatment slash prevention. So it wasn’t only for people that came back with some difficulties, it was people that would be kind of identified as having the potential. So we helped develop a program that’s actually part and parcel of most VAs now. So it’s a program that’s continuously being implemented. And parenthetically, when our students go do practicums at the VA hospitals, or internships around the country, and they see our program, they’re like, oh, I know that. That guy supervised me. So that was kind of sweet. But the program continues. And we also helped them develop a web course, and a iPhone app for that. But there was a tendency for many of the individuals to be at risk for suicide. So that became of very significant interest to us. So I’d say for the past, say, five or six years, much of our research has been focused on better understanding suicide, and to adapt some of our programs to, again, help people that are at high risk for suicide. So one of the things that we’re very lucky is to get funding from the Pew Charities Trust. And what we have now is a program that is open to all veterans, regardless of their discharge, whether it was honorable or dishonorable. And anybody, whether they work with the VA, or they don’t work with the VA, we have a program that provides free training to them.

MAURICE
Could you talk a little bit about the program? What its elements are, how does it differentiate from other approaches.

CHRIS
Sure. Well, it’s based on this psychotherapy approach that we’ve developed over decades, over basically our careers. And it’s called emotion-centered problem solving therapy. Now what that means is that it views the difficulties that people have, the symptoms that they have largely connected with having to live under stressful life circumstances, and having to face very stressful problems in life. And so what we do is, we provide people with a number of tools to be able to more successfully, and more effectively, deal with stressful life problems– anywhere from family problems, to financial problems, to housing problems, to drug abuse problems, to any kind of problems that they’re having. The reason why it’s called emotion-centered problem solving therapy is because we think some of these tools are particularly potent. One of them has to do, certainly, with having a planful problem solving approach to problems– being able to define a problem accurately, generate different solutions, weigh costs and benefits, and things like that, of an action plan. But another piece of that is really allowing in and understanding your own emotions, and having a way to manage them in a way that you’re not overwhelmed by them. Because, particularly, its negative emotions that people experience when they’re upset, or they’re facing a stressful problem. But that you manage it effectively enough to listen to it. So when someone says they’re feeling very sad. Right? And they say, oh, I can’t face this problem. I’m crying all the time, and I can’t do anything about that. We would say, using this approach, let’s use the tools to manage this sadness to be able to bring your body’s arousal down so that your brain can work. But now let’s allow you to experience and be with that sadness so that you understand, what is it in your life that you want to change? Without our negative emotions, we wouldn’t know what our goals are. Right? And so we have come to really appreciate even negative feelings that people have as incredibly precious kind of thermometers or barometers of where they want to make changes in their life.

MAURICE
Could you talk a little bit about your work with the veteran population?

CHRIS
Well, for one thing, these are folks that have made an enormous sacrifice. And they have put everything on the line for themselves. And we believe, philosophically, they deserve to have every benefit in coming back, and receiving treatment, and receiving the services and resources that they require for reentry back into a civilian world. One of the reasons why they tend to be most vulnerable– some people immediately associate things like combat, which clearly are traumatic, to be in a combat situation. But one of the things that people don’t really see very quickly is just how, culturally, the military is so different than civilian life. So that when you’re in the military, for instance, you don’t have to determine what goals you have in life. Your superior officer tells you what goals you have. You have certain missions to do. And you have missions that are no fail missions. And you’re expected to do your job, and use your training to accomplish that. And you know exactly where you stand, and you know where you have to go. And you have a band of sisters and brothers that are to get there with you. You don’t have that in civilian life. And you don’t have that kind of loyalty, that singular mission with everybody working together to achieve it. So now you come back from that kind of a situation. And you’re in the civilian life, and people are saying, what do you want to do? What do you want to study? They’re not asking you about your experience back there. They’re not expecting you to have this sense of loss, of what you had when you were, say, overseas. You know, they think of it as a wonderful relief to be back from, say, Iraq or Afghanistan. But they don’t realize just how much you’re losing in terms of that culture, that camaraderie, that security of knowing what your mission is. So I believe that’s what makes the population, one of things that makes the population in general very vulnerable. And then there’s the actual trauma, and difficulties that one might have–

MAURICE
It’s literally a culture shock on top of the trauma–

CHRIS
It is.

MAURICE
–that they’ve brought back, based on the things that they’ve been exposed to?

CHRIS
Yeah. Now you’ve got reentry into a world that’s completely different. It feels like you’ve landed on a different planet. And so adjusting to all of that is very, very difficult. And I think that in terms of suicide risk for that population, when you are placed in that situation, and you don’t see a way out of it– where you’ve tried to get a job, and that’s not working out. You’ve tried to have relationships, and that’s not working out. You’ve come back, and things are very different than they were. Or the child that you left at 6 years old is now 12 years old, and is saying, don’t tell me what to do. OK? So you don’t have the respect from your children, all right, that you had from all of the guys or the women in your unit. And so you have all of these changing situations. Everything you’re trying that you learned in your training– the way to think, the way to act, what to do, that’s not working here. You start to feel a sense of hopelessness. And I believe it’s hopelessness that is one of the real hallmarks of suicide risk, because that’s when you become very disconnected from other people.
So one of the tools that I wanted to talk about that we use, in addition to teaching people to planfully problem solve, to manage their emotions effectively, is we give them tools that might give them a greater sense of hope. And so one of those tools is the use of visualization. Now we use visualization in a number of different ways in problem solving. But particularly for hope, and to motivate them to continue to work on the challenges they’re having, we will use a visualization tool with them that has them look to a future point in time, use their imagery to transport themselves to a future point in time– and to really in their mind’s eye try and experience what this would be like for them if they could achieve some of their goals. And people describe feeling, when they do that, that their whole body feels different, that they’re feeling like there’s a light at the end of the tunnel. And it gives them motivation to work on things. Does it make them all better immediately? Of course not. But it does give them a motivation to work on the issues they’re having. And that’s what we tell our veterans. We’re not saying that this imagery is going to make everything better. We just want you to stand up, and to keep putting one foot in front of the other.

MAURICE
Fantastic.

ART
To also kind of continue to answer your original questions. It also had to do with a couple of things, and part of what you were saying too before. Maurice, about the sense of the culture. You probably have heard, or you have friends or acquaintances that have talked about, how lonely that they felt. And that the idea is that, many of our patients talk about, I have so many friends, I have so many family members that love me, but I feel so lonely. And part of it is that they feel that they no one understands me. And part of it is that they’re often unwilling to talk about them. So one of the things that– you go into the military. It’s not like, OK, the military is going to teach you to be someone who opens up. And you talk about all these personal feelings. And you’re going to go into these gut wrenching kind of discussions. It’s like, be a man. And even the women, they’re going to say, be a man.
[LAUGHTER]
OK. And you know, you just talk to people that during their experience, during their deployment may have started to feel depressed, or may have started to feel anxious, et cetera. But at the end of your deployment, you go through this kind of thing that if you came from space, and you get all–

CHRIS
The debriefing.

ART
–debriefing kind of thing. And the idea is that if somebody asks you, do you feel depressed? You know they’re going to hold you for two or three weeks. So all you care about is getting back to your family. So if you say anything like that, then– so even though the service these days, and the VA these days are trying a lot to destigmatize, there’s still a lot of stigma associated with that.
Is there a way that we can build a more emotionally centered and grounded war fighter without decreasing their ability to be ready to do their mission? I think that there’s strong attempts by different services to try to do that. One of the things that we helped the Air Force to do is not a psychotherapy or mental health program, but a program to increase their problem solving, so their basic problem solving skills– to better understand how to make good decisions even when in the context of being told but which you have to do, so that you make some better decisions. So I think that that’s kind of important to understand the balance between emotions and logic. And in some cases, you just can’t let your emotions get the better of you. But the idea is there is a place and a context where it’s OK to shut down and not use your emotions. There’s other places where you show it. So it’s never, again, a black and white thing. So again, can you have a feeling but military person? Yes, if you don’t harp on repression of your emotions in order to follow orders. But again, there is the ability to have it in terms of a balance. And I think that becomes important.

MAURICE
Thank you so much, both of you. This has been not just informative, but really, really entertaining.

MAURICE
Drexel’s 10,000 Hour podcast is hosted by me, Maurice Baynard. Our producers are Shaun Fitzpatrick and Nathan Barrick.
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