Dr. Lindsay Trent is co-founder and Chief Science Officer of Basis, leading the the team’s efforts to integrate evidence-based solutions into its model. Dr. Trent’s background is in the dissemination and implementation of empirically-based mental healthcare, specifically the development and evaluation of practical strategies to infuse science into practice. Her research examines variables that affect the availability, quality and attitude toward the provision of evidence-based practices in diverse clinical settings. The knowledge and insights gleaned from her past research inform the training methodology used with Basis Specialists.
Dr. Trent received her Master’s and Doctoral degrees in Clinical Psychology from the University of Mississippi, and completed a postdoctoral research fellowship at the National Center for PTSD and Stanford University. Dr. Trent‘s has authored more than fifteen scholarly articles published in academic journals.
Thank you so much for doing this interview with us! What is your backstory?
I am very happy to contribute! My specific areas of interest have largely been focused on development, integration, and evaluation of research-based tools strategies and I also ran a private therapy practice myself. Throughout my clinical training and beyond, I grew deeply frustrated with how little of what came from research made it into real world practice settings. While conducting research in the differential diagnosis and treatment of childhood anxiety at Stanford Medicine, I was shocked to see the relative absence of legitimate practice among the most expensive services in the country. Together, these were catalysts for Basis — a way to bring these research methods into the real world to help people.
With the holiday season almost over, many people have been visiting and connecting with relatives. While family is important, some of them can be incredibly challenging. How would you define the difference between a difficult dynamic and one that’s unhealthy?
There is not one standard, universally applicable threshold of ‘healthy versus unhealthy’ for everyone. We all experience and interpret these dynamics differently requiring an approach that best meets our personal goals and needs.
One way to help distinguish between a difficult dynamic and an unhealthy relationship is to evaluate the situation more objectively using strategies to help yourself ‘step back’ from the situation at hand.
An approach that is helpful for many is to create a tangible document outlining the features of the situation that you find distressing. Included in this description is an itemized list of the troubling (and perhaps not so troubling, or even positive) aspects of the situation. Organizing your thoughts like this will help to see a bigger picture of how something is negatively affecting your life.
If your level of psychological discomfort (unhappiness, anxiety, or depression, for example) is comparable to a level of physical discomfort that would cause you to see a doctor or dentist, you should consider seeing a psychologist or a psychiatrist.
Families have a large part to play in our overall mental health. While some members may be champions for wellness, others may trip triggers. What advice would you give about engaging both types of relatives?
Mentally preparing yourself ahead of time goes a long way in how you manage the situation in real-time. Basically, when approaching gradually (i.e, baby steps), our external triggers for stress become less and less stressful over time (i.e., in behavioral terms “habilitation” occurs). This process also helps us better predict the what, when, and where you may be “triggered.” One example of this might be calling relatives that may cause you stress or anxiety before seeing them in person, or sending an email to re-establish contact before attending an upcoming gathering.
We often hear about “toxic relationships.” Do you believe there is a difference between a toxic family and an unhealthy one? If so, how would you advise someone to handle a toxic family member?
There is not a standard cutoff for toxic versus non toxic and each person must determine what matters to them in the context of a given relationship. Oftentimes, this is whether to exert the time and energy necessary to repair the relationship after it is perceived to be broken.
One way to determine if a relationship is worth pursuing is to speak with the family member and establish that you are having a challenging time. If you are willing to work on the relationship, and so are they, this can serve as a helpful litmus test and can help you move forward in a productive manner. Invite this family member to collaborate on the plan as a way to help you co-create shared goals. Their willingness to participate in this process can also serve as an indicator of how invested they are and if it is worth your time and effort.
Can you share about a time where you helped someone overcome a challenging family member?
Dinner conversation could get a little intense during family holidays while visiting family back in East Tennessee (where I grew up) because my uncle would inevitably segue into politics, religion, etc. Dinners became quite interesting circa 2010 (i.e., Obama administration) and I learned a lot over the family meals that followed. Initially, I attempted to refute his arguments with logic (as I perceived it) to no avail. Eventually, and with the help of concurrent graduate training, I began differentially responding to the verbal behavior I wanted to see as opposed to those I could do without. So any mention of college football (a topic that I am rather indifferent about) from my Uncle elicited positive responses in his direction and compliments any time I could genuinely offer them (e.g., “What an insightful commentary about that coach’s performance! You really know this stuff, Uncle.”). Much to my surprise, the antagonistic commentary decreased and the conversation became much more pleasant within one meal. The effects lasted into the next meal and were even more pronounced.
Managing mental health in high stress situations is challenging and although gatherings are only a few times a year, they can make a major impact on overall wellness. What 5 strategies do you suggest using to maintain mental health when faced with an unhealthy family dynamic?
- Prepare ahead of time — in order to make difficult/challenging situations easier it requires getting comfortable with being uncomfortable. Create list of top values/goals that you can refer back to, to guide and reorient yourself in times of stress
- Perspective — accept that some situations will never be completely in your control, and you may need to be in distress for short periods of time.
- Have a plan — make a list of things that calm you (take a walk, listen to your favorite music album, etc.) or have someone you can readily text or call to talk to, whether its a friend, a specialist on Basis or a therapist. These outlets will help you recenter yourself and alleviate stress.
- Assess — have a clear definition in your mind of where you draw the line. Sometimes, it is not always healthy to ‘deal with’ a situation and you need to remove yourself for your own wellbeing. Setting a general threshold for this will help you assess when to leave, rather than making that decision in the moment when you are already distressed.
- Think beyond the 5 strategies — it’s a common theme today to seek how to ‘get rid of’ distressing situations. From a clinical perspective, this is the wrong goal for a positive long-term outcome. Anxiety is not something that is ‘bad’ and must be removed at all costs — below a certain threshold it is actually incredibly adaptive. Think about taking a test in high school or college — those at the low end of the anxiety curve were not the best performers, in general. They were probably still tucked away in their warm beds and had not spent time studying in the absence of perceived threat related to a bad grade. That being said, anxiety can certainly get out of hand in this and other situations, but is absolutely necessary for optimal performance in most situations (and staying alive!).
What advice would you give to family members who are allies of someone struggling with mental illness at these gatherings? How can they support strong mental health without causing friction with other members of the family?
Being an open and empathetic listener goes a long way, but it’s also important to remember you are not trained to give advice.
Just being there to hold a hand or help someone get out of a negative conversation can be extremely helpful. It’s important not to add ‘fuel to the fire’ by further escalating a situation, though. Focus on remaining as objective as possible while being an empathetic listener to friends and family members seeking support.
What is your favorite mental health quote? Why do you find it so impactful?
George Miller expressed his dream of giving psychology away in the following quote, “I can imagine nothing we could do that would be more relevant to human welfare, and nothing that could pose a greater challenge to the next generation of psychologists, than to discover how best to give psychology away.”
I read this quote around the time I was considering a career switch and was hugely impacted by Dr. Miller’s words. It’s not about the experts retaining their expert status if we have something that can really help people — why are we hoarding it for ourselves instead of getting it out there to the people who need it the most in the most scalable way possible?
If you could inspire a movement or a change in mental wellness, what would it be? How can people support you in this mission?
I’ve spent my career studying barriers to accessing mental healthcare and the simplified takeaway is as follows: we need to rethink how we perceive and address mental wellness in this country. People are beginning to wake up to the fact that no matter where you are or who you are, getting help often comes with challenges. My opinion is that these challenges can be addressed systemically to improve accessibility and quality of services.
My co-founder, Andrew Chapin, and I created Basis to help address this by offering a service that provides an accessible support system to help people through the challenges that come with being human. Services like Basis are helping to remove some of those barriers (like cost and time) to provide people with the support they need at a moment’s notice. Reducing stigma, however, is up to all of us. We can do this by educating each other on the different ways to care for our mental wellbeing, encouraging personal growth, as well as having an open dialogue beyond just a doctor’s office. At the end of the day, maintaining our mental health is just as important as maintaining our physical health.
What is the best way for people to connect with you on social media?
Thank you this was so inspiring!