The Ultimate Brief Psychotherapy

I’ve always thought that Bob Newhart is hilarious. Maybe that’s because he was one of my dad’s favorite comedians. We had a vinyl LP of his Button-Down Mind recording that was on heavy play rotation when I was growing up.

But who knew that Bob was such an effective therapist (even though he played one on TV)?

Check out the video to see what I mean. And although this is a comic skit it has real applications. After the video I’ll give you one example of how I used Bob’s “two words” in real life…

I’m sure you know that I don’t mean to trivialize psychotherapy in general or the suffering that people with serious psychological issues experience.

Still, I think we can become a little self-absorbed and sometimes taking a step back can be healthy.

Here’s a story about how I use the “stop it!” Approach in real life.

My wife Jackie is a breast surgeon (can you imagine the wonderful dinner table conversations our son grew up with?). She’s a wonderful woman and a very skilled surgeon. She’s also a spiritual seeker.

As a result, she’s often invited to speak on a variety of “alternative” topics. For example, she’s giving a keynote address at a conference on spirituality and medicine that’s coming up soon.

Even though Jackie has been on a spiritual path for years and continues to learn and grow (one example, she just came back from a ten-day Centering Prayer retreat), she has difficulty seeing herself as a teacher in these areas.

It’s a little bit odd, really. She’s not afraid of public speaking. If you asked her to give an hour talk on the genetics of breast cancer or anything else about breast health – no problem.

It’s talking about things like spirituality or belief systems that make her uneasy. She’s not willing to accept that she is indeed qualified to speak on these subjects. She also “doesn’t want to be anyone’s guru.”

So there’s a predictable pattern I’ve recognize over the years. The organizers of some event will contact Jackie months ahead of time to ask her to present.

Because the event is a long time off and Jackie does want to support the people asking her, she agrees.

She usually mentions it to me and then it drops off the radar until it comes time to prepare.

About two weeks before the presentation, she mentions it more often. Now insecurity and even a little bit of annoyance creeping in. “Who am I to do this?” “This is a pain. I don’t have the time.”, “Why did I ever agree.”… 

This kind of chatter increases in frequency and intensity right up until the day of the talk.  She’s no fun to be with.

Well, not completely miserable, but not her usual charming self.

Mention doing anything and: “I can’t, I have to get ready for this {expletive} talk…”

The thing is, her talks always go great. She actually enjoys them after the fact and gets tremendously positive feedback.

The reality is people benefit greatly from hearing of her experiences and insights. Her humble manner makes the message even more powerful.

The pattern is obvious and completely predictable, so you think she’d recognize it and just let it go. But no…

So not too long ago she had a spirituality and medicine talk coming up. A few night’s before, we were out on the deck around sunset. She’s reciting the usual litany about why giving the talk is a crummy idea and how she’d never going to agree to do another one, and yada, yada, yada…

It was the usual for this stage pre-talk. And as usual, this kind of negative self-talk was completely unproductive. Not only didn’t help her prepare for the talk, it was keeping her from enjoying the beautiful evening (we do have some very nice sunsets in our backyard).

At first, I responded in my usual way by pointing out how well her talks are always received, why she’s qualified to speak, etc. That was as successful at perking her up as it always is, which is not at all.

As she started reiterating again how bad this talk thing was, I had a different idea.

Trying to channel my best Bob Newhart imitation, I near-shouted:

“Stop It!”

Fortunately, Jackie had seen the video and got the joke. It was fun to laugh. And I think it helped Jackie reframe her thinking about the talk.

The skit is meant to be humorous and irreverent. Still, it has grain of truth in it.

Controlling our thoughts is one of the most important skills we need to acquire in life. Too often we get stuck in “thought ruts,” thinking the same low-quality thoughts over and over.

Something as simple as mentally shouting “Stop It!” when we catch ourselves in a poor pattern truly can be therapeutic.

Worry is one form of low quality thought (you can read my article on worry here).

Jackie often deals with worry in her practice as a breast surgeon. In fact, when we first watched the skit, she said “I do that with my patients.”
Not as bluntly as Bob Newhart of course.

And she uses a different phrase. The phrase she uses is “Don’t go there.”

Hearing that you have breast cancer is never easy.

For that matter, it’s also not easy to tell someone that they have cancer. Bringing both compassion and expertise to the conversation is one of the most important roles a physician can play. Part of the art of medicine is judging just what approach is best for each individual.

Often, when a woman learns of the diagnosis, she goes into a worry mode about what the future might hold. Jackie listens for a while, then advises the woman “Don’t go there.”

She explains that a successful outcome is the most likely future (these days, that’s the truth), and if anything unpleasant does come up they’ll deal with it then.

In the meantime, if the woman is going to imagine anything in the future, it’s much more accurate and productive to imagine growing old together with her family and loved ones.

Mental state really does influence physical health. Jackie knows this at her core and is passionate about helping her patients deal successfully with the psychological stress of breast cancer and its treatment. Her skills in that area probably help her patients more than her notable abilities in the OR.

Enough of that aside…

Again, I hope you took this skit in the light hearted way it was intended. Who knows? You just might find those two words really useful as you take them out in the world.


Hello and Welcome!

Dr. Joe on steps by his home.I’m Dr. Joe McCaffrey. Or more formally: Joseph F. McCaffrey MD, FACS -board-certified physician and surgeon.

That sounds a little pompous so let’s stick with Dr. Joe.

To cut to the chase, I want to help you live your best possible life, a life filled with vitality, energy and meaning. Here’s a bit of the back story.

I graduated from medical school in 1974. I went into medicine in the first place with the intent to help people as best I could.

As you might imagine, I’ve seen a lot of changes over the years. In fact, there’s almost nothing in Western medicine that we treat the same way as we did back in the 70s, or even 10 years ago. And the rate of change is getting even quicker.

There are, however, constants. I like to think that one of them is that I and my colleagues in healthcare do our best to focus on treating everyone with compassion and kindness.

There’s a saying in medicine that I like very much: “cure sometimes, help often, comfort always”.

Sometimes the most important things we can do is just be present for someone facing serious health issues.

Although I am a firm believer in the importance of Western healthcare I have a serious concern about it. It amounts to the fact that we really don’t have a healthcare system. We have a sick care system. We are more about patching up problems with either drugs or surgery after they occur rather than helping people stay optimally well.

Even our so-called “preventative medicine” isn’t real prevention. It’s just early diagnosis. A person getting a mammogram or colonoscopy isn’t preventing a problem. They’re just finding it at an early stage when treatment is likely to be successful.

I’m in a new phase of my career. I no longer have a clinical practice and I haven’t been in an operating room for a few years.

I don’t use the phrase “retired” to describe where I am now because that term often has a connotation of no longer being involved and growing. That’s not where I am.

Recently, when friends retire I’ve taken to sending them graduation cards. They’re moving on to a new phase with a lot of learning and experience behind them. That’s where I see myself.

I want to continue to help people as best I can. In fact, I want to help more people than I ever could in a one-on-one medical practice.

Also, I want to focus more on helping people achieve and maintain optimum wellness and vitality, rather than on trying to patch up problems or manage symptoms after the fact.

That’s what this website is all about.

Sure, I’ll cover some physical aspects such as nutrition and exercise and managing specific health problems. That’s only part of the story though. I also want to give you help and advice concerning the psychological and spiritual aspects of wellness.

My years of working with people in some very critical situations have convinced me that the mind-body connection is real. Mindset, mental attitude and spiritual beliefs have as much to do with our wellness as any drug or surgical procedure.

I approach this website with a certain degree of humility. As I’ve researched, studied, learned and grown I’ve had to change my opinion and beliefs many times.

I cringe when I think of some of the recommendations I’ve made in the past.

However I can say I’ve always had my patient’s well-being at heart.  I’m sure my best advice will change in the years to come. I’m looking forward to continuing to learn and grow and and as I do telling you about anything interesting that I come across.

It will be a fun journey. Come in and join me