We had the good fortune of connecting with Dr. Joseph (Dr. Joe) Shrand and we’ve shared our conversation below.

Hi Dr. Joseph (Dr. Joe), what do you attribute your success to?
WE ALL WANT THE SAME THING
I believe everyone wants to feel valuable. Think about every person you have ever met. Think about yourself. On some level we all want the same thing: to simply feel valued by somebody else. Human beings have spent millennia increasing their value by decreasing someone else’s, and are then astonished that the other person, group, culture, country does the same. This is why we have the conflict we have in our world today.
What’s cool is that at every, and any, moment in time you can remind someone of their value. And every time you remind someone of their value, you increase your own value.
And everybody wants to feel valuable.
As social animals, human being are very good at reminding someone of their value. But unfortunately, we are also really good at making someone feel worthless, dispensable, replaceable, insignificant, without any value at all. We are really good at both.
In my work, in my life, all I want to do is remind a person of their value.
WHY IS FEELING VALUED SO IMPORTANT?
Millions of years ago we were not the biggest animal, we weren’t the fastest, nor the strongest. We were isolated mammals scurrying around hoping not to be lunch. We were prey.
And then we formed these small social groups and our survival potential has increased so much that humans are now everywhere.
But to access the protection of that survival group you have to contribute something: you have to have value.
So when we perceive we have less value we can become very angry, anxious, or sad. Part of our brain begins to worry we will be kicked out of our protective group and be lunch for some saber toothed tiger. That we will again be prey. We revert to our ancient need for safety in a world of predators.
But how do we know if we are being valued or not?
THEORY OF MIND
As we were emerging as a social animal we needed some way of knowing what another person thought or felt. Especially what they thought or felt about us. Millions of years ago it was much more important to know if someone was looking at me as their lunch than if they were simply hungry.
The brain tool we use to know this is called Theory of Mind. We can’t see someone else’s mind so we have to guess, to “theorize” what they are thinking or feeling. Initially an important survival tool, Theory of Mind is also the root of empathy, enabling our ability to appreciate what other people think and feel. Humans being, as social animals, are very interested in what other people think or feel. But we are especially interested in what they think or feel about us.
Theory of Mind is the brain tool we use to remind a person of their value…or to make them feel valueless.
TREATMENT
Words are important.
In our field we are required to create a treatment plan for our patients: For the human beings who come to us for help.
The word “treat” means to care for, to nurse or doctor, to cure, heal, and remedy. Treatment is the action we take to implement that cure, healing, and care. We treat by using therapy, sometimes augmenting that therapy with medication. We treat with the intention of reaching certain goals ideally derived with the inclusion of the most important person: our patient.
To treat implies that someone is broken and needs ot be fixed.
In my field we may have unwittingly contributed to a person’s sense of being less valuable. After we meet with a patient, one of the first things we are asked is to diagnose them with a disorder. Depressive, Bipolar, Generalized Anxiety, Attention Deficit, Psychotic, Oppositional Defiant, Substance Use, even Post-Traumatic Stress. If you have a disorder, you need a treatment plan to get back to the better side of order.
Unfortunately, from a Theory of Mind perspective, the word disorder perpetuates the stigma that a person in treatment is broken: disordered. Without meaning to, the word devalues the person. It separates people into two groups. That one is ok, but that disordered one, not sure I can really trust them. How can a disordered person contribute as much as an ordered person? They can’t. And that means they have less value.
No wonder they are angry, anxious, or sad.
If everyone wants the same thing, to simply feel valued by somebody else, what happens when we tell our patients that they have a disorder, confirming that they are broken, have less value, and need treatment? What happens when we validate their perception that they are broken and inadequate? Instead of reminding them of their value we emphasize their unimportance. And when a person senses devaluation they become or remain very angry, anxious, or sad: Exactly what you are trying to “treat”!
The first thing is to use Theory of Mind and help them change their perception that they are broken, and not doing the best they can.
I do not think anyone is sick or broken or has any less value. Instead, I believe we are all doing the best we can. That’s what I teach my patients: that they are doing the best they can. But if they don’t like what they are doing, the way their life is, they can change it. They don’t need “treatment” because nothing is broken.
And they need a roadmap how to do it.
THE I-M APROACH IS A ROADMAP TO CHANGE
The I-M Approach is that roadmap.
I believe people are always doing the best they can at any moment in time. I call this your I-M. My current maximum potential. This is who I-M (I am) and I Matter.
Our I-M is defined as a “current maximum potential”. “Current”, right now. “Maximum”, the best. “Potential”, the potential to change in the very next instant to a different I-M. This is who I am. At this moment in time I am doing the best I can with the potential to change in the very next moment to another I-M. This is who I-M and I Matter.
This does not mean that your I-M is the best you will ever do. It doesn’t mean you have to like your I-M. You don’t have to condone your I-M. Just because it is the best you can do at that moment does not mean your I-M is a free ride: you will be held responsible for your I-M because everything you do has a natural consequence. And your I-M doesn’t even mean you will win and be successful.
For some people success is when you love going to work and love going home. For some, success is having enough food in the refrigerator. For some people success is having a home to have a refrigerator. For some people success is just waking up. Each of your patients can decide what success means to them.
But instead of judging ourselves and others as sick or broken, of not doing the best we can, that we should be doing better, let’s look again at why we do what we do.
Think about the words, “look again.” “Again look.” Again, to repeat something, look like a spectator. Put those together and The I-M Approach says let’s re-spect why people do what they do.
When is the last time you got angry at someone treating you with respect?
Never.
Anger is an emotion designed to change things.
We get angry when we want someone to do something different: to start doing something or to stop doing something.
But being respected feels great. So our brain does not activate anger. This has the same reliability as gravity. Apples do not fall up and the brain does not, cannot, activate anger when it feels respected.
Respect leads to value, which is what everybody wants.
Value leads to trust.
And trust is the antidote to fear, and anger, and sadness.
Because when you trust someone you can make mistakes, take chances, be creative, and not worry that someone is going to judge you as less than or broken. As not doing the best you can.
This is the power of The I-M Approach. It unleashes the power of respect.

The I-M Approach is a way to accept ourselves and each other. It is a way to respect ourselves and each other. It is a tool to wonder why we do what we do without judgement but with curiosity. It is much more rewarding to wonder than to worry. And it is much more productive to be reflective instead of reflexive. But all of them are I-M’s.

The I-M Approach teaches a person how to manage their life, not just cope with it. (Coping sounds like a person is just hanging on with their fingernails, coping with life. Management is empowering.) The I-M Approach Roadmap provides a plan where small changes can have big effects.
How do we get someone to trust us? Our patients come to us with secrets. How do we get someone to share their secrets? Secrets are not secrets because of what we have done. Secrets are secrets because we worry how will someone judge me if they know my secret. For a person to share their secrets they have to trust that they will not be judged. Our patients worry they will be judged as broken, as less-than. That’s why they are afraid to share their secrets. How do we get someone to trust us and share their secrets?

That is the foundation of The I-M Approach.

THE I-M APPROACH

(there is a logo that illustrates the I-M but it will not paste into this field.)
The premise of the I-M Approach is to remind a patient of their value. Rather than have a patient worry why they are sick, the I-M Approach helps them wonder who they are and why they do what they do. The perspective shift is from seeing themselves and others as less than and broken, to a person doing the best they can but always with the potential to change.

THE FOUR DOMAINS OF THE I-M APPROACH
We are always at our current maximum potential, our I-M. Our I-M is always changing, influenced by and responding to the Four Domains.

 Your Home Domain
 Your Social Domain
 Your Biological Domain of your brain and body
 Your Ic Domain: How you see yourself , and how you think others see you

THE TWO RULES OF THE I-M APPROACH

The Four Domains are connected and always influencing each other. This interaction of the Four Domains leads to the Two Truths.
1) The First Rule is you control no one but influence everyone. Everyone has an I-M and is interested in what you think and feel about them through the Ic Domain. You know it feels differently in the Biological Domain if you are treated with respect or disrespect. Those people are in your Home or Social Domain, and you have an influence on their I-M. You control no one but influence everyone. And you get to choose the kind of influence you want to be.
2) Because the Four Domains are so connected it leads to the Second Rule: small changes can have big effects. A small change in one Domain can have an amplified and ripple effect in the others. Each time there is a change in any Domain there is a change in your I-M. And as your I-M changes it influences the choices you make in the Domains. Small changes can have big effects. You don’t need to change everything all at once. This is the core of the I-M Roadmap to Change.

These Four Domains are the I-M Roadmap. A small change in any of the domains can have a ripple effect through the entire system. And when those changes occur it influences the I-M’s of the people in your Home and Social Domain: You control no one but influence everyone.

Small Changes can have big effects. These small changes produce measurable outcomes: goals which you can track over time as your patient moves closer to their own personal success. The I-M Approach takes the chaos of life and helps a person make sense of who they are and why they do what they do. Knowledge is power. Once you know why you do something you can change it if you want to. How are you meant to change something if you don’t know why you are doing it to begin with?

This is my brand: The I-M Approach. It is a fundamental paradigm shift away from seeing ourselves and others as not doing as well as we can, should be doing better, as less valuable. The I-M believes that we are always doing the best we can, this is who I AM, this Is Me, and I Matter. It is remarkable how quickly my patients begin to calm when they realize that I am not going to judge them, I am simply interested in who they are, and why they do what they do. We use the I-M Approach to explore the influence of the Four Domains, and then devise a small change that can have a big effect. I remind them that they control no one but influence everyone, and ask them, what kind of influence they want to be. Most of my patients think they have no influence at all. But they do. When asked, almost universally they want to be a good influence, a person who others see as valuable. And they learn that whenever you remind someone of their value, you increase your own value.

I truly believe that human beings are good. That we all want the same thing, to simply feel valued by someone else. That we do not need to decrease someone else’s value to increase our own. That we are one group, one group called humanity.

Can you open up a bit about your work and career? We’re big fans and we’d love for our community to learn more about your work.
My career started as a child actor. I’m Joe from the PBS children’s television show ZOOM, back in 1972. I was going to be an actor. After I graduated from college I worked as a writer for CARE, the international aid and development organization. I went to Belize and realized I was helping people I would never meet. So I went back to school, did my pre-med, and went to medical school. In 1982, doing my pre-med, I had to take Physics. (Are you still awake? Whenever I say physics people immediately fall asleep). In physics the symbol I stands for a potential current, for electricity. But in 1982 I thought, what if we turn it upside down and call it a current potential? And what if we see everyone at a maximum current potential, doing the best they can but with the potential to change in the very next second to another IM. And so The I-M Approach was born. This has been the foundation of my career: seeing people as doing the best they can. It has helped me to become a leader, seeing the potential in everyone I work with. This value leads them to feel respected, and that respect allows them to trust. And that trust allows them to unleash their own unlimited human potential, their creativity, their confidence.
Along the way, I learnt two important rules that I teach everyone: 1) Never worry alone. 2) The therapist must survive. You can put whatever word you want there: electrician, parent, teacher, etc.)
As to the journey, take a look at the short story I wrote called “Medicine does not Hug.”

I also combined my love for theater and working with teens struggling with substance use and created my non-profit Drug Story Theater. www.drugstorytheater.org We take teenagers in the early stages of recovery, teach them improvisational theater, and then use psychodrama to create their own scripted shows about the seduction of, addiction to, and recovery from drugs and alcohol. The teens then perform these shows for middle schools and high schools so “the treatment of one becomes the prevention of many.” In between each scene of the show the kids step out of character and do power point presentations that teach the audience about adolescent brain development and why their brains are at such risk for addiction. All the kids in the audience take a pre-show neuroscience quiz, and the same quiz after the show. We measure how kids who learn about their brains change their perception. Based on the neuroscience, you can get high but the price you pay is trust: Addiction is not about morality, it is about mortality. Simply the way the brain works. We are not trying to scare anyone: if the brain is going to choose between fear and pleasure it will choose pleasure every time. But we are just asking kids to wait until their brains are a bit more developed before using. And for our performers, they live another of my phrases: contribute to society to help with your sobriety. When they do the show, the audience reminds them of their value: and that feels better than any drug or alcohol.

I am now honored to be the Chief Medical Officer of Riverside Community Care based in Dedham, MA, have a weekly radio show and podcast, have written five books, love going to work and love going home, and am happily married to Carol who I met in 1978, married in 1987, and with whom we have brought to the world our four amazing children. We have lived by my phrase: It is much more rewarding to be amazed at who your child is than disappointed in who they are not. And our children are the proof.

Was it challenging? Yes. Carol and I early on realized that there were a lot of external pressures but the integrity of our love for each other was solid. I could not have done any of the things I have accomplished without her.

Any places to eat or things to do that you can share with our readers? If they have a friend visiting town, what are some spots they could take them to?
Fenway Park!

Shoutout is all about shouting out others who you feel deserve additional recognition and exposure. Who would you like to shoutout?
This is a huge list including Darwin, EO Wilson, many other theorists, friends, mentors, and teachers. My parents, my sisters, my nieces and nephews, my son-in-law But most importantly my wife and best friend, Carol, and my four amazing children, Sophie, Jason, Galen, and Becca. I would not be who I am today without the love and support of my family. They have embraced the I-M Approach, and find value in themselves and others. All the time.

Website: drshrand.com

Youtube: https://podcasts.apple.com/us/podcast/the-dr-joe-show/id1451527440

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