Trauma-informed care in group practices with Sam Silverman

Dan King: [0:00] Hello, everyone. I am delighted to be joined by Sam Silverman. She's the CEO and founder of Silver Linings Mental Health and the author of Silver Linings from Surviving to Thriving After 9-11. How's it going, Sam? Sam Silverman: [0:13] It's going great, Dan. Thank you so much for having me. Dan King: [0:17] Yes. You're on a book tour these days. Can you tell us about it? Sam Silverman: [0:22] Yeah, it's super exciting. I am a new author. My book, again, is called Silver Linings from Surviving to Thriving After 9-11. It can be found on Amazon. And it was just released April 1st. It's been such an experience. It was a bucket list item that I wasn't sure if I would ever accomplish. And I did, which within itself was the most rewarding experience. But the book chronicles my experience as a coming-of-age young adult living in New York City. And I experienced the 9-11 terrorist attacks. I was working in the World Trade Center at the time. I barely escaped with my life. I was working on Wall Street, and I didn't really have any clear direction or clear purpose at the time with what I wanted to do with my life. After I went through 9-11, I experienced horrid insomnia, anxiety, depression, survivor's guilt, Sam Silverman: [1:22] and as you can imagine, was diagnosed with post-traumatic stress disorder. Because of that, I sought the help of numerous mental health experts, therapists, medication prescribers, EMDR practitioners, and I ended up going back to school, pursuing my master's degree in clinical social work, and discovered post-traumatic growth and resiliency along that journey. Dan King: [1:50] What is post-traumatic growth? Sam Silverman: [1:52] Post-traumatic growth is the idea that you can emerge from a traumatic incident or a traumatic event and discover a newer and better appreciation of life, a newfound happiness, and discover strengths and resiliency within yourself that you didn't notice were there before. And it's not so much that you are over trauma and that you no longer have the post-traumatic stress disorder diagnosis. It's a way of intertwining that trauma into your life, into your world, and moving forward and using that as a source of strength for something traumatic that you've been through. Dan King: [2:38] So how have things evolved over the years? So PTSD, horrendous experience. I'm so sorry you went through all of that. And so now you're in this period of both experiencing and teaching folks about post-traumatic growth. Can you describe how have your symptoms evolved? And yeah. Sam Silverman: [2:59] It's definitely been an evolution, Dan. I'm not going to lie. I still have symptoms of PTSD to this day. I still wake up some nights screaming in my sleep. Night terrors, when I could sleep, I had horrible insomnia for years, years after 9-11. And when I did sleep, I had really, really horrible nightmares and night terrors. I still have those to this day. And I'm at, I mean, this was 25 years ago. I'm at such a different place in my life. I am married to an incredible partner. I have a 14-year-old son. I have two dogs who would guard me and do anything for me. So I wake up in the middle of the night occasionally. It doesn't happen all the time, but occasionally I'll wake up screaming and my family just knows and they know what to do and they know how to calm me and my dogs come to the side of my bed. And everyone just knows it's a symptom of PTSD. I don't know if it's ever going to completely go away, but I will say that despite still having some residual symptoms of PTSD, Sam Silverman: [3:59] I have discovered how to live my best life. And I have discovered how to live a high, incredible quality of life despite going through 9-11. Dan King: [4:13] What are your silver linings? Sam Silverman: [4:16] My silver linings are finding whatever that is within you, whatever is sacred, whatever your interests are, whatever your relationships are, what you want your relationships to be, and really painting that picture for how you want your life to be. After 9-11, I didn't really know who I was. I was 22 years old. My brain was not fully developed. Your brain does not fully develop up until around 25 years old. And I didn't know myself. I didn't know myself well enough to know what I needed. And when you go through trauma, and then if you seek help, and if you go through therapy, through therapy, you develop clarity, you develop insight, you can start working with your therapist towards developing a treatment plan, which is a roadmap for what your goals are. And once I had that, I really started doing the work, I started realizing who I was, what I was about. What can I do to add to my life? I started developing a routine where I wake up in the morning, I exercise, I feel so much better after I go through my exercise routine. I knew what I wanted in terms of relationships, in terms of hobbies, in terms of career. So I think, getting back to your question, what is my silver lining? It's just a matter of finding what it is that you want out of life and really just digging deep to answer that question. Dan King: [5:43] What do you want out of life? Sam Silverman: [5:47] Honestly, Dan, I feel like I haven't. I mean, I always have more goals. There's always bigger and better dreams, right? There's always room. There's always room to think and to read bigger, want more. Sam Silverman: [6:04] I am so happy right now with everything that I've put together. Yeah. Yeah. Dan King: [6:10] I'm so happy for you. Sam Silverman: [6:11] Thank you. Thank you. Dan King: [6:14] How do we connect then your experiences through 9-11, your development of identity, your exploration of post-traumatic growth? How do we connect that to your group practice? Sam Silverman: [6:26] Yeah, so interestingly enough, I worked for an insurance company for quite a few years. And I met actually, we have a mutual friend in common, Gabrielle. I met Gabrielle, as well as other friends when I worked in the insurance company. And I had another friend who was doing private practice and she encouraged me to go out on my own and to leave and to start my own practice. So in 2017, I left the insurance company. I embarked on my own private practice and I just absolutely loved it. It was so rewarding. It was so fulfilling. I loved being my own boss. I did home visits at the time. I worked with homebound elderly individuals and also individuals with disabilities and chronic health conditions. So I was driving around day in, day out, every hour going to a different house, a different part of town in Denver. Sam Silverman: [7:20] And I just really loved it. Well, when the pandemic hit, And Gabrielle and I, of course, we stayed in touch. She left the insurance company. She started her own practice as well. She actually mentioned to me that she was thinking of hiring her first employee. And when she mentioned that, I started thinking, oh, my God, I can do this as well. And I hired my first employee. We were so busy. We were so inundated with clients coming into the practice during the pandemic. There just were not enough mental health providers to handle all of the anxiety, depression, all of the disruptions to life that people in general were experiencing when the world just went on a complete lockdown and shutdown. Sam Silverman: [8:05] And we were just getting so many calls for clients that needed mental health services. And there was just such a need. So during the pandemic, I started hiring my first employee. Then I hired another employee a few months later. And now we have 18 therapists. We never went back to in-person. We still do virtual care in the state of Colorado. And we are a trauma-informed practice. That is actually our core mission is trauma-informed care. We accept all major insurances, Medicare, Medicaid. So it's really nice to be able to provide these services to residents of Colorado that have difficulty accessing transportation or they have difficulty maybe even getting out of bed and leaving their homes. Sam Silverman: [8:49] So it's really nice to be able to provide this care from the comfort of their own environments. Dan King: [8:56] What an unusual, it's interesting in looking at so many different group practices all over the country, this is highly unusual. This is not something I see very often. Maybe I've seen it in one or two other instances, but coming to someone's home, not only does it demonstrate, you know, a deep, a deep commitment to care on the part of providers, But what's also interesting about it is, you know, we think about the environment that's required to heal from trauma, that sense of safety, that deep, deep need for a sense of safety. Home can be such a vital place for that to happen. And so often when we think about accessing mental health services of any kind from home, it's telehealth. But here with your approach, we have the safe space of home combined with in-person. And that's that's unusual. And I got to think I'm not an expert on trauma, but I got to think that those elements combining together could be really, really auspicious for healing. Sam Silverman: [9:53] Absolutely. Yeah. And I think when I did it in home. You know, there was still a certain level of anxiety that some of my clients did experience having somebody that they barely knew coming into their home environment, especially somebody that has trauma. It is, it's very nerve wracking to invite somebody that you barely know into your home. They see how you live. They see if you have dishes in the sink or if there's something that needs to be cleaned and it's a very vulnerable experience to open your home to a therapist coming in. So I definitely felt like when I was doing in-home, I did have that bird's eye view of what the client's living environment was like. Now that we're doing telehealth, it's really different. We have just that limited scope of what we're seeing behind the screen and the background behind the screen, but we don't see the whole picture. We see what the client is, you know, choosing to show us. So on one hand, we don't have that whole perspective, that holistic perspective of what their living environment looks like. On the other hand, it is a little more comfortable because the client isn't being so raw and so vulnerable having somebody completely come into their environment. Sam Silverman: [11:16] So I think there are pros and cons to both modalities. Dan King: [11:20] Yeah. And we always have to, when we think about telehealth, we always have to compare it to the alternative of no mental health treatment at all, right? And so as much as telehealth doesn't convey as much information as the at-home did, we do have to compare it to the alternative of no treatment at all, right? And there's no question, I think. I think the bulk of the evidence shows that it's way better than no treatment at all. Sam Silverman: [11:42] Way better than no treatment at all. A hundred percent. Yeah. And I do feel like the clients, I don't see clients anymore, but when I did see clients, the clients that I personally saw virtually, when I made that transition from doing at home to virtual care, and again, that was when the pandemic happened, I feel like we didn't miss a beat. I feel like we were able to pick up where we left off. The rapport was already established. The rapport was there. And I do hear that from my therapists now who do virtual care, who have never met their clients in person, that they still develop that rapport. I mean, even, Dan, if you can think back to during the pandemic, how everything switched online and you probably joined groups, support, not support groups, but networking groups with other professionals. You never met them in person. You met them online only. And what was that rapport like? Do you think it was any different from being with somebody in person? Do you think it was about, you know, the same? I personally felt like I joined networking groups during the pandemic, and I feel like the rapport that I developed was the same type of rapport as if I would have met somebody in person over coffee or over lunch. Dan King: [12:55] Yeah, it is amazing. I still prefer just the textured quality to in-person interaction, but it is amazing how much depth you can create through virtual, which is so vital for the therapeutic process. I can think of all interesting scenarios where we, you know, in our business, we, um, are usually buying majority stakes in practices. And we have, you know, we have agreed to terms for acquisitions without meeting folks in person. We've done it entirely over Google Meet or Zoom or something like that. And I feel like I know them well, though when I finally meet them in person, I really appreciate the texture that's added. But you're absolutely right that an enormous amount can be achieved and an enormous amount of depth of connection can be achieved entirely virtually. Sam Silverman: [13:43] Right, right. Yeah, it is really interesting. Yeah, we like right now we are on a two dimensional modality of communication. But if you take that two dimensionality and meet in person and can, you know, see the full person and say, Oh, okay, I didn't know that you were that tall. Or, you know, you see different facets of them that you couldn't really pick up online. um it's it's really interesting it's an interesting concept Dan King: [14:11] It is and with respect to trauma i think what's interesting because trauma lives in our bodies the level of connection that we can create in remote conversation can be sufficiently deep that we can feel like if we have the embodied experience of feeling a conversation i think even virtually we can feel someone else's energy we can feel a great deal of what is happening beneath the surface in the conversation in our bodies even remotely. Sam Silverman: [14:37] That's such a good point. Yeah, I think that's an excellent point. And I think you are 100% correct. I think that you can still pick up on somebody's energy, more so by video than over the phone, audio only. I don't think audio only conveys that whole sense or that whole dynamic. But I do think that virtually you can definitely pick up on somebody else's energy and get a sense for what they're thinking and feeling and have that same level of emotional intelligence. Dan King: [15:07] Just to play devil's advocate for a moment. Sam Silverman: [15:10] Okay, go ahead. Dan King: [15:11] On audio, is there a different year? I agree with you that there's a level of embodied connection, which is deeper through video. But with audio, I don't think it's an accident that there's an intimacy that can be conveyed through an audio-only podcast. I don't think it's an accident that some of the best interviewers are audio-only. So I don't know, are you familiar at all with Terry Gross's Fresh Air. Have you ever heard that? Sam Silverman: [15:38] Yes, I've listened to Fresh Air many times. Dan King: [15:41] So she's famously audio only. Oh. And there is, she's an example of a level of, it's a different kind of depth and I'm having a hard time finding the words to describe it. But I guess my gentle devil's advocate would be, I think you're right that it is a less embodied experience audio, but there is a different kind of depth. I think it's partly related to the lack of visual sensory experience. So we could close our eyes and have an audio conversation, which would enable us to listen to maybe tone of voice and words more deeply than in a video chat. Sam Silverman: [16:19] Oh, that's so interesting. And my mind went to, oh, gosh, and I hope that all my facts are going to be correct. But I think the first televised presidential debate, wasn't it with JFK and Nixon? And didn't they say that those who listened to the debate on the radio thought that Nixon won and those who watched the televised version thought that JFK won? You're right. Dan King: [16:47] You are totally 100% right. Yes. So it almost, what does that suggest to you, I guess? Let me put it back. What does that suggest to you? Sam Silverman: [16:56] Different perceptions. I think when you're using more of your senses, so when it's audio only, you're using your ears, you're hearing your intuition, you're picking up on nuances of speech and, you know, this rate and speed of how somebody is talking. So you're using not only your hearing, but you're also using what you're picking up and what you're tuning into with your hearing. When you're watching something on TV, you are not only hearing what people are saying, but you're picking up on their body language and their facial expressions and intonations and Um, yeah, yeah, it's, it's really, it's very fascinating. Dan King: [17:46] And I wonder what the implications could be both. I mean, we've been talking about, we've been talking about the providing of mental health services, but then there's also the dimension of, are there any lessons here for group practice owners in terms of how they communicate with their teams internally? Could there be moments for audio only communication versus video versus written communication? All of these different modalities have, have different characteristics. I wonder what potential there could be to use audio only, right, in certain contexts. Sam Silverman: [18:19] Yeah, no, that's a really interesting concept. And you're right. No, it's so funny, Dan, this conversation is taking like a completely different turn from what we talked about before we got on the call. And it's honestly, it's fascinating, because you bring up a really good point. And just to kind of jump on that devil's advocate bandwagon with you. There's also texting, there is, I'm not going to say the name of the practice, but there is a very well-known large practice. They hire contract workers and they do texting. And the primary modes of therapy are via texting. Dan King: [18:52] Right. Sam Silverman: [18:53] Yes. Dan King: [18:54] Yes. Sam Silverman: [18:57] So I guess, you know, it just goes to show that there are different forms of Sam Silverman: [19:04] connectivity and there are different forms of humanistic connectivity. You know, it probably depends on so many factors. It probably depends on the individual, the relationship between the therapist and the client, the adaptations of what the client can do. So personally, for me, I'm actually hearing impaired, which I don't remember if we talked about on our first conversation. I'm hearing impaired from 9-11. I lost most of my hearing, and I wear hearing aids, which you can't pick up on because I have long hair. Zoom or virtual conversations are actually easier for me to participate in Versus being in person. When I meet somebody socially or even professionally in person, if we are at a crowded restaurant or an area where there is a ton of background noise and things going on, I have a really hard time hearing. Whereas when I'm in my own controlled environment, where I can turn up the volume on my devices, it's much easier for me to have a conversation because I'm not receiving all of those distractions. Dan King: [20:19] There is, this is such a rich domain. And you know, it's funny, I agree. This has taken a different turn than either of us anticipated. And there are some more traditional questions I have in my mind, but I think this is so fruitful. If you bear with me, I think there's one more kind of domain to explore here, which is our default settings. And I'm talking about both in mental health practices, but also society writ large, how we default to certain choices that have implications, right? So for someone that's hearing impaired, these choices can really affect your ability to participate, your ability to sense the texture, other elements of conversations. But then last night, I was out with a couple of friends, and one of the friends had assumed that the place that we were going to was very different than it turned out to be. He knew it as this kind of Russian bar in Miami that was very, very down to earth. And it turns out it's been rehabilitated and now it's super flashy. And we ended up going in there, but it was so insanely loud. And I think there's such a default setting that going out in most settings in America, going out has to be this loud experience where we're almost sensorially overwhelmed, right? Sam Silverman: [21:36] Yes. Dan King: [21:36] Similarly, we have such default settings in business contexts where we default to video calls so often. And that's not necessarily a bad thing. It's just each of these default settings seems to maneuver interaction. And I think the implications for healing in a society where we're also overstimulated. Sam Silverman: [21:59] Yes. Dan King: [22:00] Most of our default settings, now that I'm stream of consciousness listening this, I think our default settings seem to push us towards more stimulation rather than less. Sam Silverman: [22:11] Yes, I could not agree more. And that is so perpetuated with our society and how everybody is just vying for your attention. I mean, you go into like, I know you're a New Yorker. I also lived in New York for about five years. You go into Times Square and there are all of these advertisements simultaneously vying for your attention because the, I think, concept of our society or partially the concept of our society is that whoever makes the most noise and steals the most of your attention, they win. Like social media, advertisements. Yeah. And there's really, I think you're right. I think when you go out, especially in large cities like New York, Miami, you go to bars, restaurants, clubs, and like they have to turn the volume up like at full speed. And it's impossible you have to scream over the noise to have a conversation um yeah yeah there's there's definitely a lot of excessive sensory stimulation these days a hundred percent i could not agree with that more and it's not good for healing it's not good yeah not good with trauma i'm Dan King: [23:27] Not a trauma expert i can't imagine it is yeah. Sam Silverman: [23:30] No i actually am working with somebody um Um, and he mentioned that, so I actually told him that when we meet a person, I, we have to choose a really quiet restaurant because I can't hear. And he actually told me that he prefers that because he has complex PTSD. And if he meets in a crowded restaurant, it triggers his PTSD. Dan King: [23:55] Wow. Wow. Yeah. We are desensitized to the impact of sensory input, right? On our systems. Sam Silverman: [24:03] So true. Dan King: [24:03] I'll give you one more thought on this wavelength. What if we went in the opposite direction? So what if instead of more sensory input, we actually had less? Dan King: [24:14] And so one of the most transformative experiences I've had, maybe you've heard of this, there's these 10-day silent meditation retreats, which are free, which are, I want to say relatively common, but becoming better and better known. There's a particular school it's called vipassana meditation they will house you feed you for 10 days of total silence and i'm happy to supply if anyone is interested actually we can supply a link in the show notes to this um they're totally free they're very relatively accessible and i bring this up in this context because and i've got to think that this has some something to do with trauma healing when you're in total silence there's no sensory stimulation. Dan King: [24:59] Different parts of yourself come online, right? You are hearing if there's trauma stored on the body, you're connected to it in a different way. Sometimes in a more challenging way, because, you know, they'll often say to veterans who've experienced a lot of, you know, really, really, really traumatizing situations to really think carefully about doing like a 10-day silent meditation retreat because so much is going to emerge. I had the experience of after doing one of these, coming home. And for the next week to 10 days, my dreams were more vivid and memorable than I could ever imagine. And I had, I was running a different business in those days. And I had had a client who had a problem. And I knew I had a solution somewhere, but I couldn't figure it out prior to the retreat. And after the retreat, I had a dream in which I wrote an email to the client. And it was so memorable that I woke up and wrote down on a piece of paper. Dan King: [25:53] Four or five lines from this email and it turned out to be the exact solution to this client's problem. And so I've got to think that that lack of, it's one thing to be in an environment where there isn't much stimulation. It's another thing to be in an environment with virtually no stimulation at all, right? To go to total silence because conversation among other things is, it is distracting, right? It distracts us from all different aspects of ourselves. And so I got to think that there is this innate intelligence inside of us. And that's part of the trauma story in some ways. And so a lack of stimulation going to the reverse in a totally opposite direction, I wonder what implications that could have for healing. Sam Silverman: [26:33] Yeah. And that's such a great point, Dan. I feel like there has to be a happy medium. I mean, you look at, I'm just throwing out an example, inmates and their punishment for acting out maybe to go into sensory deprivation. But as we know, sensory deprivation is the the answer. That can lead to psychosis, anxiety, depression. So you don't necessarily want to go on the complete opposite end of the spectrum to sensory deprivation, but you don't necessarily, I don't think humans benefit from this overstimulation that's perpetuated by our society. So yeah, I think that having that happy medium, and I think the retreat, I have to look into the retreat that you just spoke to, but I think being in nature, and that's why they talk about like grounding and forest bathing as forms of meditation now. I think that you are still benefiting. There are so many sensory experiences that you can get from being in nature. I mean, it's like so beautifully overwhelming without being artificially overwhelming. It's all natural, sights, smells, what you hear, everything in nature is just, it's there, it's subtle, but it's all natural. Sam Silverman: [27:42] And I do think that that could definitely have a healing effect. And I think that when we're not... Sam Silverman: [27:49] So overstimulated with everything going on around us, it forces the mind and body to not just heal, but to have more creative outlets and to think in different ways and to open up those neural pathways to formulate different thoughts or different solutions to problems like the email that you were just referencing, for example. Dan King: [28:13] I got to wonder, I'm even in my head wondering, you're totally right, like sensory deprivation can be both a wellness routine as well as a punishment for prisoners, right? Sam Silverman: [28:25] Right, exactly. Dan King: [28:26] And I'm in my head sort of thinking through what's the difference exactly? When is this healing and when is it not? Sam Silverman: [28:32] Right, right. Yeah. And I mean, I look at sensory deprivation and I know there are, aside from prisoners, like sensory deprivation chambers and even, I think, what is it called? Floating? Floating therapy, floating tanks. I've never experienced, I've never gone to a floating tank. I've never experienced that. But at what point does that trigger psychosis or anxiety? Sam Silverman: [28:57] Yeah, there has to be a happy medium. I don't know what that is. Dan King: [28:59] Traditionally our conversations here are more focused on group practices but we've got an interesting direction and sometimes it's good to follow the tea leaves and just see just see what comes up um but i think i guess one thing that that's coming up in this moment is you know you there's a real focus given your own journey on trauma healing right in your practice is it fair to say that that your journey of you know develop your journey with trauma has deeply influenced what you wanted to create with your practice. Is that a fair statement? Sam Silverman: [29:34] Absolutely, 100%. It was my guiding light, my silver lining, yes. Dan King: [29:39] And so how has that context, there's certainly other practices that care about trauma, but your own very specific journey in wanting to create a practice where trauma is at the core of the mission, how has that influenced the practice that you've ended up building? Sam Silverman: [29:56] It's influenced more so my role as an owner and a leader of the practice and just really having that understanding and knowledge of trauma-informed care. I also think that it's helped me better understand when we have clients in crisis that... Sam Silverman: [30:18] They aren't acting in an ego-systonic way. They are acting in an ego-dystonic way in which they are not showing who they really are because they are in crisis. And I think just having that understanding of when somebody is in crisis, change cannot happen. Change cannot happen until somebody is stable, until they're grounded. And I think just recognizing what those signs look like and identifying with our clients and being able to say, okay, this client's coming and they are in a Q crisis. To know that client may not be able to make their scheduled appointment. They may need more reminders, more text messages, emails that their appointment is two o'clock today versus somebody that is stable and that is functioning. So I think just recognizing what those signs look like. I know when I was in one of my, I was actually having a horrid acute crisis situation at one point after healing from 9-11. And I was almost delving into psychosis. It was like borderline psychosis where I just had this crazy panic attack. And I reached out to my therapist at the time. And I think that my words, my sentences were just really frazzled. I wasn't cohesive. Sam Silverman: [31:45] And she said to me, okay, Samantha, do you know who you're talking to? And I said, yes, I'm talking to, and I, whatever her name was, you know, my therapist. Okay, Samantha, do you know where you are? And I said, yes, I'm in my home. Like she actually had to ask me these basic fundamental questions. And I think that was her own test and way to ascertain that I was having acute trauma. So I think just having that knowledge base and being able to have that knowledge base with my team, with our clients, just kind of knowing where they are in the process is just really fundamental to the services that we provide. Dan King: [32:21] And so would you say is every clinician at the practice trauma-informed? Sam Silverman: [32:26] I would say every clinician is either trauma-informed or learning to be trauma-informed. We do hire therapists who are right out of school and Don't have a ton of experience, but we have a learning platform so that they can learn from experienced clinicians. We also offer every other week. Peer supervision, and we also offer individual supervision. So with all of the supervisors that we have on our team and the training, they, by default, will learn some aspect of providing trauma-informed care. Dan King: [33:02] I've got to think, you know, even in, and of course, there's so many clinicians that are not trauma-informed. You've got to think that at some level, you know, we've all experienced trauma at some level. And so part of the purpose of therapy through a really robust patient-therapist alliance is to get at sort of the deeper challenges that someone is experiencing. I've got to think that being trauma-informed, even in cases where there isn't serious PTSD, being trauma-informed is going to be a very helpful mindset for patient care writ large. Sam Silverman: [33:37] Yeah, it's really the foundation of our practice. And, you know, when somebody is in trauma, it is so hard to think clearly. And I think just working with a mental health professional that can help identify how to move through that trauma, whether it's through EMDR therapy, cognitive behavioral therapy, dialectical behavioral therapy, brain spotting, whatever that modality is, just having that trained mental health professional hold your hand and say, okay, now, you know, you are in this phase of your life that is not going to be the new normal. Like we are going to move past this and you are going to find recovery and we are going to create the new normal, but this is temporary. This is not going to last forever. And I think just having somebody to guide you and hold your hand during that process is just... So needed and incredible. And yeah, it's just really important. Dan King: [34:39] Couldn't agree more. As we come towards the end of our time together, it's been a beautiful journey to sort of unpack different elements of your own journey, different elements of how the practice works and different possible explorations of stimulation and trauma, these rich subjects, taking us to maybe a lighter place to end. What do you do for fun? Sam Silverman: [35:01] Okay, so this isn't so much fun, but this is so important for me. I love my routine and I have to do my routine. I am an exercise addict, sometimes too much, and I know I take off a couple of days a week, but I love exercising. That just gets everything running, going in the morning. I started cold plunching recently, which I can speak, I can do a whole other podcast on cold plunching. But having that routine, I wake up, I go to bed the same time every day. Just, I know what to expect. I just really hold that as like one of my sacred core values. I love being with my family, camping, going out into nature. We take our dogs on this beautiful hike every couple of days. And I just love seeing the mountains. I live in Colorado. Adore being in the mountains. And then I just love being with my family, to be quite honest. whether we're driving into the mountains or watching TV, movies, cooking together. We actually love cooking together as a family. And then I love making jewelry, writing. Those are pretty much all of my hobbies in a nutshell. Dan King: [36:09] That's awesome. That's awesome. What we'll do, we'll put in the show notes for folks a link to the book. So if anyone is interested in checking out Silver Linings, the book, there will be a link on Amazon. Are there any other places where people can purchase the book? or is it just Amazon? Sam Silverman: [36:24] So actually it's barnesandnoble.com, Amazon. And we are trying to get into local bookstores, Tattered Covers, one of them that we're trying to get into. But right now it's mostly just Amazon and Barnes & Noble. Dan King: [36:40] Well, thank you so much for coming on, Sam, and having this super, super, super rich conversation. I'm going to say, keep saying super because I enjoyed it so much. Sam Silverman: [36:47] I did too. Thank you so much for having me, Dan.