– I am always looking in
every patient interaction to see, how does this make sense? How does it make sense
that you're anxious? What was going on beforehand that would have potentially
brought up some feelings and had your anxiety spike? So that we could
de-stigmatize mental health and we could help people understand that they're not crazy, this stuff doesn't come out of the blue. Your diagnosis is that you're human, that we all go through this together and that we can learn together and we can learn to heal together. (chime) (calm music) – I think that it is
important to reframe thoughts, but at the same time,
acknowledge that sometimes thoughts are not easy to reframe. And I have a three-step process
for working with thoughts. The first thing is to
challenge their veracity, or the truth of them. Just 'cause you have
a thought doesn't mean that it's more likely to
happen or that it will happen. So you need to really look at it and say, "Well, what's the evidence
for and against this thought?" And when we say evidence, it's
not another thought or belief it's actually something that's
observable by a third person.
A person that can say,
"This is what I observe to be true or untrue." And I think once you put
that through the litmus test, it's then important to try to reframe it in a way that can still feel
realistic to the individual and they can get on board with. So this is where purely
positive affirmations, especially super cheery
ones are not going to work because it doesn't feel
realistic to the person based on what's going on. And that's why I talk about this technique of yes, but, where you basically
construct your new thought using this structure. Yes, things have not been great lately, but I have practiced these tools and I believe they are
going to make a difference.
Right, so acknowledging
what's not going right, but then acknowledging something, particularly something that you
are working actively towards or something that honors
your process and commitment that gives you the other
side of the picture and really giving you a complete picture of what's going on, as opposed to just the one-sided picture. But sometimes your negative
thoughts are so strong and maybe there isn't a way
to reframe it in the moment because you're just so
stuck on that thought. Or maybe that thought
isn't even a thought trap. Maybe things are just
really bad right now. And that's when we use the
technique of de-emphasizing the impact your thoughts have on your behaviors and your emotions. And in order to do that, it's really about separating yourself and your identity from the
thoughts that you're having. And to do that, we really
essentially relabel the thoughts, and we label them differently
in that we label them as a mental event. So, if you have a thought that
nothing will ever get better, that sounds so final. That sounds like it's happening right now or it's going to happen, but if you could just add
the clause in front of it that says I'm having the thought that things are not going to get better.
It gives you the sense that the thought is just a mental event. It is a thought that you are having as a separate entity to the thought, and it gives you a sense that
perhaps there could be a way to resolve the situation, and that perhaps the situation you feared isn't even going to happen. (calm music) I can't be any different that I am right here in this moment.
And if I can give myself
permission to be exactly me, having areas of expertise
in certain places and that there may be some questions that really throw me that
I don't know the answer to, and that that in and of
itself could be okay, I could help regulate my anxiety. But absolutely, I still
get symptoms where, again, stomach upset, sweaty palms, heart racing, I can feel in complete self-attack mode. And the key for me is
being able to notice it, to regulate, to see what's going on and remind myself, often when I'm in this kind of self-attack, gosh, you can't be anywhere
other than where you are. What you have to offer is totally enough, and you couldn't offer any
more than what you have right here in this moment. And for me, that's an important mantra to keep my self-attack
and my anxiety at bay. – In the realm of mental health, what would your ideal world look like? – Gosh, in the world of mental health, my ideal situation would
be complete normalization of symptomatology. So that we could
de-stigmatize mental health and we could help people understand that they're not crazy.
This stuff doesn't come out of the blue. That I am always looking, in
every patient interaction, to see how does this make sense? How does it make sense
that you're anxious? What was going on beforehand that would have potentially
brought up some feelings and had your anxiety spike? Why might you be depressed right now? What's going on in your life that brought up some feelings, had you get anxious and now you're kind of attacking yourself or
isolating or avoiding? How can we make sense of
this and see, you know, the catch phrase that I love is that your diagnosis is that you're human.
That we all go through this together and that we can learn together and we can learn to heal together. – So many people have imposter syndrome and not just in a professional stance. Parents feel that way. Siblings, friends, coworkers, I mean in any situation you can
have that imposter syndrome. For those of us experiencing that, what would be your one word of advice? – So, if we think about imposter syndrome, so many people experience this.
And if we get really clear
about what is imposter syndrome? Imposter syndrome is
a form of self-attack. It's a way that I attack myself and tell myself that I am not enough. That they way that I'm
operating as a parent, as a worker, as a friend, a
son or daughter isn't enough. And so, part of it often, in places where we actually have a lot of experience or doing a great job, can
be related to struggling to hold healthy pride, to feel good and confident
about what we know. And then the other part can
come when there are holes in our learning or in our capacity, and that there is no one
who is a perfect parent, a perfect teacher, a perfect doctor, and that when we have to
hold this juxtaposition of I know a lot, I have
healthy pride over that.
But there are things that I don't know, and I might feel some guilt around that or feel uncomfortable that
I have to say sometimes I don't know. Rather than holding
these mixed feelings of this is who I am, this
is what I have to offer that I am enough exactly as I am, we get anxious and then
we attack ourselves. We say, "Gosh, you know nothing. You shouldn't even call
yourself a doctor, Kristy." Those are things that
we can do to ourselves, but it's so important that we recognize that self-attack comes
in the face of anxiety over mixed feelings. I'm proud of what I know. I'm proud of the position
that I've taken on, and there are things that I don't know. And can I hold this kind
of really complex mix of being an expert and a learner? Knowing things and not knowing things.
Gosh, can that make us anxious. And rather than tolerate the
anxiety and feel these feelings we often dump into this self-attack and call ourselves an imposter. So, the more that we can own what we know, allow the space for what we don't know, and settle into the
anxiety that that provides and let that kind of complexity sit, our anxiety can come down and we can be enough exactly as we are. – What is the role of
hope in mental health? – So, you know, I would suggest that hope is actually one of the
cornerstone kind of ingredients in regard to mental health.
That when I have patients who come in and tell me they have no hope, we actually can't go any further, we have to start right there. Because if they have no hope, I can hold 110%, 150%, 200% of the hope, if they have no hope, we
can't really go anywhere. That it is when we start to create space that things could change.
That we could work together to make things different in your life. Then we've got room for
potential, for possibility, for change, and this is what hope is. In my experience, we
really can't go anywhere in mental health in regard
to finding symptom reduction, in regard to changing our lives, unless we start with hope. Even if it's just a little window. I always tell my patients I
can carry the bulk of this, but I can't carry all of it. We have to align that
there is at least some hope that we can start to tap into and expand for change to happen. (calm music) – When I had that thought that I'm failing my
son and I am a failure, I noticed it and I caught it. I had probably been feeling that way and thinking those things
for quite some time, but when I noticed that thought, because I was able to
really pay attention to it, I was able to question it. I was able to label it as a thought as opposed to as reality.
And I was so, so grateful
that's something that I already had the skills to
do due to my own therapy and my therapy training,
that I challenged it. I said, "No, this is not true. I'm not a failure and
I'm not failing my son. I feel like I am, but
I'm not because I'm here. I'm doing the best that I can, and everything else
will figure itself out." This obviously didn't
magically fix everything. I didn't start to feel better right away, but I know that had I
not caught that thought and had I not labeled
it as just a thought, I would have spiraled and it would have been
really, really hard for me to manage my emotions, to actually give myself the opportunity to connect with my son, and to connect with those around me so that I could feel a
little bit less isolated.
(calm music) – I heavily believe in what I consider, I call it the five Vs for thriving. And I know that they
work because I use them. The first one was to
validate how I was feeling. A lot of times, especially
in the medical field and then professional fields, you feel like you have to
really put others first, but it's really important to
validate how you are feeling. So I have to validate that. This was painful, emotionally difficult, and then I had to vent. And so, venting for me
was regularly meeting with my own therapists. I had to really take care of the vitals. I had to take care of my sleep patterns, my eating, making sure
that I was still exercising and keeping my body in that routine. And then focusing on the
values, the fourth V, which is like, what are my true values? My values at the time were my family, my friends and his legacy.
And then vision, keeping
things in mind for the future. So, myself and the rest of the community made sure that we were going
to memorialize him every year, get together every year. So, having something on the
calendar to look forward to to keep you moving forward. Those five Vs really helped
me to get through that. And I really see this theme
with my patients today, like people who can
pull on these strengths and these five Vs, really do well in the face of obstacles.
(calm music) – You know the funny thing is is that when you talk about the moment I felt I could get out. And you know I've said this
on other MedCircle videos, is the only way out is through, Robert Frost and all of that. But I have to say it was less about I knew I was going to get out than I can think of a different
way of thinking about this. Because, to me, so much of mental health is about acceptance. We can't rewrite our pasts. The things that have happened to us have happened to us, they have. Can't go back and have different parents, can't eliminate the traumas
that have happened to us, can't eliminate the
losses that have happened.
Our stories are our stories. And so the question the becomes, for me it was the coming out of it moment, was I gotta do something differently. And so it was more of a, in a way, going through a mental health crisis, once you can start getting
almost to the other side, if you will, getting closer, is you start giving
yourself permission to say are there other options? Are there other things I could do? Can I do differently, feel differently, act differently? And that's really where it turned for me. It's like, okay there's things I can do. Part of that actually culminated in me retiring from a long
standing academic job. Some of the traumatic
things I've alluded to impacted that job. And while it hit me financially,
as you could imagine, I thought this is, in the
grand scheme of things, and this is when it's hard, you're doing all this accounting.
The one thing is dollars and cents and the other is like,
what's the price of my soul? Haven't quite figured that out, but apparently it was about the equivalent of my academic salary. So, I was like, I gotta get out of this. And, like I said, there's gonna be financial costs and all of that for me, but had this mental health
crisis recently not happened and the cumulative crisis of
COVID, family health issue, all not happened, I
think I would have stayed in an inertia state. And instead, basically
it was like the universe or the world or my mental
health or something metaphysical slapped me across the face and said, "What are you gonna do about it?" And so it was a huge call for me.
And some people around me said, "Are you sure you know what you're doing?" I said, "No, but I got to do something." And I have to say it's relieved
some fears and tensions and other things that
were coming from that, so that's great, but there's still some other tweaks that need to happen. And the other way I knew I
was kind of coming out of it was I was getting a lot
better at paying attention to sort of how I feel and
really giving credence to that saying on this day I feel well, on this way I don't feel well.
Well, let's look at the
difference between those two days and figure out what
things are in by control between those two different kinds of days. Now obviously between you and me, Kyle, if somebody gave me enough money, I'd be like peace, I'm out. I'm just gonna go sit in
some sort of green place or snowy place or maybe
go back to New England or something like that and live quietly. I could not work for the rest of my life. I have to be honest with you. But that's not in the cards for me. So for me, it was really like how is this going to lead me to think and do differently? And the severity of what I've gone through in the last eight, nine months, it ended up being a call to arms. And it's a call to arms
that has changed my life with an intentionality and a power that I don't think I would have had unless all this terrible
stuff had happened to me. – When you are in that space of an emotional mental
health challenge, obstacle, perhaps suffering from trauma
or any number of things, and you haven't reached the point of I need to change something, you're still at the point of, oh my gosh, I just wanna sleep, what is your advice to
those people in that space? – Yeah, you know it's interesting, when I look at my own story and say why didn't you crawl
into bed and not get out? 'Cause let me tell you, for several months there,
that is all I wanted to do.
I have a child. Child needs breakfast. Bills need to get paid. I have staff that needs to get paid. I have a mother that
I need to check in on. In many ways the people around me, and I think this is a
very, in some ways I know it's many women who certainly
find themselves in this role of there's people I gotta take care of. And those people I have to take care of, it wasn't in my reality or my identity, however, I know there's people out there who very much identify
as incredible caregivers and they still find that
they can't get out of bed.
And I understand that as well. For me, it was about breaking my day into pieces that were manageable. I would sometimes look
at my calendar and say, in fact, I don't want to
tell you the obscenity that more mornings than not I start. Like, I basically I'm like, curse word me, I can't believe I have to do this again. That was literally, I'm like, wow, that's really what
you say every morning. When that alarm goes off, first thing that comes out of my mind. And my cat's next to me
every morning hearing this. So, it's sort of a really tragic tableau if you want to think about it. But what I did was, and I do, and I've said this before, is I've got three things that I do in the same order every morning. This is actually many
ways where I think my cat may have saved me. She had to get fed. And she had to, she had
a routine in the morning. She'd come, she'd lay next to me, but then I'd stir and she'd
wait until the sun kind of comes up just a tiny bit.
So, she'd never wake me up in the dark. And then I had to get
out of bed to feed her. And once I was standing, I'm like, okay, girl, you're standing. And then I would use the
bathroom and brush my teeth, go downstairs, make my tea and now the day had started. One, two, three. Cat, basic ablutions, make the tea. And when that three-step
process had started, it was almost like imagining
a plane going up a runway. The day had kind of started, and then what I did try to do is I do try to follow routines. Like, then this is gonna
happen, this gonna happen, and I'd cut the day into pieces. When you're seeing clients,
that logically happens, it's an hour, it's an hour,
it's an hour, it's an hour.
And so that helped me. And on days that were more freeform, I'd cut the day up into chunks. Sometimes 15 minutes at a time because I couldn't imaging thinking about the 12 hours ahead of me. And I have to say sort of breaking it into these manageable chunks, before I knew it, I'd
lift my head and say, wow we got all the way to three o'clock. Or wow we got all the
way to seven o'clock.
And then I did other preventative things. A lot of the stuff that was coming at me that was harming me, was
coming by text messages and emails and that kind of thing, so my team, I have the
best team on the planet, they said, "We're managing these emails. And at the end of the day
we're sending you a summery, and you will handle the important stuff and we are going to protect
you from the rest of it." And that speaks to social support, Kyle. Because what I was surrounded by people who saw the cracks showing. They said, "We know what's causing this. It would cause it for us, but this isn't coming at
us, it's coming at you, so we're going to be
the front team on this." Just as I would do this for anyone else, they protected me from that and they helped me order my day too.
So that combination of social support, that cat that would get me out of bed, the three steps that I would do that the rest of the day would
kind of logically fall from, and deconstructing my day
into reasonable chunks, it was like cutting my food, you're not gonna stick a
whole pancake in your mouth, you're gonna cut it into pieces. It was the same thing. It made it digestible. And then, you know, some
days I have to admit, and it's still like this, Kyle, I feel like I'm just enduring the days. And then there's some days
where the joy cuts through.
And hopefully with time, more of the joy-filled days will be there than just the days where
I feel like I'm enduring and just pushing through. – Thanks for watching. Check out the links below
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health videos every week. Did you like what you heard in this video? If you want to ask a MedCircle
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