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How to Find Healing in Nature with Ralph De La Rosa (2023)

In this episode, Ralph De La Rosa discusses how to find your path to healing and post-traumatic growth. He explores the importance of understanding trauma and the conditions in which it occurs and explores the intricacies of the human nervous system. Ralph shares many personal reflections and psychological insights that offer a fresh perspective on trauma and how we can learn to overcome it for a more balanced and meaningful life.

Key Takeaways:

Discover effective strategies for healing from traumatic stress
Understand the role of subjectivity in trauma and its impact on personal growth
Explore the connection between rejection sensitive dysphoria, ADHD, and post-traumatic growth
Uncover powerful post-traumatic growth strategies for personal development
Learn about the benefits of the Internal Family Systems model for navigating trauma and fostering growth

Connect with Ralph De La Rosa: Website | Instagram

RALPH DE LA ROSA, LCSW (he/they), is a psychotherapist and meditation teacher known for his radically open and humorous teaching style. His work has been featured in The New York Post, CNN, Tricycle, GQ, SELF, Women’s Health, and many other outlets. He is personally mentored by Richard Schwartz, developer of the Internal Family Systems model of psychotherapy. Ralph himself is a PTSD, depression, and opiate addiction survivor. His new book is Outshining Trauma: A New Vision of Radical Self-Compassion Integrating Internal Family Systems and Buddhist Meditation

If you enjoyed this episode with Ralph De La Rosa, check out these other episodes:

Internal Family Systems with Richard Schwartz

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Episode Transcript:

00:00:19 – Chris Forbes
Thanks for joining us. Our guest on this episode is Ralph De La Rosa, a psychotherapist in private practice in New York City. He specializes in helping people resolve their early childhood traumas, anxiety, depression and intimacy issues. Ralph began practicing meditation in 1996 and has taught meditation since 2008. He’s a regular teacher at venues such as Spirit Rock, Omega Institute, and Kripalu. Today, Eric and Ralph discuss his newest book, Outshining Trauma, A New Vision of Radical Self Compassion Integrating Internal Family Systems and Buddhist Meditation. Also, I haven’t mentioned this in a while. Please go to our YouTube channel and subscribe there. You can watch the one you feed podcast interviews live at OneYouFeedPod on YouTube.

00:02:03 – Eric Zimmer
Hi Ralph, welcome to the show.

00:02:05 – Ralph De La Rosa
Thank you so much for having me. Eric.

00:02:07 – Eric Zimmer
I don’t know how many times this is. It’s three maybe, I don’t know. But you’ve been on a number of times in the past. I’m happy to have you on again. You have a new book out and I was just telling you what a wonderful writer you are. The book is called Outshining A New Vision of Radical Self Compassion, Integrating Internal Family Systems and Buddhist Meditation. So we’re going to talk all about that in a moment, but we will start in the traditional way, which is where I read this parable to you and see what you think. There’s a grandparent who’s talking with a grandchild and they say in life there are two wolves inside of us that are always at battle. One is a good wolf, which represents things like kindness and bravery and love, and the other is a bad wolf, which represents things like greed and hatred and fear. The grandchild stops. They think about it for a second they look up at their grandparent, they say, well, which one wins? And the grandparent says, the one you feed. So I’d like to start off by asking you what that parable means to you in your life and in the work that you do.

00:03:09 – Ralph De La Rosa
Oh, you know me, Eric. I’m going to make it complex because it begs the question, what are they being fed? And if the so called bad wolf were fed heartful energies, compassion, emotional nourishment, wisdom, teachings, what would happen to that bad wolf? And could they unite with the so called good wolf or at least harmonize? Right.

00:03:36 – Eric Zimmer
You know, we’ve had lots of people talk about honoring and treating the bad wolf well, but it’s the first time anybody’s, I think, brought up, you know, exactly what is the food involved.

00:03:47 – Ralph De La Rosa
Yeah, well, I mean, this is how healing works, right? That which is distraught within us, that which is distorted, distorted, that which is mangled up and bruised, is really a product of love deprivation of some form. Right. Like that’s one, one way we could frame trauma, right. Is love being betrayed or withheld. And for me, that tells us what the antidote is, the restoration of love and compassion in someone’s life.

00:04:17 – Eric Zimmer
Let’s start kind of at the beginning and talk about trauma, what trauma is, what it means to you. So let’s spend a few minutes there before we get into the healing of that trauma. So what’s a simple working definition for you of trauma?

00:04:34 – Ralph De La Rosa
Yeah, so I define it in the new book as any adverse experience wherein one’s defense mechanisms are mobilized, which comes with a lot of neurochemical activity, but those defenses are rendered useless. For any reason. For any reason. And so trauma then is not just the activation of all those neurochemicals that are quite intense and quite toxic, frankly. Cortisol is one of the most toxic chemicals that can be in the body long term, but then they have nowhere to go. And then what goes with traumatic stress? Because not all trauma becomes traumatic stress and not all traumatic stress becomes ptsd. But then if a person is met with other circumstances such as not being heard, such as maybe having to deal with alienating doctors or police or living in poverty, and all of the phenomenal amount of stressors that come with that sort of situation, then that sort of adverse experience where one’s defenses are immobilized or rendered useless in the context, in a social context, that is again, a love deprived kind of situation. Yeah. Then we’re looking at not just traumatic experience, but major traumatic stress.

00:05:55 – Eric Zimmer
So anytime our defense mechanisms are invoked, but unable to Be effective is kind of a working definition. I want to ask a question about trauma from a slightly different angle.

00:06:08 – Ralph De La Rosa
Sure.

00:06:09 – Eric Zimmer
You say at one point in the book that we should think of trauma as on a spectrum versus you have it or don’t have it, which I think is wise with nearly anything that we’re talking about in the mental realm. You know, we exist, exist on a spectrum of things. You also say that by doing that it allows us to honor the crucial role that subjectivity plays in the forming of traumas. And then you say, after all, our brains don’t respond to actualities but to perceptions. So I want to ask from that lens, is there a way in which trauma is preventable or is there a way in which things that are being deemed traumatic by certain people could be non traumatic to other people? The one thing that a lot of critics say these days is the definition of trauma has just expanded, expanded, expanded to include almost like my doordash order didn’t come last night. Right. And I know that’s not what you’re writing about, but I’m curious about that subjective angle.

00:07:14 – Ralph De La Rosa
Yeah, the subjectivity plays a humongous role because again, yeah, the brain doesn’t know the difference between your imagination, which perception is essentially imagination, actually. Right. If we really look at how it’s generated in the brain, the brain doesn’t know the difference between that and the objective reality. It only knows the subjective. And so I think I even cite the example of like, you know, getting a nasty text message and then the person blocks you. That technically fits the definition of a trauma. Now, again, whether or not that turns into traumatic stress that one holds in their body long term and then becomes a crucial factor in their life, depends on a lot of things. But I’ll tell you about one thing I’m learning about recently, Eric, is there’s this new term. It’s not an official diagnosis, but it’s a new and very helpful term called rejection sensitive dysphoria. It’s being researched now and it’s considered that up to 95% of people with ADHD have this. Because part of being ADHD or neurodivergent is you come off weird to other people and you get thousand yard stairs wherever you go where people take you the wrong way and you get rejected a lot. And over time that accrues, that builds up in the nervous system. It’s like death by, you know, not death by a thousand paper cuts, you know, death by a billion paper cuts. And that begins to really matter. And so this is far Flung. But given how wild and alive, frankly, our neurological systems are, there’s a situation that I could imagine in which somebody with rejection, sensitive dysphoria, one of the things they’re starting to understand about it is even something like getting a text message. And the person blocks you, which is a literal rejection, or even your doordash order getting messed up. That the perception of rejection itself, even if it’s not actually happening, the nervous system itself reacts as if it is. Right. Right. This is a real thing out there. And so in the context of somebody living with that kind of nervous system that’s heightened to a great extent. Yeah. Little things that are totally negligible to other people might amount to a big deal to somebody at the neurological level, meaning separate from their personality, separate from their volition and their conscious awareness. And that person still has a choice about what to do with that internal eruption. But that’s simple and not easy.

00:09:49 – Eric Zimmer
Right.

00:09:50 – Ralph De La Rosa
Then we could go to the other end of the spectrum of, you know, we know that material privilege is a mitigating factor when it comes to traumatic experience, not becoming traumatic stress. We know that emotional intelligence, that a sense of spirituality, sense of community, is really huge, a huge predictor of whether or not trauma becomes traumatic stress. So there’s all kinds of factors that could be put around a person that would make one thing negligible that is deeply adverse to the person standing right next to them.

00:10:25 – Eric Zimmer
Yep. Later in the book, you talk about healing from an upward spiral perspective. And I talk about upward and downward spirals a lot. And as you were talking, I was thinking of trauma in that way. Like, it becomes a downward spiral if you’re rejected in some way. Now you are more afraid of being rejected, and then that could cause you to be rejected. You spiral down. It made me think of, like, the cruel conclusion of a lot of loneliness studies, which is the more you’re isolated, the more you start to see neutral as threatening. And so you end up getting lost, you know, getting trapped in your own sort of loop. Right. And I think the same thing must be true in a traumatic sense. Right. That over time, you might become conceivably more and more sensitive to smaller and smaller things that, again, to your point, quote unquote, normal person would say, well, what’s the big deal? But for that person, based on a long history, that kind of winds its way back. You see how it could be a big deal?

00:11:29 – Ralph De La Rosa
Oh, yeah, definitely. Definitely. And it is interesting how we can enter into what I call a hall of mirrors, like in a haunted house. Where it’s kind of an infinity loop of mirrors going back and forth, but one of them’s warped, and so the image changes when it’s reflected back to you. Right, like that.

00:11:49 – Eric Zimmer
It’s a great example.

00:11:50 – Ralph De La Rosa
Yeah. So the mind can make. I forget who said this, that the mind is a place of its own. It can make a heaven out of hell and a hell out of heaven. Yep. I need to find the source of that quote.

00:12:02 – Eric Zimmer
Yeah, I want to say Blake, but I’m not sure if that’s true. Okay. So we’ve talked about trauma as this adverse experience where our defense mechanisms are mobilized. You talk about one of trauma’s overarching effects is a narrowing. Talk to me about what you mean by narrowing.

00:12:20 – Ralph De La Rosa
Well, you actually just gave us a very elegant example of it with the last question. Honestly, what you were describing, that downward spiral, that has everything to do with somebody’s subjective perception and not necessarily what’s actually happening, but it’s real to a human body. That’s a form of narrowing. Someone’s social world getting smaller and smaller, someone’s perceptions of possibility and perceptions of the humanity around them getting more and more contracted. It’s quite literal, too, at a neurological level that in any moment of stress, we get a form of tunnel vision that we don’t even necessarily notice in the moment until we snap out of it, we feel better, and there’s a sense of space. But anytime stress arises in the body, there’s a sense of contraction of our awareness, our muscular and fascial system. It all contracts. But then that is also a psychological metaphor, too, around, you know, our self esteem, our community. We’re seeing this hugely in our world right now, that our sense of community and that loneliness epidemic that’s going on, or how many people in the face of the pandemic started saying, you know what? I actually like this isolation thing. This works for me.

00:13:32 – Eric Zimmer
Yeah, yeah.

00:13:34 – Ralph De La Rosa
Or how many people it didn’t work for, but they were so habituated to it after we were coming out of the pandemic that it was difficult to learn. You know, people have been saying, I’ve been learning how to human again. You know, so that’s another example of a sense of contraction. But, you know, all the way up to and including our sense of connection to nature, to wonder, to spirituality, our sense of connection to our life’s purpose, the really big stuff can also become quite narrow, quite contracted, and we can feel quite limited when traumatic stress is abiding in the body and totally unmet.

00:14:10 – Eric Zimmer
There’s one other Description you use of trauma that I think can be helpful to understand. And you say trauma becomes like a record skipping in the same spot, unable to complete the natural continuum of the song.

00:14:25 – Ralph De La Rosa
So everything moves in cycles in nature. You know, every cycle wants to complete itself. Whether we’re talking about, you know, the cycles of the seasons, the cycle of breath. And we certainly have emotional and mental patterns as well. And when traumatic experience disrupts the nervous system, we can think about just how many thoughts we have that perseverate on the same point over and over again. Or how if you get in an argument with somebody, you might stay up till three in the morning thinking about what you should have said or the way you could have got them better, right? That’s one small example of what can go on. But all of us have emotional patterns in our lives, right? Like I mean my go to is depression. That’s one pattern that’s been in my life since I was very small. Other people have anxiety as what’s on their heavy rotation, so to speak. And so what trauma does is basically amplifies that natural continuum and makes it so that a person gets stuck in a loop that isn’t of their preborn disposition, isn’t necessarily of their personality or will, but is a conditioning of the nervous system. And really I think that those repetitive cycles that we enter into is actually the body asking us for healing. I talk about this to a great deal in my first book, the Monkey is the Messenger. That if we think about it, those repeat experiences where maybe we’re projecting something that happened in childhood onto a person who’s in front of us right now is in a way the nervous system saying hey, I didn’t get my needs met the first go around. I’m hoping to get them met now. And I’ll just say briefly, the hopeful aspect of this is first of all, anytime there’s a cycle that repeats, you can get to know that cycle and learn the moment in the cycle that you can drop out of it. You can break the cycle if you get to know it. And two, the love and compassion we didn’t get the first go around. We can actually offer to ourselves to respond to that question of the nervous system. Hey, can I get this need met this time? And in that way we kind of smooth out the skipping of the record.

00:16:38 – Eric Zimmer
That makes a lot of sense. I love that word perseverate. I have been thinking about it a lot lately. You know, I think any of us watch our mental world and there are things we perseverate upon And I’ve just been very tuned into that in myself lately. Just like, oh, there it is. You’re perseverating again on this thing that you’ve sort of already decided the planet action of what you’re gonna do. And yet you keep sort of thinking about it.

00:17:02 – Ralph De La Rosa
There’s one school of thought that that mental activity is just fluff. It’s meaningless. And I actually hold that view in contention. I think that that’s parts of us kind of tugging at our shirt sleeves, saying, hey, hey, there’s something here. Hey, there’s something here. Pay attention to me, pay attention to me.

00:17:19 – Eric Zimmer
So that idea has been on my mind a lot recently, but I’ve also thought about it for years, which is, to what extent do we take what’s coming up in us as something that needs attention and we should focus on? And to what extent is it a habitual pattern that just sort of comes up and there’s not much to do with it? Right. And so my depression is one I’ve thought about. And I go back and forth on this, right? On one side of me, I find myself in a depressed state. And I think, okay, it’s trying to tell me something. What message am I not getting? But on the other hand, there are times that I’ve felt like it’s been very useful for me to go, oh, this is just like having the emotional flu. Don’t make a big fuss out of this. Take care of yourself in the way you normally take care of it, and it’ll pass. And I kind of go back and forth with those things because a lot of times I’ve examined that and I haven’t found anything. You know, I go in to examine it and all I find is just blankness. I’m like, okay, well. And so trying to know when something is worth excavating and when something is worth sort of treating as noise is a difficult thing, I think, to figure out.

00:18:31 – Ralph De La Rosa
Yes, it can be. What enters the conversation here is the internal family systems model and the view of the human psyche that’s presented in that model. And in particular, this notion that we can be blended with the contents of our minds or we can be unblended. In other words, we could be all wrapped up in those thoughts and feeling things and kind of like the body experiencing it, as if whatever the content of those thoughts is happening right now. Or we could learn how to step back from those thoughts and be more of a witness, be more of an observer. We can unblend and put a little space between us. And that Mental activity and take a look at it. And when we do that, we’re in a much better position to discern. Is this what we might call in IFS a trailhead, an opening to something that could take me down a path that would be worth exploring? Or is it just mental noise, the natural chaos of our neurology?

00:19:52 – Eric Zimmer
There does seem to be a certain amount of, like you said, natural noise and chaos that does resemble a habitual pattern. It is a habitual pattern. It’s just a thought I think about a lot, trying to sort of determine when to delve deep and when to say, like, okay, let’s keep moving here.

00:20:10 – Ralph De La Rosa
I think if we can be curious, though, about that and not assume that it’s mental fluff.

00:20:14 – Chris Forbes
Right.

00:20:15 – Ralph De La Rosa
And kind of get inquisitive within ourselves and maybe even ask questions and inside of ourselves from a place of curiosity. This is another internal family system saying that. Actually, I find quite magic that if you’re in a curious place and you start inquiring about parts of you inside that are active in your mind, oftentimes you get answers, and sometimes they’re very surprising. Somebody might start with, hey, I seem to be obsessed with my inbox, for example, and like, whether somebody’s emailing me back or not, or whether somebody’s texting me back or not, and I keep perseverating on that, it creates a thought loop for me. Well, you could get curious about that thought loop and the content of it is what? Like, I’m maybe abandoned or there’s fomo. I’m missing out on something. You might be surprised if you start exploring, you know, are there emotions in there? Are there sensations in the body? What happens if you get curious about it for a moment and when you start getting in touch with what lies beneath the surface a lot of times, I mean, I see this constantly in my therapy practice and in sitting with folks in meditation groups where we do this work, that somebody will arrive at a place of like, oh, yeah, when I was a kid at school, nobody included me, and I felt ostracized all the time. I felt othered. I was bullied, perhaps, or at home, I was the middle kid who felt like they were never special enough or something like that. There’s so many examples of kind of a core wound that could belie what appears like something superficial. I’m just obsessed with whether they texted me back or not.

00:21:50 – Eric Zimmer
And I think that the amount of emotional energy that’s present also can be an indicator sometimes. Yeah, like, I have a couple thought patterns, like phrases that come up that are very. I mean, things like I hate myself comes up for a second. And sometimes I will examine that and just realize, like, it doesn’t feel like there’s anything actually that’s not true because I’ve identified what. When that comes up, it usually is. Right. It’s usually a realization that I am not going to be able to make somebody happy. It’s a realization that either I’m going to have to make a decision that’s going to make somebody unhappy, or I’m caught between two people. If I do this, then they’re happy, but then they won’t be happy. And so I’ve kind of started to realize that that’s what that is. So I guess as I’m saying this out loud, I am recognizing that I spent the time to diagnose and understand what it was. So that when it comes up now, I can kind of look at it and. And allow it to, in a sense, become noise because to a certain degree, because I’ve recognized what it is.

00:22:53 – Ralph De La Rosa
Yeah. That’s what I would call benevolent ignoring. Right. Like, in the name of love, I’ve got to, like, just let that be a stream of thought on the side, you know. But one could also choose to take that as a part of themselves that maybe again, has missed out on love and compassion in some way. You could explore the history of that. You know, it very well might come down to a core wound, Something experienced in childhood, something maybe even that you thought was negligible. That happens all the time. One could also enter into a relationship with that voice inside. You know, what is that voice really trying to do? You said there’s a fear there around. I’m not going to be able to make someone happy. And so I would suggest maybe that’s a defense mechanism of trying to get you to avoid the risk of even trying by feeling low and small about yourself, which is necessary, necessarily a method of trying to keep yourself emotionally safe. Even if it’s confused, even if it’s distorted and off, it’s still a part of you that’s actually, if we look at it from a certain angle, is acting benevolently with a voice of like, I hate myself, which is bananas. I know it’s convoluted. And yet this is what we discover all the time. And when we do this, deeper curiosity based searching inside and inquiring inside. So there’s a lot there. And again, just something that seems like ephemera, actually. You know, it was the tip of an iceberg, basically.

00:24:30 – Eric Zimmer
Right. Right. I Love that idea of benevolent ignoring at points. And it makes me think a little bit about cravings for drugs and alcohol. Yeah, like trying to discern, you know, when is this craving telling me something important and when is this craving a physiological response or a habitual response and working with that energy also.

00:24:56 – Ralph De La Rosa
And don’t we both know it as former drug addicts, both of us, you know, and with heroin, the most intense of all, I mean, Fentanyl now has come along and knocked that statement out of the water, but everybody has craving in their lives. Everybody has some level of compulsive behavior, some sort of self numbing, self medicating kind of of thing in their lives. And this is something we get into in section three of the book on inner reparenting, that you have to learn how to also hold a benevolent no and let that part of you have a tantrum and maybe throw a fit. And, you know, there’s that whole modality of urge surfing where you say no to the urge and you watch it crest and you ride the wave as it gets really intense, knowing that eventually it will die down and you’ll go back to your homeostasis. But you raise a whole different point around, is there a different kind of need that’s belying that craving in me versus again, just writing it off as mental fluff, something to ignore that doesn’t have any meaning to it. Right.

00:26:01 – Eric Zimmer
So let’s spend a couple minutes on IFS. You’ve referenced it a couple times. Some listeners are going to be familiar with it. Internal Family Systems. We did an interview with Richard Schwartz, who’s the founder of IFS, but that’s a big part of this book is internal Family Systems. So give us the couple minute overview of what IFS is.

00:26:20 – Ralph De La Rosa
Sure. So IFS is rooted in the insight that we have a natural multiplicity to our psychological being. In other words, just like your body is constructed of many parts and yet it’s one body, but your hand is a distinct part, and yet it too is the body. It works like that with our psyches as well. We can identify that there are defensive parts of us. There are parts of us that hold woundings usually in the background. And there’s parts of us that are trying to manage our lives and proactively hold us together, keep the ship from falling apart. And yet beyond that, we have, you know, heart energy as well. We have what NIFS is called self with a capital S that we know to be present anytime. There’s this sense of openness inside that might have some calm to it might have some love, some curiosity, some friendliness, openness. And so we identify all of these mind states as discrete parts that are in relationship with one another. And the idea here is it really is an internal family. We have all of these parts that are sometimes in conflict with one another, you know, called being at war with myself. Everybody experiences that probably every day. You know, one part of me wants this. The other part of me knows that that’s a bad idea, and I’m struggling now with it. Right. And so the idea here is internal family meaning. I can begin to assume these different parts of my mind are like individual family members, wherein everybody wants the same thing. To be seen, to be heard, to feel held, to feel safe, to feel loved, to feel respected, appreciated. Just like in any literal external family, everybody wants those same things. And when we begin a process of offering self love, self compassion to these different aspects of our psyches, something really beautiful begins to happen. Those parts of our minds begin to shift their presentation, and we tend to organically begin moving in the direction of healing, insight, awakening, transformation, whatever you want to call it. So that’s the basic just.

00:28:37 – Eric Zimmer
Okay, so we have these different parts inside of us which all of us can recognize, at least that multiplicity. And I think even if that’s all that we take from IFS, like if that was where you left it, Just to recognize that multiplicity inside of us and be able to identify what these different parts of us are wanting to do, I find to be incredibly helpful. Just that very idea.

00:29:03 – Ralph De La Rosa
I think it was Young Pueblo, the poet, who said, I stayed with my anger long enough to realize its real name was grief. Right. We all get that. We all get that. There’s these layers to it. Yeah. So the idea there is, you know, that there’s also a saying that anger is sad’s bodyguard. Right. You stay with a mental affliction long enough to get down to the other parts that are being protected underneath. Nobody wants to have their sadness, their vulnerability, their childhood wounding out on the surface layer running their lives. They would cease to be able to function. And so we need other parts of us to kind of hold that more vulnerable material at bay. And then when that vulnerable material gets triggered, we need parts of us to swoop in and. And address the situation, because maybe we’re being attacked. Maybe we need to get out of there. Maybe, you know, there’s a threat to our survival.

00:30:04 – Eric Zimmer
This is a question that is more curiosity driven than anything else, which is from a neuroscientific perspective or neurological perspective, do we have any sense of what these parts actually are because we’re talking in metaphor, right? We’re talking in metaphor to some degree. Or do you not think we’re talking in metaphor?

00:30:25 – Ralph De La Rosa
That is up for debate and the jury is out. Okay. I do think that we’re anthropomorphizing the nervous system. And I think that that’s the most accessible view that I ordinarily acquiesce to. There are some folks that are like, no, these are real sub personalities that you should treat like other people that are inside of you. There is that view within IFS as well. And I can’t actually answer the question, but I do know that there’s a neuroscientist, a Buddhist neuroscientist named Kelly McGonagall. I believe she lives in Jap and she wrote a number of really brilliant books, including the Willpower Instinct. And I do know that she talks about how when different regions of our brain are activated, we are literally a different personality. And so there is some neurological underpinnings of this. But this is something that the folks in the internal family systems world deeply want to study. Like, yo, can we get somebody in an FMRI machine doing what we call parts work and entering into self compassion with like maybe an angry part of oneself and what is happening in the human nervous system when that goes on? I mean, what we know with IFS work, even though much there is research on it now, it is an evidence based model, but we also know anecdotally from therapists and clients and people who experience this work, a wide range of people who experience this work, that a lot of what we do find in these processes, these self compassion processes, are incredibly consistent, are incredibly consistent across the board. Such as finding out that anger is protecting a sad part of you. Such as finding out that when self compassion enters the picture, everything inside begins to change its shape. Somehow for me as a therapist, I found that if I can really be in the heart of compassion as I’m sitting with trauma survivors all day, hour after hour, session after session, and I don’t like to take breaks in my day either. So if I’m in a space of compassion genuinely inside in the body, that day is not going to burn me out in the same way as if I’m being analytical with folks and thinking about what’s the solution to this problem and just kind of in a maybe a more habitual mind state.

00:32:44 – Eric Zimmer
You say that the guiding reality for healing trauma, and thus the north star of the entire book, is that we Cannot go wrong with compassion. And we’ve talked about self compassion. Self compassion is, I sometimes feel like it’s a little bit like for people who really struggle with it, it’s a little bit like you can get a loan from a bank when you really don’t need one, right? Like you go to the bank, if you really are broke, you’re not going to get a loan. If you got tons of money, they’re going to loan you money. And self compassion, if you’re broke, feels very hard to get or generate, right? It feels very difficult. How do you encourage your clients or the people in your programs to start to access that energy? Because we do know, I think, that it is extraordinarily healing and really important for a whole lot of different things. How do we start to get it if the message we’ve carried and the way we felt about ourselves for most of our lives has been one of really disappointing? Liking who we are.

00:33:47 – Ralph De La Rosa
Great question, great question. And thankfully there’s a number of answers because you’re right, many of us haven’t had a model for what that could look like that we got to internalize, such as an early caregiver, early school teacher. Many of us haven’t encountered somebody who really exudes love and compassion such that our nervous system knows what that’s like and has a reference point for how to get there. However, there are reference points and models all around us at all times. And the easiest one that I can point to is the Earth. Actually, if we think about the Earth, there’s a reason why people gender the Earth and call it Mother Earth, right? Because there is. We know that there are negative ions in the Earth that put our body into a healing mode. We know that our gut biome absorbs useful bacteria when we’re in nature. We know that the Earth is constantly propagating all species of life. And the Earth has provided even the materials that made this computer that I’m talking to you on and the couch that I’m sitting on and the raw materials of my apartment that I’m in right now. The Earth is, you know, propagating species that are recycling the air so that it’s the right mix of gases for me to breathe. I mean, if that ain’t love, I don’t know what is. That is incredibly generous. And you know, the Earth has a vast creative propensity density as well. And so we can relate to the Earth. And I think there are other models that we can relate to to get in touch with if our minds are open. To the natural world and to the reality of the planet that we inhabit. If our minds are open to these ideas, you know, there’s a reason why for centuries, for millennia, for probably as long as humans have been around, spiritual teachings have come from folks going out in nature and just observing the way things, things work. Right? So the earth is a nurturer. There’s a good model for what compassion is that we can begin to take in. And this is where meditation comes in. And something that I love teaching is, can you get in touch with the earth’s presence or at least imagine it? Because again, the brain doesn’t know the difference between imagination and reality. And begin to take that into your body to create a reference point for yourself of what nurturance looks like, what compassion looks like. In case that sounds way too woo woo for somebody, I’ll give you one more that’s a little less out there. Also, there are entry level states of compassion. Calm, curiosity, a little glimmer of openness inside the heart, space, friendliness, kindness. These are certainly things that anybody can begin to open to with a little bit of training, a little bit of effort. And if you follow the thread that that creates within you, you will arrive at compassion eventually. And so not all hope is lost. There’s lots of options.

00:37:00 – Eric Zimmer
Foreign. I like what you said about imagination because I think that imagination can be really useful in these ways. I may not be able to directly feel this thing, but I can imagine it. I can imagine what it would be like. And oftentimes it takes that sort of consistent imagining. My experience is before any real feeling comes along, the feelings often lag behind. You know, I read your book or we read somebody else’s book and it’s like, okay, do this and sit down and visualize that and imagine that. And I do it and I’m like, well, I didn’t really do anything, but continuing to do it little bit by little bit. Oftentimes then feeling sort of comes along. It’s that old saw that I use all the time of. Sometimes you can’t think your way into right action. You have to act your way into right thinking. And some of it, the acting in this case is imagine.

00:37:57 – Ralph De La Rosa
Yeah, we could actually do something right now that would take two minutes and would demonstrate what you’re talking about to the listener. Are you up for that?

00:38:05 – Eric Zimmer
Sure.

00:38:05 – Ralph De La Rosa
Okay, so for anybody listening, maybe not, don’t do this if you’re driving a car or operating heavy machinery, as they say. But even if you’re just doing chores around the house or Whatever, you don’t even have to close your eyes. You can just take a breath. Kind of come into being here with yourself and think of a time when you felt love or compassion coming from someone. And please don’t think of a time that would be very complex, but just a simple time, one moment where maybe somebody looked you in the eye with understanding or hugged you like they meant it or showed up for you in a time of need, something like that. Just think of one moment where love and compassion were flowing towards you. And now can you imagine what it would be like if you could really feel that right now in your body? What would that be like to viscerally sense love and compassion flowing into your body? What would shift and then notice what’s happening now? Did the dial move in that direction? Right. That was a quick and dirty version. But if you spend a little more time with that, it can become much more substantial. I love that trick. It’s one I use a lot. Like if you can’t get to gratitude, imagine what it would be like if you could feel a full bodied thank you. And what that does is it primes our neurological systems to actually have the experience. And it’s kind of a workaround in case there’s a blockage or resistance. What did you experience just now?

00:39:47 – Eric Zimmer
I thought of something that my partner Ginny does for me when I’m feeling bad and yeah, it gives a bit of a warm feeling. Yeah, it’s interesting. The other thing I’ve often done like a similar example is, you know, loving kindness meditation where you sort of direct kindness to other people. I start by imagining how I feel about. She’s passed now but a dog of mine, Beansy, because that is uncomplicated, simple and immediate. Like that’s warmth, like it’s just there. And then I can sort of take that sort of feeling and see if I can move it around.

00:40:23 – Ralph De La Rosa
Yeah, there you go, There you go. This is a wise, intelligent use of imagination within the realm of knowing this thing about subjectivity and the brain that we’ve been discussing this whole time that it’s real to the body so often even if it’s not real externally. And I do want to say this is tricky, this is a tricky area in that somebody could be way off in the way that they’re using their imagination. But if you are familiar with how basically the architecture of the psyche works and you’re using that power for good, then very, very useful. Yeah.

00:41:01 – Eric Zimmer
It also can get tricky because Kristin Neff, talking about self compassion, has said sometimes when you try and practice self compassion, you imagine it. You are in many ways reminded of all the times you didn’t get it right. So you think about a moment of warmth from your mother and you’re like, oh, that’s nice. And then you think about the rest of your relationship with your mother and all of a sudden you’re in complicated territory. Which is why when I talk about Beansy or you talked about it, it’s like, pick something simple.

00:41:31 – Ralph De La Rosa
Yeah. That is something that actually is part of why I went down the path I went down of focusing on trauma in my work and focusing on working with difficult emotions as a trailhead to trau in my practice, both as a therapist and a meditation teacher was I would teach these 30 day self love challenges in Brooklyn once upon a time, 15 years ago maybe, and we would do loving kindness phrases, but just for oneself for 30 days. And people would have the most intense, like shame spirals, trauma reminders, all kinds of things. And when I got into self love practices, I actually didn’t have that. And so I was like, wait, what do I, what do I do? What do I do? You know, in the Buddhist recipe is you just keep going with it and eventually it shifts. But in the context of trauma, if somebody’s having that kind of activation long enough, then we have a self love practice that’s actually retraumatizing somebody.

00:42:36 – Eric Zimmer
Right.

00:42:36 – Ralph De La Rosa
Which is bananas.

00:42:38 – Eric Zimmer
Right? Right. Well, I think the longer you are in this sort of space of generalized healing, well, being mental health is, you start to realize that a lot of these simple prescriptions are anything but for certain people. This idea of like, just everybody can do this and it’ll be good. You start to realize like that is a certain degree of being naive about.

00:43:02 – Ralph De La Rosa
The it’s always an if then proposition. If it’s like this for you, then this might work. If it’s like this for you, then you might need this other thing over here. And yeah, this is the problem with the Instagramification of self help and psychology and what have you for sure.

00:43:21 – Eric Zimmer
So I want to turn our attention to something you talk about post traumatic growth. We talked about the upward spiral. There’s a phrase that you used that I really liked, and it was enlightenment within reach. Talk to me about that. Because enlightenment is a very vigorously debated thing among people who care about such a thing. What is enlightenment within reach?

00:43:43 – Ralph De La Rosa
So, yeah, this is a way that we can get our heads around this, what a liberated experience would look like. And in the IFS model, they would call this becoming a self Led person. In other words, you’re healed enough that compassion, your heart energies are actually in the driver’s seat of your life. And all of your defensive and wounded parts are kind of acting in service of that and what that could look like. When we heal inner children and parts holding trauma, we begin to uncover more playfulness, more vitality, more of the best of our childlike qualities. Right. Spontaneity, uninhibited sweetness, joy, laughter. We begin to recover that stuff. That’s part of the promise of doing trauma focused work on oneself, is getting that stuff back. But when we do the reparenting work also, such as the compassionate, no, in the face of cravings like we were talking about, we begin to develop these other more mature qualities, you know, wisdom, discernment, and what have you. And so I think that enlightenment is within reach. Something that we can have in this lifetime, if not relatively quickly, as far as these things go, is a life where you’ve reclaimed the best of your childlike qualities within the context of mature qualities. So what would it look like if you had easy access to playfulness and laughter, spontaneity, joy, sweetness, and what have you, but you also had financial intelligence and emotional intelligence and ninja level communication skills and an altruistic spin on your life where you are of service of others? I think, you know, whatever Buddhahood is, I think that’s good enough. You know, I’ll take that much.

00:45:29 – Eric Zimmer
Probably my favorite line in the book, you’re describing this best of both worlds scenario and you’re sort of saying like, you know, if you only get that playfulness, but you don’t add a certain degree of maturity to it, Right. That that can be problematic. If, on the other hand, if you cultivate full maturity without wonder and spontaneity would be like replacing all playgrounds with DMV offices. That’s good. That’s a good metaphor. Nice.

00:45:55 – Ralph De La Rosa
Gotta have two wings to fly.

00:45:57 – Eric Zimmer
Yeah, I appreciated that. So in that section, you talk about two key energies we need to bring about these both worlds scenarios. And you talk about subtraction and addition. It’s become very common in certain spiritual parlance for people to talk about subtraction. You know, you need to unlearn everything and just subtract. But you’re saying we need kind of both of those. Talk to me about what each of those are and how they come into harmony together.

00:46:27 – Ralph De La Rosa
Yeah, I mean, it’s right here in this enlightenment within reach model. Right. The subtraction element is healing the traumas, unburdening ourselves of the pain, shame and fear we’ve carried around our entire lives, which can happen relatively efficiently depending really. But in the space of compassion and good support, good community, that is absolutely possible to begin unburdening your traumas. Right. So that’s the subtraction piece that allows us again to reclaim these really wonderful qualities that were maybe lost along the way. But again, the addition piece is the cultivation of those mature qualities. And that much isn’t going to come from focusing on your traumas. That is also work we have to go out and do. You can’t go to therapy and work on your childhood traumas and then suddenly know how to work with your finances or be more skillful in your place of business or whatever it is. And this is also a piece of the Buddhist path as well, right. Is how do we cultivate skillful means? How do we walk that Eightfold path of learning how to be nonviolent with our speech and nonviolent in our relationships and thoughtful about what we do for a living and how we’re contributing or not contributing to the suffering of the world. So it is a path simultaneously, it goes in both directions of somehow becoming younger again and, and finishing with growing up at the same time. Right?

00:47:57 – Eric Zimmer
Yeah. And I think that old gardening analogy is a good one. You have to plant seeds and you have to pull weeds. Right. Like both those things are pretty critical to a garden. If you’re not doing both of those, you know, you could pull all the weeds out, but you’re going to have not a whole lot there. And you can plant a lot of seeds, but they’ll get choked out if you have too many weeds.

00:48:18 – Ralph De La Rosa
Oh, and I’ve been choked out before, many a times. But I love that analogy too because it points us in the direction of something else that a gardener does that work, pulling the weeds and planting the seeds without knowing what the garden is actually going to look like, without an idea of what the final product is really going to be. You might know like, these are dandelion seeds. So I’m going to get a dandelion. But you don’t know the shape that that dandelion plant is going to take, how tall it’s going to become, how long it’s going to live, how many flowers will bloom on it versus just petals and stems. Right. And I think that that’s an important lens for us to look through when it comes to healing and growth. Because there’s this thing out there right now in the self help world of optimization, meaning I know what my life should look like. I know what my realized potential ought to look like. And therefore I’m going to engineer my inner work so that I go in that direction. That’s not gardening. That’s not gardening. And I think the way it really needs to work, or at least the easier way, the more human way, is I’m going to plant these seeds, I’m going to pull these weeds, I’m going to water this garden with love and good things. I’m going to stay consistent with that. And then I get to be in a process of discovery wherein I don’t know how this is going to turn out, but I know that Dandelion is going to be beautiful. Yep.

00:49:43 – Eric Zimmer
Well, I think that is a beautiful place for us to wrap up. Ralph, thank you so much as always for me on it’s a great book. We’ll have links in the show, notes to where people can get the book and find all your other work. So thank you.

00:49:58 – Ralph De La Rosa
Yeah. Thank you so much. Always a pleasure. Eric.

Understanding Choice Points for Lasting Changes in Eating and Exercise with Michelle Segar

December 31, 2024 Leave a Comment

Michelle Segar (Interview from 2016)

Struggling to stick to your goals? In the upcoming 6 Saboteurs of Self-Control Workshop, we’ll uncover the six hidden obstacles that sabotage your progress and teach you how to overcome them. From breaking free of autopilot habits to tackling self-doubt and emotional escapism, this live session offers practical tools and strategies to help you make better choices and stay aligned with your values. Join us on Sunday, January 12 at 12pm ET and take the first step toward lasting change.

In this episode, Michelle Segar explains the importance of understanding choice points for lasting changes in eating and exercise. She is an expert in sustainable behavior change for health and well-being and provides valuable insights and strategies for implementing consistent and lasting lifestyle changes. Michelle’s insights shed light on the complexities of habit formation, challenging conventional approaches and advocating for a more holistic and compassionate perspective.

Key Takeaways:

Mastering the art of transforming unskillful behavior into skillful actions for lasting change
Overcoming the motivation bubble to unlock the secrets of healthy habit success
Unveiling powerful strategies for building and maintaining consistent exercise and eating habits
Harnessing the role of executive functions in making healthy choices for a thriving lifestyle
Embracing value-based decision making for sustainable and meaningful behavior change

Connect with Michelle Segar: Website | X

Michelle Segar is an award-winning researcher at the University of Michigan. She has been a sustainable behavior change scientist and health coach for almost 30 years. Her work investigates how to help people adopt self-care behaviors, like exercise and healthy eating, in ways that bring joy and meaning, and can survive the complexity and unpredictability of the real world. She has authored two popular books (No Sweat, The Joy Choice), advises the World Health Organization on their physical activity initiatives, and was selected as the inaugural chair of the United States National Physical Activity Plan’s Communication Committee. Her pragmatic work is being scaled to boost patient health, employee well-being, and gym membership retention.

If you enjoyed this episode with Michelle Segar, check out these other episodes:

How to Meet Yourself with Dr. Nicole LePera

By purchasing products and/or services from our sponsors, you are helping to support The One You Feed and we greatly appreciate it. Thank you!

Episode Transcript:

Chris Forbes 00:19

Thanks for joining us. Our guest on this episode is Michelle Seager, an award winning researcher at the University of Michigan with almost 30 years studying how to help people adopt healthy behaviors in ways that can survive the complexity and unpredictability of the real world. Michele’s first book, No Sweat was featured in The New York Times and won the 2015 Best Book Awards in the diet and exercise category. It also became the number one selling book in Amazon’s exercise and fitness category. When released today, Michelle and Eric discuss her new book, The Joy choice how to finally achieve lasting changes in eating and exercise.

Eric Zimmer 01:54

Hi, Michelle, welcome to the show.

Michelle Segar 01:56

Thank you. It is great to be here again.

Eric Zimmer 01:59

Yes, I am. So happy to have you on I was saying to you before we started that, I don’t remember when we talked to you, it’s probably at least four years ago, but the conversation really has stuck with me since then. It’s one of the things I reference a lot, which is the basic idea that you know, the key is just to move in any way. Anytime that you can, and that everything counts, you know, those things really, really left an impression on me. But you’ve got a new book out called The Joy choice how to finally achieve lasting changes in eating and exercise. And we’ll get into that a second. But let’s start like we always do with a parable. In the parable. There’s a grandparent who’s talking with their grandchild. And they say in life, there are two wolves inside of us that are always a battle. One is the Good Wolf, which represents things like kindness and bravery and love. And the other is a bad wolf, which represents things like greed and hatred and fear. And the grandchild stops, thinks about it for a second and looks up at their grandparents and says, Well, which one wins. And the grandparent replies, the one you feed. So I’d like to start off by asking you what that parable means to you in your life. And in the work that you do.

Michelle Segar 03:08

I love that you started the podcast this way. It’s a profound, foundational thing, both I would say in my life and in my work. And this time around, I actually am going to tell you a quote that is so meaningful to me. And I think it has to do with this what you just read the parable. And it’s from Dan Siegel, who I’m sure your listeners know where our attention goes, neural firing flows, and neural connections grow. And so putting that parable within, you know, this essential neuroscience, which speaks to how important it is for us to feed the wolf that we really want to become, if you will, the virtues that we want to embody and live at. But I also I think it’s really important to bring the challenge to doing that it sounds logical to say, Well, if we feed the right wolves, then we’re going to live in the way we really value living. And again, I value this I believe in it. And it’s still challenging sometimes because and this is the thing because it takes conscious awareness before we feed the wealth and having conscious awareness number one enables us to see what we’re about to do and potentially to make a different choice to feed the Good Wolf, the one that again, represents what we aim to do.

Eric Zimmer 04:42

Yeah, I mean, so much of the quote unquote bad wolf behavior in our lives is completely unconscious, as you said, it’s just running on autopilot. It’s just the default behavior that we’ve either been conditioned into that we are left with after we deal with all our stresses and problems and busyness. The parable is a little dramatic, right? I mean, it’s, you know, good wolf and Bad Wolf. And, you know, I’ve always preferred the Buddhist terms of skillful and unskillful. Right. But as I’ve joked, many a time, a parable about an unskilful, Wolf just doesn’t work the same. But that’s really what we’re talking about. So most of our unskillful behavior is happening on autopilot. And we have to be able to bring things to conscious awareness in order to change them. And that is, at least half the battle.

Michelle Segar 05:31

I think when we first spoke about this five to seven years ago, I don’t know that I raised that issue. That’s why it’s so wonderful to have an opportunity to rethink. Well, what does it mean, to me today, that idea is so important to me that it is pasted on my wall right in front of me. So it’s hard to do when we have the intention. And when we practice, we get better at it.

Eric Zimmer 05:57

Yep, absolutely. So I want to pivot to the book. And I want to start with the idea that a lot of us who are listening, many, if not most of us have had significant challenges in building consistent exercise and eating habits. They are elusive for many, many, many people. And so a lot of this conversation where we’re going to start is trying to explore why that is. And then we’ll move into some of the ways we can solve that. But you start off by saying we initiate a change in eating or exercise in what you call a motivation bubble. Say a little bit more about what a motivation bubble is.

Michelle Segar 06:35

The motivation bubble, is a concept that just came to me when I was talking to a journalist about why we start and stop and start and stop endlessly. It’s because we’ve been taught to approach exercise, intentional eating in this way that focuses us on very aspirational goals. And of course, if we’re going to achieve aspirational goals, then we’ve got to do it right. And we have to do it precise in precise ways. And if you think about that, as a bubble, it’s this big thing. And we often don’t think of exercise or healthy eating. In the same way we think about parenting or our work or being a life partner with someone, it’s separate. And it’s over there. And we have to do it right. And I’m going to plan it. And it’s on a separate trajectory than everything else. It’s a bubble that is in a different orbit from the other life bubbles that we live in. And so because it’s so overinflated, by the moment, we make it whether it’s New Years, whether it’s leaving our doctor’s office, and we’re finally going to please them or do it right, or whatever it is, it bumps up against any other life area, and it just bursts. It’s fragile, because it’s overinflated.

Eric Zimmer 07:55

Yeah, I love that idea of how these bubbles rub up against the other areas of our life. And, you know, that’s a fundamental idea that runs through this book. And it’s a fundamental idea that I learned through coaching a lot of people over the years. And that idea, and you say it very well in the book, and in many different ways. The core idea, though, that you say is that habits require a stable context, to form. So that’s great. However, most of our lives are not anywhere near a stable context. If you have a demanding job, and you have children, and you have perhaps aging parents, and you have a social life, and I mean, our contexts are never stable, they’re always changing. And like I said, I really figured that out working with people where I’d be like, well, let’s just, you know, every morning at 10am, you’re gonna do X, right? And there’s a lot of benefit in some degree of specificity. And what do you do if 10 o’clock every day? You have no idea quite what’s going to be going on then? And so this idea of a stable context, share a little bit more about that.

Michelle Segar 09:03

Sure. And I want to say, I believe planning is very important. Yeah. So if we don’t plan something, it is unlikely to happen. So this concept that we’re talking about, it’s not mutually exclusive of planning. It’s actually what we have to do when our plans don’t work out. Yes. But before we go to that issue, I want to stay focused on your question about the stable context. So habit formation, which is doing something automatically without the need for cognition or effort or willpower is wildly popular. There’s been a lot of best selling books about it over well, quite a few years, but it’s become even more popular recently. Part of the reason it’s become more popular is because it is an easy way to develop apps. So if people are trying to develop fitness apps or different types of apps, it seems like oh, I’ll you Use the habit loop and I’ll create my app around, it’s very easy. And it makes sense. But the problem is, is that what works in theory doesn’t necessarily and often doesn’t work in reality. And so let’s go back to the stable context. habit formation is based on in academia, it’s discussed a little differently than, you know, the three steps of the habit loop, which is a context cue that is stable, it requires stability, then we’ve got to step to the behavior, let’s say, flossing, we associate that the cue is either putting our toothbrush down or walking in the bathroom at night, whatever that cue is that you’ve established. And then three is some type of reward with flossing, that could be a feeling of a clean mouth or accomplishment or whatever the reward is. Now, with a behavior like flossing that happens in the bathroom, often at night, after the kids are asleep, there’s not a lot of room for disrupting that context. But when we step out of the bathroom, into the realities of our full life context, and daily needs, like you introduced in the beginning, there are so many forces and unexpected things that we simply don’t know are going to happen. And the habit loop is based on the assumption that this context is going to remain stable. But when we’re talking about more complicated behaviors, that might have multi steps that might have a lot of resentment or ambivalence with them, like exercise, and intentional eating tends to have while those forces easily disrupt the context cue. And so that’s why the whole concept of habit formation, its value has been over generalized in the field of health promotion, because health promoting behaviors are much more complicated than a simple behavior, like flossing our teeth.

Eric Zimmer 12:03

Yeah. And it’s really interesting. You know, we’ve interviewed many of the leading proponents of the popular writing about habits, and there’s a lot of wisdom in there. And there is limitation in there. You know, let’s take BJ Fogg and tiny habits, right, a great method. But like, how do you scale from a tiny habit to a big habit? I mean, there’s some ways to do it. But there’s a point where it crosses over from something that can be automated to something that really can’t that’s and you know, I love what you just said there, because you pulled out two really important things, two things that are working against us. One is just the chaos of life. Yes, I plan to go to the gym this morning at 8am. And I woke up, my kid has a fever. Okay, well, not going to the gym. Right? Right. So we’ve got all these external things. And then you brought up the fact that we often have all this ambivalence inside of us around this. And when those two things collide, it’s a disaster, right? Because maybe I could overcome the internal ambivalence. If I can get just a routine going, you know, I often think I can’t make a habit out of exercise, but I can build momentum around it, you know, I can get some energy behind it, where it’s way easier to do than it used to be maybe when I was first starting the habit. So you’ve got these external things that rub up against the internal, we all would know this phenomenon, which is that like, Okay, we are supposed to be working out at 10am, we get a call from our boss at 10 o’clock. And at 1010, we’re done. And we don’t work out, right, we could. But that combination, we’ve got just enough excuse that is now rubbed up against our internal ambivalence, that it just comes off the rails.

Michelle Segar 13:40

And that’s why I don’t want to leave this conversation prematurely, because it’s so foundational to everything else we’re going to talk about, but that is why I call them decision disruptors and decision traps, because it’s that internal self talk. That, by the way, is not our fault. It does not derive from us, it derives from outside of us. We’ve internalized it through our socialization, through the education we’ve received in society and the media and research, you know, from our clinicians office, everything we’ve learned about exercise and eating has taught us to think about it in a very myopic, and really unhelpful way for most people. I mean, why is it that we think of exercise and healthy eating with this need for precision with this need to hit a bullseye? When all these other life areas, again, things that we want to sustain for life being parents, good parents, hopefully, but guess what, there’s ups and downs in our parenting. There’s ups and downs in our relationships, in our marriages, there’s ups and downs in our career, but we don’t bring that same sensibility and wisdom, yeah, to eating and exercise, but it’s again, it is not our fault as individuals. It is simply the way we’ve learned to approach it and I have To say some behavior change strategies cultivate a type of a precision thinking, which doesn’t help most people. Yeah,

Eric Zimmer 15:07

there’s a world of difference between something that you can manage to sort of keep rolling for 30 days, versus something that you’re going to keep rolling for 30 years, nearly any relationship can survive 30 days. But very few can survive 30 years, and it’s a completely different orientation. And so we’ll get to orientation around exercise and eating like why our orientation is difficult there. But let’s stay for a couple of minutes on this idea of habits when they work. And when they don’t you talk about people being habitus or inhabiting. What does that mean? Sure.

Michelle Segar 15:45

Well, you know, I want to be clear that that was a playful concept that I created, to get us to think more critically about what we’ve been taught about how to change our behavior, whether it’s worked for us why it may or may not work for us why it may or may not work for other people. So as you know, in my book, I use my husband, as an example, a pure habit or, and while I contend in the book, and I’ve been doing a lot of talking about this recently, that habit formation is not going to work for most people, when it comes to complex health promoting behaviors. It does work for some people. And my husband is a great example of this, because He has created a frictionless experience, again, to create his context cue for his exercise habit in the morning, he sleeps in his exercise clothes, and I always say, thank goodness, he is a good laundry person. And his alarm goes off at you know, five 530 In the morning, I’m not sure exactly what time because I am still sleeping, and he goes into the basement, he’s already dressed gets on the bike, exercises, no one else in the house is up. And then he has a sense of satisfaction. So his reward and I have asked him about it, his reward is that he feels like he’s accomplished something. And it’s often the only thing he feels that way about. So some people can do that. But he’s a habit or in all areas of his life. And this isn’t necessarily true for everyone. But I have tended in my coaching to to see that people who succeed with a complex behavior, like exercise or healthy eating, often are quite disciplined, often structure their life so that it doesn’t have a lot of interruptions, they check off their to do lists most of it everyday because of who they are. And I believe that they represent a minority of the population. And they have that innate self discipline to push through even when they don’t want to do something.

Eric Zimmer 17:50

I want to pick up that for a minute, but I’m not going to we’ll come back around to it. Because I think there’s a lot in there. That is actually very interesting, because I think some of what he’s doing is sort of best practices, right for this. So some of it is he’s naturally oriented that way. And, you know, the other is, he’s figured out how to get up at the time that nothing else is going to get in the way. You know, it’s people often ask me like, Well, should I exercise in the morning or the evening? I’m like, Well, the first answer is, it totally depends on you. Right? The second answer would be assuming there’s not a strong preference for in your life, morning tends to be better. And the reason morning tends to be better as less things can get in your way in the morning, right? By the time six o’clock rolls around any number of emergencies could have occurred in your career in your family at 6am. There’s far less of them. So there is something to be said for he’s done that, but I think what you just pointed to is there’s a rigidity, yes, in that. And some people don’t want to make this agenda. But I have seen this where, particularly in child rearing families where the father is able to sort of get some rigidity, and the mother doesn’t because she’s the front line of the support. And so it’s not fair to compare those two people in that way. Because their context are very different.

Michelle Segar 19:08

That’s right. And you know, what you’re speaking to is the chapter on chaos. Yes, the fact that research does show that the more chaos in the house, and of course, the person who is primarily responsible for managing the chaos has a much less ability to stick to the plan. Yeah, right, which is the quote unquote, we’re not using the word rigidity in a negative way. It’s descriptive, right? Yes, there still tends to be a gender that is primarily in charge of child rearing and house management. And it does tend to be the female but it really any whichever parent is going to be primarily responsible for these issues. I mean, think about how much on an anticipated unexpected Yeah, there is in our life is singular individuals. And now add on top of that, 123 Kids Yeah, maybe a couple of That’s, and you know, whatever else that might be going on, and that exponentially increases the amount of interruption that our self care behaviors are going to have.

Eric Zimmer 20:12

Yep. So let’s explore a couple of assumptions underlying you know, why habits don’t work for inhabiting? Sure got a few different assumptions. I don’t think we need to hit all of them. But you want to hit a couple of them?

Michelle Segar 20:26

Sure. Well, one of them. We’ve already spoken about this. So I’m just going to check a box by literally saying one of the assumptions of successful habit formation is that it’s going to work equally well across behaviors, because the books talk about many different types of behaviors they generalize. And so we know that that isn’t true based on how you and I’ve just been talking about, and even in the habit literature, which is, you know, going to be the most precise discussion of habit formation in the academic literature. There’s even a nuanced new conversation going on in that literature about xi is habit formation really appropriate for a complex multi step behavior, like physical activity. And so they’re, they’re discussing it right now. But I think it’s important to point out that that is occurring, and it’s a more nuanced, important conversation. Another assumption I can check the box on really quickly is that it’s going to work equally well for everyone. While we already talked about certain roles and responsibilities, really make that a much heavier, if not impossible, lift. And in fact, the most popular study that gets quoted both I would say, in academia and in industry, is a 2010 study that assessed how long it takes to form habits. Do you know that study that I’m talking about, it gets talked about all the time, and it it basically says while there’s a huge variation between behaviors, and people from like, 18 days to 256, something in that range, so huge variation, which is so huge, that it’s almost, it’s basically meaningless. But the 66 day average still gets talked about, even though it’s an average of, you know, 18 days over 200. But the important thing about that getting it everybody is that the study was conducted among university students who are very have very different lives. And yet, even among a group of students who have a lot more flexibility, traditionally 50%, at least of those University participants did not achieve the automaticity status, that that 66 day average is about so we have to ask, if students who tend to not be juggling all these things that we’ve been talking about, can achieve automaticity Wow. Then how are people who are you know, have a few kids, you know, and work outside of the home and have aging parents? The third thing I want to say is that the assumption is that automating our choices about exercise, and healthy eating is the ideal because in theory, automating it, yes, I don’t want to have to use willpower, yes, I don’t want to have to use my cognition. It’s such a limited resource, but in lives that necessitate pivoting and being flexible, we need the exact opposite. So the assumption that automaticity is the gold standard, what we should all aim for, I think is false. Because of the reasons we’ve talked about already, if we are not optimally primed to pivot, with our exercise and healthy eating, then you know, as 40 years shows us, we won’t be successful sticking with it, or at least most people want,

Eric Zimmer 23:45

right? And we want automaticity because it sounds easier. And we know that when something becomes automatic for us, it’s easy to do flossing as an example. Or I was trying to think of a habit I’ve just developed recently, that I realized has become automatic, but it’s a very small thing. I can’t remember what it is. Now, I want

Michelle Segar 24:03

to say not only does do we want it because it sounds easy. It is a wonderful resource that our brains are structured to have. So yeah, it is beneficial. You know, a lot of times people drive places that they know, you know, on autopilot, I don’t want people to think that I’m anti habit, I’m absolutely not anti habit. What I am concerned about is the overgeneralization of the value of habit formation for complicated behaviors that people keep failing at. And I think one of the reasons is because as a field, we keep telling people to do things that are just not valid in their life context.

Eric Zimmer 24:43

Right, right. It’s not that automaticity is bad, or that we wouldn’t want it where we can have it but you don’t want to insist on an approach that’s simply not going to work. That’s right. You just keep bashing your head against the wall. So we sort of debunked that you’re probably assuming you are trying to form a habit that is a myth. multistep complex habit like eating well or exercising regularly. And you have a complex life, right? Your life is such that it has chaos. And so I’m going to say, we’re now talking about 90% of the people at this point, right? Some people, if you’re already exercising every single day for the last nine years, you can just tune Michelle and it out and move on to the next show. For everybody else, though, last,

Michelle Segar 25:23

let me interrupt in want to understand unless that person who does have it down, wants to understand why other people in their lives are struggle so much. Yeah. So I think it is valuable for the people who get it right, or not get it right as the wrong word, who have successfully figured out how to sustain and be consistent with these complicated behaviors. Yep.

Eric Zimmer 25:49

And I’m going to pause here and say that listeners do not despair, or not saying like, you’re doomed to never stick with eating right, or exercise. And this is not, you know, abandon all hope ye who enter here, right? We’re gonna get there. But we’re sort of taking down some of the myths before we get there. So let’s talk a little bit about you’ve got a section called Why We don’t just do it, you know, just do it be in quotes, right, that phrase, just do it. So what are some of the reasons that we don’t just do it? We’ve identified some of them. Yes. But now I think we’re moving from the external to the internal.

Michelle Segar 26:23

Exactly. Thank you. That is a perfect introduction. So we have learned to perceive approach and experience exercise and intentional eating. Again, while these ideas might generalize to other self care behaviors, the book is really explicitly focused on eating and exercise, because of the reason they are uniquely united, or under the umbrella of weight loss, and all of that really problematic things that brings between weight ism and shame and hating exercise, because it’s punishing, because you think you have to do it hard, or feeling deprived, not because you actually are but because you’re making a choice out of this external should I can’t eat that bad food, and it makes you feel resentful, or rebel. And here I am jumping into the four decision disruptors, which reflect the inner scripts, the inner things, the things we tell ourselves at these decision points. We’re at a party, we recently started eating plan that we felt really good about and have really been successful following. And we’ve noticed that we feel good, we go to a party. And there’s nothing on our plan there. And on top of that, there, there’s a glistening chocolate cake across the room that, you know, is seducing us with the look and the aroma and all the stuff. And instead of saying to ourselves, oh, geez, I you know, yes, chocolate cake is great, but I love this eating plan I’m on the internal script tends to be again, it’s not our fault is how we’ve learned to think about it. I can’t have that chocolate cake. I can’t have it. It’s not on my eating plan. What is one of the biggest disruptors it’s rebellion, because humans are wired to rebel against anything which takes away our freedom. So that’s this internal rebellion script that we play. And of course, what happens is, there’s all this energy to just take the thing we don’t think we should or can have. And we don’t even do it with a sense of Gosh, how much do I want of the cake? Do I need to eat the whole piece of cake? Often what happens at a rebellion is we eat three pieces of cake, because we are just taking that energy of I can’t. And it’s boomeranging into, you know, screw you I’m gonna eat as much as the cake is I want to so that’s one of the primary internal decision traps I’ve seen in my coaching. And you know, as a as a coach, I’m wondering if you recognize these decision disruptors that happen at the moment of choice. And this is why instead of thinking we need things to be precisely right, and automated. I mean, how was that decision like that at a party automated, we are outside of any context, we’ve established our eating habits around and we have this seduction occurring. And so if we don’t have the mental wherewithal to make a choice, that is the most adaptive choice that’s going to enable us to both stick with our greater goals, whatever those are, it doesn’t have to be precisely right. But also feel like we’re participating in our social lives with our families and our friends, which is among the most motivating things that human beings have is other people. So if our exercise and healthy eating inner dialogue reflects a conflict between participating with the people we feel most connected to. Well, that is an automatic setup to fail to, because we are for anything in human nature motivated to align with our families to participate. And then we’re talking about rebellion we’ve talked about another really common one is perfection, we can use the chocolate cake as an example. So looking at the chocolate cake, it’s not it’s a black or white, it’s, can I have it? Or can’t I have it? It’s the can’t, is a perfect world, I cannot have at all the cake, all or nothing. And then nothing in that situation is eating the whole thing, or more. And that sets us up. When we look at our choices. Am I going to run for 45 minutes or walk for 45 minutes? Like I planned all? Oh, gee, that phone call only gives me 35 minutes, why bother? Or nothing, I’m not going to do anything. So it works. This all or nothing. Really this black and white thinking which by the way, is a cognitive distortion. Yet it’s the way potentially the majority of people think about these two choices in the arena’s of exercise and eating. Another one is what I call commendation, which is really a bit outside of the topic of exercising and eating. But it is fundamental to the decisions people make in the moment, right? If someone’s needs, or our work needs, seem to be competing with our plan to exercise or our eating plan, because a dear friend just handed us a delicious chocolate chip cookie that she made. And we feel that we need to show her that we care about her and value this gift she just gave to us that instead of thinking about, well, gee, I’m eating this way that doesn’t include the chocolate chip cookie, or whatever it is, it could be a burrito for all I care, my need to validate her needs is more important than my need. And again, if it’s all or nothing thinking, then it’s the whole cookie versus something else or not at all. And these things are the internal part that disrupt the in the moment decision. It’s how our brain has learned to think about it. And that’s why the book, and the method is really about guiding people to notice, in the moment, it gets back to your pivotal parable, which is Which am I going to feed this old reaction and habit habitual way of thinking, which tends hasn’t served most people for many years, or do I want to feed a different wolf that’s going to give me a more adaptive long term result.

Eric Zimmer 33:14

I want to ask you a question about the perfectionism the all or nothing on the exercise side, it seems very clear to me right that all or nothing thinking is not helpful. Because if I can’t work out for an hour, I don’t work out at all versus working out for 45 minutes or five minutes even right? I think if there’s anything that has changed my ability with many of these things, particularly exercise, it has been a little bit of something is better than a lot of nothing. Right? Do something, you can do something. But I want to pivot this to things like eating and particularly things like eating sweets, because there are differing opinions out there. And I think the answer you’re gonna give me is it depends. But nonetheless, I’m still going to kind of walk through the question more about how you would think about it than what your answer is. And that is there are people who say, you know, when it comes to sweets, for me, I am an abstainer abstaining works best for me. I don’t have to figure out under what circumstances you know, I’m a recovering alcoholic or addict. So in this case, I’m an abstainer. Right? I often talk about the beautiful clarity of zero, right? It’s just simple. There’s no debate in there, right? But food is a different animal than drugs and alcohol. So there are some people who say look, I just I cut it out completely. And then there are other people who are looking to integrate it in in a way where they’ve got some degree of moderation around it. And there’s some people who think that you’re kind of one of those or the other, and determining which of those you are is really a wise thing to do and then come down that way. But how do you think about that challenge when it comes to eating?

Michelle Segar 35:22

Thank you for raising that that is a really important issue. So I want to say as you already said, Now, there are some people who feel that the issue on addiction versus not when it comes to eating, I would say has not been solved, there are just really poor people and doing research who claim both sides, but a more mundane, how we live our lives perspective, it is important for us to figure out now, challenges if people say, Well, I am the type of person? Well, no, I’m going to take a step back. Part of the problem is that we’re asking this question without explicitly shining a light on the context of the food choices, because people would say, Oh, I’m a zero person, I cannot do moderation. But really, it’s a false dichotomy. If people are making choices under shirts, and feeling like they’ve got to do something, or feeling that their bodies are there, they are bad or unattractive, or whatever it is, if all of that junk surrounds the eating choice, then I would say we can’t know if someone is truly moderation versus a zero person, because it’s all these other forces that are inside of our brain that we’ve learned to have thought we have to be aware that that’s going to be going on because it’s very hard to do moderation. If you’re going to have perfection and rebellion and other decision traps. Because those forces, they’re not going to let you be successful with moderation or for zero for that matter, because we’re always going to be reacting number one, I want to make sure that that issue is clear. Getting back to the moderation versus zero, there are for sure individual differences. But here’s something that most people may not know, the emerging research on this question suggests that it is the moderation approach, which is going to be more effective for more people. So there’s a couple of studies. One study is looking at a weight loss registry, and I’m not focusing on weight loss as an outcome, because I think it really sets people up to not stick with exercise and healthy eating for many of the reasons we spoke about five to seven years ago. But they wanted to know, in this group of people who had lost and were maintaining a substantial amount of weight, which strategy was going to be most effective with eating over a year is it coming to a weekend with you know, trying to stick to the plan, which would be a zero approach, right, I don’t do any of it, I’m gonna stick to the plan, no matter what, or is coming to the weekend, eating with something with a little more flexibility, which is technically in the literature called flexible restraint, which of those two eating strategies is going to be most adaptive for eating over time. And the research found in you’re not going to be surprised because of the way I’ve set this up, that it’s the flexible restraint errs, who had more adaptive eating and outcomes. So I believe it comes back to this core wisdom about how we live every other area of our life. We can’t hit a bull’s eye, every time we parent, we cannot hit a bull’s eye every time we engage with our partners in our work. And it’s that sensibility that it’s about a journey and an intention. We want to do things a certain way. But sometimes we can’t. I can’t do it today, okay. Or I have to make the perfect imperfect choice. Or I could make no choice but that isn’t gonna get me as far as the perfect imperfect choice. So I think the biggest issue is that we have come to believe that exercise and eating are different than these other lifelong journeys.

Eric Zimmer 39:23

Yeah, I like that idea of flexible restrainers. Like I mean, I think could I moderate drugs and alcohol, I probably would. It seems like the better choice right? At this juncture in my life. I’ve proved multiple times that doesn’t work. And the risk reward ratio is just stupidly out of whack. Right? It’s just, you know, it’s like, well, what would I get? Well, I’d be able to have a drink a couple times a week. What might I lose everything okay, not worth doing right? Yeah, piece of cake is a little more subtle. And, you know, I certainly know that Ginni and I have been on a I would say very good healthy eating journey, particularly since her mom was diagnosed with Alzheimer’s. I think we were healthy before and then we kind of upped it. Even from there, but it has not been rigid and restraining, you know, there is flexibility in there. And I think one of the important things is there are situations like you talked about where we find ourselves in a situation, and we have to be able to make a decision. And I want to get to that, because that’s really important. I also think that we can really do well with planned exceptions. Yes, a planned exception would be today’s Wednesday, November 23. Listeners, you are going to hear this in January. But for Michelle and I, that’s the day before Thanksgiving, I could make a plan exception tomorrow, that you know what, for Thanksgiving dinner, I’m just eating whatever. And I’m going to have one piece of dessert. And that’s it done right. Now, the problem for a lot of us is that if we’re all or nothing, right, the minute that we blow up with a Thanksgiving dinner, we think we’ll screw it. It’s Thanksgiving weekend, right? It’s the holidays, right? And the next thing we know, it’s January 1, so I found, you know, okay, let me be clear about what the rules are. And again, there’s some flexibility in them, but they’re rules that are designed to have flexibility. There’s lots of ways this can go wrong. You know, I’ve been in the only on special occasions. And the next thing you know, like Billy getting to see on his report card is a special occasion. And you know, being clear birthdays, or I’ve had other people who you know, I don’t think they have alcoholism issues. They said, I’m just not going to drink alone at my home yet in their life isn’t like they’re not out partying all the time for a college student. That’s a terrible thing. It’s not gonna make any difference. But for most adults, they just go look, if I’m out with friends, I’m gonna have a couple drinks. But when I’m home alone, nothing, right. So there are ways that we can have some flexibility, and also some clarity. It’s not all or nothing.

Michelle Segar 41:40

That’s correct. And I think inherent in the flexible approach and strategy that I’m teaching inherent in that is people are making intentional decisions. So that’s also the beauty of flexibility is it asks people to be in charge of their choices, not the inner scripts. Yeah, it’s about saying, Oh, I see you perfection, staring me down, or I see rebellions staring me down. But guess what, you’re the bad wolf. And I know that I’ve been feeding you for 30 years, and it doesn’t get me where I want to go. So I want to go in a different direction. And so I think, for me anyway, in my philosophy, and it sounds like we might align on this is that when you teach this flexible approach, it is inherently about the individual saying, Okay, this is what I care most about. This is how I want to participate in celebrations, it asks people to become very clear about what they value what they most want. And it asks people to critically think about, you know, if I’m going to stick with this, if I’m going to stick with a healthier eating lifestyle, just like a parent, and you know, a for a journey of 30 years, and the other side of the 30 years, what’s really gonna let me do that and rigidity, it works for some people. And like you said, when it comes to alcohol, being rigid is absolutely the solution. You know, it’s important for people to truly know what’s going to work for them. But again, if people don’t understand the societal context, around the meaning of eating, healthy eating and exercise, that has the potential to continuously fort, what people do, because it creates these inner dialogues, the forces that lead us to the bad wolf instead of the skilled Wolf, if you will,

Eric Zimmer 43:36

yeah, underlying a lot of what you’re saying here is reconnecting with our ability to choose, and our ability to decide what’s important to us and not doing that on autopilot. Right, not just following the scripts we’ve been given not doing this, because even because my doctor said I should, right. Like, I’m not saying we should just heedlessly ignore our doctors, it’s worth going when my doctor said that I should probably do this. And why would he have said that? It’s because if I don’t, this might happen, oh, if that happened, that would affect my relationship with my children. Like, we eventually get back to what matters to us. But reconnecting with our choice is the key piece.

Michelle Segar 44:13

Absolutely. Not just choice, conscious choice, which is the opposite of an automatic habit. Now, I do want to say something that I think is crucial. We’ve been talking about it in one way. But I think it’s really crucial to say it in this way, the value of any choice at a party. After work, the value of every single choice we make is determined by the context of the other choices and needs. If we’re not aware of that, and we’re not skilled at being able to pivot and compromise, find the creative compromise. I don’t have the 60 minutes to take the walk outside. I only have 15 minutes. But I care that it lifts my mood, you don’t have all these good things to do and I’ve got All this work that I’ve got to get done, but I have 15 minutes. So when we become skilled in being able to compromise and pivot, which is, of course, the joy choice, the perfect imperfect option that lets us do something instead of nothing. When we do that, then we can keep our momentum. If we don’t know how to successfully navigate those choices with intention, then they’re going to keep derailing us, which kicks us right off the path of lasting change.

Eric Zimmer 46:00

You actually say early in the book, what we’re talking about here are choice points, you and I had an interesting conversation about where that phrase comes from. And we realized I might have arrived at it from multiple different sources. But these choice points, I’m at a choice point, do I eat the chocolate cake? Do I not now I have a choice whether I work out whether I don’t work out, and you say I call these conflicts, choice points. And they are the real place of power for achieving lasting changes in eating and exercise. And I think that’s so much of what this is about is about learning to navigate choice points. You know, when I work with a coaching client, you know, we start off and I say, well, let’s put what structure we can put in place. Let’s put what plans we can put in place. Because you know, what, if we can get some of that in great, but you know what, at the end of the day, you’re still going to bump up against these choice points. And what we can learn to do is say what is happening inside me, when I make the right choice? And what is happening inside me when I make the wrong choice? Or the choice that I want to make or the choice I don’t want to make? Let’s non moralize it, right? The choice I want to make versus the choice I don’t want to make. And the value of a choice point, actually, is that it can narrow our window of focus to a moment, we can actually go, Oh, here’s what I was saying to myself, here’s what I was thinking, here’s what I was feeling. Okay, well, what might I say to myself next time, what might I do differently next time, it gives us a real, for lack of a better word, an actual specific point in time that we can look at. And it becomes less about, oh, I got to figure out my entire emotional makeup. Versus I have to figure out what’s going on inside me now.

Michelle Segar 47:36

That’s right. And inherent in choice point is choice. And as you know, from all of your work choice, is the epitome of what cultivates autonomy and self determination. And we know that high quality motivation is embodied in the idea that I’m in charge and I get to choose, and that is the antidote to all or nothing thinking, yeah, the all or nothing, thinking there’s only two choices, and I’m forced to choose between sticking to the plan 100%, or just tossing it all to the wind. But no, the choice point is, wait a sec, there are options here that give me freedom to align myself with the context of needs and options at the moment,

Eric Zimmer 48:21

let’s pivot to what can we do in choice points, and you talk about an executive functioning team, these are aspects of our brain that we can, and you correct me if I’m saying this wrong, but that we can call upon in choice points to help us make better decisions? Is that an accurate way of saying it?

Michelle Segar 48:38

I would say that choice points evoke our executive functioning team, okay, when we are at moments of decision making, when we’re at moments of problem solving, and potentially pivoting, that is the work of our executive functions. And, you know, as you know, in the book, I talk about three primary executive functions that are discussed in the literature on an eating especially in other areas of living like ADHD, sometimes they talk about seven executive functions. So there’s different ways of talking about it. But the bottom line when it comes to executive functioning, is it is our brains innate decision making self management problem solving. Goal striving apparatus. Yeah. And so why don’t we cultivate it, the three primary executive functions to so that we better set our brains up to help us make the skill choice.

Eric Zimmer 49:40

I want to go into those three in a second, but I want to just clarify a little bit of what we’re saying here. I think that what you’re saying is that step one is we have to recognize we are in a choice point. Yes. Right? Because so often we just slip off into not exercising, not eating right Right, without any real thought of what’s happening, you know, I often talk about the very first thing we have got to do is bring whatever is happening into consciousness. That’s right, recognize that I’m about to make a decision or a choice. It may not seem like I am, but I am about to. And I’m making it the way I traditionally have made it without thinking about it. So I first have to bring it up into recognizing, okay, I’m in a choice point. And now once I’ve done that, then I call in my executive functioning tools to help me make the right choice. And I

Michelle Segar 50:29

wouldn’t say I’m calling on because it’s that oh kind of happens automatically. What I’m saying is, the way we think about it is either going to force or support our executive functioning, right? Because the old reactions, the old decision traps that we’ve talked about the inner scripts, if you’re scripting, I can’t, I can’t or it’s gotta be all or nothing. You can see how that scripts that we tell ourselves, the narrative absolutely distracts us from the options. Yes. So how can our executive functions work effectively, when we’re going down a rabbit hole with the shoulds, and all the black and white thinking, so you are 100%? Right. And I think this is becoming more out there in mainstream, but behavior change is belief change, and different choice making. And we cannot do either of those things. If we are not conscious at the point of choice, so it isn’t as sexy as peloton or habit formation, being aware at a point of choice. But we cannot change the way we think, which is the precursor to changing what we do if we do not have conscious awareness at that point.

Eric Zimmer 51:48

Great. So let’s talk about the three executive functions that you think are critical for making healthy choices.

Michelle Segar 51:55

Okay, so the first primary executive function is called working memory. And this is the part of our brain that holds and processes information at the same time. And most people can only hold and process like 1 to 3 pieces of information. So you can see that if you’re focused on a narrative about I can’t, I can’t that sort of thing, or I’ve got to please her, or I want her to know, I love those kinds of thoughts that’s in your brain. So that kind of thinking has a huge potential to overwhelm our working memory. But working memory is the backbone of effective problem solving, because that is the space is not really, you know, I’m not calling it a literal space. But that’s where problem solving happens. And if we can’t hold the information in our brain, because we’re too focused on worrying of whether we’re going to make the right decision, then we won’t be able to problem solve and pivot. So that’s working memory. And we’ll talk about the decision tool that I created to clean up that space, if you will, then we’ve got cognitive flexibility or flexible thinking. Our brains are innately wired, to do flexible thinking, if we think about eating and exercise and more flexible ways, we are basically aligning this new thought process with this very important ability, mental ability that we have to pivot, like we do in all these other areas of our life. And then the third, primary working memory is referred to as inhibition. more popularly people think about this ability as self control. And so this has been the primary focus, changing our eating, we’re just going to inhibit ourselves, we’re going to stick to the plan. But in reality, I believe more people would be successful if instead of feeling like they have to inhibit all the time, they actually learn to think about choice points. And that being flexible is actually adaptive not having to do it perfect. But actually, you know what, just like all these other life areas, I’m going to do this perfectly imperfectly. So I stay the journey. So what is the joy choice? So there’s a technical definition, which I’ll say the joy choice is the perfect, imperfect option that lets us do something instead of nothing. This doesn’t just give us the momentum, we want to keep going forward on the path or journey of lasting change. There’s another really meaningful way to think about it. And that is that if our decision to take a part of that self care activity, a part of that exercise a part of our eating plan, and fulfill that we are doing it to take care of ourselves, to respect our greater goals, and in doing so, we are fueling ourselves for the people and projects we care most about. So it is not just about the formula for sustainability that you know, has science supporting it. It’s also about making a choice that lets us be our full selves, that harmonizes exercise choice, or our eating choice with the whole other parts of our lives and who we are, which includes our connections and loved ones. So that is why it’s called The Joy choice. It lets us harmonize exercise and eating within our full self.

Eric Zimmer 55:30

I love that. So let’s talk about the decision making tool. Is it is it pop? Is that the decision making tool? Okay, that’s what I thought I just want to make sure I’m referencing the right one. So this is a way to sort of navigate choice points.

Michelle Segar 55:44

Yes, yes. Our executive functioning is this innate brain system for pivoting and problem solving and long term cold pursuit? Like, wouldn’t it be wonderful if we could support the three primary executive functions. And so this is a tool that I’ve developed and used with my coaching clients, and I call it POP.. Now I’m going to bring us back to the very beginning of our, our conversation, where you asked me about the motivation bubble. We talked about the fact that the motivation bubble is very vulnerable, and life bursts it, right, it bumps up against something in life burst the bubble, while with the pop decision to all instead of letting life burst our bubble in this passive way, where we’re kind of victimized by things. We are autonomous ly take charge and we pop it! So it’s both a metaphor for us being in charge, we pop our plan, it’s not workable any longer. So we’re going to pop it in what we do when we pop it is then we open up the option. So that is the overarching metaphor, but it’s actually an acronym, which is really good for our working memory, recall remembering and recall. So pop stands for pause. And like we’ve talked about throughout this conversation, if we don’t take a moment to bring our consciousness to the choice, then our automated unskillful responses will just take over. So pause, introduces this intentional moment where we can say, ah, which wolf do I want to feed, I’m going to feed the one that’s going to really take me to where I want to go. So that’s the first P unpack the oh, I designed it to support working memory, because it enables us to clear away to name any of the traps temptation, rebellion, accommodation, perfection. Oh, I see you. But guess what? That’s the unskilled Wolf. I’m not gonna go there. Let me focus my attention, take a breath. And then go on to the second step in pap, which is the Oh, open up our options and play WoW. how better to cultivate flexible thinking then can consider it as an opportunity to play well, gee, there’s this awesome chocolate cake over there. I want some of it. What are my options here? What did I plan to eat? What did they plan to eat later? I think I could eat half of the cake. And I could do wiggle around tweak something else. I mean, it invites us to think in creative and playful ways about the choice point. And that is flexible thinking or cognitive flexibility in its essence. And now the second P and the ending of the path Decision Tool is P pick the joy choice. There’s no right or wrong answer here. The joy choice is the perfect imperfect option that lets us do something instead of nothing, giving us momentum and helping us harmonize our eating and exercise choice within our full self. So what POP does as an acronym is it makes it easier to recall, I want to say it doesn’t mean it’s going to be effortless, you still have to learn how to use it and you can put it as a contact in your phone. That’s one way people use it so that you can learn to memorize it. But it also strategically guides our attention away from the decision traps to play. I have options here. Let me open them up and then to picking the imperfect choice that for the past three decades, I haven’t given myself permission to do because I’m forced to stick to the plan, which then I just rebel against. So it guides the specific thought process in a way. We don’t need to inhibit ourselves. It’s not about harnessing self control. That’s not the conversation the conversation is given the choice point and my full set of needs and the value that choice has right now based on the full context of other things, which is the one I Don’t have to rebel against that question.

Eric Zimmer 1:00:02

Yeah, yeah, I love that. I think that’s a very helpful acronym. And we do need some approach, because we’re often going to find ourselves at choice points. Also, in moments of stress. Yes, you know, that’s where the bubble tends to rub up against life in moments of stress. And we know that in moments of stress executive function tends to take a hike. So it’s really helpful to be like, have something as simple as pop, okay, here I am, what do I do, and walk through those things. And I love the joy choice, this idea of the perfectly imperfect, that allows me to do something rather than nothing in the context of everything I want to be eating, and exercise has changed. So fundamentally, for me, over the last decade, I would say, and it really has been in a complete reframing of it. And this is probably normal with age to some degree. But a reframing from vanity of reframing from shoulds. And into this is what I know supports me in being the person that I want to be in the world. You know, when I don’t exercise, I don’t make a good interviewer, I don’t make a good coach, I don’t make a good father, I don’t make a good dog owner, I’m not a particularly good partner. I’m very deeply unhappy within myself, you know, so for me with exercise, it’s just I just remind myself, like, you’re going to feel a certain way an hour from now, how do you want to feel in an hour? And I know, for me, the way I want to feel in an hour is the way I feel on the other side of exercise, proud of myself, energised, you know, and same thing with food, you know, how do I want to feel at the end of this meal? How do I want to feel and what supports me, in what matters to me, and you talk about this near the end of the book, which is really just the importance of value based decision making, right, the more we can be clear on what really matters to us, we have a much better chance of making good decisions, because there’s clarity there. But a lot of times, we don’t ever take the time to get that clarity. And so we’re making decisions in fog, about like, well, what really matters to me is this cake, man, you know, so. So I love that you sort of kind of near the very end sort of bring it back to that core idea.

Michelle Segar 1:02:11

Well, and the neuroscience, the emerging science directly supports that idea. I think that’s among the most exciting science on creating sustainable behavior change is the work showing that when we value when we believe that a choice aligns with who we are at our core, those brain regions light up. And also it’s predictive of people making decisions over time related to that healthy choice. So and the good news is, we can actually change a lot, some of your listeners might think, well, I don’t value exercise in that way, I don’t have those experiences, it feels like a should. So I mean, the beauty is, is that it’s actually quite easy to convert exercise from those shoulds and chores to feeling like a gift and that it’s a part of who you are. It’s reflecting your values. So I mean, I think that’s really important, because people might be feeling Gosh, I don’t know how to do that. The first step is to recognize whether you have been coming to your exercise and eating choice points with this feeling of should and rules and precision. And if you are that the first thing is to say, Gosh, has that worked for me or not? Yeah. And again, if it works for you, and it makes you a happy person, there’s no reason you have to pull away from that, right. Just like you said at the beginning, when we understand that our choices around what we eat, and how we move our bodies reflect who we want to be and our personal preferences and the realities the true realities of our daily lives. Yep, that’s the recipe for sustainable change.

Eric Zimmer 1:03:48

Indeed. Well, Michelle, thank you so much for coming on. It’s been such a pleasure to talk with you. I found the joy choice, a great read and so much great wisdom in it. So thank you. Thank you

Michelle Segar 1:03:59

for having you again. It was so much fun to talk Thank you.

How to Find Joy and Healing While Living with Chronic Illness with Meghan O’Rourke

December 27, 2024 Leave a Comment

How to Find Joy and Healing with Chronic Illness

Living with Chronic Illness with Toni Bernhard

In this episode, Meghan O’Rourke discusses how to find joy and healing while living with chronic illness. Meghan shares her personal journey through years of unexplained symptoms, misdiagnoses, and the frustrating search for answers. She delves into the intricate relationship between mind and body, exploring how our thoughts, emotions, and physical sensations intertwine in ways that challenge conventional medical understanding. We examine the role of stress, expectations, and societal pressures in shaping our experiences of illness and recovery.

Key Takeaways:

The importance of viewing the body as an interconnected system rather than isolated parts
How empathy and understanding from healthcare providers can significantly impact patient outcomes
The challenges of managing symptoms like brain fog and fatigue, which can be harder to address than physical pain
The need to balance advocating for oneself while resisting catastrophic thinking
Rethinking what “healing” means in the context of chronic illness

Connect with Meghan O’Rourke: Website | Instagram

Meghan O’Rourke is the author of the New York Times bestseller The Invisible Kingdom: Reimagining Chronic Illness and The Long Goodbye, as well as the poetry collections Sun In Days, Once, and Halflife. Her writing has appeared in The Atlantic Monthly, The New Yorker, and The New York Times, and more. The recipient of a Guggenheim Fellowship, a Radcliffe Fellowship, and a Whiting Nonfiction Award, she resides in New Haven, where she teaches at Yale University and is the editor of The Yale Review.

If you enjoyed this episode with Meghan O’Rourke, check out these other episodes:

Living with Chronic Pain with Sarah Shockle y

By purchasing products and/or services from our sponsors, you are helping to support The One You Feed and we greatly appreciate it. Thank you!

Episode Transcript:

Chris Forbes 00:18

Thanks for joining us. Our guest on this episode is Meghan O’Rourke, a journalist poet in New York Times best selling author, her work often tackles challenging subjects like grief, illness, and more Megan’s previous books include the best selling memoir, the long goodbye, and the acclaimed poetry collections son in DayZ. Once and HalfLife she’s passionate about advocating for those living with chronic illness, and is a recipient of the Guggenheim Fellowship and many other awards. Today, Megan and Eric discuss her book, The invisible kingdom, reimagining chronic illness.

Eric Zimmer 01:50

Hi, Megan, welcome to the show.

Meghan O’Rourke 01:52

Thanks, Eric. It’s so good to be here.

Eric Zimmer 01:53

Yeah, I’m excited to discuss your book with you. It’s called the invisible kingdom reimagining chronic illness. But before we get into that, let’s start like we always do with the parable, there’s a grandparent is talking with their grandchild. And this in life, there are two wolves inside of us that are always at battle. One is the Good Wolf, which represents things like kindness and bravery and love. And the other is a bad wolf, which represents things like greed and hatred and fear. And the grandchild stops and thinks about it for a second looks up at their grandparents as well, which one wins, and the grandparent says the one you feed. So I’d like to start off by asking you what that parable means to you in your life and in the work that you do

Meghan O’Rourke 02:36

such a rich parable. And I think there’s all kinds of ways we’ll dig into things today that back to that parable. But I very quickly just think about how it reminds us that our expectations shape our lives, and our expectations shape our stories. And I’ll just quickly say that I think that’s true for cultures as well as people. And so I’m thinking a lot about that story as it applies to our culture at large as well to each of us individually.

Eric Zimmer 03:04

As we talk about illness from a lot of angles, there’s certainly a cultural angle, to the way we look at illness, but maybe start off telling us a little bit about your journey of chronic illness in you know, maybe the three minute version. I know you wrote a whole book about it, but just to sort of paint the broad picture for people. And then we can kind of drill down into deeper areas.

Meghan O’Rourke 03:26

Absolutely. The three minute version is hard to tell because I in fact got sick gradually and over the course of many years. But I can say that basically I was sick for more than a decade before I got any kind of diagnosis. Right? So I was living in this period, in fact, really almost 15 years of living with no name for the suffering that I was undergoing. And my symptoms were really ones that roamed the body and early on at least came in went when I got really sick they were pretty unrelenting, but when my 20s you know basically I just start feeling tired and fatigued and having strange neurological symptoms like electric shocks and joint pain and overtime ended up with not one diagnosis but a cluster of diagnoses that included autoimmune disease. I have an autoimmune thyroid condition and also a what my doctor calls an undifferentiated connective tissue disorder. Doesn’t look quite like known diseases, but it’s there and Lyme disease and something called Ehlers Danlos Syndrome, which is a genetic condition. So you hear there’s this whole cluster of diagnoses I end up with that are in many ways, in my case interrelated, but it would take really almost two decades to learn and understand more about how those interrelations existed.

Eric Zimmer 04:44

And so you go through this process and you get sicker over time.

Meghan O’Rourke 04:47

Yeah, exactly. Sort of when I began getting sick, I had graduated from college, you know, possibly in college, there were bouts of fatigue and some of the same stuff, but it’s really when I’m 21. It’s the fall of 1990. Seven, I’m walking down the street and I start getting various sharp electric shocks. And then from there over the next 15 years I get sicker and sicker and sicker like somebody wading into ever deeper water and not knowing where it’s going to take

Eric Zimmer 05:14

them. Do you end up with a diagnosis does it get sort of narrowed down. So over the years, you’ve got all these different things, and then eventually, you kind of get and you go, Okay, now we kind of know what it is, talk a little bit about what that process was, like, in the later stages.

Meghan O’Rourke 05:31

So, you know, if I had been going to doctors in my 20s, and saying, I don’t know, something seems a little wrong, you know, what I had been met with was, well, maybe you’re just anxious, or you’re stressed, right? But when I turned 32, my mother died. And she had been living with cancer. And as is the way, you know, it was a very stressful, challenging time where I didn’t sleep much. And the day after she died, I came down with a virus of some kind, and basically never got better. So I get this virus, I start being really severely fatigued. And fatigue isn’t even the word for it, it’s, we need another word, it was more like cellular enervation, like, felt like the very, most basic energy functions of my body just weren’t working, like my legs were made of lead. And my body was sad that I had to somehow kind of hold together through effort. And you know, you go to a doctor, and you say that to them. And it’s very hard for the doctor to figure out what to do with you. So over the next

Eric Zimmer 06:33

day, often mushrooms Megan,

Meghan O’Rourke 06:37

totally right. So doctors were kind of like, well, your mother just died, you know. And I had new new health insurance. So I had a whole new set of doctors who really didn’t know me. And one of them said, Well, maybe it’s because you get your period, and you’re tired. And I was like, I don’t think so I’m also having joint pain and really distinct neurological problems at this point where I’m having a lot of difficulty with word recall. Now, I’m a writer, and a teacher and I work with words for a living. So this was really noticeable. It wasn’t like a small thing. It was just basic words like spring, couldn’t think of, and I would find myself saying, you know, the season that comes after winter. So I was getting increasingly kind of panicked, to be honest, and frustrated, and scared, because it was clear to me that something was really wrong. And I was kind of trudging from specialist to specialist and everyone was basically saying, Oh, it’s not my problem, I’m not finding anything wrong, and you’re at labs. So this goes on really for a few years. And I finally end up in the doctor in the office of this doctor, who is the first offer diagnosis, and she listens to my story and takes my family history much more carefully than anyone had. And there’s a lot of autoimmune disease in my family. And she said, Look, before we even do labs, I highly suspect that we’re going to find you have an autoimmune disease. So that was an incredibly validating moment to your question of what was it like? And it was an important moment, because it helped me feel that someone saw what I saw and believed me. And sure enough, the labs came back and showed that I have a lot of autoimmune activity, and I had this autoimmune thyroid disease. And for about a year, I thought that was it. I thought, Okay, I’ve got it. She’s given me medicine, she said, look, the medicine takes a while to kick in, let’s give us some months, we’ll tweak it, we’ll fine tune it, we do that. I’m just still not better. I’m like, marginally more energetic. But my thyroid labs now look optimal, this other autoimmune activity has gotten better. And yet, I’m just still incredibly sick. And so that’s when in a sense, the deepest part of my quest began. And I began to understand that whatever was wrong with me was not going to be a single label for which I could take a single medication, you know, and get better.

Eric Zimmer 08:56

Yeah, this conversation comes for me not too long after I had a conversation with another writer. And she wrote a book about getting seven different mental health diagnosis over the course of her adult life. And it really speaks to this idea of how difficult it is when your symptoms are not straightforward. And they seem to potentially fall into a whole lot of different categories. And, you know, she ultimately got to the point with her where she did not want and does not want diagnoses, she doesn’t want to know, and you talk about this a little bit about, you know, we can look at diagnoses twofold. We can look at them. Sometimes they are very, very helpful and encouraging because they allow us to go okay, there’s a name for what I’ve got, and they can give us hope. We also know that the flip side of them can be they can be stigmatizing they can limit us But I also think there’s a third element that we don’t talk a lot about, which is sort of what you just referred to, which is we get a diagnosis, it gives us some degree of hope that things are gonna get better. And then they don’t. And now it’s even more confusing.

Meghan O’Rourke 10:14

Absolutely. I mean, diagnosis is so complicated. So as you just heard, for me, that initial diagnosis really did bring relief. And I talked about this in my book, which is really didn’t want to diagnosis right. And in my case, it was because I, in a way, it’s a flip side of your your other guests story where I was having these symptoms that I was really convinced had some kind of origin that were not in mental health, right. And I was being met with the sort of reflexive, it’s anxiety. Now, I hope we do talk about the ways in which all this is intertwined. And I think it’s really important to talk about mental health and chronic illness and anxiety and depression and chronic illness. But, you know, as someone who had undergone a kind of mild depression in the past, this just felt so different. And it had so many very concrete symptoms that were very, very physical. And I really had the intuition, and that’s really what it was that something was being overlooked. And so that is the first piece of why I think diagnosis can matter for what are often called invisibly ill patients with things like autoimmune disease, because it does help validate and categorize your experience, right, in a world in which no one wants to make accommodations for you, where everyone is like, why are you canceling dinner yet? Again, even your friends, right? Yeah. But I completely agree that in a way with the book charts, is the journey from that moment, when I get the duck first diagnosis to a kind of understanding that diagnosis is just a small piece of the journey. And that the actual work of living with a disease is to live with the disease in whatever form it takes the illness, the manifestations of it the many ways in which it’s individual, and it doesn’t, you know, exactly map on to someone else’s experience with the same set of, of diagnosis. And then finally, to your third point, which is so important. I think one thing that really inhibited me was that it felt unlikely that I would have multiple diagnoses, right. And so I did kind of stop looking. And that was a hindrance to because actually, there was more going on. And the kinds of conditions I write about in my book, often there’s more than one of them, and they coexist. And this is part of the framework, I’m really trying to unpack and show because I think at the time I kept thinking, God, maybe this all is in my head, how could I have so many things wrong with me? Right? Does that make sense?

Eric Zimmer 12:42

Totally. Yeah. Let’s talk a little bit about this idea of invisible illness that you talk about, you say the less we understand about a disease or symptom, the more we psychologize or often stigmatize it.

Meghan O’Rourke 12:56

Yeah. So this is an idea I really borrow from the writer, Susan Sontag, who wrote a really great book published in 1978, called illness as metaphor that, interestingly was occasioned by her own experience of breast cancer. But in the book, she doesn’t even write about herself. She just writes about the fact that there are all these diseases that we don’t understand well, that we make kind of elaborate stories about. So Tuberculosis was once thought to be a disease of romantic souls, okay. And then, over time, we realized that bacteria causes it. But it’s not until we have a treatment for TB, that we stopped thinking of it as a disease that is somehow connected to a particular psychology, she makes the same case about breast cancer that, you know, it was once thought to be repressed emotions, were causing breast cancer. And she really objects that’s a part of what I was interested in this book is the ways in which I think that these invisible illnesses that are driven by immune dysfunction, that by the way, impacts every part of the body, including the brain, often, were being psychologize and stigmatized in ways that reduced their complexity and rendered them further invisible. And I think also, importantly, let society off the hook thinking about them, worrying about them, helping treat them and researching them, which is to say there was this kind of reflexive and it’s self stigmatizing idea that these people are mentally ill. And so we’re putting them in this box. And we’re not thinking about these aspects of it, if that makes sense. Yep.

Eric Zimmer 14:34

You talk about how from a medical perspective, we tended to go from broadly speaking a time where we thought that disease was a condition of the person, a problem with the person. And then we’ve moved more into a model that says, hey, there’s a germ and you know, you treat the germ and then the problem gets resolved. And that boats are sort of incomplete views.

Meghan O’Rourke 15:03

Yeah. So in my own experience of illness, what really interested me early on, and confused me, to be honest, was that it was really clear that when I was more stressed, or I had a really difficult week at work, doing things that maybe I didn’t exactly want to do, or maybe I did want to do, but I wasn’t feeling well enough to do them so that I was worried about doing those weeks, I was much sicker than any other weeks. And so initially, that to me, was really a confounding factor. Because I thought God did this mean that somehow it is all invented in my head, right, there’s maybe no illness, you know, organic illness, as we call them. And it is something purely driven by anxiety. And it was only researching this book, and really going through the journey for the next 20 years that taught me that there’s this whole category of disease, we don’t do a great job of thinking about which are diseases that are organic, to use the term that helps define them as not exclusively a mental illness. And they have a clear cause of some kind. We don’t understand that cause very well, but they are also shaped by biography by our lives by things like stress by things like food by things like sleep and all these choices we make. And it’s really hard for us to think and talk about these diseases.

Eric Zimmer 16:24

Yeah, you say complicating germ theories paradigm of a specific disease entity, or the infection that tidally resolves, researchers are showing that much of health depends on the interplay between soil and seed host and infection with the immune system and one’s microbiome is confounding factors. And as you just sort of added in there, I think our mental states are also another factor. So all of a sudden, we have these incredibly complex things going on that are very hard to tweeze apart, we all relate things back to ourselves. And so as somebody who’s recovering from addiction, and have worked with people recovering from addiction for a long time, addiction is such a complicated thing, to reduce it to say, well, it’s genetics, no genetics probably have a role. It was the way you were raised. Well, yeah, that probably had a role. It’s your social support, it’s hundreds of things. Now, again, there is in your case, if we now extend that further into illness, there is actually probably to use the term an organic underline or a germ component. But these things get so complicated.

Meghan O’Rourke 17:32

Yeah, absolutely. An addiction is a great analogy, in many ways, I think. But, you know, before modern medicine, all kinds of medical practices around the world and pre modern medicine really thought about disease as the consequence of the encounter between some thing in the world they didn’t know what it was they called it, sometimes things like animal fuels, and they had all these theories or bad winds, and also a specific person with a specific biography, right, they really thought of illness as biographical in some ways in ways that could get us into trouble, right. But in ways that I think there’s an important piece of that, that we just left behind when we embraced germ theory and moved from this idea that the soil mattered to just that the seed mattered. And part of what I’m arguing in the book is that there’s this emerging understanding of medicine and disease that I think we’ve seen, vividly dramatized in the pandemic that shows us that we really need to think about both the soil and the seed disease is not just some abstract thing that happens to us and behaves exactly the same way. And each of us even a virus behaves really differently in each of us. But for decades medicine thought, the whole definition of germ theory is based on the idea that these things behave in almost exactly the same way in different bodies, that is turning out to be really not true, as we’ve seen. And I think it leads us to a really interesting set of practical but also philosophical questions about how do we reform healthcare and our discourses around medicine and sickness to accommodate the fact that our bodies aren’t always these tidy containers that behave exactly like everyone else is?

Eric Zimmer 19:14

Yeah, like anybody who’s sick, you sought help from all kinds of places, you know, anybody who’s sick for a long time, you’ll, you’ll turn over a whole lot of stones. Let’s broadly say, though, that keep this simple. You did sort of traditional medicine, and you did alternative medicine. And they both have different paradigms. And there is helpfulness in each and there are things that I think are deeply problematic in each. Let’s start with conventional medicine and just talk a little bit about, you know, where some of your key frustrations were there and what some of the real problems that you encountered were.

Meghan O’Rourke 19:52

There were things about conventional medicine that were really important and there were things about it, that kind of ended up helping me tremendously, but What I found along the way was that I realized at some point that I was in a body that lived at the edge of medical knowledge. And as a consequence, I would show up in a doctor’s office and labs would not show really clear cut pre existing pattern, they would show a lot of strange things, by the way, I mean, it was showing up as something’s going on. But doctors often would just not have the time, the energy, the bandwidth, the curiosity, to explore this person who sickness looks really weird. And I think some of that’s that we’re in a really bureaucratic system that has as its basic building block, the 15 minute appointment. I mean, how do you take a complex history. But the other problem was that these doctors were thinking of my body as if it were a car, right, it was a body that was made up of discrete parts, and each person talked almost as if those parts were not interrelated. And they were just there for the tune up the oil change, like if they couldn’t see like, here’s the problem in the carburetor. And we know how to fix it, if I wasn’t in crisis, with a thing they could like, really operate on and repair. They didn’t know what to do with me. And I, at this point, needed not just answers, but also help living with illness in the absence of answers. And conventional medicine had really nothing to offer to me, in terms of how to help me learn to live with this new reality. And no one ever asked the question, for example, what symptom is bothering you the most, let’s work together to figure out how we can improve your life by 10%. Even if we can’t fix the problem, that kind of discourse and exchange was just utterly missing from every single conventional medicine appointment I had. And so as a result, I’m sort of trudging from specialist to specialist each one takes more blood. It’s stressful, exhausting, disheartening, dispiriting, right, and none of them are talking to each other. And this was before electronic medical records, I was often faxing records from person to person. So it felt like I had just woken up in this pageantry of care. That was really just this elaborate bureaucracy, offering me something that wasn’t what I needed.

Eric Zimmer 22:12

Yeah. And there’s that whole element of when you’re feeling really miserable, and you wait a long time to see a specialist totally, and you finally get in to see the specialist. And then it’s completely at best useless, and it worse, just insulting and all that it’s just it’s so painful. You know, it’s,

Meghan O’Rourke 22:35

it’s Yeah, exactly.

Eric Zimmer 22:36

You have a really interesting point, you referred to it, I don’t know, five minutes ago, but I’m gonna bring it back up. You said doctors don’t like to manage they like to fix. And as you said, a lot of this dealing with a chronic illness is about management. And so we’ve got a healthcare system that is not designed in any way there is no manager of your care. Ideally, your primary care physician would be this, but that’s not broadly speaking what most of them do. That’s not what they know how to do. And so, you know, the other thing you talk about is how quickly doctors empathy wanes.

Meghan O’Rourke 23:11

Yeah, yeah. So we have this structural problem. I interviewed David Cutler, who’s an economist who writes a lot about health care. And he said to me, something I wouldn’t have known he asked me, who’s the second highest paid person on a football team? I was like, Well, I don’t know. And he said, first paid is the quarterback. Second is the coach and he said, That’s because you need a coach to pull the choreography of all the moving parts together. What we lack in healthcare is the coach right primary care physicians. They should be that but that’s not really how medicine is set up. It’s unrealistic in the current situation to ask that of them. I think this was really startling. I started researching doctor patient relationships because it won’t surprise you that I was really fascinated as a reporter as a writer as a person to realize that when I was going to doctor’s office that sometimes there was this kind of fates atmosphere of antagonism right which is really strange because it’s called health care. And it was really noticeable right and and there were reasons for it. And I think a lot of those reasons have to do with as it turns out, when you study doctors and empathy and healthcare workers and empathy you find that doctors empathy wanes alarmingly quickly, it when it gets measured and actually happens in med school. And it’s almost a product by design and the way that med school is set up where these students are sent out, you know, into the hospital to do their forget what it’s called. It’s not rounds but basically it’s a when they’re, you know, practicing and all the different departments. And it’s structured in a way such that they don’t sleep and they’re just exhausted. It’s it’s kind of rite of passage and med school, you’re supposed to go through this. And what studies have shown is that that pure Riyadh transforms these eager, empathetic young med students into burned out would be doctors who have stopped being able to empathize with their patients. So it’s really clear that there’s structural realities in how medicine is set up, that conspire really to drain empathy from doctors. I don’t think it’s that not empathetic. People want to be doctors, I think, right? Right, that system does something to them. So this was pretty alarming to me. And it’s pretty noticeable. And on the flip side of that, I will just say, what makes it even more alarming is that studies confirm what any of us lay people could tell them, which is that being cared for by a doctor actually makes us feel better, right? I think any one of us who’s been in office knows that just viscerally total. But when you stop and you measure outcomes, it’s actually there. And the outcomes to that patients are, you know, pretty much impacted almost as powerfully by kindness and empathy as they are by some of the strongest medical drugs we have.

Eric Zimmer 26:24

My mother’s been in out of hospitals for the last number of years, and my partner’s mom has Alzheimer’s and that level of care when you get it, it really does make a huge difference. You know, I could just see it in my mom, you know, the difference when she’s treated with kindness and respect and interest from a doctor versus when she’s not. She’s very different, you know, the quality of her life is very different.

Meghan O’Rourke 26:49

Wow. So amazing, isn’t it? I mean, it’s, it’s so intuitive. But we’ve come to this point where we have to study it to prove it to

Eric Zimmer 26:56

right, yeah, yeah, that’s right. And to your point, a lot of this is not to vilify doctors, right, we have a structure our system is set up in such a way that time isn’t there that the pressure is on all aspects. So we’ve got this conventional health care system that we’ve talked about where you’re sort of rushed in and out, there’s less empathy, you’re treated sort of like a car, you’re sort of less than human, we’re looking at things in isolation. And then you go, alright, I had enough of this and you wander into alternative medicine, and you bump up against very often something very, very different feeling.

Meghan O’Rourke 27:31

Totally, I find it so challenging to talk about functional and alternative medicine. By the way, there’s a lot of there’s this whole middle world too called functional or integrative medicine, which often is, you know, you’re seeing MDs, people who have been trained in the Western system. And a lot of the people I saw had started as conventional doctors and got really disillusioned by what they were able to offer and had decided to study other modalities. It’s really hard to talk about because there’s so much suspicion often there’s just you know, either people reflexively hate alternative medicine or they reflexively love alternative medicine. Right. But yeah, I think there’s a lot of us in the middle, too. Yeah. Which is to say, I came to it with a lot of skepticism. I just wasn’t part of my childhood growing up, my parents were like, you know, you go to the doctor, they help you. That’s it, or they don’t help you. But what I found was that I needed this care, this warmth, and I needed coaching, I needed someone to help me calmly sort through the many symptoms, I was having to look really deeply at what was going on with me as a whole system and to see how they could support me. I mean, I just needed that I was really falling apart physically, I was really sick. And that’s what I got from alternative medicine. And did I see people along the way who I didn’t trust and who I let sell me things that I, you know, don’t don’t think I really needed? Yes. But you know, what I found in integrative and alternative medicine was another model of the body, which was one that was more like a garden, right, which was a much more appealing model as a sick person, which is your body as this kind of ecology. It’s all interrelated. If we tweak your sleep, or if we help your nervous system rest by giving you acupuncture and putting you into a calm state, it’s going to help in ways we can’t entirely measure. And that was true for me, right? It didn’t magically cure me. But I would say that saw these modalities really helped me by 20 to 40%. And the other thing they did was make me feel listened to seen cared for. And that sense, they gave me the fortitude to continue. And that sense of well being in my mind that I needed as well, if that makes sense.

Eric Zimmer 29:50

Yeah. So there’s a lot of obvious benefits in the way care is delivered. I think, to your point, the way we’re sort of seen as whole systems you know, My experiences with functional medicine have been largely positive the things that you’re describing. Yeah. And embedded in that world, broadly speaking, there are some challenges. Yeah, what would you say to you is sort of the biggest challenge embedded in that model,

Meghan O’Rourke 30:17

I think the biggest challenge is that by virtue of what they are offering, which is a more individualized approach that goes beyond what evidence based medicine can offer, there’s not necessarily evidence for it, right. And if the building block of Western or conventional medicine is this 15 minute appointment in which the doctor can offer care, in a way, the fundamental business model of some functional medicine and integrative medicine is that they don’t take insurance, and that they are offering you a lot of things that you are paying for. So what occurred to me along the way is that, you know, of course, it’s almost in their interest to make me feel I need a lot of supplements or tests or things because that sort of part of what they’re doing is that’s how they function financially. But, you know, you have to believe or hope at the end of the day, that you’re finding your trust and feel that they’re really helping you find, you know, not 20 supplements 12 of what you don’t need, but they’re helping you in a more systematic, methodological way, find the four supplements you do need, but I think that’s the challenge, right? It’s like you’re in this kind of Uncharted, unmeasured by definition territory, and you really don’t know whom to trust or who’s good and who’s not, you know, which, by the way, applies to to conventional medicine, but they’re you right, the superstructure of the idea of evidence based care. Whereas, in this other world, we’re saying, you know, we can’t really study acupuncture on large groups of people, because the whole idea is that everyone behaves a little differently. Right, which is true. Now, that said, there’s some really good studies of how acupuncture by the way does help in these immune mediated diseases that are pretty clear cut. But yeah, it’s it felt a little like I was an explorer, and are uncharted territory.

Eric Zimmer 32:09

Yeah. The other thing, I think that shows up in that world, and the way you refer to it is, it’s in thrall to the idea that we control the outcomes of our lives in the alternative health world, often to the case of self purification. This is where things like, you know, the power of positive thinking starts to show up more, or it’s all because your diet isn’t quite right. Which is not to say that diet isn’t a factor in things because of course, it’s a factor in in nearly everything. But I do think you start to run into this sense, where you can a little bit instead of the germ being the fault, yeah, it’s the way you’re living is the fault, or the way you’re thinking can be the fault.

Meghan O’Rourke 32:51

Yeah. And by the way, I really fell into this because I was having a lot of symptoms. When I ate, I became very obsessed with my diet in ways that were ultimately very positive and helped me identify how to eat for my own personal health. But along the way, I realized at one point that I was a bit caged by it, that I was so scared of eating the wrong thing that I would almost make myself sick from the anxiety of Oh, no, I did eat an egg. And I’m not supposed to write and I would focus on it. But also, one reason alternative medicine is persuasive and powerful is that we do all have the sense that there are things about contemporary life that are not that healthy, right? From our endless productivity and hyper connectedness to car exhaust, noise pollution, to you know, our food system, like it’s true that all these things are not healthy. So when presented with this worldview that said, Look, if you change these things, you might be able to get better. I wanted that to be the whole truth, right? And I write it to be utterly under my control, because I could have control of that, right, I could purify myself, I could drink green juice all day long. I could eat massaged kale salad and probiotics. And I could just will myself back to health. And in a funny way, I was still back in an old western modern relationship to my body. But I had just replaced one set of you know, muscle through it with another set of muscle through it, which is muscle through it through self purification. And so that slowed me down and actually getting to the root cause, ironically, of what was going on with me, because I think for a long time, I personally just got a little bit hung up on maybe I can control this through kind of purifying myself.

Eric Zimmer 34:38

So this kind of leads us into the next area that I’d really like to talk about, because I think you write about it in really helpful and nuanced ways. And I think that’s an important way to have this conversation because it is very nuanced and it is really the role of emotions and thoughts and how they interact with physical sensations we talked earlier about how we know that the care effect when you’re treated more kindly by your doctor, you have better outcomes. So there’s a clear element there of like, okay, something that’s happening emotionally, is translating to better outcomes. And this discussion tends to fall into one of two camps. One camp is, you know, the reason that you have breast cancer is because you have repressed emotions, or we go to the other extreme, and we go, Well, none of that stuff matters at all. And the reality is far more nuanced. Talk to me about sort of some of your journey through that world.

Meghan O’Rourke 35:40

Yeah. So it’s such a hard thing to talk about. Because I think one thing that is worth saying is that our relationships as people live with illness, to these ideas probably fluctuates and changes to right. And certainly my own did, yeah. Which is to say I existed in a somewhat paradoxical state at times, and in some ways still do. And that was that when people would say to me, Well, maybe you’re feeling sick, because you’re this kind of type A personality, you know, you’re very hardworking, and was, you know, kind of perfectionistic. And you know, it’s always type a people who are sick. And I would really bridle at that, because, you know, it kind of put the responsibility for the illness and my suffering squarely on my shoulders, right? Yeah. Well, meanwhile, letting the observer totally off the hook, right, and also reassuring them that maybe this couldn’t happen to them, because they weren’t like me, whatever that meant, right? So so there’s this kind of way you I think, as a sick person with an ill defined disease, which are many of them, you often encounter this reflexive way in which other people want to reassure themselves that they would never be in your shoes, because even if they got there, they could control it somehow through being less stressed, right. But at the same time, as I already said, I was aware that stress was playing a role in my illness. And I could tell that, you know, my own habit of taking things very, very serious, wasn’t always helping me let go or relax, I could tell, you know, I lived in New York, I was probably never relaxing, right? I was never sleeping enough, I was never figuring out how to just let go and really let the sort of restore and repair part of my body and help a nervous system kick in. So in the book, I set out to try to really think about these questions in a really transparent way. And part of what’s challenging is that it’s exactly what you’ve named, because there’s this reflexive desire to say that everything about an illness is caused by the mind, it’s harder to have a nuanced conversation about, okay, in fact, a lot of illnesses are caused by a germ, the combination of a genetic piece encountering a virus. But if that encounter happens at a moment when your mother dies, what else happens? How does that additional stress further shape and dimensionalize your illness? How does the fact that I had been bitten by a tick that have Lyme disease, intersect with my life history in ways that lead my illness story to go kind of gradually downhill, and then suddenly downhill, right. And I became really interested in that conversation, that piece, and I turned to a lot of reading that shows really clearly, by the way, that there’s this entanglement, it’s kind of beautiful entanglement in a way of the immune system and the nervous system, which makes it really clear that when your nervous system is stimulated, in certain ways, your immune system changes. And when your immune system changes, in some ways, your nervous system changes so that if you are in a world of ever constant stress, it’s just more likely that things are gonna go wrong. And that very beautiful dance of immune regulation that we’re all experiencing all day long, with immune cells changing and coming and going. But second, I stumbled on this fascinating work of a woman at Harvard named Ellen Langer, who really looks at how expectations shaped our biology. And what she found is that expectations really do shape our biology, but not in a vague power of positive thinking kind of way, right? It’s more of that when we really are convinced of the reality of something when we authentically and fully experience a reality that impacts us. What’s harder to control is using our mind to persuade ourselves of the authentic reality of something right, right. Does that distinction make sense? It’s a really important so so you can’t like be a person who’s allergic to horses, walk into a barn and just say, I’m not allergic to horses. I’m not allergic to horses. I’m positively thinking about horses. That’s not what she’s saying. That’s not going to necessarily work. She says actually, you just should Don’t go into the bar, right? You should find those triggers and avoid them. But you should be aware of the ways in which your mind is contributing to creating situations. And you can in some ways set up situations in which you try to authentically be encountering, you know, joy, for example, the telling example she gives is a study that she calls the counterclockwise study where she takes a lot of older people. And she brings them to a place where there, there’s two groups and one group is treated as if they’re 30 years younger than they are, the older group is met at the door, and people say, Please, let me take your bag, let me help you up the stairs or your knees, okay, et cetera, et cetera. The other group, no one helps them. Everyone’s like, your room is there in their rooms, they’re playing music from 30 years ago, they can only watch TV shows from 30 years. But at the end of the week, that group has completely different biomarkers, and pain levels than the other group, right? Which tells you something but what exactly? Yeah, that’s the problem for all of us. What exactly does this mean?

Eric Zimmer 41:36

I think what you speak to there is so important to which is that it’s the things that we really believe that do have an impact. It’s just that we then get caught up in trying to think that we could get ourselves to believe something. I’ve read studies about, do affirmations work or not. Anything that’s from the psychological study world, you got to take with a grain of salt, because we’ve got replicability issues, and, and all kinds of things. But what it seems to point to is that it’s sort of a cruel thing. And that affirmations work for people who need them the least because they actually believe that the affirmation that works for you is one that you actually believe. So if you can work to find an affirmation that you can believe, you know, I might find an affirmation that says, I tend to work hard most days, and I might go, Yeah, I do believe that. And that’s right. On the other hand, I can’t make myself believe something I don’t it’s the cruelty of positive thinking sometimes is that it’s just like, Well, yeah, just thought positively. The reality is, if you really thought that way, really felt that way. Sure. There’s benefits, you’ve got a line in the book, I don’t think I have it in my notes. I wish I did. But you basically talk about just the grinding weight of trying to keep this sort of constantly positive mood, and then all of a sudden, you’re in this sort of mental mind F of Oh, my God, I’m thinking something negative. I’m terrible, like, what just is this tough place? And you know, as we say, you can’t sort of completely say, well, your mind and emotions don’t play a role. So it’s another form of self purification, in a mental sense.

Meghan O’Rourke 43:21

Totally, totally. And it’s another place where I think those who, including us, those of us who are experiencing sickness or things that we’re trying to get over, and those around us, it’s another place we want to believe works, right. I can’t tell you how many people gave me John Sarno, his book healing back pain, because it works for some people to tell themselves, but but it didn’t work for me. And they didn’t believe it. They thought that still I was not doing it. Right. I was like, No, trust me. I’ve tried. It did help with my neck pain a little bit. But it didn’t help with all these other symptoms, right? Yeah. So clearly, there is this whole mysterious world of the genuine interconnection of our minds and bodies in ways that are like profoundly wild, sublime, even terrifying. But we want to reduce it to the most packaged, kind of least threatening version of itself. And this is really different. But I’ll give you an example that I’m going to botch slightly but there’s some evidence that when a mother dies, who’s carried children and her body, that her children are more likely to get autoimmune disease, that something about their immune cells changes after their, which is just like, so clearly, there’s these wild interconnections that should fill us with on and on is the knowledge that we don’t understand as opposed to the desire to say, okay, just think your way out of this cancer. Right. That’s not the path here. I don’t think

Eric Zimmer 44:51

yeah, it gets to also an area I am really interested in, which is how free are we to make different choices is based on our particular mental landscape, you know, go back to addiction. On one hand, it is absolutely true that the alcoholic or the addict is the one who has to make the choice not to pick up the drugs, right. I also know that having sitting 15 years sober today or so, and one day sober 15 years ago, the degree of choice that I feel like I had is radically different. It’s not the same thing to just say like, what was my choice? Well, yes, that’s true. And I have a whole lot more choice today than I had then for a whole bunch of different factors for a whole bunch of different reasons. And so when we start to talk about positive thinking, I think it’s pretty obvious. There are some people that just comes pretty natural to Yeah. And then there are others of us like EA, or who’s conducting the interview over here, who, you know, it’s a harder battle for me. Yeah,

Meghan O’Rourke 45:55

absolutely. And also, I think, in both illness and addiction, and any of these conditions that we’re talking about, that are embodied, physically and psychologically, there’s a journey we go on is not the journey, we think we’re going up. Right, I think there’s something fundamental that 15 years probably took you places that you could not have anticipated, right, in some ways that don’t tidy, that aren’t exactly a script that anyone could have handed you. And the same is true in these illnesses, right. And yet, we want for understandable reasons to kind of tidy the script. Yeah. Does that make sense as a metaphor? Tidy? The script? I don’t know. But you know what I mean? Yeah.

Eric Zimmer 46:38

Well, we want easy answers. I mean, we want easy answers. I figured it’s hard. It’s really hard. And particularly when you’re suffering, you know, when you’re suffering you want like, think this drink this take that, you know, like we just want to be better. Yeah, want to dive a little deeper into this idea of emotions and thoughts and physical symptoms. We’ve had a woman on the show a couple times, she’s a Buddhist teacher, her name is Toni Bernhard. She’s lived with chronic illness, chronic pain. And she described this in a way that I thought was one of the best ways that I’d heard it described. And I think it’s really interesting. She said, You know, if I’m talking about chronic pain, I can determine there sort of three elements here. Element. One is the physical sensations of pain. element two is sort of my level of resistance to those things, how much I’m fighting against it. And then the third element is sort of all the stories I’m telling myself about what this thing means. And her point is the first one, obviously, we may or may not be able to do anything about right, you assume you’re doing what you can do, you go to the doctor, you’ve got a chronic pain. And the other two, we’ve got a little bit more control over. And I think that that makes a certain type of sense, although as you and I’ve just been saying, like element two and three in there, it’s not like we have complete control over it’s not as easy as just going well, I’ll just think positive, right. But we have the ability to work with it emotionally, you described that when it came to your chronic pain, that you were able to sort of work with it a little bit easier in the way that I’m describing, you were sort of able to separate it out into its little elements, but that when you got into some of your other symptoms, things like brain fog, or tiredness, that was much harder to do. So I guess I’ll first ask you, what do you think about sort of breaking it into those three categories? And then secondly, share sort of what worked for you when it came to pain that didn’t work in other areas?

Meghan O’Rourke 48:35

So yeah, I know, Tony, burn hearts work. And I think that’s a really important observation. You know, again, with the caveat that we don’t control it all. But yeah, I thought a lot about Buddhism. And I read a fair amount when I was really sick. And I would add to her three categories. A fourth, which is what the world is throwing at you. Oh, yes. Because Speaking for myself, I’m in pain every day. But when like, I’m just dealing with someone who it’s not just grates on me, but I think like represents everything wrong in the world. Like, you don’t I mean, those kinds of people, you’re like, this is this is not what we need. My pain gets harder to tolerate, right? Or then think about, okay, that’s a trivial example, think about someone who’s got two young kids, and is the father worried about providing for them and losing his job and how that exacerbates the pain? Right? That’s not just a story. He’s telling himself. That’s a story the culture is imposing on him. So I do think part of the work in my book is to try to add that fourth piece and say, We got to all pause and talk about ourselves, but also talk about what’s coming at us, right? Yeah, in terms of pain. It’s a really interesting thing, because pain is a signal, right? It’s a signal that creates an effect or a feeling and there was a moment that I described in the book where I was in so much pain, I thought I was going to die and I remember just stopping and think came, okay, I’m just gonna observe this, this is just something that’s happening to me, that’s how I’m gonna survive it. It didn’t make the pain less bad. But it made time change a little bit. And it gave me that little degree of this too shall pass that I needed in that moment. So I do think that one of the things that we also don’t talk about in terms of pain is where is it? And how does it impact you? And how does that become part of the story so that what enters with pain is fear, right? Fear that it won’t go away fear that it will come back fear that it will come back just when you can’t afford for it to come back. So you know, I think in my life, one thing I’ve been able to identify in terms of pain, and then even these other symptoms, is the role that fear and lack of control play. Yeah. And my own intense desire for control, you know, and while I could learn to manage pain, what was really hard to learn to manage, as you said, was fatigue and brain fog, because those things were the very center of my perceptual being Yes. And they made it hard to apply effort to anything. Whereas if you think about what we’re talking about pain part of what we’re doing, it’s sort of a cognitive effort, right? You’re having to be effortful about at least moving to that place where you’re practiced at, okay, I’m breathing through this, whatever it is you need to do, but what brain fog was made it hard to even muster that effort. Right, so you’re just in this kind of morass that is really hard to visualize how you’re going to keep surviving it because you don’t even have the meaning of making meaning of it. Right? Yes, that said, what I can say is that now in my life, you know, I talked about this in the book, I’m not better in the traditional sense of the world, but I’m not as afflicted as I was. And a lot of days, I’m sort of in the 60 to 80% range. And there will be periods where those symptoms return fatigue, and particular brain fog, and it’s really scary, and I can let that symptom exist. And then this whole story starts to tell, right, my brain churns, story begins, and I think, Oh, my God, here I go, I’m sliding down this path, I’m never gonna get better my children, what will happen my job, you can really start to catastrophize. And one of the things I talk about in the book is that I think the chronically ill patient has to live in a dual reality in which she’s both insistent on the reality of her disease when she needs to be and advocates for herself and takes the time to know off when you need to, but also resist, you know, in her own most catastrophic fears, right? And you have to work in that sweet spot somehow. And it’s very much what Tony Bernhardt is talking about, of identifying the reality. Living with it, observing it. And time becomes this really complicated piece and chronic illness because it you know, it’s going to come again, right? So some part of you is always waiting, even on the good days, what’s going to happen.

Eric Zimmer 53:09

Yeah, it makes me think a little bit about depression. And I don’t even know how to talk about it anymore. I don’t get sort of back to labels and diagnosis and all that. So I’ve studied a lot in Buddhism and Buddhism, we talk a lot about using the energy of the emotion to be transforming. And I’m like, Yeah, okay, that’s great, except when you’re dealing with an emotion that has zero energy, like anger, okay, that yeah, I could see harness in anger. I can even see harnessing sadness. But when there’s nothing Yeah, it’s more of a challenge to work with nothing. And that’s what brain fog and fatigue are. They’re nothing. There’s something that’s so amorphous as to be nothing. So let’s talk a little bit about healing. You ask in the book, what does it mean for a chronically ill patient to heal? You say in some cases, it may be a remission of disease, but in others, it means the patient is now able to manage the illness with some degree of integrity. What do you mean by that word integrity?

Meghan O’Rourke 54:07

What I mean, is what I was just talking about, about advocating for yourself, accepting, you know, acceptance, overused, sort of buzzword. But this goes back to what we were just talking about, I think, when I was first sick, I just wanted to get better. And I meant better in a way that well, people mean better. I just wanted this illness to go away. I wanted to go back to the person I had been, I wanted to forget this chapter had ever been part of my life and just be living in this other sort of delusional story in which, you know, I was this intact person who was just going to keep living my life as I thought it might unfold as a person in her 20s. And so part of the travels, the quest that I went on, I thought I was going on a quest to recover, but actually, the quest took me in places that were more about learning to live with limitations. Again, that The title sort of jargony and easy to say, but I think anyone who’s really done it knows how hard it is and how real the work behind that language is. So part of what I mean is that integrity of not denying the very condition you have, but living with it with some integrity in which you have come to, if not accept, fully acknowledge, I guess the reality that your body is not working in the way that you hoped it would, and that your body is shaped by limitations as are all of ours. But in this way that’s brought a kind of heightened knowledge to you, and that you’re able to both advocate for yourself and that you have people who see and validate that reality that you have now acknowledged. I think that’s the key other piece is you can’t live in integrity unless you have that doctor, that physician that acupuncturist, whoever it is that friend, who really sees and validates and understands that reality.

Eric Zimmer 55:59

Yeah, you talk about healing, being thought of in a sense of wholeness, you say a patient is healed that is not solely by steroids or antibiotics, but also by nature, thrilling conversations, touch empathy, being made to feel whole rather than distraught as she exits doctor’s appointments.

Meghan O’Rourke 56:17

Yeah, exactly. Right. I mean, you can be a sick person whose life is you know, quote, unquote, limited, but you can have incredible amounts of joy. And these thrilling, right, what is healing, it doesn’t mean that I can do whatever I want. But it means that I have the possibility of joy, I think, for me, and what I had the worst brain fog and fatigue that wasn’t there, because also no one saw it. And so there was never this sense that I might experience a reprieve.

Eric Zimmer 56:43

Yeah, there’s an old Buddhist story of a person who is being chased by a tiger and they come to the edge of a cliff, and they start climbing down the cliff on a vine and they’re going to Tiger above them. And there’s a tiger below them. And it’s 200 feet fall, and a mouse comes out and starts snowing on the vine. And at the same moment, they see a beautiful strawberry right there, right. And I love that story. Because I think that speaks to what we’re talking about, like, chronic illness makes it more clear that you’ve got a tiger above you a tiger below you that vine is getting knocked on. But that’s everybody’s life to some degree, right? Your mom is sick, your dad is sick, your dog is sick, you’re sick, you got laid off from your job, your lover left you I mean, life is just filled with this. And then there are the strawberries. Let’s wrap up here because I know we got to go. But I just real quick want to ask a question about something you call the wisdom narrative, which is, you know, we have this narrative, you say that stories we talk about illness are almost entirely about overcoming it. But if an illness can’t be overcome, we have this story about we grow wiser as a result of suffering, right, which there’s truth in that, but there’s more nuance to it than just that. Can you say a little bit about that kind of as a way of wrapping up?

Meghan O’Rourke 57:59

You know, it’s really hard. This is another chapter where I tried to get at something nuanced and say, I think there is a way in which wisdom comes what you were just talking about the knowledge that, of course, this is all imperiled, we’re all imperiled. And we’ve got to just look at those strawberries. I think I say this in the book, or maybe I didn’t in the end. But you know, life is a lot funnier to me now than it was before I was sick, because why not? Why not look for those strawberries and those moments of joy in different ways. But what I wanted to really point out with some ways in which the society around us whether you’re chronically ill, I’m sure this is true addiction to exactly the kind of moral tax, right? In order to have to think about your suffering, it wants to get something back from you, which is the performance of moral grace, the performance of triumph over adversity, the idea that it was somehow worth it, because in the end, you’ve been enlightened. And what I objected to is the reflectiveness of that again, and what I want to point out is that many of us might not choose to have gone through We hear it all the time, by the way, oh, I would never do this. Thank God, I did go through this right. No, screw that. I wish I had not gone through this. But I did so you know. Okay, so now what but but that should be on my terms and not other people’s terms. Right? It shouldn’t be that those of us who experienced these things are kind of asked by society. There’s a sociologist who is a really famous sociologist of illness and talks about like, how inspiring it is to watch people suffer with moral grace. And I was like, well, but what if you can’t suffer with grace, right? What you are caring for six children and you’ve lost your job, like I know and there’s no great disability out there for you. So, you know, that’s a lot to ask of that person. So that’s what I’m trying to unpack and say, you know, I think Wisdom does come As the word itself is a fascinating word etymologically. It’s connected to the word doom. Right? And I think in the book, I talk about that idea that okay, wisdom is something you get from the encounter with Doom. But an encounter with Doom leaves, its claw marks on you, too, right? And it’s complicated. It’s just again, one of these really complicated things that we need to talk about in different ways, I think.

Eric Zimmer 1:00:27

Yep. Well, thank you so much. Like I said, I really loved the book, beautiful writing lots of great insight that’s not you know, as we’ve said, sort of not bubblegum insight, but true deep reflection on a really difficult situation. So thank you so much for taking the time to come on. I’ve really enjoyed getting to spend some time with you.

Meghan O’Rourke 1:00:45

Thank you so much. I really enjoyed this conversation and look forward to listening to many more and thanks again.

How to Break Free from the ‘More’ Trap and Find Balance in a Busy Life with Chris Bailey

December 24, 2024 Leave a Comment

Chris Bailey on Focus, Productivity, and Meditation (2018)

In this episode, Chris Bailey discusses how to break free from the “more” trap and find balance in a busy life. He explores the concept of ‘stimulation heights,’ the challenges of constant digital stimulation, and practical strategies for creating meaningful, intentional experiences. Chris also shares how learning to cultivate presence can lead to greater calm, focus, and fulfillment in your modern lifestyle.

Key Takeaways:

The misconceptions about calm and its crucial role in productivity
How our pursuit of “more” impacts our ability to be present
The concept of “super stimuli” and their effect on our brain chemistry
Practical strategies for creating boundaries and finding balance
The power of savoring and its impact on our overall well-being

Connect with Chris Bailey: Website | Instagram

Chris Bailey is an author and host of the Time and Attention podcast. His podcast explores the science of living a deeper, more intentional life. He is also one of self proclaimed “laziest people you will ever meet” and his drive to free up time for relaxation has led him to intensively research and experiment with the subject of productivity for the last decade. To date, Chris has written hundreds of articles on the subject, and has garnered coverage in media as diverse as The New York Times, The Wall Street Journal, GQ, The Huffington Post, New York Magazine, Harvard Business Review, TED, and many others. His newest book is How to Calm Your Mind: Finding Presence and Productivity in Anxious Times.

If you enjoyed this episode with Chris Bailey, check out these other episodes:

Tools to Find Focus and Accountability with Taylor Jacobson

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How We Can Transform Our Inner Dialogue to Heal and Connect with Kimi Culp

December 20, 2024 Leave a Comment