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Beautiful Minds Wellness

The Brain People Podcast 2023

Amanda Anguish

K'dee Elsen Crews

Maintaining Habits and Reaching Goals

Welcome to the Brain People podcast, a show where 4 mental health experts team up to bring you practical tools for overcoming mental health challenges.

The Brain People don't replace your doctor or therapist, but we will give you some extra tools to help you on your journey.

So join us as we fight mental illness, 1 episode at a time.

I'm Amanda Anguish, and I'm a licensed marriage and family therapist and I'm joined with my co-host today.

Katie Elson I'm a licensed clinical psychologist and we're gonna be talking about maintaining habits We've talked about in the past making SMART goals, but today we want to help those of you who are in the throes of your New Year's resolutions.

Maybe you're having trouble keeping up with them.

What are some things that you can consider in maintaining those goals and continuing out strong in the rest of the year.

So Katie and I have been discussing some things and we thought that maybe might be helpful to give you a little bit of a background on where some of these principles come from.

So yeah So 1 of the first ones I think is just to understand how our brain works.

We often hear the saying, old dogs can't learn new tricks.

And Amanda and I, right, just in the field that we work in, that is completely not true.

So when you look at and understand the brain more, specifically what we're talking about is neuroplasticity.

And we could probably do several episodes just on that topic alone.

But essentially, right, neuroplasticity, neuro meaning the brain, plasticity meaning the ability to change, talks about how we can basically rewire our brain.

For those of us who may have thought, oh, it doesn't matter.

I've been doing this too long and so I can't do that.

So when we talk about habits, right, and wanting to form new habits, if we have the mentality that old dogs can't learn new tricks, then we're already basically coming out of the gate with this hopeless mentality, right?

But then we realize with neuroplasticity that we can rewire our brain.

So I like to give like an easy example of this.

If for those of you that are hikers, right, and you go on 1 trail over and over and over again, What happens to that trail?

So what happens Amanda, if we walk the same trail?

If you walk the same trail, nothing is gonna grow in that path.

You've pounded down that dirt and grass and flowers and everything, And that's what creates the path.

It's defined, it's, you know, you can see it really well and you're comfortable in it as well.

Now let's say I want to start a new habit.

Maybe it's 1 of those habits that's like, oh, it's not really good for me.

So now I wanna go left instead of going right.

So what we know about starting a new trail, it can be hard, right?

There's a brush, maybe there's thorns, you're taking a machete or something and cutting down, which would apply to life of like, maybe you're cutting things out of your life, making some changes, some old friendships or whatever it may be.

We can really make this analogy the whole episode, but for the sake of time, it's difficult starting that new pathway.

And sometimes you look at the right and you're like, oh, well, that one's so much easier.

You don't even realize you're going back to it because that's what you've always done.

And so the work even includes having to go back to the new trail and keep refining it and disciplining yourself on it.

So we know that the new trail, right, then becomes deepened and that becomes your norm.

Like plants grow where you thought, oh, a plant would never grow there.

Well, it's not growing because it keeps getting walked on and stepped on.

But now that nothing is going over that, now it starts to grow up just like the previous trail that you just worked on.

Yeah, and if you've gone hiking before, sometimes you come across this place and you look at it and you say, I think that used to be a trail, right?

It's all filled in, But there's like faint traces of old habits in our lives.

And so that's really encouraging to know, if we know that about our brain, that we can start new habits.

And 1 of the principles that we gather from that is persistence, dedication, commitment, and so forth.

That's actually 1 of the things that we're gonna talk about today because 1 of the things, and I guess we don't have to go in order or anything, but 1 of the principles of maintaining a habit is fostering flexibility, being willing to try something new and continue with it even if it's not the easiest thing to do.

And we like easy, but there is effort required and discipline required in order to start new habits and maintain them.

Yeah, and it does take extra brain work to do it.

I think 1 of the things are, well, I know 1 of the things our brain likes to do is protect us, you know, from having to do something new and different, but even just allowing yourself to be flexible and say, hey, I'm gonna add some variables into my life, that can actually make making a new habit even more likely because you're already used to doing new things every so often.

And so this is not just, oh no, I've got to do this.

It's like, yay, it's kind of an adventure because I'm used to being flexible with.

So 1 way if you want to change a big habit is also just generally fostering flexibility in your life and small things, right?

And how do you roll with the punches when things do?

And I think that goes back to thinking too, like you started with is, do I accept change or do I think, oh no, this is horrible because I have to do something different.

But the first thing we wanna talk about is that, and this kind of goes back to the SMART goals, but we wanna be specific about our goal.

If I make the decision that I wanna exercise this year, this is probably 1 of the biggest ones.

I used to go to a gym and I remember in January, it's like, where did all these people come from?

That's a really big 1 that a lot of people do at the beginning of the year.

But if I say I'm gonna exercise, well, I haven't told myself even what kind of exercise I'm gonna do, so how do I know what to expect from myself?

So do you have anything to say about being specific about your goal?

Yeah, and I think it's not just sometimes when we talk about SMART goals, we're too limited of just focusing on the goal that you're setting, but being specific of why do I want this?

I like that you brought that up because that's actually 1 of the points that I wanted to talk about.

Yeah, because the example you were giving with the gym, we're sometimes specific of, oh, I need to go to the gym, but we're not specific to understand why I want to.

So it's like, if I'm just going left in that example we gave, and I don't really know why, then naturally, because I'm drawn to ease and comfort, I'm gonna go back to the right trail, right?

And so, but if I'm like, no, I know I have to get through the thorns and the brush because I have a specific why, then I am more focused and committed and so forth.

And even being really diligent about understanding that why, too, because sometimes people will say going to the gym or exercising or getting in shape is your goal, if you make that goal about, well, I want to impress people at my reunion or something like that, well, then what happens when the reunion's over?

Well, I don't have to exercise again for 10 more years until the next reunion comes.

But if my goal is, hey, my body is a temple, I wanna keep it healthy, I want God to be able to use me.

Well, there's no end in sight to that goal.

And so I continue to take good care of myself because that's a little bit more specific than, oh, I just want to, or there's a deeper purpose, I should say, than I just wanna impress people at my reunion.

And then if that person that you're trying to impress, you find out isn't gonna be there, then there goes your goal again too.

Yes, and it becomes more of a lifestyle than it becomes just a goal.

Absolutely, and that's what we're hoping for is these aren't just resolutions or fad diets and things.

These are things like if they're that important, they should be my lifestyle, not just something I do for a period of time.

So the next 1 is, I really like this 1, create a cue-based plant or have something that, like there's a, like a reminder to do it.

So this looks like when I did go to the gym, I do other exercises now.

Daniel Binus

Allen Lloyd

Factors that Contribute to Mental Illness

The Brain people don't replace your doctor or therapist, but we will give you some extra tools to help you on your journey.

So join us as we fight mental illness 1 episode at a time.

And I'm a psychiatrist, and today I'm joined by Dr.

Neil Nedley is an internal medicine physician.

He's an author, a researcher, and most importantly for me, he's been a wonderful mentor and a friend.

And, you know, I think back When I first met you, I was actually in my psychiatric residency training and through that process, it was a very interesting process because I kind of had this picture of this is how psychiatry is going to be and I'm going to help all these people and all of this.

To be frank, I got a little disillusioned cause a lot of my training, I got good training, so I'm not trying to knock that, but a lot of it was focused on treating, just symptoms with medication.

And so, through that process, I was actually introduced, to you, You you we have family connections and you really helped to revitalize My interest in mental health because he helped me to see that we can do mental health intervention in a different way.

And that really excited me as a resident and it still excites me to this day.

So I just want to say personal, thank you, Dr.

I remember also the first time you were rotating through, you mentioned that you were going to finish your psychiatry and then go into a family medicine because of that disillusionment.

And I was thinking, boy, he needs to stay in psychiatry.

He just needs to incorporate these sorts of things.

And you ended up staying in psychiatry and I assume you're pretty happy you did that.

I mean, just seeing the lives turned around is the most rewarding thing in life.

And just to fill our audience in, what happened was Dr.

Nedley actually invited me to observe and participate in his 10-day residential depression and anxiety recovery program.

It's now been moved to Weimar Institute here in Northern California.

But just going through that process and watching lives transformed from natural methods of intervention for mental health in just 10 days was phenomenal for me.

And when I looked at all the psychiatric research, I had not seen anything like that.

And then to see it in person just made me overjoyed.

Nedley, our audience might be wondering, okay, So here's an internal medicine physician who started doing depression, anxiety recovery programs.

Well, actually very early in my career, I was seeing a 30 something year old successfully employed woman who had a lot of physical ailments.

And she had been from doctor to doctor and heard about me moving into the area.

And of course, 1 of my specialties is the difficult to diagnose patient.

So I was looking at all of her records, looking at all of her symptoms, and recognizing all the certain blood tests that weren't done that are more esoteric type of blood tests and different tests that could be done to find out what was going on with her.

And I was confident with my training that I was gonna find out for sure what was going on and be able to really help this woman.

And I think I, at the time I instilled confidence that I think we're gonna be able to get to the bottom of this.

We have these tests, you know, and they said she ended her life last week.

She never told me about any of her mental health conditions, never mentioned it.

Of course, I'm a physical health doctor, but I thought I had let this woman down.

And a lot of physical health conditions can actually have mental health as a basis of it.

I never again saw a patient without asking mental health questions.

In fact, everyone came to my office, had to fill out a mental health questionnaire.

But I then realized that up to 1 in 3 people I was seeing for physical health conditions had depression or anxiety.

And I realized I need to become an expert in this.

If I'm seeing it that often, I'm seeing more depression than I am heart disease, more depression than gastrointestinal illness and all these things that I'm specialized to treat.

And so that's when I asked the psychiatrist in our area if I could shadow them for a while.

And I began to be able to diagnose all the differential aspects of the psychiatric conditions but in the mental health conditions.

And then I could see their use of medicines and high doses of medicines and combination of medicines.

But I didn't see a workup other than they would look to make sure thyroid testing had been done and a few things like that.

And I asked them, you know, I don't see any exhaustive workup trying to find out the causes here.

And they said, well, that's because there's no known cause.

It seems to come from within, but we don't know the causes.

And I said, well, obviously you think it's a chemical imbalance because you're using medication.

They say, oh yeah, no question it's a chemical imbalance, but we don't know what's causing the chemical imbalance.

Maybe genetics, other things, but we don't know all of those underlying causes.

You know, as a internal physician, medicine physician, that's 1 of your main focuses, right, is to discover, okay, well, here's some symptoms that the patient has, but we wanna understand what's triggering those symptoms.

And you weren't really seeing that when you started looking at the world of mental health treatment, right?

And what do you think is concerning about that?

I mean, and like I mentioned even earlier on in the introduction, I was seeing a lot of that too, just like treating symptoms with medication.

But from an internist or just an individual's perspective, what is concerning about not really looking at those root causes?

Well, if we don't find the root causes, we're not gonna be able to reverse those root causes and we'll never get to really transforming the patient or having a chance at eradicating the disease.

We're just going to be treating a chronic illness that's never going to be completely adequately treated.

And unfortunately, I think that's kind of what I see oftentimes day to day when people are, you know, going through a lot of different mental health providers and it's just like, you know, talking about their problems and then treating medic using medication, but it is this revolving door.

And part of what I've seen in my career is that when people don't really address those root causes, the disease process actually continues on.

And then eventually people are, now you're stuck on a bunch of meds, but the symptoms come back with a vengeance and that would eat you.

And of course, I didn't realize till I started doing the research that these medicines don't actually increase your ability to make more of the neurotransmitters, nor do they really help you with the receptors.

That would help with the synaptic activity, but they're actually plugging the reuptake channels so that more of what is short can have a chance to produce the synapse.

So it makes sense short term, but if you're blocking the reuptake channels, you're actually shorting the neuron further of the very substance you're trying to treat.

And that's why after 6 months to a year, they need higher doses, they need more medicines, and it kind of produces a psychiatric cripple, where if we have gotten to the underlying cause and help them find out why they're not making enough serotonin or why they don't have enough receptors, we can have a far better result.

So then we end up with treatment-resistant mental illness, essentially, right?

Gratitude

Welcome everyone to the brain people podcast.

I'm a licensed clinical psychologist and joining me is.

Yes, and I just wanna start off by saying, I'm so grateful for the Brain People podcast.

So are you grateful for the Brain People podcast?

I look forward to this time all the time.

It's just such a great time to think about mental health and to share.

And I get excited just thinking about all the people that are listening and enriched by the information that we've been given.

Yes, and I noticed that you're smiling as you're talking about this, right?

And of course, this has something to do with our episode.

Today, we're gonna be talking about gratitude, right?

The things that we are grateful for and emphasizing the importance of gratitude for our mental health.

Now, some of our viewers or listeners might be thinking, oh, but we just passed Thanksgiving or Thanksgiving's already passed.

But so why are we talking about gratitude?

Well, I think it's important for all of our viewers and myself included to remember that gratitude is not just an event that happens once a year and we remember things that we're thankful for, but really it should be something that we cultivate throughout the year.

And I think it's super important to realize that gratitude is 1 of the key factors for optimal mental health.

And frankly, I think without a regular practice of gratitude, people are not going to have optimal mental health.

It's really a lifestyle, how we can cultivate gratitude as a lifestyle.

Because I think Maybe we don't cultivate it because we don't fully understand what gratitude is.

And, you know, gratitude actually comes from the root Latin word, gratia.

And gratia actually means grace, graciousness, or gratefulness.

And it kind of depends on the context, but basically when you really think about gratitude, it really encompasses all of these words in 1 respect or another.

And it really has to do with focusing on something that we've received from outside of ourselves that we're thankful for and we're showing appreciation for that.

There's the affirmation of the goodness, right.

And then the acknowledgement that that goodness, a lot of it comes outside of yourself, right?

And I love that because it's not just, I think sometimes oversimplify gratitude and just say, oh, I'm grateful, I'm thankful, but it goes beyond.

It's this deep process of really thinking intentionally about what we're grateful for and what is the source of that gratitude.

And I love that element of gratitude because we see that also in the research too that gratitude is amazing at connecting us with things beyond ourselves.

Because, and I think in this world, it's so easy to get focused on ourselves, like my needs and what I want, and really self-centered sort of society and way of being.

And a lot of it is, is survival because people are highly stressed.

And so it's easy to get focused on that, but gratitude really transcends that and says, no, you know what?

I realized that I need things outside of myself.

And when I receive them, I'm going to take time to actually notice.

And so that can be, of course, being grateful to other people, but it can also be connecting us and being grateful to a higher power, to God, for the gifts that he gives us as well.

Yes, and I like that you said, take time.

It's like little stop signs in our lives to just pause.

Because if you think about it, I can't be grateful in a very fast-paced life.

I need to pause and acknowledge the gifts that I'm receiving.

And I think when we do that, it actually helps us to really cope with the stressors and it helps everything to kind of slow down.

And in reality, it's probably 1 of the best kind of grounding techniques that we could use to slow down when we intentionally practice it.

So we've talked about what is gratitude, but let's talk a little bit more about the benefits because Some people might be thinking, of course, yeah, gratitude is great, but we really wanna sell them on this, right?

And I hope that people can walk away from this episode and be like, I want to practice a lifestyle of gratitude.

So what are some of the benefits of gratitude?

Well, generally speaking, people that are grateful are more happy if they practice gratitude consistently, and they're also more relationally connected and they're less stressed.

And so I think those factors are very important.

And I'm just thinking about 1 study that I was looking at earlier.

A lot of the gratitude research has been done by Dr.

And they did 1 study where they had participants basically write a few sentences about their week and they did that.

And basically they had 1 group wrote about things that they were grateful for that occurred during the week.

The second group wrote about the irritations, the things that really got on their nerves.

And then the third wrote about events that had affected them, but there was really no emphasis on whether they had to be positive or negative.

And what they found after 10 weeks is that those that had the gratitude assignment were more optimistic and they felt a lot better about their lives.

But what I thought was really interesting and actually surprised the researchers is that they actually tended to exercise more and they had less visits to medical professionals as well.

And so we can see that gratitude, obviously it helps us feel better, be more positive and optimistic, but also it even affects us physically as well.

It doesn't just make me feel good for the moment, which often we think about gratitude just in the moment, but it really impacts different areas of our lives and even our physical health.

Yeah, yeah, and you think about the exercise piece, 1 of the elements that actually makes it difficult for people to exercise is a lack of motivation.

And so I'm thinking, I mean, I'm just hypothesizing here, I'm guessing that gratitude somehow actually can help to increase people's motivation for doing positive things.

And so it's like almost this upward spiral that can start to take place.

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The Brain People Podcast 2023

Smart Goals

Transcript

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