Brain Science – Episode #5

Managing our mental health

exploring the importance of physical and relational factors

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Mireille and Adam discuss key aspects of mental health and what it looks like to manage our own mental well-being. What are the key ingredients to managing it? How do our relationships and boundaries impact it? Are sleep, food, and activity really that important? We talk through these questions and more to better understand mental health and the ways in which we contribute to our well being.

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Mental health is a system issue — if one aspect isn’t working well, it impacts the system as a whole. Similar to that of a symphony, we, as individuals, work better when we acknowledge and allow all of our systems to work together. When key ingredients that contribute to our mental health are depreciated, we can expect that other aspects of our lives will be influenced as well. Mental health is variable. Just like our physical health, the knowledge base we have is always in flux. We never stop managing our mental health just like we don’t stop managing our money, health, relationships, etc. Remembering that there are always “knowns” and “unknowns” when we talk about health will help us better apply what we know about these things to us as individuals.

Key ingredients for mental health

Below are some key ingredients that impact our mental health.

Managing our physical body

Sleep, food, and activity are critical — as are the rhythms of each of these.

  • Sleep - at least 7 hours; 8 is better
  • Food - this is variable for all bodies. Food is fuel and without food (fat, protein, carbohydrates and fiber) our bodies don’t “move” in the same way
  • Activity - We need to exercise. We need to move around. Movement helps to “discharge” the negative and input the positive. It’s an exchange base.

Relationships and boundaries

As we’ve discussed previously, we fare better when we’ve got good social relationships and boundaries too. Boundaries involve consideration of our resources and the allocation involved in these. What are you committed to in terms of work responsibilities, home, relationships and relational demands, and stressors in general?

  • Constraints are a good thing
  • Boundaries provide clarity in terms of the expectations between you and others
  • These are particularly helpful for kids and teenagers

Transcript

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Mental health seems to be a really predominant focus in our world today, and yet it’s interesting, because I’m not sure that everybody has a clear concept of what we’re actually talking about or what is encompassed within mental health. What do you think?

Yeah, I personally have questions about it, so I can only imagine that if I represent a fraction of the world, then it’s gotta be true for them, too… Because I think mental health is this word we throw around, and it makes sense to, because we all have some sort of perceived or whatever mental status about ourselves, our positive thoughts or whatever, but I don’t think that everyone really gets the clinical version of when we talk about mental health, what it involves and what it takes to create healthy mental health.

Yeah, and I think that when we talk about things – one of the things that’s important throughout this show is being able to develop a language. You guys have so many different systems within your world that are all different languages, right? So mental health I want us to conceptualize in the idea of a system. That being said, systems aren’t static; they’re always in flux. So just like we talk about our physical health, our mental health is a fluctuation of multiple systems within our bodies.

That being said, I wanna delineate the difference between even our brain, versus mentality. Mental health is really this interplay between the physiological mechanisms within our body, our brain, as well as the interplay with the environment, and our thoughts. So it’s kind of all of the workings coming together, dare I say.

When you say that, you’re not saying mental health isn’t a healthy brain…

Mental health is the mind inside of our brain that is this interplay between the physical organ and all the memory systems, whatever it is that creates this thing we call our mind.

Right. Our health, when we tag on health, that’s even different – we’re looking at wellness. How can we optimize, so to speak, the way in which our systems of our brain make sense of our world, our relationships - all of these different factors. Mentality is the way in which we think about things, so “How do I make sense of the way in which my brain organizes information and creates output in order to do my world, my day?”

You said before this idea of a symphony. Is it like that, where you’ve got physical attributes, you’ve got other things that sort of contribute to this perception of mental health, this perception of happiness, or this perception of just healthy behaviors? Maybe even those are societal things, where society says this is healthy or whatever, kind of thing?

[04:17] There’s different systems that sort of incorporate the ability for the symphony to sound good, you know what I mean?

Exactly, yeah. And just like when we’re looking at physical health – I mean, think about the way in which our understanding of nutrition has changed over the years. Is it the same today, even as it was six months ago, or four years ago? No.

Yeah, it changes drastically. Fats are bad, fats are good…

You almost feel like you’re on this yo-yo system, and nobody really understand… But it’s in the name of progress, I suppose. Then you also have good research to prove your hypothesis about nutrition, or different things… But yeah, it’s always in flux.

Right. So this notion of symphony is very much – there’s different sections… There’s woodwind, there’s percussion… So if one aspect of the symphony isn’t working well, it’s going to modify the sound. That isn’t good or bad per se, it just is. And then you wanna look at “How do I problem-solve around that?” Because we as people, as human beings, are never gonna work the same if we amputate an aspect of that symphony.

So when I’m talking mental health, I think it’s important to look at what are some of the fundamentals or basics that make the fundamental system that we wanna start with whenever we’re examining our mental health. And some of those fundamentals, ironically, really start with managing our body from a physical perspective. Because stress is something that is a part of life. In the same way I wouldn’t expect to go into the ocean and never get wet…

Ha-ha! Good luck not getting wet if you go into the ocean.

[laughs] Stress is a part of our day-to-day world, and so I can’t imagine doing my life without things that I encounter that create stress in some form or fashion. There are fundamentals in going – loss is a part of our life, so I can’t imagine that I wouldn’t do my life, the choices I make, the way in which I live, how I relate to other people, if I don’t consider that loss is gonna be a part of that, so I have to figure out how to navigate that, and not oppose that and work against it.

So I’m looking at these fundamentals physically as sleep, food, and activity. So because we are all unique, is this going to look the same for any individual?

Yeah. Well, you wouldn’t think that it would be that simple, right? That some key ingredients for mental health being as simple as sleeping well, eating right, or just eating healthy-ish. Not even so much like on a diet or whatever, but having a lifestyle of maintaining health through food… And then this notion of activity. Because so many people abandon a couple of these at any given moment through seasons of their life.

Let’s say someone’s on a speaking circuit and they’ve gotta travel quite a bit for a quarter of the year. Well, their sleep probably goes down, their activity goes in haywire, their routines and all that stuff get off-track… And you wonder why you hit this state of burnout, or this stage of just inability to do the day-to-day as easily as you had been able to beforehand. Well, it’s because you’ve really taxed all of your core systems.

[08:05] Yeah, exactly. I think it’s helpful maybe if we talk about these things in terms of knowns and unknowns. There are generally things that are going to work for all people, all humans, regardless, and then there’s specifics; those unknowns that are relative to individuals.

Right. Their experiences in life… You’ve mentioned loss before - whether or not they’ve lost a parent, or a loved one… Unique things that happen in individual lives.

Yeah, like somebody’s health - if they have type one diabetes, it’s gonna look incredibly different from somebody who does not.

Yeah, because they have a daily anxiety that they’ve gotta deal with constantly. It doesn’t leave them.

Right, and then I can even create a further nuance with type diabetes is gonna look incredibly different than somebody with type two diabetes.

So bear that in mind as we talk about this, that generally speaking there are these knowns, and then these unknowns, or individual specificities within that.

So are you saying that sleep, food and activity are these known knowns?

Yeah. Sleep - one of the things we know is that, generally speaking, we are all going to fare better with at least seven hours of sleep, and if you want to do better, eight hours is even better than seven.

Based on different backgrounds, experiences, it might be that you can function with 3-4 hours, or 5-6, but generally speaking, 7 hours is the optimal minimal level of sleep. And the reason that is is that during sleep is when our bodies recharge. It’s sort of like defragging. I’ve gotta get rid of all the extraneous things, I have to sort and filter, because our brains want to always minimize how much energy we’re expending. So if I don’t have time to rest, that my brain can sort… I think in pictures so often, but imagine that our brain is very much like a post office, and sleep is the time in which it sorts all the packages. Where do things go? Is this one important? How urgent is this? Can this back off? Which is why when we’re stressed or we have other thoughts, we have trouble sleeping, because we’re not really sure that we can rest and relax and allow that to happen.

Right, yes. That’s interesting, too. We don’t even think – I would say everyday individuals probably do not consider what exactly happens when we sleep. Not so much just saying “Okay, great, you’ve gotta get seven hours, or eight hours, or whatever the number is, as a prescription. Go ahead and go do this”, and whatever. I think sometimes actually breaking down what happens when you sleep. Do you understand that part of it yet, or do you know much about the things that get repaired and whatnot when you sleep?

Not in specificity. Like everything, there’s so many specialists to look at just this one aspect of our physical bodies. But you know, I wanna say it was Malcolm Gladwell - and I’m forgetting exactly which book he talks about this - the law of 10,000 hours, and the research that if you wanna be an expert at anything, you need to spend ten years or 10,000 hours… But there are sub-studies even within those, which talk about the athletes who slept 8 hours over 7 hours, that they were even at that most upper echelon of the expert category.

Athletes really know this - if they want to do better, they’re going to sleep more. Because it allows your muscles to repair… Even in exercise, what happens when we’re building muscle is ironically we create small tears in the muscle fibers, so there has to be time for the repair to occur, and if I don’t rest, which is why I need to have a sort of rhythm of rest amidst my life in order for all the repairs to take place.

[12:11] Yeah. That’s actually a great point, because when we sleep, that’s when people often even burn a lot of fat, too. There’s a lot of fat-burning, there’s a lot of digestive things happening at sleep, there’s a lot of things (like you’d mentioned) in muscle repair etc. And I don’t know why our brains need to sleep, why our bodies need to sleep, but for whatever reason it does significantly contribute to our physical health and our mental health.

Something I learned several years ago - I heard somebody on the stage say “Work eight, play eight, and sleep eight.” So while I may not success everyday at that, that’s my goal. That’s what I’m optimizing for. And I’m terribly doing one of those right now, which is sleep. I’m in a cycle right now where sleep is – I get it, but it’s not perfect right now. And I realize how that’s taxing on me, too. My optimization is I wanna work eight, I wanna play eight, and I wanna sleep eight.

Yeah, and I think that’s really important, Adam. When we’re talking about these different things there’s always this sort of ideal to aspire to; it doesn’t mean that’s where you’re gonna get, but that’s your goalpost. And it’s not an all-or-nothing, like either I hit it or I don’t, but rather I just want to work towards and always be trying to get to my best self.

Right. It’s my North Star.

It’s the way in which I point my boat, you know what I mean? I may be off a degree or two sometimes, or maybe way off, but I know I’m always looking at it, and that’s the direction I’m trying to go. And when I’m off that - I’ll just sort of sidebar this for a second - I sort of say “Is this a seasonal thing? Can I get off of this North Star focus for two or three weeks because of a reason?” And give myself a window where I forgive myself for being off, and having this focus. I realize it’s just for a season, and I do my best to put some constraints on myself and not let it go beyond a certain measure. Then I’ve gotta pull back and start to create margin, and push back and say no to things etc, so that I get back to my North Star. I always keep it my frame of reference, but I may allow myself to deviate a little bit, for certain reasons.

Yes. And I’m so glad you brought up that caveat, because we’re all gonna encounter those. I can attest to that post-partum, after having children; there was a time where sleep was definitely not what I wanted it to be, and I made different choices as a result of that, because I knew it wouldn’t last forever… But really holding on to the reasoning why.

I wanna say, your will and your choices really play a critical role in that trajectory, to say “This is important to me and this is why for right now I’m doing this”, so that you’re riding driver’s seat. You’re not letting. It’s really easy in our lives, with all of the intrusions, to just default to sort of Whac-A-Mole; whatever thing comes up, I just practice that Whac-A-Mole game, like “That’s most important, that’s most important.”

And so I’m never really directing my life. I tend to tell my patients a lot - we always fare better when we participate in the choice. I think we want to believe or imagine that so much more of life is forced choice. “I don’t have a choice in regards to taxes.” Well, you actually do…

You might not like your options. It looks like you pay them or you go to prison, but it’s a choice nonetheless. So recognizing “I’m choosing to sacrifice sleep for this season in time because of a greater good or other alternative goal.” I just can’t run that play indefinitely.

Yeah. That reminds me, too - I also give myself some forgiveness with the food aspect whenever I’m on vacation.

[16:13] So often do we take vacations, and – I’m always pretty critical, and I’m always trying to maintain some sort of healthy food direction, similar to my North Star with “work eight, play eight, sleep eight”. I try to say “I wanna eat healthy. It’s okay to have a bad day, but get back on the track.” I’m not a failure because I didn’t do well this day, but so often do I attempt to go into a vacation with some sort of plan of maintaining my healthy eating, and by day four I’m like “You know what - let me give myself at least a break… Because I deserve it, right?”

Yeah, you’re exactly right. That’s the second key thing when it comes to the physical aspect of managing our mental health - it’s food. Food provides us energy. So in the same way - if I don’t put gas in my car, I’m not gonna get anywhere. I’m not going anywhere. So it is that I have no energy input to provide output. And our brains need food and fuel.

We’ve talked about much of our template comes from having kids and raising kids, and I talk with my kids a lot about food that they wanna eat, and I’m like “That gives you no energy. Your brain has no idea how to compute that food into energy, because it has no–” like Cheez-Its, while they may be incredibly yummy to my children, they don’t actually give them fuel.

What?! They don’t? Come on…!

[laughs] Yeah…

Okay, so let’s dive in a little closer then… What foods do you know of that particularly enhance brain function?

Well, we know that fats and proteins are really critical. Carbohydrates are as well, but if you look at the four basic things, protein, carbohydrates, fats and fiber are what we’re looking at. And this, within that - it’s going to look different for all people as well.

Yeah, it’s true.

Because who’s got the same genetics?

We’re all uniquely different, DNA-wise, for sure.

Right. So for whatever reason I’m aware of a number of people who have had their gallbladder removes, so their bodies aren’t’ gonna process fat in the same way in which it once did. So their diet is going to look different than somebody with another health issue, or somebody else who has – you know, all of that, there’s the health issues, but then there’s also health preferences. Not everybody likes to eat the same thing, and the plant-based diets are really important. We want to eat our greens, because those provide vitamins, nutrients…

Right. You come here to Texas, you’re gonna get barbecue. You go somewhere in Alabama, Mississippi – Louisiana, in particular, they have an entire cuisine just based on Creole.

And you go into Alabama and you’ve got Southern fried foods, South Carolina Southern fried foods… And you try to take their Southern fried foods away from them. I dare you.

It’s not gonna happen. It’s part of their culture, it’s part of their make-up, it’s part of their heritage even…

Right. So with that, there’s always caveats. Not all fats are created equal. Sugar is really more of a thing that’s involved with fats; eating walnuts or pecans, which are high in fat, are not the same as eating Reese’s Peanut Butter Cups, as much as I might like that to be.

[19:50] But recognizing different foods provide different nutrients, and that since our health is never a set point, it means I’m never going to have to stop managing health. So this is a forever-gig, where I am trying to look for ways in which my body can optimize, in terms of whatever I’m doing. Again, if you have a very physically-laborious job, it’s gonna look very different than somebody who has a very cognitive-demanding job, right?

We’ve talked about this in the past, in terms of different nutritional ways in which we’ve bent, and I noticed a significant different when I did a higher fat, higher protein diet, because I do have a very cognitive, demanding job, as well (ironically) emotionally, because I’m holding all of this energy throughout my days with individuals that I work with… So I would tend to dip toward two or three o’clock in the afternoon, and then by the time I was done at five o’clock, I was totally wasted. I had zero energy, and it would literally take me nearly an hour to sort of get my brain back online after expanding and exchanging all of that energy.

And when I went to this modified diet, I discovered that I didn’t dip, and I didn’t then dive and need an hour recovery. I can actually shift into whatever I need to now, immediately. But I know that isn’t gonna fit for all people. So what I want to offer is – food is at the forefront, but the way in which you do the food is going to be discovered as your investigation and the way in which you’re willing to practice new things.

I like the fact that you mentioned that it’s something you manage kind of forever… Because it just reminds you that – similar to my story of the North Star, my optimization, what I’m optimizing for, similar in that way you’ve always gotta keep your mind, your direction on this particular thing, whether it’s sleep, whether it’s food, whether it’s your activity, which we haven’t gotten to yet… But these three things being key ingredients that you have to manage and maintain for your entire life to have a healthier, or healthy life… Whether it’s mental, physical, interpersonal - all those things play on those kind of three core things. So if our mental health is hung on sleep, food and activity, and there’s many more layers beneath that, if that’s what hangs on that, then that means that society itself, the fabric of society depends on those key three things.

Yeah, it does. So many things are systems. In the same way my car won’t run if I don’t have oil, or I don’t have water, or I don’t have tires, God forbid.

Right… You kind of need those wheels.

Just a little bit. So these are going to look different in terms of how we manage them at different ages and stages in our life… But the value is always present. So when we go about our lives, I think it’s important to imagine – we have different filters through which we see our world. So putting on this filter of “What does it look like to manage myself as based on my genetics, my background, my experiences and the specificities relative to me?”

And just like we’ve talked in previous episodes about your discovery with mountain-biking, and that that was so huge for you, that activity, finding out your buy-in to do something so that you could move - that’s the other key thing when we’re talking about managing our bodies and our mental health. We have to move.

I’ve got good friends who love cross-fit, I’ve got good friends who love to rock-climb, even the fake kind, in the gym… And I dig that. That’s fun. But it’s not something I can do on repeat. For me, I had to find an activity that was both fun, engaging, and then also taxing physically, to progress and just to maintain. Everybody is gonna have a different version of that for themselves.

[24:14] Right. So I wonder if it’s helpful for our listeners to think about this in terms of rhythms. You mentioned the eight-eight-eight. Everybody’s gonna have a little bit different rhythm at different times, but the components that you’re going to need are sleep, food and motion, or activity… Because there’s all of this sort of bartering - like, output/input/output/input. And if I don’t allow for my body to sleep, my brain to sleep, and if I don’t input food to provide energy, and I don’t discharge the negative energy, my mental health, my whole health is going to fare differently.

It’s interesting, because in working with people with mental health disorders, anxiety - one of the best things that people can do when they wrestle with anxiety, ironically, is actually move more… Because anxiety as an emotion is energy, so instead of trying to squelch or squash it, I wanna move it. I wanna barter. It’s like, “I’ll give you two, you give me four.”

Yeah. I like the idea, and I think we’ve talked about it; it may actually appear on an episode - we talked about it like a lightning strike. It’s gotta go somewhere. It’s gonna come down from the sky, it’s gonna hit something that it contacts with here on Earth, and then it’s gonna continue, like an electrical charge. It has to go from emotions are energy, and they have to go somewhere (I believe you said somewhere). Is it similar to that?

Yeah, because there’s all of these (again) physiological processes that occur when we move. So getting your heart rate up, moving your body - it doesn’t matter what movement that is, you just want an exchange rate. So in the same way I’m gonna go to different countries and everybody utilizes a different monetary system, there’s an exchange rate. So if there was no exchange rate, what would you do?

So is your prescription then for anybody who is listening to this and has even light levels of anxiety, maybe even terrible levels of anxiety, that one easy prescription is “Move.”

And find something that is your good movement. It might be mountain-biking, and if so, reach out to me and say hello. If it’s cross-fit, don’t talk to me. I’m just kidding… [laughter]

No, but say for example you have a very stressful, high-pressured - I don’t know, I think like stock broker - position, that maybe you don’t want a super high-energy, kickboxing, shouting at you sort of activity. Maybe it looks like yoga, maybe it looks like walking, maybe it looks like kayaking, or something that has a much slower rhythm or pace to it, because it feels too similar to your daily activities.

I’ve got one for you… How about this - what if you took a walk with your good friend, your mother, your dad, your wife, your husband, your kids, whatever, and combined this necessary thing for your daily life, and attach that to relationships?

Yeah. Well, this actually connects in to the next thing I wanna talk about in regards to managing our mental health, and that looks like both relationships and boundaries. I had a friend who is an amazing individual, so a lot of people wanted her time, and words, and energy, and she was just becoming fatigued as a result of this. So she started making it a sort of caveat to interact with her that she wouldn’t meet people for coffee anymore, but rather it looked like going on a walk. “You can join me between X time, and we can walk.” And it was amazing how just setting that boundary and changing the nature of the relationship - it really reduced how many people joined her.

And so relationships are another key component of doing our mental system well.

I like how she combined both - both boundaries, as well as relationships. Because sure, we have boxes (for a lack of better terms) around us; constraints, boundaries, however you feel you wanna frame it… And in some cases we actually contribute, as you said before, to the choice, the design of those boxes. And in some ways those are societal and sort of forced upon us, based upon where we’re at in time and history and geography, and some of that is actually manufactured by us, by our choices.

I think it’s important to recognize that box is there, but also to recognize that you can modify that box. And the same case with her - “Sure, I wanna meet with people, and that’s positive for my career, for my mental health, for whatever it is she’s doing, but I’ve also gotta get this too, so how can I combine the two of them?” That’s genius, actually. I love it.

Yeah, because it just sort of controls the flow a little bit more, and it really offers to other people, like “How much effort do you wanna put forth? How important is this?” Because it’s easy to just sit and have a cup of coffee, or have a conversation, but do you want to actually expand energy, or meet me where I’m at in order to have this interaction?

One of the things that I’ve been incredibly cognizant of in working with people is when resentments come in, that resentment – imagine that it’s an indicator light to say “I gave what I actually didn’t have to give.” So in both relationship and our boundaries, our limits, to say “Look, I worked really hard to give you this gift, to give you my time, to give you my words, to give you my energy, and you don’t know the cost that that was for me… So now I’m angry with you and resentful to you, because you don’t recognize the value of the gift I gave you.”

But instead of it really being a shame on the other person, it should be a light bulb for ourselves to go “[gasp] I didn’t have that energy to give.” And so I have to be more deliberate and intentional about what I give to others in terms of my time and energy and initiative, because it’s not on them to manage my input, my output, but it’s my job. So to recognize that and go “I think I need to consider that.” And really, it looks like “If I get nothing back, if I give this to you, and I get no money back, emotionally, either literally or figuratively, I shouldn’t give it.”

How often does that happen to you? I don’t know how often I hold resentment, but I can recall recently having a conversation with my daughter about value. That “This thing was in this condition - because I was gonna let her use it - when I gave it to you, so you’re a child and you don’t really understand the value of things and what it took me to get this in the first place”, and the fact that it’s seven years old and it still looks this nice, it’s because I take care of my things… So I hold a certain value to that, and I have to somehow transfer that value to her, so that she can respect the item as well as I had, and treat it well too, so that it has the same lifespan after the gift, after giving it to her, for example.

[31:56] Sure. And I would say to some degree it looks different with kids than it does adults in our relationships, because – I always say “Kids are still cooking.”

Yeah, that’s true.

They are still very much in process… So I want to give them opportunities to grow and learn… However, with boundaries. And ironically, boundaries for kids, teenagers, pre-schoolers - kids all need boundaries in other to actually do themselves in their lives well, and they need us to help them figure those out. So one of the ways I would talk about this or explain is like I don’t intentionally give my kids certain things that I’m not okay if they literally wreck.

You’re getting upset. Are you getting upset?

Okay… [laughs]

But I think this is huge, because my husband has a very powerful car, he’s a car guy, and I say - if I give my 16-year-old son a Ferrari and he crashes it, that is not his fault, to some degree, because he has no idea the power that that car has. So as his parent, it’s my job to go “Look, one, his frontal lobe is definitely not fully cooked.” He’s got dopamine in his brain that works like an adult, so he has a full-on gas pedal with no frontal lobe to break it.

So I as his parent, and his dad and I together, need to say “That’s not wise.” It doesn’t mean he can’t, but like, really? It’s just not prudent, it’s not considerate of him being where he’s at. That is different than an adult, wherein I would create clarity around the expectation to go “Hey, this is a loan” versus “This is a gift” versus “This is a gift for three weeks.” There’s all those caveats and nuances. So you wouldn’t imagine taking a job if somebody says “Hey, I want you to come to work.”

When should I be there? And when will I be paid? How much will I be paid?

What work will I be doing? Who will I be working with? I can keep going… Anyways, I’ll stop now.

[laughs] But all of those things are relevant, because they are incredibly particular to you, in light of your North Star, in light of your relationships, in light of what you have to give. I mean, I would offer that one of the best experiences I ever had as a professional was when I worked in brain injury and I did job coaching for people of all different levels of skill and education. We’re talking everybody from a store clerk at Target or fast-food drive-through, to engineers, attorneys etc. that my job after they sustained an injury was actually to help them troubleshoot live on the job… So basically I would go and learn their job, and then teach them troubleshooting strategies for whatever was wrong with their brain.

The ultimate version of empathy, right? You put yourself in their shoes and gave them prescriptions on how to do what they do.

Exactly. So that whatever way in which their brain wasn’t working correctly, we can sort of hiccup around it. And that really highlighted the vast degree of humanity and what we’re capable of. And so what was hard for one person or what was a boundary for one person wasn’t for another, and that was so good. It really helped me see the beauty of how varied we are as people. I don’t think I’ve ever looked at going to get groceries the same way, because I know what it looks like to stock shelves…

[35:57] Yeah. When you put it back, you put it back with the label out, on the edge, stacked neatly… I’m just kidding. Yeah, when you go to the restaurant - you’re almost sort of self-preparing for the server to take the plates away, or whatever it might be. What do they call that - prebussing. We often do that a lot, me and my wife, because we’ve both been servers in our life.

Oh my word, yes, because you know what that is. Somebody who is in that job, doing that role, is going to look different in terms of managing their mental health, than say you or I in our jobs and what we’re doing. I have an incredibly social job, but that is incredibly isolating.

Yes, because you have so many people inputting, and zero output of their stuff, because hey, that’s illegal. [laughs]

Exactly, right. So I’m holding of this energy, so I have to barter in a way that doesn’t look like how the input came in.

So understanding that this will look different for all people, and I really want to cultivate respect around that, and empathy too, because what fits for you won’t fit for me… And hallelujah, that’s a good thing, because this is the way in which the world works. So when we’re managing our mental health, you are an [unintelligible 00:37:20.28] So here’s fundamentals, here’s the knowns, but the unknown is always through the filter of you.

Yeah. Your particular experiences, who you associate with, the relationships you’ve fostered, different skills you’ve picked up along the way on managing sleep, food, activity…

Yes, and so with that, when we’re talking boundaries, I wanna think of it in terms of constraints… And that constraints are a really good thing for my world, because I’m very much in the line of fire and I’m on the front lines… I say “I can’t be a first-responder in all ways.”

So where I’d like to give to other people - I’ve always said I wanna get paid to hang out with people and drink coffee… Which is ironically so much of what I do, because I care about other people and I’m fascinated by humanity, so I wanna hear the individual stories… But then I want to help, and I wanna problem-solve, and I wanna go “Have you looked at this? And what about that?” And I can’t do that in all facets of my life, because I will have no energy left.

Yeah. You’ve just made me realize probably how important this podcast is for your output… Because you hold so much in, you can generalize a lot of your experiences as a psychologist, and obviously not reference names, so it’s anonymized, whatever you’re speaking of. These are your experiences as a therapist; this is an outlet for you to output, so that’s cool. I didn’t really consider it like that for you.

I never even considered it in that way either, but you’re right… Because I think I see these ways in which – you know, they’re broad strokes that are applicable to all humans, and I want people to 1) join in the social fabric to go “You know what? You get to be human, too. Oh, and you are, too! And you and I aren’t gonna look the same.”

I can talk about things in terms of gender, or sort of expectations as being a female, a wife and a mom, and what those look like, but they’re not gonna look like my friends or my patients, because there’s – I’m like “Nobody else has my husband.” So I know… [laughs]

So we hope, yeah. Exactly, if you go back to the idea that DNA is unique, then we are all unique, and if our lives, if even our sleep patterns and our food patterns and our activity patterns and our relationships and our boundaries are all different, we’re all gonna have a different life experience… And that perspective is crucial.

[40:07] Yeah. And I would say it’s really what contributes to the beauty. When you think about the sounds that you like to hear, and the people that you wanna interface with, it’s really in the way in which we’re different, because I can learn something from someone else, and I had no idea that this was true, or other people liked this, or do that. And when we can respect that, it just creates this gorgeous harmony. But what we have to lead with when we’re managing our mental health is really this sense of empathy and respect, that I don’t need another one of me. I need another every-individual. Everybody in this world is here for a reason, and I wanna take delight in the way in which that creates a symphony…

Yeah. Diversity, not conformity.

Yes. So the next thing I wanna talk about with this - we’ve talked about the physical aspects when it comes to managing our mental health, but I wanna talk about specifically now there’s a key piece, and that involves the cognitive part. And because we’re talking about being individuals and we all have a different DNA, there’s a difference between our brains and our minds. So when I’m talking mental health, I’m talking about the way in which the physiological mechanisms of our brain and our bodies, that our mind actually operates and puts that together.

So it gets sort of modeled and nuanced, dare I say, when we start talking about this, because… Like insight, for example - our brain’s ability to have insight of, or awareness around things, is actually a cognitive function, so it’s a part of my frontal lobe function. But I can’t just say it’s one little part in the brain that does it, it’s really a cacophony of systems that work together, that create my ability to see in terms of my mind’s eye. Does that make sense?

Right. You have insight about insight, essentially. Awareness about awareness.

It’s almost chicken and egg.

That’s what it really gets to when we talk about our minds. That’s why it gets so difficult to describe even, because like “Okay, well, it requires the organ, but the organ isn’t the mind. It’s the interplay within the organ”, which is just really hard. Even neuroscientists have a hard time describing it.

Well, because it’s so complex, and it’s systemic, and it’s always changing, the more that we know. It’s just like we know that the way in which our lifestyle is changing with technology, that our brains are changing. But we don’t know how. I can tell you that attention span is less. Far less than what it was.

You mean as you get older?

No. That with technology and with all of the distractions of our world, because there’s so many pop-ups. Imagine, just like your computer has 12 file tabs open simultaneously…

Well, I think it’s this aspect of conditioning, which you’ve mentioned before. If you’re conditioned to ignore 50 things in a day in today’s world, whereas maybe 10, 20, 30 years ago you only had to ignore or discard things five times. So if you put a multiplier on the ignorance level of something every day, then that’s gonna contribute to you being more conditioned to ignore something…

Or just this aspect like – because ignoring something is sort of an attention span mechanism, right? You want to pay attention to it or you don’t.

Well, it’s like a decision. There’s so much to this… [laughter]

This could be a whole different podcast. Let’s give a sliver of it though.

[44:08] Okay. Well, attention – there’s all different kinds of attention. There’s sustained attention, divided attention, and then even shifting attention. And so all of these things play a role. But one of the things we know – email, for example… Researchers have looked at this and they say it’s not really helpful to look at your email first thing in the morning, because it ends up putting you more on the defense, so to speak. You are reacting to your day, instead of planning out and deciding where you wanna go every day.

I really want people to take home this sense of being in the driver’s seat, and I want people to practice choosing with a deliberate or intentional way of where they wanna go as based on who they are and what they want. I do think – this is cognitive aspects, like how our minds make sense of our world are very much this interplay of our background, as well as our environment. And I often tell patients, “It’s not the eyes that see, and it’s not the ears that hear. It’s how our minds make sense of that information.”

I can say I have a sense of what starvation looks like, but I have never been to Africa. So my perspective, the way in which my mind makes sense of starvation is removed, is distant. It’s only in book form or video form, or something distant. So that’s gonna look very different than somebody who’s actually experienced starvation.

Yeah. Everybody’s experiences are different, and how we see our world is based on those experiences. We’ve said this before - my perception of it and your perception of it is gonna be similar sometimes, if we’re in the same scenario, but also very different… And that plays a role in how we feel about these different things we’re dealing with.

Right. And so going back to insight - that is really a key part when it comes to managing our mental health… And I have to be considerate around my background, individually, in terms of not only where I’m from, but my biology, my DNA, as well as my experiences, and the way in which they have shaped how my mind takes in the information.

[46:49] Yeah. I had to google this real quick, just because I wanted to make sure that I had a dictionary-ish version of insight, so what defines insight. If I understand correctly, insight in the capacity we’re talking about is the capacity to - and this is them saying it, not me - the capacity to gain an accurate or deep, intuitive understanding of a person or a thing. So to have insight is this whole separate thing, where it’s like you’re almost discovering secrets, right?

Is it kind of like that?

Yeah. This is ironically another part of brain injury, that often gets impaired… Because people – their brain, literally, the physiological mechanisms don’t work the same way for them to have awareness of themselves in that way. So we all have this… I might not see myself completely as I am… So you might interface with a person and you’re like “How do they not see?”

Right. “Come on…!” You’re watching that Scary Movie - “Why are you going up the stairs?! You know better than that!”

[unintelligible 00:47:56.25]

Yeah, but this is at the heart of relationships and why it can be so challenging to interface with other people, because they literally don’t either have the insight and awareness of themselves, or the way in which they’re interacting with another person and/or hearing exactly what the other person is saying. So it’s hysterical to some degree having children and watching this live, and hearing – like, one of my kids will get upset with the other because they’re like “You said I didn’t like chocolate!” and they’re like “That’s not what I said!” Because one was talking about a chocolate chip muffin, and then he had to explain the way in which the chunks hurt his teeth, and he didn’t want the chocolate chip muffin, not that he doesn’t like chocolate.

Wow… This sounds like something you’ve actually experienced.

Yeah. But this is all of us, in different ways, to different degrees, all the time. So if we don’t hold a certain degree of awareness of ourselves and what’s going on and how we see things, it is invariably going to affect the way in which we make sense of our world and do our relationships with others, and vicariously manage our own mental health.

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