S1E3: How 'strong' is your mind?

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Transcript S1E3

In today's episode, we're going to talk about how to move your mental muscle to get stronger, faster, and more efficient. And then I'm going to share who are the mental fitness experts and how to spot a good one. So stay tuned until the end. Hi, welcome to is like this podcast, the show that explores your mental and spiritual health, with analogies, common sense, and stories. I'm your host, Dr. Uejin Kim, a board-certified child and adolescent, and adult psychiatrist from Texas, I am passionate about helping people understand their intrinsic worth to accept and own their life so that they can live the life they were designed to live. While I'm a psychiatrist, I'm a human being too. I came a long way, but I have way more to go. I hope you will join me on this journey.

So in the last episode, we talked about if you're ready to run our mental health, race, and how as lifelong and as every day, and everybody has their journey, and it looks very different. Whether you have mental health issues or mental health disorders, you know, we're all running the same race. One of the two components of running the race is exercise and nutrition. And in this episode, we're going to tackle the exercise part. We talked about the cognitive triad, you know, in the second episode, if you imagine a triangle, there are thoughts in one corner, behavior in one corner, and emotions in the third one. And cognitive triad is a concept that explains that thought affects how you feel, and how you feel affects how you act, and how you act or the outcomes of your actions. kind of pleased with your thoughts again. And if you want a little bit more details, I do strongly recommend you to go to the second episode and listen more about that. So cognitive triad is the muscle in this metaphor. And moving that muscle is the exercise piece of this metaphor. The whole point of mental fitness is about how all three thoughts, emotions, and behaviors are connected and understood, and moved together. The reason why I focus on them being connected and understood and moved together is that very commonly, we focus on only one aspect of the cognitive triad. Imagine a guy who works out only his biceps and triceps and upper body and doesn't work on his lower body. And we all know that person in the gym, right? It doesn't look right. And it doesn't work, right. So for example, behavior is a very easy thing to focus on, because it's visible and is tangible. So when you focus only on behavior, it leaves the thoughts and emotions unchecked. So a lot of times we see this as, quote, unquote, out of character behaviors. You know, like, there, a lot of times I see like, Oh, they're good dad, but as his drinking problem was, you know, out of control. Two out of character behaviors are usually due to unprocessed feelings, or desires and fears that are kind of working behind the scenes, and then kind of comes out in a random moment because we're not aware and checking them. So from patients, I hear things like this is not who I am. But what I really mean is, that this is not who I want to be. Or on the other hand, a lot of times people focus on just their feelings. And when you are just focusing on feelings, and not focusing on thoughts and behaviors, it leads to the problem of having a lack of responsibility, and ownership of that behaviors and words. So sometimes we hear people say, this is just who I am, deal with it, or you're making me feel a certain way, so I'm not going to deal with you or you're dead to me. And these are not necessarily problematic until the problem happens. And they don't take ownership of what they did. So you know, we talked about problems of not recognizing the cognitive triad as a three-part movement. So I'm going to lead into what fitness looks like. And there are different stages of working out these muscles together. The key to mental fitness is awareness, acceptance, control, and challenge. So let's dig a little bit deeper. So awareness and acceptance kind of go together. You know, when you're starting to work out, you have to know where you start, how much you can run, how much you can lift, essentially is the same thing as water you thinking and what are you feeling right now, no matter how immature that is, this is a beginning. There's no shame in this. And you're only going to get better from here. Planet Fitness by having the motto of no judgment zone attracts a lot of people who want to start to work out. But as intimidated by this gym scene, right, there are a lot of people who are ahead of the race, and they get really intimidated. And just by putting it out there, and no judgment zone,

it creates a very inclusive atmosphere, where it accepts everybody at their point in the journey. And this is the same attitude in the mental fitness journey, because we have to have awareness, but also acceptance, and they have to go hand in hand. And really, what is the benefit of judging the beginning of anyone's journey, right? Like if the person couch potato walks into the plan of fitness, and you're like, Oh, my goodness, like, he is so big, and he's so weak. What's the point in that it just discourages that person from starting their journey, it doesn't lead to anything but shame. Another example is maybe you're anxious, and there are “real reasons to be anxious.” And maybe this is a #first world problem, that's okay. This is how you feel, let's not jump to judgment or finding the legitimacy of your thoughts and feelings, you know, or even behavior is just where we start. Let's just accept that, in the end, give yourself permission to feel what you're feeling and think what you're thinking. And I say permission because we permit other people to share what they're feeling and thinking, and you're just as valuable as the next person. But sometimes we are the harshest critic of ourselves. And that's why I kind of say, give yourself permission to feel what you're feeling and thinking what you're thinking, accepting our feelings and thinking is very, very difficult. And maybe it's because you and I grew up, or we're in a culture where we were judged and put against some kind of standard of good enough. When are you worried about a legitimate thing? Or are you worrying about nothing? You know, there was a certain idea of good thought and bad thought, good emotions, and bad emotions. You know, but at the end of the day, if you sit back and think, who made that rule? And what was it based on, that rule that you went by was based on the comfortability of the authority figure who made that rule? Okay? That parent figure didn't feel comfortable with you being mad and sad. So they said, Don't cry, you know, don't be mad, or don't be sad. So there is a rule-based on their comfortability, okay, if you're listening to this, then you have some kind of authority and autonomy over your life. Now you have a choice to consent to that rule. As a minor, you know, you didn't have a lot of choices that were just kind of the rule of the house. But now, or maybe even if you are a minor, you have to know that you don't have to follow that rule of thinking, quote, unquote, only good feelings are only good thoughts, there's no such thing. So you have a choice to consent to that, you get to decide what you allow yourself to be measured against. And again, when we're talking about awareness and acceptance, there's no point in judging good enough thoughts or good enough emotions, there has to be accepted, to be present, like those thoughts and feelings to be present, so that we can work with it. So accepting is part of maturity. And I want you to choose the mature route than the immature route and deny that it ever exists. And the second thing that I want to mention about acceptance is accepting is not tolerating or excusing. It is just accepting the presence of that emotions and thoughts. It will be tolerant, and an excuse if you accept it, and just do nothing about it. But we're going to do something about it. So it's not tolerance or excusing. And the last point about acceptance is, if you don't accept yourself, who will accept you, I'm in my 30s, and something that I learned about the world is you cannot seek acceptance from other people. If you don't accept yourself. If you have that somebody who accepts you when you don't accept yourself. It creates a lot more drama and a lot more problems, especially like enmeshment Okay, or codependency and that's not healthy either. And I think mental fitness you're going towards independence and maturity, we have to start with awareness and acceptance. So the next part is control and proper form.

So when I was in college, I was in a rowing team proper form. And rowing is so important because if you don't have the proper form, then it flips a whole boat, and it affects you and your crewmates. So in the beginning of the training, there's a lot of time devoted to learning the form and also building that muscle memory. Of course, you're going to continue to work on your form all the time. But once you have that muscle memory, it really does become a part of you. So since controlling mental fitness is like that, increasing the comfortability in awareness and acceptance, it does take practice. So the practice of being aware and accepting your emotions and thoughts can be really awkward. It could be weird, it could be doubting, like, like, Can I do this, but over repetition, it is going to get better, and it's going to become more natural. Some other ways to practice. And repeat the exercise of awareness and acceptance is journaling, meditating, and other grounding exercises. And I'm going to make an episode of guided meditations so that you can kind of keep that episode and play it over and over again. So basically, components of awareness and acceptance in these practices are capturing every emotion and thoughts and writing them down, or holding it in your head like mind space. And you're exploring wise and what and how so, you know, you're, you're starting to become really anxious, you know, and you sense that you're anxious. And in your head, when you're meditating. You're asking, like, why do you feel anxious? And what happened that triggered that anxiety and you're asking those curious questions to understand your feelings. And sometimes that feeling comes from memory from the past. And understanding that memory, and understanding what happened and how is linked to what's going on right? Now, you get to really understand that emotion, and you get to kind of project more control over the future. So if next time I have a triggering, you know, event, then I can kind of come back to this, you know, mental space. And know that is from that particular event in the past. And doing this is going to prevent unchecked behavior from acting out without control. So in this whole process, you're maintaining and sustaining control over your thoughts and emotions. And you're learning the form of being curious and exploring the mental health space. So that it doesn't lead to the behavior or further consequence of this cognitive triad, kind of spinning out of control. So not having the proper form of mental health, and fitness can often lead to injuries. And one example is trying to control what is not in our control. So there is a serenity prayer that says, God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference. So oftentimes, I hear like, you know, my spouse said this to me, and I cannot believe it. And I'm feeling this and I'm thinking this and I behave this way. But if that triggering event was someone else's behavior, you cannot control that you can only control what you're thinking and feeling and acting. And when you just focus so much on trying to control the other person's behavior. It often leads to injuries and inefficiency. And it sometimes backfires. Often we people kind of who live in the past, have shame and guilt or regrets, you know, I should have done this, I could have done this, I would have done this. And what if I did this, this is part of the improper form as well, because the mental health fitness journey starts today and you're moving forward, and you cannot change the past. So focusing on the past often leads to a lack of performance and lack of growth, because you can't go back and time travel and change the past. So this Serenity Prayer is a really good one when you're doing mental health fitness journey because we need to learn what we can control and what we can do today. The next part is a challenge. You know, when you're working out when you start this fitness, just physical fitness journey, people say I want to live have heavier weights or people say I want to run more distance, or I want to run the same distance faster. So what does that look like in a mental health fitness journey?

So when you're more comfortable and in control of certain emotions and thoughts and recognizing cognitive triad and you're studying it and you're making small changes of how to behave, and act on it more in control. Now you get to decide what to do with it. And what I mean by that. As you get to decide which direction you're going to go, you know, if you're going to let go of some people who are not helpful and sometimes hurtful, and reprioritizing, your value, so works important or not as much, and you get to resist addictive cravings, you get to work on forgiveness, or accepting healing, all these things are going to be chapters of your fitness journey, and is going to overtime, more and more aligned with your values. And that's how you become a mature and wise and more integrative person with your values. You know this is when you can say, my actions, and my thoughts, and my feelings are aligned with my values. Now, please don't miss this. And remember how I kind of talked about it in the beginning, when people focus more on behaviors, first, you know, or only behaviors, and then leads to unchecked emotions and thoughts. Another way to phrase this is, if you are trying to pick up the heavier weights before you're ready, right, if you're trying to enter into a chapter of forgiveness before you're ready, it produces high functioning individuals who look very mature and wise on the outside or on their good days. But on their bad days, you get to see what's really inside. And usually, that's emotional immaturity, with a lot of hidden emotional behavior problems. And that's why, you know, behavioral-focused, you know, the approach is very different from what I'm talking about here is challenging yourself with control with proper form, with awareness, and with acceptance.

Hi, this is Dr. Kim. Again, thank you so much for being here. I hope that these episodes have been really helpful for you. I just wanted to take a moment and let you know that I have a SpeakPipe link in my description box. This is where you can record your questions and comments so that we can connect and get to know each other. And I get to know what you want to hear more of.

Let's go back to the episode. So in the last segment, we talked about what exercising your mind looks like, right? There are different stages of growth in your fitness journey. And now I'm going to talk about who are the experts in mental health fitness. An expert in fitness is someone who can teach you the proper form, exploring different muscle groups to be activated and motivating you to push yourself, like bringing you out of the comfort zone and challenging you to grow. And you might be needing the expert at different points of your fitness journey, especially in the beginning when things are overwhelming. And you want that expert to kind of, you know, bring it down to digestible portions of the exercise or kind of get you jump-started into exercise. Or you could need an expert later on in the journey where you're like, you know what I'm reaching the plateau, I don't know how to tweak my regimen to reach the next level. So these are the points where you might consider having an expert and mental health. You know, mental fitness experts are just like that, you might be needing a mental fitness expert in the beginning or later in the line when you're tackling some of the issues that are really difficult for you and you handled a lot by yourself so far, but you're just kind of like oh, I need to just kind of get a second opinion on this. So mental fitness expert is not necessarily a sign of weakness or inability on your part is just an expert who can guide you through it temporarily or for a long period of time, you get to decide how you're going to use the mental fitness expert. So mental fitness experts are who help you in the process of acceptance, awareness, control, and challenges. And this group of experts is psychotherapists or “talk therapists.” Now, there's a lot of you know, lingos out there, so I'm going to try to explain it as I go. So really therapy and Webster's Dictionary just means treatment of illness, just like IV therapy, you know, infusion therapy or something like that other medical field or other non-medical field uses therapy to mean treatment. Okay, but psychotherapy would be a more specific term, and it will translate to treatment of the mind because the word psycho means actually just the mind. So other terms that are very similar to psychotherapy is like talk therapy, counseling, or just the word therapy because, you know, people use therapy to mean talk therapy. So there is a lot of different therapists credentialing out there and I am not in this group, so I'm not familiar with it, but there's LPC there's LM Ah, see LCPC and then there's Ph.D. So I know that it can kind of get confusing with all these acronyms, but they're a licensed, you know, counselor, mental health practitioner, or psychologist. So I won't get too much into the details other than these different licenses require different levels of training, like duration and depth of it. And they have their pros and cons. But there's a big group do one would most training like academic training, his doctorate of psychology, so his Ph.D., and also there's different types of therapy, it can get, like very general and superficial, specific for different disorders or very in-depth. So the most general and superficial level of therapy is called supportive therapy. And it's just kind of being next to you, and just letting you kind of speak your mind and just showing empathy. There's more protocol-based therapy called, cognitive behavioral therapy, and is very streamlined into what to say what to challenge, and you know what to look for exercises, and homework to do. And there's a different very specific therapy technique for, specific disorders, like eye movement, desensitization and reprocessing, or EMDR therapy that's very specific for PTSD. And it doesn't mean that is only used for PTSD. But that was kind of how the therapy was designed for. And there's a very deep and intense therapy like psychoanalytic therapy, and there's faith-specific therapy like Christian counseling, that incorporates more religious values. So there are a lot of therapy options out there. And there are roughly two approaches to starting to look for an expert in mental fitness. So approach number one is to find a therapist, just anyone. And all therapists are supposed to give you their assessment and plan and see what they recommend or if this is a good fit for you, and then see if you need another type of therapy or add a medication with therapy. So that's approach number one, just started with a therapist and go from there. Approach number two is to meet with a psychiatrist who has the power to prescribe medication and see if you need just the medication with the psychiatrist or if you need both medication and therapy, or if you just need a therapist. So little caveat here and you know, as a prelude to the next episode, I am going to talk about the nutrition portion. The difference between a psychotherapy psychotherapist and a psychiatrist is that therapists cannot prescribe medications and a psychiatrist could do therapy. And every state is different. But in Texas, there are mid-level providers like nurse practitioners or physician assistants, they can also prescribe medications with psychiatry supervision. When I say psychiatrist, I also mean providers that can prescribe medications. Okay. Now, you say Dr. Kim, you mentioned two approaches, but how do I actually figure out which approach is right for me, and how I would approach it as if you think you only need help with how to work out your thoughts, emotions, and behaviors, then you can start with seeing a therapist, they're a little bit more cost-friendly. And also the weight might not be as long. So you can start seeing a therapist see that. But if you're not eating right, sleeping, right, and having a really hard time even starting to be aware of your thoughts and feelings, because there is maybe evidence of biochemical imbalance like is affecting your sleep eating, you know, your mood is way out of your control, like there's no way that you're going to bring it down and do meditation, then I will start with a psychiatrist to evaluate if there's underlying biochemical imbalance. And then once you start the medication, then that really gives you more control to start engaging in therapy. So if you are on a fitness journey, not all coaches, not all trainers are created equal, right? Like there's a good one and there's a bad one. And just like this and mental fitness experts, there are good ones and there are also bad ones. Now I'm going to share three things to look for to spot good mental health fitness experts. Number one, they're engaged. They're paying attention and studying your movements and forms of the cognitive triad. How you're going to see this in real life is you're they're very engaged with their body language. They're saying, huh, and like they're raising their eyebrows and they're really paying attention to what you're thinking and feeling. Okay. And they might question you're like, you know, what I noticed is you said the word blah, blah, blah. Or can you say What you just said in a different way? Or what do you mean? They ask you a lot of clarifying questions. And sometimes, as a patient is kind of frustrating because they're intervening way too much. And, you know, you can have way too much intervention, of course, because it stops the thought flow and all that stuff. But they are paying attention. And they're kind of cueing into what you're saying, and thinking and feeling. And they're really bringing the light, you know, into your cognitive triad spinning. Okay, so they're engaged, that's the first thing. The second thing is they're empathic, sir, they're on your side, and being in that uncomfortable space with you without judgment, but maintaining curiosity. So this is, the beauty and healing power of therapy is that you have somebody who's hearing your narrative, who's hearing you out, and really being there in a dark and uncomfortable space, and just with you. So some of the things that I heard my patients say is like, some therapist told them, like, oh, I think you're overreacting, or I think you're worried about nothing, or I don't think that's true. You know, they just really put the patient on the more defensive side. But empathic ones, they say things like, I could see why you felt that way when that happened, or I sense that you're sad about what happened. And that is an appropriate reaction. You know, there's no judgment, there's understanding, of course, nobody's going to understand what happened to you like you do, because it happened to you. And it didn't happen to the rest of us. But they're empathic, they're placing themselves in your shoes, and really trying to feel what you're feeling. And that's a second thing to look for in a good therapist. Third, this is going to be the going back to the last episode, no pain, no gain, but they are proactive and challenging and pushing for your growth. So this is when a therapist says like, Oh, they're not saying anything, they just let me vent. This is not a good one, because they're not challenging you to move forward. So they ask you a lot of like, thought-provoking questions, and sometimes you might feel offended. But as long as the therapist is saying it with a good intention, and it just feels offensive, because you're not comfortable with it, that's a sign of a good one. And they say some things like, what would it take for you to be motivated to quit drinking or doing drugs or, you know, cheating on your spouse, you know, like all these challenging questions, they're asking that in a very non-judgmental way, but also challenging way. So that's the third thing to look for when you want to look for a good therapist. 

So in summary, it is like this: mental fitness is moving all components of the cognitive triad through each stage. And don't be that guy with huge biceps and no lower body muscles, okay. And you can achieve a mental fitness routine by yourself by journaling, or meditating. And sometimes you might need guidance from an expert, aka a therapist, and not all therapists are created equal is a skill. And it's also not related to the number of training years or academic years that they have is not related to credentials. To be honest, I might have not been a good therapist in the past the therapy skills I gained actually comes from starting my own mental health journey. So I would say that number of years of academics, you know, doesn't really mean that they have a good therapist. And also as a style, you might have to try two or four therapists before you find the one that you connect with. And you can really get along with so do not give up, but also not settle. So I just wanted to give a quick shout out to my listener on the Apple podcast platform, but they had a question, you know, what is the best way to help a friend with depression, and this is a real struggle and pain, you know, for somebody who you're seeing suffer from mental health disorder or issues. And just going back to the mental fitness, I think the most important thing that you can do is be aware and accept their thoughts and feelings without legitimizing them or finding the cause of the problem about it. And kind of tying back to the role of the therapist is empathy. But also knowing your limits, you know, and knowing what is out of your control is you can't make that depression go away of somebody else. But you can help them and point them in the right direction. I would recommend that you suggest, you know, if they're in crisis, be next to them to call the suicide hotline together or make that appointment with a therapist or psychiatrist together. But also knowing that you can't fix it or that it is your responsibility to fix letting them have that independence and autonomy in their own journey. I hope that answers the question. And if you guys want more information on this, definitely let me know. So you know, my love letter from Dr. Kim to you guys. Remember, we're in the same race of mental fitness journey and we're doing it together. And I thank you so much for your time. And I am going to talk about nutrition and I'm gonna delve a little bit into biochemical imbalance and what does it look like and what does the expert of psychiatry you know, managing “your mind and nutrition,” I really encourage you to come back to the next episode, and have a great day. If you like what you heard today, please do me a favor. Go to the podcast platform that you're using to listen to this podcast, and leave a review, subscribe, and share with people who you think would benefit from this podcast as well. Also, remember to ask me what you want to know more about using the SpeakPipe link provided in the description box. Again, I really appreciate you listening in, and have a great day