Nick Sanders 0:00
Alright guys, today I am with Cara, Alex and Aaron, we are going to talk about some of the mental aspects in life, Sport, Fitness, Health, all of those kinds of good things, Alex brings his professional background, and then the rest of us are going to add in something, we'll see. We're gonna see how it goes. Hopefully, we just, hopefully, we just have a good discussion on some of the mental aspects that we see as health providers that Aaron sees in the gym. And then when you should seek out help, what help looks like and some of those types of things. And I think some of the stuff that I've been interested in is not just like crisis help, but just optimizing the way you feel and kind of making decisions for the day. So let's see where it takes us. Alex, go.
Unknown Speaker 0:52
Happy to be back. But too, I'm like wearing a different hat today. And clothes and clothes. Yeah. And then literally the different clothes. So last time, I talked a lot about kind of just life in the bike world and all that. But I come from a pretty long mental health background. I started in undergrad back in oh five. My credentials are what's called the clinical counselor. So I hold the state license through Ohio, as a licensed independent clinical counselor, and then I have a secondary license called a independent chemical dependency license. So I kind of hold a specialty both in behavioral health services and chemical dependency services. And then recently, last year, got my MBA in healthcare administration. So run a program at a local hospital here in the Cleveland area. And yeah, just kind of like been around a lot of different areas, from outpatient services to inpatient services, and basically everything in between from adolescence to adult. So yeah, that's a, I guess, a quick and dirty kind of summary of 15 years.
Unknown Speaker 2:08
So what are you doing currently, right now,
Unknown Speaker 2:11
currently, and for about the past five years, I work in what's called intensive outpatient program means that people seek services become daily, they're enrolled in the program for about two months. They attend daily for a few hours a day, and we go over basically, different types of topics in group therapy. Each hour is a new topic that's discussed. We work a lot in what's called cognitive behavioral therapy, skill development. So CBT, a lot of people are hearing that now, like you hear like apps that are kind of coming out with a lot of basic, rudimentary like CBT skills. So we kind of dive into that a little bit deeper, kind of basically equip people with a lot of different types of coping strategies, giving them a place to talk, prod, do some processing, get some medication management through some professionals at the hospital, and then eventually work on discharging and titrating them down through some outpatient services.
Unknown Speaker 3:13
Are there different sizes of groups? You will? Yeah, so
Unknown Speaker 3:17
we've, right now, I, you know, I'm sure we can get into a two COVID is just been a whiplash of changes over the past two years. I would say in the past, it kind of averaged around 12 to 15 is your average group therapy size. We've like doubled that, and added second groups and have kind of doubled the senses in those group groups, too. So we're working on expanding not only in kind of the downtown location, but both in the east and west side suburbs as well, and adding multiple locations there. So we're still trying to shoot for that, like 12 to 15 individuals in a group setting, just so everybody has a chance to talk, you know. But yeah, we've just really have really kind of been bursting at the seams with people who are really looking for some behavioral services right
Unknown Speaker 4:09
now. So is each group have kind of its own subcategory?
Unknown Speaker 4:14
Mm hmm, yeah. So in the past, so a lot of times to make sure we're addressing the needs of the people in the group will basically go through like a formal intake process. If people seem to be kind of struggling more with substance use services, we'll put them in that group. If people are kind of expressing more maybe on the depressive anxiety side of symptoms, we'll place them in another group and then we'll kind of tailor the skill development groups for each session and kind of based on what those cohort of individuals are experiencing.
Nick Sanders 4:51
Work Yeah, so I think along those lines, what kind of people seek seek you out mostly?
Unknown Speaker 4:58
I liked that question because As I think a lot of times people are pretty unfamiliar with, like what group therapy looks like. And you'd be surprised how many individuals actually seek out group in that format. It is everyone from people who are on maybe having a gap of employment, or maybe I've really struggled to find a job all the way up to, you know, probably what you would categorize as like higher functioning individuals, doctors, lawyers, teachers, I mean, it's a, it's a wide spectrum. And honestly, that makes for a really good group dynamic. I mean, people who come from different backgrounds, speaking the same language about having the similar types of struggles, it really actually can really benefit the group dynamic and conversation. So I mean, to answer the question, it's everybody.
Unknown Speaker 5:48
Yeah. What's the difference between, you know, going and seeing like a psychologist and going to the hospital for group set for group setting?
Unknown Speaker 5:56
Yeah, that's another good thing, I think that can be kind of confusing. There's all these titles in the mental health world, right? psychiatrist, psychologist, social worker, counselor, basically, we kind of do variations of similar types of things, you know, going to individual therapy, gives the person an opportunity to have maybe a little bit more focus on something that they might be going through. And oftentimes, I think that's a place where a lot of people start, but maybe you're having a hard time really getting, you know, through some of those issues group can be a great opportunity just to kind of give a little bit more attention to that. So I guess the kind of, like, summarize it, you know, you can seek out services for you know, individual appointments, really kind of hone in on what's going on. And you can get those needs met through independent social workers, psychologists, counselors, we all provide the same types of services and outpatient programs.
Nick Sanders 7:02
So I guess, you know, on my side, for most of our clients, right, there's, there's a person that is dealing with high levels of anxiety and depression. And then there's also this side of just like, you know, maybe we're not at a clinical level, but like to feel better, we'd like to perform better like to make better life choices. What kind of resources are out there for the person just kind of struggling on the day to day or just looking to improve? Yeah,
Unknown Speaker 7:31
yeah. Um, general self improvement, you know, can be done in outpatient therapy, like one on one types of things, you don't have to have like a specific diagnosis or expect to be like, diagnosed with blank mean, doesn't really matter. I mean, when you come in and sit down, you talk about what's going on, and what types of struggles you might be having in the moment. So you can, you know, have what's called short term sessions, I mean, maybe it's like six sessions, and CBT really lends itself to working on things in a short, short term kind of way, right? Right now, what we're, our goal is to try to capture people who might be experiencing things like that is, a lot of social workers, Clinical Counselors are getting paired up in primary care physician offices. So those are great front lines, to be met with somebody who might be saying, like, Listen, I'm going to work, you know, I can get the job done. But it's just like, it just seems like I'm not at my best right now. It's a great resource for a primary care physician to say like, Hey, we got some access to social workers and counselors right now. And maybe it's like six sessions just to kind of strategize or gameplan and really give some focus or attention to it or just have different types of conversations that maybe other people in your support circle, you just don't really feel comfortable getting that detailed with it. Talking to a professional can be a great place to just kind of really kind of open up a little bit you know,
Unknown Speaker 9:11
essentially anybody can kind of walk in and get service they'll need a physician no or
Unknown Speaker 9:17
no not at all. Yeah, there's so many different types of ways you can do that there's private practices in Your Community Psychology Today, which is like a just kind of a catch all website for news articles. It's kind of light hearted and stuff like that, but they do offer some like professionals in the area that a lot of people linked up to and you can go private practice and you know, just basically take it session by session, but yeah, you don't have to be like have a formal kind of Bath. I've always you know, I'm coming from like that medical background where I will probably speak to that a lot, but you don't have to have that like ticket to enter, you know, yeah, that makes sense.
Nick Sanders 9:58
All right. I know you guys are doing Some stuff at the gym, kind of along those same lines, like what kind of things are you seeing? And what kind of things have you been doing at the gym?
Unknown Speaker 10:08
Yeah, so typically, like, what we see is a lot of those cases that maybe, maybe the people aren't like quite at a clinical setting just yet, or maybe they feel like they have some of their stuff together. And like some of their stuff like that they struggle with like habits and daily habits, things that affect, like, their health long term, but they just can't seem to like make a shift or make a change, and you know, how they see themselves or what they see themselves doing every day. So really, what we try to provide it, at least at our gym is access to some mental health professionals that, you know, can help them with eating habits, sleeping habits, daily habits, you know, I think some people that they come in, at least to our gym, you know, they they are here for a reason. And it's not because they just, they want to get fit and have fun, but they themselves have had trouble making changes on their own. So they've seeked professional advice. And I think like fitness has provided them like an outlet. And it's one piece of the pie. But I think the bigger piece of the pie is like the mental health and you can web off. Again, like what Alex just said, you can web off and a lot of different areas with this stuff. You know, some people struggle with substance abuse, you know, some people, maybe you've experienced things they have, you know, PTSD. So like the list goes on and on. And like that's going to obviously have an impact on how they eat, how they sleep, how they work out? Or do they even see themselves as being capable of like making a life change that gets them to a healthier spot. So what we're trying to do is link up with, with mental health professionals to try to almost, I think there's a stipulation, like in the, in the public that like, Hey, I don't need to see a therapist, like, if I see a therapist, that means I'm like really struggling, but I think more people could or should be open to therapy than what there are now. I personally see a therapist, it's helped me tremendously, but we're also trying to bring down the barrier in which like, hey, where do I go? Like, who do I turn to? I have no, I don't know where to start. So that's another thing that we're trying to help people with is just getting started. And then leaving it up to guys like Alex to you know, you work as magic.
Nick Sanders 13:03
Man, there's a lot of insight and lots a lot to unpack in that and what you just said, but I love that that vision of like the people that are coming to your gym are looking for that guidance. And then yeah, how did the mental side of that is so important. And I think the reason we wanted to all get together was that, whether we had to we did a podcast with Alex. So we did a podcast with Aaron. And both of the podcast started with separate topics, but they ended up with this, like mental health. We're like, Alright, we gotta get the whole crew together here. What's that? And I think, if I correlate it to my world of physical therapy, you know, you got these people that are in like post surgery, rehab, physical therapy, and then you got super performers, right? They're just at the top of their game. But like everybody, most of us at least live somewhere in between where we're not broken. But we're also not performing as well. So, you know, we try to hit that gap, right of really, you know, helping people optimize. Where is that in the mental health world? Right? Like, like, there's clinical depression. And then there's what Aaron's talking about how I mean, Alex, Aaron, Cara, like how do we serve? Where I would conserve? I've put myself in that category of like, man, there's some things that I could do to improve my mental game. Where's that live? Alex, do you think?
Unknown Speaker 14:22
So? I think they're, it's funny, because I use a lot of like, exercise type analogies when like working with individuals. And I totally agree that, you know, in a lot of ways people kind of fall in the middle. And in all, I think both of our works, things are just so much on a spectrum, right, of how people are maybe coming to you right, and how they walk in the door. And I think we've always said just kind of meeting people where they're at, you know, and that's a term that we use quite regularly. So like how how do we kind of fill that gap is kind of seeing where where people are, and basically just kind of really trying to vision out what does functioning look like. And maybe that conversation looks like the same as like mobility as it does with like, daily performances and things like that. But like, where are we breaking down at? And what are we really struggling with? And for some, you know, it, I think there's a really kind of foundational thing that sometimes needs repairing, you know, and to, to offer different types of techniques. Basically, get in the rhythm again, you know, revisit the skills again, if it's literally, you know, physical movement, or if these these behavioral change skills. I think it kind of means those cracks a little bit, we start to rebuild, you know, people's personal foundations.
Nick Sanders 15:50
I have very little knowledge in your work. What, what does that mean? Like foundational skills are things that are missing? Like, can you dig into that a little more?
Unknown Speaker 16:01
Yeah, it's, it is kind of like, I don't want to drone on too much. But I guess when we look at, if I just kind of use the term from like, CBT, right, looking at, like, our thoughts, so cognitive behavioral therapy, so like, what types? Like, how do we what is our self talk look like? Maybe, maybe I didn't get to the gym, you know, and my plan is to go three or four days a week, and I skipped it, right? And I skip it. And I kind of just feel like, oh, like, here I am. Again, I'm messing up, not meeting what I said, I know, I cancelled my personal training session. And then like, here, I am kind of feeling like I'm flooding again. Right? So it's like, people get into these thought patterns where like, they start to negatively critique themselves. And so following up with checking in with, like, what is your self talk look like? behavioral strategies would mean something like, how do you take care of yourself? How are you eating? We ask those questions. I'm not a dietitian, but I'll say like, you know, are you eating and sleeping, you know, and that would be a certain type of foundational skill that it's going to be hard to access, you know, some of these personal wellness skills, you're not starting off with getting a healthy amount of sleep, you know, if you're, if you're really kind of staying out, maybe you're, you know, drinking a little too, not too much at night, and you're trying to get to work in the morning, and you're running out a little sleep and they're slamming coffee, and then now you're expecting yourself to go to the gym at five o'clock. Like, we kind of got to start with what was happening yesterday to address what's happening at 5pm today. So I think that's kind of what we mean by like, foundational, it's like, there's these things that can be really healthy for ourselves for paying attention to, you know,
Unknown Speaker 17:45
do you use, like, SMART goals in those aspects? Like, where, like, can you? Can you dive into that a little bit. I'm
Unknown Speaker 17:53
smiling, because today's Friday, and in group therapy, every Friday, I run a SMART goals group. merging together. Yes, I'm huge into goal setting, I will. So I mentioned that I do group therapy. I should also mention that my afternoons are all individual therapy to so half of my day is group therapy. Half of my day is individual therapy, I end my group sessions with goal setting, and I end my individual session for full with goal setting, it'll look different kind of depending on the session or the day or that time of the week of what we're working on. But being really specific, right. Measurable, action, focus, realistic and timely. The thing that has happened is like smart goals have creeped into like corporate world. So people are like, ah, SMART goals. Like, okay, try to like just drop that for a second. And but think about like, what are we trying to achieve, like, tomorrow, you know, and being really specific with it. Like, I want to be up and out of bed by 9am Because when I sleep till noon, and I start my day, halfway through the day, like I don't feel so good, you know, come 3pm And I've only been awake for three hours. You know, I've kind of missed my day to kind of like starting in the hole a little bit. So setting a really specific goal for myself. I want to be up by 9am and I want to be maybe dressed and kind of
Unknown Speaker 19:22
rise obtainable? Yeah, right? Yeah. Do you have
Unknown Speaker 19:25
each person do action steps as well for that SMART goal.
Unknown Speaker 19:28
We tried to break it down a little bit. Um, and if we need to, you know, we we break them down further and we break them down further. So sometimes people will start and they'll set these what's feel like specific action focus, measurable kind of realistic stuff, but then we got to kind of go back and take a step back and like break it down a little bit more and break it down just a little bit more. So yeah, sometimes we tried to like really set like what would stuff one look like to kind of transition through your morning to get you up and out of bed. You know what What could you do? You know, people say like, Oh, I'll put my phone on the other side of the room, you know, things like that just to kind of help break down a barrier. So part of the other part of goal setting is anticipating obstacles. Like, I know that when I'm like, not a morning person, right? And so if I'm, if I, if I know that about myself, how do I set a goal around that rather than setting this really high expectation for myself? missing it, and then reinforcing this thought pattern? Like, here we go, I can't do anything. Right. You know, so yeah, breaking it down and coming back. And like, sometimes you got to revisit those things more than once. And yeah, make a couple of steps.
Unknown Speaker 20:39
I like that idea. Like breaking it down. It's, it's like a hierarchy, right? It's like, Okay, this one is, you know, maybe a little, I wouldn't say too far fetched, but maybe it's not the right time. for that. You take a step back. Yeah. That's pretty cool.
Unknown Speaker 20:57
So do you see a lot of times when people are kind of overreaching with their action steps and
Unknown Speaker 21:06
you remember last podcast about the pizza analogy. So just to kind of refresh everyone's mind on the pizza analogy, we talk a little bit about creating stretch goals, right? So stretch goals in line with smart goals, meaning, I'm putting myself just outside of my comfort zone a little bit. If I stretch too far, but go too far out. Again, I kind of rip the dough, right. So we want to need the edges of the dough, right? Until we have the full pizza ball spread out on the pizza pan. You can listen to the last one if that doesn't make a whole lot of sense. No, I totally. Okay,
Unknown Speaker 21:46
did you also work at Papa John's too
Unknown Speaker 21:52
didn't hear the pizza analogy the first time they're like, I got half of that. There's about long story short is work your edges, you know, and I think we just want to set ourselves up to like, have small wins and celebrate small wins too, because that's important as well, like, did you do? Have you been out of sync, and maybe you had this as a habit like two years ago or a year ago, this is really good. I think for like, pre pandemic thinking to like, where people are now. And I think that's a big thing. People are like, comparing themselves to like, I was in this mode of functioning forever, I got completely derailed, you know, maybe my, you know, working from home and setting me off, I'm just not moving as much as I like, got out of this habit or that habit. And so like really thinking about, okay, like, how do I kind of walk my way back towards that maybe it doesn't happen all at once, though, and to be so ambitious to, you know, make this plan that we're gonna ride there all at once, I think is, you know, setting people up sometimes for failure.
Unknown Speaker 22:59
Like, Nick, we've mentioned this on a previous podcast, like people came out a COVID. And they were like, really excited to like, do something different. And now Kara and I have talked about this, like, we've we've seen some parallels now that like things are transitioning out of like that, that shut down like period of time. And people are comfortable going back to work, at least for the most part. I'm seeing old behavior pop up, like old behavior that was broken to begin with. Were like, maybe coming out of COVID people who understood like, you know, I should take care of myself, I should do a better job of like, giving myself a moment to breathe over the course of the day, like all these, like, we look at simple things, but maybe for them, it was like very new. And then now that old routines are being put in place again, and things are opened up, back up to almost full capacity. People are like, You know what, I don't have time to breathe, I don't have time to sleep. I don't have time to eat. I don't have time to work out. I don't have time. I don't have time for any of it. I just got I got to work, I got to take care of my kids and I got to do all this other stuff. And then like they get to the point where wait a second I I was doing all of this and now I'm not and I feel like a failure and then like they have to deal with that. And it's just it compounds and it gets to this like all or nothing like attitude like people were either doing it or they or they're not and there's like no sustainability to it because they can't find that middle ground.
Nick Sanders 24:38
You just described my last two weeks
Unknown Speaker 24:45
but yeah, it's crazy man like these are these are things that like I see in the gym, that again, maybe it's not quite like correct for a clinical setting but I can tell There's a, you know, there's a gap like for, for a lot of folks as far as like them being able to control their behaviors and like analyze self analyze their emotions, their actions, things that they go through every day, instead of just like, forgetting about it.
Nick Sanders 25:21
Yeah. I mean, I, like I said, I live that I think there's so many of us that deal with that at some level or another. What do I mean? What's the what's that? What's the answer? But like, where do we look? What's the, you know, what are the options?
Unknown Speaker 25:37
Good questions?
Unknown Speaker 25:38
I, I think we, I think what we're doing right now, the three of the four of us like, together on this, like, this is what it's going to require is like, instead of things being siloed off, and things being separate, I think we probably understand as well as any, like, there's more gray area in the world than there is like black and white. And teaming up and having these conversations helps to kickstart like different actions. And that's like, it's very easy for me to refer people to care, and have her work with people that are, you know, in the gym. And, you know, the next step is going to be having people like Alex and other health or other mental health professionals, and around fitness environments, so people get more comfortable, you know, having their, you know, having their access to, you know, stuff that they felt like before, maybe it wasn't right for them, but then they can warm up to the idea because they see it more often.
Nick Sanders 26:46
It's in an environment already comfortable. Yeah,
Unknown Speaker 26:49
I mean, more people go to the gym now than ever before in the history of the United States. But yet, we still have this overweight problem and mental health problem. And there's more information being put out in the public about both than there ever was before. But yeah, we still have this going on. Like, it becomes a instead of an access issue, it becomes more of a messaging issue. And how do we get in front of people? And how do we get people comfortable? Yeah, I think it's up to people like us. Yeah.
Nick Sanders 27:26
I, I mentioned to you guys, before we started that, I just actually did one today with another mental health professional. And I think the thing that came up with us was, why is the, you know, like you there's basic fitness standards of you need to get 30 minutes a day of exercise and cardio and this, right? Like, there's national standards on what we expect. Why aren't there national education levels, national standards on like, mental health strategies? Like you're talking about a goal, whether it's goal setting, or looking at how to, you know, positive self talk, whatever the strategy is? Where is it? Like, I mean, unless I talk to somebody like you, where do I get that information? Right, that's, yeah,
Unknown Speaker 28:10
there's, there's resources online? Sure. I think there's some of the gold standards, I guess, of behavioral health stuff. Um, you know, part of it, I think, too, for so long therapy is just kind of behind the curve a little bit on some things, you know, it was it had this kind of misrepresentation that therapy meant, like, sitting on the couch and the old psychoanalyst, you know, Freudian kind of stuff for a long time. And I have to process my whole history and those kinds of things. And, you know, I think now as we're trying to make it more accessible, these standards are probably going to become a little bit more common, like, I would say, like, even on social media, it seems like more people are talking about, like, what living with eight adult ADHD symptoms look like? You know, if you're experiencing this, like, you know, that becomes normalized a little bit more, you know, kind of same things with Yeah, what you're saying about the conversation, like, the more people are talking about it, the more people are saying, Here's what works for me, I think the more of this kind of standardized kind of way of working towards some of these really basic things. But, you know, at the same time to getting people to do these things are also tough. You know what I mean? So, I mean, you can you refer back to the basics, I think, for us, it's always like, you know, breathing techniques or setting goals or meditation practice mindfulness work. You've all heard that stuff. I mean, maybe it's not sitting on a list necessarily somewhere from like, like a government, you know, agency or something like that. But you know, it's around, I think it's becoming a little bit more easily accessible. Why it's not kind of laid out so simple. I guess it's hard to say maybe it's all those gray areas that you know, we're trying to figure out how to fill.
Unknown Speaker 29:58
So when somebody comes to you and says, Yeah, I can't do the these things because of time. But it's usually the course of action there.
Unknown Speaker 30:06
It's not one of the things to say. It's like guts like, what's the cure? Kind of? It's so hard to say that until I think you actually get in front of somebody, I think it's the same thing is like, you know, what your kind of like health standards are, and you're each individual disciplines. But it's not till you're sitting down with that person, do you actually know where to begin? You know, you know, your fundamentals, and you have your education. But every time you sit down with somebody, it's a personalized experience. So for what works for somebody may not work for somebody else, and you have to modify exercises to try to reach some of these same types of goals. The same thing happens in I think it takes sitting down with somebody who's, like, willing to really, I say, it's like a co collaboration, you know, I toss out suggestions, ideas, you tell me, I tried that, you know, I really didn't really like jive with me, or I didn't really like that I didn't really find to be helpful. It's not for me to say like, you're doing it wrong, you know, it's like, okay, well, let's try it a little bit differently, or kind of re approach it from this side of things. Maybe we can, like, revisit that later. Here's something else we can try. So it's, it's, it's hard to really say like, if you're short on time do these things. I think when you start sitting down with somebody, and really kind of laying out like, here's all the areas I'm just having a really hard time with, you start prioritizing, okay, what's causing the most kind of impact? And what's causing the most amount of distress or dysfunction right now? We'll start from there and kind of work our way backwards a little bit. So
Unknown Speaker 31:42
are there any techniques that you use as somebody who's not really, like ready to change?
Unknown Speaker 31:48
So there's so many things, what you're saying was like, they're like, I felt like CBT and stuff. And like, there's so many modes of theory to like, what you were saying we actually have a, what's called Stages of Change theory. So that means that at any given point, somebody is in some type of stage of change, right? So even if they're not thinking about change, there's that's a stage of change, right? Even if they're like, Yeah, I've heard of a loved running five days, but everyone's in I've never Yeah, yeah. So it's like, I've never, I've never looked into it, though, you know, I would never, I would never go running, you know, or something like that. So even that as a stage of change, it's much more resistant stage of change. But maybe people start like kicking around the idea a little bit like, alright, yeah, looked up like a couch to 5k program and doesn't sound too bad. Or, you know, now that I know, you can walk while running like, that doesn't sound too bad. But I don't know, if I can actually get outside to do that, maybe I just don't have the time. So that like research side of things that just need to change, until people like buy their first pair of shoes, you know, maybe they have a, you know, exercise clothes at home, they just haven't quite gotten to that step yet. That's a stage of change. So each one presents a new barrier to kind of break down until somebody is actually in motion, maintaining the stage of change, and then basically what we call it in a maintenance period, they've kind of sustained the change over time. And the important part of that, too, is in that stage of change, we account for relapse. So meaning somebody started running, so they started working out for the first time, they've sustained it for two months, and then there's kind of drop off. Okay, well, now, you know, kind of how to work through those stages, you know, each step of the way, what got you through that the first time, you know, you have a depth of knowledge and data now, because you've put yourself through that to work through these two again, and get yourself back to like a maintenance stage. So basically, that's kind of us meeting people where, where they're at, you know, same with fitness levels, same with like, mobility levels, you know, and then you just kind of work your way through it step by step,
Unknown Speaker 33:56
in theory, like once somebody goes through the stages, and they relapse, it's a little bit easier to go through the stages again.
Unknown Speaker 34:03
Yeah, exactly.
Unknown Speaker 34:04
Exactly. Interesting. So many people see that is. That's, it's funny, I have, you know, some folks in the gym that now that you're mentioning that they go through those stages of change, like quite often. Yeah. And they see that as failure. And that's like, where, like, it almost like takes them deeper into a hole because they see it as like, I'm failing. I'm not I'm not able to stay consistent, but it's like everyone's gonna relapse on something. Yeah, like, you're gonna have a piece of cake again, or you're gonna have a you know, you're gonna have something to eat that you you know, you probably shouldn't, but like going through those stages of change, but when they have that piece of cake, they're like, I failed. Yeah, you know, what am I doing?
Unknown Speaker 34:50
Yeah, the other access to that so we'd be and then CBT and this is good for everyone to research. I would suggest everyone to look this up. You don't need therapists, like sit down and walk you through these. But there's what we call common cognitive distortions. So it means basically, there's these fallacies sometimes that are really unhelpful in our constructs of thinking, black and white thinking is one of those constructs. So meaning that if I didn't, you know, complete this to 100% really rigid, right, so if I didn't complete this 200%, I have now I'm in the category of failing, where really, it's more of these kinds of like building on progress, you know, you fall back, but you've have all this momentum of knowledge of what it means to come to the gym for two months, you can use that as a reference point, you know, what was helpful, while I was going to bed a little bit earlier, or I was tracking food, or I wasn't, you know, going to the grocery store when I was hungry, you know, all those things that, you know, you knew were helpful, we get back on that, and we kind of build off of that again, and move ourselves forward. So again, thinking about using our thinking styles to work on our behavior change, do you know,
Unknown Speaker 35:58
self talk?
Unknown Speaker 36:00
Yeah, self talks a big part of it.
Unknown Speaker 36:02
It's not, I don't want to use this as a divert. But it's crazy, because a lot of these things that you're saying you just see within like the marketing industry of the various emails that you get after you look something up, and they just kind of chip away at it until you finally buy it. For a different podcast,
Unknown Speaker 36:20
psychology of marketing.
Nick Sanders 36:23
I was gonna, I was gonna ask Alex, what stage of change is that? Where you have to buy all the things before you can start? preparation, preparation,
Unknown Speaker 36:32
that's a stage of change. So pre contemplation, contemplation, preparation, action and maintenance. So meaning that pre contemplation is like, it's not on my radar, contemplation, like, I'm kind of thinking about it. Maybe I'll do it someday. Preparations I combine all this stuff. I haven't done it yet. And then eventually, yeah, action, and then and then maintenance. So
Unknown Speaker 36:56
preparation, dangerous one.
Unknown Speaker 36:59
That's all out a little bit. That's what we're telling ourselves. Change. And then we have like, yeah, we have like, a full on, like,
Unknown Speaker 37:07
everyone's timeline is still like that. It's interesting. To see that.
Nick Sanders 37:15
As I say, I love the idea of like, you've learned what doesn't work type of an idea. Like, yeah, all right. Yeah, this didn't work. But man, I learned a lot because that sock didn't didn't work out for me. So now I gotta revamp it just a little bit.
Unknown Speaker 37:30
Yeah, so part of that is what we call to using a growth mindset. A fixed mindset would say, like, I have these limited set capabilities, right? Like, I, I either have it or I don't, right. And I think people kind of fall into that category. I'm either either this type of person or I'm not when really, if we use, like a growth mindset, like, Can I use my skills and abilities to kind of grow my opportunities to try to get there over time. So learning, like, what doesn't work for me is a way of kind of growing into this skill set. Like, for example, I was talking to my buddy that owns a bike shop. And he was saying, like, he's like, it's kind of amazing. I've learned how to be a bike mechanic. He's like, I'm, I'm not a mechanical minded person. He's like, but you know, I had to kind of learn that, like, my mind kind of leans towards, like, a different style of thinking. So but he had to, like, grow into that skill set. And I think that can be kind of used in a lot of other areas, too. You know? Just that's cool stuff.
Nick Sanders 38:36
Is there stuff you use Aaron, along those lines? Like, I'm sure you see people that are in it hard for three months, and they drop off? And then they
Unknown Speaker 38:45
Oh, yeah, it's, I mean, I'd be lying if I said, we saw that. Occasionally, we say we see it a lot, like we see a week. I see with people that have been working with me for years, they go through these cycles. And, you know, it's, it's a very, like, what Alex said, a very fixed mindset of, hey, I'm not at this point yet. So I'm failing. So I, I call it all or nothing, but it's very, it's, it's tough for them to be successful long term, and what they see as success because their goal is so like, their expectation is so high for themselves. And because of that, like every little thing that may not be perfect, is a failure, at least in their mindset. So a lot of what I do is highlight, like the things that they do really well. You know, if they're making it into the gym consistently, that's, I mean, they're a hell of a lot better off doing that than not coming to the gym at all. And You know, if they're struggling with their mental health or they're struggling, you know, maybe with their diet, the fact that they have, you know, the movement piece as that's huge, and that's a huge win. But even that, for some people, it gets swept under the rug, when, you know, maybe they're in a rough patch, or it's that time of the year, January, February, March tends to be really dark for folks. So I see a lot of people struggle with, you know, what they feel like, Is success to themselves through those like months of, of January, February, March, where temperatures are cold, it's dark, they're coming into the gym, but they're not feeling like really good about themselves. It's kind of just like, maintenance mode. So they don't feel like they're making any progress. And to those folks that are that have that very fixed mindset, it's, you see it right away, when they walk in the doors, that everything's just weighing on him, everything feels heavy. And then when things start getting brighter, they like, clean things up a little bit, all of a sudden, the world is a completely different place.
Nick Sanders 41:12
I saw Gary, you anybody watch Gary V's crazy stuff, his marketing stuff, Gary Vaynerchuk. I've seen some of his stuff. Anyway, he's he's always preaching patience. So he's always like talking about patients, I gotta be patient with things. And then he said something on one of you know, he's got a ton of snippets. But something about like, if you're going 24/7 at something like it's going to happen faster. But if you only have so many hours to devote towards it, like you're still making progress towards that goal, you just gotta be more patient with it, because it's not going to happen as fast. And it made some sense to me, right? Like, if all you're focusing on is one thing, you're gonna, you're gonna crush that thing. But like, the reality is, there's times where life isn't gonna let you focus on that one thing. So trying to just be like, Alright, I'm still making progress on that goal. It's just not as fast as maybe I want it to be. But taking comfort in the fact that it's because I got 15,000 Other things happening, right?
Unknown Speaker 42:07
There good exercises to create, you know, that self awareness and mindfulness.
Unknown Speaker 42:12
Yeah, you know, there's, you know, our kind of speaking, so many things that, like we talked about it, I think, are really important. Um, but you asked if there's things to help with, sorry, say it again,
Unknown Speaker 42:26
like mindfulness, self awareness. So you can, I mean, because that's something that you'd have to, like, actually, be aware of yourself to make those changes?
Unknown Speaker 42:35
Yeah, you know, I think like, a little bit of like, taking inventory, you know, and recognizing that, like, like, you said, that, because of that I'm, you know, I'm grateful that I'm able to dedicate time to my family, or that, like, I've been able to, you know, go to work, and it's really kind of this balanced approach. But, you know, I think mindfulness Yeah, is a great way of kind of recognizing that. And just kind of generally just checking in with yourself, and, again, kind of comes back to this, like self talk. Because all of that kind of critique on trying to get there as fast as possible. Is this kind of, like tunnel vision, focus of life? Because, you know, how long can you do that? And what does that look like, sustainably? I think you're gonna burn yourself out, you know, or neglect some other type of priority. And, you know, so I think eventually having some way to just kind of check in with yourself and think a little bit about, you know, what's going on, and how you kind of dedicate your time to all these really important things?
Unknown Speaker 43:37
How do you have people help choose, like, what that what those priorities look like, in terms of like, is organizing,
Unknown Speaker 43:44
you know, kind of just talk it through and ask a little bit about that. And that's, you know, from my side of things, is really kind of putting a little bit of control into like, a client's needs or a patient's needs, right. So kind of saying, you know, what would you like to work on? What do you feel like is most important right now, and, you know, people can usually tell you that, if I say like, that's, you know, we might be neglecting a little something over here, that's my job to kind of reflect back and say, like, well, you know, that we'll let's definitely focus on that. But it seems like this could use a little bit of, you know, attention to, you know, that might be my job to kind of step in and say that, but you kind of just create an individualized, you know, roadmap basically, by sitting down and working through it a little bit.
Unknown Speaker 44:30
Need to be where they're at, like, yeah, yeah, patients on like more patients less burnout is, is what I've seen, like with, with folks, at least in the gym, like the more patient people tend to be, the less they burn themselves out. Or the like their fuse is not as short.
Unknown Speaker 44:51
One thing we talk about a lot in treatment, and I think it's great you had mentioned like, showing people their wings, you know, Coming in to the gym, because it's part of like a routine that they built for themselves. Because getting movement is important. And helping people to realize that I think is, is really good. So I think that's awesome that you're doing that. But progress is what we call sometimes a sawtooth progression. So basically kind of looking at it, like there's ups and downs, you look at stuff over the course of a month, you know, you're gonna have dips on certain weeks, or certain weekends or, you know, certain months and things like that. But if you're patient with it, you know, which way is the sawtooth data trending, though, you know, and it's not going to be like an airplane taking off, you know, that would kind of show us that you had some flawless execution and, and lifestyle change, which is just not common. But if you look at it as like little blips, you know, maybe you had a hard day, maybe at a small slip, but that routine of coming back to it over and over again, lends itself to progress over time, like sustained progress over the course of like, you know, months. And we use that a lot in substance use treatment, you know, people try to get sober and have a hard time with and maybe they sustain it for a little while, and then they kind of fall off, but coming back to it. And the more they kind of repeat this pattern of building this kind of muscle memory of lifestyle change, or exercising these strategies, or kind of reducing cravings, and, you know, trigger management and all that stuff, you learn how to pull in all these skills, it's not usually just one thing, that's a lot of layered skills like that eventually merged together for this significant behavior change to occur. So you know, that's a good thing for people who are like, you know, struggling to reduce or, you know, abstain from from substances is that, you know, coming back to this in repeating it over time, it's important, because eventually, we kind of find ourselves at this stage of really achieving that new behavior
Unknown Speaker 46:57
is so cool. You mentioned roadmap, because I feel like that's exactly what people don't have. And it's no fault. It's not their fault. But we don't have a roadmap of how to navigate our mind. And our body, like everyone is different. They were built differently, they grew up differently. So like, navigating our thoughts is challenging. But like, I think, in order for people to get a sustainable change in their health, their mental health, like, they need to know how to navigate their thoughts.
Unknown Speaker 47:30
So I feel like journaling has gotten a lot more popular recently. Is that something that you typically advocate for when you're, you know, trying to, because you're just like, like this data point in time, following things over time?
Unknown Speaker 47:43
Yeah. Sometimes journaling turns into again, this another thing I have to, like, do perfectly, you know, I started this new change of journaling, and now I gotta do it every night. And oh, no, I haven't journal for three nights. And that's supposed to be my tool to feel better, you know. So, um, I would say, with any of this, start with self compassion, you know, allow yourself to, like, be human, we call it like, in behavioral health services, you know, your very human experience of trying to like navigate your life, right. Journaling has been, I think, extremely helpful for a lot of people. We use it as actually, like a skills group, we teach people how to journal, you know, and he's cool. So basically, like, you know, people will sit there and think they have to kind of write in this, like, very extravagant deep slots, you don't have to dig deeper, you don't have to necessarily tap into some subconscious or something like that, you know, write down what's happening right now, you know, write down what happened throughout the day, use it as an opportunity to use like, positive self talk, like practice using some statements that, you know, could be really helpful in, in setting some intentions for yourself, you know, today, what well, or today was hard, but I was able to do blank, you know, a couple of statements like that, like, that can be great. You know,
Unknown Speaker 49:04
how often do you think you should go back and read through past and journal entries? Is that Is that a thing? It?
Unknown Speaker 49:12
It depends. Yeah, depends, I guess, you know, what, what's, what's the need that you're trying to get met in there? If it's just interesting to kind of look back and observe change? I think, absolutely. If it becomes a place to kind of reintroduce, you know, perhaps some an unhelpful or unhealthy state of mind, you know, then maybe not. But you know, I think to kind of look back on progress and change, I think can be really helpful. Yeah.
Nick Sanders 49:40
Kara, did you did you read Matthew McConaughey his book, The green lights book? It's I mean, it's basically his book on journaling. Oh, okay. Told me to read a journal about it's actually a really good book. Okay. I enjoyed it,
Unknown Speaker 50:02
like set out to you.
Nick Sanders 50:04
So he said a little bit of what you just said, like, it's called green lights, because he wanted to document when things were going well what was going well, so that he could reflect on that. And then the red lights were like when he was down. But then he would go back to read his green light moments as like kind of a pick me up or whatever. So
Unknown Speaker 50:24
whatever the How did he differentiate?
Nick Sanders 50:27
It was just his life story, basically. But like, he would tell you a story about when he was down. And then when he was up, the chapter would end with green light, you know, and Matthew McDonough haze accent and whatever, because
that whole story of how that happened and how it just kind of like, he just improvised it. And then all of a sudden, he became known for that. And, you know, it's just a very interesting book. But to your point, Alex, I was like, Oh, I'm gonna journal and I did it one morning, and one evening, and I was like, I'm never gonna do this
Unknown Speaker 51:11
today, I am journaling.
Unknown Speaker 51:15
To be off today. Today.
Unknown Speaker 51:21
You guys, you're 100% you
Unknown Speaker 51:27
know, what works and maybe what doesn't work for you. In the morning, night.
Nick Sanders 51:32
He said something he his quote was, I write things down so I can forget them. Right? Because you won't be on your mind, you can just go back and look at and that's these are your tasks for the next day. And I was like, well, that's great. And it was nice. But yeah, I didn't make it.
Unknown Speaker 51:48
Yeah, yeah, I mean, a couple of things in there. One, we use journaling as an element of what we call catharsis. So if you just need to get it out, journaling can be great, you know, to kind of just sit down, get words out and just kind of like, really get stuff off your chest. So catharsis, maybe that's like a throwaway, though to like, that's what I'm saying. Like, do you want to go back and read that, you know, the next day, it might just be the point of it might be just to kind of, like, get it out and purge it a little bit, you know, so that might be helpful to just toss it afterwards, you know, and maybe that's relevant. But you had mentioned, like, kind of green lights and red lights. One of our journaling prompts, too, that we use is red flags and green flags. You know, how do I that's part of that, I think, learning a little bit, having I guess that increased sense of self awareness is What does things look like? What do things look like in my life when they're going? Right? You know, when I'm doing blank things, you know, what does that look like to me that you list that that would be your green flags that these are the markers of, you know, things are kind of trending in the right direction and my red flags, and when my red flags outweigh my green flags, maybe it's time to ask for help. You know, it can understand if that's a good way, mostly
Unknown Speaker 53:01
a positive and negative stroke thing, like, emotional bank account? Yeah. Yeah. Interesting.
Nick Sanders 53:09
Yeah. I mean, that sounds very similar to kind of his overall message, kind of as, as he tells his story, it was it was new to me. I liked the bank account, slash sawtooth analogy that you used as well, like, I think of like investing in banks, right? Like, if you got a lot of money, you're putting a lot of money in, you get bigger growth, but there's gonna be times where you can't put that money in. But as long as you're kind of chipping away, it's not going to the growth isn't gonna happen as fast, but you're still kind of making progress. And, you know, that's how do you how do you circle back so that you keep making progress? That's the you don't lose, you don't just completely derail? Are there strategies that you use for people when they're, let's just turn off the wagon?
Unknown Speaker 53:59
Yeah, so we just kind of take again, that's like a good opportunity to just gather information. Before we go into like problem solving mode. It's just like, Alright, what's what's going on, you know, what led up to that moment where, you know, things kind of just fell off for you. And, you know, maybe people are focused on this thing that they're not doing well, but maybe if we just kind of take a step back, and we'll say like, well, you know, two months ago, our relationships at home got a little rocky, you know, maybe that's a place to kind of start and talk a little bit about that, you know, if somebody's just kind of really fallen off a little bit, it's just, I always say go back to basics, you know, what are the small things that we can start with to eventually scale back up? So like, how do we re enter and transition back into these things? Without feeling like we have to do it all at once like saying like, maybe you got out of the habit of savings, you know, saving money, right? I mean, like 20 bucks aside, you know, if you really want to put it in terms of like a bank account, you know, that, that can be the same thing, until you kind of get back into feeling like you're comfortable to, you know, putting in a little bit more. And then again, it's the same thing, you just kind of find ways to transition and scale back into it. So
Unknown Speaker 55:14
we were talking about this a little bit before the podcast, but sometimes, the best way to start that is having those difficult conversations a lot, because that's the biggest barriers, like, there's a lot of different limitations, because you don't quite want to confront any of them.
Unknown Speaker 55:30
We stay in that place of avoidance for a really long time, or kind of almost rushing over that whole thing, because now we're like, in the work mode, but people often suffer in silence for a long time, you know, they kind of stay in this space of, they know, it's like circling around them, you know, in this like war, both like frustration, you know, before it finally kind of lands and maybe that eventually, is like a tipping point, you know, somebody's just like, I really just need to talk to somebody about this. And if it's a professional, or you know, maybe a partner, somebody at home again, it can be hard to to begin to address it. You know, that's, that's, I can avoid saying that can be really hard to work with.
Unknown Speaker 56:14
Yeah, that that's one that I see often, like, in the gym environment is avoidance. So it can be gonna be tough, really tough for people that, you know, for a while, maybe they've been struggling with something or, you know, and all of a sudden, like something clicks, and you can't explain, like, what what the catalyst was, but it just finally, like you said, landed upon them, and they're like, Hey, I just want to, I want to start something different, or I want to do something different. I want to talk to somebody. And that's, you know, a lot of times that's the state in which people come in to see me is, it's finally hit them that they need to make a shift. But, again, like, a lot of this is completely up to the individual, like it has to, like hit them first, before they can make a change for themselves.
Nick Sanders 57:07
Yeah. Well, as we as we start to wrap up, what are either Alex or Aaron, what are actionable things that people can do kind of as a baseline to maybe check in with themselves or to start to work towards a goal? What are some quick actionable things that people can do? As they're starting to make that commitment to something?
Unknown Speaker 57:35
I leave that up to you.
Unknown Speaker 57:41
With that one? You know, I think again, thinking about what not putting things necessarily in this like, ideal category of like, ideally, I'm this degree of like, perfect or something like that. But just kind of starting realistically and recognizing that. Okay, maybe we just start at one thing. And we ask ourselves, like, where do I need to just kind of like, tighten it up a little bit. And I can work on these things over time. But what really feels most important to me, or it feels most disruptive to me. And if you're having a hard time doing that on your own, my biggest thing, and if, if I'd like to kind of end on anything is ask for help, you know, I have, I have t shirts that say ask for help, I have cycling caps that say ask for help. People are on their own island, thinking that their experience is unique to them. And they don't know how many other people have experienced nearly some degree of these same types of situations. So, you know, having just, I think that kind of more normalized realization that, like, you're not the only one that's felt like that, at any given point in your life. And, you know, it's okay, to kind of sit down and just, you know, put the guard down and just start somewhere, you know, it doesn't have to be again, like this big idea of what change looks like, you know, it's just sit down, and just start somewhere. And wherever you started with yourself is good. You know, it's, it's healthy. Yeah.
Nick Sanders 59:17
Where do people go? Like, you say, ask for help. And, you know, I listened to this or I'm thinking about things I could use help with, how do I pick up provider? How do I what do I search for what do I you know, what do I type into Google?
Unknown Speaker 59:32
Psychologists near me. Here's the other thing I'd like to say to you. I mean, you get to talk about it too much, but it's okay to sit down with a counselor and feel like this person is not a good fit for me. Like, there's no hurt feelings on our side. If somebody comes and sees me for a few sessions and say, like Western styles or just or you know, this is just not a good match. That's fine. That is absolutely fine. So don't be afraid to try again. And, you know, if you've sought counseling services, that wasn't a good fit, try somewhere else, you know, try something else. Google counselors, social workers, you know, psychologist near me, anybody who accepts your insurance, and then talk to your primary care physicians, there's, they've done a wonderful, we have a lot of health care access in our area, thankfully. And a lot of those providers have been linked up with, again, all those different types of mental health workers, they can get you in and get you scheduled, sometimes right there in that office, can have your yearly physical, you know, bring it up.
Nick Sanders 1:00:37
This is our bias, because most of our clients don't have primary care providers like, or they have them and they haven't seen them in who knows when. So, do you need a primary care referral to?
Unknown Speaker 1:00:51
No, not at all, in most cases, people have a primary care set up somewhere, you know, even if you haven't seen them in a few years, or whatever. So I would say that's like, sometimes your easiest office to get into, to start talking about these things. You can google anyone on the line and see if they take your insurance and, and start talking to somebody. There's a lot of agencies in the area. There's a lot of private practices in the area group practices, anything from large healthcare institutions, all the way down to one person who rents one office, and you can go see them wherever they set up. Or right now, this is a kind of product of COVID. virtual visits are a huge thing. Honestly, BetterHelp is a really great organization. They offer counselors in the state that you're in. They set up telehealth appointments, you know, you can text them, or basically write an email or set up phone calls or video conferences with them. And it's a subscription based service for healthcare,
Unknown Speaker 1:02:06
say, like, what's the cost of something like this? It may be
Unknown Speaker 1:02:09
you know, I'm not entirely sure. Um, I think that's kind of like a there's like a sliding scale, depending on what services you choose, I think. But that's a that's honestly not a bad place to start. But really, you can, there's a lot of different things that Google can probably offer you, then you probably get your targeted ads for better.
Nick Sanders 1:02:40
Anything else that we want to finish up with anything else you want to add Aeron chair,
Unknown Speaker 1:02:45
and like this is this is just cool stuff. I want to say other than the fact that like, for years, this has been lacking and I finally feel like the last few years, this is all starting to come together it just like anything else. It's going to take a lot of time. But the fact that like the four of us are having this conversation means that the world is moving in. Yeah, a better direction. I agree.
Unknown Speaker 1:03:15
I really liked your point on essentially like shopping for like for lack of a better term for your therapist. I mean, that's that's not something that is typically thought of,
Unknown Speaker 1:03:28
yeah, you think like this is like the person I tried and then therefore it's not a good fit counseling Zagat. You remember back in the day you had your favorite teachers that they just taught in a style or manner they'll Bible Yeah, you just like that that person was cool. I like taking their class same thing with counseling. I think when you feel like you're getting something out of it, you're like engaged with it. That's a good sign that you're you know, maybe in the right place. Yeah, I like that.
Nick Sanders 1:03:57
I swear if people want to work with you where can they find you?
Unknown Speaker 1:04:01
I was just saying I can't plug my actual place because I work in a large institutions I don't have a media release or anything like that. I'm allowed to plug but if you Google send me an email say what happened? You know, I I would say I'm booked up anyway. So probably take a little while to get in. But anyways, just put a Google search in into your area and start there and or again, start with your primary care physician. Both good places to work but yeah, maybe I can plug that in later time. Sorry, that was
Nick Sanders 1:04:47
sometime Yeah, we get it we get it. All right, guys. Well, hey, I really appreciate it. Like Like I was saying this. It's cool to have these conversations and if the mental stuff isn't isn't dialed And then nothing else goes as well as it should so and I love Aaron that quote I actually typed it as you said, more patients less burnout. I think that's in today's world of everything happening right now right like if we could figure out how not to do that
Unknown Speaker 1:05:14
journaling tonight
Unknown Speaker 1:05:15
I contributed
Nick Sanders 1:05:19
a journal journaling I typed it out I wrote once
Unknown Speaker 1:05:23
I say these things just I don't know they just come to me
Nick Sanders 1:05:30
I'm looking forward to your to your book your release.
Unknown Speaker 1:05:35
Oh, god. Yeah. I've read a whole book using movie quotes.
Nick Sanders 1:05:46
It's just got to be the start.
Unknown Speaker 1:05:50
I'm sure we can figure it out.
Nick Sanders 1:05:53
For our guys have a good evening. Thanks again. This was fun.
Unknown Speaker 1:05:58
Yeah, thank you. Hi, Nick.
Nick Sanders 1:06:01
Thanks for watching and supporting the channel. We hope you enjoyed this week's episode. Let us know in the comments below what you liked what you disliked. What you'd like to hear more of and any questions we can help answer. We appreciate your support and we look forward to seeing you on the next one.
Transcribed by https://otter.ai
