Goodnight! A Conversation with the Reflective Doc

Serena: Hey Everyone, I’m Serena.

Tina: And I’m Tina and we are the Mental Health Mamas.

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Serena: Welcome to No Need to Explain, we are so glad you’re here.

Tina: First, as always, a quick disclaimer.

Serena: We come to you NOT as mental health professionals or experts in the field, but rather as parents with lived experience who are on a mission to normalize the conversation around mental health.

Tina: If you or someone you love is experiencing a mental health crisis, please seek professional support. You’ll find a variety of resources in our show notes and on our website, NoNeedToExplainPodcast.com.

Tina: Quiz time podcast friends! What is one of my favorite tools in my wellness toolbox? (tick tock tick tock…

Serena: Hmm…

Tina: Tick tock… OK, I think I can hear the answers. Serena can you help our listeners out? What is one of my favorite tools in my wellness toolbox?

Serena: I’m gonna go with sleep!

Tina: Ding ding ding ding! Yes. I am excited to have a guest today who helps people with, among other things, their sleep!

Serena: Jennifer Reid has expertise in medicine, psychotherapy and coaching. She helps individuals overcome anxiety, optimize sleep, and move through stressful transitions. In order to reach a wider audience, Jennifer is a blogger and a podcaster on a mission to normalize the difficult experiences we have as human beings, and encourage people to seek the help they need to live their best lives. Jennifer, welcome to the podcast!

Jennifer: Tina and Serena, thank you so much for having me. I’m so excited to speak with you.

Tina: And we are excited to have you! So tell us a little bit of your story and how you became interested in some of the areas you focus on in your practice.

Jennifer: Absolutely. So my background…I actually grew up in a small town in rural North Dakota and my father as well as my maternal grandfather were both general practitioners, were family medicine providers. I saw, you know, the little black medicine bag when my grandfather was doing it. And so I grew up with that as sort of an interest and a focus. And a number of other family members are teachers and so I think the combination has been something that’s been really important to me throughout my life. But the reason I ended up choosing psychiatry and going through medical school and deciding on that as a specialty, I really think looking back, in part, was because of my own experiences. Because when I was in high school in this small town I didn’t feel like I fit in that well and did struggle with some symptoms of depression. Which, at the time, I didn’t know what that was. I didn’t know what I was feeling or why I just didn’t really want to do anything. I was feeling so down on myself. And then periods throughout my life where I did have some significant anxiety.

So even though I was sort of progressing along, going to college and then traveling and medical school, but there were times where it really felt like my mind was working against me. And where everything seemed more threatening than it typically would or just more difficult. And so I think the interest in psychiatry, in part, was to understand myself. I think that happens to a lot of us as we pursue our career. And so lately the work that I’ve been doing, I’ve been fortunate enough to work in a number of different settings but I started my own private practice, actually just before the pandemic started. So I shifted everything to working from home while my kids were knocking on the door asking for emergencies like a cookie.

Serena: I was going to say snacks!

Jennifer: Yes. Primarily snacks or screen time that wasn’t school mandated. But I see patients in my practice and we really work on treating their anxiety, treating their depression and their sleep but I also, you know, hearing more in the news and just seeing what was happening in our country and even world-wide with mental health and the numbers and how they were climbing and the people that were really struggling with so many of these concepts that I’m teaching my patients about every day, I really see myself as a teacher and a collaborator with my patients.

And so I wanted to find a way to share that information more broadly because some of these techniques, they’re not complicated. It’s just sort of understanding how your brain is working, understanding when it’s working against you and how can you, sort of, bring it to your side essentially. And so that’s why I’m trying to see patients, but also do some writing and podcasting and even sharing my own personal experience, which as I was saying before we started, is difficult. It’s hard to talk about things like anxiety and depression in your own life, especially when you’re a psychiatrist who is supposed to have those answers or supposed to be able to treat that and also prevent that. And so I think those are some of the reasons that led me to do this work right now.

Serena: Yeah. Thank you for sharing your personal story. I think it is hard to share those things and I think that transparency is helpful to so many people to hear that we don’t all have it figured out and that’s OK. So you do a lot around anxiety and insomnia and we are very intrigued with that!

Jennifer: Yeah. So as far as sleep, I mean, anxiety is certainly a bread and butter trait that we are taught about, not so much medical school, but definitely psychiatry and in my practice over the past decade. Sleep is something, when I look back, really there was very little training on at the time. I think you certainly could pursue it if you had interest and some do but it was something I was realizing in my practice over the years, you treat some of the other symptoms, maybe of depression or anxiety but patients kept coming back and saying, I’m just not sleeping very well. I’m feeling better over all but I’m still waking up in the middle of the night and worrying or I still can’t fall asleep at night, I’m still struggling. And so my way of coping with frustration or uncertainty, one of them anyway (the healthier one) is to really research and read about and learn about and try to figure it out for better or worse. And so I really dove into learning about sleep and I think the more I learned and understood about it, the more powerful I realized, just some simple shifts in our mindset and how that can really help us sleep better.

So I talk to people about how powerful our sleep drive is. That biologically, right, we’re out for eight hours, we’re unconscious for eight hours. How is that a good adaptation for our survival as a species. It’s pretty wild. And you start to learn more and more about what’s happening both in your brain and your body when you’re sleeping. Now some of this information can backfire. I told my son at one point, like, you’re brain’s so active while you’re sleeping, it’s consolidating memory, it’s packaging things up. And so now when I’m like, buddy, you’ve got to get to sleep. Turn off the light. Put your book away. And he’s like, well, mom, it’s not like my brain’s gonna rest anyway. It’s still gonna be active all night. Why do I have to go to sleep? And I was like, ah, oh well. At least he’s learning something.

But it is a really powerful drive but it can be disrupted and in a way that can be so frustrating because unlike other areas of our life where we can work harder, try harder, invest more time and energy, that actually can really backfire when it comes to sleep. People can have, understandably, a few nights of bad sleep because there’s something that’s overstimulating whether it’s excitement, whether it’s stress, whether it’s too much caffeine, right? Or just whatever may be happening whether it’s a new baby. We can have nights of poor sleep and what can happen that perpetuates that and creates long term issues is their belief about that. Oh gosh, here we go. I remember my mom wasn’t a good sleeper. Or I remember that time I didn’t sleep for months and months and I’m probably not gonna sleep tonight and what if I don’t sleep tonight? What if I get poor sleep and I really fail at that meeting tomorrow or I say something wrong in that interaction? I’m just not gonna be able to function. Versus if you think about it, the analogy I like to use is appetite. And that there are some days where we just aren’t that hungry when it comes to meal time. Maybe we had snacks before hand, again back to snacks with kids. It’s kind of like taking a nap. We’ve had snacks at some point and we’re just not that hungry. Or we’re stressed and that has taken away our appetite a little bit. What we don’t tend to think, at least most of us, is, oh my gosh, why am I not hungry at this meal? I’m gonna be not hungry next time at the next meal and maybe I need to take something that’s gonna help me get hungry because I have to be able to eat regularly. And I think that same analogy can apply in sleep in that there’s this sense that, oh my gosh, I’ve had a few bad nights of sleep. I need to fix this right away or I need to do something because this is something wrong, as opposed to just a signal.

We have this concept in medicine called referred pain where you can have, you know, an injury somewhere, a problem somewhere and you get pain in another part of your body like your diaphragm is bothered so your shoulder is painful. And I think insomnia is kind of the same thing. Referred pain from other experiences of things going on in your life that are creating the conflict with sleep and if we can remove some of those other issues, sleep is just a really natural, powerful drive. We can’t actually prevent ourselves from sleeping, it’s so powerful. So that’s a lot of the work I do is teaching people to work less, to not work so hard at sleep. I really help them shift their mindset around, OK, if you’ve been having insomnia on and off your whole life, tell me how many times the next day there was a catastrophe, how many times the next day you actually couldn’t function. And right, of course, most of the time they’re like, well, I didn’t feel great but I still progressed, I still functioned. And so we just start to take away some of that catastrophic, “what if” thinking and that can have a really powerful effect on our ability to sleep.

Tina: Yeah. It’s so interesting in my experience, we have a lot of anxiety in our world and the idea that sleep is such a head game, right? I think the idea that those looping thoughts, right, the looping thoughts just keep…for us anyway. That was the resounding…we had so many conversations with therapists about the resounding thoughts that keep, that, I don’t know, what did they call it? The dragon or the anxiety monster, whatever it was, right, just continuing. And night time was worse because I think there is a pressure to sleep. We know that sleep is healing and there’s so much pressure about it. I think of this when people take sleep medication, right? You might need some sleep medication at some point but what I’ve heard from people who take it is, I’m afraid to stop because I don’t know what’s gonna happen when I stop and I’m so dependent on…not chemically but just on knowing that if I take that thing it’s gonna help me sleep. I remember a newscaster talking about this very, one whole story about it and it’s really hard. Sleep is, we know, restorative and it’s so hard to get your head in the right place, right?

Jennifer: Absolutely. And especially if you have things going on during the day but maybe one of the ways you’re coping with anxiety during the day is to stay so busy that you just don’t notice it, right? Or you just plow right through it. Well, guess what? You lie down at night, it’s a dark room, quiet room, sort of creates this vacuum and our anxious mind…I really try to differentiate even with my children, like, that’s your anxious mind, right? Those are thoughts coming from the anxious part of your mind, that your thoughts are not you, right, and that we can start to separate that. So it is tough when your anxious mind is like, here’s my opportunity, right? I get to come in and I get to say all these things that are gonna keep you safe and are gonna protect you from threats and make sure that you don’t have any problems down the road.

Well the trouble is there is really no way to manage that uncertainty through thinking, through worrying, right? Worrying is really not preparing. It’s just this churning use of information, this RAM that you’re trying to clear out these thoughts and it’s really not helping you prepare. So one of the tricks I have people use is just looking for, you know, beginning to observe, with curiosity, with compassion as much as possible, not with criticism or condemnation but observe those “what if” thoughts. Because if you think about it, if you think back to any what if thoughts you tend to have, it is very unusual that we’d have a really positive what if thought. Like what if this interview goes so well that suddenly I’m gonna star in a movie because they heard it. It’s just, you know, it’s silly and it’s funny and patients will laugh but it’s…but think about how creative you can be on the catastrophe side. What if I don’t get any sleep and then tomorrow I get in my car and forget where work is and I show up late and then I get fired and then I lose the house. It can just really really grow. And so identifying those what if thoughts and trying to shift to a “if then” statement. So instead of, what if I don’t sleep well tonight and I’m a mess tomorrow becomes if I don’t sleep well tonight then tomorrow I may be more tired, maybe I’ll have a little extra coffee, maybe I will give myself a little break on some of the productivity that I wanted to do, right? Maybe I will warn my kids, you know, mom didn’t sleep that well, I might be a little grouchy today. It's just human, right? Like what are the things that you can do that sort of creates a way to bring that part of your brain, that’s that planning, organizing, kind of parent part of your brain to calm the rest down and say here are some things we can do, right?

Serena: There’s so much of what you’re saying that really resonates with me and I think about, you know, going back to what you were saying earlier about sort of like getting stuck in that insomnia place and my twenty year old who may or may not listen to this episode, I hope she does, really struggles with sleep and I think she really identifies as somebody who has trouble sleeping, if that makes sense. Like that’s her…that’s her thing or one of her things. I don’t know how to help her out of that but I, again, I hope she will listen. And I hope you land that movie deal. I really do

Tina: Yeah. Me too! Me too! And I will hope that for us too, right Serena?

Serena: Yes, absolutely.

Tina: We could totally hope for that. Yeah. I don’t know.

Jennifer: Yeah. I think that is really common is that people will come to me and they may have been on a medication for a long time for sleep and we can talk a bit more about that if you’d like. But they really have this mindset of, I’m a bad sleeper. I’m a poor sleeper. Again, if you look back and think about the evolution, it is such a powerful drive in us that it has stuck around for eons despite the fact that we are vulnerable to predators, we are vulnerable to catastrophe, natural disaster when we’re asleep, especially in the past. It’s such a powerful drive. And in fact it’s physically impossible to prevent ourselves from sleeping. In fact the brain will sort of just take over during the day if we’ve had a really poor night of sleep and we take these little micro sleeps where we just sort of nod off while we’re awake. It is a powerful drive.

The challenge is what are the things that are overstimulating us, just as simple as that. What are the things that are overstimulating us or how have we trained the brain that when I get in to bed, that’s where I worry about sleep and stare at the ceiling and get frustrated as opposed to, oh that bed is so comfortable, it’s quiet in my room, what a wonderful luxurious night of sleep I’m going to get. And those are thoughts, right, those are expectations and thoughts but we have to train our brain by saying, this is when I get in bed, this is when I wake up. Like how can we start to really entrench that schedule into our brain and also figure out what is it that’s overstimulating and it might be, and often is, our own thoughts, my own included.

I definitely sometimes will wake up, three in the morning and all of a sudden I’m thinking of the fifteen different things I need to do when I first wake up. And one thing I’ve started to do in part is just to say, well, here’s my thinking time. I’m awake, got a little time to think, we’ll see what I can get through but, you know, it would be nice to be able to go back to sleep. But none of that, like, catastrophic thinking. I think also really using things like mindfulness. The more I’ve been trying to incorporate that, both in my own life and with my patients and with my kids for that matter is just acceptance. I’m awake right now. It’s night. It’s quiet. This is just what’s happening. Maybe I’ll be able to fall asleep. I hope so. If not, I will still get through tomorrow and then I’m gonna sleep amazingly tomorrow night, right? It’s gonna be so good to crawl into bed. So I do think that that can really shift the way that we’re thinking about it.

Serena: Yeah, yeah. Thank you. So, I’m gonna shift gears just a little bit here. So in the introduction we said that you help people to live their best lives. As parents, we know that we spend lots of time making sure that our families live their best lives, sometimes to the detriment of our own mental and physical health. You have shared that you are a parent and we wonder what tips you might have for parents out there about taking good care of themselves while they are also taking care of their people.

Jennifer: Oh absolutely. It’s something I think about every day and don’t always succeed personally but I really try. You know, I think that our children really are modeling their behavior after our behavior so we can tell them one thing until we’re blue in the face but if we’re modeling some other behavior and that could be not going to sleep at a regular time, being watching TV until late at night or waking up in the middle of the night and getting up and having a snack or, you know, just not taking good care of ourselves and I think that they do model the way that we treat ourselves as well, the way we speak to ourselves.

So if there’s something that’s making us feel anxious or making us feel insecure and they hear us being really critical, they’re really insightful. Kids pick up on that so quickly. They really understand what it is that we are experiencing. And part of that, I learned that because I’m working with patients now who when they were growing up, maybe had very anxious parents, for example and they learned from them, like, these things are not safe. Pushing yourself is not safe. Trying new things is not safe. They heard a lot of, “be careful, be careful”, like “don’t do that or this bad thing could happen. And I think what we’re hopefully trying to do with our own kids is to encourage them to try out new challenges, to experience some of those things and a big part of that is modeling it. And modeling self care. And let me tell you, when I’ve had times, you know, recently, as a parent and certainly when I was in the postpartum period, that’s such a common time for anxiety, but even more recently. I mean, with the pandemic and kids going through all kinds of transitions, I recognized that I needed to treat my own anxiety so that I wasn’t causing their lives to constrict because I was repeatedly saying to them, be careful or maybe you shouldn’t do that or I don’t know if you should bike by yourself or are you sure you want to walk to school by yourself? It’s like I had to treat my own anxiety and these catastrophic intrusive thoughts that would come in like what if he’s walking to school and he doesn’t look when he crosses the street, etc, etc. Parents have these and I recognized I needed to treat my own in order to let them experience life in a way that was full and created resilience. And sometimes that’s what it takes.

Sometimes it’s very hard for us to get our own treatment just for us. We may be suffering but we say, I’ll just get through it or I’ll just keep giving. And sometimes it’s what you need to think about. You know, this actually will also help my kids. Not that I want you to make these choices for your kids but sometimes that resonates with parents because there’s a sense of, I can just deal with this. This is how I’ve always felt. I’ve managed it. Well think about this. Not only can we relieve your suffering with appropriate treatment including medication which I have taken and take at times for anxiety including medication, that we can really help you, but also generationally help those that are coming after you to kind of break this cycle of anxiety. So I really think that is powerful when you think about being a parent right now.

Tina: Wow. Breaking the cycle of anxiety. I…yeah. Oh, so, again we’ll shift a bit and say, you have a podcast, we mentioned that before, The Reflective Doc. Tell us a bit about your podcast and answer a question we are often asked, “Why a podcast?”

Jennifer: Absolutely. Well I joked recently that having a podcast is sort of an introvert’s dream because you can…

Tina: We never thought of it like that Serena!

Jennifer: I can reach out to people I really want to talk to and they agree to come on and talk to me about something they’re really passionate about, in depth, for half hour, 45 minutes. We both really learn a lot and then I get to go take a break and be quiet by myself. So that’s been a benefit I didn’t expect.

But you know I think I reflect back a lot on, you know, one of the regrets…I was listening to this great podcast on regret recently and one of my regret growing up is that I was struggling so much with who I was, with self confidence, with body image, with anxiety and I didn’t have outlets. I didn’t know where to turn to learn about it or even just to validate how common it was and that there were ways to shift our way of thinking. And because of all my training and clinical work, I’ve learned so much. Not that I’m anxiety free, but I know how many tools there that I can use. I can help my family use to get over that. So the podcast and writing in part was sort of to reach back to that teenage me or that twenty-something me that didn’t really have access.

Certainly in rural areas, so many kids don’t have access to some of this. And so podcasts…they’re free. You know, people just need something to listen to them on and certainly there are some limitations with people accessing technology but for the most part they can get this information for free. I can even have a patient listen to an episode I did on insomnia because that is basically what I told him that day. But I want them to reinforce it with some of that information. But this allows so many more people to learn these things and they don’t have to have the cost and the time to come and see me personally in my office. I don’t have the capacity for that anyway and so how else can I teach, you know it’s in my blood, how can I teach about how to really make these changes and sort of go back and help that younger version of myself so that other men and women don’t have some of those regrets I had, you know, lost time to feeling anxious, right? Like maybe having a few drinks to go to a party where I could have just survived the anxiety and really learned how to navigate some of that social, social anxiety. So I think that’s why the podcast. I mean, I love learning from new people and talking with them but the mission really is, how do I share this information in a way that is free and is equitable as it can be.

Serena: Yeah. So, tell our listeners where they can find you.

Jennifer: Yeah. So they can just go to thereflectivedoc.com. I have my podcast on Apple Podcasts, on Spotify. I’m on, you know, Twitter, Instagram as The Reflective Doc so I would love to have people reach out and tell me what they’re looking for and maybe interested in having a podcast about. Some of my recent ones have been on cannabis pros and cons, I’ve been talking a bit about that or psychedelic assisted psychotherapy or just mom guilt. I mean it really runs the gamut. So I always love to hear from people who want to hear more about some topic because then I get to learn and so many other people benefit.

Serena: That’s great . It’s one of the things we like about podcasting too, that opportunity for connecting and learning from people all over the world. So before we bring this episode to a close today, is there anything we haven’t asked you that you might like to put out to the world?

Jennifer: Hmm. Well I do think that the phrase I like to use is, your mind should be on your side. And I think when I’m working with people, when I’m sharing information or trying to create that, that’s really what I come back to is the things that people are able to accomplish when they really have their own backs, when they’re on their own side and not interfering with self-criticism or anxiety, etc. It’s just so amazing. And we need amazing people right now because there’s so many challenges, right. Healthcare numbers dropping, what’s happening in Ukraine, what’s happening just worldwide with climate change…I mean there’s just a plethora of topics so how can I help heal the people that are gonna go out and do amazing things in the world. That’s so meaningful to me and powerful and so one person at a time. Let’s get everybody’s mind on their own side so they can make those changes.

Tina: I cannot say enough about your positivity. I love it. I’ve written several things down here that I will be referring to, including that last thing you said. Your mind should be on your own side which I love. I love also that you shared not only your professional wisdom but your personal experience. We always appreciate the honesty of parents who come on and tell us all about their real lives. So yeah. So thank you so much for being with us today. And so podcast friends, we are, as always, grateful for all of you listening and supporting us. You can help us out by visiting Apple podcasts and leaving us a review. That really does help us a lot. Subscribe and please share with others. You will find lots more content on our website NoNeedtoExplainPodcast.com. You will also find us on all the socials, Facebook, Instagram and Twitter and we would love for you to connect with us there as well.

Serena: And this is your gentle reminder to take good care of yourself while you are also taking care of your people.

Tina: Thanks for listening!

Serena: Bye!

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