Mental Health Series with Mary Mosier Part 4

[00:00:00] Rob Howe: Quick announcement before this episode, got some good stuff for you guys here. This episode, we are joined by Mary Mosier, licensed marriage and family therapist and a person with diabetes living with T1D. She previously visited us on episode 199, where we talked a lot about therapy and trauma and grief associated around diagnosis with diabetes. And we realized there were a lot of things that we didn't have time in that episode to cover that are instrumental to a person with diabetes journey with mental health and also starting therapy. So for November 2022, National Diabetes Awareness month, we're dedicating our content towards mental health. And we have a new page on diabeticsdoingthings.com, diabeticsdoingthings.com slash mental dash health. So slash mental dash health. And on that page, you can find all of the episodes in this series with Mary Mosier, but also we're going to be posting previous episodes related to mental health on that page. And most of all, during November 2022, we are giving away four scholarships to see Mary Mosier and to get five therapy sessions with her. So four scholarships, five sessions each. Say that five times fast. Four scholarships, five sessions each. And in order for you to win, you must live in California. So what I'd like for you guys to do is to, if you live in California, go to diabeticsdoingthings.com slash mental health and enter the giveaway or send it to someone that you know with diabetes living in California. There are five episodes in this series and the first episode is also broadcast in Spanish. So it's our first Spanish only episode on the podcast. So shout out to Eritrea and for Mary Mosier for being willing to do that in both languages. So again, check out diabeticsdoingthings.com slash mental health during November, National Diabetes Awareness Month 2022. All right, let's get to the episode with Mary Mosier. Okay, as we continue with our mental health series, we have Mary here, who is going to talk to us a little bit about grief, and also how grief is related to a life with diabetes. So I think just for starters, like how can we talk about and how do we define grief, especially in a

[00:02:20] Mary Mosier: therapeutic and a mental health practice? Yeah. So when we talk about grief, we are acknowledging a loss, right? So that experience will bring up every feeling. And for some of us, it'll bring anger, it'll bring depression, it'll bring anxiety about the future. and we all experience grief so so differently so I know that when we talk about like the stages of grief it isn't linear it isn't just like I marked and passed phase one so let's move on that's not how it works it's kind of on a spectrum and it oscillates back and forth right where we might start in with denial and then move to anger then we might bargain then we might experience depression more like crap like i need to stop avoiding these feelings and and to a later stage is is accepting right what what that life is going to look like knowing that it's going to be

[00:03:28] Rob Howe: different. Right. I think too, for me, I was very fortunate in like most of the early years of my life to not have to deal with like a true major loss, especially of someone close to me. And I think losing my dad a few years ago now really was that first kind of like real discovery of like that cycle. And, you know, it's not did not overcoming denial one time. It's not getting over anger one time. It's not reaching acceptance one time because it does like continue to flow. And it is on a spectrum as you, as you mentioned. And I think that was like really my first understanding of like cycles and how they work and how they work for us as people and not always in our control as well. So, you know, even years and, you know, I think the cliche is time heals all things. That's true, but not if you stay in that denial phase, right? So you can, you can unfairly handicapped yourself by not really addressing that grief and, and, and, you know,

[00:04:33] Mary Mosier: staying in that sort of denial phase. Yeah. I mean, we certainly want to acknowledge like sometimes for, for some of, for some of us, the denial phase is like essential given our lived experience. And it really serves, especially in the survival, survival mode period of the grief or we're kind of like powering through, powering through, because that feels a little bit better. Not that it feels good to be in denial, but that is more manageable than all the other feelings or experiences that we're having. But you are completely right. Like if we were just in denial, we wouldn't be able to move through our emotions and we would be stuck. And that would affect our ability to function and engage with people and work and love our loved ones, right? If we're just kind of avoiding this, this change in our life. Right.

[00:05:26] Rob Howe: For me as well, I think that I had to learn and I, fortunately, this was actually one of the kind of triggering events that caused me to really dig into a longer term therapy practice with, with my therapist was my first response. My, my denial response looked more like compartmentalizing for me. that was, okay, well, I'll have time to grieve after everybody else does. And after I make sure that all of the things are in order. So I kind of like, that was part of my grieving process was fixing all of the aftermath and kind of being the go-to person. And that was, I derived a lot of worth from that. But months later, I realized like those compartments, just because I'm compartmentalizing them in my mind doesn't mean that they're not related. It doesn't mean that they're not crossing over. And so, you know, it doesn't just look like, denial, anger in a vacuum, but those things definitely affect the other, you know, interactions

[00:06:24] Mary Mosier: in your life. For sure. Cause like the point of denial is like to, to self-protect right. Temporarily like in, in, in numbing and as we're experiencing this confusion, like we're, we're shutting down in many ways. And sometimes it looks like we're completely fine where you're like, I'm okay. It's okay. You might be forgetting, you might be procrastinating, you might be avoiding. So that's how it can certainly present itself in different folks. And again, it definitely does oscillate. I know for folks with diabetes, sometimes when I'm working with younger folks or folks that are diagnosed with maybe type 2 at a later age, they're not checking their blood sugars. They're not, um, bolusing or taking their medication because they want to pretend like it doesn't exist. And that's their state at that given time.

[00:07:26] Rob Howe: Totally. And I think recognizing, and we've talked a lot about awareness, asking yourself kind of where I am in my grief cycle related to one event or another. Or I think for me, it's just a good practice is like, okay, well, why am I feeling this way? And, you know, what, what caused me to feel this way and really digging into like, oh, well, you know, this reminded me of something that I had forgotten about, or, you know, there was even a fond memory sometime can, can trigger grief in someone. And I think, you know, with somebody with diabetes, like obviously this is diabetes focused. And we've talked about how closely related mental health and diabetes are, there's a component of grief too, no matter when you were diagnosed, whether that's as a very young person in your case, or, you know, in your teenage years, like myself and kind of in between for Eritrea, you know, there there's grief associated that, that can be lifelong. And that cycle may not be very aggressive at times, but it certainly rears

[00:08:26] Mary Mosier: its head from time to time. Yeah. And that's absolutely true. Cause I think like, again, And some folks will think like, oh, the stages of grief. And that was just kind of written as a way to understand grief, not to say like, this is the flow. And if you're not in this particular flow and doing these steps at this particular time, then something is wrong with you. It was just a way to understand grief. So it does for sure ebb and flow. And it is often most heavy and painful in the beginning. and then we find how to move with that grief as we're learning about ourselves as as we are learning to accept and to feel our feelings and to really build that self-compassion because I know that word or like self-love or self-compassion gets thrown around but we do need to kind of love on ourselves when we experience grief and just in general as human beings we need a little tenderness whatever experience that we're having but specific to grief to be like gosh, this is hard. How can I love on myself, nurture myself?

[00:09:33] Rob Howe: Acknowledging that difficulty. I think we've talked about that a lot on this podcast, even my own contributions to kind of like the toxic positivity around diabetes, like certainly there it exists at the same time. I think that there is a benefit to kind of finding the good in all of those situations at the same time, it's also exhausting. So getting to understand the balance between those. And I think you mentioned it on a previous episode. Hey, if you didn't get a good night's sleep, recognizing what you need in order to feel good in that moment, because you're acknowledging like, oh, hey, there's going to be a difficult day ahead. Let me fill myself up with the things that nurture me. I think that that is something that is a really, really like salient practice for somebody with diabetes, because some of, you know, we talk about controlling what you can control. There are some diabetes variables that, you know, despite our best intentions are outside of our control. And what do you do when that happens is, you know, I think a really good question to ask yourself because certainly it's going to happen.

[00:10:40] Mary Mosier: Yeah. And I, and I think we're, we're all so different in that way. So to like specifically say like, you have to do this would not, would not be ideal. Cause I think we, we need things in different ways, right? So for me, like, because I've been doing this work on myself and like connecting with myself and my body, I know that if I just spend a little bit more time in the sun, or like right now I have this window on my right side and maybe on a tougher day, I make sure that that window and that fresh air is coming in a little bit more than in a day where I'm feeling neutral or just fine. Right. So like, even, even just that piece of acknowledging, Hey, this is really crappy right now. I don't see the silver lining and that's okay. And, and also like, it's okay if you can't find the good in it. Cause sometimes like, and I know some people like to use the phrase, everything happens for a reason. Sometimes there's no reason and that's okay too. right? Like that we, we don't necessarily have to find the silver lining and all the things. And that's, that's, I think it's good to just say like, yeah, this, this does suck, but what do I have control over? What can I do despite like this incredibly high blood sugar and I'm doing all the things, how can I create ease or how can I enlist someone else to help me on this very tough day? if we do have that resource, right? So.

[00:12:09] Rob Howe: And when you're working with your patients, I mean, you mentioned for you, it's your window, sunshine, fresh air and nature and a connectivity to that. What are some of the methods that, you know, you and your patients use to address those sort of micro moments of grief?

[00:12:24] Mary Mosier: Yeah, so I know with a lot of folks that I work with, especially if they're needing a bit more of that, like self-love support, we might acknowledge that something is difficult. So someone might say to themselves, I know it's hard and I'm learning to love myself through this. For someone else, it might be I'm listening to Rage Against the Machine and dancing around in my room because I'm so angry that today is just feeling so crappy. I think music playlist can be helpful. I know some folks will want to do some somatic touch based things, or maybe they're putting their hand over their heart and they're acknowledging that it's tough and that they deserve better. And this is going to be a rough day, but what can I hold about me that is still good? Right. Because me not controlling my diabetes every day doesn't make me a bad diabetic or a bad person. Right. And also who do we follow? Who do we follow on Instagram? Cause sometimes like seeing all those happy people with like, look at my pump, like that can be really annoying. So even just paying attention to the media we follow, cause I know some folks with chronic illness with diabetes, they tell me that like, it's really annoying to see people looking so happy when I'm like, I'm sorry, don't go on my page. Cause I'm doing something. I'm posting myself looking happy with diabetes. Follow me, follow Eritrea, come on over to depression central. So girl, yours are positive too, but just like, it's okay that not every day is going to be rainbows and sunshine. Cause it's not meant to be, we're not always meant to be happy all the time, but like, how do I take care of me? What does that look like along the shower? Me telling my mom or asking someone for help. Cause I don't want to pay attention to my blood sugars or the carb counting. Can my partner do it? Can my sister do it? Can my friend do it? Because we're going to go out to dinner? Like, can someone take a walk with me? Like what, what, what, what could be helpful? What is, what is the thing that is in your control? Cause I think we're all trying and we can acknowledge that I'm trying, I'm trying, even though it sucks right now. Oh, that's such a

[00:14:32] Rob Howe: good thing to acknowledge that like, Oh, I'm putting effort. And I think that's sometimes for me personally, the times where I feel the lowest is where I am putting a significant amount of effort into something that I know is going to be good for me, but I'm not seeing the results yet. or maybe the results just aren't like as cool as they would have been, you know, or, you know, they're not as straightforward or as binary as like, oh, if I do bicep curls, my arm muscles are going to look, you know, big or whatever, or look, you know, toned or whatever. It's more like, you know, for me, like I, I really like silent journey. I was basically on for the last three years is like opening, unlocking mobility in my hips, which is not like a thing that you, you know, as a, as a kid in pre-K, you know, wish for is like the, you're, you know, who you want to be when you grow up is like, oh, I want to be a person with mobile hips. And yet at the same time, like it has unlocked for me, like a very pain-free life that I have worked really hard for and had to celebrate minor, like very minuscule gains in. And that was an interesting practice for me, but you know, I'm on a rabbit trail now. I want to come back to the main thing. Like also you don't have the things that you do for yourself to comfort yourself in those moments of grief, or in those moments where you're feeling low, don't always have to be like, super positive or like adding to your, you know, health or wellness or, you know, a quote unquote, right thing to do. Sometimes it could just be like watching a movie or watching, associating by watching a TV show or eating a snack that that makes you feel good. I know I'm kind of like a psychopath and like all the good things that I do to try to keep myself in the right frame of mind and my ability to me the demands of my life, but I also am a real person. So sometimes I just need a bag of cooler ranch Doritos while I'm at seven 11, you know, you just need something to like, you know, get a little dopamine hit, get something that's like, you know what, I'm going to take five and address my needs as a person before I get back to, you know, whatever it was that was stressing me.

[00:16:26] Mary Mosier: Yeah. Cause the goal is not like, I'm never going to be nonjudgmental again. And even like the way that we speak of it. So you like, you eat your cool ranch Doritos, right? Like it doesn't have to be like always salads, right? Or like, it doesn't have to be for me, it doesn't have to be nature. I think one thing that people don't realize, even like with watching that TV show that we've seen 20 times, it is comforting. And for some folks, it can be a disassociation or distraction. But for other folks, it regulates our nervous system, because we know how it starts and ends. And sometimes that's what we need to see over and over a few times, right? Or like, I go to the same coffee shop, because I know the people that work there, and how this is going to start and end. So you know, like knowing what to expect can be really comforting.

[00:17:20] Rob Howe: Well, we're humans, we thrive in a routine. And that's like an important part of our, you know, biology. So, you know, creating those predictable, controllable kind of moments that you can depend on is really important. Definitely. Yeah. So from a patient perspective, you know, if you're dealing with grief or you're feeling grief and, and mourning sort of your old life or your, or something related to your diabetes, like what's a good way to bring that up in your therapy practice if you haven't done so already, or you're looking to sort of look for more help.

[00:17:52] Mary Mosier: Yeah, definitely using your own language, but just like even saying, you know, I, I realized that I'm having a hard time with this transition from being pre-diabetic to me, like, and I need to process what future me is going to look like or what me in this moment is going to look like. because I had this idea before we started and now my dream needs a little adjustment. It doesn't mean that that dream is going to a hundred percent change so we can still do the things, but the pace might look different. Right. I love the way that you frame that because

[00:18:33] Rob Howe: a huge benefit that I had, and I've talked about it a million times, but it's, it bears repeating is at the beginning of my diagnosis with diabetes, my care team came into the hospital room and they said, Hey, the dreams that you have for your life are still within reach, but there was a change. There was like, as long as you take care of your diabetes and like a new, you know, this new kind of variable. And I needed to hear that because me, I'm like, I I'm a, a thinker. I break things down into the steps to make them happen. And so that then it became, okay, well, my dreams are on the other side of this diabetes management. I want my dreams. So I better apply that same, you know, dedication to, to the diabetes management. So it's, it's important to remember though, that like your dreams, the change can be difficult and like is unfair. And I think acknowledging that as well is very just important as a person. Yeah. I would agree with that because

[00:19:32] Mary Mosier: we, it is important just to say like, this is hard. This is what was not what I was expecting. and I need support in this transition. I, I need support and knowing that I can still be me with this diagnosis or with this change or with this experience that I just had that has shifted my,

[00:19:56] Rob Howe: my worldview a little bit. Well, I think too, it's a really good parallel along with diabetes is talking about grief and talking about mental health in general, because I think for people like me who are very like task and type A oriented, we think like, okay, well, if I do these things, eventually I will reach a finish line and a level of mastery where I'm not gonna need assistance anymore. I'm not gonna have these problems because I've mastered them. And, you know, like, I don't know, just life really doesn't work that way. It's sort of just one unsolvable problem after another, after another. And the to-do list is never gonna be empty and you put down your pencil and you look out your window on a grateful universe and it's all in balance. And so, I don't know, it took me a lot of work to really relieve myself of that notion that one day I'll be perfect and I won't need this stuff anymore. So yeah, I think it was a really interesting parallel between life with a chronic illness that is never ending and life with struggles and challenges never ending as well as grief, which comes in ebbs and flows. But really you carry with you.

[00:21:05] Mary Mosier: yeah absolutely and then also knowing like with those with those struggles there are shifts that are going to happen again like the the heaviness isn't always going to be like at the first moment of diagnosis or the first year of diagnosis we will learn our bodies we will understand them a little bit better and maybe knowing that our blood sugars fluctuate and we have these like highs and lows with blood sugars and also our mood. Like, how are we staying present in those moments that are extra good? How are we savoring those? And then when they're hard, what's 1% that I can do to decrease this for just a little? Like, what's the thing that I can do? I can't take this away, but what's one thing that I can add to create ease or comfort for me, even if it's not something major or longstanding, just enough to kind of help me get through that

[00:22:04] Rob Howe: day. I love what you said about 1% better. I think that's a mantra that is applied a lot through this type of work. And I think it also really resonates with that lifelong marathon, not a sprint type mentality where if, if today I can, I'm only comparing myself to myself. And if I'm showing a step forward in the right direction, like that's something to be grateful for that. That's a win that I can celebrate. It may not be a big push, may not be a giant celebration, but there's one thing and I'm applying myself toward that. And I feel validated in that effort.

[00:22:44] Mary Mosier: Absolutely. Yeah. Cause I don't think we validate those small wins enough. I think we always think about the big things. Like I graduated college, I bought a new car or I got married or whatever it is, but it It can also be like, I worked through this like unnecessary cycle that I'm letting go of and, or I'm practicing non-judgment and that's awesome. Or I did this on my own, or I did this with the help of people for the first time. I like advocated, I asked for help and that's, that's growth for me. Right.

[00:23:16] Rob Howe: Well, I think too, like how much of those are external validation versus internal validation? Yeah. You know, like celebrating yourself when.

[00:23:23] Mary Mosier: The internal stuff is the longstanding. Because when we think about internal and external, deep versus superficial, the internal stuff is the things that make the biggest difference in our life. Not the cool car I just bought. Although that's awesome. If that's a life goal, you want that cool car. But how are we resourced to move through the world outside of the cool car?

[00:23:48] Rob Howe: I think, too, something I've learned recently is we don't see the world as it is. we see the world as we are. So what's important to you is what's important to you. And so, you know, if you're having a hard time giving yourself credit for something, maybe you just need to reframe those priorities just internally and be mindful and be curious about maybe why that is. And I think when you are engaging with that, that is mindfulness. That is mental health. That is That is the meditative. It's not a finish. And there is no big celebration. No genie pops up and is like, congratulations. You figured it all out. Welcome to bliss and harmony. But that really is that like, oh, I recognize this. I have sat with the feelings and I'm able to take a step forward. And I am in control of making that change. So this is for those listening. This is the last of our November, 2022 sessions with Mary Mosier. So I did want to express my gratitude for you for taking the time to spend with our, with our listeners and for all that you do for your patients, but also people with diabetes. So thank you. So thank you for your time and your guidance and, and partnership with diabetics doing things that it truly is wonderful to be able to work with you. And it's exciting to get, get to open up other possibilities for people like us who could use some help and some inspiration and some tools.

[00:25:14] Mary Mosier: Yeah. Happy to be here. Thank you so much for having me.