Lipedema - Desafios emocionais (Elizabeth McMahon, PhD - FDRS 2017)

All [music] right. Well, congratulations to all of right. Well, congratulations to all of right. Well, congratulations to all of you for still being here you for still being here you for still being here and I hope all of you win the raffle. So, what we're going to do is I'm going So, what we're going to do is I'm going So, what we're going to do is I'm going to talk about the emotional challenges to talk about the emotional challenges to talk about the emotional challenges of a fat disorder. You've heard that. I of a fat disorder. You've heard that. I of a fat disorder. You've heard that. I mean, you heard that from Janna Adudik. mean, you heard that from Janna Adudik. mean, you heard that from Janna Adudik. You heard it from Dr. Bartholomew. Uh, You heard it from Dr. Bartholomew. Uh, You heard it from Dr. Bartholomew. Uh, my background is I'm a psychologist for my background is I'm a psychologist for my background is I'm a psychologist for 30 years. Over 30 years, I worked in a 30 years. Over 30 years, I worked in a 30 years. Over 30 years, I worked in a medical center and now I'm in private medical center and now I'm in private medical center and now I'm in private practice and specialize in stress, practice and specialize in stress, practice and specialize in stress, anxiety, panic, phobias, and dealing anxiety, panic, phobias, and dealing anxiety, panic, phobias, and dealing with chronic illness and frequently with chronic illness and frequently with chronic illness and frequently speak to health care professionals and speak to health care professionals and speak to health care professionals and and lay groups. I am an author of books and lay groups. I am an author of books and lay groups. I am an author of books related to lympadema and to some extent related to lympadema and to some extent related to lympadema and to some extent to lipadeema. to lipadeema. to lipadeema. I wrote the overcoming the emotional I wrote the overcoming the emotional I wrote the overcoming the emotional challenges of lympadeema co-author of challenges of lympadeema co-author of challenges of lympadeema co-author of voices of lympadeema and co-author of uh voices of lympadeema and co-author of uh voices of lympadeema and co-author of uh living well with lympadema lympadema living well with lympadema lympadema living well with lympadema lympadema caregivers guide and the lympadeema and caregivers guide and the lympadeema and caregivers guide and the lympadeema and limpadeema nutrition guide so my limpadeema nutrition guide so my limpadeema nutrition guide so my financial disclosures are that I get financial disclosures are that I get financial disclosures are that I get book royalties and ignore the honoraria book royalties and ignore the honoraria book royalties and ignore the honoraria that was from another talk so I'm going that was from another talk so I'm going that was from another talk so I'm going to talk about just four common emotional to talk about just four common emotional to talk about just four common emotional challenges challenges challenges the first is anger you know anger at the the first is anger you know anger at the the first is anger you know anger at the universe. Why me? Anger at your doctor universe. Why me? Anger at your doctor universe. Why me? Anger at your doctor for not understanding. Anger at other for not understanding. Anger at other for not understanding. Anger at other people for not knowing, for not people for not knowing, for not people for not knowing, for not understanding. Uh second is just understanding. Uh second is just understanding. Uh second is just sadness, self-pity, this sense of being sadness, self-pity, this sense of being sadness, self-pity, this sense of being overwhelmed, overwhelmed, overwhelmed, you know, helplessness. This is this is you know, helplessness. This is this is you know, helplessness. This is this is too hard. I I give up. A third is too hard. I I give up. A third is too hard. I I give up. A third is self-consciousness and embarrassment. self-consciousness and embarrassment. self-consciousness and embarrassment. Like other people are looking at my Like other people are looking at my Like other people are looking at my slide and judging that I didn't get the slide and judging that I didn't get the slide and judging that I didn't get the spacing right. Uh [laughter] and shame and self-lame. You know, I and shame and self-lame. You know, I and shame and self-lame. You know, I knew I should have looked at those knew I should have looked at those knew I should have looked at those slides better. It's all my fault. You slides better. It's all my fault. You slides better. It's all my fault. You know, I you know, those negative know, I you know, those negative know, I you know, those negative thoughts out there are true. That thoughts out there are true. That thoughts out there are true. That negative bias is true about me. Just negative bias is true about me. Just negative bias is true about me. Just taking all the negative, not not taking all the negative, not not taking all the negative, not not fighting it, not challenging, not fighting it, not challenging, not fighting it, not challenging, not balancing it out. So, there are a lot of balancing it out. So, there are a lot of balancing it out. So, there are a lot of factors that contribute to this, right? factors that contribute to this, right? factors that contribute to this, right? I mean, you know, you you've heard them I mean, you know, you you've heard them I mean, you know, you you've heard them throughout the conference. uh the lack throughout the conference. uh the lack throughout the conference. uh the lack of knowledge about fat disorders. And in of knowledge about fat disorders. And in of knowledge about fat disorders. And in the absence of knowledge, what do we the absence of knowledge, what do we the absence of knowledge, what do we fall back on? We fall back on column of fall back on? We fall back on column of fall back on? We fall back on column of beliefs, we fall back on bias and beliefs, we fall back on bias and beliefs, we fall back on bias and prejudice. And we all know the common prejudice. And we all know the common prejudice. And we all know the common beliefs and prejudices about being beliefs and prejudices about being beliefs and prejudices about being overweight or having some kind of fat overweight or having some kind of fat overweight or having some kind of fat problem, right? Dr. Bartholomew just problem, right? Dr. Bartholomew just problem, right? Dr. Bartholomew just went through them. went through them. went through them. And you know, what did you know about And you know, what did you know about And you know, what did you know about fat disorders before your diagnosis, fat disorders before your diagnosis, fat disorders before your diagnosis, right? I mean, if our MDs don't know right? I mean, if our MDs don't know right? I mean, if our MDs don't know about it, how much do our neighbors, our about it, how much do our neighbors, our about it, how much do our neighbors, our spouses, our co-workers, our bosses, spouses, our co-workers, our bosses, spouses, our co-workers, our bosses, right? And we talked about weight bias. I mean, And we talked about weight bias. I mean, And we talked about weight bias. I mean, society criticizes and makes fun of society criticizes and makes fun of society criticizes and makes fun of people who have a fat problem, who have people who have a fat problem, who have people who have a fat problem, who have a weight problem. You look you look at a weight problem. You look you look at a weight problem. You look you look at the media, right? the media, right? the media, right? Look at the villains. I'm I'm I'm Look at the villains. I'm I'm I'm Look at the villains. I'm I'm I'm thinking Ursula the Sea Witch, right? In thinking Ursula the Sea Witch, right? In thinking Ursula the Sea Witch, right? In Disney's Disney's Disney's um Ariel, right? Thank you. Yes, Little um Ariel, right? Thank you. Yes, Little um Ariel, right? Thank you. Yes, Little Mermaid. Mermaid. Mermaid. She got a very sexy song, but she does She got a very sexy song, but she does She got a very sexy song, but she does not given a sexy body. not given a sexy body. not given a sexy body. There's just all of these There's just all of these There's just all of these misconceptions, these preconceptions misconceptions, these preconceptions misconceptions, these preconceptions about what a weight problem means. about what a weight problem means. about what a weight problem means. And this all of this all of this induces And this all of this all of this induces And this all of this all of this induces stress. And stress then starts this this stress. And stress then starts this this stress. And stress then starts this this whole negative cycle, right? Stress whole negative cycle, right? Stress whole negative cycle, right? Stress increases abdominal fat. Abdominal fat increases abdominal fat. Abdominal fat increases abdominal fat. Abdominal fat acts hormonally to increase stress acts hormonally to increase stress acts hormonally to increase stress hormones. You know, external stresses hormones. You know, external stresses hormones. You know, external stresses reduce stress hormones. So, you've heard reduce stress hormones. So, you've heard reduce stress hormones. So, you've heard some of the recommendations that have some of the recommendations that have some of the recommendations that have been made [laughter] by Dr. Franko, I been made [laughter] by Dr. Franko, I been made [laughter] by Dr. Franko, I think I've just mispronounced your name, think I've just mispronounced your name, think I've just mispronounced your name, by Joanna Dudek. Things like by Joanna Dudek. Things like by Joanna Dudek. Things like mindfulness, things like relaxation, mindfulness, things like relaxation, mindfulness, things like relaxation, things like exercise. finding ways to things like exercise. finding ways to things like exercise. finding ways to reduce stress. And one definition of reduce stress. And one definition of reduce stress. And one definition of stress is that the perceived challenge stress is that the perceived challenge stress is that the perceived challenge outweighs your resources and your outweighs your resources and your outweighs your resources and your ability to respond to cope. Okay. ability to respond to cope. Okay. ability to respond to cope. Okay. So my purpose in this talk is to give So my purpose in this talk is to give So my purpose in this talk is to give you tools and tips and techniques so you tools and tips and techniques so you tools and tips and techniques so that you leave here feeling more that you leave here feeling more that you leave here feeling more empowered empowered empowered because you're still going to be dealing because you're still going to be dealing because you're still going to be dealing with those stresses physical and with those stresses physical and with those stresses physical and societal and emotional. But if you have societal and emotional. But if you have societal and emotional. But if you have the resources the resources the resources then they don't impact you the same way. then they don't impact you the same way. then they don't impact you the same way. They don't impact you the same way They don't impact you the same way They don't impact you the same way emotionally and they don't impact you emotionally and they don't impact you emotionally and they don't impact you the same way physiologically. They've the same way physiologically. They've the same way physiologically. They've done studies of cortisol, one of the done studies of cortisol, one of the done studies of cortisol, one of the main stress hormones. They've measured main stress hormones. They've measured main stress hormones. They've measured blood cortisol levels in soldiers who blood cortisol levels in soldiers who blood cortisol levels in soldiers who are about to do something very are about to do something very are about to do something very physically challenging and demanding. physically challenging and demanding. physically challenging and demanding. And there was a subset of soldiers whose And there was a subset of soldiers whose And there was a subset of soldiers whose cortisol levels did not rise. cortisol levels did not rise. cortisol levels did not rise. Did not rise. And when they interviewed Did not rise. And when they interviewed Did not rise. And when they interviewed them, they found that what was different them, they found that what was different them, they found that what was different was that subset said to themselves, was that subset said to themselves, was that subset said to themselves, "I can do this. I've trained for this. "I can do this. I've trained for this. "I can do this. I've trained for this. I've got the tools. I've got this down. I've got the tools. I've got this down. I've got the tools. I've got this down. I can do it." So, it was the same I can do it." So, it was the same I can do it." So, it was the same challenge, challenge, challenge, but their belief was, "I know what to but their belief was, "I know what to but their belief was, "I know what to do. I can handle this." And so, it do. I can handle this." And so, it do. I can handle this." And so, it wasn't stressful. It wasn't stressful wasn't stressful. It wasn't stressful wasn't stressful. It wasn't stressful emotionally. It wasn't stressful emotionally. It wasn't stressful emotionally. It wasn't stressful physiologically. So, let's talk about some tools to So, let's talk about some tools to So, let's talk about some tools to reduce each of these challenges. reduce each of these challenges. reduce each of these challenges. And I like to give talks that are almost And I like to give talks that are almost And I like to give talks that are almost collaborative and interactive. So, I collaborative and interactive. So, I collaborative and interactive. So, I want you to think about right now one want you to think about right now one want you to think about right now one thing that you're feeling angry about or thing that you're feeling angry about or thing that you're feeling angry about or resentful about or that tends to trigger resentful about or that tends to trigger resentful about or that tends to trigger anger, whether it's your doctor or your anger, whether it's your doctor or your anger, whether it's your doctor or your medical condition or your teenager or medical condition or your teenager or medical condition or your teenager or your neighbor or your boss or your your neighbor or your boss or your your neighbor or your boss or your coworker. Okay? coworker. Okay? coworker. Okay? And the thing about anger is that And the thing about anger is that And the thing about anger is that psychologists talk about it as a psychologists talk about it as a psychologists talk about it as a secondary emotion. Let me talk about secondary emotion. Let me talk about secondary emotion. Let me talk about what I mean by that by by a secondary what I mean by that by by a secondary what I mean by that by by a secondary emotion. The best example is you're emotion. The best example is you're emotion. The best example is you're driving down the freeway, right? And driving down the freeway, right? And driving down the freeway, right? And maybe you're stressed already and all of maybe you're stressed already and all of maybe you're stressed already and all of a sudden somebody decides that they've a sudden somebody decides that they've a sudden somebody decides that they've got to cut right in front of you with got to cut right in front of you with got to cut right in front of you with about an inch because they've been in about an inch because they've been in about an inch because they've been in the far left lane and they suddenly the far left lane and they suddenly the far left lane and they suddenly decide that they've got to get off right decide that they've got to get off right decide that they've got to get off right now. now. now. you know, and and as they swerve in you know, and and as they swerve in you know, and and as they swerve in front of you and you almost hit them, front of you and you almost hit them, front of you and you almost hit them, right, they get off and you're thinking, right, they get off and you're thinking, right, they get off and you're thinking, right? right? right? And that's even assuming you keep both And that's even assuming you keep both And that's even assuming you keep both hands on the wheel and don't give them hands on the wheel and don't give them hands on the wheel and don't give them the little parting salute. the little parting salute. the little parting salute. But what happened right before the surge But what happened right before the surge But what happened right before the surge of anger? What were you feeling then? of anger? What were you feeling then? of anger? What were you feeling then? Fear. Fear. Fear. Fear. Exactly. Fear. Exactly. Fear. Exactly. Anger is usually a response to some Anger is usually a response to some Anger is usually a response to some perceived threat, some sense of threat, perceived threat, some sense of threat, perceived threat, some sense of threat, some threat to your respects, threat to some threat to your respects, threat to some threat to your respects, threat to your self-esteem, threat to your health, your self-esteem, threat to your health, your self-esteem, threat to your health, threat to your future. So, think about threat to your future. So, think about threat to your future. So, think about when you're angry, when you're angry, when you're angry, what's underneath that anger? What are what's underneath that anger? What are what's underneath that anger? What are you feeling threatened about? What are you feeling threatened about? What are you feeling threatened about? What are you feeling worried about? What what are you feeling worried about? What what are you feeling worried about? What what are you concerned might happen? Um, you you concerned might happen? Um, you you concerned might happen? Um, you know, what's really going on? And then know, what's really going on? And then know, what's really going on? And then also think about what are you telling also think about what are you telling also think about what are you telling yourself about the other person that yourself about the other person that yourself about the other person that you're angry about? You know, they did you're angry about? You know, they did you're angry about? You know, they did they really get up in the morning with they really get up in the morning with they really get up in the morning with the goal of pissing you off? the goal of pissing you off? the goal of pissing you off? You know, probably not. And if they are, You know, probably not. And if they are, You know, probably not. And if they are, find some way to stay away from them. find some way to stay away from them. find some way to stay away from them. Uh, you know, what's really going on? Uh, you know, what's really going on? Uh, you know, what's really going on? What are you telling yourself? Start to What are you telling yourself? Start to What are you telling yourself? Start to question it. just because it feels question it. just because it feels question it. just because it feels righteous and empowering uh doesn't mean righteous and empowering uh doesn't mean righteous and empowering uh doesn't mean it's true and certainly doesn't mean it's true and certainly doesn't mean it's true and certainly doesn't mean it's helpful. So really say, you know, it's helpful. So really say, you know, it's helpful. So really say, you know, do I really know that this is true? The do I really know that this is true? The do I really know that this is true? The assumptions, you know, what I'm telling assumptions, you know, what I'm telling assumptions, you know, what I'm telling myself about the other person's agenda, myself about the other person's agenda, myself about the other person's agenda, their meaning, their intent. Um is your their meaning, their intent. Um is your their meaning, their intent. Um is your anger helping you or hurting you? anger helping you or hurting you? anger helping you or hurting you? You know, when I get angry at other You know, when I get angry at other You know, when I get angry at other drivers on the freeway, I think to drivers on the freeway, I think to drivers on the freeway, I think to myself, my anger just raises my blood myself, my anger just raises my blood myself, my anger just raises my blood pressure and just hurts me. It's just pressure and just hurts me. It's just pressure and just hurts me. It's just raising my stress hormones. I don't I raising my stress hormones. I don't I raising my stress hormones. I don't I don't need that. I don't need that. As a don't need that. I don't need that. As a don't need that. I don't need that. As a matter of fact, I have started telling matter of fact, I have started telling matter of fact, I have started telling myself, be a Zen driver. myself, be a Zen driver. myself, be a Zen driver. And and I tend to I tend to remind And and I tend to I tend to remind And and I tend to I tend to remind myself to to just send out a Buddhist um myself to to just send out a Buddhist um myself to to just send out a Buddhist um loving kindness meditation. You know, loving kindness meditation. You know, loving kindness meditation. You know, may they be safe because I really don't may they be safe because I really don't may they be safe because I really don't want them to have another accident. May want them to have another accident. May want them to have another accident. May they be safe, they be safe, they be safe, may they be healthy, may they be healthy, may they be healthy, may they be happy, may they be happy, may they be happy, may they be made whole, and hopefully a may they be made whole, and hopefully a may they be made whole, and hopefully a whole lot better driver. Yeah. So think about what are the actual Yeah. So think about what are the actual Yeah. So think about what are the actual consequences of getting angry to you, to consequences of getting angry to you, to consequences of getting angry to you, to the other person, to the relationship, the other person, to the relationship, the other person, to the relationship, to this situation. What's really going to this situation. What's really going to this situation. What's really going on? Now, I'm not saying anger's bad, on? Now, I'm not saying anger's bad, on? Now, I'm not saying anger's bad, okay? Anger can be incredibly okay? Anger can be incredibly okay? Anger can be incredibly productive, and it's productive when it productive, and it's productive when it productive, and it's productive when it alerts you to a solvable problem and alerts you to a solvable problem and alerts you to a solvable problem and energizes you to do something about it. energizes you to do something about it. energizes you to do something about it. So get out there, write to your state So get out there, write to your state So get out there, write to your state senators, write to your representatives, senators, write to your representatives, senators, write to your representatives, you know, fight the insurance companies, you know, fight the insurance companies, you know, fight the insurance companies, you know, support new legislation, get you know, support new legislation, get you know, support new legislation, get the information you need. the information you need. the information you need. But the key is But the key is But the key is you should be angry about a solvable you should be angry about a solvable you should be angry about a solvable problem problem problem and channel your anger into effective, and channel your anger into effective, and channel your anger into effective, productive action. not churning, not productive action. not churning, not productive action. not churning, not spinning, not ruminating, not stewing. spinning, not ruminating, not stewing. spinning, not ruminating, not stewing. And when you can't change the external, And when you can't change the external, And when you can't change the external, when it's not solvable, you can't just when it's not solvable, you can't just when it's not solvable, you can't just say, "I think I'll not have a fat say, "I think I'll not have a fat say, "I think I'll not have a fat disorder." disorder." disorder." Oh, wouldn't that be nice? Yeah. So, Oh, wouldn't that be nice? Yeah. So, Oh, wouldn't that be nice? Yeah. So, when it's not solvable, right? when it's not solvable, right? when it's not solvable, right? Look at what you can change inside. Look at what you can change inside. Look at what you can change inside. Change your self-t talk. How we talk to Change your self-t talk. How we talk to Change your self-t talk. How we talk to ourselves makes a huge difference. Makes ourselves makes a huge difference. Makes ourselves makes a huge difference. Makes a huge difference. If you say, "This is a huge difference. If you say, "This is a huge difference. If you say, "This is overwhelming and I can't do it." You're overwhelming and I can't do it." You're overwhelming and I can't do it." You're going to feel overwhelmed and helpless. going to feel overwhelmed and helpless. going to feel overwhelmed and helpless. If you say, "What do I need to do? This If you say, "What do I need to do? This If you say, "What do I need to do? This is really hard. I didn't want it. I is really hard. I didn't want it. I is really hard. I didn't want it. I don't like it, but by God, by God, I'm don't like it, but by God, by God, I'm don't like it, but by God, by God, I'm going to do the best I can. Now, where going to do the best I can. Now, where going to do the best I can. Now, where can I find those tools and what can I find those tools and what can I find those tools and what information do I need? And let's roll up information do I need? And let's roll up information do I need? And let's roll up our sleeves and get down to work." our sleeves and get down to work." our sleeves and get down to work." You're going to feel better. Your body You're going to feel better. Your body You're going to feel better. Your body physiologically responds differently. physiologically responds differently. physiologically responds differently. You're going to cope differently. And You're going to cope differently. And You're going to cope differently. And you're starting a positive cycle. In you're starting a positive cycle. In you're starting a positive cycle. In most things in life, most things in life, most things in life, right, you have a choice and you have a right, you have a choice and you have a right, you have a choice and you have a choice between a vicious cycle and choice between a vicious cycle and choice between a vicious cycle and what's called a virtuous cycle. So think what's called a virtuous cycle. So think what's called a virtuous cycle. So think about what you know what what are your about what you know what what are your about what you know what what are your expectations? Where are you putting your expectations? Where are you putting your expectations? Where are you putting your attention on the problem or on possible attention on the problem or on possible attention on the problem or on possible solutions? Things that could make it solutions? Things that could make it solutions? Things that could make it better. And one way to do this is to better. And one way to do this is to better. And one way to do this is to broaden your perspective. Ask yourself broaden your perspective. Ask yourself broaden your perspective. Ask yourself what I think of as the three ways what I think of as the three ways what I think of as the three ways question. So think about that thing that question. So think about that thing that question. So think about that thing that situation that's making you kind of situation that's making you kind of situation that's making you kind of irritated right now and first sit down irritated right now and first sit down irritated right now and first sit down and write out or think about three ways and write out or think about three ways and write out or think about three ways it could be better. So start by getting it could be better. So start by getting it could be better. So start by getting the anger out. Three ways you're really the anger out. Three ways you're really the anger out. Three ways you're really not happy with it. Things you wish were not happy with it. Things you wish were not happy with it. Things you wish were different that aren't happening or different that aren't happening or different that aren't happening or things that you weren't wish weren't things that you weren't wish weren't things that you weren't wish weren't happening that are. So start out with happening that are. So start out with happening that are. So start out with three ways it could be better. three ways it could be better. three ways it could be better. But then having done that, broaden the perspective broaden the perspective broaden the perspective and write down three ways it actually and write down three ways it actually and write down three ways it actually could be much worse than it is. could be much worse than it is. could be much worse than it is. It opens up that perspective. It opens up that perspective. It opens up that perspective. And I want to tell you, I've got a And I want to tell you, I've got a And I want to tell you, I've got a wonderful daughter and she's an ER nurse wonderful daughter and she's an ER nurse wonderful daughter and she's an ER nurse and she's amazing, but you know, she and she's amazing, but you know, she and she's amazing, but you know, she went through adolescence. went through adolescence. went through adolescence. [laughter] She was developmentally appropriate She was developmentally appropriate She was developmentally appropriate during her adolescence [laughter] during her adolescence [laughter] during her adolescence [laughter] and and this tool really helped me. So what about sadness, self-pity, So what about sadness, self-pity, So what about sadness, self-pity, helplessness, right? helplessness, right? helplessness, right? One of those things is just kind of One of those things is just kind of One of those things is just kind of anchor yourself. You know, life just anchor yourself. You know, life just anchor yourself. You know, life just wasn't guaranteed to be fair. wasn't guaranteed to be fair. wasn't guaranteed to be fair. And the other thing I often find helpful And the other thing I often find helpful And the other thing I often find helpful is everybody has something. In fact, is everybody has something. In fact, is everybody has something. In fact, there's a wonderful phrase by an Annie there's a wonderful phrase by an Annie there's a wonderful phrase by an Annie Lamont, Lamont, Lamont, everyone has unseen wounds. everyone has unseen wounds. everyone has unseen wounds. Isn't that a wonderful phrase? You step Isn't that a wonderful phrase? You step Isn't that a wonderful phrase? You step back and you realize whatever is going back and you realize whatever is going back and you realize whatever is going on, they may be doing the best they can on, they may be doing the best they can on, they may be doing the best they can and you don't know what their unseen and you don't know what their unseen and you don't know what their unseen wound is. So develop a philosophy or a wound is. So develop a philosophy or a wound is. So develop a philosophy or a religious view that supports religious view that supports religious view that supports you and save your energy for you and save your energy for you and save your energy for constructive action and focus is on what constructive action and focus is on what constructive action and focus is on what is possible. is possible. is possible. Now there's a difference between sadness Now there's a difference between sadness Now there's a difference between sadness and depression because you've heard and depression because you've heard and depression because you've heard Joanna Dudik's talk that depression is Joanna Dudik's talk that depression is Joanna Dudik's talk that depression is extremely common with lipadeema. Okay. extremely common with lipadeema. Okay. extremely common with lipadeema. Okay. Clinical depression is you're in a low Clinical depression is you're in a low Clinical depression is you're in a low mood most days, most of the time. You mood most days, most of the time. You mood most days, most of the time. You may find that you're pessimistic. You may find that you're pessimistic. You may find that you're pessimistic. You don't enjoy things that you would don't enjoy things that you would don't enjoy things that you would normally enjoy. Your appetite goes up or normally enjoy. Your appetite goes up or normally enjoy. Your appetite goes up or down. That you have trouble sleeping or down. That you have trouble sleeping or down. That you have trouble sleeping or you're oversleeping. You have trouble you're oversleeping. You have trouble you're oversleeping. You have trouble concentrating. You're tired. Some of concentrating. You're tired. Some of concentrating. You're tired. Some of this can be physical effects of the this can be physical effects of the this can be physical effects of the lympadeema, of the diet, of the lympadeema, of the diet, of the lympadeema, of the diet, of the medications, of the condition. But if medications, of the condition. But if medications, of the condition. But if you have this entire cluster, right, you have this entire cluster, right, you have this entire cluster, right, don't just dismiss it. don't just dismiss it. don't just dismiss it. Consider the possibility that you've Consider the possibility that you've Consider the possibility that you've also got something going on also got something going on also got something going on biochemically biochemically biochemically uh with the neurotransmitters. Put things in perspective. Put things in perspective. Put things in perspective. So you take that broader view again and So you take that broader view again and So you take that broader view again and this time to take the broader view not this time to take the broader view not this time to take the broader view not in terms of three ways could be better in terms of three ways could be better in terms of three ways could be better could be worse but take take the broader could be worse but take take the broader could be worse but take take the broader perspective in the look you know back to perspective in the look you know back to perspective in the look you know back to the future right looking back five years the future right looking back five years the future right looking back five years from now 10 years from now 20 years from from now 10 years from now 20 years from from now 10 years from now 20 years from now what do I want to look back on in now what do I want to look back on in now what do I want to look back on in how I coped with this in the choices I how I coped with this in the choices I how I coped with this in the choices I made in the way I thought about it in made in the way I thought about it in made in the way I thought about it in the way I treated myself and other the way I treated myself and other the way I treated myself and other people you know what kind of person do people you know what kind of person do people you know what kind of person do you want to be what matters in the long you want to be what matters in the long you want to be what matters in the long run. What's going to give you a sense of run. What's going to give you a sense of run. What's going to give you a sense of satisfaction? So, what about the self-consciousness, So, what about the self-consciousness, So, what about the self-consciousness, the embarrassment? All right, we know the embarrassment? All right, we know the embarrassment? All right, we know that people respond to our appearance. that people respond to our appearance. that people respond to our appearance. They do. That's a fact. The really They do. That's a fact. The really They do. That's a fact. The really encouraging research though is they also encouraging research though is they also encouraging research though is they also respond to your comfort level. There's respond to your comfort level. There's respond to your comfort level. There's something called emotional contagion. something called emotional contagion. something called emotional contagion. people pick up the emotions that we put people pick up the emotions that we put people pick up the emotions that we put out of the people around them. So the out of the people around them. So the out of the people around them. So the more comfortable you can feel with who more comfortable you can feel with who more comfortable you can feel with who you are, the more that is expressed to you are, the more that is expressed to you are, the more that is expressed to people. And there are certain ways that people. And there are certain ways that people. And there are certain ways that you can also hold yourself and interact you can also hold yourself and interact you can also hold yourself and interact with others that will help. You have with others that will help. You have with others that will help. You have your head up and you make eye contact. your head up and you make eye contact. your head up and you make eye contact. You smile. You smile. You smile. You nod. You send out to them a sense of You nod. You send out to them a sense of You nod. You send out to them a sense of if you feel like you work on feeling if you feel like you work on feeling if you feel like you work on feeling good about yourself and you send that good about yourself and you send that good about yourself and you send that out to other people, they will respond out to other people, they will respond out to other people, they will respond to that. You have a kind of confident, to that. You have a kind of confident, to that. You have a kind of confident, relaxed, friendly posture and a relaxed, friendly posture and a relaxed, friendly posture and a confident, friendly voice tone. confident, friendly voice tone. confident, friendly voice tone. You can influence other people and engage in life. and engage in life. and engage in life. Don't avoid because you're not perfect. Don't avoid because you're not perfect. Don't avoid because you're not perfect. That just puts you in that negative That just puts you in that negative That just puts you in that negative spiral. Think about what gives you spiral. Think about what gives you spiral. Think about what gives you pleasure, pleasure, pleasure, what gives you meaning, what uses your what gives you meaning, what uses your what gives you meaning, what uses your talents and your skills. talents and your skills. talents and your skills. Make contact with people. You heard Make contact with people. You heard Make contact with people. You heard about the importance of social about the importance of social about the importance of social connection. Well, it's hard to make connection. Well, it's hard to make connection. Well, it's hard to make social connection if you're not out social connection if you're not out social connection if you're not out there with people. The internet only there with people. The internet only there with people. The internet only goes so far. You know, think about the goes so far. You know, think about the goes so far. You know, think about the fact that you have the right to make fact that you have the right to make fact that you have the right to make your own choices. You have the right to your own choices. You have the right to your own choices. You have the right to feel good about yourself. If you're not feel good about yourself. If you're not feel good about yourself. If you're not going to be taking, if you're not gonna going to be taking, if you're not gonna going to be taking, if you're not gonna be standing up for yourself, who is, be standing up for yourself, who is, be standing up for yourself, who is, right? right? right? And let go of what you don't control. And let go of what you don't control. And let go of what you don't control. And that includes other people's And that includes other people's And that includes other people's reactions. There's a wonderful phrase reactions. There's a wonderful phrase reactions. There's a wonderful phrase from AA. What other people think about me What other people think about me What other people think about me is none of my business. is none of my business. is none of my business. Isn't that great phrase? You don't Isn't that great phrase? You don't Isn't that great phrase? You don't control it. And you kind of think, you control it. And you kind of think, you control it. And you kind of think, you know what? it's on them. My job is to know what? it's on them. My job is to know what? it's on them. My job is to take care of me. So take responsibility take care of me. So take responsibility take care of me. So take responsibility for what is absolutely under your for what is absolutely under your for what is absolutely under your control and let go of the rest. control and let go of the rest. control and let go of the rest. And really think about what are you And really think about what are you And really think about what are you proud about? What are your talents? What proud about? What are your talents? What proud about? What are your talents? What are your skills? are your skills? are your skills? What do you like about yourself? What What do you like about yourself? What What do you like about yourself? What are your values? and partner with your body and partner with your body and partner with your body because it's doing the best it's can it because it's doing the best it's can it because it's doing the best it's can it can. You know, there's a phrase, You know, there's a phrase, You know, there's a phrase, your body is the precious physical plant your body is the precious physical plant your body is the precious physical plant that allows you to experience life. that allows you to experience life. that allows you to experience life. And I often think your body is kind of And I often think your body is kind of And I often think your body is kind of like a helpless baby. You know, it like a helpless baby. You know, it like a helpless baby. You know, it relies on you to take care of it. relies on you to take care of it. relies on you to take care of it. So, in what ways can you have gratitude So, in what ways can you have gratitude So, in what ways can you have gratitude for your body? Can you have admiration for your body? Can you have admiration for your body? Can you have admiration and respect that it's doing the best it and respect that it's doing the best it and respect that it's doing the best it can? That you can offer for your body can? That you can offer for your body can? That you can offer for your body loving care and compassion loving care and compassion loving care and compassion and commit to a partnership with it. You are more than just your weight. You You are more than just your weight. You You are more than just your weight. You are more than just your fat disorder. are more than just your fat disorder. are more than just your fat disorder. Focus on what makes you the unique Focus on what makes you the unique Focus on what makes you the unique person you are. That's your view of yourself. That's your view of yourself. That's your view of yourself. You want to make that your story, your You want to make that your story, your You want to make that your story, your narrative. narrative. narrative. You want to live up to that. And I've got some rules for healthy And I've got some rules for healthy And I've got some rules for healthy self-t talk and thinking. self-t talk and thinking. self-t talk and thinking. They've got to meet these two criteria. They've got to meet these two criteria. They've got to meet these two criteria. What you say has got to be objectively What you say has got to be objectively What you say has got to be objectively true. But if it is not helpful, I don't true. But if it is not helpful, I don't true. But if it is not helpful, I don't give it brain room. give it brain room. give it brain room. What you say to yourself needs to be What you say to yourself needs to be What you say to yourself needs to be true and helpful. If it's not helpful, true and helpful. If it's not helpful, true and helpful. If it's not helpful, why are you letting it in any more than why are you letting it in any more than why are you letting it in any more than you would put poison in your body? you would put poison in your body? you would put poison in your body? It needs to be realistic. It can't be, It needs to be realistic. It can't be, It needs to be realistic. It can't be, oh, everything's going to be fine, oh, everything's going to be fine, oh, everything's going to be fine, little Mary sunshine, right? BS doesn't little Mary sunshine, right? BS doesn't little Mary sunshine, right? BS doesn't work. work. work. Got to be realistic and it needs to be Got to be realistic and it needs to be Got to be realistic and it needs to be supportive. supportive. supportive. So this is where you're sort of talking So this is where you're sort of talking So this is where you're sort of talking about tough-minded support. This is about tough-minded support. This is about tough-minded support. This is where you get the perseverance. This is where you get the perseverance. This is where you get the perseverance. This is where you take care of yourself and you where you take care of yourself and you where you take care of yourself and you make a difference. Our emotions. Have make a difference. Our emotions. Have make a difference. Our emotions. Have you ever noticed when you're in a great you ever noticed when you're in a great you ever noticed when you're in a great mood, you have happy thoughts. And when mood, you have happy thoughts. And when mood, you have happy thoughts. And when you're in a lousy mood, you have lousy you're in a lousy mood, you have lousy you're in a lousy mood, you have lousy thoughts. And physically that can affect thoughts. And physically that can affect thoughts. And physically that can affect it. it. it. I used to have to wake up really early, I used to have to wake up really early, I used to have to wake up really early, do a really long commute, make a very do a really long commute, make a very do a really long commute, make a very work a very long day, and by about the work a very long day, and by about the work a very long day, and by about the third day, I got to tell you, I was in a third day, I got to tell you, I was in a third day, I got to tell you, I was in a bad mood. I was sleepdeprived. bad mood. I was sleepdeprived. bad mood. I was sleepdeprived. I would be walking into work feeling I would be walking into work feeling I would be walking into work feeling self-pity and depressed, you know, and I self-pity and depressed, you know, and I self-pity and depressed, you know, and I knew it was temporary. And yet, Right. knew it was temporary. And yet, Right. knew it was temporary. And yet, Right. Right. But so we have certain thoughts Right. But so we have certain thoughts Right. But so we have certain thoughts that come when we're feeling certain that come when we're feeling certain that come when we're feeling certain ways. But at the same time, ways. But at the same time, ways. But at the same time, how we're thinking, what we're telling how we're thinking, what we're telling how we're thinking, what we're telling oursel, where we're directing our oursel, where we're directing our oursel, where we're directing our attention influences our emotions. So we attention influences our emotions. So we attention influences our emotions. So we can't just say, "Oh, I think I want to can't just say, "Oh, I think I want to can't just say, "Oh, I think I want to feel happy right now." feel happy right now." feel happy right now." But we can go and very deliberately But we can go and very deliberately But we can go and very deliberately change the focus of our attention. change the focus of our attention. change the focus of our attention. Notice what we're saying to ourselves Notice what we're saying to ourselves Notice what we're saying to ourselves and change it to healthier, more and change it to healthier, more and change it to healthier, more realistic, more supportive, more realistic, more supportive, more realistic, more supportive, more encouraging self-t talk. And that encouraging self-t talk. And that encouraging self-t talk. And that creates a positive cycle and that creates a positive cycle and that creates a positive cycle and that affects your mood and your mood affects affects your mood and your mood affects affects your mood and your mood affects your coping and all of that affects your your coping and all of that affects your your coping and all of that affects your body. And the bottom line is don't body. And the bottom line is don't body. And the bottom line is don't believe everything you think. believe everything you think. believe everything you think. Just because you think it doesn't mean Just because you think it doesn't mean Just because you think it doesn't mean it's true or helpful. And if you're it's true or helpful. And if you're it's true or helpful. And if you're thinking things that make you feel bad thinking things that make you feel bad thinking things that make you feel bad or that interfere with your functioning, or that interfere with your functioning, or that interfere with your functioning, put them on the witness stand and just put them on the witness stand and just put them on the witness stand and just cross-examine the heck out of them. just cross-examine the heck out of them. just cross-examine the heck out of them. just get in there and and treat it like a get in there and and treat it like a get in there and and treat it like a hostile lying witness. Where's the hostile lying witness. Where's the hostile lying witness. Where's the evidence for that? Is that the only way evidence for that? Is that the only way evidence for that? Is that the only way to think about it? Is that a 100% true? to think about it? Is that a 100% true? to think about it? Is that a 100% true? Is this what you would tell someone that Is this what you would tell someone that Is this what you would tell someone that you care about? you care about? you care about? If you were a wise mentor and someone If you were a wise mentor and someone If you were a wise mentor and someone was coming to you with these thoughts, was coming to you with these thoughts, was coming to you with these thoughts, what would you advise them? what would you advise them? what would you advise them? Right? How else could you think about Right? How else could you think about Right? How else could you think about it? There's always some other way that it? There's always some other way that it? There's always some other way that we could think about it that makes it we could think about it that makes it we could think about it that makes it better. Learn from other people. Who are the Learn from other people. Who are the Learn from other people. Who are the people who are just the rock stars in people who are just the rock stars in people who are just the rock stars in terms of coping? How do they think about terms of coping? How do they think about terms of coping? How do they think about it? What do they do? What do they tell it? What do they do? What do they tell it? What do they do? What do they tell themselves? You know, how is it that themselves? You know, how is it that themselves? You know, how is it that Sarah is able to get up there and go and Sarah is able to get up there and go and Sarah is able to get up there and go and talk to the Congress people? What does talk to the Congress people? What does talk to the Congress people? What does she tell herself? How does she do that? she tell herself? How does she do that? she tell herself? How does she do that? How does she prepare? Who do you know How does she prepare? Who do you know How does she prepare? Who do you know who copes well? who copes well? who copes well? Talk to them. Interview them. Make them Talk to them. Interview them. Make them Talk to them. Interview them. Make them part of your circle of advisors. Learn part of your circle of advisors. Learn part of your circle of advisors. Learn from them. from them. from them. How do they think about themselves? How How do they think about themselves? How How do they think about themselves? How do they think about their challenges? do they think about their challenges? do they think about their challenges? Think about the challenges that you have Think about the challenges that you have Think about the challenges that you have overcome in your life. What did you tell overcome in your life. What did you tell overcome in your life. What did you tell yourself about those? yourself about those? yourself about those? How can you use that way of thinking to How can you use that way of thinking to How can you use that way of thinking to overcome these challenges? overcome these challenges? overcome these challenges? What would you do differently What would you do differently What would you do differently if you modeled yourself on someone that if you modeled yourself on someone that if you modeled yourself on someone that you admired you admired you admired with kids? This is the what would Batman with kids? This is the what would Batman with kids? This is the what would Batman do trick. do trick. do trick. I kind of like the what would Wonder I kind of like the what would Wonder I kind of like the what would Wonder Woman do trick. You know, I like that Woman do trick. You know, I like that Woman do trick. You know, I like that lasso truth. lasso truth. lasso truth. You know, think about someone that you You know, think about someone that you You know, think about someone that you admire and think about being the person admire and think about being the person admire and think about being the person that you admire and think about how you that you admire and think about how you that you admire and think about how you want to look back in a couple of years. want to look back in a couple of years. want to look back in a couple of years. And notice what works when you feel And notice what works when you feel And notice what works when you feel good. Who are you with? You know, there good. Who are you with? You know, there good. Who are you with? You know, there are people who bring you up, there are are people who bring you up, there are are people who bring you up, there are people who bring you down. Start paying people who bring you down. Start paying people who bring you down. Start paying attention to that. What are you doing attention to that. What are you doing attention to that. What are you doing when you feel better? when you feel better? when you feel better? Where are you? I have friends who are Where are you? I have friends who are Where are you? I have friends who are gardeners. Any gardeners here? Right. gardeners. Any gardeners here? Right. gardeners. Any gardeners here? Right. How do you feel when you're gardening? How do you feel when you're gardening? How do you feel when you're gardening? Right now, me, I kill plants. Black Right now, me, I kill plants. Black Right now, me, I kill plants. Black thumbs. Totally black thumbs. On the thumbs. Totally black thumbs. On the thumbs. Totally black thumbs. On the other hand, music, I love music. other hand, music, I love music. other hand, music, I love music. Lifts my mood, you know, gives me Lifts my mood, you know, gives me Lifts my mood, you know, gives me energy. What are you doing? Who are you energy. What are you doing? Who are you energy. What are you doing? Who are you with? What are you focusing on? What are with? What are you focusing on? What are with? What are you focusing on? What are you thinking? start to notice because you thinking? start to notice because you thinking? start to notice because our brain for whatever reason probably our brain for whatever reason probably our brain for whatever reason probably because it enhanced our survival, right? because it enhanced our survival, right? because it enhanced our survival, right? Our brain defaults to the negative. Have Our brain defaults to the negative. Have Our brain defaults to the negative. Have you ever noticed that? Right? You come you ever noticed that? Right? You come you ever noticed that? Right? You come home, what do you tend to talk about? home, what do you tend to talk about? home, what do you tend to talk about? What went wrong in the day? What went wrong in the day? What went wrong in the day? Right? Right? Right? That may be good for survival and good That may be good for survival and good That may be good for survival and good for problem solving. It's not very good for problem solving. It's not very good for problem solving. It's not very good for supporting our mood. for supporting our mood. for supporting our mood. And there's all this research. What I'm And there's all this research. What I'm And there's all this research. What I'm talking about here, these tools come talking about here, these tools come talking about here, these tools come from cognitive behavioral therapy, which from cognitive behavioral therapy, which from cognitive behavioral therapy, which has one of the strongest evidence base has one of the strongest evidence base has one of the strongest evidence base in terms of effectiveness, right? From in terms of effectiveness, right? From in terms of effectiveness, right? From mindfulness, mindfulness, mindfulness, from research on positive psychology, from research on positive psychology, from research on positive psychology, research on quality of life and research on quality of life and research on quality of life and increasing happiness and joy and increasing happiness and joy and increasing happiness and joy and satisfaction. satisfaction. satisfaction. So, notice patterns So, notice patterns So, notice patterns and start to do more of what works. Now this is my next to last slide. Now this is my next to last slide. Now this is my next to last slide. I want you to think about I want you to think about I want you to think about any negative emotion, any any negative emotion, any any negative emotion, any irritating or difficult or distressing irritating or difficult or distressing irritating or difficult or distressing situation that you've got right now. situation that you've got right now. situation that you've got right now. I want you to think about I want you to think about I want you to think about which of the techniques I've talked which of the techniques I've talked which of the techniques I've talked about today about today about today that you'd be interested in using. that you'd be interested in using. that you'd be interested in using. You might just take take for a trial You might just take take for a trial You might just take take for a trial run, might just experiment with run, might just experiment with run, might just experiment with whether it be thinking about three ways whether it be thinking about three ways whether it be thinking about three ways something could be better and then three something could be better and then three something could be better and then three day ways it could be worse day ways it could be worse day ways it could be worse or asking yourself is this helpful? Is or asking yourself is this helpful? Is or asking yourself is this helpful? Is this truly is this really true? How this truly is this really true? How this truly is this really true? How could I think about it differently? What could I think about it differently? What could I think about it differently? What would somebody else say? would somebody else say? would somebody else say? Or thinking, what would I advise someone Or thinking, what would I advise someone Or thinking, what would I advise someone if they came to me? What advice would I if they came to me? What advice would I if they came to me? What advice would I give? We tap into our inner wisdom for give? We tap into our inner wisdom for give? We tap into our inner wisdom for somebody else. We sometimes forget to do somebody else. We sometimes forget to do somebody else. We sometimes forget to do that for ourselves. that for ourselves. that for ourselves. So any of these techniques, think about what you're going to do and think about what you're going to do and think about what you're going to do and then write down when you're going to do then write down when you're going to do then write down when you're going to do it. it. it. what exactly you're going to do. What what exactly you're going to do. What what exactly you're going to do. What are you going to say to yourself? What actions are you going to take? What What actions are you going to take? What What actions are you going to take? What are you going to say to somebody else? are you going to say to somebody else? are you going to say to somebody else? You know, maybe you're going to practice You know, maybe you're going to practice You know, maybe you're going to practice next time before you go to see the next time before you go to see the next time before you go to see the doctor some of the ideas that Dr. doctor some of the ideas that Dr. doctor some of the ideas that Dr. Bartholomew laid out. Maybe you're going Bartholomew laid out. Maybe you're going Bartholomew laid out. Maybe you're going to start to use some look into some to start to use some look into some to start to use some look into some mindfulness or some yoga. mindfulness or some yoga. mindfulness or some yoga. Think about what you're going to do and Think about what you're going to do and Think about what you're going to do and then then then tell somebody who's going to be tell somebody who's going to be tell somebody who's going to be supportive. supportive. supportive. They did a study on New Year's They did a study on New Year's They did a study on New Year's resolutions, resolutions, resolutions, right? They found that if you just made right? They found that if you just made right? They found that if you just made the resolution in your head, you had the resolution in your head, you had the resolution in your head, you had about a one in five chance about a 20% about a one in five chance about a 20% about a one in five chance about a 20% chance of actually carrying it out. It'd chance of actually carrying it out. It'd chance of actually carrying it out. It'd be gone within a month pretty much. If be gone within a month pretty much. If be gone within a month pretty much. If you wrote it down just that, wrote it you wrote it down just that, wrote it you wrote it down just that, wrote it down, down, down, you just about doubled your chances of you just about doubled your chances of you just about doubled your chances of carrying it out. carrying it out. carrying it out. But if you wrote it down, and you told But if you wrote it down, and you told But if you wrote it down, and you told somebody somebody somebody who was going to be supportive, who was going to be supportive, who was going to be supportive, you then tipped the scales and had a 60% you then tipped the scales and had a 60% you then tipped the scales and had a 60% chance of actually carrying that out. So chance of actually carrying that out. So chance of actually carrying that out. So find who's going to support you in the find who's going to support you in the find who's going to support you in the healthiest actions that you can take healthiest actions that you can take healthiest actions that you can take and get those people in your life and and get those people in your life and and get those people in your life and hold them close to your heart and write hold them close to your heart and write hold them close to your heart and write down what you're going to do and email me if you have any questions. and email me if you have any questions. and email me if you have any questions. Thank you so much for being here for Thank you so much for being here for Thank you so much for being here for your time, your attention. [applause] your time, your attention. [applause] your time, your attention. [applause] [music] [music]