#1357 Caregiver Burnout Series: Part 2

November 13, 2024Scott Benner

Negotiating the emotional and psychological burdens that caregivers experience, with Erika Forsyth.

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Scott Benner 0:00
Here we are back together again, friends for another episode of The Juicebox podcast.

Erica and I are back again today with part two of her caregiver burnout series. Please don't forget that nothing you hear on the Juicebox podcast should be considered advice medical or otherwise, always consult a physician before making any changes to your health care plan or becoming bold with insulin when you place your first order for ag one, with my link, you'll get five free travel packs and a free year supply of vitamin D drink. Ag one.com/juice, box. Don't forget, if you're a US resident who has type one, or is the caregiver of someone with type one, visit T 1d, exchange.org/juice, box right now and complete that survey. It will take you 10 minutes to complete the survey, and that effort alone will help to move type one diabetes research forward. It will cost you nothing to help if you're looking for community around type one diabetes, check out the Juicebox podcast. Private, Facebook group Juicebox podcast, type one diabetes. But everybody is welcome. Type one, type two, gestational loved ones. It doesn't matter to me. I'm having an on body vibe alert. This episode of The Juicebox podcast is sponsored by ever since 365 the only one year where CGM, that's one insertion and one CGM a year, one CGM, one year, not every 10 or 14 days ever since cgm.com/juice box. This episode of The Juicebox podcast is sponsored by cozy Earth. Use the offer code Juicebox at checkout at cozy earth.com and you will save 40% off of your entire order. This episode of The Juicebox podcast is sponsored by the insulin pump that my daughter wears. Omnipod. Learn more and get started today with the Omnipod dash, or the Omnipod five at my link, omnipod.com/juice omnipod.com/juicebox,

Erika Forsyth, MFT, LMFT 2:24
Erica. Welcome back. Thank you. It's good to be back.

Scott Benner 2:28
Excellent. I love seeing you, and we're here to add another episode to your caregiver burnout series. This is going to be episode two. Yes, would you give me kind of an overview of what you think this one's about? Yeah,

Erika Forsyth, MFT, LMFT 2:41
yeah, so. And just as a quick summary that we're going through six themes, but we're going to be talking about them through the kind of the lens of a barrier to why it's so hard to take care of yourself as a caregiver. The first one we talked about was experiencing chronic sorrow. Today we're going to be talking about assuming responsibility for glucose highs and lows and again, these six themes or burdens or barriers have been identified through research that has all the research has ever been conducted on caregiver burden, caregivers to, you know, children with type one. So yes,

Scott Benner 3:20
can I just ask quickly, does this apply to other people, like, if I was caregiving some other illness? Would this apply? Or is it very specific to diabetes?

Erika Forsyth, MFT, LMFT 3:29
The themes that we are going through are specific to caregiver burden within diabetes, but caregiver burden can be applied to any caregiver, obviously taking care of and a loved one with a chronic illness or any, any illness really, but specifically we are going looking at through the lens of diabetes, I guess. Okay, all right, excellent, okay, so assuming responsibility for glucose highs and lows, this is obvious, because you as the caregiver are most likely making the decisions right of how much and when to dose and like we did in the first episode, where I'm going to read a quote from the research that will probably hopefully resonate with you. This is from a parent in the research. So this parent says it's kind of a guessing game. I know it's based on math, but diabetes doesn't always listen to math. No matter how hard we try, diabetes is going to sometimes just throw us a curve ball. I'm trying to do my best for my son's diabetes, but I can't. I can't keep it on track, which is very frustrating. It is scary to think I'm causing serious damage to my son's body, that's heavy. That's heavy, yeah, and the and this is going to be a little heavy in the beginning here, because it is hard and complicated, and the fear and the risk of of a low and a high is real. And so I I'm not minimizing the the true sense of responsibility around. Of that experience as the caregiver, as I already said, you know, you are the one, particularly if your child is younger, you are making the dosing decisions along with your Endo. But if you're, you know, taking on the independence and ownership of changing carb ratios, of changing basal rates, of changing anything in terms of the insulin dosing and treatment you are, you are carrying that sense of responsibility. So I just want to highlight and emphasize and validate that, yeah, absolutely okay.

Scott Benner 5:30
Yeah. We're not saying anything here like, Oh, don't worry about it. It's okay. We know. Just let

Erika Forsyth, MFT, LMFT 5:35
it go. It'll be fine, yeah. And this is, you know, this is as we talk about caregiver burden, the psychological and emotional burden experienced by caregivers is this anxiety, right? Relate caring and maintaining the glucose levels within this range, right? Whether it's a clinical range or an ideal range that feels good for you, you are living within that pressure to maintain that, and particularly in the beginning, this responsibility when you're discharged from the hospital, you're living with this I don't even understand what diabetes is, and now I have to try and keep them within this range, the sense of powerlessness and failure and fear and guilt associated with that, with that challenge, and that inability to maintain your child's glucose level within that recommended ideal range is so intense, right? As as you hear on the podcast, as I experience with my own clients, and also research affirms that there is hope in this journey, right, like the responsibility that you bear in the beginning is so intense and in seasons of change, right, like through growth periods, through changing technology, there is that intensified feeling of responsibility to learn how to manage and reduce the highs and lows. But research does affirm that over time, as you have more knowledge, more experience, more mastery, that the parents in all of this research feel more empowered and validate that they have a reduction in their perception of stress, and that all contributes To the reduction in mitigation of the caregiver burden.

Scott Benner 7:22
Does that only come from mastery? Like, getting better at diabetes, quote, unquote. Like, is that where that comes from? Or, do you, I mean, because I'm thinking that I've gained some perspective over time too, about, you know, well, if her blood sugar is 150 for a couple of hours, like, you know, it's not the end of the world kind of a

Erika Forsyth, MFT, LMFT 7:42
thing. Mastery and experience, as we say a lot, right in our community, that it is a time learned experience, that over time, you learn how your blood sugar, or how your child's blood sugar is going to respond to certain variables, right? So we always are going to have the unknown variables, but over time, you do learn. So it's it's kind of that combination of, you understand how the insulin is working, how the how your body and your child's body is working and responding to the insulin, and then you become more confident in that, in that journey.

Scott Benner 8:17
Does it happen for everybody? Or are there some people who get stuck on the this is killing them. Feeling that

Erika Forsyth, MFT, LMFT 8:24
is a good question. I think we can, we can transition into like, what? What can you do? Right? Because we're, we're talking about this as we all, you guys are living and know this burden and the responsibility and what happens if it's been weeks, months, years, and you're still living with this sense of like this parent says it is scary to think I'm causing serious damage to my son's body. And if that quote is resonating with you, that you are feeling that and thinking that on a consistent basis, I think we can, let's, let's transition into, what can you do with that if it isn't if you haven't developed that competence and confidence over time? So getting into the tool, right? So we're going to talk about the burden or the barrier to self care, and then the tool, and we're going to talk about some self talk tips today that we have sprinkled in across our various episodes, but I hopefully today will be, will be helpful to focus in on some self talk tools. Before we do that, I do want to to talk about the psychological implications of devices, not only for, obviously, the person wearing the devices, but as as we've discussed before, there's it's such a benefit and blessing and bonus to have all of this data in our hands all of the time, if your child is wearing a CGM, and it helps us, it informs our decisions. But also, there isn't a lot of research and interventions of like, what do you do if. Is causing so much anxiety for you as the caregiver, when we when we did not have CGM, were caregivers living with this intense anxiety? I don't know, maybe, but now you're in this, like, this constant feedback loop of information, and if you're living, if you're already kind of run in an anxious space. How is that impacting you? You know, it's different for everybody, but I think just to note that there are real psychological implications for these. This great all the technology and devices that we have, and we're trying to kind of catch up, right? And say, how do we live with all of this?

Scott Benner 10:41
Well, it can feel like, I've heard reported back from people, right? That the information, it feels valuable if you know what to do with it, and if you don't, it could just be a sign that says, hey, you screwed up. Hey, you screwed up. And, you know, and sometimes, every five minutes, it'll tell you that, that's right. It's funny, because some people can receive, you know, can receive information like that and just think, Oh, I did the wrong thing. I wonder what to do next. I'll try again. And some people, it hits them much deeper, and, I would say, freezes them to some degree, right? And then all they hear is, I'm doing it wrong. And the rest of it kind of melts away. Yes, yeah, that's yes, yes. This episode of The Juicebox podcast is sponsored by the ever since 365 get 365 days of comfortable wear without having to change a sensor. When you think of a continuous glucose monitor, you think of a CGM that lasts 10 or 14 days. But the Eversense 365 it lives up to its name, lasting 365 days. That's one year without having to change your CGM. With the ever since 365 you can count on comfort and consistency. 365 days a year, because the ever since, silicon based adhesive is designed for your skin to be gentle and to allow you to take the transmitter on and off, to enjoy your shower, a trip to the pool or an activity where you don't want your CGM on your body, if you're looking for comfort, accuracy, and a one year wear you are looking for ever since 365 go to ever sense. Cgm.com/juicebox to learn more. This episode of The Juicebox podcast is sponsored by cozy Earth, and right now I'm looking at cozy earth.com to see what's going on. I got, oh, look at this bamboo pajama set for ladies. The jogger pants for ladies looks like plush lounge socks. That's one of Oprah's Favorite Things. There's the bath collection. We love the waffle towels, but there's also premium plush bath towels. Everything that you see here can be had for 40% off with the offer code, juice box at checkout. Even the sheets. Now we use the bamboo sheets. You may choose different linens. I don't know what you're going to love when you get to cozy Earth, calm, but we sleep on bamboo sheets from cozy Earth. They are incredibly comfortable, and I bought them myself with my own money, using my own offer code. Juicebox at checkout, 40% off is what I saved you can as well at cozy earth.com,

Erika Forsyth, MFT, LMFT 13:25
and so, you know, starting with, yes, there is a real sense of responsibility in managing your child's blood sugars. That is true. And then I want to challenge what we're going to have the conversation about today is like, what's underneath that feeling of responsibility. So there's the reality, right? You don't want your child to go high and have long term complications. You don't want your child to go low for, you know, all of the obvious reasons, seizures, etc, and the fear around that. But what we're going to discuss is, you know, noticing the why, what is underneath the obvious of that responsibility, and so is it? Is it fear? Is it a fear that maybe you don't actually know? Are you, does your Do you? Does your child's pump have the right settings? Are you correcting, correcting at the appropriate rate? So do you need more education around it. Is it? Have you gone beyond that initial shock stage, or season of change stage, and you're still living in this fear that, gosh, no matter what we do, I'm not doing it right, and you're not quite sure what steps to take. So is the is fear driving and pushing that sense of responsibility? So exploring, yeah, what can you do with that fear? Is it? Is it more education around knowing how to help your child? I know these are like all easier said than done, but I think it is important to to name them. Is it guilt? Is guilt driving your decisions and actions? I know a lot of you. Parents I hear talk about whether they believe it or just feel it like what? How could I have prevented my child's diagnosis and then from that guilt, if you do feel like you could have, or wished or hoped you could have, are you now living in a state of I'm going to do everything I can to protect my child, and so I just need, I'm gonna, I feel so responsible for every action and reaction because of this guilt that's driving Yeah, your actions. Should I keep going or sorry? Do you want to? No,

Scott Benner 15:33
I think you should keep going. Honestly, I don't have a ton to say at the moment, and I just I appreciate how you're going through this. Okay?

Erika Forsyth, MFT, LMFT 15:40
Is it shame? And you know, Brene Brown, as we've talked shared before, she talks about the tapes that we have in our head that are just on replay. And are you living in a space where you're constantly hearing yourself say, as you already said, you know, I'm never good enough. I'm never gonna get this. And if that's kind of where you're living, what then you're gonna feel and take on that responsibility even more so, because either a you don't want it, you want to avoid feeling that shame. If it's like, oh, the blood sugar goes high, I'm never, I'm never gonna get this. I'm a terrible person or or the low, you know, and fearing something terrible and tragic happening to your child, which, again, is real, but is shame, and trying to either avoid that or is that driving that behavior? I think what we do get confused oftentimes when we talk about guilt versus shame, and guilt is can be kind of productive, right? It can say, Oh, oops, I made a mistake. I don't feel good about that, but I can change that, whereas shame is, I am the mistake. Yeah, and you know, the obvious example is, oh, we, we didn't Bolus, we didn't inject enough insulin, and now my, my child's 300 next time, we'll try giving it a little bit more or a little bit earlier, right? Versus we are never going to get this. I'm is this? This is and I'm causing serious damage to my child's body, and I'm a terrible parent, and stick and staying in that space is the shame. Do you think

Scott Benner 17:17
that having the autonomy to make changes to insulin alleviates that to some degree, because it occurs to me that if, if you're set up with poor settings, for example, or poor understanding of what you're doing from your doctor, you either see yourself as the agent of evil, right, like I'm doing the thing and it's wrong and it's my fault, or you see, people blame the doctor, well, the doctor is not Helping us. It's their fault. It's not my fault. And, you know, like, so you either put that shame on yourself or you blame, blame. Yeah, it's shame or blame, right? Like, I like that. I can't like this. Just it's, every time we get to the end, I'm like, oh, that's exactly what she said, But, but you seriously, like, when you look into the community, that's what you see, either people blaming themselves or blaming someone else, one of the other. So I'm either ashamed I can't figure this out, or I'm blaming this person. Neither of those things get you to the answer, because if the truth is the doctor's not helping you, you can blame yourself or blame them all you want. It's not going to change, as long as that's your physician and vice versa. If the doctor's giving you something that's actually actionable, that you just don't know how to put into play. The doctor is not going to change what they're telling you. This is the thing they know how to say so you get that's where people get stuck. And it occurs to me that I see people very frequently talk about I struggled for years until I realized I could change my basal if I wanted to. Like that. That one simple step seems to help people immensely. My daughter is 20 years old. I can't even believe it. She was diagnosed with type one diabetes when she was two, and she put her first insulin pump on when she was four. That insulin pump was an Omnipod, and it's been an Omnipod every day since then. That's 16 straight years of wearing Omnipod, it's been a friend to us, and I believe it could be a friend to you. Omnipod.com/juicebox, whether you get the Omnipod dash or the automation that's available with the Omnipod five, you are going to enjoy tubeless insulin pumping. You're going to be able to jump into a shower or a pool or a bathtub without taking off your pump. That's right, you will not have to disconnect to bathe with an Omnipod. You also won't have to disconnect to play a sport or to do anything where a regular tube pump has to come off. Arden has been wearing an Omnipod for 16 years. She knows other people that wear different pumps, and she has never once asked the question, should I be trying a different pump? Never once, omnipod.com/juicebox, get a pump that you'll be happy with forever?

Erika Forsyth, MFT, LMFT 19:52
Yes, and there's, and it's whether it's a light bulb moment or a sense of, okay, I can't. Kind of agency or ownership over this in a safe way. You can't force that right. That is a journey that people are on independently, but that does feeling empowered to do that. You know, where I that comes from somewhere, yeah, to feel like, okay, I can do this. I can I can make this change, and we can do this slowly and safely or however. You know it feels appropriate.

Scott Benner 20:24
Can I ask a question when I hear people say, I just got done interviewing somebody an hour ago and said something that people say constantly, right? Like I wasn't taking good care of myself as an adult with type one. Then we had a baby, and I looked at the baby and I thought, I need to be around for the baby. And that seems very real to me, that people are able to do things make leaps for other people easier than they can for themselves. But then for the people who get stuck in this shame thing, as parents, as caregivers, that same connection seems to fight against them instead of be on their side. Does that make sense? You know what I'm saying? Like a

Erika Forsyth, MFT, LMFT 21:07
caregiver. Say that, say that last piece again. People,

Scott Benner 21:10
over and over again, will tell me that I didn't do a good job for a long time, but then I realized I could do it for someone else, because I want to get married, because I want to have a kid like I can. I can find the reason to get in there. But then you put a caregiver in that situation, they already have that reason, and yet that doesn't propel them. So what's the difference? Is it time like experience is that, like does the adult have 30 years of seeing it and ignoring it, and then they decide not to ignore it, whereas the caregiver doesn't see it, they're not ignoring anything. They just can't figure it out, but they still have the stress that the draw to do something for someone else. I hope that made sense,

Erika Forsyth, MFT, LMFT 21:47
so you're considering or wanting to explore. If the caregiver already has that motivation, like their child, they want to help their child stay healthy. I think they already have that, yeah, and so you're wondering if shame keeps them stuck. I'm

Scott Benner 22:06
almost wondering if a lack of the information. I mean, obviously that's the thing that's stopping them from making a better decision, right? Like, and, you know, but is, I'm saying it's interesting that the same lever that propels one person out of it is the lever that almost tortures the other person.

Erika Forsyth, MFT, LMFT 22:26
That makes sense, yes, yes, okay, okay, I hear that, okay. I don't

Scott Benner 22:29
know what to do with that. It just, it's very obvious as I'm watching like I hear people talk about this all the time. And I realized I have a kid now, and I want to be around for that kid, so I did this, and the next person is like, I care about this kid so much, and all I want to do is help them be healthy. And that's why I feel terrible, because I don't have so so the common denominator is, is information, good information,

Erika Forsyth, MFT, LMFT 22:55
good information, and also understanding which we're going to get into next is, what is that? What is that thought process? What thoughts are driving your feelings and behaviors? Tell me, so we you okay. So you know, why? Why is it important to understand the thoughts and feelings what you know, it's we just went over. What is driving that responsibility? Is it? Fear? Is it guilt? Is it shame? Is it, you know, lack of education, is it? Are you being Are you motivated by comparison also? Are you feeling like I have to keep my child's a 1c in this range and their blood sugar in this range, because that's what I see on Facebook, whatever, right? Like, what is driving that? But if we again, it might feel like a luxury to pause and be aware of your thoughts. It's important because we can't change our behaviors or our actions unless we are attuned and understand what's driving them and our thoughts. In cognitive behavioral therapy, if you were to look up the CBT triangle, and a lot of you are already well informed in this, but the CBT triangle is basically a triangle with arrows pointing in both directions, and basically it's describing how our thoughts impact and affect our feelings, or our emotions, which impact or affect our behaviors or actions. So we'll say, and oftentimes our thoughts are the drivers of how we feel and what we do. But it can go any which way, right? So you can open the door for somebody and and feel good about yourself and then have the thought, Oh, that was, that was kind of me. I'm a kind person. You can so that's right, that the action is driving that feeling or thought. You could think, I'm never good enough, and always feel like you're failing, and then your action is probably to. Avoid or not want to look or explore or understand what's happening, because it's all painful. Does that make sense? It does so again, I know it feels like, oh, just pay attention to what you're thinking. It's just that easy. I know it's a hard thing to do and it takes time and understanding. But if you are operating from this orientation that our thoughts do impact how we feel and what we do in any which order, also we can't change unless we have some awareness and understanding of what's driving that. So if, if you are living in a shame based mindset, and perhaps you grew up in that way that shame is going to make you change. Shame keeps us trapped and isolated and stuck. It does not lean itself into into being vulnerable and motivated for change. And so I want to kind of maybe try and go back to your question of like, what's that lever of change for the caregiver, if you're stuck and feeling like you're never gonna get it right, or that you are just having to constantly that this is that overwhelming feeling of responsibility for your child's highs and lows, and you're feeling like you're never gonna get it that There is. It's not an easy answer, right? But it is spending time understanding, noticing that. Why? Like, what is driving that constant thought in Should I keep going, Ken,

Scott Benner 26:34
but I keep thinking, don't want to, I don't want to waylay you, because I feel like I'm going to say something is going to take us down a road. It's okay. I keep thinking about like people who listen, know, I ask almost every person I interview, like, are there other auto immune issues in your family? What else is going on? Right? And anxiety, ADHD, that kind of stuff pops up a lot, depression, that kind of thing. So if auto immune is a trigger for anxiety. And trying to help somebody who has type one diabetes is a trigger for a caregiver. It's very possible that when we look back at people, we go, Oh, my God. Some people just like, handle this, and some people just can't, like, blah, blah, and we talk about it like personality or, you know, stick to itiveness. We've gone through the fallacy that some people are more resilient than others, like all this stuff I'm saying. What if there's auto immune through your family, you're not aware of it, and your auto immune is low level. You don't have anything diagnosable, but you are an anxious person, and so now you have this thing. Then your kid gets diagnosed, it gets ramped up, and then you get clicked into a loop that you have no there'll be no ability to break free of because it's a physical you're having a physical implication, and a psychological match is being thrown on it to some degree. So do you know what I mean? Like, so you have the external trigger, you have physical symptoms that could be coming from an autoimmune issue. And then here we go, like, it's and on top of all that, by the way, stress can be a trigger for anxiety, hormone imbalance, which we see a lot with people with autoimmune stuff, can be a trigger even, like, you know, I know there's not a ton of like, not a ton of like, research from the NIH about it, but like, you know, there's this gut brain access, access. So if you are having an autoimmune issue, your guts unbalanced. This could all, like, be impacting it. Then you're trying to cope with a chronic illness. It flares up your anxiety, the autoimmune issue keeps it going, and in the end, all you're doing is sitting in bed going, Why am I killing this kid? You know? And so, I mean, I like talking about it so that people can understand bigger picture, but I don't want them to like therapy would be a great idea. I'm not saying it wouldn't be. But I also think you should find out if you're having an auto immune response as well, because it could be. I mean, listen, I'm not a doctor, Eric, I think we've gone over that a number of times, but I don't know how many people I got to talk to who have auto immune in their life, who are also, like, closely related to an anxious person, or have anxiety themselves. So anyway, I just, I got to get that out, or I'm going to feel like it's stuck in my head the whole time. And I didn't mean,

Erika Forsyth, MFT, LMFT 29:24
good, yeah, that's a that is an excellent point, because then it's like, well, then you do, right? Like, that's so, yeah, complicated. And then you're in it. You're in facing a chronic illness where, you know what is anxiety, feeling like you're out of control and doing anything you can in your mind to get that semblance and sense of control right. And when you are trying to manage your child's diabetes and you're trying to be quote, in good control, which I know we steer away from that language, but that's what you're trying to do. But,

Scott Benner 29:56
and we steer away from that language because some people have such. Hard intersection with it. But for the people who aren't anxious, they hear that, and they go, okay, marching orders, I know what to do. Bang, bang. And then they go, get it done. Like, so if it's if it's a physical limitation, and then you get thrown into it, but you feel like it's just a personal failure. You don't even it would be like, if you felt like having cancer was a personal failure, and somehow no one knew to tell you, No, that's not true. That's how this all feels to me. If that makes sense, I'm saying if that makes sense too much today, but

Erika Forsyth, MFT, LMFT 30:34
because this is it's hard. It's hard because there's no, we can't say, go do this and this, it's going to fix it. This is a conversation of bringing awareness to a really challenging issue of a caregiver trying to keep your child in good health. But are you noticing that overwhelming sense of responsibility that may be more than you can handle? Yeah, and manage that. It's not sustainable

Scott Benner 30:59
if you're an anxious person who didn't get good direction from a doctor, and you're floundering, and you have an autoimmune issue. On top of all that, I might as well take somebody four feet tall and tell them to go out there and block shack. You know what I mean? Like, it's just you. I don't know how you're supposed to accomplish that. You don't have any of the tools, and you have a number of things going against you while you're doing it.

Speaker 1 31:22
That's all, yes, yeah, that's, that's all.

Scott Benner 31:26
You always make me feel like, hopeful and beaten at the same time. I'm like, Look, we're shining a light on this thing that they can't do anything about, like, but you can do something about it, right? You can't.

Erika Forsyth, MFT, LMFT 31:38
You can't. So the as we're talking, you know, my hope is that you are able to just, even if it's a few minutes during this episode, kind of checking in with yourself. You know, we all again, going from from a cognitive behavioral therapy orientation. We all have these core beliefs that we're living from and out of that often are originated and stemmed from our childhood. And core beliefs lead to automatic thoughts, and those can be positive, they can be negative. You can have a blend, right? So your a core belief could be I am valued or valuable, and and your automatic thoughts stem from that in the name, since we're talking a lot about shame today, if you have a core belief that you're never good enough or not good enough, then your automatic thought would be obviously more negative when You see your child's blood sugar going up that I am I'm failing. I'm never going to get this. I'm causing serious damage, and that's coming from your core belief system. And it's hard and takes time to understand that. But I think as human beings, we're going to have those moments, right? Like this is normal journey of growth and learning and disappointment and grief and loss, all the things that we've talked about in all of our previous episodes. But we're wanting to encourage to note just just like we want to notice our patterns and our blood sugars, notice the patterns of our thinking. Again, that takes time and energy, which I know is hard to do, but it is doing Yes, yes, yes. If

Scott Benner 33:25
you, if you have the time to so it is like diabetes, if you have the time to put the focus on it, and you get good information, like you're sharing here, you maybe can step back, see the bigger picture, and help yourself through it.

Erika Forsyth, MFT, LMFT 33:36
Yes. I mean, yes. And the challenge is, obviously we don't have our clarity reports, or any reports to look at our trends. Right to say, Oh, I'm going high after every I'm going, Yeah, I'm going anxious every morning. So yes, it takes another step of analysis and pause. But you are, you are worth that. You know you are worth that as a human being, as the caregiver, and you are valuable,

Scott Benner 34:04
right? And for the people you're trying to help too, right? It's worth it. It's worth the effort. Yes,

Erika Forsyth, MFT, LMFT 34:09
yes.

Scott Benner 34:10
So what are the last

Erika Forsyth, MFT, LMFT 34:11
last tool? Last Tool here, in terms of, you know, the self we're kind of self talk tips. To get to that place, you have to have this awareness of what are you telling yourself. And so when you notice, as I think I've talked about this before here, like noticing that that mean girl voice or that mean guy voice in your head, that you have to first listen, understand it, and then you notice it when it happens. And for some people, they can quickly say, oh, yeah, I hear that all day long. Or oh, I only hear that when this happens. And naming it. This is another CBT tool, name it, call it Teddy, oh, you

Scott Benner 34:53
can give the voice a name, yes.

Erika Forsyth, MFT, LMFT 34:58
Okay, good. Do you. To share it? No, I

Scott Benner 35:00
can't, because that person is listening and I hate them. Now, by the way, 15 different crazy people think I just thought of their name. It's not, you go ahead,

Erika Forsyth, MFT, LMFT 35:12
you know, Brene Brown calls it the Kerr gremlins. Sometimes people call it a color monster, etc. And naming it, it sounds silly, but in that process, you are telling your mind that you are separate from those thoughts, like when we hear when we feel like I'm never good enough, I'm I'm never going to figure this out. I'm a terrible person. That's when in Acceptance and Commitment Therapy, they talk about that's thought fusion, like that thought is a part of you. And what we want to do is do like this, thought diffusion. And so by naming it, you're telling your brain, oh, this is, this is not me. This is, this is my old past. This is my history. This is something not this is not nice, right? So you're naming it, you're acknowledging it. Okay, monster, I know you're trying to tell me that I'm not good enough, but I in cognitive behavioral therapy, they you can kind of tell it to be quiet, to tell it to shut up. You can tell it to I'm turning the volume down. Some people don't feel comfortable with that, because it feels more like combative and that creates more conflict in your mind, in Acceptance and Commitment Therapy, you can name it, acknowledge it, and say, okay, monster, I see you, and I know you're trying to tell me I'm not good enough, but that actually you're kind of just you're sitting with it and it's there, and you're separating yourself from it, which, by the way, also interrupts the pattern, right? Like when you're you're spinning and spiraling. It feels like you can't control your thoughts. So with this tool, by naming it, talking to it, acknowledging it, you're interrupting that thought pattern, and then you're saying, Okay, actually the truth is and replace it with a truth that feels it might feel not 100% accurate in the moment, but that's where you want to get to. Like I'm doing the best I can, I'm learning. I'm taking it one day at a time, whatever truth statement that feels easy enough to remember and say, because you're wanting to interrupt that pattern of your failure, you're never going to get it. You're, you're, you're not good enough.

Scott Benner 37:21
I think you just made me realize that Eminem went to therapy. Because, you know that song, the monster with Rihanna. I'm friends with the monster that's under my bed. Get along with the voices inside of my I'm like, Oh, I think he might have went to therapy and then wrote

Erika Forsyth, MFT, LMFT 37:33
that. Yeah, you might have. That was good. That was our podcast, not

Scott Benner 37:37
big enough to reach Eminem, but, but I definitely like, that's what I thought. Like, oh, he sounds in touch with that idea that you just said, Okay, maybe you guys could just listen to that song and skip therapy. Yeah, I don't think it works that way. Can you imagine? Or could be out of a job. Oh, we've just send songs to people, if people have been in therapy already.

Erika Forsyth, MFT, LMFT 37:59
That is good. I've never thought about that song, but yes, that does feel like that.

Scott Benner 38:03
It just felt like that's what you were describing, is that somebody who, you know, found a way to separate the voice from themselves. That's all anyway, I could be completely wrong. Somebody's gonna write and be like, that's about heroin. And

Erika Forsyth, MFT, LMFT 38:19
I'll be like, oh never. Gosh, yes. I mean this again. These are, I know it's easy, and we're kind of laughing that this is, it is a it is a process and a journey of recognizing what tapes are running in your head and how much is that contributing to, in this particular theme, the responsibility of the highs and lows of your child's blood sugar? Yeah,

Scott Benner 38:42
I would like to thank you for believing in how I present stuff on the podcast enough to come on and talk about super serious stuff while I say dumb in between, because, because I do really think that this is another one of these things that, if it wasn't Amy, you know, you can think about any number ways you want, like, presented in a relatable way, whatever. I just don't think it's something people would hammer through. You know what I mean? Like, if you just came on here and were like, and you read that stuff out loud, people would be like, oh, oh, geez. And not that it wouldn't be incredibly valuable for them. I just think people have trouble, like, you know, sitting and hearing that stuff and taking it in that way. So I just, and, plus, you're teaching me as I'm talking, like, you know, as you're speaking, I'm like, Oh, that makes sense. This makes sense. I even saw at one point, like, we did that, 54321, grounding technique. And I thought, Oh, that would work here. Yes. Like, and you talked a little bit about, Gosh, how did you put it, like, core beliefs, and then, and I thought of that from like, other episodes, and I was like, I'm gonna be by the time Eric and I get done, I'm gonna be healthy, and hopefully other people listening could be as well. You know, yes, it's tough to think that 38 year old, you could be feeling like I can't do this because of something that happened an eight year old, you you know. But if. Very likely that those that self talk you have is rooted in something you don't even remember anymore. You know, yes, well, that you don't consciously remember anymore.

Erika Forsyth, MFT, LMFT 40:09
Yes, it is. It is powerful to to think that after you

Scott Benner 40:14
get done talking and I realize I'm following you, I'm proud of myself again, but, but I'm also proud of you because of the way you the way you lay it out. It just you're explaining and then giving me time to go through it, and I'm hoping that's translating the people listening, which I think it is. I just don't think it's a thing. Like, if I was actually in therapy right now, I'd be so busy spilling my guts. I don't know if I'd be able to, like, hear what you were saying. Like, I like this format for that,

Erika Forsyth, MFT, LMFT 40:45
you know, yes, yeah, yes. Well, it's, it's a journey, but thank you. No, it's

Scott Benner 40:50
a journey. Yeah, it's, certainly is. I talked to a guy the other day about, like, he's like, 70, talking about his children in their 30s, and they're coming back and asking questions still. And I thought that's always gonna happen. I thought there was a break coming at some point. There's not. And then it really made me think, like, you know, otherwise, just like well adjusted people and doing okay in the world and everything. And if you looked at them from a distance, you'd say, these people got it together, you know, but they still need help. So there's nothing wrong with asking for help, I guess is what I'm getting. That's right, yeah, that's right. Are we done? Did we do it? We're

Erika Forsyth, MFT, LMFT 41:25
done. We're paused. Yes, we're done. For episode two, all right, come back

Scott Benner 41:29
for episode three. How many episodes are there going to be six? Six.

When this started, Erica said, I don't know. We could probably do this in like three episodes. And I was like, not. If I start talking in the middle, we're not going to be able to. I appreciate this very much. Thank you.

Erika Forsyth, MFT, LMFT 41:42
Thank you.

Scott Benner 41:48
A huge thanks to Omnipod, not just my longest sponsor, but my first one. Omnipod.com/juicebox if you love the podcast and you love tubeless insulin pumps, this link is for you omnipod.com/juice box. I want to thank the ever since 365 CGM and remind you that you may be eligible to experience the ever since 365 CGM system for as low as $199 for a full year, you can visit ever since cgm.com/juice box to find out more details and learn about the eligibility. Huge thanks to cozy Earth for sponsoring this episode of The Juicebox podcast. Cozy earth.com use the offer code juice box at checkout to save 40% off of your entire order. If you're newly diagnosed, check out the bold beginnings series. Find it at Juicebox podcast.com up in the menu in the feature tab of the private Facebook group, or go into the audio app you're listening in right now and search for Juicebox podcast. Bold beginnings. Juicebox is one word. Juicebox podcast, bold beginnings. This series is perfect for newly diagnosed people. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox podcast. If you're not already subscribed or following the podcast in your favorite audio app, like Spotify or Apple podcasts, please do that now. Seriously, just to hit follow or subscribe will really help the show. If you go a little further in Apple podcast and set it up so that it downloads all new episodes. I'll be your best friend, and if you leave a five star review, ooh, I'll probably send you a Christmas card. Would you like a Christmas card? The episode you just heard was professionally edited by wrong way, recording, wrong way, recording.com, you.