#1887 - Take Your Hands Off It: The Feelings
Part two: therapist Erika Forsyth on the mental side of diabetes — trusting your settings, hypervigilance, the pre-bolus wait, grief, and the self-compassion shown to lower stress and A1C.
Take Your Hands Off It: The Feelings
Cold Open & Sponsors 0:00
Here we are back together again, friends, for another episode of the Juice Box podcast. Excellent. Erica, this is either, depending on how this works out, either the second part of a two part episode where Jenny and I were the first part or nothing you hear on the Juice Box podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your health care plan. I know that Facebook has a bad reputation, but please give the private Facebook group for the Juice Box podcast.
It gets a 150 new members a day. It is completely free, and at the very least, you can watch other people talk about diabetes. And everybody is welcome. Type one, type two, gestational, loved ones, everyone is welcome. Go up into the featured tab of the private Facebook group, and there you'll see lists upon lists of all of the management series that are available to you for free in the Juice Box podcast.
The episode you're listening to is sponsored by US Med. Usmed.com/juicebox or call (888) 721-1514. You can get your diabetes testing supplies the same way we do from US Med. Excellent. Erica, this is either, depending on how this works out, either the second part of a two part episode where Jenny and I were the first part, or it's gonna be an interstitial where I the listeners are hearing Jenny and then hearing you and back and forth.
We'll see how it goes. But how are you? Good. Good.
I'm I'm well, and I I like the, use of the inters inter
Interstitial? Interstitial. I think that's a tell is that about a television or a movie term, Isn't it?
I I immediately thought of the interstitial fluid.
Oh, interstitial fluid.
Interstitial fluid. No.
I was like, I think interstitial in movie making means am I wrong? Has
this how
we're starting? This is ridiculous. This is even when you ask, like, a like, if you should I admit to this? I sometimes feed my transcripts and ask it what good questions I asked and what bad questions I asked, and how many of my questions led to good answers and, like, that kind of
thing. Uh-huh.
And it says that sometimes I go on tangents too long, and I argued with it. I was like, I don't think I do.
So Well, yeah, you said you said inters did you say interstitial?
I thought I said interstitials because I think that's
Interstitial. And I thought of interstitial fluid, which is what we talk about in, you know, diabetes world.
Here it is. In movie making, interstitial usually means a short piece of material placed between larger sections of film showing episodic or programs, think connective tissue. I think I was pretty close to being right.
You are. You are.
I explained to my children recently, and they're like, you don't know what all the words mean that you use. And I was like, I know enough of what they mean. Thank you.
So No. I I yeah. I wasn't questioning the use of the word. I just asked I thought of
Oh, I
the other word. Immediately spiritual.
Immediately as you spoke, I thought I was probably wrong. So, anyway
Sorry. Don't
From Settings to Feelings 3:46
get me sorry at all. This is awesome. So, Jenny and I spent about an hour, you know, going through ways to reduce the practical load of diabetes. Right? And Jenny kinda hit on some things over and over again, better settings, better timing, less interaction, like less fiddling with things, less chasing.
But the reason I want to talk to you about it in the in the same conversation, different light, is because it occurred to me that somebody has something that's in their way, a speed bump or something. Even if a person like Jenny comes in and says, hey. This might be the fix to that problem. I noticed when I'm talking to people, there's always a, yeah, but. Yeah.
But Mhmm. You know what I mean? I'd you know, if you say to somebody, hey. Set some alarms, for example, on your CGM. And if it's not alarming, don't look at it.
They go, well, that sounds nice. But and I thought we would maybe walk through the things that Jenny had spoken about and see if we can find ways to make them feel more comfortable on the the psychological side of it. Sounds good?
Yes. Okay. I like it.
So first thing Jenny said was how do we remove, you know, the overwhelm? And it would be a lot about getting your settings right. So she talked about people in the diabetes community touching things constantly because they don't trust what they're seeing. But what I'm gonna ask you is that when we finally get their settings in a good place, why is it that some people might find it hard to step back, and how can we help them do that? Diabetes comes with a lot of things to remember.
So it's nice when someone takes something off of your plate. US Med has done that for us. When it's time for Arden's supplies to be refreshed, we get an email. Rolls up and in your inbox says, hi, Arden. This is your friendly reorder email from US Med.
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Why It’s Hard to Trust the Settings 6:44
Yes. So and what what we're talking about is, guess, trusting. Right? Trusting the settings. Why does it feel challenging to trust the settings initially?
Or I mean, I think there's there's a time issue. Right? Like, it it takes time to build the trust that the basals of correction factors, etcetera, are actually going to
Work out.
Repeatedly work out, like, over, you know, mass experience to reset that fear
Mhmm.
That it's not.
Do you think the fear comes from initial miss like, guess it could come asking you is the wrong way. I guess it could come from it being wrong and them having outcomes that aren't desired, or it could just come from being new at something and just being afraid of it because it's new and they don't understand it. So the question is is that once those things get hammered out, whether it's Mhmm. Time in the simulator or better, more repeatable outcomes, a lot of people still find it difficult to just go, okay. Good.
And trust it and walk away. I I guess what I'm asking from you is how do you think they could maybe accomplish that?
So in improving trust, I think, connects to reducing the fear. And that that there's a lot of ways to do that. I think stepping back and noticing, okay. Why they really kind of go hand in hand. Right?
Like, every moment, every meal, every day that you feel like, wow. Okay. I I bolus. I it did what I wanted it to do. That worked out great.
But we also know that if it worked out, the settings were great and worked out well one day, it might not work out the same way the next day. So I think it's in those moments, how do you trust that the settings are still accurate enough?
Okay.
And I think there's there's a space of trying to stay really present. There there's a moment where you can work on one can work on being present as opposed to which is also really hard to do
I was gonna
say the nature of diabetes.
Yeah. But what does that look like?
So so in the moment, you're saying, okay. Wow. I thought the settings I thought I had the settings, and I'm working on building trust in in in not touching diabetes as you and Jenny kind of talked about it. Right? I'm not trying to overcorrect.
I don't wanna you know, I'm gonna try and trust the algorithm. I'm gonna trust what my my settings are even though today, it didn't work out as well as it did yesterday. And I think in that space, choosing to practice some there's there's so many layers and so many steps. So practicing patience with yourself, practicing patience and and also self compassion, which I imagine we'll get into later, that it's not about the you. It's not about the settings.
It's about, wow. Today didn't work out the same way, but I do know that yesterday and the day before, the settings worked. So it's staying staying present minded. I mean, there's there's even a concept sorry. Go ahead.
No. Because you have to believe it. So it's my finding from doing it for so long that, yes, there can be other variables, right, that might that might blow this off course. But for the most part, it goes this way. It goes the way you know, when the settings are good, when your basil's right, when your carb ratio is good, when you're timing your meals well, you know, when you're doing all that, there's not as much that's pushing you off course.
So the thing I said to Jenny when we were interviewing was I kind of sometimes imagine like a tennis ball just pushed into space and that it's just going to go, like, I don't know if everybody understands that. But if you move something through space, if nothing else touches it, it's just gonna continue on an exact straight line. Right? But eventually, something dust particles, a meteor, whatever, is gonna bump something and it's gonna move you around. And with diabetes, there are already enough things, like, in your life, in your day bumping around things, changing your blood sugars.
But I was saying to Jenny was is, like, if you can at all help it, you shouldn't be also one of those things by touching knobs and doing stuff that, you know, isn't kinda valuable. So once it's moving along and it's moving super smoothly, it's not reasonable to think, like you just said, that it's gonna do that forever. Maybe it'll do it for a day or two or a week, but eventually something's gonna happen again. But that doesn't mean that the plan is bad. Do you know what I'm saying?
Like, it doesn't mean the plan's bad. So how do you stay calm, centered, keep yourself from becoming another one of those variables batting at that tennis ball? Stop yourself from becoming your own worst enemy in that situation, I guess. That makes sense?
Psychological Flexibility & Noticing the Feeling 12:02
Yes. Okay. There there's a concept that we have talked about here and there over the various episodes called psychological flexibility, and it's from an acceptance and commitment therapy model. And we talked about thought diffusion when we feel like the thought is so strong that it's attached to us, and I'm putting my hand over my face. Like, the thought is fused to our bodies.
And when we're when we're practicing psychological flexibility, which is very much connected to practicing resilience, is noticing you're staying in the present. You're noticing, wow. My my blood sugar went higher or lower than I anticipated even though I thought my settings were spot on or accurate. And so you're you're noticing, okay. What is the feeling that's coming up here?
Am I feeling shame? Am I feeling fear? Am I feeling discouraged? Am I feeling like, ugh. I don't even wanna look at this anymore, you know, avoidance.
Are you note are you feeling exhaustion because you've worked so hard to get the settings right and then you had this blip? So you're noticing those emotions. We're not saying, like, ignore them. We're not saying dismiss them. No.
We're not saying push through, but you're noticing, okay. I'm I'm feeling frustrated. I'm feeling shame. And I'm also not telling myself I shouldn't be feeling this way because my settings are good. Right?
We're just you're like you're noticing them, and then you're you're then having because you're taking that pause, you're separating yourself from the feeling. You're then able to make a choice based on from the psychological flexibility emphasis, like, what is your value as opposed to fear, exhaustion, stress, burnout, shame.
Is your So yeah. Explain the value idea to me. So is it Okay. Your value is I'm gonna I'm I'm gonna choose to to focus on the the worry aspect, or or I'm I'm gonna gonna choose to focus on the, hey. Most of the time, this goes well.
There's probably nothing to change here, just an anomaly. Is that the idea?
Sort of. So within within ACT, it's focused on your values, which is your why. Like, what why are you showing up? Why are you even working on your your settings? Why are you motivated to keep going?
You know, is it is it family? Is it your health? Is it your job? Is it freedom? So it's your kind of bigger picture, and that might change, but kind of your your overarching value in life.
So saying, okay. My my if your value is to show up for for your family in a way, like, as best you can, in a in a good enough kind of way. So you're you're noticing, okay. Gosh. My set my sugar my butcher isn't where I wanted it to be.
I thought I had my settings right. I'm feeling so discouraged, or I'm feeling so disappointed or so frustrated. Okay. I'm gonna I'm noticing I'm having that thought, which also separates you from the thought that it's true. I'm noticing these thoughts.
I'm gonna pause. I mean, we're getting into the weeds here of steps going back to you resetting your nervous system. We'll get into that as well, I imagine. And then say, okay. I know I do know that it worked Monday, Tuesday, Wednesday for lunch.
Today, I'm not sure why or I do know why, but I'm not gonna react from the feeling. I'm just gonna notice the feeling. I'm I'm just gonna continue on because I wanna continue to show up for my family in a healthy way. So you're separating yourself from the the judgment
and the feeling in the thoughts. That helps you sort of just let go of it. And and instead of putting putting it on yourself, you put the recognizing it releases yourself from it, releases yourself. Is that is that about it?
It kind of it redo yeah. It reduces Yeah. Reduces the intensity of that emotion that you're experiencing in that moment. So you're you're noticing it, but you're not using it as an informed decision maker to say, I'm such a terrible person. I can't believe I messed up here, and now I'm I'm gonna go in and change everything.
Mhmm. Or throwing hands up in the air. I'm never gonna get it. No. These are all things we may feel at various stages in our relationship with diabetes.
Right.
But if we're speaking from the perspective that you feel like your settings have been proven to be as accurate as they can be. In those moments, practicing the skill of noticing the thought or or acknowledging the feeling without shame or judgment and then saying, okay. But what what am I really doing? What's the bigger picture? And moving from there.
Okay.
That kind of reduces some of that emotional load in that moment from this lens.
Mhmm. Okay. Alright. Now I listen. There's a I want everybody to know who's listening that I just I threw these two things at Jenny and Erica, and I told them we're gonna just have, like, flowing conversations to try to pick our way through it because I I think it's sort of silly to just say, oh, when this happens, do that, and everything will be fine.
I think you need to hear people with diabetes. And then you and Jenny are in a specifically unique position. I mentioned this with her. Both of you have had type one for over, like, thirty five years. And you're professionally attached to, you know, diabetes in different ways.
You with therapy or with, you know, coaching people. And I just think it's interesting to hear you talk through it. It doesn't have to be super smooth or sound like a sound bite. I think it's just interesting for people to listen to a conversation like that. I I've got my hands in this too much.
I'm messing everything up. The settings are all over the place. Every time something happens, I I feel badly. I react. I do something.
I'm trying to fix it. I'm probably making it worse. Then that compounds on itself. Then on the other side, I feel like I'm failing, etcetera, blah blah blah. I finally find someone to help me put my settings into into into practice.
How do I keep my hands off it after that? And just let it play out for a little bit to see if what I did is actually gonna be valuable or if there are adjustments to be made. And what I noticed from talking to people is and and Jenny said the same thing, is that often people have trouble keeping their hands off it long enough to find out what's happening. So I appreciate it. Yes.
Helicoptering, Hypervigilance & Cortisol 18:44
My follow-up to that would be, how do you how can someone tell the difference between them be paying attention to something and that they're being hyper vigilant or helicoptering? Can you do other ways for them to see the difference? Because nobody who's being a helicopter, caregiver or on their own self is thinking they're acting that way. They always, every time I talk to them, feel like they're completely justified in the way they're handling it. You know what I mean?
Yes. So the the question is can you say that again? Why this
I tell what's reasonable and needed and over the top with my attention on this stuff?
I think noticing how is it impacting or impairing your your daily functioning. Right?
Okay.
Noticing, paying attention, responding to alarms from a posture of of calm and not a threat. Yeah. Right? So high if you are responding based on fear. Right?
Fear, as we know, is is a survival response mechanism. And so if you are operating from a place where you you become hypervigilant And this this kind of connects to what we were talking about in the, in the other series of agency and anxiety. Right? We we want to know that when we do something, this next thing's gonna happen. But when it doesn't, that increases anxiety and often then increases that sense of hypervigilance.
Well, maybe if I if I pay attention to it more, I'm gonna anticipate that I'm gonna do better.
Yeah.
I'm gonna be a better manager of my diabetes. But what we know in research, you know, will, validate this that if you are operating and functioning from this hypervigilant state, your body is in that hyperarousal threat response state all of the time. So, a, if you're the person living with it, you are you're battling the those cortisol dumps all of the time. Because even if you aren't let's say, even if you or your blood sugar is in range, but you're in that hypervigilant anticipatory state, your body is is operating as if you are in a threat. Right?
Like, a threat for your body
is And actually being threatened is the same?
Same thing. Yeah. Your body cannot differentiate. So your your amygdala right. We talked about our brain.
Your your lid is flipped. Your amygdala is is firing. Your cortisol is being dumped. And so you're fighting that within your blood sugar just from a physiological perspective, and it's hard to make rational choices.
Yeah.
Right? Your your limbic system has gone off, or your your prefrontal cortex has gone offline, so you are having a difficult time making rational thought. But it feels like you're being safer. You you're trying to tell yourself, I'm I'm I'm anticipating. I'm I'm gonna focus.
I'm gonna stare at the number. I'm gonna course correct all of the time, But it's actually counterproductive to not only your body physically, but also emotionally because you cannot think clearly, and you have all of these hormones that are interfering with the actual insulin absorption.
Yeah. And if you can't think your way through that, just look around you. And if the people around you are looking at you like, uh-oh, mommy's out of her mind. Then just go away. Maybe I'm acting a little crazy right now.
But like, I it is hard because I've interviewed I've just recently interviewed a woman who has these what she would have called overreactions to things and hypervigilance when it wasn't necessary, and we talked through them. Like, that's not even needed. Like, and then she could intellectually say while we were talking, yeah. I I know that that sounds, like, over the top. I said, why do you do it?
She goes, I don't know. Like, I can't, like, I can't even just after we named it, she couldn't stop herself from it. So, I mean, there are so many I'm just saying there are so many good reasons to find a way to overcome that because it's not good for you. I think it's bad for your short and long term health. And I also don't think that it creates a good ecosystem around the diabetes in general, especially if you're the caregiver for somebody and you're always hair on fire.
And while maybe your children are looking at you like, I'm just trying to live over here, she's acting like I'm dying every five seconds, or he's acting like because I used to do it too. I used to I've I've shared this a million times. My wife put me aside one day, and she's like, you you every time you look at her blood sugar, you mutter under your breath like shit. And she's like, you have to stop doing that. She's like, it's it's just it's so negative all the time.
And I never thought of it that way, you you know, until somebody pointed it out.
Yes. So we're having awareness of what what are you thinking? What is your body actually physically feeling when you look at the number? And I think that the shift, if we're if we're kind of staying on the the psychological flexibility track, holding space for, like, okay. Oh, that was fear.
Right? Like, use you muttered under your breath. That is fear, right, or frustration. And so it's like, okay. Oh, fear is here.
Mhmm. So instead of saying, oh, I shouldn't be I shouldn't be fearful. I shouldn't be scared. I shouldn't be frustrated that, oh, fear is here. Yeah.
I'm gonna notice it. I'm gonna create some space from it. And then just even that quick little beat can help you're you're acknowledging that you aren't being controlled by it.
Right.
I mean, this is this going back to also CBT. Right? Like, oh, there it is. It's there.
I see that. I'm afraid. It's okay. Let's pause for a second. Nothing imminently bad.
I don't want you to pause in the middle of an actual medical emergency, but, like yeah. Because the diabetes really is is it is it's training you to expect a problem to come. And and then maybe at that point, you know, you become defensive. Jenny talked about it, and in in her her bit. And then you're waiting for the next thing to go wrong and waiting for the impact of it.
And then you're hypervigilant before you even are, to be perfectly honest. It is really like you ever walk into a situation where you people have beat and you just, like, everything's already on a nine and you're like, this is just simmering. This is gonna pop in two seconds. I think living with diabetes can feel like that sometimes. Like, what's about to happen?
What's about to happen? What's about is it gonna kill her? Is it that's how I would think all the time. Like, I always felt like I was two bad decisions away from killing Arden,
which Yes.
Is I mean, listen. Technically, you could make the argument, but in in a real in a in reality, that wasn't true. Do you know what I mean? Like, we we were not on death's door every five seconds, but it I don't know if I was being dramatic or if it's how it felt to me. I don't think I was being dramatic.
I think that is actually how I felt. And I do think over time, expecting a problem, having a problem arise, expecting it, having it arise, not being able to fix it. Because back then, we didn't have any, like I didn't have any data. Like, I didn't have any CGM to look at or anything like that. It was hard not to live in a constant, like, just a perpetual motion machine of, like, it's about to happen.
It's about to happen. If you thought you hear people all the time, like, you know, back in the day, like, you see a a low blood sugar overnight and you fix it. And then you sit up and watch it for two hours. Long after, you know it's okay. And nowadays, like, if that were to happen to me, I'd look at it, see it, go, I did the right thing again.
I I put my head back down again. And then the if the alarm goes off again, it goes off again. But, like, I I I would be comfortable enough to go back to sleep, and I know a lot of people won't feel that way in the beginning. So why does the absence of a problem like, why does the the waiting create anxiety? Do you have any is there, like, a a human reason around that?
Why Waiting Feels Like Anxiety 26:57
Because it's unknown, and and anxiety wants to creep in and say, better well, you you better anticipate. You better worry. Mhmm. Right? Like, worry, you know, is when you feel like you, by worrying, we think we're it's perceived to kind of control even though we don't know we're not actually controlling anything.
But if we we feel like, oh, if I just anticipate, if I worry, if I look, if I think, then maybe the next outcome, the next reading, I'll feel better. I think we also maybe while we're in the waiting, if we've latched our sense, value, our worthiness to the number, we're waiting for either that positive dopamine hit
Mhmm.
Of, oh, I'll lay stack the landing. We hear that all the time. Right? Yeah. Yeah.
We nail I nail that bullet.
Yeah. Yeah.
I got it. Yes.
I felt that way before for sure. Yeah.
Yeah. I got Sure.
Yeah.
That is totally normal and natural. I feel that way too sometimes on on a random meal that I don't eat, and I'm like, oh, okay. Yes. Right. Great.
That's awesome. But if it's patterned behavior and a learned response to assign your worthiness to the number, then in that waiting period, it's hard. You're like, am I am I gonna feel good about myself, or am I gonna feel crappy about myself Yeah. In these next few minutes?
I just have my I just thought, like, well, diabetes is like it's like a horror movie director who knows exactly how to make you, like, put you to the edge of their seat. And while you were talking, I typed off to the side. I was trying to figure out, like, what are the human concerns that horror movies play off of? And it it I I got back a couple of different hits. It said, sometimes it's that something bigger, stronger, or hungrier than you exists, that your home, your body, or your beliefs are not safe, that someone has chosen you and reason will not save you.
Your own body can betray you. Your mind may not be a reliable witness. Society is is oh my god. Society is thinner, like being held together more more delicately than we think. The place that should protect you is contaminated.
All of those things don't somehow mimic diabetes. I'd and that just popped up in my head while you were talking. Was like, that's that's a 100% what it's like to live with diabetes. Either as a all those things are there. Oh, isn't that interesting?
And so then that's where that comes from. Alright. So let's transition to the next thing that Jenny talked about then. We were talking about pre bolus thing because this is gonna fit right into this. Mhmm.
The Pre-Bolus Wait: Why It’s So Hard 29:35
Why is it so emotionally difficult to wait? So I brought up to Jenny, if if I if if I if I sat down at 07:30 at night, flipped on a baseball game, took a handful of pretzels with me, sat them on the table next to me, And I am one of those people who would not use a dish in that situation, in case you're wondering. And and I sat those pretzels next to me on a table, and then you looked at me and said, Scott, you have to wait ten minutes before you eat those pretzels. I'd go, okay. Now given a way that in a situation where someone's low, they're gonna be ultra hungry, that's not what I'm talking about.
But when a person with type one diabetes is in that same exact situation, and you say to them, hey, put your insulin in and wait ten minutes, and then you're gonna have a far better outcome, etcetera. There are far greater people more than I've than I would say opposite feel this way. That it feels to me when I'm talking to them. I hope I'm I wanna be clear about this. It feels to me when I'm talking about them that they do not want diabetes to tell them what they have to do.
Or I've now come to think of it even bigger now that we've done the body grief stuff, that there's that feeling of, like, well, my body should just do this. That's not right. It's not fair. I don't want it to be this way. But why do you think and this really speak from your own personal selfish Mhmm.
End here. Why is it hard to do that? Like, I know it's difficult to remember the bolus before you eat, but in a scenario where the food is not an imminent thing that you have to attack, what's so hard about waiting? I just watched Erica disappear back into the 20 year old part of her brain. I did.
I did.
I I was like, okay. Where
You know what I mean? I I know you know what I mean, but what do you think?
Yes. Okay. So there's the waiting there's the remembering we're not we're not talking about remembering to pray bolus.
Right. Because different that's a different problem.
That's a different thing because that's but that's also a very significant
Oh, yeah.
Factor Mhmm. Remembering and and it becoming habit. So I think the but I think it's important to note. Like because a lot of time it is I forget, but then we wonder why do why do I forget? Because it's not built in to the rhythm of the the meal.
It's not built into it's just not become a habit. Right? So there's that component that is quite frequently Yeah. Can I have your for
an yeah but right there, and we can go back and forth for a second?
Yes.
Yeah but, if dinner was falling into a volcano and it happened three times a day and there were three opportunities for you not to fall in the volcano, I guarantee you'd figure out how to do that. So why is it so keep going.
And I wanna say, oh, and I wanna come back to I don't I don't know. I wish wish hopefully, someone will do a study on this because there are moments where there might be intention around choosing to not pre bolus or kind of intentionally forgetting. Right? Because you're caught up in the moment. You don't wanna be different.
You I'm thinking of, you know, adolescents going to the corner store after school. You don't wanna, like, have everyone everyone's starting to eat. Right? There are moments where you don't want diabetes to interrupt the enjoyment, glow, pleasure of life.
Mhmm.
I think that's that's a category.
I'll share with you what Jenny said. She said I I'm well beyond caring about this anymore, but
Uh-huh.
She could remember sitting at a table and just looking at everybody and thinking, why can't you all just wait? I have to wait. And she talked about it as, like, socially wanting to eat while everybody else was eating. Okay. It's the part that, like, that came to her when she was talking about.
I find this. I have to tell you, I find this little slice of conversation worthy of its own 10 part series.
Yes.
Seriously, this this spot right here. Like, why why can't I remember to pre bolus? Why can't I remember to put my thyroid pill in my mouth at night before I go to bed? Like, these little things that from the external look very little that but are clearly not to the person living through it. Right?
And, you know, I, you know, I used the idea of, like, falling into a volcano, but the truth is is that if you were on a I don't know. If you were on a medication that you had to take three times a day or you were literally gonna just shut off, you would do it. You'd set timers. You'd build your life around it if you had to. I I know you don't want to build your life around pre bolusing, but it has such a crazy positive impact on your present day and your future health.
It is hard to like, it's hard for me when I watch Arden go, oh, I forgot. And then she just sort of keeps going. And I'm like, why does she not feel the weight of that? And I do. Like, when she doesn't pre bolus, I feel it like she's gonna fall into a volcano.
And I know she's not. Don't get me wrong. Like, for adults who are listening, I'm not out of my mind. I get it. Okay?
I was like, but but I feel that way. I'm like, ugh. Big big miss here. It's gonna ruin the next three hours of her life. And then two and a half hours later, if she's got a high blood sugar, she's like, dad, rub my head.
I have a headache. You know how hard it is not to go, oh, yeah. I know you do. Because your blood sugar went up to one ninety f u eight, and, like
That's a shame. No. You don't know that. It's in my head,
Erica. I have to swallow it and live with it in the pit of my stomach. Okay? And so so so, like, why doesn't she or does she feel that way, the protect herself from the shame, she doesn't allow herself to pretend it matters. I can.
Anyway, I think this is all fascinating. Somebody should do a study on this, by the way. Not me. I'm very busy making a podcast, but somebody else. I mean,
yeah, the the categories around why someone remembers, forgets, doesn't care, doesn't know about prebolising. So we we've talked about the this just totally forget, and you're wondering why do we forget.
Yeah.
I think some of the time, it is life, but I think in a bigger picture, what is your relationship, and what's the narrative around diabetes? And I I will share I I forget quite frequently around dinnertime because it's a different time and a different we've got busy, you know, extracurriculars, life, work in the evenings. But I have I have habit paired, habit tracked stacked. My morning kind of cover bolus, that's automated. I don't even think about it.
I do it. Yep. Lunch is a hit and miss, but I I I do pre bolus, but however much time I have varies, and I feel the effects of that. And then dinner, it's the variables. So I think the but the question when you're going back to Arden, like, is it the aftermath of not prebull is saying you have these physical symptoms Yeah.
That are uncomfortable. And sometimes that might happen enough. Like, if you're in a relationship with your diabetes in a way like, wow. That kinda sucked. I'm gonna remember to I'm gonna really be intentional in remembering next time.
Right.
But if you hate your diabetes, if you are in kind of a resentful relationship with it, then, of course, you don't wanna think about it. And this we talked about this last time too, but then you have to think about it on the backside.
Are You in a Fight With Diabetes? 37:18
Is it almost like like fighting with a parent? Like, you like, you almost like, there's something indulgent about the fight? Like, if you're does that make sense? So if you're not in a and if you're not in a place where you're just gonna say, hey. I wanna be peaceful with my type one.
I don't wanna have a headache two and a half hours after I eat. I don't wanna feel tired or whatever. Again, I'm I'm the wrong person to talk about this because I don't know what it feels like to to have that happen afterwards. But but I've I've decided I don't want those physical feelings anymore. I'm gonna I'm gonna figure out a concerted way to make make sure I do this.
Right? But if you don't, then you're in a fight with the diabetes a little bit. Like, I'm not gonna give in. I always come back to when people say, I don't let diabetes stop me. My my back of my brain question is always, does that mean you're doing the things that you have to be doing to make sure that it's not hurting you, or does it mean that it's hurting you and you're ignoring it and not you're you're not letting it stop you?
Does that make sense? Right. Yeah.
Yeah.
Yeah. We And we've talked about it before because I'm fascinated by the difference between in between those two sentences. And so I wonder if sometimes, like, you know, sometimes people relish a fight in a situation. Like, they feel like they're they're trapped in a lifelong blood feud with somebody, they love arguing with them. I wonder if people like the I'm not giving up.
You can't make me do it portion of that. I don't I really don't know. I'll tell you what I wrote down. I wrote a note for myself. It says, pre bolus documentary.
Look for 20 adults and 10 children to speak specifically on this tiny piece right here about why is it hard for you to pre bolus. I might string them all together in an hour and a half long conversation and let people tell their stories, and maybe somebody can figure it out inside of it. Because it's a it's a real thing. It's there's if you're listening right now and you're like, I don't understand why this matters, go listen to the pro tip series because pre bolus in your meals is, I think, paramount to having stability with your blood sugar. And it's hard for people to remember.
I absolutely acknowledge that. I and I'm not telling people just shut up and do it. I'm trying to understand why it's hard and philosophizing around it. So in this scenario here, you know, I thought one of the most interesting parts of Jenny's conversation was more about it was about the waiting to see what happens, waiting before you correct, waiting before you eat, waiting before you're intervening, and, like, and I just kept thinking, like, why is the waiting, like, so emotionally uncomfortable for some people? Like, why can't they just do it?
And I don't think there's an answer. I don't think you have the answer. I just think it's interesting to talk about. So I don't know. For you personally, though, what do you think?
Do you think you're in a fight with diabetes, or do you think it's just hard to remember?
I think I I was, for sure, in a in a fight as, you know, teen adolescent, and absolutely did not wanna think about I did not want diabetes. So anything that was revolved around thinking about it, didn't wanna do
it. Yeah.
So that that, you know, that was a lifestyle of avoidance.
Do you think this touches other parts of diabetes? Do you think there's, more emotional stuff rather than the understanding of the education? Like, maybe the parts Jenny went over where she's like, if you do these things here, you're gonna have easier outcomes. Like, maybe people know those things and just pampering themselves to do them, even making adjustments to settings or keeping their hands off the stuff when they're not sure what to do. I wonder how much of it is actually fired by by the emotion of it rather than the the nuts and bolts.
I would probably say, like, 99%.
Erica's like, the whole damn thing. It got me upset, I'll tell you. Yeah.
Well, I think they're thinking about that, you know, her Jenny sharing, you know, when you're when she's pre bolusing, and then she's sitting around the dinner table, maybe you're out at a restaurant, and she needs to wait longer. So there's that you're making that choice, and there's a cost for each choice. Because, alternatively, I'm thinking, well and I might do this. I would probably say, oh, gosh. I forgot your pre bowls.
The the dinner's here.
Mhmm.
And I don't wanna lose out on the experience of eating a meal that's warm, eating while other people are eating, connecting, and sitting there kind of uncomfortably while everyone's digging in.
Yeah.
So I would maybe make the choice which has a cost
You would.
To just bolus and eat and maybe add a few more, you know
Is it any different in your mind than having a cigarette after sex or drinking a little bit when you know it might shorten your life? Like, that kind of thing? Is it maybe the same idea? I'm gonna trade a little bit of later for a little bit of now?
Maybe.
I mean,
it's it's it's the cost analysis of of pleasure versus pain.
Mhmm.
And your so how painful? You're kind of I guess, you're in analyzing how painful is it and what's the cost of okay. But you know what? Actually, I know I'm gonna feel much better on the backside if I just wait a few more minutes.
Yeah.
Even though the food's here, everyone's eating.
And it's just a personal choice, mate. Hey. I should say for young people, sex is when people get naked and put their genitals together. I know you guys don't do it anymore. And smoking is, you take a cigarette, know this is another thing you guys don't do anymore.
I'm quasi blushing over here. I'm like, oh my gosh.
Did you not know what it was? I didn't mean to be the one to explain it to you. I'm so sorry. Your mom should have told you. No.
But you need to
get more worrying if there are children listening and they haven't There's
no kids listening. If your kids are listening, shame on you. What do you think of that?
No. I think that's even worse. Stop.
Oh. No. No. It's Performing. I just what I said in the reason, I was like, is that even a good example for people now?
I hear you're all just by yourselves playing video games. I don't know. I I grew up in a different time. Okay. Let's move Okay.
You want me you wanna move on. I wanna move forward.
So numbers have improved. Okay? CGM looks more like we wanted to. Our settings are working. Our time and range has gotten better.
Why might we still feel exhausted even though we've gotten all that done? Like, could the emotional exhaustion itself become a habit?
Yes. Because your your body, your mind has learned that it it kind of restricts itself. Right? It feels like safer to stay kind of just as you can the body stay in a threat mode long after the threat gets smaller? Yes.
Because you your neural pathways have been kind of wired. Your that old tape of you you better stay on it. You better stay hypervigilant. You better anticipate.
Mhmm.
That has become so ingrained that if you were to to try and separate from that, that would feel scary
Yeah.
Or too risky.
Comfortable in the Problem: Foreboding Joy 44:23
I I'm gonna I've said this before on the podcast, so I'm comfortable saying it again. Plus, for reasons that I completely understand, my family doesn't listen to this. So when I met my wife, it did not take me long to realize that she was more comfortable when something was going wrong. And when things were good, it she looked like a a rat in a trap. It was it was really, really very interesting.
It took me a long time to make her believe that too. She was not happier. She was more comfortable if there was a problem. It was like it was like she expected there to be a problem, here it was. So I got what I expected.
This is good. And then our lives got better and then and calmer. And whenever it was calm, she was always, like, waiting for the the other shoe to drop. She was always thinking something bad was about to happen. It took her a really long time to get past it.
So if that's happening to you, I mean, Erica, do you have any idea how they could work their way through that?
I mean, that's the concept of anxiety and productivity. And Brene Brown had no shocker that I'm referencing her, talks a lot about this comparison. And are you are you anxious because you are needing to do a lot of things, or does that kind of fuel the productivity, or do you feel like that's reducing the anxiety by running on the the hamster wheel? There's also concept that you just talking about is the the shoe always gonna drop.
Yeah.
And we've talked about this way back when I can't remember in which series, but the concept of foreboding joy. Like, as soon as you feel like your settings are in place, as soon as you feel like, oh, things are stable, is it hard to let go of that fear? And if that's something you're really interested in, you can look up, you know, the the concept of foreboding joy, which is that, like, oh, I don't know if I can fully be present. Yeah. Because you never know when something bad's gonna happen.
And while we can acknowledge that part of that is true with diabetes, we also don't wanna be kind of attached and connected and feeding that that thought, which is a fear based response and trauma based response.
Hard to believe you're in a safe place sometimes.
Yes.
Yeah. Yeah. I you know, it's funny. Our dog is sick. That's not the funny part.
Our dog is sick. And my daughter today said to Kelly, mom is sad the dog is sick, but she loves that there's stuff to do. And she's like, look at her. She's, like, in her glory. There's, like, she's, like, running around handling things.
Like, it's it it really I I looked up. I was like, oh, but she's a 100% right. Like, she is just like, Kelly's, like, in her she's literally in her glory today. She's like, there is this to do and this to do and this to do. It's all very important, and I'm gonna get it done and blah blah blah, and makes her comfortable.
Pretty interesting. So
Yes. And and that could be also feeding into that sense of agency. Right? Like, she it feels good to do stuff and to get the outcome. And, like, I do x, and I know y is gonna happen, and that feels good.
Like, she's and it's probably feeding into that, which those concepts aren't bad.
No. No. No. Not at all. She's not like, don't get me wrong.
Like, she's not I'm I'm not like, oh, there's a crazy person downstairs. She's just she's like, she likes for there to be things to do. That's all. Yes. I also think my wife's one of those people who's happy when she's working.
And I don't think that's sad. Like, I think somebody who wants to be sitting around or or wants to have that other kind of life would look at it as sad. I think she's really I think she's at her optimum when she's working, and she enjoys it. So I don't stop her. Okay.
Identity, Grief & Who You Are Now 48:13
The identity problem. Jenny talked about people who become the controllers. They they learn how to manage little every little variable. What happens when being hypervigilant becomes part of your identity? Because then if you're not constantly managing, what are you doing if that was your job?
Which kinda comes in on the back of what we just talked about here with Kelly, Fem, and Happy. So that's, I don't know. Again, like, you'll find a hobby, but your hobby can't be the diabetes. Because that comes as close to the, what's that, Munchausen's by proxy as I can as I as I can imagine. Like, you don't want there to be a problem that you have to deal with.
But what what happens when someone takes it away from you? I can yeah. I can only tell you that I know it's real and that when my kids got older after being a stay at home dad for a long time, I felt, like, rudderless for a while. Like, per I I felt like I didn't have a lot of purpose outside of my job for a little bit. But I I'd like to know what you think about it.
Identity is such a huge kind of integral part of one's not only grief process
Mhmm.
And thinking about from a caregiver perspective, but also the person living with it. You know, who who am I now that diabetes is here? Who am I now that I feel like I have to be a pancreas for my child? So there's there can be and I'm kind of going off track a little bit, but we'll come back
Please.
To the hypervigilance. I think there's a loss. Right? There's a a real sense of loss and a perceived sense of loss around one's identity of, you know, who who am I now? So there's that needs to be greeted.
And then there's a journey of, like, reintegration of, okay. Now diabetes is here to stay. Where am I going to assign? Going back to that values question. Like, why am I here?
What am I doing? How can I still continue on in my journey with diabetes? Like, you're on you know, hanging out on my shoulder, but not weighing me down and not dictating, controlling my path. And for a lot of caregivers, there's even a greater sense of loss of, you know, from Kelly's perspective who really enjoy work and working outside of the home, so to speak, but feel like they might have to let go of that a little bit. Two, feel like they're helping their child manage their diabetes, and then you're kind of escalating with what does that mean to be supporting.
Do I need to be hypervigilant? What if I can't be hypervigilant? What if I don't wanna be hypervigilant? And what are I guess, the bigger question yeah.
Go ahead. The bigger question. Sorry.
Bigger question is what narrative are you telling yourself around who you are in relation to your diabetes?
I've interviewed more than a few people who have left their jobs to be stay at home diabetes parents and then taken and they were, like, they were earners. You know what I mean? Like, those people were they were out in the world hustling, and they took that hustle and focused it at the diabetes when it didn't really need all that energy. Do do you know what I mean? And then it did become their their thing.
So oh, jeez. I don't I boy, I don't know. So but so people, you know, how do you just let go of it if that's been your role for so long? And then suddenly someone comes along because I would hate for to think that you could possibly be sabotaging getting your set because in the end, this conversation, like it or not, like all my conversations, is about timing and amount. Like, I'm just talking about getting your settings right and putting in the insulin in the right time and then all the things that come from that.
I would hate to see somebody get in the way of making a problem go away because they're more comfortable in the in the shit. And they and they don't know how to make it go. Like, they don't they want calm, but they don't know how to exist in calm. And would that could that cause you to subconsciously get in the way of of a smoother path because you don't know where it would lead you. I mean, it's it's some pretty deep stuff.
I don't know if that's a thing anybody would do consciously. But, you know, I've seen people block their own happiness in a lot of different ways. So it's not out of the question. That's for sure.
I think if that were occurring, that would be, you know, very unintentional, but that's become their normal and how they feel like that's the only way they can survive. Right? It's like, how how do I survive knowing that I'm trying to keep my child alive?
Yeah. Or themselves too.
Yeah. Yeah. And and for themselves. Yeah. So thinking through, you know, what is it?
What happens when being hypervigilant becomes part of your identity? And how do you let go of that once you feel like, okay. My child has gone off to college, or or I'm an an adult, and I feel like I've figured it out,
so to speak. This algorithm on them, it's working.
Like Yes.
Yeah. Right.
I think there there's probably again, every story is different, but I'm wondering and would be curious around what is that the going back to kind of the value worthiness of if I let go, if I pull back, if I start if I choose to go back to work and if my child is at school or if I choose to not look at my CGM while I'm at work for all day every day
Mhmm.
And something bad happens, who who's gonna be to blame?
Yeah. I know that feeling. That's gonna be me. Yeah. Yeah.
Yeah. No. No one's dying on my watch. That is how it is how
it feels.
You know? Right.
Right. Yeah. So we are so Mhmm. It is like
You're gonna say screwed.
You're gonna
say we're so screwed. I know. God, I'm sorry.
We're so we're so we are so self critical. And from a caregiver's perspective or living with it, if we are attaching so much blame and shame to any higher low
Yeah.
Of course, then the answer is gonna feel like, well, I gotta stay on it.
Mhmm. Mhmm. Yeah. Because it will think
the work is looking at what what are you believing to be true about yourself if you try and step away from staring at the screen all day?
What Does Emotional Success Look Like? 54:47
I can tell you that not thinking about it all day is a lifesaver, and it it can be done in a way that doesn't hurt someone's health. That's that's my takeaway after doing this for just about twenty years. So, anyway, the the last bit here is what would emotional success look like? So what Jenny described as practical success was gentle rolling hills on your CGM, fewer interventions, fewer surprises, and less interactions with diabetes. But what does an emotional success look like?
Like, how would someone know, you know, that they that they've reached that place?
I love yeah, we're looking back. The general I mean, maybe some emotional gentle rolling hills. I mean, I know that's that's
Oh, I don't after by the way, after the horror movie thing, I just think we should just just say yes. Do this, but with your mental health. Because, honestly, gentle rolling hills, so less less Uh-huh. Ups and downs, fewer times where you're intervening, fewer surprises, fewer interactions where you're actually touching the diabetes or touching, you know, your your mental health, I guess. I mean, is there better maybe maybe maybe everything is everything.
You right? Well, you should be called Gary Curtis and just, like, sit in the field and I I we're all connected. Have I talked to you about quantum entanglement, Erica?
Oh my gosh. No. So I like well, I mean, even just like
the
gentle gentle rolling hills, fewer surprises. So when we're when you're living in an a hyperarousal state, everything is gonna feel like an attack and a surprise. Right? So going back to noticing when you have a Pigor Valley, wow. That it's okay to feel the feelings connected to those.
It's not about dismissing, ignoring, setting aside, being like, I shouldn't I shouldn't have done that, or I shouldn't feel guilty.
Yeah.
But in that process, you're also letting go of perfectionism. That's, I mean, that's easier said than done. That's a journey. Noticing, like I guess they on guard like, when you're feeling on guard Mhmm. Going back to what Jenny I think you said she people you you feel like you maybe you're on the defense.
Right? Like, you're always having to respond, and so you're by countering that, you might feel like you're on offense. So you're in this constant wrestling. So when you're and I know you're kind of this is framed from, like, once you're getting the settings right, how do you let go? So just being really aware, and it might take, you know, a lot of interpersonal work through mindfulness, through therapy, through slowing down your thoughts, but noticing what you're attaching to the peaks and valleys when they do happen.
Mhmm.
I have to tell you, I got emotional here at the end. I because, you know, if you give me a minute, at the end here, don't don't leave just yet if you're listening. This really this whole, like, conversation with Jenny and Erica, it it kinda bloomed out of a different idea. I was thinking through a conversation I wanna have with Erica about how much can a person really focus on at one time. And as I worked my way through that conversation, it it got to where it is now.
Don't ask me how that happens. There's a lot of thinking in the shower, and and trying to figure things out. And none of this is planned. So these really were and I and I will say this, I think you have the heavier lift than Jenny because Jenny can fall back on, like, you know, nuts and bolts conversations. I'm asking you to pick into, you know, therapy ideas and the the workings of the human mind and ask off the cuff questions.
You know, answer off the cuff questions that I'm asking you. So I I I I want everybody to know that I think this is a pretty heavy lift for Erica. She should be applauded for having this conversation like this without Thanks. Real without preplanning. Seriously.
But when we got to the end and you said that, maybe it's just gentle rolling hills and fewer interventions and fewer surprises. I thought, oh my god. This all dovetailed together. So love. I didn't know that was gonna happen.
But I will tell you that it's been my first of all, I think if any of this is interesting to you and you'd like to get things together, go listen to the pro tip series that I did with Jenny. I think it'll help you understand your settings and your timing much better. And it is my belief based on my own personal experience that when your basil's right, when your carb ratio is dialed in, when you understand how food impacts, when you get the timing right, those things, they lessen in your mind. They become more back mind stuff that just happens automatically, and your life opens up. And it it's just easier.
So it'll it's a little bit of work up front for a lot of good coming later. But I didn't I just didn't realize that it was gonna that it was gonna be a carbon copy of itself. In the end, you know, these two conversations are almost exactly the same. They're just they're just from two different perspectives about diabetes. And I also don't think we can avoid or ignore any of what you and I just talked about or what people went through.
Self-Compassion & Starting With One Thing 1:00:01
When I said how much of diabetes is something, you said ninety nine percent. Like, I I felt that from you. Like, this thing is I think it's way more impactful on people, aside of their physical health then maybe we either believe or want to allow ourselves to believe or maybe even have the the nerve to to be conscious of. Because it's probably just it could be really sad if you think about it all the time, like what this is, you know, and and what it can be. But I think there's easier ways through it, and one of them, I think, is settings and timing and amount and all that jazz.
So I hope this helps somebody, and I appreciate you spending the time here. Is there anything that you want to add to this?
I do. Thank you. Thank you. I think the acknowledgment that you just where you were landing that, yes, it is complicated, and diabetes is hard, and it is complex both emotionally and, you know, logistically. And I think acknowledging that, yes, is very important.
And simultaneously being mindful of how much you are exposing yourself to the diabetes is hard, diabetes sex narrative. Because if that is something that is infiltrating your brain, mind, body all of the time, it is hard to pause and take space like we were talking about today and practice that psychological flexibility. So it's it's going back to, yes, diabetes is hard, and I am doing the best I can. And I'm gonna be learning these tools, and I'm gonna be compassionate to myself. One last thing that the research has shown from a study of people that I did look this up from type one and and type two found that those who practiced self compassion had lower a one c's and less emotional distress than those who did not.
And so if you're hearing all this that maybe that that what Scott spoke to Jenny with and what in our discussion today, and you were hearing yourself say, that must be nice, easier said than done. I'm never gonna get there. I'm never gonna figure this out. Just even noticing if that's your narrative, you know, practicing self compassion isn't just a a kind nice thing to do. It actually helps you biologically to reduce those stress levels and those cortisone levels.
So I just thought we could you know, I wanted to end there for at least for me on going back to that self compassion and grace narrative is so important.
Yep. I would say that also that if you feel like you can't do it, I I normally joke and say, listen. I can do it. If I can do it, you can do it. But I I've I've brought this up once or twice recently, but there's a meme online that says, you can do it.
Juicebox can help about the podcast. And I really think that. I think if you if you really think you can't do the nuts and bolts side of it, go through bold beginnings or small sips or the pro tip series, whichever one, like, seems like it fits you better, And just listen to Jenny and I just chat about these things, and it'll sink in eventually. And Jenny was talking today about I was talking about looking at a a graph and knowing kind of pretty immediately what to do, but there 's still sometimes when I look at them, like, I think this is what has to happen, but I need a couple of more minutes before I get to it. But generally speaking, I'm a whether she would like to hear this or not, I'm an expert on how Arden's blood sugar works and how our physiology works around diabetes.
I can look at a graph, assess the situation, and pretty accurately know what to do next. Right? And it's not a thing that I'm it's not like writing math on a paper. It just it just happens. It's sort of like when I I don't know another way to put it.
Like, looking at art and knowing it's beautiful. Like, I look at that diabetes and I go, we got a bolus a unit and a half right here. Or we missed that bolus. We didn't count the carbs right. Or, oh gosh, I bet you we missed fat in this.
I know it in a split second, and it comes from experience and time. It's all it is. It's just time in the simulator and having seen it enough times that I know what I I know what it is when I look at it. I don't have to be told, and I don't have to wonder. I think people can get to that.
It just and I just under I understand that if you didn't get a good leap into it, if a doctor didn't set you up well, if a parent didn't help you, if you got caught on the roller coaster and your blood sugars got high and you got brain fog and you're having bad outcomes and it feels like you're just, you know and it must feel like going on you ever see those movies where surfers get knocked under and they film them, like, flipping through under the weight? Like, I imagine that must be what it feels like eventually. Right? And if you're under there right now and you think I'm I'm getting pulled along, I'm never gonna come out of this, it's absolutely free. I don't make any money when you listen to it.
Just go listen to the pro tip series. Like, I think you'll feel better. And if you are are having trouble with the emotional side of it, Eric and I have recorded so many conversations about stuff. It's it's on the website. Like, go to the website, find the mental health section, pick proof, find something, listen, give yourself that grace.
And and I think you'll I think you'll pop up out of the surf eventually. And and I've seen it happen to so many people who, at one point or another, would have described themselves as beyond help. So I know it's possible. I I hope you can believe that. And thank you.
I Yes.
Again, I appreciate
that. Yes. Thank you. And starting with with one thing is always the best way to start. As you you say that often, and I think it's important to note that as as you share your journey and reflection and observation and skill, if you're thinking that must be nice.
Yeah.
As you're saying, go back. Start with the project series, but also even smaller than that, just start with one thing
Yeah.
And take away one thing at a time.
If you're looking at functional, get your basal right first. I have a note here from somebody. I won't bore you, but having her on soon. She said, I saw your little estimator online about settings, and I put my stuff into it and moved my basal up by, like, at, like, 40%. And she's like, look at my graph.
She was 40% deficient in her basil. She had no idea. That one little thing could be a big difference for her. Uh-huh. Mhmm.
Alright. Erica, go, go go ahead. It's the weekend. I I release you. Thank you so much.
Awesome. I'll talk to
you soon. This episode of the Juice Box podcast was sponsored by US Med. Usmed.com/juicebox or call (888) 721-1514. Get started today with US Med. Links in the show notes.
Links at juiceboxpodcast.com. I wanna thank you so much for listening and remind you, please subscribe and follow to the podcast wherever you're listening right now. If it's YouTube, Apple Podcasts, Spotify, or any other audio app, go hit follow or subscribe, whichever your app allows for, and set up those downloads so you never miss an episode, especially an Apple Podcast. Go into your settings and choose download all new episodes. A diabetes diagnosis comes with a lot of new terms, and you're not gonna understand most of them.
That's why we made defining diabetes. Go to juiceboxpodcast.com up into the menu and click on defining diabetes to find the series that will tell you what all of those words mean. Short, fun, and informative, that's defining diabetes.
- Trust is built from repeated lived experience, not a single good day. When a day goes sideways despite good settings, the skill is to notice the feeling — fear, shame, frustration — without treating it as proof the settings are wrong, and to resist overhauling everything. Erika frames this through psychological flexibility (from ACT).
- Hypervigilance feels safer but isn’t. Living in a constant threat-and-anticipation state keeps cortisol elevated, which makes clear decisions harder and can even work against your blood sugar. The goal is responding to alarms from calm rather than fear — and if that’s hard, support from a therapist can help.
- Worthiness isn’t a blood-sugar number. Much of the pain of “waiting to see what happens” comes from attaching self-worth to the outcome — the “stick the landing” dopamine chase. Noticing that pattern is the first step to loosening it.
- Not pre-bolusing is often emotional, not informational. People may know the benefit and still skip it — to not feel different socially, to not let diabetes dictate the moment, or out of a quiet fight with the disease. Naming which one it is matters more than being told to just do it.
- Self-compassion isn’t only kind — it’s measurable. Erika cites research linking self-compassion to lower A1C and less emotional distress. Pair it with starting small: take one thing off your plate at a time, and discuss any management changes with your care team.
- US Med — Where Arden’s diabetes supplies come from — this episode’s sponsor. Or call (888) 721-1514.
- Part 1 — Take Your Hands Off It: The Settings — The Jenny Smith half of this two-part conversation.
- Mental Wellness Series — Scott’s ongoing conversations with therapist Erika Forsyth.
- Diabetes Pro Tip Series — The settings-and-timing fundamentals with Jenny Smith.
- Bold Beginnings Series — The newly-diagnosed series.
- Juicebox Facebook Group — The private community — about 150 new members a day.
