Scott Benner 12/11/23 Scott Benner 12/11/23

#1081 Ask the Omnipod 5 Training Expert: Questions about Everyday Use

Omnipod 5 Ask the Expert Series: Questions from the Juicebox Community

Episode 1 of 3: Ask the Omnipod 5 Training Expert: Questions about Everyday Use - Eric Davenport, RD, CDCES - Clinical Services Manager

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#1080 Grand Rounds: Series Introduction

Scott Benner and Jennifer Smith RD, LD, CDCES share diabetes insights for clinicians who want to do better..

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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:00
Hello friends, and welcome to episode 1080 of the Juicebox Podcast.

I'm incredibly excited to give you a preview of a brand new series that's coming in January Grand Rounds. These episodes are aimed at practitioners, but are also going to be very valuable for people living with diabetes. Our goal is to let doctors know what they should know. I've taken feedback from the Juicebox Podcast listeners to develop this series, we're going to use your words to describe to doctors what they need to know to help you. But moreover, this information is going to let you know what you should be expecting from your physicians and frankly, what you deserve. While you're listening. Please remember 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. This series is going to help physicians be the kind of people you want to consult. If you're enjoying this series, please share it with your health care provider, doctors that you know in your life or other people living with diabetes.

This episode of The Juicebox Podcast is sponsored by touched by type one touched by type one is an organization that is dedicated to helping people with type one diabetes. They're asking if you'd be willing to go check them out on Facebook and give them a follow on Instagram and do the same or at their website touched by type one.org. Head over to that website now to see all of the amazing things that touched by type one does for people living with type one diabetes. The podcast is also sponsored today by us med. US med is the place where Arden gets her diabetes supplies from she gets her Dexcom G sevens and her Omni pod dashes. But they have so much more. And I'll tell you about it a little later. For now, here's what you need to know, you can get a free benefits check at my phone number 888-721-1514. Or by going to us med.com/juicebox.

Jennifer Smith, CDE 2:36
Hopefully, none of that was recorded. I

Scott Benner 2:37
did not record any of that. But I'm recording you saying hopefully none of that was recorded. Jenny and I are having a day together. And we're gonna use that energy to build the next series of the podcast. So yeah, let's go. I'm pretty settled on calling this episode Grand Rounds, actually the series Grand Rounds. That is really only from my knowledge of the medical profession as far as I've watched Grey's Anatomy. And because I am old, I've also seen the entire run of er, that's what I know about hospitals, I realized that might not be accurate. But I do remember people saying Grand Rounds, like where all the students would get together and go around with an older more wisdom teacher and they would go from case to case and talk about things. And my idea here, Jenny is this. I feel like we can put a series of of episodes together that would simultaneously teach patients what to expect from their doctors, while teaching doctors what their patients deserve. Because that makes them how to interact, yes, and how to actually feed that information to them. Taking into account that diabetes is probably three pages in a book at medical school and 20 minutes somewhere while you're going through things. And that a lot of people are going to intersect emergency room people, doctors in what like urgent cares in their primary care offices, right? Yep. People who don't aren't schooled on diabetes, the way people who live with it and are correct, what we've done is gone out to the population that listens to the podcast, and so that people know who are listening. I'm talking about 40,000 people on a Facebook group and millions of downloads of the podcast. And we've asked these people, you know, to give their feedback about what would have been helpful, helpful, and what was not helpful. And then we've broken that down. And today, you and I, as we've come to do with the beginning of a series are going to talk through how we're going to build the series. We're going to take this information, put it in some reasonable order. Let people know what to expect. And that's what we're going to do. And you are Yeah, you're incredibly passionate about this. So if you could talk for a minute about why you think this is important. I'd appreciate it.

Jennifer Smith, CDE 4:59
Yeah, I'm, I'm passionate, that's a great word. Because I think that, as you've already stated, general medicine practitioners who haven't had the extra schooling, right, when you complete medical school, then you can specialize, right? Specializing in endocrine, you go on to a fellowship, you complete a fellowship. And so you have that more in depth. In general, a first step, anytime you're sick is going to be a primary care doctor, they're going to be a first step, whether there's symptoms for something or whatnot, you're going to go to primary care, or in the case that really urgent symptoms come up, you're going to go urgent care emergency department or whatnot. And in those cases, they're knowledgeable people. I mean, that's one big thing I want is people to hear that they're schooled. They're schooled in medicine, but they are not schooled in a specialty. And we can't expect them to be either, right. But in order for them to understand what to do, I think it's a it's a two way but right,

Scott Benner 6:14
I want to say right at the onset, that I am almost positive that through this series somewhere, if you're a physician, you're going to feel like there's Doctor bashing going on. And there, there is not we have both have the utmost respect for you, and what you do, and how difficult it is. We just know that the only doctors are the first people to say this, usually, they'll tell people with diabetes all the time, look, you're gonna have this for six months or a year, and then you're gonna know more about it than I am. Right there living with it really is the only way. But the reason that this is so important, even from minute one, is because I mean, Jenny, you know, I'll tell you a little more about what Jenny does as we're going along, but she intersects people with diabetes all day long. I do as well, I have long form conversations with them. And I can tell you that sometimes things that are said to them in the first five minutes, haunt them, sometimes forever. And so when a doctor says something offhanded, it literally it could change their life significantly good or bad. And so why not move it in the right direction is what we were thinking about making this series.

Jennifer Smith, CDE 7:24
Correct. And I think in general, when we're talking about overall medical personnel, clinicians, we're not doing any bashing. That's not the idea here at all. So that's, that's great to clear up. The idea, though, is for a communication piece, to be more in the forefront of the mind, both on the person maybe with diabetes, and how they can communicate better, but also from the physician knowing that I think a forgotten part of healthcare is that, like, health care is it's it's human care. Yeah. So we're not looking at just talking in a very flat manner to somebody, we're looking at talking to somebody about something that's going to affect their life. And with diabetes, it impacts the life on a 24 24/7 note, right, there's no shut off to it. And so as you said, you may make a statement, as a clinician, that's a statement you think may need to be in the conversation. And maybe at some point, it does need to be there. But in a, in a different way, different context, at a different point, you have to learn, you have to learn what somebody is coming in with the need for at that moment. And that takes talking, right.

Scott Benner 8:44
And there are also I think you have to build more than just a spreadsheet in your mind evolve. First of all, tell him about this. And then the next time I see them all mentioned this, like, you need to know where they are like you might deliver the information, like Jenny said too soon or too late, you might deliver it the wrong way. And I know that you could also be listening and think well, how am I supposed to know where they're at? You could talk to them. Now, that'd be a really great way. Right? And you really have to understand that no matter how much you think you can put yourself in the shoes of a person who needs manmade insulin, or the shoes of a person who is charged with caring for someone who needs manmade insulin. You can't. It's far more impactful, and potentially destructive, and difficult and time consuming and exhausting than you'll ever be able to imagine. And the only thing that will help those people not live like that is the stuff we're going to talk about in these episodes. And you can listen to these and pick it up and apply it to what you're doing. I really think you can help and that's not just me saying I make a podcast. So here's my next topic. We've been doing this a long time. We have a lot of feed back, we know what works. So I hope you guys listen. And if we sound like we're bashing you, at some point, I promise you we're not. We just feel really strongly. And we've also heard from a number of people whose lives have been, I mean, honestly, sometimes derailed by by bad medical advice.

Jennifer Smith, CDE 10:17
Right. And I think something to go along with that is bad medical advice, or misguided even really understood, right? When you are a when you're a practitioner, and someone is coming to you, that's out of your wheelhouse of being able to answer than your best ability is to say, You know what, I can't answer that the way that you need the answer to come or I don't know enough about it. My job is to direct you to the right person. So it goes along with saying the right thing are saying it at the right time. And in this instance, if you don't know enough, the better thing is to not pretend that you know, and it's to direct somebody to the right person in your healthcare system. So that the answer can be given in the right way and in the right time frame around the right context, you know, to not scare people,

Scott Benner 11:15
and I think don't just think of that as like, I said something to them that was incorrect. Like, here's an easy one, right? If I went up to your general practitioner, and I said, I use insulin, will chicken make my blood sugar rise? I think most general practitioners would say no, if there's no carbs in that, you'll be fine. Right? Like, I think that would be the answer. And it's what most people get, except proteins broken down, it's stored as glucose makes your blood sugar rise? Is it a significant rise for some people, for some people, not depending on variables, too great to even go into right now. But if you tell that person, no chicken won't make your blood sugar rise, you're the deity in this situation, you got the white coat on, they believe you, they'll never think again, is my blood sugar high because of chicken, you've told them that won't happen. And then that that's gone from their mind forever now. And then if someone comes along 10 years from now, and tries to tell them, they'll fight to defend you and what you told them 10 years prior it You mean that much to them? Right in their life. So it could be that and it could just be you have no idea could just be Miss speaking or saying something. Without enough description. I for years. For years, I only thought Novolog was insulin, you didn't know that there were other No, because

Jennifer Smith, CDE 12:36
they gave us dialogue was insulin and that insulin, this

Scott Benner 12:40
is insulin, and I went alright, and I took it now this is insulin, right. So I now now when my daughter has struggles, I don't know that I could look into other kinds of insulin, I had no idea. It just would have never occurred to me, because I've already been predisposed to believe that what I was handed is insulin. And there shouldn't be any questions after that. Right? That's all right. And again, this could seem like nitpicking, but I've interviewed over 1000 people with diabetes. And I'm sure Jenny's talked to way more people than that with type one and type two. And it's got an impact on their lives that you, you can appreciate till you have those conversations with them.

Jennifer Smith, CDE 13:18
And even the simplest statement could be misunderstood. And so that's why really unless you have a good enough idea how to give a simple but correct answer, the better idea so you know what? I don't I don't know, either. Let's look that up. Let's take the time to gather to understand it in office, I think that goes a long way with actually trust from a person with diabetes to the clinician, because the clinician is willing to take that step with somebody or say, You know what, we can set up another visit and or I'm going to have another clinician who knows all about this be the one to present you with the right information, and timely visits, I think within that are an important thing to consider when you're the clinician scheduling somebody out. It's somebody has a question. Oh, it looks like three months from now you can see this person who can answer I know, no, having worked clinically how scheduling works, I get it, but a question needs an answer. And it doesn't need a delay to it.

Scott Benner 14:26
So you know, I think it might be important to dimension here before we go through what we think are going to be the topics the topics in this in this series. Everybody who has diabetes has diabetes supplies, but not everybody gets them from us med the way we do us med.com forward slash juicebox or call 888721151 for us med is the number one distributor for FreeStyle Libre systems nationwide. They are the number one specialty distributor For Omnipod dash, the number one fastest growing tandem distributor nationwide. And they always provide 90 days worth of supplies, and fast and free shipping. That's right us med carries everything from insulin pumps to diabetes testing supplies, right up to your latest CGM, like the FreeStyle Libre two, n three, and the Dexcom, G six and seven. They even have Omni pod dash and Omni pod five, they have an A plus rating with the Better Business Bureau and you can reach them at 888-721-1514 or by going to my link us med.com forward slash juicebox. When you contact them, you get your free benefits check. And then if they take your insurance, you're often going and US med takes over 800 private insurers and Medicare nationwide. better service and better care is what US med wants to provide for you. Us med.com forward slash juicebox get your diabetes supplies the same way Arden does from us med links in the show notes links at juicebox podcast.com. To us Med and all the sponsors, when you use my links, you're supporting the show. You know what I'm gonna let it go. I'm gonna let it go. And I'm gonna bring it back up in a second. So let me let me jump forward to the time has to make a note for myself here maybe doesn't fit right here. Okay, so what we've got here is a fairly, a fairly big list of of ideas and thoughts. But I wouldn't want a physician or even a person listening who's like, what am I going to what should I be expecting from my doctor? I wouldn't want you to think, how am I going to put all this to memory? What am I going to carry bullet points around with you make sure he asked me about this, make sure I've talked about that. To me, that's not how this works. To me the way it works as these conversations you listen to them. And you sort of just fold the information into your understanding of diabetes, so that when these things do come up, your natural inclination will lead you towards answers and ideas that will be helpful for you. So don't think of this as like a study guide. And don't think of it as a list. Think of it is it broadening your understanding so that you can ask or, or give the right information? Correct. That's what I was thinking so. So we have a broken down diagnosis, hospitals, insulin food, CGM, and bgmc, insulin pumps, the humanity and mentality, communication, management and pregnancy at the end. And I actually, as we started talking, wandered out loud and wandered on my notepad to myself, do we do want at the end for school nurses too? So let's make a good

Jennifer Smith, CDE 17:48
one as well, I do we have, you know, one that came to mind since you had insulin in there, right? is safety. I think safety would go right along with that insulin topic.

Scott Benner 18:03
You're hearing Jenny and I morphing the list as we go. So the reason

Jennifer Smith, CDE 18:07
is, because I've I've seen too many things that circulate around insulin, and the topic of safety. It's not discussed the right way and or the tools that are there for safe measures aren't talked about at

Scott Benner 18:24
all. And you might, as an example, oh, everyone knows that. But I quite literally spoke to a woman two weeks ago, who is in her 30s and has had diabetes for 20 years, who until two years ago, did not know that insulin could be dangerous to her. Right? That's it. So that is a thing that I think a doctor wouldn't expect. Right? You know, and so you so you don't say also, here's a good example, and we'll go over that episode. You don't give them the insulin and say, Hey, this is really dangerous, it could kill you. Because if you use too much of it, it can kill you. You don't tell them that. That way you. You want them to know the truth about how it works. You don't want them to be scared to use it. Because all that's going to do is drive people to have higher blood sugars and complications one day, and it's just these are the things we're talking about. So yeah, I

Jennifer Smith, CDE 19:19
think within that insulin and that safety is tactics of discussion, honestly, because I think too often you brought up, you know, just the word scare. Too often, the strategy that's used, it's not a direct thing, but I think too often scare tactics are used. That shouldn't be the way that people are educated.

Scott Benner 19:46
You can't lump everybody together into one mindset. Like there are going to be some people who don't do a good job taking care of themselves. That might be because they don't understand it. That might be because they're afraid aid, it might because they're apathetic, on and online. But what you what you see happen, the stories you get back from people are that the doctor just assumed I didn't care. But that wasn't the case. And often people have, you know, psychological reasons why they can't do the things you're asking them to do. There's plenty of times and plenty of stories where you as the doctor, you think you're giving great advice, and you're not. And that person is at home, breaking their ass trying to make this work. And they come back to you, and you say, Well, you're not trying hard enough. That's how much you believe in information that is not actually very valuable to them, or you haven't done a good job of, of giving it to them in a way that that they can pick up and use. And

Jennifer Smith, CDE 20:42
that's the reason that, you know, you have to with each person, that human piece to it again, you have to bring, like your whole wealth of knowledge into those visits, and your your understanding of being human and all the variables that impact your life up to that visit time, because people are going to lean in and respond and ask questions. And that gives you who they are. And it leads you the route of simplified information, more extensive information, this type of technology to discuss Nope, we're not there yet. I mean, it leads you down the path to help this person on an individual level. But you have to be willing to listen. And I know in today's world, I don't think that doctors don't want to listen, I know that there is a time constraint, I 100%. Understand that. But I think even the first couple of minutes of of a discussion could be enough to be able to feel out the avenue, you're gonna go down for that visits.

Scott Benner 21:53
I think if you heard that, and you think, Well, look, I told them what to do if they don't do it too bad. Like, if that's your feeling, I'll say this to Jenny and I both from different perspectives have an incredible amount of experience, helping people who we are not sitting in front of. Right, and Jenny does it one on one through a video chat, right. And that's a special skill. That's why she's talking so much about getting to know people because that's what she knows, works. And for me, I have a different skill. I help people without knowing who they are. Right, I can't see them. I don't know their circumstances. And, and I'm left to give information in a way that I imagined that the most amount of people can pick up and use. And you need to be able to deliver information in a very digestible way when you do that, because I don't know who I'm talking to right now. Like I could be. And I know I There are doctors, physicians learned people whose kids get diabetes, and they can't figure it out. And they listen to this podcast to figure it out. And I have spoken to people who have not graduated from high school, and who struggle financially, who have mental disorders, like all like all different kinds of people have written to me to say, I'm better off now for listening to the podcast. And that, to me, at its core, is about delivery of the information. Absolutely, because if I said to any doctor, right now, I want you to explain diabetes to a faceless person, I can't tell you if they're male or female, if they get a period, if they don't, if they're an adult, or a child, or if they're 100 years old, or 50. And you can't give them bad information. But it needs to work for as many of them as possible. I think it would freeze them in their tracks. I find it kind of simple to do. And so it's just I don't know why. I don't know why I'm good at this. I don't know why you're good at the thing you're good at but people should, should pay a little bit of attention to this.

Jennifer Smith, CDE 24:02
Yeah, I think one of the biggest pieces that is not it's not personality based that you you start from and it's very directed to insulin, right. Your your big emphasis is all around understanding insulin. And that insulin understanding can get very precise person to person and variable to variable in lifestyle. But in general, if you have an idea of how insulin works, it doesn't matter whether you're male, female with hormone action, a child a 90 year old, you know, whatever. Insulin is meant to work a certain way and if you start to understand that, then the person becomes important because then the action and the use of insulin can be a Just based on the person, I started

Scott Benner 25:02
this podcast almost a decade ago, based on the idea that if you understood how insulin worked, that was the starting point, like I looked at all of the different things that people are told about their diabetes. And there's so many. And I looked at each one of them. And I thought, is this the core idea? No. Is this the core idea? No. What's the core idea? Like, what do I have to know on day one moment one, and it's how insulin reacts in your body. That's it, you need to have some starting point, so that you can begin to have experiences, and then witness those experiences, hold them up against your knowledge, and decide what happened there. And how do I make it do what I want? How do I bend this thing to my will, instead of sitting here waiting for diabetes to happen to me, I'm going to try to happen to it. And because

Jennifer Smith, CDE 25:54
that's where individualizing your use of insulin comes into the picture. Right?

Scott Benner 26:01
Yeah. And I think what ends up happening in a, I mean, we'll talk about it through the the episodes, but you know, you're diagnosed, there's a lot of fear right away, okay, like and good reason to be good reason to be scared, it's a scary thing. And then terms start flying around, and rules. And this could kill, you don't use too much don't use too little shoot for this range. Like they start saying things like that. It's overwhelming. It's incredibly overwhelming. And your brain picks and chooses what it's going to remember. I think most people's brains work, the way they talk about astronauts making decisions, the only problem in front of them is the next thing that can kill them. And then once they once they get that one, then they go to the next thing that can kill them, because everything in space is trying to kill you. So you don't worry about everything you worry about the next thing coming for you. And I think you can get put into that situation when you're diagnosed with type one, or type two honestly, like like, like, quite honestly, this is where at diagnosis, not saying the wrong thing is almost more important than saying the right thing. Correct. So Jenny, the next thing after being diagnosed is for a lot of people, they end up in the hospital. And for a lot of people, just as many actually sometimes I think more they end up like just being sent home adults are sent home at to me what seems like an alarming rate when they're diagnosed with diabetes very quickly. Yeah. So that's going to be we think, right, that's the next episode. So we're gonna start with diagnosis have a big conversation about being diagnosed. Correct. And then we're gonna talk about hospitals. And that first setting that you're in, because that's the next opportunity for a different group of clinicians to be in contact with you. Correct lot of nursing staff is going to be in contact with you. A lot of roving doctors are going to be in and out. I'm not saying you guys send them in just so you can build. But you know, there's a lot of people coming in and out. And they all have to say something to you, if they want insurance to cover it. So we want them to know what they're saying. There might be nothing more disheartening, when you're dealing with a doctor than when you're sitting there. And you realize they don't know what they're talking about. And they know they don't know, we're just talking at each other. Because boy, does that take the air out of you. Because you don't know what you're doing. You're looking to this person, and they're just glad handing you or just talking around things like oh, they're not saying anything. And

Jennifer Smith, CDE 28:33
sometimes that's a process. I mean, having worked, you know, enough hospital time, it's almost an intermediate step of sorts of not that you've given a diagnosis, it's diagnosis, that is something maybe nobody has ever heard of the heard of it, they don't know anything about it. And it's a you know, 100% brand new as diabetes diagnosis typically is. And I think from the clinical standpoint, that is where they don't just want to leave you with this diagnosis. And even if they don't know enough about it, because they're not specialized in it. There's a sense of not leaving somebody just with that new information. And so there's, you know, I need to stay here and talk but I really don't have anything to talk about because I don't know enough to give you answers to all the questions that you have. So I can they kind of skirt around answering things in a direct way because they don't want to miss inform. I don't think any any clinician really wants to give the wrong information at all. But I do think that that time between really talking to the knowledgeable Viet an educator or nurse practitioner or the endocrine team that's going to come in and really give you the in depth right. There's also a time segment where they may not be in the hospital yet, right? If you take your cell For a child, or a teen or a loved one in at two o'clock in the morning, you're likely not going to see a knowledgeable, true condition, physician or team until the normal hours of the day.

Scott Benner 30:14
But again, I think that's why this will be important, because you could listen through this one time, in a few hours in your car while you're working or whatever, and then actually have something valuable to say, even if you are the one at 2am. You know, like, even if you're the one at 2am, who just says, Listen, this is going to seem very overwhelming at first, and I don't want to lie to you it is, but it's doable. You and your team, you know, your family, you're gonna find your way through this, I guarantee, I'll tell you that nicest thing you can say to a person with diabetes a year from now, it's not going to feel like this. Right? It's just just going to be learning some new stuff. And it's not a test. It's not learning like that. It's just having experiences and learning from them and moving on and applying. It's gonna take a little time, but you'll see it'll be okay. Not don't promise them it'll magically be okay. Like you don't I mean, don't don't don't do the thing. That's been happening for decades. Jenny has no idea what I'm going to say right now. But what does everybody told when they're diagnosed? Oh, that

Jennifer Smith, CDE 31:15
it's going to be cured in seven years? Where did you come up with the magic number of seven to begin with? Right? Five years,

Scott Benner 31:22
seven years? 10 years? It's happening. I read an article in Forbes, he didn't say it. It's almost over like that. Don't do that to people don't do that. Right. Cuz then they don't take care of themselves. Yeah, I think it's almost over. Right. Right. So I mean,

Jennifer Smith, CDE 31:35
you asked, you know that what's the biggest thing that I really want? I want? If I if I had like my full 100% wish, this whole, like Grand Rounds, it would be part of like medical school education? It really would. It would be because I think regardless of what specialty somebody ends up going into, it may very well not be diabetes, because diabetes is it's on the rise. Yeah, you're honest, you are going to touch somebody or be touched by somebody with diabetes, whether it's type one or type two, or maybe even gestational diabetes, you know, whatnot, the more you have than the basic of the one class you took in an hour's worth of your medical schooling, you will find somebody that it's valuable for you to know just a little bit more. So that's my goal.

Scott Benner 32:31
Yeah. Because the better chance you'll have not to frustrate that person and make another person who doesn't believe you are listening to you. You know, don't be the dentist that says you shouldn't use candy to stop a low blood sugar to a woman whose four year old will only take candy when they're when their blood sugar is falling, and she's afraid the kid is gonna die. Like that's not a good time to tell her that Skittles are bad, right? I'm gonna curse for a second. She knows Skittles are bad, Jenny. He's in a situation here. The space capsule is breaking open, and she's trying to stay alive and you're telling her Hey, you probably shouldn't eat Skittles. That's what's wrong. Yeah. Like have Don't be the eye doctor who asks if you've tested your blood sugar today, you have type one diabetes, you have tested at 53 times.

Jennifer Smith, CDE 33:14
You are my one of my favorite questions at the eye doctor is Do you know what your blood sugar is? Nope. Right this?

Scott Benner 33:21
No, no,

Jennifer Smith, CDE 33:21
I was up. I was supposed to check. What No, I

Scott Benner 33:26
never look. It's crazy. It's a certainty that they don't know what the hell they're talking about.

Jennifer Smith, CDE 33:32
It's because it's on a questionnaire. It's part of the checkoff. Yes, you've asked this Yes, you've asked this. And I know Yeah, even listen,

Scott Benner 33:40
if you're a doctor, just for self preservation, you want to billable person to show back up every couple of months, I wouldn't leave them with the idea that you don't understand their diabetes, because they're gonna bolt from you very quickly if you do that. So there, let's break it down to money, if that makes it better. Like you need to understand this. So you can do good for them. But so that you can also be a viable option for other people. And if you don't think people will go online and tell them don't go see this one that's happening constantly. So, you know, that's how these people stay alive by finding each other and making a community and telling them you know, where the good information is, this is good, don't go there. Just get it you could get a reputation as just being somebody who gets that they don't know and is willing to be in a partnership with someone with it correct? Right. There's a lot of ways to think about so. So anyway, that stuff in the hospital. So those are wanting to to me, but I'd still put insulin one except I'm not asking the person the nurse in the hospital to tell you about insulin, but you're gonna get to endocrinology general practitioner Next type two type one depends on what you are, I guess, adult or child, you're gonna end up in that scenario. This is it. This is when you start explaining insulin to them. And we Jenny and I are gonna have a long conversation about how when Some work so that when you're done listening, you can really understand it too. And I know you think you do, but you don't. So I mean, if you have diabetes and you're listening, then you're just giggling along, like,

Jennifer Smith, CDE 35:11
I know you think you know, insulin, you really

Scott Benner 35:14
are not using insulin, you don't understand how it works, and not for nothing. thyroid medication, right? autoimmune issues kind of run together. So I happen to know a lot about thyroid. Most doctors are terrible at prescribing thyroid medication, they're not good at it. They don't know how it works. And I don't just mean, take it in the morning before you eat. I know you think that that's the whole thing. But it's not and you don't know. And maybe it's not your fault, you don't know. But that little decision, not understanding how to medicate someone's thyroid problem causes them problems with how their insulin works long term and how their weight reacts. And if they're heavier, then they need more insulin. And now you already didn't teach them how to use insulin. And now you're putting them in a situation where they know they need more of it. And you don't know that, you know, because you don't have a thyroid problem and diabetes, and it's cool. Like not to know, we'll explain it to you. So we're gonna go all through insulin, not just how it works, but just any brought up all your safety now. Food is next on our list, huh? Okay,

Jennifer Smith, CDE 36:18
can I say

Scott Benner 36:20
please go? Also tell them you got letters behind your name? This makes this even more impressive. What are you that

Jennifer Smith, CDE 36:26
which is the reason? Yes, so I'm a registered dietitian and certified diabetes care and education specialist. And to be quite honest, as a registered dietitian, you go through a lot of schooling specific to human nutrition. I did many years of education in human nutrition, and an internship program and application in clinical needs, etc. By no means should clinical staff that hasn't had the education be giving out nutrition information. You just really I mean, and this goes, as far as you know, years ago, when I started as an educator, so many people brought up well, my doctor told me not to eat white food. What does that mean? So I can't eat apples, because they're white. And so in general, my statement is, I would never try to tell somebody what to do for a brain tumor. I would say I'm not a specialist. Sounds like you got a problem. You need somebody specialized, though. Please don't tell people about nutrition, because I guarantee that the majority of them don't have nutrition degrees.

Scott Benner 37:41
Well, also, if I'm being told about nutrition from somebody who does not personally appear like they understand it, I have a hard time taking you seriously. Yeah,

Jennifer Smith, CDE 37:49
yes, yes, if you're the doctor who smokes and then tells people not to smoke, I guarantee with your

Scott Benner 37:55
yellow fingers, you know what you're doing, that's really hurting you smoking, I heard about it. It's bad. I think Jenny's point is and you know, it's funny when I think of you and where your value lies, for people with diabetes, obviously, being a nutritionist, and a CD is important. But I Brank. Just as importantly, you've had diabetes for over 35 years. So that's a long time and a lot of lessons. And then you, you couple in that education on top of those lessons, then you couple in the experiences you're having talking to people every day, on top of those lessons. Jenny knows what she's talking about. She's not here by mistake. And I

Jennifer Smith, CDE 38:31
I also think within the topic of food, I do think that it's under discussed in the right way. So and I find this both for kiddos, and like all ages, let's just say, you know, the whole idea around food, as you said before, you know, something nice to say is that a year from now, this will look different. And it will be it will be better than it feels right now. Right? Something around food that often gets said is that you really don't have to change anything at all about what you're doing. And I think as an in a nice way. The clinician is trying to just say, hey, it's it's not that bad, right. But in general, there is a lot to understand about food there is and it's not just as cut and dry as take your insulin and eat your food. And the other consideration there is each person again, going on the individual, very personalized basis. Each person needs to know how much they should have. It's not just a well gosh, if you just take your insulin and your time at the right way you can eat whatever you want to eat. And I think that that's that's a widespread problem. Whether you have diabetes or not is just the intake of food is not managed well because we don't understand what our real needs are.

Scott Benner 39:57
Understand food most Have it's processed, yeah, they don't have access to good food to begin with. All these are different problems. And then you just say to them, nothing has to change if you're trying to be kind. It's the same kindness, by the way, that's meant by Oh, I heard there's going to be a cure. It's the same. They're trying to alleviate your your sorrow, I get that. Don't worry, nothing's gonna have to change. Well, yeah, that's true. Unless you unless you eat like, horribly, and you know, like, and then you send them home, go, don't worry, it's gonna be fine. Then they get up in the morning and have a bowl of Captain Crunch and their blood sugar's 350. And you didn't teach them how to use enzyme anyway, by the way, I get both bucket bowls for Captain Crunch. But that's not the point. Like the point is, it's going to impact them hard. And then they roll into lunch, and it's frozen pizza. And then they roll into dinner. And it's processed chicken nuggets, and a friend and oil and all this stuff. They don't know they think they're eating well, right. I promise you. I've talked to a lot of people. I think the majority of people who are eating poorly don't know they are. Right. I honestly believe that. I don't think it's I don't think it's apathy. I don't think it's ignorance. I think they just don't know. And now you're telling them Don't worry about it's not a problem. You don't know what they're eating? How could you possibly say that? Right, right. So yeah, and how does food impact insulin? How does insulin impact food? We're going to talk all about that. Because if you don't understand that, I don't know how you're possibly directing people I am going to share with you that online the other day in the in the private Facebook group, I watched somebody tell a story, where they were in a doctor's office and said to the doctor, look, you're giving me this information. But the truth is, is that 10 grams of this food and 10 grams of that food impact my kid completely differently. Right? And they said the doctor looked at them crazy, like just sideways. And and he's like what he does? Well, there's there's obviously a personal as to the podcast, we're like, well, the glycemic impact of this food is not the same as that, right, and the loads different with this one because it's more complex. And therefore one of these needs a different amount of insulin, actually, it also needs kind of an extended Bolus, and all that and this other ones are simpler. And they're having this conversation and the doctor stopped them and said, This burned in my head when I watched when I read it, you are completely wrong about that. A carb is a carb is a carb. That's what they were told. So now this lady was, you know, educated enough that she could fight back. And by the way, she didn't fight back. You want to know what she did to look for another doctor? Yeah. So but there she was in a room that how many people? Is he saying that to? Correct, right? Yes. And that's not right. And if you heard that just now and thought, oh, wait, a card is not a card is the card for a person with diabetes, you might want to start wondering what else you don't know? Because that's a pretty basic one. And it's huge.

Jennifer Smith, CDE 42:53
Right? Right. Absolutely. Okay. And I think in today's in today's technology use that has become much more visible years and years ago, not so much, right. But in today's world, which we've had technology long enough, now, it's very visible that you can, you know, know the difference between food versus food, even though they technically fall within the same macro.

Scott Benner 43:21
And that's why the next piece of this is going to be glucose monitors, continuous glucose monitors and blood glucose monitors. Yes, because again, it's they're more than I think they're more than what most people think when they prescribe them, and the value that they have, and how you can interpret that value. And the information is huge. So that's going to be the next step. Then we're going to talk about insulin pumping. And I'm probably going to rail against all of you who think that you have to have diabetes for a prescribed amount of time before you get an insulin pump. And we're gonna talk about how they work and how you can support people with them. Then the next piece that Jenny keeps bringing up over and over again, when she and I talked about this, before we got together today is just the mentality and the humanity behind everything. You know, and how important it is to, you know, like we said earlier to treat people, not like a patient and not like a customer, but not

Jennifer Smith, CDE 44:15
like a checklist of things that you have to get through because they're necessary to ask about, while they may be important, you have to remember the person coming in is it's got a life, full of a lot of things beyond just the diabetes, which may very well be part of the part of the communication or the conversation that you have if you take the time to listen. Right.

Scott Benner 44:42
And that takes us to the next part, which is communication. We're going to talk a lot about how we have found the talking part of it to be so important. And the tactics I hate to say that word but the tactics that that Jenny and I both use it In what we do separately and together, when we're talking to people together, we're doing it now, by the way, you don't realize it, if Jenny and I were talking about this privately, it wouldn't exactly sound like this. We're delivering this in a way that we think that would interest doctors without making the mad. So they'll keep listening in a way that will let patients hear it. So they know what to go like advocate for. But without making them mad at the doctors, right, like, right, that's what you're hearing for the last 45 minutes is being given to you purposefully. And there's a way to do that. By the way, both ways, doctor to patient, patient to doctor, because, you know, if you just walk in there as the patient, and you're a big pain in the ass, the doctor still a person, and they're going to put up a wall, you know? Namie, right? Absolutely. You're gonna be like, Oh, this one is how they're gonna think when you come in. Right? Yeah, that's not how you want to get your your doctor in get any mean, you want them to be excited to see you. And, you know, and there's responsibility on both sides for that, then we have management Jenny, and I have to scroll down a little bit. To be perfectly honest with you. To see what that is a long list. We put this together a couple of weeks ago. Okay. So this is going to be kind of a big, a big kind of overview about education, you know, kind of don't just teach a man to fish. You know, right, you know, teach them how to fish kind of a situation more about ratios, like real kind of more nuts and bolts stuff that I think that isn't that difficult if you're a physician that you could understand. Right? And then Jenny added pregnancy at the end, because it's one of the things that she does, and she can be really valuable. And that I will probably not say as much during that episode, but we'll talk about that. And then I don't know, Jenny, do we? Do we like adding school nurses to

Jennifer Smith, CDE 46:51
this? I like adding school nurses? Absolutely. All right.

Scott Benner 46:54
I'm gonna tell you why. Now, just briefly, and then I'll remember when we make the episode to tell you the whole story, but I'm going to tell you in the nursing, the school nurse part, the story that a guy named Joe literally just called me last night and told me about, and just remind me when we get to that episode to tell you Joe's story about school. Okay. Okay, thank you. I really appreciate this. I'm super excited. Yes, that you're willing to do this with me. And and I can't. I'm excited. It was a great idea. Well, so that's my idea. But thank you. It was everybody's idea. I'll tell you what, being serious. It was a thought I had just out of nowhere, I think I was in the shower. And I was like, What are Jenny and I going to do next? And it popped into my head. But it's only an idea that popped in my head because of the countless hours of conversations I've had with you. And on this podcast and hearing back from people, all of that stuff together. Like it's not some stroke of brilliance? You know what I mean?

Jennifer Smith, CDE 47:52
No. And I think that at one point, I said to you, I wish, I don't know, maybe it was after a particularly frustrating conversation with somebody who was really just, they were frustrated with their, their clinician, and what they were not necessarily getting, or what they had gotten and forced them to kind of change physicians. But I think I had said to you, I was like, I wish that we could just like package the prototypes and send it out to all clinicians that are out there. I wish we could just do this so that they could understand it from this

Scott Benner 48:26
level. Right? So we have this series called diabetes pro tip. And it's this 26 part series that I mean, if you're you know, if doctors are listening right now, I can tell you that most people report back in a one seeing the low sixes the high fives just from listening to these these podcast episodes. It's with Jenny and I. And she's just like, why can't we just like, like, how do you do that? And I kept thinking, I'm like, I don't wouldn't begin to put them on thumb drives and mail them to doctors offices, like, like, yeah, that's not going to work. And, you know, and, you know, how do you talk somebody into getting information that they don't know they need? So my thought was, there are plenty of doctors that listen to this podcast that are that like the podcast. So maybe we'll put this series together and maybe they'll start sharing it amongst colleagues. This is kind of how we were hoping so anyway, I appreciate it very much. Hope you have a good weekend. You

Unknown Speaker 49:18
as well. Thanks. Thanks.

Scott Benner 49:28
I want to thank you all for listening. And I want to thank you us med for sponsoring the episode us med.com/juice box or call 888-721-1514 To get your free benefits check and to get started today, getting your diabetes supplies the same way we do from us but I want to thank Jenny and remind you that she works at integrated diabetes.com If you'd like to hire her and I'd also like to let you know that this series starts off properly in the first week of January 2024. If you're not subscribed or following the podcast right now on Apple podcast, Spotify or another audio app, do that right now, to get the very first episode of the Grand Rounds series, this series will run for my gosh, I think it's going to probably be 910 10 or so weeks. Once a week, you'll get a grand rounds episode. But there's going to be more than that in the first quarter, maybe the first half of the season of the Juicebox Podcast, which by the way, 2024 will be the 10th season of the Juicebox Podcast and thank you very much for being a longtime listeners and supporting the entire show. But we're not just going to get grand rounds, we're also going to get something called cold wind. That's a healthcare whistleblower series. Wait till you hear the whistleblower episodes. These are professionals working in healthcare, from emergency room nurses to human resources, professionals, doctors, everybody in between. They're going to be on the show, anonymously, with their voices electronically changed so that they can feel free to talk about the business they work in. I don't want to give it away, but you're going to be well, it's going to be chilling. So cold wind, healthcare whistleblowers coming in January to the Juicebox Podcast. In the meantime, you're invited to join the private Facebook group for the Juicebox Podcast. That's if you're a physician, other health care provider or someone living with type one. It's called Juicebox. Podcast type one diabetes, it's a private group. It has over 44,000 members in it, it gets over 100 posts a day of people living with diabetes. If you're a physician, if you're a nurse practitioner, or if you're just somebody helping someone with diabetes, you've heard this and you think, maybe I don't really understand this enough. Just being in that group. You don't even have to participate. But just being there will help you learn more than you can imagine. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.

#1079 Parenting: Inconsistent Discipline and Over-Involved Parenting

Scott and Erika talk about avoiding unintended consequences of inconsistent discipline and over-involved parenting.

+ Click for EPISODE TRANSCRIPT

Scott Benner 0:00
Hello friends and welcome to episode 1079 of the Juicebox Podcast.

Erica Forsythe is back today of course you can find Erica Erica forsythe.com. She's back today with another episode in our parenting series. Today's topic is avoiding unintended consequences of inconsistent discipline and over involved parenting. That's a really long title. I'll shorten that for the app. While you're listening. Please remember that nothing you hear in the Juicebox Podcast should be considered advice, medical or otherwise, always consult a physician before making any changes to your health care plan. If you'd like to save 40% off of your comfortable clothing, towels and sheets, do that at cozy earth.com. With the offer code juice box at checkout, you can save 10% off your first month of therapy at betterhelp.com/juicebox. You can check out the private Facebook group Juicebox Podcast, type one diabetes, and of course, help us out. Apple podcast changed their app it's messing everything up. You may not be getting your downloads. If you're using the Apple podcast app and you have iOS 17. Please go to your settings to automatic downloads and make sure all new episodes is chosen

this episode of The Juicebox Podcast is sponsored by us med. US med is where Arden gets her diabetes supplies from you could as well us med.com/juice box or call 888-721-1514 They've got tandem, Omni pod Dexcom libre, and so much more. Hey, Erica, welcome back.

Erika Forsyth, MFT, LMFT 1:54
Thank you. It's good to be here.

Scott Benner 1:55
We're going to look today at avoiding unintended consequences of inconsistent discipline. And over involved parenting. Yes, right.

Erika Forsyth, MFT, LMFT 2:05
Yes, that's right.

Scott Benner 2:07
That's a t shirt.

Erika Forsyth, MFT, LMFT 2:08
Yeah. It's a lot. It's a lot we're gonna try and cover today.

Scott Benner 2:13
Well, I appreciate it. I mean, this is Gosh, I don't think I've lost track of how far we are into the, to the episodes now. But it's starting to build into this really lovely companion piece for the podcast about parenting. And I think we're gonna mention here at the beginning. While it's our intention for this to help you with diabetes, not everything we always talk about is specific to diabetes. This is a kind of a more holistic view of parenting in general. Yes, yeah. Yes. So avoiding unintended consequences of inconsistent discipline. Well, I think we all must be guilty of inconsistent discipline, right.

Erika Forsyth, MFT, LMFT 2:51
I guess I think we go out as parents hoping and striving to be consistent in our parenting styles in our in our discipline, but we can't always be perfect. We can't always be consistent. And I think it might be helpful to talk about how, how does this happen? How do we find ourselves disciplining our children with their rules or their behaviors inconsistently? And so we will just jump right in?

Scott Benner 3:19
Yeah. Is it because it's fun to listen to little kids curse? And how are you gonna yell at them? When they say something? When they're like, oh, Has it ever happened to you, as your little kid like, stubbed their toe? And then they've just said something like, completely out of pocket? Just crazy.

Erika Forsyth, MFT, LMFT 3:38
I know, because I never curse and I'm perfect. Okay, yeah, no, no. Yes, that is that has happened in my household timer to yes,

Scott Benner 3:47
some of my favorite, like, tick tock videos, or have little kids just, you know, there's this one of this little boy, he's gotta be like, two or three years old in a diaper. And he's leaving the room and the moms like, where are you going? He goes, I have to take a shower. He just rolls out the door. And I think how you gonna yell at the kid for that? That's good. But you know, on a more serious note, that consistency, I'm imagining you're going to tell me is incredibly important. Because if it doesn't feel like the thing is really going to happen, then what's the reason to ever act like it's going to I guess it's probably how it looks from a kid's perspective. But tell me a little bit about how this happens.

Erika Forsyth, MFT, LMFT 4:33
Yes, so I think the first thing for it from a child's perspective if they are confused what the rules are, right? So they might not know that you have certain expectations, or you might think you've told them once and they should know. So they they are not sure what the what the rules are. And then if they are sure what the rules are, then maybe they're reinforced in consistently at different times, I think for, for example, you have to finish your vegetables in order to get your dessert. If that's a family dinner, household rule, then they understand that that's a very clear rule. But if some days you're like, oh, you know, it's okay. Yeah, I'm feeling lenient. Today, I'm in a good mood, or you want to move on to the next thing. Okay, you ate three out of your five pieces of broccoli. Here's your here's your ice cream, which again, in the moment, we all have probably done this. It's okay, what we're talking about, like, Does this happen consistently? Are you inconsistently? Are you consistently inconsistent?

Scott Benner 5:40
Are you consistently inconsistent? Once it's not a big deal, but if the kid knows, three times a week, all they've got to do is mention the ice cream ahead of time and you buckle then suddenly, there's I guess, it's it's some sort of a power struggle. You just don't even realize it. And then they're winning. And all of a sudden,

Erika Forsyth, MFT, LMFT 5:59
oh, yeah, yes. Yes. What? Yeah, we'll get into that that power struggle, for sure. Okay. Perhaps sorry. No,

Scott Benner 6:06
no, please.

Erika Forsyth, MFT, LMFT 6:08
So also, maybe your rules might be different in different environments. For example, you're out at a restaurant versus home, or you're at a friend's house or a party. And I think, to a certain extent, we might have certain expectations or rules, publicly or privately. And that's totally fine and normal, but I think it's also helpful for to make sure our children know that too.

Scott Benner 6:30
Yeah. Okay. So, if I'm like, Alright, I don't care today, I'm gonna, I'm gonna go using the ice cream idea. Do I say that to them? Hey, look, usually, we need to eat all the broccoli to get the ice cream. Tonight's a special circumstance, does that actually help if you let them know that this is not me slipping up and misunderstanding the rules, but I am making an exception. And these exceptions aren't always going to happen. Is that actually beneficial?

Erika Forsyth, MFT, LMFT 6:55
Absolutely. I think clearly communicating, you know what's happening. And you're gonna let them know, it's all about the expectation that then they can say, Okay, that one time, we got to do such and such, and the role was different today, because they explained why

Scott Benner 7:12
does this also, I'm imagining work backwards, where you can't promise something, and then it not happen. Because I'm just going to come out and say this, my wife talks about this a lot growing up, her parents will never listen to this, where they'd get told, behave today. And we'll go do this for dinner. And then when dinnertime rolled around, they didn't do it. My wife says that it taught her that her parents couldn't be trusted. Because I mean, and I'm assuming if you go back in time and find her parents, they would have said, we had four little kids. It was a summer day, they were out of their freakin mind. I promised to take them to McDonald's, and then it didn't work out. Like I just, you know, it didn't work out. And I couldn't take them. They would never, I would imagine if they heard this right now, they'd be like, that was not what we were doing. But it is what happened. And so so that is this just slightly, like thinking about it slightly differently. You can't promise something and take it away. You can't tell them something's gonna happen and then have it not happen. It's the same thing, right? Yes

Erika Forsyth, MFT, LMFT 8:19
or no? This this happens in my household. In fact, it just happened recently where we said okay, tonight's gonna be Movie Night. And then we we did not move or nor did my children move quickly enough through all the things I wanted them to do and needed them to do to get to Movie Night. So then we couldn't do it. It was too late. So they said we are you know, you're promised it was movie night by said okay, well, we didn't do all these things we needed to do in time. But I didn't. I didn't previously communicate that to them.

Scott Benner 8:48
That wasn't part of the rules. It wasn't the movie. If you little bastards don't take two hours pick.

Erika Forsyth, MFT, LMFT 8:56
There's a lot of hoops to jump through to get to Movie Night. But I needed to communicate that to them because then they're disappointed. This

Scott Benner 9:03
is making me think of this very little. Like, I always think of this as a little thing, but maybe it won't end up being in the future. We have a lot of board games in our house, but we do not play board games. And I think it bothers Arden. Like, I think that when she was younger, she wanted to sit down and play more board games together and we didn't do it. And I think that even just having them in the house the promise of it being a thing we did, but it never became a thing we did. I actually think that bothers her. I mean, I don't think it bothers her to like Jack Ruby in a bell tower level. But like I think it I think it does bother her Do you think anybody knows Jack Ruby shut can now right? It doesn't matter. But But yeah, I don't think it's gonna make her like twist off but I do wonder how much of like, how much of a small adjustment to who she is is because of that like that small almost imperceivable let down. You know, so, okay, so Be consistent and be communicative enough so that they understand what are their goals like, what is it they're shooting for? So that they know if they didn't get to it? It's because we didn't do those things, then all of a sudden, that thing not happening is a teaching moment and not a letdown. Right? Because they Yes. Okay. All right. I see.

Erika Forsyth, MFT, LMFT 10:20
And she might. So I was gonna say put the board game though, I think it's one thing as having those physical visual reminders of something, maybe she had this expectation that you did, could be painful. But also, did you say was that your rule? Was that your expectation? And did you guys talk about that, right? Today? No, we're going down a different path. But like, did you talk about, hey, we're a family who plays board games, and every Friday night, we're gonna play a board game, then you did it? Or was it just something that was kind of existing?

Scott Benner 10:50
was the intention, I think my wife wanted to be a family that played board games, but we were working in our nest diabetes, and a lot of kids played sports and time, you know what I mean? I'm bringing it up, because I think it illustrates how easily your intention can get discombobulated. And then how a child can see it in a way that you maybe would have never imagined. Because the first time she said that as an older kid, and she's like, Hey, we never played board games. And I wanted to and I was like, all like, it broke my heart. I was like, Oh, we screwed up. I knew we screwed them up. I just didn't know how, even as you and I are talking, I was like, Where the hell was Erica? 20 years ago, I should have had this conversation with her then. Because like, even just this part that we've just glossed over so far, is so obvious when you hear it out loud, and yet hard to make happen, but wouldn't have been difficult to stop it from being a problem. If I just would have used a couple more words. It's interesting. Yes, yes. Okay. All right. Well, keep going. I'm sorry. Okay, so

Erika Forsyth, MFT, LMFT 11:56
when are we so when a rules we've talked about if they're in inconsistent, different times different environments, or with different siblings, you know, if you have more than one child, they can pick up very easily if when a child gets a little bit more flexibility, because they're older or younger, and sibling order, or whatever, whatever the reason. So that is a that is a big deal. And they will use that, you know, and will reflect that back. They are very keen and are very aware of, you know, being treated equally as siblings. Yeah. Between parents. Sorry, go ahead. No,

Scott Benner 12:29
I actually was gonna say something that I don't know if I'm going to share now, like, as I as I heard, my brain said, I was like, that's probably too much. Now, I'm gonna say it anyway, my wife and her sisters refer to their older brother as Jesus Christ, because that's how they feel like he was treated when they were growing up. They joke about it, but they're not joking. Anyway, I think that's it. Right? That's what you're talking about with the Scible? Yes. Okay. Yeah.

Erika Forsyth, MFT, LMFT 12:51
And I know that this is that's a particularly challenging one. Again, I know we already you already said at the beginning of episode, you know, where this is general parenting rules. But I know this, that's a really difficult one, when one child has type one, and the other one doesn't. So I just wanted to validate and pause there. I know, that's a really, really difficult thing to navigate that I sure

Scott Benner 13:13
because it's, it's a medical thing, and you need to do it. But other children could look at it as Oh, sure. When it's for them, we have time when it's for me, there's no time. And they're not going to do the reasonable thing, which is say, Well, yeah, we stopped and helped her because she was dying. And you wanted to play a board game and we couldn't get to it. Those are not the same things. But they feel like the same thing. If you're the out of the circle kid in that Yes. Okay. Yes.

Erika Forsyth, MFT, LMFT 13:39
And those those all, you know, the awareness piece is the best thing to bring into those situations and having those dialogues you know, with your children, between parents, right, maybe one parent is feeling, as you said, kind of more lenient one day and will reinforce the rule, and the other parent won't. That happens, it's very common. And then maybe parents, you're in a different mood, like we've already said, you're in a urine exhausted, tired mood, and you're going to be you're going to consistently reinforce it or not because of that, or maybe you're in a really good mood, man, you're you're feeling maybe stronger, emotionally to reinforce or not. Can

Scott Benner 14:16
I ask a question? Do you think that this is most more specific to a certain age range? Like is there a moment when I get to the point where I can make the distinction and I don't hold it against somebody or something, or know everybody who has diabetes has diabetes supplies, but not everybody gets them from us med the way we do us med.com forward slash juicebox, or call 888721151 for us med is the number one distributor for FreeStyle Libre systems nationwide. They are the number one specialty distributor for Omni pod dash, the number one fastest growing tandem distributor nationwide, and they always provide 90 days worth of supplies and fast and free shipping. That's right us med carries everything from insulin pumps to diabetes testing supplies right up to your latest CGM, like the FreeStyle Libre two, n three, and the Dexcom, G six and seven. They even have Omni pod dash and Omni pod five, they have an A plus rating with the Better Business Bureau. And you can reach them at 888-721-1514. Or by going to my link us med.com forward slash juice box. When you contact them, you get your free benefits check. And then if they take your insurance, you're often going and US med takes over 800 private insurers and Medicare nationwide. better service and better care is what US med wants to provide for you. Us med.com forward slash juicebox get your diabetes supplies the same way Arden does from us med links in the show notes links at juicebox podcast.com. To us Med and all the sponsors, when you use my links, you're supporting the show,

Erika Forsyth, MFT, LMFT 16:05
even as from the child's perspective, or

Scott Benner 16:07
if I'm 35. My mom's still treating my brother better Am I still like see, like you know the mean? Yes,

Erika Forsyth, MFT, LMFT 16:13
I think as you mature, and you also understand the other one, there's their sibling order, there's different relationships between different parents. And maybe Maybe Dad gets along better with with son and mom gets better with daughter or vice versa or whoever whoever it is, I think there can be an understanding and maturity as you grow up. And then you can choose to work through it or not right, you can either understand those dynamics existed for a particular reason, and heal from those. So is there a point at which you understand it? Yes, hopefully. Yeah. If you're if you're healthy enough. And if you're if you're open to it, yeah. Oh, in

Scott Benner 16:53
West, maybe you just want to be mad about it. And it's an easy thing to go off on a good Thanksgiving. Yeah, I got that might be fun. Even if that happens. It's not so long. Why America, you gotta stay busy. Parents escalate when children don't follow rules? Yes. So we've kind of covered that you need to be consistent, that when the rules are flexible, what I guess let's go back to that first step, right? When the rules are flexible, what can happen, if we are

Erika Forsyth, MFT, LMFT 17:23
inconsistent in the discipline or inconsistent in reinforcing those rules, children's children will learn that, okay. There's flexibility here, which sometimes there's a benefit to having some flexibility in your household. But if they realize, okay, there's no consistency here, I can do one thing one day and get away with it. And the next day, it's fine, or it's not fine, then they're they're going to increase their behavior. And you might have some more challenges. And then they're going to test your boundaries, test the rules, test the boundaries.

Scott Benner 17:56
I'll roll the dice and see how this goes. And eventually, you'll weaken and it'll go my way more and more. Yeah, I have to ask you a question. Do you have any knowledge of how the prison systems work? Because I have a feeling like the same conversations happen within like the penal system, like be your enemy, like the testing of, of lines, what happens if you push the line, if you push the line, it never goes back again. Like, that's why you have to hold the line. If you hold the line too tightly, then there's a rebellion. This all seems very similar to me. Well,

Erika Forsyth, MFT, LMFT 18:27
I don't know if I could speak to the prison environment, but I could speak to as a former teacher, that it's really important to have those really strict boundaries, particularly in the beginning, they used to joke and when I was training to become a teacher a long time ago that, you know, don't don't smile till Christmas, or don't smile, don't winter break, like just be really consistent with your classroom management roles. So they understand. So I mean, maybe that is also applied in the prison.

Scott Benner 18:55
In fairness to me, I just got done watching the first two seasons of Mayor of Kingstown. So it's all fresh in my head. If you haven't heard, it's on experimental philosophy, you should check it out. Also, the last week of my life has been my wife making fun of the way I'm saying mayor, she's like, you're saying ma R E? And I'm like, mare and she goes, No. And I'm like, may or and she goes, No. And I'm like, and then that's how our evenings go. Her just mocking me because I can't say ma y o or correctly, Mayor. Well, apparently, but I can't do it. Mayor, did I get it that time? That sounds good. Okay. Well, tell her cuz she's, I mean to my I've gotten some real like, looks that I imagined she got as a child when she let her parents down. She's like, you're so she said it was disgusting the way I said. No, we were having fun. Okay, okay. But it wasn't a mean thing. Although if it sounds mean to you, that was just I was being playful. Anyway. Okay,

Erika Forsyth, MFT, LMFT 19:59
okay. So So okay, so now that children are there, they're testing the boundaries. And then consequently, then you as the parent, you know, we will escalate, right? So then as you were already predicting, we get into this power struggle, so we might be really strong in the punishment or discipline, or the kid wins. And so in those quick moments, we're gonna say, okay, you know, go to your room, you're grounded for the night, or however you whatever language you're using, or timeout. And while I'm not saying that timeouts are being grounded, those are bad. But in those moments where everything is escalated, and you're ratcheting up, and then you're throwing out maybe a discipline that isn't necessarily consistent with the rule, and then they they're escalating their behavior. So then you have these really quick, or you want to avoid it, you want to avoid the conflict. And so that then continues and perpetuates this maladaptive maladaptive behavior. So the child learns, I'm gonna push the boundary, and then I'm either gonna get punished for what, in a way that doesn't seem appropriate. Or the parent is so exhausted. And I know I've been there and you say, okay, just fine. Just yeah, just go do the thing. You know. So then you've created this cycle. And long term, what what we're what we've talked a lot about is that parent child relationship, and you're missing out on that those moments to teach, connect, communicate, validate the pain and that moment, because everyone's so exhausted. Yeah. Does that mean I hope I explained that it takes a cycle that we all can experience, it's hard to break it down step by step. But yeah, and

Scott Benner 21:47
the idea of like you ratcheting it up to a point, that's even unreasonable, like you say something, you say something that you couldn't even make happen if you wanted to, you know, like, You're not leaving your room for two months, like out why that's not gonna happen, that's obviously not going to happen. And then now you're, you have to give it back at some point. And then like it or not in a in a power dynamic, you've lost. And yes, and they've gained higher ground, and now you're working backwards, and you're not going to catch back up again. And then the person then their prisons being run by the inmates. Say, I told you, by the way, it's a terrific show. Really, I might not be able to say it, but I, I can't wait for season three.

Erika Forsyth, MFT, LMFT 22:28
Okay, so Okay, as we've mentioned, yes, we are, we get we often we can find ourselves in this moment. But we're, we want to strive, we're all striving to be consistent. I know that as parents, but as we said, we're tired, we're exhausted, maybe we're distracted with what happened in our day at work, or with our partners. Or this can happen too, I'm definitely guilty of this of like, Oh, I'm gonna let them have the thing or do the thing. Because I'm feeling I'm going to be kind and be lenient here in this moment, thinking that, like, that's gonna help improve the relationship. But again, what we're going back to is, we're then being inconsistent with the rules, and we're starting that cycle all over again. Yeah,

Scott Benner 23:08
I think sometimes the problem can be when you're young, and you have kids, you make rules that are like, not necessary. You don't recognize it when you're laying them down. But but you know, you have this feeling of, like, I don't want things to go the way they went in my house when I was growing up. So I'm gonna make all these rules, then later, you look back, I didn't need half of these rules. Like, it's like, Baby baby stuff. Like when you get a baby, and you buy all this stuff. And then you don't realize for about a year later, like, I didn't need half of this, but I did not eat half of this, then the next kid comes. And it's like five onesies in a box of Pampers. And you're like, we're ready. You know, like, and you realize what's really important. But in this situation, it's too late. Because now you've laid out all these crazy rules. How do you do that? If you've if you've made a rule that you don't need? How do you get rid of it without giving up the power? And without putting the kid in a position of thinking, Oh, I got one over on the old lady. How do you do that?

Erika Forsyth, MFT, LMFT 24:04
You can go back and this can happen. I think with any age, a two year old or a 16 year old to go back and have that conversation, not in the moment when everyone's heightened and upset. But the next day to say, You know what, I'm the parent, as the parent, I've made some rules that I think are really healthy and appropriate. I've also made some rules that I thought were important that maybe aren't important anymore. So here's what I'm thinking we're going to take away this role. And, you know, continuing for the reason why. And explaining I think that's why oftentimes we get pushed back is that our children need to understand why we have the rules, why we have the certain consequences to those roles, and then what to say and when we take them away, we can explain. Okay, I think it's totally fair strategy, and effective to because then they're they're there then you're telling the child Hey, I'm seeing you I'm understanding that this This thing isn't needed anymore. And you're really showing them that you're like in tune with their needs also building that trust. Okay?

Scott Benner 25:07
That makes sense to me. I was just because it's happened. I've said something where we've been doing something for a certain amount of time. I'm like, I don't think we need this anymore. So, you know, but I don't, I can't imagine just enforcing a thing. Because at this point, it's because I said, so. You know, and you don't even worry, we're worse. And to relate it back to diabetes, I think about this all the time when people are their doctors, and they're telling you to do something, and you ask them why? And they don't know the answer. I find that that's one of the most frustrating things about human communication to me that and I don't like the idea of wasted time. Wasted time really bothers me like at a core level. And if someone wastes my time, it's upsetting. Like, I'm, I'm upset by that, and this thing, where, because I think it's also a waste of time to especially when it comes to management. If you tell somebody somebody says you can't have a pump for six months, or you know, you can't do this, or we have to wait this long for that in your and you're over there struggling, and then use one day ask why and they don't have a reason. It's maddening. And it does make you feel like maybe that doctors just the parent who didn't know how to say, hey, we don't really need this role anymore. But and they just keep doing it because it's the thing they do. Or they

Erika Forsyth, MFT, LMFT 26:23
might feel like they didn't have the luxury of like time to even think about it, reflect it and have the conversation, you know that that's, it could be a possible option. And by

Scott Benner 26:33
the way, when you point it out to a doctor who realizes it, but won't back off it because they don't want to give up their power, this is an exact match to what could happen to you as a parent, like if if the if a kid comes to you and says, Hey, we're doing this thing, I don't see why we're doing it, do you. If you don't see, that's where you have to have that conversation and give it up. Because if not, now you're going to be defending, you know, an empty castle, and they're gonna know you're doing it, and it's, you're gonna look like a, you're gonna look like a hypocrite. And like you don't know what you're talking about. And trust me, your kids are going to figure out you don't know what you're talking about eventually. But you don't want to happen too fast, or, or becomes unruly. At this point. I'm 52. I know I'm a little young for how old my kids are. That maybe not a lot, but a little bit, I have a 23 year old and a 19 year old. And it's just true. They're smarter than I am. They're smarter than Kelly, they, they've already figured out who we are, I think they see when we're full of crap. They know when we don't know what we're talking about. They know when to listen to us. And they're right 80% of the time. But the problem becomes the other 20% of the time when they think they know what's best, but they still just haven't had the life experience to fill in the gaps. And then they're kind of half cocked going off and like I don't have to do that thing. He's wrong about that. I've gone through all the information in my head, and I can't find a reason why that's right. And when you try to tell them, Look, I just have more experienced than you trust me, this is where this is headed. It's it's a hard thing to sell as a parent to, you know, I don't know what my point was, but it felt important to share. So there we go. Go ahead. I'm sorry. Move on, please. Thank you.

Erika Forsyth, MFT, LMFT 28:13
Okay, so talking about having inconsistent discipline can be you know, there are obviously consequences to that, that we just talked about. And we'll get into some more on on the the other side of that of having excessive praise, which isn't necessarily something I'm highly concerned about, I think in the greater scheme of things. I think when you talk and look up research, from psychologists, therapists, you don't have a lot of kids coming into their office saying, my mom and dad, or my parents just praise me too much. You know, it's usually, you know, either feeling the, over the criticism or the pressure, right. So I don't think we need to spend too much time on this. But I know this is something that has come up in previous discussions is what you know, to praise your child, obviously, is a really positive thing. And there's a whole, you know, positive parenting. And there's a whole kind of camp of just, you know, praise your child catch them being good. And that's how you kind of reinforced the behavior that you want to see more often, particularly you see it in a classroom, and at home, I think that's really a positive, no, sorry, no, pun intended way to parent. But I think we want to be really mindful, in that we're not offering empty praise. And we're not always just saying, you know, good job, good job, good job, or while you're really you're a really good dancer, or you're a really good artist, even though we do want to highlight our child's strengths. They're what I would just wanted to encourage and talk about briefly is to spend more time praising their efforts. And for those of you who have spent some time in This topic already, maybe you've already heard and read about the growth mindset versus fixed mindset. Have you heard that? Have you talked about that? Okay, so growth growth mindset versus fixed mindset was developed in the oh my goodness, placeless language, I think in the late 1990s. And there are schools who are teaching this type of mindset. And so basically, if you're, if your child is coming home saying, Gosh, I'm just, I'm so bad at math, I'm never going to be able to figure out how to do addition, or in the sporting, you know, realm, I'm, I'm a terrible baseball player to have when your child has a fixed mindset, they believe that they don't have any opportunity to learn and adapt. Whereas the growth mindset is okay, I don't know how to do that yet. One of the best things I like to teach my children and my and my clients as well as when I hear them say, I'm terrible at this, I'm bad at this, that all that negative self talk, to say, Well, I haven't learned how to do this yet, throw in the white et at the end. And that is reinforcing this growth mindset. And in that kind of in the larger umbrella of praise, when you're noticing your child working hard at something they have for I mean, the diabetes example, they haven't quite figured out how to how to Pre-Bolus at the right time to say, Gosh, I'm really noticing you're working hard. And you've tried here, and I noticed that your your effort is there, and you'll get it. And or I'll get it if you're still talking to talking to yourself, I just haven't figured it out quite yet. Because that's where we get stuck. And that negative self talk.

Scott Benner 31:40
Yeah, I think the thing you said earlier that really lit me up was saying like, it would be difficult to ruin a child by over praising them. But it's, I think, a thing people most concern themselves with, probably, somewhat unnecessarily and it leads to the under praising, and the under, like, sharing of love. I think that honestly, like I don't want them to just think being here is enough. Right? And so you hold that back. And then I mean, come on everybody you bump into a self esteem trouble. You can be nicer. It doesn't have to be it doesn't have to always be like the tough love angle. Like I'm gonna put them in the position where they'll end up right. You know, I don't know if that makes sense or not, but that it is the thing you hear people talk about all the time. Oh, it's gonna make them soft, right? It's gonna like, you know, Bob, like telling your kids you love them. It's not going to make them soft. Gonna make them feel loved?

Erika Forsyth, MFT, LMFT 32:34
Yeah, I mean, I think it's, it's going back to the balance, right? Like, if we're praising our child for every single thing that they do, or they're like, they're just being kids. They're doing great. They're, you know, but they're not following your rules or expectations or showing responsibility or, you know, it's all about, yes, we want to praise our children and notice them when they excel when they are challenged, when they are sad when they are happy when they win when they losing all the things. But it's like you're trying to find that balance.

Scott Benner 33:02
So when Cole was very little, I remember being in a baseball practice once and it was a another boy in the outfield. They were teaching them how to catch like fly balls, which is not a thing you think about but when they first start playing, they can't really hit the ball, but they are by far so nobody knows how to catch a fly ball. The outfielders are just there from when the ball rolls through the infield. But once they get to about 989 years old, they start hitting them fly balls, like, you know, pretty high up in the air. So this kid settles under the ball, put his hand out, does not catch the ball goes straight through and whacks him like in the clavicle, like hits him pretty hard. And I and his mom yells in the stands. Good try. And I heard the coach go, well, not good try, but and he pulled the kid aside and said, I liked the way you stood there. You weren't afraid. He did what we told you to do. That was terrific. Now we're going to work on catching the ball. And it was such as like a fine line. Right? But I saw what he meant. Like he's like, he's like, trying, it's not enough. We're catching a projectile falling in your head. We need to be proficient at this or the next one's gonna catch you in the face, not in the clavicle, right. And so he just didn't want the kid to feel like it was done. But he also didn't let the kid feel like you're a disaster at this. It was really it was really well done by a guy who trust me if you knew him, you'd think Well, where did that come from? Probably because he was treated poorly playing baseball since childhood. You probably knew not to do that. It always struck me that he was not the kind of person I would have expected such a complete answer from but he had it and it was very cool. So and then you made me think great.

Erika Forsyth, MFT, LMFT 34:36
That's a great example. Yeah. He's offering a specific praise for the things that he did all the things he did, right. Here's all of these things, some cracks here.

Scott Benner 34:46
But let's not let's not walk away from this moment feeling like you did it because I like your mom and all but you didn't do it. So you know, like it was that was kind of how we came off.

Erika Forsyth, MFT, LMFT 34:56
But I love it and there's no shame in it right now. I don't like that with that. So that's

Scott Benner 35:04
what we're figuring it out. Don't worry about it. Like all that was there, you know? Where are we at on your list?

Erika Forsyth, MFT, LMFT 35:10
Okay, we are moving on to the consequences of over involvement. Okay. And like being an over involved parent, which might be you might hear overpowering over protecting. There's also all the slang terms. You know, the helicoptering the lawn, mowing, vert, all different phrases of being an over uninvolved parent. And, again, I think it's really important to just to quickly note, too, that we're not just talking about being an over involved parent in terms of your management of your child's diabetes, but we're going to be talking about all the areas of life Sure, yeah, yeah. Okay. So some examples of this as a young child, if your child is young, maybe doing their homework may be constantly, you know, communicating with their teacher, when the child demonstrates frustration, or exhaustion, you might start doing that the task for the child, whether it's cleaning up the room, maybe when they're older, doing their their essays for them, maybe help if there's a involving yourself with their friendship, troubles, maybe too much. And then moving on even, you know, doing their college applications or essays, negotiating salaries, you know, that we can name probably a lot of different examples here. And I think, too, I want to also highlight that oftentimes, the motive is to protect your child, right, and to demonstrate that you love them, and you want to prevent them from having any pain in life. That's usually where the motive comes, right? We're not trying to cause any damage to our child by being overly involved. We're just trying to create a healthy, fun, successful life. Yeah,

Scott Benner 36:57
my wife tells a story of she was hiring somebody, once she was in a position to need to hire somebody for her group. And there was this young lady probably in her early 20s 2223, kind of fresh out of college seemed like a good candidate. But she was kind of stilted. Like, it was tough to talk to her and my wife, Sicard fine, she's young, she could be nervous or whatever. Anyway, this thing came up, but I don't remember the detail of it. And the girl says, Oh, I don't know. But my mom would know. And Kelly kind of laughed a little. And then she said, she's here. Do you want me to ask her? And Kelly's like, I wrote down the paper, no. And then just kept talking to her. To her mom came to the job interview with her. And I guarantee the mom thought she was doing like, well for the kid. But that kid was going to get that job, and then did not get it for that one specific reason. So she was fine. For the position, it would have been fine. It was an entry level thing. Honestly, if she didn't work out my wife and I or somebody else, it was not a big deal, right? Like, she was getting that job. And then she realized to the mother was sitting in the in the waiting room outside, she's like, I can, like, this is too much, you know, and moreover, the girl did not see why it was weird. Like she could tell us like the conversation went on there, she thought it was completely, just obvious that her mom would be with her job, and I feel excessive praise is not the same as reasonable good praise, lay, and you're probably not going to overpraise a child, as long as it's for a real thing. Not just like, hey, what way to get out of bed this morning. You know, and I guess unless that's the thing you're struggling with. But but you know, like, it's got to be a real successful thing that you want that you want to, I don't like to like, let out my Mac of alien side too much. But there are certain things that I do to motivate my kids to do other things. Like it's not that I don't mean it or it's not honest or true. But there's a moment when you say to yourself, you know, if I if I put a little effort into saying good job here on this, it might go a long way in the future, not just in this moment. And you know, I don't know, though. But Eric at how I make a podcast. I'm not tired at the end of the day, for the most part. Do you know what I mean? Like, I'm not, I'm not working in a steel mill. Like I'm not digging a hole like I'm, you know, I get up in the morning. Let me be honest with you, I get up when I want to get up. You know, I have breakfast, I take a shower, I make a podcast I work on for a lot of time and long hours, but I'm not exhausted while I'm doing it. And if at three o'clock in the afternoon, something comes up. I can normally pause, deal with it and go back to my life. That's just that's not everybody's situation, though. Like I guess that's why you really have to be aware of all this so that when that comes up, and you're tired or bleary eyed or whatever, you still do the right things more times than not. That is really the goal, right? Like

Erika Forsyth, MFT, LMFT 39:52
yes, yeah. And being Yeah, I mean, as you were describing the having the luxury of maybe a flexible schedule or a time I'm, you're also recognizing that not everyone might have that you might be exhausted, and just not wanting to implement all the perfect parenting strategies all the time. Yeah. But yeah, trying to do your best, as much as you can, in fairness,

Scott Benner 40:14
I'm gonna get my hair cut tomorrow with a bunch of 65 year old ladies, because, you know, they don't have a job either. It is true. It's, I mean, life's hard. And you know, your days can be long, you've said it before, like, you could be having a thing with a spouse or with another person in your life. And these things don't seem, it's difficult to see these things for what they are when they're happening. Yes, I think is really the biggest problem. And that's why you almost have to teach yourself these ideas so that they come up naturally. And not. You don't have to stop yourself and go, Oh, my God, I can't say that here. Because 16 years from now, like, you know, that's, that's tough sledding, if that's how you're thinking about it, it's hard. Yeah.

Erika Forsyth, MFT, LMFT 40:56
And I think as you said, it's to keep it on the forefront. So maybe you you listen to this podcast, or you follow other people parenting, you know, lessons, instruction on on Instagram, I think it's helpful to refresh, remind yourself of some of these tactics and tools, because it's easy to forget, I you know, just even I'm reminded of things as I talk, prepare and talk with you about these these tools. I'm like, oh, yeah, that's a good one. I forgot about that.

Scott Benner 41:26
Well, I apologize. I took you backwards a little bit. We were talking about over involvement, it just I don't know, it seems important to me to say to people, like, I know, this isn't easy, and that you might not have the bandwidth for it. But here's why it's important. But anyway, I'm sorry, being over 100%. Yes. So being over involved in all the things you mentioned, it's dangerous. Why? What does it do?

Erika Forsyth, MFT, LMFT 41:48
So again, validating are the motive of an over involved parent is because you are doing your best trying to protect and prevent your child from pain. That's usually what's what's happening. And so, unfortunately, though, some of the consequences of that is that you're teaching your child, that the world is a dangerous place, for example, you're going outside with your child, I'm going to be maybe extreme like, don't, don't go out. Don't go outside without shoes, and socks, don't forget to put on all of your sunblock and bug repellent Don't Don't cross the street with a holding my hand, these are all good things. But then you're like, wait, watch out, there's a step there. Don't forget, you're gonna follow that, you know, that's like this constant. If you're the constant narrative, again, I do all of those things for my children's certain points. But then if it's like this constant chatter to your child of watching out for the next thing, either physically or emotionally, they are then internalizing, oh my gosh, this is really, it's really scary out here. I don't know what to do without, without my parent telling me, You know what to look out for, or I don't know how to interact in this situation without my parent telling me how to say what to do, how to correct this conversation. And so then, that also can develop into, you know, different types of anxieties, separation, anxiety, social anxiety, and these are, it's, it's, it does happen, unfortunately. And then in terminally the child than teen then young adult, has this narrative of like, I don't feel like I can face the world. By myself, I don't feel like I'm good enough or strong enough, or have the ability to make these decisions by myself. So in general, there's a kind of a lower, lower self esteem and confidence in their ability to make decisions and solve problems.

Scott Benner 43:41
I want to parent how would a person know if they're just doing that by mistake, or if there's an underlying reason why they're doing it, like they're trying to keep the kid close by because it makes them feel more comfortable, like, like, what happens when it's, you know, again, not much housands but like that idea of, like, let me keep them reliant on me because it makes me feel needed or it makes me feel important because you could be having your own psychological struggles to like, right, as you see the kid like separating from you, it might cause like, real panic, and like, let me keep them infantilized a little bit and keep them with me. And then, you know, I won't have to worry about this separation ever happening. I mean, that's got to be pretty prevalent with people I would imagine.

Erika Forsyth, MFT, LMFT 44:25
Either that mindset of like I want them to, I want to feel needed, or watching your child go out into the world triggers so much anxiety within yourself, that the only way to try and feel like you can control you can manage your anxiety is to control the behaviors, or feel like you're protecting your child. And that's what you're trying to you're trying to mitigate and manage your own anxiety by those behaviors. So I see those two types happening.

Scott Benner 44:54
I mean, I bring it up because for me, one of the difficult leaps of being a parent And this is gonna sound harsh, but like for a lot of things, you have to say to yourself at some point, if they die, they die. But living like this would be a different kind of death. So do you know what I mean? Like, you have to be able to go live your life. And it's the worst job in the world because you take this thing that you love, and all you want is to be with it. But everything you do is to give it the opportunity to get away from you. Which is just, it feels crazy while it's happening. I mean, listen, my kids are older, it still feels crazy. Like my wife will joke sometimes she's like, waiter, prepare them for the world. Now they don't need us. It's hard to remember that, yes, a certain amount of people are going to have like, like something terrible happen to them. And but that's not a thing, you can necessarily stop, you can reasonably protect against that don't go out at night, in a bad neighborhood by yourself, you know, that kind of thing. But if your kids like I want to move to the city, that would make me happy. You gotta let that happen. You know, like when they get their driver's license, yes, some kids wreck their cars and die, most of them don't. And how do you No, but if you keep locking them up and locking them up, they never get anywhere. And then they can't take care of themselves. Now they're still alive. And everything's a show. And because I mean, like you're talking about the anxiety, or I don't know if even got to like the lower self esteem and no confidence and all that that's going to come from that. And this is an absolute apples to apples comparison with diabetes, like 1,000,000%, you cannot, you have to take care of it for them. But you have to teach them how to take care of it for themselves. And then you have to let go of it. As it happens. I personally went with a slow release over a long amount of time. But that came from me listening to people talk who were just like thrown into it. And it never worked for them. No one comes on here and tells a story of like, you know, I was diagnosed when I was 12. My parents like you can handle it. And then everything was great. That does not usually happen like that, right. And so I just thought, the way I usually talked about on the podcast is like I see diabetes, the way I see everything else about parenting, it's a lot of repetition, not being frustrated about having to repeat yourself, knowing when it's time to stop repeating that thing and move on to the next thing. And when is it time to just let go? And then you got to know that the last piece of it's the hardest, because it's all on you. The letting go is like all on you as a parent, it's incredibly painful. So I've had a number of moments in the last four years that have been like, some of the worst moments in my life. Because I had to like, you know, I had to stand there with this person and go, Okay, well, you should just leave now. Like, that's okay. And then they're gone. And you're still here and alive. And you're like, oh my god, everything's so still. And you know, I don't have anything to do. And it's very, it's very hard to give it all away. And, you know, but if you don't, then you're screwing them over. It's just kind of the way I look at it, you know? So, anyway.

Erika Forsyth, MFT, LMFT 48:07
Oh, so it's so so hard. I think

Scott Benner 48:11
it made me sad thinking about it. I know you're making me sad to your kids are little it's gonna make you cry. Just making me sad. It's the worst thing. I'm sorry, I cut you off. I apologize.

Erika Forsyth, MFT, LMFT 48:23
I think the the over involvement piece, I think it's very, like it's a healthy involvement, right? Like finding that balance of, I think we've talked about this long time ago, like bubble wrapping your relationship with your child with the diabetes, and keeping that protected. And slowly unwrapping the bubble wrap as they get older. Right and that but they've learned how to had to manage themselves through your, and re like you've protected them. And then you're like taking these layers off of bubble wrap. So they kind of learned they're gonna make mistakes. It's okay. Yeah. And I know it's such a, it's such a painful. It can be such a painful and challenging process. But but then has to be done, as you said, eventually,

Scott Benner 49:12
oh, it's and it doesn't go in case you're wondering if it goes away as you get older, like my son's 23. In a couple of months, he's moving back home. And he's just got to drive across the country by himself. And there's, there's a little voice in your head that says, tell him to live there. Because you don't want him to have a car accident driving home, which is a ridiculous thought. But it does go through your head for half a second. Like, you know, you're like it's just you. It's just you repeatedly trying to protect a baby. Right? Like, you get the baby and everything's trying to kill it. You don't realize that you're holding it. You realize that like putting it down, twisting it the wrong way, like all of its bed food in a bathtub. You're all like, oh my god, it feels like that. And then that's your wiring, and then they get bigger and then fewer and fewer things can actually hurt them. But you still aren't In the part you started in, and you have a note here at how that could turn into entitlement for them. I was wondering about that. Okay,

Erika Forsyth, MFT, LMFT 50:10
so this, let's say, over time, your young child, that is a teen is constantly learning that someone is going to do the thing for me or be there for me fix my problem. Then, as the child launches into the real world, they might enter into the world with a sense of entitlement and assumption that things are going to be done for you that all your needs are going to be met, that you don't have to once you feel kind of like, frustrated. So and so your colleague is going to do the thing for you. So that can be that, you know, we can see like the anxiety piece, definitely playing out and the challenge, like making independent decisions, but then we can also see this other element of, well, someone's going to do it for me. Yeah, I

Scott Benner 51:03
know, I've done and I know, I've mentioned this before, but I steadfastly when my kids were playing sports, if they looked hurt. Like, it's it. Listen, it sounds like a joke. But a kid gets hurt on a baseball field. Every mom stands right up. And dad, and every dad sits there. It's like, oh, they're probably alright. And like, and the one time it happened to my son, and eventually happened Arden to Kelly's like, go help him. And I was like, Kelly, if he's hurt, he'll still be hurt a minute from now. I was like, but if he's not hurt, what we're going to screw up by running out there is far worse than the pain he's gonna feel for the next minute before we can go home. Like we have to let this play out. You know, and don't get me wrong. It wasn't even look at you get shot in the head or something. But like it was it was bad. He went down, he was hurt. And he got up and he pulled himself together. And he kept going. Now, if he's laying on the ground, and before he even knows if he's hurt or not his mom's running towards him, then that's how he's wired from then on. And I also kind of steadfastly believe that when you're raising children, you don't lead them. When you're talking to them. You don't ask them leading questions. Are you hurt? You look hurt. Don't say that. Because then they're gonna go, Yes, I'm hurt. It's just how it goes, you know? Like, don't tell them they're not okay. I don't know. Does that make sense? Like, like, you know what, I mean, people follow your lead sometimes. And I'm not just saying Say you're okay, when you're, you know, you're famous second out is that you're fine. Like, you're not, you're not fine. Right, but like, but don't lead them to believing that they're weak. You know what I mean? And then once, and once there's an actual problem, it's not weakness, it's an accident. It's you don't I mean, like, there's no, there's just, there's certain words in there and phrasings and timing that are really important to avoid these things from happening, I think.

Erika Forsyth, MFT, LMFT 52:55
Yes, I think it's, it's obviously, developmentally. But there's different different things you want to do, depending on where your child is in their development. I think as a young, newborn young child, you want them to know that they are going to be safe and cared for if a child falls and scrapes their knee. Some of these are maybe two different stereotypes. You have the parents say, Oh, you're fine, you're fine. You're fine. You're fine. You're fine. You're fine. You're fine, right? Come on, come on, come on, let's go. Or you have a child. Oh, my parent. Oh, my goodness. Let's go. Let's walk home. Let's stop the thing. Let's, we're gonna go, you know, you mustn't really hurt. Right? So there is that fine line of the validation piece? I hear, you know, you don't want to put words into their mouth. But sometimes the children would have the words but giving enough giving the validation without dismissing or exaggerating, yeah, incredibly

Scott Benner 53:52
fine line. Like, if you take a baby and pretend to be sad, you can make a baby cry. I got upset earlier, it made you upset. Like, like, so that happens, right? But so there's the line. Like, I don't want to like freak the kid out by telling them I think I'm I'm worried you should be worried too. And you also don't want them to think that it's a callous situation where they're hurt. And you're just like, whatever. It's okay. It's a it's a it's a case by case decision. You have to make that and you have to kind of make them snap, you know, snap judgment. I always my thought was just like, look 30 more seconds to make sure she's really hurt before we go out on that field is neither here nor there. But if you run out there, and she's okay, you're gonna I mean, I don't know what it is when you do it to a girl, but it's emasculating. Like, you know, like, what is that word? What does an escalation mean? Can you emasculate a woman? Ah, oh, I found a word. I don't know. Let's look it up.

Erika Forsyth, MFT, LMFT 54:47
Sorry. I think that's it. Yeah.

Scott Benner 54:53
Is emasculation something that you can only do to uh,

Erika Forsyth, MFT, LMFT 54:58
yeah, we're getting we're getting into you know, Different, what is your gender identity? And how do you present? And then? I'm not sure.

Scott Benner 55:06
Is there a more generalized word, I guess is what I was wondering. I'll figure it out. That's what I was wondering like, is there a more generalized word for that?

Erika Forsyth, MFT, LMFT 55:16
While you're looking, shall we move for the sake of time into our strategies? Okay. So talking about, you know, we now understand what are some of the what does it look like to have be inconsistent in our discipline and following rules, being an over involved parent? And so what are some strategies that we can implement, to maybe hopefully avoid some of these negative outcomes, and we already you already kind of alluded to the set reinforced double rules, right? So we, we want to, and we and again, we might not know what the rules will be like we can enforce on a consistent basis. So it's okay to redact and correct and edit and adjust. Use reasoning, instead of empty threats. So if a child or a teen is not following the rule, to again, I know this is hard to do. Because we have to be in our own, you know, grounded place ourselves as a parent to enter into a conversation and of explaining why is this not working for you? This is the rule. This is how we have to make it work. Instead of empty threats. I was taught this in a parenting class, when I first became a parent, where you're at, you're at the playground, and the child's not listening, you're saying, Come on, you need to go do this, or do that or don't do this. And then you say, Well, if you don't stop doing that, we're gonna leave the park. And this parenting educator said, No, do you? Do you really want to leave the park? Like, are you are you really gonna leave the park? And oftentimes, like, No, we don't want to leave the park. Like we're there. We have all the things are with our friends. And even in those younger years, the child will learn Oh, you know what? I did it that one more time. And we didn't leave the park. Yeah. And so that, that has sat with me now. They they will learn and I think the hardest part is when you make that really extreme that it's because you've you've done all the things we talked about originally is like you've it's everything, you've escalated, the child's behavior is becoming really aggressive. you're responding in a really aggressive way, everything, the whole situation is escalated. So you're like, if you don't do this thing, rather, we're not going to the party, or we're leaving the party or whatever.

Scott Benner 57:27
I think everybody comes to the moment where they make that read that resolution there. And then they're like, oh, I have to follow through now. Yeah. And you're like, Oh, I screwed myself. We're actually leaving. I said this thing I have to follow through if I don't, then you're gonna get all that I've had that happen to me. I was like I overreached. And now I'm end up doing a thing I don't want to do because I have to, because I said I was going to, and yeah, that's unpleasant at all. What about no favoritism between children? This

Erika Forsyth, MFT, LMFT 57:58
goes back to kind of you know, this the sibling, if rules are different or applied differently. So let's say you have no there's no playdates for children after school. And then you're feeling lenient, or you actually really need a, you know, for whatever reason, you're like, okay, just this one time, but it's for Johnny and not Susie, that doesn't work. That doesn't work. So just trying to be really consistent and the, how you apply the rules for both children? I know we've talked about that a little bit already. And

Scott Benner 58:33
yes, you have links here you want to share with people you want to tell them? Yeah,

Erika Forsyth, MFT, LMFT 58:36
so I think a lot of this information came from parenting for brain.com. Also, in previous episodes, I love the child MIND Institute, child mind.org. There are some great links and articles on a lot of this information that we're talking about. And I think one of the last tips that I think we'll get into in the next episode is to try your best to not contradict the other parent. And to as much as you can connect, communicate with the other parent, if there is one in the household. And that will communicate to your children that the rules are clear. And they are you are being consistent in how you follow through with those rules when they're when they're broken.

Scott Benner 59:20
What about when they're wrong. We'll talk about the next one. The next episodes about co parenting and unified fronts. I cannot wait to tell you all the stories I have of my wife and I disagree. So and agreeing and how I've learned to say things like your mom's right. And here's why. Or I think this is why mom feels this way. I get what your concern is here. I gotta be honest with you. I might be on your side of this. But here's what she's saying. If you try to see it from her perspective, I think you'll see what she's saying is reasonable like that stuff took time to learn. So, but anyway, I appreciate you doing that and I will let you go with this idea it looks like that imagine you learn a masculine it just seems like it might be an old word. So then when they first made it, the first word was first used, it was like, you know, to, to deprive of strength, vigor or spirit or to weaken. That's what it means. But it was. Also it also meant castrate. So I think it became a word that was, I wonder if you look back, if no one ever thought you that women had strength, vigor, spirit or strength to begin with, and so you couldn't take I wonder how like old fashioned the word is, like the I don't know what the Entomology of it is. All I know is I wanted to talk about Arden and say that you didn't want to take away, you didn't want to weaken her. Like you didn't want to deprive her of spirit, like these are all things I would have said but a mask that popped into my head and then I was like, Is that appropriate? Like for that gender? And I was like, I don't know. And anyway, that's where that led us to. So I'm gonna have to figure out if there's a word, if there's a word for genders, or if it's just a, like a unisex word, or, or if there's a different or better one. Anyway, I'm gonna find out. Yeah,

Erika Forsyth, MFT, LMFT 1:01:05
sure, sure. Next Oh,

Scott Benner 1:01:09
all right. Thank you so much. I really appreciate it. You're

Erika Forsyth, MFT, LMFT 1:01:11
welcome. Thanks. Bye

Scott Benner 1:01:21
as always, Erica is terrific. Find her at Erica forsythe.com. She can help you in I think five different states and she sees people in person in California. You can find out everything at Erica forsyth.com. I want to thank us med. Sincerely. I want to thank us med sincerely for being a steadfast and longtime sponsor the Juicebox Podcast we in fact do get Arden's supplies from us, man, and I believe you would have a good time. If you did as well. It's very easy. I love how easy the reordering is. I sincerely think you should give them a try us med.com/juice box or call 888-721-1514 If you enjoyed this episode, it's part of a series go back in your player and find the rest of them they're called parenting and then you know the rest of the scription you should be able to find them no trouble. I also believe there's a list of these episodes in the feature tab at the Juicebox Podcast, Facebook group, the private group Juicebox Podcast type one diabetes up in the feature tab you should find lists of this series and actually all the series that are involved in the podcast. Thank you so much for listening. I'll be back very soon with another episode of The Juicebox Podcast.