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In this episode of “The VBAC Link Podcast,” Meagan is joined by Lauren from Alabama. Lauren's first birth was a Cesarean due to breech presentation where she really wasn't given any alternative options. Her second was a VBAC with a head-down baby, and her third was a breech VBAC with a provider who was not only supportive but advocated on her behalf!Though each of her births had twists and turns including PROM, the urge to push before complete, frequent contractions early on, and NICU time, Lauren is a great example of the power that comes from being an active decision maker in birth. She evaluated pros and cons and assumed the risks she was comfortable with. Thank you, Lauren, for your courage and vulnerability in sharing not only your birth stories with us but also your incredible birth video!Lauren's YouTube ChannelCleveland Clinic Breech ArticleThe VBAC Link Blog: ECV ExplainedNeeded WebsiteHow to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hello, Women of Strength. If you have ever wondered if a breech vaginal birth or a breech VBAC is possible, let me just tell you right now, the answer is yes and our friend Lauren today is going to share her story to confirm that it is 100% possible. Obviously, we do have some breech VBAC stories on the podcast but they are few and far between. I mean, Lauren, when you were going through it, did you hear a lot of breech births in general let alone VBAC? Did you hear a lot of people having those? Lauren: No. I had heard a few on The VBAC Link but that was really it. I did a lot of research. Meagan: Yes and it's so unfortunate. This story is a double VBAC story but also a breech VBAC which we know a lot of people seek the stories for this because as she just said, there is not a lot of support out there when it comes to breech birth in general. We have a client right now who was just told that her baby was breech and they've already said, “We're going to try to flip this baby but if not, it's a C-section.” They didn't even talk about breech vaginal birth being an option and it makes me so sad. I'm really, really excited to get into your episode. You are in Alabama. Is that correct? Lauren: I am. Meagan: Awesome. So any Alabama mamas, listen up especially if you have a breech VBAC but VBAC in general. If someone is willing to support a breech VBAC, I'm going to guess that they are pretty supportive of VBAC in general. We do have a Review of the Week so we will get into that. This is by sarahinalaska. It says, “HBA2C attempt”. It says, “Thank you, thank you. Your podcast came to me at such an amazing time. You ladies are doing something amazing here. I'm planning on (I'm going to) have an HBAC after two C-sections in February. I look forward to listening to your podcast on repeat to fuel my confidence, ability, and knowledge.” Sarahinalaska, this has been just a minute so if you had your VBAC or just in general, if you are still listening, let us know how things went and congratulations. Late congratulations because this was a couple of years ago. Meagan: Okay, everybody. Lauren, thank you again for being here. Lauren: Thank you for having me. Meagan: Yes, so okay. Obviously, every VBAC journey starts with a C-section so if you want to start right there. Lauren: Yeah. So my first son was about 7 years ago. He was born by C-section. He was also breech. Meagan: Oh, interesting. Okay. Lauren: He was breech through the entire pregnancy. We had talked to my doctor about doing the version but at 36 weeks, my water broke. Meagan: Okay. Lauren: So once your water breaks, you can't attempt a version. I went to the hospital and they said that it would have to be a C-section at that point. I really didn't have the knowledge that I do now and basically, it was worded as “I don't have an option” and that's just it. So that's what we did. Meagan: Yeah. It's so common. Even with non-breech, there are so many times when we come into our birth experience and we are left feeling like we don't have an option. Lauren: Yeah. Meagan: It's just so hard to know. Obviously, that's why we created this podcast so you know all of your options. And then talking about flipping a baby and doing an ECV after your water broke, that is something I've only seen one time in 10 years of practicing so most providers will be like, “Nope. I won't even attempt it.” I was actually floored when my client was actually offered that. Obviously, it's a more difficult experience and it can be stressful on the baby as well so there's that to consider. She ended up trying it. He tried it twice and it didn't happen and then they ended up going into the OR. So okay. Baby was breech. Do you know why baby was breech? Did they say anything about your uterus or any abnormalities there? Lauren: No. They said sometimes it just happens. They knew how badly I wanted to have a vaginal birth and they said, “You are an excellent candidate for a VBAC.” So I was like, “Okay, great.” Meagan: Awesome. Lauren: That's when I really took a deep dive into birth in general because the stuff that they were saying just didn't sound right to me. Meagan: They said you were a candidate. So where did your VBAC journey start as you were diving in? How did that begin? Did you do that before pregnancy or after you fell pregnant? Lauren: Before pregnancy. Probably before the time I came home from the hospital with my son, I was already researching. Meagan: Baby was a couple of days old and you're like, “And let's figure this out.” Listen, I get that. That's exactly how I was too with becoming a doula. It was literally two days after I had my C-section. I signed up to become a doula. Okay. You started diving in and what did you find? Lauren: It was very shocking to me how most providers don't practice evidence-based. I found out the difference between evidence-based versus the standard of care. I was shocked about that too. I was just like, How can you do that as a doctor when you've got all this evidence here? But another doctor is practicing this way so it's okay for you to do that. Meagan: Right. It becomes the norm or it has become the norm. Yeah. Okay. So you get pregnant and you know VBAC is possible. Tell us that VBAC story. Lauren: So that was just a wonderful experience but part of my research, I joined ICAN and I wanted the most VBAC-supportive provider out there. I did switch providers and I switched even before I was pregnant. Right when we were trying, I was like, I need to get in with a provider who is supportive. I found a wonderful provider. The pregnancy was great. I did all the things. I sat on the birth ball instead of on the couches. I made sure to take walks every day. I kept up with my chiropractic care. All of that were just tips that I had seen so I did that. She was head down by 20 weeks so I was super excited about that and she waited until 40+3 which was also a big thing for me because with my first son, they took him to the NICU so I did not want the NICU. The NICU was a horrible experience. I was like, Please, please, please hold on until 37 weeks. 40 would be great.She did. She held on until 40. It was funny too. It was like a switch flipped at that point and I was like, okay. Now I want to get her out. I was eating the spicy food and everything to try to get labor started. But 40+3, my water broke with her as well before labor started. I panicked a little bit because I didn't want to be on a clock. Although I felt that I was with a good provider, I still hadn't birthed with her yet and I've heard stories about people having this doctor who tells them everything they want to hear and then they get in the birth room and it's completely different. Meagan: The bait-and-switch, yeah. It's so hard because they talk about how we have to have this proven pelvis to be considered the best candidate or to have full faith in our ability, but at the same time, I feel like sometimes from us at a patient's standpoint, they need to prove to us. They need to prove to us that they are supportive throughout. Lauren: Yes. For sure. So pretty quickly after my water broke, I started pumping and while I was pumping, the contractions started so I felt so much better. I was like, Okay, good. Now we've got contractions going. I had a doula at that point as well because I felt like having a doula was going to be extremely important for a VBAC. I called her and let her know. She came over and she just hung out a little bit. We did a henna on my belly and we just talked and talked through some fears and excitement and stuff like that. Then she said, “Well, I'm going to go get my stuff. Why don't you lay down and take a nap and see if once things pick up, we can go to the hospital?” I said, “That sounds great.” This was my first time experiencing labor because with my son, even though my water broke, I never had contractions. They just went straight to the C-section. I went upstairs and I laid down on my left side. Within a minute, I was just like, Whoa, these feel totally different. This is crazy. Probably within 30 minutes or so, I was having contractions every 2-3 minutes. Meagan: Whoa!Lauren: Yeah. I was just like, This just picked up really fast. I think I was supposed to already go in by now. Meagan: Were they intense as well on top of being close or were they not as intense but just close? Lauren: In hindsight, they were not intense but it was my first time having labor and they were more intense than the beginning contractions. “Okay, they are more intense. They are close together. I've got to go now.” I was panicking. We made it to the hospital. They checked me and I was 2 centimeters. Meagan: Okay. Lauren: I was like, “You've got to be kidding me.” Meagan: Yes. That's the hardest thing because we are so focused on the time. We are told if they are this close together, it's time to come in but we sometimes forget about the other factors of intensity and length and what's the word I'm looking for? I was going to say continuous but they are that pattern always. They are sticking to that pattern. They are consistent. They are consistent, yeah. Okay, so you're 2 centimeters which is great by the way. It's still great. Lauren: Yes. Oh, and I forgot to mention too that another that was like, Okay, I probably am with a good provider, I did call her after my water broke and she said, “What are your plans?” I just said, “I'd like to stay home as long as possible and contractions haven't started yet but I'm going to try to start pumping and get them started.” I said, “I'd like to wait until tomorrow morning to come in if nothing has started.” She was like, “Okay. Sounds like a good plan. Just let me know what you need.” I was like, Wow. She let me go past 24 hours. Meagan: Yeah. I just love that she started out, “What's your plan?” Lauren: Yes. Meagan: Versus, “This is what you have to do now.” Lauren: Yes. Exactly. She is wonderful and you'll see through the story how amazing she is too. But anyway, we get to the hospital and I actually started out with a wonderful nurse. The hospital policy is continuous monitoring. Meagan: Yeah, very common. Lauren: But I did not want that. I was so lucky because the nurse who started, she was about to leave. Her shift was about to end but she let me start on intermittent monitoring so I was able to get up, walk around, get on the birth ball just to help things moving. Shortly after that, she left and the next nurse was not so nice about it. She told me, “It's our policy. Yada yada.” I said, “Look. I've been doing the intermittent. I'm fine with the intermittent. That's what I'm going to stick with.” She said, “You're going to have to sign a form.” I said, “Bring it on.” Meagan: Yeah. Lauren: I signed the form and I was just like, “That's fine. I have no problem signing a form to say this is my choice.” Then we labored in the hospital room for several hours and my doula suggested I got in the shower at one point and that was amazing. It was euphoric. It felt so good to get in the hot shower and I was progressing slightly more than a centimeter an hour which I know is what they look for so things just progressed pretty slowly and then that night at around– oh, well actually once I hit 6 centimeters, my body started pushing. Meagan: Oh, yes. That can happen. Lauren: I was terrified when I found out I was only 6 centimeters because they kept saying, “You need to stop pushing or you're going to the OR.” I was like, “You don't understand. I'm not pushing. My body is doing it.” It was several hours of working with my doula to try to stop my body from pushing. Every time I had a contraction, and they were still going every 2 minutes–Meagan: Did they give you any tips on how to cope with that or how to avoid pushing like horse lips or things like that?Lauren: The thing that worked best for me was opening my mouth and saying, “Ahhhh.” So that helped a lot but I would still say that 50% of the time I could not stop the pushes. I still remember that nurse saying which was not helpful at all, “Are you pushing? That's the quickest way to the OR.” Meagan: Ugh. Not very kind. You're like, “I'm trying not to. Can you see what I'm doing here?”Lauren: Yes. Then my doctor came in around 11:00 that night to check me and she said, “Oh, you're complete.” I just remember being like, “Thank God.” I said, “Does that mean I can push now?” They're like, “Yes.” That was the best thing I had heard because that was all I wanted to do was push. I was already in the bed because they had me on the monitor at that point. I was on my back so they just leaned the bed back. I didn't really want to push on my back but at that point, I was like, “I'm not moving. I'm just going to push how I am.” I pushed. It took about 20 minutes and she just slowly came out. It was– oh, I'm going to get emotional. It was wonderful. My doula was also my birth photographer and she got some pictures. She got a picture of my husband. It's really sweet. I hope he's okay with me telling this but she got a picture of him crying. It was when she was almost out. I asked him about it and he said, “I just knew at that point you were going to do it. I knew how important it was to you.” Sorry. Meagan: I'm sure he had that overwhelming flood of emotions like, “I know this is important and I can see it. She's there. She's going to do this.” Lauren: Yes. It was wonderful too and then I got to hold her on my chest for a while but they weren't too thrilled with her breathing so they never took her out of the room but they did take her over to the table and they were suctioning her and stuff like that. I started feeling a little panicky because with my son, what happened was after my C-section, they showed him to me. I got to kiss him and touch him and all that but then they started leaving the room with him. I was like, “Whoa, where are you going?” They were like, “Oh, we've got to take him to the NICU because he's having trouble breathing,” but nobody told me anything. They just started leaving with him. I was panicking thinking that was going to happen with my daughter. I was like, “Please, please, please just give her to me. All she needs is me. She's going to be fine. Just give her to me.” The nurse was like, “No. She needs suction. We need to do our job,” but my doctor was so wonderful. She came over and said, “What they're doing right now is suctioning her because they are not happy with her oxygen level.” She sat there and she told me, “Okay, now she's at 94.1%. Now she's at 94.2%. Now she's at 94.3%.” Every time that thing went up, she would tell me. She was just so calm and it was like she got me. She understood. Meagan: She understood what you needed in that moment. Lauren: Yes. Yes. Another thing too which I thought was really interesting is that first off, she did ask before she did anything. We got half of my daughter's head out but she got a little stuck so the doctor was like, “You know, we really want to get her out.” She said, “I think the vacuum might help or are you okay with me manually helping you?” I said, “What do you mean by that?” She said, “I could just insert my fingers and tilt her chin. I think that will get her out.” I said, “Yeah. Let's do that one.” So she did. She went in and popped her little chin and then she came out.Meagan: Awesome. Lauren: But it was nice to be asked instead of told what needed to be done. Meagan: Well not even told and just have it done. Lauren: Yeah, just do it. I've heard that a lot and it was crazy because that actually was going to happen with my first son. Before my nurses knew I was breech, they came in and they started. They were about to put medicine in my IV and I said, “Whoa, whoa, whoa. What are you doing?” She's like, “Oh, this is Pitocin. We need to get your contractions started.” I was like, “No, I don't want Pitocin.” She's like, “We need to birth him within 24 hours or he's going to be a C-section.” So it was just crazy the difference in being told what was going to happen and being asked for not only my opinion but my consent. Meagan: Yeah, absolutely. That's so important. Women of Strength, if you are listening to this, please, please, please I beg of you to help you know. I don't know how we can let you know even more but you guys have the power to say no and consent is so important. Your consent is so important with anything, even just getting Pitocin drips. If anything is happening to your body, you have the right to say no and you always can question. You can pause and say, “Tell me all of the risks here” or whatever. You don't just have to have it be done to you. You do not have to. Lauren: Yes. Meagan: It's hard to say no in that moment. Lauren: It is. It is. Meagan: It's hard to say no especially when they are coming in and making it sound like something you need. Whether it's something you need or not, you still deserve to have consent. Lauren: Yes, exactly. Then they throw that at you where it's like, “Oh, the baby will be in danger.” You're like, if you're not knowledgable then you'll be like, “Okay, then. I don't want my baby in danger.”Meagan: Exactly. Of course, we don't. Duh. Of course, we do not want our baby in danger but most of the time rarely is our baby in danger if we are not starting Pitocin right away. Yeah. Awesome. So you had this beautiful vaginal birth with support. It was a way different experience with good, true informed consent even into the postpartum period which should keep continuing anytime you are under care with anyone like this no matter in hospital or out of hospital. This kind of consent should continue. Lauren: Yes, for sure. Meagan: Awesome. Awesome. And then baby number three. Cute little baby. I don't know if I'm allowed to say his name so I won't. Lauren: Oh, yeah. You're fine. Ollie, yeah.Meagan: I was going to say I got to see on the recording just before we got started that he was another breechie. Lauren: Yes, he was. I was just like, Oh my goodness. His pregnancy was so similar to my first son. It was a little freaky. I had a lot of anxiety to work through because of that. I was like, This can't happen again. He was breech the entire time and basically stayed in the same position. He moved his little head around and that was about it. This time, I was I guess a little more– I don't know if cocky is the right word but confident that everything would be fine. I was a little more lazy. I didn't do as many walks as I should have. I sat on the couch a little more than the birth ball and things like that. I was like, Oh, he'll be fine. So at about 20 weeks when he was still breech, I was like, Maybe it won't be fine. Maybe I need to get this going. I started trying to do a little more of that stuff. Also, my doula had moved out of state so I was like, Oh no. Meagan: Dang it yeah. Lauren: I know it's so important and having a doula was definitely important for me. I started the search for a new doula which ended up turning out great. I loved both doulas so I was very pleased but I was very nervous. But yeah. I found my doula while I was pregnant and then I just had so much anxiety about my first son's birth that I needed a plan ahead of time basically. I talked to my doctor about it and I went in there just nervous to even bring it up. I said, “So he's still breech. I know that he's got plenty of time to turn but I am nervous because I have a history of this with my first son. He was breech and I had to have a C-section.” I said, “What are your thoughts on a breech vaginal?” She goes, “Well, I don't see why we couldn't.” I was like, “What?”Meagan: You're like, “I wasn't expecting that.” Lauren: She's like, “You've already had a VBAC. You did fine. He can't be sideways. He's got to be to where he could actually come out breech. It's just something that we'll talk about.” She did mention an ECV as well and she was like, “We've got a long way away but I don't have a problem doing a breech VBAC with you.” I immediately just felt so much relief. Meagan: I bet. Lauren: Yes. So we went along the pregnancy like that and then at 37+3 at 5:00 in the morning, my water broke. Meagan: 3 for 3 water breaking, you and I. They say 10% but when you're 3 for 3, you're like, “Hmm.”Lauren: That's what I was thinking and the breech stuff is only 3-4% are breech and I had it twice. It's like, How is this possible? But yeah, my water broke around 5:00 AM and me running to the bathroom, I woke my son up and he came in. It was really sweet. He got in bed with me and we just cuddled for about an hour and I talked to him about how his baby brother was going to come today. It was just a really nice moment to cuddle with him. Meagan: Oh yeah. Those moments are so precious because you're like, these are the last moments of just us as a family of 4 and now we're adding a 5th and these are the last little moments together without little siblings. I'll always remember that. So we did that. We cuddled for about an hour and then the contractions actually started without me having to pump. This time, I was going to wait a little bit longer before pumping because I wondered if the contractions every 2 hours with my daughter for the whole labor was maybe because of the pumping. Having contractions that close made things really difficult. Meagan: Oh yeah. Not a lot of a break. Every 2 minutes, there's not a ton of a break especially when they were a minute long. Not a lot there. Lauren: No. So I was like, Maybe that will change. I knew I could handle it but I was like, If I don't have to, that would be great. They started pretty slow about 6 minutes apart or so really gently. At around 6:00, I went ahead and woke my husband up and let him know. I called my parents. I had texted my doula but I went ahead and called her just to let her know. I called my doctor. She again just asked me, “What are your plans?” I just said, “Stay here to let things pick up and then head to the hospital.” She was like, “Okay, that sounds good.” I just labored at home. My parents live 2 hours away but they were coming to get our older two kids. I was going to try to pack the hospital bag because I had not done that yet. Meagan: Well, at 37 weeks. Lauren: That was the plan for that weekend. I kept having to sit down because of the contractions. My husband said, “Let me do it. Tell me what you need.” I would just give him the instructions as I just bounced on the birth ball. We got that done and my parents showed up. They brought me a big smoothie because I was like, “I want to eat but I don't want to chew so get me a smoothie.” That was really nice just to have something in my stomach and give me some energy and stuff. They got here at around 9:30 and at around almost 11:00, I was like, “These contractions are starting to feel real.” I had a first birth reference at that point. Meagan: Yeah, like more intense and frequent and strong. Lauren: Exactly. Oh, but I will say by 7:30 again, at 7:30 that morning, I was back at 2 minutes apart. Meagan: Oh man. It's just something your body does. Lauren: That's just me, yeah. But they weren't intense and this time, I knew. I was like, Okay. I know this is not intense. I'm still able to talk through them. I'm able to recover very well, but then right around 11:00, I was like, “Things are getting really intense now so I think we need to go.”We left for the hospital and let my doula know. I called my doctor as well and it was really wonderful talking to her too because she said, “You know, when you go in there, make sure you are confident. Tell them this is the plan. You are going to do a breech VBAC. We have already discussed this.” I think she was worried too. The hospital, I will say, I do not feel was supportive. I think it was mainly that they were scared. I think she knew that too, but having her in my corner was what I needed. Meagan: Yeah, very huge. Lauren: We got to the hospital and she had gone ahead and called them to directly admit me so I didn't have to do triage and all that. That made it so much quicker. We got there probably around 11:40 or so and we were already in our room and the doctor was coming in by 12:00. She came in and she checked me. She was like, “All right. You're already at about a 5 or a 6 so you're doing great.” She's like, “I'll be in the hospital for a while so they'll just call me when you need me. Just do your thing. I was like, “All right. Here we go.” I did get in the bed for a little while so they could do the IVs and stuff like that. I told them I wanted the wireless monitor. They were having trouble working it but they still never made me do any monitors because I told them I can't do continuous unless it is wireless because I need to be able to move. They didn't argue with that so that was nice. Once they got all that done, I got on the birth ball. We played some music that I had preplanned and my doula and my husband both helped me work through the contractions then it was 12:58 which was less than an hour when my body started pushing again. I'm like, You've got to be kidding me. I can't do this.They called the nurse in because I was like–Meagan: Last time this happened at 6 centimeters. Please don't tell me. Lauren: They came to check and she was like, “Oh my gosh, she's complete and he's right there.” I was like, “What?” Meagan: Yay!Lauren: Yes. They called my doctor. I was panicking a little bit but she wasn't there. She was in the hospital but because she wasn't in my room and I went from a 5 to complete in less than an hour, I'm like, “Is this baby just going to shoot out of me?” I was like, “I need her to be here.” Anyway, she got there very quickly and this time, I knew I didn't want to be on my back so they had me just try some different positions but I really liked when the bed was sat up and I was facing the back and leaned over it so I was upright. Then I was able to move my pelvis around and just find a comfortable position. I really liked that. I started pushing because I could. He just very, very slowly came out and my doula was recording because I wanted a recording of my last birth but I was just too out of it to even ask for it so I had let my husband and doula ahead of time that I wanted it so my doula took care of that. She was there recording it. Meagan: Awesome. Lauren: Yeah. I was pushing I remember this one hurt a lot more than my daughter. I think they stretch you differently. I remember panicking to my husband, “Oh my gosh. This hurts.” He was just slowly coming out but I couldn't see what was going on. With my daughter, they rolled out a mirror so I could see what was going on. I felt like I was pushing wine. I didn't ask him to but my husband stepped in and he was like, “Okay, I see a leg now. Oh, there goes the other leg.” He started just telling me body parts and I was able to get a visual which was so helpful to be able to know how much was coming out. When it got to his chest, it felt like my body was just like, Okay, we're done. The contractions just stopped and I was like, “What's going on? They were coming so fast and now they're just chilling out or whatever.” They were like, “It's fine. We'll just wait until the next contraction.” They did start coming back but it didn't feel as strong and it felt slower. I don't know what that was about. It could have just been my perception too. He came all the way out up to his neck and then he wasn't really coming much further after he got to his neck. The doctor was turning him because he had the cord wrapped around his neck twice. He just didn't seem to be moving like he was supposed to. She said, “I need to check and see if his head is flexed,” and it was not. She had to put both hands inside to flex his head so that it was in the correct position and she had turned him over to try and get some of the cord off as well. It got a little intense there for a minute. She said, “Okay. I need you to get on your hands and knees,” so I did that and that wasn't working. She said, “Okay, mom. I want to get you to flip over. I just need a different angle to get him out.” I flipped over on my back which I was completely fine with at that point. I wasn't panicked. I had a little bit of anxiety and fear but I wasn't really scared because my doctor seemed so confident in that she's got this. We just need to do something a little different to get him out. We flipped on my back and she got his head exactly where it needed to be. I did two more pushes and he came out. He had gotten stuck longer than they wanted him to so she said, “We're going to go ahead and cut the cord and get him to the nursery team who was coming in” because they needed to resuscitate him just from the time it took. Meagan: He was shocked Lauren: She said too, “He's going to be okay. He's trying to cry but he needs help.” I said, “Okay.” I felt good at that point. I knew that if he was trying to cry that he was still conscious. The NICU team– it was charted wrong how long he was stuck. I think they panicked a little bit because they just went and they intubated him immediately and they said, “Okay, we need to get him to the NICU.” I hadn't even touched him at that point. I said, “Can I touch him or kiss him or talk to him before you take him?” I asked my doctor that and she said, “Can you bring him over here so she can give him a little pat before you take him?” The nurse looked over and she goes, “She can see him from where she's at,” and they left with him. Meagan: Oh. Oh. Oh boy. Lauren: To me, it did feel like a punishment for doing a breech. They went back and looked and they charted that he was stuck for 5 minutes. We had a video and he was stuck for a minute and 40 seconds. Huge difference. Meagan: Very big, yeah. Lauren: They went immediately to what they would do with a baby who had been stuck for 5 minutes. They charted his APGAR as 0 but my doctor said, “It can't be because he whimpered when he got out so he's got to have at least something.” It was all just a big overreaction at that point. They were supposed to monitor him for 4 hours to make a decision and they immediately just made the decision to admit him to the NICU which meant he was stuck in NICU for at least 3 days. Then within– when I went to go see him, it was within 2 hours. They had already extubated him. He was already breathing on his own with no problems whatsoever. Meagan: He was fine. Lauren: Yeah, he was fine.The next morning, my doctor went and talked to the doctors–Meagan: The pediatricians? Lauren: Yeah. Yeah at the NICU and just let them know, “This is wrong in the chart. This is wrong in the chart,” educating them about breech VBAC. She also did talk to them about the behavior of the nurse and she said, “It was unacceptable.” They talked about that. Oh, because that same nurse, when I finally got up to the NICU to see him, she had her back turned and she didn't see me coming and I heard her talk. She goes, “Well, you know, he came out the wrong way.” Then she realized that I was behind her and she walked away. I never saw her after that. Meagan: She probably was avoiding you. Lauren: I was like, Oh my goodness. I can't believe that just happened. Meagan: Seriously. Obviously, she's got a chip on her shoulder toward people who are doing things that are actually normal, just a different variation. Lauren: After my doctor talked to them that morning, as soon as she left, they called me and they weren't going to let me breastfeed or hold him or anything like that because he had a central line in his umbilical cord and they said, “It's too risky. It could fall out.” As soon as she left, they were like, “We're going to actually let you try to latch and hold him. We'll just have to be really careful.” Meagan: Good for your doctor for advocating for you guys. Lauren: That was one of my things that I just really love about her. That's not something that she had to do. She took the time out to review everything that night. I had him on a Saturday so she reviewed everything that night, got up early the next morning, went to the NICU, advocated for me, and I'll just never forget her for that. She's my angel.Meagan: Yeah. That's how it should be. That's really how it should be. Are you willing to share her name for anyone looking for VBAC support and especially for breech? Lauren: Yeah. Her name is Dr. Robinson and she's at Alabama Women's Wellness Center in Huntsville, Alabama. Meagan: Awesome. Lauren: Yes. It's really hard to find a VBAC-supportive provider in Alabama but breech VBAC? That's hard anywhere. Meagan: I have Alabama Women's Wellness Center because we have our supportive provider list that we are working on right now to perfect so everybody can get access to that in a better way and we don't have her on there so I'll make sure to add her. Lauren: Yes. Thank you. Yeah. She's amazing. That's probably an understatement. Meagan: She sounds absolutely incredible. I'm just so happy for you. I'm so glad that you had that advocate through a provider and it sounds like the second time, it was a little bit more of that informed consent, truly wanting to incorporate you into this experience with a little less of that the second time, but holy cow. Amazing. A minute and 40 seconds, that might feel like an eternity to someone watching, but really, that's actually pretty quick and your provider knew, “Okay, let's change positions. Let's move. Let's get this going,” and baby's out. It can be common for babies to come out a little stunned breech or not breech. Sometimes they come out a little stunned and you also had a really fast transition so you went from a 5 to a 10 really fast. There are a lot of things to take into consideration there for sure. Lauren: Yeah. I think she said that they charted from the time his butt came out is what they told her and with a breech, you're supposed to chart once the shoulders are out. Meagan: Yeah, the shoulders and the neck. That makes sense that they got that mixed up. Well, I wanted to go over the different types of breech. You already said this earlier that it's kind of crazy that 3-4% of people will have a full-term breech and I know baby number one was 36 weeks but pretty much right there right around the corner of full-term. But 3-4% and you've had two so it's pretty low but we know that breech is happening. It's just not being supported. I wanted to talk about a couple of different things.There are different types of breech and that is something that I think is important to know. We've got frank breech and that's where the baby's butt is down into the vaginal canal or down and the legs are sticking right up where the baby's feet are in front. Do you know if your baby was frank breech? Lauren: Yeah, they were both frank. Meagan: Yeah. That's typically where a provider, if they are supportive, will allow a vaginal birth, and then complete breech is where the butt is down and both the hips and knees are flexed. Footling is where one or sometimes both– it's like they are either standing inside or where they are being a flamingo and doing a one-foot thing facing down. Or we know that there is transverse where the baby is sideways. Footling and transverse– I mean, transverse for sure cannot come out vaginally. Footling has some more concerns so most providers will not support that. Anyway, overall, my suggestion is if you have a breech, one, know the options to try to help rotate a baby. If you so choose, there are also risks to ECVs. We have a blog around ECV and we want to make sure it's in the show notes. We are going to link some more about breech babies as well but know that you have options. You do have options. It's not like Lauren's first where she walked in and was felt that she was stripped away of all the options. If you're looking for a VBAC-supportive provider, something that I always tell my clients and I need to suggest this more on the podcast is while you are asking questions like, “How do you support VBAC?” and all of these questions talk about, one of those questions is “What if my baby's breech? What does that look like?” I think that's a really great question to add in there because then you can know, “Okay, not only is this provider VBAC-supportive, but they are even breech-supportive.” We never know. Sometimes babies just flip and sometimes they flip in the very end. It's very rare but it happens so it's just really important to know. Add that to your list of questions as you are going through and asking for support for VBAC how they are for breech. Do you have any other things that you would suggest for someone maybe going to have or deciding to have a breech birth in general? Lauren: Just try to be as knowledgeable as you can about it because that gave me a lot of peace just knowing all the facts and just the knowledge. It made me feel a lot more comfortable with it all. Meagan: Absolutely. It sounds like you did. You just told me a stat just barely so it sounds like you are very confident and you know about breech. I would suggest the same thing. Know the pros and the cons of all three– ECV, breech vaginal, and Cesarean. Let's learn all of them. Well, thank you so much for being here with me today and sharing all of your beautiful birth stories and letting me meet your sweet Ollie via Zoom and sharing these stories to empower other Women of Strength to make the best choice for them. Lauren: Yes. I really appreciate it. I was very excited when you asked me to come on. Meagan: Oh my gosh. We are so happy to have you. Lauren: Thank you. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Lauren has had three very different births. She had a peaceful C-section due to breech presentation with a difficult recovery, a wild, unmedicated VBAC, and a calm, medicated 2VBAC. Due to her baby's large size, she had to have an extra incision made during her Cesarean leaving her with a special J scar. Though her provider was hesitant to support a TOLAC with a special scar, Lauren advocated for herself by creating a special relationship with her OB and they were able to move forward together to help Lauren achieve both of her VBACs. Lauren talks about the importance of having an open mind toward interventions as she was firmly against many of the things that ended up making her second VBAC the most redemptive and healing experience of all. How to VBAC: The Ultimate Prep Course for ParentsFull Transcript under Episode Details Meagan: Hey, hey everybody. Guess what? We have our friend Lauren and her 11-day-old baby. Is that right? Lauren: Yeah. Meagan: 11 days old. You guys, I actually didn't even know that this baby existed until we popped up on the Zoom and she was holding this precious little newborn. She was like, “Surprise! I had another VBAC.” So we will be sharing, well she will be sharing her two VBACs so 2VBAC and something kind of unique about Lauren is that she has a special scar, a special J scar, correct? Lauren: Yep. Meagan: Yeah, so that happened in her first C-section. If you are listening and you have a special scar or have been told that you have a special scar, this is definitely an episode that you are going to want to put on repeat and save because I know that there are so many people out there who are told that they have a special scar and that they should never or can never VBAC again. I know we're not even getting into the story quite yet, Lauren, but did you have any flack with that? Did anyone talk about your special scar at all? Lauren: Yes. Advocating for the VBAC is probably the overarching theme of my VBAC because I really had to go to bat for myself for that without switching providers. Meagan: Yeah. We know that's so common. We see it a lot in our community just in general trying to get a VBAC let alone a VBAC with a special scar. We are going to get into her story but I have a review and I didn't even know that this was a review. It was left in a Baby Bump Canada group on Reddit actually so that was kind of fun to find. It's really nice. It says, “Seriously, I'm addicted. I find them so healing. I had an unplanned and very much unwanted C-section and I have been unknowingly carrying around all of these emotions and trauma about it since. I thought I was empowered going into my first birth, but I wasn't strong enough to stop the medical staff with all of their interventions. Don't get me wrong, I believe interventions are necessary in some instances. But looking back now, I realize those interventions were put in place to make things easier involved in delivering my baby. Anyway, I won't get into all of that here, maybe in a separate post. The point of my post is checking out The VBAC Link podcast. I listen to them all day now while caring for my babe. They also have a course you can take focusing on preparing for VBACs. Even if you just like birth stories, they have CBAC stories I believe as well. On the podcast, a guest also pointed out that what do you want for a VBAC birth– peace, redemption, etc.? She talked about how you can still feel those things if you need a Cesarean.” I love that point of view right there that you can still have peace and redemption even if you have a scheduled C-section or if your VBAC ends in a Cesarean. It says, “Another mom pointed out when she was feeling hesitant about saying okay to a C-section, her midwife said, ‘You have permission to get a C-section,' not in a way that a midwife was giving her permission, but telling this mom, ‘C-section is okay and you shouldn't feel like having one is wrong.' My baby is 8.5 months and we aren't going to try for a baby until they're about 18-24 months mostly to increase my chances of VBAC, but I really love these podcasts.” Then she says, “Okay, I'll stop raving now.” I love that. Her title is, “If you're considering a VBAC, I highly recommend The VBAC Link.” Thank you so much to– I don't actually know what your name is. Catasuperawesome on this Baby Bump Canada group. Just thank you so much for your review. As always, these reviews brighten our day here at The VBAC Link but most importantly, they help other Women of Strength find these stories like what we are going to be sharing today with Lauren's story. They help people feel empowered and educated and motivated and even first-time moms. They are really truly helping people learn how to avoid unnecessary Cesareans. I truly believe that from the bottom of my heart. Meagan: Okay, Lauren. As you are rocking your sweet, precious babe, I would love to turn the time over to you to share your stories. Lauren: Awesome, thank you. It's so nice to be here finally. I'm so excited because this podcast truly is the reason why I had my VBAC. I am kind of weirdly unique in that I didn't really feel like I had any mothering instincts. My husband and I had been married for 6.5 years before we decided to get pregnant because I always swore off children. I said, “It's not for me. I'm never going to have children. I want to travel and I want to do all of these things and children are for other people. I can't imagine myself as a mom.” My husband said, “Well, let's wait until we are 30,” because we got married really young. He was like, “Let's just wait until we are 30 and we will revisit the discussion.” I always find it kind of nice when I hear stories of women who feel similarly to the way I did because it's so relatable and I feel like we are very few and far between. That's another reason I wanted to share my story because I know there are other women out there like me. So anyway, it just so happened that at this time, my sister was pregnant. My brother was pregnant. My husband's brother was pregnant. We were like, “You know, we're almost 30. We've waited a long time. If we're going to have kids, we might as well have a kid when he or she is going to have all of these cousins.” My husband was like, “Let's start trying.” I'm like, “Great. I'm going to give it two months and if we don't get pregnant, we're not going forward with this. I'm going to say I tried and I can tell everyone I tried and that it didn't work.” Well, God has a sense of humor because two weeks later, I had a positive pregnancy test. Meagan: Two weeks later? Lauren: Yes. Meagan: So you were already pregnant when you had this conversation. Lauren: I was already taking birth control. I was multiple days into the pack. I just threw it in the trash and was like, “Let's just see what happens.” I guess when you do that, you can get pregnant. I don't know. I didn't really have a cycle. I got pregnant. I was so naive about how it all worked. I'm like, “Okay. The test is positive. I'm pregnant. It is what it is. I'm very much pregnant.” I had not doubt. I had no worry about miscarriage, nothing because I had a positive pregnancy test. That's sort of how I went through my pregnancy, kind of disconnected, very naive, and a little bit in denial that I was actually pregnant all the way up until the end. I read one book and it was called The Girlfriend's Guide to Pregnancy and it's this really sarcastic, funny book. She's very flippant about pregnancy and very straightforward with my sense of humor. I liked it because I felt the same way. I wasn't mushy or emotional. I had no connection to the pregnancy. I am pregnant. That's a fact. Anyway, at 26 weeks, my doctor was like, “You know, I think he's breech.” I was like, “Okay.” I knew what breech was, but I'm like, “Okay, what does that mean?” She was like, “Well, I would start doing some Spinning Babies exercises. Let's just keep an eye on it. I was going to a chiropractor this whole time. This is important for people to know. I was going to a chiropractor before I even got pregnant regularly. This chiropractor was seeing me. I told her that the baby was breech. “Can you help me flip him? Can we do some bodywork?” I continued to see her. I don't know if it was once or twice a week but it was often. 36 weeks rolls around and I see the midwife in the practice. She is not finding the heartbeat where it should be. She finds it up higher and she goes, “Lauren, I think your baby is still breech.” I thought there was no way. I had been seeing a chiropractor. I had been doing body work and stuff. She was like, “Well, why don't you go see the chiropractor that our practice recommends?” I'm like, “Okay.” I call this chiropractor on the phone. I leave her a message and I'm like, “I've been seeing another chiropractor, but my baby is breech.” She immediately called me right back and she was like, “What has the chiropractor been doing?” I'm like, “It feels like a normal adjustment like nothing different from before I was pregnant.” She was like, “So you've been on your side and she's been twisting your back and your pelvis away from each other?” You know how they do those kinds of adjustments? I said, “Yes.” She was like, “Oh my gosh.” She's like, “How soon can you come see me?” I started seeing her. My OB actually also recommended moxibustion. She got me set up with an acupuncturist in the area which I thought was really cool that she was like, “Some people say they swear by this. You need to do more Spinning Babies. I want you to go to acupuncture.” I saw this chiropractor and she was like, “What that chiropractor is doing to you is not pregnancy-safe. She's not Webster-certified and you needed to be seeing a Webster-certified chiropractor.” That's one of my regrets because I feel like had I known, obviously, I can't say I blame her 100%. I was also working out a ton because I'm like, “I don't want this pregnancy to change my body. I'm going to be skinny.” That's all I cared about so I'm sure I was holding my abdominal muscles way too tight too. I'm sure I contributed to it as well, but just knowing that probably was a major contributor to what ended up happening to this day irritates me. But anyway, he never flipped. He was solidly in my ribcage. He never moved. I would push on his head and he would not even budge an inch. My doctor was like, “You know, I would normally recommend an ECV, but he seems very wedged in your rib cage. He's stargazing,” which means his head is tilted up. His chin is pointed up. She said, “You are on the low end of normal for amniotic fluid.” She was like, “You have these three strikes against you basically. We can try it if you want to try it, but I'm going to say it's probably not going to work.” I had to wrestle with that. I ended up calling my husband's aunt who is a labor and delivery nurse for 30 years. I asked her for her opinion. I'm like, “Have you ever been in on an ECV? Tell me about it.” Naively, I went with her advice. She said, “If your doctor is not confident, then that means it's not going to work.” She's like, “I've seen so many births and I believe that every baby should be delivered via C-section because birth is dangerous and it's scary.” I'm like, “Okay, okay. I'm just going to move forward with the C-section. I'm so glad I talked to you.” Meagan: Whoa. Lauren: We scheduled the C-section and you know what? It really wasn't that big of a deal. My friend's husband was actually my anesthesiologist. My doctor was there. It was very happy. It was very pleasant. I had gone out to dinner with my friends the night before. If you could plan the perfect C-section, it was the perfect C-section. I just talked to my friend's husband the whole time. Again, not connected to this pregnancy at all. It was very much like, “Okay, a baby is going to come out. What is this going to be like?” I remember the doctor held him up over the curtain. I made eye contact with him and I was like, “Oh my gosh. I'm a mom.” The nurse was like, “Do you want to do skin-to-skin?” I was like, “What's that? Sure.” “Do you want to breastfeed?” “I think so. Sure.” Very naive. What ended up happening was that the recovery was just really tough. The surgery was great, but I did not expect the recovery to be so tough. I feel like the way people speak of C-sections is so casual. “Oh, just have a C-section. I had C-sections for all my babies. It's no big deal. It's a cakewalk.” That's the mindset I went into it with. Same with my husband because I reassured him, “It's no big deal. We're just going with the flow.” No. It's awful. It's major surgery. I'm allergic to– I think a lot of people are– the duramorph that they put in the spinal so I had the most severe, horrible itching for 24 hours to the point that they basically overdosed me on Benadryl because I could not cope and my vitals were crashing. I was barely having any respiration. They had to shake me awake and put cold washcloths on my head. They were like, “Hello,” because I was having such a hard time with the itching. Not only that, but the pain. It's painful. In my surgery, backing up a little bit, the doctor said, “Wow. He's really wedged in there and he's a lot bigger than I expected. I thought he was going to be maybe 7.5-7.25 pounds.” She goes, “He tore your incision coming out because he was so big.” She was like, “You have a J incision now so your incision goes horizontal and then vertically up.” She said, “Unfortunately, that means you'll never be able to have a VBAC. You're just going to be a C-section mama.” I was just lying there like, “Whatever. You're asking me what skin-to-skin is and breastfeeding and no vaginal births.” It was just a lot of information to process and take in and make decisions about. He ended up being 9 pounds. He was a good-sized baby. Anyway, that was my c-section experience. I know I'm probably one of the lucky few who could say that their C-section was so peaceful, really no trauma from it. I just thought, “I'm fine with that.” I watched my sister have a failed TOLAC and it looked kind of traumatizing and she was still traumatized from it just a couple months before my C-section so I'm like, “It's fine. I'll just be a C-section mom, but that recovery was terrible so I'll have one more baby and that's it.” I'm not going to have any more kids. I don't want to experience that again. That was May 2019. Fast forward to COVID times. We were thinking about getting pregnant before my son turned one but COVID hit so we were like, “Let's just give it a couple of months and see what shakes up with this pandemic.” The world stopped. I'm in real estate so for a while, we weren't allowed to show any property or do anything so I just was sitting at home doing nothing. I remember one night, I was just sitting there doing a puzzle bored as heck and I'm like, “I'm going to go listen to a podcast while I do this.” My phone suggested The Birth Hour. I hope I'm allowed to say that. Meagan: I love The Birth Hour, yes. Lauren: I was scrolling through the episodes and there was one on VBAC. I'm like, “Okay, I'm going to listen to this.” The interviewee mentioned The VBAC Link so I was like, Okay, I should check that podcast out. I was like, Why am I even listening to this? This is so not my wheelhouse, childbirth. I still didn't care about it, but listening to these podcasts opened up a whole new world for me. I'm so glad I found it all before I got pregnant. I started listening to all of those podcasts then I think I found through your podcast. I don't think it was The Birth Hour. Someone mentioned Dr. Stu so I started listening to his podcast and man, that guy set fire. He had so much great information. I listened to every podcast pretty much that he had done, especially the ones on VBAC because he talks about VBAC a lot and just how it really shouldn't be a big deal or shouldn't make you high risk and all of that. At the time, he was still graciously reviewing people's op-reports for them and now he doesn't do that. I think you have to pay for it, but I emailed him. I reached out to him and I emailed him my op report and I just said, “If you could look at this, my provider told me I wasn't a VBAC candidate but I want your opinion.” He got right back to me and he was like, “There's no reason you can't have a VBAC. This scar is really not that big of a deal. Yes, it's a special scar, but it shouldn't take away from your opportunity to TOLAC.” I ended up getting pregnant in the fall of 2020 and I went to my first appointment and my OB was like, “What do you want to do for your birth this time?” I'm like, “Did she forget what she told me? She must have forgotten.” I was like, “I want a VBAC.” She was like, “Okay, I'll give you my VBAC consent form and we can talk about it as your pregnancy progresses.” I'm like, “Okay, cool.” I saw her again at 12 weeks and she was like, “I'm having some hesitations because you had such a big baby and your scar is not normal. I think we need to talk about this a little bit more but let's not worry abou tit now. We can put it off and worry about it later.” I was like, “Okay.” I was so bummed because I love my OB. Funny story, I met my OB when I was worked for a home design company called Pottery Barn and I met her one day just helping her buy pillows. I'm like, “What do you do for work?” She was like, “I'm an OB.” I'm like, “Cool. I need an OB.” I had just moved to the area so I just started seeing her. I think I was one of her first patients so she knew me. It wasn't like she was a friend and a provider I only saw once a year, but we always picked up where we left off. We had a good relationship. I really did not want to change providers. I don't want this to sound like I was being manipulative, but I was like, I'm just going to really lean into this good relationship we have and just try to win her over. As the pregnancy progressed, at the next appointment I think I saw a midwife. I talked to the midwife about the VBAC and my OB's opinion and she was like, “I've seen a lot of women VBAC with a J scar at my old practice. I don't think it's a big deal, but I'll talk to the doctor for you and hopefully, we can figure this out.” I was like, “Okay.” Then I want to say I went to my 20-week appointment and they told me, “Okay, your baby is gigantic.” They said, “He is going to be between 9 and 10 pounds,” because he was measuring two weeks ahead. They said, “But the other concern we have is that you have marginal cord insertion and that could make for a small baby.” I'm like, “Okay, so is he big, or is he small?” Clearly that marginal cord insertion is helping him not being 12 pounds? What are you trying to tell me? They're like, “Either way, we suggest that you come back at 32 weeks. We have concerns about his size. He might be a tiny peanut. He might be enormous.” I'm like, “I think I'm good. Thanks, but no thanks.” Thanks to you guys, you push advocation so much that I'm like, “This doesn't add up. You can't tell me that he's too big and too small. I'm just going to go with fundal height and palpation if my doctor has a concern, we'll come back.” I never scheduled that growth scan. I was very protective of this pregnancy. I didn't want any outside opinions. I was so afraid that if I went and had this growth scan, I would be pushed to do a C-section. I wanted an unmedicated birth. I was terrified of the hospital. I was listening to so many podcasts all day every day. It was like an obsession so then I told Meagan before we were recording is that I felt like I was almost idolizing the VBAC. It was all I could think about. It was all I could talk about and it became this unhealthy obsession. Right around 25-26 weeks, I decided to hire a doula and move forward with the VBAC. It didn't matter to me what the doctor said. Right around that time, I was having some hesitations. Just getting that pushback from my doctor and knowing he was big, I started to let the fear creep in. I told my husband, “You know what? Maybe we should just do a C-section. I think I'm overanalyzing this so much. I'm just going to push aside this research I have done because clearly I'm obsessed and it's consuming me.” Meagan: Yeah, which is easy to do. Just to let you know, it really is easy to let it consume you. Lauren: It totally is. I think that we have to take a step back sometimes, come back to reality, and if you let the information override your instincts which I think is really easy to do, I think you can get too wound up or too set on something that might not be meant for you. Speaking of instincts, that night, I still remember. I had told my husband, “I'm just going to have a C-section.” I went to bed and I had a dream. I was in the hospital in the dream and I was holding my baby and my dad walked in. I have a really great relationship with my parents but especially my dad. I love my dad. He comes in the room and he's like, “How did it go?” He was meeting the baby for the first time and I burst into tears in the dream. I said, “Dad, I didn't even give myself the opportunity to VBAC. I just went in for a C-section. I just have so much regret about it and what could have happened if I had tried to have a VBAC.” Meagan: That just gave me the chills. Lauren: Yes. It was so weird. I have never really had a dream like that before. I woke up and I was like, “There's my answer. I have to move forward with this.” Having that dream gave me this peace that there is the instinct I need to follow. Yes, I have all of this information that is consuming me, but it was like, Keep going. I hired a doula which I found through The VBAC Link Facebook page. I put it out there, “Does anyone know a doula in my area?” Julie commented and it happened to be her really good friend who had just moved back to my area. I called her and it turned out that we had mutual friends. We connected really fast. I think, like I said, it was about 26 weeks. I go to my OB again and we had more of a pow-wow like a back-and-forth on the VBAC option. She was like, “I'm just worried about it. A C-section is not that big of a deal. We could just tie your tubes and then you won't have pelvic floor issues.” False. I said, “I got a second opinion from another doctor.” I didn't say it was Dr. Stu. I didn't say it was some guy with a podcast in LA. I said, “I got a second opinion and I feel like I just want the opportunity.” We didn't really land on anything solid, but she got up to leave the room and she got to the door and she turns around. She came back over to me and she gave me this big hug. She said, “I don't want to disappoint you. I want you to be happy, but let's keep talking about this.” I was like, “Okay.” That gave me a little bit of reassurance that I was leaning into that relationship I had built with her over the years because it had been 6 or 7 years of seeing her. I would also bring her flowers. I would always try to talk to her about her life and making a social connection with someone. If you let your doctor intimidate you just from the standpoint of being a stranger, I feel like that can really change the course of your care. But if you try to get to know people, and that's not necessarily a manipulative thing, but I think it's important. It should be important in your relationship with your doctor. If you don't feel like you can connect with them, there is issue number one, but I really felt like I could connect with her. I leaned into that. I have a cookie business on the side. She loved my cookies. We just had some other things to talk about other than my healthcare and I feel like it set this foundation of mutual respect. What doctor comes over, gives you a hug, and tells you, “I want you to love your birth”? So fast forward again, I see her again the next time and she said, “Look. I brought your case to my team and because we support moms who have had two C-sections, we felt like your risk is similar to theirs and that it shouldn't risk you out of a TOLAC so I'm going to support you if this is what you want.” I had given her this analogy that I think was Julie's analogy. She said, “If you needed heart surgery and you were told that you had a 98% chance of success–” because I think my risk of rupture was 2% or maybe a little bit lower, maybe 1.5. I told her this. I'm like, “If you told me I needed heart surgery and I had a 98 or 99% chance of success, we would do it. There would be no question. I have this 1% risk of rupture. I'm coming to the hospital. What gives? I should at least be able to try.” The problem is, I'm sure some people are like, “Why didn't you just switch providers?” We have three hospitals in my area. One is 20 minutes from me and two are one hour away. One of them which is an hour away is the only place where I can VBAC and there isn't a VBAC ban. There is maybe a handful of providers who deliver there. I knew my provider was VBAC-supportive sort of. She had the most experience of a lot of the providers around me so that's why I didn't switch. I had very minimal options for care. I couldn't go to LA or I couldn't go somewhere further away. It would be a four-hour drive either way. We are in an isolated area. I felt like that was a huge win. We are set to go. I remember I told Katrina. Katrina was so happy for me, my doula. I just soldiered on. I started taking Dr. Christopher's Birth Prep at 36 weeks. I was doing my dates and I was really busy in real estate. That's part of my story. I was so busy working super hard and I was getting to the end of my pregnancy. At 38 weeks, I went in and I had clients lined up showings coming up. I was like, “I can't have a baby anytime soon.” I was talking to my provider about it. “Maybe at 40 weeks, we can talk about a membrane sweep or something. I have so much on my plate. I can't have a baby this week.” My husband is a firefighter and his shift that he was going to be taking off was starting maybe the following week. I'm like, “He's not even going to be home. He's going to be gone most of this week. This is a horrible week to have a baby.” I let her check my cervix because I'm like, “I want to see if my birth prep or my dates are doing anything.” At the same time, I still had this fear of, What if I do all of this work and I don't even dilate? That was kind of what happened with my sister so I had that fear in the back of my mind. She checks me and she was like, “You are 2 centimeters dilated, 50% effaced. You're going to make it to your due date no problem. We're not even going to talk about an induction until 41 weeks.” She was like, “I'm just not worried about it. He doesn't feel that big to me. He doesn't feel small. He doesn't feel too big. He feels like a great size.” I said, “I know. I feel really confident that he's going to be 8 pounds, 2 ounces.” I spoke that out. I said, “That's my gut feeling. I just have so much confidence and peace about this birth. I just know it's going to work out.” I go on my merry little way from that appointment. I'm walking around. We had gone down to the beach. We were walking around and I'm like, “Man, I'm so crampy. For some reason, that check made me so, so crampy.” This was 38 weeks exactly. We go back home and I have prodromal labor that night. I'm telling Katrina about it. She goes, “You know, I bet the check irritated your uterus.” The next day, I start having some bloody discharge. I'm like, “What is this? What does this mean?” I told Katrina and she said, “It could mean nothing. It could mean labor is coming soon. We'll just have to see.” I hadn't slept the whole night before. She was like, “You need to get a good night's sleep.” I had to show property all day. I met these clients for the first time. I showed four or five houses to them and meanwhile, I'm like, “Gosh, I'm so sore and tired and crampy.” I told them, “I'm very obviously pregnant, but my due date is not until the end of the month.” This was June 10th and my due date was June 23rd. I said, “We have time. If you need to see houses, it shouldn't be a big deal. I don't want my pregnancy to scare you away.”That night, I get home and I'm like, “I'm going to bed. It's 8:00. I'm going to bed. I'm going to take Benadryl and I'm going to get the best night's sleep.” They call me at 9:00 PM and they're like, “Lauren, we saw this house online. It's brand new on the market. We have to see it.” They lived a couple of hours away so I'm like, “I'll go and I'll Facetime you from the house. I'll go tomorrow.” Tomorrow being June 11th. I'm like, “We'll make it happen. I promise I will get you a showing on this house.”I texted Katrina and I'm like, “Oh my gosh. I feel so crampy and so sore. Something might be going on, but I have to work tomorrow. I'll keep you posted.” I wake up the next morning. It's now June 11th and I lose my mucus plug immediately first thing. There was some blood. It was basically bloody show. I told Katrina and she's like, “Okay, just keep me posted. I have a feeling he's going to come this weekend. It was a Friday. I'm like, “Well, he can't because my husband works Saturday, Sunday, Monday. I don't have time to have a baby.” We go to the showing. I'm finally alone without my toddler and my husband. I'm in the car and I'm like, “Man, my lower back hurts. It's just coming and going but nothing to write home about, just a little bit of cramping.” Of course, I never went into labor with my first so I did not know what to expect. I get to the showing and this house had a really steep staircase. I'm Facetiming my clients and I'm going up the stairs. It was probably at noon and I'm thinking to myself, Man, it's really hard to go up these stairs. Why do I feel so funny? I finish up the showing and they're like, “We want the house. This is the house for us.” I get back in the car. I'm getting all of their information. I'm talking to the other agent. I start the offer and I'm like, “I'm just going to drive home and get in my bed because I don't feel good. I'm just going to write this offer from my bed and everything will be fine.” I get home and I tell my husband at 2:30, “I'm just going to sit in our bed and get this offer sent off.” Mind you, I had a work event, a big awards event that night for my whole office and we were going to have to leave at 4:00 PM. My in-laws were going to come get my son and take him to sleep over. It's 2:30. I'm writing this offer and I'm like, “I don't feel good.” My partner calls me. I tell her, “Listen, I don't know if I'm in labor, but I don't feel well. Maybe I have a stomach bug. I'm going to write this offer. I'm going to give you my clients' information and I want you to take over for me a little bit. They know I'm really pregnant, but this could just be a sickness but either way if something happens, I want them to have the best care and be taken care of if we are going to send this offer off.” I send the offer off. It's 3:30 at this point. I close my computer and I'm waiting for them to DocuSign. I text my husband, “There's no way I'm going tonight. I don't feel well. Something is up. I'm not sure what.” He didn't see my text for a little while. He comes in the room at 4:00 and he starts to talk to me. I literally fall to the ground with my first contraction. I'm in active labor.I don't know it yet, but I'm in active labor. I'm just like, “It feels like there's a wave crashing in my body.” That was the best way I could describe it. I'm like, “I feel this building. It's an ebb and flow,” but it reminded me of playing in the waves as a kid because I grew up in Orange County at the beach and just that feeling of the waves hitting you when you are playing in the surf. I'm like, “This is really intense. What is going on?” I'm like, “I'm certain it's a stomach bug.” I told him, “I have gas or something.” I was just like, “I'm going to give myself an enema and this will all go away.” I did that and sitting down on the toilet, I was like, “Oh my gosh.” It made everything so much more intense. I texted Katrina, “Something is going on. I'm not really sure it is.” She's like, “Well, why don't you try timing some contractions for me and let me know?” I crawl into my closet. I can hear my son and my husband getting ready. My son was 2 so of course, 2-year-olds are not always behaving. I can hear them interacting. I crawl into my closet and I'm lying on the floor in the dark. The contractions are 3.5-4 minutes apart lasting a minute. I was like, “I'm still pretty sure this is a stomach thing that is happening every 3-4 minutes.” I call Katrina and I'm like, “I don't know. I think I'm in labor. This is the length of my contractions. It's probably just prodromal.” I had so much prodromal.She was like, “Um, it doesn't really sound like prodromal labor, but I'll let you just figure it out. You let me know when you are ready for support. Make sure you are eating anything. Have you eaten anything today?” “No.” “Have you had any water?” “Not really.” “Okay. Please eat something. Please drink some water and keep me posted.” She goes, “Can you talk through the contractions?” I said, “I can cry.” She's like, “Okay. I'm ready to go as soon as you tell me.” Then the next thing I know, literally, this is probably an hour later so at 4:00 I had my first contraction. Now it's 5:00 and I'm like, “The contractions are 3 minutes apart and lasting a minute.” I said, “Maybe you should come over. I think Sean (my husband) is getting a little nervous.” We were still so naive. We didn't know what labor looked like and what was going on. We were like, “If we're not going to the event, why don't we just keep August (my son) at home? I'll just make him dinner and I'm going to make you dinner.” He starts prepping dinner and I'm like, “I don't think either of us really know what's going on.” Of course, Katrina knew what was going on and probably thought I was a crazy person but I was very much in denial. We texted her to come over and she gets there. I'm lying in my bed and she's like, “Okay, yeah. They're coming 2.5-3 minutes apart. If you're ready to go to the hospital, I'm ready to go with you.” I'm mooing through these contractions, vocalizing everything. I'm like, “It just feels good to vocalize and I just really keep having to use the bathroom. It's probably just my stomach.” She's like, “No.” I can hear her outside my bathroom telling my husband, “I think we should go. She's really vocalizing a lot and that usually means it's pretty substantial, active labor.” Meanwhile, all I can think about is, “I've got to get this offer in for my clients.” I'm waiting on DocuSign, checking my email. Finally, it comes through. This is 6:00, maybe 6:30. I see it come in. I send it off and I'm standing at my kitchen counter with my computer on, mooing, doing this freaking offer. I go to cross my legs as I'm leaning over and I'm like, “I can't cross my legs, Katrina. I feel like my bones are separating.” She's like, “Yeah, baby is probably descending into your pelvis. I think we should get going if you're okay with going.” We have a 45 to an hour drive depending on traffic and the time of day. It's a Friday night so basically where I live, there's not a ton of traffic but we get in the car. She's following us and we get to the hospital. It's probably 7:15-7:30 or something like that. I'm telling my husband as I'm mooing through these contractions, “This really isn't that bad. If this is labor, it's intense and it feels like there's an earthquake in my body, but I would not tell you that I'm in any pain right now.” He's like, “Okay, whatever you say lady.” We ended up having to walk across the whole hospital parking lot to the ER because the regular hospital entrance was closed. As soon as we walked in the hospital, the hormones changed. The adrenaline kicks in. I start feeling pain. I start feeling a little bit panicky and it starts getting harder to cope through these contractions. I'm on the floor of the triage room crying into a trash can and everyone is staring at me. Katrina's like, “They need to stop staring!” She was trying to defend me while my husband is answering all of their dumb questions like, “What's your favorite color? What city is your mom born in?” They're like, “Let's just put you in a wheelchair and get you up there.” I'm like, “I can't sit.” Anytime I tried to sit, the contractions were a minute apart and they were so intense. I get there and I was so protective of this birth and outside interventions, I just was like, “Everything is evil. Cervical checks are evil. The epidural is evil. Everything is going to make me have a C-section.” I was like, “I don't want to know how dilated I am. I don't want anyone in this room to know except the nurse. That's who is allowed to know how dilated I am.” She checks me and the doctor comes in. It was the hospitalist and of all the providers in my area, it was miraculous that I got this hospitalist because he has so much experience. He is so calm, so kind, so supportive. He just said, “Hi, Lauren. I'm Dr. so-and-so and you're in labor. Happy laboring.” No concerns about my TOLAC, nothing. He didn't even bring it up. He didn't ask to check, nothing. Just, “Happy laboring,” and he left the room. I'm like, “Okay. Clearly I'm in active labor.” So then they were getting the tub ready because my room had a tub and as we were waiting for it to warm up, I'm sitting on the ball. I'm having all this bloody show. The nurse asked to check me again before I get in the tub. Unknowingly, I had been 5 centimeters when we arrived. I was 7 now when we got in the tub an hour later. I get in the tub and I wouldn't say it provided me any relief. Honestly, I was so in my head and not necessarily in pain, just so mentally unaware of everything going on, in labor land, but also very overwhelmed by the intensity of it. I told Katrina, “George Washington could have been sitting in the corner watching me labor. I would not have known.” I barely opened my eyes. I had a nurse who was there sitting with us because I had to have a one-on-one nurse for being high-risk and I had to have continuous fetal monitoring. Because I was in the water, she needed to sit there and make sure the monitors didn't move. I couldn't have told you what she looked like, nothing. I didn't speak to her. I was in another world. I think I maybe was in the tub for 30 minutes to an hour. It's probably 9:00 or 10:00. I can't even remember the timeline of it but it wasn't that long of a labor. My water breaks and I start grunting. They're like, “Let's get you out of the tub. Let's get you out of the tub.” I think I was 9 centimeters at this point. We arrived at 7:30. This is probably 10:00 PM or something like that. I'm like, “Okay. I'm just going to lean over the back of this bed and just moo and make noises.” Me being who I am and not super emotional, I'm making jokes about how I sound. I'm like, “You guys, I sound like Dory in Finding Nemo. I'm so embarrassed. Please don't look at my butthole.” I was naked. I'm making all these jokes and coping, I would say pretty well in terms of pain but just very overwhelmed by the intensity of it. They come in and check me and they're like, “Okay, you're complete.” This is at 11:00 PM maybe or 10:30, something like that. But she was like, “You have a little bit of a cervical lip.” It was a provider I hadn't met before at my OB's office but they were like, “We will just let you do your thing. You sound pushy but please don't push because you have a lip. Let's just let him descend.” I could feel his head inside of myself. I could feel his head coming down. I was like, “I want it to be over. I want it to be over.” I'm still in denial of this whole thing this entire time. Are we sure it's not poop? I know there's a baby coming out. Once my water broke, I'm like, “Okay, I guess I'm having a baby.” That was really, truly the first time that I was like, “Okay, this is really happening.”Maybe 30 minutes later, the hospitalist peeks his head in the room and he's like, “Lauren, why don't you try laying on your side?” I tried and it was too painful. I flip over on my back and three pushes later, he comes flopping out. I screamed him out and it was super painful. I was so overwhelmed by how painful it was. I just screamed like a crazy, wild woman. He's on my chest and he's screaming and I'm in all this pain and then she's like, “I've got to give you lidocaine. You tore a little bit. I'm going to stitch you up.” It was just all this pain happening at once, but I was like, “I got my VBAC. That's all that matters. No one touched me and I got my VBAC. I don't care about anything else.” Anyway, it was great. I would not change it for the world because I never had a ton of pain. I never really thought I needed an epidural, but it was a little bit mentally overwhelming. Meagan: Mhmm, sure. Lauren: Anyway, that was my first VBAC. The doctor said, “You pushed so primally. That was the most amazing thing I've ever seen.” The hospitalist was like, “That was incredible to watch. You are a badass.” I was like, “That was such a compliment because I didn't know what I was doing and you're this doctor with all the experience.” Anyway, fast forward to my third pregnancy. This is now the summer of 2023. We decide we're going to have one more baby. I of course had no issues with the VBAC this time because I had a successful TOLAC with my second. I made it to 20 weeks. I had COVID, RSV, and the flu all right around then so they were telling me, “Your baby is measuring totally normal.” I'm like, “Yeah, because I've been sick as a dog for 6 weeks.” I'm like, “Maybe I'm going to get this newborn who is a normal size,” because my son was born at 38 and 2, the second one, and he was 8 pounds, 3 ounces. I had told my doctor 8 pounds, 2 ounces. I was one ounce off. I was like, “Maybe I'll get this little peanut baby and it's going to be so great. I'll finally have a newborn who fits in a diaper for more than two days.” Then I hit 33 weeks and I got huge. I just exploded inside. I go to my OB and I'm like, “I don't feel good. I'm too big. This baby is too big. Something is wrong.” She's like, “No, Lauren. I really just think you make big babies and he just went through a growth spurt. Let's not worry. I'm not going to have you do an ultrasound or anything like that. If he continues to measure 2-3 weeks ahead,” because I was measuring 36 weeks at 33 weeks, “then we can talk about it, but I don't want to worry about it.” I was like, “Okay.” I was having all of this round ligament pain more than I had with my others and prodromal labor was so painful. I remember telling Katrina who I hired again, “I feel like something is wrong with my muscles. I just am so uncomfortable. But I don't want to make any rash decisions based on it. I might get an epidural if this keeps up because this doesn't feel normal. “She was like, “Okay, whatever works.” So I get to my 38-week appointment and I'm thinking, I'm going to have this baby at 38 weeks just like I had my second baby. I had everything ready. Everything was good to go at my house and then day by day, it ticks on. Baby is not coming. Baby is not coming. I was due April 6th. This was just this year, 2024. I get to 38 weeks. I tell my doctor, “Just strip my membranes. I don't even care.” She was like, “Okay, I guess if that's what you want.” She did. Nothing happened. 39 weeks rolls around. She strips my membranes again. Nothing really happens and then the night of Easter, I had this strange experience where I woke up in the middle of the night and I had this contraction that wouldn't end. I couldn't feel the baby move and it freaked me out. I did everything I could to get him to move. I was in the shower. I was eating. I was drinking and doing all of these things. Finally, I called Katrina at 2:00 in the morning. I'm like, “My baby's dead. I'm 100% sure he's gone. What do I do?” She's like, “Lauren, just relax. Lie on your side and drink something sweet.” We were ready to go to the hospital. I remember we had a stethoscope. I got the stethoscope and I put it right where I knew his heartbeat was and I heard a heartbeat. I burst into tears. It was the first time I've ever cried with any of my babies even being put on my chest. I just felt this relief because I had so much anxiety about him with my size being so big and the pain I was having. I was like, “I just want this baby out.” I never really felt that way, but it was this desperate anxiety. A couple of days passed and I'm now in week 39. I'm like, “My uterus is silent like a little church mouse. She's not doing a thing. She's not cramping. She's not contracting. No discharge, nothing.” I'm like, “This baby is never going to come.” I tell my doctor at my 39-week appointment, “If this baby hasn't come by Friday, I'm back here and I want another membrane sweep.” I felt kind of crazy because I'm like, “This is technically an induction, like a natural and I'm intervening.” Me who never wanted anyone to touch me and now I'm like, “Please touch me and pull this baby out of my body.” She goes to check me and she's like, “Lauren, I think he's coming tonight. Your body contracted around my hand when I tried to sweep you. I just wouldn't be surprised. Don't worry.” I'm like, “Okay, well you're breaking my water on Monday.” I was 3 or 4 centimeters dilated and I'm like, “We're waiting until Monday but I want you to break my water because I'm over it.” She's like, “That's a good idea. Let's threaten this baby and he'll come right out.” This was early in the morning on Friday, the 5th. Anyway, I had all of this anxiety and I just felt like he needed to come out. I couldn't get any peace until I knew he was alive and happy and healthy and on my chest. Friday afternoon, I felt crampy just a little bit the whole day and then at 4:30 PM, I feel this gush and I'm like, “Okay. Is that my water or is it my pee?” because his head felt like it was on my bladder. I didn't say anything to anyone. Then 6:00 rolls around. I text Katrina. I'm like, “Listen, I felt a little gush and I keep feeling it. I put a pad on and it doesn't seem to be urine. I'm not really sure what's happening. I'm just going to do some Miles Circuit and I'll update you.”At 7:30, I'm cleaning my kitchen and all of a sudden, I'm hit with an active labor contraction. I'm like, “Not again. I want labor to start normally so I know what's happening.” No. Baby's like, “I'm ready.” At 7:30, I tell her, “Okay, I'm feeling contractions. I'm getting in the shower to see if it will stop. It might be prodromal. Let's give it an hour. I'm going to text you, but they are 2.5 minutes apart.” She's like, “I'm at dinner. I'm getting boxes. Just let me know.” I was like, “Okay. It might stop though so I wouldn't worry about it.” No, it did not stop. She gets to my house at 9:00 and my car is already running. I'm like, “We're going.” I am mooing through these contractions. I'm going to pop this baby out right now. I had thankfully put some chux pads in the back of my car. I'm on all fours in the back of my car. Mind you, we have to drive an hour to the hospital. I peed all over the chux pad. I just was like, “He's on my bladder. He's on my bladder.” It was so painful and I couldn't control anything. I'm like, “Is this water? Is this pee? I don't even know what's happening.” We get to the hospital. He did not come in the car, thank God, but we did have to go to the ER again and the ER was taking forever. It took a half hour to get me up to labor and delivery as I'm actively mooing in front of the hospital. I was like, “I'm not going in,” because there was a little girl sitting in the waiting room and some convict sitting with a police officer. I'm like, “I'm not having my labor in front of these people!” Even the police officer came out and he was like, “I don't understand what is taking so long. You are clearly about to have this baby. I will bust open these doors for you and walk you up to L&D myself if that's what it takes.” Finally, they got me up there. I arrived. I told Katrina and my husband, “You guys, I'm getting an epidural.” I said, “I have had so much anxiety and so much pain. This does not feel like my previous labor. This feels like I'm suffering.” I said, “I just want to smile. I just want to smile. I want to smile this baby out.” We get up there. I'm 8 centimters dilated. This was the part of the story that I feel like it comes back to advocating for myself. I go in there and I'm like, “I don't care what you need from me. I just need the epidural and stat.” The nurses are scrambling and this doctor walks in. I am on all fours on the bed just staring at the ground, actively transitioning. I see this doctor walk in. I see his feet and he had his shoelaces untied. Immediately, I'm just like, “No. It's a no.” I don't know why. I just was like, “Your shoes are dirty and they are untied. You seem like a hot mess. I'm already a hot mess. I want someone to come in and just be like clean-cut and normal.” He starts asking me all these questions. He's asking me my whole health history, everything about my grandparents, my parents, all of this stuff. I'm in transition then he goes, “You're aware of the risk of TOLAC, right?” I said, “Yes.” He goes, “That your uterus could burst wide open?” I literally saw red. I'm in a contraction and I just screamed like a wild lady. I was like, “Get out.” I wanted to add on some expletives and tell him to get out of the room. I just said, “Get food.” He was like, “I'm  just saying.” He ended up leaving and my nurse peeks her head under. I look over and I see this nurse peeking her head right into my face and it's the same nurse who was there with my first VBAC. She goes, “You don't have to accept care from him.” She goes, “Your doctor is actually the backup on-call doctor tonight.” She goes, “If you refuse care, we can call her and she can come in.” I was like, “Oh my gosh. This is a miracle.” We get the epidural. I'm like, “We've got to slow this thing down. I don't want to have this baby and have this crazy man who I cannot stand anywhere near my body parts, anywhere in this room.” We get the epidural and everything slowed down. I labored down. My doctor ended up coming in and she checked me. She was like, “Your bag is bulging. It feels like rubber. It's so thick.” She was like, “I think that's why he's not coming out.” We got to the hospital at 9:30-9:45. By the time we got in the room, 11:00 by the time I got the epidural, and the anesthesiologist was like, “You're going to have this baby in 30 minutes. I'm certain of it.” To slow it down, I'm closing my legs and doing all of these things to slow it down.My doctor comes in. She breaks my water and fluid goes everywhere. It floods the floor. She goes, “I don't remember any time I've ever seen this much water come out of someone without polyhydramnios. Maybe you had it. I don't know but this is an insane amount of water.” She breaks my water and then my epidural was a pretty low dose because he thought I was having the baby in 30 minutes. It's now 2:30 in the morning and I haven't had the baby yet. I'm getting up on my knees. I'm leaning over the back of the bed and I feel him descending. Then my doctor comes in an hour later and she's like, “Let's get this baby out.” It was 3:30 in the morning and she's like, “Let's go.” She feels me. She's like, “You're complete. I feel his head right here. You just need to push and you can't feel that his head is right here.” So I just get on my back, in lithotomy with the freaking stirrups like I said I would never do with the epidural I said I would never get and I pushed him out in three pushes. He was 9 pounds, 7 ounces. I am so glad I got that epidural. No regrets there because that's a really freaking huge baby. His head was in the 100th percentile or something like gigantic. I tore a little bit again, but I feel like the tradeoff was this peaceful, happy birth. I was making jokes. I had this nurse that I loved and knew. I had my doctor I loved and knew. I had Katrina and I had my husband who were the only people in the room and we laughed our way into this birth. I laughed my baby out basically. I was making jokes the whole time and I just had this peaceful experience. I told my husband, “I know I railed on the epidural my whole pregnancy and I said I would never get it,” but it's a tool ultimately. It's a tool. If you use it wisely, I was very far along. I said, “I don't think it's going to stop my labor.” I felt really confident in my decision. I didn't feel like anything was pushed on me. I made the decision. I'm happy I did it that way. Would I do it again that way? I don't know. I think with every birth, you should be open-minded to the possibilities and your needs. I hear so many stories where women are like, “And then I got the epidural. I had to.” I'm like, “It's okay. Own that decision. You're no worse off for getting it and it doesn't make you any less of a mom or any less of a good person for getting it. It's okay to not feel every single pain of labor if it's overclouding your ability to be in the moment.” Meagan: Yeah.Lauren: So anyway, that was my second VBAC story. Honestly, it was so redemptive because there was no trauma from the pain of having this wild, chaotic, primal birth. It was just peaceful and happy with all of the people. If I could have dreamt up a list of people who could have been with me, that's who it would have been. Meagan: Good. Oh, I love that you pointed that out. Well, I am so happy for you. Congrats again, 11 days ago and right now I want to thank you again so much for sharing your story. Lauren: Thank you for having me. ClosingWould you like to be a guest on the podcast? Tell us about your experience at thevbaclink.com/share. For more information on all things VBAC including online and in-person VBAC classes, The VBAC Link blog, and Meagan's bio, head over to thevbaclink.com. Congratulations on starting your journey of learning and discovery with The VBAC Link.Support this podcast at — https://redcircle.com/the-vbac-link/donationsAdvertising Inquiries: https://redcircle.com/brands

Welcome to this Aphasia Access Aphasia Conversations Podcast, a series of conversations about aphasia, the LPAA model, and aphasia programs that follow this model. My name is Janet Patterson. I am a Research Speech-Language Pathologist at the VA Northern California Healthcare System in Martinez, California, and a member of the Aphasia Access Conversations Podcast Working Group. Aphasia Access strives to provide members with information, inspiration, and ideas that support their efforts in engaging with persons with aphasia and their families through a variety of educational materials and resources. I am the host for our episode that will feature Lauren Bislick, in which you will hear about friendship, yoga, mental imagery and aphasia. These Show Notes accompany the conversation with Lauren but are not a verbatim transcript.   In today's episode you will hear about: the value of friendship in our lives and Mission SPEAK, ideas for creating an accessible yoga program for person with aphasia, and the value of mental imagery.  Dr. Janet Patterson: Welcome to this edition of Aphasia Access Conversations, a series of conversations about the LPAA model and aphasia programs that follow this model. My name is Janet Patterson, and I'm a research speech language pathologist at the VA Northern California Healthcare System in Martinez, California. Today I am delighted to be speaking with Dr. Lauren Bislick, a newly minted Associate Professor at the University of Central Florida, in the School of Communication Sciences and Disorders. Lauren is also the director of the UCF Aphasia House, and the director of the Aphasia and Related Conditions Research Lab. Across her work efforts, Lauren investigates the diagnosis and treatment of acquired apraxia of speech and aphasia, the value of mindful body practices such as yoga, friendship development, and interprofessional education and practice.    In 2023, Lauren was named a Distinguished Scholar USA by the Tavistock Trust for Aphasia UK. The Tavistock Trust aims to help improve the quality of life for those with aphasia, their families and care partners by addressing research capacity related to quality-of-life issues in aphasia. Congratulations on receiving this honor, Lauren. Aphasia Access collaborates with the Tavistock Trust for Aphasia in selecting the awardees and is pleased to have the opportunity to discuss their work and the influence of the Tavistock award.    Welcome Lauren, to Aphasia Access Conversations.   Dr. Lauren Bislick: Thank you, Janet, and thank you Aphasia Access for having me. Also thank you to the Tavistock Trust for the review team for nominating me and for selecting me. I'm truly very honored to be a recipient of this award.   Janet: It's a well-deserved award. Lauren, as we said, you were named a Tavistock Trust, Distinguished Scholar USA for 2023. You join a talented and dedicated group of individuals in this award. How does receiving the Tavistock award influence your clinical and research efforts in aphasia?    Lauren: First, I'll say again, I was truly honored to receive this award and was definitely surprised. The nomination announcement occurred at the Clinical Aphasiology Conference, and they didn't give us a heads up that the announcement was coming through, so I was very surprised. I think in terms of how this has influenced my clinical and research efforts as an academic, and as a clinician. I think a lot of people can relate to that feeling of imposter syndrome, and so receiving this award has helped me push that feeling to the side a little bit in some aspects of my work and of what I do. It's also allowed me to feel very proud about what I've been able to do. but more so through my collaborations and my students and the community that we have at UCF. It's allowed me to grow connection. Since receiving this award, people have reached out to me to talk about collaboration or wanting my help in terms of more of a consultant role. It's allowed myself and my lab to reach a larger group of people and has definitely supported that emphasis on quality-of-life work, which is not necessarily the training that I focused on when I was in my doctoral program. That's been something that I've come into in my time as an assistant faculty member or a junior researcher. It feels very good to be acknowledged for that and for these lines of work being supported.   Janet: And well deserved, for certain. Lauren, I would like to begin by asking you about your recent work investigating the role of friendship for persons with aphasia. I believe in the power of friendship and community during joyful times, and also during sad times in one's life. One of the unfortunate consequences of aphasia can be the loss or diminishing of friendships, or the communication skills important to developing and sustaining friendship and community. How did you become interested in this aspect of aphasia? And what conclusions have you drawn from your research?   Lauren: Thank you for this question. One of the things that I talk about frequently in both my aphasia course and the motor speech disorders for our graduate students, is how individuals with acquired communication disorders, whether it be linguistic, or motor based, is that their social circles get smaller, and we know that's a problem in life. Friendship is an essential component of quality of life, and as you said, whether celebrating the good things or you're going through a hard time you need those friends. This is an important area that I believe gets overlooked although now we have a couple of different groups looking at friendship and aphasia, which is wonderful. I actually have to thank Dr. Elizabeth Brookshire Madden for pulling me into this work. She is at Florida State University, and I like to call us aphasia sisters. We went through the same doctoral program, and she was one year behind me. We became very close during that time, both as friends, but also in the work that we do. [Aphasia Access note: Elizabeth Madden was selected as a Tavistock Distinguished Scholar USA in 2024.]   One of the other faculty members at Florida State University, Michelle Therrien, does work on friendship, but in the pediatric world. This grew out of conversations between Liz and Michelle, where they started talking about how we can look at friendship and aphasia. Clearly, we all believe it's an issue, but it hasn't been well investigated. That was shortly before the team Project Bridge Conference, which is really what helped initiate this kind of area of research for our group. Liz and I met at the 2018 Project Bridge conference and started facilitating a friendship group; she took the lead in this area. I got pulled to the yoga group, which we'll talk about later. Liz talked with a number of care partners of individuals with aphasia, and started discussing their social groups, and then friendship. Leaving that conference, she had some really great ideas about where to go next and what was needed in the area of friendship. From there grew her team of myself, Michelle Therrien, Sarah Wallace, at the University of Pittsburgh and Rachel Albritton, who's also at FSU.    In our first study, we did a survey with SLPs trying to ask if SLPs see friendship as being an issue? You know, is this us projecting, or is this something that clinical speech-language pathologists are seeing as an issue? If so, are we addressing it in the field? What that initial study showed us was that, yes, SLPs report that their clients are experiencing loss or difficulty with friendships. They also reported that there are barriers, there aren't assessments that ask about friendships, and there aren't interventions. So, while they see this as an important thing, and something that SLPs believe that this was within our scope of practice, they need a little more guidance as to how to support people with aphasia in terms of maintaining friendships, and then also developing friendships.    Following that study, we then spoke to people with aphasia and also spoke to caregivers of people with aphasia to get their perspectives and their lived experiences. What happens to friendship, immediately after a stroke? In that acute phase? What happens to friendship during that chronic phase? And then where are they now? What we found through these conversations is that many individuals reported that their friendships had changed after they acquired aphasia, both in the acute phase and the chronic stages. The same could be said for caregivers as they are navigating this world as caregivers. They are experiencing changes in their friendships. With aphasia being a chronic condition, this is something that people are living with for the rest of their lives. Friends can kind of be there in the beginning, and that acute care phase where they send messages or come by to say hello and show their support. As they realize that the communication impairment isn't going away, they don't know what to do and may get a little uncomfortable, feeling bad that they don't understand their friend with aphasia, or they don't know how to support them in their communication, or this problem isn't disappearing. This is me projecting, but I believe that's what's happening and what we're seeing is that people with aphasia, and their caregivers are reporting this loss. They also are reporting gaining new friends as they become ingrained in social groups. They meet other people with aphasia or care partners of other individuals with aphasia and develop friendships that way. They are also reporting smaller social groups, smaller groups of friends from their pre-aphasia life, dwindling for a lot of people. We think from our research what we're finding is that we really need interventions that target friendship maintenance and development. Some of that may be as simple as providing education, inviting friends into the therapy room. We do this with care partners, we can also offer this to friends to see how we are interacting with your loved one with aphasia. We can provide key tools to support communication; I really think a big piece of it is education. We've got to find the best way to navigate this in the clinical world. I think that's the next step not only for our group, but for the other groups that are looking at Friendship.    Janet: Lauren, you make some very good points in those comments. I wonder, do you have some brief thoughts or very specific ideas about how as clinicians, we can act in ways to optimize the friendship activities of our clients, or their care partners, recognizing though, that everyone has different styles and needs for friendship? It's like you say, we should not be projecting our desires and our styles and our needs onto our patients, but rather listen to them and figure out what their needs and desires are?   Lauren: Number one, right there, is listening to our clients, listening to their loved ones, what do they need? As I mentioned before, I think education is a really big piece of this. That may mean just having some materials as a speech-language pathologist that you can send home with family members that they can give to friends, right, so not just materials for that care partner, or the person with aphasia, but materials for friends. Here's something that will educate you a little bit on what aphasia is, there are some ways that you can successfully communicate with your friend with aphasia, here's what to expect. I think some of it is people just don't understand. They don't live in our world clinically, working with people with aphasia, working with people with communication disorders. For some, it's that they've never been exposed to, and so there's a discomfort with the unknown. I think education is huge. Also inviting friends. If you're going to have a counseling session with a care partner, and a person with aphasia, and their loved one, would they like friends to be at that table? Ask them. They may not, they may want it just for them and to be quiet and personal, but they may have some really close friends that they know they're going to lean on and want to be there. Opening the opportunity to invite other individuals and also inviting friends to support groups. Bringing friends to support groups, I think, would also be a space where friends then can observe interactions among people with aphasia, as well as their loved ones, and can have an opportunity to interact with other people with aphasia. So those are a few things that I think we can do right now. There are through many of the different resources like ARC [Aphasia Recovery Connection], for example, there are opportunities for education, communication partner training, and those are things that we can also plug friends into   Janet: Those are some very good ideas, Lauren, very good ideas. You have also worked to address the isolation felt by people with aphasia, and severe acquired communication impairment through your lab's Mission SPEAK program. Can you tell us more about this program, please?   Lauren: Absolutely. Mission SPEAK stands for Mission to Promote Socialization, Participation, Engagement, Advocacy and Kindness, for people with severe acquired communication disorders. This grew out of a lack of participation among some of our community members who had more severe communication impairments. They felt that they were just unable to be successful in a group setting, and tried some of the aphasia support groups, but didn't feel like they were being heard, or that they had equal opportunity, or were just frustrated by it. It didn't feel right for them. And so, I started thinking about, well, how can we provide an opportunity for individuals who feel this way, or maybe they're just more introverted which could be another piece to why they don't want that large group. How can we provide opportunities where they're still getting to practice communication in a safe space, develop friendships, and just be able to interact to combat those feelings of isolation that people with aphasia and other acquired communication disorders report. Mission SPEAK is a program where the students in my lab, both undergraduate and graduate students, some are CSD, some pre-med, some in their med programs, where they have the opportunity to meet with an individual with aphasia or another acquired communication disorder on a weekly basis to have a conversation. It's all via Zoom. These meetings can take any shape that the person with aphasia or the communication impairment and the student want to go with it. We have some individuals that meet to actually practice what they're learning in therapy and so the clinician has connected with my students to say ‘Hey, can you go over this homework with them or allow them opportunities to practice' and sometimes the clinician will hop on to Zoom as well. We also have opportunities such as one of my students and one of our friends with aphasia are reading a book together and so they do shared reading. In another pair we have a young man who really just needs interaction, so he meets with two different students, and they just have conversations over shared interests. Sometimes his mom is there to help support communication. We see as time goes on that as the individuals are getting more comfortable with each other, and the students are getting more comfortable, there are emerging areas where there are overlapping interests, or maybe the student is learning from the person with aphasia say, about sports, for example. We have one group where our friend with aphasia is a huge sports fanatic. He was meeting with two young women in our undergraduate program who knew very little about some of these sports and so he's taught them. It's really fun. Again, they meet at least once a week. We have one individual that at one point was meeting with three separate students three times a week. The friendships that form from these smaller groups are something special. For some of these folks it's intergenerational, for others they are peers. What you see is that the students don't want to give up this opportunity. I have some students who have been meeting with their friend with aphasia for over two years now. They've gone from their undergraduate programs through their graduate programs, and they've just developed a friendship and don't want to let go of it, which I think is phenomenal. This is something that I would like to see open up as chapters across different universities. Students want these interactions so badly and there are so many people with acquired communication disorders that need an outlet, and that would benefit from this safe space to work on their skills to just have fun. It really can be whatever they want it to be.   Janet: What a great idea. You've got my brain spinning. And I've been making notes about some clients I've been thinking about who would benefit from exactly what you're saying, just the opportunity to have an interaction and conversation. Wonderful.    Lauren, another avenue that you've been interested in is the practice of mindfulness, especially yoga practice. How do you see yoga practice supporting the LPAA philosophy of living well, with aphasia?   Lauren: Love this question. I have to backpedal just a little bit to answer it to say, I was never a yogi until I started my doctoral program. If you know me, I'm 5'11”. I'm tall and I grew up playing all the tall-person sports and pretty much was of the mindset that if you're not huffing and puffing and soaked in sweat, then it wasn't exercise or it wasn't beneficial. Well, I was wrong. In my doctoral program, I was dealing with imposter syndrome. I'm also a first-generation college student. Being at that level, and with all the different hurdles that a doctoral program offers, I was really feeling that imposter syndrome and anxiety that surrounds it. Somebody suggested starting yoga, and it's what got me out of bed in the morning, and really grounded me to face my day and feel as confident as I could in my skin during that time. After doing it for a few years, I just had this aha moment of, wow, I would love to bring this to the aphasia community. It's helped me with my anxieties and my areas of self-doubt and has just allowed me to also be present. I can only imagine for some folks with aphasia the anxiety that they may have surrounding communication, or just feeling okay with where they are in this part of their journey and that acceptance piece. Then I pushed it off. I said, well, I can't do that now I have to wait until I get tenure, I've got to focus on this very systematic treatment development program. I can't do more things.    Then in 2019 when I was an assistant professor, just my first year at UCF, I went to Project Bridge again thank you, Jackie Hinkley. While I was there, there was a small group that consisted of Dr. Amy Dietz and her friend with aphasia, Terry, who were at a table, and they were promoting yoga for aphasia. I was walking around, and I saw that table and I thought it was amazing. I went over there to have a conversation with them. Amy Dietz had just finished a small pilot project looking at methodology of how we make yoga accessible. And so I talked with Amy and I talked with her friend with aphasia, Terry, about their experience, and then more people started coming to that table; Susan Duncan, who is aphasiologist and a speech-language pathologist and a yoga practitioner, and then also a person with aphasia, Chase Rushlow and his mom, Deanna Rushlow. All the whole rest of that conference, we hung together, and started planning out the trajectory of how to bring accessible yoga to people with aphasia and to the aphasia community. Chase had experienced yoga, post stroke, and as a person living with aphasia with his mom, they shared their story about how it brought them together, and how it grounded him, how he found Zen. It was so fruitful being able to have these conversations with people with aphasia, and also their care partners, and them telling us what yoga has done for them. Not only did we all have our own experiences with yoga from myself, Amy and Susan, but then we also were getting this feedback from the rights holders, right from our patient stakeholders. And so this group moved forward.    Sorry, I had to backpedal there a little bit. Since that time, I'm so proud of what we have done as a team and what has unfolded. I was very fortunate to meet a yoga therapist named Karen Cornelius here in the Orlando area and together, we've been able to build an accessible adapted virtual yoga program for people with aphasia. It started as kind of this feasibility study with our own aphasia community group here in Orlando, getting feedback from them, figuring out how to make the language accessible, what visuals are helpful? What do people with aphasia want from a yoga practice, were there things that they liked, or things that they didn't like. We've had this really long but very informative process of delivering yoga from a yoga therapy perspective, caring experience, and then figuring out what to spend more time on and how to present things verbally and visually. Now I feel like we have this ongoing, strong, adapted yoga community that we're able to offer. We offer it every Friday at 11am. And we have participants from all over the US. We still have a strong group from Florida, from the Orlando area, but we've got people that participate from California, we've got folks from in the middle of the state, we've got people from Kentucky, we've got people from Pittsburgh, we have people from up north. And we also have a participant from Bermuda. It's amazing to see all of these individuals who would have never met each other otherwise come together so that they can have a yoga practice. For some of these folks, they participated in yoga before their stroke, and then had a really hard time getting back into it afterwards because of the language impairment, the language barrier really. Yoga is a very language heavy practice. The modifications that we've made have been really helpful in making it accessible. But then we've also brought in others that never looked at yoga before and experienced it for the first time and have heard their report that they reap the benefits of it. What we're seeing in both our qualitative research, and also in our quantitative research is that people are reporting reduced stress after participating in at least eight weeks of yoga, better sleep quality, and increased resilience. Some have discussed better pain management, so they feel like their pain, although it's not gone away, that they are able to go about their daily life without pain taking as much in terms of resources from them as it did prior. The biggest thing to I mean that sticks out is people are talking about self-acceptance. Yoga has helped them accept where they are right now in their journey. The last thing I'll say along these lines is there is something so powerful about having individuals come together in this group and there's conversation that happens at the beginning and at the end, just like you would if you walked into a yoga studio. I think it's that they're all working on a common goal, in this hour, and very little of what's being done is focused on communication, the effort is taken away. They're really just sharing a space with each other, enjoying that space, doing something that's making them feel good. And they're not having to think about their impairment. There's something really special with this group.    This work has now been funded by Orlando Health, which is our one of our big hospitals in the area. We're working with an interprofessional team and actually bringing yoga therapy into the inpatient rehabilitation program. This has been really neat, because Karen, the yoga therapist, and I are working with an interdisciplinary team of speech-language pathologists, physical therapists, occupational therapists, and recreational therapists. We'll have a group of individuals and all of these different professionals in the same room, and we're getting feedback from the professionals about what they like, what's facilitating this program for them, and what are the barriers. At the end, they will be the ones running this program, and they are very committed to keeping it up and running. We're also of course, getting the feedback from the people with aphasia and other brain injury survivors in this group, as well as their caregivers that are coming in and participating. I think now I can say I've done a good chunk of research in my life, and this area is the most fun and the least amount of work. Everything has happened organically. There has not been a moment where it feels like this really is work, or I don't want to do this. It's all just unfolded so beautifully. I feel so fortunate to be a part of this, I'm so thankful that Project Bridge pushed me into this, in a sense, when I thought I had to put it off for years and years to come. It's been a lot of fun. For our listeners, we have an ongoing yoga program on Friday mornings at 11 am EST, that is run by a yoga therapist who is amazing, and well versed in aphasia. I welcome people to join us.   Janet: I am moved by your story, Lauren, both your individual journey through your doctoral program and finding yoga to help your own self, and then taking that into the aphasia community. Several times you've used the phrase, ‘your journey through life' or ‘your journey of life'. And isn't that true? We're all on a journey, and it changes year to year, or decade to decade, if you will. It's exciting to know that you're finding a way to connect people with aphasia to a larger community that focuses on yoga, for example, rather than focusing on the impairment that they have living with their aphasia. Thank you for that. It sounds like it's a great success, and I hope it will continue to be so good for you.   Lauren: Thank you.   Janet: Lauren, another area of investigation, you're examining the benefit of motor imagery and home practice, for enhancing treatment outcomes in persons with apraxia of speech. This is a little bit different from yoga and mindfulness. But yet at the same time, it's about what people can do in their own selves, I think to improve their communications and improve their interactions with others. Will you describe this work and your current findings, please?    Lauren: Absolutely. And you really did hit the nail on the head because it does overlap a lot. It's different in that we are working on the impairment here, but the motor imagery piece grew out of what I was seeing with yoga. Many of our participants have hemiparesis, for example, or they might have apraxia of speech or more severe aphasia. When they are unable to produce a certain movement, or unable to say a certain mantra, we tell them just to visualize. If you can't move that arm that is fine, or if you can't move it to the extent that you want to that is okay, just imagine that arm moving. Just imagine or hear yourself saying this affirmation.    Based on what we were doing with the yoga I started digging a little deeper into the research on motor imagery and mental imagery, and that's where this idea arose. Surprisingly, there hasn't been a whole lot of work using motor imagery for rehabilitation of apraxia of speech. There's been a little bit of work in the area of stuttering, and motor imagery is used significantly in sports medicine, athletic training for professional sports, and musical training, and also rehabilitation of limb and gait, but really very little about speech. And so, I found a hole. My thought was maybe this motor imagery piece is a start, it's something that people can do at home without much support, and maybe it will impact their performance, either that day or in a therapy session a few days later. I wrote a grant and it was funded through the National Institutes of Health. The grant focused on looking at the impact that motor imagery has when combined with behavioral speech treatment. My thought moving forward was that I got my Ph.D. not only because I wanted to know more and wanted to create treatment programs, but I wanted to prove to insurance that healing the brain post stroke, or rehabilitation of speech and language post stroke, is not the same as healing a broken bone. It takes a lot more time. It's ongoing. In my time, I have not seen a change in insurance. In fact, I think it's gotten worse. So my thought into this is we've got to give clinicians and people with communication impairments the opportunity to work more from home. What can they do on their own to bolster the impact of those few treatment settings that they actually are getting, if they are treatment seeking individuals. The idea is, the hope is, that through motor imagery, what we're doing is priming the neural network. Patients can go home with targeted stimuli that they're working on, for example, and just imagine themselves saying it accurately, thinking about how the articulators are moving, visualizing themselves being successful. Hopefully, we're priming those networks. Then when they go into that treatment session, those networks are primed and perhaps we see a boost in performance. The hope, the long-term goal, of this is to build a home practice program that can be accessible to people in the comfort of their homes, easily and free of charge. The speech-language pathologist can also interface with the program to put stimuli into it, for example, so that it can support what they're working on in therapy. We're still in the early phases, but we just completed our first qualitative interview after somebody has completed the whole program, and they really liked it. I thought people were going to be bored with motor imagery because we're not yet allowing them to say anything. In the motor imagery piece, we really want to focus on what does imagery add, but they really enjoyed it. Our first participant, what he said was that at first he didn't like it, he thought it was weird. After we went through practice for a few weeks, he would come into the therapy session and we would do a probe and afterwards if I commented that he did really well on that today, or in the treatment session itself, or if I was seeing a lot of success with certain targets, he would say ‘the homework, the homework'. My thought was that he felt like the homework is helping. He was encouraging and felt like it was helping. We've only run a few people through, so right now, it's preliminary findings, but what I'm seeing is a benefit when they are going home and having this opportunity to practice. Even though it's not verbal practice, it's motor imagery, I'm seeing a change when they come into the session. The study itself is funded for three years, and we have the opportunity to provide free therapy for 18 individuals with co-occurring apraxia of speech and aphasia. I'm excited to see what that group data look like, but right now, and with just the conversations that we're having with the folks that are coming through, I feel very optimistic about this program. It will definitely need to grow, I don't want it to be only motor imagery forever. It's a good first step.   Janet: That is very exciting to hear. I look forward to reading the results as you have more and more individuals with apraxia of speech move through your program.   Lauren, as we draw this interview to a close, I wonder if you have some lessons learned that you would share with our listeners, as well as some Monday morning practices, that is actions that we can take on Monday morning to improve our interactions with persons with the aphasia or apraxia of speech.    Lauren: So I think first, and this is reflecting on what I do, I know many individuals out there, whether you are clinically working with the population, or you're doing research, you're in an area where you are giving. We are giving to support a community. The same thing that I tell our caregivers is to do something for you first, that will allow you to continue to give to others. What is something can you identify, something every day. When there's a little bit of something that you can do for yourself that just fuels you to be the best clinician, the best researcher, the best partner, parent, the many hats that people wear, to your community. That may look different for everyone. For some people, maybe it is meditation, for others maybe it's yoga, maybe it's running, maybe it's baking, everybody has their thing, but identify that certain something that gives you the energy and maybe the groundedness to serve your community.    One thing we've touched on, and if you're listening to this podcast, you know this, but listen to our friends with aphasia. Their perspectives give us so much more than we could ever pretend to know. I've learned so much from my friends with aphasia, even moving forward and in my research - thinking that I know what people want, talk to them, and then the realization this actually isn't an issue, this other thing is. Seek better understanding, otherwise, we're going up the wrong ladder and putting our efforts in the wrong area.    Building community through shared interests, that's what I'm trying to do a bit, and also incorporate student involvement; use your resources. With Mission SPEAK we really are trying to build community through shared interests. It's really neat to see how this unfolds. Even when you have a person with a communication impairment or a person with aphasia, who is maybe 30 years older than the student that they're meeting with, there are shared interests. And it's so neat, what they learn from each other and how this partnership grows, and this friendship grows. Then you also have peers, folks who have acquired communication impairments that are close in age with our students, and that takes on a life of its own as well. Try to match people up based on shared interests, or at least having someone that is really eager to learn. Also being open. Building community through shared interests supports what we've done with yoga. Here are folks that are finding peace and community and enjoying this activity together. It could be anything doesn't have to be yoga.   One other is interdisciplinary practices. When we're thinking about our friends with aphasia, not just thinking about the aphasia or stroke, when we're working with our more acute care friends, or those that are still on that rehabilitation trajectory. Stroke Survivors are dealing with more than aphasia, and I think sometimes we can lose sight of that. Making sure that there is an interdisciplinary team or you're offering interdisciplinary supports, asking what else do they need. I find that I've learned so much from my colleagues in physical therapy and occupational therapy. I work closely with an assistive technology professional who has just unlocked for me the world of supports that are out there that help people live well with aphasia, and also with hemiparesis. Supports such as for cooking with hemiparesis, supports for a computer adapted need, supports many things, such as positioning, seating, getting out there and playing sports, again, in an adaptive community. There are so many things that have happened, I think, over the last decade to make things more accessible for people post stroke. Educate yourself on what's out there.   Janet: Those are great ideas. Thank you so very much. And thank you, Lauren, again for taking the time to speak with me today about the Tavistock Distinguished Scholar Award, and about your work in aphasia.   Lauren: Thank you very much for having me.   Janet: You are so welcome.    I would also like to thank our listeners for supporting Aphasia Access Conversations by listening to our podcasts. For references and resources mentioned in today's show, please see our show notes. They are available on our website, www.aphasiaaccess.org. There, you can also become a member of our organization, browse our growing library of materials and find out about the Aphasia Access Academy. If you have an idea for a future podcast episode, please email us at info@aphasiaaccess.org. For Aphasia Access Conversations, I am Janet Patterson, and thank you again for your ongoing support of Aphasia Access.   Lauren, thank you for being with me today and congratulations on being named a Tavistock Distinguished Scholar on behalf of Aphasia Access and the Tavistock Trust. I look forward to learning about your future accomplishments, and seeing how you help people with aphasia and apraxia of speech on their journey of life. References   Madden, E. B., Therrien, M., Bislick, L., Wallace, S. E., Goff-Albritton, R., Vilfort-Garces, A., Constantino, C. & Graven, L. (2023). Caregiving and friendship: Perspectives from care partners of people with aphasia. Topics in Language Disorders, 43(1), 57-75. https://doi.org/10.1097/TLD.0000000000000301    Therrien, M.C., Madden, E.B., Bislick, L. & Wallace, S.E. (2021). Aphasia and friendship: The role and perspectives of Speech-Language Pathologists. American Journal of Speech-Language Pathology, 30(5), 2228-2240. https://doi.org/10.1044/2021_AJSLP-20-00370  Resources   Aphasia Recovery Connection (ARC)        https://aphasiarecoveryconnection.org  Aphasia and Related Conditions Research Lab and Mission SPEAK https://healthprofessions.ucf.edu/communication-sciences-disorders/aphasia-and-related-conditions-research-lab/  Project Bridge     Project Bridge - Research Community in Communication Disorders

You guys, I am literally giggling with excitement over what we are about to do together.  Last year, we did a series, the first series on Your Anxiety Toolkit where we talked about mental compulsions. It was a six-part series. We had some of the best therapists and best doctors in the world talking about mental compulsions. It was such a hit. So many people got so much benefit out of it. I loved it so much, and I thought that was fun, let's get back to regular programming. But for the entire of last year after that series, it kept bugging me that I needed to do a series on sexual health and anxiety. It seems like we're not talking about it enough. It seems like everyone has questions, even people on social media. The algorithm actually works against those who are trying to educate people around sex and sexual side effects and arousal and how anxiety impacts it. And so here I am. No one can stop us. Let's do it.  This is going to be a six-part sexual health and anxiety series, and today we have a return guest, the amazing Lauren Fogel Mersy. She is the best. She is a sex therapist. She talks all about amazing stuff around sexual desire, sexual arousal, sexual anxiety. She's going to share with you, she has a book coming out, but she is going to kick this series off talking about sexual anxiety, or we actually also compare and contrast sexual performance anxiety because that tends to better explain what some of the people's symptoms are.  Once we go through this episode, we're then going to meet me next week where I'm going to go back over. I've done an episode on it before, but we're going to go back over understanding arousal and anxiety. And then we're going to have some amazing doctors talking about medications and sexual side effects. We have an episode on sexual intrusive thoughts. We have an episode on premenstrual anxiety. We also have an episode on menopause and anxiety. My hope is that we can drop down into the topics that aren't being covered enough so that you feel like you've got one series, a place to go that will help you with the many ways in which anxiety can impact us when it comes to our sexual health, our sexual arousal, our sexual intimacy. I am so, so, so excited. Let's get straight to it.  This is Episode 1 of the Sexual Health and Anxiety Series with Dr. Lauren Fogel Mersy. Lauren is a licensed psychologist. She's a certified sex therapist, she's an author, and she is going to share with us and we're going to talk in-depth about sexual anxiety. I hope you enjoy the show. I hope you enjoy all of the episodes in this series. I cannot wait to listen to these amazing speakers—Lauren, being the first one. Thank you, Lauren. What Is Sexual Anxiety Or Sexual Performance Anxiety? Are They The Same Thing? Kimberley: Welcome. I am so happy to have you back, Dr. Lauren Fogel Mersy. Welcome. Dr. Lauren: Thank you so much for having me back. I'm glad to be here. Kimberley: I really wanted to deep dive with you. We've already done an episode together. I'm such a joy to have you on. For those of you who want to go back, it's Episode 140 and we really talked there about how anxiety impacts sex. I think that that is really the big conversation. Today, I wanted to deep dive a little deeper into talking specifically about sexual anxiety, or as I did a little bit of research, what some people call sexual performance anxiety. My first question for you is, what is sexual anxiety or what is sexual performance anxiety? Are they the same thing or are they a little different? Dr. Lauren: I think people will use those words interchangeably. It's funny, as you say that, I think that performance anxiety, that word ‘performance' in particular, I hear that more among men than I do among women. I think that that might be attributed to so many people's definition of sex is penetration. In order for penetration to be possible, if there's a partner who has a penis involved that that requires an erection. I often hear that word ‘performance' attributed to essentially erection anxiety or something to do with, will the erection stay? Will it last? Basically, will penetration be possible and work out? I think I often hear it attributed to that. And then sexual anxiety is a maybe broader term for a whole host of things, I would say, beyond just erection anxiety, which can involve anxiety about being penetrated. It could be anxiety about certain sexual acts like oral sex giving, receiving. It could be about whether your body will respond in the way that you want and hope it to. I think that word, sexual anxiety, that phrasing can encompass a lot of different things. WHAT ARE SOME SEXUAL ANXIETY SYMPTOMS? Kimberley: Yeah. I always think of it as, for me, when I talk with my patients about the anticipatory anxiety of sex as well. Like you said, what's going to happen? Will I orgasm? Will I not? Will they like my body? Will they not? I think that it can be so broad. I love how you define that, how they can be different. That performance piece I think is really important. You spoke to it just a little, but I'd like to go a little deeper. What are some symptoms of sexual anxiety that a man or a woman may experience?  Dr. Lauren: I think this can be many different things. For some people, it's the inability to get aroused, which sifting through the many things that can contribute to that, knowing maybe that I'm getting into my head and that's what's maybe tripping me up and making it difficult to get aroused. It could be a racing heartbeat as you're starting to get close to your partner, knowing that sex may be on the table. I've had some people describe it can get as severe as getting nauseated, feeling like you might be sick because you're so worked up over the experience. Some of that maybe comes from trauma or negative experiences from the past, or some of it could be around a first experience with a partner really hoping and wanting it to go well. Sometimes we can get really nervous and those nerves can come out in our bodies, and then they can also manifest in all of the thoughts that we have in the moment, really getting distracted and not being able to focus and just be present. It can look like a lot of different things. SEXUAL AVOIDANCE Kimberley: That's so interesting to hear in terms of how it impacts and shows up. What about people who avoid sex entirely because of that? I'm guessing for me, I'm often hearing about people who are avoiding. I'm guessing for you, people are coming for the same reason. You're a sex therapist. How does that show up in your practice? Dr. Lauren: One of the things that can cause avoidance-- there's actually an avoidance cycle that people can experience either on their own or within a partnership, and that avoidance is a way of managing anxiety or managing the distress that can come with challenging sexual experiences and trying to either protect ourselves or protect our relationships from having those outcomes as a possibility. There used to be a diagnosis called sexual aversion. It was called a sexual aversion disorder. We don't have that in our language anymore. We don't use that disorder because I think it's a really protective, sensible thing that we might do at times when we get overwhelmed or when we're outside of what we call a window of tolerance. It can show up as complete avoidance of sexual activity. It could show up as recoiling from physical touch as a way to not indicate a desire for that to progress any further. It could be avoidance of dating because you don't want the inevitable conversation about sexuality or the eventuality that maybe will come up. Depending on whether you're partnered or single and how that manifests in the relationship, it can come out in different ways through the avoidance of maybe different parts of the sexual experience, everything from dampening desire to avoiding touch altogether.  Kimberley: That's really interesting. They used to have it be a diagnosis and then now, did they give it a different name or did they just wipe it off of the DSM completely? What would you do diagnostically now?  Dr. Lauren: It's a great question. I think it was wiped out completely. I haven't looked at a DSM in a long time. I think it was swiped out completely. Just personally as a sex therapist and the clinician I am today, I don't use many of the sexual health diagnoses from the DSM because I think that they are pathologizing to the variation in the human sexual experience. I'm not so fond of them myself. What I usually do is I would frame that as an anxiety-related concern or just more of a sexual therapy or sex counseling concern. Because I think as we have a growing understanding of our nervous system and the ways in which our system steps in to protect us when something feels overwhelming or frightening or uncertain, I think it starts to make a lot of sense as to why we might avoid something or respond in the ways that we do. Once we have some understanding of maybe there's some good sense behind this move that you're making, whether that's to avoid or protect or to hesitate or to get in your head, then we can have some power over adjusting how we're experiencing the event once we understand that there's usually a good reason why something's there. Kimberley: That is so beautiful. I love that you frame it that way. It's actually a good lesson for me because I am always in the mindset of like, we've got to get rid of avoidance. That's the anxiety work that I do. I think that you bring up a beautiful point that I hadn't even considered, which is, we always look at avoidance as something we have to fix as soon as possible. I think what you're saying is you don't conceptualize it that way at all and we can talk more about what you could do to help if someone is having avoidance and they want to fix that. But what I think you're saying is we're not here to pathologize that as a problem here. Dr. Lauren: Yeah. I see it, I'm trained less in the specifics. I think that makes a lot of sense when you're working with specific anxiety disorders and OCD and the like. I've, as of late, been training in more and more emotionally focused therapy. I'm coming at it from an attachment perspective, and I'm coming at it from somewhat of a systemic perspective and saying, what is the avoidance doing? What is it trying to tell us? There's usually some good reason somewhere along the way that we got where we are. Can I validate that that makes sense? That when something is scary or uncertain or you were never given good information or you really want something to go well and you're not sure about it, and it means a lot to you, there's all kinds of good reasons why that might hit as overwhelming. When we're talking about performance anxiety or sexual anxiety, really the number one strategy I'm looking for is, how can we work with what we call your window of tolerance? If your current comfort zone encompasses a certain amount of things, whatever that might be, certain sexual acts with maybe a certain person, maybe by yourself, I want to help you break down where you want to get to and break that into the smallest, manageable, tolerable steps so that what we're doing is we've got one foot in your current window of what you can tolerate and maybe just a toe at a time out, and breaking that up into manageable pieces so that we don't keep overwhelming your system. That is essentially what my job is with a lot of folks, is helping them take those steps and often what our nervous system needs to register, that it's okay, that it's safe, that we can move towards our goals. Cognitively, we think it's too slow or it's too small. It's not. We have to really break that down.  If there's something about the sexual experience that you're avoiding, that is overwhelming, that you're afraid of, what I do is validate that, makes sense that that maybe is just too much and too big all at once. And then let's figure out a way to work ourselves up to that goal over time. Usually, slower is faster.  WHY DO PEOPLE HAVE SEXUAL ANXIETY?  Kimberley: I love that. I really do. Why do people have sexual anxiety? Is that even an important question? Do you explore that with your patients? I think a lot of people, when I see them in my office or online, we know there's a concern that they want to fix, but they're really quite distressed by the feeling that something is wrong with them and they want to figure out what's wrong with them. Do you have some feedback on why people have sexual anxiety?  Dr. Lauren: I do. I think it can stem from a number of experiences or lack thereof in our lives. There are some trends and themes that come up again and again that I've seen over the years in sex therapy. Even though we're taping here in the US, we're in a culture that has a lot of sexuality embedded within the media, there is still a lot of taboo and a lot of misinformation about sex or a lack of information that people are given. I mean, we still have to fight for comprehensive sex education. Some people have gotten explicitly negative messages about sex growing up. Some people have been given very little to know information about sex growing up. Both of those environments can create anxiety about sex. We also live in a world where we're talking openly about sex with friends, parents teaching their children more than just abstinence, and going into a little bit more depth about what healthy sexuality looks like between adults. A lot of that is still not happening. What you get is a very little frame of reference for what's ‘normal' and what's considered concerning versus what is par for the course with a lifetime of being a sexual person. So, a lot of people are just left in the dark, and that can create anxiety for a good portion of those folks, whether it's having misinformation or just no information about what to expect. And then the best thing that most of us have to draw on is the Hollywood version of a very brief sex scene. Kimberley: Yes. I was just thinking about that. Dr. Lauren: And it's just so wildly different than your actual reality. Kimberley: Yeah. That's exactly what I was thinking about, is the expectation is getting higher and higher, especially as we're more accessible to pornography online, for the young folks as well, just what they expect themselves to do. Dr. Lauren: That's right. We have young people being exposed to that on the internet. We've got adults viewing that. With proper porn literacy and ethical porn consumption, that can be a really healthy way to enjoy erotic content and to engage in sexuality. The troubling thing is when we're not media literate, when we don't have some of the critical thinking to really remember and retain the idea that this entertainment, this is for arousal purposes, that it's really not giving an accurate or even close depiction of what really goes on between partners. I think it's easier for us to maintain that level of awareness when we're consuming general movies and television. But there's something about that sexuality when you see it depicted in the media that so many people are still grappling with trying to mimic what they see. I think that's because there's such an absence of a frame of reference other than those media depictions. SEXUAL ANXIETY IN MALES VS SEXUAL ANXIETY IN FEMALES  Kimberley: Right. So good. Is there a difference between sexual anxiety in males and sexual anxiety in females? Dr. Lauren: I think it can show up differently, certainly depending on what role you play in the sexual dynamic, what positions you're looking to or what sexual acts you're looking to explore. There's a different level or a different flavor of anxiety, managing erection anxiety, managing anxiety around premature ejaculation. They're all similar, but there's some unique pieces to each one. All of the types of anxiety that I've seen related to sex have some common threads, which is getting up into our heads and dampening the experience of pleasure not being as present in the moment, not being as embodied in the moment, because we get too focused on what will or won't happen just moments from now.  While that makes so much sense, you're trying to foretell whether it's going to be a positive experience, there is a-- I hate to say like a self-fulfilling prophecy, but there's a reaction in our bodies to some of those anxious thoughts. If I get into my head and I start thinking to myself, “This may not go well. This might hurt. I might lose my arousal. I might not be able to orgasm. My partner may not think I'm good in bed,” whatever those anxious thoughts are, the thoughts themselves can become a trigger for a physical reaction. That physical reaction is that it can turn on our sympathetic nervous system, and that is the part of our body that says, “Hey, something in the environment might be dangerous here, and it's time to mobilize and get ready to run.” What happens in those moments once our sympathetic system is online, a lot of that blood flow goes out of our genital region, out of our chest and into our extremities, to your arms, to your legs. Your body is acting as if there was a bear right there in front of you and your heart rate goes up and all of these things. Now, some of those can also be signs of arousal. That's where it can get really tricky because panting or increased heart rate or sweating can also be arousal. It's really confusing for some people because there can be a parallel process in your physiology. Is this arousal or is this anxiety?  CAN ANXIETY IMPACT AROUSAL? CAN ANXIETY IMPACT SEX DRIVE?  Kimberley: It's funny that you mentioned that because as I was researching and doing a little bit of Googling about these topics, one of the questions which I don't get asked very often is, can anxiety cause arousal? Because I know last time, we talked about how anxiety can reduce arousal. Is that something that people will often report to you that having anxiety causes them to have sexual arousal, not fight and flight arousal? Dr. Lauren: Yeah. I mean, what I see more than anything is that it links to desire, and here's how that tends to work for some people because then the desire links to the arousal and it becomes a chain. For many people out in the world, they engage in sexual activity to impart self-soothe and manage stress. It becomes a strategy or an activity that you might lean on when you're feeling increased stress or distress. That could be several different emotions that include anxiety. If over my lifetime or throughout the years as I've grown, maybe I turn to masturbation, maybe I turn to partnered sex when I'm feeling anxious, stressed, or distressed, over time, that's going to create a wiring of some of that emotion, and then my go-to strategy for decreasing that emotion or working through that emotion. That pairing over time can definitely work out so that as soon as I start feeling anxious, I might quickly come to feelings of arousal or a desire to be sexual. Kimberley: Very interesting. Thank you. That was not a question I had, but it was interesting that it came up when I was researching. Very, very cool. This is like a wild card question. Again, when I was researching here, one of the things that I got went down a little rabbit hole, a Google rabbit hole, how you go down those... Dr. Lauren: That's never happened to me. WHAT IS POST-SEX ANXIETY?  Kimberley: ...is, what about post-sex anxiety? A lot of what we are talking about today, what I would assume is anticipatory anxiety or during-sex anxiety. What about post-sex anxiety? What is post-sex anxiety? Dr. Lauren: I've come across more-- I don't know if it's research or articles that have been written about something called postcoital dysphoria, which is like after-sex blues. Some people get tearful, some get sad, some feel like they want to pull away from their partner and they need a little bit of space. That's certainly a thing that people report. I think either coexisting with that or sometimes in its place can be maybe feelings of anxiety that ramp up. I think that can be for a variety of things. Some of it could be, again, getting into your head and then doing a replay like, was that good? Are they satisfied? We get into this thinking that it's like a good or bad experience and which one was it. Also, there's many people who look to sex, especially when we have more anxiety, and particularly if we have a more predominantly anxious attachment where we look to sex as a way to validate the relationship, to feel comforted, to feel secure, to feel steady. There's a process that happens where it's like seeking out sex for comfort and steadiness, having sex in the moment, feeling more grounded. And then some of that anxiety may just return right on the other end once sex is over, and then you're back to maybe feeling some insecurity or unsteadiness again. When that happens, that's usually a sign that it's not just about sex. It's not just a sexual thing. It's actually more of an attachment and an insecurity element that needs and warrants may be a greater conversation.  The other thing is your hormones and chemicals change throughout the experience. You get this increase of bonding maybe with a partner, oxytocin, and feel-good chemicals, and then they can sometimes drop off after an orgasm, after the experience. For some people, they might just experience that as depressed mood anxiety, or just a feeling of being unsettled. Kimberley: That's so interesting. It makes total sense about the attachment piece and the relational piece, and that rumination, that more self-criticism that people may do once they've reviewed their performance per se. That's really helpful to hear. Actually, several people have mentioned to me when I do lives on Instagram the postcoital dysphoria. Maybe you could help me with the way to word it, but is that because of a hormone shift, or is that, again, because of a psychological shift that happens after orgasm? Dr. Lauren: My understanding is that we're still learning about it, that we've noticed that it's a phenomenon. We're aware of it, we have a name for it, but I don't know that we have enough research to fully understand it just yet. Right now, if I'm not misquoting the research, I believe our understanding is more anecdotal at this point. I would say, many different things could be possible, anything from chemical changes to attachment insecurities, and there's probably things that are beyond that I'm also missing in that equation. I think it's something we're still studying. HOW TO OVERCOME SEX ANXIETY, AND HOW CAN WE COPE WITH SEX ANXIETY?   Kimberley: Very interesting. Let's talk now about solutions. When should someone reach out to either a medical professional, a mental health professional? What would you advise them to do if they're experiencing sexual anxiety or performance anxiety when it comes to sex? Dr. Lauren: That makes a lot of sense. That's a great question. What I like to tell people is I want you to think of your sexual experiences like a bell curve. For those who were not very science or math-minded like myself, just a quick refresher, a bell curve basically says that the majority of your experiences in sex are going to be good, or that's what we're hoping for and aiming for. And then there's going to be a few on one tail, there's going to be some of those, not the majority, that are amazing, that are excellent, that really stand out. Yes, mind-blowing, fabulous. And then there's the other side of that curve, that pole. The other end is going to be, something didn't work out, disappointing, frustrating. There is no 100% sexual function across a lifetime with zero hiccups. That's not going to be a realistic goal or expectation for us.  I always like to start off by reminding people that you're going to have some variation and experience. What we'd like is for at least a good chunk of them to be what Barry McCarthy calls good enough sex. It doesn't have to be mind-blowing every time, but we want it to be satisfying, of good quality. If you find that once or twice you can't get aroused, you don't orgasm, you're not as into it, one of the liabilities for us anxious folks, and I consider myself one of them having generalized anxiety disorder my whole life—one of the things that we can do sometimes is get catastrophic with one or two events where it doesn't go well and start to jump to the conclusion that this is a really bad thing that's happening and it's going to happen again, and it's life-altering sort of thing. One thing is just keeping this in mind that sometimes that's going to happen, and that doesn't necessarily mean that the next time you go to be sexual that it'll happen again. But if you start to notice a pattern, a trend over several encounters, then you might consider reaching out to someone like a general therapist, a sex therapist to help you figure out what's going on.  Sometimes there's a medical component to some of these concerns, like a pattern of difficulty with arousal. That's not a bad idea to get that checked out by a medical provider because sometimes there could be blood flow concerns or hormone concerns. Again, I think we're looking for patterns. If there's a pattern, if it's something that's happening more than a handful of times, and certainly if it's distressing to you, that might be a reason to reach out and see a professional. Kimberley: I think you're right. I love the bell curve idea and actually, that sounds very true because often I'll have clients who have never mentioned sex to me. We're working on their anxiety disorder, and then they have one time where they were unable to become aroused or have an erection or have an orgasm. And then like you said, that catastrophic thought of like, “What happens if this happens again? What if it keeps happening?” And then as you said, they start to ruminate and then they start to avoid and they seek reassurance and all those things. And then we're in that kind of, as you said, self-fulfilling, now we're in that pattern. That rings very, very true. What about, is there any piece of this? I know I'm disclosing and maybe from my listeners, you're probably thinking it's TMI, but I remember after having children that everything was different and it did require me to go and speak to a doctor and check that out. So, my concerns were valid in that point. Would it be go to the therapist first, go to the doctor first? What would you recommend? Dr. Lauren: Yeah. I mean, you're not alone in that. The concerns are always valid, whether they're medical, whether they're psychological, wherever it's stemming from. If after once or twice you get freaked out and you want to just go get checked out, I don't want to discourage anybody from doing that either. We're more than happy to see you, even if it's happened once or twice, just to help walk you through that so you're not alone. But the patterns are what we're looking for overall.  I think it depends. Here's some of the signs that I look for. If sex is painful, particularly for people with vaginas, if it's painful and it's consistently painful, that's something that I would recommend seeing a sexual medicine specialist for. There are some websites you can go to to look up a sexual medicine specialist, someone in particular who has received specialized training to treat painful sex and pelvic pain. That would be an indicator. If your body is doing a lot of bracing and tensing with sex so your pelvic floor muscles are getting really tight, your thighs are clenching up, those might be some moments where maybe you want to see a medical provider because from there, they may or may not recommend, depending on whether it's a fit for you, something called pelvic floor therapy. That's something that people can do at various stages of life for various reasons but is doing some work specifically with the body.  Other things would be for folks with penises. If you're waking up consistently over time where you're having difficulty getting erections for sexual activity and you're not waking up with erections anymore, that morning wood—if that's consistent over time, that could be an indicator to go get something checked out, maybe get some blood work, talk to your primary care just to make sure that there's nothing in addition to maybe if we think anxiety is a part of it, make sure there's nothing else that could be going on as well. HOW TO COPE WITH SEX ANXIETY Kimberley: Right. I love this. This is so good. Thank you again. Let's quickly just round it out with, how may we overcome this sex anxiety, or how could we cope with sex anxiety? Dr. Lauren: It's the million-dollar question, and I've got a pretty, I'll say, simple but not easy answer. It's a very basic answer. Kimberley: The good answers are always simple but hard to apply. Dr. Lauren: Simple, it's a simple theory or idea. It's very hard in practice. One of, I'd say, the main things I do as a sex therapist is help people really diversify what sex is. The more rigid of a definition we have for sex and the more rigidly we adhere to a very particular set of things that have to happen in a particular order, in a very specific way, the more trouble we're going to have throughout our lifetime making that specific thing happen. The work is really in broadening and expanding our definition of sex and having maybe a handful of different pathways to be sexual or to be intimate with a partner so that, hey, if today I have a little bit more anxiety and I'm not so sure that I get aroused that we can do path A or B. If penetration is not possible today because of whatever reason that we can take path C. When we have more energy or less energy, more time, less time, that the more flexibility we have and expansiveness we have to being intimate and sexual, the more sexual you'll be. Kimberley: Just because I want to make sure I can get what you're saying, when you say this inflexible idea of what this narrow you're talking about, I'm assuming, I'm putting words in your mouth and maybe what you're thinking because I'm sure everybody's different, but would I be right in assuming that the general population think that sex is just intercourse and what you're saying is that it's broader in terms of oral sex and other? Is that the A, B, and C you're talking about?  Dr. Lauren: Yeah. There's this standard sexual script that most people follow. It's the one that we see in Hollywood, in erotic videos. It centers mostly heterosexual vaginal penetration, so penis and vagina sex. It centers sex as culminating in orgasm mainly for the man, and then nice if it happens for the woman as well in these heterosexual scenarios. It follows a very linear progression from start to finish. It looks something like—tell me if this doesn't sound familiar—a little bit of kissing and some light touching and then some heavier touching, groping, caressing, and then maybe oral sex and then penetration as the main event, orgasm as the finish line. That would be an example of when I say path A or B or C. I'm thinking like that in particular what I just described.  Let's call that path A for not that it's the gold standard, but it's the one we draw on. Let's say that's one option for having a sexual encounter. But I also want people to think about there's going to be times where that is not on the table for a variety of reasons, because if you think about it, that requires a certain energy, time. There might be certain conditions that you feel need to be present in order for that to be possible. For some people, it automatically goes to the wayside the moment something happens like, “Well, I don't feel like I have enough time,” or “I'm tired,” or “I'm menstruating,” or whatever it is. Something comes up as a barrier and then that goes out the door. That can include things like anxiety and feeling like we have to adhere to this progression in this particular way. Let's call that path A. Path B might be, we select a couple of things from that that we like. Let's say we do a little kissing and we do oral sex and we say goodnight. Let's say path C is we take a shower together and we kiss and we soap each other's backs and we hug. That's path C. Path D is massaging each other, full body. You've got all these different pathways to being erotic or sensual or intimate or sexual. The more that you have different pathways to being intimate, the more intimate you'll be. Kimberley: That is so relieving is the word I feel. I feel a sense of relief in terms of like, you're right. I think that that is a huge answer, as you said. Actually, I think it's a good answer. I don't think that's a hard answer. I like that. For me, it feels like this wonderful relief of pressure or change of story and narrative. I love that. I know in the last episode you did, you talked a lot about mindfulness and stuff like that, which I will have in this series. People can go and listen to it as well. I'm sure that's a piece of the pie. I want to be respectful of your time. Where can people hear more about you and the work that you're doing? I know that you have an exciting book coming out, so tell us a little bit about all that. Dr. Lauren: Thank you. I do. I co-authored a book called Desire. It's an inclusive guide to managing libido differences in relationships. I co-authored that with my colleague Dr. Jennifer Vencill. That comes out August 22nd, 2023 of this year. We'll be talking in that book mainly about desire. There are some chapters or some sections in the book that do intersect with things like anxiety. There's some particular instructions and exercises that help walk people through some things that they can do with a partner or on their own to work through anxiety. We've got an anxiety hierarchy in there where whatever your goal might be, how to break that up into smaller pieces. We're really excited about that. I think that might be helpful for some people in your audience. And then in general, I am most active on Instagram. My handle is my full name. It's @drlaurenfogelmersy. I'm also on Facebook and TikTok. My website is drlaurenfogel.com. Kimberley: Thank you. Once again, so much pleasure having you on the show. Thank you for your beautiful expertise. You bring a gentle, respectful warmth to these more difficult conversations, so thank you. Dr. Lauren: Oh, I appreciate it. Thanks for having me back.

Lauren Makler is Co-Founder, and CEO of Cofertility, a human-first fertility ecosystem rewriting the egg freezing and egg donation experience. Victoria talks to Lauren about tackling the access issues around egg freezing and donation and hoping to bring down the cost, leaving a company like Uber and starting her own business, and figuring out a go-to-market approach and what that strategy should look like. Cofertility (https://www.cofertility.com/) Follow Cofertility on LinkedIn (https://www.linkedin.com/company/cofertility/) or Twitter (https://twitter.com/cofertility). Follow Lauren Makler on LinkedIn (https://www.linkedin.com/in/laurenmakler/), Instagram (https://www.instagram.com/laurenmakler/), or Twitter (https://twitter.com/laurenmakler). Follow thoughtbot on Twitter (https://twitter.com/thoughtbot) or LinkedIn (https://www.linkedin.com/company/150727/). Become a Sponsor (https://thoughtbot.com/sponsorship) of Giant Robots! Transcript: VICTORIA: This is The Giant Robots Smashing Into Other Giant Robots Podcast, where we explore the design, development, and business of great products. I'm your host, Victoria Guido. And with me today is Lauren Makler, Co-Founder, and CEO of Cofertility, a human-first fertility ecosystem rewriting the egg freezing and egg donation experience. Lauren, thank you for joining me. LAUREN: Thanks for having me. I'm so excited for this. VICTORIA: Me too. I want to hear all about Cofertility. Can you tell me a little bit more about the platform that you built? LAUREN: Absolutely. Cofertility is really like you said; we're a fertility ecosystem. And at our core, we're enabling women to freeze their eggs for free when they donate half of the eggs retrieved to a family that can't otherwise conceive, providing support and education for everyone involved along the way. You know, we're serving two very different audiences. One side of our business, our Freeze by Co, is targeted at women between the ages of 21 and 40 who might be interested in preserving their fertility. We know that really the best time to freeze your eggs, unfortunately, is when you can least afford it. And so we've really taken on this access issue and hoping to bring down the cost on that front. And then our Family by Co business is for intended parents who need the help of an egg donor to have a child, so that could be anyone from people who struggle with infertility, or gay dads, cancer survivors, et cetera. There are a lot of people that really rely on third-party reproduction to have a family, and we think it's time to really move that industry forward, and we're doing that in a lot of ways. So that's at a high level; happy to dig in more on any part of that. But we launched in October, and things have been going well ever since. VICTORIA: Wonderful. Yeah, I want to ask you more about...you mentioned the problem that you identified with when people who are most ready to freeze their eggs probably can't afford it. [laughs] But how did you really identify that problem and think I should start a company around this? LAUREN: Yeah, so it's a two-part problem. I think we see a big problem on the egg-freezing side, which is truly cost. I think we know that women are starting families later than ever. For the first time in U.S. history, the average age of women giving birth now is 30, which is the highest on record. And the experimental label from egg freezing was removed in 2012, and so it's become much more mainstream for women to do it. However, the cost to do it in the U.S. is between; I want to say, $12,000-20,000 to do it, plus yearly storage fees. And there are some women who have access to doing it through their large employer, but for the majority of people, that's just not the case. And so, for women who are really trying to prioritize their career or their education or maybe haven't found a partner yet, egg freezing can be a great option. And certainly, it's not an insurance policy by any means, and it's not a guarantee. But studies show that if you experience infertility later in life and you did freeze your eggs, you're much more likely to have a child than not. And so we see it as a great backup option. But again, cost is just truly a huge problem. And then, on the egg donation side, there are tons of families that rely on egg donation to have a baby. And I'm someone...I should mention, too, personally, years ago...I'll make a very long story very short here. Years ago, I was diagnosed with an incredibly rare abdominal disease that put into question my ability to have a biological child someday. And so, I started to look into what my options might be, and egg donation came up. And when I looked at what was happening in the space, I just couldn't believe how antiquated it was. And truly, for lack of a better word, how icky it felt. It seemed really transactional and impersonal for everyone involved. And what I realized was that it was really rooted in the stigma around egg donation that comes from cash compensation for donors. So traditionally, a donor is paid anywhere from $8,000 to $100,000 for her eggs, depending on, unfortunately, her pedigree or sometimes her heritage. Something that might be, you know, a donor that's harder to find might require more compensation the way it's done today. And so we actually saw that many women who are interested in helping another family grow through egg donation can actually be off-put by this idea of cash for their eggs. It's like, ooh, am I selling my eggs, or how do I feel about that? And it actually turns people off when it might otherwise have been something they wanted to explore. It also, I think, leaves intended parents without options that they need and really hurts the LGBTQ community that relies on egg donation for family planning. So there's a lot there. And we felt that that was something that if we remove cash compensation, perhaps it's something that really opens up the pie of women that are open to and interested in egg donation. And it also might really honor the donor-conceived person on the end of it more than what's happening today. Studies have come out that show that donor-conceived adults find the exchange of money for donor eggs to be wrong and that they can actually find it disturbing that money was exchanged for their own conception. So our model takes out cash compensation and instead gives women something that they're excited about, which is preserving their own fertility as well and really sets up everyone involved for success. VICTORIA: Yeah. I saw that in your literature, you bring this human-centered design to how you built the platform, which I think speaks to a little bit of what you're describing there. And do you think that being a woman founder yourself allows you to relate and empathize with women who have this unique perspective or a different perspective on how egg donation should work? LAUREN: Yes, egg donation and egg freezing, honestly. I think I mentioned a little bit about my own experience. Both of my two co-founders have also really, really been through it when it comes to their journeys to parenthood; both of them have been through IVF. And one of them says, you know, her biggest regret in life is that she didn't freeze her eggs at 25. And now, instead of just sitting in that, she's building a company to help other women not have that same regret. So building the company we wished existed when we were younger lets us build something that truly is empathetic and human-centered. And it's unfortunate that so much of healthcare is built and designed by people who, while maybe they have good intentions, they're not building from a place of experience, and I think reproductive health is one of those. I think women need to be involved in designing those solutions, and too often, they're not. VICTORIA: Right. Yes. That makes a lot of sense to me. And I want to talk more about you and your three co-founders and how quickly all this has come together. So, how did you know that your team of co-founders was the right team that these are the people you wanted to start this with? LAUREN: Yeah, it's an interesting question on so many fronts. I think there are people who spend a really long time, like co-founder dating, and use frameworks for evaluating co-founders, and the truth of it for us is that it all happened very quickly. Halle, who is the person who connected the three of us, she is one of my co-founders, and she's just someone I had long admired in digital health and women's health. And there was a day where...we peripherally knew each other. And she slid into my DMs on Instagram. Like, you never know where a great contact may come from. And she asked me what I was up to, what I was working on, and the rest is history. I told her I had just left...I spent eight and a half years at Uber and launched new markets of Uber across the East Coast and then started a business line at Uber called Uber Health, and Halle had always followed my trajectory there. And when she reached out to me, it was like, [gasps] what's it going to be about? And when it ended up that she had an idea centered around egg freezing and egg donation, given the experience I had had with my own fertility journey, it just felt like how could this not be the right thing for me to go build? So I would say gut instinct is really what it comes down to. Halle and Arielle, our third co-founder, had worked together a bit in their past lives. Halle built a company called Natalist, which is fertility, pregnancy tests, ovulation kits, and prenatal vitamins, things like that. And Arielle had actually built the first iteration of Cofertility, which was a fertility content site. And they had had that rapport already, and so that was something that I valued quite a bit. Really talking to some references and getting opinions of people you trust, but your gut, more than anything, will help you answer that question. VICTORIA: Right. And sounds like there's that shared experience and mutual respect, which goes a long way. [laughs] LAUREN: Yeah, that and also a shared vision. Like, if you're aligned with someone in the first month or so of talking about an idea, and when it goes from a little kernel to snowballing and becoming something real, I think it's a good signal. But if you're butting heads and disagreeing in that first really crucial time, it's probably a good idea to go in a different direction. VICTORIA: Yeah. And thinking along those lines, were there decisions that were really easy to make, and what were those? And the second part of the question is what decisions were kind of challenging to make, and what made those decisions challenging? LAUREN: It's funny. Halle was just like, "This idea is going to work, and I know it. Let's do it." I am someone who likes to see evidence before making a decision. And so I suggested in those first two weeks, like, let's get a survey together. Let's ask women, "Hey, would you actually be interested in egg donation if it meant that you got to keep half of the eggs for yourself and that there was no cash compensation involved?" So we asked a few influencers on Instagram to put out our Typeform, and within, like, I don't know, 24 hours, we had over 700 responses. VICTORIA: Wow. LAUREN: And it was a very resounding like, yes, this is something women were interested in. That gave me all the conviction I needed to go at this full force. And so I think having that proof point not only was valuable to help me get there, but it also helped investors get on board. I think some of the easy decisions were like there were certain investors that after meeting I just knew like, yes, this is someone I want to be working with over the next few years. This is someone who sees the same vision that we see. And there were a few conversations with other potential investors where I was like, you know what? That's not who I want to work with. Again, it's like, I'm very big on my instincts as it relates to people and trusting that. VICTORIA: Right. Yeah, that makes a lot of sense. And congratulations on raising your seed funding. LAUREN: Thank you. VICTORIA: And was that a stressful process? How did you feel after that happened? LAUREN: Parts of it were stressful, for sure. I think the fact that I had never done it before was stressful. I like to call myself...before this, I was an intrapreneur. I pitched the idea of Uber Health to Uber executive leadership with a deck that was very similar to what you would pitch external investors with in a scenario like this. So I had gone through a little bit of that but never before had I done anything quite like this. And so I felt very lucky to have Halle by my side through that process because it wasn't her first rodeo. But I would say trusting yourself and trusting that you can figure this out. It seems so much more intimidating than it needs to be. No one is expecting you to fully know how all of this stuff works. It's very figureoutable. VICTORIA: And what obstacles did you face in the last year that you've been working on this? LAUREN: The biggest obstacle, I would say, honestly came down to having the time to both get a company off the ground...and I like to imagine an aeroplane. You have to figure out what kind of plane you're building; then you have to find all the parts, then you have to build the plane. And then the goal upon launch, I can imagine it when I close my eyes. It is like getting the plane off the ground. And with a startup, like you can imagine, there's always a bit of building the plane while you're flying it. But doing all of that over the last year, plus finding the right people to hire, is two full-time jobs. You're sourcing incredible candidates. You're meeting with them. You're pitching them the business. But you also need to evaluate whether or not they're as great as their resume makes them seem. Then you have to convince them to join your seed-stage startup, then check their references, and then put together their offer package, and then do all of their paperwork. And it was like all of these things that I took for granted at Uber for so long of having recruiters, and having an HR team, [laughs] and all of those things that truly it is a full-time job plus building a company. So that, for me, was the hardest. And hiring just at that early stage is so, so important because you add one person, and that's like such a huge percentage of your team. So every hire has to be a great one, but you also can't wait too long to hire because then you miss your goals. VICTORIA: Right. Yes. And there's lots of uncertainty going on in the world as well. I'm sure that makes hiring extra exciting. LAUREN: Yes. I mean, exciting and also scary. I think exciting from the fact that there's great talent that's looking in a way that wasn't necessarily the case six months ago, but scary in that you have to...one of my biggest or things that keeps me up at night is like, what's the right timing to bring on new people so that your business scales appropriately but not too soon that you have people waiting around for the work to come? VICTORIA: Right, yes. And speaking of scary, I can imagine the choice to leave a company like Uber and go and start your own business was thrilling. [laughs] Can you tell me more about how that happened, or what was the order of operations there? LAUREN: I'll go back to my personal story a little bit. So I ended up with this disease that I had been diagnosed with. It was so rare and so not a lot of data on this disease that I decided it was...or these doctors were like, "You know what? Do you have a sister by any chance?" I was like, "What do you mean?" They were like, "You know, it's too risky for you to freeze your eggs just because we don't have any data on your disease. But if you have your sister freeze her eggs and donate them to you, you have them as a backup should you need them." So my incredible sister did that. And I learned a lot about the process of donation even through that experience. And went on to have three surgeries and ultimately was able to conceive without using my sister's eggs which was crazy and exciting and definitely gave my doctors a shock, which was great. And when I had my daughter, it was like this light bulb went off of, like, I have to build something in reproductive health. If I'm spending my time building something, I want it to be spent giving people who want to have a child this amazing gift that I've been given. And it was like an immediate amount of clarity. And so, after my maternity leave, I gave notice at Uber without a plan. I did not have a business idea. I did not have a job lined up. I was fortunate enough to be able to do that. But I almost think releasing myself of that is what gave me the freedom to think about other things. And it was within a day that Halle sent me that DM on Instagram without knowing I had given notice. So the universe works in mysterious ways. VICTORIA: That's wonderful and so exciting and that you just had a baby and then to be in a position where you could start a company and almost feel like I don't have enough to do; [laughter] I want to start a new company too. [laughs] LAUREN: I know. I ended up...the day we pitched our lead investors was my daughter's six-month birthday. VICTORIA: That's amazing. MID-ROLL AD: Are your engineers spending too much time on DevOps and maintenance issues when you need them on new features? We know maintaining your own servers can be costly and that it's easy for spending creep to sneak in when your team isn't looking. 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So I've been really, really specific with myself and with my team about what windows of time I'm with my daughter, and I'm meticulous about it. If that means on certain days, I wake up before she does so that I can get some work done so that I have two hours with her first thing in the morning, and then I'm off between the hours of 4:00 to 7:00 so that I can spend time with her. If that means getting back online at night, I'm down to do that. I just won't compromise the time with her. And my team has been really respectful and honoring of that. And in turn, I really encourage everyone on my team to have a life outside work, whether that's with their children or their pets, or having physical activity, or things like that in their life. I think it's so important that we're not entirely defined by our startups. I think that's how people burn out really quickly. And it's like 2023, right? We don't need to be in this hustle culture where 100% of our time is focused on building our company. It's just not sustainable. VICTORIA: Right. I like that you mentioned sustainability. And that's been a recurring theme I've seen where, yeah, the hustle culture leads to burnout. It isn't sustainable. So are there other cultural or values that you impart onto your team, this new team, that you're standing up to create that sustainability in that innovation that you want? LAUREN: Yeah. I think one thing we've implemented...I would highly recommend actually Matt Mochary's CEO Curriculum. You can find it by Googling it, or I can share the link with you. And within his curriculum, he has something called The Magic Questions. And the magic questions it's like five or six questions where you ask everyone on your team, like, how would they rate their life at work? How would they rate working with the team? How's their personal life going? Like, you know, questions that you can quickly get to the root of something. But then, aside from giving a rating for each of those questions, it asks like, "How would you take it to the next level?" And what I think implementing these questions has done is it's like each time we do it, it gives the leadership team something to act on of like, "Hey, I noticed a theme amongst the employees with this set of magic questions. Like, here are some things we can address to improve that for everyone." And then there are also opportunities with each individual to say, "Hey, manager of this person, so and so called out that they're really struggling with prioritization this month, or they're really struggling with being split on these two projects. How can we help relieve that, or how can we dig in with that person so that the next time we ask these questions, that's not still an issue and that we've been able to take swift action to help improve that?" I think that really helps to just stay close to what people are feeling and thinking. And it also gives people, I think, more self-awareness of how they're doing and what they can be intentional about and address for themselves as well. VICTORIA: I like that. I'll have to look up that book and share it in our show notes as well and -- LAUREN: It's actually even all online. It's like a Google Doc you can look at. VICTORIA: That's awesome. LAUREN: And there's also a book called The Great CEO Within by Matt Mochary. But I love the book and the Google Doc version. VICTORIA: That's awesome. And it sounds like you really pulled everything together so fast. [laughs] I'm curious about your background if you feel like there were...you mentioned that you pitched inwardly to Uber. But what else about your background kind of lends you to this leadership-founder skill set? LAUREN: I mean, I joined Uber in 2013 when we had, I think, fewer than 200 employees, and we were in about 12 cities. So I very much knew startup life. And I understood this idea of sort of building the plane while you're flying it and saw that. And so I think that certainly has contributed to this. It's important when you're a founder to surround yourself with other founders and to have people that you can tap into at any point. I'm in a few different Slack groups with different founders; some are healthcare founders, some women founders, some through the VCs that we've worked with where it's really easy to say, "Hey, which payroll tool are you using?" Or "Hey, like, how do I measure employee NPS?" Or "What tools are you using for this or that?" And if you can tap into other founders, you really can move a lot faster. You don't have to write your entire employee handbook from scratch because you can borrow from other people. I think that's one of the best hacks that I would recommend. And then some of these books that I found that really do, you know, within that Matt Mochary book, it's like, here's a way to make candidate offers. Obviously, the book isn't doing the work for you, but it certainly is helping to give you a framework. And then the other piece is like, aside from your own team, I think bringing in some advisors who you trust and can go to for certain things. So two of our advisors are people I worked incredibly closely with at Uber and would trust with my life and so why not trust them with my company? So bringing them into the mix has been a real relief. And then just sort of about your community. I think it takes a village to raise...I think, actually, I would compare launching a company to having a baby. So if having a baby takes a village, so does launching a company. VICTORIA: Right. Or no founder is an island. [laughs] LAUREN: Yeah, exactly. VICTORIA: There's like a community, a whole group around that. I've heard, even in the episodes I've recorded, that it's a common theme among successful founders, which is heartwarming and understandable. So last question about just how it all got started. But if you could travel back in time to when you first decided you wanted to go after this opportunity, what advice would you give yourself now that you have all your present knowledge? LAUREN: I say this even to our intended parents who are grappling with this decision of using an egg donor to have a baby: remain steadfast on the vision or the end goal and be flexible on the how. So if you're an intended parent, it's like, remain flexible, like, steadfast on this idea that you want to become a parent, but be flexible on the how. With a company, I think stay true to what that ultimate vision is. So, for us, it's like help more people have babies on their own timeline and be flexible on the how, so exactly what our business model was, or exactly what our go-to-market approach would be, or exactly which product we were going to use to get there. I wish I had been a little bit more open to it being a winding road than I realized I needed to be at the beginning. So now I know that, and I'm open to any possibility as long as it gets us to the same place. VICTORIA: Right, gotcha. Yeah, well, let me ask you then about your go-to-market strategy since you mentioned it. What was unique in your strategy there, especially to target the specific consumers that you want to with this app? LAUREN: So I did follow a bit of an Uber approach, which is this idea of a soft launch. And the reason for that...so basically what we did was for the Freeze by Co side of our business, so for women who are interested in freezing, they have the option to join our split program where they donate half to intended parents and do it for free. Or they can join our Keep Program, where they freeze their eggs but keep 100% of the eggs for themselves. And we help do that along the way. However, basically, we couldn't launch Family by Co to help people find donors until we had donors. So it made sense to launch the Freeze by Co side of our business first. And I wanted the ability to market to them when we didn't have the eyes of the whole industry on us, or we didn't have tons and tons of consumers reading our press or things like that just yet. And so by soft launching with a quick beta Squarespace page, we were able to test our hypothesis, test our messaging, test our funnel, test our experience before really putting a ton of marketing spend behind it or having a ton of visibility into what we were doing. And I'm so, so grateful we did that. It led us, like, we went through probably five different versions of our funnel before we got to our public launch, and our soft launch really afforded us the opportunity to do that. So by the time we turned on the Family by Co side of our business, we already had over 50 donors on day one for them because we had already gotten these women through the funnel. VICTORIA: I love that. And that's something we talk a lot about with founders at thoughtbot is that idea of validating your product, and you talked about it with your Instagram poll that you did with influencers. And the way you're talking about your go-to-market strategy is that you wanted to make sure that even though you knew this is what you wanted to do, that you had the right approach and that you could create something that consumers actually wanted to buy and had trust in. LAUREN: Mm-hmm, totally. VICTORIA: You launched in October 2022. Are there any results post-launch that surprised you? LAUREN: I feel so grateful that our launch truly exceeded my expectations. So the interest from women in our programs has been overwhelming, like overwhelming in a good way. And then intended parents are thrilled about it. So we are making matches every day of these intended parents and these donors. And every time we make a match, I'm like, oh my God, it feels like Christmas morning. You're helping people find their path towards growing their family, and there's nothing that feels better than that. I don't think that feeling is ever going to go away, so I'm thrilled about it. But it doesn't mean that it's not hard. I think back to that analogy of like having a baby, you know, you launch this company. You hope it's received. You count ten fingers, ten toes, hope that it's received, hope that it's received. It is, but then you have the demand, and you have inbound on partnership opportunities, and you have managing the demand and handling the leads and things like that. And it's like so much more than you expect. It's like the same feeling of having a newborn of, like, [gasps] how are we going to do all this? Am I going to stay up all night to manage this? Or how do we handle what we're seeing? And so it's a lot, and figuring out what this new normal is is something that my team and I are working through every day. VICTORIA: What's wonderful is that the surprise feels even better than you thought it would. [laughs] LAUREN: Yes. VICTORIA: Wonderful. For myself, as I'm in my 30s and I'm married and, you know, I'm not thinking it about at some point in the future. But what advice do you think you want women to think about regarding their fertility at any age, like if you could talk to consumers directly like you are now? [laughs] LAUREN: Totally. Just that it's never too soon to ask those questions. And the information you need and should want is like inside your body but ready to be shared with you. So by having a consult with a fertility clinic, and that's something my team could help you with, you can learn about your prospects for having a baby and understanding how fertile you are. And just because, you know, they say, "Oh, as long as you're under a certain age, you shouldn't have a problem," doesn't mean that that's the case. One of my co-founders was 28 when she started trying to conceive and was completely blindsided that this was going to be a real struggle for her, and that breaks my heart. It doesn't need to be like that. If we're more proactive and we start asking these questions younger, then we can actually do something about it. So your fertility is really about your egg quantity and your egg quality, and both of those things are things that can be tested and measured. And I think I'm someone who loves data. And having that data, I think, can help enable you to make decisions about how you can best move forward, and for some, it might mean having a baby soon. For others, it might mean freezing your eggs. For others, it might be a waiting scenario. But that's something that you can make a more informed decision about if you have that data. VICTORIA: That makes a lot of sense. And I'll be sharing this episode with all of my friends and everything on Instagram as well. LAUREN: [laughs] VICTORIA: Great information to put out there. And what's on the horizon for you? What are the big challenges that you see coming up for Cofertility in the next months or year? LAUREN: I think really like scale is what we're focused on. So we've started making matches; it feels great. I want us to be prepared to do those at scale. We are seeing no slowdown in terms of people who are interested in this. And so, making sure that our team is ready and able to handle that demand is my absolute top priority. So I think scale is top of mind. I think making sure we're optimizing our experience for that is really important. So how do we make sure that everyone is having a magical, smooth experience, both through our digital experience but also if they're on the phone with someone from our team or if they're reading our materials at the fertility clinic? Like, how do we ensure that that's a great experience all around? VICTORIA: Right, that makes sense. And right now, is Cofertility specific to a certain location, or is it nationwide? LAUREN: Nationwide throughout the U.S. VICTORIA: Wonderful. And you yourself are based in California, right? LAUREN: Yes, I'm based in Los Angeles. And our team is fully remote, which has been a really exciting thing to do. We're in different time zones and have a lot of opportunity to visit people in different cities, which is nice. VICTORIA: Oh, that's great, yeah. How do you help build that culture remotely with a brand-new team? LAUREN: So, for us, I think we're very intentional about having team off sites at least twice a year. We also get together for different things like planning meetings or conferences that are really relevant to us. But I think part of it, too, is really around different touchpoints throughout the day. And we have a daily stand-up. We also are clear about which hours everyone sort of overlaps based on their time zones and making sure that people are available during those windows and then giving everyone flexibility otherwise in terms of when it makes the most sense to do their work, not being too prescriptive. And really, again, encouraging people to have a life outside work, I think, makes it so that we get the best out of our team. VICTORIA: Right, that makes a lot of sense. Yeah, we've got similar...at thoughtbot, we have in-person meetups once or twice a year and then go to different conferences and things together. And I think some people do miss a little bit of the office experience, but for the most part, everyone is happy to put it that way. [laughs] LAUREN: Yeah, it's definitely...I think for sure it has its pros and cons. I think what I love about it is that we're not limited with talent. Our team truly, like, [laughs] we have people...we have someone in Oakland, someone in Miami, someone in Charleston, someone in Boston, someone in New York City. Like, the fact that we're not limited because of geography feels great. And I admittedly really love the ability to see my daughter throughout the day and feel like I don't have to stress over how much time I'm spending commuting. So I can't see myself ever going back. VICTORIA: That's right, and LA is certainly a place to have a long commute. [laughter] And have you gotten any benefit out of local networking and community around Los Angeles or Southern California? LAUREN: Yes, absolutely. Even this Friday night, I'm going to a female founder dinner. I have something coming up in a couple of weeks with this group of women's health founders that I really love. It's so, so valuable to have people in your network that are both local and get the life that you're living while you're doing it. I think having people understand why your life is the way it is while you're building a company is really quite nice. So there are founder communities everywhere but seeking those out early is definitely helpful. VICTORIA: And then if you have a remote team, then each team member can have that local community, so you're 10x-ing. [laughs] LAUREN: Completely. VICTORIA: Yeah, wonderful. Is there anything else, anything that you think I should have asked you that I haven't asked yet? LAUREN: No. I think one thing I would encourage is when you're trying to figure out your go-to-market approach, what the strategy is going to be. I'm a big fan of getting everything really in slides. Get it in slides and bring in some people you trust. Talk to your advisors, talk to your investors, talk to your co-founders or your team and say, "Hey, these are the three ways this could go. Here are pros and cons of each one," and making a decision that way. I think when we try to do it where it's like all in someone's head, and you're not getting it out on paper with pros and cons, it can feel like a really, really hard decision. But when you see things on paper, and you're able to get the opinion of people you trust, everything is able to come to fruition much more quickly, and you can get to a decision faster. VICTORIA: Right. So you're probably really buzzing with ideas early on and finding ways to communicate those and get it so that you can practice talking about it to somebody else. Makes sense. LAUREN: Yeah. It's like, how do you socialize it? That's a great way to do it. VICTORIA: Yeah, well, wonderful. This has been a really enjoyable conversation. I appreciate you coming on the show so much, and thank you for sharing all about Cofertility with us. Any other final takeaways for our listeners? LAUREN: Thanks so much for having me. If you're interested at all in what we're doing or it would be helpful to connect, our website is cofertility.com. You can find me on Instagram at @laurenmakler, L-A-U-R-E-N-M-A-K-L-E-R. Happy to chat really about anything as it relates to building a company, or your fertility, or just questions you have in general. I would love to chat. VICTORIA: Thank you so much. And you can subscribe to the show and find notes along with a complete transcript for this episode at giantrobots.fm. If you have questions or comments, email us at hosts@giantrobots.fm. And you can find me on Twitter @victori_ousg. This podcast is brought to you by thoughtbot and produced and edited by Mandy Moore. Thank you for listening, and see you next time. ANNOUNCER: This podcast is brought to you by thoughtbot, your expert strategy, design, development, and product management partner. We bring digital products from idea to success and teach you how because we care. Learn more at thoughtbot.com.

This episode of A365 will discuss gender expression and identity in the global workplace.     Rafael Franco (Brazil) leads the conversation with Edelman leaders to address several topics, including understanding and respecting pronouns, recognizing differences in inclusive language globally, navigating gender expression in the workplace and more. The episode will also explore the experiences of those within the LGBTQIA+ community in sharing their identity at work and in the world.    Transcript Dani Jackson Smith [00:00:01] It's who you are to work after hours and back at home. Exploring every layer. Finding out what makes you uniquely you. And letting that shine back out into the world. It's authentic. 365 A podcast that takes a glimpse into how some of the most inspiring people among us express themselves and make magic happen. I'm your host, Danny Jackson Smith, VP at Edelman by day, community enthusiast and lover of the people always. On this episode, we are engaging our colleagues across the globe in a conversation on gender identity, understanding that how gender is addressed and acknowledge shifts based on your location. Let's join the conversation now.   Rafael Franco [00:00:51] Hello. I'm Rafael from Brazil, Adama San Paolo. And we're here today to discuss to explore the stigmas around gender identity and expression, to go beyond the binary gender identity and expression at work. And for this conversation I have here, for different persons around the globe, we have Monika Tik Tok from Brazil whistles. She's a senior account manager. I will ask everyone to say your pronouns as well as tragedian director from Malaysia. Lauren Gray, Senior Vice President, New York Crisis and Reputation Risk Advisory. And Nick Nelson, Senior Vice President Austin. Welcome, everyone.   Nick Nelson [00:01:34] Glad to be here.   Monica Czeszak [00:01:36] Happy to be here, too.   Rafael Franco [00:01:38] So we just start with an open question to everyone. So one identity is important to us all, and should we be respected by everyone knowing the formal definition of gender identity and expression? What do those terms mean to you personally and your response? Again, please say your personal pronouns. Mo, you can you can start, please.   Monica Czeszak [00:02:03] Okay. Hi, everyone. Glad to be here. If everyone, I'm Monica. But let's see Mo for short. As you heard, my name is a little tricky. My pronouns are actually all the pronouns. And like the lady on the mall, that puts everything on the shopping carts. So he / she / they I'm comfortable with all of those. And to me, that's a special question because expression to me it's whatever I feel like that day. Sometimes it's braids, sometimes it's baggy clothes, sometimes it's nothing at all. I'm also very forth on getting out of that image that everyone that's nonbinary only wears pajamas. And I think expression is just feeling comfortable with yourself and being your best self every day, and that's particularly special at work. And I think respect only starts with us looking at each other and getting to know each other and asking questions and having safe spaces to ask those questions because it's not easy. Sometimes I'm very feminine, so people might assume I use she or her. Sometimes I'm very masculine, so people might assume similar he. But it's very fluid like gender and like expressions. So we have to be safe to ask each other questions and present ourselves as we are.   Rafael Franco [00:03:28] Okay, great. What about you, Asra?   Ezra Gideon [00:03:31] So yeah, my pronouns are he / him. I've recently transitioned from female to male about two years ago. And I guess, you know, I'm. How do I say this? It is more true to me being a he / him than it ever was before, you know, being in any other pronoun, to be honest. So it's most comfortable for me and this is the pronoun that I feel most myself. It's a little tricky here because the Malaysian language does not have a he / him / they / them, its all dia means they / he / she. So it's you know, it's it's an amazing language. Trouble is, in Kuala Lumpur, corporate language is still English. So but it's still kind of, you know, a yeah, there's a mix of of Malay and English. So it's it's not as difficult, I think, for us here in Kuala Lumpur as opposed to parts of other parts of Malaysia. But yeah, it's a it's those are the pronouns I'm comfortable within and I'm happy to to use whatever pronouns someone tells me they want. I will use that because I respected that, that they know themselves better than I do. So, you know. So, yeah.   Rafael Franco [00:04:52] That's great. Well, I'm making myself vulnerable here because I'm not a known non-native English speaker. So it's hard for us Brazilians as well to understand this gender way of speaking in English. So I will hand over to my English colleagues. My English speaker, English- speaking colleagues learning and make plays well.   Lauren Gray [00:05:17] Thank you so much. I actually wanted to start by just sharing a definition of gender identity and gender expression, just in case anyone who's listening in doesn't know those definitions. And these come from the LGBTQ+ advocacy organization GLAAD and its media reference guide online. Reporters can use that guide to help better understand and cover LGBTQ issues. For gender identity, it's really a person's internal, deeply held knowledge of their own gender. Everybody has a gender identity. For most people, it matches the sex that they were assigned at birth. For our transgender community members, it doesn't align with sex assigned at birth. And many people's gender identity is that of a man or woman. But for other non-binary community members, it just doesn't fit neatly into one of those two categories. And just to give you a little bit more context on that, there was a recent study by the Trevor Project that found that one in four Gen Z LGBTQ community members are non-binary with an additional other 20% questioning their gender identity, and one half of those Gen Z non-binary individuals actually don't identify as transgender. So what we're seeing is really a sea change in the breadth and variety of language that's being used to describe and understand how nuanced gender can be. For me, my pronouns are she her, hers. But as a member of the LGBTQ community, hearing people share their pronouns and seeing pronouns included in emails, signatures, or in zoom display names. It's really a signal of a more diverse, inclusive environment. And I think it's one of the very important things that our colleagues can do in the workplace as an outward sign of support for our community and for those who are also looking for other ways to be a stronger ally. I would encourage you to get to know your LGBTQ colleagues, acknowledge their partners or spouses or families in the very same ways that you would people outside of the LGBTQ community and read up on things, look at the news, watch what's happening as things develop, and try to acknowledge moments of significance to the community, moments when you have terrible setbacks and moments when we celebrate great progress.   Nick Nelson [00:07:38] Nick Yeah. Lauren Thank you so much for that. I think, you know, it's always helpful here and be reminded of my pronouns are he is and my name is Nick Nelson since I didn't start with that. I think one of the things that I am still learning is the conversation we're having right now. You know, I work in multicultural DEI space, and so I've had the privilege to learn about gender identity, gender expression, but I've also had to acknowledge my own privilege as a gender male and not having to understand people who don't identify in the same way. And it's been a really rewarding experience to learn so much and have conversations like these and facilitate conversations like these for clients and for our colleagues. And so I think what it means to me is just a learning experience still. You know, I'm 33 years old and I'm still learning so many things as if I was still in school. And I think that's been the great thing about this particular workplace, but especially the work that I do is it gives me an opportunity to educate and to bring clients and colleagues along on the journey with me. But it also provides an opportunity for me to learn more and then be more supportive of my colleagues who may not be who may not identify it the same way or feel confident or comfortable identifying the same way as I do. So I'm really glad to be in this space with you all and have this discussion because it's long overdue and it's always important to talk through and kind of hear the perspectives. And I am looking forward to walking away from this with a new perspective that I can then bring into my work and support everyone, you know, regardless of their walk in life.   Rafael Franco [00:09:35] And we have mentioned our journey to understand this this theme better. And also Lauren mentioned the pronouns on our email signatures. And this awake me about Monica because I have wrongly assumed her pronouns in the beginning as she / her only. And we never have talked about that before. So Mo, is there a best way to to make sure we are always using pronouns properly and inclusively, especially in a global firm like Edelman?   Monica Czeszak [00:10:12] Yeah. And I think that's the funny part because when you have different problems, sometimes it falls back to you to let people know about your names, but you're not always safe or comfortable with sharing. So when you have a widespread initiative like the email signatures, like Lauren said, you're showing other people that it's okay to introduce yourself and say your problems and ask people for their problems as well. To me since I relate to all of them and none of them. It's like whatever rings that they it's fine. I feel very glad when someone uses he for me because it shows me they're trying to use other problems with me or when they talk in a general neutral way, but at the same time I'm comfortable in all those spaces. So I never really made the effort of going out there and saying to people, Hey, this is my problems and I'm comfortable this and comfortable with that. And once we had the signatures, it was like, Oh, I can let people know. And it kind of blew my mind a little because it was so simple and so easy. And at the same time I had a few emotional exchanges. Rafael was one of those people, but other colleagues came to me and was like, Oh my God, I'm so sorry. I never knew. Are you okay? Should I say things different? And it never occurred to me before that people might be struck that way after knowing my problems, that they did something wrong or something was not right before. So I had a lot of very emotional and very good exchanges with my colleagues, and I tried to make sure they knew that it was okay. We were getting to know each other better and I was happy. Now they knew and they were trying to be more. I don't know, inclusive of me. And it was very good for me to have those conversations because it opened doors for us to know each other better. Go ahead, Nick.   Nick Nelson [00:12:22] Yeah. I just wanted to build on that one. Thank you for sharing. But too, it's something that I speak about in client forums and in our employee forums where inclusion or being inclusive is not difficult, but it is intentional. So using the email signature was such a simple thing that started these conversations and got you such reactions, but also gave you an opportunity to express that. That's a perfect example of that. You know, inclusion is always intentional, but it's not always difficult and it just takes people like our company or like other companies who have done that, starting these initiatives where you can put your pronouns in your email or like we've done in this conversation, starting with introducing yourself and your pronouns. So you've established that already, and that was just such a small, simple step. So I'm really glad to hear that it was that impactful for you, where it was starting some new conversations, drawing some reactions and possibly an educational opportunity for so many of your colleagues.   Monica Czeszak [00:13:35] Absolutely. And it's completely intentional. And what I like most about it, it's at the end of those conversations, what we came to realize is that it has to be intentional and it has to be like a day to day exercise. In Portuguese, every word is gendered, like objects are gendered, every pronoun is gendered. So we are still figuring out how to be gender neutral and what are the rules and how to express it. And it's hard. You have to practice, so you have to know that. You have to use it and try to use it every day. So you get to that place in which it's easy and common to be gender neutral as well. So having those conversation was great for me in getting to this place where other people were also comfortable in asking and learning and trying to exercise. It was great.   Rafael Franco [00:14:28] Yeah, and as most said, and in Portuguese we have children conversations in general, everywhere, gender, but we are figuring out ways to do it. And so, for example, we have inclusive language and we have neutral language. One of them is not like formal. So we cannot use a broadly because it's not common for people to understand. But there are some ways that you can remove the gender from the phrase, rephrasing it. So that's one way that we that we tried to do here in Brazil. And Ezra, inclusive language, as I was saying, translates differently in different countries. And can you help better help us understand this dynamic based on your local experience?   Ezra Gideon [00:15:16] Yeah, sure. I guess in when, if and when we speak Bahasa Malaysia, which is to me, how many times, how many percent of my day spent speaking Bahasa maybe 20, to 80% of my time is speaking English because, you know, in Kuala Lumpur, almost everyone speaks English. In fact, everyone does. It's a matter of the degree of English or how well they speak it. But I only spend about 20% of my time speaking Bahasa Malaysia. But it's a mix and match when you're is very close friends and it gets very, you know, how do you say gets more when you're more familiar with people that gets a little bit less structured. So then, you know, it's a mix of English and Malay but I do think that people who speak Malay, the Bahasa and the Malay language tend to be less concerned over pronouns. And it's just they / them generally. And when they speak and when they say dia means, you know, they or he or she. So it doesn't really affect the composition of the person or the wellbeing of someone. But, but again, you know, how that works for us is still we speak a lot more English than we do Malay. And it's hard to educate people in a country where it's illegal to be trans or gay. So they just won't. They just won't because I don't have to. Because it's illegal anyway. You being you. Yeah.   Rafael Franco [00:16:45] Sure. And Lauren, we were talking about places where it's illegal to be LGBTQ plus and not even in countries where it's it is recognizable and it's okay to be gay or lesbian and trans and etc.. We know that not all LGBTQ plus employees feel comfortable sharing their experiences sexual orientation, gender identity, or expression in the workplace. So how can we recognize that and still be supportive to our colleagues, of our colleagues?   Lauren Gray [00:17:23] So you're absolutely right about that. And that's actually really a surprise sometimes to people in the US. There's data from the Human Rights Campaign for 2018 that found that about 46% of LGBTQ employees are closeted at work, which is actually usually very, very surprising to people. And we really want people to be able to be their authentic selves at work. Some of it is an issue of representation. There was some really interesting research as well from McKinsey in their 2020 Women in the Workplace report that found that in corporate America, LGBTQ women specifically only make up 2.3% of entry level employees, 1.6% of managers, and even smaller numbers at more senior levels. So to help counter this and help bring people out at work, we really need to focus on ways that we can increase visibility at work and representation for business. It's great to think about recruiting and retention and what that could look like, and we actually had a really interesting experience recently at Edelman. We created this task force called Out Front. It's an LGBTQ task force. It's really meant to help to. Will clients on complex LGBTQ issues. And as part of that task force, we created a team chat to make sure that people were in the loop and that we were communicating on issues that were raised and bringing in people with appropriate expertize. And we found that that chat really brought people together across offices. It was amazing and people started communicating on it all the time, sharing articles and stories and life events and wedding photos and pictures of birth of new children, etc.. And it was just this really incredible way that really organically people came together and started to increase visibility. So as much as we can do things like that, I think that will really, really help bring people out at work.   Rafael Franco [00:19:21] And this, I guess, changes our culture, culture of the company, right. And the culture of the company is impacted and informed by the people who work there. So, Nick, how can we all be inclusive and supportive to our to all our colleagues who wish to or wish not to fully express their gender identity at workplace?   Nick Nelson [00:19:46] Yeah. I think the most important thing is to create a safe space, right? Create a safe space for our colleagues at Edelman and beyond to show up the way that they want to. Right. And for some people. I would say that doesn't necessarily mean that they're closeted. That means that that's not a part of themselves that they want to share in the workplace. And I think we have to create the space and grace for that. Right. You know, I think the term that we use a lot is authentic self. And I think authentic self is subjective and relative to every individual. And so, you know, if you choose to share these details with me. Great. Thank you so much. I appreciate it. If this is not important to your workday or if this is not a part of the identity that you want to share in any part of your life. Great. I still like you anyway. I still enjoy working with you. And so I think that's the most important thing, is just the space to be yourself and then not, we have to be careful. And this is something that I see a lot in my work. We have to be careful not to create a box or terms for what showing up as your authentic self means. Right. You know what that means for Lauren, for example, may be very different for me, and that's not because anyone is shy or afraid. But we have to consider that people are bringing a lot of different experiences into this moment that we're meeting them. You know, I have no idea what has happened to you guys before 21 minutes ago when we started this recording. Right. And I don't know what's going to happen to you after. But I have to understand that there's so many things contributing to the way that you are showing up in this moment. And so all I can do and all we can do is make sure that we're being supportive colleagues and meeting you in this moment and helping you show up the way that you want to be your best self.   Rafael Franco [00:21:54] That's very powerful and very, very true. And so I would get back to Turing because we have talked about added initiatives in during this conversation. And Adam Eco is one of our employee network groups. Adam And it was created to help to good turn on community for LGBTQ close employees and allies and provide a place and space where employees can share, learn and grow. So how can an employee group serve to good community for or benefit non cisgender employees at work?   Lauren Gray [00:22:33] It's a really great question, and I'm glad that you asked that this year. Edelman Equal has we've had several key priorities. The first is educational programing. So, for example, after the overturn of Roe v Wade, we hosted a conversation with Jim Obergefell, who is the lead plaintiff in the Supreme Court case, the marriage equality case. And we talked about what these developments might mean for LGBTQ community members and for marriage equality broadly. We also talked about monkeypox this week with Dr. David Nabarro. So we did a briefing, public health briefing on it, and we talked about considerations for employers and answered questions that people may have about what's happening and what that looks like. And I think this educational programing is really important because it doesn't just benefit our broader Edelman community. But if you are an LGBTQ employee and you want to have a voice in helping shape the conversation that's happening at Edelman, in the knowledge on these issues in your own workplace, you can really be part of planning what some of that looks like. We also advocate for employees. We want to make sure that we are on top of what employee benefits should be happening for LGBTQ employees and making sure that we're included in data that Edelman is collecting so that we're being appropriately represented. And then also just provide a space to really connect and get to know each other and advocate for each other and support each other. Sometimes it's nice just to have fun together, but other times it's it's also really nice to have built up strong relationships with other LGBTQ employees. If you have questions or want to pressure test certain things or just to talk about things that have happened in the workplace.   Rafael Franco [00:24:14] That's great. And Asra, you have started your major media transition a short time ago and not within the most ideal condition, as your country is not welcoming to the full diversity of the LGBTQ community. And you have told me that Adam and I have have have had a very powerful space in this transition. So can you share a little bit of your experiences and specifically your how your work environment has impacted your transition?   Nick Nelson [00:24:46] Absolutely. I think, you know, it took a while before I discovered, you know, you know exactly you know, what my life would would be had I had taken this journey, for example. It's a lot of obstacles. But, you know, I, I spoke to my my mother and I told her everything. And I said, if it means I have to quit, I will have to do it because it's I can, you know, cannot not live, you know, being myself. But, you know, we took it on together, actually. And I think this is very important. It's because of that kind of leadership that you feel you can go to someone you're safe for the most. You know, Muslim is Muslim muslin is Muslim I Muslim. So it it mean you need to trust this person, you know? But, you know, after all of that, long story short, we managed to find a way to bridge that gap by I said, I'm going to come out, we're going to stay and fight this together. Whatever the system is, we will will face it together. And I came out to the colleagues and I think to Ipac. And so I think online when we were all doing the pandemic at that time, and it made me so much braver. And she was right there next to me and she's saying, going, going. That's fine. You know, and it's so many people involved. It's it's not just my M.D., but she was that person for me. And had I not had someone like that to be able to help me in on a day to day, even struggle with with the outside world, because coming to Edelman is like a whole different world. When I go back home, it's a whole different world, right? So but it's made me mentally healthy, so much better. I'm so much better for it. Being able to do what I do every day. I think I've even gotten better at my job, I'll be honest with you. So, so, so that that I think was very important. But it's not just leadership. It's the whole team. They're so polite. They ask me, you know, if they're saying something wrong, they're just amazing. It's it's hard to express. But yeah, it's been amazing. So we have two sets of laws in Malaysia. One is for Muslims, which is the Sharia law, and another is secular for everybody else who is not Muslim. And I can never change my gender marker, obviously, because if as soon as I do that, it will be, you know, it's illegal. Right. But they're going to they can try and test and test you on a day to day basis if they want you to have a look at your ID card and it doesn't match with the way you look or how you express yourself, it can give you a hard. But I've been very lucky. I've been honestly luckier than most and most grateful. Grateful for that. But it's harder for a lot more people here. I'm in a good position. I could probably get a job easier than some transpeople because I've been known in the industry before I transitioned. So yeah, it, you know, there's more to it than that. But in a nutshell, it really helps to have that culture of support from top down and it helps so much.   Rafael Franco [00:28:05] Well, I think I can speak on behalf of everyone here. We are so glad to hear that you have this help and have this opportunity of transition and be yourself at at the workplace. And as we are discussing the pronoun usage, for example, and the respect for gender identity and expression, they are very important in life and at work. So more can can you give us an overview of why it's so important to respect pronouns, why these tiny words are so important and so impactful on our lives, in our day to day work.   Monica Czeszak [00:28:47] Is a little emotional, but I think what we need to start off is just stripping away everything else and just realizing that we are all human beings that want to be seen. We want to make connections, we want to be cherished. We want to love and be loved. And that's the center of everything. And. Having that in the workplace, which is, let's say, most of our day, it's the biggest slice of our day when we go to work and we talk colleagues and we talk to clients. It's so important because. Imagine spending like a third of your life not being seeing and acknowledge every day. That's that's hurtful at a human level. So having that space where you can be yourself and like Ezra, find support and have people acknowledge and see you for who you are is very powerful because that gives us the confidence and the courage to go out there and face whatever we are facing on the other aspects of our lives as well. And this week I was with our lead in Brazil. We went to an event to sign an open letter to support LGBT inclusion in the workplace alongside other companies here in Brazil. And everyone that's standing at that event and talking to each other, there was those moments when you'll find someone in the audience and you look into their eyes and you could see that connection, the power of that connection, of being seen and being heard. And two of the things that made me the most emotion out there was that cry out for us to be brave. So let's create a safe space and not be afraid of creating more safe spaces to each other. But also when people would find each other and say, We know it's hard. We know it's little by little, but every little thing makes life so much better. And this is so important in the workplace.   Rafael Franco [00:31:00] That's true. That's totally true. And we are talking a lot about how inside a company we can do to to make our colleagues days better. But since we work in the client services business, we and just like colleagues, clients can also project their discomfort or express express microaggressions towards people of the community. So Nick, if you can speak to navigating sensitivities with clients and protecting the company and employer relationship, also how we can can we protect our teams and ourselves to make everyone feel safe and comfortable of showing up as they authentic self?   Nick Nelson [00:31:47] Yeah. Yeah. And Ezra, I'm definitely curious to hear what you have to say about this, but I think in my experience, one thing that I am learning and observing is that especially with clients, sometimes they genuinely don't know when they are projecting these things. I think, you know, if it's bias showing up, it's some of those kind of, you know, inherent things that they may have brought to the table. And so my experience, which has been pretty successful in the past, is just addressing it head on, you know, stopping in that moment and saying, hey, I heard you say this thing. What did you mean by that? And that is a very intentional question. As we were talking about earlier. It creates space. It creates a space to talk through it. No judgment, but also to educate and kind of point out why that might not be okay or point out, you know, what a different way to articulate that opinion may be, but also to ask questions. You know, I, I work with a bunch of people who don't work in the DEI or multicultural engagement or things like that. And so I have to understand that a lot of people don't know. A lot of people don't sit in forums like this and have these conversations. And so with clients in particular or even with colleagues, you know, I think we have a I don't want to say a responsibility, but I do think we have an opportunity to try to get to it in that moment. I think where we may need to do some more work is letting it linger or letting it pass. Right. Because then you've not only signaled that whatever this person said was okay, but that's you're okay with it, right? And so I think there's a way to get into that conversation and have it come out of it with an educational moment, an opportunity. And then to your second question, I think. I think it's such an interesting position to be in. Right. And I think it goes back to what we were talking about earlier, you know, creating space for someone to show up however they want. Right. And if they are out and proud, as we say, great was lean into that. Let's build it. You know, I want to shout out Laura and the equal team for all of the work that they're doing, not just, you know, with the yards these, but then bringing in some of those experts to talk about the impact on our community, but then also how that impacts the broader community. Right. I don't think perspectives like that are hurt. And then as we're all transitioned to you, but one thing that you said that I always kind of keep in my brain is brave. I've never had to be, quote, brave. Right? I exist as who I am. I show up and take of space. I've not had to go through that experience that you have and I've not had to do it publicly. I've not had to kind of navigate the things like that on top of, you know, the cultural situation that you're in. So I applaud you and people like you who are willing to bring those educational opportunities to us. And like I said to Lauren and Mo, you know, all of these things that we just don't think about, you know, that I don't think about because I don't have these question marks. I don't have things that may signal something else to someone. And so I really just want to appreciate you guys publicly and openly for that kind of work and how it advances this exact conversation that we're having.   Monica Czeszak [00:35:38] I just wanted to add that. I think not everyone can relate to how huge that is. But I think we all when we go back to ourselves, we know about fear. We all fear something and the size of the fear and the importance of having that backup. But another thing I would say, we know things are hard in Brazil. We have a lot of violence against the trans community especially. And we know in different parts of the world we have different regulations and laws. So it's very different in contexts. What kind of fear you have when coming out, when reaching out for help and making those connections. But I think it's important for us to also see the hope in that, and they will hear it in your voice. They won't see your face, but the little flesh in your eyes and you're saying how much better he was than you expected and all the support you get. And I think we have to keep that in mind because we know there's a lot of bigoted people. We know there's a lot of conservative people. We know there's a lot of. Evil in the world. But there's also hope, there's also connection. There's also friendship and and help sometimes where you least expect and people can change and people can learn and we can build those networks that are accommodating and comfortable and resourceful to others. So I just wanted to bring out hope from your story, because I think we need to remind ourselves of that.   Rafael Franco [00:37:15] That's very powerful. And I'm I'm clapping here on mute does not disturb your speeches. So headed now to the end of our conversation, I would just like you to get your final, final thoughts. And we navigate this a little bit during our conversation. But just for wrapping wrapping up, what can those who are not part of the community do do to be better allies and accomplices for the LGBTQ plus colleagues at work? So, Nick, if you want to start.   Nick Nelson [00:37:53] Sure. Happy to start. I think allyship is so important because, you know, while I think this group, you know, we are having this conversation publicly and openly, I think we are at a certain part of our journey. Right. I think there are people who may not be there. Right. And so that's where allies come in. And I recall a conversation that Edelman hosted during the chaos of 2020 where the gentleman presenting said, you know, there's allyship and then there's accomplices. Right. So are you going to stand beside me or are you going to stand in front of me? Right. And some of us just need someone to stand beside us, which I believe we would consider as an ally. But then some of us who may not be as advanced in our journey or kind of still understand where we fit into an organization or to society or culture may need an accomplice. And so I think understanding where our colleagues are, creating the space to have conversations about pronouns, about workplace identity, about all of these things is where you can really understand where you fit on that spectrum. So is it, you know, walk beside me, walk in front of in front of me. And then sometimes for some of us is get behind me, move out of my way, let me clear the pad so I can make it so much easier for others who come after me. Right. And so I think that's where our colleagues, rather than whether or not they're in the community, honestly, can be the most helpful, is just really understanding. You know, is it that accomplice is an ally or is it just, I got your back. Let me know what you think.   Rafael Franco [00:39:38] Right.   Lauren Gray [00:39:39] I guess I just wanted to build on a point that my made earlier that I thought was such a good point. And I think that's that we don't expect perfection from people and being allies. And I think that's a really good thing to raise that we shouldn't let being perfect become the enemy of the good. It's enough for many people within the community just to see that you're trying, just to see that you're interested and trying to build a connection and doing what you can to be supportive. I think often people are really afraid of making mistakes in some of these conversations, and I think it's just good to affirm and I was glad that raised that that hurt a lot of people within the community. We just want to see you trying to really, really appreciate that.   Rafael Franco [00:40:28] That's totally true, Ezra.   Nick Nelson [00:40:33] I think for me, what I've noticed and what I see around me, it's always good to give people the benefit of the doubt. I think I am braver because I believe in the good of people more than anything else. I'm not brave because, you know, I didn't even see anything coming. So really, I don't know what to be scared of. But really, it was the fact that people were relatively good. And if you do try the and if they reject you, it's fine. You have to learn to heal a little bit from that. But you can educate and sometimes the more you can do that in a big way and I see this with clients as well is, is, is to yeah. To allow them to to make mistakes also and be and correct them in the in the not in a good way because they sometimes don't know. They, they don't know even what they're doing, especially, let's say for for some place like in Malaysia, you know, I mean, we're not living on trees. No, that's not that's not it. But but a lot of this awareness of the community, it's not part of the conversation on a day to day. To give them a chance. And, you know, that's that that's that's what I have.   Rafael Franco [00:41:49] That makes the work better a more.   Monica Czeszak [00:41:52] I think the first thing that comes to mind when we talk about allyship and. Our job, as well as a communications firm, is to really talk more and make it safe to talk more, because I know it's a very far and honorable place and I can speak from experience throughout my life. I made so many mistakes growing up after I grew up, as I developed as a professional and as a person. And sometimes it's hard to have those conversations, and sometimes it touches into memories or situations that you're not ready for. And there's no rush. You can take your time. You can see if, when, where it's good for you to talk about it. But as an ally, make sure to signal that you are there. When the person is ready and talk about what you're thinking, raise questions and participate because it's what we do on a day to day. As a firm, we talk to our clients, we talk to society, we talk to our colleagues. And that's part of the experience itself, to be open and to reach out and use everything. Your experience in learning and hearing to build something better. Because I like to say to my colleagues, when I talk about diversity, equity and inclusion, it's a journey so it doesn't really have a destination. We keep building up on the conversations and experience we are having.   Rafael Franco [00:43:28] That's true. And when you're in the position of being an ally, you don't need to wait to be ready. You go with fear. You just make mistakes. But few certain that you need to be there for people that you care about and your colleagues and the people in your life. So just be there and listen and have this conversation.   Dani Jackson Smith [00:43:53] And that's a wrap for this episode. Many thanks to you for talking with us. Be sure to subscribe to our podcast. And until next time, keep it authentic all day, every day. Special thanks to our team behind the scenes.  

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There's not a lot of good coming out of the current situation affecting the globe, but if there is an upside, it's the rare opportunity to learn from something this unprecedented. Through her work with National Research Group, today's guest Lauren Xandra has been able to study newly-emerging work-from-home behaviours, and how that applies to XR adoption. Alan: Hey everyone, I'm Alan Smithson from the XR for Business Podcast, and today we're speaking with Lauren Xandra, vice president of strategy and innovation at National Research Group, a leading global insights and strategy firm, about the original research on XR, AR, and collaborations in a time of Covid-19. All that more coming up next on the XR for Business Podcast. Lauren, welcome to the show. Lauren: Thank you so much for having me, Alan. Alan: It's my absolute pleasure. I'm in day 22 of my quarantine. Nothing really has changed in my life, because I work from home anyway. So how are you doing? Lauren: I'm doing well. It's a healthy adjustment for me, but it's rather timely that we're here today, because I'm excited to share new research, looking at how different demographics are adapting to our work-from-home reality, and to share some exciting findings that we see in the space with new, broader, addressable audiences for virtual solutions in light of all of this. Alan: Well, the timing on this couldn't be any better. Some dedicated, hard-working people in this industry have banded together this week to pull together an XR Collaboration guide, talking about everything from security to device management to vendor selection to feature lists, and really put a lot of effort into creating a tool online that will give people the opportunity to figure out how these tools can be used for their business or school or education, and which one is the right one for them at the time, for the need they have. And so we're really excited about that, and the information on that will come out on XRCollaboration.com. So, Lauren, please tell me, what is the basis of this study? Lauren: Sure. So, when suddenly millions of people -- seemingly overnight -- became remote workers, we're faced with these huge questions about productivity, state of mind, social and cultural impact of the situation, and the lasting impact, too. We really set out to understand how people are adapting, what pain points are felt across work-from-home, and in doing that, we can better understand and address whitespace to solve for these pain points, to ease our adjustment to this new -- and bizarre -- reality. I'd love to walk you through some of the key findings, perhaps starting with generational differences in adapting, and then perhaps looking at more industry-specific challenges and opportunities. Alan: Sounds wonderful. Let's let's dig in. Lauren: So we see that the pre-Covid-19 context really impacts different generations' concerns and expectations for the future. Probably one of the most counterintuitive insights is that the youngest in the workforce is actually the least well-equipped for work-from-home. The digital reliance of this generation already makes them victims of social distance pre-Covid-19, and for them, the effects of isolation are amplified. The impact of Covid-19 on culture is really their front-of-mind concern. And here we're thinking about culture in terms of how we connect, how we collaborate. Gen Z has really struggled to disconnect from technology. They're citing irritation from too much screentime, bad work/life balance, well ahead of other groups. And this impacts mental health, with already about half of Gen Z professionals saying that staying

There’s not a lot of good coming out of the current situation affecting the globe, but if there is an upside, it’s the rare opportunity to learn from something this unprecedented. Through her work with National Research Group, today’s guest Lauren Xandra has been able to study newly-emerging work-from-home behaviours, and how that applies to XR adoption. Alan: Hey everyone, I'm Alan Smithson from the XR for Business Podcast, and today we're speaking with Lauren Xandra, vice president of strategy and innovation at National Research Group, a leading global insights and strategy firm, about the original research on XR, AR, and collaborations in a time of Covid-19. All that more coming up next on the XR for Business Podcast. Lauren, welcome to the show. Lauren: Thank you so much for having me, Alan. Alan: It's my absolute pleasure. I'm in day 22 of my quarantine. Nothing really has changed in my life, because I work from home anyway. So how are you doing? Lauren: I'm doing well. It's a healthy adjustment for me, but it's rather timely that we're here today, because I'm excited to share new research, looking at how different demographics are adapting to our work-from-home reality, and to share some exciting findings that we see in the space with new, broader, addressable audiences for virtual solutions in light of all of this. Alan: Well, the timing on this couldn't be any better. Some dedicated, hard-working people in this industry have banded together this week to pull together an XR Collaboration guide, talking about everything from security to device management to vendor selection to feature lists, and really put a lot of effort into creating a tool online that will give people the opportunity to figure out how these tools can be used for their business or school or education, and which one is the right one for them at the time, for the need they have. And so we're really excited about that, and the information on that will come out on XRCollaboration.com. So, Lauren, please tell me, what is the basis of this study? Lauren: Sure. So, when suddenly millions of people -- seemingly overnight -- became remote workers, we're faced with these huge questions about productivity, state of mind, social and cultural impact of the situation, and the lasting impact, too. We really set out to understand how people are adapting, what pain points are felt across work-from-home, and in doing that, we can better understand and address whitespace to solve for these pain points, to ease our adjustment to this new -- and bizarre -- reality. I'd love to walk you through some of the key findings, perhaps starting with generational differences in adapting, and then perhaps looking at more industry-specific challenges and opportunities. Alan: Sounds wonderful. Let's let's dig in. Lauren: So we see that the pre-Covid-19 context really impacts different generations' concerns and expectations for the future. Probably one of the most counterintuitive insights is that the youngest in the workforce is actually the least well-equipped for work-from-home. The digital reliance of this generation already makes them victims of social distance pre-Covid-19, and for them, the effects of isolation are amplified. The impact of Covid-19 on culture is really their front-of-mind concern. And here we're thinking about culture in terms of how we connect, how we collaborate. Gen Z has really struggled to disconnect from technology. They're citing irritation from too much screentime, bad work/life balance, well ahead of other groups. And this impacts mental health, with already about half of Gen Z professionals saying that staying

What are the Secrets to Scaling Your Nonprofit with Lauren Cohen (archive) Global entrepreneur and #1 bestselling author Lauren A. Cohenis an attorney licensed in both the U.S. and Canada. Lauren is an expert concierge immigration and business legal advisor boasting a stellar track record of success. Lauren has first-hand knowledge of the visa process, having herself immigrated from Canada in 2001, and later becoming an American citizen in 2012. In 2008, Lauren started e-Council Inc. an internationally-acclaimed company focused on providing concierge strategic full-service solutions for businesses seeking capital and foreign entrepreneurs seeking access to the U.S. market. In 2017, Lauren established Find My Silver Lining, a 501(c)(3) organization dedicated to helping struggling single moms - and parents in general - to find their silver lining in a crowded world. Continuing in the tradition of sound strategic solutions, ScaleUPCheckUP is Lauren's newest initiative - an online risk assessment checkup tool for growing businesses in ScaleUP mode with the overriding mission of anticipating challenges before they happen. Designed in response to the challenges faced by so many entrepreneurs that simply do not understand the critical importance of proper professional guidance, and/or are afraid that the costs of protection are too high, ScaleUPCheckUP is poised to revolutionize the professional services industry and the way in which collaborative professional services are delivered. For more information go to https://www.scaleupcheckup.com Interview Transcript NPE Lauren Cohen Hugh Ballou: Welcome to The Nonprofit Exchange. This is Hugh Ballou. My guest today has a fascinating background and a real passion for helping leaders in any kind of organization. We are going to be specific about scale-up check-up and how it is of value to those of us leading charitable organizations. We like to say a “for-purpose” organization. We have for-profit and for-purpose. If you would kindly tell us who is Lauren Cohen, a bit about your background and what led you to doing this particular initiative today. Welcome to The Nonprofit Exchange, Lauren. Lauren Cohen: Thank you. I will speak as loudly as I appropriately can without screaming. Hugh, it's a pleasure to be on your show and to know you. I am excited about our opportunities together. I am originally from Canada. I moved here in 2001 and became a citizen in 2012. I was doing immigration law outside the corporate transactional work internationally for seven years. I kept seeing these recurring themes among businesses who were seeking to raise capital and for entrepreneurs and businesses who were looking to come into the country. The recurring theme was they were really focused on sales and marketing and getting coaching and moving up the ladder and making money, but they weren't so focused on getting a strong foundation in place. The reality is that you can't really scale your business or often even stay in business if you don't scale up your business. In response to this recurring theme, I developed this online risk assessment tool which helps companies find their missing pieces, their gaps, and fill the gaps so they can scale up successfully. It is applicable to nonprofits because nonprofits need to scale as much as for-profits. At the end of the day, we're all about making money. It's about where the money goes that is the main difference between a for-profit and a nonprofit. As a social entrepreneur with a social consciousness, I am very focused on helping businesses be able to scale up successfully without hitting all these roadblocks along the way. Not to say that they won't hit any roadblocks, but the roadblocks are going to be a lot more manageable, and they will be able to respond to them more effectively because they will have the right professional team and structure in place to be able to do that. Hugh: Russell, this is Russell Dennis who has jumped on the call. You can tell the difference between us because I have more hair. That's it. Lauren: That's the only difference I see. Hugh: Russell, you guys got snow out there in Colorado, didn't you? Russell Dennis: A little bit. We got a little bit out here. It wasn't a great deal, more in the mountains, about an inch or two here in Aurora. Hugh: Lauren is jealous. She is in the Fort Lauderdale area, and she didn't get any snow. Lauren: I think I mentioned I'm originally from Canada. I grew up in Toronto, and I definitely know snow. I have a lot of good friends living in Colorado, including in the cannabis industry and outside of the cannabis industry. Hugh: Lauren, tell us a little bit about- You are trained as an attorney. What kind of attorney? Lauren: I am. I have been a corporate and immigration concierge attorney doing international law and handling international people through advisory services for longer than I care to acknowledge. I am licensed both in Canada and the U.S. I have been working with local entrepreneurs all over the world. You name it, I have been there. Europe, Israel, South America, and Canada, and the U.S. even. Mexico. It's been an interesting ride. I have always felt a calling to the entrepreneurial side of my psyche. As much as I love being a lawyer and that training was great, I don't love sitting behind a desk. I love being with people and helping people and making deals happen. The M&A lawyers who are on Wall Street, I am that type of mindset, but with my own clients and having a much more hands-on approach to working with clients and making sure all their moving parts are moving in the right direction. At the end of the day, there are so many different things that entrepreneurs and small business owners have to deal with in nonprofit and for-profit. They just don't know who to trust and who not to trust. I became this trusted advisor on an ongoing basis and decided to turn it into a larger-scale opportunity to help these businesses scale and grow successfully. It's a nice system. I am happy to share all of the steps with you. It's a nice system that helps you get your structure in place as a blueprint to success. It's like a business plan. Hugh: Great. Do you have a volume control on your computer? Lauren: I do, and I have it all the way up. Hugh: That won't help. I will bring you up when I do the edit of this. Let's talk about the word “assessment.” Everybody uses it. I'm not sure any of us have a definitive paragraph or sentence that we can say to describe it. What is an assessment? Why is it important? why is it important especially for nonprofit leaders? Lauren: Our assessment is quite different than a traditional assessment because we are assessing various foundational issues. Do you have your corporate minutes in place? Have you set up your structure properly? Do you perhaps have trademarks? A lot of these nonprofits are sitting on potential trademark or licensing opportunities that they may be overlooking. Did you put a business plan in place? Do you have an exit strategy in place? For nonprofits, an exit strategy is much different because you have to have an exit strategy for an IRS requirement. It's a matter of looking at all the various components of getting your structure in place and making sure your structure is sound so you can scale and grow. What happens, you will agree with me I'm sure, is I find all too often these small business owners, these accidental entrepreneurs, came up with this idea and suddenly grew. They didn't pay any attention. It's like building your dream home on a sinkhole. Suddenly, the sinkhole collapses, and your whole home collapses with it. I am here to make sure that doesn't happen. I am there to help you get your business on a solid foundation and make sure you are not building on a sinkhole before you start spending all this time, money, and effort to scale your business. At the end of the day, you can only scale so far, and it will come crashing down if you don't have that foundation. That could be assessed. We are assessing your foundational infrastructure. We have a customized score report that we provide, and we have an analysis of what that score means and how you can improve your score so your foundation is stronger. We also have a quiz that I'll share with everybody on the call. It's a freebie, a free online quiz that helps you to see initially how committed you are and how committed your business is. Our mindset might be 100%, but our business may not be ready to match our mindset. Russell: A lot of people mistake assessment and evaluation. They look at it as, It's something I have to do to get somebody off my back. It could be the government or a donor. We are doing this because we have to. They talk about some aspects of their work when you ask them how they know you're effective, “Oh, you can't measure this.” How much of that do you see, and how do you address that when people come at you? Hugh: Lauren: If you can tell me the answer to that, I will have the idea that will get me on the front cover of Entrepreneur Magazine, which is where I'm going. It's challenging. What I'm dealing with, and when I go on stage, I am making broccoli great again. It's about that. when I am building the broccoli of your business, it's not the ice cream, it's not the fun stuff, it's not the dollar dollar dollar, but at the end of the day, it really is. Even for a nonprofit, helping you get your structure in place will allow you to get more donor dollars, allow you to have a stronger valuation, allow you to potentially grow your business successfully, and this adds zero's to your bank account. My new messaging is all about show me the money. If you have a strong foundation in place, you will be able to see more money, if it comes from donors, buyers, or both. Certainly a nonprofit can offer for-profit products and services and make money. It's about what happens to that money that separates it from a for-profit business. Hugh: You have a nonprofit yourself? Lauren: I do. Hugh: What's it called? Lauren: It's called Find My Silver Lining. I established it in 2017. Hugh: You used this assessment yourself? Lauren: I did. Hugh: When you talk about this, there is a strong element of enthusiasm and passion. Was part of the inspiration seeing so many people get stuck in the mud or walk in the wall or fall off a cliff? Lauren: I want to say around February of last year, I have been a part of this coaching program. I offered to review some client agreements at no charge as a gift. In doing so, I realized that there were many business owners in that program that didn't have their ducks in a row. Many had been in business for many years. I'm not saying that that's not possible; it's very possible. But once you hit a certain threshold, you're not a mom and pop anymore, so you could be a target, not just for the IRS, but for litigation, potentially bankruptcy. People see opportunities. People want to challenge you. If you have a disgruntled employee, whatever the case is. As soon as you are starting to scale, your target becomes bigger. I kept seeing this. Oh my goodness, these amazing business owners are exposing themselves to risk. There has to be a way to address that risk and provide a solution. Ultimately what I am building is a home advisor for profits and nonprofit business owners to provide a resource of certified, vetted professionals like you guys who can provide a range of services: strategic services like legal, financial, accounting, insurance, business planning, exit strategies, all high-level B2B services that they are just finding on the Internet. Finding these resources on the Internet is like going in the Yellow Pages. We all used them. AAA, so they would get to the front of that section. It's the same as Google Ads. The more you pay, the higher you rank. That is where they will get the most traction. It doesn't mean they're the best. Does it mean they have been vetted? No. Because they are at the highest ranking, you are going to call them first. I am trying to be the antithesis of that. We won't talk about the companies out there who are especially providing legal services that you have no idea what you're getting. I have a client now who applied for a patent in June. They didn't even know what a patent was. There is no guidance. There is nobody holding their hand. What I have been doing for so long—I wrote a book called Finding Your Silver Lining in the Business Immigration Process. Everything is about finding the silver lining. Part of the reason is because to find a silver lining through adversity, my nonprofit is for single moms and single parents to help them find their way through the clouds. It's all about that. In everything you do, if you have somebody to count on, a support system, entrepreneurs and small business owners are often running on empty. We are running on our own. We are isolated. We are trying to have an impact. It's very hard to have an impact without the support and trusted advisors around you, so that is what I am building. Hugh: You're an attorney. You look at things differently than an ordinary person. You look at it as part of a risk assessment. Lauren: That's a good way of characterizing it, yes. Hugh: You've seen people get in trouble unnecessarily. Lauren: Absolutely. Hugh: You're looking at the holes. We're looking at the donut; you're looking at the hole. You see the silver lining, but you realize there are some holes. You're talking about a corporation, be it for-profit or nonprofit, and that corporation is a liability shield. Without the right documents in place, people can sue you and come for you personally if they can pierce that corporate veil. Lauren: Very big deal. People don't realize that. They think if they have a company, they're protected, and they're not because people can come for you personally. That is another dimension of the problem. Hugh: The compliance piece- recording your contracts, putting them in the corporate record book. Any agreements or expenditures. It's about liability protection. It's also about, you mentioned empower donors. Russell, it would occur to me we don't always protect ourselves from audits, but it would make us audit-worthy if you had your records filed. What are you hearing here, Russ? Russell: For me, the first step to building a high-performance nonprofit is having that solid foundation. There are a lot of things that go in there. If you don't have the right legal protection or the right structure, moving forward, you have to have the right structure. For nonprofits, succession planning is critical, too. Lauren: Big deal. Russell: Moreso maybe than exit planning. Everybody plans to operate in perpetuity. That doesn't always happen. But to have a succession plan so that you know how things are going to flow, no matter who is in the building at any given time, that structure sets a nonprofit up for success. Mitigating risks. I don't think a lot of nonprofits think about risks, but risk is there. You have natural risks. You have legal risks just like any other entity. The thing that came to mind was a question because you deal with this so much on the structural side. We talk about it in terms of strategy, but we defer to legal experts, accounting experts, experts who have that critical knowledge in their field that will keep us in compliance and keep us operating correctly. When it comes to scaling, I know a lot of times growth comes out of nowhere. You catch fire. You go viral. All of a sudden, you have all of this money and donors and people approaching you. When it comes to being prepared in this, what would you say is the biggest gap that you see nonprofits have? What is the most common mistake they make when they are that point in time? Hugh: Lauren: It's common for both nonprofits and for-profits although nonprofits are more guilty of this. Nonprofits think that because they have this designation, they are immune from challenge, or they are litigation-proof, or something along those lines. That just isn't true. Nobody will come after us; we are a charitable organization; we have a 501(c)3 designation. Whatever the case is. Why would they come after us? We don't have deep pockets. Really? A lot of them have deeper pockets because of the fact that they can distribute the income to their shareholders or the dividends or whatever. As a result, there is a lot of nonprofits out there that are extraordinarily successful. United Way, Red Cross, Jewish Federation. There is a huge amount of donors, very large businesses. There is a colleague of mine in this coaching program who runs a nonprofit. He came to the coaching program, and he was looking to raise $2 million. That was his goal for the year. He ended up raising $20 million because he created this licensing program and sold it to other nonprofits, which is amazing. That is where there is an opportunity. It's not just about assessing legal risk or legal vulnerability. It's also about the opportunity that this presents to you. I was talking about trademarks, and a lot of nonprofits have access to trademarks but don't know about them. In my report, I talk not only about risk, but also about hidden fortune. There is a lot of possible fortunes that these businessowners or executive directors might be sitting on that they could be making a great deal of money giving back to the community and making an even broader impact. I think that is where that missing link is. They don't think about a nonprofit as a business. They think about it as a charity. A lot of lawyers are guilty of this, too. Lawyers and service providers. Lawyers run their business as fee for service. I have developed this professional resource success plan, which outlines all the professionals that are needed to fill all the gaps in your armor and to potentially help you to scale and grow. We talk about mindset and coaching and opportunity and where do you want to go and your exit or your business succession plan. You're right. Every business needs a succession plan, whether it's an exit or a legacy. No matter what, in order to be successful, in order for a for-profit business to be successful at due diligence or a nonprofit to be successful in their succession planning, they need that structure in place. they are just not paying attention it. They are coasting along, thinking about how much donor money they can get this year, and are they meeting your budget, and are their donors happy. This is all great stuff. But think about the potential of greater impact if you are able to get those pieces in place and make that difference. It's like night and day. For both of you, once we have the opportunity to work through this with some of your client base, you can see how much of a difference it makes. They are coming out exposed, and then they are going back in and getting their hair done and makeup. Now they are ready to show themselves to the public. You are not getting too much hair done over there, Russell. It is a completely different mindset. I hear a lot of entrepreneurs work in their pajamas. I can barely work sweatpants even if I am working from home because that is not the mindset I want. I want to be in work mode no matter where I am. It's important. I think it's the same for for-profit business owners who are running a sole proprietor. They are not looking at it as a business; they are looking at it as a hobby. Until you make that transition, and look at it as a business, you're going to stay at a certain plateau. You may scale; you may make money. But at a certain point, you're eventually going to collapse. Russell: As you talk about that, one of the things that comes to mind when you talk about opportunities and other things businesses have access to, a business revenue comes to mind. Opportunities for mission-based revenue. You also have unrelated business income, as far as, it's money that's possibly left on the table because people don't think about bringing a valuable service. When it comes to revenue generation and protecting your intellectual property is important, it should separately be maintained and protected. Everything should be walled off. There is another discussion. When it comes to revenue, whether it's business-related or unrelated, when you see organizations that have one or both, what are some of the biggest pitfalls you see them fall into? Lauren: One of the things is that there is a limitation, but you still have to stay true. If you are a nonprofit and are providing for-profit services and products, you still have to stay true to your mission. If you start making millions of dollars and use it as a sham, so you can pass through income at a tax-free rate, or through a nonprofit to get the benefits of that, or raise money to do advertising, that is where the problems happen. The separation needs to be clean. If you start paying an executive director, suddenly they get a 100% salary increase, where is the money coming from? Where is the money going to? Are you circumventing the rule of putting the money back into the directors' pockets? That is where the problems happen. There is also an issue of fiscal sponsorship, as I'm sure you're familiar with, and renting your nonprofit to another entity. There are ways to do it that are legal and kosher, as long as you follow the rules. But if you are just using your nonprofit as a sham or as a front for what you're really trying to accomplish or for your for-profit business, you will lose your designation. It's as simple as that. Russell: It's important to put your structure. You have to have a separate structure, especially for unrelated, but also business income, and mission-based revenue. You have to make sure the vast majority of those funds are going into your programs and operation of your nonprofit to keep from creating a tax event. Unrelated business income, you file separate returns. You pay taxes on that the way you do with others. What happens is people can get distracted. People who approach a nonprofit can get confused. Do you find that nonprofits that are successful with generating large amounts of mission-based revenue, or maybe a substantial amount, a good percentage of the revenue they generate, do you find that they have difficulty getting donors because they see, “Well, they are making plenty of money. I don't need to write them a check.”? Lauren: It's definitely a challenge. However, it depends on your mission and how impactful it is and how broad it is. I think that what happens with some nonprofits, and this is what should happen, is as they become more successful financially, their mission expands beyond their original intended scope, demographically or in terms of the people they are helping. There is room for that within the IRS code. As long as that happens, I don't see it as a problem. But as soon as that is not happening, or once there is a compromise in that, it does create challenges. Russell: The key is to structure and make sure everything is compartmentalized and appropriately reported. It's about the systems you have in place. In order to scale, you have to have really good strong systems. What are the ones that you think are essential for them to have first? If you had to set systems up in a specific sequence for nonprofits, what would that be? Lauren: Operating systems are critical for any business; I don't care what business you are. You have to have an operating system for everything that happens from the time you answer the phone to the time you deliver the service until after that, all the way through, for the life of that relationship. You have to have a system in place for every single touchpoint with the prospective donor, with the donor, with following up with the donor, with if the donor moves. You have to have operating systems for all of your internal processes. They should be externally driven, one for your outbound touchpoints and one for your inbound stuff. How do your people work with each other? Who is responsible for your bank account? How many people are signing checks? What is the check and balance there? How does that all work? Every single thing should be documented. When I started this, I didn't realize how few businesses have systems. The only systems they have are the ones they pulled offline. That is the exception, not the rule. This is true of legal documents too because everyone goes online and pulls documents from there. It's like filling out the 1023, the IRS 501(c)3 application. Oh, this is easy. I can do this. It's just some forms. If that were true, there wouldn't be all these businesses doing that. It's very complicated. Even the 1023 form should not be done on your own. You need to make sure you are following the rules, and whatever you put in there is going to be systematized within your organization. What happens if the executive director quits someday? I'm sure this has happened to your clients. Uh oh, now what? One of my messages is about dealing with the Uh oh, now what? You don't want to wake up in the morning and say, What is going to happen today? I cannot imagine going to work today. Steve is doing this, and Joe is doing that, and Nina is doing this. Nobody is talking to anybody. We don't have group meetings. Things are falling apart. The donors are frustrated. They don't know what is going on. They are going to move their money elsewhere because they don't know if they are getting their donation receipt. It's a mess. One thing leads to another leads to another. I wish it was as true for the good things. The messy things have a more quick and efficient domino effect. Russell: This is true. We call them internal controls, what you talk about, for the IRS. How do you control who handles what? What is your record-keeping like? That gives you the scope of any audit you do. The scope is based on several things. One is the corporate records. I know you mentioned that. I'd like to ask you to speak to that. As an auditor, when I walked into a corporation, I wanted the internal control polices. The corporate minute book was the first thing I reviewed. Lauren: Was this on the for-profit side? Russell: The for-profit side, yes. Lauren: It's similar. When you submit for a nonprofit designation, you submit all these bylaws, including a conflict bylaw. I can't remember the title. Russell: Conflict of interest policy. Lauren: My brain went dead. This is so big in the nonprofit world. It's almost like insider trading in the for-profit world. If you have created a bylaw and implemented it and approved it and ratified it, and it's part of your corporate record-book, and you don't adhere to it, it's as good as throwing it against the wall to see if it sticks. This can put you in more harm than not having it in the first place. You're purposefully going around what you implemented. That's not cool. Your minute book depends on your state because some minute books, Delaware is strict on their minute book requirements and updates. Florida is less strict. The nonprofit requirements are different. But you need to follow your policies. Your bylaw policy said, We are going to have a board of directors meeting once a quarter. You need to have it and put it in the minute book once a quarter. I will tell you something that you probably don't know, and I shouldn't say it out loud. If there are businesses out there that want help with their minute books, we can fix them after the fact as long as it's before the auditor comes in. You just have to get everything up to date and in place. That's important. You can't fudge it, but it's okay to do it after the minute you're supposed to do it as long as you get it done. Let's get together. Call us, and we can get it done with you so that we can make sure you won't have a problem if the IRS or any other entity shows up at your door. Today, they're not coming so fast because they're still unfortunately on shutdown. Russell: The greater likelihood over the few years is a state regulator will walk in your office because of the reduction, and the money has been moved out of regulation. That's another discussion. It's true with the 1023. There are certain things you represent that you're going to do. What the auditors do is they look at your books and bylaws: Are you doing what you say you're going to do? I know there are laws out there. But we go by what you say that you are going to do. That is a huge portion of what an auditor would look at as to determine if you are on track, if you are in compliance. Are you doing what you say you're going to do? These are important to put on the table. With good systems in place, and it takes a little time to do this, the operation smooths out. Am I on track with that? Lauren: Hopefully. It's just like anything. You could have paper in a book or online. Then it's a matter of implementing and enforcing. Unfortunately, we're all guilty of creating a policy where the consequences are not consistent. Like my child. They're not consistent, so his behavior is not good from time to time. It's my fault because I am not consistent in enforcing a consequence. Same with a minute book. It's the same concept. A lot of people, just like setting up a nonprofit and using it as a sham, put thing into place to cover their you-know-whats. That's it. It sits on the shelf. They do it to be in compliance. If they are not honoring it and adhering to it, whatever operating system or control you have, it won't matter. You can't suddenly say, “I can't have a policy for it.” If you haven't enforced it in the past three years, and the person has been doing whatever they have been doing, or their brother has been sending them money, I am far-fetched here. The reality is there is a lot of this that goes on. As more for-profit businesses set up nonprofit entities, this is an ongoing problem. I think it's all a matter of training. If your people are not trained properly on what your policies mean, it's only a piece of paper. You need to have the policy, create the manual, create the operating policies, create the training, train your people, get them to buy in, have them involved, and have consequences for noncompliance. It's a range of things that need to happen. Have a third party designated to oversee that process so it doesn't fall on the executive director. Hugh: Absolutely. That's why you have board members and advisors. They really have fiduciary and governance oversight. Let's go back to this assessment. It sounds painful and expensive. What's involved? If I wanted to go through the process and take this assessment, what's involved in doing it? What do I get from that? Does it help me figure out how to do all this? It sounds scary right now. Lauren: We don't let it be scary. I am the non-scary lawyer. I have a free quiz. It's not specifically oriented to the nonprofit world yet; we are developing one now. I'll be happy to share it with your listeners. It's ScaleUpCheckUpQuiz.online. You can take that quiz; it's about 2 minutes. We can set up a quick call to discuss your needs. The assessment is $47. I can share a $20 coupon code that makes it $27. It's a customized score that highlights your issues and lets you know how at risk you are. It gives you access to my calendar for a quick call. The assessment and a strategy session is only $197. That gives you time to go through the assessment results and talk about how they could be improved. How can you improve your score so your bottom in is better? Our big deliverable item. The regular price is $997. However, Hugh, you, I, and Russell can talk about a special delivery product for the nonprofit world and can get a coupon code. I don't want to charge that much for people in the nonprofit world. It's a blueprint that shows you everything you need to scale up your business successfully. Then we create a strategy based on your budget and priorities. If your priority is to get a business plan in place because you want to build a facility, that's what we will focus on first. That will come out of this analysis and deep dive we do for you. Hugh: That sounds interesting. The quiz, anybody can take that. We try to convince those that are running a nonprofit, which is a bad word, it's a misnomer. Those who are in a tax-exempt enterprise, a for-purpose organization, they are really, there is a high level, it's critical that we establish sound business principles. If you have an organization, you should run it responsibly. It's good stewardship, if nothing else. The quiz, we could evaluate it as a tax-exempt business. It's ScaleUpCheckUpQuiz- Lauren: ScaleUpCheckUpQuiz.online. Hugh: That gives them the free quiz. You fill something, and you have a chance to interpret it. Then the assessment could be available through SynerVision Leadership Foundation for people who want to find out how much trouble they are in. Then there is a prescriptive; this is what you do about it. Lauren: Not exactly. The prescriptive is more detailed in the success plan. The assessment, if they do it with the strategy session, we will give them some ideas and tips on how to improve the score. It's the success plan that will give you a blueprint of everything you should do to make your structure more sound so you can accomplish your goals. Hugh: Your basic website is ScaleUpCheckUp.com. There is everything about the products there. There is a toll-free number to contact you. You have this purple branding that is quite elegant. Lauren: I've always been into purple. My existing brand is purple. For as long as I've had a brand, I've had purple. Hugh: That's on your site. People can go to ScaleUpCheckUp.com and can learn about you. What have we not asked you that people need to know about this whole line of risk mitigation? Lauren: The real question is: So what if I don't do it? So what if I don't get my stuff in place? What happens? How do I get caught? What's the risk? There is a huge risk. As Russell knows, having been an auditor, you risk not only for the nonprofit organization losing your designation, piercing the corporate veil, which means they go beyond the business and to you personally. You can lose your own personal assets. You put your family at risk. These are serious issues that people just don't want to deal with. They want to deal with numbers and money. Numbers and money, this will get you more numbers and money than any sale is going to ever get you. Your sale will be stopped dead in its tracks. All that time and effort on that sale will be wasted because you haven't done what you needed to do. When you want to create a strategic partnership or synergy, for example, you and I, with SynerVision, if we have a joint venture or strategic partnership, we both want to make sure we both did certain due diligence, with the compliance checks. We have our business in place. Our licenses are kosher. Everything is right and in place. Otherwise, I don't want to do business with you, and you don't want to do business with me. They could have a multi-million-dollar prospect on the table. I had a client I was working with for a short time. They were about to enter into this multi-million-dollar deal, a very big name. Big. Big. One of the biggest. I'm trying to see Russell's face. I think he's smiling. I'm willing, they didn't have their minute book records in place. For three years, they didn't have a single document. Because this company is so big and successful, they wanted to see that all their I's were dotted and T's were crossed. Do you know this company would not pay me to get their records updated? It was $5,000 or something like that. It was nothing. They didn't want to deal with it. They lost the deal. Multi-million-dollars. It was too late because they could have had it done, and they would have been at the table. This is what happens. You lose your seat at the table. You will have someone come after you and sue you, whether it's a disgruntled employee or the IRS. You won't have access to potential huge opportunities with your intellectual property. You are putting yourself at risk every which way and losing out on opportunities to make a fortune. So let's have a conversation and see how we can help you scale your business successfully and not violate your 501(c)3 designation or your company bylaws. I think there is a lot of for-profit corporations that are purposeful. It's all confusing, right? I try to have a purpose and make an impact, even though I have a for-profit company. There are so many ways we can create opportunity for you as a company and business owner to scale successfully. It's silly to throw that opportunity away because of fear of the unknown. Hugh: Yes, it is. This is a huge inventory of important things that people don't know to ask about. Russell, before we do our closing sequence, do you have another issue we need to bring before this lady? Russell: I was thinking about a point you made earlier that is worth emphasizing again. There are a lot of tools out there. People find templates and guides to build contracts and agreements with. Nothing wrong with them. The problem is people don't have them reviewed by someone who has the knowledge necessary to make sure everything is in there to protect yourself. Just grabbing something. The other thing people don't do is read the fine print in their own contract. They create something that they are going to adhere to. If they look at it with the eyes of, This will protect us from other people, they may not be protecting themselves from themselves by clarifying what they are agreeing to do. How common is it that you see people with these boilerplate templates? How can they get them reviewed? They definitely need to do that. Is it something that will break the bank? I think that's what stops a lot of people from doing that. Lauren: Thank you for asking that question. One signature speech of mine is “7 Secret Scale-Up Success Strategies.” One of the secrets is: Don't download a boilerplate template without getting it reviewed. There are multiple reasons to have it reviewed, some of which you addressed. Also, they could name the wrong parties. They could pull the wrong template. It could be perfect, but for another situation. They may think they need X, and they may need Y. It could be covered with legalese that no one understands, including lawyers. I wrote an agreement last week for a nonprofit for a lawyer. I was working with this lawyer. I want it to be two pages. This was a lawyer who was telling another lawyer that this agreement should be two pages. I can make it four. I'm laughing. I saw him last night and was like, “Two pages?” We are trying to condense things and make them concise because you get lost in it. I can't give you a flat fee, but we do have packages that include a range of services, including reviewing up to five agreements of up to 10 pages each. We have them on monthly packages, semi-annual packages, and annual packages. You need to grab one of those. Not go to those online services, but have someone you can trust and contact and text, a live person, who can help you look at those agreements and see what's missing or not. What's missing is almost as bad or often worse than what's not missing. You won't catch everything. No lawyer will catch everything because I don't know exactly what every single business owner wants to accomplish. But if you don't have it reviewed, you may as well jump in the ocean without a life preserver. Hugh: This is helpful information, Lauren. Thank you. *Sponsor message from SynerVision Leadership Foundation* What I'm taking away from Lauren's interview today is there are things about enterprises that we don't even know we're supposed to know. Lauren, what thought do you want to leave people with?   Lauren: Think about your nonprofit or for-purpose business as a business. Take it seriously. It deserves your attention. It deserves the attention of professionals. Don't be everything to your organization. Bring in the professionals that you can trust to accomplish the goals you need. I am available to speak with any of you about how to scale up your nonprofit. I look forward to working with you, Hugh and Russell, and collaborating with you further. Don't take the risk of losing all that you've built because you're afraid to make a phone call or send an email. Russell: This has been an enlightening and uplifting conversation. Here at SynerVision Leadership, we have all sorts of people like Lauren that are here. Come join the community and have a chance to plug into conversations with people so you are not doing things by yourself. We are the source for all things nonprofit. If we don't have the answers, we know people like Lauren who do.     Learn more about your ad choices. Visit megaphone.fm/adchoices

  Secrets from the Eating Lab Author Dr. Traci Mann, professor of Psychology at the University of Minnesota and an expert on the psychology of eating, dieting and self-control joins Jen, Annie and Lauren in discussing the science behind the hot topics of self-control, temptation, diets and the alternative to dieting.   What you’ll hear in this episode: How much of our weight can we influence? How much of our weight is influenced by genetics? The concept of the Leanest Livable Weight Goal weights and reasonable ranges Weight regain and dieting – how common is it? Why you regain weight after dieting What happens to your body when you go on a diet What you start to notice when you go on a diet Is weight regain guaranteed? Characteristic of people who keep weight off The role of healthy movement  you enjoy in maintaining weight loss Self-control: who struggles with it and can you increase it? The obesogenic environment: what it is Temptation free checkouts and apple bins, reducing the need for willpower at the grocery store The role of small obstacles and inconveniences Making healthy choices convenient to increase compliance Keeping the focus on health instead of weight   Resources: Secrets from the Eating Lab Dr. Mann’s Facebook Page Dr. Mann on Twitter Episode 4: What A 70-year-old Starvation Experiment Taught Us About Dieting Learn more about Balance365 Life here Subscribe on Apple Podcasts, Spotify, Google Play, or Android so you never miss a new episode! Visit us on Facebook| Follow us on Instagram| Check us out on Pinterest Join our free Facebook group with over 40k women just like you! Did you enjoy the podcast? Leave us a review on Apple Podcasts or Google Play! It helps us get in front of new listeners so we can keep making great content. Transcript Annie: Welcome back to another episode of Balance365 Life radio. Before we get into today’s podcast episode with an amazing guest, I want to share with you a super sweet message that we received from one of our community members on Facebook today. Christy says “I have been a part of Healthy Habits Happy Moms for almost 2 years now and a Balance365er since May of 2018. I am all in to the way this group thinks and believes. I’m at the point now that when I workout I channel Annie Brees, when I mention establishing habits to coworkers I channel Lauren Koski and when I’m trying to give some perspective to friends about diet culture and treating myself well I channel Jennifer Campbell. I can’t thank the three of you enough for how you have changed my outlook and daily life. I’m chipping away at the program but at this point my greatest takeaway is the way I live out each day because of this new perspective. I can go on and on but I just have to give a big thanks to Jennifer, Annie and Lauren. Thank you so much, Christy and I want to share with all of our community members that any email, any message, any direct message on Instagram we read them all and we are so appreciative of any reviews that you share on the podcast. We love them all. We cannot thank you enough.   Alright, let’s jump into this podcast because I’m super excited about it. I’m not sure if we have referenced any other book on this podcast as much as we have her book, Secrets from the Eating Lab by Dr Traci Mann. Dr. Mann is a professor of Psychology at the University of Minnesota and an expert on the psychology of eating, dieting and self-control. In addition to all her impressive professional experience, she’s also a mom who loves those ice cream, super relatable, hey? If you’re curious about how much control we really have over our weight, how you can avoid temptation and why diets don’t work and what to do instead then you have to listen to this interview with Dr Mann. Enjoy! Jen and Lauren, we have a special, special guest are you two pumped for the show or what? Lauren: So pumped. Jen: Yes, I’ve been waiting. We arranged this well before Christmas I think so I’ve just been like vibrating waiting for it. Annie: Yes and what our listeners didn’t catch before we started recording was Jen gushing for about 10 minutes about how she loves Dr Traci Mann. Welcome to the show, thank you for joining us. Dr. Mann:  Well, thanks for having me, you guys are so nice. Annie: We, the 3 of us have read your book, The Secrets from the Eating Lab and we reference studies, quotes, information from this book so often in our community and our podcast if they haven’t read it, if listeners haven’t read it we would highly recommend it and it’s heavy on the science because you’re a researcher but I wasn’t overwhelmed by the science when I was reading it. I felt it was very like, I could understand the concepts that you were sharing. So, thank you so much for joining us. Dr. Mann: I would also say I’m sure I shouldn’t say this but it’s free Kindle right now. Jen: OK. Annie: Oh my! How long is it going to be free for? Dr. Mann: You know, I have a vague memory of agreeing to this with my agent like a year ago thinking it was like a month long thing and I think it’s possibly forever, I don’t know. Jen: OK we will Dr. Mann:-never sell another book. So, whatever, it’s fine. Annie: Well I will- Dr. Mann: Better people read it than buy it. Annie: say if you look at the 3 of our copies they are highlighted, like top to bottom, they have been like, right, like, they’ve been used, they’ve been well loved. Lauren: I think the name Traci Mann has been on probably 90 percent of our podcast. Jen: Yeah and this, so I have this page highlighted, what I was gushing about before we hit record was how Traci, Dr. Traci, I’m sorry, I didn’t mean to- Dr. Mann: Just call me Traci. Annie: We’re besties now. Jen: So you are very much a messy middle writer in that you really objectively look at the research, you haven’t gone headfirst into any kind of movement or philosophy and just looked at research to support your philosophy, you’ve looked at the research which has allowed you to come up with a very objective, balanced message. Dr. Mann: That was the goal for sure. Jen: And so I just I highlighted this a long time ago because it was perfect. It says, it’s on page 20 and so what we hear a lot and what our audience is very aware of is that we hear two things, we hear that you cannot control your weight, you should not even try to lose weight, it’s pointless, your weight is predetermined, what you have, what you’ve got, that’s what you’re going to have forever and then on the other side of the spectrum, we have this whole industry of transformations that it is totally realistic and sustainable to lose half your body weight forever etc, etc. When what we actually know and what the research provides is is that you, it’s actually like in the middle but what you had written and I feel like I was waiting for this message. When I found your book I felt like “I have arrived. I am home. Like, this is what I have been looking for, somebody who is just sensible.” And you say, “I’m not saying you can’t influence your weight at all, just that the amount of influence you have is limited and you’ll generally end up within your genetically determined set weight range” and I thought that was so perfect in that you’re not willing to say you cannot control your weight, you’re trying to say “Hey, we can influence our weight, it’s just not to the level that you have been led to believe by the fad diet industry.” Dr. Mann: Exactly. That’s right so it’s partly genetic, but not 100 percent genetic.   Jen: Right and isn’t there a percentage? Dr. Mann: I think it was 70%- Jen: Yes I think it was 70% but you have a, there’s about a range of 30 percent in there that you can influence your weight. Dr. Mann: Yeah and I mean, it’s not just that and it’s really interesting that people are staking out these extreme positions, you know, it’s like, “Come on, people, nothing is black and white like that.” Jen: Right. Dr. Mann: But with the weight thing, it’s not just, it’s not the case that you can’t maneuver your weight around to some extent, obviously you can’t, like you just said, you can’t lose half your body weight but you can move it around to some extent but the problem is that it’s really hard, it’s hard to move it around a lot. It’s not hard to move it around a little. Jen: Right. Dr. Mann: And that’s mostly what we talk about in the book is ways to move it around a little without it taking over your life. Jen: Right. Dr. Mann: But to move it around a lot, it’s not that it can’t be done, it’s just that it’s really, really hard. Jen: And it’s very, it can be hard on us physically and psychologically to be trying to move our weight around to those different extreme ends. Dr. Mann: Yeah, exactly. That’s why I like to talk about this Leanest Liveable Weight idea. By Leanest Livable Weight I mean it’s the lowest weight that you can comfortably have without having to work so hard at it. Jen: Right. Dr. Mann: Because the leanest weight you can live at comfortably, now that has been misinterpreted by the lovely people like GOOP.com – the lowest weight you can actually survive at without dying. Jen: Right and that’s not what any of us here are trying to talk about. That’s what a lot of women are trying to be and they might they may not even realize it, that that’s what they’re actually trying to achieve but that’s definitely not healthy, physically or psychologically. Annie: And I just want to add to that we’ve worked with thousands of women across the span of the globe and one of the common themes that keeps coming up for women is goal weights or they have this like ideal body weight and oftentimes if you asked them, like, “Well, where did that weight come from?” it’s, like, so, like, not evidence based, it’s like, “Oh I weighed that when I graduated high school or that’s what I weighed on I wedding day or that’s my pre-pregnancy weight” and it might not be realistic. Dr. Mann: Or it sounds good. Annie: Yeah, or that’s what I read on some chart in, you know, I even remember coming across a scale in the mall bathroom, why there was a scale in the mall bathroom I don’t know but it had a chart of, like, body weights and like this is if you’re large frame, small frame. And it’s really not realistic, usually not realistic for those goal weights. So we love the idea that you have a range because as a woman I know that my weight can fluctuate you know 10-15 pounds versus in a month, in a year, how would you recommend going about determining a reasonable range of weight for someone? Dr. Mann: Yeah, that’s a really good question. That’s the hardest question to answer and the question I’m least likely to be able to satisfy you with an answer to because there isn’t, like, a scientific formula to figure out your sort of set range, so instead you have to just kind of make a guess based on your sort of knowledge of what your weight has done over your life and a lot of people notice that there’s a certain weight area that they keep coming back to. So they lose some weight but then they come back to this weight or they gain some weight but then they plop down in this weight without even trying very hard and so if it’s, you know, the weight that your body seems to keep wanting to come back to that’s probably right there, right there in the set range, right where your body is trying to keep you because you’re good at it. Annie: Yeah, in your book and I know there’s going to be people they’re going to say, they’re going to scoff at this but you didn’t just look at people that have lost weight and then regained it, you also looked at people that were trying, studies that have tried to get people to gain weight and it was hard to even maintain a weight gain as well, which further supports the idea that, like, this is where your body can effortlessly live or with minimal effort. Dr. Mann: Right, it’s true and then the weight gains that are particularly interesting because so many people think, you know, I am so careful with what I eat, if I wasn’t this careful I would for sure gain a whole ton of weight. Lauren: Yes, we hear that all the time. Dr. Mann: Yeah, you do, you know, I think people really worry about that and I think partly why they worry about it is because if they do eat a lot more than normal for a while, they do gain weight, but they only gain a certain amount of weight, you know what I mean? So maybe you’ll gain your 5 pounds or 10 pounds but you’re not going to gain 50 pounds, you know, or if you do you’ll come back down pretty easily. Jen: Right,  we see a pendulum swing happen quite often with women who are coming off dieting, if they have spent a decade of their life dieting. We see this pendulum swing where they go from, you know, one weight and the pendulum swings up to a higher weight that they are comfortable with or that is maybe within their set point range but then it settles down somewhere in the middle and we talk about that and you reference this in your book, The Minnesota Starvation Experiment. Dr. Mann: Right. Jen: So if you are coming from years and years and years of restriction, you look at, we have a whole podcast on the Minnesota Starvation Experiment. So if you are coming from a period of very severe restriction, the pendulum swing is almost an expectation, it’s almost, like, we would say it’s a normal and natural response to dieting. Dr. Mann: Oh exactly, it exactly is. I mean, we all need to reframe how we think about dieting. When people think about dieting, they think of that initial weight loss and that’s their image of dieting and then they assume once they have that initial weight loss, they just stay down there. Jen:  Right. Dr. Mann: But actually, if you followed all the research looking longer at dieters, you see it’s completely predictable that the weight comes back on. Jen:  Right. Dr. Mann: There’s a tiny, tiny minority of people who keep it off. Jen: Right. Dr. Mann: But for the majority of people, it just comes back on, you know, over the next like 2, 3, 4, 5 years. So we need to realize that that is a normal part of dieting and not a failure by any particular individual dieter. Jen: Right, right. Dr. Mann: And the thing is they always blame themselves for that. Jen: For that pendulum swing. Dr. Mann: That’s just what happens. Your body needs that to happen, your body is making that happen. Jen: Yeah, it’s like, I think you also, I think we’ve used this analogy and I think it came from your book, it’s like gasping for air after holding your breath. Dr. Mann: Right, I didn’t invent that analogy but I did include it, yes. Jen: Yes. Dr. Mann: Yes, it’s true. I feel like anything I say you’ve already talked about but I mean the things that happen when you restrict for a while. Your body, of course, doesn’t know you want to look thinner, your body thinks you’re in the process of starving to death and so it makes these alterations to save you which is so kind of it and yet everyone gets so mad about that because all those changes that save you from starving to death, make, basically make it very, very, very easy to regain the weight. Jen: Right and it probably, well, you can correct me if I’m wrong, it doesn’t really matter what size you are, if you are 120 pounds or if you’re 220 pounds when you do that restriction, your body still, you know, it doesn’t matter how much body fat you have, your body still thinks you are starving. Dr. Mann: Right, if your body detects that much less is coming in than it than expected then it just, all these changes just click on, you know, your metabolism changes, uh oh, now you have to eat less to keep losing weight. Jen: Right. Dr. Mann: Hormone levels change, uh oh, you’re going to feel hungry. Jen: Yeah. Dr. Mann: When you eat an amount of food that didn’t used to make you feel hungry, you know and then there’s all these attention changes too, right? So you notice food more if it’s around, you can’t get your mind off it once you start thinking about it, so all those things make regaining the weight way too easy and keeping it off way too hard. It doesn’t make it impossible, though and so this is a key, another key thing that I think people sometimes don’t realize. Any person who knows someone who has lost weight and kept it off, you know, comes and says to me “You can’t say that your body does this stuff, you can’t say your body makes these changes that cause you to regain the weight because I know people who’ve kept it off.” Well I’m not saying that these changes make it impossible to keep off the weight, I’m saying these changes make it really, really hard to keep off the weight. So hard that most people can’t do it. Jen: Right. We were talking before we hit record, again, another thing I had brought up is that because we are, you know, we try to navigate that messy middle and help women figure out what’s right for them, I had said, you know, hearing these two, I remember when I was first getting into this and starting to read about it like 4 to 5 years ago, I would start hearing that extreme messaging “You can’t keep off weight, you just can’t” and actually my husband has lost about 60 pounds, he was, I think, he was about 300 pounds when he graduated high school and now he sits at between kind of 220 and 245, I think. I mean, he’s going to be horrified that I’m talking about this but anyways but that just, that comes very naturally to him to kind of sit around there and so I would, you know, I was the same as those people. I kept hearing that it’s impossible to lose weight and I thought, he has now kept that off for 20 years and he’s not working, like, I don’t see him get up every day and like work at it, he’s not like, he’s not micromanaging his food, he’s not, he has some great habits, he, you know, he eats balanced meals, he tries to get to the gym 3 to 4 times a week but he’s lived a high stress life like the rest of us, he’s had kids, gone to grad school, all of that and so that just didn’t sit well with me and I thought, instead of looking at everybody who is failing, what are these successful people doing? Like why are they able to do it? Which kind of comes why, again, why your book is so refreshing, because you sort of, you’ve got that sort of nailed. Dr. Mann: Well, you know, I mean, I don’t even know and it’s interesting how you describe your husband as not having to work at keeping it off. Because what the research shows of the people who lose weight and keep it off is that those people are, you know, fairly obsessed with every little calorie that goes into their body and with every little bit of exercise they do to burn calories. So that’s what I expect to hear when I hear that people kept it off for a long time but one thing that I’ve been wondering about lately and no one has done the study that I know of and I don’t actually even know how to do this study but I’ve been wondering like, the people who lose a lot of weight and keep it off are those people who had happened to recently gain a bunch of weight but weren’t normally really heavy? You know what I mean, like I’m wondering if those who end up taking, you know, people who have had this unusual weight gain as opposed to people who are just always some high weight and took it off. Lauren: Yeah we see. Jen: I have theories. Go ahead, Lauren. Lauren: Yeah, we kind of see this and this is, I think, kind of in my story too, we see people who start dieting at a young age, right and then they just keep putting on weight as they do the rebound and you know, their weight wasn’t maybe supposed to be quite that high but because of the dieting it keeps going up. Dr. Mann: It got inflated from their- Lauren: Yeah and so for me, when I, after I stopped dieting and I did gain a lot of weight, when I finally went came to this place of balance my weight did go down and I think it’s kind of just like that it came back to its normal range. Jen: My husband also, I haven’t seen any research on this, he has put on a significant amount of muscle over the years so he, you know, at 18 years old, he didn’t go to the gym. He just, you know, his body composition is completely different, he, you can just tell by looking at pictures of him that he had a substantial amount of body fat and then after he left high school he got into boxing and ended up boxing professionally or sorry I should say semi professional, he’s just going to die, when he listens to this, I’ll just give him a little plug, he won the gold medal at the Canadian games in 2007 for boxing. Dr. Mann: Wow. Jen:  I know, amazing, but he just gets so embarrassed when I talk about this. Dr. Mann: You know, just to revise what I was saying, he’s an elite athlete. Jen: Well, he wouldn’t, I wouldn’t say now, I think he’s got more like Dad bod now but he did, he just, he got into, so what we tell our girls in Balance365 is to find movement they like, like if you and you talk about this in your book that if you don’t like what you’re doing you’re never going to stick to it and so when I say my husband doesn’t work at it, it’s not that he doesn’t prioritize exercise and doesn’t prioritize a balanced way to eat, he really enjoys that so it’s not that, so I think what what happens is there are people out there that are just never, they’re never going to enjoy my husband’s lifestyle. I’m not athletic and I am not competitive. I would never have enjoyed training for a boxing match like that or several boxing matches so, but through that- Dr. Mann: I don’t think I would like that either. Jen: Right and so you have to kind of go, you know, and Annie, for example, Annie crossfits like 4-5 times a week which helps her to sustain that 40 pound fat loss that she has done but and so it’s like Annie, personally, doesn’t feel like she wakes up in the morning and micromanages her weight loss, however if I had to get up everyday and go to Crossfit 4-5 times a week, that would feel like I was micromanaging my loss, do you know what I’m saying? Dr. Mann: Yeah, it’s true, so everyone needs to just find a sort of a set of lifestyle habits that aren’t soul crushing for them. Jen: Right, for them and that’s the sort of key that it’s like, what do you like to do and it may not be what somebody else does and so you won’t get the results that person has gotten but hey, that’s OK, like, let’s just be sensible here kind of thing. Dr. Mann: True, I mean, like in the last year or so I’ve had this just chronic hamstring injury, just won’t get better no matter how long it just doesn’t get better and you know, finally my physical therapist was like, you know, it doesn’t hurt when you do spin class, doesn’t hurt when you do yoga, it hurts when you run. It’s like exactly that part of the answer and she’s like “You have to not run” and somehow, her saying that I don’t have to go all winter onto the treadmill, it’s like so freeing to allow myself to do the kinds of exercise that I, I don’t want to say enjoy but that I don’t hate. Annie: Right. Dr. Mann: Even though to me they don’t seem as potent You know, I mean like, my brain is running this but I feel like, you know, all signs are that I’m just as healthy as if I were running as long as I’m doing these other activities and it’s not miserable. Jen: Right. Dr. Mann: So thank you, Christina, for freeing me from feeling like I have to use the freaking treadmill. Lauren: Can I, can I go back to, I want to go back to something that Jen said because this. is something that I’ve been wondering about when we hear this about the set weight range is that total weight or is that like fat percentage? Because we do see people who do build muscle, right and they’re the same weight but their body composition is very different, like, how do you know how that plays into this? Dr. Mann: I don’t. I don’t recall ever hearing anyone talking about set weight ranges in any way other than referring to weight. I’ve not heard anyone describe it in terms of muscle mass. Lauren: OK. It’s always something I’ve wondered. Dr. Mann: I don’t think people have, yeah, at least I’ve not encountered it. Jen: Yeah, I’m curious. If you end up putting on this muscle mass and it leads to your total body weight being, you know, a little bit- Lauren: Are the same as what your mass was with less muscle then is that sort of like a “trick” for your body in that it’s like, oh, we’re, you know, we’re the same weight and so you see people that change their body but your body is like “But I still weigh this much and I still need this amount of calories to sustain me.” That might be a future research project for you. Annie: That would reflect my experience, for sure because I have, like, probably a 6 to 7 I would say pound weight range that I have not budged from for maybe a couple years but my body composition has changed within that. A couple of percent, I mean, to me it’s been noticeable but I cannot, like, I have to work really, really hard to get out of that range either above or below it. Dr. Mann: That’s really interesting. So yeah, that might be a good trick, you know, don’t worry about the number, just try to replace some more of that fat with more muscle. Jen: Yeah and I think my husband probably has benefited hugely from his, his body composition is completely different than when he was 18 and I think he’s still a very heavy man, right he’s still like 240 pounds, he’s a heavy man but he’s not, he just has way less fat mass and more muscle mass on him, right? Dr. Mann: That’s great. I never thought about that, very interesting. Jen: Alright. Annie: We will come be your test subjects. Jen: Yes. Lauren: Yes. Annie: Be happy to take a trip to the eating lab up north or kind of down south. Jen: Down south for me. Annie: Yeah, for Jen. Dr. Mann: You’re in Canada. Jen: Yeah, I’m in British Columbia. Yeah. Annie: Yeah, I feel like that’s kind of a good segue talking about, you know, how much your habits or lack thereof kind of consume you because one of the most common comments we get from members or of our community is that they feel like they just need more willpower, more motivation, more self-discipline and if they have those things then they could, like, just stick to their diet, they could stick to their plan, they could reach their goals, right and I know that as a researcher of self-discipline you’ve noted that you’ve heard that echoed as well, that when you share with people that you’re researching that they’re like “Oh yeah, I want more of that” or “How do I get more of that?” In your experience, is more willpower needed? Is that what people are missing? Dr. Mann: No, no, people are missing, so every dieter thinks they are uniquely bad at resisting tempting food, you know, I mean, like, something you sort of alluded to it but constantly people come up to me after talks and or like before talks, “Oh God, self-control, I need more of that, you know, that’s a good thing that I happen to need, me alone, you know,” but everyone is bad at self-control. Everyone struggles with their willpower, thin people, fat people and everyone in between. It’s not the thing that tells us who is going to end up thin and who’s not, you know what I mean, everyone struggles with it, in fact, there’s these, this group of psychologists called positive psychologists that study, like, human strengths, so things like kindness or creativity, or thoughtfulness and what they find is that like the kinds of things that all range really highly kindness, thoughtfulness, people generally believe that they are kind and generally believe they’re thoughtful, the one that comes in dead last every time is self-control. People do not think they have self-control and they’ve repeated that kind of survey in like 53 countries. Jen: Wow. Dr. Mann: It was always at or very, very near the bottom. Nobody thinks they have good self-control, it’s not, it’s not unique to dieters, it’s everyone and it wouldn’t matter if everybody had great self-control because of the environment we all live in and there’s probably no amount that would be enough to survive the onslaught of temptation every minute of the day. Jen: Is this what you would say is the obesogenic environment? Dr. Mann: Yeah, exactly and that is what we’re living in and I mean, I shouldn’t have to try to resist buying a candy bar when I’m in Office Depot, buying paper for my printer. Jen: Right and you don’t. Dr. Mann: That should not be a temptation challenge, you know. Jen: Right. Dr. Mann: You know, it’s everywhere, all the time. Jen: Right, there’s candy, I don’t know if you guys have staples down there but we have Staples and it’s like an Office Depot and there is candy at the checkout, it’s everywhere. Dr. Mann: A huge selection, I mean and really kind of awesome candy selection. Jen: Yeah. Dr. Mann: At office supply stores for some reason. Jen: So there’s and there’s, I don’t know if this is same down there, but in Canada there is a push to have, like, basically temptation free aisles, so candy free aisles specifically for parents bringing their children to shop because I just argue with my kids nonstop about not buying candy, so then it becomes this thing that children begin to focus on and then they develop these scarcity issues or because there’s just candy and they see it and you’re saying no but and so the other thing that they’ve started offering in grocery stores here is they have apple bins for children so when you are shopping with your kids you take your kids to the apple bin and they can munch on an apple while you’re shopping and this kind of stuff is brilliant, I think. Dr. Mann: Definitely, you know, it all fits the sort of general basic strategy of rearranging things so that you don’t keep encountering temptation. Jen: Right. Dr. Mann: If you don’t encounter it, you’re not going to have it. Annie: And that was kind of like a, I don’t want to say a will power hack, but that was one of the things you mentioned in your book that, like, you don’t have to rely so much on willpower or self-control or self-discipline or say no all the time if you can curate your environment to reduce those temptations, right ? Dr. Mann: Yeah, exactly. Ideally you don’t want to ever have to say no, you know, ideally you just don’t want to come up, you know. Once a food is on your plate, for example, forget it, you’re eating it. Jen: Right. Dr. Mann: If you want to keep things from getting to that point where there’s no hope of resisting it. Jen: Right and we, like, even small things, we were talking about this with our Balance365 community the other day. Simple things like dishing up dinner at the island or on the stove and taking it to the table rather than having all your dishes on the table to dish up from is just a really small hack that you could use to not have seconds or to not, you know, over dish up kind of thing. Dr. Mann: Yeah, exactly and that works because, as we talk about a lot in the book, because people are lazy and small obstacles slow us or stop us. That’s a small obstacle. I could get up from the table and walk 4 feet. That is shocking how many people that stops. Lauren: And I’ve heard you talk about it’s not even just getting up but just moving it further than your arm can reach. Dr. Mann: There’s actually a study that shows that one of my colleagues in the Netherlands literally straining your arm is enough to slow people down. Annie: That’s like the, there’s, I have a salt lamp on the opposite side of my room when I turn it on at night and half the time I get into bed and I’m like “Ugh, that lamp is still on” and I swear more often than not I just sleep with it on because I’m too lazy to get out of bed to turn the lamp on, so like I cannot be inconvenienced. Dr. Mann: I am going to one up you on that sometimes I’m in bed on my back but I really prefer to sleep on my side and I just can’t muster the energy to like just friggin roll half my body over, half! Annie: That and you actually, you actually cover small inconveniences or small opticals is also covered in your book because you tell a story about is it toilet paper. Dr. Mann: Yes, I read that online, as, I was so excited when I read that online so it was a budget tip for strapped households was to when you get the roll toilet paper to smush it a little so that it doesn’t turn easily. Jen: Brilliant. Dr. Mann: You know, so when you go to pull it off it tears off right away, so that leads people to use less toilet paper. Jen: That, I need that for my children. Dr. Mann: Actually it’s good for if you have kids. Jen: They plug the toilet. I’m in there with the plunger once a week. Dr. Mann: It would also help with that but you know, just the fact that it stops a regular adult person from using more toilet paper is another example of how small, miniscule obstacles actually really slow us down. Jen: And Lauren, Lauren only buys single servings of ice cream so that was another one. Lauren: Well, they have them at Kroger, like the little ones ,they’re, like, you know, like, this big instead of the pint or the gallon. Annie: They’re like a little cup or like six ounces or something, 8 ounces. Lauren: Yeah or I just go out to like Dairy Queen or something instead of buying the whole gallon in my house. Dr. Mann: Buy the one. Lauren: Or even just for me is like if we make cookies or something, just putting them in the cabinet and sort of leaving them on the counter, right, we used to just leave it on the counter but if I just put it in the cabinet where I don’t see it every time I walk in the kitchen I end up just forgetting about it. Dr. Mann: Yes, keep temptations out of sights. Jen: We have a saying in our community. We also have a free Facebook community that has 40000 women in it, so they just participate in our philosophy, they haven’t bought our program but one thing we talk about in there is there’s this whole veggie tray revolution and so I started it a couple years ago and my aunt gave me a hand me down, an old circular Tupperware veggie tray and I stocked that veggie tray Sundays and Wednesdays because, like, we just eat it all by Wednesdays now, so that has substantially, and having that front and center in my fridge has substantially increased my family’s vegetable intake and I even take it out during meals. If we’re having grilled cheese sandwiches, the veggie tray will go on the table. Dr. Mann: And so it’s all prepared, like, they’re all clean. Jen: Yes, I have washed them, I chopped them I and I just it’s like, if I just need to do the minimum to set us up for success for the week it’s just that veggie tray takes me under 10 minutes and so we open the fridge and it’s just right there and we’ve also moved our treats to the cupboard above the fridge so I need to get a stool out to get out chocolate and chips and you know, people, you know, these things are simple and they work, you know, and but people just, you know, you tell them but they just, if they’re not, they’re still looking there’s like this magic pill thing going on. They don’t think it can be that simple but it is. Dr. Mann: And so the veggie tray is a good example of removing the obstacles to do something healthy. Jen: Exactly, yes, exactly. Dr. Mann: If you look in the fridge and you want a snack, you’re not going to like pull open the veggie bin, you know, get out the beats, break them, clean them, cook them- Jen: No, I’m not. Dr. Mann: But if you do that ahead, and you have a little bowl or tupperware of roasted beets, you will eat them. Jen: Yes, absolutely. Dr. Mann: Vegetables are hard work. Jen: They are hard work and so is protein. So the other thing we’ve tried to bring to people’s attention is that carbs and fat are readily available to us in convenience form everywhere, so if you want to be eating a more balanced diet, focus your energy on getting protein and vegetables and fruit prepared and as convenient to you as the nuts and the seeds and the bread and you know all of that kind of thing, because they take a lot of prep work, right. So the other thing I do is I just throw some chicken breasts in a slow cooker on Sunday night and then I take it out and I shred it and I just have a little container of shredded chicken breast which I can throw in sandwiches or wraps or do you know what I mean? So- Dr. Mann: Yeah. Jen: So yeah, it’s little, little things like that have made the biggest difference in my life and in our Balance365ers as well. Dr. Mann: That’s great, that’s good, that’s just making it easier to do the healthy thing.  Jen: Just environment. Dr. Mann: Harder to do the unhealthy thing. Jen: Yeah, just acknowledging that we’re lazy. Annie: And that’s across the board, like, your research has shown that it’s across the board, like humans in general are lazy, it’s not like these people, like, you know it’s not just me, Jen and Lauren that don’t want to prep our veggies or whatever, it’s like this is human nature and so and I feel like that’s kind of refreshing to hear because it’s not kind of, it’s very refreshing to hear because again, so many people are blaming themselves for why they can’t follow the diet, why they can’t stick with the program, it’s like, look you’re just human, like, you’re asking yourself to change a lot of things at once, to do a lot of stuff that’s really not in your wheelhouse. And it’s normal if you struggle with that. Dr. Mann: And also, can I just add, because sometimes people are like, well, all those strategies you’re saying just sound like, you know, dieting tips. Jen: Yes, they do. Dr. Mann: I don’t really mean them to be dieting tips, I mean them to be, these are just little things that you can just kind of have as habits in your life that will just help you stay in that sort of the lower part of your set point. I’m not saying that by moving the cookies to higher shelf you’re going to lose a ton of weight. Jen: Or that you should never have cookies, right. It’s not about, yeah. Dr. Mann: Right, exactly I’m just saying these are just some things that help you to just kind of stay on an even keel or maybe just aim for that slightly lower part of your set range that you’re already within. Jen: There’s, I wanted to address that too, as well because I feel like there is, as far as environment, there is a lot of tips you can use and they can be used as tools or they can be used as weapons against you, right and so in diet culture these things are often used as weapons and it’s funny because I used to some of the tools I use today to stay healthy, balanced and at a leaner weight, I used to use when I was dieting trying to live a weight below what was healthy for me and I was going hungry all the time, so what would happen to me was I wouldn’t buy the cookies, I wouldn’t buy the ice cream. I didn’t want any of that in my house because my cravings were so strong because I was going hungry all the time, so when that stuff was occasionally brought in my house I would eat it all. I would go nutso on a pint of ice cream in a night or a gallon and so it’s kind of like talking in a nuanced way, right, to go like, “You can use these as tools or you can use them as weapons, it all depends on where you’re at and what’s going on inside your head.” Dr. Mann: That’s really true and that’s a really important point that when you deny yourself something, when you restrict certain categories of foods or certain foods it’s going to eventually backfire. Jen: Right. Dr. Mann: It’s amazing how fast you start to want those things you restrict. I mean, we did a study like this, I think I talk about it in the book where we forbade people from eating a food that they didn’t even love, right, it was sort of in the middle for I can’t remember how long- Jen: 3 weeks I think. Dr. Mann: Yeah. Annie: Radishes. Jen: I feel like I just know your book. Annie: Radishes and chocolate for 3 weeks? Dr. Mann: I better know my details well, in any case, the point I was trying to make about that, the main point of that study just was that very quickly they started really wanting those things that they couldn’t have. So not worth it to deny yourself certain things and instead try to just eat those things in reasonable portions. So I cannot live without ice cream and there’s really no reason to do so but my ice cream trick, when you guys mentioned some of yours, I’ll add one more is I make my husband serve me because he will serve a reasonable portion and put it away and our freezer is crazy cold so it’s not even going to be easy to take more because it’s just, you know, he’ll wait and do what you need to do. So let people wait on you, folks. Annie: That’s just good life advice. Jen: Yes, the other one thing for your freezer- Lauren: I can get behind that. Jen: I bake for my kids for their school lunches and I keep it in the freezer so I, if I want banana chocolate chip muffin it’s totally fine but I have to think about that, right, I have to take it out and then I have to unthaw it in order for me to eat it where, you know, just talking about those barriers in environment, just putting a little bit of barrier between you and that thing causes you to pause and go “Do I really want this or is this just an impulse?” Dr. Mann: Exactly, you need that pause. My 14 year old son is obsessed with baking. Well, you know, classic pre-teen boy, you know, scrawny, looks like a paper clip, you know, no body fat at all. But he’s killing me there are constantly baking here and the good news is he’s obnoxious and doesn’t always let me have any because he wants to take it all the school because he brings it to a certain class, you know, there’s 24 kids in that class. Jen: Right. Dr. Mann: Every recipe makes 24 so he often doesn’t let me have any, thank God, but a lot of the time he does and it’s like once or twice a week this is going on in my house. Jen: Yeah. Dr. Mann: That’s a lot of like baking. Jen: Extra baking. Dr. Mann: That’s a lot of baking. Jen: Yes. Annie: So, Dr. Mann, I know we’re approaching an hour, I feel like we could do this for the whole time though or a couple hours at least, just to kind of wrap up, all of your research and your experience, personal and professional, inside your book as we’ve shared so much already, you provide a lot of gold little nuggets as to how people can improve their health, reframe their mindsets, even thinking about food in terms of healthy and unhealthy, how to alter their habits to support sustainable weight loss if that’s what they’re after but really, you seem to boil it down to just, as Jen said, sensible no-fuss advice, like exercise regularly and create reasonable eating habits and that you believe that that will help you reach your goals with minimal effort, is that really it? Because if so, that super refreshing. Dr. Mann: That is it. But I will elaborate a little bit because here’s where we have to get our heads and our heads are not there yet but  where we need to get our heads is if we are exercising the recommended amount, which is 150 minutes per week if we are eating, you know, a reasonable number of servings of vegetables per day and if we’re keeping our stress level under control, not smoking, if we’re doing those things, whatever we weigh when we’re doing those things should be where we want to be. We need to define that weight as our perfect weight because that is what you weigh when you’re behaving in a healthy way. So, I don’t know, this comes up all the time with people. Everyone thinks “if I do the exercise I’m supposed to do I’ll get thin,” but that’s not true. Exercise doesn’t necessarily make you a lot thinner but it does make you healthier. What I keep pushing on people is “Behaving in healthy ways makes you healthier, even though it might not make you thinner or as much thinner as you want it to.” So whatever we weigh when we’re behaving in healthy ways we have got to find a way to be OK with that. Jen: Right, except you have a whole section on acceptance, right and let your, do what’s good for you and let your body be what it’s going to be and just accept this, like it’s actually so freeing. Dr. Mann: Yes, just if you keep the focus on health and not weight everything makes so much more sense. Jen: Yeah, I love that. Dr. Mann: You do these healthy behaviors, they make you healthier, but then again, maybe not thinner, maybe not as much thinner as you want. Annie: I wonder how many of our listeners minds are just like blowing right now hearing that. Like, behaving in a healthy way will make you healthier, it might not make you thinner but it will improve your health. Dr. Mann: Isn’t it crazy that that’s mind blowing?  I said that to some radio guy one time and he’s like “I don’t know, that’s kind of a hard sell.” Lauren: You know, well, it’s only a hard sell because you have, you know, diet companies telling you the opposite everywhere all day, every day. Dr. Mann: Seriously, you know, And because people don’t actually value their health the way they all say they do. Jen: Yeah, they value thinness. Dr. Mann: Yeah, if people truly valued health, that wouldn’t be a remarkable thing to say at all. Jen: We had a psychologist post in our group the other day she had read your book preparing for this podcast and she said “I’m a psychologist and I’m reading this book and I feel my resistance towards it, like, I feel it” and she, but you know, she’s acknowledging, like, “This is programming. This is diet culture,” so she was trying to tell everybody, like, “I am a professional and I am resisting this, like, I have a mental block there that I don’t want to hear it. I still want to believe there’s a magic pill out there” and so of course, the general population that isn’t even educated with psychology, you know, of course, there’s a massive block there, massive. Dr. Mann: And I see that and I see that in anonymous comments out there, the people who come up to me are like, “This is freeing, this changes everything, hallelujah” and the people who are like, “I can’t, no, I must believe that I can lose a ton of weight and keep it off.” Yeah, I don’t hear from those people I just hear mean comments. Jen: Right, but they just pursue people who that, whose ideas support their, you know, how they want to see the world right and you know what, honestly, when I embraced these ideals, it was, I went through a pretty big slump of emotion, like, it was like grief. I had to grieve and because it was, yeah, it was, it was an idea that I had based a lot of my life around and spent a lot of time energy and money and the more invested you’re into something, the more you resist that it doesn’t work and trying to convince different gurus or fitness professionals that have built their whole careers and social followings on selling thinness, trying to convince them of that will be even harder because they are so deeply invested in it. Dr. Mann: Oh yeah, they’re the worst. Jen: And so I think a grieving process is like pretty normal when you, like, you have the freedom but then it’s like, you know, you go through these different stages of, like, “Oh, well that sucks” or you feel somebody shame come up and your trigger, that’s kind of your trigger that typically will take you into dieting behaviors to feel like you’re actually in control of that but you’re not and you’re just realizing, “I am not in control” and that can be very depressing, right but but also very freeing on the other side once you fully accept that/ Dr. Mann: Yeah, again, we just have to remember the one thing that truly, truly matters is our health. Jen: Yes. Absolutely. Dr. Mann: You know, have someone close to you die too young and suddenly it becomes very, very real, you know, you have nothing without your health. Jen: Right. Dr. Mann: So keep that in mind as the goal. The goal is health. Not some number on the scale and they don’t measure health with that number on the scale. Jen: Right and and including psychological health in that because I have had people around me succumb to eating disorders and that’s a very real thing in our society and it has very, anorexia has very high mortality rates and so- Dr. Mann: The highest of any mental illness. Jen: Yes and so and it’s just a horrible life, right even if you don’t, even if it doesn’t lead to you passing away and dying, it’s a horrible place to be and it is not healthy and it’s, you know, this is very real as far as, you know, a lot of people think of unhealthy as, you know, very large and morbidly obese and eating and eating but there is the other end where there’s a lot of people succumbing to eating disorders as well. Dr. Mann: Yeah, it’s true. Annie: Dr. Mann, I cannot thank you enough. This is so much fun. Is there a place that people can connect with you? Do you hang out on, I already stalked you on Instagram it doesn’t look like you’re- Dr. Mann: I never post, I’m basically on Instagram to spy on my 14 year old. I don’t expect he’ll see this. Annie: Excellent. Are you on Facebook or your website? Where can people catch up with you or stay on top of what you’re working on? Dr. Mann: I guess I’m on Facebook or Twitter more but again, on Facebook I post but mostly political stuff, on Twitter I only lurk, I’m there,  if you want to find me, if you want to talk to me, tweet at me. Annie: OK. Jen: OK. Dr. Mann: Or do the same on Facebook. Annie: Awesome we’ll put that in the show notes so people can connect with you if they want to follow up with you but this was so fun. It was just like talking to a friend that knows a lot about nutrition. Dr. Mann: It sounds like you’re doing awesome stuff so I’m so glad you’re out there doing it. Annie: Yeah, we’re trying. Jen: Thank you. Lauren: Thank you. Annie: OK, we’ll talk soon ladies, thanks for joining us. Jen: Bye. Lauren: Alright, bye!   The post 53: Secrets from the Eating Lab: Dr. Traci Mann appeared first on Balance365.

When the New Year rolls around, people start making resolutions to change their lives. More often than not these ventures end in failure, but it doesn’t have to be that way. It’s not a lack of willpower, motivation or hard work. It’s just the way we make resolutions isn’t always consistent with the science of behavior change. Jen, Annie and Lauren explore the three ways you can make better resolutions this year, or even decide whether you need to make resolutions at all. Resolve to join us and learn more! What you’ll hear in this episode: The best time of year to buy used exercise equipment New Year’s resolutions and FOMO The Power of Suggestion, product placement and targeted ads Jumping on the bandwagon and following the leader The perfect storm of post-holiday shame Shame-based marketing as motivation for change Ending the binge-restrict cycle Learning to let the pendulum settle Zooming out to give context to holiday eating What happens when you try to change too many things at once Outcome-based goals vs habit-based goals How to turn an outcome-based goal into a habit-based goal Resources: Five Stages Of Behavior Change Episode 15: Habits 101 – Hack Your Habits, Change Your Life Episode 22: The Oreo Cookie Approach To Breaking A Bad Habit Learn more about Balance365 Life here Subscribe on Apple Podcasts, Spotify, Google Play, or Android so you never miss a new episode! Visit us on Facebook| Follow us on Instagram| Check us out on Pinterest Join our free Facebook group with over 40k women just like you! Did you enjoy the podcast? Leave us a review on Apple Podcasts or Google Play! It helps us get in front of new listeners so we can keep making great content. Transcript Annie: The New Year is upon us and with that comes optimistic feelings of a fresh start, a clean slate and a chance to reach our goals. Love them or hate them, it’s estimated that almost half of Americans make resolutions every year. Step into any gym the 1st week of January and it’s clear that fitness and weight loss goals are topics for most resolution makers. Resolutions are a dime a dozen. It’s sticking to them that can be difficult. Sadly, the reality is that most of us who vow to make changes in 2019 will drop them before January is even over. On this episode of Balance365 Life Radio Jen, Lauren and I dive into common reasons why New Year’s resolutions fall flat and changes you can make to help ensure you stick with your goals long after the New Year’s excitement fades. Enjoy! Lauren and Jen, welcome back! We are discussing New Year’s resolutions already, can you believe it? Lauren: No. Jen: I can’t believe how quickly this year has gone. Annie: No, I feel like I blinked and it was like the end of the year. Jen: I feel like I just saw you guys in San Francisco in February. Annie: I know, it was like a year ago. Jen: I know. Annie: That’s what happens when you see each other every day and talk to each other every day, all day. Besties. So we are talking about New Year’s resolutions because, I mean, it’s obviously a timely subject, we’re coming up on the end of the year and people are thinking about what they want to accomplish in the New Year, right? Which is ironic because we used to have a challenge, we did a challenge a couple years ago called the Screw Your Resolutions challenge and it was our alternative, our Balance 365 alternative to resolutions because so many of us have made resolutions and failed, right? Have you done that? Jen: Most people. Lauren: Yeah. Jen: In fact. Lauren: No, I’ve never done it. Jen: In fact, I keep my eye out for workout equipment around March and April because it all goes back for sale, you can get really good deals on treadmills around that time. Annie: Yes and workout clothes as well too, like they’ll go on, I mean, they’re not on sale right now necessarily but because it’s a popular time to be buying them. Jen: Yeah. Oh I mean second hand- Annie: Oh, OK. Jen: March, April, yeah people, they buy, they get the deals in December-January, they spend $2000.00 on a treadmill and then by March-April it’s back up for sale for like $400.00 So keep your eye out- Annie: Because that treadmill trend- Jen: on buy and sell websites. Yeah because you just hang laundry on it, really. This is what you do. I mean, I’ve been there as well. But I sold my treadmill when we moved last time and I really regret it because now I’m looking at getting another one. And but I’m going to wait I’m going to wait for the New Year’s resolution dropouts to put theirs up for sale- Annie: Yeah, she’s going to take advantage of you guys, listen. Jen: March-April. Annie: She’s going to prey on you. Lauren, what about you? Have you made a resolution and failed to keep it? Lauren: Yes, pretty much every year besides the last five. Yeah, it was always obviously diet exercise related too. But then I would add, like, other things so I would want to do all the things. Annie: Yep. Which we’ll talk about. Please don’t jump ahead of my outline. Lauren: I’m sorry. Annie: We’ve talked about this. Jen: I made a New Year’s resolution-ish. It was a couple years ago it was really big to choose a word, like choose a word for 2016 or 2017 whenever it was and I jumped on board that train and it was a success but we will talk about that later. I won’t skip us ahead. Annie: What was your word? Jen: It was respond. Annie: Oh, OK. Jen: Rather than react because I found myself, I was, like, you know, I could be quite reactive. Annie: No. Jen: So I really worked on that secondary, that response, when your inner B. F. F. comes in and it’s like “Whoa, chill out, girl.” Annie: Yeah, I dig that. Jen: What about this? Annie: Yeah. Jen: So then I would find, you know, I think it was 2016, I worked really hard on it and I’m much better at keeping my reactions under control and responding. Annie: Well, I’ll be interested, maybe a little bit later you can tell us about why that was so successful versus other attempts. But before we get any further, really, today we just want to discuss, I have 3 main reasons that we see resolutions kind of fall flat and I want to be clear that we are not anti resolutions, we’re not anti goals, we’re not anti action plans or whatever you want to tackle, resets, restarts, refreshes in the New Year because I’m totally one of those people that gets super excited about the idea of like a clean slate, like, that’s really, like, I love, like, a fresh start, going to start over. I get to do this. I’m going to do it right. It’s super exciting and super motivating but just the way in which people approach them and their expectations around resolutions are usually why they aren’t successful with them. Jen: Yeah we are pro, we want you to be successful. Annie: Yeah so we’re going to discuss 3 ways you can make your resolutions a little bit more successful because again, it’s not that there’s anything wrong with resolutions inherently, It’s more how we approach them and our expectations surrounding them. So let’s just dive right into it. The 1st one is that remember that you can set goals, create new habits, set intentions any time of the year, right? Like this is not something specific just to New Year’s Day or New Year’s Eve, you can do this February 1st, just the same as you can March 1st or May 15th, like whatever time you want to set new goals, you can make new goals and as I noted, I totally understand the excitement that comes when everyone else around you is doing the thing, right, and it’s contagious and I have severe FOMO, you know, fear of missing out so I feel this pressure like “Oh I want to do that, like, that’s really exciting, right?” Jen: Well, it can be like when you go shopping with your girlfriend and you only need one thing, like you need a pair of jeans and then you get in the store and your friends are like “I’m getting jeans. Oh, I also need earrings and look at this top, it’s so cute, and this coat” and then all of a sudden you’re like “Yeah, those things are so great. I should look at them too and I should get them too” and then all of a sudden you’re leaving the store with like 6 bags and you only want one pair of jeans, right? So during New Years, it’s just that you’re just surrounded by people changing all the things and you’re like “Well that is such a good idea, I need to address that in my life too. Oh and that would be great too and that too” and then all of a sudden you’ve got 10 New Year’s resolutions. Annie: And the power of suggestion, sorry, Lauren, go ahead. Lauren: I was going to say, well, even more than that for me is I would feel like I had to make a New Year’s resolution period, like even if I was not in a particular space in my life where I could handle a new goal or setting a New Year’s resolution, like, I had my daughter 5 years ago on December 1st and so it was like “Oh, I should make a New Year’s resolution” while I had an infant, you know, right, probably not the best time. Annie: Yes and I was just going to add to the power of suggestion is really, really strong around this year because Jen you’ve shared advertising budget numbers from the diet and the fitness industry, they spend a large percentage of their marketing budget this time of year. They are pushing, pushing, pushing- Jen: Yeah, the first few months of the year, the 1st quarter. I can’t remember what the numbers are, I’ve shared them on a past podcast but it’s like 65 percent of their marketing budget is spent in the 1st couple months of the year. Because yeah, so it’s everywhere. Annie: So you’re really, really, you’re likely seeing it in magazines and commercials and newspapers, in bookstores and anywhere you’re going, essentially, to buy this product, buy this program, purchase this service, purchase this membership- Jen: Yeah, people have no idea, like, how much thought goes into marketing and so even, you’ll see, I noticed in my local bookstore that throughout the year when you walk in there’s different tables set up featuring, you know, new books or this all these books on this topic. Well, in December or January the diet table comes to the very front of the store so when you walk in it’s right there. Because they know, they know that that’s the time to be selling these books, to put them right in front of you, get you thinking about it, it makes you buy them. We like to think we’re so in control of our choices but we really are not. Annie: I was just going to say that because I know, Annie 10 years ago would have walked into Barnes and Noble or whatever this bookstore, saw the diet book and “it’s like they knew what I wanted,” like, yeah, how did I, like, you know, how did they know but really? Jen: If you don’t even think about the change, it’s like, this must have always been here. Annie: Right, it’s like, like, you know, it’s like, it’s, now we have Amazon ads popping up on our feed, you know, like Lauren, you just talked about how you were, posted about your standing desk. Lauren: Oh my gosh, yes, I got this standing desk which is amazing, I got it from Costco, I don’t know if it’ll still be here when this airs but I got it from Costco and I posted about it on my story and I had never seen an ad for a standing desk before and after I posted it on my story I was started seeing Instagram ads for this other standing desk and it freaked me out. Jen: Oh. There’s so many conspiracy theories around what Facebook and Instagram listen to and of course they deny, deny, deny but that happens to me all the time. Sometimes I feel like I’m talking to a friend about something, like, in person- Lauren: Yes. Jen: Then I’ll start seeing those ads on my feed. Lauren: Yeah. Annie: There’s a meme that it’s like, of course, if I had a dollar for every time I started a sentence with “There’s a meme” on Instagram that says “Oh, oh, that’s weird how this showed up on my feed when I didn’t talk to anyone about it, I didn’t type it, I didn’t search it, like, it’s, like, there in your brains, you know- Jen: You thought it. Annie: Yes, but anyways, it is, you know, it’s kind of like when you go to Target and your kids don’t want goldfish until they see the goldfish and then you know and it’s like “Now I can’t live without the goldfish.” Jen: And you have to and there’s also food, food companies have to pay more to get their products on the shelf at eye level. Lauren: Yes. Jen: Do you know I mean because they know it leads to you choosing it more so they make a deal with, you know, whatever supermarket chain and they pay a fee to have their product at eye level, like, you really, if you know what I mean, like, it’s just there’s so much of this that goes on that consumers aren’t aware of. Annie: Right, which we kind of went off on a tangent there and I think that would make a really great podcast about how the the science and psychology behind marketing and how it works the way it does, especially when it comes to health and wellness but the point here is that you can set these goals any time of year, so even though the bookstores are pushing it or you might feel like you’re seeing these messages to get these really brand new fresh goals around your health and your wellness. It seems like it’s everywhere. Remember that you can set these 6 months from now, 3 months from now, any time a year. You don’t have to feel pressure to do it on New Year’s Day. Jen: Yes and now that we have told everybody about it, you will start noticing it and you can be more critical about it and this is called media literacy and media literacy has been found to be one of the greatest tools in preventing disordered eating and body image issues. So pass it on. Annie: Pass it on. Stay woke, right? Jen: Stay woke. Annie: OK. Number two, remember your why. Ask yourself “Does this really matter to you?” when you’re setting your New Year’s resolutions because along the same lines of getting caught up, this can tend to be following the leader, kind of like Jen said when you’re shopping with your girlfriend and in my experience, what’s personally happened to me before is one girlfriend dinner is like “Oh yeah, I’m going to join this gym, I’m going to start this program, I’m going to start this diet” and the rest of us are like “Oh yeah, like, I guess that sounds good,” like, “That sounds good to me, I’ll do that too” or like “Guess I hadn’t really given it that much thought but she’s done the research. And she seems to think it’s a good idea so I’ll do it too” and if you listen to our Stages of Change podcast with our Balance365 Coach Melissa Parker, you’ll know that skipping stages like contemplation, where you’re thinking about doing a thing and preparation, where you’re making plans to do the thing, are actually really vital to your success and this is one of the reasons people- Jen: Not skipping stages. Annie: Sorry, yes, not skipping stages. It’s really vital to your success and this is one of the reasons that people can fall flat on New Year’s resolution time is because they join the gym, they buy the meal plan, they sign up for the challenge or whatever it is they’re doing without really considering “Does this even matter to me? Is this a good time in my life to do this? Is this reasonable to think that I can do whatever is required to make this goal happen?” Just like Lauren said, like, she just felt this pressure to make a resolution and it’s like “Hey, I just had a baby. Maybe now isn’t the time to be all in on whatever it is I’m wanting to do” and if you give it some reflection and you come up with like “No, this isn’t OK. This isn’t the time, this isn’t the thing I want. That’s OK. It doesn’t mean that you’re stuck wherever, you’re out forever. It just means that maybe you need to re-evaluate and get some clarity on what your goal is and how you’re going to get there. Jen: Yeah, it often is related to, I think, feelings of guilt around holiday eating as well so, I mean, that’s why the advertising is so successful, right, because they know you’re feeling bad about all the eating and sitting around you’re doing over the holidays and that becomes your motivation, right, which is shame-based motivation, which we also know through research that shame-based motivation is not lasting. Lauren: Yeah, and I’ll add too on this that this is why we actually added a section in Balance365 it’s called The Story of You and it helps you to uncover what your values are and what your core values are and so not only does that help you when you are making changes because when you make a change if it connects with one of your core values you’re more likely to stick to it but it also can weed out this extra stuff so you can think back “Well does this really support any of my core values?” and if it doesn’t you can feel a lot better of saying like “Oh, this isn’t for me, like, it’s good for them, it’s not good for me.” Jen: Right. Annie: And circling back to what Jen said about shame-based marketing, you know, I think in the past when I have started a new diet or a new exercise routine on New Year’s Day it has usually been to combat those feelings of shame and guilt about eating too much, missing the gym because I’ve been busier than normal, the weather’s been crummy, not enough daylight, you know, whatever fill in the blank and they know this. Lauren: Yeah, that was always me, like it comes right after the holidays, right, where everyone’s crazy busy, there’s treats everywhere. And it’s just like, it’s kind of like a perfect storm, right, everyone’s doing it, you feel crappy, the advertising is being pushed to you, so it comes together on January 1st. Jen: Yeah and it’s just it’s all part of that roller coaster, though, you could start if you zoom out a bit and start identifying trends so most people wouldn’t binge over Christmas if they weren’t dieting before Christmas. Lauren: Right, yeah. Jen: And most people wouldn’t diet before Christmas if they were bingeing at Thanksgiving. Lauren: And then you wouldn’t feel crappy, right? And wouldn’t be like “I need to do something.” Jen: Right, so the period between Thanksgiving and Christmas is also a very, very popular time to go on a diet so, you know, people go into the holiday, basically, diet to counteract their Thanksgiving bingeing and to prep themselves for Christmas. Someone just said the other day, told me a friend of theirs was working on losing 5 pounds in preparation for the holidays and I’m, you know, it’s funny kind of, but you’re also like, I just cringe and think, “Oh my gosh, like, you’re basically just announcing that you have an eating disorder and that you are starving yourself in preparation for being able to binge.” Lauren: Right and that just feeds right into the cycle. Jen: Yeah and then so you binge over Christmas and then you get back on that diet rollercoaster for January and then, you know, then you restrict, then you binge and then you’re restricting for your bikini season and then it’s just, it’s just wild. Annie: And most people are trying to stop that cycle in the binge, when they’re in the binge they want to pull all the way back to restriction which I totally get, like, that seems to be, like, “Well, duh, like, I, you know, I’m either all in or I’m all out, I’m on the wagon, I’m off the wagon,” like there’s just two extremes and our approach would be to just let that pendulum settle down in the middle like, don’t pull it so far back. Jen: Yeah, so Chastity, she’s in Balance365, she said the other day is that people want to stop bingeing but unfortunately they don’t want to stop restricting. However the solution to stop bingeing is to stop restricting as well. Lauren: Right. Jen: And people just really have a hard time wrapping their heads around that. Annie: Absolutely, I mean, it can be scary because it feels like you’re letting go of some of that control, especially if you’ve been dieting for years and that’s what you know, that a lot of women feel comfortable and in control when they’re dieting, even if they’re miserable, even if they’re white knuckling it. Lauren: I remember someone when we first started doing this had been dieting for years and years and she was terrified when we told her like stop counting your points, stop counting, like, just give yourself permission to eat and she was like “I will literally start eating and never stop.” Jen: I remember that too. Lauren: And like, spoiler, that didn’t happen and now she lives a free life and she doesn’t count and she’s happy with her progress but she was terrified, like there was a real fear for her. Jen: Right. Annie: So once again we went on a little tangent. Jen: As we do. Annie: I’m just looking at our outline, like “Remember your why” and now we’re talking about restriction and it’s all connected though, isn’t it? Jen: So remember your why. So remember that you don’t want to be on the diet roller coaster and that is your why for not jumping on board a new diet in January. Annie: Well and why am I doing this again, if I am being honest and years past it would have been to try to avoid or to remove some of those feelings of guilt and shame, so it’s like “OK, I’m just going to try to regain all of my control by doing all the things and doing them perfectly” and you know, again, it just, what that does is eventually perpetuates the cycle of this diet cycle. Jen: Yeah, an alternative to feeling guilty is to say “Wait a sec, I’m human and just like everybody else at Christmas, I indulge in the holiday foods and move along.” Annie: Yeah. Because the holiday foods are yummy. Jen: They are. Annie: They are yummy. And yeah and just cut yourself some slack, right? Lauren: Yeah. Annie: OK, so we covered the first two. A, you don’t have to make these New Year’s resolutions just this time of year, you can set goals or new intentions or create new habits any time of year, then you evaluate like “Does this really matter to me? Why am I doing this? What’s my purpose? What’s my mission behind this? What am I hoping to get out of this?” and then if you come to the conclusion that “I still want to move forward. I still want to make change” and your resolutions are around things like eating healthier, exercising more, drinking less, quitting smoking then we’re talking about changing habits which, shockingly, is something we’re pretty good at helping people do. Surprise! And Lauren you have some really good information about creating and changing habits, but essentially it boils down to you don’t have to overhaul your entire life overnight because so often people go to bed on New Year’s Eve and they’re like, they set these plans and they’re going to wake up like a person with completely new habits on January 1st, like 12 hours later, new year, new me, right? Lauren: Right. That would be really nice. Annie: It would be great if it were just that simple, if all the change could happen. Jen: If worked, we would encourage it. Lauren: Yeah, right. Annie: Yeah, it’d be a heck of a lot quicker but will you share the statistics about why changing too many things at once isn’t likely to bode well for you? Lauren: Yes, so we share this all the time, actually but I find that it’s so eye-opening for people is that studies show that if you want to change a habit and you change one small thing and only that thing you have about an 80 percent chance of sticking with that change long term, which is actually really good for percentages. If you try and change too things at the same time your success rate of sticking with both of those things drops down to about 30 percent and then 3 or more changes at the same time your success rate drops to almost 0 sticking with all those changes and then the more things you add on, the less and less your success rate will be. Annie: That’s not very promising to change a lot of things at once is it. Lauren: No, so not only do you not have to, you shouldn’t if you care about sticking with it, right? Annie: Yes, so when you think about someone that wakes up New Year’s Day and is like I’m going to change all 3 of my meals, plus my snacks, plus my sleep habits, plus my water and alcohol consumption, now I’m also going to add going into the gym 5-6 times a week, that is so many behaviors that it takes to change, I mean we’re talking about, like, let’s take a look at a meal, like, what does it take to change a meal, like, it could change what you put on your plate, how you prepare your food, what kind of foods you’re buying at the grocery store, it might require, do you even go to the grocery store in the first place versus eating out, I mean, and those are the little steps that take to build a really great solid habit that so many people overlook. They just think “I’m just going to start eating a balanced breakfast, lunch and dinner tomorrow, all the time, forever and ever amen.” Lauren: And our brains just don’t work like that. It’s just the way we’re wired and you know, we, like our brains, like consistency and constants and so it’s not going to bode well for you if you try and change everything all at the same time. Jen: I don’t even like going somewhere new in the grocery store, like a new aisle. Like when I when I’m looking at recipes and there’s just some whacko ingredient, you know, that either you can’t find in a regular supermarket or I’ve just never seen that before I’m like, “Next!” Like, I just really resist. Yeah. Annie: I think, yeah, I mean, obviously when it comes to cooking I’m the same way. I see it is a recipe with more than like four ingredients and I’m like “No, I’m out.” Lauren: Thank you, next. Jen: Yeah, I know as far as our plans on expanding our our recipe collection on our website and just looking at, like, when we had a woman making recipes for us this fall and the first couple she sent me I was like, “Listen, like chickpea flour is just not going to fly.” Lauren: I feel like we should have a test where like if Annie, Lauren and Jen can’t make it it doesn’t get put out there and we would be like, “Pizza. Quesadillas. Chicken.” Jen: Yeah yeah and so it’s like, I remember I would go all in like back in my dieting days on making things like cauliflower pizza crust. Lauren: Yes I would take so long to make meals and they would always taste like crap. Jen: Yeah and so but then it’s like, you know, five years later, we’re just having pizza, like just regular crust and it’s way better. Lauren: Like, it’s fine. Jen: It’s like all those steps, right, like all those steps to make, to just get in the habit of making these healthy pizza crusts and yeah just really makes no difference. Annie: And now, yeah, I feel good just throwing some veggies and some fruit and some extra protein on my Jack’s frozen pizza. Jen: Yeah, like, I’ll just have a side of cauliflower with my regular pizza. Instead of trying to work it into the crust. Annie: I really like how you say cauliflower. Lauren: Cauliflower. Annie: Anyways, yeah, but truly I think people really underestimate how much energy is required to change just one habit and it’s definitely a slower process but what we hear from women in our community that are working through our program is that it feels effortless, they’re not white knuckling through all these changes and just like, “Oh my gosh, I hope I can do this. I just need to do this for a little bit longer before it comes automatic.” They’re like, actually, they’re kind of like looking around like “Is this really all I’m doing? Like, this is all you want me to focus on?” and we’re like “Yeah, actually.” Jen: Just this one thing. Annie: That is. Jen: Yeah. Annie: And if you’re talking about changing existing habits, which that comes up a lot around New Years resolutions too is the best way to change an existing habit is to replace it with a new one and Lauren and I have a pretty good podcast, actually two podcasts on how habits are built, like Habits 101, and then how to change or break bad habits, so if you want more information on the science and the process behind habit building and breaking bad habits, I would highly encourage you to listen to those because, I mean, I think we give some pretty good tidbits. Lauren: It’s pretty good. Annie: I mean, it’s alright. And the other thing I want to add onto that too in terms of habit changing and going a little bit slower is to discuss the difference between outcome-based goals and behavior-based goals because so often, again, resolutions seem to be outcome-based goals. I want to lose 10 pounds. I want to run a 5K. I want to compete in this challenge or whatever and it doesn’t really address the behaviors, like, OK, how are you actually going to do that? What actions are you going to take to lose 10 pounds? Like I’m not poo-pooing weight loss as a resolution goal, your body, your choice. But how are you going to lose that 10 pounds? It might be I’m going to start exercising on Monday, Wednesday, Friday for 30 minutes or I’m going to replace, you know, X, Y, Z with vegetables on my plate or I’m going to increase protein or you know, whatever that looks like, we would encourage you to write your goals based off of your behaviors, not the outcome you want, because so often if you take care of the behaviors, which we have more control over, the outcome will just naturally be a byproduct of it and so often I see women doing all the right things and they don’t get the outcome they want and then they feel like a failure, you know, they’re making all these great changes. Especially when it comes to weight loss. We’ve seen women work their butts off to try to lose weight, you know, they’re maybe exercising more, they are addressing their self talk, they’re getting more sleep, they are cutting back on sugary drinks or alcoholic drinks or whatever that is they’re working on and they step on the scale and they’re down 3 pounds instead of the desired 10 pounds and all of a sudden they feel like they’ve failed. Lauren: Right. Jen: When they’ve actually succeeded in all these areas of life that a lot of people struggle to succeed in and it’s huge, it’s a huge big deal. Lauren: Yeah. Annie: Yeah, when really if you just zoom out and it’s like “Oh my gosh, look at all this great change I’ve made, I’m feeling better I’m taking better care of my body or you know, whatever it is, fill in the blank, that we just tend to lose sight of that when our goals are outcome based. Lauren: Also when they step on the scale and they see that, that they haven’t lost as much as they had hoped, they also a lot of times will be like “Well, what’s the point, right ?” and then they don’t continue doing those behaviors and it’s the continuation and consistency of those behaviors that’s going to lead to possibly them reaching their goal, right? Annie: Yeah, so the easiest way to turn your outcome based goal, if that’s what you were thinking about before listening to podcast, into a behavior based goal is to just ask yourself “How am I going to achieve that? How am I going to run a 5K? How am I going to run a marathon? How am I going to lose 10 pounds? How am I gonna?” Jen: Yeah. Annie: You know, like and then usually that how, that’s the behavior. Jen: Yeah and then realize that that outcome goal you have actually could be made up of a series of behavior changes that need to happen one at a time, therefore it may not happen as quickly as you like, which is OK. Life is long. Annie: Yeah, it’s the tortoise and the hare, right? Jen: It’s a journey. Annie: Yeah, as cheesy as that sounds, people are probably like, “Oh, come on.” Jen: It’s a journey. Lauren: Zen Jen over there. Jen: I know. Annie: Enjoy the process. Jen: Gandhi. Annie: We need one of those successory memes. You know, popular in the nineties. OK, well those are the three main points I wanted to discuss when it comes to New Year’s resolutions. Is there anything you two would like to add? Lauren: I don’t think so. Annie: OK, let’s do a quick review. First of all, before you set your New Year’s resolutions remember that you can set these new goals, create new habits, set new intentions, you can have a clean slate any time of the year. I totally understand that it’s super enticing to have like new year, new me but you can do this on May 1st just as easily as you can January 1st. The second one is to remember your, why does this really matter to you? Are you just doing this because your girlfriends are doing this or because marketing is telling you to do this or is this something that you really desire and then on top of that are you willing to do what it takes to make that happen and sometimes the answer is no, like Lauren said, you know, she really maybe wanted some of the things she wanted after having Elliott but it just wasn’t, the timing wasn’t good and honoring that, and being like, “Hey, I can just put that on the back burner and wait a little bit to start that until I’m ready to make those changes and I’m able to make those changes and stick with them” is absolutely, that’s an OK answer. Jen: I know you always say, Annie, there is more than two options, it’s not always “yes” and “no”, there’s a third option which is “later.” Annie: I would love to take credit for that but that’s actually Lauren. Jen: Oh, I’m sorry, Lauren. Lauren: Yes. Annie: Yes. I was like, as soon as you said that I was like “Oh, I really wanted credit for it because it’s good, it’s good advice, but I’m going to be honest, that’s Lauren’s advice.” Yes, later is always an option which I think is, that’s goes back to your maturity about responding, Jen, versus reacting, you know, so many people can get reactive during New Year’s resolutions like they feel compelled to do something just because everyone else is doing them and it’s like, if you just have pause, like think like “Do I want this? Was I considering this before I heard Susan over here talking about her weight loss? Like. Jen: I always think of my inner BFF like she’s, she just like, she comes to me in that first second I react and then give it 20 seconds and my inner B.F.F. is sitting beside me like “Hey, girlfriend. Calm down.” Annie: That first voice in me though, she can be really kind of grumpy sometimes. Jen: She’s my naughty friend. She’s naughty. Annie: Let’s do it! Yeah! Is this is code for Annie and Lauren? Jen: There’s Annie and then there’s Lauren. Annie: Annie is like shoving you into the mosh pit at a concert, like “You can do it!” and Lauren’s like, “I don’t think that’s a good idea.” Jen: Let’s stay safe back here. Annie: Both are needed sometimes, OK? And the last point we just discussed today was that you don’t have to overhaul your life in one night, that to think that you’re going to go to bed on December 31st and wake up 8 hours later a completely different person doesn’t usually happen for people and that’s not, that’s not because you lack willpower or motivation or determination or discipline, that’s just the way behavior change works and it takes time and slowing down the process to focus one thing until that becomes automatic and then layering on brick by brick is usually the best place to start and we have a saying too that we stole from James Clear that “Rome wasn’t built in a day but they were laying bricks often” Lauren: We changed it to make it our own. What’s our new one? Beyonce wasn’t built in a day. Jen: Beyonce wasn’t built in a day. Annie: Beyonce also wasn’t built in a day. So if you could just lay a brick, you know, if you have these big goals 2019, 2020, 2021, start with a brick, really and lay your strong foundations, good solid habits, one by one and you’ll get there eventually and hopefully you’ll wake up one day and you’ll have this big beautiful Coliseum and you’ll be like “Oh, that was easy.” Jen: Exactly. Exactly. That really is how it happens. Annie: Yeah and I know that’s probably sounds a little bit ridiculous or a little bit too good to be true but you need to be able to play the long game for behavior change, you have to have big picture and patience which, I’m saying that to myself right now. I’m talking in a mirror. And yeah, hopefully this helps people build some better resolutions. I would love to hear what people are working on. So if you are working on something for the new year and you want to talk about it, please join our Facebook group, it’s, we’re Healthy Habits Happy Moms on Facebook. We have 40,000 women in our private Facebook group and if you need a place for safe support, reasonable advice and moderation, this is your place to go. Jen: I got a huge compliment yesterday. I was at a cookie exchange with 10 women and not many people know about my our company locally where I live and actually a couple women from my community just joined and the one woman said to me yesterday “Your group is the first place I’ve ever found that actually promotes you giving yourself grace.” Lauren: Aww. Annie: Can we like get a testimonial from her? Jen: I’ll ask her. She’s in Balance365 now. Annie: Oh that’s wonderful. Jen: She would be happy to. Anne: Yeah, I think it’s a pretty sweet place. We have amazing women, it’s really, it’s not it’s not us, it’s our community that’s made it such an amazing place to be, they provide support, applause and encouragement and tough love sometimes when it’s needed. It’s a great place to be, so find us on Facebook at Healthy Habits Happy moms You can also tag us on social media on Instagram and show us what you’re working on, show us your more reasonable New Year’s resolutions. Jen: Yes. Lauren: Yeah, I like that. Annie: Yeah, me too. OK, anything to add? Jen: No. Lauren: No. Annie: We’re good to go? Alright, well, we’ll talk soon, OK? Lauren: Bye. Jen: Bye. The post Episode 46: 3 Ways To Improve Your New Year’s Resolutions appeared first on Balance365.

Annie and Lauren interview Registered Dietitian Marci Evans to answer the question once and for all “Is sugar addiction real?” Marci delves into the science, the psychology and the keys to feeling less out of control about sugar and more in control of your life. Strap in for the latest and greatest in peer-reviewed research and what it all really means. What you’ll hear in this episode: Clickbait headlines and sugar research Is sugar addicting? Sugar and Cocaine: How alike are they? Abstinence from sugar and its impact on cravings What rodents taught us about sugar Finding food peace in the messy middle Black and white thinking and sugar The difference between diet rules and noticing what feels good for your body Stopping the cycle of all or nothing with sugar Self-inventory for vulnerability factors Exploring “problematic” foods again Building on quick wins How restriction impacts the brain’s response to sugar The importance of learning to be self-aware with the kindness Your inner dialogue and its impact on your success in reaching your goals The biggest lie of diet culture The truth about your body’s natural tendencies Building self-trust Repeat customers and the diet industry Being responsible consumers of nutrition information Resources: Marci Evans Blog on sugar   Learn more about Balance365 Life here Subscribe on Apple Podcasts, Spotify, Google Play, or Android so you never miss a new episode! Visit us on Facebook| Follow us on Instagram| Check us out on Pinterest Join our free Facebook group with over 40k women just like you! Did you enjoy the podcast? Leave us a review on Apple Podcasts or Google Play! It helps us get in front of new listeners so we can keep making great content. Transcript Annie: You feel completely out of control when it comes to candy and cookies, craving sweets even when you’re not hungry. Maybe you found yourself wondering if you’re addicted to sugar. Scour the internet for the term “sugar addiction” and you’re likely to come up with an overwhelming amount of information, much of which seems to contradict each other. Our culture has a pretty extreme view of sugar and unfortunately, the diet and fitness industry is full of pseudoscience and fear-mongering headlines claiming sugar is addictive as cocaine but what’s the truth? Is sugar really addicting? We invited internationally recognized dietitian Marci Evans on today’s podcast to discuss just that. Marci and her team help clinicians and clients alike develop smart, enduring strategies for overcoming eating disorders, disordered eating and the backlash of chronic dieting. Marci, in particular, has done extensive research on the tenants of food addiction after noting that the concept didn’t square with her clinical experience and yet she felt it captured how so many people feel in relationship to food. On today’s episode Marci, Lauren and I discuss what the past 5 years of research and experience have taught Marci about sugar addiction and steps you can take to feel more in control of your sweet tooth. Enjoy! Marci! Welcome to the show. Thank you so much for joining us. I’m so happy to have you. Marci: Oh, it is my absolute pleasure to be here, to come to chat with you ladies about a topic that is near and dear to my heart. It is just an absolute pleasure so thank you so much for inviting me to join you. Annie:  Yeah, we’ve been waiting for a while. I think we started emailing months ago and it just schedules just didn’t work out until now. Marci: Yeah, I know. You guys are very, very patient which I appreciate and I had to get through one more big talk before I could put anything else on my plate so I’m glad, I’m really glad to be here and hopefully the wait will be worth it by the time we wrap up this I know what will be a really interesting conversation. Annie:  Yeah, I’m sure it will be. Lauren’s here with us too, Lauren, how are you? Lauren: Hi! I’m good. Excited to be here. Annie: I was just going to say, I bet you’re super stoked- Lauren: Pumped. Annie: Because here we are discussing one of the most talked about topics in our Facebook community, which if you aren’t a member, it’s Healthy Habits Happy Moms on Facebook. We have almost 40,000 women in our private Facebook community and something that comes up a lot is “Is sugar addicting?” And this is a highly debated topic on the Internet and especially in the fitness and nutrition community and as Marci has noted in her blog post, which we will share a link of the show notes to her website, if you just do a google search for “Is sugar addicting?” or “sugar addiction” you’re likely to come up with a wide range of answers from “Yes, absolutely, it totally is addicting” to “No, that’s just a load of crap” it can be really confusing to the mainstream listener, reader, consumer and Marci, this is why we have you on because you’ve done a lot of extensive research on this topic. So how did you get interested in the topic of food addiction or sugar addiction? Marci: Well, I think you nailed it in a couple of different ways. The first is that many people have the experience of feeling really out of control of food and feeling really chaotic, so the term ‘food addiction’, which has gotten written about more and more just in popular media, feels like it’s very resonant for a lot of people and it’s sort of like “Oh gosh, food addiction. There’s something about that feels true for me.” And so it’s something that I have seen a lot of people come to me in my practice with, so it’s something that is definitely coming up in my work in a day to day way, just like you ladies are describing, seeing this in your Facebook group and so I think that that’s a piece of it and then the other piece of it you also alluded to is that there’s been more research on the topic of food addiction and you know, it’s definitely a double-edged sword that this research makes it into the mainstream media. It’s great that the research is being done, the problem is that the way that it often gets written about in the media is not totally accurate to the science and so you see a lot of compelling headlines that you know draw people in and you know get a lot of clicks and get a lot of post likes and are resonant to how people feel that it gets really pulled away from what the actual science says. So I became interested because I learned about it several years ago in a training that I went to but then it was just so relevant in my day-to-day work with my clients that I was like, “I can’t not look more into this. This is just like staring me in my face.” Annie: Yeah and I am, you’re so right because I do think when I’m thinking about all of the headlines and the information that I have read it is very kind of fear mongering, you know, or polarizing or it’s very extreme. We call that click bait, right?  Like, you, they’re just trying to get you to bite, right? Marci: Total clickbait. And then they have these pictures of the brain that look very, you know, very smart and you know, “Wow, look how the brain is lighting up” in these comparisons to, like, drug pathways and so it becomes very tantalizing info that people can get really pulled into for sure. Lauren:  And I think it’s become just “common knowledge” that sugar is addicting, like, if you ask just random people on the street “Have you heard sugar is addicting?” I’m willing to bet, you know, many, many of them will say “Yes.” Annie: Yeah, OK, so are we ready to just dive right in? Like, can we just, can we just go? Are we ready? Marci: We can absolutely go for it. Annie:  Alright, Marci, is sugar addiction a thing? Marci: So the state of the research tells us that sugar is not physiologically addicting. That’s the bottom line so looking at what happens in our bodies when you eat sugar and is there a chemical response that pulls you in to have it more and more and more and that you become sort of this slave to sugar and that the only way to kind of stop yourself is that you have to go cold turkey and that is 100 percent not borne out in the research. Annie: But people have to still keep listening to the rest of the show. Marci: People are going to be like “Who is this chick? Get her off. Yeah, done.” Annie: Like, “Oh I got what, I got the answer I was looking for, it’s not a thing” but you have you have some points of reference that I think are really important to follow this up. Like, to date there is no scientific evidence that sugar is addictive but that’s not exactly, like, there’s more to it than just that and I love that you say, you kind of touched on this earlier, that a person’s sense or feeling of being out of control around sugar or any food in general is not the same thing as having an addiction. Marci: Yes, that distinction to me is everything. That is like where I press pause and spend so much of my time, whether I’m teaching professionals or talking with individuals or nonprofessionals, is that there is the science part, right, that I love, that looks all about the brain wiring and what is happening in a person’s body in, as they’re eating sugar or not eating sugar, right, and we talked about that and kind of gave you the cold, hard truth, sugar is not addicting. However, the other piece of it that is equally important is a person’s experience and what happens inside of them when they eat sugar or when they deprive themselves of sugar, which is really kind of the key part that we’ll be, I think, spending quite a bit of time on, that creates feelings that are really relevant, right? So when people feel chaotic, when people feel out of control, when people feel completely preoccupied and obsessed, those things are very, very real. Those things are important. Those things we have to understand and it’s your guys’ job and it’s my job to help my clients through those experiences and they’re actually very common but those experiences aren’t rooted in an addiction but they are very, very, very important and the feeling can feel like an addiction. Lauren: Yeah, for sure. Annie: So, Marci, are you talking about when we hear in, you know, magazine articles or blog posts, when we hear the response that like this when people eat sugar that their brain lights up like they’re on some, a drug similar to like cocaine, is that what you’re talking about? Marci: Yeah. And I can speak to that if you want me to kind of tease that apart some, those headlines. Annie: Yeah, let’s just jump right into it. Let’s go. Marci: So, unfortunately that is a classic example of total misinterpretation of the scientific research and actually, what we see, when this was published, that sort of initial headline of look at these brain scans and look at this area of the pleasure centers of the brain and this is, you know, more powerful than when a person does cocaine, you know, these really, really, like you said, clickbait, fear mongering type of post was a misreading of the literature from a couple of cardiologists who wrote this post in response to the research, but when you look at the research and what the neurobiologists actually explain is that we have natural reward pathways in the brain. They are there. They are meant to be there. There’s no getting rid of them. They are actually good and helpful things in keeping us alive that we do certain things as humans and we get a reward so that we do them again. So we have natural rewards for things like eating, things like sex, things like holding a baby and feeling really good about it, listening to music, connecting with friends. We get these positive feelings and vibes and actually these neurotransmitters in our brain get produced so that we do those things again because from an evolutionary standpoint, these are the things that have kept us alive. These are the key things that have kept us thriving as a species. And so what we’ve learned is that when a person abuses a non-necessary substance, say, like cocaine, cocaine actually comes and hijacks those completely normal, healthy reward pathways that are supposed to be there. So this idea that “Oh my gosh, you see this lighting up when we eat sugar. This is evidence that you’re an addict. That is not at all what it is saying. You’re seeing normal responses in the brain. We can talk a little bit more about that in terms of what’s normal and what might be problematic in showing these brain images but it’s the drugs that come in and hijack the normal pathways that we get really, really concerned about but those pathways are there. They’re meant to be there. They don’t mean you’re sick. They don’t mean you’re flawed or that you have some big problem. Annie: Interesting. So it was just some misinterpretation of research that caused this whole, like, flood of “sugar is the equivalent to cocaine.” Marci: That’s exactly right. Lauren: And I think it’s, it can be comforting to someone too who feels so out of control around food or sugar to be like, “Oh well, that explains it. I’m addicted, right?” But I think we’ll see that that kind of takes your power away because you aren’t addicted and there are things that you can do to not feel so out of control around those foods. Marci: That’s exactly right and even to add on a layer of complexity is that the notion that I am addicted encourages people to abstain from those foods, right? Well, if I am an addict, the only way to manage this is to totally take these things out of my life and here is where this is probably the most important thing I have to offer to each of you who are listening right now is that that abstaining or we might call it restriction of those foods actually leads to changes in your brain that have a stronger pleasure response that gets lit up and actually encourages you and compels you to have those foods even more. So when the researchers looked at this phenomenon they used rodent models and what they did is they had these rodents and they took the sugar away and restricted them and put them on a diet and it was those rodents that had an amplified response in their brain to sugar and it was those rodents who demonstrated this same chaotic “addictive” behavior, binge-like behavior but when they had the rodents where they didn’t put them on a diet and they didn’t restrict them, they had completely, what we would say, just totally normal responses to sugar and none of the addictive-like behavior and so the problem with the addiction model is not only that yes, totally takes your power away but in addition, it’s going to create the exact scenario that you most fear and it’s going to create the behavior and the changes in your brain chemistry that cause you to feel more out of control and cause you to feel more and more like an addict. So it’s like this double bind, it’s like a double whammy. Annie: And Marci, does research support that for just any food, labeling any foods as bad or addicting or off limits or is this just sugar. Marci: Right now, the research is looking specifically at sugar because the researchers, what they’re trying to do is to get more and more specific and this is where that research on food is much more complicated than the research on say, alcohol or drug abuse because we as humans don’t eat singular substances like table sugar, right? For the most part, we eat things like ice cream and cupcakes or Doritos and so researchers have tried to get as specific as possible to understand is there a specific ingredient that folks are addicted to and this is again where the research right now really points to, you know, the flaws in the research is like, we don’t even have a specific ingredient that we can look at and point to and say that is the addictive substance. Annie: This is something that we talk about frequently in our community and our program Balance365 that this idea of the restriction leads to bingeing or more, it sets you up to be more likely to binge, because so often what we see in our community is that women want to stop the binge by going back to restriction. They’re like, “Oh, I ate too much sugar, got to get rid of all the sugar now!” Marci: Yeah, I have to fix it. Annie: Yeah, instead of stopping at the restriction, sort of resetting or reframing your perspective on sugar. Instead of just saying “I’m all out. I can’t have any.” Try to have it in moderation might reduce your likelihood of binge. Marci: Yes and I feel completely empathetic to anyone who identifies kind of with what you just described because I think that it’s human nature that when you feel like you’ve swung to one side of the pendulum and part of this, you see, I’m a neuro science geek, part of this is just how we’re wired to be as humans. We want to put things into boxes and we tend to be very black and white thinkers so that when we move to one extreme it is very, I think, natural and compelling to hold yourself to the other extreme as a way to find a counterbalance but what happens is that you just sort of envision a pendulum, for most people, they end up swinging between one extreme to the other and it’s not very natural for most people to say “Well, how do I respond to this chaos? I try to find a happy medium somewhere in the middle, right?”   If you just had a day or days or weeks of feeling out of control and you’re bingeing and you’re feeling awful. It is very natural to want to kind of pull over to that other side to detox, to restrict, to put up the food rules because when you’re feeling that way it feels awful and you don’t want to feel that way again and imagining dipping your toe into that middle ground can feel very, very foreign and very scary and for a lot of people, they’re like, “That just doesn’t even seem to make sense. You see, I can’t be trusted. I need to put up all the rules and all the walls and all the barriers.” Lauren: You know, it’s interesting that you say that that’s how humans are wired because we call ourselves, like, we work in the messy middle and it’s so hard to get people to kind of reframe and kind of get it and like, we were talking about before the podcast, it takes people you know a few months sometimes of following us to kind of like indoctrinate themselves in that messy middle. Marci: Totally. I love that you guys call it the messy middle because that’s usually exactly what it is. It doesn’t stay messy forever though. It does not stay messy forever but the process can be a bit messy. However, I do find that when I talk to my clients and I really, I’m sure you guys have seen this too, is that when you talk with them about their experience and their stories and what it’s been like for them over the years, that their lived experience is this sort of swinging from being on a diet to them feeling out of control and then needing another diet and then feeling out of control and so their lived experience really points to and supports what we see in the literature and in the research and why so many of us as clinicians are advocating for that messy middle because their lived experience and the research shows us that restrict-binge cycle is not their fault, it is not a failing, it’s not because they’re screwed up and doing it wrong. It’s because it’s a set up and so those skills for navigating that middle ground can feel really tough at first but that’s where the sweet spot is, like, that’s where you find food peace, like, that where you find sustainable patterns of living. Annie: That is what we share in our community often is that it’s, like, a practice and it’s a skill and it’s just a matter of practicing that new skill over and over and over until that becomes your new normal because it’s not, like, that, like you said that is not natural for me, it’s not natural for a lot of women. We’re so used to, like, being on the wagon or off the wagon, we’re in, we’re out, we’re perfect, we’re failing, we’re right, wrong, black, white, like, so to live in this like gray areas, like, “Oh my gosh, what are the rules? What am I doing? Like, there’s no boundaries, where are the boundaries?” Marci: Like, right, “Just give me the guidebook. Tell me exactly how to do it, I can follow it.” Annie: Yes, which in the in the fitness industry, that is so common, I mean, which I think was which is why our program is such a breath of fresh air, of course, I think that, but it’s, you know, we’re like trying to help you navigate that for yourself versus just telling you what to do so you can hopefully go on to create “boundaries and rules” that work for you and I mean, if that’s what you need, that we don’t have to impose our values or morals or rules on to them. Marci: Yeah, that’s awesome and I think that finding that middle space that is is something, I mean, it sounds like what you’re really describing is something that’s really internally guided rather than something that’s externally imposed and that can feel really, really scary but the amazing thing is is that as you go through the process of really kind of tuning in and really listening and really kind of taking a break from all of that external noise is that you can find patterns and habits and boundaries that are truly sustainable, you know, I wouldn’t say I have a rule of eating every you know 3 to 4 hours, it’s not like I have to follow this rule but I know that when I eat every 3 to 4 hours I feel much, much better and so that’s how I eat most of the time but it’s not a rule that’s been sort of handed down to me that you have to follow it and that’s kind of the difference. Annie: Absolutely. Lauren: Yeah. Annie: OK so to circle back then as it pertains to sugar and this sense of feeling out of control when it comes to sugar consumption, how do you break that cycle of, like, you’re either all in and you’re eating all the sugar or you’re not eating any sugar at all for 30 days or, you know, whatever it is, do you have some guidelines that you use with your clients or that you would recommend in general for how to stop that mindset, or reframe that mindset or stop that cycle? Marci: I do. I do and what I want to say before I dive and sort of offer some tips is to say this process is a process and we’ve already been talking about that, be really patient with yourself and I would also say if you can have in your mind the idea of approaching your experience with a lot of curiosity and just kind of wonder and, “Oh, isn’t that interesting?” in trying to find kind of that neutral detective voice that will help you learn along the way because it’s going to be bumpy, you know ,I love your messy middle, like, it’s going to be bumpy. It’s not as if I’m going to give you a formula and then you’re going to take the formula and you’re like “Boom, got it. No more problems with food, right?” But allow yourself to kind of take some of these ideas, try them on, experiment with them and use them to give you more data and more information but the number one place that I encourage people to start is to do a self-inventory and to take some time with the self inventory, like, do it over several days or a week or so. And ask yourself, what are the things that leave me vulnerable to “overdoing it with food right” so it could be a zillion things, like sky’s the limit, so you could think about “Well, it’s maybe related to my food environment or maybe related to how stressed out I am or my mood or how much my kids are bugging me or how much, you know, my job is completely overwhelming me or the time of day or the amount of food that’s available to me or how well I’ve nourished myself that day, how over-hungry, you know, how much maybe I’ve been following a diet that actually doesn’t meet my nutritional needs. I’m constantly undercutting in an attempt to lose weight but then go over-hungry and that’s when I find myself really having a hard time with food.” So trying to be as extensive as you possibly can in creating this inventory of what I call your vulnerability factors and then you can start to have a little bit more of a nuanced conversation in your own mind around “I have a hard time with sugar when, you know, I’m really, really tired, I’m sleep deprived, I haven’t eaten enough and I’ve got high levels of stress,” right? So you’re starting to really get to know yourself rather than saying “Oh, I just don’t have any will power” or “I’m an addict therefore I have to get rid of this,” you’re really inventorying to get a sense of “Oh these are the things that leave me really, really vulnerable to having a tough time” and the other thing that I would add in is, that’s really important and can take a little bit of time to get to know, is “What are my thoughts and beliefs that I tell myself about my relationship to food in my relationship to sugar, specifically? What is the dialogue in my brain? What thoughts do I tell myself? What do I believe and where did those beliefs come from? Are those beliefs that I learned when I was little from my own mom? Are those beliefs that I was taught from going on a zillion diets? Are those beliefs, you know, that I learned from, you know, my girlfriend down the street?” So really be very, very critical and I would say, like, literally journal this out, try to do it like on a piece of paper or if you have an online journal and really get out of your own head “What do I tell myself and what do I believe about sugar and where did those beliefs come from?” So starting with those two inventories is a really, really important place to begin. Annie: I really, really like both of those suggestions. “What you talked about, that vulnerability Journal is kind of similar, in our program we call it, like, triggers, you know, like, what are you doing, where are you at, what are you feeling, what are you thinking, what did you just do, who are you with?” Because all of those things can really impact our behavior and especially when it comes to food and fitness and I know you know we’re just coming off of Halloween season so I know a lot of people have been having candy in the house, you know, it could just be as. I mean not as simple as. but that could be an element into how much sugar you’re consuming, like, is it just a matter of convenience, like, it’s staring you in the face all day, right? Marci: Totally. Exactly, exactly, you have huge amounts of it surrounding you and I love that you guys use the language of skill building because that is the exact language that I also use with my clients, where I say “Learning to eat in a peaceful balanced way is like building a skill” and the cool thing about viewing it as a skill is that a skill is something that can be developed but if you are someone, and you are very good company if you are, who has spent a lot of your life in a dieting mindset, it’s going to take some time to rebuild that skill of balanced, peaceful, non-chaotic eating and so I am really a proponent of saying “Let’s take just little baby steps here.” Now, I do know that there are some practitioners and other people who said, you know, the best thing I did was just surround myself with tons of sugar and tell myself I have total permission to eat this food and to really listen to my body and that it was rough in the beginning but then I really got to a place where I really believed it wasn’t going to go anywhere and then I stopped bingeing on it, however if that works for you, go for it, don’t let me stand in your way. My experience is that for most people what ends up happening is they end up just feeling really out of control for a stretch of time and it feels like more proof, “See, I can’t be trusted, you see, I was out of control” and so it just feels like more evidence kind of building up and so that tends to not be the approach I go with most of my clients, that with most of my clients we’re like slow and steady, we are, you know, I always use the bike analogy. We’re starting off on a balance bike and we’ve got, you know, a bike that’s maybe a little bit bigger, a little bit, you know, a little bit more like an adult bike and then we move into something that’s more advanced and then we’re really going on the unicycle but we don’t just hop on the unicycle right in the beginning, right? We’re going to start we’re just taking these little baby steps and the point is to begin to have more regular access to the foods that you have trouble with but to do it within the framework of really honoring the things that make you particularly vulnerable. So one of your biggest triggers or one of your biggest vulnerabilities is, maybe, what do you guys see actually? What do you notice? I should ask you, in your Facebook group and you know your audience, what would you say is one of their biggest vulnerabilities? Lauren: I would say skipping meals or not eating enough throughout the day. A lot of people find themselves then bingeing or overeating on sugar and snacks at night or in the evenings after they put their kids to bed. Marci: Totally, so that’s perfect. So I would say if you have a day where maybe you haven’t adequately nourished yourself when you skip some meals and it’s evening time, I would say that’s not going to be the most helpful time for you to practice eating something like Halloween candy in a way that’s going to feel not totally chaotic, right? It’s like, well, that’s not really a fair experiment because we knew that was probably a set up from the beginning and so I kind of take that inventory and say “Let’s try to eliminate as many of those vulnerabilities as possible. And start having little exposures where you’re giving yourself permission to have these foods, low vulnerability, low trigger, challenging those old thoughts and beliefs and developing those coping skills to help you manage the craziness that is life and all the stress that life brings and then it’s repeating those things over and over again. So I had a client, I mean, I’ve done this was so many clients, she had a lot of trouble, one of her hardest foods was Nutella and she’s like “Marci, I’m telling you, every single time I bring Nutella into my house it’s gone in a couple days, like, I just can’t handle this Nutella.” And so the way we ended up going about it was we ended up deciding to integrate it at the very start of her day and so when she would come see me, we did this so slow, like we literally did this over months and I would keep it in my office and I know, some of you might be thinking “Why don’t I have my own dietician” I bet you could be really, really creative. She would come to my office, she would bring a balanced meal and she would do some Nutella with the rest of her meal and then we would note, “What are the thoughts that you are having? What kind of tools and skills can you use to kind of help you through your day because you have a busy day, what’s your food plan, like, making sure you have enough food to get you through your day.” And we sort of charted through all her vulnerabilities and then we did that again and again and then we sort of upped the ante where she took some of the Nutella and she repeated that on her own and so then we just stepped it, stepped it up and as she was developing more skillfulness and more ability, then, I mean, again it wasn’t for a couple months, then she brought the Nutella into her home but we started it with just the tiniest of baby steps. Lauren: I love that. Annie: This is a, yeah, I do too and this just feels like, my background is fitness, but it’s like a lot of times people just need a win, you know, and they kind of just build their confidence slowly and slowly and slowly and over time it’s like, you know, that quote “Little by little you travel far.” It helps to build that self efficacy so that they can believe like “Oh my gosh, maybe I can do this,” but to go from 0 to 100 can be really overwhelming like, “Oh my gosh, no I can’t ever have Nutella in my home and not eat the whole jar” like that’s just, that doesn’t seem even doable but I bet you know now she’s like “Oh yeah, maybe I can.” Marci: Exactly. Annie: or “I am.” Marci: Yeah, “I am.” Yeah it’s really cool because I no longer work with this client because she’s doing so well and she doesn’t need me anymore and that’s always my goal and absolutely, she has all of the things in her house but it took us really breaking it down and it’s exactly like you said, it was her having a little win to be like “Oh, maybe it’s not the sugar, maybe it’s all of the beliefs that I have about sugar and the ways I’ve approached it before and their reaction to all of the deprivation.” Like, I just cannot overstate the implication of having dieted and having that restriction mindset really sets us up to go to the other side of things. Like, it’s really interesting when you look at the brain scan literature when they look at folks who have a history of dieting and restriction and they show them images of what scientists call like, you know, palatable foods or we could say, like, high sugar foods or high fat foods, we might think it was “naughty foods” or “bad foods” is that their brain regions of pleasure light up even higher when you compare to people who don’t sort of hit that profile of long dieting history and so it takes time that gradual permission for that hyper response to get dialled down but it’s the only way for it to dial down. So if you keep going back to dieting and keep going back to restriction it’s going to keep that elevated response, but if you can end this gradual way, practice it and your body and your brain get used to “Oh, this food isn’t going anywhere.I have this food in my life. It’s not as if one time a year I get to eat X, Y and Z. Then that hyper response calms down and we can see kind of like the charge around food sort of settles down and it becomes more neutral. Annie: And that just, I mean, that to me sounds like freedom and such peace to be able to live, you know, or just be wherever you are and know that like you don’t have to hold yourself back or you’re just going to be a maniac on, you know, a pizza buffet or an ice cream sundae, that you can just coexist with the foods you love and enjoy them in moderation. Lauren: Yeah, another thing I really loved about your example is about going through your vulnerabilities, like that client within the Nutella probably had to build some other habits to kind of reduce those vulnerabilities, is that right? Marci: Right, you’re spot on, totally. Yes, she had to kind of identify what other tools that I need in my tool box that help me to manage when I’m feeling really overwhelmed with work and when I’m feeling overtaxed or when I have my inner critic and my inner critic is really, really loud so we had to do a ton of work on helping her to notice how is she speaking to herself and what are the consequences and what’s the likeliest outcome when you continue to speak to yourself in that mean, critical way and I would say that’s a huge, huge cornerstone of the piece, huge cornerstone of the work that I do with my clients is cultivating a couple of skills and so these are some of the broad, brushstrokes skills that I will mention for you and mention for your listeners is developing the ability to be self aware but with kindness. As well as this skill of being able to be compassionate with yourself and you guys probably see this all the time, people have a really hard time being compassionate with themselves because they feel like if I’m compassionate I’m just myself slack, right, and I’m never going to make that forward progress. It is the opposite, the more critical and nasty you are to yourself the less likely you are to achieve your goals and make positive change. If you can talk to yourself like you would to your child or talk to yourself like you would to someone you love and care about, your best friend, those are the same things that help you to remain neutral and curious and that enhances your ability to make sustainable changes and so I spend so much time helping my clients notice and shift the way that they interact and talk with themselves and really working on the inner dialogue. Annie: We have a saying in our community that gets dropped frequently and I absolutely love it, it’s “we take great care of things we love and your body is no exception” but I think you are so right, Marci, that when women think about being kind to themselves and speaking nicely to themselves or coming from a place of love, they’re worried that they’re going to get complacent or that they’re going to just, like, I won’t have a desire to go workout if I’m, like, too nice to myself or I won’t have a desire to eat vegetables if I don’t beat myself up and shame myself into eating this salad with no dressing or whatever it is. And that’s just not been our experience. Marci: Yeah it’s not, it doesn’t surprise me that that’s not been your experience because it’s fundamentally untrue. So one of the things the biggest lies of diet culture is that our nature as human beings is to lay on a couch and do nothing but eat ice cream and that we are constantly having to fight against that nature. That is not true, actually our bodies and systems create vibrancy, they crave balance, they crave things that allow us to feel well and we know that if we are polarized to any extreme we aren’t going to feel well. And so our bodies are constantly trying to move us towards homeostasis so we can flip that narrative, we have to live that narrative from “If left to my own devices, I’m going to be a total just slob on the couch” and say “You know what, actually, left to my own devices, I want to feel really good and I know that if what allows me to feel really good is to be in a pretty balanced space.” If you can imagine eating only gummy bears and bagels for the rest your life, you can imagine that probably wouldn’t feel well, right? If you can imagine eating only spinach and chicken breast for the rest your life, like, that also doesn’t sound so great and so being able to trust that our inner nature and our core souls, actually creates movement, creates balance, creates health, creates vibrancy, all of those things, that you can begin to relax a little bit and be like “I don’t have to ride myself so hard, you know, I trust that my inner core craves healthy themes but all the dieting that we do that stamps out that inner flame and when we move away from diets we find that we have it naturally and intuitively inside of us.” Annie: Absolutely. Lauren shares with our community often, like, people that say that, you know, they say what you just said, like “If I listen to my body, I would just eat ice cream all day, every day” and Lauren is like “Have you tried that? Like, have you actually tried that? Like I think you think you would feel good but I don’t think you would feel good if you just did that all day every day” and people are like “Actually, you’re probably right, like, no, that wouldn’t leave me feeling good” and that this idea that, you know, like you said, if left to my own devices, like, I might actually take good care of myself, especially if I think about it in terms of how I take care of my children, how I take care of my spouse or my partner or what I would say to a girlfriend if she missed a workout or if she overate, you know, some ice cream. I wouldn’t beat her up. I wouldn’t berate her. I wouldn’t say “You’re lazy, like, get your act together.” I would be like “Hey, that’s OK. Like, now we know too much ice cream leaves us feeling yucky, like, let’s not do it again.” Marci: Exactly and if you just can notice that what your body is communicating to you and also trust, and this is where so many people skip a step, because we’re not taught to do this in our culture is that our heads override with a rule, right, too much ice cream and our head says “Tomorrow: rule, no ice cream” but if you can say “OK, I’m going to take a pause from my busy brain and say “If I were to let my body choose what the next step might be,” you will notice that your body has all this wisdom to re-regulate you but that head jumps in way too soon and creates this big rule because you’re in a place where you’re feeling awful and you’re feeling really scared and you’re feeling really anxious, right and so but it’s that practice of noticing, “OK, my head is so loud but if I were to just ask, what would my body say?” and I did actually a hilarious experiment like the ice cream one you guys just gave. I had a client, this is one of my favorite stories, we’re working on moving away from this dieting mindset and she said “Marci, my hardest food is gummy bears.” She’s like, “I’m obsessive with gummy bears, I love gummy bears. So you’re telling me (because we were working on unconditional permission, one of the intuitive eating principles, unconditional permission to eat whatever food she wanted)” she said, “Now you’re telling me that I am allowed to have gummy bears for lunch” and I said “Totally, if what you want is just gummy bears for lunch you can totally have gummy bears but I want you to make sure of 2 things, one: you get yourself enough gummy bear so you’ve gotten enough to eat for lunch and I also am going to ask that you have to pay attention to the taste of the gummy bears and how they feel in your body and how you feel afterwards.” She’s like “OK, I’m totally going to do it.” And I think she was, like, looking to like prove me wrong, to be like “I’m just out of control with gummy bears, I can’t be trusted. You don’t know what you’re talking about.” And she came back and I said “Did you do the gummy bears for lunch?” and she’s like “I totally did” and I said “How did it go? What did you notice? What did you learn?” and she said, “Well, I thought that I was just going to be super excited and super happy to eat gummy bears for lunch, like I really felt like I was getting away with something but what I learned is that if I only eat gummy bears at lunch I actually feel sick and I kind of feel shaky” and so I kind of responded, you know, in a very neutral way to say “You know, that’s really interesting.” I said, “So if you were to redo that to where you wanted to have gummy bears at lunch time, you wanted to pair it with other things so that you could feel energized and that you could feel, you know, not distracted at work and  you’re not shaky and your stomach doesn’t feel upset, what would you choose?” and she listed out what she had in mind with gummy bears sort of on the side and it was this, like, completely, you know, nutritious, totally balanced meal and I was like “OK, you know, maybe you want to try that” and it was about her experimentation and learning “Oh, I don’t have to have this hard core rule, you know, like, “Don’t eat gummy bears” it was like, “Oh, it turns out that if I really listen I don’t want to just eat gummy bears for lunch, like, I feel kind of awful when I do that.” Annie: And it was inside of her, like, that she knew that, it was almost innate, like this is, “I did this, I didn’t like how I felt, I’m going to try this” and what an amazing moment. That’s an awesome story. Marci: And it was really cool because, like, you know, we were working on “you have to truly give yourself permission, that has to be there, it can’t be conditional, you have to really say ‘I am allowed to have these foods’ and I’m going to practice and I’m going to notice” and she did that and what she noticed was “I’m allowed to have gummy bears for lunch but do I actually want to” and when you’re not rebelling against something and you have permission, then you have the autonomy to actually make a choice. Annie: Yeah, I’ve shared this analogy so many times but when I was in 8th grade of my parents made this boy off limits for dating and his name was Alex and all I wanted to do, I wasn’t even really interested in Alex I don’t think, but when they said I couldn’t date him I was like, “I need to date Alex.” Marci: You were, like, on an Alex binge. Annie: I was like, “Well, now, watch me, now I’m going to make this happen” but yeah, but it’s kind of the same principle kind of applies to food when you make all foods permissible then a lot of them lose their appeal. Like do I really even want this now that I can have it? Marci: Yeah. Yeah and sometimes our head really wants something, especially when we’ve been really conditioned to say “Ooh, that’s off limits, you can’t have that” So sometimes our head will be like “Ooh, I really want this thing” and then we say “Well, OK, I can have it. I can have gummy bears for lunch but what will that experience actually be like and is that what I want to choose for myself right now?” Lauren: Yeah, I think that dieting, like the biggest flaw even over, you know, reducing your caloric intake in half, basically, which is a big flaw, is just that you can’t trust your body, like it teaches you you cannot, you cannot be trusted. I think that’s like the root of everything, right? Marci: Oh my gosh, I couldn’t agree more. I feel like so much of the cleanup that I’m doing with my clients in terms of the diet culture is beginning to help my clients see this notion that you can’t be trusted, that idea was planted in your brain by the dieting industry and then they put you on a diet that would guarantee an outcome to where you feel out of control, that then looks like evidence that you can’t be trusted and then they give you another diet to follow. It is a complete construct of the dieting industry. It is not rooted in reality and our jobs are helping to move you away from that dieting mindset and towards a place of that inner self trust. Annie: Amen. That’s, and you already said this, Marci, but that’s, we joke that our business model might not be the most sustainable because we want to put the diet industry out of business and give women all the tools they need, give back women all the tools that they already had and so they aren’t forever reliant on us, like you said, like hopefully your clients learn to eat well and that supports their lifestyle and their goals and they don’t forever need you, right? But that’s not the diet industry’s motive. Marci: Oh no and it’s not how it sustains itself, right? I mean, if the average listener was to list out the number of diets that they’ve been on it would be evidence of “Oh yeah, this is based on repeat customers” but  if I do my job really well, right, I’m going to work with people for a period of time and then my hope is that they aren’t going to return and maybe maybe they do, maybe life circumstances hit them up, you know, things happen but my goal is for my clients not have to be repeat customers. That’s the intention, right, is to get my clients to a place where there is so much internal self-trust built that they know how to navigate how to take care of themselves which is very, very different business model. Annie: Absolutely. Lauren: Yeah and I was just going to mention that there was actually an interview done with a Weight Watchers C.E.O. or former C.E.O. that said part of their business model that they would use to get investors is that they had so much repeat business, so many repeat clients and it’s like well, that kind of proves that your diet doesn’t work, you know? Marci: Exactly and it’s not intended to work. Lauren: Right. Marci: Right. Annie:  OK, Marci, I want to thank you so much for your time. This was a wonderful, wonderful interview with you and I think it’s going to provide a lot of valuable and much-needed information to our community about sugar, is it addicting, is it not and as we clearly stated, it’s not, but that feeling of feeling out of control around sugar is something that a lot of women are familiar with and I think you gave some really, really great suggestions on how to begin regaining a sense of safeness or control around those foods. Marci: I sure hope so. It’s been so great to be here and I know you mentioned that you guys are going to link to a blog post that I wrote that really kind of delves into some of the science and some of the trouble with the food addiction model and that might be interesting for some of your readers to see and if it’s, or listeners, I should say, the readers of this blog post and also for folks who might be interested to dive into some of the research, there might be some science-minded folks I can also provide some citations to connect to what the state of the science is and you know, we kind of hit on this in the beginning and I’m sure you guys talk about this, there is so many problems with food and nutrition related research between how it’s conducted, how it’s disseminated and how it is portrayed in the media so the last thing that I would offer up to anyone who is listening is to take food headlines very, very lightly and if they are extreme, if they are black and white, if they are really, you know, kind of imposing a really extreme rule to take that very, very, very lightly, that there’s a lot of problems with reading and interpreting and sharing nutrition-related research in media and that is another way in which you can feel so pulled and sort of feel more out of control and like you don’t know where to go and you don’t know who to trust and you get pulled into another diet and that is why I’m just loving the messaging that you ladies are putting out into the world that is about cultivating greater self-trust because there’s going to be another headline out there and there’s going to be another podcast that I’m going to have to do about that headline. That is going to be my career probably until the end of time. So, do not take every headline so seriously and to really keep doing that work of developing that sense of self trust because it’s in there, it’s inside of you if you believe in it and I hope that this has been not only interesting but also given some concrete steps and tools to help you on your path in your journey in developing healthy relationship to food and body and yourself. Annie: I am certain that it has been and I’m so excited for our listeners to experience it too. Marci: Awesome, thanks. Annie: Thank you, Marci. Lauren: Thank you, Marci. Marci: Bye. Lauren: Bye.   The post Is Sugar Addictive? appeared first on Balance365.