102 How to Shift Mindsets to Motivate Healthy Behaviors

Welcome to the Mind Body Space Podcast, where you can boost your resilience just by listening. You'll get research-backed tools to stress less, be happier and healthier while you work toward your highest potential. Hi, I'm Dr. Juna Bobby MD. I'm a board-certified physician and a mom of two amazing kids. Over 10 years ago, I left one of the most prestigious medical practices in New York City to specialize in mind-body medicine. Since then, I've had the privilege of teaching my Science of Resilience program to students who are curious and motivated to learn how to thrive in an increasingly complex world. I created this podcast to reach all the people who could benefit from the conversations that I have with experts in performance psychology, cognitive neuroscience, and lifestyle medicine. I also share tips on some of my favorite topics like how how to train our brains to focus better, and how to get organized for extreme productivity. In my special RxChill Pill episodes, I guide you through relaxation response exercises using my extra calm voice to counteract your daily stress. I do all this because I love sharing science-backed self-help tools that changed my life and so many others. I do know that there's way too much information out there, so I work hard to curate and share trustworthy sources for free. By subscribing, rating, and sharing this podcast, you are supporting this effort, and I am so grateful to you. Hello. Today, I'm so excited to be here with Dr. Beth Frates. We're going to be talking about her new book, Paving the Path to Wellness. It's a guide to thriving with a healthy body, peaceful mind, and a joyful heart. Dr. Frates co-wrote this book with Drs. Michelle Tollefson and Amy Comender. Dr. Fredes is the new president-elect of the American College of Lifestyle Medicine, and she's an award-winning teacher at the Harvard Medical School.

Hello, Beth. How are you?

Great, Juna Bobby MD.

Thank you so much for joining me today.

Thank you.

And we were having this amazing conversation before I hit record, and this is actually why I started this podcast, because I would have conversations with people and I was like, this should be shared. And I was always regretful that we couldn't record it and share it with people. And that's why I started the podcast.

Wonderful.

So whenever you and I meet, I should always have the record button on because we just talked about something so amazing. And it was Beth giving me real mentorship tips and advice. And she was, you know, basically telling me how great I am.

Yeah. So now may I share some of what I was thinking and share? Okay.

Sure. Yes, absolutely. We were talking about stress because I was in the stress response because I couldn't remember something in the last podcast.

Exactly right. And I was sharing that you have so many gifts and talents. And I said that I was joyful that you're doing this podcast because I think it's brilliant, compassionate, creative people like you. When you do a podcast, people listen for the information and they also listen to hear you and to hear your responses. And to think about your questions that you have for your guests and for yourself. And last podcast, we talked about different mnemonics, and I was describing the paving, the path to wellness paving steps mnemonic. And you, you have created a beautiful mnemonic, RELAX, and we were going through it. And like most people, there was a period where for a moment you, you couldn't remember one of the words. So common, so common. It happens to absolutely everyone. Yeah, but what I was admiring was that you were continuing to record and you were saying, "Now wait, I'm having a senior moment here," and you were laughing and you were being so authentic with the whole process that I was thinking, oh, the listeners are going to say, "Oh, that's me. Oh, it happens to Juna too. I can't believe it." And Juna is just relaxing through it. You didn't stress about it. You were confident that you could figure it out because I even gave you an out. I said, "Well, let's skip that and let's go on to the next one." You said, "No, I've got this. No, I need to get this." And then you somehow remembered the one you couldn't pull up from your hippocampus. And you did it with such ease and grace. And this is part of, I believe, the beauty of Juna, which is your authenticity, which is—

Oh, that's so sweet.

Every day and every time I see you, you are full of curiosity, you are full of compassion and a real desire to connect, a real desire to learn in the situation. You and I have been in multiple different situations together now, in this podcast, in a CME, on a call with a high school trying to figure out how we can implement lifestyle medicine into a curriculum for middle schoolers. I mean, I've seen you in various different scenarios and you bring the same person forward, Juna, this really authentic, loving, wonderful human being. So I'm delighted to be with you.

Oh my gosh, Beth, you're so awesome. And for folks, I did not pay her to say these things. No, Beth, you are truly one of my mentors. This is why, because you see a side of me and you see, uh, things that I might be capable of that sometimes I don't feel capable of. So everybody should get someone like Beth to talk to them on a regular basis, somebody who believes in you, somebody who, uh, sees the good sides of you and your potential.

Exactly, exactly. I, I see you as a major leader, and I know that you are and that you will continue to share your wisdom, your experience, your light with, with the world in, in various ways.

Oh, thank you. Well, just like you, I'm so passionate about this topic. And I just want to say a few words about you. You are an amazing coach. Everybody should be coached by Dr. Beth Frates. So because of exactly what I said, the, the way that you are able to see someone's good side and someone's potential, I think that was one of the reasons why I could muddle through trying to remember that mnemonic because I know you and I know that you're so patient and you're so such a beautiful person. Sometimes I have been in situations where I forget my own name because I'm so stressed out. So let's talk about that stress component. When we were talking about paving the path to wellness and the steps to paving, which was in the last podcast, I talked about being stressed out and going back to your old self, of going back to a mindset of somebody that maybe you thought you were before. You're not athletic, you're not somebody who eats clean or sleeps well or handles stress well. So these are all identifiers that we— stories that we tell ourselves about our mindset. We can have that. And even though I've gone through so many decades of loosening that up for myself, I still, when I get very stressed, will go back to that. Like, I will grab the bag of potato chips and like sit around and lie down and not move for hours. That will happen to me. And this is somebody, I can go back, and you were talking on the last episode about going back to childhood joyful situations where I was moving my body. I was even a second level kung fu student. In my late 30s, I started ballet. I'd never done ballet before. I showed up to a ballet class.

I did it for years.

I was good at the barre, not so great at the center. And after that, I got my yoga certificate with Dharma Mitra in New York City. So all of that is part of me, but it's still hard to go back. Do you have any tips on when somebody's stressed out? And I think, you know, I even read a paper that was written by you to my class last week about how when people are stressed out, they are less likely to exercise, they're less likely to meditate, all of the things that you need when you're stressed.

Yes, it's critical that we really find ways, and it's very individual, find ways to reduce stress. Now there's two parts to this, reduce stress in the moment. So a stressful thing happens and how do we reduce stress in the moment and then have consistent stress reduction techniques that we can do when things are good. But we know that they're helping us. They're helping our body, our physiology, so that when we are stressed later, we handle it better, like exercise, right? We know that when we exercise, we're putting ourselves in a little stressor and we're going into sympathetic response and our body's used to going into it. And then we come out when we stop and we have our endorphins and we have our dopamine and we have our serotonin flooding our brains and making us feel good. And we understand that we can feel good after a stressor and then it becomes less of an anxiety producer when we have that stress response. So let's do in the moment. In the moment is so important because when someone says something to you or you receive an email and it's an amygdala hijacking from someone, meaning they are, in a threat situation and they're responding to you in an email, really with no prefrontal cortex. Prefrontal cortex, the CEO of the brain, the planner, the, the one that is rational. They're not using the prefrontal cortex. They're doing the limbic system response, the amygdala response, the— and, and that is just all emotional and there's no rationalization available to them, so they just flare and they send some email to you and you, normal response is to get a stress response and to flare back and to respond and to what we call protect, protect yourself, protect whatever it is they were threatening, your reputation, your actions, your job, your motherhood, the way you are parenting, who knows what they sent, but you wanna also protect. Instead, the best thing to do is realize stressor and then use the pause before the response. So instead of running right back at that email and that keyboard, take that timeout, have a pause, maybe take a walk. We know that a 5 to 10 minute walk can reduce our levels of stress, our state state of anxiety, not trait, but state of anxiety. Or maybe you're someone that responds to music. So turning the music on and dancing around the room or calling a friend or jumping rope, whatever it is for you that will reduce your stress levels. Then when you come back to the situation, you're more creative, you're more open-minded, And if you think to yourself, what can I do to reach higher ground here for all of us, for the person who attacked you with the amygdala flare, for yourself, for your team, for your department, your work environment, or maybe your family, if it's a family issue, what can you do to help reach higher ground that gives you that perspective? But it's hard to get that perspective right in the moment. So taking the time out, and honestly, as you well know, having trained with Benson-Henrys Institute, as I have here at Harvard, deep breathing is one of the most consistent tools, reliable, easy, just a deep breath in and out, a long exhalation, turn on that parasympathetic response, get out of the sympathetic drive. So practicing simple things like deep breath, they're simple, but they're profound.

But neurologically, you're actually distracting yourself from that trigger that sends you into the stress response and distracting your brain into integrating the parts of your brain that are sensory motor cortex. So that's like on the outer part of your brain, your parietal lobes. And so you're kind of pulling yourself out of that bottom-up stress response, like almost a distraction, right?

Out of that amygdala. Exactly. Out of that amygdala. And if you, if you can, So when you're deep breathing, well, what am I feeling? And you really think about your breath coming in, going out. Then you can think about your feet on the ground. You're doing exactly what you said. You're bringing in your sensory cortex, which is not the limbic system. So when we're stuck in our amygdala, stuck in our limbic system, we want to get out of it like you just beautifully described.

Let's go back to that moment, even split second, right? Because we turn on that stress response in 1/100th of a heartbeat. They say. So especially if it's a visual response, if you're reacting to something visually, so it's so fast you can't even catch it. So how do you in that microsecond tell yourself, no, you really don't want to attack back, right? Because you might be like, yes, I do, I need to, right?

And a lot of people do, and they will attack back. And we've—

yeah. And I think this— I think that second part you were going to talk about about the daily practice is where that comes in, because you can't expect yourself to stop this evolutionary response of protecting yourself if you haven't worked on it and told your brain a different way to act, right, in the times when you don't have that stressor. So can you go into that more daily practice and how that could help us have that pause?

Right, exactly. Great point. So if we practice meditation, and there's a lot of different definitions of meditation, taking, taking time to be quiet, peaceful, focus on your breath. Let the to-do list go. It may come in, but you just put it aside and get back to your breath or your mantra. And you can do this 5 minutes, 10 minutes, hopefully 20 minutes in the day, but even 5 minutes in the day, some is better than none. What research does show, as you know, when you look at MRI scans of meditators versus non-meditators, you actually see a difference in their brain. So their prefrontal cortex, There's more material. There's more neurons. You have more to your pre— more volume to your prefrontal cortex, which is the CEO of the brain, which is the thinker, the planner, the organizer, the rational, how do I manage this? So meditating alone will help you do this, will help you build capacity in your prefrontal cortex. So that's one of the major changes that happens. It also helps you to regulate your heart rate, to help you stay in a calmer phase where you don't increase your blood pressure and heart rate. So when we practice these, these different methodologies of relaxation— could be the relaxation response, meditation, mindfulness-based stress reduction— there are many different techniques that put us into a place of peace, quiet, thinking about sensations of breath or feet on the ground. So there's walking meditation when you're just thinking about how your feet are hitting the ground, how your muscles feel as you pull one leg up and place it in front of the other. There's different ways to get us into that. But when we do do this regularly and when we practice self-awareness, when we take the time to think, who am I? I took this CME, it was a yoga, the Science and Art of Yoga CME last.

And CME is continuing medical education, so that means like you actually got credit for your medical degree, which is something you have to do every year.

And I was very interested in the science of, of yoga and the art of yoga. And one thing I took away from that course, which is an important self-awareness, self-reflection exercise, is thinking about who am I? Being able to answer the question, who am I? It's like your own personal mission statement. So, and who am I in times of stress? Who am I in times of quiet and peace and happiness and success and thriving? Who am I when the going is really tough, when there our arguments, when there's disagreement, when there's struggle, who am I? Hopefully we're consistently the same person, but if we don't actually sit and take the time to identify and define for ourselves, mm-hmm, who am I, then we're not sure who to bring to the table when we get that stressor. If you thought it through— I spent time on this, it was an 8-week CME We met for 3 hours once a week talking about these types of issues and yoga itself and breathing. And it took me time to think about— I believe that I am a compassionate person who wants to help make the world a better place, day by day, person by person interaction. Interaction moment by moment using the education that I have been fortunate to have through medical school and training and lifestyle medicine and coaching and mind-body medicine, using everything that I've been given and everything my family has brought and taught. A lot of this is book learning and some of it is, is heritage and family and tradition and bring all that to the table so that I can be a healer and a helper to anyone, someone in the grocery store, a student at the medical school, whoever I may interact with at the time. That's who I want to be. That's who I believe I'm meant to be. That's what I strive to be. So when I know that and something happens that, that is difficult, I say, I, you in that millisecond, if I have already worked through who am I— I'm someone that's going to lead us to higher ground regardless of the tension in the room. I'm going to try to get us to higher ground. Then I'm ready for that challenge in that second, in that moment when the challenge hits me. I've already done the work leading up to that. So I've been exercising. My parasympathetic response can come in and I won't allow my sympathetic drive to take away my peace by increasing my heart rate and blood pressure. And then of course, the amygdala flare and I'm just in threat mode. So instead, I try to think, okay, I identify there's a threat. This isn't going well. Let's bring myself— who am I? Let's bring Beth to the table. Show up calm and try to do what I know I'm meant to do. So it takes— it—

I love it, I love it. But, but like you said, it took you the 3 hours of 8 weeks. That's 24 hours of multiple different kinds of meditation. And some of that is reflection. Meditation is reflection, thinking about yourself and connecting to your core values. I always talk to my students about, do you ever think about your core values? What— and do you think about it every day? Because even after— I'm sure you know, after that 8-week course, you still have to remind yourself every time things come up. And it's like, it's almost like a habit we should have, right? Think about what our core values are, you know, because like you said, most of the time core values don't change that much, you know, even though our mindsets around things can change, even though a lot of circumstances change even— we can even change our personality. But a lot of times, core values, deep core values, like you're saying, that sense of purpose doesn't change. And that is so important in these moments where you flare up. And also, you need to remind yourself, you need to practice it and remind yourself about— of that before these things happen.

Absolutely, exactly. And perhaps next time we'll, we'll focus in a little bit on the coach approach and how you can coach yourself, how to coach yourself. Yeah, into addressing stressors in the best way possible. Maybe we can talk about that.

I love it. Yeah, because I think really it comes down to stress, because you, like you said, you can learn all these behaviors, you can learn all the most healthiest things you should be doing and must be doing, and stress comes in and everything's out the window, right?

Right.

And that's okay for short periods of time. We're looking for a high average of healthy behaviors. And, you know, we're not looking for perfection 100% of the time.

No, it's not possible, right? It's not possible. Yeah, yeah. I was gonna say it's progress, not perfection, right? We're looking for progress. We're always looking to learn and grow, no matter what age or stage we are in life. How do I learn from this? How do I grow? How can I help others learn and grow? It's about growing, really, and developing. Each day, right? No matter how old we are, we're always able to learn and grow.

That's the whole point of a well-lived life, right? To be able to grow from something. I think our brains love to learn, basically.

Exactly.

It keeps it alive.

Exactly.

Thank you so much, Beth. I love talking to you as usual.

Thank you so much, Juna Bobby MD.

That was Dr. Beth Frates, president-elect of the American College of Lifestyle Medicine. You can find out more about her at bethfratesmd.com. That link is also in the show notes at mindbodyspace.com/podcast. On her website, you can find out more about her coaching practice, and you'll also be able to find her books, Paving the Path to Wellness Workbook, The Lifestyle Medicine Handbook: An Introduction to the Power of Healthy Habits, and the Teen Lifestyle Medicine Handbook: The Power of Healthy Living. Thank you so much for listening. If you enjoyed this, go on over to mindbodyspace.com and opt into my newsletter. You'll get special tips from my neuroscience-based planner and course, which was developed from over 10 years of experience teaching high-performing students of all ages at Juilliard, NYU, Columbia, Achievement First, and many other other organizations. I really appreciate you supporting this free podcast by hitting the subscribe, share, and download buttons. Until next time, this is Dr. Juna Bobby MD wishing you and your family wellness.