You Shouldn’t Feel That Way

[Upbeat Guitar Music]

Mike: Welcome everybody. This is Avoiding the Addiction Affliction, brought to you by Westwords Consulting, the Kenosha County Substance Use Disorder Coalition, and by a grant from the state of Wisconsin's Dose of Reality: Real Talks reminding you that opioids are powerful drugs and that one pill can kill. As always, I'm Mike McGowan.

Mike: A couple of months ago, I had the privilege of speaking with our guest today, Dr. Sarah Nasir, about her holistic approach to working with people with mental health and addiction issues. I wanted to talk to her again and expand on that conversation about the many challenges her patients face, not the least of which are what people are telling them. Who supposedly love them.

Mike: Dr. Nasir is a board certified addiction medicine physician, life coach, and entrepreneur specializing in holistic addiction recovery, and empowering individuals through actionable healing strategies. Welcome back Dr. Nasir.

Sarah: Thank you so much, Mike, for having me back again and especially on the recovery awareness month.

Sarah: This is September when we're recording and that's one of the reasons why I'm wearing purple today is to show solidarity with this very important movement and I really appreciate being able to sit down and talk about this again.

Mike: Oh, I think it's great, man. You look good in purple too. I'm wearing green 'cause I don't look good in purple, so there you go.

Sarah: You are the other color. So one of the colors is purple, the others is green. So together we're repping really strongly. Awesome.

Mike: That's great. Well, I wanna dive right into something since the last time we talked. I was reading a study recently published of over 200,000 female parents. And they found about only about 26% of moms reported excellent mental health compared to a decade before that, 38%. Okay, first, Dr. Nasir, those numbers seem to me to be incredibly low to begin with, and second, we're going the wrong direction.

Sarah: Yeah, looks based on the data that's being shown here, looks like it. I'm not sure what is the big difference between 2023 and 2016, other than the fact that we had COVID for a big part of the time in between, which, you know, was extra enclosure of loss of childcare, increased workload, and having to take care of everything at the same time. I wonder if that's the thing versus another, I mean, it can go in so many different directions. Can you elaborate on the study a little bit more? Like what sparked it?

Mike: Yeah. It was from the Journal of American Medical Association.

Mike: And they just took it upon themselves, and they did attribute some of it to COVID, but I think some of it has to do with the messages that people get. If you give birth, what do people say? Oh, what a blessing. Doesn't take into account how people might feel. Right?

Sarah: Gimme a little bit more about the study, like why did they end up looking for it and what are the things that.

Sarah: Questions that they asked, does it say anything about that? Because at this point, looking at this, I'm seeing numbers. I'm not seeing the full picture. And based on that, we can go a little bit more into detail about deciphering the study here.

Mike: I think it's one of those where they go about surveying people and not knowing what they're going to find out.

Mike: And it's not coincidental, I don't think, that the numbers for mental health are going down at the same time, alcohol usage rates among that same group of women are going sky high.

Sarah: Oh, wow.

Sarah: And they looked at both items at the same time. Okay. That's an important note.

Mike: And then you look at some of the messages people get and you work with young women and women who have given birth...

Mike: Postpartum depression is something, as a man, I don't really understand. I haven't felt it right. I've felt the anxiety of having children, a tremendous burden of having children. While everybody's slapping you on the back and congratulating you, it's hard to share what you're feeling and jump for joy if you're not feeling good.

Sarah: Yeah. And as a woman who suffered from postpartum depression and anxiety on both childbirth especially after my C-section, oh my gosh, that was such a critical moment in my life for me. It feels like your own body feels foreign. You go from having a baby, being a body pumped full of progesterone just a little bit while ago, and then you give birth through that traumatic process.

Sarah: You go from weighing like you drop 10, 20 pounds, or 10 pounds at least, like in just one delivery. Then the next day, your body is just full of fluids. I had a C-section at my last pregnancy and I was like swollen, like I've never been swollen in my life before. I still look at my pictures on the day I came home and I look at my feet and I'm like, I can't believe those are my feet.

Sarah: They look like gigantic whales. And it just felt so uncomfortable. And then like after you give birth, while you're giving birth, your body's full of Pitocin, which is the contraction hormone and then stress and whatnot. And as soon as the baby comes out, now you have the progesterone slowly going down, the oxytocin coming up. And then your body transforms into a food machine from once upon a time the baby was just taking a little bit from you and now you are nursing and nothing prepares you for the chapped nipples and the the lack of sleeplessness. And the sensation of it feeling like an elephant is sitting on your chest and then everybody else around you seem to be going their merry go lucky way and messing up the system you had in place like with your dishes and clothes.

Sarah: And even those things start to like get frustrating to you is like, why can't I just take care of it myself? And in your body, your stitches are healing. If you're not having a C-section, you tear down there. If you're giving a vaginal normal delivery. You can't sit straight, you can't lay down, and there's this baby latched onto you and your whole body is like breaking and rebuilding.

Sarah: It is, oh my gosh. (laughs) It is not a fun process. And then you are worried about the clock is ticking when you have to go back to work. I was fortunate that I had a saving of money that I have a husband who can support me and provide for me, but I didn't have my usual income. And here's another financial stress being a woman who earns her own money, who earns her own finances to pay for whatever I want, be it charity, or if I like a nail polish or I like that, I can just buy it just like that.

Sarah: And then when it's time for me to get some of my own money that I have paid in taxes. Now I don't have access to it for one to two weeks. So I'm in California, so thankfully there is parental leave. I got it during my second pregnancy, not during my first pregnancy because I moved at a time where I couldn't put in the six months of, work that was necessary. So that financial stress was there as well on top of not sleeping well. And everybody's just like trying to be, I was fortunate enough to have people around me, like walk on eggshells around me. I was a fire breathing dragon, (laughs) I'll say that. And everybody was trying to be okay.

Sarah: And it's like, why are you being so mean? We're just trying to help you. And I'm like. Just shut up and get outta my face. (laughs) So you become a foreigner in your own body. And then on top of it for women who are not fortunate to be surrounded by supportive people, like I was, be in a situation like I was, I can't even imagine.

Sarah: For patients. So many of my patients, they have other children that nobody's helping them take care of them. And sometimes they have children who are special needs. They may not have the emotional intelligence that's required for navigating turbulent times as is. And then you throw them in the washer and then the dryer to add it on top. I can't imagine.

Mike: I think you just did a fantastic job of explaining where the numbers in the survey come from. You just tacked on about 4,500 stressors all at the same time. But while those around you are all grinning and smiling and expecting you to be happy.

Sarah: Because they're happy.

Sarah: I mean, having a new baby is beautiful, it's exciting. However, everybody else can play with the baby and then hand it off when the dirty diaper needs to be done or changed. Thankfully, my husband was on top of it. I'm like, I'm not even doing it. Like my job was to incubate. (laughs) And now it's your job to support the babies growth. And then he wanted to take care of the baby a certain way. And I'm like, no, I don't want you to walk around all night with the baby and give them that sense of like, this is how it is. I want to go in a direction that the baby will start to adjust to my lifestyle.

Sarah: And he's like, babies are meant to be held. And then also, like so many things I definitely was challenged with my preconceived notion that I'm gonna from day one, separate myself from the baby. Let the baby understand, like this is how it is, you know, follow the rules. And then I was told that you can't spoil a baby. (laughs)

Mike: Mm-hmm. Right.

Sarah: Babies are supposed to be held and cajoled and they're not meant to be left alone. And that's something I really appreciate my husband doing. Like he was more of a nurturer than I feel like I was. So I'm grateful to have him in my life. I think if he wasn't there, my kids might've had a little bit more trauma.

Sarah: 'Cause I would've probably just left them on the side.

Mike: For most people, they have no end if people willing to give them advice. And the advice normally comes from their own experiences, expertise regardless of whether they have it or not.

Sarah: Yeah, that's the thing, whether they have it or not, everybody is an expert when it comes to giving advice. But when it comes to showing up and pulling the night shift, it's a little hard to find people without. Being like listed of all the favors they have done for you. (laughs)

Mike: Well, and I think Sarah, that nobody really explains this to you, right?

Mike: I read all the books and I'm sure most people do, or many people do and listened to it. But between my three kids and they're not separated by decades. The way they told us that they should sleep differed for all three kids. And to this day, I feel bad about my first kid that I wrapped up like a burrito and put 'em in the edge of the crib with a little wedge in there.

Mike: So sometimes you get different advice. You follow it the best you can, but you always have somebody over your shoulder in the family saying, when I was a mom or when I was a dad, we did it this way. And so you feel criticized sometimes as well.

Sarah: Oh yeah. And you know, that's what made me feel bad about the criticism I gave others.

Sarah: And I'm like, I need to find those people and apologize for telling them what to do with their babies. They should have told me to shove it where the sun doesn't see light. It doesn't work like that. Every baby is unique. Every mom heals differently, every dad catches up differently.

Sarah: It's important to have a body of knowledge around you, but it should be something where you can draw from when it's needed. But then society in general needs to like take a chill pill.

Mike: Mm-hmm.

Sarah: When it comes to being like, oh, that is a bad parent, or that baby is bad. Yeah. I apologize to everybody for having to hear that, especially if you've ever heard me tell you what to do with your baby (laughs) and I had no clue what I was saying or doing.

Sarah: Apologies.

Mike: Yeah and you mentioned it's early September when we're doing this, and so everyone I've talked to now tack all of that on, and then you add a couple years. Everyone I know who has a school age child, especially a young one, preschool, kindergarten. Their kids are sick right now.

Mike: And everybody talks about what's going around. So you add that stressor on where you have to go to work. You have to do stuff. You're now tired. You're not sleeping. Your kid's not sleeping. You're up all night and they're home from school. Or do you send 'em to school? Do you send 'em to childcare? And if I'll add one more to you. We've now seen an increasing number of childcare close and clinics close because of lack of funding. So those are huge stresses on people as they're bringing new life into the world.

Sarah: Undoubtedly, undoubtedly. And even if they are open, it's ridiculously expensive.

Mike: Yes.

Sarah: And it's not just the current administration who's reallocating funds in a unintelligent way. I mean, this has been around from before, and had nothing to do with current administration. Childcare is ridiculously expensive and I didn't realize that until we had our own kids. We get, what, $2,500 or something per child. And it amounts to nothing. (laughs)

Sarah: Babies are expensive and we forget that these are future citizens of this country and they're the future generations that are gonna be taking care of us.

Sarah: We not only lack insight as a society, we all select foresight as a government. If we really wanted to ensure the greatness of not just us but our whole nation. We would pay attention to the people and making sure that the people are met where there is need and those needs are fulfilled. Because it's a conversation I was having recently with another host of a podcast about how if doctors are fulfilled, we show up better to take care of our patients.

Mike: Yes.

Sarah: This is not just something that is applicable to doctors, it's applicable to all of us. Is that when we put our own oxygen mask on first, when we have our oxygen, we stop being a liability and we shift into a hero mode. We can give, we can take care of each other. So I really feel like one of the directions that our society needs to move at, at all levels of support is about trauma informed care. Whether you, I mean, it's becoming a conversation in the healthcare field, the counseling field. However, where it really needs to penetrate and saturate is at the level of law, at the level of government.

Sarah: Our leaders need to be more, they need to relate more to the people who they are serving. You know, at the end of the day, this, whether you're a doctor or a politician, we're public servants, right? And so, knowing what the parents need to take care of their kids. So the mental health at every level, not just the parents, but the children, they grow up healthy.

Sarah: That cycle of violence is disrupted. And we raise resilient children who are present, competent, innovative, creative, and advances humankind, leaps and bounds. That should be our goal.

Mike: It's not hard to be empathetic.

Sarah: It is if you have your emotions locked away because you experienced trauma. And I think our current administration, our leader definitely, probably has a lot of it.

Sarah: You have to turn off parts of yourself to survive. And I wonder if he had to do stuff like that and so he cannot look at another person the way a human should be looking at another human.

Mike: What you're saying is that in order to heal yourself, you have to be vulnerable at some point and actually look at the things that traumatized you and work on them.

Sarah: In a safe space.

Mike: Yes. Mm-hmm.

Sarah: In a safe setting with the right people. 'Cause not everybody's equipped to support your vulnerability. And if they don't know how to, if they're not trained on how to deal with it, and if they themselves have trauma and they are not emotionally equipped to handle it, it can lead to more injury.

Mike: Yeah. So let's go back to circle back. I'm an uncle, I'm a grandfather. I'm a brother whatever. What can I do to be supportive? If I'm not the therapist, if somebody's going through stuff and having difficult time. Rather than tell 'em when I was your age or I had, you know, the old joke about I had to walk five miles to school and suck it up, suck it up, and pull your self up by your own bootstraps is not great policy personally or policy-wise at a national or state level either.

Mike: So what can I do to be supportive? What would be supportive when somebody's going through that?

Sarah: That's a deep question. I think the fact that you are serving yourself first and you're willing to catch yourself is the step in the right direction. Because if you are aware of what's coming out of your mouth.

Sarah: And you're in control of what comes out of your mouth. And if you even don't know what to say, sometimes silence is better than saying the wrong thing. And you can try and ask what's happening. And sometimes they don't know how to state it. Right. So being able to recognize what is the root cause that's making them do this or act in a certain way. That level of detective work needs to be built over time. So I think learning more about trauma-informed care, cycle of violence. One of my favorite books is Nonviolent Communications. It really helps you with articulating what you're feeling without doing the blame game, where you're not talking with others.

Sarah: That way you start to practice it on yourself. Definitely it's important to have like a force field around you where you can isolate, like this attack is not at me personally, that it is at something. That is being triggered in them while also recognizing that if it is at you, how do you protect yourself?

Sarah: How do you swerve out of it? How do you deescalate it? These are tricks I've learned because I take care of the population that I take care of.

Mike: Right. That's why I wanted to have the conversation with you because these are skills. One of the things they say, Doctor Nasir is when you grow up in dysfunction, the healthy thing to do is to end dysfunctional relationships and unhealthy relationships and start healthy ones. Okay, great. Thanks. Thanks a lot for that. How do you, (laughs) you know, there's skills involved in that.

Sarah: Yeah, because if you got touched by dysfunctionality, chances are that it takes root in you. And how do you prevent yourself from carrying it on to the next relationship?

Sarah: Honestly, it comes down to lifelong work with yourself and connecting with the people who know how to help you navigate that. Because after a certain point, it becomes like trying to swim in the ocean and trying to head for the shore. And sometimes you don't know what direction is what or your energy might start to drop, and that's when it's very, very powerful to connect with the professional help.

Sarah: And in many times, that turns out to be counselors, psychiatrists, LMFTs, licensed therapists. I'm finding that life coaches are, it has been an important part in my own journey and recovery, and that is something I do in addition to taking care of patients with the evidence-based medicine.

Sarah: I think if there's somebody who is struggling with that. Investing in themselves because the most valuable thing you have in your life is you.

Mike: Mm-hmm.

Sarah: I want the audience to pause and think on that for a second. The most valuable resource in your life is you. The most important person in your life is you.

Sarah: This is a question that I was asked when I was struggling to wear the hijab because I believed it was a very important thing to do, but I wasn't wearing it at that time. I felt really guilty. And I was in a youth camp and one of the inspirational speakers, he was telling me, if you saved all of mankind and you were doomed in the process.

Sarah: Who have you really saved?

Sarah: For me, it was a wake up thing that you have to protect yourself first, because once you protect yourself, once you heal yourself, once you serve yourself the goodness that's you, it's gonna flow through and it's gonna spill over the cup. And it's gonna go and carry that blessing onto everybody else around you.

Mike: Yeah. I also like the visual you gave about swimming in the ocean. Sometimes you get that riptide underneath that's pulling you in the opposite direction, and many times that's the people who you... They're working with their own agenda. Let's put it that way. When somebody says to you, well, you shouldn't feel that way.

Mike: That's about their stuff, right? That's not about reflecting what you need.

Sarah: They're operating from their level. Sometimes they might not have an agenda. To make you sink. I mean, granted, there are people who just got conditioned that way.

Sarah: That's just the way that life is supposed to be. That to rise, you have to stand on other people by sinking them.

Sarah: And there's the option to raise the ceiling while raising the floor. And so everybody who's on the floor go up together. I like to operate from that perspective. But the first category of people that we're talking about, I don't think there's very many of them. I think most people are just operating from a space of I did it this way.

Sarah: And so to justify what happened to me was, okay, I'm gonna make sure that everybody else around me that it looks like that. Otherwise you feel like the black sheep, you feel out of place. And so one of the ways to feel like you fit in is to make everything else fit your experience. There is a wisdom in passing on ancestral knowledge and wisdom, but then there's also passing on ancestral baggage where just because it was done a certain way in the past, you have to do it again in this way.

Sarah: For example, for me, like this one, I had to like really challenge the women. In my family, it was like when my kids started to eat for the first time, I thought it was so beautiful. Like, you know, I'm giving them a food. I worked hard to make it, and they're eating it and they're downing it and they're not puking it back up and they're wanting more.

Sarah: Like it is a beautiful site for me to see. But everybody in my family, my mom, my grandma, my mother-in-law. Whenever I was like, oh my gosh, she's eating, or he's eating. And they're like, don't say that! You'll put like... So there's this thing of like the jealous eye or like the bad eye, the evil eye. That's the word I'm looking for.

Sarah: Like, you'll put evil eye on your child. And I had to like, 'cause you know, I'm of this generation so I'm fortunate enough to be like, challenge them in that way. It's like, are you telling me that this baby that I made with my body and I fed with my body, that I am going to somehow cause harm in them for appreciating the growth that they're having?

Sarah: And they're like, yeah, this is what everybody told us around us. And so that's how they operated. And these three women are from the same culture. Well, most of them grew up independent of each other, so there's the societal conditioning as well. So going back to like, there's ancestral wisdom and then there's ancestral baggage. (laughs)

Mike: Yeah. Well, because if you do it differently, then you don't say it out loud, but they feel that they must have done it wrong. And so to justify that what they did, it's just that cycle just can keep going and going and going.

Sarah: Yeah. Until you empower yourself with what is like, you have to analyze what's in front of you.

Sarah: Is it really the only way or the best way? So that constant evaluation of what's happening in your life, it's not just raising kids, it's not just parenthood, but I think it's a status of life we need to develop. That constant evaluation of what is in front of you.

Sarah: 'Cause we all get to make choice every moment. If we're gonna do this or that, and it's about making the best choices, those are the things that are going to lead us to a better outcome. And if it is that you think that you find based on your experience, your knowledge, which should be continuingly growing, you know that CME needs to be CLE continuing life education. (laughs)

Sarah: You know I think we all need to engage in it continuing to grow and improve our knowledge base. That's what helps us choose the next best option.

Mike: That's awesome. I always said when I talk to parents, that of when I stood back not knowing what to do sometimes, if I just took them a moment and said, what's in the best interest of my child?

Mike: Well first, all three of my kids were different. So that answer can differ with all three of them. And as I said before, they all slept differently 'cause we wrapped them differently. And the only one who ended up not sleeping was me. So. (laughs) Gotta take care of yourself.

Mike: Let me let you outta here with this one. This has been fascinating. But I wanna ask you a question for the helpers because we have a lot of practitioners listening to this. Recently, I had a couple of doctors for a health thing, and one of them, Dr. Nasir, was just an exceptional listener. The other one I don't think, heard me speak yet.

Mike: He hasn't quit talking. And both of them were incredibly smart and knew their stuff, but their approach to the same issue was diametrically opposed. So how do practitioners strike the balance between those two things and helping in the best way that they can? Listening just enough and speaking just enough.

Sarah: I think it's the art that you have to keep practicing. I think listening is an art. Yes, there's a science behind it. One of the ways that I develop my ability to articulate, I mean, as I was mentioning, like this is a lifelong skill that I've been nurturing a little bit at a time. I think listening falls in that same category.

Sarah: My ability to listen and hone in on what is the root cause of the problem is so much better than what it was back in high school or even back in elementary school. I think we live in an amazing time where we are studying how to become better speakers, better listeners, better empath.

Sarah: We have words like presence. We have words like report. These words, they belonged in the dictionary before, but they were not present in our lives the way it is now. So I think it's very important to identify people who are doing it well. And then also identify people who are doing it really bad and then... (laughs)

Mike: (laughs) Yeah, right!

Sarah: And then you know the two boundaries. And then you need to assess where do you fall in the spectrum of really well and really bad, and figure out what is it, what are the traits that you have in common with these two groups of people. That way, you identify like, oh I say too much "a hum" when I'm talking, so maybe I identify that this is something that I don't want because when you say too much or "like", or "really". Like for example, "ums", one of my weaknesses when I listen to my podcast.

Sarah: And then another one I like to talk about is, "and them" right, I've seen like how many times I use that. And then you notice like what are the people who are doing it really well doing? I've noticed that these people will take a break and if need be, they'll pause and they'll figure out what they wanna say next without feeling embarrassed.

Sarah: And so I've started to kind of. Trying to incorporate that into myself. So as I am more consciously attuning my skills, I'm becoming more and more like having more and more like the people who have mastered the ideals and skillset that I want. So that's one of the ways that I approach self-improvement.

Sarah: That would be one advice and then put yourself in situation where people are practicing talking in that present full way. For me it was doing coaching classes when I was getting certified to become a coach, we would be put in pods to talk with each other. Because the more you do something, the brain is kind of like a muscle.

Sarah: The more you do it, the more those neuronal pathways are formed, the more it becomes natural and permanent. And when it is permanent, it takes less energy for your electrical discharge to go down that path and the chemical reaction happens, and then you have the motor activity and whatnot.

Sarah: Versus when you're having to learn something for the first time, your brain is having to allocate more resources finding those axons, having to find the connections with the other axons that it needs to connect to. So some ways like, yeah, I think that would be the answer I would give for this question.

Mike: Well, and that the second part works terrific. The practice, practice, practice for everything with most of us except golf, I think. And I still haven't got that down. Okay. (laughs)

Sarah: That means you need to keep at it. (laughs)

Mike: Yeah. Right. (laughs) Or quit.

Mike: Dr. Nasir, thanks so much for your work and for these discussions. I never know where they're gonna go and I really like where they go.

Mike: You all know who listen that there's links to Dr. Nasir's socials and website attached to the podcast. For those of you listening, watching, we always hope you find support, hope, courage, wherever you are. As always, thanks for listening. Be safe, and I think we'll end it this way. As Mr. Roger's mom used to say, look for the helpers. You'll always find people who are helping. Thanks for helping Sarah.

Sarah: That's amazing. You know, my last name means helper.

Mike: Oh, there you go.

Sarah: That is very, I don't know. It touched me. It's a very powerful ending.

Mike: That's great. We'll let it end there.

Mike: See you later.

Sarah: Thank you.