Back to Basics

Summary

Emma discusses the importance of returning to basics in managing life's challenges and health, emphasizing foundational principles, self-awareness, and incremental progress.


 Key  topics

The importance of foundational principles in health and life management
How to identify and address the root causes of problems
The concept of crisis and rehab phases in personal development
The Spark Cycle as a tool for incremental progress
The role of self-awareness, yoga, and meditation in recognizing early signals
Strategies for returning to basics during crises and stability phases


Chapters

00:00 Introduction to the importance of basics in health and life
02:12 Managing life like managing a clinical problem: foundations matter
04:23 The danger of skipping foundations and focusing on surface solutions
06:45 The importance of sleep, nutrition, and movement basics
09:29 Recognizing when you are in crisis versus stability
12:13 Handling crisis with stability and support
13:01 Rehab phase: rebuilding after stabilization
15:06 The discordance of high-achieving women in crisis and stability
17:47 Returning to basics: diagnosis, assumptions, removal, positioning
19:08 Calming the nervous system and scheduled relief
20:01 Titrating doses and understanding your body's needs
21:30 Using adjuvants after establishing stability
22:28 The Spark Cycle: a tool for managing phases and progress
23:19 Small wins, identity, and reframing in recovery
24:43 Tracking signals and adjusting your cycle
25:30 Case example: Molly’s successful symptom management and rehabilitation
26:24 Recognizing future crises and quick response strategies
27:13 Practicing self-awareness through yoga and meditation
28:11 Measuring how quickly you notice signals of imbalance
28:42 Final advice: check in with yourself and return to basics

Get in touch with Emma

Instagram https://www.instagram.com/ejones_md/

Website https://www.emmajonesmd.com/

Subscribe the the Self Trust Newsletter

https://www.emmajonesmd.com/newsletters/self-trust-newsletter/subscribe

Transcript

Copy Transcript Copied

SPEAKER_00 0:19

All right, welcome to today's episode of She Changed Her Mind. On this episode, we're going to talk about back to basics. And I want to start with a clinical story. Let me tell you about a patient named Molly who was a seven-year-old girl who had osteosarcoma that had relapsed and progressed and was metastatic through much of her body. And I got called as a palliative care consultant to come and help Molly because her oncology team was really sad and frustrated that they couldn't seem to relieve any of her symptoms. They were working as hard as they possibly could to treat her cancer and attain a cure that would allow her to live for a long time. But along the way, she was getting significant pain, nausea, constipation, and mood dysregulation that the team just couldn't seem to handle or couldn't seem to resolve. And so they called in a palliative care consultant, which is the specialty of medicine that I practice. And our team got to solve the puzzle of this intractable symptom. And that can be very frustrating when we know that we have a patient who's suffering and we have a team who has been doing their very best and believes that nothing better can be done because they believe that they have done everything. So what I will most often do in those cases is do what I call back to basics. Have we done everything we could possibly do from a foundational standpoint? Have we addressed the pain as well as we possibly can? Meaning, have we addressed the diagnosis? Have we scheduled pain medication? Have we really thought about what non-medication interventions can be done? And then we'll do that for each symptom, making sure that we're addressing each step along the way and not just skipping to one intervention that we hoped would work and then when it didn't, calling it failure. So I think of this sometimes as a complicated problem wearing a basic problems costume. So, or a basic problem wearing a complicated problems costume. You know, sometimes we can get confused and these things masquerade. And the reason why I'm talking about this here, because this isn't a clinical podcast. This isn't about me teaching you how to do symptom management in children with cancer. This is about you managing your own life. And the thing that I want to change your mind on is when we feel like something is intractable or when we feel like a problem cannot be solved, can we go back to basics? What steps have we possibly skipped? Can we be courageous enough to go back and examine the foundations? So I want to talk about why boring foundations often matter more than we would like to admit, why so many smart and capable women skip them. And then the question that is often underneath it that we skip is am I really in crisis or am I in a rehab situation? Because I believe that most of us are still in crisis, but we really haven't said so yet. So making the correct diagnosis is the first basic, and identifying, correctly identifying where you are is going to be important. So let's get into it. Why do basics matter? Well, basics are kind of like the load-bearing pillars of our lives, right? If you could picture a building and there's a crack in the ceiling on the third floor, you could plaster and repaint it for years. But if the cause is that the foundation is cracking and the house is sinking, it's just going to keep coming back. The problem often shows up far from the source. And so that's kind of the first mental shift for us to make when we're looking at something in our lives that we want to be different, instead of going right to where that problem is and saying, How can I? I just need better time management, I just need a different meal plan, adjust, adjust, adjust, right? Or lots of things outside of ourselves. We love to say, I just need my kids to be older, I just need my boss to be different, I just need my husband to be different. But what if we go back to the foundations? So we can think of some examples from the clinical realm. You know, think about really basic things in not too distant history. We could go back really far, like the pump handle on the cholera outbreak. But, you know, thinking back to even to the 2000s and looking at central line infections in the ICU, which are often serious and deadly, um, can we just do a checklist? Write a simple checklist, wash our hands, use sterile barriers, clean the skin, chlorhexidine, wash, avoid ephemeral sites when possible, and remove lines that are no longer needed. Can we just have this simple process and reduce central line infections, thereby improving survival rates and outcomes from the ICU? Every physician already knew these steps, but just being willing to do a foundational principle of making a checklist, which now sounds so simple, now sounds so intuitive. But at that time it was quite revolutionary to even suggest that. Because the knowledge wasn't missing, right? It was kind of the implementation. So a foundational principle of like, what's a really simple thing that I can implement in that kind of way? Because the trap is sometimes we have competency, we have insight, we have knowledge, but we're not really implementing. And the more we know, sometimes the easier it is to assume that knowing counts as doing. I see this constantly in high-achieving women. They can tell me all the things that they know are consistent with healthy lifestyle, sleep, rest, proper nutrition, proper hydration, creative outlets, hobbies, connecting with others, you know, all of the things that they can say, meditation, yoga, they can cite the evidence on these things, but they don't do it. They could teach a class on it, but then when we actually look at what they're doing, they're not living that. So where's the disconnect? That's because we're skipping the basics. So what are the real basics when we talk about our bodies? Sleep. I know I need it, but then we're doing five hours a night for months. Or we're looking for the right, just the right brand of magnesium that helps us sleep instead of doing something foundational and simple, like giving ourselves up bedtime. That's what I'm talking about. Food, granola bar as breakfast, coffee as lunch, and then whatever the world comes out by the time we get to dinner. That is not sound nutrition that helps our minds and bodies run its best and perform in the way that we want it to, right? It's not going to help us feel the way that we want to feel. But instead of saying I need to eat breakfast, lunch, and dinner every day, what are meals that I actually like to consume? And can I make sure I'm actually just getting food, actual food? We are spending all our time looking for the perfect adaptogen or the is keto better than Mediterranean diet? We're really focusing on the window dressing and not on the foundations. Important conversations. One direct conversation avoided can lead to numerous workarounds and numerous like rethinkings. So, what can we do from a communication standpoint that is foundational to make sure that we are keeping open lines of communication with the people that matter most and not avoiding conversations that lead to then all of this other stuff? Great place to look for foundations. Our calendars. If your calendar is just back to back to back to back to back, or your to-do list every day is like 40 things, but then like 37 of them are left undone at the end of the day, we are having some kind of problem here. We have a foundational problem of expectation. And so we really don't need a new time management system. It's really not whether you're using system A versus system B or this brand a planner or that brand a planner. It's really that we have too many things on there and we have unrealistic expectations for ourselves. That is the foundation. And then how about support? Are you diving into something that's not supportive enough? Are you trying to do personal development when you don't really have a firm foundation of self? Are you trying to take on something that's going to help you teach other people when you don't really have the foundation of practice of skills within yourself? And I have been guilty of all of these things myself. The reason why I can speak with them so competently is because I have lived them. So absolutely no shame. I am inviting you to courageously come back to basics, to courageously come back to the foundations. Because let's notice what all of these have in common. Fixing a basic would mean confronting something, right? It would mean changing something about ourselves or within our lives. To fix my sleep, I have to admit that I'm wasting time doing things that are unimportant, like scrolling or watching TV or whatever. And I would have to admit that my schedule load may be too heavy. Maybe I'm working too many shifts. Maybe I'm staying too late at work. So my whole evening is messed up, whatever it must be. I have to have a conversation, maybe just with myself, maybe with other people about what I'm going to stop doing. I have to take the risk of that conversation. A new system or a new supplement that just lets me keep everything the same and avoid every challenging thing and gives me the illusion that I'm doing something. But let's do a quick test. Could you describe your last week of sleep, meals, and movement without guessing? Like could you tell me what you did? If not, your foundations are not in place. Because one of the elements of foundation is predictability and repeatability. And so if you can't tell me what your bedtime is because it's not the same every night, or you're embarrassed about it, then we have a we need better foundations. If you can't tell me what you eat, and I don't mean every single food, but like the kinds of food that you typically tend to eat, the style of eating that you tend to do, what times you tend to eat, we have a foundations problem. And movement. What style of activities do you tend to do? Do you work out in the morning, work out in the evening? Do you like walking? Do you like to work out outside? Do you like to work out inside? Like those types of things should be able to kind of come off the tongue very easily. I walk almost every day for at least 10 minutes. I practice yoga twice a week and I lift weights twice a week. Like we know these things, unless we have a foundations issue. So those are a little bit of quick checks. Again, no shame, no shade. You're starting where you're starting. And then the question that I want to invite is that sometimes why even going back to basics feels hard when we're thinking about lifestyle change is that we're actually in a crisis. So if you're in a crisis, that's an acute phase. The system is beyond capacity already. Your system, your internal system, your family system, your work system, like every system is kind of overloaded. And in crisis, we can't think about optimizing. We can barely even think about starting small. What we need to think about is stability. We need to remove what's causing it, just like we do in the pain patient. We need to bring in support. What do we need to stabilize? What do we need to treat? In what order? We need to relieve the load on the schedule instead of just waiting for it to like to pass, because it's never going to. How many times have you said, when I just get through this season, only for another busy season to come? So crisis gets handled differently than the way we would approach incremental lifestyle change when we're in a more stable place. Rehab phase begins once we're stable enough to rebuild. So for that patient that I mentioned at the beginning, once we have done our good foundational crisis management basics, we've made the proper diagnosis, we've removed anything that's causing pain, we've positioned the patient so that we're no longer exacerbating the pain. We've turned down the temperature on the entire nervous system by calming the environment. We've scheduled pain medications so that the body can finally experience comfort and doesn't have to re-experience pain every three to four hours. The pain medicine is just there already. And then we're considering adjuvants if and only if all of that doesn't work. We titrate incrementally. So once we have comfort, then we can start to rehabilitate. Now we can try to walk. Now we can try to challenge the system to see what we're capable of from a functional perspective once the crisis has been stabilized. That's a rehab phase in a clinical context. At that point, we're starting from zero and we're trying to get to 10. When we're in crisis, we're in a negative. And if we're trying to walk while we're still in a negative, the most logical result is that we're going to fall. Just think about a patient who's lying in a bed in an ICU for the past seven days. If they woke up and just wanted to walk, we wouldn't just say, yeah, go ahead, try it. And you know what? I think you should actually look at this influencer on TikTok about the best way that you could walk. No, we would definitely say, okay, let's start you from zero. What is the first step? Probably moving your legs around in the bed or like dangling your legs over the edge of the bed, right? These would be the ways that we would incrementally progress a person who was needing rehabilitation. So we need to think kind of apply that same concept when we're thinking about our own incremental improvement. So the discordance and the real problem with high-achieving, very intelligent women is that we kind of refuse to admit which one we're in. So the first form of discordance is I'm in crisis, but I won't admit it. This is the woman who is trying the meal plan, trying the exercise regimen, trying a better calendar system. Every single one is some version of a rehab protocol, but it's not correct for where she is because we're still in crisis. The body is still sick. This is prescribing physical therapy to somebody who is not yet stable, somebody who's still labile blood pressure, still in ICU on drips and intubated. We're not going to put that person in PT and try to get them to walk. But this is what we do with ourselves. And then when it fails, we take that as a verdict on ourselves and we make a story. I can't stick with anything. Well, the protocol was fine, but the phase was wrong. So the trial wasn't fair. So I'd say that that is the profile that shows up for most of the women that I work with. Because admitting we're in crisis feels like failure, especially when our identity is built on being the one who copes and is resilient. So I just want you to wonder if that might be the discordance that you're in. The second form of discordance is when we are stable. But because our body, mind, and nervous system is so used to crisis, we manufacture crises. Your body has learned that urgency is normal and calm feels strange, which can feel unsafe. So you continue to find fires that you need to put out. You might move up deadlines or start something new, you know, get a few more plates spinning just to keep the chaos going. Find someone to rescue. Oh boy, I if I could, if I had a dollar for every mess I have created of trying to find someone to rescue or someone to help when I just couldn't deal with the fact that my life was actually calm and stable. Boy, that's gonna have to be another episode. But the work is feeling what stable feels like and letting that become your normal. So both of those patterns are what your body learned. And both can change because neither one are who you are inherently. They are just what you have been doing, what you have been practicing. And certainly neither one of them calls for shame. So how do we come back to basics? This is the order that I use with patients. Diagnosis, what's actually going on? So in this case, is it burnout? Is it grief? Is it a values mismatch? Is it really just that you've been working too many hours? What's going on? Second step is what assumptions are we making? What am I treating as a fact without checking it? Third step is removing the cause. What is still feeding this problem every single day? Where are we still causing the pain? Next step is positioning. So for that patient, that's finding a body position that is more comfortable. For us, that's looking at how's our life set up to make it as easy as possible. Schedule, boundaries, what we give energy and focus on first. These are foundational changes that can make a huge difference. The next step is calm the environment. I talked about that as turning down the thermostat or the volume on the entire nervous system. This is incredibly helpful when patients are experiencing pain or nausea or other difficult symptoms. And it can be the same for us if the symptoms we're experiencing are psychological anxiety, overwhelm, feelings of restlessness, agitation stuck in my life, just calming the nervous system. Less input, slow down. The next step is scheduled relief. In palliative care, when I'm treating a patient, that means scheduling the pain medication, scheduling the nausea medication, because chasing pain is harder than preventing it. But most of us are running our self-care and our rest on a PRN basis. We have to wait until we get to a nine out of 10 before we're even looking for any relief. The foundational principle is to put the rest and the meals and the recovery on the calendar. Have them in a repeatable cadence. So that when I ask you, how do you sleep? Then you can tell me because you do it the same every day. Adequate dosing. Now, this in the clinic, we titrate up to the effective dose. So this may be something that you have to figure out. This is part of getting curious, becoming a student of your own life. But how much is enough? Now, don't be one of those people that tells me my body doesn't need that much sleep. I sleep for four hours a night and it's fine. Well, that's only true if you also feel energetic and cognitively intact and creative all the time. If not, then you're sleep deprived and you're just lying to yourself that the amount that you can get is the right amount. So let's be committed, if we're talking about sleep, to figuring out, you know, what is the right amount, not too much, not too little. Same thing with food, same thing with water, same thing with meditation, same thing with yoga, same thing with exercise. You're gonna figure out the right amount for you. And this basic principle of titrating the dose is translatable, but you need to do it. And then adjuvants last. So we don't skip to the cherry on top, we don't skip to the window dressing. They may be helpful. Having a specific strategy for a specific goal, having a specific tool like a planner that helps you manage your time can be very helpful, but not if the foundations aren't in place. So adjuvants last. Once you're stable and we stop treating each flare as a surprise, we start looking for a pattern, right? Oh my goodness, every time I'm on service, a predictable set of things happen to me. Well, now we have a pattern. Now we have something predictable, and we can kind of build a strategy around that so that you get closer to whatever your goal is. Just like a physical therapy rebuilds a knee while also asking, why did it get Injured in the first place. When we're thinking about back to basics, we want to think about what's driving the recurrences. So when we start what we might consider this rehab phase, I teach something called the spark cycle. And I'll have a little PDF of this in the show notes if you want a visual and a little bit more about what the spark cycle is. But Spark basically is five steps. Number one is spot your phase. So are you in crisis rehab or manufactured crisis? Where am I out of one to 10 on how I want to be meeting my goals? And every cycle starts here because the right, the next right move depends on your answer, right? If you're in crisis, you need a crisis plan. If you're rehabbing, you need a rehab plan. And if you're in manufactured crisis, you need something to help you get out of manufactured crisis. Then the P is pick one microwin and make it almost too easy. So this, you know, we often start way too much. We want this to be the tiniest, tiniest step. Rehab starts where the body is today. Nobody, the minute they get out of knee surgery, goes out and runs a 5K. At least they shouldn't. We really need to start with a small thing and build from there. So pick one micro win. A is for anchor it in identity. I am the kind of person who this is what we're looking for at this step. You're being it's becoming who you are. And every repetition becomes a vote for that identity. R is for reframe the meaning. We can have everything the same. No circumstances need to change, but if we give it a new story, it's gonna feel different. A short session that you repeat over time and can build upon itself means the rehab is working. It doesn't mean that you're too lazy to do longer, right? So like we're just kind of reframing the meaning, changing the story. And then K is for keep it going. Um, repeat, track, and calibrate. When the step is steady, like when you really feel like, okay, I got this stuff, then you add more. When the symptoms flare, you notice what changed. When something happens, life throws your curveball, you get sick, there's a new complication in life, you take a step back and you have the like the fun the foundation that you have to fall back to. When times get tough, we don't rise to the occasion, we fall to the level of our practice. So we know through using this cycle, because then we'd come back around to the S again, right? And spot our phase. Am I now in a crisis? Has something happened that put me into crisis? And can I design my cycle depending on that? And we'll talk more in the future about the spark cycle and how to use it and why I think that's thinking in cycles instead of linearly is so beneficial for us. But I really want the spark step to be something that's simple on purpose. So you stop trying to rehab while sick. But even if you do, the method has a kind of internal check built in. So it's a success story of going back to basics. Well, for our patient, Molly, we did some really good basics, got her on scheduled pain meds at the right dose, allowed her to feel comfortable in her body. We also treated her nausea and her constipation so that her internal systems were working well and she could start eating again. And then once we were getting good nutrition in her and had a good foundation of pain management, she could start working with PT and rehabilitating to begin walking and playing basketball again, which really was her goal. So even as she continued to go through her cancer treatment, we were able to keep her symptoms at a level that she could participate in the activities that gave her life meaning. So that's what we can do when we go back to basics, when we are brave enough to go back to basics. I'm sure you can imagine the implications of this for your life. And the part that I care about most is that you recognize you will have another crisis. We all will. Progress is in how quickly you catch it. So instead of saying I'm right back where I started every time something kind of knocks you down, can we begin to think I'm having another crisis? But this time I recognized it and was able to get myself on a crisis plan within two hours instead of two weeks. Those are very different sentences, right? The second one describes a real change in terms of how you're seeing yourself. And so being able to spot yourself, being able to self-study is why I teach yoga and meditation inside of self-trust school. These are the practices that allow you to be able to spot yourself more clearly. Yoga teaches you to read your body while the signals are still small. Meditation teaches you to notice a thought as a thought and not part of who you are. And these verdict loops where we've already decided the verdict before we've even seen the evidence, we can recognize them and snap out at them as we train the mind through yoga and meditation. So over time, we can broaden our categories. We are not either just fine or falling apart. We start to recommend uh recognize more specific states, running on fumes but stable, early crisis, manufactured urgency, genuinely recovering, genuinely thriving, right? You can put nuance and texture to how you're feeling. Whether you have vocabulary for it or not doesn't so much matter. Whether you can describe it to other people doesn't so much matter. But do you know? Can you perceive the difference? And this is what we train through yoga and meditation. So I want you to track one thing this month, which is how long does it take to notice? Can we go from hours or days from the first signal to picking up on things within minutes, perhaps? So if you take one thing, I want you to get back to basics. And one of the basics can be simply checking in with yourself and saying, am I in crisis or am I in rehab? Answer it honestly and then make your plan from there. Remember that if anything in your life feels acutely unstable, please utilize crisis management resources, crisis line, your medical provider, 911-988. Nothing here is medical advice, of course. But recognizing when we are in a crisis that is not of that magnitude, but is still requiring a lot of care and pause in our lives can be a really important back-to-basics type of skill. Take care.