Recently, I interviewed Dr. Sandi and we discuss the role of health coaches in managing chronic conditions and thyroid health, Dr. Sandi’s career journey and why she founded the Functional Medicine Coaching Academy, the scope of health coaching and how it differs from a medical provider, the importance of individualized treatment protocols, collaboration between health coaches and medical professionals, mind-body medicine techniques, and more. If you would prefer to listen to the interview you can access it by Clicking Here.
Dr. Eric Osansky:
I am super excited to chat with today’s guest. We are going to be talking about health coaching as well as mind/body medicine. I am excited to chat with Dr. Sandi Scheinbaum, who trains people to become functional medicine health coaches. It’s going to be a great conversation. Let me finish up her bio that I just started here:
Dr. Sandi helps practitioners and businesses hire health coaches because she believes that health coaches are key to combating chronic disease and reducing healthcare costs. As founder and CEO of The Functional Medicine Coaching Academy, a collaboration with the Institute for Functional Medicine, Sandi is a leader in the field of health coaching education. Thank you so much for joining us, Dr. Sandi.
Dr. Sandi Scheinbaum:
Thank you. It is a pleasure to be here.
Dr. Eric:
Let’s dive in with your background. I’ve listened to some of your other podcast episodes. I know you haven’t been doing this your whole career. You have another career in the background. You used to do clinical psychology, I think?
Dr. Sandi:
Yes. Where I started is not where I am ending up. I started back in the very early ‘70s in education. I was in special education, and I spent some time training teachers for how they can work with children. We talked about children with special needs at the time, learning disabilities, behavior disorders.
That led to an interest in stress management. I was doing workshops for parents, teachers, kids. I did relaxation tapes. I taught kids how to get a calm, quiet state.
As a result, I went back and got my doctorate in clinical psychology. For close to 35 years, I was a psychologist. I was kind of a renegade psychologist. Mind/body medicine did not have a name at that time, but I was teaching people breathing techniques. We didn’t call it “breathwork” back then.
The approach that I used was integrating all of these ways of thriving: cognitive behavior therapy, which is where you identify thoughts that are irrational and change those; mind/body medicine; relaxation strategies; and working with people with physical conditions, like migraine headaches, for example.
Then I learned about the Institute for Functional Medicine. I went through their training program. I was in the first class to get certified. I was the only psychologist. Now there might be a few more of us. It was really eye-opening to learn about functional medicine. I was putting those principles together with the principles from positive psychology, mind/body medicine, cognitive therapy, principles that I knew were so effective in working with my clients as a psychologist.
I was encouraged to start to train people who were health coaches. There were coaches coming to me. They had trained in other programs. They said, “We just don’t feel confident as health coaches.” I had a co-founder, and we approached the Institute for Functional Medicine. They thought it was a great idea. They had wanted to have a school to train health coaches for some time. The right people didn’t come along.
Together with IFM, we built the Functional Medicine Coaching Academy. That’s my mission, my passion today: training as many people as possible of all ages all around the world because we really need health coaches to help people live happier, healthier lives.
Dr. Eric:
I agree. Before we get into that, you said you were the first class for the IFM CP. What year was that?
Dr. Sandi:
That was back in 2013, a little more than 10 years ago now.
Dr. Eric:
We have a few things in common. First of all, many listening to this probably don’t know this, but I actually got my bachelor’s in psychology. Then I switched to chiropractic. Long story, but I went to Queens College in NYC, got my bachelor’s in psychology, then decided to change careers. I also eventually went through the IFM certification. It was three years later, 2016. That was eight years ago now.
I definitely agree that health coaches play a key role. They help combat chronic diseases, including thyroid conditions, which is what this podcast focuses on, helping people with hyperthyroidism and Hashimoto’s. As you know, I started using health coaches. I didn’t tell you how long, but it’s been about 5-6 years since I started using them. They not only help to fill in the gaps, but they also help to free up more time, which allows me to see more people and help more people with thyroid and autoimmune thyroid conditions.
Let me have you take over. Why is there such a dire need for health coaches?
Dr. Sandi:
Today, people are suffering like never before. We are seeing skyrocketing rates of metabolic conditions. It’s been estimated that only 7% of adult Americans are considered metabolically healthy. So many people have chronic conditions. We are talking about type 2 diabetes. We are talking about the rise in neurodegenerative conditions, dementia, Parkinson’s, which is just off the charts, like we have never seen before.
We are also seeing our children affected. When I was in special education, back in the early ‘70s, it was considered very rare to have a child with autism. In fact, I supervise student teachers, and for an entire county, this was the northern suburbs of Illinois, there was only one class for children with autism, where they would pull them out of the regular classroom. There were so few children. We are talking about the incidence being extremely rare. Now, it’s very common.
We are also looking at skyrocketing rates of anxiety and depression. Unfortunately, there is a huge shortage, particularly mental health professionals. That is where coaches can really step in. They are not psychotherapists; they are not psychologists. They do not diagnose any medical or psychiatric conditions. They don’t do psychotherapy. They help people with emotional wellness, with regulation of their emotions, and be listeners. First and foremost, that’s what health coaches are trained to do. That’s what they are the experts in: listening.
When you feel heard and understood, and you have that relationship with your coach, that alone can be very healing. You end up leaving that conversation feeling better. When you combine what coaches can do in terms of encouraging you and guiding you for behavioral change and changing habits, like perhaps, you are moving more throughout the day, going out and taking walks, that is a great antidepressant, for example. There are so many reasons that health coaches are needed now.
We also have a doctor shortage. Good luck trying to find a new primary care doctor. My thing is health coaches are the new primary care. Why do I say that? It’s because lifestyle should be first. That is the first line before you consider anything else. What about someone’s day-to-day habits? What kinds of foods are they eating? How are they moving throughout the day? What’s their sleep like? Their stress level? Their relationships? Those are the areas that health coaches can address.
Dr. Eric:
Just to confirm, I know you’re not saying that health coaches are going to replace one’s primary care doctor. I agree with you. We want to focus on diet and lifestyle. Typically, when you go to a PCP, many times, they will just give a prescription. There is a time and place for that, but for many people, arguably, everybody needs to eat well. They want to be active. Mind/body medicine, which you’ll talk about, is important. I don’t know of any PCP who will sit down with you and talk about mind/body medicine, let alone eating a healthy diet. There are some functional medicine doctors who practice primary medicine and I’m sure do that. On average, you’re not going to expect that when you go to a PCP.
Especially if someone is going to have to wait three months, four months, six months, during that time, if you do need to see a medical doctor, go to the ER if it’s an emergency. But if you are waiting to get a physical, why not see a health coach? We will talk about what they can’t do specifically, but as far as listening to you, giving you encouragement, maybe reviewing what you’re doing from a dietary and stress management perspective. Help to hold you accountable. I don’t know if you want to further expand on what they can do, but I definitely want to talk about what differentiates a health coach from a medical doctor or other practitioners.
Dr. Sandi:
Absolutely. We refer to this as their scope of practice. At the present time, health coaches do not hold state licenses. They are not licensed medical providers. That’s why they don’t keep medical records.
They are not the ones who provide a diagnosis. A health coach is not going to diagnose you with hypothyroidism. They are also not going to have a treatment plan for you. They are not going to prescribe medication, or even things like supplements. They do not write out a meal plan.
There is a but here. Many health coaches do hold those licenses. We actually have medical doctors who train with us. If they have that license, if they are a nurse practitioner or a registered dietician in addition to being a health coach, that would be different.
Health coaches, unless they hold that license to practice medicine for example, do not order labs. They do not interpret labs. They are the educators. That’s a very important role. Somebody might get a lab result back. Increasingly, we are seeing people going to direct to consumer lab companies. They are getting assessments and results. The health coach doesn’t say, “Based on this, you have a Vitamin D deficiency.” “Looks like you are type 2 diabetic.” They are providing the education about what each test means. “Here’s your hemoglobin A1C. This is what this test measures. What are your thoughts about this?” You might see changes, like it was at 1 a year ago, and now it’s at this point. A health coach asks the right questions. “What are your thoughts about it?” That leads to how can we work together to change some of the behaviors that might be driving these lab results? That’s where the health coaches intervene.
There are programs that say, and you might see this advertised, “Become a health coach in three months. You can order labs!” That is not true. You can do that, but it is out of your scope of practice. You didn’t go to medical school to learn about the rare medical conditions that you might not be able to pick up.
What we do is look at all of the things that a health coach can do and not get into those territories that are out of their scope. The value is in collaboration, which you referred to earlier. Our health coaches are collaborating with the medical doctors. They might have clients, and they might have a consult with a medical doctor who is the expert in ordering and interpreting those labs for example.
Dr. Eric:
That’s exactly how it works in our practice with the health coaches. They don’t actually order labs or give recommendations when it comes to supplements or even diet. Initially, I consult with the coaches when it comes to each of the patients. The patient has a pretty good idea of what diet to follow after that initial consultation with me. The health coach may review the recommendations. Same thing with supplements. The recommendation for supplements comes from me; the lab orders come from me.
I agree. I know there are coaches out there who are doing those things. You’re saying that they shouldn’t be doing them. If they are just a health coach, and they are working on their own and recommending labs and supplements, that is out of their scope of practice.
Dr. Sandi:
Correct.
Dr. Eric:
You mentioned asking the right questions, so that’s important. Being a good listener is important. Those are some good, important qualities of a health coach.
You mentioned also the duration. You gave an example of if someone just went through a three-month coaching program and ordered labs. Forget about the ordering of labs. Let’s talk about the duration. There are different lengths of programs. Three months is on the shorter side. I don’t know if there are any real certifications that offer it that quickly. I’d be a little bit nervous about seeing someone who just went through that, unless if they were trained also by a doctor. Let’s talk about the program from IFM. I think it’s a 12-month program, right?
Dr. Sandi:
Yes. Our program is 12 months. The reason is because human lives are at stake here. In order to have the skills, in order to have exposure to all of the nuances that have to do with when you have an encounter with another individual, it takes time to feel confident and also to learn things like motivational interviewing, like appreciative inquiry.
Let me backtrack. Health coaching came from life coaching. Think of it like a spinoff from life coaching. Where did life coaching come from? That came from psychotherapy. Specifically humanistic psychotherapy, which was very big when I trained in the late ‘70s/early ‘80s.
It was Carl Rogers, for example, gestalt therapy. This notion of client-centered, where you as the therapist are not in the driver’s seat. You are not telling that person what to do or what’s wrong with them. You are listening. The conversation goes in whatever direction that client wants to go. You have an unconditional positive regard for that individual.
Where does this become problematic in health coaching, with a health coach who does not have that kind of rigorous training such as what we provide? Maybe they went to a course for three or four months and learned from an expert in many coaching programs that are established there. There is an orientation. Everybody should be paleo or keto or whatever their orientation might be. As a coach, what’s going to happen is you’re going to come out of that program, “I’m a vegan.” “I’m paleo, and everybody should be. That’s the healthiest way to go.”
Now, you are taking your belief system, whatever that might be, and even on an unconscious level, you are communicating that. This Is what the client should be doing. That’s not unconditional positive regard. That’s not client centered.
Health coaching, following this humanistic approach from psychotherapy, means that you are sitting with that individual. For that encounter, you are so mindful. That is your whole world. You are asking the right questions, so that client has that aha moment. “Yeah, what I am eating or not eating, maybe that is impacting how I’m feeling in my energy level, so I think I will give this a try.” But they come to that conclusion. It’s not the health coach telling them.
They can be the educators. They can give their opinion, but only if that client wants it. It’s never forced on them.
Dr. Eric:
That makes sense. The timing of this question is good because I just came out with a book called The Hyperthyroid Healing Diet. Despite the name of the book, it’s not just one single diet. There’s three different diets. One of them is similar to an autoimmune protocol. Another one is similar to a standard paleo diet. Let’s say if the health coach is going over these diets, they wouldn’t say, “You have Graves’ or Hashimoto’s. You should follow an autoimmune protocol.” Rather, they should say, “These are the options. Many of our patients may be following autoimmune protocol, but some of them follow these other diets. Ultimately, it’s up to you to make the decision.” Would that be accurate?
Dr. Sandi:
Absolutely. It would be, “Here are the diet plans.” You are giving those because they are created by you, Dr. Eric, the expert. Then you encourage the client to be the detective, or possibly to go back and think about in the past: When did you feel best? If you eat these particular foods, what happened in the past? How did you feel the next day? They might have some insights into that. Or they might say, “I never did well, or I could never stick with a food plan that had this food.” “I don’t like the taste of it.” They will arrive at that decision.
Also, more importantly, they are going to arrive at where they want to start. A perfect example is the elimination diet. This was a diet that was developed by the Institute for Functional Medicine, and our coaches are trained in how to guide people through it. You eliminate for 3-4 weeks those foods that are likely to trigger a reaction. It can be challenging because you’re asked to give up coffee and chocolate and so many foods and beverages that you may depend on.
We actually did a randomized control trial with IFM. It was published in the peer review journal Medicine. This was for medical professionals going through IFM’s initial training course. They were asked, it was volunteer, to try the elimination diet. If they were going to be teaching it to be recommending to their patients, it would help to have that personal experience. It was hard for them. “How could I give up my coffee?”
We paired our graduates for five sessions of coaching. The group that got the coaching, the compliance went up. The waiting room control group that just got the PDF guides to the elimination diet did not do as well in terms of their compliance. It does increase compliance.
With that individual, be in the driver’s seat. What does that mean? They might tell you, “This is when I’m ready to start. I’m not ready to start.” Or, “This is what I can do.” Perhaps, it’s starting very small, and the coach will ask, “How can I help you?” Often, it’s accountability. “We will chat again next week, and I will ask you how that went, giving up your coffee.” Or maybe it was, “I am going to do half decaf.” That was what they could tolerate.
It’s always listening to the client. Where do they want to start? When do they want to start? What are going to be the potential obstacles? How can I support you?
Dr. Eric:
Great points. Everybody is in a different place. Some people might be used to eating fast food every day, and they may not be ready to start a strict elimination diet. People work with me all the time, and they have already done it on their own. They have made a lot of dietary changes. It does depend on the person. Some people may be ready to do it, except for coffee. Or maybe the dark chocolate. Usually, it’s coffee, if anything that they don’t want to give up. It might be, “Let’s compromise. Ultimately, it’s up to you.”
A health coach can’t say this. I guess I could say, “This is the diet I want you to follow.” Even if I say this, it’s up to the person ultimately. I won’t follow them around their home. Ultimately, it is the person.
If I say my preference is for someone to follow an autoimmune protocol or a paleo diet, then that is part of the health history, too. Usually, the person will say, “I don’t know if I can give up my coffee.” Then we might have a conversation.
Honestly, them and the health coach, that’s where they get into a deeper conversation with that. That’s usually what I have the health coaches talk about. Sometimes, they will bring it up to me. “Do I have to give up coffee? Do I have to give up gluten?” I will give them my opinion but also say they could talk to the health coach about that.
What you said, I completely agree with.
Dr. Sandi:
Nine times out of ten, it’s what you don’t want to give up, what you’re resisting, that is probably doing you in. If they say, “I can’t give up bread,” that’s probably the culprit. Same with coffee. Maybe now with people having Oura rings, they might notice, “Let’s do an experiment.” Could you go a couple days? What would happen to your sleep? Are you getting better sleep? They have that aha moment. “Oh my gosh, I did see that connection. I think I can do this now.”
Dr. Eric:
Excellent point. If someone is a little bit hesitant, “I can’t just give up coffee,” and they are drinking two or three cups, or the gluten, then you’re right. At least that is one of the things that they probably need to take a break from or eliminate. That’s an excellent point.
I wanted to talk to you about the different ways that health coaches are used. In my practice, a lot of it is one on one. There are group options, too. What do you see other practitioners do? Even maybe some health coaches who have their own practice. As far as seeing people one on one. How many sessions do they typically see on average? Is there a recommended number of sessions? How does it work for health coaches who help people in a group setting?
Dr. Sandi:
Sure. First of all, how they can work is multiple ways. It can be in person. They can come into the office. We even have some coaches who make home visits. They help with pantry makeovers for example or hands-on cooking, if they have that background.
Most of the time, it is now increasingly remote. Health coaches, because they are not licensed by the state, and they don’t have the regulations as many practitioners do only to work in the state or states where they hold a license to practice, as non-practitioners, they are not bound by that, so they might be in Illinois but seeing someone in California or any part of the world. That allows practitioners who have health coaches to expand their reach because their health coaches can practice out of the state, as their own medical license may have more restrictions.
They can be one on one. Increasingly, they can see people in groups. I love groups. We teach people how to do group coaching. In group coaching, the community is the healing element, the medicine. We feel like we’re not alone when we’re in a group. When we are with others, “If this person can change, I can, too.” There is that social modeling. The impact of going along because you are in the group with the group norms, so you’re more likely to change. It is a wonderful way of working.
There are a lot of practices that are insurance-based, and this is something that can be billed through insurance. There are ways the doctor or nurse practitioner can take people out of the group for breakout sessions, where they have that individual time, and they bill for that through the health insurance system. The coach is facilitating the group.
We have found the sweet spot for the number of sessions to be around 5-8 sessions. That’s enough time. Often, there is some check-ins. Again, because it’s client-centered, how do you want to check in? Some people will say text or email or a phone call. It’s highly variable how many sessions. The average tends to be around 5-8.
That depends on what’s going on. Depending on the chronic condition, etc. Sometimes, people may work on one issue, and when that’s resolved, they want to work on something else.
Dr. Eric:
I’m sure you’re familiar with HIPAA and patient privacy. That’s been a concern. I do group coaching calls. The way I do group coaching calls is they don’t interact with each other. I just finished a five-day challenge, which was not for patients, just the general public. Everybody was on Zoom, and we had a Facebook group. Everyone was interacting. They’re not patients of mine.
When I do a group call with patients, they’re not seeing each other or communicating because I’d have to have their permission to do that. Is it similar with health coaching, where you would have to get everybody who joins permission that it’s going to be in a group setting, and they will be interacting?
Dr. Sandi:
Yes. It’s usually best if you are a practitioner and want to run a group. You have that first session with somebody. It’s a private session to explain why coaching in a group is a good choice for them. You go over the rules of engagement. One of the most important rules is you are going to abide by HIPAA.
I should point out, because health coaches are not what’s called “covered entities,” they don’t hold medical records, so they are not legally bound by HIPAA. But they are ethically, morally bound. Through the National Board for Certification for Health Coaching, NBHWC, if you are a board certified health coach, you abide by the rules of that professional body. That includes abiding by confidentiality. You are not going to disclose anything that is revealed in your health coaching session. That’s a given.
When you have a group, what you would do, if you are leading a group, is go over the rules, just like a classroom. You want to speak in a courteous way. There would be no talking over somebody else. You want to be respectful of others’ opinions. These are the standard classroom rules.
A big rule is that what is heard in that setting stays in that room. However, because each individual who is in the group, you have no personal control over them. Somebody may go out and post something on social media. That’s very rare because what happens is the group, they become close with one another and honor bound. You would go through those rules every time that you start the group, just to remember that what we share stays in our group room. People do abide by that.
But it is not legally bound. Somebody who goes out and inadvertently discloses something, they are not legally bound. They are just private individuals; they are not medical practitioners violating HIPAA.
Dr. Eric:
Okay. Any other roles that you see health coaches play besides what you mentioned, one on one, either in person or remotely, or working in a group setting?
Dr. Sandi:
If you’re a primary care doctor, your health coach might be in the session/visit. They are the ones assuring that people understand what is recommended. They understand the diagnosis. Some practices use health coaches that way.
Increasingly, we are seeing health coaches being the patient advocate. If you are going through the conventional medical system, you may feel overwhelmed, especially people who are not technically/computer-savvy. They can’t just call up the old-fashioned way. Maybe they had a primary care doctor who they would just pick up the phone, the receptionist answers, you make an appointment. That’s old school.
Now you call, and it’s this huge medical conglomerate, and you are feeling lost in this system of talking to robots. It’s very stressful. A health coach can help you with that.
If you are a health coach and have your own business, they might help you with referrals to specialists, for example, finding a functional medicine doctor. If you are dissatisfied with the care you’re getting, suppose your medical team is in one of these huge hospital conglomerates. You feel you are given seven minutes, and they’re ignoring what you really wanted to discuss. A health coach can help you find that right practitioner, or they are the ones who are your primary contact. They can help you navigate this increasingly complex medical system, where you just feel like a number.
Dr. Eric:
A lot of different roles that health coaches can play. I want to talk with you a little bit about mind/body medicine. Before we do that, is there anything else that I should have asked you that I didn’t ask you about health coaching? Anything you have a burning desire to talk about that you didn’t talk about?
Dr. Sandi:
Well, I should say that if anybody is listening, and they are thinking, “Gee, I think I would like to be a health coach,” we need so many health coaches because of people getting sicker and sicker. This is a career. If you are a practitioner and learn health coaching skills, it brings meaning and purpose to your life.
You are personally transformed. We know that. Every session, it is client and coach who are personally transformed. It’s not like you are the teacher if you are the coach, and the client is the learner. You are both the learners. You’re learning that person’s story, and it’s also a personal transformation and a process.
Dr. Eric:
Toward the end is when I ask how people can find out more about you. I am going to ask you to do it now also. FunctionalMedicineCoaching.org is the website for people who are interested in learning more about becoming a health coach.
Dr. Sandi:
Yes.
Dr. Eric:
Wonderful. Mind/body medicine. What is your definition?
Dr. Sandi:
Well, this was a saying that I started to describe way back in the late ‘70s: What’s real in the mind is real in the body. That is mind/body. You can’t separate. Every thought, every emotion that you have is going to be inflammatory or anti-inflammatory. It goes to the cellular level.
That was just a wild hypothesis back then. Today, we have the advanced technology to show that that happens. It affects our microbiome. It affects our cellular functioning.
What you imagine, the power of imagery, the power of what you are experiencing and how you are defining your circumstances, goes so far in terms of your physical wellbeing. It’s remarkable how many ways that you can impact your physical health.
Dr. Eric:
A two-part question: What type of mind/body medicine techniques do you recommend? What do you personally incorporate?
Dr. Sandi:
It always starts with breathing. We hear a lot about breathwork. Sometimes, some of the strategies out there can actually be detrimental if you perhaps are prone to panic and anxiety. You can induce a panic attack if you are working some of the breathwork where you are hyperventilating.
The easiest, most effective way is to notice where your breath is coming from. Put your hand on your stomach. Put your hand on your chest. Are you initiating with the diaphragm, where you push your stomach out, the slow belly breathing? James Gordon talks about it, a soft belly breathing. You become aware of where you’re breathing from.
Then you become aware of how fast you’re breathing. Is it very fast or slow? I have taught this to thousands of patients as a health psychologist.
Then it’s using imagery. As you feel the breath, what images occur to you? Whatever direction your mind goes, that is what is at the moment. It can also be an image or sensation where you imagine the warmth of that breath.
Where does that lead? It leads to warmth in your heart. That is actually a heart math technique for better heart rate variability. As you take these slow, deep breaths through your belly, and as you exhale, you imagine they’re warm. That warmth is flowing through your heart. Now you’re sending a warmth through your heart out to all parts of your body.
I personally love a strategy which is again very old. I don’t see it very often, but it is autogenic phrases. This is in a nutshell self-programming. What does that mean? You repeat some things over to yourself, maybe 2-3 times. “My feet feel loose and relaxed. My hips and thighs are feeling loose and relaxed. My breathing is slow and regular. Warmth is flowing down my arms into my hands and fingers.” You keep repeating these. It can be whatever you think about, whatever areas need a bit of extra love.
I go through this. I might focus on my adrenal glands. I talk to them. Or I am talking to for example my digestive tract. Imagining all of the good bugs in the microbiome and giving them some love. That is the power of imagery.
Some people use external imagery, like imagining a beach, mountains, whatever appeals to them. This is so personalized. It’s not one size fits all.
There is progressive muscle relaxation, another very tried and true technique. It was developed in the ‘20s by Edmund Jacobson. You are taking each body part and squeezing and tightening as hard as you can. When you release, you release as much as you tightened.
I did that for kids. They loved it. They tighten up and squeeze. You’re holding your breath. Then you let go. These are very simple strategies that you can incorporate into your daily routine.
Dr. Eric:
I heard you mention heart math. Do you utilize heart math on your own or with clients?
Dr. Sandi:
Yes. I used to use it quite a bit. In fact, I trained back in the day when it was first established. You’re impacting heart rate variability, which is movements between each heartbeat. It has been highly correlated with a quieting response.
Dr. Eric:
I use the Inner Balance pretty regularly. The emWave for my computer. Not that you need to use both of them. One is sufficient.
Another two-part question. Do you utilize mind/body medicine every single day? Is it 3-4 days a week? When you do utilize it, how long is an average session? Is it spread out throughout the day, where you do it for five minutes, three times a day? Or a single session of 20-30 minutes, whatever technique you end up using?
Dr. Sandi:
I do it the same way I approach exercise, as snacks throughout the day. I might have a longer session as well. I was never one to meditate for 20 minutes a day, just sit there and see what comes. I am very full of zest and hyper, so that never worked. I need something more structured.
I might do a meditation walk for example. Or I take ballet class. That is a very meditative state as far as practicing relaxation techniques. Perhaps if I am out in the sun and feeling the warmth, that is going to lead to a few moments of going through this. If I am sitting in a sauna, I might go through that round of autogenic phrases.
Most importantly, it’s throughout the day. If something happened that was potentially stress-producing, like before recording this podcast, I always like to check, “Do I have the call-in?” I checked on my phone, and I didn’t see anything. It could have been that moment of stress, like, “Oh no, what if I don’t have the link, and I’m late to getting on for this interview?” Luckily, I found it on my computer, so it was all good.
That is where I said to myself, which comes through cognitive behavioral therapy. I consider those relaxation strategies as well, “So what if I don’t have the link? I have Eric’s email. I’ll get it.” Or, “Okay, what if I can’t get ahold of him? What if I’m late? What is the worst thing that can happen then?”
Often, you take it to the nth degree. Is this worth dying over? At my age, I’m 74. I hear almost every day my contemporaries who have passed away. Really, it’s that perspective that is also very important to practice. “Will this matter in five years, 10 years? Will I remember this?” We tend to upset ourselves and get into that stress response over things that are relatively trivial in the long run.
I wear a CGM. For me, what causes those blood sugar spikes is not the foods I am eating as much because I eat a really healthy diet, but it is those variations in terms of potential stress that is going on.
Dr. Eric:
I am glad you said that about spreading it out throughout the day. I think some people get the impression that you have to do it 20 minutes. Just like some people exercise. When I exercise, it is all at once. I try to move throughout the day, but if I am doing weightlifting, it is usually blocking out whatever time, an hour, to do the weight lifting. It’s not spread out throughout the day. Some people think it has to be the same with mind/body medicine, that you have to have larger chunks.
What I encourage people to do is get into the routine. If you are not doing it, just start with five minutes. Don’t try to do 15-20 minutes at a time. It will be more difficult. I’ll start that routine to begin with, and some people stay there. It’s really about getting started.
I’m glad you didn’t say people should be doing 20-30 minutes a day consecutively. Some people, it’s fine if they do that. If some people are already doing that, there is not one way that everybody should do it. It’s different.
I’m glad you gave your perspective that someone can do smaller chunks, 5-10 minutes, multiple times per day. That can just be as effective as blocking out 20-30 minutes to incorporate mind/body medicine.
Dr. Sandi:
I used to teach people to take 30 seconds, a minute in between emails. You set a timer. Or the times when you most need it, let’s say you’re in an airport and waiting for your luggage to come off the carousel. Instead of checking your phone, do some shoulder rolls and breathe at the same time to let go of tension. It’s often when you most need it that you can just do this quick relaxation response.
Dr. Eric:
I agree. Thank you for sharing. Anything else on mind/body medicine before we wrap this up?
Dr. Sandi:
It is the most powerful tool. It is really something that you have within you because your mind and body are always interacting, but they may be producing a stress response. They can be turned around to produce a profound healing, relaxation response.
Dr. Eric:
I agree. Going back also to what you said about the CGM, you notice more the stressors than the diet because you’re eating a pretty clean diet. But the stress also can affect blood sugar, adrenals. I’m glad you mentioned that.
This was an amazing conversation on both health coaching as well as mind/body medicine. As far as people finding out about you, I’ll let you take over. Your website or anything else you’d like to drive the listeners to, feel free to share.
Dr. Sandi:
FunctionalMedicineCoaching.org is the website. If you’re on Instagram, my personal is @DrSandi. @FunctionalMedCoach is our main Instagram site. Those are the main places that you can reach us. We’re also on Facebook, Functional Medicine Coaching Academy.
Dr. Eric:
Thanks again, Dr. Sandi. I really enjoyed this conversation. I learned some things, and I’m sure the listeners did as well.
Dr. Sandi:
Thank you so much.
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