#1887 Take Your Hands Off It: The Feelings

Summary

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Juicebox Podcast: Type 1 Diabetes

Episode #1887 — Take Your Hands Off It: The Feelings
Host: Scott Benner
Guest: Erica (mental health professional and long-time person with type 1 diabetes)
Date: June 26, 2026

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Episode Overview

This episode is a candid, deeply insightful conversation between host Scott Benner and returning guest Erica about the psychological realities of living with diabetes—specifically, the emotional barriers that arise even after getting the practical aspects ("settings," as they call them) under control. It’s a companion to a previous episode with Jenny, which focused on actionable management tactics. This conversation dives into the feelings that persist even when the “nuts and bolts” work, exploring trust, fear, identity, and self-compassion.

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Key Discussion Points & Insights

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1. The Trust Problem: Why Is It Hard to Let Go?

(Starts around [03:38])

• Scott summarizes Jenny's prior points: Reducing diabetes overwhelm often comes down to better technology settings, timing, and less micromanagement. Despite having good settings, people struggle to step back:

  “When we finally get their settings in a good place, why is it that some people might find it hard to step back and how can we help them do that?” — Scott [04:52]

• Erica’s response:
  • Trust takes time and repeated, positive experience.
  • Fear can be rooted in both prior bad outcomes AND the simple newness of letting go.
  • Practicing patience and self-compassion is necessary, especially when a day’s result is unexpectedly off:

    “It’s staying present-minded... practicing patience with yourself, practicing self compassion... it’s not about you, it’s not about the settings, it’s about, ‘Wow, today didn’t work out the same way. But I do know that yesterday and the day before the settings worked.’” — Erica [09:12–09:40]

• Scott’s metaphor:
  • Good settings are like a tennis ball moving in space—if nothing bumps it, it keeps going. But life constantly “bumps” diabetes, so don’t be the one causing extra bumps through over-management.
  • The challenge is not becoming your own worst enemy by “batting” at the ball unnecessarily.

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2. Psychological Flexibility & Thought Diffusion

([12:02]–[16:18])

• Erica introduces “psychological flexibility”:
  • Instead of fusing with every fear or momentary outcome, notice and name your emotions without letting them dictate action.
  • Values-driven action: Act from your why (family, freedom, health), not from anxiety or exhaustion.
  • Memorable quote:

    “Because you’re taking that pause, you’re separating yourself from the feeling. You’re then able to make a choice based on... your value... not out of fear, exhaustion, stress.” — Erica [15:48]

• Self-compassion:
  • Separating from judgment reduces the “emotional load,” enabling momentum towards what actually matters.

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3. Am I Being Attentive or Hypervigilant?

([19:13]–[22:16])

• How do you know if you’re helping or helicoptering?

  • Erica: Notice if diabetes management impairs daily life or is driven by fear.
  • Hypervigilance triggers constant “threat mode”—which is damaging both mentally and physically.
  • Notable quotes:

    “If you’re the person living with it, you’re battling those cortisol dumps all of the time. Because even if... your blood sugar is in range, but you’re in that hypervigilant anticipatory state, your body is operating as if you are in a threat.” — Erica [20:28] “Anticipating a threat for your body and actually being threatened is the same thing.” — Scott [21:13]

• Scott’s anecdote:

  • His wife once pointed out his negative body language—like muttering under his breath at the CGM—which affected everyone.

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4. The Threat Response & Living on Edge

([24:37]–[28:22])

• Anxiety is hard-wired, even when rationally unjustified.
  • Diabetes can feel like a perpetual horror movie: always waiting for the next “jump scare.”
  • Key insight:

    “Diabetes is like a horror movie director who knows exactly how to make you like, put you to the edge of their seat... your own body can betray you... your mind may not be a reliable witness.” — Scott [29:06]

  • When you measure self-worth by BG numbers, intervals of waiting are emotionally fraught—will I feel good about myself or “crappy” in five minutes? — Erica [27:53]

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5. Why Is It so Hard to Wait? (Pre-bolusing, Intervening, or Not Intervening)

([31:11]–[42:06])

• Remembering and “choosing” to pre-bolus:

  • Sometimes folks simply forget; sometimes it’s resistance—diabetes shouldn’t get to dictate.
  • Adolescents often want to “fit in” and not feel different; sometimes, refusing to wait becomes a statement of agency or rebellion.
  • Scott: “If dinner was falling into a volcano... three times a day... I guarantee you’d figure out how to do that. So why is it so hard?” [32:02]
  • Erica: Habit formation is a factor, but emotional resistance is too—“You don’t want diabetes to interrupt the enjoyment, flow, pleasure of life.” [32:17]

• The “fight” with diabetes:

  • Deliberate or unconscious battle against the disease can lead to avoidance or even self-sabotage.
  • Scott wonders: “Is it almost like, like fighting with a parent?... there’s something indulgent about the fight.” [37:18]
  • Erica: “If you hate your diabetes, if you are in kind of a resentful relationship with it, then of course you don’t want to think about it.” [36:32]

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6. Emotional Exhaustion as a Habit

([43:21]–[47:24])

• Even when “it’s working,” many people feel stuck waiting for the next problem.
  • Erica: The nervous system, after years of high-alert, becomes conditioned to expect crisis.
  • Brene Brown’s “foreboding joy”: Some struggle to accept periods of calm, always bracing for the “shoe to drop.”
  • Scott’s anecdote: His wife is almost more comfortable in a crisis, mirroring how diabetes caregivers or patients may find security in stress.

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7. Hypervigilance and Identity

([48:54]–[54:32])

• What happens when “control” becomes your job or identity?
  • Hypervigilance can become a “role” for caregivers, particularly after withdrawing from work to focus on diabetes.
  • Letting go can create crisis of meaning—“If I’m not constantly vigilant, who am I?”

  “What happens when someone takes it [that job] away from you? ... I felt like I didn’t have a lot of purpose outside of my job for a little bit.” — Scott [48:54]

• Letting go means confronting beliefs about worthiness and blame.

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8. Emotional Markers of Success

([55:24]–[57:47])

• Jenny’s “practical” measure: Gentle rolling hills (stable CGM traces), fewer interventions, fewer surprises.
• Erica’s “emotional” corollary:
  • Gentle, emotional rolling hills; less volatility.
  • Noticing, allowing—rather than suppressing or over-drama—when peaks/valleys arise.
  • Letting go of perfectionism is key.

  “When you’re living in a hyperarousal state, everything is going to feel like an attack and a surprise... so when you’re getting the settings right, how do you let go?... It might take a lot of interpersonal work... but noticing what you’re attaching to the peaks and valleys when they do happen.” — Erica [56:10–57:47]

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9. Self-Compassion and Takeaways

([60:42]–[65:28])

• Practicing self-compassion is both an emotional and biological tool:
  • Research shows those who practice it have lower A1Cs and less distress.

  “Just even noticing if that’s your narrative... self-compassion isn’t just a kind, nice thing to do. It actually helps you biologically to reduce those stress levels and those cortisol levels.” — Erica [62:44]

• Start with one thing: If all feels overwhelming, pick a single actionable step rather than “everything at once.”
• Scott’s closing encouragement:
  • Mastery comes over time, not instantly.
  • Experience (“time in the simulator”) enables calm confidence when reading a CGM trace.
  • For practical help, use the podcast’s Pro Tip Series or resources at juiceboxpodcast.com.

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Memorable Quotes

“If you can at all help it, you shouldn’t be also one of those things [that bump diabetes off-course] by touching knobs and doing stuff that, you know, isn’t kind of valuable.” — Scott [11:01]

“When you feel like the thought is so strong... like the thought is fused to our bodies... when we’re practicing psychological flexibility... you’re noticing what is the feeling? Am I feeling shame? Am I feeling fear?... We’re not saying ignore them. But you’re noticing. Okay. I’m feeling frustrated, I’m feeling shame... But you’re not using [the feeling] as an informed decision maker.” — Erica [12:02–16:18]

“If you’re the person living with it, you’re battling those cortisol dumps all the time. Because even if your blood sugar is in range, if you’re hypervigilant, the body acts as if you’re under threat — your amygdala is firing, your cortisol is being dumped.” — Erica [20:28]

“I always felt like I was two bad decisions away from killing Ardyn, which is… I mean, listen, technically you could make the argument — but in reality, that wasn’t true.” — Scott [25:54]

“If you hate your diabetes... then of course you don’t want to think about it. But then you have to think about it on the backside.” — Erica [36:32]

“99%… the whole damn thing got me upset, I’ll tell you.” — Erica, on how much of diabetes is emotional rather than technical [40:53]

“If I’m not constantly vigilant, who am I?” — Scott, paraphrased summary [48:54]

“When you’re living in a hyperarousal state, everything is going to feel like an attack and a surprise... so when you’re getting the settings right, how do you let go?... It might take a lot of interpersonal work... but noticing what you’re attaching to the peaks and valleys when they do happen.” — Erica [56:10–57:47]

“Self-compassion isn’t just a kind, nice thing to do. It actually helps you biologically to reduce those stress levels and those cortisol levels.” — Erica [62:44]

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Timestamps for Key Segments

• 03:38 — Why is it hard to trust settings and let go?
• 12:02 — Psychological flexibility; noticing and naming feelings
• 19:09 — How do you know the difference between vigilant vs. hypervigilant?
• 24:37 — Living in a perpetual threat state
• 31:11 — Why is waiting (to eat, intervene) so emotionally hard?
• 43:21 — Can you be “addicted” to emotional exhaustion?
• 48:54 — When hypervigilance becomes part of your identity
• 55:24 — What does emotional success look like?
• 60:42 — Final words: self-compassion and taking things one step at a time

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Tone & Language

The conversation is warm, validating, collaborative, reflective, and peppered with laughter and realness. Both Scott and Erica openly share their experiences, stumbles, and small victories, offering both practical wisdom and deep empathy for anyone wrestling with the emotional grind of diabetes.

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Summary Takeaways

• Emotional responses—fear, frustration, shame—linger even with good diabetes practices.
• Learning to trust the process requires self-compassion, making space for feelings without letting them dictate your actions.
• Hypervigilance is natural, but unhealthy when it overtakes daily life or becomes identity.
• Recognizing “gentle rolling hills” in your emotional life is as meaningful as achieving it on your CGM.
• Start with “one thing,” and look for support, conversation, or self-reflection—not expecting instant mastery but knowing ease is possible.

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For listeners: The Juicebox Podcast's Pro Tip Series and mental health episodes offer further support on both the emotional and practical sides of diabetes management.

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Transcript

[A]

Here we are back together again, friends, for another episode of the Juice Box Podcast. Excellent, Erica. This is either, depending on how this works out, either the second part of a two part episode where Jenny and I were the first part, or nothing you hear on the Juice Box Podcast should be considered advice, medical or otherwise. Always consult a physician before making any changes to your healthcare plan. I know that Facebook has a bad reputation, but please give the private Facebook group for the Juicebox podcast. It gets 150 new members a day, it is completely free, and at the very least you can watch other people talk about diabetes and everybody is welcome. Type one, type two, gestational loved ones. Everyone is welcome. Go up into the featured tab of the private Facebook group and there you'll see lists upon lists of all of the management series that are available to you for free in the Juice Box Podcast. The episode you're listening to is sponsored by usmed usmed.com juicebox or call 888-721-1514. You can get your diabetes testing supplies the same way we do from US Med, Erica. This is either, depending on how this works out, either the second part of a two part episode where Jenny and I were the first part, or it's going to be an interstitial where I, the listeners are hearing Jenny and then hearing you and back and forth. We'll see how it goes. But how are you? Good.

[B]

I'm well. And I like the use of the inner interstitial. Yeah, interstitial.

[A]

I think that's a tele. Is that another television or a movie term? Isn't it?

[B]

I. I immediately thought of interstitial fluid.

[A]

Oh, interstitial fluid.

[B]

Interstitial fluid.

[A]

I think interstitial in movie making means. Am I wrong? Is this how we're starting? This is ridiculous. This is. Even when you ask like a mo. Like if you should I admit to this. Um, I sometimes feed my transcripts and ask it what good questions I asked and what bad questions I asked and how many of my questions led to good answers and like that kind of thing. And it says that sometimes I go on tangents too long and I argued with it. I was like, I don't think I do so well.

[B]

Yeah, you said, you said inner. Did you say interstitial?

[A]

I thought I said interstitials because I think that's interstitial.

[B]

And I thought of interstitial fluid, which is what we talk about in, you know, diabetes world.

[A]

Here it is. In movie making, interstitial usually means a short piece of material placed between larger Sections of film showing episodic or programs, think connective tissue. I think I was pretty close to being right. You are.

[B]

You were.

[A]

I explained to my children recently, and they're like, you don't know what all the words mean that you use. And I was like, I know enough of what they mean, thank you.

[B]

Yeah, I wasn't questioning the use of the word. I just. That's. I thought of.

[A]

Oh, the other word immediately. Immediately as you spoke, I thought I was probably wrong. So anyway, sorry. No sorry at all. This is awesome. So Jenny and I spent about an hour, you know, going through ways to reduce the practical load of diabetes. Right. And Jenny kind of hit on some things over and over again. Better settings, better timing, less interaction. Like, less fiddling with things, less chasing less. But the reason I wanted to talk to you about it in the. In the same conversation, different light, is because it occurred to me that somebody has something that's in their way. A speed bump or something. Even if a person like Jenny comes in and says, hey, this might be the fix to that problem, I notice when I'm talking to people, there's always a. Yeah, but. Yeah, but. You know what I mean. You know, if you say to somebody, hey, set some alarms, for example, on your cgm, and if it's not alarming, don't look at it. And they go, well, that sounds nice, but. And I thought we would maybe walk through the things that Jenny had spoken about and see if we can find ways to make them feel more comfortable on the. The psychological side of it. Sounds good.

[B]

Yes, I like it.

[A]

So first thing Jenny said was, how do we remove, you know, the overwhelm? And it would be a lot about getting your settings right. So she talked about people in the diabetes community touching things constantly because they don't trust what they're seeing. Um, but what I'm gonna ask you is that when we finally get their settings in a good place, why is it that some people might find it hard to step back and how can we help them do that? Diabetes comes with a lot of things to remember, so it's nice when someone takes something off of your plate. US Med has done that for us. When it's time for Arden supplies to be refreshed, we get an email. Rolls up, and in your inbox says, hi, Arden, this is your friendly reorder email from usmed. You open up the email, it's a big button that says, click here to reorder and you're done. Finally, somebody taking away a responsibility instead of adding one usmed has done that for us. An email arrives, we click on a link, and the next thing you know, your products are at the front door. That simple. Usmed.com juicebox or call 888-721-1514. I never have to wonder if Arden has enough supplies. I click on one link, I open up a box, I put this stuff in the drawer, and we're done. UsMed carries everything from insulin pumps and diabetes testing supplies to the latest CGMs like the Libre 3 and the Dexcom G7. They accept Medicare nationwide, over 800 private insurers. And all you have to do to get started is call 888-721-1514 or go to my link usmed.com juicebox using that number or my link helps to support the production of the juice box podcast.

[B]

Yes. So, and what, what we're talking about is, I guess, trusting, right? Trusting the settings. Why does it feel challenging to trust the settings initially? Or, I mean, I think there's, there's a time issue, right? Like it, it takes time to build the trust that the basals of correction factors, et cetera, are actually going to work out repeatedly work out, like over, you know, mass experience to reset that fear that it's not.

[A]

Do you think the fear comes from initial miss? Like, I guess it could come asking you is the wrong way. I guess it could come from it being wrong and them having outcomes that aren't desired, or it could just come from being new at something and just being afraid of it because it's new and they don't understand it. So the question is, is that once those things get hammered out, whether it's time in the simulator or better, more repeatable outcomes, a lot of people still find it difficult to just go, okay, good and trust it and walk away. I guess what I'm asking from you is how do you think they could maybe accomplish that?

[B]

So in improving trust, I think connects to reducing the fear and that there's a lot of ways to do that. I think stepping back and noticing, okay,

[A]

why

[B]

they really kind of go hand in hand, right? Like every moment, every meal, every day that you feel like, wow, okay, I, I bolist I. It did what I wanted it to do. That worked out great. But we also know that if it worked out, the settings were great and worked out well one day, it might not work out the same way the next day. So I think it's in those moments, how do you trust that the settings are still accurate enough?

[A]

Okay.

[B]

And I think there's There's a space of trying to stay really present there. There's a moment where you can work on. One can work on being present as opposed to. Which is also really hard to do. I was gonna say in the nature of diabetes.

[A]

Yeah, but what does that look like?

[B]

So, so in the moment you're saying, okay, wow, I thought the settings, I thought I had the settings. And I'm working on building trust and not touching diabetes, as you and Jenny kind of talked about it. Right. I'm not trying to overcorrect. I don't want to, you know, I'm going to try and trust the algorithm, I'm going to trust what my settings are, even though today it didn't work out as well as it did yesterday. And I think in that space, choosing to practice some, there's so many layers and so many steps. So practicing patience with yourself, practicing patience and also self compassion, which I imagine we'll get into later, that it's not about you, it's not about the settings, it's about, wow, today didn't work out the same way. But I do know that yesterday and the day before the settings worked. So it's staying, staying present minded. I mean, there's, there's even a concept. Sorry, go ahead.

[A]

No, because you have to believe it. So it's my finding from doing it for so long that, yes, there can be other variables, right. That might bet that might blow this off course, but for the most part it goes this way. It goes the way, you know, when the settings are good, when your basil's right, when your carb ratio is good, when you're timing your meals well, you know, when you're doing all of that, there's not as much that's pushing you off course. So the thing I said to Jenny when we were interviewing was I kind of sometimes imagine like a tennis ball just pushed into space and that it's just going to go like, I don't know if everybody understands that, but if you move something through space, if nothing else touches it, it's just going to continue on in an exact straight line. Right. But eventually something, dust particles, a meteor, whatever, is going to bump something. It's going to move you around. And with diabetes, there are already enough things, like in your life, in your day, bumping around things, changing your blood sugars. What I was saying to Jenny was, is like, if you can at all help it, you shouldn't be also one of those things by touching knobs and doing stuff that, you know isn't kind of valuable. So once it's moving along and it's moving super smoothly, it's not reasonable to think, like you just said, that it's gonna do that forever. Maybe it'll do it for a day or two or a week, but eventually something's gonna happen again. But that doesn'. That the plan is bad. You know what I'm saying? Like, it doesn't mean the plan's bad. So how do you stay calm, centered, Keep yourself from becoming another one of those variables, batting at that tennis ball? Stop yourself from becoming your own worst enemy in that situation? I guess that makes sense.

[B]

Yes. There's a concept that we have talked about here and there over the various episodes called psychological flexibility. And it's from an acceptance and commitment therapy model. And we've talked about thought diffusion. When we feel like the thought is so strong that it's attached to us and I'm putting my hand over my face, like the thought is fused to our bodies. And when we're, when we're practicing psychological flexibility, which is very much connected to practicing resilience, is noticing you're staying in the present. You're noticing, wow, my blood sugar went higher or lower than I anticipated, even though I thought my settings were spot on or accurate. And so you're noticing, okay, what is the feeling that's coming up here? Am I feeling shame? Am I feeling fear? Am I feeling discouraged? Am I feeling like, oh, I don't even want to look at this anymore, you know, avoidance? Are you not. Are you feeling exhaustion because you've worked so hard to get the settings right and then you have this blip? So you're noticing those emotions. We're not saying, like, ignore them. We're not saying dismiss them. We're not saying push through. But you're noticing, okay, I'm feeling frustrated, I'm feeling shame. And I'm also not telling myself I shouldn't be feeling this way because my settings are good. Right? We're just like, you're noticing them and then you're, you're then having. Because you're taking that pause, you're separating yourself from the feeling. You're then able to make a choice based on, from the psychological flexibility emphasis. Like, what is your value? As opposed to fear, exhaustion, stress, burnout, shame is your.

[A]

So, yeah, explain the value idea to me. So is it okay, your value is. I'm going to, I'm, I'm going to choose to, to focus on the, the worry aspect or I'm going to choose to focus on the. Hey, most of the Time this goes well, there's probably nothing to change here. Just an anomaly. Is that the idea?

[B]

Sort of. So within. Within act, it's focused on your values, which is your. Why. Like what? Why are you showing up? Why are you even working on your settings? Why are you motivated to keep going? You know, is it. Is it family? Is it your health? Is it your job? Is it freedom? So it's your kind of bigger picture, and that might change, but kind of your. Your overarching value in life. So saying, okay, my, my. If your value is to show up for. For your family in a way like as best you can, in a good enough kind of way. So you're. You're noticing, okay, crashed my set, that my sugar, my butcher isn't where I wanted it to be. I thought I had my settings right. I'm feeling so discouraged or I'm feeling so disappointed or so frustrated. Okay, I'm gonna. I'm noticing I'm having that thought which also separates you from the thought that it's true. I'm noticing these thoughts. I'm gonna pause. I mean, we're getting into the weeds here of steps going back to you resetting your nervous system. We'll get into that as well, I imagine. And then saying, okay, I do know that it worked Monday, Tuesday, Wednesday for lunch today. I'm not sure why, or I do know why, but I'm not gonna react from the feeling. I'm just gonna notice the feeling. I'm just gonna continue on because I want to continue to show up for my family in a healthy way. So you're separating yourself from the judgment

[A]

and the feeling and the thought, and that helps you sort of just let go of it. And instead of putting. Putting it on yourself, you. But the recognizing it releases yourself from. It releases yourself. Is that about it?

[B]

It kind of. It reduces. Yeah, it reduces. Yeah, reduces the intensity of that emotion that you're experiencing in that moment. So you're noticing it, but you're not using it as an informed decision maker to say, I'm such a terrible person, I can't believe I messed up here and now I'm going to go in and change everything or throwing hands up in the air, I'm never going to get it. No. These are all things we may feel at various stages in our relationship with diabetes. But if we're speaking from the perspective that you feel like your settings have been proven to be as accurate as they can be in those moments, practicing the skill of noticing the thought or acknowledging the feeling without shame or Judgment and then saying, okay, well what am I really doing? What's the bigger picture? And moving from there, that kind of reduces some of that emotional load in that moment from this lens.

[A]

Okay, now I listen. There's, I, I want everybody to know who's listening, that I just, I threw these two things at Jenny and Erica and I told them we're going to just have like flowing conversations to try to pick our way through it because I, I think it's sort of silly to just say, oh, when this happens, do that and everything will be fine. I think you need to hear people with diabetes and you and Jenny are in a specifically unique position. I mentioned this with Hari. Both of you have had type one for over like 35 years and you're professionally attached to, you know, diabetes in different ways. You with therapy, her with, you know, coaching people. And I just think it's interesting to hear you talk through it. It doesn't have to be super smooth or sound like a sound bite. I think it's just interesting for people to listen to a conversation like that. I, I've got my hands in this too much. I'm messing everything up. The settings are all over the place. Every time something happens, I, I feel badly, I react, I do something, I'm trying to fix it, I'm probably making it worse, then that compounds on itself. Then on the other side I feel like I'm failing, et cetera, blah, blah, blah. I finally find someone to help me put my settings into, into, into practice. How do I keep my hands off it after that and just let it play out for a little bit to see if what I did is actually going to be valuable or if there are adjustments to be made. And what I noticed from talking to people is, and, and Jenny said the same thing, is that often people have trouble keeping their hands off it long enough to find out what's happening. So I appreciate it. My follow up to that would be how do you, how can someone tell the difference between them paying attention to something and that they're being hyper vigilant or helicoptering? Can you do other ways for them to see the difference? Because nobody who's being a helicopter caregiver or on their own self is thinking they're acting that way. They always, every time I talk to them, feel like they're completely justified in the way they're handling it. You know what I mean?

[B]

Yes. So the question is, can you say that again?

[A]

How do I tell what's reasonable and needed and over the top with my attention on this Stuff, I think noticing.

[B]

How is it impacting or impairing your daily functioning? Right.

[A]

Okay.

[B]

Noticing, paying attention, responding to alarms from a posture of calm and not threat. So if you are responding based on fear, fear, as we know, is a survival response mechanism. And so if you are operating from a place where you become hypervigilant, and this kind of connects to what we were talking about in the other series of agency and anxiety. Right. We want to know that when we do something, this next thing's gonna happen, but when it doesn't, that increases anxiety and often then increases that sense of hypervigilance. Well, maybe if I pay attention to it more, I'm gonna anticipate and I'm gonna do better. I'm gonna be a better manager of my diabetes. But what we know and research will validate this, that if you are operating and functioning from this hypervigilant state, your body is in that hyperarousal threat response state all of the time. So, a. If you're the person living with it, you're battling those cortisol dumps all of the time. Because even if you aren't, let's say even if you or your blood sugar is in range, but you're in that hypervigilant anticipatory state, your body is operating as if you are in a threat. Right. Like anticipating a threat for your body is.

[A]

And actually being threatened is the same.

[B]

Same thing.

[A]

Yeah.

[B]

Your body cannot differentiate. So your amygdala.

[A]

Right.

[B]

We talked about our brain. Your lid is flipped, your amygdala is firing, your cor. Cortisol is being dumped. And so you're fighting that within your blood sugar, just from a physiological perspective. And it's hard to make rational choices.

[A]

Yeah.

[B]

Right. Your. Your limbic system has gone off or your. Your prefrontal cortex has gone offline. So you are having a difficult time making rational thought, but it feels like you're being safer. You. You're trying to tell yourself, but I'm. I'm. I'm anticipating. I'm going to focus. I'm going to stare at the number, I'm going to course correct all of the time. But it's actually counterproductive to not only your body physically, but also emotionally, because you cannot think clearly. And you have all of these hormones that are interfering with the actual insulin absorption.

[A]

Yeah. And if you can't think your way through that, just look around you. And if the people around you are looking at you like, uh, oh, mommy's out of her mind, then just go, hey, maybe I'm acting a little crazy right now. But like, I, it, it's hard because I've interviewed, I've just recently interviewed a woman who has these, what she would have called overreactions to things and hyper vigilance when it wasn't necessary. And we talked through it. I'm like, that's not even needed. Like, and then she could intellectually say while we were talking, yeah, I know that that sounds like over the top. I said, why do you do it? She goes, I don't know. Like, I can't. Like, I can't. Even after we named it, she couldn't stop herself from it. So, I mean, there are so many, I'm just saying there are so many good reasons to find a way to overcome that. Because it's not good for you. I think it's bad for your short and long term health. And I also don't think that it creates a good ecosystem around the diabetes in general, especially if you're the caregiver for somebody and you're always hair on fire and while maybe your children are looking at you like, I'm just trying to live over here. And she's acting like, I'm dying every five seconds. Or he's acting, because I used to do it too. I used to. I, I've shared this a million times. My wife put me aside one day and she's like, you, you, every time you look at her blood sugar, you mutter under your breath like. And she's like, you have to stop doing that. She's like, it's, it's just, it's so negative all the time. And I never thought of it that way, you know, until somebody pointed it out.

[B]

Yes. So we're having awareness of what, what are you thinking? What is your body actually physically feeling when you look at the number? And I think that the shift, if we're, if we're kind of staying on the psychological flexibility track, holding space for like, okay, oh, that was fear, right? Like you, you muttered under your breath. That is fear, right? Or frustration. And so saying, okay, oh, fear's here. So instead of saying, oh, I shouldn't be, I shouldn't be fearful, I shouldn't be scared, I shouldn't be frustrated that, oh, fear is here, I'm going to notice it, I'm going to create some space from it and then just, even that quick little beat can help. You're acknowledging that you aren't being controlled by it.

[A]

Right.

[B]

I mean, this, is this going back to also cbt, right? Like, oh, there it Is it's there.

[A]

I see that. I'm afraid it's okay. Let's pause for a second. Nothing imminently bad as I don't want you to pause in the middle of an actual medical emergency. But like, yeah, because the diabetes really is, it's training you to expect a problem to come and then maybe at that point, you know, you become defensive. Jenny talked about it and in her bit, and then you're waiting for the next thing to go wrong and waiting for the impact of it. And then you're hyper vigilant before you even are, to be perfectly honest. It is really like, you ever walk into a situation where people have beef and you just like, everything's already on a nine and you're like, this is just simmering. This is gonna pop in two seconds. I think living with diabetes can feel like that sometimes. Like, what's about to happen? What's about to happen? What's about, Is it gonna kill her? Is it? That's how I would think all the time. Like, I always felt like I was two bad decisions away from killing Ardyn, which is, I mean, listen, technically you could make the argument, but in, in a real, in a, in reality that wasn't true. Like, you know what I mean? Like we, we were not on death's door every five seconds. But it, I don't know if I was being dramatic or if it's how it felt to me. I don't think I was being dramatic. I think that is actually how I felt. And I do think over time, expecting a problem, having a problem arise, expecting it, having it arise, not being able to fix it. Because back then we didn't have any, like, I didn't have any data, like, I didn't have any CGM to look at or anything like that. It was hard not to live in a constant, like just a perpetual motion machine of like, it's about to happen, it's about to happen. It's you, you hear people all the time. Like, you know, back in the day, like, you see a, a low blood sugar overnight and you fix it and then you sit up and watch it for two hours long after, you know it's okay. And nowadays, like, if that were to happen to me, I'd look at it, see it go, I did the right thing again. I put my head back down again and if the alarm goes off again, it goes off again. But like, I, I, I would be comfortable enough to go back to sleep. And I know a lot of people won't feel that way in the beginning. So why does the absence of a problem, like why does the, the waiting create anxiety? Do you have any idea, Is there like a, a human reason around that?

[B]

Because it's unknown and, and anxiety wants to creep in and say, you better, well, you, you better anticipate, you better worry. Right. Like worry, you know, is when you feel like you. By worrying, we think we're, it's perceived kind of control, even though we don't know we're not actually controlling anything. But if we feel like, oh, if I just anticipate, if I worry, if I look, if I think then maybe the next outcome, the next reading, I'll feel better. I think we also maybe while we're in the waiting, if we've latched our sense, our value or worthiness to the number, we're waiting for either that positive dopamine hit of, oh, stuck the landing. We hear that all the time, right? Yeah, yeah, I nailed that bullet.

[A]

Yeah, I got it.

[B]

Yes.

[A]

I felt that way before for sure.

[B]

Yeah, sure. That is totally normal and natural. I feel that way too sometimes on a random meal that I don't eat and I'm like, oh, okay, guess, right, great, that's awesome. But if it's patterned behavior and the learned response to assign your worthiness to the number, then in that waiting period, it's hard. You're like, am I, am I going to feel good about myself or am I going to feel crappy about myself?

[A]

Yeah.

[B]

In these next few minutes, I just had my.

[A]

I just thought like, wow, diabetes is like, it's like a horror movie director who knows exactly how to make you like, put you to the edge of their seat. And while you were talking, I typed off to the side, I was trying to figure out, like, what are the human concerns that horror movies play off of? And it, I got back a couple of different hits. It said sometimes it's that something bigger, stronger, or hungrier than you exists, that your home, your body, or your beliefs are not safe, that someone has chosen you and reason will not save you. Your own body can betray you. Your mind may not be a reliable witness. Society is, is. Oh my God. Society is thinner, like being held together more, more delicately than we think of. The place that should protect you is contaminated. If all of those things don't somehow mimic diabetes. And that just popped up in my head while you were talking. I was like, that's, that's a hundred percent what it's like to live with diabetes either as a. All those things are there. Oh, isn't that interesting? And so then that's where that comes from. All right, so let's transition to the next thing that Jenny talked about. Then we were talking about pre bolusing. Cause this is going to fit right into this. Why is it so emotionally difficult to wait? So I brought up to Jenny, if, if I, if, if I, if I sat down at 7:30 at night, flipped on a baseball game, took a handful of pretzels with me, sat them on the table next to me. And I am one of those people who would not use a dish in that situation, in case you're wondering. And, and I sat those pretzels next to me on a table. And then you looked at me and said, scott, you have to wait 10 minutes before you eat those pretzels. I'd go, okay, now given away that in a situation where someone's low, they're going to be ultra hungry. That's not what I'm talking about. But when a person with type 1 diabetes is in that same exact situation and you say to them, hey, put your insulin in and wait 10 minutes and then you're going to have a far better outcome, et cetera. There are far greater people, more than I, than I would say opposite. Feel this way that it feels to me when I'm talking to them. I hope I'm, I want to be clear about this. It feels to me when I'm talking about them that they do not want diabetes to tell them what they have to do. Or I've now come to think of it even bigger now that we've done the body grief stuff that there's that feeling of like, well, my body should just do this. That's not right. It's not fair. I don't want it to be this way. But why do you think, and this really speak from your own personal, selfish. And here, why is it hard to do that? Like, I know it's difficult to remember to bolus before you eat, but in a scenario where the food is not an imminent thing that you have to attack. What's so hard about waiting? I just watched Erica disappear back into the 20 year old part of her brain.

[B]

I was like, okay, where.

[A]

You know what I mean? I know you know what I mean. But what do you think?

[B]

Yes. Okay, so there's the waiting, there's the remembering. We're not, we're not talking about remembering to pre bolus.

[A]

Right. Because different, that's a different problem.

[B]

That's a different thing because that, but that's also a very significant factor. Remembering and it becoming habit So I think, but I think it's important to know like because a lot of time it is. I forget. But then we wonder why do, why do I forget? Because it's not built in to the rhythm of the meal. It's not built into. It's just not become a habit. Right. So there's that component that is quite frequently.

[A]

Can I. Yeah, but right there. And we can go back and forth for a second.

[B]

Yes.

[A]

Yeah. But if dinner was falling into a volcano and it happened three times a day and there were three opportunities for you not to fall in the volcano, I guarantee you'd figure out how to do that. So why is it. So keep going.

[B]

Um, and I want to say. Oh, and I want to come back to. I don't, I don't know. I wish we. Hopefully someone will do a study on this because there are moments where there might be intention around choosing to not pre bolus or kind of intentionally forgetting. Right. Because you're caught up in the moment. You don't want to be different. I'm thinking of adolescents going to the corner store after school. You don't want to have everyone starting to eat. There are moments where you don't want diabetes to interrupt the enjoyment flow. Pleasure of life. I think that's, that's a category.

[A]

I'll share with you what Jenny said. She said I, I'm well beyond caring about this anymore. But she could remember sitting at a table and just looking at everybody and thinking, why can't you all just wait? I have to wait. And she talked about it as like socially wanting to eat while everybody else was eating. It's the part that like, like came to her when she was talking about. I find this, I have to tell you, I find this little slice of conversation worthy of its own 10 part series. Yes. Seriously, this, this spot right here. Like why, why can't I remember to pre bolus? Why can't I remember to put my thyroid pill in my mouth at night before I go to bed? Like these little things that from the external look very little that. But are clearly not to the person living through it. Right. And you know I, you know I use the idea of like falling into a volcano. But the truth is, is that if you were on a, I don't know if you were on a medication that you had to take three times a day or you were literally going to just shut off, you would do it, you'd set timers, you'd build your life around it if you had to. I know you don't want to Build your life around pre bolusing. But it has such a crazy positive impact on your present day and your future health. It is hard to like. It's hard for me when I watch Arden go, oh, I forgot. And then she just sort of keeps going. And I'm like, why does she not feel the weight of that? And I do. Like, when she doesn't pre bowl, I feel it like she's going to fall into a volcano. And I know she's not. Don't get me wrong. Like, for adults who are listening, I'm not out of my mind. I get it. Okay. I was like, but. But I feel that way. I'm like, oh, big miss here. It's going to ruin the next three hours of her life. And then two and a half hours later, if she's got a high blood sugar and she's like, dad, rub my head. I have a headache. Yeah. How hard it is not to go. Yeah, I know you do, because your blood sugar went up to 190 F. You ate. And like, I have to swallow it and live with it in the pit of my stomach. Okay, so. So, like, why doesn't she. Or does she feel that way? But the sh. To protect herself from the shame. She doesn't allow herself to pretend it matters. I can. Anyway. I think this is all fascinating. Somebody should do a study on this, by the way. Not me. I'm very busy making a podcast, but somebody else.

[B]

The categories around why someone remembers, forgets, doesn't care, doesn't know about pre Bull listing. So we've talked about the. You just totally forget and you're wondering, why do we forget?

[A]

Yeah,

[B]

I think some of the time it is life. But I think on a bigger picture, what is your relationship and what's the narrative around diabetes? And I. I will share. I. I forget quite frequently around dinner time because it's a different time and a different. We've got busy, you know, extracurriculars, life work in the evenings. But I've habit paired habit track stacked. My morning kind of COVID bolus. That's automated. I don't even think about it. I do it. Lunch is hit and miss. But I do pre bolus. But however much time I have varies, and I feel the effects of that. And then dinner. It's the variables. So I think the. But the question when you're going back to Arden, like, is it the aftermath of not pre bull is saying you have these physical symptoms that are uncomfortable. And sometimes that might happen enough. Like, if you're in a relationship with your diabetes in a way, like, wow, that kind of sucked. I'm gonna remember to. I'm gonna really be intentional in remembering next time. Right? Um, but if you hate your diabetes, if you are in kind of a resentful relationship with it, then of course you don't want to think about it. And this, we talked about this last time too, but then you have to think about it on the backside.

[A]

Is it almost like, like fighting with a parent? Like you, like you. Almost like there's something indulgent about the fight? Like, if you're. Does that make sense? So if you're not. And if you're not in a place where you're just going to say, hey, I want to be peaceful with my type one. I don't want to have a headache two and a half hours after eat. I don't want to feel tired or whatever again, I'm. I'm the wrong person to talk about this because I don't know what it feels like to. To have that happen afterwards.

[B]

But.

[A]

But I've. I've decided I don't want those physical feelings anymore. I'm gonna. I'm gonna figure out a concerted way to make. Make sure I do this right. But if you don't, then you're in a fight with the diabetes a little bit. Like, I'm not gonna give in. I always come back to when people say, I don't let diabetes stop me. My. My back of my brain question is always, does that mean you're doing the things that you have to be doing to make sure that it's not hurting you, or does it mean that it's hurting you and you're ignoring it and not allow. And you're. You're not letting it stop you? Does that make sense?

[B]

Yeah, yeah, yeah.

[A]

We've talked about it before. Because I'm fascinated by the difference between. In between those two sentences. And so I wonder if sometimes, like, you know, sometimes people relish a fight in a situation. Like they feel like they're. They're trapped in a lifelong blood feud with somebody and they love arguing with them. I wonder if people like the I'm not giving up, you can't make me do it portion of that. I don't. I really don't know. I'll tell you what I wrote down. I wrote a note for myself. It says, pre bolus documentary. Look for 20 adults and 10 children to speak specifically on this tiny piece right here about why is it hard for you to pre bolus. I might string them all together. In an hour and a half long conversation and let people tell their stories and maybe somebody can figure it out inside of it because it's a real thing. If you're listening right now and you're like, I don't understand why this matters, go listen to the pro tip series because pre bulletin your meals is I think, paramount to having stability with your blood sugar. And it's hard for people to remember. I absolutely acknowledge that. And I'm not telling people, just shut up and do it. I'm trying to understand why it's hard and philosophizing around it. So in this scenario here, you know, I thought one of the most interesting parts of Jenny's conversation was more about. It was about the waiting to see what happens. Waiting before you correct. Waiting before you eat, Waiting before you're intervening. And like, and I just kept thinking, like, why is the waiting, like, so emotionally uncomfortable for some people? Like, why can't they just do it? And I don't think there's an answer. I don't think you have the answer. I just think it's interesting to talk about. So I don't know. For you personally though, what do you think? Do you think you're in a fight with diabetes or do you think it's just hard to remember?

[B]

I think I was for sure in a fight as teen, adolescent and absolutely did not want to think about. I did not want diabetes. So anything that was revolved around thinking about it, didn't want to do it.

[A]

Yeah.

[B]

So that, that, you know, that was a lifestyle of avoidance.

[A]

Do you think this touches other parts of diabetes? Do you think there's more emotional stuff rather than the understanding or the education? Like maybe the parts Jenny went over where she's like, if you do these things here, you're going to have easier outcomes. Like maybe people know those things and just can't bring themselves to do them. Even making adjustments to settings or keeping their hands off of stuff when they're not sure what to do. I wonder how much of it is actually fired by, by the emotion of it rather than the nuts and bolts.

[B]

Oh, I would probably say like 99%.

[A]

Erica's like, the whole damn thing got me upset, I'll tell you.

[B]

Well, I think they're thinking about that. You know, her, Jenny sharing, you know, when you're, when she's pre bolusing and then she's sitting around the dinner table, maybe you're out at a restaurant and she needs to wait longer so there's that you're making that choice and There's a cost for each choice. Because alternatively, I'm thinking, well, and I might do this. I would probably say, oh, gosh, I forgot to pre Bolst that the dinner's here. And I don't want to lose out on the experience of eating a meal that's warm, eating while other people are eating, connecting, and sitting there kind of uncomfortably while everyone's digging in.

[A]

Yeah.

[B]

So I would maybe make the choice which has a cost.

[A]

You would.

[B]

To just bolus and eat and maybe add a few more.

[A]

You know, is it any different in your mind than having a cigarette after sex or drinking a little bit when you know it might shorten your life? Like that kind of thing? Is it maybe the same idea? I'm going to trade a little bit of later for a little bit of now.

[B]

Maybe it's the cost analysis of pleasure versus pain. And you're so. How painful. You're kind of. I guess you're analyzing how painful is it and what's the cost of. Okay, but you know what? Actually, I know I'm going to feel much better on the backside if I just wait a few more minutes. Even though the food's here, everyone's eating,

[A]

and it's just a personal choice, maybe. Hey, I should say for young people, sex is when people get naked and put their genitals together. I know you guys don't do it anymore. And smoking is. You take a cigarette. I know this is another thing you guys don't do anymore.

[B]

I'm quasi blushing over here. I'm like, oh, my gosh.

[A]

Did you not know what it was? I didn't mean to be the one to explain it to you. I'm so sorry. Your mom should have told you.

[B]

But you need to get more warning if there are children listening and they haven't.

[A]

There's no kids listening. If your kids are listening to. Shame on you. Do you think of that?

[B]

I think that's even worse. Stop.

[A]

Oh, no, no. I just. What I said, I was like, is that even a good example for people? Now I hear you're all just by yourselves playing video games. I don't know. I. I grew up in a different time. Okay, let's move.

[B]

Okay. You want me. You want to move on?

[A]

I want to move forward. So numbers have improved. Okay. CGM looks more like we wanted to. Our settings are working. Our time and range has gotten better. Why might we still feel exhausted even though we've gotten all that done? Like, could the emotional exhaustion itself become a habit?

[B]

Yes, because your. Your body, your mind has learned that it. It kind of constricts itself. Right. It feels like safer to stay kind of just as you can the body stay in a threat mode long after the threat gets smaller. Yes. Because you. Your neuropathways have been kind of wired. That old tape of, you better stay on it. You better stay hypervigilant. You better anticipate that has become so ingrained that if you were to try and separate from that, that would feel scary.

[A]

Yeah.

[B]

Or too risky.

[A]

I'm gonna. I've said this before on the podcast, so I'm comfortable saying again. Plus, for reasons that I completely understand, my family doesn't listen to this. So when I met my wife, it did not take me long to realize that she was more comfortable when something was going wrong. And when things were good, it. She looked like a. A rat in a trap. It was re. It was really, really very interesting. It took me a long time to make her believe that too. She was not happier. She was more comfortable. If there was a problem, it was like. It was like she expected there to be a problem. And here it was. So I got what I expected. This is good. And then our lives got better and then. And calmer. And whenever it was calm, she was always, like, waiting for the. The other shoe to drop. She was always thinking something bad was about to happen. It took her a really long time to get past it. So if that's happening to you, I mean, Erica, do you have any idea how they could work their way through that?

[B]

I mean, that's the concept of anxiety versus productivity. And Brene Brown, no shocker that I'm referencing her, talks a lot about this comparison. And are you anxious because you are needing to do a lot of things, or does that kind of fuel the productivity? Or do you feel like that's reducing the anxiety by running on the hamster wheel? There's also the concept that you just talking about is the shoe always going to drop? And we've talked about this way back when. I can't remember in which series, but the concept of foreboding joy, like, as soon as you feel like your settings are in place, as soon as you feel like, oh, things are stable, is it hard to let go of that fear? And if that's something you're really interested in, you can look up, you know, the concept of foreboding joy, which is that, like, oh, I don't know if I can fully be present, because you never know when something bad's going to happen. And while we can acknowledge that part of that Is true with diabetes. We also don't want to be kind of attached and connected and feeding that that thought, which is a fear based response and trauma based response.

[A]

Hard to believe you're in a safe place sometimes. Yeah, yeah, yeah. I, you know, it's funny. Our dog is sick. That's not the funny part. Our dog is sick. And my daughter today said to Kelly, mom is sad the dog is sick, but she loves that there's stuff to do. And she's like, look at her. She's like in her glory. There's like, she's like running around handling things like it's, it really. I, I looked up, I was like, oh, she's 100% right. Like, she is just like, Kelly's like in her, she's literally in her glory today. She's like, there is this to do and this to do and this to do. It's all very important and I'm going to get it done and blah, blah, blah, and makes her comfortable. Pretty interesting. So.

[B]

Yes. And, and that could be also feeding into that sense of agency. Right. Like she feels good to do stuff and to get the outcome. And like I do X and I know Y is going to happen and that feels good. Like she's can. It's probably feeding into that. Which. Those concepts aren't bad.

[A]

No, no, no, not at all. She's not like, don't get me wrong, she's not. I'm, I'm not like, oh, there's a crazy person downstairs. It's just, she's like, she likes for there to be things to do.

[B]

That's. Yes.

[A]

I also think my wife's one of those people who's happy when she's working. And I don't think that's sad. Like, I think somebody who wants to be sitting around or, or wants to have that other kind of life would look at it as sad. I think she's really, I think she's at her optimum when she's working. She enjoys it, so I don't stop her. Um, okay. The identity problem. Jenny talked about people who become the controllers. Um, they, they learn how to manage little, every little variable. What happens when being hyper vigilant becomes part of your identity? Because then if you're not constantly managing, what are you doing if that was your job? Which kind of comes in on the back of what we just talked about here with Kelly. Theme and happy. So that's, I don't know again, like, find a hobby. But your hobby can't be the diabetes because that comes as Close to the. What's that? Munchausen's by proxy. As I can, as I can imagine, like, you don't want there to be a problem that you have to deal with, but what, what happens when someone takes it away from you? I can, yeah. I can only tell you that I know it's real and that when my kids got older, after being a stay at home dad for a long time, I felt like rudderless for a while, like per. I felt like I didn't have a lot of purpose outside of my job for a little bit. But I'd like to know what you think about it.

[B]

Identity is such a huge kind of integral part of one's not only grief process and thinking about from a caregiver perspective, but also the person living with it, you know, who, who am I now that diabetes is here? Who am I now that I feel like I have to be angriest for my child? So there's, there can be. And I'm kind of going off track a little bit. But we'll come back, please, to the hypervigilance. I think there's a loss, right? There's a real sense of loss and a perceived sense of loss around one's identity of, you know, who, who am I now? So there's. That needs to be grieved and then there's a journey of, like, reintegration of, okay, now diabetes is here to stay. Where am I going to assign going back to that values question, like, why am I here? What am I doing? How can I still continue on in my journey with diabetes like here on, you know, hanging out on my shoulder but not weighing me down and not dictating, controlling my path. And for a lot of caregivers, there's even a greater sense of loss and thinking, you know, from Kelly's perspective, who really enjoy work and working outside of the home, so to speak, but feel like they might have to let go of that a little bit to feel like they're helping their child manage their diabetes. And then you're kind of vacillating with, what does that mean to be supporting? Do I need to be hyper vigilant? What if I can't be hyper vigilant? What if I don't want to be hyper vigilant? And what are, I guess the bigger question.

[A]

Yeah, go ahead. The bigger question, sorry, bigger question is

[B]

what narrative are you telling yourself around who you are in relation to your diabetes?

[A]

I've interviewed more than a few people who have left their jobs to be stay at home diabetes parents. And then taken, and they were like, they were earners, you know what I mean? Like, those people, they were out in the world hustling, and they took that hustle and focused it at the diabetes when it didn't really need all that energy. Do you know what I mean? And then it did become their. Their thing. So. Ooh, geez, I don't. I. But I don't know.

[B]

So.

[A]

But so people, you know, how do you just let go of it if that's been your role for so long? And then suddenly someone comes along. Because I would hate freak to think that you could possibly be sabotaging getting your set. Because in the end, this conversation, like it or not, like all my conversations, is about timing and amount. Like, I'm just talking about getting your settings right and putting in the insulin in the right time, and then all the things that come from that. I would hate to see somebody get in the way of making a problem go away because they're more comfortable in the. In the shit. And they. And they don't know how to make it go. Like, they don't. They want calm, but they don't know how to exist in calm. And would that. Could that cause you to subconsciously get in the way of. Of a smoother path? Because you don't know where it would lead you? I mean, it's. It's some pretty deep stuff. I don't know if that's the thing anybody would do consciously, but, you know, I've seen people block their own happiness in a lot of different ways. So it's not out of the question, that's for sure.

[B]

I think if that were occurring, that would be, you know, very unintentional, but that's become their normal. And how they feel like that's the only way they can survive. Right. It's like, how do I survive knowing that I'm trying to keep my child alive.

[A]

Yeah. Or themselves, too.

[B]

Yeah. And for themselves.

[A]

Yeah.

[B]

So thinking through, you know, what is it? What happens when being hypervigilant becomes part of your identity? And how do you let go of that once you feel like, okay, my child has gone off to college, or I'm an adult and I feel like I've figured it out, so to speak,

[A]

Slap this algorithm on them and it's working like.

[B]

Yes.

[A]

Yeah, right.

[B]

I think there. There's probably. Again, every story is different, but I'm wondering, and we'd be curious around, what is that going back to kind of the value worthiness of if I let go, if I pull back If I start, if I choose to go back to work and if my child is at school or if I choose to not look at my CGM while I'm at work for all day, every day and something bad happens, who's going to be to blame?

[A]

I know that feeling. It's going to be me. Yeah. No, no one's dying on my watch. That is how it is how it feels, you know?

[B]

Right, Right. So we are so, and it is

[A]

like right now you're gonna say screwed.

[B]

We're so screwed.

[A]

I'm sorry.

[B]

Oh, we're so, we're so, we are so self critical and from a caregiver's perspective or living with it, if we are attaching so much blame and shame to any higher low, of course then the answer is going to feel like, well, I've got to stay on it.

[A]

Yeah.

[B]

Because it won't work. So I think the work is looking at what are you believing to be true about yourself? If you try and step away from, from staring at the screen all day,

[A]

I can tell you that not thinking about it all the day is a lifesaver. And it, it can be done in a way that doesn't hurt someone's health. That's, that's my takeaway after doing this for just about 20 years. So anyway, the, the last bit here is what would emotional success look like? So what Jenny described as practical success was gentle rolling hills on your cgm. Fewer interventions, fewer surprises and less interactions with diabetes. But what does an emotional success look like? Like how would someone know, you know, that they, that they've reached that place I love?

[B]

Oh yeah, we're looking back the general, I mean, maybe some emotional gentle rolling hills. I mean, I know that's, Oh, I

[A]

don't after, by the way, after the horror movie thing, I just think we should just, just say yes, do this but with your mental health. Because honestly, gentle rolling hills. So less, less ups and downs. Fewer times where you're intervening. Fewer surprises, fewer interactions where you're actually touching the diabetes or touching, you know, your, your mental health. I guess. I mean, is there better? Maybe, maybe, maybe everything is everything. You. Well, you should be. Merry Christmas and just like sit in the field and hum. I, I, we're all connected. Have I talked to you about quantum entanglement, Erica?

[B]

Oh my gosh, no. So I like, I mean even just like the gentle, gentle rolling hills, fewer surprises. So when we are, when you're living in a hyper arousal state, everything is going to feel like an attack and a surprise. Right. So Going back to noticing when you have a peak or valley. Wow. That it's okay to feel the feelings connected to those. It's not about dismissing, ignoring, setting aside, being like, I shouldn't, I shouldn't have done that or I shouldn't feel guilty. Yeah, but in that process, you're also letting go of perfectionism. That's, I mean, that's easier said than done. That's a journey, noticing. Like, I guess they on guard. Like when you're feeling on guard. Going back to what Jenny, I think you said, people, you feel like you, maybe you're on the defense, right? Like you're always having to respond and so you're, by countering that, you might feel like you're on offense. So you're in this constant wrestling. So when you're, and I know you're kind of, this is framed from like once you're getting the settings right, how do you let go? So just being really aware. And it might take, you know, a lot of interpersonal work through mindfulness, through therapy, through slowing down your thoughts, but noticing what you're attaching to the peaks and valleys when they do happen.

[A]

I have to tell you, I got emotional here at the end. I, because, you know, if you, gimme a minute at the end here, don't, don't leave just yet if you're listening. This really, this whole like conversation with Jenny and Erica, it, it kind of bloomed out of a different idea. I was thinking through a conversation I want to have with Erica about how much can a person really focus on at one time. And as I worked my way through that conversation, it got to where it is now. Don't ask me how that happens. There's a lot of thinking in the shower and trying to figure things out and none of this is planned. So these really were. And I, and I will say this, I think you have the heavier lift than Jenny because Jenny can fall back on like, you know, nuts and bolts conversations. I'm asking you to pick into, you know, therapy ideas and the workings of the human mind and ask off the cuff questions, you know, answer off the cuff questions that I'm asking you. So I, I, I, I want everybody to know that I think this is a pretty heavy lift for Erica. She should be applauded for having this conversation like this without real, without pre planning, seriously. But when we got to the end and you said that maybe it's just gentle rolling hills and fewer interventions and fewer surprises, I thought, oh my God, this all dovetailed together so lovely. I didn't know that was going to happen, but I will tell you that it's been my first of all. I think if any of this is interesting to you and you'd like to get things together, go listen to the Pro Tip series that I did with Jenny. I think it'll help you understand your settings and your timing much better. And it is my belief, based on my own personal experience, that when your basil's right, when your carb ratio is dialed in, when you understand how food impacts, when you get the timing right, those things, they lessen in your mind. They become more back mind stuff that just happens automatically and your life opens up and it. It's just easier. So it's a little bit of work up front for a lot of good coming later. But I didn't. I just didn't realize that it was going to. That it was gonna be a carbon copy of itself in the end. You know, these two conversations are almost exactly the same. They're just. They're just from two different perspectives about diabetes. And I also don't think we can avoid or ignore any of what you and I just talked about or what people went through. When I said, how much of diabetes is something you said? 99%. Like, I. I felt that from you. Like, this thing is, I think it's way more impactful on people, aside of their physical health than maybe we either believe or want to allow ourselves to believe or maybe even have the. The nerve to. To be conscious of, because it's probably just. It could be really sad if you think about it all the time, like what this is, you know, and, and what it can be. But I think there's easier ways through it. And one of them, I think, is settings and timing and amount and all that jazz. So I hope this helps somebody and I appreciate you spending the time here. Is there anything that you wanted to add to this?

[B]

I do. Thank you. Thank you. I think the acknowledgement that you just where you were landing, that, yes, it is complicated and diabetes is hard and it is complex, both emotionally and, you know, logistically. And I think acknowledging that yes is very important. And simultaneously being mindful of how much you are exposing yourself to the diabetes is hard, diabetes sucks narrative. Because if that is something that is infiltrating your brain, mind, body all of the time, it is hard to pause and take space like we were talking about today, and practice that psychological flexibility. So it's going back to, yes, diabetes is hard, and I am doing the best I can, and I'm going to be learning these tools and I'm going to be compassionate to myself. One last thing. The research has shown from a study of people that I did look this up from type 1 and type 2 found that those who practiced self compassion had lower A1Cs and less emotional distress than those who did not. And so if you're hearing all this, that may be that what Scott spoke to Jenny with and our discussion today, and you were hearing yourself say, that must be nice. Easier said than done. I'm never going to get there. I'm never going to figure this out. Just even noticing if that's your narrative, you know, practicing self compassion isn't just a kind nice thing to do. It actually helps you biologically to reduce those stress levels and those cortisone levels. So I just thought we could, you know, I wanted to end there for. At least for me on going back to that self compassion and grace narrative is so important.

[A]

I would say that also that if you feel like you can't do it, I normally joke and say, listen, I can do it. If I can do it, you can do it. But I, I brought this up once or twice recently, but there's a meme online that says you can do it. Juice Box can help. About the podcast, and I really think that. I think if you, if you really think you can't do the nuts and bolts side of it, go through Bold Beginnings or Small Sips or the Pro Tip series, whichever one like, seems like it fits you better and just listen to Jenny and I just chat about these things and it'll sink in eventually. Um, Jenny was talking today about. I was talking about looking at a. A graph and knowing kind of pretty immediately what to do. But there's still. Sometimes when I look at. I'm like, I think this is what has to happen, but I need a couple of more minutes before I get to it. But generally speaking, I am a. Whether she would like to hear this or not. I'm an expert on how Arden's blood sugar works and how her physiology works around diabetes. That I can look at a graph, assess the situation, and pretty accurately know what to do next. Right? And it's not a thing that I'm. It's not like writing math on a paper. It just. It just happens. It's sort of like when I. I don't know another way to put. It's like looking at art and knowing it's beautiful. Like, I look at that diabetes and I go, we got a bolus a unit and a half right here. Or we missed that bolus, we didn't count the carbs right? Or. Oh, gosh, I bet you we missed fat in this. I know it in a split second. And it comes from experience and time. That's all it is. It's just time in the simulator. And having seen it enough times that I just, I know when I, I know what it is when I look at it. I don't have to be told and I don't have to wonder. I think people can get to that. It just. And I just unders. I understand that if you didn't get a good leap into it, if a doctor didn't set you up well, if a parent didn't help you, if you got caught on the roller coaster and your blood sugars got high and you got brain fog and you're having bad outcomes and it feels like you're just, you know, and it must feel like going on. You ever see those movies where surfers get knocked under and they film them like flipping through, under the waves? Like, I imagine that must be what it feels like eventually, right? And if you're under there right now and you think, I'm, I'm getting pulled along, I'm never going to come out of this. It's absolutely free. I don't make any money. When you listen to it, just go listen to the Pro Tip series. Like, I think you'll feel better. And if you are having trouble with the emotional side of it, Eric and I have recorded so many conversations about stuff, it's on the website. Like, go to the website, find the mental health section, pick through, find something, listen, give yourself that grace and I think you'll pop up out of the surf eventually. I've seen it happen to so many people who at one point or another would have described themselves as beyond help. So I know it's possible. I hope you can believe that. And thank you again. I appreciate that.

[B]

Yes, thank you. And starting with one thing is always the best way to start. As you, you say that often and I think it's important to note that as, as you share your journey and reflection and observation and skill. If you're thinking that must be nice, as you're saying, go back, start with the Pro Tip series, but also even smaller than that. Just start with one thing.

[A]

Yeah.

[B]

And take away one thing at a time.

[A]

If you're looking at functional, get your basil right first. I have a note here from somebody. I won't bore you, but having her on soon, she said, I saw your little estimator online about settings and I put my stuff into it and moved my basil up by like at like 40%. And she's like, look at my graph. She was 40% deficient in her basil. She had no idea that one little thing could be a big difference for her. Anyway. All right, Erica, go, go. Go ahead. It's the weekend I I release you. Thank you so much. I'll talk to you soon. This episode of the Juice Box Podcast was sponsored by usmed usmed.com juicebox or call 888-721-1514. Get started today with us med links in the show notes links@juicebox podcast.com. I want to thank you so much for listening and remind you. Please subscribe and follow to the podcast wherever you're listening right now. If it's YouTube, Apple Podcasts, Spotify, or any other audio app, go hit, follow or subscribe, whichever your app allows for and set up those downloads so you never miss an episode. Especially in Apple Podcasts. Go into your settings and choose Download all new episodes. A diabetes diagnosis comes with a lot of new terms, and you're not going to understand most of them. That's why we made Defining Diabetes. Go to juiceboxpodcast.com up into the menu and click on Defining Diabetes to find the series that will tell you what all of those words mean. Short, fun, and informative. That's Defining Diabetes. Is.