RealTalk MS Episode 418 Summary

Episode Title: The Importance of Developing a Growth Mindset When You're Living With MS
Host: Jon Strum
Guest: Dr. Miriam Franco (MS Specialist, Psychologist, EMDR and Guided Imagery Certified)
Release Date: September 1, 2025

Episode Overview

This episode explores the transformative power of cultivating a “growth mindset” while living with Multiple Sclerosis (MS). Host Jon Strum welcomes Dr. Miriam Franco to break down the difference between fixed and growth mindsets, why mindset is critical for managing the ongoing challenges of MS, and practical tactics for individuals, care partners, and supporters. The episode is rich with lived experience, scientific insight, and actionable advice.

Key Discussion Points & Insights

MS News & Policy Landscape (00:18–11:03)

• Impact of Research Funding Cuts (01:29):
  Jon underscores the real-world consequences of cuts in medical research funding, highlighting layoffs of mental health providers at USC Keck Medicine, and emphasizes the importance of mental health in MS care.
  Notable Quote:
  “This action is no different than walking into an operating room and stopping surgery in the middle of a procedure... you don’t turn the lights out mid treatment.” – Jon Strum (03:30)
• Tolebrutinib Approval (05:05):
  A new BTK inhibitor drug, Tolebrutinib, is approved for non-relapsing secondary progressive MS in the UAE. Uniquely, it lowers the risk of disability progression independent of relapse activity. U.S. FDA decision pending.
• International Data Sharing Initiative (08:32):
  Launch of a massive anonymized clinical data and imaging resource (72,000 MRI scans, 13,500 participants) to accelerate MS progression research and clinical trial efficacy.
• Patient Voice in Drug Development (11:03):
  The National MS Society's “Shaping Tomorrow Together” initiative aims to integrate patient experiences into FDA regulation and encourages listeners to complete a new survey and participate in an upcoming live meeting.

Introducing Mindset for MS (11:03–14:50)

• Linking Mindset to Living with MS (11:03 & 14:50): Strum connects the importance of mindset to managing MS, quoting Sun Tzu:
  “Every battle is won before it’s ever fought.” – Jon Strum (14:50)

In-Depth Conversation: Growth Mindset & MS

Guest: Dr. Miriam Franco

What is a Growth Mindset vs. Fixed Mindset? (15:38–19:03)

• Dr. Franco’s Take:
  • Fixed Mindset: “You become attached to ways we do things... things we’ve learned before that got us by.”
  • Growth Mindset: “An attitude or orientation towards coping and interacting with what’s happening to you now... even if that’s taking one small step at a time. It embraces curiosity and flexibility.” (17:00)
• Key Insight:
  Disease severity is a weak predictor of quality of life—psychological factors are more important (19:03).

Benefits of a Growth Mindset for MS (21:21–21:59)

• “A growth mindset is self-empowering. It means you can continue to have meaning, participate in life, develop new skills, surprise yourself that you didn’t have.” – Dr. Franco (21:25)
• Promotes emotional flexibility, enhances problem-solving, and creates greater resilience and self-efficacy.

Growth Mindset vs. Toxic Positivity (22:10–23:41)

• Toxic Positivity:
  “Always being positive or being grateful too quickly before you’ve actually mourned something can be a way to avoid... feeling states of distress.” (22:22)
• Growth Mindset:
  Dr. Franco highlights the need to coexist with suffering and hope:
  “You have to have the capacity to live with illusion. You have to believe that change is possible, even if it’s small steps.” (23:18)

How to Cultivate a Growth Mindset (23:46–27:58)

• Example: Coping with MS Fatigue
  • “Fatigue is your central nervous system calling out for rest... like a hunger pang.” (24:27)
  • Dr. Franco recommends mind-body techniques such as slow breathing, guided imagery, sensory exercises—imagining relaxing scenes to shift perception:
    • “You’re in a dual state of consciousness... healing occurs. You interrupt the automatic pilot of worrying and reacting and you’re busy experiencing the new experience.” (25:56)
  • This allows people to lower reactivity, restore energy, and find empowerment.

Overcoming Cultural and Familial Barriers (27:58–30:00)

• Growth mindset can be developed, even if “baked in” by upbringing:
  • “Environments that allow one to practice and make mistakes encourage a growthful mindset... Safety is important to a point, but you must have dynamism and change also to live well.” (28:49)
  • MS support groups are highlighted as “natural incubators” for growth (29:23).

For Care Partners: Helping Others Shift Mindset (30:00–32:15)

• Effective Support:
  Care partners should first reduce reactivity instead of offering advice.
  • “The best way to do that is not to use intellectual cognitive techniques, but to help people slow their breathing. Ask them, ‘What do you need right now?’” (30:32)
  • Shared quiet presence, gentle matching of breaths, and validation fosters trust and opens space for healing.

Resources for Developing a Growth Mindset (32:15–33:53)

• Recommended Resources:

  • Carol Dweck’s work and workshops
  • National MS Society, MSAA (MS Association of America), Can Do MS (workshops for couples), and The MS Foundation (online support and articles)
  • EMDRIA website for therapists specializing in somatic/right-brain techniques (e.g., EMDR, guided imagery, hypnosis)
  • Support groups online and in-person

• “Good therapy cultivates a growthful mindset.” (33:24)

Notable Quotes & Memorable Moments

• “A fixed mindset is something that we all have because we become attached to ways we do things.” – Dr. Franco (15:56)
• “Disease severity is a weak predictor of quality of life. In fact, it is psychological factors that are most important.” – Dr. Franco (19:03)
• “Toxic positivity is just as damaging as toxic negativity.” – Dr. Franco (paraphrased, 22:10–23:10)

Key Timestamps

| Segment | Time | |--------------------------------------------|--------------| | Host Intro & Funding News | 00:18–06:30 | | Tolebrutinib (New MS Therapy) | 05:05–08:32 | | Clinical Data Resource | 08:32–10:15 | | Patient-Focused Drug Development | 11:03–14:50 | | Dr. Franco Interview—Growth Mindset Begins | 15:38 | | Fixed vs. Growth Mindset | 15:47–19:03 | | Benefits of Growth Mindset | 21:21–21:59 | | Growth Mindset vs. Toxic Positivity | 22:10–23:41 | | Cultivating Growth Mindset (Fatigue Ex.) | 23:52–27:58 | | Overcoming Upbringing & Cultural Factors | 27:58–30:00 | | Care Partner Strategies | 30:00–32:15 | | Resources & Programs | 32:15–33:53 | | Closing Thanks & Wrap | 33:53–34:04 |

Summary Takeaways

• Mindset is critical to living well with MS: A flexible, growth-oriented mindset fosters adaptation, healthy coping, and the ability to find meaning—even with fluctuating symptoms and uncertainty.
• Growth comes from engaging with discomfort and possibility: Feeling loss and pain is valid, but believing in small steps and resilience is vital.
• Practical strategies: Daily breathing exercises, guided imagery, and supportive environments—especially MS-specific support groups—support growth.
• Care partners: Can best help by listening, creating safety, and co-regulating stress with the person they care for.
• Abundant resources: From acclaimed psychologists like Carol Dweck to MS organizations' workshops and articles, there’s support available for everyone seeking a stronger mindset.