Mike Carruthers (3:04)

have you ever noticed what position you're in when you come up with a good idea? There may be something to this as we will discover as we begin this episode of SOMETHING YOU should Know. Hi, I'm Mic Carruthers and I am glad you're here. So if you've ever noticed that your best ideas come when you're lying down, that may not be a coincidence. Research in psychology suggests that body posture can influence how we think. When we're standing up or sitting upright, our brains may be in a more focused, vigilant mode, good for detail oriented tasks. But when we lie down or recline, we tend to relax, which can promote broader, more associative thinking. That shift may make it easier to connect unrelated ideas and arrive at creative solutions. So the next time you're stuck on a problem, changing your posture might change your thinking and give you a better idea. And that is something you should know. It seems like everyone today is allergic to something, whether it's pollen in the air or certain foods, medications, even pets. But what is an allergy really? And once you have an allergy, are you stuck with it for life? And here's something really surprising. Up to 90% of people who claim they're allergic to penicillin actually aren't. So how does that happen? How can so many people be wrong about something so important? Well, if you've ever wondered whether your symptoms are a true allergy or why allergies seem more common today than ever, or whether they can disappear by themselves over time, well, you're about to get some very clear answers. My guest is Dr. Zachary Rubin. He's a double board certified pediatrician and allergist immunologist at Oakbrook Allergists in the Chicago area. He's also author of a book called all about allergies, everything you need to know about asthma, food allergies, hay fever, and more. Hey doctor, welcome to something you should know.

Dr. Zachary Rubin (5:15)

Thanks for having me.

Mike Carruthers (5:16)

So walk me through an allergy, like

Interviewer/Host (5:18)

what happens when it happens using an example of because, you know, everybody claims I have allergies, I think I have allergies to the stuff in the air because my nose gets stuffy at certain times.

Mike Carruthers (5:32)

And I assume that's an allergy.

Dr. Zachary Rubin (5:34)

Well, it may be or maybe not. So the reality is that when you experience nasal symptoms like a runny, stuffy or itchy nose chronically, that's rhinitis. That's inflammation of the nasal Passages and the underlying trigger of that could be allergic rhinitis or non allergic rhinitis. In other words, you could have the immune system responding in a way that creates protein tags known as IgE antibodies that when you have subsequent exposure to something like pollen, cats, dogs or mold, it can create histamine release and other chemicals released from the immune system to cause those symptoms that we talk about. If you have non allergic rhinitis, that means there's a different pathway that your body is abnormally responding to non specific triggers like changes in weather, cigarette smoke, air pollution, getting sick. And so the actual treatment is different and you technically don't have allergies when you have non allergic rhinitis, but the symptoms are essentially the same.

Mike Carruthers (6:41)

But what would be the difference in the treatment?

Interviewer/Host (6:43)

It seems like you would take, you know, Claritin or Flonase or something, regardless of which one it was.

Dr. Zachary Rubin (6:50)

Right. So actually that's not the case. So if you have allergic rhinitis, yes, something like Claritin or an antihistamine helps because one of the main chemicals released from your immune system is histamine. So you take an antihistamine to block those effects. But if you have non allergic rhinitis, there's a lot less histamine being released. So taking an antihistamine is not quite as effective. So we have to rely on other treatments like nasal sprays that contain steroids that that can help just decrease the overall immune response locally in that area to treat those symptoms. Antihistamines are great for sneezing and runny nose and even potentially some coughing or post nasal drip. But if your nose is really stuffy and there's a ton of mucus production, then a steroid is going to be more effective when you take that topically like a flonase or a nasacort.

Mike Carruthers (7:41)

And so can I tell the difference or do I have to go to

Interviewer/Host (7:43)

the doctor to tell the difference?

Dr. Zachary Rubin (7:45)

You would need to go to an allergist to get formal testing to be able to tell the difference. It's not something that I can figure out clinically without testing. So basically what happens is either they will order a blood test or a skin test that's trying to measure for that IGE antibody either on your skin or blood to specific substances in the environment. If it's a positive test, you have allergies. If it's negative, we call that the non allergic rhinitis.

Mike Carruthers (8:11)

Is there a sense as to, because

Interviewer/Host (8:13)

so many people complain of those symptoms, as to how many people have allergies versus how many people have the non allergy version.

Dr. Zachary Rubin (8:22)

It's not entirely clear because we aren't able to skin test everybody in the United States. We kind of have to extrapolate it. More people have allergies in general, but as you get older, it tends to turn into this non allergic subtype. There are a lot of elderly who have just a constant runny nose as an example, and that has nothing to do with pollen. It's something that constantly happens. And we treat that with different nasal sprays to try to dry up the nose as an example. But allergies in general, whether we talk about allergic rhinitis, hay fever is another term for that. Eczema, food allergies, asthma, chronic hives, medication reactions. It's one of the most common chronic diseases that we face in the United States that affect millions of people. And it's just not talked about enough.

Interviewer/Host (9:15)

So you just mentioned the medications. Like, you know, people say, well, I'm allergic to penicillin. Is that really an allergy to penicillin or is that some sort of intolerance to penicillin?

Dr. Zachary Rubin (9:26)

So roughly 10% of Americans believe they're allergic to penicillin. But if you test them out, we estimate that about 90% of those individuals don't have a true penicillin allergy. And so it could be that they have a parent who has a penicillin allergy and were afraid to give it to them when they were a kid, so they just had the label. That's one example. Another is, as a baby, you had an infection, the doctor gives an antibiotic and you get a nonspecific rash. That's not necessarily a severe allergic reaction. It could actually be a response from the virus or bacteria infecting you and creating a rash. And it gets confusing to figure out, is this truly from the medication or from the infection itself. There are a lot of what we call viral exanthems where you develop rashes naturally as your immune system's fighting off an infection. So it can be difficult to truly verify whether it's an allergic reaction or not. And even if it was, we estimate that most people with a true penicillin allergy outgrow it. If you abstain from that medication for at least 10 years, the majority will lose that sensitivity over time and they get lost to follow up. Or there's difficult issues related to having physicians test this out because it's not always covered by insurance. There's a lot of issues related to the resources that go into doing this type of testing. And so this is something that many allergists are trying to figure out, ways to streamline this process of delabeling penicillin allergies on people's medical charts. Because if you carry that label, you're at a higher risk of developing severe complications while you're in the hospital, Longer hospitalization stays, and even potentially higher mortality rates by having that label. Because you can't take a highly effective medication that has less side effects, you end up having to take these different antibiotics that are more expensive, potentially more side effects, and may not be as effective.

Interviewer/Host (11:23)

When I was growing up, I don't remember hearing people talk about food allergies that, you know, little Johnny could die if he's exposed to a peanut. I mean, I just, I never ever heard that.

Mike Carruthers (11:40)

Now you hear it a lot.

Dr. Zachary Rubin (11:42)

Yes. And when I was a kid, I had a milk allergy that I outgrew, and I knew one girl with a peanut allergy, and that was it. And part of that is recognition. There are many accounts of people who would have what we would now consider a food allergy that it just was not talked about or recognized that actually has existed. There's even documentation from the middle ages of. Of dignitaries who had food allergies and potentially used it for political gain as a possibility of saying that somebody was trying to poison me. But they likely had a food allergy. These things did exist, but they were poorly understood. And since the 1990s, not only has the recognition increased, but we have seen diagnosis of food allergies rapidly increase where food the rates have more than tripled over the past 20 to 30 years.

Mike Carruthers (12:37)

And why would that be?

Dr. Zachary Rubin (12:39)

That is the billion dollar question. So I'll give you some factors as to why this may be the case. One which you may have heard about in the news, which is we used to recommend delaying introduction of highly allergenic foods like peanuts until later in life, like two to three years of age, depending on the food. But that was meant for only high risk individuals, like children who have eczema. As an example, we then learned a study called learning early about peanut, or the leap study. It randomized kids to either consume peanut protein before they turned one regularly or wait until they turned five. And delaying the introduction significantly increased the risk of those children developing peanut allergies. If you introduced it before one, there's about an 80% less likely chance of that happening. Not 100%, but something that we recognize now that we've changed the guidelines over the past 10 years or so, and we're starting to see a slow decline in food allergy rates, especially for peanut allergies. As an example. There's also associations between C sections, early antibiotic use, and early antacid use. These are all issues related to the gut microbiome. That's the bacterial milieu that helps process foods and present it to our immune system. And so if you take antibiotics early in life, that could kill not just bad bacteria, but good bacteria. If you're born through C section, you're not exposed to the birth canal and the bacterial flora that is present. If you take antacids, that could also disrupt the gut microbiome, we also have increases in eczema prevalence. Eczema is a chronic itchy skin condition characterized by a disrupted skin barrier. So when any foreign substance comes into contact with a disrupted skin barrier, your immune system in your skin recognizes that material as foreign and could create an allergic response to it. And that is what we call the atopic march or allergic march, where someone who was born early on develops eczema. They're more likely to develop hay fever, food allergies, and asthma later in life because they're all interconnected. There could be issues related to how food is processed and prepared. There could be a pollutant. We don't really know, but I can guarantee you it's not one particular issue. As most complicated chronic diseases are, it's multifactorial.

Mike Carruthers (15:10)

We're taking an important look at allergies and My guest is Dr. Zachary Rubin. He's a double board certified pediatrician and allergist, immunologist, and author of the book all about allergies. Everything you need to know about asthma, food allergies, hay fever, and more.

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Interviewer/Host (16:00)

Whenever you start something new, like a

Mike Carruthers (16:02)

new business idea, you always doubt yourself.

Interviewer/Host (16:05)

You think, ooh, this is exciting.

Mike Carruthers (16:07)

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Interviewer/Host (17:24)

were something very treatable, not benign, but not life threatening. But now you hear about peanut allergies or nut allergies, people dying, and I don't understand that. How do you die from an allergy?

Dr. Zachary Rubin (17:40)

So what happens, unfortunately is if you have that abnormal immune response, it can present in a multitude of ways. It could be mild, it could be severe and potentially life threatening. And no testing I can offer can determine the next time you eat something if you're allergic to it, if it's going to be a mild, moderate, severe, potentially life threatening situation. It's how the immune system responds to it. What chemicals are being released, where are they being released and does it trigger a cascade of events towards something called anaphylaxis. That's a continuum where your immune system, if it leads towards shock, could cause your your blood from especially the periphery in your arms and legs to pool out. And it causes the blood leaving your vital organs like your heart and your brain. So in rare instances, if you develop anaphylactic shock, your blood pressure drops and that can cause a heart attack, stroke, or even death. It's not common, but you hear about it on the news every so often. Even if you give epinephrine, which is the first line of treatment, anybody experiencing a severe allergic reaction should carry that with them at all times. But if you delay use of it or there's potentially some underlying issue going on, in very rare instances, even with epinephrine use, we have had tragic cases where people have passed away just from eating a food that normally would sustain us. But it actually can cause significant harm to a small group of people. And that's very hard for people to understand. But that's why we have to take food allergies seriously.

Mike Carruthers (19:16)

I know a lot of people. I don't know. I actually don't know that a lot of people, but it seems like a lot of people have seafood allergies, shellfish allergies. And generally, what are the symptoms of a seafood allergy?

Dr. Zachary Rubin (19:29)

It's quite variable. I can't predict based off of testing what it is. Any type of food allergy could be mild, where you get itching or a mild rash. It could be severe vomiting, potentially diarrhea. It could be wheezing, difficulty breathing, swelling of different parts of the body. The concerning aspect would be like the tongue or your throat could swell. You could have a combination of those symptoms that I just mentioned. Or the dreaded anaphylactic shock where blood pressure drops, you feel faint, you turn pale, potentially blue. And some people report the sense of impending doom, like they feel like they're going to die.

Mike Carruthers (20:07)

Ooh.

Dr. Zachary Rubin (20:08)

Luckily it's rare, but it happens from time to time. And knock on wood, I have yet to see a child in my practice experience that level of shock. It's something that usually is more common in adults and it has to do with the physiology of how the body works when you're a young child versus as an adult changes. So this risk of shock is usually much higher in adults.

Mike Carruthers (20:32)

Is there a good understanding of how

Interviewer/Host (20:35)

you acquire an allergy? You had mentioned peanut allergies. Maybe it's because you weren't exposed to peanuts.

Mike Carruthers (20:41)

But what about other allergies? Is it passed down?

Interviewer/Host (20:45)

Is it all environmental?

Mike Carruthers (20:48)

Some or both?

Interviewer/Host (20:49)

I don't know.

Dr. Zachary Rubin (20:50)

Yeah, so most of these allergic diseases, it's a combination of genetics and environmental factors. So if you have a parent with asthma as an example, their child is significantly at higher risk of developing asthma, which. That's an airway disease that's chronic, usually diagnosed in children, but can happen in adults. And it's often triggered by a lot of these things we talked about earlier in terms of pollen, mold, different environmental triggers or pollutants, irritants, exercise, all those things can be triggering to an extent. Eczema is a significant risk factor for developing asthma. So that's one example. The exposures make a difference. Air pollution as an example, is a significant risk factor for developing asthma. Or if you are in housing that's very old and has a lot of dust and mold, those early exposures can be problematic. And what's interesting is recently we've had studies seeing strong associations between somebody who has a gas or wood burning stove in the house and developing asthma. Because when you are burning that in your home, you are releasing a lot of volatile organic compounds like nitrogen dioxide, which can really cause inflammation in your lungs. And you don't necessarily smell it, but it causes that. So if you don't have an electric stove and you're using gas, you got to make sure you put on the fan on your stove as well as opening up windows whenever you're cooking to reduce the amount of exposure that you have to those irritating substances.

Mike Carruthers (22:29)

Is it safe to assume that the most common allergy is things in the air? Pollen, Whatever is in the air that makes people sneeze. And that's the most common.

Dr. Zachary Rubin (22:41)

Right. So pollen is one of the most common environmental allergens, whether it's from trees, grasses or weeds that are wind pollinated, not the fresh cut flowers like roses. When you sneeze with that, that's from the fragrance, not the pollen, because you don't get exposed to that regularly. So that's your seasonal allergens. The most common indoor allergens is typically dust mites, which are found anywhere where there are human skin cells and humidity, like in your bedding is the main one, or carpeting as an example.

Interviewer/Host (23:11)

And do allergies tend to go away? You had said some of them do.

Mike Carruthers (23:16)

But do most of them eventually disappear

Interviewer/Host (23:19)

or most of them don't?

Dr. Zachary Rubin (23:22)

Usually it's pretty persistent. If we're talking about environmental allergies, there is a shift that happens later in life where it goes from kind of this allergic rhinitis to non allergic rhinitis, where the antibodies that cause the reaction start to fade over time. But you still have similar symptoms. That happens with food allergies. If you've got egg, milk, wheat or soy, that can be outgrown usually. But if you have something like peanut tree nuts or seafood that's usually not outgrown, it's more persistent. Yeah, we don't fully understand why that's the case.

Mike Carruthers (24:01)

I want to get your lastly get

Interviewer/Host (24:03)

your thoughts on, because I have what I assume are airborne allergies and I get stuffy when in the spring and all that. And I use a NETI pot, which I discovered not that all that long ago. And I find it amazing. But what's your sense?

Dr. Zachary Rubin (24:22)

Oh, those devices, whether it's a NETI pod, a saline rinse bottle, anything that uses saline water to clean out the nasal cavities is very helpful for most people. It can be a little hard to tolerate when you're first using it, but the concept is, is that as you're breathing the air Constantly you're being bombarded by these allergens and irritants that will stay there because you have mucus that acts as a first line of defense. It's like a wall that's sticky that traps all of these things and it stays there, but it can create swelling and inflammation that leads to all the symptoms that we're experiencing. So by using these devices and rinsing your nasal passages once or twice a day, it'll help you breathe a lot better, more naturally than having to rely on medications. Or if you use nasal sprays, rinsing your nose first, then blowing your nose and then using it, it's much more effective because you're putting the medicine on the actual tissue. So it's really, really effective to use those devices. Keep in mind, though, that you should never use tap water unless it was previously boiled and cooled. It's just easier to get distilled water in a jug to use because there is a rare but actual complication that is reported pretty much every year, very rare, but pretty much universally fatal, which is the brain eating amoeba called Nygleria fowleri. You could get infected with that with tap water.

Mike Carruthers (25:46)

What's your take on nasal sprays like Flonase? A lot of people say they really help. What do you say if people use

Dr. Zachary Rubin (25:53)

nasal sprays, they often don't know how to use it correctly. I tell folks if you're snorting it and taking a deep breath in when you use it, you're likely going to taste the medication. But if you're tasting it, that means you're wasting it. It's not going in the right part of your body. When I teach my patients or when I talk about it online, the light bulb goes on and people don't realize that they weren't taking it properly when they do it. It makes a huge difference.

Mike Carruthers (26:17)

I don't know anybody who's not affected by allergies. They either have one or two or three or they know someone or live with someone who does. And it seems like there's a lot people don't understand. So I appreciate you clearing it up. Dr. Zachary Rubin has been my guest. He's a double board certified pediatrician and allergist immunologist in the Chicago area. And he is author of the book called all about everything you need to know about asthma, food allergies, hay fever and more. And there's a link to his book at Amazon in the show notes. Doctor, thank you so much. I appreciate you coming on.

Dr. Zachary Rubin (26:53)

Thank you so much.

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Mike Carruthers (28:28)

have you ever promised yourself I'm not going to do that again? And then you do. You stay too long. You drink too much. You say yes when you mean no. You stay quiet when you know you should speak up. And then afterwards you're not just frustrated, you're confused. Because it's not like you didn't see it coming. So why do smart, self aware people keep repeating behaviors that make them unhappy? It turns out these patterns are not random. They're learned, reinforced, even rewarded in subtle ways. And until you understand what's driving them, willpower alone probably won't fix them. Licensed marriage and family therapist Kati Morton has spent years helping people uncover the hidden reasons behind their self sabotaging habits. She's the author of why do I keep doing Unlearn the habits keeping you stuck and unhappy. And she's here to explain why we get stuck and how to stop. Hey Katie, welcome to something you should know.

Kati Morton (29:32)

Thanks for having me. I'm excited to be here.

Mike Carruthers (29:35)

So start by throwing out some of these behaviors that you're talking about. I just mentioned a few. But give people a flavor of what you mean.

Kati Morton (29:45)

Like me saying yes when I mean no because I don't want to hurt someone's feelings or I want to please someone, make sure they're happy first. It could also be another example of why do I keep doing this? Is why do I think that everything has to be perfect and I keep doing something over and over and over hoping that this time I'll think it's finally good enough. It's kind of the patterns in my life where I find myself trying to shrink to fit spaces I don't belong.

Interviewer/Host (30:13)

And do you think when people do those things they know it's a problem

Mike Carruthers (30:18)

or that's just the way they do things?

Kati Morton (30:21)

I think it depends. I ultimately believe that we all know it's a problem because it doesn't feel good. But I think for a lot of us, myself included, we were raised a certain way and so it's almost like it's all that we know. And so, I mean, I ended up in therapy feeling super stressed out and wanting to talk about my stress reduction and like, how do I manage all that I'm doing. And over talking with my therapist for many weeks, she was like, I think this might have to do with people pleasing or I think this might be part of, you know, what you think your role is in life. And it was, it's getting down to more the patterns of it rather than just the one off examples. Because I think for all of us we can have those one off examples and think like, oh, you know, I really wish that this had turned out differently. But until we see it, it's almost like if we pull ourselves out, bird's eye view, then we can see like, hey, I keep doing this same thing. And it can take a minute for that realization or that awareness to come to be.

Interviewer/Host (31:21)

And so where do these things come from? These are patterns, you say, but patterns had to start somewhere one day. How?

Kati Morton (31:30)

Great question. When we're being raised by parents, a close family, whomever is around us the most. We are picking up on all of the different behaviors, how people engage in conflict, how do people show that they love each other? How do people make up after a fight? All of the different patterns of behavior we see expressed by our parents, our grandparents, our aunts and uncles. And we slowly kind of draw the blueprint for life and how we're going to engage in it. And that's usually where these types of patterns come from. For better or for worse, right? We might be like, hey, our family's really good at, like, getting over a conflict and coming back together and repairing. Yay. So we grow up with that blueprint. Or it could be, hey, my family's really good at pretending everything's okay, even when it's not.

Interviewer/Host (32:17)

In order to address it, though, you have to realize it's a problem. If you don't think it's a problem, then there's no problem. So do people have a tendency to think, to say, I know I do this, and it's causing trouble, or do people say, I just. This is. This is me.

Kati Morton (32:34)

I think a lot of people, especially more recently, think it's a problem and realize it, but it's not just, aha. Oh, my. Oh, my God, I hate that I do this. I don't think the realization is so clear like that. I think it's more like I feel tired and I don't know why, or I'm super stressed or I feel anxious. It kind of comes out in other ways. Because if. If you think about it, if we're always putting everybody else first, then that means that our needs aren't getting met and we might find ourselves exhausted or unable to sleep at night or even getting sick a lot. There can be a lot of different ways that it can come out, and I feel like it's through the repetition of those kinds of symptoms that we then realize, like, oh, my God, this. What's happening? Like, why is this happening to me? Why am I. Why do I keep doing this? Why. Why do I keep feeling this way? And that kind of curiosity, the wondering of the why, is how we discover it.

Interviewer/Host (33:28)

And then when you discover it, how do you start to address it, fix it, get it, get it out of the way?

Kati Morton (33:35)

I think the best first step in that is honestly just realizing how it shows up for you. One of the first homework assignments my therapist gave me was to notice how often I say sorry every day. And for anybody who doesn't struggle with people pleasing, they're like, this would not be a big deal. When I tell you the Number was embarrassingly high and I stopped counting midday because it was ridiculous. You know, that was a good place to start. I know a lot of times when we're doing like self care or self help stuff, we think like, I want this quick fix or I want these five steps to get better. In the case of, you know, of control and us trying to control things that we can't, it's less about quick fixes and more about showing ourselves compassion as we try to act differently. So in that example of like, oh, I say sorry all the time instead of thinking like, Katie, why do you keep doing this? Is so stop it already. Just stop saying sorry. That would be the goal, sure. But instead I needed to realize, like, how often I was doing it. What was triggering it? Was it certain situations are there certain places I do it more. And then my therapist had me. As odd as this sounds, one of the places I apologize the most is like public spaces, like sharing, like a grocery store aisle with people. I say sorry all the time or I'm traveling right now. So the airport is also a place where I would do this a lot. And I can always hear my therapist voice where she's like, you don't have to apologize for taking up space. You don't have to apologize for being here. And so that's kind of that first step of work is like, hey, it shows up for me this way. And so I'm going to try to not do that. And I know that's very specific. But if each of us are kind of honest with the patterns that we see, we can also, you know, identify some behaviors that we could maybe shift a little bit. It's not, you know, all or nothing, but apologize a little less when I'm not sorry, when I'm just being a human sharing space.

Mike Carruthers (35:29)

So I'm curious, like, when you're in

Interviewer/Host (35:31)

the grocery store, what is it you're sorry?

Mike Carruthers (35:33)

What is it you're apologizing for?

Kati Morton (35:36)

It's a great question. My therapist asked me the same thing. The truth is, I don't know. And I know that makes me sound like I'm losing my marbles. I promise you I'm not. It's that I feel like if. So here's an example and this will kind of help me explain it. Like, if, let's say you and I are in the grocery store and I haven't met you before, I don't know you, and we're both looking at cereal and you've wanted to cross over where I am looking at cereal because, like, you want to get to the granola, and it's on that side. As you cross my path and I step back to give space to you, I will apologize. And it's not because I'm sorry. I'm not sorry for anything. That was kind of the next step, my therapist said, is she's like, if you can't tell me what you're sorry for, I don't want you apologizing and let me know how that feels. It felt terrible, but I think it's less about what it means to say I'm sorry and to apologize. And it was more of a. Like, I am taking up too much space. Like, I haven't earned the right to be here. It's a little deeper than I'm sorry. And it's more of a I. Other people always come first.

Interviewer/Host (36:42)

Doesn't it seem like there's a lot

Mike Carruthers (36:43)

of people like that?

Interviewer/Host (36:44)

And then, of course, there's a lot of people who don't have any idea what you're talking about. Talking about.

Kati Morton (36:50)

Yes, I think there are the people like me who apologize, and there's people that don't see any reason for that at all. And I think that's the interesting thing about control or this illusion of control, because it, for me, it shows up like that. That's one of the ways it manifests. And for other people, it might be, you know, more of the perfectionism type of thing. Or, you know, it can show up in totally different ways for different people. That's why that first step is figuring out how it shows up for you.

Interviewer/Host (37:18)

So why is it, if we can pick on you and use your example, when you're made aware of that, you're really not sorry, and why don't you just stop it? I mean, what compels you to continue when you already know intellectually you're not sorry? You are just as entitled to take up space as anybody else. You have every right to be in that aisle at the grocery store. Why don't you just stop?

Kati Morton (37:47)

That's a tough. It sounds obvious I should be able to just stop. But it's not just about that. It's like an inner belief. And when we try to shift beliefs about ourself, it's more than just the symptoms. I mean, the first knee jerk answer to why don't I just stop? Is because it feels uncomfortable and because I don't think about it. It's a knee jerk reaction. But deeper than that, it's in order. And I talk to my patients all the time about this. I'M like, in order to stop this outside symptom, right. I like to think of our issues as kind of like trees. And for me to just stop saying sorry would be like trimming some leaves off of the end. But that doesn't actually, you know, eradicate the tree or get rid of this problem. It just trims a little bit of it, but there's still a lot there. And so in order for me to actually be able to stop saying sorry when, and I don't mean to, and to be like, you can take up space, Katie. This is ridiculous. I have to get to the root. I have to figure out where it comes from. And the truth for me, I mean, this is like kind of spoilers for the book, but not really because it's every person's on their own journey. Mine is that I thought or I believe deeply that I have to earn my worth. And I know you're like, how does that connect? It connects in the fact that if we think about, like, I feel like I'm a second rate person, like other people's needs come ahead of mine. That means that in order for me to receive or accept love or attention, I have to earn it. I have to do something for it. I have to, like, pull myself out from the underdog role into the, you know, the leading role. And that realizing that that core belief was like messing my life up essentially was a huge eye opener for me. And I believe that we all have these false beliefs about self that need identifying and then that's what we work on. Does that make sense?

Interviewer/Host (39:48)

Yeah, because I think what you're describing about yourself, so many people identify with that, that need to earn your place at the table rather than just feel like you have a place at the table.

Kati Morton (40:00)

Exactly.

Interviewer/Host (40:01)

Well, stop it.

Kati Morton (40:04)

Easier said than done, right? My therapist's homework is, it's funny when you're like, just stop doing it. My therapist is like, I want you to try not saying sorry for a week. I didn't even make it a day, Mike. It was terrible and embarrassing, but it was eye opening. You know that like, why is this silly behavior? Like, why do I keep. Why do I keep doing this? And I don't want to. And it was because it was bigger than that.

Interviewer/Host (40:26)

And so how important is it to figure out the why? Why are you doing it?

Mike Carruthers (40:33)

Is it important to figure that out?

Interviewer/Host (40:35)

Or is it important to change it? And you don't really need to know why?

Kati Morton (40:40)

I think the why is vital. I believe strongly that if, if we just try to, like I said, like trim the leaves off the ends. If we just try to stop doing certain behaviors, it will. Either one of two things will happen. Number one, it will come right back and we'll find ourselves doing it again and it'll be really frustrating and we'll. We'll feel really stuck. Or number two, we will suppress that one action and it will crop up in another way. Ta da. It's all tied to the same belief. It's all tied to the same thing. It just comes up in a zillion different ways. Until I was honest with myself enough or had enough courage to admit that I just didn't think I was worth it and that that was a really terrible feeling. But if I didn't build work to build my confidence or build my. I don't know if it's faith in self, but rightful place on this earth just like everybody else. If I didn't fight for that, it would keep coming up.

Interviewer/Host (41:38)

So is it lack of confidence?

Kati Morton (41:40)

Lack of confidence is part of it. It's. It's worth. Because if you think of like my belief of self is like that I have to hustle to earn my worth, I have to prove to you that I'm worthy of your attention or affection or whatever, then that means that I'm not good enough as I am just straight up, just me. And so part of that is confidence. But for me, it was. It was confidence and it was like self talk. The way that I. I navigate conversations with myself. And it goes back to. I think it's all confidence, even as I try to explain it and tease it out another way. For you, I feel like that's what it is for me is. Is definitely confidence and self worth and those are so inextricably linked that all of the things that I've done in therapy to get better come back to that. Like talking to myself more kindly, not apologizing for taking up space, being okay, speaking up and sharing my opinion. I think all of that is tied to confidence and self worth.

Mike Carruthers (42:35)

And what are some of the.

Interviewer/Host (42:37)

It was my first question. But some of the other ways that this kind of thing shows up for other people, for you, it's saying you're sorry when you're not. But how do you see it manifest in other people?

Kati Morton (42:53)

The most common, and I use this. I don't. I can't take like, credit for this quote, but lighting yourself on fire to keep someone else warm is probably the most common symptom. And what I mean by that is that I find people tend to do things for Others ahead of their own self. So let's say I really need to rest, but my sister needs me to get her from the airport and so I'm going to stay up late and go get her or something. I know it's a random example, but it's essentially, you know what your needs are, but you meet someone else's first. I find that to be incredibly common. This could even look like I have another member of my community who shared taking on extra work within her job even though she doesn't get paid more for it. And other people could help out too, but she's always the one that does that or like taking extra shifts, you know, always being the one to fill in. And a lot of us could say, well, that's because I'm reliable, or that's because I do, you know, I like to be that person. Sure, maybe. Or is it because that's how you earn your worth? Again, even though my issue sounds very specific, like, oh, I'm hustling to earn my worth. Worth is a big piece. It's a big motivator for our behavior. And I think a lot of different people will do different things. Like that's why a lot of my friends who are mothers will do everything for their children because they put a lot of worth. A lot of their identity is in being the best mother ever. And so even if they're not doing great, they'll. They'll make sure that their child has everything, you know, and as sad as it is to say, it's like we're leading by example, then the blueprint for their children is that mom's needs don't exist and only kids needs exist. I'd be curious for you, Mike, if you find yourself in any situation like this where you, you have behaviors you don't like that are repetitive, that kind of go down to your worth or your self confidence.

Mike Carruthers (44:50)

Well, see, that's the thing.

Interviewer/Host (44:52)

Because like the person that needs a ride from the airport, I like to think of myself as the person who will sacrifice what I need to sacrifice

Mike Carruthers (45:02)

because I couldn't go back to sleep

Interviewer/Host (45:05)

knowing somebody was stranded at the airport, even though they probably find somebody else.

Mike Carruthers (45:09)

But.

Interviewer/Host (45:10)

But where's the line between being a good person and, you know, getting stomped on?

Kati Morton (45:18)

It's all about balance. I think just like anything in moderation is great. Like you said, I wouldn't want someone to be at the airport either. Like that. To me, that's not a kind person that would just leave someone. Right. However, the behaviors I'm talking about Aren't just one offs or I'm being kind. It's like this is the only way I know how to be. Meaning that like I, I need to be needed and if no one needs anything from me, I don't know how to relax or if I can't be of use to someone. Whether it's work, whether it's school, whether it's friendships, whether it's kids, you know, family, if, if nobody is needing of me, I don't know who I am. Does that make sense? It's like it's a deeper thing. It's like instead of it being just, I'm being a good person and I, I want to show up for people because I believe we all should do that. And that's what, that builds healthy relationships, having people you can count on. However, when that comes at the cost of our own health, of our own well being time and time again, that's when it's a problem.

Interviewer/Host (46:24)

Time and time again, that's the, that's the key phrase there, I think, is

Mike Carruthers (46:28)

because we all, we all.

Interviewer/Host (46:30)

I mean, I like to think I would go out of my way to help somebody, but if I did it all the time, then yeah, that would be a big problem.

Kati Morton (46:38)

Yeah, then it gets in the way of you being able to do anything else that you want to do. Right. Or ways to take care of yourself. We all have things we love to do, hobbies that we want to spend time in. Like I love to read. And so if I'm always doing for other people, then I'm not going to have any quiet time for myself to do that. And we have to make sure that it's a balance between filling our own cup and filling other people's. I kind of love that analogy in general. Like you can't pour from an empty cup because it's so like visual. You legitimately can't. You know, if there's no water or beverage to be poured, you can't pour. And so I think if we're not pouring into ourselves first and only pouring out, that's, you know, that's when it's an unhealthy behavior versus just me being a good human to people in my life.

Interviewer/Host (47:24)

Well, I love that phrase, setting yourself on fire to keep somebody else warm because that nails it. I mean, that's the perfect visual. I know exactly what you mean. And I bet all of us, well, not all of us, but many of us have done that and then regretted it or thought, yeah, this just didn't work right.

Kati Morton (47:49)

100%. I think a lot of times it depends on again, how we're raised and how we think about our relationships. But for almost everybody out there, there have been times when we've been in a relationship where someone is a taker and we're a giver and we over give. You know, we do light ourselves on fire to keep them warm. And yeah, I love the visual too. And I love that because then what ends up happening and it's kind of like good play on words is then we're burned out. You know, if we keep doing that, we don't have anything left to give and we, we don't feel good. And the relationship itself truly cannot stand. You know, when there's one giver and one taker, there needs to be the ebb and flow. So yeah, it's, it's a very common problem. We've all been in situations like that. I feel like at least once in our life and it doesn't feel good.

Mike Carruthers (48:41)

Well, I think an awful lot of people listening can relate to this whole idea of behaviors that you do repeatedly

Interviewer/Host (48:48)

that you really wish you wouldn't.

Mike Carruthers (48:50)

And I admire your willingness to share your journey with what you went through to help other people. Katie Morton has been my guest. She's a licensed marriage and family therapist, and she's author of a book called why do I keep doing Unlearn the habits keeping you stuck and unhappy. And there's a link to her book at Amazon in the show notes. If you want to lose weight, you should exercise more. I think most people believe that, and it's not really true. The uncomfortable truth is that exercise is one of the least efficient ways to lose weight. Now, it's great for your heart and your brain and your mood and your lifespan, and exercise is excellent at preventing weight gain. But when researchers look at weight loss specifically, exercise alone produces far less fat loss than people expect. Why? Well, it's because the body adapts. When you burn more calories through exercise, you often get hungrier. You may unconsciously move less later in the day, and your metabolism can subtly compensate. In other words, the calories you think you burned off don't translate cleanly into fat loss. A major scientific review concluded that physical activity by itself is not very effective for weight loss without dietary changes to go along with it. So exercise matters, but not for the reason most people think. And that is something you should know. I hope you got something out of this episode, and if you did, you could share it in a review or at least leave us a rating on whatever platform you listen on. It really helps the show in terms of exposure. So please leave us a rating and review and I'd appreciate it. I'm Mike Carruthers. Thanks for listening today to Something you should know. I know you like interesting and thought provoking conversations and ideas because you listen to something you should know. So let me recommend another podcast I know you will enjoy. It's the Jordan Harbinger Show. Jordan has a real talent for getting his guests to share stories and offer thought provoking insights. Over the years I've sent a lot of people to listen and I get feedback from people who are so glad I introduced them to the Jordan Harbinger show recently. He discussed Scientology and the children who are raised in that organization. It's a fascinating conversation and he talked with Dr. Rhonda Patrick about how to protect your mind and body from the modern world and it's tougher than you think. I've gotten to know Jordan pretty well. We talk frequently and I tell you he is a very smart, insightful guy who does a hell of a podcast. Check out the Jordan Harbinger show on Apple Podcasts, Spotify, or wherever you listen to podcasts.

Vulgar History Podcast Host (51:49)

Oh, the Regency Era. You might know it as the time when Bridgerton takes place or the time when Jane Austen wrote her books, but the Regency Era was also an explosive time of social change, sex scandals, and maybe the worst king in British history. And on the Vulgar History podcast, we're going to be looking at the balls, the gowns, and all the scandal of the Regency era. Vulgar History is a women's history podcast and our Regency Era series will be focusing on the most rebellious women of this time. That includes Jane Austen herself, who is maybe more radical than you might have thought. We'll also be talking about queer icons like Anne Lister, scientists like Mary Anning and Ada Lovelace, as well as other scandalous actresses, royal mistresses, rebellious princesses, and other lesser known figures who made history happen in England in the Regency era. Listen to Vulgar History wherever you get podcasts.