Now Jen is an expert at dealing with people with chronic health conditions and helping them have hope and I think that's one of the big messages of this interview; that she really finds instilling people with the message of hope helps success. And we talk about a lot of the challenges people face, because let's face it, life doesn't go on a straight line. Behavior change is hard, nutritional change is hard but it certainly can be done.
And we just have to be able to prepare for what the challenges may be and understand how to overcome them and keep coming back to the message of hope. And I think that's the big take-home from this interview with Jen Unwin. She doesn't have products to sell, she doesn't have websites to visit, but you can see her on Twitter at Jen_Unwin and she just has a wonderful message to spread. So I hope you will enjoy this interview and if you want see the transcripts or see any of our prior podcast episode, you can find us at DietDoctor.com. Enjoy the interview.
Jen Unwin think you so much for joining me on the Diet Doctor podcast today.
Give us a little bit of your background and tell us how you got into this working with people with health problems and helping them with their behavior changes?
As we know, these days there are lots of people living for many, many years with chronic pain or diabetes or other disabilities that maybe limit their lives in some way or challenge their quality of life and that for many, many people make daily life a struggle. So I suppose what I've dedicated myself to is understanding how to help people to live well and to have some sort of hope and positivity in their lives.
So the way that I've kind of tried to think about that is drawing a lot of influence from the positive psychology literature, which I find fascinating which is about the role of things like hope and optimism and being goal-focused and what difference that can make to people and then how to sort of have those conversations with people in a way that's helpful and empowering.
And I use an approach called solution-focused that comes from- historically kind of began in the States actually as a form of family therapy in a place called Milwaukee and it's been around for quite some time now. And it's used in education and social care as a form of therapy, as a kind of conversation which focuses relentlessly on the person and their own personal goals and their own personal strengths and so on to enable them to do that, to move in a direction which is right for them and is more hopeful and positive for them. So that's kind of quite a long answer.
You probably choose to do that, you know, you make yourself vulnerable and you don't know what the person is going to be like, what they're going to ask you... So I always say, "Oh, you've come today. "Obviously you are hoping for something to be different or better. Tell me about that. And that's always the first really detailed exploration which is around... if they can... I mean sometimes I see even a real struggle for people... that they've got so low and hopeless that there is a real struggle to think about what might be different and what might be better because they've lost the sense that there is much possibility of that.
And trying to get- I think what you said was really important... was almost like a visualization of what that might look like. And that's a really powerful thing. Once people start to be able to imagine that in their minds and picture some kind of sense of better or sort of preferred future, that's when the magic begins really... When somebody can picture that in their minds.
So the approach that I take is really through the kind of questions that you are asking people, is directing their attention to other things, shining the light on other things and trying to train them to do that. And you do that through the kind of questions that you ask. So, sensitively asking, when did you have even a slightly less bad day or tell me about a time when just for even a few minutes you weren't thinking about the pain?
So you have to ask very sensitively because people are suffering and you have to acknowledge that... But tiny glimpses, if you like, I often say, like in a grey sky... are there any times when there's just the tiniest little bit of blue? Tell me about that. Let's kind of unpack that. When they had a slightly better day and they tell you about it, what made the difference, what was going on that was different that day and trying to be a real kind of a detective.
People often say things like, "The grandchildren came around "and you know, that made me laugh because I got distracted by- They were messing about something and that was really nice and..." And I say, "I notice you smiling... you are smiling when you talk about that. Your eyes light up when you talk about that." And you can really dig down into that and emphasize it and kind of shine a light on the things that are exceptions to the rule of everyday as suffering 100% of the time. Which is-
The joy of the grandkids or just being able to exercise more, spend time where you can concentrate on your loved ones and not worrying about your own problems. I mean whatever the goal may be, I think connecting with they can be so powerful. So do you help people sort of find that and reconnect? I guess you have little tips you give people of how to reconnect with the goal and how to reconnect with the "why".
And exploring those kinds of values and as you say goals can also lead into, you know, how can you get more of that in your life, how can you use maybe the reduced energy that you have because people with chronic conditions often have a much less energy to spend during the day and they often feel that they have to spend it on things they should do like their jobs and you know, the kind of things that don't bring much joy to their lives. So I try to encourage them to notice the times when they are living their values if you like and do more of that.
I think you can and David does it in his 10 minute appointments. I think if you've got extended contact with someone- yeah, maybe it's only 10 minutes but that may be every week or you know, in a hospital setting every day... you can then build up quite a good rapport with somebody.
So I present it as, we've talked about that your best hopes would be around- you know, maybe that our maybe having more energy to play with the grandchildren, maybe have a goal of taking them on holiday or something, whatever it is for that individual... if that was your 10 out of 10, that absolutely would be brilliant for you and not to have 10 where actually absolutely none of that thing exists or it feels completely impossible... where are you now? And nine times out of 10 people don't say zero actually.
Nine times out of 10 people would say, "I did spend an hour with the grandchildren. "I was able to play a game of snap with them or something and you know, maybe I am a two or a three." And that again already gives people a sense of progress. They're not at zero. That's a different case. If they say zero you kind of go down a different road. But two or three, okay, that's really interesting. Maybe if you were a three and a half. Tell me about that. What would that look like? They say, I don't know, I'd take them to the park.
They will come up with something themselves. The fact that they've come up with it themselves means it's kind of doable because they've generated it themselves you already know that they're contemplating that they could actually do that. So you have to say to the person, "Go and do that" or "What is the next step?" It's not about the means if you like, it's just asking, "What would that look like?" And nine times out of 10 they do usually go away and do that thing. Not always, but quite often.
And because you've not said to go and do it if they come back and they haven't done it is not a failure. So you're never setting someone up for failure because if they come back and they have done it that's fine, but they might say, "I didn't do that but we did- People go away and have complicated lives, so I think the trouble with setting specific goals is that sometimes people can't achieve them.
And people start with something negative actually but usually will come up with something that has been better or they may have done the thing that they said that they were noticing. And you can say, "10 out of 10 is where you've been. "Last time we met you were at two and a half. "What would you give yourself today and why? And what else is going well? What else have you noticed?"
I mean in the keto community, in the low-carb community, you hear a lot about success, you hear a lot about people doing wonderfully, but there's a pretty large subset that struggles for different reasons. So tell us what you think some of the biggest struggles you've heard are? And then we can maybe talk about some strategies to get past that. But what are some of the biggest struggles people have or the reasons why they're not succeeding the way they want?
So I would say that's probably the biggest reason for the struggle or for setbacks and then we try and never frame that as a failure, but just as like, "Okay, interesting"... What were the kind of circumstances of coming off track? If they want to get back on track... "You might handle that differently next time... would you have a different plan? How are you going to get back on track? "
So I always say to people it's about building those good habits and engineering the environment, yeah. So if you can, put stuff out of sight. So if other people in the house want to have it, can you have your own cupboard and only go in that cupboard? Can you have your own shelf on the fridge so that you are kind of training yourself to have those new habits really.
So if you tend to overeat certain things even if they might be the kinds of things that you are allowed to eat, like we often overeat nuts or cheese, and maybe don't want to... Because quite a lot of good food is about packaging things up in smaller packets, so even if you buy things in bulk then transfer them into smaller pots.
So engineering the environment, thinking about preparation, taking things to work rather than being tempted to go to the canteen if there's- Some canteens obviously you're going to find would have good options, but some places I guess is not going to be much that you want to eat.
And so trying to think how you can have those conversations with people in a way that you feel comfortable with. And do you want to put that politeness above your own health? Yeah, all of these things are challenges. I think all of us are still on a learning journey. We've been doing this for six or seven years ourselves and I think it's still a challenge.
Because if there's a food addiction issue we know that that hijacks the dopamine pathways and other neurotransmitters. And dopamine really strongly links with motivation, but what it does is it makes you just motivated for that one thing, you are getting all your reward from food. So let's name that and let's think where else you might get rewards or kind of pleasurable brain experiences. So what hobbies or, you know- physical activity is actually a big one.
Not necessarily for weight loss but to enhance people's mental health and I think that has a really powerful effect if you just get people even walking. We know, all the science is there, for mental health and exercise. And to get those kind of good endorphins going. What hobbies have they maybe given up either due to their size or pain or whatever? But what kind of things might they enjoy, social connectedness, you know, all of those things are other ways of getting that good feeling.
There is nothing so inspirational than seeing someone else who you identify with who lives in your community who might be the same age as you, you know, doing amazingly. And quite a few people in the group have been doing it for five or six years now, so one or two people are still losing weight after all that time or who have lost really a significant amount, six or seven stone, and they are occasionally bringing their photos to show the new people who always are obviously blown away.
People really get that because it explains a lot about physiology to the patients and the idea of trying to keep insulin low and not needing to eat breakfast and there's all the evidence now for the kind of window eating. So I think that can be a kind of a second phase for people who want to get used to the idea of the whole nutrition side, then they can start reducing the window. But also David always is really against snacking because again that can creep up. So I think if you can base your daily routine around meals and not kind of an endless grazing... again there's evidence of that because of the insulin side.
Bret:And snacking frequently is more of a psychological issue than our biological hunger issue. Jen: Feeling a bit where, you know, you kind of fancy a treat... We have all been kind of trained into the snacking thing. Sometimes it still blows my mind how far this is from the sort of conventional wisdom that we all grow up with, which is, you know, eat little and often, eat low-fat.
Well, you know, when you find out you didn't really need to struggle, there was a response to that and having had family members who definitely would have benefited from this. I know for sure that my mother would have been so much more well because we have basically the same sort of physiology. Kind of, you, there is an emotional response to that and people have that as well in the group.
So some people often brings with them so we definitely need a bigger room. The standing room only is- some of the groups we've had were, you know, 20 to 30 people. Started off as only a few. But we are still getting a good interaction as well and people are sharing success, asking questions, sharing recipes. I've got a little Facebook group for them as well.
Transcript pdf