Hurricane Harvey was a turning point for many, but for Dr. Manizeh Mirza-Gruber, it was the catalyst that clarified the powerful role of mindfulness in healing. As we sit down with the founder of Mindful in Practice, she shares her transformative journey and how it shaped her mission to integrate mindfulness into the fabric of psychiatry. Dr. Mirza-Gruber's personal insights and professional expertise in mind-body medicine take center stage, offering a heartening glimpse into the ways mindfulness can alleviate suffering and promote overall well-being in the most trying times.
Throughout our engaging conversation, Dr. Mirza-Gruber unpacks the science and spirituality of mindfulness, equipping you with practical tools and techniques to navigate your own internal landscape. Whether you're new to the practice or seeking to deepen your understanding, this episode is a treasure trove of wisdom on harnessing the present moment. From grounding exercises to breathwork, Dr. Mirza-Gruber illuminates how these practices can serve as a lifeline during trauma, soothe the sting of shame, and foster a more compassionate self-connection, ultimately leading to richer, more mindful living.
Follow The Menninger Clinic on Twitter, Facebook, Instagram and LinkedIn to stay up to date on new Mind Dive episodes. To submit a topic for discussion, email podcast@menninger.edu. If you are a new or regular listener, please leave us a review on your favorite listening platform!
Visit The Menninger Clinic website to learn more about The Menninger Clinic’s research and leadership role in mental health.
Hurricane Harvey was a turning point for many, but for Dr. Manizeh Mirza-Gruber, it was the catalyst that clarified the powerful role of mindfulness in healing. As we sit down with the founder of Mindful in Practice, she shares her transformative journey and how it shaped her mission to integrate mindfulness into the fabric of psychiatry. Dr. Mirza-Gruber's personal insights and professional expertise in mind-body medicine take center stage, offering a heartening glimpse into the ways mindfulness can alleviate suffering and promote overall well-being in the most trying times.
Throughout our engaging conversation, Dr. Mirza-Gruber unpacks the science and spirituality of mindfulness, equipping you with practical tools and techniques to navigate your own internal landscape. Whether you're new to the practice or seeking to deepen your understanding, this episode is a treasure trove of wisdom on harnessing the present moment. From grounding exercises to breathwork, Dr. Mirza-Gruber illuminates how these practices can serve as a lifeline during trauma, soothe the sting of shame, and foster a more compassionate self-connection, ultimately leading to richer, more mindful living.
Follow The Menninger Clinic on Twitter, Facebook, Instagram and LinkedIn to stay up to date on new Mind Dive episodes. To submit a topic for discussion, email podcast@menninger.edu. If you are a new or regular listener, please leave us a review on your favorite listening platform!
Visit The Menninger Clinic website to learn more about The Menninger Clinic’s research and leadership role in mental health.
Welcome to the Mind Dive podcast brought to you by the Menninger Clinic, a national leader in mental health care. We're your hosts, Dr. Bob Boland and Dr. Kerry Horrell twice monthly.
Dr. Kerry Horrell:We dive into mental health topics that fascinate us as clinical professionals and we explore those unexpected dilemmas that arise while treating patients. Join us for all of this, plus the latest research and perspectives from the minds of distinguished colleagues near and far. Let's dive in. Well, welcome to the Mind Dive podcast. Today we are joined by the wonderful Dr Manizeh Mirza Gruber MD. She is the CEO and founder of Mindful in Practice, based in Houston, texas. Dr Mirza Gruber is a licensed board certified psychiatrist with the American Board of Psychiatry and Neurology. In addition, Dr. Mirza Gruber is a certified mindfulness meditation teacher, a certified mind body medicine skills facilitator and a certified yoga teacher. That is really what we're here to talk about today is your expertise on mindfulness meditation and what role that plays in modern psychiatry. Welcome.
Dr. Bob Boland:Welcome. Thanks so much.
Dr. Manizeh Mirza-Gruber:Thank you for what an honor and pleasure it is to be with both of you, bob and Kerry. Really thank you for allowing me to be your guest on the podcast and, if it's okay with you all, I always begin with coming into the space with whoever I'm with, whether it's on screen or in person, so would you allow me a minute to please enter into the space together? Yes, please, okay. So I will just begin with the sound of one bell and we'll end with the sound of one bell.
Dr. Kerry Horrell:Okay, all right.
Dr. Manizeh Mirza-Gruber:So, just for a moment, I invite you to allow yourselves to transition from wherever you were before you came into your space, to transition from the space we are in before we began the recording, and to land and arrive in this present moment, to be here just the way we are and to be present with all that is arising right now, both within us and beyond, and what will arise as we share together, perhaps allowing yourselves to take three fuller, deeper breaths so that we may settle on of a system, calm our mind and come into a heart space.
Dr. Manizeh Mirza-Gruber:So a slow, deep in breath in through your nose and a longer, fuller, deeper outbreath out through your nose. Amount whichever is most comfortable slower, deeper in breath and a longer, deeper, fuller outbreath, perhaps allowing the in breath to go to a place that may be holding some tightness or tension and, as you breathe out, allowing that place to soften and release, to release what is not needed in this moment, and to just be in a space of kindness and gentle, mindful presence and returning to your own natural breath, as you hear the sound of the bell.
Dr. Kerry Horrell:Thank you, not our usual opening, a very experiential opening it's really helpful to listen to.
Dr. Bob Boland:Yeah, get ready for this, get ready for this talk.
Dr. Kerry Horrell:Like if people stopped listening right now, they still got.
Dr. Bob Boland:Yeah, they got something.
Dr. Kerry Horrell:They got a minute to really settle into their body and have a mindfulness experience.
Dr. Bob Boland:Yeah.
Dr. Kerry Horrell:Thank you for that.
Dr. Bob Boland:Yeah, and you're like yourself like how did you get interested in specializing in mindfulness and now you're coming from an MD background, so I'd like to hear more about that.
Dr. Manizeh Mirza-Gruber:Goes back a long, long way, goes back to childhood. So I was born and raised in Karachi, pakistan, and the youngest of three sisters Never even really knew I wanted to go into medicine, leave alone psychiatry, but always, always taking care of people since as long as I can remember. But what I also remember is that I was very aware of my own sensitivity and perhaps anxiety, and would get nervous easily, care deeply and was more empathic than most people. And part of that was noticing, as I was growing up, that I felt my emotions deeply in my body. Thank you, I was aware of a mind-body connection. I just didn't know what it was. And I did yoga. I remember sitting. I loved silence, I loved being in spaces where I could connect with myself. I loved to color and draw and do very mindful activities. I always loved being present. But we lived mostly, even growing up and then moving to the United States For my residency and fellowship that everything was so quick and I was not resonating with that. And then, through my residency and fellowship, I had a life event that was extremely difficult and I took to running. Now I've always been a fast runner, growing up very competitive, but when I took to running, I connected once again with my body and running became my healing. I'm a marathoner, I'm an ultramarathoner and running is still my source of healing because it allows me to connect breath and body.
Dr. Manizeh Mirza-Gruber:Fast forward, hurricane Harvey happened and we flooded, and I was affiliated and knew the Institute for Spirituality and Health and was invited to join the Greater Houston Healing Collaborative when the Center for Mind Body Medicine came in with Jim Gordon to join their professional training program and advanced training program so that we could bring healing in the aftermath of Harvey. I subsequently became certified as a mind body medicine skills facilitator, was leading workshops and groups in the community, the first one on Zoom for healthcare professionals, and through that and through the Harvey experience and following that, which is all these years later, there were subsequent challenges in my family. There was death, there was illness, and the only thing that saved me from dark nights of the soul was a mindfulness-based practice, was connecting with the inner wisdom of myself, connecting with my mind, body, heart and spirit, and that led me to wanting to give back. It's about finding purpose and knowing that through my life experiences, I can provide something to others who are suffering, and even those who are not, because I do know that this works. It's transformative, and so that became part of my practice. I was already doing that. I always did breathwork. I always related to patients in a very compassionate way.
Dr. Manizeh Mirza-Gruber:My practice has always been both in community mental health as well as when I started my private practice. It's always been holistic and integrated because I know it works for me and fast forward. I'm a mindfulness meditation teacher. I'm soon to become a mindfulness mentor and I lead workshops in groups and one-on-one training. It is really my life's purpose. I still do clinical psychiatry. I love it and this is what I bring into practice. This is what I bring into practice with my patients, with students, with my dogs, with my home life and with a daily 24-7 way of being in the world. I begin my day like this. I end my day like this.
Dr. Kerry Horrell:I have so much that and I know we've connected and talked about this, our mutual involvement in the Institute for Spiritual and Health and I have so much I want to talk about and think about in regard to mindfulness, because I see it as such an important part of healing, especially from trauma, and that's some of the work that I've done. But I think before we hop in too far into them, talking about the benefits, we should probably orient people to what is To the characteristics.
Dr. Kerry Horrell:Because I think, especially in mental health, it's something we use that word all the time. It's so a part of nearly every kind of treatment for any kind of struggle someone's having. But I don't know, though, we always really, truly talk about what it is. What is mindfulness?
Dr. Bob Boland:It's become a bit of a buzzword.
Dr. Kerry Horrell:Yeah, and then now it's such a buzzword that I think nobody's like well, hold on. Actually, what does that actually mean?
Dr. Bob Boland:Yeah.
Dr. Kerry Horrell:And so I wonder if you can say a little bit about your understanding of the concept of mindfulness. What are the key principles, or what is it? This thing?
Dr. Manizeh Mirza-Gruber:Wonderful question and you're right, it is a buzzword. We're using it and throwing it around without really being with it. So many different definitions, whether it's a definition by John Kabat-Zinn, whether it's Tara Brock, Jack Cornfield, who are my teachers, and so many other teachers, Sharon Salzburg, Joseph Goldstein, all those who brought mindfulness meditation from the East to the West, an old practice over 2600 years old. I, for myself, I refer to mindfulness as a moment to moment, awareness of what is arising both within and outside, and being with what is arising in the present moment, without judgment. The key word becomes a non-judgmental awareness, and mindfulness practice is most people will say I cannot, oh, I can't do this. I have so many thoughts and I'm always distracted.
Dr. Manizeh Mirza-Gruber:That is mindfulness practice. The moment we notice that we are becoming distracted, that is a moment of mindfulness. It's mindfulness notices that we are distracted and brings us back to whatever that anchor is in the moment, whether it's breath, body sensations or sound. And the way I see it is, there is the formal practice, which would be the formal meditation practice, whether it's sitting, standing, laying down, walking. But life happens in the informal practice. Life happens off the mat, off the cushion. But what we practice on the cushion, whether it's even five minutes, is what allows us to be mindful of the cushion, which means bringing awareness to what is arising in our thoughts, in our emotions, in our feelings, in our sensations, and to what is happening around us.
Dr. Kerry Horrell:I have thoughts about this, but I want to hear from you. If someone said to you, dr Mayer is a group, why would that matter? Why should we or why might we benefit from being more connected to what's going on inside of us, both physically, emotionally, spiritually what's the point of it? Why would I do that? What might you say? Because I've gotten some people who've said that you know, I don't like to meditate, I don't like to do this, I don't need to be stewing in all my thoughts. I need to be moving forward, thinking about my life, I need to focus on things that matter, not just slowing down. And yeah, I'm curious how you might respond to someone who's kind of skeptical of this stuff.
Dr. Manizeh Mirza-Gruber:In order to be in the world, in order to be with other people. We don't live in isolation. One of the most important aspects of being human is knowing that we belong and that we are connected in a much larger way to what is around us. We cannot, in my mind, know that we belong if we don't know what we belong to and where we belong. Mindfulness, being mindful, allows us to connect to ourselves, to our breath, to our body, to what is arising in the feelings, those hundred thoughts, that is the chatter going on, and for those thoughts are going to be there. The thing about the people I feel most must understand is that to meditate or to be mindful means to not have any thoughts. We're going to have the thoughts. The thoughts are not going to stop they are going to come.
Dr. Manizeh Mirza-Gruber:They are going to come right now, right now, to one thing with me. Okay, I am going to, in a few moments, set a timer 30 seconds. Usually I do it for one minute, but I'll do it with you for 30 seconds, unless you want one minute. You're going to count your thoughts when I turn the timer on. All right, thoughts can be visual images. Thoughts can be words that pop up. Thoughts can be ideas. You may not have any, you may have many. There's no test. This is not a test. All right, One number doesn't matter more than another, but let's see what happens if, for 30 seconds, you just begin to notice how many thoughts. So just count them, that's it. You just have to count them as they pop up. You don't have to do anything else but count. Okay, so I am going to set my timer 30 seconds. Let's go, all right, let's stop, let's take a nice breath in and out. And if I were to ask you did you have any thoughts?
Dr. Kerry Horrell:I had about nine that I counted no way. How many do you have? Nine? You had nine.
Dr. Bob Boland:Yeah, okay, I was on the phone.
Dr. Manizeh Mirza-Gruber:Okay, all right, you had nine thoughts. Okay, were you able to?
Dr. Bob Boland:First, mostly we're about thinking about the same thing. Yeah, okay.
Dr. Manizeh Mirza-Gruber:Were you able to control them?
Dr. Bob Boland:Oh, were we supposed to?
Dr. Manizeh Mirza-Gruber:No, that's why I'm asking you. No, we're not supposed to Right, no, no, okay, so you had to.
Dr. Bob Boland:I got to say, though, I think just the whole tenor of how you presented it, I think I kind of slowed down. Yeah, I think I would have had a lot more thoughts. Okay, without the exercise.
Dr. Kerry Horrell:I think a lot of my thoughts were. Am I supposed to be having thoughts right now?
Dr. Bob Boland:That's a thought Right.
Dr. Kerry Horrell:I know and I was like I guess I'm hearing the rain, that's a thought.
Dr. Bob Boland:Yeah, right, that was wondering if I can hook him. He didn't use the gong Right.
Dr. Manizeh Mirza-Gruber:And were you, am I doing this right, right?
Dr. Bob Boland:Yes.
Dr. Manizeh Mirza-Gruber:Whenever the thoughts you were having the fact is you may not have had any, but what did you do when Bob said you noticed? You actually became aware of your thoughts. We live in a world where it's mindless, remindless. These thoughts are going to come and go. The analogy is observe them like clouds in the sky and just let them float on by. And, as when I teach, I'll say just the thoughts are like clouds in the sky. You are the vast, expensive sky. You are not your thoughts. The thought is a wave in the ocean and you are the vast ocean that holds the thoughts.
Dr. Manizeh Mirza-Gruber:What ends up happening is we get stuck. So, even for those who are skeptical, we think we should not be thinking. If we are being mindful, we are going to keep thinking. That's what the mind does. A salivary gland secretes amylase. Our mind secretes thoughts. It's what it does. Thank you for watching. The noticing the being in the present moment, with whatever is arising, allows us to notice our thought. We notice it's a thought. Then we can name it oh, planning, judging, happy, sad, fearful. And then we can work with it, because most of the time we get stuck in the content of the thought, which is 90% or 95% of times a rerun. It is watching the same episode over and over again. Those are ruminative thoughts. We get stuck in thinking. Mindfulness allows us to notice thinking and let it go by and bring us back to the present moment before we can even go deeper into the content of the thoughts. And there are many, many practices where we can actually go further into those thoughts, which generally are negative self-talk.
Dr. Bob Boland:I know we're limited here, but do you want to mention some of the actual techniques used in mindfulness, some of the actual things you might do with someone? The body scan you don't make a thing for you.
Dr. Manizeh Mirza-Gruber:Absolutely so one of the things that to be cognizant of. If I was one-on-one with someone, I would also check in with them what their needs are and get an idea of where they are, because mindfulness, for me, is a beautiful practice, but for some individuals Kerry, you mentioned trauma. For some individuals, becoming more mindful might not work initially. So one of the things we can do is begin with a grounding practice, and a grounding practice is just becoming aware of where an individual is in their breath and body, so it may be noticing the five senses. Grounding in the five senses Also is, as I lead them, is noticing where the feet are in this present moment. I'd invite you to notice even now as we're talking, notice where your feet are, where it is pressing on that surface below. Perhaps press down a little bit deeper and allow yourselves to feel that contact of the earth beneath your feet, holding it and supporting it. When we notice where our body is or where our breath is, we are always in the present moment, as our breath and body cannot be anywhere else. We're not in the past where we dwell. We're not in the future what we worry about. So grounding, whether it's in the feet, whether it's on the contact surface of your seat, whether it's where your hands are, whether it's grounding in a sound, whether it's noticing the sensations coming into the breath. Allowing that to anchor you becomes a practice. If someone is not able to even ground, you can go one step before that, which would be resourcing, which is bringing into mind a visual image of a place someone felt most comfortable in, or perhaps putting their arms around themselves holding or imagining a loved one holding them. Resourcing with an image that allows them to feel comfortable in the moment, then begin to ground and then bringing more awareness to the breath. In mindfulness practices, the breath does become the anchor in the moment because it is the present moment and whether that's a natural breath, deep or full of breaths, audible, sound breaths, we come into that. Then I do a body scan, not always, but just to settle. Just to settle. I will lead them to a body scan.
Dr. Manizeh Mirza-Gruber:Mindfulness practice can also include loving, kindness or meta. That is the Pali word for loving, kindness, compassion practices, equanimity practices, sympathetic joy, appreciative joy practices, gratitude practices. It encompasses all of that, and so I lead individuals and groups in different sorts of practices. This month, my theme is presence. It's on my newsletter. I choose a theme for the month, but I have found that presence, which is different to being present, presence, being a state of being, allows me to truly connect to the light within, to this inner goodness that I know is within me and shines in each one of us, to the inner goodness that is within you right now, and so I come into presence so that and coming back to your question, kerry if I am not in presence with what is happening within me, how can I be with you?
Dr. Manizeh Mirza-Gruber:It's pivotal in any relationship. How can we be with our patients? How can we be with our partners? How can we be with our four-legged beings? How can we be in nature? Mindfulness in nature is absolutely a beautiful practice. I do it every day. How can we be in this world if we cannot connect with the one most important person, that is, yourself?
Dr. Kerry Horrell:And I think about so. When I was doing my training, I was not a huge. I wasn't drawn to the mindfulness meditation mind-body side of things, probably because I felt like I was quote not good at it, which is funny. As you describe it's like I think people love to say that I'm not good at this. It's like good at just existing. That's not great. But one of the people who really sold me on it was a longtime social worker here at the clinic. Her name was Linda Gwackenbush. Her name is and continues to be, and when I was a trainee we led a trauma group together and one of kind of the ways that she broached this with patients and it was so compelling to me as a trainee as well is she would talk about how, for folks who've been traumatized and the experience of mental health symptoms related to trauma on the brain, what research has found is that some of the only things that really help rebuild the brain after people have experienced intense trauma is mindfulness, yoga, meditation. So I was hooked by the science of it.
Dr. Kerry Horrell:I was like okay well then, I guess this really, I want to go down this path, I want to learn more about it. And then I think, in working with people, my two areas that I tend to really care a lot about is trauma and shame and shame. Brené Brown would say people don't ever want to talk about it, we don't want to be with shame, we don't want to be inside our body when we're having that feeling. And then with trauma, that's also the case. That is like people want to get away from even their own internal experiences when they're in those, those symptoms. And so you know, I think about mindfulness. It's it's really quite simple, like the actual idea of it. Non-judgmental awareness is really simple.
Dr. Kerry Horrell:But I think, especially for people who have known a lot of pain in their life or are struggling, this becomes incredibly challenging. It's a very challenging thing because to be present with oneself is often to be present with pain and some of the struggles that they've had, and so, again, I I found in my work like it's been something people tend to not want, especially if they've had a lot of pain in their life and have found it really, really a critical part of learning to come back to themselves, the present moment, healing, safety by learning to have a different experience of their body again. And so I do. I do wonder and yeah, go wherever you want with this question, but like what have you found in regard to the science, the research, your own clinical experience in regard to the benefits of mindfulness and healing, especially from mental illness, trauma, shame?
Dr. Manizeh Mirza-Gruber:I think I'll begin with prefacing once again that it's really important to meet the individual we're working with where they are cannot push this, and so it may mean taking a step back and allowing other practices for instance, a gratitude practice, a loving kindness practice, a self compassion practice or even compassion for others, to allow an individual to feel comfortable belonging wherever they are, however they are. You know Sebeni Salasi, who's written the book you Belong. It's a beautiful book. We long to belong and it's really hard when there's been trauma and pain and we feel that shame. There's also the rain practice that Tara Brak teaches, which is the acronym. Rain stands for our for recognize, a for allow, I for investigate, and N for nurture, and then there's a period after the rain and two. It's like a tango or a waltz one step forward, two steps back. You titrate, you pendulate, you see what is helpful, or the individual in front of you, but them to see their own goodness, their own light, their own humanness and to trust it. The element of trust has to be there. So in my practice, if someone is coming with trauma and which one of us doesn't in one shape or form, including myself building that relationship of trust and going baby steps at a time, checking in frequently becomes really important.
Dr. Manizeh Mirza-Gruber:I really do feel we can't rush it, but the benefits of it, I mean, are incredible. I mean both from mental health, where so you have a psychological, emotional health, of where research has shown how the practice of mindfulness reduces stress. That's what MBSR is right, mindfulness-based stress reduction that John Kabat-Zinn brought in in the early 90s. That is now in almost every medical school and is being taught. So reduced stress, depression, anxiety, trauma symptoms, ruminative thoughts, emotional regularity, the affective tolerance, all of that. Then there's the physical benefits of reducing blood pressure, improving heart rate, immune function, the inflammatory responses, pain that's MBSR right, it's chronic pain.
Dr. Manizeh Mirza-Gruber:And then I feel the most important is also our social benefits connecting with ourselves and others, compassion, improving both the home environment as well as our work environment, the empathy, the caring, the kindness, the compassion, the gratitude, forgiveness, all of that I mean the benefits are tremendous and I find in my interaction with people, both in those who come to my mindfulness classes as well as my patients, it's tremendous, it's just incredible. I mean I was seeing someone yesterday who just said, dr MG, I just love being in your presence, I'm not tooting my own, but how can we connect with each other? It's what we are meant to do. We need to know that we belong, with our fear, with our shame, with our trauma, with our depression, all of it.
Dr. Kerry Horrell:I think that's so beautifully said and, again, my sense is that it's challenging for so many people to learn to do that slowing down, and I'm very grateful for your work and for your practice. And I wonder, as we begin to wrap up for today, what might you want to leave our listeners with?
Dr. Bob Boland:Actually before you, can you mention more about your newsletter? Is that online, that's?
Dr. Manizeh Mirza-Gruber:a good point. Oh, thank you for bringing that up. So I write, I write, I'm prefacing, I write. No other artificial intelligence does my work for me. I take my own photographs. Okay, that's why I'm prefacing.
Dr. Manizeh Mirza-Gruber:So I write a newsletter which is sent out on the first and 15th of the month to anyone who subscribes to the newsletter. So if they go to my website, there is a button that they'll click subscribe to the newsletter. They just put in their name and email address. It's free, there is no spam, and in it I have created a theme for the month and it's personal reflections, it's mindfulness tips, it is few upcoming workshops and classes, but what it has for those who subscribe is for the last two years I have facilitated a free virtual on zoom guided meditation that is called mindful Mondays. It's every Monday from 12 to 12 30pm, central time, except for holidays, although I still let it on modern Luther King day because it was important. It's come one, come all, no experience necessary. Keep your video off if you want, just listen, show up. No RSVP, no registration, just subscribe to the newsletter and the zoom link is there.
Dr. Manizeh Mirza-Gruber:So I love sharing what I not just know, but what I know deep within every cell of my body that has given me a second chance. I truly believe that being present and being in the presence of each other and being with whatever is arising, even in the difficult moments, my challenges, my suffering, are my teachers. I wouldn't be here without them. They are my guiding light. They are my guiding light when Carl Jung said only the wounded physician heals. That's how I've had, that's how my healing is and it will be. It'll be an ongoing process because I know there'll be more wounds. But what I do know is that I can heal and I have it within me to do that. And if I can do that, I want to share this with other people. That is my purpose. That is my purpose to give my experiences. I'm not shy about being vulnerable. I will keep lovingly firm boundaries, but it is through my experiences that I know I can help other people.
Dr. Kerry Horrell:I am very grateful for your work and again, also especially Mindful Mondays and that gift to not just our community but to people who are available to join that. So gosh. Thank you so much for coming and speaking with us, Dr Music Group. I feel like there's so much beauty in what you're talking about and so much more we could talk about, but thank you for what you have shared and for coming and chatting with us. We've been your hosts. I'm Dr Kerry Harrell and Dr Bob Bowland.
Dr. Kerry Horrell:Thanks for diving in. The Mind Dive podcast is presented by the Menninger Clinic. If you're curious about the professional experiences of mental health clinicians, make sure to subscribe wherever you listen.
Dr. Bob Boland:For more episodes like this, visit wwwmenningerclinicorg.
Dr. Kerry Horrell:To submit a topic for discussion, send us an email at podcast@menninger. edu.