#88 Working through Anxiety with Psychotherapist and T1D mom, Joanne Robb

Being a parent or caregiver to a child living with type 1 diabetes can come with a lot of anxiety. Listen in to today's episode as Psychotherapist and fellow T1D parent, Joanne Robb, and I try to unpack some of that anxiety and discuss how to work with it and through it. Joanne is such a great resource for parents and caregivers of type 1 diabetics. In her practice, coaching courses and podcast, she primarily deals with the emotional and relational challenges that come along with managing T1D. Check out all the links below to find Joanne! Enjoy!

For JOANNE'S WEBSITE click HERE.  Click on the dark purple banner at the top of the page to be a guest on her podcast and have your questions answered! You'll also find a direct link to the podcast itself.

OTHER EPISODES YOU MIGHT ENJOY
Trialnet
Early episode on Anxiety
The Grief and the Trauma of a T1D Diagnosis

Transcript

Katie: 0:00

This is episode 88 of the sugar mamas podcast today. My guest is Joanne Rob, a psychotherapist and fellow T one D mom, Joanne actually has two children living with type one diabetes. One is already grown and flown, and one is a freshman in high Joanne has so much wisdom to offer listeners. In her practice. She primarily deals with the emotional and relational challenges that come alongside being the caregiver of somebody with type one diabetes. Joanne is actually going to be my guest for a handful of episodes. As I do a little mini series. On anxiety, validation, feelings, and emotions. And relational challenges all from the lens. Of a type one parent. The topic for today's episode is anxiety and working through the anxiety that we may experience. As T1 D parents. Make sure you check out the links in the show notes to find Joanne's website at diabetes. Sweet talk.com. There you'll also find a link to her podcast, which we're going to talk about in this episode. Uh, I won't give anything away, but just to let you know it is awesome and you're going to want to find it. I'm also going to link to a few other episodes that I mentioned in this one, such as the episode I did on TrialNet. If you're interested in having your non-type. Type one kids tested for the diabetes auto antibodies. I did a very early episode on anxiety that I think you would enjoy listening if you like this episode. And I did an episode on grief and the trauma of a type one diagnosis that I think you would also enjoy. If you enjoy this interview with Joanne. So again, check out the links in the show notes for all of that. Okay. Without further ado, let's get started. You're listening to the sugar mamas podcast, a show designed for moms and caregivers of type one diabetics here. You'll find a community of like-minded people who are striving daily to keep their kids safe, happy, and healthy in the ever-changing world of type one. I'm your host and fellow T one D mom, Katie Roseboro. Before we get started. I need you to know that nothing you hear on the sugar mamas podcast should be considered medical advice. Please be safe, be smart, and always consult your physician before making changes to the way you manage type one diabetes. Thanks. Hey everybody. I am here with Joanne Robb today, and I think this is just gonna be a fantastic episode. Joanne is actually gonna be joining me for a handful of episodes. But Joanne, I would like for you to introduce yourself and tell the listeners how you are connected to the world of Type one Diabetes.

Joanne: 2:56

Hi Katie. Thanks for having me on the show. I'm so excited to be here. I am a mom with three kids and two of them have type one. They are the, my type ones are now 23 and 14, diagnosed at nine and four, and my poor middle child is currently 19 years old. And I am a psychotherapist. I have a practice in Oakland, California, and I specialize among other things in treating adults family. With Type one Diabetes, but I actually started a group called Sweet Talk. Diabetes sweet talk.com is the website and I, my goal with that group, it's a coaching program for parents of kids with type one to help them reduce their anxiety and stress to sort of move diabetes out from the centerpiece of their lives. So that they can live with less anxiety and with less focus on diabetes so that they have the possibility of focusing on the things they want to right, the things that bring them joy. Cuz diabetes is a heavy load, as we all know, and I think that parents can get really bogged down in it in a way that's actually not productive for themselves, for management, for family relationships. And so I. My goal is to help with that in the coaching program, and I recently actually started a podcast that's a q and a format, kind of like an ask the therapist format called Sweet Talk for Parents of Kids with Type one Diabetes. And I get on and answer parent questions about sort of the social, emotional, developmental anxiety problems that we struggle with that we can't get answered in the Endo office. So those are all my connections to diabetes.

Katie: 4:28

Yes, and I can tell you for sure that most of the time, I, or at least 50% of the time I should say, when people reach out to me with questions, they're mostly like focused around the anxiety of it all, the emotional toll that it takes on. You as a parent and a caregiver, and then of course your kid who's living with this disease. And, and you know, I've had several people ask, Can you recommend somebody that I can go and talk to about my anxiety or just, you know, the depression that I'm having because of this? And there's really not a whole lot of people out there that really specialize in, therapy sessions for a, a type one caregiver or just a caregiver who has a kid with, you know, a chronic medical condition no matter what it is. So that's pretty rare to find. So I was really excited when you reached out and I was like, Oh, good. Now I have somebody that I can refer these people to,

Joanne: 5:21

people to,

Katie: 5:23

who can, who can help them. It's such a challenge.

Joanne: 5:26

It is and it's part of why I wanted to create the coaching program. So it's much more behaviorally focused and the goal is to help really both bring people together so it normalizes everybody's experience cuz everyone in the space is having a similar experience and also provide parents with some very concrete tools to help them. Shift their worry, their anxiety over, Right? Because there are so few people who do the work. You know, there are a few clinics I know who have a psychologist on staff, but those are few and far between, and so I feel like parents need more support than that.

Katie: 6:01

Right. And anyone can access the coaching courses that you offer, Correct. It doesn't have to be just within your state. Yeah.

Joanne: 6:08

Yeah. That's part of why I offer it than that way.

Katie: 6:11

Yes, and anybody can also access the podcast. And I just wanna tell you guys that I had to be home all day today because we. People here, maintenance workers replacing one of our air conditioning units, which is always a joy to do. And it's, you know, so, so cheap too. It's just so cheap. But I, so I was, you know, doing chores around the house and I got on your website cause I always like to do a little, you know, a little bit more research and I have to do. Pretty soon before I interview somebody cuz otherwise like I forget a lot of things. So I was on your website today and I was like, oh, she actually started her podcast cuz in the emails you had just said, I'm going to start. A podcast. So I was like, Oh, let me take a listen. Cuz I, I love podcasts. I'm a podcast junkie. You have five episodes out so far? Correct. And you guys, I listen to every single one of them today. no, I did speed them up. I'll, I'll be honest. Only because, And it's not you, it's everybody. I speed all my podcasts up because that's just how. That's just how I roll. One time I turned on my player and it was not sped up at all, and I literally thought for a solid five seconds that I was having a stroke because I was like, Oh my God, what is wrong? These people are talking so slow. But it's just that I forgot. I just forgot to speed it up. So, no, but I listened to all five today and I really wanna put this at the beginning of the episode cause I want people to hear this, that like, they, they were so good. I mean, I felt like even though I wasn't the one, you know, Sitting behind the desk talking and asking you questions like I felt like I was in on a mini therapy session for myself, and I truly felt so seen and so known and validated, and I just, it was like, Oh, wow. Like there's somebody that actually gets it out there. And all the questions people were asking, like, I could relate to every. Single one of'em, even though I hadn't experienced that exact same thing, there was a, there was always a part of it that I could relate to and your answers were just so great. So everybody, I will put a link to it in the show notes to your website. Honestly, your website has links to everything, so I'll put a link to the website in the show notes, but definitely check it out. It was great. Sweet talk for parents of kids with type one is the name

Joanne: 8:20

Diabetes. Mm-hmm..Yep. Thank you, Katie. I really appreciate the feedback and I, and I really welcome people to get on, not just to listen, but to sign up to get their questions answered, because it's a good way for people to get some personalized support.

Katie: 8:32

Yeah, absolutely. If you guys have questions, you, how do you do it? That you just sign up on your website and you'll contact them or.

Joanne: 8:39

Yeah, there. Right now there's specific times, but I think I might be able to expand that. If someone can't do the time, they can just email me and we'll find a time.

Katie: 8:46

Okay. All right. Awesome. Well, I know it's been many, many years since your kids were diagnosed. You, you've been dealing with type one now for a very long time. What, 15 years you said?

Joanne: 8:56

I think it's almost 14. I can't quite remember, honestly,

Katie: 8:59

Yeah. So just, I'm just curious, like what stands out in your, because even only two years out from diagnosis for me, I mean, it's, it's very much so a big memory in my head, but like even now, It's still, some of it is a little fuzzy, you know, the memory starts to fade over time. So what, I'm just curious, like what do you remember about that time? Like what stands out to you in your mind about, you know, the time surrounding, like your kid's diagnosis?

Joanne: 9:22

actually, I think that those memories are pretty sharp for me. The actual diagnosis?

Katie: 9:27

Yeah. I mean, they're very sharp, but like, I don't know. I've never been a great, I've never been great with details, so, you know what I mean? Like it, like for instance, I can't tell you every single detail of what happened, but I can, I just remember an overwhelming sense of sadness. You know, everybody has, their emotions come out in different ways. You know, Some people are so angry and some people are so fearful and some people are just in complete denial. But I just was so. Sad. That was my overwhelming

Joanne: 9:56

issue. Mm.

Katie: 9:57

Yeah.

Joanne: 9:58

I think for my first diagnosis, I honestly, I have to say, I don't think I know how I felt because I was so busy, which is totally how I operate. When things are hard, I just get super busy to learn everything. It wasn't till my second diagnosis, I think that I could even let the sadness really in, in a, in a profound way, which wasn't to say I didn't have sad moments when my son was diagnosed, but it wasn't until my daughter was. She was sort of on the verge of diagnosis, right? Because we got diagnosed with her through Trial net. So it was a very not standard diagnosis, but it meant I knew for a while what was coming. And that was deeply sad with my son. I think it was deeply busy and frantic. Right? Cuz I think I, my response is frantic. But I also have specific memories of, you know, sitting in the hospital. Er, and there wasn't a room for him. And so the doctor came and talked to us and did a consult, like in the hall, on the gurney, in the er and said, You're gonna be fine. And me sort of latching onto that, like it was like, it was the god-given truth because I didn't, it was scary. Right. And then a memory with my daughter of, you know, a moment where I just wept and wept and wept because it was just so, Hard. Right. And also I think we, you know, I'm like the unicorn having two kids. It can happen, but we're rarer and thank God. And you know, a friend of mine said it's not often that we get to repeat a crisis or an emergency. And so it really was different how they played out.

Katie: 11:33

That's so interesting. And how far apart, I know one was nine at diagnosis and one was four, but how many years in between their diagnoses

Joanne: 11:41

I'm trying to do that math.

Katie: 11:42

know?

Joanne: 11:43

So four years, because they're nine years apart. So when my son was diagnosed, so maybe three and change when my son was diagnosed my daughter was still a baby. Like I was still nursing her and naps and the whole thing. And I would wake her up and haul her into school to give him shots and you know, the whole thing. So I'm gonna say three end change years.

Katie: 12:06

Okay. Just curious, This episode, specifically is gonna be on anxiety. So just in your practice, what are some ways that you have seen anxiety just kind of manifest or come out of people? You know, cuz it can take so many different forms.

Joanne: 12:23

mm-hmm. So it can take so many different forms. And actually I think with a new diagnosis, if that's what you're asking about, Anxiety takes every form, right? Because it, it actually like channels through every emotion. So like for me, when my son was diagnosed, it was frantic. For some parents, I think it's anger, it's sadness, it's anxiety channels into all those places, right? And it moves people forward. I think what I also see though is the kind of Frantic need to get it exactly right. And I would say as an overarching Presentation. That's what I see is that newly diagnosed parents have a deep need to get it exactly right and have their kid be in range all the time and be sure that they've counted every carb and it, it makes total sense, right? You leave the hospital and this is what you're told is essential, and you as a parent looking ahead feel like what is the, what are the health risks here? And so I think that. Largely how I see it show up in newly diagnosed parents. And, and then there are, and then there are all the emotions that come along with the anxiety that I already named, which can, you know, be in really almost any form. But I think they're often attached to anxiety that's in there too. They're not like, it's not just pure anger. There's like anxiety woven in with it.

Katie: 13:39

Mm-hmm. Yeah. And how do, I mean, how do you kind of teach people to recognize their anxiety? You know, if they're maybe even a little bit unaware that they're even. having it. I mean, cuz I, I do think you're right. Like, you know, when I, I think anxiety is synonymous with worry. And, and I guess in some ways it is, but I feel like it can show up in so many different forms. So how, how do you kind of coach people through recognizing their anxiety and then validating their anxiety?

Joanne: 14:10

Well, I think this is, This is the work I do mostly in the coaching course, and so what I would say is there are a few prongs to that. One is, I love that you use the word normalizing and validating, right? That's exactly what I'm there to do. And we normalize it in part by seeing that everybody's having the same experience in this weird way. None of us are special. Like of course our children are incredibly, deeply special and we love them and are protecting them, and it feels very unique to us. But when you're in a room full of parents with type one, we sort of recognize that everyone's having a really similar experience and it's super grounding for most parents to feel like. They understand like all these people get it cuz I do think that part of what makes us anxious is that we don't know how to reach out for help because we feel like it's both it so much and also we speak this weird language that nobody else speaks right? We speak in code almost like a friend of mine once said, I speak stock broker. Like to her it just sounded like this really weird thing. And so I think some of how we deal with anxiety is just being in a room with other people. Who speak like we speak, who have the same experiences we have who can understand our experiences. I think that's profoundly important. It's one of the reasons I'm a huge proponent of things like diabetes camp and in particular family camp, cuz I think parents need it Another way I help work with anxiety. Well, there two more ways. I think you named it is validating it. Like, of course it makes sense that you're anxious, duh, Like there's no reason for you to feel badly about it. Right. It's just normal. It's a huge growth curve. It's a huge learning curve, and it's not something you signed up for. And it's not something that you want. So we work from that place as well. And then in the coaching courses, I actually have a lot of tools that I've built to help people create one behavioral change. And I'm a really big believer that small changes have a huge ripple effect over time. Like you can't bite off a big, you can't eat a whole five course meal in one bite. You right? You take one bite and one bite and one bite. And so I'm a believer that taking a small step towards change can have a ripple effect in impact, in part because it makes you feel competent to create the change. So one example I have that's really common is people who over check the Dexcom. Right, and, and I mean, over check these, you know, we all, we're all guilty of it. Like I wake up in the night and often look at my daughter's number. How does that serve me? I do not know. Just have the alarm set and go to sleep. Like lean into trust, right? And that behavior that like ocd, like checking behavior, actually increases our anxiety loop. So what would happen if, And we set a behavioral goal one day you check whatever it is, one time less, or you check only once around lunch or whatever it is that feels manageable to see if you can lower your anxiety around that moment. So those kinds of small changes is a big way that I think is effective to work with.

Katie: 17:13

Mm-hmm. Okay. So just little, little steps That's a very common comment that I hear from parents just being glued to the, to the Dexcom situation. And then, you know, freaking out a little bit when the. Their kid goes offline, which, which happens, you know, quite, quite frequently. Yeah.

Joanne: 17:31

Yep. Yep.

Katie: 17:33

I always just have to remind myself that, you know, that's just how that was, How it was like not even 10 years ago, pretty much. So, we're gonna survive. Sarah has a support group at school that I can call upon if I need to, I remember my husband texted me one day, he's like, Hey, Sarah's been off the grid for like four hours. I'm like, Yeah, I know. He's like, Are you gonna drive up there and fix it? And I'm like, No, I'm actually kind of enjoying the break.

Joanne: 17:54

That's awesome. That's awesome. Katie, look at you

Katie: 17:58

He was like, I think he was more like, Well, I'll drive over there if you're not going to, But he, he did not. He, he couldn't. He was in some sort of meeting that he couldn't get out of. But, but yeah, no, I've said it on the podcast before, but like, my favorite 30 minutes of the day. I mean, this is, this is dramatic. It's not my favorite 30 minutes of the day, but when Sarah goes to recess and is like off the grid for a little bit, I'm like, Oh, I don't have to pay attention because there's no point. I'm not gonna see it, see the number. Anyway, so

Joanne: 18:23

Yeah, I mean, when, when my kids started, they didn't have technology to do that. I mean, I'm sure they did, but I'm sure it was the size of like a VCR cassette tape, right? I'm dating myself, so that was not practical and my son really didn't wanna wear it. And at some point I said to him, I need you to do this. Like, I was literally dying. I was waking up to alarms. Like I would set an alarm in the night, wake up every night, do fingert sticks. It was exhausting. And I was working multiple jobs and the, you know, that I re, I'll never forget the night I sat down on the bathroom floor sobbing. Like, I cannot do this anymore. They need to be on this technology. And he agreed, and therefore she agreed, she did anything he told her. Older brother, younger sister. But yeah, we lived without it all the time. And, and your kids do learn, you know, not teeny little kids, right? That's not realistic. But your kids do learn as they get older, like what it feels like in their body. And that's actually what you want, right? Because the, the Dexcom isn't always accurate either. Like it can be off. It's important for them to know, for example, when they're lower than what the Dexcom says, right? All of these things are important, so they do need to have that physical knowledge and awareness.

Katie: 19:30

So I kind of wanna, if I, if I can, I wanna ask you about, I'll give two specific examples from just my experience and maybe you could kind of tell me how you would approach both of these things, cuz, So the, the first one would be like a short term. Anxiety situation. I mean, not, it could be long term, but for me it was short term. It was, it was almost more of like a panic situation, which I am, I am not one for panic attacks. I don't, I can think of, you know, very few times in my life where I've have felt very, very panicky. But shortly after Sarah's diagnosis, I just started having these. What I would call irrational. I mean, I guess they're not irrational cuz truly it could happen. But I started having these fears of what if, what if something happens to me like, and I wouldn't be there to take care of her. Like it wasn't even about, I mean I've had those fears too about what if something happens to her, but like what if something happens to me right now and. and I'm not here. And, and I, I was getting short of breath. I was not able to sleep at night, and finally I just kind of like stabbed myself out of it, which I feel like honestly for me was a gift from God. Like, he was just like, Look, what are you doing? Like you can't control this. Like you have no, you have no control over this, so why are you wasting your time worrying over it? But how would you kind of help somebody? With more of a I would say more of like an intense, kind of shorter term, almost panic situation

Joanne: 20:51

Mm-hmm..Mm-hmm. It's a great question, Katie, and I have to name that I had a very similar, like near to panic. I actually had a few panic attacks not long after my son was diagnosed, and it's not how I normally fly. Right. So you, you did exactly what a therapist would do. I have to. Brilliant. Which is that you recognized you couldn't actually control it. So I, this, it, honestly, if I got someone in with this level of panic and it was continuing, I would probably refer them to somebody who is specializes in cognitive behavioral therapy, because that's sort of the gold standard for things like panic attacks. And what I understand of it is that the treatment is exposure. So, and the exposure in this case is really knowing that you can't do anything and recognizing that no disaster happens because of the thought that you're having, right? It's just a thought it could happen. Sure. Bad things can happen and it's not happening right now, and everybody's safe and okay right now. And so that's sort of the treatment for something like that for. And you did it yourself. You snapped yourself out of it and acknowledged that you can't control it. And so there's no point in worrying and thinking about it like you have all your ducks in a row in some way to address the possibility. Like as a parent, you know who your kids would go to if something happened to you, right? Or you have a will, or whatever it is. Certainly those things, structural things, having that in place is helpful, but really you have to come to some kind of piece inside yourself that like bad things do happen and we don't have control over everything all the time. No matter what. And of course, diabetes makes that worse, right? Because it's scarier.

Katie: 22:30

yeah. And I had to remind myself too, like, there's other people in her life. Like there's my husband and there's grandparents, and there's aunts and uncles that love her too. So it's gonna be So then, okay, so that would be more of like intense, kind of shorter term. What about like, you know, I kind of, I feel like for the most part I'm good, but like with like the whole I worry. I worry more about the emotional burden and toll that it's gonna take on her way more than I even think about the medical side of things. Like, sure, I think about like the complications that could happen, but mostly I find myself having anxiety about like, how is this gonna affect her? Mentally. And that just kind of comes and goes. I don't, I definitely don't spend all day thinking about that. It's not debilitating. I'm still obviously functioning and performing my life duties, but, for more of like a, a lower grade, but longer term anxiety such as that, how would you approach that?

Joanne: 23:24

So I wanna name like how I would approach that as different in different settings. So as a therapist, we'd be talking, we have more time and space to look at that kind of thing. In my coaching course, we're looking at a behavioral shift in modification that can get made that would help you feel more in control and less like you're thinking about that. And off the top of my head, honestly, Katie, I can't think about what exactly I would grab for that. So I'll keep thinking about it, but. I think that with that kind of anxiety, there's partly just the normalizing of it, which is that the research does show that that's actually really common. So with kids with for example, cancer, their parents are anxious. Like if you were to look at a. Curve, their parents have high anxiety and then it comes down, right? Because there's treatment and then there's resolution one way or the other, hopefully to for the better, right? With diabetes, parents get in there fast and then over time their anxiety creeps up, right? Because they recognize more and more like how heavy a load it. So it's a really different looking curve and I think I would say, yeah, that makes sense to me. Like as you sit with this and you see the ramifications and the impact for your daughter every single day, and you imagine out to the next thing developmentally what's coming for her? Like, how could you not feel a little worried about emotionally, how it's gonna resonate? and then I would send you to do exactly what you sensible Katie are doing, which is creating community around it because it helps you to see. She's gonna be okay. You know, it takes attentive parenting in any situation, right? Our kids can throw us curve balls no matter what, and we have to pay attention and be watching for the places that are hard for them to be able to help and support them. But when you're in community, you also can see people who have diabetes, who are 20, who are 25, who are 30, who are doing fine. And so that's an important antidote also, I think, to the worry. Does that all make sense?

Katie: 25:23

Yes. No, I, I think it does. We, I just went to a um, conference touch by type one in Orlando. They have an annual conference and a friend of mine also obviously a T one D Mom uh, we went together and. It really was just amazing, even just to be, I didn't, I wasn't speaking at this conference, I wasn't promoting the podcast at this conference. I was just there as a caregiver of a T one D and it really was quite spectacular to be in a giant conference hall with all these other parents. Of, of kids that have type one. Solidarity was palpable, you know, and just to listen to all these speakers, you know, most of the speakers had type one and were doing. Amazing things, or just normal things like, you know, they were just thriving in life. And then a lot of them were parents of type one. So it was great. I, I, I wanna echo your recommendation to just get involved with community and You know, not, not all day, every day, cuz I think that would be a little bit too much, but sprinkle it in, in every now and then for sure. And then this particular conference also, we did not bring our kids to this. It was like a mom's weekend away. But they have, you know, they have programs there for kids too. So while the parents are learning, the kids are playing and hanging out with other kids with type one. So it's, it was.

Joanne: 26:38

It sounds amazing and I think actually what I love that you just said is that there were people who were just thriving living their regular lives. Cuz I think at those kind of conferences they tend to throw up, you know, the person who climbed Mount Everest with type one or the person who cycled across America with type one. And those are amazing, amazing things. But not our most of our children. And so I think that it's nice to see people who are just living normal lives, who have jobs and families and are thriving, doing regular things. It's not to say our kids can't climb Mount Everest, bike across America, go live in Africa, do all those amazing things, but it's nice to know they can just be good functioning, professional, smart, working family people.

Katie: 27:18

Mm-hmm. Yep. Really my main goal as a parent is to keep the kids outta jail. So if I can do that, That's, really goal number one and alive, I guess, alive and outta jail. If I've, if I've accomplished that when the day's over, I have done my job

Joanne: 27:36

of a low bar.

Katie: 27:39

I do That's probably a, a strength and a

Joanne: 27:43

and a weakness,

Katie: 27:44

Depending on

Joanne: 27:47

Okay. I'm not quite believing you, but it's a good line,

Katie: 27:51

No, it's okay. It was funny, you actually in our, my church group the other day, we were, we, that question was asked like, what does it mean to you? Like, what would it mean for you, like for your kids to be successful, like when they're grown? Like what would be your, your benchmark or your standard? Like, okay, well they did. Did this, so I know they're successful, and one guy was like, I mean, I think if they just get a job at Chick-fil-A, that's probably it. Right? Like they're That's like the measure of success, right? For a good kid, I'm like, that's pretty funny.

Joanne: 28:19

Well also, he's probably talking about his 15 year old, not his 30 year old. Like he's having trouble seeing far enough out

Katie: 28:26

Right, right,

Joanne: 28:26

for sure. But you know what, that's such an important question for our diabetic kids too. Like what's a measure of success for them? And it's really the same. And we're aim and what's important is for us to keep, I mean, I'm a big believer in keeping our relationship with our children in the. of everything as opposed to diabetes in the front of everything. And so we need to remember that, that what we want for them is to be close to us because we love them and also because we're protective for them. Like we are a protective factor for their mental health. And so if they have a strong connection with us and are able to talk to us even when their diabetes is going sideways, it's gonna turn out better for them.

Katie: 29:05

Yeah. Definitely. I agree you, you said that a few different times today when I was listening to those episodes and I was like, it was like, I was, talking to myself, walking around my house like, Yes, you know, agreeing with you. Like, But yeah, that was a big point that you made a few times that I really agreed with that. The relationships really just need to come first and. that's not to say you throw all caution to the wind and just let it all, let it all go. You know, diabetes management wise, but relationships should be first and foremost for sure. Okay. Let's see. So just what are some, some tips and tricks? You know, you've already mentioned a few, but like, some fast tools that you give parents to pull out when they're feeling overly anxious or you know, if they're just kind of having like an overly anxious week, or what are some, some things that you suggest to help them decrease their anxiety?

Joanne: 29:52

So actually I don't really suggest I ask them because I think you're the expert of your own experience more than I am. Right? And you know, you know when you've been successful in the past with decreasing your anxiety and those are the things we have to remember and help. Ourselves and parents moved to right, is like what used to work, what has worked in the past. What could you do that would be helpful? I could come up with a long list for you and you know, I'm, you and I in a Venn diagram would probably have a lot of overlap, right? Because most people do. Getting enough rest, having people to connect to having a hobby you love. Like for me, I like to read a book. I like to cook a meal I've never made before. These kinds of things. I love to go for a walk or a hike, right? But yours are gonna be different than mine. Maybe you like to pet a dog, maybe you like, you know, whatever it is. So I think it's, it's recognizing what is helpful for you. And there's some foundational pieces, right? Like we all need human connection, It's important for us to have that. So where do you get that? Who are the people who like fill you up and help you feel well nourished and well cared for and loved, especially in the moments where you're feeling at your most vulnerable and weakest. But I, I don't have a go-to list. I feel like my job is to help you create your own.

Katie: 31:04

yeah. I mean, I, had that thought several times when I was listening to your podcast today about just how, you know, there are some people that really and truly just feel so isolated and alone. Like, I mean, they, you know, a military family for example, they might be miles away from any family or close friends. And now they're dealing. This. Um, But I, that was one thing that I felt while I was listening to you like I almost felt like there was community, even though it's, you're not sitting with other people and, you know, I don't, I wouldn't say that would take the place of like real life human interaction with other people, but it really was like a very comforting thing to listen to. You know, almost like you're sitting in a conference and listening to other parents talk and kind of bounce ideas off each other and just to know that you're, you're not alone. Again, if, if any parent out there is feeling very isolated and alone highly recommend, look up where your local JDRF chapters are, and then listen to my podcast and Joanne's podcast,

Joanne: 31:59

thank you for the plug. But I think, I think the local jdrf, you know, and, and there are so many resources and because the world is connected and the internet exists, there're even more, right? So there's, there's just all kinds of forums and places for parents to get some connection and I cannot recommend it more. However it works for you. It's important.

Katie: 32:19

Yeah, it's easier now than it ever has been. And I think even more so coming out of this pandemic cuz everybody's so hungry for actual community, authentic community. Not just let's chat over a Zoom call, you know?

Joanne: 32:31

Yep.

Katie: 32:32

All right. Let's see. So So is there any, any family or parent that you've like worked with, obviously without giving names and details that really stuck out to you in terms of like you know, their anxiety and just your experience helping them through their anxiety. Do you mind, do you mind sharing if you have a story or two that stands out, how you kind of coach them through that or do you feel comfortable

Joanne: 32:54

no, I thought I've been thinking about this since you sent it to me. So you just added a piece, which is How did I coach them through that and. I'm thinking of families who have been in my coaching course and one of the families, and I, I say this with absolute empathy, like this is what I did too. When my son was diagnosed, I just slept with him every night as though sleeping with him would give me information. I. Because it didn't, we didn't have a cgm. I would just wake up and roll over and prick his finger and man, I didn't have to get outta bed for a while. Right. But that, it wasn't really a sustainable lifestyle for 10,000 reasons. And there was a family I worked with where that was mom's strategy for dealing with her anxiety. And she was really stuck there. It was really hard for her. And And she wasn't in a place that she was really ready to make a shift around it either. So I can help with managing anxiety, but there has to be openness to suggestions of change. You have to be coachable basically. I'm thinking of another family where mom was actually quite angry. Like it, it was anxiety, but it looked like anger at her kid for the way he was not managing at school. And I honestly can't remember a lot of the details of how that worked, but we just, she did my coaching program like we went through, and some of it is me just setting realistic expectations, like when you have a teen child, they're not gonna manage their diabetes. As well as you want them to. And of course that is stressful, but we can't pile on all the expectations at once. It's just like we're not gonna say to our 14 year old, Okay, well now you're a teenager, so you should be able to do all the laundry and wash all the dishes and make all the meals. Like, we're not gonna do that. We're gonna slowly, slowly, slowly teach them how to be independent and how to do those kinds of things. And it's the same thing with diabetes, like. They're really not gonna do a great job. And it's stressful, right? Because we feel like their health is at risk, but we can't make them do all of it at once. And it gets in the way of the relationship. So I'm just thinking about this family and through the coaching program, she was able to take small bites, right? And I, I can't even remember, Katie. I think it was like she was helping support him to check one time a day while he was at school. And, and she was able to settle down and like understand through me reflecting how normal it was. Like, of course you don't wanna unclip your seatbelt, but it is by the data, a very normal experience for teenagers to not do as well with management. Right? It's just what it is. And so helping her to recognize that take a small step, we got to a place where she was a lot less anxious.

Katie: 35:30

That's good. You know, I didn't put this in the questions, the pre the prewritten out questions that we exchanged, but, you know, you talk about the, the teenagers and how they typically have higher a1c during those formative years. And this, you know, our expectations really shouldn't. Extremely high for them during that time of their life. But you know, wh where, where do you feel like social media falls I feel like social media is good in so many ways because it is how we find that community, right? I mean, that's, And we can. Ask questions and, you know, hear from other moms and feel like we're not alone. But then there's the other side of it, which I think is very anxiety inducing and just really will just steal all the joy and suck all the joy out of your soul when you see these, You know, and it's funny because there's, I'm not gonna name names, but there is, there's, there's some personalities online where they do have teenagers and their teenagers. Their, their graphs are always perfect. They're always, they're always, and I'm like, Did you screenshot this like six years ago and now you're posting it? Or like, but it's amazing how the loudest people speak the most. It, and it really makes, starts to make you feel like, Wow, I'm, I'm really doing about job. Like when you start comparing yourself to these, to these other people it's just, I just feel like social media is such a rabbit hole that you can spiral.

Joanne: 36:54

you

Katie: 36:55

Out of control very quickly in terms of comparing yourself to other people, and that causing a lot of anxiety. So do you ever just tell people like, you just need to get off social media? Like how have, have you dealt with that at all?

Joanne: 37:05

I love this question because I I love this question because I grapple with this a lot, with this idea of perfection. I think this is the same thing with the Dexcom, frankly. It's like a double edged sword. Thank God we have it, we all sleep better for it. We all are much more sane in so many ways, and yet it's created this 10 outta 10 of anxiety where we're watching all the time. Like, that's not good for us either. And so I think you're exactly right, like online creates community and it also creates competition in a way that's very specifically anxiety inducing for us as T one D parents. I've never said to anyone get off social media. I try to be as generous and diplomatic as I feel like you're being right now. But part of why I wanted to be on your show is I feel like you have a pretty level perspective. I like your sensible, grounded perspective on your show, and that includes that we're not gonna be perfect all the time. That this is one of many things that we do. And I, so in my coaching program, I have an actual. Little piece, you know, it's all, it's all reverse classroom, so it's all, you know, videos I've created and lesson plans and all of this stuff that you do on your own. And then you come to the meeting prepared or as prepared as you wanna be. And then there's a group chat also where I answer questions, but one of the teachings is called Numbers Perfection. And it talks about the data. Right. The data really shows this, so you can kill yourself to try and get to a flat line, but I don't think it's real for most people. I do think, of course, there are some people who probably eat no carbs, who Probably are very, very watchful. And if, and if those people have kids with that, I suspect that those kids are gonna have some kind of rebound around it later. Right? It's too hard to do. So I'll name that my son who's now 23, was highly anxious about his diabetes, like crazy amounts of anxiety and was because of that, an excellent manager. And as he's gotten older and is less anxious and he's on closed loop. Dexcom and Tandem. He's exhausted, He's genuinely exhausted and I don't wanna say he's not taking care of himself, but I've noticed like he's actually home right now. He's leaving to move to Spain soon. And so he is having a little hiatus here while he's waiting for his visa. the other day he forgot to dose for. Forgot to dose for dinner. I was so stunned, right? So this idea that you're gonna get a flat line and you're gonna cheer yourself on, like, all right, but it's gonna change later. And what we have to do is create permission not to fall off the rails, but that it is possible that you're gonna have hard days. That it's possible that you're gonna wanna eat a donut and you're not gonna dose for it, right? That it's possible that, you know, all kinds of things can happen. Your Dexcom goes off, your pump falls apart, you go back to shots, you, whatever, right? All those things happen, and I think when we hold a line of perfection, we do our children a tremendous disservice, like for the long term of their lives. Like they, This is not a perfection game. This is a like making it through game

Katie: 40:11

Yeah. I have a, I had a, a little, a humbling experience the other night. We were out to dinner at a hibachi restaurant for my oldest son's birthday. And you know, all the things, all the rice and the noodles and the sauces and I mean, it was, you know, We were definitely not a low carb family over here. I can tell you that for sure, which to each his own. But I completely forgot to bolus, like, remind my daughter. I forgot to do it like we had started eating. I was like, Oh my gosh, Okay, let's see how many, what do we think this you know, like, so now I'm like, backpedaling, we're already eating. And, and so it was, it was a humbling experience and it was a good reminder for me that. I, I'm an adult, like, you know, and I forgot and I forget sometimes. And so how in the world can I expect, you know, a, a 10 year old or how old your kid is to remember all the time. Or even really wanna do it all the time, you know? I'm sure there's just some days where you're like, I don't wanna do it. And I get that too.

Joanne: 41:07

We call that a diabetes vacation, and those are, there are ways to take a diabetes vacation in a way that's structured. This is for when your kids are older, like how can mom take it all back on for a day or two so you don't have to do it right, But yeah, and they're gonna make mistakes. I left my daughter home yesterday for the day, and I looked at her. Dex come read out and suddenly she was three 15 double arrow up. And I text her and I'm like, Did you forget to bowls for something? And she's like, Oh yeah, sorry. You know, she just doesn't remember.

Katie: 41:36

Yeah, we ha we had a similar morning and it was actually the morning that we were going to our checkup, which it's, what is it? It's now October and we haven't been to the endocrinologist since March, just because we had to cancel. And then they did not even have a time for us to reschedule cause they're so busy. So it was like our checkup day, you know, for the first time in several, several months. And and it just, anyway, it just. Some things were forgotten. And we walked into the endocrinologist and we were like, three 50. And I'm like, I'm sorry. Look at the rest of the data. Like, we, we do good. Most of the time. This is just a really off morning. And she's like, I'm not, I'm not, What do you think? I'm gonna yell at you. I'm like, Well, some, I think some endocrinologists do yell at people, so I'm grateful you're not one of those

Joanne: 42:22

Well, but also like how that feeling of shame, like, that's terrible. We don't need to feel that way. And it comes from, you can't grow and create positive change for yourself if you're coming from a place of shame. And so, The goal for the endocrinologist for us in community with each other is just support each other where we are. We don't need judgment. It's hard enough. Like we just need to support each other where we are. Sure. We could almost always do better. Some days we don't feel like it, and some days we have the energy to take it on.

Katie: 42:51

my husband texts me, he's like, Did her pump fail? I'm like, No, no. It was just some, some uncovered grapes.

Joanne: 42:58

Yep.

Katie: 42:59

No worries. We went to Chick-fil-A after that office because in, in the end, overall it was a great checkup. We had a great checkup. We got a good report, so we were like, Let's go get some Chick-Fil-A and go back to school.

Joanne: 43:08

Can I, Can I name one more thing there, Katie, that I noticed too? I You said you're two years into diagnosis. This feels normal to me, right? Like at the beginning I am sure you washed everybody. Food that went into your daughter's mouth, you counted every car, you weighed things, you measured things. You did all the things. And now you're eyeballing things. You're going to Chick-fil-A, you had grapes you forgot to cover, you're eating, you know, at the restaurant with the sauce. Right. You're expanding your life in a way that's actually appropriate, and diabetes isn't in the center anymore, so that's beautiful. That's kind of what you want and need and diabetes sometimes drops off in a way that like you're not perfect anymore around it. That's okay. Like I'm not saying, again, I would never say unclip your seatbelt. Like it's a very, very important thing to pay attention to and be attentive to. But we're also teaching our children how to live their lives fully and richly, even with.

Katie: 44:01

That's a great point. I had, I wanted You were, That reminded me. I wanted to ask you something and Hold on. It'll come back. Oh, this is it. This is it. Okay. So in terms of just anxiety and all the feelings like. how do you talk to parents about showing those emotions in front of their kids? Because I feel like there is a difference between panic.

Joanne: 44:25

difference. Mm-hmm.

Katie: 44:25

Like you don't, like, you don't want to like I have a fear of sharks and And I watched the movie Jaws way too many times when I was way too. So now I have an

Joanne: 44:34

you have some trauma around shark

Katie: 44:36

my husband calls it an irrational fear, but I call it a, I could get eaten by a shark when I go in the ocean. Fear, like that's true anyway, but I don't wanna, I didn't wanna pass that on to my kids, so I like suck it up and I get in the water when we go to the ocean and I just have a talk. You know, I'll come to Jesus meeting with myself. Like, Look, if this is my day to get eaten by a shark, this is my day to get eaten by a shark. But I don't want my kids to be fearful of sharks. So I feel like with diabetes, These anxieties that you don't want necessarily to rub off on your kids, but you also don't wanna have, feel like you have to hide everything and bottle it all up. So just how do you talk to parents about that?

Joanne: 45:14

yeah. It's different depending on what the emotion is that's coming out. So anxiety itself, if we're talking pure anxiety, which is what this episode for you, this podcast is supposed to be about, I would say you need to keep that in check, right? Just the same way you're doing with the shark. You need to do that with diabetes. You don't wanna spook your kids and you want to, The message you wanna give them is you can do this. You are gonna grow into the adult you're meant to. I am gonna help you get there. I am right here alongside you. And if your anxiety is, Oh my God, what are the medical conditions gonna be? Oh my God, they're not gonna manage well. Oh my God. All those things. You need to take that and put it someplace else with other adults who can safely help and support you. If it's feelings like I am sad that you have diabetes, that you get to. Some of right? I'm a believer that our children actually learn how to be in relationship to their own feelings, in part by seeing us model them there lots of ways. You know, we, we help them with their feelings, but we also show them feelings and they also, we also are impacting each other all the time. So if your kids do something rude that hurts you, you get to say, ouch, right? You have to say it carefully cuz there are some way we don't want our children to feel like they're damaging. Right? So that's where you have to be important. That's where it's important to be careful with diabetes, because in my work with people with diabetes, what I find over and over and over is that no matter how old the client is, that they end up feeling like somehow they hurt their parent. Somehow they were too much because, or somehow they had to hold themselves back because they knew their parents were doing a big job managing their diabetes. And so even though I honestly don't think that's really avoidable, I think they are gonna carry that. And I think we have to be attentive to it. I think we don't wanna reinforce it by being too much with our own feelings but with anxiety for sure, that needs to get parked someplace. So if we're sad, we get to say, Yeah, it's sad for me that you have this. I'm so sorry and sad that you have it. You can say it, but you can't be weeping in front of your kids. Right. There's a difference. You get to show some, but not a too much and anxiety needs to get parked somewhere

Katie: 47:25

Mm-hmm. No, that's good advice. Yeah, I usually sit with her in the sadness for a while, but then I'm like, Okay, we gotta move on. I mean, we've been sad. We've done our sadness. Now it's time to, to pick ourselves up and onward.

Joanne: 47:40

Mm-hmm.

Katie: 47:41

So let's talk about if there's times where anxiety can maybe be helpful or beneficial. Like, is that even a possibility to where it can benefit

Joanne: 47:49

Sure, of course. Like if, think about it evolutionarily, right? It's like you know, you're in the brush and the lion comes and you get anxious and you flee, right? That kind of way of operating is helpful for us and anxiety often. Creates it motivates us to plan, to look ahead to do all the things that we as T one D parents absolutely have to do. Like you need all those supplies and all the cars and all the bags and all the, everything and anxiety can push us to do that. Too much anxiety, right? Where that's all we're thinking about and we're buzzing and spinning about it over and over and over, that's not good. But a little healthy dose of anxiety, like that's what gets your kid to study for the social studies test when they're not prepared. A little healthy dose of anxiety gets you to prepare for that speech you're gonna give, right? You know, so that you can get over those hurdles. But but too much obviously is not healthy for anyone.

Katie: 48:42

So trying to create a healthy amount of anxiety in our kids. Like I have had multiple adult type one diabetics tell me that One thing that their parents did that they absolutely hated was use, like a scare tactic with them. Like, you're gonna ruin your, you know, X, y, z all naming all the organs if you don't do this. And and they nobody liked that. That was not effective for any of the people that I've talked to. Which is understandable. I mean, I think if any of us really sit down and think like, Well, somebody was doing that to me, I don't, I don't think I would respond well to that either. but I, I guess just surrounding diabetes, like not so much a social studies test, but surrounding diabetes like we do. Maybe what are some ways we can motivate them to take care of themselves without scaring them to death or just causing them to be resentful of us being crazy people?

Joanne: 49:27

Mm-hmm. Yeah. I'm not a believer in scaring our children to death. That actually was a question that recently came up that somebody asked me about which is that her son was, was doing well, he was recently diagnosed a teenager. He was doing well with it, and she was worried that he was a little too laissez fare and that he wasn't understanding. And at some point it was gonna go south and he wasn't gonna. We need to quiet. That's our own buzzing noise, and we need to get off that hamster wheel. In our minds, it is not helpful to scare our children. Nobody gets motivated by fear, And so, In terms of motivation, I'm a big believer in positive motivation, right? They do. Well, you tell'em how they knocked it out of the park for that one thing because people love praise and people love to feel like they're doing well. And our children, all children want to please their parents. They do. The research actually is so interesting on this that kids lie to their parents because they don't wanna create conflict. Like 99% of children lie to their parents. The numbers are staggering, and the reason they do it is to avoid conflict with their parents. Right. So you don't, you don't want that. You want them to come to you because they're, they can, you can be delighted in them and that you're praising them and you're always finding the small edge, even when they're doing badly. You wanna find the small edge where they're doing well and you can message, you know, this is an, an unfortunate thing that you got handed this and still we gotta find a way to help you do it well so that you get to have a rich and full life. You don't need to message any of the bad.

Katie: 50:52

Mm-hmm.

Joanne: 50:53

be saying to them that it's important to do it well, they, they're gonna know, I promise the soup is out there, they're gonna figure it out, that it's not good to not manage well. It doesn't need to come from you.

Katie: 51:03

Yeah, that's a great point. Good advice and a good reminder for me, I, I haven't really used that. I, there's times in my head where, like my head is saying that, but I don't think the words know. The words have never come out of my mouth. Not yet. I'm, who knows? It might have a moment,

Joanne: 51:18

Well, also the other thing is that the research shows that these, the terrible complications that we know most about blindness, kidney failure and amputation are really, really super rare now. So it doesn't really happen so much. It's like in 1%, something like that. It's very, very low. There are some complications that can happen more about heart disease, but that's. That's not what people even know about. So it it, the scare tactics kind of don't really work all that well. They're not that accurate, I guess is what I wanna.

Katie: 51:48

Yeah. Well, that's a good point too.

Joanne: 51:50

Yeah.

Katie: 51:50

Well, Joanna, is there anything that we kind of didn't chat about or that we missed that you feel you know about anxiety specifically surrounding diabetes that you feel like would be helpful for parents and caregivers to to know, to hear?

Joanne: 52:02

I love your questions, Katie. I think they were really thorough.

Katie: 52:05

Thank you,

Joanne: 52:05

No, you, you, you're in the right line of work here. I think the only thing I would say is don't be attentive to when it gets to be too much. Right? Like, if you are having panic attacks that you can't shake yourself out of, right? Go get help. Don't assume that it needs to be that way if you can't get off the DLE wheel in your head. Buzzing about numbers all day long. All day long. All day long. And you're past a year and it's not shifting at all. I'm not saying that like I still wake up in the night sometimes x number of years later and sometimes check my decks come. But if you really feel like that's all that's there, I really wanna say that there's help to be had cuz it doesn't need to be that way.

Katie: 52:42

Yeah. That's great. Okay, well, Joey Ann, thank you. I so appreciate your time. I loved your answers. I loved chatting with you. I. Have no doubt this will be very beneficial for listeners. And like I said, Joanne will be back for a couple more episodes. We're gonna talk dive a little deeper into some of the other emotional, mental challenges that come along with caring for somebody with type one. So

Joanne: 53:04

Thank you, Katie, for having me.

Katie: 53:06

you're welcome. Bye.

Joanne: 53:07

Bye.

Katie: 53:11

Okay guys, that was it for our episodes day. I hope you enjoyed that chat with Joanne. I know I loved talking with her. I hope you gleaned as much wisdom as I did. From listening to her chat. Again, please, please, please check out the links in the show notes there you will find links to a few other episodes that if you really enjoyed this one, I think you will enjoy those as well. You will also find a link to. Joanne's website diabetes. Sweet talk.com. And on her website, you can find a link to her podcast. Sweet talk for parents of kids with type one diabetes. And if you click the purple banner at the top of the page, you can submit your question. For Joanne to answer, and you can even be a guest on her podcast. And of course, that can be done completely anonymously. Check it out. All right, you guys have a fantastic week. I will chat with you soon, but until Ben. Stay calm and bolus on my friends. Bye.