Ep #178: Let’s Discuss Racism

Katrina Ubell:      You are listening to the Weight Loss for Busy Physicians podcast with Katrina Ubell, MD, episode number 178.

Welcome come to Weight Loss for Busy Physicians podcast, the podcast where busy doctors, like you, get the practical solutions and support you need to permanently lose the weight so you can feel better and have the life you want. If you're looking to overcome your stress eating and exhaustion, and move into freedom around food, you're in the right place.

Hello, my friend, I am so glad that you're here with me today. I am really glad that you have even hit play on this episode and that you are considering listening to this one. I can imagine that there's a number of people going, “Katrina, seriously, why are we talking about this? This is a weight loss podcast. Stay in your lane.” And I can see that point, but I also know that I have something to offer here and I am willing to get it wrong, and maybe not say things exactly the right way in order to get this conversation started. And in order to bring things that, for a lot of people, were not top of mind to the top of their mind.

Now, of course, the last couple of weeks there has been, again, a ton of discussion on racism, systemic racism and police brutality with the deaths of George Floyd, with the death of Breonna Taylor, with the death of Ahmaud Arbery. And I know that it really has taken on a level of energy, just in general, but also with me as well. And I want to honestly take advantage of that to have this discussion. And what I want to start off by first telling you is that well, a couple things. I am definitely not an expert in this area, nor do I claim to be, never have claimed to be. But I do think I have something to contribute. And I do want to just offer you some thoughts about it.

And the second thing is that I am not going to come at you today from any kind of accusatory place. I've seen some things online that have kind of come from a real, maybe, aggressive place. And while I think sometimes that's what it takes to get through to people that's not really my style. And so, I am going to offer you a loving, and maybe a little bit more gentle discussion. But what that means is that it's not less important, it just means that I really want you to listen and think and be open to what I offer to you.

I also want to be very clear that this is not a partisan issue, I will not be talking about politics here. And I want to be clear that the systemic racism that we have in the United States is perpetuated by both political parties, both major political parties and is something that everybody involved in to some extent or another.

So I first want you to just notice if you're like, “Oh, is this going to be some liberal nonsense,” or something like that it really is something … or, flip side, I want you to really think about it from a open minded kind of a place and not allowing politics to come into this discussion.

So, there's a few things that I want you to know about and I want to offer to you, and they really are extensions of what I already teach you. And that's why I think that this work is so important. Yes, I teach weight loss, but weight loss and no longer relying on food, or alcohol to make you feel better or for your life to be tolerable is the first step toward really living a life that you're proud of. That really helps you to live up to your full potential. And I think that doing work to help people who are oppressed and to do work toward anti-racism is really important work and can definitely be the next step for so many people once they have done the work to no longer rely on food because of the personal work that is required to do that. So I'll get more into that a little bit later.

So I first want to talk to you, especially if you're thinking, “Listen, I am not a racist. Everyone's saying that we're all racists. Why should I do anything different than I'm already doing? I already take care of black patients, I respect black people. I really don't think that I'm racist. And why does everybody keep telling me that I'm racist?” What I want to offer to you is an idea that I think most of us actually accept and agree to be kind of the factor, or the truth. And that is that there are messages that we pick up as children in the world. And some of those messages are direct messages as to what our parents, or other adults who were influential to us said and did.

And so, you might be thinking, “Listen, I was brought up properly. I was brought up not to be a racist and I'm not,” but those were just some of the influences that you had. What we, generally, all agree on is that there are a lot of messages that young kids get. And we got, of course as well, when we were kids about what women should look like. What is a good way for a woman to look, how women should act, what's appropriate, how women should be treated by other people, by men in particular. We absorb messages about what's good and what's bad in the world.

And we talk about this in terms of overeating and weight as well. So, often you see these ads where you see someone, like a woman who's scantily clad and very fit and trim, and she's eating a massive burger and fries or something where it's like, if you eat the food that she is selling in that ad you don't end up looking like someone like her, at least most of the time, and at least not if you're older than 16. So, we absorb all of these messages and we agree that there are these messages in the outside world to us about what is okay. I mean, just think about all of the teen magazines and all the ideas that I know I got about what a girl's body should look like and what is attractive hair, and all kinds of different messages.

If you agree to that, then it would make sense that there's also messages out there about skin color. And therefore that white skin color is better than brown or black skin color. That people who have a body that looks like this are better than people who have a body looks like that. That can be because of the size of their breasts, the size of their thighs, or what color their skin is. And so, those messages are there whether we want to believe that they're there or not they really are there. And those messages become a basic programming for us. And our thoughts are then generated based on this programming.

If you got a message that you'll never be good enough when you were a kid, you may not be thinking actively, “I'll never be good enough,” but you have thoughts that pertain to that. Pointing out your flaws, not allowing you to actually take any kind of compliment, or praise from people when it's offered to you because you always have to be reconfirming that basic program that you'll never be good enough. And so, what our brains will do is offer us thoughts sometimes, or perceptions, just the way that we interpret the world, the meaning that we assign to it based on what our brains have absorbed about white skin color versus brown or black skin color. And so, those thoughts then are actually in line with the definition of racism because they're grounded in a belief that one type of person is superior to another.

And I was thinking about this in terms of the hierarchy that is present in medicine. I mean, it's a very well defined hierarchy, everybody's aware of it. People don't like it when certain people overstep their bounds within that hierarchy, even amongst attendings. If you're in any kind of academic environment there's a total hierarchy. It's very important to us that we know where we stand within that hierarchy. We also often compare ourselves to others. We either compare ourselves to others with the purpose of pointing out our perceived flaws in comparison to them. We compare ourselves to, and then our brains show us how we are worse than them. And we suck for all these reasons.

Or we'll do it the other way, where we compare ourselves to others and in an attempt to make ourselves feel better about ourselves, we will elevate ourselves above other people. So, we do this through judging other people. And I know that I've done it so much. And I mean everybody I coach, we talk about judgment all of the time. We have all these thoughts about the people in our lives, how they should be acting, how they shouldn't be acting, that they should be doing things differently. And, of course, we judge ourselves as well so harshly that we're doing things wrong, or there's something wrong with us. And just pointing that out to ourselves all the time. And we're open to accepting that we can be judgmental of ourselves and of others. So, it also makes sense that probably some of our judgments pertain to race as well.

So, here's what I think happens for a lot of us, especially those of us who are resistant to the idea that we may have racist thoughts. What often happens if we notice a racist thought, or a racist perception is that we feel guilt and shame for having thought that thought. We think something's wrong with us, we've done something bad and we want it to go away right away. And so we ignore it, we squash it down, we just want to make it go away immediately. And so, that's kind of like shoving it right back down to where thoughts come from. I've often described that our brains have so many thoughts in them, 60,000 or so thoughts a day, I mean, it's so many.

And I think of it like when they're doing the lottery balls. They're pulling out the lottery winner numbers and they have all the balls with the numbers on them, and the balls are all blowing all around like crazy inside the ball. And then, they hit a button and it sucks one of the balls up and then, oh, that's the thought that we've got today. And that's kind of what I think about it. Because it's like some of them can be such good thoughts and some of them are so random and weird you're like, “Really? Oh no, we're not doing that one.” And when you are not willing to even explore the idea that you might have racist thoughts, what ends up happening is you hit the button, it sucks the ball up. You look at the ball, you look at the thought and go, “Ew, gross. No, that's not in line with who I am. I don't even know where that came from.” And rather than throwing it out, you put it back in the barrel to keep floating around in there. And then, sometime in the future when you hit the button and it'll come back up and you'll go, “Ooh, no, no, no, no. I don't think that way,” and you put it right back in the barrel.

So, what I'm suggesting is if you're willing to even be open to the idea that you might be a good person, yet still have racist thoughts when one of those thoughts comes up, you can go, “That's really interesting, wonder where that one came from? I don't want to go put that right back in the barrel and recycle it again. I want to actually look at this and keep it out of the barrel.” So, think about it this way, the thoughts that you have don't determine whether you are a good or worthwhile person or not. You can definitely be a good person and still have racist thoughts. Now, of course, there are people who are members of the Ku Klux, Klan, and all kinds of different things. I don't think those people are listening to this podcast, so I'm not really addressing them. I'm addressing people who are like, “Listen, I have a servant's heart. I am a good person,” yet are still not really open to believing that they may have some racist thoughts.

So, a big way that I talk about self-love and self-worth and self-acceptance with my clients is in teaching them that they have to unconditionally love themselves, which means they have to love the parts of them that they like and the parts of themselves that they don't like. And when you are able to do that, where you love all of you, even the parts that you wish that were different you're able to look at the parts that you wish were different from a place of love and support, and compassion, and effectively move to change those things compared to when you are resisting yourself like crazy and thinking that you can only love yourself, or think you're acceptable, or worthwhile when you get to a place where 100% of you is the way you want it to be.

Then what you're doing is you're asking yourself to change from a place of rejection, and from lack of acceptance, resistance and just negative rejection energy. You're like, “Ew, that's gross. That's not who I want to be. And that needs to be different.” And I find that if anybody comes to me with that kind of energy, I'm quite resistant to changing. I feel attacked. I might feel defensive. It's very hard for me to change. That part of you that feels attacked will also resist change. So, when you are open to accepting all of yourself, you are actually able to move more towards that person that you want to be more quickly because you're not rejecting the parts you don't like, you're moving toward them with compassion and curiosity, and genuinely wanting to change, but not from a place of judgment.

So, what this looks like is understanding that there are no absolutes for any of us. We like to believe certain things about ourselves, and we don't really want to think other things. Like I think I'm 100% not a racist, and that makes me feel good about myself. And so, we think that thinking absolutes actually helps us, but it prevents us from seeing the parts where we actually could improve. So, what this ends up looking like, for my clients and the way I'm often coaching on this, is understanding that who you want to be is you part of the time or most of the time, but there's also that part of you that isn't that.

So, for instance, many of my clients will say, “Well, I just really want to work on being kind. I can really bite people's heads off and I can really be harsh with my kids. And I don't want to be like that. And I can be really nitpicky with my husband. And I just want to be a kind person.” And so, what I suggest is that they work on believing that they are a kind person, except for those times when they're not kind. And that they're a good mom, except for those times when they aren't. And that they're a really loving person, except for those times when they withhold love. And understanding that there's that gray zone. None of us are 100% anything. That we are going to try our best to be who we want to be yet we're going to fall down on the job sometimes and that's okay. Then we go, “Interesting, I wonder why I'm struggling in that area? Let me look at that and understand that a little bit better,” from that place of unconditional love, then you can actually make a change.

I saw this firsthand for myself. I tried for years to be the “good mom” that I thought I should be. And, if anything, it made me a worse mom. Once I finally just decided, you know what? I am a good mom, but sometimes I'm not a good mom. Most of the time I am, I became actually so much nicer of a mom. Much, much, much nicer because I actually accepted all of myself. Now, the same holds true for believing that you're not a racist. I think it serves you to believe I'm not a racist, except for those times when I have racist thoughts. You get to believe the belief that makes you feel good about yourself, yet you're still open to examining and exploring the parts of you that you'd like to change. If you are not willing to even open up to the idea that you may have some racist thoughts, you're not going to be able to find them and change them.

So, this is an active practice. This is not something where you just go and figure it out, and you're like, “Okay, I've cleaned it all out, I found all the thoughts,” and that's it. This is going to be something you're going to want to be approaching and reassessing on a repetitive nature. So, what thought work helps you to do, when you're willing to explore what your thoughts are and what you really believe, it helps you to find out what is that programming, so that you can work on it. Because often we find out what that programming is or that belief, and then we're horrified. We're like, “Oh my gosh, no! I don't want to believe that. Or I don't believe that. It's not even actually true.” Wonderful. Now, you can work on deciding how you really want to believe, and remind yourself of that.

Just like any time else that you're changing a belief that you have, which I've taught you about so many times. You are understanding that you believe one thing, wanting to believe something new, and then going through the process of changing that belief. But you first have to understand what you believe right now. So, that involves finding your hidden biases. And on the conversations about racism and medicine that I had before this, I hope you'll listen to those. If not, please make the time to listen, they are absolutely amazing. I believe it was Melanie who talked about the implicit assessment test. This is put on by Harvard. It is actually up in one of my tabs on my browser. I'm going to be taking it here very soon. And I suggest that you do as well to just find out what your biases are. That's one of the hardest parts about this work is figuring out what's there that you don't see, but there's ways to figure it out.

So, what I find is people are like, “Well, how am I supposed to know?” They start feeling defensive. “If I can't tell how do I know?” There's ways to find out and potentially taking this test, doing some other work. There's a book that I'm going to be going through with a group of friends called Me and White Supremacy, which is all about uncovering what those beliefs are. And it probably isn't going to be easy, that's what everybody says. You find things in there that you're like, “No, I don't want to think that way.”

But I also want to suggest that you don't have to feel guilt and shame for what you find. You can be glad that you found it, so that you can actually do something about it. Because right now it's just been still there, this little invisible rudder on the ship of your life and you just didn't know it was there. It's like barnacles that are—I’m taking this metaphor, I'm going with it—like barnacles that are helping to direct your boat. And you're like, “Oh, look, there's some barnacles, let's see if we can get them off and get rid of them, so that we can be more in control of the direction of the ship.” I don't know if barnacles do that, but you get what I'm trying to say.

So, when you are willing to work on yourself that's when you can really lead by example. And I've taught you this so many times, I have had so many people say to me, “Listen, how do I get my kids to eat better? How do I get my husband to eat better? How to get my parents to eat better? How do I get them to stop emotionally eating?” And what I always say is do your own work first and lead by example. And there is no exception here. When you are willing to really dig in you're able to actually then have meaningful conversations with other people. When you look around and go, “Hey, I'm not the one who's contributing to this it's all of you people. And let me just tell you all the ways you're doing it wrong,” that generally is not as well accepted I found.

So, let's talk a little bit more about why we don't do more to help this cause. And I'm kind of mostly specifically talking about white people, like me, but I think it could apply to other people as well. As you know, within medicine the percentage of white people in medicine is less than the average population, but it's still a little bit of a majority. I think it's about 55% white in medicine, but also there's going to be other people too, who are people of color, who are going to be understanding that they're maybe not taking action in the way they could as well.

So, why don't we do more? Why do we tend to shy away from leading by example? I think that's where a lot of us then get stuck. They're like, “Yeah, I like the idea of leading by example. But when I think about doing it, I don't know. I don't know if I could really do it.” Because what this involves is saying something when someone tells a racist joke around you, or someone says something that's just inappropriate. It's putting yourself out there to let them know that that's not okay. And I believe it was Tendi in her conversation with me where she was saying she, as a black woman, is not generally in the presence of the people who are saying these things and it's our job as the non-black people to, from the inside, make change and say something like, “Hey dude, that's not okay. That's not cool to say that. I wanted to understand a little bit more what you meant by that.”

Doesn't mean that you are angry or confrontational, but there are lots of ways of letting people know, hey, that's not cool. That's not okay. But it puts us out of our comfort zone, so let's talk about what are the reasons why we tend to not do this work because I think when we understand it, then we can overcome it, and we can move forward and make real lasting change. So, the first reason is our human brains are designed to avoid discomfort. This is a primal, primal thing. And so, when you have the benefit of white privilege you are not experiencing discomfort over this and the brain likes that. It's like, “Yeah, why would we think about this thing that theoretically doesn't involve us, or isn't something that's affecting us yet creates discomfort for us?”

You experience discomfort when you speak up, when you ask someone to explain something, when you let them know, hey, that wasn't cool. And here's the deal, the reason why we have always avoided discomfort was because that protected us as humans. But now we're at a point where we have so much comfort and so much protection, especially as white humans, that we have to put ourselves into the discomfort. We have to go against what's natural for us to do the right thing. And if you really think about it, this is so similar to eating. You don't want to feel discomfort in the moment, so you have the cookie. But then there's so much more discomfort later because you didn't do what you said you were going to do because your body is overweight because you're not feeling good in your body. You're letting yourself down again.

When you don't say something to somebody who's making racist joke, or making a racist comment, or is taking part in a microaggression, or something like that what you're doing is you're letting yourself off the hook in the moment, which allows you to not feel that discomfort in the moment. But in the long-term you feel more discomfort because you feel badly you didn't say anything because you don't know what to do about that. You wish it wasn't a problem. So, what do we do, and myself included? Just ignore the news, not look at stuff, not want to think about it because we don't want to experience the discomfort.

So, here's the way that we approach that. You have to feel afraid and then do it anyway. You have to be willing to get it wrong. I think so many of us are so concerned that we're going to say something and it will offend people. And you know what? They might be offended. You can't ever take a group of millions of people and act one way, and have everybody agree that the way you did it was right. In fact, I'm quite sure there's people who's going to listen to this podcast who are going to let me know I've gotten this all wrong. But you have to be willing to speak up, and get it wrong to make any kind of movement forward. If you don't do anything, then nothing changes. You have to be willing to be afraid and do it anyway.

Honestly, talking about this subject on the podcast it's not the most comfortable subject for me, but I'm going to do it anyway because I feel really compelled to help because I have this platform. This is an important issue. And I want people to know about it, and I'm willing to take whatever heat comes because of it. And I'm willing to learn if I'm doing it wrong. And so, that's the thing. If you're willing to get it wrong and someone explains to you how you got it wrong, then you can do better.

But this leads me to the second reason why we tend to not speak up, and it's because of perfectionism. We think that it's all in absolutes. There's a certain right way to do it. And if I could just figure that right way out and everybody would be okay with me, and nobody would be mad at me then I'll finally say something, and I'll finally do something to change how the world is once I have that all figured out. And that, also, it kind of dilutes you into thinking you're making a change even though you're not really. You're like, “Yeah, yeah but I'm still just trying to figure it out. I'm still trying to learn more.” And there is definitely a period of time where learning is required, and necessary, and encouraged. But then, you also have to take action. If you think there's a perfect way, then you will never do anything.

If you think the only way you can make any difference is by quitting your job and becoming an activist full time, and being willing to live in jail of course you're never going to do anything. You have to start thinking, what are the small ways that I can start making a difference? And I think one of the best ways to start with that is to understand what your biases are, and to start changing the way that you are approaching other people, the way you're thinking about other people, and leading by example. So, look for the perfectionism in your … basically the perfectionism that is holding you back.

And then, I think another reason is so many of us just don't see it. We don't actually see the racism. We don't. We don't see how what somebody has said is offensive, or is a microaggression. And it's our job to learn more about that. It is not black people's job to let us know. There's so much information out there. It's like what Tendi said. People ask her, “What are good books for little kids that feature black kids,” and she's like, “Well, how do you think I figured it out?” She went to Google and she searched. So, it doesn't mean you can't ever ask a question, but what you don't want to be doing is putting all of the work onto someone else.

Have you ever had that where someone goes onto Facebook and is crowdsourcing some information that's super easily Google-able. And so, you go to Google and you find the answer and you give it to them. You can do the same thing where you're going and asking the black folks that you know, or that you're friends with, and asking them to come up with the information for you. Or you could just go figure it out yourself. There are so many leaders that you can follow, you can learn from. There are many excellent books, there are podcasts to listen to. There are so many different things that you can be doing. And if you just commit yourself to doing one or two of those things, it doesn't have to take over your whole life, but just learning more, being interested, being aware, understanding what's going on it's going to help you in so many ways. It's going to help you to be a more informed voter. Maybe it'll help you to make sure that you get out there and actually vote because it's something you understand. And you understand the ramifications of which direction you're supporting.

So, when you don't see it, which I think is the case for a lot of us, it's our jobs to find it. Just because you don't see it doesn't mean it doesn't exist. This is really important to understand. Our brains have a filter through which they show us the world. If you want to believe that the world is not racist, you will not see the racist acts that are happening. And so, I know I've learned so much in the last week or two, things I just had no idea about, or connections between different things in history that I had no idea were connected. And all it took was for me to be willing, to watch a video, or be willing to watch a documentary, be willing to have a conversation with my child about this. Like, “Hey, let's talk about this. So, what do you think? What would this look like for you? You're moving into high school next year, you might start seeing things like this. We need to have these discussions.”

So, I'm going to leave it there. I think this is some food for thought. Again, if you haven't listened to the conversations about racism in medicine that I had earlier this week, there's four of them. They are amazing. I strongly, strongly suggest that you have a listen. So much of what I was talking about, like you just don't see it, you will see it more once you listen to these conversations. They are able to share, these women, their experiences and help you to see what's actually true for a subset of people that I wasn't aware of. And you probably aren't either. So, please have a listen to those. Please take that implicit assessment test, we'll put the link to it in the show notes page. And just start being open to ways that you can change because when we all change from within it totally influences the whole rest of the world.

And, on that note, I am going to say goodbye. I hope that you are able to care well for yourself this week, that you're able to take a break when you need to, and that you're able to move forward in the areas that you're ready to move forward on. So, have a good weekend, if you're listening to this when it comes out. Otherwise, have a great rest of your day. And I'll talk to you very soon. Take care.

Did you know that you can find a lot more help from me on my website, go to katrinaubellmd.com and click on free resources.