Welcome to the Weight Loss for Busy Physicians podcast. I'm your host, master certified life and Weight Loss coach Katrina Ubel, M.D. This is the podcast where busy doctors like you come to learn how to lose weight for the last time by harnessing the power of your mind. If you're looking to overcome your stress, eating and exhaustion and move into freedom around food, you're in the right place. Hey there, my friend. Welcome to the podcast today. I'm so excited to invite back my friend and excellent, excellent coach Krista Saint Germain today. I look back, she did her first two episodes with us in 2020, so almost about two and one half years ago. It's episodes 176 and 177. If you're interested in going back and checking those out. Krista has a really interesting story that she, of course, goes into in her previous episode. So you can definitely start there and listen back if you'd like to. But she herself is a widow and has just become this incredible coach for widows and more broadly an incredible coach and knowledge base on grief and what to do about grief and how to work through grief. And as I mentioned, a little bit more on this episode, but I want to mention here is that, yeah, maybe there isn't a loss that you're processing right now.

Maybe this isn't going to be information that's going to directly apply to you right in this minute. But I know that you touched a lot of people in your life, and maybe it's patients, maybe it's family members or friends. There's going to be people out there who have struggled with a loss, who are currently struggling with the loss, or it could just be even be that this time of year is difficult for them because it brings up memories of their person that they lost. And that could be a spouse or it could be any number of other people in your life. So I was very excited to bring Krista back to be able to share more about current trends in grief and something really interesting she calls a grief plateau, which I know you're going to want to learn more about. And so I am just excited to let you listen in on my conversation with Christa Saint Germain. Please enjoy Christa, So glad to have you back on the podcast.

So happy to be here. It's been too long.

It has been too long. We've just been chatting about other things. From here we go. So excited to get into this stuff. You know, I love talking about grief, truly. I mean.

You're one of my weird friends that likes to talk about grief.

It's really true. Okay, so let's just start off because you have been on the podcast before. Let's just start off with a little bit of a refresher on how you define grief.

So I like to think about grief first. It's just the natural response to a perceived loss, right? It is the natural thing that we go through when we perceive that we have had a loss. But then more specifically, I think a lot of people think of grief as just a feeling like just the emotional experience of the loss. But I like to think about it in more broad terms. So the totality of our response to the loss, which includes all of our thoughts, all of our feelings and how they adjust over time, right. How they change grief is not something that has an end, right? It's just something we adapt to. It becomes part of the fabric of our of our being. It changes the way that we see the world. So it's not something we ever get over or move past. It's something we move forward with. You know, it's not just a feeling. It's so much more than that.

I like that too, because, I mean, you know, I've told you, I think I've said this on the podcast before. I told you this before when my daughter passed, like I read this book and it had this quote in their grief as patient, it will wait for you. It's like and even just that idea of like, yeah, if you try to avoid it, it's going to wait for you, but it's also still present with you ongoing. That was actually very helpful for me to understand that early on because I kept being like, This hurts so bad. This feels so, so bad. When do I get to the other side and finding out there isn't another side and that it will just change and evolve? I was like, At least you know what it was is it set my expectations like, okay, now I know what to expect. Like I can deal with if I know the way it's going to be. So. So this is actually kind of perfect, though, because so many people talk about like what can make grief better and it's time, right? You know, time heals. And as this episode is going live, you know, we talk about the holidays and holidays can be very, very difficult for people who've experienced losses. You know, whether the loss was around the holiday period or this is, you know, a time when they're remembering the person that they lost more than you say, that time doesn't really heal.

Nobody likes me when I say that.

And so let's talk about that.

Yeah, nobody wants to hear that. As with anything, I think it's just it's nuanced. It's not black or white. So it would be unfair to say as a blanket statement, time heals, but it would also be unfair to say that time has nothing to do with healing, right? So it's just a little bit more nuanced. So part of what has to happen in healing is that the brain has to go through a learning process, right? The brain has to relearn your relationship with the person. So when you have a significant bond with someone, the brain actually encodes that bond. And so, of course, it makes sense then that it has to relearn. It's kind of like if you think about phantom limb syndrome, right where people are, that the limb is no longer there, but yet they're reporting that they can feel it. But we know that it's not really there. But the. Brain hasn't really rewired itself yet to catch up. And the same thing happens in grief. So, yes, time has to pass for the brain to relearn that when the garage door goes up. It's not your person that when you pick up the phone to try to text them, they're not going to respond. When you reach over in the middle of the night and they're not there.

You know, the brain is expecting them to be there. It has to relearn through exposure over time that they are no longer somewhere you can find them. And it will keep yearning and longing for you to find them until it learns that. So in that way, time is necessary for healing. But also it's important to consider what are we actually doing with our time? Because what I see so many widows struggle with is that. They just believe that time heals and all they need to do is just let time pass. And so then instead of giving themselves the opportunity to feel their feelings right and stay present with themselves and explore what the loss means to them and kind of do what we would call, quote unquote, the work of grief. Then they just kind of white knuckle their way through and distract themselves and try to stay busy or they turn to coping behaviors that maybe create results that they don't want, like overeating, right over drinking. They do things to distract themselves because they think they just need to hold on for a certain amount of time to pass, and then they end up doing themselves a disservice and creating more hardship than is necessary. So time in and of itself doesn't heal. Time is necessary for healing.

Right? Okay. That's really good stuff to think about. Wow. I love that. I love our conversations so good. So when you were on before, we talked briefly about post traumatic growth, but we didn't really get into it so much, particularly how it looks with grief. So what is post-traumatic growth and how do we create that, particularly in a scenario where there's been a loss?

Post traumatic growth, I think for me, when I heard about it was incredibly encouraging. I also appreciate, though, that for some people it's a little bit confronting when you hear the term because kind of the last thing you're thinking about after you've lost someone important is growing. Think right? Like, yeah, don't really care. I'm just in pain. But post traumatic growth is a term that was coined in the mid nineties by a couple of researchers, Tedeschi and Calhoun, and they were noticing that some people after a traumatic event, which of course is very subjective, some people were experiencing a decreased level of wellness perpetually and at that point in time, kind of before their work, it was thought that the best you could hope for or the end goal was there was the level of wellness. Before the traumatic event there was a decrease, and then the goal was to get back to the baseline that the person was experiencing before the last. And what they noticed in their studies is that some people were actually reporting a greater level of wellness, so greater appreciation for life, greater spiritual change. They were considering new possibilities, their relationships were improving. They were perceiving themselves as stronger, more resilient. And that just didn't match up with anything that had been studied before. So that's the idea that it is possible and some people don't even have to work at it to experience growth after something traumatic. I know for me in some ways it was something I worked at. In some ways it was just something that happened. You lose someone precious to you. It can be a tremendous wake up call. You know, life is short. Maybe you aren't living the life that you want to live. Maybe you aren't living the values that you have, or maybe you are kind of just going through the motions and taking things for granted.

Or maybe you aren't really making the impact in the world that you want to make, and that can be just such a beautiful time to reassess and live a life that's even more aligned. But what will hold people back from that sometimes is that they they make it mean something that it doesn't need to mean. Like if I'm more satisfied with my life after this person that I love so dearly died, then what does that mean about my love for them? Right. And to me, it doesn't mean anything. I like to think about it like I live in Kansas, so we have tornadoes here. If a tornado came and knocked down your house, you needed to rebuild the house. You could just rebuild or try to rebuild a house as close as possible to the one that you had. That would be fine. And also, if you had lived in that house for any number of years, you probably would have learned a lot about what you like and what you didn't like. Right. There may be some things that you would really like to change about that house, not because there's anything wrong with the house, but because maybe you want more light in the kitchen, right? Maybe you want a different layout of your master bedroom, Right? Whatever it is, we have the ability as humans to take what we have learned and apply it going forward. Why not? Why would we miss that opportunity? To update the design of your house is not an insult to your previous house. And that's how I like to think about it, right? It's just an opportunity that we have. And why not?

It's like a yes and yes. We love that person. We never would have wished that ever on our worst enemy. And it happened. And here's what we did moving forward. Yeah, nothing of that.

Yeah. When my husband died, it was because of a car accident. And so I had to replace my Camry. I could have got another Camry. I probably could have found that exact same Camry. But it didn't make sense in my life at that point. I was, like, toting my daughter's cello around. And, you know, it made sense for me to change cars. Right. And so I did. So I got a minivan. Like, does that mean the Camry was bad? No, It just means I learned some things and adjusted.

Yeah. And you had another opportunity. You know, maybe it was an opportunity what I've chosen. But the opportunity presented itself to redesign something.

Yes. 100%. Yes, 100%. I did not choose that. And and just because. Right. Like you do go on to redesign your house, that doesn't mean. You are also saying, I'm so happy that this happened. Not at all. Not at all.

Right. Or glad that it happened. Yeah, absolutely. Think that's so good. So the DSM was updated and now. Prolonged grief disorder is an official diagnosis. So tell us more about that and what do we think about that?

Yeah, I'm mixed on this one. So it used to be called complicated grief. And I actually preferred in many ways that term complicated because, you know, when you think about complications, you can just kind of understand that like in healing, there can be complications, right? Things can interfere with healing. And the same thing can happen in grief. So complicated felt just a little more approachable to me. But now we have the term prolonged grief disorder, which in some ways I hope will be helpful. My biggest hope is that people won't use it against themselves. But basically what we're saying is that, you know, when you have intense yearning, when you are intensely longing, when you are preoccupied with thoughts and memories, and it is disrupting your life for an extended period of time. And I'm not obviously trained to diagnose because that is left to the folks who are licensed to do such. But if we declare something a disorder. Then, of course, insurance will cover treatment. And so I can see the benefit there. I can see the benefit of people who are thinking that there's something wrong with them feeling validated that there is a term for what they are dealing with. What I hope will not happen with this term is that people will start diagnosing their loved ones. Right. And saying that because grief doesn't end right, deciding that a person's response to their loss is somehow wrong or disordered and they will misuse that term. And it's really only about 10 to 15% of bereaved people like generally speaking, that would even have prolonged grief disorder anyway. So I'm very mixed on it. I hope that what people do here is at a certain point, you know, six months or beyond, for most people, if grief is really interfering with your daily life and you are adapting to it, then there is help available for you. And let's get that support right. Let's not let it really impact the quality of of our our lives on an ongoing basis.

I think that's really helpful. Thank you for explaining that, because, you know, so many of the people listening to this are doctors who are taking care of patients. Right. And, you know, so it's like so it's like, of course, you know, the people who are listening and like directly helping them that so many people who listen also directly help so many other people. And so just even educating, you know, the people who listen to this, you know, episode on what's available and ways to look at this can really help them to direct their patients to the help that they need.

Totally. And I think Columbia Center for Prolonged Grief used to be Columbia Center for Complicated Grief, but now they've changed their name as well. Dr. Katherine Shear. Her work is very accessible to anyone, both clinicians, in terms of mental wellness, but also the general public. And she has some incredibly useful tools in terms of educating yourself and sorting that out a little bit. And I think it's important to know, too, that it's kind of a common misconception that prolonged grief only happens when there was a conflicted relationship with the person who died. Not true at all. Prolonged grief can happen and maybe even more likely to happen when someone had an amazing relationship with someone or if the death was sudden, or it was unexpected or violent if it was a young person. But yeah, the more information we have, the better. And most people are not trained about prolonged grief.

Okay, so you talk about a grief plateau. Can you explain what that is and how would someone be able to tell if they were stuck in one and what to do about it?

A grief plateau is the space I found myself in where everybody was telling me I was doing so great and I didn't feel great and I didn't know what to do about it because I was past acute grief. So there's like the acute grief experience, which most of us have different for everyone. You know, I don't want to make any super blanket statements, but basically it's that beginning experience where it feels like your world just exploded and the rug got pulled out from under you and your hormones are a hot mess and you're not sleeping and you have grief, fog and just everything. Just maybe you feel really numb. Your emotional swings are intense and intrusive. If you wanted to go back to work at that stage, you probably couldn't because, you know, the biggest thing you're celebrating might be a shower, right, in early acute grief. And then there's that kind of back to normal from the outside perspective in that I'm functioning, I'm getting the things done. I am back to work. If I wanted to be, I look like I'm doing okay. The kids are getting fed. We appear to be back to quote unquote normal. And this is the grief plateau. This is where you probably not really thinking you're ever going to love your life again. You are feeling more robotic, more empty, more hollow than you want. The joy just isn't where you want it to be. It's not depression, right? It's just you're not excited about your day. You're not jumping out of bed and ready to chase a new goal. You're probably not even dreaming again, necessarily. You're thinking about the near term and you're getting things done in the near term, but you can't really imagine what you want five years from now, ten years from now. It's very much a surviving experience and not anywhere near thriving.

Would you say that people in that phase, they're often feeling like they're not sure who to talk to about how they really feel? Because like I feel like so many of the people who are your loved ones, they want you to be better. And so if you share what's going on, sometimes they're like, Oh, it'll get better. Like they just want you so badly to be better that maybe they're not the best people to talk to about it. And people keep telling you how great you're doing. And so it's like, I would imagine it could feel quite lonely and isolated to be in a grief plateau.

Yeah, And that's one of the struggles that people who are experiencing a grief plateau often have is they don't know where they fit in socially or they don't feel like they fit in socially. They're kind of trying to manage other people's feelings about them, and they might be playing their cards very closely and picking and choosing who they talk to or being very chameleon like in social situations because they don't really want to bring it up. But also they're not really experiencing the connection that they want to experience with people. Everybody else is kind of gone back to their way of living, but they don't want to rock the boat it can feel. Very isolating and very lonely for sure. And by the way, Grief Plateau is a term I totally made up. It is what I wish somebody would have have given me and said, This isn't all there is. Like, this is where you are right now. You haven't done anything wrong because you're there and you don't have to stay there. It is possible for you to actually love your life again. And what's so sad to me is that most people who when I talk to them about what I describe as a grief plateau, this is the point where most people go, Oh, this is my new normal. I'm going to make it, but I'm never going to be truly happy again. I'm never going to really love my life again. And I should just count my blessings. That breaks my heart. Those are the women that I'm like, get into my program. Like when they're widows, right?

Like, I guess the rest of my life is just going to be like this.

I'll be exactly.

Sad and hollow my whole life. Yeah, I was going to say, so these are the people that you really serve, right? These people who are like, kind of through that acute phase or close to it. The dust has settled a bit and they're like, you know, life is continues to move forward and is this it? Yeah. And so just to give just, you know, maybe one or two ideas or kind of tools that you use to help women who are in that grief plateau to start moving out of it.

So it kind of depends on what they're particularly struggling with. But generally speaking, you know, we're working on like coping self efficacy, right? Like how do we get our attention focused on what we can control? When it is largely focused on what we can't. And sometimes that means getting super clear on a lot of the things we think that we can't control are actually things we can and vice versa, right? Helping us understand that. So like an example of that for me was if you had asked me if my life was going to be better in the future, I would have told you probably not. And I wouldn't have thought at the time that was something I could control, right? I thought that was just something I was experiencing. And so it was a newsflash for me that my best days are probably behind me was actually something I was thinking and could choose not to think. That in itself is is completely transformative. And then how do we navigate the emotional experience we're having? Because most of us are kind of, you know, instead of being in a position where we're better poised to allow the whole emotional experience of being human, we're actually shrinking. We're like stagnating because we've just been through this intense emotional experience.

The last thing we want is more intense emotion when we're exhausted from what just happened, and we don't really have a skill set that points us toward another less awful experience. So can we develop the capacity to allow our emotions to flow through? It's just a lot of the work that you do too, right? So that we aren't kind of shrinking into that stagnation zone and we actually are able to and actively pursuing the full breadth of the human emotional experience because that's what really living again is. But we're afraid to do it and we kind of understand why. Like if you want another relationship, but you're so terrified that someone is going to be taken away from you again as just happened and you don't believe you have the capacity to handle that emotionally, you're not going to put yourself out there. You're not going to be vulnerable. You might have ideas of a dream of something you could accomplish or could create for yourself that you really like. But if you can't stand the idea of the emotional potential downside of that and you don't believe you have the capacity to handle it, you won't pursue it, you will stay small. And so it's those kinds of muscles that we need to be developing.

I don't really see how the post-traumatic growth can come from that, though, right? Like if someone comes and works with you or, you know, just with therapy or coaching or whatever, if they're if they came into their loss without that skill set, without that knowledge, without that kind of experience and introspective ability, then it's like if a good thing can come from the loss, it could be developing yourself as a person because you could have probably benefited from that before the loss as well. It just happens to be that through the loss, this is your opportunity to learn from that and that can be that way. Where you go, you know what, that happened and it was awful. And through the process of healing, I've took steps forward.

Yeah. And we also kind of have to or at least have the opportunity to go from we to I. Right. So if you have lived your whole life or most of your adult life in a particular way as a we, the transition to AI has a lot of complications. And so even things like decision making, right, when you used to have a person that helped you make decisions or perhaps you leaned on them to make certain decisions, right? And you never even made those decisions yourself. You might not have the skill of decision making or you might not have ever dealt with the financial aspect of your life. Maybe your person did that, or you might have more. I see this a lot. You might have more money than you have ever had because you got a life insurance payment and you have less security. You feel less secure than you've ever felt, where you have no peace around that money. You don't like how it came to you. You resent having it. You don't want other people to know that you have it. You don't want to spend it, all kinds of things. Or maybe, you know, maybe your spouse had a business and now you're trying to run that business and you don't really want to run that business. That business wasn't your dream. You can imagine there are endless opportunities, but no limits.

I love the work that you do. That's I'm seriously I like. So I just feel like so honored to know you because I think what you do just make such a big difference for people. I really, really mean that this is oh gosh, there's so many people who need this. And I just think back to like, you know, generations before how people just, you know, suffered and struggled and thought that that was all that was available to them. And it's so great to know that for people who are open to it, for people who are interested, there is help available. And and I just I just know that what you do really, really transforms people's lives. And I made what a gift.

I honestly sometimes have to pinch myself. And even what I have been realizing recently after now, having done this work for a few years is it's not only the widow's life who I get to transform, it's the ripple effect that that has into the world and the way that then she is able to help her children and what they see her role modeling and. Just that part is like that. If you want to make me cry, we can, you know, like, that's where it will happen, right? It's just seeing the impact of that in the world. Yeah.

This is why we get up every day and do this work, right, and deal with running a business and entrepreneurship and all the lovely things that we were talking about before, you know, the ups and downs that come with it. So I would love to know. First of all, the name of your program is Mom Goes On and they can find out more about that where.

They can go to coaching with Krysta dot com. Krista and I have a podcast called the Widowed Mom podcast, which of course is very specific but very useful for anyone who's just interested in learning about grief. Right? If you want to learn about grief or how to support someone, or if you want to learn about post traumatic growth, it's a very useful podcast. Oh, I do have an advanced certification coming up, so if anybody is listening, that is life coach school certified. What I find is that people are a little hesitant to coach around grief. It's a little bit scary to them and I don't think coaching around grief needs to be scary at all. All of everyone in the world is going to experience grief. So if you are a coach and you are not comfortable coaching grief, you're not helping your clients to the fullest extent. So I'm working on right now an advanced certification just to help people see that grief coaching doesn't have to be so scary, right? Yeah. So that'll be coming out soon too.

Especially if they haven't really, as a coach, really gone through a big loss. I could see that being because that changed everything for me. I'm like, Oh, okay. That's why I'm like, I love talking about me.

Yeah, But I do think you and I are the exception to the rule. Most people are like, Oh, I don't know, maybe I should refer out. No, you don't need to. Like, we can help them, Right?

Right. Or maybe it's a yes and right. Like, we can coach on this and, you know, maybe there's some additional help that would be helpful. So.

Well, yes. And that's not to say coaching is the only answer for grief. I don't mean to say that, but you don't need to send someone to a grief coach if you are a coach and it falls within the bounds of coaching. I want you to be comfortable coaching on all subjects, right?

Definitely. Definitely. So good. So good. Chris, thank you so much for being here. As always, an absolute pleasure. And I know for those who are struggling with grief on the holidays, this is going to be really helpful because I think that's something that, you know, not a lot of people talk about, but this can be a really, really tough time for people. A lot of people, actually. And it's just always good to feel seen and understood. And I think that that's what we've offered people today. So thank you so much, Krista.

Thank you, Katrina.

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