BONUS: Responding To Listener Feedback
Subscribe to Lemonada Premium for Bonus Content
Description
We’re not done yet! We are back with an encore episode to respond to all of your amazing feedback over the course of the season. Stephanie, Jackie and Dr. Robin Hornstein (Jackie’s high school therapist who you might remember from episode 10) answer listener voicemails, emails, and DMs about season two. Come for the insight, stay for the montage of Stephanie losing her mind behind the mic.
Resources from the episode:
- Learn more about designated crisis responders (DCR) in Washington State
- Kid or no kid, breathe in, breathe out with Cosmic Kids Yoga
- Shake your stuff to the Bollywood video Robin mentioned
- Stay tuned for the interviews that didn’t make it into season two by subscribing to our Patreon
If you or someone you know is struggling emotionally or feeling hopeless, it’s important to talk to someone about it now. Contact one of the resources below for a free, confidential conversation with a trained counselor anytime.
National Suicide Prevention Lifeline: 1-800-273-8255
Crisis Text line: Text “Connect” to 741-741
The Trevor Project: 1-866-488-7386
Season 2 of Last Day is created in partnership with The Jed Foundation. The Jed Foundation (JED) empowers teens and young adults with the skills and support to grow into healthy, thriving adults. You can find tips, tools and resources for taking care of your emotional health available at: www.jedcares.org/lastday
To follow along with a transcript and/or take notes for friends and family, go to https://lemonadamedia.com/show/last-day shortly after the air date.
Stay up to date with us on Twitter, Facebook, and Instagram at @LemonadaMedia.
Click this link for a list of current sponsors and discount codes for this show and all Lemonada shows.
Transcript
SPEAKERS
Dr. Robin Hornstein, Emma, Jackie Danziger, Stephanie Wittels Wachs
Stephanie Wittels Wachs 00:03
Hey, hey everyone, welcome to LAST DAY. Hey, hey? What am I like a DJ? A radio DJ?
Jackie Danziger
This is a normal way you start every conversation.
Stephanie Wittels Wachs
What? I’m gonna try it again. Hey everyone .Welcome to the LAST DAY. I am your host Stephanie Wittels Wachs. Okay, so I know that we said we were doing 12 episodes and that is absolutely true, we would never lie to you. But we decided that we would make it a baker’s dozen and round up with one episode. And the reason for this is because all along this season, you have been sending feedback in the form of voicemails, emails, DMs, all of it. And you are such an important part of why we do this, you are such an important part of this entire process.
Stephanie Wittels Wachs
So, today we want to feature you and to do that I am inviting on our producer Jackie to share some of your greatest hits from this season. And then we’re going to chat with Dr. Robin Hornstein who you remember from Episode 10. She is our favorite friendly psychologist to answer some of your lingering questions about suicide and mental health. So, welcome Jackie D.
Jackie Danziger
Well, thank. Or you would say, “hey, hey”
Stephanie Wittels Wachs
All right, so Jackie What are we doing here today? What have you pulled for us?
Jackie Danziger
So today we’re going to listen to some voicemails respond to listener feedback, chitchat with Robin, but also I do want to say that like this season somehow I ended up crying more into a microphone than you did and I just don’t want people to think that somehow your mental wellness is like significantly stronger than anybody else on this team. So the rest of the production staff and I wanted to put together this little montage slash […] to you, our fearless leader Stephanie Wittels Wachs.
Stephanie Wittels Wachs 02:15
Oh my God I’m scared Here’s the thing. Here’s the thing I think you can use that […] oh my God, I’m running out of breath Alright, that’s 75 times. I’m sorry that you have to add all that together. Could not say that word to start over. We don’t have a throw to the next episode. There’s another fucking plane. Health care? Nope. Nope use the other one. […] how did she who hate themselves work together? Like this… Already a disaster. All right, I’m obviously running out of steam.
Stephanie Wittels Wachs
Okay, cut that out. Jackie was right, Jackie’s always right. Don’t worry Kegan. I’m going to give you a room tone at the end. I have a post it note up on my computer. Wow, sorry. Bless me, Harry, mommy’s working right now. Let me see. Let me see. Oh my god, another hole in your mouth. Go away. I don’t care. Close the door. Do not come back. Bla bla bla bla bla bla bla bla bla bla bla. Let’s see.. la la la la la la la la la la la la la la la. Can you tell that I’m losing it? Giulia? Or whoever’s listening to this. Okay. The end.
Jackie Danziger 04:30
You, Stephanie are just delightfully unhinged. Thank you for being you. With that out of the way, I think we should listen to some voicemails.
Emma
Hi, my name is Emma. And I just want to say thank you for your podcast, because last year, when I first found your podcasts, I was recovering from my substance abuse. And crazily enough this year, my best friend killed herself. So, you, in more ways than have helped me so much get through some of the most worst times of my life. So, I just want to say thank you, and keep doing what you’re doing. I really need it. And more than you think.
Stephanie Wittels Wachs
Oh my gosh.
Jackie Danziger
Isn’t that nice?
Stephanie Wittels Wachs
Why don’t you start with that I’m like, weeping. I just thought…
Jackie Danziger
It really made my day when we got this message. I mean, it’s one of those things where it’s like the tension of our show where I mean, so much about that is sad. Like, theoretically, this kind of message should be sad to hear, but it’s really nice to know that people are listening and that it means something.
Stephanie Wittels Wachs
Yeah, that’s, I mean, that’s absolutely truly 100% why we did this, why we do this show. It’s not the easiest one to make, you know, for many reasons. But getting feedback like that, and being someone who has been on the other side of that, where I have so desperately needed resources that I can trust and not having them. That just means absolutely the world to me and to Jess. I mean, that’s, that’s what it’s all about. So thank you, Emma. I appreciate that.
Jackie Danziger 06:26
Thank you, Emma. Okay, so our next one is from Caroline.
Caroline
Hello, Stephanie and team. Forgive me, I’m walking my dog. But I’m listening to the latest episode of LAST DAY. And I am inspired to call. I’m an inpatient psychiatric nurse. And so to listen to this last episode, just broke my heart. Because we are on the receiving end of those patients who spend 24 hours in an emergency room, on top of which they come up, psychotic, and scared to us, often not wanting to be treated. And we, in the meantime, had just had our ratios changed to one nurse to eight patients. So you could have one, someone psychotic, you can have someone actively suicidal, you know, I had this moment of real defensiveness when it’s like, it feels like a jail. And I have to really check myself because of course, it feels like a jail when you’re looking at it or when you’re in it.
Caroline
But there are also severe incidents of people killing themselves in the hospital. It’s awful. It’s wonderful. I love my job, like, I love my job, but it is so much. It’s so much. And you are correct that the system is so broken and so imperfect and so laden with stigma, it’s just unreal. You know, we’re 1 to 8, our social workers are 1 to 12 that never ends. So again, thank you so so, so much for what you do. Your podcast makes me a better nurse. I listened carefully. And I try to put those things into my practice every day.
Stephanie Wittels Wachs 08:26
I love a woman who will multitask and walk the dog and listen to this episode, and then pick up the phone and call, what an absolute hero. I love her.
Jackie Danziger
That was my favorite part of it, too. She kept apologizing. I was like, No, that’s, I love it.
Stephanie Wittels Wachs
Oh, you are a wonder, you’re a wonder in this world and don’t ever change. Yeah, I love all of this. I love that she’s calling from someone who’s in the midst of all of this every day. You know, that’s one of my favorite things. from season one where we interviewed Stefanos wife. And she was like, you know, the EMTs came in and they were so rude to me. And they basically just pushed right past me and my husband had just died and they were not at all kind or compassionate or empathetic.
Stephanie Wittels Wachs
And then the next episode, we talked to the EMTs, who I mean, not those specific EMTs. But people working on the front line, who were like, “listen, we do eight calls a day from the same person sometimes.” I mean, you know, I love the idea that we are giving the perspective of everyone who is a stakeholder here because the system is going to have to acknowledge all of these people in order to ever make any sort of big systemic changes.
Jackie Danziger
Yeah, I feel like one of the important things with this one is we talked so much this season about how the system is broken. But I hope that that never gets misconstrued as, like, the broken system is that way because everyone within it is bad. You know, I think there are so many good people who are just trying so hard, but you listen to these numbers, and it’s like, this is bad for everybody involved. You know, the fact that she’s, What’d she say, 1 to 8, 1 to 12. I mean, that’s, that’s overwhelming.
Stephanie Wittels Wachs 10:28
I mean, we heard a little bit of this in the finale, when Susan was talking about wait times, it’s not like anyone goes into being a mental health worker, because they don’t have compassion and empathy, and quite the opposite. Often personal firsthand experience in a variety of ways. So I think if we approach everything with this sense of like, these people want to do the right thing they want to help. There’s a lot of red tape, there’s a lot of hands being tied, there’s a lot of 1 to 8…
Jackie Danziger
Budgets being slashed.
Stephanie Wittels Wachs
Yeah, money is a big thing. We have to acknowledge that. So I really do appreciate this perspective. And I love that she spoke so openly and vulnerably about how the episode broke her heart. I mean, that’s the people that I want working on the front line, I want people who are not shut down and closed off and who can continue to empathize with the people who come in and have their best interest and their family’s interests at heart.
Jackie Danziger
Absolutely. All right, you ready for one more?
Stephanie Wittels Wachs
Yep.
Abby
Hi, my name is Abby […]. I’m 21. And I’m from Pennsylvania. And for the majority of my life, I’ve struggled greatly with an eating disorder, for the past four years has been diagnosed, and I’ve been in and out of treatment. And currently, right now I’m struggling in my recovery and struggling to stay on track. And it’s been very difficult for me, because I feel like it’s very difficult to reach out for support, because people just say, just see the food or stop doing something that you know, isn’t working. And obviously, I know it’s not working. And I feel your podcasts, especially on Substance Abuse and the depression suicide season has been extremely, extremely helpful for me.
Abby 12:18
I personally don’t struggle with substance abuse. But I feel like the stigma is very similar for eating disorders, depression, all mental health issues, that just you need to get over it and suck it up. And that’s so not true. And I really, really appreciate the way that you guys share our stories. I’m in nursing school, and I love to talk about this type of stuff. Thank you guys so much for all that you do. You guys are truly making a difference and an impact on the world and on my life and so many others. And I really, really appreciate you guys. Okay, have a great weekend. Bye.
Stephanie Wittels Wachs
I love her. Love her. Absolutely. I’m obsessed with her. I love her so much. Abby, please find me on Instagram and we will become internet friends. I love that so many helpers, listen to our show. That is something like we get so much feedback from nurses and therapists and social workers and people who are in it and making a difference. And it’s just very validating that they’re getting something out of this work.
Jackie Danziger
I agree. I also feel like we’re gonna talk a little bit more about the eating disorders connection with Robin, but I do feel like that whole mentality of like, just suck it up, is really real.
Stephanie Wittels Wachs
Yeah, when she said that, that got me right in my heart, chakra.
Jackie Danziger
Where, and I feel like with season one it was like this. This stigma like we’ll just stop doing this because it’s too bad and harmful. For this one I really do feel like it comes across as like, Oh, just get over it because like it’s dumb. What you’re feeling right now is like a waste of time. Or you’re overreacting or I think about like, Lisa in Episode Two talking about where it’s like, what do you have to be sad about? You have everything.
Stephanie Wittels Wachs 14:12
Oh, man, this is. Yeah, this is a big thing. I think, you always talk about how I interact with Iris. And when she comes in and interrupts and I give her my attention, and I never invalidate them. I’m not gonna say never I’m a shitty parent, like the rest of us at times. But I really try to listen to her and hear her and reflect back and I just think like, starting so young, not negating someone’s experience not minimizing and sort of like brushing somebody off. I think that is the stuff we can start to do at the beginning to lay the groundwork for not feeling like you can’t take up space in the world. Later, and I feel so deeply for Abby, about being told to suck it up and reflecting on Harris and reflecting on like, that was the smartest person who ever lived.
Stephanie Wittels Wachs
That is an objective fact, he was the smartest. And if he couldn’t stop, if his willpower wouldn’t allow him to stop, then it’s not about willpower. I mean, that was a huge shift for me in season one, you know, where addiction is not a choice. It is a chronic medical illness. Thank you, doctor in Nzinga Harrison for bringing that into my head like a drum. And that is the mantra, right? So like an eating disorder is not, you suck. It’s like you have a disease, mental health, depression. It is a disease. It is something that must be treated that way. And if there’s anything that you can get out of this whole show, it’s that.
Jackie Danziger 16:00
Yep. You’re not crazy. We understand you.
Stephanie Wittels Wachs
You’re not crazy, Abby. Look me up on Instagram—@wittelstephanie
Jackie Danziger
Should we go to our next segment?
Stephanie Wittels Wachs
Yeah, yeah, I love, we have segments on the show now?
Jackie Danziger
Yeah.
Stephanie Wittels Wachs
Hey, hey, what’s the next segment?
Jackie Danziger
The title of the next segment is GOOD CALL LISTENERS.
Stephanie Wittels Wachs
You’re my favorite voiceover actor. I love it. “GOOD CALL LISTENERS”—all right, go ahead.
Jackie Danziger
So there’s a lot of ways to contact us, you can find us on our Instagram accounts, you can email us you can submit forms. Luckily, people did all of the above to tell us things that we had, like sort of missed or got wrong. And we’re all for that, because the whole show was a learning process. And here are some things that people pointed out to us that we wanted to share. You want to take this first one?
Stephanie Wittels Wachs
Yeah. Okay. So this is from a listener in Washington State in response to Episode Seven with Jenny that really focused on emergency room failures. So here’s what she said, “I wanted there to be some communication that there is actually a resource available for people who are having mental health emergencies. They are called DCR—Designated Crisis Response—And they are trained mental health professionals who will come to your house, or wherever the individual is, and assess on the spot and initiate voluntary or involuntary inpatient treatment. It would be great if you could offer some communication about this service. I want others who feel helpless in the face of a mental health emergency to know there is something out there.
Jackie Danziger
Oh, I love this message. I found this really helpful. I have to be honest; every single episode has an extra 30 minutes of content that is written and cut.
Stephanie Wittels Wachs 18:01
She does have to be honest about that. It is true. We would make three-hour episodes if we could.
Jackie Danziger
Yeah. And there would be a full act of every episode that was just me being like, ooh, except and here’s a caveat. And also you should know.
Stephanie Wittels Wachs
But really?
Jackie Danziger
Here’s the Jenny episode.. Yeah, but really.
Stephanie Wittels Wachs
But here’s the thing.
Jackie Danziger
Exactly. This episode was especially tricky, because we were really focusing on things that weren’t working. And there are some new programs like the ones that this listener is talking about. So this was, this is a 2018 update that came out of 2016 law. They’re called Designated Crisis Responders. And it’s great. It’s a great initiative that happened in the face of tragedies like what happened to Jenny and her husband. So it’s good. It’s only in Washington State. There are other similar programs and other states, but it’s not nationwide. And, you know, there’s also I should say, that episode talked about psychiatric boarding.
Jackie Danziger
The state also after Jenny’s story passed a law to make that illegal now. But the reason why we didn’t go into it in depth is like I said, it’s not, it’s not across the board, but also, when it comes to the emergency room updates. It hasn’t quite worked yet. So we’re trying to avoid having too many episodes that ended. We’ve come far, but we have a long way to go.
Stephanie Wittels Wachs
Which really is how we could end every single episode, that or also it’s not the same in your state. Bye. I mean, that’s the other thing about this, right is that there is so much disparity between how one state does it versus another. And so it really does matter where you live in terms of the kind of care you’re going to get, what the options are. I don’t think people understand how many variables there are, when it comes to the care you’re going to get, and to the coverage you’re going to get.
Jackie Danziger
Completely, so I’m really, I’m so, so glad that the listener pointed this Because it’s a great thing to know. I also want to say while we’re here, that things like Designated Crisis Responders—are some of the initiatives that are happening in various states that are trying to get the onus out of the hands of law enforcement. So the idea is that if 9011 is your only option, there’s a lot of things that can go wrong. And everybody wants that to change, including police officers, firefighters, they’re not trained to be mental health professionals. So these are good. These are good initiatives. And I recommend everybody looking into what their state has for crisis response.
Jackie Danziger 20:37
So this next one is actually one of the earliest pieces of feedback we got on this season. It’s from a listener who lost her father to suicide. She’s responding to something that came up in your conversation with Courtney, in Episode One, we were talking about the impact of losing someone to suicide, and we said something like “it fucks you up forever” And she said, “for the first three years, and some days, currently, I would have agreed with you, I was broken. But most days, I know that I’m not.”
Stephanie Wittels Wachs
Here, here, here, here. If I was a listener, yeah, I am like doing the snaps. Like I just heard some very amazing slam poetry, I feel this very intensely. My loss is not a suicide loss. But it is certainly a sudden, very deeply stigmatized, loss to overdose. And I would absolutely agree with you. It definitely fucked me up. I would say the forever piece of it is that it has impacted me forever. It has changed me fundamentally, it is guided and directed. What I do with my days, what I do with my time, how I deal with my kids, how I have relationships, how I move through the world, it is impacted all of it. This podcast would not exist if I had not lost my brother. And so I think it is a gross understatement to say it fucks you up forever, I think it would be more accurate to say it changes you. If I were gonna speak to that.
Jackie Danziger 22:13
Yeah, same I.. as someone who has lost someone close to me from suicide, the person who I lost was my husband’s best best friend who was the best man at our wedding. So I can see it through just the change that has had on him. So that I know for myself, there are things that I hear things that I see that I’ll just never have the same reaction to again, because they’re going to be associated with him and with suicide. But also, it comes and goes for both good and bad. There are moments where it’s still sad, but it’s also like every great thing that happens to us, we think to ourselves, “Oh, man, I wish we could share this with him” so it’s just something that is there forever. But I agree we were probably being a little bit too, too flexible. Yeah, make a point.
Jackie Danziger
And just last thing, because we talked to Courtney about this one is that I think that often this gets framed when we’re thinking about people who are considering suicide as like the listener, who I think that’s like who he was talking to in that moment where so frequently, the logic is like, people will get over it, I’m a burden to them, they’ll see that it’s better this way. So the more that you can sort of say like no, the people in your life will be changed forever. The people in your life will never get over. I think it’s another one of those moments where we have to be conscious of who we are talking to and like if you’re talking to that person, are you alienating another one. So it’s hard to be perfect all the time. So I do just to say where I think we were coming from on that one.
Stephanie Wittels Wachs
Yeah, I’m glad you said that. Totally. Okay. This is a listener who is responding to Jackie’s episode of LAST DAY that we did, Episode 10. She sent an email that said, “I just listened to the latest episode of LAST DAY, and I was taken aback by how similar my story is to Jackie’s. You, Jackie, said that you meant to frame a hopeful example of what works. before I was even halfway through the episode, I had to pause it to send my bestie a voice memo and this is what I said to her. If my life is following the same pattern as this story, then this trajectory gives me hope that I’ll make it past 30. That you still have the same struggles wasn’t surprising or disappointing to me. I admire that you still find the will to face them again and again. Maybe this episode wasn’t about what works. But I think you are objectively a hopeful example for people like us.” Yay. I love this. I love this email so much.
Jackie Danziger 24:42
This was so nice. So first of all, I really appreciate it. I had a few people reach out to me from Instagram and through our email address lastday@lemonadamedia.com and it really was nice. I as you know sort of hated making this episode for a lot of it because I just
Stephanie Wittels Wachs
I do know, yes.
Jackie Danziger
I felt so exposed and I was really dealing with, you know, what the voicemail said about feel like you should suck it up. I spent the whole season being like, “why can’t I just suck it up? I really need to.” So it was really nice to hear from people who related. I liked this one because I love that it was like, Hey, you said it wasn’t hopeful. But it was. And I think that this was something we were consciously playing with, which is like, Stephanie convinced me to do it as an episode of hope, what works, look at where you are now. And through making it I did not feel like I was anything to I just kept saying, I was like, I have no advice for anybody.
Jackie Danziger
Like, I have no advice for myself right now. And through making it I left feeling really strong. So I kept that in really more as an example of the negative message that I tell myself, and how the whole thing became a representation of the negative message just running wild. So I do appreciate that this person was like, FYI, it was still hopeful, because that was the goal.
Stephanie Wittels Wachs 26:07
I also think it’s such an interesting kind of behind-the-scenes example of how we think a story will be one thing. And then once we dive in and start making the story, we realize it’s another thing altogether. And that’s part of what we love about storytelling. That’s why storytelling is so exciting. If you’re paying attention and listening, and it was so fascinating, because the original idea was you’re a hopeful example, like let’s not, let’s not just do an episode on self-harm, let’s do an example of someone who was engaging in non-suicidal self-injury and then got to the other side. And we can see that you can be a 16-year-old, who cuts herself and then be an amazing producer one day, right? And that what’s so fascinating about this email is absolutely that is what she got out of it.
Stephanie Wittels Wachs
The journey of the show of the episode, though, was that in the making of it, you started to experience the same thought pattern that you had when you were 16 and cutting and that became something that I remember, like cooking dinner, and we had just like gotten off and I called you I’m like, “Listen, we have..” I think I often call you when I’m cooking dinner, listen, and my kids are screaming, “we have to do this episode about how you’re like still having the same negative thought patterns.” And the jukebox thing that Robin said became such an inspirational mantra of this episode.
Stephanie Wittels Wachs
And it’s something that I keep using in my life now where I’m like up, that’s that song. Oh, there’s that song playing, you know, and it’s just, it’s made things like all the therapy I’ve gotten over the years, it’s made me realize that that jukebox is just so powerful. And it’s such a part of the narrative we tell ourselves about ourselves, is such an integral part of this season.
Jackie Danziger 28:10
I’m glad you’re related to it.
Stephanie Wittels Wachs
Yeah, that was awesome.
Jackie Danziger
Okay, so we’re gonna take a little break, and then come back with fan favorite from my episode. Robin Hornstein.
Dr. Robin Hornstein
Hi, Stephanie.
Stephanie Wittels Wachs
Oh, my gosh, it’s the celebrity Robin Hornstein.
Dr. Robin Hornstein
So nice to meet you.
Jackie Danziger
So, we have welcomed you here for our mailbag episode, I sent you some of the questions ahead of time. I think the first one that we should jump in on because it just relates to so many is why is it so hard to reach out? We got this question from a listener. They said, “why is it so hard to reach out, ask for help and tell someone that you’re struggling? We know it to be a fact it’s hard to be open and to have honest conversations about mental health. But why I struggle with this because I know it’s hard, but I’m having a hard time understanding. And this has stars around it. Why it’s hard?”
Dr. Robin Hornstein
Oh, man, that is a million-dollar question, right? Because there’s so many people that are in pain that are living with, you know, mental health issues or family issues or pain that you know, physical pain, and they’re afraid to ask and you know, I made, I jotted down a couple ideas because I was thinking what do people tell me when they finally get in? And number one is shame. Shame that they can’t fix it themselves. Shame that they can’t do it for themselves. There is just this very deep sense of like, you know, and maybe it’s a family message they got or maybe it isn’t, but it is a sense of like I’m failing if I’m asking for help.
Dr. Robin Hornstein 30:00
I also think sometimes people have asked for help, and the first experience they got was negative, and that shuts them down. They’re done. There’s also a disbelief in the fact that anybody wants to waste their time. Like if you’re feeling depressed or anxious, why would you think anybody wants to take the time to talk to you, and that gets in the way as well. And yet the helpers are there, whether they’re friends or family, or therapists, or psychiatrists, or trauma informed yoga instructors, right? Like there are people there waiting to help.
Dr. Robin Hornstein
I think the last thing I really wanted to say about this question, because it was such a good one is, sometimes people don’t ask for help, because they think they’re betraying someone else, if they talk about them, and what they’ve done that has harmed them, or hurt them. So I think if you wrap those things up in a nice package, you can see why it’s really hard to ask for help.
Stephanie Wittels Wachs
Yeah, I mean, I think shame is at the root of all horrible things in the universe, I just feel like it is such a primary color and emotion. And when you have that in your gut, it just seems to inform everything. And I mean, why is that Robin? Why is shame such a big one for people.
Dr. Robin Hornstein
Because it’s the first negative emotion that most children feel. So it’s really deep, deep, deep inside. And it can be from a simple thing, as a parent as across the room, they have a crawling child, the child is crawling right over to something that they get knocked down right on themselves and hurt themselves. And what is the parent do if they can’t make it across the room, they yell “No” loudly. And that sets up shame and it needs to be there little bit, we do need a little bit to kind of operate in a constructive way as you know, a member of society, right?
Dr. Robin Hornstein
And I’m not saying we need to be ashamed. But we do need to know there are boundaries and limits. But when kids learn it, it’s almost pre verbal. And you know, some parents handle it better than others. Because some are like, you know, like, hey, no. And sometimes that still feels upsetting. Like, if you’ve never heard that before, and all you’ve gotten is this person has fed me and played with me and given me food, and suddenly I am operating independently. And I’m told no. That’s where the shame starts.
Jackie Danziger 32:27
Are there things that parents can do to try to counteract that, like, our instinct to feel shame and teach others shame?
Dr. Robin Hornstein
You know, I’m not sure we can live without it as an emotion. So I don’t know. I mean, yes, of course, they cannot, you know, add a, you know, a slap along with the, you know, sort of saying no, to get a kid out of the way, and they cannot scream and yell at a really loud tone. That’s, you know, if you normally talk to a kid like this, and you’re suddenly screaming at the top of your lungs, which I wouldn’t do to either one of you right now. And it may be coming from your own pain, shame or fear as a parent, because you’re like, Oh, my God, my kid could get hurt right now.
Dr. Robin Hornstein
But I think, you know, explaining, explaining, explaining, although, remember, when kids are pre-verbal, you starting that conversation, they don’t always get it. So it’s a lot of, parenting is repetition and repair. Right. It’s not being perfect. So saying, I know, honey, I know you wanted to play with that. Let’s just go and do something else right now. That’s not safe. And moving them aside.
Stephanie Wittels Wachs
Man, I’m just feeling very indicted in this moment. I mean, it’s just it’s like I can I can feel you know, that knee jerk when you’re so in the moment, and like, literally five minutes ago, my daughter was just she’s making Valentine’s cookies. And she took the sprinkles and just dumped them into her hand. And then because they’re tiny, they dumped out of her hand, all over the hardwood floor and my knee jerk was to be like, oh, Iris, you know, and I’m like, Oh my god, that is so shaming, you know, if I could, but those little moments happen 75,000 times a day as a parent.
Dr. Robin Hornstein 34:20
Right, and luckily, kids get used to those things. And if they also are countered by lots of other things, like you made those cookies with her and you’re having a good time and you’re like, you know, going out to the park and doing other stuff. That’s not what she’s going to remember. I think what sets in the harder shame is when people aren’t getting the other side of it. They’re not getting availability of parents. They’re not getting like deep love. They’re not getting a conversation about it.
Dr. Robin Hornstein
Yeah, it’s a pain in the butt when your kid you know, does something, I remember my daughter did a science experiment which exploded all over my kitchen, because she took everything, everything and dumped it into a ball and eventually something sparked that went […], I was like, “I have to clean this whole frickin kitchen now” so no, you’re not indicted. You’re just a parent. All right.
Stephanie Wittels Wachs
I like that. I’m into that answer. Thank you.
Dr. Robin Hornstein
You’re welcome.
Stephanie Wittels Wachs
All right. So here’s the next question. What is the relationship between eating disorders and suicide? Is it a risk factor like self-injury?
Dr. Robin Hornstein
Yeah. So let’s start out by saying that one of the number one.. is that Iris?
Stephanie Wittels Wachs
This is what she just came to bring me. It’s a beautiful cookie.
Dr. Robin Hornstein
That’s a gorgeous cookie.
Stephanie Wittels Wachs
Keep going.
Dr. Robin Hornstein
One of the number one reasons people die from mental health issues is actually eating disorders. Sometimes, it’s because of the eating disorder itself. You know, sometimes it’s because of this, the eating disorder itself, people can have cardiac failure, they can aspirate, they can, you know, get very, very, very ill from bulimia from anorexia from orthorexia. And sometimes, it’s because there’s, so that’s more of a passive kind of way that they’ve died. There are though people who are so depressed, and they have an eating disorder, and they feel suicidal. And so the rate is really like it’s people die from eating disorders plus suicide together more than just suicide. From what I see from the latest statistics.
Jackie Danziger 36:31
I had no idea. Did you have any idea, Stephanie? I can’t believe this is the first time this is coming up.
Stephanie Wittels Wachs
Nope, I’m horrified actually.
Dr. Robin Hornstein 36:38
Well, people don’t, I think part of it is people do not understand that you know, what is happening. So for instance, with anorexia, if your body has shrunk, your organs have shrunk. And it’s really hard to convince somebody that that means their brain functioning isn’t as good, their executive functioning is gone, they may be having trouble making memories, their heart is not working to capacity. So there’s that. And then people who are binging and purging are really, really destroying their insides, right?
Dr. Robin Hornstein
So you know, and people who exercise to the point of not getting any caloric benefit from food they’re eating, like, it is just really dangerous. And so, you know, if you put that with, I’m never good enough. And I feel like crap, and society tells me I’m not the perfect looking person anyway. Sometimes people commit suicide on purpose, and sometimes they just die.
Stephanie Wittels Wachs
It’s so interesting. I just hadn’t made the link before now between the idea of self-injury and eating disorders, that there’s a, would you characterize or categorize an eating disorder as a form of self-injury?
Dr. Robin Hornstein
Sure, actually, probably, I mean, I don’t always, I mean, it’s not like I would diagnose that specific for insurance companies. Sure. But when I’m looking at it, it is self-injury. Think about it, like all our bodies need is to eat, to sleep, you know, to be, you know, to move to do things, and when you’re doing an exaggeration, or you’re restricting, or you’re eating so much that you feel so sick, then you’re harming yourself.
Jackie Danziger 38:21
It was interesting, when I was going through, you know, Janice, who was on my episode, who does all of the research on self-injury, they put it in a different category, just because if not, there would be so much, so much data. And so the one thing that they do to distinguish it from non-suicidal self-injury is the definition for that NSSI—is it has immediate damage as opposed to cumulative damage, which is where then the eating disorders fall in, which I just thought interesting, but I think the motivations feel very similar.
Dr. Robin Hornstein
Yeah, I love that answer. Yeah, the motivations are, you know, well, their motivations are some are similar and some are different, right? with an eating disorder, you’re really looking to, you know, escape who you are, and perfect yourself in some way. And, you know, or you’re tired of being marginalized and oppressed, and you’re like, you know, F it, I’m just gonna do whatever I want to do. And you treat yourself poorly.
Stephanie Wittels Wachs
The issue of shame also feels very entrenched in anecdotally that the friends I’ve had that the stories I’ve heard about eating disorders, there is a lot of shame that comes along with that, correct?
Dr. Robin Hornstein
Yeah, there’s shame that might start it. There’s shame that continues it, there’s hiding out and underneath all of that, you know, there’s a ton of trauma. But yeah, there’s a lot of shame. There’s shame. You know, like, these days, people are still trying to perfect themselves or hide or disappear in some way from all kinds of things, right? We could talk about microaggressions we could talk about racism here, we could talk about homophobia, transphobia. I mean, just throw it all in there. It’s all part of the package.
Jackie Danziger 40:05
How do you actually approach your patients that have comorbidities? Like if someone comes in with multiple issues, and they’re just like, “Everything is broken? Fix it, now!” How do you how do you prioritize things? Where do you even get started?
Dr. Robin Hornstein
Well, that’s what I like about the fact that therapy is collaborative, unless someone is in a place where I need to get them to a higher level of care. Other than that, I don’t say I think we need to do this first or the second, I feel like that’s actually like me or ordering somebody about I’m like, Okay, so we’ve got, you know, you’re depressed, you’ve got an anxiety disorder, you have OCD going on, there’s a lot of different things that overlap. There’s some treatment differences in here, like, what feels doable. And I always say to people pick the tiniest thing first. Let’s not say, I will fix this big thing, because I need to chunk it down.
Dr. Robin Hornstein
I don’t know about you, but I have to start small enough that there are successes and on top of which everybody hates changing, I don’t know, don’t let anybody lie like to you like, I hate change. People hate change. So changing a major way that we support ourselves, even if it’s not our fault, even if it’s not something were, you know, like, we’re just used to doing these kind of harmful patterns, saying let’s do something else is pretty scary. So I want to change a little bit of it. Not all of it.
Jackie Danziger
What would be an example of a little change somebody could make if they, let’s say, are coming in with an eating disorder.
Dr. Robin Hornstein
Just observe or mindfully eat, pay attention to hunger signs, if they’re still there, because sometimes hunger, hunger and satiety are gone. You know, and I’ll take a full history of traumatic events. I’ll take a history of like dieting. I mean, I want to know all of that stuff. So we start with sort of getting a picture of how did we get here? Like, just take me on a journey?
Jackie Danziger 42:02
Relatable. How did we get here? That’s what we’re asking. All the time. Okay, I’m gonna move on to our next question, which is, what are some long-term options for treating severe depression beyond weekly talk therapy? It seems like there are options for substance use and eating disorders. But where can someone go when they are just a danger to themselves?
Dr. Robin Hornstein
Okay, so there’s lots of answers to that. First of all, there are IOPs—which are Intensive Outpatient Programs. And IOP—for mental health is usually about three days a week, and it’s probably about two to three hours a day. There are PHPs—which are Partial Hospitalization Programs, a Partial Hospital Programs is five days a week, and it’s usually probably four to five hours at a time. There are residential programs, and there’s hospitals. So residential care is usually two to, you know, like, six weeks, where it’s 24/7, you’re kind of being watched, you’re being supported, you’re being helped, you’re not having time to do your daily life, that’s ceased, right?
Dr. Robin Hornstein
Because you’re still not doing well enough, stabilizing yourself at the five-day week, partial and then finally, there’s hospitalization if somebody needs to be stabilized on medication, if somebody is in a dangerous place, so there’s all of those. And people find that I mean, usually therapists in all areas know about those kinds of programs. There are also other things besides talk therapy that’s really useful for depression. So there’s somatic treatments that are more of the body there’s EMDR—which is Eye Movement Reprocessing. And where somebody is really actually having both sides of the brain kind of talk to each other at the same time. There’s Tapping, which is, again, sort of its bilateral stimulation that you can do yourself at home.
Dr. Robin Hornstein 44:02
There’s Biofeedback, which is amazing for depression. There’s TMS—which is Transcranial Magnetic Stimulation, which is non-invasive, it’s several days a week, maybe every day for like three or four or five weeks. But insurance will pay for it. And it’s it kind of unfolds and moves the brain enough to kind of like allow for some healing around depression and anxiety. I also think what’s important is that sometimes when you’re depressed, you don’t move your body and when you don’t use your body, you’re not getting like you’re not stimulating all the good neurotransmitters that happen when we move around that give us sense good joy juice feeling.
Dr. Robin Hornstein
So I’m really big on people figuring out ways to move. And I always I’ve been telling my people since COVID started, I am turning into the queen of a 10-minute Bollywood video that I’ve been practicing on YouTube. I look terrible, and I know that, but nobody can see Jimmy and I say that too, because I’m like, pick a kind of dance. Take a kind of you know, the everything you want is free on YouTube. You don’t have to pay for it. You can just do it.
Jackie Danziger
We will put the link to this in the show notes.
Dr. Robin Hornstein
Oh my god, the guy is so good who teaches it. It’s 10 minutes.
Stephanie Wittels Wachs
I love the music too. It’s like so infectiously joyful. This is a question about this, it’s so interesting, because we all know and feel that once I do move my body for 10 to 15 minutes, it’s like night and day. But why are we wired to not want to do that? Why are our brains trying to sabotage us? Because if I have the choice, I’m not going to do it. I don’t want to get up and do it. I want to watch TV. So why aren’t our bodies and brains helping in that way? What is that?
Dr. Robin Hornstein
Our bodies and brains aren’t helping because we’re asking them to do something when all they really want is to like melt into a space and not move, right? You think about somebody super depressed and you almost picture somebody laying on a couch or in a fetal position almost, right? And it’s almost like an emotional space, we get into that. And we tell ourselves all sorts of things, tomorrow, or I don’t deserve to move my body or you know, like, how many times has somebody told me I can’t go to the gym until I like get in shape. Well, but you can’t get in shape until you go to the gym, so and what is in shape name, right? I think also it means analyzing with somebody what messages they’re giving to themselves.
Dr. Robin Hornstein 46:28
Because what I consider exercise when you consider exercise can be very different. And I try to help people formulate one, something that feels doable for them. I don’t care if they stand up and do like five minutes of stretching and sit back down again. But it is once you start, it’s infectious. But until you start it feels like another task. And I feel like crap already. So why are you telling me to do anything?
Stephanie Wittels Wachs
Jackie, I need you to also add to the show notes “Cosmic Kids Yoga”—it’s something that I do with Iris in the mornings. And Robin, you should tell everyone this. They don’t sponsor the show. But I love them. It’s this woman who creates all of these 15-minute yoga videos for kids based on different stories. And she sort of creates the worlds of the stories. And every time we do it, I feel it’s so great because I get to connect with her at the beginning of the day, which sets both of us off on a really good path. And we’re moving our bodies and we’re breathing and stretching and it is I can’t recommend it enough “Cosmic Kids Yoga”, even if you don’t have kids, you should still do it. Because they’re incredible. I love this woman.
Jackie Danziger
Thank you for the perfect pivot. That’s the next question, which is COVID is really impacting families. What are you seeing? What are you hearing? And what can people do to take care of themselves and their loved ones?
Dr. Robin Hornstein
Okay, so I’ve been told in every workshop I’ve done over the past year, to never use the word “self-care” around the parent, so I won’t
Stephanie Wittels Wachs
Thank you. I as a parent to young children very much appreciate that.
Dr. Robin Hornstein 48:02
You are welcome. So we won’t start with self-care, although it is much needed. I think the problem here is we are I know this is going to be basic, but in my mind, we’re pack animals, we’re no different than cows. We need to live in community. And we live in those communities as parents in all different kinds of ways. Whether you know, we meet other parents at school, whether it’s at the playground, whether it’s the daycare center, whether it’s like the dance, so the you know, ballgame, whatever it is, we rely on each other. And thank God really ironically, for Facebook, because there are a million parenting Facebook groups where people can go on and say, “I’m losing my shit here. I can’t do this today”
Dr. Robin Hornstein
Like it could be that your neighbor says you know what, I made a really large lasagna. Let me bring you half, right? And I will still socially distance we won’t be in each other’s homes will still have a mask on. But I’m bringing you this over. COVID has made us these little isolated pockets. And it’s not how we operate. I love my family. I love my house. I love my work. But I travel a lot as much as I can. I like to go see my friends across the country. I like to get on a plane and just go and here we are sitting with our kids. And if we’re single parents, that’s one piece of it. If we have a partner, that’s another piece of it. And that’s the person we’re looking at all day long, or we’re Zooming and we all know how that makes everybody feel.
Jackie Danziger
Bad. makes us feel bad.
Stephanie Wittels Wachs
Yeah.
Dr. Robin Hornstein
It’s […]
Stephanie Wittels Wachs
It’s so lonely. It’s interesting too. I mean, I have a two-and-a-half-year-old and so, so much of his life has been in lockdown. And my husband and I were noting yesterday that when we take him to the park now he says out loud he doesn’t want other children to be there. If other kids are there, he doesn’t want to get out of the car. And it’s like, what? I mean, and it’s for safety. He knows we kept to stay away from people, but now he’s developing the sense that other people are not to be embraced and not to be around. And how do we rewire that? I mean, that feels really counter to what I want my children to feel about their community.
Dr. Robin Hornstein 50:25
Yeah, the difficulties that kids will have to undo, including some Agoraphobia, a little bit of fear of other people. I don’t know what that does to us, like nobody, how do we know what it does to our psychology if we haven’t lived through it yet. To see and I think part of it is to, you know, with, certainly with your son to be able to say, here’s how we keep safe, we don’t have to stay away from all children. It’s okay, if they’re there, which I’m sure you already say. And to demonstrate and role model, being able to talk at a social distance from the parent of that kid that’s running around.
Dr. Robin Hornstein
And you know, like, you’re showing those things, despite all of what children are living through right now. What is incredible about children is they are resilient. They come back from who knows what, and they are just like, let’s go, let’s figure out life now. It’s different than it was before. And their resilience is actually infectious to us. Like as we’re trying to rewind our own lives. So I have a feeling that the kids are going to come out of this like a whole lot better than we think they are.
Stephanie Wittels Wachs
Well, I feel like I am, like I said, when we started in the midst of a very important celebrity. You, Robin, it has been a true pleasure to have you here. You don’t understand how much I have heard about you for a very long time. I mean, Jackie talks about you so warmly. And I feel like it was just such a pleasant surprise to have you come on the season. And to have you come back. I’m just very grateful for your participation in this season of LAST DAY.
Dr. Robin Hornstein 52:13
Wow. Well, thank you. And it’s actually it’s so funny. I told I think I told you this Jackie, like, when I met Jackie, she was so cool. I was pretty sure my inner teenager was like, if I was in school with her, she would never have hung out with me. So therapists have those thoughts, too. But like, I hope and I, you know, I feel like it’s really important just to end on the note of like, I think you know, this show is amazing. And everybody who has listened to the show since that knows me since I was on it and kind of talked it up. Then like, this is an incredible, incredible, incredible show. So I feel really honored and lucky to be on the show. So thank you.
Stephanie Wittels Wachs
Okay, so Robin is a national treasure. Absolutely love her.
Jackie Danziger
Like the luckiest person ever that she was my high school therapist.
Stephanie Wittels Wachs
Yeah, she’s incredible. I’m so glad that we got to have her back for this and that we had an actual mental health expert in the room for these questions. Oh, it was good. All right. So Jackie, we are done. Now for real. We are done with Season Two. Wipe your hands never to be seen or heard from again. That’s absolutely not true. We are going to continue working right now. I just want everyone to know from my heart and soul and Jackie’s heart and soul and Jess heart and soul and Kegan and Giulia and Claire and everyone who works on the show that we have deeply appreciated everything that you’ve sent us this season.
Stephanie Wittels Wachs
And if we didn’t share your voicemail or your email today, please, we have read it. And we have internalized it. And it has been passed amongst the team. And I’m just really grateful for all of you. We are coming back for a Season Three. Absolutely. We will be getting to work on that later this year. Very excited about that season. And there is a lot of work to be done on the topic we are thinking about. So stay tuned. And I also want to say just continue to share if you’ve gotten something out of this show.
Stephanie Wittels Wachs 54:35
People come to us all the time that say “I just found season one about addiction and it has done X, Y and Z for me. And if you have gotten something out of this season, please spread the gospel and share it far and wide. You know I think this content can help people now and six months from now and a year from now and until we find into oblivion. Haha. Okay, what else Jackie?
Jackie Danziger
Okay, so I also do want to mention that we talk to a lot of extremely smart people. And we heard a lot of moving stories anyway, long story short, we cut a lot of interviews, that did not make it into the season. And I can’t live with that. So we’re going to do some really, really great content on Patreon. If you’re not already a Patreon supporter, I highly recommend joining now, because I’m not just saying at this time, we’re about to put out a lot of good stuff. It was the only way that we didn’t cry ourselves to sleep was to convince ourselves every time that we couldn’t fit an interview into an episode, we were like, don’t worry, we’ll put it on Patreon. So there’s some good stuff coming your way.
Stephanie Wittels Wachs
I am saying yes to that, please tune into Patreon. It’s also a way for us to just stay in touch with you because we love you and we want to stay in touch with you. So, that’s it. I guess, Jackie, thank you for everything.
Jackie Danziger 56:02
Hey, Stephanie. Thank you.
Stephanie Wittels Wachs
Enjoy you so much.
Jackie Danziger
Same. Same
Stephanie Wittels Wachs
All right.
Jackie Danziger
It’s such a labor of love and I’m happy to do.
Stephanie Wittels Wachs
All right, friends. We’ll see you soon.
Jackie Danziger
Bye.
CREDITS
LAST DAY is a production of Lemonada Media. Our supervising producer is Jackie Danziger. Associate producers are Giulia Hjort and Claire Jones. Technical Director is Kegan Zema. Music is by Hannis Brown. Executive producers are Jessica Cordova Kramer and me Stephanie Wittels Wachs. We are so thrilled to have partner with the JED foundation this season and grateful for all their wisdom and support. You can find them online at @JEDFoundation. And you can find more mental health resources at jedcares.org/lastday. If you want to hear more LAST DAY, we have an entire first season. Please go listen to that wherever you get your podcasts. And while you’re there, please rate and review and subscribe if you have not done so already. You can find us online at @LemonadaMedia, and you can find me at @wittelstephanie. I’m Stephanie Wittels Wachs, thank you for listening.
