the idea that i would complain or think negatively about my life sends me into a a tremendous amount of guilt because on paper it's so great but here i am exhausted with anxiety um and i feel guilty for it and it drives me nuts and then i feel guilty for feeling guilty for feeling guilty you know can it be that today i don't feel great inside where did you get the message that certain forms of pain are more valid or allowable [Music] hi welcome i'm dr romini kyle welcome to welcome to my virtual office it's so nice to meet you yeah thank you i'm glad i'm here i need it so how are you feeling and then also tell me what you mean by i need it how am i feeling well i'm tired today um but that's just because i'm alive and awake so if i'm awake i'm tired um and when i say i need it i need to be i i'm not new to therapy okay i've been to therapy um i just haven't been to therapy in a while and for the first time in my life i'm in therapy for reasons that i haven't been to therapy for um and so part of me is is uh irritated with myself that i have not been more on top of this i i feel like i'm a little late to the game i know i can catch up um but that that's what i mean when i say i need you okay now you you shared a couple things i want to follow up on but you started by saying when i'm up i'm tired so how long have you been experiencing this level of fatigue retiredness well i was born in 1986 so probably around there uh your whole life okay my whole life i mean i've been to sleep doctors and other doctors and gotten all the tests and done all the diets and um i i mean it's i could easily sleep 12 hours a day and take a nap in the middle of the day and so anything less than that is me pushing through and obviously i cannot run the life i have for myself on 14 to 16 hours of sleep a day so uh yeah i'm tired all the time and then i and then i and i know that impacts my mental health um but there's just no way around it that i have found so your whole life like even in childhood adolescence you have you've had this history of this long-term fatigue and and you've seen medical professionals mental health professionals sleep experts and none of them have really shined light on what this is about the conclusion is that i have crohn's disease i have a surgery that took out part of my stomach um so i don't absorb nutrients i don't get what i need and uh look i was also diagnosed with depression when i was nine years old and when that is rearing its head yeah my side effect is more exhaustion yeah so i think it's a combination of chronic long-term depression and chronic crohn's disease okay so i mean crohn's disease being an autoimmune condition and it means it really in essence also is sort of your body attacking itself and it can also be made worse autoimmune conditions are can significantly be um uh made significantly more severe or debilitating if a person's under stress right because they're mediated by the immune system and which is go in many ways really that stress is sort of like the puppet master of the immune system and so you have the you and on top of that you have depression how long how long have you had a history of depression well i was diagnosed with depression at nine i've been diagnosed many times since throughout adulthood and i think the true first symptoms of uh you know high levels of anxiety um you know a lot of thought processes and cognitive distortions i i suppose they would be we're probably around six or seven years old and then it finally came to a head when i was nine and my parents were like we've got to get this kid to therapy and thank god they did and then i you know and i'm medicated i'm on 40 milligrams of prozac and i've been on many antidepressants over the years have have you in your in your over your lifetime the the therapy the medications has it helped with depression oh yeah yeah okay absolutely i mean helped is an understatement that is therapy and meds are the reason that i can do this mock therapy session yeah so when you're um given how much fatigue you've been experiencing your history of crohn's disease and your history of depression how does all of this come together to affect your day-to-day functioning well that's a long question or a long answer but one thing that is new to me is the guilt i have for feeling this way i have a fabulous life oh my gosh i i cannot the idea that i would complain or think negatively about my life sends me into a a tremendous amount of guilt because i on paper it's so great but here i am exhausted with anxiety for you know the second real time in my life the first time i was six years old um and i feel guilty for it and it drives me nuts and then i feel guilty for feeling guilty for feeling guilty you know it just continues on right so in essence you're you feel guilty for having [Music] a normal reaction to your life well i don't i guess i don't look at it as super normal because i don't have the stressors that i hear other people have i hear about stress i hear about trauma i hear about what people are going through and i'm not going through that yet i am there's a part of me mentally that responds as though i were which is so even saying that out loud honestly dr romney i'm like oh god like get it get over yourself like you you don't have anything to be upset about you know okay so do you feel guilty when you feel hungry no okay but you i mean really like you have access to food you have everything you have a kitchen i'm guessing you have money to buy food so why should you ever feel hungry well i don't know i i don't know i mean i to me that's not in comparing apples to apples because i'm [Music] i my internal monologue is how dare you feel like you have something to be upset about when you really can't identify anything to be upset about okay all right i understand what you're saying but you do see what i'm saying like you have a natural experience of hunger and you allow yourself to feel it and you're like well better get something to eat because i'm hungry and you don't judge that but you have set up in your mind this idea what i'm hearing is that it's almost as though you're viewing stressors or misfortunes or problems quantitatively and only if you get over a certain level is a person allowed to feel bad yeah what's the number kyle 100 scale you nailed it and you sound like my dad my dad has told me he's like kyle you're the guy who goes well i only lost one leg i have another one he's like you're allowed to be upset that you lost one leg um you nailed it but you see what you're doing kyle even here it's like i lost the leg like can it be that i got two legs and i got a functioning body but today i don't feel great inside it's as though you are you require you believe that there are certain valid reasons to feel bad and if you don't have a valid reason then it's somehow shameful or wrong and so then you feel guilty yeah yeah that's exactly correct that's exactly correct and so made and i didn't have the awareness of it going into this um therapy session so i guess just for a time sake what do i do now with that awareness i'm in this session you provide it for me i get it sometimes that's enough i leave i go home and i go oh my gosh i don't allow myself to feel normal feelings um and i judge the feelings i have unless they are stood up compared to something to warn those feelings in my head i want to ask you though i want to understand sort of the only way to really fully understand the tree is to understand its roots right what do you think the roots of this are where did you get the message that certain forms of pain are more valid or allowable than others uh well i assume somewhere in my childhood but i can't recall something um [Music] you know right off the top of my head i i also think it's a it is uh a symptom of the nature of some of the work that i do at med circle i get a lot of emails from people sharing their lives and i am so thankful that people feel uh comfortable enough to do that but i'm i don't know how well equipped i am to go through an inbox every day of people being abused people dealing with suicidal ideation people struggling with children who are struggling that's a lot for me to take on and so after i read all that all day and then i go oh poor kyle you you live in a nice apartment and you have a great dog and you're healthy and you're but you're tired and that's what's giving you anxiety you don't have the right to be tired because you just got an email from mrs miller who is struggling with her two kids drug addiction so in a way kyle you're sort of your own perpetrator you're the one you know because what i'm hearing in you is interesting it's something i actually hear you know as you know from looking at my website before you came in a lot of the work i do is in this area called narcissistic abuse or helping people who are going through relationships with sort of difficult demanding and often quite judgmental people but it's almost like you're in an abusive relationship with yourself and the people who are in these relationships i tend to work with they invalidate their partner's emotion and say what do you got to complain about you know what why are you so sensitive why are you getting so difficult when i'm you know when i'm why are you being so you know so you're acting like a child right so they invalidate the emotion of their partner who's merely having an experience and they judge them you're kind of a one-stop shop here mr kittleson because you've sort of done it all in your same person you have a part of you that gaslights yourself there's this interesting dichotomy within you you know and it's a one of the healthiest places we can get a person to is where they don't judge their own emotion because emotion is like air temperature stand outside long enough it's going to change right it passes but with emotion if we judge the emotional state we're in and shame it try to wall it off it will come back and bite us if we don't allow it to be expressed or someone else doesn't allow it to be expressed again we wall it off and then we have all these compartmentalized parts of ourselves and we don't become a whole authentic person we're we're almost our own worst enemy at those times and what we're doing what we're then doing is we're deriving our sense of how we're even allowed to feel from the world in essence we've outsourced ourselves and you know i'm i'm wondering for you you know can i ask you are you in a relationship are you i'm dating someone and tell me about this person you're dating i actually told him about you a while ago and uh i said yeah i ended it and you said man that seemed a little uh i asked for your opinion you said uh it seems a little you know quick harsh and um now we're seeing each other again it's been great okay what do you think your experience as a gay man and it's a it's a it's it shapes the process of development so differently right for uh to be a boy um and you grew up in a you know it's not i think those journeys are still very difficult but mercifully we're having more open discourse but for you there was there was a coming out journey i'm wondering how much you see a connection between any of the experiences you have in terms of your self-judgment the judgment of your emotion this dichotomized self we see in you and even your history of depression and how that might line up with your process of coming out um [Music] there is probably a part of me that expects more of myself because i'm gay to prove to everybody else that hahaha uh jokes on you you thought i wasn't going to amount to x y and z and i did that plus more and so when i'm in uh not in that state if it's anything less than like 10 out of 10 the self-judgment starts um i think probably when i was 22 23 i'm 35 now i had some uh what is that called dr romney when you're like it's not like this is an over simplification but it's when [Music] gay people don't like themselves for being gay self-loathing self-self-loathing right um there was there was probably some of that and i don't even need to say probably there was that i remember telling my friend she asked me would if you could take a pill to be straight would you take it i'm like right now god every morning that'd be so much easier i was in my early 20s you know as an adult now i would not do that um but you know that's where i came from if that helps if that gives you an answer it helps a lot because you know if i could take a pill and not be gay inherently negate part of my authentic self right yes for you that compartmentalization has been there like you said you've gone through your process you've integrated your identity you're clear on that it's it's it's very to be you you know to be a gay man that's that's this you this isn't a this is until if i could make this go away because there was that self-loathing because it and again that self-loathing is magnified through the lens of society right the self-loathing doesn't come out from anywhere it comes from the biases that society has against any individual that's a member of one or more marginalized groups and that that internalization of that is such a quiet process sometimes we're not even aware of it and then we may turn it inward judge our emotions judge ourselves labor our label ourselves negatively and we'll think this is all an internal process when in some ways that process is society you know we've internalized these messages from society and we think they're our own and so it does make me wonder how much you judging something as integral and human as your own emotions is sort of a lifetime of having judged yourself and who you are i mean the short answer is that's that is a large chunk of it you know and so and and so in our work together i hope that we can talk about this more that you find spaces where you feel you feel that you can be you authentically genuinely and not feel that you're being judged or valued conditionally but also kyle there is a there's a reality to this the nature of your work where you are reading difficult stories from people's lives right there's an actual toll to that right it's actually called compassion fatigue people who have to compassion a lot you wear out no more than any other muscle if you were if you were lifting stuff all day or digging ditches all day or fixing roofs all day you would be wearing out different parts of you and in the case of what you're doing reading these really difficult stories that people are sharing with you in a vulnerable manner is having two impacts on you one that compassion piece but the second it's activating this ancient shame for you wow yeah wow okay yeah i mean you're really good you're really good you're really good dr romney you're really good that's good thank you that was really good that was really good i'm a little irritated to be honest because it was so good um really good thank you i'm not even i don't even want to talk about it anymore um yeah that was really good [Music] so um i have questions about all that okay about our therapy session awesome one how much of the how we've known each other for years now so how much of that history did we have impact this type of session i'm going to be frank with you kyle again because i was doing a mock therapy session i was really trying to obviously i had pieces in here but i also even with the little bit you gave me like for example i was trying to set it i know you're a gay man but i didn't want it to be presumptive since we were sort of laying it out as though it's the first time i'm meeting you and all of that but not as much as you would think what you gave me was enough and what did i give you you told me you told me how you're feeling you know you told me how um even how you've been feeling like this for a long time you gave me a glimpse into your mental health history and your physical health history and how they kind of come together you let me know that you obviously had solicitous parents who encouraged therapy um but then you really were able to you know pivot into the space of being able to talk about the guilt and then ultimately the shame you felt about having having any negative thoughts about your life in light of the fact that people have it so much worse right this kind of um [Music] it's it's a very um it's a very stoic kind of who the heck am i to complain when people have it so much worse where and i have to say when i hear that it always concerns me because at some level i often think to myself like ah this person is going to be perceived as so strong by everyone like you're right what do you have to complain about right but our i have to remember after tell you i i once read this book by a woman named dr dr um edith eager and she did such a beautiful job she really sort of she's sort of the um like a very female parallel voice to victor frankl and in her book it's called the gift she writes about this idea of so often we feel like we either don't get to be in we don't get to complain about our lot in life because some people have it worse or she gave a great example of a person getting aggravated at someone like a therapist getting aggravated at someone for complaining thinking how could you be complaining about this like you know thinking like as a therapist two hours before i might have been hearing someone had a much worse problem right but what what dr eager says is that the therapist has to be sort of masterful at being able to at being able to understand that everyone's crisis is their crisis from a subjective point of view for one person not being able to get to their nail salon when it could open felt tragic to them for another person processing the suic the the suicide of their child and you're like can these be these two things be compared and dr eager would say yes because in both cases that person had a negative mood experience and we don't get to judge it i have to say her her writing has been quite influential for me and again builds on dr frankel's work as well so it's this idea that we don't get to judge not as therapists nor do we get to judge ourselves as individuals your pain is your pain and so that theme really struck me hard about you and then i wanted to get to the core of where that came from and that's where your history came in you know and i do know you're gay and i knew that very much so that people who have statuses that are who maintain who hold roles i should say role statuses that are marginalized by society are often the ones who judge themselves most harshly because society already does that for you that societal judgment almost passively gets internalized and as a result people who live within marginalized roles and statuses are more likely to self-pathologize than other groups yeah look you really nailed it you really nailed it when you tied it all together at the end i felt all of it being tied together in my brain um that's how in line it was with what was going on in my head what you were saying which really made me feel uh heard i think that was my reaction was not just the realization of where these feelings are coming from but also oh my gosh this woman in 10 minutes understood what i was talking about um i've been to a lot of therapy dr romini and those moments that i just had with you truly in 15 minutes uh i mean i don't have a lot i don't have those every therapy session you know what i mean um it's a build uh i don't have any good questions i probably have some bad some stupid questions but bridget are there any stupid questions i can ask about this i'm too emotional right now you know i i kyle first of all thank you i'm i'm glad like we were able to do something that would teach people let me tell you though part of what i think we were able to do here that i hope and wish more people would get in therapy and that's that idea of understanding those internalized societal messages i think that too often therapy doesn't integrate that we're so focused on the closed system of the individual that we don't weigh in on what structural systemic issues do to a person and how that can actually be a major driver to our mental health we the the one of the biggest problems to me in psychotherapy is the unwillingness to consider all of that the outsideness of it all and you know listen i practice in los angeles and a significant proportion of people bring at least one kind of marginalized status whether i guess a gender race ethnicity whatever and it's not like i'm saying that that's the the soul explanatory mechanism but it really does help sometimes understand that volley between in and out and i think a lot of people don't think of it that way and why a lot of people don't is they're almost afraid of feeling like they're blaming the world for their problems or they're putting themselves in a victimized stance and at no point were you doing that if anything you were really almost self-shaming self-harming and self-gaslighting and so it's to sort of break you out of that cycle because for me the win with you would be for you to give permission to yourself to be able to be okay with not being okay so that you'd be get you'd get back to okay a lot more quickly that this idea that my my feeling sad and my feeling tired doesn't get to happen because someone else lost a child or lost their job is it's it's a it's comparing to it's like comparing it's not even apples and oranges it's like hammers and cows like there's literally no like they're not even fruit like they're not even common and so and i think that one of the problems is is that we have this sort of inter-subjectivity like i can only judge my experience on the basis of someone else's experience so what we humans do that we're a tribal species right we tend to look outside of us but it's also being able to know that no more and no more than i judge myself for example let's say it's a warm day and i feel cold it's tempting to say oh gosh there's something wrong with me i'm cold i'm cold we tend to be more comfortable doing it with physical states i'm cold i'm hungry that sort of stuff we don't judge but when it comes to our emotions we judge and that's that's what i would love for if we had worked together what we would keep working on [Music] so you know the few takeaways kyle would be you know number one is pay attention to how you talk to yourself right so if someone was talking to you the way you were talking to yourself you'd be like hey like hello um you need to step back because this isn't okay except way meaner but yeah yeah we most of us accept from ourselves far far worse than we would ever expect from someone else so part of this becomes mindful self-monitoring of your own self-talk which is never easy to do because the self-talk is such a passive experience that's internal to us right so it's i'd love for you to spend more time being more mindful and aware on how you talk to yourself number two i'd love for you to do almost like a one or two week experiment where you honor your moods and honor and and and be with them so when your body is telling you you're tired instead of saying oh my god kyle what's wrong with you so many people have it worth say i'm going to honor almost like talk to your body maybe not do it in front of other people but honor your body and say you're tired let's go rest and go and and take care of you right instead of yelling at you take care of you so you're tired let's go let's go take rest because i think after a while once your body and your psyche connect and feel confident like our host has got us like we will be okay we know we're gonna be taken care of they together you might actually feel better does that make sense like if i know i'm going to someone's house and they're going to be like if you want you want to take some rest you want to take a shower you want something to eat i feel taken care of but if they're like um you're going to do everything on my agenda and i'm going to wake you up at 4 in the morning and then i'm going to make you go to bed at 10. we're going to only talk about what i want eat what i want i'll be like i don't want to be here right and i'd feel tense and upset well i want you to be a better host and so i want you to just sort of work on some of that very simple self-compassion listening to yourself because i'm hearing you won't take advantage of that like you won't say okay i'm gonna stay in bed for two weeks i think you'll say i got my rest i'm good and you know that you'll honor your need for rest when you when you may need it at a later you know at a later time those would be two things that i'd really want you to work on again especially that mindfulness staying in the moment being with your feelings and not judging them and as a third enhancement you may want to consider journaling journaling can take a lot of forms and sometimes people like i am not writing dear diary every day and i'm not telling you to do that sometimes it's as simple i tell some of my clients you don't feel like journaling every day give yourself a little rating i actually have an app and it goes off at whatever time it goes off and i can actually rate my um i can rate my moods if that makes sense right i can rate my um you know like did i have a good day do i have a bad day am i tired am i sad am i this am i that so it gives me a chance to just sort of like touch base and over time i get data okay and i can look at that data over time and say oh wow that was a bad week or this is a better week or what was it about that day that was better or worse and so keeping that kind either through a mood tracking app or jotting a few things down like watching the sort of the ebbs and the flows of time that can help too well just so happens i started bullet journaling yesterday perfect i'll uh i'll uh incorporate the other two and that this has been fabulous i mean thanks for the thank you dr romney got it my pleasure i'm glad it's a great deal over here uh you can watch more uh with dr romini right here on youtube or medcircle.com i'm kyle kittleson remember whatever you're going through you got this thanks for watching check out the links below for more information on how to access this full series and subscribe to our youtube channel to watch new mental health videos every week did you like what you heard in this video if you want to ask a med circle doctor a question directly you can learn how by visiting the links in the description below [Music]