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Scot: Do you take time just to reflect on things in your life, Troy? Do you have any knowledge about the act of reflection, the art of reflection, if you will?

Troy: All I know is what Dr. Chan told us before. He told us, "We think about the past and it makes us depressed. We think about the future and it makes us anxious." Those were his words, so maybe reflection isn't always a good thing. Sometimes it does, and we can, I think, become a little bit nostalgic and think the past was so much better than maybe it was, which was interesting to hear him say that. But as he said that, I thought, "Oh, that makes sense."

But I think there's value in reflection, certainly, in terms of appreciating what has happened and appreciating the experiences, and taking it in a positive way, while also recognizing that sometimes it can be a little depressing to reflect.

Scot: Mitch, do you take time to reflect?

Mitch: That is a complicated question because . . .

Scot: I love it.

Mitch: It's the opposite of what Troy was just saying, where as someone who has struggled with mental health for a lot of their life, who is just barely starting to learn a lot about myself and about how I can manage and cope with things, my therapist says that I need to not self-reflect, but instead be introspective.

So it's this idea that, for me, I do remember the bad stuff and I do focus on the terrible things that have happened, and I replay them over and over and over again. It's like bizarro nostalgia where things were terrible and things will probably always be terrible, etc.

So instead, introspection, or at least the way that it has been taught in this particular definition when it comes to my mental health work, is taking an intentional look back on things that have happened, and having this kind of approach and mindset of, "What did I feel when that thing happened? What was it that made me feel that way? How can I prevent it in the future?"

Rather than just like, "Oh, man, that was a great time," or, "Oh, man, that really, really sucked," actually going through in a very active process to kind of stop the potential of . . . I don't know another word for it, but just this negative despair-based nostalgia from kicking in.

Troy: Interesting.

Mitch: Yeah. It's an exercise I do.

Scot: Let me tell you, I think maybe you're doing a deeper reflection than I am.

Mitch: Sure.

Scot: Which is part of the reason why I think this is a good show to do, because that word is thrown around a lot, right? Reflection. It's time for a reflection. When we get to this time of year, at the end of the year, we reflect on whatever. But what does that really even mean? And that's why we're doing this episode today, to work on this notion of reflection.

This is "Who Cares About Men's Health," offering information, inspiration, and a different interpretation of men's health. My name is Scot Singpiel. I bring the BS to the podcast. The MD to my BS is Dr. Troy Madsen.

Troy: I'm here, Scot, and I'm ready to reflect.

Scot: Mitch Sears is in the mix.

Mitch: Hey, I'm going to reflect too, I guess.

Scot: And psychiatrist Dr. Benjamin Chan is going to talk about the power of reflection with us as well. How are you doing, Ben?

Dr. Chan: Doing great. Happy to be here.

Scot: Do you take time to reflect, Dr. Chan? Is that something you do?

Dr. Chan: All the time. Incredibly powerful. Incredibly needed.

Scot: So we're really looking forward to hearing about the benefits of this exercise of reflection. I mean, we've talked about other things that have benefits that you might not think have them, like gratitude, for example. So reflection, this is going to be a lot of fun.

Are you guys ready for a quote drop to start this thing? I'm going to drop a quote on you. Are you ready for this?

Troy: Let's do it.

Scot: All right. Here it comes. "We don't learn from experience. We learn from reflecting on our experience." That's John Dewey. He was a philosopher and a psychologist and an educational reformer. And he was the guy . . . his form of learning is "we learn by doing." So he's saying, "You get that experience, you do things, and then it's not truly learning until you pause and actively reflect on what just happened."

So, Dr. Chan, I have a question for you. Reflection seems like kind of a big concept. What is reflection when it comes to your practice of mental health?

Dr. Chan: Great question, Scot, and happy to tackle that one right off the gate. We're going deep right at the beginning. I love it.

So, from a mental health perspective, reflection is essential. And I love that quote by John Dewey. I think the first step is to look back at the situation or experience. We're all creatures of habit. We have built in patterns into our thoughts and behavior, so taking a pause and looking back at a specific situation or experience, I think, is the first step of reflection.

And I don't know, Mitch or Troy, can you think . . . I'm going to turn the tables on one of you. Can you think back to a situation or experience that you really thought about and pondered?

Scot: Generally, it's at a party and generally it's the day after and I'm like, "I was too loud and obnoxious." That's usually my reflection. And I think, "I'm a little over the top. I need to cool my crap a little bit."

Troy: I mean, mine often comes down . . . I certainly reflect on personal events. I have spent a lot of time reflecting on some events that have happened in the ER. Sometimes I think that's been a little detrimental because I've probably dwelt on it and maybe have even beaten myself up over it. But yeah, no doubt I definitely reflect.

Mitch: Yeah. Like I had mentioned a little earlier, for me, especially as I'm going down this long road of mental health and dealing with past trauma and dealing with all this other stuff, I have been practicing and learning strategies to reflect in such a way that it is productive and not mentally exhausting or retriggering or whatever. So, yeah, I reflect on a lot of things, but learning how to do it in a way that doesn't impact me has been a journey.

Dr. Chan: I think that's beautiful. And I think that's the first step, is to look and recognize. And then, Troy, and Mitch, and Scot, as you all mentioned, I think Step 2 is to think about it, reflect upon it. And then Step 3 is to learn. So look, think, and learn.

I think this is where we kind of break past behaviors, past thoughts. And you can do this either talking about it with someone, and that's the role of mental health. A lot of people, that's what we do. We talk about these past experiences or these past situations.

I really like journaling. I'm big into journaling now, and I think this is linked to what we discussed previously about gratitude, but just to actually write about these different experiences and what you learned about it.

Troy: I wonder though, Ben, is there danger in spending too much time in reflection? When we had an episode on anxiety, I remember you said, "We think about the past, it makes us depressed. We think about the future, it makes us anxious." Is there danger in just spending too much time thinking about the past?

And also, does that encourage just . . . Let's say if we already have some neurotic tendencies, does it encourage further neuroticism, where we are just overanalyzing situations and dwelling on them and thinking through them? I'm curious about your thoughts on that balance there.

Dr. Chan: Yeah, you used the word I was going to use, Troy. Balance. Moderation in all things. And the last step I was going to advocate for is to plan. What can you do next? What could you do differently?

Yes, if we're caught up, if we start perseverating, if we start just fixating on past behaviors, past traumas, past experiences, and we don't come up with a plan, we don't come up with a new way to approach it, yes, it would increase neuroticism or anxiety.

It's really difficult. It's extremely hard. And I don't know if anyone would feel comfortable in sharing something that happened in their past, but I think we're all experiencing and navigating life. And again, we're creatures of habits. I think life just gives us the same learning experiences again and again until we actually learn from them.

Mitch: Sure.

Troy: I like, though, what you said about looking at it as more of a looking to, "How can I act? How can I do things differently?" rather than just dwelling on it, which can definitely be a problem, I think.

We just dwell on maybe . . . Like you said, Scot. "Wow, I just talked way too much last night and I just feel stupid." And you think over and over, "What did I say? Okay, these guys must think I'm an idiot," versus just saying, "Hey, I had a good time there. Maybe I did talk a little too much. I'll try and talk less next time." I don't know.

Scot: Or maybe I could come to the conclusion that, "No, I'm fine with that, and I just need to make my peace with that." I think that seems to be the difference, using these remembrances of these experiences or reflecting on these experiences. And I love that you said plan, because that's kind of the thing then that gives it closure to me. You come up with, "All right. Well, what am I going to do about this going forward if I choose to do anything about that going forward?"

And one of the benefits I saw when I did some reading on reflection is it can help improve sleep because of that. A lot of times, the act of reflecting can give closure to things that otherwise we might dwell on. Does that sound accurate, Dr. Chan? Have you heard that?

Dr. Chan: Yeah. Again, Scot, I love your examples. Yes, I think all of us to a certain degree, when we lie down in bed at night, we start replaying a lot of those experiences and situations from our days. And we're our own worst critics. We tend to focus on the negative, not so much the positive, like, "Oh, I should have said that in that meeting," or, "When that person interacted with me, I should have said that," or, "I was quiet in that moment, and I should have spoken up," or, "This happened at the grocery store," or, "This interaction happened with a family member."

That is reflection, but also, like what Troy said earlier, if you perseverate on it, if you can't let it go, that could cause you to have insomnia. That could cause people to have difficulty falling asleep. Totally accurate.

Scot: Some of the other benefits I saw of reflection, in addition to better sleep, is it can reduce stress and anxiety levels. Why would that be, Dr. Chan?

Dr. Chan: Again, we're going to have the same situations presented to us again and again and again. And we can't control how other people think or feel or act. We can only control how we think and feel and act. And if that is sparking a reaction inside of us, that causes anxiety. That causes stress. So that's why I love doing this podcast, because to me, this is essential for high-quality mental health.

Scot: I also saw some of the benefits. Gives clarity to thoughts, which I think we've all experienced that. When we've reflected on something, we get some clarity maybe we didn't before. It creates self-awareness, and it can also create room for growth. So those are some of the benefits I came across.

Has anybody else, when they've reflected, noticed benefits that they'd like to share at this point?

Mitch: So through the work that I've been doing with my mental health specialist, the process of kind of an active reflection has allowed for me just very much that room for growth. It allows me to kind of put all the thoughts and memories and all these things that are kicking around in my head all the time to be able to say, "I don't need to worry about this anymore. I don't need to think about this anymore. I have an understanding about it. I've acknowledged the feelings that I had. I've come up with a plan to prevent any negative thing from the future." Or if it's a positive thing, how I'll get more of that in my life, whatever.

And when you don't have so much mental . . . Or myself at least, when I don't have so much mental processing power being completely devoted to the past, to just thinking about that reflection and re-feeling and reliving those things over and over and over again, it allows me to think about new stuff, and to figure out what I do and don't like in life, and how to make sure I get more of it.

Troy: I don't know if you mentioned, Scot, I didn't hear specifically, but we had our gratitude episode, and I do think that reflection does also help us to reflect on . . . Certainly we reflected on a lot of things we were grateful for, but just on a daily basis, I think it helps us in terms of reflection to experience gratitude for the positive things. And I think there's value in that too, just because it kind of helps you reframe things in your mind rather than reflecting on the negative things.

And then as new things happen, seeing negative in that, I think it then helps to potentially carry that reflective attitude of gratitude forward into the day. Certainly, there's value in that as well.

Dr. Chan: And something that I've seen again and again and again, especially during the pandemic, just to make it real world, is emails. All of us have received emails that seem upsetting or have what we perceive as a negative tone. And to me, this power of reflection is not to immediately fire back an email and reply.

Scot: But it feels so good, Dr. Chan.

Dr. Chan: I know. It feels terrific. Again, reflection. Did that person really mean to say that? Taking a pause, going for a walk, or reflect upon the intent.

I tell everyone I work with that if you get an email that causes this negative reaction inside of you, don't respond right away. Sleep on it. Revisit it the next day. Maybe type up a rough draft. Kind of process your thoughts, going back to the journaling, and then really think about pushing send.

I always feel it's better to pick up the phone and just talk to people. And unfortunately, I think with the pandemic, a lot of our communication has been altered in many ways, and sometimes we over-rely on technology. So that's just a real-world example that I've seen of reflecting about the intent and the tone of people's emails.

Troy: That's so true. I wish you could have told me this 20 years ago, Ben. And I wish there was something you could implement in your email that would just not allow you to respond for 24 hours. I will tell you, 90% of the things I've said in the course of my life that I've regretted, I've said via email. Because you don't say those things in person. You just fire off a response. You misinterpret the tone. It's so impersonal, it's easy to say things you would not say otherwise.

It's so true. Definitely power of reflection. I agree. If you can take time just to reflect on an email and let it sit and sleep on it and continue to reflect on it, there's huge value in that.

Scot: So reflection is this really broad thing, but it seems like it kind of breaks down to this. It just breaks down to if you're experiencing something or if you're thinking about a memory or if you are wondering how to move forward, it's just taking a pause and thinking about it and trying to break it down and analyze it. 

For me, at the end of the year, I tend to reflect on the goals that I set for myself that year, or the things that I wanted to try to accomplish for that year. And reflection in that instance is like a plateau when you're hiking. You can stand at that plateau, and you can look down and see how far you've come, and you can look up and see where you still want to go. You can celebrate the victory of making it to that plateau while still admitting, "I would like to continue on my journey."

So let's bring this back to the Core Four and health for a little bit. Do you guys reflect on your activity, your nutrition, your sleep, your emotional health? And what does that process look like?

Really, our whole show is based on this notion of a turning point, and reflection is required for those turning points. Things happen, we do things, we think about them, then we create this new thought that sometimes puts us in a new direction. And it might make things a lot better or just even a little bit better.

Dr. Chan: I love that, Scot. And I don't know if you're teeing this up for New Year's, but what is our plan? What are our goals for 2023? And this, to me, is where reflection comes in. We're coming out of the pandemic, there have been a lot of changes, and we all have different goals, personal goals, professional goals. Where does that growth occur?

Because if you're not actively reflecting, or as Troy and Mitch have talked about, expressing gratitude for where you've come from, how do you know where you're going?

And to me, this is a perfect segue into what is going to happen next year for us? What is the plan? And you need to reflect upon where you've come from. So I think of 2023. When you talked about that hiking analogy, Scot, that's what came to my mind.

Troy: And I would say, Scot, too, I certainly do that as well. I can't say I have a formal process in terms of that reflection on the Core Four, but what I often find is when things just kind of feel off, like just, "Something is off," it often comes back to thinking, "Okay, how's my sleep? How are things going there? How's my mental health?"

Just kind of checking in on a lot of those things and then finding, "Great, I've made these changes recently. Maybe this I didn't implement as well as I could have." Maybe we can revisit that and potentially refocusing, and then moving forward with that in mind.

Scot: As I was doing some reading, I came to the conclusion that there are some rules for good reflection. We've talked a little bit earlier, that Dr. Chan brought up, which I loved, that you've got to look, think, learn, and plan. And it's that planning part that helps give you closure.

But some of the rules I found for reflection . . . Feel free to add to these or tell me it's a bunch of crap if you want to, Ben. I think the first thing you have to do is you have to stop and make space for reflection. We're so busy and we occupy our brains all the time, even in downtime with our phone or whatever, that you actually kind of have to stop and be . . . What am I looking for here? You have to be . . .

Troy: You have to be still.

Scot: Yeah, you have to be still, but you have to . . .

Troy: Your mind has to be open and still.

Scot: You have to be intentional about stopping and making space for reflection. And I've read some stuff that said even maybe do a little meditation first to kind of get your brain in the place to do that.

Is that something you've heard of, Dr. Chan? When you talk to patients, is there a bunch of steps that you have them go through to prepare themselves to reflect and then to reflect properly?

Dr. Chan: Totally. It's almost like an adult homework assignment. You need to literally carve out time. For a lot of us, we're all working professionals and we have very busy lives, and our Outlook or Google Calendars rule our lives. So you need to go in and set aside a couple of hours a week and block those out so people can't schedule something in there.

I don't know if you use the word reflection, but executive time or personal time. You can do that during the day. A lot of people do that during the lunch hour. This is time for not just sitting at your desk and returning emails, but just go for a walk, or go out to eat by yourself or with friends. I mean, there are ways to carve out time.

So it's like an adult homework assignment, and it works extremely well. There are a lot of demands on our time and you need to prioritize this reflection time. If not, you never reflect. And that's unfortunately the cycle you get into.

Scot: And as the quote earlier said, "You don't learn from that experience. You learn from the act of reflecting." So if you're not scheduling time to do that, then you're not learning. You're not progressing.

Not only just at the end of the year or beginning of the year, I think a lot of times reflection happens during maybe vacation when we do have a little downtime or when our routine is broken up. So you've got to make that space.

And then something else I read said, "Don't beat yourself up." It's an honest evaluation based on what's working and what's not compared to your values and your priorities. And you're just honest and just very straightforward about it. Try not to be emotional about it if at all possible.

And then also be kind, because change can take time as well. So you reflect and you want to make some changes, but that doesn't necessarily always happen overnight.

Troy: Yeah, I like that. And being kind to yourself I think is essential. A lot of it gets back to what Ben said about just using it as a time you can plan, and plan your next steps. I think you can do that, you can reflect, be kind to yourself. Say, "Hey, should I do anything differently?" If not, no. Forget it. Forget about it. Don't reflect on it anymore. And if so, great. Take the lessons you can learn and move forward.

I think that's the biggest risk for me personally. I do have a tendency at times to reflect way too much on things and beat myself up and I think that's problematic. So I think if you can take from it what you can and move forward, that's the best approach.

Dr. Chan: That's beautiful, Troy. I love that.

Scot: I found some questions from a paper from Halloran 2016 called "The Value of Self-reflection." And I wanted to share some of these questions and see what you think.

This notion of reflecting, some of us might have things we want to reflect on or that come to our mind, but maybe this would be some thought starters for you if you want to take time to reflect.

And it doesn't always have to be at the beginning of the year. It could be during the workday. I often will make myself a cup of tea and take 15, 20 minutes. The rule is no social media, no work, no email, and I just sit there and I sip my tea and I just think about things. I give myself that space to reflect.

So here are some of the questions that I found interesting, and see how these resonate with you. Am I using my time wisely? Am I taking anything for granted? Am I employing a healthy perspective and not letting matters that are out of my control stress me out? Am I living true to myself? Am I still passionate about my career? Where am I feeling stuck? What do my finances look like? How have I allowed fear of failure to hold me back? When have I felt the most alive? How can I improve my relationships? Am I taking care of myself physically? What old habits would I like to release? What new habits would I like to cultivate? How can I be kind to myself? And finally, what is it time to let go of?

Mitch: Can I . . .

Troy: Yeah, can I get that list? Those are some great questions to reflect on.

Mitch: So side story here, one of the things that I started doing with my friends in college when we were struggling with anxieties, depressions, whatever, is we started doing an adaptation of a kind of witchy ritual called "Candle in the Wreath."

And with "Candle in the Wreath," everyone gets a single candle that they hold, and you light it up and you have a wreath of dead bows from the winter, and you have a big candle in the middle. And everyone, either aloud or to themselves, stands with their candle lit and lets the wax drip and they're supposed to say what the things are you are letting go of this year.

And everyone will say things and whatever, and then you have this big . . . when everyone blows their candle out, when they're done, when they feel they've given enough time, this wreath is so disgusting and covered in wax and just gnarly and gross. And you throw that on a bonfire and everyone lights their candle one more time and you say, "What am I saying yes to? What am I welcoming in the next year?" And it's supposed to let out bad energies, bring in good energies. And it's funny to see that those same questions are in a research article. That's all.

Troy: I love that you described that as kind of witchy.

Mitch: It is kind of witchy.

Scot: Troy, you want to get together and do that ritual?

Troy: Are you guys free tonight?

Mitch: Yeah. Well, you would be shocked . . .

Troy: I'll bring the branches.

Mitch: . . . how much catharsis . . .

Dr. Chan: Candles. I'll bring the candles. 

Mitch: Year in, year out, you have all these very high-functioning, super intense often, accelerated students for a while and things like that, and they just . . . It's like the only time that some of these people have ever done that kind of reflection or asked those types of questions to themselves, and it's shocking.

Troy: But I think there's incredible value in doing that regardless of how you go about doing it, if it's an actual physical act like that or some other process. But yeah, I think that's something that we need to do more of.

Scot: So, as we wrap up the episode, I was thinking about a couple of things I wanted to reflect on. One came to mind almost immediately, and I need to build in more time to actually think more deeply about this.

But as I was exercising the other day, my right shoulder used to be . . . I don't know what I've done to it over the years that I couldn't lift something over my head, but I've been working really hard to get that strength back in that shoulder.

And the other night as I was lifting, I'm like, "Wow, actually I've got strength back. I can do this again." It's not where I want it to be. It's not the same level as my left arm, but that was that plateau for me. I'm like, "I'm not where I want to be. I'm not where I was. I'm feeling pretty good about this."

And this has been something that I've been working on, or at least thinking about because I work out off and on, for over two or three years. So that comes back to that time thing.

Troy: Yeah. And it's nice because there you have a very physical manifestation of your progress. And for a lot of us maybe, it's just like, "Hey, I didn't react to that email like I might have reacted a year ago." And it's maybe something more like that where it's kind of our analogy being like, "Hey, I got my arm up higher than I did a year ago."

Scot: Well, gentlemen, I encourage you to take some time to reflect. I will get you a copy of those questions. Of course, we'll post that along with this podcast episode on our website. So, if that list of questions was useful for you, you can start asking yourself some of those questions and go through this process of reflection whether it's at the beginning of the year, which is kind of a natural time for a lot of people to do it, or like Dr. Chan recommended, maybe you need to carve out . . . Maybe you can't do two hours, but maybe you can do a half hour. Maybe it's 10 minutes before bed. You can pick something.

I like, Troy, you're just kind of doing a gut check and then going, "Well, how could I make this better? Why is it that I'm concerned about this? Is it something that I really do need to worry about?" and then putting some closure to that.

So, gentlemen, as always, it's always a pleasure talking with you. Thank you for listening, and thank you for caring about men's health.

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