Introduction: Coming up on this episode of The Doctor’s Farmacy.
Nedra Tawwab: When we think about mental health, there are so many physical aspects to that show up in a treatment space. The number one being sleep issues. So many people with relationship issues have sleep issues.
Dr. Mark Hyman: Welcome to The Doctor’s Farmacy. That’s a pharmacy that have a place for conversations that matter. And if you’ve ever struggled with family relationships, with challenges with your parents, with your children, with drama, then you’re going to love this podcast, because I know I need it. And certainly there’s been plenty of drama in my family and I’ve struggled to figure out how to deal with it. And I’m sure many of you also are in the same boat. And we have an expert to help us navigate these very treacherous waters of relationships. It’s Nedra Glover Tawwab. She’s the author of the New York Times Bestsellers, Drama Free, which sounds like a great place to start. Set boundaries, always hard for me. Find peace, which it would be amazing.
She’s a licensed therapist and sought after relationship expert. She’s practiced relationship therapy for more than 15 years. She’s appeared on a Red Table Talk, at the Breakfast Club, Good Morning America, CBS Morning show, just to name a few. Her work has been highlighted in New York Times, a Guardian Advice, and she’s been on numerous podcasts including the School of Greatness. Oh yeah, Lewis Howe’s awesome. We can do hard things, 10% happier. Dan Harris is awesome. I love him. And Nedra runs a popular Instagram account where she shares practices, tools, and reflections for mental health and relationships. And she lives in Charlotte, North Carolina with her family. Welcome.
Nedra Tawwab: Hi. Thank you for having me.
Dr. Mark Hyman: Oh, so great to have you. I think this is going to be such an important podcast because so many of us struggle with relationships. And from my perspective as a doctor, one of the foundational principles of health is healthy relationships. It’s nutrition, exercise, sleep, stress management, and healthy relationships. And actually it’s at the bottom of our matrix in functional medicine, what we use to actually diagnose people. So if you have stressful relationships, it plays a huge role in your health. And I think it’s important to understand how to navigate those. And we don’t really get a roadmap. We learn reading, writing, and mythic, but we don’t learn the other are, which is relationships. And it’s probably the thing that determines the quality of our life more than anything else. I think, I forget who said it, but the quality of relationships determines the quality of our life. And maybe Esther Perel said it, and I think that’s true.
And often we don’t know how to have healthy relationships. So one of the things you talk about, Nedra, is idea of boundaries and personal boundaries in healthy relationships. Because they set expectations, they help us understand the right behaviors, how we communicate with others. But setting boundaries can be really hard. And especially if you’re someone like me who’s a nice-aholic and a people pleaser, which I’ve managed to wrestle to the ground, but I still struggle a little bit with it. It’s really hard because you don’t want to say no, you want to please people.
Which actually I think is a very selfish thing because what you’re trying to do is avoid their wrath or their anger, which I did as a kid. I had a very rage-aholic dad. So I learned to be somebody who was constantly vigilant to his moods and his rage, and managed to actually people-please, and do the right thing, and lie, and say all the things that where my heart wanted to say something, but my mouse said something else. So how do we navigate this? And why is this the hard to set boundaries? And what blocks us from it? And then what do we do in relationships when boundaries are crossed?
Nedra Tawwab: You mentioned people pleasing. And I think most people, to some extent, if we think about people pleasing on a spectrum, most of us are somewhere on the spectrum. And for those of us who are very high people-pleasers, boundaries are going to be really hard because all you worry about is what will they think? What will they do? What will happen after I say this thing? They’re going to be mad, they’re going to be upset. Anxiety really takes over and gets in the way of you being able to set a boundary. I will say that when you have safe relationships where you feel emotionally comfortable, it’s much easier to set boundaries with people.
And each of us, we have the opportunity to help someone feel emotionally safe and comfortable bringing up issues, talking through things just by thinking about the way we respond when things come up. We’re not shutting people down, we’re allowing them to have an issue with us. That’s a wonderful way to create an environment where people actually feel comfortable and you’re minimizing some people pleasing. But we like to have our way. And so, sometimes it’s really hard for us to hear bad stuff. And so, we do become defensive and we push back, and we challenge people, which again, it makes it really hard for a person, particularly those with lots of people pleasing tendencies, to speak up.
Dr. Mark Hyman: Yeah. I mean, I, for sure have struggled this my whole life. And what I realized in the end was that actually not telling the truth and not having clear boundaries was in some ways very manipulative for me. I was trying to manipulate other people’s emotional response so that I didn’t have to deal with the wrath, or the reaction, or the discomfort of what it would feel like if they were unhappy, or they were going to blow up at me, or put my life at risk. Which it felt like as a kid. So I’m dealing with this ancient programming. And I’ve done a tremendous amount of work around it, and I feel much better. And I’m proud of myself for saying no. But I still want to get that email and somebody asks me something, like I still go through that experience of, “Oh, I don’t want to say no. But I’m going to say no, but it’s hard and how do I do it right?” And it’s such an interesting struggle for so many of us.
And in your book, Drama Free, which sounds like a dream for relationships, you discussed the importance of unlearning dysfunction. And how do you know what dysfunction looks like? How do you recognize it in family? And how do you start to think about managing dysfunctional family relationships? Because I think Ramda said, if you think you’re enlightened, just go home for Thanksgiving.
Nedra Tawwab: Yesterday I was reading a lovely article, I believe it was in The Atlantic. And it was about a person who inherited being a rage-aholic from their father who was a rage-aholic. And she spoke about an incident where her father picked her up from the dentist and she wasn’t ready yet. And he flipped out. He started screaming in the lobby, cussing out the staff, and she didn’t even get her service. So when she went back a few weeks later, they’d written on her chart, she saw, they written on her chart, “Dad has a lot of rage. See this patient immediately.”
Dr. Mark Hyman: Yeah. Yeah.
Nedra Tawwab: Yeah. And she talks about how for a while she didn’t have any rage and then she had kids and she noticed once she had kids, she would start to fly off the handle. So that is typically what happens with dysfunction. We experience it and we repeat it because we are not aware of how it impacted how it us and the things that are required to overcome some of those tendencies. And so, unlearning the dysfunction is first acknowledging what it is. Is it rage? Is it alcoholism? Is it maybe everyone in your family has these toxic partnerships? It could be all sorts of things. I think historically, we think about family dysfunction as abuse, neglect, these really big things, when there are so many things that happen in homes that can be a level of dysfunction, because dysfunction is an unhealthy pattern in a relationship.
Dr. Mark Hyman: It’s in the Bible, the sins of the fathers are visited upon their children or sons, or something. I forget the exact passage. But it’s like this intergenerational trauma that just goes on, and on, and on through cycles. And I remember, just to share a few stories, my stepfather, when I was seven, my mom just got remarried. And I was a little boy and we just moved in this new house. And we didn’t have those carburetors, you know when you disposals in the sink back in the day, because that was in the 60s and I’m old. And she said, “Can you please throw the soup down the toilet?” So I took the soup pot and I brought it to the bathroom, I flushed it down the toilet.
And my stepfather was a clean freak. And he stood outside the bathroom and this booming voice said, “Did you wash your hands?” And I just told the truth. I said, “No,” because I didn’t go to the bathroom. I just flushed the soup down the toilet. And he went into a rage. He picked me up, he threw me against the wall across the room on the bed. I mean, it was just terrifying. And so, I learned that telling the truth wasn’t safe. And so, that was just the pattern that I repeated. My mom reinforced that.
And I didn’t actually repeat the rage in my life, but I took that early learned pattern and it’s affected so much of my life. So I’ve gotten a lot better about it. But it’s definitely these intergenerational things that go on. Actually, my father, the same thing. I finally understood some of his behaviors when he started talking about his grandfather, when actually he was and how he treated his father, and how his father treated him. And I began to see this linkages over generations. And so, the real question is how do we start to break this intergenerational trauma? How do you break it? People don’t even know. People aren’t even aware of this. It’s just like they’re in the matrix of it. You don’t even know you’re in the matrix. And then there’s a way to get out the matrix and see what’s going on so you can begin to break these generational traumas and the lineage that needs to be healed.
Nedra Tawwab: Every time we speak about our stories, we are taking a step towards breaking some patterns because silence is a really big pattern, pretending as if everything was okay, nothing really happened. And that can be very challenging when you still have relationships with some of these people who cause the major issues in your life. It’s really hard to recover in an unwell relationship. And so, the more that we are silent about those things that happen, the more that we suffer. And so, even you just sharing that story, your heart is getting a little lighter. You’re able to reflect on it in a different way and pull some things out of that story and think about. I hear you talking about, “Well, this is how it manifested in my life.” Those are things that I think many of us, we really don’t do. We don’t talk about those moments because we’re trying to forget them.
We think the forgetting is the healing when in actuality the healing is processing these things. Because when you’re seven years old, you don’t even have the mental bandwidth to understand what’s happening to you. And you certainly can’t respond to it because it’s not even safe to. But now you can talk about that story and say, “Ph gosh, that made me feel so scared. I felt like this should have happened. I was so shocked when this happened.” Those are the things that we never got to do in the moment because it was like, oh my gosh, it was a crisis. And so, now that you are away from the incident, it is very beneficial to think about how you felt in those situations. What was more appropriate in that situation and how you continue to be impacted by those events?
Dr. Mark Hyman: Yeah, I know it’s true. It’s really helped me to look back at them and understand what interpretation I made about the world from those experiences. My interpretation was that my stepfather was not safe and I can’t tell the truth. And that may have been true with him, but it wasn’t generally true for everybody. But I basically took that software programming and I carried it through my whole life. And I spent the last 20 years trying to unwind it once I really understood it. And I think a lot of people suffer in the same way. They don’t have the tools to actually do it. But what’s been interesting, I’d love you to talk a little bit more about is, when these things happen to us in our childhood, and maybe you can share some examples, it carries over to when we’re adults. And then that trauma gets re-triggered and the cycle’s repeated. So how do these childhood traumas impact our adult relationships? And how do you break that cycle of those unhealthy family patterns?
Nedra Tawwab: Well, you mentioned it just a bit ago. The interpretations we create from those events, we apply to everything. So it’s not just my mom is unsafe, everybody is unsafe. We create that as a overarching theme in our lives. So when we get into romantic relationships, friendships, we’re repeating a lot of those same dynamics because this is our belief system now. People, it’s gone from, “My mom is not safe,” to, “People are not safe. No one listens to me.” We create these stories and they don’t necessarily have to be true for us to believe them. And it’s really hard, especially when it’s your parents, to believe that other people in the world can treat you favorably when you’ve had unhealthy experiences with your parents, with your siblings, with close family members. So it takes a lot of work to get back to that space of people can be trustworthy. I have to allow myself to be open. Perhaps this is a safe person. Perhaps this person is doing things and they can manage their own behavior. Perhaps this is a situation where I can speak up and I don’t need to walk on eggshells.
Dr. Mark Hyman: What happens if you have a family member where they’re still in their dynamic and still, if you told the truth or whatever they would, you would just get craziness, or rage, or vitriol and abused. How do you deal with that? Because you might personally have sorted out in yourself. But then when you’re still in that dynamic, what do you do?
Nedra Tawwab: Well, I don’t think we can go to unwell spaces and expect healing. When a person is unwell and they have no interest in shifting their behaviors or owning up to anything, it can be… What’s the word I’m looking for?
Dr. Mark Hyman: Traumatizing. Re-traumatizing.
Nedra Tawwab: Traumatizing. Thank you. It could be re-traumatizing to go to these folks and say, “Oh my gosh, remember that time you slapped me in the face?” And they’re like, “No, I didn’t.” Or, “You deserved it.” Because sometimes people will say, “Well, I did that because…” Or, “It didn’t happen that way.” Then now we’re being gaslit.
Dr. Mark Hyman: Gaslighted.
Nedra Tawwab: Yeah, now you’re being gaslit. And you’re in this space of, “Well, did this happen? Am I remembering this correctly? Maybe I’m overreacting. Maybe they weren’t…” So going back to a person who is still in those unhealthy behaviors, it’s not always best. It’s not always best to expect them to validate what happened. What can happen is to, as we love to say, meet them where they are. So you can decide what type of relationship you can have with this person, or you can decide to not have a relationship when that this is where boundaries comes in.
Now, if someone is yelling at you, you have the power to walk away, to leave, to end the conversation, to do all of these other things that maybe you didn’t have the power to do in childhood. Maybe when someone asks you to do something, you had to do it, but now you have choices. It’s, “No, I don’t want to. I’m not coming to this thing if this is going to be your behavior.” So you have choices now. So it’s not about changing this other person or making them understand their behaviors. They may not be ready for that. They may never be ready for that.
Dr. Mark Hyman: And then just having clear boundaries with them is what you’re saying, can protect you while still maintaining relationship. So, “This is what I’ll accept. This is what I won’t accept. This is the ground rules that I’m creating for our relationship. You can make them or relieve them. But this is what I need.” And I think it’s often very confronting to people who are used to you behaving a certain way and then all of a sudden you change your way of relating, and it can be very disruptive for them. And then they get really upset. And then it’s like you have to tolerate that period of transition where you change the rules, you change the rules by creating boundaries that protect you, and enable you to have at least some relationship with a family member. So if it’s a kid, or a parent, or a sibling, you hopefully don’t cut them out of your life forever. You want to figure out how to navigate that, right?
Nedra Tawwab: Yeah, there’s an adjustment phase when you’re making these changes, you’ve been thinking about them. Maybe you’ve been to therapy, you’ve told your partner, you’ve shared with your friends, all of these changes you’re going to make. The person in the relationship that you want to change, they don’t know. They don’t know the history of your issue and all the work you’ve done to make this request or to set this boundary or whatever it is. So in that case, they may feel like the relationship has been disrupted. There may be a phase of discomfort in the relationship. A few days of maybe not talking to each other or figuring out how to navigate this. Or they may completely disrespect what you said because they want to continue in their behaviors, and that’s when you start to issue the consequence of not respecting that boundary. What is the consequence? If you set this boundary, what will you do if they’re not listening to you? I think sometimes we think-
Dr. Mark Hyman: That’s a great question.
Nedra Tawwab: Yeah. Yeah. A really common one is a family member who comes to your house without letting you know they’re stopping by. So if you say to them, “Hey, give me a call before you come,” and they continue to stop by without any warning, do you let them in? Do you say something to them when they arrive? Do you let them know, “Hey, this isn’t a good time. I wasn’t prepared for a visitor?” There are so many things you can do that can be consequential to their actions so that they can understand, “Oh, I need to call before I show up.” Or, “I need to send a text.”
We assume that the people that we have issues with have issues with everyone. It is typically not true. That person who’s showing up to your house without warning, they make doctor’s appointments. They don’t just pop up at the doctor. So it’s like they have the ability to not be impulsive. For some reason with you, because there’s no consequence, they can be impulsive. So if you want their behavior to change, you will have to have the conversation with them to say, “Hey, this is my boundary. And if you don’t respect it, here is the consequence.”
Dr. Mark Hyman: Yeah. That’s very powerful, really. It’s not just having a boundary, but it’s having a clear conversation. It’s having a clear expectation and a clear setting of boundaries, and then a clear understanding of what the consequences are if those boundaries are breached. So it’s actually a very tough conversation to have for most people. But I think what you’re saying is that that leads to less drama, and more clarity and more healthy dynamics. But you also say that if your reference point is just a dysfunctional set of relationships and family, changing to a healthier pattern often involves starting from scratch. I’d like to know what you mean by that. And it seems like it’s an easier said than done. It’s not on your computer. You can just wipe the hard drive and start over.
Nedra Tawwab: Well, there are times when the relationship is such a disruption to your mental health and wellbeing, that you can’t have the relationship. I’ve seen that so often in therapy where people present with depression, anxiety, personality issues. And the biggest trigger is a relationship. It is going home for Thanksgiving. It is a birthday. It is a particular month in the year. Or even a caller conversation with a person that will spin you into an episode that is now impacting your mental health and certainly your physical health. Because when we think about mental health, there are so many physical aspects to that show up in a treatment space.
The number one being sleep issues. So many people with relationship issues have sleep issues because they’re anxious and they’re thinking about what to say, what to think. “Why didn’t I say this when they said that to me? What will I do next time?” All of these things, the replaying, all of that stuff, it keeps us up at night. All of the yeses, “Yes, I can help you with this. Yes, I can help you with that.” When we lay down at night, we’re like, “Oh my gosh, how am I going to fit this all in?” So I think we like to separate, oh, mental health wise, it’s like mental health, physical. It impacts so much of who we are. So these conversations, although they seem hard to have, and it may seem hard to move away from certain relationships when needed, it can certainly be something that can save your life, something that can extend your life. Because when you’re in these dysfunctional relationships that have no hope of changing, you will constantly be in these mental and physical health cycles that are not great for you.
Dr. Mark Hyman: Well, it’s the real physiological stress. And stress causes or contributes to 95% of all illness. So if you are in this constant low grade stress from bad relationship dynamics, it has a huge effect on your health, which is why it’s really at the foundation of what I call lifestyle. But it’s not just actually what you eat and exercise. It’s really relationship. And you look at longevity hotspots like the blue zones around the world, they have deep connections and relationships, and that’s part of their secret, I think, of their longevity is these deep sense of belonging, social connections, and fun, and being with other people. And I’ve been to these places and it’s amazing. It’s like a very different set of dynamics. I’m sure they have their dramas, but it’s like tart. So for us, how do we reboot ourselves? Is there a process or a set of tools, or a workshopy process that you can go through with yourself, or with a therapist that actually helps to rewrite that software that makes us respond in these automatic ways, these automatic ways of being that are programmed when we’re childhood?
Nedra Tawwab: Well, one of the most common types of therapy is cognitive behavioral. And I find it to be very effective for shifting the way we think about our lives and our relationships and certainly our behaviors. When we create certain scripts, we have to rewrite the script. When we have certain patterns, we have to believe that there is a new way to exist. And so, a cognitive behavioral is usually pretty effective. And I think also a narrative approach that talking and reprocessing a lot of what the story is, because the story to a seven-year old is not the same story to a 17-year-old or a 27-year-old. And so, sometimes we have to think about the story we’ve been telling and all of the figures in it and the other factors. And there are so many things that we haven’t gotten to the bottom of because we’re not even maybe thinking about it.
When I work with people who were mature for their age, made to be many adults, one of the exercises I’ll do is I’ll say, “Go to a store and just look at the toys and the age that are on the toys.” And they’re shocked. Because at whatever age that was, they were cooking for their siblings. They weren’t planned with Legos at four. They weren’t doing these things that are actually appropriate. This is what you’re supposed to do when you’re seven. It’s not making sure your siblings get on the bus. It’s not waking your parents up to go to work. That’s not what you were supposed to be doing. So just showing them, “Wow, can you believe the activities you had?” You could go to a website and say appropriate chores for a 12-year-old, you were doing way more than that. So just showing people sometimes that this version that you’ve created of yourself, you may have needed these skills. It may have been really important to be a people pleaser when you were seven. That helped you survive.
Dr. Mark Hyman: Yeah. It did. Totally. Right.
Nedra Tawwab: Yeah, that’s not a bad thing. So I try to use a very encouraging approach. Like, “That was a great thing. I’m happy you use those skills because it got you through that environment. But now we need a different set of skills. You’re no longer in that environment. So those old tools are now ineffective for the healthy relationships you want to create.”
Dr. Mark Hyman: It’s really true. I realized that a lot of my adaptive behaviors become maladaptive as I get older. And that was really helpful for me to look at the meaning I made from those experiences. So when things happen to you as a kid, you tell a story about what it means and then you generalize it your whole life. So for example, my stepfather example, I learned from that experience that it wasn’t safe to tell the truth. And then I generalized that to everything, which isn’t actually a true interpretation of reality. And it was really hard to reprogram. And I think families are complex. They’re a cultural system. You describe them as a cultural system. I’d love you to explain what that means and what role that plays in dysfunctional families.
Nedra Tawwab: In dysfunctional families. One of the biggest cultural dynamics is silence. Not really talking about problems and just moving on as if nothing is happening. I remember once going to a family function and a fight broke out between a cousin and his girlfriend. And it was like they got into a physical altercation. And once the crisis settled down, it was like we were eating again. There was no like, “Ph my gosh, what’s going on? Is this person okay?” It was like it was so the norm. This was the norm at the family gathering. And so, sometimes when we’re in those dysfunctional situations, we’ll take our dysfunctional norms and think that everybody does this. This is what everybody do, and that is the culture. The culture is moving on quickly after high stress events. It can be hiding some dynamics that might not look good to other people. It could be pretending that things are okay. One of the things you hear a lot in dysfunctional homes is don’t tell our business or what happens here, stays here. “Don’t tell your grandmother this, don’t tell this. Don’t go to school and say this,” because they know.
Dr. Mark Hyman: Keep secrets lying. It’s like a lying culture.
Nedra Tawwab: Yeah, it’s a lying culture because if you’re honest like, “Hey, we don’t have water,” it’s like, oh my gosh, they’re going to come take you. It’s like, well, people should know that that is a problematic thing. But when you’re in a system that says, “Hey, if you say this, if you say that, we’re going to get in trouble.” It’s like, are we getting in trouble for a reason? Is there something that people should be concerned about? Now, there are some things you may not want to share, how much your parents make. There are some things you may want to keep secret, but if they are harmful things, we have to rethink the secrets that we’ve been holding and the people that we’ve been protecting. So the culture of it is what feels normal in this environment, what is the way that we respond to things?
And it becomes really impactful when there are other people who are pulled into the family. Like, when you get married and you step into your partner’s culture and you’re like, “Oh my gosh, everybody here is yelling. So is this a part?” And it’s like, yeah, this is a part of the cultural dynamic. They’re loud. They yell. So there are certain behaviors that we exude as a family, and often we may not notice until we engage with other families, or we see something on TV, or we start to have friendships and we start to see how other families operate.
Dr. Mark Hyman: Yeah, it’s so true. I think in my family, it’s Jewish family is very, very loud and often yelling. And got together with my friends from WASPy families. And it’s like, “Whoa, there’s so much underneath the surface there, but you guys all are pretending and polite and nice. But seething underneath, it’s so weird.” But yeah, I suppose just getting it out. One of the things that you talk about is this concept of toxic forgiveness. So what is that? And what are the myths about forgiveness? Because often in order to move on in relationships, you’ve got to forgive, and let go, and move on.
Nedra Tawwab: Well, toxic forgiveness is when we pretend to forgive and forget. And we’re moving through these relationships with this passive-aggressive undertone because in actuality, we still have some issues with the person or with the situation that transpired with the person. With forgiveness, there is this idea that we have the ability to forget. And I’ve seen a lot of Marvel movies and I think that we think, “Oh, my superpower is forgetting all of this terrible stuff that’s happened to me. That’s my superpower.” And it’s not real for us humans.
Dr. Mark Hyman: For sure. For sure.
Nedra Tawwab: You can forgive, but you will remember. You can forgive, and sometimes certain feelings might still come up depending on what’s happening. You can forgive and still talk to the person about the thing that they did that bothered you or harmed the relationship. You can forgive and decide not to reconcile. Because that’s a big thing. People will say, “Oh, you don’t forgive them because you don’t want to talk to them anymore.” No, I forgive them. I wish them well. I try to send positive energy their way, but because they have not changed or because the event was so significant, I am unwilling to put myself in harm’s way again. But I do forgive them.
So there is this idea that, oh my gosh, you must forgive and stay bonded to the person who’s causing the issues, when in actuality you can decide not to do that. You can continue to talk about it. You can do many, many things. But pretending that you don’t have an issue with someone is toxic for us. And it’s one of the things that we often do in families in particular, because that’s just the way it has to be. It’s like you could have a situation with your sibling where there’s a big fight. And then five minutes later your parent is like, “Apologize to your brother.” And it’s, “Okay. Sorry.” And then you’re punching him again. It’s like, are you really sorry? It seems like you were really holding on to that.
Dr. Mark Hyman: Yeah. Yeah. Well, I’m wondering if you have personal examples from your life where you’ve had to relearn some of these things. If you’re open to sharing them. I think we’d love to hear how you’ve navigated and learned these things. All of us, we have issues and we learn from them. And some of those stories I think are helpful to get people to understand how to actually do it.
Nedra Tawwab: Yes. So I was certainly a child who grew up very fast because of my environment, and I was mature for my age. So lots of adults would share things with me. And I was the listener. Sometimes because I was curious and sometimes because the adults had no one else to talk to, and I was a kid and I had to listen. So with that, I wasn’t a very playful child playing with toys and that thing. So as an adult, I find that, just last week I took my kids to the arcade and I played as much as they did. So that’s something that I’ve had to relearn how to play. Because even as a kid, I’m like, “Who wants to play a game?” I’m watching mature content on TV and reading the same books as my mom. So I’m not thinking about like, “Oh, let’s go play Pac-Man.
But now I know that it is an important part of being a human being, is not just a kid thing is a person thing, to go to the arcade, and play basketball, and to play ski ball, and all of these things. I am years behind because I did not play in childhood, might I add? I’m like, gosh.
Dr. Mark Hyman: So your video game skills are not so good you mean?
Nedra Tawwab: I know. I need to spend the rest of my adulthood figuring that part out. But I think there is this ability in some instances to reclaim those things that we could not have because of that level of maturity. I’ve been responsible for a really long time. I’ve been getting myself up. Getting myself together, working since I was 14. And sometimes I have to remind myself, it is okay to rest and relax, and not be productive. Sit on this couch. Don’t get up. Watch this whatever movie. You don’t have to respond to email. You don’t have to write. You don’t have to do anything. You can just do nothing. And it is a practice to really get myself to the space of enjoying it and not guilt tripping myself for not doing enough. Not guilt tripping myself for having that time away.
Dr. Mark Hyman: Because you were an over responsible child, Right?
Nedra Tawwab: Yes.
Dr. Mark Hyman: I actually had the same experience. And again, this is the intergenerational thing. My mother was the child of deaf parents. So her parents couldn’t hear at all. And she was the first child and basically she could hear. And so, she was the voice in the ears of my grandparents. And basically, she had to take care of them from a very young age, like five years old, and go to the butcher, and go to the baker, and talk to them. And she had a term for this called a parentified child. And she did the same thing to me. I mean, she basically used me as her therapist and it was really inappropriate. And she had a bad marriage with my stepfather.
And I was the same thing. I didn’t really play in that way. I was way ahead and I felt like I was an adult very young, and had to take care of everything and be responsible for everything. And it was awful. And I think it led to a lot of the dysfunction in my adult life. And I spent a lot of time trying to heal that and undo that. And it’s not easy, but it’s essential if we want to become healthy humans and have healthy relationships, right?
Nedra Tawwab: Yeah, and it’s a process. It’s a process of getting to the point where you actually recognize the ways in which you were impacted by having to be so responsible so early. Now, in my relationships with my parents, I’m very clear about, “Hey, I’m the child. You’re the parent. That sounds like something you should talk to your friend about or call a therapist.” Again, when I was a kid, when I was a younger adult, I didn’t have those boundaries. I didn’t know like, oh, I don’t have to listen to them talk about this stuff for an hour and a half. It’s like, oh wait, I don’t have to listen to this. It’s like, I have the power of choice. Now I can say, “It sounds like you’re having some really tough problems and I wonder if there is a group, if there’s a therapist, or if there is a friend that you can call.” Because these are things I talk to my friends about. These are things that I talk to my peers about. And there is an age dynamic here where it’s like, I don’t know if I need to know this.
Dr. Mark Hyman: Yeah. Yeah, that’s fair enough. And it’s really what you talked about, which is understanding how to reclaim your own emotional sovereignty in the world.
Nedra Tawwab: Oh, I love that.
Dr. Mark Hyman: And have agency over your relationships, whether you’re not at the behest of somebody else’s dysfunction, or trauma, or abuse, or bad behavior. And it’s tough because you love these people, but they’re often like a bull in the China shop and actually very destructive in life in general, and in your life. And so, it’s a very tough thing to navigate. And I think your work, your books, the things that you’ve done really help map out for people how to think differently about this. The idea of set boundaries, and find peace, and drama free. These are really things that seem almost out of reach in some ways for so many of us. But I think these are things that need to be healed if we want to actually feel good in our lives and have healthy relationships.
And it’s not something we learn anywhere. It’s not something that it’s easy to understand. And we don’t actually know how to communicate and we don’t know how to express our feelings. We don’t know how to be open. It’s not something we actually learn. So how do you start to open up, and express feelings, and be better at communicating in our relationships in general?
Nedra Tawwab: Often we think that the things we bring up about other people are like right or wrong. So it’s like, “Should I be upset about this thing? Should this thing be a problem?” And one of the things that can be really helpful for us is not to figure out if it’s okay to have a problem, but just to allow yourself to have a problem with something. Just allowing yourself to have an issue with whatever that thing is a really big step towards being able to communicate more emotionally. And a very basic thing that I think is needed is, we need to know what actual feelings mean. We need to know what anger is, sadness is. Frustration, happiness, joy. Many of us don’t even use a lot of feeling words.
One of the exercises that I’ll have my clients do is name 20 feelings, write down a list of 20 feelings. And they usually get stuck around seven to nine. It’s like, “Anger… So how can we talk to anybody else about our feelings when we only have three? You feel so many different things. You feel confused, you feel upset, you feel left out, all of these things. So to be able to communicate your feelings, you have to be aware of what feelings are. So that is step one. Another exercise is to incorporate feelings into all of these thoughts you’re having when you’re thinking about this person did this, that happened, this happened. How did I feel? How did I feel when that happened? How did I feel when they said that? That is another important thing. Then as you’re communicating with people, let’s start using feeling words. “When you yell at me, I feel frustrated. When you say you’re going to do something and you don’t do it, that makes me sad.” Because what we typically do is, we just talk to them, “Stop yelling. Don’t do this. Don’t do that.” How do you feel?
Dr. Mark Hyman: It doesn’t work very well, does it?
Nedra Tawwab: It doesn’t work very well. People aren’t listening. But sometimes saying how you feel about something can give someone a chance to pause and consider your feelings. But you have to insert the feeling in there and instead of, “Stop yelling. If you continue to yell at me, I will not stop yelling.” They can yell as much as they want to. What will you do if they continue to yell? What will you do if they continue to gaslight you? What will you do if they continue to tell you lies about something? What will you do? So much of what we think is important is really about controlling this other person. They have to acknowledge that they have an addiction. They have to figure out how to do things on their own. They have to apologize for their behaviors, they, they, they, they, they, they, they. The only person with the issue in the moment is the person talking about the issue. So what will the person who has the issue with this thing that’s happening to them, do about it?
Dr. Mark Hyman: Yeah, that’s so true. I mean, I think we put it all out on the other person, but we don’t realize we have the agency to change our response. Viktor Frankl who wrote Man’s Search for Meeting and was in a concentration camp, and he wrote about this belief, this experience that he got when he was there, which is that we have a choice all the time about our own internal experience no matter what’s happening outside of us. And so, to externalize all the blame and all the responsibility for our emotional wellbeing out there, is actually abdicating our own sovereignty and our own emotional wellbeing. And so, he said between stimulus and response, there’s a pause. And in that pause lies a choice. And that choice lies your freedom.
And so, the stimulus was the concentration camp and he got to respond. The stimulus was the abuse from the Nazi guards who would beat them. He got to choose how he responded to that, whether he responded with love, or hate, or whatever. I remember when I was in medical school, I went to Nepal on a trip to do a public health expedition. And I got to meet this Tibetan doctor who was an older guy. And he was a Tibetan monk and a doctor. And he’d been in a Chinese Gulag for 22 years in the Chinese Gulag for being a Tibetan monk. And I said, “What was that like? What was the hardest moment?” He says, “Well, the hardest moments were the moments I thought I would lose my compassion for my Chinese jailers.” And I was like, whoa, okay.
And so, he was even in the midst of that for 22 years, being in prison, being able to meet it with love and compassion. And that’s obviously extreme, but most of us humans like that. But it speaks to the reality of the choices we do have. And Chinese Gulags or concentration camps are extreme examples. But most of us don’t have that. We have other things. But we don’t have to actually surrender our emotional wellbeing or have it determined by another person’s response to what we want, or need, or would like. We have to deal with the reality and the truth. So that’s a very liberating idea, and it breaks that cycle of having to be the people pleaser, and not telling the truth. And being in the cycle of having these dysfunctional relationships that perpetuate the trauma that you had as a kid or that are ongoing family dynamics that perpetuate the lineage. I believe each of us in our lifetime has a capacity to heal our family lineage by breaking that trauma cycle. How do you think about that?
Nedra Tawwab: I just want to go back to what you said about meeting them with compassion, because I think about so many of us who have challenges with our parents, and it’s the anger, it’s the why did they do that? And as we think about our parents’ stories, as much of it as we know, there is room for compassion in how they became who they are. There is room for compassion with many people in our families that have certain behaviors that we can’t manage for them. I think about people who have family members with undiagnosed mental health issues. How challenging it must be for us to see someone who has whatever the issue is, but for them to not get treatment and then have all of these life consequences. And we know that this is a mental health issue. You can’t keep a job, or keep relationships, or function in society because of your manic disorder.
But if you’re not going to get treatment, if you’re not going to get help, I can understand how hard that is to step into a space of doing something that is new and uncomfortable, to acknowledge something like that about yourself. So the compassion that we can have, even if we decide, “Hey, I can’t be in this relationship,” or whatever it is, the compassion can really free us from the anger of it all, the frustration of it all. It really brings us back to, even if we’re in the relationships or not, it brings us back to a place of peace because we know that other people have things going on with them and we can have some empathies who are that.
Dr. Mark Hyman: Yeah, I mean, the biggest trap for us is believing we can change somebody else and needing someone else to change for us to be happy. And that’s what you’re talking about is letting go of that concept because we can meet the reality we have with truth. We can be honest, we can be direct, we can have clear communication, we can have clear boundaries. But that still doesn’t mean someone’s going to actually be changed. I remember in medical school I learned the difference between someone who’s neurotic and someone who’s got a personality disorder. So someone who’s got a neurosis is someone who drives themselves crazy and thinks everybody else is fine. And someone of the personality disorder, someone who thinks they’re fine and drives everybody else crazy.
And we have those people in our life and they don’t think they have an issue, they won’t look at themselves. And it’s a very hard thing to fix. And it’s probably because of their early childhood traumas or their stresses that they went through. And it’s something that at face value, it can seem super offensive, and destructive, and awful, and they’re wrong and they’re bad and they’re this and they’re that. But if you understand that the historical lineage of people’s lives and the traumas that they experience and maybe the why and what’s going on for them, it doesn’t make it okay or you have to accept it, and even abide it into your life. But it changes your own emotional wellbeing. It’s like someone said to me once, resentment is taking poison and expecting someone else to die.
Nedra Tawwab: Yeah. Yeah.
Dr. Mark Hyman: And I think that’s not good. So we do a lot of that in our lives, and it actually is a very destructive thing for our own health and wellbeing. So regardless of the relationships that you have, there are ways to heal them, there are ways to break lineages, there are ways to repair. There’s all sorts of strategies and tools to do that you share in your books, and your teachings, and your Instagram account. But at the end of the day, we may not be able to actually do that, and we have to find a way for us to not have that poison pill that we’re taking that’s hurting us.
Nedra Tawwab: Yeah. We hold on to this stuff with these people who have little desire to change any of this stuff. They have very little desire in some instances. And for the folks who are ready to change, sometimes there’s still resentment towards them for what they did not do. Sometimes people have problems in their relationships with a sibling or a parent when they’re younger. And as an adult, those problems no longer exist. But there is this still holding on to the past. And you can’t be in two places emotionally. You can either be present or you can be in the past, but when you are both, there is resentment.
Dr. Mark Hyman: Yeah. No, it’s true. I mean, I remember with my father, he died a few years ago. But my parents got divorced and he checked out. He tried a little bit, but he wouldn’t, he didn’t really make time to come visit. I mean, my mother was obviously, participating in some of the reasons why he couldn’t. But he didn’t really show up. And it was just so hurtful to me. And I finally as an adult, had a chance to sit and share with him my experience, and what it was like, and to have him hear it. And then he began to share his own childhood, and his father, and his grandfather, and I was like, “Whoa, now I understand why you behave this way. It doesn’t make it right. But you were a victim and then I became a victim as a kid. But we don’t have to stay being in that victim role.”
So I began, even though he didn’t really change, I was able to see who he was and love him for what he was, and enjoy being with him, and have compassion. And it was really this beautiful healing and resolution. Even though he didn’t really change that much, but it was more my own healing around how I held it all. And to have that compassion for the little boy that was him that had to leave home at 13 years old. So that really is a process that we don’t learn how to do. And I think your work is so important, Nedra, because it really helps us to think about practically how we start to do this for ourselves and get into a place where we have peace, where we don’t have tons of drama in our life and relationships. I mean, wouldn’t that be amazing? I think it would be so amazing if we all had that. And there’s just so much psychological trauma that gets recapitulated from generation to generation. And what you’re talking about are tools and practices to break that cycle.
Nedra Tawwab: Change is really scary. I think about when people can’t change, what might be happening with them. I’ve heard some folks share stories of how their changes actually changed other people. And that’s what happens when we set boundaries. I’ve known people to start saying I love you to their parents who never said it. And eventually, the parents catch on and they start saying, “Okay, I love you,” or hugging them, or just doing these different things, that we can impact change in some ways, even if this person is not initiating it on their own. So it may not be, oh my gosh, they’re going to initiate it every time. But you’ll see sometimes with grandparents in particular, they’re very different than how they were with their children. And so, it’s like, “Oh my gosh, when I was a kid, I couldn’t sit on this couch. I couldn’t do this thing. And now my mom is letting these kids do this and that.”
So there is some recognition within them that, “Oh, maybe there is a softer way to be. Perhaps there is a different way to exist.” So even sometimes when people can’t change with us, they’re capable with changing with our siblings. They’re capable of changing with their grandchildren, with other folks in the family. So maybe it’s not the relationship with us that can improve, but maybe they’re at least able to learn some lessons from us to improve in other relationships.
Dr. Mark Hyman: So it’s a way of almost passive healing just by being different, they get to witness how you’re different and then they can respond differently to you, and then maybe even learn some of different ways of being in general with relationships.
Nedra Tawwab: Absolutely.
Dr. Mark Hyman: Yeah. So one of the challenges I think often occurs for people as a parent, I had two kids and I actually was a single father. And I mean, there was no instruction manual. There was no, “Here’s how you do it. Here’s how you keep your kids safe emotionally. Here’s how you relate to them. Here’s how you talk to them. Here’s what to do when things go wrong. Here’s how to celebrate them when things are good.” We just don’t get a roadmap. And so, we often repeat these patterns from our childhood that get recapitulated on our kids, but we don’t have to do that. So what are the mistakes that parents make when their kids are young? And how do we break those cycles?
Nedra Tawwab: Parents often shield their kids from discomfort by giving them stuff instead of being with them. I think we try to control their outcomes instead of allowing them to experience consequences with parenting. I think there is some, “We want them to be assertive, but not with us. We want them to be happy, but we want to determine exactly what that happiness is.” The happiness is only if you go to this college. Yeah, so we have to be a little more flexible in allowing little humans to become adult humans, and allowing those adult humans to just human different than how we did it.
And as I stated, when you’re younger, so much of who you are is controlled by your environment. Then when you turn 18, there’s a level of autonomy that you’re able to have in your life. And for some folks, you can see the seeds of your parenting. And for others it is like, what is this thing? And it’s like, this was brewing. Perhaps these are things that you could not control that this person wants to experience or they want to exist in a certain way. And how can we lovingly care, and support, and have a relationship with a person who is becoming themselves? Is really the biggest question of parenting. How do I uniquely love this individual who is becoming more of themselves?
Dr. Mark Hyman: Yeah, powerful. Any last thoughts for people who are listening to this and going, “yeah, this is great because I definitely don’t have good boundaries. I definitely have a lot of drama in my life. I definitely have struggled with my parents or with my adult kids. Where do I start?”
Nedra Tawwab: I would say start in the biggest area that you’re having the boundary issue. I know people always say start small. Well, the small stuff is not the big stuff. You want to start with the thing that’s keeping you up at night. You want to start with those hardest relationships. And it is a continuous practice. I think often we want to set a boundary and then like, “Okay, I did it. That’s it.” And it’s like, well, that was just the first thing. You’ll have to repeat it. You may have to issue a consequence. But you’ll have to change the way you respond to this person. If you want someone to do something different, you have to be different. It’s not their boundary, it’s your boundary. You have to advocate for it. You have to be serious about it.
And often when we have to do that, we get so mad at this other person, “How dare you make me set this boundary? How dare you make me tell you no.” When in actuality, they’re giving you a gift. They’re giving you the gift of courage. They’re giving you the gift of self-advocacy. They’re giving you the gift of being comfortable in who you are. So it is a gift to be able to say to someone, no. It’s a gift to be able to say, “Hey, here’s what I want in this situation.” Or, “Hey, this thing has been bothering me.” Because I’m a therapist, I do think therapy is a really important practice. But I go to therapy and I see the power of having a person listen to you uninterrupted for 50 minutes or whatever it is, in a way that the other humans in our life do not listen to us.
Most of the time in our relationships with our friends or family members, there’s a back and forth that’s occurring. With a therapist, you’re sitting there, you’re getting insight. So I think sometimes when things aren’t working in our lives, we are not the person to maybe correct the issue. We’ve been trying. You’ve been working on this thing by yourself all these years, and you haven’t gotten very far. Perhaps there is a professional to help you, which we’re willing to do in so many other areas of life. If we can’t figure out our plumbing issue, we call the plumber. If we can’t figure out, “Oh my gosh, I’ve been coughing a week,” we go to the doctor. And we need to do that with our mental health as well. We need to go to that next level and seek some professional help.
Dr. Mark Hyman: Yeah. Well, thank you. This has been such a great conversation and your work is so important. I think everybody, we’re going to put in the show notes her Instagram page, which is a fabulous treasure trove of insights and little useful tips. Her website, Nedra Tawwab, nedratawwab.com, is also wonderful. She’s got family quizzes, relationship quizzes, boundaries quiz. And you have a beautiful quote on there, which is, I think, a beautiful spot to end, which is end the struggle, speak up for what you need, and experience the freedom of being truly yourself. Because at the end of the day, it’s about getting free. And emotionally free for ourselves, emotionally free in our relationships. And your books are just tremendous.
So I love the title of your latest book, Drama Free, A Guide to Managing Unhealthy Family Relationships. And I think probably everybody on the planet needs one copy of that book. So thank you so much for your work. Those of you who love this podcast, please share it with your friends and family on social media that sure, everybody needs to hear this. Leave a comment, have you figured out how to navigate unhealthy and painful family relationships or other relationships? And subscribe wherever you get your podcast and we’ll see you next time on The Doctor’s Farmacy.
Closing: Hi, everyone. I hope you enjoyed this week’s episode. Just a reminder that this podcast is for educational purposes only. This podcast is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided on the understanding that it does not constitute medical or other professional advice or services. If you’re looking for help in your journey, seek out a qualified medical practitioner. If you’re looking for a functional medicine practitioner, you can visit ifm.org and search their find a practitioner database. It’s important that you have someone in your corner who’s trained, who’s a licensed healthcare practitioner, and can help you make changes, especially when it comes to your health.
