Today. I'm really excited to interview Catherine Van Tassel. You know, Catherine and I We've been friends for quite some time. She specializes in helping people find not only healthy weight, but changing behaviors.

And she's a licensed clinical social worker. She's a physician assistant and ultra marathon runner. I mean, you name it, Catherine has done it. So, Catherine, welcome.

Thanks for having me. I'm really excited to be here. Yes. So any question you might have on how to improve your life in any space and Catherine will be your go to person.

So, you know, to really get started, I really want to highlight with you the importance of habits. And so the first question is, why is it important to prioritize like gradual changes over drastic lifestyle overhauls when trying to either manage hypertension or other chronic disease?

Yeah, well, I think this comes in to how do we set ourselves up for success. Right. And and it's just like, if you think of anything we've ever done in our lives, graduate high school, maybe have a baby, you get married, you go to college, you start a new job.

You never do all of those things overnight. It takes nine months to have a baby. It takes 12 plus years to get an education. And whenever we do this, which we have really good evidence of this, right.

January 1st is the perfect example of how this has never worked in the history of ever, because two weeks later, about 50% of us have given up and then four weeks later, forget about it like we're back to where we've been.

And that's not because we're not strong enough. We don't have enough willpower. It's because that's the way life is. Our brains are set up and just how things play out.

So instead of thinking, okay, I've been given maybe a diagnosis of hypertension and that scares me. I'm worried about this. I'm worried about my future. I want to be here for my kids or my family, whatever that looks like for you.

I need to get on top of this. Well, what is one thing you could do today? And then that thing be tomorrow and the next day and those things add up and then you add something else to that.

It's very tangible and easy and it doesn't feel overwhelming because we get a lot of guilt and shame when we feel like we haven't done something wrong and what's going to happen if we set up ourselves for failure?

Now we're going to have more guilt and shame. And then just like January 28, we give up and we're back to the beginning. Yes, absolutely. So those small, fragile changes, can you give an example of what that might be?

Maybe what are some of those things that someone can start small and build over time that will have an impact on something like high blood pressure? Yeah. Yeah.

So how does somebody take inventory? Okay, maybe. How did I get here? And always the good news. Let's always look at the good news. Well, I have lots of ways to address this.

And we know that food, sleep, exercise, stress management. Well, just look at those four things. And of course, you know, what have we been given by our provider?

Maybe that starting a medication or increasing it while we're doing some other lifestyle changes and we have all of these things that can make really great change and be really positive.

So let's pick one where we feel like that one. I feel really strong about that. I could do something in my sleeping only five or six and a half hours a night.

We know that sleeping less than 7 to 8 hours a night can increase your chances of worsening your hypertension by 200%. We see that in age group of 45 and older.

And so what? What? Is there something I could do is I mean, I just watch one less Netflix show a night. Does that mean I start pushing back like the things that I do at night so I can get into bed earlier and that might be motivating because if I sleep longer, I'm going to feel better.

If I feel better, I'm going to make another change that might make it easier for me to get up and exercise because I'm not so tired. So okay. I just made one small change by not watching that extra show I got to bed earlier, got more sleep.

Then that can roll over into another one of exercise. And so what if sleep? Okay, sleep seems a little overwhelming. I want to focus on nutrition. Okay, well, let's look what is holding me back is that family and this family love to have really high fat, sugary tasting foods for all the reasons why they're very addictive to us.

What? Can I talk to my family about it? Hey, you know, I have this diagnosis. I really like to make some changes. Involve your family with you and it's more fun to do things together, especially if you're living together.

That can be challenging if you're doing one thing and they're not. Not all families want to make change, and that's okay too. That's where you have to set boundaries for yourself.

This is really important for me and I would love it if you supported me. Let's build an environment here where I can be successful and everybody in the family's happy too.

Stress management and doing meditation. We know meditation is so effective for so many diseases and hypertension is not exempt from that because think if you are in a constantly stressed state, you're in this fight or flight, you're pumping a lot of cortisol through your body all the time.

And when you're in this fight or flight state, your body's trying to save you. Your heart rate increases or blood pressure goes up. That's the last thing that we want.

So we know that just simple breathwork doing and square breathing. So breathing in for four or holding for four breathing out for four holding for four just doing that for 5 minutes.

That will bring down your heart rate. Your body goes from fight or flight into rest and digest. That's free. You can do it anywhere and it's very accessible.

So look at all the areas where you can make some behavior change. And again, just pick one. We're not going to do all of them. What seems most interesting or you can maybe get a partner on board, pick one thing you can do and start doing that and then pick another and another.

So that's a great segue into the next question. So let's say that we've picked one nutrition, sleep, stress management, whatever that might be. How do we know when and how to add in a secondary habit to see that compounded effect?

Yeah. Yeah. I think once we feel like we're not overwhelmed by that first habit and that first habit is starting to be more of a habit. So we think about brushing our teeth.

I'm pretty sure that 99.9% of us never think about having to get up and brush our teeth or brush our teeth at night. And now we're just a repetitive behavior and her brains are plastic.

This is what's so cool about neuroplasticity. So essentially we build these tracks in our brain the more we do a habit. So that's why if we start small and not overwhelming, we're more likely to continue to do that behavior.

And so we'll just use exercise for this example. And let's say you want to start exercising honestly, all I would say is for the first week, and if exercise is brand new to you the first day, all you do is put out a pair of shoes and walk around the block.

That's it. That is it. You have a sense of accomplishment from doing that. You showed up for yourself and you committed and followed through with your plan.

And then the next day could you do another block and you can see how this goes. Okay. So now I've been doing this for a week, two weeks. I'm walking 20 minutes three times a week.

I don't feel overwhelmed. It's now on my schedule. People know what I'm doing. They're not bothering me or trying to take away from my time that I've set apart for myself.

All right, what else can I do? So I start now focusing on sleep. What about nutrition? Could I start going through my house and taking out some of the foods that aren't?

Maybe I'm contributing to my health. So once you feel like you've got one down and you're not going to be overwhelmed to add another, that's when I would say to add that second behavior change.

Well, let's dive into the nutrition piece like let's how would we start eating those foods or how would you suggest moving into that direction? Because I think nutrition is something we do three times a day.

Most of us multiple times do the week it's required for us to survive. How can we start making different choices? And what foods should we maybe focus in on first?

Or how would you suggest for someone to get started? Yes. Oh, I love the question about food. This food is almost like a religion to people. And we see a lot of people have very strong feelings about what kind of diet they should be following for other people telling us what kind of diet we should be following or not following.

And so I always say, let's just let's be very sensible about this. What do we know that I don't think is too controversial? We know that unprocessed foods are better than processed foods, and we know that foods like fruits and vegetables and grades and nuts and seeds, you know, those are all our healthy foods.

And what do we know in terms of help that I think very few people, no matter where you fall, would agree on? Well, it's mostly fruits and vegetables and whole grains.

And let's start there, because those are the foods that are highest in fiber. They make us feel really full because nobody wants to be hungry when they're changing the way they're eating.

Also, being hungry when you change the way you're eating is like probably the first thing that's going to then send you back to doing what you were doing before.

Because we don't like to have hungry bellies. I don't. Hungry is a word for a reason. And so okay, we're going to start we know we just want to have more unprocessed foods.

If this was very overwhelming, my suggestion is just to start with one meal a day. So let's say this is week one of new and improved. We use me as an example, an improved character and she's going to make a change that's going to set her up self for success.

Let me just pick breakfast. Let's just start with breakfast. What can I change in my breakfast? So let's say I want to include more whole unprocessed foods.

They're plant based in the morning. I usually really like to have cereal. Could you replace cereal with oatmeal? What if you really like to have bacon and eggs and pancakes?

Okay. What about a whole grain toasted tofu scramble that has your favorite veggie? So would that be mushrooms or bell peppers and broccoli? You choose, you get to do whatever you want and you just pick, you know, what are you eating now?

And how could you replace that with a new breakfast on Sunday? Set yourself up. Getting those prepared. You could get oatmeal baggies and put in and put in the oatmeal in it and maybe put in some flaxseed.

So that's really great for our health and or help all your vegetables do that for a week. Neuroplasticity, we're going to build a behavior after you have that.

Now, the next week, we just focus on lunches. I could make a week full of grain bowls, so all I'm going to do is cook a whole bunch of rice, open some cans of beans and saute some sweet bell peppers and maybe add some carrots.

I can do that in less than an hour and make all my lunches for the week and already have breakfast down to about two thirds of the way there. Okay. Week three not overwhelming myself.

I have breakfast and lunch that now I'm going to go to dinner. What can I have for dinner? What are the things that I normally eat and. Okay, let's say spaghetti a lot.

Well, let's do whole wheat or like a chickpea pasta. And can we sauteed some spinach into that? Where can we add more greens and processed foods but not have really changed all of the things that we like and try and stay in that same wheelhouse.

But look for replacements that are healthier for you. Tacos, two corn tortillas and lots of veggies. You could do some tofu in there or some lentils, some mushrooms.

There's so many different options and get creative with it. And Instagram. Instagram has tons of different ideas. The Internet, get a new cookbook and bring your family into it.

Bring your support system in. Okay, so small, consistent changes within a day or week or months and then just keep adding into it as you feel better and just keep making progress. Great.

That's awesome. So we've made these changes and we're really kind of humming along, but of course things happen. So what strategies can someone employ to remain consistent with these small changes, especially when a media results may not be truly apparent, but pressure can improve quickly, but sometimes it takes a little bit longer.

So what do you suggest for someone to remain consistent for the long haul? Six, 12 months that might be required to really see significant change? Yeah.

Yeah, I think there's there's so many things here. So a couple of things that I think is one and small realistic goals. So the benefit of doing this is not only having better blood pressure outcomes, but did all the side effects of You'll feel better, you may lose some weight, you may have more energy, your skin might be brighter.

I mean, these are just the things that happen when you start using stress management techniques, you start eating better, you start sleeping better. So start noticing the things that you're seeing that are change, that are changing.

And one good thing would be have a journal at your like at your nightstand, on your bed and every night write down a couple of things you're grateful for that day, how you showed up for yourself, maybe a change that you made when was really hard.

Maybe everybody in your family went out for ice cream and you got sorbet instead of dairy ice cream break down. Those are really big wins where you showed up for yourself.

Also, give yourself grace. So we see this. We maybe make a choice that we didn't align with our values. And so then we just throw everything out the window.

This is like my stop sign or stoplight analogy. And you know how many times if we had a meal that we thought was bad, you know, there's not bad or good, there's just what fits with our goals and how we feel.

So we have this meal that we perceive as bad, then we have guilt and shame. And so then what happens? Well, I already screwed up. I'm just going to screw up everything after that, because now I almost have the flight path that I've given myself.

But we would never do that if we accidentally ran a stoplight or a stop sign, which we all have probably done. Know, what do you do immediately? Well, that was really close.

I'm glad we're okay. The next time, I'm going to be a little bit more careful. So if for some reason you don't wake up that morning and exercise or you only get 5 hours of sleep, okay, sure, that happened.

And now our next meal, I'm really going to be on point or tonight I'm really going to make sure that I get to bed on time. It's just that that was just evidence of one thing, what maybe happened that threw you off track of what what you've set up for your goals and how can I have that not happen again?

This is just like sports. What are they? What do these teams that make multimillions of dollars, they analyze all of the games. Okay, I don't like how that happened.

We're going to do it better next time. And there's no reason why we can't just what can I do better next time? Perfect. And I guess we kind of maybe go back a little bit, retrace your steps and just give an example of exactly why it is a habit loop, because I think once people understand, they can literally design their behavior to be the behavior designers of their own life. It's quite empowering.

So could you explain what the power movements are? How to power? Oh my heavens. Ability? Yes, yes. I love this because I think once you understand this, it helps you understand why maybe we haven't been successful in the past or maybe had a successful behavior change.

And so let's pick a behavior that we want to change. Let's say it's nutrition. We want to change. And let's say we're always like we maybe overeat or eat too many sweets at the end of the night.

Okay. Well, let's look at that. What is happening around that time? Is there stress that's happening around that time? Boredom. Did we not eat enough during the day?

We go into dinner to hungry. We always want to like be aware of our triggers and what's going on. And when we look at a behavior we want to change, what we typically do is just try and white knuckle it.

So okay, today's Monday because everything starts on Monday or the new year or birthday or I don't know. It's so it's just like which is good. It's good to pick good time like that.

But it's Monday and I'm not going to do this even though I've done this for the past five years today I'm not going to do this. And so then it's just sheer willpower and and that usually never works out well.

That's because when we weren't aware of why we did that until we didn't replace that behavior with something else that's where you get into behavior change, where you're really successful.

So, okay, I don't want to eat and I a lot of high sugary fatty foods at the end of the night, even when I'm not full. Well, I know I do that when I get really bored.

So tonight I'm going to make a change. Okay, so I have my regular dinner. Great. I know I get bored and I do this behavior. I'm going to replace it instead of just not do it.

I'm going to replace it because I ask my friends to go on a walk after we eat dinner or my family or I'm going to a place to do go or I'm going to watch that favorite movie I wanted to watch, or I'm going to play some music to play an instrument.

I'm going to if you can pick anything that you like and just replace that behavior and and then you continue to do that over and over again instead of white knuckling it, you just have this replacement.

And I always tell people, write down a list of like ten, ten items that you really like to do. And whether that's playing music, play with your dog, be with your family, paint your nails and knit crochet.

I play solitaire, play game, whatever that go for a walk, whatever that looks like, that brings you joy. Make a list so that when you're going to change a behavior, you have this list ready.

Oh, I want to do that. Insert that. There we go. I'm moving on and I'm going to be real successful. Perfect. That is definitely one strategy is behavior substitution in.

There's so much more. So we spoke to the habit loop and substituting behaviors. Can we maybe even speak to one either mindset or how do we stop a bad behavior right.

So maybe there's a really detrimental behavior that we're having or our habits. So those two things go together. And how would you approach someone who is really struggling with something that keeps undermining their goals or moving into a healthy direction?

Yeah, yeah, absolutely. So there I mean, it's fun to dig into these because there's usually some reason why this is happening. So I would start out okay, what what do you see?

That is that's difficult for you, too, and for you to follow through with this change that you've wanted to do. And then give me some examples. So what are some let's look back and you've really, really tried.

And what has happened during that time was that and there's so many different reasons. I think this is the other thing of having grace with ourself. And this then also translates into mindset instead of negativity and guilt and shame, bringing positivity, grace and compassion to ourselves because if you look at this is and I always want to say this isn't because somebody didn't want to make the change or they didn't know they should.

So many factors play into this. This could be socioeconomic, this could be stress, this could be and time management, this could be family dynamics, friend dynamics.

Those are all the things that not necessarily I want to say get in our way that can build some resistance in difficulty for us to make these behavior changes.

So let's be really concrete and look back at when you weren't successful, what happened there so we can pull that apart and see. Okay, well, we noticed that this was a family system issue within our home.

Great. Let's dove into that. What did you try and how didn't that work? And instead of repeating the same behavior, expecting a different result, let's change that.

And or did you pick something that wasn't sustainable and didn't have a realistic goal? Let's change your goal then. And or, let's say exercise. You chose to start running five miles a day and you've never ran before.

Didn't was that not sustainable? Can we make a change there? And so I would say going back and looking at what potentially could have stood in our way and looking at all of the different ways that we can hit some resistance.

And then there was one other thing I was going to say about that. But now I can around it and now it went out of my brain. Oh, and education about it.

Do you feel like that maybe you didn't go in with enough knowledge? You felt like, Oh yeah, I got this. And then you got there and you were like, Who?

I don't have this. I don't know. Is there some more education that could be given and and who could give that to you? Maybe there needs to be another team member that we pull into your care team.

Would it be beneficial for you to meet with a trainer? Do you have a lot of back pain in you going out and doing an exercise program on your own? Is it realistic and or what about a nutritionist?

Would that be helpful? And and then the other part of this that I think would be really helpful is we know a lot of behaviors can come out of trauma. So we have these maladaptive behaviors that have happened, coping with trauma that we've had in our past, especially childhood trauma, anything during our developmental years.

So is it not necessarily that you don't have this goal that's realistic and that you have the support around you, that maybe there's something under lying and it would be helpful to meet with a therapist with that, maybe to come back and look at what's happening with that trauma that is standing in the way of your goals.

And that would be another way that I would suggest to get some help. Perfect. I really like the trauma aspect because I think a lot of people develop these habits unbeknownst to them, just trying to learn how to cope with something.

So how can someone really start investigating like the trauma that they've had? You know, is there a special type of therapist or is there some journaling?

Like how does someone even begin to understand? They're like, Yeah, I do do this. And how do they if I can go back and say, Oh yeah, that was the time that it actually started.

Yeah. So if anybody has had trauma in their past, have they ever addressed it? And, you know, again, do they feel like it's impacting their life now? And I would say that most people would say yes, because they're seeing these and these habits that are impacting their life are likely out of that trauma.

We see a lot of that. And with food habits, we tend to have negative relationships with food and when we've had trauma in our past. Okay, so let's say we've identified that what would be the West best way to approach getting help?

There's a few different options. If this individual's working at their workplace, do they have an EAP? Because again, we want things that are and have the least amount of resistance and are easily accessible, especially we look at mental health.

We know that people get better for mental health conditions, but they need to have care that's easily accessible and quick to access. And that would be one of the easiest ways.

If it's free, usually you can just call a phone number. Let's try that. And if not, we can look through insurance. There's a website PsychologyToday.com that you actually can filter through your area insurance type of therapist.

You can see their picture and read a bio so you can feel like, oh, this person I feel like I can mesh with or not. Therapists are like swimsuits or your favorite pair of jeans.

Sometimes you have to try on a few to get the right fit. And, and then there are types of therapy to be aware of. Maybe research like EMDR can be really effective if somebody has had a traumatic event in their past and so those would be some like, okay, we're just going to get started.

Has this happened to me? Do I feel like I have maladaptive behaviors from that? And here are some ways that I can start to look for some help. That's perfect.

So any final conclusions to looking at habits like helping someone? Maybe they're feeling a little overwhelmed, like, wow, there's so much here I could maybe start with, maybe address the initial overwhelmed just to get started people or literally talk themselves out of even taking the first step.

Yeah, yeah. I would start with the visualization exercise. I would sit down, I would close my eyes and I would envision you at the finish line. So right now you're at the start line.

I would envision what you're hoping to get at the finish line, whatever that looks like to you is that moving your body with your friends three days a week and sitting down and having a really nutritious meals that have been fun that you've made together with your community, you name it, whatever that is.

Maybe you're now playing pickleball with your friends or your family and going to the doctor and standing on this scale and seeing one of the goals. And your blood pressure is within normal range.

Visualize all of these things and before you know, anyone's like, Oh, that's kind of woo woo and NBA players that do visualization and really this is Olympic athletes, any major athlete, they have studies done when they visualize themselves making the basket or whatever that goal is.

When they do that before they're more successful in doing that. And so we know that this works. And again, in these organizations that have the most that have all of the resources given to them and all the best science to make these athletes amazing, let's pull that into our everyday life and think of us as our own athlete in our life.

So what is this you look like at the end? Okay, the reason I also want you to do that is because it's positive, right? No shame, no guilt. And how am I going to get there now and then pick this is again a marathon and pick what are you going to do from now at mile one and then we'll worry about mile two.

We're only worried about mile one because we're not going to be overwhelmed. We're going to pick one small goal and it's kind of fun. You can plot out mile, two, mile three mile four because we love to check things off lists.

And so whether you do that on an app or on pen and paper, plot that out after you do this visualization exercise where you will get you will get there.

And that we're just going to start with day one. And what does that look like for you? Perfect. Well, thank you, Catherine, for sharing your wisdom and your experience with this And I hope everyone you found this very helpful and see below where you can learn more about Catherine and potentially work with her in the service this year.

Thank you. Thanks.

Catherine Van Tassell, MSW, PA-C

Mastering Hypertension: The Power Of Mindset