Episode #97 – Dr. Mark Goulston On Becoming Your Own Health Advocate

Dr. Mark GoulstonOur guest for this week’s episode is Dr. Mark Goulston, a respected psychiatrist and consultant – and author of several best-selling books.

We discuss those reasons why people fall off the wagon when it comes to health and fitness, and how we allow stress to knock us off course. Seeking comfort in food after a difficult encounter or event is often the downfall in many diets. Equally, feeling disheartened with daily stresses and problem people can lead to the use of breaking from goals as a reward.

Dr. Mark talks about the techniques we can all use to reassess how we handle impulses, such as taking the time to reflect on choices before we act with an 8-step pause. We also discuss how to overcome obstacles thrown up by difficult people through calm negotiations and helping them to feel important and wanted.

We also talk about how you need to be the advocate of your own health if you are going to get results. Don’t be afraid to challenge your doctor, and make sure you know what outcome you hope for before you go to appointments – that way you can push for a positive result.


Further reading from Dr. Mark Goulston

Visit Dr. Mark’s website here
Find Dr. Mark on Twitter @MarkGoulston

Order Talking to Crazy: How to Deal with the Irrational and Impossible People in Your Life
Order Just Listen: Discover the Secret to Getting Through to Absolutely Anyone
Order Get Out of Your Own Way: Overcoming Self-Defeating Behavior

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MELISSA: Welcome, Dr. Mark. Thanks so much for taking time to be on the program today.

DR GOULSTON: Well, I’m very pleased to be here and looking forward to biting into our conversation.

MELISSA: Yeah, you’ve got several books, many books. You’re a very prolific author as well as speaker. And I’m going to put links in the show notes to all of them because I think every one of them has something somebody can benefit from and gain knowledge on in helping to improve their personal view of themselves and also in helping them to improve their help by their mental attitude. But one of the big things people have trouble with and I had trouble with this myself and it could be just my generation or people that are over 40, but that was in making changes in my own health one of my biggest barriers was being able to deal with my regular, what I call “regular doctor” and be persistent enough to ask questions about why different things weren’t working and what else we could try and things like that. I think for my point of view, because I was brought up that doctors know everything, you know nothing, and so whatever they say goes. But I think a lot of people, that’s the stumbling block for them to take the next step to say maybe this isn’t the doctor for me. Maybe this isn’t working for me, and to get up the courage to kind of question the stuff, this is a big road block. What would be your advice on that?

DR GOULSTON: Well, you know, you have to be your own advocate in the medical profession and that’s because it’s so complicated and because doctors and hospitals and clinics and everyone is just so overloaded. I think the challenge is that when you go into a doctor’s office, there’s such an ache in everybody to have someone take care of us, especially when we’re feeling pain, when we’re afraid. And in fact, when we’re feeling afraid or in pain, the first thing we really want in the world is comfort. And one of the reasons we reach for food is because often food comforts us when the people around us don’t, and so when you go the doctor looking for him to comfort you and almost envelope you with all his/her skill, knowledge and competence, that’s a lovely wish but you really have to be your own advocate. I recently went to the Apple Store and I loved how they took care of me. I mean, I didn’t have to be an advocate.

MELISSA: It’s the best experience, isn’t it? I mean, it’s a really great, one of their best-selling points, I think, is their physical stores because like you said, you just walk in there, you’re automatically taken care of.

DR GOULSTON: In fact, when I work with organizations and companies, I say if you want to learn how to increase your front office and your patient connectedness and patient focus, family focus, you should close your office and I’ll go to the Apple Store. And if any of you have Apple products, go the Genius Bar and have everybody watch just how you’re taken care of and then go back to your office, if you’re the doctor, and say what can we learn from that? The problem is the medical profession currently is not like the Apple Store because everything is pulling out it, and so it works slightly different. But something I wanna bring up that, in anticipation of our conversation, is there is a journey in my books, so my first book was called “Get Out of Your Own Way,” and I’m humbled by its success. It came out 20 years ago and if you look up self-help books in Amazon-

MELISSA: Yup, it’s still out there.

DR GOULSTON: It’s in the top five for the last five years.

MELISSA: Yeah, it’s a really good book and I guess we’ll link to it in the show notes. Everybody should, I think, get at least three of your books, minimum if not all.

DR GOULSTON: That would be great. And then, there were many other books and then one book that did very well was “Just Listen,” and it’s not about getting people to listen to you, it’s about how you can be a better listener and when you’re a better listener, you actually have more influence over other people. And the reason being is that everybody—and I’m going to use some food related words—everybody is hungry to feel listened to, to feel understood, and “Just Listen” was about how do you listen to people so they feel felt. And when someone feels felt by your listening, they exhale and they lean into the safety of it. But interestingly, a lot of the interest I got from the book, “Just Listen,” there were two chapters that people said, “Tell us about that.” And one chapter was steering clear of toxic people.

MELISSA: Right, that’s a big one.

DR GOULSTON: That’s a big one. And then the other chapter was how to go from OF to OK and we’ll use “F” being “fudge,” because we’re all about food here.


DR GOULSTON: There you go. And that chapter was how do you calm yourself down when you’re dealing with difficult people. So that got so much interest that I wrote my recent book “Talking to Crazy: How to Deal with the Irrational and Impossible People in Your Life.” And where this fits in is sometimes when I give interviews, and I’m talking about people who can’t stay on a diet and people who can’t stay on an exercise program, and I’m going to run this by you and you can tell me, “I can see how that would work,” or “Kick me to the curb. Nah, I can’t go along with that.” What I’ve discovered in my studies and research is that people who don’t love dieting, people who have trouble staying on a diet, people who don’t love exercising and have trouble staying with it, often they go off a diet or their exercise program when they’ve had what I call “a close encounter of the worst kind,” meaning when you have just been with someone who really, not just stressed you out but distressed you.

MELISSA: I think that’s dead on. I think personal interactions or having a bad commute on the freeway or something can definitely throw you off, it’s sort of is a self, kind of a self-fulfilling, perhaps it gives you an excuse to then deviate from something you’ve decided to do.

DR GOULSTON: Absolutely.

MELISSA: It creates, and you create your own reward, which in a bad way defeats your purpose. But you’re sort of giving yourself a prize for having to have dealt with XYZ, whatever that is. I think that’s correct, yes.

DR GOULSTON: And here’s the prize, is “I deserve a prize because after dealing with that person, I wanted to kill them and I didn’t. I’m a good person.”

MELISSA: Exactly, exactly. Or I think, and just to go back to the beginning of the question, when, like you were saying, when you go to your conventional, I just used that word, “conventional” as opposed to some of the others practitioners which are more in the integrative or functional medicine line who pretty much say “get ready to spend an hour with me asking you about yourself and your history,” when you get the 15-minute visit, when you have a lot of things you want to talk about and you get almost no in-depth feedback from your doctor, you’re ready for a reward of some kind.

DR GOULSTON: So here’s how we’re going to kill a bunch of birds with one stone. So here’s the approach I have, if what I just said was true about having close encounters with people that stressed you out, everybody who’s listening, take out a sheet of paper, no one else will see this. Draw a line down the middle of the sheet and on the left side, without editing it because no one else will see it, write down all the names of people and situations that give you energy so that when you’re with them, after you finish, you say to yourself, “I need to get back in touch with them sooner.” Or at the end of the call you say, “We really need to call each other again. This was great.” And so those people who that give you energy or situations that give you energy, on the right side, without editing, list all the people that take the energy out of you, some who suck the life out of you, some who exasperate and infuriate you and make a commitment to maximizing your interaction with all the people and the situations in the left side in the next three days and minimizing your interactions with people and situations on the right side. And what you’ll find is that you’re more motivated to stay on diets and with exercise regimens.

Also, be sure to thank the people on the left side because one of the worst things we do is we get so worn out by those difficult, high-maintenance, difficult-to-please, easy-to-upset people on the right side that just getting, dealing with them causes us to not be appreciative of the people on the left side. And so you want to make sure that you thank those people in the left side. Now, this goes back to—so one of the reasons I wrote “Talking to Crazy” is a lot of people will say, “Well, I can’t avoid everybody in the right side because some of them I’m related to.” And in fact, some interviews I do around the holidays, one of the favorite interviews is how to paper train your problem relatives for the holidays.

MELISSA: Yeah, I think that’s a key one because when you try to change, obviously your lifestyle and things you’re going to do and if you’re doing this in the health area which involves changing what you’re eating, changing what you’re doing, this is where you hit the big roadblocks for sure, because a lot of people that are closest to you are going to say, “Oh, you’re doing that again?” “Oh, you fail doing that so many times, it’s just the diet of the month or diet of the week or whatever,” which again brings you back to the situation we just discussed where you now feel “Okay, I want to kill that person” or “I’ve had to deal with them so I now would like a reward off my plan,” or something like that which I don’t know, I’ve taken the view on this and you can tell me if this is a good or a bad plan is you have to minimize exposure even if they are your relatives, to people who consistently give you stressful or negative feedback which you know isn’t helping you.

DR GOULSTON: So here’s a two-for tip. How to deal with those relatives and also how to deal with doctors who may not be difficult that they just look so rushed you don’t want to frustrate them further. They don’t come in calmly anymore because they’re always behind, rarely are they smiling and it’s not your fault, but you don’t want to burden them, but that takes away from your being an advocate. So here’s the suggestion, so we’ll start with the doctor and we’ll finish with that problem relative.


DR GOULSTON: What you might want to do is be proactive because the more you can be proactive about something in the future, the less stress there is than being in a situation in which you’re reactive, and whether you’re reacting about, “Gee, I spent that time with my doctor and I didn’t ask him or her questions and then they were gone,” or “They didn’t answer what was on my mind.” So what you want to do is when you’re about to go see a doctor, I want you to imagine that you’re leaving the doctor’s office and you say to yourself, “That was one of the best visits with my doctor that I’ve had in months.” So what happens in that appointment and write down what questions do you get answered, what questions do you ask to get answered, what information do you get? So that when you leave, you feel satisfied and when you do it ahead of time, you’re not there just being passive and dependent and hoping that person will pull out everything that’s vital. So write that down and something you might do and that they might push back but you might reach out to the front office and say, “I know all of you are overworked and overwhelmed, and might I send you an e-mail that can be shared with the doctor about really my three main concerns when I meet him or her,” and don’t make a huge list. Pick your top three concerns and just so he or she won’t feel blindsided or distracted, will that be okay if I just sent those so that when I leave, I get my questions answered and so you and my doctor will feel that you really help me with what was on my mind.

MELISSA: Yes, I wanna say, I think that’s a great idea. And it’s one I use myself with one of the doctors I work with who’s—we actually work by Skype and by phone because he’s in Northern California, quite away from me. So I’ve never visited his office but we definitely do that to prepare for our time on the phone or on the Skype and to go over things I have questions on. So I do exactly that. I send him my three biggest questions, you know, what happened with these blood work. I’d like to know what the score was on this and what’s our plan for changing this, that and such and such around. And I know that a lot of doctors, even conventional doctors here or across most of the US now have some sort of connected e-mail provision with their patients. So they can communicate for your next checkup or whatever. They have some conduit there that you can get through on e-mail. So I think that’s a super good tip, and one that people should definitely use because you’re right. It sets the tone. It makes it really a gentle push for questions you want asked without having to whip out a piece of paper the minute you see the doctor come in the room and say, “I need these questions asked right now.” He’s got them all ahead of time.

DR GOULSTON: I know, absolutely. And there’s a saying that I learned from my colleague Marshall Goldsmith. Marshall Goldsmith is the top executive coach in the world. And part of what he says is focus on the future which nobody has messed up or disappointed another person because when you focus on the past or you’re in the moment, there’s a kind of agitation and agitation begets agitation. And so if you’re there hoping that your doctor will be able to read your mind and satisfy all your needs, I think I’m being proactive by sharing something. And again, don’t overwhelm them but send this to the office and they’ll be able to, and my guess is because of electronic recordkeeping, they’ll be able to send that over to the doctor, send into those patients three questions that they want to have answered, I think people would be appreciative of that because the doctor then has a chance to know what’s on your mind as opposed to you just pulling it out when you’re with them. And even if they’ll feel more prepared and they’ll feel more respected. And so that’s a good idea. But to change this to problem relatives…

MELISSA: Yes, I was going to forget that part for sure.

DR GOULSTON: So the same focus is focus on the future as opposed to waiting for something bad to happen and reacting to it. So something about most problem relatives is many of them don’t feel important in life. They feel that the world has mistreated them, and one of their ways of getting even with life is to come to holiday parties and dinners and spoils everyone’s time.

MELISSA: How true, how true.

DR GOULSTON: And so this is what you do and it’s helpful, by the way, if there is a male involved in the holiday proceedings, because men don’t ask for help. So it’s much more disarming than when a woman asks for help. That may be a little sexist but it’s true. And so, you have, if there is a male involved, a spouse, a brother, dad or something, you have them contact the most difficult person that you can’t uninvited and they say to that person, “You know, I’d like your help with something around Thanksgiving or Christmas dinner.” And what you say to them is “You’re very important person,” and what you’re really thinking is “because we haven’t figured out how to get rid of you.” But what you say to them is “You’re a very important person and you’re here every year and we don’t know what people have gone through.

We don’t know whose kids are ill. We don’t know whose kids have school problems, behavioral problems. We don’t know what people have cancer in their family and so what I would like to do because you’re such an important person is when you come over, I would like you to be kind of almost like a co-host. I would like you to go over to people and just say, “Hey, it’s nice to see you. Can I get you a drink or how’s your year gone?” but I would like you to be a greeter or a co-greeter and I really could use your help with that.” Now, again, this is something in a future and they’re unlikely to say—the worst they’re going to say, “Well, I don’t-” in a grumpy tone on the voice, “Well, I don’t know if I can do that.” That’s the worst they’re going to say.

They’re not going to say “I don’t think I can do that because I was planning on spoiling it like I always do. That’s my gift to the family.” And so, it’s unlikely that they’re going to say anything more negative than “Well, I don’t know if I can do that.” You can say, “Well, do the best you can and I’d really appreciate it.” And then when the holiday dinner comes around, make sure that when they arrive you go over to them. And I’m sort of a toucher–if you’re not a toucher, don’t do this—but what I would do is I would touch the person lightly in the shoulder and say, “It’s really good to see you. Remember that thing I asked you about a month ago about kind of being kind of a co-greeter/co-host? I really could use your help because I get a sense some people have not had the best year and it would really mean a lot to me if you could do that.” Now, they may not agree but I think that’s a way of helping them feel respected and important. And if we go back to the doctor by giving them information ahead of time as opposed to expecting them to be able to be the index medicus all in front of you when you throw them three questions that they don’t know the answers to, I think it’s being respectful when you talk to people about something happening in the future. So try those tips both with your doctor and with your challenging relatives and friends for the holidays and I think you’ll be able to stay on your diet.

MELISSA: Yeah, well, another big stumbling block—that’s great advice and I think a lot of people maybe aren’t changing their health or having trouble with relatives at holiday dinners can use those tips—but one of the biggest problems that a lot of people face and I hear from people responding to different podcasts we’ve done in the past, and it’s a problem I face but was able to finally overcome it after years of not doing it, but is just repeating, as I said in the beginning, repeating past behaviors and not realizing that, in other words, the fitness and health and diet industry have sort of drummed into us that a new diet and a new exercise program are the key to what’s going to change your health, what’s going to help you lose weight, whatever. And it’s always the latest diet, the latest exercise program that’s going to be the key. And to my mind, it’s doomed to fail unless you change your relationship with food, number one, you realize that food’s not the enemy. It’s actually the thing you need to help you change and improve your health, and if possible, lose weight as well. But also, that killing yourself on a calorie-restricted diet and a huge exercise program is only gonna, as you said, make you feel that you need a reward and so therefore you have to break the diet or break the current eating plan.

DR GOULSTON: I think that’s absolutely true and you’re just triggering something else also. One of the things that I talk about in “Talking to Crazy” is how our personality develops and there is some charts in there that people find very helpful and really when we’re children and we’re facing the unknown, we basically look back at our parents or the people who care about us and there’s four kinds of responses that people can give to us. They can be critical of us which can often turn us into criticizers and blamers, they can be preoccupied with themselves because of depression or they’re overwhelmed and they can ignore us, so that makes us feel alone. They can coddle us which kinds of spoils us, and if they do too much for us, then when we face the world, which doesn’t go along with that, that stresses us out and the best is they can be supportive of us. And what supportive means, and this is the ideal thing and sadly not that many people got it, but when you were in pain and fear growing up, what you really needed was a focused, comforting warmth and that can come from a mother or father, but you know we more often associate that with a mother, so when you’re in pain or fear, you want that focused warmth, you don’t want a solution initially.

And then what you want is focused, encouraging courage from another person, and that could be a mother or father, but that’s someone who actually focuses in with so what happened, tell me what happened as opposed to just saying, “Oh, you’re fine. You’ll do great.” And when you don’t get those things, it creates a gap in you. And this leads to, I think, one of the things that I use to help me not engage in a self-defeating behavior is I picture my mentors, I’ve had six mentors, they’ve all passed away, and whenever I’m frustrated with someone else or myself, I picture any of my mentors smiling at me and suddenly, I just look at their smiling face and I just feel their overwhelming love for me and they’re believing in me. And it’s interesting, instead of feeling like the world or another person has taken a chunk out of me, I immediately imagine my mentors and I’m overwhelmed with this feeling of gratitude and even blessed that they cared about me, and something in “Talking to Crazy” that I often use them to and people will, what I might be able to do is actually send you the PDF, but there’s something called the “eight-step pause,” and the eight-step pause is a way to walk yourself away from acting on an impulse and making things worse and it’s actually a whole way of walking you through your mind and brain to being more rationale. And it works for me when I picture one of my diseased mentors as asking me these questions. So here’s the eight-step pause. The first thing physical awareness.

So it’s all different types of awareness. And the physical awareness, and again, I imagine my mentor saying this to me, what are you physically feeling right now because often when we’re stressed out we feel it adds a physical sensation. And the importance of doing that is because we’ve succeeded already in the exercise. And then the next thing is emotional awareness, and so I picture my mentor saying to me, “Put an emotion on it.” What are you feeling? Are you feeling angry, sad, frustrated, exasperated, whatever? And when you’re able to accurately identify a feeling, it lessens your agitation.

The third step is impulse awareness. And again, you can do this with yourself but it works better for me when I imagine that loving mentor, and imagine them saying to me “And what does it make you wanna do? What does that feeling make you wanna do?” And then, in my mind, I think of the impulse and then the next step, step four is consequence awareness and I imagine the mentor asking me, “Well, if you do that, what’s likely to happen?” And usually when you give into an impulse, what’s likely to happen is I will feel good about myself for nanosecond and then I’m going to feel embarrassed and ashamed and I have no self-discipline, and then the next thing is insight-awareness, and the idea then is my mentor saying, “Now that you’re a little calmer, how might you be reacting to this situation and taking it personally when it’s not meant that way? What are the facts?” And so I’m able to explain what those are. Step six is solution awareness and imagine again that person saying, “So what would be a better thing to do right now?” And what’s interesting is if you do this exercise or you do it with your children, teaching them how to self-regulate their emotion, the better thing is having this conversation with you. I mean, you’re talking me through this. Step seven is benefit awareness. So if you do this thing, if you do that solution instead of your impulse, what’s the benefit? Well, the benefit is going to be, “My god, I’ll stick to my diet. I’ll exercise. I’ll feel good about myself.” And then the final step, step eight, is what we call “Let’s go awareness.” And that would be imagining that mentor saying to you, “Okay, so what are you going to do now?” Now, I know it seems cumbersome but what I’m hoping, Melissa, and what I’m hoping with our listeners as they heard me go through that, and again, I will send you a PDF of it.

MELISSA: Well, that will be great.

DR GOULSTON: You know, that people say, “God, you just walked me through an impulse.” You literally took me from my emotional brain, and I talk a lot about emotional brain and your thinking brain, and your fight-or-flight brain, and I think what most people will say is “you just locked me from my emotional brain away from shooting from the hip. You just got me back into my head. I felt less alone in dealing with my impulse, and you’re right. If I can imagine that loving mentor or relative walking me through it, you help me to feel cared about and I don’t have the impulse anymore.”

MELISSA: Yeah, I think that’s great. And also, like anything, if you practice this a few times, pretty soon the steps will be very quick. You’ll be able to mentally go through the steps. You know, the first few times you might have to look at your cheat sheet. But if you get good at it, you can probably go through it mentally without needing your cheat sheet and sort of have it take place in a minute.

DR GOULSTON: What’s happened to me is if you do this, and again, I like using people who have cared about me or who care about me, and taking that in. For me, it doesn’t work to way pro’s and con’s. When I’m feeling in pain, pros and cons are not very comforting. Thinking about someone who cared about me or cares about me works much better. Now, that’s just for me but it’s exactly what you said. Right now, I have these things so internalized about a mentor all I have to do is picture the mentor and think of myself saying to the mentor, “I’m so frustrated right now I just picture their smile and they say to me, “Mark, I understand, so now what?” And it’s all locked and loaded. I mean, I practice all the other things and in my mind, I guess leaning to their smile understanding me, and then when they say “so now what?” I go there.

MELISSA: And let me ask you a question that’s related to this topic of mentors because I know this comes up a lot for people that are changing, you know, making big changes in their life or decided to do something different than the way they’ve been raised or in sort of the path they’ve chosen to take, and now, they’re deciding a life change, and obviously changing your health in a major way is a big decision. What would you recommend about finding this kind of mentor that you’re talking about? Because I think that’s really an important point, and so many times people grab on to people on TV in the fitness and diet realm which may not be the best mentors. They may be actually directing them to an unsuccessful path.

DR GOULSTON: Well, I think what you want in a mentor is what’s most important to them is loving you and liking you in more than you’re being successful. My last mentor who passed away about a year ago, he founded the whole field of leadership. He was a guy named Warren Bennis. And if you look up Warren Bennis in leadership, he started the field and I had an anniversary reaction to his death. He died in July 31, 2014 and even though I’m a psychiatrist and I know about these things, I’d never experienced one before. And in July 31st of 2015, I felt something odd and I realized, “Oh, a year ago, he died.” And I actually wrote something on this because what I didn’t realize is that—and when I talk to mentors, I say, “You have the power to not only help people be successful. You have the power to heal people.” And what I realized is I had fought with this respect for me, such a respected person respecting me. I thought that’s what really helped me and I wish he’d been alive for me to tell him that was his bad metaphor that was icing on the cake. What I realized is he enjoyed me. And so when I saw him, it put a smile in his face just to see me as opposed to, “Well, let’s get focused on your regimen. Are you really staying true to that?” So for me, I think there’s a difference between, what we’ll we call it? I guess there’s a difference between a coach and a mentor. A coach is someone who helps you stay focused and holds you accountable. Now, for me, again, this is my makeup because I’m more of an empath, and I’m more sort of—you know, I’m in touch with emotions, I think a coach would be helpful but what I need is that mentor first. I need that person smiling at me when I’m about to not smile at myself because I’m about to do something that I’m going to regret.


DR GOULSTON: And so I would select someone in your mind’s eye because they can be deceased. And if they’re deceased, one of the things you should do is you call their next of kin and tell their next of kin what their father or mother did for you. It will make your day. So for me, I would select that person who believed in me and then superficially believed that I can accomplish certain things. But that’s what works for me because all my books, if you go read “Just Listen” or “Talking to Crazy,” my whole approach in life is how do you listen and connect with people from their inside-out. And I mentioned “Just Listen” was about having conversations while the other person feels felt. And when they feel felt, they feel safe and they relax and they’re grateful to you. And “Talking to Crazy” or talking to irrational people is, the key there is when someone is acting irrational, unless they’re really evil, there’s usually something else going on underneath their irrational behavior, and usually it’s fear, frustration, exasperation.

As we mentioned about the relative who spoils everyone’s holiday dinner, it’s they don’t feel important. Rightly or wrongly, the feel unimportant in the world. They feel forgettable and it has hurt them and the hurt turned into anger and getting even. And so my whole approach in “Talking to Crazy” is about leaning into the person’s irrationality, letting them vent, letting that go over your shoulders when they’re venting, looking them in the eye but not in an intimidating way, and after they vent, believing that there’s something underneath, pausing, when you pause, they’re going to get nervous because many times, they vent to manipulate you and they’re going to say, “What?” And you keep looking them in the eye and you say, “What’s really going on?” But you have to say it in an inviting way.

MELISSA: Right, not a challenging way.

DR GOULSTON: What’s really going on? Well, they’re just going to escalate and they’re going to go, “What?” And you could say, “I can hear how angry and frustrated you are even with me. But what’s really going on?” And I think if you lean into that and you hold on to their eyes because if you look into people’s eyes as opposed to avoiding it, and you keep looking, you will be able to see their fear, their anger, their hopes and dreams underneath it all, because it’s always there.

MELISSA: Definitely. Yeah, alright. We’re almost out of time but I have one last question because I know this comes up a lot for people, again, that are changing their behavior, deciding to embark on a new path for health, and that is you invariably run into the know-it-all, whether they—know-it-all or not, but it’s a very challenging situation because some know-it-alls may be friends of yours, again, some know-it-all’s may be in your family, but they can really sort of throw a wrench into the works if you have made the decision to go down a new path and recover your health. And the know-it-all then gives you a depressing lecture on a topic they may have—know nothing about.

DR GOULSTON: So here is a tip to use for the know-it-all, and there’s a term that I use in “Talking to Crazy” called “assertive submission.” And again, it’s a way of leaning into it. So the key is when you’re with a know-it-all, know ahead of time that they’re always going to behave that way. So even if at the beginning of the conversation they’re acting that way, just always expect them to bring that know-it-all behavior, so you’re not blindsided by it. And so what you want to do is when they start to act like a know-it-all, within about ten seconds, you literally, if you were them, you put your hand up and just sort of a signaling motion say, “I need to stop you because I need your help.” And that’s the assertive submission, they’re going to say, “What?” “Yeah, I need to stop you because I need your help.” And they’ll be able to say, “What?” And then here’s where you let them off the hook even though you don’t want to, you could say, “I have a feeling that you have the best intentions for me, but when you speak to me the way you’re speaking, you trigger flashbacks in me. And you trigger flashbacks of people who didn’t have the best intentions for me, and I get all messed up in my head listening to you. And so I really need your help because I believe you have the best intentions, but if you can take a deep breath and take it from the top, I don’t want to miss what you have to say and I am not because I’m just having the strong reaction and I think it’s about all those people in my life who kind of talked to me in the way you’re talking to me, and they really didn’t have good intentions.”

MELISSA: That should sort of stump them.

DR GOULSTON: That’s amazing Jiu-Jitsu because a lot of times underneath know-it-alls are people who also don’t feel they’ve been respected enough. They don’t feel important enough. And so, again, you’re telling them that what they have is really important and you don’t want to miss out on it. And by the way, there’s a lot of truth in that, what I just said, it’s not just the tactic, a lot of the reasons we react to know-it-alls in the present in a negative way is because we were powerless and defenseless against know-it-alls in the past who really hurt us, who didn’t care about us. And what happened is we barely got through those times in our childhood and we said, “When I get older, never again am I going to let someone speak to me this way.” And then when the know-it-all in your present talks that way, voila, there’s your chance to keep your promise.

MELISSA: Great, great. Well, great advice, Dr. Mark. And we’re almost out of time here but I want to let you tell people where they can find you online, your website, and any other sites you have where people can get more information.

DR GOULSTON: Sure. My website is www.goulstongroup.com and our tagline is “We create ‘Gotta Have it.” And so, what we try to do is help organizations and companies and perhaps even people like you with your listeners create “gotta have it” in your potential clients and customers, because when you create “gotta have it,” you don’t have to persuade them.


DR GOULSTON: They say-

MELISSA: They gotta have it.

DR GOULSTON: And what they say is, “I can’t believe what I just heard. I gotta try that.” And I think we’ve shared some tips hopefully that people will say, “I’ve never looked at people that way. I gotta try that.”

MELISSA: For sure.

DR GOULSTON: And so the Goulston Group’s all about that and you can find me on Facebook. I have two sites, the personal one is Facebook.com/MarkGoulston. But if you go to Facebook.com/DrMarkGoulston, I have a personal mission, actually have trademarked this term, and this is what I like to do for the rest of my life and maybe get some support. And my personal mission is healing the world one conversation at a time because my belief is if you can teach people to talk with other people instead of over at and even just informational to them, if you can teach people how to talk with another person, and if you have people practice it once a day with a person, it will change the world.

MELISSA: Yeah, I would think it would. And I wanna mention to that you have, in addition to the books you’ve mentioned, you have a book on PTSD and some other books. And also, you were involved in training hostage negotiators, I believe, so you’ve got quite a big spectrum of information that can help people in all different situations. But we’re going to put links in the show notes to all your books, and also to those sites you’ve mentioned so people can go and visit and we’ve only scratched the surface, so I hope down the road we can have you back on.

DR GOULSTON: I would like that. Do I have a moment for a stay tuned?


DR GOULSTON: I’m at the stage of my life, Melissa, where I’m asking myself what was I born to do? I think there’s three stages in life when you’re early on in your career, it’s about what you should do. That means—that’s developing credibility. Are you just a rebellious person or do you do what you should do and do you keep your promises? And then if you do that, the middle of your life is what you could do and that’s how you bring all your skills and potential together to really sort of maximize the effectiveness in your life. I’m at the stage of my life where I’m focused on what I was born and meant to do and I feel blessed because I found the project. So what I would like everyone to stay tuned for, I am the expert minor co-author of a book called “Inside the Mind of a School Shooter.”

MELISSA: Oh, yes.  I should mention too that people may have seen you, in case they’re not placing your name, but you’ve been on major television news.

DR GOULSTON: I was on CNN after the Oregon shooting and what’s happened is I’m working with someone who’s a 40-something person who 25 years ago had guns placed in his high school, a thousand rounds of ammunition and he was all set to shoot all the people who had done him wrong, including the high school administrators who ignored it. And then he had a life-changing experience and he didn’t. And he told nobody except his wife. He actually graduated at police academy, but police work was too violent and he had learned how to forgive everybody. And then he became a prison guard and all the riots were too violent, and so he then went into construction and he developed so much empathy for the prisoners building things in the prison that the pain of these, what he thought were decent people was too much, so he’s in construction but his wife has been telling him, “You have to write a book on your experience.” And in the book, it’s his story of going from bullied to homicidal rage and in each of the chapters, I add input to parents if you’re worried that your child might be feeling some of this stuff, this is how you get them to open up. And if you’re that teenager who doesn’t know what to do with your rage, this is how you get your cry for help heard. And as I said, I feel like I won the lottery in terms of my purpose in life because this will save lives.

MELISSA: Yeah, I hope that this will be available as widely as possible because I think this is one of—as people know, this is the most, the highly-debatable topic that keeps surfacing every few months, one or more of these incidents occurs. And people are so quick to gloss over what the cause is and what’s bubbling up under the surface that’s create this, and placing easy blame on all these areas which may or may not relate to it. So I think it’s really important to get to the bottom of it and find out how we can hopefully resolve this and make sure that we don’t have these incidents going forward, or at least try to minimize them.

DR GOULSTON: Oh yeah, and if not every few months, I had the major author, I said, “Do a search for school shootings.”

MELISSA: Every three years.

DR GOULSTON: No, and I think in the last several years, not even that many, he found 174 school shootings.

MELISSA: Oh, okay. Wow.

DR GOULSTON: But what happened is if you only kill one or two people, it doesn’t even make the news anymore. That’s what’s come to it. It’s awful.

MELISSA: I know. And I think it’s getting to the point now, I think we’ve almost reached the numb point for the general public, so unless you live in a community where it happens, you’re like just passing it off and say, “Oh yeah, another one of those. We gotta do something about that, but I don’t know what to do so I’m moving on.” It really has. I remember when these incidents first began to happen, it was so out of the normal, usual realm of things that people were completely blown away by it, not to use that pun there, but they were just really upset and there was massive coverage that went on and on and on for days and weeks. And now, it’s like, “Oh, it’s another one of those.” And I think that’s really dangerous in my opinion, when people are beginning to get numb to events like that.

DR GOULSTON: No, I feel badly for our President because you can see he’s deeply affected by it but he almost looks shell shocked.

MELISSA: I think that’s frustration. I think-

DR GOULSTON: Absolutely.

MELISSA: -people are crying out for an easy fix, as usual. And there isn’t out. I’m pretty sure you would agree with that. It’s not a simple “flip the switch” and this will solve everything. But that’s what people want because they don’t want this kind of thing in the news all the time, or they don’t want people dying all the time like this in this tragic way, particularly in schools, and particularly in the many cases where it was small children that were affected like this. But there isn’t an easy solution unfortunately. But hopefully, your work will provide a new path for this.

DR GOULSTON: I think there is a simple solution, but it’s not easy because people need to practice it. And I think what that is when you’re dealing with someone who’s angry, or even someone who has hate, unless you believe they’re evil through and through, engage them in a conversation and keep talking to them until they’re talking from the hurt underneath it. I am blessed because one of my close friends ran the Marines in the ‘90s who had a transition program in 2006-2008 for Marines. And the most important thing that Marines got out of that two-week program was their hour and a half with General Marty Steele. And I asked him, I said, “What did you talk to them about?” And he said, “When you’re a Marine, you’re a Marine for life. So I would meet with these more men than women, and I’d say, “Marine, what’s going on?” “Well, sir, you know, I’m back from, about to be back from the war, and it’s kind of frustrating getting things together.” And he would just say it four times. “Well, what’s really going on?” “Well, sir, there’s some communication problems with my spouse and me.” And because he was steadfast knowing there was something else going on, he said after about the fourth question, he said, they would look him straight in the eye because he’d look them straight in the eye, and some of them would say, “Sir, I saw and did awful things and I don’t close my eyes often, Sir, because when I do, I see them more clearly.” And then he gave them a direct order, he said, “War isn’t pretty. It’s necessary, but it’s not pretty. And I’m giving you a direct order to put all that aside because we all saw and did those things. And you have earned the right and your family has earned the right to having a wife, and that’s an order, Marine.” And he got so many letters from spouses saying, “You don’t know it, but you just saved my husband’s life.”

MELISSA: That’s amazing.

DR GOULSTON: So I think that the point is your intent. And if your intent is if you really believe that underneath most angry people is frustration and underneath frustration is disappointment, and under disappointment is hurt, and if you can just take the time to listen into it and for it, it’ll reveal itself.

MELISSA: That’s amazing. Now, is this program for the Marines, is it still ongoing?

DR GOULSTON: No, what happened after 2008, it was privately funded. The stock market, everything crashed, so the private funders couldn’t do it and so General Marty Steele is now at University of South Florida in Tampa and that has one of the largest veterans transition initiatives in the country and so he oversees various partnerships from veterans to other resources, and so that’s his current position. And I’m sure he’s integrated some of what we learned in the transition program. But again, you know as well as I do, the world’s in a rush. The world doesn’t have time for the pain.

MELISSA: Right. Today, my biggest pet peeve is the mindlessness that technology has delivered which makes everybody have the shortest of short attention spans and again, crave a quick solution or quick reward for—

DR GOULSTON: Well, we live in a connected world of people who don’t know how to relate to each other.

MELISSA: Exactly. Technology has only made it worse which is frustrating in it of itself. But I think you have to take a break from technology. I’m a big fan of that. I mean, I love my technology, but I think you have to take at least a day, if not two days, and go technology-free. Or what I call screen-free. So no screens for at least a day. You can got to a movie outside of your house, let’s put it that way, to a movie theater. But other than that, no screens for 24 hours.

DR GOULSTON: Well, something I’ve told people, and this will change your life, I’ve said once a day—this is not just talking with people—once a day, give people power thank you from your life, past to present, send them an e-mail and say, “This is long overdue.” And that could be the kind of person who guilt trips you, and a power thank you has three parts, you thank them for something they did, the second part is the effort for them to do it. You don’t have to do that but you went out of your way for me. And the third part of a power thank you is what it means to you and when you’re giving the third part, you’ll be emotionally-touched and then so if you could do that every day, maybe give yourself a weekend, and here’s the other thing, if you can give a power apology once a week to someone.

MELISSA: Ooh, that’s a hard one.

DR GOULSTON: Well, I’ll tell you. It’s amazing the power of an unsolicited apology. I mean, to reach out to someone and say, “I’ve been shying away from this because I feel embarrassed, but I owe you a long overdue apology for something.”

MELISSA: Yeah, that’s good. That’s great. And the power thank you, let me add a little part to that. I think what used to be a power thank you was a thank you written note back in my day. And I have used that to very good result in people, such as yourself or someone may have not known well that has done a favor for me or has done something for me. I have sent them a very illegible, I must say, in my handwriting thank you note, and received back amazing gratitude from them and a claim for taking the time to do a handwritten note which I would say is like four lines.

DR GOULSTON: That is so true and you’re write. A handwritten note, in fact, in my office, I’m staring at one that I received because I created a program, co-created a program on listening for the Canadian Management Center which is their big management organization, and I’m going to save this card forever because everyone in the organization thanked me.

MELISSA: Yeah, nice.

DR GOULSTON: It’s a keeper.

MELISSA: It’s a keeper, yeah. But that used to be a regular practice back in the day and it’s so unusual now in our electronic age for someone to receive a handwritten note and as I said, all it needs to be, you can get the cards at the card store in the supermarket, a thank you card, just a plain piece of paper where you write the “thank you,” pretty powerful, I would say.

DR GOULSTON: There’s a church I attend, because I love the pastor and they give homework assignments-

MELISSA: Oh great.

DR GOULSTON: And about a month ago, I thought this was a brilliant homework assignment. What they said is go out and buy, you know, don’t spend that much money, but buy a hundred thank you cards that are blank inside, and write inside them “Thank you, you make a different in the world.” And always have them on you and you give them to police officers. And you walk away, you don’t watch for them to read it. And it’s in an envelope and you know, just a little thank you note. And you give it to police officers, you give to bus drivers, you give it to people who—firemen, but you always have them with you and I thought that is brilliant.

MELISSA: That is brilliant. Yeah, it makes you feel good. It makes them feel good. Yeah, I think-

DR GOULSTON: Oh, absolutely.

MELISSA: -very cool. Alright, Dr. Mark, well, we’ve kept you on here for much longer and I know you’re super busy. But as I said, we could definitely carry this conversation on into many more areas that you’re expert at. So I hope you come back sometime in the future.

DR GOULSTON: Well, it was your fault because you were a good listener.

MELISSA: Thanks so much for that credit. But we’ll see you I hope down the road and good luck with your books and your latest book, and all your other books. As I said, we’ll put links in the show notes and we’ll look forward to talking to you again soon.

DR GOULSTON: Yes, when the “Inside the Mind of a School Shooter,” when it comes out, we’ll do this again.

MELISSA: Okay, very good.


  1. I just wanted to stop by and thank you for yet another GREAT episode. Im so thankful for podcasts like yours, you keep it so real, keep such a variety, and touch on so many topics

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