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Guest: Dr. Blair Steel

Release Date: 3/28/2022

Welcome to Trulyfit the online fitness marketplace connecting pros and clients through unique fitness business software.

Steve Washuta: Welcome to the Trulyfit podcast where we interview experts in fitness and health to expand our wisdom and wealth. I am your host, Steve Washuta, co-founder of Trulyfit and author of Fitness Business 101. In today’s episode, I speak with Dr. Blair steel. You can find her at Dr. Blair psi d on Instagram. She is a licensed, licensed clinical psychologist. And she tells us about the scope of practice in comparison to a psychiatrist and the credentials that she has. We go over addiction, which is one of our specialties.

We talk about other mental health issues like depression, and anxiety. And some issues that I was not aware of were not vanity-based issues, but control-based mental health issues. It was a great conversation. And I think it’s important not only for the general population to know a little bit more about this, but also, obviously for people in the fitness and health industry who have clients who potentially have these diagnoses.

And knowing a little bit more about these can do a lot of service for us when helping our clients along their journeys. It was a great conversation I had with Blair. I’ve known her since I was three years old. It was fantastic catching up, and I hope to have her on a podcast down the road to discuss other mental health issues. With no further ado, here is Dr. Blair Steele. Dr. Blair, thank you so much for joining the Trulyfit podcast.

Dr. Blair Steel: Thanks for having me.

Steve Washuta: Why don’t you give the listeners in the audience a little background on who you are and what it is you do in the health world.

Dr. Blair Steel: Okay, so I am a licensed clinical psychologist. I’m OSI D. And we’ll talk more about what that means exactly. But I’m, I live in California from New Jersey, as are you and moved to California about 15 years ago and got a Master’s in Counseling Psychology. I had already had a bachelor’s in psychology and philosophy in New York City, anyway, came west coast and really didn’t know it even at the time that this was a huge mecca for mental health.

In the treatment world, especially for work a lot in addiction, I did a lot of my clinical training in treatment centers, I’m working with dual diagnosis, which means a substance use disorder and a mental health disorder, they tend to go together, right if we especially if we look at substance use as a symptom. Um, that’s that I’ve been licensed for. Just over two years, I’ve maintained a private practice the moment being licensed. And yeah, my mother of two.

Steve Washuta: and full disclosure here, Blair and I have known each other our entire lives entire live, since we were running around in diapers together. It’s exciting for me to do this, because I don’t always get to do these things with, you know, people who have good things to say, but also that I’ve known my entire life. I want to go back to something you just said, because I had never really thought about this. But is it just because of the weather? Specifically? Or is it because of the the type of population or the there’s more physicians out there? What Why is there such a, like a large clinical setting for those sorts of things in California?

Dr. Blair Steel: Great question. I think a lot of it does have to do with the weather, which seems so just whatever. But truly, um, part of mental health and wellness is leaving, where you’re from, where your family or support system, and if you’re going to do so why not do it in a place where you can engage in hiking, outdoor activities, there’s so much evidence showing how sunlight and physical activity being connected to nature, you know, an ocean view makes me smile, for sure.

And so yeah, I do think it is very much like that. And there’s also a cultural influence in California, I feel like has been talking about self-care, kind of spearheading that conversation in this country. Coming from the northeast, you know, I still struggle with self care being like, just go to work, you know, or get over it, or whatever, you know, put it strap up your boots and just figure it out, because of the clock’s ticking.

Steve Washuta: Yeah, and I don’t know if it’s a northern thing, or like a population thing, because we’re so like, where we grew up is the most populated state per square mile. I feel like you’re always fighting for something I’m fighting to, like, weave into traffic, I’m fighting to be first in line because I can’t wait and there’s like, go, go, go, we have to get it. That’s great. Because of that, unfortunately, people aren’t as nice because it’s just that’s just the way of life. So

Dr. Blair Steel: yeah, I heard a funny thing when I first moved here that like, people in California might open their arms to everyone, this is such a generalization. Okay, so just whatever for this to give you an idea that they might open their arms to everyone. They can’t really, you know, wrap up all the way around, we’re seven in New Jersey’s not going to like open their arms to just anyone. But if you’re one of their people, they will wrap around you so hard, watch your kid, move yourself, but show up for you whatever you need, but a bing, bada boom, we are there.

Steve Washuta: I do think that’s the case. And I’ve seen that with like, even cities like Chicago, and I don’t know what it is, I don’t know if it’s, you know, I hesitate to say it’s like, the Italian Irish thing, I really do think it’s maybe just more of the, we, once we trust you, you’re in. Yeah, we love you for life. But we’re, we’re in a rush. And we got to make sure that you’re on our team, and you’re helping us get to what we need to do.

Dr. Blair Steel: Exactly. I would imagine that has something to do with it

Steve Washuta: is the you you touched on it briefly. But then you go into depth on the differences between your degree and you know, a psychiatrist and psychologist and the different levels of them because the general population just doesn’t know.

Dr. Blair Steel: Sure. So psychiatrist is a medical doctor, a psychiatrist has gone to medical school can prescribe medications, okay, so they’re in a league of their own. And in fact, um, anytime someone’s really presenting with a mental health diagnosis, that requires any sort of Psychopharmacology, anything, it is crucial, that individual be referred to a psychiatrist, the medical doctor, okay, so there is an importance of staying in your lane, so to speak, in this field, and knowing your scope of practice working within it. And if something presents that’s outside of that, knowing when to pass the baton so to speak, and even better sign a release of information that would allow some collaboration between providers is really can help treat the the whole person is you’re

Steve Washuta: sorry, it started rough, but as you’re like, patient experience, typically people who seek you out or or are you referred by another physician or somebody else in the medical community?

Dr. Blair Steel: Yeah, so I have been referred, having worked in treatment centers, upon discharge if someone’s completed treatments successfully. So in other words that left against medical advice, but has really, it’s deemed safe to be treated on an outpatient level of care. I’ve received many referrals, almost all of them from treatment centers that I’ve worked in. Gotcha.

Steve Washuta: Yeah, it’s interesting to know, like, how that’s interconnected, I know. Yeah, from from my wife, as a pediatrician, that’s, at least here, where I’m where I’m located, it’s difficult to find people who do what you do, especially on the pediatric level. So people are waiting, sometimes months, to see somebody before they before they get in, and you don’t have the option to see a psychiatrist. And even if that’s what you have to do, so then they’ll send you somewhere else. So do you get what you would say, like overflow as well?

Dr. Blair Steel: Sure, well, you know, especially when it comes to substance abuse, you’re really dealing with a level of safety. So so it’s there’s some real critical and medical necessity for someone to be in an inpatient versus outpatient level of care. So this is unique in that sense. But even you know, you mentioned child psychology, I’ve had worked with someone who said, you know, I’d really love my 15 year old to work with you, and I just don’t do kids. Yeah, and then especially like, so a teenager could have some, some, let’s see, challenges that we might be able to address in an adult manner.

But still, that would be me staying in my lane and finding someone to refer to. But then imagine what an eight seven year old that kind of clinical intervention is so unique and and delicate and not to be practiced flippantly. Right, I’m not gonna like open a manual about how to work with that position. Yeah, because they’re few and far between it can be really frustrating to find someone.

Steve Washuta: Yeah. And I imagine not just because of the actual sort of psychology, the mental side, but because of like, anecdotally, it’s good to have seen a certain amount of a type of patient because things repeat themselves, right? So if you’re seeing these patients over and over and over, you have a little bit more anecdotal data on how to deal with things but if you don’t see kids then then you’re not you’re not going to have that necessarily. Sure. But you know, in the in the personal training world, unfortunately, it’s funny the higher you go up, it seems in education, the more people stay in their lane.

And the more they understand like no, this is this is only what I do. My wife is the same like she’s She She refers out all the time, but in what we do in the certification level stuff, people think they can do everything right. It’s like I want to lose 30 pounds I have you I want to gain 30 pounds I got you I’m gonna go up on stage and body build I have you so I try to work with personal trainers to say eventually if you really want to be effective you have to niche out and start to learn about one particular thing so that you see it over and over and over and that you can help people.

Dr. Blair Steel: Absolutely. And even ironically, so in the mental health field, the lower the degree, the more critical of cases you’re dealing with. When I had a bachelor’s in psychology, my first job in New Jersey, was dealing with dually diagnosed adults, which was not just substance use disorder, but mental health, I’m talking severe schizophrenia. Major, major mental health diagnoses with minimal training. And it’s, it doesn’t seem it seems kind of backward. counterintuitive, that’s for sure.

Steve Washuta: Yeah. Yeah, for sure. You mentioned addiction. That’s one of your specialties that you work in. Mm hmm. That’s an umbrella term, obviously. But you know, does the clinical community or you, you can speak to yourself, if you think differently than than the community see all addictions as somehow interconnected. And I could just expand on that a little bit. If I’m addicted to gambling, and Bob is addicted to alcohol, do we have some sort of inter inter issue connection? Or are these things completely separate?

Dr. Blair Steel: Sure, I would say there’s an interconnection, I would say that really to simplify it, it’s like outsourcing our self regulation. So it’s using something outside of us to regulate some sort of internal process. So that could be gambling, it could be shopping, that could be sex, that could be food, any process addiction would fall under that, right, it’s serving some sort of function, whether it’s to feel nothing, so that could be more of your numbing. It could be to feel something, some people want to feel something they want to thrill.

So even within gambling, actually, my first internship, I’m at an amazing facility in LA called beta shuba. Had a gambling program. Even within the gambling, they tend to separate the action gambler, which tended to play craps. More stimulant drugs, escape gambler, who was kind of like, what we were seeing was like middle aged women who would sit behind that slot machine for hours. The casinos could play on the loneliness that might come with empty nesting or with whatever that could be going on during that life stage. They’ll repeat your name Welcome back Patty, and have a whole different function. Within gambling in and of itself.

Steve Washuta: Yeah, that’s really interesting. I, I had a period of my life where I was sports, gambling, I don’t do it anymore. Not that I was considered addicted by any means. I started enjoying the sports less when I wasn’t gambling on them. And to me, that was that was the issue. It’s like, okay, I’m at this game. And like, I can’t bet on it. It’s not as fun. So I just, I just saw that that could potentially be a problem. And pretty much just cut it out cold turkey. And so this is this is not worth it. Because I’m not enjoying watching sports and like, I don’t want to be at my, my child’s softball game thinking that I have to have $20 on booty.

Dr. Blair Steel: Right? Right. Well, you know, congratulations, you, sir. Not addicted. So basically, second bring us to what even like addiction is right or how it’s diagnosed, what are the diagnostic criteria? Because quantity of consumption doesn’t necessarily define addiction, right? We mentioned Italian Irish cultures earlier, and not even to throw out stereotypes. But in a way, there’s so it would be totally normal to have a glass of wine, seven days a week with food, whatever, in an Italian culture, for example.

So we wouldn’t be like how many glasses of wine a week do you have? But rather, Are there negative consequences in your life? For you, you saw something this isn’t fun. I’m going to stop. So if it started affecting people’s relationships, mood, ability to function at work, and increased tolerance, which would then for therefore, imply, like some sort of withdrawal if the substance wasn’t had, now we’re getting into real problematic usage. Right?

Steve Washuta: Can you be addicted to anything then because I can think of a plethora of things that would fit into that category like so. And I don’t mean like, just from the general sense, but I mean, actually diagnosed, so can I be addicted to video games? Can I be addicted to what’s gets into the next question? Can you be addicted to fitness?

Dr. Blair Steel: Certainly, certainly. And so that all of those that are not substance use would be called a process addiction in the DSM, the diagnostic manual. So that’s called a process addiction. So certainly all of those things. Fitness is one that you see people transfer so there can be for addiction. I’ve seen people stop drinking alcohol and then gain 50 pounds, you know if it goes to food or transfer to gambling, or, you know, I used to do heroin, I don’t I don’t touch the stuff. Um, but isn’t $30,000 worth of debt to do a shopping? Addiction, right?

So, so if the coping skills are not improved, right, so if there’s not insight into the underlying motivations to have this sort of behavior, then we can see it like the pressure level, just kind of like, it’s like whack a mole, you know, you hit run, and that goes down. But then something else pops up. Unless you’re doing more treatment for sustainable change.

Steve Washuta: Yeah, I’ve actually worked with a handful of clients. Again, it’s above my paygrade. So it’s not really like I could step in and say anything, but they were addicted in the past to something not immediately had come to me, maybe it was three years later, or even 10 or 15 years later, but you can tell they still had.

Again, I’m not trying to sort of pigeonhole anyone but an addictive personality, and they came into fitness, and they only wanted to do a, like, they need to run ultra-marathons, they couldn’t just, they couldn’t just take it easy, or they wanted to go up on stage and be a bodybuilder and had to take it to the next level. And I started to see some self harm in those areas to where they were doing all the wrong things to get to where they want it to be, and, and sort of masquerading it as health and fitness.

Dr. Blair Steel: Mm hmm. That risk is there. Right. There are certainly personality traits, as you mentioned, um, you know, especially in early recovery, if you think of someone who just came up with years of, of utilizing a substance outsourcing or self regulation, and now they’re just kind of they’re sober, they’re really interested in achieving and maintaining sobriety. Um, we know better than to think it’s like, okay, just stop it now.

Right. So in my opinion, if you were to use that transfer addiction and and direct it more towards fitness, in my opinion, exercise all day long. If that’s going to keep you from shooting fentanyl, which might not allow you to, you know, see the next day, then personally, I would, I would say, go ahead and do it. Now. That’s early recovery, not to mention, let’s say someone starts hitting hitting the treadmill, you’re going to start getting endorphins going. It’s an incredible treatment for depression. Because of that those positive neurotransmitters, it’s also an incredible treatment for anxiety.

So anxiety is an anticipation of a stressor, by getting your heart rate up and maintaining that heart rate, it can really help bring you back down to homeostasis, more balanced. So I say by all means not to mention self-esteem, right? People start looking better, feeling better. Um, there’s a lot of benefits. Yeah,

Steve Washuta: I’m with you. I mean, it’s, it’s the lesser of two evils, I guess you would say in that case, right. So you’re at least transferring it to something better. And, again, this is well above my paygrade. But maybe there is no opportunity for this person, or at least in a quick manner to get from where they are to, let’s say that the ideal perfectly mental, healthy lifestyle, so they, they need to have some sort of progression.

Dr. Blair Steel: And does that even exist? Probably not. Our ideas of perfectionism and the way people should be, um, really seem to be changing. I know, COVID has brought a lot of these conversations into the mainstream. What is normal? And what is this? And what is that? So? So in understanding the complexities of human behavior? Exactly. Now, you’re going to run into some risks, right? So let’s say someone starts utilizing performance-enhancing drugs that can get, you know, can be a whole different level of unsafety or even pre workout.

I’ve seen people in recovery just slamming this these pre-workouts and they can’t sleep and and, you know, so there’s, there’s some, still some caution to be around it. If someone’s running on an injury, that could be problematic, like if their bodies that their knee or something’s telling them to slow down and they’re not listening to that. I would say that’s where your coaching would come in. Right, and your expertise and your support.

Steve Washuta: I have a really good friend Chris Scott. He’s been on this podcast before and I guess he doesn’t call himself a recovering alcoholic but you know, from a general perspective, that’s what he is. And he focuses on sort of the the physiological imbalances that that alcoholics which I find really interesting because there is a lot of like, you know, if you’ve been drinking, let’s say handle the vodka every other day for the past 10 years, your body is now lacking certain things right? You have like your GABA beta stuffers.

We’re all off, you haven’t been sleeping well, and you’ve been obviously beating up your body, you haven’t been eating right, because a lot of these alcoholics don’t eat because they’re spending their money on that alcohol. So he focuses a lot on that side, which I find is really interesting. And I hope there’s down the road, there’s more more research put into actually helping to, not just the sort of, like, you need to find Jesus. But you also need to, like heal your body from the inside. 

Dr. Blair Steel: That’s right, hydrate, right? liver enzymes can be way off. Absolutely, I find, you know, I’m a data person, at the end of the day, I love data, I’m comforted by it. And there’s a lot of obscurity and things that are abstract with therapy, which doesn’t deter me at all. I’m all I’m ready to hop on that journey with people however long it might take. But there is something comforting about the measurable, the quantitative.

Steve Washuta: Sure. And I think too, I mean, if I was in that position, personally, I would want to know that this isn’t just like me healing myself through through like some psychological broken process, but that I could also either expedite it, or it’s sort of a 5050 thing, I guess there’s also something wrong with me physically, that I can help speed up this process, I just think that would be happy to know that this isn’t just me being broken, but that there are fixes there that are physiological that can also pair with my slow gaining back of that sort of mental psychological side,

Dr. Blair Steel:  totally. And then you can have great benchmark, benchmark workouts, you can see progress, really short term, attainable goals, whether that’s a few pounds down a few more pounds up on the weights that you’re lifting. So that’s nice, too, it can really create momentum.

Steve Washuta: Yeah. So on our health history forms, as personal trainers, we work with people. And I know, again, you’ve explained this on the front end that you don’t prescribe medication, you’re not right, you’re not a psychiatrist. But do you know of any? Or do you see any issues when people are, let’s say, off medication as opposed to on medication, things that you have to be like concerned with, even you even have to let us know from like a personal training standpoint, or like general population standpoint.

Dr. Blair Steel: Um, you know, medications affect people differently. So they really, really do. The one that I would really raise a flag with would be any benzodiazepine. So that’s your Xanax. That’s typically prescribed for anxiety when we’re talking like Generalized Anxiety Disorder. Okay, so we’re not talking like I’m feeling nervous about my job interview, we’re talking like, pervasive, disproportionate debilitating anxiety. That’s the person who would be prescribed this.

Even I would say, in the medical fields, people are much more conservative about prescribing than they were, let’s say, 20 years ago, maybe even 10 years ago, we see this in our culture, we see this opioid we see this commonly right, but benzos is one that I’ve just observed people a little lethargic, should not necessarily sharp, right? It also has a similar impact, it attaches to similar receptors in the brain as alcohol.

So um, so any benzo would be contraindicated for an alcoholic. So in other words, if someone has a propensity to get addicted to alcohol, any psychiatrist who’s aware of someone’s history like that, like they would not prescribe that medication. That’s the one that comes to mind. Um, as far as the antidepressants are concerned, it really would, would require a self report by the individual themselves.

Steve Washuta: Sure, yeah. And it’s good that you said that just know us as personal trainers, we have to do our own due diligence, unfortunately, yeah, I’m on hand so soon, like a health history form. And they’re writing all their medications out, we have to then go online, research these medications and see like, What are potential side effects so that I know if I’m working with a client, that something could be wrong due to the medication? So it’s interesting, I’ve never worked with anyone who’s on benzos.

But I would imagine, like you said, if it has that alcohol esque effect, where you’re more tired, then you have to be even more attentive when working with that client. Because you don’t know if they’re, let’s say, I don’t wanna say not paying attention, but the but the, the lapse in energy. Yeah, more subjected to injury so it’s something you have to stay on top of and not just that’s a that’s a part of our job.

That’s that’s difficult because again, it’s it’s well above our pay grade, but I and I’ve had issues with it in the past because some of the medications when we work past a certain point, let’s say if I’ve changed their lifestyle completely, Hmm, wow. Well, what I mean by that is like maybe they were sitting down All day long at their desk, and they never worked down, they ate like crap.

And then three months later now we’re working out three days a week, another eating healthy, and now they’re getting up for walks through midday, right? Everything has changed yet, you know, they might have, let’s say, their cholesterol levels are still high, or excuse me, their cholesterol levels have now lowered. But they’re on Lipitor or something, right? So like, the doctor says, oh, it’s the laboratory that’s doing and I say, No, it’s our lifestyle changes that are doing it.

That’s an issue that we have as personal trainers because we have to sort of fight that like, okay, is the work that I’m doing helping this person? Or is it the fact the medication is helping this person? How am I ever supposed to know if they’re not pulled off that medication? And I would imagine, you have that maybe issue too, if you’re working with someone who is depressed, let’s say, and they’re on, you know, antidepressants, and you’ve been working with them for two years. It’s like, well, how do I know if my work has been doing the the vast majority of the good? Or if the medicine has been doing the vast majority of the good,

Dr. Blair Steel: right? Right. But point is, if someone’s better, that’s all

Steve Washuta: that matters. Yeah. So what are some this is the fun stuff now. Okay. All right. What are some alternative treatments that are going on now whether it’s in you know, or experimental depression, anxiety, addiction that you find intriguing?

Dr. Blair Steel: I’m certainly intrigued by the psychedelic world. And definitely not the population that I primarily work with what I ever recommend that, but But outside of that, I’m certainly intrigued to know how perspective can really alter someone’s lived experience. But as I mentioned earlier, as a clinician, I love data, right? So there’s some really good stuff happening with technology, it’s on our side.

I’d mentioned earlier, there’s brain mapping, also known as neurofeedback, we’re clients are hooked up, I want to say it’s an EEG, don’t quote me on that. And you can see activity in the brain and parts of the brain that might be less active, let’s say in the prefrontal cortex, where you have executive functioning, so that would be your ability to to plan, play up the tapes and see consequences before they happen. Etc. Um, you might see low activity there and someone with a, a DD or ADHD, certainly effective for that particular diagnosis.

But part of the the issues that we face with whether it’s depression, anxiety is this arduous process of trial and error of what works, what doesn’t work, whether it’s the modality of therapy, so what I do, which is talk therapy, there’s numerous modalities and approaches to that. Okay, so there’s that, then there’s countless antidepressants, if someone decides to take that route, which works for me, um, one of the most impressive things that I’ve ever seen in my 10 years, so it’s really I’m kind of a novice still in the field, which is exciting is as a woman, right? The older I get, the better I’ll be, is the genetic testing.

You could do a whole blood panel to see which antidepressants are compatible with your genetic makeup, which is awesome, because let’s say it narrows down a list of 25 to 50 to five, okay, fantastic. With brain mapping, really, what they can see is responsiveness versus non responsiveness. Taking a medication or engaging in some sort of talk therapy, whatever, and there’s no change, you can pivot more quickly, then going about something and trying medication at different dosages, etc.

For six months, some of these medications then you’d have to like slowly titrate down. Which is like again, it’s frustrating and people not that a quick fix is the way to go. But the sooner the better. Right Let’s spare people if we can. Sure. Another awesome thing is called TMS. Insurance does cover it that’s another thing with neurofeedback because it’s so measurable and a short term treatment you’re more likely to have your insurance cover it great, right? So I’ve worked I was a program director at passages Malibu and I’ve worked at cliffside Malibu, these are pretty expensive places.

While it’s so wonderful to discharge someone with a plan, that includes regular acupuncture and breath work, and all sorts of providers and size and and psychologists, everyone, the average person can’t afford that. Right it’s it’s we need to find things that will be covered by insurance. Again, so cost effective time effective in These are some of the things that are coming up that I think are going to help a lot of people.

Steve Washuta: Well, that’s great, especially from, you know, we talked off camera about the sort of the subjective objective nature of some of this stuff. So it’s great that there have these tests, that you can really see if the medications working number one, because you can get on the other medication, that you need to be on quicker so that there aren’t issues. And then any, any medication, let’s say it’s a cancer treatment, when it’s targeted, and they’re doing the research, then we know you’re going to heal faster. So I think that’s, that’s great.

You know, speaking of what we’ve talked about before, the psychedelics you mentioned, I know that they’ve been doing a lot of work with people with PTSD, specifically in the military, both low level psilocybin, but also MDMA. And they’ve, they found great results, I know, for years overseas, and sort of like marriage counseling, in in the Nordic countries, they use low level MDMA for, you know, a lot of healing processes that seem to be successful. Then, I don’t read the data, I don’t, I don’t have these, these long form, things to look into. But as far as, again, just reading about the anecdotal stories and how it works, and how the, the practitioners who use them are really pushing forward, it seems like it’s just 510 15 years away from being the norm.

Dr. Blair Steel: Fantastic. And really, the way I operate is if it helps someone somewhere, by all means. Um, so there’s certainly some risk attached with those sorts of chemicals. But if it works fantastic, and if it’s done safely, beautiful, um, years ago, there was a study done out of NYU, with psilocybin, and this woman was a cancer patient, and really, really depressed, right. So the motivation to continue with our treatments was really starting to, she’d had a lot of hopelessness around that.

Participated in one of these kinds of controlled studies. For the first time, notice that there was even a plant in the room, she had been in this room several times didn’t even see the plants. It connected her to the world around her. Motivated her to continue doing the things that the medical doctors were suggesting, and the treatments that she was actually losing, losing motivation for. I literally have goosebumps on my arms right now, sharing that study.

Steve Washuta: Yeah, I mean, taking yourself out of your own body, so to speak, allows you to see things from afar and get away from those things. I know, I know, they have the similar research to people who were taking psilocybin to got over their smoking addiction. Yeah. Because of the same thing that you mentioned, where they sort of had this, this experience where they were sort of outer body for lack of a better term and said, I, I don’t need this, this isn’t me, this isn’t who I am. And one sees the self different from like a philosophical standpoint,

Dr. Blair Steel: perspective, you know, people with eating disorders, it can go from, well, disordered eating in general is eating with the mind, right? It’s not eating with the body, it’s you know, grains, and something like a psychedelic experience can help people differentiate between that and have the self love, and the self esteem to want to make positive change. You know, and we spoke on the phone the other day, and I had mentioned self esteem.

I feel like at the end of the day, that’s kind of what it is, right? When we have self worth, we’re worth the gym membership, we’re worth the physical go into the doctor’s one year just to just to be preventative and proactive about about whatever, we’re worth the relationship. We’re worth asking for a raise, we’re worth all of these things. So there any any path to that, by all means, in my opinion,

Steve Washuta: I’m with you. You’re, you’re preaching to the choir, and I tell, I tell a lot of my young personal trainers that I work with who like want to start a business, and they’re kind of worried about it, obviously, would you tell your significant other, that they don’t have the skills to do this, that they’re not worth doing this, that they’re not smart enough to do this, that they’re not capable enough to do this? Now? Why do you tell yourself that? Right? Right, you wouldn’t tell your partner that when you tell yourself that so like, critic, you got 100 to yourself.

And then also, like, as far as the physical stuff that you just mentioned, like you know, investing time self care, we we started the conversation talking about the sort of the self care thing. People just don’t do it. I mean, even like, my wife was like, I don’t want to spend She’s a doctor $18 A month on this gym membership. I’m like, I think once like you need like this is for you. You have to do this or else you’re not going to be ready to see your patients if you are not holding yourself and I think people need to.

I don’t mean this in a bad way, sort of like a sort of a course of use Cosman way used car salesman way but we need to pitch that to our general population as personal trainers and as medical professionals to say to other people, sometimes you have to pay and pay an expert to help you with your psychological side and your physiological side. To get you to where you need to go

Dr. Blair Steel: person, Mind Body Spirit. And this is where stuff like self care gets complicated. People can become paralyzed with guilt around that. Yeah. Yeah, totally. I mean, it’s so that’s where we’re the talk therapy. Then it’s like, well, who was modeling that. Who modeled that, that it’s one shouldn’t participate and act that actually doing so selfish was a message that a lot of us has received. And it’s worth exploration to see whose voice that was. Complicated. We’re complicated.

Steve Washuta: But it’s, it’s a blessing and a curse, double edged sword. It’s good to be our harshest critic sometimes. Because it pushes us to get to where we want to be in life. But at the same time, we have to look back and say, I’m only this age. I still have a lot more time to go or, you know, this is only one day. I think people and this works both in the fitness, business, and even in the finance world. Where people, you would never look at your retirement account every day, and be like, oh, there’s only 11,000 in there.

The next day, there’s only $11,003 in there, there’s only $11,006. And then the next day, no, you look at it once every six months, right? But we look at the achievements that we have on a 24 hour basis. And be like, You know what, I didn’t get enough done today. I’m a shithead. It’s like, no, it’s you can’t view everything from a 24 hour perspective, you have to give yourself a break. And look at things and that’s a big problem with weight. We have clients they want to hop on the scale every day, every other day, and view everything off of that particular number.

When it’s like listen, that’s its has to be more about how you fee. About how your clothes fit. It has to be more about your health and your labs. I always say health is in your labs, not in your apps, and all that. Yeah. And that’s that’s how we have to move forward. But it’s again, it’s it’s a it’s a difficult thing. I don’t expect people who don’t think that way to change overnight. They have to work with people like you.

And make this a lifelong concerted effort to sort of change the way their brain is thinking about these things. Right. Right. Do you we didn’t talk about this. But do you work? Or have you worked with people who would say vanity issues for lack of a better term. Whether that’s anorexia or bulimia or any of that stuff? Is that any? Have you dabbled in that?

Dr. Blair Steel:  Sure. I have. And I would say vanity is probably on the bottom of the list about what that’s about? Oh, really? Yeah, it really is. In fact, bulimia is there’s a lot more of dissociation involved in leukemia, bulimia is not really even an effective form of weight loss. I think there’s like an average of an extra 10 pounds on most people who are engaging in that sort of behavior.

Anorexia is a lot of dealing with control, perfectionism. I see perfectionism everywhere and so much with alcoholics, so much, there’s so much pressure to be perfect. And the split sense of self of like, I have a side of me that presents well, and I have the side of me that like, maybe, whatever it may be, doesn’t look a certain way.

Maybe he’s attracted to people of the same sex, maybe whatever it may be. And we hide that side of ourselves. But being we’re human, we can only handle that amount of pressure without needing something to to soothe. Yeah, so perfectionism is one of the things I see most frequently I see it across all socio-economic. All cultures, it’s, it’s there.

Steve Washuta: I wanted to ask you about and again, this is something else just popped in my head. We didn’t talk about this previously, but with social media here, and it’s here to stay. It’s not going anywhere. It seems like we have three personalities. Now. We used to just have the Steve that presented itself to at work, maybe with his colleagues, and then the Steve around Blair, and his friends.

But now there’s the Steve who’s online, right? The Steve who presents himself as as a character and we’ve seen it I’m sure we have mutual friends from high school, who like present themselves online as these people who who they’re just not right, like maybe they were never funny, but like they try to be the comedian online. Is this. You think this is an issue now? Are people like you dealing with this? Is it going to be an issue moving forward?

Dr. Blair Steel: I think it is. I really do. Certainly see it with young people. When I was working with someone this week. I’m an adjunct psychologist at oceanfront recovery and Laguna Beach down here in Southern California. And this young man who’s 20 said, I went off on social media two years ago, and my jaw like dropped, which made me feel like wow, maybe I made an assumption that the Gen Z is like 100% across the board obsessed.

Yeah, um, so that Put me in my place a little bit. But I also was like slow clapping, like how? Yes, okay, um, because of all the things of the FOMO of this, that and the identity, especially for people coming out of high school who went to college who didn’t? What that looks like when people start getting jobs or are having families. And a lot of the, the feelings that can come up when you see your peers doing things that you want to be doing, and appearing to be this thing, right. So I’m sure we’ll create this fantasy in the story about what we see. That is not helpful.

Steve Washuta: No. And I think people, people think they’re motivating people when I think the data’s out, that’s not the case. So if we were seeing, especially females, young females, I think, like three fold increase in self harm, we’ve seen suicide rates through the roof. Now, of course, some of its COVID. But it’s really a lot of it is the social media. burstner People have asked me before Blair, like, Hey, Steve, how can we never see any of your workouts? Like how come you don’t post your workouts, and I’m like, Well, again, this is gonna, this sounds, I’m trying to make myself sound good. And at the same time, I’m making myself sound bad, but like, you can’t do what I do.

That’s what I like, I don’t want to show you what I do. Because you’re not going to feel good. You’re gonna say, I wish I could do that you’re not going to be able to do the things that I can do. Some of it’s just genetic, right? Some of it are exercises that I’ve worked on for years to reflect my form to perfect everything I’m doing, does that show you a 32nd clip about what I’m doing? I don’t think that’s gonna make you feel motivated to do that. I think it’s gonna make you feel like shit that you can’t do that. So that’s why I don’t post the clips of you working out. And I don’t think that’s going to change. I think people lie to themselves and say, I’m just motivating my, my fan base. I think you’re doing more harm than good.

Dr. Blair Steel: Yeah, the statistics that came out with with young people talking like 12 to 15 was extremely disturbing. And I’m a parent, you’re a parent, I have two daughters, and I’m terrified, quite frankly, I really am. Plan. So when the bubble burst, I don’t know, maybe it’ll be illegal. By the time they’re of age. My girls are three and a half and one. But just briefly, my husband, I took our girls to this, this little lagoon, locally towards the end of summer, and there was a 12 year old birthday party happening. And we saw one girl take a picture of another girl in a bathing suit and posted and the girl whose picture was taken, flipped out. Like, like, take that down. And it had like a whole visceral reaction, and 

Steve Washuta: there’s no filter on it. And she didn’t get to see the picture. Right. 

Dr. Blair Steel:  And she clearly didn’t like the way that she looked in it. And it was it was really hard to watch. And it was very real. Yeah, it was real. There was nothing, a facade about her emotional reaction and response in the way it affected her. So it’s terrifying.

Steve Washuta: Yeah, yeah, I don’t. I don’t I don’t have an answer, either. It’s terrifying. I’m hoping that things sort themselves out between now and then. But it’s probably unlikely. So us as parents just have to do a better job of

Dr. Blair Steel: Right, exactly. And we’re adaptable. You know, we’ve always been adaptable. Um, I had to renew my license and do all sorts of psycho Ed stuff, and which ones are being fun, expensive, of course, but fun. And they were going into the history of technology. And even when power steering came out, everyone’s like, no one’s gonna know how to drive anymore. Oh, like, who cares? Okay, it’s totally irrelevant. We adapt. Um, so I think we just need to stay really privy to what’s going on. Right and, and keep our awareness up and and pay attention.

Steve Washuta: Yeah, I’m with you. You know, the I’m, I’m going to be on a podcast soon talking with someone she’s a registered dietitian, about vanity versus health. It is a big issue, just, you know, sort of like we’re briefly touching on now is that, you know, people are masquerading what they’re doing in gyms and with their bodies as health when really it’s just vanity right. So the the, some of these people are healthy, they’re actually doing it as health.

But health is a secondary effect of the vanity as opposed to vanity being a secondary effect of the health. And that’s really what I’m concerned with, with with the social media as far as like, I’m inundated with, obviously, a non targeted by the social media with with fitness based things. So I’m seeing these things all day long. And I know that if I’m seeing them all day long, then all these other fitness people are seeing them all day long.

And I hope that they start to see them as I do or start to tell themselves like, this isn’t real. These are all filters. Everyone doesn’t look like this. There’s more to this. And I don’t I don’t want my daughter involved in that. I don’t know the answer. Maybe the answer is don’t let your kids on social media until they’re of a certain age or just explain to them that this isn’t real life. Right?

Dr. Blair Steel: Right now Play just doesn’t have as much value.

Steve Washuta: So clinical guidelines taken away, okay, Blair can do whatever she wants. Ah, it’s it’s, they’re all taken away in America. Okay?

Dr. Blair Steel: No, there’s no law abiding board, nobody to answer to

Steve Washuta: nobody the answer to you’re not going to get in trouble there, you have you have one change to make, what would you change what would help the either the population you currently work with, or someone else that you can think of that as dealing with issues within your realm that you think could could make a difference that is just not there, due to some like regulation,

Dr. Blair Steel: I would have to go, um, and we’ve touched on this a few times already today would be the strict HIPAA regulations, right? If I could keep in contact and have collateral information from someone’s personal trainer from someone’s loved one within reason, never, never a perpetrator, never someone who’s harmed an individual. To see the whole person, I think it would be really effective. I’ll give you an example working in treatment and that treatment centers, my favorite part about it is that I get to work with a team I get to private practice is a pretty isolated relationship between a provider it really is and not only do not talk to people, but you can’t. Now the people that I work with at the gate, I do share that I love talking especially to a psychiatrist like I need to.

So I will request that someone sign a release of information. So and and let them know it is only out of your benefit. And I can even keep you posted on any correspondence. And if someone’s unwilling to do that. That actually is a boundary that I would set that we I I can’t work with someone who does not want me working with a psychiatrist because now I’m confused. Right? To see what that would be about. Maybe there’s some medication seeking that the person hasn’t disclosed to me.

Yeah. But like at a treatment center, for example. You’ve got a whole team psychiatrist, psychologist. Even so people on the ground level that are seeing the clients, individuals, from the moment that they wake up. So there was one client in particular who I was at a clinical meeting. Presenting the case and speaking about how well he presents. And they were like, no, no, no, no, aside from going into session. We can’t get him to make his bed to get out of his pajamas to do any sort of ADL. But there was something that he some way he wanted to present to me in session. Right. But without that information, I would have never known that. Yeah. So it was something that I could bring in and talk about,

Steve Washuta: you know, that is a perfect lead into what I was going to sort of finish on here. I’ve talked to so many health professionals. Whether it’s a low level, professional with the certification. Or the highest level, professional with with doctorates. Seems like the fix everyone says, in some sense, is exactly what you said. We need a collaborative process where you have a physical therapist, and a personal trainer and a psychiatrist and a you know, a general pediatrician. All these people working in concert with one another, and their individual patients. And I think the you know, the problem with that is obviously is insurance. There’s a burn insurance thing going on, the more people I can see.

Dr. Blair Steel: HIPAA, it’s confidentiality. So let’s say like someone signed up with you, Steve, Monday, Wednesday, Friday 6am. Then they only show up Mondays and Wednesdays. Then they never show up Mondays, because maybe whatever’s going on in the weekend. You imagine if you could be like, hey, just so you know, this person was showing up three days a week. Then it went to two and now it says none, like what what pertinent information? That would be

Steve Washuta: I mean, to keep somebody accountable. Somebody who potentially, let’s say is on medications where they have a an issue, a mental health issue. Yeah, that would be very important for all parties, right? Including the person themselves. So I do, I do think it’s a problem. And it’s, also a problem. Because I would learn so much more if I was allowed to collaborate with people who are upstream of me, right? And because I can’t collaborate with people upstream of me that I don’t learn as much.

Now we can as personal trainers, we’re usually networked with like a physical therapist, and maybe like an orthopedic doctor. So now I can’t call the orthopedic doctor and tell them what’s going on. Or he can’t call me and tell me what’s going on right with the patient without them releasing stuff. But I can call him to say, Hey, I’m working with one of your patients. I know that you did this surgery. Do you think it would be okay if I do XYZ exercises? She’s only you know, two months post op. They can give me information like no, I would stay away from that. Because I don’t think the healing is done yet. 

Dr. Blair Steel:  amazing for you to know. Right? And especially under the assumption that we’re all here with the patient’s best interest in mind. That’s it. Right? That’s it, we had that assumption, one would hope that our communication would just be seen as such.

Steve Washuta: Now you say it’s HIPAA. I’m not disagreeing with you, I’m sure part of it is HIPAA, it’s not the vast majority of HIPAA. But you know, I see the the other part of it. As just that these other physicians sometimes don’t have time. So like, if you’re a psychiatrist, you might be seeing 24 people a day or something, right. Or so many people, then you’re backed up, and you have so much to do.

So like, they don’t feel like they’re not getting paid to like contact you and then or contact me and like work collaboratively like they’re overworked. And I feel like that’s another issue is that there’s a problem there needs to be. I don’t know how this works. But there needs to be more more of these jobs. Because it seems like every you can go on, you can go online right now. And if you’re looking for a physician job, there’s 1000s of physician jobs all over the place. There’s just not enough physicians right now to fill them.

Dr. Blair Steel: Wow. So unfortunate. I really wasn’t making change there.

Steve Washuta: Yeah. So let’s end here. I want you to tell the audience how they can find more about you and what you do. And if they want to contact you directly, or just follow you on the socials how best to reach you.

Dr. Blair Steel: Yeah, thanks. I’m Dr. Blair, Dr. BL a, IR, Psy D. So it’s psi d.com. Find me I’m there. I do have a small private practice. I just started with a group of called peach wellness. Which is a personal trainer, another guy who is able to hire something like 200 people a year with criminal records.

So a treatment center that is designed around incorporating physical fitness, and job placement, is huge. bBecause some people get their life together and then are stuck due to some poor decisions they made in the past. Sure. I’m working to develop their curriculum. I’m around I’m on social media as well. Dr. Blair saw it on Instagram, at your service.

Steve Washuta: Well, we’ll have to do this again. Sometime we’ll pick out another topic. Maybe when you start working there, you can come report back on how that process goes. Because it seems very unique. I’ve never heard of that sort of collaboration.

Dr. Blair Steel:  These guys have a vision and they are so excited. One of the guys Tony Hoffman was a BMX athlete who Olympic athlete. Became addicted to heroin and was in jail for two years. Sober ever since and is now co totally motivated to tell the story and to help others get back on track..

Steve Washuta: Well, can’t wait to have you back on to talk about that. This has been a summation. Thanks for joining. 

Dr. Blair Steel: Thanks for inviting me on. 

Steve Washuta: Thanks for joining us on the Trulyfit podcast. Please subscribe, rate, and review on your listening platform. Feel free to email us as we’d love to hear from you.

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Thanks again

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