self-image with steven reyes

OH2016 Session with Dr. Steven Reyes – Now You See Me, Now I Don’t

March 9, 2017

So here we go guys, the name of our presentation this afternoon is, “Now You See Me, Now I Don’t!”

[View NYSMNID OVERVIEW slide, #2 in the slideshow below]

Alright in the overview, we’re going to be talking about a lot of things this afternoon including:

  • Body image and how we feel in relation to our body and how we treat our body.
  • We’re going to be talking about identity / self-perception and our lenses and how we develop the lenses in which we see ourselves and how we see the world.
  • Also our health and what these things mean as far as maintaining long-term.
  • How the three relate and what it means for your success both now and forever. That is the kicker, is maintaining long term, right?
  • Helping you to not lose yourself along the way in the journey.

[View BIO slide, #3 in the slideshow below]

So bio, a little about me and then we’ll get past that to the good stuff here. I’ve been working in the field of Bariatric Psychology now, since 2005. It’s crazy, it's been I think 11 years this December. It is amazing how fast time goes by.

I was speaking with one of the vendors earlier today, who has been in the industry about the same time, or as long as I have, and we were talking about vitamins and protein and the products and all of the options that you guys have in this day and age. Just so you guys know, you are in a good day and age because 10 years ago and plus beyond that, the options were very nil as far as that goes. There is a lot of good quality products out there for you guys to use and take care of yourselves. You should be happy about that, and grateful for that!

So over the years, I’ve conducted thousands of interviews with patients considering weight loss surgery. I do psychological evaluations at different hospitals, I have a private practice where I meet with folks to work on any post-op issues they may encounter along the way. I’m pretty passionate about health, I like to think that what I teach, I preach and I live as far as that goes. I have a pretty good gig. I’m pretty blessed.

I have a Doctorate and Masters of Science in Counseling Psychology. In fact, my research and dissertation was a Qualitative and Phenomenological study with weight loss surgery patients. They were between one and two years post-op and I did a series of clinical interviews and qualitative study. What I like about qualitative research is that it gives us a lot of detail and not only identify the “what” as far as what is going on but we also get to the “why” of things and why is very, very important for each and everyone of us because once we kind of figure out why we do what we do, we become a little more empowered to change our lives, to make our lives better and ourselves better.

[View TRANSFORMATION slide, #4 in the slideshow above]

One of the coolest and one of the best things about what I do is that I get to witness transformations. I’m not only talking about physiological standpoints and aesthetics standpoints but I’m talking about a difference in thinking as far as transformation, and it is always cool to me when...there is a term in my field when someone “gets it”, whatever that is. You know when you come across someone that just “gets it”, it's just such a cool thing. When in their prior history,  they did a lot of things that worked to their detriment and that is super inspirational, super encouraging to experience that.

[View BODY IMAGE BEFORE WLS slide, #5 in the slideshow above]

Now, body image before weight loss surgery.

Show of hands here, how many of you guys had body image issues before surgery?

[Audience Hands Raise-Up]

Alright, the good news is you’re normal!

[Audience Laughs]

Ehhh, I take that back because I know some of you out there.

[Audience Laughs]

Normal is a sliding scale, right? Just like crazy is, we’re all along there somewhere but yes, we have body images before hand right? What we see with our folks, those folks that elect to get into weight loss surgery, we see significant levels of low self-esteem with our folks.

This is significantly associated with what they call body image dissatisfaction and with our folks it is up to three times greater than the general population, so it is a pretty prevalent thing that we see.

I see this a lot of times with my folks too, being self-critical in different ways. Engaging is self-deprecating behavior, all that sort of thing. Also, social impairment, where due to body image due to their weight or appearance they avoid social activities, family outings, work outings, family gatherings. All that type of thing.

[View BODY IMAGE AFTER WLS slide, #6 in the slideshow above]

After weight loss surgery, do you guys have body image issues after weight loss surgery? Show of hands.

[Audience Hands Raise-Up]

Alright, you guys are still normal, for the most part.

[Audience Laughs]

But are they same or different?

[Audience collectively says “different”]

Okay, different how? What’s the number one issue we hear afterward?

[Audience members say “skin”, “sagging skin”.]

Yep, far and away, skin. Sagging skin, numero uno for sure.

We still have issues but the issues can play out differently. What tends to happen before surgery is there is a general body image dissatisfaction, afterward it can be real specific.

So, body image afterward, the first year. Do you guys know, and have experienced, during the first year, what? We lose weight at the fastest pace we will probably more than any other point, right? Was that true for most of you guys?

[Audience says “Yes”]

And it’s pretty trippy! Now just so you guys know, I love the adjective “trippy”, you’re going to hear me say that probably 20 times today because I think it’s really cool.

[Dr. Reyes & the Audience Laughs]

The first year, yeah, we’re going to lose weight at the fastest pace more than we will at any other point. You have to adjust to the new version of you, [hand gesturing to the side] and then the newer version of you, [hand gesturing to the side again] and then the newer version of you and so on and so forth, right?

Alright, do you see what I see? That is what I call that phase. Because you guys well know, the version that you may see of yourselves in the mirror is different than maybe the version of you that your friends and family see of you. Right? Have you guys experienced that?

[Audience Hands Raise-Up]

Okay, you’re still normal, ok good! So let me ask you this, why do we see the prior version of ourselves? Have you guys ever thought about that? Why do I still see this former image of me in that way?

Alright, think about it this way. If you’ve never seen...or if there is a time in your life where you hadn’t seen a particular relative for like a year, especially like a niece or nephew or someone during childhood. Think about it this way, the last time you saw that person, that serves as your point of reference. So you have this image in your mind of what this person, your niece/nephew is maybe going to look like. And so that sets up the expectation, so now you haven’t seen them,  let's use the example of a 9 or 10-year-old, and we know especially during those years a lot can happen in 12 months if you haven’t seen someone, right? So we go see our relative, we have this expectation of seeing them, we see them and what comes out of our mouth? We’re like “Oh my gosh, you’ve grown so much, you look so different, you look so big, whatever the case may be. It’s because that expectation is different and that last point of reference serves as that.

Now, as it pertains to ourselves, every time we looked in the mirror over a course of time, that image (self-image) is ingrained again and again and again and again in the brain. It’s almost like a photographic negative, you know what I’m talking about here? That serves as your reference and you guys know it’s going to take a long time to adjust to that new version of you because that template is so well engrained in our head.

[View HEAD-TRIPS & ADJUSTMENTS slide, #7 in the slideshow above]

So head-trips and adjustments, I told you I liked trippy, right?

[Audience Laughs]

Okay, these are the phenomenon a lot of you guys have told me over the years and have experienced.

Staying at the same weight, yet going down in size. Ever experienced that?

[Audience Nods and Says Yes]

What was that like?

[Audience Talks, Someone Mentions Trippy, Audience Laughs]

People telling you that your clothes are too big because you’re wearing your old “comfort clothes.” Right? Any guilty parties out there?

[Audience Nods and Says Yes]

These are my pants? In a state of disbelief.

Not recognizing yourself in pictures? The general population has no idea what we’re talking about, they can’t relate, they can’t get there.

Getting attention and the feelings that come along with it. You guys know that this can play out in different ways. What's interesting for me too is when I hear people tell me that they're getting this attention, it feels good, depending on where the attention is coming from but they're getting attention from other people that they aren't so sure what to do with. For instance, getting attention from a co-worker now where in the past six months you guys have barely talked at all. That can bring about feelings of resentment in that way toward that person.  Any of you experienced that at all?

[Audience Chatter]

This is the main thing, getting your brain to catch up with your body. It takes a lot of time for the brain to catch up with the body because the transformation is so radical, especially early on.  

These are my pants. That’s when you believe you’re seeing what you’re feeling, what you’re wearing, that type of deal.

Making sense of it all, adjusting to the newness. You guys know, I see this all the time, it is a “learn as you go process” but it is so important that we learn as we go.

[View IDENTITY & SELF-PERCEPTION slide, #8 in the slideshow above]

We’re going to talk about factors that help shape who we are and how we see ourselves.  

Basically think about your lives from childhood to where you are now, at this point in your life, all the experiences you’ve had, the culmination of experiences that make up who you are now.

Think about the significance of your interactions with others, and the impact of their words. We’re going to focus on the whole word thing because, guess what, we use language every day and words are pretty important.

Let’s take a look at words, how words help develop the lenses that we have.

[View EYEBALL slide, #9 in the slideshow above]

[Dr. Reyes - this is purely to creep you out; Audience Laughs]

Dr. Now is looking at you guys.

[Audience Laughs & Chats]

[View MINOR DAMAGE slide, #10 in the slideshow above]

We’re going to talk about our childhood for a second. Think about our childhood history. What amazes me is when I meet with people and we talk about their childhood, go through their weight history and development, how people will recall a time, an instance that took place when they were in third grade. The person I’m speaking with could be in their late 40’s. They will recall a time in third grade that they were called “ugly” “stupid” or what have you.  

What amazes me is the thoroughness. In addition to that is the detail in which they recall that particular experience. They’ll remember the first and last name of the bully, the person that called them that, what they were wearing that day, this took place 40 years prior but the detail is indicative, is pretty significant of something. The detail is indicative of profound meaning and impacted us in that way.

Why do words matter to us?  

[View THE WEIGHT OF WORDS slide, #11 in the slideshow above]

We all have a fundamental need for acceptance.  Every single one of us has this need. It is a common need for all of us.  

When you think about words. Negative comments from people doesn’t give us a sense of belonging. It actually makes you feel not part of the group. Any experience you have that you walk away from that has you think you’re weird, different, not normal, any of the other things you can think of is very distressing for us.

Having a sense of belonging is a warm blanket to use on a cold winter’s night.  It is safe, comforting and secure. Security is so important for each and every one of us. Especially, not being secure works against us in a number of ways. We’re going to get into that in a second here.

Acceptance is important because it solidifies our self of sense, our identity and the meaning to who you are. We’re going to look at an example here.

[View STICKS AND STONES slide, #12 in the slideshow above]

Sticks and stones may break my bones but ….

[Dr. Reyes Pauses for Audience to Finish the Saying...]

[Audience Finishes] “words will never hurt me.”

We had a thing earlier, is it words or names?  

[Audience says alternately “words” and “names”]

[Dr. Reyes] The history is, it is actually both. We asked ourselves late this morning, is it words or names?

[Dr. Reyes] I’ll say it again, sticks and stones may break my bones but...

[Audience] words will never hurt me.

[Dr. Reyes] Biggest lie in human history. Right?

[Audience Chatter]

[Dr. Reyes]  Words hurt. Heavy. They hurt.

What we’re going to do right now, we’re going to process a vignette together. This is taken from a patient from a few years ago. The patient’s name is Jamie.  Let’s walk through this.

Jamie recalled an event that took place when she was eight years old. Her family, who she hadn’t seen in awhile, was visiting from out of town. Excited to see her aunt, who she was very fond of, she ran up to her aunt to say hello. Jaime remembered her aunt’s greeting and the words that impacted her greatly.

Now, when I interviewed Jamie, she was 27 and this took place 19 years earlier. Watch the detail in this quote. It is from a transcript actually.

”My aunt said, “Oh my God (at my little sister) you look so good!” and then to me, “Jamie, you know you’re fat right?”

[Audience Responded With “awww”]

“I’m not fat! I’m just chunky!” And my aunt straight up told me, “No, you’re fat!” She told me “You look like a little whale.]

[Audience Groaning]

[Dr. Reyes] Cruel?  You think that had an impact on this 8-year-old?  

[View CORE IMPACT slide, #13 in the slideshow above]

The confused little 8-year-old girl tried to make sense of the words, “A whale...fat?” She didn’t know what to do with that. These descriptors were now part of her identity. She wasn’t sure what to make of those. She associated herself with them.

Relationally, this is something we don’t talk about often enough with people after surgery as far as the issues we get into.

Relationally, check this out what happens here, the sense of safety that she once had with her aunt had changed, and so did the relationship with her. Safety is so important, you know that, with this community, this is a safe community because we all want the same thing, we’re all trying to encourage, edify one another, to take care of ourselves, be healthy, to be successful with our lives. Safety is so important. At eight years old, that was removed from Jamie, [Dr. Reyes snaps his fingers] just like that.

And at eight years old, think about this too, she didn’t have the cognitive or emotive skills to make sense of that experience so she internalized it. We have the tendency to do that. When we internalize things, it always works out in detrimental ways. It plays out in detrimental ways. All Jamie knew was this - it hurt. It hurts bad.

From that point forward, she would entertain negative thoughts and feelings about herself. Her mind would begin operating out of that core belief system.

Her lenses began to form.

[View THE EFFECTS slide, #14 in the slideshow above]

The effects of this. Any of us that ever experienced anything like this, it is typically how it plays out to varying degrees.

Beginning to filter all experiences through those lenses. In Jaime’s case, she was told she was fat, she was a little whale. It could be applied to someone called ugly, stupid, whatever the case may be where now we begin to entertain that stuff and we take it on ourselves.       

The beginning of undervaluing who you are. I cannot emphasize how detrimental this is to our being for us taking care of ourselves. Beginning that acceptance is tied to your shape, appearance.

I call this conditional long as I’m a certain way, I have value. Or performance based value, as long as I jump through enough hoops, do the right things, I have value and I’m in good standing with you. If I don’t, then I don’t.

Can you relate to that?

This is where we become self-critical. Because it’s a lot of pressure trying to please other people. A lot of work. A lot of work.

We allow things in our lives that we shouldn’t.

Saying “yes” to the bad, and “no” to the good. And again, allowing things in our life that should not be acceptable. This all serves as the foundation for self-neglect.

Now all the interviews that I’ve done over the years, especially with the female population, with the females I’ve met, I would say easily 70%-75% of them have a psychological profile of what I call self-neglect.

What I mean is they are so good at taking care of other people that over time it has come at the expense of themselves. I’ll say on a weekly basis, to my own patients or clients, I’ll say “I give you permission to be selfish. You have to take care of you. Guess what?  No one else is going to.”

You know what I mean about being selfish?  Not being selfish, selfish. Making yourself a priority. This is so huge. This is the foundation for the self-neglect stuff.

[View THE RESPONSE slide, #15 in the slideshow above]

Our response to this. This is important, you guys. If you’re going to write anything down, write this down right here.

Your response to your history is what matters, more than the history itself. And whatever we’ve  encountered in life as far as that goes, anything that was negative, we want to give less power over to that from this point forward.

We want with to work with all our being, not to let that part affect the here and now. It is bad enough that you went through with what you went through at whatever stage. By the way, this does not only apply to childhood but applies to adults too. We have relationships as adults and can experience some bad things during that time as well.

We want to stay empowered. We want to re-think life. When things that some of you guys that know me, and have been in teaching for awhile, is that we talk about this where when the surgeon works on this part of the body [Dr. Reyes points to his stomach area], does he do this surgery [Dr. Reyes points to his head].

[Audience responds with “no”] 

[Dr. Reyes] Who has to do that?  You!  And, it isn’t covered by insurance. Well, unless you see someone like me, a psychologist, it isn’t going to be covered. That’s the battle. The battle for the body begins with the battle of the mind. That’s where it all transpires and takes place. That’s the battlefield. One of the things I’m a big believer in, and this is just my personal philosophy.

A few years ago, I was trying to come up with a book title for a book I’ve been working on for awhile. I asked myself, how much does the average human brain weigh?  I looked it up and it is about three pounds. The key to addressing all this is the last three pounds. There’s going to be a book sometime that has the Last Three Pounds that hopefully has my name on it.

Be deliberate, be intentional. We have to be deliberate and we have to be intentional about taking care of ourselves and develop new habits and tendencies because guess what, no new habit develops by accident. It has to be deliberate. It has to be intentional. We have to live that way.

Fundamentally, you have to maintain yourself as a priority.

Re-writing your history to give yourself what you didn’t get. That’s where you taking care of you really plays comes into effect. If you didn’t have that, it is now time for you to give yourself what you didn’t get in that way.

[View THE RESPONSE CONT... slide, #16 in the slideshow above]

Body respect, taking care of it. This is more than just eating the proper way, doing your exercise and being hydrated and all that stuff. We have to do soul care with taking care of ourselves emotionally, relationally, psychologically and spiritually. All those realms as well. Surround yourself with safe people. Any toxicity in any form, people, learn boundaries. We have to set good boundaries with those folks because otherwise that will interfere with what we’re doing here.

Don’t let life distract you. Life is short. It goes by quick. It does. Right? If we don’t maintain ourselves as a priority, there are going to be things that will take over.  I promise you. And remind yourself of doing this at least the first few years after surgery. Sit down and write this out. Remind yourself of why you had surgery in the first place. Believe it or not, sometimes people forget about that and they forget originally, what was my incentive in doing this whole deal. We get distracted by life and other things and we forget about keeping the main thing, the main thing.  

It is possible to love yourself and change at the same time. You do this and you’ll experience it yourself.

[View POSITIVE BODY IMAGE & WORDS slide, #17 in the slideshow above]

Beware of comparisons - everyone has their own journey, you’re only responsible for yours.

The person that “has it all together” trust me, they don’t. You believe that?  We’re all crazy.  

[Dr. Reyes & the Audience Laughs]

It isn’t a clinical term by the way. It’s a term of endearment.  

[Audience laughs]

Treat and talk to yourself like you’re the most important person in the world. The standard you would apply to other people, more than likely, that probably doesn’t apply to you. It needs to apply to you.

Do not criticize yourself out loud - this reinforces the negativity and all that old history that we’re trying to move on from.

Being self-critical, I didn’t make this up. I stole it from somebody, I don’t remember who said it. Being self-critical is like having an abusive relationship with yourself.

Validate yourself on a daily basis - positive words are like verbal vitamins! Remember, words are powerful, both negative and positive, they are very, very powerful. Sometimes the most positive words can come from ourselves. I believe too, especially when we were talking about community earlier, edifying and encouraging from other people and not being stingy with compliments, not being stingy with verbal sunshine, verbal vitamins in that way. We get something out of it when we do that with other people.

The practice of these things will help you succeed and not get lost on your journey.

[View FINAL THOUGHTS slide, #18 in the slideshow above]

This is some final thoughts.  I think we’re going to for some exercises after this.  You guys cool with that?

[Audience Replies “Yes”]

I’m talking about burpees and jumping jacks.

[Audience Laughs & Chatters]

[Dr. Reyes] Actually, I’m serious, I probably need to do it.

As it pertains to our health and taking care of ourselves…

If you don’t reinforce that you’re worth it, you’re not going to sustain it. And people wonder, we’re trying to figure out why do people one to three years regress in their weight loss after surgery. We know a lot of us go back to the old eating habits but the fundamental thing that happens is they go back to self-neglect. Life takes over. Old habits come into play, all that stuff. Part of us changing that, breaking that whole thing, is loving ourselves through these words.

As one patient admitted to me years ago…This is a quote from a gentleman that sustained over a 340-pound weight loss over the past seven years. If you thought Jaime’s story was interesting and sad, his story would put hers to shame. He had a very horrendous upbringing and this guy had such a low view of self, he struggled with it his whole life, he got to the point where he pursued surgery for health reasons and he got serious about taking care of himself.

This is the quote he told me. It brought me to tears.

“I was always good enough, I just didn’t know or believe it.”

There was a point in this gentleman’s life where he finally owned that. That was HUGE for this guy. It was pivotal for him and his life. I encourage you guys, you can believe it, because you are. Now, we have to live it. We have to execute it.

That’s all I got.

[Audience Applause]

Let’s go to 3:20, I think?  Perfect.

Q&A, any questions at this point?

[Audience member question]  So when we start hitting on yourself and self-image, you know taking yourself down, or someone else, what’s a good exercise to immediately change your mind. You know you’re doing it. Oh, I’m not good enough for this. You hear yourself doing this. How do you switch? It’s going to take time but how do you recognize it in the moment?

[Dr. Reyes] Great question. Because there is a process and changing the whole thing because, for a lot of us, it is so well-engrained. My thing growing up, and I’ll share this on a personal note. My thing was never my body image, weight issues, I grew up thinking I was stupid. I had no confidence whatsoever in that way.

It was interesting how I would engage in all this self-depreciating humor and my thing is that if I put myself down, then you couldn’t put me down. If I beat you to it, a preemptive thing that I’d do, we tend to do that. If I make fun of me, then you can’t make fun of me. I lived that. All of my upbringing.

I finally got to the point in my 20’s that I finally got there. Like you were saying, I thought it, I thought it and I fought with every ounce of energy not to utter those words. I would call myself different names (I’m not going to cuss). I used to do that all the time. I’d be by myself. It could be something as silly as I dropped a pencil on the floor, knocked my coffee cup over, “Reyes, you  ______.” I didn’t want anyone around.

It was so well-engrained so it starts with we have to commit to doing that. I’m big on writing stuff down. Having some point forward, on October 1st, I choose not to ----. It’s a start but we need to implement it and we need to execute it. Part of that is we have to accept that we’re going to think it for awhile. If we have that tendency we’re going to think it because it’s natural for us to do that, almost intuitive.

Here’s the thing. You may say something detrimental, you take it back right away. You catch yourself. What I would try to do as much as you can is to identify situations where this will play out. If you’re around a certain group of people, and you tend to do this, as much as you can, anticipate situations that you would engage in this behavior and play it out.  Believe it or not, the more we can anticipate the way it plays this stuff out, when we do encounter those situations we’ll be less likely to act on it because it will trigger in our head not to. The theory is the more you do that the better you get at it. We tend to be creatures of momentum. If you slip up, slap yourself [Dr. Reyes tapped his hand] and move forward.  Keep walking. You don’t beat yourself up, you keep going.

[Audience member question]  My question is whether or not Dr. Reyes is familiar with Dialectical Behavioral Therapy (DBT). It is a road I’m just starting down now. I have found a counselor that uses DBT in her practice and its very specific for those of us who may have, I will say significant, highly dysfunctional relationships with our family of origin.

Through my weight loss surgery journey, I’ll be honest with you all, I’m in my 50’s, I always knew my mother was fragile, temperamental, maybe a little on the narcissistic side, and I recently learned it is much more than that. She’s a non-diagnosed Borderline Personality Disorder. And, I’m going back and reviewing all of my childhood and my entire relationship with her through a new construct. What I’m doing is grieving the mother that I always wanted and craved, and accepting my biologically mentally ill parents. 

To come to that realization in your 50’s is really interesting, it’s a real head-trip. That’s the head-trip I‘ve got because I grew up with a lot of stuff that I thought was my fault but turns out it isn’t. That’s colored every relationship I’ve ever had, even my own relationship with my child.

If there’s anyone in this room that is young or thinks she might have some particulars that are similar with your parents or your family, do not wait. I’m telling you my gut instinct is a lot of us have had something like this. It is a really significant factor in how long I waited to deal with my weight. Anyway, I just wanted to mention that and share with you. I don’t know if you have time to tell a little bit about DBT or go into it because I don’t really want to since I’m so new to it.

[Dr. Reyes] To your credit, kudos to you, congratulations to you for getting to that point because some people never do. They never get to that point. You don’t have to be young to address that. We can have epiphanies of sorts at any point in our life. Where she is right now is at the point of being empowered in that way, she can fully recognize, this awareness, how that particular relationship played out in most aspects of her life. That’s great.

To be honest, I believe in therapy. I’ve had therapists over the years. They fire me usually after two sessions.

[Audience Laughs]

I believe in therapy, it’s worth it. Basically, what we just talked about over the past 35 minutes, we have to invest in ourselves. Any resources you have at your disposal for you to take care of yourself is worth it. What she said there. If you have to seek professional help, like Lauren said, a head coach to help you, do it. You’re absolutely worth it.

[Audience member quick comment and then a question]  I’ve been doing therapy for the last two years and I had surgery eight years ago, and I think one thing I’ve found is exactly what you said here. There’s a difference between self-confidence and self-worth, and I think a lot of us are actually pretty self-confident. We’ve found ways to be confident about ourselves even though we were overweight but the self-worth piece is what kept us doing a lot of those things like agreeing to do things you don’t want to do, which was high on my list. I say “yes” to a lot of things to people-please.

My question I have is about body dysmorphia. When you see it, for me, it is a fun-house mirror situation all the time.I can look in the mirror, one second and go “I look pretty good” and then turn around and go “whoa, I see 300 pounds again.” Are there strategies to deal with my self-image?  Even in therapy, my therapist doesn’t know how to help with that kind of situation or is it something we’ll have to deal with for the rest of our lives?

[Dr. Reyes]

In fact, to be back on the (pointing to the slide of Final Thoughts). I have an exercise that we’ll do, it’s not burpees so you know, but an exercise we’ll go over together that plays out.

If you guys heard her, you’re eight years post-op, and basically what she’s saying is that sometimes she looks in the mirror and sees the reality and sometimes she doesn’t.

It is total anecdotal, I don’t have research to support this, but what I’ve found over the years, and I’m not saying this to discourage any of you, but I’ve found through the years for people that struggle with excess weight, it takes a long time for them to adjust to seeing themselves as they are, their self-image.

A patient of mine that’s 11 years out, I’ve known her since I’ve been doing this, she’s sustained a 130-pound weight loss over 11 years, a gastric bypass patient. It is phenomenal, it’s great. To her credit, she’s done really good. She’s honest about herself. She’ll admit she still struggles 11 years post-op but what is interesting about that phenomenon is to this day, she’ll walk down the aisle, and move a chair when she doesn’t have to. 11 years out. She still has that image in her brain.

I’m going to do this exercise with you, and we’ll wrap it up so we can get out of here.

[View MIRROR POSSIBILITIES slide, #19 in the slideshow above]

I call this the mirror possibilities. Basically what she was talking about is that we need to recalibrate how we see ourselves, our lenses.

This is an exercise we can do. Find a pre-weight loss surgery photo. Stand in front of a full-length mirror. If you don’t have a mirror, get a mirror. Come home, unpack it, put it up somewhere. Look at the photo, look in the mirror from your head to your toes, trace your image in the mirror. From your head to your toes, trace it down your legs and all the way back up. We’re wanting to recalibrate to what we’re seeing here. So you trace that. Note the differences, say them out loud, does that make sense?  

That’s one little thing. We can, we don’t have three hours for deep stuff here. Does that make sense?  Do you have questions about this? Seriously, I would do that on a regular basis.

[Audience member question but inaudible until receiving a microphone]  I would take a Post-It and write down all the positive things. The neighbor hadn’t seen me in a couple of months and they go “I didn’t recognize that was you.” I’d write it down.

I had colored pens and Post-Its, and I have this mirrored closet door and I’d put down all the positive thoughts, and I’d read them, all my non-scale victories, my scale victories, anything positive so I could keep reading them and have that self-worth to regain that self-worth, and know that I was worth it, and that I was doing a good job.

Seeing it in the mirror wasn’t working for me. I didn’t see it. I’ve just starting seeing it and I have, like the one person said, sometimes I’d see myself now and sometimes you’ll see yourself then. I can look at myself in the mirror now and think “great” but if I see a picture of me right now, I think “oh my gosh, I still weigh 300 pounds.” My self-image is skewed sometimes.

I took down those Post-its for awhile because I thought I was okay. You know what, I had to start putting the Post-It notes back up because I felt myself slipping back. A positive, something that will help you, is to write down any positive, anywhere you can to get you through the day. In your car, on your cupboards, in your bathroom, any and all positive comments you have received, put them down and read them because those people meant that when they told you that and you are worth those comments.

[Dr. Reyes] That’s a great thing to do. It really is.

[Audience claps]

[Dr. Reyes] Writing that down solidifies it is there because you guys know the days that you doubt and question, you can go back to that and that can help ground you in the reality. Your self-image will eventually catch up. 

I can’t believe it wasn’t in the presentation as it pertains to compliments. “Oh my gosh, you look great” - so many times we diss those things “Oh, no I don’t.”

I don’t care if you believe it. Be open to believing it. All you have to do is say “thank you.” But get used to acknowledging those things, get used to hearing those things, and they’ll immensely get in here (pointing to his heart).

I’m outa here. Thanks, Guys!

As additional info: 
[View BODY LANGUAGE slide, #20 in the slideshow above]
[View RETHINKING slide, #21 in the slideshow above]

(Transcript lightly edited for ease of reading.)