Amanda Dinsmore, MD (00:01.049)
Hey guys, welcome back to the podcast. I am Amanda.
Laura Cazier, MD (00:04.885)
I'm Laura.
Kendra Morrison, DO (00:06.278)
And I'm Kendra.
Amanda Dinsmore, MD (00:07.881)
And we've said this before: we read the book so you don't have to, and we are going to talk about a really good one. All three of us have read this, and all three of us were impacted by it. It is the book Us: Getting Past You and Me to Build a More Loving Relationship by Terrence Real.
Amanda Dinsmore, MD (00:39.265)
Okay, so we wanted to get started by summarizing the first few chapters, and Laura's going to start us out.
Laura Cazier, MD (00:46.424)
Okay. So, as Amanda said, this book—if you haven't read it, we read the book so you don’t have to. I would say you need to read this book; I will be rereading this book for the rest of my life. It is so very, very powerful and gives a framework for us to be able to understand why we, and the people that we love, show up in the ways that we do in our relationships. He talks a lot about the concept of a wounded child, an adaptive child, and the wise adult.
Laura Cazier, MD (01:30.768)
These three individuals all reside within us. And the way it goes is that when we were kids, something might've happened to us and we got a wound. We felt terrible about something. For me, maybe my parents were fighting, screaming, and I felt terrible. So I would do something to help myself feel better. And that is my adaptive child. My adaptive child would go and hide under the bed or in the closet. And the way that can show up in my adult relationships is that when things get a little hairy or hard or stressful, I will withdraw. I won't say what's on my mind always, or I won't try to figure things out. I'm just like, I'm out. See ya. I can't deal. Versus, the wise adult.
Laura Cazier, MD (02:30.458)
When we are in Adaptive Child, we are often in a reactive state, stressed, which will often send us into adaptive child. Wise adult is where we want to go, and we'll talk about that in just a minute. The adaptive child is really rigid and harsh, perfectionistic and unrealistic, relentless, very certain that they are right. They have a black-and-white sense of right and wrong. And if you’re talking about the way it shows up in our bodies, they're very tight and kind of combative. It’s when we're in either fight, flight, or fawn mode.
Laura Cazier, MD (03:12.458)
It is a defensive kind of posture that we assume in adaptive child. And the wise adult—and these correlate with parts of our brain as well—the adaptive child is when we're working out of our limbic system, our emotional brain. That is not the problem-solving part of our brain, not the part that's going to show up as our best self.
Laura Cazier, MD (05:38.968)
The wise adult is the person that can regulate themselves emotionally, which means if they notice that they're starting to have their heart race or feel stressed or out of sorts, they take a time out. They don’t continue in the conversation because they know they’re not going to be wise adult anymore; they’re going to be adaptive child. The wise adult is very present in the moment. They don’t rehash things from 10 years ago. They care about the relationship. They care about the “us” more than acting like an individual. The adaptive child is more like a young child behaviorally—"This is mine!"—very concerned about their own rights, very concerned about people doing things to them, being very indignant. The wise adult can see nuance and can see where they have a part in any situation. When we're in our wise adult selves, we realize that we can't control other people and we stop trying to.
Laura Cazier, MD (07:30.768)
We try to see where we are blind and where we need to improve ourselves to become the best version of ourselves that we can. And when we're in wise adult, we're up in our prefrontal cortex. He talks about a concept called relational mindfulness. For us doctors, medicine is not a relational culture. In general, it’s a very hierarchical culture. It’s very “power over” versus “power with.” It’s not relational. So when he's talking about relational mindfulness, he means we’re choosing to be centered and not acting on our immediate impulses. We are accessing our right brain. We are caring about the ecosystem that we live in more than our own personal rights and needs.
Amanda Dinsmore, MD (12:32.879)
That's not very helpful. Okay, so Terry does comment on the idea of being an individual is actually just a self-perception based on acquired knowledge. When you are first born, you're symbiotic with your mom and it takes a while before your brain can even conceptualize that you're anything different than connected. I love the whole story of Jill Bolte Taylor when she had the AVM rupture in the left part of her brain.
Amanda Dinsmore, MD (14:38.963)
One person builds the houses, the other person farms the field, the other person cares for the kids. When we pool our resources, that's how we are able to survive in a much better scenario. Social baseline theory suggests that being connected with others and in social settings helps us conserve energy. It also helps us regulate emotions. Humans find it much easier to co-regulate each other than trying to do it all yourself.
Amanda Dinsmore, MD (16:59.811)
But the goal is to be to start to understand each other, to start to be relational rather than individualistic. And part of that is becoming aware of what triggers you, what makes you activated. You're gonna be far better able to explain it if you, we expect our partners to know everything about us and we don't even know everything about us, which is kind of funny. Like how could they possibly know when we don't even know ourselves? So becoming aware of what triggers you.
Kendra Morrison, DO (17:44.049)
Yeah, so I think this is huge. That awareness piece is huge. I mean, I know when I personally started coaching, there were a lot of mind-blown moments just from an awareness, like getting asked questions and being like, "I should know this" or "I should be able to spit this out." And then I got stopped in my tracks, like, what brings you joy?
Kendra Morrison, DO (19:33.029)
In intimate relationships, we actually co-regulate each other. We’re never meant to individually regulate our nervous systems. We take cues from all around us, and that's especially important in our intimate relationships. We know from studies that secure relationships lead to increased immunity and less disease, lower scores on depression and anxiety scales, and higher well-being scores. On the flip side, insecure relationships increase stress, make you sick all the time, and ultimately shorten your life.
Kendra Morrison, DO (21:29.935)
One more study worth noting: Renee Spitz’s work on orphanages in the 1950s showed that children who had all their physical needs met but weren’t held or emotionally engaged with had a high death rate from what was termed “failure to thrive.” Spitz argued these babies essentially died from loneliness due to a lack of connection and co-regulation with caregivers.
Kendra Morrison, DO (22:58.935)
Another example involved prisoners in solitary confinement. In studies conducted at the University of California, prisoners kept in confinement for longer than a couple of weeks began showing signs of acute neurosis and psychosis. They’d act out in bizarre ways when let outside because they couldn’t synchronize or co-regulate with others. When left entirely to their own devices, they had no way to self-regulate.
Kendra Morrison, DO (24:29.385)
These studies really illustrate the framework Terry Real is laying out: connection and intimacy are fundamental human needs. Modern society might push an individuality message—“You do you, boo”—but this actually works against us. When we act as individuals, we’re missing out on the resilience and joy that come from building a shared “us.”
Kendra Morrison, DO (25:15.329)
So hopefully you guys will follow along with us as we continue in our book club and keep digging into this book. There are so many great nuggets from Terry Real. He has a lot of resources online, and you can also find him on YouTube. Check it out!
Kendra Morrison, DO (25:45.760)
Thanks for listening today. We’re super excited to announce we have a new free video, so scroll down in the show notes to check it out. And until next time, remember: you are whole, you are a gift to medicine, and the work you do matters.
