Beyond ADHD A Physicians Perspective Ep 15: Dr. Rashmi Schramm (Board Certified Family Medicine Physician, National Board Certified Integrative Ayurveda Health Coach)

Dr. Rashmi Schramm: Let's just define meditation and mindfulness, because even that can be kind of muddy sometimes, right? Meditation is simply moving from activity into stillness, mindful. It is a formal way. It is a way to practice mindfulness and mindfulness. Most people would agree that definition is the awareness that arises when we are paying attention to this present moment without judgment and with curiosity.

Dr. Diana Mercado-Marmarosh: Hi, welcome to Beyond ADHD, A Physician's Perspective podcast. I am your host, Dr. Diana Mercado-Marmarosh. I'm a family medicine doc, with ADHD, practicing in a rural setting in Texas. I am a mother to two very energetic toddlers who are three and four years of age.

And in the past year, I have undergone radical transformation after discovering  ADHD coaching, and life-coaching. For the past decade, my typical day consisted of having 300 charts backlog, a graveyard of unfinished projects, and a lack of time awareness. I didn't realize that I was not filling my own cup. I was running on fumes, the last year I figured out the secret; learn to stay in your lane. So now my mission is to help others develop systems that tap into their zone of genius. So they too can reclaim their personal lives back. Like I have.

 

Hello? Hello. I am so excited. I have an incredible guest today. One of my dear friends and colleague and amazing guest coach in my group. And of course I am very biased. Right? Because I have outstanding people that I bring to you. So this is Dr. Rashmi Schramm, and she's a board certified family medicine physician, and she is. In her 21st year of practice. Oh my goodness. Isn't that amazing? She's a National Board Certified Integrative Health Coach with a specialized interests. And I'm going to mess that up. Can you help me pronounce that?

Dr. Rashmi Schramm: Yeah, Ayurveda.

Dr. Diana Mercado-Marmarosh: Ayurveda, and meditation and she teaches two easy types of meditation, which is mantra and yoga nidra. Okay. So she is a founder of Optimal Wellness where she incorporates evidence-based medicine techniques into individual and group coaching. And she helps busy women to ditch that guilt and tap into the inner peace and power so that they can live more energetic and. Purposeful lives. She regularly hosts live weekly meditations for those interested in easy and effortless way to dip into this type of meditation or to go deeper into their practice.

And so please welcome this amazing treat that we have for you today. So tell us a little bit, how did you get into this amazing practice? People probably don't know this yet, but yoga nidra, she introduced me to it and she of course has changed the way I see meditation because I used to think that I was doing it wrong.

 And I, my brain just kept saying what you have to sit still. This is no way, but the way that she taught it to me, it was very relaxing. I even felt like more energized. So, which was weird. Please share with me about how you got started on meditation specifically. And how are you like able to share this gift with others through coaching.

Dr. Rashmi Schramm: Yeah. Thank you so much for having me, Dr. Diana, you know that I am so honored to be here with you and for, with all your listeners. So I actually was born in India and I grew up there. I was there until I was almost 12. And so I was exposed to meditation spirituality. That's sort of thing. Not that I was like a meditative kid or anything, but it was very normal.

It felt like home for me. And then we immigrated to the United States. We, I actually, my entire adolescence was in a very small coal mining town, where there weren't really very many other ethnicities other than, you know, Caucasians there. And so I kind of, at that point, like had abandoned all of my Indian essence.

As an adolescent growing up, trying to just fit in. And then when I went off to college, I really like, I found a group of people that were meditating. So it was like this on and off kind of love for me. And I was like a secret meditator. I was like a closet meditator because I was afraid people would think that, you know, like I was whatever, I didn't, I dunno what I thought.

Right. But it was my brain in college. I really loved meditating then. And then I went to medical school, completely abandoned meditation again. And then was like a very intermittent meditator until about 10 years ago. And I, you know, it was in my thirties, I had young kids, um, my husband and I had started this practice that was growing by leaps and bounds.

And it was all going very well from the outside world. I had these two beautiful girls, you know, they were like, they were, you know, I mean, it was, it looked perfect from the outside and it's not that it wasn't perfect on the inside, but inside my brain, things were not that great. I was really experiencing a great deal of, you know, now we call it burnout.

I didn't even have any language I wasn't on social media. Didn't really know a lot of other people. That was, they were openly talking about being in this really like, kind of like irritable state. I mean, I was just like this long burning, like, oh, somebody presses my buttons, it's going to cover it, you know?

And I would press my own buttons and it was like this ongoing. And I was, you know, I was like fixing all the things on the outside to make sure everything was perfect. Right. Like I was taking more and more exotic vacations. I was like, it's that hedonic treadmill that I, now I recognize it. Right? Like I cannot find that kind of content meant outside of myself, it doesn't exist.

And also that perfect life doesn't exist. And so, , I really began to question a lot of things in my life and I sorta just one day. Remembered my meditation practice and just kind of dipped right back into it. And I was, you know, I should mention that while I was feeling these, issues within my emotional mental states, I was, it was then translating into lots of physical illnesses too, for me.

So I was having digestive issues. I was having chronic daily migraines. Wouldn't talk. I wasn't tolerating medications. So all of that stuff was going on. So I kind of almost waited way too late. Right. Until I had a whole, a bunch of physical symptoms, then I was like, I gotta do something. And so, you know, I initially went to meditation because I was reading some things about how much it helped with migraines.

And so. And with insomnia. And so that's, and then I started to dip in and out of meditation for a while for a couple of years, actually. And, you know, I would meditate, my migraines would go away. It would sleep great. Then I forget about it. And then another few months would go by all of the same stuff.

What happened? It was like this, you know, like I called myself a crisis meditator back then, you know? So it wasn't like I grew up in an Ostrom and all of a sudden here, here I am teaching meditation. I, it was a really messy. Ugly start to meditation for me. But once it really took hold, it was like, whoa, it was like this massive personal growth, this space that opened up this evolution that began to happen for me.

And where I noticed that I could find contentment and live. In a different space and in a way that I dealt with my, you know, whatever emotions that were going on with me, not as like a fight kind of thing, but it just became a different way of being, and living it spread to my kids, you know, people were noticing.

And then I was, I wasn't really qualified to teach for a while. Obviously I didn't go to teacher training, but I was like, Every day, like I was grabbing my office staff, I was grabbing anybody that would, that would like to meditate with me. Like, come on, let's do this two minute meditation. So it started like that actually just with me, like being like, come on, I got to get you to come on.

You know, we'll do this lunchtime meditation and then it became kind of a thing with my staff. And then people will start to hear about. And then, they started asking me to go teach at different places. And I was like, I don't, I don't know. And I, then I started to look at how I can teach, you know, I wanted to have the deep knowledge.

So over the last several years, I've developed the ability and the certifications to be able to teach, those different kinds of meditations I was telling you about. So that's the long story.

Dr. Diana Mercado-Marmarosh: You know, it's so interesting. How exactly what you said like last year when I discovered coaching and stuff. When I, I remember I did the first program that I did, they asked us to do like a burnout questionnaire and I was like, why are we even doing that? I'm not burned out. There's no way I'm burned out. Like, I didn't even know what that meant, but. I laughed when you said you were irritable, because that was me.

Like they would ask me to do different things and I would get overwhelmed. And instead of say like, no, I need help. Or, or let me do that a little later, I would just kind of blow up and I didn't even know what was happening or I would come home. And I was so drained that I didn't feel like I could function or have extra energy to cook or do anything like that.

And it's funny how now you said they have words, at least to help you identify with what's going on, but you know, sometimes we're so oblivious to what is going on, that we are reacting to things that are happening, but we're not even aware that we're reacting, we think is just happening to us. And that we don't realize that through meditation, it could be.

Step into that little bit of a window that maybe I could control it maybe a little bit. And we don't realize that that could be the case. If you don't realize what mindfulness is. I know that when I talked to you, I was telling you about my ADHD. And I was in a journey of trying to discover how to focus and things like that.

And you shared with me that that meditation can be a way to help people who had problems with concentration or with procrastination, or even with like task initiation. Have you noticed that to be the case for people that have ADHD or no ADHD, like does that type of method, can they, can it help anyone?

Dr. Rashmi Schramm: Yeah, absolutely. And we've got now hundreds and hundreds of studies that have been done and in adolescents and in adults as well. That show that practices of meditation, mindfulness practices, all of those things can definitely strengthen those neural pathways that require more focus that require more concentration.

And so before we get too far, let's just define meditation and mindfulness, because even that can be kind of muddy sometimes, right? So meditation is simply moving from activity into stillness and mindful. It is a formal way. It is a way to practice mindful. And mindfulness, most people would agree that definition is the awareness that arises when we are paying attention to this present moment without judgment and with curiosity.

So it sounds really simple, right. And it actually is the way that we all were as children. So I think you've got a four-year-old right. And so, or she's three or four. She's always mindful. You don't have to teach her mindfulness. In fact, she's going to teach you how to be mindful. She's going to teach you how to be in this present moment and not be as judgy as our brains are, you know, I'm 47. And so like, I've had that many years of conditioning of me going like, this is good. This is bad. I like this. I don't like this, all of these things, but if we free ourselves from that amount of judgment, for even short periods of time and just stay curious instead like a three-year-old would then magical, wonderful things begin to happen.

Really, truly. I know it sounds that way. But there's more openings. There's more, there's more freedom, in that mindfulness. And so it doesn't mean you have to always sit down to meditate. So for example, you can have a mindfulness practice then, you know, you're, you're either just doing breathing cause I've had, you know, when I work with one-on-one folks, there are some that are coming in 15 out of 10 anxiety.

Right. And that's all right. That's okay. What we do then is we just work within the breath. That's all we do. We do some breath work for a week or so, and then we can move into some kind of meditative practice. So there's so many different ways to go about that, you know, kind of changing those neuropathways.

But to answer your question, the way really. Neuro, you know, kind of physiologically that, you can imagine that meditation would help, whether it's concentration or focus is that during meditation, let's say it's five minutes of meditation and we'll take, for example, a yoga nidra, because we mentioned that already, which is fully guided, right?

So all you're doing is you're listening to a guidance and sometimes, it's the guidance is saying breathe a different way. Sometimes the guidance is saying, put your attention on different parts of your body. There's different, you know, there's different parts of the guidance. There's guided imagery, there's all kinds of different things.

And so what's the brain going to do when, when you're, when you've decided, okay, I'm going to spend 25 minutes inside this guided meditation. Your brain is going to be like, no way. I don't have time for this. Oh my God. This woman has no idea how busy I am. Listen here. I got two young kids. I work full-time, I'm a coach.

I have a podcast. I also have this other program. I got deadlines coming up. She didn't know what she's talking about. So all those things are going to happen. Right. And that's okay. They're supposed to happen. So your only job once you've decided I'm going to just do this. Nidra is then to notice all those thoughts and come back to the guidance.

And then there's going to be something else that shows up. Oh, crap. I forgot to email that person. Yeah. That's a thought you come right back to the guidance, then it's going to be like, oh my God, I forgot about the form. I think it's due today for my kid's school. That's all right. That's a thought you come back.

Right. And so. Each time you do that, where you notice that you're in the middle of a thought or a thought train, they're usually trains because they sweep us along, and your job isn't to be like, oh, this sucks. I'm not doing this right. Your job is really simple. You just come right back to the guidance.

And the more times you do that, the faster you can do that the next time. And so think about how that can be useful if you're trying to chart. I mean, how many people need you the minute that you need? We're going to finish a chart. It's going to be 15, maybe 20. Right. Everybody needs you all the time. And so your ability then if you've been sharpening it and training your mind to come back to the task at hand is literally you're rewiring the brain to do so.

And so. In a, in kind of a fun way, because those nitrous have all kinds of other, and same for the mantra too. They have all kinds of other, you know, benefits, like as far as neuropeptides and all these other things go in kind of a fun way. You can train your mind to really come back to the focus and use our ability for the concentration that we already have.

Dr. Diana Mercado-Marmarosh: Yeah. You know, one of the short sentences have been very helpful for me is just thinking right here right now. Like when my mind is like in a thousand places and the patient's right in front of me, I have to just tell myself right here right now, like right here right now. The patient is the most important thing right here right now, or if the kid's having the meltdown, right.

It's like right here right now, I have to validate their feelings. Or I have to ask the question that is not, instead of me screaming back at them as. Uh, or, or awarded in the way where I'm like, okay, um, you know, you're a great kid having a hard time. How can I help you? Right. Like, so it's about their behavior and not them.

Right. But the human instinct is to screen back. Right. And so just the right here right now. Like if my husband's mad at me or if I'm mad at me or whatever right here right now, Bringing it back that I'm not, it's not really that bad. Like I'm not in the middle of the street, naked in the car is running over me, even though the brain wants to tell me that.

Right. And so I think because of the yoga nidra that you have helped personalize for me, I've been able to realize that I can focus at will or that, I think part of it says just. Let it go, let the universe take care of it, which sounds nice. And it makes you feel supported, but our brain doesn't want to let go of anything.

Dr. Rashmi Schramm: Yeah, we have that. And I love that. It's kind of a mantra that you use, right, right here. Right now. I might start using that too. Sometimes I'll use, I'm like, oh man, I have this ability to really go back in the past. Like I made kind of a large mistake. I mean, it's not a mistake if you learn from it last week and who as you know, like for a while, uh, you know, like the next day I was like, I could recognize what I was doing.

I wasn't spending that much time on it, but it was still happening for me. Cause it was thoughts still kept showing up. So I started to just go to past past, or what's done is done or, you know, it's just good to be able to remind ourselves what's done is done. What's done is done. Um, I mean it wasn't like horrible, terrible.

I didn't hurt anyone. I just made a mistake in a purchase and that's okay. Because we all make mistakes. That's okay. And so it's like, all right. And what's done is done. Let's, let's be right here right now, like you said. And so the more we practice that, the better we get at it. And if we have those precepts, like the kind you're talking about, where you can just come right back to it, where you don't have to explain a whole, you know, series of events, then your training is like, you know, of your mind is even more powerful.

Dr. Diana Mercado-Marmarosh: Yeah. And it took a while because the brain wants to tell us all kinds of things. Like obviously when we're doing our notes, right. Or we're trying to close the encounter, it's telling us that we're so slow. Like we're like really, really slow. Right. And it's probably not the case, but our brain is telling us that.

So like, I've learned to acknowledge that. But at the same time, I tell myself I hurry slowly. So it tells me that I knew move on with it, but not so much to where I'm going to make a mistake and put the order on the wrong patient, or I might miss a big thing. Right. So it's enough to tell my. Okay, let's go, but not get outta here. And then we missed the whole bowl.

Dr. Rashmi Schramm: I know. And that's the danger, right? Is there, there are so many opportunities for the wrong click and the wrong chart. And, and we are really tasked as physicians. We are tasked. Something that I think is nearly impossible, for the brain to sometimes do where sometimes most of the time doing the job with three or four people.

And on top of that, all of the emotional and, the complexity, the, of the social aspects of all the things that we're dealing with our patients, and then what's happening with our staff, let alone whatever hospital system or clinic you're in. I mean, it's a lot, it's a lot to manage for sure. And be. That way of just reminding yourself and then, like having your own back and reminding yourself of that self compassion that can, that can take us a long way.

Dr. Diana Mercado-Marmarosh: And you know, people with ADHD, we even though in the U S it's not recognized as emotional dysregulation to be a thing that is used to diagnose ADH T in Europe. It is. And so it makes you wonder whether people having society or depression. Along with ADHD or if it's just part of their ADHD, because they're so irritable that they can't accomplish a task because they, you know, their brain has 25 tabs open and can't prioritize which one it is whenever things are gonna happen throughout the day.

You seen as mom meditation, a two or three minute meditation, when you feel like you're about to lose your shit. Right? Like I, excuse myself, I go to the restroom and I do a little micro meditation and it's my way of telling myself I can't. Sit and overwhelmed the whole rest of the day. Or I can sit in this uncomfortable overwhelm for two or three minutes and try to rewire how I'm going to see the rest of the day.

So maybe this encounter went to shit, but I still have five other patients that I would want to show up at a better place. I'm still a human being. I'm not a robot, but acknowledging that, how I show up in how I'm choosing to show up. Sometimes you can control it. And sometimes you can't because there's so many things where we're human, right.

We might be dealing with the worry of a family member who is sick or a neighbor who is dying, or you don't know. Right. Or you're going through a divorce, things happen. Right. And so. That's the beauty of understanding that we're human and understanding that meditation can be a tool for us to regulate us.

Right. And to support us because to me it's a very strong, self care form because, nobody's going to be like, oh my God, you look tired, good. Sit down. Like you have to be aware of how you're feeling so that you can. Recharge yourself, right? Because I keep saying this, you cannot give what you don't have.

Like, you can try to pour from an empty glass, but nothing comes out, you know? So you gotta make sure you fill that cup up. And that way you do give from a place of abundance, not from like, you know, a feeling of having to do things.

Dr. Rashmi Schramm: For sure. And that minute that we start to do that, we start to get resentful and that's like a big red flag for me.

Like when I noticed it was that meant showing up, I'm like, whoa, what is, what is happening here? Just slow down for a second and notice what's going on. It doesn't have to be that, you know how to fix the situation, but just bringing awareness to something can be really powerful in and of itself.

Dr. Diana Mercado-Marmarosh: So tell me, what are you goals for the next year or two?

I'm so excited to hear. I know you're a trailblazer and you're everywhere. So just share with me.

Dr. Rashmi Schramm: Within Optimal Wellness, I've got a whole bunch of things in the works right now. So. We've got a small group program, which is almost full. It starts on the 31st and that goes for 12 weeks. That's going to be amazing.

You're actually going to be coming on as a productivity coach, Dr. Diana, and I'm so excited about that. And so were all the women that are registered already and all the ones who are going to register from now until then, and then. So have my one-on-one program and that is actually full with a wait list. Right now I have two retreats that are coming up here locally, where we're going to do meditation, some yoga we're going to do like some workshops. It's going to be a whole lot of fun. Really my bigger goals are to do more in-person retreats. That's my goal. We all know that that is not under your controller, my control that is under the COVID control.

So, I have big dreams and big goals, and I know where I want to host these things. But, I'm working cautiously. So right now the retreats that I have in person are all outdoor and they're one full day retreats. So which we can still do and require vaccinations and all that. But once you start to get into the multi-day retreats, then it can be a little bit tricky.

So that's definitely on my mind. The, you know, sort of offering to help, really burned out and not even if they're not even burned out, but just in general, women who need community who are ready for personal growth, who are looking for personal or a spiritual journey. That's what I want to be able to, provide in a larger scale.

Dr. Diana Mercado-Marmarosh: Yeah. Like at some point in my future, of course, you and I have talked about this doing retreats, like all over the world. I love to travel with. So I'm like, Hey, we got to go hang out in Croatia or Spain or Italy, you know, how amazing would it be for people to come and like figure out their systems, figure out their way of taking care of themselves.

And then we can offer CME and they can be a business expense or a medical. Professional developer expense. Right? And then again, like you taking care of you, it's the ripple effect, how amazing you show up as a parent, as a daughter, as a physician, right. As a neighbor, right? All of a sudden. Have you're functioning from a place of peace and embodying it, not just like, you know, having the thought about it, but actually living it.

Right. So it's very different. Tell me, if our listeners are wanting to get in touch with you, how can they find you? Where can they find? Yeah,

Dr. Rashmi Schramm: I'd love that. So I'm on Instagram and Facebook and, the handle, there is just doctors, Dr., and then my name, which is Rashmi Schram. And then, my website is optimalwellnessmd.org, and I'm on LinkedIn.

I'm also on. Ah, clubhouse. So wherever people are, come hang out with me and, we'll have a lot of fun together.

Dr. Diana Mercado-Marmarosh: Awesome. So if there's anything like one final takeaway point that you want the listeners to hear, what advice would you give?

Dr. Rashmi Schramm: Yeah. You know, I think it's that normalizing the idea that whether you've been identified as somebody with an ICD 10 diagnosis or DSM-5, you know, meet the criteria for ADHD or not.

Every human being in 2022 has ADHD tendencies, period. If somebody doesn't recognize that they're not living in our world, we live in a distracted distractable world. And so to normalize. This notion that it is really hard to focus and concentrate because we carry a computer around in our pockets. We then we, we have so many ways of dings and beings and all this other things that, to like, have that sense of self-compassion that, that nobody is alone and that nobody is just born.

I think with just this like laser focus and that we can all get there and the systems that you provide, you know, there's so many different tools that are out there that to just continue to, you know, again, just a curious and bring back, come back into that self-compassion and just keep growing. That's what I would say.

Dr. Diana Mercado-Marmarosh: Awesome. Well, thank you so much for those that are obviously my clients and have worked with Rashmi already. It's I mean, what do they say other than life-changing and she teaches him how to do breath work and she teaches them how to meditate, but. I am only bringing you people that I trust and people that I myself have worked with.

And of course I am her client. So I want you to know that I'm not just here making a podcast about XYZ. I am giving you the tools that have helped me to be able to function. You know, tapping has been one of the tools that was helpful for me. And that in combination with yoga nidra have been really supportive for me, because like I mentioned, if you guys don't know what that is, you can go to YouTube or you can find Dr.

Rashmi's information and try some of her meditations. And then you'll see that you're going to come out of it. Refreshed. Energized. That's what we want. We want you to feel refreshed and energized alive, right? Not numb. So please give, give it a try. If you have never tried something, you can't, you don't know if it's gonna work or not until you try it.

So give it a go.

Dr. Rashmi Schramm: Yeah, I love that. Thank you for reminding me about YouTube. I actually have several, I have a, I have a meditation for focus on YouTube. That's perfectly free. So you can just go to YouTube, Google my name. And that would be a great one to try.

Dr. Diana Mercado-Marmarosh: Don't worry, guys. I'll get the links and I'll put in the comments.

Okay, thank you again. I know that time is your most valuable asset and I am so grateful that you gifted that with us today. And so thank you.

Dr. Rashmi Schramm: It's my pleasure. Thank you for having me.

Dr. Diana Mercado-Marmarosh: As someone who understands that time is your most valuable asset, I am so honored that you have shared your time with me. Please click the subscribe. And join my Facebook Group: Beyond ADHD A Physician's Perspective so that you never miss an opportunity to create time at will. Do share this podcast with your friends. So they too can learn to live life and stay in their own lane.

 

Connect with Dr. Rashmi Schramm

Website: https://www.optimalwellnessmd.org/

Social Media Handles:

facebook.com/Dr.RashmiSchramm

instagram.com/dr.rashmischramm/

youtube.com/c/DrRashmiSchrammOptimalWellness

linkedin.com/in/rashmi-schramm-md