Dr. Krieger’s Three Resilience Tips

Date Published: June 11, 2019

In this mini-episode, Stephen Krieger, MD, Neurologist at The Corinne Goldsmith Dickinson Center for Multiple Sclerosis at Mount Sinai, shares resilience insights he’s learned from treating patients with multiple sclerosis. Dr. Krieger’s patients include Elizabeth Jones and Kate Milliken from Ep. 12: Somebody to Lean On.

One of Dr. Krieger’s tips is to view uncertainty as a positive. When coping with chronic medical conditions, patients wonder, “What is going to happen next?” and “When exactly will it happen?”

Dr. Krieger, who specializes in multiple sclerosis (MS), finds that patients often present as anxious because of the uncertainty of living with MS, a disease hallmarked by ambiguity. He shares strategies to help his patients with this lifelong chronic disease.

Podcast Transcript

Dr. Stephen Krieger: 00:00  
OK, three resilience tips: View uncertainty as a positive. That is to say, view uncertainty as an opportunity to do well.

Host: 00:10
Wait, say more about that. What do you mean by that?

Dr. Stephen Krieger: 00:12  
So I think—I have often described that when someone gets a diagnosis of a chronic disease or really faces any challenge, in some ways it—I feel like it amplifies their existing personality, especially uncertainty. So if you take somebody that views things in a very negativistic way and tell them that there's uncertainty to their prognosis, they are gonna go down a very dark path. If you take somebody who has been very optimistic and positive their whole life and tell them that there's uncertainty that they're facing, usually they imagine the best outcome and try to target that. And so for me, I try to bring optimism into the room for all of these patients who get diagnosed with MS and recognize that that variability of disease course and that uncertainty, we can harness that for good. We can say, 'This does not have to be a bad prognosis. This does not mean that you are going to become disabled. Let's take the best possible outcome and then align everything that we do around trying to achieve that best possible outcome.' So that's, that's one.

Host: 01:25

Dr. Stephen Krieger: 01:25  
Optimism in principle, but realistic optimism. Number two would be, um, celebrate the small victories. So when somebody has a stable MRI scan for instance—and we do these MRI scans every six months or every year—I really wanna celebrate that piece of good news. If somebody has been stable in this disease, has had no new lesions, for instance—that's our favorite three words to be able to say, "No new lesions." Um, but I really try to celebrate that. That's not just a checkbox. "Yeah, your MRI's stable." No, I want to show it to them. I ask people in the visit, "What are you going to do to celebrate this good news tonight?" Um, and then I think the third resilience sort of technique in essence is, um, to realize one's own personal resources. To realize how much someone has already done and overcome already at the point of this diagnosis, or, let's say, someone who's had MS for 10 years, to really look at how they've struggled, how they've done well, to draw from past successes and to recognize their own strengths. So I think in a sense those are the three: Consider the best possible outcome and target it. Celebrate small victories. And recognize their own strength in history of success.

Dr. Stephen Krieger: 02:56  
I'm Dr. Steven Krieger. I'm a neurologist at Mount Sinai and I'm an MS specialist at the Corinne Goldsmith Dickinson Center for MS here at Mount Sinai.

Host: 03:06
Road to Resilience is a production of the Icahn School of Medicine at Mount Sinai. It's produced by Katie Ullman, Nicci Hudson and me, Jon Earle. Our executive producers are Dorie Klissas and Lucia Lee. For more resilient stories and tips, subscribe to us on Apple Podcasts, Spotify or wherever you get your podcasts. And if you like what you hear, rate us. We'd really appreciate it. We'll be releasing a new full-length episode at the end of the month. Here's a preview:

Dr. Cardinale Smith: 03:33  
I was on the plane with my husband, and we were flying to Puerto Rico. And I became really emotional and started crying. And I remember the flight attendant came over to us to ask if I was OK, and even though my husband kept elbowing me to stop crying, I couldn't. And it was, I realized in that moment that I was remembering all of those patients I had cared for that had died and that I had actually never grieved for. And I knew that if I was just now at the beginning of my career that this was something I was going to have to address.

Host: 04:05
That's coming up later this month. For the entire Road to Resilience team. I'm Jon Earle. See you then!