Ep 192: Navigating Burnout: Strategies for Emotional Well-Being with Dr. Jessi Gold

In this conversation, Dr. Jessi Gold, Author of “How do you Feel?” discusses her book on mental health and burnout, particularly in the healthcare sector. She shares her personal experiences and insights on the subtlety of burnout, the cultural perceptions surrounding mental health, and the importance of self-care and compassion. The discussion emphasizes the need for individuals to recognize their own emotional states and the societal pressures that often prevent them from taking necessary breaks for mental health.

Dr. Gold advocates for a shift in how we view mental health issues, encouraging listeners to treat themselves with the same compassion they would offer a friend. In this conversation, we explore the complexities of emotional responses, particularly in caregiving roles. They discuss the importance of understanding and articulating feelings, the challenges of burnout, and the necessity of self-care and mindfulness.

The dialogue also addresses trauma, emotional disconnect, and the need for open conversations about mental health in the workplace. Jessi emphasizes that acknowledging one’s feelings and experiences is crucial for personal well-being and for fostering supportive environments in caregiving professions.

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Speaker 1: 0:00

Hello, my dear friend, welcome back to another episode of the Cures Neuron podcast. My name is Cindy Hevington and I am your host. I am a mom of three from Montreal, canada, and I have a PhD in neuroscience. My goal here with Cures Neuron is to help you learn how to regulate your emotions and how to model this and teach this to your child. I know that many of us didn’t learn how to do this when we were young, and so that means, now that we are parents, it’s really hard to model and teach this to our kids because we were not taught the tools, and so I want to pull all of the insights, the information and tools and tips that I can for you from research and have conversations with experts that are going to help you learn how to manage your emotions. Today’s conversation is a little bit different. This conversation is for parents, but if you work in a field where you also give and nurture and help other people, then this conversation is for you in particular, although everything we’re going to talk about, every single conversation or part of this conversation, is also going to apply to parents, because, as parents, our job is to give and give and give and nurture our child right, so this applies to everyone, but we are talking about specifically the medical field with our guest today.

Speaker 1: 1:09

Before I introduce our guest and the topic, I want to thank the Tannenbaum Open Science Institute as well as the McConnell Foundation for supporting the Cures Neuron podcast. Thank you, and thank you to you for listening to the podcast. I hope you are subscribed. If not, double check that. Click on the button to make sure you’re subscribed and get the episode on your playlist every single Monday morning and make sure that you leave a review and a rating if you haven’t done so yet. Every single rating and review allows this podcast to continue. So I know some of you reached out to me and said Cindy, I’ve been listening to this podcast for years now. I never took the opportunity to rate the podcast or review the podcast, and I’m so sorry. I’ve done it now. Please don’t wait. Please take the moment now to do it, because this is what allows the podcast to continue and the funding from these organizations. They look at metrics and the metrics matter and it allows them to know that this podcast matters to you. So please take a moment to do that. Also, what is helpful is when you share an episode, and so if you know somebody who’s in the medical field, who’s a nurse, who’s a doctor, who’s any other position in the medical field where you support and nurture other people social workers, police officers, teachers all of these fields can benefit from the conversation we’re having today with Dr Jessie Gold. Her book is a new book that is out now. It’s called how Do you Feel, and I’m also going to gift this book to my doctor because I just feel that it helps people feel seen. It’s for the people in medicine, obviously, but I think anybody who works in a field again where you are serving others and helping others you need to read this book.

Speaker 1: 2:51

Dr Jessie Gold holds the esteemed position of the first chief wellness officer for the University of Tennessee system, a role encompassing five campuses across the state of Tennessee and over 62,000 students. She also serves as an associate professor of psychiatry at the University of Tennessee Health Center Science Center. Dr Gold is an international speaker and has been featured in the Washington Post, new York Times, forbes and Self. What I enjoyed the most about Dr Gold’s book was that she brought in stories of patients, and so she is a psychiatrist and not only shares her own journey with mental health and wellbeing during the pandemic and coming out of the pandemic. She shares the stories of others, and I think something that was a takeaway for me was also what the medical field went through during the pandemic something that many of us don’t realize, and we were on the other side, home, safe, whereas they were risking their lives every single day and the story she shares helps us feel a little bit more compassionate towards that and realize what they had to go through.

Speaker 1: 3:59

I think the fact that Dr Gold shares her own journey allows us to feel seen as well, that we’re not the only ones, and so, if you are a parent or somebody in the medical field or any other field that serves and nurtures others, I hope that this book makes you feel seen, because it is not easy to always support others, like I said before, even parents we are always giving. This need to always have the energy and the capacity the emotional capacity is not sustainable. It is very hard, and so what I try to gain in terms of insight in my conversation with Dr Gold is what do we do when we’re in this position? How do we nurture ourselves when what we do every single day is nurture someone else? And that’s exactly what I learned from my conversation with her. I hope you enjoy my conversation with Dr Jessie Gold just as much as I did. I will see you on the other side.

Speaker 1: 4:52

Welcome back everyone. I’m here with Dr Jessie Gold. Hi, welcome to the podcast. Hi, thanks for having me. I am so excited to speak with you. I had the lovely opportunity to read your book and I think this is something that is needed. I actually want to buy my kid’s doctor this book as a gift for Christmas, you know, and just kind of put it out there. It’s almost like a warm hug for people in this industry. So thank you for sharing your knowledge with the world and your experiences as well.

Speaker 2: 5:19

Yeah, I mean it would be my honor for people to go give that as presence, to like their doctors and their therapists and their nurses, because it might seem like you’re saying I think you have a mental illness and you’re struggling, but but I also think it’s like hey, I actually care about you as a human and I really liked this and found it helpful and I hope it’s helpful for you too, and I think that that’s so nice in so many ways and like we don’t get thanked enough anyway, so but that’s like nice in so many ways and like we don’t get thanked enough anyway, so, but that’s like after reading it, that’s the feeling that I got.

Speaker 1: 5:48

I just needed to hand this out to everybody around me that was in the medical industry as a thank you, as a I want you to feel seen. Not you know, you have issues you have to work on, but more of like I want you to feel seen, and I’m assuming, I’m hoping, that’s what they get from this book. I’m really curious to know how your work led to the idea of this book. Was there a moment Was it an accumulation of different moments when you thought you were ready for this?

Speaker 2: 6:14

I think it was probably an accumulation of moments. I think there’s like an aha moment in general at the beginning of my book where it’s like I clearly a problem for me that, like my life and what I’m experiencing is interfering with work. But I think in so many ways, like through the pandemic and sort of processing stuff myself and processing, like with my patients in parallel, I think I did a lot of learning and in that learning realize, like what I didn’t know and what nobody taught me and also what nobody taught my patients and how unseen they felt, despite, like you know, being called heroes and people clapping for them and you know that sort of thing. It felt like the first time anyone had ever recognized that part of them. But it also felt kind of fake. And so I had this like if this stuff is stuff I’m struggling with and I’m supposed to be an expert in it, maybe that’s worth talking about. And if all my patients feel unseen, maybe it’s worth centering them in the conversation somehow, and so that sort of led to it. I also think, like in a lot of ways, like I think about this stuff a little differently than some of the people who do this work. So there are lots of people who do work in systems and who do work in burnout and who do work in healthcare workers.

Speaker 2: 7:28

But I’m an anthropologist by training and very much think about culture when I think about stuff and I feel like culture was worth talking about, because we’re so stuck in systems all the time and then if it’s not systems, it’s only the individual, and both are frustrating, I think, because systems change is so big and takes so much time and individual stuff people get mad at, like thinking that you’re saying there are no system problems and so culture is kind of a happy medium.

Speaker 2: 7:59

It’s like how do we have a bad system? Try to fix the system and help each other and ourselves in the same way. And having that different perspective felt like something worth talking about too, just because I do think, you know I go to give these lectures and it’s so clear that people have had this fed to them in that way that they just don’t like for so long, like a pizza party plus a wellness lecture, and you know they like turn off immediately, right, but there’s definitely good content in there. They just don’t want to hear it because they don’t trust the messenger, they don’t trust how it’s being taught to them or they don’t trust what it means, or what it means that’s not happening as a result, and so, like putting it in story and putting it more on culture, felt like a safer way to have the conversation too. Like maybe people wouldn’t be turned off immediately and maybe they would actually get some of the content you know.

Speaker 1: 8:51

I appreciate that and I agree with you because I give talks here in Montreal. I give talks in schools and work on well-being with teachers, and so what I’ve heard from them is similar to what you just said, in the sense that it’s just another person kind of coming here to talk to me about my well-being when our system isn’t making changes that will support us and prevent the burnout that we’re going through and you know, reducing class sizes and there’s so much more. But I’ve experienced that through their, you know stories that they’ve shared with me, so I get that they’ve shared with me, so I get that. I love that you did it that way because I do feel that it’ll help those that are reading to feel seen through the stories. There’s so many different stories that cover different aspects of that, and so I appreciate that and sharing your story as well.

Speaker 1: 9:37

That openness to share that was so important because, again, as the messenger, sometimes we share it and you’re coming from a place where you’ve studied something and it’s as if you can’t go through it because you’ve studied it, and so I really enjoyed hearing your story as well, and especially that moment when you kind of realized with your own therapist like oh, wait a second Now I see what it is, I see the signs now and you had that moment, that aha moment, what it felt like in the book kind of makes it real for everybody reading right when you don’t notice it when it’s happening. Can you share a little bit about that in terms of burnout and kind of being in it but not really realizing until you’re kind of far ahead in it?

Speaker 2: 10:20

right, yeah, I mean you say aha moment. I call it a gross, embarrassing situation. You know like I mean I get it and I know why we need externalized sometimes. But in the moment when you’re having a conversation and somebody points out that you’re dealing with the thing that you just gave a lecture on, like 20 minutes ago, it’s a little bit like oh gosh, like that’s bad, right, and so as much as it is like totally true, and I get why that happens, I also think it’s it’s like a mix of embarrassment and aha, aha, awkward.

Speaker 2: 10:53

But you know, for me, you know, burnout is really subtle, and it’s subtle in the context of workplaces, because in our workplaces we expect them to be hard and we expect ourselves to feel tired as a result, to feel like emotionally exhausted if you do something, like patient care, to feel like we don’t always get stuff done, which are literally all the symptoms of burnout.

Speaker 2: 11:14

And so it can mask as just like I think I’m having a bad workday or I’m not getting as much done as I want to, or this is just the way work is supposed to be, and I think you mask it like for so long that you blow past like the little symptoms because you’re like, eh, like I think this is work.

Speaker 2: 11:32

And then when it actually is bad, then you’re like, oh no, like now it’s interfering with work, right, like it’s not. It goes very quickly from like subtle, subtle, subtle, it must just be how I’m supposed to feel to like, oh no, now it’s actually going to make me do something bad at work or affect somebody at work, and that is a problem, right, and for me, you know, some of that is because we aren’t checking in with ourselves along the way and we’re just doing our job, and I’m an overwork to cope person. And so you know, of course, if you’re doing like 17 jobs, you’re going to be tired from your 17 jobs, and so you have to be really tired to say something’s wrong, right, and so in that context, I feel very much like it becomes easy to just kind of not know until you know.

Speaker 1: 12:22

I get that. You know what’s difficult with burnout also is the acceptance of it and then the time you need to kind of step back. And also, as I had given a talk at this place where the company said, please don’t share the signs of burnout when you give your well-being talk, because we don’t want to lose 70% of our employees, so that kind of was a red flag for me in terms of that workplace and what was going on and the support that they were getting. But what, what can, what can we do to be our own advocate? Right, because we’re going to, like you said, we’re probably especially those in the in the healthcare industry, and I posted about this on social media to see what the feedback would be. I asked about their wellbeing and if they worked in the healthcare or in the education field, and it was even police officers and social workers.

Speaker 1: 13:16

Everybody who takes care of somebody spoke about how hard it is because you can’t really stop. They just felt like they had to continue to be there for the people that they’re supporting. So if you’re in it, there’s the pressure from your like a boss, right, like saying, like I don’t want to disappoint them, you don’t want to disappoint yourself, and then you can’t really stop, and then you’re probably coming home to a family or people that you have to take care of again. How do you?

Speaker 2: 13:40

how do you navigate that? And insurance is based on employment, Like. There’s so many other things too, Like if you step back, like how long can you take disability before it affects your family or financially affects you, et cetera. You know that workplace makes me so angry, Like because you know telling someone the signs doesn’t all of a sudden mean they have it. They had it before. You know, and if you’re that concerned that them knowing the words and the verbiage is going to make people want to leave, like you probably should not have a talk that could at all touch on that, because you clearly don’t care, but I still gave the symptoms.

Speaker 2: 14:14

by the way, Good yeah, you should.

Speaker 1: 14:16

You’re like shh don’t tell anybody, I’m doing it anyway.

Speaker 2: 14:25

But you know, what I hear so often from people is like the word burden, like the word burden comes up all the time in the kind of the context of all mental health stuff, but especially in the context of like this is it bad enough to really need to take the time and what counts and burnout feels, like you know, minimized in some way, I think probably because we use it like I’m burnt out from work and it’s so hard.

Speaker 2: 14:47

And so, since we use the word like that. I think people, when they actually are struggling with it, feel like it’s not a big enough reason to take time off or to ask for that, or to be able to step away. You know, in the context of patient care, if you step away, maybe someone has to cover for you, maybe, if you step away, all of your patients have to be rescheduled for however long. And so you’re burdening right Like your patients and your workplace. And that’s really hard for people, so much so that, like, if I’m sick, I look at my whole schedule and I go can these people wait a month? Like instead of like you know, cause I don’t have more space, like I’m not going to magically have space tomorrow if I feel better, like it doesn’t work like that, and so the system isn’t really set up for us to be able to step back. There’s not enough redundancy, there’s not enough support, and then there’s so many people who rely on you, like you just feel a lot of guilt and a lot of like burden, and so I think there isn’t a perfect way to absolve yourself of that. I don’t think that anything I could say about how burnout is real and how it affects your life is real is going to make that go away. I think saying it makes a lot of sense that you feel guilty and that you feel like a burden, but in the same respect, if you stay at work, you’re actually doing a worse job for the people. In the same respect, if you stay at work, you’re actually doing a worse job for the people. If you stay without taking space, you’re not doing as good of a job as a mom or whatever else. Right, like our brain is conditioned, like because of how we define work and stuff, to think like if I just keep going, it’ll go away and I’ll be like somehow better at this eventually. I just have to not ever give up and just keep going. And it doesn’t work like that.

Speaker 2: 16:27

I used to feel like this in college, like people would pull all-nighters and try to study more and more and more and you would just kind of be like I feel like there’s a point at which it stops being effective and you should just take a nap or sleep because I don’t think that it’s getting in there anymore. And it’s sort of the same way with burnout, which is like we say I can’t afford to step back, but if we step back. We’re so much better when we come back and we’re actually doing what we want to be doing, like we don’t even realize how not ourselves we’re being like with our partners, with our workplace, with, you know, patients if that’s what you see, like so many people tell me that like even patients will point stuff out, like you don’t seem yourself as much or something like that. But they don’t make errors, right, they haven’t hurt anyone, which is my patient’s favorite thing as a limit. Like I’m good, nobody’s dead.

Speaker 2: 17:17

And you’re like great, that’s not great, you know, but inherently like if you’re seeing a patient and they know you and they like you for some reason, and you actually are pulling back, like as an empath, or you’re pulling back because you’re so tired and overworked or whatever, like you won’t enter the workplace, the same person Like you haven’t hurt them but you are not doing work the way that you want to work. And I used to be like, oh, if I show up at 80%, it’s better than me not being there and it’s better than some people’s 100, right, it’s selfish and narcissistic. But you know inherently like that’s wrong, right, like it doesn’t make any sense, like my 80% will still upset me that I was 80%, so maybe I don’t want to be in the workplace at 80%. So I think it’s a reframe of like actually. Yes, you feel guilty, yes, you feel like a burden. I can’t make that go away. But I can tell you that stepping back will make all of that better and all of the work that you’re putting out better in the long run.

Speaker 1: 18:26

I think that’s really important advice, because I think when you’re in it, you don’t see that right. You just see it as I need to take time and it’s not. I can’t do this, and I think seeing it that way can at least give you that perspective of I will be better when I come back from this. There was this idea that I think was brought up a few times, like not being sick enough when it comes to mental health and people that the people that you spoke with struggling with that, somebody who might not be struggling with burnout but might be in the medical industry and feels that I’m not sick enough, you know, to kind of step up and talk about this, or how will this be perceived if I talk about this? What are the first steps that somebody can take in order to take care of themselves when it comes to their mental health?

Speaker 2: 19:11

Yeah, I mean, our bar is very high, right. So it’s not just that burnout in general is kind of normalized in the workplace, it’s that like we have to be actively hemorrhaging to think we earned time off, right. Like I broke two feet and I probably took no days because I was like, oh, I can do virtual, like my God, like you know, which is 100% true, right. But like then I came to work one time with a boot and my patients were like and in crutches, how long have you been in a boot and crutches? And I was like four weeks. And they were like oh, like you didn’t skip any time, you know. And they even are like that’s really bad right. Like when you say it out loud, it sounds really bad.

Speaker 2: 19:45

And so, you know, I think our bar is so high that mental health pretty much never makes it, because if you have to be like bleeding, you are not going to be bleeding. It doesn’t show right. And so I think some of it is that having mental health concerns and having burnout is a valid reason to need to take time away or to need to take care of yourself. I think, you know, one of the things that I’ve had to do for myself is really check in on myself more often. So we spend so much time asking other people how they’re doing and really never ask ourselves. And when my therapist was like when’s the last time you asked yourself how you were doing? And I was like what does that mean?

Speaker 2: 20:27

like I’m supposed to look in the mirror and be like how are you just?

Speaker 2: 20:30

I was like that’s the dumbest thing I’ve ever heard, and she was like no, but just like try, and she was right, because she usually is. But, um, you know, we don’t notice subtle differences unless we’re paying attention, and we don’t pay attention because we think we shouldn’t. And so one of the easiest ways to start taking care of yourself in the workplace is to actually start recognizing yourself as a human in the workplace, which means like how is work making you feel? How is the day making you feel? If I did that, I would notice like subtle stuff. For me, that’s like emails make me super angry, not like a little angry, like super angry, and I don’t really feel like that unless, like, I’m heading towards burnout because the super anger is like I have no capacity. And emails are people asking me for more, because it always is.

Speaker 2: 21:16

They’re not like nice and checking on me and saying they love me or something or like giving me more work, and every time you reply to emails it actually comes back in like a double or something. I don’t know how that works, but you know, when you’re like that to me, like I used to go, sometimes emails piss me off. Right. But really, if I’m really mad at email, I need to step away and do something about it, right? Like I have to do some kind of thing to make myself feel better and do something about it. Right, like I have to do some kind of thing to make myself feel better. If we don’t pay attention until we’re like 10 out of 10 burnt out, you’re gonna need time off work Like there’s no question. If you pay attention and you notice emails piss you off. Like you actually could go for a hike, talk to a friend like go do yoga, whatever it is you like to do, and like if someone suggested it when you like to do, and like if someone suggested it when you were really burnt out, you’d throw something at them. That is like what works earlier, right, like it works earlier. We just are not paying enough attention to ourselves for those interventions to be useful. And so, you know, what I often say is like, like really pay attention to yourself. I think it helps you notice, like what it presents in you, what things to be looking for in you, what really affects your mental health and what really affects how you interact with others in the workplace. You know the same goes for checking on other people. Sometimes that feels nice too, but you know that’s an easy place to start.

Speaker 2: 22:34

I think there’s a lot of like guilt and shame and things like that that probably need to get worked through a little for me not to say like like it’ll always feel bad to take time off work. I just I get it. I don’t know that like there’s a great step to say this is how you no longer feel burdened by taking time off work for mental health reasons. I think we will, until society decides it’s the same. Like nobody would blame a doctor who’s a cancer doctor, who has cancer, for taking time off for cancer, right.

Speaker 2: 23:06

But if I’m a psychiatrist and I need a mental health break, they’re even like are you sure that you should be a psychiatrist, right? Like that’s how different it is and how we perceive it, and so like we have a long way to go with that, but know that that stuff in your head is not actually coming from you, like that stuff in your head is coming from culture and what you’re reading, what people are saying. Try to figure out where you land like and why that’s coming at you, because you might be able to realize that you actually think if, like, a friend wanted time off work when they were burnt out, that you would tell them that was the right thing. You’re your own friend too.

Speaker 1: 23:43

Which is hard sometimes. Right, that brings in Kristen Neff’s work in self-compassion, where, you know, even when I talk to parents, it’s like, well, what would you say to somebody else who, you know, yelled at their child? And they’re like I would say, well, maybe you had a bad day and maybe it’s just a really shitty week, and it’s okay to say that you know and yelled at your child. But then when it’s them, then they’re like why am I such a bad parent? Why have I failed at this whole thing? And it’s like, no use that friend voice. And we do the same when it comes to our mental health. You’re right in saying that sometimes there might be that guilt and shame we might judge ourself. Or why am I feeling sad? Why am I feeling this way? Or why am I catching myself in these moments of anxiety Like I need to calm down, like just relax. There’s nothing to be worried about. But we have to kind of step back and show up for ourselves in a more caring and compassionate way.

Speaker 2: 24:31

Yeah, when I have feelings I want them to go away. Right, like, if I have big feelings, I’m afraid that big feelings are going to be disruptive and they need to stop. Right, like I like an anger. But if I feel really angry, I’m like how do I make that stop immediately? Sure, and I’ve had to spend time being like it’s okay that you’re angry, it’s not good or bad that you’re angry, you do not need to fix it right this minute.

Speaker 2: 24:53

What does it look like to just be angry? And it is hard, do not get me wrong. Like we have emotions kind of conditioned out of us early when, like you know, you’re trying to be successful and it gets in the way. I mean, I talk about my own experience with that kind of growing up. But I think that gets into your head when you’re not being self-compassionate, right, like what’s coming out is again what you learned about emotions in your workplace, in training, or what you learned growing up about feelings, and so it all compounds and all you hear is like quit it, Like it’s going to get in the way, like you shouldn’t have those, or what can you do to make it go away?

Speaker 2: 25:32

Because, in a physician model problem, fix it right, like it’s not problem, just hang out with a problem, like you know, and so that also gets in your head. Where you’re like my job is to make things better, like how do I make this better? And maybe it’s not bad to begin with and it’s okay that you’re just angry or sad and you don’t have to apologize either.

Speaker 1: 25:53

It’s very uncomfortable for many of us because, you’re right, we didn’t learn that when we were young. I just think about something as simple as worry. When I was young, my mom would say and she didn’t mean ill on me, she just didn’t know how else to do it. And she was raised that way too. But it was like I’m worried about this, well, there’s nothing to worry about. I had severe exam anxiety and she’d be like it’s just a test, and then off I go with these worry thoughts and I was like, okay, I guess there’s nothing to worry about. And then it would happen again and I was stuck in this pattern, you know, being sad. It was like just let it go. It’s like just it’s enough, just stop, be happy and that’s it. And I think that that’s why it’s so hard for us now, even as adults or as parents, are supporting somebody else, because how can we be comfortable with their emotions when we’re not even comfortable with our own and we don’t know how to sit with that emotion, that uncomfortable, awkward emotion.

Speaker 2: 26:43

For sure. And you wonder why doctors like change the subject when you talk about feelings, right, I mean, it’s the same thing. It’s like they can’t handle their own. They’re not going to handle yours very well. And you know, you mentioned test taking.

Speaker 2: 26:55

I had the same experience with tests. It was, like you know, standardized tests were like the worst for me. Like I threw up in the ACT and had to cancel my scores, like not in the room, like, which is good, but I made it like you know, when they said like five minutes left or something, I probably had the equivalent of like a semi panic attack but didn’t know anything of it and like really blanked out and like got very nervous and like finished wherever I could and then ran to the bathroom when we could, threw up and left and canceled my scores. And I wasn’t like that with school tests. I was just like that with the big ones, because it felt like if I do badly, my life is over and like I can’t do all of these things. And again, my parents never told me that and they did similar to you, like Jessie, like what is a test Like? Why are you not? Like what?

Speaker 1: 27:43

are you sick?

Speaker 2: 27:44

about Like it’s okay, it’s a test, and what do you mean? You like left, couldn’t you just go back and finish the test? And I was like no, like I can’t imagine going back after that. I can’t even like tell anybody. I just did that, you know.

Speaker 2: 28:03

And so I think yeah, I mean it starts really early, like the things that are really bothering us, like, you know, as a parent or something, asking what’s going on there and understanding more about it, as opposed to just like it’s okay, you don’t need to feel that way, it’s a test, like I don’t blame my parents, they’re awesome parents but I think like asking me why or like trying to understand the big reaction more wasn’t part of it. I definitely didn’t go to therapy and you know it maybe would have been helpful if I understood that in high school so that it wouldn’t have been a problem for the MCAD and it wouldn’t have been a problem for board exams. But it continues to be a problem for the MCAD and it wouldn’t have been a problem for board exams, but it continues to be a problem because it’s just the way it is for me, you know Well you know that question how do you feel?

Speaker 1: 28:49

Just that, in itself, I think, is not easy for us to answer. Sometimes, when I talk to parents, it’s like I feel fine, and I know that word was brought up in your book as well. You know, I think that we don’t even have the vocabulary around it sometimes where we’re feeling off and I don’t even know why, or I’m feeling it’s not mad and I don’t know exactly what there is, and then you see this wheel with like a thousand feelings and you’re like oh, I don’t know. I’ve never really taken the time to explore the different ways that I can feel sad, right Like in the different like degrees of that. It’s really hard, but I think having that sort of language kind of allows you to say like, oh, I’m going to sit with this feeling of you know, frustration in that moment. And it feels good in the moment when, like after you do it, you’re like I accepted myself in that moment and I just feel like it’s rewarding for yourself.

Speaker 2: 29:37

It feels bad until it doesn’t it’s rewarding for yourself. It feels bad until it doesn’t Like for a while you’re like well, this is miserable.

Speaker 1: 29:44

There’s the quote.

Speaker 2: 29:46

You know, and then you realize it wasn’t as bad as you thought. Or you know, and I think some of that like you learn by doing like we do the same thing with people with panic attacks. You know, inherently they’re like, oh no, I’m having a panic attack, like I’m going to die, because it feels like that, but they last a minute and they don’t die, you know. And so sometimes you have to be like, well, what if we just have a panic attack and see what happens on the other side? You know, and that’s scary, and but they survive. And then they know they survive for the next time.

Speaker 1: 30:16

You mentioned something before that I want to come back to the capacity. So, with the work of supporting others and being with others, whether it’s in the medical field, again teaching you know social workers that I’ve spoken with when you’re just always giving. And so you have maybe a patient in front of you that’s not well, and you’re trying to help them be okay. And then you have a child in front of you who’s screaming and they’re mad at their test scores and you’re trying to help them be fine, and you know, move past that uncomfortable emotion and you’re just giving and giving and giving.

Speaker 1: 30:45

And then the end of the day comes and you’ve got nothing left and, like we said before, you leave work and then you have to somehow recharge in that drive between work and home, or the walk, or the 10 steps between your basement right and a different floor, which is what one parent had told me. She had said 10 steps, 10 steps between work and home where all of a sudden I have to be okay to support my family. I mean, we can’t make that go away. Right, that will be part of the work. And so what do we have to start being more mindful of? Again, we can’t change that person in front of us and the reactions they’re having and the distress that they might be having. But is there anything we can do to, kind of, is it being attuned to ourselves, like you said before, in these micro moments throughout our day? What should that look like?

Speaker 2: 31:35

Yeah, I mean in order to take care of other people or take care of yourself. Which one Both?

Speaker 1: 31:41

Both right, like knowing that the work involves always supporting the emotions of others, and that that drains our vitality and our capacity. What can we start doing about that? Yeah, we need to talk about it.

Speaker 2: 31:52

So you know, for some reason it’s like a shock when we’re burnt out from jobs, that we take care of people all day and then we go back home and take care of more people all day. Right, I’ve learned to approach it like, of course you’re going to burn out or of course your job’s going to affect you. What are you going to do about it? Right, like it’s not. It shouldn’t be in novel or news that a job like that affects you. Or going to a challenging home because somebody’s sick and you’re taking care of that affects you. Or going to a challenging home because somebody’s sick and you’re taking care of them affects you. You have to think of, like, the fact that it’s not your fault that it does. It makes sense that it does. And in that context, then, what do you do about it? You prepare, you pay attention to warning signs, you figure out what works for you. You ask for help when you need it. You step away when you need it. Right With that 10 steps. Transitions are really important. So 10 steps might be 10 steps, but maybe in those 10 steps you actually can focus on you for the 10 steps and maybe you do them a little slower for a second, but people do the same thing driving home or in their garage for a second. But transitions really matter, like at the end of the day, at the beginning of the day, in between patients, if you’re a person who sees patients like, or lunchtime if you see school kids or something you know. Like making time when you can actually not carry the whole day with you and then carry the whole day with you into your next. Like shift of something you know either work-wise or home-wise. You know I use a metaphor in the book that my therapist uses about Mr Rogers, like actually coming home and taking off your home. You know, taking off your outside clothes and putting on your inside clothes is simple, but it’s a way to check in with yourself and say, like I’m home, like that part of the day is over, like what does that feel like? And so sometimes we don’t have a ton of time and I don’t know that I could tell you a way to magically make time, though I will say time away will help with time present.

Speaker 2: 33:52

I do think like transitions and thinking of times where it’s not adding a lot to do things can make a big difference. You know there’s a lot of data that, like, exhaling longer than you inhale actually changes your brain chemistry. That takes two seconds, like I mean it doesn’t take, like people don’t even know you do it Like it’s not even obvious, right, so you just breathe out a little longer than you breathe in and you might feel better. I keep stress balls and stress putty like on my desk, like it’s all over my desk, for the same reason, because sometimes, like, if you’re in a meeting and you feel like it’s making you activated or something like you can’t see my hands. You can only see my hands if I’m doing this, right, right, and so you can do things like that to support yourself during the day, where you kind of reground in you if you need to.

Speaker 2: 34:38

You know some people. Somebody yesterday told me that they high-five themselves in the mirror in the morning, not in the face, because I said do you smack yourself in the face? And she said not in the face. But you know that’s again super simple, but it like starts your day off like you’re doing great. You know some people like that.

Speaker 2: 34:56

Some people like mantras and things like that for the a lot of evidence and like trying to identify the good parts of your day, and not just the bad ones. You know, because our brains, you know this, but our brains are like you ate a poison berry today. You shouldn’t eat that berry again, you silly person who ate a poison berry, but you don’t remember, like before the poison berry, that, like, you hung out with your kid and had a really great time. Right, because your brains are trying to save you, but that doesn’t help you with a balanced thought. Right, because your brain’s like silly well, probably like stupid person. You ate a poisoned berry. You’re a horrible mom. You’re a horrible, you know, but you don’t remember when you were a good one, right. And so it isn’t toxic positivity, it’s balance to try to remember some of the good stuff too and make time to do that in these transitions, even like walking the 10 steps, like what was good today?

Speaker 2: 35:57

Okay, you can do what was good, what was bad, if you’re a person who needs that, if you don’t believe that the good like is like a way that you can think. You know, when I say think about the good stuff, I’m not saying there was no bad. Like you could say, today was really hard and somebody was really nice to me and that was great, or I helped somebody feel better or whatever. It is right, like you can. Kind of the dialectic of it is true, like you can have a hard day and there’s good stuff in it. You just don’t see it.

Speaker 2: 36:25

And there’s a lot of evidence from a group at Duke about literally just doing the three good things every day for 15 days has like year long Like we’re not talking like two minutes of effects. It like can actually help you in the long term and that takes no time, you know, like at all. And so you know. So many of my patients are like I don’t have time to take care of myself, and they’re not wrong, right. My patients are like I don’t have time to take care of myself, and they’re not wrong. Right, like. I can see where that perception comes from, because you don’t have time to go to yoga class and you don’t have time for go, go on a long run or whatever. Right, like you have time to tell yourself what to do in those 10 steps.

Speaker 1: 37:02

Exactly. I love that and it’s true because I brought up journaling to some people and they say I don’t have time for that. But at the end of the day, just talking to yourself and noticing those three good moments, I think is something that’s possible whether you’re on your drive home or you’re showering or whatever. It is right. You don’t have to stop doing what you’re doing. And I literally posted my last week’s podcast.

Speaker 1: 37:23

Well, now, this will be posted later, but there was a podcast in September or early October where I talked about articles that focused on intentionally noticing the joy, the moments of joy in your day, and so that’s very similar to what you were saying, where, just by focusing on the moments of joy, when there is a moment of stress, you don’t perceive it as stressful, as if you were not noticing the other moments of joy.

Speaker 1: 37:48

So I think that highlights what you were just saying, which is really interesting. You know, thinking about what you just said, what comes to mind is also those who see very you know distressing things or things that really impact them emotionally that you almost can’t get off your mind and it sticks with you. You know you spoke about a few patients as well that like really had, like I don’t know if the word is traumatic, but all you know very intense moments, and so if somebody is listening to this saying great, everything that you talked about applies to me, but what if I saw something that I just can’t you know brush off and it’s really impacting my mental health and I keep thinking about it. Now, what does that look like for that person?

Speaker 2: 38:33

Yeah, that could be PTSD. I think that sometimes we think we can’t get that by hearing something or witnessing something, but it’s in the criteria. You don’t have to be the person who has physically experienced it to be affected by it. Though you know what you see as a healthcare worker, what you hear could be almost like direct contact. Anyway, if it’s affecting your day-to-day life, if it’s affecting your ability to do the things that you want to do, if it’s affecting your sleep, you probably want to go to therapy. That’s not going to be anyone’s favorite answer, because the mental health system is a hotbed of disaster, but, um, that’s what’s going to probably be needed to make that better, because it’s already impacting your life and because it isn’t something you can just make go away.

Speaker 1: 39:23

It won’t go away with time.

Speaker 2: 39:25

It probably not. You know, you put it on a shelf and then this shelf breaks Right, Like I think that’s the fun thing about trauma. Do you want to use the word fun? No, timeline comes when it wants Right, so you could push it down, but it’ll find a way back up. It might not be in the way you would expect and maybe it’s going to be in a different kind of like symptomatology, but it’ll find a way. You can only put it on a shelf for so long.

Speaker 2: 39:57

But you know, trauma therapy can be hard because you often have to, like, walk through the experience and talk through it until it doesn’t have the same emotional response, and I think that makes it so people often get worse before they get better and that alone is scary.

Speaker 2: 40:08

Like you mean, I have to go talk to someone about stuff.

Speaker 2: 40:10

You don’t always have to talk about your trauma, but you probably have to talk about some of the stuff surrounding it, like how you’ve been feeling, what are you doing, all of that stuff and that can impact you in a lot of ways.

Speaker 2: 40:25

But you know, other than that, you know if you feel activated by a memory in the moment, it’s often like things like if you look up the word grounding techniques, those can be really helpful. They basically just kind of help you self-regulate, have a lot of physical sensations but you’re not like present. It helps you kind of reestablish bodily connection. There’s a thing called progressive muscle relaxation, which is literally just like flexing and contracting every muscle, starting with the tiny ones in your fingers and the ones in your face all the way to your toes and like again. All that does is tell you like I’m a human, this is my body, I am safe, and all of that can be really helpful. You know, I think some of those skills are helpful in the moment for somebody who’s really struggling, but you probably will need to eventually go talk about it because you can only do like a scrunching your face for so long.

Speaker 1: 41:24

Right, and something that comes up as well in the book and that I’m questioning now is somebody who has been through something that feels well, there’s no time to deal with this, or you know, this system doesn’t allow me to deal with this and so I’m just going to bottle that up or suppress it or, you know, not talk about it or disconnect from the emotions that come with the work that I’m doing, and this was another theme that came up in your book that come with the work that I’m doing, and this was another theme that came up in your book, and I thought this was really interesting, because these are jobs and fields where you deal with people but then you’re disconnecting from the person in front of you, right, so that it doesn’t affect you or impact you emotionally.

Speaker 1: 42:02

That’s hard I can’t imagine. But I understand I’m not in this field, I was in neuroscience, but just that in itself I didn’t have to disconnect. But I know that I would come home with like a lot of heaviness from stories that I would hear or people that I would meet. I worked with people who had schizophrenia and so I would hear of their stories, but I can’t imagine that being full time and having four or five, six of those every single day. How does how, how somebody listening to this again being in that field how can they deal with that or cope with that heaviness?

Speaker 2: 42:41

Yeah, I mean they teach us to just not be affected by it. Just like that you know. And yeah, like, if somehow you’re like magically not going to be, like if you hear it enough it won’t affect you. And so you see, modeled for you, like people have no emotions and they’re very disconnected, no-transcript, another bad story, and you didn’t ever go.

Speaker 2: 43:39

But what was the deal with that story before and how did I feel about it and what was like? What’s something that’s bothering me and is there a way to get that out? Maybe it’s journaling, maybe it’s therapy, but really having the ability to recognize that your job can and will affect you, that our natural response because we were taught to is to just assume that we’re fine and we can tolerate it by removing ourselves completely. Often, when we remove ourselves completely, we begin to remove ourselves completely all the time, and so you want to be able to check in with your feelings and have feelings, because otherwise you will not anymore, and so giving yourself space to go like today was a really challenging day. How did I feel about the day, and whether that again is like a journal prompt or whether that’s you just sit with that and tell yourself the answer in your head, like that’s also okay too, but I think if you don’t give yourself space to go of course this affected me or like that was really hard You’re not going to feel as like good at the end of the week or month or year.

Speaker 2: 44:44

And I think this is where workplace support can be really helpful is like somebody else who experienced the same thing or somebody else who has a similar job.

Speaker 2: 44:54

Having groups where you talk about that stuff, or even lunches where you always have time to talk about that stuff, can be almost as therapeutic as therapy. You know, like having someone in the workplace who you can be authentic with and that is regularly on your calendar, that can be helpful. You know, in medicine they do some like support groupy kind of things where you talk about cases and you can talk about your emotions around them. And they’re not, like you know, everywhere, doesn’t have them and not everyone’s going to join them. But for some people, like having that space and being around other people who are also in that space and can can validate the fact that, like of course this is a thing and of course this affects you, I think makes a big difference yeah, I think that talking about it makes such a difference for for people, even parents, like just being able to say I had a really bad day today.

Speaker 1: 45:43

I think it there’s a you’re given that space to be open about it. It’s so powerful, you know, given I want to be open about it. It’s so powerful, you know, given I want to be mindful of your time and I’m enjoying this conversation so much. Thank you for taking your time. There’s one quick question the concept of general adaptation. You kind of touched on that, I think, before. I thought that was really interesting because I was under the misconception as well as well. You’ll learn how to deal with stress the more you are put in these situations of stress, but it doesn’t seem to be the case, yeah, I think it’s basically like we aren’t like becoming better able to deal with it.

Speaker 2: 46:18

We just aren’t noticing it anymore. And so it’s like it’s not like, oh good, I’m resilient and coping. It’s like I just ignored it instead and oh, that’s not really impacting me. And so like the little things are not recognizable because we’re not identifying it. And then you know, like for me it’s like, oh my gosh, where did this come from? I don’t understand. And in part that’s because I didn’t check in all along, but in part it’s because I was like conditioned to sort of like not right. And so we kind of feel like all of a sudden the worst.

Speaker 2: 46:52

But it isn’t all of a sudden, it’s just you kind of are conditions like exposed to stress enough where we go? I don’t notice it. I don’t notice it. Oh, I notice it, but it’s not because that thing that made you notice it was enormous, it’s just the thing that tipped it over right, like if all of a sudden, like that much stress came down on you, like you would feel miserable, like worse than that. But it’s like the little tiny things kind of all adding until it like falls down on you. That that is kind of what that general adaptation is it’s like you learn to deal by ignoring. You learn to deal by ignoring, you learn to deal by ignoring. And then, oh nope, now you’re tired, burnt out, having sleep problems, having trouble concentrating, and you just think you’re fine.

Speaker 1: 47:38

until you’re not you know, right, I think that’s the theme of our conversation today. Right, it’s truly tuning in to ourselves and that, because you don’t want to wait until you’re not fine, we ignore the signs, we are on autopilot and we just keep going and pushing and working harder and more hours and thinking that you know it’ll be okay at the end. It’s not going to be okay. We need to truly take care of ourselves and I think that’s truly. You know what I’ve taken from this conversation, so I really appreciate it If you were to fast forward just to end this conversation. You know, if you were to fast forward five years down the line, after now that your book has been released, what are you? Are you hoping to see some changes at somewhere? Are you hope what? What are some conversations that you’re hoping happen as a result of your book being out?

Speaker 2: 48:24

Yeah, I mean, I think for me, um, I want people to feel comfortable, like comfortable, not feeling alone anymore. First of all, like I think, because we don’t talk about this stuff out loud, we feel like we’re the problem or somehow we’re not tolerating work in the right way, and that’s not true. Like I think very much that all of us are experiencing these things. We just don’t talk about it and so we feel alone, all of us in our little silos, and so I hope that people realize they’re not alone and they’ll talk about it a little more, so then the next person will realize they’re not alone. I have a lot of hope that in writing it, people use it as a conversation starter. Like you know, you said, give it to your doctor, but I also think your teams at work, or your trainee or your kid who wants to go into a field that’s harder emotionally.

Speaker 2: 49:19

Really having these conversations that are based on that can really change the expectation of the workplace and the culture of it.

Speaker 2: 49:27

I would never want someone in college to be scared away from medicine, from the book, but I would want them to go.

Speaker 2: 49:33

This is what medicine is, and I’m going to prepare for it right, like I’m going to figure out how to deal before. I’m in those situations, so I’m better at dealing with it when I am, and if I had done that I’d be so healthy. So you know, I think you know I don’t have faith that sometime magically I’m going to fix it all Right, but I hope that by like peeling back my own experience and showing how, like even someone who’s an expert in it can’t recognize it and also has trouble, like with their feelings and being vulnerable, like that just makes it easier for everybody else and I hope that leads to more conversation and through conversation, workplaces get more caring. You know, I think the systems at work are always going to be the systems. Patients are always going to be hard. I think we can hope to change some of the systems, but it takes a really long time and I think if we support each other in the systems, more people will stay in their jobs.

Speaker 1: 50:29

Yeah, thank you again for writing this book and for sharing this knowledge with us, and I had an absolutely wonderful time chatting with you. Thank you again.

Speaker 2: 50:37

You too, thanks for having me.

Speaker 1: 50:39

Thank you so much for listening to the podcast. Please make sure that you are subscribed. If you enjoyed this episode, share it with a friend, share it online through a text message or through an email, help us grow this podcast and please take a moment to subscribe to the podcast, to rate it, to review it. Thank you so much and I’ll see you next Monday. Bye.