So I have the geeky brain episode today. So I’m diving into some neuroscience about burnout and brain health and how that applies to therapists. So during the throes of my burnout, I really noticed my health was taking really a bad turn. So I tried to apply my knowledge as a certified brain injury specialist. I worked with the brain injury population for over a decade. And looking at brain health, I find is multifaceted. So it’s looking at how do I really restore that brain functioning that I used to have, be prepared for my deep dive early. I don’t really have much segue once we get going. And then I kind of talk through my pillars of brain health, which I derive from my work with brain injury folks, where I talk about movement and sleep, nutrition and connection. So we often forget the connection we need as therapists is so important to our work, and a lot of times we’re isolated in those therapy office silos. So I hope you enjoy this.
This is the Finding Joy after Burnout podcast, a podcast for therapists and mental health professionals. Together we unravel burnout and find our road back to joy. Here’s your host, Dr. Jen Blanchett.
So, in an interesting Swedish study, a team of psychological scientists so, Golker, I hope I’m saying that correctly. And the Karolinska Institute from Sweden found evidence that workplace burnout can alter neural circuits in the brain. So we know that there’s certainly implications neurologically for chronic stress, and I think it’s important for therapists to hear this research. So they took a group of 40 participants. Again, that’s not a huge N, but it’s pretty good. And I think it’s also commensurate with other research that we know from neurological research as well. What they had participants do was look at two different types of tasks. So they asked subjects to look at a standardized series of neutral and negative images, looking at that image for about 5 seconds. And then they were asked to either suppress or intensify. So down regulate suppress that reaction or intensify up regulate their emotional response to that picture. And then immediately after that, they were asked to look at that same image again. As they were looking at that, a loud burst of sound would play, startling them. And then they measured an electrode on their participant’s cheek to see the reflex reactions to the stressful stimulus. The two groups showed similar startle responses when instructed to maintain or intensify their emotional reactions. However, when asked to downregulate their emotional responses to negative images, clear differences emerged. People who were overworked not only felt less able to control their reactions to negative stimulation, their bodies also showed an inability to downregulate those negative emotional responses. The group, also suffering from burnout, had dramatically stronger reactions to the startling noise that the control group had. So they also looked at some fMRI data on these participants. The two groups showed key differences in the amygdala. So that’s our brain structure that is critical in emotional reactions to fear and aggression. The amygdala was not only relatively enlarged among participants in the burnout group but also appeared to have stronger connections between the amygdala and brain areas linked to emotional distress. So those emotional structures of our brain that fire a lot in fight or flight, the more stressed an individual reported feeling, the stronger the correlations between the brain regions were on fMRI scans compared to the control group. The overworked group also showed weaker connections between activity in the amygdala and the mesial prefrontal cortex, a structure involved in inexecutive functioning. So weaker connections can explain why the burnout group had more difficulty controlling their negative emotions. Also, an impairment of the ability to down regulate negative emotions in subjects suffering from occupational stress may render them more vulnerable to depressive symptoms. So basically, if you’ve kind of delved into the polyvagal research, you’ll kind of understand that concept. So we need our nervous system to basically be able to do the dance between when we’re activated and when we’re in that kind of safe social system. Maybe I should just go over like our polyvagal zones. So green zone is safe and social. I’m connected. I’m having a soft eye gaze. I’m looking at my dog. I’m petting him. And I’m able to feel that ease in my nervous system. So we’re healing. We have digestion. Those things are all beautiful. And I think the thing is we’re not meant to stay there. That’s not life. So life is naturally. Our bodies go through a little dance in our nervous system. So in our yellow zones, that’s our fight or flight zones, we’re going to be elevated also those zones, I’m a tennis player. So I want my sympathetic nervous system to be on during that time because I want all my faculties to be able to get the ball. So it’s not that we want to stay out of our sympathetic nervous system. It’s we want that toggle switch to be activated. So when we need to upregulate to get that energy that we need, or when you’re driving and someone cuts you off, we need our sympathetic nervous system to be able to react. So it’s adaptive. It’s a good thing. It’s just when the switch turns on and we can’t turn it off is the problem. And we know that as therapists, we see our clients who cannot turn when it’s on high and they can never turn it off. They can’t go back into safe and social very easily or at all is problematic. And then our red zone, of course, which they’re talking about at the end of that research related to depression is when we go into dorsal vagal shutdown as opposed to ventral vagal. So if we’re talking about our vagus nerve, the vagus nerve connects from the 10th cranial nerve. And I should also include a picture of the I’m getting excited. Let me simmer down for a second here because I love talking about the vagus nerve. So I’ll slow down just a little bit. So our vagal nerve and just bring up a picture. This is audio. I can probably put that in the workbook of just a little picture of the vagus nerve. So it goes from our 10th cranial nerve in our brains and it’s called the wonderer nerves. That’s what vagus means, wanderer. And it has those connections to our organs. So when we have that stimulation, it’s supposed to make our heart race. It’s supposed to make our gut cease from digestion so we can be motivated to move. So if we think about all that and the role of chronic stress that it has on us, it’s pretty dramatic. So ventral vagal venting up to regulate that. I’m able to use those regulation skills if I need to. Deep breathing, the things that you teach your clients, and we know how to do that for ourselves. But when we get into chronic fatigue, chronic stress, we can go into dorsal vagal shutdown where we are feeling depressed when our bodies feel like, how do I get myself off the floor here? And I remember in the pandemic at one point getting into a dorsal vagal shutdown. I literally laid on the floor in my office and just couldn’t believe what was happening. I still was in fight or flight a lot through that time, but I definitely had moments of shutdown where I was like, I don’t know how I can do this. I always told my therapist friends there always has to be a couch in a therapy office because I have to take a nap sometimes because there was just some days where I could not make it throughout the day without a nap. Naps are good. Shutdown is real at the same time. And I really haven’t met a therapist who hasn’t experienced some of that where their body really just shuts down on them. And I probably will talk about this over and over again on this podcast of my body shutting down on me in different experiences, whether that was just a momentary shutdown or when my body was when I went through panic attacks with driving, had to go through a year of EMDR therapy to kind of work through that. And I’m good. But it wasn’t pretty. Wasn’t pretty at all. So anyway, I love polyvagal theory and that illumination that it gives us of the nervous system and how it’s tied to those brain structures. I think our bodies are just designed in a way that’s really cool. I’m getting all brainy. So I do have a background in NeuroRehab and I’ve worked with brain injury survivors for the past twelve years. So it’s been a passion of mine to understand the brain and really how it affects my clients and myself. So I hope that I can help start to apply this to therapists as well because we’re going through it, too. I say all that to say that there’s a lot going on in our bodies with burnout and compassion fatigue because many of us, yes, we may be struggling from burnout, but we may be struggling with hearing the traumatic material of our clients and how that affects our bodies. Part of the love it or leave it phase is kind of figuring out where you are in burnout. So I’ll include a burnout inventory in your workbook. So if you’re listening to this, you can go to my website and grab the workbook that will be part of this workshop series. So that include a burnout mini assessment. And that’s not diagnostic in nature, but it’s informational for you. I always put that caveat because certainly see a mental health professional. I have my own therapist and I think that’s good. But also just a tool of awareness for yourself, just a self check in is how I want you to think of this. So that’s part of it, part of that kind of nervous system awareness. How is my body doing right now? How is my body reacting to the stresses that it’s put under in my role as a therapist? So from a recovery standpoint, I like to think of my four pillars of brain health and I talk to my brain injury clients about these pillars. So I love to think of the parallels when we have something going on neurologically. So I’m drawing on my work in neuropsychology where I helped brain injury survivors recover from a TBI and concussion. We know that trauma affects the brain neurologically and needs to be addressed in a certain way from a brain health perspective. So we’re going to go back to my pillars of brain health and I think this is very applicable to therapists as well. And it’s things that, you know, you quote unquote should do. But the neurological implications are huge. I mean huge. So I saw that in the TBI and concussion literature that recovering from a concussion aerobic exercise was probably the best thing that you could do and especially early on in a concussion. So if someone who had a concussion engaged in a graded exercise program, so gradually they would and one of those tests is called the Buffalo concussion test. A physical therapist typically does that. When I worked in NeuroRehab, they would kind of handle that piece, and they would take someone through a workout on the treadmill, and they would essentially try to see how much they could work out before they became symptomatic with their brain injury symptoms, before they felt like fatigue or they had headaches, for example. All of those things. And that would be their baseline. So once we know our baseline, then we would ratchet up that aerobic exercise to help them in that recovery of concussion. So why am I talking to you about concussion? I’m talking to you about concussion because what I know about aerobic exercise and really any exercise, walking is great exercise. It doesn’t have to be like, I got to go to the gym. So I’m talking about can you walk three times a day between sessions? Find that little 30 minutes window where you’re able to get some more blood flow to the brain. What we know is that that is so helpful for regulation. So it’s imperative to think about a movement plan. And I’m not saying exercise, I’m saying movement because a movement is a gift. Exercise is for a hamster on a hamster wheel, right? So a movement plan for yourself, for recovery, that would be my first pillar that I’d want you to address. So I’m thinking one thing, first pillar I’d want you to do is exercise. The next one is sleep. Oh, my gosh. We are not sleeping as a society and working with brain injury survivors for so many years, their sleep was so disrupted and once they could get a regular sleep schedule and were sleeping more regularly, they got better. And I know that you’ll feel better if we address your sleep. So also thinking about your sleep, doing a sleep inventory. If you have a wearable technology, like a Fitbit or a Garmin, they actually have these cool sleep monitors now that actually go on your bed. If you don’t want to wear anything, you can have them between the mattress and it’ll measure your movements in sleep. I’m going to write that down to link it to you. Sleep pad. So that would be my second. My third that I’d want you to really address is belonging. So what I know as a therapist in the pandemic, I became as disconnected from other people while also being very connected to my clients every week. But personally, my relationships have grown and if I’m being honest, they’re just different. They’ve changed. There’s some people I don’t talk to anymore that I would see every week. I would know their lives, know their story, because I got so wrapped up into my own stuff and that’s my family, like I was taking care of my kids, I got really disconnected from other friends in my life. I think about belonging as a brain health pillar because there’s excellent research on belonging and mental health. I just love this research study. So I wanted to talk to you a little bit about the social relationships and mortality risk meta analysis. So if you haven’t read this study, it really kind of changed my perception of my focus with clients because if I can do anything with my clients, yes, the exercise and the sleep, great. But this is key. We need social relationships and we’re more disconnected than we have ever been, and especially therapists because we have all this emotional output going out. But what do we have coming in who is feeding into our lives? And I think of like the so I’m heart math certified. I think about the renewing emotions and depleting emotions. So every time we have a depleting experience, we need to have a renewing experience to counterbalance that. And with therapy, if you’re seeing seven clients, I just saw seven clients back to back yesterday because I’m trying to fit in clients. There was a snow day last week, and I was literally wiped. And then today is just kind of getting myself back together again. So thinking of that renewal to depletion anyway. Social relationships and mortality risk. I’m getting excited. Love research. So Julianne Holt Lundstad, Timothy Smith and Bradley Layton did a research study. And this is from 2010. They did a metaanalysis on mortality and social relationships and which aspects of social relationships are most highly predictive and which factors moderate the risk. Okay, so they looked at things like smoking in excess of 15 cigarettes per day, and they looked at an effect size of what each stressor or each factor for mortality would have on each person’s life. So an effect size. Let’s go back to stats class. Quantifies the size of the difference between two groups. So the difference in the likelihood of death between the groups, the different terms of their social relationships. Okay. And the results were shocking. They report that the average or there was a 1.5 effect size, people with stronger social relationships had a 50% increased likelihood of survival than those with weaker relationships. To put it another way, 1.5 means that the time half of a hypothetical sample of 100 people has died, there would be five more people alive with stronger social relationships than people with weaker social relationships. The researchers also report that the social relationships were more predicted about the risk of death in studies that considered complex measurements of social interactions, in the studies that considered simple evaluations as marital status. So they indicate the influence of social relationships on the risk of death are comparable with Wellestablished risk factors for mortality, such as smoking that’s in excess of 15 cigarettes per day, and alcohol consumption. Alcohol. That’s how I say alcohol. I can’t help myself. Alcohol. I’m from the DC. Metro and exceed the influence of other risk factors such as physical inactivity and obesity. Furthermore, the overall effect of social relationships on mortality reported in the metaanalysis might be an underestimate because many of the studies used a simple single item measure of social isolation rather than complex measures. So I first heard this research when I was in actually a suicide training, and I was digging into it. I was like, what? Social relationships are that important. We really need to focus on this more. So I’m thinking about this for you, therapist for you right now. How are your social relationships? Do you have people in your life who know you, who get you, who, when you have the most horrible day of sessions, you can tell them, oh, my gosh, I had someone who was cutting today and showed me their cuts, and my body’s reacting to that. That was me yesterday. I have heard an infant death case that made me have trauma symptoms. Who can you tell that stuff to that might be? I do have a supportive partner and my partner is a psychologist and I can tell him those things. So that’s great for me. But I also need other people, other clinician friends, other therapist friends who I can talk to or receive clinical supervision. I did go to therapy in that case. When I did have symptoms related to that infant death case, I was so challenging. So I know you therapists, I know you’re holding these things that we can’t tell a lot of people about and maybe you don’t of course not want to burden people in your life with the heaviness of that. But can you tell someone? I’ve had a really hard day and it was heavy and I’m not sure what to do with this stuff right now. So belonging key, key essential for you. So I’ll go over those four pillars again. So movement back up the train. Fourth pillar. Fourth pillar is nutrition. So thinking about our nutrition as a means of recovery. So again, I’m drawing on my NeuroRehab experience. I’m drawing on my work with folks who had issues related to their brain health. And nutrition was key, I think, of adding nutrition versus taking away nutrition and not dieting. So I don’t claim to be a nutritionist. You might still want to work with a nutritionist, but it can be key in helping to restore some functioning of brain health. We know, as I kind of laid out in the beginning of this, brain health is affected in burnout. So if we know that it is affected, how can we integrate these four pillars to help our brains recover? So nutrition is key and I’ll link the mind diet. I think it’s hold on. So I like to link for my brain injury survivors and anyone, the mind diet, a scientific approach to enhancing brain functioning and function and helping prevent Alzheimer’s and dementia. So there is a scientific approach to enhancing brain functioning. They say diet. I wish they wouldn’t put diet on there, but anyway, they do. They also have all kinds of books out now, a Mind diet for beginners. I think it’d be fun to kind of put some recipes out there for you guys too or like a sample eating plan that I do to help with brain functioning. The essentials of it are that we’re going to make sure we’re getting lots of fiber because that flushes all the toxins out of our brain, a green leafy vegetable and lots of superfoods lean proteins. So it’s pretty simple. I will link some stuff up with that and potentially put in even like a meal plan. Again, I’m not a nutritionist, but I think it’s important for you to think of that you might choose to work with a nutritionist to help yourself recover from the burnout that you’re struggling with. But you could also just integrate some of these, know, trying little things at a time. Integrating. Hmm. Maybe I can add blueberries to breakfast. Maybe I can add in romaine lettuce at some point in the day. So I get that green leafy vegetable. I’m from the south, so I love greens, so I can’t get them much in the state of Maine where I live, so I have to make them if I want them. But sauteing spinach is also another strategy I try to do because it’s quick and pretty painless for me if you like spinach. So I will review the four pillars of brain health. That’s going to be nutrition, which we just ended with belonging, sleep, and movement. Movement, sleep, nutrition, belonging. Yes. There we go. We have our four. My brain doesn’t seem to want to hold all those together for some reason, but there we are. Hey, therapist. I wanted to let you know about a free resource that I’ve developed for you, introducing the Before You Quit guide. This is a free resource I wish I had when I was in the throes of burnout. So it’s going to include focused journal props on areas of struggle and burnout in clinical practice, identification of depleting experiences in your practice and in your life. And then we’ll hopefully identify some actionable items for change. If you’re feeling depleted in your role, please give yourself the gift of slowing down and assessing what’s really going on with your career turmoil. As a therapist, I know it can be confusing, isolating, and totally overwhelming. So grab your freebie. The link for that is in the show notes. Thanks you. So I think that is helpful to think of burnout recovery, what do I need to do? Certainly therapy can be in that mix. Getting clinical supervision is in that mix. That would be another recommendation. And I think it can be overwhelming to know what to do first. So getting expert support, having someone who understands and knows you, that can help you wade through this stuff. I think you have to look out that burnout recovery before you’re making career decisions. Because you could and I don’t. Know, I’m talking might be talking about a friend that I know who changed their web copy, like every other month in the pandemic, thinking that if I offer therapy intensives or offered this or do that, that’s the way out of Burnout when it just stresses you out more. And you literally had a breakdown because you’re trying to do too many things. So that was me. I started to change everything in my practice, think that I could recreate the wheel and I didn’t. I wish someone would have told me to pause, to stop, to just heal from what you’re going through. Prune your schedule. Oh my gosh. If someone would have just said, let’s just reduce your schedule and let things breathe, let’s really think about it. Stop trying to push into this. But I think that’s a tendency because leaving your role as a therapist, it’s imbued with shame. So if I can say anything at all, would be to pause. Don’t create an online program. Also learn from experience. That’s probably not the best thing to do in burnout, but to pause, to breathe. There’s no rush. You don’t need to figure this out. Tomorrow you might make the decision to close your practice and that might take you two years. That took me two years to come up with. Or if you’re leaving an agency job, that might be more of a few week process. And today there’s so many options available to therapists that I didn’t have when I was making some of these decisions. Whether start a new practice like telehealth wasn’t a thing ten years ago. I was like, what? Who’s doing that? So there’s so many ways to have a practice that are much more sustainable. I think if I had started it now, knowing what I know, I would have built it way differently. But we have so much conditioning in keeping up with the therapist status quo of taking on everyone, not saying no. Every client deserves to be treated and they do. I believe that can be true. But that doesn’t mean that you have to do that work. So if you need permission, I always tell my clients this, if you need permission, I grant it. But you already have it anyway. You already have that permission anyway, I think, to look through. So what I really want you to think about if you’re in this phase, you just can’t do it anymore the way you’re doing it. I get it. I’ve been there on many occasions. This one is huge. So I want you to think about taking things away versus adding things. So doing a schedule, prune. And I want you to think about maybe you pause this podcast right now. This will be in the workbook I want you to think about right now. What are things that you’re doing that you need to stop doing right now? This can be personal, professional friendships, anything. So pause the podcast. It’s right there. The pause button is right there in your player if you’re driving. Let’s do a mental check, right? Don’t hit your podcast player if you’re driving. So pause the podcast if you’re able and just take some notes, write some notes out on your phone or wherever and come back to me. Okay? So if you’ve done that, you’ve identified what are some things you need to stop doing clinically, I think it’s important to think about so what? I often have people do that. I often have other therapists look at what clients am I seeing right now? That number one, are not making therapeutic progress. We are holding on to clients. I have done this. I’m guilty. I’m raising my hand. This is audio, but I’m raising my hand up in the air because I’m guilty of doing this. Because we get into patterns of being with people. If you’ve had a practice for many, many years, people, if you’re doing good work, they want to stay with you, but they may not be making progress in their treatment and you’re feeling like it’s your personal failure that they’re not making that progress, and you feel like you should keep them on. So in the ethical standards for psychologists, this is ethical standard 2.1 and 10.1 A, we’re going to look at two. So 2.1 is boundaries of competence. So psychologists provide services, teach and conduct research with populations and in areas only within the bounds of their competence based on their education, training, supervised experience, consultation, study, or professional experience. There’s many times when possibly I should have referred out, but maybe it was depression, but they had some other issues and I kept them on because I felt like I should keep them on if they were totally out of the boundaries of my competence. Like if it was eating disorders, I never have treated clients with an eating disorder. I would refer them out. So think that’s one thing to think about. Is this within my competence to continue to see this client, especially if they’re depleting a lot of my energy? Clinically, two would be terminating therapy psychologists, and this is in ethical codes. It’s probably different for counselors and social workers. Psychologists terminate therapy when it becomes reasonably clear that the client and patient can no longer that the client or patient no longer needs the service, is not likely to benefit or is being harmed by the continued service. So we really need to think about, do they need the service anymore? A lot of times with the clients who were pretty depleting, they are likely not to benefit from service. So if it’s been six months or a year, you’re continuing to see that client, they aren’t making progress, rather on their treatment goals. We need to think about that, referral out for a different type of therapy. And I’m thinking about someone with OCD that I worked with that probably needed an expert on OCD, and I probably should have referred them out sooner, right? So they’re not benefiting likely from the services I’m providing, or I need someone with a different expertise to see their client. Now, another thing I want you to do is a clinical inventory. So right now I want you to think of the clients you see every week that are depleting your energy, that are maybe a more difficult client for you to treat. Now, that doesn’t mean that they’re difficult. Maybe they’re either issues or the things they’re bringing into therapy room. That can be, for so many different reasons why that is. But you just think about your energy. I don’t want you to think about those other factors depleting your energy. The most depleting for you to do are. Those clients making progress? Do they need to be referred out? Those are very simple and ethical issues that we should think about, but when we get burnout, we forget to address it because we feel like we have to keep going or we’re kind of failing, right? We’re feeling like our treatment isn’t working and it’s us. So right now I want you to pause this podcast and think about who are the clients that are depleting your energy and not making treatment progress and come back to me. I want you to identify those and think about, are those clients that I need to make a plan to refer out or to terminate services with? It could be clients that aren’t they really don’t need therapy. They’re just in there for venting sessions, whatever that is. It’s not really therapy anymore. And we’ve gotten into bad habits, and I’ve done that too. So there’s no shame in that. It’s just I think we need to bring awareness to it. Sometimes we just become unaware that that’s happening in our practice and it’s important to kind of get back to those things that when we were in ethics class, we’re like, oh yeah, we have to discharge clients, of course, that they’re not meeting treatment progress. The problem with our training is that oftentimes my experience and often yours might be this experience, is that in your training you have Practica. So there’s a beginning and an end to treatment. You know, that from the outset of treatment. So you often don’t get into these issues. So I didn’t get into these issues until I was fully licensed and I was no longer in clinical supervision. So when I showed up at the different sites that I worked in, whether that be my predoctoral internship, postdoctoral training, Practica assignments, they handed you your caseload and those were your clients. There was really no choice in the matter. I don’t even remember a discussion of, oh, I can’t work with this client. I need to refer this client out. It was like, no, that’s your client. That’s who you have do the treatment period. And I’ve been reflecting on that recently about like, that’s really messed up that we’re not considering. Like, this client might bring up an issue in me that I really can’t work with this issue. Maybe it’s a countertransference issue for me, for example, that’s preventing me from doing this work in a particular way. So I just want you to think about this ethically because we’ve been programmed to just keep taking clients and to keep them to keep treating that if they’re not making progress, it’s likely a failure with us. Not that maybe it’s the clinical issue that I struggle with treating personally. So for me, I did not do very well with developmental trauma. My boundaries were harder with that particular issue. With other issues, like, if I had a couple, I did really well with couples because I could have those boundaries, it just seemed to flow for me, and I didn’t get into those stickier situations for myself. So I think just for you to look at the caseload and to consider ethically, do I need to let some people go and make plans for that? So make a discharge plan, make a referral plan, and then communicate that back to your client. And you might need some supervision with that. So you might need some clinical supervision to help you through that process if you’re fully licensed. And I think for myself, it was becoming EMDR trained and going through the clinical certification process and engaging in that. It’s supposed to be consultation, but there was a lot of supervision involved with my consultant. So when I was going through that process, I just need to submit my paperwork to get that EMDR certification. So, yeah, I think engaging in those relationships throughout our career are really important, and it should be regular, we should regularly be doing that. I mean, think about the frequency that we had that in our training. At least for me. I remember having, I think at one time I had a site supervisor, my clinical supervisor at school, a supervision group. I think there was like 4 hours of clinical supervision I had in my training at one point. And it may be a little too much for sure, but then we go to having nothing and having to do that on our own, and I think we can just do a lot more to help ourselves, really. To really help ourselves there. Okay, so my top four recommendations for this phase are number one, healing from burnout. Using my five pillars of brain health, I walked you through those. That is movement, nutrition, sleep, and belonging. Awesome. Number two, clinical supervision or consultation. So getting help with those clients that you might need to refer out. Three is personal therapy. So that was certainly part of my mix in my burnout recovery, was helping my nervous system regulate. I did my own personal EMDR therapy to work through panic attacks and things like that that I never had before the pandemic, but that’s how it showed up in my body. Four would be schedule pruning. So I talked a little bit more about the clinical schedule pruning, but also thinking about what am I doing at home that I need to stop doing? Do I need help at home cooking dinner? Do I need more support with children if I have children at home? Do I need more support with schedule planning in my family? Maybe you’re taking on a lot of those roles that you need to have more balance in your life. So I would also think about that. So check out the guide that I have on my website. That’s at www.drjenblanchette.com. The link will be in the show notes if you’re in a podcast player, click on the episode. The link will be there underneath this episode. Title also on my website. So that’s Dr. Jen Blanchette is B-L-A-N-C-H-E-T-T-E. And I will talk with you all soon. Bye.
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