Speaker A: Trees and providing the trees with carbon dioxide. I’m such a people pleaser that I would get when I was burnt out. I would be stressed out that I was taking too much oxygen from the trees.
Speaker B: Oh, wow.
Speaker A: Right? Like, this is how far my brain went, so. But when you are walking amongst trees, not only are you having this, this, you know, carbon dioxide oxygen exchange, but you’re also. The sunlight, when it reflects off bark, turns into infrared light. And that infrared light that reflects off bark encourages your mitochondria to produce energy. That’s why that’s, like, what? Wow, that’s mind blowing. The person that told me about this, she’s a really big researcher, and she reads things really in depth. And even when she said it, I was like, okay, I’ll read that myself, because, like, yeah, that’s interesting, because, really. And then I looked it up, and I was like, oh, my God. I. She was not even kidding. So sometimes we are looking for really sophisticated answers. We’re like, should it be ashwagandha? Do I need a magical chinese herbal formula? Do I have to have, like, maybe just, like, find a tree?
Speaker B: Welcome to the therapist Burnout podcast, episode 38. Hello, therapist. Welcome back to the podcast. I have a special guest today, Cait Donovan, host of Fried the Burnout podcast. It’s so great to have you.
Speaker A: I am so grateful for this space, and thank you so much for inviting me in.
Speaker B: Well, I’m going to kick it to you and just ask you, what is your burnout story for those who don’t know you and a little bit about you.
Speaker A: So, my background is not. I’m not a therapist. I am an acupuncturist. So, still in a private practice, solo practice kind of scenario.
Speaker B: That’s.
Speaker A: Those are some of the similarities between. I know not every. Not every therapist works in that. However, there are some similarities in the way that we work. Also, how much money we make is dependent on how many patients we can see and how to fit everything into a schedule and then figuring out when to chart after you haven’t had a second to go to the bathroom all day and all of that. So there’s a lot of overlap in the way that we work with people. And so when I burned out, I didn’t know that I was burned out probably for about six years. So my health was failing, my thyroid was letting go. I had gained weight. I was in a bad mood all the time. I was miserable where I was living. I just. Everything was off, and I didn’t know that burnout existed. So it wasn’t really on my radar. During that time, we moved countries, so I had been living in Poland. We then moved to Prague. And I changed a lot of things. I put up new boundaries. I was only working 25 hours a week. I was seeing less patients. And so, theoretically, in my mind, even if I didn’t know, it was burnout, like, I was doing a lot of the things that were told, get you out of burnout, and I still felt terrible. And so one day, I opened an article. If I remember correctly, it was a Harvard business review article, and it was on burnout. And I just went down the list, check, check, check. Like we all do when we’re in school, because you have every single disorder in the DSM when you go through. You know, we have every single disorder when we go through acupuncture school, too. That’s normal. But I was sitting there, and I was like, oh, my God, there’s a word for what I’ve been experiencing. And then I went into a massive amount of self judgment. I’m an acupuncturist, which means I learned how to meditate when I was 18, which means I know qigong and tai chi, which means I know more about regulating the nervous system than most people will ever learn in their entire lives, because that’s what my medicine uses. I learned breathing techniques in school. I mean, there is no reason for me, with the. In my mind, this was what I was saying to myself. There’s no reason for me, with the amount of knowledge and wisdom I have about stress, for me to end up burnt out. This doesn’t make any sense. So I nerded out as one does. My husband was studying at doing a postgrad degree at Cambridge at the time. So I signed into the university library and downloaded everything that was available on burnout. This is 2016. Almost everything was by Christina Moslach and et al. At the time, there was a couple. There was an italian researcher and a couple of other things, but not much. It took me a year to read through all of it. And the whole time, I was like, this isn’t about me. This is about doctors and nurses and corporate workers. I have worked for myself only ever. I don’t have a boss that’s micromanaging me. There’s not an unfair workplace environment. I’m not psychologically unsafe. I’m not like, so if it’s not this, then what is it? And during this time, all of you will be happy to know that I am. Even though I do work with people through burnout, I am a proponent of therapy. I send clients to therapy all the time. Oftentimes I send clients to therapy and say, you need to do this first before we can even get into any coaching. So I’m very pro therapy. I used both therapy and coaching myself to get out of burnout. And while I was digging through, I started noticing some of my patterns. So perfectionism and people pleasing and lack of boundaries, martyrdom, moral superiority, the ones that we don’t like to talk about, like, we like to say, I’m a perfectionist people pleaser, because even then it sounds good. You know, I’m only trying to do the right things and be nice to people, but that’s not really what was to happening. I was trying to ensure that my status in the world, I was trying to act in a way that would ensure that I would be loved and accepted. I was trying to prove my worth and value all the time. So there was a if I can do it better than everybody else, right. This moral superiority thing meant that I was spending a lot of my energy judging other people on the tram, walking down the street kind of anywhere, because they’re not doing it right. And all of these things, the bottom of the bucket was a huge pile of self neglect. And it took me another probably three or four years of writing about that, reading about that, digging into that to understand more about it. But that was when I realized it was self neglect, was when I was able to start making real change.
Speaker B: Oh, my gosh, there’s so, so many good things in there. I think that therapists that I’m hearing from identify with, and I think it’s. That’s interesting that you really say that. You know, it’s kind of wrapped up into it, not just perfectionism, because there’s so many different things that are driving the burnout for a lot of us. You know, for me, it was like, I built this practice. I built this, and if I let that go, then what does that say about me? And of course, it was about exhaustion. It was about the vicarious trauma, the collective trauma I was in as a therapist in the pandemic. But I also had to look at my stuff, too, and say, what does this mean if I quit this practice? What does this mean if I can no longer do this work?
Speaker A: What does it mean for me if I no longer do this work after having had invested $100,000 in a four year master’s program?
Speaker B: Right.
Speaker A: Acupuncture is a four year master’s degree.
Speaker B: I didn’t know that.
Speaker A: Yeah, it’s a huge chunk of school. So not only did I spend this time, but I also had a huge student loan. And in my head I had this weird equation. This is the sunk cost fallacy, right? Like, I’ve spent this energy, so now I have to make it worth it somehow, whatever that means. But I had this equation in my head that said I should be able to pay back my student loan, earning money, doing the thing that I paid to learn how to do.
Speaker B: And I hear that story over and over and over again, which keeps us stuck in the same position. You know, I’m hearing from therapists like, I’m in this agency job. I just received a message the other day, my doctor telling me to take a two weeks or a month off, but I can’t do that. I can’t afford it. What else can you do if that’s what your doctor is telling you to do?
Speaker A: Well, and if you don’t take the time off, this is. I was really careful about speaking this way in the very beginning of the podcast and in my book, but I’ve gotten to the point where I think people really just kind of need to hear it. Yeah, you don’t take those two weeks off now, you’re gonna be out of work anyway, but you’re gonna be in the hospital instead. Something is going to take you out, whether you take the time yourself or you are forced to take the time. But a lot of people have this belief that if they’re forced to take it, that’s better, because then there’s no fault. They’re not at fault if they got sick and they had to take time off. But if they choose to take time off, then there’s shame and guilt and fault.
Speaker B: Mm hmm.
Speaker A: So people, I have. I talk to people every day who are basically waiting. I’ve had people say, like, sometimes I think about, like, just sticking my leg in front of a bus. Like, I don’t want to. I just want to break my leg, and then I won’t be able to do anything. Or I just, you know, I wouldn’t mind this. During the pandemic, a lot of people were saying, I wouldn’t mind getting like, Covid, that I knew that I would get better from, but that was bad enough to keep me home for a while. When you are desiring lack of something’s wrong.
Speaker B: And I think, you know, therapists are primarily women or female identifying. And I think it’s also like, you know, the human giver syndrome, too, that, you know, we give, we give, we give, we give. We show up. We show up. Show up. We don’t give up on people. And I think that internalization of I quit, that means I gave up on them or gave up. And it’s not like I’m giving up on myself right now.
Speaker A: Well, I think it’s also the question of worthiness.
Speaker B: Mm hmm.
Speaker A: Right. So I think this, like, I give, I give, I give. And if I’m not giving, then a. Everyone else will fall apart. And the reason I believe that is because if I don’t believe that, then the work that I’m doing isn’t powerful enough and not worth it. So it’s not even just, I think. I think that. That underneath layer of I can’t let people down. But mostly because if I leave, if I let people down first, there’s that guilt factor, and underneath it, I’m no longer worth anything because my entire worth comes from the fact that I’m helping.
Speaker B: Yeah. And that’s my identity, and that’s who I am.
Speaker A: Literally, that’s who I am. My entire world is defined by my relationship with giving because that’s what I have been told equates to value.
Speaker B: Yeah. From a very young age, from forever. Yeah. And so to start to think about, what does that mean to not give, to not have a career or a job or anything that I have to do that requires that. And that, I think, is the question and the reckoning that I had to come with, I think people early in their recovery process probably are just like I was. They’re scrambling. They’re like, you know, what do I do? I can’t work. I can’t do this. I have to find the next thing right away. And I really want to tell them as much as possible, slow down. This is going to take years, months, most likely. Most likely. I mean, you might find, unless you pass the buck and change your setting. And then maybe you.
Speaker A: Even if.
Speaker B: Even if.
Speaker A: Yeah, even if. Even when you do change a setting, what we have to understand about burnout, and which I think sometimes is missing from the therapist conversation around burnout, is that burnout is not just a mental thing. Burnout has happened to you in your entire physical body. So you have muscle atrophy. You have gut bacteria that are off. You have not just your dopamine and serotonin, but there’s all sorts of. Your HPA axis is off. Like, your body is not physically functioning well. So you can change your environment, and that might pull away some of the stressors that you are aware of, but that doesn’t necessarily heal all those other things that are off at the moment, those things actually require attention. And I think that. I think one of the biggest issues in the world of burnout now is that people don’t understand that this is a very holistic problem. And you can have therapy for burnout. Absolutely. But you also have to have something physical.
Speaker B: Yes.
Speaker A: Whether that practice is, whether it’s a yoga nidra that you’re doing on your own in your room, or whether it’s an acupuncturist or a massage therapist or a nutritionist or a functional medicine doctor or, I don’t know, whatever. There’s so many options. A Reiki practitioner even care. But there’s. I love Reiki. That’s a whole separate thing. But there’s a. You can’t do burnout only mentally, emotionally, or only physically. You have to do both because it affects everything.
Speaker B: Yeah. And I think, you know, I’m reflecting back. I came, my training was in neuro rehab, so I would see people in therapy for concussion, and they had done all the physical stuff. Right. They had had a PT. They went to all these different specialists, and they didn’t get their mental health or their trauma treated. And so that was a missing key, or they need to go to a neuro optometrist and have that addressed. And I think the research from concussion and from brain injury really helped me understand the best outcomes come from a multidisciplinary team, because we’re looking at all of the different things that might be impacting, really, a metabolic disorder, which I think burnout can get into. Yep. So I kind of have these parallels from that work and concussion of talking to therapist. Yeah, go to therapy, but also think about what your body needs. What does your body need for healing? So a PT has been on my team. I did see a dietician during the time, just me, too. Cause I had diet trauma of chronic dieting, and I, you know, all of that stuff also plays into burnout. Yeah.
Speaker A: And a lot of times when your gut bacteria shifts, you don’t have the ability to absorb nutrients from food. So you might even be eating well. You’re probably not if you’re super burnt out. But even if you are eating well, you’re not getting the things that you need from your food because you don’t have the gut bugs that allow you to get those things.
Speaker B: Yeah. I’m always aghast by the research on folks that have a mental health diagnosis, like anxiety, depression, and the gut dysbiosis. Yes. And how that happens together. And we’re not treating those things together. We’re not seeing the relationship. But I think what you’re saying at the core is that it’s a stress related problem that we’re trying to piecemeal what we’re doing with it. Like, okay, I’m just going to do some yoga, which maybe can segue into what do we really need? Or do that again, the difference between burnout prevention and burnout recovery, and maybe if you are in full burnout, what do you need for that? And maybe what we’re given, which is burnout prevention many times in our field.
Speaker A: Exactly. So this is a huge issue for me. This is something that I talk about a lot. It’s not something I hear a lot of other people talk about. I’m sure the conversation is happening somewhere. It’s just not, it’s. I’m not privy to it just yet. Most of the things that you will read online about burnout recovery are really actually burnout prevention, and burnout prevention at its most basic. If we’re going to go super layman, super clear, super basic, burnout prevention is stress management, end of story. However, and this is where people get annoyed with me, I don’t necessarily think all burnout is preventable because I think that in order for you to notice that stress is building up in your world and then take an action against it, you have to have a certain developmental track throughout your life that allows you to pay attention to that, notice it, and make a reaction. Most of us in the helping fields, not maybe not most. It’s actually, it is most because it’s 52%. So the more than half of people that enter helping fields have some history of big t or little t trauma that has on some level influenced their development and led to a decision later in life that I’m going to become a nurse because my brother got sick when I was small and the nurse was the best thing that helped us. And I’m going to help other kids and I’m getting into therapy because I didn’t have anybody to talk to because even subconsciously, consciously and not everybody has those reasons. I know that. However, those of us in helping professions do have a higher tendency to higher aces scores. End of story. That’s just that. Those are just the statistics. And those of us that have higher aces scores tend to be lacking in a develop method, a skill that we should get while we’re developing called interoception, which is our own ability to reach into our body to understand what we need at any given moment and respond appropriately. This literally can be something as simple as I feel this emotion and I’m going to allow myself to move through it. And it can be, I’m thirsty, so I’m going to get some water. It can be esoteric and it can be very, very practical.
Speaker B: I’m just going to add this in. I love on your podcast how you say pee when you need to pee.
Speaker A: Pee when you need to pee. This is why I say it, because there has been research that shows that when you engage in the smallest physical self care practices, peeing when you need to pee, drinking when you’re thirsty, resting when you’re tired, closing your eyes when they’re exhausted from looking at a screen, standing when you’re standing and moving when you’re antsy, eating when you’re hungry. All of these really basic, okay, body, I hear you saying something. I’m going to respond to you. One of the things that happens is your interoception increases and because of that, your emotional regulation improves without you doing anything emotional, without you talking to a therapist, without you going through any of those things. If you just pee when you need to pee for a few weeks, your life will be different because your brain will be different. So I think that what we need to understand is that most people who are looking for help with burnout are already in burnout. The stress has already taken a toll on their bodies and the, the stress management practices are too little, too late. You will need to engage with them again once you get through burnout and re enter life as a full human and need to reengage with life. And stress is going to happen and you’re going to need to use those practices. So it’s not that those stress management practices. Stress management practices are not good. They’re crucial. They’re just not helpful when you’re in the thick of it. When you are in the thick of it, you most often need another person because it is much easier to co regulate than to self regulate. So sometimes one of the most important things you can do for yourself is invest in some type of what I call other care. Maybe it’s a coach, maybe it’s a therapist, maybe like I said, it’s an acupuncturist. Maybe it’s your best friend. I don’t know. But you there, your ability to learn what your body feels like at safety is a key element to your ability to recover. And that’s much easier to do with people than without.
Speaker B: Yeah, I just think people are trying to do it solo and yeah, I want to kind of go back to think kind of the pee when you needed pee a little bit, because for therapists, especially the nature of our work, we’re seated and we are taking in other people’s trauma, other people’s stories, other people’s emotions, and we’re in a field where we’re not really taught. I think it’s changing. I mean, you know, I was trained in EMdR, which really focuses a lot on the body. We’re really kind of taught to not move and not really listen to our body or use our body’s knowledge of, like, okay, I need to get up. I’ve talked before in the podcast how, when I was doing telehealth, when the pants have my kit, my cuticles were bleeding, literally, because I knew grounding strategies. But it’s like when you’re thrust into burnout and your body is going through that, it’s like, oh, I had to remind myself, okay, I need putty, and I need, you know, movement breaks in between. I need to pee when I need to pee, which I was pretty good at doing, but still, it wasn’t enough. And we can’t be prepared always when burnout will hit. I think of, like, let’s say, and I know this is not an exact parallel, but a police officer or someone who’s been to war, and we don’t blame them to say, like, oh, you have PTSD. Now, of course, they might have it because of the nature of going through that trauma, and especially for therapists who have had vicarious traumatization that are experiencing trauma symptoms based on their clients stories, you can’t always predict that. I have gone through it. And I know I was like, I can manage trauma. Oh, I’m so. I can handle it. And then I had one session, an infant loss case. I won’t go into the details. I had trauma symptoms. I was thinking about it at night. I had all the symptoms of PTSD and needed treatment for vicarious trauma.
Speaker A: Yeah.
Speaker B: And I think for a therapist, I think it’s like the burnout trinity. You know, you have burnout, you have compassion fatigue, you have vicarious trauma, and we don’t move our bodies. So, anyway, as a body, someone who’s trained in body based techniques, what would you say to a therapist based on all that I just kind of spewed at you?
Speaker A: I would say, first, to be gentle with yourself, because the fact that you didn’t listen to or didn’t notice or didn’t respond to the signs is not your fault. That is a combination of development, genetics, and lessons when we were in school, when we grew up in school, you had to raise your hand to go to the bathroom. And sometimes the teacher said, no, we’ve taken all of these lessons in addition to the lessons that you got in school. Well, if you just stand up after a patient’s set says something revelatory like that might really freak the patient out. So you, your job is to be still, like, makes sense. But for a therapist, it might be that movement is part of your burnout recovery journey. And movement is the most restful thing that you can offer yourself. But when I say movement, I’m thinking about really slow walking in a forest or on a beach. I’m not thinking about a crossfit. I’m thinking about just the actual normal act of a normal, everyday humanity. Motion, walking, swimming, being the simple things. I also think that especially for therapists who have, and this is true for acupuncturists, too, because our patients are usually so frustrated by the time they come to see us that we get a lot of their emotional world is engaging in some type of exercise like tai chi or qigong. Because these exercises have been developed over millennia in China to help emotions move through the physical form that is part of their function. That’s literally part of the reason they exist. So engaging in something like that, even looking up, like qigong for anger on YouTube, or qigong for sadness on YouTube, it will show you which meridians to move, what to do, how to hold your body to allow space for that particular emotion to move through. And I think that that is a particularly useful thing for this community.
Speaker B: I agree. I think as someone who, I teach yoga classes and I’m a certified personal trainer. So I think, and just working with brain injury, I saw how key movement was, because a lot of times when those folks had been through a concussion, they stopped moving because everything then made them feel like they were in the throes of their concussion symptoms. And so not moving begets more not moving. And then when they moved, it became worse and worse and worse until they have to literally be in a dark room for hours upon hours. And I know it’s not that dramatic for someone in burnout, but I know that therapists, a lot of times, maybe you’re like, no, maybe it is. But I think for therapists, a lot of times, I’ve seen posts of like, I don’t even know how to start moving. And when I see those questions, I’m like, wow. I think just knowing walking can be one of those simple tools. Gentle walking in somewhere green. If you don’t have somewhere green, try to fill your space with green things. I have some green things in my office. We know there’s a lot of great research on blue and green spaces, but just how simple movement can be. But yet it’s so untethered to our natural, modern, or normal modern life now, because we don’t walk to get anywhere, it’s not a natural part of our day. It used to be for.
Speaker A: I mean, it still is in Europe.
Speaker B: Yeah, in Europe, but not in America.
Speaker A: Not in the US. Yeah, not in the US. And I think one of the things about if you have access to a forest path, even if it’s, like, really busy and a lot of people use it and whatever, yes. Green and blue space is tons of research. And also, when you are walking amongst trees, the. Not only are you getting oxygen from the trees and providing the trees with carbon dioxide, I’m such a people pleaser that I would get when I was burnt out. I would be stressed out that I was taking too much oxygen from the trees.
Speaker B: Oh, wow.
Speaker A: Right? Like, this is how far my brain went, so. But when you are walking amongst trees, not only are you having this, you know, carbon dioxide oxygen exchange, but you’re also. The sunlight, when it reflects off bark turns into infrared light. And that infrared light that reflects off bark encourages your mitochondria to produce energy. That’s why that’s like, what? Wow, that’s mind blowing. The person that told me about this, she’s a really big researcher, and she reads things really in depth. And even when she said it, I was like, okay, I’ll read that myself. Because, like, yeah, that’s interesting because, really? And then I looked it up and I was like, oh, my God. She was not even kidding times. We are looking for really sophisticated answers. We’re like, should it be Ashwagandha? Do I need a magical chinese herbal formula? Do I have to have, like, maybe just, like, find a tree?
Speaker B: Right? I know. And there’s, you know, there’s no money made of walking or a tree. You know, like, you’re not going to see an advertisement walking. The new cure for everything. Trees touch them. Not really going to happen.
Speaker A: It’s, like, not going to happen, but it is really true. That’s one of the. When I’m doing a. A corporate event or an association event, if I’m giving a keynote, one of the things that I aim to do is at least 75% of the suggestions that I make while I’m there are free.
Speaker B: Yes, it really it is simple, but I agree with you. You need a guide to help you kind of walk you through those steps. But I think the.
Speaker A: For the co regulation piece, but also for the horse blinders piece. So when you have chronic stress for extended periods of time, the parts of your brain that are responsible for allowing you to see perspective and possibility decrease. And actually, literally, your peripheral vision decreases. So you actually can’t see as far as you normally would be able to see. And you can’t metaphorically see as far as you used to be able to see either. So you get into this rut of, like, having horse blinders on and not understanding what’s possible for you. I can’t even tell you how many times I hear from clients. Yeah, but it’s either this or that. And I’m like, is that true? They’re like, these are the only two options. And I’m like, are they really? But we get stuck in this, like, because this is the only thing I can see. And sometimes we need to borrow a therapist or friends or whoever’s eyes in order to understand that we have blinders on and that we’re missing part of the picture.
Speaker B: Yes. That is interesting about the peripheral vision.
Speaker A: Fascinating. The research is keys.
Speaker B: I need to find a link for that because as a former trauma therapist, I definitely know with increased trauma symptoms, we have increased isolation. And so I know all the mental part of that side of things. And I think working with concussion folks, definitely the physical and how, like, when someone’s vision gets treated, that was often the biggest key to concussion recovery, because the visual. Visual, the ocular and vestibular system are often highly connected. And so when they got either one treated. And so I always think through, like, if you have balance issues, you might want to go to PT or think through someone who can help you with that. It could be working on that imbalance can be really, really helpful.
Speaker A: Yeah. And we often say that a clumsiness is a sign.
Speaker B: Makes sense. Makes so much sense. Okay. I covered that. I want to get into what is left out of the definition of burnout.
Speaker A: Well, I think people, like I mentioned before, I think people are left out of it. So I think that’s a piece of it. And I know you said that this was something that you read in my book, but that was that book I wrote a long time ago, so I don’t remember all the things that are in it.
Speaker B: Yeah.
Speaker A: But to me, part of the thing that’s missing is this acceptance of the fact that it doesn’t have to be work that burns us out. So, according to the current definition, according to the World Health Organization definition, this is a workplace phenomenon.
Speaker B: Right.
Speaker A: But that means you’re telling me that caregivers that are working in homes and not getting paid and, like, stay at home moms, they can’t burn out. Pretty sure they can. Like, I think that that’s a big part missing. And I. I also think that when you read through the research, there are two pieces that are offered for burnout causes. I don’t believe in the word causes when it comes to burnout at all. But there’s two buckets that they use. The first bucket is workplace, and there are six factors that are the most important. Work, strain, fairness, praise, or lack of praise, et cetera, et cetera. And then there’s some personality traits, like the people pleasing and the type a personality. And if you look at ocean, it’s the neuroses and all of these things. Things. So those are the things that are in the research. And then the rest of it doesn’t exist. In my. My work, I’ve found four more buckets. One of them is the cultural bucket. So if you are subject to any of the isms, you will have a higher tendency to burn out because your inflammation levels will be higher, because you will be tripped up easier, because you will be in all of the things. So, cultural stuff. The other cultural thing. In the US, two of our top ten american cultural values are hard work and individualism. That’s, like, not your fault. Everybody. Like, that’s not. You didn’t do that. But did you absorb it because. Yeah, probably because we did. Because that’s just part of. So, culture is a whole bucket, which we could go into for an hour. The next bucket is family. So, when we’re talking family, we’re talking generational trauma. We’re talking actual trauma. We’re talking attachment styles. We’re talking value systems that you maybe never chose to review to see if they actually fit you. So, family. And this. This family counts as family of origin and current chosen family. That’s a bucket. Another bucket is health. So if you have a chronic disease, if you have a tendency toward anxiety or depression, if you have, you’re gonna have a higher tendency to burn out. That’s a whole bucket. And then environment is a whole nother bucket that nobody wants to talk about. Nobody wants to talk about the fact that if you hate the color on your walls, you have a higher tendency to burn out. If you go into your house every day and you feel unsafe because of colors, because of shapes because of the people, because of whatever. You will have a higher tendency to burn out if you have access to nature, but you don’t use it. You have a higher tendency to burn out if you have no access to nature. You have a higher tendency to burn out. This, this environment piece, I always, I tell clients all the time to buy a mug that they love, and they’re like, really? I’m paying you how much to tell me to buy a, like, really a mug, but sitting down in your favorite seat with your favorite mug that fits your hand exactly the way you want it to fit your hand and drinking your coffee or your tea in the morning could be a burnout prevention ritual if it is comforting and safe. And so I think there’s a lot missing from the definition.
Speaker B: Yeah, I mean, and I think a lot of people, including myself, experience a great deal of mental health diagnoses or difficulties. We don’t have to put diagnosis on it, necessarily, whether that be it looks like panic disorder or it looks like depression that is somehow not captured. And then I feel like, especially therapists, because this is what we do, we treat mental health disorders. We’re scared. We’re less likely. We know from the research, we’re less likely to seek treatment due to stigma of being perceived as ineffectual. A lot of us don’t bring up in our own supervision that we have struggles. I’ve talked about that on the podcast many times that, you know, in my training, I didn’t want to bring up, like, when I had a client who was going through a breakup, I was going through a breakup, and I was feeling all those things, and I just took the day off and I didn’t tell them. So somehow we’re giving these messages, you know, that, that hard work, that individual individualism, that I can manage this, and.
Speaker A: Then if I can’t, I’m a failure.
Speaker B: And especially for therapists, if I develop symptoms of a mental health disorder, then I might be compromised.
Speaker A: Oh, it’s the same with acupuncture. And, I mean, doctors also don’t talk about it because then they’re afraid of malpractice, right? They’re afraid of insurance. They’re afraid of, you know, I mean, there’s. We could go on and on.
Speaker B: Yeah, definitely. Definitely. And I think, you know, that thing with talking about individualism as well, I think even more so now as I’m reading. I was in the pre call. I was talking about anxious generation, a new book that’s really highlighting for our teens what’s happening. And I think the influence of social media and the media we’re consuming, the rates of mental health for a general population have skyrocketed upwards. Many people, especially for our young people, but also for you, the therapist, for you, doctor, nurse, whatever, the people you talk to, because I think we’re untethered much more than we used to be.
Speaker A: I agree. And I think that it’s biologically messing with us. So being in front of your phone all day again will interrupt your ability to have great peripheral vision, because you’re too forward focused, so you’re not getting enough physical eyebreaks to give you the perspective that you actually need. We’re not moving as much because also we’re sitting on the couch looking at our phones instead of going for a walk. We have the dopamine addiction to the scrolls and the likes and the colors and the sounds and the things and the whatevers, so we dont know how to feel the dopamine that comes with anticipation. Naturally, we only can feel it from our phones, which is problematic. So I think that theres a lot of, and I think this is, and ive said this earlier, I think this is another piece thats missing from the definition of burnout. People talk about it like its just a stress issue and a mindset issue when there is this whole biological portion to it that we really need to address. So I think that the phones interrupt a lot of normal biological processes, and then we don’t have to talk about, I mean, the blue light that happens. And if you’re looking at your phone at night and then you’re interrupting your ability to sleep, so then your body can’t recover the way that it’s supposed to, and your glial cells don’t clean out your neurotransmitters from your brain that were like, we. So there’s this whole biological piece to it that’s really important that most of us don’t understand. So we don’t think about it.
Speaker B: I’m going to ask you a little bit about therapists specifically, if that’s okay, because I know that you’ve worked with a number of therapists, you’ve had a podcast. What do you think is helpful for us to recover if we need to make a pivot? And maybe why are we susceptible? I think we talked about a number of reasons why, but maybe just specific to therapists and your observations.
Speaker A: So, like I said before, like you mo, it’s so hard to use the right words sometimes, but there are a proportion of the popul of the therapist population that have higher Aces scores, which will mean that their brain development may interrupt their ability to see, interpret, and react to stress appropriately. So then you’re going to miss when things start going sideways because you’re not in tune enough with yourself, really. And every single person that I’ve ever talked to that’s been burned out has told me how self aware they are, because they know enough about what they do wrong. They know how to judge themselves, they know how other people will judge them, and they can get on top of those things before they happen. So they think that that’s what self awareness means, but that’s not what self awareness means. So I think that some of these developmental issues are big in therapists and in teachers and nurses and helping field. The helpers. Right, the helpers. So I think that’s a big one. I think this lesson of you are valuable only when you are giving everything of yourself is a huge one. I think this idea that we care for others, we don’t need care, is another. So I think there’s a lot of things that add to therapists and then, like you said, the vicarious trauma and the etcetera, etcetera, the compassion fatigue, and sometimes the moral injury involved in trying to deal with insurance companies when, like, you really know that she just needs to talk to you for another year because things are a mess and you have to fight that fight on the back end, and it feels ridiculous. So I think there’s all of those things, but the things that help you are not different than the things that help everybody else best. Free things is walking near trees. I know not everybody has trees near them. So walk wherever you can. Get plants at home if you can. The next is yoga, nidra or non sleep, deep rest or body scan meditation. All three of those things are the same thing. And those three things, all three of them have been shown to increase blood flow to the prefrontal cortex, which decreases when you’re in burnout, to help the amygdala go back to a normal size instead of being hypertrophic, which is something that happens during burnout, and to help the hippocampus regrow after being hypotrophic during burnout. So those three things that yoga, Nidra, or body scan, or whatever you want to call it, done consistently, will help your brain to actually biologically, physiologically, physically get back on track, which is important for anyone going through it. Then I think we have to do an internal external assessment what things are happening in my workplace, in my environment, that I can maybe adjust or not adjust, so that I know where I have influence, so that this internal locus of control becomes real, that I know what I can and what I can’t. And then what pieces of this story belong to me and my behaviors and my patterns that I might need help unwinding and adjusting in the future and not doing those things without the other. So I believe that staying in a toxic work environment is much the same as staying in an abusive relationship. If I’m just good enough, it won’t happen anymore. If I learn how to manage my emotions around it, then it won’t even matter that it’s happening anymore because I will be good enough and clean enough and all the things in order to have this not affect me. If I just do enough self care, yes, I will be able to manage this environment. Like if you walk through a noxious substance, you’re going to get sick because that’s how things work. So I think that this, one of the things that I think therapists get hung up on is this belief that they shouldn’t have to change their job environment because they should be able to be good enough to be able to handle it.
Speaker B: Right.
Speaker A: Not, not acknowledging that maybe it is just simply unhealthy, no matter. And you’re not going to be able to overcome it as a single person, especially if you’re working in a bigger.
Speaker B: Yeah. Or not.
Speaker A: Even if you’re, I mean, even or not. That’s true.
Speaker B: Yeah. I mean, both. I mean, seen it both ways, you know, personally, and I think otherwise, some is just the work and the emotional load that. The work, that’s just the work.
Speaker A: Yeah.
Speaker B: And then some of it is that toxic culture and like, what, and those high expectations and then being made, like, felt, other than if I can’t meet, you know, seeing that 30 clients a week or 35 clients a week in agency work, which most people I know, most therapists cannot do that.
Speaker A: And when you think about it, how is that even a suggestion?
Speaker B: Medical model?
Speaker A: Are we really so far behind that we really don’t get it? I know the answer, but, yeah, I.
Speaker B: Mean, I tell therapists, you know, it’s systemic in nature and it’s not your personal failure. And I keep saying it over and over again, no.
Speaker A: And even the pieces. Exactly. And even the pieces that are part of your personality and coping mechanisms, etcetera, those pieces are not your fault either. You created those things in response to a system that you were in, whether it’s your family system, your culture, or your work system, you created them in response to yeah.
Speaker B: Or what I thought, like, a good therapist should do, I should give my work away for free. I want to help people, and that’s what I need to do to help the world. And because that’s what’s been socialized, that’s what we’ve been socialized in that way. And so when we no longer can do that, then it feels, oh, I have to charge this fee to make a living that I need to make to be sustained in my career, to eat, to live, to be able to.
Speaker A: Have children if I want them.
Speaker B: Let’s not even forget about, like, saving for retirement.
Speaker A: That’s like, oh, jen, now you’re just getting crazy.
Speaker B: I’m getting crazy. So we need to wrap up this discussion. I could talk to you all day. And to end, I just want to ask you how you are finding joy.
Speaker A: My easiest and fastest joy comes in nature without a phone. And it doesn’t matter to me if it’s a forest path or a beach or a in nature, no phone. Look around. I am hit with awe immediately. This is my best reset, my biggest joy and the healthiest thing I think I can do for myself.
Speaker B: Where can the good people find you?
Speaker A: They can find all things. Burnout@friedtheburnoutpodcast.com. and I think that’s really the best place to kick it off because from there you can find anything that you want about me.
Speaker B: Great. Well, thank you for this work that you’ve been doing. It’s so needed. And I feel honored you talked with me today and that other therapists listening to this could hear your knowledge, your expertise and your truth.
Speaker A: And thank you for sharing the space with me because it takes all of our knowledge and all of our expertise and all of our truths to come out in order to hit people the right way. So we can’t do this alone. So thank you for inviting me in.
Speaker B: Awesome. Thank you so much. Hey therapist, thanks for listening to the episode today. If you love this podcast, send it to a therapist friend who may need it. Also consider leaving a rating and review on Apple Podcast. It lets the podcast player know that this is a great podcast. We should send it to more people. I’d love to hear from you. So I have included my pen pal list for other therapists. Yes, I do write back and I’d love to hear from you request for podcast topics to know how you’re doing in this, in these therapy streets. So I’m here for all of it. So I would love to hear from you and we’ll talk soon.
