Speaker A: Welcome to the Therapist burnout podcast, episode 64.
Hey, therapist, today I’m talking to you a little bit about how to help your brain when it’s spinning.
So I talked last week a little bit about the neuroscience applied to Burnout. I talked about how many times when I’m talking with people in burnout, they are feeling really overwhelmed cognitively.
And so I wanted to do this episode to help you get some support with that specific problem. So a lot of times when I start working with my clients, I see this as well.
I felt this as well as the person in Burnout that I was really taxing my brain. Because honestly, like we know from last week’s episode, the amygdala is running the show, you are in fight or flight.
So of course you’re going to have this increased desire to get out of it. So the push for your brain in that state is to stay hyperactive, is to feel like you’re kind of manic and figure this out, get out of it.
Because what the brain is trying to do, what you are trying to do, is get out of threat mode. And so literally you’re doing everything to do that. Oftentimes when I hear or I get emails or people on console calls and they’ll say, what is the thing that I can do to get out of therapy?
I need to stop doing so much one to one. And they want the simple answer from me, which I could. The simple answer is take a break,
quit, you know, get another job. If you have to do that, take fmla. That is the quickest way to do it, to stop actually doing the work that you’re doing.
I know that’s not always the answer people want to hear, but if you actually need that break, like you are not functioning and your body is really giving you information that you need to do a full stop.
Like, I’m talking about panic attacks where I was, deep depression, physiological symptoms where,
you know, you. You’re struggling to get out of the bed, then we, we are at that point, right? Your body is, is kind of really giving you that information.
However many times we’re not to that point, but our body’s really giving us a lot of information. Like, whoa, you, you have to slow down or we might take you out.
And I got to that point. I’ve talked to a lot of clients who have gotten to that point and oftentimes we take it on as a personal feeling or we have shame in that we can’t quote, unquote, hack it.
But literally our brains are just trying to Help us survive. It’s trying to get us to stop doing a thing that we’re doing that’s way too much.
So today I wanted to do a little play off of cognitive rehab. So my experience working in neurorehab and also in the past three years, I’ve worked as almost three years, two and a half.
Ish. I’ve worked as a school psychologist and I’ve done evaluations for folks who are on the spectrum who have neurodevelopmental disorders or conditions such as learning disabilities, dyslexia,
and need executive supports. I’m just pausing there because my child was just dragging a piece of luggage down the stairs. I might leave that in.
Okay, so we are going to be a little quick today. It’s going to be a quick episode and I hope to do a deeper dive into some of the things that are really going to help change the game for you cognitively.
The caveat here, and please hear me, please hear me in my work with people who I just say have a different brain. Right. And that could be you, therapist. So if there’s anyone listening to this who is on the spectrum who has adhd, who has a learning disability,
and they know that from their history, you know, likely your brain needs more rest than a, quote, neurotypical brain. Right. If you need that, then applying these strategies to yourself, you might already be doing that and it’s not enough because you might need more rest or you might need to reduce more sensory inputs than someone who doesn’t need that.
Of course, you might have wonderful, wonderful strengths. And I always come from that strengths perspective of how a person who, you know, is on the spectrum or you know, has, like, has adhd, how their brain works differently and perhaps more creatively, perhaps making more, making different connections and celebrating,
like, the difference that we have in how we think. I think it is beautiful.
And.
And it still might be. It requires you to rest more. Both and both. And okay. So in either case, if due to burnout, you’re in a state of chronic stress and your brain really needs rest, or your brain is more susceptible to cognitive fatigue due to a brain injury due to neurodevelopmental conditions such as autism,
adhd, learning disabilities, and such, that is my caveat. You have heard it.
And moving on.
This week I was talking to somebody and I was like, isn’t. Don’t you wish that insight brought about change?
I wish that was true because many of us know all of this stuff,
yet we struggle to apply it to ourselves until it, like, smacks us in the face. And I have found that to be true for myself time and time again. And I still have tried, right.
I still have tried to incorporate these things. And I think the interesting part of me going through my training in Neurorehab around 2010, 2011,
was not everyone had a smartphone. It’s. It’s around the time I got my own smartphone. But the clients I was working with often did not have a smartphone. A smartphone yet.
So I don’t think we understood then the cognitive fatigue that smartphones would cause. And there’s been so much research I’ve podcast on this. So check back to my episode on Anxious Generation,
which was episode 29, and also my hot take on burnout in your phone. So episode 20, 29 and 30, really talk specifically on your phone and how it’s stressing you out.
It is taking vital cognitive resources from you. So please go back and listen to those. If you haven’t listened to those, go back in the Wayback Machine. So I think it’s just something I’m going to be touching on more frequently for therapists because it’s obviously an issue.
It’s an issue for clients that you’re seeing if you’re still in practice.
So check those out, 29 and 30 of the podcast.
All right, so I’m going to talk with you just on three points, because three is great for the brain. We love it.
And you can only take in so much information. Right. So the first I want to talk to you about. One of the biggest concepts that I took away from Neurorehab was pacing.
So everyone is different.
So I love when I see in therapist spaces,
how many clients is full for you?
It is so relative, but I understand the question. So a lot of new therapists coming into private practice, or just new therapists in general, will ask that question, how many clients is full for you?
So some people would say, full for me is 10 clients. Another clinician might say, full for me is 35 clients. And I’m drowning some people that that’s their capacity and that’s what they can do, that’s what they can hold.
And I think we’re in this constant state of comparison of what can I hold? And I see Sally therapist over here holding 30 clients a week. And I can’t do that.
I had someone write into me and say they were actually being reprimanded because they weren’t meeting their product productivity guidelines for 30 clients a week. And I remember in agency, when I was working in agency, I had those productivity expectations of meeting 30 clinical hours per week.
And it was tough. It was really tough. If I wanted a vacation, I had to work 30 hours per week. And I didn’t stay there very long because I had a son who had heart surgery and launched my private practice and did that for another almost 10 years.
But it was a lot. You know, it was a lot. And I don’t think I could have done it long term.
So thinking of pacing,
knowing your capacity is at the root of pacing,
and if you’re listening to this, likely you’ve come up against.
I cannot hold the amount of things that I am doing in my life, clients,
my home life,
other obligations,
you know, in my family system or in my personal life,
I am really struggling to hold them. Most of the people that listen to this podcast are female identifying and, you know, in the ranges of, you know, 30s, 40s, 50s.
I have some younger folks that also listen to this. And just a caveat that our younger therapists are dealing with higher rates of burnout. I’m seeing that a lot in the literature that Gen Z is experiencing higher levels of burnout.
And I need to do a whole episode on that because I just. I just want to also be a voice for younger therapists that if you feel like you can’t hold this, there is a trend that is happening that Gen Z feels like they are burning out before they even get started.
So what is happening there? That is a huge trend.
Pacing.
So working at a normal human pace is my mantra for 2025.
Oh, my gosh, y’all.
I have throughout my career,
pushed myself to the point of being unable to work,
being unable to do many things. And that’s in, like when I first started mothering. So as a new mother, I was not sleeping.
I had a baby who had heart surgery,
and I. I was honestly traumatized from a traumatic birth. Now that I can. I can see that now that that heart baby is 11 going on 17.
Love him.
We’re in a little bit of a season, though.
Yeah. So working in a normal human pace, how many sessions can you hold? I know some of you are, you know, some of you are not in private practice, so you have this productivity demands of your time.
And I think when I first started in private practice or in practice in general,
90837.
I think you couldn’t really bill it like you can now. Like, it wasn’t the code that people are billing,
so we were billing the 90834. And so if you are across the pond or somewhere else, so insurance pays for a 45 minute session. That’s that code. And so we had to see the client at least 36 minutes or so.
I can’t remember because I’ve been out of it for a couple years, but I usually look at that regularly.
But I remember that the code for 60 minute sessions you had to physically see the client for 52 minutes butt in chair. So your butt in the chair, their butt in the chair or like with them for that amount of time.
And I was just talking on a console call with, with a current therapist client and they were saying maybe I should reduce my income so I can have a break, so I can have a, have some time for notes.
Because they were doing notes for like hours and hours and hours.
And so we’re just trying to problem solve their day. Like how do they help themselves complete their paperwork and get a little break? Because they were just like, I just need to break.
And I was like, I get that. I really get that. Sometimes you just, after the session you just need a break, you need a snack, you need to go to the bathroom.
And that five minutes that you might have between sessions is all that you, that’s what you need to do. So trying to productivity,
trying to do some kind of productivity hack rather,
that’s not, that’s not a good use of your time or your cognitive resources, your emotional resources. That’s not honoring your body.
So I think insurance,
you know, has dictated our work again and how we even work because most therapists are billing that 60 minute session in the US anyway. I don’t know how. Let me know, write to me, let me know what it’s like.
How, how long are your sessions if you’re elsewhere in the world. So if you’re in the uk, if you’re. So most of my listeners are US based, Canada based UK and Australia.
So let me know. I’d be interested to know that.
So how can I start to work at a human pace is I think the question I’d like to pose to you. I know that it seems like the world is going, coming at us at warp speed and it may feel impossible.
I mean really. So I’m taking a page from my neuro, my neuro rehab days when I found that people just really needed some guidance of how to help themselves because everything seemed like too much.
And I’m talking about like they would go to the grocery store and then have to lay down for four hours or they would start back to work and maybe start back to work for half days, maybe four hours at work a day.
And that’s all they could do. And that wasn’t enough for them. And still that’s what they had to do. They had to pace themselves.
And so this concept of pacing, I think is important because life has really taken off at warp speed, especially with the information that’s coming at us. And so I was reading digital.
I was reading digital minimalism,
which is a tongue twister, by the way. But I. I rocked it out.
And I’m just really thinking of, like, the inputs that are happening in my life, right? Like, how much information I’m taking in just as I wake up in the morning because my alarm CL is broken.
It’s been broken since like last year. So I’m using my phone again as an alarm clock, which I don’t recommend because I’m looking at my phone first thing in the morning.
Too much input. I’m trying to like, not go down the squirrel moment of the phone, which is like a whole separate episode which I probably will like, redo as part of this, like overwhelmed brain thing.
But it’s part of it. Yeah. I think we have to reduce the inputs of information.
So part of that has to be the phone.
And so we generally ignore rehab thought of. And this is from the Cogsmart program. And that program was produced by the VA for people with a TBI or people with other neurological demands.
And so as a rule of thumb, every hour, take a 10 minute break.
True break. I’m going to go over that in a minute.
And then one day per week rest,
like legit rest. Like we need. We need legit rest.
One week every quarter, just about 12 to 16 weeks,
also rest.
So 10 minutes per hour, one hour per day, one day per week, one week every 12 to 16 weeks. We need to take off, we need to rest. And that’s a rule of thumb.
That’s where people that were in cognitive rehab and that wasn’t enough. A lot of times after a brain injury, for my folks who really had to let their brain rest.
Now, I’m not saying that you have a brain injury, but I’m saying that a lot of people in burnout, as I talked about on my last episode,
have neurological symptoms which have switched their brain into fight or flight. And if you feel like you’re constantly feeling like you are gripped to your computer, you have to work, work, work, work, work.
There is no other solution for you. Then you will, like, start to consider this. Start to consider that you have overtaxed your cognitive resources and you’re in cognitive burnout and you need to do some of this, Some of this is prescriptive now for you because you have start to hit chronic stress and chronic fatigue where no matter how much rest you do,
you constantly feel tired. I will offer that to you how you can pace yourself. Start with that. 10 minutes per hour, 1 hour per day of true rest.
And so when we’re thinking about a break for our brain and our body and therapist, you probably know this, but it looks like walking or breathing or resting your eyes.
I like listening to music. That’s fine. I think that’s fine.
Great research on music and all the wonderful things that it does for us neurocognitively. So I love that closing your eyes for that time. I think a lot of things movement related I would love you to do because I know what you do most of the day is sit.
So if you’re sitting, I love some kind of movement break to help yourself relax.
And for that one hour per day, you know,
I’m just going to be real here. I’m like running around doing all the things I’m. I have two children,
I have a job, I have a podcast.
I don’t always take my best, my, my own medicine. So that is sometimes just a show at night that I’m watching.
But I do try to spend some time in nature every day. And I want you to get like start where you are. So start with like one of my consulting clients, I told them go outside for 10 minutes per day.
You don’t even have to walk, you don’t have to do anything. Just go outside and look at a tree. Because what I know is that 10 minutes of being in nature, arresting your eyes will give you some relief.
And if we start the process of going outside, then maybe you will walk, maybe you’ll stay out there longer, maybe you’ll get more regulation by being out there.
The second point I’m going to talk to you about is reduce your inputs. So a lot of times, again, when I was working with folks after brain injury,
I would help them think about reducing the inputs, their sensory inputs. And sometimes this would happen where they would be overstimulated in certain environments. And I see this with children too, who are on the spectrum who probably have some kind of neurological difficulty or neurodevelopmental disorder.
And oftentimes, like we see kids with headphones,
right, who have a different brain, their brain becomes more overstimulated and so that helps them in loud environments. I have become somewhat like this just to the noise level of my children.
So I have earbuds in sometimes just because like I was trying to do stuff in the car. Like I had to work in the car yesterday when we were traveling.
Not the best look, but that’s what I had to do.
And I’m had the earbuds in because my partner is listening to some loud show.
I don’t even know what it was. Football, Some kind of football.
Like why are we listening to football anyway? It’s March and football is still happening.
I don’t even understand why we’re talking about drafting some kind of team. Fantasy football. I don’t get it. That isn’t the side point of like I don’t understand how football action happens year round anyway.
My kids are playing some kind of game in the back and like literally screaming half of half of the time.
And I was trying to do something that was due yesterday and I don’t recommend it,
but I tried, I tried to put some earbuds in to reduce some of the input and still it was not enough. Like not nearly. I need to just get some noise canceling headphones for these types of situations.
Exactly.
I digress, but not really.
So if you want some tips for how to declutter your phone, I’m thinking of doing a 30 day digital declutter.
And so I’m using Cal Newport’s Digital Minimalism. It’s a great book. I think it highlights why when we’re constantly scrolling on our phone, we’re checking multiple apps,
it’s stealing our attention, it’s stealing our time, it’s stealing from us. The rest we need.
So I can’t have this discussion without talking about your smartphone because it is literally causing you stress.
Okay. So I might redo an episode on your phone through this series because it is really so important. Really is.
If at all possible, can you book in your day without media?
Even if it’s a few minutes per day, even if it’s 10 minutes starting small. To book in your day with some kind of moment of rest, of movement, of breathing,
staring at the wall, staring at a tree, but just to not have that input of your phone or of media right when you get up or when you go to be.
And sometimes, you know, I get to my bed and it’s literally two minutes of my book and I’m out, you know, so it’s, it’s not even. That’s my routine.
But thinking through booking, bookending your day without media can be just the start.
All kinds of things that can help us sleep.
I just woke up, so my voice is raspy.
And I think the last point I would add is add,
make small moves with helping your brain. A lot of times the tendency is to do the revamp.
I need a whole, like I need a new calendar. I need a new system because I’m,
things aren’t working. I’m going to look up, you know, some kind of new mind diet. I’m going to. No, no, no, no, we need to stop.
So one habit at a time is most helpful.
Sometimes we need a full stop. Our bodies and brains really need that rest. But for most people I find it’s incorporating one small change. So thinking about, okay, maybe I can bookend my day.
When I’m making my coffee in the morning, I can try to incorporate some movement,
have some weights around. I’m going to do a little bit of movement during my, while my coffee is going.
At the, at the end of my day, I’m going to read a novel and that’s going to be how I can relax my brain a little bit more.
So I, I think starting with 1% changes. I love Atomic Habits and the Premack principle. So you know, he talked about habit stacking or habit pairing.
That’s the Premack principle from behavioral psychology. So a lot of these authors have taken behavioral psychology and they’ve applied them to a larger audience, which is great. You know, before I was like,
you’re calling something new. It’s the premac principle. You didn’t, you didn’t develop that. Okay.
They made it sticky in our brain. So Atomic Habits, if you haven’t read that book, wonderful, wonderful book by James Clear on how we can build habits and I think build them sustainably.
So starting one or two habits at a time at most.
So if it’s, I’m going to try to take that 10 minute rest every hour. I know you’re on the. Potentially you can’t do that every hour.
But considering, you know, if I have three to four sessions, I’m going to take a longer break after that so I can inch up toward that 30 minute mark of the breaks that I need.
Interestingly enough, right. Like at a job,
it is required to have a break.
Let that, just let it sink in.
So after, you know, every two to three hours, like by law in the U.S. at least, you have to have like a 15 minute break and then a 30 minute break for lunch,
a 15 minute break halfway through your second part of your shift.
So that equals about an hour of time. So if we just think about, even the laws dictate that we’re taking breaks, but we’re not taking our breaks. We’re not like truly resting in those breaks.
I want you to think about how can I really let myself rest throughout the day if I just start there, then that, that can be a start.
Sometimes I tell myself,
so in the school setting we have some students who just have behavioral needs that need a behavioral plan. And so think of like a positive behavior support plan for myself sometimes where I’m giving myself little rewards.
Right. I, you know, if I kind of gamify some of this, give myself little breaks, I’m going to reward myself. Okay. If you don’t look at your phone for, you know, two to three hours in the morning, then, you know, you get to have it at a certain time or we’re going to have like a fa.
Our favorite treat, or we’re going to like reward ourselves in some way. So I think sometimes I put myself on a behavior plan because I need it.
And so any way you can kind of trick yourself through this can be helpful.
Okay, so my three tips for helping your overwhelmed brain are. Number one is pacing.
Work at a normal human pace. Yes.
Two would be reduce your inputs. Think about what information’s coming at you, your phone, the apps. I don’t know if we can put it.
I would like to reduce the input of my children. Can I. That doesn’t work. Okay, Just kidding.
Media,
email, like how can I check my email last.
Just deleted off your phone. Okay. Check it in the computers. I, I think I’m gonna have to redo like the media episode again. All right. Won’t get into the weeds.
Bookend your day without media.
And lastly, small moves. So we’re making 1% changes,
one or two habits,
thinking about ways that we can do that. So I reference atomic habits often thinking about habit stacking. So I’m going to, you know, I’d like to work on my balance.
I’m going to do that while I brush my teeth. So I’m going to balance on one foot while I brush my teeth. That’s a way to pair behavior. I take medication when I brush my teeth.
That thing happens every day. So I pair it with that particular behavior. So you might think about a habit of rest.
You might pair with a high frequency behavior such as your coffee. For me, that always happens,
you know, breakfast always happens for me. So thinking through, how can I incorporate this. That’s easy. That works.
That’s what I have for you today. I will talk more potentially next week about helping our brains. I will. I think I’m gonna talk about a calendar system, because I know you’re probably in search of the perfect calendar.
You know, the best calendar that you can get is the one you use and the one that helps you.
So oftentimes, when I worked with folks after a brain injury, we worked on their calendar system to help them remember because literally, if they didn’t write it down, it didn’t get remembered.
And sometimes when you are in this state of cognitive burnout as well,
I’ve had people tell me like, I am, in a sense, a state of brain fog. Like I’m having struggles to remember things. That makes sense if you’re in chronic fight or flight.
Makes total sense. So I’m going to talk a little bit about a.
I’m going to say a mindful way to use your calendar, a sustainable calendaring system. I’m going to play around with what I’m going to call it. Okay,
I am gonna wake up because it’s Monday and I am getting this episode to you in the 11th hour.
But I’m also committed to this habit of delivering content to you weekly because I think it’s important and thousands of you listen to this. I’m so grateful to have this group of therapists that listen to this podcast.
And so I thank you for listening. Please share it with your therapist friends. Spread the message that we do not have to live constantly burnt out. Okay, Have a good one.
