010 Spiritual Burnout and The Phoenix

This is an interesting conversation between Mary and myself. I would love for us to have a follow up conversation on this topic. Here are the show notes:

  • Possible Individual Symptoms
    • Losing Connection, Passion
    • Feelings of Synasism
    • Old practices, such as church or praying that seem to no longer fulfill connection to greater sense of self
  • Burnout in our Society – connection to the universal experience that’s happening in the world right now
    • Structures of Power, Privilege, Government, Finances
    • Feelings of burnout representing greater macrocosm
  • Feeling of burnout not a personal flaw that needs to be fixed
    • empathy for greater system & self
    • Tended to own suffering differently
  • What’s the effect of professionals treating people in fight or flight/sympathetic arousal, on the mirror neurons of the professional?
    • Example of being in the dentist chair with heightened heart rate
  • Disillusionment
    • Beliefs about life and how it all works were being dismantled
    • Beliefs about fair and being in a developed country and working hard will equal success
    • Recognizing how systems are unfair
    • Many people in the U.S. are seeing behind the curtain – unfairness, oppression, racism, structure of power and privilege to maintain success of some and oppression of others
    • Me too movement
      • Helping organizations grow better leaders – saw how organizations protected male leaders, lost faith
      • Larger awareness working ass off to alleviate suffering and support people in feeling, saw that amount of suffering in the world is still the same – heart broken
    • Media and it’s effect
  • Psychedelices & Spirituality –
    • Personal stories
    • Sense of connection and boundaried connection

The relationship between spirituality and burnout among medical students

Medical student burnout has been associated with depression, loss of empathy, and suicidal ideation. Spirituality has been identified in previous studies as a protective factor in coping with the stress but has not been examined as a factor in medical student burnout. An internet link to an anonymous survey was sent via email to medical students at a public northeastern medical school; 259/469 (55.2%) completed it. The survey included measures of spirituality, burnout, psychological distress, coping, and general happiness. A Pearson-r correlation showed significant inverse correlations between measures of spirituality and measures of psychological distress/burnout (r’s ranging from -.62 to -.14; p’s <.01). In contrast, a positive correlation was found between life satisfaction and spirituality (r’s .53 to .12; p<.05). Using hierarchical multiple regression with demographics (Step 1), mental health variables (Step 2), and satisfaction and Adaptive coping (Step 3), burnout remained significantly related to lower scores on both spirituality measures (FACIT-SP p<.00 and DSE p<.05). Students having higher levels of spiritual well being and daily spiritual experiences described themselves as more satisfied with their life in general, while students with low scores on spiritual well being and daily spiritual experiences had higher levels of psychological distress and burnout. Spirituality may therefore be a protective factor against burnout in medical students and future studies should explore potential causal relationships.

008 Physical Burnout & Restorative Activities

This podcast looks at the Burnout and how it affects us physically. Below are the show notes:

  • Moral Injury and Burnout
    • Societies desire to not go deep and address top layer issues instead of root cause, sometimes could include Solution-focused (brief) therapy (SFBT)
  • No Energy yet difficulty with Sleep
    • Sleep deprivation is being shown to increases amygdala activation.
      • A study showed that while both groups expressed significant amygdala activation in response to increasingly negative picture stimuli, those in the sleep-deprivation condition exhibited a remarkable +60% greater magnitude of amygdala activation, relative to the control group
      • A sleep deprived person may see an event as an emergencies (due to activated amygdala) that needs to be urgently addressed, when in fact those that have had more sleep interrupt what’s needed differently
    • Loneliness and Withdraw due to sleep deprivation
      • A study demonstrate that a lack of sleep leads to a neural and behavioral phenotype of social withdrawal and loneliness; one that can be perceived by other members of society, and reciprocally, makes those societal members lonelier in return. We propose a model in which sleep loss instigates a propagating, self-reinforcing cycle of social separation and withdrawal.
    • Cognitive abilities, behavior, and judgment
      • Multiple studies have been done to determine the effects of total sleep deprivation; more recently some have been conducted to show the effects of sleep restriction, which is a much more common occurrence, have the same effects as total sleep deprivation. Each phase of the sleep cycle restores and rejuvenates the brain for optimal function. When sleep is deprived, the active process of the glymphatic system does not have time to perform that function, so toxins can build up, and the effects will become apparent in cognitive abilities, behavior, and judgment.
  • Feeling tired & wired
    • A combination of physical exhaustion or low physical energy while simultaneously feeling anxious or wired, stressed
    • Being unable to feel rested even if you are getting enough sleep
    • Body confused about not getting enough light and enough darkness; circadian rhythm
    • Body and stomach pains. Gut hurting when stressed and eating
    • Chronic exhaustion
    • Some people experience aches and pain
      • When people feel emotional pain, the same areas of the brain get activated as when people feel physical pain: the anterior insula and the anterior cingulate cortex. A study on social rejection seemed to demonstrate this.
      • The body isn’t getting enough natural light or enough natural darkness
      • We live in man-made boxes of artificial light
  • To go deeper into the sleep studies, please see Rhonda Patrick, PhD & Matthew Walker PdD
  • Practices – Physical
    • Breathing – Breath of Fire
    • Eating well-balanced meals
    • Sleep – 7-9 hours, before 10:00 pm; sleep hygiene and artificial lights
    • Exercise, gentle
    • Sex
    • Touch, Massage, Self-Massage, Cuddle – serotonin and oxytocin
    • Play, Dancing, Coloring, Drawing – engaging a younger or more carefree part of yourself
    • Get outdoors and touch the ground
  • What is it you need? And how are you going to implement this?

006 Emotional Burnout & Support

Mary Kuentz and Laura Wade explore their journeys through emotional burnout, some of the research about burnout symptoms.

  • Definition of Burnout
    • Mechanical – When there’s nothing left to combust, no more energy in the system
    • Emotional “burnout” was coined in the 1970s by the American psychologist Herbert Freudenberger. Emotional burnout describes the consequences of severe stress and high ideals in “helping” professions. Doctors, therapists, coaches, and other healers, who sacrifice themselves for others, would often end up being “burned out” – exhausted, listless, and unable to cope. It’s the shadow side of self-sacrifice. We will be looking at how to support without sacrificing and what to do when you’re already sacrificing.
  • Mary and I are passionate about taking Holistic views, so we will be discussing how issues affect us on an emotional, mental, physical, and spiritual levels.
  • Today we will be looking at the Emotional side of Burnout, and including how to know when you’ve entered the spectrum of burnout and what to do about it.
  • Emotional Signs of Burnout
    • Reduced Performance (difficulties in maintaining boundaries)
    • Emotional Protection/Isolation – Flat Affect Feels, nothing to look forward to, joyful things from the past no longer seem joyful in the present
    • Hopelessness about the state of the world and being unable to affect the issues of the world. Suffering is still happening in the world. What’s the use?
  • Practices to Heal Emotional Burnout: 3 practices, 2 and 1 of micro and large
  • Self-Empathy – begin to practice self empathy that you would give a friend client or loved one
    • Journaling – stream of conscious writing, to give it a place to vent
    • Take a Break, a day, a week – Emotional Well-being Day
      • May be different from a SPA DAY!
  • What’s the one shift, easy and doable, that would make the biggest difference?
  • How can you begin integrating that shift into your life, even in a small way?
  • Stop Blaming yourself for feeling burnt out
    • Many people keep pushing, internally and externally to overcome burnout in the early stages, i.e., “If I can just finish this project…” “If I can just get to Friday…” “If I can just push through this pain…”
      • Pushing to keep up
      • Punishing themselves to be who they have been in the past
  • Informed Health Online [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Depression: What is burnout? 2012 Dec 5 [Updated 2017 Jan 12].Available from: https://www.ncbi.nlm.nih.gov/books/NBK279286/
    • Listed 3 main symptoms of Emotional Burnout:
      • Exhaustion: People affected feel drained and emotionally exhausted, unable to cope, tired and down, and do not have enough energy. Physical symptoms include things like pain and stomach or bowel problems.
      • Alienation from (work-related) activities: People who have burnout find their jobs increasingly stressful and frustrating. They may start being cynical about their working conditions and their colleagues. At the same time, they may increasingly distance themselves emotionally, and start feeling numb about their work.
      • Reduced performance: Burnout mainly affects everyday tasks at work, at home or when caring for family members. People with burnout are very negative about their tasks, find it hard to concentrate, are listless and lack creativity.

Feeling discomfort when trying to relax is part of the process

The scientific model tells us that nothing is proved as true, it’s just not wrong yet. Here’s Dr. Feynman brilliantly explaining the scientific method.

I come across many models that don’t seem to hold up when I compare them to different studies or how I see them working with my clients.

One model that seems to keep proving it’s worth is Dr. Saj Ravzi’s Stress Response Hill, shown below. Check out his entire video, it’s worth the investment of time. The one point of his I want to highlight, is that most of us are operating at the “1”, we are slightly activated most of the time, and when we try to do mindfulness or relaxation exercises to get to the “0”, we may actually fell more agitated. It’s common to then think the exercise must not work, when actually the agitation in the body increases before it fully relaxes, so the increase in agitation means it’s working. I find this model extremely helpful to explain to clients prior to beginning relaxation exercises, as it helps them understand the increase in anxiety is part of the process.

New Experiences & New Healing

New experiences can bring up opportunities to examine childhood wounds and begin healing them. A common new experience I see people having is their first child or their first child that’s the same gender they identify with. Seeing the child grow to be ages the parent was when different traumas happened can bring up old childhood pains. While it can be very challanging, the experiences can also be a blessing allowing us to see parts of ourselves that need love, understanding, and forgiveness.

If you or a client is going through a new experience and has a response that exceeds the circumstance or seems like it belongs to a younger self, take the time to examine that response. What’s its’ message? What is it needing to heal? Provide the piece of the self that responded in this way with compassion.

What new and challanging experience can you try this week? Be mindful while doing it and see what emotions or sensations arise. If any parts of yourself are uncomfortable, take the time to comfort them, and be thankful to the new experience for showing you this piece of yourself to heal.

Thrive Moments

Arianna Huffington spoke on Masters of Scale about how her organization is using AI to monitor call centers. After an operator hangs up with a difficult caller, the AI detects the intensity in the call, and instead of patching through another caller, the operator will get a Thrive call. This Thrive call is a 30-60 second guided call, which could be on mindfulness, gratitude, breathing, etc. Arianna’s company Thrive understands that these small investments in emotional fitness pay for themselves. Emotional fitness supports the operators and the callers both have better experiences. What emotional fitness practice can you begin incorporating today?

FYI – A recent meta study on breath work comparing 8 types of breathing showed that all types of breathing were effective for a portion of the participants. There wasn’t one style that was effective for everyone. So explore different emotional fitness practices, what seems most supportive for you? The exercises that seem the most supportive may also change over time. Try keeping a list in your phone of what works and even what doesn’t work for you, so you know where to turn after a more intense moment, since most of us don’t have Thrive calls coming in to remind us what there is to be grateful for.

Shine on and have the day that’s best for you.

Emotional Recovery

Emotional Recovery

When you think of physical recovery after an intense workout or running a race – what comes to mind? Possibly:

  • Hydration
  • Mobility/Stretching
  • Rest
  • Sleep
  • Nutrition

Intense physical exercise, focused on the same muscle groups, day after day, is counterproductive, as it doesn’t allow for the repair cycle, and instead causes repetitive small injuries. While the small injury that occurs after one intense workout is beneficial with rest, as the muscle is allowed to repair itself and becomes stronger.

When you think of emotional recovery after an intense session or a multiple hour session due to a safety planning intervention for suicide – what comes to mind and are we as diligent at applying these recovery methods?

The research studies I’ve reviewed about emotional burnout are still unclear about exact causes and conditions, yet they have been able to define the symptoms burning as exhaustion, alienation from activities, and reduced performance.

Prioritizing our emotional recovery with the same awareness we allow ourselves to recover from physical exertion, I believe, could support healers in growing and becoming stronger from the intensity we experience in supporting others.

What steps can you take to support yourself in emotional recovery?

Hero’s Journey

Joseph Campbell, renown for unifying concepts from literature across many different cultures, developed the philosophy of The Hero’s Journey. The Hero’s Journey seems to identifiable and meet warmly in many different contexts. When I see clients, especially those re-entering their life after a residential stay for substance abuse, able to structure their story similarly to the Hero’s Journey, they seem to be welcomed back and offered support.

What are ways you identify with the Hero’s Journey?

What are ways you can support your clients in identifying with the Hero’s Journey?

Beginning the Practice of Emotional Fitness

What comes to mind when you think of ways to maintain or improve your physical fitness?

For me, I think of high intensity interval training, strength training, mobility & stretching, setting new goals for myself in gymnastics training, sleep, hydration, and nutrition. 

Now think of ways to maintain or improve your emotional fitness and how frequently you engage in them. 

I was oblivious for years, and then for years ignored, ways to improve my emotional fitness. Now, I engage in several techniques on a daily basis. The techniques shift over time, just like my interests in different physical fitness techniques change over time, yet I still engage in regular practices. Our emotional wellbeing can be shaped similarly to our physical fitness with different exercises and practices.

What’s an emotional fitness technique that you are willing to begin practicing daily?

Finding Compassion for a Broken Man

He didn’t imagine this for my life. He’s in his 40’s and walking back to his halfway house, after working a long day of construction framing. His body aches and his mind is screaming at him. He uses alcohol and drugs when he can, it quiets his mind. Yet he knows he will likely be drug tested tomorrow, so he walks past the liquor store with what little strength he has left. He gets back to his dingy room, the cockroaches hiding from the light. He swallows a couple sleeping pills and waits for sleep to come. Sleep has always been hard for him. It’s been 40 years and he still hasn’t figured out how to sleep, what type of man can’t fall asleep.

He’s being hard on himself again, that’s really the only way he knows how to speak to himself. While he remembers his past, he isn’t yet able to offer himself any compassion or forgiveness about why he can’t sleep now. When he was a toddler, the youngest of the bunch, he wasn’t able to protect his older sisters. He laid in bed hearing the repeated sound of a belt as it hit his sister’s flesh. His oldest sister would bawl so loudly, yet that seemed to end her punishments sooner. Then his mother would begin to belt the younger sister, and she never made a noise. Her beltings would last the longest. He would finally wet the bed and cry out. His mother would leave his sisters alone, now he was the one to face her pain.

Towards the end of her life, he would get to know his mother. She was a depression child, the middle of seven. After her father left the family, her mother had to try to keep seven children feed, which seemed like an impossible task. She gave her middle child away, to be a maid, for a household that had plenty of food. Over her entire life, she would only share one story of her time in that household, so what happened there would mainly be a mystery. Yet it’s evident to see, she carried a lot of pain, and it would leak out and effect those she loved the most.

Back to him though, he’s lying in bed with his noisy brain. Even in prison, he had better access to alcohol to calm his brain. Within a year in prison, he was a bootlegger, sneaking juices from the cafeteria and fermenting them in his cell. He was able to trade his moonshine for a little more safety in prison, and the alcohol allowed him to get some rest. Rest might be an overstatement, it allowed him to black out, more of a respite from his mind and his physical cell. He didn’t have alcohol in this moment, so all the memories of how he messed up everything in his life flooded his mind. How he and his wife were both been sent to prison for being marijuana farmers. His kids were in their early teens and drifted among family members, each suffering from their own trauma and not being able to provide his kids a home. By the time he got out of prison, his kids were adults, thus no longer needed and no longer spoke to him.

He had a temper, he knew that, he was far from the perfect man. When he was born, the trauma of his mother, already impacted his epigenetics. His DNA was methylated, which is actually a protective factor, if a human was born into a warring tribe, it was safer for us to think less and react more, this piece played into his temper. He spent his entire life reacting, no one had showed him a different way. The traumas of his prison life added on to the traumas of childhood meant he had a highly activated amygdala. His amygdala would take input anyone else would sense as beneigning and send him into fight of flight. What happens in fight or flight, is blood flow to the prefrontal cortex almost stops, this prevents the ability to empathize with another or even yourself (another reason he frequently speaks so harshly to himself) and shuts down logical thinking. It floods his body with stress hormones, so he’s ready to take out the threat in front of him, even when the threat is someone he loves. He has no way of sensing this, he’s flooded with cortisol and lacks blood flow to his prefrontal cortex. While it’s possible to demethylate his DNA, he didn’t know to search out for this, he keeps blaming, ridiculing, and torturing himself for not being able to act differently.

************************

This is my portrayal of a small part of my uncle’s story. A few months after this point, I’m 19 and visiting my grandmother and see him viciously lashing out at my grandmother. She got down on her hands and knees crying. He began yelling racial epithets, I never knew existed, at two of my friends. I held a bitterness and fear towards him for this event.

My uncle’s story does change. After his third DUI, his life begins to change with the support of his mandated counselor. He praises her frequently for altering the course of his life. He becomes the only family member of that generation who encourages me to take care of myself. He appears to release the manipulative traits he picked up as a child to obtain safety. He rebuilds the relationships with both of his sons. He’s in intense, chronic pain. He chooses to spend his money on their college education, instead of obtaining medical insurance and addressing his needs. They both get their associate’s degree and walk for their graduation on the same day. He then allows his son and myself to help him get insurance and begin to have doctor’s visits. They discover he’s already stage four cancer. He’s surrounded by his sons, nephews, and niece during the last year of his life. He’s healed many of his wounds, and supported us in beginning to do our own healing. I believe he became the man he wanted to be.