Do you feel like you're constantly stressed, overwhelmed, and exhausted? You might be experiencing burnout, and it can be tough to deal with on your own. That's why it's important to seek help if you're struggling.
This week on Therapy Talks, Carolyn Rubenstein sits down with Hailey Kanigan to deep dive into burnout and anxiety.
In This Episode:
Carolyn Rubenstein, PhD is a licensed psychologist in private practice in Florida specializing in anxiety, burnout, perfectionism and trauma. She particularly enjoys helping anxious overachievers experience greater ease by finding worth in being, not just doing.
If you or someone you love is experiencing burnout or anxiety please reach out to a mental health professional for more ways to ease and manage your symptoms. Don't suffer through burnout alone- help is out there!
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Disclaimer: Therapy Talks does NOT provide medical services or professional counseling, and it is NOT a substitute for professional medical care.
If you don't mind, I'd love for you to introduce yourself and like your practice. So I am Dr. Carolyn Rubenstein. I'm a psychologist in practice in South Florida. I practice primarily with adults, young adults, working on anxiety, burnout, and perfectionism, all the good stuff with some trauma thrown in there.
Which usually, you'll see you. Collab, collaborate. Not collaborates, but we'll join up with anxiety and burnout and perfectionism oftentimes. There's been a lot of overlap with trauma. , that makes so much sense. Yeah. Cause not only is the anxiety, the fear of something and perfectionism is the fear of not being good enough or trying to always be good enough to compensate.
And sometimes that comes from a place of trauma in some way. So it all comes together and then it's so much energy here we are burnt. Exactly right. I think for all, even without the trial, I think throughout, the past couple of years, our world has experienced collective trauma. And so we have, I think everyone at this point is feeling a sense of burnout.
And together, that just creates this general sense of anxiety in the air, which I feel like people are catching and it's contagious. It doesn't feel very good. So for sure, definitely seeing more and more of that in my practice, which I love. I. And how would you categorize burnout different from just being tired?
Oh my goodness. I think burnout a huge part of it is that physical exhaustion, that emotional exhaustion that you feel. That's really one component. The other, I'd really like to look at it in three components, so you've got that emotional exhaustion, then physical fatigue. Then the second part is really feeling really cynical and detached.
So just a feeling. Nothing you do really matters. Feeling isolated from others. So little different than the just the physical exhaustion. And then the third piece is just feeling a decreased sense of accomplishment like you are working and working or doing and doing, and nothing really seems to be making a difference.
And so oftentimes with perfectionism in the mix, I often will see people. That point when they start to notice a difference in their performance or their productivity versus they're so exhausted, they're physically tired, they are having chronic illnesses, they're completely detached, completely isolated, but it's not until the performance goes down that I'll see them in my office.
So it's interesting. Yeah, it's that so far gone experience, right? And it's not only that tiredness, it's so many other things, like the reduced performance and things. It makes me think of this term quiet, quitting. Have you heard that? Oh goodness. Have I heard that? Yes. I feel like that is the buzz word right now.
Quiet, quitting, which I like to. Think of as healthy boundaries, right? Like people are learning healthy boundaries. , which is like the end of the day, we turn things off and we create a sense of checking out and having boundaries. I think that there might be some sense of there's obviously different ways that the term now is being used, but I think, some people are like, I just don't care anymore.
Mentality of I'm burnt out. But I think some people to way up being like, I'm gonna actually just turn off everything and detach from it, which can be really healthy. Yeah, for sure. And the way that I also conceptualize it is doing the bare minimum at work. So you're quietly quitting your job, but you're still actually at your job, and so you're not fully engaging to your full potential.
And I also see it as more of a subconscious choice rather than a conscious choice. Oh, interesting. Yeah, so it's not like you're intentionally doing it, but maybe more so like it's a subtle kind of shift in how you approach your work. , it's like for so long you're doing so much, and so you don't have any more energy towards being able to do your full potential at your job or at your work.
And so I jokingly would say, I don't know if you can validate this. It's like when you give a client a reflection and you validate them, but maybe you're like, oh man, that was like not maybe. Perfect as it could have been, or you feel like, oh, I didn't quite catch that the right way. Or No, maybe someone at work completing a project but not going the extra step of adding that creativity to it because it's just sometimes so much you, but you still wanna get your things done so you don't necessarily do it at the full potential.
Totally, you're checking the box, but maybe that's it, right? You just getting through the check box and maybe not doing it with your sparkly pen like you normally would do it . Wow. Or anything extra. You it takes away a sense of you, all of you from it, which can take away from that feeling of being like the joy, also the part of that, that actual, like the joy that you would get, you might get. doing less and less like draining, but also you get, you don't get the good emotions as well. , definitely. And wouldn't you also say that depending on who you are, you would see quite quitting as a negative thing?
Or maybe you could look at it through a compassionate light? So for example, if you're a business owner, you might look at quite quitting as such a negative thing cuz you're really measuring productivity and trying to have successful business. But then from like our lens as a therapist, we have so much more compassion for it cuz we understand.
Where that's coming from. Totally. Yeah. I think you can look at it through different lens for sure. And and I think it comes down to also like the intention behind it. If there is intention behind it, if someone's doing it intentionally as I need to start setting boundaries and taking care of myself and I have been giving a thousand percent and it's not working and so I need to try something else. Versus I don't really, I'm not intentionally doing this Giving a little. I'm giving less because I'm so exhausted and they don't deserve this, and I'm totally disconnected from the why behind what I'm doing.
you're making such a good point, because sometimes quiet, quitting, like you say, it's a form of boundaries, right? So at work. And so it's like maybe shutting off your emails at the appropriate time instead of sending that one more email at the end of the day that is taking you into overtime territory.
Yeah. Yeah, exactly. And I think that's just it can be a powerful thing to have boundaries, but I think it's. . I think then also in our culture, in our minds, the idea of quitting with a boundary is like a very negative connotation. And which is why people will push back against the idea of boundaries because it's oh no, that's quitting.
I can't do that. . And so I think that almost the term when used with boundaries can be. Create that negative that less compassionate lens and more like they're quitting at the end of the day versus setting like a more empowered boundary for themselves. It's so interesting, like how much our sociological lens affects, like things that are individual experiences of burnout or quiet, quitting.
Yeah. It's kinda interesting. It's really our perspective. I know, I feel like if you asked about like 15 people, 15 people might have very different views of what that actually means and looks like, and if it's a positive and negative or whatnot. And I think if there were 15 therapists you'd have very different than the general population as well.
, I would love to go into a discussion of number one, if an individual's experiencing burnout, how to manage that a little bit more effectively. And number two, if you were a loved one or a family member, friend, colleague, et cetera, of someone who is. Experiencing burnout, how would you support them in that side role as well?
Yeah, so I think the first one, if someone's experiencing burnout, like step one, the biggest step, which I think is therapist we always highlight is that awareness of just being aware that burnout is occurring because we often do not recognize that it is occurring. We think it's like this big moment of a breakdown or there's some explosion, but it really is more of a slow leak that occurs over time.
And so just to be aware that. The signs are there. I'm becoming more detached. I'm not feeling that sense of accomplishment. I am pulling a little bit away. I'm feeling very drained and exhausted. That's huge. So just that awareness part is the first part of the battle because many times we ignore it and it takes a lot to get us to realize that we are experiencing it.
Personally, I went through burnout and it took me. Getting to the point of being like very physically ill to be like, oh, now I'm burn I'm experiencing burnout. Like now I get it. Cause my body is telling me. And so I think when we are experiencing burnout, we often will think, look out like, what can I change outside of me?
I need to quit my job. I need to go on vacation. I need to take a leave of absence. I need to do all these things. Instead of doing that, which all those things are very valid. I say step one is more. So look in and look at what is going on inside of you? Let's figure out the internal terrain first. What are you experiencing?
What is happening for you? What are the main symptoms that you're feeling? Is it the physical exhaustion? Is it a sense of accomplishment? Is it feeling detached? And start to look at ways that you can begin to just recognize those and begin to make little tiny changes to begin to change how you.
Internally which is just acknowledgement, self-compassion. That this is really hard and that you don't deserve to be feeling this way. And obviously we're doing this podcast, a lot of people feel this way, so we're all connected especially right now through this experience. So really being able to recognize that element and looking.
What things really drain you? What are the things that will make you feel more depleted, more exhausted, more detached, more just like you're not getting anything done. What are those things for you? And I'll talk a lot about with my clients, like auditing your calendar, just looking at it day by day, what are the things that are making you feel?
Drained. What are the little actions that are drained? Like doing a podcast for me is very fueling. I love it. I come away and I just feel energized. Whereas maybe spending an hour doing homework with my kids, I feel very drained. So I can pinpoint exactly what those things are for me in terms of the day and what that looks like, and it helps me to anticipate.
My needs beforehand, like little putting able to put little things that are more fueling for me which might be listening to a meditation for five minutes before homework or after homework. Or going for a walk outside for a few minutes around those really draining things. So just getting more aware of what drains, what fuels and staggering them so that you're taking care of yourself in advance.
And also afterwards you're really being, very aware. And these things are things that you can do without making drastic changes to your life, which I think is really important to recognize. However, there are times when you do have to make drastic changes. And so it's helpful to be able to do that internal audit, make the little changes and be like, Okay, I've done this feeling a little bit more like I have a idea of what's going on and then looking externally and seeing what is going on.
What are the things that are really draining you? How much control do you have over them? How much flexibility is there in wiggle room. Beginning to look at bigger shifts in your life and how that might be possible or not and timing. And I think that's where your support system becomes incredibly critical.
, a lot of times we might have to lean on someone for extra support and managing things that might be, feel incredibly tough and unchangeable at the time. For sure. Yeah. And so that's where. Bringing in someone else from the support, support side can help you look at your life through a lens of more flexibility.
Having compassion just for validating yeah, this is beyond difficult, what you're managing. I don't know how you've been, just to hear those words is incredibly just reaffirming that you are understanding what's going on, acknowledging it, someone else sees it, and then to be able to look at it from 30,000 feet and be like, okay, let's kinda tackle this together.
, what are some things that maybe someone could help with a little bit? Cause a little bit of breathing room can make a big difference. And just to be able to help look at, and I create ideas and generate ideas. So I think that's really helpful in terms of support. But the number one thing, Validation is key cuz burnout, you feel really detached and isolated.
. So any connection is amazing for. That would be my main beyond anything else don't jump right into problem solving, I would say, but , the compassion, the validation, and then, when the person is ready, like help problem solve, get creative with the person and know that things, something has to change might not be very drastic or it might be, and be open and willing to explore that with the person.
I love your terminology of what drains you and what feels you , right? Because it's not one or the other. It's a combination of both. Even if you stop the drain, you might still have an empty cup, right? Absolutely. So it's so important to like, recognize, and I like when you say it's not necessarily always that big drastic change right away.
So for example, if you go on vacation, you might feel better for that week, but then you might come back and just still feel really burnt out. So it really. To be that inward, like you're saying, that inward acknowledgement of what you're feeling and noticing. I really love the stereotypical classical idea of cognitive behavioral therapy that says it's a lot of the time, it's not actually the issue itself, it's the way that we perceive the issue.
Yes. And so if we perceiving ourselves in an unhelpful way, like when we talk about perfectionism or we perceive ourselves as not good enough, or we perceive that we need to do things a certain way and not quit, for example, then we're going to be stuck into that cycle. So we have to change our perceptions and change the way that we see things, and then also start adding in something that fuels you, which might even just be.
A five minute meditation or a quick little walk in the morning, or it might be literally sitting and doing nothing for 20 minutes. My favorite . That is my favorite one. Yes, . I had a nap on the weekend and I was like, that was the best thing ever. . Oh my gosh. Naps are my kryptonite. I love naps. Oh goodness.
Yeah, it doesn't have to be right. Sometimes especially like in Florida, like a lot of greenery, right? So like sometimes it's like we notice like you don't look outside or we don't go outside. Just stepping outside sometimes is enough to give you that actual reset that you need for sure. And I always joke break out the cheese grater.
I'm about to get some cheese and shred some because I always wanna encourage people. It's so cheesy. You were never too old or too anything to change what you're doing in your life. Like you always have the opportunity to change something and you don't have to perceive that you are stuck like you do have those options available for you.
Yeah, and it often just comes down to that flexible mindset, a little bit of creativity and thinking outside the box. , and it really is Fulfilling and empowering to realize like you don't, you aren't stuck in that box, that you can make changes for sure. And I really love your point around validation.
So can we give some examples of what validation verbally could look like? I think I love the tangible examples. Yeah. Yeah. So from, I think for a lot of us, like honestly, I think a lot of times it's like, This sounds like a lot. It sounds really hard, what you're going through. This is really hard, right?
This isn't what you expected to be feeling right now. This is much more than you ever realized like you were handling and so I think just saying these words and honestly just mirroring what the other person is saying, using their own language and reflecting that back, right? Like exactly like what we learn as therapists.
This is really hard. Period. And silence and really being able to just sit with the person with that hard thing without going writing, right into solving problem solving mode. . So yeah, I would just, the validation is instead of I think as a supportive person, it can be really hard to say something is really hard without jumping.
You'll get through this and everything will be okay and everything, you do hard things all the time and this is no big deal. And you've been through harder before. It can be feel easier to try to put like a pretty bow on top, but sometimes for someone, I think if you think about what feels good to you, oftentimes it's just like someone just saying yeah, this is really hard and that's it, and I feel it's too oftentimes feels too simple, but it's so powerful. Yeah. Because once we say something validating, I don't know about you, but sometimes there's that feeling to oh, this is really uncomfortable. I should fix this. Yeah. But I think that's really important to acknowledge that there is no need to fix someone else's burnout experience or emotional experience.
Yeah. You are gonna be way more help. Full by just holding space and holding space is like that. Validation, good, positive body language and just really leaning into that person. Cuz I don't know about you, but so many clients will come and go, my partner or my friend, a family member, they're really struggling and I don't know what to do.
And I sometimes go, have you tried validating them? Have you tried just sitting with them? Have you tried even just asking them, how can I help you? Exactly. That's the big one. I think that's the big thing too, the validation. It's With the silence and like the validating, but then being like how can I help you?
And sometimes that can feel like a loaded question at times for people. Cause they don't know. And that can feel like, oh, I don't know how to help. But that's, I think just knowing and being telling the person that you're willing. Whenever they do know or do want help, like you are there to support them.
, even if they don't know right now, big or small, you are there to help them. But asking, because if someone does know, if you could be with my children or if you could help me with dinner tonight or that would be amazing. I think. Just being able to share that and for someone else, cuz most times if someone asks, like the other person really does wanna help and wants to do that thing.
And so sometimes just being able to say what you need help with, it might not be feel like the biggest thing. If you could just help me with dinners this week, like that would just take a load off, and if the person off is oh wow, that's a lot easier than I was imagining. Yes, I'm in like, let me help you.
People wanna. People really do wanna help. And so even if it's not like someone who's like an intimate partner or something, be willing to ask for support, I think that's a big one. Cause , I know if someone comes to me that's not even like the closest person to me, but is struggling and I say if there's anything I can do, please let me know if I, I can I really do wanna help if I'm asking and I would, I feel good helping.
I think most of us feel good helping. And so really take people up on that offer. When they say, can I help? , yes. Take them up on it and off, suggest something. Yeah, of course. And that when you offer an option, that person still can say no, and that's okay. Totally. Yeah. I would love to jump into a little bit of discussion of anxiety, cause I know that's one of the other main areas that you work in, so conceptualize anxiety as like a clinician. I look at anxiety a lot as. Obviously one of our primary emotions that keeps us alive. But it's also a major emotion that motivates us. And as a result, I tend to look at it as what is the, like what is this motivating for someone? Because a lot of times it's holding people.
Still or in place. And we get really comfortable with that. And so I'm often looking at with anxiety as the why behind it. So why is this showing up here? Why is this being reinforced? Why is this present for so long? Because there is a mechanism of survival with anxiety. There's a, a. A reason that it keeps showing up and it keeps staying in place.
And so with anxiety, my big thing is instead of trying to erase it, I try to look at it as this huge source of information. It's like one of those those little eight balls which my kids now are obsessed with is why all I'm thinking about right now is like shaking it up and being like, okay.
What's going on here? I feel like anxiety, when people show up it's oftentimes, it's not even really anxiety, it's just like the source of a lot of information. . And so I'm looking at it as okay, why is this showing up? What is going on? What's motivating? And let's dig underneath the surface a little bit from a more C B T perspective, right?
I'm gonna look at like the core beliefs, fueling it and, we'll look at the evidence and all of that and if it is truly anxiety, but sometimes it's. Not, sometimes there's other things going on and anxiety for people has become really comfortable. And so if we have to resort to anything, we'll often clinging to anxiety.
There might be sadness, there might be loneliness. There might be a lot of other things going on, but I feel like anxiety tends to be something that we've become as a society a little bit more comfortable talking about. So it's often something that will. Bring up first. And I think of it as just like the first layer on a cake and we'll we'll dig in and sometimes it's the only layer.
Sometimes it is the primary emotion, but oftentimes it's gonna lead us to maybe specific types of anxiety or specific types of triggers or panic or things like that. Or we're gonna go into other emotions completely. And other transitions and shifts in life. Completely. . So I look at it more recently, especially in the past couple of years, as something as a starting point for our journey rather than, I guess when I was training I was just like, anxiety is anxiety separate and that's it.
I'm not gonna look at it like to see if there's anything else around the surface or in it, but looking at it more as a entry point for people. , I see it as a lot of people being very comfortable coming in with anxiety, but it's often not the mean. Issue. At definitely, I would agree with you as much, and I think a lot of clients will use the word anxiety to describe their emotional experience.
And so I like to hit them with what are you fearful of? And they go, I don't know, but I'm like, generally anxiety is a fear of some sort. So you can maybe dig around and figure out what the fear, but. Maybe what you're describing is anxiety, is other emotional experiences that are all mixed together that create this overwhelming feeling.
And also I like to always clarify stress is more of that pressurized experience versus anxiety is that fear. And so trying to help them to understand what it is. Yeah. And then once we have that understanding what's happening, it's like those light bulb moments. And I find that, I think there's a misconception in therapy.
Or there should be more clarification that you get a lot of relief if you understand what's happening. Yeah. No actually. Yeah. Yeah. Generally that's helpful. Eventually. Eventually. Yeah. Yeah. And so like with that more understanding, there's a lot more relief in your experience because then we can have it to more clear cut and not so much confusion around it as well.
. Yeah. So what are your main, like you said, use cbt. Are there any other modalities or approaches that you would help a client with their experience of anxiety? Yeah, with anxiety specifically, I think a lot of C B T for sure. For someone who is specifically very caught in the thoughts in their head space.
, I'll use a lot of more the behavioral, we'll do a lot of exposure. I love exposures. , so really confronting that anxiety head on and facing it. And so my training background is heavily. Working with OCD specifically, and so doing those exposure hierarchies where we'll face fears like little by little and build up over time.
And I'll use exposure hierarchies honestly for everything. I think they can be used for perfectionism. They can be used for. Burnout, like everything that we wanna do. It's almost just like creating little steps at a time, stepping stones to prove to yourself that you can do these things and they're not as scary as they feel.
Setting boundaries. You can create a hierarchy like all of these things. And so I'm a big hierarchy person. Trauma I will definitely use like emdr things like that. More recently gotten trained in and, learned more about and just cause of the trauma backgrounds that a lot of my clients are having.
But I'm trying to think. I'm a big CBT person, a big act. I love act. And sometimes for people that are very cognitive, sometimes it's important to get out of our heads a little bit and not think so much about what's going on. Actually just accept that there's gonna be anxiety beside us and we're gonna take action regardless.
And so take the anxiety, put it in the car with us, strap it in, and we're gonna take action towards our values, despite whatever the anxiety's telling us. I think of it, the anxiety. Sometimes it's just like a toddler throwing a tantrum and the back backseats and eventually, We don't give in, it's gonna get quieter and quieter.
And that's the goal with the more of the act mentality of learning. You can tolerate and coexist with the anxiety and then it doesn't have to be driving the car for you. . Yes. And for anyone act as the acceptance, commitment therapy. Yes. Yes, for sure. And. In your mind, like in your belief systems or your like clinical belief systems, do you feel as though individuals can fully recover from anxiety and not have it as a lifelong experience?
I think that's a very nuanced question a therapist would ask as a like DSM diagnosis. Yes, for sure. Generalized anxiety disorder for sure. But we need anxiety for survival, right? We need to have that, we need to be anxious about certain things for our survival, but, and for some of us, I think that we will have tendencies towards anxiety.
And that's just learning about it. It's almost like a muscle that's just like a little bit. We'll get activated at certain points in our life, like a kind of a part of our shoulder or our neck and we get used to it, but it gets quieter. It becomes almost like white noise where you don't really notice it unless you like really listen in very intensely or when it goes off the rails is really loud.
But I think for sure, it definitely doesn't have to become the, doesn't have to stay the main actor in your life. It can become something that you don't even notice anymore that is not controlling your life day to day. I would agree with you. I think sometimes we can get triggered or we can have some anxious experiences, but they don't have to be long term.
They can be very short and momentary and we can live in a lot more comfort and agree with you. We do need some fear cuz if we weren't afraid, we wouldn't look. Crossing the street air is running after us. Yeah, for sure. So we do need some of those aspects as well. But I do really. In my own belief system believe that people should know that is available to them.
That they don't always have to feel anxious or in distress, that they can get into a place of peace because the feelings are so intense. It creates like this alone and disconnected sensation that you're stuck in that experience. But it doesn't have to be that way, and that's why I always love talking about different forms of modalities and the treatment options that are available for.
There's so much power within acceptance and acting to change within acceptance and commitment therapy or cognitive behavioral therapy changing the way that you're thinking and doing, or emdr, like resolving and reprocessing some of the traumas that we may hold that create the fear, right? Yeah. So there's so many different options for clients, and I always try and help clients not be in the dark about what different modalities or ways that they would like to align with treating or managing their emotional experie.
Yeah, I think that's it's so empowering to learn that there isn't, I think people just think, oh, the's just talking. There's so many, it's almost like ice cream flavors. There's so many flavors out there and there's dairy free and there's all these different, types and for different people, and it's like really learning.
And I think that's when you're working with a therapist, like I think all therapists, regardless. Training that's, you typically know an overview of the different modalities. That is a basic and therapy training. And so a therapist should be able to talk someone through, like if someone's coming in with something and they're not trained in it, like they should be able to, recommend and be like, this is, the most recommended treatment for this.
And people to explain a little bit about it and help the client to make an informed decision. So I would even, I would encourage. Clients as well to definitely ask questions if you're like not jiving with a client, with a therapist like modality to ask if there are other modalities. It's not outside the realm to ask and to be informed.
And it's not something that clients should know on their own cause it's not something that we talk about an everyday language. Definitely. But I'm just welcoming clients to ask questions and to be informed and be okay to do a bit of reading on different modalities and have that understanding that there's, like you said, the different ice cream flavors and options available to them.
Yeah. So one modality that I saw that you offered, that I actually am not too familiar with is the Safe and Sound Protocol. , I'd love if you could chat about that, and if you're open to a little bit of a biology lesson on the polyvagal theory, that would be, I'm like, yeah. Barely. I've. Bring up my brain power here,
So it really comes down to when we think about the polyvagal theory, it really comes down to your nervous system, right? And when you're in an activated state, your sympathetic nervous system, which is what really activates you, gets the heart racing. Your kind of gets you ready for that bear to come attack you is on high alert.
So what you think about, like if someone's having a panic attack, you're very activated. And so your sympathetic nervous system, Can get into a chronic state of activation. And so the safe and sound protocol is really about training and learning to activate the alternative nervous system, which is the parasympathetic nervous system.
I like to think of it if it's if you think about a parachute, right? It's gonna help you to come down, right? It's gonna help to deflate, to help you to bring all of these activating. Elements of you to safety and so to security to the ground bring you back to safety and downwards. And so we wanna learn how to better activate our parasympathetic nervous system.
For a lot of people biologically, our sympathetic nervous systems are more activated. And so something like, there's different protocols, but something like the Safe and Sound protocol can. To retrain and help to activate more of that parasympathetic nervous system using the ear canal. And don't ask me about the auditory system cuz I.
Try to become an expert in it. And I'm definitely not an audiologist. In my next life I will become an audiologist. But they do talk about how the auditory system is connected to the polyvagal system. It helps to reusing this, like the bidirectional, so almost like emdr, you're using bidirectional auditory stimulation, so over the head earphones and you're listening to auditory like music that has been Change to different frequencies.
And so it's at different frequencies. It's supposed to activate different parts of the brain to help retrain, and you go over hours and hours of listening in a very calming environment. And what you notice is that you become much, much less triggered and much less sensitive to normal stimuli that maybe would've triggered you in the past.
It could be sensory things. People like for example, I've had clients. Maybe we get very triggered in showers just by the water hitting them or noises outside, talking to people, having conversations, all the noises and just we'll start to notice that their. Nervous system is so much calmer at baseline and it takes a little bit more to get it activated and to stir it up after they've been through this protocol.
And so it's used a lot. It's, I think it started with children to help with children that have more sensory issues. And then we started to be used with adults with trauma. Really intense anxiety, and that's where I've been using it and I've been finding it to be really helpful, especially with individuals who are maybe not yet ready for emtr are still very activated, can help as like a step to help you begin to learn how to calm yourself down, round yourself.
And to learn to use the resourcing that you need in order to be able to do something like emdr. So it's like a really good way to learn how to check in with your internal. Sense of activation, how you're feeling, what kind of zones you're in, if you're feeling more red or green or getting into those safety zones and really helping people to become more aware of how they're feeling. Is it more of that state change support from like a hypo arousal to the state of car? Yeah. And I wouldn't say that you ever really get. Point of the program is you don't really wanna get into hypo arousal, so you don't wanna get too activated through it. So it's a lot of you do it with your therapist, you do it, you have to get very good at recognizing when you're going into that state, pausing, grounding, and then going back into the protocol.
And so there is a lot of back and forth in the beginning, which I think is really powerful to learn. So someone who's very activated, you're not gonna do it during, let's say a panic attack. You don't wanna be too activated. You wanna enter it pretty calm and notice when you get activated.
So you're getting very aware of your own sense of arousal so that you can learn to regulate for yourself, which is really hard for many individuals who've become very disconnected for their bodies. So it's a really good first step I find. Interesting. And so it's something that they would, the client and yourself would only do in session, or would they listen to any of these auditory tones individually as well?
I tend to do it in session just because it. Especially getting very act, it can be activating and I wanna make sure they're pausing cuz a lot of people will just power through and that's not really doing much. I'll let people listen to it if they wanna go through it like a second time after the first round.
But most of the time, the first we're going slowly through it and really just depend. Is this any relation to when I see like different hurts waves to activate different brain waves and things like that? Yes. Yes. So there it definitely is. And there's so many different protocols, even within the safe and sound protocol.
There's the connect, there's like focus, there's different ones. And so they all have different brain waves that they use. It's fascinating. It really is Fascinat. Is it also helpful for clients experiencing dissociation? So I've never used it with a client like experiencing dissociation in the moment.
And I tend to refer out a lot for dissociation in terms of like trauma treatment and emdr. So like more extreme cases just based on right now virtual. So it's would be a little hard to be virtual working in terms of that at this point. , I believe that there are protocols within it that would be helpful for that.
But not ones that I'm trained in. Okay. Interesting. Wonderful. Yeah, something that was really interesting to me cuz I've always heard about it and I was like, what is this? It's a gold of mine of information. It's so once you go in, there's so many and there's just so much information. It's tr it's amazing.
It's remarkable. And the changes I've seen have been. Astounding with individuals. And I also really like how when you're saying you're doing it in session, cuz often I'll give a client a regulation tool to practice. And so they find it really challenging to practice in their own individual time, but they're still a very motivated chi client for positive change.
Yes. And so I like how you're helping them in session to develop that ability to regulate from that. Escalated anxious or activated state into a more calm state. Yeah. And having that ability within the time. And once they learn that they can regulate, they're able to do it more often in practice, exactly. And they'll practice that, at home to be able to recognize and notice, like getting more like and little activities they can do and little tricks that they learn in session. But I like that we are able to practice together. And then I'll notice them be able, they'll just jump into things themselves in future sessions, knowing like what to do.
And they'll pause. You're supposed to pause. They'll pause and and do it on their own without me having to guide them, which is really amazing. . Wonderful. Okay, is there anything that we missed today that you wanted to chat about? We've chat about so many wonderful things.
Burnout out and anxiety to a power hour care. I loved it. It so fun. Think so we talked about my favorite topic, so I could talk about this all day. Anxiety and burnout are, they kind of intertwine. And I think especially with those two, like I think all modalities touch on them.
So I feel like all clinicians have their own little way of approaching, which is so interesting and fascinating cuz you could find, I think every modality kind of approaches it a little bit differently, which is it's so nice to hear the different approaches and strategies and for individuals, someone might, who's maybe.
They don't, they're more physical with their anxiety. CBT might not be the best thing for them. They might want something more ACT related or, something else. So it's very interesting to think about, the different ways of approaching and how that might fit someone and their individual needs and not just the therapist needs.
Trying to find that right match. Yeah, definitely. And if a client in your area is looking to get connected, where could they reach out to? Yeah, I think Instagram is definitely where all my contact info is and everything. So it's just my name, Carolyn Rubenstein, PhD. My website's carolyn rubenstein.com.
That's a mouthful, but pretty all aligned there. . I really appreciate your time and coming on today. So lovely to meet you. Have a good rest of your day, . You too. Okay, bye.