How We Find Our Way Back From Burnout with Dr Jillian Bybee

Burnout is often described as being too busy, working too hard, or having too much on our plates. But what if it has as much to do with how we relate to ourselves as it does with how much we do?

In this episode of A Thought I Kept, I talk to Dr Jillian Bybee, a paediatric intensive care physician, certified coach, writer, and host of the Humans Leading podcast. Having experienced burnout twice herself, Jillian brings a thought that completely changed the way she understands wellbeing: wellness is not a state of being, but a state of action.

Together, we explore what happens when we stop thinking of wellbeing as a destination we eventually arrive at and start seeing it as something woven through everyday life. We talk about the difference between stress, overwhelm, and burnout, why so many of us keep pushing through long after we've run out of energy, and what it means to build small moments of restoration into busy lives.

Along the way, we discuss emotional suppression, self-compassion, nervous system regulation, perfectionism, motherhood, leadership, and the challenge of caring for ourselves in cultures that often reward self-sacrifice. Jillian shares why five minutes can sometimes be enough to begin, how burnout can disconnect us from joy as well as difficult emotions, and why rest is about far more than simply taking time off.

This conversation is full of gentle reminders that wellbeing doesn't live somewhere beyond our lives, waiting for us to finally get everything right. It is something we practise, imperfectly, in the midst of work, family, grief, responsibility, and ordinary days.

Whether you're feeling emotionally exhausted, navigating stress, recovering from burnout, or simply wondering how to care for yourself in a more sustainable way, I hope you'll find something here that stays with you.

Dr. Jillian Bybee is a busy pediatric intensive care physician, toddler mom, certified coach, and creative who uses what she’s learned from recovering from burnout twice to help other ambitious women live less stressed, more satisfying lives. Her Substack publication and podcast, Humans Leading, aim to remind us that, although we can do amazing things, we are not machines (and even machines get regularly scheduled maintenance). She believes that we all need and deserve rest, joy, and time away from work. If you are looking to make a change in your own life, Dr. Jillian offers 1:1 coaching, group coaching for teams, and workshops.

 You can find Dr. Jillian in the following places:

Substack: Humans Leading | Jillian Bybee, MD | Substack

Instagram: Jillian Bybee, MD (@lifeandpicu) 

LinkedIn: Jillian Bybee, MD | LinkedIn

Website: Jillian Bybee, MD- Physician Leader, Coach, Speaker

Podcast: Humans Leading

Books and papers mentioned in the podcast:

Burnout: Solve Your Stress Cycle by Emily & Amelia Nagoski

Atlas of the Heart by Brene Brown

Rehder K, Adair KC, Sexton JB. The Science of Health Care Worker Burnout: Assessing and Improving Health Care Worker Well-Being (2021).

Duke Well-Being Toolkit Resources

Forty-five Good Things — Sexton et al.

Transcript

SPEAKER_00 0:08

Hi, and welcome to this week's episode of A Thought I Kept, a weekly podcast about the ideas that stayed. I'm Clavit Simmons. I'm the founder of If Lost Start Here, and I'm on a mission to make sense of all the well-being advice that's out there. Because there is so much of it out there. Each week I ask my guests about the ideas that have really stayed, the one thought that they have kept, the one that really shifted something for them. Sometimes it's something that someone's grand said, other times it's a line in a book. Sometimes it's a thought that they've held on to, like a precious object since childhood. And other times it's more recent. Maybe something that they heard in a conversation with a friend that just landed for them and shifted their whole mindset. Today's guest, Dr. Jillian Bibee, brings something that I think is at the core of this podcast, which is to really reimagine well-being in a way that does feel kinder to ourselves, that is much more relatable and sustainable. The thought that she has kept and that she's sharing with us this week is something that I think we can all experiment with in order to really find a better way to well. Gillian Bibe is a really busy pediatric, intensive care physician. She's a mum of a toddler, she's a certified coach, and she is someone who has experienced burnout twice in her life and now supports other ambitious women to live much less stressed and more satisfying lives. She also writes and hosts the podcast Humans Leading, that are really affirming spaces and can really help us to connect with the idea that we do need and deserve rest and joy and time away from work. Here is my conversation with Dr. Gillian Bibee, and I'm really curious whether this week's thought is one that you will keep, whether you will hold on to it too. So maybe we can check in at the end of this episode to see what this week's thought means to you. Hi Gillian, welcome to the podcast. Thank you for having me. Thank you for being here. It's such a delight to meet you and to spend this time with you. And I'm just wondering how you're arriving here this week.

SPEAKER_01 3:00

Um I am arriving uh a little bit tired. So I have worked a lot of overnight shifts in the hospital recently. So but I'm excited to be here.

SPEAKER_00 3:11

My sense of you is that you have all these different pieces. You have your work in the pediatric ICU, you have your writing. I was wondering how you hold all those different things.

SPEAKER_01 3:24

Uh, it's a challenge. I recently saw a video clip that someone was asked, you know, how do you do it without getting burnt out? And the person replied, I don't. I'm exhausted all the time. And I don't know that I'm burnt out all the time, but I'm definitely tired a fair bit of the time. And I think we'll definitely get into how the thought I've had, but also a lot of the things that I teach and work with other people about help me not be so exhausted and not get burnt out.

SPEAKER_00 3:51

Burnout is something that I hear about so much right now, and just that general feeling of whenever you ask them how they are, it's it feels like being busy has been replaced by being tired and being exhausted, and there's this overwhelming sense of fatigue in our individual lives and our collective culture, which I think is just it's so interesting and so difficult to contend with given all the different factors, but I know we'll get into that. So, why don't we go to your thought? So every week on the podcast, I ask guests the same question, and that's out of all the different ideas, out of all the different things that could stay with us, what has stayed with you? What is the thought that you've kept?

SPEAKER_01 4:28

Speaking of burnout, when I was burnt out, I read the book Burnout by Amelia and Emily Nagoski. And in that book, they say wellness is not a state of being, it's a state of action. And that sort of stopped me in my tracks because it was different than how I'd been thinking about well-being. And it really shaped then how I started to work my way out of burnout and also the way my career looks now.

SPEAKER_00 4:55

Okay, so what did you think it was before? You said that it wasn't something that you had considered that way before. What did you think it was?

SPEAKER_01 5:02

I think like a lot of people, I imagine well-being as maybe a state I would arrive in someday and just be able to stay there and I would achieve it. I would just feel good. And I think it really the action piece was the part that reminded me that it's something that we're working towards, not laboring towards and not striving for, but something that we can control our actions to get a sense of well-being about. And especially during a time of burnout, that really gave me a feeling of agency that I couldn't control the fact that I was working extra hours and my job was really stressful, but I could actually do things in my day-to-day life multiple times a day that made me feel better.

SPEAKER_00 5:47

When you thought it was a state and there was this idea that well-being is something out here, this is something that you achieve, this is something that you get to. And I suppose those daily practices are in service of getting there. What did that do to you? Like, how do you think that idea contributed or didn't contribute?

SPEAKER_01 6:05

I experienced burnout twice in my life, like a serious burnout. One of them was when I was in training as a pediatric ICU fellow, working sometimes 90 to 100 hours a week, often not sleeping for multiple nights a week. And then I experienced it around the time that I read this book that I mentioned. And I think what I thought would get me to well-being was time away from the hospital, was days off. And I think that's a question I still get from people is how many days do I need off? How much vacation do I need in order to prevent burnout? And I say, Oh, it's really unfortunate that even if you had all of the days off, if you're going along like I was, which was striving and not sleeping and living in perfectionism, uh you're not going to get into wellness. You reach a state where you're less stressed and more well. And so I don't think I was working toward anything. I think I was thinking that if I took a break from my work, or actually if I looked over another job the second time I was burnt out, that wellness would arrive to me in this new place. And that was clearly not true.

SPEAKER_00 7:18

Yeah, because well, it can't be aside your life, it can't exist in your life the way it is. It just has to be a place that you visit outside of your life, but it's not possible to get there. And yet we're sold that idea that we can, and that it is something that easily can just we just can wear it and it can fit into our lives, and it's this sort of seamless thing. So when you think about it as an action, okay, what did that start to change for you?

SPEAKER_01 7:39

So I started working with that idea of some practices that they have in the book, which often are what we think of as nervous system restoration practices and stopping our stress cycle and allowing it to complete. And so I started doing some of those things in my life. So I started having a more mindful practice in my morning. I started checking in with myself out throughout the day. And then I started realizing that even when I had time enough, I was often doing things that weren't that restorative to me or not really having rest. And so I slowly started adding those things in my life. And I don't want people to get the idea that I did that all of a sudden and like snapped my fingers and again arrived at that. That's a practice that now, you know, I've been doing this for about eight years. And it's these slow micro moments of sort of pivoting toward the life and the things that you want to be doing. And so that's what I've done in my own life, and that's what I helped my coaching clients realize is we need slow practices to get us where we want to go, not just expecting that things will arrive to us.

SPEAKER_00 8:48

Why do you think that idea landed in that moment? I know I know you said you were burnt out and you're reading this book, but often those practices are things that we could be conscious of. There is a sense sometimes that we know we should be. Like we know that we should be breathing, we know that we should be meditating, we know that we should be doing gratitude. Like, why do you think in that moment you heard something that then could have a positive impact on you and then you did the thing, but you did it in a way that served you, that didn't work against you, that didn't make you feel worse for not doing it right, but that actually helped to you?

SPEAKER_01 9:20

So I want to say that I don't know that we all know we should be doing those things. Maybe we know them now. But you know, when I was first burnout, it was back in 2020 15, so pre-pandemic. I like to say I had burnout before we started talking about it all the time. And sure, I knew that self-care was important, but I don't think we had all the research and data and understanding that we do now. And it definitely was not something we talked about in medicine. And so it was not even on my mind that I should be being mindful the first time I had burnout. The second time, it probably wasn't also on my mind that it mattered. And so I think the book, because of the way it's written, it's written by two people who have one of them has a PhD, and so it has a lot of science in it. And it finally was the thing that I thought, oh, as a scientist and as a person who likes data, this finally is presenting that data in a way that has shattered the illusion that I had that this stuff was not for me. And I think that is true of a lot of the people that I coach and I lead workshops for still in medicine, now that we have all of this data, is that they continue to think that it's not for them. Um, and so in addition to the book, but also all of the studies that have come out since, um, that's how I reach them as well. For people who aren't in medicine or healthcare or aren't as science-y also uh break down those things into digestible ways of living and doing their practices.

SPEAKER_00 11:00

Yeah. Why do you think some people think those practices are not for them? What gets in the way of that? You're laughing. You're like so many things.

SPEAKER_01 11:11

Then true. Thank you for reading my mind. That truly was what I just thought. Um, the reason that I really laughed is I went to a coaching conference a few years ago when I was getting certified to be a coach, and it was for primarily people who coach healthcare workers. And someone, a group of people put together a bunch of things that you need to be aware of if you're going to coach physicians. And when I tell you things, it's like a multi-page document of many different subsets of not defects, but opportunities for growth that those of us who go into medicine are presented with. And when they read the first table, I was like, how dare you? And many of them are in line with what medicine is. So it's a really difficult profession where you're held to a very high standard. And of course you're held to that because, like in my job in the pediatric ICU, if I make a mistake or if I'm not on my game, I could make an error that significantly impacts someone's child's life. And to me, that is a very difficult thing. And so I work really hard to make that happen or not happen. That being said, it also self-selects for people who are incredibly self-critical, who are perfectionistic, who don't take breaks. And even during the pandemic, when there were a lot of signs talking about how healthcare workers are heroes, that sort of public mindset really sets us up to not feel like we can be human beings. And so part of the reason that I named my podcast and my Substack Humans Leading is that I think I want to give myself permission that I'm a human being. And I think that's what I help a lot of other people do, and not just physicians and not just people in healthcare, but other ambitious people who feel like to accept help or take a break or to make a mistake makes them not enough. Just to show them that really they're human.

SPEAKER_00 13:12

Yeah. I wonder, like extending this from medicine and healthcare, but more generally, in this idea about why we don't do the thing that might help us, or what gets in the way of that. One of the things that I see a lot is this idea that it may signify that I can't cope. If I'm to do certain things that will suggest both to myself and to others, if it's public facing, that I can't cope. And what's incredibly important right now is that everybody believes in that, including myself. How do you start to deal with somebody who is bringing that to you, who is in this mindset that I can't look at that, I can't even accept that. I can't even, I just have to keep holding on and holding tightly and pushing through and coping.

SPEAKER_01 14:02

The great thing about having gone through coaching certification is that it also requires that you get a lot of coaching. So I got to work on these things for myself. And so some of the ways that I now work with other people, I do the same things that worked for me. So one of those examples was I had worked a bunch of different shifts and was really busy, and I crammed this 30 hours of three days of coaching certification into a weekend, and then I knew I was going back to work. And I had one day where I looked at my schedule and I thought, wow, I have all these meetings, but if I don't take a day off, I'm not going to be good going into the rest of my work that I have. And so when I was coaching with one of my classmates, he said, How's this working for you now? That's a great question. That's so rude.

SPEAKER_00 15:01

And now that's why you went. And I went, wow, that's really deep. And you're like, no.

SPEAKER_01 15:05

Well, no, it was the same, right? Like, that's the he has that personality. I'm uh a pretty sarcastic person, but I thought, how dare you call me out like that? Um, and so I tried that on one of my clients when I first started coaching in my organization. And she's a leader in a family medicine practice and has all these things both in her work life and her home life. And and so I asked her what her current approach was costing her. And her answer without even missing a beat was my sanity. Well, that really settled and landed for her because I don't know that she had ever admitted that to herself, even though she felt it. Like she knew she was experiencing burnout, she knew she needed to change things, just like you're saying. I think now more and more we know these things, but we possibly haven't realized or admitted the cost of the way that we're living. And so part of coaching is really to help the client get some of that awareness of what is the actual cost of the way that you're doing things right now. And when she said her sanity, she thought, oh wow, that is a serious thing. And so then we were able to start building things, which we didn't start again with what's the perfect way that you would engineer your day. It was like, okay, well, you you currently have no breaks and no time, and you're doing things for everybody else in your life. And so we started with what seems like an amount of time that you could do something for yourself. And she said five minutes. And I love that because as I often remind people, five minutes is less than one percent of the time that you spend awake. So if you can't spend one percent on yourself, I'm not sure that your life will change, but she felt like she could. And so she took five minutes every day and decided that she would read in a room in the basement of their clinic where nobody could find her. And then as we worked together, that time built up and up and up and started to spread out into other areas of her life because she had finally given herself permission to start doing that, and also she had finally realized that if she continued in the way that she was going, it was not going to be good for her.

SPEAKER_00 17:33

Is five minutes enough?

SPEAKER_01 17:37

Well, one of my favorite answers in critical care is probably the same answer I'll give you now, which is it depends. So it depends on if that's all you're ever planning to do. Because if you are truly running at the max, you feel like you're spent, to say you need to do some number that's more than five minutes sets you up for a defeatist feeling because you're like, I don't have time to do all the things that I already need to do. How would I possibly fit that into my life? And so you already are like, I'm not gonna do that. And so I think when you're either starting out on this process or when you're in a very busy period and you truly don't have capacity for more than that, to say, I'm at least going to give myself five minutes, allows you to say, This is the five minutes that I have, I'm gonna give myself that, and think of it as that action that I talked about earlier where you're controlling those five minutes, and to truly just be there doing whatever you're doing in the five minutes, whether it's a mindfulness practice, it was like my client who was reading, it's going outside, staring off into space, whatever you want to do. And just give yourself permission that in that moment that's what you need and that's enough. And then the other part of it depends is I promise that that won't be enough for you. Once you start doing it regularly, you're like, oh, I would like more than five minutes. I need to find another way to get 10 minutes or get multiple five minutes or to do things on my day off that are truly me on my day off. And that's one of the things that I think we're often bad at is when we go on vacation, especially those of us who are physicians, we spend a lot of time working on our vacation. And so finding ways where you can truly be off on your days off is a whole different process, but it kind of starts the same way.

SPEAKER_00 19:44

I was hoping you would say that. So often one of the things that we contend with is this idea that we're just too busy, we can't add anything else into our days, we are overwhelmed, we are at capacity, we don't have the energy. When is one of the hardest things? Like, when is that possibly gonna happen for me? But also the next question is but what would I do with those five minutes? So, like, what's the right amount of time and what is the optimal way of spending that time? And sometimes people have this like paralysis well, I could journal for five minutes, or I could go outside, or I could do X, Y, and Z. And I wonder how you contend with this idea about I think you're right. I think at the beginning, when I asked you about we know so many things of what we could do, I do think things have significantly shifted in this time period. And there are so many options for what we could do. How do you contend with that idea about the paralysis and the overwhelm and the fatigue that in and of itself can come from choice?

SPEAKER_01 20:39

I think that is a great point that you're bringing up because even just the other day, um, I wrote a piece on my Substack about not making the most of my time. So I was at a conference and I was alone in Northern California in wine country and the sun was out. It was 70 degrees. Meanwhile, it was negative degrees here in Michigan and the United States. And all I could think was, what should I do with my time that will make the most of it? And that feeling was stressing me out. And I think it does, like you're saying, for a lot of people. And I thought, oh, there's that old pattern again of me trying to optimize and get the most of it because my son's not here and I'm alone. And I thought, oh, what do I want to be doing now? So I think that is something that I do for myself, but I also try to teach clients and other people is to think in this moment where I've noticed that I'm doing that feeling or that I feel like I need a break, what would be helpful? And then the thing that works for me that hopefully works for other people is to think about things that work for you when you're not in that emotionally overwhelmed moment. So um, I help clients. Both in workshops and one-on-one, think about ways to plan their own stress relief activities, but also think about things that help feel like they're resting. And so for me that day, I was like, oh, it's so nice outside. And I thought, you know, I should be going for a walk outside because it's so nice and it's not nice at home. But then when I evaluated it, I didn't want to be walking outside right then. I really wanted to sit and write for longer than I'd gotten to in a long time. And so that's what I did. I sat and I wrote things. And once I felt like I had wrote written for long enough, I was done. And then I was able to do other things. And so I didn't have to feel bad about it. And that's one of the things that I've been working on. I'm an incredibly self-critical, not by nature very self-compassionate person. And so the other thing that goes along with this wellness practice is starting to work on my mindset of what does enough look like? How can you be kinder to yourself? How can you say, I've worked really hard and it doesn't mean anything about you if you choose not to go out for a walk right now? It may mean that you are tired and you would like to sit here and write instead of doing that. And maybe if you write, you will actually have more energy later because you haven't been fighting with yourself to force yourself to do something you think you should be doing rather than something you'd like to be doing.

SPEAKER_00 23:28

Yes, because as much as well-being or wellness isn't a destination and it is an action, it's also a mindset that you have to bring to it. Because that mindset is just about berating yourself for not doing the right thing or not making the most of the time you have or not optimizing, then it's going to be a trap for you. And so a healthier mindset for you is one that is more about checking in with yourself, self-trust, compassion, some kindness, some openness. That's what I'm hearing.

SPEAKER_01 24:00

Yes, I think that's so true.

SPEAKER_00 24:04

So then how do you do this when you are in the cultures that you operate? So we've talked already about medicine and alluded to that, but everybody operates in some sort of system. Everybody has like their family context, their family's environment, their the work environment. So what if you know that those five minutes are important? What if you know how you'd like to spend those five minutes? And yet you have people around you who will have opinions about your relation to wellness, will have theories about whether wellness is appropriate in certain contexts, or beliefs that whether it's appropriate in certain contexts. How do you contend with the idea that we are not distincting our wellness practices in isolation, but we are existing in these different systems, that they also have to value wellness and wellness for us as well?

SPEAKER_01 24:56

I think that's such a great and an important point that um we may recognize that wellness is important for us, but potentially the other people around us don't. When I first started this, I was married, but we didn't have a child yet. And so we had a few, I had a few less responsibilities when I first started this process than I do now. I also didn't have a leadership position or two, plus all this other stuff on the side. So I got to slowly start building. And I think I had conversations with my husband about things that I need. I need time alone because at my job, I'm an introvert. I'm pretty close to an extrovert, but I recharge alone. And so when I recharge, I need to be alone, not thinking about other people. And so I had to say that out loud. I had to actually tell the this wonderful person that I'm married to, hey, you know what? Sometimes I need to go on a walk alone or I need to do this thing. And because he's a wonderful person, he was like, that seems good, but he's also seen the cost of what it does when I am not doing that. So I think it's easier for him to say, yes, you should do things that help you stay more optimally well for yourself than to be dysregulated and dysfunctional. And that's true even with our son. I think he does so much work because I work overnight. He watches my son overnight. So I'm working two nights overnight this week. He'll be home alone with our son during both of those nights. And so there's the tendency for me to think in my head, oh no, he's already done all this work. I can't go to a yoga class or do something for me because he's already done all this. And sometimes I have to check myself because that is a thought that I have. It is not something he's ever said to me, where he was like, you can't do anything for yourself. I think that is conditioned from the system of society where women think that they should be doing all of the work, and sometimes are explicitly told that they should be doing all of the work. I'm happy to be married to a partner who doesn't ever say that to me, where he's supportive and he's a great partner and dad. But I know that that is not true for everyone, and so that can be tricky to start to have those conversations. And it might not be a whole night away, it might be a small period of time or a retreat in your house. There's a cardiac anesthesiologist who's also a coach, who was one of the people I started learning these things from when I first started out, and she made a chair in her bedroom. She bought herself a nice chair, she put it in the corner of her bedroom, and she has four children. So even when they were little, she started teaching them when I'm in that chair, unless it's an emergency, like this is mom's time for herself because she needs that, whatever that time is. And so she said, you know, it took time to for her husband and her children to understand what that meant. But even her small children started to understand oh, unless this is really an emergency, I don't actually need to be interrupting you. I can give you that time. And then the other thing is then I'm more present and more able to be there for my son and for other people. And so part of it is showing other people how us being able to take care of ourselves is it's a public service for other people. And that shouldn't be the only reason that we do it. We should just get to have rest and time for ourselves because we're inherently valuable, but we could have a whole long talk about that. But that being said, you know, at work, that's how I get into people's brains is we have data now that show that people who are not burnt out and people who are feeling rested are actually doing better work, they're more productive, they have better outcomes for patients. And those things are true not just in healthcare, but in other workplaces where if you create an environment in the workplace that honors people as human beings, they will do better work for you and you will be more successful as a company. So I think it's true both at work and at home.

SPEAKER_00 29:16

What does a healthy wellness culture look like, do you think, in the workplace? I've had various conversations with people around ideas of like how we were maybe in a professional context that we would have to stay late, we would have to answer emails on a Friday night, we would skip lunch, we would probably not chat to our colleagues because that was seen as taking away time from important work. We definitely wouldn't go out and look at the sky at lunchtime. You know, like how have you seen this sort of this almost like a generational shift, but a way to develop a workplace culture that honors our full capacity and potential as humans?

SPEAKER_01 29:55

So I think all of those things that you mentioned are so true, and I'm so grateful that there are a ton of people researching this in healthcare. So there's groups across the United States and other places where they are publishing about what organizational wellness looks like and what organizational well-being is for people that work inside healthcare, but I think it can be extrapolated to other places. And so when I go and do talks in organizations and even within my own, those are some of the things that I talk about is workplace well-being and team well-being. And unfortunately for leaders, a lot of it starts with leaders. And as a leader and as a person who has a lot of leader friends, it's really hard to be a leader. You're asked to do more with less. There are constant stresses. Your well-being might not be good because you're so overwhelmed. My husband just was had a promotion not that long ago, and right now he's doing two people's jobs. And so his life looks a lot like working in the morning, going to work to work, coming home and being with us for an hour or two, and then working after work. But he's doing that during a time where he knows that a replacement is coming soon. And so I think that's where his workplace is helping, is they have told him this is a temporary thing. We uh see and value the work that you're doing. And that's where leaders can come in is when you're asking people to do extra work, to actually say, hey, you're doing extra work right now. Hopefully there's an end point, but at least thank you, or I recognize you, or something that is not just I expect that at a drop of a hat, you'll pick up this extra work and do it. The other thing is creating spaces where people truly can be honest about how things are going. That's part of team well-being. Leaders can do that, but that is what how I started some of my wellness work within my own team in the pediatric ICU was walking around and saying, you know, how are you really doing? And being okay with someone saying, I'm not doing great, and just providing a little bit of space for them to be honest about that. And then the nice thing now is my organization has a lot of resources available for people who are not doing great, like an employee assistance program and peer support and other structural things that workplaces, especially large organizations, can have, that I can say, oh, hey, we have these resources. Have you heard about them? Usually they say no. And so I do some of that providing of the resources to them. And I think that is one way I do it. And there are a lot of other people inside my organization doing the same thing.

SPEAKER_00 32:50

You said about asking someone how they're doing and them answering, I'm doing not so great, rather than I'm fine, I'm okay, there's nothing to see here. And I'm curious about what emotions have to do with burnout and how we do or don't process emotions, and what that connection is, or what you have found that connection to be between how we feel what we feel or how we don't feel what we feel.

SPEAKER_01 33:20

So, about the fine thing, first, I have a social worker friend who reminds us that fine is not a feeling. It stands for feelings I'm not expressing. And again, just like that person who asked me the question, what's it costing you? I thought, oh no, that's so true. And that being said, it could be completely adaptive not to be expressing the feelings in the moment because you know, in my job, for example, really hard things happen to the patients and their parents and their families. And it would not be fair if I brought my grief or my own whatever into those situations. In those moments, you know, I need to compartmentalize. That's not the right time. That being said, I have grief related to my work. It's really hard and stressful. And that was part of my burnout, both in when I was training and also as an early career faculty member, is I didn't admit the fact that it was hard to watch people die or to have hard things happen to them and to constantly be asked to be the support person. I didn't ever admit that I needed the support. And so that has been something I've learned. We have really good data now that shows that emotional suppression actually activates the stress response inside your body, and that people who routinely suppress their emotions or pretend that they're fine, especially women and anger, have worse health outcomes. They have higher blood pressure, they may have heart attacks, they may have strokes or memory loss. Um, having high stress in our lives is not good for us. And so finding a place where we feel like we can safely express emotions is really important. Sometimes that is within the workplace to our colleagues. I'm really glad to have people I can talk to, not only the physicians, but all of the other team members where we can be honest about how we're feeling. That might be with a partner or a friend or a coach. And then I think I never expected to become the poster child for therapy, but you know, I also had depression when I had burnout as a fellow. And part of it was learning to be able to say to somebody else, like, I'm not doing great. Because that wasn't something that we did in my family of origin growing up. People did just shove down the emotions and carry on. And they expected that you would also, you would just move on from them. And so I have learned to do that. And then now as a leader, I have had to learn to in a safe way where I'm not disclosing everything, be a little vulnerable and say, hey, you know, I'm tired today. So if I seem like I'm either stressed or a little bit short with you, it's not about you. It's the fact that my son woke up four times last night and I have not slept well. Because the people that you're leading often interpret your stress and your shortness with them as they're doing something wrong or you don't like them. And so I had to learn, oh, I'm actually affecting them and their stress. And so that was part of me figuring out that I needed to take care of my own emotions, was it is a leadership behavior, and there's a whole bunch of research about wellness-centered leadership. It makes me a better leader and a better team member when I take care of myself emotionally. So now I have all these different ways of doing that, and then I teach them to other people.

SPEAKER_00 36:59

One of the things that we fear can happen with emotions is that once we start to let them out, they're all gonna come out. We're gonna get flooded, they're gonna overwhelm us. And if we're approaching that from a position of burnout or overwhelm, there is maybe the sense that we're just gonna get stuck in them. They're not gonna release something for us, they're not gonna lighten at something, they're just gonna like, whoosh, there's gonna be this wave. Like, how can we contend with that idea that letting a little bit of emotion out lets all of them out? And then that's it for us.

SPEAKER_01 37:32

One of the things I always tell people who are experiencing burnout is that they shouldn't do it alone. So I think in the scenario that you're presenting, a lot of us try to do it alone. We try to think, okay, I'm going to, you know, let a little bit out, and I'm just going to be able to do a little. But often, even if you start to let a little bit out, it will come out. And the thing I tell people is you once you let the emotions out, you won't be destroyed by them, but you don't have to hold on to them anymore. And the thing about having a coach or especially a therapist or someone who has mental health training is that that person can be the person to help you hold those things and get rid of them. It doesn't have to consume you. You don't have to be stuck in a pit of despair because you've been sad. My dad passed away a little over a year ago. And I never knew that kind of grief was possible. And so because I already had this practice of being transparent about my emotions, but also now that I have a wellness director title and other people who I say you have to feel your emotions, I have a lot of people who come around reminding me that it's important for me to feel my feelings too. And so I found a grief therapist. And that was where I helped process that information so that in those sessions I could actually release a lot of it, but be witnessed by somebody else. And then that allows times where I'm still like, I'll be watching a show, something triggers me, I tear up a little bit, I miss him, and then I'm like, oh, okay, that's over. And that was, you know, love coming back up for him, but it wasn't something that swallowed me for the whole day. And so I think we it's understandable that people are afraid to let those things out. The thing I'll say is if that happens to be you or whoever, doing it with somebody else can be really helpful because then they can help you learn tactics to recover. There are a lot of nervous system practices where after you release big emotions, you can learn different tactics to restore yourself to balance so that even if it happens when you're not in therapy, you can continue to build those skills. And that's really important for well-being as well.

SPEAKER_00 40:00

How have you come to understand burnout now? If you were to think about what burnout is, having been through it twice, having worked with people in this area, what do you think burnout is?

SPEAKER_01 40:12

One of my favorite definitions comes from Duke University's Center for Well-Being. And it's they describe it as the inability to feel positive emotion. And for me, that was sort of true, where everything felt negative. I felt negative about the work that I was doing. I felt negative about the likelihood for me to improve the situation. I felt negative about unfortunately patients, families, other people I was working with. And it wasn't until I started learning some of the well-being things and things I could do to make an impact where I started to feel more hope and gratitude. And so they have, they do have a lot of different practices that they teach that allow you to like build your positive emotional capacity. And I think that's something that we don't often think about when we're suppressing emotions, is that you can't self-select which emotions you suppress. So if you're suppressing anger and sadness and other things, you're actually also suppressing joy and awe and connection. Um, and so it wasn't until I started allowed to feel more joy and happiness. And so that's what burnout looks like. I think it looks like different for everybody. I think emotional exhaustion is still the number one thing that a lot of people think about when they think about burnout. And especially for women, that's true. They're just completely spent on tending to the emotions of others and pouring themselves into others and having nothing for themselves.

SPEAKER_00 41:52

It's interesting as you're saying that, because I think I used to believe that burnout was something to do with productivity. I think I thought it was something to do with a relationship to like there was how much we were doing. And I've only recently come to understand that it was related to feelings.

SPEAKER_01 42:09

Yeah.

SPEAKER_00 42:09

I didn't entirely understand that. And sometimes I think sometimes there's something around wellness that's about productivity hacks or how we spend time, which is a consideration, but so much more of it I'm finding is about that feeling space and emotional well-being.

SPEAKER_01 42:24

Yeah, I think it's so important. And also in there is the fact that the language that we use about things really shapes our experience of them. And so one of the things that I teach to people is the difference in labeling something stress and labeling something overwhelm. And I'm not the only person who talks about this. Brene Brown talks about it too. It's a lot different to say I'm experiencing stress because maybe that allows you in your head to think, okay, here I can do all the things on my little stress recovery menu. You know, I have some agency. But when you say I'm overwhelmed, that implies complete being emotionally flooded or being completely flooded and shut down, unable to do anything. And that requires a different set of tools. It it is not these everyday practices. It's okay, maybe I need time off from my job. Maybe I need that person that is a mental health professional, you know, whatever it is. It's not to say that overwhelm never happens. It's just I hear a lot of, especially younger people that are in training, say, oh, I'm so overwhelmed. And then we have to dissect that a little bit because I don't think they mean they're feeling overwhelmed. I think they mean, oh, wow, it's very stressful to do this job. I'm not sure if I have the ability to cope with this right now. And then we navigate it together and they're like, oh, I do have the ability to cope with it right now. I just didn't know that about myself before, and I needed to learn it. And I think that's the thing about all these well being. Practices and going back to the action part is these are strategies and tools that we can learn that help us eventually achieve some sense of feeling well, whatever that looks like for each of us. Or I sometimes instead of well-being, I prefer to think about life or personal satisfaction. But I think you don't have to be scared that you experience stress. It's not always a negative thing, it just means that you're a human navigating the world.

SPEAKER_00 44:28

It's incredibly important that we are using the right words and we're approaching them in particular ways. So there's stress, there's overwhelm, and there's burnout. How have you? And I know we have this five-word segment, so maybe we'll make it very easy, and we'll just go overwhelm. Stress and burnout as three of your words. How do you differentiate between those three things and how do you recognize them? Or how could someone recognize them in themselves?

SPEAKER_01 44:52

So I'll add a word which is stressor. Stressor is a thing either that you experience with your emotions or your senses. So something you see, hear, or even think that activates then the next word, stress. Stress is just the biochemical, so it's the chemicals on your body process of revving things up. So another thing that is released in stress is adrenaline. And it's not always negative. In order to do the job that I do, where I run medical emergencies or speak national conferences to hundreds of people, I need stress to rev me up to get me prepared. And so stress is something that you can feel within your body as a set of different physical symptoms. Often you feel like your heart is going faster, your breathing might get shallower, your muscles might get tighter because your body is preparing you to do something that is a natural way for it to happen. And that leads to this sort of fight, flight, freeze. So if you experience too much stress or you experience what a lot of people call chronic acute stress, mean you just have stress and stress and stress and stress, and you never do these practices to help yourself, you can get to overwhelm, which is where your whole body is just frozen and it's just done. It's flooded with chemicals. You don't think right, you don't act right. And the reason I teach them of the importance of this in healthcare is it's possible to go into overwhelm at work. I work in one of the most stressful places in the hospital. And especially if you've made an error or if something has happened quickly that you didn't anticipate. So I think I don't remember the exact terminology that Brene Brown uses, but she describes being in the wheel. Yeah. Yeah, she, you know, she was a server, and so there'd be like I'm stressed, and people would help you. Or oh, I'm blown, I'm busted. I don't remember exactly what she says. But when you when you say that phrase, no one asks you to do anything, they just take over for you. And so that's what overwhelm is. Burnout's kind of separate from both of those. It's really this thing that happens over time. So, you know, you can have stress in a moment, you can have overwhelm that either happens in this cumulative process or just with one thing. But burnout is something that gets developed over time. You eventually, through a series of stresses or whatever it is that are not addressed, you have then a constellation of symptoms. And still the most common framework says three different symptoms where you're emotionally exhausted, you have depersonalization, or you're reduced efficacy at whatever it is that you're doing. We don't need all of those, but most people have one of those. Um, and that is, you know, a constellation of different ways that it can look in your life.

SPEAKER_00 48:27

Thank you for taking us through those four words. That was really fascinating and I think so, so helpful. I'm wondering what that fifth word should be then. And I'm wondering whether it should be actually I wonder whether we could use selfless as a word. Because I'm I love your instant reaction. And I'm saying that because I almost said selfish, but there is something about selfless that holds something right now for me. I'm curious about what that means to you, this idea about being selfless.

SPEAKER_01 48:56

Oh, I hate it. That was the reaction. I think my first reason to react that way is sometimes people feel that's the best compliment that they can give to a woman. She's so selfless. She puts every other single person on the whole planet, and usually that means her children or her partner, or but it could mean anybody if you don't have children or a partner. She just does everything for everyone and she runs herself completely into the ground to make sure everybody else is okay. And I think that's the cultural way, and sometimes people's cultural expectations that we would be doing that. And then to add in the sixth word, selfish, that's how we feel because we are made to feel like we should be giving of our whole selves completely. And we feel like if we take that second for ourselves, that we're selfish. But selfish really means prioritizing yourself at the expense of everything else. That's the actual like Merriam-Webster definition of selfish. And none of us who feel selfish when we take five minutes for ourselves, none of us are at risk of doing that. We're not going to become this selfish person if we do five minutes. You're not going to prioritize yourself over every single thing. Taking five minutes to care for yourself or the more minutes you deserve just means that you get to keep yourself going to do whatever it is that your purpose and life is meant to be. And all the other people in your life benefit still from you doing that. And you don't have to be selfless in order to do that.

SPEAKER_00 50:41

And you have a sense of self.

SPEAKER_01 50:43

Yes. I would not want to be without neb nebulous, non-Gillian nothing. I have grown to like this person, and it's taken, I'm 42 now, it's taken many years to get here. And I would not like to give her up. I think she has lots of things to offer the world and still left to do in my life and career, and I want to be without a self.

SPEAKER_00 51:12

I mean, that actually dovetails really nicely to your thought, and if we can return that before we close. And this idea that well-being is a state of action. How do you continue to hold on to that? And it also comes almost comes right back to the beginning when you said you're arriving and you were like, oh, actually, I feel quite fatigued, and I've just come out of this. And so, how do you continue to hold on to this idea of it being a state of action?

SPEAKER_01 51:36

So the other day I was on a well-being team meeting, and it's great to be a wellness leader because you're with other people who constantly think about well-being practices and hold you accountable for it, you doing them in your own life. But I was with three other people and we started the meeting with the check-in. Um, that's one of the ways that you do this in your workplace. And each one of us went around the circle, and none of us were doing great. And so having that conversation allowed us to feel like, oh, okay, we weren't having a great time. But we had already planned ahead of time that that meeting would be what we call a movement meeting. So we could be cameras off if we wanted. I walked on the treadmill, I went outside, one of my colleagues meal prepped. Um, someone just kind of sat in a dark room, but also we all had our computers on still. We reviewed what we needed to review, but each one of us left that meeting feeling better. And so those were the actions that we set up in that moment. And being able to do that as a team with other people who also needed help allowed me to go, oh, I actually need a day off away from work. Otherwise, it looks like on my calendar, I will have worked for 12 days straight without a break. And that seems not good for me or for anybody else. And so having that space in that meeting allowed me to look at my calendar for two days later and say, oh, I can move these things around without a penalty and give myself space. So that sometimes is the action that you take. It's not the do the practice in the five minutes. It's really how do I schedule something for myself or how do I put it on my calendar that I'll get the thing that I need so that I can continue to be well.

SPEAKER_00 53:23

I love that that there was a question about how we're all doing. And you didn't all just say it's all great. There was a real acknowledgement about how you what you were feeling. Yeah. And there's a sense that it wasn't just about you're just an individual who has to go figure this out. There is a collective group here who, for the time of that meeting, can hold you whether you're meal prepping or going outside. But there's a collective witnessing of just trying to be well. And then the the things that have to come out of that afterwards happen as well.

SPEAKER_01 53:51

I love the team that I work with from the wellness perspective for that reason. But I think it's some of these practices that we can infuse into our workplaces and our lives that we don't often give ourselves permission to even ask about because we think someone will think that we're crazy or it's too much. But especially on teams of a lot of women or just busy people in general, it doesn't have to be women. Everybody has something else and allowing space to say, wow, you know, it's kind of a lot right now. But also then for the other people to wit, like you said, witness that and just say, Hey, we're here for you. That sounds like a lot that you have going on. Like it doesn't have to take the whole meeting, it can take three seconds and then you move on. And we still did all the work that we were had planned on doing that day and probably felt better because we had taken that time.

SPEAKER_00 54:45

Janine, thank you so much for being here. Thank you for what you brought. And I think there is a real reframing, a reimagining of well-being right now. And my hope is that it is becoming kinder, more sustainable, more collective. And I think so much of what you've spoken to speaks to my hope anyway, and some of the things that I'm seeing. So thank you so much for bringing this today. Yeah, thank you so much for having me. I had a great talk with you. Thank you. So, as you go back into your day, here's a question that I always ask you, my listeners, and that is whether you will keep, forget, or share today's thought. Wellness is not a state of being, but a state of action. I would love to know what that means to you and how the very idea that Gillian brought today has landed with you. You can find details about Gillian's work in the show notes as well as links to the books that she's referenced and some of the research papers as well. If you would like to stay connected with some of the ideas that we explore here, then do join my Substack community, More Good Days, where we spend some time exploring what a more sustainable, relatable, human version of wellness even looks like. Or if you're curious about how to work with me and need more one-on-one support, then do visit if loss. If this episode stays with you, then please do consider sharing it with someone who might need to hear it too. Until next Monday, when I'll be here with another thought that a guest kept. Bye for now.