PR Dr. Darria Long | Burnout

 

Dr. Darria Long Gillespie is a Harvard and Yale-trained emergency physician and a regular health expert on CNN, NBC, and Netflix. She is also a nationally best-selling author and a widely viewed TEDx speaker. She joins Adam Markel to share how to escape the grip of burnout that kills us bit by bit in form of self-comparison, stress, and anxiety. She opens up how her experience as a patient made her realize how to leapfrog out of uncertainty and develop coherence. Dr. Darria also discusses how the mind-body connection can help address pain and the importance of disconnecting in letting yourself recharge and recover.

 

Show Notes:

  • 0:00 – Introduction
  • 2:42 – Patient experience
  • 9:22 – TEDx Talk
  • 16:10 – Mind-body connection
  • 21:29 – Suppressing negative feelings
  • 26:36 – Study of women in burnout
  • 33:51 – Getting out of the grind
  • 36:31 – Takeaways from the study
  • 42:57 – Pause, ask, and choose
  • 48:26 – Little movement habit
  • 55:34 – Conclusion

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Breaking Away From The Grip Of Burnout With Dr. Darria Long Gillespie

In this episode, we’ve got Dr. Darria Long on the show. She is a Harvard and Yale-trained emergency physician, and a regular health expert on CNN, NBC and Netflix. A nationally bestselling author as a widely viewed TEDx Talk called Ending The Crazy Busy. She’s also a mom of two, a clinical assistant professor at the University of Tennessee, and the Founder of Trueve.com and The Burnout Study In Women. You’re going to love this episode, so sit back and enjoy.

Dr. Darria, you have committed so much of your life to the work that you do. You’ve been in academia, but you’ve done so many things. It’s one of the more, I don’t want to say impressive, highfalutin kind of word, but it is. It’s an impressive bio. There’s a lot there, and probably the most important of which is that you’re a mommy and all that. I want to ask you the question that I always start these things out with, which is what is the one thing that’s not part of that standard intro or bio that you would love for people to know about you?

One of the most defining things is my experience as a patient over the last few years. I’ve been a physician for years and I’ve been a patient. We’ve all been patient, had babies and done things like that, but it wasn’t until I had a terrifying medical experience. Going through that vulnerability honed and helped me refine what I wanted to do with my life and work.

I know I’d probably get hate mail or something, but it would be comments for sure if I didn’t follow that breadcrumb right there or follow that lead. What do you mean?

Here’s what happened. I’d always been super healthy. I’d been a runner. I did 3 miles pretty much every day, maybe a half marathon here or there. I wasn’t super intense. I got sick in February 2020 then somewhere in that fall, I don’t even remember which shows how much I was ignoring my own body. I would be running and have these episodes where I suddenly would have chest pain, shortness of breath and lightheaded so bad that I couldn’t keep standing up and running. I’d have to sit down and wait about 30 seconds. The symptoms would go away and I would get back up and keep going because I had things to do and I needed to finish my run before my kids woke up and all the other stuff.

I didn’t have a smartwatch at that time because I was so consistent with my runs. I didn’t bother. As an ER doctor, I was like, “It’s probably some benign SVT. It’s one of these things. I’m deconditioned from COVID. We’ve all been on lockdown. It’s not a big deal.” It started to happen more and more. I was working with a digital health company, consulting them. I got to the point I was having daily so I got a little monitor.

On December 30, 2020 at 4:00 PM, I’m at home by myself in the basement. My kids are playing in the bounce house, which is what they usually do when I run and my monitor arrives. I’m going to get it to work and see what this is. I’m going to get some answers. This is an interesting experiment on myself. I love biohacking. I get the monitor. I run and symptoms come on. I sit down and get the heart rate. I see that my heart rate was 270 and it’s in something called Ventricular Tachycardia. You don’t have to be a doctor to know what that is. If you’ve watched Grey’s Anatomy, it’s usually when they start yelling, “Code blue,” because the heart rate is not that normal. It’s typically followed by the pads.

I’m at home alone in the basement with my kids and suddenly, all the things I had explained to myself about what this was and all the potentially benign causes as an ER doctor. I never had a patient with that heart rate who had been sitting there talking to me. I knew that there was no benign cause. I called my cardiologist, a friend, and I said, “I’m in ventricular tachycardia.” They didn’t believe me. I sent the EKG that I got to them and they called back in about eight seconds.

That began the next fourteen months of doctor’s visits, second opinions, and trips to Johns Hopkins and Cleveland Clinic. It was a time when I sit and had to wear a life vest, which is one of those defibrillator vests for six weeks. I have to wear that through the Atlanta airport. I’m going off in the Atlanta airport and then went into V-tach again. Me sitting there with wires strapped to my chest and a battery pack that’s now sirening because I’m now in V-tach and I’m anxiously trying to pull out the battery.

I didn’t want the TSA agents running at me to shoot me and getting shocked on the side of the highway one night coming home from the ER and nobody knowing what it was causing because of causing it. That experience led me in a couple of different ways. Now we’ll get into that. It led me to do that vulnerability of being a patient.

Previously, I’d seen a patient scope for things and I say, “There’s no data behind that. Don’t waste your time.” When somebody is telling you, “We have to talk about heart transplants,” then I realized why you will go to any extreme, woo-woo or anything you can find to find answers. I went down that track and it made me mad at what gets pedaled to people when they’re at their most vulnerable. It led me to the work that I do with stress and burnout and part of that work in meaning. How do we come through these moments of uncertainty and how do we survive them? You talk about change proof, I talk about shatterproof. We can come through that without it breaking us.

There are many inroads. I want to continue to talk about for the moment anyway, what it was like for you to be a patient. It’s reminiscent of a book years ago called My Stroke of Insight, which probably you have read. Folks out there, if you haven’t read that book, Jill Bolte Taylor is the author. She was a researcher and a doctor. She was a brain researcher and she was experiencing a stroke. She was having a stroke and was conscious of what was happening and going on the same way that you were. The same thing people around would be like, “No, that can’t possibly be the case. You couldn’t be having this conversation with me, reaching out to me calling or anything,” if that’s what was happening, but she was.

She had a TED Talk on it for your audience who wants an easier inroad to hear her content, which is great.

The book is brilliant and not every book in that space can be. It can be if it’s too scientific or woo-woo. This one hits the mark in the middle. What was it like for you to be a patient? You shared that there was a level of understanding and compassion perhaps even that didn’t exist in the same way before you became the patient.

There was a level of understanding of what it feels when you’re at that rock bottom. I’ve always tried to be empathetic toward my patients, but you learn even more about the value of words.

You were a doctor with a bedside manner. It’s a rare thing.

I tried to be. That’s the goal. Even more the value of words and realizing my diagnosis also the uncertainty. When you don’t have it, you will do anything to get some answers. I also realized how much my physicians also wanted to give me certain answers, even though when they did not exactly know. It wasn’t from a malicious standpoint, but sometimes they didn’t know. As a patient, sometimes I realized it was very hard, but you had to hear what people were saying and then distill it even further this one especially when you have 2nd and 3rd opinions.

I also realized a challenge that you have one doctor saying this and another saying the other, but both are smart people. How do you digest this? How do you not internalize it, but keep moving forward? That’s hard as a physician and even harder as a patient. It made me, as a physician, know when my patients are going through things and trying to help them understand not just the facts. When there’s some duality to it, how do we weigh that together? That’s part of the hardest part and the art and science of medicine.

PR Dr. Darria Long | Burnout

Burnout: Physicians must help their patients understand not just the facts of their condition but how to get through it as well. That’s the hardest part of the art and science of medicine.

 

You’re a TED speaker as well. Correct?

Yes, I am. Mine was on Ending The Crazy Busy and how not to feel crazy busy, how not to use that word phrase in your vernacular.

I haven’t seen your TED Talk. I will but is this story a part of that TED Talk?

No, because that TED Talk was in 2019 and this happened on New Year’s Eve of December 2020. This is not a part of that. I like to keep things dramatic

If you were now delivering a TED Talk and this experience was going to be included, is there a through line from that experience that would be the essence of your TED Talk? Tough question, but I’m putting you on the spot.

What it was is living with the uncertainty and how you live with the uncertainty, how you find meaning amidst it, and particularly how you flex that muscle of living in uncertainty. It’s very easy. I just want an answer. I want to know what this is. We try to rush because it’s so uncomfortable to feel so uncertain. The challenge is learning to live within that. I think also I would bring in something that we studied in The Burnout Study In Women, which I know we’ll talk about it in a little bit. One of the things that are most important was a factor called Coherence.

You do a ton on resiliency. In building that coherence is slightly different. I’m sure you know of Viktor Frankl and his book Man’s Search For Meaning. For any of your audience who’s not familiar with it, go read the book. You’ll have every page dogeared in there. He looked specifically at himself who had survived the concentration camps. He looked at people who also survived.

He found that those who were most optimistic and hopeful about survival and being about being rescued were not the ones that did the best and survived the concentration camps. It was the ones who had a sense of meaning. What’s become this factor known as coherence? Coherence is three factors. 1) Do you make sense of what’s happening in your life? What’s the story you tell about it? Number 2) What is the degree of manageability controller agency you have? Number 3) What is the meaning you give to it?

That sense of coherence in how we look at the world. What Frankl found is they survived. We also survived concentration camps. In The Burnout Study In Women, we found that when you look at burnout, women with higher degrees of optimism did not protect themselves against burnout. It was their higher degree of coherence that was more predictive and more preventative against burnout.

Optimism did not protect women against burnout but their higher degree of coherence. Click To Tweet

Frankl’s meaning therapy was born out of that experience, even being incubated while he was a prisoner. It’s hard to even put yourself in that situation. You could imagine this, but people are dying all around him the likelihood of him dying in that camp was very high, almost 100%. He’s thinking about how this experience is going to be something he will be able to use and help people with afterward. This ability to look beyond the immediacy, the circumstances as they were. What’s interesting to me in connection with what you said earlier is that in some capacity, that’s looking beyond the uncertainty.

This is not Victor Frankl’s work. It may be part of what you’re describing as coherence, but it’s almost like you leapfrog not living with Pandora with the Pollyanna glasses or something. This constant everything is always good toxic positivity as it’s sometimes referred to these days but being able to leapfrog outside of that uncertainty is almost like rising when a plane goes above the cloud line and you think, “It’s a cloudy day and there’s no sun. I travel a lot.”

As soon as you hit that level above the clouds, the sun has returned. To know that that’s the truth and a fact that the sun didn’t go away, clouds moved in and temporarily obscure your view of the sun. It’s not optimism and not BS. That’s just the truth of it. When we’re so locked in the moment that all we can experience is the clouds and the clouds being that, “I cannot see things uncertain,” it can be quite debilitating.

That was one of the things that kept me through when I was at these points of heart transplant conversations. As a note, as anybody doctor out there reading who never has that conversation of, “We want to make sure that you understand that heart transplants in the future.” It’s like, “I know.” One of the things where is the meaning, “If I don’t find some meaning in this, I’m going to lose my mind.” I have to. Secondly is the agency, which is one of those your sense of control. I remember one night, right after when they were trying to figure out what was going on, I was wallowing. There’s the, “Why me? What did I do wrong to deserve this?”

I was watching my face one night and suddenly it hit me. I was like, “I’m sitting here crying. I know the top people at all the top institutions. I spent the last 48 hours not messaging them because I’ve been too busy crying. I have stuff I can do here, but it’s so easy. It is human nature. You get this awful news and you want to do the one, but as soon as you realize, “I have agency,” as soon as you can figure out just that one thing, it helps you lift your eyes above the clouds. It’s not just the optimistic Pollyanna vision of looking above the clouds of, “What’s one thing I can do? Where’s my agency right now?”

What was your agency then? What did you seize upon?

At that moment, it was the five people I can reach out to who can get me a second opinion here and can help me get more information about figuring out this diagnosis of what was going on.

If we’re TED Talk, did you end up getting a heart transplant?

No. I’m so grateful for the work of Cleveland Clinic. I had a nine-hour ablation procedure with five different attendings at Cleveland Clinic. It is the best people in the world. I went for a little walk jog beforehand. I didn’t want more caffeine. I was like, “I need to wake up.” It’s different. I’m not going to be doing any more marathons. Probably not in my future and modifications. I’m back to finding that joy, being able to move and moving forward.

I so appreciate that Dr. Darria that you do a spoiler alert with us. I want to ask you about the mind-body connection. If I was going to ask any number of doctors that question, they’d probably cringe. Maybe they wouldn’t show it, but on the inside, “What the F is he about to do?” Let’s get into it. I’ve been reading a book by Dr. John Sarno, which was a massive bestseller years ago. It came out in 1991. It’s been reissued a lot of times called Healing Back Pain.

In many ways, it’s a book about his research. He is a medical doctor and he has thousands of patients who came to him with back pain and other pains. Primarily, it was a study about folks with those issues with their back. I think readers go, “If I can only just heal my lower back or my sciatica. If I could just not ever get another back spasm in my life, I’d give away a lot of money if I could guarantee that.”

His whole piece of this has to do with the mind-body connection as an answer to this back issue. I didn’t know where this was all leading. I want to quickly parenthetically say I went to get my physical and hadn’t had one through COVID. It’s the first time I’ve been there. Doctors said to me, “You’re in great shape, but your heart rate is a little low. I think you should go, at your age, see a heart guy or a cardiologist.” I was 55 or 56 at heart rate. Long story short, I wore a heart monitor. I got a CT scan of my heart and all that kind of stuff to be sure.

In the end, all is great. Better than normal is what they said. I don’t know, magnesium or calcium or something. All parts working good. I live also with that little bit of uncertainty for several weeks about what’s going on. I’ve been athletic my whole life and my heart is always, “Am I super calm?” I was pretty much a type A personality lawyer for so many years so I was living with that bit of uncertainty. I was managing my thoughts and my emotional reaction to that uncertainty while that was going on as well as with people around me, who knew, my wife and others.

I want to get back to this mind-body connection because the mind turned out to not be structural, but we were just concerned and go out and get the test and all that kind of stuff. Yours was a structural thing. You did require surgery to fix something inside. What are your thoughts on the mind-body connection as to what you experienced?

I want to go back to one thing you said about most doctors might cringe when asked about the mind-body connection. It’s interesting. As my own platform and then launching Trueve.com is systematizing more of what I do of bringing truth back to the information people here, making it actionable and giving you peace of mind. I launched it because having been this patient, having seen this woo, and realizing why at times you’re vulnerable. Not that everything is wooed, but seeing how we will go to any source when you’re desperate and talking to some smart female friends who said, “My doctors aren’t talking about this stuff over here. There are these other sites I find,” that I will not name the names, “that talk about wellness and lifestyle and have zero science behind them.”

There’s nothing in the middle and I had questions about this stuff in the middle, but nobody is talking about it. I went over here because nobody else is talking about it. That’s why I thought, “We can talk about it. I can talk about that. I look at the evidence on a daily basis.” I know these top experts across all aspects. I think there’s truth amongst all of it. You can find grains of truth and all of it. Let’s answer those questions that are keeping women up at night and men too, particularly about their wellness and health with the evidence. Let’s go there. I’m glad that you asked that because I love this stuff. The evidence is incontrovertible at this point that there is a mind-body connection.

It goes both ways anatomically. Your sympathetic nervous system is your fight or flight. That doesn’t just make your muscles run quickly. That changes how your gut is working. That changes what your bladder is doing. It changes your reproductive hormones because we’re not made to be having a lot of babies when we’re currently being chased by tigers. The parasympathetic nervous system exists. We know how it affects how our gut functions, then how our gut, our microbiome and what we eat. The things we put in our body affects our stress levels and our mental health.

It’s incontrovertible. Is it the only thing could I cure myself with? Could I cure my heart by thinking it itself? No, I think that sometimes people like to go to camps because it’s easier to make them there to be sound bites when you go into an extreme camp. There are things that are independent of the mind-body connection that we can have as problems. The mind-body connection is absolutely a key component of any condition and it’s something we always have to consider whether we’re talking about anxiety or diabetes. It’s not something we can ignore anymore.

It’s interesting because a lot of people have pain, whether it’s intermittent or chronic. I’ll use myself as an example as opposed to generalizing. I’ve had some challenges with my back at times and problems with a knee and shoulder that lasted about a year that came and then went. I had some blotchiness on my skin at a certain point that would come and go. I started to only not just think, but sit with the idea that I’ve been great at coping. I wrote a book called Pivot, which is a book about how you cope with and the book, Change Proof is a book about how you cope with uncertainty, vast amounts of change and unending change, and things like that.

On some level, being a great coper, you still pay a price for that. What I’ve been sitting with is the idea that sometimes our bodies are great at defending us from feeling the kind of things that are uncomfortable. As you said, sitting in that uncertainty is super uncomfortable and we will do almost anything to get out of it no matter what that is, even if it’s reaching for that the quickest answer that we want to hear or something else. The feelings that we have are difficult to deal with and we learn from very early on in our lives, sometimes even from our parents’ example and examples elsewhere, that it’s better not to feel certain things, move on and get on with stuff.

We suppress those feelings. My question to you is in your experience and what your belief system is, do you believe that some element of our physical challenges in life, aches and pains, and that kind of stuff is the result of our suppressed emotions? The stuff that we’ve routinely pressed down so we can be better copers and more successful, perfectionists and achievers of all kinds have all these physical problems that sometimes they think, “I injured myself. There’s degeneration in my spine, disc or some other stuff like that,” when in essence the root cause of it is not dealing with their own emotions. What do you think of that?

In some people, it might be suppressed emotions or it could simply be suppressing your response. You have pain somewhere, a headache, you’re exhausted and you think, “I have to push through,” so you’re suppressing your response. A physiological example, we have patients that could be in septic shock or shock for a number of reasons. We give them adrenaline, epinephrine, norepinephrine or all these things.

Eventually, you get to a point where you are giving them the max dose of epinephrine or norepinephrine. You are flogging their receptors, but their receptors are so saturated. You can’t do it anymore. Sometimes we have this mentality of bringing it back to a lifestyle that, “I’m exhausted, let me take some more caffeine, burn that midnight oil or keep flogging.”

There’s a book called The Body Keeps The Score. You get to a point where your receptors are full. You cannot keep saturating them. You cannot keep pushing and you have to come back. When we talk about not using crazy busy or solutions from the burnout with The Burnout Study In Women, the solution is not slogging. It is not to say, “Let’s do less. Let’s all run off to an ashram and leave our lives behind.” It is to say, “How do we compete? How do we do the things that we want while weeding out the other things that are forcing us to slog, whether that is actual tactical things that we’re doing or mentally how we’re looking at it?”

I love another speaker who got a very successful TED Talk. We should all have as many views on our TED Talks as Angela Duckworth. I do love her work and it’s a great talk. I do this fairly often now, I take exception to this idea that we should be gritty and grit is our answer to resilience. I push back on that quite a bit because I feel like while that may have been even what would’ve created more opportunity for success before the pandemic. I don’t believe that. I think it is a last-century paradigm and this current century, Millennials and Gen Zs are telling us for a long time.

My wife and I have four kids in those demographics as well. We’ve been seeing it. They don’t buy into that. That’s not because they’re lazy or don’t have passion for life, want to do great things or aren’t willing to work hard as some people have suggested. it’s that they intuitively understand that grit, grind or slogging is the method that you get things done in the world. That’s a broken paradigm and it’s not sustainable. It will never lead to sustainable resilience either. It sounds to me like your study of women in burnout has come to similar conclusions. Will you tell us about The Burnout Study Among Women? I’m very curious.

PR Dr. Darria Long | Burnout

Burnout: Millennials and Gen Zs are starting to understand that grit and grind are broken methods that will never lead to sustainable resilience.

 

Where this came from was I launched Trueve, which is when there are questions that keep us awake at night, we put data-driven guidance behind them and lens to them. We’re looking at all sources and we make it actionable to give you peace of mind to get back to your life. I wanted to write an article on burnout. I realized that there were lots of anecdotes about people being miserable. I said, “What do we do about this?” There wasn’t a lot of actionable data.

It was one of those examples of the universe coming together. I found these amazing researchers who do institutional burnout, looking at physicians and then now looking at individuals. They partnered with Good Housekeeping as our media partner, which is one of the things we do now. We identify the researchers and the media partners, and then we bring in the funding as well.

LUNA Bar and Computers4Kidz came on as corporate funding. Everything came together in this beautiful ecosystem. We had 4,000 plus women take this 30-minute academic study. It’s the first large-scale study of burnout in women since COVID. I’m looking not so much at how bad it is because we know it. You didn’t need enough study to tell people that they’re feeling burned out, but looking at why and what can we do about it.

It’s one of the things we looked at. We developed a new framework. We call it The Do It All Discrepancy. It gets the fact that 82% of our respondents said they felt they should be able to do it all and 7% said they felt that they could. We are going to go and talk to that 7%. I want to know what their special sauce is and what’s working for them. I know you talk about a gap in a slightly different way, but it is the gap. What is driving my one person’s burnout? It’s maybe different from somebody else’s, but what is universal is that gap between your feeling of what you should, be able to your ideal, and what you have the resources to do. That gap we found is directly predictive of burnout, anxiety, depression and a number of things. Specifically, burnout for this study.

Where Millennials are getting and starting to understand, and Gen Z even better is in that shoulds list, is we have the very real things. It also are becoming a more complex work that you might have to do, which now is becoming 24/7, childcare, which is always getting more complex and health. All these things become more complicated. On top of that is this idealized stuff. Speaking of working moms, for those people but you can extrapolate this to every audience. Not only is it enough to be a working mom but when you cook, are you baking organic cakes made out of oats that you grow in your own backyard? Are they in travel soccer at the age of three and it’s pay-lay one of their coaches?

Don’t you think all women and moms shouldn’t be growing their own food? Don’t you think that everything they put in their kids’ mouths should be something that they sourced from their own backyard?

I do it regularly in my garden where I also grow the up yours for anybody who asks me to do that. With perfect hair and we’re seeing this because we’re seeing it on social media all the time. Well over 60% of women we surveyed compare themselves against somebody who they think is doing it all. We wanted to get all of that.

In seeing our species, that’s what I want to say about that. A male perspective is BS. This is not gender-related. That’s a personality trait. We don’t have to try to unravel that. You grow up wanting to be liked, please people, do things perfectly and achieve. There’s nothing wrong with that, but the pressure of that and the feelings that it produces, which sometimes subconsciously, we don’t even realize that we feel anxious about it, resentful of our children or of these things, or angry even about this.

It’s subconscious. I was talking to somebody who was one of the early five employees at one of the big social media platforms. He said, “I realized when they had as many neuroscientists about how to make this algorithm sticky as they had coders, we were going to be changing how we use technology.” That is when I realized they were building this to make it addictive. What we found also is that women’s top two emotions they felt after being on social media were worry and envy, and way below were happiness, optimism and pride. That again was directly tied to burnout. It’s because we as a species are driven to compare and look around us. Social media makes that universe against, which we compare ourselves. It’s so much more prevalent. We can compare ourselves with everybody. You also see only the snippet. You see the perfect-looking image.

Women felt worry and envy after being on social media. They are driven to compare themselves against everybody and chase the perfect-looking image. Click To Tweet

Magazine covers and airbrushing started that long before social media. Not to take them off the hook at all, but we’ve been trying to tell people of all kinds, all shapes and sizes what they should do, look like and how they should behave forever.

Forever. It’s just that now it’s 24/7.

You have no place to retreat from it. I ask our people this all the time because, as you said, this is constant cognitive arousal for us. We can’t go anywhere with it. All the time during my keynotes, I used to say it as a joke, but I go, “How many of you go to bed with this thing at night?” Forty percent of the audience now raises their hands to say honestly they do.

I talk about burnout, philosophical things, uncertainty and coherence and things, but then we talk tactical. One of the things is having a moment to disconnect. When you look at the research on recovery, there are five multiple recovery experiences. One of the things is having that disconnection, turning off that hypervigilance and not just saying, “I’m in between checking emails now.” Literally, it’s wasting this hour. I’m not picking it up. I’m not looking at it. That’s key because another part of it that I talk about is micro recoveries. We are up here in our sympathetic nervous system fight or flight response all the time. Our bodies are not made to do that. We made a cycle between sympathetic and parasympathetic.

Having those moments where you drop down and you cycle back down, breathe your parasympathetic nerves, which is your rest and digest system becomes predominant for the period. These little micro recoveries when you’re dropping down. That includes setting down your phone and having those moments. For those people watching who can’t do it for an hour, do it for 5 minutes. Go to the bathroom without your phone and see what happens because our brain needs to digest.

If our brain doesn’t have time to digest with quiet moments, then it’s always chattering. That’s why we can’t sleep at night because we lay down and it’s the first time we have quiet and our brain is going to digest. I challenge all of your audience. I’d like anybody to message me if they did not pick up their phone when they went to the bathroom. I’m sure I’ll get some great comments from that one.

Another one of those things that’s simple is our research is very similar in this respect that resilience is not about endurance. It’s not the grit model in all due respect to folks that have been talking about how important it is that you grind and you should be doing your side hustle from 7:00 PM until 1:00 AM. It’s nonsense because when we’re depleted, everything suffers mentally, emotionally, physically and spiritually. It’s literally the lower tide lowers everything. The raising of the tide raises everything. The way you raise the tide is in the word that you shared with us, which is in recovery. This is not about how we endure. It’s about how we restore.

Restoration is its own unique part and its science. It is a combination of both art and science. It’s such a holistic practice even if you decided that at the beginning of the day. These people that have the phone either in their bed with them or next to them because it’s easy to start your day immediately by engaging with this, whether you turn off the alarm clock, you could still get a windup alarm clock.

I don’t have a windup alarm clock, but I have a non-phone alarm. I have a light-up alarm clock.

Do you think it’s that when the lights would go out or the power would go out, the thing would blink that people got so annoyed with how to figure out how to get it to stop blinking that they just got rid of those entirely?

There’s a new invention called the battery.

Ten minutes at the beginning of the day not looking at your phone because when you pick this thing up, it’s always going to be someone else’s agenda. I’m not saying it’s terrible or bad. I’m picking up the phone and as soon as I look at these text messages, emails or even the news or whatever else is showing up on my phone, it’s other people’s agenda.

At the start of the day, it’s important that you begin in a place where you are determinative of your thoughts, your feelings, and even engaging with your feelings or the stuff that you processed while sleeping. Much of what’s going on for us is only those suppressed or repressed feelings that come out during our sleep. That’s why dreams are so good for. It’s the allegories of those dreams. It’s a simple thing. Don’t take the phone to the bathroom with you.

Start your day, maybe the first ten minutes, that you’re tech-free. That’s a simple small toggle solution. I want to know a little bit more about how you are utilizing the information from that study because it’s funny. The numbers are similar. We have a resilience assessment tool that we deployed a few years ago. It’s gotten popular because it takes three minutes, which is remarkable. It’s sixteen questions.

We’ve come to understand some things that you and I can trade a little information, a little recon. There are a couple of things that come out across the board. This is studying leaders in organizations of every size, shape and kind public, private, for-profit, and not-for-profit. It’s about 5,000 leaders have taken this thing now. Can you give us some of the takeaways that you’ve gotten out of that study that you’ve seen among women in burnout?

How we are using it is we published our very first paper. We had so much data out of it that it’s going to be a series of publications. A couple more coming out. We’re speaking at conferences on it and a number of different places. Our first paper was specifically on The Do It All Discrepancy, which we talked about and we’re looking at that. We partnered with Luna to do a campaign of #DefineYourAll because social media and the world around us push us to have everything be our all. You are doing all of it, but all of it doesn’t always matter to you. It is not the slog just for doing it all’s sake.

What floats your boat? What lights you up doing those things like you talked about doing late night? Sometimes we all have to do late nights and do one more work every once in a while. It’s the fact that it’s not every single moment. 1) Choosing your all and 2) Being deliberate about how we use social media. We’ve dove into social media for that very first paper since the impact of social media is so unique on our current generation. We are also looking at self-comparison. One other thing we haven’t discussed is what I call compare-tinnitus. Other people talk about it as the comparison quicksand, no matter when you start to have those comparison moments and how to make it. Comparison is not necessarily like stress intrinsically a bad thing.

You can use comparison to motivate you or to say, “Why do I feel this?” Instead of allowing it to internalize and become that comparison quicksand, it makes you feel worse about yourself. Be very careful with how we are handling comparisons and then we’re going on with more papers. One thing we did create was the What’s Causing Your Burnout quiz. We figured people don’t need another quiz on, “How burned out are you?” We want to know how at risk are you and what risk factors you can go. It’s an eight-question quiz. It takes 2 or 3 minutes depending on how quick of a reader you are. At the end of it, we give you your risk. More importantly, we personalize it and say, “Given your answers, here are your top three drivers of stress.” We email that to them.

Comparing yourself to others can be used as motivation. It only becomes a bad thing when you allow it to make you feel worse about yourself. Click To Tweet

The idea is we want to take you from feeling burned out to how do we take you along this journey to not feel burned out anymore and give you 1 or 2 tips. We’ll be writing way more on burnout and the responses and then also on the mind and body. I talk a lot to people who are on my newsletter for burnout about the food intermittent fasting, how that impact both your health and your mental health, melatonin for sleep, what are all these other things that also are going to fit into that ecosystem and cause or improve your burnout levels?

Stress is a thing people think they want to get rid of or it’s sometimes misunderstood as something we need to have less of. Back to the research, it’s not stress that’s the issue. There’s a great TED Talk, “Stress is not the problem. It’s our lack of recovery from stress.” In that particular TED Talk, I remember the woman talking about how stress is not the thing that kills us. It’s our belief about the stress that creates madness.

As an ER doctor, we’re in the midst of it. I remember one time I had a patient. I was working in the ER and I get a call from security on the walkie-talkie because we still use walkie-talkies. It’s saying that the patient was admitted for a heart attack. She’s been going up to the fourth floor when the elevator broke and she was stuck between the 3rd and 4th floors. Could I please come to help her because she was now stuck in the elevator and having chest pain? I ran and pocketed some aspirin, nitroglycerin, and got my stethoscope, and went running to the fourth floor. You can see the elevator in the shaft leaning in. I ended up taking care of her and getting her better before they even fixed the elevator, which I considered a win.

I remember my intern saying afterward, “How did you stay so calm? How did you do that?” It is about how you function amidst chaos without letting the chaos be internalized by you. We will do things to try to reduce the uncertainty and the chaos around us. We will talk about routines all the time. We will decrease our decisions and some of the variables as much as possible. To a certain extent, uncertainty and chaos will always exist. How do you live amidst that chaos and uncertainty without letting it be internalized?

PR Dr. Darria Long | Burnout

Burnout: Try to reduce the uncertainty and chaos around you. Decrease your decisions and variables as much as possible.

 

Chaos, uncertainty, and the unknown are the norms. Everything else is an exception to that rule. What do you do in a world where that’s not only the norm, but it’s going to become more and more prevalent? Disruption, change, the pace of it, and velocity only increases. What do you do in that situation? That’s where both our work overlaps. I have a diagram where we have a common belief system and what I think has been guided by the research that you develop your resilience before you need it. That’s the point of it. Being calm in the moment of chaos isn’t because somehow or another you’ve you’re a great Zen. You’ve done the prep work to be calm in chaos.

I don’t mean that because I practice meditation or something like that. It’s that you’ve got recovery rituals as part of your normal routine so that you are not depleted. Because you’re not depleted, it’s possible to think rightly at the moment and make the right decisions then. That’s the result of a lack of being exhausted and depleted because when we’re verging on burnout or we’re burned out, what we see happen, what happens is that we lack the capacity to think clearly and be patient. I got interviewed by Psychology Today about what happened at the Oscars, which was an odd thing that I was being tapped for some insight on that topic.

We watched Will Smith’s get up or at least we saw it on YouTube. I couldn’t believe it because I saw it on YouTube that night and watched it. I thought it was a joke or it was somebody’s meme or something, but it wasn’t a joke. It was real and I was asked for an opinion as to why that could have happened. There are a lot of ways to look at it because he had a very challenging childhood and there’s stuff about his mom, defending women and his wife, and all that kind of trigger stuff that was in there. I didn’t speak to any of that. I just said he was depleted. He goes, “Does a guy who’s at the top of the game truly is a person at the top of the heat in terms of everything that you might think you want out of life? Money, fame, celebrity, a great marriage, kids, health, and all those good things. What in the world does he have that’s stressing him out?”

To me, a person who is depleted is a person that reacts to a stressor the way he reacted. Will Smith did not put his feet on the floor that morning and go, “Today, I’m literally going to sabotage everything I’ve been working on my entire life. I’m going to do it in front of the world. I’m not going to do it privately. I do it in front of everybody.” It never happened. If Psychology Today came to you and said the same question, any thoughts on that event? What would you say to them?

It gets to what we’re talking about powering through. There comes a point at which we all have to power through at times. There are times that I’m exhausted in the middle of an ER shift and I still have the next patient coming, but how do I get those moments of recovery? How do you replete when you’re depleted even if it’s just for minutes? How do you not live your life in this moment of constantly being triggered?

It’s a lot of being attentive to taking the recovery, your feelings, emotions, and questioning the stories. It gets back to coherence. What are the stories we’re telling ourselves about what’s going on? What were the automatic stories for that example for Will Smith that came up for him at that moment that had nothing to do with perhaps what Chris Rock was saying? What were his automatic stories and how do we question those and not being able to take that moment for ourselves?

For those of you out that have either dealt with something similar or may deal with something similar in the future, I don’t mean being at the Oscars in the front row and that whole thing happening, I mean where you feel triggered at the moment to react because it’s epidemic, the level of not just anxiety in the world around us, but anger and impatience. It’s staggering how quickly people at the end of their rope or fuse. This a little self-serving note to say it this way. In the book Change Proof, there’s a model that’s similar to the coherence model you identified earlier. It has three parts.

It’s super simple. It’s to pause, ask, choose, and there’s more detail to it and all that. I won’t get into it, but you can figure out what that looks like. Simply, you pause and ask. For example, “What are my options at this moment,” and then you choose. I feel like if Mr. Smith had sat there, paused, and asked simply a couple of questions like, “Should I get up and go punch this guy? Should I get up, get on stage and hit somebody in front of the world?” He would never have chosen that.

He just didn’t pause and ask any questions. It was his fuse lit and an explosion after that. If we think about our own lives and the places where we write an email and hit send on that email, we shouldn’t have hit send on that email, or we have a conversation where we needed to be listening more than we were speaking, or we were not monitoring our tone in speaking to somebody. Wherever it is that this shows up, my call to action to everybody is wherever that might happen, somebody flips you the bird in the car or they beep, they lean on their horn because you didn’t move past the light fast enough, pause, ask, and choose is something you can do as well.

It makes me think of two things. One is, we were talking about uncertainty. When you’re in uncertainty, it’s so uncomfortable. It’s like that itch. You got to get an answer or similarly when you are triggered, it’s that itch, “I’ve got to punch somebody to make this feeling go away. I feel like I have to do something.” Pause is important because you can remember that awful feeling of bloodedness. It doesn’t last. It lasts about 90 seconds if you look at the biochemical research.

I think about it frequently in the emergency department. He said something rude. It dissipates if you just give it a second to pause and don’t react. The other thing is the ability to pause is often not dependent on how you are at that moment. It’s dependent on what you’ve been doing the last 72 hours. Have you given yourself time to recover? Are you doing things that are meaningful? Are you doing things where you feel like you have an agency and you can be effective? Are you taking action in those ways?

The awful feeling of bloodiness lasts only about 90 seconds. It dissipates if you just give it a few seconds. Click To Tweet

Dr. Darria, I could talk to you all day.

This has been wonderful.

I have one last question for you. I’m curious about what type of ritual is most effective for you. I use the word ritual to replace the word habit. There are things that we do on a ritual or habitual basis to help us to recharge and recover in the sense that you described it. I’d love to know what’s the one go-to that you have.

I know you’re a guru about having those routines. I wanted to say one thing earlier if I can add it in. We were talking about your morning routines with not picking up your phone. Decide it the night before because that cognitive decision low would give us more decisions. You don’t want at 5:00, 6:00, or 7:00 in the morning, “Do I pick up my phone or do I not?” Decide the night before, not picking it up for ten minutes, and then just make it a norm. For me, there are 3 rituals, but I’m going to say 2.

One is the minute I wake up. Now I go move. I am not a morning runner. I look at those people who get up and say, “I love to get my run out in the morning.” It’s like those people who are, “I like drinking tea. I don’t need coffee. I don’t need caffeine.” I want to punch him in the face, which maybe not be a good conversation since we just talked about the Oscars. I don’t plan to punch him in the face.

I could have built that routine very slowly about twelve weeks of slowly getting up and moving in the morning. Now no matter what, I get up, I head to my treadmill, I get in 5 or 10 minutes, even if it is a walk, I move. No matter what else happens that day, I have the physical benefits of movement and I have mental health. No matter what happens that day, if something happens, I took 5 or 10 minutes for myself, usually half an hour or so. I had that for myself and I got that in. I encourage everybody to create a little movement habit for five minutes.

I’ll share mine as well because you inspired me to do that. I gave a TED Talk some years ago, just like you did, which was such a joy and so nerve-wracking. I’ve been a public speaker for so long and doing a TED Talk literally had me by the throat.

It’s so hard to talk for just eleven minutes.

I had eighteen back in the day, but it is still difficult. I told my wife at some point when she was saying to me at 11:00 at night, “Do your talk. This is how our relationship. I’m trying to get in bed at 11:00.” I just go, “No. You cannot make me do it.” It was literally like, “Leave me alone,” then I would do it. It was just torture because I don’t know if I have enough brain cells to do this anymore. It was perfect meaning the way she supported me that way. It was beautiful. I shared the development of a ritual. That was what my talk was about, how I developed this ritual from the life that I used to have, which was for many years as a practicing attorney.

I’m retired now, but having had a panic attack ending up in the ER with somebody like yourself looking at me and going, “Look at this poor knucklehead right here. He thinks he’s dying. He thinks he’s never going to see his kids again.” I mean like sweating profusely, fingers tingling, heart beating on the outside of my body. In that feeling, I was scared and terrified. At the same moment, I was so pissed at myself. I was so angry and had so much self-loathing that was baked into that. It was getting worse and worse. I’m looking at it and I’m going, “I can’t believe I’m putting my beautiful wife through this. I can’t believe this is the way it’s going to end.”

It was that moment. Coming out of that, waking up in the morning and starting the day with that anxiety, which is how the day greeted me for many years. It’s anxiousness, angst, and anger at the start of the day even. I was so frustrated with why I would even feel that way because they didn’t understand it.

I started doing something at the beginning of the day which is when my feet hit the floor, the first recognition consciously that I have is, “I’ve been given this gift.” When I’m having that awareness taking that breath in that moment, there are people taking their very last breath in that exact same moment. I started saying, “I love my life,” in the morning. When I wake up, before my feet hit the floor, the first thing I say is, “I love my life,” which could be replaced with, “I’m grateful for my life. I appreciate my life.” That’s been a thing I do consistently every day.

I do something similar after spending about a week in the hospital at Cleveland Clinic one time. I remember the first morning I woke up at home. I was like, “I’m here. I’m in my bed.” There are many people for whom that’s not an option. Thank you for crystallizing that for me. That’s a wonderful thing you say. That’s the first thing I do still to this day, I wake up, “I’m going to go say hi to my kids. I’m here. I got this day.” Thank you for that.

I know we’ll get phenomenal comments based on this conversation. I have a reminder for folks. If there’s somebody that could benefit from reading what Dr. Darria shared, the insights and the wisdom, feel free to share this show. That’s how the word gets out. It may seem like it’s being self-centered to say it, but we want the message to get out to more people. We do this at least at the level we’re at, which has got a great following.

It’s not a money component. I’m not saying there shouldn’t be or there couldn’t be, but that’s not the primary driver for why we do this show. If you do know some people that would benefit from tuning in to this, please share that. Leave a review. The reviews are great because it helps the algorithm to help us get the word out and have more people consume this content. The review would be great. You can leave a comment at AdamMarkel.com/Podcast for either Dr. Darria, myself or both of us. We will respond to that accordingly. Thank you so much for your time. I love this conversation.

Me too, Adam. Thank you so much. I welcome any questions from them. I love hearing from people who have snippets of these conversations.

Everybody, Chao for now.

I enjoyed that conversation with Dr. Darria Long. To know a doctor, especially someone with her experience, expertise, and insights. She share so vulnerably about what it meant and what it was like for her to be on the other side of that diagnosis, what it meant to be a patient, having to deal with the uncertainty and the worry over the health of her heart as she was busy doctoring and helping others to resolve their health challenges as well as being a mom, and everything else that she had going on in her life. She gave us quite a recipe for how it is that we can be more resilient in the face of those challenges. She used the word coherence.

There were three things that she identified as being part of how we develop coherence, which is a word I easily feel is interchangeable with the word resilience. She was giving us some concrete examples of how it is that we have to use this three-step process as a way to get leverage over the fear that comes up when we are living in a state of the unknown. Often, the worst fear has to do with the unknown surrounding our health, especially when we receive some diagnosis or when we’re given some reason to believe that there’s something structurally wrong with us because our bodies are exhibiting signs of some pain, or we are experiencing pain in some area of our bodies.

I brought to the table a reference to Dr. John Sarno and his book Healing Back Pain. I wanted to find out from our guest what her thoughts were on the mind-body connection. We got to get into that, which was fun for both of us in doing. We did track the source of so much of our worry and how it relates to fear and our relationship to change and uncertainty. I thought this conversation was valuable not just to me, but to anybody that I feel would also have moments where you feel almost paralyzed by the level of uncertainty that can exist when your health is not as you’d like it to be. Maybe you’re feeling anxious and don’t exactly know why or what to do about it.

I think there’s a great underlying cause for a lot of the discomfort that we’re feeling. I expressed some of my own thoughts and opinions about that and got to go back and forth with Dr. Long. We had a great time at it. I hope you love the episode. I hope you found it as valuable as I did, and that there are others in your world that might also benefit from this conversation. If that’s the case, please as always, feel free to share this episode with a friend or a colleague. It’s one of the ways that our mission is realized when more people are having conversations about their well-being, mental wellness, physical, emotional, and even spiritual well-being.

Ultimately, that holistic concept is how we define resilience in the world we’re living in right now with stressors of every kind. It’s only multiplying in magnitude, whether it’s the economy, politics, life at home and what’s happening in and among our family members, dealing with the holidays, or with any number of other things that can trigger us. We are living in a time of great anger, it seems and in some ways even something that we’re getting that people are getting entertainment value out of. Angertainment is a phrase that was coined to describe where we’re seeing people enrage and watching videos on YouTube. YouTube channels coming out that focus on seeing folks in rage, whether they’re on an airplane or in a car, supermarket or elsewhere.

The underlying cause of a lot of that is just fear that is born out of the confluence of things and a level of uncertainty that we probably have not dealt with in this quantity in our lives. At least, I haven’t. This was a great conversation to talk about a lot of those things. We’d love it if you’d leave a comment. You can go to AdamMarkel.com/Podcast to leave a comment. We thank you for that.

As always, if you want to find where you are on your own holistic journey toward more coherence and resilience, you can simply go to RankMyResilience.com. In three minutes with complete clarity, you’ll learn a little bit more about how resilient you are. You will do that in a way that sets the table for moving forward in a world that will only become that much more uncertain as we move forward. It’s entirely complimentary. Enjoy that as well. Thanks.

 

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About Dr. Darria Long Gillespie

PR Dr. Darria Long | BurnoutDr. Darria Long is a Harvard and Yale-trained emergency physician, regular health expert on CNN, NBC, Netflix, and other networks, national bestselling author, and has a widely viewed Ted on “Ending the Crazy Busy”. She’s also a mom of two, Clinical Assistant Professor at the University of Tennessee, and founder of Trueve.com, and The Burnout Study in Women.