ER Doctor Teaches How to Overcome Burnout from a Body-Based Perspective w Dr. Laura Hays, MD

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Knowing how to overcome burnout can help you deal with stress. 

Everyone, today. I’ve got a very special guest. It’s Dr. Laura Hays. She’s a physician and she has worked in the emergency department for years and today she’s going to be talking with us about how to manage burnout.

And I love her approach because it’s very science informed but it’s also very body aware.

So, Dr. Laura Hays has worked in the emergency department for decades and she also teaches yoga and she’s the host of the podcast Lasting Impact Wellness. So, they’ve got a bunch of really great resources there.

I’m really excited to hear what she has to say today about burnout how we can heal that and so, let’s jump in. Let’s go!

Emma:

Awesome! Well, thank you so much, Laura, for joining us. I’m super excited to talk with you today about burnout and stress and everything.

Dr. Laura Hays:

Thanks, Emma. I’m really happy to be here and talk with you too

Emma:

Yeah and I think your experience as an emergency room physician is going to be so informative because am I right in understanding, like, ER doctors and police probably have some of the like highest rates of burnout out of all professions.  

Dr. Laura Hays:

Yes, that’s correct.

What Is Burnout

Emma:

Yeah. So, okay, like, just to start out like what is burnout for those who are maybe unfamiliar with the term or how would you define burnout? What is it?  

Dr. Laura Hays:

So, good question. A lot of my understanding of burnout came from, of course, personal experience, being in the emergency department. But also recognizing how my body and my mind were responding to these high stress situations.

So, I actually started researching it and reading books about it trying to really understand it more for myself but then also when I was in a leadership role kind of trying to understand it for my team as well to try to help guide them. And you know burnout has been studied for decades. I’m sure you know this Emma but they really started focusing on it back in the 70s and there was this man I think his name was Freudenberger in the 70s and he did a lot of his research on workplace burnout.

And a lot of what we know about burnout has come from that research on occupational burnout specifically but throughout recent years maybe the last 5 to 10 years or so people are starting to look at burnout in these other arenas. So, particularly parental or caregiver burnout we’re starting to see some research being done there and I wouldn’t be surprised if even more research comes out in different arenas since the pandemic because that highlighted a lot of different type of stress for all of us essentially.

But when you think about what burnout really represents and that is if you think of the actual WHO definition which they define it as a syndrome of chronic stress that hasn’t been successfully managed.

So, if you think of it just in a basic form like that then you can see how easily you could extrapolate it to a number of your life scenarios, so to speak. So, that’s kind of the definition of burnout that’s accepted now.

Again, originally started with workplace but I think as we talk about it more a lot of people listening will think, oh well yeah, I feel that too not necessarily at work or maybe in my in my personal life too.

Three Main Component Of Burnout

Dr. Laura Hays

So, it’s really composed of these three main components and the first is emotional exhaustion. I think of that as the feeling of, it’s kind of, it kind of makes sense like you are just, you feel like I’m completely maxed out, like my light is so dim right now that I can barely see it. That kind of, I like to use the term soul sucked, like you feel like you are something is just totally sucking your soul that’s that feeling of emotional burnout like you have nothing left to give.

And then the second part of it or the second component is this depersonalization and I think of that really is just a disconnection. You’re disengaged from what your main roles or your primary job is. Maybe you don’t feel personally invested in what you’re doing anymore even though you once did. And this shows up a lot, at least, for me it did but for a lot of people as just you’re just going through the motions you’re checking the boxes that need to be checked and maybe you’re even just showing up for the paycheck honestly but it’s that attitude of like I’m just done with this place and you know, you start to see in teams who experience this or groups or organizations especially at the workplaces they lose that kind of team player attitude where they’re part of the team technically but they don’t really even want to be anymore. This is the component that I think any manager or boss would just not want to hear from his or her employees you know that disengagement.

So, then, the third one is this reduced like personal accomplishment so that feeling that no matter what you do you are not affecting any change like you’re busting your butt but you feel like nothing’s changing nothing’s improving, you know, I used to use the term when I was during COVID and in my leadership role I would say to my husband I feel like I’m just banging my head against the wall. I’m saying the same stuff over and over again and it feels like nobody’s listening. So, again those are kind of the main three accepted components of burnout. So, emotional exhaustion, depersonalization, and then that feeling of decreased personal accomplishment or effectiveness.

Emma:

Yeah! That’s so interesting I’m already learning so much. I’m really not an expert in burnout. I have my own theories and approaches to it but as you talk about that that makes a lot of sense and that third one, you know, I think there’s a lot of overlap between um trauma and depression and burnout and that third one where you start to feel like, why try? Like, what’s the point? I keep putting effort in and I’m not seeing any outcome or if you do see an outcome maybe it doesn’t even feel good like you have some big success and you’re like cool, whatever, you know, and that’s like closely overlaps with both like nervous system hypoarousal with trauma and that feeling of depression where you just can’t get excited about anything anymore.

Dr. Laura Hays:

Yeah, for sure and I think too sometimes even noticing again that soul sucking feeling of just the dread that dread factor of having to get up and go do, you know, again in the context of work but that dread factor of, oh my god, I’m dreading going to work today even if you know years before you really found a passion and a purpose in what you were doing. Those are the little signals and the signs that hey, maybe there’s something here to look into or be aware of. Almost feels like that’s not who I am, you know. Why would I feel that way I used to love doing what I did.

How Would You Describe Chronic Stress?

Emma:

Yeah! Interesting and I wasn’t aware of kind of the depersonalization aspect of it like just going through the motions I hadn’t thought of that as like a little bit of dissociation a little bit of like separation from your sense of self and your sense of purpose and again that’s another, like, I see things a lot of times for trauma informed lens and that’s you know trauma can be a form of chronic stress. It’s just interesting to see this overlap with the chronic stress. So, that leads me to wonder about like how does chronic stress cause this psychological state. I mean it’s a mind body state, it really is. Like, what’s going on in the body? What’s the body aspect of this or how would you describe that?

Dr. Laura Hays:

Yeah! Well, I think you’re correct in saying it’s a mind body state. I mean, you know the two are not they can’t be separated. There is no separation.  

Emma:

There is no separation. It’s not a thing.

Dr, Laura Hays:

Exactly! And also just, I guess before I touch on that, you know, these components of burnout, they’re kind of a continuum, right? There’s you can have all three components you can have more of one less of the other you might fluctuate between the three components so by no means is it a strict definition it’s really, you know, there’s some gray area there. But it’s more of a general concept but, you know, your mind and body are in constant communication with one another. And I think how burnout shows up is really in the form of chronic stress as the definition says. You know, chronic stress that has not been managed successfully. So, what does that look like? Well, you know at the physiologic level that looks like your sympathetic drive that is on all the time. So, I know you know this part but I’ll review it for listeners if it’s helpful in this context.

So, you know your body or mind senses a threat and that is usually from one of your senses your ears your eyes your anything around you. Your body senses this threat it’s happening automatically.

Emma:

And that could be anything from someone yelling at you to seeing a life and death situation in the emergency department or an email that says you have more work to do right?

Dr. Laura Hays:

Exactly! All of those could be a threat. Something that is triggering you. A trigger from any context and you know that gets processed through the amygdala, which is the part of your brain that processes emotion and then the amygdala interprets what it’s sensing and what’s coming into it and if it interprets it as a threat then it’s going to send signals to other parts of your brain specifically the hypothalamus and then the hypothalamus is going to start this cascade of neurotransmitters release that goes out through the autonomic nervous system telling your body to start preparing itself for this threat and basically kicking it into action in order to protect you. And you get signals sent to the adrenal glands which primarily in stress when we talk about the stress response we’re talking about adrenaline and cortisol, with adrenaline being kind of the first immediate hormone that is produced and starts making physiologic changes to your body. So, speeding up your heart rate constricting certain blood vessels while dilating others so really just preparing your body to do something,  preparing you for action to overcome that threat and then once your body senses that threat is still present and is still there and you need to stay in this mode of action or doing something that’s when the cortisol release starts to happen which again has all kinds of effects on your body similarly in protection mode but it’s really designed to help you move help you do something, help you stay in action. So, when we think about acute stress, we just take that picture of that process happening acutely it’s fine. It’s doing what it’s supposed to do there’s nothing wrong with that process and yeah, I like to tell people you know, it can be helpful at times that’s what helps you get out of bed in the morning, it’s what helps you put one foot in front of the other when you’re a little frightened to do something or get out on stage or give a presentation or ask somebody on a first date. You know, it’s that sympathetic drive that’s pushing you that acute stress so that’s good and that’s not bad for us but it’s when that cycle is not dampened down or it’s not settled ever and it stays constantly running in the background pretty much at all times. That’s what leads to chronic stress and then that’s what becomes detrimental to our physical bodies and all our mind as well and then that’s where that burnout comes in.

How Burnout And Chronic Stress Show Up

Dr. Laura Hays

It’s this chronic stress or this even low-level heightened response if you will in the sympathetic system that never goes away and when you are dealing with that even if you’re not realizing it which a lot of us don’t, that’s when those components of burnout can start to become a little bit more obvious and I think you know, we can think about these formal definitions of burnout and they’re helpful for sure but a lot of times in reality burnout and chronic stress are going to show up for people as changes in their mood, irritability that was a big one for me, I found that again especially going through COVID when in the very beginning when things were really, really hard and you know, we didn’t, I mean, my husband and I reminisce now thinking back on how we would, you know,  you’d have to change out of your scrubs shower at the hospital, put your scrubs in a bag. I mean, we were so terrified of this and during those really heightened times I was very irritable and I did not recognize that as a sign of stress or burnout for me but I was much more short-tempered more emotionally labile, I would kind of snap at my kids a little bit more than I normally would and have a lot more guilt and shame around that too. And that so that shows up for a lot of people for sure and then I think too like these self-sabotaging behaviors that we get into.

We don’t stop and realize what’s going on but maybe we go from drinking one glass of wine every couple nights to having a glass of wine or two every night when we get home from work just to decompress or you know or you’re just craving different things or you’re binging on things that taste good or feel good in the moment but then they make your stomach hurt later, give you the runs in an hour, you know but you just sort of like you kind of ignore those things.

But again, I bring up to say that those can be your signs of burnout if you’re starting to see those things.

Emma:

Totally, yeah. one of the first things I noticed when I start to get stressed is a change in  my eating and I just started learning about how the cortisol release actually triggers, correct me if I’m wrong here I’m not a doctor,  insulin. It triggers insulin. So, your body can mobilize blood sugar which makes your blood sugar drop which makes you crave more sugar, which makes you like get on this like roller coaster of like blood sugar basically. Is that right?  

Dr. Laura Hays:

Yeah that’s basically right. And that’s why you know these chronic states of high cortisol can lead to weight gain, diabetes, exactly metabolic syndrome. And it’s interesting, this is kind of a side comment but when you when you think about people who work night shifts or parents who are up all night with their kids, their little kids, and then your sleep gets all messed up and your cortisol levels are fluctuating in a very different way than if you’re on a normal day night schedule, right? So, then you start to realize like, why am I like, I’m so hungry all day.

Emma:

I just want to eat all day just to get a little bit of energy or something.

Dr. Laura Hays:

Exactly and you start going different things and you’re wanting sugar and more sugar and that’s when you know people start to see a little bit more belly bloat or they might put on weight. I saw that in myself when I was when I was in different phases of my career where I was working more night shifts for example or again, having little babies where I was up most of the night and messing that up. I know, yes.  

Emma:

Sounds exhausting. I mean I’m just tired like just managing my kids but I don’t work nights and I think, you know, the other thing I just find all this stuff really interesting but the circadian rhythm has a direct interaction with your cortisol level. So, there’s this cortisol awakening response that comes usually in the mornings but if you’re working night shift it’s going to be like, your body’s just like boink, boink, boink like all over the place.

Dr.Laura Hays:

Exactly, just adds another additional component to all of this.

Emma:

Seriously. Seriously.  So, people who are experiencing burnout they’re going on to see a lot of stuff going on in their bodies and you just described like yeah more lability, more irritability, maybe more cravings, maybe more unhealthy coping strategies, and I would imagine also people feeling tired like emotionally tired or physically tired or having a hard time sleeping or sleeping too much I mean like just a lot of these physical symptoms, right?

The Practice Of Being More Mindful During The Day

Dr. Laura Hays:

Yeah, for sure well and I think the sleep thing comes in a lot to where you know, a lot of people struggle with they lie down at night to go to sleep and that’s when the racing thoughts in the mind starts to work and for a lot of us that’s because that is the first time all day that you have stopped that physical activity has ceased for the day. You’re not managing physically the things around you and you’re finally lying there your body is still but your mind is, now your mind, I think, I describe it like a little hamster on a wheel. It’s like soon as you lie down the hamster wakes up, perks up, its little ears perk up and it’s like I’m ready to run and it runs over and over again on that wheel. And there’s a lot to be learned from that and that definitely happens with chronic stress and burnout where you are so physically and emotionally exhausted but then you lie down and go to sleep at night and you can’t sleep because your mind won’t stop. It won’t rest and you know,  and in that lies the practice of being more mindful during the day or making time to pause take those moments where you can actually give your body your some physical rest let your emotions settle down sit with your mind, let that little hamster run just a little bit.

Emma:

It doesn’t keep piling up.

Dr. Laura Hays:

Exactly! It’s not just saving it all up for later.

Emma:

And I think I’m really interested to talk more about this. I think, as we look at our body sometimes we think, well, I’ve got to kind of go to war against my body because my body’s all stressed out at night and that’s bad and I need to make my body be quiet and it’s like, actually, if you look at this like the reason like you described that hamster turns on, our body and our mind have a natural ability and desire to resolve stress. Like, we’re built to get that sympathetic activation and then to relax. We have a parasympathetic response but if we stay in the alert or activated state all day, all day, all day; our body is just like trying to like, okay can I turn on that like let’s process these emotions, let’s process these thoughts, let’s process these body chemicals and it’s like, nope, I’m staying busy, busy, busy, busy, busy. Okay, I’m laying down and your body. Your body is like, okay I guess now’s the time. I guess now’s my chance to like process through these emotions and turn on that that response. But first we have to process through them.

Dr. Laura Hays:

Right and that’s the key and, you know, and the people who are listening and they’re thinking, well, I actually fall asleep pretty well but then I wake up at two in the morning and that’s when my hamster starts.

Emma:

That’s me. I can fall asleep great but three to five that’s a tricky time for me.

Chronic Stress Does Not Have To Be A Major Life Stressor

Dr. Laura Hays:

Right and you know, sleep is very nuanced conversation but that for a lot of people that is part of it. They’re not completing the stress cycle before they’re lying down to go to bed and I don’t know if you’ve read the book Burnout, there’s one of many but it’s by the Nagoski Twins. I may even be butchering their names. It’s Emily Nagoski and her twin sister, I can’t think of her name right now. But the book’s called Burnout. It’s a great book and I highly recommend it but they talk through this concept of completing the stress cycle and how as you just mentioned, like, just because your body’s tired and it’s a certain time at night where you know you’re ready to go to bed physically it doesn’t mean that your insides have completed that stress cycle and so, how do you do that well, it’s hard. You know, it’s hard to do that but I think some of the things we mentioned of being more mindful taking pauses throughout your day, doing some check-ins with yourself, taking inventory and I’m happy to talk a little more on that that’s kind of my little golden tool. But then also having ways to complete the cycle so you get home from work and you maybe engage in some physical activity. You get some of that. You kind of let that sympathetic drive finish out. You have some release for it maybe you go for a walk or you get outside in nature or you come home and you hug your partner or you hug your kids or you call someone and you have a, you know, you have an emotional or social connection with someone. Those are things that can kind of trigger the parasympathetic to start turning on and telling your body, okay I’m in a safe place. I’m home, and I can start settling down. Okay, sympathetic drive you can start to turn off now. Then certainly breathing and things like that that we can talk more about.

Emma:

Oh!  I love it! I love it and one of the things I want to highlight for listeners is I think a lot of people think when they think of chronic stress, they think I need a vacation. That’s what they think they need and while vacations can be helpful and like getting a perspective can be helpful. You laughed a little bit. I want to hear what you have to say before I say my part. Go for it.

Dr. Laura Hays:

No, I was just thinking I would never turn down a vacation but of course, I mean, it’s sort of I mean if you’re not processing or managing the stressors then the stress can be mitigated a little bit but it’s not going to go away. I mean that’s you know when you think about the stressors versus the stress so the thing that’s stressing you out versus the response in your body that you’re having to it. Going on vacation can make the stressors go away for a little bit but that stress is still working through you and most of the time when we go on vacation when we come back, maybe we can gain some different perspectives and I think there’s some if you do vacation, well, you know and you practice some of these other coping mechanisms then great, you may come back and have a different mindset but that’s why I laughed because I thought, oh vacation never turn it down but it does not solve all that’s for sure.

Emma:

Yeah, that’s and that’s the thing that’s really important. So, if I were to if I were to think about this right it’s like, what I love about what I hear you describing is you’re talking about a sustainable approach to managing the stress response in your body day to day, moment to moment and when people think of a vacation it’s like, okay, what I’m going to do is I’m going to be stressed out and tight for the next four months and then I’m going to take two weeks off and then I’m going to be stressed out and tight for the next four months and it’s like if we were if we looked at like physical health that way, that’d be like I’m going to sit on the couch and eat potato chips for four months and then I’m gonna go to the gym for two weeks and then I’m going sit on the couch and eat potato chips for four months and then I’m going go to the gym for two weeks and they’re like, why aren’t I healthy I do 600 workouts in two weeks. Like that’s just not how not how it works so when I imagine chronic stress and burnout I think of someone being in the like I’m visualizing like if you’re in this like safety state this parasympathetic state and then you get activated during the day and you just stay activated, activated, activated all day and then you go home and it’s like this cliff and you’re not really like processing through. Then you’re just kind of doing this this cliff thing where you’re stuck in the activated state all the time and it sounds like what you’re describing is like, okay let’s practice regulation throughout the day like nervous system regulation throughout the day to manage chronic stress instead of like escape.

Dr. Laura Hays:

Yeah, well the other thing too is you know chronic stress doesn’t have to be major life stressor. Of course, those happen. People lose you know people lose their jobs, they get divorced, they die, tragedies happen. You get sick. Your kids get sick. All of these things that seem obvious but the majority of us dealing with chronic stress it’s more indolent than that it’s those hidden stressors it’s the never-ending to-do list. It’s the mental load that we bring to bed with us every single night it’s you know, the managing maybe a sick family member or getting older realizing that now you have to start worrying about your parents as well as your kids. It’s all of these little things that we feel like we’re managing well and maybe we are to some degree but I think that’s where you have to just be a little cautious of saying, well, I feel like I’m managing it well but actually I don’t really sleep that great or actually I’m waking up at two in the morning every single night or, you know, again kind of recognizing it and to me that all starts with being a little more self-aware and valuing yourself enough to say I’m going to get to know me and I need to be able to start to recognize my own triggers. I need to recognize my own body’s warning signs and signals that it’s sending me. And then you can start to take on some of these practices on how do you get, like you said, how do you get down from this high that you’ve had in your nervous system, you know, all day or all week or all month or all year.

Emma:

So, how would you describe that like if we were talking about it and I wish we had like hours and hours to talk about this but if we were to coach someone, an emergency physician or someone who just has a stressful job or a mom whose kids like are always needing her and she’s afraid they’re going to get run over in the street in front of her and they’re like you’re constantly like, I got to make dinner and I got to do all these things and it just feels like this chronic stress. How would you coach them like, what would you what would be the steps you’d encourage them to do with the practical actions you would encourage them to take day-to-day moment to moment to help manage that chronic stress.

Action Steps To Help Manage Chronic Stress

Dr. Laura Hays:

Yeah. So, good question. I think the first thing is recognizing that this is not something wrong with you. It’s not a problem. It’s not something that’s off with you, especially when we think about burnout you know, there’s some personal component to that but a lot of burnout really stems from systematic issues and systemic issues I should say. But, you know, issues within the workplace, issues with all of the, again, mental load stuff that you’re managing and dealing with throughout the day. So, I would say that’s first is recognizing there’s not something wrong with you but let’s figure out how to help you get through this. And again, knowing that you’re not alone too. I think it can feel really isolating especially when you’re going through chronic stress you can consciously acknowledge that other people deal with stuff but it’s really hard to see beyond your own stuff when you’re really in the thick of things especially when you’re in that really in a state of burnout you really do feel very isolated and alone. And then so, I think for coaching somebody or advising someone and what I would tell my partners or colleagues is recognize and remind yourself that there are things that you can control. When you get to this point of chronic stress or burnout you may feel like you have lost control of everything and as humans, we like to be in control and so, reminding ourselves what can we control. We can control our breath. We can stop take a pause and we can use our breath to our advantage. We can control our movement. We can choose to move our bodies. We can choose to incorporate functional fitness or physical activity into our day. We can choose what we put into our body and into our mind. So, sometimes it doesn’t feel that way but we can control what we’re saying to ourselves, our negative self-talk. All of that stuff, our mindset.

First and foremost, you have the ability to just pause and then choose your response to any situation and that’s really where that mind body connection comes in and this mindfulness work and again, it’s for me, it’s probably just starts with taking a pause. We have this podcast episode that we did on our podcast, I think it’s in our self-awareness episode where I tell the listeners to stop for 30 seconds, no matter what they’re doing even if they’re driving just keep driving but just stop for 30 seconds and just breathe and just notice what comes up and your body. That’s a typical mindfulness practice and that’s a great place to start and if you have a hard time just sitting with yourself for 30 seconds that’s okay. It’s not bad but that’s probably a sign that you might benefit from doing that a little bit more often. So, I think that’s a great place to start is just stopping,

Pausing, taking a breath and then from there you can increase that 30 seconds to a minute or five minutes and you know, these breathing practices don’t have to look like formal meditation or you know, they don’t have to happen at a certain time of day. It just gives you a moment to stop and then tap into your physical body and what your mind’s doing at that time and start building that connection so that you can, you know, you can manipulate it to your advantage. These things happen automatically like we discussed earlier but you can influence them for sure by things like breathing and movement.

Emma:

Absolutely and it makes like, if you look at the kind of the allostatic load like, basically the total amount of stress that someone carries the whole day if instead they go and they get a little activated something stressful at work and then they breathe and they slow down, then they’re down here for a little bit and then they maybe climb back up and breathe and slow down and they’re down here. But you look at the like this sum amount of stress under that chart, I’m imagining this line graph here in my head. There’s like a lot lower, like less minutes stressed during the day. Like, your body is less stressed out and it gets a chance to process or it gets a chance to move some of that cortisol out of your system, right?

Dr. Laura Hays:

And it’s a practice. So, I mean, you wouldn’t go out and expect to hit a home run at the World Series if you’ve never swung a bat in your life. So, right. And as humans, we tend to be harsh on ourselves and if we don’t get it right first time we think we’re a failure. So, this is where some grace and self-compassion can come in as well but practicing these things takes time and the more you practice, the more you’ll really reap the benefits and start to feel different. I mean, these things work. There is some scientific basis behind breathing and deep breathing and doing some parasympathetic stimulation and I mean that’s real stuff you just have to allow yourself the time and space to do it

Emma:

Yeah, for sure for sure. I’m absolutely positive of that and you know our parasympathetic response can be strengthened, like our ability to get activated can get strengthened especially if we get stressed out all the time we get really good at getting stressed out but the more you practice that parasympathetic response the stronger that parasympathetic muscle basically can activate that vagal tone.  

Dr. Laura Hays:

Yeah for sure I mean, for me when I think about when I’m the most, when I feel that real rush of adrenaline particularly at work, if I have somebody coming in and it’s a really difficult case and I’m aware of it. I’ve heard the medic radio chime in and it’s a let’s say it’s a pediatric cardiac arrest, something that’s really stressful. Then I know, as I’m prepping the room and my team’s coming in and we’ve got all the necessary people there, I can feel it’s a natural response. Like, we said, you know, my inside start to rev up. My heart rate goes up. I get goosebumps. I get a little gurgle in my stomach and I start breathing a little a little faster but I have learned that I have to control that I have learned that throughout my career because if I can’t control that in that moment if I can’t call upon the tools that I’ve practiced that I can use to slow it down then I’m not going to be effective. I won’t be able to communicate with my team and I ultimately won’t do the right thing for that patient. So, just to the point of practice, so, I practice my breathing. I practice my mindfulness. I mean, as you know I’m a yoga instructor so that’s been a big part of what has helped me get through those stressful times. And that’s an extreme example but I can tell you that I’ve practiced long enough now. I don’t get it perfect every time but I’ve practiced it long enough now where I can abord it. Pretty much immediately. But then I have to let it go somewhere after you know, and that’s kind of that finishing that stress cycle like we talked about so, you know there needs to be an outlet for it later but I can control my breath at that time to bring myself down which is which is great.

Emma:

It sounds, I really appreciate you sharing that and I think of myself as a mother and seeing situations like that and it’s like, wow, my heart like is so sensitive to as a mom that it’s hard to manage those emotions. Would you consider, like your response, as you as you describe doing that. I’m just curious would you describe that as kind of like. white knuckling it or gritting your way through it or would you describe that as regulating your way through it or is it a little bit of both with an ER situation? 

Self-Regulating Is A Learned Response

Dr. Laura Hays:

I think it’s regulating but again I think that takes time and it’s a learned response. Probably in the beginning it was a lot it was more white knuckling and trying to get through it and just staying trying to tell yourself just be focused just be focused.  

Emma:

Like compartmentalize put that in a box and put it into the store room with more boxes.

Dr. Laura Hays:

Exactly and over time I think it is more self-regulating and again that just comes with practice. Now, there’s definitely still some compartmentalizing that goes on because there’s a lot of emotion that comes with those types of cases of course but I think that speaks again as I said it out loud, I think well that’s really speaks to the practice of it because it changes over a career over years of having to be in that situation and yeah it seems very more regulated to me now than it does to be just a grin and bear it type of reaction yeah more of a controlled response if that makes sense as opposed to a reaction

Emma:

I really appreciate you taking like yeah exploring that because I think there are a lot of people who can like get through stressful situations but not in a sustainable way and what you’re describing is a sustainable approach to regulating your body in the middle of a stressful situation. You’re not escaping the situation and you’re not avoiding it in your mind. You’re not just stuffing and suppressing those emotions. You’re regulating through those emotions and of course, with these big situations you’ve got unpack them, sometimes later you got to debrief them and work through them and process them, I’m sure. That’s really cool really really appreciate that do you have any other like tips or suggestions on how people, so the first thing I noticed you said you got to be aware you got to stop distracting yourself and being so busy all the time you got to be aware of what’s going on in your body. Second thing would be take a breath be mindful be present. Anything else you’d recommend to like help turn on that parasympathetic state or that sense of calm.

More Recommendations To Turn On The Parasympathetic State.

Dr. Laura Hays:

Yeah, so, for that specifically some things that we talked about already but that emotional connection. So, you know hugging people, hugging especially if you’re a parent. Sometimes I tell my daughters, sometimes when I hug them, I’ll just say out loud to them, this is the best feeling I’ve had all day because it does something. It creates hormonal shifts within your body and it really fills you up and it really does activate that parasympathetic. So, you know, finding an emotional connection or social interaction certainly as we mentioned physical movements. The other thing that I do that’s kind of a simple practice that I recommend to people and people can try it or not, I used the term earlier take inventory. So, I’m glad we could kind of come back to that. So, it’s something that my husband and I practice that we got into over again the last few years when we started recognizing, hey we’re feeling a bit burned out or a lot burned out and how can we start how can we start gaining control over our lives again and over what’s going on in our world in our place in the world around us and so we use this term take inventory and it’s really just taking a moment to assess your short-term situation, your kind of midterm situation and your long-term. So, what I mean by that is, you know, take a moment throughout your day where you short-term okay, how does my body feel right now?  And that’s that mindfulness piece. It’s sitting, pausing for 30 seconds, and saying, how do I feel like, are my shoulders up to my ears? Okay, if they are, can I just like pull them down a little bit. If I’m like super slouchy like, sit up tall. And again, without judgment, let’s just see what’s going on physically. And then in that moment you can start being more mindful and a little more present and then you move into that sort of midterm inventory which is okay, now that I’m here now that I’m present for this moment, I’ve checked in, what’s stressing me out right now like? And it’s not about adding more tasks or running through your to-do list, it’s all right what am I feeling right now and if I’m feeling stressed like what’s the primary cause of that right now or what’s currently sucking my soul? What’s the thing?  And then the longer term is okay, now what do I need to do to deal with that? like what do I really want and what small changes can I start making right now that are going to have the greatest impact?

And I say it sort of flippantly is this taking inventory but it’s really just about stopping, pausing, noticing how you feel. Noticing what’s showing up for you and then doing like a check-in. What’s stressing me out? What’s sucking my soul? All right, now that I’ve identified that, what are some steps I need to take to just make this a little more manageable? How can I engineer my life a little bit differently today so that it’s more manageable. And you know, a lot of people listening and I talk to patients all the time about all kinds of things and people and friends and myself I’m sure have been guilty of thinking or saying this, they feel like, well, I don’t have a few minutes to pause. I’m so freaking busy that I do not have that time and to that I say we all can take a pause like I don’t accept that answer. I don’t accept it for myself. Even in those moments and again I talk about this in one of the podcast episodes about this these stressful moments of being in the ED. You can always take five or 10 seconds to pause. You can take five or 10 seconds to get yourself together to take a breath, to check in, and to decide and choose your next move and do it when you’re in the bathroom. The bathroom is probably the one place of solace that we all can find in our busy day. Now, as a parent we all know sometimes you cannot even get to the bathroom without being disturbed. However, it sort of is the one place though where if you even lock the door people kind of understand. Oh, all right. Well, she’s going to the bathroom you know and they just give you like five or 10 minutes. So, instead of bringing your phone to the bathroom which is what the majority of us do, you’re like, oh I got five minutes I’m going to go to the bathroom I’m going to check my email I’m going to look on social media? You’re in that autopilot mode. next time maybe don’t do that and while you’re sitting on the toilet or even after when you’re washing your hands, like, look in the mirror and just take a moment to just take inventory just a minute, two minutes you know and you’ll start if you feel different when you do it it’s just getting yourself to get into that habit and that practice of doing these things.

Emma:

Yeah, I really like that I can see how that could be applied in so many levels like as a mom I think about some of the like the area I’ve been kind of working on right now with my family is the car like when we’re in the car. I’ve got four kids there is often like messes and fighting and yelling and people can’t get their seat belts on and other people are on clicking their seat belts and I’m like ahhhh! Stop it and my initial reaction is to like yell or do something because I’m like driving and I can’t get my hands on them and so if I were to think of your inventory it’d be like okay in the moment, I’m going to like slow myself down it’s not an emergency. I can breathe and then in the midterm I’d be like okay, we’re going to stop the car until everyone has their seat belt on or until you guys stop hitting each other or until we solve this problem amicably and then the long term this is the area that I haven’t quite gotten to but it’s like the next thing on my list, is like okay we’re going to have like family evenings where we sit and talk about car rules and we’re going to educate the kids and we’re going to print up car rules and tape them on the seats and every time like we’re gonna do a star chart and we’re gonna so like creating a system to prevent like the long-term problems that we’re having and I like this idea of like taking inventory, like short-term, I can’t make a new rules list for the car I’ve just got to breathe. Midterm, we’ve got to get to where we’re getting can we do it calmly and long-term, can we make a system that’s going to be sustainable for our family to drive places.

Dr. Laura Hays:

It’s perfect. Yeah exactly.

Emma:

I like that. I like that a lot that’s really helpful. So, that’s really cool.

Dr. Laura Hays

I’m sure I can relate to your example too for sure the chaos the constant chaos of trying to herd cats which is moving your children trying to get them to do anything.

Emma:

My four-year-old’s line lately is I’m too tired to buckle myself I’m like no, like, just do it like, you can do it.

Dr. Laura Hays:

Oh that’s awesome. That’s funny.

Emma:

Well, ell awesome well thank you so much. Like, I’m so like it’s so interesting to hear your experiences and to learn from you and I feel like you have so much good stuff to share so thank you thank you so much for taking the time out of your busy schedule to be here today and share that with my audience really appreciate it

Dr. Laura Hays:

Thank you. This was great. I was telling you before we started recording I think that I love these types of connections and you know just getting to meet and talk to all kinds of people and it’s awesome. Good for your wellbeing, social connection we’re doing it right now. Perfect practice

Emma:

Totally, okay and then just tell everyone where they can find you and a little bit about your community or your course resources options what people can do to find more about what you do.

Dr. Laura Hays:

Yeah, thank you for that opportunity. So, first and foremost we have our own podcast it’s called Lasting Impact Wellness and it’s available on Spotify and Apple and through our website as well and our website is lastingimpactwellness.com and my husband and I,  we have a health coaching and consulting company where we meet with organizations about how to improve their well-being from leadership all the way through and so we’re really excited about the work that we do there and you can go on the website and learn more about that and a lot of the things that we talked about today in a little more detail we have some podcast episodes about that stuff too so but yeah and we’re always excited to talk to new people so you can email us at info@lastingimpactwellness.com and will certainly respond. So, thanks again yeah this was great, Emma, thank you

Emma:

Yeah, really appreciate you being here so yeah okay well we’ll talk to you again some other time I hope.  

Dr. Laura Hays

Yeah that’d be great. 

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