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The cost & courage of caring - stories that spark resilience.
Welcome to the Caregivers Podcast today.
The most important question that's come to me as we've developed the podcast and thought
long and hard is that how do we ensure our self-care in the process?
And that'll be an overarching theme that keeps coming back and is really probably the most
value added uh element of this wonderful platform for an amazing conversation today and in
conversations to come.
So I'd like to introduce our first guest.
is an honor to have you with us.
Bev Blaney.
uh Bev comes from a broad background of caregiving.
She's in fact a caregiver of the caregivers, if you will.
Bev has a long history as a psychotherapist, trained broadly across numerous dimensions,
which she may share with us during this conversation, but at the same time uh has been
involved in pediatric care, but also in the care of undergrad medical students,
postgraduate students and professionals.
She brings a lot of experience to the table, to this discussion.
And the goal here really is to understand it from her perspective and not only to
understand what she's learned, but what also drives her caring.
Because the most important thing that we can understand from these conversations today and
the many to come is that there's a common thread, there's a common denominator, it's
caregiving.
And there's something to learn from each other about how we care and how we give and how
we give back to ourselves.
So without much further ado, um Bev, welcome.
It's ah so befitting that a caregiver of caregivers be our first guests and we'll start
from there.
So is there anything you wanted to say as we kick this off?
Well, first of all, m thank you for asking me to be your guest.
feel honored actually to be the first um and part of this whole thing evolving.
um
You know, I think it's sorely needed.
I'm glad you're doing it.
I think it's exciting and um I think it'll lead to lots of conversations about what does
it mean to care?
um I guess from my perspective, um what motivates me is um I care about living with a full
and open heart and establishing
genuine and open relationships with people.
I care about love and I think that is probably one of the biggest motivators for me
personally.
Great.
I think it's really important that we establish that for the person, for the people who
might be tuning in today and who really want to understand where this is all coming from.
So this is ah for the hearts of those listening, coming from the heart.
Tell me a little bit more about yourself and what brought you to this.
point where you decided that caregiving for the caregivers was really where you could make
such a big contribution.
m
think I've always been really interested in listening to people's stories.
It's always been something that has fascinated me.
um I grew up in a beauty salon.
My parents had a barbershop and beauty salon.
And I spent lots of summers helping my grandmother, my mother.
um Just through that whole process, we had this wonderful...
um
business where all the women from the neighborhood would come and they all had their
appointments every week at the same day in the same time.
So I got used to listening to people's stories.
And so I think that's what initiated it.
I've always wanted to do the work I do.
I guess I would describe it more as a vocation than as a career or a job.
It's always seemed like the most important thing in life was to really be connected with
people in a deep way.
And um I spent a lot of time pursuing a number of different avenues for training.
I was fortunate enough to get a job in an area that I was very interested in.
As a psychotherapist, I worked at Hotel Dew and um
I worked initially with adults and with adolescents, but later sort of focused more on
working with adults and in private practice I worked with um adults.
uh I was given an opportunity to work for the School of Medicine, which I...
I love doing.
um I was asked to provide psychotherapy to medical students and residents and medical
staff was a bit later.
um But that was done under the School of Medicine.
I did that for several years and it really allowed me to develop, I think, a pretty wide
understanding of what's required of that field.
different than other um fields.
And so I was really happy with that opportunity.
um Dr.
Smythe and I also developed a mindfulness course that we taught for them as well that we
offered to medical students.
We did that for a number of years and I think I was told that it was very helpful.
Most of the residents and the students seemed to enjoy it.
And we did that for a number of years.
And then I've been seeing medical doctors probably for over 10, 15 years.
And so I really feel like I have a good grounding in the field itself.
And then having worked in hospital as well really broadened that for me as well.
So yes, that's what brought me into this and got me here.
It's so incredible and uh befitting of the cause because, you know, we're talking and
looking forward to developing new ideas and pathways regarding caregiving and self-care.
But whatever we learn today has to be adapted to and brought to the next generation.
Thinking of it in a vacuum today of what we can do now and not thinking about the
generation that come or the generation that just started their first year of
um be it medical school or nursing school or occupational therapy, um whatever, um using
the medical model as an example, there's so much that can be brought to the next
generation to ensure their success based on what we learned today.
So it's really nice to hear that you bring that experience with you.
m
having had a chance to exchange ideas and to share and advise across such a wide span.
So tell me a little bit about what you care about the most today, as opposed to perhaps,
you know, years back, there's been an evolution.
You must be caring, there must be something that really sort of hits home today and that
is the focus of your caring.
I think I'm really struck by how much people struggle just trying to get through their day
and to live their life.
think it's, I think this is a really difficult time for a lot of people.
And so I'm really interested in helping people begin to evolve their story, their self
narrative in a way that is
relevant and meaningful to them.
um
I really find people really a bit lost and you know the whole question about burnout and
all of that.
I think some of that speaks to the fact that people really do feel quite lost and are
really sure about how to move forward.
It's interesting that you bring up that idea of lost yet, you know, the pathway towards
getting to square one in many elements of caregiving is methodical.
It's well thought out.
It's ah process oriented.
People are really on their game when they're given a shot to involve on training in a
career to be free to healthcare providers, for example, or other forms of caregiving.
Yet suddenly we find ourselves lost.
It's as though everything that worked before suddenly doesn't work anymore.
So what have you learned about those elements that fuel that sort of sense of being lost
and maybe directionless?
Or maybe it's a question that the old tools aren't working anymore.
And what tools do I, as a young caregiver in training, need to now turn to to inform
myself and to...
hopefully ensure my longevity through a career I've made a big commitment to training
towards.
You know, I don't think that it doesn't surprise me that we are sort of in this state of
crisis.
And it's interesting because I quite recently had a number of people reconnect with me
that I haven't seen in, you know, probably six or seven years, some and in one case
longer.
And, you know, they sort of came with the question of I don't
know whether I'm burned out or I don't know what's wrong with me, but I'm just having
trouble getting through my day.
To some extent, I think that this is bigger than just the individual.
I think there's all kinds of things around us that are sort of falling apart, that are
changing or evolving, however you want to think about it.
um A lot of our institutions are struggling, but also are
people's belief in the institutions have actually been quite compromised.
I I think we're sort of at a point of crisis in a way.
Everything that seemed clear and obvious has really been scrambled for people in general.
I mean, it's to the point where you can't you know.
It's going to be controversial, I'm sorry, but like even questioning whether you're a man
or a woman, like that's such a profound level to be uncertain about.
so and I see it reflected across our institutions.
Schools are not actually teaching what they were originally intended to do.
I'm really concerned about some areas of medicine are
not maybe providing what they maybe originally were set up to do.
So I think there's, you know, it's sort of on a number of levels, I guess.
You know, I see it on a personal level, but also our culture and that's reflected in our
institutions as well.
It's a time where people have, there's a lot of uncertainty and not much um
shared meaning for people.
It can't depend on the old values or opinions or assumptions or whatever.
And so
In some ways, I think we're all trying to find our way into some kind of sense of purpose
and order and meaning.
And at the same time, a lot of things that may have provided that to us at one time seem
to be collapsing or being reorganized or reimagined, if you like.
um
It seems to me, sorry, just something that jumped out, but it seems to me like with all of
these competing levels of importance that draw us to give attention to and require us to
give attention to, we can appreciate how the sense of self and our own positioning within
ourselves and our own self-care and our own ability to look after ourselves amidst all of
these competing...
requirements for our attention, for our thoughtfulness, ah be they conceptual, be they
individual, be they our patients, our clients, our causes, that there's something uh about
just the competition for our attention and our bandwidth for so much we need to think
about that just doesn't leave very much for ourselves.
And I wonder if that's what's fueling the sense of loss.
It's that depletion of ah
our span or our capacity to uh leave a little bit behind for us to nurture and to build.
And from that comes resilience, yet we don't really feel that empowered in doing so.
So let me spin this a little bit.
Why did you want to be a doctor?
What was it that threw you into this?
When I look back over the years, and what's interesting is that um I didn't necessarily
have this sort of story behind me that I knew when I was two, I wanted to be a doctor.
It was actually something I grew into.
uh I enjoyed the health sciences, but when I look back, uh I always was a good listener.
um
and I was someone that people wanted to talk to and that informed a lot of my experiences
through various formative requirements that go back to high school, that were involved in
giving on oneself and engaging with community and what have you.
And it sort of guided a path towards, you know,
combination of interest in science and physiology and medicine and that ability to listen
and to give and it just sort of all kind of melded together.
By the time I was in college, that sort of seemed like a direction that really felt right
to pursue.
medicine?
Why medicine?
That's a good question.
That was a long um also when you asked that question.
um It just sort of flowed in that direction.
It was uh obviously a big challenge and it was something to aspire to at the time.
And for me, it seemed like the right fit.
For me it's a little easier.
There was someone in my background who was Dr.
Roger Billings who was ages ago that he would have been involved in Kingston Medicine.
And I met him at the barbershop and he was listening to me and he sort of slowly
introduced me to the idea of therapy, psychotherapy in particular.
so there's some common elements there.
We're talking about listening and wanting to be helpful, but how does medicine...
In your mind, allow that to happen like the institution that you work in, where does it
provide opportunities for you to actually be able to listen to people and actually be able
to care for them?
So, you know, that's really interesting is that, you for me, it's always been such.
an outlet for giving.
um I think it's a natural outlet to give.
It's also a natural outlet to give more.
And then when you've given the most you think you can, probably give a little bit more.
um But when time affords it, it has afforded unique opportunities to make a difference.
Like what?
To actually listen at a more granular level than just what's the symptom.
but what's the symptom experience?
How does the symptom make you feel?
How are you coping with the symptoms?
These symptoms are chronic in the chronic disease setting, which is a large area of my
practice.
And how are you dealing with the chronicity?
Some of the most rewarding experiences I've had actually more recently in my career ah
stem from times when there was a lull in clinic.
And I was able to explore and actually recommend some books and really take things to a
level.
And I still remember hearing one patient say, wow, this is what it's supposed to feel
like.
I was like, this is great.
I wish I could do this all the time, but we took advantage of a lull in the schedule and I
had some extra time and I'm really glad we got a chance to do this.
I think we're witnessing
an erosion of that ability that's palpable and very tangible, we can almost taste it.
ah We're speaking today to large swaths of listeners who come from different backgrounds,
maybe practicing or caregiving on different continents, each with their own flavor uh
locally of requirements and...
jurisdictions and uh organizational mantra, if you will, that will definitely affect that
ability to listen, that ability to give of yourself.
uh I've been fortunate in my medical career to uh be able to uh craft that listening
skill, but also find the time for it, probably on occasion.
uh
means running a little bit late, but I've always tried to explain to my patients when it's
your turn for me to run a bit late for you, I'll do so.
Thanks for your patience today.
ah But it's...
um
What do you think that's sort of an ironic piece here that, you you went in wanting to
listen and care, but you have to have a lull in the day so that you can actually be able
to do that.
I mean, I understand you're not working as a psychotherapist, but certainly a lot of
somebody seeking care from you is going to, they're going to want to know that you hear
them and that you understand them.
You're not just
Like, obviously you're treating a specific year's self-specialist, right?
So you are sort of have an exclusive focus.
But people's, need is still, they want to be known, they want to be understood.
And I'm not sure that our institutions are actually allowing those kinds of relationships
to develop.
I know for me personally, at the end of my career at the hospital,
And I love my job, I absolutely loved working there.
I never was at a point where I wasn't happy to be there until the last two years.
That's another story.
But, you know, it's like there was this push for getting more and more and more people
through.
And I'm not sure.
Like, what is the end game here that we have at these hospitals where
Is it to make money or is it to provide care?
Because sometimes those things are not going to be able to align together.
And that's a huge conversation that's being had around the world right now as different
care models and different organizational structures battle with some really important ah
realities.
People are leaving caregiving professions left and right.
It's not just physicians, it's nurses, it's uh allied health personnel, it's lots of
things.
you know,
To your point, I think when constrained, you have to really parcel what you can offer
during the patient encounter.
um You're required to use your skills to still listen and still um provide holistic
consultant care.
But I think the issue is that the Lull provided just that next level of ability to really
go somewhere.
And I think it was rewarding for the patient and also as a caregiver, was really
rewarding.
It was really rewarding for you.
I think I walked out of there and just sort of said, a lot of the thinking of the last
five to 10 years of my life is paying off in this moment.
um it's now something I've had the chance to, know, opportunistically take advantage of
when there have been lulls, but also incorporate into my practice increasingly and, you
know, finding those key moments to share.
a story or share uh a resource or what have you, which um I've really come to appreciate
and I look forward in the last third of my career to incorporating it into my practice
considerably.
Well, know, there's sort of like, we're sort of, there's so many things that we're trying
to do, right?
Like you, you're actually training young doctors about information they're going to need
to know.
So that's one level.
The other is that the patient needs service, right?
That's another level.
And then there's this sort of notion that we're supposed to be guiding people towards
health and wellbeing.
So I'm not really sure how much time we make for all of those things, but I'm quite sure
that most of the people who have come to see me for burnout have lost that sense of being
able to really connect with others in a meaningful way.
mean, you know, anybody can Google burnout, they can all see the symptoms.
So don't need to, it's not so much that I want to go into that, but it's more, I think I'm
almost of the feeling that the way we are offering care within the frameworks that we're
offering it are actually taking us away from really providing what we want to provide.
And I think that also has a really serious impact on the person trying to provide the
care.
I like one thing you said, you know, we're under constraints and I kind of understand all
that, but you know, why does, you know, nobody says that the military has to make a
profit.
Like we don't have people crunching the numbers to make sure that, you know, that we're
providing it with the most economical services, but there seems to be more and more, and
maybe it's just because of who is
doing most of the administration in my mind, they're not necessarily the caregivers.
They're not people who are actually interacting face to face with the patient or the
client.
Very often they're one step removed and they're says, we have to have accountability and
we have to make sure that the services are being absolutely the most effective.
efficiently used.
And I'm not sure that their goals and our goals necessarily meet up in a way that allows
us to do what we're really there for, but also that keeps us healthy and happy and engaged
in the work.
So it's, you know, I think there's some, I think we have to kind of look at how we're
delivering service and think about it.
we don't make the same demands from the military, you know.
Well, we are a family of caregivers, but your identification with family starts with self
and then what builds around it.
And as you allude to, are different layers or different, it's kind of like cousins.
um When you're cousin three times removed, you're still part of the family, but um you
need to have an awareness of that family structure.
And I think the same applies um with caregiving.
ah There are people at different levels making difficult decisions, but they're not
necessarily understanding or sharing the process they go through, the angst they may feel
in making them, even the sense of moral injury that they may need to.
The challenge I think is always that...
I think it could be leadership at different levels.
uh
be too hard on leadership because I know obviously we do.
Well, we count on them a lot and I've been fortunate to work with amazing leadership at
grassroots level in uh my division and our department.
You know, it's been uh a rewarding experience and I think we witnessed leadership that is
uh better able to listen than ever.
But sometimes these layers don't always talk to each other and um
you know, we eventually sort of function within the level of our own sort of microcosm,
even though we're all invested in the uh broader sort of zone of healthcare.
um I think what makes things a bit different for clinicians and uh in different fields,
and I said clinicians, that's not just physicians, but there is the patient we need to
think.
And the person who is closest to the patient is
the one who's engaged with the patient at the moment.
And that has a huge impact.
And when you talk about disconnection because of, or feeling lost is when you don't
understand why certain decisions are made, but you have a patient in front of you saying,
why is it like that?
It's very difficult to come up with an explanation that's authentic.
And I think that puts a lot of strain.
And we talk about,
you talk about moral injury, well, there's moral injury and then there's microtrauma.
I don't like the word trauma because it has big connotations, but there are these little
sort of hacks that work away and eat away at you, which eventually culminate in some
degree of uh moral angst in that you don't have the answers and that this is the way the
system is and you may not actually be able to inform a patient or if you're an allied to a
personnel client.
um about why things are the way they are.
But I can understand how that can start sort of the series of events that could result in
um disconnection.
Disconnection from your patient, disconnection from your cause, disconnection from your
why, the disconnection from your team, your co-leadership, your...
broader domain within the healthcare field.
And I think we see that a lot these days in op-eds.
We see that in social media where people are really trying to understand how this is all
interrelated, how we can reclaim sort of a sense of togetherness in our cause.
I think
Without that, we can very easily feel disconnected, as you said.
But providing care, I think, also comes from the ability to provide self-care.
you know, well, I mean, I think there has to be a starting point.
And because no matter what we do, if there's no longevity,
in the system and there's no longevity in the process.
And that starts with entry level individuals who are entering caregiving administration,
caregiving at the grassroots level, caregiving no matter where.
If you cannot um have something that fans the flame in the individual to keep it going, um
then um
we run into some trouble and the mere act of caregiving is not enough to fan that flame.
It's other oriented, we've, just like we've cut back in so many dimensions of holistic
patient engagement because of time constraints, I think we've actually done the same in
our own self care.
The biggest currency is time and time is something that,
we're not very good at finding anymore, especially when it comes to ourselves.
We may blow four hours every night doom scrolling on social media, yet we have no time for
ourselves.
And maybe we've taken...
taking the opportunity to rationalize that that time we spend doomscrolling is time
invested in us like we've earned it.
Well, I think there are a lot of arguments out there.
That's why people do them screw, although I think, you know, and it does sort of remind me
a little bit.
think one of the things I'd like to be careful about putting forward, in my opinion, is
this notion of, you know, self care that if somehow we.
just followed some regime for self-care that everything would be fine.
Somehow we've dropped the ball.
And it's one of the reasons why I started to feel increasingly uncomfortable about giving
talks about work-life balance to residents at the hospital.
For me, it just was this idea that
On top of everything else they're asked to do in a day, they're also supposed to be able
to do this component of balancing their home life with their work life.
And it just, you know, it felt like another burden to be placing on their shoulders.
So on top of everything else that we expected from them, you know, staying up all night,
being on call,
you know, having to study and pass all kinds of exams that they also have to be somehow
perfect at taking care of themselves so they don't burn out.
Despite the fact that there's been like endless amounts of research showing that in almost
every subspecialty there's a significant portion of
learners who are burned out even before they graduate.
And that's true across all fields, whether it's nursing or psychiatric work or the kind of
invasive work that you do.
Like there's just no question that
we're doing this and what is happening are connected.
And I'm, you know, everybody, I think it's a bit of a loss to give an answer for how do
you educate people to become doctors and yet at the same time have these healthy, happy
individuals.
And I'm, you know, I guess for me, I just have lots of questions and
You know, I'm somebody who likes to deconstruct things so that perhaps we can put things
together more mindfully and more in a way that does promote health.
And, know, it's always been one of the things I always said to medical students when we
would run the mindfulness course is that, you know, I don't think that you can
expect people to be able to really provide health care when at the same time you are
grinding them down and breaking them down.
So I think it has to be incorporated, not just self-care.
I'd like to see that woven in.
how people are being educated so that it's supported.
Like, I don't know, like have a course on it.
Not a course, because that's just one more thing for them to do.
But like even simple things, like when you have the residence lounge, what do you stock it
with?
Is it like coffee or is there actually food there where they could go and get some real
food?
Yes, the proverbial stale cheese sandwich of my past doesn't go very far and I'm pretty
sure it was processed cheese.
uh
I think there's a perfect formula for self care.
I think you just hit the nail on the head because as you say, it's not the perfect
formula.
I don't think there's a perfect definition for burnout.
I think that um there are subtleties and specificities underlying that term, which are
very individual and informed by individuals' experiences um and their mindset and...
um
It's just too convenient to just slop on with a big rubber stamp burnout, you know, next
file.
uh
different for different people.
Have you ever had that experience yourself?
uh I mean, you my experience with burnout uh was um I was trying to do too many things and
took pride in doing a lot of things well and amassed a palette of responsibilities that
culminated in my just, you know, hitting the wall and suddenly...
Why you were burned out, but what about how you felt when you were?
What was possible?
was that sort of notion of I didn't feel like myself.
I felt physically sort of disconnected from myself walking down the hall.
I remember an afternoon soon before I went on some burnout leave in 2019 where I was sort
of walking down the hall to clinic and just kind of didn't feel my arms next to me.
They were sort of floating as I took my strides and
It was kind of like that moment of, whoa, there's something not right here.
I know when I experienced it, I couldn't think clearly.
Like I was okay in a session, but when I had to write the note, like I'd write something
and then do some, come back and read it.
And it just wouldn't even make any sense.
So it was...
You're right.
There are, so many different levels and here's the funny story.
So when I finally decided that I was going to take some time off, which I was encouraged
to do and had the full support of the leadership team around me.
And it's part of, you know, part of our practice plan to be able to do so.
The date for my burnout leave was about two weeks down the road.
So I made sure I finished everything I needed to do and, you know, chair into the desk,
desk all cleared.
Everything's ready to go out on burnout leap.
uh I look back at it and I remember sort of how pleased I was with myself that I leave any
of my colleagues hanging.
ah And, you know, it's one of those special memories.
uh But it's also um tagged with the memory that I had my colleagues support and there were
no repercussions and I came back stronger than ever.
And uh...
me, I'm a small woman, I'm only a hundred pounds.
I lost 20 pounds.
Not one person in my division came and said anything to me.
So it was like it was invisible as I got more invisible.
So I think it's great if you're working in an area where people actually recognize it,
acknowledge it, and are willing to
provide support, but I'm not sure that that happens everywhere.
And I'm also not sure that it should, something must be happening before you got to that
point.
And how does our work environment, it's like the caregivers have to be cared for too,
within the environment that they're trying to provide care.
No care, no culture can be any healthier than its caregivers.
And so, you know, this notion of self-care laid down as if it's your responsibility.
Well, yes, of course it is to some extent, obviously ours.
But I think it also has to be incorporated within the environment.
And most of the people that I know and I see
You know, they're more like you.
um They work more than is probably reasonable, and they have a certain pride in their
work, have a good work ethic.
They're not looking to be lazy.
They're not looking to let other people carry the ball for them.
So it's not like we have to worry about efficiency and making sure that you're doing all
of your hours and seeing as many people as possible.
I think there's something else that is necessary in this environment.
If we're really going to have an environment of caring and healing and optimal health.
And I think that sometimes that
isn't brought into our institutions.
I think that other things are prioritized and you know, I'm not saying I have all of the
answers.
All I'm trying to say is that I don't see it being woven into the fabric of
where we work.
I'm lucky.
I work in my own little environment now, in my own private practice, and I can see as many
people as I want or not.
It's not coming out of the government's pocket, obviously.
So I understand that the hospital has to be able to justify people's salaries.
But I think that maybe there's a bit too much emphasis on that end of it and not enough
of, I think we've lost something, you know, in terms of what is our goal?
And I honestly don't believe that we'd be seeing as much burnout as we are if the
environment itself was more caring and nurturing.
And maybe I'm just too idealistic, I don't know.
Well, I think we've seen lots of...
oh
improvements in uh the way the different layers and departments and faculties and
hospitals and universities and other institutions are starting to incorporate uh wellness
awareness.
I've seen a lot of workshops being offered.
So workshops are one-offs, right?
And I think there's a really important literature that's emerged.
can think of countless scenarios where I've seen this pop up on the grid where, you know,
self-care is not a day at the spa.
Self-care is a lifelong process.
And if self-care is going to thrive, it needs to thrive in an awareness or where there's
a...
group think, if you will, that that's an important item on the business agenda.
And not just how is the individual doing, but how are we doing as a collective to nurture
the ability for people to self care, but also, you how are we caring for ourselves?
How are we caring for our mission?
How much does our mission actually reflect the need to care for those people who are
carrying out the mission?
And I think once it's embedded in that fabric, as you allude to, um
I think it's a huge uh win.
Nothing succeeds better until it becomes a regular item on the agenda for discussion.
And ad hoc sort of, oh yeah, we need to tackle that.
We need to make sure that fits in.
There's some accreditation or another coming in that makes sure it's visible, but it
really has to be visible all the time.
visible repeatedly, it needs to be collectively bought into.
And there are lots of areas.
And I don't think we're just witnessing that in healthcare.
I think we're witnessing that in caregiving.
I think like I started with this, I think it's all across our culture and all of our
institutions.
Absolutely.
And, you know, we're witnessing um the caregiving experience in the non-professional sense
and what caregivers everywhere have, in some instances, assumed that role overnight when a
loved one has a more acute uh health event.
um It's something that really, I think, takes on even a more societal uh
connotation, know, what are we doing to create an environment where self care can thrive?
And, you know, for something to thrive, there has to be a framework, there has to be
fertilizer that needs to be sun, there needs to be all kinds of things for a plant to
thrive, but similarly for the individual who's uh engaging in self care.
you know, those are...
Could you change your job so that you could have more moments where you were actually,
that you experienced when there was a lull in your day?
So part of that is a supply demand issue.
um The idealized care versus what care can be delivered within the constraints of the
resources that are available is a constant conversation.
My bias is towards providing the best possible and always trying to be optimistic.
that's never on the chopping block.
um
You know, we're all aware of constraints.
We're all aware of...
uh Well, the personnel constraints.
There are the fact that we're lacking in the presence of a footprint for patients, family,
doctors, people to...
I think, you I was thinking about the best term of a squad of individuals who are involved
in providing patient care.
You need a quarterback.
And a lot of patients don't have quarterbacks championing the coordination of their care
and their next move on the healthcare playing field and on the health uh span playing
field, to use a very important term which I've really come to appreciate.
And I don't have an immediate solution, but the numbers are staggering.
um
didn't they cut down the medical costs?
I'm under the understanding that a medical cost used to be much quite significantly larger
than the current one is.
And it was my understanding that was done about 10 or 15 years ago.
They used to have like 250 students in a class and now it's significantly less.
And there can't be any, I'm sure there's no end of people who want to go into medicine,
right?
Like they're all like amazing applicants.
So we're not having a problem because there aren't enough people who want to be doctors,
right?
You're absolutely right.
think more recently we've seen people leaving the profession because of conditions.
And I consider myself pretty blessed to still sit here today launching this uh
conversation, this journey, this adventure.
I really think of it as an adventure and I haven't been excited about a project.
oh
of this scale in a long time.
And I've worn many hats in my academic career and I've enjoyed wearing each of them.
ah Some which taught me about uh true passion for my work.
But this is something that's very different because I think we're looking for unifying
themes that extend even beyond the medical landscape into the true inner workings of
caregiving.
But ah I mean, if you
you reach that point where you can't care give because your inner ethics or your inner why
or you're just so broken from not being able to deliver care the way you know is right.
uh If you get to that point, you can understand why someone might walk away.
And I mean, I can only speak from the experience as a physician and uh you know, this
podcast is not meant to be.
medicine grounded and only medicine oriented, but we're going to use this as an example
for all caregivers.
um
lot of the care that is provided that well, not for sure.
But I think a lot of us work in government run institutions.
And I'm just wondering if there these constraints aren't really a major source of burnout
for a lot of people.
So, you know, it'd be really interesting to have people respond to this.
I mean,
I've been upfront saying, you know, I know there's a side of this that I don't understand
that's about running an institution and blah, blah, blah, blah, because I know that's
true.
um But I think for anybody who is involved in caregiving, you know, generally most people
start with a Y.
uh
I would probably argue that most people are probably pretty passionate about that, why?
um Right from the get-go.
And yes, I think, you know, certainly there's a big cultural component right now that has
people kind of at odds with themselves.
But...
I think that there's something about how the circumstances that we find ourselves in where
we're trying to offer care that I think really affect the individual who's trying to give
care.
Or maybe even trying to innovate in care, right?
Innovation needs room.
Innovation comes with new expectations and new costs.
And we certainly learned through our um training that innovation is such an important
place.
And we're certainly grappling as a society right now with the place of innovation at so
many levels.
And that applies to caregivers and to healthcare as well.
But...
It's amazing how you could groom future healthcare providers, but not tell them that
they're entering an environment where it's a bit of a zero sum game.
And that if you are going to have funding for innovation, you probably have to cut back
from somewhere else.
And no one really knows that going into it, right?
And that's an important part of...
sure if it's um required as much as we're led to believe.
I think we're making a lot of um judgment values about how we provide services.
And I'm not sure what the motivation is, the stated motivation, but what's really lining
up those limitations and restrictions.
uh I'm not sure.
What makes you continue to do what you do and why are you so passionate about being a
caregiver of caregivers?
And what are some of the stories that have informed that?
And then what, from what you know now, would inform the 20-year-old or the 25-year-old
version of yourself embarking on a career of caregiving?
And maybe that involves some of your vulnerability where you may have...
felt a little weak and burned out in the process of being a caregiver for caregivers.
And then, but also a call to action at the end.
We talked about self-care, but you've isolated very nicely that this is not something that
someone does as an island, but it has to be done in an environment that nurtures it, where
there aren't all of these competing demands.
And how do we shape our environment so that those demands are not there?
You know, perfect example recently for me, made me think about it was how um it's become a
popular uh sort of way of thinking that, you know, we have accountability as physicians to
the climate and we better think twice about how much IV tubing we're using because the
cost of incineration of used IV tubing is, you know, is affecting the climate.
And we have to take on that burden too and think about that amongst everything else that
we think about.
And, you know, there better be a spot in the teaching curriculum about climate action and
climate sensitivity when providing healthcare.
And it better be there because the accreditation is coming up.
You can see where I'm going with this.
And, you know, my reaction to that was like, you cannot realistically think that imposing
that on young or even mid-career physicians is yet another thing they need to think about
is really in the best interests.
of ah the profession or the caregiving nation, if you will.
I mean, it's just, I'm not saying it's absurd, but it's that notion of all the physicians
will have to take care of that, of that story, of that narrative, all the physicians will
have to do it.
And it rolls down to the caregiver every time.
And I mean, I even think of the person who runs the training program who needs to be
accountable for, ah you know,
what's now a accreditation requirement and to think that, we need to now find someone
who's gonna go away to learn about the impact on healthcare decisions on climate.
And we now need to teach that, we need to prove we've taught it we need to impose that as
yet another onus on the profession.
I'm well aware of how the system just sort of flows down towards the care provider.
And it's something that frustrates me a little bit because
there is no place to take anything on.
We're talking about self-care in one, in the right arm and then in the left arm is feeding
yet another task that's got global implications and global connotations and yet somehow
we're supposed to demonstrate in the blink of an eye that we're sharing in some
accountability for that where we can barely be accountable to ourselves.
So maybe this should have been all recorded.
Maybe it is.
Hopefully it is, because there's some interesting clips that can come from this, it's, I
mean, you can't overburden the individual and then suddenly say, oh, by the way, you need
to take care of yourself too.
And there's a tick box for that.
And you need to take this class and make sure you go away at least once a year on
vacation, because that'll be proof for the tick box that the system's working.
That's not how the system works.
I sort of think that what you're talking about right now, does, like, it really reminds me
about what I was trying to say about the environment.
It's like, I understand that it's reasonable that they would have fiscal concerns.
So their concerns about this tubing and stuff.
But you can't lay that on the residents.
They're just, they're already up to their eyes and ears and trying to learn.
the technique and the skill and you know, like that's just too much to ask them to care.
mean, there's an overload moment.
That's an environmental thing.
Well, that's the environment, right?
That's where the environment is like having unreasonable expectations from the people
they're working with.
And that applies to multiple domains of caregiving where there's this sort of waterfall
that just trickles down to the most basic care provider and what more can they take on
their shoulders?
And no, I think you're absolutely right.
I think you cannot speak about self-care if you're in fertile environment where there is
no nourishment of self-care.
by creating an environment that's actually caring about self-care.
Well, it's so focused on the bottom line that it's sort of taking away the juice that
would actually nourish people while they're doing the work.
And it is work that takes a certain amount of energy.
There's multiple layers to caregiving which demand probably a different energy currency
than other professions or other circumstances.
And again, it's not to be comparative, but it's just to acknowledge that, as you say, the
pool can get depleted eventually, right?
uh The individual as well as the collective.
And that's what we're seeing in certain parts of the world where
people are leaving the healthcare system, even though they're gifted providers, but they
just can't provide anymore.
And they're hurting, they're living each day in pain.
I'd be curious to know about from your experience, what are the pain points that
caregivers in trouble are expressing these days in terms of just like...
What are the warning signs?
I knew what mine were and I've shared a couple of them with you.
I mean, they were a bit superficial in terms of just, you know, to be illustrative, but
there's some deep foundational ones.
And you touched a little bit earlier about disconnection and not feeling connected to the
moment in your caregiving role, but there's gotta be more than that.
Is it the, my God, I picked the wrong thing to do?
Or is, oh my God, I wanna do this so badly.
but I'm actually not in a place where I can do it.
And I don't know what's wrong, but there's something that feels wrong.
And I've been thinking about doing this and I had planned on doing this for the last 20
years, because it took a long time for me to get this point.
If you look at cumulative schooling and training, ah what in your experience
are people reporting as the manifestations of when caregiving and trying to care in the
environment just are not working?
What are they feeling and experiencing?
I think there's always a disconnection from their own heart.
know, it's like all the things that like on a daily basis, I think a lot of people have
trouble knowing when their heart is open and when it's closed.
And I think that as they start to get in trouble, what's happening is their heart is
closing down.
And often because they're just
By their heart, do mean their empathy?
Not in the heart.
Their capacity to have empathy only comes if you have an open heart.
If you have a closed heart, you cannot be empathetic.
It seems like you can't be empathetic to others, but maybe even not empathetic to yourself
anymore.
at all.
There's no, there's nothing going out there because there's nothing coming in because
you're so overwhelmed, whether it's from the environment or the institution, your personal
life.
But it's really like people have lost track of being able to feel when their heart is open
and when it's starting to close down.
And the more it closes down, the less close.
There's less flow between you and the person in front of you, but there's less flow within
you as well.
There's nothing coming in to nurture you.
like, you know, it's a cell that's uh membrane is too rigid.
So nothing goes out, nothing comes in.
And so they're sort of stuck in a position of just trying to hold onto and save whatever
little bit is in there.
Well, usually that involves sacrificing blood flow to other organs.
So it's interesting that you say it gets whittled down just to that sort of barely
functioning low flow state.
And I think that's what a lot of caregivers facing.
But that causes starvation, right?
Because nothing is getting in.
It's not just that nothing you're not able to give, you're not able to receive.
So almost like a double-edged sword.
So when somebody recognizes that and has the courage to speak up for themselves, not to
their environment or to their entourage, but to actually speak up to themselves, to
themselves, and recognize that something needs to change, what are the avenues?
What are the first steps involved in like
turning things around from that closed heart and that low flow state.
Well, it's really hard because there's all kinds of fear that comes up for people as well.
So there's like, well, do I have to change my job?
Well, there's all kinds of economic reasons why they can't afford to do that.
Absolutely, especially in this day and age where people are starting off with debt, where
they may have even taken on additional debt because somehow they feel they've earned it.
so took on a whole lot of debt and then two years into their practice or to their next
level of training or their third sub-specialization or what have you, um suddenly they
realize and have this wake up call that the organizational tools that they used
don't work, or they have used up until now, don't work anymore in terms of their inner
organizational tools.
I mean, I can see how that's such a huge shock to the individual in that context.
what they expected and certainly some places, whether you're a vet or whether you're
doctor, you've spent, as you said, a lot of years working towards this.
And there's this delayed gratification notion that, you know, when I finish medical school
or when I finish my residency, then suddenly everything is going to be different.
And it is not different.
So there's the whole fear of I put all this time and energy into this field.
And am I in the wrong job?
There's also, am I in the wrong relationship?
Do I have to leave my partner?
So there's all this imagining.
Well, there's this prevalent notion in the literature too about, better times are around
the corner.
And ah how often we've told ourselves that, that, things will get better.
Things will get better.
Don't worry.
ah
line was better days ahead.
And I know that some of my colleagues wanted to bat me on the head because I'd always say,
oh, better days ahead.
Those better days were never coming for anyone.
enough.
But that's the same notion, right?
That somehow something magical will happen and then everything is going to be OK.
But that's not.
Magical thinking also guarantees the status quo, doesn't it?
What have been the most effective first steps that you've seen people take to start
turning things around?
And again, it's not one step like a light switch where you engage the current and then the
environment changes from uh dark to bright.
This is...
This is the first steps in initiating a process which takes time, which takes reflection,
reevaluation, engagement.
Tell me a little bit about what the sort of the best pivotal first steps one can make when
they've recognized.
to be a willingness to turn on, to just be able to acknowledge what is, what is the state
of your life right now, what is actually happening.
Kind of like being present for yourself for a change as opposed to being present for
others.
Well...
We're not very good at being present for ourselves.
I've come to learn.
I mean, what do you do when things were not working as you thought they would?
Well, you work harder or you provide harder, you provide more.
know, providing and caring and giving can actually become a currency, a currency that you
turn to when your own personal organizational models.
are not working out for you.
And short of like knocking down the whole building and rebuilding it, which we're often,
you know, forced to do, uh sometimes just giving more is like, you know, it's like that
little bit of plaster work that keeps.
think can be, being in that position can be a place where you're hiding.
Like I think it's really, and certainly some therapists do work that way as well.
It's like, let me be a witness for your work.
And I don't have to look at my own body.
And I think that the role of caregiving can be a place to hide from caring for yourself.
What proportion of individuals that you encounter identify with the process that's
involved as opposed to, sort of just stuck needing that sort of one fix and then they just
can't conceptualize?
Are we at a point now where people realize that it is a process, it's an ongoing
engagement, and just like as you alluded to earlier, curricula cannot rely on point in
time interventions.
to make sure that the curriculum has accounted for that one hour in the lecture schedule,
so to speak, and therefore, we're done with.
You identified a really key point.
It's a time-bound process.
It's a continuous process.
And some may navigate em what it takes quicker than others because they're more capable,
they're more open, they're more able to engage in it.
But um are there individuals who just need to approach it differently?
I'm not sure that we're really aware of the process, of process at all.
I think that most of us are kind of outcome, and our focus is on the end product.
And so I think that that's almost an art in and of itself, to be in process and to be
comfortable being in process.
Well, you look around us, right?
And there's nothing about process.
It's all about output.
mean, everything, you know, we speak, we speak to our children, we speak to our teenagers,
we speak to our young adults, we speak to everybody about how, you know, that objectivity,
what it needs to be like, and how much that's informed by the likes of social media and
other things.
um And just, you know, caring more about what the output of another is compared to what
your own is.
And somehow that other
ah opinion about output is more important than your own about your own personal output is
is huge and
And we speak from a role position as well.
Like when you were talking, it's like we speak as a mother or we speak as a, you know,
teacher or we speak as it's like from a role.
It's not from me in this moment.
What's happening?
So I think that makes it even harder and also makes it more sort of outcome oriented.
You know, I remember very early on in my Gestalt training, one of the things they did to
help us get this notion of process was really using the image of the cell, a healthy cell,
and how that boundary needed to be firm enough to contain
but permeable enough to let there be a flow between both sides getting things out, but
getting things in.
And I think that we don't tend to think of each moment as a process of us becoming, of us
actually being unfolding in the moment.
It's...
It's more in terms of how am I functioning?
What is my output?
How do I look?
How am I doing?
And I think that is very alienating, both with others, but with ourself.
So we get disconnected all around.
And there's no way to evaluate whether we feel
that what we are doing is nourishing for ourselves or anyone else.
So I'm the listener at home, tuned in to the Caregivers podcast and I hear what you're
saying.
I need some process.
I need to take it to the next level.
do I start?
How am I going to do this?
Who do I turn to?
Do I start writing things down on paper?
Well, the notion of who do I turn to even to some ways, you know, makes me say, well,
there's nowhere to turn.
You need to sit down in your chair and you need to just feel whatever you're feeling in
this moment.
Do I write it down?
um Well, before you write it down, you have to feel it.
You have to be willing to pay attention to yourself as if that is a worthy, worthwhile
exercise to be engaged in.
Can caregivers do this in their busy day, everyday life?
Is it something that, like, are there micro-moments that we can steal to sort of ask
ourselves?
don't think, um I think it needs to be happening all the time.
And I think it's possible to be happening all the time if you're willing to.
If you have a lot of restrictions around yourself about what's okay or what's not okay.
It's like almost if your ego or your ego story is bigger than you actually are.
then there's no way to get beneath it, under it, around it.
People get confused that they are the ego.
Well, you're not.
Who you are is more intimate and more sacred than any sort egoic storyline you could be
running.
I'm going through a phase where ah I'm starting to question a little bit of, know, can I
do this?
Am I being honest with myself?
I thought this was what I always wanted to do.
Things don't feel right.
um I'm not happy.
I'm not sleeping.
I'm not.
would say, then what are you?
You're not happy?
What are you?
Tell me what you are right now in this moment.
I don't think people find the time anymore to actually answer that question because
they're too much, ah know, hustling to get everything done and getting all the tick boxes
done.
ah whether that's, you know, professionally ah or even, you know, there's what you leave
at work and then when you come home and then there's a whole new array of things.
But as the individual and it extends next to uh even partnerships, but
you know, how am I doing where I'm sitting right now?
What am I feeling?
And authentically answering that question.
And then at the same time, if you are partnered, turning to your partner and saying, well,
this is how I'm feeling.
How are you feeling?
How are we feeling together?
But, um you know, we always speak of the currency of time.
And I'm going to be bringing this up and coming back to this so often in this podcast,
because I think time is the ultimate currency.
as long as you perceive that you have no time,
or no time left, you will never find time to do this.
And the more I listen to you, the more it just seems instrumental uh that, you know, we
spend as caregivers, we spend so much time trying to be present for the cause, present for
the patient, present for the client, present for our loved ones, but we're not actually
present.
everybody but ourselves.
Exactly, well that's it.
um But at the same moment, we can't actually find the time to sit with ourselves and ask
us how we're doing.
not about time though, Mark.
It can't be about time.
We have nothing but time.
How we choose to spend that time, how we choose to be in that time, how we choose to
occupy that time, I think, is what matters.
So how do we, how do we feel the redirect?
What's, what's going to liberate that ability to refocus?
Because really what I'm hearing from you is we've lost the ability to focus on those
important parameters, those important elements of, which ultimately probably fuel self
care and also can fuel an environment where there's group awareness of the need for self
care.
But that seems to be like the
pivotal moment if we've lost that ability or not that it's been taken away from us, but if
somehow we're no longer choosing it, how do we put that back on?
I think that's probably closer to the mark, are we choosing it.
How do we put it back on the menu?
And how do our listeners out there say, okay, I need to change something and I need to
actually see that it's a choice on the menu of options.
um So some of this is really being willing to feel what we actually do feel, regardless of
whether it is what we think we should feel or who we hoped we were.
It's like the courage to just being willing to sit down with myself and feel.
my feelings, whatever they are, without having, you know, this is okay or this isn't okay,
a willingness to be with yourself.
And I think that's one of the things that people do experience when they sit in a session
with a therapist is they're willing to be who they are, hopefully, otherwise they're kind
of wasting their time.
and the therapist holds that container for them.
They provide the space, the time, there's an appointment made.
It's like, come and be here.
And I think often sessions are an opportunity for people just to be checking in with
themselves, to be open with themselves, and to maybe be non-judgmental.
um But I think a lot of times people are not willing because they are afraid.
It could be a bit of an earthquake, right?
Well, they're afraid that there might be, but generally it isn't.
People have all kinds of fears about, if I start to cry or if I give in to that, I'll
never stop, I'll cry forever.
But of course they won't.
Is it as caregivers, perhaps maybe more so professional, but even if we're caregiving for
loved ones where there's a culture of caregiving expectation that runs through families,
is the just-
It's not always considered okay for the caregiver to need care.
Exactly.
Well, there's the caregiver, then there's the self-caregiver is probably the most
important tool for success in being a caregiver.
I mean, you're pointing to that fact that we're, part of self-care actually is whole
self-care.
And that means hearing both sides of the story, hearing and listening to what you're
prepared to tell yourself when you open up.
And if things don't feel right, well, then feeling empowered to, uh
decide what you can do about it and what you should do about it.
But even before you get to that point, even before you're moving to solutions, there's
just that willingness to be in the not-knowing position and to be uncomfortable.
It's interesting how we've seen such a large change in some of the sort of popular
thinking these days that you don't need to have it all figured out by the time you're 20.
And even though you're seeing lots of demonstrations uh through various media about
everybody who seems to have it all together and enjoying the best of life, like there's a
lot involved in that process for most people and it's not going to be figured out by 20 at
the pressures on.
Well, I think that's some of that reluctance to see
the breadth of answers you have for yourself when you take the time to sit down and ask
yourself those questions about where you are and how you're feeling.
You could see how it could be a very foreign concept or a foreign exercise to put yourself
through because we're not really that well prepared to deal with the answers because it
fits outside of the framework these days.
you know, moreover, you know, part of the process is to ask ourselves these questions.
And as I was alluding to,
we don't give ourselves enough time to figure things out.
And uh you probably have a lot longer than you think to figure things out, to still be on
track and be able to look back and say, wow, what an amazing life, what an amazing career,
what an amazing thing I've been through.
And I'm hearing that in what you're saying.
So for the listeners who are sort of, have a lifetime commitment or uh
have a near-term commitment to caregiving where they're starting to feel and question, can
I do this?
Something doesn't feel right, yet I feel obligation.
feel whether it's familial, whether it's moral, whether it's vocational uh commitment,
whether it's professional.
uh To that individual who's starting to identify that things are starting to not feel
right, but they don't know how to take it to the next level, what are the next steps
involved?
Therapy is not available for everyone, unfortunately.
um Although I'm a big believer that, um you know, in this day and age, if sports teams can
uh get therapy to score more, those of us in the trenches who are caregivers could
certainly benefit from a little bit of uh coaching and therapy.
but unfortunately it's not universally accessible.
But for those listeners who are identifying that um I'm at a place where things don't feel
right, I'm trying to listen to myself, I don't know what to do with the answers, but I'm
listening.
Where do we go next?
What can we do?
How can we self-empower a little bit?
ah You've seen a lot in your career and you've seen some success stories.
What resonates with you that can be like the next steps involved in this process?
I think, you know, sort of developing curiosity, like a willingness to not know, but to be
curious.
So then is your curiosity fueled by a strategy and a new mindset of that?
I have it in me to get to know what the answer is if I just work at it and here are the
things I can do to kind of get to know and to engage in the process.
I'm just thinking about the listener who's thinking about it today and um who tomorrow
wants to follow up and on Tuesday and Wednesday wants to follow up on what they thought
about today and what are the steps they can next gauge.
Is it a question of sitting with yourself every day and seeing if the answers to your
questions are consistent so that you at least...
know that that's what you need to zone in on or what are the sort of next steps involved
that one can do in their own caregiving day once they've identified that they're reaching
that point, maybe long before burnout occurs and you know maybe burnout's the culmination
of not having that conversation with yourself.
Once the sense has been tingled a little bit, what do you think are the most effective
tools that
we can apply longitudinally, because I don't think there's a quick instant fix for this.
What are the nourishing tools?
Well, I don't think that, I don't actually think there needs to be a fix.
And I think that thinking about it, like I understand why you would ask me that that way.
We're not going to be finished.
We're never going to be finished.
We're going to live and then we're going to die and who knows what's next.
So it's not about, I don't think it's, I think it's an approach to life.
It's like,
I wake up in the morning and instead of just naturally letting myself go to everything I
have to do that day, just let myself wake up.
Like just be in my bed, be awake and maybe just notice how I breathe.
Am I breathing?
that's a good news, right?
Like I got another day ahead of me.
It's, and just that's what, you know, being curious.
about an unfolding process of meanness.
um
It sounds to me like we hear so much about the practice of gratitude, but there's nothing
more to be grateful for than the awareness that you got to take your first breath today.
Because there was no guarantee of that.
So I hear what you're saying.
Or even just taking your first breath and being there while you take it instead of being
in your head thinking about something else.
Just breathing.
Breathing in and noticing the breath all the way in and noticing your entire exhalation I
think is a good place to start.
ah
One breath or many?
Okay, I would say seven.
Seven's gonna be the magic number.
Follow your breath for seven full inhalations and full exhalations.
And then just allowing the process of waking up to unfold rather than having to direct it
and push it.
it's, I'm not saying you have to be there for 20 minutes, just like it's...
When you catch yourself thinking about what do I have to do today, just bring your
attention back to your breath.
Notice the inhalation.
Notice how you breathe.
Do you inhale through your nose or your mouth?
How do you make that transition between inhaling and exhaling?
How deeply do you bring your breath in?
Just notice yourself.
And then swing your legs over the edge of the bed.
And what's it feel like when your feet touch the ground?
Of course you have to think about things sometimes that are not how you're processing.
But I think we almost never do.
Like how often do you actually get out of bed and notice what it feels like when your
weight transfers onto your feet?
Just on your feet, right?
What's it like when you actually take a step?
Of course we...
couldn't ever think about walking or we wouldn't be able to walk.
It's fortunately habituated.
So it's not something we ever have to really have to think about, okay, I'm gonna do this
step by step.
But um we live so much in our head that we spend almost no time actually present and in
our body.
And I think that encourages us to
you know, be looking at ourselves almost from the outside and judging who we are and how
we are and what's our worth and what's our value and how do we measure up?
I think, and that also I think, you know, adds to that fear of like people being wanting
to look at their feelings, especially if they're difficult feelings.
It's like, because it means something about how I'm living my life and then that means I'm
a success.
or I'm a failure.
Like, no it doesn't.
Like, if you could just let the storyline go and come back to your lived physical
experience, you know, and any moment, we are perfect, almost always we are perfectly fine.
Nothing terrible is happening.
Everything is okay.
You you're sitting on the edge of your bed.
You're about to stand up.
You know, you haven't made a mess of your life yet.
just standing on your feet.
And I think that we get ahead of ourselves.
And we're so good at thinking ahead and planning and evaluating and considering.
that we just, the thinkers, more there than the person that's actually there in the
organism.
And then you've got the think tank that's housed in your phone on your night table, which
just makes things worse.
And something about getting up with feeling the weight of your feet without the weight of
your phone probably is a healthy step.
And I can certainly appreciate that there's a big movement to make sure you go bed at
night with your phone in another room.
That whole doom scrolling and all of that stuff is just hiding.
I think most of the time we are hiding from our life, we're not actually living it.
And I think that's such a shame, it's such a loss.
It seems like also the empowerment of others' opinions who we don't even know, but who
made otherwise shape how our day unfolds.
And that you can imagine.
uh
of us are none of our business.
And it doesn't mean anything about us.
It's about them.
So we've taken an incredible journey today to sort of um explore a little bit about what
has shaped your experience.
And you've certainly navigated a lot of realms and have uh brought stuff to share with us
today, which I think is really, uh really enlightening.
it's down.
The building blocks are there, it's actually from what I'm hearing from you and what we
could share with those listening is that, you know, it's not about taking 700 breaths and
not getting out of bed, it's taking seven and then very quickly standing up for the next
experience of oneself as we engage with the world and tuning everything else out.
And from there, the various rituals that begin and we've certainly got a wealth of
literature and wealth of ideas and how to structure our day and our mornings and with lots
of value added.
And I think most would recognize that the value proposition is there if we give ourselves
the space.
And the way to give ourselves the space, I think, is actually to be present with
ourselves.
And that's a skill that's been eroded.
So I'd like to thank you for that tip because I think it's one that's really important.
we're so prone to putting the pressure on ourselves, but if we only experience the breath
to start the day, and that's day one, we can really build on that, especially if on day
two we're successful at feeling the breath as well.
And then from there, the empowerment ensues.
And it's really quite...
uh
and reflective of what we talked about earlier about processes.
And it's changing the culture with yourself.
And then when you're empowered in that domain, you can start changing the culture of your
environment and it goes from there.
Well, regardless of whatever culture we find ourselves in, right?
Like, they're not all going to be perfect.
There's always going to be a problem with whatever culture.
It's really, if we can stop thinking and just start being, which some people would call
mindfulness, right?
Whether it's first breath, standing up, brushing your teeth, whenever you get caught too
much in your head,
You're really at risk of being unhappy because, you know, we have that default zone and
most of what we're doing in that default zone is examining our past for all the mistakes
we made and thinking about the future and all the mistakes we could make.
And most of those things never happen.
mean, there's
It is a weird way of us trying to take care of ourselves, because if we can figure out
what did go wrong and what might go wrong, well, maybe we can prevent it from going wrong
again.
So it's useful, but I think we've sort of overdeveloped that capacity and at the cost of
just being able to be in our life.
Well, I think um I can't pull it out exactly um where I remember reading it, but I think
there's that familiar quote at 85 % of what we worry about is never going to happen.
Wayne has a fantastic uh line about that.
My life has been full of lots of misery and terrible events, most of which never happened.
wrote that sorry.
It was Mark Twain that, well, at least that's who I found.
You know, these days you go online and you'll look up a quote and it turns out it's from
six different people you've never heard of.
But originally when I saw the line, it was Mark Twain.
So who knows who it is now?
And that in itself is kind of probably part of the contribution of anxiety is all of this
AI and
You know, all the internet and all that stuff is like just having confidence in knowing
anything is compromised to some extent.
But there's one thing we can be sure of if we choose to pay attention to it.
It's that right now I actually am breathing and I'm OK in this moment.
And I may not be in the next, but in this moment I am.
And I think that can be.
grounding and I think it can be
Nourishing just realize that right now.
I'm okay
Such an important starting point and certainly a welcome tool for someone who's trying to
take the first step.
before we wrap up today, um I wanted to turn to a bit of a different scenario and maybe
just taking things one step further.
But there's one thing of recognizing that something doesn't feel right.
But what about that moment where I can't do this anymore?
I'm paralyzed, I'm frozen.
What do I do now?
What do I do next?
ah You know, when the danger signals are really there, there may be more involved ah for a
caregiver in distress than just doing some breathing exercises to start the day.
Like, what's the next level when the alarm bells, like it doesn't start with a subtle
awareness that things don't feel right.
It's like,
You go from functioning to bang alarm bells that you've never heard before, or maybe the
chimes that preceded them you weren't prepared to hear or listen to, but it's alarm bells.
What do caregivers need to recognize are important resources to turn to when things become
a little bit more urgent.
I guess one of things I'd like to have people consider is I know how people usually frame
that and I know the storyline that usually goes along with that.
But what if when you have that experience, you could say, oh my gosh, this is fantastic.
I'm so pleased.
Right.
This is it.
I'm so grateful for this experience because now I can do something different.
And we, you know, you may not know what they need to do that's different or they may not.
um
You know, it's not like it really it's an attitude change that I'd like to encourage
people to have because generally when that comes up, there's dread and fear and confusion.
And what if having this awareness was the best thing that's ever happened to you because
it's going to bring you into being able to develop a life that you want to have.
that it makes you feel passionate and happy and excited.
And if you'd never sort of reached that point, you would have just kept going along until
you fell over, I guess.
But, you know, most people have this sort of experience and it's, they frame it as a
really terrible thing.
And I guess I'd have, you know, have to say,
that it's possible that the very worst thing that's ever happened to you could be the best
thing that's ever happened to you.
And maybe realizing that you can't do this anymore, you can't stand this anymore is the
opportunity for you to reinvent, recreate, re-update your story rather than it being an
ending or a possible ending or a bad thing.
Maybe it's something to celebrate, something to feel grateful about having finally
realized it rather than it taking another 10 years.
Do you think that's the doorway to healing?
Or is it the first step towards healing?
I it's the second, because there's first the feeling, and then there's the meaning you
make of the feeling.
And that's, we have it sort of set up so that whenever we have these negative feelings or
a hard time, we have a whole thing that just unpiles that it's going to be a disaster
or...
a bad thing.
And, you know, it's like, let's give ourselves the freedom to write new meanings to
feelings that we have previously been uncomfortable with.
Because I think burnout is like, it's an opportunity.
It's like
Nobody enjoys feeling burned out, right?
Like it's not like, yeah, I get to be burned out this month.
But really, if you stood back from that, this could be something that is the best thing
that's ever happened to you because it's against your will, no matter how much you fought
against it.
You know, you finally got yourself and you can't look away and you can't pretend and you
can't ignore and you can't deny.
And so you can see clearly that whatever path you were on, there's something about it that
has to be changed.
And it's your story, it's your path.
And so being grateful that you finally saw it and that you finally have this opportunity
to do it differently.
So, you know.
Change is uncomfortable.
Everybody is uncomfortable with change.
Maybe all of us have to face change at some point.
whether we face it or not, it's happening.
we always hear about the most drastic scenarios, of course, because they, you know, they
just intellectually carry a lot of leverage.
But is there anything we can do better to prepare ourselves for the little wake up calls
for change that are going to come along the way in our career as caregivers so that, you
know, the ongoing exercise of the coping muscle, if you will.
I'm all ears.
We're always changing, right?
Like this idea that we're not changing is just not gonna be true.
Like we evolve all the time.
We're always becoming something new.
And so I think the organism is afraid of change because it's not sure you're gonna
survive.
But if you really look at it, we've done nothing but change from the moment we were born.
Right?
Like, until the moment we die, we're still changing.
I really wanted to thank you for joining us today and I look forward to uh hearing more
stories and to sharing more stories and hopefully a future visit.
really enjoyed this process and it has taken, we've had a couple of meanders here and
there, but that's part of it, right?
It's a process.
So thank you very much for letting me be here.
Appreciate it.
Right, well to our listeners at home, thanks for tuning in to the Caregivers Podcast with
Dr.
Mark and we'll see you next time.