NASW Social Work Talks - EP17: Self-Care and Avoiding Burnout

Episode Date: November 6, 2018

Kristen Lee, Ed.D., LICSW, is a professor of Behavioral Science at Northeastern University, and is the author of "Mentalligence" and "Reset." With more than 20 years' experience as a clinician, educator, researcher and parent, she speaks about her area of expertise: preventing and treating burnout.

Welcome to Social Work Talks. I'm your host, Greg Wright. Our guest today is NASW member Dr. Kristen Lee. She goes by Dr. Chris. Dr. Chris is an internationally recognized, award-winning behavioral science professor, clinician, and author from Boston. She is the lead faculty for behavioral science at Northeastern University. Dr. Chris operates a clinical and consulting practice devoted to preventing and treating burnout. She is the author of the award-winning book, Reset, Make the Most of Your Stress and Mentaligence, A New Psychology of Thinking. Dr. Chris is a regular contributor for Thrive Global, The Huffington Post, and Psychology Today, and has also appeared on NPR and CBS Radio. Welcome to Social Work Talks, Dr. Chris. Thanks so much, Greg. It's great to be here. Americans are really burned out. Why? What's actually leading to that?

So right now, if we look worldwide, we're looking at high rates of burnout. But in the United States, we have some particular factors. Lots of us are working, you know, the equivalent of multiple jobs. And in this hyper-competitive market, people are forced to do more with less. and you know obviously technology plays a huge role too right so it's this whole idea that we have to be on 24 7 and that we have to just you know never unplug and never give our bodies and brains a respite from the overload and so lots of folks are not taking even a lunch break never mind their vacation days and then also in the United States not everybody has paid vacation

so there are a lot of factors that are contributing to this sense of overwhelm and then one thing when we think about burnout, we can think about sustainability, right? So a lot of times the ways in which we're operating are not sustainable in the long run and they end up eroding both our mental and physical health. Ways that are not sustainable means what actually? Like we're just going and going and going or what? Yeah, so we're expecting ourselves to perform like robots and machines, right? So just again, with all the demands of today, you know, they're calling it infobesity. They're saying that we're taking in the equivalent of 174 newspapers a day into our brains, right? And they're also calling it, you know, techno stress, right? So this idea

that we have to just every day perform to these heightened levels. And I think this happens not only in our professional lives, right? But in our family, in our relationships, for those of you who are parents out there, right? It's like, there's more parenting styles and serial choices now, right? There's all this, you know, information about how we're supposed to always be on. And, you know, I think there's even pressure almost to be Zen, you know, it's like, we have to do everything and then still kind of show up and have a good hair day and act like everything's fine. And so this really hyper competitive market bears down on us all this in all these kinds of ways, but also, you know, there's just this information that forces us to think that we have to be

perfect in order to be okay in our society. You've also said that there's a lot of folks out here walking around who look quite normal, calm, serene, but that you should always assume that other folks are under a lot of stress. Why so? If you look good. Yeah. Well, that's the classic lie of like mental health or burnout. It's sort of, it doesn't look like what we imagine it to be. And I often, you know, say in my work to use universal precautions. So just like we would be careful handling blood in a medical field, when we think about burnout, we have to use universal precautions. One, they're calling it the occupational risk of today. And they're saying that one in three of us have high levels of anxiety. Globally, they're saying that 350

million of us are experiencing depression. So, and then I love, you know, the American Psychological Association also says that we often don't know how stressed we are until we actually physically show up with, you know, signs of it that we get physically sick. So like, for example, the number one reason people go to the ER is for heart palpitations, they think they're having a heart attack. And then, you know, it's anxiety related. And so we know that oftentimes, you know, we're conditioned to sort of override those cues from our body. And we don't recognize that we're in jeopardy until we've actually sort of come to that point of crisis. Are women more prone to it? Or is it more men? Or is it everybody?

So one thing that I found interesting, there was a Yale study that talked about women and heart attacks. And they talked about the idea that the very conditions that sort of created that like burnout factor, and that sort of escalated the cardiovascular risk, was the same like phenomena after. So as soon as they sort of had the heart attack, They then kind of went back right into the arena, right back into the heavy workloads and the caregiving demands, et cetera. So when we look at like the full mental health and burnout spectrum, we know that all people are at a particular risk when they're in high demand roles, particularly for those of us who are in caregiving professions, such as social work or in education or psychology, the medical fields, and even leaders of today face those particular risks. because the work is so important and so demanding. All work is important, of course, but the needs of the people you're serving can often supersede your own needs.

But one thing we notice is that women are more likely to be proactive, to talk about their mental health needs, to reach out and get therapy. What we know about men when we look at the data is that oftentimes they won't verbalize or vocalize what's happening or even maybe pay attention to it until they're at more of a point of a crisis. So when we look at things like suicide rates, for example, we know that men, if you look at the data, they will actually schedule their first appointment on the day that they were actually planning to end their life. And so it's very important to look across gender, but again, for all of us to think about prevention is less costly than repair. So how do we take that lens of assuming within today's context where, again, they're calling it the age of anxiety and they're calling our work environments even modern hazards.

So how can we sort of be mindful and tuned into the fact that this could happen to anyone? It can happen across age, gender, culture. It can happen across all of our varied affiliations and social identity groups. It doesn't discriminate according to class or any of the factors. So I think it's important for us to all sort of pay attention and recognize that we're human beings, not human doings, and that we really have to, you know, pay attention and not, you know, take on this type of risk factor. I have a two-pronged question for you. Sure. What are the signs that you are burnt out?

So if most folks go on and on and on, like, what is a way that I can recognize, look, I might have an issue here? Yeah, great question. So, you know, the burnout by definition has been characterized as a syndrome of emotional exhaustion, depersonalization, and even cynicism. So what that means is that, you know, you sort of feel disengaged from your work or your relationships or your roles. So just not really that same fervor or passion for those kinds of connections and things that you typically care about. It can also just mean that you're just in that state of depletion, right? So just feeling like there's no gas in the tank kind of thing. Just that sense of just overwhelm and not being able to get out from underneath it.

And then the other thing that's, I think, hard in all of this whole realm of burnout is the cynicism part. So it's that sense of, like, I don't feel like things can change. I don't feel like they're going to get better. I just have to kind of succumb to this. And that can be, you know, all those processes together can lead us to depression and anxiety. And again, those kinds of states can lead us to just feel really revved up, maybe even having panic type symptoms or just, again, like really disengaged or just sad or discouraged or even sometimes irritable and angry. So is it almost like having a depression type symptoms or is it like different from having depression? They definitely have parallels. And so certainly like scholars have this different debate about what it looks like. But ultimately, there's definitely similarities. But with burnout, it's more of a chronic pervasive condition. So all that means is like it goes on for a while. So say again, you've been in a particular role. This can be a professional role. It could also be a caregiving role.

So like for our listeners out there who are in either or both situations, you know that over time, again, thinking of that sustainability piece over time, if you're just, you know, so hyper focused on everyone else's needs or what you have to do, but you're neglecting your own needs over time, that can really leave you without that gas in the tank, so to speak. And one way I think about it is, you know, good airplane protocol, like put your mask on first. And I think that often seems very counterintuitive. You know, and your first question about in America, I think it's so tricky here because we're an individualistic culture. We're bootstrappers. We think we have to put on our suck it up T-shirt and, you know, stiff upper lip kind of thing. And it's very hard for us, you know, to think about what it means to ask for help and to not feel shamed or stigmatized around that kind of thing. You've also said that a good cure for all of this is relationships. How so? Yeah, so when we look at the resilience literature and we think about resilience and our capacity to endure hardship or difficult context and to be able to, you know, bounce back or, you know, to stay on track, we know that relationships are among the most important things as protective factors, things that really bolster our total health and well-being.

So one thing that I find just like, you know, shocking is this this assertion that's come out lately. It said that loneliness is the new smoking as a health risk. So when I hear that, it just, you know, it is this whole idea. I'm actually reading a Brene Brown book, another social worker who's also saying that, too, as well. We're like just isolated people now, much, much more so. Yeah. And I love Brene Brown and I love the sociologist Sherry Turkle, who wrote a book called Alone Together. Right. So it's this weird paradox of like we're always on and we're always connected, but yet we're lonely and disconnected. And I think, you know, there's a lot of deep reasons for that. I think across culture, across society, we have a lot of in and out group. We have a lot of disparities and isms because of race and class and gender and sexual orientation and age and ability and religion. So we have a lot of these, you know, forces in society that I think are some of the deeper reasons in which we struggle and we feel disconnected and we're trying to make sense of our identities and trying to show up, right? And so I think finding, you know, the ability to find diverse and to find deep connection with one another, to look for common ground.

Also, we are in a political time that's a stressful one. It's a divisive era. um you're either on the far right or the far left looking at our news at night can be a a stressful like thing so um is it a good thing to just like turn it off isolate from all of that going on yeah i think you know we need to kind of put on our critical thinking hats and realize that the news outlets are making a lot of money off this divisiveness and on this polarization So when we look at this sociopolitical landscape where people are really locking down on ideology and really, you know, getting very just aggressive, it's important for us to sort of tune it out and to think better and think deeper. And so that's something that I've recently done a lot of writing and public work around, because, again, what we're hearing, you know, just about like our alleged differences and positions, it's all, you know, really triggering our brains, our amygdala, our fight or flight response in our brain and the fear factor.

And it's really like sort of amplifying that in and out group and the dominant group, what they say is acceptable or OK. And, you know, just all these things are really damaging. So I definitely encourage people to tune out and to look for more, like, you know, nonpartisan, to look for things that are more substantive, and even to look at the data that, like, you know, on so many levels, there's great examples of how people are working across so-called differences, and there's a lot of good that's happening that's not being reported. So what are some simple self-care things that, like, anyone without a big, big budget can actually do? a lot of the things like to start is giving yourself permission which doesn't cost any money right so it's this whole thing of a lot of times people think self-care is selfish right so they feel guilty about it or they feel bad or that there's too many other competing demands so giving yourself permission to carve out even little chunks of time so at Harvard they're

calling this break rituals which is just a way of saying like just like you brush your teeth every day or you have like these certain routines add them in so even if it's just like you actually sit with your cup of coffee, which you're doing anyway, but you actually taste it. And this is kind of that whole mindfulness movement of like, actually like being present in the moment and enjoying something that's before you. Yeah, bubble baths are great, you know, but some other things that we know like the science really supports is walking. So even just like a 20 minute chunk of time where you're walking, at that time, your body, both sides of your body moving, and your brain is also, both sides of your brain is also moving. So that actually helps you process

problems and analyze and solve things in new ways. Breathing. How many times when we're stressed out do we forget to breathe, right? I know, right? We all do it. We hold our breath, we clench our fists, we clench our teeth maybe, but we're not even actually getting the proper oxygen. So just taking the time to do the deep breathing in a day. The other thing is humor. Looking at like the funny side of life and just be able to joke around and find people that you can sort of be fun and funny with. Other things, they're calling it lifestyle medicine. So all that means is attention to sleep and sleep hygiene, making sure we're getting enough sleep, nutrition, hydration, exercise and movement, fresh air, and people time. Social work is a very stressful career.

uh social workers are dealing with folks in um a lot of traumatic like places etc um like what is it that a social worker um can actually do for self-care that's a bit beyond what average people do it's a great question so to me and this might seem centric social social workers are sacred people you know it's sacred work and you know just like our you know other disciplines like teachers and psychologists and for all of us in these roles where we're caregiving there's a particular risk when we look at the data there's a particular risk and I think again giving ourselves permission you know when we think about how willing we are to help everyone else and sometimes how reluctant we are to help ourselves I think sometimes we think well we already have the

information or I shouldn't feel this way and we're and I so I think changing the expectation and just recognizing if this is a particular risk for our profession it begs our deepest attention right to how we can engage in self-care so a couple things one is setting boundaries right it's so easy for us to take our work home with us or again as you mentioned like this polarized this whole socio-political landscape right there's so much work to be done and it's easy just to sort of you know in all of our respective roles just be on 24-7 the other thing I'm finding a lot and I've talked a lot about this with my colleagues who work in sort of the clinical realm is that not only are you serving people in your professional life your clients your patients

your constituents but also oftentimes family members know about your particular expertise and they come to you as well so you're sort of getting it like there's sort of like never that time when you're not on call, so to speak. So I think, again, it really, you know, demonstrates the importance of, you know, maybe it's like you shut your phone off, or you just have those chunks of time where you really allow yourself to engage in the types of self-care that are high impact for you. Let's talk a bit about your book, Mentelligence. Is that right? How did that term come up? Mentelligence. Yeah, so it's actually the fusions of words mental and intelligence, right and so um again in this work for the last 22 years i worked in you know both macro and

clinical work outpatient lots of community settings and then 10 years ago i stepped into higher education where i started to work with students from all around the world and i kind of like in all that i realized that like those those words mental often has like a negative connotation so think of like mental disorders or you know mental health and sort of all the you know, images, the stigma that sometimes comes up. And similarly, with the word intelligence, also, there's a lot of connotation to that, like, you know, the narrow boxes, we try to frame intelligence around and sort of that whole in and out group thing. So intelligence, the subtitle is a new psychology of thinking, learn what it takes to be more agile, mindful and

connected in today's world. So think of those keywords agile, right? A lot of times we can be very rigid when we're dealing with like change is the only constant, right? So a lot of times we can sort of shut down um mindful again like there's a lot of mindless behavior that's going on writ large and then connected and again we've talked about this whole notion of like how we sometimes feel disconnected and and alone so uh mentelligence is actually based on um a grounded theory study that i had the chance to do over a few years with my students from around the world and my main question was like you know and you know in social work right we we love story right we we get to really you know get on a deep level around our stories and the complexity of our stories and

sort of like the amazing like spirit of being a human and be able to be resilient right so I got really curious as I saw the stories of my students unfolding and I was like wow they're they're resilient and like what was behind it what was behind their capacity to sort of recover from hardship and to keep going and to keep persevering and so we started to really talk about what does it mean in today's world to show up not airbrushed how can we be our authentic selves in a in this world where it's always telling us to fake it till we make it so out of this whole study came these four lenses to help us avoid the blind spots and the behavior traps of today right again like that we have to like you know get the likes on our feed or how many linkedin followers we have

or like, you know, all those like, you know, the money in the bank or our image, that those are the things that actually make us happy. When we look at the science of resilience and human flourishing, those metrics of success are actually not the things that actually make us resilient or happy. And so what we know is that it's the presence with each other, our ability to show up real and raw and to be our true selves in a life that's characterized by impact, not performance. not what people think, but bringing impact to people's lives and change agency, that those are the things that help us get to a better place together. And so I'm so excited. It's allowed for my writing and the work that I have the chance to do. It allows for deeper conversation around

what does it mean to be a conscious global citizen? What does it mean to get out of our insularity, our own little bubbles, our own circles, and to think more broad and to think about, you know, how do we unlearn our social instincts or our primitive instincts, our social conditioning, and, you know, think more about how we can, you know, not focus on me so much, but focus on the we. So could you explain decision fatigue for the listeners? Decision fatigue is something that I think all of us are experiencing, right? There's so many choices when we think about our past generations, right? And they didn't have the kinds of choices. So on one hand, you could say, wow, we're so fortunate to have all of these choices. But when we look at the research,

we know that this can lead to something called choice paralysis, or again, just lead to this, like, so what do I choose? So one of my favorite examples of this is they did a study in an upscale Cali supermarket where they put out 24 jars of jam, right? And what they found is when they put out all the jars of jam people just couldn't make a choice and they weren't buying so then they reduced it to six jars and boom that was the secret formula they were getting big time sales right so so i think that's a great illustration of sort of the choice paralysis and the exhaustion we feel because we think we can do everything and that we have to do everything right and it can be very hard to select so one of the ways um that the research show like you know

helps us with this or to think about this is that when we align our values with our behaviors, that can help us make decisions that actually help us to flourish and help us to bring impact. So again, to unpack that just a little bit more, it's like figuring out what are your core values? What are the things that are most important to you? And then are the types of things you're doing at work or in your relationships actually lining up with that? And, and, you know, that's something I really encourage my students that I have the chance to work with again they're like okay I could do everything I could do I could do this path in this career I could live in this country or I could this you know we have more choices to where we live how we love where we go you know

how we communicate than any generation past and again that's fantastic but it can lead us to sort of like have our heads spinning or just feel like it's never enough so I encourage them to think about what are your values? What are your core values? And then how do you set up your life accordingly? How do you design your life in a way that really helps you to live those out? Smartphones, they are everywhere. 70 or so percent of our citizens are on Facebook every day. So is that a stressor? Should we just like turn them off a few hours a day or not? What's your advice with that? Yeah, I mean, even beyond advice, if we look at like our brain and the brain science, you know, being on the screen all the time like that is really, you know,

eroding our sense of creativity, our sense of mindfulness and productivity. So every time we pop on the screen, we're losing time that we could be devoting. You know, today, we're talking a lot about self care and protective factors against this environment. But we're really sabotaging our brains and our capacity to sort of get into psychological flow. So to really immerse ourselves in the activities that really light us up. So like, for me, I love to write, like I get in the zone, like that's my thing. I love to write or I love to, you know, go for a walk. And that's where I can really be present and really in the moment and enjoy things. When we're constantly on the screen, again, we're really, you know, I always think it's like we're bruising our brain up,

or we're just sucking the gas right out of ourselves. And I think it's really important that we, you know, there's things even now on the phones like Checky or different apps where you can measure how many times you're checking the phone. But certainly the more we can be away from our screen, the better. Dr. Chris, thank you so much. This was a wonderful conversation. Thank you so much. I enjoyed being with you. Thank you. You have been listening to NASW Social Work Talks, a production of the National Association of Social Workers. We encourage you to visit NASW's website for more information about our efforts to enhance the professional growth and development of our members, to create and maintain

professional standards, and to advance sound social policies. You can learn more at www.socialworkers.org. Don't forget to subscribe to NASW Social Work Talks wherever you get your podcasts. Thanks again for joining us. We look forward to seeing you next episode. Thank you.