The Liz Moody Podcast - What Everyone Gets Wrong About Self-Care & Burnout (+ What To Do Instead) With Dr. Pooja Lakshmin

Episode Date: March 22, 2023

A psychiatrist’s best tips for implementing self care practices that actually work, figuring out what you value in life, and reclaiming a sense of agency. the four principles of real self care + why the self care you’re doing isn’t effective why your burn out fixes aren’t working + what to do instead   how systemic societal issues issues get in the way of real self care (+ how to take care of yourself despite the broken systems) tips to stop focusing on pleasing the people around you, including family the one question that will help you figure out what your values are  how to live more in line with your values, regardless of your life circumstances concrete tips for actually asking for help (+ how to know exactly when to do so) what “martyr mode” is and how to tell if you’re guilty of it how to stop letting perfectionism get in the way of your best life  and so much more! For more from Dr. Lakshmin, check out her new book Real Self Care: A Transformative Program for Redefining Wellness (Crystals, Cleanses, and Bubble Baths Not Included) and find her at www.poojalakshmin.com.  To enter the giveaway to win a copy of Real Self Care: A Transformative Program for Redefining Wellness (Crystals, Cleanses, and Bubble Baths Not Included), follow me @lizmoody and Dr. Lakshmin @poojalakshmin on Instagram and comment on a recent post of mine something you loved or learned from the episode!  To join the Healthier Together Podcast Club Facebook group, go to https://www.facebook.com/groups/healthiertogetherpodcast. This episode is sponsored by:  AG1 by Athletic Greens: visit athleticgreens.com/healthiertogether and get your FREE year supply of Vitamin D and 5 free travel packs today.  Paleovalley: head over to paleovalley.com and use the code LIZM for 15% off. LMNT: go to DrinkLMNT.com/Liz a to get a free LMNT sample pack with any order.   Healthier Together cover art by Zack. Healthier Together music by Alex Ruimy. Learn more about your ad choices. Visit megaphone.fm/adchoices

Hello, friends, and welcome back to the healthier together podcast. I'm your host, Liz Moody, and I'm a best-selling author and longtime journalist. This podcast is all about helping you live your healthiest, happiest life, whether we're uncovering the health impacts of alcohol, learning how to ease chronic pain, or getting raw, honest tips for up-leveling our relationships. And yes, those are all real episodes, so if any of those topics sound good to you, scroll on back in the archives. Today, we are getting into why everything that we have been taught about self-care is wrong

and exactly what we should be doing instead. I am so excited to welcome Dr. Pooja Lachman to the podcast. Dr. Luchman is a board-certified psychiatrist, a New York Times contributor, and the founder of Gemma, a physician-led women's mental health education platform, centering impact and equity. Her new book, Real Self-Care, a transformative program for redefining wellness, crystals, cleanses, and bubble bass not included, was just released this month. This was such an enjoyable conversation.

me a ton of clarity and made me question a lot of my previously held beliefs, which I always love. Dr. Lachshman is so, so smart and cool and just really fun to talk to. We get into the four principles of real self-care, plus why the self-care that you're doing isn't effective, why your burnout fixes aren't working and what to do instead, how systemic societal issues get in the way of real self-care, plus how to take care of yourself despite the broken systems. tips to stop focusing on pleasing the people around you, including family, the one question that will help you figure out what your values are, how to live more in line with your values, regardless of your life circumstances, concrete tips for actually asking for help, plus how to know exactly when to do so, what martyr mode is and how to tell if you're guilty of it, how to stop letting perfectionism get in the way of your best life and so much more. I would love to hear your thoughts and your biggest takeaways as you're listening to

to the episode. So definitely screenshot and tag me. I'm at Liz Moody. And Dr. Luchman is at Pooja Luchman on Instagram. This is definitely going to be an episode that you are going to want to share. I cannot stop talking to my friends about it. So please send a link around so we can change the conversation around all of these things and begin to shift the system as a whole. Sharing the podcast is 100% the best way to support it. And it is so, so appreciated. Also, be sure to stick around until the end of the episode because Dr. Luchman is offering an amazing giveaway for healthier together listeners. So listen to the end to find out how to enter. Okay, let's get right into it with Dr. Pooja Lachman. Pooja, welcome to the podcast. I'm so excited to have you here.

I was telling you before we got on that I'm such a fan of your Instagram and all of the ways that you're really changing the conversation about self-care and motherhood and all of these different things. Thank you so much, Liz. It's such a pleasure to be here with you. And thank you for being so kind about my work. Let's just start off. Let's get right into it. What do we get wrong on a societal level about self-care? So when we're talking about self-care, I am distinguishing between faux self-care versus real self-care. And when I say faux self-care, I essentially mean all of the like products and services, whether it's like the massage or the essential oils or the bubble bath, all the stuff that is sold to us, primarily women, that's marketed and branded towards us as these quick

fixes for the problems that we all feel. It's so common in my practice in women's mental health to have a woman, usually a mom, come in and say, Dr. Lachman, I'm so stressed out. I know I'm burnt out. I'm not eating well. I'm not sleeping well. And I feel like it's my fault because I have this meditation app on my phone that I know that I should be using. But I never have time. And when I do finally have time, all I want to do is doom scroll. So I feel like it's my fault.

I call that the tyranny of faux self-care because it takes huge social problems, like the fact that we don't have mandated federal paid leave or the fact that we don't have mandated federal paid leave. or the fact that, for example, a black woman has to work for 19 months to make as much at work as a white man makes in 12 months. Those are social, systemic problems. And when we use wellness and faux self-care to fix the fact that women have no discretionary time, that women are exhausted, that we're stressed, you're basically exonerating the toxic system. and again, putting the onus on individuals to make themselves feel better. Not to mention the fact, one, we don't have time. Two, it doesn't work.

It doesn't last long. It's interesting because I feel like one of my key takeaways from the book was that there are these systemic things that need to change. And there are different individual actions that we can be taking to make ourselves feel better in the moment, to take care of ourselves, as is the essence of the word. and, and correct me if I'm wrong in this, you seem to be making the assertion that in some ways, engaging in real self-care as opposed to a type of self-care that's perhaps grounded in quick fixes and capitalism is enough to start to push the system in a different direction. Like, you seem to assert that it was a radical act in itself and it could start to put into motion some systemic change. Absolutely.

And I love that that was one of your big takeaways, because that's what I was. not so secretly hoping for when people read the book. I give examples from my practice where the patient goes through the steps of real self-care, starts to set boundaries, starts to have conversations with herself that are coming from a place of compassion as opposed to a place of guilt and martyrdom. And that leads to having a hard talk with her husband about how resentful she is that he's never taken a parental leave. And when they have their third baby, he actually goes to his employer and asks for a parental leave. And they do grant it. And that change in the company goes on to impact everybody else that works at that company. It's not like any of my patients

are doing real self-care for the explicit purpose of advocacy. But what happens when you engage in your relationships differently, when you engage in your family differently, when you engage in your workplace differently, when you start to make different choices for yourself, there will automatically be cascade effects and other people around you then have permission to make changes. When we're talking about self-care as self-preservation inside these toxic oppressive systems, I see it as like there is a really powerful interconnect between personal agency and systems change. It can feel really tough. There's these huge, terrible forces that we're constantly waiting in. And it's really easy to get hopeless around that and just like turn to the

phone and doom scroll. And what I hope is we can step back and say to ourselves, well, no, the way that I show up in my relationships actually is part of that change work. The fact that the systems need to change doesn't mean that there isn't stuff that we can do to feel better in our lives. and focusing on putting all of the onness on ourselves isn't the right path either because it completely dismisses the impact of the system. Exactly. A question I often get is should I feel guilty if I really just love going and getting a manny petty?

And my response to that is that guilt is never a great motivator. It's not helpful for you to sit around and feel guilty about getting your nails done. that does nothing for anybody that doesn't change any systems. Instead, it's about saying, how can I let myself actually really have that time? And then when I feel full, when I feel generous, what can I do from that place of generosity that gives back to people or women or marginalized groups that don't have as much as me? And often it's not something like super showy. It's usually just something like small, like talking to somebody different at school pickup, having a new type of conversation, taking the shame out of it. And instead allowing yourself to look at your decision making and understand that when you feel good and when you feel like you're coming to your life from a place of agency, then that automatically starts to bleed over to other aspects.

In your mind, what is the goal of real self-care? How do we know when self-care has been accomplished? There's a quiz in the book called the Real Self-Care Thermometer. When you take the quiz, you get back to reading red, yellow, or green. And when you're red, that means that your real self-care level is low. Green means that you're in a good place with real self-care. So the way that I would describe somebody who has a healthy relationship to taking care of themselves is that you're clear on what your priorities are. You understand what activities, what relationships feed you and bring you energy. When somebody comes to you with a request, you're able to be relatively decisive in your decision making. Essentially, you're able to operate in your life from a

place of agency and a place of self-efficiency. Can you speak a little bit to this particular moment in time in terms of self-care? Are we historically more needing of self-care than we have been in the past? Are we more burnt out than we have been in the past? What does this moment in time look like? I did some research into the origins of the term. And what I found is that self-care as a concept came into being around the 1950s, originally on psychiatric units, where doctors were taking care of patients who were on involuntary units. And the term self-care was used for exercise programs and food choices as a way for

patients that were on locked units to have autonomy and agency. And then the nursing profession started to use self-care when they were talking about compassion fatigue. And pretty soon after that, folks like Audrey Lord and other queer black activists, Bell Hooks, started to bring self-care into the national conversation as self-preservation, as really a social activist human rights movement. The other interesting tidbit was that Google trend searches for self-care peaked in 2016 after the election in the United States. So my take on this as a psychiatrist is one of the reasons that we are so seduced by wellness and faux self-care is also connected to the complete breakdown of the mental health system in the United States. It's so much easier to click buy on a pretty beige pack of vitamins on Instagram that are kind of purporting to cure your anxiety than it is to have to sit on hold with your insurance company for 30 minutes to fight with them to get your therapy bills reimburse. So I don't blame anybody, but I think with the increased lack of access to quality mental health services, wellness and faux self-cure. have sort of jumped into that void.

And do you think that there's a difference along gender lines with that? Do you think women are more easily susceptible to that type of marketing-based self-care? Or do you think women are experiencing more demands? We're expected to be mothers and successful in our careers and incredible partners and run a household and all these things in a way that I don't think we have in history before? Or do you think it's something else? Well, there's definitely research that shows that women are for sure hit with more of this marketing and are hit with more contradictory expectations. All of these forces are conspiring against us.

I reference Martha Beck, who is one of my heroes, Oprah's life coach, just are all around rock star, and her conceptualization of essentially for women in particular, we are sold this contradictory. set of expectations. Be a mom, but also be a rock star CEO. But those two roles are almost diametrically opposed. And women are more likely to internalize conflict. So when you get contradictory rules from the outside as women, we're more likely to turn that into, well, I'm not doing enough. I'm not working hard enough. I need to do more. Whereas men are more likely to externalize and to say like, hey, wait, no, that doesn't make sense. I will say when it comes to gender equity, we don't get anywhere unless men are on board. So I think it's problematic to phrase these things in terms of men versus women because men lose out too when we put them in a box of just this certain masculine role.

What we really need is equity so that women are supported in all these different roles and that men are supported in taking on caregiving and more domestic labor. We need to be kind of looking at the system as a whole, as opposed to pointing fingers. It's such a tricky situation because I do feel like I want to applaud the notion that women should be able to have it all, that I should be able to have a really successful career, and I should be able to have a thriving social life and a thriving relationship and all of these different things. But there is literally no time in history where one person has done all of those things.

Like before women were largely in the workforce, there was somebody taking care of the home and somebody else in the workforce and somebody raising the kids and we were living communally. And there's just no historic precedent for it. And I don't want to say that we can't have it. You know what I mean? It's a tricky thing to navigate because I don't want to give up on any of these separate dreams. But there's also literally no precedent for being able to simultaneously have all of these separate dreams. Yeah, I struggle with this all the time I'm struggling with this in this book launch too,

figuring out how to balance being a mom and we need to change the definition of having it. Like, what does having it actually mean and give ourselves space and time to actually engage with each of these different buckets of life? As opposed to viewing it as like, I'm just checking it off the list. Like, oh, I have a social life. Let me check it off the list. thinking deeply about, well, what does that social life actually look like? What type of social life actually feeds me? The majority of my patients are moms. And the idea of taking the time out to really think about that feels absolutely laughable because we are just constantly in this go,

go, go place. Let's have a different conversation. Let's not just have this conversation keep being like, oh, I feel guilty. Oh, I'm not doing enough. Oh, I need to work. more, oh, I need to be a better mom. No, you're doing enough. Everyone is already doing too much. And instead, getting really deeply clear on what are the things that really bring me joy? I know it sounds so cliche. I want to roll my eyes at myself for saying that. But what are the things that actually fill me up and that are really deeply impactful for me? And then how do I build more of that in my life? And the thing is, when you do that, there are going to be people. people that are pissed at you. There are going to be people that are like, well, you used to just go

along with whatever we wanted you to do. That's part of the work of real self-care, being okay with that. I call them the kill joys. What's one thing that we can do to be okay with the kill joys? There's an exercise about planning your dinner party. You're throwing a dinner party for yourself, but you only have $200. So if you only have $200 to plan this event, what is it going to to look like for you. Is it going to be a potluck? Is it going to be your house? Are you going to make everybody dress up? Everyone's $200 dinner party is going to look totally different. And there's no one best dinner party for $200. Taking some of the morality and the like the keeping up with the Joneses out of the equation and just having it be something that's just sort of silly and fun that you can

mentally play with and see what comes out. With loosening up the kill joys, it's reminding myself, there are so many different paths to a fulfilled life. There are so many different paths to real self-care as well. This is just a map to ask yourself different questions and to be less concerned with what everybody else thinks that you're supposed to be doing. I'm really open in the book about, you know, all the missteps that I've made on my own journey. When I was younger, especially in my 20s, I was so, so terrified of, of falling out of the pack. I wanted to please the killjoy so badly that I completely lost

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firmer. It looks glowier. The texture feels dramatically smoother. And I feel like you can see that too. I also love the body moisturizer. It dries down really quickly, which is always a pet peeve of mine with moisturizers. I hate that like sticky feeling when you go to put your clothes on. This does not do that. But it does moisturize really, really well. And then again, I'm reducing my skin's biological age. I am not making it just look younger. I am making it actually younger. OneSkin has four peer-reviewed clinical studies and over 10,000 five-star reviews. The data backs everything up. For a limited time, get 15% off with code Liz at oneskin.c.co slash Liz. Again, that's 15% off at oneskin.co with code Liz. Was there anything on your journey that was especially transformative

in eliminating some of those people-pleasing tendencies? It was really just profound failure, to be honest. In my late 20s, I dropped out of my psychiatry residency training after going to school for almost a decade to become a doctor. I left my marriage. And part of this was because I was very disillusioned with psychiatry, and I felt like there was a lot of failings in terms of what we could offer, our patients and all the systemic inequities that go,

on in our healthcare system, but also I was just deeply broken at that time. I left and I moved into this wellness commune that studies orgasmic meditation. I stayed with that group for two years and did neuroscience research at the Rutgers Orgasm Lab. And after that period, I realized that there's just as many hypocrisies and inconsistencies in alternative medicine as there are in alopathic, more academic medicine. And ultimately, I found out a couple years after I left the group in like 2013, 2014, that the story inside this group was really, really dark. I went into my own psychoanalysis three days a week on the couch. I had to come to terms with the fact that I was a physician speaking on behalf of this group. I was so ashamed that I had sort of fallen for it,

but then at the same time, I was so deeply hopeful while I was there. And the practice had really helped me. That was such a profound failure on my part that once I got through my own journey in healing, I was never again susceptible to somebody else telling me what the path is or what to do. Now, I don't recommend that everybody else goes through that type of trauma to learn that lesson. Like it was a very hard way to learn that lesson. Most people won't feel it to that extreme, but we see it coming up just in our day-to-day lives with friends or family members who are kind of offering up their own solutions or their own advice. You have to learn for yourself. I don't know if that answers your question,

but that was kind of my honest. It does answer my question. And I also think it provides a really beautiful reframe on the notion of failure. I think we shouldn't necessarily be a mean to end up in a situation as extreme as yours, as you said. But when we are in moments that are really hard that are testing us, that we feel like we're failing, for me at least, knowing that that's a moment that I'm probably going to maybe not learn a lesson because that feels trite, but discover a new part of myself, activate a different part of my brain, transform my thinking a little bit. That is helpful for me. It reminds me a little bit of when I was going through IVF last year, one of our ag retrieval cycles, I had a bad lab visit or sonogram visit where things

didn't look great. And there was like this really deep moment for me of like surrender to like I don't have control. Like my body is going to do what my body's going to do and I just have to let it go. And there was relief in that too, which actually does remind me a little bit of that pivotal moment of failure for me, even though I was so embarrassed and depressed and nearly suicidal, there was also like this relief of, gosh, I can't imagine something worse. And like, I'm going through it and I lived through it and I rebuilt my life. And now I'm not as afraid of bad things happening. Yes, I don't want bad things to happen. But I also know that I have the strength to move through. Humans are so much more resilient than we think, and you can hear that till the end of time. But until you have

those proof points for yourself, sometimes it's very hard to have that sink in. People who've been through those types of whether it's trauma or grief or just in whatever way that shows up, there's a different quality to somebody like that in the way that you're able to make decisions that you can ground yourself in a knowing that when you haven't been through those life lessons, even though it sounds super trite, when you haven't been through that, it's hard to grasp it. Can you explain briefly the four principles of real self-care? Yes. This is conceptualized based on my clinical practice and also the concept of eunomonic well-being,

which basically means a life that is focused on me. meaning and purpose. The first principle is getting clear on boundaries and dealing with guilt. The second principle is developing self-compassion in the way that you talk to yourself. The third principle is identifying your values and getting closer to yourself. And then the last principle is to recognize that this whole process is about power. And by reclaiming real self-care, you are actually taking your power back from these oppressive systems. And if you're somebody who does have privileges in your life or does have access to resources, part of the responsibility that comes with power is to pay it forward to people that have less than you.

I want to dive into the nuances of some of those. So let's start with self-compassion. I think self-compassion is vitally important on a self-care journey. but in practice, it is truly startling to realize how much of our time we spend essentially talking shit to ourselves and about ourselves in our head. And it can feel really, really, really hard to shift that conversation. So I'm curious if you have any actionable tips for bringing more self-compassion into our lives. I love that you said changing that conversation because that's exactly how I frame self-compassion. It's not that. It's not that.

affirmations and the mantras, it's actually really about just developing a different conversation with yourself. So I lean on Dr. Kristen Neff's framework for self-compassion. Kristen Neff is one of the foremost self-compassion researchers. And she conceptualizes self-compassion using psychological flexibility, which is a term that comes from acceptance and commitment therapy. There's a term called cognitive diffusion, which essentially means that you're making space from your thoughts. So when you notice whether it's like that inner self-critical voice or whether it's like your inner mean girl that's coming out, instead of engaging with that voice, asking it a question, saying something like, hmm, that's curious.

Where did you hear that? or if you're saying to yourself, oh gosh, Pooja, like you're a terrible mom. Wow, that's really harsh. So you're pushing back on the inner critic and trying to create a different narrative for yourself as opposed to just buying the thought as the truth. And do you need to literally replace the narrative or is the pushing back enough to begin to create the new narrative? Like, do you need to put in a new story?

I've found that putting in a new story ends up feeling artificial. So I prefer the pushing back. That's what I do in therapy with my patients. And then once you push back, it opens up a new potential dialogue or a new conversation that can happen organically. But I've found that inserting the new language doesn't always stick as much. Could you give an example of how that might work so we can put it in practice ourselves? Recently, I had a patient who was beating herself up because she had gotten childcare over the weekend.

And she was like, you know, gosh, I can't believe that I'm paying for a babysitter. Like, why did I have kids if I can't even take care of them? And I said, that's really interesting. Where have you heard that before? And she said, it really sounds like something my dad would say to me. Like, I think my dad has said that to me before. So we got clear on these messages come from outside of us. The way that we talk to ourselves really has its roots in our families of origin as well.

So if we're like, oh, I heard that from my dad. Oh, I heard that from my mom. It's ingrained that I should trust them and trust their belief system. Do you have any advice for disentangling? These are my beliefs. These are my values. And these are the external beliefs and values that have come from either people, that I love or society at large.

Yeah. This is a very long process of getting through and untangling all of these different narratives, especially if you've come from a family where there's trauma or addiction or any type of dysregulation. So I first want to just say, this isn't the type of thing where it's like, I learn this and like now a week later I got it. I'm cool. Great.

You know, this is the type of thing that takes years and years and years. step one is certainly recognizing it, questioning it, and then the first time that you recognize it, then after that, you'll start to pick it up in all of the different places in your life. Part of that process usually involves grief as well, coming to terms with, oh, wow, I've had to live like this for so long. I've treated myself so badly for this long, giving yourself compassion for this actual healing work. It can be really helpful to have a therapist in untangling all of these different narratives because it can be really confusing because in many situations, not all situations, but in many situations, your parents were not doing this maliciously.

They were doing the best that they could with the skills that they have. I have a patient currently who is first generation, her parents or immigrants. I come from an immigrant family thinking about intergenerational. generational trauma and how all of these different forces can coalesce, it's normal to feel angry, it's normal to feel grief, and moving through the process of forgiveness for yourself, for your family, understanding what that looks like. I don't know that I can provide a one-size-fits-all takeaway or solution because I think it's just so individual how you're coming to this. But I will say when you're working through this type of inner narrative, that's a place that therapy can be really helpful.

Can you share some advice for figuring out individually what our values might be? One of the things that I've found is that when you ask people straight up, like what are your values, people either go blank or they give you answers that they think that you're supposed to have, like, oh, I really value service. Or, oh, I really value compassion. It's like, okay, yeah, but what else? So in real self-care, the values exercises are all kind of indirect because I want you to come to these words. The values, words are all adjectives because a value isn't a goal. A value is a way to be, a way to show up in the world.

They're indirect because it gets you closer to the truth when you're coming from the side. One of the examples that we were just talking about is the $200 dinner party. What kind of dinner party would you throw? What would it look like? Are you the person that wants everybody to be like laughing and having a great time? And are there lots of costumes? And is there a pinata? And then so are your values like, do you really value fun? Like a silliness, something that is really important to you. Or are you somebody who wants there to be like this reflective like circle? where everybody's like sitting around and sharing their deepest, darkest secrets. Do you really value one-on-one connection?

Do you really value authenticity when you're in a group with other people? It's indirect, but having these low stakes thought experiments where you're just fantasizing in your mind, those are the places that your values actually come out as more crystal clear, as opposed to what's the most important thing to you. Because of course, like everyone is just say family, right? It's actually an interesting question if you would invite your family to your $200 dinner party. You can be like, oh, family, family, family. But if it doesn't occur to you to invite your family to that party, like some sort of interesting thing to grapple with.

Exactly. That's sort of the fun part too with a lot of these exercises. There's reflective questions. And then there's different doors you walk down and different conversations that you can have. with yourself, but it's less of a one specific, here's the answer. And do our values change over time or our values, core parts of who we are and we just need to uncover them over time? We all have a huge long list, and that list is always shifting over time. And some are moving to the top, some are moving to the middle, some are moving

to the bottom. And that can change in the different seasons of your life. For example, if you come to parenthood or, you know, if you're taking care of your aging parents, or if you're in the midst of big career transitions, flexibility and coming to understand that there are different seasons in life, that's also part of the process and you don't need to feel like you've failed or that you're somehow off the path. It's not like you're betraying your identity to change what you want and you need in your life. You just said it so much better than I did, exactly. What if you've identified your values?

You're like, I value fun. Let's say you value family. Let's say you value adventure. Are those values that countenifies? Adventure and fun are values, yes. Okay. Adventure and fun. But you look around your life and you're like,

I literally don't have time for adventure and fun. I don't have the money. Obviously, the systems need to change. But if I'm just looking around my life and I don't feel like my life, can accommodate my values at this moment, what can I do? The first thing that I would say is it's okay. If you get back an answer like that and you're like, oh shit, nothing in my life works. You don't need to overhaul your life.

You don't need to quit your job and get a divorce. Like I already did that. It doesn't work, right? I did that for you guys. Like, you don't need to do that. The first thing is you can sit with these answers. Let yourself sit with them. You don't need to rush into action.

The process of change is always a long process, especially if you're coming from a place of burnout. We have this illusion that when you're burnt out, there's going to be like some magic one choice, whether it's quitting the job, leaving the relationship, but that's going to be the thing that fixes everything. When in reality, the way back from burnout is like hundreds of small choices over time. It's usually a years-long process. Some people might find that to be scary and intimidating. I find it to be more relieving because it means that on any one decision, the stakes don't need to be so high. So for the example that you just brought up of like, well, what if I really like and value

fun and adventure, but my life feels really serious and regimented and there's no room for any of that, then I would say, okay, how can you bring some fun into your life for an hour a week? If you're somebody that has a family, can Saturday mornings be a time that you can carve out silliness? How do you make that happen? What needs to change? Who are the other stakeholders that you need to be in conversation with, whether it's your partner or other caregivers?

I don't know what that solution is. But the first step is to acknowledging that this is something that is important to you and saying, I'm willing to commit to taking some sort of small action. And usually that small action will involve negotiation with somebody else in your life and figuring out how you can make that work. And just to kind of bring a lot of what we're talking about together, part of the assertion that you're making in general. is that if we're not doing a step like that, that would allow us to live in line with our values, that would allow us to bring fun into our life if fun is something we value, that all of the manny petties in the world aren't going to make us feel better on this deep level. It's not the mani pettie itself.

It's that the mani petty is perhaps masking or putting a band-aid on what our bodies and souls and minds are actually crying out for. Yes, taking it a step further, I conceptualize the manis and petties as tools, but all of this deeper work, those are principles or perspective. So a tool is something that you can use very specifically for a specific time, but tools are limited in their utility because they don't apply for every single situation. So the reason that when you get your Manny Petty and you find yourself still obsessively checking your email and feeling like you still need to get all your work done and when you leave the Manny Petty, you need to make up for all the lost productivity is because you've checked a tool off of your list, but you haven't done this deeper work of getting clear on what your values are and what pieces of your life, what pieces of your schedule, what aspects of your family and your relationships are actually deeply nourishing for you. And you said almost every time that's going to involve some other person, like having a conversation about a boundary or asking for help. Let's talk about asking for help for a second. It is so important.

It is so hard. Can you share some concrete advice to make asking for help easier? My biggest piece of advice with asking for help is start asking even before you need it. I think of asking for help as a skill and a muscle that women in particular need to get so much better at because we're terrible at it. It's like riding a bike or lifting weights. Like you have to actually practice and learn how to do it because every time you do it, you're going to get all of that toxic messaging back of like, oh my gosh, you're so selfish. Oh, my gosh. Everybody else is so busy. I can't believe you would inconvenience anybody.

You have to be able to let all of that go. So I had a patient a couple years ago who had two kids and her husband was going to be out of town for a night traveling for work. And she was like, my sister offered to come over to help with bedtime on dinner. But I don't need it. It's fine. I was like, well, why would you say no? She was like, no, she has a lot going on. I'll be fine.

It's just one night. But that's not the point. The point is that your sister said she wanted to help. And like these are the moments actually for you to say yes. and to learn how to receive and to be in community. Again, we're like talking about relationships and how real self-care, again, always comes back to like navigating our relationships. Why not give her that opportunity to be there with you

and to feel good when you said yes to her offer? Why is that you can only accept help when you are at a crisis point? Why is that? Why are people mostly only able to accept help at a crisis point? There's a lot of reasons. They come back to, like a lot of things, these deeply embedded structural norms in our society that we exalt productivity. We exalt efficiency with our time. Then that puts everybody in this mentality where time is money.

Everybody's operating in their own nuclear family hamster wheel. of like a race against the clock. And I do think in the United States growing up with that culture that's grounded in that puritanical work ethic of like the individual and what you do and what you accomplish. And then we have our nuclear families and most of us or many of us don't live close to other family members or extended family. So everybody's hyper segmented. And because of the way our economy works and labor functions, there isn't this.

extraneous extra time, be leisurely and just be about. The fact that everything is so self-contained, it always feels like a risk to go outside of your little operating system. The work of parenting and this community work is to go outside of your nuclear unit, develop a real community that is interconnected and that can be there for each other. It takes. takes time because it's about relationships and building trust. We can have that conversation with ourselves. We can give ourselves more compassion, but we can also learn to trust other people in our lives to be there for us too. When you think about strength and resilience, like your ability to feel energized, to recover well, to stay strong as you get older, what do you think that

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Moody. I think there's this dual thing. One, you don't want to put other people out. And also, it's almost this fear that you have failed within the system that we live in. Like, you aren't being productive and optimized and all of these things that we've come to really associate with our own sense of worth and value and to admit that to somebody else, to ask for help is to admit that to somebody else in some ways. And I think that that can feel really painful to do. I know that I'm still working on disentangling my own sense of self-worth from what I produce and what a value I can offer to other people

and working on the fact that I have worth just as the person that I am just by being. And I know that asking for help, like taking that self-worth ping within the context of how we've defined self-worth on a societal level can feel really scary. What you're pointing to too is the ego that's involved in it. The dopamine hit that we get when we're so efficient

and we get everything done, and crossed off our list. One of the things that just came to mind for me as you were talking was, as we started in this call, I didn't have my mic set up. And so you were so generous in giving me the space and the time to get it set up properly, which to me, that was like a gift. That was you caring for me and saying, it's okay if we start a little bit late. And like, I want you to take the time to get it set up.

And that felt to me generous. When you're coming from a place of empty, you take the real self-care. thermometer and you come back, I was red on burnt out. When you're at that place and your shoulders are all scrunched up and like everything is just like urgent and hard and not enough, like, you don't have the space to be generous then to other people in your life. And it's a feedback loop. And the only person that can stop it is for you to step back and say, okay, wait, no. Like, I have enough. this is enough what I have, who I am, this is enough. And I can give that to myself and I can give that to other people too. I feel like if you could really cement in the idea that who you are and what you have

is enough and you could get better at asking for help, those two things in conjunction would create that sense of spaciousness that I think a lot of us are craving and that a lot of us really feel the absence of in our lives. Yeah. Another patient and mine who took the risk of taking a mental health leave from her job. She had OCD, and it was in context of a whole bunch of other life stressors, and this cascade effect, when she took that leave, you know, she was bracing for the worst. But ultimately, it ended up that she started a support group for other employees who had mental health issues or had kids with mental health issues, and she advocated to get that paid for in her, you know, in her line items of how she was compensated. And

She ended up getting a promotion. So the thing that we're fearing, whether it's asking for help, whether it's like, quote-unquote admitting that you don't have it all together, there's a relief there in that spot where you finally just say, I need to take this time for myself. I need to make this space for myself. What comes after that is often something really good. I don't want to like make it like toxic positivity because that's not the goal either. This is all hard.

but this is the type of stuff that actually propels change as opposed to the many petties. And I think that when you do something like that, you fear judgment from other people, but what you often find is that so many other people are in the exact same position as you, but they've just been afraid to talk about it. Yes. The transparency is really valued and seen and respected. We're talking about making decisions in a different way and thinking about your time and energy in a different way. So it will always be a risk.

You can't be certain how people will respond. But the people that really matter and the people that have done some of this work themselves will see. Can you talk to me briefly about martyr mode? What is it and why do we do it and how can we stop? Martyr mode is that phenomenon where you're running at like 200 miles an hour, getting everything done, taking care of everything else, everyone else. And you're so resentful because nobody is paying attention to you. Nobody is helping you. Nobody is looking out for you. And yet you are bending over backwards, getting everything done. In my practice, the time that I see this come up the most is around the holidays, especially for moms, you know, with like all of. of like, whether it's Christmas or Hanukkah or, you know, Thanksgiving. It's like the mom that's up all night, doing all the presents and the rapping. Or it's even like in the workplace, too.

I once had a boss that would brag about keeping a sleeping bag under her desk, which is just terrible for so many reasons. We all know those coworkers, the ones that are just like, oh, yeah, I just pulled an 80-hour work week. Or even just in regular conversation, I'm so stressed, is like a badge of honor. It means that your time is valued and people desire. your time and you have so much to do. That has become something we almost brag about. Totally. It's this busyness epidemic because the empty space can be anxiety provoking. The reason that martyr mode is so destructive is because it breeds resentment. You're making

yourself smaller and smaller for the sake of everybody else on the surface. But really, it's about your ego and wanting secretly or not so secretly to be seen. and upheld as the person that saved the day. I noticed this pattern first in the medical community, like as a physician, where there's so much martyr mode. But of course, I see it with my patients too, and I struggle with it as well. All of us are always so worried about being called selfish. So what I do is ask more questions around what selfish means to you versus self-less. And self-less is something that is really exalted.

But self-less is not what we want to be striving for either. We want to be striving for this middle ground where your needs are also part of the conversation. It's interesting. The idea of exulting self-less literally means without self. And why are we spending so much time trying to discover and become our authentic selves and then exulting something that is without self? It is definitely very tangled up. It comes back, especially for women, with like this tendency to deify sort of the self-sacrificing woman. And then I also think there's a freedom too where if you can

have the conversation with yourself and you can say, well, why am I trying to make Christmas like this or whatever? Why am I putting all this effort into it? If you can come to, oh, I want this. this is something that I value, then it takes it from being a martyring act to something that you can celebrate about yourself in a way. And then I think that can also take away some of that resentment as well. I think it's just this resentment that comes when you're like, I'm doing this for all of you and you don't appreciate it. And everybody else is like, well, I didn't ask you to do it for me. So why should I appreciate it? 100%. I'm glad that you mentioned that. It's not that any of these activities are inherently bad. It's just that you need to understand what your motivations are.

It actually reminds me a little bit about a conversation I had a couple weeks ago with the patient who was trying to decide if she was going to have a second baby or not. And originally she was coming to the decision of yes from martyr mode, which to be clear is not a good reason to have a baby. She was really identifying with like, well, I really want my first child to have a sibling. And we spent multiple weeks talking about it and unpacking and getting clear. And like, yes, she wanted that. But she also wanted to have another baby. And for her having four people and the family really felt like that was the vision that she had had for her family.

So it can be small things like Christmas. It could be big things like whether to have a baby or not. But immediately, the whole mindset that she would go into having a baby with if she's like, I'm undertaking this huge thing. for my body and my relationships and my finances and for the rest of my life, bringing another human in, and I'm doing it for you, child. And what a heavy burden to place on this child

that you brought the sibling into the life of versus, I'm doing this because I want this. It opens it up and it just changes all of the conversations mentally around it for not only yourself, but for all of the other players involved. Yes. That's incredibly powerful. Okay, I would love, just as we're coming to a close here, can you share some advice for softening perfectionism? And you choose the word softening perfectionism instead of eliminating perfectionism. Can you talk to me a little bit about the distinction between those two things? So perfectionism is it's about control. It's about controlling other people's reactions to you. And I choose the term softening because whenever we say eliminating, it always puts.

the pressure on to get rid of something and we know whether it's guilt, whether it's perfectionism, if you're so focused on getting rid of it, you're actually still controlled by it. So softening, thinking more as a volume dial is how I like to frame it. I like to ask myself, like, what am I trying to control? Everything. Right. One of the places that I see this kind of show up so much is, especially in motherhood, because so much is out of control and so much is unpredictable, we can often turn to perfectionism as to a misplaced form of order. So if you are somebody who is type A or linear, perfectionism is an easy measuring stick that you can always go to in your mind when your house feels chaotic.

when life feels chaotic. And that's not only about motherhood. You could also apply that to if you're somebody who has chronic health issues, or if you're somebody who has mental health condition, it's applicable a lot of places like the way that we sort of try and make order out of situations that are inherently uncontrollable. One, recognize that you're doing it. I also like to always ask myself, well, what is the cost?

because perfectionism takes so much energy. It also prevents you from having genuine, authentic interactions with other people because you're spending so much of your time being kind of internally preoccupied on your own performance or on your own agenda. That inherently takes you out of the spontaneity of a conversation or an interaction and keeps you in your own head. So when you're stuck in perfectionism, you're giving people less of yourself for the sake of trying to create some sort of order or rigidness in your own internal system. That's so interesting.

So you think that the awareness of that even just understanding what you're giving up in hopes of attaining this can be enough to start to show. shift away from it, maybe in a moment-to-moment way where you notice that you're doing it and you think about what you might be losing? Yeah, when I frame it in terms of interpersonal relationships, that always is a motivating factor for me. Like I'm putting less of myself into a conversation or into an situation if I'm bringing all of my perfectionism there. So that motivates me also like to think about perfectionism in the context of thinking of it as an indicator, too, because if you're somebody that struggles with perfectionism, you will probably notice that the times in your life that are more chaotic or where the stakes feel more high,

you will probably find that your perfectionism takes it up a notch because you're feeling more of a sense of urgency. So like developing a relationship and an understanding of your perfectionism so that you can see like, oh, if you know there's going to be a particularly stressful month, like looking ahead and saying like, oh, I bet my perfectionism is going to like totally show up that next month. And then think about being prepared for that and putting in place some conversations with yourself and checkpoints over the course of that period of time to say, where is my perfectionism showing up? What am I noticing? And can I, make changes to my schedule? Can I give myself some more downtime? Can I be more realistic with

myself about the demands on my time? And going back to the conversations that we had about values, it sounds like some of the times perfectionism is the most harmful is when it's actually getting in the way of us living the life that is aligned with our values, the life that we really want to live. Yes. And the reason for that is because perfectionism is very externally focused. It's about exerting this control on how you're perceived. The reason why values are so powerful is because they have to come from the inside. And that's so hard. I think everybody feels this, particularly as women, we're taught almost from the time we're born that so much of our value and our worth is in being perceived, is in the role we play for other people and how we look for other people and how we appear to

society at large, that even just that understanding that, like, no, I am not here to be perceived, I am here to be is so powerful. It's hugely powerful. And it takes a really long time to grasp that and to internalize it. And then at least for me, I feel like in every new kind of phase in my career or transition season in life, it comes back. I have to almost relearn it each time because there's these new scenarios where the perfectionism or the people pleasing or whatever it is. That's like always the first thing that I reached for. And then I have to remind myself, wait, no, I've learned this before.

A hundred percent. Can you leave us with just one homework assignment, something that listeners can do immediately when they turn off this podcast to start bringing more real self-care. into their lives? Yes. The question that I have been meditating on myself over the past few weeks is, what is enough? How will I know when I've done enough? How will I feel when I feel like enough? And I would love for folks to take that question, meditate on it, apply it to different parts of your life. I think it's a really powerful question. And it's one that we don't ask ourselves often. Do you have any answers for yourself yet? I find that when I ask myself that question, the answers that come back usually are that I've already done it, that I already am enough,

that everything else is icing is extra, that I don't need to feel like I'm constantly proving myself or proving my worth. So even just the whispering the question to myself like grounds me back to that truth. I love that. Can you just tell us a little bit in your own words about your beautiful book and any other work that you'd like to highlight? So the book is called Real Self-Care, a transformative program for redefining wellness, crystals, cleanses, and bubble baths not included. You can get it on March 14th, and it is available for pre-order at all the places that you can buy books. And my company, Gemma, G-EM-M-M-A, GMAWomen.com, is a physician-led women's mental health community that I founded in 2020 and myself and two other psychiatrists, Dr. Callie Cyrus, and Dr. Lucy Hutner are building this community. We have a membership.

We have WhatsApp threads. We have lots of courses. and a free substack email newsletter that's called Therapy Takeaway. So you can check that out as well. And then I'm on Instagram at Pooja Lakshman. And I really hope that some of you decide to check out the book. And I'd always love to hear from you. And I'm really excited to keep continuing this conversation.

Amazing. Well, I so enjoyed this. Thank you so much for taking the time to be here with us today. Thank you, Liz. I felt so fired up after this interview. I think it's just such a wildly important conversation to have that we need to take care of ourselves, but also we need to create a system that doesn't make us feel so unsupported at every single turn. And we need to not disguise that system and almost give it permission to exist by being like,

okay, I'll work a zillion hours and barely afford child care and have to answer email on vacations. And I'll just do like a DIY footpeel and feel all better. Like we can take responsibility for our lives and our well-being while acknowledging that this isn't okay. and it's not sustainable, and as a whole, on a societal level, we can do a lot better. Please send a link for this episode to anyone and everyone you know so we can have these conversations because that's where change begins. Okay. Pooja generously agreed to give three winners a copy of her brand new book, Real Self-Care,

so you can dig even further into all of her incredible wisdom. All you need to do to enter is follow me. I'm at Liz Moody and Pooja. She is at Pooja Lakshman at P-O-O-J-A-L-A-K-S-H-M-I-N on Instagram and then comment on a recent post of mine, something that you loved or learned from the episode. The post does not need to be about the episode. Just mention Pooja, so I know which episode you're talking about and which giveaway you are entering. And if you are new here, make sure that you're following the podcast on whatever platform you like to listen on.

Just go to the main podcast page. It's the one that lists all of the healthier together episodes. And you'll see the word follow under the logo on Spotify. Spotify. And then there's a little follow with a plus sign button on the top right of that same page on Apple Podcasts. That way, all of the new episodes will show up right in your feed so you never miss out on one. And you are definitely going to want to be notified because we have some incredible episodes coming up, including one all about hacking our circadian rhythms and a fresh edition of our pros and cons of having kids series that I'm very excited about. So make sure that you're following so you do not miss out. Okay, I love you and I will see you next week on next episode of the Healthier Together podcast. I'm genuinely confused how masterclass gets literally the absolute top people in every single field to teach every single one of their classes. I use it when I want to learn things directly, like the cooking class from Thomas Keller has all of the wisdom that you would normally

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