Are you tired of hearing the phrase self-care isn't selfish?

If you are a senior leader or healthcare professional, it's one thing to encourage

your team to look after themselves, but if you are giving them permission,

who's giving you that permission?

The truth is it often doesn't come from your boss or your colleagues,

and in many cases it can't.

So it's our responsibility to look after ourselves.

It really shouldn't be called self-care.

It should be called necessary care, which is easier said than done, right?

This week, Dr. Caroline Walker, psychiatrist, author and founder of

the Joyful Doctor, and my co-host in the Permission to Thrive community,

makes a well overdue return to the podcast to talk about what we need

to give ourselves permission to do and what happens when we don't.

If you are feeling guilt and shame over saying no or setting boundaries, or

you've noticed yourself putting your own needs aside, this episode is for you.

If you're in a high stress, high stakes, still blank medicine, and you're feeling

stressed or overwhelmed, burning out or getting out are not your only options.

I'm Dr. Rachel Morris, and welcome to You Are Not a Frog.

I'm Dr. Caroline Walker and I am a psychiatrist and therapist

by background, and I specialize in the wellbeing of doctors and

other high stress professionals.

Wonderful to have you back on the podcast.

Caroline, you're a, you're a, I'm gonna say an old face.

You're not an old face, you're an old friend.

and Caroline and I do a lot of work together, including hosting the

Permission to Thrive membership with a, a load of doctors, which is

really a, a personal professional development community for doctors.

Now, I wanted to get Caroline onto the podcast to talk about

permission, 'cause you've just written a book called Permission.

Caroline On Earth.

Did you write a book called Permission?

What do we need permission for?

Well, uh, I needed permission to write a book, uh, certainly to start with.

I, yeah, I've always loved writing and I think I always had a book in me.

Uh, but like many doctors and busy professionals, I got kind of, you know,

on the conveyor belt with work and all the different roles in my life.

Um, and yeah, it was a personal journey for me actually to stop and give

myself permission to, to pursue a real passion, you know, which was writing.

Uh, why this book?

Why Permission?

Well, I, I talk about that in the book, uh, but I think

basically it was something I saw.

Every single time I worked with a stressed out professional,

I saw this theme coming up.

You know, a lack of permission, uh, lack of permission to go home on time, to say

no to staff, to look after ourselves, uh, to be who we really are, um, at work

So what is it or who is it that doesn't give us permission?

it basically, it's ourselves.

Um, I mean, I think as we grow up as, as children, as human beings in

the world, we look to others around us for permission to start with.

So we might look to our parents or teachers at school or our

friends, you know, to let us know what it is and isn't okay to do.

Uh, but gradually as we get older, we, we start to give ourselves more permission.

Uh, but then again, when we get into the world of work, often that reverses

again, like into, uh, looking at others.

So we might be in a workplace where everyone's really, really

busy and no one's leaving on time.

So we're looking around as a, you know, going home time and thinking, well,

I can't leave 'cause no one else is.

So often we are looking to others for permission, but actually the

key to a happy, healthy, joyful life is to start to give ourselves

permission to do what we need to do.

And if you're not giving yourself the permission to do what you need to

do, typically, how does that show up?

And I know you work with practitioner health, you work with a lot of,

patients who are doctors who haven't given themselves permission.

Where do you end up if you, you're chronically not

giving yourself permission?

Yeah, it's a great question.

Um, essentially we end up burnt out.

You know, I think drip, drip, drip over time, if we are consistently not meeting

our needs, if we are not having a good work life balance, then, you know, we can

keep that up for a short amount of time.

But eventually, uh, we all break, right?

Eventually.

Uh, if we're running on empty for too long, then yeah, quite often

I'll see people who, other areas of their life has started to fall apart.

Like maybe their relationships at home are suffering or their health is suffering,

but they're just keeping going at work.

So others around you might not think there's anything wrong, right?

They might think you're doing great 'cause you are, you know, achieving a lot.

You are really reliable.

Eventually, once every other area of your life has started to

fall apart, then work does give.

And you know, I've seen numerous, uh, examples where doctors or other high

stress professionals have just literally their, like their body or their brain

has just stopped working one day, so they literally can't get out bed or

they're going to type an email and their hands just stop on the keyboard,

you know, they can't do it anymore.

But it's odd, isn't it?

Because you know, doctors, these people in high stress jobs and lots

of senior healthcare professionals, we know that we need to rest and

we know that we're not at our best.

You know, some of it is, you know, enshrined in, in safety.

So, you know, if we were a pilot, we wouldn't be allowed to fly.

I dunno what the flying, you know, the, the how long you're allowed to fly window

is, or the how long you're not allowed to drink alcohol before you do it.

Why hasn't that got through to doctors yet?

Yeah, another great question.

I think you, you know, you say we know it, but I'm not sure we do

collectively as a group of people.

I think we know it intellectually and we know it for others, but we haven't

yet learned how to do it for ourselves.

And I, I think it's a mixture of reasons.

I think one of the main reasons is we're not role modeled it particularly well.

I mean, that is getting better as more and more of us are trying to role model

more healthy behavior and boundaries.

But generally speaking, we don't see other doctors and

healthcare professionals doing it.

What we see is people giving and giving and giving, sacrificing themselves kind of

slightly, you know, martyring themselves, um, having that kind of hero mentality,

you know, we must put others first.

And we sort of put that up on a pedestal, don't we?

And a lot of our self-esteem or self-worth, um, is driven by that.

So it's really difficult for us, I think, to see that it's okay.

You know, we, the idea of us saying no to something or going home and there's still

work to do is, it kind of goes against our core values as a person quite often.

And so a lot of the work I do with DOS is to help 'em to see that that's not true.

You know, that actually when you do peel it all apart, you, you have to

be well in order to do this job well.

So if you really, genuinely want to do the best by your patients, then

you have to look after yourself first.

It's really hard though, isn't it, when there's no slack in the system and,

Totally.

and if you do look after yourself, that actually impinges on somebody else.

It impinges on somebody else, which means that they can't look after themselves.

So people are stuck between a rock and a hard place.

How do you navigate that?

Well, it kind of depends where people are at.

I mean, as I shared before, we'll often see people where they're at really

at breaking point, and at that point the sort of, it's kind of taken outta

your hands a little bit, isn't it?

'Cause if you are so unwell that you can't go to work, for example, you're

gonna have to take some time off, then that does at least give you a bit

of breathing space and a bit of time to kind of work through this stuff

and to realize how important it is.

If someone's not that unwell, let's say you've just noticed that you're

starting to get a bit more tired, or you're starting to notice some

warning signs, um, that you're not at your best, then we would start a bit

more, a bit more gentle, a bit slower.

We just start with some small changes that are doable.

You know, I think the really important thing about this is not,

not to get too fancy about it, but just to be, start really, really

simple and really straightforward.

So, you know, if you're leaving late, could you leave like 15

minutes earlier than you have been?

Or, you know, if you are saying yes to 10 things, could you say

no to just one of those 10 things?

You know, so we start with really small changes and, and that kind of

tends to build people's confidence over time because then it's like,

okay, well the, the sky didn't fall down, you know, nobody died.

It was okay, maybe I could do that again tomorrow, and then we build from there.

Do you think that the people you see are waiting on permission

from other people as well?

Definitely.

Yeah, and I think we're, as I say, we're trained to do

that even as children, right?

We're trained to look towards adults to tell us how to behave.

Um, and then as you know, uh, doctors or whatever profession you're in, you will

have looked to those that have gone before you to see what is it okay for me to do

and what is it not okay for me to do?

Um, so, and that's quite normal.

But the problem is if we just keep doing that on automatic pilot, that

we are not gonna get our needs met, we are not gonna make those decisions

that we need to make to keep well and to stay well and to avoid burnout.

So, yes, whilst it's quite normal and, um, common for us to look to

others for permission, and that's okay, um, we've also got to, as I say,

start giving ourselves permission.

'Cause most of us know, like I often do this exercise where I say to

people, write down the sentence, I give myself permission to dot dot dot.

And I get them to answer to fill in that question, to

finish off that sentence, sorry.

So, because most people do know what it is they need to do, you know, most people

know they need to, um, let go of a project that is causing them too much stress or,

you know, say no to the in-laws coming at Christmas or whatever it might be.

Most people have got a little inkling, they've just not necessarily had

that opportunity and that permission to stop and, and ask that question.

I mean, I've observed that even when people have been given permission by

other people and they've written that down those sentences, and they, they've

tried to do it, there seems to be the shift that needs to go on in inside them.

And I see this shift happening when people are really burnt out.

They're like, right, flipping heck, I am not going back there, i'm not

going to back to that level of burnout.

Um, and then they change their whole life, they really do.

They're like, you know this right now.

Here's my b My boundaries were like, blah, blah, like this, and Jelly.

Now they are really, really firm because I don't want to get where I was before.

How can we get people to do that before they get to that absolute

rock bottom bit of burnout?

Because it seems to me we're wasting so much time and energy, 'cause it's

just that much harder isn't to climb back up the curve when you are done.

It's not impossible, but it, it takes time and it takes, it takes some work, it

takes a lot of self-awareness and I just think, gosh, wouldn't it be, wouldn't

it be good if we could manage to do this before we have this, this absolute crash?

But in my experience with myself, you almost need to have that crash.

So I don't know that, that, that doesn't need to be very fair to me that, that

we need to like experience rock bottom.

Before we, before we go up, is there a shortcut?

Is there any other way?

Uh, honestly, I'm not sure there is a shortcut.

I think in my experience we as humans often don't learn the lessons we

need to learn until we learn them.

And sometimes we do have to hit rock bottom, as you say, or you know,

sometimes the pain has to be enough for us to want to make a change.

Um, and like you say, I see it all the time that I, that kind of, I don't

wanna go back there, it was so bad.

I now get it.

I now understand it.

I think sometimes you can be lucky and kind of skirt at the edge of it,

and that's just enough to give you that little view of, oh my goodness,

okay, this is only gonna go in one direction if I'm not careful.

So I do sometimes see people kind of come back from the edge

before they go over the top.

But now for many of us, we do have to go over the top.

I certainly had to when I was, you know, having my first difficulties

as a junior doctor, I went to some very low places before I kind of

learned how important this stuff is.

Sometimes I think you might see it in others.

That can help, um, like someone close to you if you see them go through it.

But yeah, we all have to, like you say, have, find that internal motivation.

And I don't know if there is a shortcut.

I think, I think we can absolutely do some stuff to try to prevent us

getting unwell without having to get it, if you know what I mean.

So I think we can put in those kind of healthier boundaries and learn

to say no and do all that stuff.

Um, but you've gotta prioritize it.

And in the busy, busy world we're living in right now, that's a tough call.

What do you wish you'd given yourself permission to do?

I would love to have, yeah, got off the train a little bit earlier than

I did, you know, the stress train.

But again, I'm not, I think it's really difficult, isn't it, until

you see it for yourself, until you feel the consequences to really know.

I think we're all a bit young and, and invulnerable aren't we, to start with.

We don't think it's gonna happen to us.

And we see that particularly in doctors and high stress professionals

because they've worked all their lives in an environment where

they do well, they're succeeding, they're getting a lot of praise.

It's only when they then, something doesn't go their way that it

can be pretty catastrophic.

it's a bit like the success trap that my, a good friend and

colleague Nic Malcomson talks about.

He's a, a positive psychologist who works with practitioner health, works

with doctors, um, and he noticed a, a really common pattern with high

achieving professionals where, you know, they've done well most of their

life, they've, um, achieved great things and life has pretty much gone

in the way that they wanted it to.

But then they find themselves in a job, for example, where the resources are

too few, the demands are too high, a situation they're not fully in control

of where they can no longer succeed and something, you know, bad happens.

So either there's a big complaint or they just start to not be able to keep

on top of stuff or, you know, they're not working in the way that they would like

to and, and suddenly that inability to be successful, um, they, they take it really

personally and they see it as a massive failure and that has this huge impact

on their sense of self-esteem, sense of self, um, when actually it wasn't,

it isn't them that's failing, right?

It's just that we are humans and we have limits.

Um, and in any, any situation, any of us would break right?

With enough pressure, um, and without enough resource

to deal with that pressure.

He, he often helps these professionals to take a step back and just reevaluate

like, what does it mean really to be successful for them and, and does it

really matter if they make a mistake?

I know you and I talked about this in our recent Permission to Thrive

gathering about seeing failure as data, as useful information rather

than something that, you know, is catastrophic to our sense of self.

Why do we personalize things so much as doctors?

I don't think it's a doctor thing, I think it's a human thing.

I think most humans are self aware and self-reflective and tend to think about

things from the, their point of view.

So people listening to this now will be listening and thinking, oh yeah,

I recognize that, or I recognize this, or, yeah, it's natural, right?

We all do it.

Um, we all take in information all day long and apply it to ourselves.

I think doctors though, do have a very intense, uh, relationship with their

identity in relation to their work.

So I do think that it is one of those professions where often you'll

hear doctors saying, it's like, it's who I am, it's not just what I do.

You know, I am a doctor as opposed to I, I happen to be a doctor

as, as you know, the work I do.

Um, and I think it's kind of tied up with a lot of things, but we're often,

um, the type of people that take responsibility from a very early age,

we're very caring, very compassionate.

Um, we like to be in control and to be able to do things to

help others and help ourselves.

And I think we're sort of slightly sold a myth that as a doctor you

can, you can always do that when you know, we know now that you can't.

And again, that's where it can cause problems, right?

When you are trying to do a job where you're trying to help people and then

you suddenly realize, oh, actually maybe I don't have quite so much power

or control here as I thought I did.

So we sort of see things and take the system's failings very personally.

Like, I, I failed, you know, or, you know, you are given more work to do

than you could possibly get done.

But then we blame ourselves for not being able to do it.

We sort of gaslight ourselves into, in saying, well, why can't you do that?

You must be absolutely useless because you can't see 30 patients in three hours.

Who, who'd have thought?

Who'd have thought?

It just, it doesn't work, does it?

Yeah, so there's, there's, I guess, the, the permission to fail and permission

to see ourselves as human beings, as, as fallible human beings and the

permission to see the system and its, its failures as well, and not take

them personally as, as our failures.

I remember in COVID when, or just after COVID where, you know, access was a real

problem for GPs, even though GPs were like giving more, um, appointments than ever.

They'd have people being incredibly vicious down the phone, go, we

can't get appointments, we can't see, blah, blah, blah, blah, blah.

And people were feeling really hard done by and, and getting very defensive

and having big arguments rather than going, yes, isn't it awful?

Yeah, the system's really broken it's crap that you can't get.

You know, we're really sorry, but you know, because it wasn't

then, it was totally the system.

And I think we need permission to be truthful.

You know, I think we sort of role modeled, um, how to help patients

and how to smooth things over, how to make people feel more comfortable.

And sometimes actually it's totally okay and it's really important that

we just tell it how it is, that it is rubbish, that the system is a bit broken

at the moment or, you know, it's not okay, and it, and it annoys us too.

And I think that's again, something we haven't been particularly well, well

modeled, um, in the past, you know, that kind of sense of having to present.

The health service or what we are doing, uh, in a really positive light.

And actually, of course we are trying to help, but we are also in a system that

is really, really struggling right now.

And it's hard for all of us.

So I think it's, yeah, important that we are honest about that.

I do remember really struggling to say no to patients that were coming

in requesting, you know, pills that, that they shouldn't as a very,

very junior, newly qualified GP.

And, uh, some, some guy just come in and was wanting a load of load of diazepam.

And I went see the, the senior partner who just said, well, he

knows he doesn't get them from me.

I just say no.

And I was like, can you just say no to a patient?

Like, straightforward, no, I'm not doing that without trying

to help them in different ways.

She said, yeah, absolutely.

But

Exactly, he gave you permission, and then you then able to give

yourself permission to do it.

And I think with the, the kind of self-care stuff and the mental health

and wellbeing stuff, that's what we're starting to see is that as more and more

of us are openly looking after ourselves and giving ourselves permission to, you

know, go home on time or take breaks or say no to things or go less than full time

or whatever it is we need to be doing, that other doctors are then seeing that

and are get, getting permission from us to give themselves permission to do that too.

Although I have seen that there is a little bit of a generational issue

here as well, because you've got people in, in my generation, I've

just turned, I'm, I've just turned 50.

I'm Gen X, And then there's people coming up who didn't do those really,

really, really long shifts that we used to do, like 120 hour weeks.

But I had a team around me.

We had a doctor's mess.

It was great fun.

It was there some camaraderie.

Um, we have people that have been treated like shift workers and, and

then quite rightly they're saying, well, then my shift finishes.

I go home and, and I demand my rights and stuff.

And then you've got, other people have gone the other way of saying, well,

nope, you know, and probably just putting quite appropriate boundaries.

But people in my generation who are now the leaders and the, the senior

clinicians, they're like, well, okay, yeah, of course we have to listen to you.

That's quite right.

But that then means that I have to do it.

So your wellbeing, the fact that you are having your wellbeing stuff and going

off sick at the drop of the hat and, and, and is meaning that I have to work extra.

So how do we solve that conundrum?

Because I think it's a real generational issue.

Yeah, I, I absolutely agree.

Um, and I also see a lot of senior colleagues who are starting to put

wellbeing at the forefront for their juniors, but not for themselves.

So I've, I've, you know, I've heard more than once from a senior colleague,

you know, I'm absolutely fine, I encourage my, uh, you know, my juniors

to go off sick and I say, okay, and, and do you let yourself go off sick?

And then, oh, no, no, no.

So I think it, it absolutely is.

Um, there are generational differences.

And I think this is, if you look at any kind of change throughout

human history, it can take time.

It can take several generations for a big shift to occur.

And it's always difficult in the transition, because you're always

gonna have people that are on the, the kind of the previous way of

thinking if you like, uh, against, clashing with the new way of thinking.

I always think about the individual doctor in front of me and I think whoever they

are, whether they are a junior doctor in their first year on the wards, or

whether they are a senior, you know, GP or hospital consultant that's been

doing this for 20 years, they have this absolutely the same human rights, the

same right to for their work, not to damage their health, for them to be

able to do work that is rewarding and enjoyable and that doesn't make them ill.

So I was trying to try to bring it back to that individual.

You know, if they're struggling because their juniors are looking after themselves

much better and they're then feeling they've got too much work on, then we

need to look at how much work they've got.

You know, we have to bring it back to them.

What are their choices and options in that situation?

Um, because I do think we generally, as doctors and as really

compassionate, hardworking people will just flog ourselves, right?

We will just keep going and going and going, like you said, if they see, see

10 patients, you see 10 patients see 20, you see 20, see 30, you try and see 30.

And we just keep going.

And I think we have to take personal responsibility as individuals to say,

hang on a minute, this is too much, you know, for me, this isn't healthy and safe.

So I think it's actually the onus is on those, the, that older generation, if

you will, to, for them to be brave and come forward and say, hang on, I'm not,

I'm not coping here, this is too much.

And we will help them.

Because you are right.

The system isn't working, so it shouldn't be that one particular group

should take the pressure of that.

Yeah.

I hundred percent agree.

You know, rather than saying to the younger generation, oh, you know,

stop demanding wellbeing, stop demanding that you're thriving at work.

But that's ridiculous, isn't it?

Let's start saying the older generation.

You have the same rights.

You, I love that the equal rights for your work not to be damaging your health,

and just because you might be a clinical lead or senior consultant senior partner

that does not, that does not mean you've got less right to take a day off than

the most junior person in your team.

Then that's just ridiculous.

In fact, you probably need to do it more because you've got so much more

stuff going on and more critical stuff that you need to do probably.

Absolutely.

And you've got that responsibility to role model as well.

I, I always think about the, was it the, um, Danish Prime Minister, or it was one

of the Scandinavian countries where the Prime Minister took some sick leave for

mental health reasons a few years ago.

And I think that is such a great example.

Like there's nobody that this doesn't apply to.

There's nobody, it is not just 'cause you, you know, further up

the tree you go the less, it's okay.

I do think there is truth that it's can feel harder.

It can feel harder because of the stories that we tell ourselves that

you know, oh, I can't do this 'cause I'm the one in control, or I'm the

one in charge, or, you know, I, what impact will that have on everyone else?

But, um, you know, during COVID, Boris Johnson got COVID right?

He's still allowed to go into a hospital.

There's nobody, these things don't affect.

So I think it's really important that everybody at every stage of their

career gets the same message and the same permission to look after

yeah.

And just a caveat there, I'm not saying that all, all people in the, the

generations below me are over egging it on the wellbeing front, not at all.

But you know, they're really, really diligent.

And I think sometimes when people feel that they're not listened to,

that they're, it, they're not taken seriously, they can get a little bit

more militant in order to say, well, okay, if you're not just gonna do it,

we're gonna, we are gonna demand it, 'cause it seems to be the only way

we can, we, we can actually get it.

But then it just puts people against each other and, and then people say,

well, I don't wanna appear like that.

And they're like, well, I don't wanna appear like that.

And it's, it, it, it's just madness, isn't it?

And actually, the thing that's failing is, is the system.

And sometimes the system needs to be allowed to fail for

someone actually higher up to have to try and fix the problem.

I think if you are always the one that's plugging the rotor gap, well maybe how,

how about you don't plug that rotor gap and, oh dear, what's gonna happen now?

Well now someone's gonna take, note of that, right?

I mean, that's really hard to say because genuinely it affects patients, doesn't it?

So, so how do we, how do we square that?

Caroline?

Because one of the reasons people give is that they don't

want patients to come to harm.

And that's always the excuse, isn't it?

You know, harm to patients.

Harm to patients, and of course, we don't want patients to come to

come to harm, so what do we do?

So if, I mean, if you follow that through, then, what's the

most harmful thing for a patient?

An unwell doctor or an unwell nurse, right?

So do I really want me or my family to be seen by someone who is, you know, looks

okay and seems okay, but when they're at home at night, they're suicidal

and, you know, drinking too much and deeply depressed and, you know, no.

Um, actually I think the, um, if you really want to do the best for

your patients, then you absolutely have to be in reasonable health.

Um, you know, we can all work with a little bit of a cold or a little bit

of lone mood or a little bit, but you know, that we know from the evidence,

there's so much evidence that, you know, unwell, unrested, um, unhealthy

clinicians make more mistakes and ultimately harm their patients more.

So it's about patient harm and not doing patient's harm.

You're better off being off than being in.

And that you've gotta take the longer term view as well, because yes, it might

mean that a few patients have their appointment canceled or their surgery

canceled, for example, or postponed.

But in the long run, you, you've potentially got 10, 20, 30, 40 years ahead

of you to give to, you know, the health service and to give to your patients.

So, um, when we're talking about taking a week off or a month off, or even six

months off, if you take the long view, that is gonna be absolutely the best

thing for you in order to then be able to help your patients longer term.

I think we have to also gently challenge that kind of slightly, um, omnipotent

sort of sense of like, you know, everything will collapse without me.

It, it really doesn't tend to.

And I say that even when you are the lead of your service or you are

your single-handed GP, you know, there are mechanisms in place.

It might not be the absolute ideal, but there are mechanisms in place.

And any one of us could get run over by a bus tomorrow, right?

And the world would continue, you know, people would still get seen.

So I think we have to gently start to challenge that idea that, it's

gonna, like the sky is gonna fall down if we take some time off.

It really isn't.

And I, and I say that having been there, you know, having felt that,

that, you know, my life was over.

I couldn't be a doctor again.

I could, you know, you know, all those catastrophic

thoughts went through my head.

But, you know, a few days, a few weeks into some time off, I realized,

okay, yeah, i'm not as indispensable as perhaps I thought I was.

Yeah.

So, no, and that doesn't mean I'm not great at my job and

can help a lot of people right.

In my work and in my lifetime.

But I'm gonna do that if I'm well.

We often think we're indispensable to our work.

We are not.

And then we think we are dispensable to our families and we are not.

We are indispensable to our families and those are the people that end

up being the residual beneficiary of everything else when we're sacrifice

everything to our job, aren't they?

Caroline, in terms of permission, there's obviously permission to give

yourself time off, to take a break, to rest, to rejuvenate, um, you

know, to to practice necessary care.

What else do doctors and other high stress professionals find it really difficult

to give themselves permission to do?

Are there any hidden permissions that we need to know about?

Oh, definitely loads.

Um, I think one of the ones I see most often is, uh, permission to be you,

permission to be who you really are.

Like so to show up in your work as.

Your authentic self.

So I see a lot of doctors who are, uh, very funny or very creative or you know,

they've got kind of hidden interests or ways of being in the world that they

just don't bring to their work, 'cause they feel as if there's this kind of tick

box of what it means to be a doctor and what they should and shouldn't be like.

And that can express itself in all sorts of ways.

So it might be from like the kind of socks you wear, up to the types of

projects you take on, or you know, what you choose to do for your work.

You know, you might choose to go, um, part-time so that you can

explore doing something completely different in the rest of your week.

So that can take many, many forms, but I see that really commonly in

doctors, this kind of hiding of their true self and their true passions

and what really brings them alive.

And when they can start to give themselves permission to bring that into their

work, it's so joyful, it's so wonderful.

It's like, oh, oh, I didn't realize, you know, that I could have a bit more fun

with my work or, um, that I could steal my job in a way that means I do more of

the stuff I love and less of the stuff I

Yeah, we have this weird guilt thing that we've got to do.

Everything that's demanded in our role.

I remember a career session I was running for a bunch of GPs and one, we would talk

about how to work in a center genius.

And one GP said about how they absolutely loved being on call,

triaging on call, loved it.

Another GP said how they absolutely loved admin, give them admin all day every day.

And they looked at each other and went, we should work together.

Like, yeah, you two genuinely should work.

But I've never heard of a GP just being able to sit there and do

admin and a GP just doing on call.

Now I know there are some progressive practices are doing more of that,

but you know, there is, there are some, pat, there's some, you know,

GPs, i'm talking about GPs 'cause I'm a GP so I, you know that.

But yeah, love getting really into, you know, diabetes,

chronic disease management.

I could do that, you know, but I really, I quite like the emergency

stuff or whatever and, um.

But we think, well, 'cause I'm a generalist, I must do everything.

I must do everything that's required by my specialty because that's what doctor does,

and if I ask someone else to do this, bits I don't like, I am dumping on them, which

is just nonsensical and doesn't really happen in that many other professions.

Or maybe it does, if you're listening and you are in different profession and

you are, you've got examples of that.

I'd love to hear it, but I'm presuming you've experienced a lot

of that with, with your patients coming in saying, well, I can't

possibly drop that bit or that bit.

Absolutely.

And I don't think it's just generalists.

I think it applies to all doctors, and it's been particularly bad over the

last 30 to 40 years, because there was a big shift in how we regulated our

profession and how we, uh, monitor all the different things that doctors do.

Um, and again, after in the aftermath of things like the Harold Shipman case, et

cetera, when appraisal changed, and so we went from being a profession that really

did cater for a lot of different tastes.

You know, when I first went into medical school, doctors then could

still very much pick and choose the jobs they did, the style of working they

did, the things they did day to day.

So one might do more research, one might do more teaching, another

might do more clinical and so on.

Whereas now we are very much living in an age where it's everybody

has to do a bit of everything.

You know, I'm coming up to my annual appraisal again, and

I'm expected to tick every box.

I'm expected to have done a bit of research and a bit of this and a

bit of that, and, and actually it doesn't suit us all, it absolutely

doesn't, and you're quite right.

There is some really progressive workplaces which are recognizing this

and fighting back against that a bit.

So a lovely example of some, um, supervision, you know, in some,

specialties where supervision is really a wonderful embedded part of the practice,

like in psychiatry, for example.

Um, there for a long time every doctor had to supervise, but

it didn't suit every doctor.

You know, some people were really good at it, really nurturing and

wonderful and loved doing it.

Others really didn't like it.

Lots of problems for their supervisees.

Whereas some trust in our recognizing that and saying, it's okay, we'll

let you know the people that wanna do it can do it and take on a few more.

The people who don't wanna do it, you know, don't have to.

So again, it's about permission and I think not just individual permission

as a profession, saying to ourselves that actually it's okay that in our

GP practice or in our department or across our trust or local area, we

are going to give ourselves permission to do this a bit differently.

You know, like in COVID.

When COVID came along, suddenly all bets were off.

You know, people were given this freedom, weren't they, to, to pull their

resources and do the best they could.

And it got rid of a lot of that red tape and it gave people permission

to be autonomous and say, okay, we can do this and we can do it

quickly, and we can do it well.

And that's, I think, what we've lost sight of a little bit in

modern medicine as it is today.

So again, we've gotta reclaim that permission to say no, we don't

necessarily have to do it this

Yes, and it's, it's that permission to play to your strengths rather than

try and develop all your weaknesses.

And that's just like good, good psychology.

I, I remember my coaching course being taught about, well, you know,

the strength surveys and stuff, and that you get much more bang for your

buck if you develop your strengths then if you develop your weaknesses.

You know, I'm not very good at accounts and stuff like that, and I spent hours on

spreadsheets if I wanted to, but actually I'd be much better getting better at

doing podcasts, you know, because that's my strength and that's what I like doing.

But we, we feel guilty about the stuff we are not so good at

and think we ought to be doing.

It's that ought word, isn't it?

Isn't it?

Mm. And in my book, I talk about permission to feel guilt.

And I know we've spoken about this before, but you know, I

would say that's a good guilt.

It's a good guilt that we feel because we want to do.

Everything we're meant to do.

We want to kind of be good doctors and good, you know, parents and children and

friends and, but we, we just can't, right?

It is just, there are some limits to our human capabilities and capacities.

So I think that, that it's okay to feel guilty.

But like you said, guilt does tend to make us look at what we're not doing

and not look at what we are doing.

So that's something you are identifying in listening to this, you know, you think,

well, okay, I'm probably feeling this girl 'cause I'm, I'm not a psychopath, right?

I'm a good person.

and what is it I am doing to help?

Well, hang on.

I've seen this number of patients today, or I've helped to lead this service

through this transition recently, or whatever it is you might have been doing.

I promise you, you start to look at what you are doing, you'll

see a lot of evidence for it.

'Cause as caring, compassionate, hardworking doctors and, and

high stress professionals, generally we are doing a lot.

And there's also that for, you know, those of you out there with families

permission to give your kids baked beans for dinner, they will be full.

They'll love it.

Beans and cheese and jack, potatoes and sausages, you

know, all that sort of stuff.

You don't need to have a perfectly cooked organic meal all the

time, but we just sort of more and more pressure on ourselves.

Permission to make it easy.

That's one of my favorite ones.

I mean, this, the book I wrote, the, um, Permission: How to Feel, Heal and Thrive

in a Challenging World, um, you know, I've talked a lot about emotions in that.

So I've talked about, you know, permission to feel anxious, permission

to grieve, permission to feel angry, permission to feel happy or joyful,

or, but the, it was the first of a sort of three part book in my head.

And the second part's very much those like, you know, permission

to say no, permission to let go of stuff, permission not to be perfect,

permission to make things easy.

And I think in the modern world, we live in these little, um, powerful questions,

like what would make this easier?

Are so helpful.

'cause we are so often thinking it's gonna be hard, right?

Like, oh, I wanna make a change to my, my diet or my daily

routine or something like that.

And immediately we're full of all the complexity of it and the challenge of it

and all the noise of all the information and choices that are out there.

And actually we can just stop, take a breath and say, what would make this easy?

Give us permission to make it easier.

We overcomplicate things, don't we?

I think we have been brought up to think if it's hard, it must be worthy

and it must be the right thing to do.

I think the hardest bit is the permission bit though, Rachel, honestly, because

we're not role modeled it and because we don't think it's okay to do that.

Right.

We think that it all has to be really hard work and we've got to tick all the

boxes and we don't stop and think to ask, actually, could I make this bit easier?

So all this permission, and I wholeheartedly agree with everything

you've said, but there's a bit of me going, yeah, but how?

Because my head might agree with it, Caroline, but then the next time it

comes to maybe saying no or meaning that someone else is inconvenience, not me.

'cause I need to look after myself, there's gonna be me gonna go,

oh, but Rachel, I mean, really?

Yes.

I mean, I know you talk about this, but in in this case it

probably doesn't apply here.

How do we go about doing that?

What, what helps and what doesn't help?

I'm glad you've asked that because it isn't a theoretical thing.

This is a very practical thing.

Right.

We actually have to do it.

To give yourself permission to leave on time, you actually have to leave on time.

You know, to give yourself permission to take a break, you

actually have to take a break.

So it is a practical doing thing, right?

Otherwise it's just, it's just theory and we're just reading a book, right?

And it's just not real life and we're not applying it, and yeah.

So I would say start small and start easy.

So, you know, you might not, you might be staying four hours late every day at work.

You are not maybe suddenly gonna leave on time the next day, but could you

leave maybe half an hour earlier?

Maybe you don't start saying no to everything, but is there a

little something that you would find it slightly easier to say

no to that you could start with?

So start small, make it easier, and build that confidence because

this is a practice, it's a thing you have to keep doing.

So there's no point in me just leaving work on time today, right?

The whole point is I've gotta try and leave on time every day.

Um, and I might not be able to do that right now.

That might seem a way too much.

And I still remember the first day as a junior doctor.

I'd been working I think two or three years by then.

But the first day that I left work with something that I

hadn't done on my to-do list.

And I still remember that day because it felt so awful.

I felt like the worst doctor in the world.

I felt like, you know, I was gonna get into loads of trouble,

I felt so anxious, but I did it.

And that's the point.

I think it's about doing something.

So it's not so much like how do I do this, but what, what could

I do that is something small that is actually achievable?

Rather than it being like the fantasizing, like, a New Year's resolution style,

kind of like, I'm gonna eat healthy every day and I'm gonna, you know,

go for a run three times a week.

And it's like, well, you know, actually I, maybe that's not realistic.

But could I have a five minute break?

Whereas normally I wouldn't have any break at all.

Yeah, okay.

I could do five minutes.

Yeah.

So I would say it's the what, not the, how do I do this?

It's what, what, could I do?

I like that.

And, and take just the little thing says, yes, five minute

breaks and maybe it's five minute breaks, not in front of your desk.

Could you go outside for five minutes and stand under a tree?

You know?

Yeah.

'cause that's practicing the permission, right?

You're practicing giving yourself the permission to do it.

The actual, what you're doing isn't so important as the

practicing doing it at all,

What roles are other people have in all of this?

Because in my own life I found the weirdest things have given me permission.

I was talking to an author, she'd written an amazing book, and I said to

her, so when do you do your thinking?

She said, well, every day I go and sit in the sauna for an hour and I think.

I'm like, oh my gosh.

You know, like, I love soreness, but.

It then gave me permission.

I'm afraid I would love to go and sit this order for an hour every, every day.

Didn't manage to see that, but even 20 minutes once a week,

I'm like, I've got permission.

'cause that person I really respected, who's written this amazing book, and they

told me about how it helps them think.

And I was like, oh, well, if they can do it, so can I.

And then you suddenly find out about a colleague that does go off, you

know, at lunchtime and go out of the hospital and, and go for a walk.

Or even go for, oh, that person.

Hang on.

How did, did someone give a memo out that I didn't see that

says you're allowed to do that?

It's always like finding your own little memo, isn't it?

Yeah, that's the second big tip I was gonna give actually, is look for the

people that can role model it for you.

So we are often looking around and seeing the people that aren't leaving

on time or aren't having the breaks, you know, or are just kind of martyring

themselves, you know, like we are.

But really look for those people where it's like, oh, they've done

this well, they've done that.

Yeah, so although it's about you giving yourself permission, it's

perfectly reasonable and normal to want to have seen someone else do it.

You know, there's that phrase, you can't be what you can't see.

And so it's, so I would look for those people, like actively look

for the examples of the people in your profession, in your specialty,

at your grade that are doing those things and do what they're doing.

What if you can't find any role models?

You know, I think we are lucky enough to live in a world where we are really

connected, obviously through the internet, and, and actually there's always someone

you know, Google it ChatGPT it, there's always somebody who can give you an

example of the thing that you want to do.

Do you wanna leave medicine?

There's loads of people out there that have left medicine.

Do you want to go part-time?

There's literally millions of people that have gone part-time.

Like there's always gonna be someone.

So you might have to look a little harder than a minute or

two, but you will find someone.

Ask around as well.

But I think it starts with you getting clear about what it is you want.

And that goes back to that permission to be you.

So often some people are kind of struggling, but they're not

really sure what's going on and they're looking at other people

and think, oh, do I wanna do this?

Do I wanna do that?

And they're sort of fantasizing and escaping into other

ideas and possibilities.

And, and as I just say, just stop for a moment and just check in.

Like what is it you really need right now?

And often it's actually something a bit more, like, normal day to day.

Like, you're tired, you need an early night, or you know, you're thirsty,

you need a drink, or you're a bit lonely, you need to chat with a friend.

So sometimes the permissions aren't these big things.

they're actually those little day-to-day, moment to moment things

that help us to stay well and connected to ourselves and our own needs.

I think asking a friend is really helpful as well.

You know, like, I've got this conundrum.

What do you think I should do?

And they'll often say, why is this even a conundrum for you?

It's really obvious.

And actually you weren't asking them 'cause you didn't know what to do.

You were asking their, what they thought so that they would give you permission.

And actually, I had a conversation with some really good friends the other day.

I said, look, I'm feeling really guilty about something.

It's something, nothing to do with my job.

It's something to do with what we were doing on a, on a trip.

We're going on in a, in a couple of months time.

I said, I just need permission not to do this one thing.

And they talked to me about it.

And actually I was asking for them permission to not do it.

They, they ended up talking about, well, what's the issue with it and

why is it you want, and actually I'm gonna do that thing, but I'm

gonna make it really nice for me.

Um, and so just talking it through was so, so helpful.

Otherwise, you're trying to solve this on your own and you are, it's very hard,

I think, when you're thinking things through on your own to identify those

little gremlins that are whispering the shame and guilt stories in your, in

your ear because you've normalized them.

And when you say them out loud, it helps.

And then when you say to someone else, it really helps.

'Cause they're like, excuse me, what did you just say you

think you ought to be doing?

Who says and why?

And what sort of, either savior are you anyway, or Really the other person's

not gonna care that much, Rachel?

Yeah, and I think this is where coaching can be really helpful as well.

Like friends can be great 'cause as you say, they can mirror back to you.

They've got their own thoughts, they know you really well.

Um, but also like having a conversation with a coach can be great 'cause

it, again, it just a space to hear yourself say it out loud and to come

to an understanding that you might not have seen otherwise, you know?

So quite often I'll be working with, um, a doctor in coaching and they'll come for

a session and they'll say, I wanna try and make this big decision in my life.

And I'll say, do you know what the, you know, do you know what

decision you've made already?

And honestly, about eight times outta 10, they've already made the decision.

So all they needed was that permission to say, yeah, actually I do know.

I heard someone say once.

I think it was on a, a motivational interview or whatever, he was saying

that his coach had said to him, stop pretending to be confused.

You know exactly what you want to do and you need to do, but you're

finding it too hard to do it and there's something stopping you.

Let's talk about that.

Not about the decision.

Don't say I'm confused about what I should do.

'Cause actually, you know what you should do.

And I think a lot of us, we know, we know it, but we feel confused 'cause

it just, it just feels too hard.

And that's coming back to the feelings.

And I think that's why this first book about permission

is really about the feelings.

It's like permission to feel confused, permission to feel scared as well.

It's so often when we're, we are making a change in our behavior,

particularly around our wellbeing at work, it can be really scary.

We are thinking, oh, what's everyone gonna think of me?

And you know, what's gonna happen and, oh, um, so, but that's okay.

You know, feelings aren't gonna kill us.

They're not gonna hurt us.

They're not comfortable, but they actually go pretty quickly.

Once we do the thing.

Particularly if it's fear, it tends to dissipate pretty quickly.

So I'd say, yeah, permission to feel the feelings that come up when you are, when

you're making these choices, when you are, you are changing these behaviors,

um, the feelings will come and go.

No feeling ever stays forever.

I've got a bit of a yes, but Caroline.

I've got a little voice in my head going, the problem is here that what

if I do take some time for self care.

What if I do leave on time and somebody else doesn't like it and I get pushback

and they actually give me some grief about and say, no, hang on a sec, you,

that's not what's supposed to happen.

Um, who do you think you are?

They either tell you you're being unprofessional or a

bad parent or, you know.

Then you've not only got your internal voice telling you you're a dreadful

person, you've actually got it confirmed by that person who is either insinuating,

maybe it's more insinuating stuff, but sometimes they genuinely push back to you.

Oh, totally.

I, I tell a story in my book on this where a, I was at a sickness review meeting.

I'd had three days off sick.

Um, and it had triggered a signature review meeting and my consultant

said, doctors shouldn't take sick leave ' cause it's selfish.

Actually said that?

Yes.

Actually said that in a sickness review meeting.

I know.

Unbelievable.

Right?

So like jaw dropping, you think, hang on, that can't possibly have happened.

But it did and it does exist and you are absolutely right.

It exists blatantly.

People say those things to each other.

And patients say those things.

I talk to GPS all the time where patients are like angry that they

couldn't get an appointment even though they knew the doctor was all sick.

You know?

So it happens.

It is out there.

There is a reality that when we change our behavior, other people

can react and they can react badly.

So let me turn the question around to you Rachel if it's alright to do that.

Like, what would you do if that happened?

Past Rachel probably would've beat her, beaten herself up for days.

New Rachel or evolving Rachel probably would note it.

I would note the guilt and the shame I was feeling.

And I think nowadays, having done a lot of work with you in our Permission to

Thrive community and all my wonderful guests on the podcast I would probably

try, first of all, feel it, feel it, rather than try and explain it away.

I would try and go, oh, what am I feeling?

I'm feeling shame.

I'm feeling this way.

Telling me you're a bad person.

They're absolutely right.

Well I would talk to someone about it.

'Cause like we always say like, shame can't survive being spoken.

Share it but also, no, it's, it's not mine, but.

Even if you have caused someone else a few problems, and even if you are being

selfish, 'cause actually in order to practice necessary care, don't call itself

care anymore, you have to be selfish.

But we, we've decided in, our profession, being selfish is one of the

worst crimes you could possibly have.

And I think I've learned to start telling myself, you know, well, okay,

of course you're feeling like that.

Of course you're feeling guilty and awful and shame because look

what you've grown up with, but look what you're dealing with.

So of course you're gonna feel like that.

So it's this whole trying to recognize it.

Like you were saying, guilt is just a, a sign.

You're not a psychopath.

It's a sign that you wish you had unlimited time, energy, and capacity, but

you don't, but you still feel, it doesn't stop those feelings from happening.

And I, I think

It doesn't, and they're not comfortable feelings, don't get me wrong.

And do you know what?

I wish I had a magic wand that I could wave and nobody ever

had to feel shame ever again.

But it's a really common, normal human emotion.

And it often gets triggered when we change our behavior in a way that

kind of slightly unsettles other people and they don't like it, so they

might get a bit passive aggressive or a bit whatever, and you get a

sideways look or a little comment or, yeah, and it's really uncomfortable.

But I think we have to stay really honest and true to ourselves.

Like what do we really believe here?

Do we believe that we're some evil, horrible person that's

done something horrendous?

Or have we learn and do we believe that actually there's shame that exists out

there in the world, doesn't belong to you or me, but it does a bit triggering.

But if we feel it, we share, it doesn't last forever.

It passes.

And you know what?

You'll feel okay, because you took that break or you took

that day off or whatever it was.

The alternative is we carry on with that old story.

We carry on, like you said at the very beginning of this interview,

you know, what happens if we don't give ourselves permission?

Why?

You know how, and we carry on just getting more and more tired, exhausted,

stress burnt out, and it it's a road to somewhere very, very bad and difficult.

So this is important.

It's important that we tolerate those little blips, those

little reactions from others.

They do settle down and sometimes magical things happen.

Like, I love it when I hear from doctors, they say, oh, I, I just went home on

time, and then the next day, like four of us went home on time, or you know,

well, we all went for lunch together.

Or, or I told someone that I'd gone to speak to someone at Practitioner health

and then now they've gone to see them and they're feeling a lot better and it starts

to spread in a really positive direction.

Yeah, in an ideal word, no one would ever feel shame.

At all in the real world.

We do.

And I think sometimes I've tried to either explain away shame so that I

don't feel it, so you, you are wrong, and unless you change your mind and

you agree with what I've done or whatever, that's not gonna be okay.

Or I've tried to do so much work on myself and change my stories

that I don't feel shame anymore.

I actually think half the time it's going, oh look, there's shame.

Yeah.

And my shame's been triggered and that's okay.

It's not gonna kill me.

It's horrible.

Don't get me wrong.

My shame triggers used to last days to weeks and they were horrendous.

Now they last maybe a few minutes to a few hours at the worst.

But I like you, I know to notice it, name it, and talk

about it with a trusted other.

Um, and it does go, and I do realize that, oh, hang on.

I'm not a bad person.

You're a human being, right?

I was reading somewhere that actually if you have a friend that's

totally perfect and they've done anything wrong, you are not friends

with them for very long, right?

Because they're a really, really boring, and b, no.

had a friend like that?

Sorry, I've never had a

you of course, obviously you're Perfect.

apart from me.

But no, I mean because like they just seem just so good and you're

like constantly thinking, oh God, they're so good, aren't they?

They're so

oh,

amazing.

Yep.

here's me.

But they're not right.

You know, that is the wonderful thing about being a, a doctor

or a high stress professional.

You can't be in a job like that without seeing real human, like, behavior.

And like, we've all seen it, haven't we?

In ourselves and in others.

Like, you know, we've all had bad days and not been on our best.

And that is the human condition.

So again, it's permission to feel whatever you're feeling.

It's okay.

You know, feel angry, feel shame, feel guilt, feel it's all right.

Um, there's different things, little tiny strategies and tips that can help.

And that's what's, you know, partly what the book is about.

Um, that certain things can help a bit more uncertain with certain

feelings, but ultimately it's about it's okay to feel what you're feeling.

And it's okay to be human and that's what makes life worth living.

But I read a quote the other day saying that burnout is what happens where you

try and avoid being human for too long.

I like that.

Yeah.

We often talk about, um, stretching our limits and wonderful questions that

can make us think anything is possible.

But actually I think it's a balance, isn't it?

Between anything is possible and also recognizing our human limits.

And we all need rest.

We all need, you know, some love and connection and someone telling us

it's gonna be all right, you know?

We all need food and drink and, um, and we all say and do stuff that

we wish we hadn't, and we all make mistakes and we're all gonna have

our shame triggered at some point.

And I think learning to deal with our shame in a healthy way is one of the

most important professional things you can do, and personal things you can

do, because as we can see on the world stage, when people's shame is triggered,

they behave really, really badly.

I don't behave very well When I'm feeling shameful, I try and make it

someone else's shameful try, you know, trying to get, do anything to make

it so it's not me or, or whatever, and I'm not a very nice person, so,

Become like a spiky hedgehog, right?

You're lovely and soft on the underbelly, but as soon as you're

frame trigger, it's like spiky.

It's a big spiky ball.

I think that's what's happening in, in healthcare.

You know, when people are talking about the, their colleagues who are behaving

abysmally, you know, and I'm thinking, gosh, are these the same doctors that

I used to know or have you thinking?

It's because they're all so overwhelmed and feeling ashamed that they can't

do ev everything and feeling really pissed off and defensive and it's just

becomes a big spiky ball of spike.

Everyone's spiking everybody else rather than just going, let's just

talk to each other and admit we're human and see what we can do.

And if I'm feeling over responsible for someone else, I am gonna feel really

pissed off when they put in boundaries and want to practice self-care.

'Cause I will automatically think that impacts on me.

Um, and I, I, I see that in a lot of senior healthcare pressures.

Boy, I see that in a lot of my family members.

They're so over responsible, such a rescuer, they get really annoyed when they

see other people making bad decisions.

'cause they think, well now I'm gonna have to go and rescue them.

No, don't do it.

Stay away.

That's a big theme that's come out of me from our chat today actually,

is around codependency and how we, we so often as, as doctors and caring

professionals, will take care of others and that gets unhealthy, right?

We're taking responsibility for how they feel, for what they're

saying and doing, and it's not ours.

It's not our responsibility.

It's our responsibility to look after ourselves, to look after our

emotional response and our decisions and our choices, not theirs, right?

It's like your zone of control, your zone of power, you know, and a lot of

this comes down to that permission to, to let go a little bit of what other

people are thinking and saying and doing.

And I've realized recently that actually people pleasing, someone said this to me,

that hit me like a brick between the eyes.

People pleasing is not me being nice.

It's me trying to control someone else's opinion of me.

A hundred percent.

on that note, Caroline, let's, um, it's been, you know, there's, there's

so much more we can, we can talk about permission and I think one of the things

that we have seen is getting a community of people together to explore all this

together about like, what is it that you actually need to be able to work at your

best, to be able to be who you are, be authentically yourself, whether you think

in a neurotypical way or a neurodivergent way, like what is it that I need in order

to give my best to work for my patients and for my colleagues and for my team

members and all that sort of thing.

And getting people together to actually plan it, to connect, to share some of

these shame stories we've got going wrong has been incredibly powerful.

And that's what we've seen in, in Permission to Thrive our, um, personal

development community for doctors.

So if you're interested in that, do check out the links in the show notes.

But before we go, Caroline, what would your top three tips be?

You've written a whole book on this, so I'm asking you to

distill it into just three tips.

I think, uh, number one, give yourself permission, emphasis on the yourself.

Number two, give yourself permission to be you.

Emphasis on the you.

I'd love to make the third one sound like it fits in with those,

but I'm making this up as I go, so I'll tell you what, uh, yeah.

Permission not to do things well.

to permission To fail.

I heard someone once said, um, everyone needs to have something.

They're really mediocre at.

I was like, brilliant.

That really helped me with my tennis.

Yeah.

But I was like, I've gotta be really good.

And I'm like, I'm really not very good, but yay.

This is, I'm really good at being mediocre, so I'm still winning.

I obviously don't need any therapy or anything about Caroline.

no, never crossed my mind

Lovely.

Right.

How can people get hold of your book?

How can people find out more about what you do?

Caroline?

so they can find out about me at joyfuldoctor.com and across social

media as the Joyful Doctor, um, and the book is called Permission:

How to Feel, heal and Thrive in a Challenging World, and it's available

via our website or on amazon now.

So thank you so much for being with us, Caroline.

That's been really interesting, really helpful for me.

And if people are interested, um, if Caroline's work, check out,

check out the Permission to Thrive community, you can come and try it out.

We have a, um, a money back guarantee if you wanna come and try it.

If you don't like it, no worries at all.

But honestly, it's been really transformative for,

for both of us, hasn't it?

And, and the people that are in it.

Oh, it's been amazing.

And like you said, just that chance to come together with like-minded

people, a chance to stop, think about what it is you need.

Yeah, absolutely.

Do come join us.

We'd love to see you there.

It's some of our favorite, uh, mornings and evenings of

the year, isn't it, Rachel?

When we hang out with our Permission to Thrive

We do it.

One, one thing that I found powerful is because it's in the

diary regularly, you've already given yourself permission to do it.

You've booked your study, leave you, you, you do it regularly.

And I think that for me,

Absolutely.

Permission's baked

baked in permission, 'cause you've, it's in the diary and once it's

in the diary, it's in there.

So yeah, if you wanna check that out, do um, and, uh, thank you so much for being

with us and we'll talk to you again soon.

Thank you so much for having me.

Thanks for listening.

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