1 00:00:00,063 --> 00:00:05,133 A few years ago, I was feeling really stressed and really bored at the same time 2 00:00:05,433 --> 00:00:09,993 in a job that I didn't particularly like, but I trained for years and years to do. 3 00:00:09,993 --> 00:00:13,633 I had fairly small children and life was full. 4 00:00:13,963 --> 00:00:19,183 I've told the story several times, but I went on a retreat in the Alps, and as I 5 00:00:19,183 --> 00:00:22,813 was there to sort of think about what did I wanna do with the rest of my life, I was 6 00:00:22,813 --> 00:00:26,683 reading the poem by Mary Oliver, which is that wonderful poem called A Summer's Day. 7 00:00:27,013 --> 00:00:31,533 And the final line in that poem is tell me what is it that you plan to do 8 00:00:31,533 --> 00:00:33,993 with your one wild and precious life? 9 00:00:34,283 --> 00:00:38,963 And that line jumped out at me, your one wild and precious life. 10 00:00:39,263 --> 00:00:42,863 It didn't feel like at that time my life was particularly wild and it 11 00:00:42,863 --> 00:00:47,270 certainly didn't feel that precious And I remember feeling trapped and 12 00:00:47,270 --> 00:00:52,010 stuck in my work because my other half ran a business in Cambridge. 13 00:00:52,220 --> 00:00:57,710 I had several jobs, one at the university, one in a busy practice, and I felt 14 00:00:57,710 --> 00:00:59,510 that I had no choice but to stay there. 15 00:00:59,510 --> 00:01:02,150 My kids were in school and I couldn't do anything about it. 16 00:01:02,425 --> 00:01:04,765 And that got me thinking, well, actually I did have a choice. 17 00:01:05,065 --> 00:01:06,205 I could choose to leave. 18 00:01:06,205 --> 00:01:09,025 I could choose to move to the Alps, ditch the family. 19 00:01:09,055 --> 00:01:10,075 I wasn't gonna do that though. 20 00:01:10,315 --> 00:01:11,245 I didn't want to do it. 21 00:01:11,245 --> 00:01:12,775 I was gonna choose to stay. 22 00:01:13,075 --> 00:01:16,495 And then the question became, well, how can I have a world and 23 00:01:16,495 --> 00:01:20,335 precious life in the life I'm already living on a Monday morning? 24 00:01:20,625 --> 00:01:26,562 Because it must be possible to thrive, not just survive as a doctor in a busy job. 25 00:01:26,862 --> 00:01:30,590 Where I am in the life I'm currently at, and that's what I became obsessed 26 00:01:30,590 --> 00:01:32,270 with finding out how to do it. 27 00:01:32,570 --> 00:01:37,280 But that was the first time I realized I had a choice about what I did and 28 00:01:37,280 --> 00:01:41,420 that actually I was in control of a lot more than I thought I was. 29 00:01:41,807 --> 00:01:45,047 But I had been pulled along on the wave of expectation. 30 00:01:45,287 --> 00:01:46,517 This is just what you do. 31 00:01:46,817 --> 00:01:50,927 And to be honest, the the person holding me back the most was myself. 32 00:01:51,331 --> 00:01:53,421 But I would've given all sorts of excuses. 33 00:01:53,421 --> 00:01:57,251 I would've said it's the pressure of work, the pressure of the family, 34 00:01:57,461 --> 00:02:01,451 the fact that I had to earn a certain amount of money, the fact that I had 35 00:02:01,451 --> 00:02:06,131 to do this, actually, I wanted to do half of it, but the way I was living 36 00:02:06,161 --> 00:02:10,291 was at a huge personal cost, and that's what I want to talk about today. 37 00:02:10,657 --> 00:02:14,557 The cost of stress, the cost of overwhelm, and the cost of burnout. 38 00:02:14,857 --> 00:02:17,167 And in my mind, it's not a great equation. 39 00:02:17,407 --> 00:02:20,827 Why are we paying a massive cost in order to feel terrible, in 40 00:02:20,827 --> 00:02:22,387 order not to enjoy our lives? 41 00:02:22,687 --> 00:02:26,287 There's so much stuff behind that, but today I want to explore 42 00:02:26,407 --> 00:02:30,577 just what that cost is and why we are underestimating that cost. 43 00:02:32,640 --> 00:02:37,320 This is a You Are Not a Frog quick dip, a tiny taster of the kinds of things we 44 00:02:37,320 --> 00:02:39,990 talk about on our full podcast episodes. 45 00:02:40,290 --> 00:02:43,620 I've chosen today's topic to give you a helpful boost in the time it 46 00:02:43,620 --> 00:02:47,010 takes to have a cup of tea so you can return to whatever else you're 47 00:02:47,010 --> 00:02:49,380 up to feeling energized and inspired. 48 00:02:49,950 --> 00:02:53,760 For more tools, tips, and insights to help you thrive at work, don't 49 00:02:53,760 --> 00:02:57,720 forget to subscribe to You Are Not a Frog wherever you get your podcasts. 50 00:02:59,201 --> 00:03:05,291 Now, it's not often that I have a massive realization and I find a new idea which 51 00:03:05,351 --> 00:03:06,671 I then start to get obsessed with. 52 00:03:06,671 --> 00:03:08,111 Well, I say it's not very often. 53 00:03:08,111 --> 00:03:10,781 I'm sure my friends and family and colleagues will tell me that I'm 54 00:03:10,781 --> 00:03:13,721 coming up with them all the time, and their job is just to reign me in. 55 00:03:14,025 --> 00:03:16,455 But I have been struggling with this conundrum. 56 00:03:16,755 --> 00:03:22,095 You see, recently I met a colleague who had surveyed the doctors in his 57 00:03:22,095 --> 00:03:26,805 workplace with the Maslach Burnout inventory, and on the survey, between 58 00:03:26,805 --> 00:03:32,835 40 and 50% of them were burnt out according to the validated burnout survey. 59 00:03:32,835 --> 00:03:37,455 So 40 to 50% of the doctors in his workplace were working in burnout. 60 00:03:37,661 --> 00:03:42,041 And I'm sure that applies to nurses, physios, and managers, and many of 61 00:03:42,041 --> 00:03:45,401 the other healthcare professionals working in the NHS right now. 62 00:03:45,551 --> 00:03:48,416 So 40 to 50% of people working in burnout. 63 00:03:48,716 --> 00:03:52,586 But that gives me a bit of a conundrum because we teach the stress curve. 64 00:03:52,616 --> 00:03:56,576 And the stress curve is a really helpful way of understanding what happens to your 65 00:03:56,576 --> 00:03:58,526 performance under increasing pressure. 66 00:03:58,826 --> 00:04:02,276 So initially, as the pressure increases, your performance will go up. 67 00:04:02,326 --> 00:04:06,076 We all need a few deadlines to perform well, but you'll reach a point where 68 00:04:06,076 --> 00:04:10,516 you are at peak performance for a bit, and then as the pressure builds up, 69 00:04:10,756 --> 00:04:12,856 your performance will start to go down. 70 00:04:13,156 --> 00:04:15,914 And so we can see that under increasing pressure, a human being's 71 00:04:15,914 --> 00:04:20,024 performance will go off the top of the curve and we'll start to slip 72 00:04:20,024 --> 00:04:21,734 down the other side of the curve. 73 00:04:21,764 --> 00:04:23,714 And this happens to everybody. 74 00:04:23,864 --> 00:04:25,394 This is a human phenomenon. 75 00:04:25,689 --> 00:04:29,564 And yes you can improve your mental fitness and your wellbeing, 76 00:04:29,564 --> 00:04:31,934 which means that you can probably withstand a little bit more pressure 77 00:04:31,934 --> 00:04:35,014 before you start to slip off the curve, but it happens to everybody. 78 00:04:35,014 --> 00:04:38,551 There's well validated, important neuroscientific reasons for this. 79 00:04:38,551 --> 00:04:40,831 Your prefrontal cortex gets overwhelmed. 80 00:04:40,831 --> 00:04:42,646 You've got high circulating cortisol. 81 00:04:42,721 --> 00:04:44,431 You literally can't think straight. 82 00:04:44,689 --> 00:04:48,589 And side note, I'm really sick of doctors coming to me for coaching 83 00:04:48,589 --> 00:04:49,759 and saying, what's wrong with me? 84 00:04:49,759 --> 00:04:50,599 Why can't I cope? 85 00:04:50,599 --> 00:04:53,749 So the first thing I do is show them the stress curve and say, you are normal. 86 00:04:53,899 --> 00:04:57,859 You are having a physiologically normal response to too much 87 00:04:57,859 --> 00:04:59,929 pressure, to too many demands on you. 88 00:05:00,229 --> 00:05:02,749 And we were in a training session once, and I presented this so 89 00:05:03,049 --> 00:05:06,319 somebody ran out of the room really upset and I caught up with them 90 00:05:06,319 --> 00:05:08,359 at break and I said are you okay? 91 00:05:08,359 --> 00:05:08,929 What's going on? 92 00:05:08,929 --> 00:05:10,849 She said, oh, she said, I've been off with burnout. 93 00:05:10,849 --> 00:05:15,139 And seeing that was such a relief, I realized it wasn't my fault. 94 00:05:15,439 --> 00:05:16,429 No, it's not your fault. 95 00:05:16,429 --> 00:05:17,599 It's the way you are built. 96 00:05:17,839 --> 00:05:18,859 Under increasing pressure. 97 00:05:18,919 --> 00:05:20,179 Your brain just doesn't work. 98 00:05:20,239 --> 00:05:21,649 You start to perform badly. 99 00:05:21,913 --> 00:05:23,203 But then that's the conundrum, isn't it? 100 00:05:23,203 --> 00:05:26,713 Because the stress curve tells us that you are not performing when 101 00:05:26,713 --> 00:05:31,243 you're in burnout, yet my colleague survey showed that 40 to 50% of his 102 00:05:31,243 --> 00:05:35,263 doctors were working in burnout, and yet they were still performing. 103 00:05:35,566 --> 00:05:38,966 Now the other day I also recorded a podcast with Dr. Richard Duggins. 104 00:05:38,986 --> 00:05:43,006 He's a consultant psychiatrist and works with practitioner health, so he helps 105 00:05:43,006 --> 00:05:46,816 diagnose, and he's also a psychotherapist, so he works with many, many doctors who 106 00:05:46,816 --> 00:05:50,656 come through suffering with the effects of stress, overwhelm, and burnout. 107 00:05:50,959 --> 00:05:53,179 And he's noticed the burnout cliff. 108 00:05:53,179 --> 00:05:56,989 So he has noticed that particularly in healthcare professionals, they 109 00:05:56,989 --> 00:06:01,014 go along and their performance is, is okay, probably wavering a little 110 00:06:01,014 --> 00:06:04,014 bit, maybe dropping a little bit, but suddenly they reach a point of 111 00:06:04,014 --> 00:06:06,324 burnout where it massively drops off. 112 00:06:06,624 --> 00:06:08,634 So you have this burnout cliff. 113 00:06:08,904 --> 00:06:11,994 And that's a little bit at odds with the stress curve where you 114 00:06:11,994 --> 00:06:14,354 reach peak performance, and then gradually, as the pressure gets 115 00:06:14,354 --> 00:06:16,864 higher, your performance decreases. 116 00:06:17,201 --> 00:06:21,369 So I've been thinking, well, If you've got this burnout cliff and up to 50% 117 00:06:21,369 --> 00:06:25,149 of doctors are working in burnout, how does that square with the stress curve? 118 00:06:25,545 --> 00:06:30,112 And I asked Richard this, and his answer just really blew my mind. 119 00:06:30,412 --> 00:06:34,642 He said, well, you might carry on performing well at work, but 120 00:06:34,762 --> 00:06:36,172 everything else is suffering. 121 00:06:36,472 --> 00:06:40,642 Essentially, you are borrowing your performance from other areas of your life. 122 00:06:40,952 --> 00:06:44,812 You are borrowing your performance from your health, you are borrowing 123 00:06:44,812 --> 00:06:49,132 your energy from your family and from your relationships, you are 124 00:06:49,192 --> 00:06:53,785 borrowing your performance from any hobbies or any life outside of work. 125 00:06:54,012 --> 00:06:58,722 And actually the chap who initially coined the term burnout, he 126 00:06:58,722 --> 00:07:00,672 was referring to a building. 127 00:07:00,672 --> 00:07:02,352 It was in one of the suburbs of New York. 128 00:07:02,352 --> 00:07:04,482 I think it looked fine on the outside. 129 00:07:04,772 --> 00:07:05,432 On the inside. 130 00:07:05,462 --> 00:07:07,022 ,It had completely burnt out. 131 00:07:07,022 --> 00:07:11,012 There'd been arsonists who'd set a fire and there was nothing inside. 132 00:07:11,012 --> 00:07:14,482 So outwardly it looked fine, inwardly, there was nothing. 133 00:07:14,782 --> 00:07:15,442 So. 134 00:07:15,742 --> 00:07:20,302 In healthcare, perhaps what is happening is that you will preserve 135 00:07:20,302 --> 00:07:24,618 your performance in your work at the cost of everything else. 136 00:07:24,808 --> 00:07:29,368 And this strikes me as being absolutely what goes on. 137 00:07:29,368 --> 00:07:33,948 Because often I remember as a GP you'd get healthcare professionals coming 138 00:07:33,948 --> 00:07:38,748 into you saying, gosh, my other half said I had to come and seek help. 139 00:07:38,748 --> 00:07:41,988 You know, my friend said I really, really needed to come and see, but 140 00:07:41,988 --> 00:07:46,248 they were performing really, really well, functioning as head of a, a unit 141 00:07:46,248 --> 00:07:50,478 as clinical director, but everything else was crumbling around their ears. 142 00:07:50,778 --> 00:07:53,868 So the commonly held view is that people know when they're burnt 143 00:07:53,868 --> 00:07:57,168 out because their performance will be really, really suffering. 144 00:07:57,168 --> 00:08:01,338 And we know that the hallmarks, their diagnostic criteria for burnout are 145 00:08:01,608 --> 00:08:05,115 extreme fatigue, not relieved by rest, lack of empathy, increased 146 00:08:05,115 --> 00:08:06,675 cynicism towards your work and. 147 00:08:06,975 --> 00:08:11,265 A feeling of poor performance, which then really tips into poor performance. 148 00:08:11,565 --> 00:08:15,675 Yet these doctors, they're still performing because what's happening is 149 00:08:15,675 --> 00:08:19,665 that even though their overall performance is going down, they preserve their 150 00:08:19,665 --> 00:08:24,135 work performance and everything else, their performance is at rock bottom. 151 00:08:24,435 --> 00:08:28,395 So this stress curve looks a bit different for people in high stress jobs. 152 00:08:28,695 --> 00:08:32,865 You've got two different types of performance, outside work and inside work. 153 00:08:32,865 --> 00:08:37,515 Now, I'm a huge fan of the Apple TV show called Severance. 154 00:08:37,935 --> 00:08:39,405 I don't wanna give you any spoilers and. 155 00:08:39,670 --> 00:08:43,600 I haven't got to the end of it yet, but the premise of the show is that 156 00:08:43,900 --> 00:08:48,220 people are going to work in a very difficult, toxic organization, but they 157 00:08:48,220 --> 00:08:50,020 have given their consent to be severed. 158 00:08:50,320 --> 00:08:52,600 So they essentially have two different minds. 159 00:08:52,600 --> 00:08:56,830 They have a microchip planted in their heads, and that means that when they 160 00:08:56,830 --> 00:09:01,825 enter the lift to go to work, they go down and the microchip activates one 161 00:09:01,825 --> 00:09:06,115 part of their brain, which is called their innie, their in work persona. 162 00:09:06,295 --> 00:09:08,245 They have no memories of anything. 163 00:09:08,275 --> 00:09:10,855 They can only remember what happens inside work. 164 00:09:11,035 --> 00:09:12,775 They have no memories of the outside world. 165 00:09:12,775 --> 00:09:14,828 They don't know who they are in the outside world. 166 00:09:14,985 --> 00:09:17,498 They don't know even if they're married, what they like doing. 167 00:09:17,848 --> 00:09:21,738 And the only thing they know is their environment in the office. 168 00:09:21,738 --> 00:09:24,438 So they're sort of kept in these very sort of sterile offices. 169 00:09:24,438 --> 00:09:28,488 Now, at the end of the day, they get back into the elevator, they go up, 170 00:09:28,488 --> 00:09:32,118 something happens to their brain, the microchip gets switched, and they're in 171 00:09:32,118 --> 00:09:34,458 their outie, their outta work persona. 172 00:09:34,758 --> 00:09:38,568 So they then, you know, put their stuff away, go off and have a life. 173 00:09:38,928 --> 00:09:43,295 And the main character in the series, well, he decided to take a severed job 174 00:09:43,295 --> 00:09:46,685 because his wife had died and he was struggling with the emotions so much. 175 00:09:46,685 --> 00:09:50,345 He just wanted not to feel that pain for eight hours of the day. 176 00:09:50,645 --> 00:09:54,455 Now it, the story expands and it's a really good watch, so I'd really suggest 177 00:09:54,455 --> 00:09:58,805 you look at it, but I think in healthcare, we've probably got it the other way round. 178 00:09:58,805 --> 00:10:01,655 You see in Severance, the innies suffer. 179 00:10:01,685 --> 00:10:02,825 They work really, really hard. 180 00:10:02,825 --> 00:10:04,625 They're doing a job they don't really understand. 181 00:10:04,805 --> 00:10:07,445 They're treated really, really badly. 182 00:10:07,460 --> 00:10:10,880 But as soon as they leave work, their outies are having a ball, they don't have 183 00:10:10,880 --> 00:10:15,440 to think about work at all, they're having a really nice life, they're going out, 184 00:10:15,440 --> 00:10:20,020 they're partying, and then they just have to turn up, go to the elevator, their 185 00:10:20,020 --> 00:10:23,330 innie does the work for them, and then they can step out at the end of the day. 186 00:10:23,630 --> 00:10:24,800 We've got it the other way round. 187 00:10:25,130 --> 00:10:29,960 I think in healthcare what happens is that our innies work so hard that 188 00:10:29,960 --> 00:10:32,720 the outies don't get a life at all. 189 00:10:33,020 --> 00:10:38,770 We are miserable, because we are using our finite energy for work. 190 00:10:38,920 --> 00:10:41,530 We are not using our energy on our hobbies, the things that we 191 00:10:41,530 --> 00:10:45,460 enjoy doing outside of work, our opposite worlds, which is really 192 00:10:45,460 --> 00:10:46,630 important to prevent burnout. 193 00:10:46,870 --> 00:10:50,590 See the episode on, um, the opposite world and burnout with Nick Petri, 194 00:10:50,590 --> 00:10:52,000 we'll put the link in the show notes. 195 00:10:52,400 --> 00:10:56,870 Any free time we have outside of work, well, we spend catching up on work. 196 00:10:57,110 --> 00:11:00,170 So all our outie time is spent doing any stuff. 197 00:11:00,470 --> 00:11:03,020 We borrow performance from our future health. 198 00:11:03,020 --> 00:11:06,860 Yeah, it might feel okay today, but what about in five years time where 199 00:11:06,860 --> 00:11:09,080 you have a stress induced heart attack? 200 00:11:09,413 --> 00:11:13,267 We don't look after ourselves, we don't eat properly, but most 201 00:11:13,267 --> 00:11:18,337 importantly, we borrow our energy and our time from the most important 202 00:11:18,337 --> 00:11:23,227 things in life, which are our relationships, our family, our friends. 203 00:11:23,527 --> 00:11:24,997 We don't have time for them anymore. 204 00:11:25,297 --> 00:11:30,607 And as for our partners, well, they become what's called the residual beneficiary. 205 00:11:30,607 --> 00:11:36,517 Like if I have any energy left after work, after other obligations after 206 00:11:36,517 --> 00:11:40,087 the kids, then my residual beneficiary can get that like five minutes at 207 00:11:40,087 --> 00:11:43,597 the end of the day where my brain is so addled that the only thing I can 208 00:11:43,597 --> 00:11:45,577 do is zoom scroll on social media. 209 00:11:45,817 --> 00:11:50,667 So no wonder so many people end up in difficulty with relationships 210 00:11:50,667 --> 00:11:52,827 because relationships take time. 211 00:11:53,177 --> 00:11:57,367 And what's more, the message you are sending to your friends, to your family, 212 00:11:57,367 --> 00:12:01,567 to your significant others, is that they don't matter, is that work is 213 00:12:01,567 --> 00:12:03,367 much, much more important than them. 214 00:12:03,691 --> 00:12:05,851 Now, the problem is in the moment. 215 00:12:06,151 --> 00:12:09,031 You could always argue that it is, particularly in healthcare, we could 216 00:12:09,031 --> 00:12:10,681 doing some really high stakes stuff. 217 00:12:10,711 --> 00:12:15,181 Yes, saving that person's life, doing that operation, doing that clinic. 218 00:12:15,481 --> 00:12:20,491 But in the long run, you are putting your patients first at the cost of 219 00:12:20,826 --> 00:12:26,046 you, you relationships, and in the long run, the patients suffer because 220 00:12:26,046 --> 00:12:27,839 you will become like that building. 221 00:12:28,169 --> 00:12:29,639 You will just be performing at work. 222 00:12:29,939 --> 00:12:32,969 But you'll be burnt out inside and eventually you'll drop off 223 00:12:32,969 --> 00:12:35,819 the burnout cliff when you can't perform anymore because the 224 00:12:35,819 --> 00:12:37,649 performance does not go on forever. 225 00:12:37,949 --> 00:12:43,882 So we borrow from our time, from our energy, from our health outside of work. 226 00:12:44,149 --> 00:12:45,409 And we use all sorts of excuses. 227 00:12:45,409 --> 00:12:48,439 One excuse might be finance, you know, I need, I need to earn this amount of money. 228 00:12:48,739 --> 00:12:51,919 Another excuse might be, well, you know, it's what I've trained 229 00:12:51,919 --> 00:12:55,969 for all these years, but actually underneath it all, it's all about 230 00:12:56,269 --> 00:13:00,199 not being thought of badly by other people, being seen to do good stuff. 231 00:13:00,259 --> 00:13:03,289 And we have a conscience that we, we really, genuinely want to help. 232 00:13:03,569 --> 00:13:08,099 But that can overreach and it can mean that we end up just not helping anybody. 233 00:13:08,399 --> 00:13:09,839 So we have a choice here. 234 00:13:10,049 --> 00:13:14,969 We can carry on borrowing our performance from our life outside of work. 235 00:13:15,269 --> 00:13:18,989 If we carry on doing that, we will eventually hit the burnout 236 00:13:18,989 --> 00:13:21,269 cliff where everything goes south. 237 00:13:21,569 --> 00:13:24,419 Our job as well, not just our relationships. 238 00:13:24,719 --> 00:13:29,519 Our health will get worse and slowly we will lose the support 239 00:13:29,519 --> 00:13:32,756 that we have at home, the support that we have from our friends 240 00:13:32,756 --> 00:13:35,019 because they're just not seeing us. 241 00:13:35,259 --> 00:13:37,946 And life will feel really, really empty. 242 00:13:38,186 --> 00:13:40,946 It'll be very busy, but it'll be empty. 243 00:13:40,946 --> 00:13:44,816 I had a quote the other day that the busy life is the empty life. 244 00:13:45,116 --> 00:13:48,446 If you wanna live a full life, you need to balance your energy 245 00:13:48,446 --> 00:13:50,486 between work and between home. 246 00:13:50,786 --> 00:13:51,896 That's hard, isn't it? 247 00:13:52,136 --> 00:13:53,366 Let's look at how to do that. 248 00:13:53,516 --> 00:13:56,726 Well, there's no quick, easy solution. 249 00:13:56,756 --> 00:13:58,896 If there was, I wouldn't have a job, right? 250 00:13:58,909 --> 00:14:00,954 But here are some thoughts I've had about it. 251 00:14:01,254 --> 00:14:07,134 So often when I notice things in myself, my first reaction is to jump into action. 252 00:14:07,134 --> 00:14:08,244 Right, what can I do about this? 253 00:14:08,244 --> 00:14:09,324 What can I do about it? 254 00:14:09,499 --> 00:14:13,958 But as I talked about in a previous podcast, the first action on the 255 00:14:14,198 --> 00:14:19,508 action step ladder is not to do any action, it's to face reality and 256 00:14:19,508 --> 00:14:21,488 work out what actually is going on. 257 00:14:21,788 --> 00:14:26,263 So if you are not sure if you are stressed, overwhelmed, or burnout, 258 00:14:26,293 --> 00:14:31,033 or you secretly worry that you might be working in burnout, then the first 259 00:14:31,033 --> 00:14:35,473 thing you should do is download our free PDF Burnout Self-Assessment Toolkit. 260 00:14:35,520 --> 00:14:39,120 This contains links to loads of burnout, self-assessments you can do. 261 00:14:39,420 --> 00:14:42,690 It contains some reflection questions for you to ask yourself. 262 00:14:43,020 --> 00:14:45,780 It contains some stuff around the difference between stress, overwhelm 263 00:14:45,780 --> 00:14:48,020 and burnout, and it contains a stress curve, so you can actually 264 00:14:48,020 --> 00:14:49,310 put yourself on the stress curve. 265 00:14:49,610 --> 00:14:52,220 That will help you face reality and workout like. 266 00:14:52,510 --> 00:14:54,220 Where am I on this stress curve? 267 00:14:54,550 --> 00:14:56,530 How urgent is this situation? 268 00:14:56,680 --> 00:15:00,430 But don't be misled by thinking, I only need to do something about 269 00:15:00,430 --> 00:15:01,480 this when it gets to urgent. 270 00:15:01,480 --> 00:15:04,630 Because it's much, much, much, much easier to do something about it when 271 00:15:04,635 --> 00:15:07,120 you are starting to slip down the curve, when you're starting to feel really 272 00:15:07,120 --> 00:15:10,360 stressed and going into overwhelm, rather than waiting till you are in 273 00:15:10,360 --> 00:15:12,460 burnout when you've gone off that cliff. 274 00:15:12,490 --> 00:15:16,750 'Cause often that takes a lot of time off work and some serious 275 00:15:16,750 --> 00:15:18,100 work on yourself to recover. 276 00:15:18,400 --> 00:15:19,900 So face reality. 277 00:15:20,200 --> 00:15:23,080 Is that you, are you currently working in burnout? 278 00:15:23,380 --> 00:15:28,270 Secondly, work out where am I borrowing my performance from right now? 279 00:15:28,360 --> 00:15:29,830 What is suffering at home? 280 00:15:30,130 --> 00:15:31,900 Think to yourself, is it my relationships? 281 00:15:31,900 --> 00:15:34,810 And you can rate them on a scale of one to 10 if you want to. 282 00:15:34,990 --> 00:15:37,480 Yeah, what is really important in your life? 283 00:15:37,780 --> 00:15:41,320 If I was thinking about that right now, I would say my family a hundred percent. 284 00:15:41,620 --> 00:15:44,980 But then I need to rate how much time am I actually spending with them. 285 00:15:45,220 --> 00:15:48,460 You know, I might rate that 10 out of 10 in importance, but if 286 00:15:48,460 --> 00:15:52,480 you were to look at my diary, what would someone else rate that as? 287 00:15:52,640 --> 00:15:56,037 So if you were to look at my diary, I'm saying it's 10 out of 10 in 288 00:15:56,037 --> 00:15:59,817 importance, probably you'd say, well, maybe it's only a five or six because 289 00:15:59,817 --> 00:16:04,227 you spend a lot of your time, Rachel, at work or traveling, uh, doing 290 00:16:04,227 --> 00:16:05,817 conferences and things like that. 291 00:16:06,117 --> 00:16:08,337 So what does your diary tell you? 292 00:16:08,637 --> 00:16:12,237 Rate how important those things are to you, and then rate what an external 293 00:16:12,237 --> 00:16:17,057 observer would say if they looked at your actual diary and your actual schedule. 294 00:16:17,297 --> 00:16:21,467 Think through to the last month, how much time have you spent on your hobbies? 295 00:16:21,467 --> 00:16:24,497 How much time have you spent with your significant people? 296 00:16:24,797 --> 00:16:27,287 How much time have you spent looking after yourself? 297 00:16:27,287 --> 00:16:29,867 Because you might say that's important to you, but if you're not 298 00:16:29,867 --> 00:16:31,757 doing it, there's a problem there. 299 00:16:31,907 --> 00:16:35,327 And just by rating it, you can start to create some cognitive dissonance, and that 300 00:16:35,327 --> 00:16:37,697 is the first step towards some change. 301 00:16:38,017 --> 00:16:41,077 Recently I realized that I just wasn't seeing my friends as 302 00:16:41,077 --> 00:16:42,697 much as I wanted to see them. 303 00:16:42,967 --> 00:16:45,667 And we had a little routine when the kids were little. 304 00:16:45,877 --> 00:16:48,607 Those of us who didn't work on a Monday morning, we would always 305 00:16:48,607 --> 00:16:52,297 meet at a local coffee shop from nine till 10 after school drop off. 306 00:16:52,357 --> 00:16:55,957 And we have continued this and it's really wonderful. 307 00:16:55,957 --> 00:16:59,137 But in the last six months, I've just thought that I'd been too busy. 308 00:16:59,397 --> 00:17:03,537 And I knew it took up an hour of my day just at a time where actually I could 309 00:17:03,537 --> 00:17:05,127 be getting some really good work done. 310 00:17:05,127 --> 00:17:06,207 So I stopped going. 311 00:17:06,507 --> 00:17:08,967 And gradually I started to feel like I was missing out. 312 00:17:08,967 --> 00:17:10,557 And some of the relationships suffered. 313 00:17:10,587 --> 00:17:13,677 'Cause quite literally, I wasn't seeing some of these people 314 00:17:13,827 --> 00:17:16,347 for six months, whereas before I'd been seeing them weekly. 315 00:17:16,600 --> 00:17:22,990 So I decided not to borrow that time from my outie life just to serve 316 00:17:22,990 --> 00:17:27,130 my innie work life, and I am going back there and it's been joyous in 317 00:17:27,130 --> 00:17:28,960 the last few weeks that I have been. 318 00:17:29,177 --> 00:17:32,937 Now obviously I have the luxury of being more in control of my diary than 319 00:17:33,177 --> 00:17:38,678 than many people listening to this podcast, but have a look at your weekly 320 00:17:38,738 --> 00:17:42,458 working schedule, and we provide the Thrive Week planner to help with this. 321 00:17:42,458 --> 00:17:45,218 And if you haven't got that already, we'll put that link in the show notes 322 00:17:45,218 --> 00:17:49,628 as well, and that just helps you plan what your ideal week should look like 323 00:17:49,628 --> 00:17:51,128 or what you would like it to look like. 324 00:17:51,128 --> 00:17:54,728 Now, you'll never get to that ideal week, but you can get as close as you can. 325 00:17:55,028 --> 00:17:56,738 There will be some times free. 326 00:17:56,918 --> 00:17:59,408 There will be some times where you are choosing to work when you 327 00:17:59,408 --> 00:18:00,668 could be doing something else. 328 00:18:01,085 --> 00:18:03,035 But that throws up another problem, doesn't it? 329 00:18:03,035 --> 00:18:06,395 Because you're gonna have to start saying no and setting boundaries. 330 00:18:06,822 --> 00:18:09,882 And when we work in healthcare, when everything seems like it's 331 00:18:09,882 --> 00:18:13,998 important, it's very hard to think, well, what on earth could shift? 332 00:18:14,188 --> 00:18:16,408 And this is where you might need to do a zone of power. 333 00:18:16,678 --> 00:18:20,188 Simply draw a circle and work out what's in your control and 334 00:18:20,188 --> 00:18:21,478 what's not in your control. 335 00:18:21,478 --> 00:18:24,418 You know, if you are employed for a certain amount of surgeries 336 00:18:24,418 --> 00:18:28,138 or clinics or operating theater lists or ward rounds, put in those 337 00:18:28,138 --> 00:18:29,608 times that are non-negotiable. 338 00:18:29,758 --> 00:18:34,425 But there will be negotiable times in your week, and there will be times 339 00:18:34,425 --> 00:18:38,865 where you have that extra discretionary effort that you are putting in. 340 00:18:39,151 --> 00:18:44,701 And it's this discretionary effort time, and it's this non-scheduled time that you 341 00:18:44,701 --> 00:18:47,041 can start to choose what you do with it. 342 00:18:47,328 --> 00:18:52,158 And part of it might be just becoming a little bit more efficient and focused 343 00:18:52,158 --> 00:18:55,548 with the time that you do have, making sure that you are getting deep work 344 00:18:55,548 --> 00:18:57,408 thinking time not being interrupted. 345 00:18:57,708 --> 00:19:01,248 And if you wanna find out how to get some of that and avoid the urgency trap, then 346 00:19:01,398 --> 00:19:04,038 do sign up for our urgency trap training. 347 00:19:04,038 --> 00:19:05,898 Again, we'll put the link there in the show notes. 348 00:19:06,198 --> 00:19:10,758 But sometimes it's choosing to perform less well at work so that 349 00:19:10,758 --> 00:19:14,088 you can perform better at home with your friends and your family. 350 00:19:14,388 --> 00:19:15,348 I'll say that again. 351 00:19:15,648 --> 00:19:19,698 Sometimes you need to choose for your performance to go down. 352 00:19:20,085 --> 00:19:23,698 One of the first people I was coaching while I was a trainee coach 353 00:19:23,908 --> 00:19:25,348 really brought this home to me. 354 00:19:25,348 --> 00:19:28,858 I asked him to fill in the performance diamond, which is a simple rating 355 00:19:28,858 --> 00:19:32,981 tool where you rate your enjoyment of work, your learning that you 356 00:19:32,981 --> 00:19:36,521 are doing, the purpose you have in work and your achievement at work. 357 00:19:36,581 --> 00:19:43,131 Now, this guy was a really high flying medic and his ratings really 358 00:19:43,131 --> 00:19:48,231 surprised me because he rated his achievement as like a nine. 359 00:19:48,231 --> 00:19:51,471 He was on all sorts of college boards. 360 00:19:51,691 --> 00:19:53,915 He was, you know, one of the clinical directors. 361 00:19:53,915 --> 00:19:55,175 He was an amazing guy. 362 00:19:55,220 --> 00:19:56,598 but his enjoyment. 363 00:19:56,898 --> 00:20:00,378 Was sort of around four or five, and I then said to him, well, 364 00:20:00,378 --> 00:20:01,758 where would you like that to be? 365 00:20:01,758 --> 00:20:05,598 He said he'd like his enjoyment to be at eight, and he actually said he wanted 366 00:20:05,598 --> 00:20:07,788 his achievement to be more like a seven. 367 00:20:08,125 --> 00:20:10,288 That was the first time I'd come across that concept. 368 00:20:10,288 --> 00:20:11,698 I was like, that's so interesting. 369 00:20:11,698 --> 00:20:12,478 Tell me about it. 370 00:20:12,478 --> 00:20:14,938 He said, well, there's a direct line between my achievement enjoyment. 371 00:20:15,238 --> 00:20:17,998 As soon as I achieve more, I enjoy less in life, and as soon as I 372 00:20:17,998 --> 00:20:19,888 achieve less, I enjoy my life more. 373 00:20:20,215 --> 00:20:21,688 So we need to think about that. 374 00:20:21,978 --> 00:20:24,095 How important is achievement for you? 375 00:20:24,395 --> 00:20:28,115 And let's face it, we have been brought up to think that I am only as 376 00:20:28,115 --> 00:20:32,285 good as what I do as the output that I produce, you know, as, as my exam 377 00:20:32,285 --> 00:20:34,775 results and as the status that I've got. 378 00:20:34,775 --> 00:20:36,485 And that is what other people think about me. 379 00:20:36,485 --> 00:20:39,155 And to be honest, that's how I think about myself. 380 00:20:39,455 --> 00:20:42,605 I need to achieve to be a valuable human being. 381 00:20:42,605 --> 00:20:45,455 But what if that is just totally the wrong success story? 382 00:20:45,755 --> 00:20:49,445 We know that it's happiness that leads to success. 383 00:20:49,505 --> 00:20:52,285 It's not achievement that leads to success. 384 00:20:52,465 --> 00:20:53,953 That's quite hard to get your head around. 385 00:20:54,121 --> 00:20:56,831 the problem is, whilst we've had those success stories ingrained 386 00:20:56,831 --> 00:21:00,911 in us all our lives, it's very difficult to get outta that. 387 00:21:00,911 --> 00:21:02,801 And that is where you might need to do some work. 388 00:21:02,861 --> 00:21:04,751 You might need to read some books. 389 00:21:04,901 --> 00:21:07,091 You might need to go and see a therapist. 390 00:21:07,391 --> 00:21:10,001 'Cause bottom line, if we don't think we can achieve as much as we 391 00:21:10,001 --> 00:21:12,775 want to achieve, we start to think, well maybe I'm not good enough. 392 00:21:13,075 --> 00:21:16,135 When we say no to doing those things on our to-do list, we go, 393 00:21:16,135 --> 00:21:17,485 well, I might not be good enough. 394 00:21:17,838 --> 00:21:20,485 When we have to give up that role, or is it because I'm not good enough? 395 00:21:20,785 --> 00:21:25,135 And it's a quick hop, skip and a jump from I'm not good enough to, I am not enough. 396 00:21:25,501 --> 00:21:27,835 And the underlying emotion there is shame. 397 00:21:28,135 --> 00:21:29,875 Shame about ourselves. 398 00:21:30,180 --> 00:21:33,262 But if you be our choosing that we are not gonna perform as well, we are not 399 00:21:33,262 --> 00:21:37,792 gonna achieve as much at work so that we have more energy and time for the 400 00:21:37,792 --> 00:21:42,262 things outside work that make life worth living, actually, we will be happier. 401 00:21:42,412 --> 00:21:46,312 We might not achieve as much, but the main thing blocking us there is our 402 00:21:46,342 --> 00:21:49,972 own internal mindset and the stories we are telling ourselves around shame. 403 00:21:50,475 --> 00:21:54,785 So can I suggest you might wanna reduce your performance at work by 404 00:21:54,995 --> 00:21:59,105 scrapping that discretionary stuff that you are doing, because achievement 405 00:21:59,105 --> 00:22:00,785 seems to be the most important thing. 406 00:22:00,785 --> 00:22:04,175 So just have a look, think where can you bring the achievement down a little 407 00:22:04,175 --> 00:22:07,985 bit so that you can increase it at home? 408 00:22:08,299 --> 00:22:12,409 The next thing you need to do is just start putting some recovery time in. 409 00:22:12,654 --> 00:22:17,124 Use the ABC of wellbeing, stay active, take breaks, and connect with people. 410 00:22:17,124 --> 00:22:22,324 If you get at least that in every day, you will start to rebuild 411 00:22:22,614 --> 00:22:24,354 your performance and your energy. 412 00:22:24,544 --> 00:22:26,464 So start to look after yourself. 413 00:22:26,794 --> 00:22:30,154 Make sure that you put date night regularly in your diary. 414 00:22:30,274 --> 00:22:33,699 You cancel stuff outside of work that's purely driving the achievement thing 415 00:22:33,699 --> 00:22:35,439 rather than giving you proper rest. 416 00:22:35,439 --> 00:22:38,743 We'd often pursue leisure, which means that we're sort of 417 00:22:38,773 --> 00:22:40,453 having to perform really highly. 418 00:22:40,453 --> 00:22:45,673 But what if we just focused on switching off type of rest rather than that sort 419 00:22:45,673 --> 00:22:47,827 of driven rest that so many of us have? 420 00:22:48,328 --> 00:22:51,828 Make sure you are able to turn off completely. 421 00:22:52,316 --> 00:22:56,927 Doing nothing or even just sitting reading a book, that is a great way of resting. 422 00:22:57,227 --> 00:23:01,427 I have started to make sure that I spend at least an hour at the weekend 423 00:23:01,427 --> 00:23:04,877 sitting in my hanging pod, in the garden, reading the Week magazine. 424 00:23:04,877 --> 00:23:06,347 I find that really restful. 425 00:23:06,347 --> 00:23:09,663 But to be honest, there's so much stuff to do, uh, I have to force myself to do it, 426 00:23:09,663 --> 00:23:11,553 and I'm always so glad when I've done it. 427 00:23:11,553 --> 00:23:12,033 And you know what? 428 00:23:12,273 --> 00:23:14,853 After that hour of just sitting still. 429 00:23:15,153 --> 00:23:18,483 The other stuff, it just doesn't seem so important. 430 00:23:18,783 --> 00:23:23,283 So when you've had time to rest, you start to get a little bit of perspective back. 431 00:23:23,283 --> 00:23:26,583 You know, like when you go on a holiday and it seems like, gosh, I can't possibly 432 00:23:26,583 --> 00:23:29,793 leave, there's so much I need to do, and then you're away for two weeks and 433 00:23:30,093 --> 00:23:32,883 halfway through the second week you're thinking, gosh, that really wasn't so 434 00:23:32,883 --> 00:23:35,673 important after all, I can't really remember what I was stressed about. 435 00:23:35,673 --> 00:23:38,703 And then in the last couple of days of holiday, the stress starts building 436 00:23:38,703 --> 00:23:40,893 back and you start to predict all those emails you've got to deal 437 00:23:40,893 --> 00:23:42,273 with before you even get back. 438 00:23:42,639 --> 00:23:46,299 So put some time into discover an opposite world, something that gives 439 00:23:46,299 --> 00:23:50,739 you the opposite of the achievement and the drive that you have to do at work. 440 00:23:50,939 --> 00:23:53,339 And finally, as part of facing reality. 441 00:23:53,639 --> 00:23:57,719 Identify those stories in your head that you are telling yourself, how 442 00:23:57,719 --> 00:23:59,609 are you making your overwhelm worse? 443 00:23:59,639 --> 00:24:04,349 Why are you doing the extra stuff that you don't really need to do, that nobody 444 00:24:04,349 --> 00:24:08,429 asked you to do, or maybe you could have said no to, that wasn't compulsory, 445 00:24:08,429 --> 00:24:12,329 that's not in your job plan, that you're not gonna be sacked for not doing? 446 00:24:12,679 --> 00:24:13,609 Why are you doing it? 447 00:24:13,909 --> 00:24:16,099 And we have these six overwhelm amplifies. 448 00:24:16,099 --> 00:24:20,249 I've noticed that senior leaders in healthcare have all the time, 449 00:24:20,549 --> 00:24:24,269 that just means they're working so much harder than they needed to. 450 00:24:24,569 --> 00:24:26,939 The first one is being stuck in the agency trap, responding to 451 00:24:26,939 --> 00:24:28,409 everyone else's stuff all the time. 452 00:24:28,709 --> 00:24:30,539 Learn how to leave it to other people. 453 00:24:30,839 --> 00:24:35,639 Number two, being a rescuer, feeling that actually your job is to rescue and help 454 00:24:35,639 --> 00:24:37,439 your team, and that's not your fault. 455 00:24:37,469 --> 00:24:40,319 You've been built like that, but where are you rescuing your team and 456 00:24:40,319 --> 00:24:43,349 doing their work for them and not leaving them to do their own job? 457 00:24:43,574 --> 00:24:47,818 The next overwhelm amplifier is this superhero's delusion. 458 00:24:48,118 --> 00:24:52,318 This delusion that we don't actually have limits, that we can operate without any 459 00:24:52,318 --> 00:24:53,878 sleep, we can operate without any breaks. 460 00:24:53,878 --> 00:24:56,398 I hate to break it to you, but that doesn't work for you. 461 00:24:56,698 --> 00:25:00,928 Even if as a junior doctor you manage to do 120 hours a week, believe me, as you 462 00:25:00,928 --> 00:25:02,638 get older, that is not gonna work for you. 463 00:25:02,638 --> 00:25:04,818 You are human, you have limits. 464 00:25:05,118 --> 00:25:07,788 These wellbeing factors are really important for your 465 00:25:07,788 --> 00:25:09,318 mental and physical fitness. 466 00:25:09,318 --> 00:25:09,858 And you know what? 467 00:25:09,858 --> 00:25:11,448 They also make life worth living. 468 00:25:11,748 --> 00:25:15,258 The fourth overwhelm amplifier is fear of conflict. 469 00:25:15,558 --> 00:25:18,828 It means that we don't have the difficult conversations that we need to. 470 00:25:18,828 --> 00:25:25,147 We don't say no, we don't challenge people when they are causing issues in the team. 471 00:25:25,147 --> 00:25:28,477 And what happens is that the issues build up, build up, and they're far more 472 00:25:28,477 --> 00:25:29,947 difficult to sort out down the line. 473 00:25:29,947 --> 00:25:33,667 So we make life much, much harder for ourselves because we are so scared 474 00:25:33,667 --> 00:25:35,737 of disrupting the relationship. 475 00:25:36,037 --> 00:25:37,027 Another overwhelm. 476 00:25:37,027 --> 00:25:38,797 Amplify is over responsibility. 477 00:25:38,797 --> 00:25:42,607 This mindset that if I don't do it, who's going to? 478 00:25:42,937 --> 00:25:45,652 I am responsible for everybody and everything. 479 00:25:45,652 --> 00:25:49,942 And I see this time and time of day again when I do training with say, GP trainers 480 00:25:50,152 --> 00:25:53,932 who are feeling totally responsible for everything about their trainee, 481 00:25:53,932 --> 00:25:55,852 about if they hand in their portfolio. 482 00:25:55,852 --> 00:26:00,052 So, so the trainers are giving up their annual leave to mark the late portfolios. 483 00:26:00,052 --> 00:26:03,382 They feel responsible for whether their trainee passes the exams or not. 484 00:26:03,382 --> 00:26:06,502 But they're so much that they can't possibly be responsible for, and 485 00:26:06,502 --> 00:26:09,922 we feel guilty when stuff happens that's outside of our control. 486 00:26:10,222 --> 00:26:14,272 That we can't be responsible for, but we still take responsibility for it. 487 00:26:14,739 --> 00:26:17,019 And finally, biscuit boundaries. 488 00:26:17,295 --> 00:26:19,199 We try and put these boundaries in. 489 00:26:19,199 --> 00:26:22,379 We try and say no, but as soon as we get pushed back or somebody else 490 00:26:22,379 --> 00:26:24,599 doesn't like it, the boundaries crumble. 491 00:26:24,599 --> 00:26:27,929 We feel like terrible people and we think, oh no, I really, really ought to do that. 492 00:26:27,929 --> 00:26:29,459 And so everything crumbles. 493 00:26:29,715 --> 00:26:34,440 So all of these things are mindset shifts that we need to have in order to 494 00:26:34,440 --> 00:26:38,900 really be able to protect our time and our energy, and protect our performance 495 00:26:38,900 --> 00:26:40,940 outside work, not just inside work. 496 00:26:41,260 --> 00:26:46,460 Because when the pressure builds up, what we tend to do in healthcare in 497 00:26:46,460 --> 00:26:50,300 these high stress, high stakes jobs is to maintain our performance at 498 00:26:50,300 --> 00:26:55,450 work, but our energy is taken up there and our performance suffers at home. 499 00:26:55,750 --> 00:26:59,170 We borrow our performance from our home life, from our relationships, 500 00:26:59,470 --> 00:27:02,440 from our kids, from our wider family, from our friends, from our 501 00:27:02,440 --> 00:27:08,590 hobbies, from our leisure, from our spirituality, and life becomes empty. 502 00:27:08,590 --> 00:27:14,260 We are in burnout, in this burnout shell of a person whilst 503 00:27:14,260 --> 00:27:16,660 maintaining our performance at work. 504 00:27:16,960 --> 00:27:19,090 But at some point we drop off that cliff. 505 00:27:19,390 --> 00:27:23,860 It comes at a huge personal cost, but often we don't realize till 506 00:27:23,860 --> 00:27:28,330 it's too late, till our relationship has gone wrong, or till we have 507 00:27:28,330 --> 00:27:30,280 a really bad, bad health problem. 508 00:27:30,580 --> 00:27:33,760 So please recognize the cost of what is going on. 509 00:27:34,087 --> 00:27:34,837 Recognize what. 510 00:27:34,837 --> 00:27:37,927 The cost of not doing anything about this is. 511 00:27:38,067 --> 00:27:42,627 Recognize the cost of not understanding those toxic, difficult, overwhelm 512 00:27:42,632 --> 00:27:47,637 amplifier mindsets that we get into, which mean we make it worse. 513 00:27:47,961 --> 00:27:49,731 And this is something we can help with. 514 00:27:49,731 --> 00:27:53,991 So if you wanna check out our Beat Stress and Thrive course, our Escape the 515 00:27:53,991 --> 00:27:58,415 Urgency Trap training, and there's lots of other ways that we help you recognize 516 00:27:58,475 --> 00:28:01,295 and beat the overwhelm amplifiers. 517 00:28:01,535 --> 00:28:05,455 But start off with downloading the burnout self-assessment toolkit. 518 00:28:05,455 --> 00:28:09,231 It's totally free, and it will just give you a snapshot of where you are now. 519 00:28:09,470 --> 00:28:13,340 And I'll just finish with that really amazing challenge from that 520 00:28:13,370 --> 00:28:15,140 wonderful poem by Mary Oliver. 521 00:28:15,440 --> 00:28:20,750 Tell me what is it that you plan to do with your one wild and precious life? 522 00:28:21,197 --> 00:28:21,924 You choose.