WEBVTT
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[SPEAKER_01]: High-achieving women find any way possible to get everything done, as well as possible, because we need to outperform our male peers.
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[SPEAKER_01]: It's just we're also carrying the gauge of expectations about what a good woman should be doing, and I think guilt becomes major outcome of this dynamic.
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[SPEAKER_00]: What are the four categories of expectations that drive women towards burnout?
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[SPEAKER_01]: One is being constant caregivers.
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[SPEAKER_01]: There's hyper-accountability, third one is the idea that we need to show up everywhere perfectly.
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[SPEAKER_01]: And the last one is the idea of having it all.
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[SPEAKER_01]: Do you want to talk about how women feel selfish for self-care?
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[SPEAKER_01]: We've been told that we should be able to tolerate childbirth.
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[SPEAKER_01]: pain every month, bloating, changes in our mood, parry menopause and menopause and that is something we've absorbed because we have had to find a way to adapt.
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[SPEAKER_01]: Is this why women are stripped of their joy in the post part of the period, these changes are brains go through in postpartum period.
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[SPEAKER_01]: Make us vulnerable to depression and anxiety, but also more tune with our baby and maybe a little forgetful elsewhere.
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[SPEAKER_00]: When guilt alarm is going off, what's an actionable item you recommend.
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[SPEAKER_00]: One of my favorites is
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[SPEAKER_00]: The disruptor podcast is for informational purposes only and does not constitute medical advice.
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[SPEAKER_00]: Views expressed by guests are their own.
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[SPEAKER_00]: Consult your healthcare provider before making any medical decisions.
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[SPEAKER_00]: Hi, and welcome to the disruptor.
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[SPEAKER_00]: Today's guest is Dr. Jennifer Reed, a physician and an academic with serious clinical weight.
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[SPEAKER_00]: She has earned her medical degree from Columbia University, completed her residency at UCLA, and now holds dual faculty appointments at UPAN and Cooper Medical School.
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[SPEAKER_00]: But what I love most is the why behind her work.
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[SPEAKER_00]: She's the daughter of a family legacy of physicians and educators,
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[SPEAKER_00]: So medicine and teaching aren't just what she does, they're part of who she is.
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[SPEAKER_00]: And today's conversation is not a surface level self-help chat.
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[SPEAKER_00]: This is a peer-to-peer deep dive into the science of guilt, why ambition women are biologically and socially conditioned to ignore their own needs until they hit a breaking point.
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[SPEAKER_00]: And what it takes to actually interrupt that cycle.
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[SPEAKER_00]: do you want to tell us a little bit about why high achieving women or women in general are excellent students of guilt?
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[SPEAKER_01]: Yeah.
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[SPEAKER_01]: It was a big question because I did, I was seeing this anecdotally right?
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[SPEAKER_01]: Everyone in my psychiatry practice and I'm seeing very high functioning women in medicine, lawyers, attorneys, people running businesses and I was just hearing this from so many women.
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[SPEAKER_01]: This sense of
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[SPEAKER_01]: I should be doing more, I'm not enough, I'm not doing everything perfectly, why is this happening to women and I wanted to understand that and I was feeling it too.
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[SPEAKER_01]: My sister, older sister, is a surgeon and raising three kids and she is a phenomenon and she and I would just call each other and be like, why do I still feel?
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[SPEAKER_01]: so overwhelmed and so guilty all the time like I'm not doing what I'm supposed to do.
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[SPEAKER_01]: I think that high-achieving women what's been adaptive for us is to find any way possible to get everything done and to do it as well as possible to absolutely be as perfect as we can because let's be honest in some cases in many cases, especially the highest echelons, we need to outperform, maybe our male peers, to get where we need to be.
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[SPEAKER_01]: That was certainly the
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[SPEAKER_01]: men are entering medical school classes at this point, but you could still see those differences, even in what specialty we might be expected to enter.
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[SPEAKER_01]: So I think there's been this pressure from a very young age if we wanted to achieve, which we had that inside of us, we needed to do things perfectly.
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[SPEAKER_01]: And with this vision of effortlessness, which is just impossible, and I think putting us in a double bind, but that's what we did, that was adaptive for us to get ahead.
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[SPEAKER_01]: It's just we're also carrying this bag of expectations about what a good woman should be doing, should be feeling how we're supposed to be taking care of everyone else even as we climb the ladder potentially or even as we go after something we really want so that combination expectations of this ideal woman caregiver nurture.
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[SPEAKER_01]: plus idea that we had to really outperform many of our peers to get ahead, sort of combine and I think guilt becomes, unfortunately, the major outcome of this dynamic.
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[SPEAKER_00]: So I want to dive in a little bit deeper because here you are this high achieving woman yourself, recognizing it in your patients and you're sibling.
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[SPEAKER_00]: And for me, my guilt presented as almost wishing I could, I think it was a show about this right, splitting myself into two because when I was home,
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[SPEAKER_00]: I was constantly like, oh, I should be with my patients or I should be reading more articles or I should be, you know, like I couldn't answer that question or I should be doing charts.
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[SPEAKER_00]: But then the opposite when I was at work or in the operating room, I was like, oh, I'm missing for steps and first words and, you know, I remember falling my eyes out, my son needed
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[SPEAKER_00]: a tonsil surgery, tonsil and adnoids, and the nurse simply asked a question.
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[SPEAKER_00]: She's like, what's his favorite toy?
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[SPEAKER_00]: And I started crying because I knew all the toys he played with.
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[SPEAKER_00]: I just didn't know which one was his absolute favorite, but it's manning good.
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[SPEAKER_00]: And in that moment, I'm an OBGYN.
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[SPEAKER_00]: I had a try, I had one at that point.
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[SPEAKER_00]: And I just remember crying, because I felt like a complete and utter failure.
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[SPEAKER_00]: my only child's favorite toy.
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[SPEAKER_00]: And it was really, really sad.
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[SPEAKER_00]: And my husband was like, it's okay.
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[SPEAKER_00]: I don't know it either.
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[SPEAKER_00]: And he didn't feel that guilt.
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[SPEAKER_00]: Because he didn't know, he was like, I don't know what either, but I felt so guilty.
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[SPEAKER_00]: And I think you're right.
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[SPEAKER_00]: It's that expectation of, well, I should be able to do it all, right?
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[SPEAKER_00]: Like, why can't I?
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[SPEAKER_00]: But I remember, so I want to know how you felt it if you're willing to share a specific example.
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[SPEAKER_01]: Well, certainly during COVID, I had, I had been in an academic center and then had started a private practice and COVID everything came home to my home office where I am now.
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[SPEAKER_01]: And my kids were home, not going to school, and it just felt like everyone needed me.
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[SPEAKER_01]: And I couldn't be in multiple places at once.
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[SPEAKER_01]: I was trying to see a patient who's really struggling because I was such a scary time.
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[SPEAKER_01]: And my kids would be knocking on the door and they were feeling anxious and I'm getting certain about things.
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[SPEAKER_01]: And it felt like I had internalized that I was failing.
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[SPEAKER_01]: I should be seeing more patients because there's a lot of need, and especially in mental health at that time and still, I should be with my kids nurturing them through this really difficult time.
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[SPEAKER_01]: So it absolutely showed up for me.
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[SPEAKER_01]: And I think as a working mom, whether it's in medicine or otherwise, we are facing this constant pressure,
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[SPEAKER_01]: This idea that daytime events at the kid's school invite parents, kind of assuming that there is a parent who's home during the day and would come to the event, so there are social structures keeping this in place, right?
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[SPEAKER_01]: So, absolutely, for me, and I still have guilty thoughts.
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[SPEAKER_01]: It's still the sense of I should be doing more.
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[SPEAKER_01]: I should be showing up perfectly.
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[SPEAKER_01]: I called to schedule my mammogram the other day and it was like six months late and I felt so guilty because I was like why am I not on top of this and taking care of myself and of course it's it's going to be fine but there is this constant sense that I need to be productive every day.
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[SPEAKER_01]: I need to be exercising the right amount cooking healthy meals for my kids.
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[SPEAKER_01]: It just never ends.
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[SPEAKER_00]: Never stop.
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[SPEAKER_00]: So what are the four theories that you talk about or the four specific categories of expectations that kind of drive women towards burnout?
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[SPEAKER_00]: Because I will tell you, I had the worst burnout of my life, and it was, I felt like a hypocrite.
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[SPEAKER_00]: As I was building a health, a national health care platform for women, I was the most burned out, and it wasn't until my co-founder.
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[SPEAKER_00]: pointed it out.
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[SPEAKER_00]: She actually sent me something and she said, I want you to look at and she was the non doctor on the founding team and she's like, you look at this and tell me if you think you're burned out and I was like,
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[SPEAKER_00]: Oh my god, I have the symptoms of the worst category of burnout, but you know, we just normalize it.
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[SPEAKER_00]: We just keep like, okay, okay, and I just assumed it was part of being a founding physician and a mom and no, I was burned out.
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[SPEAKER_00]: So can you tell us about the four specific categories of expectations that drive us towards that burnout?
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[SPEAKER_01]: Yeah, when I really started thinking about the patient side scene over the years, this is thousands of women struggling with this, and like I said, many, very, very high achieving.
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[SPEAKER_01]: The fourth that stood out, one is just being constant caregivers.
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[SPEAKER_01]: So this idea that from a very young age, we may have been tasked with caring for siblings, being told, make sure you go and touch base with that friend, she seems really down, and
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[SPEAKER_01]: messages that we've received from the primary care takers in our own life.
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[SPEAKER_01]: We saw that pattern.
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[SPEAKER_01]: Was it a woman that was our primary care taker?
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[SPEAKER_01]: Of course not always, but there were a lot of examples of that probably growing up, teachers, nurses, others, so there's constant care taking and that any lapse or any care directed inward is selfish because then we're not taking care of someone else during that time because we can't split ourselves into.
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[SPEAKER_01]: There's hyper accountability, which is a really powerful one, and that is this belief we have that we can control other people's feelings.
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[SPEAKER_01]: And what do we do if we feel like we're trying to do that we over, we are just so competent and we're so active, we're saying, if I have the perfect birthday party for my son, he won't be disappointed.
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[SPEAKER_01]: And if I clean my house beautifully when my mom comes, she'll be impressed with me or she'll think that I'm successful or that you're just the idea that somehow we can control other peoples of emotional experience, but that's been the case again, something we were taught.
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[SPEAKER_01]: Like, oh, Jenna, when I was growing out my family calls me Jenna.
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[SPEAKER_01]: Oh, Jenna, you know, like, your mom seems kind of bummed out today.
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[SPEAKER_01]: Maybe you should try and like, see if you can cheer her up.
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[SPEAKER_01]: Or maybe you shouldn't go with your friends, just stay with her.
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[SPEAKER_01]: And like, see if you can kind of get her out of this mood that she's in, right?
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[SPEAKER_01]: So that's the second one.
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[SPEAKER_01]: Third one is just perfection.
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[SPEAKER_01]: The idea that we need to show up everywhere perfectly.
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[SPEAKER_01]: Like, I have a friend who's a dermatologist.
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[SPEAKER_01]: And she said almost every woman who comes into her practice.
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[SPEAKER_01]: The first thing she does is apologize for something.
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[SPEAKER_01]: I'm sorry my legs aren't shave it and I'm sorry my skin's so dry, I'm sorry I just I didn't put on the best stuff right now or these clothes are, you know, just apologize for ourselves because there's this belief that even when we're going in to get some care or you probably see this, it's an OBGYN.
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[SPEAKER_01]: I need to show up appearing like I got it all under control and then I'm perfect.
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[SPEAKER_01]: And the last one is just this idea of having it all.
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[SPEAKER_01]: which I think I don't want to discount the idea that women can do whatever we want to do and put our minds to, but this sense that we can do it all at once and do it all perfectly without any sign of effort and without asking for help.
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[SPEAKER_01]: I mean, think about how we used to raise kids, Eonsiko, it was a community.
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[SPEAKER_01]: and now we're more and more isolated and looking for community maybe online where we're comparing ourselves in a negative way or refining examples that we can't possibly achieve.
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[SPEAKER_01]: So those those four key areas come up and I find that they they map on pretty well to most of the areas of guilt that women experience.
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[SPEAKER_00]: I agree with you so much.
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[SPEAKER_00]: I think it took me entering my fifth decade to really lock on to the idea of, because I don't want to be a Debbie Downer until women get they can't have it all.
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[SPEAKER_00]: I agree with you.
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[SPEAKER_00]: I just don't think we can have it all at once.
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[SPEAKER_00]: And there's no perfect, everyone's like, how do you balance everything?
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[SPEAKER_00]: I'm like, is there ever really balance?
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[SPEAKER_00]: I feel like it's a constant state of,
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[SPEAKER_00]: You know, sometimes families, you know, spread the priority, sometimes work, sometimes my health takes, you know, because my body says, okay, if you're not going to pay attention, I'm going to claim some time for you and declare itself with whatever.
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[SPEAKER_00]: And so it, but it really took me entering this phase of my life.
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[SPEAKER_00]: And then as far as the social media pressures, I agree with you, the toxic comparison.
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[SPEAKER_00]: And I tell people all the time that I even was living a dichotomous life,
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[SPEAKER_00]: Yes, people saw the headlines like, oh, you raised, you know, another 10 million or 20 million, but they didn't know that personally maybe I was in the throws of all
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[SPEAKER_00]: horrible burnout, right?
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[SPEAKER_00]: I was exhausted.
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[SPEAKER_00]: I was having the worst migraines of my life.
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[SPEAKER_00]: I had hit, um, I had high blood pressure.
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[SPEAKER_00]: Those would that wasn't well controlled, you know?
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[SPEAKER_00]: And so they didn't realize that a lot of things were unraveling and they're like, oh, she's got it all together.
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[SPEAKER_00]: And I said, you guys, there's like two different lives.
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[SPEAKER_00]: There's like all the wins on social media.
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[SPEAKER_00]: But what I really learned from that when I sat with that was,
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[SPEAKER_00]: I have learned so much more from my failures and then my successes and I have also learned my absolute never-against and my moustaps for my personal relationships and my professional relationships.
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[SPEAKER_00]: And so I really tried to take that learning from that.
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[SPEAKER_00]: So, you have often said that guilt is expectation minus perceived reality.
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[SPEAKER_00]: I love that.
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[SPEAKER_00]: So guilt is expectations minus perceived reality.
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[SPEAKER_00]: As a woman who came from a long line in lineage of healers, and I always talk about medicine, how we don't heal our healers.
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[SPEAKER_00]: How do you have to unlearn the expectation that physicians needs always come last?
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[SPEAKER_00]: When we do, we suppress our physical needs, our emotional needs.
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[SPEAKER_00]: We don't eat, right?
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[SPEAKER_00]: When we want to, we don't go to the bathroom.
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[SPEAKER_00]: We want to, we don't often sleep.
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[SPEAKER_00]: So how do you unlearn that?
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[SPEAKER_01]: Yeah, that's so complicated in my mother's father was a small town physician in rural North Dakota as was my dad, the men in the family, and my grandmother was a nurse, but stayed home with to raise her six kids and then returned to nursing, my mom stayed home with us.
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[SPEAKER_01]: And so I had this dual message of this is what the physician does and my dad worked very long hours while my mom took care of everything at home.
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[SPEAKER_01]: And then what a mother does or what a good woman does.
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[SPEAKER_01]: And that was my mother's example is that she was home and doing everything for us cooking homemade meals and volunteering for things and making me.
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[SPEAKER_01]: the most ridiculous Halloween costumes every year.
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[SPEAKER_00]: I love that.
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[SPEAKER_01]: She was very, she was very willing to jump in when I had some really crazy.
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[SPEAKER_01]: I was a skunk one year, which was an interesting choice, but.
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[SPEAKER_00]: I've been a minion costume one year, and I'm not good at it.
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[SPEAKER_00]: But it actually was decent.
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[SPEAKER_00]: And I felt pretty good until this other one came out.
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[SPEAKER_00]: Of course, then you get in a toxic comparison.
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[SPEAKER_00]: I'm like,
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[SPEAKER_00]: How does that mother even do that like that but um I think that's lovely that makes me smile.
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[SPEAKER_01]: Yeah, so I think for me, a big part of it was, I had this vision for what a good doctor would be.
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[SPEAKER_01]: And it's 100% dedicated.
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[SPEAKER_01]: All my time in energy and effort was put forth to caring for my patients, reading, getting involved, participating in that clinical setting, my father, seeing patients from our local town.
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[SPEAKER_01]: And then I also thought, well, this is what a mom needs to be.
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[SPEAKER_01]: So coming into my adult life,
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[SPEAKER_01]: I had this sense of, I'm supposed to be both of those things, which is frankly impossible.
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[SPEAKER_01]: I can't be always at home and always at the clinic or always in the hospital.
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[SPEAKER_01]: And even when I switched over to a private practice, I too went through burnout because it had been years with COVID and doing it all in my own, seeing patients who are really suffering and trying to give them something.
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[SPEAKER_01]: of myself, giving that to my kids, my partner, that I actually stepped away from clinical medicine for a bit.
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[SPEAKER_01]: In fact, I'm just still now planning to return in a more specific way, but the guilt I felt about that was, was, and truly still is very, very high.
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[SPEAKER_01]: Because again, I had this image.
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[SPEAKER_01]: If this is what a real,
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[SPEAKER_01]: physician would do.
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[SPEAKER_01]: They wouldn't stop seeing patients for a while because that's their entire identity.
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[SPEAKER_01]: And me writing a book, a nationally published book that was going to be helping women with guilt, it didn't like help me that much with that feeling that I was letting people down by not seeing patients.
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[SPEAKER_00]: You know, well, because that's where I am in my journey.
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[SPEAKER_00]: So I gave up delivering babies and then felt guilt, but then really what did I do.
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[SPEAKER_00]: I over achieved learned about men of pause and sexual health 10 years ago, before everyone.
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[SPEAKER_00]: And so kind of filled that gap and that filled me and then this past December.
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[SPEAKER_00]: I have walked away from practicing and full blown into advocacy speaking podcasting.
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[SPEAKER_00]: writing a book and right now it's good because I still have people coming up to me saying thank you you know I did x y and c because I heard you but i'm hoping that there's not guilt in a year or two but uh you know so i was hoping that all this other activity was a way of um
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[SPEAKER_00]: Not displacing the guilt because I don't want to say that because that's not what I made the decision from I made it from a space of how and where do I want to spend my professional time to make biggest difference you know how can I utilize my skills.
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[SPEAKER_00]: Because you are right, so much of identity is tied up.
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[SPEAKER_00]: For me, it was both in being a doctor and also with the company I founded 10 years ago.
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[SPEAKER_00]: So, very, very interesting.
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[SPEAKER_00]: So, then are you planning on returning to patient care?
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[SPEAKER_01]: I think that my plan is to return focusing on ideas around guilt and interpersonal therapy for women as part of what I want to do because I do miss it.
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[SPEAKER_01]: And I do think, when I think about different values, I think that that is what makes sense for me right now, but in a broader scale, I think it's just this idea of how do we really decide what healing means?
18:19.591 --> 18:23.213
[SPEAKER_01]: Because we're both still in the setting of healing, even if we're not seeing patients
18:24.314 --> 18:25.554
[SPEAKER_01]: particular setting.
18:26.455 --> 18:27.815
[SPEAKER_01]: We're healing in these other ways.
18:27.875 --> 18:39.339
[SPEAKER_01]: I mean, you've described the reach that some of these conversations you've had, how many people have been able to hear that, how many people have learned about menopause from you, learned about their bodies, learned about their minds.
18:39.960 --> 18:43.461
[SPEAKER_01]: And I remind myself of that that I'm healing in all of these ways.
18:44.041 --> 18:46.322
[SPEAKER_01]: It's not just in this prescribed.
18:46.342 --> 18:48.803
[SPEAKER_01]: This is what it looks like because that's what it looked like for my father.
18:49.463 --> 18:54.847
[SPEAKER_01]: I'm trying to find my own way to share information and teach because I also come from a lot of teachers.
18:55.528 --> 18:56.849
[SPEAKER_01]: And you really are a teacher.
18:56.869 --> 19:01.292
[SPEAKER_01]: It's just who's in your classroom and right now it's sort of the entire world.
19:01.312 --> 19:11.299
[SPEAKER_01]: And I think it's getting back to that value and for me it's like really value spreading information and teaching and healing in whatever capacity I have the most energy to give.
19:12.000 --> 19:13.981
[SPEAKER_01]: And that might be clinical work for a bit.
19:14.021 --> 19:14.602
[SPEAKER_01]: It may not.
19:14.842 --> 19:17.964
[SPEAKER_01]: I mean, I may decide tomorrow that's maybe not the direction I want to go,
19:19.085 --> 19:26.772
[SPEAKER_01]: I think it's figuring out for each of us, especially in medicine, what way do we want to heal and then putting our best into that?
19:26.813 --> 19:32.938
[SPEAKER_01]: Because then we can accomplish, I mean, think about what the people in medicine, the women in medicine can accomplish, whatever they want.
19:33.219 --> 19:41.867
[SPEAKER_01]: Once they know this is aligned with my values, this actually energizes me and this is how I want to heal people in my community or or writ large.
19:43.220 --> 19:47.161
[SPEAKER_00]: So we already know that there are so many barriers to care for women, right?
19:47.202 --> 19:49.642
[SPEAKER_00]: We weren't included in clinical research trials.
19:50.063 --> 19:53.864
[SPEAKER_00]: There are even though women outnumber men in the workforce.
19:53.924 --> 19:56.525
[SPEAKER_00]: We don't outnumber them in those decision-making rooms.
19:56.685 --> 20:01.827
[SPEAKER_00]: I think the average time that we stay full time is six years before we alter our schedule because of this.
20:02.715 --> 20:12.699
[SPEAKER_00]: dichotomy or on whatever you want to call it imbalance of work home life that we are passed over for promotions.
20:12.739 --> 20:15.440
[SPEAKER_00]: We don't have mission-driven work.
20:16.321 --> 20:21.023
[SPEAKER_00]: There is gender bias in the way that we were taught.
20:21.383 --> 20:23.684
[SPEAKER_00]: And there's lack of funding so there's so many things.
20:23.804 --> 20:25.665
[SPEAKER_00]: And then I love this
20:26.525 --> 20:38.911
[SPEAKER_00]: Well, I don't love that this is happening, but your explanation that guilt can lead to self abandonment and then women start to normalize and kind of dismiss their own symptoms.
20:39.031 --> 20:46.495
[SPEAKER_00]: Whether we're talking about enemy trusses or fibroids or abnormal bleeding or perimenopause in menopause, which are hot but in topics.
20:46.735 --> 20:49.377
[SPEAKER_00]: And so, because women feel selfish.
20:49.417 --> 20:53.339
[SPEAKER_00]: I mean, you just talked about how you were six months late to your mammal.
20:53.519 --> 20:55.200
[SPEAKER_00]: I was 18 months late to my
20:56.209 --> 20:57.210
[SPEAKER_00]: colonoscopy.
20:58.411 --> 21:00.353
[SPEAKER_00]: And to me, that's crazy.
21:00.513 --> 21:02.395
[SPEAKER_00]: You and I are both healers.
21:02.435 --> 21:03.937
[SPEAKER_00]: So do you want to talk about that?
21:03.997 --> 21:09.322
[SPEAKER_00]: How women actually feel selfish and there's guilt for self care?
21:11.768 --> 21:24.894
[SPEAKER_01]: Well, again, it's somehow we've been told this message that we should be able to tolerate, I mean, the idea that we would just tolerate childbirth, that, oh, it's really not that big a deal, and then you have your maternity vacation and then you go back to work.
21:24.914 --> 21:35.318
[SPEAKER_01]: I mean, these messages are still out there, and we've been told that even though we may have a lot of pain every month, we may have bloating and changes in our mood, all those things that can happen around menstruation,
21:36.245 --> 21:45.947
[SPEAKER_01]: Perry menopause and menopause certainly the communication we've received from medicine in general and from the world is it's not that bad, it's like deal with it right and move on.
21:46.767 --> 22:02.670
[SPEAKER_01]: And I think that that is something we've absorbed not because we are not strong but because we have had to find a way to adapt in a situation where we're really not being cared for and you see that this is changing women are asking for more information of her red much more and
22:05.251 --> 22:06.532
[SPEAKER_01]: lately than ever.
22:07.733 --> 22:22.946
[SPEAKER_01]: Part of this, I think, though, in this guilt, the way we kind of internalize it, it is that I way of resting that control somewhat because it's like, okay, if I can't find any help out there and I feel totally scared and uncertain, I'm gonna figure it out.
22:23.166 --> 22:25.488
[SPEAKER_01]: I'm gonna take it inward and I'm gonna see how I
22:26.469 --> 22:27.290
[SPEAKER_01]: can take care of myself.
22:27.330 --> 22:42.864
[SPEAKER_01]: And so you see that in women and men, but women seeking alternative therapies, and treatments, some helpful, and some unfortunately not, is a way to try and get back that control and say, well, if I'm not going to get any support externally, I guess I have to do this myself.
22:43.365 --> 22:47.809
[SPEAKER_01]: And I think that we say that to ourselves a lot in a lot of environments.
22:48.562 --> 23:04.880
[SPEAKER_00]: So with your expertise in women's behavioral health, is this why you think that women are sometimes robbed or stripped of their joy in the postpartum period or why they just, they self-described themselves as crazy or out of control during perimenopause?
23:06.734 --> 23:13.777
[SPEAKER_01]: Well, I think that there are, and I just spoke with someone about the really amazing changes our brains go through in that postpartum period.
23:13.857 --> 23:27.882
[SPEAKER_01]: And it does make us more vulnerable to depression and anxiety, but there's also this remarkable sort of pruning and specific changes that happen to make us more tuned with our baby and more organized around childcare, maybe a little forgetful elsewhere for a bit.
23:28.542 --> 23:31.485
[SPEAKER_01]: and even around Perry meant it for us, yeah, the mommy brain.
23:31.825 --> 23:39.011
[SPEAKER_01]: But even in Perry meant it for us, yes, we have these fluctuations that the truly affect us, I think, they do, right?
23:39.071 --> 23:49.439
[SPEAKER_01]: And so I think where I see a lot of distress in, especially postpartum women, where I treat more of, I'll be at this time, is I should be feeling certain way.
23:50.020 --> 23:53.943
[SPEAKER_01]: I should be experiencing motherhood the way I thought I would.
23:54.283 --> 23:54.483
[SPEAKER_01]: Right.
23:54.503 --> 23:56.224
[SPEAKER_01]: The idea of this is what the birth plan should have been.
23:56.284 --> 23:57.925
[SPEAKER_01]: This is what my delivery should have looked like.
23:58.405 --> 24:01.486
[SPEAKER_01]: For me, I had to have a four steps delivery for my first child.
24:01.606 --> 24:03.147
[SPEAKER_01]: And I still feel guilty about that.
24:03.187 --> 24:03.848
[SPEAKER_01]: He's 15.
24:04.408 --> 24:08.250
[SPEAKER_01]: But there was a sense of, I failed to push the kid out.
24:08.270 --> 24:10.891
[SPEAKER_01]: I mean, you know, he had the huge dog in, but anyway.
24:10.911 --> 24:13.312
[SPEAKER_00]: What was the reason that I just could be called in medicine?
24:13.332 --> 24:17.394
[SPEAKER_00]: And I did a renaming revolution with peanut.
24:17.494 --> 24:20.055
[SPEAKER_00]: It poor maternal effort.
24:20.655 --> 24:23.737
[SPEAKER_00]: Like that's what the diagnostic code was.
24:25.074 --> 24:26.536
[SPEAKER_00]: you're so vulnerable.
24:26.576 --> 24:27.256
[SPEAKER_00]: Think about that.
24:28.077 --> 24:28.337
[SPEAKER_01]: Wow.
24:28.538 --> 24:31.120
[SPEAKER_00]: It's not poor maternal effort.
24:31.561 --> 24:33.202
[SPEAKER_00]: It's like it's not working.
24:33.302 --> 24:35.805
[SPEAKER_00]: But yeah, even the language and medicine, but I'm sorry.
24:35.825 --> 24:36.846
[SPEAKER_00]: I just had to tell you that.
24:36.886 --> 24:38.167
[SPEAKER_00]: Like, yeah, yeah.
24:38.287 --> 24:44.454
[SPEAKER_00]: So you had four steps, but obviously something was, you know, wrong.
24:44.754 --> 24:48.277
[SPEAKER_00]: And so it's amazing to me that you felt guilt about that.
24:48.418 --> 24:48.678
[SPEAKER_00]: So.
24:49.850 --> 24:54.312
[SPEAKER_01]: Yeah, I think a lot of women don't necessarily talk about really complicated deliveries.
24:54.972 --> 25:00.794
[SPEAKER_01]: That someone called it a normative trauma that there are so many scary aspects of it to fucult aspects.
25:01.454 --> 25:07.517
[SPEAKER_01]: And again, it's that sense of like, well, yeah, it's hard, but you'll bounce back, the bounce back thing, whether that's in mind or body.
25:08.597 --> 25:10.038
[SPEAKER_01]: does women such a disservice?
25:10.678 --> 25:12.779
[SPEAKER_01]: You've done this remarkable thing.
25:13.459 --> 25:15.560
[SPEAKER_01]: You're going through this incredible change.
25:16.140 --> 25:18.241
[SPEAKER_01]: How do you care for yourself through that?
25:18.641 --> 25:26.004
[SPEAKER_01]: Becoming a mother is as complex as going through adolescence and think about how we subtract support adolescence and all the hormonal shifts they go through.
25:26.644 --> 25:29.005
[SPEAKER_01]: In the postpartum and perimenopause, it's similar.
25:29.985 --> 25:36.306
[SPEAKER_01]: but there's a sense of like women just like, this is natural, so you should be able to do it with ease.
25:36.506 --> 25:39.467
[SPEAKER_01]: Like breastfeeding is natural, so you should be able to do it with ease.
25:39.547 --> 25:45.888
[SPEAKER_01]: Well, most of us have some challenge with breastfeeding or some discomfort, you know, with that.
25:45.908 --> 25:57.110
[SPEAKER_01]: And so I think these messages are just so harmful and what a good normal, healthy, maternal, woman should be experiencing across these reproductive stages.
25:57.822 --> 26:09.763
[SPEAKER_00]: And with Perry menopause, what I see is, and at least some of Sconey's work has also shown this, is there is this link zone of chaos with hormonal fluctuations and feeling rage or out of control.
26:10.351 --> 26:19.479
[SPEAKER_00]: But for a lot of women, there is increased empathy and emotional regulation once you've gone through the transition.
26:20.200 --> 26:34.673
[SPEAKER_00]: And there's also this, you know, how we're built to be nurturers, nurturers, nurturers, all of a sudden, quote unquote, you become a selfish or what we perceive to selfish before, because those neurotransmitters and those levels are actually changing.
26:35.114 --> 26:35.995
[SPEAKER_00]: And so now,
26:37.034 --> 26:45.237
[SPEAKER_00]: I see it in women in the workplace, where the fastest growing subset of entrepreneurs are women 45 to 55.
26:45.797 --> 26:55.041
[SPEAKER_00]: In that, perimenopausal, menopausal transition, because I think you're like, okay, I'm done with the nurturing and the child rearing.
26:55.461 --> 27:04.325
[SPEAKER_00]: And now I can focus on things other things that I want to get birth to, whether it's in a company or an idea or a new career, or a new hobby, whatever it is,
27:05.427 --> 27:10.949
[SPEAKER_00]: And so that's what I tell women is waiting on the other side.
27:11.330 --> 27:15.391
[SPEAKER_00]: The promise those paramount of puzzle transitions can sometimes last seven to ten years.
27:15.431 --> 27:17.332
[SPEAKER_00]: It doesn't mean you have to be symptomatic.
27:19.053 --> 27:25.516
[SPEAKER_00]: So moving into solutions and treatments because you and I are both healers.
27:25.856 --> 27:31.058
[SPEAKER_00]: Do you want to walk us through your five step therapeutic framework called speak?
27:32.583 --> 27:43.652
[SPEAKER_01]: Yeah, so speak was just a way to describe what's gonna happen in the therapy office, for example, but that you can bring into your own lives and if you've been in therapy, you may recognize some of these strategies.
27:43.672 --> 27:53.660
[SPEAKER_01]: So the first one is show up, S is for show up, and that's so important because again, you're saying I'm valuable enough to put attention and time and energy into myself.
27:54.220 --> 28:00.265
[SPEAKER_01]: And I'd love, I'm trying to think as you're describing this shift from nurturing nurturing, nurturing to selfishness, what language we could create.
28:01.435 --> 28:03.717
[SPEAKER_01]: Instead of, like, what is it actually called?
28:03.837 --> 28:05.218
[SPEAKER_01]: Because I see it the same thing.
28:05.238 --> 28:11.904
[SPEAKER_01]: So many of my peers in their 40s and 50s are shifting and doing remarkable things and just like coming alive again.
28:11.924 --> 28:15.227
[SPEAKER_01]: And I think, wow, this, what could be, what could we call that?
28:15.247 --> 28:17.088
[SPEAKER_01]: I have to think on that a bit, because that would be.
28:17.689 --> 28:23.594
[SPEAKER_00]: We have to think on that, because someone, the other day, said to me, I hadn't seen them in the wild.
28:23.834 --> 28:29.479
[SPEAKER_00]: And they were like, you just are smiling more than you have ever smiled.
28:30.802 --> 28:33.383
[SPEAKER_00]: because I'm doing the work I really want.
28:33.443 --> 28:35.124
[SPEAKER_00]: We all have to do things we don't want to do.
28:35.204 --> 28:38.445
[SPEAKER_00]: Scrubbing forward, and you know, there's more than we all have that we don't.
28:39.145 --> 28:44.747
[SPEAKER_00]: I said the majority of my time is now spending it in the way that I want.
28:44.947 --> 28:50.629
[SPEAKER_00]: And I think that's the lightness and the happiness that you're seeing.
28:50.769 --> 28:52.670
[SPEAKER_00]: So, and I agree with you.
28:52.810 --> 28:53.790
[SPEAKER_00]: But I call it selfish.
28:53.810 --> 28:55.011
[SPEAKER_00]: I'm like, what do we call it?
28:55.051 --> 28:56.691
[SPEAKER_00]: Let's come up with a different name.
28:56.891 --> 28:58.272
[SPEAKER_01]: All right, so I'm going to noodle on that.
29:00.361 --> 29:03.385
[SPEAKER_00]: All right, so continuing through your framework.
29:03.925 --> 29:06.568
[SPEAKER_01]: Yeah, so speak as is showing up.
29:06.709 --> 29:12.996
[SPEAKER_01]: And again, just picking up the book, right taking out a journal, writing things down, piece for pay attention.
29:13.176 --> 29:15.178
[SPEAKER_01]: And that's really looking inward.
29:15.358 --> 29:19.243
[SPEAKER_01]: And then it's also outwardly not noticing where these emotions are coming up.
29:19.563 --> 29:19.803
[SPEAKER_01]: Right?
29:20.223 --> 29:21.984
[SPEAKER_01]: What thoughts are coming up throughout the day?
29:22.644 --> 29:29.187
[SPEAKER_01]: And there can really be a lot of grief in this process because women can start to recognize I've been so hard in myself.
29:29.327 --> 29:40.331
[SPEAKER_01]: I've been giving myself these really awful critical messages for years There's real sadness in that because it's like I can't have that time back But it's like okay, how do I pay attention to what's going on around me?
29:41.131 --> 29:42.772
[SPEAKER_01]: E is just examining that evidence.
29:43.372 --> 29:44.873
[SPEAKER_01]: Where is it coming up most frequently?
29:45.373 --> 29:47.074
[SPEAKER_01]: When do I find myself feeling the most?
29:47.435 --> 29:53.718
[SPEAKER_01]: Self-critical, maybe after comparing myself to someone or after a call with the family members or friend or have you.
29:53.738 --> 29:58.561
[SPEAKER_01]: A is taking action and I really wanted some very concrete strategies.
29:58.661 --> 30:01.162
[SPEAKER_01]: And I borrowed these from other evidence-based treatments.
30:01.202 --> 30:02.843
[SPEAKER_01]: I wanted to make sure it really was grounded.
30:03.443 --> 30:05.064
[SPEAKER_01]: In science, you know, we both have that.
30:05.084 --> 30:08.665
[SPEAKER_01]: I think compulsion to say, let's be clear about what actually has some evidence.
30:09.545 --> 30:16.847
[SPEAKER_01]: And that's things in self-compassion, positive psychology, which was developed at Penn, and so I've gotten to connect with some of them about that.
30:17.207 --> 30:28.170
[SPEAKER_01]: Growth mindset work, Carol Dweck's work, and growth mindset, which is that we learn from our setbacks, like you said earlier, the failures you've learned a lot more from, it allowed you to grow and change.
30:29.003 --> 30:34.735
[SPEAKER_01]: and then some cognitive conveys structuring being able to really take those self-critical thoughts as first drafts.
30:35.750 --> 30:39.593
[SPEAKER_01]: because we are not our thoughts, which gets into a whole conversation or unconsciousness, right?
30:39.613 --> 30:52.403
[SPEAKER_01]: Like, what are we then, which part of our brain is conscious, but that we are not our guilty thoughts, our anxious thoughts, our ruminations about past failures, and then K is most important that's keep going.
30:53.083 --> 30:59.268
[SPEAKER_01]: Because you know, this is a process, as you've described, these different journeys and challenges we've had, how do I keep growing?
30:59.308 --> 31:00.469
[SPEAKER_01]: How do I move toward growth?
31:01.423 --> 31:09.534
[SPEAKER_01]: as opposed to closing down or saying, well, now I'm too old or it's too late or whatever the different limiting thoughts we might have.
31:09.714 --> 31:15.722
[SPEAKER_01]: So that's sort of the speak over our chain description and then I try to plug in different strategies throughout.
31:17.413 --> 31:21.235
[SPEAKER_00]: So I want to speak to two different audiences here.
31:21.315 --> 31:24.737
[SPEAKER_00]: So I wrote a statistic the other day that I was not aware of.
31:24.837 --> 31:32.141
[SPEAKER_00]: So I've known for a very long time that women live longer, but we live in much poorer health for a multitude of reasons.
31:32.841 --> 31:37.006
[SPEAKER_00]: But I did not know that that excludes female physicians.
31:37.187 --> 31:40.911
[SPEAKER_00]: We actually die earlier than our counterparts.
31:40.951 --> 31:43.955
[SPEAKER_00]: I mean, our use of was like, I was surprised too.
31:43.975 --> 31:44.495
[SPEAKER_00]: So yeah.
31:45.456 --> 31:48.120
[SPEAKER_00]: And they think some of it is what you and I are talking about.
31:48.160 --> 31:52.465
[SPEAKER_00]: This, you know, balancing act of we are constantly
31:53.185 --> 31:59.750
[SPEAKER_00]: taking care of everybody else, like even our jobs are healers and taking care of everybody else.
31:59.810 --> 32:15.960
[SPEAKER_00]: So to the physicians listening, what one take home message you would take about integrating the speak framework into their lives today is particularly given that statistic, that was alarming.
32:16.000 --> 32:18.262
[SPEAKER_00]: I was like, what am I going to do right now to change this?
32:19.934 --> 32:25.036
[SPEAKER_01]: And I think a big part of that, too, is this sense that women, we as physicians should be able to heal ourselves.
32:25.596 --> 32:31.199
[SPEAKER_01]: I mean, I know when I was postpartum, I had all these intrusive anxious thoughts, which I've learned since are very, very common.
32:31.899 --> 32:32.919
[SPEAKER_01]: But I was ashamed of them.
32:32.939 --> 32:34.100
[SPEAKER_01]: I didn't want to talk about them.
32:34.120 --> 32:35.400
[SPEAKER_01]: I'm as a psychiatrist.
32:35.420 --> 32:36.461
[SPEAKER_01]: I was in training at the time.
32:36.481 --> 32:39.962
[SPEAKER_01]: But I should be able to just figure this out and treat myself.
32:40.462 --> 32:44.764
[SPEAKER_01]: So I think there's also this sense of, maybe even shame about seeking help.
32:45.124 --> 32:50.249
[SPEAKER_01]: for something, because while my doctor, I should know this already, or I should be able to take care of myself.
32:50.289 --> 33:06.362
[SPEAKER_01]: So I think that is a piece among many others that you mentioned, the research, the availability of care, dismissal of pain and other symptoms, to physicians that are out there, to women in medicine, the idea of self-compassion is really powerful.
33:06.462 --> 33:09.645
[SPEAKER_01]: When I really looked into it, it's not just, I'm going to be nice to myself.
33:10.305 --> 33:11.326
[SPEAKER_01]: It's this sense of,
33:12.528 --> 33:15.748
[SPEAKER_01]: I'm going to create a safe atmosphere where I can look at myself.
33:17.416 --> 33:23.217
[SPEAKER_01]: The good, the bad, the ugly, so to speak, I can really see myself for who I am and still accept that person.
33:24.018 --> 33:27.398
[SPEAKER_01]: But not try to bury things under the rug like, I'm not really experiencing symptoms.
33:27.478 --> 33:29.059
[SPEAKER_01]: I'm not really having burnout.
33:29.879 --> 33:35.120
[SPEAKER_01]: Being able to really look openly with curiosity and not judgment and say, okay, this is what I'm feeling.
33:35.340 --> 33:41.982
[SPEAKER_01]: This is the reality because a lot of women, physicians are disconnected from those emotional experiences.
33:42.002 --> 33:45.243
[SPEAKER_01]: They don't even know they're in burnout till a friend holds up a mirror as yours did and says,
33:49.364 --> 33:54.828
[SPEAKER_01]: So self-compassion, it is self-kindness, but it's also this understanding that we're a part of a common humanity.
33:55.488 --> 34:04.394
[SPEAKER_01]: And I think women physicians who are talking with each other around this, I did a book group with a number of women physicians, it was so powerful because hearing each other describe these challenges.
34:05.054 --> 34:11.499
[SPEAKER_01]: Maybe symptoms they were having, difficulties they were having, number of them said, I never thought you would have had that.
34:11.519 --> 34:16.282
[SPEAKER_01]: You're like the leader of our department, or you're just crushing it all the time, or I never would have thought.
34:16.302 --> 34:21.666
[SPEAKER_01]: So I think that's another piece and third is just mindfulness, which is a bit of a buzzword.
34:22.466 --> 34:30.232
[SPEAKER_01]: But it really implies that I'm in this experience this moment now, not in the anxious future, not in a room-native or dreadful past.
34:30.312 --> 34:34.275
[SPEAKER_01]: But I'm really, again, taking stock of what I'm feeling right now.
34:35.981 --> 34:38.922
[SPEAKER_01]: And that might be guilt that I'm not seeing patients right now.
34:38.942 --> 34:44.024
[SPEAKER_01]: That might be joy that writing a book was such a, such a thrill to like see on the shelf.
34:44.905 --> 34:47.106
[SPEAKER_01]: But what is it in this moment that I'm feeling?
34:47.146 --> 34:49.067
[SPEAKER_01]: And how can I be present for those in my life?
34:49.087 --> 34:53.569
[SPEAKER_01]: Because we know about the lunchevity benefits of our relationships, right, in nurturing those.
34:54.310 --> 34:59.292
[SPEAKER_01]: So how can I be present with the people in my life I love as much as possible, right?
34:59.712 --> 35:03.015
[SPEAKER_00]: And I think that's what I learned is that I'm an extroverted introvert.
35:03.075 --> 35:07.419
[SPEAKER_00]: I can give give give, but I was taught to give until I burned out.
35:07.579 --> 35:09.781
[SPEAKER_00]: I didn't just have the vocabulary around it.
35:10.361 --> 35:18.108
[SPEAKER_00]: And now I make sure in my calendar that if I'm going to be doing a lot of talks or I'm going to be teaching a lot of courses.
35:18.620 --> 35:30.187
[SPEAKER_00]: that I've built in time for rest, recovery, fun, or the things that fuel me, whether it's time with my family or an incredible hike or booking them a set.
35:30.247 --> 35:34.069
[SPEAKER_00]: Wherever I am, finding those boat moments, we call them.
35:34.908 --> 35:49.559
[SPEAKER_00]: um, that make sure that I don't take my tank to empty, um, because then, uh, I drove just like when I was in my 20s and you either have a night of drinking or you had a, I had a night of, you know, delivering babies.
35:49.939 --> 35:51.200
[SPEAKER_00]: I would recover like this.
35:51.660 --> 35:54.402
[SPEAKER_00]: Now that I'm 50, I don't recover that quickly.
35:54.682 --> 36:00.807
[SPEAKER_00]: And so, by just that simple act of building time into my calendar, to allow
36:03.075 --> 36:12.743
[SPEAKER_00]: that recover me, it has paid back so much, multitude in the way that I can put out to the world as long as I can fill my own bucket.
36:13.503 --> 36:19.508
[SPEAKER_00]: And so I guess, we spoke about the speak framework and particularly asked you as two physicians.
36:19.548 --> 36:28.776
[SPEAKER_00]: I was really interested in this particularly because I saw that statistic, but to other women or to other people who are listening other individuals,
36:30.437 --> 36:34.639
[SPEAKER_00]: guilt alarm is going off because that's what it does feel like a guilt alarm.
36:35.799 --> 36:44.703
[SPEAKER_00]: What's you know an actionable item that they can take home from the speak framework that you would you know recommend to them.
36:46.775 --> 36:56.637
[SPEAKER_01]: I think one of my favorites is the friend exercise from self-compassion, which is really, very simple, but it's what I say to what good friend in this scenario.
36:57.457 --> 37:04.299
[SPEAKER_01]: Because I think when you're having that guilt alarm using that guilt equation, it's sort of okay, what expectations are a play here?
37:05.299 --> 37:07.039
[SPEAKER_01]: And where are those expectations coming from?
37:07.279 --> 37:08.780
[SPEAKER_01]: Are they people that I want to emulate?
37:09.300 --> 37:10.680
[SPEAKER_01]: Is it coming from social media?
37:10.720 --> 37:13.801
[SPEAKER_01]: Is it coming from some other idea that isn't aligned with my values?
37:14.681 --> 37:24.024
[SPEAKER_01]: So can I make adjustments to that, right, but then if I figure out, okay, like I'm just really being harsh on myself I'm expecting the actually unreachable.
37:24.224 --> 37:25.224
[SPEAKER_01]: I'm expecting perfection.
37:25.244 --> 37:30.706
[SPEAKER_01]: I'm expecting control over people's emotions I think what would I actually say to our friend in that scenario?
37:31.226 --> 37:33.047
[SPEAKER_01]: So that might be you know what?
37:33.067 --> 37:43.470
[SPEAKER_01]: I'm just tired and I don't want to go to the gym today and that means I'm so lazy right catching that What would I say to our friend it might be you know, it's okay to have a day of rest
37:44.598 --> 37:51.485
[SPEAKER_01]: It's simple as that, but just giving yourself a little bit of objectivity from your experience can be so powerful.
37:51.525 --> 37:55.008
[SPEAKER_01]: So it sounds like really simple exercise, but it's one I practice a lot.
37:55.709 --> 38:03.216
[SPEAKER_01]: And I do use the ghost equation a lot in my own life to identify what expectations I'm setting and are they in any way fair?
38:03.316 --> 38:04.917
[SPEAKER_01]: If they are, okay, I better get busy.
38:05.678 --> 38:13.461
[SPEAKER_01]: but also on the other side, making sure I'm paying attention to what I'm doing well, because that perceived reality is shaped by where we're paying attention, what are we perceiving?
38:13.881 --> 38:22.024
[SPEAKER_01]: And if I don't perceive any of the things that I'm doing, any of the ways that I'm healing outside of clinical medicine, for example, then I am going to feel more guilt.
38:22.144 --> 38:25.205
[SPEAKER_01]: I need to pay attention to those who are my helping, who are my reaching.
38:26.336 --> 38:27.918
[SPEAKER_00]: And it's in here wins.
38:27.998 --> 38:31.181
[SPEAKER_00]: Like I've listened to you talking about your book twice in passing.
38:31.281 --> 38:36.246
[SPEAKER_00]: And you're like, yeah, and as someone who's writing her book and knows how difficult it is, I was joking the other day.
38:36.266 --> 38:40.650
[SPEAKER_00]: I was like, I raised $40 million easier than I have this book journey.
38:40.811 --> 38:47.457
[SPEAKER_00]: And so you can be like, you know, take the wins when they come because it is incredulous when they do.
38:47.577 --> 38:47.818
[SPEAKER_00]: So,
38:48.378 --> 38:49.659
[SPEAKER_00]: Congratulations on that.
38:49.719 --> 38:53.923
[SPEAKER_00]: I think that is truly amazing.
38:54.243 --> 39:04.553
[SPEAKER_00]: And so for our listeners today, can you tell us where they can find you and follow you and do you have any exciting announcements coming up?
39:07.088 --> 39:08.368
[SPEAKER_01]: Yeah, no writing it writing a book.
39:08.388 --> 39:11.629
[SPEAKER_01]: I actually received an email from one of the prior residents that used to teach it pen.
39:11.669 --> 39:17.250
[SPEAKER_01]: And he said, I just wanted you to know that I found your book, I'm using it with a patient and it's really helping her.
39:18.071 --> 39:20.351
[SPEAKER_01]: And like that email, I've kept it.
39:20.391 --> 39:22.232
[SPEAKER_01]: I've highlighted it, started it, gone back to it.
39:22.252 --> 39:25.973
[SPEAKER_01]: Like that meant so, so much to see that in real life.
39:26.053 --> 39:27.633
[SPEAKER_01]: So that was definitely a win.
39:28.713 --> 39:32.654
[SPEAKER_01]: People can find me, so I have a sub-second a podcast, it's called a mind of her own.
39:32.854 --> 39:34.675
[SPEAKER_01]: And that's really what I'm trying to create.
39:36.435 --> 39:40.276
[SPEAKER_01]: remove the guilt or remove the other aspects that interfere with our joint agency.
39:40.857 --> 39:42.417
[SPEAKER_01]: And that's on sub-stack.
39:42.437 --> 39:48.720
[SPEAKER_01]: So I think it's a mind of her own dot sub-stack.com or my website is justgenopherreadmd.com.
39:49.420 --> 39:59.564
[SPEAKER_01]: And I have guilt groups available on my website because I wanted women in rooms to be talking about this book because I think that's such a key message you're not alone in this feeling.
40:00.725 --> 40:12.274
[SPEAKER_01]: by any means, and I have the ability to see that so to you as a caretaker, because I'm speaking to a lot of different women, but not everyone knows that this is ubiquitous, so that is also available if people want to start their own group.
40:12.875 --> 40:18.799
[SPEAKER_01]: You know, it doesn't bring anything back to me, but just allows them to explore the book together and build community.
40:19.940 --> 40:25.925
[SPEAKER_00]: Is it ironic in this day and age where you and I didn't grow up with social media?
40:26.872 --> 40:30.335
[SPEAKER_00]: And we're now you can reach people at the touch of a button.
40:30.375 --> 40:32.537
[SPEAKER_00]: Like we had to write our bikes, knock on doors.
40:32.557 --> 40:34.298
[SPEAKER_00]: You don't mean actually like all people.
40:34.959 --> 40:40.543
[SPEAKER_00]: But how alone people feel when you actually talk to them and how isolated they feel?
40:40.583 --> 40:45.307
[SPEAKER_00]: Like even when they expressed you, they were shocked that you had felt certain ways.
40:45.788 --> 40:54.075
[SPEAKER_00]: It's amazing to me in this media social media age that so many women, particularly feel alone.
40:55.075 --> 40:55.676
[SPEAKER_00]: It's interesting.
40:56.447 --> 40:58.488
[SPEAKER_01]: Yeah, it's interesting and really sad.
40:58.889 --> 41:02.952
[SPEAKER_01]: And I think we, again, the way we evolved, it is to have community.
41:03.192 --> 41:07.014
[SPEAKER_01]: It is to be doing things together, caring for our kids together, making plans together.
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[SPEAKER_01]: And I'm seeing more and more women coming together and doing remarkable work as what you're doing and your team and other women.
41:13.219 --> 41:19.183
[SPEAKER_01]: And I think more and more of that is really what we need right now, because we're needed, you know, more than ever.
41:19.751 --> 41:31.735
[SPEAKER_00]: Communities, one of the core pillars of every, I'm obsessed with the blue zones and the fact that you can actually make the blue zone because people think, oh, it's something the water or something in the earth and actually know they did that experiment where you can actually.
41:32.177 --> 41:40.544
[SPEAKER_00]: make a blue zone where people will live longer and one of the core pillars is always community so I find that also very fascinating.
41:40.564 --> 41:42.245
[SPEAKER_00]: I could talk to you for days.
41:42.845 --> 41:57.037
[SPEAKER_00]: I want to thank you so much for being a disruptor and for taking the time to have this conversation with me and for those of you out there share this episode with someone you love or someone who needs to hear this incredible advice.
41:57.257 --> 41:58.278
[SPEAKER_00]: Thank you again.
41:59.353 --> 42:01.182
[SPEAKER_01]: Thank you so much for having me and the work you do.
42:01.242 --> 42:04.376
[SPEAKER_01]: Disruptor is really incredible, so thank you.
42:05.398 --> 42:07.139
[SPEAKER_00]: This is more than a conversation.
42:07.319 --> 42:09.859
[SPEAKER_00]: It's a call, a call to build something better.
42:10.300 --> 42:14.041
[SPEAKER_00]: Subscribe, share, and bring more disruptors into this room.
42:14.521 --> 42:24.524
[SPEAKER_00]: For unfiltered insights and bold ideas, go to drsomeet.com to sign up for the monthly disruptor newsletter and follow us on social at drsomeet.
42:24.924 --> 42:26.785
[SPEAKER_00]: We're not waiting for a seat at the table.
42:27.265 --> 42:28.986
[SPEAKER_00]: We're building our own table.
00:00.111 --> 00:07.315
[SPEAKER_01]: High-achieving women find any way possible to get everything done, as well as possible, because we need to outperform our male peers.
00:07.495 --> 00:15.640
[SPEAKER_01]: It's just we're also carrying the gauge of expectations about what a good woman should be doing, and I think guilt becomes major outcome of this dynamic.
00:15.700 --> 00:19.924
[SPEAKER_00]: What are the four categories of expectations that drive women towards burnout?
00:20.144 --> 00:22.146
[SPEAKER_01]: One is being constant caregivers.
00:22.286 --> 00:26.530
[SPEAKER_01]: There's hyper-accountability, third one is the idea that we need to show up everywhere perfectly.
00:26.570 --> 00:28.692
[SPEAKER_01]: And the last one is the idea of having it all.
00:28.792 --> 00:32.536
[SPEAKER_01]: Do you want to talk about how women feel selfish for self-care?
00:32.656 --> 00:35.899
[SPEAKER_01]: We've been told that we should be able to tolerate childbirth.
00:36.099 --> 00:43.402
[SPEAKER_01]: pain every month, bloating, changes in our mood, parry menopause and menopause and that is something we've absorbed because we have had to find a way to adapt.
00:43.582 --> 00:50.324
[SPEAKER_01]: Is this why women are stripped of their joy in the post part of the period, these changes are brains go through in postpartum period.
00:50.364 --> 00:55.666
[SPEAKER_01]: Make us vulnerable to depression and anxiety, but also more tune with our baby and maybe a little forgetful elsewhere.
00:55.786 --> 01:00.087
[SPEAKER_00]: When guilt alarm is going off, what's an actionable item you recommend.
01:00.287 --> 01:01.668
[SPEAKER_00]: One of my favorites is
01:04.044 --> 01:09.772
[SPEAKER_00]: The disruptor podcast is for informational purposes only and does not constitute medical advice.
01:10.133 --> 01:12.076
[SPEAKER_00]: Views expressed by guests are their own.
01:12.516 --> 01:16.202
[SPEAKER_00]: Consult your healthcare provider before making any medical decisions.
01:17.662 --> 01:19.503
[SPEAKER_00]: Hi, and welcome to the disruptor.
01:19.803 --> 01:24.607
[SPEAKER_00]: Today's guest is Dr. Jennifer Reed, a physician and an academic with serious clinical weight.
01:25.147 --> 01:34.814
[SPEAKER_00]: She has earned her medical degree from Columbia University, completed her residency at UCLA, and now holds dual faculty appointments at UPAN and Cooper Medical School.
01:35.174 --> 01:38.196
[SPEAKER_00]: But what I love most is the why behind her work.
01:38.556 --> 01:42.299
[SPEAKER_00]: She's the daughter of a family legacy of physicians and educators,
01:42.679 --> 01:47.621
[SPEAKER_00]: So medicine and teaching aren't just what she does, they're part of who she is.
01:48.081 --> 01:52.183
[SPEAKER_00]: And today's conversation is not a surface level self-help chat.
01:52.303 --> 02:02.947
[SPEAKER_00]: This is a peer-to-peer deep dive into the science of guilt, why ambition women are biologically and socially conditioned to ignore their own needs until they hit a breaking point.
02:03.507 --> 02:06.628
[SPEAKER_00]: And what it takes to actually interrupt that cycle.
02:08.787 --> 02:17.374
[SPEAKER_00]: do you want to tell us a little bit about why high achieving women or women in general are excellent students of guilt?
02:18.554 --> 02:18.795
[SPEAKER_01]: Yeah.
02:20.056 --> 02:23.859
[SPEAKER_01]: It was a big question because I did, I was seeing this anecdotally right?
02:23.879 --> 02:34.266
[SPEAKER_01]: Everyone in my psychiatry practice and I'm seeing very high functioning women in medicine, lawyers, attorneys, people running businesses and I was just hearing this from so many women.
02:34.307 --> 02:34.807
[SPEAKER_01]: This sense of
02:35.227 --> 02:45.613
[SPEAKER_01]: I should be doing more, I'm not enough, I'm not doing everything perfectly, why is this happening to women and I wanted to understand that and I was feeling it too.
02:46.433 --> 02:54.238
[SPEAKER_01]: My sister, older sister, is a surgeon and raising three kids and she is a phenomenon and she and I would just call each other and be like, why do I still feel?
02:55.238 --> 02:59.380
[SPEAKER_01]: so overwhelmed and so guilty all the time like I'm not doing what I'm supposed to do.
02:59.400 --> 03:21.330
[SPEAKER_01]: I think that high-achieving women what's been adaptive for us is to find any way possible to get everything done and to do it as well as possible to absolutely be as perfect as we can because let's be honest in some cases in many cases, especially the highest echelons, we need to outperform, maybe our male peers, to get where we need to be.
03:21.370 --> 03:22.071
[SPEAKER_01]: That was certainly the
03:25.291 --> 03:33.617
[SPEAKER_01]: men are entering medical school classes at this point, but you could still see those differences, even in what specialty we might be expected to enter.
03:33.677 --> 03:42.084
[SPEAKER_01]: So I think there's been this pressure from a very young age if we wanted to achieve, which we had that inside of us, we needed to do things perfectly.
03:42.244 --> 03:51.771
[SPEAKER_01]: And with this vision of effortlessness, which is just impossible, and I think putting us in a double bind, but that's what we did, that was adaptive for us to get ahead.
03:52.672 --> 04:11.131
[SPEAKER_01]: It's just we're also carrying this bag of expectations about what a good woman should be doing, should be feeling how we're supposed to be taking care of everyone else even as we climb the ladder potentially or even as we go after something we really want so that combination expectations of this ideal woman caregiver nurture.
04:13.210 --> 04:24.388
[SPEAKER_01]: plus idea that we had to really outperform many of our peers to get ahead, sort of combine and I think guilt becomes, unfortunately, the major outcome of this dynamic.
04:25.208 --> 04:32.896
[SPEAKER_00]: So I want to dive in a little bit deeper because here you are this high achieving woman yourself, recognizing it in your patients and you're sibling.
04:33.757 --> 04:44.908
[SPEAKER_00]: And for me, my guilt presented as almost wishing I could, I think it was a show about this right, splitting myself into two because when I was home,
04:46.698 --> 04:55.803
[SPEAKER_00]: I was constantly like, oh, I should be with my patients or I should be reading more articles or I should be, you know, like I couldn't answer that question or I should be doing charts.
04:56.343 --> 05:08.330
[SPEAKER_00]: But then the opposite when I was at work or in the operating room, I was like, oh, I'm missing for steps and first words and, you know, I remember falling my eyes out, my son needed
05:09.190 --> 05:13.812
[SPEAKER_00]: a tonsil surgery, tonsil and adnoids, and the nurse simply asked a question.
05:13.872 --> 05:15.773
[SPEAKER_00]: She's like, what's his favorite toy?
05:15.793 --> 05:20.855
[SPEAKER_00]: And I started crying because I knew all the toys he played with.
05:21.255 --> 05:25.257
[SPEAKER_00]: I just didn't know which one was his absolute favorite, but it's manning good.
05:25.397 --> 05:28.779
[SPEAKER_00]: And in that moment, I'm an OBGYN.
05:28.799 --> 05:31.060
[SPEAKER_00]: I had a try, I had one at that point.
05:31.580 --> 05:35.982
[SPEAKER_00]: And I just remember crying, because I felt like a complete and utter failure.
05:39.512 --> 05:41.793
[SPEAKER_00]: my only child's favorite toy.
05:42.074 --> 05:43.915
[SPEAKER_00]: And it was really, really sad.
05:43.975 --> 05:45.556
[SPEAKER_00]: And my husband was like, it's okay.
05:45.576 --> 05:46.536
[SPEAKER_00]: I don't know it either.
05:46.656 --> 05:49.658
[SPEAKER_00]: And he didn't feel that guilt.
05:49.718 --> 05:53.841
[SPEAKER_00]: Because he didn't know, he was like, I don't know what either, but I felt so guilty.
05:53.861 --> 05:54.701
[SPEAKER_00]: And I think you're right.
05:54.741 --> 05:59.504
[SPEAKER_00]: It's that expectation of, well, I should be able to do it all, right?
05:59.544 --> 06:01.165
[SPEAKER_00]: Like, why can't I?
06:02.346 --> 06:08.390
[SPEAKER_00]: But I remember, so I want to know how you felt it if you're willing to share a specific example.
06:10.542 --> 06:19.588
[SPEAKER_01]: Well, certainly during COVID, I had, I had been in an academic center and then had started a private practice and COVID everything came home to my home office where I am now.
06:20.448 --> 06:25.111
[SPEAKER_01]: And my kids were home, not going to school, and it just felt like everyone needed me.
06:25.832 --> 06:27.633
[SPEAKER_01]: And I couldn't be in multiple places at once.
06:27.713 --> 06:31.295
[SPEAKER_01]: I was trying to see a patient who's really struggling because I was such a scary time.
06:31.855 --> 06:35.838
[SPEAKER_01]: And my kids would be knocking on the door and they were feeling anxious and I'm getting certain about things.
06:36.640 --> 06:39.842
[SPEAKER_01]: And it felt like I had internalized that I was failing.
06:40.022 --> 06:49.028
[SPEAKER_01]: I should be seeing more patients because there's a lot of need, and especially in mental health at that time and still, I should be with my kids nurturing them through this really difficult time.
06:49.649 --> 06:51.710
[SPEAKER_01]: So it absolutely showed up for me.
06:51.790 --> 06:57.754
[SPEAKER_01]: And I think as a working mom, whether it's in medicine or otherwise, we are facing this constant pressure,
06:58.695 --> 07:12.001
[SPEAKER_01]: This idea that daytime events at the kid's school invite parents, kind of assuming that there is a parent who's home during the day and would come to the event, so there are social structures keeping this in place, right?
07:12.501 --> 07:15.603
[SPEAKER_01]: So, absolutely, for me, and I still have guilty thoughts.
07:15.623 --> 07:18.044
[SPEAKER_01]: It's still the sense of I should be doing more.
07:18.884 --> 07:20.465
[SPEAKER_01]: I should be showing up perfectly.
07:20.486 --> 07:37.320
[SPEAKER_01]: I called to schedule my mammogram the other day and it was like six months late and I felt so guilty because I was like why am I not on top of this and taking care of myself and of course it's it's going to be fine but there is this constant sense that I need to be productive every day.
07:37.340 --> 07:40.383
[SPEAKER_01]: I need to be exercising the right amount cooking healthy meals for my kids.
07:40.423 --> 07:41.764
[SPEAKER_01]: It just never ends.
07:42.004 --> 07:42.585
[SPEAKER_00]: Never stop.
07:43.279 --> 07:52.404
[SPEAKER_00]: So what are the four theories that you talk about or the four specific categories of expectations that kind of drive women towards burnout?
07:52.424 --> 07:58.667
[SPEAKER_00]: Because I will tell you, I had the worst burnout of my life, and it was, I felt like a hypocrite.
07:58.727 --> 08:08.092
[SPEAKER_00]: As I was building a health, a national health care platform for women, I was the most burned out, and it wasn't until my co-founder.
08:08.798 --> 08:09.538
[SPEAKER_00]: pointed it out.
08:09.759 --> 08:19.725
[SPEAKER_00]: She actually sent me something and she said, I want you to look at and she was the non doctor on the founding team and she's like, you look at this and tell me if you think you're burned out and I was like,
08:20.730 --> 08:27.836
[SPEAKER_00]: Oh my god, I have the symptoms of the worst category of burnout, but you know, we just normalize it.
08:27.936 --> 08:36.723
[SPEAKER_00]: We just keep like, okay, okay, and I just assumed it was part of being a founding physician and a mom and no, I was burned out.
08:36.763 --> 08:41.807
[SPEAKER_00]: So can you tell us about the four specific categories of expectations that drive us towards that burnout?
08:43.141 --> 08:50.704
[SPEAKER_01]: Yeah, when I really started thinking about the patient side scene over the years, this is thousands of women struggling with this, and like I said, many, very, very high achieving.
08:51.404 --> 08:54.685
[SPEAKER_01]: The fourth that stood out, one is just being constant caregivers.
08:55.305 --> 09:03.768
[SPEAKER_01]: So this idea that from a very young age, we may have been tasked with caring for siblings, being told, make sure you go and touch base with that friend, she seems really down, and
09:04.588 --> 09:08.571
[SPEAKER_01]: messages that we've received from the primary care takers in our own life.
09:09.011 --> 09:10.012
[SPEAKER_01]: We saw that pattern.
09:10.492 --> 09:12.514
[SPEAKER_01]: Was it a woman that was our primary care taker?
09:12.534 --> 09:28.885
[SPEAKER_01]: Of course not always, but there were a lot of examples of that probably growing up, teachers, nurses, others, so there's constant care taking and that any lapse or any care directed inward is selfish because then we're not taking care of someone else during that time because we can't split ourselves into.
09:29.605 --> 09:36.857
[SPEAKER_01]: There's hyper accountability, which is a really powerful one, and that is this belief we have that we can control other people's feelings.
09:37.918 --> 09:47.462
[SPEAKER_01]: And what do we do if we feel like we're trying to do that we over, we are just so competent and we're so active, we're saying, if I have the perfect birthday party for my son, he won't be disappointed.
09:48.022 --> 10:01.547
[SPEAKER_01]: And if I clean my house beautifully when my mom comes, she'll be impressed with me or she'll think that I'm successful or that you're just the idea that somehow we can control other peoples of emotional experience, but that's been the case again, something we were taught.
10:02.168 --> 10:04.649
[SPEAKER_01]: Like, oh, Jenna, when I was growing out my family calls me Jenna.
10:04.729 --> 10:07.690
[SPEAKER_01]: Oh, Jenna, you know, like, your mom seems kind of bummed out today.
10:07.730 --> 10:10.012
[SPEAKER_01]: Maybe you should try and like, see if you can cheer her up.
10:10.052 --> 10:12.032
[SPEAKER_01]: Or maybe you shouldn't go with your friends, just stay with her.
10:12.112 --> 10:15.834
[SPEAKER_01]: And like, see if you can kind of get her out of this mood that she's in, right?
10:16.374 --> 10:17.335
[SPEAKER_01]: So that's the second one.
10:17.555 --> 10:18.815
[SPEAKER_01]: Third one is just perfection.
10:19.556 --> 10:21.877
[SPEAKER_01]: The idea that we need to show up everywhere perfectly.
10:21.917 --> 10:23.578
[SPEAKER_01]: Like, I have a friend who's a dermatologist.
10:23.618 --> 10:26.019
[SPEAKER_01]: And she said almost every woman who comes into her practice.
10:26.419 --> 10:28.620
[SPEAKER_01]: The first thing she does is apologize for something.
10:29.140 --> 10:42.910
[SPEAKER_01]: I'm sorry my legs aren't shave it and I'm sorry my skin's so dry, I'm sorry I just I didn't put on the best stuff right now or these clothes are, you know, just apologize for ourselves because there's this belief that even when we're going in to get some care or you probably see this, it's an OBGYN.
10:44.191 --> 10:48.394
[SPEAKER_01]: I need to show up appearing like I got it all under control and then I'm perfect.
10:49.175 --> 10:51.677
[SPEAKER_01]: And the last one is just this idea of having it all.
10:52.438 --> 11:05.423
[SPEAKER_01]: which I think I don't want to discount the idea that women can do whatever we want to do and put our minds to, but this sense that we can do it all at once and do it all perfectly without any sign of effort and without asking for help.
11:05.443 --> 11:09.505
[SPEAKER_01]: I mean, think about how we used to raise kids, Eonsiko, it was a community.
11:10.487 --> 11:20.394
[SPEAKER_01]: and now we're more and more isolated and looking for community maybe online where we're comparing ourselves in a negative way or refining examples that we can't possibly achieve.
11:20.794 --> 11:28.560
[SPEAKER_01]: So those those four key areas come up and I find that they they map on pretty well to most of the areas of guilt that women experience.
11:29.524 --> 11:31.345
[SPEAKER_00]: I agree with you so much.
11:31.385 --> 11:40.412
[SPEAKER_00]: I think it took me entering my fifth decade to really lock on to the idea of, because I don't want to be a Debbie Downer until women get they can't have it all.
11:40.992 --> 11:41.713
[SPEAKER_00]: I agree with you.
11:41.733 --> 11:43.554
[SPEAKER_00]: I just don't think we can have it all at once.
11:43.974 --> 11:47.857
[SPEAKER_00]: And there's no perfect, everyone's like, how do you balance everything?
11:47.877 --> 11:50.058
[SPEAKER_00]: I'm like, is there ever really balance?
11:50.139 --> 11:52.140
[SPEAKER_00]: I feel like it's a constant state of,
11:52.581 --> 12:04.824
[SPEAKER_00]: You know, sometimes families, you know, spread the priority, sometimes work, sometimes my health takes, you know, because my body says, okay, if you're not going to pay attention, I'm going to claim some time for you and declare itself with whatever.
12:05.244 --> 12:09.465
[SPEAKER_00]: And so it, but it really took me entering this phase of my life.
12:09.925 --> 12:14.367
[SPEAKER_00]: And then as far as the social media pressures, I agree with you, the toxic comparison.
12:14.907 --> 12:19.588
[SPEAKER_00]: And I tell people all the time that I even was living a dichotomous life,
12:20.129 --> 12:28.547
[SPEAKER_00]: Yes, people saw the headlines like, oh, you raised, you know, another 10 million or 20 million, but they didn't know that personally maybe I was in the throws of all
12:29.062 --> 12:30.443
[SPEAKER_00]: horrible burnout, right?
12:30.563 --> 12:31.764
[SPEAKER_00]: I was exhausted.
12:31.784 --> 12:34.146
[SPEAKER_00]: I was having the worst migraines of my life.
12:34.266 --> 12:36.808
[SPEAKER_00]: I had hit, um, I had high blood pressure.
12:36.848 --> 12:39.050
[SPEAKER_00]: Those would that wasn't well controlled, you know?
12:39.230 --> 12:45.155
[SPEAKER_00]: And so they didn't realize that a lot of things were unraveling and they're like, oh, she's got it all together.
12:45.215 --> 12:48.397
[SPEAKER_00]: And I said, you guys, there's like two different lives.
12:48.417 --> 12:50.699
[SPEAKER_00]: There's like all the wins on social media.
12:51.220 --> 12:55.043
[SPEAKER_00]: But what I really learned from that when I sat with that was,
12:56.047 --> 13:10.710
[SPEAKER_00]: I have learned so much more from my failures and then my successes and I have also learned my absolute never-against and my moustaps for my personal relationships and my professional relationships.
13:10.790 --> 13:15.370
[SPEAKER_00]: And so I really tried to take that learning from that.
13:15.530 --> 13:24.332
[SPEAKER_00]: So, you have often said that guilt is expectation minus perceived reality.
13:24.452 --> 13:25.092
[SPEAKER_00]: I love that.
13:25.717 --> 13:29.300
[SPEAKER_00]: So guilt is expectations minus perceived reality.
13:30.021 --> 13:36.747
[SPEAKER_00]: As a woman who came from a long line in lineage of healers, and I always talk about medicine, how we don't heal our healers.
13:37.668 --> 13:46.013
[SPEAKER_00]: How do you have to unlearn the expectation that physicians needs always come last?
13:46.073 --> 13:49.996
[SPEAKER_00]: When we do, we suppress our physical needs, our emotional needs.
13:50.977 --> 13:51.817
[SPEAKER_00]: We don't eat, right?
13:51.837 --> 13:53.518
[SPEAKER_00]: When we want to, we don't go to the bathroom.
13:53.538 --> 13:55.419
[SPEAKER_00]: We want to, we don't often sleep.
13:55.520 --> 13:57.721
[SPEAKER_00]: So how do you unlearn that?
14:00.203 --> 14:16.232
[SPEAKER_01]: Yeah, that's so complicated in my mother's father was a small town physician in rural North Dakota as was my dad, the men in the family, and my grandmother was a nurse, but stayed home with to raise her six kids and then returned to nursing, my mom stayed home with us.
14:17.273 --> 14:24.797
[SPEAKER_01]: And so I had this dual message of this is what the physician does and my dad worked very long hours while my mom took care of everything at home.
14:26.082 --> 14:29.104
[SPEAKER_01]: And then what a mother does or what a good woman does.
14:29.164 --> 14:35.909
[SPEAKER_01]: And that was my mother's example is that she was home and doing everything for us cooking homemade meals and volunteering for things and making me.
14:36.336 --> 14:39.239
[SPEAKER_01]: the most ridiculous Halloween costumes every year.
14:39.519 --> 14:40.460
[SPEAKER_00]: I love that.
14:42.021 --> 14:47.166
[SPEAKER_01]: She was very, she was very willing to jump in when I had some really crazy.
14:47.186 --> 14:50.829
[SPEAKER_01]: I was a skunk one year, which was an interesting choice, but.
14:50.909 --> 14:54.372
[SPEAKER_00]: I've been a minion costume one year, and I'm not good at it.
14:54.412 --> 14:56.154
[SPEAKER_00]: But it actually was decent.
14:57.415 --> 14:59.877
[SPEAKER_00]: And I felt pretty good until this other one came out.
14:59.897 --> 15:01.659
[SPEAKER_00]: Of course, then you get in a toxic comparison.
15:01.679 --> 15:01.899
[SPEAKER_00]: I'm like,
15:02.399 --> 15:09.209
[SPEAKER_00]: How does that mother even do that like that but um I think that's lovely that makes me smile.
15:10.703 --> 15:16.947
[SPEAKER_01]: Yeah, so I think for me, a big part of it was, I had this vision for what a good doctor would be.
15:17.027 --> 15:18.768
[SPEAKER_01]: And it's 100% dedicated.
15:19.229 --> 15:29.415
[SPEAKER_01]: All my time in energy and effort was put forth to caring for my patients, reading, getting involved, participating in that clinical setting, my father, seeing patients from our local town.
15:30.076 --> 15:32.617
[SPEAKER_01]: And then I also thought, well, this is what a mom needs to be.
15:32.777 --> 15:34.499
[SPEAKER_01]: So coming into my adult life,
15:35.259 --> 15:39.924
[SPEAKER_01]: I had this sense of, I'm supposed to be both of those things, which is frankly impossible.
15:40.024 --> 15:44.289
[SPEAKER_01]: I can't be always at home and always at the clinic or always in the hospital.
15:44.969 --> 15:56.402
[SPEAKER_01]: And even when I switched over to a private practice, I too went through burnout because it had been years with COVID and doing it all in my own, seeing patients who are really suffering and trying to give them something.
15:57.162 --> 16:04.550
[SPEAKER_01]: of myself, giving that to my kids, my partner, that I actually stepped away from clinical medicine for a bit.
16:04.590 --> 16:14.539
[SPEAKER_01]: In fact, I'm just still now planning to return in a more specific way, but the guilt I felt about that was, was, and truly still is very, very high.
16:14.599 --> 16:15.801
[SPEAKER_01]: Because again, I had this image.
16:15.821 --> 16:16.802
[SPEAKER_01]: If this is what a real,
16:17.302 --> 16:18.243
[SPEAKER_01]: physician would do.
16:18.903 --> 16:22.467
[SPEAKER_01]: They wouldn't stop seeing patients for a while because that's their entire identity.
16:23.127 --> 16:33.557
[SPEAKER_01]: And me writing a book, a nationally published book that was going to be helping women with guilt, it didn't like help me that much with that feeling that I was letting people down by not seeing patients.
16:33.877 --> 16:36.379
[SPEAKER_00]: You know, well, because that's where I am in my journey.
16:36.499 --> 16:40.722
[SPEAKER_00]: So I gave up delivering babies and then felt guilt, but then really what did I do.
16:40.742 --> 16:45.645
[SPEAKER_00]: I over achieved learned about men of pause and sexual health 10 years ago, before everyone.
16:45.745 --> 16:51.409
[SPEAKER_00]: And so kind of filled that gap and that filled me and then this past December.
16:51.689 --> 16:58.394
[SPEAKER_00]: I have walked away from practicing and full blown into advocacy speaking podcasting.
16:58.956 --> 17:19.473
[SPEAKER_00]: writing a book and right now it's good because I still have people coming up to me saying thank you you know I did x y and c because I heard you but i'm hoping that there's not guilt in a year or two but uh you know so i was hoping that all this other activity was a way of um
17:20.958 --> 17:37.205
[SPEAKER_00]: Not displacing the guilt because I don't want to say that because that's not what I made the decision from I made it from a space of how and where do I want to spend my professional time to make biggest difference you know how can I utilize my skills.
17:37.765 --> 17:40.849
[SPEAKER_00]: Because you are right, so much of identity is tied up.
17:40.969 --> 17:45.676
[SPEAKER_00]: For me, it was both in being a doctor and also with the company I founded 10 years ago.
17:46.236 --> 17:48.459
[SPEAKER_00]: So, very, very interesting.
17:48.539 --> 17:52.645
[SPEAKER_00]: So, then are you planning on returning to patient care?
17:54.592 --> 18:06.221
[SPEAKER_01]: I think that my plan is to return focusing on ideas around guilt and interpersonal therapy for women as part of what I want to do because I do miss it.
18:06.601 --> 18:19.110
[SPEAKER_01]: And I do think, when I think about different values, I think that that is what makes sense for me right now, but in a broader scale, I think it's just this idea of how do we really decide what healing means?
18:19.591 --> 18:23.213
[SPEAKER_01]: Because we're both still in the setting of healing, even if we're not seeing patients
18:24.314 --> 18:25.554
[SPEAKER_01]: particular setting.
18:26.455 --> 18:27.815
[SPEAKER_01]: We're healing in these other ways.
18:27.875 --> 18:39.339
[SPEAKER_01]: I mean, you've described the reach that some of these conversations you've had, how many people have been able to hear that, how many people have learned about menopause from you, learned about their bodies, learned about their minds.
18:39.960 --> 18:43.461
[SPEAKER_01]: And I remind myself of that that I'm healing in all of these ways.
18:44.041 --> 18:46.322
[SPEAKER_01]: It's not just in this prescribed.
18:46.342 --> 18:48.803
[SPEAKER_01]: This is what it looks like because that's what it looked like for my father.
18:49.463 --> 18:54.847
[SPEAKER_01]: I'm trying to find my own way to share information and teach because I also come from a lot of teachers.
18:55.528 --> 18:56.849
[SPEAKER_01]: And you really are a teacher.
18:56.869 --> 19:01.292
[SPEAKER_01]: It's just who's in your classroom and right now it's sort of the entire world.
19:01.312 --> 19:11.299
[SPEAKER_01]: And I think it's getting back to that value and for me it's like really value spreading information and teaching and healing in whatever capacity I have the most energy to give.
19:12.000 --> 19:13.981
[SPEAKER_01]: And that might be clinical work for a bit.
19:14.021 --> 19:14.602
[SPEAKER_01]: It may not.
19:14.842 --> 19:17.964
[SPEAKER_01]: I mean, I may decide tomorrow that's maybe not the direction I want to go,
19:19.085 --> 19:26.772
[SPEAKER_01]: I think it's figuring out for each of us, especially in medicine, what way do we want to heal and then putting our best into that?
19:26.813 --> 19:32.938
[SPEAKER_01]: Because then we can accomplish, I mean, think about what the people in medicine, the women in medicine can accomplish, whatever they want.
19:33.219 --> 19:41.867
[SPEAKER_01]: Once they know this is aligned with my values, this actually energizes me and this is how I want to heal people in my community or or writ large.
19:43.220 --> 19:47.161
[SPEAKER_00]: So we already know that there are so many barriers to care for women, right?
19:47.202 --> 19:49.642
[SPEAKER_00]: We weren't included in clinical research trials.
19:50.063 --> 19:53.864
[SPEAKER_00]: There are even though women outnumber men in the workforce.
19:53.924 --> 19:56.525
[SPEAKER_00]: We don't outnumber them in those decision-making rooms.
19:56.685 --> 20:01.827
[SPEAKER_00]: I think the average time that we stay full time is six years before we alter our schedule because of this.
20:02.715 --> 20:12.699
[SPEAKER_00]: dichotomy or on whatever you want to call it imbalance of work home life that we are passed over for promotions.
20:12.739 --> 20:15.440
[SPEAKER_00]: We don't have mission-driven work.
20:16.321 --> 20:21.023
[SPEAKER_00]: There is gender bias in the way that we were taught.
20:21.383 --> 20:23.684
[SPEAKER_00]: And there's lack of funding so there's so many things.
20:23.804 --> 20:25.665
[SPEAKER_00]: And then I love this
20:26.525 --> 20:38.911
[SPEAKER_00]: Well, I don't love that this is happening, but your explanation that guilt can lead to self abandonment and then women start to normalize and kind of dismiss their own symptoms.
20:39.031 --> 20:46.495
[SPEAKER_00]: Whether we're talking about enemy trusses or fibroids or abnormal bleeding or perimenopause in menopause, which are hot but in topics.
20:46.735 --> 20:49.377
[SPEAKER_00]: And so, because women feel selfish.
20:49.417 --> 20:53.339
[SPEAKER_00]: I mean, you just talked about how you were six months late to your mammal.
20:53.519 --> 20:55.200
[SPEAKER_00]: I was 18 months late to my
20:56.209 --> 20:57.210
[SPEAKER_00]: colonoscopy.
20:58.411 --> 21:00.353
[SPEAKER_00]: And to me, that's crazy.
21:00.513 --> 21:02.395
[SPEAKER_00]: You and I are both healers.
21:02.435 --> 21:03.937
[SPEAKER_00]: So do you want to talk about that?
21:03.997 --> 21:09.322
[SPEAKER_00]: How women actually feel selfish and there's guilt for self care?
21:11.768 --> 21:24.894
[SPEAKER_01]: Well, again, it's somehow we've been told this message that we should be able to tolerate, I mean, the idea that we would just tolerate childbirth, that, oh, it's really not that big a deal, and then you have your maternity vacation and then you go back to work.
21:24.914 --> 21:35.318
[SPEAKER_01]: I mean, these messages are still out there, and we've been told that even though we may have a lot of pain every month, we may have bloating and changes in our mood, all those things that can happen around menstruation,
21:36.245 --> 21:45.947
[SPEAKER_01]: Perry menopause and menopause certainly the communication we've received from medicine in general and from the world is it's not that bad, it's like deal with it right and move on.
21:46.767 --> 22:02.670
[SPEAKER_01]: And I think that that is something we've absorbed not because we are not strong but because we have had to find a way to adapt in a situation where we're really not being cared for and you see that this is changing women are asking for more information of her red much more and
22:05.251 --> 22:06.532
[SPEAKER_01]: lately than ever.
22:07.733 --> 22:22.946
[SPEAKER_01]: Part of this, I think, though, in this guilt, the way we kind of internalize it, it is that I way of resting that control somewhat because it's like, okay, if I can't find any help out there and I feel totally scared and uncertain, I'm gonna figure it out.
22:23.166 --> 22:25.488
[SPEAKER_01]: I'm gonna take it inward and I'm gonna see how I
22:26.469 --> 22:27.290
[SPEAKER_01]: can take care of myself.
22:27.330 --> 22:42.864
[SPEAKER_01]: And so you see that in women and men, but women seeking alternative therapies, and treatments, some helpful, and some unfortunately not, is a way to try and get back that control and say, well, if I'm not going to get any support externally, I guess I have to do this myself.
22:43.365 --> 22:47.809
[SPEAKER_01]: And I think that we say that to ourselves a lot in a lot of environments.
22:48.562 --> 23:04.880
[SPEAKER_00]: So with your expertise in women's behavioral health, is this why you think that women are sometimes robbed or stripped of their joy in the postpartum period or why they just, they self-described themselves as crazy or out of control during perimenopause?
23:06.734 --> 23:13.777
[SPEAKER_01]: Well, I think that there are, and I just spoke with someone about the really amazing changes our brains go through in that postpartum period.
23:13.857 --> 23:27.882
[SPEAKER_01]: And it does make us more vulnerable to depression and anxiety, but there's also this remarkable sort of pruning and specific changes that happen to make us more tuned with our baby and more organized around childcare, maybe a little forgetful elsewhere for a bit.
23:28.542 --> 23:31.485
[SPEAKER_01]: and even around Perry meant it for us, yeah, the mommy brain.
23:31.825 --> 23:39.011
[SPEAKER_01]: But even in Perry meant it for us, yes, we have these fluctuations that the truly affect us, I think, they do, right?
23:39.071 --> 23:49.439
[SPEAKER_01]: And so I think where I see a lot of distress in, especially postpartum women, where I treat more of, I'll be at this time, is I should be feeling certain way.
23:50.020 --> 23:53.943
[SPEAKER_01]: I should be experiencing motherhood the way I thought I would.
23:54.283 --> 23:54.483
[SPEAKER_01]: Right.
23:54.503 --> 23:56.224
[SPEAKER_01]: The idea of this is what the birth plan should have been.
23:56.284 --> 23:57.925
[SPEAKER_01]: This is what my delivery should have looked like.
23:58.405 --> 24:01.486
[SPEAKER_01]: For me, I had to have a four steps delivery for my first child.
24:01.606 --> 24:03.147
[SPEAKER_01]: And I still feel guilty about that.
24:03.187 --> 24:03.848
[SPEAKER_01]: He's 15.
24:04.408 --> 24:08.250
[SPEAKER_01]: But there was a sense of, I failed to push the kid out.
24:08.270 --> 24:10.891
[SPEAKER_01]: I mean, you know, he had the huge dog in, but anyway.
24:10.911 --> 24:13.312
[SPEAKER_00]: What was the reason that I just could be called in medicine?
24:13.332 --> 24:17.394
[SPEAKER_00]: And I did a renaming revolution with peanut.
24:17.494 --> 24:20.055
[SPEAKER_00]: It poor maternal effort.
24:20.655 --> 24:23.737
[SPEAKER_00]: Like that's what the diagnostic code was.
24:25.074 --> 24:26.536
[SPEAKER_00]: you're so vulnerable.
24:26.576 --> 24:27.256
[SPEAKER_00]: Think about that.
24:28.077 --> 24:28.337
[SPEAKER_01]: Wow.
24:28.538 --> 24:31.120
[SPEAKER_00]: It's not poor maternal effort.
24:31.561 --> 24:33.202
[SPEAKER_00]: It's like it's not working.
24:33.302 --> 24:35.805
[SPEAKER_00]: But yeah, even the language and medicine, but I'm sorry.
24:35.825 --> 24:36.846
[SPEAKER_00]: I just had to tell you that.
24:36.886 --> 24:38.167
[SPEAKER_00]: Like, yeah, yeah.
24:38.287 --> 24:44.454
[SPEAKER_00]: So you had four steps, but obviously something was, you know, wrong.
24:44.754 --> 24:48.277
[SPEAKER_00]: And so it's amazing to me that you felt guilt about that.
24:48.418 --> 24:48.678
[SPEAKER_00]: So.
24:49.850 --> 24:54.312
[SPEAKER_01]: Yeah, I think a lot of women don't necessarily talk about really complicated deliveries.
24:54.972 --> 25:00.794
[SPEAKER_01]: That someone called it a normative trauma that there are so many scary aspects of it to fucult aspects.
25:01.454 --> 25:07.517
[SPEAKER_01]: And again, it's that sense of like, well, yeah, it's hard, but you'll bounce back, the bounce back thing, whether that's in mind or body.
25:08.597 --> 25:10.038
[SPEAKER_01]: does women such a disservice?
25:10.678 --> 25:12.779
[SPEAKER_01]: You've done this remarkable thing.
25:13.459 --> 25:15.560
[SPEAKER_01]: You're going through this incredible change.
25:16.140 --> 25:18.241
[SPEAKER_01]: How do you care for yourself through that?
25:18.641 --> 25:26.004
[SPEAKER_01]: Becoming a mother is as complex as going through adolescence and think about how we subtract support adolescence and all the hormonal shifts they go through.
25:26.644 --> 25:29.005
[SPEAKER_01]: In the postpartum and perimenopause, it's similar.
25:29.985 --> 25:36.306
[SPEAKER_01]: but there's a sense of like women just like, this is natural, so you should be able to do it with ease.
25:36.506 --> 25:39.467
[SPEAKER_01]: Like breastfeeding is natural, so you should be able to do it with ease.
25:39.547 --> 25:45.888
[SPEAKER_01]: Well, most of us have some challenge with breastfeeding or some discomfort, you know, with that.
25:45.908 --> 25:57.110
[SPEAKER_01]: And so I think these messages are just so harmful and what a good normal, healthy, maternal, woman should be experiencing across these reproductive stages.
25:57.822 --> 26:09.763
[SPEAKER_00]: And with Perry menopause, what I see is, and at least some of Sconey's work has also shown this, is there is this link zone of chaos with hormonal fluctuations and feeling rage or out of control.
26:10.351 --> 26:19.479
[SPEAKER_00]: But for a lot of women, there is increased empathy and emotional regulation once you've gone through the transition.
26:20.200 --> 26:34.673
[SPEAKER_00]: And there's also this, you know, how we're built to be nurturers, nurturers, nurturers, all of a sudden, quote unquote, you become a selfish or what we perceive to selfish before, because those neurotransmitters and those levels are actually changing.
26:35.114 --> 26:35.995
[SPEAKER_00]: And so now,
26:37.034 --> 26:45.237
[SPEAKER_00]: I see it in women in the workplace, where the fastest growing subset of entrepreneurs are women 45 to 55.
26:45.797 --> 26:55.041
[SPEAKER_00]: In that, perimenopausal, menopausal transition, because I think you're like, okay, I'm done with the nurturing and the child rearing.
26:55.461 --> 27:04.325
[SPEAKER_00]: And now I can focus on things other things that I want to get birth to, whether it's in a company or an idea or a new career, or a new hobby, whatever it is,
27:05.427 --> 27:10.949
[SPEAKER_00]: And so that's what I tell women is waiting on the other side.
27:11.330 --> 27:15.391
[SPEAKER_00]: The promise those paramount of puzzle transitions can sometimes last seven to ten years.
27:15.431 --> 27:17.332
[SPEAKER_00]: It doesn't mean you have to be symptomatic.
27:19.053 --> 27:25.516
[SPEAKER_00]: So moving into solutions and treatments because you and I are both healers.
27:25.856 --> 27:31.058
[SPEAKER_00]: Do you want to walk us through your five step therapeutic framework called speak?
27:32.583 --> 27:43.652
[SPEAKER_01]: Yeah, so speak was just a way to describe what's gonna happen in the therapy office, for example, but that you can bring into your own lives and if you've been in therapy, you may recognize some of these strategies.
27:43.672 --> 27:53.660
[SPEAKER_01]: So the first one is show up, S is for show up, and that's so important because again, you're saying I'm valuable enough to put attention and time and energy into myself.
27:54.220 --> 28:00.265
[SPEAKER_01]: And I'd love, I'm trying to think as you're describing this shift from nurturing nurturing, nurturing to selfishness, what language we could create.
28:01.435 --> 28:03.717
[SPEAKER_01]: Instead of, like, what is it actually called?
28:03.837 --> 28:05.218
[SPEAKER_01]: Because I see it the same thing.
28:05.238 --> 28:11.904
[SPEAKER_01]: So many of my peers in their 40s and 50s are shifting and doing remarkable things and just like coming alive again.
28:11.924 --> 28:15.227
[SPEAKER_01]: And I think, wow, this, what could be, what could we call that?
28:15.247 --> 28:17.088
[SPEAKER_01]: I have to think on that a bit, because that would be.
28:17.689 --> 28:23.594
[SPEAKER_00]: We have to think on that, because someone, the other day, said to me, I hadn't seen them in the wild.
28:23.834 --> 28:29.479
[SPEAKER_00]: And they were like, you just are smiling more than you have ever smiled.
28:30.802 --> 28:33.383
[SPEAKER_00]: because I'm doing the work I really want.
28:33.443 --> 28:35.124
[SPEAKER_00]: We all have to do things we don't want to do.
28:35.204 --> 28:38.445
[SPEAKER_00]: Scrubbing forward, and you know, there's more than we all have that we don't.
28:39.145 --> 28:44.747
[SPEAKER_00]: I said the majority of my time is now spending it in the way that I want.
28:44.947 --> 28:50.629
[SPEAKER_00]: And I think that's the lightness and the happiness that you're seeing.
28:50.769 --> 28:52.670
[SPEAKER_00]: So, and I agree with you.
28:52.810 --> 28:53.790
[SPEAKER_00]: But I call it selfish.
28:53.810 --> 28:55.011
[SPEAKER_00]: I'm like, what do we call it?
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[SPEAKER_00]: Let's come up with a different name.
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[SPEAKER_01]: All right, so I'm going to noodle on that.
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[SPEAKER_00]: All right, so continuing through your framework.
29:03.925 --> 29:06.568
[SPEAKER_01]: Yeah, so speak as is showing up.
29:06.709 --> 29:12.996
[SPEAKER_01]: And again, just picking up the book, right taking out a journal, writing things down, piece for pay attention.
29:13.176 --> 29:15.178
[SPEAKER_01]: And that's really looking inward.
29:15.358 --> 29:19.243
[SPEAKER_01]: And then it's also outwardly not noticing where these emotions are coming up.
29:19.563 --> 29:19.803
[SPEAKER_01]: Right?
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[SPEAKER_01]: What thoughts are coming up throughout the day?
29:22.644 --> 29:29.187
[SPEAKER_01]: And there can really be a lot of grief in this process because women can start to recognize I've been so hard in myself.
29:29.327 --> 29:40.331
[SPEAKER_01]: I've been giving myself these really awful critical messages for years There's real sadness in that because it's like I can't have that time back But it's like okay, how do I pay attention to what's going on around me?
29:41.131 --> 29:42.772
[SPEAKER_01]: E is just examining that evidence.
29:43.372 --> 29:44.873
[SPEAKER_01]: Where is it coming up most frequently?
29:45.373 --> 29:47.074
[SPEAKER_01]: When do I find myself feeling the most?
29:47.435 --> 29:53.718
[SPEAKER_01]: Self-critical, maybe after comparing myself to someone or after a call with the family members or friend or have you.
29:53.738 --> 29:58.561
[SPEAKER_01]: A is taking action and I really wanted some very concrete strategies.
29:58.661 --> 30:01.162
[SPEAKER_01]: And I borrowed these from other evidence-based treatments.
30:01.202 --> 30:02.843
[SPEAKER_01]: I wanted to make sure it really was grounded.
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[SPEAKER_01]: In science, you know, we both have that.
30:05.084 --> 30:08.665
[SPEAKER_01]: I think compulsion to say, let's be clear about what actually has some evidence.
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[SPEAKER_01]: And that's things in self-compassion, positive psychology, which was developed at Penn, and so I've gotten to connect with some of them about that.
30:17.207 --> 30:28.170
[SPEAKER_01]: Growth mindset work, Carol Dweck's work, and growth mindset, which is that we learn from our setbacks, like you said earlier, the failures you've learned a lot more from, it allowed you to grow and change.
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[SPEAKER_01]: and then some cognitive conveys structuring being able to really take those self-critical thoughts as first drafts.
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[SPEAKER_01]: because we are not our thoughts, which gets into a whole conversation or unconsciousness, right?
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[SPEAKER_01]: Like, what are we then, which part of our brain is conscious, but that we are not our guilty thoughts, our anxious thoughts, our ruminations about past failures, and then K is most important that's keep going.
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[SPEAKER_01]: Because you know, this is a process, as you've described, these different journeys and challenges we've had, how do I keep growing?
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[SPEAKER_01]: How do I move toward growth?
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[SPEAKER_01]: as opposed to closing down or saying, well, now I'm too old or it's too late or whatever the different limiting thoughts we might have.
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[SPEAKER_01]: So that's sort of the speak over our chain description and then I try to plug in different strategies throughout.
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[SPEAKER_00]: So I want to speak to two different audiences here.
31:21.315 --> 31:24.737
[SPEAKER_00]: So I wrote a statistic the other day that I was not aware of.
31:24.837 --> 31:32.141
[SPEAKER_00]: So I've known for a very long time that women live longer, but we live in much poorer health for a multitude of reasons.
31:32.841 --> 31:37.006
[SPEAKER_00]: But I did not know that that excludes female physicians.
31:37.187 --> 31:40.911
[SPEAKER_00]: We actually die earlier than our counterparts.
31:40.951 --> 31:43.955
[SPEAKER_00]: I mean, our use of was like, I was surprised too.
31:43.975 --> 31:44.495
[SPEAKER_00]: So yeah.
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[SPEAKER_00]: And they think some of it is what you and I are talking about.
31:48.160 --> 31:52.465
[SPEAKER_00]: This, you know, balancing act of we are constantly
31:53.185 --> 31:59.750
[SPEAKER_00]: taking care of everybody else, like even our jobs are healers and taking care of everybody else.
31:59.810 --> 32:15.960
[SPEAKER_00]: So to the physicians listening, what one take home message you would take about integrating the speak framework into their lives today is particularly given that statistic, that was alarming.
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[SPEAKER_00]: I was like, what am I going to do right now to change this?
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[SPEAKER_01]: And I think a big part of that, too, is this sense that women, we as physicians should be able to heal ourselves.
32:25.596 --> 32:31.199
[SPEAKER_01]: I mean, I know when I was postpartum, I had all these intrusive anxious thoughts, which I've learned since are very, very common.
32:31.899 --> 32:32.919
[SPEAKER_01]: But I was ashamed of them.
32:32.939 --> 32:34.100
[SPEAKER_01]: I didn't want to talk about them.
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[SPEAKER_01]: I'm as a psychiatrist.
32:35.420 --> 32:36.461
[SPEAKER_01]: I was in training at the time.
32:36.481 --> 32:39.962
[SPEAKER_01]: But I should be able to just figure this out and treat myself.
32:40.462 --> 32:44.764
[SPEAKER_01]: So I think there's also this sense of, maybe even shame about seeking help.
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[SPEAKER_01]: for something, because while my doctor, I should know this already, or I should be able to take care of myself.
32:50.289 --> 33:06.362
[SPEAKER_01]: So I think that is a piece among many others that you mentioned, the research, the availability of care, dismissal of pain and other symptoms, to physicians that are out there, to women in medicine, the idea of self-compassion is really powerful.
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[SPEAKER_01]: When I really looked into it, it's not just, I'm going to be nice to myself.
33:10.305 --> 33:11.326
[SPEAKER_01]: It's this sense of,
33:12.528 --> 33:15.748
[SPEAKER_01]: I'm going to create a safe atmosphere where I can look at myself.
33:17.416 --> 33:23.217
[SPEAKER_01]: The good, the bad, the ugly, so to speak, I can really see myself for who I am and still accept that person.
33:24.018 --> 33:27.398
[SPEAKER_01]: But not try to bury things under the rug like, I'm not really experiencing symptoms.
33:27.478 --> 33:29.059
[SPEAKER_01]: I'm not really having burnout.
33:29.879 --> 33:35.120
[SPEAKER_01]: Being able to really look openly with curiosity and not judgment and say, okay, this is what I'm feeling.
33:35.340 --> 33:41.982
[SPEAKER_01]: This is the reality because a lot of women, physicians are disconnected from those emotional experiences.
33:42.002 --> 33:45.243
[SPEAKER_01]: They don't even know they're in burnout till a friend holds up a mirror as yours did and says,
33:49.364 --> 33:54.828
[SPEAKER_01]: So self-compassion, it is self-kindness, but it's also this understanding that we're a part of a common humanity.
33:55.488 --> 34:04.394
[SPEAKER_01]: And I think women physicians who are talking with each other around this, I did a book group with a number of women physicians, it was so powerful because hearing each other describe these challenges.
34:05.054 --> 34:11.499
[SPEAKER_01]: Maybe symptoms they were having, difficulties they were having, number of them said, I never thought you would have had that.
34:11.519 --> 34:16.282
[SPEAKER_01]: You're like the leader of our department, or you're just crushing it all the time, or I never would have thought.
34:16.302 --> 34:21.666
[SPEAKER_01]: So I think that's another piece and third is just mindfulness, which is a bit of a buzzword.
34:22.466 --> 34:30.232
[SPEAKER_01]: But it really implies that I'm in this experience this moment now, not in the anxious future, not in a room-native or dreadful past.
34:30.312 --> 34:34.275
[SPEAKER_01]: But I'm really, again, taking stock of what I'm feeling right now.
34:35.981 --> 34:38.922
[SPEAKER_01]: And that might be guilt that I'm not seeing patients right now.
34:38.942 --> 34:44.024
[SPEAKER_01]: That might be joy that writing a book was such a, such a thrill to like see on the shelf.
34:44.905 --> 34:47.106
[SPEAKER_01]: But what is it in this moment that I'm feeling?
34:47.146 --> 34:49.067
[SPEAKER_01]: And how can I be present for those in my life?
34:49.087 --> 34:53.569
[SPEAKER_01]: Because we know about the lunchevity benefits of our relationships, right, in nurturing those.
34:54.310 --> 34:59.292
[SPEAKER_01]: So how can I be present with the people in my life I love as much as possible, right?
34:59.712 --> 35:03.015
[SPEAKER_00]: And I think that's what I learned is that I'm an extroverted introvert.
35:03.075 --> 35:07.419
[SPEAKER_00]: I can give give give, but I was taught to give until I burned out.
35:07.579 --> 35:09.781
[SPEAKER_00]: I didn't just have the vocabulary around it.
35:10.361 --> 35:18.108
[SPEAKER_00]: And now I make sure in my calendar that if I'm going to be doing a lot of talks or I'm going to be teaching a lot of courses.
35:18.620 --> 35:30.187
[SPEAKER_00]: that I've built in time for rest, recovery, fun, or the things that fuel me, whether it's time with my family or an incredible hike or booking them a set.
35:30.247 --> 35:34.069
[SPEAKER_00]: Wherever I am, finding those boat moments, we call them.
35:34.908 --> 35:49.559
[SPEAKER_00]: um, that make sure that I don't take my tank to empty, um, because then, uh, I drove just like when I was in my 20s and you either have a night of drinking or you had a, I had a night of, you know, delivering babies.
35:49.939 --> 35:51.200
[SPEAKER_00]: I would recover like this.
35:51.660 --> 35:54.402
[SPEAKER_00]: Now that I'm 50, I don't recover that quickly.
35:54.682 --> 36:00.807
[SPEAKER_00]: And so, by just that simple act of building time into my calendar, to allow
36:03.075 --> 36:12.743
[SPEAKER_00]: that recover me, it has paid back so much, multitude in the way that I can put out to the world as long as I can fill my own bucket.
36:13.503 --> 36:19.508
[SPEAKER_00]: And so I guess, we spoke about the speak framework and particularly asked you as two physicians.
36:19.548 --> 36:28.776
[SPEAKER_00]: I was really interested in this particularly because I saw that statistic, but to other women or to other people who are listening other individuals,
36:30.437 --> 36:34.639
[SPEAKER_00]: guilt alarm is going off because that's what it does feel like a guilt alarm.
36:35.799 --> 36:44.703
[SPEAKER_00]: What's you know an actionable item that they can take home from the speak framework that you would you know recommend to them.
36:46.775 --> 36:56.637
[SPEAKER_01]: I think one of my favorites is the friend exercise from self-compassion, which is really, very simple, but it's what I say to what good friend in this scenario.
36:57.457 --> 37:04.299
[SPEAKER_01]: Because I think when you're having that guilt alarm using that guilt equation, it's sort of okay, what expectations are a play here?
37:05.299 --> 37:07.039
[SPEAKER_01]: And where are those expectations coming from?
37:07.279 --> 37:08.780
[SPEAKER_01]: Are they people that I want to emulate?
37:09.300 --> 37:10.680
[SPEAKER_01]: Is it coming from social media?
37:10.720 --> 37:13.801
[SPEAKER_01]: Is it coming from some other idea that isn't aligned with my values?
37:14.681 --> 37:24.024
[SPEAKER_01]: So can I make adjustments to that, right, but then if I figure out, okay, like I'm just really being harsh on myself I'm expecting the actually unreachable.
37:24.224 --> 37:25.224
[SPEAKER_01]: I'm expecting perfection.
37:25.244 --> 37:30.706
[SPEAKER_01]: I'm expecting control over people's emotions I think what would I actually say to our friend in that scenario?
37:31.226 --> 37:33.047
[SPEAKER_01]: So that might be you know what?
37:33.067 --> 37:43.470
[SPEAKER_01]: I'm just tired and I don't want to go to the gym today and that means I'm so lazy right catching that What would I say to our friend it might be you know, it's okay to have a day of rest
37:44.598 --> 37:51.485
[SPEAKER_01]: It's simple as that, but just giving yourself a little bit of objectivity from your experience can be so powerful.
37:51.525 --> 37:55.008
[SPEAKER_01]: So it sounds like really simple exercise, but it's one I practice a lot.
37:55.709 --> 38:03.216
[SPEAKER_01]: And I do use the ghost equation a lot in my own life to identify what expectations I'm setting and are they in any way fair?
38:03.316 --> 38:04.917
[SPEAKER_01]: If they are, okay, I better get busy.
38:05.678 --> 38:13.461
[SPEAKER_01]: but also on the other side, making sure I'm paying attention to what I'm doing well, because that perceived reality is shaped by where we're paying attention, what are we perceiving?
38:13.881 --> 38:22.024
[SPEAKER_01]: And if I don't perceive any of the things that I'm doing, any of the ways that I'm healing outside of clinical medicine, for example, then I am going to feel more guilt.
38:22.144 --> 38:25.205
[SPEAKER_01]: I need to pay attention to those who are my helping, who are my reaching.
38:26.336 --> 38:27.918
[SPEAKER_00]: And it's in here wins.
38:27.998 --> 38:31.181
[SPEAKER_00]: Like I've listened to you talking about your book twice in passing.
38:31.281 --> 38:36.246
[SPEAKER_00]: And you're like, yeah, and as someone who's writing her book and knows how difficult it is, I was joking the other day.
38:36.266 --> 38:40.650
[SPEAKER_00]: I was like, I raised $40 million easier than I have this book journey.
38:40.811 --> 38:47.457
[SPEAKER_00]: And so you can be like, you know, take the wins when they come because it is incredulous when they do.
38:47.577 --> 38:47.818
[SPEAKER_00]: So,
38:48.378 --> 38:49.659
[SPEAKER_00]: Congratulations on that.
38:49.719 --> 38:53.923
[SPEAKER_00]: I think that is truly amazing.
38:54.243 --> 39:04.553
[SPEAKER_00]: And so for our listeners today, can you tell us where they can find you and follow you and do you have any exciting announcements coming up?
39:07.088 --> 39:08.368
[SPEAKER_01]: Yeah, no writing it writing a book.
39:08.388 --> 39:11.629
[SPEAKER_01]: I actually received an email from one of the prior residents that used to teach it pen.
39:11.669 --> 39:17.250
[SPEAKER_01]: And he said, I just wanted you to know that I found your book, I'm using it with a patient and it's really helping her.
39:18.071 --> 39:20.351
[SPEAKER_01]: And like that email, I've kept it.
39:20.391 --> 39:22.232
[SPEAKER_01]: I've highlighted it, started it, gone back to it.
39:22.252 --> 39:25.973
[SPEAKER_01]: Like that meant so, so much to see that in real life.
39:26.053 --> 39:27.633
[SPEAKER_01]: So that was definitely a win.
39:28.713 --> 39:32.654
[SPEAKER_01]: People can find me, so I have a sub-second a podcast, it's called a mind of her own.
39:32.854 --> 39:34.675
[SPEAKER_01]: And that's really what I'm trying to create.
39:36.435 --> 39:40.276
[SPEAKER_01]: remove the guilt or remove the other aspects that interfere with our joint agency.
39:40.857 --> 39:42.417
[SPEAKER_01]: And that's on sub-stack.
39:42.437 --> 39:48.720
[SPEAKER_01]: So I think it's a mind of her own dot sub-stack.com or my website is justgenopherreadmd.com.
39:49.420 --> 39:59.564
[SPEAKER_01]: And I have guilt groups available on my website because I wanted women in rooms to be talking about this book because I think that's such a key message you're not alone in this feeling.
40:00.725 --> 40:12.274
[SPEAKER_01]: by any means, and I have the ability to see that so to you as a caretaker, because I'm speaking to a lot of different women, but not everyone knows that this is ubiquitous, so that is also available if people want to start their own group.
40:12.875 --> 40:18.799
[SPEAKER_01]: You know, it doesn't bring anything back to me, but just allows them to explore the book together and build community.
40:19.940 --> 40:25.925
[SPEAKER_00]: Is it ironic in this day and age where you and I didn't grow up with social media?
40:26.872 --> 40:30.335
[SPEAKER_00]: And we're now you can reach people at the touch of a button.
40:30.375 --> 40:32.537
[SPEAKER_00]: Like we had to write our bikes, knock on doors.
40:32.557 --> 40:34.298
[SPEAKER_00]: You don't mean actually like all people.
40:34.959 --> 40:40.543
[SPEAKER_00]: But how alone people feel when you actually talk to them and how isolated they feel?
40:40.583 --> 40:45.307
[SPEAKER_00]: Like even when they expressed you, they were shocked that you had felt certain ways.
40:45.788 --> 40:54.075
[SPEAKER_00]: It's amazing to me in this media social media age that so many women, particularly feel alone.
40:55.075 --> 40:55.676
[SPEAKER_00]: It's interesting.
40:56.447 --> 40:58.488
[SPEAKER_01]: Yeah, it's interesting and really sad.
40:58.889 --> 41:02.952
[SPEAKER_01]: And I think we, again, the way we evolved, it is to have community.
41:03.192 --> 41:07.014
[SPEAKER_01]: It is to be doing things together, caring for our kids together, making plans together.
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[SPEAKER_01]: And I'm seeing more and more women coming together and doing remarkable work as what you're doing and your team and other women.
41:13.219 --> 41:19.183
[SPEAKER_01]: And I think more and more of that is really what we need right now, because we're needed, you know, more than ever.
41:19.751 --> 41:31.735
[SPEAKER_00]: Communities, one of the core pillars of every, I'm obsessed with the blue zones and the fact that you can actually make the blue zone because people think, oh, it's something the water or something in the earth and actually know they did that experiment where you can actually.
41:32.177 --> 41:40.544
[SPEAKER_00]: make a blue zone where people will live longer and one of the core pillars is always community so I find that also very fascinating.
41:40.564 --> 41:42.245
[SPEAKER_00]: I could talk to you for days.
41:42.845 --> 41:57.037
[SPEAKER_00]: I want to thank you so much for being a disruptor and for taking the time to have this conversation with me and for those of you out there share this episode with someone you love or someone who needs to hear this incredible advice.
41:57.257 --> 41:58.278
[SPEAKER_00]: Thank you again.
41:59.353 --> 42:01.182
[SPEAKER_01]: Thank you so much for having me and the work you do.
42:01.242 --> 42:04.376
[SPEAKER_01]: Disruptor is really incredible, so thank you.
42:05.398 --> 42:07.139
[SPEAKER_00]: This is more than a conversation.
42:07.319 --> 42:09.859
[SPEAKER_00]: It's a call, a call to build something better.
42:10.300 --> 42:14.041
[SPEAKER_00]: Subscribe, share, and bring more disruptors into this room.
42:14.521 --> 42:24.524
[SPEAKER_00]: For unfiltered insights and bold ideas, go to drsomeet.com to sign up for the monthly disruptor newsletter and follow us on social at drsomeet.
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[SPEAKER_00]: We're not waiting for a seat at the table.
42:27.265 --> 42:28.986
[SPEAKER_00]: We're building our own table.
