Volledige transcriptie van The TikTok-ification of Self-Care (And How to Fix It) with Dr. Pooja Lakshmin

lot of backlash, especially of late, but we know that it's not what social media is selling us. And I just recently started watching apple cider vinegar. I don't know if you've watched this yet, but Pooja Lakshmin: I've had multiple people tell me I need to watch it. Like literally sending emails, being like, with the subject line, you need to watch this show. Jen Fisher: Yes. So I am not done with it yet, um, but I just started watching it. Um, so if there is a never a more important time for. Telling us what real self care looks like. I think it's right now, Pooja Lakshmin: yeah. You know, for me, this kind of came through, I guess probably like five, or maybe even six or seven years ago now. You know, when I had patients coming in, this was like 20 16, 20 17, where they were saying like, Dr. Lakshmin I'm so [00:07:00] stressed out. I'm burnt out. I'm not eating well, I'm not sleeping well, and I feel like it's my fault. Because I have the meditation app on my phone that I know I'm supposed to be using, and I know I'm supposed to go to yoga and I know I'm supposed to be drinking more water and you know. List your litany of wellness tasks that we all know we're supposed to do. Um, but at the end of the day, when I'm done with all of my work duties and my caregiving duties, like all I can do is just bring myself to, you know, sit in front of the TV like a zombie and just watch Real Housewives or Doom Squirrel. Then I feel bad. And so I found myself saying to my patients over and over again like, this isn't your fault. Like we live in a society that has been completely, I mean in large part, built upon the labor, the unpaid or underpaid labor of women and people of color, and. At, at that time, you know, something like 30 million Americans like, you know, didn't have health insurance. A quarter of American workers couldn't take a [00:08:00] paid sick day. These are structural issues, like real wellness shouldn't be about willpower. Um, and so that's where I got, I. Got sort of thinking about, okay, we need to have a different conversation about self-care. And then, and then I actually did some research looking at like, well, where did this term even come from? Because now, you know, on TikTok it's just basically like a juice cleanse or you know, a trip to Sephora where you spend a couple hundred dollars on like different beauty products. I'm like, I'm pretty sure Sephora didn't coin the term self-care. And it turned out that, um, no, but they're benefiting from it. Jen Fisher: Yeah, they're definitely benefiting from it, for sure. Um, and I will say I do like a good Sephora trip, just, you know, just to be clear, fair, clear. Nothing wrong with it, but yes. Pooja Lakshmin: No, and I mean, I get my Botox, um, so like, it's not, we're not like demonizing it, but. What I wanted to do is take us back to the roots of self-care. Yeah. Which is actually like black queer activist thinkers from the [00:09:00] 1950s and 1960s that were talking about self-care as self-preservation. Audrey Lorde Bell hooks When you live in a society that is literally attacking your humanity, or the other lineage, which I thought was really interesting is actually in psychiatry. At the same time, were using the term self-care. To refer to the decisions that patients could make on locked inpatient units about how they were gonna spend their time. So like what clothes they were gonna pick out, which therapy group they're gonna go to, what they were gonna eat for lunch, which I thought was really fascinating because that's a situation, right, where you have so many of your choices stripped away. But then there's this word self-care for like where can you exert agency? And, and I think, so that's what I'm kind of trying to do with. Shifting this conversation. It's not about buying something else. It's not about like those are band-aids. Right? That's an escape. Mm-hmm. But in reality, real self-care is an internal process. And I have four principles. And they're not anything revolutionary. They're, they're actually just like tried and [00:10:00] true psychological skills that we all need and that we would benefit from employing boundaries, compassion values, and power. And, um, those four, four. Internal principles. That's the work of real self-care. And then once you've done that, then you can do, then you go to yoga, then you do your meditation. But if you're not using those internal principles and you're not doing that internal work first, then the external tools, whether it's the, you know, the nutrition stuff, or whether it's the working out or whatever it is that's gonna be empty, it's not gonna actually be coming from a place of real nourishment. Jen Fisher: Right. And I have to tell everyone that on those days where I'm having a really hard time sticking to my boundaries, I don't wear a bracelet, but I have a little voice inside my head that says, what would Puja do? Or what would puja tell me to do? Because I will tell you, you are the person that [00:11:00] has taught me especially about boundaries the most. Mm-hmm. In just in the way that you. Live your life yourself. So I owe you gratitude for that, but for anybody that helps, you can do a What would Puja do in the, in the back of your head too. Pooja Lakshmin: Well, and maybe this is a good time to talk about boundaries actually. Yes. In particular. Um, and I will say before I kind of share my framework on boundaries, I will say my own therapist. Um, there have been many sessions that I've had with her where she would be like, you know, I think somebody wrote a book called Self Care. I think somebody talked about boundaries. I'm like, yes. Thank you. So, you know, we don't, we don't Jen Fisher: always, we're not always good at doing what we tell other people to do. I admit it. Well, it's Pooja Lakshmin: a work in progress for all of us. And Totally. That's kind of the message too, of real self-care. Like that this doesn't end, like, it's not like

you learn how to do boundaries and you check it off the list and you're like, okay, I'm good for life. No, like in every new situation, whether it's like. Getting a promotion or moving to a different [00:12:00] industry, or, you know, having a baby or becoming a caregiver of elderly parents, you'll have to kind of come back because the context has changed. And so you have to, um, retrain yourself. And that doesn't mean that you're starting from zero, right? All these skilled spills on themselves. But I think like we have to let go of the fallacy that it's like you just do it once and then you're good. That this is actually just like a lifelong practice. Um, in terms of boundaries. So my framework is that, um, the reality is you can't always say no, um, because no comes with a cost. Uh, you know, whether that's financial, whether it is emotional. Like if you tell your mother-in-law, Hey, I'm not coming for Thanksgiving this year. Like, there's gonna be some drama, there's gonna be some price that you have to pay. Or if you know that your company is going through restructuring and your boss asks you to work over the weekend or to pick up a new project. You, you could, you could lose your job and maybe your, maybe your whole family gets insurance benefits [00:13:00] through your work. So like it's, there's very real consequences. So my framework is that the boundary is not saying no, the boundary is the pause. So somebody asks you to do something, somebody makes a request, you get an email. The boundary is the pause, and then you always have three responses. Yes, no, or negotiate. Negotiate meaning, ask more questions, find out what, what is the pay gonna be? What, how much time will this take? What is the workload? Who else is involved? Because the pause, you can always do, you can always stop and give yourself a minute and a beat to actually do the mental calculus to see, maybe you say to yourself like, yeah, I really do wanna say no to this, and the risk is quite low, so I can say no, but maybe on the other hand, you get a request and. You want to say no, but you're worried that the risk is too high. So then in that case, you say yes now, but you make a mental note for yourself and you say, okay, what do I need to do? So that six months [00:14:00] from now I can be closer to saying no. And that's a question that you can take to your coach or your therapist or your book club or your, you know, your group chat. And you can actually strategize on that, whether it's a question related to work or whether it's a question related to your family life that at least has. Tangible. You can, you can build action steps for yourself. One of the things that I've kind of been reminded of recently is I think when you're in this place of burnout or you know, kind of close to burnout, it's it. It's so easy to just think that no is impossible. Like no, just doesn't even cross your mind. And so that's why I like the pause because it's something that's like a little bit lower stakes, that feels a little more, um, like a baby step, which is what you need when you're in that burnout place. Jen Fisher: Are there [00:15:00] strategies for. I guess like habitualizing the pause because I think sometimes. I'll speak from my own experience, um, you know, whether in a state of burnout or not, we're just kind of on this auto reply. And the auto reply is yes. Mm-hmm. And so how do we, how do we get to habitualizing the pause? Because I think that's really powerful. And you also talk about kind of. When so many things are coming at you all at once, which is kind of what I'm thinking of. Like how do you create this brain space for yourself? Yes. 'cause sometimes that feels like too hard to do. Pooja Lakshmin: Totally, totally. It always feels the most difficult when you need it. The most. Pooja Lakshmin: Um, so a couple things. I'll tell you what I do, and this is what I also advise. My patience to try and implement is one, I'm a big fan of the one one sheet of paper method [00:16:00] where whenever you find yourself in this situation where it's like, you know a zillion different things are on your plate and everything just feels so overwhelming and you don't feel like you could say no or drop any of these things, I put everything down on a piece of white paper just so it's all on one sheet. And then I look at and I say, okay, which of these things are. Absolutes, which of these things, hopefully there's a few, are things that actually bring me some joy or excitement or I'm actually looking forward to. And then which of these things are things that I dread that actually could be extra, that maybe don't need to happen or maybe can be pushed off or maybe can be delegated to somebody else. And I find that even if I just can. Circle one or two in that last category, that provides some relief to me. Hmm. Um, like I think sometimes we overestimate how much needs to [00:17:00] be taken off when we're in this place of like extreme overwhelm. Yeah. Like, you just sort of, for me, the, the image that comes up is like, I just wanna like move away. I wanna like live on a farm. I wanna have this like, simple life. I like, I hate dirt and like messiness. Like there's no, I would not, you would be miserable on a farm. Be miserable. I'd be miserable. But it's like my brain's way of this black and white thinking, right? Or like in extremes when in reality. That there's a lot more nuance here and, and you do. Like, again, coming back to that definition of self-care, we do have agency even when it feels like things are out of control. Yeah. Or so much is out of our control. I. So I would urge like if anybody's in that position, I would urge you to like, put everything down on one sheet and try and find one thing that you can let go of and then see how that feels. The other thing with this is like collecting data, keeping, um, whether it's a journal, I. Or whether it's just like an ongoing note on your notes app, on your iPhone of like,

when you let go of that thing, what happens? Like, does the world fall [00:18:00] apart? You know? Yeah. Does everything totally powerful? Crumble powerful? Yeah. Right? Or is it, is it generally just fine actually. Um, and what I find usually is like, people understand people are human too. People get it. Um. To answer your, your question about how do we kind of like, um, make this a routine. What I've been doing is I try every Friday to have a 30 minute block to a, a blank time on my calendar where I can look back at my whole week. See how I spent my time and kind of put, put each thing into some of the, in these three buckets of like what actually kind of filled my cup a little bit. What felt like a burden? What felt like, um, it was sort of like it had to be done, but it wasn't super burdensome, but it also wasn't like joyful, right? And giving myself that space to sort of like take a bird's eye view. Really helps when I do it [00:19:00] regularly because then I start to notice patterns and then that's when I can make a larger kind of executive decision to make a change. So like for example, with a patient who noticed, like every Wednesday she has a standing four 30 meeting with somebody on her team. But the thing is technically she's supposed to be picking her kid up from daycare at four 30. And so she's always like kind of trying to scramble and it's always like this really stressful thing. And so through this like practice of kind of. Really taking a look at like what are the pain points in your schedule? She was able to finally say, you know what, I don't need to, it does, this meeting doesn't need to be at four 30. This doesn't work for me. Let's find a different time. Yeah, and sometimes you need to like take that step back to actually be able to reflect and like look at the small places that you do have agency. Jen Fisher: I love that. And I, I just had a conversation, uh, with Tessa West for another episode of the podcast, and she was saying that many of the things that we believe that cause [00:20:00] kind of the most angst and stress, especially related to work, aren't the big things. They're like the small annoying things. Right. Just like that example, right? Like that was a, not really a big thing, but it was just something that. The pattern wasn't identified and she didn't take the steps before to just say, Hey, can we move this call? And so it frustrated her every single week. Great. Yeah. Yeah. So I I, I love that connection. I love how the, all the, all the podcast experts are connecting with one another. So, so you mentioned caregiving a couple of minutes ago, so I wanna go there. Um, obviously there are all kinds of different. Care, you know, types of caregiving. I wanna talk in particular a little bit about elder care because I think there's more comfort now in talking more openly about childcare. I wouldn't say we're, we're a hundred percent where we need to be, but elder care, so many of us are experiencing it. I'm experiencing it. You're [00:21:00] experiencing, and it just feels. Like this shadow crisis that, that no one is addressing. And so let's talk about that generally, but why is it so hard to talk about this at work? Like why are we struggling talking about this? Pooja Lakshmin: Yeah, I mean, I think that it's something that, um, I agree with you. I love that word shadow crisis actually. Um, because it feels like very apt for this. It's sort of like invisible and there's like. Hushed whispers about it, but it hasn't quite gotten the airtime yet that the parenting crisis has received. And like you said, like there's still obviously a lot of work to do in all these different spaces. But yeah, you know, I think that I. I actually had a conversation, um, for my newsletter, for my real self-care newsletter about parenting versus caregiving and how caregiving, I think because it's, our culture doesn't see it as like the same type of milestone that having a baby [00:22:00] is, right? Like it's sort of like when you're in your twenties or thirties or forties, right? Like you have a baby and it's like this big thing and it's like external. Whereas, because I think just historically we've not. We've not done a good job in our culture of like really kind of like respecting and venerating our aging, right? In fact, you could say the opposite right, um, that we have as Americans are, are very fearful of aging, that it's something that's always kind of been in the shadows. Now with baby boomers, um, you know, I think it's something like, the statistic is like 60 million Americans or something are, are considered caregivers and that number is only gonna like, increase exponentially over the next few decades. I, I think, like we don't have a language around it because it's not seen as something that's celebratory, therefore, there's no value put towards it. So it becomes something that's sort of like on the side. You know, it's funny, like a few days ago I was emailing with a woman who had emailed me for a speaking [00:23:00] engagement and she was like, she had to cancel a meeting and she was like, oh, I'm, I'm so sorry. Like I, you know, we, I need to reschedule. And she said. You know, my mother actually is, is suffering from dementia. Um, and there was an issue at her skilled care facility that I had to help take care of. And I said, I wrote back and I was like, thank you so much for sharing that. Yeah. You know, like that's actually like to voice. That is so, um, it's rare that people do, and like, I think we just need more of it of people saying like, no, this was the issue and putting it into. The workplace conversation. Jen Fisher: Yeah. I, I, I, that, that makes me happy that she was open to say that. I always, and I know that experience well. Yeah. Yeah. Um, and I'm, I am always very open about it. For, for that reason, I hadn't really thought about. What you said about, you know, the, the caregiving, um, aspect, kind of not being, you know,

celebratory. And I [00:24:00] think that that's so true and wow, like really powerful and there's so many, like, there's just so many aspects of, of. Elder care giving, like the mental load of it, how it, it just hits differently, right? It's like, especially for someone who is, you know, caring for an aging parent with some sort of terminal illness. And my example, my mom has Alzheimer's and this acceptance that no matter what you do, no matter how hard you try, the reality is is they're not, they're never getting better, right? And so your job really becomes. How can you make whatever is left of their, their life, you know, filled with love and dignity the best that you can. But that comes with a huge sense of like guilt and worry and, you know, can you give us some guidance on like how to best deal with those things? Pooja Lakshmin: Yeah. Um, you know, as you were speaking, I was thinking [00:25:00] about, well two things. One, you know, I think. It's important to name kind of the gender aspect of this too, and just the fact that like with parenting, the lion's share of this caregiving work of this unseen labor, unpaid labor typically falls on women in the household. And I think it's something like 60% of caregivers are women, and so that's like something around like 30 million Americans or something like that. So it's, it's largely the, the women who are gonna be faced with the fact that this, um, responsibility is either upon you right now or will be upon you at some point in the future. And one of the things I think that is so difficult with the. Caregiving work is the unpredictable nature of it. I think that's what makes it tough, also makes it difficult in terms of like how it, the friction with workplace stuff because yeah, things just happen. You get a phone call and you have to drop everything or um, or you don't [00:26:00] know what the situation is gonna be. You can't really plan out. Two months into the future, two years in the future because there's so much that is uncertain. So in my conversation that I had, uh, in my newsletter, I got to talk to a friend of mine who is a psychologist and she focuses on caregiver stress. She actually is a founder of, um, the first caregiver stress clinic. Her name is Dr. Allison Applebaum. She would be a great future guest for you, Jen. Hmm. Um, and she wrote this book called Stand by Me. Um, and she. She, her advice is that we have to hold onto our humanity like that. It's important to find small ways to bring back parts of your life that are so easy to fall by the wayside. So for Allison, she talked about how she actually used to do dance. I think she, she used to do ballet and one of the little kind of small things that she did for her own real self-care, while her father, her, she took care of her aging father who had dementia is there was a [00:27:00] little, she, she kind of found a little bar in the, the hospital where he was, and she would like, kind of like do little dance exercises there. I love that. Um, and it was like this really small thing, you know, that just kind of reminded her of like, no, I'm more than the roles. Yeah, I fulfill. Um, and I have interests and I have things that make me feel human and alive. And it's okay. It's okay for me to take time out. It actually, it's more than okay. Like I need to have that. Um, yeah. Coming back to the point of the conversation, we're talking about like the difference between parenting and caregiving and sort of like how. Parenting is sort of celebrated. I think it's also like, I mean, this is kind of morbid, but you know, like, right, like the end, the end goal of caregiving is that there is death, right? Like it's, it's it, so it's, it's like we're kind of, I think it really forces us to have like conversations of, ooh. [00:28:00] What is a meaningful life and how can I show up meaningfully and how can I be there to support somebody that I really care about in their journey towards an ending? Jen Fisher: Yeah, and I was gonna, I was gonna say, I, yeah, I was gonna say is when, you know, when you're talking, I'm thinking about, well, why isn't caregiving celebrated? I mean, in many ways it's one of the. Most loving, beautiful things that, that we can do for someone else in, in our life. And so that should be celebrated, um, because, you know, as, as you know, the proverbial walking someone home, right? I mean Yes, yes. What, what could possibly be more important than that? And there was, there's a book that's called the in-Between, um, that I read that was written by a hospice nurse that I think, you know, for me changed. So much about my mindset, about what my, you know, what my mother's going through and how I can show up for her and how I can just be present in the moment, whatever [00:29:00] that moment is. And she starts the book talking about how she started her career as a, as emergency room nurse, and then she went into hospice and the struggle that she had in shifting between emergency. See in hospice. Because in hospice it's really just that it's caring for the human, like for the humanity and kind of making sure that they are comfortable and treated with dignity. And you know, this is kind of that last phase and it's so important. But you know, in the emergency room in many ways, and I'm not an emergency room doctor, so please no one take offense to this, but you know that it's triage, right? Yeah. You're not really necessarily always. Thinking about the person, but you're thinking about how do I save their life without kind of stepping back and saying, if I save their life, what's it gonna be like? Whereas in hospice, it's not about saving their life, it's making sure that the end of their life and their final days are as comfortable and as dignified as they can be. And for me, that like for anybody struggling with it, this, that kind of changed everything about my [00:30:00] perspective. Pooja Lakshmin: Hmm. That's so beautiful. Yeah. Yeah. Yeah. And I Jen

Fisher: think that should be celebrated. You know, we're, we're all going to be there one day, right? Yeah. So why not celebrate it? And, and I think the part about caring for yourself and taking those moments for yourself. I what I tell myself, and I believe this, it's not just a, it's not just an excuse that I tell myself to make my feel better. My mom would want me to take care of myself. She wouldn't want me to fall apart taking care of her. That's not what she would want for me in my life. And so that's how I deal with, you know, some of the guilt. Not all of it, but some of it. Pooja Lakshmin: Yeah. Yeah. Yeah. I think that that's really important to have that perspective, and especially when that guilt voice gets loud, it's, it's, it's really important to have those other voices that you can lean on. Yeah. Um, the other thing that I'm thinking about is just how, how lonely this whole experience can be and, and how. You know, we, um, [00:31:00] especially when you're in the throes of sort of all the logistics of caregiving and, you know, all the demands in terms of like the doctor's appointments and, you know, just there's, there's so much administrative burden there. Um, it can be so easy to lose connection with the people in your life who could support you. Yeah. And, and I think that that's, that's a place where, you know, when we're talking about kind of finding whether it's like, you know, with Allison's story of the ballet and the dancing. Yeah. Um, but also like finding community and, and, and reconnecting with friendships I think can be really powerful during this time too. Jen Fisher: Yeah. I, uh, yes, very much so. And it is, it's, it's one of those things that's. Easy enough to say, I don't have time for friends right now. And then you end up saying, you end up feeling very isolated. But I wanna, actually, I could talk about this elder care conversation forever, but, but you mentioned friendship, so I actually do want to talk about, 'cause there's this [00:32:00] broader. Umbrella of kind of, you know, adult friendships beyond whether or not we're, you know, caring for, um, elderly, you know, our parents or someone that's elder to us, whether we're caring, you know, and raising our kids. But adult friendships are, are hard, you know, making and keeping real friends like as a grownup is just, I don't know. I have found it. Oddly harder than anybody tells us about. So why is it so hard to maintain friendships, especially when we need them the most as adults and like what's your take on this whole like friendship seasons? Like how we deal with friends growing apart, growing together, like just this broader topic of adult friendships. Pooja Lakshmin: Yeah, I mean, I think, you know, we all know about the loneliness e epidemic. Like I think we can probably all agree that like just in general, like as a. Society we're not very good at, at keeping friends and staying in touch. Um, and I think part of it is because it's not something that has an [00:33:00] immediate. Financial contribution to your life. And I think like, especially like in times of, you know, stress economically and, and socially it's, you know, we kind of double down on the things that we feel like are going to be keeping like, that are, that are our safety net. So whether that is like your job, right and keeping your job and making sure you have insurance and, and then your kids if you have kids or your caregiving responsibilities of kind of making sure that everyone's taken care of. And I think that we forget. Get or we don't, or we don't, we haven't learned, um, because we don't do a good job of talking about this, of just that actually, your. Friendships and your relationships are actually also just as much of a safety net in times of stress. And you know, every single study that that comes out, looking at interpersonal relationships, I mean, shows that people who have close friends do better. They live longer. They are mentally more [00:34:00] resilient. They are physically more resilient. So it's interesting how, you know, we put so much emphasis on like exercise and diet and all these things like that, but we don't do that with friendships and relationships. And I think it's because it's harder, right? Because with friendships, yeah. We're talking about like human, another human, and there's conflict and there's, you know, accountability and, yeah. What I hear all the time in my practice, um, with my patients is like, yeah, like I don't feel like I have real friends. I don't feel like I have people that I can just like call up and say like, here's what's really going on, and I think that that is something that I. We, we all need to do a better job of working on and cultivating and, you know, even dare I say it, sort of like forcing ourselves in, in like awkward situations of like actually going out and, and trying to make friends. Um, Jen Fisher: and how do we do that? Yeah. Yeah. I know you, you have a great, you have a good story [00:35:00] around this, so. Yes, yes. Pooja Lakshmin: So I, um, you know, so one piece that comes is like. Learning to actually prioritize it and make time for it. And it doesn't have to be like super big things. So I have a patient, I was telling you this earlier, Jen. Um, I have a patient who, um, her neighborhood has a, a little evening walking group. So it's just like women in her neighborhood or they, um, a couple nights a week we'll get together and they will just go for walks around the neighborhood. She kind of joined it on a whim. Like she wasn't really sure 'cause you know, 'cause she has two little kids and she works full time and you know, just a very busy life. And she's like, I just, I don't know. Like, I don't know if I can really do this. I don't really know these people that well, like I live here. But you know, we hadn't really been connected. I. But she just kind of started going. She would go once a week and um, and I was talking to her the other day

in a session and she was like, yeah, it's actually surprisingly, it's, it's been really good for my mental health just to have that like chit chat. Like these aren't my best friends, but they don't need [00:36:00] to be my best friends. To have that chit chat and physical activity and also have it something that's pre-scheduled, it's something that I do like every Thursday night. It's on the calendar where I don't have to re-litigate it. Every single week in my mind. What really struck me about that one is that it's social, right? But it's like low stakes, social, it's like an activity, right? That you can all kind of do together. So there's a reason to meet up. And two, the fact that it, um, is pre-scheduled, right? So you don't have to kind of like constantly decide or make plans. It's just kind of like, oh, every Thursday, like we all meet at this, you know, at this street. Stop sign, whatever. And then we do our little loop and, and we chit chat. Um, and it's very low stakes. And even something like that, something that small makes such a big difference. Jen Fisher: Yeah, I mean, I think that describes perfectly the psychology behind why group exercise also works. Right? You know, the, the people that love going to different types of group exercise classes, it's the, it is the. You get the physical health [00:37:00] benefits of it, but the social and mental health benefits of it too. It kind of like everything all in one, right? Pooja Lakshmin: Yes. Yes. And I think sometimes when we talk about like this loneliness thing, it's, it's easy to mistakenly think, oh, this means I need to like find a new like BFF or like, you know, I need to put myself out there and like, you know, do something like really dramatic, but it doesn't need to be. It doesn't need to be that dramatic. It could even be things like, you know, volunteering once a week at your local church. Right. Or soup kitchen or maybe signing up to do something at your kids' school. I think having a structured activity in place makes it a lot less Jen Fisher: so it doesn't leave it to chance. Pooja Lakshmin: Exactly. Exactly. And then there's something to do as well. So, so there it doesn't feel as awkward. Jen Fisher: Yeah. Yeah, coming from the introvert in me, I'm like, I don't wanna just like have to stand there and talk to somebody. I won't know what to do with my hands. You know? I think the other thing that, you know, in my conversations and, and certainly in my own [00:38:00] life is kind of like adult, like the seasons that adult friendships go through, and perhaps we go through them as kids and certainly as teenage girls. Um, but, and, and maybe in the moment they feel very extreme, but I feel like as. As like with adult friendships, like, I don't know, growing apart and growing together and like to your point, kind of feels like. A lot of work, right? Mm-hmm. Or feels very, especially the growing apart, like feels very heavy and in many ways can exacerbate like feelings of, of loneliness if you're already experiencing those. So are there ways that, I mean, I think that it's. Probably normal and natural that, you know, sometimes they're seasons in our friendships and they're not always because something bad happened or because you're a horrible person or the other person's a horrible person, but that it just happens. Are there ways, like better ways to kind of deal with. You know, the struggle or the pain that comes with that? Pooja Lakshmin: Yeah. Yeah. [00:39:00] I mean, I will say like, it, it, it sucks. Yeah. It sucks. Like it can, it can sometimes feel almost like, like a breakup. Yeah. Um, even, even if it's not that dramatic externally on the inside, it can really feel like this loss. I think one, first I would say like, it's. It's okay to grieve. It's, it's, it's okay to have that grieving period and that space of, of just feeling bad about a friendship that isn't as close anymore as it once was. So, so one, I would say that, two, I think that one thing that has helped me is just thinking, you know, now that I'm in my forties, like just thinking over like the trajectory of just. The ebbs and flows of friendships and, you know, some friendships that were, you know, were close for a certain period of time in my twenties, and then maybe not so close anymore, and then coming back together to be close again and, and how like, I guess I try and remind myself that none of this is personal, that.[00:40:00] There's so many women in my life who, you know, I say women because I, I do think that largely this is about women having relationships and friendships with each other, you know? Yeah. That we, we are all going through our own cycles and seasons, and there will be times where there's overlap, you know, where there's common struggles or common challenges that we're going through where we're kind of drawn closer to one person or another. And then that situation changes and their circumstances changes or people move or people get divorced or people have babies or whatever, and, and then you move a little bit further apart, but that there's this big sort of matrix or network, almost like a constellation maybe of stars and kind of like always moving, like nothing ever stays stagnant, I guess is, is is something that brings me comfort. So that could be one thing to use to kind of reframe for yourself. Like even if right now things feel more distant, that doesn't mean that they will always feel distant. [00:41:00] Um, and then I think we all have to work out for ourselves, sort of the interpersonal dynamics. Like sometimes there's good reason that right. People move, move apart emotionally, and maybe that's better from a boundary standpoint or, you know, kind of like an emotional health standpoint. Um, sometimes you need to give people space to work out their own stuff and trust that they'll come back when things are more resolved or things are more, um, manageable on their side. Um. So Jen Fisher: giving, giving

ourselves and others grace and compassion. Pooja Lakshmin: Generous. Being generous. Yeah. Yeah, yeah. Jen Fisher: Um, yeah, so, um, I like that. I think that that, uh, I, I, I think we could all stand to do that a little more with, with others in our life, whether they, regardless of gender, but certainly with our, with our female friendships. The one thing I wanna, the, the thing I wanna close on, [00:42:00] um, that I know that you and I both share a similar passion for, um, but you is, is hope. Mm-hmm. And you talk about hope as a practice. And so right now in a world where everything seems to feel pretty heavy right now on, on a lot of different levels, what does that actually look like in real life? Because I believe that. Many people think that, you know, that hope is, is, has, has the wrong idea about hope. So tell me, tell me how you view hope and what that actually looks like in real life. Pooja Lakshmin: Yeah, yeah. So I, I learned this framework of hope as a practice when I was a psychiatry resident at George Washington University, the former chair of our department. Um. Came up with this framework. He called it the Hope Modules. Um, and he came up with it as he was working with patients who had chronic illness [00:43:00] actually. Um, so folks who were very sick and who were dealing with things like, you know, MS or, you know, different neurological conditions that were di. Going to get worse, not better. And he found that the patients who were able to say that they were hopeful, um, this was different than being optimistic, right? But hopeful he said, was, um, being able to still. Find the good and, and to be able to, to look forward with a sense of agency. Um, he found that there were four practices, or four specific things that happened when people turned towards hope as sort of like an active process. So one was problem solving. So in times of hardship or in times of uncertainty, moving, using, using that part of your brain, your prefrontal cortex, that helps to solve problems. So that is. You know, maybe making a to-do list or thinking about what things you do have control over, or activating [00:44:00] your, your support system or your support network. The second skill is emotion regulation. So these are things that are very in the moment kind of helping your nervous system calm down. So whether that's things like movement, going for a walk, um, listening to your favorite move. Music, um, taking a cold shower. So like in those times of, of extreme stress or extreme uncertainty, doing something physically to change how you feel in your body. And this next one I think is really powerful, activating your, um, identity. So, so source is a core identity. So for example, in healthcare, finding people who, um, when they're going through really tough times, maybe will lean on the fact that they are a healthcare professional. So finding other nurses or colleagues or maybe if you're a teacher and you're going through a particularly hard time, leaning on other friends that are also teachers. Um, and then finally, uh. Activating your, your support systems, your networks, so your friends, your family, um, the people that you can [00:45:00] call on and, and chat with and text with in your group chats. Um, so, so these are all, if you notice like they're all like active things, like very specific tangible things that you can turn to. And it's funny 'cause for me, like I, I don't, I wouldn't. I don't know if I would describe myself as a hopeful person, but you know, recently, um, when, when I was going through like a particularly tough week, I, I was reading through this Hope Modules page paper again, and I was finding to myself, I was like, oh, wow. I actually had naturally turned to like reaching out to friends, you know, scheduling a coffee date with, with another woman. Author, friend, going for a walk, getting some fresh air, um, you know, strategizing, doing some problem solving. And, and it was helpful for me to see like, oh, I, I am actually doing some things to help myself feel hopeful. And it's not something that I just have to like, wait around Jen Fisher: or wish Yes. Pooja Lakshmin: Or which, right. Exactly. Exactly. Jen Fisher: I, but [00:46:00] well, and I love that. I love that realization 'cause that's. You know, that's, I think most people don't think that that's what hope is, right? They think of, of hope as, you know, positive thinking or wishful thinking or, you know, putting something out into the universe and waiting for it to happen or waiting for it to show up versus kind of taking these actions that, that are what cultivate and. Create a more hopeful mindset. So I do think you're a hopeful person. So for what it's worth, thank you. You, you also, um, you know, and I think this isn't aligned with, with hope, so I'm, I'm gonna, I, I actually have two more questions for you. This one and one more. Um. You talk about kind of small, unexpected moments, um, and maybe these make us hopeful. Certainly they make us or help us kind of seek out goodness and joy, so they're all around us, but how do we, in the world we're living in, how do we train [00:47:00] ourselves to notice them? Hmm. Pooja Lakshmin: Yeah, I mean, I Jen Fisher: think, don't turn on the news. Pooja Lakshmin: Turn on the news. I think like what comes to mind is, is that I think being present, you know, like actually being present and not, you know, having our face in our phones all the time. Um, and I say this to myself too, like fully with a phone addiction and that I need to, you know, constantly be reminding myself to put my phone down, put my phone down, but actually be like living in the moment to notice I. When things are happening, when, when there's good out there in the world, or even just small things like, you know, uh, a, a neighbor stops by because you know, the wrong package got delivered. And, and you take a moment to actually chat and ask like, how's your week going? What's

going on? What, how are the kids, you know, where you actually stop? And again, the pause, the pause to notice and appreciate and actually be living in that space. Um, I. You know, I think that when, [00:48:00] especially in times of political turmoil and everything that's going on in the United States, I think actually allowing ourself to have those moments of peace and contentment and like real connection with the physical world around us and like our actual communities that we live in. Um. I think that that's actually a powerful form of resistance and, and actually resilience too. Um, because so much of, you know, of the news and just everything that's around us is like doom and gloom and, and, and, and, and just so many scary things that are happening that to actually come back and say, well, yes. And it's also up to me to find places in my life where I can have small moments of peace and joy, um, because. If you don't cultivate that, then that's when you risk becoming cynical and burnt out. Yeah. Jen Fisher: Yeah. For sure. So, Puja, last thing, like what's giving you hope right now? Like really giving you hope? Mm-hmm. I don't want, I don't, not, not that any of this has been [00:49:00] polished, professional guard, but I want the real answer. Pooja Lakshmin: Yeah. Yeah. What's giving me hope right now? You know, I have a two and a half year old. Um, he's almost, he'll be three in June and I do feel like there's something really special about. Seeing, um, just his little brain developing and, you know, just like the innocence and the curiosity that was coming out from him of, of just his surroundings and the world. Um, I, I, you know, I think it's, it's. It's a combination of like hope and worry for sure of the world that we're leaving for the next generation, but also just understanding that, um. That there's so much good. Yeah, there is so much good. And I think like, spending time with young people I think is, is a reminder. And I'll say one other thing. I, I did a speaking engagement a few weeks ago at, um, at a school in New England. Um, and so getting to [00:50:00] be around high schoolers that were just, Jen Fisher: yeah, Pooja Lakshmin: so earnest and, and really just like care so deeply, um, about. The future and, and what they're, what they're trying to build and what they're doing. Like these kids are so smart. Um, that, that made me hopeful. Um, yeah. Too. Yeah. Jen Fisher: Yeah. I, I, I definitely agree with that. Seeing, seeing the world through the, the eyes of. Someone younger than you. Mm-hmm. Um, I think that's a, a good, uh, uh, a good last piece of advice. So, Puja, thank you for being on the show again, amazing as I knew it would be. And I, I, I will always be in conversation with you anytime. Pooja Lakshmin: I feel the exact same way. Jen is such a pleasure to come back and, and I can't wait for the next time. Jen Fisher: Today, I am thrilled to bring you another installment of our LRA lens segment where we dig deeper into the practical applications of [00:51:00] wellbeing science. I'm joined by Dr. Kendall Brown, clinical psychologist and director at LYRA Health, who's here to share some game changing strategies about a challenge so many of us face, particularly women, Kendall. In a world where women are constantly asked to do it all, how do we decide? When to say yes, when to say no without the guilt. That so often comes with setting boundaries. Kendall Browne: Absolutely. Jen, you know, as a mother of two young children, this topic is really near and dear to my heart. And I'm actually, I'm actually gonna use a phrase you shared in the episode because I think it captures my recommendations so perfectly. And in the episode you talked about habitualizing, the pause. So when we are being constantly asked to do more, we're getting pulled in all sorts of directions. It's critical that we hit pause and actually give ourselves a moment to just really consider what we're being asked and what the implications are specific to that ask. Jen Fisher: It seems so simple, yet in [00:52:00] practice it's really, really difficult to implement. What are some practical ways that can help make this a real habit rather than just saying, oh yeah, I should pause. It's a good intention, but I never do it. Kendall Browne: A hundred percent. Yeah. I, I want to first acknowledge that a lot of this can feel easier said than done. And I think this is especially true when many of us have been conditioned or really reinforced for saying yes all the time, you know, for sort of constantly giving of ourselves. So let's make this really tactical and talk about steps we can take to plug this into our busy lives. And the first step I recommend is coming up with a go-to response to use when someone asks you to do something. So yeah, having a response ready to go, that actually helps you hit pause and it can be something really easy and quick. Something like that might work. Let me check and I'll get back to you or thank you so much for thinking of me, and I love this recommendation when I first came across it because I found that having a response at the ready can really get you into the habit of hitting pause. But then what do you do? Once you actually [00:53:00] hit pause, what happens next? You know, you've bought yourself some time to really play the line out about what could happen if you say yes or no, and it doesn't have to be a long drawn out process. You can do this by asking yourself a series of quick questions. So the first question I like to get people thinking about is, you know, do I have a choice here? This is something where you actually say yes or no, or you have a choice. The second question is, does this actually align with my values? Is this gonna be something that moves me toward the things I care about that are really meaningful to me? If you can say no, and it's not something that's gonna help you move towards those things, might be something to consider taking a

pass on. But you know, if you do have a choice and it does align with your values, the third thing you can ask yourself is, do I actually want to do it? And I wanna be really clear here that I'm not saying, you know, I'm saying do I want to do it and not do I feel like I should do it? Hmm. You know, those are two different things that I think can often feel like one, especially if you're really used to giving a lot of weight to other people's needs above your own. [00:54:00] And then, does it actually make sense for me? Is this in my best interest? And here's where I think it can be really helpful to think about what the cost would be. If you do say yes, you know, what does that mean for your current bandwidth? What might you actually have to say no to down the road if you do say yes to that. And then if you've gotten through all of that and you're still thinking, yeah, okay, maybe I'll do this, you know, really thinking, is this actually in the best interest of the person asking? And this one is always really interesting to me. You know, sometimes I realize that it's actually in everybody's best interest to draw a boundary, because it's gonna mean that I have more bandwidth, that I'll be actually more supportive to that person who's asking and to myself, if I say no, Jen Fisher: I wanna talk about. Boundaries too, right? Because I mean, I think there's this idea of habitualizing the pause and then there are true boundaries. I think everyone struggles with boundaries. So can we talk about that and why they're so uncomfortable for us to establish for ourselves? I. Kendall Browne: Absolutely. And you know, the pressure [00:55:00] to respond is very real. I think particularly at work, what I've found for myself is the more I use that go to response to hit pause, the more I run through those questions we just walk through, the more it builds that sort of muscle memory and it really does. It becomes easier, it becomes quicker. It's this kind of thing you can click through in your brain, but it's really not at all uncommon for women or really anyone, to your point, Jen, to struggle with what we can call porous boundaries. So this is essentially where you get into a pattern of almost always saying yes. You know, even when you actually wanna say no, it almost doesn't even matter who's asking. You feel just constantly pulled to give of yourself. And on the opposite side of the spectrum, you may find that you have what we can think of as inflexible boundaries. And this is when you find yourself rarely or even never saying yes to new things. And this can actually happen if you've had porous boundaries for too long and you're just sort of at your breaking point, you're overwhelmed, you're run down. So it's this means of self-preservation to just say no to it all. And while you may be keeping out tasks or things that could cause further [00:56:00] overwhelm, you also can find that you're keeping out activities that could be supportive or positive. So really the aim of Habitualizing, the pause is to be somewhere in the middle and to have what we can think of as purposely permeable boundaries. You are not always saying yes. You're not always saying no. You're using that pause in some of the questions that we talked about to just really consider is this ask aligned with what is important to you and is it in the best interest of you and the person asking. What we know about boundaries is that they actually help us maximize our time, our attention, our energy. They help us increase our productivity. It means you have time to recharge so that you can actually be more helpful to others, more motivated and able to engage in life at work and at home. I think another truth bomb that we can hold onto is that boundaries can actually help us build and maintain healthy relationships. 'cause they allow us to build trust. You know, I think we all sort of intuitively know this. We think about people where, you know, if we kind of understand their boundaries, we understand what we can expect from [00:57:00] them. We understand sort of the when and how of how we're gonna work together that can feel like a more supportive relationship. Than when someone is maybe over promising and not delivering. Jen Fisher: Dr. Kendall Brown, thank you for these incredible practical insights to our listeners. Continue to join us for more Lira lens conversations as we explore the science behind workplace wellbeing and mental health. I am so grateful Puja could be with us today to help us understand the real challenges women face and how we can find hope through connection and authentic self-care. Her insights on elder care, friendship, and cultivating hope, give us practical tools for creating more supportive and understanding workplaces. Thank you to our producer and our listeners. You can find the Work Well podcast by visiting various podcast catchers using the key word work Well all one word to hear more. And if you like the show, don't [00:58:00] forget to subscribe. So you get all of our future episodes. If you have a topic you'd like to hear on the Work Well podcast series, or maybe a story you would like to share. Reach out to me on LinkedIn. My profile is under the name Jen Fisher. We're always open to recommendations and feedback and of course if you like what you hear, please share. Host and like this podcast. The information, opinions, and recommendations expressed by guests on this podcast series. Are for general information and should not be considered professional advice, diagnosis, or treatment. Always seek the advice of your physician with any questions you may have regarding a medical condition. The podcast owner, producer, and any sponsors are not liable for any health related decisions made based on the information discussed. Thank you and be well.