burnout

Burnout: The Secret to Unlocking The Stress Cycle

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Burnout: The Secret to Unlocking the Stress Cycle

by Emily Nagoski and Amelia Nagoski

“The problem is not that we aren’t trying. The problem isn’t even that we don’t know how. The problem is the world has turned “wellness” into yet another goal everyone “should” strive for, but only people with time and money and nannies and yachts and Oprah’s phone number can actually achieve.”

Sometimes a book comes along at the exact right time in your life. Sometimes, that’s a book you probably should have read three degrees ago. This book is exactly that for me. It provided a brand-new way of looking at stress in my life by separating stress from stressors. They write:

“Dealing with your stress is a separate process from dealing with the things that cause your stress. To deal with your stress, you have to complete the cycle…Stressors are what activate the stress response in your body. They can be anything you see, hear, smell, touch, taste, or imagine could do you harm. There are external stressors: work, money, family, time, cultural norms and expectations, experiences of discrimination, and so on. And there are less tangible, internal stressors: self-criticism, body image, identity, memories, and The Future. In different ways and to different degrees, all of these things may be interpreted by your body as potential threats.”

A failure to go through and resolve the stress cycle can result in burnout, which was “first coined as a technical term by Herbert Freudenberger in 1975. ‘Burnout’ was defined by three components: 1. emotional exhaustion—the fatigue that comes from caring too much, for too long; 2. depersonalization—the depletion of empathy, caring, and compassion; and 3. decreased sense of accomplishment—an unconquerable sense of futility: feeling that nothing you do makes any difference.”

If we’ve known about burnout for so long, how is it that we’re just now figuring out how to fix it?

This is not quite a rhetorical question. The answer is: Because it’s hard. If everyone knew how to combat burnout, we would all be doing it! (And the monetized “experience of self-care” that’s sold by the capitalist machine will go away, but that’s for another time…) Part of the problem is that we’ve been looking at stress the wrong way. “The good news is that stress is not the problem. The problem is that the strategies that deal with stressors have almost no relationship to the strategies that deal with the physiological reactions our bodies have to those stressors. To be “well” is not to live in a state of perpetual safety and calm, but to move fluidly from a state of adversity, risk, adventure, or excitement, back to safety and calm, and out again. Stress is not bad for you; being stuck is bad for you.”

To get un-stuck, the Nagoskis’ write, we must move. Run, dance, kickbox, tense and release muscles, and, most importantly, breathe. The book has other great tips, as well as a way to plan out all of the options you have for completing the stress cycle.

So the real question is: How are you completing the stress cycle today?

helping kids with transitions

5 Tips for Helping Kids with Transitions

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Many children, with and without disabilities, have difficulty managing transitions. This is especially true when you’re moving from a more preferred activity to a less-preferred activity. Who hasn’t had the battle of bedtime, especially when kids are involved with a fun project, watching tv, or playing right before? Here are some practical tips to help with transitions.

  1. Use a visual schedule or checklist

I live by checklists and schedules for myself, and have found that many of my clients have a reduction in stress, tantrums, and meltdowns when a schedule is provided to them. If your child can’t read yet, a combination of pictures and words (to reinforce reading!) can be really helpful. Try a wipe-off board where you write (and check off!) the list for the morning, or a folder with laminated pictures velcro-ed to it.

  1. Use a timer

Many kids have success with visual timers and 10 or 5 minute warnings. If your child can’t read an analogue clock, use a digital one, or use an analog that has a colored portion that ticks down, so they can see how much time is left.

  1. Think forward

In behavioral circles, this is known as FIRST-THEN, as in “first put your toys away, then we’ll go make lunch.” Setting it up this way helps ease anxiety about what’s coming next. You can also do this by reminding your child when they will have the opportunity to engage in the activity you’re asking them to transition away from again. “We have to put up the toys now, but after dinner, you will be able to play again.” I sometimes pair this with an IF-THEN. “If you can show me how quickly you can clean this up, then you’ll have more time to play later!”

  1. Make transitions fun

This can be especially helpful when you have to move from one extreme of activity level to another, i.e., a very active event to a very quiet one. As you transition, you can have your child pretend to be an animal or use their imagination to sneak to the next activity. If we have to go from playing outside to naptime, I build in about 10-15 minutes to pretend that we’re mice and we have to sneak past a cat, or pretend that we’re sneaking into a bank to jump in the vaults, Scrooge MacDuck style. It works similarly in reverse—pretend to be an airplane, careening down the hallway, or a T-Rex, stomping to your next destination.

  1. Provide choices

Another tip from the behavioral sphere: forced choices work well, and aren’t as horrible as they sound! Essentially, as the parent or teacher, you give two options that are equally palatable to you. “Do you want to use this pencil or that one to do your math?” “Do you want to take your shower before or after dinner?” The key is holding the child accountable for the choice that they made, and following through. We all like to feel like we have choices, and this is one way to give your children choices without letting them run the show.

  1. BONUS TIP! Teach calming skills

None of us are born knowing how to self-regulate. We all have to be taught how to calm ourselves down when we are over-stimulated, upset, angry, or sad. When children are small or have neurological challenges that make it difficult for them to follow multi-step directions, we have to co-regulate with them. Researchers Grolnick, Kurowski, McMenamy, Rivkin, and Bridges[1] identified multiple ways caregivers can co-regulate with children:

  • Prompting/helping: Caregiver physically or vocally prompts and scaffolds child (e.g., physical prompting with toy if child becomes frustrated)
  • Following the child’s lead: Caregiver is sensitive to child’s interests and follows the child to his/her desired toy/activity (e.g., Caregiver may appear to wait for child to choose a toy and then insert herself into interaction)
  • Redirection of attention: Caregiver distracts the child or directs the child’s attention away from negative stimulus (e.g., pointing out other toys in room)
  • Active ignoring: Caregiver actively ignores child during distress episodes (e.g., mom may continue to play with a toy or purposely turn away from child)
  • Reassurance: Caregiver reassures or encourages child surrounding frustrating or negative activity (e.g., It’s okay. You can do it!)
  • Emotional following: Caregiver’s reflection, extension or elaboration upon child’s distress or preoccupation (e.g., I know you want the toy)
  • Physical comfort: Caregiver initiates behaviors to comfort child (e.g., hugging, kissing, picking up the child, rocking)
  • Vocal comfort: Caregiver initiates vocalizations to comfort the child (e.g., sshhing, singing, sing-song voice)

[1] Grolnick, W. S., Kurowski, C. O., McMenamy, J. M., Rivkin, I., & Bridges, L. J. (1998). Mothers’ strategies for regulating their toddlers’ distress. Infant Behavior and Development, 21(3), 437–450. http://doi.org/10.1016/S0163-6383(98)90018-2

 

family estrangement

Things We Don’t Talk About: Family Estrangement & Cutoff

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Content note: This post contains mention of childhood abuse and trauma. Please exercise discretion if this is something that may be triggering or upsetting.

This is part of a continuing series of “Things we don’t talk about,” also known as “Why people are in therapy” and “the elephant in the room.” While many therapists work with people who are estranged from family members. Not as many will acknowledge that there are times and events that make it appropriate to limit or even cut off contact with a family member. With more frequency, I am discussing and hearing about adult children who have experienced this with a parent. More often than not, the estrangement comes after years of verbal, emotional, physical, and/or sexual abuse. I often find myself asking the critical question: If you were not related to this person, would you continue to have a relationship with them?

I’m very lucky to have the parents that I have. I would still be friends with them even if I wasn’t related to them. Their parenting wasn’t perfect (no one’s is!). But they learned from their mistakes and tried to repair any tears that happened in our relationship over the years. They set appropriate limits with me and my sister, held us accountable when we broke rules, and raised us with the knowledge that we were loved and cared for.

It is appropriate to set boundaries.

Remember, boundaries are not for the other person! They are for the person setting the boundary, in order to draw the line and set a healthy limit on what is (and isn’t) acceptable. Sometimes cutting off contact is the healthiest thing to do. However, there’s a narrative in our culture that says that children should always love and be connected to their parents. When some of my clients have shared with friends that they don’t speak to their parent(s), they hear the old saying: Blood is thicker than water.

That phrase is often used to force someone to continue a relationship that not only isn’t healthy, but is actively harmful. But that’s not the whole saying. The whole saying is: The blood of the covenant is thicker than the water of the womb. Translation: the promises you make to people are more vital than a biological tie. With the help of a supportive therapist, you can start to learn your appropriate boundaries and work on setting them. When people violate those boundaries, they’re showing you who their covenant is with—and it’s not you.

out of the darkness

Out of the Darkness

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Hank Buckwalter, his wife, Chelsea, and Rommie and I participated in the Out of the Darkness Walk this past weekend at Waterfront Park.

It can be emotionally overwhelming to be in a gathering of people that are celebrating the lives and passing of their loved ones. I listened as the “Honor Beads” were given to the family members and friends of those who had taken their lives. They celebrated these beautiful humans that saw only one solution to the pain they were experiencing.

I lost a friend of 47 years this year to suicide. He was in a lot of pain. At his memorial service, an acquaintance commented, “I can’t believe Jeff took his own life.” I forgive him for his insensitivity. As much as I miss Jeff, our laughs, our High School pranks, our wonderful conversations on his deck near Hikes Point, I understand why he took his own life. He was in pain.

I struggle with the legality and morality of suicide.  Having said that, I will do everything in my clinical and personal power to prevent others from taking their own lives.

People need hope and when they lose hope

 they see very few solutions to their problems.

I wrote a blog a year ago about hope. Here is what I said:

People come to therapy because they have feelings of hopelessness. As a young therapist, I was inspired by Moltmann’s admonition, to be an instrument of hope. At the very heart of therapy is the goal of helping people find hope, because without it they cannot live. I believe that hopeful people inspire hopefulness in others. A hopeful therapist has many tools and strategies for helping people, but most important they inspire hopefulness. I believe they infect people with their hopefulness. They engage in a Therapy of Hope.

If you have thoughts of suicide, even fleeting thoughts, contact a therapist. We have included the suicide hotline number on our website. Call it and make an appointment. In Kentucky, all therapists are required to take a workshop every three years on suicide prevention. Make the call.

After the walk this past Saturday, Hank and Chelsea, and Rommie and I went to First Watch and had breakfast together. We reverently celebrated life.