October 15, 2024 • 28 mins
It's time to talk about the mental health impact of *parenting*... and what we can do about it. Join me and our special guest, Ashley, a working mom, as we explore practical tools and exercises to recognize and address signs of BURNOUT. This episode is for parents AND for all of us who need to take care of ourselves so that we can care for others. We talk about practical tools like:
** The stress continuum: Are you green, yellow, orange, or red?
** 'What's on your plate' or 'What's on your mind?': Exercises to assess and reprioritize responsibilities.
*** Self-care that WORKS to recharge mentally and physically: including social connections, creative expression, and exercise
Check out our website PsychEd4Peds.com for more resources.
Follow us on Instagram @psyched4peds
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dr. Elise Fallucco (00:00):
Welcome back to PsychEd4Peds, the child
(00:02):
mental health podcast forpediatric clinicians, helping
you help kids.
I'm Elise Fallucco Childpsychiatrist and mom.
Now many of you may already knowthat United States surgeon
general, Dr.
Vivek Murthy recently released asurgeon General's advisory on
the mental health and wellbeingof parents.
(00:23):
Now this advisory highlightedhow parenting can lead to
significant stress and burnoutand negatively impact our mental
health.
And one of the stats that heshared was that about half of
parents say most days, theirstress is completely
overwhelming.
So today we're going to talkabout stress and burnout in
(00:43):
parents and share a couple ofpractical tools and exercises to
help us realize when stress isaffecting our mind and body.
And.
More importantly, talk about howwe can fix it.
/So to help me with this, I'mreally delighted to have a
special guest with us who is aworking mom with two kids in
elementary school.
She has graciously agreed tohelp me demonstrate how to use
(01:06):
some of these burnout tools anddo some of these exercises with
us.
So please join me in welcomingto the pod Miss Ashley.
Ashley (01:15):
Hi, Elise happy to be here.
Dr. Elise Fallucco (01:18):
Thanks so much for being vulnerable and
for showing everybody how we usesome of these tools, because I
think it's more interesting whenyou get to see them in practice.
One of the universal truthsabout burnout is that we tend
not to notice when we'repersonally burned out until it's
very late.
My friend from med school,Bianca used to talk about this
analogy all the time of thefrogs in the pot of hot water.
(01:39):
I don't know if you've heardabout it, but basically the idea
is like we're frogs in a pot ofhot water and the temperature
gradually rises.
And the frogs hardly registeredthe difference.
They notice maybe it's a littlebit hotter who knows.
Until the point that the wateris boiling.
And then they're in completetrouble.
So I feel sometimes like thatfrog in the pot of boiling
(02:00):
water.
And I have no idea how I gotthere.
This has been totally true in mylife.
This definitely resonates withme and I don't think I ever
really.
I recognize when the water iseven starting to boil it's full
on when it's boiling and alittle detail here is that I
have recently reached that pointin my life of complete burnout.
(02:21):
And I am flailing to try andstay alive in this boiling pot
of water.
So this is me right now.
Yes.
Oh my gosh.
We need to get like one of thoseskimmers to.
To get you out.
But I think like this.
Sadly this half that can happenso easily because it's really
hard to recognize it inourselves.
And in an ideal world, we'd beable to identify when we're
(02:43):
starting to become less healthyand a little bit more stressed
and weed.
No, what to do and get help orintervene before we get to the
boiling point.
So to speak.
This is where our first toolcomes into play.
This tool that I've used withpediatricians, with parents,
with various adults.
This tool that I'm about to tellyou about has helped me check in
(03:04):
with my stress level and it'scalled the stress continuum.
And basically.
This tool is first created bythe us Marine Corps for use in
combat settings.
And it's used to help usidentify how stress is currently
affecting our body and mind.
So instead of, it being an onoff switch, like I'm burnt out
or I'm not, it's.
(03:24):
This tool categorized as stress,according to a color system
where green is ready andhealthy.
Yellow is reacting, or ratherstarting to experience some
unhealthy responses to stress.
Orange is injured from apsychological perspective.
And red of course is not whereyou want to be.
(03:45):
And that's considered critical.
I'll go into a little bit moredetail about what each of these
categories is about so that ourlisteners can figure out where
they currently fall on thestress continuum.
So green is obviously the idealstate you've got healthy sleep.
You're spiritually andemotionally healthy, physically
healthy.
You are emotionally available,practicing gratitude and have a
(04:07):
sense of mission.
So this is where we want to be.
And obviously we're probably notgoing to be there all the time,
but that's certainly the goal.
And then yellow is consideredreacting, but it's when you're
starting to fall away from that.
So that's when you start tonotice a little bit of sleep
differences maybe you're gettingtired during the day.
You have some fatigue.
You have a shorter fuse.
(04:28):
You might be a little bitirritable.
You're noticing you're lessmotivated, maybe cutting
corners.
You're not so creative.
That's your yellow state.
And then orange is usually astate where you're having pretty
significant sleep issues.
You feel a little disengaged inyour relationships.
You're exhausted, not just alittle tired, but super tired.
(04:50):
Exhausted.
You may have physical symptomslike headaches, stomach
problems, worsening of chronicillness.
And.
Orange would be considered.
Burnout.
Entering into the burnout phaseand then red is beyond burnout.
That's where you would haveinsomnia, we'd expect to see
more major mental healthproblems, like anxiety, panic,
(05:12):
depression, thoughts of suicide,hopelessness.
And potentially intrusivethoughts and really broken
relationships.
So Ashley, what do you thinkwhen you see this scale?
I think.
Many individuals often just blowpast all of these different
colors and then find themselvesin the orange to red zone.
(05:32):
And I think looking back at thispast year as a working parent, I
could say that in January I wasmore in the green zone and then
steadily throughout the year, Imoved into the different
subsequent zones.
So I started having aninteresting time at work with a
very toxic boss and the wholeentire organization was really
suffering from it.
(05:52):
And so at that point, I foundmyself getting really tired and
changes in attitude about, work.
And lack of motivation at work,because I didn't want to work
for somebody who didn't valuetheir workers.
And then a couple months later,I started having to deal with
some health issues with my kids.
(06:13):
And so adding that on top of thework issues, I slowly started
finding myself more exhaustedand numb to things at work and
that burnout.
And you talked about it in oneof your recent episodes, having
the cynicism and disconnectionat work and not really caring
about the end result of my work.
So that squarely started puttingme in this orange zone.
(06:35):
And now I would say I'm notquite at the critical point, but
I'm starting to see some of thatstuff creep in.
I definitely have some anxietyand then I do find myself.
Like very focused on cleaningand organizing around my house
when I feel out of control,because it is my way to try and
exert control in a chaoticsituation.
(06:56):
So I think if I had been lookingat this continuum earlier in the
year, I would have been able toput my feelings and my physical
reactions on this continuum andto see them and be able to try
and step back and try and dealwith those colors before they
kept progressing.
Thank you so much for sharing.
(07:16):
And I think like what you'vedescribed, I think a lot of our
listeners can relate to.
I think for a lot of us, itstarts with having some sleep
problems, which then affect yourenergy level during the day.
And then it feels like you'rejust losing your spark the irony
of all of this, or I don't evenknow if it's ironic is that I
stumbled across this stresscontinuum when I was preparing a
(07:37):
Burnout workshop for some of ourlocal pediatricians during the
start of the pandemic.
And the goal of the workshop wasfor us to help them.
Identify and manage, stress andburnout and et cetera.
And when I was practicing onthis stress continuum by looking
at it regularly and trying tofigure out where I was, I was
shocked.
(07:57):
I was, squarely in the orange.
And I'm just thinking, why am Ileading the workshop in burnout?
I'm completely orange right now.
But more to the point that youcan't tell.
Yeah, I think you can't tell.
And I think also some peoplemight look at this and say, oh,
I'm in the green because that'swhere they want to be.
So when you do this continuumexercise, you really have to be
(08:19):
honest with yourself anddetermine where you are as
opposed to where you want to bein, where you want to project
yourself, how you want toproject yourself to others.
And I think if I had this toolright.
Six months ago, and I noticed Iwas tired and maybe in the
yellow zone.
If I had noticed that I wastired and saw the other symptoms
in this category, I might've hada better tool to help me realize
(08:43):
I was burning out becausethinking just of fatigue in and
of itself.
My mind started thinking of,okay, what is wrong with me?
Do I have a cold?
Am I physically sick?
I didn't have the other.
List of things to realize thatthis was more of a psychological
and mental health issue.
And so having this in front ofme, checking in do I have any of
(09:04):
these other things?
Could that fatigue be somethingelse?
I think it would have helped mereadjust.
And I also wonder if there areother tools to use at each color
to help you course correct.
So is there something I could dowhen I'm in the yellow zone
versus something I could do inthe orange zone?
Zone to help me get back to thatgreen.
(09:26):
Having self-awareness of whereyou are is really important.
And to your point, I think it'sa great idea to think about what
are you going to do with thisinformation?
So if you're green, I think youpat yourself on the back and
you're like, woo, this is great.
The I'm managing the stressreally well.
Like I'm still able to do this.
I still have a sense of mission.
And I'm feeling like overall I'mhealthy and things are going
(09:47):
well.
And you may even want to selfreflect and try to figure out
like, what am I doing?
That's helping me stay healthy.
What are the things that arecharging my battery and.
Helping me be super resilient atthis point.
Yeah, that's a really goodpoint.
I think a lot of times we focuson the negative, like what is
going wrong or what is making usfeel bad instead of looking at
the positive.
Focusing on those good thingscan help you realize how you can
(10:10):
get to that really good spotthat you want to be at.
Definitely.
Yeah.
And then let's say you're in theyellow, which is you're
reacting, or you're starting tonotice that stress is affecting
your mind and your body.
And you're having sleep problemsor whatever else.
I think the question at thatpoint is what can I do, maybe.
Is there anything I can do tofix this?
Do I need to make some changesat work or at home, or to try to
(10:37):
take care of myself better,whatever that looks like.
Before it gets worse.
And I think that's what Istruggle with too.
Because I can identify that I'mstruggling with something, but
there's only 24 hours in a day.
So how do I make room?
For more sleep when I have allof these other commitments and
responsibilities to do.
In a day.
(10:57):
And so I think that is where Iwould love help with as well.
Yes.
That is a great segue to ournext tool that we're going to
talk about.
So this next exercise is calledwhat is on your plate?
And basically for this exercise,you get a sheet of paper or an
actual paper plate, whicheveryou want to use, and you either
(11:19):
write down or draw out thevarious projects and
responsibilities that are onyour plate.
And this can be, it's reallyhelpful to be as inclusive as
you possibly can.
What are the specific projectsat work that you're involved
with or what are the specificthings that you're doing at home
or responsibilities?
With your family and make sureto include, your own personal
(11:41):
outside of work and home orextracurricular activities too.
So for.
And it may be a little bit hardto visualize and everybody does
this in a different way.
And you can use your creativity.
But if I think like right now,my plate is filled with thinking
about the kids, variousactivities Cross-country or
sports and their upcomingevents.
(12:02):
And then we've got an upcomingtrip to our annual child
psychiatry conference, which ofcourse is across the country.
And I just transitioned to a newjob and.
I'm just naming some of thesethings starts to stress me out a
little bit.
But I think the more granularyou can be, the more helpful it
is to just visualize here arethe things that I'm taking care
(12:23):
of right now.
And potentially, are there anythings on this plate that I
could delegate or that I maybedon't need to be spending as
much time on?
But Ashley, what did you thinkwhen you did the plate exercise
or how did you approach it?
I've done a similar exerciselike this before, and I think
what I really like about the wayyou framed it is getting into
(12:45):
that nitty gritty, granulardetail, because when I've
previously done it, I've justseparated out work from family
and myself.
Whereas the granular reallyallows you to dive deep into
those specific projects andreally understand how you're
using your time.
So I had a much harder timedoing this exercise after your
(13:07):
guidance on that granularity.
Because you really have to thinkabout all of those little
things.
So when I did my plate, I reallytook it literally and drew a
steak on my plate and thatrepresented work for me.
And then I had mashed potatoeson the side and that represented
my husband.
And he's going to love.
(13:28):
Mashed potatoes.
Mashed potatoes with gravy.
That's a really delicious.
So he gets the delicious one.
And then I did green beans andthat represented my kids because
here a point where you'retalking about.
All of the things that your kidsare doing.
Each green being for merepresents, different practice,
swim lessons, a play date,school meetings, whatever it is
(13:49):
for my kids.
And then I had a very tiny sidesalad and that was for me.
Each element of the saladrepresented a different type of
volunteer work that I do, or anelement of the salad, we'll say
cucumbers because they're myfavorite.
Those represent the funactivities I get to do like with
my friends What I did findmissing from this exercise is a
(14:11):
lot of women these days inparticular talk about the mental
load and it's the running to-dolist.
In your head, right?
So while this plate separatesout all of the different
activities, I do it didn't quitecapture that constant worrying
concern in my head of, okay.
I have to call the doctor andmake this appointment and I have
(14:31):
to contact this friend to set upa play date for my kid.
And oh, there's the birthdayparty this weekend and I have to
buy a gift and oh, I have tosend the Christmas gifts.
Oh.
Week in advance so that theyarrive on time.
All of those smaller activities.
And so I like to also thinkabout another way of how to do
this exercise, which is likedrawing a brain.
And I came up with this ideabecause my six-year-old son
(14:53):
actually came home recently.
Having done this himself on hisown unprompted.
And it was very sweet because,he had a brain and inside of his
brain was video games, dronemovies, all the things that he
either loves doing or the thingshe wants to ask for Christmas.
You start early, starting veryearly.
(15:13):
He has written out three listsat least already.
Oh my gosh.
But taking that hint from him, Ithink, I actually did it after
he brought his home to show himwhat mine looked like.
And I think you can use all ofthe things that I used on my
food plate and put that in mybrain, but I can also have a
section within that brain thatcaptures those running lists of
(15:34):
questions.
It's just a little bit morevisual to get at what is always
going on in my brain.
So it's more of the physical andthe psychological and mental
part of.
Things.
I really love that.
I love the idea of the brain.
Like instead of what's on yourplate, it's what's on your mind.
What's taking up your brainspace.
Yes.
(15:54):
And I agree with you.
There's a lot of people who'vetalked about the mental load.
Sometimes particularly heavy forwomen or for whomever is in
charge of the day to dayoperations in the house with the
kids and with the family.
And that, and also the personwho's more likely to get called
by the school when the kid issick or bite somebody.
(16:15):
Although my kids have not beenbiting anybody.
Recently.
That's good.
I think that emotional load,that mental load also really
contributes to that.
That burnout.
Because even if I take a momentfor self care say I take a
bubble bath or, go exercise.
Guess what I'm thinking about inthose moments, all of those tiny
little things.
(16:35):
And so it's really hard tounplug from that constant
running list of things.
And I think that's also whatadds to the fatigue, why people
are tired and can't sleepbecause they can't turn their
brains off.
Even when you're taking a bathor trying to relax, even if you
relax your body, which is great,you still have the running mind
or the monkey mind.
Are there things that you can doto recharge your battery to help
(16:58):
you feel?
Not only physically.
Restored, but also mentally andpsychologically restored.
And, for some people that's yogafor some people that's
meditation.
So I typically find meditationand baths and all the things
that I'm told to do to quiet mymind as not super helpful in
recharging my battery.
And I think that's because Ireally thrive on being an
(17:21):
extrovert and doing things it'svery hard for me to sit on my
couch and do nothing.
So there are a couple of thingsthat I would love to highlight
to your listeners because I knowthey really help me feel like I
have.
Have rejuvenated and I havereached out to.
Other people and found some joyand happiness.
(17:41):
And so one is social connection.
I love talking to my friendsgoing out for dinner, whatever
it is, just having thatconnection with friends and
family and having a break fromthe daily grind of work and life
at home is huge.
And so that can be hard as aworking parent with your
(18:01):
schedule or trying to find ababysitter, but any chance you
can find to incorporate thatinto your daily.
Life I think is huge.
Second of all, I think creativeexpression is very helpful, so I
know not everybody he loves artsand crafts or painting, but I do
love those things and that hashelped me as well.
(18:23):
And it sometimes results in anunfinished painting or an
unfinished, necklace that I'mmaking, but it still is a way to
focus on something that'smindless aside from your other
daily responsibilities I lovethe idea of the unfinished
painting because the whole pointof creative expression is just
(18:44):
to express yourself in some way.
We're such a S capitalisticsociety that's all about
productivity and checking thingsoff lists and the beautiful
thing about creative expressionand about play in general is
that it's not about the endproduct.
It's just about enjoying theprocess.
Exactly.
I think the definition of playis basically doing something
like some sort of activity.
(19:06):
With no purpose.
Yep.
Yep.
I read that definition recently.
And you hit the nail on the headbecause I'm an example is my
husband and I used to go out fordinner for date nights.
And we suddenly realized weactually hate dinner date nights
because we go out and we'd talkabout the kids and we talk about
work.
And so there's no realrejuvenation and recharging for
(19:26):
us.
So we have realized that we liketo do activities together that
allow us to just totally havefun.
There's no purpose, no end goal.
And so whether it's going outand hitting golf balls or going
out on a boat or whatever it is,That has really been a better
thing for us.
To connect over, cause it forcesyou to get outside of your heads
(19:48):
and your to-do list and okay,you're my co-manager for the
family or like for our family inincorporated.
And so let's take care of itbecomes a business meeting
sometimes.
Yes, exactly.
And so if you're distracted andyou're playing mini golf or
taking, maybe taking a long walkor just doing something where
it's not a setup for having abusiness meeting, then.
(20:09):
You can actually physically andemotionally recharge.
Yes.
And I think the third thing Iwould advocate for your
listeners to do is to exercise.
And I know, doctors oftenrecommend that and sometimes it
can be hard because it makes itfeel like a chore.
I know sometimes exercise feelslike a chore for me, but I have
recently gotten back intoswimming with Elise and it's a
(20:31):
two for one, because I get theexercise, but I also get to
connect with Elise and the otherteammates.
And it's been really great.
And I feel like I am totallyjust happier, more at ease.
And swimming laps for me, allowsme to tune out everything in my
brain.
And I've only ever really hadthat with two different types of
exercise, a swimming and B yoga,where my mind just goes blank.
(20:55):
And so that's really beenanother way to help recharge my
battery.
Yeah.
And the, just any type ofmovement, it doesn't even have
to be like breathtaking you'reunderwater.
And you're like, Gasping forair.
Yeah, no, not at all.
Even just a walk with a friendor walk your dog today.
I did that with a friend and itwas great.
We got out it's cooler nowoutside.
(21:16):
And so we had a really lovelytime just catching up and
getting some steps in.
That is excellent.
I think I have a question foryou though, Elise, because we
talked about our plate or ourbrain and we have all of these
things.
That are going on.
And one thing that I strugglewith is how to rearrange those
(21:37):
plates, right?
So if I have a huge steak on myplate, but I want to have more
potatoes.
How do I do that?
Because it's hard for me to findthe time when I still have a
mountain of green beans on myplate for the kids.
Yes.
And this is the hard part, likeone of my mentors.
Madeline once said to me, shesaid, Anytime you take on a new
(21:58):
responsibility, you have toremove something from your
plate.
Yeah.
Which would have been greatadvice like 20 some years ago.
I had started to follow it.
Then maybe we wouldn't be doinga podcast about burnout right
now.
But now once you're in themoment and you're like, okay,
prevention too late for that.
So what do we do now?
This is where self care andburnout strategies become really
personal because there is no onesize fits all.
(22:21):
For each of us, it's going tolook differently.
The first question is thereanything on my plate that I can
get rid of and buy, get rid of?
We mean can you delegate some ofthis?
Can you say no to it?
Can you at least inform somebodyfrom your volunteer board?
As of a couple months from now,I'm no longer going to be able
to serve on the board or toparticipate in this.
Thank you for this opportunity.
(22:42):
It's been great, we have some.
Other things going on right now.
So just planning to let thingsgo or having a timeframe for how
long are you going to keep someof these responsibilities
around?
And obviously there are thingson the plate that we can't
delegate and we don't want to.
And usually things surroundingour kids.
Some people have you get reallydetailed and basically look at a
(23:02):
24 hour schedule and look at howmuch time were you spending on
your phone?
How much time are you spendingsleeping?
How much time are you spendingtalking to your friends and
recharging?
How much at work, how much withyour kids?
And trying to see if there's anykind of.
Any opportunities for you to cutdown on social media scrolling
or watching Grey's anatomy orwhatever it is so that you can
(23:24):
devote more time to whatever'struly charging your battery.
Yeah.
I think that's a great idea todo the 24 hour outline because
it, I think a lot of people.
In their mind say, oh, I'veonly, I only look at social
media 20 minutes of the day whenin reality, it's an hour and a
half.
And so if you really take thetime and I know it's even hard
to sit down and map out everysingle thing you did that day,
(23:46):
but if you can just take one dayto do that, I think it would
really open.
People's eyes to see how muchthey actually do things.
And then they might be able topick.
Certain activities to do adifferent day or to take off
their plate completely and thendevote that time to something
else.
Yeah.
Definitely.
(24:07):
So to close, I wanted to endwith our practice of gratitude,
which is another exercise tohelp with burnout.
So both Ashley and I are goingto try the three good things.
Exercise.
That we mentioned in the lastepisode and share three things
that we experienced or happentoday for which we are grateful.
And Ashley, I'm going to put youon the spot.
Do you want to go first?
(24:28):
Sure.
I feel like an obvious one is tosay that.
This has brought me joy being onthis podcast with you.
I feel like it's been a toughyear for me.
And so anything I can do to helpother working parents.
See where they're at in terms oftheir journey.
And even just to say tothemselves, this might be me,
and just de-stigmatize burnout.
(24:48):
So I love having done this withyou.
Another thing that I'm gratefulfor today is the walk I went on
with that friend, just gettingfresh air and outside was
awesome.
And I actually would say myhusband traveled today.
He gets to go overseas, which Imust say I am jealous about, but
(25:11):
I am grateful.
He gets this opportunity becauseI think this is some self care
that he really needs.
So all.
That's very, it makes me happy.
That's very kind and generous.
my three things that I'mthankful for today are getting
to go to swim practice earliertoday after being holed up with
(25:31):
the kids at home because of therecent hurricanes, it felt great
to go outside and be in thesunshine and with some of our
friends.
My second thing for which I'mgrateful is getting to have a
little bit of time with the twoolder kids who are still out of
school today.
And we did a little coffee dateat the local coffee shop.
No, I do not give them coffee,but they got still delicious
(25:53):
drinks and we all worked on ourlaptops and did some work
together.
And then the third thing forwhich I'm grateful is my
friendship with you.
Ah, thank you.
And for you very kindly andvulnerably agreeing to share
what's going on in your life sothat other people can recognize
what, ideas and tools and tipsand strategies that might help
(26:15):
them.
And I think for all of us thisis a lifelong journey and we are
not always going to be in thegreen and that's okay.
And stress is going to affect usbecause that's what it does.
And it doesn't say anythingabout us.
And, the best we can do is tryto figure out what are the
things for each of us thatcharge our battery to help us
going.
I wanted to give a big, thanksto Ms.
(26:36):
Ashley.
Thank you.
Thanks again for having me.
And as a brief recap for ourpsyched for paeds listeners, we
talked about the stresscontinuum, which is that four
color scale that determines howstress is affecting your body
and mind.
And we'll have a link to that onour web page.
Psyched, the number fourpaeds.com.
We also talked about a couple ofexercises you can do.
(26:58):
To increase awareness about themany things that are either on
your plate or in your brain.
And the purpose of that is notjust to stress you out, but
rather to help you be empowered,to make decisions about
potentially making changes orreprioritizing.
Or most importantly, asking forhelp.
And as a final point, I justwant to emphasize that none of
(27:19):
us is perfect and.
That this is a lifelong processof constant juggling and
balancing and rebalancing to tryto figure out.
How to keep ourselves healthywhile we take care of others.
So thank you so much forlistening.
I'd love to hear your commentsand thoughts, and if you enjoyed
this episode or any others,please leave us a five star
review and rating.
(27:40):
This will help other people findour podcast and also helps our
pod.
Thanks again so much.
We'll talk to you next week.
Welcome back to PsychEd4Peds, the child
(00:02):
mental health podcast forpediatric clinicians, helping
you help kids.
I'm Elise Fallucco Childpsychiatrist and mom.
Now many of you may already knowthat United States surgeon
general, Dr.
Vivek Murthy recently released asurgeon General's advisory on
the mental health and wellbeingof parents.
(00:23):
Now this advisory highlightedhow parenting can lead to
significant stress and burnoutand negatively impact our mental
health.
And one of the stats that heshared was that about half of
parents say most days, theirstress is completely
overwhelming.
So today we're going to talkabout stress and burnout in
(00:43):
parents and share a couple ofpractical tools and exercises to
help us realize when stress isaffecting our mind and body.
And.
More importantly, talk about howwe can fix it.
/So to help me with this, I'mreally delighted to have a
special guest with us who is aworking mom with two kids in
elementary school.
She has graciously agreed tohelp me demonstrate how to use
(01:06):
some of these burnout tools anddo some of these exercises with
us.
So please join me in welcomingto the pod Miss Ashley.
Ashley (01:15):
Hi, Elise happy to be here.
Dr. Elise Fallucco (01:18):
Thanks so much for being vulnerable and
for showing everybody how we usesome of these tools, because I
think it's more interesting whenyou get to see them in practice.
One of the universal truthsabout burnout is that we tend
not to notice when we'repersonally burned out until it's
very late.
My friend from med school,Bianca used to talk about this
analogy all the time of thefrogs in the pot of hot water.
(01:39):
I don't know if you've heardabout it, but basically the idea
is like we're frogs in a pot ofhot water and the temperature
gradually rises.
And the frogs hardly registeredthe difference.
They notice maybe it's a littlebit hotter who knows.
Until the point that the wateris boiling.
And then they're in completetrouble.
So I feel sometimes like thatfrog in the pot of boiling
(02:00):
water.
And I have no idea how I gotthere.
This has been totally true in mylife.
This definitely resonates withme and I don't think I ever
really.
I recognize when the water iseven starting to boil it's full
on when it's boiling and alittle detail here is that I
have recently reached that pointin my life of complete burnout.
(02:21):
And I am flailing to try andstay alive in this boiling pot
of water.
So this is me right now.
Yes.
Oh my gosh.
We need to get like one of thoseskimmers to.
To get you out.
But I think like this.
Sadly this half that can happenso easily because it's really
hard to recognize it inourselves.
And in an ideal world, we'd beable to identify when we're
(02:43):
starting to become less healthyand a little bit more stressed
and weed.
No, what to do and get help orintervene before we get to the
boiling point.
So to speak.
This is where our first toolcomes into play.
This tool that I've used withpediatricians, with parents,
with various adults.
This tool that I'm about to tellyou about has helped me check in
(03:04):
with my stress level and it'scalled the stress continuum.
And basically.
This tool is first created bythe us Marine Corps for use in
combat settings.
And it's used to help usidentify how stress is currently
affecting our body and mind.
So instead of, it being an onoff switch, like I'm burnt out
or I'm not, it's.
(03:24):
This tool categorized as stress,according to a color system
where green is ready andhealthy.
Yellow is reacting, or ratherstarting to experience some
unhealthy responses to stress.
Orange is injured from apsychological perspective.
And red of course is not whereyou want to be.
(03:45):
And that's considered critical.
I'll go into a little bit moredetail about what each of these
categories is about so that ourlisteners can figure out where
they currently fall on thestress continuum.
So green is obviously the idealstate you've got healthy sleep.
You're spiritually andemotionally healthy, physically
healthy.
You are emotionally available,practicing gratitude and have a
(04:07):
sense of mission.
So this is where we want to be.
And obviously we're probably notgoing to be there all the time,
but that's certainly the goal.
And then yellow is consideredreacting, but it's when you're
starting to fall away from that.
So that's when you start tonotice a little bit of sleep
differences maybe you're gettingtired during the day.
You have some fatigue.
You have a shorter fuse.
(04:28):
You might be a little bitirritable.
You're noticing you're lessmotivated, maybe cutting
corners.
You're not so creative.
That's your yellow state.
And then orange is usually astate where you're having pretty
significant sleep issues.
You feel a little disengaged inyour relationships.
You're exhausted, not just alittle tired, but super tired.
(04:50):
Exhausted.
You may have physical symptomslike headaches, stomach
problems, worsening of chronicillness.
And.
Orange would be considered.
Burnout.
Entering into the burnout phaseand then red is beyond burnout.
That's where you would haveinsomnia, we'd expect to see
more major mental healthproblems, like anxiety, panic,
(05:12):
depression, thoughts of suicide,hopelessness.
And potentially intrusivethoughts and really broken
relationships.
So Ashley, what do you thinkwhen you see this scale?
I think.
Many individuals often just blowpast all of these different
colors and then find themselvesin the orange to red zone.
(05:32):
And I think looking back at thispast year as a working parent, I
could say that in January I wasmore in the green zone and then
steadily throughout the year, Imoved into the different
subsequent zones.
So I started having aninteresting time at work with a
very toxic boss and the wholeentire organization was really
suffering from it.
(05:52):
And so at that point, I foundmyself getting really tired and
changes in attitude about, work.
And lack of motivation at work,because I didn't want to work
for somebody who didn't valuetheir workers.
And then a couple months later,I started having to deal with
some health issues with my kids.
(06:13):
And so adding that on top of thework issues, I slowly started
finding myself more exhaustedand numb to things at work and
that burnout.
And you talked about it in oneof your recent episodes, having
the cynicism and disconnectionat work and not really caring
about the end result of my work.
So that squarely started puttingme in this orange zone.
(06:35):
And now I would say I'm notquite at the critical point, but
I'm starting to see some of thatstuff creep in.
I definitely have some anxietyand then I do find myself.
Like very focused on cleaningand organizing around my house
when I feel out of control,because it is my way to try and
exert control in a chaoticsituation.
(06:56):
So I think if I had been lookingat this continuum earlier in the
year, I would have been able toput my feelings and my physical
reactions on this continuum andto see them and be able to try
and step back and try and dealwith those colors before they
kept progressing.
Thank you so much for sharing.
(07:16):
And I think like what you'vedescribed, I think a lot of our
listeners can relate to.
I think for a lot of us, itstarts with having some sleep
problems, which then affect yourenergy level during the day.
And then it feels like you'rejust losing your spark the irony
of all of this, or I don't evenknow if it's ironic is that I
stumbled across this stresscontinuum when I was preparing a
(07:37):
Burnout workshop for some of ourlocal pediatricians during the
start of the pandemic.
And the goal of the workshop wasfor us to help them.
Identify and manage, stress andburnout and et cetera.
And when I was practicing onthis stress continuum by looking
at it regularly and trying tofigure out where I was, I was
shocked.
(07:57):
I was, squarely in the orange.
And I'm just thinking, why am Ileading the workshop in burnout?
I'm completely orange right now.
But more to the point that youcan't tell.
Yeah, I think you can't tell.
And I think also some peoplemight look at this and say, oh,
I'm in the green because that'swhere they want to be.
So when you do this continuumexercise, you really have to be
(08:19):
honest with yourself anddetermine where you are as
opposed to where you want to bein, where you want to project
yourself, how you want toproject yourself to others.
And I think if I had this toolright.
Six months ago, and I noticed Iwas tired and maybe in the
yellow zone.
If I had noticed that I wastired and saw the other symptoms
in this category, I might've hada better tool to help me realize
(08:43):
I was burning out becausethinking just of fatigue in and
of itself.
My mind started thinking of,okay, what is wrong with me?
Do I have a cold?
Am I physically sick?
I didn't have the other.
List of things to realize thatthis was more of a psychological
and mental health issue.
And so having this in front ofme, checking in do I have any of
(09:04):
these other things?
Could that fatigue be somethingelse?
I think it would have helped mereadjust.
And I also wonder if there areother tools to use at each color
to help you course correct.
So is there something I could dowhen I'm in the yellow zone
versus something I could do inthe orange zone?
Zone to help me get back to thatgreen.
(09:26):
Having self-awareness of whereyou are is really important.
And to your point, I think it'sa great idea to think about what
are you going to do with thisinformation?
So if you're green, I think youpat yourself on the back and
you're like, woo, this is great.
The I'm managing the stressreally well.
Like I'm still able to do this.
I still have a sense of mission.
And I'm feeling like overall I'mhealthy and things are going
(09:47):
well.
And you may even want to selfreflect and try to figure out
like, what am I doing?
That's helping me stay healthy.
What are the things that arecharging my battery and.
Helping me be super resilient atthis point.
Yeah, that's a really goodpoint.
I think a lot of times we focuson the negative, like what is
going wrong or what is making usfeel bad instead of looking at
the positive.
Focusing on those good thingscan help you realize how you can
(10:10):
get to that really good spotthat you want to be at.
Definitely.
Yeah.
And then let's say you're in theyellow, which is you're
reacting, or you're starting tonotice that stress is affecting
your mind and your body.
And you're having sleep problemsor whatever else.
I think the question at thatpoint is what can I do, maybe.
Is there anything I can do tofix this?
Do I need to make some changesat work or at home, or to try to
(10:37):
take care of myself better,whatever that looks like.
Before it gets worse.
And I think that's what Istruggle with too.
Because I can identify that I'mstruggling with something, but
there's only 24 hours in a day.
So how do I make room?
For more sleep when I have allof these other commitments and
responsibilities to do.
In a day.
(10:57):
And so I think that is where Iwould love help with as well.
Yes.
That is a great segue to ournext tool that we're going to
talk about.
So this next exercise is calledwhat is on your plate?
And basically for this exercise,you get a sheet of paper or an
actual paper plate, whicheveryou want to use, and you either
(11:19):
write down or draw out thevarious projects and
responsibilities that are onyour plate.
And this can be, it's reallyhelpful to be as inclusive as
you possibly can.
What are the specific projectsat work that you're involved
with or what are the specificthings that you're doing at home
or responsibilities?
With your family and make sureto include, your own personal
(11:41):
outside of work and home orextracurricular activities too.
So for.
And it may be a little bit hardto visualize and everybody does
this in a different way.
And you can use your creativity.
But if I think like right now,my plate is filled with thinking
about the kids, variousactivities Cross-country or
sports and their upcomingevents.
(12:02):
And then we've got an upcomingtrip to our annual child
psychiatry conference, which ofcourse is across the country.
And I just transitioned to a newjob and.
I'm just naming some of thesethings starts to stress me out a
little bit.
But I think the more granularyou can be, the more helpful it
is to just visualize here arethe things that I'm taking care
(12:23):
of right now.
And potentially, are there anythings on this plate that I
could delegate or that I maybedon't need to be spending as
much time on?
But Ashley, what did you thinkwhen you did the plate exercise
or how did you approach it?
I've done a similar exerciselike this before, and I think
what I really like about the wayyou framed it is getting into
(12:45):
that nitty gritty, granulardetail, because when I've
previously done it, I've justseparated out work from family
and myself.
Whereas the granular reallyallows you to dive deep into
those specific projects andreally understand how you're
using your time.
So I had a much harder timedoing this exercise after your
(13:07):
guidance on that granularity.
Because you really have to thinkabout all of those little
things.
So when I did my plate, I reallytook it literally and drew a
steak on my plate and thatrepresented work for me.
And then I had mashed potatoeson the side and that represented
my husband.
And he's going to love.
(13:28):
Mashed potatoes.
Mashed potatoes with gravy.
That's a really delicious.
So he gets the delicious one.
And then I did green beans andthat represented my kids because
here a point where you'retalking about.
All of the things that your kidsare doing.
Each green being for merepresents, different practice,
swim lessons, a play date,school meetings, whatever it is
(13:49):
for my kids.
And then I had a very tiny sidesalad and that was for me.
Each element of the saladrepresented a different type of
volunteer work that I do, or anelement of the salad, we'll say
cucumbers because they're myfavorite.
Those represent the funactivities I get to do like with
my friends What I did findmissing from this exercise is a
(14:11):
lot of women these days inparticular talk about the mental
load and it's the running to-dolist.
In your head, right?
So while this plate separatesout all of the different
activities, I do it didn't quitecapture that constant worrying
concern in my head of, okay.
I have to call the doctor andmake this appointment and I have
(14:31):
to contact this friend to set upa play date for my kid.
And oh, there's the birthdayparty this weekend and I have to
buy a gift and oh, I have tosend the Christmas gifts.
Oh.
Week in advance so that theyarrive on time.
All of those smaller activities.
And so I like to also thinkabout another way of how to do
this exercise, which is likedrawing a brain.
And I came up with this ideabecause my six-year-old son
(14:53):
actually came home recently.
Having done this himself on hisown unprompted.
And it was very sweet because,he had a brain and inside of his
brain was video games, dronemovies, all the things that he
either loves doing or the thingshe wants to ask for Christmas.
You start early, starting veryearly.
(15:13):
He has written out three listsat least already.
Oh my gosh.
But taking that hint from him, Ithink, I actually did it after
he brought his home to show himwhat mine looked like.
And I think you can use all ofthe things that I used on my
food plate and put that in mybrain, but I can also have a
section within that brain thatcaptures those running lists of
(15:34):
questions.
It's just a little bit morevisual to get at what is always
going on in my brain.
So it's more of the physical andthe psychological and mental
part of.
Things.
I really love that.
I love the idea of the brain.
Like instead of what's on yourplate, it's what's on your mind.
What's taking up your brainspace.
Yes.
(15:54):
And I agree with you.
There's a lot of people who'vetalked about the mental load.
Sometimes particularly heavy forwomen or for whomever is in
charge of the day to dayoperations in the house with the
kids and with the family.
And that, and also the personwho's more likely to get called
by the school when the kid issick or bite somebody.
(16:15):
Although my kids have not beenbiting anybody.
Recently.
That's good.
I think that emotional load,that mental load also really
contributes to that.
That burnout.
Because even if I take a momentfor self care say I take a
bubble bath or, go exercise.
Guess what I'm thinking about inthose moments, all of those tiny
little things.
(16:35):
And so it's really hard tounplug from that constant
running list of things.
And I think that's also whatadds to the fatigue, why people
are tired and can't sleepbecause they can't turn their
brains off.
Even when you're taking a bathor trying to relax, even if you
relax your body, which is great,you still have the running mind
or the monkey mind.
Are there things that you can doto recharge your battery to help
(16:58):
you feel?
Not only physically.
Restored, but also mentally andpsychologically restored.
And, for some people that's yogafor some people that's
meditation.
So I typically find meditationand baths and all the things
that I'm told to do to quiet mymind as not super helpful in
recharging my battery.
And I think that's because Ireally thrive on being an
(17:21):
extrovert and doing things it'svery hard for me to sit on my
couch and do nothing.
So there are a couple of thingsthat I would love to highlight
to your listeners because I knowthey really help me feel like I
have.
Have rejuvenated and I havereached out to.
Other people and found some joyand happiness.
(17:41):
And so one is social connection.
I love talking to my friendsgoing out for dinner, whatever
it is, just having thatconnection with friends and
family and having a break fromthe daily grind of work and life
at home is huge.
And so that can be hard as aworking parent with your
(18:01):
schedule or trying to find ababysitter, but any chance you
can find to incorporate thatinto your daily.
Life I think is huge.
Second of all, I think creativeexpression is very helpful, so I
know not everybody he loves artsand crafts or painting, but I do
love those things and that hashelped me as well.
(18:23):
And it sometimes results in anunfinished painting or an
unfinished, necklace that I'mmaking, but it still is a way to
focus on something that'smindless aside from your other
daily responsibilities I lovethe idea of the unfinished
painting because the whole pointof creative expression is just
(18:44):
to express yourself in some way.
We're such a S capitalisticsociety that's all about
productivity and checking thingsoff lists and the beautiful
thing about creative expressionand about play in general is
that it's not about the endproduct.
It's just about enjoying theprocess.
Exactly.
I think the definition of playis basically doing something
like some sort of activity.
(19:06):
With no purpose.
Yep.
Yep.
I read that definition recently.
And you hit the nail on the headbecause I'm an example is my
husband and I used to go out fordinner for date nights.
And we suddenly realized weactually hate dinner date nights
because we go out and we'd talkabout the kids and we talk about
work.
And so there's no realrejuvenation and recharging for
(19:26):
us.
So we have realized that we liketo do activities together that
allow us to just totally havefun.
There's no purpose, no end goal.
And so whether it's going outand hitting golf balls or going
out on a boat or whatever it is,That has really been a better
thing for us.
To connect over, cause it forcesyou to get outside of your heads
(19:48):
and your to-do list and okay,you're my co-manager for the
family or like for our family inincorporated.
And so let's take care of itbecomes a business meeting
sometimes.
Yes, exactly.
And so if you're distracted andyou're playing mini golf or
taking, maybe taking a long walkor just doing something where
it's not a setup for having abusiness meeting, then.
(20:09):
You can actually physically andemotionally recharge.
Yes.
And I think the third thing Iwould advocate for your
listeners to do is to exercise.
And I know, doctors oftenrecommend that and sometimes it
can be hard because it makes itfeel like a chore.
I know sometimes exercise feelslike a chore for me, but I have
recently gotten back intoswimming with Elise and it's a
(20:31):
two for one, because I get theexercise, but I also get to
connect with Elise and the otherteammates.
And it's been really great.
And I feel like I am totallyjust happier, more at ease.
And swimming laps for me, allowsme to tune out everything in my
brain.
And I've only ever really hadthat with two different types of
exercise, a swimming and B yoga,where my mind just goes blank.
(20:55):
And so that's really beenanother way to help recharge my
battery.
Yeah.
And the, just any type ofmovement, it doesn't even have
to be like breathtaking you'reunderwater.
And you're like, Gasping forair.
Yeah, no, not at all.
Even just a walk with a friendor walk your dog today.
I did that with a friend and itwas great.
We got out it's cooler nowoutside.
(21:16):
And so we had a really lovelytime just catching up and
getting some steps in.
That is excellent.
I think I have a question foryou though, Elise, because we
talked about our plate or ourbrain and we have all of these
things.
That are going on.
And one thing that I strugglewith is how to rearrange those
(21:37):
plates, right?
So if I have a huge steak on myplate, but I want to have more
potatoes.
How do I do that?
Because it's hard for me to findthe time when I still have a
mountain of green beans on myplate for the kids.
Yes.
And this is the hard part, likeone of my mentors.
Madeline once said to me, shesaid, Anytime you take on a new
(21:58):
responsibility, you have toremove something from your
plate.
Yeah.
Which would have been greatadvice like 20 some years ago.
I had started to follow it.
Then maybe we wouldn't be doinga podcast about burnout right
now.
But now once you're in themoment and you're like, okay,
prevention too late for that.
So what do we do now?
This is where self care andburnout strategies become really
personal because there is no onesize fits all.
(22:21):
For each of us, it's going tolook differently.
The first question is thereanything on my plate that I can
get rid of and buy, get rid of?
We mean can you delegate some ofthis?
Can you say no to it?
Can you at least inform somebodyfrom your volunteer board?
As of a couple months from now,I'm no longer going to be able
to serve on the board or toparticipate in this.
Thank you for this opportunity.
(22:42):
It's been great, we have some.
Other things going on right now.
So just planning to let thingsgo or having a timeframe for how
long are you going to keep someof these responsibilities
around?
And obviously there are thingson the plate that we can't
delegate and we don't want to.
And usually things surroundingour kids.
Some people have you get reallydetailed and basically look at a
(23:02):
24 hour schedule and look at howmuch time were you spending on
your phone?
How much time are you spendingsleeping?
How much time are you spendingtalking to your friends and
recharging?
How much at work, how much withyour kids?
And trying to see if there's anykind of.
Any opportunities for you to cutdown on social media scrolling
or watching Grey's anatomy orwhatever it is so that you can
(23:24):
devote more time to whatever'struly charging your battery.
Yeah.
I think that's a great idea todo the 24 hour outline because
it, I think a lot of people.
In their mind say, oh, I'veonly, I only look at social
media 20 minutes of the day whenin reality, it's an hour and a
half.
And so if you really take thetime and I know it's even hard
to sit down and map out everysingle thing you did that day,
(23:46):
but if you can just take one dayto do that, I think it would
really open.
People's eyes to see how muchthey actually do things.
And then they might be able topick.
Certain activities to do adifferent day or to take off
their plate completely and thendevote that time to something
else.
Yeah.
Definitely.
(24:07):
So to close, I wanted to endwith our practice of gratitude,
which is another exercise tohelp with burnout.
So both Ashley and I are goingto try the three good things.
Exercise.
That we mentioned in the lastepisode and share three things
that we experienced or happentoday for which we are grateful.
And Ashley, I'm going to put youon the spot.
Do you want to go first?
(24:28):
Sure.
I feel like an obvious one is tosay that.
This has brought me joy being onthis podcast with you.
I feel like it's been a toughyear for me.
And so anything I can do to helpother working parents.
See where they're at in terms oftheir journey.
And even just to say tothemselves, this might be me,
and just de-stigmatize burnout.
(24:48):
So I love having done this withyou.
Another thing that I'm gratefulfor today is the walk I went on
with that friend, just gettingfresh air and outside was
awesome.
And I actually would say myhusband traveled today.
He gets to go overseas, which Imust say I am jealous about, but
(25:11):
I am grateful.
He gets this opportunity becauseI think this is some self care
that he really needs.
So all.
That's very, it makes me happy.
That's very kind and generous.
my three things that I'mthankful for today are getting
to go to swim practice earliertoday after being holed up with
(25:31):
the kids at home because of therecent hurricanes, it felt great
to go outside and be in thesunshine and with some of our
friends.
My second thing for which I'mgrateful is getting to have a
little bit of time with the twoolder kids who are still out of
school today.
And we did a little coffee dateat the local coffee shop.
No, I do not give them coffee,but they got still delicious
(25:53):
drinks and we all worked on ourlaptops and did some work
together.
And then the third thing forwhich I'm grateful is my
friendship with you.
Ah, thank you.
And for you very kindly andvulnerably agreeing to share
what's going on in your life sothat other people can recognize
what, ideas and tools and tipsand strategies that might help
(26:15):
them.
And I think for all of us thisis a lifelong journey and we are
not always going to be in thegreen and that's okay.
And stress is going to affect usbecause that's what it does.
And it doesn't say anythingabout us.
And, the best we can do is tryto figure out what are the
things for each of us thatcharge our battery to help us
going.
I wanted to give a big, thanksto Ms.
(26:36):
Ashley.
Thank you.
Thanks again for having me.
And as a brief recap for ourpsyched for paeds listeners, we
talked about the stresscontinuum, which is that four
color scale that determines howstress is affecting your body
and mind.
And we'll have a link to that onour web page.
Psyched, the number fourpaeds.com.
We also talked about a couple ofexercises you can do.
(26:58):
To increase awareness about themany things that are either on
your plate or in your brain.
And the purpose of that is notjust to stress you out, but
rather to help you be empowered,to make decisions about
potentially making changes orreprioritizing.
Or most importantly, asking forhelp.
And as a final point, I justwant to emphasize that none of
(27:19):
us is perfect and.
That this is a lifelong processof constant juggling and
balancing and rebalancing to tryto figure out.
How to keep ourselves healthywhile we take care of others.
So thank you so much forlistening.
I'd love to hear your commentsand thoughts, and if you enjoyed
this episode or any others,please leave us a five star
review and rating.
(27:40):
This will help other people findour podcast and also helps our
pod.
Thanks again so much.
We'll talk to you next week.
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