Managing Stress and Burnout

Mental Health Series: Managing Stress and Burnout
Patrick B. McGrath, PhD

Bice: Do you often find yourself trying to fit a Tupperware lid to a container that looks like it will fit, but it doesn’t?  And, sometimes, you’ll even try a few different ways, and force the container to make it fit, with no luck.  Doesn’t this just sound so simple?  But it becomes a stressful one.  So, if you keep trying harder at what isn’t working, it’s probably not going to work too much more.  Instead of trying harder, maybe you should try something different, like a different lid!

Welcome to the Abbott Nutrition Health Institute’s Power of Nutrition podcast.  My name is Bice Dolciato, and I’m with the Abbott Nutrition Health Institute.

I’m so excited to bring you another episode of our mental health podcast series.  Today’s topic is Managing Stress and Burnout.  We are so lucky to have Patrick McGrath back with us today.  He is the Chief Clinical Officer at NOCD and the author of the book titled Don’t Try Harder; Try Different.   Welcome back, Dr. McGrath.

Patrick:Well, thanks!  Great to be here – appreciate it.

Bice: Before we get started, I just wanted to share with our audience that I’m recording in a studio, while Patrick is dialing in from Wisconsin, so you may notice a small difference in the sound quality of our respective microphones.

So, Patrick, for those listeners that didn’t have a chance to listen to the first podcast, would you mind taking a moment just to tell us a little bit about yourself and some background?

Patrick: Of course!  My background is I’m a licensed clinical psychologist, and I’ve been treating anxiety disorders, OCD, PTSD for 23 years now, and most of the work that I do uses a type of therapy called exposure and response prevention treatment, where we purposely want people to do things they’re afraid of, and learn that they could handle them, instead of trying to do things like distract from them, or run away from them, or seek a lot of reassurance.

Bice: Patrick, I’d love to spend some time taking a deep dive into your book titled, Don’t Try Harder; Try Different.  But, before I get into the specific questions that I have for you, can you just share with us – what was the motivation behind the writing of this book?

Patrick:It was the phrase that popped out of my mouth one day when I was talking to a patient who kept doing the same thing over and over, but was hoping to get a different result, which, sometimes, people have said is the old definition of insanity, right?  This – this notion of, if you keep doing something over and over again, but hope something else will happen, that’s not going to work.  So, instead, I said to someone, “let’s do something else instead – if all of these safety behaviors that you’re doing aren’t giving you the ultimate result that you want, we’ve got to do something different.”  And that was just kind of the key phrase to me that started me down the road of collecting themes, and so the book collects, really, all the themes that I saw – should type of thinking, can’t versus won’t, practice makes perfect versus routine – this notion I call “specialness” that the rules of the world apply to me differently than they do to other people.  Or, the desire to be in total control of everything that’s going on in our lives and how, when we do those things, how they actually interfere with our lives, even if they feel good in the moment, but, in the long run, they might actually be helpful to us.  So, my ultimate goal is how can I help move people away from what feels good to do right now, to doing something maybe better over time, instead of having to be perfect the first time, and those don’t always agree with each other.

Bice: That explains it clearly, so I’m not going to “should” all over this podcast…

Patrick:[Laughing]

Bice: …but, could you mention in the book the stress, anxiety are not about something you cant do, they’re about something that you won’t do.  So, can you describe that a little bit more for me too?

Patrick:Of course.  There are many people who will come in and say to me, “I can’t get on an elevator,” and – and I will say to them, “that’s fascinating, let’s walk over to the elevator.”  And so, we’ll go to the elevator, and I’ll press the button, and I’ll say to them, “I’d like to watch you bounce off the invisible forcefield that appears in front of the elevator,” and they look at me and say, “what are you talking about.”  And I said, “well you told me that you can’t get on an elevator, so that must mean something – that must mean that there’s a forcefield there, because you have walked from my office to the elevator, and you’ve walked through doorways to come in and out of the building.”  Getting onto an elevator involves going through doorways and walking, or if you’re in a wheelchair, rolling through there, and therefore, I don’t believe that it’s that you can’t do it – I believe that you won’t do it, because if you can’t do it, there has to be a forcefield there.  So, I’d like to watch you bounce off the forcefield.  Go.  And, then they look at me cross-eyed, and then they smile a little bit and say, “okay, fine, I can get on the elevator, but I don’t want to.”  It’s like why don’t you want to?  “Well, I’m afraid I might get stuck and all these kinds of things.”  And I’ll say, “great, I can help you with that.”  There is very little that I can do for somebody who can’t do something, but there’s a whole lot of things I can do for people who don’t want to do something because they’re afraid.

Bice: That’s a really great way to describe it.  So, let’s go back to your book and take a deeper dive into it.  We often hear practice makes perfect, but in your book, you flip it by saying, “practice makes routine.”  Now, let’s talk about that.

Patrick:  Sure, if practice made perfect, once you got perfect, it would never be anything but perfect.  You would never make a mistake again.  And, I’ve even gone to orchestras of professional musicians, and once in a while, you hear a wrong note.  So, did that mean they didn’t practice enough to become perfect at it, or are we humans, and now and then, we miss things, even if we’ve really mastered something.  So, our goal ought not to be to try to be perfect, because perfect is an opinion, kind of like should actually.  They have a lot of similarities in that way.  And, just because I think something’s perfect doesn’t mean you think it’s perfect, so how could somebody do something for the two of us that we both find to be perfect if both of us have a different opinion of what perfect is.  The goal ought not be to be perfect; the goal is going to be to try to do, potentially, the best that we can to create a routine that really works for us and helps us survive in the world.  But when we strive for perfection, we probably fail because we either don’t meet our expectations or what we think the others in our lives have as expectations for perfect.  So, let’s work towards toward developing routines that help us really function well in life and keep doing those routines, master those routines, and have those routines work for us on a day to day basis.

Bice: Yeah, I agree with everything you just shared with us – super, super helpful.  Is there anything else in your book we should also take into consideration when we’re trying to manage stress and burnout that would be helpful for, well, me and our listeners?

Patrick:  Sure.  And I think some of the things, even from the themes of your podcasts – sleep well, eat well, do things that are good for you and for your body – are so very important too.  It isn’t just about changing the way that we think and the way that we behave.  As everybody else in the world can see, it’s the little things that we can do for ourselves.  Are we getting enough exercise?  Are we giving ourselves enough sleep to be able to allow our body to restore itself, as it does while we’re sleeping.  And, are we making wise choices in the foods that we eat?  Are we going for quick fixes and quick rushes of serotonin or things like that – or adrenaline when we’re drinking extra caffeine or having a lots of sugary types of things, as well, too.  We want to make sure that we’re putting good fuel into the system so that the system will work efficiently, so, in conjunction with the things that we do psychologically, we have to make sure we’re being good to ourselves physiologically, as well.

Bice: Everything that you shared with us is so valuable for everyone, especially for myself, but as we think about health care professionals, what are some particular stressors, as we’re thinking about managing stress and burnout, especially coming out of the pandemic?

Patrick: Yeah, it’s lasted so very long, right?  Very often, when we’ve had stressors, we’ve maybe been able to look ahead and see a little bit of light at the end of the tunnel; but, this one, the tunnel just seemed to keep going and going and going, and there was not a lot of light going on, and for a while, health care workers were being celebrated, and they were being cheered as they were coming home, and that was very motivating and uplifting.  But, after a while everybody was kind of the same, and we were all doing our jobs, and there were still issues going on in healthcare where people were dying, and sometimes it might have felt that, no matter what kind of efforts you put into the – the experience and the people that you were working with, they weren’t making it – they weren’t pulling through, and the more that something like that happens, where you feel as if what you’re doing just isn’t helping or moving something over the line like it needs to, it can really wear down on us and cause us to have doubts and insecurities about our own abilities, our own training, and even the worthiness of the care that we provide.  And so, I think it’s very important for everyone to recognize that, when you’re going into a situation like this, and we probably will have more of this happen over the course of our lifetimes, that when we’re entering uncharted territory, we’ve got to all be in this together and support each other.  And, not only do we have to support each other in terms of health care, we’ve got to make sure that people are doing things to take care of themselves, as well.  As difficult as it might be with shortages and the ability of people to work extra shifts or something like that, people still have to find times to make sure they do things to take care of themselves, because how can we be a good health care provider for others if we’re not also taking care of ourselves too.  So, striking that balance and supporting each other to find that balance is so key in our field to make sure that we are there for the people who rely on us and need us every day, but we’ve got to be there for each other, as well.

Bice: Dr. McGrath, and how do you envision health care professionals to find value in the book that you have written?

Patrick: My goal would be that people recognize that when you’re not at work, you don’t have to be held up to the same joint commission standards that you may have to at work, right?  Obviously, we’d like to people to be really on point when they’re at work, and there’s absolutely a lot of pressure on doing something like that, and that, in and of itself, can be a stressor.  But, when people try to take that outside of work and apply that to their home, and maybe their family, their children something like that, those can be real big stressors in people’s lives when things don’t run as maybe efficiently or as directly as a hospital or a health care setting may.  So, you’ve got to know when to be able to take a break from some of those types of rules and have a set of rules that work better in your day-to-day life versus your work life.

Bice: Thank you again for just sharing all of these valid points with us.  As we close out our podcast, are there any key takeaways, like what are the big sound bites that I should walk away knowing?

Patrick: I think the biggest takeaway is going to be: how are you talking to yourself; how are you trying to motivate yourself?  So many people, unfortunately, are very negative in the way they motivate themselves.  They remind themselves of every mistake they’ve made – all the things that they’ve done wrong.  And I like to say to people, would you ever do that to anyone else that you love?  If your child is playing baseball, would you go up to them before they go up to bat, and would you say to them, “hey, now, the last three times you’ve been up to bat, you have really missed horribly – it’s been awful, frankly, we’re pretty embarrassed to even be related to you – we won’t be attending the rest of the game, because it’s just too much for us to watch – good luck – please sneak over to the car when we’re done – we’ll get you out of here as fast as possible.”  Or, would you say, “hey, you’re awesome, we love you, we can’t wait to see you go up and give your best effort – that’s all we’re going to ask from you.”  Right?  That’s the kind of ways that we would talk to other people.  It’s unfortunately not always the way we talk to ourself.  We’re really good at trying to put ourselves down to make ourselves better while we build other people up to make themself better.  If I can get people to build themselves up to be better, that’s what I want to do, and recognize the times that I’m trying to tear myself down hoping that it will make me improve, because it never will.

Bice: Wow.  That’s quite insightful, and just having this conversation with you, you’re already making myself feel better so I really do appreciate that.  I really enjoyed the time with you today, Dr. McGrath, and for joining us on today’s Power of Nutrition podcast.

For our listeners, the 988 lifeline provides 24/7 confidential support for people in suicidal crisis or mental health related distress.  By calling or texting 988, you’ll connect to a mental health professional.

Thank you for listening today.  ANHI is excited to provide a series of podcasts on a variety of mental health related topics.  So, please join us for the next episode by visiting ANHI.org/resources/podcasts.  We will be adding new episodes often, so please check back throughout the year.

Stay healthy and be safe.