258: Overcome Burnout w/ Dr. Zarya Rubin

* Rough Transcript *

Ep. 258

Welcome

Aurora: Hello. This episode is a recording of our talk with Dr. Zaria Rubin on from Burnout to Brilliance, and you can find the full discussion and video presentation in the embracing Intensity membership library.

Next Saturday, we have our next call. Zaakirah Muhammad on seeing life through a different lens, mindfulness and gratitude as a creative, so you can join our call for free and then find the full discussion in the Embracing Intensity membership immediately after the call.

I’m super excited for our lineup of calls this year, and you can find the recordings immediately in the Embracing Intensity membership, along with 30 plus calls already in there on topics related to giftedness, neurodivergence, and thriving when you’re intense. Enjoy.

Awesome. So welcome everyone. I am super, super thrilled to have Zarya joining us again for a talk on burnout. This topic is very relevant to me right now, and Zarya herself. So, I’m so glad to have you. And if you didn’t already see it, Zarya has another talk in the community library on breaking the stress cycle.

You can also find that on the podcast. And Zarya is just such a wealth of information. I’m super thrilled to have her back.

Zarya: Well, thanks so much for having me back. It’s a real treat and I’m in Portland, Oregon, but I’m Canadian. And it’s, yeah, it’s great to be here with you all this beautiful morning. We’re gonna talk about burnout and one of my favorite topics,

Burnout and Brilliance

Zarya: We are going to talk today about burnout and how to get from burnout to brilliance because I want all of us to be able to shine our light and share our gifts with the world.

And if you’re burned out, you can’t really do that. So, it’s gonna be fun.

Okay, so who am I and why am I qualified to talk to you guys? So, I’m a physician, I am a functional medicine coach. And I specialize, oh, I’m going backwards. I don’t specialize in Zoom, obviously. And I’m also a speaker, believe it or not, when the technology works. I help passionate women in midlife overcome chronic stress and burnout so they can heal from the inside out and truly thrive.

Something I’m really passionate about, I love speaking about it. I love writing about it and I love coaching on it. And that’s my website on the bottom at the end. I will give you guys ways to stay in touch with me. Okay. So, I’m gonna share a little bit about my personal burnout story cause I think it’s very relevant and it just shows sort of how far things can go with burnout without.

Us doing anything about it, and there’s a lot of reasons for that, but hopefully this will shed some light and give folks some comfort to know that you’re not alone.

Personal Burnout Story

Zarya: So, let’s see, I was living in New York City. I was completing a fellowship and you know, I was living the dream.

So, it was a little bit after nine 11 and I was doing a subspecialty neurologic fellowship at Columbia. I graduated from Harvard, gone to McGill and was on the way to the top of my field. From all external measures, I was at the top of my game and I was outwardly very, very, very successful.

But success not always feel good on the inside.

And so, every day I just felt. Pretty miserable. I was exhausted and it was like a deep bone tiredness that I just couldn’t get out of bed. Every morning the alarm would go off and I would just be like, I can’t, this is insane. I had constant nightmares and insomnia, I had anxiety, I had panic attacks, I was very irritable.

Always was, you know, kind of very irritated with people, especially at work. I really dreaded going to work. I had, you know, like the typical Sunday scaries of, oh my gosh, I can’t believe it’s Sunday and I have to go back to work. Although in medicine you often work on the weekends as well, nights, weekends, there’s no set schedule.

I did experience something called compassion fatigue, which I will go into a little bit later. That is a, one of the key features of burnout, and believe it or not this, this subway car right here. This was the train that I took every day to work the C train.

A Dark Turn

Zarya: And at a certain point, although I had never suffered from depression or never been suicidal in my life, I would think to myself, the train was coming, so should I get on it or should I jump in front of it? And I almost kind of made a joke about it every day, which was insane. But that’s where I was at. But I didn’t do anything about it. I thought, well, there’s not really anything I can do.

There’s no other option. I can’t quit, I mean, who, first of all, who quits medicine? I mean, nobody, I had so much debt. There’s a huge stigma attached to it. And I thought, well, I can’t tell any of my colleagues. They’re all happy, they’re all doing fine, they’re all, they all love this. They think that this is the greatest thing since sliced bread.

And also, how could I not be a doctor? I mean, if I’m not a doctor, then. Who am I? What am I? It went beyond a profession. It was a source of my identity. And I thought, well, what else could I even do? I’m not qualified to do anything else. This is all I’ve done my whole life. How would I tell people? Like just the thought of having to break the news to my parents and my friends and family.

A Turning Point

Zarya: It was just my boss. couldn’t, couldn’t fathom it. Nobody quits their dream job, right? I mean, I’d wanted to be a doctor since I was five years old. There just felt like there was no way out, and I know a lot of people struggling with burnout feel this way as well.

But then something happened that changed everything. One night I got a phone call from my best friend and in an instant, everything changed my whole life. She called to say that. Her husband was playing Frisbee. They were at a Frisbee game, and he had collapsed on the field, and they had tried to resuscitate him.

They brought him to the hospital.I said, oh, well, but that’s horrible, but he’s okay, right? She said, no, no, he died. And I almost dropped the phone on the floor. He was my age, you know, 35, healthy, no medical issues, nothing in the prime of his life. And I just thought, wow, okay. This is my wake-up call.

This is not a dress rehearsal. I cannot live the rest of my life this miserable, and just expect that maybe one day things are going to be better. I mean, I was dreaming about retirement and I hadn’t even finished my training and I was in my thirties. This was a real problem, but this horrible event kind of gave me permission. To exit medicine, and

A New Path

Zarya: I came across this quote, it was actually my mom who shared this quote with me. She never wanted me to be a doctor and go into medicine, so she was very open to the idea of me leaving. She was worried about me, but she shared this quote that was. No matter how far you’ve gone down the wrong road, turn back.

And this really resonated with me. And I realized that I had been on the wrong road, and if I continued, it was never gonna get me where I wanted to be. So, I was able to leave medicine. This talk is just about getting unstuck together and sharing ideas and strategies for how to cope with burnout, how to prevent burnout, and a little bit about what’s burnout all about anyway?

So, let’s talk about. Okay, so we’re gonna go over a couple of definitions, like what is burnout? Talk about the differences and similarities between burnout and stress. A couple of scary stats cuz what would it talk by a scientist? Be without some scary stats. Self-care. Talk a little bit about self-care, what it is, what it isn’t.

I’m gonna do some fun exercises together, depending on how much time we have. I’m gonna hopefully just do a breathing exercise with you all. Just talk about committing to yourself in the process. We’ll do some questions and I’ll let you guys know how to stay in touch with me and some next steps if you want.

What is Burnout?

Zarya: Okay, so what is burnout? There’s this cute little infographic, Venn diagram that shows the intersection between exhaustion. Cynicism, inefficacy kind of the perfect storm of different elements combining. Now I pulled the W.H.O. Definition cuz people are like, ooh, the W.H.O. Is recognizing burnout. But I gotta admit I don’t love it.

According to the W H O, it’s classified as a workplace condition and not a medical condition, not a disorder. I really disagree with that. And they also say that burnout can only take place in the workplace, which I also disagree with, but cause it’s the W H O I’m sharing it. So, burnout is a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed.

It is characterized by three dimensions, feelings of energy depletion or exhaustion. And it’s more than just like, I’m tired and I take a nap and I feel better increased mental distance from one’s job, feelings of negativism or cynicism related to one’s job and reduce professional efficacy. So, some of it I like, but I much prefer this definition.

That was from an article on burnout. Burnout is a state of emotional, mental, and often physical exhaustion brought on by prolonged or repeated stress. Though it’s most often caused by problems at work, it can also appear in other areas of life, such as parenting ding, dinging, caretaking, or romantic relationships.

Many Manifestations of Burnout

Zarya: So yeah, there’s many different ways that burnout can manifest, and it’s not just work according to me, according to this definition. So, it’s a little more complex than simply, well, I have a stressful job. Now, obviously, if you have a stressful job, I think you’re gonna be more prone to burnout. It’s more than long hours, it’s more than a lot too many tasks.

There’s an element of lack of control and a component of the tasks that compete with your sense of self, like maybe you don’t believe in the company or what you’re doing, or. Working towards a goal that doesn’t resonate with your values. Maybe you have a terrible supervisor or manager and you don’t have a lot of support at work.

Maybe your colleagues are terrible. I don’t know. It’s a lot of elements that contribute. It’s often pretty relentless. Like you don’t ever get a break. That’s certainly true of medicine. It’s certainly true of parenting, no recognition and something called compassion fatigue. So, compassion fatigue shows up in areas of caregiving where you are exposed to a lot of pain and suffering and trauma, and eventually you become a little bit numb to it and exhausted by it, and you stop feeling compassionate toward the people you’re supposed to be caring for.

Whether this is your patient or your kids. Or a parent or you know, spouse if you’re a caregiver. And it’s really a terrible feeling because then it’s compounded by the guilt of feeling that way. So not only are you feeling terrible about your job and about the people you’re supposed to be caring for, but then you feel terrible about yourself.

Compassion Fatigue

Zarya: So that is the nature of compassion fatigue, and it’s a key feature of burnout in many cases. Okay, so let’s talk a little bit about stress versus burnout. I love this graphic of the matches and just totally crapping out at the end. And people often ask like, well I don’t understand? So, is it stress? Is it burnout?

Or what is it and how are they related? Well, so stress generally refers to the mismatch between demand and capacity, and it actually originated from the engineering world and materials and stress and things like that. Stress can take many forms. It can be acute. So, something very sudden happens that’s very stressful.

You get in a car accident, that’s an acute stress. It can be episodic, so it can be predictable or unpredictable. But generally, like, let’s say you have a long commute every day in terrible traffic and the drivers are jerks and you know that every day to and from work, you’re gonna have this very stressful commute.

Understanding Stress & Burnout

Zarya: And that is episodic stress. Then there’s chronic stress. And chronic stress is when you’re in a situation or an environment where the stress just keeps on going. It can be a bad job, it can be a dysfunctional relationship. You know, it can be. School, if you’re in a very difficult program and struggling and prolonged chronic stress can lead to burnout.

Interestingly, stress, we associate stress with a heightened neurologic nervous system state. It’s often a little bit of more sympathetic overdrive. Your stressed, your heart’s beating fast, your palms are sweaty, you’re like your blood pressure’s going up, versus burnout where the nervous system is more in a depressed state, you can’t function.

You’re exhausted, you can’t get out of bed. You feel hopeless. There’s not this, you know, overabundance of energy that often coexist with stress. So, a little formula here, stress plus with chronic stress, I would say, plus apathy and hopelessness equals burnout. And I made this cute little graphic here, thought it was really pretty.

I was very proud of myself. That shows the progression from stress to burnout. So, you can start out. What might start out as mild stress can then progress, you know, to moderate, to chronic, to severe chronic it can intensify and then eventually become burnout under the right condition.

Signs & Symptoms of Burnout

Zarya: Okay, so what are some signs and symptoms of burnout? Well, there are very similar to signs and symptoms of stress in many ways, especially chronic stress, and it can really take a toll on your physical and mental health. People don’t always associate stress and burnout as having very real, physical physiologic consequences, but they do so exhaustion, irritability, lack of concentration, lack of interest or motivation in things that you used to enjoy and get pleasure from.

Anxiety, panic attacks, poor. Insomnia, nightmares can have skin issues. Headaches is pretty common. A lot of muscle tension, jaw tension. I used to have terrible tmj, had to wear a mouth guard, grind my teeth, all that stuff. That’s all gone now. And then there’s some often unhealthy coping techniques that we use to help cope.

So, if we could be using food or drugs or alcohol or, or even you know, screens and social media as an escape, chronic health concerns like high blood pressure, obesity, diabetes, poor immune functions can all become factors of extended periods of stress and burnout. You’re less able to fight infection, you get sick more often.

For women, it can have reproductive consequences for men even can have reproductive consequences. On and on. So, there’s like a little graphic here, which shows just all the areas of the body that can be impacted by chronic stress and burnout.

Risk Factors for Burnout

Zarya: This was really interesting to me and this was risk factors for burnout and, you know, what makes one person develop burnout and another person not to be the same job, same exposure, same conditions.

I think it really is an intersection of who you are, your past and your history, your personality, your tendencies, your temperament and the environment. So, history of depression or anxiety. This one was really interesting. History of childhood trauma. I’ve done some studies on this. Sleep deprivation.

Obviously if you don’t sleep, everything’s gonna be worse. And I think medicine has sleep deprivation just baked into the job description. Lack of work-life balance. Again, when you embark on a career in medicine, you sign on the dotted line. I will not have a life, I will not have work-life balance.

High Expectations

Zarya: Certainly, personality traits like perfectionism as well as pessimism, which might get you far in your career, the perfectionism. But then can backfire. Lack of social support, feeling isolated. Being female is of course in and of itself a higher risk of burnout. And whether that is an internal physiologic component due to the hormonal fluctuations or I would say more likely the fact that women are just asked to take on so much more workplace, home environment, parenting, all the things, being a parent.

Working a job that involves caring for others, cause that also can lead to the compassion, fatigue, difficult family life, dealing with illnesses. Like you’ve got all these things that kind of, you know, the last straw and of course financial worries make everything worse and it make you make, you also feel like you cannot quit a terrible job or a terrible relationship.

Understanding Neurodivergent Burnout

Zarya: Okay, so I wanted to actually add this in. This is not something that I always talk about in presentations, but for this group I thought it was very interesting and relevant. Just a word about neurodivergent burnout. It’s a concept that has emerged recently. There’s not a ton of scientific evidence for it, although there are some articles in the literature.

It’s mostly anecdotal or observational, but there is such a thing as neuro divergent burnout being neuro divergent in a neurotypical world. Takes a lot of effort. Often there is a lot of judgment. There’s a lot of negative self-talk. There’s exhaustion, there’s withdrawal, and there’s reduced executive function.

Then of course, there’s the practice of masking, which is in and of itself exhausting the social practice of suppressing one’s identity in order to fit in with the people around you. This is often driven by stigma, avoidance, and a desire to be socially accepted. Autistic burnout and ADHD burnout are the ones that are most commonly described, but I’m sure there are more, and interestingly, it can manifest similar to depression, but the origins are very different and the treatments are different as well.

And in one study I read, treating this type of phenomenon with antidepressants can actually make it worse. So just something to be aware of, and I thought it was super interesting that neurodivergent burnout is a thing. It can definitely, definitely coexist with other kinds of burnout. And of course, we have the lovely pandemic.

Magnifying Burnout

Zarya: So, the pandemic made everything worse and we feel like burnout should be getting better because the pandemic was sort of improving and it’s not what it was three years ago, but it isn’t. So, a bunch of different studies and data here. So up to 79% of employees said they’ve experienced some form of burnout, 59% experiencing moderate plus moderate to severe burnout.

42% of women say they experienced burnout on a regular basis compared to 35% of men. So that echoes what I just covered in the last slide. And then in 20 21, 1 in three women considered downsizing their career or leaving work all together. That’s pretty significant. I don’t blame them. Yeah. So, here’s another cute infographic that I need about the perfect storm.

We’ve got the causes of burnout and the fact that it’s not just one thing, it is the perfect storm of your past. So, your childhood and all your exposures, your personality, what are you predisposed to? Are you a perfectionist? Is it your temperament? Are you really hard on yourself, are you an empath? Are you a highly sensitive person?

And then of course, your job. And when these things coalesce, ding, ding ding, burnout. But it’s important to remember it is not your fault. I think this is something that I try to reiterate because it’s important to remember you are not a failure. You are just human.

You Can’t Pour From an Empty Cup

Zarya: And I love this one. You can’t pour from an empty cup, although we try, especially as moms, Okay, we’re moving from the doom and gloom portion of the talk into the more positive, what can we do about it section, right? So, I wanna give you guys some tools and tips and things to do.

Okay? So, we’re gonna talk about a couple of different ways to prevent stress, manage stress, set boundaries, and build resilience. So of course, prevention is always the way to go, and sometimes we don’t get there. It’s already happened. But for future episodes of burnout, because once you’ve experienced burnout once in the literature, and in my own experience, you are very likely to experience it again unless things really do change, and that includes the job.

It also includes the internal environment and the way you approach everything. Because I have gone from frying pan into fire with different jobs, different careers, and especially if you’re high achiever and a perfectionist, you’re gonna go from one high stress job and leave it and think, oh, I’m gonna solve burnout by going to a different high stress job.

And I can tell you from experience that that doesn’t work. Okay. So, sleep, it’s not very complicated or very sexy, but if you don’t get adequate sleep, everything trickles down from there. Food. Now again, this is pretty basic, but if you are eating unhealthy food, that can create stress on your body as well.

What You Put in Your Body

Zarya: If you have food sensitivities that are not diagnosed, or food allergies, that creates a constant stressful environment within your body that can. Make you less tolerant and resilient to external stressors. And also, if you don’t get enough sleep, studies show that you’re more likely to make very poor food choices.

And suddenly that fried, you know, pastry thing coated in sugar is looking really good in the morning as opposed to an egg moving your body in ways that are nourishing and not stressful. I think those of us prone to burnout are also prone to maybe intensive exercising. I know I used to, when I was very burnt out in medicine, I would go running like two hours a day and like that was not helping my adrenals.

So, moving your body, but in a restorative way, and this is something that I have come up with and that I share with all my clients that I work with, is we do one thing, less phenomenon. And I know that in our culture, in our society, we’re conditioned to always do one thing more.

Put The Cup Down

Zarya: And the analogy that I like to use is like, let’s say you’re clearing the table and you’ve got a bunch of plates and things and you’re carrying them all and you see that, oh, there’s one more cup that’s on the table and I’m just gonna take it, right?

Cuz I should really take the one more cup and not come back. And you take the one last cup and you pile it and then everything comes crashing down. So, you know what? Don’t take the cup, leave the cup on the table, do one thing less. And I, guarantee you, it’s, a game changer in your life. It can mean like, do one errand less in the day that you’ve got this list of all the things you’re gonna do one thing less on your to-do list. It’s pretty magical.

Managing Stress

Zarya: Okay. Managing stress, because stress is gonna come up. We can’t prevent it. It’s kind of a fact of life. But what can we do? So, making a list to prevent overwhelm, I find is very helpful. Sort of a brain dump, getting things out from inside your head onto paper. Some people even like to keep a list by their bed so that they can, you know, if they’re having trouble sleeping, their mind is racing and they’re trying to go through their list, and you just get it out, write it down, speaking up, making your concerns heard.

If something is not right at work, you know, let somebody know. It’s often easier said than done, and that’s gonna come into the next key point about setting boundaries, completing the stress cycle with self-care that works for you. So, in my last talk that I gave, I did talk a bit about, you know, what does that mean, completing the stress cycle.

Completing the Stress Cycle

Zarya: And it’s a whole other talk, but it’s a concept that, you know, there’s the stressful event in and of itself, and then there’s the aftermath. And all of the, the emotions and the hormones and all of the things that get built up in our system that we need to release. And we’re often not that good at doing that.

So, in the old days, if you were chased by a sabretooth tiger, and then you turn around and you kill it, and you go back to your village and you have a celebration, that’s kind of like completing the stress cycle. But in modern times, let’s say you’re having some sort of terrible discussion on Facebook and someone’s being really mean to you, and then you log off and then you feel horrible.

And then what? Like you’re still carrying all of that negativity and those stressful emotions. Your blood pressure’s high, your heart is pounding, and you feel very anxious. So, you need to find a way to discharge that. And whether that is going for a walk-in nature, gentle exercise, meditation taking a hot bath, you know, figuring out what are the things for you that can help offset that stress.

And just make it more manageable. Okay. Setting boundaries. Boundaries are such a beautiful thing. I have this great book sitting on my desk called Boundary Boss by Terry Cole. Highly recommend it. She also gives a free course on Insight timer, which is fantastic on boundaries. What are they? How to set them.

Knowing Your Own Limit

Zarya: Knowing your own limit. I think that’s something that we could all be better at. No is a complete sentence and no, it doesn’t feel that way a lot of the time. Feels like we have to justify or explain or take care of other’s feelings or that, you know. It’s just no, you can be responsible for yourself and say no, and you do get to decide.

I think there’s an element of feeling a loss of control or a lack of control in a situation that can lead to burnout and. Really reclaiming that power and realizing that you do have the ability to change your circumstances and your environment. And there is always a way out. And asking for help, I mean, asking for help is really important.

I think I get to this later, but you know, this is not something that should be taken lightly. Especially if you’re having negative thoughts or suicidal thoughts and you have to reach out, call a mental health professional, call a hotline, call a friend. You know, this is really not the time to go it alone. Oh yeah, it’s on my next slide.

Building Resilience

Zarya: Building Resilience. So, note, I did not say build tolerance because I hate that when people come to me and they say, I just, I need help. I need to work with you cuz like, I just really wanna build more tolerance. And I’m like, yeah, you actually need to build less tolerance, distress.

I hate to break it to you; more Tolerance distress is not necessarily what we want. We want to be able to check in with ourselves, know when our stress levels are getting too high, and not try to push to higher levels, but to yes, flex those muscles and build up resilience so that we are a little more resilient to stress so that the very smallest amount of stress doesn’t break us.

So that includes things like learning, breathing techniques and practicing those when we’re calm, which is what we’re gonna do today. Starting a meditation practice is something that I help folks with all the time. I’ve been a hardcore meditator since 2018. I haven’t gone a single day without meditating.

And prior to that I used to say, I can’t meditate. I’m too stressed to meditate. So that’s what’s hilarious. But, very poignant and telling, discovering what recharges you. So, is it a hobby? Is it crafting? Is it for me, I’m a semi-professional singer. I sing with the Portland Symphony and just doing something artistic, creative, performing headphones are falling up that can really recharge your batteries and bring you some joy.

The Importance of Seeking Help to Overcome Burnout

Zarya: And then of course, seeking help from a qualified professional, whether that’s a therapist, a coach, a psychologist, a psychiatrist, maybe your workplace has resources. It’s really important and I think that so often we avoid seeking help for various reasons. Whether it’s, you know, the stigma or, oh, I can handle it by myself.

And it was interesting cuz med Scape just published a study of about physician burnout and of course it’s at an all-time high. It’s epidemic right now across professions. So, teachers also are experiencing epidemic burnout. And when they surveyed the participants about like, why haven’t you sought help for this?

Cause most people have not sought help. The majority said, oh, I can handle this by myself. This isn’t something that requires, you know, it’s no big deal. Well, I would say not true. Okay. These are some of my images about rest, reset, recharge. And sometimes at this point in the talk, I also, we talk about different types of self-care, different types of rest, but I don’t wanna get too in the weeds and I wanna make sure that we still have enough time for questions and enough time for our little breathing exercises.

But gosh, I really wanna eat this food right here in the corner and take a lovely bath and read my book. Do some yoga, meditate, blow bubbles in a field of sunflowers. Who doesn’t wanna do that? Right? Okay. All right. We’re, we’ve come to the breathing portion of the whole thing.

Breathing Exercises

Zarya: I thought that it would be fun to do some interactive. Exercises with you guys and just teach you some very, very simple breathing techniques.

You might actually know these already. Who knows about box breathing? Okay, we’ve got, got a couple. So, I’m gonna teach that one cuz it’s really simple. And then maybe we’ll do a more advanced technique, which is the 4 78 breath.

Do people know the 4 78 breath too? Oh, we’ve got a couple of nods. We’ve got some advanced experts here. That’s one of my favorites. But, you know, for the newbies, we’ll teach some of that. Okay. So, box breathing is really simple. If you think about a box and picture that in your mind, that’s what we’re gonna do.

We’re just gonna, it’s about breathing in and breathing. And timing things and just timing your inhales and your exhales and being very conscious and mindful of your breathing. Cause breathing is something that can either be automatic as part of the autonomic nervous system, or it can be voluntary. So, you can either not think about your breathing, cuz most of the time we’re not thinking about it.

We’re just breathing, we’re staying alive. We’re not like, okay, I need to breathe now. Or you can consciously make an effort to focus on your breathing. And when you do that, you shift the activity of your nervous system towards the parasympathetic end, which is important because there’s a balance between the sympathetic branch of the nervous system and the parasympathetic and the sympathetic is the whole fight or flight.

Fight or Flight Response

Zarya: I’m gonna die, I’m being chased by sabretooth tiger. There’s a freeze component in there too. I’m gonna play dead. I’m losing my mind. That’s not a great arm of the nervous system to live in. It’s a great arm of the nervous system to activate when you have to. But a lot of us live there and that’s not terrific.

So, if we can shift things to the parasympathetic, which is more governed by the vagus nerve, it’s the rest and digest and the chill side of the nervous system, then we can have an impact physiologically on our body, on our mind, and just kind of bring everything down. Okay. That’s my little sciencey talk before we actually do this.

Box Breathing

Zarya: So, box breathing is, oh, yes. There is also the fawn response. Yes. Yes. And that is especially popular among people pleasers and constant people pleasing gets to be very exhausting as well. So, with the box breathing, you’re gonna breathe in and you’re gonna hold, and you’re gonna breathe out. Then you’re gonna hold and you’re gonna repeat.

And it’s really simple. And you’re gonna breathe in through the nose, breathe out through the mouth. So, we’re gonna go in, hold out, hold in, hold out, hold. I’m not gonna talk now. I’m gonna just let us do it for a moment or two.

And when you’re breathing in, if you can try to think about filling your lungs from the bottom. Of your chest, ribcage, abdomen, cuz your lungs go all the way down. I think some people think the lungs are here, the lungs are not here. And we breathe sort of from here to here. That’s very shallow breathing. If we wanna get deeper down into the ribcage and just imagine you’re filling from the bottom up.

And then that will also give you these more relaxed breaths that are less up here like {breathing}. So that’s if you’re doing box breathing and it’s up here, it’s not gonna be very restorative or relaxing. Something you can practice on your own, really anytime.

And then if you’re in traffic and something’s bothering you, you’re gonna be like, okay, I’m gonna breathe, I’m gonna breathe through it.

4 7 8 Breathing

Zarya: Okay, I think we have time to do the 4 78 cuz I’m nearly done with the slides. So, the 4 78 breath is something that I learned from Dr. Andrew. Who is a really cool dude. He’s an integrative me medicine expert and specialist and founder of the Institute for Integrative Medicine in Arizona. He’s really great and he’s got a video online of the 4 78 breath that you can watch, but I’m gonna teach it to you guys now. It’s similar to box breathing.

It’s a little bit of a different pattern and a different concept. So, you’re gonna breathe in for a count of four through the nose and you’re gonna hold for a count of seven. That’s pretty long. You wanna kind of pace yourself and then you’re gonna breathe out through the mouth slowly for a count of eight.

So, you’re gonna wanna, you’re gonna wanna pace yourself with the holding and the breathing out, but the fact that it’s elongated really kind of. Kicks in that parasympathetic response and then ideally you are gonna repeat that hold. So that’s like one, that’s one, you know, set the 4, 7, 8 and you’re gonna repeat it four times and that’s one cycle.

And then you can build up to doing more cycles. Now some people get dizzy when they’re doing this, so definitely don’t do this one while you’re driving until you’re a real expert. I love to do this one falling asleep. So, if I’m stressed out and I’ve got a lot in my mind if I do the 4 78 breath while falling asleep.

Putting it Into Practice

Zarya: Also, if you’re dizzy, you’re lying in bed, probably fine. Then next thing I know, I’m asleep and I used to have terrible insomnia. So, it’s really pretty magical. So, ready to try it? Yeah. Okay, so we’re gonna breathe in for a count of four through the nose, and again, try to focus on that deeper breathing and expanding the lungs.

So, we’re gonna go.

Hold, 2, 3, 4, 5, 6, 7.

Yeah. Did anyone, did anyone make it? Did anyone not make it? It’s okay if you didn’t make it. Cause it does take some practice to build up to that. And I can send Aurora the link to the video where he talks through it and shows you how to do it and it’s really pretty great. And so, the way I coach people and I teach people is you gotta practice these things when you’re feeling great and when everything’s fine, it’s not a good idea to practice or to try to learn them when you’re in the middle of.

A fight or flame moment, because that’s not the time when any kind of learning is gonna take place. And so, if you do practice this, when you are in a good state of mind and calm, then when you do need it, you can just kick in and you’ve got the ability to really call on these tools in your toolbox when you need to.

Connect With Zarya

Zarya: We’re getting towards the end. So, we’re gonna move to questions and then this is just a couple of ways that you guys can get in touch with me. Obviously, you can email me. Hello Dr Zarya.com. Can check out my website. It’s just Dr Zarya.com. You can come find me on Instagram and follow me at Dr.

Zarya Rubin. I do have a private, a free private women’s community on Facebook that’s a Facebook group called From Burnout to Brilliance. And we talk about all this kind of stuff. We share healthy recipes. We talk about life and parenting and clean beauty and all that fun stuff. And there are a couple of ways to work with me if you guys want.

I do offer a free discovery call on my website, so I’ll, you know, can talk to you guys. I do offer one-on-one coaching. So, if you have questions about that, feel free to reach out. Oh, also on my website, you can download a free guide. So, I have a free guide that is like the guide to, you know, conquer Burnout and truly thrive.

And so, we can get that. And we cover a lot of the stuff that we covered here. So, I’m just gonna say thank you for being here on your Saturday morning and spending your time with me, and I hope this was helpful and enlightening and enjoyable.

Final Thoughts on Overcoming Burnout

Aurora: Any final thoughts before we wrap up?

Zarya: Oh, yes. I forgot to share my book. It’s not my book. I have a chapter in the book it’s called Thriving After Burnout. And it is a really cool book that just came out on Amazon and it is a compilation of real stories by female physicians. And so, we all submitted a chapter, so my chapter’s in there, you can read all about my CPTSD and how it impacted my medical career and leaving medicine.

So yeah, this is all of us back here on the book and it was a real honor to be part of the book and hopefully it’s gonna help other women and other physicians and to read about our stories and how we coped. And some people stayed in medicine, some didn’t. And I think it’s, everyone has a different path and it’s all about figuring out what is your path and what path do you wanna walk down and what do you want your life to look like?

Because this is really it, man. It’s not a dress rehearsal, the real deal. It is Thriving after Burnout. And I actually have the link to it too. I can put the link in as well.

Yeah, so I would love to, you know, chat with any of you privately or have you join my group, or if you feel like you wanna try some coaching, happy to talk about that too.

Wrapping Up

Aurora: Awesome. Well, thank you so much and like I said, if you guys wanna dive more into the stress cycle piece of it, Zarya I went like super deep dive into the stress cycle and the last one, in fact, I don’t even really think we had that much time for discussion because the presentation was so long, but it was like jam packed. So, if you guys have interest in that, like I said, the audio talk part is in on the podcast, but you can also access the full video in the membership library for guest calls.

Zarya: And if anyone feels like their workplace or would benefit from a talk like this, like I’m happy to come in to your workplace and deliver a little talk or a workshop something like that too.

So, thank you so much. It’s always fun to hang out with you and your folks and I hope it was helpful.

Aurora: Yeah, for sure. Thank you so much.