Why Burnout Prevention Is More Than Self-Care with Shaina Siber, LCSW

You clock out, but your brain doesn't. You're still short with your kids, still numb through your own weekend, still running on a threat response that never got the memo the workday ended and you're not sure self-care is actually touching it.

Shaina Siber, LCSW, is a licensed clinical social worker, integrative therapist, and founder of AFFIRM Mental Health, a continuing education company for mental health professionals. She's the author of "Using ACT and CFT for Burnout Recovery: The Beyond Burnout Blueprint" and host of The Affirming Minds Podcast.

In this episode, you'll learn:
- Christina Maslach's 6 systemic drivers of burnout — and why most of them have nothing to do with willpower or self-care
- How Compassion-Focused Therapy's threat/drive/soothing model explains why "well-intentioned" coping (a workout, a glass of wine) often doesn't actually calm your nervous system
- Why venting has a real physiological upside in small doses — and how it backfires when it becomes reflexive ("the dose makes the poison")
- Two steps from Shaina's Beyond Burnout Blueprint: creating a compelling vision, and identifying your unique strengths
- What she'd change first as an employer to prevent burnout on a team — starting with psychological safety

Timestamps:
0:00 Welcome & Meet Shaina Siber, LCSW
0:53 The Martyrdom Baked Into Helping Professions
3:34 What Burnout Actually Is (Beyond "Being Tired")
6:59 Christina Maslach's 6 Systemic Drivers of Burnout
28:31 Compassion-Focused Therapy: Old Brain vs. New Brain
33:01 The 3 Systems of Emotional Regulation (Threat, Drive, Soothing)
38:44 Step 1: Creating a Compelling Vision
44:35 Step 3: Watch Your Words (Venting, Complaining, Reassurance-Seeking)
49:27 Step 4: Identify Your Unique Strengths
54:29 Step 5: Be Kind to Yourself and Others
59:49 What Leaders Can Do to Prevent Team Burnout
65:44 Where to Find Shaina Siber

If you liked this episode, you might want to check out this episode on Perfectionism education and research.

Resources mentioned:
- Shaina's book: "Using ACT and CFT for Burnout Recovery: The Beyond Burnout Blueprint"
- The Affirming Minds Podcast (Shaina's podcast)
- AFFIRM Mental Health 
- Christina Maslach's burnout research (6 systemic drivers)
- Paul Gilbert, founder of Compassion-Focused Therapy
- Kristin Neff's self-compassion research (restorative and fierce compassion)

A short mid-roll CTA inviting listeners to take the Stuck Point Quiz at lorainmoorehead.com/quiz, identify their clinical stuck point, and access personalized resources. Includes an optional invitation to join Lorain’s newsletter.

The Self Careapist Therapist Podcast is a biweekly conversation with Lorain Moorehead, LCSW a therapist in private practice.  With guests ranging from expert psychologists, therapists, researchers and authors, each episode offers a deep dive and keeps listeners from intern to advanced supervisor  in mind while dropping gems and aha moments for everyone who loves to learn! If you love learning and want to keep track of some future learning opportunities, grab your personal curriculum here!

If you liked this episode, feel free to subscribe and leave a review! Your support helps us be a top mental health podcast and resource.  See you next week!

Transcript

SPEAKER_01 0:00

Welcome to the Self-Cherapist Therapist. I'm Lorraine Moorhead, and this is a Therapist to Therapist podcast for mental health professionals who want practical, evidence-based skills they can actually use in session. Each week I'm joined by leading experts in the field as we talk interventions, modalities, client populations, clinical supervision, and sustainable self-care. The kind that helps you do meaningful work without burning out. If you're a therapist, counselor, social worker, psychologist, or graduate student looking for real continuing education, you're in the right place. Welcome back, Carapists. Today we have a really exciting episode in front of us on burnout, which I know is a topic that we think about and maybe even experience a lot in our field. And I'm so happy to introduce Shayna Syber, LCSW, who is an author on the topic, an educator on the topic, and happens to be the host of her own podcast called Affirming Minds. Welcome, Shayna.

SPEAKER_00 1:05

Thank you so much for having me. I'm thrilled to be here.

SPEAKER_01 1:09

So, as you know, I've been deep diving into your book, Using ACT and CFT for Burnout Recovery, the Beyond Burnout Blueprint. And I think it's going to be such an interesting conversation today where we really get to talk about the evidence-based approaches that you've learned about and developed when it comes to burnout.

SPEAKER_00 1:33

Yeah, no, I'm excited to get into it. And my own personal relationship with burnout has evolved over the years. And I think kind of utilizing some of these theoretical frameworks to guide my thinking and sort of intervention around it has been really helpful because, you know, we're both social workers. For a long time, I was just like, listen, this is our lot in life. We will be burnt out. And almost sort of some of that martyrdom that can be built in our profession, that we're just like part of doing this work well is um self-sacrificial in a way. And I'm really glad for my own sustainability because I happen to really love being a social worker and a therapist that um I have been able to apply different approaches that I think are gonna allow me to do this work much longer and sort of uh decouple from some of that early career thinking.

SPEAKER_01 2:24

Oh, I think that's such a mouthful that you just said because some of that really is built into the framework of our training and then into the careers where we are even maybe conditioned in some ways for better or worse to expect this isn't a career path that will pay a lot. You'll have to find the joy in other areas. I remember hearing messages like that in grad school. And then I remember having um a boss when I was leaving for supervision purposes, you know, I was needing to get something that this job didn't offer that mentioned, well, these clients need you. It really is baked into some of the work that we're doing to have a bit of martyrdom, probably across disciplines, but in particular in social work.

SPEAKER_00 3:12

Absolutely. And like caregiving and helping professions are sort of historically lower compensated in our society, which I think kind of speaks a lot to our values because it doesn't it doesn't fit neatly into a capitalist system that just sort of looks at outputs and profits and productivity that kind of grow in that way. And yet we are still embedded in healthcare and helping professionals within this capitalist system. So, how do you get people to do this emotional labor at scale? Well, you make them feel like their morality is tied up in it. And I think that's a lot of what, you know, social workers, therapists, teachers, um, you know, anybody in healthcare really is sort of has this sort of uh complex and loaded relationship with burnout that is one guided through uh the lens of capitalism, but also how our morality and self-worth gets very intrinsically tied into doing the work.

SPEAKER_01 4:13

That's so interesting. For anybody kind of thinking about burnout for the first time, how would you summarize it? How do you look at it and what does it look like?

SPEAKER_00 4:23

Yeah, so um, you know, the technical definition um that was sort of I I oftentimes default to the World Health Organization um definition of burnout, uh, just to sort of have some shared language, although I have, you know, my own um, I think it has its own limitation, is when we're talking about burnout, um specifically occupational burnout, we're really looking at it as an occupational phenomenon. Um it is not categorized as a mental health condition or a medical syndrome, um, but core symptoms or characterizations are dimensions of exhaustion and energy depletion, um, increased uh distance or uh negativity or cynicism related to one's work, and reduced professional efficiency. So, again, like we kind of have to conceptualize this from burnout, is oftentimes when we have historically been looking at burnout is when people become less productive at their jobs. And we miss a lot of people that are suffering with burnout symptoms in their occupational context. And we see this all the time with really high-achieving professions like physicians, where they have amongst the highest rates of completed suicides, um, but oftentimes aren't getting support around burnout because their productivity and their work performance are uh very rarely the last things, if at all, impacted, even though they're significantly suffering. So the way I sort of have come to see it over the years of doing this work is that burnout is a likely outcome of a person's attempt to function or conserve energy in the context of chronic occupational stress. And it kind of reflects our attempts to adaptively respond and to sustain our occupational demands and pressures, but frequently has these negative impacts on our mental, physical, and relational health and well-being over time. Um, and certainly burnout happens at really high rates. Different studies show different things, but uh many indicate that at least three-fourths of the workforce will have burnout at some point in their lives. Um, but certainly things like the type of job that you have, the work environment and culture, and your own personal like trauma history, uh, physical and emotional health uh may impact your vulnerability to experiencing burnout and the severity of that burnout experience.

SPEAKER_01 6:56

Something that you said really jumped out with the examples that I've seen, which is the relational element and the physician example was a really powerful one because I think I see that in our colleagues as well, that a client may never see burnout in their therapist, but the people that will might be friends, family. I've heard examples of people responding out in the community on a holiday or on a weekend in a way that they later checked in and said, that wasn't me. I would want to help that person or I would have wanted to listen and hear their story. And I just didn't have the capacity for that because I've left it all at work.

SPEAKER_00 7:37

Yeah. Yeah, absolutely.

SPEAKER_01 7:41

What are some of the systemic drivers that have been found to contribute to burnout?

SPEAKER_00 7:46

So Christina Maslak, who's like the premier researcher on burnout and has been doing um burnout research since the 70s, identified six systemic drivers of burnout that I think really sort of stand the test of time and are deeply relevant today, even as sort of our workspaces can evolve in terms of emerging technologies and things like that. Um, so first being overwork or work overload. So um when expectations, volume, and pace are not sustainable, that is a significant driver of um burnout, significantly, as well as um health problems and even your increased risk of mortality. So we see when people are like just from a time perspective, when people are working more than 55 hours a week, deaths go up in terms of risk of stroke, heart attack, things like that. Um, but certainly things like overwork and workload are a huge issue that I think we always need to be talking about in terms of burnout. Um, the next is lack of job autonomy. So when people do not feel like they have meaningful influence of the how, when, and what they're doing at work um and where now today in our modern context, when we think about like when there is flexibility around remote work and things like that, um, that is also something that can be a hidden risk for burnout. Um, and then the converse can be protective, right? So if uh lack of job autonomy is a risk factor, then more autonomy is typically a protective factor. Um, another one is lack of reward. Um, so we're really thinking about both recognition and compensation, which I think in burnout conversations, we historically really underemphasize the importance of monetary compensation. We don't talk about people are being paid appropriately to meet their level of uh sufficiency they need to live well. Um, and many people in our country we know don't, as uh cost of living increases and wages sort of stagnate behind. Um, so certainly a lot of this is recognition through verbal acknowledgement, appreciating people, supporting people, promoting people. But also I think we really have to talk about compensation in this country. Um, because when people are living in poverty or poverty-adjacent um conditions while working, um, you know, there it there's not like no pizza parties, no like, you know, wellness programs are really gonna be able to supersede the uh the physiological and health impacts of that. Um, so yeah, so another one would is that sort of lack of reward. Lack of community is another one. So is there community and connection? Do people experience support and trust and a sense of belonging at work? Um, do they feel like they can work with people effectively? All of those good things. And it's way more nuanced and complex than just like sending everybody back into the office and having everybody in the same physical space. Like, you know, we've had burnout predates any of the more modern kind of hybrid and remote work context. And lack of community is something that has often plagued different work communities in in a big way. The next one is a lack of fairness. So it really is troubling to see how much uh bullying and harassment still happens in modern-day work environments. Um, this really increases in risk for marginalized folks. Um, so whether that be gender minorities, racial minorities, or other people that have marginalization related to body size, um things like ableism, et cetera, um, that bullying and harassment are still chronic place workplace issues that really need to um be addressed and eradicated in healthy work cultures in meaningful ways. Um, because even if someone is not being directly bullied or harassed, even being exposed to bullying and harassment in the workplace increases burnout risks for other members of the community. Um, so it really is like a contagion when we think of burnout when bullying and harassment is happening. So even when there aren't those like really um malignant bullying and harassment, even lack of fairness, like favoritism and lack of transparency can also be under that sort of broaden umbrella of lack of fairness and can contribute to um, you know, uh increased burnout risk in the work culture and community. And then the last one is a mismatch of values. Um, so that can be, you know, the work uh being misaligned with uh people's deeply held personal values. And at an extreme, we're seeing more and more in the literature about moral injury. Um, so this was first conceptualized in military context of when people were asked to do things through their service that directly compromise sort of their deeply held moral and ethical values. So um, but we have historically now been seeing this. We have been seeing this more recently, rather, in healthcare context and other professional settings. I think right now in the political climate, we're seeing this a lot, that people are literally resigning all in different, you know, states, uh areas of government agencies because they're being asked to do things that are, you know, morally compromising and feel like they are at the, you know, sort of um, they're being challenged in that way. And everybody is different states of privilege. So when people are being asked to things to do and their livelihood depends on it, um, it it's not always uh accessible to do the thing of saying, you know, I'm just not going to participate or I'm gonna leave this job. Um so one, I want to just say that as a call out. When people do that, take that courageous step, we should really be as a community supporting them and uplifting them. Um but we have to also recognize that moral injury is happening in all sorts of work environments. Um, and how do we acknowledge that and and indicate that a lot of my burnout recovery work really got my curiosity really piqued at the height of COVID? And we saw this for for many, many people during the height of COVID for frontline healthcare workers who felt really morally compromised of sort of being thrown into this um like treatment environment with very little knowledge or resource in how to effectively manage the pandemic and that cause um not just burnout, but moral injury, we're finding more and more almost has symptoms that can mirror post-trauma symptoms. So things like deep shame, anger, um, intrusive thoughts, nightmares, recurring symptoms, hypervigilance, things like that. So something we definitely want to be cognizant of. Um, but even if there's not something that reached the height of uh moral injury, like I think for me as a social worker, I have just had times where I felt like I was being asked to see too many high-risk clients that it didn't feel safe or it didn't feel appropriate, and those sorts of things could feel more like them morally compromising. Or perhaps I had to call, I'm a mandated reporter and I had to make a report that I felt in my bones like I was required to do to maintain my license, but felt like would do more harm than good to a family. Like those are sort of some of the ethical and moral dilemmas that can come up all the time in professional settings.

SPEAKER_01 15:37

Yeah. I I'd like to spend a little bit of time kind of thinking through some examples of each too. But you're right. This field in particular is so full of ethical dilemmas where both choices sometimes feel suboptimal. And that was a great example. I think I I hear that a lot from colleagues, but also um associate licensed professionals or interns in the field that they know in their bones that they won't get to see that client again once they make the report. And holding in the other hand, they know that it's they're sure that from their ethical board's perspective, they need to make that report.

SPEAKER_00 16:17

Yeah. Yeah, absolutely. Absolutely. Sort of stepping back that like rules and regulations are often met with like good intention, but their applications, when they're done rigidly, can be really, really complicated. And we run into that all the time. Um, where we have these systemic challenges that, and we're, you know, we kind of often have that conversation that we're working within broken systems. And how do we work within broken systems in ways where we can still show up fully as ourselves and feel like that we are practicing in ways that feel aligned with our values? And that's sort of a lot of the work that I wind up doing, especially with people in these healthcare spaces, and then increasingly things, even like legal spaces and uh and other things like that, that kind of really have these like systemic challenges deeply embedded in them.

SPEAKER_01 17:06

Yeah, so true. I think it'll be helpful for us to talk a bit more about that too, because some of these perceived challenges in a singular workplace really do start from a really macro lens. And so some of the things that people hope and wish could be changed in their small office are actually coming down from insurance, some different systems that I think it'll be important to talk about. Um, with our per profession specifically, when you were talking about rewards, I was thinking about the reward of clinical supervision toward licensure and how sometimes that can be one of the agreements that a person makes with their employer when they're signing on, and then for whatever reason that ends up not being sufficient, or the supervisor with the correct discipline for supervision leaves the agency, or um they end up not maintaining their supervision credential or whatever it is. So you've expected and maybe taken made compromises in other areas of the uh the job, and then this main reason for signing on ends up not coming to fruition or being available.

SPEAKER_00 19:04

Yeah, absolutely. And I think, you know, certainly speaks to a lack of reward, but also a lack of of fairness, right? So like when we sort of are are going and we're sort of already making concessions to try to, I guess, think with that long-term thinking of like, okay, well, how do I use this opportunity to support and move as like forward as a, you know, a professional and maybe at least set myself up to be well supervised and then be, you know, compensated further in the future because I've gained all these like skills and I'm moving towards my independent life's insurance or whatever, whatever the goals are, like those things can feel deeply, deeply um, you know, sort of like a deep injury, of course.

SPEAKER_01 19:48

And then I was thinking too, when you were talking about a lack of positive feedback, or when the feedback doesn't amount as a sign I'm on the right track for this promotion or this raise or this thing, and then those things never come. So it feels like a clarification and a transparency about what to expect and when.

SPEAKER_00 20:14

Right. Absolutely. And I think that's a really good point because I when I was sort of at the height of my burnout, um, some of this like overwork was self-inflicted. I did a lot of like striving to prove myself and prove my worth and prove my value, um, a lot of people pleasing and like boundary, like personal boundary violations and volunteering for things, just sort of like taking on more to prove my birth and value, in some ways, hoping that I would get consideration for improved compensation and, you know, uh promotions and things like that. I got a lot of attaboys. I got a lot of like, wow, you're doing great. You're doing amazing, fantastic, keep up the good work. But a couple things can happen there. One, in that overwork, if we are doing it with that sort of need for approval or need for a validation, it could be like an endless well where um, even if I was getting praised, it was very easy to like kind of minimize it with any perceived negative feedback or um not being considered. And it did not amount to me being treated fairly in terms of compensation and other and other mechanisms, even when I did get promoted. Um, and I think it also shifted expectation, meaning like the more I did voluntarily, the higher the expectation norm became for me. And then I sort of like worked myself up into a frenzy that I couldn't meet my own internal expectations that I had created. Um, so a lot of times we can do that if we don't have boundaries and we overwork beyond it. Instead of being like getting all of this acknowledgement for extended efforts, what happens is there's a slow drift of expectations where that becomes a new normal. And I think that has happened in our field, right? Where, you know, in a community mental health, like the caseloads people are seeing today would have not ever been considered 20 years ago, but there's just like a slow drift of more and more and more. Um, but sometimes these are also self-inflicted. And that's also a lot of the work that I'm doing is like when we are um getting curious about why we sometimes contribute to our own burnout dynamics in this way. A lot of it is systemically driven, but then there is also a participation in peace where we are sort of have a relationship with some of these systems that can be oppressive, that can. Amplify our suffering in certain cases.

SPEAKER_01 22:41

Oh, I think that's such a great point. Everyone knew that they could count on you for certain things. And if this is not about you, obviously, but if an employer is looking for a different metric for promotion, they're accepting all of that work, but maybe they're looking for something that you're not even aware of. But that agreement where you where a therapist could be working themselves into the ground and the employer is allowing it, or lightly saying, Oh, you don't have to do that, but they're looking for something completely different that the therapist hasn't had an opportunity to show yet or doesn't even know that the employer might be looking for. I'm thinking like specific leadership skills or specific clinical judgment, things like that, when the person thinks they're proving what they need to prove by just taking on so many extra clients, staying beyond the hours that are recommended, leading up projects, things like that, but the employer all the whole time has been looking for something else that they haven't been clear that they'd be looking for.

SPEAKER_00 23:50

Right, absolutely. And that's what I'm thinking a lot about with burnout is patterns, right? And especially what are the reactive patterns, the the patterns we're we're kind of engaging in without much thought. To me, it wasn't a thought of like being the first person to volunteer. But for me, it wasn't a thought to say yes instead of no to things. It was happening reflexively. And oftentimes with burnout, we really are in these autonomic nervous system loops that detach us from intentionally choosing in any given moment. Um, you know, what what our next choice is, what our the next step is, and connecting that to some sort of bigger mission or or um connection to sort of what our our why is when it comes to our our professional work and identities.

SPEAKER_01 24:42

Yeah, I think that that it just in my own practice, this is an issue that I talk about a lot with the high achievers that I work with because some of that automatic response is coming on so early in life. You know, it's such a sophisticated response method to get a need met, starting so early that I I think you explained that so exquisitely that of course that feels automatic and necessary through the whole trajectory because it's it's developed really early for a lot of people.

SPEAKER_00 25:21

Yeah. And it's so interesting you say that because when I first became a therapist, my um I really wanted to work with adult survivors of childhood trauma. And as I got through, you know, kind of moved into this burnout work, um, you know, maybe there was like a s the slightest thought was like, am I departing from that? And I would say not at all, because what happens in our professional lives, and I, you know, I work with people in the United States. Um, imagine many people tuning in might be um practicing or living in the United States. There's this kind of two-fold process. One, we spend so much of our adult lives working. So it's of the average American, it's something like 90,000 hours. So, well, more than one-third of our waking hours of our adult lives, more than most of us will spend with our partners, with our friends, with our children in many cases, right? So a lot of our lives are connected to our work. It's also a very American concept, a very that our work is who we are. It becomes sort of synonymous. So people ask, like, what do you do? As almost like a interchangeable question of like, who are you? Like, what are you about? What is like, what is it that you do in this world, right? Which if you go to other countries, like you could go through a dinner party and like be introduced to someone and that never comes up because it is not as centered as it is in our US westernized concept and relationship with work, which is very work-centric into our identity. So when we spend a lot of time somewhere when it's critical to our survival for most Americans, that if they miss one or two paychecks, for most people, it's very difficult to have long-term survival. And there's these power dynamics of being employed, where your relationship with an employer will have a lot to do with your daily work experience and your livelihood. It can pull up all of that stuff from our childhood in terms of our attachment, how we navigate complex social dynamics really maps onto a lot of our childhood experiences. So a lot of the people that I work with that are struggling with burnout, they are oftentimes trauma survivors, and they really often fall into this fawning response where they were oftentimes survivors of persistent trauma, meaning they were exposed to some sort of chronic neglect, abuse, complex in childhood where it wasn't like a one-and-done experience. It was something where their attachment was, you know, kind of wrapped up in their survival, that they had to have a relationship in some sort of oppressive system or abusive relationship to survive. So a lot of people learn to fawn, to acquiesce to a system, to try to please caregivers and then later bosses or the system at large to be accepted, to survive, to function well. So a lot of the people that I work with at at least some point in their burnout uh journey are engaging in some sort of overfunctioning. So, you know, sort of over-achieving, rushing, overscheduling themselves, never feeling enough, sort of chronic vigilance or anxiety, or that fawning of like appeasement, people pleasing poor boundaries, um subjugating their own needs for other people, feeling responsible for other people's needs and codependency patterns. And this really comes up in the work of burnout.

SPEAKER_01 29:04

It's similar to attachment that we see in relationships, where um you expect, oh, I don't, I don't want that kind of attachments anymore. You would expect that a system would seek out a more helpful, secure attachment, but instead often our systems seek out something familiar. And so it makes a lot of sense that we we we enter into the workplace, the relationship we have with our work in the same way, a way that feels familiar, a way that feels in some cases abusive or that we're taken advantage of because we feel it's familiar enough to navigate rather than maybe being automatically able to, on instinct, select something that allows our nervous system to sort of relax. Absolutely. Can you talk about how you apply CFT or compassion-focused therapy in your lens of looking at burnout?

SPEAKER_00 29:59

Sure, sure, absolutely. So compassion-focused therapy is a therapeutic model that was developed by Paul Gilbert in the 2000s. And what he was essentially finding is he was doing cognitive behavioral therapy and finding it to be effective in many cases, but was struggling with people who individuals that had high levels of shame and self-criticism. So even when they could do some exposure work, even when they could do some cognitive, that was not necessarily getting at their felt experience in relationships to their thoughts. So they could say things like, yeah, I know it's stupid to look at it like that. I know that when I go to the gym, nobody else is thinking about me. But right, but it was still almost like either not touching the shame or self-criticism or activating it. So he wanted to look at how we can help people generate self-supportive inner voices and have a felt sense of compassion. So he created compassion-focused therapy, which is one grounded in attachment theory, looking at sort of our wiring around attachment and also on a growing body of neuroscientific evidence that demonstrated our affiliative motives and emotions can have a major impact on self and our affect regulation. So essentially, the part of our mammalian drives that are wired for connection in relationships and feelings of soothing and safety that, like, how could we leverage those to help soothe our emotions? So he essentially proposed a biological framework for compassion. Um, and he talks about our evolutionary system. He talks about these old and new brain systems that we have the sort of reptilian parts of our brain that are our brainstem and our basic survival that were developed 500 to 600 million years ago, and this mammalian brain that's more of our limbic system and the attachment I was just describing that is like 150 million years ago in our evolutionary history. And that part of our brain is wired for survival. It keeps you alive, it ensures the survival of our species, it connects us to care about our own imminent survival. Um, and it's very fast and it's very automatic and it's very reflexive, but it's really rooted to keep us reproducing as a species. And then we have this newer part of our brain that's only evolved in the last three million years or so, um, that is our neocortex, our prefrontal cortex, does that do all of this higher level thinking and reflecting. And it helps us plan, it helps us make meaning, it helps us create art and build cities and not just think about reproducing for the future, but sustaining for the future. It's more slow, it's more deliberate, but it also can function in very, very tricky ways with our old system. So we have this old programming and these new programming that's sort of lopped on top of each other. And the way they interact, instead of working seamlessly together, they can interact in tricky ways that get us trapped in rumination and comparison and self-criticism, and we can get us trying to think harder to deal with issues of threat, right? Because we're so good at anticipating threat that we can almost feel like it's happening in the here and now. Um, so he uses this sort of tricky brain as a way to normalize our struggle, right? That many of the like shame and self-criticism are not coming because we are deserving of shame or self-criticism, but are functions of this very tricky brain that are trying to protect us from rejection and humiliation and alienation from social groups, or which are all things that are central to our human need to belong.

SPEAKER_01 34:00

CFT is not a modality that we've talked about or even uncovered at all on self-care so far. So I think it's really neat to have the information that if people want to learn more about it, they can. Also, in your burnout recovery approach, you integrate ACT as well.

SPEAKER_00 34:19

Yeah, I think psychological flexibility winds up being a lot of the model, a lot of the practical interventions that we do. Um, but where compassion-focused therapy, I think, has become so important for me personally and the work that I do with my clients is understanding something called the three systems of emotional regulation that was proposed by Paul Gilbert, which he basically says we have three primary emotional drives. And one is our threat system. So this is the part of our um our experience where that is really built for threat detection and protection. So that's sort of better safe than sorry, um, operates from that amygdala, uh, that threat response part of our brain. When we are in threat, we produce things like adrenaline and cortisol, and feelings associated with threat are things like anxiety, anger, and disgust. And threat is probably the most dominant system. It's like if we are feel that we're in an imminent danger, it puts us on alert to protect ourselves, and it is fundamentally important. Um, the next system is the drive system. So that is the part of our minds that are motivated, motivate us towards resource allocation. So, you know, there's no predators. Now I'm going out for food, water, shelter. In our modern day society, it's like, let me go earn my paycheck, let me go get a job, let me go get a partner, let me go on a date, you know, let me go do these dopamine-seeking activities. Both of these things are essential to our short-term survival, right? Like we need to be able to protect ourselves from imminent threat, and we need to be able to go out and get what we need to function and survive in the world. Um, but when we're burnt out, we're often stuck between threat and drive. Um, and a lot of our threat and drive is also tied up in our social status, but their threat system gets activated from daily modern stressors. Like they open an email that feels threatening to them and they convince themselves they're gonna get fired, right? And that adrenaline and cortisol starts activating through their body because of that tricky brain. And their drive system kind of kicks in of like, I gotta do send this email back and I gotta do all of these reports to show that I'm good and I'm worthy and all of these other things. So burnout really gets us in this threat and drive. And what's often neglected is this third system for emotional regulation, which is our soothing system, which is how we need to manage distress, promote bonding and feelings of safety and connection, vital to our long-term survival. And this is oftentimes what we're pushing away and we're not addressing, which is this part of us that feels content, safe, protected, cared for, feels trusting in relations, that feels satisfied with ourselves, that can feel feelings of compassion. Um, and that's where we kind of associate those experiences of like oxytocin and endorphins. Again, this is our prefrontal cortex that's contributing to this. Now, what happens often is when we're feeling threatened, we use drive as a way to try to get rid of that adrenaline and cortisol, but that's not actually how our systems work. We really need that oxytocin and endorphins to downregulate our threat response. So many people that I work with, they're feeling threatened at work, they're feeling less than, they're feeling insecure, they're feeling worthless, they're feeling really scared about the future. And they do things like even really well-intentioned things that holistically are good for their health, like go to an orange theory class, right? Or um, you know, go have a glass of wine or go um, you know, work on a paper that they're supposed to do. None of those things are inherently wrong, but none of them are going to necessarily downregulate their threat system. So we have to really almost teach people in this capitalist society how to activate their soothing system. And one of the most effective ways to do that is compassion. Compassion actually releases oxytocin, endorphins, serotonin helps reduce cortisol and um activates um and reduces the sympathetic activation. So it slows down our heart rate. Um, it does all of these things that interrupt cycles of shame and self-criticism. So teaching compassion as a skill has been a really wonderful balance to this other work of psychological flexibility and act where we teach people to be with these difficult emotional inner experiences and emotions and then take action steps towards their, you know, highly cherished values.

SPEAKER_01 38:58

I just want everyone to know that this book is like part workbook. Tana, you have so many prompts that someone can really do to get to know their own process. I think to actually be able to work through and answer the questions that you've posed and integrate the language that you've included is gonna be really integral for anybody that it wants to really get to know their burnout more clearly.

SPEAKER_00 39:23

That was my hope is that people could read the book either as a therapist using this as an adjunct in therapy to support your clients through some exercises that you want to do to really target um burnout recovery, but certainly also for the reader to just work through this as you're doing it and giving yourself some um, you know, tools and strategies to help build your capacity, but also get clarity about you know what's in what's important for you and kind of creating a work life that feels meaningful to you.

SPEAKER_01 39:58

Can you start with the first step of compelling vision brainstorm in the print?

SPEAKER_00 40:03

Sure. So where we start is creating a compelling vision. And why this is really important to me is as I was mentioning, oftentimes when we are burnt out, we're we're in autopilot, right? That we're often time like sort of stuck in these loops of autonomic responsiveness, which means that we are responding to evade feelings of threat rather than to move towards something, you know, meaningful. So we're we're choosing behaviors to avoid emotional experiences rather than choosing behaviors to move in the direction of something that is valuable to us. Um, so part of creating a compelling vision is start with the end in mind and say, what is it that we're creating for our lives? And that can certainly include achievements that you want to have. It can include money I would want to make to feel resourced and sufficient and things like that. But also, like, how do you want to feel every day? What kind of relationships do you want to have? What kind of impact do you want to make on the world and the people around you? What kind of relationship do you want to have with work and then the rest of your life when you come home from work? What do you want that to look like? Do you want to have more freedom or time with your children or your friends? Or um, you know, really getting granular about like what is what am I actually desiring? And what's really important right now is a lot of people are not in a situation where they can necessarily leave their jobs. And for many, many years, the the idea was like, oh, if people like out, you know, you're not happy, you leave your job, and then like your burnout is sort of cured. And you know, in 2022, we've had things like the great resignation, where millions of people left their job, and it has not had a meaningful impact on the rates of burnout, even for many people that left during the great resignation, try to get their jobs back. So, really an implication that like oftentimes escaping your job is not sufficient to, you know, get rid of your burnout. We do a lot of brainstorming to figure out what is the life you're trying to create and why. And even if you can't leave now, there's something about tying the thread of what's happening in your current job experience to that greater vision. You're always building towards it. I listen to a lot of business and personal development podcasts, and you'll you'll hear these like hundred millionaires that have built these like, you know, social entrepreneurial businesses, and they'll talk about being a valet driver or being a waiter and how that was the best job they ever had in their lives because it taught them how to talk to people or they were able to connect with people. And to me, that's the strength of a vision is it doesn't necessarily matter about your current circumstances. You can see the vision and everything. You can see how everything you're doing now is moving you in the direction of the life that you're building. And if it's not, it gives you the ability to stop and be intentional and pivot so that you are moving in that direction. Um so doesn't mean your life is going to be devoid of challenging things. And, you know, I talk about in the book, like, you know, notes are still very much like the bane of my just, you know, existence. I hate writing clinical notes, but what helps me is connecting them to my broader vision, that being able to accept insurance, to, you know, continue to be a therapist, that being able to see this as like part of that meaningful hold, that like seeing everything as connected to that broader vision. And we do this all the time outside of work, right? If you have a dog, for example, you kind of accept that you are going to maybe have like accidents on the carpet and a chewed-up slipper and you're gonna have vet bills, and your dog is gonna probably die a lot sooner than you are, because the vision of having that connection and bonding and going like fetch with them and taking them to the beach and bonding with them is so compelling to you that you can take the difficulty as part of that meaningful. So creating that compelling vision is about understanding what you want, why you want it, and having it be centered in your daily experience of work.

SPEAKER_01 44:07

I love that there in the long term it can keep you on the path, but in the short term, it offers you something to check against to see am I still, you know, am I saying yes because it's just natural for me, or am I saying yes because this is going to contribute to the outcome of how how I'm able to reach my vision at some point?

SPEAKER_00 44:28

Absolutely. Yeah. And and the other pairing of that is having a vision with your compell having a relationship with your compelling vision that's compassionate. Because I work with a lot of people that are very Very ambitious. So maybe that they have a vision, but then they use that vision as a yardstick. So everything is negatively compared to in their current reality, that they're not there yet. And it becomes like a source of shame and self-criticism. So it's having the vision and then using that vision as a source of inspiration and connection and drive versus something that becomes a tool to compare yourself against, right? That we are always coming and leaning and living into a vision of the life we want versus we are only enough. We are only going to be happy when we are in that state of achievement. Because I've seen so many people that are high achievers, they get what they want and they have like 10 minutes of contentment around it before they're like, it didn't make me feel like the way I wanted it to feel. And I would say these aspirations that aren't rooted to more of a vision of how you want your life to feel and the kind of person you want to be, which critically like is a part of it, your identity, not just having things, not like just racking up achievement is a big part of it.

SPEAKER_01 45:42

Yeah, I think that is such an important distinction of setting a meaningful goal with healthy striving versus just on the grind for the sake of the grind.

SPEAKER_00 45:53

Right. Absolutely. Yeah, couldn't agree, agree more. The second step is welcome the unwanted. So that's really about um willingness and um which is, you know, a concept that's related to acceptance and commitment therapy. So it's sort of making space and being with those difficult emotions that we may be evading, whether that's fear of protection, anxiety, inadequacy, anything you are trying to get rid of or evade, like how do you make space to be with it? So mindfulness, increasing your capacity and being with the difficulties of your life in a way where you can make space with them without being controlled by them. Um, control strategies are a lot about what happens with burnout. It's like all these things we're doing to try to get rid of unwanted feelings. And it's about sort of, you know, unlocking yourself from that. Um the third step is watch your word. So we talk about sort of the paradox of language and how language can have so much to do with narrating our experiences. Um, so it's trying to do compassionate word swaps for things that can really get us kind of stuck in these uh verbal traps that can exacerbate stress. Like I should be doing this, I need to be doing this, like these things that can inadvertently increase shame and urgencies and kind of do some other ways of languaging, things that can be helping. But also things like venting, complaining, and reassurance seeking, which is kind of like the trifecta and burnout like emotional processing, and figuring out ways to like move towards self-advocacy, move towards support seeking without getting into these um verbal ways of processing that can get us a little bit more stuck.

SPEAKER_01 47:42

Um, I think this is so important. It can get us stuck, it can get our colleagues stuck. I think about starting at a community mental health, you know, decades ago, really. And the culture was sort of that we all complained and that we all vented, and there was humor in it, but I think now sometimes about what it might have been like if any one of us had had more of a forward motivating stance and how it could have shaped the culture.

SPEAKER_00 48:11

Yeah, absolutely. And I'm a recovering ventolic. I definitely am as a person who relied a lot on venting. And one thing that's really interesting is a little bit of venting does actually uh produce oxytocin. So there's like a little bit of social bonding that actually helps with like connection and feelings of belongingness. But like anything else, the dose makes the poison. So if you are reflexively and chronically venting, instead of getting that nice like oxytocin release where you feel validated and connected and understood and heard, you start to start to like rev yourself up and work yourself up and more into these unworkable, rigid perspectives of what's happening that you can't see yourself beyond, right? Like you, I would definitely like I would have this big vent about like, oh, I'm a workhorse and I'm not respected as much as other people. They want me to do a little work, but they don't, I'm not as prestigious as other people and I'm not being and even when things would happen that would counter that narrative, because I was speaking it into existence so much, like it wouldn't really penetrate even when alternative experiences were actually happening. So being able to kind of recognize that and say, like, well, what do you need? Right. Like we can, we are not talking about not complaining, you know. And I think this is particularly important for marginalized folks. Women of color are always having to deal with that. Like anytime they're speaking out, they're being penalized for using their voice, right? And so we don't, I don't want this to be sort of interpreted as like telling people to silence themselves. Policing, right? Tone policing, encouraging people to acquiesce or anything like that. It's really about being intentional. And it's also about being connected to what's actually happening in your emotional state, in your physiology, and you know, just kind of making sure the things that you're doing that are these creative survival strategies to get through the day are actually having the impact that you're hoping they will.

SPEAKER_01 50:07

There's that darn mindfulness, right? And just being aware of, you know, we chatted brief this for this long, and that felt so good. I felt really held and understood. And then when I've chatted for 30 minutes instead of 15, I started to be on the other side of that slope where now I start to feel kind of yeah, I feel mad, I feel more like irritable. I leave feeling a little, you know, and just being sort of mindful and aware of where that balance is for each individual, it sounds like a hundred percent.

SPEAKER_00 50:39

Like where's the tipping point for you? And being able to make sure that like you're you have some uh awareness of that, absolutely.

SPEAKER_01 50:45

Okay, uh for identify your unique strengths.

SPEAKER_00 50:49

Yeah, yeah. So identifying your strengths or your gifts, I think is, you know, I get a little bit into that particular chapter, incorporating some like positive psychology research about, you know, flourishing and like building on strengths and things like that. But why I think it's really, really important um is that burnout is certainly about like assessing things like workload and you know, making sure that we're not doing too much. But it's also about doing things that feel like um are aligned with our our unique contributions, our unique aptitudes where we can kind of um participate in ways that feel meaningful um and giving ourselves the space to explore what our gifts and contributions are. The other reason that I think, which is a little bit of a, you know, like the paradox here is the more we can be connected to our unique strengths, the less that we have to be good at everything. And perfectionism is something that plagues so many people that they feel like they have to be all things to all people, that they have to be good at everything, that it's not acceptable to not be good at something, to make a mistake, to not have a strength. And another thing that works against compassion and our ability to activate that soothing system is highly competitive environments, right? And capitalism like runs on competition, right? Like that those two things are intrinsically linked. So the more we are in touch with our gifts and the more we can lean into and explore our gifts, the less I have to be in competition with my colleague because I can also start to notice and observe their gifts. And I can start to name and honor what they do well. And therefore, I don't have to be better than them at everything. I don't have to never make a mistake in front of them for God forbid that I, you know, show any vulnerability because I can kind of uniquely understand what I'm good at. And what we want to ultimately do is try to see if there are opportunities, and like obviously not every job setting is the same, that you could take, you know, up more space doing the things that you're truly gifted in, um, you know, at your your place of employment, right? Because so sometimes like doing more of what you love is also an antidote to burnout, right? Not just doing less, but doing more of the things that make us feel in flow, that make us feel meaningful and purposeful, that give us a sense of um contentment or connection or challenge, right? Like we're not always avoiding challenge. So it could be things like if you work at a group practice, like talking to the group practice owner about having certain types of referrals, you know, sent your way that you have a lot of curiosity about working with or that you feel like you're particularly well suited to do. I think other people often like ask for permission to be invited into certain opportunities. And I think under identifying your unique gifts is also being able to identify your strengths and communicate them to others. What would it be like to say, you know, I actually think I'm a really strong writer or I think I'm a really good speaker? Are there opportunities to write a newsletter for this practice? Or are there opportunities to do some sort of teaching or speaking gig for this practice? And, you know, there's not a guarantee that everything's going to be yes, but I think a lot of people, when they are not connected to their own strengths, they're waiting for other people to validate their strengths, to name their strengths, to anoint them and say what they're doing is valuable. And I think this can be a much better use of your time and energy, is for you to communicate your strength outward.

SPEAKER_01 54:38

I love that. I'd also posit that that's exactly what makes a meaningful referral network among independent therapists, too. When one person can identify and be really clear on their strengths, then you leave room for other people to shine in other areas rather than, you know, feeling forced to take uh any client, you know, you knowing that you have built a community where each individual has identified a strength.

SPEAKER_00 55:06

Yeah, absolutely. And I think we're in a woman-dominated profession, and we get a lot of social conditioning about it not being appropriate, like about humility to a fault. And a lot of us in work environments truly doing ourselves a disservice because we feel so much discomfort saying that we're good at things, or saying that we could be good at things, um, or saying that we want an opportunity. Um, so I I feel really strongly that uh, you know, sort of cultivating the skill in therapists and beyond is really, really critical. Okay. Um, number five. Sure. Be kind to yourself and others. Um, so this is where I really get into some of that nitty-gritty of um self-compassion. We talk about um and you know, compassion that sort of flows outwards, talking about the work of Kristen Neff, um, sort of the uh restorative and um fierce compassion called like the yin and yang of compassion, this idea that compassion can both be soft and nurturing, but also can be things like self-advocacy and resistance um and all sorts of things. So that component I think is really important. I talk also about foundational self-care. So these like kind of basics of things that we know are kind of the building blocks of taking care of our physical bodies and our our mental state, like drinking water, eating nutrient-dense foods to the extent that's available to us and moving our bodies and getting exposure to natural sunlight. I think those things are really, really important. There's a lot of systemic barriers that prevent people from being able to participate in those things. And we I think we have to societally address that and acknowledge that and work through that with clients and ourselves. If what are the barriers to acting on them, right? Because I think a lot of people know what to do, and there it's not, there's a lot of internalized shame for not doing them when I think there's much broader societal explanations that make it difficult for people to take care of themselves. And also taking care of yourself in a way that is fused with a self-respect versus a self-hatred. I see to me, somebody who is running on a treadmill 60 minutes telling themselves that they hate their body and they have to lose 15 pounds to be acceptable, that is not an action of self-care to me. That is an action of punishment, right? So it's it's not just the behavior, it's our relationship to any given behavior. A lot of our concepts of um self-care are very driven on consumption, right? And like consumerism is like the sister of capitalism, of like, we need all of these like things and products and uh experiences to be happy. Consumerism or consumption can be certainly part of like a self-care repertoire of of behaviors. Um, but I think that we overrely on it and thinking about things um like self-care habits that we could build into our system that uh, you know, focus on rest, focus on um connection, connection, yeah, um, and meaningful pursuits. So doing things that um, you know, really make us feel purposeful. Like one of the max of self-care that I've done is like go to protests, right? That has been meaningful to me. That has made me, and it's not what we think about when we think about like traditional self-care practices, and the last one being sort of presence. What are we, how are we working in these things? Um, and in the book I go on like those different sort of domains of self-care actually activate different hormones and neurotransmitters in your body, right? So you have an internal system for healing and self-regulation that we have to recognize how to activate. Um, and the compassion to others piece is like also things like that you wouldn't always think are like in a burnout recovery book, like forgiveness, you know, working with difficult people, um, how to show up with like compassion um and and repair in and interpersonal difficulties. A lot of people's burnout experiences is very interpersonally driven, like, you know, relational stress at work and beyond. Um and then lastly, letting your values take the wheel, which is like how do we in a cons it is it's not possible to be intentional 100% of the time, right? Like it's a good thing that we run on autopilot and we automate a lot of the habits and experiences we have. Um, but I think being able to figure out how to take committed action steps behaviorally to um live out our values and the things that are deeply meaningful to us is important. And also knowing how to prioritize, how to, you know, you know, uh recalibrate. Oftentimes when we're choosing something to do something, it means we're not choosing something else. And most of us have a lot of competing priorities. Like I'm a parent, I'm a business owner, I'm a therapist, financial responsibility is and all of those things are important to me. And I think sometimes um it can be really hard to figure out how to prioritize and it that overwhelm can paralyze people and shut people down. Like they're they can never do right. They're always disappointing something or some ball is always dropping. So it's learning how to act on our values, but also, you know, figuring out how to like compassionately prior prioritize, knowing that we can always choose again and how to collaborate when we inevitably get off course. Like we will, like, you know, any given day, I'm not a hundred percent in values alignment, but I've gotten a lot better about recognizing when I'm off course and, you know, kind of getting myself back on track. And I have some strategies to support people through that.

SPEAKER_01 1:01:06

Yeah, great example. I'm so glad people have some access to this information for themselves, perhaps, but also for their clients. If you were the owner of a small or large business where you had employees, what would be a couple of things that you would implement to be able to support people from reaching burnout?

SPEAKER_00 1:01:28

Yeah, no, it's it's a great, a great uh question. So one thing that I would really get familiar with is um psychological safety. How do you make an environment psychologically safety, uh psychologically safe? How do you make it trauma-informed? Um, so there is research that has shown that they were they were looking at a group of doctors and teams of like who was the most productive, who were the most like collaborative teams, who was getting the most done. And they were sort of were really, really floored that the team that made the most progress was accomplishing the most, was the team that made the most mistakes. And um, this is the researcher who really coined the term psychological uh safety that did this research. And she's like, well, that's kind of weird. Like that, why would that be? And when she threw to really investigate it, it wasn't necessarily that that team was making the most mistakes. It was that that team had the most safety to give feedback to the leaders when they didn't know something, to say if they were overwhelmed and stressed out, to say if they needed help, to ask questions, to admit failures. And the more safe the environment was, the more that that team got done. And the teams that were not able to do that, it wasn't that those mistakes weren't happening. It's just that people couldn't say anything. And then therefore, there was no recalibration, there was no pivoting, there was no support, there was no connection. So nobody is going to be a perfect leader to a group of people. You're hiring strangers that you're basically kind of getting from a CD. What you're gonna take all of these humans with different nervous systems, differ different capacities, um, different lived experience. And you have to learn how to get a team of different people to work best together. So the best way to do that is create trauma-informed workspaces that the environment, the relationships are are safe and that people can talk to you and you can be in a constant state of optimizing, making things work better for people. Um, but I think also understanding that um when people are burnt out, not like being wary not to put the onus completely on them to correct it. I think sometimes when people are coming in, it's like, what are you doing in terms of self-care to to deal with your burnout? And we want to kind of make sure there is, of course, like we all have personal responsibility and like how we show up and care for ourselves. But I think kind of creating some space that there is, there's a relationship in in a work environment and a leader and the person who is working there. So I think one strategy that is always something I'm thinking about as someone who's an employer is evaluating workloads, right? So I'm if I'm adding something new, what am I taking away? Right. Like if I am, you know, how am I assigning what's a reasonable amount of work? Am I evaluating if people will have time to stop, use the restroom, um, do their paperwork? Um, how am I incorporating like who is like the most efficient employee with the least efficient employee? And how am I kind of figuring out like what is reasonable when people have different personal capacities? And how am I adjusting for that? How am I adjusting if someone has a death in their family or a medical issue? How am I having conversations about workload adjustments and things like that? Um, so those are the things that I would really be thinking about. I also think just being recognizing the fawning response that is particularly high in um our profession. So, for example, I started a business, I have an employee, I created an unlimited PTO policy. Fantastic, right? Like, I'm like, this is gonna be so flexible. This person, as long as they're like doing their work and they're communicating me, it's fine. We're going six months through the year, and I'm like, this person has not taken any days off. Like they haven't taken a single day off. And I had to kind of actually recognize that I had was working with someone who struggled more to ask for their needs to be met. And even though I created an a policy that had maximum flexibility, I'm encountering a human being that might struggle in setting some boundaries for themselves. So I had to adjust my policy to make an unlimited PTO policy with a minimum mandatory that you had to take off, right? So I'm building in the boundaries. So we want to be create a boundary respecting culture and make sure that we're not just saying that in our interviews, we're not just saying that flippantly, but like when things are when it's inconvenient, when it's difficult, we are acting out those promises and we're modeling those by also kind of enforcing our own boundaries.

SPEAKER_01 1:06:42

Oh, I think that's such a great example. Okay, we've looked at individual level burnout and we've looked a little bit about at the system level burnout. And like I said, I think this is something that afflicts so many in our sector. So I this is gonna be such an important episode. Shayna, if people want to learn more, where can they find you?

SPEAKER_00 1:07:03

Sure. Uh you can find me at on LinkedIn at Shayna Cybersanderwitz. I can give that over to you because I have a long, full last name. Um, Affirm Mental Health is where I have a continuing education program. Um, if you are in need some are in need of CEs, you know, feel free to check that out. Um, and check out the Affirming Minds podcast. So, yeah, between Affirm Mental Health and the Affirming Minds Podcast, those are great ways to connect. Feel free to message me. I always love to connect with other uh, you know, therapists and other, you know, people interested in mental health topics.

SPEAKER_01 1:07:35

So all right. Thanks so much for joining us today.

SPEAKER_00 1:07:39

Oh, thank you for having me.

SPEAKER_01 1:07:41

Thank you for listening to the Self-Cherapist Therapist. I hope today's conversation gave you insight, clarity, or a tool you can take straight into your clinical work. If you found this episode helpful, be sure to subscribe to the show on YouTube and leave a review on Apple Podcasts or Spotify. It helps other therapists find the show and keeps these conversations going. Until next time, keep learning, stay curious, and take care of yourself too.