199. The Mental Strength Playbook: Workplace Stress, Burnout, and Showing Up Under Pressure | Amy Morin, LCSW

Welcome to Medicine Redefined. I'm Dr. Altama Sharaja. And I'm Dr. Dar Shum. Let's put the hell back in healthcare. If you've been with us for a while, you already know Amy. She joined us back on Episode 153, where we talked about dating, marriage, and raising mentally strong kids. And you all loved it. So, we brought her back. Amy Morden is a licensed clinical social worker, mental strength trainer, and one of the most recognized voices in psychology today. Her 13 mentally strong people don't do series has sold over a million copies, has been translated into 40 plus languages, and her TEDx talk on mental strength has over 25 million views. She'd consulted for companies like Google, NBC, and Under Armour, and host the award-winning mentally stronger podcast. In this episode, we get into what it really means to perform under pressure, not just white knuckle through it, but actually thrive. We cover burnout. White busyness is often just socially acceptable avoidance. The difference between dread, anxiety, and rumination, and how to manage up when the system feels stacked against you. This is deeply relevant for physicians, founders, and high performers of any kind. And Amy also has a brand new book out, The Mental Strength Playbook. Her most tactical work yet. 50 signs backed tools, organized by situation, that you can flip to exactly what you need in the moment. You're going to want to check it out after this episode. If you're a high performer who wants a clear plan for longevity, performance, and staying active with fewer setbacks, I'm now seeing patients through my telemedicine practice refining health and performance. I'm opening a limited number of founding members spots at refininghealthrx.com. All right, let's jump in. Pressure isn't a problem to avoid. It's a resource to be channeled. Was that mean? So really, sometimes our natural tendency is to say I'm going to run from something that feels like it's high pressure. But every time you run away from it, let yourself, I can't handle this, and I have to continue to avoid it. Every time you face it, at all, and you teach yourself like a more capable than I give myself credit for, a more competent than I thought I was, and I have the courage and the ability to face this. And you build confidence, and it reminds you I can do hard things. It's not the case every time though, right? There are certainly some people I think that I would put the three of us as high performers you much more so than us. We were just talking offline about book number seven. And there are some people that are more inclined to rise out of the ashes, so to speak. When you get that pressure, they're much more resilient by their baseline. And there are some people who will crumble under pressure as the same goes. In your time working with people, what is it unique about the folks who are in the former category and the latter? Sometimes it's about our life experiences, right? If I have struggled with a lot of distress in my life, then when I face something distressing, I'm probably still going to struggle. So again, it's about building those little wins. And I think people that face pressure with a sense of courage, and they just say, I'm going to run into this head-on, are often the people who have that confidence in themselves, but they're also the people who can say, I'll be okay even if it doesn't work out. Or if somebody who struggles to face a head-on thinks, well, if it doesn't work out, then my entire world might crumble. Or what if I can't tolerate it? And then there's a fear associated with it. And sure, we all have different personalities, different biology, different life experiences. And all of those things affect our distress tolerance too, but it's something that we can all work on managing. I always think there's room for improvement as well. What role do genetics and upbringing hang in that? So I think genetics are certainly a component when it comes to your personality, when it comes to how your brain responds to stress. Your early life experiences, we all know, that early childhood experiences play a huge role in how your brain and your body respond to stress. But we also know that we have the capacity to be incredibly resilient, to learn new things, and to change our biology too. So last time you were here, we talked about dating. We talked about marriage. We talked about mentally strong kids, right? Things that are both relevant to ours, both relevant to me, but also a lot of our audience. This is the book, the first book that you're writing, as we were talking offline, that is more prescriptive. It's much more for the person in the workplace and pressure-focused. And I'm curious, what shifted your thinking into writing this book? And the second part of that question, what did you have to unlearn from your typical 13 things framework to write prescriptive playbook like this? So for a while, I hesitated to write this book because I didn't want to give people like these little life hacks that they could then put into play and think, well, I'm incredibly mentally strong because I know exactly what to do in this moment and that they would then walk away thinking, there, I've done it. And so my other books really focus on lifestyle changing, changes giving up the unhealthy habits that hold us back. But at the same time, I'm getting so many messages from people I'm talking to so many people in my practice who are saying, like, I'm drowning at work, especially at work right now. I feel like I'm getting burned out, I'm overwhelmed, and I'm struggling. And it's people, sort of across the board, I do a lot of speaking engagements, and companies are saying, we need help. Even our high performers right now are really struggling. These really successful people are having a hard time. So I wanted to give people things that work in the office, not just this huge lifestyle overhaul. And I think people are also feeling like I don't have the energy to create huge changes in my life, but something needs to give, and I need something that works right now. So I said, all right, it's time to finally write this book about a playbook that will give you those fast-acting tools that you can put into play right now. And for me to write this book, it's a book I've been wanting to write for years. I wanted to finish the 13 things, mainly Chinese people don't do series, and I just kept writing books as long as people kept asking questions. That's been the amazing part of this journey, is whatever people ask, I know it's going to be my next book. So when people say, how do we teach this to kids? I wrote a parenting book, and that's made it easy. And then for this one, I've just had so many questions over the years of people saying, yeah, but what about my boss? Or how do I make sure that I'm not getting burned out, even though my workload is huge? So I knew it was time to say, all right, let's write this book. I'm curious, Amy. Has there been more burnout that you're seeing now with your clients and as you're doing these speaking engagements? Is there a certain, you know, is there something in the water air where more people now are feeling this sort of heaviness when it comes to work? Yeah, it's the pandemic. I think since the pandemic where so many people are saying, I have the freedom and flexibility to do more remote work. But at the same time, it's made it that so many people struggle to shut it off. And it's not just in our heads that is I need to make the shift. One of the problems is the majority of your coworkers are probably responding to emails at 9 p.m. So to be the one person who says, no, my day ends at 5 is really hard to do because there can be some legitimate consequences to that. And, you know, technology obviously makes it more difficult. We're caught up and I do it myself in this idea of, if I just work a little bit later today, I'll get ahead. Tomorrow will be easier. It doesn't happen. And even though we know that, we still do it. Right now, I'm going to work on my inbox tonight. And then tomorrow will be better. We all struggle to take vacation days. We know from the statistics that so many people leave tons of vacation days in their books every year and even companies that offer unlimited vacation time. Nobody takes them. And all of these things that we're doing and we're doing them to ourselves. And there's some systemic issues that we can't necessarily transform. But gosh, she only get one life. We sure spend a lot of time at work. And to figure out how to create a life that is a wonderful life. And even if you don't love your job, it's awful to wake up every day and think, oh, you know, I hate my job, but I also hate my life. So I really want to write this book to make sure that people know, even if you are feeling burned out, like there are strategies that we can put into play. And even though it might not be an option to quit your job tomorrow, there's still things that we can do to make your day a little bit better. Well, I'm curious. I mean, I'm, I think I'm just going to get right into it. I mean, some problems and things that I think about. At least ultimately, I'm curious from your perspective, because I'm only been attending now. If we're going to keep this likely related for a little bit, it's hard for me to understand kind of right now what burnout looks like. Right, I just started for you since you've been doing this for a little time. Is there anything you've noticed a lot for when you first started to now that there's been a change where maybe you feel a little bit more burned out or dumped on and certain aspects of medicine? I think we've talked about this as the business of medicine. So I don't know Amy, how familiar you are with how the medical system works in this country. But you know, when you're working in the conventional business model, you have to play the game. You have to play the game. If you're trying to get your patients the best possible care. And a lot of times unfortunately, insurance companies dictate that you can get. And whether or not it's good or they don't really care. Because they're, I mean, they're responsibility. They're fiduciaries is the bottom line, right? And so the less they pay for, the higher that is. So that was good. And that's really, really tough. You know, so there are some strategic ways to do this. Are you and I've talked about the strategic documentation piece. And it gets really, really tricky. And that's not something I wish I had to think about every single time after every patient encounter. So I think that's probably the thing that's on top of mind. And it's very similar in the world of being a therapist if you build insurance companies. It is fairly dreadful. And that's why so many people are trying to get away from the traditional medical model just because the insurance industry makes so much extra paperwork and so many extra hoops that you have to jump through. But sad reality is a lot of people don't have the cash to cover appointments. Otherwise, it's so it does become a lot of extra stress. And I don't know about you, but I feel like they didn't prepare me for that in graduate school. And I was in college. It wasn't like, hey, by the way, you're going to be dealing with all this stuff. I was like, clinically, I feel ready, but I didn't feel ready to figure out how to deal with all of that extra stuff. Right. And at the same for therapists, even though we're supposed to be like trained in mental health, the average therapist lasts seven years. That's horrifying to think like, all right, here's the people trained in stress management. We're supposed to be helping other people burn out. And yet so many of them are burning out. Yeah. I think it's interesting, right? Because I think in medicine, we're able to perform whatever it is or calling or whatever it is that we go to school for. But then of course, there's this shadow that kind of comes on. Like you said, that we don't learn, which is, hey, the business. And you better be making sure that you're kind of planning with the metrics. Otherwise, hey, we're going to take you out a week and just put another doctor in, right? But what I think when you look at the corporate world, you know, it's interesting because you said a lot of people have a difficult time not taking vacation, right? And I think it's almost a smart strategy that a lot of companies do where they do unlimited PTO. Because that was an employee. It's almost like, I'm not, I have to compete with my colleagues. Like if I take more than them, how does that actually look? And everything kind of comes down to perception. And then I'm also assuming that with AI trying to out compete AI in a way, right? And try to become more sticky as a worker. So how do you think about those things when you talk to your clients? When you know AI is rising, there are certain policies in place. And there's kind of this competition that's occurred. So this is about keeping a bigger picture in mind, right? Like when you're 85 years old and you're looking back at the work career you had, how are you going to feel if you thought, wow, I really took 20 years without taking a vacation or I only took two days off every year? Is that the kind of life that you want to live in? What else people would say no? So then like to zoom back in and say, well, then why would I be okay with that? And what can I do to make it happen this year? If I took two days off with what I really get so far behind at my job that I wouldn't be able to recover? So sometimes it's the thoughts that we have that feel that need to keep showing up to overwork. Sometimes it's the idea that I need external validation. And we live in a world where bosses and supervisors are often praise us for overworking, right? Like, wow, I didn't think it was possible to get that project done by Friday, but you did it. And then everybody gives you the big round of applause and you think, oh, nobody knows I just worked 80 hours in order to get it done on time. So recognizing that too, like where does yourself worth come from? What are your values? And yes, well, it's important to help people. Are you really doing the best job at helping people if you are, say, overworked and never taking a vacation? And sometimes when we zoom out, that helps. Sometimes it's also just about giving ourselves permission to know how to be perfect. And that at the end of the day, what's your goal when you come home? Do you want to be in a good mood? Do you want to be so burned out that you have literally nothing left to give friends or family members? Or do you want to be the kind of person who says, okay, I'm going to come back and I'm still going to have the energy to take care of myself so that I can do this for the long haul. Yeah, so as you were saying that, I quote, came to mind. And I don't know if I heard Hormosi talk about this. I think he said something to the tune of celebrate the sacrifice if you're going to celebrate the success. And being a doctor is a classic example, right? So Amy, I don't know if you know this, but I come from a South Asian household where you're either a doctor or a lawyer or an engineer. And a lot of my family and part of my extended family will still often say, oh, you're a doctor. You must be able to do X, Y, and Z. And they have no idea the student debt, the sacrifices externally. You're just kind of thinking about what the golden age of medicine used to be. But more so than that, the time that we've invested your entire 20s. You know, the residency time that you've done fellowship afterwards that the opportunities you've taken because you maybe or maybe not feel handcuffed to your student loan situation if you have to do a PSLF or whatnot. And so, you know, that always comes to mind. It's like people see the product. They'll see that outcome that you got that report done or you close that client or what that happened. But what it took to get there, what you gave up, they won't really know. And the reality is if they did, they might not make those decisions to kind of get that outcomes to be celebrated, to be externally validated, like you talk about. So I guess to me thinking a lot about ambitious people in general, I think a lot of them confuse mental stress with suppression. Yeah. White knuckling or just grinding harder. What do they get wrong there? Yeah. There is this idea that you can suffer the more that you make yourself indoor, the more that you achieve that somehow you're mentally strong. And I think that we forget that those things aren't really all strength, right? I get a lot of people that will tell me like, I were in a marathon on a broken ankle, tell tough I am. I'm really proud of themselves, but they don't realize like it actually probably would have taken more men's ranks to opt out of the race. But your ego gets in the way and you think, well, I'm going to, I set out to do this thing. I'm going to accomplish it no matter what. And then people a case of that, like people literally injure themselves for life was so important to finish that thing or do that thing. It's easy for us to do that. Sometimes we put our eye on the prize. We forget like what the real goal is. And we become so ambitious or we become so set on telling everybody. And it was easy. I didn't really have to put that much effort in this because it feels good in the moment. And then we lose sight of what are our values? Again, when I'm older, what do I want to say? Gosh, lad, I really suffered through that. And it is easier to say like that didn't bother me or it wasn't an issue. And there's a place for that, right? If somebody's a Navy seal, you don't want them on the battlefield to turn friends and say, hey, I have a lot of anxiety right now. We need them to be able to shove that down and work through the moment. And we need to do that in work sometimes too, right? If you're going to see a patient and you just got some bad news about somebody else on the phone, you're going to set that aside for a minute so that you can focus on the person in front of you. But at the same time, shoving all of those emotions and shoving everything aside for too long, creates all this other stuff for us. And a lot of the illnesses we're seeing in people, physical health, people are struggling with mental health issues, even really successful people because they aren't dealing with the emotions, they aren't working them, not even acknowledging them really. And if you don't acknowledge them, pretend like nothing bothers you. At some point, it's going to come out in various ways, whether you want it to or not. Yeah, and it's crazy in medicine in particular. And imagine a lot of the difficult doctors. I mean, from sure, like as you're getting your psychology and for those reads, for those extra time that you're spending, you have to do that. Like I used to have this saying where I would just say the show must go on. And really what I was talking about is like when I'm stepping into a patient room, it's like I'm stepping on stage. And you just like camera action, you smile. It doesn't matter what happened. Maybe you just had a cold blue situation in the other room. Somebody just passed. You had a different conversation with their family. You move out of the next person and you can't bring that over. You have to be able to reset. But did you get to grieve? Did you get time to process what just happened? No, the show must go on. And I think this is this narrative that we have to create a note to be able to get through it. And it's necessary. I didn't. I used to believe this. And I still think I don't remember when I was go medical school. This urologist that I had talked to, he was like, yeah, like there are very few professions out there that can understand what we have to go through. I think that maybe some military professionals and personnel can understand that. I think granted when he went through residency and now runs very different, I'm not really sure I would compare it to the military now. Definitely not in PM&R. But maybe some surgical specialties. But I think that to your point, that's necessary. But then the flip side of it, like you started with what Max Shank had talked about before, is the certificate of suffering and the badge of burnout. One of the things that the core of it that I've recently discovered is, business is a really potent anesthetic. And intellectualization and avoidance. When you're a high performer, intellectualizer, and you know how to distract yourself from the pain, you know how to distract yourself from this external things that, maybe the state of the world is too overwhelming for you, right? Whatever your political affiliation is, what's going on overseas, maybe that's just too much for you to process. So you dive deeper into work, dive deeper into things that you know you're really good at. And it becomes this really vicious, positive feedback move that's hard to snap out of. It's impossible sometimes. Yeah, you're right. And distractions are great skill and sometimes for us, right? Again, you need to change the channel and your brain sometimes and you're worried about something else because you need to be present with your next client, or you need to pay attention to the meeting that you're in. But yeah, for a lot of people, it becomes this badge of honor. And you even hear people say that. Somebody just lost a loved one. You say, how are you doing? They're like, I'm just working hard to stay busy. And somebody will go, oh, that's really good. That's good that you're staying busy. And they're really just trying to avoid the grief or the pain that they're going through. But we applaud for it. Like, that's great. You get out of the house so much that you don't actually have to face the emotional pain that you're in. And that's why this whole idea, like, oh, time heals. Everything comes up and people think you just got to wait long enough and it will go away. Well, it doesn't. And so many of the problems I think that we create in life are just because we're trying to numb ourselves. Whether people are overeating, they're drinking too much, they're using drugs. Or they're just saying busy. And some of them are more socially acceptable than others, right? This idea of being busy and exhausted all the time gets a lot of social applause. Yeah. I want to dive into what it is appropriate to increase that work ethic. Right. So I was listening to a podcast on the all-in podcast and they were interviewing a guy named CZ. He's one of the crypto founders of. Fear what company was called either Coinbase or something. But he said this quote about needing, so they asked him, hey, how did you become so successful in all these things? And did you have this genetic intellect? And he said, no, I just knew how to kind of increase my surface area of luck and know when to work. And he always says that you have to work at about 110 to 120%. Now, I think for us high performers, that's kind of easy to quantify because we know kind of what our 100% is and know what our 200 or 300 might be. But for someone who's just started out getting into the workforce and they want to develop into a high performer, they want to be able to make a difference. How do they understand maybe what it means to try to over achieve at times but not get to the point of actually burning out? And building enough capacity, I guess I should say. That's a good question. And I think a lot of it just has to do with how are you feeling? Are you waking up energized, excited to go. At the end of the day, do you still have energy left over? Do you feel like you're giving enough to things outside? And then when you're in one of those seasons of your life where maybe you do have to work a lot. You have a project at the deadline, something going on, you're covering for somebody else. Like, how long are you able to do this? Is it one week, six months? But just knowing that too. I mean, we know when people launch a business, sometimes they're like, I had to work 70 hours a week in order to get this off the ground. But is it worth it if you do that for say six months? A lot of people would say, yeah, absolutely. If I could then I can relax a little bit more, I'll do that for sure. We know that a lot of people get caught up in that where you just start working the same amount of hours over and over and over again. You keep bringing work home and it's really tough to shut it off. And that's when you know it's becoming a problem. When you're stressed out, when you're frantic, when you're going through the day and your nervous system is overactive all the time. For me, like one of the signs is that is I'm like rushing through the day. I have an electric toothbrush where the timer takes two minutes. But I'm like scrubbing my teeth. Like somehow I'm going to like get through this task quickly because I'm in a hurry to get on to the next thing and you think, well, this is ridiculous. It's going to take two minutes either way. But that's when I know my nervous system is overactive and I need to all right, it's time to take a step back. Because I'm actually crossed the threshold where doing more and being frenzied is going to actually backfire and tasks are going to take me twice as long. So I think just that self awareness of like how am I doing? How am I getting along with people? Do I still have enough time to give to other people? Do I come home feeling like I'm in a good work? I'm in a good mood at the end of the workday or am I just so depleted that I tossed myself down in the couch. My life has become work and Netflix. You said that you kept practicing therapy through some of the worst periods of your life, right? I think you lost your mother and your husband within three years. Yeah. And your new book, it talks about showing up when your person life is falling apart. I think a lot of us, if we're fortunate, that won't happen until very late in life. You were in your early 20s, I think that's what happened. I was. I was 23 and my mom passed away in 26 when my husband died. Yeah, that's crazy. So I'm interested in learning about what the difference is for somebody who's mentally strong. Like how does somebody who's mentally strong show up in those situations versus the person as we talked about earlier who's just grinding or whitenuckling through the day? What's the distinction there? Yeah, I think it boils down to, can you admit at least to yourself like when you're struggling? The person who's just grinding through the day is, I'm just going to say like I'm fine, nothing bothers me. Or is somebody that's mentally okay, kind of anxious today? And I'm doing this anyway. I'm feeling kind of sad right now. How is this going to affect my ability to attend this next meeting? You're checking in with yourself, acknowledging, yep, I feel this way rather than just pretending it doesn't exist. But it's also about the thoughts that you have, the person who says, yes, I'm going to just show up and pretend it didn't happen as the kind of person who says, you know, just don't think about it. Don't think about that thing that happened. Push it, push it to the side versus somebody who's mentally strong is like, okay, this happened. This is going to be really hard. Here's what we're going to do about it. And then you actually take that action plan. For me, I was a therapist. I was supposed to help other people deal with their problems and my own life had fallen apart. But I was lucky that my coworkers were therapists too. So they knew like we had a plan in place after my husband passed away, especially they had me come into work on a day when I wasn't working like before I officially returned to work. I was able to take a little bit of time off and we developed a plan like what would be helpful to you and what wouldn't like should we ask you how you're doing? We decided, no, let's not check in with me during the day. Let's just at the end of the day, if you want to know how I'm doing, ask me that. Don't ask me when we pass each other in the hallway, how are you doing today? Because I'm just going to have to say good and pretend like I'm good. So some of those things really helped. And I lived in a small town, select the whole town new anyway. So my coworkers knew. But let us see if we go through struggle silently, right? You had a fight with your partner yesterday. You probably don't go into work and tell everybody about it. So you don't have the opportunity to make a plan or people who are dealing with financial distress or maybe have a parent with an illness. If you don't want to announce it to everybody, so how do you do it then? Sometimes it's just about knowing you don't have to announce it to everybody else, but to just get really honest with yourself, how am I doing today? Because we'll say like, oh, check your feelings at the door. But anxiety from your personal life feels over your professional life, whether you want to acknowledge it or not, research will show. If I'm anxious about something going on in my personal life and my boss says, hey Amy, do you want to take this new opportunity? I'm much more likely to say no. Even though my anxiety has nothing to do with this opportunity. What's the difference between dread and anxiety? Dread is when you're anticipating that something is going to be awful. So it might be like, oh, this meeting is going to be horrible and awful and terrible. And it's really about that anticipation. Anxiety is about the feeling you get in your body. So when I'm in that meeting, maybe I'm anxious. My heart's racing or my palms are sweaty. But I'm not necessarily dreading something in the future. Dread is always about the future and thinking that things are going to go way worse than they usually are. You draw the root canal or you dread having to do something next week. And it just fills your mind with all of these thoughts about how awful it's going to be. Is it appropriate to say it's like an above the neck versus below the neck type situation? It can be anxiety can also be associated with worry. A lot of us spend a lot of time just thinking about gosh, I hope I don't look stupid in that meeting or what if I forget what I'm going to say. But dread is just more about the anticipation of knowing it's going to go awful. And I feel awful right now about the fact that things are going to go bad in the future. Where does rumination fit in? So what rumination is really about the past. This is when you're often thinking about rehashing that thing that you said yesterday. Oh, I sound it's so stupid in that meeting. Or in thinking, I don't know if I did a very good job in that performance review today. What if I said the wrong thing? It's really about rehashing things that already happened. Okay. Okay. So now that we have the vocabulary, I understood it here. I think I read somewhere that there's a total of 50 tools. Is that correct? There are, yep. For someone who might already be overwhelmed, right? Somebody who's going from one project to the next, who is in that season of life where they've really dialed up the intensity to quote Jonathan Goodman on your podcast. Is that something that might be choice overload? And if so, how should that person enter this book? Yeah, so that's a good question. And it's really not about saying I have to do these 50 things. It's about knowing when I'm struggling. What are the options I have? It's more like a choose your own adventure book. Where if I am dreading a meeting, I can flip open to that chapter that says here are five dread diffusers that will make things better. And I did it this way because I know as a therapist, the same thing doesn't work for everybody. What works to calm me down might not work to calm you down. But when you have a choice in the matter where you can say, you know what, I'm going to try this right now. I'm going to experiment with this one. Or maybe this works when I'm dealing with a dreadful meeting, but when I'm dealing with a specific coworker that doesn't work. And it's really about trial and error and experimenting and just knowing these things will give you fast acting relief. So I'm not asking you to add more things to your already stressful day. I'm just saying, when you are in a difficult place, what player are you going to run to get some relief from it? Can you give us maybe one dread diffuser that would be universally applicable to multiple professions? So I'm thinking about physicians, founders. I think probably a lot of medical students listen to this and maybe just the individual who wants to be in avid participant in their own health. But I want to, again, make it as applicable to as many people as possible. So one of my favorite dread diffusers is to text a motivation buddy. So when you have something to do and you don't want to do it, we know you'll procrastinate because you think, I don't want to start that boring report or I don't want to do my paperwork. If you text somebody and say, hey, I'm working on this, working on my slideshow, check back in with me in an hour and ask how I'm doing. The social pressure that you just created for yourself will get you going. And once you start on a task, the momentum is there. So then you keep going. It's just getting started. And we know that we do better when we have that social pressure. So create your own. So if you have a friend you can text and you say, check back in with me in an hour about how I'm doing on my paperwork. And that person in one hour says, hey, how are you doing? You'll want to make sure that you have something good to report. Tons of research behind this. It's a really simple but effective way to say, this is how I'm going to get going on a dreaded task. How does somebody find a motivation buddy? It could be your grandmother. It could be somebody else, a fellow co-worker who also understands the pain you're in. Maybe it's another friend who works in a completely different industry. You just want to make sure it's not somebody that's going to collude with you. Right? If I were to say to my best friend who also likes to write, let's check in with me an hour and so many pages we've written. We might be more tempted to be like, or we'll just chitchat about fun stuff. But if you know that somebody else is like, all right, I don't necessarily know what you're doing or it's not something I'm going to try to talk you out of doing. And they really do check back in with you. That's all you need. So again, it doesn't have to be somebody who 100% understands. You just need somebody responsible. Who will send a text back in an hour or give you a call and say, what do you got to report? I love that because I think a lot of times people think about accountability partner and just the language that you use motivation buddy because it's the same thing. I think I just speak to this idea of the perspective. I often tell the people that I work with perspective is a superpower. Two people can look at the same exact problem and see completely different opportunities, completely different outcomes. And as we started with the conversation, it was just have a different approach in terms of whether they're going to come out stronger or that's going to be something that's going to set them down as spiral. I think I listened to Arthur Brooks with the run of Patrick lately talking about the difference between paid and suffering. And he had this really interesting frame where he was talking about individuals like when we go to the gym, we recognize you're going to have pain. Nobody says that they're going to the gym and it's going to be a fantastic feeling. You recognize this can be painful if you're doing it right, but you know that the process afterwards over it's a sustained period of time you're going to be stronger or you're going to look better. You're going to have better metabolic health and et cetera. And so he talked about what about other life events? Lifequakes as I think he said it and he stole it from somebody else and every five years you're going to have something that life is going to hit you in the face. You had some loved ones that you lost, other people like you know, had members who got cancer and you just not ready for it. And when that happens, you just have to think this is going to make me stronger. This is going to make me better because inevitably you've been through some stuff in life before and you're still here standing hopefully and you've gotten wiser over time. But you also mentioned earlier that sometimes you're systemic things. Sometimes there's things outside of our control. And you could do all the mental strength playbook scripts that you want. It's going to be outside of your control. And I know you've consulted with a big company, Google NBC I think, Keynoted some oncology summits. And I'm wondering when you look at problems, what are some problems that you can think about that no individual tool or strategy can touch because they're more systemic in nature. And if that's the case, what is the person, like what mindset is that person need to have to be able to deal with that, to cope with that? Just like earlier in years ago, I had insurance companies. Not a single one of us is going to be like, okay, I'm going to badly insurance company and create all of this change in America's healthcare system just doesn't work like that. Or somebody might say the policies and procedures at my office or I can't control the economy. I can't control so many of the things I have to do, because even when you're self-employed, you still have to juggle a variety of people who probably help pay your income. So knowing I can't control other people. And I think that's what it really boils down to, is just focusing on what can you control? And we know from the research that as long as we find one little thing we can control, it can help you get through some pretty bad situations. So even if you have a toxic boss or you work in an environment where conditions are less than ideal, focusing on that one thing you can control, we'll get you through it much easier than if you're just battling and feeling like you're banging your head against the wall every day. And I always think about there's a study where they looked at kids who have cancer. And it's a horrible thing to envision that these kids have to go through all of these different cancer treatments. And they often don't understand why people are holding them down and doing these painful procedures. But when they taught them breathing exercises and the kids said, at least I can focus on my breathing despite being in this MRI machine or despite the things that they're subjecting me to, the kids reported a lot less pain. And that always sticks with me. If a kid with cancer can come up with a strategy to deal with things that are completely out of their control, we certainly can too. If I work in an office building where the conditions are pretty bad, what's one thing I can still control? And when we focus on that, everything changes. So I want to ductail off that office idea of control and kind of positive psychology and reframe. Some people might be listening to this and they are an employee. And they're doing a fantastic job at what they do. They're an overachiever, there's no complaints, they get along with everyone, except their supervisor or boss tends to under-appreciate them. They don't give them the kudos, they don't actually see or feel what that employee is going through, but they know that they're reliable, they know they can hold them accountable. But this employee loves what they do. It's just that either they're not getting paid enough or that they are asking for more, they just aren't receiving that appreciation, they aren't receiving exactly what they're looking for. If you were to zoom in and also zoom out to this employee's mindset when they wake up in the morning and they have to go to work and they may have dread, even though, or anxiety, what either or. But then also zooming out when understanding their values and understanding, hey, is there an opportunity for a career change? Let's say there isn't, let's say they're stuck in this position, they're trying to find leverage. How do you think about what that employee should either think or feel as they wake up that morning and when it comes to their work knowing their situation? One question with me is, like, do you get internal validation from this? Do I feel good about myself for what I'm doing? Regardless of whether my boss points it out or rewards me for it. And if you feel great about it, then good, then maybe you can say, maybe I don't need that, maybe I don't have the kind of boss that offers praise or I don't have the kind of boss as it's going to notice this. But another question would be, is have you ever talked to your boss about your struggles? A lot of people will say, I've always gone to work every day, I show up early, I'm the last one to leave, and I get all these projects done, I never complain. But then the boss just assumes everything comes really easy to you. I can count on this person because if I give them a load of work tonight, they'll magically show up and have it done tomorrow, no questions asked. But if you were to say, gosh, this is really tough. Then your boss at least gets to know, oh, you're a human being who has real struggles. And then they know you're working through your struggles, you're not just snapping your fingers and magically making things happen. But there's so much pressure sometimes to say, play it cool, act like it's not a problem. And because we put on that mask and pretend like we aren't struggling with anything, then your boss doesn't know that actually you can handle pressure. They think you don't have any pressure. And then when you do zoom out and you think, am I getting like satisfaction out of this job? How is it affecting my well-being? Maybe not. If not, start looking elsewhere. We know so many people that have really loyal to their job, to their boss. And then years later, they feel blindsided when they don't feel like they had that same loyalty returned in terms of promotion or race or even they get let go or laid off. And they think, I just gave 40 years of my life to this company and look at what happened. And you don't want to end up being that person. So maybe I start looking at your other opportunities too. And sometimes when people do that, they realize like grass is always greener. Other times people are like, why didn't I do this sooner? But there's nothing wrong with looking into other opportunities. If you feel like the one you're in now just isn't really meeting your needs. Yeah, oftentimes in medicine, there's this hierarchy or power struggle, depending on the title and the experience of things like that. If the employee goes up to the boss and says, hey, this is exactly where I'm feeling pressure. This is what I need help with. This is what I'm looking for. But the boss comes back with solutions that really are not great solutions. How does the employee at that point go back to the boss and say, hey, listen, I appreciate these solutions, but they aren't exactly going to help me with what I exactly need. Yeah, I think that communication is so important and about knowing how you're going to interact. I think we've probably all been there. Were you asked for something, your boss gives you, yes, for X, your boss gives you Y, and you think, not exactly what I was looking for. And then you walk away feeling frustrated. I know I have and haven't then gone back and said, actually, thank you for that. However, maybe I wasn't clear in my communication about this is what I need or these are the strategies or I think open-ended questions are wonderful. Okay, you offered this, but I'm wondering how is that going to help with the problem I presented. Tell me more. And so often it's a miscommunication. They didn't understand us. We didn't understand what they were suggesting. I was playing my book called Pause in Parrot, where sometimes we just, instead of saying, let's silly, I just come back with, okay, so I said I was struggling with getting my work done by Fridays, and you said I should take a vacation, help me understand how those two things are linked. And instead of offering a solution, you just repeat back what you heard. Okay, so you're suggesting a vacation would be helpful. Tell me more about that. I'm going to show that willingness to listen, but you also just parrot back what you heard. It is astronomical how many times we get it wrong where we think somebody said one thing and they said something else. We do this in therapy all the time and thank goodness we do because so often our interpretation is out in left field because of what we're thinking about and the other person's recommendation is completely different. But when you just take a minute and parrot back, is this what you really mean? Then we can clear up a lot of that miscommunication. But if your boss is really sticking with that, then sometimes you have to come to that place of acceptance of, okay, guess, you know, because I've worked in healthcare for a long time too, and sometimes the boss doesn't understand the exact pressure that you're under, or they make a suggestion that it's not going to fly with the insurance company, or they just really don't have it in the budget to meet your needs and you say, okay, guess this isn't going to work out. Yeah, so I know in medicine hierarchy often follows experience, right? The more experience you are, the higher totally get. I feel like there's a shift now, more like tech corporate world, where it's achievement that kind of lets you direct a team or whatever it might be, especially with startups and things like that. And so it leads me to ask you about maybe your thoughts on generational work ethic, right? I think a lot of the younger generation things out of Gen X or baby boomers are old. They don't know technology, but then vice versa. They're thinking Gen Z, millennial, they're lazy. But in reality, they just have different priorities, right? If you just Google generation work ethic, you'll see boomers in Gen X value, loyalty, hierarchy, face time, younger generations, however, flexibility, purpose, work like balance. Is there anything in your playbook that kind of takes people through how to communicate this, or how to understand the different dynamics, especially when it comes to those power struggles? Yeah, and you're absolutely right. And I've worked with people who will say in the first three seconds of a Zoom meeting, even if I don't have the camera on, I can tell you how old you are. Whether you make small talk, or you just jump into the meeting, and all of these ideas of how different generations function. And a lot of it is quite accurate, right? I didn't grow up with technology. It wasn't until I was in college, really, that we started adopting a lot of the things we use now, as compared to somebody who's had technology since they were a small child. One of my favorite strategies I think is to use what we call the platinum rule. We talk so much about the golden rule. Like, I'm going to treat you like you want to be treated. But what if I don't know how you want to be treated? I just treat you like, I think you should be treated. So I think, all right, when we start a meeting, there's no small talk. We just dive in. It's all about business. We log off a 30 minute meeting, but we log off in 20, and I feel great about the extra 10 minutes. And somebody else is like, it's really cold and impersonal. So what if instead of just doing what I wanted, I said, the platinum rule, what is it that you need? And I started trying to meet your needs, not just always trying to meet my own. And it couldn't be in these little things in the office. Like, I prefer email, but you prefer a phone call, or you want to communicate with somebody on Slack. What do I get to know that rather than just make an assumption? Because how often do we do that? Different departments will say, oh no, we only communicate by Slack. Somebody in the other side of the building says, I'm in check Slack in a week and a half. But yeah, we're frustrated that they didn't respond to our message. And so just getting to know that, and you don't have to communicate with everybody in a completely different way. But sometimes the people that are like the key people in your life, the people that you're interacting with the most, just ask them, if I have a question, how do you prefer I ask? Do you want me to send an email, set up a meeting? And just getting to know those things can make a huge difference in how we interact with people of other generations, but also how we show up and just figuring those things out. Because I might not know that you think I'm cold and impersonal. When I think I'm just getting down to business. But if I learn that about you, then I know, oh, little small chat goes a long way to helping you feel like you're part of the team. And sometimes those little differences can really help us to all get along and cooperate and work better together. Yeah, and something that I'm thinking about is, in our patient interactions, the simplest things will be when somebody comes in, new consult, they're sitting in front of you. You have asked me, hey, what are your goals for today? I think we have the assumption as a physician, people come in with a problem, they want us to fix the problem and leave. And that's not always the case. Sometimes you're just curious, sometimes just want an answer, especially if you're there for their fifth consult. Like, I'm just looking for this. And this would call, I would call this a successful visit if this is what happened. And I feel like setting that up front. Okay, all right, let's together work towards this. In this meeting, this interaction, let's work towards that. Sometimes we like to ask people, it's like, what would make this a home run for you? That's another one. I don't know who I stole that from. I also remember, I think, you know, you're talking about channeling and ultra ego as a confidence tool. I think you were talking about that being a skill. And that got me thinking, when we think about physical training and physical performance, that's the world my background that I come from, we recognize that with age, you're not going to progressively overload and get stronger and stronger and stronger. There is biology to it. Over time, you're going to have limitations. And like, you're going to have periods where you're going to go down and then up and intensity wise. But I think when we think about psychology and our mental strength, we think about that with age, with maturity, you're going to be wiser, you're going to be better. And you're going to always be on the upslope. And I'm not sure that's the case. But I'd like to get your understanding because your whole MO has been mental strength and constantly pushing it. And I don't know how young you are, you look very young. But I'm curious how you think about that. Is that something that we can always just be stronger than we were 10 and 20 years ago? Like, how do we think about that? Yeah, I think we can. I think there's always room for improvement. And hopefully, I mean, the goal is to be able to think back to something five years ago that you wouldn't dare do. And now maybe it's become second nature. And I think all of us have that. Like, oh, once upon a time, I thought, I'm not sure I can do that. But once you start doing it, you realize, oh no, I can actually do that. I can crush this all day long. But it's easy to lose sight of that. But I certainly have plenty of patients that come into my office who will say, I thought by the time I turned 40, I was going to feel like I had it all together. I wouldn't have the same insecurities I had when I was 12. And then people feel really bad that they still struggle. It's okay to still struggle. But the goal is to hopefully keep making progress. And I do believe we can continue to make more progress. And different seasons of our life call for different things. Sometimes, as you say, might be every five years we get hit with something huge. Well, it's easy to be feel mentally strong when life's going well, but then you go around that next curve and life throws you something and you realize, okay, I still have some things to work on. Or this thing that was really easy, maybe isn't so easy anymore. And I'll work with people who say, once they retire, their confidence takes a huge hit. They're like, my identity was wrapped up into what I was doing. And now that I'm not doing that anymore, who am I? And what does that say about me? If I go to a dinner party, am I still an interesting person? Or somebody might say, you know, now that I've gotten older, I feel like I used to get by on my good looks and I've lost some of that. So now people don't give me the same attention they used to. So what does that say about me? So as life is shifting, I think it's always giving us new opportunities to build mental strength, sometimes in some fairly surprising ways. I love it. So you had this mental strength audit, which is a pre-order bonus. And so people, I think, there's a workshop that they have missed at this point. Is that going to be included in the book as well? It's not. So the only way to get my mental strength audit is to pre-order it and get the bonuses that come with it. All right. We're definitely recording this before. So by the time this comes out, people will miss that, unfortunately. But hopefully they've been listening elsewhere. But let's talk about the mental strength audit. A little bit, though, if you can't hear. I think we, in medicine to love metrics, that's what drives everything. I think as an optimizer, we just love metrics and we're measuring everything in the hope to get better, right? What gets measured gets finished, as they say. And I guess the question is, how do you actually measure that mental strength change over time, like you talked about? And can you even change that? A lot of our mental strength happens so slowly that we don't notice it. So again, you have to zoom out and say, well, where was I a few years ago? And it's tough to do that. Like, well, five years ago, what kind of thoughts did I have compared to now? Well, a lot of us don't really know that it's kind of all blend in. But if you have somebody a trusted person in your life, too, that you can talk to and say, five years ago, how do you think I've changed? And that can often strike up a conversation. But also just in reflecting, how have my thoughts changed in the past maybe six weeks? What kinds of things do I struggle with? Do I still put myself down? Do I still doubt myself when I walk into a room? Do I not try new things because I'm afraid of risk? All of those sorts of things are really a key into your mindset. And then we look at the emotions. Like, some nice people are like, I never have anxiety. It probably means you're not putting yourself out there and trying new things. We want to make sure that you're experiencing a wide range of emotions, just like we've talked about in terms of acknowledging, yeah, I feel afraid sometimes. Yeah, I feel the sting of rejection. That's a great sign, too. That means you've tried something new. And then you access your behavior. What am I doing today that maybe I didn't think I could do six months ago? Or what kinds of things do I do every day to challenge myself? Am I pushing myself to my limit in some ways? Am I trying new things that are good for me? And just taking a step back and looking at it, we spend so much time planning out things like you plan a vacation or people really plan their wedding. We don't really plan how do I want to grow mentally stronger and just taking a little bit of time to write down some notes on how you're doing in terms of your thoughts, your feelings and your behavior can give you a lot of insight into how far you've come and where do you want to go next? Awesome. Amy, I really want to thank you so much for your time and for doing this amazing work. It's been fun. The two books that I've read for you, and I'm super excited for this one. I can't wait to pick this up. I encourage every single person to pick that up because I think that, as opposed to your previous stuff that you wrote, this is much more tactical in nature. And I love the fact that you said, you can just flip to that page. You don't have to necessarily go into orders and necessarily building up previous ones, although there are themes to that. Before we close, I don't want to get your idea generally. I know you spend some time. You have your own podcast. You're getting to pick people's brains. In your opinion, what are two mental strength tactics that are overrated and two that you think are underrated right now that people are talking a lot about? Oh, good fun. I guess if I were to say overrated, I would say cold plunges and people talk about, I'm going to expose myself to extreme circumstances as opposed to us. Darce has been trying to get me to cold plunge and I have no interest. He's not doing what? Just to feel that dope of me and Roger that have no interest. I always tell people, I'm from Maine. And all of us have times when the furnace goes out or you lose your electricity and you have to take a cold shower. I've been there and I've done that, and I don't want to do it again. You know what? This guy's in Tampa. This winter, this past winter in New Jersey, it was like negative for, yeah, we're good. Anyway, keep going. And I think another one is waking up early. So many people that really pride themselves on log it up at 3.30. Congratulations. But I think there's a lot to be said for getting enough sleep or going to bed at a time that's reasonable and getting up at a time that's reasonable for you. So I don't think the amount of cold exposure at the bedtime or the wake-up time that you have is necessarily hallmarks of mental strength. So I think those two are overrated as far as being underrated. I think gratitude is incredibly underrated. It's simple, it's easy. Only takes a couple of minutes of your day. And that would be one. And number two, I think just managing self-talk and figuring out, like, what are the conversations I have with myself? Self-compassion is huge in terms of helping us grow mentally strong. Or you don't have to be a harsh critic of yourself or a mean coach. Just be kind to yourself and it can do wonders for how you think, how you feel, and how you behave. And what's the most important thing that we haven't talked about that we should have talked about today? I guess I would just say that every day is a new opportunity to build mental strength. And no matter what happened yesterday or what your afraid is going to happen tomorrow, at the end of today, if you just asked yourself, what's one thing I did today to grow mentally stronger? That can help a lot. Because there's a lot of things you couldn't control today. You can't control how other people behave or what kind of weather you had or anything like that. But you can always say, I had that tough conversation. I spoke up in that meeting. I didn't speak up when I really wanted to. Sometimes that's a sign of mental strength too. But just checking in with yourself and asking that question reminds you that you have inner strength that you've probably forgotten about. Quick, quick follow up on that. Are you, when you wake up, or you actively seeking out like difficult, challenging opportunities or this more of a nighttime routine where you're looking back at your day and thinking about, these are the difficult things that I actually did that I did not realize at the time. I think this one is a great question to ask yourself at the end of the day. When I was a therapist, it was so easy to judge how I was doing as a therapist based on how my clients are doing. Well, 30% of them are doing better and 10% are kind of stuck. But really, I don't have a control over how my clients do. But I have control over what I did that I sharpen my skills today. So I always encourage people and I do this myself. And then I do challenge myself every day. But it's more about, I think, at the end of the day as I reflect on it rather than beating myself up for what didn't go well just saying, what did I do today to grow stronger? Yeah, absolutely. Also, maybe just been amazing conversation. Thank you as well. I'm super excited to get this book. And yeah, I think there's just so many situations that we're all in that we don't realize. I think this book will definitely elucidate for us and then help us out. For all the listeners, where can they go to or the book and learn more about you and your work? So my website is the best place. It's Amy Morin. LCSW is in licenseclinicalsocialworker.com. Awesome. And then what's your podcast called? It is called mentally stronger with therapist Amy Morin. Fantastic. Our Amy last question we ask everyone is, how do we put the health back in healthcare? I can't remember what you said the first time around. So, you know, I don't remember either. But I think it's all about taking charge of every area of our wellness from what we're eating to how we're sleeping and how we're spending our time and who we're spending it with. Absolutely. Creating that mentally stronger version of ourselves. Love it. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you very much. I hope you'll think we'll gain value from this as well. Now, time for the ever so important disclaimer. This podcast is intended for General Public Use and is for educational purposes only. It does not cost you the practice of medicine. No should be construed as a medical advice. 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