If you haven’t already listened to last week’s podcast with Dr. Ken Ginsburg, check it out! There were so many nuggets but I want you to focus on just ONE right away!
Here’s the scenario: A child shares an accomplishment with you. Our tendency is to give accolades and praise for the accomplishment! You may even be a step ahead, doing a great job focusing on effort over outcome. But…we can do even better! Instead of focusing on the effort, or even the accomplishment, focus on what the child is bringing to you, in relationship.
Good: Focus on Accomplishment Child: Look at my report card! I got all A’s this semester! Adult: Wow, that’s amazing, I knew you could do it! Keep it up!
Better: Focus on Effort Child: Look at my report card! I got all A’s this semester! Adult: Wow, that’s amazing – your hard work and determination paid off.
Beautiful: Focus on Relationship Child: Look at my report card! I got all A’s this semester! Adult: I love it when you share important parts of your life with me!
In the “good” scenario above, you’re rewarding an accomplishment. This isn’t necessarily bad, but the underlying message your child may read is that you only want to hear about wins, success and achievement. In the “better” scenario, you’re encouraging effort. This is great because we want kids to know that effort is just as important as outcome. If my child gets a B or C, but tried her best, asked for help and sought support, I’m proud.
But here’s where Dr. Ginsburg shared some magic…
In the “beautiful” scenario, you’re focusing on the relationship. You’re saying to the child, bring ANY important life events to me – success OR failures – when you’re proud OR when you’re beating yourself up. Being in relationship with you is the most important thing to me. Share YOU with ME.
Folks, just practice this one small shift, will you? I’m going to try too – it feels like a fundamental swing towards unconditional love and secure relationships.
Let me know how it goes!
Oh, speaking of relationships, if you are a medical provider looking to build a community of likeminded colleagues while getting CME AND educational resources for your patients and practice, check out my membership. It’s truly made for YOU.
Can we talk a bit about emotional endurance? I’ve heard this phrase popping up lately as a remedy for pandemic fatigue. I’m down with relying on a phrase to create meaning. Words help us make sense. People use words and create phrases as a way to construct meaning during times that feel out of balance, trying, or hopeless. Language is our way of finding a common understanding or agreement to how we’re going to talk about something. But, if we’re using language and words as a tool, let’s be clear about what we mean. For instance, you know what English word has over 645 definitions?
It has three letters.
Starts with “R”
R _ _
I’ll run bath water. I’ll run to the store. Did you run up a bill? Does your nose run? I run up hills.
Ok, you get what I’m saying. So, if we’re going to say we need to build or create or maintain “emotional endurance” what does that mean? The ability to have feelings for a long time? The ability to tolerate feelings? Having grit to bear emotions over time? Endure – to undergo, to tolerate, to stomach, to bear…I mean really, having endurance could mean so many things! If I tell you to stomach something vs. tolerate vs. undergo – it determines whether or you not you feel like you can show up for it. And then throw in feelings??? Who wants to tolerate or endure feelings, especially negative or hard feelings? Happy, sunny, loving feelings – I’ll endure those all day.
What I really think people mean when they say we need “emotional endurance” is that we need to build muscle in order to continue to undergo the stress and strain of pandemic life. And that, over time, if we adapt, we will have the stamina to endure these continued ups and downs.But here’s where I have a problem: Time after time, we continue to ask individuals to ENDURE without fixing systems! AND, we continue to place this burden on individuals instead of leaning on relationships!
Folks – no human was meant to endure prolonged stress and continue to adapt. It FRAZZLES our nervous system. Predictable, tolerable stress creates resilience, but prolonged, erratic stress creates overwhelm, which leads to burnout. So, if we’re going to ask people to continue to build emotional endurance despite no systemic change and no recognition that we DO BETTER in relationships of trust and support…I cannot support this mentality.
The only way to heal and learn from what we’ve “endured” over the last many months is to begin to address systemic harm and build supportive relationships where it’s ok to be human instead of heroes. You know where you’re going to learn more about responding to trauma and creating resilience?
On my new podcast – join us this Wednesday – the episode with Dr. Ken Ginsburg, pediatrician, drops this week! Oh, and if you are interested in joining my membership community for medical providers, check it out here!
In preparing for my upcoming podcast launch, I made a list of 3 incredibly well-known physicians to invite as a special guest for a kickoff party. I was terrified because this is a new project for me and even the best of us get imposter syndrome at times. But, I’m passionate about creating a space where providers can share their stories and normalize talking about trauma and stress – for themselves and for their patients. And, for them to begin to answer the question – now that I know about trauma, what do I DO for myself and my patients to address it?
So, I took a deep breath and sent my emails. Two didn’t even respond. Nada. Nothing. I was like, “Oh geez, I shouldn’t be doing this. This is going to fail. No one is going to listen.” But, something inside me told me, “This is important. This message is critical.” So, I continued to be patient and wait. Then, one physician responded with a resounding – “I’d love to” – and I exhaled. He was interested, excited, and supportive.
Please come! All are welcome. Let’s celebrate ways to normalize talking about trauma so that physicians and patients feel less alone. One brave story at a time.
You can listen to the promotional episode now! And then join us Wednesday evening because you won’t want to miss out on Dr. Ginsberg’s insights and be entered for a chance to win one of 2 Spafinder gift cards! What’s a party without prizes?
Oh, are there certain questions you’d like answered by Dr. Ginsberg about creating resilience in children and families? Shoot me an email!
On Thursday, I hosted a meeting for physicians regarding burnout. At one point, there were about 7 physicians and nurses on the call. That’s wonderful! And, we recorded the session so that others, who may have missed, could watch later. I’ll take seven people to help, don’t get me wrong. It’s why I shifted from 1:1 therapy to organizational consultation and training – I wanted to have a more significant impact. But here’s the problem. The program that I was hosting the call for serves dozens of physicians. Seven were able to attend.
After the call was over, I knew the words that were shared, the information sought out and the community that gathered provided much-needed support. But, I also left wondering what happened. Here are some thoughts that went through my mind:
The content is horrible. (Don’t we always go there first?) You must not think this is helpful. But hey, you’re here and I’ve read the surveys, so…
You’re still seeing patients. This is a likely culprit. Lunch meetings are tough. But let’s face it, so are morning or evening meetings. Darn.
You’re catching up. Another likely culprit. Finishing charts, calling in prescriptions, and answering questions. Often it leaves little time for lunch, let alone a meeting.
Competing needs – seeing a new baby over lunch or attending to a delivery, running a personal errand or catching up on calls & emails.
A meeting about burnout, or crossing something off the list of to-dos? It’s a tough call.
The answer is pretty straightforward. There’s not enough time. Your days are packed with obligations and compounded by staffing needs and demanding schedules. Pausing to take in a meeting, even if it’s helpful and meaningful, feels like an unaffordable luxury.
If I may, I’d like to offer a few suggestions that might be helpful:
Give yourself permission to block off time for yourself. It can be for anything you desire – even if that means 15 minutes of doing nothing at all. Doing nothing IS DOING SOMETHING.
Reach out to HR about your workflow. Sometimes even small shifts in well vs. acute visits or same-day appointments can make a huge difference.
Pretend a meeting that’s for you is for your patient or an obligatory hospital requirement. Make YOU a priority.
See if there are meetings at your clinic or hospital for affinity groups – black physician groups, LGBTQ+ groups, working parent groups – spaces that you’ll find support and encouragement from peers facing similar issues.
Check-in with a colleague or partner. If you’re not ok, likely they’re not ok.
I know these suggestions might not solve causes of burnout, but they will decrease isolation and protect your time a bit more.
I want you to join me for a conversation about trauma and provider stories. How trauma manifests, how it can be triggering, and what to do about trauma – we’ll talk about all of it. And the good news – you can listen ANY time. Here’s the link for the podcast launch party – it will be a PARTY. Join me and Dr. Ken Ginsberg as we talk about resilience and you’ll have a chance to win a $75 Spafinder gift card – who couldn’t use that now? REGISTER NOW!
Oh, and PLEASE email me back to let me know what steps you are taking to address your own burnout — I want (and love) to hear from you!
Oh my gosh, I’m so excited to announce my VERY SPECIAL GUEST for the podcast launch party: DR. KEN GINSBERG!!
Of course, you’ve probably heard about him, but if you’ve not, you can check him out here. Dr. Ginsberg is a pediatrician specializing in teen medicine at the University of Pennsylvania Medical School and the co-founder of the Center for Parent and Teen Communication. He’s notably an expert in building resilience for families and many of you will recognize his work regarding The 7 C’s of Resilience as a cornerstone in my workshops and trainings. He’s written several books and, equally important, he is a kind, relatable soul who’s graciously offered to be a guest with us!
Here’s what we’re going to talk about:
How Ken got interested in the work of trauma and resilience-building. How trauma shows up in primary care. Why Ken believes building resilience is a natural antidote. Why it’s important to talk about trauma in primary care and; Why the word “resilience” is getting a bad rap lately. Plus, he’ll talk to us about his work: Reaching Teens and Building Resilience.
We’ll learn so much together and celebrate at the same time. In case you missed them, here are the details so you can join us!
WHAT: The Most Important Medicine: Responding to Trauma and Creating Resilience in Primary Care – PODCAST LAUNCH PARTY!
WHO: If you’re a provider or a patient – THIS MEANS ALL OF US – you should tune in and celebrate! Providers because this is THE space to be and patients because you need your healthcare provider to know about this!
WHY: Because parties are fun AND because understanding and responding to trauma is, truly, THE most important medicine!
Oh, and if joining us for a virtual party isn’t reason enough, because I get you and who wants to be on another zoom call, here are two more reasons: We’ll draw for TWO Spafinder gift cards, each $75.00 and you must be present to win.
We have a party to plan! On August 3, our podcast, The Most Important Medicine: Responding to Trauma and Creating Resilience in Primary Care will officially launch! I cannot begin to tell you the journey my team and I have been on creating this podcast. First, I had no idea how to record and launch a podcast. You could literally see steam coming out of my head as I tried to figure out Garage Band on my Mac. And Zoom? I’m all about zoom, but putting Zoom together with other applications – goodness, did I mention I’m a psychologist and NOT a tech expert? Well, after a steep learning curve, plus the help of my incredible team, we’re launching! Anything, and I mean anything that looks beautiful on the platform, my webpage, Buzzsprout, etc…that’s because of my amazing team, specifically my project coordinator, Tegan. Second, I really struggled with YET.ANOTHER.PODCAST in this world. I mean, really? But as I scoured the sources of podcast worlds, I could find nothing like it. It seems that nothing like this exists – a space for providers in healthcare to gather, share stories about trauma and resilience, and gain education and resources for themselves and their patients – all within reach of their earbuds? So, I feel like we’re uniquely positioned to create a space where this magic can all come together. I simply want to create a space and disseminate incredible, relatable information.
So, this is your official invitation to join us for our launch.
WHAT: The Most Important Medicine: Responding to Trauma and Creating Resilience in Primary Care
WHO: If you’re a provider or a patient – THIS MEANS ALL OF US – you should tune in and celebrate! Providers because this is THE space to be and patients because you need your healthcare provider to know about this!
As of last week, we were notified that The Provider Lounge:A Learning Collaborative for Primary Care Providers to Build Resilience for Themselves and Their Patients was approved for Continuing Medical Education! As of July 2022, providers will receive 1.0 hours per month of CME from OHSU. Imagine me, doing a happy dance last Wednesday when this news came in! First, I was ecstatic, then tearful, then tremendously hopeful.
Let’s work through all of this news so you can be as excited as we were last week!
Ecstatic – my team and I have been working for months to ensure that providers can have access to quality CME regarding trauma-informed practices, wellness, and building resilience. Our hard work paid off and the news was so sweet! Tearful – because we recognized the enormity of what this means – not only can providers have a space with excellent resources regarding resilience, consultation from a psychologist with 23 years of experience, a community of fellow providers to gain insight, share stories, and a TON of online resources but now then can ALSO get 1.0 hour of CME for every Provider Lounge meeting they attend. And Hopeful – so hopeful because this is truly how providers can heal amongst colleagues, help patients respond to trauma and stress and build resilience for their families and patients. We’re changing lives here and transforming medicine by building competency and confidence in responding to trauma!
This means that if you join the Provider Loungefor a year, you’ll get 12 hours of CME that feels like fuel for your soul and a healing balm for your patients! If that’s not enough, here’s what The Provider Lounge offers:
Monthly meetings, the first Thursday of every month, over the lunch hour. Attend live or watch the recorded session later. We know you’re busy!
A monthly re-cap of each session with a resource page chalk-full of goodies!
An entire library of online resources including training videos, scripts for resilience-building interventions and pdfs loaded with educational information for you and your patients.
We’re also building out other offers within the Provider Lounge at no additional cost! A space for behavioral health providers, coffee chats with subject matter experts on topics of your choice and Provider Lounge Leaders – a monthly meeting for those of you who are leading the way in healthcare.
Offering CME should have tipped you over the edge from, “I’m not sure if I have time to make this investment,” to “How could I say no?”
You need CME. You need to fill up your cup in a community of eers to overcome burnout and overwhelm. And your relationship with your patients will change dramatically with these conversations. Oh, and ALL of what we talk about it guided by trauma-informed,efficacious interventions to support your practice.
That’s a WIN-WIN-WIN-WIN!!!
So, here’s what we’ve got for you – come and check us out in July, even bring a friend. We’re growing at the speed of trust and community! Here’s the Zoom link to join us July 7 at 12:30 pm.
If you’re not convinced, here’s a sneak peek into the Pillars of Provider Lounge:
We must first care for you because we cannot lose more providers due to burnout and overwhelm.
Shared wisdom is present in this group. Support and resources will come from each other, in community.
Medicine is transformed through relational health and relational leadership.
Questions? Just ask – firstname.lastname@example.org – we’re here to support and guide. We truly believe that, together, we’re transforming medicine!
I don’t know about you, but it seems that kids families, and adults are more complex than we have seen as professionals in a long time. There are lots of reasons for this (I’d love to hear your hunches) but suffice to say that between COVID, isolation, distance learning, lack of resources for mental health, compounding stressors of politics, climate concerns, and more attention being paid to gun violence and legislation, people are in various stages of trauma responses.
I think trauma is an accurate term right now. It’s more than overwhelm. It’s greater than burnout. And it’s beyond workforce wellness. And, believe me, I’ve talked A LOT about those topics over the past many months. People are traumatized. There’s a great deal of sensitivity and hyperarousal in our communities right now.
So, because I tend to respond to stress by searching for purposeful tools, I want to tell you about a few things I’ve been working on lately.
1.) There are new resources on my webpage – check them out! Resources for boundaries and creating cultures of trust are now available to download for free! Please share with colleagues.
2.) You’re invited to join us at The Provider Lounge: A Community to Build Resilience. Your first month is ALWAYS free! After that, we have a paid membership program so that I can better serve you.
The Provider Lounge is where trauma-informed education meets “now what” interventions. It’s a library of tools, resources, videos and prescriptive Cards for Connection to use at EVERY well visit prenatally through early adulthood.
We meet every month, on zoom, for 60 minutes of didactic, consultation, and community.
Even better – we’re almost approved for CME – it’s a win-win!
I look forward to the monthly provider lounge. Dr. Amy has very practical positive ideas, insights, and strategies that are helpful both for my patients and for me. Jennifer Bass, MD, Provider Lounge Member
3.) I’m creating a flow chart for how to respond to the complexity that we’re all seeing right now. More that next week! Stay tuned.
And finally, a BIG announcement – I’m starting a podcast for all of you in August. What??? Ok, I know everyone is doing it right now but when you come for the podcast launch on August 3rd at 6:00 PM (pssst, mark your calendars and an official invite is forthcoming!), I’ll share with you WHY now is the best time for this particular podcast and you’ll get to see an interview with a VERY SPECIAL GUEST.
So, two questions – what resource are you going to check out this week? And who else are you sharing this amazing information with so that they can benefit you too?
A couple of weeks ago, I posted a blog regarding the shootings in Uvalde, TX. So many of you responded and expressed shared sadness and heartbreak. I know we all do. And, a couple of you reached out and expressed disappointment that I had not addressed other shootings that had proceeded this one, including the mass shooting in Buffalo, NY that was racially motivated. I’ve truly sat with this feedback over the past couple of weeks. I offered thoughtful apologies and expressed gratitude to those of you who reached out. This work around responding to trauma is messy and I make mistakes daily, I’m sure. In an effort to support providers after there had been weeks of deadly shootings, I tried to get as much information and support out as possible. But, what we DON’T say matters too. Of course, I was aghast by the shootings that had proceeded and have continued since the massacre of 19 children. But what I didn’t say was that my response to the shootings of children and the extreme exhaustion and overwhelm I felt was a direct result of the hopeless feeling and compounding stressors from the other horrific acts of violence that had proceeded this one.
We can always do better. I believe intention matters. My intention, my purpose is to help healthcare workers understand and respond to trauma. To mitigate stressors and build resilience. To have actionable tools for the children, families, and patients they see so they feel more confident and competent in their practices. And because there are times when it feels like trauma in our world is unfolding faster than we can respond – there will be mistakes made and lessons that need to be learned. If I’m doing this work – I bravely step into the world and open myself up for constructive criticism for when I don’t do it right. And that matters to me.
I don’t believe that we grow unless we’re willing to fail forward. I’m thankful every day that I have a platform to reach others and create meaning, especially during difficult times. And, I appreciate that I’ve created relationships with so many of you that you feel you can reach out and say, “Hey Amy, I’m not sure you got that right” or “I think you missed something and that hurt me.”
I don’t always make my views on the work of equity known as explicitly as I could. As a white, educated, cis-gendered woman, I believe that it’s my job to work and gain trust. And, it’s my job to be an ally to those who recognize my work and efforts. I also strive to be an ally and gain the trust of those who may not see me that way yet. I will continue to strive to do so. And I will try to make my work and dedication to these efforts more explicit.
In the meantime, if you’re interested, here’s some of the work that I do and I’m committed to continuing:
Offering scholarships for trainings I provide for those who may not be able to afford an experience otherwise, especially medical residents.
Find subject matter experts to partner with and facilitate trainings with me – especially on issues related to diversity and equity.
Elevate voices of those with lived experiences any time that I facilitate parent trainings or professional consultation. I truly believe that communities have inherent abilities to heal when appropriate funding and resources are provided.
Ensure that when organizations request resources that voices of BIPOC & other marginalized groups are included as expert authors and contributors.
Contribute financially to organizations that provide opportunities for youth and families who’ve experienced trauma – historically, intergenerationally and systemically. The most recent example was contributions from my business were:
I was on a telehealth Zoom call with a client last Tuesday afternoon when she asked, “Dr. Amy, did you hear what happened today?” I had not, having been busy in meetings all day. She began recounting details she had heard so far. At that time, 17 children and 1 teacher were dead. We would later find out that 19 children and 2 teachers perished in a senseless, murderous act. This type of incident happens often to healthcare professionals – we learn of news from our patients or clients and find ourselves processing with them while reconciling the information ourselves. As I helped my college-aged client process her own grief and despair, I wondered, “Are my kids ok?” “Did they hear the news yet?” “Are they scared?” and then, “Dear God. Dead children. Again.”
I was in graduate school working at an Indianapolis Public School when the Columbine High School murders took place. The day after the incident, metal detectors were installed at the high school I was assigned to; but nothing could have prepared me or the children I worked with for the worry and confusion they faced. That was 1999. 23 years later, I watched the news as faces of 10 & 11 year-olds scrolled on the screen along with their teachers.
What did I do the rest of the afternoon? the only thing I know how. I continued to support my clients, one at a time, then a group of parents for our weekly parenting group. I didn’t have much time to process my own feelings, but when I did, I felt numb, helpless, sad and angry. I worked on a handout for parents and professionals to help them understand how to talk to children in the aftermath of violence. I re-posted the National Association of School Psychologists’ one page handout on responding to school violence. Again. How many time had I posted this? How many times have I talked with parents and professionals about developmentally appropriate ways to talk to children about unmentionable tragedies? Too many.
Wednesday, more clients processing trauma and trying to understand our world. Then, I taught an ECHO meeting for medical professionals. I offered to meet with them before and after our regular session, should they have questions about childhood trauma or ways to talk to parents, children, or take care of themselves. It was the only thing I could offer while feelings utterly helpless. I tried to remind them:
Focus on purpose
Eat. Drink. Rest.
Know that your actions matter
Validate all feelings
To be honest, not much during the past 2 and a half years has broken me. I truly feel that I’ve had the honor of helping many professionals process a completely unpredictable world of COVID in healthcare and various other organizations. I compassionately listen and find words to heal the compounding stressors related to it – murders, racism, fires, loss, elections – so many additive stressors that people were enduring ON TOP OF a global pandemic. Together, with so many professionals, we have tried to make sense of our world – listening, crying, compassionately caring, and simply being present for so much grief.
But Tuesday, something in me closed off and shut down. By Wednesday afternoon, I reached out to my husband after teaching. I realized that after more than 24 hours of pushing through a tragedy, trying to make sense of it so that others could make sense of it, I was utterly exhausted. In a tired voice, I said, “I’m not ok.” I forwarded my emails, closed my laptop, and went to bed at 2:30 in the afternoon. I slept for over an hour. My husband was home by 4 pm and sat in the sun on our patio with me and listened.
I cried for the moms and dads and families who would never see their children again.
I cried for the teachers who hovered over terrified children.
I cried for the dead children and I cried for the children who lost classmates, brothers, sisters and friends.
I cried for the first responders.
I cried for the first responders.
I cried for the hospital workers delivering horrible news.
I cried for the school staff triaging the chaos.
And then, I did the only next thing I could do. I tried to take my own advice – I rested. I ordered take-out. I turned off the news. I answered my children’s questions. I talked with friends. And on Thursday, I did the next thing I could do: I continued to work on my book about childhood trauma, adversity and resilience. Because that gives me a sense of purpose. It’s the work I will continue to do – to help others understand how trauma affects children and what to do to strengthen children and families despite tragedy.
I hope you know if this week broke you, you’re not alone. Together, let’s take one next step. Not the right step, just that next step that feels ok to you. Tell someone if you’re overwhelmed. Ask for help. You’re not weak – you’re human. We’ve all had moments, especially. since the beginning of 2020, that have been unbearable.
But, when we’re connected and in a community, we are not alone. I share that so that you know that you’re not alone.
And in other news, not so small news I might add, I’m continuing on a path to purpose. With that, I’ll be launching a podcast this summer focused on ways to respond to trauma and build resilience in primary care. I hope you’ll join with me on this journey. More to come.