00:00:00: Hello, everyone.

00:00:00: My name is Egle, and I'm the host of UEG Talks, Educational and Hopefully Fun Diving to GI World and Beyond.

00:00:07: We're happy to have you with us for another exciting episode.

00:00:11: And today I could not be more excited.

00:00:13: For one, we are talking about crucial questions in medical practice.

00:00:18: Why do we go down the burnout

00:00:20: route?

00:00:21: How to come out of perpetual numbness?

00:00:24: Is there a healthy way to fight in a hospital?

00:00:27: And for

00:00:27: another, this conversation takes place in my home, Vilnius University Hospital.

00:00:33: And

00:00:34: we're talking today with the Chief Strategist of Hospital Warfare, Paragon of Mental Fortitude, and all-around incredible human being, organizational psychologist, Lina Sopiene.

00:00:45: Welcome to EG Talks, Lina.

00:00:47: Hello, everyone.

00:00:49: Thank you for inviting me.

00:00:50: We're extremely happy because this is such a hard and prevalent topic in our daily... life that we do not talk a lot, but you are the freaking expert.

00:01:01: Thank you for participating.

00:01:03: Yes, I talk with the doctors and nurses a lot and wanted to touch to their daily life in the hospital.

00:01:12: Yeah, full disclosure for our audience.

00:01:14: in Linus room therapy cabinet or whatever, you can either get a hug or have a very safe space to throw a temper tantrum and I have done that from time to time.

00:01:28: So let's get cracking on.

00:01:31: The thing is, to become a doctor, you have to put quite a lot of effort.

00:01:36: You usually

00:01:37: have to be

00:01:38: somewhat

00:01:38: of a top of the class,

00:01:39: top of the medical school, and you are rewarded for working hard.

00:01:44: You get the positive reinforcement, and this continues back into the hospital, the more you work, the better you are, a better human being, better specialist, and you get this dopamine rush.

00:01:56: How do we get out of this vicious circle of getting high on dopamine while running ourselves to burnout?

00:02:03: Usually the answer is in the question, how to get out or just not to flow for dopamine.

00:02:10: What's the alternative?

00:02:11: Just to understand why you need this dopamine.

00:02:14: Let's go to the roots.

00:02:15: Usually we have such expression when you were a child and like the mother asked you for something and just be good, bring me a cup of water or tea or coffee.

00:02:27: And logically, our brain can accept this like, okay, if I will bring this cup of tea or coffee, I will be good.

00:02:35: If not, I'm not good.

00:02:38: So accept this and understand that, look, if I can't do something, It doesn't mean that bad, it just means that I'm still good enough.

00:02:48: I don't need more dopamine to be good enough.

00:02:51: The problem is only in the way how we think about ourselves.

00:02:56: When I'm good, I'm good only then when I'm the best.

00:03:01: Okay, if I lose my ability to be a doctor.

00:03:05: what I will be bad person.

00:03:07: I will open a bakery and deliver baked goods.

00:03:10: to be a good person again just another

00:03:12: way.

00:03:13: But you see, you have to do something to be good.

00:03:18: Yes.

00:03:19: But initially, we are all good by ourselves.

00:03:25: We don't have to be something someone.

00:03:30: It's not enough to be just honest or to live honest life.

00:03:34: to be a good person you connected two things.

00:03:39: good person is only when and you have to fit to this some reasons or some

00:03:47: expectations expectations

00:03:48: of other people.

00:03:49: for example if you can't fulfill some expectations what you are a bad person.

00:03:56: now you're still good.

00:03:58: you are still the same good person.

00:04:02: Look, this is a child brain who is still thinking that if I can't bring the cup of tea, I'm bad.

00:04:09: It doesn't mean you can't bring or not.

00:04:12: We are talking about the unconditional love.

00:04:16: If we had this in our childhood, then we know that even if I'm not so successful, even I am not the best in the class, It's still good enough to be valued.

00:04:31: My value, it's in me, not what I can or

00:04:35: can't.

00:04:36: Okay, you're speaking English, but I'm having trouble understanding your concepts.

00:04:41: What happens then?

00:04:42: Okay, these are intrinsic things, but what happens when I say I can't because I'm too tired, I'm just out of my wits?

00:04:51: But others can.

00:04:53: Then

00:04:53: I'm

00:04:53: worse than them because they still can.

00:04:56: Because

00:04:56: you compare yourself with this person, but you have different abilities.

00:05:02: Like, for example, you are working twenty-four hours and this person just came to work and he has more resources at this moment, but just at this moment and you don't.

00:05:17: And it's normal.

00:05:18: My height is as it is.

00:05:21: And other person is taller.

00:05:24: Of course, he has different abilities than I. He can reach like from the top shelf in the shop and take something, but it doesn't mean that he's better than I, just he's taller.

00:05:39: I don't compare uncomfortable things.

00:05:41: Well, I've been a doctor for gastroenterologists for four years and then five years of residency and I've been doing a lot of vocals and I can still do them back to back and haven't reached my limit.

00:05:54: And the more

00:05:54: I do, the

00:05:55: better I'm with my bosses, the better I'm valued, the more experience I gain.

00:06:01: So far, I haven't reached my limit.

00:06:03: So

00:06:04: the simple question How much time do you have for yourself, for really what you want to do after work?

00:06:10: How many time you can just give to yourself and do nothing?

00:06:16: This is a weird concept.

00:06:19: And I think that the audience will resonate with

00:06:21: it.

00:06:22: Doing nothing is not something that we're used

00:06:25: to.

00:06:25: Exactly.

00:06:26: Because the error of thinking is like, I am valued only then.

00:06:32: When I'm doing something, human doing,

00:06:35: not human being.

00:06:36: Yes,

00:06:36: but this human doing leads only to burnout.

00:06:41: Nothing else.

00:06:42: A lot of people are talking about the balance.

00:06:45: Yes, you have to work hard, but it doesn't mean just only doctors, teachers, psychologists, nurses.

00:06:53: Everyone who is working, they have to work hard to achieve some results or some occupations or whatever.

00:07:01: But also, when they get this, they understand that, OK, if I will stop, the next will be better than me.

00:07:09: And I can't stop.

00:07:11: OK, I can't stop.

00:07:12: I can't stop.

00:07:13: And this means that, OK, it's a burnout.

00:07:15: Welcome.

00:07:16: It's

00:07:16: a perpetual race, rat race.

00:07:18: This is why people came to psychologists to understand what does it mean unconditional love and to start to love yourself in such a way?

00:07:31: that it's healthy because if I want to take care about other people, I have to take care about myself.

00:07:40: So

00:07:40: we are taught how to take care about others, but it seems like no one has taught us to take care about ourselves.

00:07:50: Okay, Lena,

00:07:51: I feel like you've been talking, you were talking in English, but I'm not sure that I understood.

00:07:56: Did I understand you correctly?

00:07:58: Because we have somewhat warped image of ourselves, of what we're valued for internally.

00:08:06: We try to put too much stock in what we do.

00:08:11: And we ascribe our value to actually our work.

00:08:17: The more we do, the more valuable we are.

00:08:19: And this leads to the burnout and intrinsic conflict between what I am and what I do.

00:08:28: Yes, exactly.

00:08:29: Okay, so it was a bit difficult for me, but I guess I grasp it.

00:08:34: I hope everybody did it too.

00:08:37: So we are not to be valued because of the cup we bring to our mother, but because of that we are there.

00:08:44: Exactly, exactly.

00:08:47: Okay, so

00:08:49: coming out from that, what else happens at work is that as the time goes by we learn not to react to smaller things.

00:08:57: And actually at some point it becomes that you need a really

00:09:02: huge

00:09:02: thing for it to cause drama.

00:09:05: It means that you need a bloodbath or someone actually dying for it to mean something or

00:09:10: be

00:09:11: of any importance.

00:09:12: And the threshold for drama gets higher and higher.

00:09:15: But

00:09:16: what happens when we bring that same attitude at home?

00:09:19: And the

00:09:20: other people

00:09:21: might not have the

00:09:22: same

00:09:23: scale of drama.

00:09:25: For instance, for me, taking one pill of anti-hypertensive medicine is not a big issue.

00:09:31: But for instance, for my family, it might

00:09:33: be a huge

00:09:34: psychological thing to start medication.

00:09:38: Yes, we all have our own interpretation.

00:09:42: What is normal?

00:09:43: And what is?

00:09:44: it's already a problem?

00:09:47: There are no one answer to this question.

00:09:49: Is it too sensitive to this or I'm already detached from this?

00:09:54: I think that I should look at this from different perspective.

00:09:58: You give an example that it's not a big issue until there is

00:10:02: a blood bath.

00:10:03: Yeah.

00:10:04: Yeah.

00:10:04: Yeah.

00:10:05: Yeah.

00:10:05: Exactly.

00:10:06: But I'm listening here.

00:10:07: I'm thinking like, okay.

00:10:09: Well, for me, it does mean that you have a lot of experience and you know that if the surgery or something is going in such way, the patient is really safe.

00:10:21: And you have your own science when it is already bad.

00:10:26: For other people, we have different science when the drama or problem starts.

00:10:32: So for other, to take one pill per day, it's a drama.

00:10:36: And for others, who's really serious ill, he takes maybe ten,

00:10:44: twenty, thirty.

00:10:46: And it's not a problem.

00:10:47: Yeah, it depends from a person.

00:10:50: So

00:10:51: I get your point.

00:10:52: But what happens?

00:10:53: I can understand that.

00:10:55: Let's say my threshold is not the same as my non-medical family.

00:11:00: But what happens when they think I'm cold and.

00:11:04: you know, insensitive because I don't see it as a problem.

00:11:08: Yeah, it would be nice that you can sit and talk about this situation from different points of view.

00:11:14: And it's normal.

00:11:15: And I would invite people to sit and talk about this, how you see this.

00:11:21: It doesn't mean it's like the same evaluation or label that you are called, you are not called, you are more experienced.

00:11:30: If you have different point of view about this, it doesn't mean that you are right or I'm wrong or I'm right, you are wrong.

00:11:38: That you are very sensitive or I'm cold.

00:11:41: You see it differently, but can we agree that yes, we have different points of view, but it doesn't mean that I'm cold or you are too sensitive.

00:11:52: Just

00:11:53: less labels,

00:11:54: it's the same thing, just different approach.

00:11:56: Yes, less labels and more understanding.

00:11:59: Why I don't react so sensitive?

00:12:02: Why I don't see the problem in this situation?

00:12:06: I don't see because I know that it could be bigger ones.

00:12:11: And it can always get worse.

00:12:13: Of course, exactly.

00:12:15: This is my experience, my nervous system is saying for me that Look, it's all okay.

00:12:21: It's all controllable at this moment.

00:12:23: Fair enough.

00:12:24: But

00:12:24: for our relatives or close people, maybe they are thinking that they can't control the situation, but you know that you can.

00:12:33: So you are not called.

00:12:34: Are they not too sensitive?

00:12:36: It's about the question about the control.

00:12:38: Who wants to control what?

00:12:40: Okay.

00:12:40: There are different points of view.

00:12:42: I'll

00:12:42: try this.

00:12:44: Talking about control and actually the control of our bodies,

00:12:47: we

00:12:48: actually can detach for some time.

00:12:51: In long hours, in the wars, on calls, we forget

00:12:55: to eat,

00:12:56: to sleep, sleep is out of the question.

00:12:59: Being might be there, but also only on occasion and we become so detached of our bodies.

00:13:04: And you've talked a lot in what I know you do in your daily practices, getting back to your body and how you feel.

00:13:13: How do you combine these two radically different things, you know, putting your bodily needs and your feelings out of the way to work and then getting back to your body?

00:13:26: It's impossible to go out from your body and come back to your body.

00:13:30: What do you have?

00:13:31: You have only your body, nothing else in this world.

00:13:36: So you can't go out from your body.

00:13:39: You just can't pay attention.

00:13:42: I can

00:13:42: ignore it for

00:13:43: a long time.

00:13:43: Yeah, exactly.

00:13:45: You are not going out from your body.

00:13:47: You're ignoring what your body is saying to you.

00:13:51: How do you talk with your body?

00:13:53: It's like your body is screaming, I want to go to the toilet and say, please be patient because someone else wants or other person wishes are higher than yours.

00:14:07: It's not wishes.

00:14:08: It's their health.

00:14:10: Yeah.

00:14:10: Yeah, but if you fall down, you can't help to your patient.

00:14:16: This is why every time I'm asking to find the balance, this means that the help to patient shouldn't be done in the price of your body or of your inconvenience or your

00:14:32: needs.

00:14:33: Yeah, you should promise to your body.

00:14:36: It's like, yes, I hear you.

00:14:38: But I will take care about your needs in five minutes in ten minutes.

00:14:44: Can you wait?

00:14:45: You should talk with your body.

00:14:46: You can't ignore it.

00:14:48: Otherwise, your body just learns not to send any signs.

00:14:53: It's just your body will get sick.

00:14:57: I think that a lot of doctors had burnout.

00:15:00: Actually, I had burnout too when I didn't listen.

00:15:04: And from that time, I have learned my lesson and I'm listening very careful and I'm talking with my body.

00:15:11: And there are a lot of techniques how to talk or how to listen or how to understand or, okay, how to get back to your body.

00:15:19: Do you have

00:15:20: like your favorite trick or how to get in touch with your needs, with your body?

00:15:27: I think that... even if you are in very problematic situation.

00:15:32: Take five or ten seconds just to stop and just look at yourself.

00:15:40: I feel tension in my shoulders, in my hands, I'm tired of my feet or whatever.

00:15:45: Pick any part of your body and just put attention to this for just a few seconds and you are already in your body.

00:15:53: Fair enough.

00:15:55: This

00:15:56: is doable.

00:15:57: Yeah, yeah, just a few seconds, you don't need a lot of people thinking that all to get back to your body, it's, it's, it takes about an hour or two.

00:16:06: No, but when it will become a habit, you have just few seconds to understand, okay, how I am at this moment.

00:16:15: And do I need to change my body posture or I don't know to put the feet in different position or just to take deep breath, just Yeah, I think that the easiest way to get to your body is just to start thinking how you're breathing, just to take attention to your breath, how you inhale and how you exhale.

00:16:37: Doable.

00:16:38: This we can do.

00:16:39: And there are a lot of other techniques like yoga, meditation, any gym, just if you consciously walk or whatever you are doing, you can do this very consciously.

00:16:51: Fair enough.

00:16:52: Okay,

00:16:53: very last question.

00:16:55: I think there is a full moon coming and today

00:16:59: was

00:16:59: quite interesting at work.

00:17:01: And I would like to ask you about anger in a workplace, because I do remember you saying that doctors or medical personnel are inherently avoidant of any confrontation.

00:17:14: So not

00:17:14: to be

00:17:15: bad people, like uncomfortable people.

00:17:18: Yeah.

00:17:19: And it boils down until one minute, there's a huge fight.

00:17:25: Sometimes

00:17:26: a fist fight,

00:17:27: this can happen.

00:17:28: Is there

00:17:28: a healthy way to

00:17:30: let

00:17:31: out our frustrations, anger, disappointment in a healthy way that's not destructive?

00:17:37: Yeah, every time you can go to the street and start to just scream, it's a better way to have a room like where you can let out all your feelings or tears or anger or frustration or whatever.

00:17:52: Or to draw or to shout or to scream or to jump or to dance or to sing, whatever it helps you.

00:18:01: Just go for a walk or a group.

00:18:04: for ten minutes, if you can, and just to walk and to let it out.

00:18:11: And what's about interpersonal conflicts?

00:18:14: How do we address that until the point that we punch each other?

00:18:19: I have a very nice story.

00:18:22: A monk taught the young monk how not to accept the anger of other person.

00:18:27: It's like, okay.

00:18:29: We can deal just with our anger, okay?

00:18:32: Okay, there are a lot of techniques what we can do.

00:18:35: Okay, the first step to say that, okay, I'm angry, I need five minutes to calm down, okay?

00:18:41: Use these five minutes as you want, what helps you to relax or to let the anger out.

00:18:47: But other people angers, this is a little bit more difficult.

00:18:51: to learn, not to accept.

00:18:54: And I have the story about a monk who taught a younger monk how not to do this.

00:18:59: It's like, if you think like about other people's anger as a gift, it's metaphorical.

00:19:06: It's a lot of, it's a law of nature.

00:19:11: That's mean that the anger or the gift is in my hands now.

00:19:16: Okay.

00:19:17: And if I want to to give you this and you are not taking it.

00:19:23: Where anger stays in your hands.

00:19:26: Exactly.

00:19:27: You are responsible not to take it.

00:19:30: Logical, but not that easy to stay in the heat of the moment.

00:19:33: Exactly.

00:19:33: Yeah, exactly.

00:19:35: And if you understand that my feelings is about me and your feelings is about you and the colleague's anger is about him, not about you.

00:19:45: And then it's easier.

00:19:48: Like, yeah, it's easy to say, but exactly why people avoid to say like, stop, look, maybe I did something wrong, like for example, or I didn't do this on time when I had to do.

00:20:05: Yes, I did.

00:20:06: But it doesn't let you to shout on me or to behave in such way as you're behaving.

00:20:12: But as you told, before that a lot of doctors, they are really very good people and they try to avoid this conflict or try to avoid to draw some limits.

00:20:24: Like said boundaries.

00:20:26: Yes, to see that they stop not to do this.

00:20:29: And this avoidance came from our childhood.

00:20:34: Welcome to our childhood.

00:20:36: When someone, your brain made such a logical connection that if you are hearing or you are in conflict situation, you are bad.

00:20:47: If you are angry, it's equal bad.

00:20:50: It's the same.

00:20:51: But wait a minute, it's impossible to avoid a conflict.

00:20:55: Just simply, if you have, if you avoid a conflict like with another person, that means you have conflict in yourself.

00:21:05: You took this gift.

00:21:07: to inside yourself, and now you're going with this gift and don't know what to do with this.

00:21:13: Exactly.

00:21:13: So please don't take it and don't avoid the conflict, but try to learn how to do this in a tolerant way, just to set boundaries, to set that stop.

00:21:27: Even you don't know how to behave in this moment, but every time you can say stop and say or just say, no, please.

00:21:36: I don't want to talk.

00:21:37: I can't talk now.

00:21:39: Let's come back to this situation when we will be calm and we can talk in a different way.

00:21:47: Also fair

00:21:47: enough.

00:21:50: Just simply start to say no.

00:21:53: Stop behaving with me in such a way.

00:21:57: Can we talk like colleagues, not like you're not my father?

00:22:02: Nobody's giving you a right to shout at me.

00:22:04: Hey, Lina.

00:22:05: Thank you so, so much for your time and expertise.

00:22:09: I'm sure this was immensely useful for our audience.

00:22:13: Yeah.

00:22:14: Thank you, Lina.

00:22:15: You're welcome.

00:22:16: And I will see our audience in the next one.

00:22:20: Thank you for tuning in.

00:22:21: Bye.