Emily Nagoski and Amelia Nagoski
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[How to Deal with Difficult Feelings]

Cloe Shasha Brooks: Hello, TED community. You are watching a TED Interview series called "How to Deal with Difficult Feelings." I'm your host, Cloe Shasha Brooks, and a curator at TED. Today, we'll be focusing specifically on burnout, both personal and professional, with the help of two experts, Dr. Emily Nagoski and Dr. Amelia Nagoski. They are identical twin sisters and the coauthors of a book about burnout, for everyone who is overwhelmed and exhausted by all they have to do, who is nevertheless worried that they're not doing enough. Let's dive right in. You coauthored a book called "Burnout: The Secret to Unlocking the Stress Cycle." And the inspiration for this book was actually based on a personal experience that you had with burnout, Amelia. Can you tell us more about that experience?

Amelia Nagoski: Well, it began with me going to school while I was getting my doctorate in musical arts in conducting. I ended up in the hospital, and I had abdominal pain, which they diagnosed as stress induced, told me to go home and relax. And in fact, I had no idea what to do. But luckily, I have a sister who has a PhD in health behavior. So when I'm in the hospital, just in pain, laying there, not even really understanding how I got there or why. And I honestly didn't even believe that stress could cause physiological symptoms. And Emily said, "How did you not know that?" I'm a conductor and a singer. I have learned in my musical training to express my feelings with my body, to use my body as a vehicle for expressing emotion. And it occurred to me that if it was true that I didn't just have those feelings onstage — I had them all the time, my whole life — and if that was true, wow, that was a lot of feelings. So I didn't even want to believe this was true. But once Emily brought me a huge stack of peer-reviewed science, I couldn't deny anymore, yes, stress manifests in the body and can turn into symptoms of illness.

CSB: So, OK, well, let's start with some definitions. What are the three components of burnout?

Emily Nagoski: So, according to the original technical definition from Herbert Freudenberger in the 1970s, burnout, which originally was inclusive only of the workplace but has expanded now, involves depersonalization, where you separate yourself emotionally from your work instead of investing yourself and feeling like it's meaningful; decreased sense of accomplishment, where you just keep working harder and harder for less and less sense that what you are doing is making any difference; and emotional exhaustion. And while everyone experiences all three of these factors, over the 40 years since this original formulation, it turns out that, broadly speaking, for men, burnout tends to manifest as depersonalization in particular. And for women, burnout tends to manifest as emotional exhaustion. So anyone can experience burnout, But your specific way of experiencing it is probably going to be different, depending on who you are.

AN: And the factors that lead to burnout are not just professional ones. They are parenting and social activism and anything where you need to care and invest, where there are ongoing demands that are unmeetable expectations and unceasing demands. That is the formula, no matter what context it's in, for burnout.

CSB: Your work is around the stress cycle and how we can complete it. So, will you talk a little bit about that?

EN: Oh, yes! This is my favorite part. So, the main thing people need to begin with is that there is a difference between your stressors, the things that cause your stress, which is what Amelia was talking about — the unmeetable goals and expectations, your family issues and money ... Those are your stressors. And then there's your stress, which is the physiological thing that happens in your body in response to any perceived threat. And it's largely the same no matter what the threat is. And evolutionarily, we know the threat response as being the fight, flight, freeze response intended to help us run away from a lion. So when you're being chased by a lion across the savanna of Africa, what do you do? You run, right? So you use all this energy that happens in your body, all this adrenaline and cortisol, every body system has been activated to help with this escape from the perceived threat — your digestion and your immune system and your hormones. Everything is focused on this one goal, including your cognition. Your problem-solving is focused just on this one problem, and it will not let go, because your life is at stake. But you manage to get back to your village, and the lion gives up, and you jump up and down and shout, and people come and listen to you tell the story, and you hug each other, and the sun seems to shine brighter. And that is the complete stress response cycle: it has a beginning, when you perceive the threat; a middle, where you do something with your body; and an end, where your body receives the signal that it has escaped from this potential threat, and your body is now a safe place for you to be.

Alas, we live in a world where the behaviors that deal with our stressors are no longer the behaviors that deal with the stress in our bodies. We are almost never chased by lions. Instead, our stressors are "The," capital T, capital F, "Future," or our children, or a commute is, like, the classic example. When people have commutes, it's one of the most stressful parts of their lives, and your body activates the same adrenaline and cortisol and digestion and immune system, and you finally get home, right? You have dealt with your stressor. Do you suddenly jump up and down and feel grateful to be alive, and the sun seems to shine brighter? No, because you've dealt with the stressor, but that does not mean that you've dealt with the stress itself. This is excellent news, because it means that you don't have to wait for your stressor to be gone before you can begin to feel better, because you can deal with the stress while the stressor still exists. Good thing, because most of our stressors are what are called "chronic stressors," that are there day after day, week after week, year after year.

And I hope people are like, "OK, so how do I complete the stress response cycle?" And we have a list of, like, a dozen concrete, specific, evidence-based ways to help people deal with the stress response cycle. But just taking the example of a commute: you get out of your car or you get off the bus, and your shoulders are trying to be your earrings, and you're grumpy and cranky and still thinking about the jerk who did I don't know what. And what you do is jumping jacks in your driveway, or you go for a long walk around the block or you just tense every muscle in your body, standing outside your apartment door, holding your breath, tense, tense, tense for a slow count of 10. Even just that little bit of using your body is what communicates to your body that your body is now a safe place for you to be. You have to separate dealing with the stress from dealing with the thing that caused the stress.

AN: And this need to deal with the stress in a separate process from dealing with the things that cause your stress is why the doctor is telling me to relax was not going to be an effective means of recovering from burnout. I had to deal with the stress in my body. And if, let's say, you get out of your car, and instead of doing jumping jacks, you just say, "OK, I'm going to relax now. Relax now. You, relax!" Not effective, right? You've relaxed, but you haven't changed your body's physiological state into one of safety.

CSB: Totally. And our first question from the audience. OK, from Facebook, someone asks, "How do you know whether what you're experiencing is burnout or something else?”

EN: Yeah, ask a medical professional for sure. And there's a lot of overlap between burnout and lots of other experiences, including depression and anxiety and grief and rage and repressed rage — we've all got it. So our layperson's definition of burnout is, as you said, that feeling of being overwhelmed and exhausted by everything you have to do, while still worrying that you're not doing enough.

CSB: Mm hmm.

EN: If you feel like you are struggling even to get out of bed and get the basics done, that goes beyond burnout. Burnout is where you can show up for work, but you spend your whole day fantasizing about being at a different job.

AN: It's important to know that "burnout" is not a medical diagnosis, it's not a mental illness. It's a condition related to overwhelming stress. So it's not like it puts you in this different state where you're going to be trapped, and you have to have 13 years of therapy and whatever. It just means that you need to be completing your stress response cycles.

CSB: Work burnout is just such an important thing to talk about, I think, for so many, and I'm curious if we can focus on that for a moment. Like, what are some of the earliest warning signs of professional burnout?

AN: Let's say there's two kinds of people. There's Emily people, who are aware of what's going on in their bodies at all times. And if they have signs of burnout, they notice it just right away because that's how they do. And then there's people like me, who never know what their body is experiencing. I didn't notice I was burning out until I was literally in the emergency room. But one of the things that causes burnout is our inability to recognize the hard stuff welling up inside us. And the solution is to be able to turn toward the difficult feelings with kindness and compassion and say, "Oh, I feel stressed. I feel unreasonably angry right now. I'm so cranky. I wonder why that is," and instead of just trying to, like, tell yourself to relax, ask that feeling, "Why are you there? What do you need from me? What has to change?"

EN: One of the primary barriers to listening to your body is a fear of the uncomfortable feelings that are happening in your body. One of the things I say over and over, we say it over and over in "Burnout," is that feelings are tunnels. you have to go through the darkness to get to the light at the end, right? Feelings are tunnels. Stress is a tunnel. You've got to work all the way through it. Not that the stress is bad for you, it's getting stuck in the middle that is bad for you, never having an opportunity to take your body through the cycle. One of the reasons why people don't do that is because they feel afraid of their uncomfortable internal experiences. When I first started learning this stuff explicitly — we grew up in a family where uncomfortable feelings were not allowed, and the idea that feelings were tunnels, I was just like, "I don't think that's true. I'm pretty sure that uncomfortable feelings are caves with bats and rats and snakes and a river of poison. And if I begin to experience my uncomfortable feelings, I will be trapped forever in the dark with the rats and the bats." I began a practice of noticing when my body was experiencing a sensation, allowing it to be and allowing it to move all the way through. And as I practiced that with gentle emotions, I began to be able to practice it with more and more intense emotions, both positive and negative, intense emotions. So that now when I'm confronted with big, difficult stuff, I trust that my body will go all the way through the feelings without me being trapped in the dark with predators.

AN: And I started doing it 20 years after Emily did, but it's never too late, you can always recover.

CSB: Let's bring up another audience question. "How can you talk to your manager or supervisor about the fact that you're experiencing burnout and get real support?" A question from Facebook.

EN: If you're in a workplace where you don't feel like you can say to your boss, "My mammalian body is having mammalian needs, and I need to adjust my work situation to accommodate the fact that I live in a monkey suit," know that we consult all the time with gigantic corporations that are making active efforts to incorporate acknowledging people's emotional and physical needs, checking in at every meeting, saying, "Where are you at?", asking people to become aware of and more clear in expressing how they feel and promoting the idea that managers should be ready to cope when their supervisee comes in and has a bunch of feelings that they need to process and move through. So it exists. People are working on it. I feel optimistic. And I also know that there's a lot of workplaces that are trapped in this sort of, like, industrial, super patriarchal, rabidly individualistic mindset, where you just need to protect yourself against the toxic culture by creating a bubble of love at home, where everyone in your household cares for your well-being as much as you care for theirs.

CSB: How can people who feel truly stuck take a first step towards wellness? And how do you define wellness, too?

AN: We define wellness as: the freedom to oscillate through all the cycles of being human from effort to rest, from autonomy to connection ... And we always say that the cure for burnout is not self-care, cannot be self-care. How can you be expected to "self-care" your way out of burnout? You can't. What you need is a bubble of love around you, people who care about your well-being as much as you care about theirs, who will turn toward you and say, "You need a break. I'm going to help you with this. I'm going to step in in that way," or even just give you 15 minutes for you to yell about whatever the problems you feel at that moment and just be on your side and go, "Yeah! I can't believe that happened to you! I'm so on your side," for 15 minutes. Just that can give you enough of a release to feel a little bit better to take one more step. The cure for burnout is not self-care. It is all of us caring for each other. We can't do it alone. We need each other.

EN: Making that happen in real life is, of course, easier said than done. And one of the things that is my little reminder to myself is that when I feel like I need more grit, what I actually need is more help. And when I look at Amelia's life, and I think, "She needs more discipline, she needs more perseverance, she needs to work harder," what she actually needs is more kindness. That's the baseline culture change that’s going to end burnout forever.

AN: And usually the next question people ask us is, "I don't have anyone like that in my life. I am the leader, I am the one who's doing all of the things." And the solution for that is probably closer than you think. I mean, I grew up in a household where feelings were, like, not allowed and we were not close our whole lives. And then we started reading the research that said that connection and sharing support was the way out of burnout. And we started trying, and we, like, broke down this 30-year barrier of, you know, societal and family pressure not to, like, feel our feelings around each other. And it turns out that if you feel like you're isolated, there's probably someone on the other side of that wall, it turns out, who wants just as much as you to connect with someone else. And we've been isolated because we've been told that it's stronger to be independent. It's not true. We're going to be healthier and stronger when we work together. There's probably someone already waiting who also wants the kind of relationship that you are desiring.

CSB: I think that's just so nice to hear, too, in the pandemic, when we're all feeling so isolated. We have one final question we'd like to bring up from the audience, that we'll have to keep brief. So let's bring that up. OK. "What can you do about burnout if you are a teacher, where every day is filled with stressors?

AN: I taught school for five years. That's how long I made it. I burned out after four years and then I pushed through one more year. If you have any possible means of reducing the everyday stressors by getting involved in administrative decisions, that's great, but that's almost never the case. The thing, number one, is to complete the stress response cycle. You can exercise if that works for you. A good night's sleep will do it. How do I get a good night's sleep when I have to get up at 5am? You have to go to bed earlier, and that means your whole family has to give you permission to go to bed earlier. They have to cherish your sleep the way you cherish theirs. You can use your imagination and imagine yourself pummeling all of the stressors into the ground. And you recover from that, because your imagination doesn't know the difference between pummeling the stressors in your imagination versus pummeling them in real life. And you surround yourself with a bubble of love, other teachers who can support you and tell you, "Yes, you deserve care. You are a valuable, educated, wonderful human being. You are not just, you know, Darth Vader dealing with these kids. You are a valuable person who deserves resources, who deserves care, who deserves love, who deserves freedom to oscillate."

CSB: Thank you both so much for joining us together and for teaching us about burnout and the stress cycle. This has been really illuminating. So, thanks for your time.

EN: Thank you so much. AN: Thanks.