If you find yourself constantly stressed out and on the edge of burnout, it’s time to take a breath. Author Amelia Nagoski and Dr. Cynthia Stonnington talk about the reasons why women and gender diverse people are prone to burnout — and what you can do to break out of stress-inducing patterns.
We talked with:
- Amelia Nagoski, D.M.A. (it stands for Doctorate of Musical Arts) is the co-author, with her sister Emily, of the New York Times bestselling “Burnout: The Secret to Unlocking the Stress Cycle” and the “Burnout Workbook.”
- Dr. Cynthia Stonnington is a professor of psychiatry and the associate medical director of the Office of Joy and Wellbeing at Mayo Clinic in Arizona. She is the previous chair of Psychiatry & Psychology at Mayo Clinic in Arizona, where she remains an active staff member. She’s the author of “Burnout in Women Physicians: Prevention, Treatment, and Management.”
We talked about:
In this episode, Dr. Millstine and her guests discuss:
- Stress is a cycle. Amelia breaks down the difference between what’s causing your stress (stressors) and the physical effect on your body (the stress). To stop the stress cycle, you might need to start listening to your body.
- Why women (and gender diverse people) are prone to burnout. Our guests discuss the historical and systemic reasons that women tend to burn out, including their role as caregivers and their propensity to pick up the “invisible” household work that needs to get done.
- Accept yourself. By refusing to judge yourself by external standards, you can more easily say “no” when you’re tempted to take on commitments and tasks that won’t fit in your life. Our guests also discuss how body acceptance plays a role in battling burnout.
Can’t get enough?
- Purchase Amelia’s book “Burnout: The Secret to Unlocking the Stress Cycle.”
- From Bookshop.org
- From Amazon
- From Barnes & Noble
- Want to read more on the topic? Check out our blog:
Got feedback?
- If you’ve got ideas or book suggestions, email us at readtalkgrow@mayo.edu.
- We invite you to complete the following survey as part of a research study at Mayo Clinic. Your responses are anonymous. Your participation in this survey as well as its completion are voluntary.
Read the transcript:
Dr. Denise Millstine: Welcome to the “Read. Talk. Grow” podcast, where we explore women’s health topics through books in the same way that books can transport us to a different time, place or culture, “Read. Talk. Grow.” demonstrates how books can also give a new appreciation for health experiences and provide a platform from which women’s health can be discussed.
At “Read. Talk. Grow.,” we use books to learn about health conditions in the hopes that we can all lead happier, healthier lives. I’m your host, Dr. Denise Millstine. I’m an assistant professor of medicine at Mayo Clinic in Arizona, where I practice women’s health, internal medicine and integrative medicine. I am always reading and I love discussing books with my patients, my professional colleagues, and now with you.
Today we are talking about the incredibly pervasive topic for women, burnout. I’m so excited about my two guests. My first guest is Amelia Nagoski, DMA, which stands for a Doctorate of Musical Arts. She says that means most of her job is running around, waving her arms and making funny noises, generally doing whatever it takes to help singers get in touch with their internal experience.
She’s the coauthor, with her sister Emily of the New York Times bestselling book “Burnout: The Secret to Unlocking the Stress Cycle,” as well as “The Burnout Workbook.” She lives in New England with her husband, one cat and two rescue dogs. Amelia, welcome to the show.
Amelia Nagoski: Thank you so much.
Dr. Denise Millstine: My second guest is Dr. Cynthia Stonnington, who’s a professor of psychiatry and the previous chair of psychiatry and psychology at Mayo Clinic in Arizona. She’s also the associate medical director of the Office of Joy and Well-Being. She completed medical school at Mayo Medical School in Rochester, Minnesota, and residency training in psychiatry at Stanford University Medical Center.
She’s written more than 60 academic articles, including several on well-being and peer support. She’s the co-editor of the academic book “Burnout and Women Physicians: Prevention, Treatment and Management,” published by Springer in 2020. Dr. Stonnington, welcome to the show.
Dr. Cynthia Stonnington: Thank you so much, Denise. Glad to be here.
Dr. Denise Millstine: So this is an incredibly important topic. I’ve been meaning to read your book, Amelia, for some time, and I had it on my holds at the library. When I got it and was able to borrow it, I saw there were 17 people behind me waiting to borrow it as well, and before I even cracked it open, I told our producer, “We need to get them on the show. This book is resonating.” Is that what you’re finding?
Amelia Nagoski: I have talked to a lot of people since the book came out, and it seems like people are finding both new ways of thinking about health and maintenance of their own well-being, as well as just reinforcing things that they always thought or believed or suspected were true, but that have been denied to them by the wider social message. So yeah, in those two ways, people have told us that they definitely understand and feel seen and heard in the book.
Dr. Denise Millstine: Cynthia, this topic is not new to you as well. You have seen colleagues, your patients, I’m sure, your friends and family dealing with burnout for a long time.
Dr. Cynthia Stonnington: Absolutely. Obviously, as you know, I got started in this work back when we stumbled across the idea of doing this authentic connections group for women, physician moms and advanced practice provider moms.
And oh, my gosh, did my eyes get opened, and it just felt like there is so much work to do and there’s so much to know and so much that we need to respond to. So absolutely. Amelia, when I read your book or listened to your book, I should say, which I loved, I just really resonated. I particularly loved that you grounded it in evolutionary biology because that’s a topic near and dear to my heart. So we’ll talk more about that, I’m sure.
Dr. Denise Millstine: Burnout, I think, can be confusing, and we’re going to dive into the “why,” the “what can women do about it,” and the “how to recognize.” But let’s start where the book starts, which is with stress.
So the stress cycle. Stress versus stressor. Amelia, there’s some great analogies in the book. Do you want to offer some insight into that?
Amelia Nagoski: Sure. This is an important thing that I needed to learn. Our editors and agents as they started to read what we were writing, all agreed that this needed to be chapter one. In fact, the idea of the stress was in the subtitle of the book, because this is such a foundational, fundamental idea that if you are burned out, if you are having trouble managing your stress, step one of the things you need to do is separate in your understanding the thing that is causing your stress from stress itself.
I needed to learn that stress was not like an idea or a concept or some kind of thing that existed just as an untouchable in theory. No. Stress is a cycle that happens in your body. It has a beginning and a middle and an end, and it’s made up of neurochemicals, hormones and electrical signals that accomplish tasks and change just about every system in your body.
Whereas the thing that causes that stress, that initiates the stress response cycle exists, nowadays, independent of the stress itself that happens in your body, which is really great news, because it means that just because that thing that causes your stress is ongoing, you can still start to feel better and manage the stress in your body. I don’t know how long you want to talk about this because I could legit talk about it for the whole hour. So let me know how big I should go.
Dr. Denise Millstine: No, I think that was a great introduction to distinguishing between the stress, the stressor, and then recognizing the stress cycle. Cynthia, talk a little bit about completing that stress cycle.
Dr. Cynthia Stonnington: Absolutely. I really love the terminology. I hadn’t heard it said that way actually before I listened to your book, and I think it is so important because that is what happens. During second wave feminism, we tended to think that women went for doing it all. You can be the perfect mom, you can be the perfect wife, you can be the world-class whatever. You know, we can do it all.
That was what was fed us, I think, and less awareness of what that actually meant to our bodies and the stress cycle. There has been this sense, this idea that you just sort of suck it up, you keep going. Obviously when you do that, you’re not fully processing all of those stress responses that are just completely 100% normal under various circumstances, but sometimes are triggered in maybe even false alarms based on evolution in the way that we have had to survive and then sometimes are perpetuated by a lot of perhaps even useless emotions.
Emotions are great, but sometimes they’re useful for the situation and other times they’re not. Piling all of that on, if you don’t take that time to rest and recharge or recognize or tune in, then that has a huge wear and tear effect on one’s body. I also practice as a psychiatrist and in consultation liaison, where I’m seeing people who are coming to the Mayo Clinic for a variety of medical problems and physical problems.
A lot of that really sometimes relates to not recognizing how to complete that stress cycle and recognizing the impact that all of this has on our body and legitimately so. It’s not made up. It’s a real legit thing. Teaching people like you have done in this book, Amelia, is such an important lesson. To be able to listen to your body, to take that time and to have that compassion for yourself so you can let that process and recognize when something’s useful, when it’s not, etc.
Amelia Nagoski: You just named four things that I absolutely needed to know when I was burned out. One, to recognize that emotions are real, that stress is a thing that actually happens and having compassion. That’s chapter eight. I forget what the other two things are because I started talking and then I let them go. But yes, everything you just said was exactly the stuff that, in 2011, when I was in the hospital with stress-induced illness, those are the exact things that I needed to learn.
It ended up being the evidence-based approach to managing stress that people don’t talk about as much because they’re too busy reinforcing the barriers to wellness. “Listen to your body” was definitely one of them because we’re all taught so often that the things that are wrong with us are going to be identified by other people. That we need to go into a professional medical system in order to find out what’s broken inside us when, in fact, if we are given permission to listen to our own bodies, and then once we’re given permission, recognize that, okay, this takes practice, learning to do that opens up so many possibilities for understanding that you might not be a disease, you might just be striving for a goal that’s been set by an outside world that believes you are expendable, like a tube of toothpaste.
When you’re trying to strive for those goals, you have to learn to let go of that and listen to your own body and find out what its goals and needs are and not try to cross the bridge between who you are and who the world expects you to be. There’s no bridge. It’s just a chasm.
Dr. Cynthia Stonnington: It’s hard. It’s hard to recognize that we have limits and that we have to sort of say, “Okay, wait a minute, I may have bitten off more than I can chew. I have to just sort of give myself a little bit of time.”
Amelia Nagoski: Yeah, I feel like that’s not failure.
Dr. Cynthia Stonnington: Yes! Exactly!
Amelia Nagoski: That’s success.
Dr. Cynthia Stonnington: Exactly. That is success. The success is noticing that and taking that time, and it can be a really short amount of time. If you do it in little bites, right?
Amelia Nagoski: Yeah. As long as you know, you have permission to use resources and time and sleep and food for yourself and you’re not bogged down by guilt by the fact that you dared to have a full night’s sleep while other people could have benefited from you and your work and your labor and your time and your body. In that spirit.
Dr. Denise Millstine: What I like about what both of you are saying is, Cynthia, you’re talking about the perfect woman, the woman who can have it all. This idea that we were sold through feminism, that we could do everything and all parts of our lives and sort of be superwomen.
Then, Amelia, in your book, you named this “The Human Giver Syndrome” — that we are functioning because, and I’ll paraphrase, of course, but that our life would have meaning if we were just pretty calm, happy, generous and attentive to the needs of others. I thought this was brilliant, to name it in this direction, because I don’t think most women feel like, “I’m trying to be perfect.” I think they have been pulled into this desire to be the constant giver without recognizing how depleted that leaves them.
Amelia Nagoski: We adapted this idea from a book called “Down Girl: The Logic of Misogyny” by a moral philosopher named Kate Manne and in it she posits a world where there’s two kinds of people. The human beings are the first type where they have a moral obligation to be their humanity, to live it, to express it, to acquire whatever resources are necessary to do that.
And the human givers who have a moral obligation to give their time, their lives, their bodies, their humanity to the human beings. This is a cartoonish, black and white, exaggerated illustration, but in a book called “Down Girl: The Logic of Misogyny,” do you think she means the women are the Beings or the Givers? It’s the Givers.
A lot of people’s first response to this idea was: “Well, then every once in a while you get to be a Being.” But what if we made a world full of Beings? Everyone would feel acquisitive and entitled and we’d end up with the world that’s a whole lot like the one we have now. Whereas if everyone were Givers, surrounded only by Givers, not by Beings who feel entitled to what the Givers have, that means that a Giver who has given until they’re running low on resources to keep themselves alive and healthy and well and happy, they’re surrounded by other people who are also Givers, who will turn toward them and offer support and resources, reminding each other that we all deserve them just as we are.
Dr. Cynthia Stonnington: I love that. I think that’s great. One of the things that I have found is that men would like to be rid of that dichotomy as well. This idea that all men just want to be in control and in power. I think there’s a lot of evidence that they’ve been screaming for a long time, “Let’s have a more kinder place as well.” Yet that’s not socially acceptable.
What’s exciting to me is that we’re starting to see a little bit of a shift of men sort of stepping up and saying, I want to take parental leave. I want to be a part of the family. This is important to me, and there’s been a little bit of a shift, I think. Definitely we’re not there yet, but there’s a little bit of a shift in it being a bit more socially acceptable for men to do that.
Amelia Nagoski: A little bit of a shift. At the same time there’s backlash towards that shift where there’s also this far right conservative, very traditional or old-fashioned sense of men having to be manly and women having to be womanly and they have a definition of what that means; that the idea of violating that paradigm is not only gross, but morally reprehensible; that if you are a man who dares to express and show tenderness to his own children — to say “I love you” to his kids and to read them to sleep at night, to bathe them and take them to the park and play with them, that that kind of lightness and gentility is wrong and bad for a man, which is, of course, scientifically untrue.
Men are human beings who have access to all of the emotions that a woman would have and someone who is non-binary. We all have emotions and we’re all real full human beings, and not to give a man the opportunity to express that kind of tenderness and excitement.
I’ll never forget one year I was having my choir sing a duet from La Boheme, where the romantic lead male sings about how passionately in love he is and how he’s trembling with desire and art and whatever and a bass in my choir went: “Guys don’t feel like that.” And I was like: “Oh, sweetie, I’m so excited for you to discover that they can. I can’t wait for the day when you find out, ‘Oh, my God, I can feel this thing. I never thought it was possible for me.’”
It’s one of the beauties of working with art is I get to show people potential things that other people know that they might not know yet. Anyway, the idea that men have access to things that they didn’t used to have access to, and if we can keep that backlash to a minimum and really make it, and this is why we say in the book that the cure for burnout is not self-care. It’s all of us caring for each other.
When we can make this gradual change of, “Oh yes, there is an increasing acceptance and tolerance for men who father and for women who are breadwinners and gradually hopefully it’ll turn into like a non-binary. We don’t expect someone’s genitalia to determine their social role.” That’s the dream, right? But we can only work slowly toward that progress. It’s not going to happen in our lifetimes. Our kids might start to see progress and their kids could potentially see real change.
Dr. Denise Millstine: I think another aspect of these roles is invisibility. So much of the work that is traditionally carried by women or people who are in that Human Giver Syndrome is work that goes unrecognized and even unseen. Dinner doesn’t make itself, the laundry doesn’t — even though we are lucky enough to live in an era where there is a washing machine, it doesn’t get cleaned and folded on its own.Even things like planning social interactions for your family or your work group, I think is a lot of the invisible work that tends to be done by the giver.
Dr. Cynthia Stonnington: That’s really important. I mean, of course there’s been a lot of attention and research about that, showing that in fact women do tend to do that regardless of how high they are on the hierarchical spectrum, that they still take on the burden of that, and that isn’t always recognized.
That’s one of the things that we’re really working on in the Office of Joy and Well-Being is to really increase that sense of recognition for things that aren’t normally measured or celebrated and to really try to bring that forward.
I have this other author also. “Fair Play.” Have you ever read that? That’s all about doing that, about putting on the table what it is as a couple, what you’re doing. Not to say it has to be equal, but that it all gets noted and that in doing so you have a better appreciation, understanding of each other and making space for what’s necessary.
Amelia Nagoski: That’s a fantastic idea because I know we all believe and we all do work so hard and as much as we can, and it’s really easy to default to, “Well, I’m the one doing everything.” So that’s great to have a thing to really see and even quantify. “Here are the things that I do.” And then you reach in and be like “How much value is this thing?” and “How much do we need?” whatever X, Y, Z. That’s really cool.
Dr. Cynthia Stonnington: Right. The whole point of that is, is exactly that. You start to reexamine, “Well, maybe I can let go of that one.” Or “maybe I don’t have to be so insistent it has to be done exactly perfectly.” Or “Maybe I can just back off,” and so you start to reassess and reassign once you kind of put it all on the table and then talk about it together.
Amelia Nagoski: That’s awesome. I get asked so many times, “Well, I have all this stuff on my to do list and, you know, my partner just won’t help me with these things.” My first question is then, “Who put that stuff in your to do list? Did you put it there because you really want it, or did Instagram put it there because it wants you to buy more stuff or suck your eyeballs back to more things?”
In most cases people are like, “Yeah, there’s stuff that’s on there that I don’t care about as much as I’ve been told I should.”
Dr. Cynthia Stonnington: I love that section of the book where the husband was forced in now to do some of these things. Can you talk a little bit more about that section? There’s a lot of layers there.
Amelia Nagoski: Throughout the book, we have these two stories going on of Julie and Sophie, who are women who lead very different lives, but in each chapter we see how the content of that chapter would influence their lives. These stories are made up of scenes from real stories from a wide variety of sources. We just compressed them down to two characters who are named Sophie and Julie.
In the book Julie is a teacher and she has an episode of a severe digestive situation. She goes to the emergency room and she finds out she needs to change a lot of things about her lifestyle in order to make her digestive system work. It means she needs to start doing a lot less. She’s a mom and she’s having trouble getting along with her husband.
Her husband suddenly steps up and does the things that she needs him to do so that she can lay in bed and rest for a day, or catch up on other things, and he comes home and he’s like, “That’s so much harder.” He had no idea just how much she had been doing until she’s like, “This is all your job now.”
It’s this kind of eye-opening, inspiring moment of seeing and understanding that shifts the way they view what their roles are in their relationship, which is how it’s going to work. You have to have a partner who’s willing to see that what you do is of value and that it is not just easy for you, no matter how easy you make it look. It has its physical toll.
Dr. Cynthia Stonnington: The other thing that happened, I thought, which was interesting, was that Julie recognized that she had felt like she was supposed to be in control of everything and doing everything, and it was supposed to be done a certain way and had a certain standard, and she had to be willing to let go of that. And that it just has to be good enough. It doesn’t have to be like where she went.
Amelia Nagoski: Yeah. The final twist in the story is her husband’s name is Jeremy and he’s doing the things but not “the right way,” which is to say not her way, and the phrase he uses is, “If you want something done your way, you have to do it yourself. Because your way is not necessarily the only way.” And I’m just going to say that I was recently diagnosed with autism and it opened my eyes to why my way seemed like the best way.I was like, “Oh, that could be a reason.”
It’s not just like a neurodivergent thing that people fixate on exactly the only way that I think can be done. A lot of us are just in habits of, “This is how it’s always been done, therefore, that’s how we must always do it.” And making that change is various degrees of difficult, but difficult for everyone to accept, “Maybe I was wrong. Maybe you don’t have to.”
Dr. Denise Millstine: Well, sometimes I think it just takes being open to considering that. Maybe we believe that that’s the right way, and it’s not that we’re rigid, it’s just that we’ve always thought that to be true. And it’s not until you back off and say, “Is it okay that my bookshelf is a lot messier than Cynthia’s bookshelf, which looks very well together right behind her there, and mine has books going all different directions and double stacked?” It might be OK for me and one way might be OK for the next person.
Let’s talk a little bit about headwinds, because I think this is really important, especially in this day and age. When we are pushing against something, at least in the book, you say we notice that, we notice that we’re trying harder, but when we have tailwinds, when we have people behind us supporting us or making the process easier, we don’t necessarily notice that. Can you just talk a little bit about that?
Amelia Nagoski: Yeah, I taught this book for a semester to my undergrads and there were two masculine students in the class and the other like 18, all identified as some feminine gender. When we got to this chapter, it’s chapter four about the patriarchy, and there’s the section about the headwinds and tailwinds asymmetry that says that we really notice when we have to work harder because there’s headwinds pushing us back as we try to drive forward.
We don’t really notice when we have tailwinds of something behind us pushing us forward and helping us. That means that we’re constantly overestimating how much effort that we have to face and underestimating the things that have provided us support and benefit. I asked them at the end of each chapter: “Name one important thing you learned in this chapter.” Both of the masculine students said it was the headwinds, tailwinds, asymmetry.
Evolutionarily it makes sense. You notice and pay attention when a thing is hard because clearly this is where learning has to happen. This is where change and growth has to happen, and therefore you pay more attention to it and you are able to proceed into more difficult circumstances. Whereas why would you have to notice all the things that help you? That’s just there, you don’t have to turn to that and be like, “Oh, I need to cultivate that some more. It’s already there. So it makes sense that you don’t notice the tailwinds, but it really stood out to me that it was the two masculine students in the class who were like, “Oh yeah, I really never noticed all the tailwinds and I really overestimated all those headwinds.”
Dr. Cynthia Stonnington: Can you say more about what it was that you think that was, what resonated with masculine as opposed to the more feminine?
Amelia Nagoski: Yeah. They did not specify, but because the context of that chapter, it’s a book that’s written for and about women because it was written for and about me, we wrote the book that I needed. So it addresses some people on the feminine side of the gender, certainly non-binary folks also.
The ideas in that chapter, I mean, we lay out statistics and numbers and history to describe exactly how the oppression of women is manifest in the white supremacists, heteronormative, exploitative, capitalist patriarchy. Like what exactly does it look like to be a woman in that system?
I think in the context of that, where they’ve just read about relationship violence and harassment, and being overlooked at work for promotions and other kinds of prejudices and the danger that women face every day, that in the context of having read all about that, just a list of historical facts and statistics, and then to be like, “And now here’s why it’s hard sometimes to remember that you have privilege versus you live in a in an oppressive system.” I think it’s because it came in that context.
Dr. Cynthia Stonnington: Yeah. Now that makes sense. And I think the things that we talk about specific to women physicians is that the healthcare environment grew up in a system in which pretty much it was mostly men who were the physicians who had wives at home taking care of all of the family domestic responsibilities, etc., so that they could really focus in on their work and not have to worry about anything else.
That’s the system we’re assuming that when you go to work, you don’t have to really think about anything else. It’s really been interesting as 50% of medical students are women and we’ve begun to have a little change in the way we’re thinking about the importance of well-being and the rise of burnout and all of those things that are happening.
We’ve had to really reimagine that system and sort of think, “Well, of course. That isn’t the way it is now. We don’t all have wives at home taking care of all of these things, and so what are we going to do about it?”
Amelia Nagoski: It’s not just in medicine. That’s a great point. What needs to happen is that the systems that are causing burnout need to change. It’s not that the people who are in the systems can’t handle it and they’re too wimpy, and, “Oh, you know, the tough survive and if you can’t hack it, then you don’t deserve to be here.”Which is the pervasive message for a long, long time, but the truth is that the things that are being asked of students these days are unreasonable. We just don’t live in a world, as you’re saying, where that is how it works. So this system needs to change, not to keep on as it is demanding unreasonable things from the student population.
Otherwise people are not going to finish the programs and they’re not going to go into this field. They’re going to feel like they’ve been tortured and hazed. That’s how I felt coming out of my graduate degree. It’s not just medicine. It’s higher ed in general has this kind of hazing perpetuating the same old garbage system, like just thinking that, “Well, this is the way it is, so this is the way it should be.”
It’s so wonderful that you’re recognizing. You’re in a position to recognize and then create change in a system that could benefit, not just women students, but everybody.
Dr. Cynthia Stonnington: Everybody. Think about how we are even making more tailwinds, I guess, for men as well as women, right? In doing that.
Amelia Nagoski: Exactly. Yeah. When I was in graduate school, actually, it remains true, I was the only woman in the conducting program and I’m the only woman ever to complete the doctorate in conducting from that school. There are other students who’ve graduated since I finished, and they’re all men, and I was surrounded by men.
Conducting is completely male-dominated. I was also in the doctoral program of the whole PhD DMA, all of the degrees they offered in the music department. I was the only married woman. There were men who were married and their wives did other jobs and took care of the house.
It was exactly like you were describing where they are married and that means that their lives are easier and they get to focus exclusively on their work. I was married and a stepmother and commuting and it wasn’t the same to be a wife in graduate school as it was to be a husband in graduate school.
Dr. Cynthia Stonnington: Exactly. Yeah.
Dr. Denise Millstine: I think another reason your book, Cynthia, is so important for physicians is that we go into a caring and a giving profession. So you already have these givers who are professionals and high achievers, and while this is not unique to women physicians, I think it is pervasive among women physicians. I am so grateful that you put the book into the world.
I want to change gears a little bit because I would suspect that most readers who pick up “Burnout”don’t think that it’s going to dive into weight and body acceptance as much as it does.
Amelia Nagoski: Yeah, it’s a whole chapter.
Dr. Denise Millstine: It’s a whole chapter, but it’s a whole paradigm shift which goes to what drives us and the pressures that we put on ourselves. But one of your statements in there is that “Being thin is not about female beauty, it’s about female obedience.” And you talk about movements such as Health at Every Size and shifting to the new hot, which is a reframing of how beautiful people of every size are and can be. Talk a bit about that whole piece of the work.
Amelia Nagoski: This comes primarily from a book by Linda Bacon called “Health at Every Size.” The first half of the book is about the science of eating and digestion and metabolism, which was very interesting science information that did not stick in my head real well. But the second half is their study, the research that they did comparing health interventions with people of size, fat people, depending on how they want to identify.
In the control group, they got the traditional exercise and diet and striving to have a new weight loss goal to lose a certain amount of weight. In the other experimental group, they were not given the goal to lose any weight. They were just taught about good health behavior, what kind of foods are good for you, is physical activity good for you? Just to be neutral about the size and shape of their body and not to evaluate their health by the way their body appears, which I had been taught to evaluate my health by the way my body appears. I thought that that was correct. It turns out in this research that the people who got healthier, whose like actual metrics, not weight, but blood pressure, resting heart rate and also like the amount of stress they experience and how they feel about the experience, it was a much better outcome for the group who did not have a weight loss goal.
When they were just being encouraged to do behaviors that are healthy and not ending up just measuring their health by how much effect gravity has on their frame. That’s changed everything about how I think about my body and my health. It’s not just about fat necessarily.
The idea can also be extended to color and the placement and quantity and texture of hair on your body. About the presence of scars. Do we feel ashamed of our bodily differences that happen because we’ve been wounded in our lives? Or because how dare we have a baby and still have stretch marks? “Oh my God, that’s so terrible.”
The new hotness game comes out of that, where it happened one day that I was in a kind of a fancy boutique, buying a gown for a performance I had coming up. At the time I was like 14, 16, kind of on the edge between standard sizes and plus sizes. It’s hard to shop for. So I’m like trying on the largest size dress they got in this little boutique.
I take a picture of myself in the mirror and I was like, “I’m the new hotness!” That comes from the “Men in Black” movie with Will Smith. He’s like, “I’m the new hotness” and tells Tommy Jones that he’s old and busted, but he’s the new hotness. So I took this picture and I texted it to Emily and I said, “I’m the new hotness.”
And she was like, “Yes, you are.” I was wearing the largest dress they have in this store. But I look great in it, just as I am. Like, I don’t have to be thin to look really, really awesome in this dress and to feel really awesome and valid and proud to stand in front of an audience in this dress.
Then it turned into a thing that we did all the time. Like we’d be going out for a meeting or for a lunch thing, take a picture, send it: “I’m the new hotness,” and just like restating that every time it starts to become a mantra and work itself into your head where you learn to look at yourself and not judge by the standard that’s been imposed upon you by some external force, but by your own understanding that who you are is valid and acceptable.
Not just failing to be healthy the way that the world is taught you that you’re supposed to see it, but also failing to be moral. We place this moral judgment on people who don’t conform to the socially constructed ideal. We tell them not only that they’re unhealthy, but that they’re like a menace to society, that they’re a terrible role model for children. It’s turns out the stigma is more dangerous to our well-being than the fat on our body is.
Dr. Cynthia Stonnington: I completely get that. That chapter, I agree, was so liberating and really was helpful to me as well. I think it was just beautifully written and it makes so much sense when you think about it. Exactly what you just said, because can you imagine how many times you’re triggering your stress response every time you look at your body and you have those judgments. Every single time. That’s like constant. That’s a constant stress. Of course, that’s going to increase. It’s going to make you fatter in a way. But it also is going to make you feel really bad.
Amelia Nagoski: Not that fat wouldn’t necessarily be inherently evil if you get fatter. Not that it’s necessarily dangerous to get fatter. But, yes. It would increase your stress and you might make things more difficult for you.
Dr. Cynthia Stonnington: I know, but the point being if your goal is to not be fat for whatever reason and you are doing that to yourself, you’re going to be counter. It’s like when people try really hard to get anxious about going to sleep, right? Sleep is a natural thing and they’re just like, “Ugh! I have to sleep! I have to sleep!” We have to learn not to try to go to sleep.
Amelia Nagoski: The number one cause of insomnia is anxiety about not sleeping.
Dr. Cynthia Stonnington: Exactly.
Amelia Nagoski: It’s a self-reinforcing thing. Yeah, and once you let go of, “Oh, this is the goal. Nope, it turns out the goal is something bigger, something larger.” It’s about listening to your own body and letting it tell you what it needs.
Dr. Cynthia Stonnington: Exactly. Exactly.
Dr. Denise Millstine: I don’t want to spoil the book for people who are going to go out and read the whole thing, and they should, but I do want to wrap up with the end, because I do think it’s really well aligned with Cynthia’s academic work that she started to talk about. In the book it’s the bubble ingredient, the bubble of love. The trust….
Amelia Nagoski: Bubble of love..
Dr. Denise Millstine: That the trust, the connected, knowing the space to recharge. Cynthia, can you just tell us briefly about how important you’ve found that to be in some of your academic projects?
Dr. Cynthia Stonnington: Connection is absolutely, 100%. Probably if you had to pick one thing that is probably the most important in terms of resilience, in terms of stress reduction, in terms of thriving, it’s being able to have human connections and to feel very psychologically safe as well. But connections.
Boy, I could go on and on. There’s so many biological reasons for that and evolutionary reasons for that, but it is such a key piece. A lot of the studies that I’ve been involved in and that I’ve read have really reinforced that notion that when you create environments that allow for support, connection, peer support, shared stories, a sense of universality and acknowledgment, that that makes a huge difference in our ability to thrive and really is a great buffer for preventing or minimizing burnout or recovering from burnout, let’s say. I mean, all of those things.
Amelia Nagoski: When Emily and I started doing the research to take us to the next step in writing the book, we felt we were going to be writing like a self-help type book, like a “things you can do to feel better,” and it turned out, overwhelmingly the research as you’re saying is there is that connection, that shared understanding and compassion among humans, is the thing. It doesn’t necessarily have to be other humans. It can be with a loving, divine presence, it can be with your own inner child, it can be with your pets, it can be with nature itself. But if you feel a connection and especially a connection with other humans, that connection is like the foundation.
That’s why we ended up saying over and over in the book that the cure for burnout is not self-care, it’s all of us caring for each other. Because, yes, as you’re saying, connection is the thing. If that’s the most powerful means of completing the stress response cycle and making yourself feel protected from outside forces who provide goals that are unachievable because those people you’re connected to will remind you that you don’t have to achieve that goal, that who you are is already enough, and there’s nothing that fights burnout more than that. And, yeah, we call it the bubble of love in the book.
Dr. Cynthia Stonnington: I love it. As you point out, loneliness is more toxic than cigarette smoking and that’s been a big, big charge, of course, of our surgeon general to really talk about loneliness and combating it. I love that very long longitudinal study that started at Harvard with looking at some of the elements that were important for health and longevity and flourishing, and the one thing that they came up with, and this is men again, so it’s not just women, was whether or not they had social connections.
That was the thing that was the thing that stood out about everything. So it really is key and is again, a big pillar of what we’re trying to do in our Office of Joy and Well-Being is to create those connections and make it easy for that to happen because it’s so powerful.
Amelia Nagoski: That’s so great to have a study that focuses on the result on men because connection is stigmatized as being kind of weak and feminine, that you’re supposed to be autonomous and independent, and that’s who the heroes are. But in reality, no, you’re going to be who you are, or your fullest self. Your most thriving humanity cannot be expressed unless it is in connection with a community.
So to have science, hard science, men can show their boss and say, “No, no, it’s not weakness for me to work in a team. It is in fact better for all of us.” Because that stigma is so much of a barrier.
Dr. Denise Millstine: This has been such an amazing conversation and I hope that it’s inspiring our listeners and people watching the podcast to go out and read “Burnout: The Secret To Unlocking the Stress Cycle.” Maybe buddy-read it with one of your friends because it would be a great one to discuss or with your book club, for example. It’s really been my honor to talk to both of you who are burnout experts and who are really changing the paradigm and giving us so much hope to be even healthier. Thank you both.
Amelia Nagoski: Thank you.
Dr. Cynthia Stonnington: Thank you. This was fun. Thank you.
Dr. Denise Millstine: Thank you for joining us to talk books and health today on “Read. Talk. Grow.” To continue the conversation and send comments, visit the show notes or email us at: readtalkgrow@mayo.edu.
“Read. Talk. Grow.” is a production of Mayo Clinic Press. Our producer is Lisa Speckhard-Pasque and our recording engineer is Rick Andresen.
The podcast is for informational purposes only and is not designed to replace the physician’s medical assessment in judgment. Information presented is not intended as medical advice. Please contact a health care professional for medical assistance with specific questions pertaining to your own health if needed. Keep reading everyone.
