The Strong MD | Season 2 Episode 3

Building Resilience with Ted Paulsen

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From Legal Prowess to Mental Health Champion: Ted Paulsen’s Story

Strong MD podcast features Ted Paulsen, CEO of Lecticon

Dr. Jaime Seeman: Welcome to The Strong MD podcast. I’m your host, Doctor Jaime Seeman. Today’s guest is Ted Paulsen. As a University of Utah law School graduate and an accomplished securities attorney, Ted has significantly contributed to numerous business ventures. His journey led him from Southern California back to Utah, where he advanced to become the coo of a national insurance company and now the CEO of Lecticon. At Lektacon, TeDs leadership is best EAP services, and it focuses on enhancing mental health and resilience, particularly for over 20,000 individuals and families, including first responders and medical professionals. In addition to his professional roles, Ted is a certified scaling up leadership coach, speaker, and a family man. He’s a husband, a father, and a grandfather. His love for the outdoors extends to hiking, mountain biking, swimming, fly fishing, and golf. Join us as Ted shares insights on fostering resilience in high pressure careers, leveraging his experience and Lectacon’s innovative strategies to support those facing unique professional challenges.

Among high performing medical professionals, burnout is really real, Ted says

Let’s welcome Ted Paulsen to The Strong MD podcast. Ted Paulsen, welcome to The Strong MD podcast. It’s so wonderful to have you here.

Ted Paulsen: Thank you. It’s great to be here.

Dr. Jaime Seeman: So, for our listeners, I’m really excited about this conversation, because as medical professionals, we are in a very demanding career. we’re getting pulled in lots of directions, and I think resiliency is something that we really, really need to address. I was looking up some statistics for today. You know, amongst high performing medical professionals, burnout is really real, and in the last couple of years, it’s been amplified. So, according to the American Medical Association, Ted, in 2020, burnout rates, among physicians, when they were polled about just how they feel about their lives and their jobs, was like 38%. In 2021, it went up to 63%. That’s like two in three physicians that are feeling burnt out. And it really weighs on my heart, because we need, you know, good doctors and good medical professionals, to take care of the patients, and we’re seeing them leave in droves for a variety of different reasons. So, I really hope that today’s podcast can. Can help people, in some way, shape, or form, whether it’s one little nugget or a big one, too. So, I’m really excited, Ted, about the conversation that we’re going to have today. So, for our listeners, Ted, can you kind of just share your company’s mission and your passion behind it?

Ted Paulsen: yeah, you bet. Again, thanks for having me. And I, you know, when we talk about the medical profession, we talk about, we do a lot of work with first responders as well. And you really can lump those, the medical profession in with that as well because they are really responding, on the front lines, particularly as we went through the COVID crisis and, those challenges that we faced. And, it’s a tribute to the people who stay involved and they stay engaged. There are tools and there are some things that hopefully we can provide, and we like to refer to them as sticky notes. I hope that somebody walks away with a sticky note that they can stick on their computer that helps them in some way. But we got involved with this, five or so years ago. We’d been working with first responders across the country and training them on, of all things, safety and driving to, keep them alive so they didn’t hurt people when they drove through to the intersections. And so we did that with, both firefighters, with police, with emts. And, as we started working more with them, one of the things we noticed is they really need some mental health support. It was kind of lacking out there. And so even before the pandemic hit, we were talking about how do we take some coursework and materials out to, the first responders to provide them with help with mental health. And as we started working on that, we, we also had some work that we were doing with, in the learning and development space with corporations as well. And so we took some of the information that we learned there and we started putting that resiliency and the training around mental health, in a format that we could provide it to teachers and corporate people and people in the medical profession. So, it’s all the same sort of baseline of how do we provide a, means for people to understand how they work and operate. and just the hardwired system that we all have. You mentioned some statistics with the medical health profession and that turnover rate, right. And everything that’s going on there. And unfortunately, it’s mirrored in the rest of society. So it’s not just limited there to that industry, but we’re all having these struggles and Covid really brought it out. And so it’s something that as we learn how to really, connect, we learn a little bit about resilience. We learn about our hardwired system, we learn about recognizing where we are at a point in time. We build connections. Those are all things that really elevate and lift the community. So not just medical professionals, but everybody else in the community, we all need the same help and support. Now, what happens is we need to tailor that a little bit for the industry, because it’s a little bit different if I’m a police officer and I’m going out every day, and first thing in the morning, I strap on my bulletproof jacket, right? And it’s in my vest, so protect me. And that’s where vests ended up coming from, is we provide all these physical protections for people, but we rarely think about the mental and emotional protections that they really need. And so that’s what we ended up creating, is this mental and emotional vest and this framework to provide to, medical professionals and to other people that need to find ways to be more resilient.

Your husband is a 15 year veteran police sergeant

Dr. Jaime Seeman: Well, you, may not even know this, but I am married to somebody who is almost, 15 year veteran police sergeant. And it’s really interesting sometimes in our relationship, as our careers have kind of run in parallel through our relationship and through our marriage. Early in our career, we used to kind of exchange battle stories at the kitchen table, right? It was, like, new, and it was exciting. And then as kind of, we got into the years of our career, it was like we stopped exchanging those stories because we just needed to come home and, kind of unplug from that, from that life and the stress of that. so everything you’re saying is just like, I’m sitting here just, like, resonating with all of it, and my own husband, I don’t think he’ll care that I’m sharing this, but went through a traumatic event in his police career and got to a point where he needed some counseling and needed, you know, to talk to somebody about it. And I watched, you know, this man who. We have three daughters, right? So everybody looks up to him as, like, this, you know, big, strong guy, his best in his uniform, and he was, you know, embarrassed to be able to have to ask for, you know, help in that situation. And, at the end of the day, you’re right. You know, we can go through all the. The checklist checklists and the stops and things to keep us safe. but the mental, aspect of it is just something that never gets addressed.

Your company has five focus areas for first responders and medical professionals

So when you work with first responders and medical professionals, I know that your company basically has these five key focus areas. So let’s kind of dive into these. The first one is building resilience against stress and anxiety. Talk to us about that.

Ted Paulsen: Yeah, so what we found is, we provide an employee assistance program in Eap. That’s one of the things that we’ll provide to clients, that we work with. And one of the things that when we talk about a traditional eap, it’s really. They’re all really about providing the counseling and therapy, which is so important, and it’s so important that people reach out for those services when they need them. But really, what happens is they don’t focus a lot. And it’s the same with the whole, really, the medical industry, right. We don’t focus as much, really, as we should on preventative medicine as we do on, hey, we’ll take care of you when you come in with your broken leg. but, we’re not going to do a whole lot to help you from breaking your leg. And so one of the things that we do, here at vest, and the reason why we develop the vest framework, which is an acronym, and, the acronym is for being vigilant. Vigilant in understanding the stressors and understanding our hardwired system and how it works, because, as we’re informed, it allows us better to understand what are some of the ways that we work within that system. So v for vigilant, e is for engagement, and how we engage on a daily basis to keep ourselves regulated in what we call the reservoir of resilience. Next, is for. S is for sustain, which is how do we sustain ourselves with meaningful connections in our life? And those connections can take a number of forms. They can be connections at home. They can be connections at work. They can be connections with friends and family. They can be connections with counselors and therapists and professionals. And we need to look through those connections. And then lastly, and the thing that resonates, and what you were just talking about with your husband is transitioning, is how do we take what goes on during the day? Or if we find ourselves in a place of dysregulation, understanding that we’re there, what do we do to effectively get ourselves back into a place of regulation? How do we transition? So it’s wonderful to hear that you used to share right when you came home, but what ends up happening with a first responder, and particularly with medical professionals as well, you’ve got them both covered, is the first responder is going to come home. And the first time he says, guess what I did today? I picked up this body off the road. And it’s like, you know what? I don’t think I need to hear this. I mean, let’s keep it light, because at work for me today, I lost a patient. So, I mean, how do you. What do you communicate when you come home? What can you communicate about? How can you keep it to the point where you feel like you’re sharing enough that you’re able to basically regulate and get some of these things out and you’re not bottling stuff in. but what can be shared? What can’t be shared, and then what is a way that we can tell somebody? When I walk in the door and say, you know what? I had a hell of a day today, and the last thing I want to do is repeat it. So if we have somebody that’s there at home that greets us with, hey, how was your day? Tell me about it. How can we politely say, today’s not the day that I really want to go into detail? Do we have a safe place? Do we have some basically, parameters that we work within to keep us from really making things worse?

Dr. Jaime Seeman: Yeah. Yeah. And I think a lot of the reason we stopped sharing these stories is, like, we both had these experiences that we didn’t really want to relive once we came home. And so I think my husband really found that having kind of this neutral person, you know, that wasn’t his loved one, that he didn’t have to, use me as a sounding board, essentially. when does somebody in, if they know, for instance, that they have this employee assistance program, when do they know when to access that? Like, what for a listener, like, what would be red flags that it’s time to, you know, move into accessing a service like that? Because I think for me personally, and I’m just speaking for myself, you know, when I come into a new job or a new career, I’m like, oh, yeah, I’m not, I’m not going to. That’s nice that you have that. I’m not going to need that. I’m a very, you know, strong willed person.

Ted Paulsen: Well, you know, as a general rule, we all are. and so the norm is to say, not for me. And it’s the reason why, if you look at, if you look at EAp programs, traditionally over the years, I won’t go into the detail in the history of how they came about and all that sort of stuff, but the utilization rate on Eap, generally, nationally, will be about like 3%. So if you think about that, three out of 100 people are actually going to access and use that sort of a service. That’s not good. I mean, it. I mean, even if we were using baseball averages, right, 3% wouldn’t be good. So, you know, how do we drive that up? And so one of the things. And, and you’ll find different things out there, right? We happen to focus on sort of upstream support. That’s sort of our differentiator, where we really go in and try to educate upfront, where we really look at it from the standpoint of what can we provide them to, that’s going to be preventative. And so we focus a lot on that. But one of the things that people can do is just understanding where they are.

We talk about the reservoir of resilience when we’re in state of regulation

I’m going to talk about the reservoir of resilience for just a minute. And, there’s wonderful work by Dan Siegel out there relating to the window of tolerance and some of these things of regulation, dysregulation. And what we’ve done is we kind of looked at that from a standpoint of how do we make it a little bit more practical and accessible. And so if you envision, a reservoir and look at it as a shape of a v, and this is our reservoir where. This is where we’re regulated. This is where we’re regulated. And, yeah, you can show it, Mike, but, you know, I’ll describe it because, we’re on the air, right? So. But if you look at this and you think about this v and it’s a reservoir, and that’s where we find ourselves when we’re in a state of regulation, a state where we’re more resilient. This is a place where we’re in our frontal lobe. This is a place where we’re thinking, where we’re feeling, good about ourselves. It’s where, hey, this is a great place where we want to find ourselves most of the time, is in that place. Now, to either side of that reservoir, if you picture this v, and on either side, if we get outside of the v, moving to the left or the right, on one of the sides, you move into fight or flight, and the other side, you run and you turn, you look and you go into freeze, which is, again, our self preservation part of our brain. And again, somebody’s going to watch this and say, ah, that guy, you know, he’s not describing things the way. No, this is a practical approach to just look at this simply. If. And there’s much more nuanced information out there. And there’s great materials on polyvagal theory and self therapy theory and some other stuff out there that go out and research and look at. But if we think about this, when we go into a state of fight or flight, that’s. And just to relate to that, right, that’s when we get off, cut off by the car, on the freeway, and you feel that surge that goes through you immediately after that. It’s kind of the easiest way that all of us can relate to. What does it really feel like when our autonomic system takes over for us for a moment? and then another thing we can think about is when do we feel like freezing? If anybody has ever gone home and said, you know what? Don’t bother me, don’t talk to me, don’t, I’m just going to be under this blanket for right now, and I don’t want any engagement because I have been overstimulated all day. It is not a bad thing to find ourselves in those places, and it serves us. It’s why that exists, it’s why we’ve evolved, or however you want to look at it, how we’ve come to the place where we are. We’ll go into fight or flight for self preservation. But what happens when we’re constantly stressed? If we’re constantly, let’s say we’re an ER doctor, for example, right? There’s always something coming at us and always something we’re having to deal with. And even the nurse that’s dealing with these things continually because they’re going constantly from room to room to room and dealing with these issues. And you think about that. If you take a moment and say, where am I? If we’re finding ourselves living in fight or flight or freeze, then what we’re doing is we’re living in that limbic part of our brain and we get more comfortable there. And our reservoir in this, you envision this reservoir in the v, that water level starts to drop. And the more that water level starts to drop, the more time we are spending outside of our reservoir of resilience. And so we don’t want to be spending our time out there. So what we need to do is we have to have some self checks and we can check ourselves. But more importantly, it’s important also to ask other people, because other people can also help us pinpoint where. Where are we? And it’s like, you know, you’re not making sense or, you’re talking crazy or you’re not. You know, we need to understand that we are in some place on this very simple diagram. And if we’re spending a lot of time out there, the lower we go in our reservoir, the more likely it is that we have to reach out for professional help. So what happens with a first responder? Or what happens with somebody who’s constantly dealing in the medical profession with things that are just hard to process for them, and that they’re just putting off and saying, you know what? I’ll deal with this later. I’ll partition that off. We’re down in that reservoir. And at that point, it’s really, hey, it’s time. Let’s talk to somebody. And we need to take away the stigma of thinking that that’s a big deal. It’s not a big deal. And if there’s one thing that we could do for the mental health of everybody in the. In the world, right, it would be, okay, guess what? Guess who your mentor is or your partner that you can talk to anytime for any reason and just call them up. So it’s really a self check. But then it’s also asking somebody else. And a lot of times we’re not brave enough to say, you know what? You seem like you’re really spinning or you’re stuck. How can we get you back? I’m going to use the example of your husband coming home. Right? And at first it was, let’s share things. So now if you get to the point where you say, well, what can we share? What you can share is what you’re feeling. You don’t have to share the specifics. You can share the feelings of, well, what am I dealing with today? And it’s like, well, I’ll tell you what I’m dealing with today. I’ve got imposter syndrome. I’m in here treating this person. I don’t know what they have. I don’t know what’s going on. I don’t know how to manage the situation. I failed today. I failed miserably. That’s a feeling that can be shared without getting into the details where it can be.

Self checks can help you identify emotions associated with failure

Well, let’s talk about it. What’s causing you to feel like you’re a failure? and we can share things without getting really specific and having to relive it. But just recognizing and identifying the emotions that are associated with it by talking about the emotions, it’s one of those things that’s liberating and freeing. So it can actually help things disperse from this physical being that we are and let it escape. So it lightens our load figuratively. But there’s also something to that, too. And, you know, whether you subscribe to, eastern sort of philosophies that are really coming in or not, there is something that allows us to really kind of relax and find our way back into this place of regulation.

Dr. Jaime Seeman: Yeah. You know, in medicine, the way I practice, you kind of talked about, we’re not really prevention focused. We’re much more algorithm, right? Identify disease. You have diabetes. Here’s the drug for it. I am such a preventative medicine based doctor, so I want to kind of come at that with this same lens. So when you say, like, self checks, is this just carving out five minutes to tap in with yourself? How am I feeling when, when you say self checks, what is, like a tangible thing that our listener could be thinking about incorporating?

Ted Paulsen: just. That’s a wonderful question. And, you know, the self checks, I’ll throw out a couple of suggestions. It’s really becomes important that you understand what works for you. And you mentioned the best one. And that is sometimes people don’t like the term meditation or mindfulness, or they think, oh, that’s a bunch of, you know, a yogi on a mountain in pose and burning incense or something in the background. And that is really sometimes a lot of what people think. But mindfulness and meditation can take the form of, if you’re a religious person, prayer. Prayer is something that, again, allows somebody to reach outside of themselves. If you believe in the quantum field and that there’s a universe and that there’s these forces that that we’re just a part of and we’re part of that flow, it’s getting in touch with that quantum field. And that can be through meditation, where we’re thinking about nothing and we’re trying to clear our minds. Or it can be mindfulness, where we’re kind of really focusing in one of the exercises that I use. And interestingly enough, this came from when I was a high school. I was an athlete in high school and college. And so my high school coach taught us way back when, in ancient days, really, this relaxation techniques where we would lay down on the ground and we would first concentrate on your breathing, which, again, you’ll recognize as a meditation technique, but we’ll concentrate on our breathing, but then we’ll go through and we’ll try to feel each part of our body, starting with your toes, your feet, your legs, your arms. If you go through this process, it’s doing two things. The first thing it’s doing is by focusing your attention on these areas. You have to be in your frontal lobe, right. You’re going to be more likely that you’re thinking and reasoning as opposed to in a constant state of emergency, because that’s where the limbic system hijacks our system. And we don’t think and reason and have logic. So this is just one simple, simple, example of go through and just focus on those different parts of your body.

Breath work is fantastic. It really, it resets you every day

Spend five minutes laying down and trying to tell yourself, hey, relax. And you might start that by thinking of a favorite place. For me, it was the wind river mountain range. I used to love backpacking and the wind rivers. And I would take myself there and I would envision the stream coming down and listening, and the more you can engage your senses. So I’m seeing the mountain. There’s the mountain there behind me. I’m seeing the stream coming down with the, with the pine trees, and there’s some quaking aspens. I’m hearing the sound as that goes over and gurgle comes down and falls down. the wind is blowing through the trees. I can smell the pineapple.

Dr. Jaime Seeman: Ah.

Ted Paulsen: And that’s something. And I can even taste, unfortunately, I can maybe taste a pemmican bar, if you know what those are. Right for a backpacking treat. Right. But the more you can involve your senses in this exercise, the more you’re going to be able to put yourself in a state where you’re not thinking about what’s gone on in the past. You’re not thinking, necessarily what’s going on in the future, but you’re thinking about your present state of mind and body. That’s a great technique that somebody can use if you don’t have time for that one. The one that is reminded on a lot of our wrists now with, with all the sorts of different contraptions we can put on our wrists and rings we can put on our finger is to simply take a moment and practice square breathing. So, for hold four out, four. Hold four in, and just go through that three or four times. And there’s a lot of different breathing patterns. Breath work is fantastic. Just google it. and they’ll, they’ll have some different patterns. Those are two really good, solid ways that people can find and check in with themselves. Where am I? And if they can’t do that and feel like they’re in a place of resilience and a place where they feel comfortable and calm for a moment, they may need to check with somebody else.

Dr. Jaime Seeman: So as a prevention strategy, would it be better for a, doctor listening to just start to incorporate this as part of their daily routine? Does this really help prevent them from getting into that crisis situation, or is this better when you’re like, I’ve had a. I’ve had a rough day, I’m going to go, you know, do this practice.

Ted Paulsen: I love preventative medicine people. Right? Yeah, of course. It’s better to get in that routine because as you do it. It really, it resets you every day. And, you know, I won’t get into what everybody thinks on here on cold plunges, right. Because they’re kind of the rage now. And, you know, you get kind of a good thing and then you turn it into, hey, more has got to be better. And I don’t know that’s necessarily the case, but the routine, I love what you just pointed out, right? If you can get into that routine and say, okay, five minutes in the morning, I might roll up. I might. I roll out of bed, and I’m just going to sit and just listen for a minute, just to the sounds of the silence. And you’re gonna find it’s not silent. You’re hearing things. This morning, you know what I heard for the first time, I live in Utah, a bird. A, ah, bird outside the window. And it was like, yes, spring is finally coming. I am so excited.

Dr. Jaime Seeman: I just heard that this week here in Nebraska, too.

Ted Paulsen: It is so wonderful. But if you think about that for somebody else that might be rolling out of bed and getting on their knees and saying a prayer because they’re religious. so taking the time to do that on a daily basis and check in with yourself, that routine is key. And you’ve really nailed that. Right. That helps us to stay much more regulated, rather than saying, hey, well, I’ve got this thing and I’m going to grab when it’s an emergency, that’s like somebody’s throwing us the life buoy and we’re going to grab it only when we’re drowning. No. let’s practice swimming. So I love what you’re saying. Yes. That preventative maintenance is a great way to get into the daily routine.

Dr. Jaime Seeman: Okay, so these self checks, this is part of vigilance. Is that. Is that correct? Is there anything else absolutely in vigilance that we should be aware of?

Ted Paulsen: you know, I just want to bring it back to, if you understand that your system has a certain makeup, it’s hardwired. If you understand that you’re working within that parameter, and then what you’re really working with is the software. So there’s some great, I can’t remember the happiness hypothesis. I can’t remember the author. I apologize right now, right where he really talks about, and you’ve heard this analogy before, of the rider and the elephant. The elephant really is the equivalent of our hardwired system. It is going to go where it wants to go sometimes. And if we understand that, it helps us to relax a little bit. And not have the anxiety come up that would otherwise come up when we’re thinking, hey, what just hijacked me? Why, why can’t I get control of this thing that just hijacks me? That’s your hardwired system, right? And the writers, that software. And we have to redirect most of the time, but every once in a while that elephant’s going to go off and do what it does. And I think it’s a great analogy. And I apologize. I can’t remember the author’s name right now. but, just a wonderful example of that, right? Where, where if we understand and we’re vigilant in understanding that system, it’s a lot more likely we’re going to be able to work effectively within it without going to these outlying areas of fight or flight or freeze.

Dr. Jaime Seeman: Okay, okay. Is there a way for people to know when they’ve come? I mean, is it just kind of a self reported, okay, I’m back in a good state. How do you know if you’re stuck in freeze or flight? Do you.

Ted Paulsen: Ah, really? good question. And Doctor Seeman, let me put that back, that question back to you.

Have you ever felt stuck in one of those areas

Have you ever had an experience where you can say, you know what, I for a time was stuck. When you, as you think about that, you know, what got you stuck in fight or flight or in freeze, where it’s like, I don’t want to even see anybody. Have you ever had that experience where you felt stuck in one of those areas? What was it that caused you to feel stuck? Can you think of a specific instance even?

Dr. Jaime Seeman: Yeah, I had the loss of one of my best friends, back in 2015. And I was really stuck for, weeks. And it kind of almost drug into months is what it felt like. In retrospect, I, don’t know if it was. I mean, now looking back, I see that, but in that moment, I don’t know that I was stuck. But it really started to affect every area of my life. My ability to be a mom and my ability to perform at work and, and, you know, I thought it was just like part of the normal grieving process, but I was, I was definitely stuck.

Ted Paulsen: I love that example because we all deal with it. and great research out there on the five stages of grief. And some, there’s a six sometimes that people plug in there, right, that we have to go through. And you bring up something that’s really valuable here is as much as we do, self check and we can get good at that, right? Where we’re self checking. But while you are in that actual circumstance, in there, the self check becomes much harder because we are going through those five stages. And again, it can be any stage at any time that comes at us. That’s where it’s really valuable to have connection. and we’ll talk a little bit about that with the s. But it’s really, how do we sustain ourselves? Because that’s where you really need a self check. That’s why you need to look. I’ll use an example. And my wife, when her dad died, I mean, she went through a grieving process that lasted a long, long time. And it was something that I wasn’t aware enough, to be able to say, hey, let’s help you because you’re not able to help yourself. And we need to find a way for you to move through this. And that’s where, again, licensed clinicians and professionals and sometimes life coaches, too, right? That might be right fit for some people, but. But these clinicians have tools to help you move through and deal with that. And so, it’s good to have somebody else that you also can check with, because self checks are not always reliable. You know, we see ourselves differently in the mirror than other people see us. I don’t know whether people know that, right? But we do. We forgive ourselves for certain things. And I might look in the mirror and say, oh, well, there’s a whole handsome guy. Somebody else might look and say, you know what? You’re really self deceived because you’ve created this image of yourself that we’re not seeing. Right. So you have to be a little bit careful there and reach out for help and ask other people and say, are you noticing something different in my behavior? do I seem like, I’m moving through this okay? Because I feels like it feels pretty heavy. Really heavy. Ask. Check with other people as well.

Dr. Jaime Seeman: Yeah. Yeah. Okay.

Next is engagement. How can we be better at, uh, engagement when it comes to this

So, moving from vigilance, the next is engagement. How can we be better at, engagement when it comes to this?

Ted Paulsen: Well, engaging in our tool set really is understanding what tools. And I’m going to put it on kind of on the timeframe of the daily basis. So what are we doing on the daily basis? So what you brought up, which was so important, and that is what is our daily ritual, what are we doing to support ourselves routinely? And I look at that reservoir of resilience. If you think about the top of that reservoir, we’re kind of paddling around and kicking around on that every day. Really on kind of the top of our reservoir. And as we’re kicking around on the top of that reservoir, what are the things that, if we’re noticing, we’re going out to these outlining areas? What tools have we identified for ourselves that work for us? Because there’s a lot of tools out there, but you have to find things that resonate with you. And so, in one of our trainings, for example, in our resiliency training, people complete a, personal resiliency plan. And so we ask them questions. As they go through the training, they come up with responses. We plug that into their personal resiliency plan. It’s something that they can reference. So the breathing we talked about is an engagement tool that helps us come back on a daily basis. Having, a few of those that work. sometimes I talk about when I was a young man, a very young man, okay. A kid. I had a horse, a plastic horse. And it would. And I named it applesauce because it’s the mat. The plastic smelled like applesauce to me. Well, that’s something that, if I think of that applesauce, it basically makes me not necessarily return to there, but it provides me with a feeling from childhood that is burden free.

Dr. Jaime Seeman: It’s like when a kid has, something.

Ted Paulsen: Absolutely.

Dr. Jaime Seeman: Same thing to touch, feel. Yeah.

Ted Paulsen: Yes. And as you think about it, there’s probably something that you still have in your life. Right. That provides that comfort. and what is it when you go home? For some people, it’s food. Now, that can be a dangerous thing. For other people, it becomes alcohol. And so we need to be careful what that thing becomes, because those are really artificial. For the real thing. For the real. How do we get back in centered? So what, on a daily basis causes you to just take that moment to reflect, to try to understand where you are and to try to say, you know, I’ll be so bold as to say this. If you get up in the morning and, all you can see everywhere you go is me, me, me, me, me, me, me, me, me, me, me, me, me, me, m. Me, me, m. You’re not in a place of resilience if you’re seeing other people. And if you’re saying, how am I tending to their needs? And how am I tending to their needs? And how am I taking care of the medical professionals? That can seem. Well, wait a minute. I care for people all the time. That’s all I do is run around and care for people all day long. So. But you need to think about that. Who, outside of that normal sphere, that you’re doing your job.

One of the key things that drive us out into dysregulation is lack of sleep

is there something that you’ve done that out of the ordinary, right? That have you sent a text to a friend? This is another great daily tool. And one of the people in our organization, Craig, he routinely sends out, and I think he’s on day 14 or 1500, where every day he will send out a note of gratitude and thanks to somebody. Great research. Another, another tool. Great, highly researched gratitude journals are one of the number one things you can do on a daily basis to engage yourself in a practice that causes you to come back to a state of regulation, and be in your reservoir of resilience by just expressing, I’m grateful for these things in my life and that I have, and particularly for these other connections outside of yourself. So that’s really talk about when we talk about engage.

Dr. Jaime Seeman: Yeah, I love that. When I went through this kind of time in my life, back in 2015, where I had this major tragedy, the happy part of the story is I did eventually come out of it, but I came out of it with a completely different perspective in life and almost out of a place of gratitude and appreciation that, like, I’m still alive. Like, I. She’s not. but I always use the analogy of, you can’t fill other people’s cups if your cup is empty. And, what happened for me is I kind of went into this place of my life where I said, okay, you know what? I’m going to start taking care of myself. I realized I wasn’t eating very healthy. I wasn’t prioritizing workouts anymore. And it was affecting my ability to be a mom and be a wife and be a good doctor. So I call it pay yourself first. So I started working out again. I started eating healthier, and I started, and it really spilled over into every area of my life. And as I hear you kind of talk about this ability to get back to this place of regulation and resilience, I am a firm believer that when you take care of yourself, when, you really prioritize things that make you physically perform better, mentally perform better, you know, tap into that spiritual that I think it’s easier to get back into that space of regulation and resiliency. Do you agree?

Ted Paulsen: Like, wholeheartedly. And it’s less likely you’re going to fall out if you think about the foundation for that. And I love that you have this holistic approach. The very core foundation of, the engagement tools that we look at are these, these basic things that we know are just the right thing to do, and you’ve nailed them. All, right? When you think about it, am I eating healthy foods? am I getting enough hydration and just drinking water? Right? I mean, these are just such basic things. And we say, oh, that’s part of a diet plan. No, it’s not. There’s a reason these things, we’re just not.

Dr. Jaime Seeman: We’re like, we’re horrible patients. Like, that’s. Our listeners need to. We’re the worst.

Ted Paulsen: Yeah. you know, it’s one thing to say, hey, do as I say. It’s another thing to walk the walk. Right? So what you’re talking about is so key, because one of the. One of the key things that drive us out into these outlying areas of dysfunction and dysregulation, right, is a lack of sleep. And when you think about the medical professional and what they require, the dumbest. I shouldn’t say this out loud, but the dumbest thing of all time is to force people to be on 24 hours shifts where the hardwired system of our.

Dr. Jaime Seeman: I used to do 36 hours shifts, and that was after they made rules. 36 was the max. Yeah. Now it’s getting down to, like, 24 hours, but it’s still, like, at 24 residents, because we’re gonna have medical students and residents that are listening to this, and there still are some that are doing 24 hours shifts.

Ted Paulsen: Yeah. And sometimes I think, we think, oh, no, you know what? We can train for that. You do not train your body to stay up for 36 hours at a time and function the way it’s supposed to function. I’m sorry. It, just doesn’t happen. Now, can we get ourselves conditioned so that we can go through the motions? And, hey, look, my arms are moving. It’s been 36 hours. And I know this because I did the grand Canyon rim to rim to rim one time. And. And again, that was, And when we got out of there, I could not think. I could not stand up hardly, because it had taken us, basically 21 hours and a ton of exertion in order to do that. So it’s another. I mean, you bring up a really good thing as far as self checking ourselves, right. Is we need to be able to report when this is going to be dangerous to ourselves or other people. We need to stand up a little bit, when that’s happening. So just, you, know, beware of those things.

Being physically resilient means eating healthy foods, working out, taking care of yourself

I can’t even remember where I was going with this because I got sidetracked on that, where you went when you were really talking about. Because I’m so passionate about this. We’ve got to work within the parameters that our body allows us to.

Dr. Jaime Seeman: So we’re just talking about, you know, being physically resilient, like eating healthy foods, working out, taking care of yourselves, makes it easier to get back into that place of renewal. Yeah.

Ted Paulsen: And you know what? There’s no greater time to fall out of, fallout of physical fitness, of eating properly. Everything else was when you’re going through rotations and, and you’re, you’re going through this, educational process where we’re cramming all this stuff into our minds, our bodies and everything else, it’s like, what, what’s the easiest thing to cut out? The easiest thing is, well, you know what? I’m not going to go on a half hour run. I’m going to go on a ten minute run. Then it’s like, I’m not going to run at all. Oh, you know, I’m not going to go get that salad because that’s down the street. Because here’s the vending machine. And it just. Easy, we’re all pushing the easy button and that easy button just drains our reservoir. And so we’re in residency or whatever, and it’s like that. Our reservoir is going, drain, drain, drain, drain, drain. And the simplest things that we could do is engage in these tools on a daily basis, which is, okay, take that time for that. Five minutes to meditate, check in with yourself and your body’s going to tell you, I’m eating the wrong stuff. I got to start eating better. Hey, I’m not getting enough sleep. When. Hey, Ted, that’s really easy to say, get more sleep. But you don’t understand my schedule. They’re requiring me to be on a 36 hours shift. And, you know, you have to work within those parameters. But then when you do get that break, when you do get that opportunity, how are you using it? Right. What happens is that that ancient part of our brain, right, takes a lot of energy to run. And the more time we spend out there, the more we spiral out. And if we’re spiraling out, the less time we’re spending in our, in the, in our frontal lobe and this place of regulation where we actually can think and reason our way out of our problems and troubles. So it’s self perpetuating?

Dr. Jaime Seeman: Yeah. I. I mean, literally, I lost myself in medical school and residency. I had three kids. I was newly married. the funniest part is, I know you work with first responders and I talked about my husband being a police officer back in residency when I was working these 24 and 36 hours shifts at the police department. They got rid of twelve hour shifts because they said it was unsafe. And, that the police officers in that last 4 hours of their shift were not doing effective police work. So they mandated eight and ten hour shifts at my husband’s police department while I’m working these 24 and 36 hours shifts. I mean, I’m just like, what is going on? This is crazy. but you can, you can make so many parallels between those professions. It’s just like it’s unsafe for you. it does drain your resiliency and kind of that, that, ah, regulation space, 100%. Okay, so, we got on a tangent, but I think it was a really good, important one. Take care of yourselves. I really think that as physicians, we need to do a better job of just fiercely protecting that personal, ah, time that we have to, to get our workout in, to do some meditation or breath work or whatever it is. Don’t put it at the bottom of the priority list. It has to be at the top. because if you don’t do those things, you can’t be a good doctor, you can’t be a good first responder. and then, like I said, what happened to me then it starts affecting your marriage, it starts affecting your ability to parent your children. So we just have to fiercely protect that self, you know, care time.

In those circumstances where you feel yourself going down that plane, seeking outside help

so one thing that they do talk about in medical training is kind of this second victim thing that happens when we have a really, really bad event that happens. We have a patient die, or a bad outcome or whatever it is, is that the doctor ends up being the second victim in this whole thing. Maybe there’s a legal aspect or litigation or something, and then they tell you not to talk about it, which is a whole other part of this that we could get into. But for somebody, that maybe has, experienced this. So it’s not just this daily check in. This is like a big traumatic event. Can we, can we unpack that for our listeners, what to do in that situation?

Ted Paulsen: Yeah. So I’m going to preface it with this. In those circumstances where you feel yourself going down that plane, going down that path, it’s really important to seek outside help. Okay? So, and I’ll provide some thoughts and advice here. I’m not a licensed clinician, so I’m not telling you, you know, you’ve got to follow this stuff, right. but I do want to. I’ll provide, I’ll answer that question. And we’re all human, and the basic foundation of humanity is connection. So it’s very natural, like, you with a friend, and the passing of a loved one, all of us, that connection, there is something more. And whether, you know, some people say, no, you don’t know what you’re talking about. There’s something deeper connection that ties us together that a lot of times we don’t really talk about or emphasize, but we have connections that are deeper than just are we physically present with a family member or a loved one or a friend? that just is woven into our fabric. As human beings, it is extremely natural to have those feelings and to go down that path. When somebody else is suffering, we want to suffer with them because we believe that will lighten the burden. and so we’ll let ourselves go there, and that is not a bad thing. I do think in the medical profession, one of the things that happens is we kind of have to compartmentalize a lot of times. and this is something we talk about with first responders specifically, is, hey, maybe one of the tools is, I’m going to compartmentalize this thing that happened. I’m going to have to put it over here, and it’s going to live over there because it can affect everything else going on in my life. And that’s also something that can be helpful. Right. And there’ll be other people that say, no, never do that. You know that. So there’s different ways to this. You have to find out what works for you. However, when. When these sorts of things happen, I think what happens in the medical profession is we take that to an extreme a lot of times, and this ends up impacting our bedside manner because, you know, my. My father recently passed away. and, you know, that that is a challenge. It happened to be that he was 91 years old, and we had a wonderful relationship. That makes things easier, in a sense, but it’s still. You lose a loved one. The doctors were very good, right. And the medical providers were very good in that instance. on the other hand, I’ve been in the hospital with my mother. she’s gone through some trauma and tragedies, and I think a lot of times we’ll try to partition and compartmentalize this off to the point where. Where medical professionals will come across as unfeeling or uncaring and more just Cya. And that is, did you know this could happen, this could happen, this could happen, this could happen, this can happen. Another example, my daughter comes home from the visit with the doctor. She’s pregnant, right now thinking, oh, I got all these problems that are going to happen to me. And the doctor now said, this is one of the things that might happen. But you know, what our brains does is I’m, scenario, I’m, my baby’s in danger. I’m in danger. What? You know, and it’s kind of like, no, no. They said that because they had to Cya, whatever that somebody’s told them to do because of their medical malpractice insurance. And you know what? There’s a really, there’s a balance here of being a compassionate professional and letting ourselves feel those emotions, but also being able to say, I’m going to let those emotions live there. I’m going to give them what they need in the moment. But I’m also, I can’t take everything on myself because then I wouldn’t be able to function. So what is that balance? And I am, here today to tell you this one magic key. Go find it for yourself. Because I can’t give you one key for that finding that magic balance. But I will tell you, as somebody who participates in the community, it would be wonderful if we could find more of a balance with that compassionate professional than just the, You know what? The industry has beaten it out of me. This is what happens with first responders, right? The job has beaten it out of me. I used to be compassionate. Now it’s just like, no. So how do we get some of that compassion back for you? And only you can decide what works for you to say, I’m willing to feel this human connection with the patient. But I also understand that, you know what? There’s some things that are outside of my control, and I have to recognize that and just say, you know what? I did all I could have done in that circumstance. I feel good about it. And sometimes, you know what? Maybe we didn’t do all we could have done, because we don’t know everything. We’re not God. we don’t have that ultimate determining power to say no. We’ve diagnosed everything perfectly. Every surgery goes exactly as planned. That just doesn’t happen in our world. And unfortunately, the legal community doesn’t want us to think that because they’re going to come at us for whatever. But you know what? We don’t have to give up the humanity. We don’t have to give up the connection. We can still touch a hand and touch a shoulder and say, you know what? I feel you. And we don’t have to share anything other than that. And I’m here and I care about you. But then we do need to move on and say there’s other things in our life that we can focus on, because I will let you have this, a, piece of me while I’m here with you. And then when I leave, I have to leave you to deal with your issues and I’m going to go provide this support and help other places.

How do you transition from traumatic events to your home life

Dr. Jaime Seeman: Yeah, I think that’s a really hard thing sometimes for doctors to experience something really traumatic at their job. And then you come home and you’re at the dinner table with your smiling children and, you know, they’re ready for you to just be mom. And is there any advice you can give our listeners in? How do you make that transition from walking out of the hospital, scrubs covered in blood, whatever the horrible, awful thing that was, that happened, and go back into your life in a, How do. How do you make that transition easier?

Ted Paulsen: Yeah. Well, the first thing. The first thing to say, right, and preface this with is, it’s hard. And it. And it is. There is some transitioning that needs to happen there. And we will never be able to just totally disengage, these two worlds. And so when that. When that thing happens and for the rest of us, that might not be able to relate to the, situation of a medical professional that deals with this on a daily basis. Right. Is that example of having a loved one die or something that happens? it might be a job loss. And then those are stresses that happen to us as we think about those things. There always is a point where, hey, we’re going to have to transition from some state that we find ourselves in. So if we’re in these outlying areas and we’re thinking, all right, what. What works for me, how can I transition back? It’s something that you will end up discovering for yourself. It can be that blanket, it can be that plastic horse. And really what those things are doing is we’re just trying to get back into the present moment for a moment. Because what happens is we all live our lives because it’s so. It’s so much easier of living our lives where we’re over here. And the past is providing us with identity. And I think it was Eckhart Tolle in his book. He’s got some great books out there. Right. if you’re into that sort of a thing, I think he provides some very good advice. But we live in the past for our identity. That tells us, I am this incredible professional. I’ve got this degree, I’ve got these letters behind my name, I’m all that and more. So that’s what we use to identify ourselves. And then we look into the future. and the future really is determining our happiness, right? Because we want to move into this place where our future is, where we’re looking. So that transition period is a period where we have to get back present in the moment, and say, where am I really? And if I’m coming home off a shift, you know, bent up to my elbows in blood, and things didn’t go exactly the way we wanted them to go at work. What do I do for myself to tell me that I am transitioning. Bad term here, but trigger, you know, in a positive way? Is there a positive trigger that I can use that tells myself, all right, get into the present moment. What happened at work happened. That’s the past. And whatever went on there and whatever’s going to happen in the future is going to be a future if I have to deal with it tomorrow. But for right now, I’m in this present moment. I am sitting in my car. I am sitting in the driveway of my home. I have a lovely home. I have people that love and care about me. Yet it’s getting back into that present moment, practicing that mindfulness or even that meditation, and, saying, okay, I’m going to walk in the door and I’m going to give my attention to them because they don’t know what happened in the past. They don’t know what I’m looking for in the future. They don’t know what these things that are causing me the anxiety are actually these things that are on either side of the present moment. Because when I roll up to the driveway and I’m home, are all my body parts here, to your point? You know, I’m alive. can I think? Can I feel? Can I see? Can I appreciate? Can I have gratitude in my heart? Now I’m back in the present moment. It’s like now when I walk in there, my spouse doesn’t deserve to get the brunt of what happened to me at work because I’m bringing that crap home with me and saying, look, all this crap happened at work, and I want to share the load. So guess what? You’re going to share it along with me. And this is why relationships suffer when we deal with these sorts of jobs that are really quite high stress is we don’t have that means for coming home. So I’m going to make a suggestion. One of the reasons why we created the vest. Vest that I’m wearing today, right? I’m wearing a vest that says vest on it, which is our logo. If we’re a first responder, we’ve got our uniform. If we’re a medical professional, we generally have a uniform. If we use that as our cue to transition that I am literally, I’m taking off my scrubs. I’m taking off my vest. And if you envision on that, that all the crap, right, that has clung to that during the day, I am taking that off. I am shaking it out outside the door. I’m hanging this thing up in the garage before I walk in the door or in the. I’m hanging in the closet. I am literally, in, figuratively, in my mind, saying, I am taking all that crap. I am hanging it up and leaving it here, and I’m going to walk into that other room, present in the moment, to say, how was your day? Or, what are you feeling? And that’s the best thing we can do, is find that one thing, that cue for us, right? You know, there’s religions that have certain things on their door when they walk in the door, right, to remind them of certain things. If you want to do that, have something that reminds you. Do you have a fidget spinner? Do you have something in the. In the console of your car that the last thing I’m going to do before I walk in the house is I’m going to pull out this rock and I’m going to rub this because it centers me again. It gets me back into the present moment where I can now deal with things as they come at me, instead of dealing and using this moment to lash out at what happened at work or what I think is going to happen in the future.

Dr. Jaime Seeman: Interesting. I like that. I, I did a fellowship in integrative medicine, and one thing they were very into is ceremony. And I remember the first couple times I experienced it, I was kind of like, this is kind of silly, you know, but it, like, it is so true. It is like, I think, incorporating, like. And I’m just imagining you, like, this whole taking off the vest thing.

What advice can you give someone who has experienced second victim tragedy

It’s like the ceremonial thing of, like, coming into this, like, safe space, almost, is how I almost think of it. like you’re giving yourself permission to, like, escape and just be human. And, I love that. I love that so much. Ted. I think one of the things, that I watch my colleagues experience kind of back to the second victim thing, because I know there’s going to be. This is going to really resonate with somebody. Ted, and we can make the parallel even to first responders and police work when a bad outcome happens, or like a police officer uses their duty weapon and then suddenly you’re on like, paid administrative leave. And now, like, the whole world is going to like, unpack this situation generally with a lot of judgment and a lot of Monday morning, you know, quarterback, essentially. And you just feel almost like re victimized, like over and over. And this is a common time when people leave their career, for obviously the daily occurrence, you know, take off the vest, take off the white coat. What advice for somebody who has a situation like this? You know, what advice can you give them and how to kind of step through this situation and how to come back? Because it’s not like a daily resilience thing. Like this is maybe a career resiliency thing.

Ted Paulsen: Yeah. You know, the, the s invest for sustaining ourselves is really sustaining ourselves with connections. And so, the, the best advice I can provide there, is, again, people have to figure this out for themselves. But in those search, those circumstances, it’s really when it’s important to have the support network, because sometimes we do just have to go outside of ourselves. And if the lawyers come in and say, don’t say anything, you know, don’t tell them, I know you want to talk to everybody about how this happened or that happened during the surgery, but don’t say anything. So it’s like, well, I can’t talk to my colleagues because they’ve specifically told me I can’t. so who can I talk to? Who can I share with? So one of the things that can be done, obviously, is we’ve talked about earlier, and that is I might not be able to talk about specifics with you, but I can talk about how I’m feeling. You know, why does this have me boxed in? And so you’ve got, a great advantage, right, of having a first responder at home that is going to understand a lot of this stuff. And if you say, let me just tell you how I’m feeling, I can’t share a lot of the specifics, but this is what’s going on. And at that point, what we want to do is we just want to be a good, reflective listener, right. And say, hey, I understand, and that must be tough, and how are you dealing with it, you know, that sort of thing. And we won’t get into kind of that, listening exercise, but, but we want to have somebody that, that is an effective listener for us. This is not somebody who immediately comes at you and says, well, you need to do this, this, this, and this, and then everything’s going to be fine. You need to have in your, in, your orbit, right? You need to think about before these things happen. Who is somebody that’s support for me? Do you have a family member that is somebody that you feel confident and be able to share things with? Do you have a trusted friend that is a listening friend as opposed to the one that is not the good listening friend? Because we all have those too. So do you have that friend and do you have somebody, have you ever reached out to, a clinician or somebody that you feel is somebody that, hey, I really connect with this person because it’s important to have, when those events happen, if you have a licensed person that you can go talk to and share things with and find one that you connect with, right? Because it’s like all professions, you got to find one that you connect with that that resonates with you, that gets you, that you like their mode of operating, right? So you might have to shop a little bit, but find these people before the fact. Find somebody you can just go share stuff, stuff with. Because we all are going to have those events where we come home and we have to process and go through those stages of grief. We’re going to go fight or flight, and then we’re going to go freeze really quickly. The best way out of it is through these connections and back to our reservoir analogy, right? I use the analogy of, I was a lifeguard growing up, right? And so as a lifeguard, they teach you to reach, throw, row, go. Meaning the first thing you need to do is you need, if you can reach somebody, reach them and pull them in. If you can’t reach them, then you can throw something to them and pull them in, then row. And the last thing you ever do for a drowning person is go out there and try to save them by swimming. Because as you know, at that point, somebody’s in fight or flight and they will drown us. So as you’re looking to come off this, the worst thing you can do is go and find somebody that participated or is living in that same experience at that moment and commiserate and say, oh, yeah, you know, because what we do is we hang on to each other while we both sink. You have to find somebody who’s in their reservoir of resilience to help you. And, it’s important to recognize who is there because you’ve got somebody reaching from a place of resilience to help you back in. If you go home and you scream at your spouse, that’s not a person that’s going to help you pull you back into a place of resilience and regulation. At that point, you need to identify and say, I need to find a friend. Go reach out to your friend to help you and just share. Look, here’s what I’m feeling, and the friend’s going to say, well, tell me about it. And as we share again, that burden is going to be lightened and we’re going to get some feedback, probably, that says, wait a minute, it’s one event. It’s one thing that’s going on right now. And you know what the anxiety from this event is? What you are anticipating is going to happen in the future, which is guaranteed 100% wrong. Oh, I’m going to, it’s malpractice. And my insurance is going to go up. I’m going to get my license pulled. I’m going to, you know, the family’s going to be mad at me, you know, whatever. Those are things that are in the future that if, again, we have a trusted resource or friend, a connection that will sustain us, they can help pull us back to that reservoir of resilience so that we’re not out there paddling alone. So the sticky note on this is, you don’t have to do it alone. There’s somebody that’s going to be there for you, that will help you through those most difficult times. And that’s when you’re going to want to go into freeze and say, no, I don’t want to talk to anybody. I want to communicate. You have to have some sort of a ritual. To your point. I loved what you just said about rituals. You have to have a ritual that causes you to say, I am going to reach out in the time when I need it most. Because what happens with a lot of people is they reach for the bottle because that’s the easiest thing to grab. And now we’ve got an alcohol problem, we have a substance abuse problem. and when we want to avoid that. So what is that ritual that you put into place that automatically triggers. Right. For both. That when we’re trying to sustain ourselves and transition, that ritual is key. And I love the fact that you use that term ritual, because if it’s ingrained in us, it’s much more likely we’ll find ourselves back there more quickly. Find your trusted resource and reach out for help.

60 to 63% of physicians are feeling burnt out, according to survey

Dr. Jaime Seeman: I think that’s so interesting. You said the, lifeguard analogy, like you’re thinking, like you don’t want to be next to the other person, that’s like, also sinking, because, I mean, back to how we started the podcast, you know, what was it like? 60 to 60, 63% of physicians are feeling burnt out. So it’s like, even though you feel like you want to turn to your colleagues sometimes, like they may be drowning, too. So I feel like, you know, maybe we really need to start looking, you know, outside of our colleague circle for these people that can kind of bring us back into this regulation and resilience. Because I think we want to lean on our colleagues because we feel like they may understand what we’re going through, but I think we all may be dealing with our own struggles in that regard. That’s so interesting that you said, because I do feel like sometimes we watch our colleagues go through these bad situations and we try so desperately to build them back up. You are a good doctor, and you are, you know, and I think you can, you can say that to the cows. Come home. but, ah, sometimes these are just situations that you really have to trudge through. And, that, that, was really helpful for me, Ted, to even to hear that, because I think that we could do so much better, within our own professions. You know, it’s.

Ted Paulsen: Yeah. And, you know, one of the, one of the things to do in the profession too, right, is because colleagues can be just huge supports. They’re great support mechanisms. It’s important to identify somebody who’s a good listener, right? A good listener is somebody who is going to hear what you say and be reflective back. and that’s what counselors and therapists are so good at, right? They’re trained listeners so that they’re not just immediately jumping in. And what happens a lot of times with colleagues is, as you say, they do want to provide that. They think, well, the support I can give is to bolster and to build and say, yeah, you know, you’re all that. Where it’s, no, let the feelings come out, let them share them. And are we listening? We do an exercise on the five b’s of listening that I won’t get into. Right? Of how we effectively listen. but what you say is important. We should be training our peers to be better listeners and not fixers. Because as trained medical professionals, everything that’s drummed into us is fix, fix, fix, fix, fix. And if we can’t fix, it’s like I’m a failure. It’s like, don’t equate that to listening. Just listen and be supportive and express love and support and hey, I’m here for you. And now that becomes an effective peer that you’re talking to, as opposed to the peer that says, yeah, yeah, I’m there with you. Oh, yeah, you know, yeah, my spouse sucks too. They don’t understand me and they don’t get, you know, that’s not good. So if that’s the kind of peer that you have, that’s the kind of appear to avoid, find the ones that listen and allow you to express yourself.

Dr. Jaime Seeman: And manage through your feelings, you know, that’s interesting. We definitely are fixers, but one thing they do teach you in medical school is to listen to the patient and just keep listening to the patient because eventually the patient will give you the diagnosis. And I think, like I said, you know, they’ve really kind of, you know, squeezed us in the sense of, you get these ten to 15 minutes office visits, it’s like checkbox, checkbox. Now we have electronic medical records. It’s taking us away from the patient. Got to check all the boxes, gotta click all the buttons and sign all the charts. And I think sometimes as a doctor, one thing I try to do is I just, I try to just, I don’t take my laptop in the room. I’m, I’m the chicken scratch on paper still, because I feel like it just allows me to sit there and just kind of listen to the patient. And I find sometimes the patients come in and they just want to be heard, you know, I don’t even have something to offer them. But I think just as humans in general, it’s something that we’re not all good at, great at, even myself, you know, sometimes. But one of my greatest mentors really said, the one skill you have to learn to be successful in this world is listening without judgment, which is really hard to do. You know, one thing just to hear it, but, but to not give back that, well, now, here’s my opinion about it. it’s a really hard skill. It’s a really hard skill.

Ted Paulsen: Well, I love that you, I love that you’ve pointed out that training, right? So if you just take that same training and just say, okay, I’m going to apply this in every conversation, particularly with colleagues, right, where maybe that conversation isn’t always the same. I love, I love that. What great training.

Dr. Jaime Seeman: Yeah. Well, I’ve learned a lot from my husband. Being in the police world, especially when it comes to parenting. That man has taught me so many de escalation techniques with our children not jumping in and being the fixer. Sometimes it’s just, you know, listening and, letting them come to solutions.

Ted Paulsen: Gol, if you can do it there, you can do it anywhere, right? I mean, that’s the hardest one.

Dr. Jaime Seeman: Yeah. Yeah. I always joked that, like, I was the, t Rex and he was the Easter bunny when it came to parenting. It was, He. He definitely taught me in that regard.

Critical incident stress management can help medical professionals deal with traumatic events

Ted, is there any other, examples that you can give us as medical professionals with this best, kind of framework that could assist us in just being better doctors and better humans?

Ted Paulsen: well, as you say, that one thing comes to mind, that I’ll pull over. That, they use in the first responder industry, sometimes effectively, sometimes not. But one of the things that you could use, and I don’t know whether you use it in the medical profession, and that is critical incident stress management or critical incident debriefing. So when something happens, right? And if something happens in the, in the operating room or something happens in the clinic or a nurse has something happen, a patient dies, what’s happening is that’s impacting the whole team. It doesn’t just impact one person, because, again, this connectivity and that, we’re all connected. So I’ll use an example. We did a debriefing in a first responder department where an officer had been shot and a suspect had been killed. And we had 16 officers in the room doing a debriefing. And every single one of them had a level of anxiety and stress that was associated with how they were involved with that incident. And there’s not one that’s more important than the other. It’s just recognizing that everybody suffers. So do you take the time when something happens and after the paperwork is filed or however you do this? Right. How do you reach out to that person that’s suffering? And I’ll use another example that might not be directly medically related, but, it happens every single day. And that is, one of our colleagues loses somebody to suicide. And how do we process that? Well, what do you do within your environment? Do you have a peer support mechanism that goes into, that clicks into action, that says, hey, first thing we need to do is we need to check in with the person. How are you? Is there a spouse or partner family that we need to check in and say, hey, how can we support you? how do we support their coworkers who are engaged with that event of saying, hey, I don’t even know what to do? And instead of having the whispers in the hallways of what happened or what are they thinking? Were they feeling, have a debriefing, have a professional clinician come in and do a debriefing when you have 5610 people in the room and just say, hey, what are your thoughts? And let’s explain exactly what happened. Here’s what happened, here’s how we’re dealing with it, here’s kind of the impact, here’s the people at home, we lost this patient and how are they dealing with it and how did we respond? Because that’s very therapeutic as well, to get everybody back in that reservoir of resilience at the same time so that it’s not. This person here’s a little bit here, this person here’s a little bit here, this person here’s a little bit there. But we’re actually taking kind of an affirmative, positive, upstream approach to saying, let’s get this on the table and manage it in a very effective way, not just for the legal and everything else stuff, but how are we managing the people involved in this circumstance? Because that doctor that makes a mistake or is perceived as having made a mistake, whoever’s in there, the nurse, is having similar feelings of, oh, what do I do? How do I manage this? How do I process? Let’s be aware of what’s going on in the community beyond just ourselves.

Dr. Jaime Seeman: Yeah, I think that we definitely did that in my medical training and I think it’s such an important thing for the team because, we can learn from experiences, even when they are bad, where we can improve. and I think it gives you that shared experience too. Kind of like hearing that maybe you’re not the only person that, you know, that has created angst and anxiety. and that connection too, just to be in a space and share. I love that, Ted. That’s definitely something that we did in our medical training. But honestly, years now, later, I don’t see it as much in the real world and I don’t know in the police world how much they do that. I’ve never asked my husband about that, but, I could see how valuable that could be in a bad situation.

Ted Paulsen: Yeah, a lot of departments use it. I think they could use it a lot more, obviously, but I’ll tell you that. And sometimes this doesn’t occur to people, but the person who is one of the people who is most deeply affected in the circumstance was the person who wasn’t there.

Dr. Jaime Seeman: Mmm.

Ted Paulsen: Because coulda, woulda, shoulda, you know, if only. And it’s, you’re so out of control. It’s like the analogy I use is when you’re driving your car, right? When you’re driving your car and you’ve got a spouse or partner, you got a friend, you can be driving crazy, and you’re always in control, and you feel, and the person next to you is white knuckling it because they don’t have any control. They don’t have that steering wheel in front of them. And sometimes we forget and we neglect those people that we think, well, you weren’t even here. You weren’t even on duty. What do you think? What do you mean? You’re stressed. Well, I feel bad because I wasn’t here supporting the team. Maybe I could have made a difference. There’s real psychological impact there, and for mental health and for keeping the team and keeping people engaged. It’s really something that’s very important to help avoiding that turnover and helping create that community.

Dr. Jaime Seeman: Yeah, I like that. I like that, Ted.

Two takeaways from this podcast

Okay, so we started the podcast talking about people taking home these sticky notes. So, if you could give our listeners two sticky notes to leap with, what would they be in regards to this vest framework?

Ted Paulsen: gosh, I’m going to leave them with this first sticky note, is understand the framework. Where am I? Where am I in this, am I regulated or dysregulated? Even if it’s just that simple question, right? A state of dysregulation, or out in these outer realms where, you know, you might not be dysregulated because you’re in those realms wholly. But just understanding basic principles of that diagram of where am I in this moment? So that self check in that we talked about would be really key. I really like that. and the other one, I’m going to use your term, what’s my ritual? What’s my ritual for putting this into my daily life so that it becomes routine, so it catches me when I’m not looking. And what I mean by that, when I say catches me when I’m not looking, is sometimes we’re not doing what we need to do to create that foundation of resilience. And if you have that ritual and you say, you know what, I’m going to spend my five minutes in meditation or mindfulness. I’m going to spend the time and make sure that I eat something healthy today. So those would be my two takeaways, is understand the framework, create ritual.

Dr. Jaime Seeman: I love that. I love that. I, was reflecting, as you were saying, that back to when I was a medical student, I went to a small town here in Nebraska to do a rotation. And, it was an orthopedic office. And I’ll never forget this before the clinic started, right? Everyone’s busy. You got the check in lady at the front desk, there’s a nurse, there’s a doctor. Here I am the medical student. The doctor summons literally everybody in the clinic. It was like the front desk, the nurse, everybody. And they did this prayer before clinic started, and I’ll never forget it, but it was like a way for just the whole office to kind of connect. It was this ceremony, it was this ritual, and then everybody, like, went about their business. And I just think we’re all kind of driving in our own lanes at our own speed so much in life. And, I’m going to really, I’m going to start to think about this more, Ted, this has been, this has been so fun and so enlightening, even for, for me. So I know our listeners are going to take some, some sticky notes, for sure. Ted, how can people, if they’re interested in this best framework and, you know, eAp services, how does somebody find you and, and the work that you do?

Ted Paulsen: Well, the easiest way is just to go online. It’s vestee ap.com is the easiest way. And, I’m Ted Paulsen on LinkedIn. I love to connect to people, love, to, connect with communities, as well. So those are some ways that they can, connect in and find out a little bit more about what we do and see some of the training and stuff that we’ve developed and put out there.

Dr. Jaime Seeman: Fantastic. Thanks, Ted, so much.

Ted Paulsen: Doctor Seeman, thank you. I appreciate, great questions. I love what you’re doing here, and I love your approach to medicine, just from the short time that we’ve been talking here. And I greatly value, the service that our medical health professionals provide. And unfortunately, I use too many of their services, particularly the orthopedic surgeons and stuff. but I very much value what they do, particularly with the things that my parents have gone through and loved ones with cancer and other things. Right. It’s a such an important profession and industry. And thank you for all you do.

Dr. Jaime Seeman: We gotta take care of our healers, that’s for sure. Thanks, everybody, for listening. Thank you guys for listening to today’s episode of The Strong MD podcast. I hope you took those little sticky notes and you can put them on your desk or your refrigerator in your car, start incorporating those rituals and ceremonies in your life. And a few more check ins, if you guys wouldn’t mind. Of course. Leave us your reviews, your comments. Share this with all your medical professional friends who might find it helpful. We appreciate you guys so much, and we’ll catch you on the next episode.