Burnout in weight loss with Dr Karen Leitner

Hello lovely ladies. Welcome to the podcast, today I have an amazing guest for you, I have my dear friend and fellow colleague, Dr. Karen Leitner!

Karen is an amazing coach, and instead of me doing all the introduction, I'm just gonna let her introduce herself so you can actually hear from her what she does and what we're gonna be talking about today.

Yay. I'm so excited to be here with you. So thank you Amruti, I am an internal medicine and pediatric trained physician, and I did primary care for a number of years, now I am full-time coaching physician women to help them feel better in their lives. I live in Boston, so we are across a big ocean, but that's what's been so fascinating about this coaching journey is just meeting people everywhere and seeing how universal our struggles are. I have three kids and a dog and I love to run, I love to sing and I love to talk about coaching and to help women feel better. So thank you so much for having me!

Yay. I did not know you love to sing. Oh my goodness. When we meet up in a few weeks, I am gonna like have to hear you sing.

Oh, gosh. Okay. I'll start practicing.

I love singing too but I love singing Bollywood songs and I'm not that good and I'm not trained or anything but we could sing together. That's so fun.

Well, send me one, if there's anyone with harmony and I'll learn it. I don't know if I even know any Bollywood songs.

Oh my gosh. We, we have to sing together. I love that. Okay. That was a tangent, but thank you so much for coming on the podcast.

I'm so honored to.

I know that you help physicians feel better and one of the things that you help them deal with is burnout. So what I thought would be a really, interesting thing to talk about today is how burnout shows up in your physician clients, but also in people in general and then, uh, how we I'll kind of like relate it to how it may show up in weight loss and how some of my clients can help deal with that. And then we can maybe talk about what kind of processes you use to help with burnout and what to do about it. How does that sound?

It sounds amazing. The first thing I wanted to say that I didn't get to tell you during our little pre-conversation is that for a lot of physicians, they do not want to talk about burnout. They don't like the term burnout because it seems like it's blaming them for some kind of personal failure, and so I think it's good to set the stage. And I think in, you know, like the burnout vernacular, like when we're just talking about burnout in a slang, you know, pop culture kind of way, it has a different connotation, but physicians are really tired of feeling like it's the system, that's the problem that's creating an untenable place for them to work and adding to so much of their discontent, which for sure it's a huge problem. And COVID and all of it, sort of the elephant in the room, but burnout specifically is like a clinical syndrome defined by the WHO. It has three tenets. One is emotional exhaustion, which we don't need to explain. The second is depersonalization or feeling kind of a disconnect, or we can describe it as like a loss of empathy. So you're sitting with a patient they're telling you something terrible, and you went into medicine cuz you wanted to help them. And you wanted to care about them. And you're sitting there being like, what about me right now? Like, you're overwhelmed, exhausted. Like, that's how I feel too. Like, it's just an inability to sort of have those caring kind feelings. And then the third piece is loss of personal, like efficacy. Feeling like nothing I do matters. What is the point? And it can be the end result of being exposed to, you know, a healthcare system that doesn't allow you to show up the way you want to and feeling like so much is out of your control. So that's, I forget if that was the question, but that's how I defined and burnout. What did you ask me?

I can't remember exactly what I asked, but that is so interesting because I think that shows up with a lot of my clients too. And even though that is the, you know, official definition, I think it shows up in so many of the professional women that we coach, right? Like, the first one, remind me it was emotional exhaustion, wasn't it?

Yeah.

Yeah. So I find that with my clients, it's the same thing. So they're on a journey to lose weight, but they are actually emotionally exhausted. They are doing all the things, they are juggling all the hats. They're so successful in other areas of their life, but they are just exhausted with doing things for everyone else and not doing things for themselves. And they're tired. And so then they numb it out with food. They use the food to actually make themselves feel better. I think the other thing that you said, the second one was the depersonalisation, right? And having not as much empathy for everyone else. And so I think how it shows up for a lot of the people that I coach is that they don't have that empathy for themselves. Right? They are so kind and empathetic and lovely to everyone else. But when it comes to themselves, it's kind of like, they're the complete opposite, right? They're just so judgmental, harsh and critical of themselves. And they just think that's the norm. They think that actually that is gonna make them better. They think that when I'm so critical of myself, that will push me to keep doing all the things, right? And keep being successful. Because this is what's got them to success in their eyes so far. Right? And the third one, remind me of what the third one was.

Can I just comment on the second one real briefly?

Yeah, sure. Well, what is coming up for me now and listening to you is it's sort of like, sadly, unfortunately, or just as a fact, the lack of empathy for ourselves. To me, I think it's separate from burnout. I'm sure burnout makes it worse but that's just kind of like a baseline from what I notice from women as we are socialised in general. It's like we are the caregivers. We are the helpers. We do everything for everyone else. But when it comes to us, our internal monologue is like self critical, not doing a good enough job, I'm faking everything. Right? So that's just like, that's not even burnout, that's just always there. And then what happens in burnout though? It's like, we're used to be able to be so feeling and so caring for people outside of us. And now we're not even caring about them either. Um, so that'd be really interesting to sort of talk about like, yeah, we just, women have critical inner voices and we are much less likely to have empathy for ourselves than we are others.

Sure.

You use this all the time. But so often I'm asking my clients like, well, how would you talk to your best friend if she was going through this? Because the voice we use is so different. Right? We're so loving towards her. And then towards ourselves, we're like, what's the matter, pull it together.

I use the same thing with like children, so I'm like, okay, how would you speak to your child about this? Um, or your best friend and, and it's completely different voice. So I completely hear what you're saying.

Yeah.

And then it's so interesting as women are like, then we're like really negative about how self critical we are then we're like, I know it's terrible. I'm so critical of myself.

So critical. We're oh my gosh. There's so many layers. Yeah. Um, but the third piece was the, lack of agency, lack of efficacy, feeling like nothing I do matters. What's the point? What's the point of me? What am I even doing? Why bother, you know?

Yeah. And that shows up all the time with my clients in the sense that they are doing so many things, but they don't feel valued and they're expecting other people to value them because they're showing up with wanting to do things to seek approval from others. But actually the real problem is that they're not approving of their own selves. And so when they're not doing that, when they're doing so much, they often go to the food to numb it out. And also when they're doing so much in their weight loss journey, they think, oh, do you know what effort? Let me just eat all the foods. And that's when a lot of the kind of binge eating behaviors and things come up and overeats and things like that. So, yeah, it shows up so often.

Yeah, because I'm just thinking from what you said, like, you have to believe that it's even possible for you to lose weight for you to keep doing all the things you're doing. And if you don't even believe that, and you're like, what's the point anyway, I'm never going to be able to then if that thought is in there, it's like total sabotage.

Yeah. And that's how it often starts, off isn't it? Like when they've been losing weight in the past, what they've been doing is focusing on the actions. I need to eat this. I need to do this exercise. When they start the mind management, they also think I need to do these mind management tools. Like, you know, do a thought download or, keep a food diary or whatever it is. Right? So they focus on the actions and the actions are great, but they're not the things that are gonna create the results. Right? It's our thoughts that create our results. So if they're thinking I'm never gonna be able to get there, they're feeling disheartened and they're still taking those actions. It's just never gonna be sustainable for them. So they'll lose weight a little bit, and then they'll just gain it all back because the thinking catches up with them. So that's how it shows up with my people.

Yeah. And it's always the thoughts, right? I think for physicians, it's like we're doers too. We're like just tell me what to do. I'll do it. Tell me how to exactly. How do I do my charts? So they're gonna get done. So they're not like a hundred in my inbox. I think there's a lot of parallel between weight, considering yourself overweight and like having all those charts and all that paperwork and all that stuff follow you around. And you think you need to just be doing all the things for that not to be the case, but it's actually, you have to be thinking differently to get those charts down.

And it sounds a little bit like, like general avoidance behavior, right? It's like, you want to, you want to lose the weight, you want to do the charts, but we end up kind of like avoiding it because it's just too painful to deal with the disappointment that we are gonna feel when we don't do it. Right? Okay. So it's kind of like all that avoidance behavior. And I've noticed even when I was a physician, I used to do the same thing. I used to leave all of my notes till the end, and then feel overwhelmed and, you know, constantly be thinking I'm not doing enough. And I was always the doctor who used to spend way longer with my patients, because I was want to do more and more and more. And it was just always at the expense of myself because it's because I wasn't believing I was doing enough. And so I would constantly be doing that. Right?

Yeah. And it's like, we think that doing more is helping the patient. But it's not because what happens is we get overwhelmed and then we're stressed out, and then we're less present and less listening and more scattered and more likely to make a mistake and all these things. So it's, you know, it's just finding those errors in our thinking.

Yeah.

If you don't stop and really analyze them, you're like, why do I have to feel differently? I just need to stop eating all the food. It's like, you're eating cause of the feeling you're having cuz of the thoughts you're having. Yeah. Work backwards. Yeah.

Yes, exactly that. So even though it feels much more productive for a lot of my clients to change their eating and you know, do a thought download. That's still an action. So that will only be sustainable when we are changing our thinking and our feelings to fuel that and make it sustainable. Right? Okay. That is awesome. So what I wanted to ask you is how does it show up for you and how does it show up for your clients?

That's a great question. So, you know, I did primary care and I always wanted to take care of families and I was super excited to do it, even though I found it very stressful to go through training and be responsible for so much. I think I jumped in and put everything into work too much and like didn't have boundaries, didn't have self-belief, self-confidence. And then when I added having babies into the mix and then had all that pressure I put on myself to be a good mom. I'm sure this is like every working woman story. I found the way it showed up for me, and I didn't even know that this was burnout, but I just felt less and less. I felt like I was drowning. I felt like I was not doing a good job with anyone. Whereas if you asked my boss they're like, no, she's totally fine. Great, great doctor. Everyone loves her. If you ask my husband or my parents, or my friends, they'd be like, you're a good mom. What's the problem? But in my own mind, it was just, I can't do it. It's too much. I'm letting everyone down. I just started to feel this like stuck, stressed out. All these anxious feelings. And I remember being on vacation. I think I had two, I have three daughters now, but I, my second one was little and I was like at the buffet on vacation, you know, when you're holding a kid and it's a buffet and you're trying to get food for two, like, and then she was like shoving all these Cheerios down my shirt. And I just remember thinking I was so scared to come back to work, cuz it was just all, it felt like this huge wave of like, what if a patient died? What if someone was mad at me? What about all those messages? And I just felt like I cannot keep doing this. Like I have to stop, but I think, you know, when I left my job, I thought it was my job that was doing it for me. And so I left and I found someone to take over for me, and then I had another child and I realised when I didn't have the job, a lot of those thoughts were still there. Now I had free time or I had a job where I worked from home. It was way more flexible. I could be with my kids more. I could go to the gym, I could like take guitar lessons. And I still felt like I'm not enough. And I felt so much worse about it. Cuz I was like, what is wrong with me, you know? And so I dunno if that was burnout anymore. Like the burnout piece I feel like is that it never occurred to me that the system contributed to me feeling the way I felt it was just like a personal, I felt like, there's something wrong with me. I can't keep up with this. It must be me. I failed somehow. And there was like a lot of shame about that. So I never asked for help. I never talked to anyone. I didn't. I mean, I, I had a coach briefly but what I wanted her to tell me was just like, what's the job I should do that will fix this problem. And she, she wouldn't tell me that. And I was like, what good are you? I'm gonna go find it myself. So, um, so I don't know, that's sort of my burnout journey and like coaching really helped me realise that when I start to work on my thoughts, everything else changes.

Isn't it interesting, because that's the power of changing your thoughts? Like this happens with my clients all the time when they were like, no, no, just tell me what to do. I mean, I can do that, but what works for me isn't gonna be what works for you. Right? And so it's like, how can we change your thinking and empower you to find what works for you? Because only you know really what's gonna work for you. I had this one client, she's a physician as well, and she was going through some exams and she was working for her Obs and Gyny exams. And she was like, you know, gonna become a consultant. And they were the last exams she had to do. And she was really stressed. She's like a mom of, I think, three or four children. And she was like really, really stressed. And she's like, Amruti, as soon as the exam is over, I'll be fine. It will all be okay and it will all be fine. And I kept telling her when you change the circumstance, that's not gonna change how you feel, unless you change your thinking about it. And we worked through it, but she was still stuck on no, no, when the exam is over and when the exam was over, she said, Amruti, now I'm stressed about being the consultant on call, you know, I was like, yeah. Right? So it does carry forward. It does keep going with you until you change the underlying thoughts that are creating that for you, right?

Yeah. That makes me think of like the analogy of just like the worry pocket, you know, like you're gonna have something else to put in your worry pocket, unless you start looking at, like, why do I have a worry pocket? Do I want a worry pocket? What am I thinking that's creating it for me? The other, you know, when you were asking me, like, how does it show up for my patients? I, cuz I think it's a hard concept sometimes. Like we talk all the time about how your thoughts create your feelings. Just like, what does that even mean? I've had several clients, so many of my clients where they'll come in feeling like the work I'm doing doesn't matter. And here's an example. I had a client who is a, you know, a gastroenterologist or something. She goes to work and it's like, it's the same thing every day, you know, I'm just telling them whatever, like I'm not, I'm not like curing cancer. I'm not like operating and saving lives. I'm just going in. And it's that way of thinking about yourself and undervaluing yourself and minimizing your value creates kinda like blah, about your job. And when I was able to say to her, like, like every patient, you help. Every person you're kind to in the world, if you really just embrace that, I'm making a difference for this person. I have the potential to change their experience with their life. I'm listening to them and being kind to them, especially when we're so disconnected. And COVID, everyone's so like, people are crazy right now. Everyone's so isolated, the mental health problems, even just being fully present for another person and listening to them and being kind to them and like, relieving some of their medical insecurity is so important. Yeah. And we just diminish it. Like it's nothing. Oh yeah. There's another, friend I have, who's like an urgent care physician who is doing COVID tests all day, all day, all day. And she was like, what's the point of this? Like 150 COVID tests, you know, what a waste of my education. I'm like, do you know how scary it is to think you might have COVID to not be able to get in there to just see someone who's like, I'm on it. I'm like, so it's just how you think about what you do. You can have so much power to, and it's not about just being like, I'm amazing. I'm wonderful, but yeah. It comes from this feeling of like, I'm not enough, I'm not valuable, what I do doesn't matter.

I've just got so much to say about this. My clients are exactly the same, right? It's like, They're so successful in so many other areas of their life. So they have this thought that I have to be successful here too. So even when they are having success, They diminish it because they may not see the scale moving. They may say, well, no. Okay, fine. I'm feeling a bit better, but I don't see the scale moving. So it's basically like when they're already thinking that they're not enough, anything that they do is not gonna be enough. Even if they get to their goal weight, Then it's gonna be something else is not enough. So when they're on this hamster wheel of not enough, I need to do more, not enough. I need to do more, not enough. I need to do more...then when they're not solving for the not enoughness and actually, you know, changing the way they're thinking about that, then they're constantly gonna be seeing their life through that lens. What I often say to them. A lot of who I coach are, are mothers. So they're often working mothers, not, not exclusively, but, um, a lot of them are mothers. And so when they think about the impact that they have on their child, they just kind of normally like, they undermine it, like, this is just the norm. I should be doing this. I should be doing that. But when we talk about like one, an experience where they have helped their child with something that they were struggling with, or they have cuddled them in the night when they're having a nightmare, instead of actually just thinking, do you know what I'm doing well at this? Or that was something really nice that I did, instead of like doing that when they're used to thinking that they're not enough, they'll just look for all of that evidence and, and just disregard any of the good things or the positive things that they're doing. So what we do in coaching is try and remind them of all the other bits as well. So it's kind of like trying to equalize things. So all the negative thoughts are up here. So we try tone down the, volume on that and, and increase the volume on some of the good things that they're doing that they're already doing, but that they don't even realize, right?

Yeah, because what is enough? Right? Like it's a choice you make. Like this was one of the biggest impacts that coaching had on me. I just remember, this idea of like being born worthy, just being born worthy. Everyone is born worthy. It's just a given there's nothing to do with like how much you do, how much you weigh or don't weigh, how much you work. If you're like a Nobel prize winner. If you're like a janitor. Like we would never look at all the other people and say, well, that person's enough. And that person's not enough. When you just choose to believe you're enough. It's like, you know, most of the time when we ask women like, well what is a good doctor? Like really? What is a good doctor? Cause like our brain is like, well, a good doctor has all their charts done and everyone likes them and no one ever complains. And it's the same with moms. Like what is a good mom? Like what does that even mean? Or our brain is just sort of. Programmed to tell us, cause it keeps us motivated, you know.

And also it's unrealistic right when we decide, okay, this is a good mom. You know, she always looks after her children. She always does this. She always does that. When you actually think about that, it's that realistic? Probably not. Do you know anyone who's like that? Probably not. Right. So we have this idealistic expectation of this is how I should be. And so constantly we're just gonna keep disappointing ourselves, right? Because we're like, I'm not living up to that ideal that I think everyone else is. But actually when I really like question myself, no one is actually there. So like just kind of like having that more realistic expectation and also accepting our flaws. I really struggled with my clumsiness or quite a clumsy person. I'm always dropping things when I'm cooking.

Oh, I love that. My best friend calls me rag doll, all like arms and legs and yeah.

And I'll like walk into things and my husband's like, oh, there you go again. You know, when I, when he hears a thud or something, he's like, oh, Amruti walked into something. I'm like, yeah. And so now, like before I used to be really like, oh my gosh, I shouldn't be doing this. What am I like? You know, what's wrong with me?

Yeah.

Yeah. And now I'm like, do you know what - I'm clumsy. And I'm proud. I love that I'm clumsy. It's something about me that I'm embracing. And you know what, when I accept that about me, rather than beat myself up, it's just so much more loving. It's so much more chilled and I can love  it now. And it's like, so freeing from what I used to be like of this perfectionistic mom, wife, doctor, coach, you know, just being like, you know what? Yeah. Sometimes I'm goofy and I laugh at my own jokes, you know, and sometimes I drop things it's just so much more freeing. So when we can enable ourselves to be like that, that's when I felt like I was able help my clients with that so much more and embrace some of the things that they don't like about themselves. I just laugh about them sometimes. Right?

Yeah. I mean, Because I just think about. You can't beat yourself into being a good, anything. You can't, you can't beat yourself to lose weight. You can't beat yourself to be a good mom. Cause then what happens is you're like telling yourself you're terrible all the time, and then you're upset about it. You're irritable, you're critical. You're frustrated, you're stressed. And then you're that much more likely to like blow up at your kids or your partner or whoever. So it's not even just. We all should love ourselves. We should. I mean, what should means? Like, we, it's a better experience for us when we're able to, but it also, we show up so differently and that aligns much more with like this vision we have for ourselves. And it feels so much nicer to ourselves as well.

Right. Wow. Okay. Awesome. So what I wanted to do now is I wanted to think about what kinda tools, well, firstly, we've talked about how burnout can show up, but how can we start solving for burnout? So what kind of things do you help your clients with? And then I'll jump in and add to it with mine. So what kind of things do you help your clients with when burnout shows up for them?

I mean, we've addressed already this idea of self-compassion and like stop beating ourselves up all the time. But I think one of the most powerful ways that coaching helps them is to restore their own sense of control over their lives. Like so much of the kind thinking we do inside our minds is like, I don't have the power to change any of it. I'm stuck. I can't leave or I can't talk to my boss or it can't be different because everything outside of us is the way it is. Like we blame how we feel on all the things I talked about in the beginning of the conversation that are problematic, but sort of showing my clients that within that framework, there is a, a lot about how they're thinking in their day that is making their experience worse for them and sort of giving them back that control, so it is thought work and, you know, it's changing your thoughts and it can sound, woo, woo . Or even I call it, or I guess Katrina called it - woo adjacent - but it really changes for them. They just start to be like, oh, what if I could speak up in that way? What if I could get through my day and get all my charts done. What if I could ask for a raise? What if I could look for another job? What if I could speak to, you know, it's just opening up that possibility that they've been telling themselves this is how it is and I don't have control. And suddenly now there's so many places you can have control when you learn the skills of thought management and emotional regulation and self compassion.

Yeah. So how can like the listeners actually put this into practice in their everyday lives?

Well, they have to learn how to start to be the watchers and the observers of their own day to day and notice their thoughts. I mean, that's where it all starts. So when you're asking me how that's like the a yeah, they, they should find coaching or they should start listening to some of the podcasts. Ask me it in a different way.

Hmm. So if someone's listening to this podcast and is thinking, yes, I think that sounds like me. What can I start? Yeah, it's gonna be an action, but what can I start doing that will help me with this even, and if it's changing the way I'm thinking, but what other things can I start doing to stop, noticing and changing the way I show up?

I would start with noticing the way we talk to ourselves inside our mind and realising that's not actually who we are because who is noticing all those thoughts. Right? There's like the thoughts that just go on like a little rattle. Like I need to do this and I need to do this. And I have this and this, and I did that wrong and I did that wrong and I look ugly today and right? It's noticing. It's even recognising those are thoughts that are what your brain is thinking, and deciding if you want to be thinking those things, start asking yourself. Is that true? Do I wanna be thinking that, why am I thinking that? Do I wanna be talking to myself in that way? How might I speak to someone in a more kind and gentle way? So I think that's where I would start. Yeah. Like you can be kinder to yourself if you don't even realise that you're being yourself.

Yeah. That's, that's what I do with my, my clients as well. So what we start off with is awareness. So, oh, there I go again. So even just naming it, I'm feeling this emotion and then like, narrating it in their brain. So I'm feeling this because what am I thinking? So just I'm feeling this because I'm thinking this thought, so then it helps them detach from, this is me and there's something wrong with me. And they, as you were saying, become a watcher of their own brain, right. Because they see, oh, it's not because I'm wrong. It's because my brain is thinking this thought, and this is making me feel this way. Right? So we start off with awareness and then acceptance that, okay, this is how it is right now. And then kind of questioning, do I actually want to carry on thinking this? Do I actually like the results that it's creating for me and how can I be okay with that that's what's going on? How can I accept that? And then decide, is there something that I want to believe that seems like even 1% better than what I'm believing right now? Cause it doesn't need to go from, I hate my body to, I love my body. It could just be something in between. It could just be okay, 1% better. Maybe I like this about my body. Some of my clients even struggle to say even one thing that's good about their bodies, but just finding the one thing that they are accepting of as opposed to they love. Right? And so just 1% better is, enough. And the main thing that we talk about in weight loss coaching is feeling your emotions, right? Because when you are able to feel anything that comes up when you're able to check in with your body, when you're able to kind of, accept that this is how you're feeling right now and not try and push it away or avoid it and use food or social media or, you know, TV or anything to make it better. Then that is like the root of, of, of all of this. Right. Because it's that true? Acceptance. So that's what we do and oh, and questioning anything that comes up. Right? So when your brain says, oh, you know, it's just because you're not a good enough mom, or when it says you're not being a good enough wife when you are, or partner, when you are doing this, just being like, okay, brain, how is the opposite true? Or how can that not be true? So just like questioning some of that rather than accepting it all as the truth.

Okay. First of all, I love listening to you talk so much. Every time you say the word body, I just like, it's like my favorite word. I'm gonna have you say it like over and over. And again, I you're gonna have to teach me how to say it. It just sounds so sweet. I hope it's okay that I said that.

I remember you telling me about what you watching, the British bakeoff, right. And you loving the accent and then you're like, whatever I have called with you you're like I always love your accent. I'm the same with you, Karen, because I love the American accent too. And because obviously you coach like, you know, mainly the US and stuff. I know you're worldwide, but like mainly the US you're used to the accent and stuff. So like it's the feeling is mutual. I love your accent.

I feel like I will love my body more if I just call it a body.

I love that.

OK. But the very first thing you said, you gave this lovely explanation of the full process. How do we make all this change? But the very first step is like name the emotion. And I think it's really interesting that I'm assuming - tell me if this is true - people who are eating more than they want to, or people who really wanna be losing weight. You talked about it's like the food serves to help them not feel the emotion. With physicians we can't even get to step one. What am I feeling? I have no idea. And there's reasons for it. I mean, so learning how to feel your feelings is like what you and I spend so much time doing, because it's actually our feelings that create everything in our lives. And we so don't realise it, but physicians, you know, it's like we are so thinking everything is up here in our brains. It's like, it's like this equation, this equation, this differential, this set of labs, whatever. And then you layer on the training we go through to try to turn off, you know, I'm tired. Forget that, you have to not pay attention to being tired. You can't pay attention to having to go to the bathroom. You can't pay attention to being hungry. Not that those are emotions, but I think in some ways we turn off or we try to bury an awareness of even how we feel as part of a way to survive in the job. Right? If you're like working on a crashing patient or something and you know, and it's a child, you cannot feel sadness in that moment or it gets in the way. So you just like don't allow yourself to, so I think for a lot of women that I coach they're like, I don't know how I'm feeling. But noticing those behaviours that we do to try to buffer. So for sure, like so many of us eat when we're feeling that way to try to feel better, instead of feeling the bad feeling or we drink, or we scroll on social media or we go on Netflix and watch, you know, Bridgeton or whatever we do, it's we do all those things to avoid feeling the feelings. And when we learn how to feel feelings more, we don't need to do all those things as much cuz we just have another way to manage what's driving us in the first place.

So often clients don't even like realise that that's what they're doing. They just think that this is the norm. When I get home, I have a glass of wine or when I've put the kids to bed that's when I watch three episodes of Netflix with my husband and we get out the crisps and the chocolate and that's when it happens. So It shows up as habits, but it's because like, remember actions are always created by, you know, thoughts and feelings. And so when we can actually really dig into that, it's normally my clients are like, um, struggling to feel bored or they don't want to feel deprived or they want to feel connected to their partners. And food is like what they've always done, especially in the south Asian culture. It's very much like, you Okay. Food means love or food means connection. So there's so much food everywhere. Right?

I know in Judaism too, I think in like many cultures.

Yeah, totally. I remember one of my, I, was, um, coaching a lady from Israel and she said, um, food shows love. So I can, I can definitely, understand that it's in most cultures as well. And so often it's due to an emotion. Well, all the time it's due to an emotion, but we're not taught really to learn about our emotions like I got told, growing up, not particularly from my, my parents, but from society, you don't feel your emotions that makes you weak. You don't talk about them. That makes you soft. You want to be strong. You want to just get on with things. And so that's the culture that we grew up in, right. That you just get on with things, you just push it away.

Right? Suck it up. don't be a human being. Don't feel sad. Don't take a minute. Just like soldier on, you know?

Yeah. And we often do that as mums as well. Don't we like, you know, sometimes, we are having to deal with a lot of emotion, but we just have to, we try and be the strong ones. Like I had this one client who was dealing with some grief and she was like the strong one for the whole family. And we really coached on how can she actually be the strong one for herself first and actually feel her emotions first and, you know, look after herself first so that she can then be the strong person she wanted to be for her family. And that normally doesn't come naturally to us because we think we're gonna put ourselves last on the list. Right. It's gonna be first my children, then my patients, then my family then the neighbour then like everyone else. And then okay. If we have time, eh, well I'm too tired. So let me go and overeat. Right? Because there's just no process.

Yeah. So how do you get your clients to put themselves higher on that list?

So often what we do is we start off with like, they often come in they're last on the list, but they have that, from reading my emails or, you know, watching webinars, listening to the podcast, they have that possibility. They like really, their deepest desire is to be kinder to themselves. And even if they don't articulate it like that, they say things like, you know what? I really just want to stop being so critical of myself or I really wanna get things done or I really wanna just enjoy myself or I really wanna just lose the weight and not be so critical. So what we work on is the thoughts that they have about themselves. And normally it always comes down to, I'm not doing enough. I'm not good enough. I am unworthy, all of those underlying thoughts. So. Even though we work on weight loss, the underlying thing is the thoughts that they're having about themselves. Right? So if they're constantly thinking they're not enough, they're not enough, they're not enough then whatever they do in their weight loss journey, they're gonna have that same thought going through. So we work on how are they enough? How are they? Because often when I say you're a hundred percent worthy, they don't believe me. They're just like, yeah. Right. Okay. I don't believe it. So we work on that thought, but we look for little wins along the way. They may not see the, the wins on the scale straight away. I mean, a lot of them do, they lose a tremendous amount of weight, but a lot of the time they'll see wins in other ways, they'll start feeling calmer, their clothes will be fitting loose, their measurements will change. They'll look at themselves in the mirror and not think I hate the way I look. They may, you know, want to put some lipstick on because they want to be getting dressed up. They may not feel shy getting naked in front of their partner. So many other little wins along the way that we highlight and that we really celebrate. And so when they are then able to build on that, then it's much easier for them to access those thoughts when they're struggling. It's kind of like a ladder process. We just kind of keep laddering it up.

Yeah. You know what it makes me think about when people ask what a life coach is and it's like, there's so many misconceptions about what a life coach is like, is it a friend you pay? Is it just someone tells you how to live your life, but in hearing you talk about it, what comes up for me is sort of like everyone is so much in their own experience of being human being. They just don't even realise that so many of the things they think and feel that we are embarrassed to even share with anyone are like ubiquitous. It makes me, I, I think about you're a physician in practice and everyone comes in and they're like, oh, I'm sorry, my toes or toenails are like, I didn't, I don't know.  You're just like, no, you're human. Everyone has toenails. Yes. And it's fine.

Oh my gosh. That reminds me of, I'm using a super dad mug right now. I'm human because I like all my other mugs are in, in the dishwasher. So I'm kinda like really loving my husband's super dad mug. And I'm just like, yeah, I'm super dad, you know, like just, it's just about yeah. Being human and just being like, I don't need to apologize for that. I can actually just accept things and just be okay.

Now we know all the thoughts people are having, you know, we just understand what are going on in those human brains. And we just get to sit with a person and be like, yeah, of course, like we can talk about this. This actually isn't a problem that has to do with you inherently, this is a way you think. It's like most other people also think, and here's how you can think differently.

Yeah.

So I think bringing it back to, my story about burnout when I was like, oh, something's wrong with me that I can't do this. And then it was just learning like, nope, nothing's wrong with me? My brain just defaults to a certain way of thinking. And sometimes that's wonderful and sometimes it really doesn't help me at all. Like, let me look at trying to think a different way. So that I just feel differently about myself and everything changes when you learn how to do that. So I just love, like how you just outlined how you do it. it's like very clear. Um, but little, little baby steps. Yeah. Like breaking down little thoughts that are in our way. We just decide, oh, I, I don't have to keep thinking that I don't have to think this. Right. We think the thoughts that we are given inside our brain, we have to think them, they are truth. And it's just, what is we get to be like, oh, I don't have to think that

Yeah. And I get so much freedom there. Yeah, I get to choose. And a lot of my clients struggle with, what do you mean? My thoughts are my choice. They're like, no, they just happen to me. So even just breaking that down and even just making them aware that not everyone in the whole world thinks that that thought about what's happening right now.

Right. Um, and so like, for example, when the scale goes up, A lot of people would, would be like, eh, no big deal. Like I'm doing, doing all the things that I want to do. I'm feeling better. No big deal. It will go down. And some people are like, oh my gosh, the scale's gone up! You know? So it's kinda just like, just making them realise that actually they, they don't have to think this way if they don't want to. And just giving them that, that ownership back makes them feel so powerful. Cuz they're like, wait, what? It is actually in my power, how I feel. Oh my. So then that's when the like momentum starts building. Take that responsibility. And they're like, okay, if I've been thinking so many horrible things about myself, I can equally think fun things about myself and accept myself.

Right? Yeah. And like the two other ways I like to think about it. One is like, our thoughts are just, they're volume dials in our mind. So you can never totally throw away a thought, like, if your thought is you're not worthy or you're not enough, like that's gonna be there. But instead of having it be like full blast volume, you're listening to it. And you're like, you're just like, what if I just turn it down a little? What if I turn up a little, like, there's lots of things that I do in my life that I, that I love, or even, I like to tell my clients sometimes like, the person who gets on the scale and is like, oh my God, right? Like that's a movie that they have watched a thousand times. Yes. Like let's put on the movie where this means the end of the world. This means I'm never gonna lose weight. Now I beat myself up. Everything is terrible. I feel bad for a while. Then I go eat two buckets of ice cream. Like we've watched that movie so many times. Did you know there's another movie? Why don't we plug in the one that's like. Huh. I wonder why that happened today. Mm. I wonder what's going on? We think the same thoughts and we think they're true when they're just like a version of something that we've listened to and thought over and over again. And there's lots of other ways we could choose to think about it and that'll get us unstuck.

I love that. What an amazing way to start closing out this conversation. Karen, do you have any last bits that you wanna impart all that amazing knowledge that you have to the listeners?

Okay. This is one of my favourite things. Like, I don't know if this is my trademark, but I think so much of the time we spend thinking about what other people are gonna think about us, right? From the time we're very young, like my daughter woke up and she had a rash on her face today and it was like, the world was ending cuz she was like, everyone is gonna be thinking this thing. And I love to just question that and just be like, when I'm freaking out about something, right. Like, oh my god, I'm up at this meeting two minutes late and everyone else is already here. Right. And they're gonna think something, just get to be like. No one cares Like no one cares. No one cares if you bring your kid to school late, no one cares if you get a second helping of mashed potatoes, no one cares. if my kids' hair's unbrushed like I care and it's normal to think that everyone cares. But in reality, like no one really cares.

Oh my gosh, I love that. Yeah. that is brilliant. So everyone listening, when you overeat and you're thinking everyone's gonna think everything about you? No one cares actually, cause they're in their own head worrying about what everyone is thinking about them. Karen, it's been such an honour to have you on the podcast. Thank you so much for coming and imparting all your knowledge on all the listeners. I'm sure everyone really loved the episode. And can you let the listeners know how they can get in touch with you if they wanted to find out more.

Yes. So I coach women physicians exclusively, and my website is www.karenleitnermd.com And I would love to hear from anybody and I, I mostly do group coaching for women physicians.

So amazing. And so I'll have Karen's details in the show notes, if you would like to contact her, and she's amazing so go and get coached with her!

Speak to you soon!