Melvin Varghese:
Hey, it's Melvin. Before we jump into today's podcast session, just wanted to take a moment to thank the team over at Alma for supporting today's podcast session. If you are a solo practitioner that wants to take insurance or you've been taking insurance and you're either frustrated with the reimbursement rates or just done with all of the administrative headaches of going through insurance, definitely encourage you to check out Alma. They handle all of that. And the best part is that you actually get reimbursed within two weeks of the appointment. You can learn more about Alma and the services that they provide over at SellingTheCouch.com forward slash Alma. SellingTheCouch.com forward slash Alma. Hey, it's Melvin. Before we jump into today's podcast session, just wanted to take a moment to say thank you from the bottom of my heart for taking the time to listen to this podcast and taking the time out of your day to listen. You know, when I launched this podcast back in 2015, it was done with a lot of fear, and a lot of uncertainty, and I just never realized the impact that it would have on so many. And for that, I'm just so humbled and so grateful. If you do find the podcast helpful, if you could do a small favor for me, which is to subscribe to the Selling the Couch podcast, the best way to do that is to go to sellingthecouch.com forward slash listen and subscribe on your favorite channel and on your favorite device.

Practically, this allows the podcast to be able to reach more people, for us to increase our download numbers, which also helps us to land bigger guests, so that we can serve you through these guest interviews. Have a wonderful day, and I hope that you enjoyed today's session. Hello, hello, welcome to today's session of Selling the Couch. I hope you're doing well, having an incredible day. So today's podcast is with Dr. Jesse Gold. Dr. Gold is the chief wellness officer at the University of Tennessee's health system, basically is in charge of five campuses, 59,000 students across these campuses, and Jesse actually recently wrote a book called How Do You Feel? One Doctor's Search for the Humanity in Medicine.

I wanted to have this conversation with Jesse because I feel like as clinicians, and Jesse is a trained psychiatrist, so I wanted to have this conversation because I feel like as clinicians, many of us, right, have realized this for a long time, and many of us are currently realizing, which is realizing, especially here in the US, how flawed the health care system is, and how do we exist as clinicians in the midst of this to do good work, yet And on another level, how do we sustain ourselves from a holistic perspective, not just self-care and mental health, but from a whole perspective? And that's the conversation that we're having today. Jessie made an error, which she will share more about. But basically, a patient that she had seen three weeks prior, she had a second session with this patient and completely forgot they had met the first time. And it led to Jessie realizing just how much she was teetering on the edge of burnout and all of those kinds of things and what she learned about herself and how do we do good work in the world and also prioritize self-care. I think you're gonna really love this conversation. I learned a lot as well. Here's my conversation with Dr. Jessie Gold from drjessiegold.com. Hey, Jessie, welcome to Selling the Couch.

Dr. Jessi Gold, MD:
Thank you so much for having me.

Melvin Varghese:
Goodness. I'm excited. Shout out to our mutual friend Tamara for connecting us and also the magic of LinkedIn. You know, I feel like, I don't know about you and LinkedIn, but my whole understanding of LinkedIn has always been, it's like job updates or I'm looking for a job. And it's interesting how it's like completely changing. I feel like in the last, I don't know, year and a half, two years.

Dr. Jessi Gold, MD:
I've never been a LinkedIn person. I was always a Twitter or, you know, the artist formerly known as Twitter person, but I feel like academics is sort of looking for a new space and that a lot of people have gone to LinkedIn for it because of kind of what you're saying, like that was a place for jobs and discussing some topics related to that. And then it was a natural transition maybe. So I have had a lot of academic friends kind of transition to LinkedIn. So I'm trying it. I'm not great at it, but I'm trying.

Melvin Varghese:
Yeah, listen, I feel like I'm in the crash test dummy phrase of LinkedIn as well, trying a bunch of different stuff. But you're right. I do feel like there's been a huge segment of folks that are either cross-posting on Twitter X or whatever it's being called these days and LinkedIn or just have shifted completely to LinkedIn. But Yeah, it's a cool platform. And I mean, you're doing so many amazing things. And even I thought a lot about like how to even guide our conversation. So you're the first chief wellness officer for the University of Tennessee system. That sounds like a both an amazing job and then kind of a fun job. And then could also be an extremely stressful job because there are five campuses, 59,000 students. So two part question on this. What's your favorite part of the job and what's been the most challenging?

Dr. Jessi Gold, MD:
Yeah, for your listeners, Tennessee's a really big state if you've never been there. So when we also talk about five schools, it's a lot of landmass. I think people don't realize how big of a state it is, but it is a pretty big state and all of the campuses are pretty spread out. But I have the unique job of being placed at the system, which means that I have this sort of coordinated approach to what's going on on all five for wellness defined really broadly. So we kind of use the eight domains definition, which is not just emotional or physical wellness, but is also financial, spiritual, occupational, social, right? So all these things intersecting to make well-being. And so what I get to talk about is the ways that the schools are doing well, the ways that the schools need help, the things that they're struggling across the board on. And I think my favorite thing is silo breaking. So academics is very, very siloed in any bit of academics. I come from a healthcare space as well, and it's pretty siloed there. And, you know, when you have five schools and each school has a bunch of different divisions doing a bunch of different things, all related to the same topic, my job is really to figure out like where the redundancies are, what students even understand, how to help students better understand navigating that process. And it's really fun to be like, these silos were not created for the user. And my job is to get rid of that. And it's not something you always get to do. And I feel very supported in it. And the most challenging bit is probably the scope. I think it's a big scope and it's hard to start even. I've been pretty mindful about really doing more of like a needs assessment and an assessment of where we are up front before trying to do anything new or put anything new in place. But that doesn't always feel, sexy is the wrong word, but that's what comes to mind to people when you're like, I'm going to spend a year getting all of our data on one page, you know, and be able to compare between schools. And so it's just a lot of information and a lot of directions you can go. And it can be pretty hard to know exactly where to start or where to lay your hat. And so that part can be challenging. And I mean, I guess I like that challenge too, but that would be the thing that if I was to tell you like the hardest thing about my job is for sure the scope.

Melvin Varghese:
Yeah, no, I'm so glad you outlined that because I was thinking even as you were sharing at a practical level, I mean, I'm sure you have the main University of Tennessee system, which I'm sure is huge. And then you probably have these, you know, these smaller campuses, but size wise, and even, I don't know, like staff wise, all that stuff is all different, right? So it's almost like you're having to do, I don't know, I would think like, five different like factors into play and

Dr. Jessi Gold, MD:
super different and the cultures are different too, right? So a tiny campus is going to have a really different culture than a big football-centered fraternity and sorority campus in the United States, right? So I think that can be really hard to know exactly what to do. And they all have their individual identities. And so my job is not ever to go change or do something completely like this campus because it's working there, but to see like common themes, how you support a smaller campus with the larger campus, how you keep their cultures the same, but kind of look at what the barriers are on each campus because of that, because a rural campus is going to have different approaches to mental health. and wellness, but particularly mental health than other campuses. And so understanding that is essential for people even going to seek out resources or ask for help, you know.

Melvin Varghese:
Yeah. You used the phrase silo breaking, which I just thought was such a wonderful phrase. You know, most of the listeners for STC are mental health providers. How have you navigated just silo breaking, particularly related to mental health? And then again, like you said, Tennessee broad, like all these different campuses, different cultures, like how have you thought about that or thinking about it?

Dr. Jessi Gold, MD:
Yeah. So, I mean, the mental health system is inherently broken and the breaking in all of the places that exist definitely contributes to people not getting help at different points along the way. So that is a silo in itself, just like navigating and understanding the system. You could create a system that works, like most campuses have a college counseling center with some therapists, some psychiatrists, some outreach folks, and they're doing a lot of work and working so, so hard. But, you know, getting people in and even understanding that is a whole process. Understanding, you know, for faculty and staff to know where to send people and when I think is a whole process. So that's another sort of silo in mental health, which is like people are most likely to present to their friends, their family. or a faculty or coach first, and a faculty or coach person is often not trained in mental health the same way we are for sure, but even just to know, okay, that's a warning sign, now I send them to here is an education and process in itself that affects the faculty and the staffs. own mental health, which is another kind of component there that often gets neglected. And so I think across the board, how do we talk about these topics and identify them? What do we like know about how to send people? Where are the breakdowns along the way? And then, you know, really important to me too, like our own mental health in the process. So not just faculty and staff, but the folks doing the work. So I think that it's really hard to be a college mental health provider. Sometimes the system there often is set up for short term therapy. And so you're really trying to get people in and get people out. And that's hard in itself when you're not necessarily trained like that and people are not coming in with these like perfect prescribed one issue to target problems. And so, you know, I think that can be pretty hard, especially in a resource poor environment for some students where you don't want to just send them to a community because there could really not be anything in the community, let alone a long wait list or maybe not as good as going to you. And so I think all of that contributes to because you have sort of like the school ecosystem, but it can only support so much. And so you do need to rely on what's going on in the cities or what could be going on virtually. And that creates even more layers of kind of complication and siloing, I guess you could say.

Melvin Varghese:
Yeah, it's fascinating. I mean, you know, a lot of my training was that I university counseling centers. And so I know at a real level, like the challenges of that short term therapy model and like referring out and all of the layers and layers that go into that. Thank you for articulating that. Wanted to shift a little bit. You're releasing your first book or I guess by the time this episode goes, it'll officially Well, I guess it's officially live. Congratulations. It's titled How Do You Feel? One Doctor's Search for Humanity in Medicine. What do you think makes it so hard to care for oneself, especially as a mental health provider, while also caring for others?

Dr. Jessi Gold, MD:
Yeah, I mean, I think it's a lot of reasons. I think one is just kind of the people that we are. So we enter the field prioritizing other people before we prioritize ourselves and often are writing these essays like I just want to do that to help people. Right. And so inherently at our core, we are focused on others before we are focused on ourselves. And I think training only makes that worse, because in lots of ways, training either tells you that you shouldn't have your own emotions and your own reactions, or tells you to sort of remove them as much as possible from the patient setting. Self-disclosure is not encouraged. Freud made that even worse by sort of saying we should be blank slates in mental health. And that just doesn't make any sense in my opinion. But I think it does contribute to this like desire to push down and ignore our own emotional reactions. As much as our training programs like talk about things like countertransference and how we feel when a patient's talking to us, I think we talk about it in an academic way to then go back to helping the patient. We don't necessarily always talk about, okay, well, if that affects you, you should be getting help for that. I also think applying things to ourself is not as easy as we think it is. There's sort of this baseline This is just how I'm supposed to feel when I do a job like this. It's just supposed to emotionally affect me. It just boasts to make me tired. It's just supposed to be like this. Everyone else looks like this, whatever you want to say. Right. And so our baseline is to kind of be burnt out. And so when we look around, everyone else seems burnt out. And if we go, I'm not sure I should be burnt out. It feels almost like identifying a weakness or a reason you might lose in a perfectionism competition where we're all overachieving perfectionists and don't want to lose. And so we don't get help in that sense. Or, you know, I think inherently we're all pretty bad at practicing what we preach in that we might understand signs and symptoms, but not in ourselves, especially not until it starts to interfere with work. So we try, and this is a problem in college students too, we have this like objective measure of not okay. And that is like. Is my school affected or is my work affected? It has nothing to do with anything else. Like sometimes I'll ask college students like what the rest of their life looks like and they haven't left their room. They're just eating like takeout. They don't talk to friends. They're drinking. But but their grades are getting A's. So, you know, they're fine. Right. And you're like, oh, there's a disconnect here. And I think we do the same thing. We say, well, I haven't dropped a ball at work. I'm still being a good clinician to my patients or clients, depending on who you are and how you define that. But we don't notice all of the steps along the way sort of leading up to it because we aren't checking on ourselves. We aren't applying those symptoms to ourselves, and it isn't affecting work. So inherently, we must be okay, right? So I think that contributes all kind of compounded.

Melvin Varghese:
Yeah, it's just it's so fascinating, because I think you're right, like, there's definitely this weird badge of honor kind of thing, right? Also, of like, I can take on x amount, like, it's usually around, I can see x amount of clients or patients back to back, or I can over my overall caseload is this many people and, but then like, I'm kind of curious, for you, what have you noticed? I've noticed there's been a little bit of a shift, especially pandemic and post-pandemic, of clinicians being like, oh my gosh, is this model that we've been taught consciously or subconsciously, is that the best and most sustainable thing? What have you observed?

Dr. Jessi Gold, MD:
Yeah, I mean, I'm glad you mentioned that badge of honor thing, too, because I think people would probably be surprised the stories I've heard from health care workers, especially in sort of what they've done when they're sick and what their limits are. I mean, I've heard so many stories of people like miscarrying at work, you know, going getting in a car wreck, going to their shift and then going to the ER. Right. Like these things that just are illogical, but that you know, in a lot of ways are a really high barrier for physical health. So mental health doesn't even scratch the surface of what's an acceptable reason to not work. And I think, you know, when you think back of stories in training, like I can think of times I thought it was cool that somebody like passed out, ate a banana and came back into a surgical case. Right. And that shouldn't be something that I thought was cool, but it's kind of viewed like that, just like you're saying. And so, you know, we don't want to miss work because we're not supposed to. And, you know, I think when we think of the role of COVID, COVID forced us to miss work, right? There were a lot of rules around who could work and who couldn't. And I think we kind of went, oh, why were we working before? And it did reevaluate that in a lot of ways. It didn't make us feel less bad. for the burden we place on patients or the burden we place on our colleagues for needing to be out. But it was like this, these are the number of days you have to be out when this is the case, the end, right? And there's nothing you could do about it. And it kind of forced in a very strong way, you to take those days and realize that like, if you took one day now, maybe that would be okay, right? Like people can handle it. I think we're also, you know, because it universally impacted not just clinicians, but the whole population mentally, I think there was more conversation around it. So it was more normalized, like, hey, like our jobs do affect us. Our jobs are not easy. It's okay if our jobs affect us, but you should do something about it so you can keep doing your job and keep supporting yourself. I worry sometimes though that like we view it like this COVID fairy came down from the clouds and made everything worse. And when the COVID fairy left, we're going to be fine now. And that worries me. I mean, it's one reason I felt kind of motivated to write a book on that time period and that conversation because it wasn't good before COVID just compounded things and made it worse and trauma has no timeline. So the envisioning of it. Being fine now doesn't make any sense and I think it's really important for people to realize that that stuff's gonna affect us for a while But we weren't good to begin with and what we should take out of it is more Oh, we should care about our mental health. Oh, we should care about ourselves in this conversation It shouldn't be I just did for that time period because they made me and it was a particularly hard time period now We're fine again, and that worries me. I think a little bit

Melvin Varghese:
Yeah. I mean, I'm so glad you outlined it. I mean, even like we're navigating this currently as a family, you know, my partners had to go back into the office, like, and, you know, we've got a young child at home and it's like, we went through COVID where, you know, she was able to work from home and we were able to kind of just like manage a lot of like childcare stuff. And now it's like, this new normal of like she's got to get up early and go and often comes back late. And I'm like, oh, I got to I got to do this or do that. And then, oh, yeah, we have to go pick up. And it's it is it's interesting. And I do I have the same concern as well of how it seems like quickly we've reverted back like we're oh, post pandemic, we're beyond like and now like we're I don't know, in some ways, I feel like this is even harder, you know.

Dr. Jessi Gold, MD:
It should be, I think. Like, that's the point is it made it worse. It didn't make it like just a blip worse. It made it worse compounded. And, you know, the stuff you're talking about too, like we forget we're humans doing the job and we like to pretend that like we have life over here and work over here and they don't intertwine, but that's impossible. When I don't sleep, a patient's story affects me much more. When I'm going through something at all challenging, a patient's story affects me much more. And I'll catch myself, like I had a time period where my dog, not my current dog, my previous dog, like had a sudden illness and was dying and I wasn't sleeping and I was in the doggy ER with her a lot and You know, for me, I was like, that was the first time I realized how much like my external life impacted my ability to deal with what patients were dealing with because it was all of a sudden like, oh my gosh, the world is really dark and depressing. And it was it was somehow like I didn't hear it before because we had learned so much to hold everything that patients are saying, no matter how dark and traumatic and challenging. But for some reason, like without that extra layer of sort of like, I mean, to use a word that will make people cringe, like resilience. you know, without that extra layer, because I was dealing with my own emotional stuff and dealing with my own stuff, like I just couldn't like unhear it. And I actually like cried after a patient told me their story, like not in session, but after and was like, what is wrong with me? But I had to realize that like our lives do impact our work and vice versa. And you can't just say one's over here and one's over here and we're good.

Melvin Varghese:
Yeah, and especially I think as we age, right? Like, I don't know, inevitably life gets more complicated. We're, you know, caring for loved ones or have additional responsibilities or responsibilities that we have just seem so weighty, right? And it is really hard to just like, you know, say, oh, let me just separate that out from the clinical work that I'm doing. Which brings me to the book. So, you know, so much of your story about especially being superhuman and just going above and beyond, taking on anything and everything. And often like, you know, in past episodes of the podcast, I've shared it, like, I'm sure this happens at a lot of families, but particularly like in Indian families, we, a lot of our parents bought these like corral plates, like often from like Walmart, right? and they come in different sizes. And for me, if my life priorities and stuff I have is like a small Corral plate, it's so easy for me to swap it out with a large one as more and more responsibilities come on. And there was a quote just in the writer for the book, I'll just read it. It says, her patients, colleagues, and loved ones needed her. So who was she to say no to any opportunity to help, be that an extra therapy session, corporate wellness talk, or favor for a friend? She was a doctor trained to serve, to put the needs of others before her own. But when Jessie is so mentally overwhelmed that she commits an unthinkable error during a patient session, she's forced to re-evaluate everything that the medical system has taught her. What was the error?

Dr. Jessi Gold, MD:
Yeah, it's so interesting. I mean, people listening, especially the people who do mental health, will understand why to me it was a serious error. Other people have said that wasn't that bad. But really, so I completely forgot I missed. I met a patient before and I reintroduced myself like I was in a first session and gave the same spiel like I was in a first session. And then the patient was like, Dr. Gold, I met you three weeks ago, you know, and I've never done that before. Charts help, obviously, with things like that. But when you're so bogged down and you haven't had a chance to really like get into that. You know, I didn't really have time to look and see that I'd seen the patient before. I had time to go. I have an hour appointment and an hour appointment usually means that it's a new patient for me. And if it's not, then it's because they're chatty or they need more time or they're anxious, but I didn't think about that. I just thought one hour new patient go. And I started talking in the, I could just like feel the rupture in the room. Right. Like, and, and how much, like, I mean, we were on zoom, but how much even physically the patient pulled away in discomfort and sort of like went in on themselves about sort of you know, how hard it is to tell someone your story in what we do and not have them remember you is not great. And didn't, you know, I worked really hard to sort of get that back, but I felt horrible. I mean, and I think I had never done something like that before. I've been told by other people it's not that serious because it wasn't a mistake that injured someone, but I really don't like that that's our bar, and that's my healthcare worker patient's bar. I'm okay. I didn't hurt anyone today. I hurt somebody. I emotionally hurt that person because they told me a lot about them that they had never told anyone, and instead of proving that I knew that and validating that, I forgot them. And that felt really bad to me. It felt really bad to them. And, you know, it was kind of a product of too much going on for me. I was burnt out and didn't define it that way. I was starting a program for like, you know, our faculty and staff to get care and at the same time doing all the outreach for it. I had a lot of guilt about being a frontline worker who was behind a screen all day. And all of that kind of compounded to me just not being as present as I would have liked to be and not being as on top of my job as I would like to be in our job as people and people who don't tell people their stories very often and people who. need us to be a certain way so they feel safe and secure. And I wasn't that. And it really upset me because I try really hard to be that person. And sometimes, obviously, we can't be as good as, you know, we can't be perfect all the time. But this really did impact me significantly because I did feel like I hurt that person.

Melvin Varghese:
First of all, thank you so much for even articulating and sharing that. I think it's one thing to talk about it and write about it in a book, but to be able to just verbalize that, I thank you for just doing that. You were burnt out, but you didn't define it that way. Looking back, what were things that you were like, I was definitely teetering?

Dr. Jessi Gold, MD:
You know, I've learned over time that I have early signs that I don't notice at all. And an early sign for me is that my email or my patient inbox, like messages, make me angry, not sort of mad. Like I'm going to take my computer and throw it across the room angry. And it is because an email or a patient message in an inbox is asking for something. They need something, need an answer to a question. They need me to give a talk. They need me to be present in some way. They're not like, Hey, Jesse, how are you? Just checking to say hi. Right? Like most of your emails or most of your messages are asks. And if you have nothing to give and ask is like an affront on your existence. And so I've learned that that's a really early sign for me that I tend to blow off and just go, I think I'm just mad today. But now I sort of go, why am I mad? What's that about? And do I need to look at that further? I mean, I got to the point where I was sleeping every day after work, like really burnt out. Like it looked like a physical illness to me. Like I would finish patients and then go sit on my couch to watch like an hour of television and decompress. And I would wake up three hours later. and not even know that I had fallen asleep and then it messed up my night sleep, obviously. But, you know, it was one of those like sleeps where your whole body just goes like out and you don't even know because you didn't even have a chance to fight it because you're that tired. And so I actually really did think I had a physical illness because it made sense to me that like it was a physical illness how tired I was, but it was really like my body's reaction to the job and the systems and like what we were dealing with, but I couldn't I had trouble seeing that, and especially until it was that bad, right? Like I clearly had other stuff that I could have noticed ahead of time where a slight intervention could have been helpful, but it got to the point where when you're like that, you have to take time, you have to get vacation, you have to take time off work, or you have to like you can't There's no other real answer at that point. Like yoga is going to make somebody want you to like, you're going to punch someone in the face if they suggest it. But if someone suggests yoga, when you're just mad at your email, it actually could be helpful, right? It's a, it's a scale problem. And most of the time when we suggest that stuff, everyone's at the 10 out of 10, not the three out of 10. And so, you know, being mindful of that in my own life is really important. Part of the reason for the title of the book, the like, how do you feel bit is the you. And I don't ask myself enough, like, yes, in our job, we spend tons of time saying that to each other, to patients and clients. But like the you, when applied to me as a human, I neglect. And I think that's the part where. If I paid attention more, I would notice subtle changes. If I paid attention more, I would notice before it's really bad. And I try to be better about that now, but it was like kind of a reckoning in some capacity for me.

Melvin Varghese:
Yeah, it's, I don't know, I feel like for so many of us, I can just speak for myself, like, I'm really, I was like, you know, heavy into clinical work, I tried to be consistent between what I was saying and what I was doing. But I noticed there was like this, at times, there was a disconnect, you know, I would encourage self care to my clients. But then often, I wouldn't do things until I was like, seven or eight. And by then, like, you're right, like a yoga session or doing like deep breathing or getting out for a hike, you know, it's not gonna like really move the needle. You know, it's often you're spot on. It's usually in those moments when it's three, four. And I think you're right. Like it's the not dismissing the little patterns, right? That's the key.

Dr. Jessi Gold, MD:
And we would tell a patient that or a client that, right? Like we would say, Oh, pay attention to that. Oh, what do you think that means? Or, you know, we would try to get them to identify those patterns in them. We just don't do it to ourselves. We just assume that we're are okay all the time and aren't all of a sudden not okay. Like I, if you would ask me, I'd be like, I don't know where this came from. I'm just sleeping every day after work. And that's just weird. And it wasn't like an obvious buildup. It was like a catastrophe. Right. And that there's no way that was true. But that's all I could pay attention to because it wasn't a problem till it was a really big problem.

Melvin Varghese:
Yeah. You know, one of the things that I struggle with is because I know I have this like overachiever perfectionist side of me. That side of me can easily dismiss these three, four level kind of things. How do you navigate that? Because I think that's the real battle for me of like, well, listen, you know where this is headed, you know? But it can be really easy to be like, hey, I'll just cut it out.

Dr. Jessi Gold, MD:
Yeah, I mean, I think we're all a lot of us are perfectionists. It probably helped us get where we are. And I think the overwork probably did too. I think a key for me has been to recognize that it's not actually a failure to have this be an issue, right? Like it's not actually a failure to burn out, it's life. If you do as much as we do, if you see patients like we do, if you are balancing 45 different things in your life and then doing work, of course you're going to burn out. And so I've almost like shifted my mindset to being like, it's an expectation instead of a mistake or a failure or something that proves that like, I did something wrong. And that's helped me be a lot better about noticing the early stuff because I'm like, I'm going to burn out because I know I'm going to burn out. I'm going to need to pay attention to the fact that I might burn out and then I can make adjustments along the way because I don't want to burn out so badly that it affects my job or that I have to take time off. I want to pay attention and do a better job adjusting along the way. And so that shift has really helped me.

Melvin Varghese:
Yeah, I'm glad you're articulating that because I think similar for me, and I don't know if I get it right all the time, but realizing where the path is going and realizing, wow, this has happened before. I think that's been really key. The final question, Jesse, I was I'd love to hear your thought, like as a fellow mental health professional, I feel like so many of us as clinicians are entering seasons where we're caregiving for loved ones or we're entering like later stages of life or retiring, or we realize maybe we need caregiving. What would you share with them? And many of us are still doing clinical work and navigating all of this.

Dr. Jessi Gold, MD:
You know, self-compassion is really big there. I try to pay attention to the things I tell myself because the things I tell myself are quite mean. I think it goes to the perfectionism bit as well. And if you hear those thoughts out loud, you would never say them to a client or patient or friend. You just wouldn't be like, you made an error because you're an idiot, right? Like you just couldn't tell someone that. And when you hear that, you're like, why am I so mean to me? And so I think reframing that is really important. I think allowing yourself to have feelings is really important. So I think we learn in training to tamp down in our own feelings and our own reactions. And maybe we already had that from our own cultural upbringings or whatever else that compounded gender. Right. So all of those things compound that, but. Feelings don't go away just because you push them down and push them down. They just manifest in other ways, like falling asleep every day after work, right? And so I think we need to let ourselves have feelings and not judge ourselves for them. I think if it feels authentic to you to be self-disclosing in times where it makes sense in clients and patients, that's okay. I think we don't learn it enough because I think we think we're not supposed to, but there are great ways to use it that can really help patients and can help you in your sort of authenticity journey to practicing the way you want to be practicing. And I think that matters too. And then lastly, I'd say, like, I go to therapy every week. I don't have a clear issue that I'm dealing with every week, but it makes me better at my job. It makes me better able to identify those things and those thought patterns. And I need that. And it makes me have an hour a week where no matter what, I will be taking care of me. And so in the context of all that you were describing, it's very easy to go, oh, I just don't have time for that this week. But to me, it feels like just another appointment, like I would for a patient, except for I'm the patient, right? Like it's fit in that way. And it really makes a difference. And I mean, my therapist is awesome. Half the book is probably like a gigantic thank you note to her and in like the most creepy, but also kind way possible. But, you know, it makes a big difference to my ability to take care of other people, to have someone who's also supporting me outside of friends and family. And I really would encourage folks that you know, you have that mindset a lot of time in training and it's encouraged in training and then we lose it. We still can benefit from that in different ways. And our job didn't get easier just because we're not in training. So paying attention to that and actually taking care of ourselves in that way can make a big difference.

Melvin Varghese:
Yeah, thank you for saying all of that. I think, I don't know, maybe it's just like the wisdom of aging. Or I realized like for the longest time, I took so much pride in like how much I could stretch and push myself. But now I think particularly seeing like a lot of friends, you know, loved ones with like terminal illnesses and these kind of things, like the last year and a half, I've really tried to say What if the other stuff I'm doing outside of work, what if I optimize for those? And I wonder if it could have a significant effect on my work. And it's not like a, I feel like it's more of a journey. You know, for me, it's like, you know, I have this wellness spa that I go to every week now. I do, you know, therapy as well, try to do a daily hike. But all of these things in the past, I used to think of it as like you're just being lazy, right? And it's keeping you away from the work, whereas I'm like slowly realizing those things actually help me to do better work, which is just so weird.

Dr. Jessi Gold, MD:
Well, so often we're like, oh, we have to keep studying. If I just keep studying, I'll be better. Instead of going, if I took a break, I'd actually be better at the test or better at studying after, right? And I think we apply that to work and our lives just as much. It's like, oh, I have to spend time on myself. Oh, no. Then somebody can beat me or I'm not being as good at my job or whatever it is. And I actually agree with you. Like I does take in some reframing from me, too. But like time out on me makes me better in all the other ways. We just don't view it like that. It doesn't always have to be a hike or something that takes a lot of time. Sometimes people just think about something when they're jelling in and out of a room or when they're walking the stairs at work or they're driving to work on a commute or on a train or whatever. there are these little moments in our lives where we're probably just not paying as much attention but could be focusing on ourselves and that can be helpful too, I think.

Melvin Varghese:
Awesome. Jessie, I'm so grateful for you, excited for you as the book launches. Where can we learn more about you, about the book and the awesome work that you're doing in the world today?

Dr. Jessi Gold, MD:
So I'm at Dr. Jesse Gold on most platforms. Jesse spelled J-E-S-S-I. I also have a website that's just drjessegold.com. And on there is like all the articles I write. You can get more information about my book. You can see where I'm going on tour for some of it and all of that's there. And you can contact me through it as well.

Melvin Varghese:
Perfect. Thank you again for this conversation. And I'm so excited for the ways that, well, I'm so encouraged by your courage to share something so vulnerable that most clinicians wouldn't talk about. And I'm just so encouraged by the ways that it's going to help other colleagues.

Dr. Jessi Gold, MD:
That would be my honor. So thank you for saying that. I hope that it does.

Melvin Varghese:
Have a great rest of your day.

Dr. Jessi Gold, MD:
Thank you. You too.

Melvin Varghese:
Hey there, I hope you enjoyed my conversation with Jesse and especially if you are in a season as a clinician and as a business owner where you do feel like you're in that early stage of burnout and or you may be a little bit further along I hope that today's conversation has just been really helpful for you. And you know, more than anything, I hope that it normalizes that each of us are worthy of self care. What you know, I just wanted to like highlight something I shared on the actual interview, which is, you know, for the longest time, I felt like I had to take on more and do more. And the what I could handle was a byproduct of my own competence and my own ability as a clinician and a business owner. And what I've kind of been realizing, and I think this is for me personally, I think it's a lot because, you know, our daughter was born two months early, and just going through the whole NICU experience and really having these like real questions around like, priority and mortality and all of these things it just made me realize that that time that we spend outside and again i realize we all are in different seasons right like i get the extreme privilege of you know being able to do like if you know an hour long hike right in the middle of the day i realize not everyone has that but i think the other side just to think about is what are like little things that you can incorporate into your day one thing at a time in order to focus on yourself so that when you are at these like level of two or three of burnout that you can use those things to kind of to recenter yourself and get back to baseline versus when it gets much more significant. Jessie's book is over at or it's called How Do You Feel? One Doctor's Search for Humanity in Medicine. It's available at all major retailers and you can also find more information about Jessie and the awesome work that she's doing in the world over at DrJessieGold.com. Have a great rest of your day and I will see you next time. Bye!

Narrator:
Thanks for listening to the Selling the Couch podcast. For more great content and to stay up to date, visit www.sellingthecouch.com.

Melvin Varghese:
Hey, it's Melvin. Before we continue with the rest of today's session, just wanted to take a moment to thank the team over at Alma for supporting this week's podcast session. So building and maintaining a private practice that you want can be extremely challenging. Alma offers a bunch of different tools, from administrative tools, time-saving resources, and an easy way to navigate insurance. So whether you're just starting out or you've been working independently for years, you can get the support you need to build your private practice. So creating, Alma has this online directory, so you can actually create a free directory once you join Alma, and then share what makes you unique, like your specialties or areas of expertise. People who are looking for you can filter by these details, so they're not just finding any therapist, they're finding you, and by extension, you're finding your perfect client. Alma will also help you get credentialed with all of the major insurance payers within 45 days, handle all of the administrative paperwork from eligibility checks to claim submissions. That means you can spend less time on the details and more time on providing great care. Plus, they provide, as I mentioned, they provide guaranteed payment within two weeks of every appointment. You support your clients and Alma supports you. You can learn more about Alma over at sellingthecouch.com forward slash Alma and there's a special discount code there if you go through that link. That's over again at sellingthecouch.com forward slash Alma. We'll jump right back into today's session. Hey there, I hope that you enjoyed today's session. Thank you again for taking the time to listen all the way through. If you are a therapist and you're specifically in a season where you're a seasoned therapist and you are wanting to move from clinical to online course income, We actually have a specific mastermind for therapists who are doing this. So this is basically a group of really kind and supportive therapists who are also wildly successful as business owners. We meet together to build and grow and scale our online courses. you can learn more about that mastermind over at sellingthecouch.com forward slash mastermind all one word sellingthecouch.com forward slash mastermind thank you so much for taking the time to listen to today's session

00:48: Mel's Intro
04:53: The challenges of addressing mental health in academic settings
12:26 Why it's hard to care for others as a therapist and care for yourself
23:18 Why forgetting a patient's name lead to Dr. Gold realizing she was burning out
39:29: Mel's Reflections