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Adventures in Adversity | Michael McGee, MD Cont.

For most of us, our healing requires continuous mindful vigilance, as the psychological inertia of our
trauma-based ways of being can pull us back into anxiety, internal stress, imbalance, fear, and frantic
striving to restore our fragile senses of goodness and safety. In The Gift of Therapy, the master therapist
Irvin Yalom sagely advises all of us therapists to be in therapy ourselves. That is good advice.
Social Stigma and Brain Shame. The next barrier to healing burnout is social stigma and brain shame, a
term coined by Michelle Frank and Sari Solden in reference to women with ADHD not feeling that their
minds live up to neurotypical standards.

When we are burned out, we may feel shame about our brains not working well. Stigma and shame fuel
isolation and secrecy. The risks for us are real. In one survey of medical students that affirmed what we
all already know, sharing our distress with colleagues resulted in negative judgments of us by colleagues.
Sharing our struggles with licensing boards, and credentialling bodies can be tantamount to career self-
destruction. One recent deplorable example of social stigma is Yale’s alleged policy of encouraging stu-
dents with mental illness, particularly suicidal behavior, to drop out, as described in the article, What if
Yale Finds Out? The lawsuit is currently in settlement.

In another study, two thirds of psychologists reported mental health issues and said that shame and wor-
ries about harm to their careers prevented them from telling others about their mental health issues and
getting help. We tell ourselves we must be models of resiliency and health for our clients. Patients and
colleagues expect us to be thick-skinned, to be OK all the time, and to be perfectly wise, healed, and inte-
grated.

Given these strong forces, it takes effort and courage—and humility—to seek out therapy, enroll in a
wellness program, or join a peer support group. But as we all know deep down, seeking out help is a sign
of strength, not weakness.

We just need to take stigma seriously. We need to live in a way in which we take everything seriously but
not personally. This means being discrete and careful to avoid the judgments of others and their harmful

consequences. It is tragic and ironic that we must hide our pain, grief, anxiety, and distress from supervi-
sors and colleagues, but this is the reality of the wounded and wounding world we live in. Knowing this
and knowing that about one-half to two-thirds of our colleagues are also having a hard time, we can also
lend a kind, nonjudgmental, helping hand to our colleagues. Ultimately, we all need to help each other

get by.
Difficulties mitigating stressors. I recently went on vacation, and while away from my routines, realized

how difficult it was for me to set limits and say “no” out of my own fears of displeasing others—you
might call it my early punishment and abandonment schema. And then there is that background
“worthiness schema” that says that if I DO less, I will BE less. It takes awareness and intentional effort to

change our default habits of being and doing, to slow down, to do less, and to narrow our life focus to
what we can manage.

In addition to trauma, some of us might feel trapped in our work or life situations due to concerns about

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NORTHERN CALIFORNIA PSYCHIATRIC SOCIETY Page 21 January / February 2023