The Courage to Transform Burnout

How is self-caring difference from self-care and resilience?

“Anyone can burn out,” quipped Dr. David Kopacz at the very end of our recent conversation about his new book, Caring for Self & Others: Transforming Burnout, Compassion Fatigue and Soul Loss. He and I have been talking about and working towards publishing this book since April 2020, not long after COVID struck. We were all feeling the shock of quarantine, wearing masks, counting so many deaths, seeing reports of how hard it was for health care professionals especially to care for the sick and dying and not succumb themselves to overwhelm.

David, a psychiatrist who works at the Seattle VA, puts it this way: “I think one of the things that changed during the pandemic is burnout went from something that some people were feeling some of the time to something that most people were feeling most of the time.”

My very first note I kept on this project back in 2020 are words from poet Julia Fehrenbacher, from the intro to her Beyond the Noise poetry e-book she offered for those times:

Because forgetting to take care of yourself is no longer an option. Because this hurting world does not need another hard, hurried, harried, busy, sick, tired, empty, overworked, overwhelmed, scrambling-for-worthiness human. ...

What you give to yourself is ultimately what you will give to others. We are all connected and woven together like a most amazing, intricate, complicated, beautiful, colorful tapestry....You are not the noise, but the space between the noise.

Words like this can speak to our heavy heart in ways that our intellect is otherwise too tired or overwhelmed to hear. Which is why David’s book invites us to begin exploring self-caring in terms of a framework he calls the 10 dimensions of being fully human:

I love how this list of words describes the wholeness of who we are—not only body, emotion, mind and heart, but creativity, intuition, spirit, context, time, even leadership. Seeing these words (which mirror the book’s Table of Contents) helps me feel that if I tend to more than my body or mind, I may be able to truly find a sustainable path forward. That’s just me — publisher, author coach, writer with now-8-weeks post-surgery hands that still need rest and healing, and daughter/roommate of an aging dad with health concerns thanks to surviving so many birthdays. Caring for my self and others is a daily awareness and challenge. It has been for a long time (scroll below for my personal reasons for publishing this book).

I bet you have your own stories of burnout, whether you work in health care, have been or are in caregiver mode, or have lived some version of your own exhaustion and depletion, and hopefully with some renewal. Even our book’s indexer saw herself in Caring for Self & Others:

This book really resonated with me, even though I am not a health care professional. I'm looking forward to integrating some of the practices in the book in my meditation and mindfulness practice.
~ Silvia Benvenuto, Indexer

A few days ago, author Elizabeth Gilbert shared a “Letters from Love” Substack post by

Sari Botton

of

Oldster Magazine

that prompted readers to share their own relationship to caring:

This week, my friends, we are thinking about which side of the caregiving spectrum we’re on, if either. Even if you don’t identify as a full-time care giver or care recipient, you might reflect on whether the issue of caring for another or receiving care yourself might define some part of your life. If so, you can pose either of these questions to Unconditional Love: What would you have me know about caring for others? or What would you have me know about being taken care of? And of course, if those don’t work there is always our old, gold standard: Dear Love, what would you have me know today?

Self-Caring is Different Than Self-Care

Think about the energetic sense of saying “I need a self-care regimen.” Self care—there’s almost a heaviness to it, the weight of a big “should.” But saying “I need a self-caring practice” has a different ring to it.

Did you notice in the image above how each dimension is expanded by three more words or attributes, words that are verbs ending with -ing? For instance, with the chapter about the dimension of Body, the three concepts to explore are embodying, animating and nourishing. David choice of words—of “verbing”—was inspired largely by his work with Southern Ute elder Joseph Rael (Beautiful Painted Arrow), with whom he has co-authored several award-winning books.

“Joseph would often talk with me about the distinction in indigenous languages, how verbs tended to be emphasized more than nouns. And in Western languages, nouns were emphasized more,” said David. “And I thought this was really interesting, because then he would say a noun is a person, place or thing. And a verb is an action; it’s what’s happening between two things. So it was a shift from the thing, the object, to a relationship . . . It’s also just the subtle shift towards re-animating ourselves to think of ourselves as something that’s in process rather than something that’s static.”

Re-animating, or re-humanizing, ourselves is possible—with practice(s). Have you heard of post-burnout growth? This quote hints at it:

Practice any art, music, singing, dancing, acting, drawing, painting, sculpting, poetry, fiction, essays, reportage, no matter how well or badly, not to get money and fame, but to experience becoming, to find out what’s inside you, to make your soul grow. 
~Kurt Vonnegut

Dave and I talked about all this and much more in our Creative Courage Live conversation. Because we jumped right in to our talk on the video, first let me share a bit more about David’s background.

David R. Kopacz, MD is a psychiatrist in primary care at the Seattle VA and teaches Whole Health to VA staff nationally. Board certified in psychiatry, integrative, and holistic medicine, he is also an assistant professor at the University of Washington. David has spoken around the world on self-care and well-being for patients, health care professionals, staff and students. His focus is on staff wellness, post-burnout growth, healing and spirituality, trauma, transformation, holistic health, and the healing power of story and creativity.

While finishing Caring for Self & Others, David was diagnosed with cancer—a malignant melanoma. That became an unexpected challenge to test his own theories and healing practices as a cancer patient himself. Art, photography, poetry, iRest meditation and yoga, and time in nature have been vital to his own well-being.

I hope you’ll grab a coffee and enjoy listening to our chat, where we spoke…

On the journey from his first book, Re-humanizing Medicine, to the new one: “After my first book, I realized practical application was needed. This book provides exercises for each dimension of being fully human to implement re-humanizing medicine.”

On the concept of soul loss: “Soul loss captures what gets lost with burnout —that pilot light of passion and vitality. Indigenous traditions view it as common sense; the soul is what brings humanity to healthcare.”

On hopes for a compassion revolution: “A compassion revolution means shifting healthcare culture to prioritize the whole person—mind, body, emotions, spirit. It’s about practitioners caring for themselves so they can better care for patients.”

On an example self-caring practice: “Body scanning is a simple way to nurture yourself without judgment. Taking time to listen to your body allows its wisdom to guide what you need in that moment.”

On the spirituality of the book: “Spirituality has always been intertwined with healing. This book weaves it in to help connect readers to what gives them spark, passion and meaning when facing burnout.”

On how Dave’s health issues shaped the book: “Cancer forced me to reevaluate my self-care. The book focuses on sustainable practices to prioritize well-being over productivity and prevent future burnout.”

On making time for art: “I try to prioritize what I love like painting before other tasks. Even short creative practices can nourish your soul and balance a busy life.”

My Own Reasons as Publisher

By publishing Caring for Self & Others, I feel like I’m coming full circle in caring about caregivers, going back to 1986 when my mom was diagnosed with stage-four ovarian cancer and 1987 when she was pronounced a cancer-free miracle. She lived 35 more years thanks to a few caring physicians who offered radical chemotherapy on top of surgery, to the care of many sisters who were also nurses, and to a support organization in Denver called Qualife. Mom also told me that Julia Cameron’s The Artist’s Way was one of the books that helped her regain a sense of wholeness after nearly dying.

My fierce advocacy for caregivers also circles back to 1998 when my husband then was diagnosed with brain cancer (and is still alive and well). I saw up close what it means to patients and their families to be cared for by compassionate physicians and nurses collaborating as teams. I am forever grateful to Dr. Edward Arenson, who had the energy and humanitarian heart to create a multidisciplinary brain and spinal tumors team at the Colorado Neurological Institute, resulting in statistic-defying survival rates, many patients outliving the organization itself. He transformed his own burnout and heartbreak of caring for children with leukemia into a very caring, successful and humanitarian cancer program for adults. He was also a lover of art and birding, both aspects of his own self-caring (see his memoir To Be of Use).

For me, the toll of 24/7 caregiving—even with an amazing support network—almost broke me. What brought me back to life after caregiving burnout was creating the Emotikin (my art manikin / inner artist, born out of an artist’s date thanks to Mom giving me my own copy of The Artist’s Way). Around then I also joined a local circle of Women Writing for (a) Change, which invited back another part of myself. In that class, I discovered Let Your Life Speak by Parker J. Palmer, giving me the quote I’ve lived by ever since:

In 2012, I self-published Damocles’ Wife: The Inside Story of Cancer Caregiving & Long-Term Survival in the Midst of Motherhood, Marriage & Making Life Matter. Writing and sharing my “inside story” was a matter of soul survival, which made it an act of true-self care.

Fast forward to 2017 when I was struggling to finish writing The Courage Way: Leading and Living with Integrity, particularly chapter six called “The Courage to Care for True Self.” The chapter featured Dr. Mukta Panda and briefly myself, describing a day when I noticed the nuances between self-care on a physical level and something deeper. In 2019, Mukta asked me help her publish her memoir, Resilient Threads: Weaving Joy and Meaning into Well-Beings and then I asked her to be the first author for Creative Courage Press. From Mukta, I learned about the systemic issues contributing to clinician burnout, that suicide rates for physicians are next highest after veterans, and the importance of tending to one’s whole life, passion and purpose, to find sustenance.

I learned about the tensions around the word “resilience” that often place the burden on the individual when it’s the system that needs transformed, but systems are comprised by the people who lead and serve, so it’s those hearts and minds and bodies that need tending. Add in the context of COVID, where we all witnessed the best and worst of a broken health care system.

That’s why I committed to publishing Caring for Self & Others by David Kopacz. His practices and inspiration and insights will help create a new path toward rejuvenation so that we have more compassion to keep caring for ourselves, each other and the bigger picture (systems) we’re all part of and rely on.

I once joked with a surgeon who casually asked “So what do you do”, just before removing my gallbladder, that I couldn’t explain my job very clearly, working for a place called the Center for Courage & Renewal, unable to succinctly describe what we did there. But he got it, saying, “Who doesn’t need more courage?”

I have felt similarly stumped about previewing all the reasons to read Caring for Self & Others. It boils down to this: Who doesn’t need more courage and compassion for caring? And ideas and practices for transforming suffering from burnout, compassion fatigue, and soul loss?

Six Invitations to Engage

This isn’t a one-time conversation. It’s a book that joins a bigger conversation with new insights and perspective and invitations. I hope you’ll join us.

1. Listen as Dave tells more of his story in our Creative Courage Live conversation on YouTube.

2. Buy and begin reading Caring for Self & Others from your favorite bookseller. Bookshop… Amazon… Barnes & Noble... Fishpond in Australia...

3. Or start reading now with a free sample PDF—the first 33 pages of Dave’s book.

4. Give a copy to your favorite nurses, doctors and health care professionals, or ask your local library to buy it.

5. Request a few bookmarks so you can have at-a-glance the 10 Dimensions of Being Fully Human, to keep or share. Dave and I will mail some to you.

6. Let us know your thoughts! What has helped you the most in times of burnout? You can interact with David at his blog, Being Fully Human, on X/Twitter or Instagram or LinkedIn.

Read the full review here at Foreword Reviews magazine online.

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