Ep 20: The Art of Self-Compassion: A Guide to Embracing Your Inner Friend w/  Gabrielle Juliano-Villa

  • This is a rough transcript created with Artificial Intelligence technology. Any misspellings and sentence errors are a result of imperfect Al.

    So you have been working with clients with chronic pain since 2015. Yes. Um, what got you started in this population?

    It kind of happened naturally. So I first was working in Child Protective Services and got burnt out from that shocking . And I applied for a job with an insurance company doing in-home care management with their Medicare Advantage people.

    And so that's really where I started working with chronic pain and chronic illness. I actually worked with it, um, some. Child Protective services as well, but it just looked different. So in this new role I was doing in home care management with people who were disabled or elderly, so all of them had chronic health issues and that was my caseload, um, for, you know, 40 hours a week.

    And then I got a little burnt out on that too, . And there were some changes happening, um, with the company that I worked for. Like there were layoffs coming and so I was like, What am I gonna do next? And so in 2017, I. Started my private practice and I focused on older adults, and I also had a big focus on chronic pain and chronic illness because there were also not a lot of therapists who worked with that population.

    So, um, I started my private practice just doing that and I did all in-home sessions with my clients and then I expanded to a group practice. And so we all had the same focus where we really, um, worked with chronic pain, chronic illness, and older adults. .

    Yeah. And you, you are still with that group practice or that's your group

    practice?

    So I actually sold my group practice in 2021. Um, so I'm still there right now, kind of in a different role. Um, but I'm not seeing as many clients. I'm more like in a managerial position. Okay.

    And going back to just feeling burnt out from your past jobs, um, how did you know you. Getting to burnout or did you know once you were like way past it?

    I knew when I was way past it and I've learned a lot from that experience. So the first time I got burnt out was definitely when I was working in cps. Um, and like looking back I can see that I was, I, you know, wasn't making enough money, so I was working. Night duty shifts there too. So I was working overnight shifts to make ends meet, and I was having nightmares and my hair was falling out.

    And I remember that I had like taken a couple days off to try and, you know, get on top of things and just kind of like have respite. And when I came back I had like, 55 voicemails. And I remember I was like, I just can't check them. Like, I am so overwhelmed and so apathetic right now. Like, I don't even care.

    Um, and so that was a really big sign for me. There were a lot of things happening physically too. Like I kept getting sick and I wouldn't get better. Like I had a sinus infection and then I had the flu. And so I, I kept having to take time off of work, but it wasn't rest. It was because I was sick. And.

    Towards the end, I would like, I just remember I couldn't stop crying and I was like, there's, I just felt depressed and I probably was . So, uh, my family kind of had an intervention with me and they were like, This job is killing you. You need to do something else. But like a lot of agencies, um, they made me feel like I couldn't leave, that there wasn't anything better.

    This was such an amazing position and I was lucky to have all this flexibility. Um, but my supervisor is actually the one who helped me get to that point. Quit with no notice after being there for like, I don't even know how many years. Um, and when she did that, I was like, Oh shit. If she can quit, then I can't do, There are other things out there for me.

    So I quit and I went to work for that insurance company. . Um, and then, you know, as I said, I quit there and I started my own practice and that is where I got burnt out for the second time that I'm still like in recovery mode from. And that was again, , just not listening to myself and not noticing when I was taking on too much because I was running a group practice and at our biggest, we were 15 and I was doing everything.

    I was still seeing clients. I. Doing supervision with people. I was doing all of the billing. I was doing all of like the admin stuff with new referrals coming in. And so again, looking back, , you know, I'm like, Oh my God, I was doing way too much and I could feel it because I could feel those same feelings that I had before where it was really for me, like a lot of like apathy.

    Feeling numb and really disconnected from my work. So now I'm, I'm still kind of working through that burnout, but I, I'm getting closer to being on the other side of it.

    What do you think causes burnout? Is it more of just simply doing too much or is it doing the wrong kind of work or something else?

    I.

    In our field as therapists, it happens quite often because we wanna help people and we sometimes confuse empathy with sympathy. And we take on way too much. And we don't wanna say no because we might be people pleasers, , and we don't wanna hurt somebody's feelings and we feel like, you know, we need to help people, so we need to take on all of these things.

    So I think it's partly us, but it's also partly the system. You know, thinking about community mental health or like even child protective services where, um, we're expected to do way too much also, and the caseloads are way too high and we're not paid enough and we don't have enough space to care for ourselves.

    So it sounds like it's not so much the type of work, but how much work we're doing

    is. . Yeah, I think it's how much work we're doing and also sometimes just personality traits. You know, people who aren't really good at setting boundaries or, um, people who are really like type A and perfectionist and don't wanna delegate and wanna do everything themselves.

    Yeah. Yeah. And how do you notice the intersection between that and chronic illness? What do you notice?

    So what I notice about it is that, you know, when we are in our fight or flight, which, you know, thinking back to like being in Child Protective Services, that's where I was, the entirety of the three and a half years that I worked there.

    All, you know, just thinking from like a physical standpoint, like all of those hormones are being dumped into our. Into our bloodstream, and we're not paying attention to that because we're so focused on just surviving. And, um, as you may know, or some other therapists who are listening to this, when you're in that place for too long, that's gonna push you into your freeze response.

    And that's where burnout lives is in our freeze response. That's where we're like numb and apathetic and disconnected and, um, detached. And so I feel like. When we're chronically ill, um, those hormones and things that are being dumped into our bloodstream, of course affect us. So, and they might affect us more if you've already been diagnosed or it could lead to a diagnosis from having all of those things, um, in your body.

    Um, but it makes us more susceptible to being ill. It makes us fatigued and we can't do as good of work.

    Yeah, I think that's a beautiful way to. The mind body connection. Um, I think even now in my work with clients, it still sometimes feels like a struggle to, to really explain, to really make it clear that it, it's not in your head even when stress is the cause of something.

    Mm-hmm. . Um, and so, yeah, I do find it's helpful to use like hormones and cortisol and all of these different body processes. They just, they flare up when you're feeling this way, so, It makes sense when you understand the mechanics of it, but yes, you don't understand the mechanics. It just feels like, why can't I just handle this?

    Why can't I just

    do it? Yes, That is totally it. It's like, why am I feeling this way? Why can't I just pull up my bootstraps and just keep going? But yes, there is physical things that are happening in your body that are not allowing you to keep going.

    Yeah. What else comes to mind? Do you work with clients around burnout, particularly, Is that something that you, you would say, say you specialize in or not?

    I do specialize in working with burnout, um, and both with. Clients, but also with other therapists and entrepreneurs and small business owners. And I'm just really passionate about it because I have been through it and I've seen how it's negatively affected my life, and I can see other professionals putting themselves in that situation.

    And so I just feel called to help them not go through what I've gone through .

    Yes. Okay, so when people come in, I'm sure most people don't come in saying, I'm burnt out. I need a therapist to help me with that. What does it usually sound

    like? It usually sounds like taking on too much, being stressed.

    Um, like one example that is just coming to mind is like caregiving. So we see a lot of caregivers getting burnt out because they do take on too much. And so I'll hear people say is, Like, oof. Like I'm just, I'm feeling stretched too thin, but I feel like I need to do this and I don't wanna ask for help.

    That's a really big thing. Or I feel uncomfortable saying, No, I don't want to let anybody down. I don't wanna be a burden and ask for help. And those are really big red flags that I hear where I'm like, No, this is going to. Leads you down a path of being burnt out. And the recovery is way more difficult and stressful in a bigger journey than it is to prevent it.

    So

    it usually comes down to. Not wanting to ask for help.

    I think that's a big one. . Yeah.

    What are, what are some of the obstacles you help people overcome? I'm sure there are, as you start to, I know in my line, in my line of work anyway. Um, when we start to bring up this topic of asking for help, there are a lot of objections.

    Yes. What are some of the objections that you tend to hear?

    There are so many, and it's, I mean, it takes some unraveling, right? Of course. And usually at the core it's something else, , um, like guilt or shame. Um, but I'll hear a lot of objections like, well, I, you know, don't wanna burden other people. Um, I. Be able to do it myself, and we know what shoulds are, , and if you don't know shoulds or judgements that we place on ourselves.

    Um, so it's more like people feeling like they should be able to do this and feeling guilty if they can't and wanting to, and maybe they don't see it this way, but how I see it from my perspective is like wanting to perform or look a certain way and not feeling like weak because they have to ask for help.

    Where do you take clients when you're exploring this type of stuff? Do you kind of go into childhood or do you go into maybe their, their work experiences? I'm sure it's different for every client, but what's kind of like your, where do you like to go with clients?

    Childhood is always a good place to start.

    as therapists, we know . That's where a lot of stuff comes from. So yes, I think that's important. And just asking like, where was the first time you heard that or when was the first time you felt that? Um, and I do a lot of work with people on, um, understanding their nervous system responses, so, For people who are listening and don't know what that means.

    Well, first of all, we all have a nervous system and it responds to our environment. And so what I was talking about earlier about being in fight or flight, um, we have certain responses to our environment. And so if you are in your. Fight or flight too often or, and you don't know what that looks like, how are you gonna know what changes you need to make?

    So I like to do a lot of psychoeducation on our responses and what we're feeling in our bodies and when to pay attention to that.

    Can you give some examples of Yeah. What comes up when you're. Uh, helping clients observe that, or if you're more comfortable sharing your experience or, um, but just for the audience to kind of understand specifically what this could look like, just like an example or

    two.

    Yeah, so I can share about myself because why, again, it's so important to me and why I work with this with clients is for my own lived experience and understanding my own body, um, has been life changing. Like that is the number one thing that has really helped me. So I. What I have done is some work on what makes me happy and when I feel grounded and joyful, what's going on in my life and what that looks like.

    And so I have a list of those things that can bring me back to being grounded. And I also have a list and know what happens when I get into fight or flight. I know that my mind starts racing. I know for me, like my chest and my throat get really tight and my hands will start shaking and my mouth gets really dry.

    So that is an indicator for me , that I need to do some of the mindful things to get back. To where I need to be. And also that being in those activated phases, like being in fight or flight or being in my freeze, that there are good things that come from that too. So when I'm in my freeze response, which is like where burnout lives, and obviously that's not a good place to spend a lot of time, but it also forces me to rest and to take some time for myself and to slow.

    Yeah, that, those are really good examples. Um, and so you, you mentioned a little bit like this is, uh, it means, it tells me that it's time to go into some of my mindfulness, uh, work. Um, can you give some examples of what maybe your old responses would've been to feeling shaky and tight and sweaty and all of these things?

    What would you have done to try to, what would be your behavior after that in the past? And then what does it look like?

    That is such a good question, . So in the past I would've ignored. And I would've been like, Okay, just swallow this feeling of being tense and anxious and just keep moving. Like ignore it and just move through it.

    And don't pay attention to it. Don't start crying. So, That is how I dealt with it. It was just to push it away. And also as therapist says, we know if you push things away, they will come back eventually , which they have. Um, so that was my old way of dealing with it, was to, to me feeling like I, I didn't need to deal with it.

    Just push it away, push it to the side. Just keep moving. You don't need to feel those uncomfortable feelings. They are uncomfortable. I don't like them. Just keep pushing through. Um, and then I would get. Or I would get angry and I would get really frustrated and I would, um, like my fus would be really short, so I would get like pissed off about things that were out of my control and just hyper focus on them.

    And then that's not good either, right? Because now I'm feeling all of these anger and all this other stuff that's coming out and it's affecting people in my life and it's affecting my clients and it's affecting my work because, Like the example before, and I have 55 voicemails that I don't wanna deal with or answer.

    And those are my clients, and that was my duty to them also. So very complicated and convoluted. But now, um, I have done a lot of work on just sitting with my uncomfortable feelings and just noticing them and you know, trying not to give them an assignment of good or bad, but just feeling like, okay, this is what's happening right now in my body.

    Let me take a couple deep breaths so I can think rationally. Instead of just reacting like I did before.

    Yeah. What was that journey like for you in trying to implement mindfulness as a response to stress? Was it always something that you were drawn to and like, Yes, this works, or was it a little bit more rocky?

    Um, I wish my therapist was here, . She would probably have a good answer, but I'll give the answer that I think is really honest and that it was very rocky and it did take me a long time. I mean, it took me years of therapy like, God bless her for sticking by my side. While I would just like be one of those clients that came to session with like fluff, like, Oh, we're not gonna talk about the real issue.

    I'm gonna talk about this instead. . Yep. So she was very patient with me. , um, Because that is, again, just how I had learned to deal with things and how to keep myself safe in my life was to not deal with the underlying shit. So, yeah. Yeah, it's been a very long, like four years of therapy for me to, um, make sense of this and to allow myself to be vulnerable and to feel those feelings.

    Um, and my therapist also does a lot of parts work, which I find really helpful for me. Um, and that's also been really helpful for like, I think a lot of my. Chronic pain and chronic illness clients too, to just kind of like name those parts and what they need. Yeah.

    Yeah. And thank you for being vulnerable here.

    Um, , I feel like I might, might have put you under like rapid fire for a moment, but No, I resonate with, with a lot of it. Um, it's not easy in when you first, when you first hear, when I first heard, like to sit with your feelings. . It's like, All right, cool. That's, that's, that's what I'm supposed to do. Got this.

    And then you do it and you're like, Wait, but now what? Yeah. Like what? Okay, well what do I do? Like, what do I do? Like I wanna do something. Yes. Um, so I, yeah, it's hard. Um, and when my clients ask that same question, um, when I was a newer therapist, it was, I would get caught in that. I would like, Wait, oh, I gotta help them with this, cuz I know how bad that feels and now I'm like, nothing.

    You do nothing. Yep. You just, you sit. Exactly and , and they're like, What do you mean I'm gonna fire you? And I'm like, No, you're not. We're gonna get through

    this together. . That is so funny that you bring that up because I had that exact situation last week in a session with a client, and that is what happened.

    He was like, Well, now what I'm like, You notice it and he's like, And then what do I do? I'm like, You notice it

    Absolutely, Yes. It's, it's hard. It's hard, you know, we're just, we're taught in this society and our families and our school systems, like if you're not doing something. You're lazy. If you're not doing something, you are wasting time. If you're not doing something, you are, you know, even incompetent or you know, dumb.

    And so, um, I think there's just so many different messages and each person will obviously, like resonate with a different one. Maybe laziness is your worst kind of insecurity, whereas someone else's is being incom. Yeah. Um, the engram kind of helps with this a lot. Do you, do you do anything with the engram?

    I do not, but that is an area that I would like to learn more about cuz I think it can be really helpful to just understand those, those pieces of us.

    Yeah, it's fascinating. But what is also fascinating is ifs and I'm wondering if you can talk about that. So you don't practice ifs, right? But you've, you're an IFS

    client.

    I am an IFS client and I have done a little bit of my own training and research, but I am not IFS certified. Okay. Um, and so I just wanna make that clear. . Yeah, Yeah. And,

    and for those who don't know, that's Internal Family Systems. Yes. And yeah, it's a whole like three year training process, right? Yeah. Um, and.

    But there are like, you can be educated on it and, and do a little bit of it, but yeah, to do like a full IFS session, then you need that full certification. But can you tell us a little bit about what Internal Family Systems is like, how it can help people with chronic illness? Just, yeah, a brief overview.

    So IFS basically says that there are, there's our true, authentic self, and then we have little parts. And all of these parts have different. Like job responsibilities, I guess is how I would think about it. Some of them, um, are protecting us from something, Some of us, some of them motivate us to do things.

    And so what has been helpful for me and I, and also with chronic illness too, is to know that like, for example, like your chronic pain is not all of you. Like that is just a part of you. And so your chronic pain or. Your Lupus or your Hashimotos or your MS is just a part of you. And so you can name that and understand that, you know, maybe some of the symptoms or that chronic illness part of you has a purpose and what its purpose is.

    Um, and just kind of like we name our emotions. You can name that part of you too. Like, um, I had a client who. This was a couple years ago. She suffered from migraines and so she had headache girl, and that was the migraine part of her was headache girl. And so we would talk about like what. Was its purpose, When does it come up?

    And what is it trying to tell you? Is it trying to tell you that you're getting a migraine coming on because you've been doing too much or you need to rest? And so it just kind of helps us identify that. Um, sometimes when we feel these ways, especially when you have chronic pain or chronic illness, it sometimes feel like that's your entire identity.

    But it's not. It's just one piece of you that comes out sometimes.

    Yeah, the identity piece is really big, um, because a lot of people find identity in their diagnosis and then they'll find a community based on that diagnosis and that can be helpful for, I guess a good way to put it is That's helpful for a part of you.

    Yes. But then there are other parts that really are, it's not good for. Yeah. Yeah. I like

    that.

    Yeah. Um, what else feels important about, uh, ifs and, and do you incorporate. The mindfulness, like work and somatic work into, um, parts work?

    Yes, I do. Um, because, and I'm thinking again about myself cuz that's kind of the easiest example,

    But, um, like, you know, I have different parts that come up when. I might feel, um, triggered or I might feel like I am being lazy because I'm resting. And so that helps me again, just kind of pay attention to that part because when I feel those things, when those parts come up, I feel it's somewhere in my body too.

    Um, Usually in, like I said earlier, like my throat or like my chest. And so then I'm like, Okay, I'm feeling things here. How can I be back to feeling settled or like grounded? Um, and so that's a good indicator for me that again, I just need to practice a little bit of mindfulness, take a break, uh, pat my dog.

    Those are like little things that I just do to kind of.

    Yeah. Yeah. Reset is a good way to look at it. Cause I think, I think the now what mentality and like the, um, you know, okay, but what do we do next is, um, it's like we're constantly looking for when we're gonna feel better and never feel bad again.

    Mm-hmm. . And, um, I think whether you have a chronic illness or not, that's just never gonna happen. It's life comes with hardships. Like to be alive is to feel

    pain. That's so important too because I, I find with a lot of my chronic illness clients, it's, we talk about that a lot. It's like, I want the pain to go away and that is my goal.

    Or, um, I worked with a client who had non-epileptic seizures, um, and. That was like her goal for, for therapy was to not have seizures anymore. And I'm like, well, that's probably not realistic, so let's talk about that. Because feeling pain or having seizures is probably part of your life experience and we can't get rid of that.

    But you know, we have to ride those uncomfortable waves too instead of trying to push them away.

    And I think, um, even as like medical doctors and health practitioner, No matter what, no matter what your discipline is, you cannot promise that someone's going to be pain free. Their cancer's gonna go away, their, you know, illness is gonna go into like any type of remission.

    Mm-hmm. , it just, you cannot promise that. Um, and ironically, I think when you don't promise it, but you offer a ton of support, pain does start to reduce.

    Yes.

    And then it might come back later. Um, but you move through it quicker. You move through it with less anger and resentment and stress, and you just, it's just like a, an experience.

    It just is. It's, mm-hmm. not one of the more pleasant experiences, but it is just an experience rather than something that proves I'm unworthy or incapable or broken. Yes.

    Yes. I love that. And that's really the goal, right? Is like you said, we can't get rid of it and we don't know if the cancer's gonna go away, and we don't know what tomorrow brings, but we can offer you tools and support and resources to work through that in different ways.

    Yeah. Yeah.

    I think when I first started working, As a therapist, I was nervous to say like, I can't promise. I can't promise you , um, that this is, that your depression's gonna go away, your anxiety is gonna go away. Any of your pain is gonna go away. And now, um, If somebody tries to tell me they have a cure for something or like this is going to work, I automatically don't trust them.

    Yes,

    I totally agree with that. and I felt the same way as like a new baby therapist. It was always like, Which again, probably leads to burnout, right? Is like I felt like I had to fix everything. Yes. And. Especially I think as a social worker and working in like case management before was a hard, um, pivot to just allow and like be on the journey with people because I always felt like I had to fix everything.

    Um, and again, I think that just leads back in to burnout in this field is like we do take on those things and feel like we have to say yes to everything or we have to find a way to fix it. And it doesn't look like that all the. Yeah, most of the time . Yeah, most of it.

    Exhausted . That's right. Yeah. I think learning to say no and learning more about who you are, being able to differentiate your feelings from someone else's feelings, uh, is key in being able to then say like, I can't fix this.

    We aren't, we aren't trying to fix this, but I can be with you along, along the way on this journey. And that's really what any of us, that's all we any of us need. We just need somebody to witness us. Um, which is what ifs, you know, Internal family systems is all about too. It's these different parts of you witnessing each other and not exiling each other, allowing everyone to kind of, can you equally feel resentful or angry and love somebody at the same time.

    Mm-hmm. , um, things like,

    Which even that example is really difficult for us to come to terms with, right? ? Yes,

    it is. It is. Cuz there's so many layers just wrapped up and it gets confusing. Um, sometimes I can see it in my clients, this, I can feel the same confusion that I have been through or felt, which is like, you understand this concept logically, but there's so many different layers to it that they're like, It just kind of feels like blurry in your mind and there's, you can kind of just see the layers happening, you know, trying to understand what it means to love somebody and, and be mad at them at the same time.

    There's so many different messages from growing up. There's so many different things that you have. Um, You've practiced over and over and over again in your life, like behaviors that you've done the same behavior. And so it's now trying to figure out how to do a different behavior requires different neural pathways.

    Mm-hmm. . So then everything is just confusing. Like there's so many different moving pieces. Um, It is, it's hard and you really just need someone to kind of hold your hand and say like, We're just gonna take this one piece together, and the rest of it, we will figure it out later, but like, let me help you focus Right.

    Yes. That's what makes our job so special. . Yeah, .

    Absolutely. So are you still seeing clients or, um, at all, or, or not really?

    Um, I still see a handful of clients, um, but I mostly am focusing now on doing consulting and coaching for other therapists, or I work with other therapists. I also work, um, with other entrepreneurs or small business owners.

    On burnout, prevention and healing and management. Um, and then I also do consulting with therapists on clinical issues like polyvagal theory, how to work with people who have chronic illness.

    Yeah. What, um, what are some of the things that you tell people who are, are looking to prevent burnout and, and do.

    How would somebody know, like this is where they're at, um, that I'm trying to prevent this from

    happening. , Well, hopefully paying attention to some of those like red flags and triggers. So, um, Noticing when you feel stressed, like what's happening when you're like angry about work or something that's happening, like what is going on in your world?

    Is that something you can delegate? Is that something you can do less of? And if it's not, that's okay. Um, but pay attention to that and then. You know, instead of assigning it a bad or unwanted emotion, can you just look at it neutrally? Um, so I think that's really helpful. Um, What was the other part of the question?

    I just had a brain fog moment. seeking a chronic illness. Yeah, no,

    I totally get it. . Yep. And I also am eight months postpartum, but the sleep has not started yet, so Devil whammy. . Um, yeah, so it was, yeah, like how does someone know when they're there, what you just answered, and then like, what do you, he, what do you help people do in

    preventing.

    Okay, good. , thank you for clarifying that for me. So what I help people do in preventing, um, and like my consulting sessions is, um, I will do some. Um, mapping of people's nervous systems will actually, I'll help them do it themselves. So understanding what, you know, pisses you off what happens when you're in your freeze response and what happens when you're feeling really good and you're connected and mindful, um, and then connecting that.

    Usually it's to work. Of course, you can get burnt out in other areas of your life, like caregiving, um, or if you have chronic health condition. Um, so that's a really big piece of it is for me, using our nervous system. Um, I'm also going to look at your supports if you have good boundaries in place, if that's a problem.

    But supports are a really big one. And then another really big one that I talk about a lot with consulting clients is values. So what are your personal values and what are the values of your employer? Or even if you're self-employed, like your private practice values. Might be different than your personal values, which is okay.

    Um, but if they are very misaligned, that will lead to burnout too, because then you're not, you know, leav leading your authentic, true self day to day.

    Yeah, I like that a lot. Values work is at the heart of what I do as well. Um, I feel like it should be what all of us are doing, but um, yeah, if you don't know what your compass, it's your compass.

    If you don't know what you're moving toward, then you kind of just feel like. Floundering around and can lose sight of what's important.

    Yep. I love that you do that. Yeah.

    Yeah. Acceptance and commitment therapy was what I was introduced to in undergrad, and I just think it's one of the best ways to frame everything that we do.

    And then you bring in the other pieces like somatic work and, and all of that fun.

    Yep. It all works nicely together, doesn't it? ? Yes.

    Yeah. Good. Is there anything else that feels important that you wanna share, um, about, uh, you know, burnout or even chronic illness? Uh, parts work acceptance?

    You know, one thing that just came to mind is just, um, Giving yourself grace and being compassionate towards yourself, and I think that that's a really difficult one when you have chronic illness.

    And even working as a therapist who has chronic illnesses, again, we like feel this, pull that we need to be there for our clients and we have to take on all of these things. And if you haven't figured it out already, when you take on too much, it's gonna lead to a flare up, and that's a lot more painful and difficult to deal with on that side then if you just tried to prevent it in the first place.

    If you are feeling like you're not having a good day and you need a break and you need to cancel or move some things around, then I hope that you can, you know, give yourself the space, um, and permission to do that for yourself and to rest.

    Yeah. One thing I know that it's not always possible, um, especially depending on your job, but mm-hmm.

    um, but when you're a therapist, I think making your own schedule. It is a little bit more possible than we like to believe it is. Uh, but I really, really strongly encourage planned days off and people will feel like. But I don't know when I'm gonna flare up. So like, if I plan this day in advance and it's a good day and I could have worked and then like I've wasted that day.

    And I think that's just a part of the problem. Mm-hmm. , . It's like if it's a good day and it, you know, you planned it off, then great. Like you get to experience your body PainFREE in a way that feels good to you. Um, and also when we plan time off and give ourselves that planned rest, your body trusts you.

    Like, Oh, okay, we're, we can push through this hard thing because we're gonna get rest later. And that can be a really hard concept to, to, um, encourage someone to believe. Yes. But once you, once you get it, it's pretty powerful.

    It is really powerful and it seems so small, but that's, you know, the bread and butter of life is, it's all the little things.

    Yeah. I

    agree. Well, thank you so much, um, for yeah, talking to us about burnout and this was really, I think, insightful. Uh, really good examples. People will get a lot out of it.

    Thank you again for having me. I love talking about this with you.

Episode Summary and Notes

Meet Gabrielle Juliano-Villani: a therapist specializing in burnout prevention and recovery, who shares her journey and expertise in helping others navigate this challenging terrain. She started in Child Protective Services but transitioned to an insurance company, where she began managing in-home care for Medicare Advantage clients. This role exposed her to the world of chronic pain and chronic illness. Gabrielle shares her decision to start her private practice in 2017, focusing on older adults with a significant emphasis on clients dealing with chronic pain and illness. Her initial sessions were conducted in clients' homes, eventually expanding into a group practice with a shared focus on these challenging issues.

Recognizing Burnout

Gabrielle opens up about her experiences with burnout, which she first encountered during her tenure in Child Protective Services. Her symptoms included working night shifts, having nightmares, and even losing hair. She narrates a turning point when she returned to work after a brief break and faced an overwhelming workload. Her family intervened, recognizing the toll it had taken on her mental and physical health.

The Second Bout of Burnout

Gabrielle discusses her second encounter with burnout while running a group practice. She reflects on taking on too much, performing multiple roles, and the toll it took on her emotional well-being. Her journey through this burnout phase has provided valuable insights for her current work.

The Intersection of Burnout and Chronic Illness

Gabrielle highlights the connection between burnout and chronic illness, explaining how the body's stress response can affect physical health. The conversation emphasizes that understanding the physiological aspects of burnout helps individuals recognize it as a valid and serious condition. Gabrielle's passion for helping others avoid burnout led her to specialize in this field. She discusses her work with clients, therapists, entrepreneurs, and small business owners, emphasizing the importance of preventing burnout before it becomes overwhelming. Gabrielle underscores that addressing these objections often involves unraveling deeper emotions like guilt and shame.

Understanding Nervous System Responses:

Gabrielle emphasizes the importance of educating clients about their nervous system responses. She explains that everyone has a nervous system that reacts to their environment. Understanding these responses is crucial for recognizing when changes are needed in one's life. Gabrielle provides examples of what nervous system responses can look like. She mentions symptoms like a racing mind, chest tightness, shaking hands, and a dry mouth. These are indicators that one's nervous system is reacting to stress.

Old Responses vs. Mindfulness:

Gabrielle contrasts her old responses to stress with her current mindfulness practices. In the past, she used to push away uncomfortable feelings, leading to increased anger and frustration. Today, she has learned to sit with these feelings, allowing herself to experience them without judgment. Gabrielle acknowledges that implementing mindfulness was challenging for her. She initially struggled with the concept of sitting with her feelings, as society often encourages us to stay busy and avoid discomfort.

Identity and Chronic Illness:

The conversation touches on the role of identity in chronic illness. Gabrielle notes that some people identify strongly with their diagnosis, which can lead to finding a supportive community. However, she emphasizes that chronic illness is just one part of a person's identity, not the entirety of who they are.

Naming and Understanding Parts:

Gabrielle illustrates the concept of naming and understanding these parts by sharing an example of a client with migraines who named her migraine part "headache girl." This approach helps clients recognize the purpose and function of different parts of themselves related to chronic illness. Gabrielle provides valuable insights into the integration of mindfulness and IFS techniques in therapy, offering a holistic approach to helping individuals navigate the complexities of chronic illness and its impact on their lives.

Preventing Burnout and Practicing Self-Compassion: 

Gabrielle Juliano-Villani shares valuable insights on preventing burnout and practicing self-compassion, which are essential, especially for therapists dealing with chronic illness. Gabrielle suggests that individuals pay attention to red flags and triggers that indicate they might be experiencing burnout. She encourages people to examine what's causing stress and explore whether they can delegate tasks or reduce their workload. It's essential to look at these issues neutrally rather than assigning negative emotions to them. 

Practicing Self-Compassion:

Gabrielle underscores the importance of giving oneself grace and practicing self-compassion, particularly when dealing with chronic illness. She acknowledges the tendency for therapists with chronic illness to feel the need to be constantly present for their clients. However, she advises taking breaks and resting when necessary. Planning days off, even when you're feeling well, can build trust with your body and provide much-needed rest when it's required.

Conclusion: Seeking Help and Building Resilience

In this enlightening conversation, Gabrielle Juliano-Villani and our host stress the importance of recognizing burnout and the significance of seeking help. Gabrielle's journey from burnout to burnout recovery serves as an inspiring example for anyone grappling with the challenges of high-stress professions.

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Ep 21: Navigating Chronic Illness and the Burden of Asking for Help w/ Taylor Marmel

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Ep 19: Navigating Complex Medical Trauma within the School System: Insights from Victoria Rodriguez