How do you cope with burnout when work (not to mention the world) is so overwhelming? A medically-backed practice called GAIN may be just what you're looking for to start managing the stress.
Burnout is more than just a feeling of being overwhelmed. Untamed, it can present a real medical risk. Today, my guest is Dr. Greg Hammer, an intensive care physician, Stanford University professor, and author of the book GAIN Without Pain: The Happiness Handbook for Medical Professionals. He shared his simple, medically-backed framework for conquering burnout and finding your happier, healthier place.
I'll summarize our discussion here. But, as always, I encourage you to listen to the full interview by clicking on the audio player above or listening on your favorite podcast platform to gain every nuance.
What is burnout? Why are so many of us feeling it?
Dr. Hammer began by defining burnout as "a state of emotional and physical exhaustion, which is related to stress."
"People who are burnt out are often cynical," Dr. Hammer said. "They tend to depersonalize. They often have low self-esteem. They are impatient. They may ... blow up and be temperamental. Yes, it is a huge problem now as ever. But I think, since burnout is a stress-related phenomenon, and the stress related to this COVID pandemic is so ... global and so persistent. ... People have been under stress, which has now gone from acute stress to chronic stress, which has significant deleterious physiologic effects."
Dr. Hammer explained that stress is often associated with poor sleep which, in turn, leaves us drained of the energy we need to make good choices. So, our diet and exercise begin to suffer, creating a “vicious cycle” that leaves us unhealthy and exhausted.
If you can’t change your circumstances, you can GAIN your way to health
I asked Dr. Hammer how he advises patients who may know they are burned out but don’t feel empowered to make a change right now. Maybe they’re afraid to leave their job amidst a pandemic, or caring for ailing family members, or worried about paying the bills. What can you do when you feel unable to move away from the situation causing your burnout?
Dr. Hammer developed a four-part framework in response to that very challenge. The framework, GAIN, is an acronym for its four core principles which are:
G - Gratitude
A - Acceptance
I - Intention
N - Nonjudgment
Experiencing gratitude amidst a crisis can be difficult. But it’s all about staying present and maintaining a sense of perspective.
Although the coronavirus pandemic is scary, Dr. Hammer explained that we're in a better place now than our ancestors were over 100 years ago. We may be navigating a scary pandemic, but there are things to be grateful for.
You can get in touch with people you love and care about and have video chats. So you might be physically isolated, but you're not necessarily emotionally isolated.
"Let's remember and learn about the great influenza pandemic of 1918," he said. "How much better we have it now than our forebearers—our grandparents and great grandparents—did. There was no internet, so we were physically and otherwise isolated back in 1918. And now you and I are meeting each other and having a lovely [virtual] conversation. And you can get in touch with people you love and care about and have Skype sessions or other video chats. You can be connected. So you might be physically isolated, but you're not necessarily emotionally isolated. That's something we have now that we didn't have a hundred years ago during similar circumstances. And medical care is so much better now."
Dr. Hammer isn’t encouraging us to minimize the pain and fear the current situation is causing. He’s simply inviting us to spend a moment focused on what there is to be grateful for.
“I lost my son three years ago at the age of 29,” Dr. Hammer told me. “There's nothing I can do about it. So, with regard to acceptance, we need to discern between what we can change and what we cannot change. We need to sit and really open our hearts and bring those things closer and closer until we merged with them. In other words, we need to have total acceptance and not resistance.”
Suffering = Pain x Resistance
Dr. Hammer referenced a formula: Suffering = Pain x Resistance. By reducing our resistance, he says, we reduce our suffering. I wondered whether gratitude (focusing on the good) and acceptance (acceptance of the bad) could co-exist.
“We can ... say this pandemic is bad. I'm overwhelmed, I'm trapped at home. I haven't seen my family. There's a lot that I'm afraid of," Dr. Hammer said. "But I am going to accept all that. And, at the same time, I will be grateful that I do have a home and I'm safe. I accept that I haven’t seen my parents, but I’m grateful we can Zoom.”
Intention is all about where you turn your attention. We may feel like we have no control over where our minds go. But there is medical evidence that proves otherwise.
Dr. Hammer described a multi-year project that’s been ongoing at Duke University. They are inviting participants to be intentional in their thinking just before going to sleep. Instead of simply replaying the day—allowing thoughts of I shouldn’t have done that or I wish I hadn’t said that—participants are asked to simply recall three good things before going to sleep.
Simply by thinking of three good things before we go to sleep, our sleep is improved, and we become happier.
"What they found in this study,” he explained "is that simply by thinking of three good things before we go to sleep, our sleep is improved, and we become happier. [This] is an excellent example of [setting] intention simply by being purposeful about what we think about for 15 seconds at the end of the day. We can actually start to rewire our brain toward a more positive and happy and resilient outlook."
Nonjudgment, as Dr. Hammer describes it, is the practice of seeing things as they are without evaluating them. Dr. Hammer described an experience where he started to judge someone and was able to dial it back and have a positive experience.
As I catch myself judging, I let go of those judgments. I look at them and smile and they look up at me and smile. And lo and behold, it was a really pleasant experience.
"I get on my bicycle every day. I go through this beautiful lane that's rather narrow. It's covered with a beautiful canopy of tree leaves and branches. And sometimes the sun is coming up and it's beautiful. And then as I'm riding down this lane, I encounter a person who's walking on the path in the same direction I'm going. And, I noticed they're kind of in the middle. Why are they walking in the middle? They're going to be in my way. And then as I get closer, I see they're looking at their screen. ... I'm thinking, wow, this person's walking down this beautiful lane with the new sunlight of the day, filtering through the leaves, and why are they looking at a screen? So I start to make all these judgments. And then I catch myself. ... I realized I started to make these judgments and assumptions. ... So as I catch myself doing that, I let go of those judgments. And as I'm riding past the person, I look at them and smile and they look up at me and smile. And lo and behold, it was a really pleasant experience."
Judgment might be a natural response. He could allow himself to be annoyed by the students' behavior. But embracing nonjudgment allowed him to have a positive experience rather than a negative one.
What does GAIN look like in practice?
Dr. Hammer was kind enough to describe his own daily GAIN practice with me, and I share it as a helpful example.
His morning practice begins seated in front of a window with a brief mindfulness breath meditation. He contemplates what he’s grateful for—perhaps the beautiful day or the opportunity to connect with students—and accepts what he must. Often, he confessed, the loss of his son shows up here.
"Then I will transition to intention, and I often go back to three good things that happened the day before. … I focus on the things that I have—all the wonderful elements in my life—so when I do my 30 or 45 seconds of nonjudgment contemplation, it's seeing the world exactly as it is. [I’m] not labeling it as good or bad. Even though there's a lot of pain and suffering, there's [also] a lot of joy and it's just the way the world it is.”
How can you create your own GAIN practice when things feel chaotic?
I asked Dr. Hammer to envision somebody working from home, as so many of us are. You might be trying to focus on an important conference call with a toddler clamoring for attention, for example. When we're feeling utterly out of control, how can we get started with a GAIN practice?
His advice? Small bites done daily. Spend three minutes each morning practicing a GAIN meditation. Understand things won’t change overnight and manage your expectations accordingly.
I’ll leave you with Dr. Hammer's final words of wisdom.
"Remember, we're not alone; we're all in this together. We're all experiencing the stress of COVID, whether we're employed or not, a parent of a young child or not, we all in our own ways are going through this time together. … Let's just remember, we're all connected. ... We share this experience."