MCH Bridges: The Official AMCHP Podcast

Episode #5: Rest is Infinite: Shifting Our Mindsets on Rest & Productivity

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In this episode, we tackle the topic of redefining rest and productivity with Marissa McKool, Career and Life Coach. Marissa shares her personal wake up call on the brink of burnout, explores why we are sometimes hesitant to take time off, discusses how supervisors and managers can be more supportive of staff, the intersection of oppressive systems and thoughts on rest, and shares ideas and tips for reshaping our mindset throughout the conversation.

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[00:00:00] Marissa McKool: I want everyone in public health who works in the field to get access to these tools and get the support to change their mindset. So while we are working to dismantle systems and change structures, we don't have to burn out. 

[00:00:24] Maura Leahy: I like most other people working in the public health field. I'm doing this work because I want to make a difference in people's lives.

[00:00:30] As cheesy as that may sound. What drives me every day when I wake up is knowing that I'm contributing to something bigger than myself. One of our AMCHP board members, Marcus Allen recently shared with us his thoughts on how people who work in human service type jobs are givers by new. We really want to do everything.

[00:00:47] When it comes to service and making this world a better place, we are often serving an extended roles at work in the community, and often in caretaker or support roles for children, parents, and friends. We have to remember that we can't be everything to everyone though. And at some point we have to step back and trust the idea of stepping back and resting as one.

[00:01:07] I know I often scoff at rest quotes that I don't have time. I love my job and working in public health so much that I'm currently doing an unpaid fellowship that I complete. In addition to my full-time job. I also have a second job that I work on weekends since, let's be realistic, most of us aren't in public health for the money.

[00:01:26] I'm also in the midst of planning my wedding. I know I'm not alone and that many other public health workers wear multiple hats in our professional and personal lives. And what this looks like for everyone is different, but I think what looks similar is just how much we all care and the way that can pile up until our plate is overflowing, despite how much we all care, or perhaps as a result of it.

[00:01:49] Another word we hear a lot in the news and media these days is burnout with headlines like "US public health workers leaving in droves amid mid pandemic burnout" and "The pandemic has devastated the mental health of public health workers." Then there's the added burden that state and local public health officials had to face because they've dealt with harassment throughout the pandemic.

[00:02:10] A recent survey found almost 1,500 cases of harassment against public health workers between March, 2020 and January, 2021. What needs to give what's in our power to change and control? How can the public health workforce go from a place of burnout to a place of balance? Let's find out on this episode of MCH Bridges.

[00:02:38] Thank you for tuning in to this episode of MCH Bridges, where we lift up innovative ideas and inspiring stories from people in the maternal and child health field. 

[00:02:46] Marissa McKool: Hi, I'm Marissa McKool career and life coach and CEO, founder of McKool Coaching. 

[00:02:52] Maura Leahy: Marissa. Thanks so much for joining us. You and I briefly exchanged emails last summer, when you were working at a center of excellence and MCH education, science and practice at that point, what had your career path looked like?

[00:03:04] And what were some of your day-to-day responsibilities in MCH?

[00:03:07] Marissa McKool: Yeah, thanks so much for having me. Actually that time. I was at an adjacent maternal and child health research center, affiliated with the center of excellence, leading the research center at the intersection of technology and MCH research.

[00:03:22] But three years prior to that, I was the assistant director for the center of excellence. So I loved hosting an intern that that's what that collaboration was from, but my career journey has been. Long story short. I think this is very common. Many listeners probably had this, that I thought I was going to go into clinical work and had a moment where I realized actually public health is what I wanted to do.

[00:03:45] Like the prevention and not the one-on-one treatment, although I had done some one-on-one social work. And so I received my bachelor's in public. Bye masters in public health, went on to do a fellowship at the CDC and the division of violence prevention, and then went on to be an assistant director at a center of excellence in maternal and child health.

[00:04:05] After several years there then moved on to be an executive director of a research center in maternal child health. And along the way, I experienced many other challenges. I know everyone listening is experiencing right now with burnout, being overworked, struggling with funding, struggling with staffing and all of those things.

[00:04:24] And that's essentially what got me to the place I am now, which is coaching folks on those. 

[00:04:29] Maura Leahy: I feel, I know I, for one had a various similar path where I was, gung-ho definitely like wanting to go to medical school and I kind of stumbled into public health and found that. And I know it's very similar for now a number of my Amtrak colleagues as well, that we all were thinking clinical and then saw the potential that public health has.

[00:04:48] For me. One of the biggest things was just that I feel like I had a bigger reach and impact that I could make in public health versus direct service. So kind of a little zigzag. It led me to where I am today. And Marissa, you just shared with me that you found yourself burning out. Was there a moment when you sort of realized you were heading towards burnout and how did you realize that? What did it look like? 

[00:05:10] Marissa McKool: Yeah, so I had, I have this vivid memory. It was my first year working at the center of excellence. Where I would find myself, like when I get an email notification on, on a night or weekend, I would just start crying because I felt so overwhelmed. And it was like yet another email.

[00:05:28] And I will say within the center of excellence and the staff there and the faculty there. They were extremely supportive yet. It wasn't a hundred percent protective from the broader challenges at the school of public health or the university as a whole, because of course there were more challenges on that level, too.

[00:05:46] What I was really struggling with was okay. I have so much on my plate, essentially. I was doing the work that could have been. Three people's roles, which I know most of you listening, probably feel similarly. And I think the biggest thing that I really found myself, which I think I hear now from so many folks I work with is the sense of like, nothing's going to change.

[00:06:08] Like, I don't have control. I can't change this. And it seems like externally structurally nothing's changing. Like I I've advocated, my peers have advocated changes aren't being made for whatever reason. And so you get to this point where we talk about burnout, a lot of like emotional exhaustion, and I think that's true, but I think there's another level of kind of hopelessness or apathy or despair where it's kind of like.

[00:06:36] I have nowhere to turn and I don't feel like I have any power, anything I can do, except for the one way out, feels like quitting or leaving public health, which I disagree with. But I definitely had that perspective at that moment. And I think a lot of folks do. 

[00:06:51] Maura Leahy: So when you got there to that point of sort of feeling like nothing's going to change feeling kind of like hopeless that you didn't have much of the power, what did you do? Like, what were your next steps and thinking, I don't want to leave public health, but something's got to give? 

[00:07:06] Marissa McKool: Yeah, that was exactly it. And I also felt like I had tried everything I could, like I tried advocating. I was one of the most outspoken people in our school and our university. I tried scheduling differently.

[00:07:18] I tried calendaring differently. I tried like different ways of getting my work done, different scheduling of when I would do stuff, I try to working out more. I tried eating healthy. I tried all the things they tell you to try and nothing was giving. And what happened for me, what I was feeling at that point was resentment.

[00:07:38] That was like the emotion I was stuck in. And I got into this kind of space, like, okay, I've tried all the things and nothing's working. So it must be their fault, the leadership's fault, the structure's fault, the system's fault, very blame-based, which also is very powerless. And my roommate at the time who also worked in the school in a different department recommended this podcast, which I won't share the name of it because it has the curse word in the title, but essentially I started listening to it and this a woman ended up becoming my coach, my career in life.

[00:08:16] And what I was hearing from her was understanding the ways in which how we think our mindset creates a lot of our emotional reality. I will be honest when I first start listening to her, I'd come home and be like, this can't be true. Like you're telling me that, like I could change my mindset and feel better even in.

[00:08:37] We still don't have funding and don't have more staff and work's not taken off my plate. That was cognitive dissonance. It was hard for me to really believe, but I kept listening and I kept wrestling with it. I started seeing results. And what I mean by that is the people were outside of me. Weren't changing the structure.

[00:08:56] Wasn't changing. Factors outside of me weren't changing. But I started to notice I was feeling less resentful. I was feeling more hopeful. I was feeling more empowered. I was feeling more in control of my work. I was feeling more confident and I kind of was like, okay, there's something here. Like I noticed an emotional difference.

[00:09:17] And so I started working with her and really doing the deep work on uncovering how our thinking and how our minds. Interacts with our experience. This doesn't say that policies or procedures or structures don't need to change. Of course they do. But if that's the only way for us to get out of burnout, then that leaves us very hopeless because we don't have a hundred percent control over those.

[00:09:43] And learning that I had more control than I was aware of by what I was going to focus my mind on and what I was going to believe gave me so much hope. None of that would've happened. If I didn't learn these tools to be able to support myself in the face of these external challenge. 

[00:10:01] Maura Leahy: Well, I think that's a brilliant kind of fast forward to today and where you are today.

[00:10:04] So you've created your own coaching company dedicated to helping public health professionals and students understand the impact of socialized messages. We're getting about things like rest and productivity and how to undo these messages that have been so ingrained in us that I'm realizing as we talk about these things that I don't think that.

[00:10:24] Really understood how, how much that is ingrained and what society hounds in us that, you know, work is work and you need to be productive and rest is for the week or all of these things that I up till now, I think just kind of assumed that's just the way it is. That's the status quo. And I can't change that.

[00:10:43] So to change some of these socialized messages to me sounds a little bit of like a Herculean task, but I'm actually really sort of starting to feel empowered that there is something that I can do and that our listeners can do. Can you describe, just get a sense of what some of these socialized messages are.

[00:11:01] Can you describe one of these socialized messages around rest or productivity and what that looks like? 

[00:11:07] Marissa McKool: There's a host of messages we receive such as rest is earned. You have to deserve rest, rest as a reward. Or even on the flip side, that if you take rests, when you haven't earned it, then it must be to serve others, or you must not rest must serve for you to do more.

[00:11:29] And that productivity matters most. And productivity is the key to rest. Now, as I say that, for those of you listening, you might think, well, I don't believe that. But what happens is we get these messages in kind of direct and indirect ways, and then our brain processes them and internalizes them, and then thinks about these things in ways that speak to us in our voice.

[00:11:51] So, for example, I like to use this example, those of you listening. I bet almost every one of you have had the experience where it's lunchtime. Your brain is telling you, I can't take lunch. I have too much to do. I can't stop. I need to finish this. And either you delay lunch, skip it or go grab an EDA as you work.

[00:12:13] That was one of my go-tos. And what's underneath that. What's driving those thoughts is the belief that internalized belief that rest has to be earned. That rest is a reward. That's just one example, but it is a good illustration of how we now believe we have to do. We have to produce before we can take rest.

[00:12:35] But part of the reason we don't is because we have these underlying internalized beliefs that drive our actions. And so it's not as simple as saying, Hey, take your lunch. Because when we do take that action, our brain is going to freak out and be like, oh no, you didn't do it. You know, something's gonna happen.

[00:12:52] You're not going to get this done. You're going to burden other people. And so that's the space where we have not just power, but ability to really change our experience. 

[00:13:03] Maura Leahy: And so building off this example around working through lunch break, because I think it's a great one that I think most, if not all of us have been guilty of a one time or another, what would undoing this message look like?

[00:13:14] So say I'm working at an organization where it's become the norm that everyone's just working through lunch. What would undoing this message look like for someone. Based on maybe where they are, whether they're in a more supervisory role versus perhaps more of an entry-level employee who's just started.

[00:13:31] But you know, sees that this is what people are doing and is concerned that if they don't do the same thing, that it could hurt their career advancement or something. 

[00:13:41] Marissa McKool: Yeah. So I think there's two layers that the first is to understand part of the reason. If it is a norm to do something we struggle with doing the opposite is because evolutionarily speaking over thousands of years, it was our benefit to our survival to be accepted socially.

[00:14:02] Our brains still have that pattern because it is a survival pattern that we've had for thousands of years. So part of where we struggle with. Quote unquote, going against the norm is our brain worries about what that means for our safety and survival. It doesn't mean like that worry is logical or that danger is real, but that is part of the reaction.

[00:14:23] So that's it just important to note that if everyone is working through lunch, part of the challenge you're facing with taking the action to take your lunch, is your brain worrying about what that means socially for you? So that's just good to know. The other piece is. When you decide to take that lunch, it doesn't feel comfortable.

[00:14:45] And we have been kind of told that resting should feel good and resting should be, feel comfortable and should feel easy. So when it starts to feel uncomfortable, when we decide to take lunch and our brain starts telling us, you need to do more, you're not a hard worker. And so really what it is about is taking a moment to interact with your thoughts.

[00:15:06] So I would say the first thing is. Cut like in a re-upped your thoughts and really question them. We are kind of taught what we think is just the truth, like our brain sharing observations of the truth, but that's not necessarily true. So notice what you are thinking and interact with your thoughts.

[00:15:24] Don't assume they're true. Get curious about them and interrupt them. And it doesn't mean that when you do that right away, you're going to take lunch and feel great about. This is a practice like anything else, but it's getting you in the habit of not assuming or reacting to your thoughts as if they're true and that's where you can get your power.

[00:15:45] And I think the second thing is when it feels uncomfortable, when your brain is kind of offering you thoughts that they're going to think you're selfish, or you're not a hard worker, all of that allow it to be uncomfortable. There is growth in the discomfort itself. For those of you who are listening, who are in kind of the burnout phase and really struggling with this, it is going to be uncomfortable at first because what you're doing is rewiring your brain.

[00:16:12] You're creating new habits. And so of course it's uncomfortable. Our brains hate change. But what's ironic. Our brains are really good at change. So there's a space of discomfort where our brain really doesn't like it. But if we're able to be patient and compassionate and curious with ourselves and get through that period, our brains change really fast and are really efficient at changing.

[00:16:37] Again, it's a, it's a positive outcome of our survival mechanism. So I think that applies no matter where you are in your. There's a lot of folks who at entry-level, they're worried about not being considered a team player, and then they get into a leadership role and they're still worrying about that. So I think it's very similar, but I would say for folks who are a manager or supervisor who are trying to support their staff, one thing that's important for them to recognize is even if you have the structures in place, like even if the norm is for everyone to take lunch, that doesn't mean it's going to be.

[00:17:12] Easy for someone to take that action. It doesn't mean their thoughts about wrestling need to be earned, are going to go away. So as a manager is actually really powerful to understand one of the barriers to taking more risks for your employees for your directs is their belief system is their internalized beliefs.

[00:17:30] Doesn't mean you have to become their mindset coach, but just recognizing that helps so much. 

[00:17:36] Maura Leahy: I feel like there's also a, another layer here too. The part of the burnout that the, I think public health professionals are experiencing is influenced by the challenging system that we all work in that shaped and influenced by systemic racism and political challenges.

[00:17:53] And I know a lot of ambient members and all of us really are in. In that sphere of trying to navigate work, their personal and professional lives, amidst all of this going on in society. What would you do or suggest to support coworkers navigating this work as those sort of political and larger systemic issues continue to shift?

[00:18:17] Marissa McKool: Yeah, I think what's really important and I actually felt like this was really missing and is missing and public health is, you know, we worked to. Addressing systems of oppression, racism, sexism, and all of that in the field, in our communities, in the work we do, but we don't talk enough about how staff and public health, the public health workforce ourselves are influenced by those systems of oppression.

[00:18:46] And these messages about rest and productivity are definitely influenced by those. What's really helpful is just recognizing that in ourselves. No one, no one is like, what's the word I'm looking for? No one is excluded from being, having internalization from systems of oppression. No one, everyone has internalized something, no matter your identity.

[00:19:10] And so recognizing that, that also is at play is really helpful for me. I've found it with my clients to be like, oh yeah, these thoughts. I might, I'm thinking not only are they not necessarily true, but I have been told to think them by these systems, I've internalized. Which also means I can undo some of that internalization, which is so empowering, like even as we're trying to dismantle the structures and the policies and all that in myself, I can work to undo how I've internalized this and not as zone power.

[00:19:44] I feel like, uh, one of the other things that I keep hearing you talk about is just, I think some of the language that we're using and some of the reframing that needs to happen, because I feel around the lines of language. I know that one word. I hear a lot that I know that the public health workforce has heard a lot, especially during the pandemic, is that of self care.

[00:20:06] And that for a lot of people, I feel like at this point, it's kind of like a triggering word for them is self-care something that we should be working towards or the right ideal to strive for, or what should, what does that framing or that. And goal that we want to get to. I'm not sure what the exact term is for it, but I think our listeners would benefit from thinking about another way to think about how to get where we all want to go so that we can be the best versions 

[00:20:38] of ourselves.

[00:20:39] Yeah. I'm really glad you brought that up. I think the way we talk about self care and also. Is again an outcome of believing that it comes after being productive. So we hear words like recharge. You need to rest after you've exerted a lot energy and part of this as an outcome of kind of what happened during the industrialized revolution, where mass production happened.

[00:21:03] And then, you know, we started really expanding on that across the whole workforce. So I think we need to switch the framing and stop thinking about rest as an afterthought. And I think that's why folks get so frustrated because it's like, What we're yearning for. And I think what our bodies know is that rest isn't after rest is before, during and after.

[00:21:26] And we just haven't been viewing it that way. What I like to say is I don't really use self care as much or, or wellness or other things. The way I think about it is how can we think about rest in a way that is not only empowering, but is fluid. That is infinite, that is always available. So kind of intentional thinking that I go to, and if you can't believe these right away, that's okay.

[00:21:54] It's just good to kind of have maybe north star isn't the right word, but like a set of possibilities of what you could believe, which is rest is always available to you. Rust is infinite. Rest is unique and specific to you. You decide what rest is for you. And you decide when to take rest, because we have also been sold this idea.

[00:22:16] Not only does Russ come after you do a lot, but that rest is only a certain set of things. It's a spa day. It's sleeping in, it's taking a nap and I think that's false and we need to reframe and see that if rest is an outcome of how we choose to think. Then rest can be anything. That's why some people feel rested after running five miles and other people would not in some people, you know, are on a massage table, not feeling rested at all.

[00:22:43] Cause they're just thinking about work the whole day. So when we kind of frame it as rest, isn't necessarily an action. It's the way in which you're thinking. It's the way in which you're prioritizing your life. It's the way. Which are choosing what is right for you then that means rest is available all the time before, during and after.

[00:23:03] And I think that is more helpful and more empowering. 

[00:23:06] Maura Leahy: This may be an overly philosophical or somewhat loaded question, but I know so many of us are in public health because we care and because we're givers and we want to make the world a better place. Do you think that there's such a thing as caring too much?

[00:23:24] Because the more that I sort of think and marinate on all of these things, you're sharing a part of me wonders is part of the burnout too, that public health professionals experiencing are we experiencing it differently because we do care so much and are a little more susceptible to you know, wanting to do all the, we can.

[00:23:47] Marissa McKool: I love this question. I think about this a lot, and this could definitely be its own podcast series, but I'll just give a few thoughts. One is it's possible that people who are drawn to public health are naturally more interested in giving, but it's also possible that people are drawn to public health or people who are socialized to believe that their role in society is to give is.

[00:24:13] And I say that because there's a lot of folks in public health who are either socialized as women, or are people of color or people from communities or marginalized identities that have experienced oppression. And within those spaces, folks in those communities and individuals. Are socialized to have some of these beliefs about their role in society and who, how they need to show up in order to be worthy and to be valuable.

[00:24:43] But what then does having a field full of folks who are. Kind of see themselves as givers or believe it's selfish if they don't give or whatever, kind of the beliefs are structurally and on a society level, what that means for what resources are allocated, what supports are allocated versus other fields.

[00:25:05] So that plays a role. And then I think the third thing that plays a role, we don't talk about enough is that because public health is prevention. We're saving money, but we don't get that return on money where other fields that are making money, they get those resources. This is all very complex, of course.

[00:25:26] And it's not just individual and it's not just society. It's the kind of cross section of both, but that doesn't mean that working for you individually to get more rest and eliminate your burnout. Is going to be burdensome and exhausting and fighting all these systems. I think that's kind of where sometimes we feel powerless.

[00:25:47] That's why I think coming back to the individual thinking you have and going at that level actually is way more empowering. And when you think about it, that's how we're going to get traction on these community, organizational societal level issues, because what are norms, what are policies? What are barriers?

[00:26:04] They're just actions. People have taken driven by their own beliefs. So if we have more individuals in the world, believing in public health, believing rest is always available. Rest doesn't have to be earned. Rest is taken, then the policies will change. The social norms will change. The barriers will change. So it is both it's Hey, we got to address this individually in ourselves, but also doing that helps us address it structurally and socially and organization.

[00:26:36] Maura Leahy: So one of the things that we're asking, all of our MCH bridges, guests this season is, uh, what is your why? Because we're really celebrating and elevating all the different pathways and identities that folks bring to the MCH field.

[00:26:49] So what is your why for, for doing the work that you do? 

[00:26:54] Marissa McKool: My, why is folks in public health? I had this moment in like the beginning of the pandemic. Where I looked around at my colleagues who we have very similar circumstances, more work. Of course, all of us public health are not, you know, we're worried about safety, but in public health, we had these other challenges and what I saw.

[00:27:19] Folks, my colleagues, my peers were experiencing so much more stress, so much more suffering, so much more fear than I was not because I'm special. Not because I'm better than them, just because I had these mindset tools. And that is my why I think the most liberating thing, the most powerful tool we have is the ability to undo our own internalization.

[00:27:44] That's true. Liberation. You don't have to necessarily rely on anyone else or wait for the system to change. You can do some of that work yourself. And that is my why. I want everyone in public health who works in the field to get access to these tools and get the support to change their mindset. So while we are working to dismantle systems and change structures, we don't have to burn out.

[00:28:09] And I think we are more likely to get to that outcome. Whether it be faster or more efficiently or more effectively if individually, we all have these resources to not be burnt out. Ultimately, what is systems of oppression want? They want folks who want to dismantle a system who wants to speak out, who wants to show up authentically to be burnt-out make ourselves small hideaway feel too exhausted to do the work.

[00:28:34] And so my passion is helping the field individually and collectively to be able to undo some of that. So we can do more work and not at the cost of ourselves. 

[00:28:45] This conversation has been so helpful for me because. Prior to this, I just always assumed I've shrugged it off. Like it's out of my control. I think it's going to be so empowering for all of our listeners to hear that there are things we can do.

[00:28:56] There are actions that we can take. And was there anything else you wanted to share that we haven't touched on? 

[00:29:02] I think the other thing, and I felt this way, too, that folks get frustrated about is like, there is a lot going on about talking about burnout, but underneath it is kind of this idea of, well, if you tend this webinar, if you do this thing and you take these actions, you'll just feel better.

[00:29:17] And I think it's important to recognize, like this is a process we have spent our whole lives being socialized to believe certain. And that's been reinforced, you know, externally, and also we have a brain that is impacted by the way, in which functions for our survival. It doesn't mean it's going to take you as long as you've lived for you to undo some of this at all.

[00:29:40] So what I want to share with folks listening, if you want to continue learning about this questioning and this getting help with us, I do have on my podcast some podcasts up. So that would be helpful that I'm happy to share links to. I have one on like why we don't take sick days and kind of help you change your beliefs about that one on why vacation can be challenging for us and change your beliefs on that.

[00:30:04] I have several coming up throughout me and June around, you know, how burnout is a state of mind, why we chase productivity and why you're not taking your paid time off and obviously a host of others, but those are free resources that folks can continue to listen to, to continue this journey. And I also have a free burnout recovery mini course that dives a little bit deeper into this for folks.

[00:30:26] So, you know, this is all to say it is a process that is transformation that is. 

[00:30:32] Maura Leahy: Well, Marissa, I cannot thank you enough for taking the time to chat with us today. I kind of view it as a journey. I think, I think I need to kind of go on a little bit of a journey to figure out how I can shift these mindsets in a way that works for me.

[00:30:46] And I think that might look different for each person, given whatever different hats that they might wear in their personal professional. 

[00:30:54] Marissa McKool: Thanks so much. I'm so happy to be here and MCH will always have a special place in my heart. I really love the people in that part of public health and the work. And it's so important.

[00:31:03] So I really am so thrilled to be here.

[00:31:09] Maura Leahy: Thank you all for joining us on this MCH bridges. We kindly ask that you take a few minutes to fill out a quick feedback survey and let us know what MCH related topics are. Interesting. And who you want to hear from on future episodes, I'll link to the podcast feedback survey, as well as the transcript of this episode can be found at www.Mchbridges.org.

[00:31:31] Be sure to follow AMCHP on social media. We're on Twitter and Instagram at DC_AMCHP. We hope this episode creatives, new connections for you stay well. And I hope our paths cross on the next MCH bridges.

[00:31:51] This project is supported by the health, resources and services administration, or HRSA of the U S department of health and human services, or HHS as part of an award totaling $1,963,039 with zero percent finance through of non-governmental sources. This information or content and conclusions are those of the author and should not be construed as the official position or policy of nor should any endorsements be inferred by HRSA, HHS, or the us government.