Have you ever put on a face mask, expecting it to solve all your mental health problems?
That seems… unrealistic, but that’s what self-care marketing tells us: get your self care right, and all your difficulties will evaporate.
This week, Dr. Pooja Lakshmin breaks down what “self-care” actually means when we’re living in a complex, capitalistic world. It’s an exploration of grief, burnout, and exhaustion, and what it takes to care for yourself inside systems that repeatedly ignore their part in your suffering.
After leaving med school to join a wellness group that turned out more cult-like than liberating, Dr. Lakshmin went on a journey to heal herself. Along the way, she founded Gemma, a women’s mental health organization, and wrote a book called Real Self-Care: A Transformative Program for Redefining Wellness (warning: crystals, cleanses, and bubble baths not included).
In this episode we cover:
Related episodes:
For more on systems that fail us and what to do about it: Rage Becomes Her (and by “her” I mean US) with Soraya Chemaly
A fantastic discussion of the “wellness movement” and what it means for chronically ill folks: Living with Chronic Illness: A Conversation for Everyone with a Body with Sarah Ramey.
Notable quotes:
“Hope is different than optimism… Hope is something you can build. It’s a practice. It’s a skill.” - Dr. Pooja Lakshmin
About our guest:
Dr. Pooja Lakshmin MD is a psychiatrist, a clinical assistant professor at George Washington University School of Medicine, and the founder and CEO of Gemma, the women’s mental health community centering impact and equity. She has spent thousands of hours taking care of women struggling with burnout, despair, depression, and anxiety in her clinical practice. Her debut non-fiction book, Real Self-Care: A Transformative Program for Redefining Wellness (Crystals, Cleanses, and Bubble Baths Not Included), is out now and available in e-book, hardcover, and audiobook narrated by Pooja.
About Megan:
Psychotherapist and bestselling author Megan Devine is recognized as one of today’s most insightful and original voices on grief, from life-altering losses to the everyday grief that we don’t call grief. She helms a consulting practice in Los Angeles and serves as an organizational consultant for the healthcare and human resources industries.
The best-selling book on grief in over a decade, Megan’s It’s Ok that You’re Not OK, is a global phenomenon that has been translated into more than 25 languages. Her celebrated animations and explainers have garnered over 75 million views and are used in training programs around the world.
Additional resources:
More from Pooja Lakshmin:
Gemma Women’s Mental Health Community
“Hope is Not a Thing to Have – It’s a Skill to Practice” Oprah Daily
“How Society Has Turned Its Back on Mothers” NY Times
“Saying ‘No’ Is Self-Care for Parents” NY Times
Want to talk with Megan directly? Join our patreon community for live monthly Q&A sessions: your questions, answered. Want to speak to her privately? Apply for a 1:1 grief consultation here.
Check out Megan’s best-selling books - It’s OK That You're Not OK and How to Carry What Can’t Be Fixed
Books and resources may contain affiliate links.
Get in touch:
Thanks for listening to this week’s episode of It’s OK that You’re Not OK. Tune in, subscribe, leave a review, tag us on social with your thoughts, and share the show with everyone you know. Together, we can make things better, even when they can’t be made right.
Follow the show on TikTok @itsokpod and use the hashtag #ItsOkPod on all social platforms
For grief support & education, follow us at @refugeingrief on Instagram, Facebook, Twitter, and TikTok, and follow Megan on LinkedIn
For more information, including clinical training and consulting and to share your thoughts, visit us at megandevine.co
When I first started on the faculty at George Washington University, my mentor took me out for lunch and she was like, coulda I have one piece of advice for you. You don't have to answer your phone. You can let it go to voicemail and then listen to the message and then decide what to do. And that was an AHA for me because that was like right after medical school and residency, and at that time we had pagers and so it was like, you know, your pager brings you answer it. It's like this hyper vigilant fight or flight, you know kind of thing. And I was like, oh, okay, your boundary is in the pause.
This is it's okay that you're not okay. And I'm your host, Megan Divine. This week on the show, psychiatrist doctor Posia Lashman on real self care, which does not include bubble bass or crystals or any of the things that get sold to us in the name of wellness settled in everybody. All of that coming up right after this first break before we get started. Quick note, while we cover a lot of emotional relational territory in our time here together, this show is not a substitute for skilled support with a licensed mental health provider or for professional supervision related.
To your work.
Hey friends, Okay, burnout is a big issue. Burnout in your job, burnout in your relationships, burnout in the like constant one more thing of daily life. Right, and what is the one thing that always gets pushed as the cure for burnout or other mental and physical health issues. That's right, it's self care. Take time for you, have a bubble bath, nourish yourself. Now, I am clearly being snarky here because I do actually like many of those things. But this idea that, no matter what is wrong, self care, preferably of the bubble bath and scented candle's variety, is somehow the answer, rather than like you know, actually addressing the conditions that are having you feeling exhausted and burned out. This is a really big problem in the wellness industry, this tendency to oversimplify and sidestep the core issues that actually need attention. This week on the show, doctor Puja Lakshman, author of the book Real Self Care and founder of GEMMA, a women's mental health community centering impact and equity. Now long before she wrote a book on the problems with self care. Doctor Lashman was a burned out, overwhelmed medical doctor, just finishing up her residency, the life that she'd built for herself, her marriage, a career in the medical field. All of these outward markers of success were beginning to feel toxic and unsustainable. Now she tells the story, she says she blew up her life. She left med school, got divorced, and joined forces with a women's spiritual wellness community dedicated to women's empowerment through sexuality and orgasm. And that worked for a while, and then she realized she had traded one oppressive, punitive, restrictive community for another. The wellness movement was just as toxic as the medical industry. And on top of that, she realized that she'd used a focus on wellness and empowerment as a way to avoid her own grief and her own depression. And that's what a lot of people do, right when things get hard. We look for something that promises empowerment and freedom. The problem is, obviously, that you cannot wellness your way out of grief. You cannot wellness your way out of stress or burnout or toxic situations, or even just a life that doesn't fit you anymore. Bubble bass and chanting mantras are not going to fix it. So one more time, Pousa left the life that she'd worked so hard to build. And when she left, she felt depressed, suicidal, and just adrift in the world. And what she found in the time after she left that wellness community and really sad in the truth of her life and her own needs, was that the answer wasn't in leaving her profession as a psychiatrist. It was using her position as a woman, as a doctor, and as a person of color to explore the oppressive systems that keep us burned out and isolated. Now, we cover a lot of territory on today's show, including why simplistic wellness movements can never fix what's wrong, why boundaries are the secret to basically everything, and what real self care care that acknowledges and addresses the systems in which we live is a wellness movement we can all get behind. Now you will get a lot more of Pusha's story in her book, Real Self Care. So if you're listening and you find yourself saying, like, wait a second, wait, what happened a few times in the show, be sure to pick up her book Real Self Care wherever you get your books for the whole story. Now, one last thing before we get into the show. A brief content note. Doctor Lashman uses drowning as a metaphor for emotional overwhelm a number of times in the show. If you have lost somebody to a water related incident, Hi, me too. Common metaphors can be a lot. All right, onto my conversation on Real Self Care and the systems we live in with doctor Pusha Lakshman. Okay, I am ridiculously happy to have you here with me together today. We have been rambling before we started officially rolling, and just like sidebar thing everybody, I had to make myself focus on the questions that I have for Poosha today because we have so much in common and so many good things, and I love her so much even before we get started with this conversation. So anyway, all of my gushing aside, I am so so happy to have you here today in this space with me.
I am so excited to be here with you, Megan, Thank you so much for having me.
Now.
When we were getting set up, I said, I don't like to ask sort of the traditional repeated questions when somebody has a new book out, And I'm going to break that rule just this once, because you start your book with what you call a snapshot from a traumatic and transformative time in your life. It's not just the story that you tell in the beginning of your book though. Like when I was doing my research on you, I was looking at your website, which is gorgeous, by the way, and that story is actually really prominent on your website as well. So since you start there in so many places, it feels important, and I wonder if we might start there with what happened, yes, but also why it felt important to center that particular story.
Yeah, I'll start with sort of the what. So we're all on the same page. So right now, in twenty twenty three, I am thirty nine years old, and I am a psychiatrist. I specialize in women's mental health. You know, I take care of patients. I wrote a book. I'm like a professional person that is vaguely normal. But about a decade ago, in my late twenties, I blew up my life. So up until that point, I had sort of lived kind of like the cookie cutter Indian girl one and a half generation thing. My parents are immigrants from India and my dad's a doctor, and so it was like I did all this stuff. I followed all the rules, you know. I went to an Ivy League college, I got good grades, I was valed victorian. I went to medical school, became a doctor, got married, and then I was in my second year of psychiatry residency at a prestigious program, and it was kind of like I checked all the boxes and I was like, Okay, now I'm allowed to be happy. How do I be happy? Right? It's actually funny. At that time I was reading Greshien Rubens The Happiness Project, right, Like, I was literally like I were happy happy right, yeah, and like a narrator like it didn't work because I had designed my whole life based on other people's values. And that was the personal bit. The professional bit was that I was training to become a psychiatrist, and I was in the system where you know, naively, I went into becoming a doctor thinking that I was going to be able to help people, and I found that the problems that people had in their lives were largely above my pay grade in that, you know, I could prescribe zoloft, I could prescribe psychotherapy, but I couldn't solve the housing crisis, the cost of living crisis for an unhoused man that comes into the VA and needs housing, or a woman who has like three PhDs and is at home raising four kids and feels stuck in her life, and you know, she's not able to be employed outside the home because she doesn't actually have the work experience, right, and the job market won't account for that, right. All these sort of like structural barriers that you can in therapy. You can get treatment for your depression or anxiety. But when the world is so deeply broken, and when our government and our systems aren't built for taking care of actual human beings, I felt very let down, and I was really angry because I felt like I was like sort of sold this spilt goods, Like if you follow all these rules, then you'll be happy anyway. So I just broke it all. I blew up my marriage. I moved into a wellness commune in San Francisco that was focused on female orgasm and sexuality and meditation and spirituality. I quickly after that dropped out of my residency, and I spent two years with this group and professionally. It was really transformative for me because I got to work at the Wretgers Neuroscience Orgasm Lab where they put people in fMRI machines and look at their brains. Only one of two labs in the whole world that do this, so that was really cool and I learned a lot during that time. But what came out by the end of it is that I realized that I was just running away from my problems and that there's just as many inconsistencies and hypocrisies in the quote unquote spiritual world as there are in mainstream medicine. And ultimately, you can't outsource your problems. You can't outsource your decision making, Like you just have to do the hard work in your own life and there's no shortcut to that. So I left the group, and I was really depressed, nearly suicidal, you know, went back on antidepressants. Was so privileged and lucky to be able to get back into therapy and have access to a psychiatrist and all these things, and then did face like the hard, really really hard thing of coming back to medicine, sort of having to admit that I had failed and like, here I was crawling back, coming back to being a doctor, and then building my career, and then you know, fast forward. I graduated residency, came on the faculty at George Washington University, this women's mental health practice, started writing for The New York Times, and like that's how this book, Real Self Care came about. Second part of your question, why do I focus on that or why do I put that up front? It was a really deliberate decision for me. Part of it is defensive in that it's kind of like, hey, look, this is it. This is a story, like right, Like it's a wild story. I've been in psychoanalysis, Megan. You know this, but your listeners might not. Psychoanalysis is the really hard core type of therapy where you're on the couch and the analyst is behind you. I've been in psychoanalysis for seven years. My analyst actually is retiring in December, which is very sad. I had to grapple with the fact that I was a physician with this group, and I when I was very deeply entrenched in their dogma, like I was a proponent. Right, that's hard and sucks, right, And so I think part of it was like I just want to acknowledge that, but I think the next level, and probably the more important one, is that I've had to do so much work to bring compassion for myself, and that every single person that knows about this time in my life, all my friends that stayed with me, and then also like new friends who learn about it, no one is ever like oh my god, wow, like jeez, They're all just like wow, I kind of understand. I kind of understand why that happened, you know, like that kind of makes sense. I think that there's a lot of snark around like wellness culture, and I get that, but I also think that, like we need some compassion because it it happens to smart people. And the reason that it happens too is because we're not finding solutions in the places that are supposed to be giving us the solutions. So there's a reason, right.
Yeah, Can I jump in for one secare?
Yeah?
Because I think there's something.
Really important here. And if people haven't read that whole story or read your book yet, but you totally should because it's awesome. I want to pull one thread here, and like the summary is so like you did everything right, as you said, and you know everything that a good immigrant person is supposed to do in med school and all of these things and studying happiness and getting really disillusioned with the systems that you encounter from the inside, right, Like you don't always see the machine when you're outside of it, but when you're inside of it, you're like, holy crap, Like I can't fix what's really broken. And what's broken is not my patient, it's not my client, it's the systems they're working in, right, And so that disillusionment to me is this I'm gonna put words in your mouth here, so you correct me if I'm wrong, But like there is a longing for connection and community and realness, like can I address the root of what I'm seeing show up at my patients and my clients in my life? Right? And I think this longing for realness is what makes a lot of people dive into quote unquote wellness communities. Two things that I want to pull out here. One is you said that, like your experience in this wellness community is sort of like hot gossip, right, Like it's this really tabloid could be this like really tabloid fiesta talking about this, And I really love that you claim it and you own it. And you put it front and center, because like the things that we put front and center, they don't have fangs to them anymore if we're talking about it in like real, human centered ways. So one, I love that, and two I love what you just said about bringing some compassion to people who find themselves fleeing one system and jumping into the arms of another, just to find that it's the same toxic system with flowier robes.
Right.
So those I think those two pieces. One that like what I hear in that story from you, and one of the reasons that I wanted to lead with it is like, there is this longing for realness, and sometimes we fall into holes longing for realness, only to find out that these are just as fake. And so I there's something about community and empowerment in that story, which is one of many reasons why I love how you center that that longing for like realness and community. Does that feel accurate for you or am I telling my own story and study yours? No?
I think that's right. I think, and I think in particular the realness. I think the realness is the seed and then the community, and that's sort of the meaning. And then the interesting bit is that how it can get twisted, right, and you can think that you have that and then come to understand that it was not that. And for me it took years. That's there even really know that I did not have it. I left the group devastated, right. I didn't leave the group making them the bad guy. I left the group devastated, right, And then it took years of years and years to really understand what was going on. So you know, in how you describe that, Megan, the thing that stood out to me too of what you said sort of jumping from one oppressive system to another one. And the reason that I think that that happens is when you skip the grief, right. I think I wanted to skip the grief, right. I didn't want to feel the grief, but it came right.
It always does, that's what it want, right.
Yeah, how does that grief show up for you? I love how you just frame that, like we skip from one system to another system as this like a solution to the grief we fail, or the pain we feel. But you can't bypass that stuff because it will come back. What's that grief thread for you?
Yeah? You know it's interesting because I think for me now, the way that it's showing up is in being an author, like this whole this is my first book, right, And we talked a little bit before we started rolling about what it feels like to be an author launching a book in the world. And I think the way that I'm holding that grief right now is in this understanding or trying to make sense of, like how do I put real self care out there with the understanding that a self help book is not going to fix all your problems? Right, This is not a panacea, This is not a matter of kell. This is just a beginning of a conversation. Right, This is just a very micro step of the conversation and acknowledging that and then also being able to hold obviously all the work and heartache and stress that goes into the endeavor of creating some thing and knowing that you're just kind of one person. But I think the way that I think of it now is that almost like the grief is almost always with me, for better or worse. What I took away from that time in my life is that I wanted to be somebody who could talk about these larger systems and could talk about women's mental health and wanted to be able to reach people outside of my office or my zoom room. Now, so that means by definition, I have to be working with these oppressive systems, whether we're talking about media, whether we're talking about capitalism, right, just all this stuff. So now it's just part of my job. In some way, it's a different part of my job. I kind of feel more in touch with it, Like it's less of like a huge dark pit and more of just like obviously at a much lower volume, but it's just kind of like there in different ways.
Yeah, I mean it's like it's it does.
I mean, it's like it gets all of you, gets a seat at your table.
Yeah.
Yeah, right, And if.
You are going to do this work of being a voice for better or worse in a wellness industry, a mental health industry, a whatever it is industry, that it's only real if you're also doing the work. I love that you said a self health book is not going to solve systemic problems. And it's also not going to solve grief. It's not going to solve overwhelm, it's not going to solve unequal burdens like all of these things. But there's something that I want to pull out and what you said I have. There's a line that I have highlighted in your books, one of my favorites, and it says, if it's somebody else's answer, it can never be your solution. That idea that is really really common in the wellness speaks sort of self help world of all of your answers are within Sometimes the way that I hear that or interpret that is you're on your own. There is no help for you. Don't go to anybody else, don't lean on anybody else. The answers are within you. You figure it out. Having been a child who was like encouraged to become everything, but given no tools to figure out what everything could be. That whole message of the answer is within you. You don't need anybody else to find it. Feels mean hm m m. That sort of seems to be like the antithesis of what we might be looking for in our questions, which is a sense of community and connection and companionship while we're looking for answers, right right, yeah.
Because in some sense these questions that we're asking, or that you know, the searching is also a bid for connection.
Say more about that searching is a bid for connection.
I love that. Can you say more about that?
I was giving a talk yesterday and we were talking about why it's so hard for women in particular to accept help, Like you feel like you can only get help when you're drowning. If things are fine and your neighbor or things are like maybe not fine, but they're like, yeah, you're okay.
Right, under control, under control.
Right, And your neighbor says, hey, let me drop off dinner. You're like, no, no, no, it's fine, I got it. It's okay. We don't need the handout, right. What if instead you interpret that offer from your neighbor as a bid for connection. This is your neighbor saying, hey, I want you to be part of my village, right, I'm offering a gift so that we have this connection. So I was thinking, there's this, there's a parallel process there around. Hey, I'm struggling in my life. I'm like looking for answers in one way or another, and I'm reaching out to my support system to kind of get some tools. And it is about connection. And so when somebody says it's all inside you, you can experience that as a rejection, Like, yes, It's true, it is inside you because ultimately you do have the answers, and like we're humans, we want to be learning and growing in connection with everybody else and in a community. So I think that's very true. And I think like so much of this kind of like self development work, if that's what we call it. I don't know, I hate that word.
Sure, but let's use that for sure.
So much of it is learning how to navigate relationships and interpersonal spaces, right, and even in real self care, Like that's where we're talking about boundaries, self compassion, values, power, Right, It's all about in relation to the people that you care about or the people that you're responsible for, and then how do you navigate your needs versus somebody else's or your wants and someone else's and then what happens in that in between space. I'm on a thread here, but I think that when we center it on you're the only one who knows. And when that's the language that we use, I think that that does come across as cruel and could be like need as isolating.
Now, yeah, it's such a contradictory message, right, Like all of that sort of wellness language around those two ends of the spectrum, right, like reach out and get help, feel connected, like have these authentic relationships, but also do it all yourself and don't look at anybody else for the answers and only you note like, Okay, which one is it?
Yeah?
Which one is it? I love that you brought boundaries in here, because boundaries are one of my favorite things in the things in the entire world. A conversation about boundaries, and like, boundary work is relationship work, and relationship work is about that. Yes, all of the answers are mine and they are in me, but we also need connection and relatedness and sometimes we need lights in the woods, right to show us where we're going, Like there's there's so much in there and what There's this whole section in your book about boundaries, And the question that I have for you about boundaries is like, what is it about boundaries? Claiming a boundary, stating a boundary, making a boundary that feels so dangerous to us a lot of the time?
Great question? Can I first share my definition of what boundaries are to me at the end? Okay? Awesome? So when I talk about boundaries in the book, I give an example of the little aha moment that I had with boundaries. So it was this has been in twenty sixteen when I first started on the faculty at George Washington University. My mentor took me out for lunch and she was like, Poja, I have one piece of advice for you. You don't have to answer your phone. You can let it go to voicemail and then listen to the message and then decide what to do. And that was an AHA for me because that was like right after medical school and residency, and at that time we had pagers and so it was like, you know, your pager brings you answer and it's like this hyper vigilant fight or flight, you know kind of thing. And I was like, oh, okay, your boundary is in the pause. You let it go to voicemail, you pause, and then you decide. You can say yes, you can say no, or you can negotiate. A boundary isn't always no. A boundary is the pause. And then sometimes it's the front desk and they just have paperwork and it's like, oh, will come at the end of the day. And sometimes it's a patient that you know, someone who I know if she misses a day of her stimulant, she has ADHD, she's gonna like, that's gonna be bad. Let me call in the refill, right, You use your judgment, right, So that's the boundary for me. The boundary is the pause. I think it's uncomfortable because in that pause, as women, you feel every the other person's feelings, right, You feel their disappointment, you feel their anxiety, You feel that, and then you feel your own anxiety. You're bracing. It's like the waiting, the slowness, and then having to actually feel that you might let somebody down and not meet their expectation. And then after that, if you you say no, or if you do negotiate and have some questions, then of course is the requisite guilt, right, and then you have to sort of deal with that. But you know, I think when I'm sort of teaching about boundaries, I always like to remind people that with boundary setting, there's two parallel processes. There's the actual operations of communicating the boundary, which we know kind of like the best practices for that, like be clear, be direct, don't over explain, YadA YadA YadA. But the other side is the other person's feelings, and you can't look to the other person to take care of you. You have to have a separate lane, whether it's like a therapist or a trusted friend, or you know someone else that you can go to hold that piece. You can't look to get permission and care from the person who you're setting with the boundary with, especially if that person is someone you've never set a boundary with before.
Yeah, and boundaries like boundaries go against cultural conditioning, especially for women around I have needs that might not match your needs, or I don't like what you're doing. And there's something that I teach a lot when people are going through usually grief related to death. You know, if somebody asks a question like a personal detail, like how did they die? And sort of the internal process we go through is like it's impolite to tell them none of your business, right, even though I'm uncomfortable answering this question and this relationship does not warrant that level of detail. I am going to override my own needs because this is what's expected of me. There's something in that act of even before you voice a boundary, recognizing that your needs have value, right, and that you're allowed to take up space. So you wrote part of learning to set boundaries is internalizing the fact that you do have limits and that there's nothing wrong with that. It's such a simple sentence, but it is such a foundational thing that we're taught, especially as women, as like your needs, whether you're grieving, whether you're just living your life, whether you're like deciding whether you want to go to med school or not. That in order to put a boundary in place, you need to value yourself enough to recognize that you have needs in the first place. I feel like that's really the root of what you're talking about when you're talking about self care. And this works within systems, which I love that you attack. This works within interpersonal relationships, this works within loverships, like this works in everything. In order to truly care for yourself, you have to believe that you're worth caring for. So how does that almost that requirement that in order to care for yourself you have to believe that you're worthy of care no matter what is going on in your life.
Like.
What does that look like from where you sait? Maybe not necessarily in your own life, but like that framing of this work, Like I feel like, Okay, I'm going to get lost in myself here, but like that that pause to use your language that you just used, that pause being the boundary to me, that pause is this ongoing practice of valuing myself enough to know that I deserve to find out what I actually want so that I can then say yes, no or maybe yeah.
You know. The funny thing that as you're describing all of this, I'm finding myself wanting to loop back to grief because when I do this work with patients, grief is one of the first things that comes out. And I mean like little g grief, but like when you kind of get it and take it in and you're like, oh, I deserve to give myself the pause. I deserve to take the time to stop and think and feel. The first thing that comes is like, Wow, how many years have I spent not doing that? And like how devastating that that can feel. You know, most of my patients are somewhere between late twenties to like early fifties, right, so it's a big range. But like whether you're in your thirties or whether you're in your sixties, there's still that grief that comes with when you understand like, oh my gosh, I've spent so much of my life putting myself at the very bottom of the list. I think like that that's the thing, actually that I see a lot of Hey.
Before we get back to my conversation with doctor Pusha Lakshmin, I want to talk with you about getting help inside. Pusha and I have spent a lot of time talking about finding support that actually serves you, and honestly, it is not easy to find, especially if you're looking for somebody who understands grief. We get a lot of messages from people wanting to speak with me directly, and we used to say no because I simply didn't have time. But now we are saying yes for a limited time and a limited number of people. To apply for one of the grief consultation spots on my calendar, send us an email at support at refuge in Grief dot com, or use the contact form at megandivine dot co. And remember, if individual work with me is out of reach or that waiting list gets too long, you can join me every single month for a live Q and A at Patreon dot com. Backslash Megandivine. You can join me every month for a live Q and A at Patreon dot com. Backslash. Megandivine details on both options for skilled grief support in the show notes. I've spent so much time lately talking about my phrase is the everyday grief that we don't call grief. And this is a really good example of it. It's like, as you start to become aware of how much of your life you have lived for other people and not for yourself, there is immense grief in that, right, all of those wasted years, all of the things, all of the life you haven't gotten to live because of this stuff. And this is why, like I say that all self work is grief work, Like all work that you do for your own self development involves grief.
I am on board with that. Even with self care, it's like, you know, you have to first understand and recognize that the systems have let you down, and then also in the values bit of it, making the hard choices of like well what am I really going to prioritize what's really important to me? And there's going to be things that you have to let go, right, And there's always costs to boundaries. Right. The pause, I think is available, but the no is not available for everybody. And even if the no is available for you, there will be a cost, whether that's financial, emotional, and there's grief in that.
I love what you just said is that the no is not available for everybody. Tell me what you mean by that.
I guess I think of it in terms of my own life experience, which is kind of in this rigid medical system where you for so many years you feel like you don't have a choice. You have someone to have a head of you that says you had got to be two in rounds at five am, Right, that's what you gotta do. There's a patient that needs X, y Z, that's what you got to do, right. And so you might have no's available to you in the future, right, But in the current present tense, if you want to stay in that machine, which again that's a choice, right, But do you have student loans? Right? How much of it? And I've talked about this publicly before. I didn't have student loans, and so that was also something that enabled me to say no and leave. If I had had student loans, I wouldn't have been able to make that choice and write like that would have looked very different. So, and you know, when we're talking about like race and identity. When a black woman says no in the workplace in corporate America, she's going to be penalized more than a white woman. Well, right, all those things are true, and so that's that's what I'm kind of speaking to when I say no is not available for everybody. But I do think the pause like the pause is, and so you can take that pause and then understand why you can't say no. And I'm not saying that that's fair. There's going to be grief with that.
Right, there's so much in what you just said. We're going to get into systems in a second, because I know we've mentioned that a lot, and some people might be like, right on, taken down the machine, and other people might be like, what the heck are you talking about with systems? So we're going to get there in just a second. But I love that you just said the no might not be available, but the pause always is, right, which is a really cool way of looking at this. When I'm teaching and talking and helping people figure out how to get their racist uncle to stop making racist comments at the dinner table, or how to get their sister to stop trying to set them up on blind dates, when it's only been like four months since their husband died. Like when we're trying to get somebody to stop doing something that makes us uncomfortable, there is a cost to that. There is a cost to a boundary, and sometimes that cost is too high. Sometimes you do need to bite your tongue. But making that a choice for yourself understanding in that what I to use your language, that pause right to say here is a thing that I do not want, that is not in my best interest? What is the cost benefit analysis to speaking this right now? And is it worth it?
Right?
You want to state a boundary in a situation that would be dangerous for you, And as you said, you know for certain people, certain populations. You know, if you are a black woman in corporate America, pushing back against an inhumane system is going to cost you your job or something right in more ways than somebody else might. So that sort of cost benefit analysis is really important. And this is such a comp like all of this stuff is so complex to me. This is why these simplistic wellness movement things can never fix what's wrong, because there's just so much other shit involved. There's so much involved, Like you cannot just choose yourself and have like be one and done. That's not always true, right. One of the things that I love about you and love about your work in all the ways that it shows up, is like you ignore knowledge the systems in which we all live, and that nothing is as easy as the bumper sticker wellness movement wants us to believe, or that the sort of pathology based medical model wants us to believe. Like they're both wrong. Human life is so much more complex than that. And I love that you are not only willing to speak into that gap, into that middle place, but do it with something for us to hold on to.
Well, I'm blushing right now. I don't know if you can tell, but thank you, Megan, I really I appreciate it. And and you know, I think that's that's like this tightrope that we're trying to walk, because I think it's so easy to veer into cynicism and hopelessness.
Right.
Either you're like want in that woo woo wellness like love and light, or you like, you know, listen to NPR and like are you know the world as shit? To be fair? I do listen to NPR, and I love MPR, but like I think there's a middle ground, and so like the work I think is to how do we say as much as possible, never one hundred percent, There's always going to be days where you just all you can do is doom scroll, But how do you stay in a position of agency? And that's one of the reasons that I also founded GEMA, which is my women's mental health community where we're trying to kind of bring the systems in and talk about the systems and educate about social determinants of health and also provide real coping skills. And so whether it's like through our emails or whether it's the what's app threads or that we're doing. We've just started doing courses for clinicians and for mental health providers, right, because I do think that part of this is like actually educating people in our field, like having a nuanced approach and understanding so much is broken on the outside but there also are It's not a panacea like the wellness world says it is. It's actually it's just an invitation, right, Like we've been talking about here, a bid to connect with yourself in a different way, a way to engage with a realness. Right, we're talking about this realness right, and acknowledge that that's messy and it's usually not linear, right, just like grieve Right, It's like it's messy and there's layers and you have to take a leap of faith too because you don't know really where it's going to go. You just have to trust that it will kind of lead you to the next place.
Yeah, I love that you brought up Gemma because it's in my notes to link Gemma with a different kind of community, right, or a different kind of community building, a different kind of connection personally, professionally, as leaders, all of these things.
It's like it's that false.
Binary, right that you either are like in the medical model trying to fix stuff through that direction, or you're in the whole wellness world and you've got answers over here and if you don't follow them, then you're a fail. Your failure inherent on both ends of that binary. And I think one of the things we sort of think is like, well, crap, if there's no if all of the solutions are in me as we talked about before, and there's no one answer, then there are no tools, then there is no structure. And honestly, if your choice is between a broken system that has some answers and some structure and some things for you to do, versus the great gaping void. You're gonna choose the faulty structure. And again, like one of the things that I love about what you're trying to do with a book, with your speaking and with Gemma is like, okay, how about option three, which is the messy middle of the spectrum, not a binary, where your truth is the truth that matters and only you can say what that is. And this is true in grief, this is true in relationships, this is true in all parts of life, even the joyous parts. Like only you know what that is, but that doesn't mean you're alone in it. It doesn't mean there's nothing you can do to access it, or to support yourself or to have guiding questions for it. And to me, like if I had a soundtrack, this would be like when the clouds part and the you know, the angels sing, like this is this is our role as providers, This is our role as as writers in this space, as leaders in this space, is to be like there are other people swimming in here with you, and there are things that you can try, and there are tools that you can try. You aren't in this alone, even while at the very same time all of this is yours. I love that there's a word in your book which is totally related to this. You wrote about you demonic well being, and I hope I just answered that correctly, you demonic well being. It's really rare for me to come across a word I don't know because I'm very much a smarty pants. So that was exciting. If I have to go look up a word when I read, I'm like, oh, I love this person forever. Okay, So you tomonic well being. First of all, I want you to define that for everybody who did not go rushing to their to their stuff to look it up the way that I did. But how does that apply to work, to personal life and to what we just talked about about? That like messy middle thing where there are no answers and you're your own answer, but everybody's here with you, Like, can you summarize that for me? Or can you? Can you no pressure at all? But can you catch all of the balls that I just threw it? You?
Yes, let me try, Let me try. So you Tomonic well being is in contrast to hedonic well being. Okay, So hedonic well being might be a term that people are familiar with that is like pleasure centered happiness, right, things that feel good. Whereas whereas you tomonic well being is meaning centered well being. So that's a life where you are connected to your purpose and you'll or activities, your choices line up with your internal values, with what matters most to you. When so you look at your career, when you look at how you spend your leisure time, when you look at how you interact with your family or how you build your family, all of that, like you're able to point to your reasons why, you're able to point to what it means, you've spent time thinking about that and deliberately choosing how you structure things in your life. Again, as opposed to hedonic well being, where your well being slash happiness is kind of focused on experiences that make you feel good. Right, So like vacations right.
Right, I love.
There's something that you pointed out in the book where you say hedonic which is happiness, positivity, and pain avoidance versus you demonic, which is striving to do what is meaningful even if it is hard to achieve, right, and this idea that if you do everything right, you're gonna have this pleasure filled, joy filled, always on vacation lifestyle. But inherent in that is avoiding pain, running away from it. And I think this is one of the one of the false promises of the wellness movement, is that if you do everything we say, if you do your jade eggs and your facials and your mantras, then you will be perpetually happy and perpetually positive. And if you're not, then you're failing. Right and man baked into that is the avoidance of pain. Yep, you're not able to feel the stuff. Yeah, yeah, same, same, Like nothing is allowed to hurt you if you are in your protective ball of white light.
Yeah.
Such trash, Such trash. There's something so much more real about that. You'damonic, which is striving to do what is meaningful even if it is hard to achieve, and inherent for me, and that is like, Look, life has pain in it, it has grief in it, it has ouch points, and.
That is it's just the nature of life.
And we can connect in that and we can work with that and all of those things. Like I feel like I should have something similar to that statement boiled down briefly to tattoo on myself somewhere. Now we have mentioned systems a lot, and I know we're rounding the corner towards our time here, but I think this is an important little piece to put in. You wrote that self help traditionally does not acknowledge the systemic barriers that women and people from marginalized groups face. We must shift away from commodified versions of wellness, which continue to uphold and perpetuate inequitable systems.
Of power.
Who I feel like we could do an entire other show on systemic power systems and how they impact wellness and health and all of these things. But there's one piece of this that I want to pull out. So much of your work addresses women. In your book, you quote Sylvia FEEDERICI, who when asked to define the word women, said, quote to me, it's always been mostly a political category. I don't think that we can separate the wellness movement from women and the women's movement, whatever that means. But your definition of women feels a lot broader and more inclusive than we sometimes think about. So can we can you tell me how you use the word women, because it's in your work so much and so often.
Yeah, this is a tough one for me, I think, because I think woman is sort of still the default word, and we talked about this, We've talked about this internally at GEMMA quite a bit, so, a women's mental health platform, and it's sort of like, do we want to use that word? What's the other word that we use? And I think it's very easy also to get caught up in the politics and polarizing nature of the words that you use, when in reality, I think the solution is more about the conversations that we're having and the dialogue that we're having. And my co founder at GEMMA, doctor Cally Cyrus, she is a black queer psychiatrist. She's just awesome at everything, but particularly around this type of thing, around like, well, how do we talk about stuff that's hard to talk about right? And you know, when you write a self help book, it's not usually a given that you'll have a chapter that's about identity, privilege and systems of oppression, which is one of the first chapters in my book. And I think I really wanted to signal upfront that I want to be as inclusive as I can and that even in like the most sort of like vanilla, if we say version of the word woman, there's so many diff different shades of privilege. Right, Are we talking about white women? Are we talking about brown women? Are we talking about queer women?
Are?
Right? And then what's available to you when it comes to resources, when it comes to choices, and where you fall in that line. I'm not really answering your question here, I think that, and that's on purpose because I don't think I have an answer, right. I think it was like I wanted to the state that it was hard and like it's a question that I'm still working on, and also like acknowledge that I don't want it to just be a given. I wanted it to be something that we think more about. And then I don't have a better word yet. And so that's the one that I'm going with.
You are actually answering my question because a lot of this work is about addressing the brokenness of systems and the polarization of language and words and othering and all of these things and not being able to see that our grief, our joy, our losses, our wellness, they don't all look alike, and we don't all have equal access to finding the answers for ourselves and the labels that we have, the systems that we have, we outgrow them a long time ago, but we still have to use them. In the book, you say you inclusively mean all people who suffer under the oppressive conditions that have been typically associated with the female sex, which includes queer folks, trans and non binary people, intersex and age ender people. So, you know, I wanted to pull this in because so much of the language around self care, around wellness, and even for me, around grief, Like talking to men about grief is a really taboo thing for men to talk about.
Right.
We can't talk about self care, we can't talk about wellness, We can't talk about personal agency and sovereignty without at least giving a nod to the constructs that we interact with, the systems that we bump up against the limits of language, the inclusive, exclusive nature of words like it's just like it starts to get really really mucky, which I think makes a lot of people shy away from a lot of these conversations, right because we start to be.
Like a crap.
I need words to hang on this and again coming back to me so much of your work is about. It doesn't matter if the language is messy, it doesn't matter if there's not a clear solution. What matters is that we are here together.
In this mess.
And there are some lamp posts, some light posts in the forum very often of questions that will help you and investigate this for yourself. What does inclusivity look like? What does what does the system look like? For you? Where are your pause points in your boundaries that are available or not available? Where is the grief in the life that you didn't get to have because you didn't know this self care was an option for you.
Yeah, yeah, And that's such a it's a much kinder way to think about this conversation. I was talking to somebody a couple of weeks ago who was you know, admitted that she does reiki right, And I actually in the books talk about how when I was pregnant with my son, I went to do crany and sacral therapy. I just really liked the room, I liked the woman. I liked getting to lay on the bed with a nice soft pillow. Right. So it's like, you have to know what you're doing it for, right, And she was waiting for me to condemn her and like just be like oh my gosh, and it's like no, like let's think more about it, Like what does it do for you? Oh, like you're setting boundaries. You go once a week, that's a specific time where you are unavailable for any work calls. You are kind to yourself during that time period. I don't know what's happening with like the actual energetics of the reiki, Like that's a separate thing. But can we do more of this? Like maybe it doesn't to be the reiki, but the structure, the containment that you built in your schedule for this, that's great. So you know, we get a long way with curiosity, I think, and I'm just trying to model that for myself too, like just you know, as as and also in this space of like providing more questions, providing new language, providing a different way for folks to engage with their own minds and think about their lives, but also not pretending that I have it all figured out and like I'm some sort of like zen person who's up on a mountain like just like totally blissed out. No, not at all. I'm on zoom calls and I am drowning.
Also thanks, also thanks, It reminds me.
It reminds me of where we started in our conversation together, when we were talking about your time in that particular wellness movement and looking back on it and trying to have some kindness to yourself and to see the details of that experience. Yeah, well, there's some problematic stuff in there, but the longing and the containers and the space set aside, like you were looking for something and maybe that wasn't the answer, but the looking is important, and having that orientation of kindness to self is really important. And thank you for modeling that here in our time together and in your book, because there's a whole section around kindness to self, which is a whole other topic, because being kind to yourself is one of the hardest things in the world to do sometimes. But we don't have time for that today. So I want people to go and find your book and listen to you speak so that maybe you'll get into it with them. But the last thing that I want to talk about for us together is a topic that you have written about, and we will link to it in the show notes along with everything else. But hope, my friend trying to end everything on hope here, and I know that you've written quite a bit about it. Knowing what you know and living what you've lived, including what you're living right now as a person inhabiting the author role in this way for the first time, What does hope look like for you now?
So you know, hope is different than optimism, right, Optimism is like glasses half full. Hope is like, yeah, the glass fight have a leak in it, but I have the problem solving capacity to fill the leak. And what I've learned actually at GW where I train and I'm on the faculty now, is that hope is something that you can build. It's a practice, it's a skill, and there's actually reliable things that people who call themselves hopeful turn towards. And so that's you know, your relationships, right, we were talking about being in community, really leaning on your people, like the people that you really trust. Problem solving actually, like use that pretty frontal cortex helps with hope because it takes you out of that drowning feeling. It gets you into action. I know that's a little bit counter to grief and allowing yourself to feel, but sometimes that problem solving is a nice distraction, the little bit of a life raft when you're drowning too hard. Right. And then there's identity. And then I use the word identity to mean, like, what parts of your identity really have you feel like you belong So as much as I as much as I've had a conflicted relationship with being a physician, for better or worse, being a physician is a part of my identity and it does mostly give me hope. I love the qualifiers, but I think another place is like if you're part of a spiritual community, if you have a churst that really some really you're connected to. Yes, that's relational, but that's also part of your identity, and that helps with like sort of like grounding, with reminding you that you have a place in the world. So maybe what I'm pointing to you here is that in this kind of conceptualization as hope as a practice, what can you do to help yourself remember hope? For me, a lot of that is tied to belonging right, belonging to yourself, belonging to a community, belonging to these larger groups. So the takeaway is it's something that you can embody right, there's actual real things that you can do, like who do you talk to? Who do you go to? Right? What are your practices? All of that might not be second nature. Right. What might be second nature is just to sit there and doom scroll. But when you think about hope as something that you can actually act, it puts the agency back in you too, because it's not just like, oh I feel hopeless, woe is me? It's like, Okay, how do I go look for hope? What do I do? Who do I talk to? What's a reminder for me? Maybe I should get to that meeting. Maybe I should go volunteer next weekend. Maybe I should take my kid to the Science Museum because he you know, like whatever it is.
Two things that I love in that One is this idea that hope isn't passive, right, and also that it's not like some ephemeral, floaty thing that there are actual it's something that we talked about earlier, right, like there is no answer other than your own truth, and here are some skills and some tools and some practices and questions that might help you uncover that. And like I just heard you say that hope for you sort of falls within those same that same mechanism right, that it is something that you need to own for yourself, and there are some practices that might help you looking for it. And the second thing that I love because this is how I feel about it, and I'm biased towards myself, but like that, hope is relational, right, It's not an if then like endpoint thing, right, Like I have hope in the world suddenly getting better. No, it's like, well, the world is currently a mix of awesome and terrible, and who is with me? And how do I draw hope from my identity and my connections and my relatedness? And I super super love that because I am all about the relatedness. Now, I'm going to link to your essay on hope that you did for Oprah Daily because there's also a whole element that we don't have time for today about hope and anger, which is obviously also one of my very favorite things in the show, Notes everybody. I'm also going to link to our episode with Shariah Somali, author of Rage Becomes Her, because I think I don't know if you know her work Pusha, but you and Soraya have some really cool overlaps in so many things.
I'm absolutely a fangirl of hers.
She is the Yes, we love her if you're listening to this, or we love you okay so much here. There's so much in everything that we talked about, and I love that, Like this is very meta of me right now, But like so much of what we talked about is complicated, right It's complicated. It's complex, and being able to speak about that with skill is a work in progress for all of us. So thank you for picking up all the balls that I threw at you, and I hope that I picked up as many that you threw at me that we got. I'm going to link to your book in show notes obviously, I'm also going to link to Jemma. But is there anything else that you want people to know about where to find you or what you I don't know what message you want to leave them with before we wrap up.
Yeah, well, I'll just say thank you Megan for having me. This was just such a lovely conversation. It was a joy. It was a joy to be here for folks that are listening. Yes, please buy my book. I'll say it's super directly, Please buy my book. There's also an audiobook that I narrate on Audible, so if you like to listen to your books, that's available and check out Gemma. We also have a substack that's called Therapy Takeaway, so that's a nice way to get a free little weekly dose of therapy in your inbox. Not therapy therapy, but you know.
Disturper notes, disclaimers, and substack is not a substitute for therapy with a supervider, right exactly.
Yeah, it was such a pleasure. Thank you so much for having me, Megan, and I can't wait for the next time because I know there will.
Be there totally, totally will be all right. Thank you so much for being here here on this show and in the world and everybody. I know there was a lot in this one, but I think that this is one of those episodes that I super encourage you to share in your friend groups, in your whatever your relationships are, because there are so many starting points for interesting conversations. And remember that the whole point of this show is to encourage you to have these kinds of complex, complicated, nourishing conversations in your own lives. On that note, please stay tuned for your questions to carry with you coming up right after this next break each week, I leave you with some questions to carry with you until we meet again. Now, you know, it really struck me in my time with doctor Lakshmin was just how interrelated everything is. I mean, this is how my mind actually works.
I always feel.
Like I'm looking for the puzzle pieces and how they fit together. But the ways that spiritual bypassing and this emphasis on the answers all being inside of you just take care of yourself. Like how prevalent that is when we are talking about grief specifically. It's literally everywhere. It is baked into our ideas about health and resilience and what is expected of us as support people when we know that somebody's going through a hard time, right, we've learned this thing that we're supposed to cheer people up, encourage them to look within. It's all one cloth, isn't it. I mean, it's why I talk about the stuff. It doesn't just matter when you're grieving a death. It matters when your life isn't feeling very good to you. It matters when you're tired and you're feeling lonely. It matters when you're feeling ground down by the weight of the world. It matters on an ordinary Tuesday when things just aren't going the way you planned. Shifting the conversation on what real wellness looks like, what real self care looks like, what real community and connection and support looks like. That's really powerful work, wherever you apply it. Aspousha says, finding your own edges and your own boundaries, giving yourself that space. That is a simple, though granted, not always easy, way of exploring the entire system, the entire puzzle. Right, if you have to choose just one thing, spend some time with those boundaries and what real self care and real connection might mean for you. Okay, I can clearly go on about patterns and interconnections and overlaps and all of that stuff, but how about you what stuck with you in this conversation. Everybody's going to take something different from today's show, but I do hope you found something to hold on to. If you want to know how today's show felt for you, or you have thoughts on what we covered, let me know. Tag at Refuge and Grief on all the social platforms so I can hear how this conversation affected you. Follow the show at It's Okay pod on TikTok and Refuge and Grief everywhere else to see video clips from the show, and use the hashtag It's okaypod on all the platforms, so not only I can find you, because I do go looking for you can find you too. None of us are entirely okay, and it's time we start talking about that together. It's okay that you're not okay. You're in good company. That is it for this week's show. Remember to subscribe to this show and leave a review please. I have seen a lot of great comments about the show on social media, but there hasn't been a single new review of the show on Apple Podcasts since season two. So I would love it if you a post a review there and keep doing it on social because I love to see them everywhere. Coming up next week, Malkiadavitch Cyril. Now that name may not be familiar to you yet, but if you are the slightest bit interested in grief as a grieving person or as a movement leader, as a human being with human relationships, next week you are going to meet one of the most brilliant people I have ever met. Follow the show on your favorite platforms so you do not miss an episode. Want more on these topics. Look, grief is everywhere. As my dad says, daily life is full of everyday grief that we don't call grief. Learning how to talk about all that without cliches or platitudes or simplistic dismissive statements is an important skill for everyone, whether you're trying to support a friend going through a hard time, or you work in the helping professions, or you're a human being having a human life which is not always easy. Get help to have those conversations with trainings, professional resources, and my best selling book, It's Okay that You're Not Okay, plus the guided journal for Grief at Megan Divine not co It's Okay that You're Not Okay. The podcast is written and produced by me Megan Divine. Executive producer is Amy Brown, co produced by Elizabeth Fouzio, Logistical and social media support from Micah, Post production and editing by Houston Tilley. This season's intern is Hannah Goldman. Music provided by Wave Crush and background noise provided by my neighbor across the backyard fence who has been powerwashing his house for the last three days.