In This Issue: November/December 2019Special Edition: Holiday Recipes WassailGreen Onion PancakesGordon’s Matzo Ball SoupMinestrone SoupCranberry Sauce BHWP Spotlight CHAD MORRIS, Ph.D., Director What better
KATHIE GARRETT, M.A., Clinical Associate
For the past few weeks, I have been engaged in a personal gastronomic mindful meditation. My intention is to restore trust in myself as an intuitive eater. How I came to doubt my ability to make healthy food choices is interesting. You see, I’ve had a lifelong healthy relationship with food. I love the taste, smell, and feel of fresh whole food. Moreover, I deeply appreciate the magical effect a spoonful of herbs or spices can have on food, transforming something plain into a mouth-watering gem. Perhaps most importantly, I did not inherit the family “sweet gene” or learn as a child to view food as a primary go-to source for emotional comfort. So, how is it then that I lost my flow and began to question my relationship with food?
CHAD MORRIS, Ph.D., Director
Where I live, spring arrives in fits and starts. In our neighborhood, we begin slowly emerging from our houses to the growing hum of yard activity. As the spring rains wash away the last remnant of winter, I impatiently await outdoor activity. With the planting season, my inner social imperative shifts into high gear. While I can contently spend days alone, the strengthening sun presents new opportunities to be out and about, to be in community. Throughout my own journey, I have learned that I am more whole when I work to grow healthy relationships. Not content just to be around others, I want to know others. This season, just as I prepare the garden beds, I will work to weed out daily anxieties and my ongoing “to-do” list to build bridges with others and to be present. This shared experience is critical to my health, and in turn, allows me to help others to be healthy.
Increasingly, researchers, healthcare providers, and city planners, among others, focus on the therapeutic power of belonging. There is a growing awareness about the negative impact of isolation and an epidemic of loneliness. Meaningful connection is key. It is the bedrock of well-being. I and our team welcome working with all of you to sow seeds of social wellness.
Kathie Garrett, M.A., Clinical Associate
Recently, I had the opportunity to lead a BHWP Work and Well-Being seminar for medical students at the University of Colorado School of Medicine. One of the activities we include in the seminar is Defining Your Values. We invite students to choose their ten top values, and then, through a process of elimination, whittle that list down from ten to five to three to one. This activity helps students to clarify their values and draw associations between their core values and lifestyle choices. What students discover is that there are often one or two core values under which all other values are subsumed. When our daily lifestyle choices and health behaviors are not aligned with these core values, we may feel unbalanced or disconnected from the natural “flow” of life.
In preparation for the seminar, I thought about the eight dimensions of wellness: emotional, environmental, financial, intellectual, occupational, physical, social, and spiritual. Using a process similar to the Defining Your Values activity, I considered each of the eight wellness domains within the context of my overall sense of well-being. What I learned is that, for me, environmental wellness is the most salient dimension. It is the swaddle that cradles all that is essential to me in life.
CINDY MORRIS, Psy.D., Clinical Director
With each transition, comes a new opportunity. A chance to do and see things differently. An opportunity to be transformed. Transitions come in all shapes and sizes. Whether it’s ringing in a new year, traveling to a place yet unknown, or arriving home from a day of work, we have the chance to set a new goal or intention for the next segment of our lives, no matter how long or short it may be.
In the spirit of appreciation for the power of transitions, I’d like to set my intention for 2019. My intention is to be more intentional. Let me explain. As we move through our lives, we develop habits—patterns of being, thinking, and doing that ease our movement through the world. These grow out of our learning about what is most efficient or effective, saving us time and energy. Or they are simply automatic responses we’ve repeated many times before. While these habits can bring feelings of comfort and ease, they also bring rigidity and lack of awareness and present a barrier to positive growth and change. We become fixed in a structure with few novel and interesting experiences. While we feel safe as we engage in the familiar and known, there is little room for what we really want, which are novel opportunities—encounters with the potential to spark something new in us. Something to help us to tap into the magic of our everyday experience.
CHAD MORRIS, Ph.D., Director
Certain foods conjure up memories of friends, family, and moments in time. Some of the experiences I savor include watching my maternal grandfather cook fried bologna—possibly the only thing he knew how to cook—at their home in Minnesota. Add a little mayonnaise, and at that time in life, it was the most delicious food I could imagine. Corn bread, baked beans, overcooked porkchops, and cherry pie are intertwined with weekends spent with my grandparents on my father’s side. Whether it was a summer day, Thanksgiving or Christmas, it was the same amazing comfort food. And as the last leaves of the season dance through the yard, pozole brings back times spent with friends as the Broncos played in the background. From simple fare to culinary delights, we offer you some of our favorite recipes to try as you create new memories this holiday season. Voilà!
Physician Burnout: A Public Health Crisis
CHRISTINE GARVER-APGAR, Ph.D., Research Director
What is burnout? Burnout is a work-related syndrome involving emotional exhaustion, cynicism, and a sense of reduce personal accomplishment and effectiveness. It often arises from chronic stress associated with emotionally intense work demands, particularly when the resources to address those demands are inadequate. Rates of burnout are markedly higher among physicians than people in other careers, even after adjusting for work hours and other factors. In fact, recent national studies in the U.S. of both physicians-in-training and practicing physicians find rates of burnout symptoms reaching epidemic proportions – approaching or exceeding 50%.
Why is it important? Burnout matters because it is associated with negative consequences for patient care (e.g. increased medical errors and malpractice suits), the physician workforce and healthcare system costs (e.g. reduced productivity and increased turnover), and for physicians’ own care and safety (e.g. increased risk of substance abuse and suicidal ideation).
JIM PAVLIK, M.A., Program & Policy Analyst
BHWP provides technical assistance (TA) to local public health agencies across Colorado working in the areas of adult cessation and facilitating health systems change. In June, we closed the final year of a three-year cycle. In the past three years, we’ve had several successes as a statewide community working to drive prevalence rates down in the face of dwindling attention to this issue, shrinking budgets, and macro-socioeconomic countervailing forces.
Providing TA means providing agencies existing tools and resources, connecting them to other professionals with on-the-ground expertise, conducting research and translating new scientific findings for application in clinical and public health settings. Sometimes, it means creating new resources when the existing materials just don’t suffice.
KATHIE GARRETT, M.A., Clinical Associate
I completed my first MI training in 1995, and, like many newly trained MI practitioners, my first goal was to temper my “righting reflex” or that burning desire to correct my client’s “wrong thinking” with education and persuasion and replace it with a stance of expectancy. A few days after the training, I had the opportunity to try this new approach. I found myself counseling Becca (not her real name), a young breast cancer patient. Like me, Becca was in her 30’s, a writer, and the mother of an adolescent. I learned from her that she had recently been diagnosed with high grade, stage III breast cancer and was refusing conventional medical treatment. She was amazingly resolute in her conviction. The words, “poison, toxic, and deadly,” scurried off her tongue in what sounded like a well-practiced and comfortable monologue.
Although I honestly attempted to be curious, within minutes, my righting reflex was fully activated. I found myself thinking of all the reasons why Becca needed to pursue treatment accompanied by my certainty of illness progression and death if she did not. My judgment arose in part from my knowledge of the aggressive nature of breast cancer in younger women and my belief in evidence-based cancer treatment, but it was also energized by my identification with Becca. In fact, when I looked at her, it was hard to not see myself, my eleven-year-old son, and my own mortality.
MARY MANCUSO, M.A., Clinical Associate
Ten faces looked at me, each with a unique expression: enthusiasm, reluctance, contemplation, fatigue, reservation. I was surrounded by a group of 4th year medical students about to learn where they will be matched for their 3 to 7 years of residency training. Some of these students will further specialize and add 2 more years to their education.
As our conversation evolved, it became clear that some of the medical students were anxious about the grueling environment of residency training, including competitive atmosphere, exhausting work schedule—sometimes working 30 hours in a row—and being subjected to harsh, and not always constructive, feedback from attending physicians. While all these conditions can lead to burnout for young physicians, in some tragic cases, the unrelenting pressure and stress leads to suicide.
How are individuals expected to endure almost a decade of such traumatic conditions? One medical student mentioned the term resiliency. The American Psychological Association (APA) defines resiliency as the process of adapting well in the face of adversity, trauma, tragedy, threats or even significant sources of stress.