Dr. Elizabeth Frei - Your frequently asked questions, answered

Burnout is an endocrine injury. Your stress system, your nervous system, has been overwhelmed by so much cortisol that it literally cannot function in the way it's supposed to.

Hello everyone. Welcome back to the show today. I am so grateful to be joined by Dr. Elizabeth Frei, who will help us get a behind the scenes look at what the journey of burnout recovery could look like. Elizabeth is an American born therapist and clinical psychologist working in Switzerland. She co-founded the C2 community, which is a mental health practice in Biel/Bien Switzerland to address the need for English speaking support services in the country. She is certified by the Federation of Swiss Psychologists and is also licensed in the United States. I've had the privilege of meeting some of the professionals at C2 and would never hesitate to recommend their services to individuals looking for mental health care, particularly in English. In this episode, I ask Elizabeth some of the most common questions we face when experiencing burnout. Like, when is it time to get professional help and what a recovery trajectory could look like, and some fundamental notes about returning to work. This is one episode you don't wanna miss. Welcome to the show, Elizabeth. Thank you for joining me today.

Thank you so much.

Well, I'm so excited 'cause I know we've had several conversations around burnout and return to work and so I thought having you on the show, especially at in its early stages for our listeners, would be really helpful to answer some questions that are so present for people who are wondering if they're burnt out or what help could look like, because what I find is not only are they worried about their health and how they're feeling, but they're also worried about. What recovery looks like and how long does it take, and what kind of help do they need? And there's all these questions that can sometimes distract from focusing on recovery. And so I thought your experience would be super valuable for our listeners, um, particularly those based in Switzerland, given that your practice is also here. So I'm so grateful for your time and I know that, I'm gonna learn a lot from you as well.

I've learned a lot in this process too, just by navigating the system as a, Right. here and trying to interact with various medical professionals to achieve. certificate, so

Yeah.

can get the time off from work. Um, so it's been a

Yeah.

process for me as well, and exciting to see how the concept of burnout has evolved in the public consciousness.

Absolutely, and I, I'd love to come back to that as well later on to see what, what you're noticing after several years of burnout kind of being in the mainstream conversation. But before we start, can you just tell us a little bit about the work you do as a clinical psychologist and the work you do with C2 as a practice as well?

Yeah, sure. So I'm a, an American trained clinical psychologist, but I started working in Switzerland in 2013. Doing, psychotherapy. I'm accredited to, to practice, um, psychotherapy by the Federation of Swiss Psychologists. my colleague Patricia and I have, um, developed a group community, practice where we're really dedicated to offering accessible mental health care to people different backgrounds with all different languages, um, with all different challenges. and, uh, we've been doing this work, since 2017. we also are passionate about training mental health professionals supervising, um, trainees and things. So we have quite a broad, uh, swath of, of interests that, uh. Through at C2.

I appreciate you mentioning that because one of the things that stood out to me with C2 as well was exactly that, the range of services that you offer, and given that we're in a. Space where mental healthcare sometimes feels inaccessible or feels very single dimensional as I go to therapy. one of the things I really learned from C2 is there's so many ways of providing care and providing options. I don't know how many times I've. Provided the C2 link to people knowing that even if the care is not available at C2, somebody will probably know who to point them to. So I'm just very grateful for, for the work of C2. but as I said, uh, when we started, one of the things I really thought would be helpful was to talk through some of the. Frequently asked questions that I'm sure you get. I know I get as well in the work that I do, supporting clients around getting professional help for burnout and what recovery looks like. And one of the questions I get asked a lot is, well, how do I know it's burnout? And not just, I'm just tired, or I'm just stressed. so can you say a little bit about what your experience is as to what, how burnout presents itself and when do people need to start paying attention? That help is really needed.

I'll start by saying that just identifying the need for, for support is one of the most courageous things a person can do. I think unfortunately due to our, our society that it's just normalized. I. To overstep your limits and not pay attention to what your body is telling you. and so I find maybe this surprises people. I find that most people are not aware that they're on the verge of burnout or they are not ready to consider that as an option. you know, there's a lot of other ways to understand and explain what they might be experiencing. So Maybe I'm seeing the client for another presenting issue, but then over time it becomes clear that maybe burnout is something that they're, they're facing. And often it's quite a long conversation, um, where we talk about what, what that looks like and, and, know, how exhaustion presents and, and how, know, how that shows up in relationships and at work and how cognitive challenges might be part of that. And oftentimes the person is not surprised, but they are sort of, sad and, resistant, I would say to the idea that they deserve time to recover.

Hmm.

there's a quite a, quite a process of, yeah, let's, let's talk to your doctor about this. Let's, let's

Yeah.

he, what they're able to offer you in terms of support.

that's interesting because I, I also often find that, you know, it's, burnout is not one of those things that happen overnight. It's like, today you're burnt out. You know, yesterday you weren't. It's one of those things that kind of creep up on you over time, and I've also learned that there are. Probably different phase or stages of burnout. and if you catch it early, you know that probably easier. It is. But to catch it early means just a recognition of, okay, this, this experience I'm going through has been going on for a while and it's no longer sustainable. and so there's, I think this self-awareness that's really required to say something's different and I'm experiencing my work or my life differently and this doesn't sit right. Yeah. Yes.

some people I think are confronted by the intensity of it in, in quite abrupt ways, like I've, I've had clients who, who just all of a sudden couldn't get out of bed in the

Right.

there's that like, kind of intense presentation, but usually that's after sometimes years of buildup, and so it becomes very hard to differentiate what is normal and what is not for that person.

Yeah.

general rule of thumb, we find that recovery from burnout takes about a third, the amount of time as the person has already been experiencing symptoms of burnout. So, for example, I had a client who'd been in burnout unrecognized until the last part of it for about three years just pushing through white knuckling it. so one third of that time.

People are often surprised to realize how long it takes to recover from burnout because you have still people who think, you know, I take a week off or I take a month off and then I'm ready to go back to work. And I often kind of say, hold your horses and don't commit to that. 'cause it probably takes a little bit longer, than that because as we know, it's not just about resting. Right. So, at the moment that an individual realizes that they need to take time off from work, what advice do you have particularly. In our local context in Switzerland about looking for help and support because a lot of people I know have never had a psychologist or a therapist. They don't even know big where to begin looking for one. So what advice or considerations can you give about how do you even begin to start looking for qualified help?

for those who aren't already seeing, someone to support them, they probably end up first at their general house doctor. Right. And, they may be complaining of things that seem completely unrelated to burnout. So they might be having a rash, they might be struggling with insomnia. and hopefully there's a, a skilled enough clinician in that practice to be able to, to talk with them about, Hey, you know, how is stress. Going for you, how are you managing this? And at that point, sometimes we see referrals to a psychologist. but I would also recommend that people. You know, look for their own, sources. So the, the, the house doctor might refer you to someone that, that's within their network. But I empower people to, Google around and see what language there is available and what context. counselors, for example, are very well, uh, trained to, to deal with, uh, burnout, symptoms as well. So there's a lot of, there are a lot of resources out there, especially in, in English. This is growing more and more. But if you don't have a, a skilled to help you diagnose and understand what's going on for you, it might take a lot longer. It might be your, your partner, it might be your friend who's suggesting, Hey. You know, maybe you're burnt out, in which case, you don't necessarily have to see your house doctor about that. You could go ahead and

Right.

yourself directly. it's up to you. It's up to you. It, it's a process.

It's a process also finding the right fit, right. And you know, it might be that the first professional you work with doesn't sit right, and so you'll have to go look for another one. I remember when I was needing to find, a therapist, I didn't get a referral from my general practitioners. I need to do the search on my own. and I did it like so quickly. I was like desperate for help. And one of the things I didn't realize was you need to know if they're covered by insurance or not. And so I ended up, working with someone who was amazing for me, but wasn't covered by insurance. And so I also needed to make that decision of do I stay with this therapist and pay privately or say I need to find someone else. Right. So I, I find that As one other consideration for people to like check you know, what your, is your insurance covering or not, and what your wi willingness is to pay out of pocket or not.

Yes. And I think the majority of, mental health professionals are not covered or reimbursed by insurance. Unfortunately, I'm, I'm, I'm

Yeah.

as a psychotherapist that I can be. So it's, it's something you have to, to look at your budget as well. And, know, think about this as an investment in your long-term wellbeing.

Yeah.

taking this time and taking it in a way that really helps you make sense. Systematic changes to the way that you see yourself and, and your workplace and the world essentially, something that could be invaluable for some people.

And.

there are real life consequences and practicalities that are gonna interfere, and that's okay.

I love that you positioned it as a long-term investment in your health. I mean, we see that phrase used a lot for like working with coaches and so on. I, I love that you mentioned that for mental health as well, because it is indeed an investment, but I, I know that we're. Kind of in the process of de-stigmatizing, getting mental health care and saying that it's totally fine to go see a therapist or a psychologist, and there's nothing stigmatizing about that. you talked about seeing clients at different trajectories of their burnout experience. What are you observing as patterns? And I'm aware every journey is different, right? But maybe you're noticing some patterns about what recovery looks like. You know, how do we know people are getting better? What are some of the. Areas of focus or change that you notice happening through burnout? Recovery.

So it's, usually the most obvious ones are the physical ones first, so that people are sleeping better, they're eating more regularly, they're engaging in exercise in a moderated fashion. Uh, they're seeing friends again. They're, about larger issues of how do I wanna spend my life? Like what are the values that I wanna build on? there's space for that. There's brain space to make those kinds of more tangible. and then later on there's a kind of an equanimity that's clear how much more time they need to integrate back into work. So in the beginning, I think there's a rush to. I'm fine, let's go back as quickly as possible, you know, and on, I think once people get used to having that time off from work

Yeah.

useful and helpful, then they're a lot more moderated. So often when my clients. Are pushing to go back faster or at a higher percentage. That's to me kind of a sign that maybe the perfectionism is still quite entrenched and we should slow it down even more. And I

Yeah.

confronting for them oftentimes. But once they can kind of accept that, there's a lot more possibility to prevent relapse later in the future.

Yeah, I, I notice sometimes with people I've worked with that it's really difficult to disconnect from work so abruptly because mental health absence typically happens abruptly, so there's no time to mentally and emotionally prepare for that time off. And so from one day to the next, they're just out of work. And so it takes a bit of time to like. Calm your nervous system and give yourself permission, to rest. Um, it's very similar when you go on a holiday, right? Like it takes a couple of days to settle into your holiday and then to settle back into work. Um, probably a bad analogy. Um, but you're right. I think there is a desire sometimes to go back quickly. And I know for myself that. Part of that is the feeling of guilt. Part of that is, you know, the high performance, high work ethic mindset of like, oh, but I gotta go back and I have work waiting for me and I can't let my colleagues down. And all of that narrative plays into, um, the early days of being away from work.

Absolutely. And the reality is the shorter the burnout leave is, or the medical leave is the less time the institution has to create a system that supports that person in their medical

Mm.

So if you only take three weeks off. Which is the minimum that I recommend for people who are really resistant but struggling. They will come back after three weeks and have way more work to catch up on. Absolutely. And if, if they're, if they're saying I'm out for three weeks, that their bosses, their, their structure won't compensate for that longer term need. And so they

right.

oftentimes slammed once they get

Yeah.

three weeks, which makes them very reluctant to take more time off. it's really, it's a really, really tricky paradigm. To negotiate with the client who's, who's very engaged with doing a good job and not letting

Yeah. Yeah. And maybe this sounds, maybe rather harsh, but if your employer has a sick leave policy that allows you to take time off for a period of time, take it. Right. Like why rush it if the system allows you? But what I find is, the other thing that I also notice is we don't know what policies our employers have around these things. 'cause we never assume we'd need them. And so we don't know. so we forget that, you know, we're actually entitled to take the time off and, you know, we kinda deserve to do that. But yes, I think the personal narrative of like, what is this absence saying about me and my work and get in the way in those early days,

That's a good point. I think structurally there's a lot of employees that I see that overtake responsibility for their, their work culture, right? Like that,

right?

There's this undue pressure that's put upon them to maintain a system that's not working for anyone.

Right. Yeah.

feeling well, often nobody is. And, by just going back too quickly, you're just, we're putting a bandaid on what might be a systemic issue within the organization that, that the organization has an opportunity to address if,

Right,

you're out of work for a while,

right.

maybe they won't. I can't say that they will, but our hope is that it's a kind of feedback for the employer as well.

Yeah, I, I, I'm glad you said that because I've been, you know, in the research I've been doing for this podcast, more and more thought leaders will. Emphasize and reemphasize that burnout is a systemic issue. And so I'm mindful, you know, we're talking so much about individual recovery, but you know, that's only half of the story, right? The other half of the story is what's going on in the system, and is the system willing to take that feedback and check in with themselves to say, you know, why are we having employees burning out? And I think that's really difficult if they don't have the numbers like. I've heard managers say, oh, you know, it's a couple of people here and there over the year. So they don't necessarily take the feedback that it's a systemic issue. 'cause it's like, you know, well it's not the majority of people, but we don't know what's happening behind the scenes for others.

Right. And we can't just continue to sort of take the fall, um, and sacrifice our own mental health in

Yeah.

continue with this kind of toxic, culture. I mean,

Yeah.

organization right, where people burn out, but it, it

Yeah.

often.

Yeah.

and I know we're talking a lot about, you know. Corporate or workplace environments. But burnout happens also for people who aren't being paid for their work. So

Right.

parents or for, um, caregivers in other capacities or for people who have to manage a chronic illness, there are other contexts in which burnout occurs, beyond

Yeah. Yeah. And I thank you for saying that because, I also have quite my, let me put it like this. I'm hoping that the research over time will talk more about. Burnout as something that happens in multiple contexts and is validly. So, because right now there's always this occupational context to it and we know that it's not just occupational, it's not just paid work, but a lot of, you know, people going through non-paid versions of work that are just as important go through the same as well. I wanna go back to, to recovery. So you touched a little bit about, you know, we look for the physical science and seeing things around their physical being is changing. Um, but you're also looking at what things might have changed for them, what their values might look like, the brain space to think bigger about their lives. And at some point, you know, going back to people who are. Employed, they're confronted with a question of, am I ready to go back to work? And that's one of the other most frequently asked questions that I know I get is like, how do I know I'm ready? so do you have maybe a perspective to share about what might be things to be reflecting on? I know it's not a checklist, right? It's not, here's a criteria to know that you're ready. Um, but what are you noticing around readiness

That's a

that.

It, it is so individualized, but often it would be things like the person being able to ask really thoughtful questions like that of themselves. Like where, where there's the actual question, am I ready versus, I'm ready, let's go, or I'm not ready at all. You know, there's a, there's a real ambivalence. I think that's, that's. normal in that space of, of not knowing. And often if, if you're not sure, I would recommend that you try One day per week, or two half days per week. and then you can keep it there in that space until you continue to build upon the different resources that you have to increase the workload.

Yeah.

caution people to feel free if possible, within their, you know, employers guidelines to, to go back at a very, very low percent in the beginning. To exercise, putting their body back in that position that's become associated with stress.

Yeah, I find that that's underestimated. The, the spacing is so underestimated. 'cause I, I sometimes get the, the 20%, like what's the point of the 20%? But to your point, it's like get to allow your body to just experience being back in that routine and taking on responsibility. I don't know what you've observed with your clients. I find that those who've just gone back are often confronted with things they don't expect. Like they don't realize that their other energy's not that way, or Oh, this is still con, this continues to be a stressor for me. So are there things you've noticed that tend to surprise clients in their early days back at work that might be hard to anticipate?

I think tearfulness is one

Hmm.

oftentimes people are surprised by the, and, concern that their colleagues have for them when they return. and there's a lot of like emotionality associated with that. And, also I think just remembering that. they will, they will be surprised by how tired they are in the beginning because it's literally your body. It's like a exercise for your brain, for your nervous system, for your physical body to, to bring you to work to, or to log to whatever virtual platform. All of that is consuming energy that is a little bit out of practice, so that even if you're very tired in the beginning, it doesn't mean that. not in recovery. It's just going to be an acclimatization that's necessary

Yeah. How have. I know it's probably more secondhand, or anecdotal based on the clients that you work with, the employer's receptiveness to the pacing or maybe the adjustments to the type of work that they come back to. how, I know this is a, I know this is tricky one, so I'm like, I'm, you know, I, I I'm touching on something that I know we've talked about before as well, but I'm just curious from your perspective, you know, what, what are you noticing from that end?

I find that

I.

of the time individuals. extremely thoughtful and considerate. even if they're in a managerial position, they're in general. the majority I would say understand and aren't asking invasive questions or trying to be respectful or trying to be supportive. Um, maybe go as far as implementing a check-in around the integration and how that's working for the person. But the organization and the policies as part of that organization are not. Typically very humanistic. And oftentimes, know, managers or superiors have internalized some of that. And there can be a little bit of, of, of pushback or judgment. You know, there are, instances of discrimination. Uh, not as many as I think people think, but there can be. and it's a very, Varied experience, but in general I would say that people are surprised how quickly they can just go back

Yeah.

absence from work.

Yeah. Yeah. I also wanna under, coming from kind of my HR background, I also noticed a similar pattern where, um, the manager plays such an influential role in the experience of reintegration, there are managers who will say, oh, but there's no policy, so I can't really do anything. Or I'll leave it to HR to tell me what to do. and to your point, there aren't a lot of policies or practices. Around return to work. but then you also have other managers who understand they have some latitude on decision making and flexibility and figuring out a curated way for to help their employee return, right? And so, you know, my hope as well is that managers can start to take some. Influence and responsibility and be willing to take that on and say, okay, what can I do and what, you know, what can I, shift or say or do to make this experience as successful as possible? 'cause it's not for the employee, it's for the team as a whole too. and I, I find, you know, people are watching, right? So if somebody takes time off and they go back and they see it's a terrible experience, or they're. You know, going through performance improvement plans and so on, other team members will take that as a signal to say, I probably shouldn't dare take time off when I need to, if this is the outcome that's gonna be waiting for me. Um, so it, it does have repercussions I think, to the organization to see how an individual's experience is playing out.

Absolutely. Absolutely. And I think that's part of the, the process of, of having support while you are reintegrating to work is to explore how to advocate for yourself safely. this process, you know, who are the people that you can talk to about this? Or who are the people who can write letters for you to your doctor? Or you know, how do you safely advocate

Yeah.

best work? Because

Yeah.

wanna do their best work

Right.

know, if you feel comfortable having a difficult conversation with your manager and telling them how to set that up for you, it can really be a beautiful. beautiful experience that people take with them from their, their burnout.

Yeah. Can you say a little bit more about self advocacy? Because I know that this plays such an important role for people going back, that they're not just on the passenger seat telling, having their employers tell them what to do, but what responsibility can they take for themselves to speak up? Because I know it's a skill. not everybody can just do that on their own.

I think they have to know their boundaries and their limits, which unfortunately have been forced upon them by taking the, the, the leave sometimes and, and

Yeah.

burnout. Um, so they, they have a sense, an innate sense, an embodied sense of what their limits are, and then how to translate that into, I. Practical everyday demands. So if you're noticing that, having meetings at 8:00 AM does not work for you. if there's some wiggle room around that. Like is your employer willing to, to, to, to make that a little bit more flexible or have that at the end of the day rather than the beginning of the day? What are the kinds of requests that you can politely, make to your organization to be able to set up, better productivity for yourself and overall better mental health consequences for yourself? It, it's. is scary, it's super intimidating, but there's a way to do that that really centers, how everybody benefits from you being well.

Yeah. Yeah, yeah. I'm glad you mentioned that. Be, and some of the things I, you know, when I have individuals coming to say and say, I'm like, I'm about to go back to work. What am I supposed to do? I'm like, talk to your healthcare professional to help you identify the things that you will need. I. To feel more productive and feel more safe back at work. So like you don't have to do this on your own. You can

Right.

with your doctors or your healthcare providers. And then the other part of it, which you mentioned is how do you communicate it to your employer in a way that's. Collaborative that's meeting mutual goals and not just say, Hey, I have a problem and I need you to do this for me. Right. So sometimes it's just taking a bit of time to script out your words if you have to, but also you don't have to figure it out on your own.

Absolutely. I think it, it, it takes a certain amount of skill, but in general, doing it what, whatever the outcome is doing. So helps you feel better and helps you recognize that you have the capacity to learn this skill.

Yeah.

it's very empowering to be able to say, look, this isn't just an exploitation sort of situation. I get to say a little bit about

Yeah,

that work best for me and

yeah.

or not that's taken on board. We don't know, but, but

Yeah.

worth trying, I think, almost always.

And if it's not taken on board, it's data that an individual can use to say like, okay, I, now I have a data point about what my employer or what my manager thinks about this. And they can use that data to inform any decisions they. Need to continue to make about their jobs and their, and work. So, but yes, I, I think in the beginning it probably feels vulnerable for people to feel like now I have to go back and ask for three different things and, you know, and I'm guilty and I feel like I have to make up for it and compensate for all this time and relax. Stop that thought. Even though we can't let that thought train go, it's like, pull it back,

Yeah.

right? Yeah, pull it back. Right.

it comes back to that fundamental understanding of how this is an injury like this. Burnout is an endocrine. Injury. Your stress system, your nervous system, has been overwhelmed by so much cortisol that it literally cannot function in the way it's supposed to. You need to drink a lot of water to flush out all of that cortisol that's built up in your body. I mean, this is just like. your leg, right? Like from one day to the next, you could be on your bike and hit by a car and not be able to go to work the next day. And when you go to work, when you go back, say to your employer, look, I need there to be a ramp outside so I can, I can come up with my wheelchair until, you

Yeah.

to be able to go to my doctor to have my check-ins. You know, there, there have to be certain accommodations afforded for. Nervous system injuries in the same way that we would forsan with a, a more visible physical, body injury.

I think that's, you know, we have a way to go, I think, in that department. Uh, but you know, hopefully we're taking a step at the time, in the right direction. I have one question around returning to work, and then I'd love to talk about kind of your experience, you know, practicing in Switzerland and you know, how burnout is being talked about here. One of the fears I often hear is, well, what if I burnout again?

It's a

advice do you have? it is a valid fear, and if we go back to work with that fear being so intense and present, it might distract from applying all the new skills and all the learnings we've had through recovery. So what can you offer to individuals who have such a fear of burning out again?

I often say that anxiety is the opposite of trust, right? And part of the recovery processes is learning to trust your own resources, trust the tools and the skills that you've built. Trust your instincts, trust your community, trusting your, your healthcare provider, like that you don't have to have all the answers, you don't have to have all of the certainty in order to do something. But trusting that you, when confronted with a challenge, will be able to navigate it with the tools and the strategies that you have available.

I love that. Thank you for naming that. I'd like to think that there is a silver lining to burnout. what have you seen that silver lining to be? What does that look like for people? Not to say that we recommend people to burnout to get that silver lining right, but there is something on the other side of burnout that I think surprises some people, including myself, about who we end up becoming as people. Um, what does that, what, what have you seen?

I think I've seen a lot of reformed perfectionists. And we think about perfectionism. I think the colloquial understanding of that is like, perfectionism means you do everything perfectly,

Yeah.

means you try to avoid making mistakes. You try to avoid letting people down or yourself down. that's a, that's an avoidance leads to anxiety. So what people often get out of it is a sense that there's a lot more range of performance or productivity than they knew. they can actually do less but higher quality work they can let themselves off the hook. They cannot answer that email on Sunday night, that they can let go of sort of tasks that feel like it's keeping them safe or keeping them productive or, that actually it gives them so much more freedom and rest. Than they might have imagined otherwise. We just kind of fall into habits of working and stick with those for our entire lives, and they may not serve us anymore. You know, they're going through like major life transitions. Those rules might not work anymore.

Yeah, I think it is an opportunity to take a step back and say, okay, what rules apply to me now and what don't, and what new rules might I need to create for myself? Right. And I, I found that to be very common from. Those who've kind of gotten out of burnout to the other side, to to say they're much more grounded in their awareness of what's important to them or like what's serving them and what's not serving them. So I, I, you know, I think that's a very encouraging thing to hear if people take the time to actually do the recovery work and not, very quickly, step out of it and go back to their old patterns.

Absolutely. And I think as part of that too, there's a lot of people who their burnout, um, experience to bridge to more long-term or, different kinds of, for their wellbeing. You know, maybe they learn that they have a DHD or maybe they recognize that, they need to do body work. Um, there's lots of different realizations that come from self-compassion that come from self-knowledge that they can then leverage, uh, across their lived experience. That's my hope anyway.

I think to build on that, you know, people ask, well, when, when I, when do I say I'm fully recovered? I'm like, I don't know what that looks like, but I know that the work continues. It just might be addressing different goals or meeting different needs. But the work does continue and kinda stays with you for the long term, right? As we work towards, you know, becoming better humans, for ourselves and for others. This has been really helpful. E Elizabeth, I've learned so much listening to you and I wanna close with just your perspective about burnout in Switzerland and how are we talking about it? Are you seeing more cases, less cases? I know that you can't state the statistics, but you know, what are you just noticing in your practice? as far as burnout in Switzerland and this,

Yeah, so I've

yes.

for in Switzerland for about 13 years now. And I have to say, as an American, the concept of burnout was, was, was non-existent really when I finished my training. And so moving to Europe and experiencing this concept for the first time was, was interesting for me. and I've definitely seen it become something people talk about more now, certainly since c. Because I think, during that time there was just an explosion in awareness about mental health and wellbeing and an openness to have conversations about how to support that, that

Yeah.

before COVID. but I, I do think there is something particular about the workforce in Switzerland. even though in Europe people have a, you know, five weeks minimum holiday. They are, which is, which is an anomaly for Americans. We have two weeks to right. So I thought, wow, all these Europeans with all their holidays, this is incredible. They must be so well rested and healthy and,

Right.

actually is that people put so much effort into life here. There's so much more. Decision making and planning and, intentionality. in living life in Europe, in, in America, I certainly, burnout exists, but we have more convenient, it's a convenience culture. We have our cars, we get in our cars whenever we want. We go to the gym. It's open 24 7. The grocery stores are open all weekend, so we don't have to plan. We're gonna go to the grocery store. But here in Switzerland particularly, life is quite regimented and there are. demands on us that, you know, for example, with and the garbage, you have to buy the certain bags and then you have to make sure you know which day is recycling this and that and this. And it's just very, it's a very intensive culture here, and I think as human beings. tricky and we have to bear in mind that we just need time sometime unstructured time. Like even though you could

Yeah.

an amazing holiday, you know, maybe just doing nothing. You know? Maybe it's okay to just stay home and have a staycation or like. The, the, the pull to keep up with things and get the most out of life. And, know, our life here is wonderful. We have great quality of life and it's beautiful. And so people wanna use every weekend to do this amazing thing, but maybe some weekends you just need to binge watch Netflix and that's okay.

Yeah, totally not feel guilty about binge watching on Netflix once in a while, right? I think, yeah, you're right. I think, It's making me reflect on my early days in Switzerland and thinking like, how do I even remember all the rules and, you know, making sure I don't miss the bus 'cause like they're so punctual, so like I can't be, you know, half a minute late and things like that. And so we get caught into this routine. especially I think my experience with people who've experienced burnout. it's this need for perfection. The need to, like, I need to be everything for everyone. And, and also we don't necessarily, people who move to Switzerland don't necessarily have a strong care and support network with them. and so there's so much that falls under on their shoulders to do. And so I think your advice of like, it's, you know, it's okay to just do nothing and there's nothing to explain or justify around that. it's also just good to give ourselves that permission.

is. And, but, and your point about

Community.

we're so isolated. You know, whether we're coming here for work or escaping war or looking for economic advantages, we are isolated. as, and, and we need to take into account the importance of community support and social support. social creatures. We, we really need that. And even if we're surrounded by people all the time in Swiss

Yeah.

It can be very lonely, especially if

Yeah.

in a marginalized group of some kind. So just really making an effort to, to start your own community if you don't

Yeah.

have access to or

Yeah.

if, especially if you're someone who really needs that or misses that.

Yeah, really good advice. Something to be more intentional about, I think, especially for people moving to, to Switzerland. Elizabeth, thank you for spending the time with me. I, like I said, I learned so much. Um, I'm sure our listeners will as well. and I'm just personally really grateful for the conversations we've had and the collaboration we aspire to have. just making sure that care is more holistic and that it follows the individual. Based on the journey that they have. and I just really value that. So thank you.

Thank you for

Thank you for having me.

It's, it's wonderful to be able to, de-stigmatize this, uh, very common, but really challenging experience that

Yeah,

we might encounter.

absolutely. Thank you, Elizabeth.

Thank you..