Healing Family Relationships with Empowerment Coach, Marisa Ferrera (Part 2)

Productivity goes up by 400%. And that's just talking about connection with purpose. Now, if someone feels a sense of deep self-compassion and has a growth mindset, more productive.

If somebody is able to communicate effectively instead of just letting their emotions go wild because they got upset on the way to work, productivity goes up even further. So what used to be called soft skills, these are hard skills. This is the foundation of having a team that works well, self-awareness, awareness of others' needs and desires, a willingness to collaborate and communicate, a willingness to think creatively, and to think about the future and not just react to the present in the past.

This is the future of work that will end burnout. It's no other way. [MUSIC PLAYING] I welcome to another episode of the Healing Podcast.

This is the place where you learn and get inspired to heal in, to achieve higher levels of satisfaction in every area of your life. I am Karen Millinger-Host, and I believe that what we resist, persists, and that we cannot change what we don't face. And it was finally when I accepted this reality and invested time, energies, and money into myself, in professional support that my life was completely transformed.

And now I'm on a mission to demystify this process for you to inspire you to do this work yourself. Today, I'm excited to have with me, Dr. Jonathan Fisher, to talk about our thoughts and how well-being practices, mindfulness and meditation can significantly help you achieve balance, success, and achieve the best version of yourself.

Dr. Fisher is a Harvard trained physician at clinical cardiologist at Novent Health Hunter's Villal Medical Center in North Carolina, a certified mindfulness teacher and coach. He was recognized in 2022 as a top doctor, award winner by Charlottes Magazine.

He is a dynamic keynote speaker, a retreat facilitator, an organizational well-being and resilience leader in his institution, and the upcoming author of the bulk just one heart, a cardiologist guide to healing health and happiness. You can find more about Dr. Jonathan Fisher at justoneheartbook.

com or on LinkedIn or Instagram at Happy Heart MD. On this episode, we talked about his journey from feeling burnt out and anxiety to being the well-being leader that he is today about seeking support. We talked about what really helped him the most back then.

And we talked about his book and the three principles of just one heart. I truly enjoyed, really loved this conversation. And I hope you do too.

And if you do too, please share it with us many people as possible. Rate this podcast and help me and him inspire as many people as possible to do this work, to work on yourself, to achieve the best version of yourself. Welcome to the Healing Podcast, Dr.

Fisher. I'm super excited that you're here today. Thank you.

It's my pleasure. I'm really excited to talk about this subject and to talk about it with you. Awesome.

I started following you on LinkedIn or Instagram about two years ago when you were leading or promoting the Ending Physician, Burnout Summit. And I have to tell you that I've been in awe of you and in awe of you being a man, speaking to other men and physicians about love, about kindness, about compassion, self-compassion, connection, loneliness, like what a breath of fresh air. And I tell you that.

Because I worked with physicians for over 10 years and mainly surgeons. And I then married one. And the attitude in old medical circles are like, tough it up, suck it up, big skin.

And it's just crazy for me. And actually our stepdaughter just graduated from her residency program. And we didn't see her in three years.

No Christmas is for three years, no Thanksgiving. Our travel plans were horrific because it's like, OK, let's wait for her program director since we came. What is this?

Like you are passionate about your profession. You want to save lives, but you have to give up your own, basically, to do what you do. So would you be gracious enough to sharing with us a bit of your journey into the amazing well-being leader that you are and your role model for mindfulness and awareness and balance and connection?

Yes, I'd be happy to share Karen. And congratulations on your stepdaughter. That's wonderful.

And it's exciting. And it's scary all at the same time. And we need amazing people who are going to lead health care in the right direction.

Because right now it's struggling. Health care is really struggling. And some people are saying that it's breaking or even broken.

And I'm careful with the language that I choose to use because the words we use will influence how we feel and then that influences how we think. I tend to be an optimist. And so I'm hoping that the next generation will follow in the work that we're doing now for well-being.

And I'm just following the work that many amazing physicians have done before me. So my story goes back to New Jersey, where I grew up as the youngest of seven children. And my father was the town doctor.

And one by one, we all went into the practice of medicine. And I was always a nerdy kind of sciency sort of a guy. A little bit of interested in the arts, like I learned how to do to juggling and a little guitar, and I learned to do magic.

So I always had a little kind of a spark for interesting things. But I still followed kind of my parents' footsteps. Mom was a physicist.

And she used to help me with my physics homework. And dad was a chemical engineer and a physician. And it was pretty clear I was going to follow a straight path all the way through.

And what I didn't notice at the time was that as I was going in through my medical training, I was being more and more separated from friends, from free time, from taking care of myself even. And it was just like this was natural. This is what you do.

You're going to go and spend 12 years of your life, 12 years. You're not going to see much of friends and family. And there's a big celebration.

It's wonderful. You sacrifice all these things. It's so good for you.

You're doing such a good thing for society. It's wonderful. And it's a little bit of a good feeling in a way when people say, oh, you're such a good servant and you're helping so many people.

And I think that feeds you for a while. But eventually you look around and you see people having their lives. And if you're in medicine and you're in a field like surgery or like my field is cardiology, we're seeing a lot of death.

And we're seeing a lot of life and death. And people who are every single day extremely anxious, extremely worried, am I going to be OK? Is this a heart attack?

Is my mom going to survive? Or someone dies and you have to be with a person who's lost a loved one? So there was this whole side of emotional work, emotional labor.

And I didn't train to be doing emotional labor. I thought I would just study how the heart worked and that would be enough. And so that was the beginning of my journey.

It's a long story how I got here today. I'm still practicing cardiology. 60% of my job is cardiology.

But as I went through my own struggles with anxiety, with depression, with burnout, with loneliness, with isolation and grief over the loss of my sister, who was my best friend all while I was working, taking care of 3,000 patients every year, trying to pretend like everything was fine. Eventually you would imagine things weren't fine anymore. And so I got help, one therapist, and I learned the science of positive psychology.

And so I studied how can I be a happy person again? And it turns out there's a science. So I studied the science and it led me to one practice called mindfulness meditation, which everyone knows now.

But 12 years ago, not as many people were talking about it. And at some point I said, how can I bring my worlds together? This brokenness that I'm feeling when I'm hiding at home, and this I'm supposed to be a healer of other people's hearts.

But I was really just going through checking boxes, like I'll figure out the chest pain, I'll give you the medicine, I'll do the treatment, and then I'll see the next person. So I was giving myself this whole new way of healing and putting myself together, but my patients weren't getting any of that. Not from me, not from anybody, in what was like a system.

And so I started to explore back in 2010, what are other ways of healing the heart? Now for me, it was the emotional heart at the time. For my patients, it was the physical heart, but at the more I studied and the more I got into studying, you know, yoga, Hindu traditions, Buddhist traditions, Taoism, stoicism, all of these ancient philosophies and wisdom traditions were saying one thing, which is that there is no separation between our emotional heart and our physical heart.

It's all connected. And there's another truth, which is there's no separation between the health and well-being of my heart and yours. Now I may lose sight of it, I may be blind to our connection, but there's always a connection between us and every single person on the planet.

And that shift in my own philosophy was the beginning of my own healing, healing myself with self-compassion for the wounded parts of my emotional side and helping my patients in a new way by just simply coming at them with deeper empathy because I then knew what suffering was. I had a name for it. So what helped you seek support and say, "I want to talk to someone."

And I ask you this because I know a lot of people and when I was working with a lot of physicians, and they would share with me their emotional pain and 70% of them going through the wars and their teenagers who wouldn't talk to them and their worth experiencing depression and emptiness. And he's like, "I gave them my all, I paid all the bills and no one must be with me." And but going for help is such a hard, what motivate you, what helped you?

- So I think there's two things that come to mind. One, there's always a balance between the pain of the suffering and the loneliness and the family that doesn't want to be around you anymore and not having joy in your life. There's the pain that's there.

On the other side, there's a pride and an ego and an identity that this is who I am. I am someone who is accomplished. I have all these achievements.

And it's possible to live your whole life just relying on the second one. Not realizing that you're losing joy, meaning, connection and positive memories in your life. And so what helped me was I saw the scales.

At some point, Karen, for me, the suffering was too great. It was too great. And I was lucky that I had a few very, very caring and kind people in my life who were able to speak to me in a way that I could get beyond my ego, beyond my fear that, oh, this is okay.

That it doesn't mean something about me as a man or as a doctor in our society if I need to ask for help because it's really an uphill battle, right? In our society, in the Western society in particular, we have a huge bias and stigma against mental health challenges, against emotional health challenges. Forget about those just against having emotions to begin with.

Now, that's just our society in the West. Let's get more specific if you look at the way boys are raised as opposed to girls. And I've got two boys and a girl, it's very different.

Now, some of us are maybe trying to be more progressive and teach our boys to get in touch with their feelings. This is not the norm. This is very recent, very recent the last 50 years.

And so we live in a society that teaches us that your value comes from the work that you do and the achievements that you make. We live in a society where we're told not to feel your emotions to stuff them away because they are either embarrassing or they're a sign of weakness. And now, you're meeting a 60-year-old physician who's miserable and whose family's leaving them.

Of course, they're going to say, I don't need help. Denial and righteousness and pride are incredibly powerful forces and the only way to overcome them is with a sensitivity and empathy, a patience, a kindness, and a willingness to witness and be with the suffering of someone else without rushing to a quicker fix. - Very well said.

And so what do you think helped you the most? You talk about self-compassion, cognitive reframing, mindfulness, medication, but what would you tell someone going through that same space? Like, where do they start?

- Yeah. For me, I can tell you how it worked for me and it worked, I would say very well. Very quickly, I started to see that there was a totally different way that I could experience my life very quickly.

But then I had to spend 10 years and 10,000 hours doing lots of different practices so that I could build this muscle of awareness, of self-compassion, of reframing and all this. So for me and for many scientists, I don't think it's a good first step to talk about mystical practices and ancient Buddhist traditions and a vipassana meditation and non-dual spiritual practice. All of that is esoteric and it's a big turn off for a lot of scientists.

Now some are curious. For me, it had to have the word science in it because that's all I knew. And so when I saw evidence-based.

And so when I saw that there was this field called positive psychology, I said, "Wait, wait a second. I studied psychology in medical school and psychiatry, but it never was called positive psychology. It was negative psychology."

- You're gonna just yet know saying the words. - Yeah. I began with positive psychology.

I read Martin Seligbens book, "Flourish." I then I read every book by every one of his students, Sonia Lubimorski, a Talben Shahar, and just Barbara Fredrickson, that a lot of work on positivity. And the more I read, the more I realized that was missing out on my entire life, that at the end of our life, we look back and we judge our life on the quality of our life, and we have a subjective assessment.

And we can either give it a thumbs up or a thumbs down. And a large part of that I learned had to do with the overall balance of emotions that we felt every day of our life. So if most days I feel like a four out of 10 and a little bit tired and a little frustrated and a little bit exhausted, well at the end of my life, it's not gonna be better than a four out of 10.

So I realized that I had to start living each day as if I wanted to feel that way at the end of my life. And then it occurred to me that if I wanna live a day in a certain way, experiencing a certain thing, I had to at least start to practice living one moment in a positive way. So I couldn't start too big like a day or a week.

So then I asked, well, what does it mean to have a moment of joy? I had never paused to think about that. I had been canoeing down the Yellowstone River.

I had done all these, of rafting all these wonderful things. I had never stopped in the moment to notice that I was actually having joy. And so they kind of slipped in and slipped out.

And part of the practice of positive psychology is becoming very keenly aware of our experiences as they're happening. Noticing when we're getting stuck in our heads with judgment, with shame, with embarrassment, with fear, with predictions, and checking those thoughts for accuracy and recognizing that the thoughts that are happening don't define who we are. And then I realized that that philosophy, just right there, that we are not our thoughts, is overlapping and very much that the core of a Buddhist mindfulness practice, which goes back 2,500 years.

So I then developed a meditation practice and I had trouble sitting still for like two minutes. It was just like all over, I had this mind. It was like used to studying 1,000 subjects and now I had to just sit still and do nothing.

Just do nothing. And it was painful. But then there was a joy and a pleasure that emerged from the discomfort in the frustration.

And that was from this experience that was totally radical, that I never had in my life. And it was an experience of stillness. Stillness in my mind started to settle.

Stillness in my body, as I noticed the parts that I was holding and lots of tension for many years. And I noticed there were parts of my body that were asking for attention, like my heart. And so I'm giving you a little roadmap here.

The roadmap is positive psychology, led me to mindfulness meditation. At the same time, I discovered that, well, mindfulness is good for the mind and checking in with the body. But most of the time, the body is moving.

So how can we develop awareness of the body? As a tool to know what emotions are happening. Remember, this is going back to, we have to develop emotional literacy.

And that's where yoga and Tai Chi and Chi Gong came to my attention. And I became very studious about practicing yoga for an hour, hour and a half at home, at classes, on retreats. So the practice of meditation and yoga for me came together very beautifully.

To teach me a new way of relating to my body in each moment and relating to my experience in each moment. And then I would say if there was a final practice, the final practice I wasn't ready for, until I had learned to settle my mind. And the final practice was the practice of compassion.

I thought I was compassionate my whole life. I thought I was kind and caring, but in reality, a lot of the care that I was showing for other people I'm a little ashamed, but it was kind of pretend. It was like playing the role of a doctor, I'm caring for other people.

But if you watched me caring for them, you wouldn't see someone sitting down and holding hands and giving a very warm smile or a hug. It was more like the act and the mechanism of caring without the deep feeling of caring. So this is where the ancient, again, Buddhist practice of compassion and loving kindness practice come in.

And for people who aren't familiar with it, it basically says that just as if you wanted to learn to play violin, you would practice playing violin. If you want to be a kinder person to yourself, you can't just read a book, you have to practice it. With the way you act towards yourself, the thoughts that you recognize and you replace with more positive thoughts and then the thoughts that you have about other people, you have to become totally in tune with the thoughts that you're having with your wife, with your child, with your friend, with your colleague.

And when you have thoughts of frustration, anger, resentment, hostility, you can either let them flow, or you can say, "I'm tired of living this way. I want to feel more connected." So then I need to be more aware of the thoughts that I'm having and check them for accuracy, maybe replace them with others that bring me closer to my life's experience in a more positive way.

- Love it. Love it. I have several episodes on mastering or thoughts, questioning them, how to are they?

What's the evidence that we are not good enough or that our daughter's lazy or that, what else could be true? We have 60,000 thoughts a day that doesn't mean any of them are real. And it's cognitive behavioral therapy, right?

And I loved that you said, it's one of the first steps, right? Let's control our mind and then let's everything else follow. My latest episode before this one is on yoga therapy, you will love it.

And he's all the benefits of flow and mindfulness but also how it also heals all traumas that get stuck in our nervous system. You know, when we were yelled, when we were ridiculed, like where he said, "Let it flow." Love it.

Love it. And the world needs you and more of you. It's amazing, especially in the medical field.

Let's talk a bit about burnout. I know you've been a leader in this field and you hold that summit. What is behind burnout in your opinion?

- So there are some little details about burnout that I think we should clarify. It's popular now for anyone to say I'm feeling burned out. And sometimes what people mean is that they're feeling emotional distress or exhaustion.

Burnout originally was a workplace phenomenon. But you could certainly, if you're working at home and caring for children, you can be burned out. But traditionally, it was referred to people doing emotional work.

So in the 1970s and 80s, it was a psychiatrist in New York who discovered that certain people who work in the healing professions have more burnout at work than people who are, let's say, dealing with numbers or dealing with calculations because there's this emotional labor, this work, this giving, this depletion that happens. And if those people work in the healthcare industry, oftentimes we don't have the resources like during COVID to help all the people that needed help. And that creates a sense of injury inside of ourselves.

Well, our job is to help other people, but we are limited in help, we can help them. It hurts. And that's kind of like when soldiers go into the battlefield and they're told to go attack a village, but they hurt young children.

So it's what's called moral injury. So we know now that a lot of the burnout that's happening in healthcare is from moral injury. And there are three aspects of burnout, according to the research, that the most basic one that everyone can talk about is exhaustion.

I feel exhausted, I'm so tired. That's okay, but that's not the main driver of burnout. Because if you have passion for what you do, you can work much harder than do more each day without becoming burned out.

So I think the second piece of burnout is really important. And that's what's called cynicism or depersonalization where we're working so hard, we've lost touch with what matters in our lives. And we start to view other people as just objects to interact with instead of human beings with hearts and feelings.

And so that cynicism sets in and that's really the most poisonous part of burnout. And then the last part of burnout really has to do with the theory of peak performance in flow states where we know that if you're gonna live a good life and a fulfilled life, you have to have lots of experiences where you feel like a sense of, yeah, I'm a master of what I'm doing right now. It could even be in this conversation.

I feel like we're really deeply connected. This is a moment of flow. Well, if you're at work and every day, you're trying to do, let's say you're a surgeon and you're trying to do your surgery and help people.

But the operating room's not working, the nurse calls in sick, the administrator makes you change your schedule, they overbook two other patients on the same schedule. Suddenly that hand and the scalpel is no longer steady. It's being blocked and someone is almost like they're swatting you and they're trying to make it hard for you.

So it's that feeling that you're no longer excellent at what you were born to do. And so those three aspects of burnout are really lying at the root, but underneath that, underneath those drivers of burnout, it's very simply the way our modern capitalist system is set up. And this goes back to the debate between communism and capitalism, 150, 200 years, we have to look at that.

That's a different conversation. But there's no solving of burnout. There's no solving of burnout in the modern workplace unless we look at the incentives that the workers are paid, the power differential between the workers and the leaders and the way that leadership happens.

And I'm hopeful and I'm happy as I've met hundreds of leaders around the world to see that there is a shift towards more of a consciousness, more of an awareness towards the impact that our capitalist practices are having on every single person in the workplace. It can't be an individual problem if 50% of the workforce is burned out. It can't be a flaw in a person.

We have to look at the structures and the systems, which explain this. And so that's just a basic high level overview of what burnout is and what causes it and the solutions. Now you can see the solutions have to be, we have to understand how systems work.

We have to understand how organizations work. We have to understand how incentives work and not only that, we have to understand what motivates human beings, what makes us feel good and alive and what makes us feel depleted, down and set. And if we don't have that basic psychological understanding, there's no hope of solving burnout.

So we need people who are interested in what lights people's hearts on fire. Otherwise, if the heart is no longer on fire, it's burned out. That's the problem.

- Wow, really insightful and interesting is in my view, I was always thinking, it's not doing enough of what brings us joy, right? It's been really busy doing everything else. But also interesting, I think that there is a movement of healing, right?

And I think social media helps a lot in this, all this healing talk and all this podcast like mine and many others, the work that you're doing that is also educating the employees and physicians to be like, stop, I'm worthy. I matter, I'm not associating my worthiness just with performing. 'Cause when I was a little boy and a little girl, I only got attention from my parents when I got ACE, right, like good boy, good girl, good night, he's good and he's like a pill, right?

That we keep going for this, less impress or boss, less impress or no, it's like that healthiness within us. And in a lot of the work I do one-on-one with clients is with physicians being like, this is important to me. My wellness is important to me, making time for the things that matter, right?

Creating buckets like my spouse matters, my kids matter, my workout routine matters, my meditation matters, stopping for an hour to eat a healthy meal matters. I'm not going to do a hundred hours, I'm not doing 80 hours, I used to be in conversations about decreasing the 100-hour week work 10 years ago. And a lot of the older generation was like, oh, you know, whimps, 80 hours a week, I'm like, oh my God, that's still half as much of what regular people work, 40, 45, 60 hours a week.

You know, when do people grocery shop? When do they prepare a healthy meal, right? Yeah, so true.

So I think it's that movement that you're working towards, like less educated leadership and systems, to stop with the overachieving and the overworking and the over, right? Yeah. And the population with this type of work to be like, no, you're still smart, you're still capable, you're still saving lives, you're still creating value.

But I'm not going to kill myself. Yeah, I like how you're describing that. And the natural response to that is, well, if we're so focused on well-being and taking care of ourselves, we're not going to make any profits anymore.

We're going to lose money. But all the research says the opposite. Research says that when we're feeling unfulfilled and we're pursuing achievements just to look good and we're sacrificing our own joy because our relationships are suffering, our work suffers.

We're less creative, we're less focused, we're less productive, as opposed to when we're in a positive mindset, which means we're feeling connected and alive and joyful and filled with love in the workplace. And when you have a workforce that is feeling that way, like you said, filled with their purpose and their passion, this has been shown again and again. If you look at research from McKinsey or any of these companies, once the average worker has a connection with their own sense of purpose and passion, productivity goes up by 400%.

And that's just talking about connection with purpose. Now if someone feels a sense of deep self-compassion and has a growth mindset, more productive. If somebody is able to communicate effectively instead of just letting their emotions go wild because they got upset on the way to work, productivity goes up even further.

So what used to be called soft skills, these are hard skills. This is the foundation of having a team that works well, self-awareness, awareness of others needs and desires, a willingness to collaborate and communicate, a willingness to think creatively and to think about the future and not just react to the present in the past. This is the future of work that will end burnout.

It's no other way. - Amazing. And communicate with compassion.

You know, we would decrease so much drama and fighting in the workplace or at home if we put ourselves in the other person's shoes. Instead of like you're not doing this, I understand how hard it is to do this. I've made mistakes too.

You know, just such important work and so proud of all the efforts that you're doing. Let's talk about your book, just one heart. - Yeah, so just talk about the title and that's part of your, when you started the podcast talking about the connection between your emotional heart and your physical heart.

And you know, I think you've talked about how kinder people live longer and have healthier hearts. - Yeah. Yeah, I've been working for about 10 years to kind of simplify everything that I've been learning about how I can experience more joy and connection in my life.

And I realize that there's just a few pieces and they all come together under one umbrella, which is this concept, this philosophy of having just one heart. So the first meaning of just one heart is that I would go and train for triathlons, right? I did this.

I would train 10 or 12 hours a week, a few years ago. I would work out all the time. My heart was in great shape.

My heart rate was like 45, 50, it was efficient. But I was a jerk at work. I would go into the office and all I would think about is how can I get through the day?

I treated people in a very unkind way, not because I'm a mean person, but because I felt, in a sense, closed off from other people. I was thinking, well, what are they thinking about me? I was actually depressed and I wasn't treating it and I was taking it out by maybe exercising more.

And so I started to realize that I was treating my physical heart one way, but my emotional heart, I was ignoring it all together. And as I started to take care of my emotional heart, my physical heart, I enjoyed my workouts even more. And I realized then my patients too, those patients who are constantly angry, cynical, bitter, isolated, they had more heart disease.

So I was like, we've got this emotional heart on one side in the physical, but they're the same thing. Same thing. So I started to study the science of the chemicals that are emotional emotions, our feelings and our physical heart, the nerves, et cetera.

So that's one, just one heart. The second was I realized that if my heart was breaking or aching and I came into a space and I was supposed to be a leader, but I was really frustrated about my last job or what happened yesterday, I would see, it would have a negative impact on the emotions of the people all around me at work. And so I realized the opposite.

Yesterday I went into work and before I went in on a Monday, I said, you know, I don't know if I want to go in today for like a moment and then I said, I'm going to have a great day. And you know what happened? It was a great day because I had this attitude and other people noticed it and they gave it back.

So that meaning is the second meaning of just one heart is that my emotional state has an impact on your emotional state and also your physical heart state. So if I start yelling at you, your heart rate's going to go up. So in a sense, my heart is impacting your heart.

And the opposite is true. If I'm feeling loving and kind, if I'm relaxed and breathing into my belly and you see my shoulders aren't up, but they're down and my face is relaxed, your heart is going to relax and your healing will begin more quickly because of something someone else is doing. And this is proven by the social research, social psychologist that your health is impacted by the health of the people around you.

So that's the second meaning of just one heart. And the last meaning of just one heart of the third meaning is we live our whole lives assuming we can keep behaving the same way and with the same addictions, the same hiding, the same numbing out as if we are going to live forever because we don't want to think about death in our culture. But I see death and I can't avoid it.

I've lost my sister, I've lost loved ones and I've lost many patients. And so I want to remind people that you're not going to live forever. You have just one heart.

So can we take care of it starting right now, right now? So that's where just one heart came from. - I love it.

That's brilliant. - Thank you. - I love it.

Yeah, it is so true. Can we go a little deeper on how and why does anger, frustration, sadness affect our physical heart? Like get a little biological here.

Like why do people have more heart attacks and heart Christmases? - Yeah. Yeah, so we have to answer this question by looking at a few different fields of science.

So we can't just look at chemistry or neurology or physiology, et cetera. I find it helpful to begin with evolutionary psychology which is just basically saying, we humans didn't just come on the planet. We've been here for millions of years.

And the brain function that we have today is as a result of brain function that helped us survive millions of years ago. And so then the next principle is if I have an emotion like anger today, I shouldn't think, oh, anger is a bad thing to have. Anger is not a bad thing.

I should think there's a reason why anger exists after millions of years. It serves a very important function. And so the function of anger, let's say, is to mobilize our body in a state where something's really important to us and to mobilize it in a way where we feel threatened and we want to ward off the threat, usually in a physical or in a vocal way.

So anger is an outwardly directed, either a transition of fear or a sense of feeling threatened. Sadness is there so that we can have shifts in our facial expression, we can have tears coming from our eyes so that other people around us will see that we are needing help, that we are experiencing pain so that our tribe can come together and respond to that sadness. So there is an intimate connection between how we're feeling and what shows up on our face and micro expressions, et cetera, whether it's anger, sadness, joy, so that other people in our tribe can know right away how we're feeling and to respond.

Now how does this cause heart problems or how does this protect the heart? Well, we evolved from very simple organisms that, and we still only are very simple in our responses. There can be a thousand emotions, but they only do one or two things.

They either cause us to become activated, feeling threatened, or they cause us to feel relaxed, receptive, and at ease in a state of connection. So you can imagine certain emotions, whether it's anger, rage, frustration, cynicism, et cetera, they're going to activate us and emotions like love and intrigue, amusement, joy, satisfaction, grace. These are going to activate the other nervous system.

So we've got two nervous systems, which evolved for basically two decisions. Do we relax, to heal, digest, connect with others, or do we become active to protect ourselves from threat? The problem is that today, the same threats that existed before don't exist anymore.

The biggest threat now is if somebody writes a mean message on LinkedIn and says you're an idiot, or if someone doesn't like you, and social media and children is an example. So these are serious threats because our brains don't know the difference, and we sense that we're going to be isolated or threatened our sense of belonging from the tribe will become activated. So there's a sympathetic nervous system and a parasympathetic nervous system, and within the sympathetic nervous system, the one that gets us revved up for this fight or flight or freeze response, there is a sequence that happens from the center of our brain, the amygdala, and then there's a release of chemicals, cortisol, adrenaline, or epinephrine, which circulated our blood down to our heart and to our blood vessels, which get ready for a fight or even to get cut and bleed.

So they tend to make us inflame our arteries, they can cause blood clots, they can constrict our blood vessels, so our blood pressure goes up in case we need it. But remember, this is not happening running in the desert from an animal. It's happening while I'm reading a text.

So this reaction then causes incredible stress on our body and on our hearts. Now for a few minutes, it's no big deal. The problem is that most people, many people, I'll say in the West are suffering from chronic and repetitive stress caused by emotional distress that's beneath the surface, which is silently activating all of these hormonal pathways, causing moment to moment day to day stress on our cardiovascular system, until we have a fight on Christmas or we smoke cigarette or too many beers on New Year's Eve, temperatures very cold, and there's a family conflict and we have a heart attack.

So that's a very simple version of a very complex pathway that's evolved over millions of years. It was amazingly said. And it summarizes some of the previous episodes, explaining the parasympathetic and the sympathetic, and so all that happens creating inflammation, heartening of the arteries, hurting our heart or physical heart that then leads to plaque building and heart attacks and dysfunction.

So amazing. - I'll add one thing there, Karen, because in that explanation, we left out a big bucket. So that explanation was focusing on the physiology of the mind and the heart.

We forgot that there's a whole other piece, which is behavior. So when I'm feeling angry, when I'm feeling lonely, when I'm feeling sad, forget about the plaque and the blood vessels and all this. How do I behave when I'm feeling angry and alone?

Do I choose healthy foods? Do I treat the people around me with kindness or do I treat them with anger and hostility? Does that lead to more social connection, which comes my heart or does it lead to more isolation, which is a great predictor of heart attack?

So I wanted to throw in that extra explanation, the mechanism of the behavioral piece as well. - I love it. A great reminder that your thoughts drive your emotions, your emotions drive your actions and your actions drive your results.

And you can live like that in that cycle for years and decades, amazing. And remember that that is driven by thoughts, by the 60,000 thoughts, that if you're in a state of fear and you think you're gonna go bankrupt or you're gonna, it's just a thought. Comes and goes, how through is it, how everything?

We're not living in this sense of scarcity or wherever that came from from the past. So awareness and mindfulness is key. Thank you so much for joining us today.

I ask all my guests, what is healing for you? - This conversation is healing for me. (laughs) Every time I'm opening my mind to new ideas and listening deeply to someone else's experiences and their questions, my own way of thinking and understanding life broadens.

And that is healing for me because for me healing comes from the origin, means wholeness. Healing and wholeness mean the same thing, same origin. And so it's always about a restoration or return to our natural wholeness, whether it's from when we were young before we had an adverse childhood event or going back to before something happened when we were a teenager or before we sought all of these accolades and achievements, whatever it is, or before we start eating foods that are making our bodies sick or whatever it is, healing is a return to wholeness and integration.

And it means there are parts of us that maybe aren't imbalance, parts of our lives or relationships, our health behaviors. So total wholeness, total health means bringing into balance all aspect of our life and all aspects starting within our thoughts and our feelings, recognizing that we have, all of us have a dark side. We have dark thoughts, we have negative behaviors, negative impulses or challenging impulses.

And there's a tendency towards shame and splitting off parts of ourself and pushing them away. And we can spend our whole lives if we don't realize that just trying to quiet that shame with alcohol or some other behavior. And so for me, healing is about reintegrating the parts of ourself that we carry shame, embarrassment or denial over.

And it often requires forgiveness of ourselves, forgiveness of others. And it also requires a sense of grace that life is really, really hard sometimes. And that's just the way it is.

And it can be wonderful once we accept that there's a fluidity to life that we have no control over. Just what's happening inside of us. So for me, that's what my own healing journey is about and it's still happening every day.

- For all of us and we're not alone. Most children make every single action, mean something about themselves. So if their parents work too much, I'm not worthy, I'm not a priority, I'm not important enough.

And sometimes that's what drives that feeling of unworthiness, of shame. Who are we without the acutates? Who are we without our degrees and our accomplishments?

Right? So Dr. Fisher, why should people do this work?

Why should people work on themselves? - Hmm, I don't think people should. I don't think people should.

A little alarm goes off in my head when I hear the word should. Because if our audience is listening now and they are kind of coming along with the conversation and thinking, yeah, I'm gonna try some of those things out. And the moment that someone else says, you should do something, there's something about this ego that puts up a defense and says, stop, don't tell me what I should do.

And so with that being said, I can tell you why I am committed to doing this work for myself. I can tell you why I'm committed to helping 38,000 of my team members. I'm responsible.

I'm on a team at Novant Health. It's called the Office of Wellbeing and Resiliency. And we have 9,000 nurses and 2,000 physicians and 10,000 other employees and leaders.

And our job is to look after their healing practice. It's not to heal the employees. We're all responsible for our own health ultimately.

But it does recognize that we spend the majority of our lives at work. And if we feel a sense of brokenness, and I don't believe anyone is broken, but if we feel a sense that we are broken and flawed and unworthy, then we at the end of our lives will not have a sense that it was a fully wonderful life. And the reason that I do this work and that I invite others into this conversation is, because it feels right.

It just feels right and there's a better way. There's a better way. And once people feel too much suffering and they're wondering why they're having all this conflict in their lives and unhappiness, they can begin again with acceptance, with compassion, with mindfulness, and with learning to relate to life in different ways.

But it takes a lot of work. You would have please said, "Thank you so much for being with me today, and thank you for the work you do, and please let me know how I can support you in what you're doing." I'm a converted.

- Well, this is such a pleasure, Karen. And I love your mission. I love your mission.

It's all about healing. And I believe so strongly as a doctor now for 25 years that healing doesn't happen in the hospital. Healing doesn't happen in the doctor's office most of the time.

Healing happens when an individual decides that they are not broken, that they can return home to a place where they were more balanced in the past. And when they become curious about new ways of connecting with others, I think that's when healing really happens and that's the work that you're doing. So I really celebrate that.

- Thank you. Thank you. - Really love this conversation.

And I hope you do too. And if you do too, please share it with us. Many people as possible.

Rate this podcast and help me and him inspire as many people as possible to do this work, to work on yourself, to achieve the best version of yourself.