8. STRESS MANAGEMENT FOR HIGH-PERFORMING INDIVIDUALS - WITH DR. SHIDEH SHAFIE

Michael: Well, hey guys, and welcome back to Doctors Living Deliberately. We are here. We have such an exciting episode today. Super excited to bring to you Dr. Shideh Shafie, she is a performance coach for high achieving professionals. Welcome Shideh, how are you?

Shideh: Good. Thank you for having me.
Michael: Absolutely. Well, before we get started, why don't you tell us a little bit about yourself, your background, and all the things.

Shideh: Sure. I live and work in Providence, Rhode Island in smallest state with the biggest heart, I would say. I'm an emergency medicine physician by training and I am also a performance coach. And I've got two children, they're twins, they're turning seven soon. And a dog and a husband who is super busy as a attorney. And so we live that two hardworking professional life with young kids. And I am living that life.

Michael: Well, that sounds incredibly stressful. Being an emergency room doctor in and of itself is stressful, but then two young kids and a super busy husband, so, let's you know, since you love talking about stress, I've heard you talk about stress before and it's, it's incredible. So what does stress mean to you?

Shideh: So I spend a lot of time working with people on stress and understanding stress. And the thing is like I chose this life that is super stressful, right? Like I want the nice house, I want a husband with a busy career. I want kids, and I'm like super ambitious. I want that same ambition to apply the across the board for my children. I send 'em to a fancy private school. Like I want all of those things. That life is stressful, especially because it has a lot of value for me. Like I want good outcomes in all those areas. And that's one of the things I first clarify for my clients and I've clarified in my own life, is we choose stress in areas where we have value, but sometimes that misfires and we actually choose stress in areas where we don't really care that much or we think we should care, but don't care. And then we create all this hoopla stress.

You know, the first thing about understanding stress is like realizing it's not a bad thing. Like for example, if, you know, we all have children in this group, and when your kid has ever been sick, you're stressed out, right? Like if your kid's vomiting and like they don't look good and you're like, oh my God, I'm gonna have to take them to the ER, which is like the worst place on earth where I work, by the way, but you know, if you think about that, you get stressed out. And the reason is, cause we don't want our children to be sick. We don't want them to suffer. We really value them being healthy. Or if they're doing poorly in school or having some kind of challenge or worried that they won't be able to overcome. We get really stressed out. Our children are a place where we have a lot of value. Our work, our finances, those things are things that like are really important us. So yeah, they cause stress in your life. No big deal. So we can know that there's stress and then we can realize that there's something we can do with stress. Stress is not just this like amorphous thing that we just have to be like, Ugh, we don't know what to do with this. When you choose stress, you gotta make room for stress and how to move it through your life and then actually can use it to motivate you in parts of your life too.

Arpita: You mentioned at the very beginning when you first started talking about how we start having stress in areas that are big or impactful and then it kind of infiltrates into the other areas that are not as important. Almost like we're not intentional with it kind of spreading into the perfectionism per se, maybe in certain areas. Can you talk a little bit about that, about how maybe you can build awareness around when that's happening for you or when people see that happening more or give some examples?

Shideh: Yeah, sure. Like I think one of the, especially as a working mom who has like a high powered job and has you know, wants to be involved in her school community, et cetera. One of the places that I see a lot of women suffers, like they feel like I should do this as a good mom. I should like volunteer to like be the person that goes to the book fair and like does whatever. And it like creates all the stress for them. They're like, I'm not a good mom because of this and that. And it creates all the stress. And the question is like, let's pull back a little bit, what are your values for motherhood? Like, you wanna be a good mom, what does that look like for you and, and you wanna be engaged in your school? So like, does it look like taking a day off of your work where you like, create a lot of money to like pay for this fancy school and like go and sign things at the book fair? Or is there like a different role that you could play in the school that might be something like, that might make you feel connected to the school and also like won't cause so much stress in your family because what happens when you're at the book fair and you're losing a day of work and you're gonna have to make that all up the next day or in the next few days. And you see your kid at work and you're like, Hey, mom, at the book fair, you're like, oh my God, I just gotta like get these like books signed. Like stop talking to me. I'm like, you don't even show up as a good mom and you're stressed out about something that like doesn't really matter to you. What matters to you is that you have a touchpoint and a connection with your children.

So like, maybe that looks like being able to free up your time so that you can pick them up two days a week from school or drop them off every day at school or whatever that looks like to having the connection point and seeing the other parents. Maybe for you, it's not like taking the time to volunteer at the book fair, but we sometimes choose something that's like dangled in front of us, but not mainly being intentional with like, is that gonna create the result I want in my life, which is connection with my kids and connection with my kids school community without creating, and then it creates all this stress that's like not even necessary. Does that make sense?

Arpita: Yeah, I definitely can see that point where, how we, you know, take little things and because stress has become like kind of like an automatic reaction to, or we're so consumed by stress with all the different big things in our life that are, deserving of stress or creation of stress. And like you mentioned also talking about how it's good to have stress. We also sometimes unbeknownst to ourselves have that reaction automatically to everything, and I think that's what you're, you're mentioning here is how it starts to be your kind of go-to reaction in a sense to these little things that don't matter. Maybe it has also a little bit to do with, like, you talked about, planning deliberately, you know, what's my end goal with this activity that I'm trying to do? I, I want to build that connection with my kids or go to school and build that connection. But I also don't want this to create more stress for me with regards to loss of income and having, you know, the children really not want you there and then being stressed at the activity that you're doing. So yes, all those things I think make a lot of stress. So talk a little bit more, I guess about how stress has impacted you in your life and career. I think you had recently had some changes that are super exciting. So tell us a little bit about that and how coaching helped you there.

Shideh: Yeah, so, well, you know, as an ER doctor, I deliberately obviously choose a stressful career. And one thing I think we do need to separate out, which I hadn't kind of included, is this idea of there's stress and then there are stressors. And that's really important to separate out those two things. Stressors are the problems in our life, the challenges, right? And so that is that last minute email that you get that's like, oh, your kid's sick, come pick 'em up from school early, and you're like, oh, shit, I have like five patients to see, or I have two hours left of my shift. How am I gonna do that? That's a stressor and we always solve for that. Like that we always solve for in our lives. We figure out, nanny can go pick them up, my husband will go pick them up. I'm allowed my shift, like, I'm like, sorry, I have to leave cause my kid's sick. Whatever it is, we figure out the solution.

And as like ambitious doctors, we always figure out the solution, but then the stress is like the physiologic reaction that happens in our body after something like that happens. And that is something that we can actually move through our bodies. And so as an ER doctor, I choose that every day, right? Like every time, you know, and all the physiologic reactions are not the same, right? As you become more senior in, you're training, you know, if you're an intern and you have a patient who's coding, it feels really different, right? Like, you're freaking out. Like, I don't really freak out a code anymore. You know, I know what I'm doing there. It's just like, okay, let's get the things done. But there are times where other stressors, and I think as we become more senior in medicine, is generally not the clinical medicine that causes us the stress. It's very rare. That's always the scary thing when it does. But it's very rare that that's what causes the stress. But it's more like the tedium of, you know, the administrator that sends you this email that's like, can we talk? And you're like, oh my God, what are they gonna talk to me about? You know, that kind of feeling.

So we have those stressors and the way we make room for them is by actually doing something with the stress reaction in our body. And what is the stress reaction? It's this reaction that's like created in our lives to keep us safe. It's that idea of like, you know, bear is chasing you in the wild, you're running away from it. And so the stress reactions mediated by hormones that are intended to get your muscles tense and ready to run. That's the adrenaline, endorphins and the cortisol levels going up. We always talk about the cortisol levels going up during stress. All of that, that's really a cascade of hormones and they're meant to make you run away. So the most effective way to deal with all the stress is to actually move your body, run away. You can't run away in the moment, right? Like, I can't run outta my shift and be like, oh, I'm gonna deal with my stress reaction right now. That can't happen. But after the fact, you can make time for doing that.

And that is like one of the pivotal things that changed for me when I decided to make a lot more changes in my life, was I worked a lot of seven to three shifts, or three to 11 shifts. I always went to the gym at, in the morning, at the three to 11 shifts, but I started scheduling that at four o'clock I'd go to the gym right after my shift, I gave myself enough time so that I'd be able to get out on time. And increase my childcare so that between four and five I always had childcare and I would just go to the gym. And when you start doing that, you start feeling better. And now, you know, a lot of my clients are like, I don't have time for going to the gym. Right? Like if you are not a gym person, you haven't like built that into your life, you may not have an hour to dedicate to that. That's okay. And one of the things that, like you two have known me for a long time is I'll tell people like, put in your pods and dance to one song.

And I see that now at the end of my clinic days. I work at an urgent care clinic part of the time now, and my shift ends at eight o'clock, but at like seven o'clock they roomed the last patient. So it's normally, there's like 15 minutes of like downtime where they can't room any patients, but we can't leave the premises in case someone walks in. So I always go into one of the rooms and everyone knows I put on my music. I go into one of the patient rooms that's empty and I have a little dance party. I'm like, we gotta leave all the junk that has been built up through the day, all the hormones out of my body. I'm not gonna go to the gym between eight and nine. I'm like trying to go home and go to bed, but you can give yourself that minute. So like really processing the stress reaction in your body.

And then once you start feeling a little better, because you are like getting the stress out, then you have the room to like kind of dream and imagine. So here I am an ER doctor and I said like, okay, I want my life to look different. I'm tired of working overnight and I'm tired of working a ton of weekends. Like, you know, I want time for my family, but I love being an ER doctor. So I actually restructured my time. So I went and like talked to my boss and I was like, well what did this look like here? Did the math then figured out. Now I am working two days a week in an urgent care where we like, serve really underserved people in Rhode Island. It's a like a wonderful institution that like really sits with my values. We serve like undocumented immigrants, we serve the underinsured and we serve people that are under the poverty line, 98% of our patients are there and it's awesome and I love the work I do and I like plug them into getting insured, getting like primary care doctors, even if they're not insured, all these kinds of things so like, love that work. I do that twice a week. Once a week I work in the ER and the rest of them, I coach. No more overnights. And that works for me. And you know, I also do a bunch of real estate, so like the financials work. And the thing is you just need to give yourself a little time to sort it out. It's like a, remember when you, you used to put all your necklaces in a jewelry box and like they're all like tangled.

Arpita: I think Michael does that a lot.
Michael: Yes. Yes. Untangling necklaces is, is actually, that's how I de-stress actually.

Shideh: Untangle them to see their beauty and to like be able to wear them and enjoy them. So that's what we do with our clients. Also like untangling, like what is it that you want outta your life and then going for that.

Arpita: Yeah. I love the dancing in the room. That's a great way to, like you talked about just eliminating or purging that stress that's built up in your body with the interaction. So...

Michael: And for any men that are listening, it's okay to have a dance party. It's also okay for any type of movement. That movement can be you can jump around, you can do like jumping jacks, you can do squats, like whatever. But I think Shideh what you are kind of talking about here is completing the stress cycle, right? So, so when you are stressed and you have all of these, all of the adrenaline, all of the endorphins, and we kind of push all of that down in the moment because we have to get through the stressful situation. It's really important to see that stress through, to complete the stress cycle. And we do that as you were mentioning, through movement and, and the movement can be anything. It can be going to the gym, it can be dancing around, any of those things. But you really need to kind of complete the stress cycle so that you can move to the other side of it and create the clarity that you were just talking about. And when you create the space, right? When you complete the stress cycle, you create space and that allows you to be more of who you want to be, to lean into kind of your creativity and figure out like, am I doing the things that I want to be doing? Right? Did I get that right?

Shideh: Yeah. And I would say the movement, it can be any kinda movement. But there's one thing it can't be, it can't be multitasking doing something else, right? Like I don't do yoga for that reason because when I do yoga, I sit there and I'm like, let me think about my to-do list. Let, like it's just too slow for me. Like that's not gonna work for me. And that might work for other people and they can put aside their to-do list. That's why like dancing is really like very powerful because it's like very short. but it's really about focusing for like three minutes on just like your movement and like, you can't be like putting away the dishes while you're dancing. That does not count. You just gotta like, just for three minutes. I'm not talking like three hours. Three minutes. Give yourself the time for movement.

And you know, when we're talking about men and doing this work, like, the other thing is we think about it as finishing our stress cycle, but we also like use it to get ourselves ready to go do something big and strong. And when you think about and men doing that, like think about sports teams, right? Like when you go into a locker room at a football game you know, they psych themselves up because they're creating a physiologic reaction that's actually called the challenge response. It's a modified version of the stress response. When you know that you're gonna go, like, you know, when you're a professional athlete or even if you're a high school athlete or college athlete, you know that when you're getting on that field, you gotta leave it all out there. And you gotta play your best, even if you're losing, right? Like, you just gotta get it out there. And that's why they psych themselves up. They do the huddles, they do all that movement. That's what they're creating. They're changing their physiology and their mindset to kind of get in that like, oh, we're gonna go pumble this other team. Now, they might not be able to pumble them, but they get their bodies and their brains in that mindset.

Michael: The other reason to really think about dancing, right, is because music in and of itself changes mindset. Right? That's why a lot of times, you know, actually I believe, and maybe I'm wrong about this, but I think at some point, I don't know if it was the Olympics or what have you, the athletes were not allowed to listen to music before they were competing because it changed, you know, it it, was felt to provide an an unfair advantage. And I'm not sure if it was the Olympics or other sporting event, but music in and of itself can do that on its own. And so when you combine music with dancing or something like that, it really does help to change perspective, change mindset, and allow yourself a different perspective in the moment.

Shideh: Totally. Music is so powerful in that way. It's especially really powerful for us as physicians because I think one of the things you learn in physician life is that you get really good at packing away your emotions, right? Like, you, you as an ER doctor, like somebody dies. Then I go and like see somebody who's sprained their ankle and like I have packed away that I just saw a 35 year old die. I like put it away. And then I go next to my next task. And then we get really good at compartmentalizing, which is great. It's a really important skillset. But then when we wanna reach our emotions, like, cause we're so good at hiding them away, I like, it's hard for us to feel sad. It's hard for us to figure out what we're feeling. And music can really help you feel that. Like to understand what's going on, right? Like you've had this hard day, and you put on like a sad, soppy song and you suddenly start crying, which by the way also finishes out your stress response cycle. You like ugly cry for a little bit, because sometimes you need to ugly cry or, and then, oh, you're like, oh, I have this emotion of sadness because, and you, you might not even know. And that's the thing, like, I love therapy. I don't love yoga. I love like all the softy stuff too.

However, Some of us are super busy and like it's not necessarily efficient for us to talk about every single hard case that we've seen. It's not official. It's not easy for us to talk about all the little mini stresses. Music, it's just like, oh, three minutes I cried out. I'm over. Let's go. Let's get back into our life. Or I move it out of my body like, I'm all about time efficiency cause I'm trying to cramp as much into my day as possible. And so it's a very effective tool. I like, it's not, it doesn't require a lot of like, well what did you feel when this person, like, I can't do all that all day with every single sadness and stressor that I have in my life. I don't got time for that.

Arpita: I think, and that's a good point too, that everybody has their own way of releasing stress, and the key here is recognizing when you have embodied it, how you've, as you stated, compartmentalized it and how you best release it. What works best for you, you know, is it going for a run? Is it doing the dance party for three minutes? Is it doing the yoga or the meditation? What works best for you? And just tapping into that and figuring it out so that you're able to process and purge that stress, embodiment from you. And be able to be much more effective in how you're showing up and just more present honestly, after that. So tell us, and, and I think we touched about it a little bit, but specifically choosing stress to reach goals versus other stress. Can you talk a little bit about that?

Shideh: Yeah. So the first thing I do, like what are my big goals in life? And I will tell you that most of us, when we set time to set goals, we like get into the space of like making realistic goals. One of my clients, we finished working together. She'd reached her goal and she was like, you know, I thought you were crazy when I first started working with you. I was like, okay, let's keep going. And she was like, because I just wanted to change my job. But then you were like, why are we just stopping there? Like, let's blow this whole thing up and change it. So she ended up taking a new job, in a new city with a new childcare. All the things changed because she actually, like, there was a lot of parts of her life that she didn't like, but she was like, well, I'm just gonna change this a little bit.

So first thing is like, choose your goal big, right? It should cause, like big goals cause big stress, no big deal. We got you. We can get there, right? So first, like, decide the goal and then know that your brain is gonna fucking flip out every step along the way. Right? Like that's just what happens. I'm like, oh my God, is it crazy to move and get a new job? No, it's not. You don't like where you live, you don't like the job you got. Why would that be crazy? But you can talk back to your brain. So teaching your brain that like it's, there's gonna be stress. That's okay. Anytime we have any big change in our life, we have stress. I am choosing the stress intentionally because what I want is on the other side of this stress mountain. And I will walk you through this stress. No big deal. You will talk to yourself in a way that will keep you moving, right? Like You know, I talked to a lot of physicians who've recently changed their jobs and they're like, oh my God, I'm really scared. A lot of them have gone to nonclinical work or they've gone to other clinical position that are better suited to them.

Like, oh my God, I'm so stressed out, am I making the biggest mistake of my life? I'm like, ain't nobody knocking the door down to get these clinical jobs that you think that are like so amazing. Like we were seeing people leave medicine left and right. You can always go back down and yes, your brain is gonna freak out. No big deal. No big deal. That is just what brains do when things are different. That is what stress looks like in action and it's okay. We got you. Like rise and surmount to the challenge of this stress and climbing that stress mountain.

Arpita: Yeah, I can relate. I think with regards to doing that, like, you know, when we started our medical practice 10 years ago, my husband was like, okay, I'm not doing this anymore. I'm not gonna be part of an academic institution. I wanna start my own thing. And immediately I was like, brain keeping us safe. What are we doing? No, no, no, no, no. We don't wanna do this. So I was afraid of that stress that would come with this change. And I think we talked about this even with, you know, where we all trained for coaching is that discomfort is the currency of our dreams, right? If we are comfortable, we're not really creating change. And so when we want to change something in our life, it's going to come with stress, but that's the good stress. That kind of is the drive that helps us get to where we wanna be. Where it becomes problematic is when it's occurring over and over and over, and we don't have the resources there to support us to push through the stress, and we don't have the connection to be able to, to speak to our colleagues or friends or loved ones to help have that communication in between. Those things kind of make it shift towards toxic stress. And then when it builds and builds and builds it becomes trauma. And so that's kind of the difference I think between good stress and bad stress and how, how stress can evolve into something that's not so good at times. So, yeah.

Shideh: If I were to say there's like a trajectory of how it looks like to work with physicians in this space or working professionals in this space. It looks like this. Looks like you got a lot of stress. It's all jumbled up, we sort that out. We make you feel a little bit better. You feel better cuz you learned how to take care of the stress cycles. Once you start feeling better, you start be like, how do I want this to look different? And then you say, oh, okay, I want it to look this different. And then you're like, holy shit, I just fixed all the stress of my life. That was like, I was feeling bad. Now I'm gonna like choose to feel bad again. I'm like, yes you are. You're gonna choose to have the stress, but you're not gonna feel bad about it. Cause you're gonna be like, oh, this is the currency to my dreams. I have this comfort idea.

And then on the other side, you land there and you're like, oh, I've created this whole thing that feels freaking much better. I don't feel as bad. I have achieved some of my goals, but now I'm like addicted to goals and I want another goal, and that's what it looks like. And then it's just like rinse and repeat. Rinse and repeat. And it's so fun, right? Like, I work with the ambitious professionals because we like ambition, we like growing, we're here for the growth, we're here for learning, we're here to like make our lives awesome. But what happens is a lot of them are in the space where they can't grow because they're just being pummelled down every day.

So first you gotta feel better, and that's like that burnout engagement like ratio down here, and you get that more on the engaged side of their life, then you feel a little better, and then you start setting goals intentionally, not necessarily. And when you're talking about like, you know, having your own practice, right? Like not just meeting other people's metrics, meeting metrics that are important to you in your life. And that's super important. It's so fun.

Michael: Yeah, in summarizing here, I think, you know, I never had an opportunity to think about stress really until I met you. Stress for me was just bad, right? Like stress was bad. And, and I think what I'm taking away from this and through our discussions is, you know, being able to, number one, first and foremost, recognize stress. Number two, giving yourself an opportunity to process the stress in some way after the stress experience, right after the, you know, allowing yourself to move all the way through it. Giving yourself the space then to kind of process all that to dream big and then to choose your stress, to lean into it, to remember that you are in this stressful situation, because in a lot of cases, not obviously not every case of stress, but in a lot of the cases that we are discussing here professionally, we chose those things, right? And when we give ourselves an opportunity to process it all, then we can choose how we want to deal with stress moving forward. And I think that is, I think one of the most powerful parts of your message, Shideh is that, we get to choose our stress in a lot of situations. Obviously there are stresses that come up in life that we don't have a chance to choose, but professionally speaking, we get to choose that and that just feels so much better. It's so empowering. And so if there was a key takeaway that you could give our listeners, what would that be?

Shideh: I would think, tell you to choose your stress intentionally and recognize that you are a badass for being able to handle that stress. Right? Like, and when I think of, well, we're talking about the clinical scenarios, right? Like you scope cirrhotics who are like vomiting blood up out of their varices after they've been stabilized and are in the MICU or in the ER. Right? And you try to save their lives. That is a high value thing. It is stressful because they are very likely to rebleed and have poor outcomes. But you do that, right? So don't put yourself this pressure like I should be stress free. Like no. That should have stress in your life, right? Or like the cardiothoracic surgeon who's sewing up little tiny coronary arteries together. Or you're a husband who's like injecting people's backs and doing all kinds of crazy stuff and like is taking on this big problem that's hard to solve and has a high risk of failure of being solved and yet, we do it. Being able to hold onto that stress makes us and doing this incredibly valuable job in this world is so important. So be intentional and don't beat yourself up for having stress. Be like, yeah, I'm a badass who can handle stress.

Arpita: Mm-hmm. A hundred percent. A hundred percent Shideh. So good. Well, it was awesome today talking with you, helping kind of shed a little bit of light on stress with our audience. Tell 'em how they can find you if they wanna learn more or reach out to you for some one-on-one coaching.

Shideh: So you can find me on my website, which is my name, www.shidehshafie.com. Or if you just wanna hear me talk all the time, come to Instagram. I live and post a ton on Instagram. That's the easiest place to find me. The way I work with people, I work one-to-one. We get deep. You have seen my personality. I will not take it easy on you. I will beat you up and push you across that finish line if I have to. So and I love big goals. I love, love the space of stress between having young families and creating a future that we love. Like that is my favorite space to work in because those people, I feel like, you, you tell yourself all this stuff yourself, like, I'm not doing anything right. No, man. You're holding lasers in the air and you have a superpowered brain that can do that. So like, let's shift it a little bit and make it the exact balls that you wanna be holding in the air. Oh, that's what we love working in that space.

Michael: That's fantastic. And just for our listeners, your Instagram handle at Shideh Shafie? Shideh: Yes.

Michael: Perfect. We will have this in the notes for the show. Dr. Shideh Shafie, awesome chatting with you. As always, thank you so much for being here and we will see you.

Arpita: We should have a dance party.
Michael: Yes, absolutely. Yes, and we'll see you next time. Take care. Shideh: Bye