Beyond Burnout: Healing Moral Distress in Healthcare – Interview with MInky Van Der Walt – The Entrepreneurial Clinician Podcast

While not all allied health professionals may have experienced burnout, moral distress may be a more common but less-known experience for many. But what is moral distress and how is it different from burnout? In this episode, Jo is joined by therapist Minky van der Walt to explore this question.

In this conversation, Jo and Minky discuss:

• The difference between moral distress, vicarious trauma and burnout
• The impact of safe systems of work on moral distress
• What does it mean to deliver a safe system of work and how you can build that in your practice or workplace,
• The changes Minky has observed in workplaces that weren’t common 5 years ago
• The impact of a debriefing practice and how to create a safe space for it
• The importance of getting out of our heads into our bodies, and
• Minky’s advice to a new graduate to help them stay in the work

About Minky: Minky van der Walt (she/her) is a clinical member of PACFA, the Australian Music Therapy Association and the Music and Imagery Association of Australia. Within PACFA, Minky is an Accredited Mental Health Practitioner and Accredited Supervisor.

Through her work across medical, education and community settings, particularly as a child and family trauma therapist, Minky has become a passionate advocate for the wellbeing of helping professionals. In her private practice, Tempo Therapy & Consulting, Minky supports health professionals offering therapeutic supports, individual and group supervision and professional learning.

With expertise in chronic stress and post-traumatic mental health, Minky offers support based in trauma-specific practice, including Eye Movement Desensitisation and Reprocessing and Internal Family Systems Therapy approaches, music, creative arts and somatic processes, as well more traditional talk-focused approaches.

Minky is based in the beautiful lutruwita / Tasmania where she loves gardening, being in, on or near the ocean, or out and about with her not-therapy dog, Pablo.

You can connect with Minky via her website tempotherapy.com.au and on Instagram at @Tempo.therapy.

Special thanks to our podcast sponsor, Practice Conquest!

Resources mentioned in this episode:

• Future Proofing Health Professional Facebook group 

 If you know you need more support, please visit my website at https://jomuirhead.com

Finally, if you loved this episode, please make sure you subscribe and leave us a review.

Transcript

Jo:

Well, here we are again with another episode of the Entrepreneurial Clinician Podcast, season four, where we’re talking about all things burnout, burnout related, how to take care of ourselves better, why Jo went on sabbatical, and what she saw along the way. Before we get into this episode today, I would like to acknowledge the nation and the land on which I stand. It is the land of the Darug people here in Western Sydney, and I pay respects to their elders, past, present, and emerging. And just wanna give my heartfelt thanks for the way they have looked after this land and allow me to be able to live my life here. Today is going to be an interesting conversation because it’s one that we have not been having in the whole rhetoric around self-care. And my guest today really helped me to understand this very important and key missing link to our discussion around self-care for health professionals. So today, welcome Minky Van der Walt, all the way from Tasmania, which is a part of Australia. For those of you who don’t know, Minky, welcome to the podcast. I am really grateful to have you here today and being willing to have this discussion. Before we get into our discussion, can you just share with everybody who you are, what you do, who you serve, and how you’ve ended up where you are today?

Minky:

Thanks for having me here today. Jo, I’d like to acknowledge that I am coming to you from the unseated lands of the Muwinina people in lutruwita, Tasmania. So, I’m an allied health clinician. I originally trained as a registered music therapist and have subsequently trained as a psychotherapist and a clinical supervisor. And my work really focuses on delivering supports, training and supervision in for health professionals, so health professionals individually as well as teams, and also now organisations. So I’m really passionate about bringing together a lens of neuroscience, social justice, creative arts music and somatic processes so that we can really kind of integrate and embody and have some daily weekly moment to moment practices to support ourselves and the teams around us in this work. So that’s my huge passion. I came to this as a registered music therapist who graduated in 2000, it’s always been a huge part of my role to advocate. So I’ve set up many different services and had to introduce and write so many grants to <laugh> find my own work as a music therapist. And then over time became a child and family trauma therapist. And it was really in that space that I witnessed and experienced the significant impacts on the helpers around children exposed to traumand just have really developed, developed a strong passion in supporting us, the workers on the ground.

Jo:

Yeah, and that’s why you’re here today because the passion that you have for supporting those of us who do the work is, it’s phenomenal. It really changed the way I thought about what needed to happen. And I think you have really added to this conversation, which is my whole goal, right? How do we progress from the, in my case, nearly 30 years of talking about it and not much changing to how do we have different conversations about this? So I’m looking forward to unpacking that a bit a little bit later on. But I guess my first vulnerable question to you, <laugh>, is, can you think of a time when you’ve been really burnt out by your work and can you share some of that experience for us and what you did to kind of pull yourself through that?

Minky:

Yeah, this was such an interesting thing for me to consider before meeting with you today, Jo, because it just really highlighted to me the language and the need for education. And I’m not saying education of you, but I was thinking, have I experienced burnout? I know a lot about burnout, but it just really and then I thought, no, I haven’t really, I wouldn’t call it burnout. And then I thought, would I call it vicarious trauma? And then I went, no, it’s actually moral distress has been the significant part of my experience. So I think a lot of us know about burnout these days, and a lot of us know about vicarious trauma, but moral distress is really this part where there is a values betrayal really in the work. And this, as you probably know this terminology comes from the world of moral injury, which is originally researched and discussed in terms of war.

But there’s been an increasing conversation and research base being built around it, led by one of the key people that I know who works in this space is Wendy Dean in the States, and she talks about moral distress for health professionals and how it’s this moral transgression. So we enter into the work to do well, to support people, to do all the right things with our very best of intentions. And often the workplaces that we find ourselves in are make it not possible to prioritise the people whom we’re serving. So for me, that was really working in an organisation where, yeah, the sort of values clash happened and I wasn’t supported by the management and went through a whole process and ultimately needed to leave that workplace. So I guess that’s a fairly extreme version of how did I manage it? But I think when you’re in the face of those real systems challenges and it’s really having a significant impact, and you feel like your hands are tied, that was the option I took because I just wouldn’t stay there. And so once I recovered from, or once I left that position, I was then able to engage my own supports. And of course I had my family and friends around me, which is always one of the most important things. But sometimes we have to get out.

Jo:

Yes. Sometimes we do <laugh>.

Minky:

Yeah, I guess luckily I could, I guess that’s also a point of privilege that I could.

Jo:

Wow. Throughout this entire season, I have been flabbergasted in a good way on on the vulnerability of people sharing. And already within the first five minutes of this conversation, you’ve brought up, I think, a way of languaging that is not familiar to a lot of people, but as soon as you talked about it, I went, oh, I just put a post on LinkedIn that is exactly that.  Not realising that that’s exactly what I’m fighting against. I find it some of the things that we are forced to do or the expectations of us are morally reprehensible. And is that what we’re talking?

Minky:

Yeah. And I think to quote Wendy Dean, she talks about it by whereas in warfare, it’s often horrific and extreme in healthcare. It’s more like what she calls a death by a thousand cuts.

Jo:

So can you don’t have to give your specific example now, but I know you’ve worked in other places and you’re a very thoughtful person. Like you spend time thinking about things. Can you give us some examples of where we might have misunderstood that it is actually a moral injury that we’re experiencing and we’ve kind of brushed it off as something else. Can you give any examples that come to mind?

Minky:

I can’t think of anything specific, because often it’s just in the personal person’s experience, and things can all look the same from the outside. So it’s all about the personal experience that people have. I can talk a little bit to that.  There’s a sense of with burnout, we know that sense of depersonalisation and brain fog and becoming socially isolated and really struggling to face things feeling dejected about things. Vicarious trauma is more that where our whole world view changes in the face of the work that we’ve been doing. So for example, I know for myself that having worked with children exposed to trauma, it meant that when I was with my own kids, I was a bit more hypervigilant around them going to a public toilet, for example, things like that. So it’s like that worldview that’s not exactly vicarious trauma, but it’s that worldview change where you are expecting things to be in a way that you possibly wouldn’t have before the work. And so the moral distress is really where that there’s that values misalignment and that can have really significant consequences for people in general. So, I don’t know if I really answered that question.

Jo:

Yeah, I love the answer that you gave because I think a lot of us will be grappling with, and I know I have been grappling with, well, what are the features of burnout and how are they different to vicarious trauma? And now we’ve got this whole moral injury component that we need to think about, which is the environment that we work in, right?  And I think this is the point I really wanna drive home. What Minky’s work showed me was that we are not the people to blame as the individuals because we’re not resilient enough or good enough or competent enough that it just comes a time that we find ourselves as ethical quality people who wanna do good work and help people that we go, the system in which I find myself, the workplace in which I find myself cannot help me achieve those goals. And it was really helping me understand the missing piece of the conversation. It’s actually a work health and safety issue.

Minky:

Yeah, absolutely.

Jo:

Yeah. Which is where I wanna drive this conversation next, but before I do, I I wanna just make sure I’ve understood the concept. So, as we know, I’m a rehabilitation counsellor and I have worked pretty much my entire time inside the lens of personal injury insurance. So we are asked as health professionals to provide evidence-based best practice, which means we treat people as a whole person. We look at their bio, their psycho, their social, vocational, their whole orientation to help them return to work or some other part of their life. But then we have other people who aren’t health professionals making decisions about how much money we can spend, and they just ignore one of those things. They go, I just want you to focus on the bio and ignore the rest of it. Or in the case, I recently supervised somebody about a  dominant arm shoulder injury, go to the gym and strengthen, like your physio has said, but we’re not paying for the injury to the right hand. So you can’t actually pick up any of the weights. So I feel felt stuck and stymied, and it took me a long time to realise that I actually wasn’t the problem.

Minky:

Yeah. I think people can feel complicit. Yes. So you’ve got a good intention, but you feel like because you’re operating within this system and you are having to go along we in general, we have to follow what our line managers say, for example, or what our the senior management says. And if it feels like a values misalignment then we can feel complicit, which then has all kinds of implications for our self perception, our meaning making all of those sorts of things about ourselves.

Jo:

Yeah, absolutely. I’m glad I got that. Yeah. ’cause you’re right, the meaning making I was telling myself for a long time was that I’m no good at this. I need to work harder. I need to prove myself better. Which then I’ve taken this moral problem and turned, and in my case, I over functioned and turned it into a burnout problem. And the burnout problem was all about me addressing me, forgetting that there was this core component that was problematic.

Minky:

Yeah, that’s right. 

Jo:

See, told told all the listeners that this was gonna be a bit, so people are just gonna be hitting pause, going, wait, what? Now, <laugh>, this is, this is a really big topic. I think it’s important. So let’s talk about safe systems of work, right? Because here in Australia, we have legislators. We actually have it all around the world. It’s just not always called this. But here in Australia, our workplaces are supposed to provide safe systems of work. Your expectation is that you go to work and you’re not harmed. Talk to me about what you are seeing, like in broad brush strokes. ’cause I don’t want you to put anybody <laugh> into difficulty. What are you seeing or hearing in workplaces that make you go, oh, we’ve gotta do this better?

Minky:

Oh, so much Jo. I don’t even know where to start almost, but people feel responsible for the fact that their wait lists are full and they feel terrible. They feel in pressure, internal pressure, as well as external pressure to take on more. They sometimes services are feeling criticised by the public. And then when you work for that service it’s difficult when you’re sort of out at the supermarket and someone sees you and knows you’re associated I mean, I just think people are exhausted. This is very sad and a loss for everybody. So many really wonderful clinicians just leaving healthcare in general in whatever avenue it may be, whether it’s medical or allied health or social services. So, I mean, there’s just so many ways.

Jo:

The implications of this are very, very far reaching, because if we don’t have enough people to provide services, then people don’t receive services. And selfishly, I’ve been very open about this. I don’t wanna need get to the point where I’m needing extra services and there’s no one around to provide them, or I get the new graduate who’s only got six months experience <laugh>. And it is starting to happen, right? I mean, you live in a part of Australia where waiting lists must be exorbitant.

Minky:

Yeah. And I guess what’s really important too, so we’re talking about health professionals here, but we could also look at what happens to the people who are trying to access the services or the people who are accessing the services that are at times inadequate as well. So there’s all of that side of it too. So it’s not just that we need to be focusing on all of the people in healthcare. So that means the people accessing the services and all of the workers. So not not just the health professionals either, but the whole management right down through to all of the people on the ground, whether it’s healthcare workers, or whether it’s receptionists or cleaners or whoever it is, everyone is impacted.

Jo:

Yeah. I’m gonna just share a story about a receptionist that was impacted in a service. We were working with this really large government organisation here, and they were having a lot of churn with their reception staff, and we were trying to figure that out. And it was because they would take calls from very upset, very traumatised people who were often not seen in our community, right? And people joined this organisation because they wanted to be able to provide something to the social justice. They wanted to make a contribution. So that was what they were attracted to. But as soon as they put that call through to another person, they didn’t didn’t know what happened. So they were left going, is that person okay? Did that person actually hurt themselves? Did that person actually go and hurt someone else? They were left with all these unanswered questions because these weren’t health professionals. They didn’t know how to deal with that either.

Minky:

There’s there’s a huge vicarious trauma load on people hearing stories, like on the phone, or lawyers working through information or people reading through reports, all of those things. Those workers also have a huge vicarious trauma load.

Jo:

So, when you talk about, well, when we are gonna start talking about safe systems of work, give me the Minky ideal. Like, if there was a way Minky could create a safe system of work inside with an organisation, right? What types of things would be included?

Minky:

Well, first of all, you need a dual focus of the organisation and the individual. And it’s gotta start with leadership. So we need to start with leadership. We need to work with leadership to understand what’s working and then really shift the cultures that are there. And then you could go further up in terms of we need policies around that because there’s not enough workers. I think the World Health Organisation have predicted international shortage of 10 million healthcare workers by 2030.

Jo:

A shortage of 10 million people?

Minky:

Yeah.

Jo:

Holy guacamole, Batman.

Minky:

Yeah.

Jo:

That’s too many zeros. But that’s just devastating.

Minky:

Yeah. So we need to find a way to [reduce that]’cause we’ve got people leaving and we need people to come in. So we need to find ways of having that as something encouraging and rewarding and safe enough at the basic for people. So, I mean, there’s a whole conversation you could have around that side of things, but I think on the ground in terms of people need, we have need that dual focus. We know that if people are engaged with at least 20% of their load has been truly meaningful for them, that’s sort of good enough to be satisfactory and give people a real sense of value and compassion satisfaction in their work.

Jo:

That’s not a lot <laugh>.

Minky:

20%. No, that’s what I mean. If you’ve got a full caseload, you only need 20% according to the research of it to be truly meaningful for you. So the rest can be admin, maybe work that you’re not so keen on, but you know how to do all those sorts of things. So yeah, flexibility, having workplaces provide psychoeducation around the impacts but not just ongoing psychoeducation and ongoing development of practices to identify impacts and build practices of support, not just what they call aftercare after an incident, but through the day. And in that instance, you need team and system supports to make the time and space for that. I mean, these aren’t all easy things to do, given the shortages and the time pressures and the workloads that everybody has, but these are things that are possible with some tweaks. So yeah, it’s psycho component, the daily practice component and space to go places, teams, I mean, teams are just wonderful when a team is good. People don’t get by without their teams. But as we know, that can change as I certainly had that experience a couple of different times but that’s just the thing that I just find so inspiring in the work that I do, is just seeing the supports and the wonderful resources that teams are for each other. So collective care, having an understanding that this is not all on an individual. I mean, of course we need to look after ourselves. Of course we do. And if we’re not traveling well, we need to access support. But sometimes it’s hard for us to see that. So we need colleagues and friends to help us to acknowledge that when it’s the case as well. 

Jo:

Without fear of being put on a performance improvement plan.

Minky:

Yeah. Or without fear of it impacting our career progression either.

Jo:

Or then feeling like, oh, I’m gonna impact my team negatively because I’ve asked for extra support and I know how hard everyone else is working right now.

Minky:

Yeah. I can’t go into work today, but I feel really bad because I know that means everyone’s gonna be really under the pump. I hear that quite a bit too.

Jo:

Yes. When I was keeping nurses nursing, which I did for a long time, that came up a lot. Like the nurses would limp into their wards with really significant injuries going, I’ve seen the rosters. we can’t find people to fill the space. I have to be here. I can’t let you know Mary and Susan and Bob deal with the rest of this. These are the conversations, we’re not having Minky. Why are we not having them? Do you think? Why is it taken until today for us, or in your case for a little while, but why haven’t we been having them? What’s the resistance>

Minky:

They’re starting, I think that’s the positive thing. They’re starting, like there’s pockets around the world of amazing researchers who’ve actually been doing this work for a long time. And it’s trickling through, it’s slow. And it’s hard, but it is starting. So I think it’s important to remember that because there are lots of, like, I could, I could just name so many different individual people and d different individual initiatives that are happening. But I think why hasn’t it happened sort of on mass? I don’t know. I think there’s a culture of pushing through, pushing on people who come into this work, wanna help. Possibly. Lots of people in healthcare have always just put other people first so they don’t raise their hand and say that. But also there’s this culture of there’s a real hierarchy and that’s changing a little, but there’s a real hierarchy in healthcare that has a very top down kind of approach that people, we’ve all been indoctrinated into, I guess <laugh>.

Jo:

Yeah. And what’s exciting for me is seeing some of the younger people coming through. Like, I’m in my fifties, so I’m watching younger people coming through who really don’t wanna do it the way we did it, or the way I did it. And I can see ta lot of my colleagues who are owners of private practices or their own health businesses often talk about the entitled younger people. But I’m like, we’ve actually given them permission to express what they need. They’re actually holding boundaries. They’re actually telling us what’s not working. We just dunno what to do with it. Which is where I think that top down approach is now so limited because we actually need these younger people coming up. And I think what you said before about the resources that we have in our team, it’s like, if you’ve got a problem within your team, get the team to help you solve the problem.

Minky:

Yeah.

Jo:

I think it would be fascinating for health, like owners of businesses to sit down and go, what do you perceive we need that the risks are for you in this work? And just be open to that conversation.

Minky:

Oh, absolutely. Being able to be on the ground and be leading from a grassroots perspective is really important, I think, in this kind of cultural shift that needs to happen.

Jo:

Yeah. I agree. I do think it needs to be grassroots. While I think policy is important, I just know how hard that is. That’s like trying to turn the Titanic, or which is, which we know sank. But if we stand up and say, no, I refuse to do it that way. This is the way I’ll do it. It’s gonna take a little bit of a time, but if hmost of us do it and enough of us do it, then change. We will force change. 

Minky:

We will. The best team leaders that I’ve had have had that kind of grassroots leadership style, and they’ve just led amazing teams.

Jo:

That was my always my favourite in leadership was when I had a team where I could sit down with them and go, how do I help? How do I help today? How do I help? And nobody ever wanted me to do it for them, which I think a lot of overtired over pressured practice owners’ fear. It is like, I’m just gonna be given more responsibility. It’s like, no, they just wanted to know that it was safe.  They just wanted to know that they could say no to this unreasonable request. They just wanted me to know that they were trying to get pregnant and were scared. There’s that sort of stuff comes up.

So you’ve been around in health for a little while and you’ve just mentioned that you’re seeing some changes, which is great. What are some of the things that you can now see coming into workplaces that are really positive that weren’t there maybe five years ago?

Minky:

Hmm. I mean, I know that there’s different initiatives that are starting, like the Schwartz rounds that have started in various hospitals around the country. And I’ve never attended one of those ’cause I haven’t worked in a hospital as an employee for a long time. But I know they’re way of a format of debriefing. I can’t really sort of talk too much to the detail of that. But that’s one example. I mean, there are wellbeing teams within hospitals now. How much they affect change, I’m not sure. And that’s a question for individual ones, but I guess that never used to be a thing. And I think there’s more awareness. There’s definitely a huge increase in awareness about things like burnout. And so it is just that we now need to move it away from that individual focus and go and seek EAP support or take some time off. Like of course those things are important when they’re needed, but actually that’s not the problem. It’s not the individual that’s the problem. It’s the workplace stressors and all of the things that we’ve been talking about that put a person in that position in the first place. There’s initiatives all around the country in terms of there’s the compassion revolution that happens bi-annually often in Melbourne. There’s different initiatives that are happening that didn’t used to happen. But there’s a number of different initiatives around and I know that many people sort of in different organisations and private practices, it doesn’t mean that it’s yet trickled through to make significant change, but these are things that weren’t around and now are, and there’s lots of people who are very much more aware of all the things that we’re talking about.

Jo:

Yeah, absolutely. And I just wanna bring you back to something that you talked about ’cause I think it’s something that people listening to this podcast can actually grab a hold of. And you talked about, I think you called it a Schwartz meeting or something. Anyway, it was around debriefing. And I was just thinking, huh, I know so many mental health professionals of various disciplines who have gone on to learn critical incident stress debrief, whether or not you agree with it or not, but I’m just like, that’s what used to happen when I worked for government agencies. We had informal debriefing, right?

Minky:

Yeah. The incidental debriefing in between sessions or over coffee.

Jo:

Someone heard you on the phone and could tell that that was a really difficult conversation you were having and would just pull you here, here you hang up and pull you aside and go, that sounded really horrible. And it wasn’t a formal process that needed to be documented. But that’s just got me thinking that because we now are that the tension that we need to hold between wanting to work from home and the flexibility that that affords, but then what we are missing out on being a part of a team or part of a collective that the, the is a tension we have to hold. Right?

Minky:

Yeah. And I think it’s a particularly big one for private practice private practitioners, because even if they work in a team, I just hear so many of them say that because they’re sort of on their hourly basis they’re just sort of ships in the night with other practitioners a lot of the time.

Jo:

Yeah. Or unfortunately, as my previous executive person said to me, isn’t that what they’re trained to do? Can’t they just get on with it?

Minky:

<Laugh>

Jo:

<Laugh> Imagine that we have a private practice with multiple staff in it. How could we set up a debriefing process that felt safe, that was useful, that didn’t lead me as maybe the business owner to feel like, oh my God, I’m gonna have all these industrial relations and work health and safety issues to contend with? How can we do that? Any ideas Minky? ’cause I know how much you love me putting you on the spot like this <laugh>.

Minky:

I think well, co-creating a safe space is always important. And then really kind of setting some parameters around what’s appropriate and what’s not appropriate in the space. I really like the idea of this is a little bit adjacent to what you said, but seeking permission for a suitable time and place for a debrief. So I think just really setting up that maybe having an understanding of shared values is helpful in those initial discussions. But it would be an iterative process in that you are just sort of checking in each time, how are we wanting this to play today? What are we needing today? What’s helpful in terms of how much content we share? Do we need to share the content or do we need to address more of the impact on us? I mean, that’s a conversation to have because sometimes we can think the most helpful thing is to just kind of regurgitate everything that just happened. And in fact that can actually sometimes be more distressing for people ’cause then they’re having an experienced focused vicarious trauma of the story, if you will. So it’s about the different ways that we might be able to process or share that don’t necessarily involve a regurgitation of the story.

Jo:

Yeah. Great. So the then leads me to think of a career progression for people probably like yourself, because not everybody’s gonna be suited to that type of debriefing facilitation, right?

Minky:

No.

Jo:

And it’s not something you can just hand around in a team and go, next week it’s Eric’s turn and the week after that it’s Cheryl’s turn it. We do need somebody that’s got quite a passion for this, but also the skillset to be able to go, Hey, I get that the story’s important to you, but this is not the place for the whole story. It takes a special type of person and skill.

Minky:

Well I guess it’s in the contracting at the beginning, isn’t it? It’s like, this is what we know about what’s helpful or not helpful. It’s psychoeducation as well

Jo:

Is this some of the work that you now do in your private practice? And you’re nodding your head okay. So explain to us how you work because I think it’s important?

Minky:

Well, I mean, Jo, it depends. <Laugh>. I very much work from a process point of view. So working with what’s emerging with what’s happening between people, amongst people in what they’re saying and what their bodies are showing us. So are you talking about sort of supervision or ’cause it’s different whether it’s supervision or whether it’s like an organisational health approach.

Jo:

Let’s talk about the supervision. Let’s talk about the supervision of particularly the groups that you’ve been running.

Minky:

Okay. So I run supervision groups privately. So for individual practitioners to sign up for as well as offer team supervision for different healthcare teams. And those run either online or face-to-face. And usually they’ll start with the check-in. We have maximum of six participants in a group. For the most part, they’re closed groups. So that means that it’s the same group of people meeting each month for at least six months, sometimes longer, sometimes people like to be together for longer periods of time so that we can get to know each other and build that trust. And there’s an invitation to share how you’re travelling and if you have a need for supervision that week. And then we work out amongst us what will be the focus of the supervision.

And sometimes themes emerge across a group and so we’ll work with that theme in general. Or sometimes it’s just one person saying, I’ve got this particular case, not sure what to do, or not sure why it’s bothering me, that kind of thing. And sometimes people just say really keen to hear what everybody else’s resources are in relation to X. So, and then the way that we might process that is often through kind of trying to step into what’s going on beneath the surface and what’s connecting for that for that particular practitioner or group of practitioners. And often the way that I do that is through a different mix of creative arts and music and working with different types of somatic resourcing or processing. Yeah. It’s very organic in the way of unfolds. 

Jo:

One of the things I’ve always looked forward to when I hear you talking about it, is that you are very conscious of helping health professionals get out of their heads and into their bodies. And that’s a big part of the work that you’ve done. Why is it a big part of the work you do? Why is it important to get us out of our heads and into our bodies?

Minky:

Well I dunno the exact statistic, but over 80% of the data coming into our system is below our conscious awareness. So only 15 to 20% or less is actually cognitive. And so a lot of that is hard to then we’ve got all this information in our bodies and we’re only relying on 20% of our functioning to access what the rest of us knows. So it is about finding ways to connect with that. We also know that stress is stored in the body. And that we also know that as human beings, our experiences are reciprocal. So if I started crying now, possibly you would feel sad too. Yes. If I’m laughing, you’ll feel a little bit happy too. So sometimes it’s about what do you notice is happening in you when you’re sitting with that client or when you’re sitting here now and talking about that situation? And people will say, well, oh, I’m they’re all kinds of things they say, but they might say things that sound quite weird. Like, well, I dunno, but I just noticed that I wanna move my arm in this way. Or I’m just noticing that I am feeling a lump in my throat. Or so many different things. And so then we get sit with that and understand that a bit more. And some of the ways that we can do that is with different somatic approaches, different arts with music, and connecting in with those.

Jo:

Yeah. Because I see the somatic work, having experienced it a lot myself, because that’s what I’ve been focusing on for the last, at least 18 months, is the root emotion that’s turned up for me a lot is anger.  But it was completely inappropriate for me to express my anger in that moment that things were happening because there was injustice going on. Usually it’s around injustice and it’s like, oh my God, this is so unfair. If I was allowed to react, like, oh no, this is so unfair. I hate that this has happened to you. I’m sorry that this has happened to you. This is just unfair. And instead I’ve had to go, well, you can stay in this place, the victimhood, or we can help you. So, and even in talking about that, I felt my stomach clench right as I was storing that anger. Again, I’m trying to give people a really concrete example, storing that anger again, because I felt myself put on my stoic health professional face.

Minky:

Yes. And the more that we can connect with what’s happening in ourselves, the more congruent we can be with the people that we’re sitting with. Because one of the threats to the nervous system is this kind of incongruence. So if we’re able to then say, I’m just noticing my stomach’s really clenching around what you are saying, that might then resonate for them in a way that other ways of talking about it may not. And there’s also a bit of, well, that’s a weird thing to say. So there’s a process of getting to know that language and way of being, because it’s not a habitual thing in our society.

Jo:

No. And it’s certainly not a habitual thing for smart health professionals who have spent so long in their heads learning all this information being told how to behave. And then we’ve been told how to emote.

Minky:

I don’t know about you, but I graduated in 2000 and I was told the professionals here and the personal is here, and they do not cross over.

Jo:

Absolutely.

Minky:

And that’s changed now, I think, and it’s changing now. But we bring our whole selves to work just like we bring our whole selves home. So it’s about how can we stay connected to what is going on for us, because if we don’t, we’re disconnected and then we are not able to pay attention to what’s happening to us. And that’s when we can just push through and not do all the things that we know that we need to do because we’re on autopilot.

Jo:

Yeah. Autopilot, which then sometimes is hypervigilant autopilot.

Minky:

Or shut down

Jo:

Or shut down paralysis.

Minky:

All of the ways that we know are not healthy,

Jo:

So I trust that this has been a very eyeopening conversation for people who have, who have been listening today. If you could give a piece of advice to a new graduate who is just starting out on their career, what would that piece of advice be to help them stay in the work?

Minky:

I would say work with what is most meaningful to you. Find a workplace that aligns with your values and pay attention to who is in leadership and how they’re in leadership if you can. Or at least talk to people there to find those things out.

Jo:

Yeah. Nice. So, for the owners and leaders of health businesses listening to this podcast, there is a fair amount of responsibility here for you guys. But it doesn’t mean that your workload becomes more difficult. So please go back and listen to the beginning of this interview where you were given a fantastic resource on how to use your team to help you solve your problems, <laugh>. So therefore you as the leader in the business, don’t feel like you have to be the one to solve all the problems.

Minky:

And also, I think it’s important to acknowledge that leaders and managers are in a really difficult position. So this is not sort of to demonise any leaders or managers at all ’cause they’re all absolutely part of this systems challenge. So it’s about how can we support each other? How can leaders get the support that they need and that that is okay and important for them to do so?

Jo:

Absolutely. It’s not just the frontline workers who need the support. Like we’ve said, it’s the people who answer the phone. It’s the people who clean up after us. It’s the people who service our cars. It’s the people who lead us. If all of those components aren’t working in a safe system, right? Like, if there was a puddle on the floor, somebody would put a sign there and say, don’t step in the puddle. Everybody can participate in not stepping in the puddle. We could put it in multiple languages and if we needed to, but if we are not thinking about our emotional health or our psychological health in the same way, then we’re gonna be left with isolation. And we’re gonna have a detracting health workforce, which terrified me when you told me those numbers earlier.

Minky:

It is terrifying. But it’s also a really helpful statistic in thinking, okay, I can’t actually solve this. It’s not on me to fix the wait list problem. This is a bigger problem. And yes, I do need to do what I can to be well and do well. But no single service is gonna solve that statistic.

Jo:

Absolutely not. So we are forced now to collaborate, right?  We are actually forced to, if we genuinely want to see the change that we say we wanna see, we have no choice but to collaborate. <Laugh>, there’s a whole new podcast. <Laugh>. I just got all excited about a whole new way of thinking. And Minky heard it go pop. Minky, we may one day have the absolute pleasure of meeting each other in real life.
Minky:

That would be good.

Jo:

I’m hoping that’s in Tasmania, there are plans afoot. So <laugh>, I’m just letting you know.

Minky:

Excellent. 

Jo:

When we get to do that and I get to take you out for coffee, what will you be ordering?

Minky:

I’m just your regular latte kind of a girl.

Jo:

Excellent. That makes my life so much easier. <Laugh>. I can do that. I can even remember that <laugh>. Wonderful. Minky, if people wanna get to know you better or find out more about the services that you offer, how can they do that? Where do they go to find you?

Minky:

Well I’m on social media, so you could find me on Instagram at tempo.therapy. I’m on LinkedIn under my own name. So just Minky van der Walk or my website is tempotherapy.com au.

Jo:

Beautiful. And I strongly recommend that everybody goes and checks her out because her emails are powerful. They’re not rubbish <laugh>, they’ll help you be kind to yourself. <Laugh>. I have learned a lot from Minky’s content and I know the people who have engaged in her supervision groups have found them to be priceless. So I just wanna give her a shout out there as well. <Laugh>, I have had people reach out to me going, thank you so much for leading me to Minky. She has been a real gem. We need to get better at telling each other that. On that note, thank you to all of you who have listened today. I trust that you have taken something meaningful, powerful, potentially life changing away from this conversation. To continue this conversation. Come and join us over in the Future Proofing Health Professionals Facebook group because this is obviously a conversation that we need to further if we are going to future proof ourselves, our industry for the people who need to access our services. So until next episode, I’m Jo Muirhead. Go be your awesome self.