And this is why, when I think about what are the superpowers that we all hold in us that is also part of our source code, it’s that self-awareness — is there a pause point to be able to step out of that automatic pilot and then be able to make an intentional choice?
There’s a quote that’s attributed to Viktor Frankl, and he says, “Between stimulus and response, there is a space. And in that space lies our power to choose. And in our choice lies our growth and our freedom.” And it’s such a beautiful encapsulation, I think, of that self-awareness and that pause, which is so hard to do at this time, because we’re so activated. And so it’s just recognizing when we can pause and say, oh, that’s what that is.
Tippett:And I think, having just been steeped in your world of thought and knowledge, I understand that better, actually, the physiology of that quote. So you’ve been talking about this, but we haven’t — that we talk about the amygdala and the fight or flight; that’s all the most primitive parts of our brain, but that that’s the part of our brain that is most natural, and those connections are fast and automatic. And what I’ve been learning from you is — and of course, I knew about our prefrontal cortex, where we — the thinking brain, the primitive brain and the thinking brain. That takes a little more effort. It is our superpower, but, as you’re saying, we have to take that space and make that choice.
Runyan:It’s really that power of the pause. It’s imperfect — there’s plenty of times where I have done that, paused, and then just went right back down the rabbit hole. [laughs]
Tippett:[laughs] Right, right.
Runyan:But every so often, every so often, I’m able to catch myself and to make a very intentional choice to turn towards — closer towards my values, closer towards what’s really meaningful to me.
Tippett:I want to talk a little bit about Tend, because you do primarily work with health care providers.
Runyan:I do.
Tippett:I just want to read something you wrote about this work. You said, “No amount of sophisticated technology can do what health professionals have done these past few months — offered care with uncertain evidence, sat with the dying, comforted family members from afar, held one another in fear and grief, celebrated unexpected recoveries, and simply showed up. We have asked and expected clinicians to show up in ways they were never trained to do. No one has been trained in how to emotionally manage months of mass casualties. No one has been trained on how to keep showing up despite feeling feckless on the job. No one has been trained how to keep regular life afloat at home and anxiety at bay, while working day after day with a little known biohazard.” Wow.
Runyan:And that’s what they’ve done. That’s what they’ve done, and I want to stand in deep gratitude and honor every one of them, and serve in the way that I can.
Tippett:Thank you for that.
Runyan:Thank you. It’s powerful, to have something you’ve written read back to you. [laughs]
And what I really enjoy is holding space for people, bearing witness, and being of service. And because I know medicine, because that’s where my career has been, it feels like the time to be doing this. And that was the inception of Tend Health.
Tippett:I want to just — this is something I’ve thought about a lot this year, and I’d love to discuss it with you. I’d love to hear your reaction to it from your whole career of working in the military and now with doctors, on what we say is the “frontline.” Just thinking about the trauma — again, I feel like these layers of trauma that we’ve been through, that we just haven’t paused to name and really sit with and grieve and even wonder about what they’re doing to us — there’s some things we wonder about what they’re doing to us, and others that we don’t.
So for me, there was this moment of seeing my daughter, my 20-something daughter, last summer for the first time in six months; she’d been working with children, so really quarantined, and I haven’t seen her since, which is hard. And it was in New York City, so they had gone through that. And even though we were sitting outside, she kept her mask on. And I — [laughs] you started crying, and now I feel like I’m gonna start. And so I was thinking the whole time, “I need to respect the fact that she’s being really careful.” And then, at some point, I realized that she was keeping this mask on because she was so scared of getting me, her elderly mother, sick. [laughs] She wasn’t being cautious for herself. So I’ve thought about, we need to take in what it has meant, this year, that we became a danger to each other by virtue of our breath.
Runyan:That is a trauma, to feel — I can’t help but understand it at the level of the nervous system, precisely because of that. Our nervous system — it takes a lot of work for our brain to say, “Oh, but they have a negative COVID test,” or “They haven’t had this,” just when walking around to the grocery store or seeing somebody that you care about, or to have this feeling — my son coming home from college, and his girlfriend coming, and “Where have they been, and what have they been doing?” [laughs]
Tippett:Oh, yeah, I’ve had that, too — you’re scared of your kids.
Runyan:Yes!
Tippett:But there’s this subtle thing, or not so subtle, that the uncertainty and the threat, yes, is about getting the virus, but also that we’ve all been walking around fearing being a danger to others.
Runyan:And truthfully, that happened a lot in healthcare settings, that because of the incubation period, people were able to transmit virus. We saw rates around employees just skyrocket, more from infecting one another than being infected from patients.
Tippett:And wow, that’s another thing to consider about what our healthcare professionals scaring for us, and carers, have been carrying.
Runyan:And naming it is helpful, but those — the messaging between those parts of our system, because there’s always this active level of sensing that’s happening outside of our awareness. And so we can say that, sitting on the bench with your daughter, but then, as soon as you get up to go walk to your car and may pass by however many other people, your nervous system is re-sensing that all over again. So compassion is the, I think — compassion for others and compassion for self, for all that we’re feeling, all that we’re sensing, and in many ways, all that we’re doing to try to get out from under what we’re feeling — that, assuming we’re not hurting other people, but what other kind of numbing behaviors, or having compassion when we’re snappy with somebody …
Tippett:Or they’re snappy with us. [laughs]
Runyan:Yes, or they’re snappy with us, yes.
Tippett:You know, when we were speaking about — when you talked about just strategies and techniques, actually one that I had written down that I don’t think we talked about was gratitude. But you also coupled it with this word, “savoring.” And you talked about — again, the scientist in you, which is about how we’re so good at, skilled at looking out for what’s wrong, both physiologically and also culturally, but this “savoring” is inclining the mind to look, moment to moment, for what’s gonna release oxytocin in us. [laughs]
Runyan:Yeah, exactly. It’s so easy to pass over how things — “oh, this is how it’s supposed to be,” so we don’t actually drop into the wonderment of whatever is here, and to do that as much as we can, through our sensory experience. And we do have to incline the mind. And when we know that that’s not a personal failing or that somehow we didn’t get the update [laughs] in our particular neurobiology, that that’s true for all of us, because of needing to stay alive and needing to stay safe. And that’s how our nervous system is wired. And so we actually have to put some effort in towards noticing that which is neutral or pleasant — in fact, if we can really notice, most things that are even neutral become pleasant, because they become fascinating. But we do have to create those conditions. And it’s so worth it, if we do.
Tippett:So I think we’re not gonna be able to end on an upbeat note. [laughs] And that’s OK, because I think that may also be part of just being present to being honest. And somehow, I don’t know, something I’ve — there’s been so many uncoverings in this year, so many things that surfaced that were true, but they really surfaced. And one of them is that we don’t know how to mourn and grieve in this society. Giving the numbers of how many people died — that’s not mourning. And isn’t there something in us physiologically, that needs to do that — that needs to …
Runyan:Absolutely.
Tippett:… sit with our losses? And so maybe that’s the — it’s not upbeat, but it’s a step towards health, a step towards that balance that we need to recover.
Runyan:We are pretty conditioned to turn away from discomfort and suffering in our society. We are not very good at allowing for grief, which is always on its own timeline, and it’s unpredictable in its own right. And this is a tough one, because it’s not a pinpoint experience. I don’t know what it looks like to have a day of remembering or some sort of ritual around — because we’re still in it, is the other thing. We’re trying to grieve a trauma that is still ongoing. And I don’t have the answer to how to do that, other than one breath at a time — because it’s still here.
Tippett:OK. Thank you so much. I’m really grateful.
[music: “Plainville” by Jeremy Udden]
Christine Runyan is a professor in the Department of Family Medicine and Community Health at the University of Massachusetts Medical School. She’s also a certified mindfulness teacher, and she cofounded and co-leads Tend Health, a clinical consulting practice focused on the mental well-being of medical and health care workers. You can learn more about that at tend.health.
[music: “Plainville” by Jeremy Udden]
The On Being Project is: Chris Heagle, Lily Percy, Laurén Drommerhausen, Erin Colasacco, Eddie Gonzalez, Lilian Vo, Lucas Johnson, Suzette Burley, Zack Rose, Colleen Scheck, Julie Siple, Gretchen Honnold, Jhaleh Akhavan, Pádraig Ó Tuama, Ben Katt, Gautam Srikishan, and Lillie Benowitz.
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I am a hopeless yet hope-filled hugger. Touch is my #1 love language, even the simplest fingers through my hair. Yes, I have missed touch deeply. I ache to hug again, anyone, everyone.
}:- a.m. (aka Patrick the anonemoose monk)
This was great - helped to gain perspective on whst i am feeling - NOW!
Here's to: naming what we're experiencing, not pathologizing, being compassionate with others and self and to breathing. Thank you so much for a validating human to human interview with such clarity in practical info shared as well.
Together, we get through!