S4 E10: Remembering our Humanity

CASAT Podcast Network

Hello and welcome to season four of CASAT Conversations.

I am your host Heather Haslem.

This season we will explore the impact of trauma on those who work in human services.

You’ll hear from researchers, authors, and people with lived experience.

We hope you enjoyed today’s conversation today.

I’m excited to welcome Dr. Anne Weisman.

Anne is the director of well being and integrative medicine at the ca korean School of Medicine at UNLV.

She is responsible for developing the schools Well being an integrative Medicine curriculum and workshops for students, faculty and residents.

Welcome, Annie, thank you Heather, I’m so glad to be here.

I’m so happy to be here with you today.

So, um as we dive in for today’s conversation, I’d love for you to just share about yourself and the work that you do.

Sure!

Um gosh, so I’m anne, I have lived in Nevada all of my life, Las Vegas most of it.

And um I was hired in 2015 to work on this project at this brand new medical school that was forming of building well being an integrative medicine into our curriculum.

So, having never worked at a medical school, I said yes and thought this is going to be so easy and fun.

It’s been fun.

It has not been as easy as I anticipated, but it’s really cool, I’m proud of our school for and our founding dean, having the vision to really bake this into how we’re training our students and um gosh, I really love doing it.

My background before I was in this role.

I worked for many, many years as a massage therapist and I studied public health.

So my Masters and my doctorate are in public health and I had this really interesting experience of working with people at the end of their life while also studying prevention every night in public health.

So my perspective is unique in that I I see that we have that holistic framework that’s really intact, that we do in hospice at the end of life and it’s mandated by Medicare, which I love.

Yet throughout the lifespan we don’t have to my knowledge that kind of holistic system, so that’s what I intend to create and build.

Nice.

I love um you know, you mentioned that your work in kind of founding Integrative Medicine and well being within the school of medicine is fun, but not easy.

I’m curious what are some of the inherent challenges in that?

I think how we train doctors frankly is is a real um opportunity to do things differently.

You know, it’s, we ask these young people to really focus and and be the very best and have these incredible metrics to even be considered to become a physician and then when they’re trained the demands of the way that we educate physicians in our country are such that inherently.

I don’t feel like it’s a very um how do I say like a healthy or health promoting kind of um environment that’s shifting I think and started to shift before I came into this field, but I, I really take pause a lot of times as I look at how our curriculums are set up, the things that are asked of students, residents, faculty.

It it feels to me from a well being lens that we have a huge opportunity to shift because it seems, you know, you know, from the data and just common sense, none of us are at our best when we are sleep deprived or we haven’t eaten or we haven’t rested yet.

This field in particular seems to really ask almost in superhuman type of things of the people that go into it.

So it’s a, it’s a really unique situation.

Mhm.

I’ve often thought of how ironic it is, you know, that physicians take an oath really to promote health in a way and um that in the training of physicians really were asking them to turn off all the bodily functions that produce health, you don’t need to sleep, you really don’t need to eat.

Um and if you’re sick, you still have to show up to work.

Uh and I understand like the logistics of it yet, you know, it’s just so ironic in a lot of ways.

Yeah, it feels sometimes like there’s not a lot of room to be a human being while being a physician.

So I’m excited to see things shifting and I’m proud of our school for trying to move the needle, I think um we have a ways to go, I think I think we’re heading in the right direction, I think the younger generation is really wise and they do not want to continue making the thing the mistakes or maybe do things the way that we did, and I think that’s awesome, so it’ll be fun to see how we evolve.

Um And so what are some of the shifts that you’re seeing?

I’m seeing a real passion right now for nutrition in medical education.

Um We have a culinary medicine class that we um really purchased the curriculum from this physician dr Tim Harlan, He was a chef first and then he became a doctor.

So his curriculums like my dream because it has all of the science and medical content that I really need along with some wonderful recipes.

And it’s interesting in working with our students, we piloted this over during covid, so we were doing it all by zoom, which was hilarious and we just now did one class with our nutrition master students in person and it’s interesting the students, a lot of the students seem like they want more prevention kind of material.

They want to know more about how to talk to their their patients about nutrition, how to take care of their own nutrition.

So it’s a really interesting opportunity where I do an integrative Medicine research, concentrate, concentrated um summer class where a handful of my students are really focused on nutrition, which I think is cool because there’s so little of it, there’s like some dedicated hours but it’s it’s very small.

Mhm.

That’s really cool.

You know, as you think as I think about these newer students coming in future doctors, I’m curious if any of them speak to um some of the barriers that they bump up against, you know, like I think they maybe see this world of how they want to practice medicine and yet maybe practicing medicine hasn’t caught up with that.

And so what are some of those barriers that they experience?

Gosh, that reminds me the first I remember with my first class when the students got into the clinical settings, they were like dr Weissman everything you tell us goes out the window once were in the clinical setting because that’s not how our doctors that were working with think or that’s not how they’re trained.

And so it becomes a matter of planting the seed I think and helping them have enough skills or ways that they can help take care of themselves while also shifting the culture.

So also teaching them how to quietly advocate or loudly advocate.

You know, there’s there are things that we can do.

So it’s it’s challenging.

It’s it’s changing a system kind of from the inside out.

Mhm.

And that takes time mm hmm.

What have you personally learned as you work within this culture change of promoting well being that I have to do it too.

You know, I get into patterns of overwork or trying to like really push things because I believe in it so much.

So it’s at first I remember to take really gentle care of myself and step back.

Um second I think is also noticing the patients that it requires, you know, all the years of working as a massage therapist, I felt that my work was pretty instant gratification.

Like I had this set amount of time that I was going to be working on somebody and I knew essentially within the first part of it, what I was going to do with this person and by the end of it almost always their issue, whatever they were coming in for what I was seeing them for was you know was better different other.

So I missed that instant gratification work that is very concrete and finished.

Um I also really appreciate the time that it takes because this is a new chapter in my life and so the intention and the, the lack of the instant gratification I think is also kind of cool because things are unfolding, I feel like as they need to and it’s also like with well being or any of these type of interventions, I think about it a lot like sobriety, you know, like people we know and you know with my own journey, like we all know more or less what we need to do, but nobody can get you to that point, you know, you have to do that for yourself.

So I just think about it like with behavior change, having, planning all these seeds, having all of these things available but not forcing it, you know, like I was just laughing with one of our resident directors about mandatory wellness, you know like in our ACGMA.

Requirements and that’s I take a pause because that causes a lot more stress.

I’m glad we have the time and it’s being intentional and deliberate so that we’re meeting people where they are and they also have the autonomy and self efficacy to select what they need for their well being.

Not telling people how they need to be well, you know, and historically I think that’s how it’s been done and it’s wellness I think sometimes feels like a checkbox, Another thing on the to do list, especially when it’s in that mandatory piece.

I remember presenting to a group of residents who thought I was coming in to present on wellness, but I was presenting on programs for older adults that had to do with wellness and I, you know, I heard them speaking after um and they were like, oh thank God that wasn’t another wellness thing that we had to do in like we actually learned about some resources that are useful which was such an interesting perspective, like oh thank God we didn’t have to do wellness for ourselves and we learned about these resources which was just, it was a fascinating thing I overheard it, but it was really interesting.

So I know um much of your work does include integrative practices to heal trauma.

Can you share with us some of the modalities that you use?

Sure, sure.

So right after we experienced the mass shooting here in las Vegas, I, one of my colleagues at Mount Sinai reached out and connected me with the Center for Mind Body Medicine.

So I’ve been really fortunate.

I’ve trained with them, I’m certified with them and I’m on faculty now with them as well.

So I bring a lot of what we do in mind body medicine into my didactic into pretty much everything that I do.

I just, I love it so much and I wish that these were things that I had learned as a much younger human.

So often I’ll start with breath.

You know where we’ll do a type of meditation or breathing called soft belly breathing.

So we’ll inhale through our nose is thinking of the word soft and we’ll exhale through our mouths while we think of the word belly often I will invite people to close their eyes or just find a relaxed state or find a soft gaze if they don’t want to close their eyes.

So breathing together is a way that I like to begin and end things.

I like kind of the bookmarks if you will like where we come in and we kind of take a few minutes to come into the room or whatever experience we’re having.

Um we’ll check in a lot.

So in my body medicine we also do check ins like how are you right now in this moment And you know during covid this really came in handy.

We were called to work with the I.C.U.

Team and our residents that were rotating had never ever worked with that much death.

And so coming in to do these debriefs we would just use these mind body medicine practices which are really simple.

We breathe together, we calm our nervous systems that way when we breathe in through our nose and out through our mouth you’re bringing your body out of fight or flight.

You’re calming your vagus nerve often.

That gives us the invitation in to notice what is happening in my body at this moment.

Instead of racing to what I think I should be doing next or rewinding to whatever I thought I messed up.

You know So it’s a really cool way of like bringing everyone in and then from there often will just teach different mind body skills.

So when I’m doing a small group will do drawings.

Those are really powerful.

Just requires paper and crayons.

And I love giving positions and medical students crayons and paper and really any humans but it’s really cool to see what happens when we bring some play into this work.

Um I’m really fond of active meditation so we’ll shake and we’ll dance and we’ll also, I like guided imagery a lot because we all have our imaginations with us all of the time.

And I think it’s a really cool way to demonstrate how effective our imaginations are.

Lots of times.

I’ll start with like the lemon imagery that so many of us have done where we imagine like, you know, cutting a lemon and then biting into it will go into excruciating detail so that they can really imagine this.

And then it’s really fun to see the experience of how that felt in their bodies and realizing like, oh I only thought about this and this is what happened.

So that’s a fun way of demonstrating how powerful our minds really are and then we’ll use like a safe place, Excuse me.

Like I’ll hear a lot of times how different rooms that they’re supposed to work and are not wonderful.

So we’ll use imagery again.

Okay, let’s let’s design one that would be um gosh, what else do we do food?

Like bringing people together that way just to sit and be human.

I’m pretty basic.

I think breath food checking in, you know, music, just being human together goes a really long way and that vulnerability, you know, like it’s okay to not be okay.

Yeah.

And how how have you seen people react to that?

It typically if I’m in a typically goes like there’s people that love it.

people that whose body language suggests, they don’t love it at all a bunch in the middle and I just kind of chill with it, like meet them where they are and give it time.

Mhm.

Yeah, I mean I really, what I hear from you is this deep intention to sit with people and to remind them of their humanity um and it it is this like this patience and curiosity and showing up uh sounds like a lot of what you practice in your work.

I try I think some days are better than other like like any other human if I am well rested and well nourished I’m it’s easier to hold that space.

Um it’s really funny just how much the deeper I go in the longer I’ve done this work, how much I can realize when I start to lose my patience with other people pretty quickly, I instantly reflect like what am I doing or not doing because that’s not my natural way.

So I know like oh I might need to feed or water myself or go outside.

Yeah which is all about self awareness right?

And that getting to know ourselves and knowing these habit patterns that we have and it’s like okay we’ve got a red flag here needs some attention.

What’s called for right now.

Yeah.

Yeah and I really think most of the solutions for me so far are pretty simple.

Mhm Yeah.

Um I would love to hear some of the ways that you’ve been working to support the Las Vegas community after the October one shooting.

Oh gosh, yeah.

Um that was just such a shock.

I was asleep that night and woke up to the news the next morning and like I was sharing in the answer to one of the other questions.

I feel so fortunate that one of my colleagues reached out and connected me with this Center for Mind Body Medicine.

You know, it was, it gave me tools to help People and what we’ve done in the years since we’ve trained almost 200 people in our state.

I am so excited about that.

So basically will train people will through different funds and grants will train different people in Mind Body Medicine.

They’ll go through a training where it’s a professional training program where you learn and you do small group and you learn all of the experiential is first for yourself and then the second one, the advanced training, you start to learn how to facilitate a small group and then if you want to carry on and go through certification, you go back for another advanced training, you run some small groups in your community.

And we’ve been really fortunate a number of the people that we’ve trained have now gone through this as well.

So they’re able to do so and so it’s not just me anymore.

There’s lots of other people that can bring this work to the community however they want and um december 2nd, we’re going to have a reunion virtually with every person that we’ve trained to see and for whoever can make it, but like just to see where they’re at, what they’re doing with it, if they’re doing nothing, just kind of where what we’re doing and then now really my, my goal and my vision is that we can bring the statewide, I think, you know, we do workshops or things that are really easy.

I say yes, just about always if I’m asked to speak on something or teach something, I almost always say yes and this stuff is so easy and it’s fun and it, I love seeing people like kind of shift where their bodies like kind of seem to relax or they open up a little bit more and it just looks like they’re lighter after realizing like I’m not carrying, I don’t need to carry this by myself.

So, um, we’re gonna be doing some work.

The Agassi Foundation is funding more of our program to go statewide.

So we’re going to be training even more people throughout Nevada, which really excites me because I think we have such a unique opportunity in our state when I was a student of public health, I used to look all of the time at our health outcomes and I think these interventions of learning how to calm our nervous systems, learning how to like reconnect with others, having that i towards nutrition and putting different foods into our bodies that help nourish us plus that ability to connect with others and then physical activity.

I think we could really shift the health outcomes in our state in less than a generation.

So that’s why we’ve chosen to do it statewide.

I really and you know, I went to UNR and UNLV but I just want this state to be purple and work together and come together and have a better, healthier future.

That’s so awesome.

Well, as you know, I love love your vision and have done the training too, and it’s such awesome work.

So really just commend you for all of your efforts in bringing it statewide and thank you.

Thank you.

I just want to be really inclusive to and especially our colleagues that are in the rural areas.

One of I think a big silver lining for me.

I’ve thought about this for so long how to really reach all of our rural partners and that silver lining of zoom and hybrid and and learning how to do things virtually I think makes it possible for us to really connect statewide in a much more meaningful, deeper way.

Mhm.

Yeah, absolutely.

And uh sometimes just going there, I do a lot of work in the world’s and uh sometimes you know, just showing up and being there makes such a big difference too.

Um so I, you know, you’ve had your own experiences with traumatic events and sitting with people during traumatic events.

I’m curious does the work that you do sometimes have an impact on you.

Um and if so, you know, what do you do to support yourself?

Gosh, I do have a rich trauma history and all of the years of working with hospice patients and death and dying.

I think that’s when I really began to do things more deliberately actually, as I’m thinking out loud when I was at U and R and have gone through trauma there, I really leaned on the outdoors, I’m a snowboarder, so I would go snowboard as often as I could just to be up on the mountain and be alone and just kind of with my thoughts and in my body and then down here in Las Vegas in the years of working with hospice so much I really relied on music.

Um I love show tunes, so I would listen to music in between my home care visits.

Um I also am a big rewards human.

So dangling the carrot of like treating myself to a coffee goes a long way.

Um I would treat myself.

So I like to treat myself to like something a day.

So it was like coffee or something like that, but just being really intentional with my, my energy and my time.

Um I remember when I was starting this work with my body medicine and in the aftermath of the shooting, I was doing so much with, as were so many in our community and I remember feeling overwhelmed with all just being in trauma with trauma all of the time.

So again for me it’s nature, it’s going back outside and noticing that like cyclical energy of of our existence, you know, like right now it feels like this, but the sun’s gonna rise and set like that.

It just kind of reminded me of the fullness of the experience and then rocking out to some music and moving my body that always held them right now.

I’m learning how to play guitar.

Yeah, so I like to do things that are completely unrelated to whatever it is that I’m spending a lot of energy on.

So I’ve got different outlets.

Mhm Yeah.

And really reminding yourself to see some of the, the play that you spoke about earlier and um yeah, but things will inevitably change even if it feels stuck right now.

And I think for me too, learning to not minimize, you know, like I’m, I used to be such a like I got this, I can do anything and uh and didn’t even give myself room for emotions or feeling and kind of normalizing some of the things that I would deal with or see.

So it’s really interesting in this last couple of years noticing like uh huh Yeah, I feel this way it’s okay.

I don’t need to be like fine and good and keep on, I don’t need to be like Pollyanna.

Yeah.

And I there’s so much in our world, I think really about it’s I think of it as toxic positivity where it’s like I’m going to be fine, we just gotta keep going, look at the bright side, right?

Like we have all of these um phrases or sayings or I shouldn’t, you know, someone else has it worse than me.

That happens a lot in the trauma world that comparing mind comes in um versus what you’re talking about about just acknowledging.

And I don’t mean just but um acknowledging how how are you feeling?

Um which in my own experience, something I too have been working on.

It’s not necessarily that easy or comfortable sometimes to sit with our feelings?

Yeah.

I remember when I was working at Hospice, my husband, I had just met my husband um and he had said something to me while we were dating.

It’s like just because I’m not dying.

And a lot of my work used to be in HIV and AIDS doesn’t mean that this like just because I’m not dying and I don’t have this doesn’t mean that I’m, you know, how is it just because I’m not dying?

Doesn’t mean that I’m okay kind of stuff and I was there, that doesn’t matter and I was like, oh man.

And I didn’t realize how much I minimized my own experience or others in that because so much of my work was with people that were dying or people that were living with HIV and AIDS often I didn’t make room for myself because I wasn’t and so I was like, well I’m not dying so I can blah blah blah blah and it’s like well you are someday, so while you’re at it kind of making that room for his emotions, my emotions and just that whole experience and I think for me it was easy to like minimize anything else that was going on if it wasn’t in those two spaces.

Mhm.

I hear this a lot um when I work with first responders who are dealing with heavy situations um life threatening situations on a daily basis and then how challenging it can be when you’re talking to a friend who’s stressed out about something, you know, that seems so minimal but is big to them, how challenging that can be to feel a connection.

Um it’s it’s a real thing when you’re working in these um heavier trauma work environments.

I think for me, this work has really taught me um how to be in in relationship and hold that space for people with all the different things that they’re going through without like trying to fix or minimizing or offering some kind of guidance or suggestion and that was I think for me one of the most profound shifts I think I I liked and I got a lot my ego got a lot out of trying to like help people you know and be be there and you know, also being early in my recovery, you know, I think that helps me feel like I was okay.

So I really identified with helping others and doing for others.

And so it’s been a really cool shift through working through this lens with the mind, body medicine of like I don’t need to fix or solve anything for anyone.

Everybody has this divine right to get there on their own time in their own way.

But what I can do is I can be just be there by holding space.

And we learned that a lot in massage school, you know, we had really explicit training for how to set up our rooms, how to set the energy, how to really manage our own energy and well being before we came into the room to touch and be with another human.

And so I rely on that a lot too.

I think about that so often and how how priceless that information is.

I try to share that with our medical students every time I teach, you know about really being mindful of what we’re bringing into the space and what we can do each day to really set our own energy and be mindful of what’s happening so that we’re not just like putting it all over everyone.

Mhm.

That or I mean something that I’ve seen and experienced with physicians is kind of this wall that goes up for protection and then as a patient um you know, patients don’t typically respond that well to talking to a wall and then that impacts treatment outcomes.

And it’s it’s a really interesting delicate balance between um you know, having this mask to protect yourself and when do you take it off?

And so I’m curious if you ever give any sort of advice or suggestions um even though we just talked about not advice giving um four people around that.

Yeah, for sure.

We talk about so my favorite piece of PPE is what I lovingly refer to as the body condom.

It is basically that when when I’m teaching my students about their energy and how they come into a space and how the patient and like how they’re impacted about how they’re impacting others.

I’ll teach them this technique where basically they put their feet on the ground and I imagine them, I have them imagine or do it where they put their arms like all around their body and we we do breath of course first I want them to notice how they’re feeling and then drawing this invisible bubble around themselves knowing that like this is the energy that you have, it will change throughout the day.

But this is your energy and we’ll have them hold their wrists so that anybody that your touch and working with you can send your love and your good intentions to but you’re not going to take on what’s not yours and then basically just asking them to be mindful of, you know, once you have that body condom but like that that energetic bubble around yourself.

You can go about your day interacting with whomever you interact with and you can be really present, but you don’t have to take on what isn’t yours energetically, you know, so often we’ll frame it in like have you ever come into something and you feel really good and then somebody comes in and when they leave you feel terrible or just having them become aware of that energy imbalance or like what we call like energy vampires so that they all of us I think can can remember a time where somebody like left us just feeling completely zapped so we’ll play with that to kind of set up the body condom exercise and then well that’s the way that I teach it.

But I also asked the students to like figure out what works for you and if you forget to set your energy before you go into your day.

Remember all these different points throughout your day where you can reset it.

Like if you notice that you’re really impacted or you’re feeling a certain way and you didn’t take that time before you began use doorways like those are wonderful cues to reset before I come into this space, what am I bringing in with me or while I’m washing my hands before I come in to do what I’m going to do.

Like what really?

Washing off whatever it is that you’re coming in with and being intentional about what you’re bringing in.

So we do a bunch of stuff like that with them.

That’s so cool.

In another interview um with Daniel mate, we talked about how shamans have this or he talked about how shamans really have a practice called Olympia, that cleaning at the end of um a session.

Um, and so are their work And so the importance of that and how it’s just naturally built in to the work that they do and in human services, it feels like we need those same practices so much.

I mean whatever it is that we’re called to do when we wake up each day and when we go to bed, I love having these kind of rituals for lack, you know, like in the morning and in the evening to kind of set the day and release the day and then that process throughout because man, we’re emotional beings that are doing whatever we’re here to do.

And I think part of why we get so burnt out in our field in particular is that lack of vulnerability and humanity, you know, being able to express that safely.

So we’re trying to bring it back.

That’s so cool.

So Annie as we wrap up, is there anything else that you feel is important for our listeners to know or understand today?

Mm Gosh, just know yourself as well as you can Pay attention to that little voice inside of you, those that intuition that you carry with every cell in your body, you know, paying attention to that body of yours.

So often I think at least I’ll speak for myself.

I can live from like neck up and just be all in my head.

So anything that gets me back into my body helps me so much.

And I invite whomever is listening today to just come back into yourself.

Pay attention to your body.

You know, our culture, our the time that we get to be alive for teachers so much about compartmentalization and I reject that you think we have this divine right to be fully human, fully messy and flawed and to feel it all.

So I would love for people to just come back into themselves and trust themselves.

Mm Thank you.

Um now I have one follow up question for you though you with your comment on compartmentalization.

I’m curious even just in the training that you see within the medical school, something I often think about is, you know, we there’s these specialties that narrow that focus onto one area of the body, which is really smart in a lot of ways because the human body is so intricate and there’s sometimes like this forgetting that that that part is connected to this whole system.

So I’m curious, you know, in the training that you do um with future physicians, like do you, do you talk about that?

You just struck one of my favorite chords?

Yes.

Yes.

Yes.

Um I think we’ve done ourselves a great disservice in some ways.

It’s really cool that we are as specialized and can focus on just these itty bitty parts.

And I think at times we lose sight of the whole, I think that’s also reflected in our planet.

You know, we’ve become so focused.

I think in in the time we’re alive or on on ourselves as the eye that we forget that we’re all linked.

And so I think it’s like macrocosm, microcosm, it just reflects.

And uh it’s really right now, I just finished, one of my doctoral students just graduated and he did this beautiful project on Parkinson’s and improv.

So that yes.

And and so what I loved about his work is he was doing it on soon because it was during Covid, he invited these people living with Parkinson’s to come together and do these improv sessions.

And what it did was it gave that freedom that permission that flexibility to play and be silly and mess up and in the sessions that I got to go to.

I loved every second of it and I helped him analyze the data.

And when I was reading through these transcripts so often, what was emerging was people feeling like they were escaping from their own prisons and they were connecting and they weren’t just their disease.

So I think you know you could substitute Parkinson’s for so many other conditions that people experience and just being human.

And so I love thinking about the whole.

I love thinking about the yes and how do we do these things differently and how do we bring our ourselves from that very hyper focused cellular level back up to the broader, more expansive view and then back down.

But also like remembering that we’re all connected.

I think that’s part of how we heal not only ourselves but our planet.

Well I just wanna thank you for your time and for sharing yourself and all the wisdom that you’ve gained throughout your years of practice and work with us today.

Thanks for having me heather.

So good to be with you.

It’s always a joy and have a good day for me too.

Okay bye.

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