A Harvard physician’s guide to rewriting your brain’s stress responses

Stress is a force that is all around us like gravity. It's a part of our lives and it's

inescapable. There are so many societal perceptions of what stress is and burnout is

and how we are supposed to behave that we often don't feel a sense of openness and sharing our

own struggles, vulnerabilities, or weaknesses. But understand that underneath it all, you are

not alone. It is not your fault. And likely many other people are feeling just like you

I noticed it when I was a clinician in Boston, seeing patients in a packed waiting room

No one speaks to each other, but those same patients would come into my exam room, the door would close, and they would burst into tears because of the stigma and taboo about

stress and burnout. The goal of life is not to live a life with zero stress

It's in fact biologically impossible to do this. It's to live a life with healthy, manageable stress so stress can serve you rather than

harm you. I'm Dr. Aditi Narukar, a Harvard physician with an expertise in stress, burnout, mental health

and resilience, and the author of The Five Resets, Rewire Your Brain and Body for Less Stress and

More Resilience. I became an expert on stress and burnout because I wanted to become the doctor I

needed during a difficult time. I was a medical resident in my second year of medical residency

I was taking care of everyone else's hearts, but not my own in that cardiac ICU. My head would hit

the pillow. I'd be exhausted from a long day's work. And I would suddenly have the stampede of

wild horses across my chest and it continued to happen. My doctor did the full medical workup and

everything checked out normal. And so my doctor very reassuringly with a big smile said, everything's

great. It's probably just stress. We've all been there. Just try to relax. My first reaction was

stress. Stress doesn't happen to people like me. I'm resilient because I was living the resilience

myth as many people are. I was taught at a very young stage of my medical training that pressure

makes diamonds And so as I was moving through medical training working 80 hours a week I would say to myself whenever there was a difficult moment hey I a diamond in the making And then my diamond cracked And the resilience myth is that resilient people don get burned out and don feel a sense

of stress. But in fact, true resilience also honors your boundaries and human limitations

It honors your ability to say no, and it uses a lens of self-compassion

And so I was living the resilience myth because I didn't know any better. And then when I found my way out of stress, that is when I said, I want to be the doctor I wish I had back during that difficult time

Not all stress is created equal. In fact, there are two kinds of stress

There is healthy, productive stress. In scientific terms, we say that that is adaptive stress

Getting a new job or a promotion. Falling in love. Healthy stress moves your life forward

But when stress goes unchecked and is untamed, dysfunctional, and unproductive, that's when stress goes from being adaptive to maladaptive

And those two are very different when it comes to how they impact your brain and your body

Under normal circumstances, our brain is led by the prefrontal cortex. That's this area right behind your forehead

and that area, the prefrontal cortex, governs things like memory, planning, organization

forward strategic thinking. But under periods of stress, your brain is governed by the amygdala

and your amygdala is focused on survival and self-preservation or your fight or flight response

Think back to when we were all cave people. You would be in the forest and you would see

a tiger. You could either fight the tiger or you could flee. The challenge now is that all of the

tigers that we have in the modern day are ongoing and chronic. Bills, relationship constraints

job constraints, or parenting. All of these metaphorical tigers in the modern day

make your stress response and the amygdala on in the background at a low hum chronically

During stress, your inner critic gets a megaphone. Those negative experiences are sticky in the brain

like Velcro Your brain grabs onto those because it a sense of hypervigilance in your body and brain are trying to keep you safe And so often there this tension between that inner critic and that sense of self and self You want to be able to do new important exciting things in your life

And when you reset your stress, you can take that megaphone out of your inner critic's hand

There are so many false perceptions about ways that stress can influence you

Unhealthy maladaptive stress can feel like a sense of constraint on the mind

because you are living in a scarcity mindset. So think about that as you're moving through your day

and moving in the world, that likely the same amount of good and bad is happening at all times

The goal with resetting your stress is to make negative experiences less sticky

moving away from Velcro to Teflon. If you are feeling a sense of stress and burnout

if that inner critic is relentless in your ear, understand that first, you are not alone

and it is not your fault. There is robust data to show that early childhood experiences, particularly adverse events in

childhood, can influence your stress response throughout your life into adulthood. But it's also important to understand the science of the brain

We used to think that your brain, what you had at birth, is what you have for life

It was like a real grab bag. But now we are learning that your brain, in fact, changes, grows, and adapts based on

life's circumstances, situations, and stimulation. And through the process of neuroplasticity, your brain is constantly regenerating brain cells and circuits. So if you have had a difficult

childhood experience, if you've experienced trauma and you do have an influence on your

stress response, you can, over time with patience and practice, create a new neural pathway for

managing your stress and burnout. It is a misconception to think that to decrease your stress and burnout, you need to revamp

your whole life. So how can you reset your stress and burnout in the here and now in the middle of your

messy, overscheduled, and stressful life? Let's start with these two resets. The first is a breathing exercise and the second is gratitude The reason your breath is such a great first step is because your breath is the only physiological process in the body that is under both voluntary and

involuntary control. So you can use your breath as a way to tap into your mind-body connection

to understand it and then later influence it to serve you. This is a three-second exercise. Stop

breathe and be. The instructions are in the name. The first thing you're going to do is no matter

what you're doing, you're just going to stop, take a beat, and take a pause. Next, you're going to

breathe. Take a deep breath in and out. And then you're going to be. Just ground yourself in the

here and now in the present moment. When you are feeling a sense of stress and burnout, you're often

feeling anxious. And anxiety is a future-focused emotion. You are on that runaway train of what-if

thinking. What if this doesn't go well? What if I fail? What if it's a disaster? It's all of this

doom and gloom thinking. And Stop, Breathe, Be gets you out of that what-if thinking back to what is

in the here and now, in the present moment. Gratitude is also a very effective practice

What you want to do is you want to write down five things you're grateful for and why

The reason gratitude is so important in reframing your stress and burnout

is because it focuses on a scientific principle called cognitive reframing. What you focus on grows

A written gratitude practice at 30, 60, and 90 days has shown to have demonstrated effects in managing your stress, burnout, mood, and resilience

So often when we are feeling a sense of stress, overwhelm, and burnout, there are things in our

external world that are happening that are out of our control and so we often end up feeling

powerless. Learning how to manage your stress is a skill just like riding a bike. It's not an innate

thing that we are born with. It is something that you can teach your brain to do and it is something

that you can teach yourself to do. You can rewire your brain and body

for less stress and more resilience