TRIGGER WARNING- This episode contains references to and information about suicide which may be upsetting to some people. The purpose of the episode is to educate and bring awareness to the stigma around mental illness and provide resources but if you are not in a position to handle this discussion, please skip this episode.
If you are concerned about a friend or colleague, or if you are having thoughts of self-harm or suicide, please call the USA National Suicide Prevention Lifeline (1-800-273-8255), Canada Suicide Prevention Service (1-833-456-4566), or just dial 911.
You may also Text HOME to 741-741 to reach a volunteer Crisis Counselor. The crisis text line is also available via Whatsapp and FB messenger.
Today I am joined by Dr. Marie Holowaychuk to hear her thoughts on why veterinarians have an increased stigma around mental illness, how emotional intelligence can help us, and why team leaders need to develop psychological safety in their work cultures to allow for discussion of mental wellbeing to become commonplace.
About Dr. Holowaychuk
Dr. Marie Holowaychuk is a board-certified small animal emergency and critical care specialist and passionate advocate for veterinary team wellbeing. She lives in Calgary and travels worldwide as a speaker, consultant, and locum. Marie has spent more than 15 years practicing emergency and critical care medicine in academic and private referral hospital settings. She has been primary or co-author of more than 30 manuscripts published in peer-reviewed journals and is an Assistant Editor for the Journal of Veterinary Emergency and Critical Care. She is also co-editor of the Manual of Veterinary Transfusion Medicine and Blood Banking.
Outside of veterinary practice, Marie facilitates wellness workshops and retreats for veterinary clinics or organizations and offers individual or group wellbeing sessions for veterinary team members. Marie is a certified yoga and meditation teacher and has completed a mindfulness-based stress reduction course for professionals. She also has Compassion Fatigue Training from the University of Tennessee School of Social Work, as well as Mental Health First Aid Training from the Mental Health Commission of Canada and Applied Suicide Intervention Skills Training from the Centre for Suicide Prevention. Marie is a certified life coach and writes a monthly blog and e-newsletter on pertinent issues related to veterinary wellness. Recently Marie launched her own podcast Reviving Vet Med and has a YouTube channel that features monthly Wellness Wednesday videos.
When she is not working, Marie enjoys listening to podcasts, reading, hiking, and strength training, as well as spending time with her family and friends. For more information, please visit www.marieholowaychuk.com or follow Marie on Facebook, Twitter (@DrMHolowaychuk), LinkedIn, or Instagram.
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Hey there, it's Dr. Stacey Cordivano. I want veterinarians to learn to be happier, healthier, wealthier and more grateful for the life that we've created. On this podcast, I will speak with outside of the box thinkers to hear new ideas on ways to improve our day to day life. Welcome to the whole veterinarian. Hi there, I just want to start out this episode of the trigger warning. This episode contains references to and information about suicide which may be upsetting to some people. The purpose of this episode is to educate and bring awareness to the stigma around mental illness and provide resources to enhance a person's knowledge of risk factors and warning signs in order to help prevent suicide. But if you are not in a position to handle this discussion, please skip this episode. If you are concerned about a friend or colleague or if you yourself are having thoughts of self harm or suicide, please call the USA National Suicide Prevention Lifeline at 1-800-273-8255 The Canada suicide prevention service at 1-833-456-4566 or just dial 911. You may also text home 2741741 to reach a volunteer crisis counselor. The Crisis Text Line is also available via WhatsApp and Facebook Messenger. I will include a list of warning signs of suicide along with all of these resources in the show notes for you to reference. I also want to let you know that there are several online suicide intervention programs that will be mentioned. If you want to investigate them further. The free QPR training from the AVMA the ASK training from vet folio and the applied suicide intervention skills training from living works are great places to start. Links to these programs will be in the show notes as well. In order to help me learn more about mental health and suicide issues within veterinary medicine. I am honored to be joined by Dr. Marie Holowaychuck for this two part episode. Marie is a board certified small animal emergency and critical care specialist and a passionate advocate for veterinary team well being. She lives in Calgary and travels worldwide as a speaker, consultant and locum. Marie has spent more than 15 years practicing emergency and Critical Care Medicine and academic and private referral hospital settings. Outside of veterinary medicine. Marie is a certified yoga and meditation teacher and she facilitates wellness workshops and retreats for veterinary clinics and organizations and offers individual or group wellbeing training for veterinary teams. Marie has a compassion fatigue training from the University of Tennessee School of Social Work as well as Mental Health First Aid training from the Mental Health Commission of Canada and applied suicide intervention skills training from the Center for suicide prevention. Marie is also a certified life coach writes a monthly blog and E newsletter on pertinent issues related to veterinary wellness. She has authored dozens of articles and recorded a multitude of podcast interviews related to personal and professional well being and recently launched her own podcast called reviving that met. When Marie is not working. She enjoys spending time with her toddler, practicing yoga, hiking in the Rocky Mountains and listening to podcasts. She also has a soft spot for reality TV and has yet to miss a season of Survivor. For more information, please see the shownotes where I will link all of her contact info. And now here's Part One of my discussion with Dr. Marie Holowaychuk. Hi, Marie, thank you so much for being here today. We have a topic that is not the easiest thing to talk about. So I'm really grateful that you're willing to sit here and chat with me about mental illness and suicide prevention in veterinary medicine. So thanks for being here.Marie Holowaychuk:
Oh, thanks for having me, Stacey. It's great to be here.Stacey Cordivano:
I was hoping you could tell people a little bit about yourself before we dig in.Marie Holowaychuk:
Yeah, so I am a small animal emergency and Critical Care Specialist, veterinary speaking. So that's sort of the veterinary hat that I wear. I normally say by profession, but I'm speaking to all vet professionals here. So but in addition to the work that I do as a ECC specialist, I'm a very passionate advocate for mental health and well being so it started about five or six years ago really came through my own work, you know, dealing with my own mental illness and promoting my own mental well being really found strategies that worked well for me and some strategies that I thought would be very resonant with others in this profession. That was just kind of one We're starting to talk about people who were struggling and, and suicide in the profession. So I really felt called to share that information with other people. I'd already been speaking a little bit on emergency and critical care topics, but thought, You know what, there's not enough people talking about mental health and wellness. So let's broaden the conversation and and that's where that started. And it's just kind of morphed into my blog, my newsletter, online programs and other speaking gigs that I do. So it's become a real passion of mine, for sure.Stacey Cordivano:
I can relate to that for sure. And we will talk about your blog and newsletter and stuff later. But they're both amazing. So thank you. And actually, I think kind of the topic I want to start with was inspired by one of your blog posts and talking about the barriers to seeking mental health. But for me, I think I've probably said this, I don't know, 85 times on this podcast. As veterinarians, I feel like we are trained to just shove emotions down and not deal with them. And I'm learning more about feelings and emotions and the difference. And I was hoping we could talk a little bit about your thoughts on, you know, emotional intelligence, and veterinarians in general.Marie Holowaychuk:
Yeah, such a great topic. And I think you, you know, you identified it perfectly, and that we as very intellectual type a people who are very driven and really spend a lot of our days working. And in our thinking part of our brain, we don't really allow ourselves to be in that feeling part of our brain very much. And it's really interesting, actually, there's a lot of research to indicate that the higher individual's IQ is, the lower their emotional intelligence is. So I always think of, you know, Sheldon Cooper from the Big Bang Theory, who's like a genius, but literally can't read emotions, he doesn't know how to understand his own emotions, and to process those. And to your point about shoving things down, I think we often want to think our way through things and just sort of birdie things are just not even think our way through it, just sort of put it to the side and keep on going. And, unfortunately, that can really build up over time. And those emotions are going to come out in some way or another. And very often, they come out in situations where it's, you know, really disproportionate to the situation at hand. So, we often refer to those situations as being triggered. So something upsetting happens, it triggers something in us probably from a situation that happened a long time before. And we have this very exaggerated, almost inappropriate response to it, whether we lose our temper fly off, the handle burst into tears, or, you know, freeze and run away, whatever it might be. But inevitably, that is happening, because we have emotions that we haven't processed from a situation that happened previously. So it is so important to identify those emotions and and really deal with them.Stacey Cordivano:
Do you have strategies for people to help identify those emotions?Marie Holowaychuk:
Yeah, so it takes practice. I mean, it's like you, you talked about, you know, building our emotional intelligence, it really is about learning the language. It's like learning a whole new language with, you know, what do people say, when you ask them? How are you feeling? How is it going today? People say, Fine, okay. So so, you know, busy, whatever they come up with, you know, and there's hundreds of emotions that people aren't identifying. And so, you know, there's different exercises that you can do, I always start by really recommending that people read more about emotional intelligence. And there's a really great book that I just finished called Permission to Feel, which is a really excellent book, the author talks about becoming an emotion scientists were, you know, really, were just like looking at our emotional experience as something really interesting. And what's coming up for me? And can I understand more about this and learn more about this, just like we do research in the veterinary field, to understand and learn more about our patients. There's a lot of research investigating emotions and emotional intelligence and how that helps our well being and helps us to function. So, you know, he goes through all of the evidence in that book, but really, he talks a lot about just learning the language of identifying emotions, and even if you can't necessarily put your finger exactly on what it is that you're feeling. Can you identify general states of being like, do you feel more calm versus really energized? Or do you feel sad versus more on the angry side and then sussing it out from there in terms of you know, I'm feeling disappointed or frustrated or envious, or you know, and then there's all sorts of different You know, facets within there. But if we can get in the habit, and for a while there, I was getting prompts on my phone every single day to say, How are you feeling like name three things that you're feeling and why you're feeling them. And it just puts a person in the habit of really tuning in, like, how am I feeling today, and it might be tired, it might be joyful, it might be grateful, it might be sad, you know, and really getting to the root of what's causing those and just really improving your emotional awareness and your language around emotions.Stacey Cordivano:
on when it might be a good idea to think about seeking professional help for mental illness or depression or any of the number of things that can cause problems for us?Marie Holowaychuk:
totally, and you don't, I don't even think we have to put a label on it. I mean, it's, you're right, like anxiety, depression, definitely the most common mental illnesses that most of us would experience as adults. And I don't think you even need to be feeling anxious or depressed, necessarily to seek help. I would say in general, if you feel like there are situations in your life, that you just feel that you're having difficulty navigating or managing. Oftentimes, this shows up in relationships. So it might be an interaction with the same person that you just keep having these emotions building up, whether you find yourself feeling resentful, or frustrated or angry after them or you're feeling really sad or uncomfortable, or, you know, there's so many different things that can come up. And maybe it's not a relationship, maybe it's a particular situation that you're faced with, but you're just having a hard time getting past it or making sense of it. Or continuing with your regular daily functions, whether it be with work, family, life, whatever. Because you're so caught up in that, then for me, that's definitely a situation that would warrant speaking to someone. You know, for those who do live with mental illness, I have lived with anxiety and depression, you know, for most of my adult life. And for people like me, we do I think, especially as we age, and we develop more self awareness and more knowingness around our disease and what it is that we're living with, we can better recognize situations when we have flare ups of our depression, where we need to talk to someone or we need to maybe, you know, consider restarting medication or trying medication for the first time. With anxiety. It might be you know, debilitating panic attacks, or just dreading situations so much that we're not going out anymore. We're not interacting with people. Again, when your daily life and your regular functioning as being impacted. Those are definitely situations where you would really want to consider reaching out. All that said, though, honestly, I believe that therapy is for everyone, we can all benefit from talking to someone, I guarantee you will learn something about yourself. And for me, I wish it was like a regular maintenance. Like we had to take our car in for an oil change that we would have our you know, semi annual check in with our mental health.Stacey Cordivano:
Yeah, I went through a period where I was feeling really overwhelmed. And I used better help. And it went from the overwhelm and like counseling aspect, and then turned into more of project management, like it was helpful to have someone else in your situation to like be bouncing things off of. So I agree, I think everybody, everybody, regardless of how you're feeling should, but that is not true for all veterinarians. Right. The studies, I'm going to read some stats, which like you have written about. So significantly more veterinarians than the general population disagree with the statements that treatment can help people with mental illness, and that people are generally caring and sympathetic to people with mental illness. So that's a problem, right?Marie Holowaychuk:
It's a huge problem. And it's shocking, like when you read those statements, they sound so logical, of course, people would be caring if we shared we had a mental illness or, of course, treatment would be helpful. I mean, we're treatment providers, we, we make treatment recommendations all the time, why would it not be helpful? I remember when I came first came across that research, I was like, Oh my gosh, my mind is blown. Like, where does this come from? What is this and so what you just shared is really an indication of the stigma that we have amongst veterinarians, and where does that stigma come from? I mean, I think there's all sorts of theories circulating. I know for me, and I have to catch myself because there are times where I will try and talk myself out of needing to go back into therapy or needing to restart medication. And I think it comes from this reliance on ourselves to just get through just power through like, we'll go back to what we talked about at the beginning of our conversation where it's like nose to the grindstone, just keep going. I'm a caregiver like I can't possibly need help that would decapacitate me in terms of my ability to help others that would be seen as a form of weakness. I think, too, you know, we use our brains so much in the work that we do that when we think of mental illness being a disease of the brain, I mean, really, it's disease of chemicals. But when we think about it like that, I think that sometimes too, we perceive that we won't be able to do the work that we do, or even worse, that if we let people know that we're dealing with a mental illness, that they are going to question our ability to do our work. I mean, the difficulty with mental illness is this is an invisible disability. This is not obvious to individuals. And so it makes it even harder when we're not feeling like ourselves, or we're dealing with this under the surface. It's not like we have this broken arm that we can just, you know, I need a cast, and I need pain relief, and I need to be off work for a set period of time, mental illness is so great and ambiguous. And so I think too, sometimes, unfortunately, people have had really not so good experiences within our profession of revealing that they have a mental illness and then being penalized for it in some way. So working in a work environment that maybe isn't psychologically safe. And so they reveal this, and they feel like they become an outcast in some way. Or they're not receiving the support that they need from their teammates, or their employer that people become frustrated with them, or that,Stacey Cordivano:
you know, taking time off or that isn't okay,Marie Holowaychuk:
exactly, exactly. I mean, the general population, while much less stigmatized about mental illness compared to veterinarians, there still is some stigma out there. And there is still this sort of glib advice that is often offered, like, you know, we'll just, you know, be positive, just, you know, Buck up, or things aren't so bad, or you'll feel better tomorrow, or, you know, whatever it might be, we're not looking at these as chronic debilitating long term illnesses that can really impact people, both physically and mentally. So, you know, I've personally had some experiences where I felt like people really treated me, you know, from the stance of, oh, buckle up, it's not that bad. When is she going to get over it? Or, you know, I think back to my residency, and, you know, my dog was euthanized. During my residency, it was a horrible low point of my life. That was really when I fell into my first really deep depression. And I remember overhearing one of the ICU techs, say to somebody else, like, you know, like, when is Maria gonna get over this already, and just get back to normal? And it was just, it was shocking to me. I think those kinds of experiences, they really stick with us. And then, you know, with confirmation bias, we look to have that reinforced. And so a lot of people believe these beliefs, and maybe they sort of start to share with someone and then they get that glib advice. And so they think, Yep, see, there it is, again, like people aren't going to understand and people aren't going to take me seriously. You know, I've also spoken to people in the industry, who, when they've revealed, you know, that they had mental illness, they had troubles getting disability insurance, or their disability insurance was, you know, just astronomically priced. I mean, it can be really difficult. And so yeah, I think for numerous reasons, very often, people would rather just keep this to themselves.Stacey Cordivano:
Yeah. And I think also, we don't see that like, in our mentors or older practitioners, I know, I was just speaking to a recent grad, and we were talking about mental health care access. And she was like, Oh, they added a counselor in my third year vet school. And I was like, Oh, that's great. And she's like, well, no one went because like, how could you dare ask for time off of clinics to go to that appointment? Even though is there free for us? And so all I know, is the equine world. Right. But like, like not would not be okay. And so I don't know, I think a big a big point, maybe for leaders and practices listening might be to just demonstrate that it's okay. Right? Is that a tactic that people could use?Marie Holowaychuk:
Absolutely. It's a, it's a really important point you make Stacy and honestly, if you look at that research, and those statements that you shared, that people disagreed with the demographic that tended to disagree tended to be older veterinarians, and I think there are some generational differences, for sure. And so I think sometimes when we look at who is in a mentorship role, or a leadership role, I think very often they are individuals who maybe don't believe you know, that this is important or that we should talk about this or that there's a place for this in the veterinary industry. And it's really unfortunate because without that permission to speak up and just that a person is struggling or to say that they need help or to say that they need time off, there is no safety in the workspace or in the school environment for them to seek that help, which is not going to be an environment at all that is conducive to mental well being. The other piece of it is just the general culture, like what's acceptable and what's not acceptable. It should be something we talk about openly, we really need to talk about emotions and emotional well being and mental well, being way more in this industry, this should be a daily check in that we do just like we check in and have rounds on our patients, let's let's check in and have rounds with our team. And absolutely, if you need time off to go to a mental wellness appointment, you get that time off, and there is no questions asked. But that's a culture. That's that's what makes things okay or not okay. And that absolutely comes from the top down. So leadership has to lead by example. You know, it's interesting, I recently spoke to a management team at a practice that I've done some presentations and coaching for. And long story short, they were talking about, how do we get people more engaged in the Employee Assistance Program, and I said, first of all, everyone needs to be using the Employee Assistance Program. And that starts with all of you sitting in this room like that you would make use of the program and share your experience with others or normalize it like say, as twice a year as as part of everyone's employment, you are going to get an hour of time paid off, that you can participate in your EAP use it for whatever you will, but this is going to be time that is given to you. And we're all going to make use of it, you know, so it absolutely, I said you can sit here all you want and tell your employees to make use of this. But if you're not making use of it, they're not going to either.Stacey Cordivano:
I'm fully convinced as of late that psychological safety and team leadership is like the key to getting a lot of the stuff changed in veterinary medicine, because it's like impossible for people to do it without that.Marie Holowaychuk:
Yeah, I wholeheartedly agree.Stacey Cordivano:
Are there things that an individual practice leader an owner, a managing DVM? What are some things they can do to decrease the stigma and allow for more access or use of mental health care?Marie Holowaychuk:
Yeah, it's such an important question. And I think it you know, to tie into everything that we've touched on, I mean, really creating a culture where mental health is prioritized. So we need to have that safety in the workplace that if people need time off for a mental wellness appointment that that is offered to them. Certainly I know a lot of companies now that are implementing wellness days where people don't even need to say like, what's happening or what it is, but these are paid days off, you know, that they are able to do whatever they need to do if they feel like their mental health needs attention, then they can take a mental wellness day with no questions asked. I do think even just inviting mental health into the conversation more. So when people are having reviews or check ins or connects, you know, that they are being asked about their mental well being it's not just hey, how's things going on the job? How are things with you in general, but pointed questions about, you know, how's your mental health managers and employers are often reluctant to do that? Because they're like, Well, I'm not allowed to ask about somebody's health. And no, of course, you're not allowed to ask them to reveal diagnoses and everything else. But if somebody at work had shared that they hurt their back and they needed time off for their back, you would probably say, Hey, how's your back doing? Like how are things going you would be checking in with them, you would be making modifications to their work for that, you know, you would be giving them time off for physio, same thing goes for mental health, if they have indicated to you that you know what, I've been having panic attacks. That's why I've been late in the mornings, and I, you know, going to be connecting with a therapist, and I'm going to need some time off to deal with this. Those are instances where you can connect with him about that, you know, How's it been going? How are things you know, I'm here if you ever need to talk and let me know if we need to make any other adjustments, you know, to accommodate you, like you have these conversations, you document it, you document it in the way that you would with anything that was impacting a person's work, and what the plan is to make accommodations for that. So, you know, having real conversations, checking in with people, sharing as well, I think is really important from a place of authenticity. It takes vulnerability, anybody who follows Brene Brown's work, especially in the context of daring leadership, it is not always comfortable to share, but that creates a safe space for others to have the courage to share and speak up as well. That is component of creating that psychological safety is that we normalize having these conversations we normalize, stepping up and owning it when we're feeling off mentally, or we're not having a good mental health day and hey, you know what, that's okay. It would be like somebody has like a wicked headache, and oh my gosh, I've got a migraine, I'm having trouble looking at my screen. It's like, no worries, you know, what, why don't you dictate to me? I'll type up your medical records or do what I can to help you with that, you know, same can go for, you know, I'm just really feeling mentally emotionally off today. Okay, you know, what I saw that you have like, for euthanasia is on your schedule today? Should we shuffle some of this around? Or what can we do to help? you know, making it normal to have these conversations.Stacey Cordivano:
That reminds me of a discussion I had with someone on Instagram, she was finding difficulty in getting some of her team to open up about things like that, is there anything you can recommend about that? Like she, you know, she says, I'm working on being a vulnerable leader and you know, creating a safe space. And I feel like some of them are struggling, and I just can't quite get them to open up. And, you know, maybe it's just, they have to do it when they're ready. But I your description of that made me think of that question. If you had any insight on that.Marie Holowaychuk:
Yeah. Kudos to her for working on her vulnerability as a leader and really putting emphasis on having these conversations. I think the saying and forgive me, I know speaking to an equine vet, but how does it go, you can lead a horse to water, but you can't make them drink. I know, for me with my wellness endeavor endeavors and my coaching, one of the biggest things I've learned in my life coaching certification is that you can't help anyone more than they want to help themselves. It sounds like she's doing everything right. I mean, self disclosure, being vulnerable, creating a safe space for those conversations, short of making it mandatory for people to engage in some sort of mental wellness day or mental wellness activity, whether they make it mandatory that everybody on the team participates in Mental Health First Aid training. Unfortunately, even with suicide intervention training, it can be dangerous to make that mandatory. I mean, it's not, it's not something that we recommend, because that can be triggering for some individuals. So unfortunately, she may be dealing with some individuals that have some really deep rooted heavy stuff that they're just not ready to own yet. And that's going to take time. And unfortunately, I tell people all the time, you know, as much as we want to help others, they do have to come to it on their own. So I would encourage her to keep doing what she's doing. And eventually people will get there or maybe they won't, and if they don't, then she has to meet them where they're at and helping them as best as she can.Stacey Cordivano:
Got it. That's great advice. And it's actually a good segue, I want to talk about QPR, training and things like helping people to recognize symptoms of mental illness or you know, even signs of risk of suicide. Thanks again for taking the time to listen in. So today we covered facts about the stigma around mental illness, specifically in the veterinary medical world, and how it affects access to mental health care. We also emphasize the role of leadership and encouraging an open discussion around mental wellness in our workplaces. And on the next episode, Maria and I will get into more specific recommendations such as QPR training and how to recognize if someone might be contemplating suicide. We hope to provide tactical strategies in order to help increase suicide prevention awareness, because that is possible. Please tune in in another two weeks for the continuation of our discussion. Also, please make sure to check the show notes for references and resources related to suicide prevention. You will also find Dr. Holowaychuk's contact in ormation there. I know that ei her one of us would be happy to talk to you directly if you ne d any assistance. I hope you ha e a great couple of weeks and I ill talk to you again soon.