Burnout Expert: How To Deal With Burnout And Move Forward

You are one of the world's leading experts. Your work over the years is mind blowing. The awards that you've received, the citations.

When we read about burnout, it all sounds pretty sad and pretty pathological. Burnout is most likely to be experienced by caring, nice, reliable, dutiful people. Type A personality. Those people are more likely to get it. The rest would be difficult to tolerate. For somebody who's going through burnout, they're absolutely for affectionistic, they're working huge hours, they're setting high standards.

I was obsessed with competing, with winning, with practicing.

I believe there is a difference between burning out and being burnt out. The 247 Eat, Repeat Grind is a big factor for contemporary burnout. That's a very difficult one to handle.

Burnout. It's something I hear a lot of people talk about. It seems to be on the rise globally. When you look at the statistics in every western country, it seems to be on the rise. So I've sat down with one of the world's leading psychiatrists who's dedicated his life to understanding burnout. His most recent book is A Guide to Identifying Burnout and Pathways to Recovery. Yes, there is hope we can actually move forward. You're going to get to meet Gordon Parker. He's simply incredible. He's won so many awards. He was a finalist in the Australian of the Year awards and also when you look at what he's been recognized in his field for, unbelievable. He's been published in more than 900 papers, over 600 in peer reviewed journals, 70 book chapters and written and edited over 18 books. This guy is incredible. Deeply studied, deeply researched and is able to share it in a way that lands so powerfully. So if you have a lot on your plate, maybe you're a bit stressed out. I want you to be able to define after this episode, am I on the road to burnout or if you've already reached there, how do I get back on track? I hope you enjoy the show. The Lead on Purpose podcast is made possible by our generous sponsor, NZ Mortgages. You can check them out at NZMortgages Co NZ. Gordon, a huge welcome to the Lead on Purpose podcast.

Thank you, James.

I'm so excited to go deep on one very specific topic with you. And before we do that, I just want to let the listener or the viewer know that you are one of the world's leading experts and we've done our research as a team and the depth and the breadth of your work over the years is mind blowing. The awards that you've Received the citations, it's just simply mind blowing. And when it comes to psychiatry, Gordon, you are the man. And I'm very excited to go very, almost deeper and more distilled in one area of that, and that is burnout. So just to get started, Gordon, what is burnout?

There have been varying definitions over the centuries, and that's part of the problem. The current definition of burnout, that's captured in an official classificatory system the World Health Organization ICD talks about. It's a triadic model, meaning three symptoms of exhaustion.

What they call depersonalization or lack of empathy and decreased accomplishment. Now that's only three symptoms. And in fact, the third may not be a symptom at all. It may simply be a consequence of the first two.

So that is a very narrow restriction. And we've therefore put a bit of time into.

Seeing whether we can come up with a richer model. And the model that we've ended up with is actually fairly consistent with another model. So our model is captured in what we call the Sydney burnout measure. And there's also another measure developed in Europe called the bat and similar constructs. So if I could just take you through those, that'd be brilliant. Firstly, we give a big tick to exhaustion. That is the central and most defining features feature. After that, the next important feature is actually cognitive impairment. And that's not listed in the dominant triadic World Health Organization model. And basically patients report that they have difficulty in registering information and retaining it. And women who've had children will say it's a bit like baby brain. And if we go back to the ancient history of burnout, going back to the 5th century when there was an epidemic amongst monastics and it was actually listed as the eighth cardinal sin and called acedia, then one of the key constructs was cognitive impairment. So somehow that's been left out of most definitions. But we highlight it, the third component, which is sometimes described as depersonalization or lack of empathy or compassion fatigue. I believe we can extend that a bit to more. Define a construct where the individual doesn't get a buzz out of much at all. There's a lack of pleasure, there's a lack of feeling tone to everything, positive or negative. Then the next construct, people become very insular, self contained, they keep to themselves. So rather than going off and having lunch with their colleagues, workmates, they go off and sit alone at the dining room table. They just keep to themselves after that. There are a number of secondary symptoms that they accompany burnout to such a high degree. That they, I think, need to be included. And they include a depressed mood, a level of anxiety, and despite people being exhausted, insomnia is a very, very common feature.

So we have a model that captures six differing constructs as against the dominant three construct model. So that's how we define burnout. Yep.

So that's amazing. And for people, I often hear people saying this. I'm on the brink of burnout and I sometimes ask myself, are they just tired? Have they had a big week? Because often I think we don't understand truly what burnout is. And the symptoms you just shared with me, do all of them have to be present to then actually classify that as burnout?

There's a problem there in that there are no guidelines or rules. So there's been a dominant model, that triadic model that I talked about earlier, and that generated a particular measure called the Maslick Burnout inventory in the 80s. And that Maslick burnout model then influenced the World Health Organization definition.

The problem is that that particular measure and all other measures don't have any cutoff scores, and you therefore get extraordinary prevalence estimates. So there was one big estimate of physicians, and this meta analysis was published in a leading psychiatry journal, and it found overall rates of burnout in physicians to be in the order of 60%, but the range was from 5% to 80%. So there's a real problem that we have no precise cutoff scores for burnout, and therefore there is a real risk that we can inflate the actual prevalence. And so no one is capable of giving a definite statement about what is burnout caseness as against some other position along the dimension. But your question does raise a central point that strikes me. I believe that there is a difference between burning out and being burnt out. And it's a bit like Hooke's law in physics, where you can stretch an elastic body within its limits of elasticity. If you let it go, it will come back to normal. And then if you stretch it beyond its limits, it will not come back. It's lost its elasticity. So I think when many people talk about burning out or even being burnt out, they're more talking about being exhausted. But maybe if they have a weekend off, play a game of golf, distract themselves completely, they'll spring back to normal, so they retain their elasticity. But the burnt out stage is a much more finite one and much more severe one. So here and in our book, we have examples of people who just physically impossible to get out of bed. And one woman who is a senior professional we have her story at the end of the book. She describes not being able to get out of bed when she was taken to the emergency department. None of the doctors could work out what was going on. Her blood pressure was 60 over 40 and her pulse rate extremely high. So that shows you where burnout can get to this very, very severe stage where people are quite debilitated. And again, I emphasize inability to get out of bed, complete inability to function. And so the whole burnout story encompasses transient minor levels of burning out through to this finite stage of where people have to completely rework their existence to get back into living 100%. Yep, huge problem.

And are there any indicators. So, ideally, you and I don't want to experience full burnout. We don't want to get there. So are there yellow flags along the way before we get to the red flags that an individual right now could be going, aha, I am experiencing some of those things. Or does anything like that come to mind?

Yes, I think that the only warning signs would be exhaustion and certainly that lack of feeling tone, not getting a buzz out of anything.

And after that would come the other features, but you'd still be able to get out of bed. In fact, it may not be too difficult to get out of bed.

And people will often tend to struggle on. And James, there's a really important point that I need to make here that the early definitions of burnout basically said it was a simple equation. An individual was exposed to major work stress and didn't bring anything to the table. Personally, what we find is burnout is the. You have the same set of features in people who are formally employed, as in people who may be looking after young children, elderly parents, both doing it all as part of home duties. But importantly, we found that there is a strong personality contribution to burnout.

And that burnout is much more likely to be experienced by diligent, caring, reliable, conscientious, if not perfectionistic people. And that's fundamental, I think, to understanding burnout and also to its management. But it's also relevant to your question, because when you talked about yellow flags, yes, many people will be aware of the yellow flags, but as a consequence of their personality, the dutiful and reliable, they keep on keeping on. And they therefore are much more likely to go into a more inelastic state of burnout as a consequence of believing that they have to do their duties, they have to care for everybody, they cannot resile or walk away from their responsibilities.

And therefore, part of the management is the need to address that nuance.

That'S huge.

And when you think about environment, so let's say a workplace, most listeners are in some form of work or self employed or founders, or they work for others. So how does the environment impact the individual when it comes to the creation and the manifestation of burnout?

Well, the environment is pretty fundamental. It's the key precipitant. And of course we've got multiple predictable environmental factors such as excessive work hours, the office being, or the workplace being overlit or too noisy. But there are other triggering factors that are relevant. A set of them comprise where you feel that your core values are being compromised by your employer or by your organization. And in fact, even burnout can even occur when there's a lack of stimulus, when people are really, really bored. So the environmental factors.

Range considerably.

However, there is increasing recognition and I think it's valid that what has occurred over the last 20 years has been a big driver of contemporary burnout. And that is the requirement that we have a 24, 7 presence, that we're always on our emails, we're almost on our iPads, being readily available to everybody at any time. And so we've become very driven by this model. And Arianna Huffington wrote a really informative book. She's the editor of Huffington Post and the book is called Thrive. She developed burnout and again, the physicality was there. In her description, she actually fell to the ground hitting her head on the table. In that book she has some lovely vignettes of a man who could only read his son 10 second bedtime stories because any longer he had to get back to his phone. And other people having difficulty even spending time having a pee. And one medical colleague actually described to me as a young doctor how she felt such a demand to be constantly available and performing at a top performance. She actually decided to have a urinary catheter put in so she wouldn't have to spend the time going to the toilet. So I think those vignettes capture exaggerated way, of course, the sort of ways in which people are responding to.

The incredible pressures that they are putting on themselves by having a 247 presence. And of course, you know, I can't drive to work without seeing school kids, you know, with their face buried in their phones and so on and so forth, and how they are tortured when they're required to turn them off. So I think it's a very plausible model to suggest that the 24, 7 eat repeat grind is a big factor for contemporary burnout.

Absolutely. And if we think of burnout being a Result, a destination. You've arrived. What's the opposite of burnout? What's the thing that we want to aim for?

Well, I think Huffington captured in her book title, thrive, Thrive to have joy de vi.

You know, to get pleasure out of life, to feel, to get a buzz, you know, to, to feel alive. So I think that's, that's the, that's the, the antonym. Yeah.

Yep, I love it. That's so interesting because I work with people who are professional athletes, some are CEOs of companies and some I would, well, actually all of them I would call high performers to a degree. But some of them are thriving high performers and that's kind of rare because often they get caught in the obsession of producing, the obsession of winning, and therefore everything kind of ends up out of balance. So just to share with you over.

The years, can I just give you a couple examples of sportsman because I think it's relevant here. So Don Bradman, you know, Australia hero, the greatest batsman we ever produced, etc. In our book we detailed how he saw a Macquarie street specialist earlier on in his career and he's advised to take time off because there was the suggestion that he had burnout, even though the term in those days wasn't established. And then Ash Barty, one of our favorite most recent tennis stars, also had a period off before her formal retirement and she described a period of burnout. So just to underline your point, sportsmen, particularly those who set very high standards and are perfectionistic, are also at high risk at even a young age of developing burnout.

I could sense that. Thank you for sharing that. And it's interesting as you shared that, it made me think of our former Prime Minister here in New Zealand, Jacinda Ardern. You know, she stepped down as Prime Minister and was quite open about the fact that there was a lot of pressure, a lot of expectation, a lot of mental, well being challenges that she was going through. So she might have been on the cusp of or arrived at burnout. Yes, we're all equally susceptible to it. It sounds like we're not all equal.

Sociopaths are remarkably resistant to burnout because they do not feel reliable or dutiful or absolutely needing to tick every box. They just go through life prioritizing their own needs. So they represent a group where burnout is virtually non existent. Wow.

I mean, that's one of their.

That's the sad aspect of the burnout story. The burnout is most likely to be experienced by caring, nice, reliable, dutiful people.

Unbelievable. Well, I hope that this conversation and your book, and by the way, for the listener or the viewer, I'm going to put a link right now in the show notes for the book Burnout. So please go and grab, grab a copy. But I'm hoping that this conversation might equip people those kind, pairing conscientious people with some research based evidence, say, hey, here's how you can actually mitigate, here's how you can bring things back to the green rather than the red. So with that in mind, what can we do if we're starting to feel that we're on the trajectory towards burnout?

Well, what we've suggested in the book is first of all we have an appendix where people can tick the particular triggers that may be relevant and salient to them. And that's quite a good idea because by going through the list, they may well identify factors that they hadn't put at the front of their head. Then after that there's a burnout measure which gives you some estimate of the severity of the burnout.

Then after that there are a number of de stressing strategies and they're pretty bleeding obvious. But when we ask people, they basically said time off.

So having weekends off, having holidays. After that came exercise and they put a real emphasis on strenuous exercise. And of all the psychological techniques then in fact mindfulness and meditation came up as top of the pops compared to all the others.

So they are the suggested de stressing strategies. We did review the literature and there was a meta analysis and it didn't identify any particular advantage, say to cognitive behavior therapy or more established psychotherapy interventions. So basically the first line strategies are to de stress and have more time off. Now that's the common model. But if you accept our model.

Which allows for predisposing factors as well as precipitating ones, and the key predisposing factor is a personality style where you're reliable, conscientious, perfectionistic, etc. Then we argue that there's a real need to tweak that personality component and that in practice is very difficult because perfectionistic people do not really want to move very much. And I used to work for the aphorism that you didn't treat perfectionistic people, you employed them because they are such good employees.

So we actually have a chapter on perfectionism in the book and then I invited a psychologist to write a chapter on how he handles perfectionism in people who are having burnout. So it's a difficult trade to modulate, but I think it's fundamental to handling burnout itself, that you just don't address the symptoms, you try to address the soil as well and do something about it. And therefore.

A composite model is, I think, in play and very relevant. So there are other personality factors that are overrepresented. So type A personality, those people are more likely to get it. Those people who can't stand being in queues and are very impatient and very driven and interrupt other people, like I've been doing to you today.

So again, addressing the personality that may be contributing to the burnout, to the stress, I think is also highly relevant.

That's really interesting. And I was thinking, is there a divide between men and women as well?

Women have higher rates than men and almost certainly that's a consequence of them being more likely to be required to not only have a job, but also to look after the children and cook for their husband, et cetera. Also there are slightly higher rates in younger people, around about 40 is the key.

High rate period. And again, that probably reflects the need to have a job and look after family and so on and so forth. So the epidemiological variables that come into play are I think best explained again by the work stresses. However, I think it's important to emphasize that burnout is well described in adolescents. And I've certainly seen a number of high school students who've had significant burnout syndromes, even been admitted to hospital when they're only 15 or 16. But again, the formula is there. They're absolutely perfectionistic, they're working huge hours, they're setting high standards and they can't walk away from accepting, well, they can't work to the sort of the principle that I think is relevant, that in essence good enough is good enough.

Yeah, really powerful. And I see this in high performance sport a lot where it's just, you know, it has to be perfect, not excellent, isn't even good enough, has to be perfect time after time. And you know, we see some major mental health challenges within high performance sport because of that. I mean, there's no doubt that that self driven, high expectation has a consequence. Now Gordon, have you ever experienced burnout yourself?

Yes, I did probably about 10 years ago.

I realized something wasn't right and I was basically not getting a buzz out of things. I certainly had a level of exhaustion I was tending to keep to myself and I thought, you know, gee, this must be depression. But I didn't take any antidepressant tablets. But then when I thought about it, it doesn't really quite fit with depression. And so I started reading about burnout and decided that was the key thing. And then I became very excited about it and decided I better research burnout.

That put me back in the sort of the circle again.

I love it. And so what I hear there, which is really crucial, I think, is that we've got to have passions because passions get us interested and give us a buzz. So for those who have lost passion or interest in their passions, how can they reignite that passion?

I can't give you any definitive answer. Simple speculation.

I think you have to step away from the passion for a period. Whether it's, you know, having a holiday, extended break, you have to step away by building other things into your existence, whether it's a sport or something else. You have to contemplate that while the passion is very attractive, you have to recognize that it's got this downside of burnout and that if the burnout increases, then the balance of pleasure and pain will change and your passion will therefore become more of a yoke around your neck rather than something that you can really enjoy. So I think self contemplation and then working that therapeutic model, that corrective model that I have suggested is all important. So again, in the book, we start with a physician in the United States describing his severe burnout. And we finished with a professional in Australia describing her burnout. And both of them got to that burnt out stage where they just could not function. Both of them redesigned their life and basically after taking time off, they came back with a new formula. The woman who was very senior in one profession actually retrained in another profession and got to the top of that profession. But the point I'm making is that they needed to take a period of time off and then they came back with a better work life balance. And I think that last phrase sort of captures the model that needs to be embraced, that you need to review your work life balance and just realize that your passion may be great for a decade, three or four decades, but if it keeps on being your driver, then in fact you're going to pay a price.

It's so interesting that you shared that in the way that you did. I've never thought of this personally, but now reflecting, I'm thinking, well, maybe what I experienced was burnout. So at 8 years old of age, I grabbed a set of drumsticks and was very passionate about drumming. By the age of 13, I was fortunate to win the World Solo Drumming Championships and again at 14. And all of a sudden I was obsessed with competing, with winning with practicing like eight hours a day of practice, no problem, all about it. But it meant I sacrificed a lot socially. I suffered with RSI and carpal tunnel from a very young age. Didn't care, wanted to win. So Fast forward to 31, 32 years of age, had won multiple world titles, national titles, ran a business that was all about selling drums and all about percussion. Had an online community all about drumming. I got to a point where I was fed up. I was bored.

I was drinking a lot of alcohol, wasn't exercising. If I was on holiday, I was using that time to research what my next game plan would be constantly. I couldn't. I was restless. And in the end, I retired from competing. And I've never lifted a set of drumsticks since. And I totally changed my career, changed my life, changed the balance of work.

And now I'm very focused on other things. I'm passionate about those. And I never thought of it as burnout at the end, but potentially I was right in that realm of burnout.

Yes, it certainly is supportive and suggests that you're now beating to another drum.

Yeah, quite literally.

But what you did was very smart. You realized that whatever at that stage, you actually didn't realize have a name to it, but you recognize the process as no longer being profitable, no longer providing pleasure, and you elected to get out and you did a lateral arabesque and came out and pursued another course. And that is very compatible with, as I say, the vignettes in the book of the people who succeeded. And I think it allows me to make another point when we read about burnout. It all sounds pretty sad and pretty pathological, but most people that I see with burn actually do very well. The ones that do poorly are those who are usually in the public service and they have not been able to function, and so they're not able to get to work. And the human resources department is putting pressure on them and.

They really should need the job and reinvent themselves. But because they're so dutiful and so caring and so proud of their work, they believe they can't step away. And you get this impasse. That's where it gets really difficult. And again, predictably, most of them have got perfectionistic personalities. So when it gets to that stage, then it can get very, very nasty because the employer is generally irritable, if not angry. HR is coming down very heavily. The employee is unhappy, not going to return to work. There are no winners. So how to break through that nexus becomes pretty fundamental. And at the psychiatrist level, when I'm seeing these patients, it's a no brainer to me. I basically say you've got to get out. But how many out of 100 people did I persuade to get out? Maybe 5%.

Is it fear that stops people? As well as their perfectionism as well as their loyalty, Is there a sense of fear that traps them?

Yes. Sometimes I don't know where I want to go next or where I can go next. It's that.

But also in their current and or previous employment they've realized their strengths and they want to continue with those strengths and they don't want to move into.

Nebulous land where it may or may not work. And again, that's perfectionism where there's a wish to keep everything under control.

And not take risks.

It's important. I guess living life's a risk. Right.

I wanted to share with you what I think of high performance. So my definition of that is consistently exceeding norms whilst maintaining healthy relationships and well being. That's what I consider a high performer. Is there anything you would add to that or is there anything you would do to challenge that?

Yes, I'd challenge it. I think a high performer is somebody who produces high performance, but I don't think they are necessarily, I don't think they necessarily have the other attributes.

And I read something recently about elite sportsmen that the most successful elite sportsmen at times can be quite sociopathic because they prioritize themselves above others and they go through the motions of saying what's a team game, blah blah, blah, blah. So in fact high performance I think isn't necessarily associated with other positive attributes in terms of their social interaction, their generosity, et cetera. It can be quite selfish. And of course there's so many famous.

Authors and other people who succeeded and you know, their marriages don't last or their partners, when interviewed, you know, say, look, you know, he performs superbly but at home he's a proper pain in the neck and you know, he's not involved with the kids and blah blah, blah, blah. So I think high performance is defined by high performance but not by anything else of necessity.

Thank you for challenging me on that. I appreciate it. Yeah, I guess my view on it is when I look back at when I was performing at my best as a performer and winning world titles and so forth, people were pointing at me going high performer. Like look at that. And all I could think of was I wish they could just take a little peek underneath the hood just for a minute and see the hot mess that my life is you know, I was going through a divorce, I was drinking too much. So to me, I was a high performer in one, one very slim aspect of my life. But my life wasn't high performance. And so I guess I wanted to look at is high performance achievable across other aspects of life, almost like a culture that you create for yourself, as opposed to one silo or one area of your life?

Well, I think there are people who fit into both models. There are some people who can only exceed and be a high performer in one domain, and there are others who can embrace multiple domains.

And there are several famous exemplars, obviously of both types.

I think that if we were to say, if you've got a person who has a lot of skills, they have a distinct skill set.

Is there a better model? Is there a best model for their living their life? For some it will be stick to that domain and continue with your expertise until you burn out or you lose interest. For others, they'll say, look, I've mastered this challenge. I'd like to go away and have another challenge. And again, we get many exemplars of that. People who are excellent in one sport and who then move to another sport. And certainly in the academic field, we see the same. I don't think any model is necessarily ideal or the preferable one. I think we just need to allow and concede and accept that there are multiple models and as horses for courses and whatever works for us or for that individual, whatever works, I think is the key thing.

I like that.

I think we take a utilitarian model to the whole exercise.

100%.

And you mentioned three things, one being rest, the other being strenuous exercise, and the other being mindfulness or meditation. So I probably do quite well in one and three, probably not nearly as much in number two. So, number one, for those that are listening, what does rest actually mean? So is that, hey, I take the weekend off, but I still check my emails every now and then, or I go away to Fiji, but in the evenings I do zoom calls with staff. What does proper rest look like?

Look, I'm not sure that rest is the best strategy. I think it's taking time away from the work, although work demands, but not necessarily resting, because the person lying on the bed will probably feel quite morose and unfulfilled. They need to be doing something. So again, I think strenuous exercise. Now, I personally cannot do mindfulness or meditation. It just doesn't work for me. But if I go out and play golf, then in fact I think I'm actually practicing mindfulness because I'm completely unaware of other people on the T around me and I'm absorbed with nature and I'm doing some walking and whatever. Whatever. So I think that is probably an exemplar of what I mean by taking time off. You don't just lie on your bed or sit around or whatever, or possibly even read books, because that is not that distracting. But getting out and doing something, particularly exercise, particularly exercise that involves a mindfulness component, as I tried to exemplify, I think is the way to go. But rest, no rest would be difficult to tolerate for somebody who's going through burnout.

That's really good to know. I've been classified personally as what they call me, an active relaxer.

I can't sit still. I like to do things and learn and read and move and try things. And sitting on a beach in Fiji for a week sounds like hell, to be honest.

Yep, yep. Exactly. Exactly. Yep, yep.

I love it. And when you talk about, say, going golfing and that's a state of mindfulness. So what came up for me was Mihaly Csikszentmihalyi's kind of thought around flow. So to be in flow, would you say being in flow is a state of or a type of mindfulness?

No, I don't think so. I think flow is more when your expertise is actually working for you. Okay.

I remember I wrote my first book, book of fiction in 1966. Wow. And I would come home from the university, have a meal and go into my room and start typing because there's no computers. I old typewriter at 7 o', clock. And I'd think, oh, it's probably about 11 o'. Clock, I'll go to bed. And I'd look at my watch. It was three o' clock in the morning and the characters had all taken over. And that, I think, was flow. I was just. It was working for me. And that, I think, is a creative component and it's not just relaxing. So flow means you are using your skill set at the highest level and you actually feel you can actually get a buzz out of it most of the time, because you know that it's working for you. And it's usually, I think, associated with creativity. I don't think you can be in flow without being creative.

Yeah. Again, takes me back to my drumming days of, you know, on the world stage. You're very focused. It's quite challenging. But actually there's a sense of flow. Seven minutes feels like 30 seconds.

Yep, exactly. That would be flow for me as well. Yep, yep.

Yeah, I totally get it. This is fascinating. And for the person out there right now that does feel they're on the far right extreme of burnout, what's your advice for them right now today?

I guess contemplate what we've talked about and see what is relevant to them and what they feel that they can.

Put into a sort of formula to address how they're seeing things. I hope that by giving the symptoms that would be able to establish to the listener as to whether they are likely to have burnout or not. I mean, there are many false positives of burnout. You give a burnout measure and somebody scores high, they may not have burnout, they may have depression, they may have anxiety, they may be receiving chemotherapy, they may be anemic. So the first thing is to say, do I really have burnout or is there something else going on? And then if they do have burnout, consider whether they're burning out or they're inelastic stage of being burnt out. And then consider the other factors, the stresses that may be relevant to them, the extent to which they can redress those stresses. Not everybody can, of course. And then the degree to which there are predisposing factors such as personality that need to be tweaked and modulated. So I think if they contemplate the issues that we've discussed and see what works for them. So it's a pluralistic model, taking out what is salient and relevant and trying to come up with a formulation and therefore a management plan.

Fantastic. And I'm going to advise everyone that's listening right now to get a copy of Burnout. I'll put a link in the show notes. And Gordon, I've got one just final question for you and I want you to imagine for a moment that we'll fast forward many years into the future and you're highly aware that it's your last day here on earth and someone very young that you love dearly comes into the room and says, gordon, how do I go about leading my life on purpose? What advice would you have for them?

That's a very difficult one to handle.

For some of my patients. I suggest to them that they should read Man's Search for Meaning by Viktor Frankl.

The problem with that in giving that recommendation is many people may think I'm telling that they're not doing working hard enough and so on and so forth. But I think if we move it away from my psychiatric patients and say to that maybe the grandkid, assuming the grandkids over 18, the grandkid comes up and asks that advice. I'd probably say something like that. Read Man's Search for Meaning and recognize what Viktor Frankl went through and what he got out of it. And I mean, just to give you one example, after he had adjusted to the camps, he would wake up each morning and say, I'm going to find something positive out of everything today. I'm going to find something to laugh about. And then he moves into the particular therapy that he espoused even before he was in the camps, but developed later. And I think that is a very useful strategy for people to contemplate how to find meaning in life. And for most of us, meaning comes through relationships. Secondly, and for many people, the priority would be work, but the combination is best. So once Freud was asked to define mental health and he got a bit irritated and he just tersely replied something along the lines of work and love. But I think he got it, he nailed it. It's having healthy, reciprocal, loving, caring relationships and having meaningful work. Now, we can set that as our aims, but for many people, if you're required to sort of work in some incredible, demanding, noisy factory and you're paid low wages, all of that sounds too aspirational. And I regret if I've tried to set the answer at that level. But even so. And again, as a psychiatrist, I see many, many, many people who don't have much money and they're having great difficulty, but in fact they've got a great philosophy on life. So I may say to somebody, how's your week been, Bob? And he'll say, oh, you know, bit ordinary, Doc. My wife left me, the boss sacked me, daughter's just got preggers and the dog got run over by a car.

I guess it was a bit ordinary, but how's your week, Doc? And my heart goes out to those people. So even in the most difficult of circumstances, I find often people have tremendous resilience. And when I press with those people, the basic formula still operates. They're finding meaning in life despite adversity. So I think that would be the.

Message that I'd want to put such a powerful message. And I'm sure there's a listener or a viewer that needed to hear that. And Viktor Frankl, his book is phenomenal. I read it right after the Christchurch earthquake. I wasn't quite sure of myself, didn't really know what to make of life, and it was very helpful. And another one, I don't know if you've came across it is by a gentleman called Eddie Jaku and he went through the concentration camps. He ended up moving to Sydney, Australia, lived the rest of his years in Sydney, published his book at 100 years old called the Happiest man on Earth.

Sorry, I've certainly heard of the book but not read it. Yes, yes, yes, brilliant book.

It might be Happiest Man Alive or Happiest man on Earth, but definitely worth a read. He died at 102 or a few years after publishing, but again, very similar philosophies with what Victor shared. So I'm really glad you brought that to the table. I've asked hundreds of guests that, Gordon, what their advice would be and you're the first one to bring up man's search for meaning, and I'm so glad you did.

That's great, James.

Well, thank you so much for your time and thank you for sharing your.

Book with the world and such wonderful questions and I found it personally very enjoyable. I hope other people listening also find issues that are helpful to them and enjoy it as much as I have.

Thank you. I'm sure they will. The Lead on Purpose podcast is made possible by our generous sponsor, NZ Mortgages. You can check them out at NZMortgages Co NZ.