As my training and clinical practice in somatic psychotherapy and trauma deepened, it became clear to me that our system of medicine and health care was becoming unsustainable. Our cultures were failing to adapt and evolve in response to increasingly indifferent and hostile forces.

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For some time, we have understood that our deepest nature has been to survive. As stresses imposed on physicians and other healthcare providers become unremitting and overwhelming, survival patterns originating in the nervous system and brainstem emerge and escalate. Invariably - without some profound shift in how we operate our healthcare system - this will only get worse. Our responses to increasing adversity, driven by deep brain survival structures, will become more desperate, dangerous and unpredictable.

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In the summer of 2012, I read Trauma Stewardship by Laura van Dernoot Lipsky, a social worker in Washington state. Her powerful book, alongside my own sense of impending challenge and change, would lead me to conceive of the Caring for Self while Caring for Others series.

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When Irina and I introduced the program in the fall of 2012, burnout was not yet fully part of the collective consciousness in healthcare. That would change following the landmark study, published later that year in the Archives of Internal Medicine, which surveyed more than 7,200 U.S. physicians, finding that nearly half reported at least one symptom of burnout, putting doctors at higher risk than most other U.S. workers.

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Since our inception in the fall of 2012 (following a wild two days of driving back home from the Berkshires, on the tail of Hurricane Sandy), Irina and I have been offering four to five original presentations annually in Toronto, as well as additional presentations for various groups such as medical students and medical specialists.

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Our foundation has always lay in trauma theory, stress physiology and somatic psychotherapy. We emphasize that without exploring unaddressed trauma and stress physiology, trauma and stress physiology will rule us, leading to burnout, addiction, mental illness, chronic mind/body illnesses, medical errors, family breakup and other forms of suffering.

Building on those foundations, our presentations evolved to explore a multitude of areas in the realm of restoring health and a sense of aliveness, ranging from somatic regulation and resilience tools, to sexuality and vitality; to facing the challenge of navigating rapid shifts in the social and environmental landscape.

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Each of our presentations includes PowerPoint and video as well as opportunities for sharing and discussion. One principle we’ve always upheld - whether we’re teaching you to make your own smoothies or reviewing the latest scientific findings in the trauma and stress fields - is that we always include a somatic practice, led by Irina. Due to her enthusiasm for sharing her love of mindful movement, these aspects of our presentations and workshops attract positive feedback and help draw attendees back to future presentations.

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As well as drawing from trauma and burnout literature, our presentations draw from:

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• Sensorimotor Psychotherapy and the Comprehensive Resource Model.

• Literature

• Contemporary music, television and film

• Blogs, print and online journalism

• Modern psychoanalysis

• Social media

• Eastern practices including yoga, Qi Gong and schools of meditation

• Interventions such as journaling and art therapy.

• The trauma-informed model.

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From our outset, we have extended invitations widely to colleagues working in the health care and mental health fields. This has allowed for depth and richness. We were cautioned that this might lead to discomfort, self-awareness or awkwardness. Instead, it has instead added richness, breadth and diversity to the series. We have proudly witnessed profound collaboration and bridge-building as attendees share stories and challenges and recognize how we are far more similar than different. Building on Kristin Neff’s model of compassion, we see ourselves as a series built on common humanity.

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In our seventh year, with the support of the Physician Health Program at the Ontario Medical Association, Irina and I offered our first live presentation simulcast on Zoom. This technology allows for a wider dissemination of self-care teaching and the sharing of new ideas.

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As we enter our eighth year, what is our vision? We are actively reflecting upon and looking at ways we can bring more sharing and interaction to our presentations. And ultimately, we do want to continue with our original vision of community building. We understand that if a regulated nervous system is the foundation of health, growth and change, healthy and connected communities are the most powerful bedrock of regulated and socially engaged nervous systems.

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Current attempts to address burnout, moral injury, addiction, depression and suicide can only succeed when we name and address the underlying social factors, traumatic stresses, perpetrator-victim dynamics, dysregulation and the survival strategies that overlay them. We hope that our series can continue to play a role in bringing us closer to a day when we can intervene at a preventive, holistic, systemic and integrative level, reducing the incredible burden of suffering and despair that now threatens the very fabric of healthcare and emergency services.

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