Episode 06: Deal with Stress & Fear

Dr. Ryan Cheney

Episode 06: Deal with Stress & Fear

Episode 5
45:58

About the Speaker:

Dr. Ryan Cheney is a Professional Mental Health Counselor and a Clinical Advisor. His aim is to provide help to people experiencing different mental health issue/s and make a difference through a collaborative partnership approach. 

Listen to the specific part

01:49
Ryan Cheney talked about his background and his roles before he became a mental health counselor
03:03
The importance of the mental health sector and its role in our lives.
05:41
How to address fear especially if you are communicating and working with people
09:28
How to deal with people with Imposter Syndrome
14:25
Tools for Breathwork to help people suffering from stress.
18:44
Stress it not totally BAD but it’s a double-edged sword for mental health.
20:40
What are the tools and steps to overcome stress, especially in a critical times.
24:38
Box Breathing technique and how it helps.
28:16
The breathing component, movement component, and recovery component.
34:33
How balance is important in dealing with mental health.
38:14
How to create space by learning to say NO and when is the right time to say NO.
41:16
What are the things money-wise or time-wise Ryan wished he spent more when he started.
43:39
What would Ryan 5 years ago think of Ryan now and what are the learnings and experiences he had.

Episode Transcript:

[00:00] Ryan: We need to take action, but there is so much power and slowing down, right? There's, there's a slow, slow, smooth, and smooth as fast creating space to say, what is my state? How do I shift the state? Right. And there's some really good tools about like vision, breath and movement. These are kind of the biggest ways that I've found a shift, our nervous system state.

 

Into more of not, not so calm, like deep parasynthetic right before we're about to fall asleep. That's not performance, but in this kind of performance, middle zone where we're not in the fear or in the like, go, go, go answer or the move through it, or grit answer and finding space to get a little bit lower than that.

So you can actually gear what's a more connected answer.

 

[00:54] Pranay: Hi, and welcome to the, from MD to entrepreneur podcast, inside local, how to become a physician entrepreneur.

 

Hey everyone. I can't wait for you to hear my conversation with Ryan Cheney, licensed professional counselor and high performance coach. He's helped countless executives and doctors take themselves to the next. We talk about why it's important to learn more than just a tape or hacked handles the stresses of entrepreneur.

 

Hey, Brian, how are you doing? Good. How are you? I'm so happy to talk to you. All our conversations are always super interesting. So I'm happy to finally be able to record one. 

 

[01:33] Ryan: Yes. I'm excited. Thanks for having me and I mutually agree conversations can be such a good, beautiful thing. We can learn from each other and, you know, hopefully your listeners will get something out of this. 

 

[01:44] Pranay: For sure.So, uh, Ryan, um, tell me a little bit about yourself 

 

[01:49] Ryan: Professionally. I'm a mental health counselor. So my master's degree is in clinical mental. Been doing that for over 10 years now. Um, and a variety of different roles, you know, everything from crisis work to assessment-based work community mental health is kind of where I started and, you know, cut my teeth per se, and, and worked my way up into a clinical supervisor role, running a, a clinic.

 

And, um, from there, decided to kind of jump off the cliff and go into private practice and start slowly trying to expand into something. A little different. Um, that's still to be totally honest, still a story that's unfolding. And I think for most of us who are looking kind of this, this bin of entrepreneurship and ongoing process 

 

[02:38] Pranay: Yeah.It's it's ever done. And, uh, I think that's part of the fun, you know, it's a little frustrating right now, you know, cause you want to be, you know, at whatever you are, but I find that a lot of times, if you take. Uh, step back and look, you've, you've progressed so far, you know, because a lot of times our us entrepreneurs are really just us medical professionals.Our goals are like, it's like the Mooney, you know, it's like so far away.

 

[03:03] Ryan: Yeah. And there's so much gap between that. Right. We, we talked in the past a little bit about mindset before mindset. One of the things that I've read this quote right before I kind of tried to figure out what's this next move beyond community mental health.

 

Not like community mental health is super important. It's a, it's a highly needed mental health kind of sector of, of work. Cause there are a lot of people that have big needs. Um, I read this quote by Howard Thurman. Don't ask yourself what the world needs, ask yourself, what makes you come alive and go and do that because the world needs people who have come along.

 

And I started like, okay, am I alive? Or here? And in a lot of ways I was, but like deep down, it didn't feel like I was right. This wasn't where I was supposed to be. There's something more, I don't know what that, something exactly is, but I have to create space to find that something and then move forward into it.

 

Right. Take that first step. There's a process to that. That I've kind of been focused on. And this mindset around kind of being a beginner or a learners mind, right? Like the difference between being a successful clinician and a successful clinical supervisor is very different. As soon as I stepped into that leadership role, it's like, okay, beginner's mind.

 

What do I not know? What do I need to learn about being a leader? Because a leader is very different than being a really good clinician working directly with clients. And so same thing as I'm stepping out the last four or five years into my own thing is, okay, what's this beginners or learner's mindset around what's the process or.

 

It's okay. To not know. It's okay to say, I don't know. Right. But then what's the process to learn and figure that out and find those answers and make that first step and then make the next step. And right. 

 

[04:49] Pranay: You know, a lot of us are doing that, but we're, you know, especially in medicine, we're not used to failing that F-word is really just getting a, B you know, uh, getting a, B is like an app, right.

 

Or a minus. So how do we, how do we switch? The lot of us, especially when we're attendings were literally dealing with life and death where the small place misstep could cause a problem. Um, but I, I find that kind of bleeds into the rest of our life. We become so conservative with taking risks. So I know you've worked with a lot of really high performing doctors in the past.

 

So, you know, say I come to you and I'm saying, Hey, Ryan, I really want to do this. Um, let's say a speaking career, you know, I really want to speak, but I'm just, I'm just so scared of saying the wrong word. Like what did you say? 

 

[05:41] Ryan: You know, the, the first thing when I'm, when I'm working with people is how do we start to bridge this gap to fear as not being so scary, but being something to be really curious about?

 

So our instinct often is to, and this there's a lot of layers to this. Um, our instinct is to kind of avoid fear, right? Like, okay. And I want to jump off this cliff into the water. I know the water's deep, but it's just, it's really scared to do, you know, is it a skillset gap? Is it a belief system problem?

 

So we're going to start getting curious about like, what's that fear as you move towards fear. It actually gets smaller, especially in these kinds of scenarios, right? Like if you move closer to a cliff and you don't have a rope and no safety gear, the fear goes up for legitimate reasons. But a lot of the few that holds us back in life can feel like this big animal.

 

Right. And once we start moving towards it and start developing that curious mind of like, oh, what about this? Am I afraid of? And we start building kind of. Bridges to better understanding around sensations to the fear or emotions to the fear or thought processes to the fear. We can start to build kind of this mind map of how fear plays out in your life.

 

And then we can start kind of seeing what is it attached to? Are there root things? Are there experiences early in our life that created a certain kind of programming or understanding of the world? Keeps us from moving in that direction. And so depending on what we are curious with and we uncover right, then we're going to start creating different.

 

Practices to help with that or different ways to work. There's so many different ways to work with people on, on dealing with that fear. If there's trauma by trauma, meaning largely relational, but like a high emotional state at some point in your life. And sometimes that just gets trapped down in the deep unconscious parts of our brain.

 

Our limbic system is like, I got to look out for that. So sometimes fear, for example, for me, fear of speaking was always a huge thing and it's a pretty common thing. For for people. Um, and so as you do more of it, you get better at it. But I recognize like, wow, it's still holds, like, it takes so much energy for me to manage this.

 

I'm exhausted afterwards. Like there's something more here and then kind of moving back into more developmental kind of traumatic type of experiences or highly emotional places realizing some of that stuff was early on. And once I reprocess that and work through. Yeah, it's gone. It's not nearly the same thing anymore.

 

So it's fascinating how much our past can come bleeding into our here and now, or keep us fear wise from our future. But again, that story is different for everybody. 

 

[08:32] Pranay: Yeah, it kind of depends on it. Taking a look at what you're already doing. You know, a lot of doctors I know have had to have some very difficult, probably the most difficult conversations that you can have with a person.

 

And they're able to do that eloquently, you know, without fear. And that's probably, for most people, that'd be a lot harder to do than get on a stage and talk to 500 people. Um, but. Taking a look at what you're already doing and kind of reframing it because you have the skills, right? Pretty much every doctor is at some point a public speaker, but it's sometimes it's, it's also what I find is that a lot of people think they're just a doctor.

 

Uh, I don't know if you've had to, if you've dealt with, oh, I'm just a, you know, just a crisis counselor. I'm just. You know, mental health. Um, and I know you work with a lot of doctors, so you might be, you know, have you dealt with, I guess the imposter syndrome. You're working with all these doctors and you don't have a medical degree.

 

[09:28] Ryan: Yes. Dealt with it as far as like clinician to client, but also in my own life. Right. Where some of this process of like even doing this years ago, I probably would have been like, yeah, I'm not ready. Right. Like I need to know more. I need to learn more. I need to be more expert. I need to be a better technician before I can go do this.

 

Right. And I, and I had a friend who works with, um, like as a business coach who works with. People kind of expanding into more of the online teaching spaces. And one of the things she said is like, Hey, there's no new all there's new information in the sense of like scientific discoveries. But like a lot of this stuff is a new it's what's important is how you are saying like how, what you're providing towards them.

 

Right. So you only need to know a little bit more than the person that you're teaching or lecturing to. Um, and it's more about, for me, it's more about process than it is about, you know, that knowledge base. Right? So again, similar to the other fear of like, wow, if there's imposter syndrome getting curious, what's this fear about, of not being enough, where's that rooted at there's different ways of working that top down, right?

 

Thinking top down, meaning cognitive behavioral type therapies, mindset shifts, um, tools and skills. And then sometimes. Some of this is rooted really deep, where it's much more of an unconscious process where we need to do more kind of reprocessing work in it. And in my field that might be EMDR, somatic, experiencing brain spine has been a really powerful one.

 

So ways to getting into this kind of deeper part of the brain where talk doesn't necessarily get there, or behavior change can be helpful, but we still feel that huge kind of. Activation in certain areas right. Of fear or worry or wa or whatever it is, but yeah, it's a big piece and then facing it right.

 

Experiencing is knowing. So it's okay. What's one step to face this discomfort. You know, the other thing that pops up for me printing as part of this is like state. If we're in this state of fear or we're in this state of like anxiousness or stress or, uh, you know, I gotta perform or go, go, go. Our answers are very different than if we're in a state where we feel calm and creative and connected and like a power zone state.

 

Right. And so I really think about that a lot in my own work. In, in any of these, like fear-based facing fears or I'm not good enough or whatever it comes up, or I need to know more before I talk about. And finding ways to actually slow down. Right? Cause our entrepreneurs are so much like fast, fast, go, go take action, which is so good.

 

We need to take action, but there's so much power in slowing down, right? There's there's a slow, slow, smooth, and smooth as fast creating space to say, what is my state? How do I shift the state? Right. And there's some really good tools about like vision, breath and movement. These are kind of the biggest ways that I've found a shift or nervous system state into more of not, not so calm, like deep parasympathetic, right before we're about to fall asleep.

 

That's not performance, but in this kind of performance, middle zone where we're not in the fear or in the like, go, go, go answer or the move through it, or grit answer and finding space to get a little bit lower than that. So you can actually hear what's a more connected. Because when we're in a place of like internal dissonance, this internal conflict, you can actually measure like the brain and heart waves, EEG and EKG.

 

And it looks like this chaotic mess. That's disaligned and there's different tools and ways to slow down and get that to all line up. And the answers from that come different. So as an entrepreneur and like, I'm not sure what the next step is, slow down. Spend some time in that. See what answer comes up. And then go.

 

[13:28] Pranay: Wow. I hope you have a few hours. Cause I, I took a lot of notes. I actually literally right before this podcast talked to a good friend of mine and he has a business that's very successful. It's only a year old. It's very successful, but he talks about anxiety and kind of what you talked about, you know, he gets an email from a client and feels a need to.

 

Reply right away, you know, and he's been super successful on all times a day. He'll see it he'll reply. And he has partners, you know? Um, and a lot of times he's the first one to reply because his partners are busy, but they don't necessarily need to feel the need to do it right away. So. How would you kind of counsel him?

 

And if you could just talk, we've mentioned the word tools a couple of times, I'm dying to figure out what some of these tools maybe to breath work, or, um, if we can kind of break down some of those maybe slow down time for this. Very good for. 

 

[14:25] Ryan: Yes. There's so much here. Like my mind is just spinning with different ideas.

 

Some of this, like I'm, I'm working with another colleague and a good friend of mine, Dr. Orman, that they, you listened to his stuff and we're kind of developing some ideas around this because some of what you're talking about, regardless of the mental health diagnosis, I might be working. With there's some basic feigns that over the years I've started to kind of see as beneficial for people to thrive.

 

So the first piece is, is this awareness piece. Like, and again, these are practices, we don't just know it and then do it. So, first of all, your friend, like is aware now of this, this feeling of anxiety and this urge to just reach out right away and, and solve this problem or respond really quickly. And so that's a huge piece without awareness or an upgrade in consciousness.

 

We just keep doing our kind of same stimulus response patterns. And so that is one element. And then there's this kind of second element and we're working on building kind of a program or a way to help people go through these experiences and build a Sybil. Of acceptance and equanimity, meaning, okay, now I'm, I'm an ex I'm accepting that I struggle with this problem.

 

I'm not ignoring it. I'm not trying to push it away. Not fighting it. I'm accepting it. That actually is empowering. It kind of feels a first defeating, but it's actually empowering because you're taking responsibility or you're accepting this piece. And the equanimity piece is I, can I build this skill because it's it's skill.

 

It's not like something you're born with. To have this stimulus come at me. So this anxiety around this email and this client responding right away. And can I notice it without it kind of consuming me and going straight to a response, can I slow it down? Can I find that space between now I'm paraphrasing, but Viktor Frankl has this wonderful quote, right?

 

The, the space between stimulus and response is choice. And in that choice lies our freedom. And so it's like, how do we slow down? And how do we, you know, watch this bubble go by us of anxiety, the sensation in our body. Cause that's a little different for everybody emotion so that we can get to know it a little bit better.

 

We can be curious a little bit more and we're slowing down that process of stimulus response and creating the potential for more choices. So how do we build that skill set? And then this third piece of like regulation, how do we regulate our nervous? Anxiousness is more alert, sympathetic kind of zone of our nervous system.

 

Okay. How do we learn how to come down out of that? And when those kind of three pillars start to get developed and build skills, like you open up so many possibilities. So the first piece is like, yeah. Keep noticing, get more curious for the, for this friend of yours, get more curious about this anxiety and notice, how does it come up?

 

How does it stay? How does it fade away? Like when does it come up and what scenarios? So you're just gathering data and you're trying to do this from, um, there's an acronym I use with a lot of, I do a lot of trauma work with people in my, in the clinical setting. And there's this acronym called pace P a C.

 

Playful. Like how do we create this a little bit more, a little more playful, like ease up on yourself a little bit. Hey, is attunement, like how do you increase this attunement to the different things that are going on here? See is the commitment, how are you committing to accepting facing working through this?

 

Because this stuff's not easy when these, these patterns are hard to look at and then ease this empathy piece or compassion piece. Can I give myself some compassion or empathy? Fail or to work on this stuff or to actually look at it that that'd be a starting point, but there's, there's so many elements to learning how to, to work through this stuff.

 

[18:20] Pranay: And I find it's a spectrum, right. Cause it's totally, it's not, this is not something that you just want to say. Okay. You know, I want to be so calm that this email is just hanging out in my inbox for weeks. Right. So some of that it's some of that is learned because it's, it probably helped him become successful.

 

Right, because getting to these responses quickly, but it becomes almost its own beast at some point. 

 

[18:44] Ryan: Yes, there is completely. And I see this rampant in the healthcare industry, whether it's, you know, clinicians in the community health place or ER, doctors or nurses, it doesn't really matter where there's this pretty high level of, uh, sympathetic activation and performance.

 

And that's not bad thing. Like stress is stress. Stress is not bad. Stress is a beautiful thing. Like there's a massive stress response when we're born. And that helps us like turn on. We breathe, we start breathing tons of cortisol coming up. And so it's not bad. It's just looking at when and how am I doing this?

 

And in medical professionals, it kind of can become this double-edged sword cause it's encouraged. And then you get rewarded for it. And. You can't really escape it. So then it becomes more about with a lot of my medical professionals. I'll use this term, like taking moments. You're not going to take your day and turn it into this really calm, relaxing day because your workloads high.

 

And there's a lot of natural stress. Can you learn to take little moments to down-regulate that nervous system. So at the end of the day, maybe you're not fried so much. There's a big difference between redlining a car at 7,000 RPMs all the time. Versus that modulation where yeah, you rev it sometimes, but not all the time and you, and you make sure the engine's warm and you cool it down and right.

 

So you can develop these little practices of taking moments to be more intentional on kind of cooling the system down or down-regulating that high level performance state. 

 

[20:24] Pranay: And so if someone was, say, say an ER, doctor, ICU doctor, or even a hospitalist that has 10 admissions pending, what would you say for them to do in a minute, you know, to really regulate and take a moment like you said.

 

[20:40] Ryan: Yeah, and it can be in a minute. It can also be in the moment, breaths, a huge one, just begin paying attention. How am I breathing in certain situations? When I first started diving into the breath world, it was more in the performance space than it was in, um, clinical kind of mental health space. But it's definitely transitioned into, into both for me.

 

But I noticed when I was doing, and this was when I was in the clinical supervisor role, when I was doing computer work, like I was holding my breath all the time. Hold hold, hold, hold, hold. I'm like, wow. That like that's a tension state, not even aware of it. So the first thing is like, okay, notice your breath.

 

If you can breathe through your nose. Full breath in slowly, exhale, right? Three and six out, five and 10 out. That's going to help take the gas, your foot off the gas pedal and coast a little bit, or if it's more intense, right. I'm gonna, I might, I might kind of shift between, okay. I'm really focused on maybe this surgery or whatever it is or this ER patient.

 

And then I'm going to take a moment and really expand my vision wide. Get my peripheral vision really, really wide. That engages this phrenic nerve. Um, but for any of your listeners, Dr. Andrew Huberman has like awesome stuff around all this stuff, but it really helps us. Downregulate our nervous system opening that peripheral vision wide just for a moment.

 

And you can do that and still focus or you're walking between patients down the hallway, open vision as wide as you can breathe in slowly through the nose slowly, slowly, exhale. And that's. Put the gas out that pedal, you know, everyone's systems are a little different. So you, you end up in the breath world, you have to start to kind of play around with patterns and see how you respond.

 

Certain patterns might increase alertness and focus for one person and put the other person to sleep. So do there is some individual differences, but one that can be really powerful is this kind of double inhale and exhaling side. So you're breathing in. And then a quick at the top and then, ah, slowly exhale.

 

Right? And some of this comes from research around people who were in like elevators and feeling claustrophobic and you see these natural patterns to relieve the pressure of that nervousness or that, or that activation and the, of the alertness of the nervousness. So playing around and building these different regulation skills are really helpful.

 

Movement is really helpful. Gosh, I can't remember when this was some thought sometime in 21 or 20. I can't remember. There was, there was a hospital that had like a massive amount of COVID patients and the ICU docs were just really stressed out life and death all the time. Like not enough beds. And what they started doing is, is every hour they would go out in the parking lot and do a 62nd one minute sprint, not, not at a hundred percent, right.

 

But like 60%, like full on scrubs, everything just to release some of this stress because we are, we're used to developing this ability to deal with stress through. We're not moving as much anymore. That doesn't necessarily mean go out and kill yourself. Right. Cause that's just another stress on top of stress, intense interval work is stress.

 

And so sometimes that's good. And sometimes that's, that's not building more awareness about where you're at, where your nervous system is. As far as repair recovery goes helps a lot in that, but finding these different ways to help modulate taking these moments can be helpful.

 

[24;21] Pranay: And one of the things we talk about we actually do is do box breathing and, uh, you know, actually keep in touch with them.

 

And they're like, yeah, sometimes we still do this box breathing now and box breathing is, um, you think of your breathing? Um, actually you've mentioned it before you want to just go over box breathing really quick. 

 

[24:38] Ryan: Yeah. I mean, imagine a box with four corners, right? You're breathing in. And then you have a hold and then you're breathing out and then you have a hold breathing in, you have a hold, right?

 

And a lot of box breathing is like three seconds in three seconds. Hold three seconds out, three seconds. Hold. It can be a very powerful way to calm down or for my nervous system. Like one of the biggest, easiest ways for me to calm down is five and 10 out and keeping it simple. Like if you can't remember that, it's just like, okay, I'm going to take a nice full breath in through my nose.

 

And I'm if I can, and then I'm just going to elongate that exhale right before I hopped on this podcast, it's like, okay, what's the state I want to have coming on here because I can get too excited and into this, or I can feel a little nervous. And so I'm going to go. I went for a little five minute walk, opened my eyes really wide, breathe in five, out 10 for five minutes, and then come in.

 

And like, um, the state is different. It brings me down into this more of a kind of performance complex. As a learning how to regulate is an important thing. One of the things I've noticed though, is, is that when you teach regulation skills without the upgrade or the increase in awareness skills and the acceptance equanimity skills, what can happen is people then take these tools of regulation and they apply it to their whole same way of working through the world.

 

And they kind of conduct themselves in a whole sometimes. Right. Like, I'm going to, I'm going to just keep downregulating or upregulating when I'm feeling tired and exhausted to get my focus back in place that sometimes you have to do that as docs, but like there's a cost to that. So I've, I've seen people kind of, I've done this in my own life, honestly.

 

Well, I had dug myself in a hole because my body and my nervous system is telling me like, dude, you need rest. And I'm just like, oh, I'm feeling that. Okay. I'm going to up-regulate myself a little bit. So I can focus on this client and keep going and keep going and keep going. 

 

[26:38] Pranay: Yeah. So you're kind of rushing through all these barriers, um, that your body's, you know, at some point you got to listen to your body and get some site.

 

[26:46] Ryan:Yeah. 

 

[26:49] Pranay: It's funny. Um, I really like how you mentioned that, um, this is really individualized cause you know, um, I read it a decent amount of books, as I know you do as well. There's a book called breath, but you know, a lot of times it's, it's almost like a, a one word answer, you know, um, solution to all your stress is breath work or your solution to all your stress.

 

X, you know, I think there's another one called movement, you know? And it's, it's, it's the one example that they use. For example, the five second, 10, second. I do a five second, eight second, five second inhale. Eight sec. I use that asleep. So if I did that during the day, I'd be out for you. It works to kind of calm me down.

 

Thanks so much sense, um, that, you know, we, we need to kind of come up with this individual as planned in this way. A lot of people come to you because you're able to kind of see what, what works for certain people and what doesn't. Um, I did want to really talk about some of these, uh, I know you kind of gave some example, but if you can give me some specific examples of how people, um, have kind of earned.

 

Uh, doing the regulation without the awareness. Cause that's, you know, no one has, at least to me know, usually just breath work or meditation. That's just a solution. That's kind of what I've been telling people. So I haven't really dug into this awareness, um, and stuff. So can we first start off with, what are the downsides, if you can kind of give me a specific example that comes to mind.

 

[28:16] Ryan:Yeah. I've misused in that a couple. Uh, and I'm gonna not remember this guy's name. A couple of things like gummy thinking about that. So 2019, I went and got certified as an XPT coach. And XPT is a sharper, uh, extreme performance training. This is Laird Hamilton and Gabby Reese kind of came up with this system and it's really, I mainly went to for the breath work.

 

It was one of the, the better ones. There's a couple really good kind of certification or, or teachings around breath, but they have. A breath component, a movement component, and then a recovery component. And so after this, I started doing these one day workshops for people. We would dive into some nervous system education and then like an hour long breath work where I'm guiding them through different.

 

So they can start to see what it feels like to up and down regulate their nervous system and notice all these pieces. Cause it's a really powerful tool. And then we do these kind of intense pool workout. And put them in another uncomfortable situation and then we'd put them in and we'd do like three hours of contrast therapy, like ice bath, sauna, ice, bath, sauna, ice bath.

 

And in that, like you can't run away from the sympathetic reaction of getting into an a 32 degree ice bath, like it is going to happen. Right. And so now it's going to happen and I'm sitting there with you, coaching you, helping you to try to regulate. And in these workshops, I kind of started noticing, cause there was some repeating people that they would take some of these really intense recovery tools or, or nervous system modulation tools.

 

And they'd be using it in like the same way that got them into trouble before learning about this, this tool, I'm like, oh, what is going on here? Right. Oh, they're taking this, this new tool, this hammer. And they're using it in the same way. They've always known how to use anything because. Something else hasn't changed.

 

What is that? And as I started kind of thinking about it and spending space and time in that I started thinking about, oh, okay. There's, there's a missing component around awareness and around how they're using these things. And so fast forward a little bit, and there was this Ted talk I was listening to, uh, I think he was like, I want to say probably a business coach of some soar or a performance coach.

 

And he ended up in prison. This was in, um, I think England, I wish I could remember his name, but just not there. Maybe I'll I'll look it up and send it to you. So you can add it in the show notes. He was talking about this experience in the prison and saying, okay, here's, here's my chance because I ignored this.

 

Call to go to court. And I thought it was nothing, but it ended up being something. So now I have to go here. Here's my chance to see if I can live what I teach, right. If I can go into this really bad environment and, and succeed and come alive and help people. One of the things he was talking about in there was that in, in research, around rehabbing prison systems, often the answer is knowledge and education, right?

 

And he said, when you look at the research, it's failed, because all it does is it make smarter guys smarter, prisoners, smarter. They go out of prison and now they're smarter at being criminals. And what they're, what he kind of started to notice was if you, if you can upgrade their consciousness, their awareness to things, and now give them tools, they're going to use it in a new and different.

 

So the combination of those two experiences are what kind of started me thinking about this idea. I'm like, wow, I like you love to learn. And I, and I see all this performance-based stuff, not very many people are talking about that piece of it. Here's this regulation tool. This is the answer. This will calm you down.

 

This will focus you. This will energize you. I'm like, yeah, it can. But that's just one component. If someone comes into my office and they experienced something really traumatic. Let's just say let's make it simple. Like they were in a car wreck and we're massively injured. And now every time they get in the car, they have this nervous system response.

 

Right. Kind of like a PTSD response. And I go and I start teaching them how to resource. I teach them how to down-regulate their nervous system. I teach them about breath work. I teach them about all these elements. Like it's, it's good. It's helpful. You know, it's like I'm teaching them how to bandage their wounds.

 

But it's not going in and cleaning out the, the wound, the gunk in the system, that's creating that response. That's what ends up just being this repetitive tool over and over and over again. So some of these skills and these things you learn, like if you're having to constantly use them to manage certain stimulus reactions, it's like, okay, I'll take a deeper look.

 

They're powerful tools, but maybe there's something else here that needs. We're through healed, integrated, you know, whatever that is. So I'm not constantly acting to bandage or use this thing to regulate and regulate and regulate 

 

[33:33] Pranay:Ryan. You know, a lot of doctors kind of face a choice when they want to start kind of the path that you've been down in entrepreneurship and really trying to make a bigger impact.

 

The problem is that they like you are having trouble kind of. Really asking for money, you know, it's, uh, it's, it's, uh, you provide such a decentral service in the work. You do both on the mental health side and the performance side, right? I mean, obviously the world would be a better place with a million Ryan's who can work one-on-one with, uh, all of these doctors and all these people.

 

And I know if you could, I know you'd do it for free, but how did you kind of change your mindset on. Taking money. And how second question, um, how do you balance it with your family? Cause, um, if I remember correctly, you have four children.

 

[34:28] Ryan:I do four boys, four and four boys. 

 

[34:31] Pranay:One is two Tufts. I can't even imagine

 

[34:33] Ryan: I wanted two kids.My wife wanted four settled at three. And then you see where that went. And there they're amazing boys that keep us on our toes, but that is a hard balance. And all the really honest again with you, like I'm still figuring that out. Um, mental health is fascinating where I think it's, it's a very underpaid group of people as a whole.

 

The spectrum is huge. Um, and I even wrestle with like now, you know, on a technical level or more experiential level, I'm getting into that higher zone and not wanting to limit access of care to people who can't afford that. And so I really wrestled with like, what's that balance look like, right. And making the hard decisions of like, gosh, I really can't take this low pain insurance anymore.

 

Um, you know, maybe I need to up some of my cash pay or I need to take only the panels that are a little bit more and it's a constant wrestling match. Um, it's fascinating to me, like how much of a spread there is between clinical, mental health and life coaching. Right? Some of those people make massive amounts of money and they're not really providing that much more.

 

And in some ways they have a whole lot less experience in education. Um, so I just, it's really hard to balance and something I'm currently wrestling through. I had, how do I take care of myself and create more space to. Figuring out a way is really to help more people. You know, we we've had some conversations off offline on how much, like I feel this pull towards getting beyond the office and helping more people and taking this skillset and finding ways to share it beyond because there's just not enough clinicians.

 

And at the end of the day, I get bottleneck really quickly doing the one-on-one thing. Um, It's, I don't feel like I have a solid answer for you. It's a, it's a hard thing, right? Like what are you worth? I think one of the things that does pop up for me around this as just a, who are you around entrepreneurship is not, I don't need to go in it alone.

 

I don't need to have all the answers. And what's been really powerful for me the last couple of years, as I said, okay, I'm gonna face these fears. I'm gonna move into them. I'm going to put myself out. There is I get exposed to people who are super supportive. W like nothing great has happened in a silo.

 

It just doesn't right. And so getting people around you who support you in that and like what your worth is or facing these fears is really, really helpful. Another favorite quote of mine is from Margaret Mead. Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed.

 

It's the only thing that ever has. And it's like, who's around me. How does that influence what I get paid, asking for money, how to ask for money. 

 

[37:40] Pranay: Yeah. And so on top of that, so, you know, the money issue kind of goes hand in hand with. Balance. Right. And there's always more clients. There's always more time you can spend.

 

So how have you been balancing with your four children, your wife, and kind of, um, new and entrepreneurship, because you know, you've been doing clinical practice for a while, but entrepreneurship is relatively new for you. So I want my listeners to hear kind of from established people, but also people like you and me who are learning along the way.

 

[38:14] Ryan: Yeah. Yeah. We learn as we go. That is for sure. You know, I'm trying to do a little bit better at creating space. Sometimes it's going to be different for everybody. But for me, part of this is learning to say no, because when we learn to say no, um, there's this book I read recently called, um, hell yes or no, right?

 

Like what is, what is your hell? Yes. So adding a podcast conversation with Pranay is like a lot in a busy schedule, but it's a hell. Yes, because like, it makes me come alive. Like it it's putting that, that voice out there. Maybe somebody out there gets something from this. And so my, my journey or struggle is to learn, to say no more.

 

What am I saying no to, to create space that I can really go all in when that hell yes. That's a concept I've really been thinking about lately. Right. And so where does it start for me while I'm saying no, to just taking on another clinical, mental health client? Because that line is out the door, like it's never ending and it's so easy to just fill that space then pretty soon, you know, 25 plus clients a week and in my field is a decent amount and that's all you have space and time for.

 

So there's no time for these other ideas to expand. Right. So expanding inward first through saying, okay, what am I saying no to w w what's my hell. Yes. So I need to say no to some of these lower pain insurance companies. I need to say no to these certain clients. And I need to say yes to these other types of clients that create more freedom for me, because maybe it's financial freedom.

 

[40:11] Pranay: Um, but it is, it's an ongoing process. And. I've definitely not arrived.

 

Um, you know, about, I think just kind of, kind of the w like the awareness you're talking about, just thinking about trying to find some balance. Um, I mean, I know my wife has to remind me all the time you weren't going to work today, you know, and it's like one more email. Yeah. Yeah. But, you know, it's, it's letting, trying, failing and driving.

 

[40:32] Ryan: Yeah, and failing and trying again. 

 

[40:35] Pranay:Story of life. Um, couple last questions, rapid fire, you know, in the starting of entrepreneurship, a lot of times we're kind of cashed. Is there anything that you wish you would have spent more money on, kind of gave you would have helped you grow quicker, faster, and I can give you an example, uh, of my own life.

 

I was very hesitant to use like freelancers and stuff. Um, or a big one for me was a maid. You know, I like a clean place, but I was like, oh, I can clean. Why would I pay someone so much money to clean my house when I could do it? But it just freed up so much time and I wish I had done. Anything either money-wise or time-wise that you would wish you spent more time on in the beginning?

 

[41:16] Ryan: You know what actually instantly pops up for me and maybe that's because money wasn't know, not a surplus of that. As I made, it was hard to make the transition from community mental health to this. One of the things that was really important for me was actually, how do you spend less money? So like, what do you think you need to have that you don't need to have?

 

Right. So. For example, I started looking for office space. Okay. I'm going to go out on my own. I need office space. It was so tempting, the big, nice office, two windows, you know, thousand plus dollars a month. And then I was fortunate to have some mentors saying. Don't put yourself in that situation, right? So there's certain areas where like, maybe you really, aren't very good at that skill and maybe it's better to offload it.

 

Or for example, the maid saying like, if you have the money and it's all this time, hire someone to mow your lawn or do whatever. Um, for me, it was looking more at where I could not spend money, right? So like now I don't have the stress because I found a month to month office for $500 a month. Took that cost half out and now I can make that transition so much easier.

 

So I think like how many massive successful companies started out of somebody's garage? So many of the tech companies are that way, right? Disney, apple, Microsoft, like go on and on and on. Like they didn't go out and spend money to look a certain way or have the right things. Because often at the end of the day, what people really want is like, how do you make them feel.

 

When you're around them, do they feel seen, heard and supported any new in this new client or this new thing? Not what your office looks like. If it's the big shiny office, um, at the end of the day, that's not what they're going to remember. You know, now four years later, that corner office with big windows and really open space is something I have, but worked your way up.

 

[43:10] Pranay: Yeah, the isteners can't see, but I see two windows. It looks pretty nice. Uh, so Ryan, last question, you know, uh, a lot of times we, we have an idea of what we want to do when we grow up, but what, what ends up happening and who we become is a little bit different. So, um, you know, me from five years ago, when.

 

[43:39] Ryan: You know, a medical student is a way different than I am right now. So what do you think, you know, young crisis counselor Ryan would think of, uh, the Ryan now. 

 

Oh, wow. I think it, I mean, he'd feel proud. That's kind of a cool thing to look back on, you know, and so much growth and change. There were periods of time where I think you can probably relate that.

 

Like it was hell I'll never forget I had, and she was a great supervisor, actually loved her. When I was like six months into ongoing crisis work and being on call. And then I did all these intake assessments. Whereas basically you get to hear everyone's worst stuff, write about it for three hours in your chart, and then send them off to a counselor and never see them again.

 

Like it was a horrible space because you don't get to see the growth or change. I was really depressed between those two things and. I never free. She's like maybe need, consider medication. I'm like, this is not a medication issue. Like this is my environment, right? Like this is just so unhealthy. Um, and so there is, that's the pride that I think this, this younger Ryan would say is like, Hey, you stuck with it.

 

You worked through it. You grew, you learn. I'll never go back. And, and not like I don't regret any of it. All of it is what formed me to who I am now. And we have to kind of go through the fire. Right. And so keep showing up, keep showing up, keep learning. 

 

[45:03] Pranay: Definitely what an amazing place to stop. Ryan. If people want to reach out to you, they want to get some counseling, they want to do some performance work. What would we the best way for them to get ahold of you?

 

[45:14] Ryan: Yeah, probably the best way right now would be email. Cause my phone is I'm always behind on incoming referrals. Um, cause that's ringing off the hook. Yeah, Ryan cine@newtidescounseling.com. And I can send that to you as well. I think you actually have it put in the show.

 

We'll get into his show notes, but that's probably the easiest way to start the process of figuring out, you know, how I can help or, um, if it's a good fit.

 

[45:40] Pranay: Awesome. We’ll definitely hit up Ryan. He's been amazing. He's worked with countless CEOs. 

[45:46] Ryan: Thank you for having me.

 

[45:50] Pranay: I hope you enjoyed this episode. If you did, please leave a review on apple podcasts and Spotify and share this episode with a few of your friends.

 

Meet your hosts:

Dr. Pranay Parikh

Host

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