Amy Brann  00:00

Have you ever felt like your to do list is never ending, that no matter how much you get done, there is always more piling up, and when someone asks you how you are, your answer is normally so busy. We live in a world where busyness is almost a badge of honor. But is this constant state of overwhelm really productive, or is it just burning us out? Today, we’re diving into the neuroscience of prioritization, why our brains struggle to decide what truly matters and how stress hijacks our ability to focus. Plus, we’ll share some practical research backed strategies to cut through the noise, to get clear on what’s important and to take back control of your time. So if you’ve ever thought I have so much to do I don’t even know where to start, then this episode is for you.

Dr. Jessie Gulsin  00:41

Me, me, me.

Dr. Jessie Gulsin  00:45

I know that you and I both can resonate with this particular subject matter. Amy, so come on, tell us what questions I can guess, but what questions do people tend to ask you around this topic? Yeah, it really is. I don’t know, challenge of our age, isn’t it? And people are asking,

Amy Brann  01:04

I feel like I’ve got so much to do. How do I even decide where to start? People are aware that the response to how are you is often, oh, busy. And the one that people are questioning is this healthy. And people are sharing that they can feel overwhelmed. I’ve got friends that share. I’m overwhelmed. I don’t know how to juggle everything, and I, I don’t think that snapshot is healthy. You know, you and I both experience it at times, and we, we know that if we’re getting stressed and stressed for prolonged period of times, which overwhelm correlates with then that can be damaging. We know the the impacts of chronic stress. We know if we’re ruminating on being busy a lot of the time and busyness is associated with a negative component, then we know that that’s affecting mental health, emotional well being, cognitive function, physical health, and just that sort of that piece around how we want to look back on how we’ve experienced life, and how satisfied, content, at peace we are with this that’s concerning me. I don’t think we want to look back and go, yeah. Well, you know, I lived my 20s, 30s, 40s, 50s, crazy, busy. Or do we want to be able to look back and go, Yeah, I did the important things, you know, and I did them well. So I feel like your role, your job, is a very challenging one at times, but it’s also you get to see things that others don’t, which doesn’t mean that you are immune, as you’ve already kindly shared, to these challenges of overwhelm, but it does give you more food for thought when you step back. I mean, is that? Is that something, am I right in assuming that that’s the case for you? Yeah, absolutely.

Dr. Jessie Gulsin  03:02

Amy, I think, um, I think, like you mentioned in the introduction to this podcast, sometimes we do wear it as a bit of a badge of honor, don’t we? And acute stress, in some situations, can be helpful to kind of push things forward and get the job done and just kind of encourage you and motivate you to crack on. But as we know, chronic stress has got so many health implications. And yes, my job is sometimes very stressful, but I feel really privileged. You know, people meet me and instantly there’s this trust that they feel, yes, sometimes I do have to work on that, but on the most part, people feel that they can trust their GP and share with them things that have really been worrying them. And it is a very grounding job. You know, I sometimes go into work thinking, Oh, I’m so busy. I feel so stressed. I’ve got so much to do, and then I just have to come across one patient who’s going through something life changing and completely alters the kind of trajectory of their life, that I think, wow, my problems really aren’t that bad, which, you know, I’m not to say that we should feel that our problems aren’t they don’t matter, and that they’re not significant, but I do feel very privileged in that sense. And I had a very dear patient recently who unfortunately passed away, but she came to me and unfortunately, had some quite worrying symptoms, and within a few weeks, had a very horrible diagnosis, which had a very poor prognosis, and she since sadly passed away. But in that, in those few months where things had taken a turn, she completely overhauled her her her life, her perspective on things, you know, she would come in with this just amazing zest for life and this energy. And I would feel really energized by her. She was amazing. And when I reflected on this, I thought, why do we not live like that every day? You know, she is this pain. Patient has now realized that her time is short, and only now she admitted to me, only now Was she really, truly living. And I just thought, I don’t want to look back on my life and think I haven’t lived. But of course, the busyness of life, the chaos of life, the multiple roles we all have, they sometimes just take over. And it’s really easy for us to sit here on this podcast and say, oh, you know, we must take a step back and try and enjoy life. But actually, I mean, you know what my day’s been like? Today, I’ve been running around like, hey, there’s chicken, and it’s it’s been so chaotic. And I just think, my goodness, how am I going to do this for another few days? Even so I am privileged, in that sense, with my job, it grounds me. I get to meet some truly inspirational people, and it reminds me of the things to value in life. But of course, we’re allowed to feel sorry for ourselves, aren’t we? Yeah, and

Amy Brann  05:53

I think, I think you’ve articulated really well that we have to blend together those two perspectives. Is that we’re not saying that the niggly, frustrating, day to day, monotonous, sometimes challenges are not real, are not important. We do need to pay attention to them and the load. You know, if the washing isn’t done, which, if you’re taking one perspective on life, you would say, Well, you know, the washing, the ironing, that’s not important. Let’s not worry about that, but it gets to a point where it really, really needs to be done. Otherwise, no one has any clean clothes to wear. And I think the narratives, certainly in the UK, the additional different podcasts and different mediums where people are able to talk about sides of life that we didn’t used to talk about and death, but we didn’t really, you know, in some cultures, it’s not openly discussed, and we’re then, we’re missing that perspective in things. And I think one of the one of the big challenges that that I see in organizations and in individuals is that actually we try to do more than is possible. We we are trying. A lot of people are trying to do too much, and I feel it’s almost irresponsible for us to not even become aware of that in that there was a brilliant example in one of the manager as coach programs that that we both run, and this wonderful, very capable woman, you know, classic, could hold it all together, was doing lots of different things, had a really important job also wanted to train for a marathon. And when we actually looked at why she hadn’t been doing the training at the level that she wanted to do, we looked at sort of her plan, her weekly plan, and there weren’t things that she wanted to take out of that very full existing plan in order to put the marathon training in. It just wasn’t possible. We couldn’t make it work on paper. Therefore, of course, it’s not going to work in real life. But then we get into the place where we feel busy, overwhelmed, exhausted, and we don’t feel like we’re achieving the things that are important to us. So I mean, I know for myself, last year I was doing quite a big voluntary role. I was obviously still running synaptic potential. My daughter transitioned to secondary school, which was harder than I’d prepared myself for. I was still trying to manage and get on the right meds for this chronic health condition. So it felt like a lot, and it didn’t. It didn’t feel good. And actually I was, I was just trying to do too much, so I needed to choose which things I could do, so then I could do them better and which things I wasn’t going to do so much. So this is really an important topic. We’ll unpack it further, but some of the brain regions that are involved, it just is always a good place to start when, when we get overwhelmed. So our brains can work really well, but once we start down a track that typically through our internal narrative, our self talk, if we start going down that track, then it can be bad news and make everything more difficult. So our dorsolateral prefrontal cortex won’t be able to work as well. Won’t help us to plan, to reason, to hold things in our working memory as well. We won’t be able to evaluate things as effectively. We won’t be able to organize our actions based on the perceived importance of them. Our anterior cingulate cortex responsible like the flashing red light on the dashboard if your car was going wrong, helps us to detect the errors it it’s really important for helping us adjusting our priorities and making new decisions if unexpected challenges arise, like they do in life, but if, if we’re depleted, if we’re already telling ourselves, I’m so busy, I’ve got so much to do, I don’t know how I’m going to get all of this done. It’s we’re already making it more difficult for ourselves. So I would probably say, for this topic, our self talk is one of the most important tools we’ve got at our disposal, and the other is, quite possibly, our diary. You know, if, again, if we can’t make it work on paper, we’ve got no chance in the real world, this whole Old recommendation of taking a break, getting some fresh air, it works because it gives the brain a chance to settle down a little bit for if we’ve got high levels of cortisol or adrenaline surging that are not working for us at that point, then it gives us a chance to calm that. And the metaphor that we sometimes use in our family is my daughter has to have a specific laptop for school, and I wouldn’t say it’s the best laptop. It’s not the most user friendly, and quite often it gets totally overloaded. It just becomes unresponsive. It does weird stuff. It just doesn’t work the way you need a laptop to work, which is more frustrating. But the other day, Stu my husband looked at it, and he said, Ah, I can see the problem. It’s working at 89% capacity, so it’s got, it’s got no bandwidth to actually do what you’re wanting it to do. It’s just so clogged up with all the other stuff. And at this point, my daughter’s about to explode, because she’s at the end of her tether with the laptop, and both of them just needed a break. So we just closed the laptop down so that it could have a moment, and we closed the daughter down so she could have a moment, and then everyone came back together. But that’s how we work, too, isn’t it? It is,

Dr. Jessie Gulsin  11:38

and I think you can probably tell us a bit more about the neuroscience behind this, but what you’ve just described there, if I was to have, if I was to propose this scenario to my partner, who is much better at rationalizing sometimes than I am, and if I was to describe this scenario to him, he is very good at then looking at just going into solution mode and looking at the solutions, whereas I seem to attach a lot of you know, I’ve focused a lot on the emotional aspects of that, of that story that you just told me about the trials and tribulations that you went through, and the meltdowns, and I could feel my empathy for you in that situation, which, of course, isn’t very helpful, actually. So I know that, you know, you’ve explained this to me before, but there are parts of the brain which do you know, kind of you know, they help process emotions as we know, but also that they can associate prioritization of tasks based on emotions, which isn’t necessarily the most helpful thing.

Amy Brann  12:38

Yeah, I think the chat. So once emotions get involved, we need emotions. Sometimes emotions are demonized, but we need our emotions to help us make decisions. But I think it’s really interesting you say, yeah, the empathy at that point wouldn’t be helpful. And I think it could be that we that we need to switch, like your partner, into the task, the solutions. But when you think about children, and I know you do this really well, if the child is in a space where they’ve already had a big reaction to something they’ve not been able to regulate, and they’ve had this big reaction, then we’ve got to meet them where they’re at first. And it’s the same with adults, isn’t it, so we’ve got to almost be empathetic to their situation, to where they’re coming from, and then move them from there. But I might have misunderstood,

Dr. Jessie Gulsin  13:28

yeah, no, that’s absolutely what I was kind of inferring. And I think as I mean, we’re both very empathetic people. So of course we’re empathetic, but also they are our children, so we have that emotional attachment, so it’s near on impossible to remove emotion from those types of situations. I think so it is important to empathize. But I think for me, definitely, I know that at times I need to then take a step back, like you say, the brain needs to just have a moment for you to re evaluate the situation and just try to think calmly, okay, like we’re going to take a step back, but then what needs to happen for things to move forward? And there’s so many things now that resonate with me compared to before I had a child, Amy, but I know that you and I both are big Michael McIntyre fans, and there’s this sketch about getting your child or your children ready to leave the house. And I remember finding it absolutely hilarious. You know, you just before children, you think, oh, I want to leave the house. So you grab your coat, and then you grab your keys, and then you’re out the door. But with children, there are multiple steps, and it takes so long that you need an extra hour. And I think back to the days where I could just leave the house and I think, Wow. I mean, I I used to find that sometimes a bit stressful, because I would find I was running late, whereas now that’s a perpetual state in my house. But no, you’re right. You’re right. There is, there is a need for empathy in these situations. Our brains, my brain, definitely. Cannot separate emotions always, but I think sometimes it is important to try and take a step back and think of it with less emotions involved, so that you’re able to prioritize what needs to be done.

Amy Brann  15:15

Yeah, I totally agree with that. I think, yeah, meeting someone where they’re at, but without becoming too embroiled in the situation. I think when we’re supporting others with their possible busy, overwhelmed, exhausted state, this is where we then need to bring in those logical tools, rather than just meeting them with empathy. It’s sort of the empathetic meat and what goes next, and a couple of the cognitive biases that we can utilize to help us help someone who might be struggling with prioritization are around our distance bias and our that involves looking at how we’re temporarily labeling something. So if we’re thinking about something that’s close in time and space, we often prioritize it more, but it can be more difficult to say yes to something because we might already know or we’re chocker, but we’ll often say yes to something that’s further in the future. But we can also think about all if we step out in the future, will this still be a problem? And I know when I’ve been talking to friends or colleagues, when times are really tough, we want to meet them in that toughness, but also step forward and go in six months, this is going to be a distant memory, and sometimes that doesn’t always help people, but sometimes that can be just what’s needed for someone to go, Yeah, I know that. I know we’re in it right now, and it’s very difficult right now, but in time, things are going to be different, and then almost step them out, maybe just a week in time, and go, okay, in a week, this situation is going to be different now, as we look back from our week in advance, as we look back towards now, what are the things that will have happened and people then might find it easy to easier to articulate those because they feel like they’re standing in a different place, and also physically, if someone is presenting in a very overwhelmed, exhausted, overloaded state. It might be that physically, you take them somewhere different. I mean, ideally outside for a few moments, just breathe for a couple of minutes and go, Okay, what actually needs to be done that’s going to change the state. And these are sort of the management tools for in the moments. I think we still have to hold the bigger picture that we can’t give you enough tools that will mean that when you’re trying to do 10 hugely important things in your life, and your life has only got room for five, then we can’t fix that through hacks and through understanding how different brain regions work. It’s all nonsense. If you actually are trying what you’re trying to do is impossible, so we have to start there and go, Okay, these are the important things. This is how we will feel good about living our life. And then this is what we can do for when things still go are more difficult in the moment. And

Dr. Jessie Gulsin  18:14

then in order for that to happen, I think you know, based on what you just described, having those conversations with people, you’ve got to have some level of trust there. And you know, if we’re looking at organizations, for example, having a frank conversation with somebody and saying, look, it will it will get better in three months, our projection will improve, which can just seem very airy fairy. And is that even possible? But actually, if you’ve made a connection with someone, and you’ve got that trust between the two of you, you can kind of get away with being a little bit frank with people. I mean, I definitely find that with patients, you know, continuity of care, yes, I think sometimes people struggle with that in healthcare these days, but I’m very, you know, I try really hard to ensure that I maintain continuity of care, because I like to get to know my patients. And so once you’ve got to know somebody on a more personal level, I think having those conversations when they’re seemingly out of the blue, they’re less likely to take offense by that. And you know, they know what you’re like. You know what they’re like. So if you’re coming across Frank, I mean, I often just give them a bit of a warning shot and say, Look, I’m going to sound really mean now, or I’m going to be really brutally honest with you, but having those social connections with people, there’s, there’s, you know, there’s neuroscience and evolutionary benefits and perspectives behind that, isn’t there? Absolutely

Amy Brann  19:37

so we want to watch out for people feeling socially rejected, or just feeling rejected, it activates the same regions of the brain as physical pain. Can got several studies that show that, and the difficulty with that is then people will often recoil and won’t be able to hear what you’re going to say. So what you’re talking about is making sure that. Probably that you’ve triggered some oxytocin release in them, so they are more likely to have bonded to you, just like babies do, but more likely to be connected so that, yes, they trust but also then they feel safe enough that they can hear what you’re going to say, and then when you say something that might make them wrong, it might be that something that they’ve been doing is not helpful to them, just as can be the case with really over busy people, it might be that actually, no, we do need to change some things. You’re not bad for having things having got the way they are, but equally, they’ll they’re not going to get better unless, less you do some stuff differently too, which might mean saying no to some things, but people can get in their minds if they’re feeling like it might isolate them or leave them out in the cold, as it were, evolutionarily, it makes sense that we we don’t want to do that we want. We can be very people pleasing in nature, because it might be the early life experiences or conditioned responses through childhood and then adulthood can make us much more sensitive to anything that could sever those ties, and we we get dopamine hits when we get approval often, and this is all difficult because it impacts so much on our ability to set boundaries. And there’s some brilliant boundary setting books out there with really practical suggestions around how to improve our boundary setting. Many people struggle with that, and that’s contributed to them being busy, overwhelmed and exhausted, but it can be reconditioned. I think that’s the key thing to remember, is that we are meaning making machines. And you know, I used to think if, if I say no to a friend, then I’m letting them down. And that’s what I would tell myself, or like, we can’t let them down. You need to be there for them when they need you. And yes, that is a good intention, but practically that might be causing more problems. So then could we ask a different question, how can I be there for people and still do the things that I need to do? And yeah, I just say it’s possible to rework stuff.

Dr. Jessie Gulsin  22:20

Now I remember a conversation we had around this, and I similarly would happily say yes without even thinking. Do I actually have time to do that? And it’s because you want to help people, and you want to to Yeah, you want to offer some assistance to them when they’re in difficulty. But actually, if it’s then going to be detrimental to you, why? Why would you say yes? And I sometimes have those conversations with myself, why did you say yes to that? Jesse, you could have said no, but one thing that I’ve changed, which I remember us kind of talking through at one stage, was if you can’t say no because it feels uncomfortable, just try to put a pin in it for that moment and just say, Look, can I get back to you on that? I’m just in the middle of something really important, and then it gives your brain time to process and think, and in my case, come up with a nice way of saying no. But you know, at the end of the day, if you don’t prioritize your self care, and I say this to patients all the time, it’s classic, isn’t it? It’s like the airplane, you know, put on your life jacket first before helping someone else. Someone else. And there’s, there’s merit behind that. You’ve got to prioritize your self care, which does mean saying no sometimes, and it doesn’t have to be an outright No. It’s just not, not at this moment in time. And if, like me, you find it uncomfortable, then getting back to people later is absolutely fine, but you’ve got to be able to look after yourself before you can actually help anyone. Otherwise, as we know, chronic stress and the physical effects of that will unfortunately rear its ugly head at some point. Yeah, and

Amy Brann  23:54

I think that’s really wise, and I think the challenge with do it, for some people, with doing things face to face is also then dealing with responding to the other person’s response, if they look disappointed, if they say, oh, you know, and use tones that evoke things in us that we are then laying meaning on, if we’re not really tight and have conditioned ourselves to then respond to that in a healthy way, we can end up quite quickly flipping back and go, no, no, no, of course, I’ll do it. It’s probably it won’t take me that long. I’m sure I’ll be fine, which isn’t always helpful when we’re around people that might react negatively to us sharing some boundaries, we might absorb some of their distress. We know with emotional contagion, this happens, and then we might have this desire to fix the situation, to make it better, to soothe things. All really, really normal. And we might need to find other ways of doing things if we know that these are challenges for us. And I love the idea of, let me get back to you on that, you know, I want to check some things, or, you know, let me just make sure that that will work, and then going back. And sometimes I go back in email and then in person, because I sometimes find it easier to write things down and explain things before, then talking it through

Dr. Jessie Gulsin  25:26

so but also sometimes not feeling like you have to explain yourself as well. Then the number of times I’ve tried to find the right phrase or the right way of of in my mind letting someone down when actually it’s okay to just say I’m really sorry I can’t do it. I know someone

Amy Brann  25:42

that doesn’t even do the sorry, no, we can’t do that, and that’s it. And the first few times, it’s very abrasive, like my I was like, oh, where’s the softness, where’s the packaging? But actually, I know exactly where I stand, and I do love it whenever I go to different parts of the world, and the social norms are different. And you know, they we are laughed at by different cultures, for the our the way that we respond to things. And if I was with some people from Amsterdam recently, and they were especially tickled by our the English use of the word interesting. They said, you, you’re so funny. You, you say interesting, and you don’t mean it’s interesting at all. Oh, yeah, we do do that. Yeah, sorry about that.

Dr. Jessie Gulsin  26:36

And you know, as a society, definitely we, I mean, I’m, I have been conflicted in times because I am of Indian background, as you know, obviously, and I’ve been born and brought up in the UK, and the approaches are so different in the two cultures, and I am much more of the UK cultural norm in the sense that I hate conflict. I really don’t like confrontation. I will try to avoid it at all costs. And I think sometimes that in itself, does need to change, like you need to kind of expect a certain level of conflict, but realize that it’s you know, worst case scenario won’t actually happen again because you’re trying to preserve your own sanity, I guess.

Amy Brann  27:26

So I think what I’ve heard is that we do need to get clear on what’s most important to us, and we need to the classic story I talk about this in make your brain works. I think it’s a brilliant analogy, but putting the big balls in the jar, first the things that are most important to us, and then filling the space around with the other things that sometimes needs to come out. And we know when people can get really sick often, there’s one big ball, and that’s that’s it. That’s all that there is room for. And so we need to make sure we’re setting ourselves up well. But then we need to use our cognitive reframes, how we’re packaging stuff, what frames we’re putting around things, like you do when you say to your patient, you know, I’m going to be really honest here, or I’m going to say something, and you’re not going to like it. It’s helpful to package things in particular ways both of us it sounds like, have practiced our small nose and communicating that in different ways. We’ve talked about regulating our emotional responses, because if we’re getting into a really stressed situation, our brains may not function as well as they could in order to do things we know we can go outside. We could do journaling if we’ve got time for that in the in the midst of things, or just taking a few deep breaths. Or one of my friends loves lying on the floor with her legs up the wall. I’ve not looked into the neural responses that are happening, but She assures me that they’re sound. I think I’d probably feel better with my legs up for the wall for a bit. But we also sometimes need to rewire our responses, so we can’t expect that we will be great at this immediately. It’s taken time to condition our brains to respond the way they do, and for us to, you know, have a dopaminergic response when we are doing the things that we’re doing. So we will be wired to be as we are, whether that’s helpful or unhelpful, but then also your point about that we might just need to build some of our assertive skills too. We might need to be able to say the things that are difficult and that people may not need to hear, and maybe we don’t need to give an over explanation, which I know I can be, can be guilty of. I sent about five emails to a guy this morning because I was changing the time of a meeting, and I just wanted to explain. I wanted to tell them it’s not normally like this and back and forth, which is, yeah, poor chap, yeah. He probably could have done without those five emails. There we go. But also, if we remember that the dis, the discomfort is temporary, that might be helpful to a lot of a lot of us. I love the fact that we’ve not even. Tech. Jess, we don’t feel that the solution for this situation is to add in more apps, or, I don’t know, yeah, hacks. From those perspectives, we’re more talking about the human side of things.

Dr. Jessie Gulsin  30:14

I mean, I think tech will have its place. And obviously, with the emergence of AI, there’s lots of fascinating stuff coming out, but at the moment, I think I’m quite happy trying to use my human skills to work and navigate through this. But yeah, if you come across anything Amy, let me know.

Amy Brann  30:35

We’re always optimistic, aren’t we? Yeah, well, I hope people have taken from this that it’s it’s a really widespread challenge. It doesn’t need to be like this. And there are people that journey through life with it not being like this, but it often takes a bit of an investment to change how we’ve got things set up. And I know organizations are taking note and are move, trying to move their people towards not just feeling like they are so busy and the load is so high. But if you have enjoyed today’s episode, please share it with a friend or colleague who might find it helpful. It’s great to help us grow and reach more people like you. Then

Dr. Jessie Gulsin  31:16

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