The Breakdown and Breakthrough: Dianna Moulden
Dianna and I have a lot in common. We both completed our Masters of Physiotherapy at McMaster University, pursued a specialization in sport physiotherapy and completed our Masters of Clinical Science in Manual and Manipulative Therapy at Western University. And disclaimer: we both lost a bit of ourselves while doing it. Today on the blog, Dianna shares her “breakdown and breakthrough,” the importance of finding balance, and how she redefined success.
Describe your “breakdown” to me. Was there a trigger? What did it feel like? How did you seek help?
It was a long time coming – I think one of the biggest misconceptions is that it doesn’t happen overnight, which is why I think it is harder to recognize. It is only now that I can see how it happened and identify the warning signs. And when I say warning signs, they’re not glaring and they are very common in our profession, which is why I think this is something so common in the healthcare profession. Let me explain:
After graduating from physio school, I started working at the McMaster Sports Medicine Clinic, one of my mentors/role models, Colleen Cupido, essentially gave me a position when there wasn’t one available. She took me on initially for 8 hours a week, but the understanding was, as I consistently filled my schedule and maintained a caseload, I could increase my hours. This was huge for me, I felt like someone was giving me a chance and therefore, I had something to prove. Additionally, I have the ability to turn anything into a competition and I quickly began the “Quest to be the Best Physiotherapist”. Long story short, 8 hours spread over 2 days, quickly turned into treating full days Monday to Saturday. In addition to my regular hours, which was now 45 hours a week, I started to spend time shadowing the Athletic Therapist, Chris Puskas, to fill the sport-skill knowledge gaps I felt I had after finishing school. Another aspect that we often feel we need to do immediately following school is to continue our education – so if there was a course, I took it: acupuncture, manual therapy levels, soft tissue release etc – this continued (and is still continuing) for a long time into my practice.
I was stretched too thin and exhausted, but I felt I had validation for my ways from listening to those around me “Dianna, you’re so busy. I don’t know how you do it”, “everyone wants to see Dianna, she has the busiest schedule”, “Dianna, do you even sleep at night?”, “even when she doesn’t have openings in her schedule, Dianna will always fit me in”. Looking back, it’s funny that those statements were giving me the positive reinforcement I needed, when really those statements should have been telling me I need to slow down. We work in a profession where being busy is the goal – the busiest physio is the best right? – but at what cost:
- I wasn’t dating anyone – I didn’t have any available time! Who wants to create a meaningful relationship with someone who has no personal time?
- I was missing out on family events – family dinners, family gatherings. I guess I figured they would always be there and right now I was trying to grow my career.
- I wasn’t seeing my friends – I would never get back to people to the point where people stopped reaching out. The time I did spend wasn’t meaningful time with friends – I didn’t know what was going on in their lives. That can be very lonely. I didn't notice it when I was busy, but I started to notice it is when I had exciting news to share and realized I didn't have anyone to share it with (except for my patients, because those were the only people in my circle).
- I did not know who I was – I lost myself in the process. I didn’t have hobbies, activities I did in spare time. I wasn’t investing in myself.
This started taking a toll on me physically and after 3 years of continuing that schedule I ended up in the hospital. I had been sick, but kept working and ignored all signals my body was telling me. It wasn’t until I went to the hospital and was informed my kidney’s were starting to shut down that I thought this might be something serious and I ended up staying in the hospital for the next 5 days
Was change instantaneous? Unfortunately not. It took one more trip to the hospital (this time in an ambulance!) a year later to make me begin to think about changing my ways. This time, while laying the in the hospital I was told I was suffering from exhaustion. Exhaustion? It couldn’t be, there must be something else going on, you’re telling me I am working so hard my body is shutting down – can’t be. We think we’re invincible. I mean on every form of clinic stats, I was the best, because I was the busiest and in addition to full days in the clinic, I was getting great experience on the field and traveling with teams, working through my Sport Physio Specialization, working through my Manual Therapy Levels, now beginning to teach within the physiotherapy program at McMaster. Professionally, I was on top of the world, but it was lonely at the top and personally, I was hitting rock bottom.
Looking back my biggest problem was I could not say no. If my schedule was full and someone was trying to get in, I would come in early, stay late, skip my lunch. I was there on the weekends to cover games or I would stay in the evening after already working a full day. I had this fear of disappointing people. I had no confirmation that people would be disappointed in me if I said no, but that was what I thought. My fear of disappointing others, prevented me from taking care of myself.
After physically shutting down, mentally things started to change for me. I was recognizing that there was nothing in the tank for myself and therefore very little to give to other people. I was slowly starting to realize the value of having meaningful relationships with friends and family and how important that was. I realized I no longer wanted my default response to “how are you doing” to always be “busy” – who wants to always be busy? I wanted to discover what my hobbies were and who I was. I no longer wanted to have a significant other who constantly had to explain to his family that I was working, when I wasn’t at yet another family engagement.
I finally decided it was time to head in a new direction. I sat down with my boss and told him I was leaving (and proceeded to cry for 90-minutes straight) – I said to him, if I wasn’t doing this for myself, I wouldn’t be doing this at all, but for the first time, I needed to put myself first. The best thing was, he looked at me and said “I am so happy for you.” I had never changed anything previous in my career out of fear of disappointing people and when I finally made a decision for myself and I was met with positivity and encouragement – not at all what I was thinking. Had I imagined people’s disappointment in me if I had made decisions for myself, when in fact they would have understood?? Had I been wrong this whole time?
What happened next, has gotten me to where I am today.
What changed for you after that experience? How do you manage yourself and your time now?
It took a long time to get the pieces in place, but I feel like I am getting better at a routine. The first amazing thing I did for myself was hire a life coach, It Starts With Be – Rebecca Babcock. She has pushed my boundaries and has helped me find myself again. When we started, I felt like I didn’t know who I was anymore, I defined myself by what I did not who I was. I remember one of our exercises early on, she had me visualize I was standing on a stage and talking to a crowd about myself – and I didn’t have anything to say that didn’t involve work – I couldn’t come up with anything! This brought on the tears, but I have since moved on from there and although I wouldn’t have a ton to talk about yet, I am getting there. My coach has helped me create my current schedule, organize my morning routine, set goals and plans to achieve them and she has taught me how to say NO.
The most important thing I have learned was to manage my schedule. My previous self felt any available hours during the day should be filled with working. If I was in the clinic from 12-8 treating clients, that gave me time to swing by Women’s Soccer Practice from 7-8:30, teach at Mac from 9-11:30 and then swing by Men’s Soccer practice from 8-10:30pm. Now, I try to work a normal amount of hours (we are still working on a comfortable definition of normal) and not extend myself beyond those hours – and that means saying NO! I use a gratitude journal, make time for exercise, read books (sounds trivial, but something I have never had time for before), meditate, spend regular time with family and friends and make regular time for passion projects
Your story is not unlike my own or others within the physio and health care industry- why do you think so many people have a hard time saying “no?”
I think instinctively physios are people pleasers and we worry about disappointing people and letting them down. We are also involved in an important part of our patient’s lives – their health. It is hard to say no when you are dealing with other people’s well-being, we don’t want our patients to think we don’t value them or think their health is important. Additionally, in our profession, often busy means the best but what we have to remember is, it often comes at a cost – which is our own well-being!
I think you would agree that you don’t regret pursuing higher level training and credentialing to excel within the profession but what advice would you give new graduates as they start out in their careers?
Take your time! I was in a rush to take and do everything the profession offered, but it was too quick! Every course you are going to take is a gift – the gift of knowledge that will benefit both you and your patients; however, only if you give it the time and attention it deserves. I feel like so many of my courses I took and then rushed through before moving on to the next, not taking the time to review, practice, share and expand some concepts further. I would encourage new graduates to slow down and take your time. Get the basics down first, the profession will always be here! And READ – one thing I never had time to do
5 Lessons for Young Health Care Practitioners
2. People will not be disappointed when you make decisions for yourself. Initially they might be sad, but that is because they are thinking of their own health, as you are of yours. They will always understand, and if they don’t – discharge them!
3. It is impossible to please everyone – this was extremely hard for me to swallow, because I am a people pleaser. Once you come to terms with this and have strategies to deal with the people you can’t please, NO becomes easier
5. Try to not answer “How are you?” with “Busy”. Work hard for the work-life balance. Work on hobbies and routine. Work on figuring out who you are instead of what you do – this is easier said than done, but don’t give up.
Thank you Dianna for sharing your story! I know I can relate to this and so many others will too. You can find Dianna on Instagram @dinamophysio or in clinic in Ancaster, Ontario at The Physio Spot at the Foot Knee Back Clinic.