Virtue and self-sacrifice were supposed to be my protection. As a first-generation immigrant, the necessity of hard work had long been ingrained like a birthmark. I never questioned the belief if I overworked and overprepared, I would fulfill my responsibilities, be accepted, and become worthy of happiness. By the time I finished medical training, I had checked off the first two boxes, but worthiness? Fulfillment?

I never considered asking those questions as I confronted the daily barrage of tasks that came with residency and my mother’s end-stage cancer. People thought I was “so strong,” doing my job no matter what else happened. Even I assumed I had found a hack. I had found the escape hatch from emotional presence by numbing my distress with things that would guarantee external validation: work and people-pleasing. After I finished medical training and buried my mother, rather than gaining resiliency from these experiences, I noticed less and less capacity for difficult experiences. Minor disturbances began to feel threatening, primed by all the painful experiences I didn’t realize were left unprocessed because it was easier to obsessively scroll through social media instead.

Raising a baby while operating at one percent emotional capacity has been sobering: Apparently, my ability to tolerate distress is not much better than my toddler’s. The difference between her and me is an instinctual humanness. She feels – not intellectualize, explain away, or judge – her emotions for as long as she needs to. Then she moves on. In contrast, I have learned how to expertly squish my difficult emotions where I can ignore, disavow, and numb using myriad socially acceptable behaviors.

I am learning to tolerate distress, not to remain complicit in the current health care system that ignores and gaslights health care workers’ human needs, but to start honoring my own human needs – the ones we preach to our patients – even when it feels uncomfortable to do so, even when I disappoint people, so I can start changing this dehumanizing system, however small of a step at a time.

Here I share some ideas and books that have helped me remain emotionally present to connect with my wiser self:

1. Human needs include more than food, shelter, and minimal sleep. Survival mode is not a virtue. I equated what I needed to stay alive with what I needed to thrive. Residency helped reinforce my distorted subconscious belief that if I could lean into the deprivation and use more willpower, I won’t have any needs. It even seemed to work for a bit. It turns out the body remembers and will revolt sooner or later.

Learn more: What Happened To You? by Dr. Bruce Perry and Oprah Winfrey.

2. Stress is sensed in the mind and stored in the body. When a stressor (e.g., running a code) is sensed, the body may enter fight/flight/freeze mode and initiate an inflammatory cascade to confront the stressor. But when the stressor is eliminated, the body may still feel on edge. Your conscious thoughts (e.g., “the patient is saved”) originate from the brain’s evolved cortex; however, the body speaks a different language because it’s controlled by a much more primal system: the brainstem and autonomic nervous system. Evolutionarily, stress experienced in the body is meant to be processed physically at the time of the stress (e.g., running from a predator), but our industrialized lifestyle isn’t conducive to physically processing this stress, so we mistake taking care of the stressor with processing the physiologic stress itself. After spending many years treating my body like an appendage to my brain, learning to calm my body has been instrumental in helping me calm my mind.

I first heard about this concept from the book Burnout, which emphasizes exercise as the best way to process stress from the body. I have also found the following to be quick and effective:

• Breathwork: conscious breathing patterns can change the state of the autonomic nervous system quickly
• EFT tapping: gentle finger tapping on acupressure points to calm the body/nervous system
• Being outside: focus your senses on the natural world instead of a screen
• Clenching and relaxing your fists and/or stomping your feet

Learn more: Burnout: The Secret to Unlocking the Stress Cycle by Dr. Emily Nagoski and Amelia Nagoski; Waking the Tiger: Healing Trauma by Peter Levine and Ann Frederick

3. Shame is not the same as guilt. Shame researcher Dr. Brené Brown said guilt is “I did something bad”; shame is “I am bad.” She defines shame as the “intensely painful feeling or experience of believing we are flawed and therefore unworthy of love and belonging.” When I notice myself desperately trying to cram just one more non-urgent task into the day, I take a deep breath and ask myself why. Most of the time, I’m trying to avoid – and atone for – my internalized shame and sense of unworthiness.

Learn more: Daring Greatly: How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead and The Gifts of Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are by Dr. Brené Brown.

4. Productivity is a capitalist concept, and capitalism traces its roots directly to slavery. Yet productivity has seeped into our most intimate daily lives, judging us on vacation while having dinner with our family in bed. Hobbies may even feel wasteful unless we monetize them by turning them into a side hustle or building a personal brand.

Our brains evolved from nature, not capitalism. We need unstructured time, rest, and a deep sense of safety in our bones to access our wisest, truest, and most creative self. Exhaustion, however, ensures we keep going along with the system already in place, benefitting those already in power. I don’t have answers, but how could we even begin to imagine something different when we are all trying to get through another day in survival mode? We deserve rest even if we haven’t finished all our work. We deserve rest even if someone doesn’t approve.

Learn more: Rest Is Resistance: A Manifesto by Tricia Hershey.

Xinran Maria Xiang is a pediatric neurologist.