스트레스와 번아웃의 이해 및 관리

### 스트레스 이해 및 관리 의사의 관점
* 하버드 의사이자 작가인 아디티 네루르카 박사는 **건강한 적응형 스트레스와 건강하지 못한 부적응형 스트레스**를 구분하는 것이 중요하다고 강조합니다.
* 🧠 스트레스를 받으면 뇌는 **전전두엽 피질에서 편도체로 이동**하여 투쟁-도피 반응을 촉발하고 내면의 비판자를 증폭시킵니다.
* 어린 시절의 경험과 트라우마는 스트레스 반응을 형성할 수 있지만, **뇌의 신경 가소성은 시간이 지나면서 스트레스를 관리하는 새로운 경로**를 만들 수 있다는 것을 의미합니다.
* 🛑 순간적인 스트레스 관리를 위한 두 가지 핵심 리셋은 **간단한 호흡법(멈추고, 숨 쉬고, 있음)**과 **감사 연습(감사한 일 다섯 가지와 그 이유를 적는 것)**입니다.
* 📈 감사는 **"집중하는 것이 성장한다"는 인지적 재구성**으로 인해 효과적입니다.
* 🧘 네루르카르 박사는 스트레스 관리는 배우고 연습할 수 있는 기술이라고 강조하며 **"스트레스를 줄이고 회복력을 높이기 위해 뇌와 신체를 재구성할 수 있다"**고 강조합니다.
* 🌱 인생의 목표는 스트레스가 전혀 없는 삶을 사는 것이 아닙니다. 사실 생물학적으로 불가능한 일입니다. **스트레스가 해가 되지 않고 도움이 될 수 있도록 건강하고 관리 가능한 스트레스를 받는 삶**을 사는 것이 목표입니다.
* 💬 "스트레스와 피로감을 느끼고 있다면, 내면의 비평가가 끊임없이 귀에 들려온다면 **먼저 혼자가 아니며 자신의 잘못이 아니라는 점**을 이해하세요."

하버드 의사인 아디티 네루르카 박사는 스트레스, 번아웃, 회복탄력성을 전문으로 다루며 더 건강한 삶을 위한 스트레스 관리의 중요성을 강조합니다.

- Stress is a force that is all around us, like gravity. It's a part of our lives, and it's inescapable. There are so many societal perceptions of what stress is and burnout is, and how we are supposed to behave, that we often don't feel a sense of openness in sharing our own struggles, vulnerabilities, or weaknesses. But understand that underneath it all, you are not alone. It is not your fault, and likely, many other people are feeling just like you. I noticed it when I was a clinician in Boston seeing patients in a packed waiting room. No one speaks to each other, but those same patients would come into my exam room, the door would close, and they would burst into tears because of the stigma and taboo about stress and burnout. The goal of life is not to live a life with zero stress; it's in fact biologically impossible to do this.

It's to live a life with
healthy, manageable stress, so stress can serve you
rather than harm you. I'm Dr. Aditi Nerurkar,
a Harvard physician with an expertise in stress, burnout, mental health, and resilience, and the author of The Five Resets: Rewire Your Brain and Body for Less Stress and More Resilience. I became an expert on stress and burnout because I wanted to
become the doctor I needed during a difficult time. I was a medical resident in my second year of medical residency. I was taking care of
everyone else's hearts but not my own in that cardiac ICU. My head would hit the pillow, I'd be exhausted from a long day's work, and I would suddenly have the stampede of wild horses across my chest, and it continued to happen. My doctor did the full medical workup, and everything checked out normal. And so my doctor very
reassuringly with a big smile,

said, Everything's great. It's probably just stress. We've all been there. Just try to relax. My first reaction was, Stress? Stress doesn't happen to people like me. I'm resilient, because I was living the resilience myth as many people are. I was taught at a very young stage of my medical training that pressure makes diamonds, and so as I was moving through medical training working 80 hours a week, I would say to myself whenever there was a difficult moment, Hey, I'm a diamond in the making. And then my diamond cracked, and the resilience myth is that resilient people don't get burned out and don't feel a sense of stress. But in fact, true resilience also honors your boundaries and human limitations. It honors your ability to say no, and it uses a lens of self-compassion. And so I was living the resilience myth because I didn't know any better. And then when I found my way out of stress,

that is when I said, I wanna be the doctor I wish I had back during that difficult time. Not all stress is created equal. In fact, there are two kinds of stress. There is healthy, productive stress. In scientific terms, we say that that is 'adaptive stress.' Getting a new job or a promotion, falling in love. Healthy stress moves your life forward. But when stress goes unchecked and is untamed, dysfunctional, and unproductive, that's when stress goes from being adaptive to maladaptive. And those two are very different when it comes to how they impact your brain and your body. Under normal circumstances, our brain is led by the prefrontal cortex. That's this area right behind your forehead, and that area, the prefrontal cortex, governs things like memory, planning, organization, forward strategic thinking. But under periods of stress, your brain is governed by the amygdala, and your amygdala is focused on survival.

and self-preservation or your fight-or-flight response. Think back to when we were all cave people: You would be in the forest and you would see a tiger. You could either fight the tiger or you could flee. The challenge now is that all of the tigers that we have in the modern day are ongoing and chronic. Bills, relationship constraints, job constraints, or parenting. All of these metaphorical tigers in the modern day make your stress response and the amygdala on in the background at a low hum, chronically. During stress, your inner critic gets a megaphone. Those negative experiences are sticky in the brain like Velcro. Your brain grabs onto those because it's a sense of hypervigilance and your body and brain are trying to keep you safe. And so often there's this tension between that inner critic and that sense of self-agency and self-efficacy.

You want to be able to do new, important, exciting things in your life, and when you reset your stress, you can take that megaphone out
of your inner critic's hand. There are so many false
perceptions about ways that stress can influence you. Unhealthy maladaptive
stress can feel like a sense of constraint on the mind because you are living
in a scarcity mindset. So think about that as you're
moving through your day and moving in the world, that likely the same amount of good and bad is happening at all times. The goal with resetting your stress is to make negative experiences less sticky, moving away from Velcro to Teflon. If you are feeling a sense
of stress and burnout, if that inner critic is
relentless in your ear, understand that first you are not alone and it is not your fault. There is robust data to show that early childhood experiences, particularly adverse events in childhood, can influence your stress response.

throughout your life into adulthood. But it's also important to understand the science of the brain. We used to think that your brain, what you had at birth is
what you have for life- it was like a real grab bag- but now we are learning that
your brain in fact changes, grows, and adapts based
on life's circumstances, situations, and stimulation. And through the process
of 'neuroplasticity,' your brain is constantly regenerating brain cells and circuits. So if you have had a difficult
childhood experience, if you've experienced trauma and you do have an influence
on your stress response, you can over time with
patience and practice, create a new neural pathway for managing your stress and burnout. It is a misconception to think that to decrease your stress and burnout, you need to revamp your whole life. So how can you reset
your stress and burnout in the here and now in the middle of your
messy, over-scheduled

and stressful life? Let's start with these two resets: The first is a breathing exercise, and the second is gratitude. The reason your breath is such a great first step is because your breath is the only physiological process in the body that is under both voluntary and involuntary control. So you can use your breath as a way to tap into your mind-body connection to understand it, and then later influence it to serve you. This is a three-second exercise. Stop, breathe, and be. The instructions are in the name. The first thing you're gonna do is no matter what you're doing, you're just gonna stop. Take a beat and take a pause. Next, you're going to breathe. Take a deep breath in and out, and then you're going to be. Just ground yourself in the here and now in the present moment. When you are feeling a sense of stress and burnout, you're often feeling anxious, and anxiety is a future-focused emotion.

You are on that runaway train of what if thinking. What if this doesn't go well? What if I fail? What if it's a disaster? It's all of this doom and gloom thinking. And stop, breathe, be gets you out of that what if thinking back to what is - in the here and now in the present moment. Gratitude is also a very effective practice. What you wanna do is you wanna write down five things you're grateful for and why. The reason gratitude is so important in reframing your stress and burnout is because it focuses on a scientific principle called 'cognitive reframing.' What you focus on grows. A written gratitude practice at 30, 60, and 90 days has shown to have demonstrated effects in managing your stress, burnout, mood, and resilience. So often when we are feeling a sense of stress, overwhelm, and burnout, there are things in our external world that are happening that are out of our control.

and so we often end up feeling powerless. Learning how to manage
your stress is a skill, just like riding a bike; it's not an innate thing
that we are born with. It is something that you
can teach your brain to do, and it is something that you
can teach yourself to do. You can rewire your brain
and body for less stress and more resilience.

Harvard’s stress expert on how to be more resilient | Dr. Aditi Nerurkar

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스트레스의 이해와 관리 개인적 및 직업적 여정

스트레스는 피할 수 없는 것이며 종종 낙인이 찍히기 때문에 어려움과 취약점을 공유하는 데 있어 개방성이 부족합니다.

하버드 의사인 아디티 네루르카 박사는 건강하고 관리 가능한 스트레스의 중요성을 강조하며 회복력을 위해 뇌를 다시 연결하는 것을 목표로 합니다.

스트레스와 번아웃에 대한 그녀의 전문 지식은 의대 레지던트 시절 자신의 힘든 경험에서 비롯되었으며, 이를 바탕으로 어려운 시기에 필요한 의사가 될 수 있었습니다.

회복탄력성 신화와 스트레스의 실체

발표자는 처음에는 스트레스가 자신에게 영향을 미치지 않는다고 생각하는 '회복탄력성 신화'를 믿었지만 나중에 진정한 회복탄력성을 위해서는 경계를 존중하고 자기 연민을 갖는 것이 중요하다는 것을 깨달았습니다.

스트레스에는 건강하고 생산적인 적응 스트레스와 무절제하고 비생산적인 부적응 스트레스의 두 가지 유형이 있으며, 두뇌와 신체에 미치는 영향은 서로 다릅니다.

스트레스를 받는 동안 뇌는 전전두엽 피질의 주도에서 편도체가 지배하는 방식으로 전환하여 생존을 우선시합니다.

현대인의 스트레스 관리하기: 내면의 비평가와의 싸움

현대 사회의 스트레스는 만성적이며, 뇌의 편도체와 내면의 비평가를 활성화합니다.

지속적인 스트레스는 제약감과 과잉 경계로 이어져 부정적인 경험이 뇌에 고착화됩니다.

스트레스를 재설정하는 것은 자기 주도성을 증진하고 건강에 해로운 스트레스가 마음에 미치는 영향을 줄이는 데 매우 중요합니다.

어린 시절의 경험은 성인이 된 후 스트레스에 대응하는 방식에도 영향을 미치며 자기 연민의 중요성을 강조합니다.

신경 가소성 및 스트레스 관리의 과학

뇌는 스트레스와 번아웃을 관리하기 위한 새로운 신경 경로를 생성하는 능력을 통해 일생 동안 변화하고 적응하는 것으로 알려져 있습니다.

스트레스에 대처하기 위한 두 가지 리셋 방법은 간단한 호흡 운동과 감사 연습으로, 두 가지 모두 심신 연결을 활용하는 데 도움이 될 수 있습니다.

스트레스와 번아웃은 종종 미래에 초점을 맞춘 감정인 불안과 관련이 있지만, 현재의 순간에 집중하면 이러한 감정을 완화하는 데 도움이 될 수 있습니다.

감사로 스트레스와 번아웃 재구성하기

'만약'이라는 생각을 '현재'라는 생각으로 바꾸면 스트레스와 불안을 완화하는 데 도움이 될 수 있습니다.

감사 연습은 스트레스, 번아웃, 기분, 회복탄력성을 관리하는 데 과학적으로 입증된 효과가 있습니다.

스트레스를 관리하는 방법을 배우면 장기적으로 스트레스를 줄이고 회복력을 높일 수 있는 기술을 개발할 수 있습니다.