Burnout: The Secret to Unlocking the Stress Cycle by Emily Nagoski - PDF

 Copyright © 2019 by Emily Nagoski, PhD, and Amelia Nagoski Peterson, DMA All rights reserved. Published in the United States by Ballantine Books, an imprint of Random House, a division of Penguin Random Ho...

 Copyright © 2019 by Emily Nagoski, PhD, and Amelia Nagoski Peterson, DMA All rights reserved. Published in the United States by Ballantine Books, an imprint of Random House, a division of Penguin Random House LLC, New York. BALLANTINE and the HOUSE colophon are registered trademarks of Penguin Random House LLC. LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA Names: Nagoski, Emily, author. | Nagoski, Amelia, author. Title: Burnout : the secret to unlocking the stress cycle / Emily Nagoski, Ph.D. and Amelia Nagoski, DMA. Description: First edition. | New York : Ballantine Books, | Includes bibliographical references and index. Identifiers: LCCN 2018051131 (print) | LCCN 2018054198 (ebook) | ISBN 9781984817075 (ebook) | ISBN 9781984817068 (hardback) Subjects: LCSH: Stress management. | Women—Health and hygiene. | BISAC: SELF-HELP / Stress Management. | HEALTH & FITNESS / Women’s Health. | SOCIAL SCIENCE / Women’s Studies. Classification: LCC RA785 (ebook) | LCC RA785.N35 2019 (print) | DDC 155.9/042—dc23 LC record available at https://lccn.loc.gov/2018051131 Hardback ISBN 9781984817068 International edition ISBN 9781984817808 Ebook ISBN 9781984817075 randomhousebooks.com Book design by Elizabeth A. D. Eno, adapted for ebook Cover design: Faceout Studio Art direction: Joseph Perez v5.4_r1 ep  Contents Cover Title Page Copyright Introduction Part I: What You Take with You 1. Complete the Cycle 2. #Persist 3. Meaning Part II: The Real Enemy 4. The Game Is Rigged 5. The Bikini Industrial Complex Part III: Wax on, Wax Off 6. Connect 7. What Makes You Stronger 8. Grow Mighty Conclusion: Joyfully Ever After Dedication Acknowledgments Notes References About the Authors  INTRODUCTION This is a book for any woman who has felt overwhelmed and exhausted by everything she had to do, and yet still worried she was not doing “enough.” Which is every woman we know—including us. You’ve heard the usual advice over and over: exercise, green smoothies, self- compassion, coloring books, mindfulness, bubble baths, gratitude….You’ve probably tried a lot of it. So have we. And sometimes it helps, at least for a while. But then the kids are struggling in school or our partner needs support through a difficulty or a new work project lands in our laps, and we think, I’ll do the self-care thing as soon as I finish this. The problem is not that women don’t try. On the contrary, we’re trying all the time, to do and be all the things everyone demands from us. And we will try anything—any green smoothie, any deep-breathing exercise, any coloring book or bath bomb, any retreat or vacation we can shoehorn into our schedules—to be what our work and our family and our world demand. We try to put on our own oxygen mask before assisting others. And then along comes another struggling kid or terrible boss or difficult semester. The problem is not that we aren’t trying. The problem isn’t even that we don’t know how. The problem is the world has turned “wellness” into yet another goal everyone “should” strive for, but only people with time and money and nannies and yachts and Oprah’s phone number can actually achieve. So this book is different from anything else you’ll read about burnout. We’ll figure out what wellness can look like in your actual real life, and we’ll confront the barriers that stand between you and your own well-being. We’ll put those barriers in context, like landmarks on a map, so we can find paths around and over and through them—or sometimes just blow them to smithereens. With science.  Who We Are and Why We Wrote Burnout Emily is a health educator with a PhD and a New York Times bestselling book, Come as You Are: The Surprising New Science That Will Transform Your Sex Life. When she was traveling all over talking about that book, readers kept telling her the most life-changing information in the book wasn’t the sex science; it was those sections about stress and emotion processing. When she told her identical twin sister, Amelia, a choral conductor, Amelia blinked like that was obvious. “Of course. Nobody teaches us how to feel our feelings. Hell, I was taught. Any conservatory-trained musician learns to feel feelings singing on stages or standing on podiums. But that didn’t mean I knew how to do it in the real world. And when I finally learned, it probably saved my life,” she said. “Twice,” she added. And Emily, recalling how it felt to watch her sister crying in a hospital gown, said, “We should write a book about that.” Amelia agreed, saying, “A book about that would’ve made my life a lot better.” This is that book. It turned into a lot more than a book about stress. Above all, it became a book about connection. We humans are not built to do big things alone, we are built to work together. That’s what we wrote about, and it’s how we wrote it. IT’S THE EMOTIONAL EXHAUSTION When we told women we were writing a book called Burnout, nobody ever asked, “What’s burnout?” (Mostly what they said was, “Is it out yet? Can I read it?”) We all have an intuitive sense of what “burnout” is; we know how it feels in our bodies and how our emotions crumble in the grip of it. But when it was first coined as a technical term by Herbert Freudenberger in 1975, “burnout” was defined by three components: 1. emotional exhaustion—the fatigue that comes from caring too much, for too long; 2. depersonalization—the depletion of empathy, caring, and  compassion; and 3. decreased sense of accomplishment—an unconquerable sense of futility: feeling that nothing you do makes any difference.1 And here’s an understatement: Burnout is highly prevalent. Twenty to thirty percent of teachers in America have moderately high to high levels of burnout.2 Similar rates are found among university professors and international humanitarian aid workers.3 Among medical professionals, burnout can be as high as 52 percent.4 Nearly all the research on burnout is on professional burnout —specifically “people who help people,” like teachers and nurses—but a growing area of research is “parental burnout.”5 In the forty years since the original formulation, research has found it’s the first element in burnout, emotional exhaustion, that’s most strongly linked to negative impacts on our health, relationships, and work—especially for women.6 So what exactly is an “emotion,” and how do you exhaust it? Emotions, at their most basic level, involve the release of neurochemicals in the brain, in response to some stimulus. You see the person you have a crush on across the room, your brain releases a bunch of chemicals, and that triggers a cascade of physiological changes—your heart beats faster, your hormones shift, and your stomach flutters. You take a deep breath and sigh. Your facial expression changes; maybe you blush; even the timbre of your voice becomes warmer. Your thoughts shift to memories of the crush and fantasies about the future, and you suddenly feel an urge to cross the room and say hi. Just about every system in your body responds to the chemical and electrical cascade activated by the sight of the person. That’s emotion. It’s automatic and instantaneous. It happens everywhere, and it affects everything. And it’s happening all the time—we feel many different emotions simultaneously, even in response to one stimulus. You may feel an urge to approach your crush, but also, simultaneously, feel an urge to turn away and pretend you didn’t notice them. Left to their own devices, emotions—these instantaneous, whole-body reactions to some stimulus—will end on their own. Your attention shifts from your crush to some other topic, and the flush of infatuation eases, until that certain special someone crosses your mind or your path once more. The same goes for the jolt of pain you feel when someone is cruel to you or the flash of disgust when you smell something unpleasant. They just end. In short, emotions are tunnels. If you go all the way through them, you get to the light at the end. Exhaustion happens when we get stuck in an emotion. We may get stuck simply because we’re constantly being exposed to situations that activate emotion—our crush is there, all day, every day, even if only in our thoughts, and so we’re trapped in our own longing. Or we return to our stressful job every single day. No wonder “helping professions” are so exhausting—you’re confronted with people in need, all day, day after day. No wonder parenting is so exhausting—once you’re a parent, you’re never not a parent. You’re always going through the tunnel. Sometimes we get stuck because we can’t find our way through. The most difficult feelings—rage, grief, despair, helplessness—may be too treacherous to move through alone. We get lost and need someone else, a loving presence, to help us find our way. And sometimes we get stuck because we’re trapped in a place where we are not free to move through the tunnel. Many of us are trapped in just this way, because of a problem we call “Human Giver Syndrome.” HUMAN GIVER SYNDROME In Down Girl: The Logic of Misogyny, philosopher Kate Manne describes a system in which one class of people,7 the “human givers,” are expected to offer their time, attention, affection, and bodies willingly, placidly, to the other class of people, the “human beings.”8 The implication in these terms is that human beings have a moral obligation to be or express their humanity, while human givers have a moral obligation to give their humanity to the human beings. Guess which one women are. In day-to-day life, the dynamic is more complicated and subtle, but let’s imagine the cartoon version: The human givers are the “attentive, loving subordinates” to the human beings.9 The givers’ role is to give their whole humanity to the beings, so that the beings can be their full humanity. Givers are expected to abdicate any resource or power they may happen to acquire—their jobs, their love, their bodies. Those belong to the beings.  Human givers must, at all times, be pretty, happy, calm, generous, and attentive to the needs of others, which means they must never be ugly, angry, upset, ambitious, or attentive to their own needs. Givers are not supposed to need anything. If they dare to ask for or, God forbid, demand anything, that’s a violation of their role as a giver and they may be punished. And if a giver doesn’t obediently and sweetly hand over whatever a being wants, for that, too, the giver may be punished, shamed, or even destroyed. If we had set out to design a system to induce burnout in half the population, we could not have constructed anything more efficient. Emotional exhaustion happens when we get stuck in an emotion and can’t move through the tunnel. In Human Giver Syndrome, the giver isn’t allowed to inconvenience anyone with anything so messy as emotions, so givers are trapped in a situation where they are not free to move through the tunnel. They might even be punished for it. Your body, with its instinct for self-preservation, knows, on some level, that Human Giver Syndrome is slowly killing you. That’s why you keep trying mindfulness and green smoothies and self-care trend after self-care trend. But that instinct for self-preservation is battling a syndrome that insists that self- preservation is selfish, so your efforts to care for yourself might actually make things worse, activating even more punishment from the world or from yourself, because how dare you? Human Giver Syndrome is our disease. The book you’re reading is our prescription.  How the Book Is Organized We’ve divided Burnout into three parts. Part I is “What You Take with You.” In the Star Wars movie Episode V: The Empire Strikes Back, Luke Skywalker sees an evil cave. Looking toward the entrance in dread, he asks his teacher Yoda, “What’s in there?” Yoda answers, “Only what you take with you.” This beginning section of the book explains three internal resources that we carry with us as we take our heroine’s journey: the stress response cycle, “the Monitor” (the brain mechanism that controls the emotion of frustration), and meaning in life. Meaning is often misunderstood as “the thing we’ll find at the end of the tunnel,” but it’s not. It’s why we go through the tunnel, regardless of what we find on the other end. (Spoiler alert: meaning is good for us.) Which brings us to Part II. We call it “The Real Enemy.” That’s a reference to The Hunger Games, in which young Katniss Everdeen is forced into a “game” organized by the dystopian sci-fi government, in which she has to kill other children. Her mentor says to her, “Remember who the real enemy is.” It’s not the people the government wants her to kill, and who are trying to kill her. The real enemy is the government that set this whole system up in the first place. Can you guess what the enemy is in this book? [Cue ominous music] The Patriarchy. Ugh. Most self-help books for women leave this chapter out and instead discuss only the things readers can control, but that’s like teaching someone the best winning strategy of a game without mentioning that the game is rigged. Fortunately, when we understand how the game is rigged, we can start playing by our own rules. And then Part III—the thrilling conclusion—is the science of winning the war against these “real enemies.” It turns out there are concrete, specific things we can do each and every day, to grow mighty and conquer the enemy. We call this part “Wax On, Wax Off.” In the original Karate Kid movie, Mr. Miyagi teaches Danny LaRusso karate by having the kid wax his car. “Wax on,” says Mr. Miyagi, rotating his palm clockwise. “Wax off,” he says, rotating his other palm counterclockwise, and he adds, “Don’t forget to breathe.” He also has Danny sand the deck, stain the fence, and paint the house. Why the repetitive, mundane tasks? Because in the mundane tasks live the protective gestures that help us grow strong enough to defend ourselves and the people we love, and to make peace with our enemies. “Wax on, wax off” is what makes you stronger: connection, rest, and self- compassion. Throughout the book, you’ll follow the stories of two women: Julie, an overwhelmed public school teacher whose body will revolt against her, forcing her to pay attention to it; and Sophie, an engineer who will decide she is not here for the patriarchy.These women are composites: In the same way a movie is made of thousands of still images, edited together to tell a story, they are composed of fragments of dozens of real-life women. We’re using this technique partly to protect the identities of the real women and partly because this larger narrative arc more effectively explains the science than stand-alone vignettes can. The research doesn’t come close to addressing every woman’s experience, but we hope that these stories will give you that sense of how each individual’s experience is unique and yet, at the same time, universal. And each chapter ends with a “tl;dr” list. Tl;dr is the Internet abbreviation for “too long; didn’t read.” If you write a five-hundred-word post on Facebook or a multiparagraph comment on Instagram, someone may well reply, “tl;dr.” Our tl;dr lists contain the ideas you can share with your best friend when she calls you in tears, the facts you can use to disprove myths when they come up in conversation, and the thoughts we hope come to you when your racing mind keeps you awake at night. A CAVEAT OR TWO ABOUT SCIENCE In this book, we use science as a tool to help women live better lives. We’ve turned to diverse domains of science, including affective neuroscience, psychophysiology, positive psychology, ethology, game theory, computational biology, and many others. So a few words of caution about science. Science is the best idea humanity has ever had. It’s a systematic way of exploring the nature of reality, of testing and proving or disproving ideas. But it’s important to remember that science is ultimately a specialized way of being wrong. That is, every scientist tries to be (a) slightly less wrong than the scientists who came before them, by proving that something we thought was true actually isn’t, and (b) wrong in a way that can be tested and proven, which results in the next scientist being slightly less wrong. Research is the ongoing process of learning new things that show us a little more of what’s true, which inevitably reveals how wrong we used to be, and it is never “finished.” So whenever you read a headline like “New Study Shows…” or “Latest Research Finds…,” read with skepticism. One study does not equal proof of anything. In Burnout, we’ve aimed to use ideas that have been established over multiple decades and reinforced by multiple approaches. Still, science doesn’t offer perfect truth, only the best available truth. Science, in a sense, is not an exact science. A second caveat: Social science is generally done by measuring lots of people and assessing the average measurement of all those people, because people vary. Just because something is true about a group of people—like, American women are, on average, five feet four inches tall—doesn’t mean it’s true about any specific individual within that group. So if you meet an American woman who isn’t five foot four, there’s nothing wrong with her, she’s just different from the average. And there’s nothing wrong with the science, either; it’s true that women are, on average, five foot four—but that tells us nothing in particular about any specific woman we may meet. So if you read some science in this book that describes “women” but doesn’t describe you, that doesn’t mean the science is wrong and it doesn’t mean there’s something wrong with you. People vary, and they change. Science is too blunt an instrument to capture every woman’s situation. A third caveat: Science is often expensive, and who pays for it can influence the outcome and whether or not the results are published. As enthusiastic as we are about evidence-based practices, it’s important to remember where that evidence comes from and why we might not see contrary evidence.10 Science has a fourth specific limitation worth mentioning in a book about women: When a research article says it studied “women,” it almost always means it studied people who were born in a body that made all the grown-ups around them say, “It’s a girl!” and then that person was raised as a girl and grew into an adult who felt comfortable in the psychological identity and social role of “woman.” There are plenty of people who identify as women for whom at least one of those things is not true, and there are plenty of people who don’t identify as women, for whom one or more of those things is true. In this book, when we use the word “woman,” we mostly mean “people who identify as women,” but it’s important to remember that when we describe the science, we’re limited to the women who were identified at birth and raised as women, because that’s mostly who has been studied. (Sorry.) So. We try to be as science-based as we can be, but we’re aware of its limits. That’s where the art comes in. As science fiction author Cassandra Clare writes, “Fiction is truth, even if it is not fact.” This is what storytelling is for—and in fact research has found that people understand science better when it’s communicated through storytelling! So side by side with the neuroscience and computational biology, we’ll talk about Disney princesses, sci-fi dystopias, pop music, and more, because story goes where science can’t. THE OWL AND THE CHEESE Here’s a real study that real scientists really conducted:11 Research participants were given some mazes—just lines on paper—and instructed that their goal was to get the cartoon mouse from one side of the maze to the other. In one version of the maze, a cartoon owl loomed over the page, hunting the mouse. In another version, a morsel of cheese awaited the mouse at its destination. Which group completed the maze faster, the ones who were moving toward the cheese, or the ones who were fleeing from the owl? The cheese group. Participants completed more mazes, more quickly, when their imaginations were propelled toward a reward even as mild as cartoon cheese, than when running away from an uncomfortable state even as subtle as the threat of a cartoon owl. It makes perfect sense when you think about it. If you’re moving toward a specific, desired goal, your attention and efforts are focused on that single outcome. But if you’re moving away from a threat, it hardly matters where you end up, as long as it’s somewhere safe from the threat. The moral of the story is: We thrive when we have a positive goal to move toward, not just a negative state we’re trying to move away from. If we hate where we are, our first instinct often is to run aimlessly away from the owl of our present circumstances, which may lead us somewhere not much better than where we started. We need something positive to move toward. We need the cheese. The “cheese” of Burnout isn’t just feeling less overwhelmed and exhausted, or no longer worrying whether you’re doing “enough.” The cheese is growing mighty, feeling strong enough to cope with all the owls and mazes and anything else the world throws at you. Our promise to you is this: Wherever you are in your life, whether you’re struggling in a pit of despair and searching for a way out, or you’re doing great and want tools to grow mightier, you will find something important in these pages. We’ll show you science that proves you’re normal and you’re not alone. We’ll offer evidence-based tools to use when you’re struggling and that you can share with people you love when they’re struggling. We’ll surprise you with science that contradicts the “commonsense” knowledge you’ve spent your whole life believing. And we’ll inspire and empower you to create positive change in your own life and the lives of those you love. Writing this book did all of these things for us—showed us we’re normal and we’re not alone, taught us important skills to use when we’re struggling, and surprised us and empowered us. It has already changed our lives, and we think it will change yours, too.  PART I What You Take with You  1 COMPLETE THE CYCLE “I’ve decided to start selling drugs so I can quit my job.” This is how Amelia’s friend Julie recently answered the question “How are you?” the Saturday before the new school year started. She was kidding, of course…except she wasn’t. She’s a middle school teacher. Her burnout had reached an intensity where merely the anticipation of the start of the first semester had activated a level of dread that left her reaching for the box of Chardonnay by 2 P.M. Nobody likes to think of their kids’ middle school teacher as burned out, embittered, and day-drinking, but she’s not alone. Burnout—with its cynicism, sense of helplessness, and, above all, emotional exhaustion—is startlingly ubiquitous. “I saw that story about the teacher who showed up on the first day of school drunk with no pants, and I thought, ‘There but for the grace of God go I,’ ” Julie told Amelia, from the bottom of her first glass. “Dread is anxiety on steroids,” Amelia said, remembering her own days teaching middle school music, “and the anxiety comes from the accumulation, day after day, of stress that never ends.” “Yes,” Julie declared, filling her glass again. “The thing about teaching is, you can’t ever get rid of the causes of the stress,” Amelia said. “And I don’t mean the kids.” “Right?” Julie agreed. “The kids are why I’m there. It’s the administration and the paperwork and that crap.” “And you can’t get rid of those kinds of stressors,” Amelia said,  “but you can get rid of the stress itself, when you know how to complete the stress response cycle.” “Yes,” Julie said again, emphatically. Then she said, “What do you mean, ‘complete the cycle’?” — This chapter is the answer to Julie’s question, and it might be the most important idea in the book: Dealing with your stress is a separate process from dealing with the things that cause your stress. To deal with your stress, you have to complete the cycle. “Stress” Let’s start by differentiating our stress from our stressors. Stressors are what activate the stress response in your body. They can be anything you see, hear, smell, touch, taste, or imagine could do you harm. There are external stressors: work, money, family, time, cultural norms and expectations, experiences of discrimination, and so on. And there are less tangible, internal stressors: self-criticism, body image, identity, memories, and The Future. In different ways and to different degrees, all of these things may be interpreted by your body as potential threats. Stress is the neurological and physiological shift that happens in your body when you encounter one of these threats. It’s an evolutionarily adaptive response that helps us cope with things like, say, being chased by a lion or charged by a hippo.1 When your brain notices the lion (or hippo), it activates a generic “stress response,” a cascade of neurological and hormonal activity that initiates physiological changes to help you survive: epinephrine acts instantly to push blood into your muscles, glucocorticoids keep you going, and endorphins help you ignore how uncomfortable all of this is. Your heart beats faster, so your blood pumps harder, so your blood pressure increases and you breathe more quickly (measures of cardiovascular functioning are a common way researchers study stress).2 Your muscles tense; your sensitivity to pain diminishes; your attention is alert and vigilant, focusing on short-term, here-and-now thinking; your senses are heightened; your memory shifts to channel its functioning to the narrow band of experience and knowledge most immediately relevant to this stressor. Plus, to maximize your body’s efficiency in this state, your other organ systems get deprioritized: Your digestion slows down and your immune functioning shifts (measures of immune function are another common way researchers study stress).3 Ditto growth and tissue repair, as well as reproductive functioning. Your entire body and mind change in response to the perceived threat. And so here comes the lion. You are flooded with stress response. What do you do? You run. You see, this complex, multisystem response has one primary goal: to move oxygen and fuel into your muscles, in anticipation of the need to escape. Any process not relevant to that task is postponed. As Robert Sapolsky puts it, “For us vertebrates, the core of the stress-response is built around the fact that your muscles are going to work like crazy.”4 So you run. And then? Well, then there are only two possible outcomes: either you get eaten by the lion (or trampled by the hippo—in either case, none of the rest of this matters) or else you escape! You survive! You run back to your village, the lion chasing you all the while, and you shout for help! Everyone comes out and helps you slaughter the lion—you’re saved! Yay! You love your friends and family! You’re grateful to be alive! The sun seems to shine more brightly as you relax into the certain knowledge that your body is a safe place to be. Together, the village cooks a lot of the lion and shares a communal feast, and then you all bury the parts you can’t use, in an honoring ceremony. Hand in hand with the people you love, you take a deep, relaxing breath and give thanks to the lion for its sacrifice. Stress response cycle complete, and we all live happily ever after. Just Because You’ve Dealt with the Stressor Doesn’t Mean You’ve Dealt with the Stress Itself Our stress response is beautifully fitted to the environment where it evolved. The behavior that dealt with a lion was the behavior that completed the stress response cycle. And that makes it easy to assume that it’s the elimination of the lion—the cause of the stress—that completed the cycle. But no. Suppose you were running away from the lion, when it’s struck by lightning! You turn and see the dead lion, but do you suddenly feel peaceful and relaxed? No. You stop, puzzled, heart pounding, eyes darting in search of the threat. Your body still wants to run or fight or hide in a cave and cry. The threat may have been dealt with by an act of God, but you’re left still needing to do something to let your body know you’re safe. The stress response cycle needs to complete, and just eliminating the stressor isn’t enough to do that. So maybe you run back to your village and breathlessly tell your tribe what happened, and you all jump up and down and cheer and thank God for the lightning bolt. Or a modern example: Suppose the lion charges—it’s coming right for you! Adrenaline and cortisol and glycogen, oh my! And so, thinking quickly, you grab your rifle and shoot the lion, to save your own life. Bang. The lion drops dead. Now what? The threat is gone, but again your body is still in full action mode, because you haven’t done anything your body recognizes as a cue that you are safe. Your body is stuck in the middle of the stress response. Just telling yourself, “You’re safe now; calm down,” doesn’t help. Even seeing the dead lion isn’t enough. You have to do something that signals to your body that you are safe, or else you’ll stay in that state, with neurochemicals and hormones degrading but never shifting into relaxation. Your digestive system, immune system, cardiovascular system, musculoskeletal system, and reproductive system never get the signal that they’re safe. But wait, there’s more: Suppose the stressor is not a lion, but some jerk at work. This jerk will never be a threat to our lives, he’s just a pain in the ass. He says some jerky thing at a meeting, and you get a similar flood of adrenaline and cortisol and glycogen, oh my.5 But you have to sit there in that meeting and be “nice.” “Socially appropriate.” It would only escalate the situation if you vaulted across the table and scratched his eyes out, as your physiology is telling you to do. Instead, you have a quiet, socially appropriate, highly functional meeting with his supervisor, in which you recruit the supervisor’s support in intervening the next time the jerk says another jerky thing. Congratulations! But addressing the cause of the stress doesn’t mean you’ve addressed the stress itself. Your body is soaked in stress juice, just waiting for some cue that you are now safe from the potential threat and can relax into celebration. And it happens day after day…after day. Let’s think about what this does to just one system, the cardiovascular: Chronically activated stress response means chronically increased blood pressure, which is like constantly turning a firehose on in your blood vessels, when those vessels were designed by evolution to handle only a gently flowing stream. The increased wear and tear on your blood vessels leads to increased risk for heart disease. That’s how chronic stress leads to life-threatening illness. And this happens, remember, in every organ system in your body. Digestion. Immune functioning. Hormones. We are not built to live in that state. If we get stuck there, the physiological response intended to save us can instead slowly kill us. This is the upside-down world we live in: in most situations in the modern, post-industrial West, the stress itself will kill you faster than the stressor will —unless you do something to complete the stress response cycle. While you’re managing the day’s stressors, your body is managing the day’s stress, and it is absolutely essential to your well-being—the way sleeping and eating are absolutely essential—that you give your body the resources it needs to complete the stress response cycles that have been activated. Before we talk about how to do that, let’s talk about why we aren’t already doing it. Why We Get Stuck There are lots of reasons why the cycle might not complete. These are the three we see most often: 1. Chronic Stressor → Chronic Stress. Sometimes your brain activates a stress response, you do the thing it says, and it doesn’t change the situation: “Run!” it says, when you’re confronted by a terrifying project—speaking in front of a group of your peers, say, or writing a giant report or interviewing for a job. So you “run,” in your twenty-first-century way: when you get home that day, you put on Beyoncé and dance it out for half an hour. “We escaped the lion!” your brain says, breathless and grinning. “Self high five!” And you’re rewarded with all kinds of feel-good brain chemicals. And then tomorrow…the terrifying project is still there. “Run!” your brain says again. And the cycle begins again. We get stuck in the stress response, because we’re stuck in a stress-activating situation. That’s not always bad—it’s only bad when the stress outpaces our capacity to process it. Which, alas, is a lot of the time, because… 2. Social Appropriateness. Sometimes the brain activates a stress response and you can’t do the thing it’s trying to tell you to do: “Run!” it says, pumping out adrenaline for you. “I can’t!” you say. “I’m in the middle of an exam!” Or, “Punch that asshole in the face!” it says, dumping glucocorticoids into your bloodstream. “I can’t!” you say. “He’s my client!” So you sit politely and smile benignly and do your best, while your body stews in stress juice, waiting for you to do something. And sometimes the world tells you it’s wrong to feel that stress—wrong for so many reasons, in so many ways. It’s not nice; it’s weak; it’s impolite. Many of us were raised to be “good girls,” to be “nice.” Fear and anger and other uncomfortable emotions can cause distress in the people around you, so it’s not nice to feel those things in front of other people. We smile and ignore our feelings, because our feelings matter less than the other person’s. And also it’s weak to feel those feelings, our culture has taught us. You’re a smart, strong woman, so when you’re walking down the street and a guy shouts, “Nice tits!” you tell yourself to ignore it. You tell yourself you’re not in danger, it’s irrational to feel angry or afraid, and anyway, that guy isn’t worth it, he doesn’t matter. Meanwhile, your brain shouts, “Gross!” and makes you walk faster. “What?” the guy who isn’t worth it calls after you. “Can’t you take a compliment?”  “Just ignore it,” you tell yourself, swallowing the adrenaline. “You’re too strong to be affected by this.” But it’s not just that it’s not nice, and it’s not just that it’s weak, it’s that it’s impolite, we’re taught. When your cousin posts a misogynistic comment on Facebook, you could YELL AT HIM FOR REPEATING NONSENSE THAT IS NOT MERELY FACTUALLY INCORRECT BUT ALSO MORALLY WRONG OMFG I CAN’T BELIEVE I EVEN STILL HAVE TO SAY THESE THINGS. Then he—and probably several other people—will respond that you might have a point, but he can’t listen to you when you’re so shrill. So angry. You need to make your point more politely if you want to be taken seriously. Be nice, be strong, be polite. No feelings for you. 3. It’s Safer. Is there a strategy for dealing with, say, street harassment, that deals with both the situation and the stress caused by the situation? Sure. Turn around and slap that guy in the face. But then what? Will he suddenly realize that street harassment is bad and thus stop doing it? Probably not. More likely, the situation will escalate and he’ll hit you, in which case it just got way more dangerous. Sometimes walking away is the win. Smiling and being nice, ignoring it and telling yourself it doesn’t matter—these are survival strategies. Use them with pride. Just don’t forget that these survival strategies do not deal with the stress itself. They postpone your body’s need to complete the cycle; they don’t replace it. — So many ways to deny, ignore, or suppress your stress response! For all these reasons and more, most of us are walking around with decades of incomplete stress response cycles simmering away in our chemistry, just waiting for a chance to complete. And then there’s freeze. Freeze We’ve been talking about the stress response in the familiar terms of “fight or flight.” When you feel threatened, the brain does a split-second assessment to determine which response is more likely to result in your survival. Flight happens when your brain notices a threat and decides that you’re more likely to survive by trying to escape. That’s what happens when you run from a lion. Fight happens when your brain decides you’re more likely to survive the threat by trying to conquer it. From a biological point of view, fight and flight are essentially the same thing. Flight is fear—avoidance—whereas fight is anger— approach—but they’re both the “GO!” stress response of the sympathetic nervous system. They tell you to do something. Freeze is special. Freeze happens when the brain assesses the threat and decides you’re too slow to run and too small to fight, and so your best hope for survival is to “play dead” until the threat goes away or someone comes along to help you. Freeze is your last-ditch stress response, reserved for threats that the brain perceives as life-threatening, when fight or flight don’t stand a chance. In the middle of the gas pedal of stress response, your brain slams on the brakes— the parasympathetic nervous system swamping the sympathetic—and you shut down. Imagine you’re a gazelle running away from a lion. You’re midflight, full of adrenaline—but you feel the lion’s teeth chomp into your hip. What do you do? You can’t run anymore—the lion has hold of you. You can’t fight—the lion is much stronger. So your nervous system slams on the brakes. You collapse and play dead. That’s freeze. You don’t have to know about freeze in order for your brain to choose it, but if you don’t know that freeze exists, you may think about a circumstance where you were unsafe and wonder why you didn’t kick and scream, why you didn’t fight or run—why, in fact, you felt as if you couldn’t scream or kick or run. The reason is that you really couldn’t. Your brain was trying to keep you alive in the face of a threat that seemed unsurvivable, so it slammed on the brakes in a last- ditch attempt to do that. And you know what? It worked. Here you are. Alive and reading a book about stress. Hello! We’re really glad you’re here. We’re grateful to your brain for keeping you alive. “THE FEELS” Our culture gives us a lot of ways to describe what it feels like when your brain chooses the “Go!” stress responses. When your brain chooses fight, you may feel irritated, annoyed, frustrated, angry, irate, or enraged. When it chooses flight, we have words to describe that feeling: unsure, worried, anxious, scared, frightened, or terrified. But what are the words that describe the emotion of “freeze”? Words that might feel right: Shut down. Numb. Immobilized. Disconnected. Petrified. The very word sympathetic means “with emotion,” while parasympathetic—the system that controls freeze—means “beyond emotion.” You may feel disengaged from the world, sluggish, like you don’t care or nothing matters. You feel…outside. If we don’t have a good word to describe the experience of freeze, we really don’t have a good word to describe what comes next: After a gazelle freezes in response to a lion attack, the lion, feeling smug, wanders off to get her cubs so they can feed on the gazelle. And that’s when the magic happens: Once the threat is gone, the brake gradually eases off, and the gazelle begins to shake and shudder. All the adrenaline and cortisol built up in her bloodstream get purged through this process, the same way running to safety purges those chemicals. It happens in all mammals. One woman, when she learned about freeze, told us, “So that’s what happened to a cat I accidentally hit with my car—she was just lying there and I was terrified she was dead; I felt terrible. Then she started twitching and shaking and I thought she was having a seizure, until it was like she woke up…and then ran away.” It happens to humans, too. People have told us, “That happened to my friend, when she was coming out from under anesthesia after surgery.” And, “My kid went through that in the emergency room.” And, “When I was coming to terms with a trauma I experienced, sometimes my body would go into this state where I felt out of control, and it scared me because I felt out of control during the trauma itself. Now I know it was actually my body taking care of me; it was part of my healing.” We don’t have words for the experience of having the brake  come off—the shaking, shuddering, muscle-stretching, involuntary response that is often accompanied by waves of rage, panic, and shame. If you don’t know what it is, it can feel scary. You might try to fight it or control it. That’s why it’s so important that we give it a name: We call it “the Feels,” and it’s nothing to fear. It’s a normal, healthy part of completing the cycle, a physiological reaction that will end on its own, usually lasting just a few minutes. Feels usually happen in extreme cases where the stress response cycle is interrupted suddenly and not allowed to complete. It’s part of the healing process following a traumatic event or long-term, intense stress. Trust your body. The sensations may bring awareness of their origins, or they may not; doesn’t matter. Awareness and insight are not required in order for the Feels to move through you and out of you. Crying for no apparent reason? Great! Just notice any apparently causeless emotions or sensations or trembling and say, “Ah. There’s some Feels.” The Most Efficient Way to Complete the Cycle When you’re being chased by a lion, what do you do? You run. When you’re stressed out by the bureaucracy and hassle of living in the twenty-first century, what do you do? You run. Or swim. Or dance around your living room, singing along to Beyoncé, or sweat it out in a Zumba class, or do literally anything that moves your body enough to get you breathing deeply. For how long? Between twenty and sixty minutes a day does it for most folks. And it should be most days—after all, you experience stress most days, so you should complete the stress response cycle most days, too. But even just standing up from your chair, taking a deep breath, and tensing all your muscles for twenty seconds, then shaking it out with a big exhale, is an excellent start. Remember, your body has no idea what “filing your taxes” or “resolving an interpersonal conflict through rational problem-solving” means. It knows, though, what jumping up and down means. Speak its language—and its language is body language. You know how everyone says exercise is good for you? That it helps with stress and improves your health and mood and intelligence and basically you should definitely get some?6 This is why. Physical activity is what tells your brain you have successfully survived the threat and now your body is a safe place to live. Physical activity is the single most efficient strategy for completing the stress response cycle. Other Ways to Complete the Cycle Physical activity—literally any movement of your body—is your first line of attack in the battle against burnout. But it’s not the only thing that works to complete the stress response cycle—far from it! Here are six other evidence- based strategies: Breathing. Deep, slow breaths downregulate the stress response—especially when the exhalation is long and slow and goes all the way to the end of the breath, so that your belly contracts. Breathing is most effective when your stress isn’t that high, or when you just need to siphon off the very worst of the stress so that you can get through a difficult situation, after which you’ll do something more hardcore. Also, if you’re living with the aftermath of trauma, simply breathing deeply is the gentlest way to begin unlocking from the trauma, which makes it a great place to start. A simple, practical exercise is to breathe in to a slow count of five, hold that breath for five, then exhale for a slow count of ten, and pause for another count of five. Do that three times—just one minute and fifteen seconds of breathing—and see how you feel. Positive Social Interaction. Casual but friendly social interaction is the first external sign that the world is a safe place. Most of us expect we’ll be happier if, say, our seatmate on a train leaves us alone, in mutual silence; turns out, people experience greater well-being if they’ve had a polite, casual chat with their seatmate.7 People with more acquaintances are happier.8 Just go buy a cup of coffee and say “Nice day” to the barista. Compliment the lunch lady’s earrings. Reassure your brain that the world is a safe, sane place, and not all people suck. It helps! Laughter. Laughing together—and even just reminiscing about the times we’ve laughed together—increases relationship satisfaction.9 We don’t mean social or “posed” laughter, we mean belly laughs—deep, impolite, helpless laughter. When we laugh, says neuroscientist Sophie Scott, we use an “ancient evolutionary system that mammals have evolved to make and maintain social bonds and regulate emotions.”10 Affection. When friendly chitchat with colleagues doesn’t cut it, when you’re too stressed out for laughter, deeper connection with a loving presence is called for. Most often, this comes from some loving and beloved person who likes, respects, and trusts you, whom you like, respect, and trust. It doesn’t have to be physical affection, though physical affection is great; a warm hug, in a safe and trusting context, can do as much to help your body feel like it has escaped a threat as jogging a couple of miles, and it’s a heck of a lot less sweaty. One example of affection is the “six-second kiss” advice from relationship researcher John Gottman. Every day, he suggests, kiss your partner for six seconds. That’s one six-second kiss, mind you, not six one-second kisses. Six seconds is, if you think about it, a potentially awkwardly long kiss. But there’s a reason for it: Six seconds is too long to kiss someone you resent or dislike, and it’s far too long to kiss someone with whom you feel unsafe. Kissing for six seconds requires that you stop and deliberately notice that you like this person, that you trust them, and that you feel affection for them. By noticing those things, the kiss tells your body that you are safe with your tribe. Another example: Hug someone you love and trust for twenty full seconds, while both of you are standing over your own centers of balance. Most of the time when we hug people, it’s a quick, lean-in type hug, or it might be a longer hug where you each lean on each other, so that if one person lets go, the other person would fall over. Instead, support your own weight, as your partner does the same, and put your arms around each other. Hold on. The research suggests a twenty-second hug can change your hormones, lower your blood pressure and heart rate, and improve mood, all of which are reflected in the post-hug increase in the social-bonding hormone oxytocin.11 Like a long, mindful kiss, a twenty-second hug can teach your body that you are safe; you have escaped the lion and arrived home, safe and sound, to the people you love. Of course, it doesn’t have to be precisely twenty seconds. What matters is that you feel the shift of the cycle completing. Therapist Suzanne Iasenza describes it as “hugging until relaxed.” Happily, our capacity to complete the cycle with affection doesn’t stop with other human beings. Just petting a cat for a few minutes can lower your blood pressure, and pet owners often describe their attachment to their pets as more supportive than their human relationships.12 No wonder people who walk their dogs get more exercise and feel better than people who don’t—they’re getting exercise and affection at the same time.13 And for people whose experiences have taught them that no one is trustworthy, therapies with horses, dogs, and other animals can open a door to the power of connection. Our capacity to complete the cycle with affection doesn’t even stop at connection with mundane life on Earth. Often when researchers examine the role of spirituality in a person’s well-being, they talk about “meaning in life”—which is so important we’ve got a whole chapter on it (chapter 3)—or about the social support provided by fellow members of a religious community. But a spiritual connection is also about feeling safe, loved, and supported by a higher power. In short, it’s about feeling connected to an invisible yet intensely tangible tribe.14 A Big Ol’ Cry. Anyone who says “Crying doesn’t solve anything” doesn’t know the difference between dealing with the stress and dealing with the situation that causes the stress. Have you had the experience of just barely making it inside before you slam the door behind you and burst into tears for ten minutes? Then you wipe your nose, sigh a big sigh, and feel relieved from the weight of whatever made you cry? You may not have changed the situation that caused the stress, but you completed the cycle. Have a favorite tearjerker movie that makes you cry every time? You know exactly when to grab the tissues and sniff, “I love this part!” Going through that emotion with the characters allows your body to go through it, too. The story guides you through the complete emotional cycle. Creative Expression. Engaging in creative activities today leads to more energy, excitement, and enthusiasm tomorrow.15 Why? How? Like sports, the arts—including painting, sculpture, music, theater, and storytelling in all forms—create a context that tolerates, even encourages, big emotions. In the first flush of romantic love, for example, all those songs on the radio suddenly make sense! And those songs keep us company even when our friends are rolling their eyes and sick of hearing about how in love we are. And when we are heartbroken, there’s a playlist to lead us through the tunnel of our grief and keep us company as we move through it, to a place of peace. In this way, literary, visual, and performing arts of all kinds give us the chance to celebrate and move through big emotions. It’s like a cultural loophole in a society that tells us to be “nice” and not make waves. Take advantage of the loophole. Writers and painters and creators of all kinds have said the same thing one Nashville songwriter told us: “Looking back at my very first songs, it’s completely obvious that I was dealing with my past, and trying to process my trauma history into something meaningful. At the time, I was completely in denial—I didn’t even know I had pain. But writing songs helped me feel what my mind had hidden from me. My songs were a safe place to put what I couldn’t deal with otherwise.”16 Sophie is an engineer and a Star Trek geek and a lot of other things, but she is not an athlete. In high school, people saw a six- foot-one black girl and told her she should play basketball, and she told them where they could put their basketball. She hates exercise. She will not exercise. In fact, if she ever tries to exercise, after a few days she inevitably comes down with something or is injured, or a project comes up that means she doesn’t have time anymore. She can’t exercise. Can’t. Hates it, can’t do it, won’t do it. So when Emily visited her office to lead a lunchtime seminar about stress and said, “Exercise is good for you,” Sophie approached her afterward. “You don’t understand, Emily. It’s boring and painful and every time I do it, something goes wrong. I can’t, I won’t, I don’t want to, just no. No. I’m not going to exercise. I don’t care how good it is for my stress.” Not everyone is a natural exerciser. But the research is so unambiguous that exercise is good for you that, as a health educator, Emily has searched for ways to support people who can’t exercise or hate exercise or just don’t exercise, for whatever reason. When she looked at the research, to her astonishment, most of the conclusions said things like “Join a team sport” or “Make it a hobby, not just exercise!” In other words, the advice said, “Find a way to enjoy exercise!” Which is good advice, but not for someone with chronic pain or illness, injury or disability, or someone like Sophie who will. Not. Exercise. But then Emily found a remarkable branch of research on body- based therapies, whose results she applies to folks like Sophie. Here’s what Emily suggested. “Okay, so just lie in bed—” “My favorite sport,” Sophie said. “Then just progressively tense and release every muscle in your body, starting with your feet and ending with your face. Tense them hard, hard, hard, for a ssslllooowww count of ten. Make sure you spend extra time tensing the places where you carry your stress.” “Shoulders,” Sophie said instantly. “Super! And while you do that, you visualize, really clearly and viscerally, what it feels like to beat the living daylights out of whatever stressor you’ve encountered.” “Okay,” Sophie said with some enthusiasm. “Imagine it really clearly, though—that matters a lot. You should notice your body responding, like your heart beating faster and your fists clenching, until you reach a satisfying sense of—” “Victory,” Sophie said. “I got this.” She did. And strange things started to happen. Sometimes, when she was doing the muscle-tension activity, she felt inexplicable waves of frustration and anger. Occasionally, she’d cry. Sometimes her body would seem to take over and shake and shudder in strange ways, as if she were possessed. She emailed Emily about it. “Totally normal,” Emily assured her. “That’s your baggage unpacking itself. All those incomplete stress response cycles that have built up inside you are finally releasing. Trust your body.” — There are so many ways to complete the cycle, it’s not possible to catalogue all of them here. Physical activity, affection, laughter, creative expression, and even just breathing have something in common as strategies, though: you have to do something. One thing we know for sure doesn’t work: just telling yourself that everything is okay now. Completing the cycle isn’t an intellectual decision; it’s a physiological shift. Just as you don’t tell your heart to continue beating or your digestion to continue churning, the cycle doesn’t complete by deliberate choice. You give your body what it needs, and allow it to do what it does, in the time that it requires. How Do You Know You’ve Completed the Cycle? It’s like knowing when you’re full after a meal, or like knowing when you’ve had an orgasm. Your body tells you, and it’s easier for some people to recognize than others. You might experience it as a shift in mood or mental state or physical tension, as you breathe more deeply and your thoughts relax. For some people, it’s as obvious as knowing that they’re breathing. That’s how it is for Emily. Long before she knew about the science, she knew that when she felt stressed and tense and terrible, she could go for a run or for a bike ride and at the end of it she would feel better. Even on the days when she looked at her shoes and thought, Ugh, I just don’t want to, she knew that on the other side of those shoes and that run or that ride was peace. Once, she even cried at the top of a hill in southeastern Pennsylvanian farm country, breathing hard and marveling at the smell of cows and the glow of sunlight on the pavement, as the gears of her bike whirred under her. She has always been able to feel it intuitively, the shift inside her body. How does it feel? It’s a gear shift—a slip of the chain to a smaller gear, and all of a sudden the wheels are spinning more freely. It’s a relaxation in her muscles and a deepening of her breath. The more regularly she exercises, the more easily she gets there. If she has let the stress accumulate inside her for days or weeks, one workout won’t get her all the way there. She’ll feel better at the end of a run, but not done. If you’ve spent a long time accumulating incomplete stress response cycles inside your body, you may have this experience, too. When you begin practicing strategies to complete the cycle, you’ll feel only some relief at first, not necessarily the full relaxation of completion. That’s okay, too. For others—like Amelia—recognizing when the cycle completes is not so intuitive. She was in her therapist’s office, feeling anxious, the first time she noticed it happening. The therapist asked her to describe what her anxiety felt like, and Amelia waxed poetic for about four minutes, talking about the tension in her shoulders and the heat in her neck and the quivering in her hair follicles, then stopped to breathe. “And how do you feel now?” the therapist asked. “Um. I…I don’t know. I can’t find it anymore. I think it’s just…gone?” “Yeah. That’s how it works. If anxiety starts, it ends.” “It just ends?” “Yeah. If you let it, it just ends.” We asked a group of therapists how they could tell they had completed the cycle. One therapist talked not about herself, but about her young daughter. When her daughter came to her in distress, she would hold her, as a mother does, and watch her face as she cried. Gradually, the taut muscles in the little girl’s face and body would soften, and she would give a great big shuddering sigh, and then she’d be able to talk about what had happened to cause the distress. The big sigh was the signal that her little body had made the shift.17 Don’t worry if you’re not sure you can recognize when you’ve “completed” the cycle. Especially if you’ve spent a lot of years—like, your whole life, maybe —holding on to your worry or anger, you’ve probably got a whole lot of accumulated stress response cycles spinning their engines, waiting for their turn, so it’s going to take a while before you get through the backlog. All you need to do is recognize that you feel incrementally better than you felt before you started. You can notice that something in your body has changed, shifted in the direction of peace. “If I was at an eight on the stress scale when I started, I’m at a four now,” you can say. And that’s pretty great. The Practical Advice The “how to” here is very simple: First, find what works. It would be convenient if we could just tell you which strategy will work best for you, but you’ll probably find that different strategies work better on different days, and sometimes the strategy that works best isn’t practical day to day, so you need a backup strategy. You can probably already think of a few things that feel right, but experiment, then schedule that stuff into your day. Put it in your calendar. Thirty minutes of anything that works for you: exercise, meditation, creative expression, affection, etc. Because you experience stress every day, you have to build completing the cycle into every day. Make it a priority, like your life depends on it. Because it does. Remember, Emily intuitively understood completing the cycle from early adolescence, while Amelia, genetically identical and raised in the same household, didn’t even begin to understand until after years of therapy, two hospitalizations for stress-induced inflammation, formal meditation training, and explicit instruction from her health educator sister. So we know everybody’s different. But with practice, you’ll begin to notice what different stress levels feel like in your body, and you’ll get a sense of which days require more or less time or intensity to complete the cycle. — For a lot of people, the most difficult thing about “completing the cycle” is that it almost always requires that they stop dealing with whatever caused the stress, step away from that situation, and turn instead toward their own body and emotions. By this point in the chapter, you know that dealing with the stressor and dealing with the stress are two different processes, and you have to do both. You have to, or else your stress will gradually erode your well-being until your body and mind break down. Signs You Need to Deal with the Stress, Even If It Means Ignoring the Stressor Your brain and body exhibit predictable signs when your stress level is elevated, and these serve as reliable cues that indicate you need to deal with the stress itself before you can be effective in dealing with the stressor. 1. You notice yourself doing the same, apparently pointless thing over and over again, or engaging in self-destructive behaviors. When your brain gets stuck, it may start stuttering or repeating itself, like a broken record, or like a breathless eight-year-old trying to get her mother’s attention by saying “Guess what? Guess what? Guess what?” You might notice yourself checking things, picking at things, thinking obsessive thoughts, or fiddling with your own body in a routinized kind of way. These are signs that the stress has overwhelmed your brain’s ability to cope rationally with the stressor. 2. “Chandeliering.” This is Brené Brown’s term for the sudden, overwhelming burst of pain so intense you can no longer contain it, and you jump as high as the chandelier. It’s out of proportion to what’s happening in the here and now, but it’s not out of proportion to the suffering you’re holding inside. And it has to go somewhere. So it erupts. That eruption is a sign you’re past your threshold and need to deal with the stress before you can deal with the stressor. 3. You turn into a bunny hiding under a hedge. Imagine a rabbit being chased by a fox, and she runs under a bush to hide. How long does she stay there? Until the fox is gone, right? When your brain is stuck in the middle of the cycle, it may lose the ability to recognize that the fox has gone, so you just stay under that bush—that is, you come home from work and watch cat videos while eating ice cream directly from the container, using potato chips for a spoon, or stay in bed all weekend, hiding from your life. If you’re hiding from your life, you’re past your threshold. You aren’t dealing with either the stress or the stressor. Deal with the stress so you can be well enough to deal with the stressor. 4. Your body feels out of whack. Maybe you’re sick all the time: you have chronic pain, injuries that just won’t heal, or infections that keep coming back. Because stress is not “just stress,” but a biological event that really happens inside your body, it can cause biological problems that really happen inside your body but can’t always be explained with obvious diagnoses. Chronic illness and injury can be caused or exacerbated by chronic activation of the stress response. Amelia told Julie the story of how the science of completing the cycle saved her life (twice). “It was when I was in grad school. I was trying to do something that mattered a lot to me, while simultaneously battling this totally dysfunctional administration—” “Oh my God, that’s so familiar,” Julie said. “—and the stress built up inside me in layers that got denser and denser until they finally crushed me. Halfway through the program, I was hospitalized with abdominal pain and a white blood cell count that was through the roof. They couldn’t find a cause; they sent me home and told me to ‘relax.’ ” “Whatever that means,” Julie said. “I didn’t know either! I just knew I had to do something. So I started noticing all the external stressors that activated my stress and recognizing how little control over them I had, so I could start letting go of those things. I feel sure it helped save my life. But it wasn’t enough. A year later, I was back in the hospital and they took out my appendix—the pressing layers of stress inside me had finally destroyed an organ.” “Stress can do that?” “Heck yes,” Amelia said. “So my sister visited me in the hospital. She brought me a book about inflammation.” “Your sister gave you a book while you were in the hospital?” “And a balloon that sang ‘Don’t Worry Be Happy,’ which also helped,” Amelia said. “But this book explained how health conditions like repeated infections, chronic pain, and asthma—all of which I had—are exacerbated or even caused by stress. By unprocessed emotion. I got home and read this book, and I just started crying, even though I was thinking, That’s nonsense. It sounded like hippy-dippy bullshit. But, dude, I was in so much pain all the time, and it was getting worse as I got older. So I called Emily sobbing, like, ‘This book says emotions exist in the body. Is that true?’ ” “Okay, wow,” Julie said. “Even I knew that.” “That’s what I’m saying. If I can learn to deal with the stress itself, learn to complete the cycle, you can, too. Anyone can. “Anyway, I asked Emily what I was supposed to do with all this emotion and pain and crap in my body, and she drove an hour and  a half to my house, to bring me a book of relaxation meditations.” “Because of course Emily would give you a book,” Julie said. “Exactly. So I started using these meditations on the treadmill and elliptical machine, paying attention to physical sensations and recognizing for the first time that certain stray thoughts corresponded with specific bodily discomforts. It was wild. It was mind-blowing. And it worked. I’m healthier—and saner and happier—than I was in my twenties, because I realized my emotions and my thoughts and my body are all connected to one another. Now I’m the one who nags her to exercise and cry and write fiction when she needs to.” “Because those are the ways she completes the cycle,” Julie observed. “Okay.” She twisted her wineglass between her fingers, thinking. Julie made a plan. She started the school year with two new strategies: She would begin sifting controllable stressors from uncontrollable stressors, and she would practice completing the cycle. She set aside half an hour a day, six days a week, for exercise or pure play with her daughter, Diana. It helped…but a few months later she hit a serious obstacle. And that’s the subject of the next chapter. The good news is that stress is not the problem. The problem is that the strategies that deal with stressors have almost no relationship to the strategies that deal with the physiological reactions our bodies have to those stressors. To be “well” is not to live in a state of perpetual safety and calm, but to move fluidly from a state of adversity, risk, adventure, or excitement, back to safety and calm, and out again. Stress is not bad for you; being stuck is bad for you. Wellness happens when your body is a place of safety for you, even when your body is not necessarily in a safe place. You can be well, even during the times when you don’t feel good. — Here’s the ultimate moral of the story:  Wellness is not a state of being, but a state of action. Our job in this chapter has been to teach you how to deal with the stress so that you can be well enough to face another day of stressors. But of course, that still leaves you with a life full of goals, obstacles, unmet obligations, not-yet-fulfilled hopes, and other sources of stress, both big and small, both enjoyable and painful. So let’s talk about those goals, and the brain mechanism that keeps track of them. tl;dr: Just because you’ve dealt with a stressor, that doesn’t mean you’ve dealt with the stress itself. And you have to deal with the stress—“complete the cycle”—or it will slowly kill you. Physical activity is the single most efficient strategy for completing the cycle—even if it’s just jumping up and down or a good old cry. Affection—a six-second kiss, a twenty-second hug, six minutes of snuggling after sex, helpless laughter—are social strategies that complete the cycle, along with creative self-expression— writing, drawing, singing, whatever gives you a safe place to move through the emotional cycle of stress. “Wellness”is the freedom to move fluidly through the cycles of being human. Wellness is thus not a state of being; it is a state of action.  2 #PERSIST Sophie, the non-exerciser, is an engineer, but she’s also a black woman, so she rarely gets to be just an engineer. She has to be an engineer and a social justice educator, teaching the oblivious white guys who surround her about the experience of being a woman of color in science and technology—not because she wants to; all she ever wanted to do is science. But since she is so often the only person of color and the only woman in the room, they all look to her to explain, ya know, why she’s the only person of color or woman in the room. One day as we were sitting around a table at an end-of-semester breakfast with her and a bunch of other women, Sophie told us a story about the ways she was being taken for granted on a “diversity” committee she’d been assigned to. “Is it…racism?” Emily said hesitantly, a white lady afraid to hurt anyone’s feelings. “Is it because you’re a woman?” “It’s just the usual nonsense,” Sophie said. “I’m used to all that.” Amelia, not hesitant, said, “What is wrong with them? Isn’t it obvious that putting people of color in charge of helping white people learn how not to be racist is just more white supremacy? White people are the ones with the problem; we should be doing the work, not putting more labor demands on black and brown people.” Sophie grinned at her omelet and said, “Actually…I’ve been thinking, if they’re going to ask me to do all this, I can turn it into a way to get paid. Codify a package of talks and workshops. Take the  Sophie Show on the road. I get requests all the time.” “Can we talk about the science of how smart that idea is?” Emily said, excited and impressed. “There’s so much research about how to turn our frustrations into assets.” “Can we talk about the science?” Sophie echoed. “Let’s always talk about the science!” This chapter is that science. — Chapter 1 was about dealing with the stress itself. Chapter 2 is about managing the stressors. It’s about knowing how to persist when you’re past the edge of your capabilities, and it’s about knowing when to quit. Specifically, it’s about what we call “the Monitor,” the brain mechanism that manages the gap between where we are and where we are going. Exactly what this looks like is different for everyone, but it impacts every domain of life, from parenthood to career success to friendships to body image. And for women, the gap quickly becomes a chasm. In this chapter, we’ll explain how the Monitor works, and why it sometimes breaks down. Then we’ll talk about how to implement evidence-based strategies for every frustration and every failure, from traffic jams to tenure. Allow Us to Introduce…the Monitor Technically, it’s called the “discrepancy-reducing/-increasing feedback loop” and “criterion velocity,” but people fall asleep immediately when we say that, so we just call it the Monitor. It is the brain mechanism that decides whether to keep trying…or to give up. The Monitor knows (1) what your goal is; (2) how much effort you’re investing in that goal; and (3) how much progress you’re making. It keeps a running tally of your effort-to-progress ratio, and it has a strong opinion about what that ratio should be. There are so many ways a plan can go wrong, some of which you can control and some of which you can’t, all of which will frustrate your Monitor.1  For example, imagine you’re working toward a simple goal: driving to the mall. And you know it usually takes about, say, twenty minutes. If you’re getting all green lights and you’re zipping right along, that feels nice, right? You’re making progress more quickly and easily than your Monitor expects, and that feels great. Less effort, more progress: satisfied Monitor. But suppose you get stuck at a traffic light because someone isn’t paying attention. You feel a little annoyed and frustrated, and maybe you try to get around that jerk before the next light. But once you’ve hit one red light, you end up stuck at every traffic light, and with each stop, your frustration burns a little hotter. It’s already been twenty minutes, and you’re only halfway to the mall. “Annoyed and frustrated” escalates to “pissed off.” Then you get on the highway, and there’s an accident! While ambulances and police come and go, you sit there, parked on the highway for forty minutes, fuming and boiling and swearing never to go to the mall ever again. High investment, little progress: ragey Monitor. But then! If you sit there long enough, an enormous emotional shift happens inside you. Your Monitor switches its assessment of your goal from “attainable” to “unattainable,” and it pushes you off an emotional cliff, into a pit of despair. Lost in helplessness, your brain abandons hope and you sit in your car sobbing, because all you want to do now is go home, and there’s nothing you can do but sit there and wait. In an almost painfully funny video posted in January 2017, the satirical news website The Onion reported that “an increasing number of women are leaving the workplace to pursue lying facedown on the floor full-time. A Department of Labor report says lying motionless in utter resignation on nights and weekends is just no longer enough for most women.” That’s the pit of despair: resignation and helplessness. The tremendous power of understanding the Monitor is that once we’re aware of how it works, we can influence our own brain’s functioning, with strategies for dealing with both the controllable and the uncontrollable stressors. Dealing with Stressors You Can Control: Planful Problem-Solving The Monitor keeps track of your effort and your progress. When a lot of effort fails to produce a satisfying amount of progress, we can change the kind of effort we’re investing. For example, the frustration of being stuck in traffic can be minimized with a GPS giving you a new route to go around the traffic. All you need to do is make sure you’ve got the GPS handy. This strategy is called planful problem-solving. If you carry a purse laden with the complete contents of a drugstore, you already know about planful problem-solving. If you write lists, keep calendars, or follow a budget, you know what planful problem-solving entails. It does what it says on the label: you analyze the problem, you make a plan based on your analysis, and then you execute the plan. The good news is that women are socialized to planfully solve problems. The bad news is that every problem calls for a specific kind of planning. For example, if we’re talking about, say, managing cancer treatment while working full-time and raising your kids and being a partner to someone, there are a lot of calendars involved, and information about medication side effects and how they’re managed, and strategies for making sure everyone gets fed and does their homework and gets where they need to go each day. Or if you’re trying to find a job, there’s the routine of looking for postings, sending résumés, attending networking events, prepping for interviews, and so on. There are pragmatic steps to manage the controllable factors, and controlling what you can control makes the rest of it more bearable. The least intuitive part of planful problem-solving is managing the stress caused by the problems and the solving. As we learned in chapter 1, what works to manage your stressor will rarely help you manage the stress, so remember to build completing the cycle into your plan. Which brings us to the effective way to deal with uncontrollable stressors. Dealing with Stressors You Can’t Control: Positive Reappraisal So imagine that you’re stuck in traffic and your GPS is busted. For this situation, the strategy we turn to is “positive reappraisal.”2 Positive reappraisal involves recognizing that sitting in traffic is worth it. It means deciding that the effort, the discomfort, the frustration, the unanticipated obstacles, and even the repeated failure have value—not just because they are steps toward a worthwhile goal, but because you reframe difficulties as opportunities for growth and learning.3 Some people naturally notice what’s valuable in difficult situations. These natural optimists expect good things to happen and automatically believe that bad things, if they happen, are temporary, isolated events that will have no lasting impact. If that’s you, congratulations! Optimism is associated with all kinds of positive outcomes related to mental health, physical health, and relationships.4 You probably don’t need any more persuasion or instruction on positive reappraisal. You just keep on keeping on—see the silver lining of every cloud and the rainbows of every storm. Do you. Pessimists, by contrast, don’t always expect good outcomes and may view bad things, if they happen, as symptomatic of larger-scale problems that could have lasting impact. Amelia is the most pessimistic person we know—we’ve measured it objectively, with survey instruments used to assess pessimism and optimism—and, moreover, she’s a conductor whose professional training teaches her that she can and should be responsible for everything. So she did not buy this “positive reappraisal” thing. It sounded to her like a video a friend of ours shared on Facebook titled “Eight Things Happy People Do Differently.” It included such helpful if idiomatically capitalized gems as “EXPRESS GRATITUDE—never let the things you WANT make you forget about the things you HAVE” and “CULTIVATE OPTIMISM. Stay positive. When it rains, look for Rainbows. When it’s dark, look for Stars.” That is not what “positive reappraisal” means; it’s not as simple as “look on the bright side” or “find the silver lining” or “enjoy the journey.” Nor is it about not feeling frustrated by the persistent gap between what is and what could or should be. Nor does it mean sticking your fingers in your ears and going, “La la la, nothing is wrong, everything is fine!” With positive reappraisal, you can acknowledge when things are difficult, and you recognize that the difficulty is worth it—it is, in fact, an opportunity. So Emily presented a couple of decades’ worth of peer-reviewed science to Amelia, who had no problem with the first two steps: first, acknowledge when things are difficult; then, acknowledge that the difficulty is worth it. Pessimists assume everything is hard and will require work, so that’s easy. The hard part is acknowledging that those difficulties are actually opportunities. But positive reappraisal works because it’s genuinely true that difficulties are opportunities! When something feels uncomfortable, you’re probably doing something that creates more and better progress than if it were easy. Just a handful of examples: Students whose assigned reading is typed in an ugly, difficult-to-read font remember more of what they read in the short term and score higher on exams in the longer term than those whose materials are more legible.5 A noticeable, annoying buzz of background noise can increase a person’s creativity.6 Groups that are more heterogeneous generate more innovation and better solutions to problems, even though those groups feel less confident about their solution and find the process more difficult.7 And, most straightforwardly, people who challenge their bodies with regular exercise develop stronger bones, muscles, and cardiovascular systems—strength is the body’s response to doing something effortful. In fact, there is a distinct downside to effort that is too effortless: When a task feels easy, we feel more confident about our ability to perform that task even though we are actually more likely to fail. Novices who are thoroughly incompetent rate themselves as very confident in their ability to do a thing they’ve just learned to do. By contrast, genuine experts know how difficult their work is, so they are realistic about their competence and thus rate their confidence in their own abilities as moderate, even as their performance is, of course, expert-level. The reduced stress of positive reappraisal is not an illusion. Struggle can increase creativity and learning, strengthen your capacity to cope with greater difficulties in the future, and empower you to continue working toward goals that matter to you. Reappraisal even changes our brain functioning: The dorsolateral prefrontal cortex activates, which damps the ventromedial prefrontal cortex, which damps the amygdala, which reduces the stress response.8 Not every kind of stressor is explicitly beneficial, of course. Knowing you’re being compared with other people, for example, is quite likely to reduce creativity.9 But often, the uncomfortable or frustrating process is more successful. As the researchers put it, you can “convert affective pains into cognitive gains.”10 Change the Expectancy: Redefine Winning Planful problem-solving and positive reappraisal are evidence-based ways to change the effort you invest as you move toward a goal. They’ll reduce your frustration by keeping you motivated and moving forward. But suppose you do all that, and it works…except…it’s much more difficult or much…slower… than… you… expected. Even as you’re succeeding, you grow frustrated because your progress is not meeting your Monitor’s expectation about how effortful the task should be. In this case, you need to change your Monitor’s expectancies about how difficult it will be or how long it will take. Expectancies are the plan. “Twenty minutes to the mall” is an expectancy. “Four years to finish my degree” is another. So is “married with a kid by the time I’m thirty.” When you’re frustrated by the slow or interrupted progress toward your goal, and planful problem-solving and positive reappraisal don’t help with the frustration, you need to redefine winning. Here’s how: Say your goal is to climb Mount Everest. If you start marching up the mountain expecting that you’re going to zip smoothly to the peak, as soon as it gets difficult your Monitor will start to freak out. You might give up. You might start to wonder if there’s something wrong with you—after all, somebody told you it was supposed to be easy, and it turns out it’s hard, so it’s not the mountain that’s the problem, it’s you! But if you begin the climb knowing ahead of time that it’s going to be the most difficult thing you’ve ever done, then when it begins to get difficult, your Monitor will recognize that without getting frustrated. It’s just a difficult goal, so it’s normal that you’re struggling. If you’re trying to do something where you will inevitably fail and be rejected repeatedly before you achieve your goal—like, if you’re recording music or you’re an actor or you sell insurance or you’re trying to raise a teenager to be a reasonable adult—then you will need a nonstandard relationship with winning, focusing on incremental goals. Amelia tested this strategy one summer, at a choral recording session. If you were to imagine a recording session, you might visualize a group of musicians jamming together for hours, or maybe a singer in gigantic headphones, singing her heart out into a microphone, and the musicians leave hours later, filled with the joy of artistic expression. Maybe that’s what it’s like sometimes. But most of the time, a musical recording session is more like being stuck in heavy traffic on your way home from work. It’s stop-and-go, when all you want to do is get home. In a recording session, the goal is perfection, and humans are not perfect, so it’s six measures (maybe fifteen seconds of music) over and over, with a guy behind a window saying, “Great singing, choir; let’s do one more,” in between. After twenty minutes of singing the same six measures of music over and over…you start to get bored. After forty minutes, the music no longer has feeling. And then the guy behind the window says, “Lovely singing, choir. It sounds a little dry. Can we make the color more specific this take?” And you want to rip your hair out, because no, we can’t make the color more specific, because all the neurotransmitters associated with emotional (and therefore timbral) specificity were burned up fifteen minutes ago when measure two was out of tune. So, no. But you have to. It’s a recording session, and the goal is perfection—every take, every snippet, every moment. Six to eight hours of artistic and vocal perfection is the goal. “So we have two choices,” Amelia said to a choir of forty professional singers. “We can stuff the frustration down deep where it will cause us to explode at someone else at a later date or otherwise adversely affect our art and our health…or we can redefine winning. “The goal, with each take,” Amelia proposed, “is to fill Andrew with joy.” Andrew was their guy behind the window, the recording engineer—and not just any recording engineer. Andrew was the Grammy-winning recording engineer who had worked with some of the most prestigious performers of the twenty-first century. It didn’t hurt that he was also a cutie patootie—blond, British, bashful. Everyone in the choir was pretty giddy to be working with him. Forty singers smiled at the possibility of filling Andrew with joy, and the energy in the room shifted. “It’s better already, isn’t it?” Amelia observed. It was. On the third day of trying to fill Andrew with joy, when it was getting pretty tough to stay focused but they still had another track to lay down, a soprano asked Andrew, “Andrew, are you filled with joy?” Andrew paused in moving a microphone cable, considered for a moment, and nodded. He said, “Yeah. I really am.” Redefining winning made the recording session far less agonizing. But better still, a year later, when the group met again, several singers approached Amelia privately to tell her, “That Monitor thing? That’s changed, like, my whole life.” You’ll find a worksheet at the end of the chapter to help you brainstorm incremental goals that will keep your Monitor satisfied, but the super-short guidelines are: soon, certain, positive, concrete, specific, and personal.11 Soon: Your goal should be achievable without requiring patience. Certain: Your goal should be within your control. Positive: It should be something that feels good, not just something that avoids suffering. Concrete: Measurable. You can ask Andrew, “Are you filled with joy?” and he can say yes or no. Specific: Not general, like “fill people with joy,” but specific: Fill Andrew with joy. Personal: Tailor your goal. If you don’t care about Andrew’s state of mind, forget Andrew. Who is your Andrew? Maybe you’re your own Andrew. Redefining winning in terms of incremental goals is not the same as giving yourself rewards for making progress—such rewards are counterintuitively ineffective and may even be detrimental.12 When you redefine winning, you set goals that are achievements in themselves—and success is its own reward. Change the Expectancy: Redefine Failing For goals that are abstract, impossible, or otherwise intangible, you can reduce frustration by establishing a nonstandard relationship with winning. But sometimes you’re aiming for a clearly defined, concrete goal that can’t be redefined. For these, you will need a nonstandard relationship with failing. You may do all the things you’re supposed to do, without getting where you’re trying to go, only to end up somewhere else pretty amazing. Or, as Douglas Adams’s character Dirk Gently puts it, “I rarely end up where I was intending to go, but often I end up somewhere that I needed to be.” Widen your focus to see the inadvertent benefits you stumble across along the way. This sort of reframing makes failing almost (almost) impossible, since it acknowledges that there’s more to success than winning. And we don’t just mean the “We played our best!” spirit of your six-year- old’s soccer team. There are endless examples of people not achieving their specific goal but achieving something important, something world-changing, along their path to failure. Post-it notes were invented when a chemist tried and failed to make a strong glue; it turned out his very weak glue had a very popular use. The pacemaker was invented when Wilson Greatbatch was trying to create an instrument to measure heart rate, and he built his prototype wrong. Hillary Clinton’s failure to win the White House set the stage for record-breaking numbers of women to enter and win political contests and other leadership positions in the United States. Post-its and pacemakers and a tidal wave of women entering American politics were world-changing outcomes of someone’s failure to accomplish something else. It’s the most demanding form of positive reappraisal, and none of this takes away the pain of failure and loss. Part of recovering from a loss is turning toward your grief with kindness and compassion, as well as completing the cycle of stress brought on by failure. But another part is recognizing failing’s unintended positive outcomes. HOW NOT TO MANAGE YOUR MONITOR Planful problem-solving and positive reappraisal are the adaptive coping strategies, meaning they generally work and they carry minimal risk of unwanted consequences. There are other coping strategies that don’t necessarily help, and some strategies that are actively destructive. These maladaptive strategies include things like self-defeating confrontation, suppressing your stress, and avoidance. We often turn to such strategies when we feel out of control in a stressful situation and are desperately trying to regain control. An example of self-defeating confrontation is, “I stood my ground and fought!” Standing our ground is important in principle and can be effective when we’re not overwhelmed, but not when we’re stressed and out of control. When you’re still fighting even while you’re overwhelmed, it’s less a valiant struggle and more that you have your back to the wall and are surrounded on all sides. Ask for help instead. Suppressing is, “I didn’t let it get to me.” If something matters, it should get to you! It should activate a stress response cycle. Denying that you experience the stress prevents you from dealing with the stress—and we know from chapter 1 what happens if you do that. If you notice yourself acting as though you’re fine when you’re deeply distressed, again: ask for help. Avoidance has a couple different flavors. There’s “I waited for a miracle to happen,” which abdicates personal responsibility for creating change, and there’s “I ate until I couldn’t feel my feelings,” which numbs you out. These can both be useful stop-gap measures when the stress, worry, frustration, rage, or despair are overwhelming. Sometimes we need to numb out with Netflix and a pint of Häggen-Dazs. Once, Emily was teaching about “completing the cycle” and the importance of actually feeling your feelings and one person asked, “Is this true if you’re, like, caring for a terminally ill parent? Is it bad to just shut everything out sometimes and spend all day watching Pride and Prejudice?” Heck no. Sometimes you need to close the door on the world and allow yourself to feel comfortable and safe—as long as it’s not the only thing you’re doing. Think of it as a short-term survival strategy. You also need a plan and a sense of what value there is in the struggle. Perhaps the most reliably maladaptive response to distress is “rumination.” Like a cow chewing its cud, we regurgitate our suffering over and over, gnawing on it to extract every last bit of pain. If you find your thoughts and feelings go back again and again to your suffering, ask for help. “This is why people quit self-care,” Julie said to Amelia, opening a bakery box to reveal a gooey chocolate cake. She cut a big slice. “When you paint the dingiest wall in a room, it just makes the other walls look dingier. You said, ‘Process your stress, which is separate from processing the stressor.’ Well, I did that, and it helped, and now I’m thinking about getting a divorce, and it’s basically because of you. Dig in!” She offered a slab of cake on a plate. “What the huh?” Amelia said, accepting the slab. “The huh” was that Julie had spent a month learning to recognize the stressors in her life, and then completing her stress response cycles. That was all it took for her to notice that one of her chronic stressors was her husband, Jeremy. “I started noticing how much work I was putting into managing his feelings,” she said, “how much additional stress I had because of his stress. Then last week it was Diana’s fall recital, and I told Jeremy, ‘It’s time to go,’ and he groaned, ‘All those kids and that terrible music,’ and I tried to make him feel better, you know? It’s not like this is my first choice for spending three hours of my life, but this is what we do. So I said, ‘This is a special moment. We get to see our daughter on stage,’ trying to help him see the bright side. And you know what he said? He said, ‘You can make me go but you can’t make me like it.’ Make him go! Make him like it! Recitals are parenting! Why am I having to ‘make’ him parent?! And why am I having to make him feel better? Nobody makes me feel better, I have to do that myself! I have to find things to enjoy about things that are not enjoyable. I have to find a way not to complain about things I don’t like or want in my life. So that night, we got into a fight about it, and he said, ‘Well, if you don’t want to do it, don’t do it. Don’t try to make me feel good. Don’t try to look on the bright side. Complain if you want to!’ “So that’s what I did. Usually, my first instinct is to just do something myself because he never does it—the dishes, the laundry, wiping the kitchen counters—and instead I complained. And you’ll never guess what happened. A week later, he said, ‘What’s wrong with you? All you do is complain and criticize! You’re so negative!’ I’m so negative! Can you believe that? I said, ‘You told me to complain when I wanted to complain. You said don’t try to manage your feelings. And if I’m not managing your feelings then I’m telling you that just running the dishwasher does not count as cleaning the kitchen.’ “And then he says—brace yourself for this—he says, ‘You know, if you want something done your way, you have to do it yourself.’ ” “Hence considering divorce,” Amelia said. “Except sometimes it’s great. It’s amazing,” Julie said. She stopped for more cake, washing it down with dark beer, then she went on, “You know how slot machines are designed to hook you?  Like, most of the time, you’re just shoving good money after bad, but every now and then it pays out just enough to make you feel like you should keep going? That’s my marriage,” Julie said. “So I quit. I don’t know what I quit, I don’t know for how long, but I