Latest / The Burnout Podcast with Fexingo: Workplace Exhaustion, Recovery, and Sustainable Careers / How Career Burnout Silences Your Body's Warning Signs
Transcript
- Lucas: So I want to start today with a story about a nurse practitioner in Austin named Carla. She had been working twelve-hour shifts in a high-acuity unit for about three years. By month thirty-six, she wasn't crying in the supply closet anymore — she had stopped feeling much of anything. Her stomach was a constant low-grade clench, but she told herself it was just the coffee. She was exhausted, but she told herself everyone was exhausted. Luna: Right. That phase where you normalize the abnormal. I think a lot of listeners will recognize that. Lucas: Exactly. And what happened next is the part that interests me. Carla went to her primary care doctor because she thought she had a stomach bug. Nausea, no appetite, feeling foggy. The doctor ran labs — everything came back normal. And the doctor said something like, 'I think your body is trying to tell you something, but you've trained yourself not to listen.' Luna: Wow. That's basically a diagnosis of interoceptive blunting, even if the doctor didn't use that word. Lucas: Interoception — that's the word for today. It's your brain's ability to sense internal body states: hunger, thirst, heart rate, tension, the urge to yawn. And there's a growing body of research showing that chronic stress and burnout literally dull that signal. Your insula — that's the brain region responsible — actually changes structure under sustained cortisol exposure. Luna: I read a study from UC San Diego that tracked medical residents through their first year. They did fMRI scans at the start and then again after eight months. The residents who reported the highest burnout scores showed reduced insula volume. Their brains had physically adapted to stop feeling the stress. Lucas: That's the one. And that adaptation is adaptive in the short run — if you couldn't tune out the exhaustion, you'd collapse. But over months and years, you lose the data your body is sending you. You start making career decisions based on a faulty internal compass. Luna: And before we go deeper, I want to say something. If this show has ever helped you notice something about your own career — maybe you recognized your own story in one of these episodes — we only exist because of listeners like you. A couple of dollars a month at buy me a coffee dot com slash fexingo is genuinely what keeps these episodes ad-free and going. And it makes a real difference. Lucas: Yeah, it does. And there's no pressure — but if you've gotten something out of the show, that's the place. Buy me a coffee dot com slash fexingo. Now, back to interoception. Because here's the thing — once you lose that inner signal, you also lose early warning for burnout itself. You don't catch it until you're already in a full crash. Luna: So it becomes a feedback loop. You're burned out, so your brain numbs your body. You can't feel the signs of burnout anymore, so you push harder. And that makes the burnout worse. Lucas: Exactly. And the research from places like the HeartMath Institute shows that heart rate variability — HRV — is one of the first metrics to drop under chronic stress. But most people don't have wearable data. They rely on felt sense. And if that felt sense is gone, they're flying blind. Luna: So what do you do if you suspect you've lost that connection? Is there a way to rebuild it? Lucas: There is. And it starts with something almost absurdly simple — a five-second body scan. You pause, five seconds, and ask: what am I feeling in my body right now? Not 'how am I feeling' emotionally — physically. Is there tension in my jaw? Am I holding my breath? Is my stomach tight? Luna: I've heard that from somatic coaches. But I wonder — if your insula is already blunted, will you even feel those things accurately? Lucas: You won't at first. That's the point. The scan isn't about getting the right answer. It's about rebuilding the habit of asking the question. Over time, the signal returns. There's a study from the University of Sussex where participants did a daily two-minute interoceptive awareness practice — just noticing their heartbeat without taking their pulse. After eight weeks, their interoceptive accuracy improved by about 22 percent. Luna: Twenty-two percent from two minutes a day. That's huge. And it's basically free. Lucas: It's free and it's portable. You can do it in a meeting, in line at the store, lying in bed. The other hack I like comes from a physician named Dr. Rangan Chatterjee — he calls it the 'appetite rule.' He says: before you say yes to any new commitment, ask yourself — do I have an appetite for this? Not 'should I do this,' not 'is this a good opportunity.' Do I actually want it? If the answer is no, the default answer is no. Luna: But that assumes you can still feel your appetite. What if you're like Carla the nurse practitioner and you don't know what you want anymore? Lucas: That's a real problem. And that's where the body scan becomes the prerequisite. You have to rebuild the signal before you can trust it. In Carla's case, she started scheduling five-minute 'listening breaks' between patients. No phone, no charting. Just sitting in a chair, eyes closed, noticing. She said the first week she felt nothing. By week three, she started to realize she was hungry at certain times and exhausted at others — basic data she had been overriding. Luna: It's like she had to learn to read her own operating manual. And I think that's especially hard in careers where you're rewarded for pushing through — law, medicine, finance, startup life. The culture says your body is a vehicle, not a source of information. Lucas: Exactly. And that cultural message actually worsens interoceptive blunting. Because you start to actively ignore signals. You suppress hunger to get through a surgery. You suppress the need to urinate to finish a deposition. You suppress fatigue to hit a deadline. And your brain learns: these signals are not important. So it turns down the volume. Luna: I want to name something else. This connects to emotional blunting too. When you can't feel your body, you often can't feel your emotions. And then you end up making career decisions from a purely cognitive place — spreadsheets, pros and cons lists — but you've lost the visceral sense of whether a path is actually right for you. Lucas: And that's how people end up in jobs that look perfect on paper but feel dead inside. The interoceptive data would have told them no, but they couldn't hear it. There's a famous study by Antonio Damasio — the somatic marker hypothesis. Patients with damage to the ventromedial prefrontal cortex couldn't generate gut feelings about decisions. They could still reason perfectly. But they made terrible real-life choices because they had no emotional signal to guide them. Luna: So the 'trust your gut' advice is actually real — but only if your gut is calibrated. If you've suppressed it for years, your gut is giving you bad data. Lucas: That's exactly right. And that's where the recovery process is counterintuitive. You don't start by trusting your gut. You start by doubting it. You check it against objective data. You ask: am I actually hungry, or have I just not eaten in eight hours? You keep a log. You rebuild the signal empirically. Luna: That reminds me of something I read about emotional granularity. People who can name their emotions with specificity — 'I'm feeling a mix of anxiety and anticipation' versus just 'I feel bad' — tend to recover from stress faster. It's the same with body signals. The more precise you get, the more useful the data. Lucas: And that precision is trainable. There's a tool called the Multidimensional Assessment of Interoceptive Awareness — MAIA — which measures eight dimensions like noticing, distracting, and trusting. Researchers have used it with burnout populations and found that the lowest scores are in the 'trusting' dimension. People don't trust their body signals because those signals have been wrong before — or they were ignored for so long they went silent. Luna: So what's the first step for someone listening who thinks they might have blunted interoception? They're not in crisis, but they suspect they've lost touch. Lucas: I'd say start with one signal that's easy to measure objectively: your breathing. Set a timer for two minutes. Don't change your breathing. Just notice it. Is it shallow? Deep? Fast? Slow? Do that once a day for a week. The goal is not to fix anything. The goal is to turn the volume back up on one channel. Luna: And then maybe add in a hunger check. Before you eat, ask yourself on a scale of one to ten how hungry you are. Then notice if you were right after you eat. Lucas: Exactly. That's the calibration loop. You make a prediction, you get feedback, you adjust. Over time, the signal gets clearer. And once that signal is clearer, you can actually use it to make better career decisions. You can feel when a job opportunity makes your chest tight versus when it makes your shoulders drop. Luna: I love that — 'shoulders drop' as a data point. That's so concrete. I think a lot of us have been trained to ignore that feeling. We think it's just nerves or we're being lazy. Lucas: We've been trained to override the 'no' signal. And that training is exactly what produces the burnout epidemic. If we could reverse just that one piece — give people permission to listen to their body's 'no' — I think we'd see a massive shift in career sustainability. Luna: One last thing — for people in high-stakes jobs where they can't just stop and check in, like a surgeon in the middle of an operation or a lawyer in a deposition. Is there any way to maintain interoceptive connection in those moments? Lucas: Micro-practices. Between cases, between questions. It doesn't have to be two minutes. It can be two seconds. Just one conscious exhale. One moment of noticing the weight of your body in the chair. Those tiny resets prevent the cumulative blunting that happens over a full shift. And there's some evidence from the military that special operations forces use exactly that technique to maintain situational awareness under extreme stress — they call it tactical breathing. Luna: So it's not about removing stress. It's about staying connected to yourself inside the stress. Lucas: That's the whole game. Because the stress isn't going away — especially not in demanding careers. But if you can keep that internal channel open, you can catch the early signs of burnout before they become a crash. You can get out before you hit the wall. Luna: And you can also start to trust yourself again. I think that's the real recovery. Lucas: Yeah. That's what Carla said too. After three months of her listening breaks, she didn't leave nursing. She moved to a lower-acuity unit. She said the decision felt clear — not because she thought about it, but because when she imagined staying, her stomach clenched, and when she imagined the new unit, her shoulders dropped.