Cultivating Compassion in Veterinary Medicine | Episode 79 | Reviving Vet Med

Compassion is at the heart of veterinary medicine, but sustaining it can be tough in the face of long hours, high expectations, and emotionally intense work. While many of us focus on compassion for patients and clients, the missing piece is often self-compassion, which is critical for reducing burnout and building resilience.

In this episode, we sit down with Dr. Megan Davis, a veterinarian and educator passionate about mental health and human factors, and Dr. Katherine Wakelin, a clinical psychologist specializing in compassion-focused therapy. Together, they introduce a free 14-day Compassion Course for Veterinarians, designed to help professionals counter self-criticism, reduce stress, and develop healthier ways of relating to themselves.

You’ll learn what compassion-focused therapy is, why self-compassion can feel so counterintuitive in our profession, and how small shifts in mindset can make a big difference for wellbeing. Megan and Katherine also share practical tools you can start using right away to manage stress and sustain your capacity to care for others.

Whether you’ve been curious about self-compassion or skeptical of it, this conversation offers science-backed insights and accessible strategies to support a long, meaningful career in veterinary medicine.

Watch the Video Version of this Episode
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Resources
Follow Dr. Megan Davis on LinkedIn: https://www.linkedin.com/in/megan-davis-a5ba7a151/  

Take the free online 14-day compassion course for veterinarians: https://vetmindmatters.org/resources/free-online-compassion-course-for-veterinarian-mental-wellbeing/

Being Brilliant Every Single Day (TEDx video): https://www.youtube.com/watch?v=Q_fFattg8N0

Feasibility and efficacy of an online compassion-focused imagery intervention for veterinarian self-reassurance, self-criticism and perfectionism (article): https://bvajournals.onlinelibrary.wiley.com/doi/full/10.1002/vetr.2177 

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Order Dr. Marie Holowaychuk’s book A Compassionate Calling: What It Really Means To Be a Veterinarian: https://www.routledge.com/A-Compassionate-Calling-What-It-Really-Means-to-Be-a-Veterinarian/Holowaychuk/p/book/9781032389035?utm_source=cjaffiliates&utm_medium=affiliates&cjevent=26e8517167f611f0806101060a1eba24 

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Transcript

Dr. Marie Holowaychuk - Hi everyone, it's Dr. Marie Holowaychuk here. If you're like me and love staying up to date on what's happening in Vet Med beyond just cases and clinical pearls, you'll want to check out What's Up Doc, the new podcast from Scribenote, hosted by Dr. Katie Gallagher, veterinarian and co-founder of Scribenote, what's Up Doc dives into the real conversations happening in our industry, from the latest trends in tech to mental health and the everyday challenges veterinary professionals face. I had the chance to be a guest on the show to talk about all things veterinary wellbeing and trust me, it's not your average vet med podcast. So wherever you listen to your podcasts, search Whats Up Doc by Scribenote, hit follow and join the conversation. Hey everyone, welcome to another episode of Reviving Vet Med.

Dr. Marie - Hey everyone. Welcome to another episode of Reviving Vet Med. Today we're talking about something at the heart of veterinary medicine. Compassion. We often hear about the importance of compassion for our patients and clients, but sustaining it, especially for ourselves, can feel incredibly challenging in the face of daily stress and emotional demands. Joining me today are Dr. Megan Davis, a veterinarian and educator passionate about mental health and human factors in the veterinary profession, and Dr. Katherine Wakelin, a clinical psychologist whose research focuses on compassion focused therapy and wellbeing. Together we are discussing a 14 day free compassion course for veterinarians designed to help veterinary professionals cultivate self-compassion, reduce self-criticism and build resilience. In this episode we explore what compassion focused therapy is, why it matters so much for veterinary wellbeing, and how self-compassion can counter burnout and rumination.

Dr. Marie – Megan and Katherine share practical strategies you can start using right away and they explain why self-compassion can feel so counterintuitive to the people in our profession.

Dr. Marie – So whether you've been curious about self-compassion or skeptical of it, this conversation offers research backed insights and practical tools to help you care for yourself while caring for others. Let's go ahead and dive into this inspiring discussion. This is the Reviving Vet Med podcast and I'm your host, Dr. Marie Holowaychuk. My mission is to improve the mental health and wellbeing of veterinary professionals around the world.

Dr. Marie –Okay. Hi Megan. Hi Katherine. It's so wonderful to have you both on the podcast today. Thanks for joining me.

Dr. Megan Davis – Thanks for having us.

Dr. Katherine Wakelin – Yeah, definitely.

Dr. Marie – I am going to go ahead and jump right into it. Compassion is often talked about in veterinary medicine, but it can sometimes feel challenging to sustain it in the face of our day to day stress and our emotional demands. From your perspectives, why is cultivating compassion, both for other people and ourselves so important in v medicine today, I think.

Dr. Megan –As you've identified, our jobs are hugely about compassion as vets. And I suppose when most people think about compassion in the veterinary profession, they start by thinking about compassion towards our patients and our clients. That's kind of what most people would jump to immediately if you said that word to them. But we also have to maintain compassion towards our colleagues in order to maintain those kind of happy, healthy working teams and environments. And I think probably the thing that gets forgotten about the most is that self-compassion, that compassion towards ourselves. And I think you're right. I think it does kind of become this thing that people feel like they just don't have time for. I don't have time for that.

Dr. Megan – But in my experience we talk a lot about compassion fatigue as having just run out of compassion because we've given too much compassion to others and we just don't have any left for others or for ourselves. But I think really we need to kind of start thinking about it the other way around because in my experience when I wasn't showing compassion to myself, those were the moments at which I couldn't show compassion to others. So in order for us to be able to maintain that compassion for our teams, for our clients and for our patients, we have to show ourselves that compassion first before we are able to do that. 

Dr. Katherine – Okay, what Megan said, really, I don't know if it's helpful to chip in from a kind of research perspective. I guess what we know, particularly around vets in particular veterinarians with higher levels of factionism are shown to be kind of less able to tolerate that uncertainty. That's just routine and part of clinical environments. The decisions making involve application of theory into practice is quite blurry. And I guess what we know is individuals with that higher level perfectionism at higher risk then of internalizing those difficulties of practice and the uncertainties and basically turning that in on themselves. Exactly as you said, Megan, actually that kind of not just lack of self-compassion ourselves, but actually that internal critic actually kind of really taking hold. 

Dr. Katherine – I guess what we know is then kind of those high levels of self-criticism really correlate and associate with levels of psychological distress developing and then kind of as well can kind of associate with other more clinical mental health difficulties developing or at least just kind of really quite unhappy and unsatisfactory kind of life we're living. 

Dr. Marie – Yeah, they're such important points. You know, I think that inner critic can get very loud when we have very high expectations of ourselves, right?

Dr. Marie – The higher our self-oriented perfectionism, often the Higher that critical inner voice. And I think for many of us, we feel like that's been beneficial to us. It's been like our inner coach, you know, like pushing us forward. And in the past when I've talked to vets about self-compassion, it's been very unsettling to them because they feel like this is a really helpful tool to be very hard on themselves to push them towards doing better. And I know that we'll talk about that as our conversation goes on today. 

Dr. Marie – I feel so lucky to talk to you both because as a fellow researcher and someone who really looks to the evidence to support what I'm recommending and sharing with others, I am so grateful that you are doing work in this area and you have done research in online compassion focused imagery using a specific intervention tool that showed really promising results in reducing that self-criticism and rumination and increasing resilience and self-compassion among veterinarians. Can you briefly explain what compassion focused therapy is and why it's particularly relevant for veterinarians? 

Dr. Katherine – Yeah, really good question. Well, I guess compassion focused therapy and my research that's drawn on is the model from Paul Gilbert. And I guess what that really teaches is there's three key motivation systems that essentially interact to regulate our emotions in day to day experience. One system being kind of the threat system that's very much designed to help us detect, respond to danger. It's all about survival. It involves a kind of fear, anxiety and it seeks safety basically. And it's kind of, I guess underpinned by the cortisol and adrenaline kind of stress hormones. We need that to survive. So that's kind of one element of our kind of motivation systems. I guess what we've also got is the drive system. And essentially this is the system that motivates us to kind of achieve, to strive. 

Dr. Katherine –It's those kind of endorphin hit we get from going on a long run, from handing in that assignment on time. It's a success. We feel when we've done, we've got praise or done something well at work and it can be quite competitive, it can be quite ambitious, driving to earn money, get up the career ladder or do X, Y and Z. But essentially it helps us manage our sense of threat by helping us achieve things. And it's underpinned by that kind of, yeah, endorphin and like reward hormones. And I guess then the third system we've got is the soothing system, which is essentially our ability to kind of self-regulate, kind of connect and soothe ourselves. And this system first develops if babies are comforted and looked after and soothed when they're distressed. 

Dr. Katherine –And it's kind of linked to those feelings of safeness and closeness to others and the idea of kind of compassion being cared for. And this is again linked in with our endorphin, feel good hormones. And essentially what we know from the compassion perspective is no system is good or bad. We need all three of them. And I guess they interact and balance each other out. But I guess when they're really out of balance, that's when psychological distress can kind of really kind of come into part of the picture. And I guess often in our work with that, I guess often patterns we sometimes saw were quite large threat systems. Obviously there's a very stressful job, it's high demand. 

Dr. Katherine – But then to cope with that, developing a really large drive system to strive, strive, which essentially, if your system is really small, that's quite a recipe for burnout and actually kind of running, you're not able to kind of replenish yourself if you like. So I guess that's a bit of theoretical background, Compassion focused therapy. And essentially compassion focused therapy is a particular therapy that's developed to target individuals who have really high levels of self-criticism and you tend to have poorer outcomes in more traditional kind of cognitive therapies. And so the aim of compassion focused therapy, or CFT is essentially to cultivate and deliberately trying to develop our self-compassion and our deliberately our soothe system to develop that self-reassurance to counteract that kind of internal self-criticism and all those kind of negative emotions that associate with it. 

Dr. Katherine – So that's a little bit of a whistle stop tour, kind of a summary intro into CFT. But I don't know if you want to add anything, Megan. I know obviously you've got having kind of engaged a little bit more with theory practically. How kind of you think it links to that? 

Dr. Megan – Yeah, I think Marie will definitely kind of echo what you've said about that really high drive system. So if you watch Katherine's videos, the threat system is red in color, the drive system is green, and the soothing system is blue. And I think if you could like cut open a veterinary professional, they would just be like green basically all the way through. And I think as you touched on before Marie, that high drive has often served us really well to get us to where we need to be. You know, I am definitely one of those kind of very typical people that wanted to be that since they were this tall and I knew exactly what I needed to do. To get there. And that was grades and study and the next qualification. The next qualification. 

Dr. Megan – And it can be really hard, I think, to get to a point where you kind of need to let that go a little bit because as you said earlier, there's that real reluctance to kind of let go of that thing that has bought you so much success. And I certainly found it hard to really recognize that actually that system that had served me so well up to this point in my life was no longer serving me and that I needed to do something different. And I also think it's really interesting what Katherine says about some traditional kinds of cognitive therapies. People are potentially struggling a bit more with that. 

Dr. Megan – And that's definitely something that I found personally because I found that it became another thing that I needed to be good at and that I needed to achieve and do well in and get the right answer. And I put a lot of shoulds on it, like I should be doing this. And so I think considering a slightly differently focused therapy for people particularly who find that drive very driving, I suppose is really beneficial as well. 

Dr. Marie – I cannot tell you how much this resonates. And yes to all of this. And I love that you broke it down into this threat. Drive and soothe, because you're right. I think the veterinarian's inclination is to always just push harder. You know, there's more stress. Okay, put your nose down. I'm feeling upset. Let's just work through it. You know, like there's all of these things. It feels very uncomfortable and counterintuitive to go inward and soothe and reflect and you know, all of the strategies that are introduced within this. And I am fascinated by the fact that you said that traditional therapies like cognitive behavioral therapy don't work with individuals with very high drive. Because I understand all the concepts of CBT. When it was first introduced to me, you know, 20 years ago when I started therapy, it was very mind opening to me. 

Dr. Marie –And I can't tell you, I just actually signed up for an app based CBT program because I've been having some additional challenges with my 5 year old and for me, staying regulated in the face of her dysregulation. And it's like, I know this stuff, I get it. And yet I still find myself in this. Like I need to figure this out and I need to push through it. And then beating myself up when things don't go well when absolutely that compassion directed inward has been so transformative for me. And that's what led me to Kristin Neff's work and that's why I'm, you know, so excited for us to have this conversation today. I'm delighted to see that you have put this theory into an online compassion focused imagery intervention that is a 14 day free compassion course for veterinarians. 

Dr. Marie –I have it on my to do list. I wasn't able to get through it before our conversation today, but I can't wait to take it. And I want to know what inspired you to develop this course and what can participants expect when they participate? 

Dr. Megan –Oh yeah, brilliant. 

Dr. Katherine –So I guess it's kind of going back to 2018 now when I was training to be a clinical psychologist as part of my doctorate thesis, kind of developing my thesis question and in particular I was quite interested in researching in an area of CFT and I guess at the time I was attached to the University of Surrey and the that school there, had kind of reached out to the psychology department sort of asking for any support or help, I guess, or guidance around kind of supporting their students with their mental health. And I'm not from a veterinary background myself obviously as a clinical psychologist today I didn't at that point know many vets at all. 

Dr. Katherine – So when I kind of looked into it was quite striking, quite quickly actually and I was unaware of this previously how high the suicide rates unfortunately is amongst the veterinarian profession. And actually the kind of also really high levels reported, kind of perfectionism, self-criticism or everything we've talked about so far and there was lots and lots of research reporting quite clearly high prevalence of distress amongst the profession. But I guess there wasn't anything practical, I guess going forwards to kind of address that there weren't any intervention studies or even any, yeah, any early studies like that. So I guess what my doctorate thesis, which finished in 2021 and we published it a couple of years later, was a feasibility trial. 

Dr. Katherine –So essentially it felt like CFT theoretically sounded like quite a good match for some of the presentations I guess within the veterinary profession around yes, high self-criticism, perfectionism as we talked about. So what we developed was this kind of online intervention which we trialled as part of the feasibility study which found it to be acceptable and feasible and indicated good effectiveness. We then kind of went on I guess to do further research in it. But our, I guess our finished product, if you like, is available for free on the Mind Matters website who kindly supported or funded our latest RCT in the intervention. So yeah, it's a 14 day series of videos, one video each day for two weeks. Each video is probably about 10 minutes. They're guided exercises by myself and my colleague Sarah Cawthorn and they're free to access for anyone. 

Dr. Katherine –So they are designed for veterinarians, but also there's other people, veterinary nurses, other people in the profession, linked professionals who may find them useful. And it's free and readily available on the links on the website. So you'll find lots of, I guess it. It builds on. So encouraged to do it one each day, I guess sequentially to build on the learning each day. But there's lots of initially sort of psychoeducation around emotions and understanding the brain and compassion before. We then start developing specific techniques around breathing, but also kind of imagery techniques in particular that kind of go on and build as the course builds on itself over the two weeks, basically. 

Dr. Megan -  And I should add as well that the videos are beautifully illustrated and designed by Katherine and that Katherine has a wonderfully soothing voice as well. So even if you're not that interested in the content, the videos are just a real pleasure to just watch and listen to because they are just really beautifully designed and illustrated and voiced as well. 

Dr. Katherine -  Oh, you're too kind, Megan. I'm by no means an official illustrator and I think. But yeah, there's some simple animations I've done along the way to kind of bring it to life. Really. 

Dr. Marie – I love it. I'm so inspired to take it. I can't wait. I think that this is a tremendous tool and I guess I have a question about the 14 day intervention. I know that's the way that it's designed for the purposes of your research. If an individual is like, I don't think I can do this every day for 14 days in a row. I mean, I guess we don't know statistically if they'll see benefit, but is that still something reasonable for someone to consider if they need to pace it out longer? 

Dr. Katherine –Yes, you go onto my Matters website. I guess all the links are listed and they're kind of free to access kind of YouTube links. So you just click on the link and watch it whenever you're ready. So if you do need to space it out, I won't be able to know. No one will tell you. Use your time how you want to. Yes, our evidence base is that it's worked sequentially day by day to kind of a more focused package. But yeah, it's a free resource that can be used kind of in line with what works for you. 

Dr. Megan –I love it. 

Dr. Marie –Well, I'm certainly an advocate for doing things every single day and hopefully we can all spare 10 minutes by, but I just wanted to ask. I will definitely link to the program in the show Notes so that everybody can access that. 

Dr. Marie – Hey everyone. As veterinarians, we all know the highs and lows that come with this profession. But how often do we pause to really reflect on what it means to live this life of service and care? My new book, A Compassionate Calling: What It Really Means to be a Veterinarian, digs deeper into those experiences, including my own chapter on the importance of self-compassion and self-care in sustaining our wellbeing. It's also a perfect read to share with loved ones who want to better understand the realities of veterinary life. Learn more at acompassionatecalling.com. 

Dr. Marie –You mentioned, you know, some of the concerns that we're experiencing among veterinarians and others in this field. You mentioned psychological distress. Certainly burnout is a big topic of interest these days. From your research and experience, how does the practice of self-compassion help veterinarians build resilience and manage stress? Because I think we've been programmed, as Megan said, not to respond that way. What have you seen based on the research in your theoretical understanding? 

Dr. Katherine –Yeah, so as I said, we did a feasibility trial first and then I guess we progressed and did a larger randomized control trial to really kind of establish more robustly our effects. And I guess what we found was the intervention significantly improved resilience and self-reassurance, self-compassion, and also reduced rumination and self-criticism over the intervention period. And that was kind of showed good evidence of being largely sustained at our follow up as well, compared to a control group. I guess the findings in that sense were unsurprising as we know vats with higher self-compassion actually illustrate higher resilience. And that's been something kind of reported in other previous studies as well. But I guess the question is kind of why isn't it? 

Dr. Katherine – And I guess what certainly from a compassion focused therapy point of view teaches is I guess self-compassion being kind of the antidote to shame and self-criticism. Because essentially when we're our worst inner critic, we blame and we shame ourselves for feeling our emotions. We tell us, if you're struggling, we're stupid, toughen up, this is our fault. And I guess by doing that, we avoid and we deny those difficulties that often are causing us more suffering. And that can kind of go around in quite a vicious cycle. And the more we feel ashamed, the. 

Dr. Megan – More we hide away. 

Dr. Katherine –And I guess that prevents us from learning that we're not alone in our struggle and we might not be the only person feeling this way in our field. And our self-criticism can get louder and louder the more isolated we become. So I guess the flip side of the point of view, a compassionate viewpoint and really trying to deliberately cultivate that more teaches us that life is difficult is a normal human experience to feel emotions and there's a whole range of them and some of them aren't very nice to feel. But I guess essentially it's about helping us work through our emotions so they subside rather than bottling up, pushing away, avoiding them so they then kind of explode back later. 

Dr. Katherine –And I guess it's really kind of being honest with ourselves to kind of own up to some of our responsibilities at times, things we're doing that aren't helping the situation to then be able to really work with those difficulties directly. And I guess that's something compassion focused therapy teaches quite a lot. It may not be your fault the way you're feeling and the things that have happened that led to this situation. But I guess it is your responsibility now to work out how we move forward and how we break these cycles. I don't know what your experience of kind of thinking about that question is, Megan. 

Dr. Megan –Yeah, I suppose my personal experience of the course was quite full on. So you guys launched the sort of trial for the feasibility study and it happened to coincide with the start of the COVID pandemic, which also happened to coincide with when I had my first baby. So which must be the same for you Marie, if you also have a five year old. So I completed the course at home in lockdown with a two week old child. So I guess I was actually already in a non clinical role by that point. I had already kind of experienced burnout and came out of clinical practice. So I sort of did this course, I guess slightly separate and outside of the veterinary profession, but I was still obviously really keen to do it. 

Dr. Megan – And actually I found as I went through parenthood and particularly new parenthood in a pandemic, I found that there were a lot of parallels between that and what I had struggled with in practice. You know, the uncertainty, the self-doubt, the constant questioning of every decision that I made, not knowing whether it was the right one or not knowing whether it was okay to hug a friend or you know, whether my child was crying again and what I had possibly done wrong. So I think that actually doing the course at that point was equally relevant and useful, if not more so than if I'd done it, you know, when I was back in clinical practice and experiencing all that self-criticism and uncertainty again. 

Dr. Megan – And I have certainly found that what I have learned from the course and from my kind of further research then into self-compassion has really helped me, has helped me to navigate parenthood and continue to navigate parenthood, but it's also helped me navigate a return to practice. So for the first time in close to eight years now, I'm back in practice two or three days a week and enjoying it, which I never thought I would say again. And I'm convinced that a lot of the reason that I'm able to cope with it so much better than I was back in 2016, 2017 is the self-compassion side of things because I'm able to quell that inner critic and to be compassionate towards myself in when I face difficult situations in practice. 

Dr. Marie –Yes.

Dr. Katherine –Wow. 

Dr. Marie – So much of this resonates. Megan. Yes. My daughter was born in June of 2020. So right there with you, living amidst the pandemic. I was a single mom at the time and I chose to have her on my own, but not realizing we were headed into a pandemic. And boy, did it make an already challenging situation that much more isolating. And you know, I think so many of us in this profession, and I heard you say it actually as you were speaking, Megan, you said, what did I do wrong? You know, with my child, that she's crying again. And I think we feel that way in practice. You know, the case doesn't go the way we expect it to. And it's like, what did I miss? What did I do wrong? 

Dr. Marie – I know for me as a mom, it's the first thing that goes through my head is I've had large number of challenges with my daughter is especially as I've gone back to traveling for work and it's, you know, her behavior shifts or she's dysregulated and I'm like, what did I do wrong? Or why am I not a better mom? Or why am I a bad mom? Or you know, what's wrong with me? And so that shame piece, as Katherine said, you know, that really does drive us into isolation. I don't want to admit to people that my daughter is having challenges and I feel like a bad parent. Makes us separate and we feel othered and then we don't fix anything. We don't reach out for help, we don't seek resources, we don't learn. We end up in that cycle of rumination. 

Dr. Marie – And so yeah, this practice really for me as well, has been transformative in that way to like you both described, you're not alone. You're not the only one feeling this way. You're not the only one having these challenges and these are normal feelings. We are going to experience difficult feelings as a parent, as a veterinary professional, and there is a way forward. I know that your study noted significant reductions in both that self-criticism and rumination, especially work related rumination. Why do you think that those particular changes are so important for veterinary wellbeing and career longevity? 

Dr. Megan –I think we can all as veterinary professionals recognize that self-criticism and that rumination. You know, we have sat in our car or sat at home after work and mulled over that case that hasn't gone right. And I think for me, what led to my burnout was that but times 100, like every day, you know, it's okay, I think, to kind of go home and think about that one case. There will always be the odd case that gets under your skin and that you query and question and. Well, for me personally, it's usually like a client that I know really well, you know, who I've built that relationship with and who I just really want to go that extra mile for them. 

Dr. Megan – But I think when that tips over into happening with all cases and that's what happened for me, that, you know, it wasn't just the odd case that I was hanging onto. It was every consult I sat there thinking, okay, have I missed something? Should I have done something differently? You know, and when that's happening over and over, you just can't carry that. It's too much. And I have been kind of, you know, banging on for years now and will continue to bang on until probably the day I die about the fact that it is skills of self-compassion, these human skills that are the key the sustainability of our profession. 

Dr. Megan – And it bugs the hell out of me that these things are still considered to be, you know, soft skills and kind of a bit fluffy and, you know, nice to have and not an essential thing. But for me they are essential. And they are arguably more essential than the clinical and technical knowledge that we need to do our jobs in order to prevent all our professions getting to that burnout phase. 

Dr. Marie –Yeah, I wonder if we can maybe share some, you know, practical exercises or techniques from the course. Obviously, I want everybody to take this course. I plan to take the course. What could people consider trying as a bit of a snippet into what they can expect to learn within the 14 day program? 

Dr. Megan – I think the biggest takeaway for me and the thing that I found most useful was first of all to notice and to recognize what I was saying to myself, that internal monologue, that voice that was within me and what that voice was saying. And I would like to consider myself to be compassionate towards others. I like to think that I am kind to my friends and to my family and to my clients. And so the biggest fifth for me was when I noticed that inner monologue being critical and being self-doubting was to question whether I would say that to a friend. And the answer is almost always no, absolutely not. It would never be that rude or that critical to a friend. Then turning that around, okay, what would I say to a friend? 

Dr. Megan – If I were my friend in this situation and I was talking to them, how would I speak to them? And that's the biggest, easiest kind of practical technique that I use regularly when I notice those moments of self-criticism. 

Dr. Katherine – I think the course is designed to be really practical. So the first two videos are more kind of educational and then after that the remaining 12 are kind of quite practical skills and different things will work for different people. So I think that's why it's quite nice to try all the sessions out to see what sticks. And with Megan that really stuck with her, I guess. A quite practical skill technique that's introduced early on in the course is the idea of soothing rhythm breathing. I think quite a lot of people might be familiar with breathing techniques, may find them more or less helpful, but I think if you understand the science behind what we're trying to do, it makes a lot more sense because essentially soothing rhythm breathing is the idea. 

Dr. Katherine –If we can control the rhythm of our breath, we can then have a knock on impact quite quickly on our physiology. Because I guess what we know is the rhythm of our breath really quite quickly links and impacts our heart variability. And essentially if we can improve our heart pattern, we essentially find our body is sending better quality fuel right to our brain, getting better oxygen pumped around our fats more effectively, our brain's going to work more efficiently. So actually by controlling the rhythm of our breath, we quite quickly have a knock on impact to then actually kind of ability to think more clearly, solve problems more effectively. There's a really nice TED talk, it's called being brilliant every single day. But it illustrates this really nice the science of soothing rhythm breathing. 

Dr. Katherine – And the key part, it's not the idea of oh, take a few deep breaths and you'll be fine. Because actually a few deep breaths not going to do much, but it's about the rhythm and a few minutes of rhythmic and finding your groove, a rhythmic breathing pattern that essentially can have that positive impact on our heart pattern or variability and a knock on impact into our kind of getting that fuel that we need to our brain to then be able to move on with our day and focus and tackle our problems more effectively is scientifically kind of shame to be really quite significant, practical place to start. So the course certainly talks you through that technique really clearly, but I always say that's quite a good starting point and I guess is really kind of grounded in the science and the evidence base. 

Dr. Marie – Yeah, I've written it down. I will link to that TEDx talk in the show notes. So thank you for mentioning that. I know the first time that I was exposed to self-compassion type of exercises and well, I guess just the concept of self-compassion really in the veterinary literature was in some of the research getting even almost to 10 years old now looking at self-compassion scores among veterinary students and finding that those students with higher self-compassion scores also concurrently had higher, tended to have higher resilience scores. You know, this seems to mirror a lot of what you're seeing as well.

Dr. Marie – And I'm wondering in light of that, how do you think veterinary education can integrate these skills more effectively so that, you know, like Megan and I, we don't get into this like early habitual patterns, self-flagellation, rumination and so on? 

Dr. Megan – Yeah, this is an area of huge passion for me. So when I came out of clinical practice in 2018, I went into veterinary education. I worked at a university for four and a half years and then continued to work with students regularly even when I left the university. And as I kind of touched on before, I think these non clinical skills are as important, if not more important than the clinical side of things. And certainly in the UK and I'm sure in the US as well, veterinary schools are starting to put this stuff into their curriculums, which is fantastic. But my belief is that we need to go a step further than that. 

Dr. Megan – I think if it's there as an add in and a bolt on and something that's squeezed into the curriculum around all the other stuff, then it can get quite lost within all the other clinical stuff. And I think it becomes less important to the students because for the most part it's the clinical stuff that they get examined on and they are still exam focused, grade focused. And so when they have stuff in the curriculum that's not necessarily something they feel like they have to engage with, then it discourages them from engaging because they have enough on their plate. Right. They have a lot of stuff to learn. So if there's stuff that they think they can kind of take a bit of a backseat on. They will do, understandably. And I think the way around that is to really integrate this together. 

Dr. Megan – So every time we're having a conversation in veterinary education about something clinical, we bring the non clinical factors into that as well. So when we're talking about oncology and we're having a conversation about making difficult diagnoses and talking about euthanasia as a treatment option, we're not only talking about the diagnostic tests that we're going to run and the treatment options that are available to us, but we're asking for a moment of self-reflection there and saying, how is this going to make you feel as a veterinarian? What's this going to do to you internally to be the one delivering this news to these owners, to be recommending euthanasia as a treatment option when all else has failed? What's that going to do to you when you go home that night? And how are you going to be able to cope with that? 

Dr. Megan –Because I think all the while the two are very separate. We will still end up with this viewpoint that the non clinical stuff is less important and less vital. I think we have to integrate them in order for everyone to really understand the importance. 

Dr. Marie – Yeah. And the research definitely shows that. I know when I investigated this for my book that was recently published. When you compare elective offerings to embedded wellbeing offerings, there's significantly greater uptake and impact of those offerings that are a part of the curriculum, like you said, and even better to make it equal. It's not just that it's part of the curriculum and not optional, it's that this is actually a part of your clinical curriculum. Like this is a part of the skills that you need to learn alongside your other technical skills. I think it needs a rebranding. This whole notion of soft skills, emotional intelligence, whatever else, we need to come up with something better to make it more impactful. 

Dr. Marie – I think, you know, I speak for many of us, Megan, I'm sure you can attest to this, that self-compassion for many of us is often misunderstood. These types of, you know, compassion focused therapies can feel like self-indulgence or weakness or being soft on ourselves. What would you say to veterinarians and others who are still hesitant or skeptical about engaging in these types of modalities? 

Dr. Katherine – Yeah, I think. 

Dr. Megan – And there's lots and lots of literature. 

Dr. Katherine – Around the fears and blocks around self-compassion. So if you're wondering if you're not alone, I guess I'd probably start off by kind of just gently being a bit curious about what someone means when they're talking about self-compassion and I guess are they kind of really genuinely understanding in its fullest form? Because I guess, yeah, there is that misconception, compassion being kind of thought of as easy, soft, a bit of a cop out. But I guess if you really look and study Paul Gilbert's definition of what self-compassion is, he defines it in several parts. The first part is a real genuine sensitivity to your suffering or somebody else's suffering, which takes quite a lot of courage, quite a lot of strength to genuinely face up. It's the exact opposite of putting your head in the sand. 

Dr. Katherine – It really involves kind of looking someone in distress in the eye or looking yourself in the eye and actually kind of really seeing that. And I guess the second part is then a commitment to alleviate that suffering and actually a wisdom of how to prevent it from circling back round and reoccurring which takes a lot of understanding, as I said, wisdom, but also kind of a dedication to really following this through. So I guess for example, say someone's struggling at work, you know, you might think go home, have a bubble bath, kind of suck it off, like just be kind to yourself that self-compassion have loads of chocolate. But I guess actually it'd be really thinking about what is that situation, if it's safe. For example, maybe bullying in your workplace or a manager that's treating you unfairly. 

Dr. Katherine –Actually the most self-compassionate action isn't to crawl in sick to work probably in this scenario it actually probably involves drawing quite a lot of nerve and quite a lot of courage to actually speak up in the workplace. Maybe speak to your manager directly about the bullying or speak to someone senior in the service about the difficulties you're having in your management. 

Dr. Katherine – It'd actually be to look the problem in the eye I guess and actually start taking action. Action that moves us forwards to alleviate this suffering cycle we're in. I'm not saying bubble bath and chocolate can't have a place but that's taking self-compassion at every level. And actually if you really think about that definition and the scenarios we face ourselves in, they require a lot more strength and courage than, yeah, merely going home and having a bubble bath. That actually self-compassion is a real commitment and a long term action that requires quite a lot of thinking and knowledge and expertise and how we move forward in that. So I think understanding what self-compassion is before we dismiss it is probably the first place to start and I guess we all have pretty tricky brains and pretty complicated emotions. 

Dr. Katherine -  And so I guess it's to begin, starting to challenge some of these mixed misconceptions is a good place, I would say, to start. I don't know what you think about that.

Dr. Megan – Yeah, I think it can be really helpful to make that reframe. And you know, we talk a lot about language being so important, but I think self-compassion and admitting that we need help can feel like a weakness. And I think reframing it as a strength and actually taking it, taking a huge amount of courage is really important to make that reframe and to change that language. 

Dr. Katherine – And it's actually wise to seek help. Right. We are stronger together than we are apart. And when we're isolated, that's at us at our kind of weakest, isn't it? So, yeah, I think that reframe being really important to keep coming back to. 

Dr. Marie – Yeah, it's interesting. This reminds me of Kristin Nest's latest book called Fierce Self-Compassion where she takes it a step further and really enunciates what you're sharing, which is the action side that follows that self-compassion. Right. So I think to myself, the example of I make a mistake at work. Well, I'll share a real example. I can think of a time at work when I miscalculated infusion of an opioid. It was an opioid I didn't use very often. We were out of other opioids in the hospital. I didn't have a nurse with me that day. So I calculated it myself. It was the end of the day. 

Dr. Marie – It was late. There were all these reasons I could have made this mistake and I did. And I was so upset with myself the next day when I came in and I found this semi comatose dog on the floor who thankfully reversed, you know, right away with naloxone. But you know, I was like doing the typical self-criticism, you know. Why did you do that? What were you thinking? Why didn't you double check this? Like, you know, this is so embarrassing, like all of these things, you know, as I was a relief doctor at this hospital and taking a step back and just recognizing anybody could have made that mistake under those circumstances. I'm human, so I will make mistakes. 

Dr. Marie –And then once I stepped out of that place of shame and embarrassment and into that place of wow, that sucks anybody that could have happened to anybody. And there was a reason it happened. One of those reasons was that we were short staffed and I didn't have a designated nurse with me in the icu. And so the action that prompted me to take was to go and talk to the manager and say hey look, if you're going to bring me in to cover the shifts of these other criticalists that are on vacation, I need a nurse with me too. I can't work these shifts alone. So like you said, there can be so much good that comes out of this. Whether it's asking for help, setting a boundary, connecting with somebody. I love that, I love that. 

Dr. Katherine – That's a really good example of compassionate action and that's not easy and that's not wishy washy. That's the real opposite of that. Yeah, you had to do it. 

Dr. Megan – Well, I'm a great example of systems thinking and human factors as well, which is my other pet topic which we definitely can't get into because we're going to run out of time. But I know. Example. 

Dr. Marie – Thank you, Megan. Yeah, we could talk all day, couldn't we? I'm going to link to the 14 day course in the show notes. It's free for anybody. I wanted to ask, are there any prerequisites or commitments needed to participate? I know that previously you were collecting survey information before and after. What do people need to know before they can access the course? 

Dr. Katherine – Yeah, there is a kind of just a pre survey and a post survey that if you're willing and able to complete it. I guess it's sort of an ongoing not research project but it's touching base on who's all anonymous but acknowledging I guess how many people are using the course and I guess monitoring the impact it's having. But there's no way of kind of making that mandatory and the links are available to kind of watch the resource without that for whatever reason that's kind of not able to do that. But yeah, it's all there, the links and hopefully quite self-explanatory. 

Dr. Marie – I love that. Well, thank you so much to you both. I'm going to ask you each one last question before we sign off and that is what does the phrase reviving veterinary medicine mean to each of you?

Dr. Megan – I think for me as a profession we are at a huge turning point at the moment and there is a lot of change that needs to happen. But I think that is exciting and I think in bringing new ideas and bringing those changes in we can really revive the profession and bring it back to life as long as we are open to those, to those changes and to those new ideas and to doing things a little bit differently to the way that we have comfortably always done them. 

Dr. Katherine – I think just to add to that, from my experience, I think collaboration has been really key as part of this kind of moving profession forward. So obviously my research project and research has been a collab between obviously the veterinarians like Megan, who's been a big part of the research about, and myself coming from a psychology background, it's not expecting veterinarians to hold all the answers actually. And drawing from research in other fields, drawing obviously kind of in terms of all the mental health and wellbeing literature within psychology, the research, the resources, the interventions that we can adapt and draw on for veterinarians specifically, that is reviving in and of itself. 

Dr. Marie – I love those responses. 

Dr. Marie – Thank you both so much for your time and your expertise and your sharing today. It's just been such a pleasure to talk with you about this important topic. So thank you so much. Thank you for having us. 

Dr. Megan – Yeah, thanks Marie. It's been great. 

Dr. Katherine – Thank you.

Dr. Marie – So that's it for this episode of Reviving Vet Med. I hope this conversation with Megan and Katherine showed just how powerful compassion, especially directed inward, can be for sustaining. A long, meaningful and healthy career in vet medicine. The free 14 day compassion course offers accessible and practical ways to reduce self-criticism, manage stress and build resilience in a profession that demands so much of us. If you found this episode helpful, please share it with colleagues who might need a reminder to care for themselves as much as they care about others. Don't forget to subscribe so you never miss an episode and please check the show notes for links to access the free compassion course and the other resources mentioned by Megan and Katherine. You can also follow us on social media @RevivingVetMed for more wellbeing tips and strategies. And if you have any questions about this episode topic, ideas for future episodes or sponsorship inquiries, please reach out anytime at podcast@revivingvetmed.com.  A huge thank you to both Dr. Megan Davis and Dr. Katherine Wakelin for joining us today. To the Podcast Prime Team for producing this episode and to you for listening.  Until next time, take care of yourself. Bye for now.